1.1 	A bill for an act
1.2 	relating to state government; establishing the health and human services budget; 
1.3 	modifying provisions governing children and family services, chemical and mental 
1.4 	health services, community supports, direct care and treatment, operations, health 
1.5 	care, continuing care, managed care, housing, health licensing boards, and 
1.6 	Department of Health programs; requiring reports; modifying fees; making technical 
1.7 	changes; appropriating money;amending Minnesota Statutes 2016, sections 13.69, 
1.8 	subdivision 1; 103I.005, subdivisions 2, 2a, 12, 20a, 21, by adding subdivisions; 
1.9 	103I.101, subdivisions 2, 5, 6; 103I.105; 103I.111, subdivisions 6, 8; 103I.205, 
1.10 	subdivisions 1, 2, 3, 4, 5, 6; 103I.208, subdivisions 1, 2; 103I.235, by adding a 
1.11 	subdivision; 103I.301, subdivisions 1, 2; 103I.315, subdivision 1; 103I.501; 
1.12 	103I.505, subdivisions 1, 2; 103I.515; 103I.525, subdivisions 1, 2, 5, 6, 8; 103I.531, 
1.13 	subdivisions 2, 5; 103I.535, subdivisions 2, 6; 103I.541, subdivisions 1, 2, 2a, 2b, 
1.14 	2c, 2e, 3, 4, 5; 103I.545; 103I.601, subdivisions 2, 4; 103I.711, subdivision 1; 
1.15 	103I.715, subdivision 2; 119B.011, subdivisions 6, 19, 20, 20a, by adding 
1.16 	subdivisions; 119B.02, subdivisions 1, 5; 119B.025, subdivision 1, by adding 
1.17 	subdivisions; 119B.03, subdivisions 3, 9; 119B.05, subdivision 1; 119B.09, 
1.18 	subdivisions 1, 4, 9a; 119B.10, subdivision 1, by adding a subdivision; 119B.11, 
1.19 	subdivision 2a; 119B.12, subdivision 2; 119B.125, subdivisions 1b, 4, 6, by adding 
1.20 	subdivisions; 119B.13, subdivisions 1, 6; 119B.16, subdivisions 1, 1a, 1b, by 
1.21 	adding subdivisions; 144.0724, subdivision 6; 144.122; 144.218, subdivision 5; 
1.22 	144.226, subdivision 1; 144.3831, subdivision 1; 144A.071, subdivision 4d; 
1.23 	144A.472, subdivision 7; 144D.03, by adding a subdivision; 144E.35, subdivision 
1.24 	1; 144G.02, subdivision 2; 146B.02, subdivisions 2, 3, 5, 8, by adding subdivisions; 
1.25 	146B.03, subdivisions 6, 7; 146B.07, subdivisions 2, 4; 146B.10, subdivisions 1, 
1.26 	2, by adding a subdivision; 147.01, subdivision 7; 147.02, subdivision 1; 147.03, 
1.27 	subdivision 1; 147B.08, by adding a subdivision; 147C.40, by adding a subdivision; 
1.28 	148.514, subdivision 1; 148.519, subdivisions 1, 2; 148.5194, subdivisions 2, 3, 
1.29 	4, 7, by adding a subdivision; 148.5195, subdivision 2; 148.59; 148.6405; 148.6420, 
1.30 	subdivisions 1, 5; 148.6445, subdivisions 1, 2, 3, by adding a subdivision; 148.997, 
1.31 	subdivision 1; 148E.180; 153A.14, subdivisions 1, 2; 153A.17; 157.16, subdivisions 
1.32 	1, 3, 3a; 245.4661, subdivision 9; 245.4889, subdivision 1; 245.814, by adding a 
1.33 	subdivision; 245A.03, subdivisions 2, 7; 245A.04, subdivisions 1, 4; 245A.07, 
1.34 	subdivision 3; 245A.09, subdivision 7; 245A.10, subdivisions 2, 4; 245A.14, by 
1.35 	adding a subdivision; 245A.151; 245A.16, subdivision 1, by adding a subdivision; 
1.36 	245A.18, subdivision 2; 245A.191; 245A.40, subdivisions 1, 2, 3, 4, 7, by adding 
1.37 	a subdivision; 245A.50, subdivisions 2, 7, 9; 245C.02, by adding a subdivision; 
1.38 	245C.03, subdivision 1, by adding a subdivision; 245C.04, subdivisions 1, 8; 
1.39 	245C.05, subdivisions 2b, 4, 5, 7; 245C.08, subdivisions 1, 2, 4; 245C.09, by 
2.1 	adding a subdivision; 245C.10, subdivision 9, by adding subdivisions; 245C.11, 
2.2 	subdivision 3; 245C.15; 245C.16, subdivision 1; 245C.17, subdivision 6; 245C.21, 
2.3 	subdivision 1; 245C.22, subdivisions 5, 7; 245C.23; 245C.24, subdivision 3; 
2.4 	245C.25; 245C.30, subdivision 2; 245D.03, subdivision 1; 245E.01, by adding a 
2.5 	subdivision; 245E.02, subdivisions 1, 3, 4; 245E.03, subdivisions 2, 4; 245E.04; 
2.6 	245E.05, subdivision 1; 245E.06, subdivisions 1, 2, 3; 245E.07, subdivision 1; 
2.7 	246.014; 246B.05; 246B.10; 252.41, subdivision 3; 253B.19, subdivision 1, by 
2.8 	adding a subdivision; 254A.01; 254A.02, subdivisions 2, 3, 5, 6, 8, 10, by adding 
2.9 	subdivisions; 254A.03; 254A.035, subdivision 1; 254A.04; 254A.08; 254A.09; 
2.10 	254A.19, subdivision 3; 254B.01, subdivision 3, by adding a subdivision; 254B.03, 
2.11 	subdivision 2; 254B.04, subdivisions 1, 2b; 254B.05, subdivisions 1, 1a, 5; 
2.12 	254B.051; 254B.07; 254B.08; 254B.09; 254B.12, subdivision 2; 254B.13, 
2.13 	subdivision 2a; 256.01, by adding a subdivision; 256.045, subdivision 3a; 256.962, 
2.14 	subdivision 5, by adding a subdivision; 256.9686, subdivision 8; 256.969, 
2.15 	subdivisions 1, 2b, 3a, 3c, 4b, 8, 8c, 9, 12; 256.975, subdivision 7, by adding a 
2.16 	subdivision; 256.98, subdivision 8; 256B.04, subdivisions 21, 22; 256B.055, 
2.17 	subdivisions 2, 7, by adding a subdivision; 256B.056, subdivisions 1b, 3b, 3c, 3d, 
2.18 	by adding subdivisions; 256B.057, subdivision 9; 256B.059, subdivision 6; 
2.19 	256B.0625, subdivisions 3a, 6a, 7, 18h, 30, 45a, 57, by adding a subdivision; 
2.20 	256B.0651, subdivision 17; 256B.0652, subdivision 4; 256B.0653; 256B.0659, 
2.21 	subdivisions 11, 21; 256B.0755, subdivisions 1, 2, 3, 4, 7; 256B.0915, subdivision 
2.22 	1; 256B.092, subdivision 4; 256B.0943, subdivision 9; 256B.0945, subdivisions 
2.23 	2, 4; 256B.15, subdivisions 1, 1a, 2; 256B.199; 256B.431, subdivisions 10, 16, 
2.24 	30; 256B.434, subdivisions 4, 4f; 256B.49, subdivision 11; 256B.4912, by adding 
2.25 	a subdivision; 256B.4913, subdivision 4a, by adding a subdivision; 256B.4914, 
2.26 	subdivisions 2, 3, 5, 6, 8, 10; 256B.50, subdivision 1b; 256B.75; 256B.76, 
2.27 	subdivisions 1, 2, 4, by adding a subdivision; 256B.761; 256B.766; 256B.85, 
2.28 	subdivision 16; 256C.21; 256C.23, subdivisions 1, 2, by adding subdivisions; 
2.29 	256C.233, subdivisions 1, 2, 4; 256C.24; 256C.25, subdivision 1; 256C.261; 
2.30 	256C.30; 256D.44, subdivisions 4, 5; 256I.03, subdivision 8; 256I.04, subdivisions 
2.31 	1, 2d, 2g, 3; 256I.05, subdivisions 1a, 1c, 1e, 1j, 1m, 8; 256I.06, subdivisions 2, 
2.32 	8; 256L.03, subdivisions 1, 1a, 5; 256L.04, by adding a subdivision; 256L.05, by 
2.33 	adding a subdivision; 256L.11, subdivision 7; 256L.15, subdivision 2; 256N.26, 
2.34 	subdivision 5; 256N.27, subdivisions 2, 4; 256P.05, subdivision 1; 256P.07, 
2.35 	subdivisions 3, 6; 256R.02, subdivisions 4, 18; 256R.10, by adding a subdivision; 
2.36 	256R.40, subdivision 5; 256R.41; 256R.47; 256R.49, subdivision 1; 257.73, 
2.37 	subdivision 1, by adding a subdivision; 327.15, subdivision 3; 364.09; 518.68, 
2.38 	subdivision 2; 518A.40, subdivision 4, by adding a subdivision; 626.556, 
2.39 	subdivisions 2, 3, 3c, 4, 10b, 10d, 10e, 10f, 10i; 626.557, subdivisions 4, 9, 12b, 
2.40 	18; 626.5572, subdivisions 2, 4; 626.559, subdivision 1; Laws 2012, chapter 247, 
2.41 	article 6, section 2, subdivision 2; proposing coding for new law in Minnesota 
2.42 	Statutes, chapters 103I; 119B; 144; 147A; 245A; 256B; 256I; 256L; 256R; 
2.43 	proposing coding for new law as Minnesota Statutes, chapter 245G; repealing 
2.44 	Minnesota Statutes 2016, sections 103I.005, subdivisions 8, 14, 15; 103I.451; 
2.45 	119B.07; 119B.125, subdivision 5; 119B.16, subdivision 2; 144.0571; 147A.21; 
2.46 	147B.08, subdivisions 1, 2, 3; 147C.40, subdivisions 1, 2, 3, 4; 245A.1915; 
2.47 	245A.192; 245C.11, subdivision 4; 245C.16, subdivision 3; 245C.17, subdivision 
2.48 	4; 245E.03, subdivision 3; 245E.06, subdivisions 4, 5; 246B.06; 252.41, subdivision 
2.49 	8; 252.451; 254A.02, subdivision 4; 256.9692; 256B.0625, subdivision 25a; 
2.50 	256B.0659, subdivision 22; 256B.4914, subdivision 16; 256B.64; 256B.69, 
2.51 	subdivisions 1, 2, 3, 3a, 3b, 4, 4b, 5, 5a, 5b, 5c, 5d, 5f, 5g, 5h, 5i, 5j, 5k, 6, 6a, 6b, 
2.52 	6d, 7, 8, 9, 9a, 9c, 9d, 9e, 10, 11, 16, 17, 18, 19, 20, 21, 22, 23, 25, 26, 27, 28, 29, 
2.53 	30, 31, 32a, 33, 34, 35; 256C.23, subdivision 3; 256C.25, subdivision 2; Minnesota 
2.54 	Rules, parts 3400.0185, subpart 5; 5600.2500; 9503.0145, subpart 6; 9530.6405, 
2.55 	subparts 1, 1a, 2, 3, 4, 5, 6, 7, 7a, 8, 9, 10, 11, 12, 13, 14, 14a, 15, 15a, 16, 17, 17a, 
2.56 	17b, 17c, 18, 20, 21; 9530.6410; 9530.6415; 9530.6420; 9530.6422; 9530.6425; 
2.57 	9530.6430; 9530.6435; 9530.6440; 9530.6445; 9530.6450; 9530.6455; 9530.6460; 
3.1 	9530.6465; 9530.6470; 9530.6475; 9530.6480; 9530.6485; 9530.6490; 9530.6495; 
3.2 	9530.6500; 9530.6505.
3.3 	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

3.4 	ARTICLE 1
3.5 	COMMUNITY SUPPORTS

3.6 	Section 1. Minnesota Statutes 2016, section 245A.03, subdivision 7, is amended to read:
3.7 		Subd. 7.Licensing moratorium. (a) The commissioner shall not issue an initial license 
3.8 	for child foster care licensed under Minnesota Rules, parts 2960.3000 to 2960.3340, or adult 
3.9 	foster care licensed under Minnesota Rules, parts 9555.5105 to 9555.6265, under this chapter 
3.10 	for a physical location that will not be the primary residence of the license holder for the 
3.11 	entire period of licensure. If a license is issued during this moratorium, and the license 
3.12 	holder changes the license holder's primary residence away from the physical location of 
3.13 	the foster care license, the commissioner shall revoke the license according to section 
3.14 	245A.07. The commissioner shall not issue an initial license for a community residential 
3.15 	setting licensed under chapter 245D. Exceptions to the moratorium include:
3.16 	(1) foster care settings that are required to be registered under chapter 144D;
3.17 	(2) foster care licenses replacing foster care licenses in existence on May 15, 2009, or 
3.18 	community residential setting licenses replacing adult foster care licenses in existence on 
3.19 	December 31, 2013, and determined to be needed by the commissioner under paragraph 
3.20 	(b);
3.21 	(3) new foster care licenses or community residential setting licenses determined to be 
3.22 	needed by the commissioner under paragraph (b) for the closure of a nursing facility, ICF/DD, 
3.23 	or regional treatment center; restructuring of state-operated services that limits the capacity 
3.24 	of state-operated facilities; or allowing movement to the community for people who no 
3.25 	longer require the level of care provided in state-operated facilities as provided under section 
3.26 	256B.092, subdivision 13, or 256B.49, subdivision 24;
3.27 	(4) new foster care licenses or community residential setting licenses determined to be 
3.28 	needed by the commissioner under paragraph (b) for persons requiring hospital level care; 
3.29 	or
3.30 	(5) new foster care licenses or community residential setting licenses determined to be 
3.31 	needed by the commissioner for the transition of people from personal care assistance to 
3.32 	the home and community-based services.;
4.1 	(6) new foster care licenses or community residential setting licenses determined to be 
4.2 	needed by the commissioner for the transition of people from the residential care waiver 
4.3 	service to foster care services. This exception applies only when:
4.4 	(i) the person's case manager provided the person with information about the choice of 
4.5 	service, service provider, and location of service to help the person make an informed choice; 
4.6 	and
4.7 	(ii) the person's foster care services are less than or equal to the cost of the person's 
4.8 	services delivered in the residential care waiver service setting as determined by the lead 
4.9 	agency; or
4.10 	(7) new foster care licenses or community residential setting licenses determined to be 
4.11 	needed by the commissioner for people receiving services under chapter 245D while residing 
4.12 	in an unlicensed setting before May 1, 2017, and for which a license is required, as 
4.13 	determined by the commissioner. The exception is available until June 30, 2018. This 
4.14 	exception is available when:
4.15 	(i) the person's case manager provided the person with information about the choice of 
4.16 	service, service provider, and location of service, including in the person's home, to help 
4.17 	the person make an informed choice; and
4.18 	(ii) the person's services provided in the licensed foster care or community residential 
4.19 	setting are less than or equal to the cost of the person's services delivered in the unlicensed 
4.20 	setting as determined by the lead agency.
4.21 	(b) The commissioner shall determine the need for newly licensed foster care homes or 
4.22 	community residential settings as defined under this subdivision. As part of the determination, 
4.23 	the commissioner shall consider the availability of foster care capacity in the area in which 
4.24 	the licensee seeks to operate, and the recommendation of the local county board. The 
4.25 	determination by the commissioner must be final. A determination of need is not required 
4.26 	for a change in ownership at the same address.
4.27 	(c) When an adult resident served by the program moves out of a foster home that is not 
4.28 	the primary residence of the license holder according to section 256B.49, subdivision 15, 
4.29 	paragraph (f), or the adult community residential setting, the county shall immediately 
4.30 	inform the Department of Human Services Licensing Division. The department shall decrease 
4.31 	the statewide licensed capacity for adult foster care settings where the physical location is 
4.32 	not the primary residence of the license holder, or for adult community residential settings, 
4.33 	if the voluntary changes described in paragraph (e) are not sufficient to meet the savings 
4.34 	required by reductions in licensed bed capacity under Laws 2011, First Special Session 
5.1 	chapter 9, article 7, sections 1 and 40, paragraph (f), and maintain statewide long-term care 
5.2 	residential services capacity within budgetary limits. Implementation of the statewide 
5.3 	licensed capacity reduction shall begin on July 1, 2013. The commissioner shall delicense 
5.4 	up to 128 beds by June 30, 2014, using the needs determination process. Prior to any 
5.5 	involuntary reduction of licensed capacity, the commissioner shall consult with lead agencies 
5.6 	and license holders to determine which adult foster care settings, where the physical location 
5.7 	is not the primary residence of the license holder, or community residential settings, are 
5.8 	licensed for up to five beds, but have operated at less than full capacity for 12 or more 
5.9 	months as of March 1, 2014. The settings that meet these criteria must be the first to be 
5.10 	considered for an involuntary decrease in statewide licensed capacity, up to a maximum of 
5.11 	35 beds. If more than 35 beds are identified that meet these criteria, the commissioner shall 
5.12 	prioritize the selection of those beds to be closed based on the length of time the beds have 
5.13 	been vacant. The longer a bed has been vacant, the higher priority it must be given for 
5.14 	closure. Under this paragraph, the commissioner has the authority to reduce unused licensed 
5.15 	capacity of a current foster care program, or the community residential settings, to accomplish 
5.16 	the consolidation or closure of settings. Under this paragraph, the commissioner has the 
5.17 	authority to manage statewide capacity, including adjusting the capacity available to each 
5.18 	county and adjusting statewide available capacity, to meet the statewide needs identified 
5.19 	through the process in paragraph (e). A decreased licensed capacity according to this 
5.20 	paragraph is not subject to appeal under this chapter.
5.21 	(d) Residential settings that would otherwise be subject to the decreased license capacity 
5.22 	established in paragraph (c) shall be exempt if the license holder's beds are occupied by 
5.23 	residents whose primary diagnosis is mental illness and the license holder is certified under 
5.24 	the requirements in subdivision 6a or section 245D.33.
5.25 	(e) A resource need determination process, managed at the state level, using the available 
5.26 	reports required by section 144A.351, and other data and information shall be used to 
5.27 	determine where the reduced capacity required under paragraph (c) will be implemented. 
5.28 	The commissioner shall consult with the stakeholders described in section 144A.351, and 
5.29 	employ a variety of methods to improve the state's capacity to meet long-term care service 
5.30 	needs within budgetary limits, including seeking proposals from service providers or lead 
5.31 	agencies to change service type, capacity, or location to improve services, increase the 
5.32 	independence of residents, and better meet needs identified by the long-term care services 
5.33 	reports and statewide data and information. By February 1, 2013, and August 1, 2014, and 
5.34 	each following year, the commissioner shall provide information and data on the overall 
5.35 	capacity of licensed long-term care services, actions taken under this subdivision to manage 
6.1 	statewide long-term care services and supports resources, and any recommendations for 
6.2 	change to the legislative committees with jurisdiction over health and human services budget.
6.3 	(f) At the time of application and reapplication for licensure, the applicant and the license 
6.4 	holder that are subject to the moratorium or an exclusion established in paragraph (a) are 
6.5 	required to inform the commissioner whether the physical location where the foster care 
6.6 	will be provided is or will be the primary residence of the license holder for the entire period 
6.7 	of licensure. If the primary residence of the applicant or license holder changes, the applicant 
6.8 	or license holder must notify the commissioner immediately. The commissioner shall print 
6.9 	on the foster care license certificate whether or not the physical location is the primary 
6.10 	residence of the license holder.
6.11 	(g) License holders of foster care homes identified under paragraph (f) that are not the 
6.12 	primary residence of the license holder and that also provide services in the foster care home 
6.13 	that are covered by a federally approved home and community-based services waiver, as 
6.14 	authorized under section 256B.0915, 256B.092, or 256B.49, must inform the human services 
6.15 	licensing division that the license holder provides or intends to provide these waiver-funded 
6.16 	services.

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

6.18 	Sec. 2. Minnesota Statutes 2016, section 245D.03, subdivision 1, is amended to read:
6.19 		Subdivision 1.Applicability.  (a) The commissioner shall regulate the provision of home 
6.20 	and community-based services to persons with disabilities and persons age 65 and older 
6.21 	pursuant to this chapter. The licensing standards in this chapter govern the provision of 
6.22 	basic support services and intensive support services.
6.23 	(b) Basic support services provide the level of assistance, supervision, and care that is 
6.24 	necessary to ensure the health and welfare of the person and do not include services that 
6.25 	are specifically directed toward the training, treatment, habilitation, or rehabilitation of the 
6.26 	person. Basic support services include:
6.27 	(1) in-home and out-of-home respite care services as defined in section 245A.02, 
6.28 	subdivision 15, and under the brain injury, community alternative care, community access 
6.29 	for disability inclusion, developmental disability, and elderly waiver plans, excluding 
6.30 	out-of-home respite care provided to children in a family child foster care home licensed 
6.31 	under Minnesota Rules, parts 2960.3000 to 2960.3100, when the child foster care license 
6.32 	holder complies with the requirements under section 245D.06, subdivisions 5, 6, 7, and 8, 
6.33 	or successor provisions; and section 245D.061 or successor provisions, which must be 
7.1 	stipulated in the statement of intended use required under Minnesota Rules, part 2960.3000, 
7.2 	subpart 4;
7.3 	(2) adult companion services as defined under the brain injury, community access for 
7.4 	disability inclusion, and elderly waiver plans, excluding adult companion services provided 
7.5 	under the Corporation for National and Community Services Senior Companion Program 
7.6 	established under the Domestic Volunteer Service Act of 1973, Public Law 98-288;
7.7 	(3) personal support as defined under the developmental disability waiver plan;
7.8 	(4) 24-hour emergency assistance, personal emergency response as defined under the 
7.9 	community access for disability inclusion and developmental disability waiver plans;
7.10 	(5) night supervision services as defined under the brain injury waiver plan; and
7.11 	(6) homemaker services as defined under the community access for disability inclusion, 
7.12 	brain injury, community alternative care, developmental disability, and elderly waiver plans, 
7.13 	excluding providers licensed by the Department of Health under chapter 144A and those 
7.14 	providers providing cleaning services only.
7.15 	(c) Intensive support services provide assistance, supervision, and care that is necessary 
7.16 	to ensure the health and welfare of the person and services specifically directed toward the 
7.17 	training, habilitation, or rehabilitation of the person. Intensive support services include:
7.18 	(1) intervention services, including:
7.19 	(i) behavioral support services as defined under the brain injury and community access 
7.20 	for disability inclusion waiver plans;
7.21 	(ii) in-home or out-of-home crisis respite services as defined under the developmental 
7.22 	disability waiver plan; and
7.23 	(iii) specialist services as defined under the current developmental disability waiver 
7.24 	plan;
7.25 	(2) in-home support services, including:
7.26 	(i) in-home family support and supported living services as defined under the 
7.27 	developmental disability waiver plan;
7.28 	(ii) independent living services training as defined under the brain injury and community 
7.29 	access for disability inclusion waiver plans; and
7.30 	(iii) semi-independent living services;
7.31 	(3) residential supports and services, including:
8.1 	(i) supported living services as defined under the developmental disability waiver plan 
8.2 	provided in a family or corporate child foster care residence, a family adult foster care 
8.3 	residence, a community residential setting, or a supervised living facility;
8.4 	(ii) foster care services as defined in the brain injury, community alternative care, and 
8.5 	community access for disability inclusion waiver plans provided in a family or corporate 
8.6 	child foster care residence, a family adult foster care residence, or a community residential 
8.7 	setting; and
8.8 	(iii) residential services provided to more than four persons with developmental 
8.9 	disabilities in a supervised living facility, including ICFs/DD;
8.10 	(4) day services, including:
8.11 	(i) structured day services as defined under the brain injury waiver plan;
8.12 	(ii) day training and habilitation services under sections 252.41 to 252.46, and as defined 
8.13 	under the developmental disability waiver plan; and
8.14 	(iii) prevocational services as defined under the brain injury and community access for 
8.15 	disability inclusion waiver plans; and
8.16 	(5) supported employment as defined under the brain injury, developmental disability, 
8.17 	and community access for disability inclusion waiver plans employment exploration services 
8.18 	as defined under the brain injury, community alternative care, community access for disability 
8.19 	inclusion, and developmental disability waiver plans;
8.20 	(6) employment development services as defined under the brain injury, community 
8.21 	alternative care, community access for disability inclusion, and developmental disability 
8.22 	waiver plans; and
8.23 	(7) employment support services as defined under the brain injury, community alternative 
8.24 	care, community access for disability inclusion, and developmental disability waiver plans.

8.25 	EFFECTIVE DATE. This section is effective upon federal approval. The commissioner 
8.26 	of human services shall notify the revisor of statutes when federal approval is obtained.

8.27 	Sec. 3. Minnesota Statutes 2016, section 252.41, subdivision 3, is amended to read:
8.28 		Subd. 3.Day training and habilitation services for adults with developmental 
8.29 	disabilities. (a) "Day training and habilitation services for adults with developmental 
8.30 	disabilities" means services that:
9.1 	(1) include supervision, training, assistance, and supported employment, center-based
9.2 	work-related activities, or other community-integrated activities designed and implemented 
9.3 	in accordance with the individual service and individual habilitation plans required under 
9.4 	Minnesota Rules, parts 9525.0004 to 9525.0036, to help an adult reach and maintain the 
9.5 	highest possible level of independence, productivity, and integration into the community; 
9.6 	and
9.7 	(2) are provided by a vendor licensed under sections 245A.01 to 245A.16 and 252.28, 
9.8 	subdivision 2, to provide day training and habilitation services.
9.9 	(b) Day training and habilitation services reimbursable under this section do not include 
9.10 	special education and related services as defined in the Education of the Individuals with 
9.11 	Disabilities Act, United States Code, title 20, chapter 33, section 1401, clauses (6) and (17), 
9.12 	or vocational services funded under section 110 of the Rehabilitation Act of 1973, United 
9.13 	States Code, title 29, section 720, as amended.
9.14 	(c) Day training and habilitation services do not include employment exploration, 
9.15 	employment development, or employment supports services as defined in the home and 
9.16 	community-based services waivers for people with disabilities authorized under sections 
9.17 	256B.092 and 256B.49.

9.18 	EFFECTIVE DATE. This section is effective upon federal approval. The commissioner 
9.19 	of human services shall notify the revisor of statutes when federal approval is obtained.

9.20 	Sec. 4. Minnesota Statutes 2016, section 256B.0625, subdivision 6a, is amended to read:
9.21 		Subd. 6a.Home health services. Home health services are those services specified in 
9.22 	Minnesota Rules, part 9505.0295 and sections 256B.0651 and 256B.0653 and Minnesota 
9.23 	Rules, part 9505.0295. Medical assistance covers home health services at a recipient's home 
9.24 	residence or in the community where normal life activities take the recipient. Medical 
9.25 	assistance does not cover home health services for residents of a hospital, nursing facility, 
9.26 	or intermediate care facility, unless the commissioner of human services has authorized 
9.27 	skilled nurse visits for less than 90 days for a resident at an intermediate care facility for 
9.28 	persons with developmental disabilities, to prevent an admission to a hospital or nursing 
9.29 	facility or unless a resident who is otherwise eligible is on leave from the facility and the 
9.30 	facility either pays for the home health services or forgoes the facility per diem for the leave 
9.31 	days that home health services are used. Home health services must be provided by a 
9.32 	Medicare certified home health agency. All nursing and home health aide services must be 
9.33 	provided according to sections 256B.0651 to 256B.0653.

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

10.2 	Sec. 5. Minnesota Statutes 2016, section 256B.0625, subdivision 7, is amended to read:
10.3 		Subd. 7.Home care nursing. Medical assistance covers home care nursing services in 
10.4 	a recipient's home. Recipients who are authorized to receive home care nursing services in 
10.5 	their home may use approved hours outside of the home during hours when normal life 
10.6 	activities take them outside of their home. To use home care nursing services at school, the 
10.7 	recipient or responsible party must provide written authorization in the care plan identifying 
10.8 	the chosen provider and the daily amount of services to be used at school. Medical assistance 
10.9 	does not cover home care nursing services for residents of a hospital, nursing facility, 
10.10 	intermediate care facility, or a health care facility licensed by the commissioner of health, 
10.11 	except as authorized in section 256B.64 for ventilator-dependent recipients in hospitals or
10.12 	unless a resident who is otherwise eligible is on leave from the facility and the facility either 
10.13 	pays for the home care nursing services or forgoes the facility per diem for the leave days 
10.14 	that home care nursing services are used. Total hours of service and payment allowed for 
10.15 	services outside the home cannot exceed that which is otherwise allowed in an in-home 
10.16 	setting according to sections 256B.0651 and 256B.0654 . All home care nursing services 
10.17 	must be provided according to the limits established under sections 256B.0651, 256B.0653, 
10.18 	and 256B.0654. Home care nursing services may not be reimbursed if the nurse is the family 
10.19 	foster care provider of a recipient who is under age 18, unless allowed under section 
10.20 	256B.0654, subdivision 4.

10.21 	Sec. 6. Minnesota Statutes 2016, section 256B.0651, subdivision 17, is amended to read:
10.22 		Subd. 17.Recipient protection. (a) Providers of home care services must provide each 
10.23 	recipient with a copy of the home care bill of rights under section 144A.44 at least 30 days 
10.24 	prior to terminating services to a recipient, if the termination results from provider sanctions 
10.25 	under section 256B.064 imposed by the commissioner, such as a payment withhold, a 
10.26 	suspension of participation, or a notice of termination of participation. If a home care provider 
10.27 	determines it is unable to continue providing services to a recipient, the provider must notify 
10.28 	the recipient, the recipient's responsible party, and the commissioner 30 days prior to 
10.29 	terminating services to the recipient because of an action under section 256B.064 taken by 
10.30 	the commissioner, and must assist the commissioner and lead agency in supporting the 
10.31 	recipient in transitioning to another home care provider of the recipient's choice.
10.32 	(b) In the event of a payment withhold from a home care provider, a suspension of 
10.33 	participation, or a notice of termination of participation of a home care provider under 
11.1 	section 256B.064 imposed by the commissioner, the commissioner may inform the Office 
11.2 	of Ombudsman for Long-Term Care and the lead agencies for all recipients with active 
11.3 	service agreements with the provider. At the commissioner's request, the lead agencies must 
11.4 	contact recipients to ensure that the recipients are continuing to receive needed care, and 
11.5 	that the recipients have been given free choice of provider if they transfer to another home 
11.6 	care provider. In addition, the commissioner or the commissioner's delegate may directly 
11.7 	notify recipients who receive care from the provider that payments have been withheld or 
11.8 	that the provider's provider has been notified of a suspension or termination of participation 
11.9 	in medical assistance has been suspended or terminated, if the commissioner determines 
11.10 	that notification is necessary to protect the welfare of the recipients. For purposes of this 
11.11 	subdivision, "lead agencies" means counties, tribes, and managed care organizations.

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

11.13 	Sec. 7. Minnesota Statutes 2016, section 256B.0652, subdivision 4, is amended to read:
11.14 		Subd. 4. Home health services. Home health services including skilled nurse visits 
11.15 	and home health aide visits must be authorized by the commissioner or the commissioner's 
11.16 	designee. Authorization must be based on medical necessity and cost-effectiveness when 
11.17 	compared with other care options. The commissioner must receive the request for 
11.18 	authorization of skilled nurse visits and home health aide visits, including qualifying 
11.19 	documentation of the face-to-face encounter as specified in section 256B.0653, subdivision 
11.20 	7, within 20 working days of the start of service. When home health services are used in 
11.21 	combination with personal care and home care nursing, the cost of all home care services 
11.22 	shall be considered for cost-effectiveness.

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

11.24 	Sec. 8. Minnesota Statutes 2016, section 256B.0653, is amended to read:
11.25 	256B.0653 HOME HEALTH AGENCY SERVICES.
11.26 		Subdivision 1.Scope. This section applies to home health agency services including 
11.27 	home health aide, skilled nursing visits, physical therapy, occupational therapy, respiratory 
11.28 	therapy, and speech-language pathology therapy.
11.29 		Subd. 2.Definitions. For the purposes of this section, the following terms have the 
11.30 	meanings given.
12.1 	(a) "Assessment" means an evaluation of the recipient's medical need for home health 
12.2 	agency services by a registered nurse or appropriate therapist that is conducted within 30 
12.3 	days of a request.
12.4 	(b) "Home care therapies" means occupational, physical, and respiratory therapy and 
12.5 	speech-language pathology services provided in the home by a Medicare certified home 
12.6 	health agency.
12.7 	(c) "Home health agency services" means services delivered in the recipient's home 
12.8 	residence, except as specified in section 256B.0625, by a home health agency by a home 
12.9 	health agency to a recipient with medical needs due to illness, disability, or physical 
12.10 	conditions in the settings permitted by section 256B.0625.
12.11 	(d) "Home health aide" means an employee of a home health agency who completes 
12.12 	medically oriented tasks written in the plan of care for a recipient.
12.13 	(e) "Home health agency" means a home care provider agency that is Medicare-certified.
12.14 	(f) "Occupational therapy services" mean the services defined in Minnesota Rules, part 
12.15 	9505.0390.
12.16 	(g) "Physical therapy services" mean the services defined in Minnesota Rules, part 
12.17 	9505.0390.
12.18 	(h) "Respiratory therapy services" mean the services defined in chapter 147C.
12.19 	(i) "Speech-language pathology services" mean the services defined in Minnesota Rules, 
12.20 	part 9505.0390.
12.21 	(j) "Skilled nurse visit" means a professional nursing visit to complete nursing tasks 
12.22 	required due to a recipient's medical condition that can only be safely provided by a 
12.23 	professional nurse to restore and maintain optimal health.
12.24 	(k) "Store-and-forward technology" means telehomecare services that do not occur in 
12.25 	real time via synchronous transmissions such as diabetic and vital sign monitoring.
12.26 	(l) "Telehomecare" means the use of telecommunications technology via live, two-way 
12.27 	interactive audiovisual technology which may be augmented by store-and-forward 
12.28 	technology.
12.29 	(m) "Telehomecare skilled nurse visit" means a visit by a professional nurse to deliver 
12.30 	a skilled nurse visit to a recipient located at a site other than the site where the nurse is 
12.31 	located and is used in combination with face-to-face skilled nurse visits to adequately meet 
12.32 	the recipient's needs.
13.1 		Subd. 3.Home health aide visits. (a) Home health aide visits must be provided by a 
13.2 	certified home health aide using a written plan of care that is updated in compliance with 
13.3 	Medicare regulations. A home health aide shall provide hands-on personal care, perform 
13.4 	simple procedures as an extension of therapy or nursing services, and assist in instrumental 
13.5 	activities of daily living as defined in section 256B.0659, including assuring that the person 
13.6 	gets to medical appointments if identified in the written plan of care. Home health aide 
13.7 	visits must be provided in the recipient's home or in the community where normal life 
13.8 	activities take the recipient.
13.9 	(b) All home health aide visits must have authorization under section 256B.0652. The 
13.10 	commissioner shall limit home health aide visits to no more than one visit per day per 
13.11 	recipient.
13.12 	(c) Home health aides must be supervised by a registered nurse or an appropriate therapist 
13.13 	when providing services that are an extension of therapy.
13.14 		Subd. 4.Skilled nurse visit services. (a) Skilled nurse visit services must be provided 
13.15 	by a registered nurse or a licensed practical nurse under the supervision of a registered nurse, 
13.16 	according to the written plan of care and accepted standards of medical and nursing practice 
13.17 	according to chapter 148. Skilled nurse visit services must be ordered by a physician and 
13.18 	documented in a plan of care that is reviewed and approved by the ordering physician at 
13.19 	least once every 60 days. All skilled nurse visits must be medically necessary and provided 
13.20 	in the recipient's home residence or in the community where normal life activities take the 
13.21 	recipient, except as allowed under section 256B.0625, subdivision 6a.
13.22 	(b) Skilled nurse visits include face-to-face and telehomecare visits with a limit of up 
13.23 	to two visits per day per recipient. All visits must be based on assessed needs.
13.24 	(c) Telehomecare skilled nurse visits are allowed when the recipient's health status can 
13.25 	be accurately measured and assessed without a need for a face-to-face, hands-on encounter. 
13.26 	All telehomecare skilled nurse visits must have authorization and are paid at the same 
13.27 	allowable rates as face-to-face skilled nurse visits.
13.28 	(d) The provision of telehomecare must be made via live, two-way interactive audiovisual 
13.29 	technology and may be augmented by utilizing store-and-forward technologies. Individually 
13.30 	identifiable patient data obtained through real-time or store-and-forward technology must 
13.31 	be maintained as health records according to sections 144.291 to 144.298. If the video is 
13.32 	used for research, training, or other purposes unrelated to the care of the patient, the identity 
13.33 	of the patient must be concealed.
14.1 	(e) Authorization for skilled nurse visits must be completed under section 256B.0652. 
14.2 	A total of nine face-to-face skilled nurse visits per calendar year do not require authorization. 
14.3 	All telehomecare skilled nurse visits require authorization.
14.4 		Subd. 5.Home care therapies. (a) Home care therapies include the following: physical 
14.5 	therapy, occupational therapy, respiratory therapy, and speech and language pathology 
14.6 	therapy services.
14.7 	(b) Home care therapies must be:
14.8 	(1) provided in the recipient's residence or in the community where normal life activities 
14.9 	take the recipient after it has been determined the recipient is unable to access outpatient 
14.10 	therapy;
14.11 	(2) prescribed, ordered, or referred by a physician and documented in a plan of care and 
14.12 	reviewed, according to Minnesota Rules, part 9505.0390;
14.13 	(3) assessed by an appropriate therapist; and
14.14 	(4) provided by a Medicare-certified home health agency enrolled as a Medicaid provider 
14.15 	agency.
14.16 	(c) Restorative and specialized maintenance therapies must be provided according to 
14.17 	Minnesota Rules, part 9505.0390. Physical and occupational therapy assistants may be used 
14.18 	as allowed under Minnesota Rules, part 9505.0390, subpart 1, item B.
14.19 	(d) For both physical and occupational therapies, the therapist and the therapist's assistant 
14.20 	may not both bill for services provided to a recipient on the same day.
14.21 		Subd. 6.Noncovered home health agency services. The following are not eligible for 
14.22 	payment under medical assistance as a home health agency service:
14.23 	(1) telehomecare skilled nurses services that is communication between the home care 
14.24 	nurse and recipient that consists solely of a telephone conversation, facsimile, electronic 
14.25 	mail, or a consultation between two health care practitioners;
14.26 	(2) the following skilled nurse visits:
14.27 	(i) for the purpose of monitoring medication compliance with an established medication 
14.28 	program for a recipient;
14.29 	(ii) administering or assisting with medication administration, including injections, 
14.30 	prefilling syringes for injections, or oral medication setup of an adult recipient, when, as 
14.31 	determined and documented by the registered nurse, the need can be met by an available 
15.1 	pharmacy or the recipient or a family member is physically and mentally able to 
15.2 	self-administer or prefill a medication;
15.3 	(iii) services done for the sole purpose of supervision of the home health aide or personal 
15.4 	care assistant;
15.5 	(iv) services done for the sole purpose to train other home health agency workers;
15.6 	(v) services done for the sole purpose of blood samples or lab draw when the recipient 
15.7 	is able to access these services outside the home; and
15.8 	(vi) Medicare evaluation or administrative nursing visits required by Medicare;
15.9 	(3) home health aide visits when the following activities are the sole purpose for the 
15.10 	visit: companionship, socialization, household tasks, transportation, and education; and
15.11 	(4) home care therapies provided in other settings such as a clinic, day program, or as 
15.12 	an inpatient or when the recipient can access therapy outside of the recipient's residence.; 
15.13 	and
15.14 	(5) home health services without documentation of a face-to-face encounter according 
15.15 	to subdivision 7.
15.16 		Subd. 7.Face-to-face encounter. (a) A face-to-face encounter by a provider must be 
15.17 	completed for all home health services, regardless of whether the service requires prior 
15.18 	authorization. The face-to-face encounter may occur through telemedicine according to 
15.19 	section 256B.0625, subdivision 3b. The encounter must be related to the primary reason 
15.20 	the recipient requires home health services and must occur within 90 days before service 
15.21 	begins or within 30 days after service begins. The face-to-face encounter may be conducted 
15.22 	by a practitioner licensed in Minnesota to practice a profession described in section 214.01, 
15.23 	subdivision 2:
15.24 	(1) a physician;
15.25 	(2) a nurse practitioner or clinical nurse specialist;
15.26 	(3) a certified nurse midwife;
15.27 	(4) a physician assistant; or
15.28 	(5) for a recipient admitted to home health service immediately after an acute or postacute 
15.29 	stay, the attending recipient's acute or postacute physician.
16.1 	(b) A practitioner described in paragraph (a), clauses (2) to (5), performing the 
16.2 	face-to-face encounter must communicate the clinical findings to the ordering physician. 
16.3 	The clinical findings must be documented in the recipient's medical record.
16.4 	(c) To ensure clinical correlation between the face-to-face encounter and the associated 
16.5 	home health services, the ordering physician must:
16.6 	(1) document that the face-to-face encounter related to the primary reason the recipient 
16.7 	requires home health services occurred within the required time frames;
16.8 	(2) indicate the practitioner who conducted the face-to-face encounter; and
16.9 	(3) indicate the date of the face-to-face encounter.

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

16.11 	Sec. 9. Minnesota Statutes 2016, section 256B.0659, subdivision 11, is amended to read:
16.12 		Subd. 11.Personal care assistant; requirements. (a) A personal care assistant must 
16.13 	meet the following requirements:
16.14 	(1) be at least 18 years of age with the exception of persons who are 16 or 17 years of 
16.15 	age with these additional requirements:
16.16 	(i) supervision by a qualified professional every 60 days; and
16.17 	(ii) employment by only one personal care assistance provider agency responsible for 
16.18 	compliance with current labor laws;
16.19 	(2) be employed by a personal care assistance provider agency;
16.20 	(3) enroll with the department as a personal care assistant after clearing a background 
16.21 	study. Except as provided in subdivision 11a, before a personal care assistant provides 
16.22 	services, the personal care assistance provider agency must initiate a background study on 
16.23 	the personal care assistant under chapter 245C, and the personal care assistance provider 
16.24 	agency must have received a notice from the commissioner that the personal care assistant 
16.25 	is:
16.26 	(i) not disqualified under section 245C.14; or
16.27 	(ii) is disqualified, but the personal care assistant has received a set aside of the 
16.28 	disqualification under section 245C.22;
16.29 	(4) be able to effectively communicate with the recipient and personal care assistance 
16.30 	provider agency;
17.1 	(5) be able to provide covered personal care assistance services according to the recipient's 
17.2 	personal care assistance care plan, respond appropriately to recipient needs, and report 
17.3 	changes in the recipient's condition to the supervising qualified professional or physician;
17.4 	(6) not be a consumer of personal care assistance services;
17.5 	(7) maintain daily written records including, but not limited to, time sheets under 
17.6 	subdivision 12;
17.7 	(8) effective January 1, 2010, complete standardized training as determined by the 
17.8 	commissioner before completing enrollment. The training must be available in languages 
17.9 	other than English and to those who need accommodations due to disabilities. Personal care 
17.10 	assistant training must include successful completion of the following training components: 
17.11 	basic first aid, vulnerable adult, child maltreatment, OSHA universal precautions, basic 
17.12 	roles and responsibilities of personal care assistants including information about assistance 
17.13 	with lifting and transfers for recipients, emergency preparedness, orientation to positive 
17.14 	behavioral practices, fraud issues, and completion of time sheets. Upon completion of the 
17.15 	training components, the personal care assistant must demonstrate the competency to provide 
17.16 	assistance to recipients;
17.17 	(9) complete training and orientation on the needs of the recipient; and
17.18 	(10) be limited to providing and being paid for up to 275 310 hours per month of personal 
17.19 	care assistance services regardless of the number of recipients being served or the number 
17.20 	of personal care assistance provider agencies enrolled with. The number of hours worked 
17.21 	per day shall not be disallowed by the department unless in violation of the law.
17.22 	(b) A legal guardian may be a personal care assistant if the guardian is not being paid 
17.23 	for the guardian services and meets the criteria for personal care assistants in paragraph (a).
17.24 	(c) Persons who do not qualify as a personal care assistant include parents, stepparents, 
17.25 	and legal guardians of minors; spouses; paid legal guardians of adults; family foster care 
17.26 	providers, except as otherwise allowed in section 256B.0625, subdivision 19a; and staff of 
17.27 	a residential setting.

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

17.29 	Sec. 10. Minnesota Statutes 2016, section 256B.0915, subdivision 1, is amended to read:
17.30 		Subdivision 1.Authority. (a) The commissioner is authorized to apply for a home and 
17.31 	community-based services waiver for the elderly, authorized under section 1915(c) of the 
17.32 	Social Security Act, in order to obtain federal financial participation to expand the availability 
18.1 	of services for persons who are eligible for medical assistance. The commissioner may 
18.2 	apply for additional waivers or pursue other federal financial participation which is 
18.3 	advantageous to the state for funding home care services for the frail elderly who are eligible 
18.4 	for medical assistance. The provision of waivered services to elderly and disabled medical 
18.5 	assistance recipients must comply with the criteria for service definitions and provider 
18.6 	standards approved in the waiver.
18.7 	(b) The commissioner shall comply with the requirements in the federally approved 
18.8 	transition plan for the home and community-based services waivers authorized under this 
18.9 	section.

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

18.11 	Sec. 11. Minnesota Statutes 2016, section 256B.092, subdivision 4, is amended to read:
18.12 		Subd. 4.Home and community-based services for developmental disabilities. (a) 
18.13 	The commissioner shall make payments to approved vendors participating in the medical 
18.14 	assistance program to pay costs of providing home and community-based services, including 
18.15 	case management service activities provided as an approved home and community-based 
18.16 	service, to medical assistance eligible persons with developmental disabilities who have 
18.17 	been screened under subdivision 7 and according to federal requirements. Federal 
18.18 	requirements include those services and limitations included in the federally approved 
18.19 	application for home and community-based services for persons with developmental 
18.20 	disabilities and subsequent amendments.
18.21 	(b) Effective July 1, 1995, contingent upon federal approval and state appropriations 
18.22 	made available for this purpose, and in conjunction with Laws 1995, chapter 207, article 8, 
18.23 	section 40, the commissioner of human services shall allocate resources to county agencies 
18.24 	for home and community-based waivered services for persons with developmental disabilities 
18.25 	authorized but not receiving those services as of June 30, 1995, based upon the average 
18.26 	resource need of persons with similar functional characteristics. To ensure service continuity 
18.27 	for service recipients receiving home and community-based waivered services for persons 
18.28 	with developmental disabilities prior to July 1, 1995, the commissioner shall make available 
18.29 	to the county of financial responsibility home and community-based waivered services 
18.30 	resources based upon fiscal year 1995 authorized levels.
18.31 	(c) Home and community-based resources for all recipients shall be managed by the 
18.32 	county of financial responsibility within an allowable reimbursement average established 
18.33 	for each county. Payments for home and community-based services provided to individual 
18.34 	recipients shall not exceed amounts authorized by the county of financial responsibility. 
19.1 	For specifically identified former residents of nursing facilities, the commissioner shall be 
19.2 	responsible for authorizing payments and payment limits under the appropriate home and 
19.3 	community-based service program. Payment is available under this subdivision only for 
19.4 	persons who, if not provided these services, would require the level of care provided in an 
19.5 	intermediate care facility for persons with developmental disabilities.
19.6 	(d) The commissioner shall comply with the requirements in the federally approved 
19.7 	transition plan for the home and community-based services waivers for the elderly authorized 
19.8 	under this section.

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

19.10 	Sec. 12. Minnesota Statutes 2016, section 256B.49, subdivision 11, is amended to read:
19.11 		Subd. 11.Authority. (a) The commissioner is authorized to apply for home and 
19.12 	community-based service waivers, as authorized under section 1915(c) of the Social Security 
19.13 	Act to serve persons under the age of 65 who are determined to require the level of care 
19.14 	provided in a nursing home and persons who require the level of care provided in a hospital. 
19.15 	The commissioner shall apply for the home and community-based waivers in order to:
19.16 	(1) promote the support of persons with disabilities in the most integrated settings;
19.17 	(2) expand the availability of services for persons who are eligible for medical assistance;
19.18 	(3) promote cost-effective options to institutional care; and
19.19 	(4) obtain federal financial participation.
19.20 	(b) The provision of waivered services to medical assistance recipients with disabilities 
19.21 	shall comply with the requirements outlined in the federally approved applications for home 
19.22 	and community-based services and subsequent amendments, including provision of services 
19.23 	according to a service plan designed to meet the needs of the individual. For purposes of 
19.24 	this section, the approved home and community-based application is considered the necessary 
19.25 	federal requirement.
19.26 	(c) The commissioner shall provide interested persons serving on agency advisory 
19.27 	committees, task forces, the Centers for Independent Living, and others who request to be 
19.28 	on a list to receive, notice of, and an opportunity to comment on, at least 30 days before 
19.29 	any effective dates, (1) any substantive changes to the state's disability services program 
19.30 	manual, or (2) changes or amendments to the federally approved applications for home and 
19.31 	community-based waivers, prior to their submission to the federal Centers for Medicare 
19.32 	and Medicaid Services.
20.1 	(d) The commissioner shall seek approval, as authorized under section 1915(c) of the 
20.2 	Social Security Act, to allow medical assistance eligibility under this section for children 
20.3 	under age 21 without deeming of parental income or assets.
20.4 	(e) The commissioner shall seek approval, as authorized under section 1915(c) of the 
20.5 	Social Act, to allow medical assistance eligibility under this section for individuals under 
20.6 	age 65 without deeming the spouse's income or assets.
20.7 	(f) The commissioner shall comply with the requirements in the federally approved 
20.8 	transition plan for the home and community-based services waivers authorized under this 
20.9 	section.

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

20.11 	Sec. 13. Minnesota Statutes 2016, section 256B.4912, is amended by adding a subdivision 
20.12 	to read:
20.13 		Subd. 11.Annual data submission. (a) As determined by the commissioner, a provider 
20.14 	of home and community-based services for the elderly under section 256B.0915, home and 
20.15 	community-based services for people with developmental disabilities under section 256B.092, 
20.16 	and home and community-based services for people with disabilities under section 256B.49 
20.17 	shall submit data to the commissioner on the following:
20.18 	(1) wages of workers;
20.19 	(2) hours worked;
20.20 	(3) benefits paid and accrued;
20.21 	(4) staff retention rates;
20.22 	(5) amount of overtime paid;
20.23 	(6) amount of travel time paid;
20.24 	(7) vacancy rates; and
20.25 	(8) other related data requested by the commissioner.
20.26 	(b) The commissioner may adjust reporting requirements for a self-employed worker.
20.27 	(c) This subdivision also applies to a provider of personal care assistance services under 
20.28 	section 256B.0625, subdivision 19a; community first services and supports under section 
20.29 	256B.85; consumer support grants under section 256.476; nursing services and home health 
20.30 	services under section 256B.0625, subdivision 6a; home care nursing services under section 
20.31 	256B.0625, subdivision 7; or day training and habilitation services for residents of 
21.1 	intermediate care facilities for persons with developmental disabilities under section 
21.2 	256B.501.
21.3 	(d) A provider shall submit the data annually on a date specified by the commissioner. 
21.4 	The commissioner shall give a provider at least 30 calendar days to submit the data. If a 
21.5 	provider fails to timely submit the requested data, medical assistance reimbursement may 
21.6 	be delayed.
21.7 	(e) Individually identifiable data submitted to the commissioner in this section are 
21.8 	considered private data on an individual, as defined by section 13.02, subdivision 12.
21.9 	(f) The commissioner shall analyze data annually for workforce assessments and how 
21.10 	the data impact service access.

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

21.12 	Sec. 14. Minnesota Statutes 2016, section 256B.4913, subdivision 4a, is amended to read:
21.13 		Subd. 4a.Rate stabilization adjustment. (a) For purposes of this subdivision, 
21.14 	"implementation period" means the period beginning January 1, 2014, and ending on the 
21.15 	last day of the month in which the rate management system is populated with the data 
21.16 	necessary to calculate rates for substantially all individuals receiving home and 
21.17 	community-based waiver services under sections 256B.092 and 256B.49. "Banding period" 
21.18 	means the time period beginning on January 1, 2014, and ending upon the expiration of the 
21.19 	12-month period defined in paragraph (c), clause (5).
21.20 	(b) For purposes of this subdivision, the historical rate for all service recipients means 
21.21 	the individual reimbursement rate for a recipient in effect on December 1, 2013, except 
21.22 	that:
21.23 	(1) for a day service recipient who was not authorized to receive these waiver services 
21.24 	prior to January 1, 2014; added a new service or services on or after January 1, 2014; or 
21.25 	changed providers on or after January 1, 2014, the historical rate must be the weighted 
21.26 	average authorized rate for the provider number in the county of service, effective December 
21.27 	1, 2013; or
21.28 	(2) for a unit-based service with programming or a unit-based service without 
21.29 	programming recipient who was not authorized to receive these waiver services prior to 
21.30 	January 1, 2014; added a new service or services on or after January 1, 2014; or changed 
21.31 	providers on or after January 1, 2014, the historical rate must be the weighted average 
21.32 	authorized rate for each provider number in the county of service, effective December 1, 
21.33 	2013; or
22.1 	(3) for residential service recipients who change providers on or after January 1, 2014, 
22.2 	the historical rate must be set by each lead agency within their county aggregate budget 
22.3 	using their respective methodology for residential services effective December 1, 2013, for 
22.4 	determining the provider rate for a similarly situated recipient being served by that provider.
22.5 	(c) The commissioner shall adjust individual reimbursement rates determined under this 
22.6 	section so that the unit rate is no higher or lower than:
22.7 	(1) 0.5 percent from the historical rate for the implementation period;
22.8 	(2) 0.5 percent from the rate in effect in clause (1), for the 12-month period immediately 
22.9 	following the time period of clause (1);
22.10 	(3) 0.5 percent from the rate in effect in clause (2), for the 12-month period immediately 
22.11 	following the time period of clause (2);
22.12 	(4) 1.0 percent from the rate in effect in clause (3), for the 12-month period immediately 
22.13 	following the time period of clause (3);
22.14 	(5) 1.0 percent from the rate in effect in clause (4), for the 12-month period immediately 
22.15 	following the time period of clause (4); and
22.16 	(6) no adjustment to the rate in effect in clause (5) for the 12-month period immediately 
22.17 	following the time period of clause (5). During this banding rate period, the commissioner 
22.18 	shall not enforce any rate decrease or increase that would otherwise result from the end of 
22.19 	the banding period. The commissioner shall, upon enactment, seek federal approval for the 
22.20 	addition of this banding period.
22.21 	(d) The commissioner shall review all changes to rates that were in effect on December 
22.22 	1, 2013, to verify that the rates in effect produce the equivalent level of spending and service 
22.23 	unit utilization on an annual basis as those in effect on October 31, 2013.
22.24 	(e) By December 31, 2014, the commissioner shall complete the review in paragraph 
22.25 	(d), adjust rates to provide equivalent annual spending, and make appropriate adjustments.
22.26 	(f) During the banding period, the Medicaid Management Information System (MMIS) 
22.27 	service agreement rate must be adjusted to account for change in an individual's need. The 
22.28 	commissioner shall adjust the Medicaid Management Information System (MMIS) service 
22.29 	agreement rate by:
22.30 	(1) calculating a service rate under section 256B.4914, subdivision 6, 7, 8, or 9, for the 
22.31 	individual with variables reflecting the level of service in effect on December 1, 2013;
23.1 	(2) calculating a service rate under section 256B.4914, subdivision 6, 7, 8, or 9, for the 
23.2 	individual with variables reflecting the updated level of service at the time of application; 
23.3 	and
23.4 	(3) adding to or subtracting from the Medicaid Management Information System (MMIS) 
23.5 	service agreement rate, the difference between the values in clauses (1) and (2).
23.6 	(g) This subdivision must not apply to rates for recipients served by providers new to a 
23.7 	given county after January 1, 2014. Providers of personal supports services who also acted 
23.8 	as fiscal support entities must be treated as new providers as of January 1, 2014.

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

23.10 	Sec. 15. Minnesota Statutes 2016, section 256B.4913, is amended by adding a subdivision 
23.11 	to read:
23.12 		Subd. 7.New services. (a) A service added to section 256B.4914 after January 1, 2014, 
23.13 	is not subject to rate stabilization adjustment in this section.
23.14 	(b) Employment support services authorized after January 1, 2018, under the new 
23.15 	employment support services definition according to the home and community-based services 
23.16 	waivers for people with disabilities under sections 256B.092 and 256B.49 are not subject 
23.17 	to rate stabilization adjustment in this section.

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

23.19 	Sec. 16. Minnesota Statutes 2016, section 256B.4914, subdivision 2, is amended to read:
23.20 		Subd. 2.Definitions. (a) For purposes of this section, the following terms have the 
23.21 	meanings given them, unless the context clearly indicates otherwise.
23.22 	(b) "Commissioner" means the commissioner of human services.
23.23 	(c) "Component value" means underlying factors that are part of the cost of providing 
23.24 	services that are built into the waiver rates methodology to calculate service rates.
23.25 	(d) "Customized living tool" means a methodology for setting service rates that delineates 
23.26 	and documents the amount of each component service included in a recipient's customized 
23.27 	living service plan.
23.28 	(e) "Disability waiver rates system" means a statewide system that establishes rates that 
23.29 	are based on uniform processes and captures the individualized nature of waiver services 
23.30 	and recipient needs.
24.1 	(f) "Individual staffing" means the time spent as a one-to-one interaction specific to an 
24.2 	individual recipient by staff to provide direct support and assistance with activities of daily 
24.3 	living, instrumental activities of daily living, and training to participants, and is based on 
24.4 	the requirements in each individual's coordinated service and support plan under section 
24.5 	245D.02, subdivision 4b; any coordinated service and support plan addendum under section 
24.6 	245D.02, subdivision 4c; and an assessment tool. Provider observation of an individual's 
24.7 	needs must also be considered.
24.8 	(g) "Lead agency" means a county, partnership of counties, or tribal agency charged 
24.9 	with administering waivered services under sections 256B.092 and 256B.49.
24.10 	(h) "Median" means the amount that divides distribution into two equal groups, one-half 
24.11 	above the median and one-half below the median.
24.12 	(i) "Payment or rate" means reimbursement to an eligible provider for services provided 
24.13 	to a qualified individual based on an approved service authorization.
24.14 	(j) "Rates management system" means a Web-based software application that uses a 
24.15 	framework and component values, as determined by the commissioner, to establish service 
24.16 	rates.
24.17 	(k) "Recipient" means a person receiving home and community-based services funded 
24.18 	under any of the disability waivers.
24.19 	(l) "Shared staffing" means time spent by employees, not defined under paragraph (f), 
24.20 	providing or available to provide more than one individual with direct support and assistance 
24.21 	with activities of daily living as defined under section 256B.0659, subdivision 1, paragraph 
24.22 	(b); instrumental activities of daily living as defined under section 256B.0659, subdivision 
24.23 	1, paragraph (i); ancillary activities needed to support individual services; and training to 
24.24 	participants, and is based on the requirements in each individual's coordinated service and 
24.25 	support plan under section 245D.02, subdivision 4b; any coordinated service and support 
24.26 	plan addendum under section 245D.02, subdivision 4c; an assessment tool; and provider 
24.27 	observation of an individual's service need. Total shared staffing hours are divided 
24.28 	proportionally by the number of individuals who receive the shared service provisions.
24.29 	(m) "Staffing ratio" means the number of recipients a service provider employee supports 
24.30 	during a unit of service based on a uniform assessment tool, provider observation, case 
24.31 	history, and the recipient's services of choice, and not based on the staffing ratios under 
24.32 	section 245D.31.
24.33 	(n) "Unit of service" means the following:
25.1 	(1) for residential support services under subdivision 6, a unit of service is a day. Any 
25.2 	portion of any calendar day, within allowable Medicaid rules, where an individual spends 
25.3 	time in a residential setting is billable as a day;
25.4 	(2) for day services under subdivision 7:
25.5 	(i) for day training and habilitation services, a unit of service is either:
25.6 	(A) a day unit of service is defined as six or more hours of time spent providing direct 
25.7 	services and transportation; or
25.8 	(B) a partial day unit of service is defined as fewer than six hours of time spent providing 
25.9 	direct services and transportation; and
25.10 	(C) for new day service recipients after January 1, 2014, 15 minute units of service must 
25.11 	be used for fewer than six hours of time spent providing direct services and transportation;
25.12 	and
25.13 	(D) after December 31, 2017, 15 minute units must be used for fewer than six hours of 
25.14 	time spent providing direct services and transportation;
25.15 	(ii) for adult day and structured day services, a unit of service is a day or 15 minutes. A 
25.16 	day unit of service is six or more hours of time spent providing direct services;
25.17 	(iii) for prevocational services, a unit of service is a day or an hour. A day unit of service 
25.18 	is six or more hours of time spent providing direct service;
25.19 	(3) for unit-based services with programming under subdivision 8:
25.20 	(i) for supported living services, a unit of service is a day or 15 minutes. When a day 
25.21 	rate is authorized, any portion of a calendar day where an individual receives services is 
25.22 	billable as a day; and
25.23 	(ii) for all other services, a unit of service is 15 minutes; and
25.24 	(4) for unit-based services without programming under subdivision 9:
25.25 	(i) for respite services, a unit of service is a day or 15 minutes. When a day rate is 
25.26 	authorized, any portion of a calendar day when an individual receives services is billable 
25.27 	as a day; and
25.28 	(ii) for all other services, a unit of service is 15 minutes.

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

26.1 	Sec. 17. Minnesota Statutes 2016, section 256B.4914, subdivision 3, is amended to read:
26.2 		Subd. 3.Applicable services. Applicable services are those authorized under the state's 
26.3 	home and community-based services waivers under sections 256B.092 and 256B.49, 
26.4 	including the following, as defined in the federally approved home and community-based 
26.5 	services plan:
26.6 	(1) 24-hour customized living;
26.7 	(2) adult day care;
26.8 	(3) adult day care bath;
26.9 	(4) behavioral programming;
26.10 	(5) companion services;
26.11 	(6) customized living;
26.12 	(7) day training and habilitation;
26.13 	(8) housing access coordination;
26.14 	(9) independent living skills;
26.15 	(10) in-home family support;
26.16 	(11) night supervision;
26.17 	(12) personal support;
26.18 	(13) prevocational services;
26.19 	(14) residential care services;
26.20 	(15) residential support services;
26.21 	(16) respite services;
26.22 	(17) structured day services;
26.23 	(18) supported employment services;
26.24 	(19) (18) supported living services;
26.25 	(20) (19) transportation services; and
26.26 	(20) independent living skills specialist services;
26.27 	(21) individualized home supports;
26.28 	(22) employment exploration services;
27.1 	(23) employment development services;
27.2 	(24) employment support services; and
27.3 	(21) (25) other services as approved by the federal government in the state home and 
27.4 	community-based services plan.

27.5 	EFFECTIVE DATE. This section is effective upon federal approval. The commissioner 
27.6 	of human services shall notify the revisor of statutes when federal approval is obtained.

27.7 	Sec. 18. Minnesota Statutes 2016, section 256B.4914, subdivision 5, is amended to read:
27.8 		Subd. 5.Base wage index and standard component values. (a) The base wage index 
27.9 	is established to determine staffing costs associated with providing services to individuals 
27.10 	receiving home and community-based services. For purposes of developing and calculating 
27.11 	the proposed base wage, Minnesota-specific wages taken from job descriptions and standard 
27.12 	occupational classification (SOC) codes from the Bureau of Labor Statistics as defined in 
27.13 	the most recent edition of the Occupational Handbook must be used. The base wage index 
27.14 	must be calculated as follows:
27.15 	(1) for residential direct care staff, the sum of:
27.16 	(i) 15 percent of the subtotal of 50 percent of the median wage for personal and home 
27.17 	health aide (SOC code 39-9021); 30 percent of the median wage for nursing aide assistant
27.18 	(SOC code 31-1012 31-1014); and 20 percent of the median wage for social and human 
27.19 	services aide (SOC code 21-1093); and
27.20 	(ii) 85 percent of the subtotal of 20 percent of the median wage for home health aide 
27.21 	(SOC code 31-1011); 20 percent of the median wage for personal and home health aide 
27.22 	(SOC code 39-9021); 20 percent of the median wage for nursing aide assistant (SOC code 
27.23 	31-1012 31-1014); 20 percent of the median wage for psychiatric technician (SOC code 
27.24 	29-2053); and 20 percent of the median wage for social and human services aide (SOC code 
27.25 	21-1093);
27.26 	(2) for day services, 20 percent of the median wage for nursing aide assistant (SOC code 
27.27 	31-1012 31-1014); 20 percent of the median wage for psychiatric technician (SOC code 
27.28 	29-2053); and 60 percent of the median wage for social and human services aide (SOC code 
27.29 	21-1093);
27.30 	(3) for residential asleep-overnight staff, the wage will be $7.66 per hour, except in a 
27.31 	family foster care setting, the wage is $2.80 per hour;
28.1 	(4) for behavior program analyst staff, 100 percent of the median wage for mental health 
28.2 	counselors (SOC code 21-1014);
28.3 	(5) for behavior program professional staff, 100 percent of the median wage for clinical 
28.4 	counseling and school psychologist (SOC code 19-3031);
28.5 	(6) for behavior program specialist staff, 100 percent of the median wage for psychiatric 
28.6 	technicians (SOC code 29-2053);
28.7 	(7) for supportive living services staff, 20 percent of the median wage for nursing aide
28.8 	assistant (SOC code 31-1012 31-1014); 20 percent of the median wage for psychiatric 
28.9 	technician (SOC code 29-2053); and 60 percent of the median wage for social and human 
28.10 	services aide (SOC code 21-1093);
28.11 	(8) for housing access coordination staff, 50 percent of the median wage for community 
28.12 	and social services specialist (SOC code 21-1099); and 50 percent of the median wage for 
28.13 	social and human services aide (SOC code 21-1093);
28.14 	(9) for in-home family support staff, 20 percent of the median wage for nursing aide 
28.15 	(SOC code 31-1012); 30 percent of the median wage for community social service specialist 
28.16 	(SOC code 21-1099); 40 percent of the median wage for social and human services aide 
28.17 	(SOC code 21-1093); and ten percent of the median wage for psychiatric technician (SOC 
28.18 	code 29-2053);
28.19 	(10) for independent living skills staff, 40 percent of the median wage for community 
28.20 	social service specialist (SOC code 21-1099); 50 percent of the median wage for social and 
28.21 	human services aide (SOC code 21-1093); and ten percent of the median wage for psychiatric 
28.22 	technician (SOC code 29-2053);
28.23 	(11) for independent living skills specialist staff, 100 percent of mental health and 
28.24 	substance abuse social worker (SOC code 21-1023);
28.25 	(12) for individualized home supports, 40 percent of the median wage for social worker 
28.26 	(SOC code 21-1029); 30 percent of the median wage for social and human services assistant 
28.27 	(SOC code 21-1093); and 30 percent of the median wage for community and social service 
28.28 	specialist (SOC code 21-1099);
28.29 	(11) (13) for services authorized through December 31, 2017, for supported employment 
28.30 	staff, 20 percent of the median wage for nursing aide assistant (SOC code 31-1012 31-1014); 
28.31 	20 percent of the median wage for psychiatric technician (SOC code 29-2053); and 60 
28.32 	percent of the median wage for social and human services aide (SOC code 21-1093);
29.1 	(14) effective January 1, 2018, for employment support services staff, 50 percent 
29.2 	rehabilitation counselor (SOC code 21-1015); and 50 percent community and social services 
29.3 	specialist (SOC code 21-1099);
29.4 	(15) for employment exploration services staff, 20 percent rehabilitation counselor (SOC 
29.5 	code 21-1015); 50 percent social and human services assistant (SOC code 21-1093); and 
29.6 	30 percent community and social services specialist (SOC code 21-1099);
29.7 	(16) for employment development services staff, 50 percent education, guidance, school, 
29.8 	and vocational counselors (SOC code 21-1012); and 50 percent community and social 
29.9 	services specialist (SOC code 21-1099);
29.10 	(12) (17) for adult companion staff, 50 percent of the median wage for personal and 
29.11 	home care aide (SOC code 39-9021); and 50 percent of the median wage for nursing aides, 
29.12 	orderlies, and attendants assistant (SOC code 31-1012 31-1014);
29.13 	(13) (18) for night supervision staff, 20 percent of the median wage for home health 
29.14 	aide (SOC code 31-1011); 20 percent of the median wage for personal and home health 
29.15 	aide (SOC code 39-9021); 20 percent of the median wage for nursing aide assistant (SOC 
29.16 	code 31-1012 31-1014); 20 percent of the median wage for psychiatric technician (SOC 
29.17 	code 29-2053); and 20 percent of the median wage for social and human services aide (SOC 
29.18 	code 21-1093);
29.19 	(14) (19) for respite staff, 50 percent of the median wage for personal and home care 
29.20 	aide (SOC code 39-9021); and 50 percent of the median wage for nursing aides, orderlies, 
29.21 	and attendants assistant (SOC code 31-1012 31-1014);
29.22 	(15) (20) for personal support staff, 50 percent of the median wage for personal and 
29.23 	home care aide (SOC code 39-9021); and 50 percent of the median wage for nursing aides, 
29.24 	orderlies, and attendants assistant (SOC code 31-1012 31-1014);
29.25 	(16) (21) for supervisory staff, the basic wage is $17.43 per hour with exception of the 
29.26 	supervisor of behavior analyst and behavior specialists, which must be $30.75 per hour;
29.27 	(17) (22) for registered nurse, the basic wage is $30.82 per hour; and
29.28 	(18) (23) for licensed practical nurse, the basic wage is $18.64 per hour.
29.29 	(b) Component values for residential support services are:
29.30 	(1) supervisory span of control ratio: 11 percent;
29.31 	(2) employee vacation, sick, and training allowance ratio: 8.71 percent;
29.32 	(3) employee-related cost ratio: 23.6 percent;
30.1 	(4) general administrative support ratio: 13.25 percent;
30.2 	(5) program-related expense ratio: 1.3 percent; and
30.3 	(6) absence and utilization factor ratio: 3.9 percent.
30.4 	(c) Component values for family foster care are:
30.5 	(1) supervisory span of control ratio: 11 percent;
30.6 	(2) employee vacation, sick, and training allowance ratio: 8.71 percent;
30.7 	(3) employee-related cost ratio: 23.6 percent;
30.8 	(4) general administrative support ratio: 3.3 percent;
30.9 	(5) program-related expense ratio: 1.3 percent; and
30.10 	(6) absence factor: 1.7 percent.
30.11 	(d) Component values for day services for all services are:
30.12 	(1) supervisory span of control ratio: 11 percent;
30.13 	(2) employee vacation, sick, and training allowance ratio: 8.71 percent;
30.14 	(3) employee-related cost ratio: 23.6 percent;
30.15 	(4) program plan support ratio: 5.6 percent;
30.16 	(5) client programming and support ratio: ten percent;
30.17 	(6) general administrative support ratio: 13.25 percent;
30.18 	(7) program-related expense ratio: 1.8 percent; and
30.19 	(8) absence and utilization factor ratio: 3.9 percent.
30.20 	(e) Component values for unit-based services with programming are:
30.21 	(1) supervisory span of control ratio: 11 percent;
30.22 	(2) employee vacation, sick, and training allowance ratio: 8.71 percent;
30.23 	(3) employee-related cost ratio: 23.6 percent;
30.24 	(4) program plan supports ratio: 3.1 15.5 percent;
30.25 	(5) client programming and supports ratio: 8.6 4.7 percent;
30.26 	(6) general administrative support ratio: 13.25 percent;
30.27 	(7) program-related expense ratio: 6.1 percent; and
31.1 	(8) absence and utilization factor ratio: 3.9 percent.
31.2 	(f) Component values for unit-based services without programming except respite are:
31.3 	(1) supervisory span of control ratio: 11 percent;
31.4 	(2) employee vacation, sick, and training allowance ratio: 8.71 percent;
31.5 	(3) employee-related cost ratio: 23.6 percent;
31.6 	(4) program plan support ratio: 3.1 7.0 percent;
31.7 	(5) client programming and support ratio: 8.6 2.3 percent;
31.8 	(6) general administrative support ratio: 13.25 percent;
31.9 	(7) program-related expense ratio: 6.1 2.9 percent; and
31.10 	(8) absence and utilization factor ratio: 3.9 percent.
31.11 	(g) Component values for unit-based services without programming for respite are:
31.12 	(1) supervisory span of control ratio: 11 percent;
31.13 	(2) employee vacation, sick, and training allowance ratio: 8.71 percent;
31.14 	(3) employee-related cost ratio: 23.6 percent;
31.15 	(4) general administrative support ratio: 13.25 percent;
31.16 	(5) program-related expense ratio: 6.1 2.9 percent; and
31.17 	(6) absence and utilization factor ratio: 3.9 percent.
31.18 	(h) On July 1, 2017, the commissioner shall update the base wage index in paragraph 
31.19 	(a) based on the wage data by standard occupational code (SOC) from the Bureau of Labor 
31.20 	Statistics available on December 31, 2016. The commissioner shall publish these updated 
31.21 	values and load them into the rate management system. This adjustment occurs every five 
31.22 	years. For adjustments in 2021 and beyond, the commissioner shall use the data available 
31.23 	on December 31 of the calendar year five years prior.
31.24 	(i) On July 1, 2017, the commissioner shall update the framework components in 
31.25 	paragraphs (b) to (g) (d), clause (5); (e), clause (5); and (f), clause (5); subdivision 6, clauses 
31.26 	(8) and (9); and subdivision 7, clauses (10), (16), and (17), for changes in the Consumer 
31.27 	Price Index. The commissioner will adjust these values higher or lower by the percentage 
31.28 	change in the Consumer Price Index-All Items, United States city average (CPI-U) from 
31.29 	January 1, 2014, to January 1, 2017. The commissioner shall publish these updated values 
31.30 	and load them into the rate management system. This adjustment occurs every five years. 
32.1 	For adjustments in 2021 and beyond, the commissioner shall use the data available on 
32.2 	January 1 of the calendar year four years prior and January 1 of the current calendar year.
32.3 	(j) The commissioner must ensure that wage values and component values in subdivisions 
32.4 	5 to 9 reflect the cost to provide a service. As determined by the commissioner, a provider 
32.5 	enrolled to provide services with rates determined under this section must submit business 
32.6 	cost data to the commissioner in concurrence with the five-year provider revalidation cycle. 
32.7 	Reporting elements include, but are not limited to:
32.8 	(1) worker wage costs;
32.9 	(2) benefits paid;
32.10 	(3) supervisor wage costs;
32.11 	(4) executive wage costs;
32.12 	(5) vacation, sick, and training time paid;
32.13 	(6) taxes, workers' compensation, and unemployment insurance costs paid;
32.14 	(7) administrative costs paid;
32.15 	(8) program costs paid;
32.16 	(9) transportation costs paid;
32.17 	(10) vacancy rates; and
32.18 	(11) other data relating to costs required to provide services requested by the 
32.19 	commissioner.
32.20 	(k) A provider must submit cost component data with provider revalidation and 
32.21 	reenrollment required under section 256B.04, subdivision 22. If a provider fails to submit 
32.22 	required reporting data, the commissioner may disenroll the provider.
32.23 	(l) The commissioner shall conduct a random audit of data submitted under paragraph 
32.24 	(j) to ensure data accuracy.
32.25 	(m) The commissioner shall analyze cost documentation in paragraph (j) and submit 
32.26 	recommendations on component value and inflationary factor adjustments to the chairs and 
32.27 	ranking minority members of the legislative committees with jurisdiction over human 
32.28 	services every four years beginning January 1, 2020. The commissioner shall make 
32.29 	recommendations in conjunction with reports submitted to the legislature according to 
32.30 	subdivision 10, paragraph (e).
33.1 	(n) In this subdivision, if Bureau of Labor Statistics occupational codes or Consumer 
33.2 	Price Index items are unavailable in the future, the commissioner shall recommend codes 
33.3 	or items to update and replace missing component values.

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

33.5 	Sec. 19. Minnesota Statutes 2016, section 256B.4914, subdivision 6, is amended to read:
33.6 		Subd. 6.Payments for residential support services. (a) Payments for residential support 
33.7 	services, as defined in sections 256B.092, subdivision 11, and 256B.49, subdivision 22, 
33.8 	must be calculated as follows:
33.9 	(1) determine the number of shared staffing and individual direct staff hours to meet a 
33.10 	recipient's needs provided on site or through monitoring technology;
33.11 	(2) personnel hourly wage rate must be based on the 2009 Bureau of Labor Statistics 
33.12 	Minnesota-specific rates or rates derived by the commissioner as provided in subdivision 
33.13 	5. This is defined as the direct-care rate;
33.14 	(3) for a recipient requiring customization for deaf and hard-of-hearing language 
33.15 	accessibility under subdivision 12, add the customization rate provided in subdivision 12 
33.16 	to the result of clause (2). This is defined as the customized direct-care rate;
33.17 	(4) multiply the number of shared and individual direct staff hours provided on site or 
33.18 	through monitoring technology and nursing hours by the appropriate staff wages in 
33.19 	subdivision 5, paragraph (a), or the customized direct-care rate;
33.20 	(5) multiply the number of shared and individual direct staff hours provided on site or 
33.21 	through monitoring technology and nursing hours by the product of the supervision span 
33.22 	of control ratio in subdivision 5, paragraph (b), clause (1), and the appropriate supervision 
33.23 	wage in subdivision 5, paragraph (a), clause (16);
33.24 	(6) combine the results of clauses (4) and (5), excluding any shared and individual direct 
33.25 	staff hours provided through monitoring technology, and multiply the result by one plus 
33.26 	the employee vacation, sick, and training allowance ratio in subdivision 5, paragraph (b), 
33.27 	clause (2). This is defined as the direct staffing cost;
33.28 	(7) for employee-related expenses, multiply the direct staffing cost, excluding any shared 
33.29 	and individual direct staff hours provided through monitoring technology, by one plus the 
33.30 	employee-related cost ratio in subdivision 5, paragraph (b), clause (3);
33.31 	(8) for client programming and supports, the commissioner shall add $2,179; and
34.1 	(9) for transportation, if provided, the commissioner shall add $1,680, or $3,000 if 
34.2 	customized for adapted transport, based on the resident with the highest assessed need.
34.3 	(b) The total rate must be calculated using the following steps:
34.4 	(1) subtotal paragraph (a), clauses (7) to (9), and the direct staffing cost of any shared 
34.5 	and individual direct staff hours provided through monitoring technology that was excluded 
34.6 	in clause (7);
34.7 	(2) sum the standard general and administrative rate, the program-related expense ratio, 
34.8 	and the absence and utilization ratio;
34.9 	(3) divide the result of clause (1) by one minus the result of clause (2). This is the total 
34.10 	payment amount; and
34.11 	(4) adjust the result of clause (3) by a factor to be determined by the commissioner to 
34.12 	adjust for regional differences in the cost of providing services.
34.13 	(c) The payment methodology for customized living, 24-hour customized living, and 
34.14 	residential care services must be the customized living tool. Revisions to the customized 
34.15 	living tool must be made to reflect the services and activities unique to disability-related 
34.16 	recipient needs.
34.17 	(d) For individuals enrolled prior to January 1, 2014, the days of service authorized must 
34.18 	meet or exceed the days of service used to convert service agreements in effect on December 
34.19 	1, 2013, and must not result in a reduction in spending or service utilization due to conversion 
34.20 	during the implementation period under section 256B.4913, subdivision 4a. If during the 
34.21 	implementation period, an individual's historical rate, including adjustments required under 
34.22 	section 256B.4913, subdivision 4a, paragraph (c), is equal to or greater than the rate 
34.23 	determined in this subdivision, the number of days authorized for the individual is 365.
34.24 	(e) The number of days authorized for all individuals enrolling after January 1, 2014, 
34.25 	in residential services must include every day that services start and end.
34.26 	(f) Beginning January 1, 2018, for foster care and supportive living services provided 
34.27 	in a corporate setting and with rates calculated in this section, the number of days authorized 
34.28 	must not exceed 350 days in an annual service span.

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

34.30 	Sec. 20. Minnesota Statutes 2016, section 256B.4914, subdivision 8, is amended to read:
34.31 		Subd. 8.Payments for unit-based services with programming. Payments for unit-based 
34.32 	services with programming, including behavior programming, housing access coordination, 
35.1 	in-home family support, independent living skills training, independent living skills specialist 
35.2 	services, individualized home supports, hourly supported living services, employment 
35.3 	exploration services, employment development services, and supported employment support 
35.4 	services provided to an individual outside of any day or residential service plan must be 
35.5 	calculated as follows, unless the services are authorized separately under subdivision 6 or 
35.6 	7:
35.7 	(1) determine the number of units of service to meet a recipient's needs;
35.8 	(2) personnel hourly wage rate must be based on the 2009 Bureau of Labor Statistics 
35.9 	Minnesota-specific rates or rates derived by the commissioner as provided in subdivision 
35.10 	5;
35.11 	(3) for a recipient requiring customization for deaf and hard-of-hearing language 
35.12 	accessibility under subdivision 12, add the customization rate provided in subdivision 12 
35.13 	to the result of clause (2). This is defined as the customized direct-care rate;
35.14 	(4) multiply the number of direct staff hours by the appropriate staff wage in subdivision 
35.15 	5, paragraph (a), or the customized direct-care rate;
35.16 	(5) multiply the number of direct staff hours by the product of the supervision span of 
35.17 	control ratio in subdivision 5, paragraph (e), clause (1), and the appropriate supervision 
35.18 	wage in subdivision 5, paragraph (a), clause (16);
35.19 	(6) combine the results of clauses (4) and (5), and multiply the result by one plus the 
35.20 	employee vacation, sick, and training allowance ratio in subdivision 5, paragraph (e), clause 
35.21 	(2). This is defined as the direct staffing rate;
35.22 	(7) for program plan support, multiply the result of clause (6) by one plus the program 
35.23 	plan supports ratio in subdivision 5, paragraph (e), clause (4);
35.24 	(8) for employee-related expenses, multiply the result of clause (7) by one plus the 
35.25 	employee-related cost ratio in subdivision 5, paragraph (e), clause (3);
35.26 	(9) for client programming and supports, multiply the result of clause (8) by one plus 
35.27 	the client programming and supports ratio in subdivision 5, paragraph (e), clause (5);
35.28 	(10) this is the subtotal rate;
35.29 	(11) sum the standard general and administrative rate, the program-related expense ratio, 
35.30 	and the absence and utilization factor ratio;
35.31 	(12) divide the result of clause (10) by one minus the result of clause (11). This is the 
35.32 	total payment amount;
36.1 	(13) for supported employment support services provided in a shared manner, divide 
36.2 	the total payment amount in clause (12) by the number of service recipients, not to exceed 
36.3 	three six. For independent living skills training provided in a shared manner, divide the total 
36.4 	payment amount in clause (12) by the number of service recipients, not to exceed two; and
36.5 	(14) adjust the result of clause (13) by a factor to be determined by the commissioner 
36.6 	to adjust for regional differences in the cost of providing services.

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

36.8 	Sec. 21. Minnesota Statutes 2016, section 256B.4914, subdivision 10, is amended to read:
36.9 		Subd. 10.Updating payment values and additional information. (a) From January 
36.10 	1, 2014, through December 31, 2017, the commissioner shall develop and implement uniform 
36.11 	procedures to refine terms and adjust values used to calculate payment rates in this section.
36.12 	(b) No later than July 1, 2014, the commissioner shall, within available resources, begin 
36.13 	to conduct research and gather data and information from existing state systems or other 
36.14 	outside sources on the following items:
36.15 	(1) differences in the underlying cost to provide services and care across the state; and
36.16 	(2) mileage, vehicle type, lift requirements, incidents of individual and shared rides, and 
36.17 	units of transportation for all day services, which must be collected from providers using 
36.18 	the rate management worksheet and entered into the rates management system; and
36.19 	(3) the distinct underlying costs for services provided by a license holder under sections 
36.20 	245D.05, 245D.06, 245D.07, 245D.071, 245D.081, and 245D.09, and for services provided 
36.21 	by a license holder certified under section 245D.33.
36.22 	(c) Beginning January 1, 2014, through December 31, 2018, using a statistically valid 
36.23 	set of rates management system data, the commissioner, in consultation with stakeholders, 
36.24 	shall analyze for each service the average difference in the rate on December 31, 2013, and 
36.25 	the framework rate at the individual, provider, lead agency, and state levels. The 
36.26 	commissioner shall issue semiannual reports to the stakeholders on the difference in rates 
36.27 	by service and by county during the banding period under section 256B.4913, subdivision 
36.28 	4a. The commissioner shall issue the first report by October 1, 2014, and the final report 
36.29 	shall be issued by December 31, 2018.
36.30 	(d) No later than July 1, 2014, the commissioner, in consultation with stakeholders, shall 
36.31 	begin the review and evaluation of the following values already in subdivisions 6 to 9, or 
36.32 	issues that impact all services, including, but not limited to:
37.1 	(1) values for transportation rates for day services;
37.2 	(2) values for transportation rates in residential services;
37.3 	(3) (2) values for services where monitoring technology replaces staff time;
37.4 	(4) (3) values for indirect services;
37.5 	(5) (4) values for nursing;
37.6 	(6) component values for independent living skills;
37.7 	(7) component values for family foster care that reflect licensing requirements;
37.8 	(8) adjustments to other components to replace the budget neutrality factor;
37.9 	(9) remote monitoring technology for nonresidential services;
37.10 	(10) values for basic and intensive services in residential services;
37.11 	(11) (5) values for the facility use rate in day services, and the weightings used in the 
37.12 	day service ratios and adjustments to those weightings;
37.13 	(12) (6) values for workers' compensation as part of employee-related expenses;
37.14 	(13) (7) values for unemployment insurance as part of employee-related expenses;
37.15 	(14) a component value to reflect costs for individuals with rates previously adjusted 
37.16 	for the inclusion of group residential housing rate 3 costs, only for any individual enrolled 
37.17 	as of December 31, 2013; and
37.18 	(15) (8) any changes in state or federal law with an a direct impact on the underlying 
37.19 	cost of providing home and community-based services.; and
37.20 	(9) outcome measures, determined by the commissioner, for home and community-based 
37.21 	services rates determined under this section.
37.22 	(e) The commissioner shall report to the chairs and the ranking minority members of 
37.23 	the legislative committees and divisions with jurisdiction over health and human services 
37.24 	policy and finance with the information and data gathered under paragraphs (b) to (d) on 
37.25 	the following dates:
37.26 	(1) January 15, 2015, with preliminary results and data;
37.27 	(2) January 15, 2016, with a status implementation update, and additional data and 
37.28 	summary information;
37.29 	(3) January 15, 2017, with the full report; and
38.1 	(4) January 15, 2019 2020, with another full report, and a full report once every four 
38.2 	years thereafter.
38.3 	(f) Based on the commissioner's evaluation of the information and data collected in 
38.4 	paragraphs (b) to (d), the commissioner shall make recommendations to the legislature by 
38.5 	January 15, 2015, to address any issues identified during the first year of implementation. 
38.6 	After January 15, 2015, the commissioner may make recommendations to the legislature 
38.7 	to address potential issues.
38.8 	(g) (f) The commissioner shall implement a regional adjustment factor to all rate 
38.9 	calculations in subdivisions 6 to 9, effective no later than January 1, 2015. Beginning July 
38.10 	1, 2017, the commissioner shall renew analysis and implement changes to the regional 
38.11 	adjustment factors when adjustments required under subdivision 5, paragraph (h), occur. 
38.12 	Prior to implementation, the commissioner shall consult with stakeholders on the 
38.13 	methodology to calculate the adjustment.
38.14 	(h) (g) The commissioner shall provide a public notice via LISTSERV in October of 
38.15 	each year beginning October 1, 2014, containing information detailing legislatively approved 
38.16 	changes in:
38.17 	(1) calculation values including derived wage rates and related employee and 
38.18 	administrative factors;
38.19 	(2) service utilization;
38.20 	(3) county and tribal allocation changes; and
38.21 	(4) information on adjustments made to calculation values and the timing of those 
38.22 	adjustments.
38.23 	The information in this notice must be effective January 1 of the following year.
38.24 	(i) No later than July 1, 2016, the commissioner shall develop and implement, in 
38.25 	consultation with stakeholders, a methodology sufficient to determine the shared staffing 
38.26 	levels necessary to meet, at a minimum, health and welfare needs of individuals who will 
38.27 	be living together in shared residential settings, and the required shared staffing activities 
38.28 	described in subdivision 2, paragraph (l). This determination methodology must ensure 
38.29 	staffing levels are adaptable to meet the needs and desired outcomes for current and 
38.30 	prospective residents in shared residential settings.
38.31 	(j) (h) When the available shared staffing hours in a residential setting are insufficient 
38.32 	to meet the needs of an individual who enrolled in residential services after January 1, 2014, 
38.33 	or insufficient to meet the needs of an individual with a service agreement adjustment 
39.1 	described in section 256B.4913, subdivision 4a, paragraph (f), then individual staffing hours 
39.2 	shall be used.

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

39.4 	Sec. 22. Minnesota Statutes 2016, section 256B.85, subdivision 16, is amended to read:
39.5 		Subd. 16.Support workers requirements. (a) Support workers shall:
39.6 	(1) enroll with the department as a support worker after a background study under chapter 
39.7 	245C has been completed and the support worker has received a notice from the 
39.8 	commissioner that the support worker:
39.9 	(i) is not disqualified under section 245C.14; or
39.10 	(ii) is disqualified, but has received a set-aside of the disqualification under section 
39.11 	245C.22;
39.12 	(2) have the ability to effectively communicate with the participant or the participant's 
39.13 	representative;
39.14 	(3) have the skills and ability to provide the services and supports according to the 
39.15 	participant's CFSS service delivery plan and respond appropriately to the participant's needs;
39.16 	(4) complete the basic standardized CFSS training as determined by the commissioner 
39.17 	before completing enrollment. The training must be available in languages other than English 
39.18 	and to those who need accommodations due to disabilities. CFSS support worker training 
39.19 	must include successful completion of the following training components: basic first aid, 
39.20 	vulnerable adult, child maltreatment, OSHA universal precautions, basic roles and 
39.21 	responsibilities of support workers including information about basic body mechanics, 
39.22 	emergency preparedness, orientation to positive behavioral practices, orientation to 
39.23 	responding to a mental health crisis, fraud issues, time cards and documentation, and an 
39.24 	overview of person-centered planning and self-direction. Upon completion of the training 
39.25 	components, the support worker must pass the certification test to provide assistance to 
39.26 	participants;
39.27 	(5) complete employer-directed training and orientation on the participant's individual 
39.28 	needs;
39.29 	(6) maintain the privacy and confidentiality of the participant; and
39.30 	(7) not independently determine the medication dose or time for medications for the 
39.31 	participant.
40.1 	(b) The commissioner may deny or terminate a support worker's provider enrollment 
40.2 	and provider number if the support worker:
40.3 	(1) does not meet the requirements in paragraph (a);
40.4 	(2) fails to provide the authorized services required by the employer;
40.5 	(3) has been intoxicated by alcohol or drugs while providing authorized services to the 
40.6 	participant or while in the participant's home;
40.7 	(4) has manufactured or distributed drugs while providing authorized services to the 
40.8 	participant or while in the participant's home; or
40.9 	(5) has been excluded as a provider by the commissioner of human services, or by the 
40.10 	United States Department of Health and Human Services, Office of Inspector General, from 
40.11 	participation in Medicaid, Medicare, or any other federal health care program.
40.12 	(c) A support worker may appeal in writing to the commissioner to contest the decision 
40.13 	to terminate the support worker's provider enrollment and provider number.
40.14 	(d) A support worker must not provide or be paid for more than 275 310 hours of CFSS 
40.15 	per month, regardless of the number of participants the support worker serves or the number 
40.16 	of agency-providers or participant employers by which the support worker is employed. 
40.17 	The department shall not disallow the number of hours per day a support worker works 
40.18 	unless it violates other law.

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

40.20 	Sec. 23. Minnesota Statutes 2016, section 256C.21, is amended to read:
40.21 	256C.21 DEAF AND HARD-OF-HEARING SERVICES ACT; CITATION.
40.22 	Sections 256C.21 to 256C.26 256C.30 may be cited as the "Deaf and Hard-of-Hearing 
40.23 	Services Act."

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

40.25 	Sec. 24. Minnesota Statutes 2016, section 256C.23, subdivision 1, is amended to read:
40.26 		Subdivision 1.Scope. For the purposes of sections 256C.21 to 256C.26 256C.30, the 
40.27 	terms defined in this section shall have the meanings given them, unless the context clearly 
40.28 	indicates otherwise.

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

41.1 	Sec. 25. Minnesota Statutes 2016, section 256C.23, is amended by adding a subdivision 
41.2 	to read:
41.3 		Subd. 1a.Culturally affirmative services. "Culturally affirmative services" means 
41.4 	services that are designed and delivered within the context of the culture, language, and life 
41.5 	experience of a person who is deaf, a person who is deafblind, and a person who is 
41.6 	hard-of-hearing.

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

41.8 	Sec. 26. Minnesota Statutes 2016, section 256C.23, subdivision 2, is amended to read:
41.9 		Subd. 2.Deaf. "Deaf" means a hearing loss of such severity that the individual must 
41.10 	depend primarily on visual communication such as writing, lip reading, manual 
41.11 	communication, and American Sign Language or other signed languages, visual and manual 
41.12 	means of communication such as signing systems in English or Cued Speech, or gestures.

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

41.14 	Sec. 27. Minnesota Statutes 2016, section 256C.23, is amended by adding a subdivision 
41.15 	to read:
41.16 		Subd. 2c.Interpreting services. "Interpreting services" means services that include:
41.17 	(1) interpreting between a spoken language such as English and a visual language such 
41.18 	as American Sign Language;
41.19 	(2) interpreting between a spoken language and a visual representation of a spoken 
41.20 	language such as Cued Speech and signing systems in English;
41.21 	(3) interpreting within one language where the interpreter uses natural gestures and 
41.22 	silently repeats the spoken message, replacing some words or phrases to give higher visibility 
41.23 	on the lips; and
41.24 	(4) interpreting using low vision or tactile methods for people who have a combined 
41.25 	hearing and vision loss or are deafblind.

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

41.27 	Sec. 28. Minnesota Statutes 2016, section 256C.233, subdivision 1, is amended to read:
41.28 		Subdivision 1.Deaf and Hard-of-Hearing Services Division. The commissioners
41.29 	commissioner of human services, education, employment and economic development, and 
41.30 	health shall create a distinct and separate an organizational unit to be known as the Deaf 
42.1 	and Hard-of-Hearing Services Division to address the developmental, social, educational, 
42.2 	and occupational mental health, communication access, and human service needs of persons 
42.3 	who are deaf, persons who are deafblind, and persons who are hard-of-hearing persons
42.4 	through a statewide network of collaborative services and by coordinating the promulgation 
42.5 	of implementing public policies, regulations, legislation, services, and programs affecting 
42.6 	persons who are deaf, persons who are deafblind, and persons who are hard-of-hearing 
42.7 	persons. An interdepartmental management team shall advise the activities of the Deaf and 
42.8 	Hard-of-Hearing Services Division. The commissioner of human services shall coordinate 
42.9 	the work of the interagency management team and receive legislative appropriations for 
42.10 	the division.

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

42.12 	Sec. 29. Minnesota Statutes 2016, section 256C.233, subdivision 2, is amended to read:
42.13 		Subd. 2.Responsibilities. The Deaf and Hard-of-Hearing Services Division shall:
42.14 	(1) establish and maintain a statewide network of regional service centers culturally 
42.15 	affirmative services  for Minnesotans who are deaf, Minnesotans who are deafblind, and
42.16 	Minnesotans who are hard-of-hearing Minnesotans;
42.17 	(2) assist the Departments of Human Services, Education, and Employment and Economic 
42.18 	Development other state agencies to coordinate the promulgation and implementation of 
42.19 	public policies, regulations, legislation, programs, and services affecting persons who are 
42.20 	deaf,  persons who are deafblind, and persons who are hard-of-hearing persons; and
42.21 	(3) provide a coordinated system of statewide interpreting or interpreter referral services
42.22 	oversee and manage grant-funded services for persons who are deaf, persons who are 
42.23 	deafblind, and persons who are hard-of-hearing and a person's family as provided in sections 
42.24 	237.23, 256C.25, 256C.261, 256C.30 and as appropriated by the legislature; and
42.25 	(4) meet as a team with the commissioners of education, employment and economic 
42.26 	development, and health or the commissioners' designees at least three times per year to 
42.27 	coordinate the promulgation and implementation of public policies, regulations, programs, 
42.28 	and services affecting persons who are deaf, persons who are deafblind, and persons who 
42.29 	are hard-of-hearing.

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

43.1 	Sec. 30. Minnesota Statutes 2016, section 256C.233, subdivision 4, is amended to read:
43.2 		Subd. 4.State commissioners. The commissioners of all state agencies shall consult 
43.3 	with the Deaf and Hard-of-Hearing Services Division concerning the promulgation of public 
43.4 	policies, regulations, and programs necessary to address the needs of Minnesotans who are 
43.5 	deaf, Minnesotans who are deafblind, and Minnesotans who are hard-of-hearing Minnesotans. 
43.6 	Each state agency shall consult with the Deaf and Hard-of-Hearing Services Division 
43.7 	concerning the need to forward legislative initiatives to the governor to address the concerns 
43.8 	of Minnesotans who are deaf, Minnesotans who are deafblind, and Minnesotans who are 
43.9 	hard-of-hearing Minnesotans.

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

43.11 	Sec. 31. Minnesota Statutes 2016, section 256C.24, is amended to read:
43.12 	256C.24 REGIONAL SERVICE CENTERS SERVICES.
43.13 		Subdivision 1.Location. The Deaf and Hard-of-Hearing Services Division shall establish 
43.14 	up to eight regional service centers statewide services for people who are deaf and, people 
43.15 	who are deafblind, and people who are hard-of-hearing persons. The centers services shall 
43.16 	be distributed regionally to provide access for people who are deaf, people who are deafblind, 
43.17 	and people who are hard-of-hearing persons in all parts of the state.
43.18 		Subd. 2.Responsibilities. Each regional service center The Deaf and Hard-of-Hearing 
43.19 	Services Division shall:
43.20 	(1) serve as a central entry point for deaf, deafblind, and hard-of-hearing persons in need 
43.21 	of services and make referrals to the services needed provide culturally affirmative direct 
43.22 	assistance to a person who is deaf, a person who is deafblind, and a person who is 
43.23 	hard-of-hearing and the person's family to improve the person's communication access and 
43.24 	quality of life at home and in the community. Direct assistance may be provided using 
43.25 	technology only in areas of the state when a person has access to sufficient quality 
43.26 	telecommunications or broadband services to allow effective communication. When a person 
43.27 	who is deaf, a person who is deafblind, or a person who is hard-of-hearing only has access 
43.28 	to insufficient telecommunications or broadband service, direct assistance shall be available 
43.29 	in person. Direct assistance may include:
43.30 	(i) teaching communication strategies and coping skills;
43.31 	(ii) offering guidance and problem solving assistance;
43.32 	(iii) making referrals related to enhancing a person's independence;
44.1 	(iv) providing information and assistance to support the person's ability to be 
44.2 	self-sufficient and live independently; and
44.3 	(v) identifying technology solutions to improve access to communication and to 
44.4 	environmental information;
44.5 	(2) employ staff trained to work with persons who are deaf,  persons who are deafblind, 
44.6 	and persons who are hard-of-hearing persons;
44.7 	(3) provide to all deaf, deafblind, and hard-of-hearing persons access to interpreter 
44.8 	services which are necessary to help them obtain services;
44.9 	(4) implement a plan to provide loaned equipment and resource materials to deaf, 
44.10 	deafblind, and hard-of-hearing persons;
44.11 	(5) cooperate with (3) advise responsible departments and administrative authorities to 
44.12 	provide about providing access for persons who are deaf, persons who are deafblind, and
44.13 	persons who are hard-of-hearing persons to services provided by state, county, and regional
44.14 	and local agencies;
44.15 	(6) collaborate with the Resource Center for the Deaf and Hard-of-Hearing Persons, 
44.16 	other divisions of the Department of Education, and local school districts to develop and 
44.17 	deliver programs and services for families with deaf, deafblind, or hard-of-hearing children 
44.18 	and to support school personnel serving these children;
44.19 	(7) when possible, provide training to the social service or income maintenance staff 
44.20 	employed by counties or by organizations with whom counties contract for services to 
44.21 	ensure that communication barriers which prevent deaf, deafblind, and hard-of-hearing 
44.22 	persons from using services are removed;
44.23 	(8) when possible, provide training to state and regional human service agencies regarding 
44.24 	program access for deaf, deafblind, and hard-of-hearing persons; and
44.25 	(4) provide training and technical assistance to county, state, regional, and local agencies, 
44.26 	and others on hearing loss, deaf culture, assistive technology, and other related topics to 
44.27 	ensure that programs and services are accessible to persons who are deaf, persons who are 
44.28 	deafblind, and persons who are hard-of-hearing;
44.29 	(5) provide training to persons who are deaf, persons who are deafblind, and persons 
44.30 	who are hard-of-hearing to develop the skills and knowledge needed to advocate for 
44.31 	communication access and service needs;
45.1 	(9) (6) assess the ongoing need and supply of services for persons who are deaf, persons 
45.2 	who are deafblind, and persons who are hard-of-hearing persons in all parts of the state and 
45.3 	cooperate with public and private service providers to develop these services.
45.4 	(7) provide culturally affirmative mental health services for persons who are deaf, persons 
45.5 	who are deafblind, and persons who are hard-of-hearing;
45.6 	(8) provide telecommunications devices to a Minnesotan with a communication disability 
45.7 	according to sections 237.51 to 237.56; and
45.8 	(9) assess requests from provisionally certified educational interpreters and transliterators 
45.9 	for onetime limited certification extensions according to section 122A.31.
45.10 		Subd. 3.Advisory committee. The director of the Deaf and Hard-of-Hearing Services 
45.11 	Division shall appoint an advisory committee eight advisory committees of up to nine 
45.12 	persons for each regional service area per advisory committee. Each committee shall represent 
45.13 	a specific region of the state. The director shall determine the boundaries of each advisory 
45.14 	committee region. The committees shall advise the director on the needs of persons who 
45.15 	are deaf, persons who are deafblind, and persons who are hard-of-hearing and service gaps 
45.16 	in the region of the state the committee represents. Members shall include persons who are 
45.17 	deaf, persons who are deafblind, and persons who are hard-of-hearing, persons who have 
45.18 	communication disabilities, parents of children who are deaf and parents of children who 
45.19 	are hard-of-hearing, parents of children who have communication disabilities, and 
45.20 	representatives of county and regional human services, including representatives of private 
45.21 	service providers. At least 50 percent of the members must be deaf or deafblind or 
45.22 	hard-of-hearing or have a communication disability. Committee members shall serve for a 
45.23 	three-year term and shall serve no more than two consecutive terms. Each advisory committee 
45.24 	shall elect a chair. The director of the Deaf and Hard-of-Hearing Services Division shall 
45.25 	assign staff to serve as nonvoting members of the committee. Members shall not receive a 
45.26 	per diem. Otherwise, the compensation, removal of members, and filling of vacancies on 
45.27 	the committee shall be as provided in section 15.0575.

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

45.29 	Sec. 32. Minnesota Statutes 2016, section 256C.25, subdivision 1, is amended to read:
45.30 		Subdivision 1.Establishment Duties. (a) The Deaf and Hard-of-Hearing Services 
45.31 	Division shall maintain and coordinate statewide interpreting or interpreter referral services 
45.32 	fora statewide information source about available interpreting services for a person who is 
46.1 	deaf, a person who is deafblind, and a person who is hard-of-hearing. The information 
46.2 	source shall be available for use by any public or private agency or individual in the state.
46.3 	(b) The division shall identify areas of the state where there are shortages of qualified 
46.4 	interpreting services and develop strategies for addressing the shortages. The division shall 
46.5 	directly coordinate these services but may contract with an appropriate agency to provide 
46.6 	this service implement the strategies. The division may collect a $3 fee per referral for 
46.7 	interpreter referral services and the actual costs of interpreter services provided by department 
46.8 	staff. Fees and payments collected shall be deposited in the general fund. The $3 referral 
46.9 	fee shall not be collected from state agencies or local units of government or deaf or 
46.10 	hard-of-hearing consumers or interpreters.

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

46.12 	Sec. 33. Minnesota Statutes 2016, section 256C.261, is amended to read:
46.13 	256C.261 SERVICES FOR A PERSON WHO IS DEAFBLIND PERSONS.
46.14 	(a) The commissioner of human services shall combine the existing biennial base level 
46.15 	funding for deafblind services into a single grant program. At least 35 percent of the total 
46.16 	funding is awarded for services and other supports to deafblind children and their families 
46.17 	and at least 25 percent is awarded for services and other supports to deafblind adults. The 
46.18 	commissioner of human services shall use at least 35 percent of the deafblind services 
46.19 	biennial base level grant funding for services and other supports for a child who is deafblind 
46.20 	and the child's family. The commissioner shall use at least 25 percent of the deafblind 
46.21 	services biennial base level grant funding for services and other supports for an adult who 
46.22 	is deafblind.
46.23 	The commissioner shall award grants for the purposes of:
46.24 	(1) providing services and supports to individuals who are deafblind; and
46.25 	(2) developing and providing training to counties and the network of senior citizen 
46.26 	service providers. The purpose of the training grants is to teach counties how to use existing 
46.27 	programs that capture federal financial participation to meet the needs of eligible deafblind 
46.28 	persons and to build capacity of senior service programs to meet the needs of seniors with 
46.29 	a dual sensory hearing and vision loss.
46.30 	(b) The commissioner may make grants:
46.31 	(1) for services and training provided by organizations; and
46.32 	(2) to develop and administer consumer-directed services.
47.1 	(c) Any entity that is able to satisfy the grant criteria is eligible to receive a grant under 
47.2 	paragraph (a).
47.3 	(d) Deafblind service providers may, but are not required to, provide intervenor intervener
47.4 	services as part of the service package provided with grant funds under this section.

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

47.6 	Sec. 34. Minnesota Statutes 2016, section 256C.30, is amended to read:
47.7 	256C.30 DUTIES OF HUMAN SERVICES COMMISSIONER.
47.8 	(a) As described in this section, the commissioner of human services must enter into 
47.9 	grant agreements with television stations to make live local news programming accessible 
47.10 	to persons who are deaf, persons who are hard-of-hearing, and persons who are deafblind 
47.11 	persons as defined in section 256C.23.
47.12 	(b) The grant agreements must provide for:
47.13 	(1) real-time captioning services for broadcasting that is not emergency broadcasting 
47.14 	subject to Code of Federal Regulations, title 47, section 79.2;
47.15 	(2) real-time captioning services for commercial broadcasters in areas of Minnesota 
47.16 	where commercial broadcasters are not subject to the live programming closed-captioning 
47.17 	requirements of Code of Federal Regulations, title 47, section 79.1(d); and
47.18 	(3) real-time captioning for large-market noncommercial broadcasters who produce live 
47.19 	news programming.
47.20 	(c) For the purposes of this section, "real-time captioning" means a method of captioning 
47.21 	in which captions are simultaneously prepared and transmitted at the time of origination by 
47.22 	specially trained real-time captioners.

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

47.24 	Sec. 35. FEDERAL WAIVER AMENDMENTS.
 47.25 	The commissioner of human services shall submit necessary waiver amendments to the 
47.26 	Centers for Medicare and Medicaid Services to add employment exploration services, 
47.27 	employment development services, and employment support services to the home and 
47.28 	community-based services waivers authorized under Minnesota Statutes, sections 256B.092 
47.29 	and 256B.49. The commissioner shall also submit necessary waiver amendments to remove 
47.30 	community-based employment services from day training and habilitation and prevocational 
48.1 	services. The commissioner shall submit all necessary waiver amendments by October 1, 
48.2 	2017.

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

48.4 	Sec. 36. TRANSPORTATION STUDY.
 48.5 	The commissioner of human services, with cooperation from lead agencies and in 
48.6 	consultation with stakeholders, shall conduct a study to identify opportunities to increase 
48.7 	access to transportation services for an individual who receives home and community-based 
48.8 	services. The commissioner shall submit a report with recommendations to the chairs and 
48.9 	ranking minority members of the legislative committees with jurisdiction over human 
48.10 	services by January 15, 2019. The report shall:
48.11 	(1) study all aspects of the current transportation service network, including the fleet 
48.12 	available, the different rate-setting methods currently used, methods that an individual uses 
48.13 	to access transportation, and the diversity of available provider agencies;
48.14 	(2) identify current barriers for an individual accessing transportation and for a provider 
48.15 	providing waiver services transportation in the marketplace;
48.16 	(3) identify efficiencies and collaboration opportunities to increase available 
48.17 	transportation, including transportation funded by medical assistance, and available regional 
48.18 	transportation and transit options;
48.19 	(4) study transportation solutions in other states for delivering home and community-based 
48.20 	services;
48.21 	(5) study provider costs required to administer transportation services;
48.22 	(6) make recommendations for coordinating and increasing transportation accessibility 
48.23 	across the state; and
48.24 	(7) make recommendations for the rate setting of waivered transportation.

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

48.26 	Sec. 37. RATE INCREASE FOR SELF-DIRECTED WORKFORCE 
48.27 	NEGOTIATIONS.
 48.28 	(a) The commissioner of human services shall:
48.29 	(1) increase reimbursement rates, grants, or allocations by 3.09 percent for services 
48.30 	provided on or after July 1, 2017;
49.1 	(2) increase reimbursement rates, grants, or allocations by 0.1 percent for services 
49.2 	provided on or after July 1, 2018; and
49.3 	(3) increase the reimbursement rates, grants, or allocations by an additional ten percent 
49.4 	for services provided on or after July 1, 2018, for service recipients with complex needs, 
49.5 	defined as recipients with eligibility for 12 or more hours of personal care assistance services 
49.6 	per day according to Minnesota Statutes, section 256B.0652.
49.7 	(b) The rate changes described in this section apply to direct support services provided 
49.8 	through a covered program, as defined by Minnesota Statutes, section 256B.0711, subdivision 
49.9 	1, paragraph (b).

49.10 	EFFECTIVE DATE. This section is effective if the labor agreement between the state 
49.11 	and SEIU Healthcare Minnesota according to Laws 2013, chapter 128, article 2, is ratified 
49.12 	by the legislature. The commissioner of human services shall notify the revisor of statutes 
49.13 	when ratification occurs.

49.14 	Sec. 38. FEDERAL WAIVER REQUESTS.
 49.15 	The commissioner of human services shall submit necessary waiver amendments to the 
49.16 	Centers for Medicare and Medicaid Services to add employment exploration services, 
49.17 	employment development services, and employment support services to the home and 
49.18 	community-based services waiver authorized under Minnesota Statutes, sections 256B.092 
49.19 	and 256B.49. The commissioner shall also submit necessary waiver amendments to remove 
49.20 	community-based employment from day training and habilitation and prevocational services. 
49.21 	The commissioner shall submit the necessary waiver amendments by October 1, 2017.

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

49.23 	Sec. 39.  REPEALER.
 49.24 	(a) Minnesota Statutes 2016, sections 252.451; 256B.4914, subdivision 16; 256C.23, 
49.25 	subdivision 3; and 256C.25, subdivision 2, are repealed.
49.26 	(b) Minnesota Statutes 2016, section 252.41, subdivision 8, is repealed.
49.27 	(c) Minnesota Statutes 2016, section 256B.64, is repealed.

49.28 	EFFECTIVE DATE. Paragraph (a) is effective the day following final enactment. 
49.29 	Paragraph (b) is effective when sections 2, 3, and 16 become effective. The commissioner 
49.30 	of human services shall notify the revisor of statutes when sections 2, 3, and 16 are effective. 
49.31 	Paragraph (c) is effective July 1, 2017.

50.1 	ARTICLE 2
50.2 	HOUSING

50.3 	Section 1. [256B.051] HOUSING SUPPORT SERVICES.
50.4 		Subdivision 1.Purpose. Housing support services are established to provide housing 
50.5 	support services to an individual with a disability that limits the individual's ability to obtain 
50.6 	or maintain stable housing. The services support an individual's transition to housing in the 
50.7 	community and increases long-term stability in housing, to avoid future periods of being at 
50.8 	risk of homelessness or institutionalization.
50.9 		Subd. 2.Definitions. (a) For the purposes of this section, the terms defined in this 
50.10 	subdivision have the meanings given.
50.11 	(b) "At-risk of homelessness" means (1) an individual that is faced with a  set of 
50.12 	circumstances likely to cause the individual to become homeless, or (2) an individual 
50.13 	previously homeless, who will be discharged from a correctional, medical, mental health, 
50.14 	or treatment center, who lacks sufficient resources to pay for housing and does not have a 
50.15 	permanent place to live.
50.16 	(c) "Commissioner" means the commissioner of human services.
50.17 	(d) "Homeless" means an individual or family lacking a fixed, adequate nighttime 
50.18 	residence.
50.19 	(e) "Individual with a disability" means:
50.20 	(1) an individual who is aged, blind, or disabled as determined by the criteria used by 
50.21 	the title 11 program of the Social Security Act, United States Code, title 42, section 416, 
50.22 	paragraph (i), item (1); or
50.23 	(2) an individual who meets a category of eligibility under section 256D.05, subdivision 
50.24 	1, paragraph (a), clauses (1), (3), (5) to (9), or (14).
50.25 	(f) "Institution" means a setting as defined in section 256B.0621, subdivision 2, clause 
50.26 	(3), and the Minnesota Security Hospital as defined in section 253.20.
50.27 	(g) "Segregated setting" means:
50.28 	(1) a registered housing with services establishment under chapter 144D;
50.29 	(2) a licensed board and lodge facility;
50.30 	(3) a licensed boarding care facility;
50.31 	(4) a licensed adult foster care;
51.1 	(5) intensive residential treatment (IRTs); or
51.2 	(6) a supervised living facility.
51.3 		Subd. 3.Eligibility. An individual with a disability is eligible for housing support services 
51.4 	if the individual:
51.5 	(1) is 18 years of age or older;
51.6 	(2) is enrolled in medical assistance;
51.7 	(3) has an assessment of functional need that determines a need for services due to 
51.8 	limitations caused by the individual's disability;
51.9 	(4) resides in or plans to transition to a community-based setting as defined in Code of 
51.10 	Federal Regulations, title 42, section 441.301(c); and
51.11 	(5) has housing instability evidenced by:
51.12 	(i) being homeless or at-risk of homelessness;
51.13 	(ii) being in the process of transitioning from, or having transitioned in the past six 
51.14 	months from, an institution or segregated setting;
51.15 	(iii) being eligible for waiver services under section 256B.0915, 256B.092, or 256B.49; 
51.16 	or
51.17 	(iv) having been identified by a long-term care consultation under section 256B.0911 
51.18 	as at risk of institutionalization.
51.19 		Subd. 4.Assessment requirements. (a) An individual's assessment of functional need 
51.20 	must be conducted by one of the following methods:
51.21 	(1) a certified assessor according to the criteria established in section 256B.0911, 
51.22 	subdivision 3a, using a format established by the commissioner;
51.23 	(2) documented need for services as verified by a professional statement of need as 
51.24 	defined in section 256I.03, subdivision 12; or
51.25 	(3) according to the continuum of care coordinated assessment system established in 
51.26 	Code of Federal Regulations, title 24, section 578.3, using a format established by the 
51.27 	commissioner.
51.28 	(b) An individual must be reassessed within one year of initial assessment, and annually 
51.29 	thereafter.
52.1 		Subd. 5.Housing support services. (a) Housing support services include housing 
52.2 	transition services and housing and tenancy sustaining services.
52.3 	(b) Housing transition services are defined as:
52.4 	(1) tenant screening and housing assessment;
52.5 	(2) assistance with the housing search and application process;
52.6 	(3) identifying resources to cover one-time moving expenses;
52.7 	(4) ensuring a new living arrangement is safe and ready for move-in;
52.8 	(5) assisting in arranging for and supporting details of a move; and
52.9 	(6) developing a housing support crisis plan.
52.10 	(c) Housing and tenancy sustaining services include:
52.11 	(1) prevention and early identification of behaviors that may jeopardize continued stable 
52.12 	housing;
52.13 	(2) education and training on roles, rights, and responsibilities of the tenant and the 
52.14 	property manager;
52.15 	(3) coaching to develop and maintain key relationships with property managers and 
52.16 	neighbors;
52.17 	(4) advocacy and referral to community resources to prevent eviction when housing is 
52.18 	at risk;
52.19 	(5) assistance with housing recertification process;
52.20 	(6) coordination with the tenant to regularly review, update, and modify housing support 
52.21 	and crisis plan; and
52.22 	(7) continuing training on being a good tenant, lease compliance, and household 
52.23 	management.
52.24 	(d) A housing support service may include person-centered planning for people who are 
52.25 	not eligible to receive person-centered planning through any other service, if the 
52.26 	person-centered planning is provided by a consultation service provider that is under contract 
52.27 	with the department and enrolled as a Minnesota health care program.
52.28 		Subd. 6.Provider qualifications and duties. A provider eligible for reimbursement 
52.29 	under this section shall:
53.1 	(1) enroll as a medical assistance Minnesota health care program provider and meet all 
53.2 	applicable provider standards and requirements;
53.3 	(2) demonstrate compliance with federal and state laws and policies for housing support 
53.4 	services as determined by the commissioner;
53.5 	(3) comply with background study requirements under chapter 245C and maintain 
53.6 	documentation of background study requests and results; and
53.7 	(4) directly provide housing support services and not use a subcontractor or reporting 
53.8 	agent.
53.9 		Subd. 7.Housing support supplemental service rates. Supplemental service rates for 
53.10 	individuals in settings according to sections 144D.025, 256I.04, subdivision 3, paragraph 
53.11 	(a), clause (3), and 256I.05, subdivision 1g, shall be reduced by one-half over a two-year 
53.12 	period. This reduction only applies to supplemental service rates for individuals eligible for 
53.13 	housing support services under this section.

53.14 	EFFECTIVE DATE. (a) Subdivisions 1 to 6 are contingent upon federal approval and 
53.15 	not effective until nine months after federal approval is obtained. The commissioner of 
53.16 	human services shall notify the revisor of statutes when federal approval is obtained.
53.17 	(b) Subdivision 7 is contingent upon federal approval of subdivisions 1 to 6 and not 
53.18 	effective until ten months after federal approval is obtained. The commissioner of human 
53.19 	services shall notify the revisor of statutes when federal approval is obtained.

53.20 	Sec. 2. Minnesota Statutes 2016, section 256D.44, subdivision 4, is amended to read:
53.21 		Subd. 4.Temporary absence due to illness. For the purposes of this subdivision, "home" 
53.22 	means a residence owned or rented by a recipient or the recipient's spouse. Home does not 
53.23 	include a group residential housing facility. Assistance payments for recipients who are 
53.24 	temporarily absent from their home due to hospitalization for illness must continue at the 
53.25 	same level of payment during their absence if the following criteria are met:
53.26 	(1) a physician certifies that the absence is not expected to continue for more than three 
53.27 	months;
53.28 	(2) a physician certifies that the recipient will be able to return to independent living; 
53.29 	and
53.30 	(3) the recipient has expenses associated with maintaining a residence in the community.

53.31 	EFFECTIVE DATE. This section is effective July 1, 2017.

54.1 	Sec. 3. Minnesota Statutes 2016, section 256D.44, subdivision 5, is amended to read:
54.2 		Subd. 5.Special needs. (a) In addition to the state standards of assistance established 
54.3 	in subdivisions 1 to 4, payments are allowed for the following special needs of recipients 
54.4 	of Minnesota supplemental aid who are not residents of a nursing home, a regional treatment 
54.5 	center, or a group residential setting authorized to receive housing facility support payments 
54.6 	under chapter 256I.
54.7 	(a) (b) The county agency shall pay a monthly allowance for medically prescribed diets 
54.8 	if the cost of those additional dietary needs cannot be met through some other maintenance 
54.9 	benefit. The need for special diets or dietary items must be prescribed by a licensed physician. 
54.10 	Costs for special diets shall be determined as percentages of the allotment for a one-person 
54.11 	household under the thrifty food plan as defined by the United States Department of 
54.12 	Agriculture. The types of diets and the percentages of the thrifty food plan that are covered 
54.13 	are as follows:
54.14 	(1) high protein diet, at least 80 grams daily, 25 percent of thrifty food plan;
54.15 	(2) controlled protein diet, 40 to 60 grams and requires special products, 100 percent of 
54.16 	thrifty food plan;
54.17 	(3) controlled protein diet, less than 40 grams and requires special products, 125 percent 
54.18 	of thrifty food plan;
54.19 	(4) low cholesterol diet, 25 percent of thrifty food plan;
54.20 	(5) high residue diet, 20 percent of thrifty food plan;
54.21 	(6) pregnancy and lactation diet, 35 percent of thrifty food plan;
54.22 	(7) gluten-free diet, 25 percent of thrifty food plan;
54.23 	(8) lactose-free diet, 25 percent of thrifty food plan;
54.24 	(9) antidumping diet, 15 percent of thrifty food plan;
54.25 	(10) hypoglycemic diet, 15 percent of thrifty food plan; or
54.26 	(11) ketogenic diet, 25 percent of thrifty food plan.
54.27 	(b) (c) Payment for nonrecurring special needs must be allowed for necessary home 
54.28 	repairs or necessary repairs or replacement of household furniture and appliances using the 
54.29 	payment standard of the AFDC program in effect on July 16, 1996, for these expenses, as 
54.30 	long as other funding sources are not available.
55.1 	(c) (d) A fee for guardian or conservator service is allowed at a reasonable rate negotiated 
55.2 	by the county or approved by the court. This rate shall not exceed five percent of the 
55.3 	assistance unit's gross monthly income up to a maximum of $100 per month. If the guardian 
55.4 	or conservator is a member of the county agency staff, no fee is allowed.
55.5 	(d) (e) The county agency shall continue to pay a monthly allowance of $68 for restaurant 
55.6 	meals for a person who was receiving a restaurant meal allowance on June 1, 1990, and 
55.7 	who eats two or more meals in a restaurant daily. The allowance must continue until the 
55.8 	person has not received Minnesota supplemental aid for one full calendar month or until 
55.9 	the person's living arrangement changes and the person no longer meets the criteria for the 
55.10 	restaurant meal allowance, whichever occurs first.
55.11 	(e) (f) A fee of ten percent of the recipient's gross income or $25, whichever is less, is 
55.12 	allowed for representative payee services provided by an agency that meets the requirements 
55.13 	under SSI regulations to charge a fee for representative payee services. This special need 
55.14 	is available to all recipients of Minnesota supplemental aid regardless of their living 
55.15 	arrangement.
55.16 	(f) (g)(1) Notwithstanding the language in this subdivision, an amount equal to one-half 
55.17 	of the maximum allotment authorized by the federal Food Stamp Program for a federal 
55.18 	Supplemental Security Income payment amount for a single individual which is in effect 
55.19 	on the first day of July of each year will be added to the standards of assistance established 
55.20 	in subdivisions 1 to 4 for adults under the age of 65 who qualify as shelter needy in need 
55.21 	of housing assistance and are:
55.22 	(i) relocating from an institution, a setting authorized to receive housing support under 
55.23 	chapter 256I, or an adult mental health residential treatment program under section 
55.24 	256B.0622; or
55.25 	(ii) eligible for personal care assistance under section 256B.0659; or
55.26 	(iii) home and community-based waiver recipients living in their own home or rented 
55.27 	or leased apartment which is not owned, operated, or controlled by a provider of service 
55.28 	not related by blood or marriage, unless allowed under paragraph (g).
55.29 	(2) Notwithstanding subdivision 3, paragraph (c), an individual eligible for the shelter 
55.30 	needy benefit under this paragraph is considered a household of one. An eligible individual 
55.31 	who receives this benefit prior to age 65 may continue to receive the benefit after the age 
55.32 	of 65.
56.1 	(3) "Shelter needy Housing assistance" means that the assistance unit incurs monthly 
56.2 	shelter costs that exceed 40 percent of the assistance unit's gross income before the application 
56.3 	of this special needs standard. "Gross income" for the purposes of this section is the 
56.4 	applicant's or recipient's income as defined in section 256D.35, subdivision 10, or the 
56.5 	standard specified in subdivision 3, paragraph (a) or (b), whichever is greater. A recipient 
56.6 	of a federal or state housing subsidy, that limits shelter costs to a percentage of gross income, 
56.7 	shall not be considered shelter needy in need of housing assistance for purposes of this 
56.8 	paragraph.
56.9 	(g) Notwithstanding this subdivision, to access housing and services as provided in 
56.10 	paragraph (f), the recipient may choose housing that may be owned, operated, or controlled 
56.11 	by the recipient's service provider. When housing is controlled by the service provider, the 
56.12 	individual may choose the individual's own service provider as provided in section 256B.49, 
56.13 	subdivision 23, clause (3). When the housing is controlled by the service provider, the 
56.14 	service provider shall implement a plan with the recipient to transition the lease to the 
56.15 	recipient's name. Within two years of signing the initial lease, the service provider shall 
56.16 	transfer the lease entered into under this subdivision to the recipient. In the event the landlord 
56.17 	denies this transfer, the commissioner may approve an exception within sufficient time to 
56.18 	ensure the continued occupancy by the recipient. This paragraph expires June 30, 2016.

56.19 	EFFECTIVE DATE. Paragraphs (a); (b); (c); (d); (e); and (f) are effective July 1, 2017. 
56.20 	Paragraph (g), clause (1), is effective July 1, 2020, except paragraph g, clause (1), items (ii) 
56.21 	and (iii), are effective July 1, 2017.

56.22 	Sec. 4. Minnesota Statutes 2016, section 256I.03, subdivision 8, is amended to read:
56.23 		Subd. 8.Supplementary services. "Supplementary services" means housing support 
56.24 	services provided to residents of group residential housing providers individuals in addition 
56.25 	to room and board including, but not limited to, oversight and up to 24-hour supervision, 
56.26 	medication reminders, assistance with transportation, arranging for meetings and 
56.27 	appointments, and arranging for medical and social services.

56.28 	EFFECTIVE DATE. This section is effective July 1, 2017.

56.29 	Sec. 5. Minnesota Statutes 2016, section 256I.04, subdivision 1, is amended to read:
56.30 		Subdivision 1.Individual eligibility requirements. An individual is eligible for and 
56.31 	entitled to a group residential housing support payment to be made on the individual's behalf 
56.32 	if the agency has approved the individual's residence in a group residential setting where 
57.1 	the individual will receive housing setting support and the individual meets the requirements 
57.2 	in paragraph (a) or (b).
57.3 	(a) The individual is aged, blind, or is over 18 years of age and disabled as determined 
57.4 	under the criteria used by the title II program of the Social Security Act, and meets the 
57.5 	resource restrictions and standards of section 256P.02, and the individual's countable income 
57.6 	after deducting the (1) exclusions and disregards of the SSI program, (2) the medical 
57.7 	assistance personal needs allowance under section 256B.35, and (3) an amount equal to the 
57.8 	income actually made available to a community spouse by an elderly waiver participant 
57.9 	under the provisions of sections 256B.0575, paragraph (a), clause (4), and 256B.058, 
57.10 	subdivision 2, is less than the monthly rate specified in the agency's agreement with the 
57.11 	provider of group residential housing support in which the individual resides.
57.12 	(b) The individual meets a category of eligibility under section 256D.05, subdivision 1, 
57.13 	paragraph (a), clauses (1), (3), (5) to (9), and (14), and paragraph (b), if applicable, and the 
57.14 	individual's resources are less than the standards specified by section 256P.02, and the 
57.15 	individual's countable income as determined under section 256P.06, less the medical 
57.16 	assistance personal needs allowance under section 256B.35 is less than the monthly rate 
57.17 	specified in the agency's agreement with the provider of group residential housing support
57.18 	in which the individual resides.

57.19 	EFFECTIVE DATE. This section is effective July 1, 2017.

57.20 	Sec. 6. Minnesota Statutes 2016, section 256I.04, subdivision 2d, is amended to read:
57.21 		Subd. 2d.Conditions of payment; commissioner's right to suspend or terminate 
57.22 	agreement. (a) Group residential Housing or supplementary services support must be 
57.23 	provided to the satisfaction of the commissioner, as determined at the sole discretion of the 
57.24 	commissioner's authorized representative, and in accordance with all applicable federal, 
57.25 	state, and local laws, ordinances, rules, and regulations, including business registration 
57.26 	requirements of the Office of the Secretary of State. A provider shall not receive payment 
57.27 	for room and board or supplementary services or housing found by the commissioner to be 
57.28 	performed or provided in violation of federal, state, or local law, ordinance, rule, or 
57.29 	regulation.
57.30 	(b) The commissioner has the right to suspend or terminate the agreement immediately 
57.31 	when the commissioner determines the health or welfare of the housing or service recipients 
57.32 	is endangered, or when the commissioner has reasonable cause to believe that the provider 
57.33 	has breached a material term of the agreement under subdivision 2b.
58.1 	(c) Notwithstanding paragraph (b), if the commissioner learns of a curable material 
58.2 	breach of the agreement by the provider, the commissioner shall provide the provider with 
58.3 	a written notice of the breach and allow ten days to cure the breach. If the provider does 
58.4 	not cure the breach within the time allowed, the provider shall be in default of the agreement 
58.5 	and the commissioner may terminate the agreement immediately thereafter. If the provider 
58.6 	has breached a material term of the agreement and cure is not possible, the commissioner 
58.7 	may immediately terminate the agreement.

58.8 	EFFECTIVE DATE. This section is effective July 1, 2017.

58.9 	Sec. 7. Minnesota Statutes 2016, section 256I.04, subdivision 2g, is amended to read:
58.10 		Subd. 2g.Crisis shelters. Secure crisis shelters for battered women and their children 
58.11 	designated by the Minnesota Department of Corrections are not group residences eligible 
58.12 	for housing support under this chapter.

58.13 	EFFECTIVE DATE. This section is effective July 1, 2017.

58.14 	Sec. 8. Minnesota Statutes 2016, section 256I.04, subdivision 3, is amended to read:
58.15 		Subd. 3.Moratorium on development of group residential housing support beds.
 58.16 	(a) Agencies shall not enter into agreements for new group residential housing support beds 
58.17 	with total rates in excess of the MSA equivalent rate except:
58.18 	(1) for group residential housing establishments licensed under chapter 245D provided 
58.19 	the facility is needed to meet the census reduction targets for persons with developmental 
58.20 	disabilities at regional treatment centers;
58.21 	(2) up to 80 beds in a single, specialized facility located in Hennepin County that will 
58.22 	provide housing for chronic inebriates who are repetitive users of detoxification centers and 
58.23 	are refused placement in emergency shelters because of their state of intoxication, and 
58.24 	planning for the specialized facility must have been initiated before July 1, 1991, in 
58.25 	anticipation of receiving a grant from the Housing Finance Agency under section 462A.05, 
58.26 	subdivision 20a, paragraph (b);
58.27 	(3) notwithstanding the provisions of subdivision 2a, for up to 190 supportive housing 
58.28 	units in Anoka, Dakota, Hennepin, or Ramsey County for homeless adults with a mental 
58.29 	illness, a history of substance abuse, or human immunodeficiency virus or acquired 
58.30 	immunodeficiency syndrome. For purposes of this section, "homeless adult" means a person 
58.31 	who is living on the street or in a shelter or discharged from a regional treatment center, 
58.32 	community hospital, or residential treatment program and has no appropriate housing 
59.1 	available and lacks the resources and support necessary to access appropriate housing. At 
59.2 	least 70 percent of the supportive housing units must serve homeless adults with mental 
59.3 	illness, substance abuse problems, or human immunodeficiency virus or acquired 
59.4 	immunodeficiency syndrome who are about to be or, within the previous six months, has 
59.5 	been discharged from a regional treatment center, or a state-contracted psychiatric bed in 
59.6 	a community hospital, or a residential mental health or chemical dependency treatment 
59.7 	program. If a person meets the requirements of subdivision 1, paragraph (a), and receives 
59.8 	a federal or state housing subsidy, the group residential housing support rate for that person 
59.9 	is limited to the supplementary rate under section 256I.05, subdivision 1a, and is determined 
59.10 	by subtracting the amount of the person's countable income that exceeds the MSA equivalent 
59.11 	rate from the group residential housing support supplementary service rate. A resident in a 
59.12 	demonstration project site who no longer participates in the demonstration program shall 
59.13 	retain eligibility for a group residential housing support payment in an amount determined 
59.14 	under section 256I.06, subdivision 8, using the MSA equivalent rate. Service funding under 
59.15 	section 256I.05, subdivision 1a, will end June 30, 1997, if federal matching funds are 
59.16 	available and the services can be provided through a managed care entity. If federal matching 
59.17 	funds are not available, then service funding will continue under section 256I.05, subdivision 
59.18 	1a;
59.19 	(4) for an additional two beds, resulting in a total of 32 beds, for a facility located in 
59.20 	Hennepin County providing services for recovering and chemically dependent men that has 
59.21 	had a group residential housing support contract with the county and has been licensed as 
59.22 	a board and lodge facility with special services since 1980;
59.23 	(5) for a group residential housing support provider located in the city of St. Cloud, or 
59.24 	a county contiguous to the city of St. Cloud, that operates a 40-bed facility, that received 
59.25 	financing through the Minnesota Housing Finance Agency Ending Long-Term Homelessness 
59.26 	Initiative and serves chemically dependent clientele, providing 24-hour-a-day supervision;
59.27 	(6) for a new 65-bed facility in Crow Wing County that will serve chemically dependent 
59.28 	persons, operated by a group residential housing support provider that currently operates a 
59.29 	304-bed facility in Minneapolis, and a 44-bed facility in Duluth;
59.30 	(7) for a group residential housing support provider that operates two ten-bed facilities, 
59.31 	one located in Hennepin County and one located in Ramsey County, that provide community 
59.32 	support and 24-hour-a-day supervision to serve the mental health needs of individuals who 
59.33 	have chronically lived unsheltered; and
60.1 	(8) for a group residential facility authorized for recipients of housing support in Hennepin 
60.2 	County with a capacity of up to 48 beds that has been licensed since 1978 as a board and 
60.3 	lodging facility and that until August 1, 2007, operated as a licensed chemical dependency 
60.4 	treatment program.
60.5 	(b) An agency may enter into a group residential housing support agreement for beds 
60.6 	with rates in excess of the MSA equivalent rate in addition to those currently covered under 
60.7 	a group residential housing support agreement if the additional beds are only a replacement 
60.8 	of beds with rates in excess of the MSA equivalent rate which have been made available 
60.9 	due to closure of a setting, a change of licensure or certification which removes the beds 
60.10 	from group residential housing support payment, or as a result of the downsizing of a group 
60.11 	residential housing setting authorized for recipients of housing support. The transfer of 
60.12 	available beds from one agency to another can only occur by the agreement of both agencies.

60.13 	EFFECTIVE DATE. This section is effective July 1, 2017.

60.14 	Sec. 9. Minnesota Statutes 2016, section 256I.05, subdivision 1a, is amended to read:
60.15 		Subd. 1a.Supplementary service rates. (a) Subject to the provisions of section 256I.04, 
60.16 	subdivision 3, the county agency may negotiate a payment not to exceed $426.37 for other 
60.17 	services necessary to provide room and board provided by the group residence if the residence 
60.18 	is licensed by or registered by the Department of Health, or licensed by the Department of 
60.19 	Human Services to provide services in addition to room and board, and if the provider of 
60.20 	services is not also concurrently receiving funding for services for a recipient under a home 
60.21 	and community-based waiver under title XIX of the Social Security Act; or funding from 
60.22 	the medical assistance program under section 256B.0659, for personal care services for 
60.23 	residents in the setting; or residing in a setting which receives funding under section 245.73. 
60.24 	If funding is available for other necessary services through a home and community-based 
60.25 	waiver, or personal care services under section 256B.0659, then the GRH housing support
60.26 	rate is limited to the rate set in subdivision 1. Unless otherwise provided in law, in no case 
60.27 	may the supplementary service rate exceed $426.37. The registration and licensure 
60.28 	requirement does not apply to establishments which are exempt from state licensure because 
60.29 	they are located on Indian reservations and for which the tribe has prescribed health and 
60.30 	safety requirements. Service payments under this section may be prohibited under rules to 
60.31 	prevent the supplanting of federal funds with state funds. The commissioner shall pursue 
60.32 	the feasibility of obtaining the approval of the Secretary of Health and Human Services to 
60.33 	provide home and community-based waiver services under title XIX of the Social Security 
60.34 	Act for residents who are not eligible for an existing home and community-based waiver 
61.1 	due to a primary diagnosis of mental illness or chemical dependency and shall apply for a 
61.2 	waiver if it is determined to be cost-effective.
61.3 	(b) The commissioner is authorized to make cost-neutral transfers from the GRH housing 
61.4 	support fund for beds under this section to other funding programs administered by the 
61.5 	department after consultation with the county or counties in which the affected beds are 
61.6 	located. The commissioner may also make cost-neutral transfers from the GRH housing 
61.7 	support fund to county human service agencies for beds permanently removed from the 
61.8 	GRH housing support census under a plan submitted by the county agency and approved 
61.9 	by the commissioner. The commissioner shall report the amount of any transfers under this 
61.10 	provision annually to the legislature.
61.11 	(c) Counties must not negotiate supplementary service rates with providers of group 
61.12 	residential housing support that are licensed as board and lodging with special services and 
61.13 	that do not encourage a policy of sobriety on their premises and make referrals to available 
61.14 	community services for volunteer and employment opportunities for residents.

61.15 	EFFECTIVE DATE. This section is effective July 1, 2017.

61.16 	Sec. 10. Minnesota Statutes 2016, section 256I.05, subdivision 1c, is amended to read:
61.17 		Subd. 1c.Rate increases. An agency may not increase the rates negotiated for group 
61.18 	residential housing support above those in effect on June 30, 1993, except as provided in 
61.19 	paragraphs (a) to (f).
61.20 	(a) An agency may increase the rates for group residential housing settings room and 
61.21 	board to the MSA equivalent rate for those settings whose current rate is below the MSA 
61.22 	equivalent rate.
61.23 	(b) An agency may increase the rates for residents in adult foster care whose difficulty 
61.24 	of care has increased. The total group residential housing support rate for these residents 
61.25 	must not exceed the maximum rate specified in subdivisions 1 and 1a. Agencies must not 
61.26 	include nor increase group residential housing difficulty of care rates for adults in foster 
61.27 	care whose difficulty of care is eligible for funding by home and community-based waiver 
61.28 	programs under title XIX of the Social Security Act.
61.29 	(c) The room and board rates will be increased each year when the MSA equivalent rate 
61.30 	is adjusted for SSI cost-of-living increases by the amount of the annual SSI increase, less 
61.31 	the amount of the increase in the medical assistance personal needs allowance under section 
61.32 	256B.35.
62.1 	(d) When a group residential housing rate is used to pay support pays for an individual's 
62.2 	room and board, or other costs necessary to provide room and board, the rate payable to the 
62.3 	residence must continue for up to 18 calendar days per incident that the person is temporarily 
62.4 	absent from the residence, not to exceed 60 days in a calendar year, if the absence or absences 
62.5 	have received the prior approval of the county agency's social service staff. Prior approval 
62.6 	is not required for emergency absences due to crisis, illness, or injury.
62.7 	(e) For facilities meeting substantial change criteria within the prior year. Substantial 
62.8 	change criteria exists if the group residential housing establishment experiences a 25 percent 
62.9 	increase or decrease in the total number of its beds, if the net cost of capital additions or 
62.10 	improvements is in excess of 15 percent of the current market value of the residence, or if 
62.11 	the residence physically moves, or changes its licensure, and incurs a resulting increase in 
62.12 	operation and property costs.
62.13 	(f) Until June 30, 1994, an agency may increase by up to five percent the total rate paid 
62.14 	for recipients of assistance under sections 256D.01 to 256D.21 or 256D.33 to 256D.54 who 
62.15 	reside in residences that are licensed by the commissioner of health as a boarding care home, 
62.16 	but are not certified for the purposes of the medical assistance program. However, an increase 
62.17 	under this clause must not exceed an amount equivalent to 65 percent of the 1991 medical 
62.18 	assistance reimbursement rate for nursing home resident class A, in the geographic grouping 
62.19 	in which the facility is located, as established under Minnesota Rules, parts 9549.0051 to 
62.20 	9549.0058.

62.21 	EFFECTIVE DATE. This section is effective July 1, 2017.

62.22 	Sec. 11. Minnesota Statutes 2016, section 256I.05, subdivision 1e, is amended to read:
62.23 		Subd. 1e.Supplementary rate for certain facilities. (a) Notwithstanding the provisions 
62.24 	of subdivisions 1a and 1c, beginning July 1, 2005, a county agency shall negotiate a 
62.25 	supplementary rate in addition to the rate specified in subdivision 1, not to exceed $700 per 
62.26 	month the maximum rate in subdivision 1a, including any legislatively authorized inflationary 
62.27 	adjustments, for a group residential housing support provider that:
62.28 	(1) is located in Hennepin County and has had a group residential housing support 
62.29 	contract with the county since June 1996;
62.30 	(2) operates in three separate locations a 75-bed facility, a 50-bed facility, and a 26-bed 
62.31 	facility; and
63.1 	(3) serves a chemically dependent clientele, providing 24 hours per day supervision and 
63.2 	limiting a resident's maximum length of stay to 13 months out of a consecutive 24-month 
63.3 	period.
63.4 	(b) Notwithstanding subdivisions 1a and 1c, a county agency shall negotiate a 
63.5 	supplementary rate in addition to the rate specified in subdivision 1, not to exceed $700 per 
63.6 	month the maximum rate in subdivision 1a, including any legislatively authorized inflationary 
63.7 	adjustments, of a group residential housing support provider that:
63.8 	(1) is located in St. Louis County and has had a group residential housing support contract 
63.9 	with the county since 2006;
63.10 	(2) operates a 62-bed facility; and
63.11 	(3) serves a chemically dependent adult male clientele, providing 24 hours per day 
63.12 	supervision and limiting a resident's maximum length of stay to 13 months out of a 
63.13 	consecutive 24-month period.
63.14 	(c) Notwithstanding subdivisions 1a and 1c, beginning July 1, 2013, a county agency 
63.15 	shall negotiate a supplementary rate in addition to the rate specified in subdivision 1, not 
63.16 	to exceed $700 per month the maximum rate in subdivision 1a, including any legislatively 
63.17 	authorized inflationary adjustments, for the group residential provider described under 
63.18 	paragraphs (a) and (b), not to exceed an additional 115 beds.

63.19 	EFFECTIVE DATE. This section is effective July 1, 2017.

63.20 	Sec. 12. Minnesota Statutes 2016, section 256I.05, subdivision 1j, is amended to read:
63.21 		Subd. 1j.Supplementary rate for certain facilities; Crow Wing County.
 63.22 	Notwithstanding the provisions of subdivisions 1a and 1c, beginning July 1, 2007, a county 
63.23 	agency shall negotiate a supplementary rate in addition to the rate specified in subdivision 
63.24 	1, not to exceed $700 per month the maximum rate in subdivision 1a, including any 
63.25 	legislatively authorized inflationary adjustments, for a new 65-bed facility in Crow Wing 
63.26 	County that will serve chemically dependent persons operated by a group residential housing 
63.27 	support provider that currently operates a 304-bed facility in Minneapolis and a 44-bed 
63.28 	facility in Duluth which opened in January of 2006.

63.29 	EFFECTIVE DATE. This section is effective July 1, 2017.

64.1 	Sec. 13. Minnesota Statutes 2016, section 256I.05, subdivision 1m, is amended to read:
64.2 		Subd. 1m.Supplemental rate for certain facilities; Hennepin and Ramsey Counties.
 64.3 	(a) Notwithstanding the provisions of this section, beginning July 1, 2007, a county agency 
64.4 	shall negotiate a supplemental service rate in addition to the rate specified in subdivision 
64.5 	1, not to exceed $700 per month or the existing monthly rate, whichever is higher the 
64.6 	maximum rate in subdivision 1a, including any legislatively authorized inflationary 
64.7 	adjustments, for a group residential housing support provider that operates two ten-bed 
64.8 	facilities, one located in Hennepin County and one located in Ramsey County, which provide 
64.9 	community support and serve the mental health needs of individuals who have chronically 
64.10 	lived unsheltered, providing 24-hour-per-day supervision.
64.11 	(b) An individual who has lived in one of the facilities under paragraph (a), who is being 
64.12 	transitioned to independent living as part of the program plan continues to be eligible for 
64.13 	group residential housing room and board and the supplemental service rate negotiated with 
64.14 	the county under paragraph (a).

64.15 	EFFECTIVE DATE. This section is effective July 1, 2017.

64.16 	Sec. 14. Minnesota Statutes 2016, section 256I.05, subdivision 8, is amended to read:
64.17 		Subd. 8.State participation. For a resident of a group residence person who is eligible 
64.18 	under section 256I.04, subdivision 1, paragraph (b), state participation in the group residential
64.19 	housing support payment is determined according to section 256D.03, subdivision 2. For 
64.20 	a resident of a group residence person who is eligible under section 256I.04, subdivision 1, 
64.21 	paragraph (a), state participation in the group residential housing support rate is determined 
64.22 	according to section 256D.36.

64.23 	EFFECTIVE DATE. This section is effective July 1, 2017.

64.24 	Sec. 15. Minnesota Statutes 2016, section 256I.06, subdivision 2, is amended to read:
64.25 		Subd. 2.Time of payment. A county agency may make payments to a group residence
64.26 	in advance for an individual whose stay in the group residence is expected to last beyond 
64.27 	the calendar month for which the payment is made. Group residential Housing support
64.28 	payments made by a county agency on behalf of an individual who is not expected to remain 
64.29 	in the group residence beyond the month for which payment is made must be made 
64.30 	subsequent to the individual's departure from the group residence.

64.31 	EFFECTIVE DATE. This section is effective July 1, 2017.

65.1 	Sec. 16. Minnesota Statutes 2016, section 256I.06, subdivision 8, is amended to read:
65.2 		Subd. 8.Amount of group residential housing support payment. (a) The amount of 
65.3 	a group residential housing room and board payment to be made on behalf of an eligible 
65.4 	individual is determined by subtracting the individual's countable income under section 
65.5 	256I.04, subdivision 1, for a whole calendar month from the group residential housing 
65.6 	charge room and board rate for that same month. The group residential housing charge
65.7 	support payment is determined by multiplying the group residential housing support rate 
65.8 	times the period of time the individual was a resident or temporarily absent under section 
65.9 	256I.05, subdivision 1c, paragraph (d).
65.10 	(b) For an individual with earned income under paragraph (a), prospective budgeting 
65.11 	must be used to determine the amount of the individual's payment for the following six-month 
65.12 	period. An increase in income shall not affect an individual's eligibility or payment amount 
65.13 	until the month following the reporting month. A decrease in income shall be effective the 
65.14 	first day of the month after the month in which the decrease is reported.

65.15 	EFFECTIVE DATE. This section is effective July 1, 2017.

65.16 	Sec. 17. [256I.09] COMMUNITY LIVING INFRASTRUCTURE.
65.17 	Each calendar year, the commissioner shall allocate funding to agencies for: (1) outreach 
65.18 	to locate and engage people who are homeless or residing in institutions or facilities to 
65.19 	screen for basic needs and assist with referral to community living resources, (2) housing 
65.20 	resource specialist staff to provide technical assistance and consultation on housing and 
65.21 	related support service resources for persons with both disabilities and low income, or (3) 
65.22 	administration and monitoring activities related to housing support funds. The commissioner 
65.23 	shall allocate funding according to indicators of need, such as poverty rates and housing 
65.24 	cost burden. An agency may partner with another agency. The commissioner may adjust 
65.25 	allocations to partnered agencies to reflect regional coordination.

65.26 	EFFECTIVE DATE. This section is effective July 1, 2017.

65.27 	Sec. 18. REVISOR'S INSTRUCTION.
 65.28 	In each section of Minnesota Statutes referred to in column A, the revisor of statutes 
65.29 	shall change the phrase in column B to the phrase in column C. The revisor may make 
65.30 	technical and other necessary changes to sentence structure to preserve the meaning of the 
65.31 	text. The revisor shall make other changes in chapter titles; section, subdivision, part, and 
66.1 	subpart headnotes; and in other terminology necessary as a result of the enactment of this 
66.2 	section.

66.3	Column A
	Column B
	Column C
	
66.466.5	144A.071, subdivision 4d
	group residential housing
	housing support under chapter 
256I
	
66.666.7	201.061, subdivision 3
	group residential housing
	setting authorized to provide 
housing support
	
66.866.966.10
	244.052, subdivision 4c
	group residential housing 
facility
	licensed setting authorized to 
provide housing support 
under section 256I.04
	
66.1166.12	245.466, subdivision 7
	under group residential 
housing
	by housing support under 
chapter 256I
	
66.13	245.466, subdivision 7
	from group residential housing
	from housing support
	
66.1466.15	245.4661, subdivision 6
	group residential housing
	housing support under chapter 
256I
	
66.1666.17	245C.10, subdivision 11
	group residential housing or 
supplementary services
	housing support
	
66.1866.19	256.01, subdivision 18
	group residential housing
	housing support under chapter 
256I
	
66.20	256.017, subdivision 1
	group residential housing
	housing support
	
66.2166.22	256.98, subdivision 8
	group residential housing
	housing support under chapter 
256I
	
66.2366.24	256B.49, subdivision 15
	group residential housing
	housing support under chapter 
256I
	
66.2566.26	256B.4914, subdivision 10
	group residential housing rate 
3 costs
	housing support rate 3 costs 
under chapter 256I
	
66.27	256B.501, subdivision 4b
	group residential housing
	housing support
	
66.2866.29
66.30	256B.77, subdivision 12
	residential services covered 
under the group residential 
housing program
	housing support services 
under chapter 256I
	
66.3166.32	256D.44, subdivision 2
	group residential housing 
facility
	setting authorized to provide 
housing support
	
66.3366.34	256G.01, subdivision 3
	group residential housing
	housing support under chapter 
256I
	
66.35	256I.01
	Group Residential Housing
	Housing Support
	
66.36	256I.02
	Group Residential Housing
	Housing Support
	
66.37	256I.03, subdivision 2
	"Group residential housing"
	"Room and board"
	
66.38	256I.03, subdivision 2
	Group residential housing
	The room and board
	
66.39	256I.03, subdivision 3
	"Group residential housing"
	"Housing support"
	
66.40	256I.03, subdivision 6
	group residential housing
	room and board
	
66.41	256I.03, subdivisions 7 and 9
	group residential housing
	housing support
	
66.42
66.43	256I.04, subdivisions 1a, 1b, 
1c, and 2
	group residential housing
	housing support
	
67.167.2	256I.04, subdivision 2a
	provide group residential 
housing
	provide housing support
	
67.367.4	256I.04, subdivision 2a
	of group residential housing 
or supplementary services
	of housing support
	
67.567.6	256I.04, subdivision 2a
	complete group residential 
housing
	complete housing support
	
67.767.8	256I.04, subdivision 2b
	group residential housing or 
supplementary services
	housing support
	
67.967.10
	256I.04, subdivision 2b
	provision of group residential 
housing
	provision of housing support
	
67.1167.12	256I.04, subdivision 2c
	group residential housing or 
supplementary services
	housing support
	
67.1367.14	256I.04, subdivision 2e
	group residential housing or 
supplementary services
	housing support
	
67.1567.16	256I.04, subdivision 4
	group residential housing 
payment for room and board
	room and board rate
	
67.1767.18	256I.05, subdivision 1
	living in group residential 
housing
	receiving housing support
	
67.19
67.20	256I.05, subdivisions 1h, 1k, 
1l, 7b, and 7c
	group residential housing
	housing support
	
67.21	256I.05, subdivision 2
	group residential housing
	room and board
	
67.22	256I.05, subdivision 3
	group residential housing
	room and board
	
67.2367.24	256I.05, subdivision 6
	reside in group residential 
housing
	receive housing support
	
67.25
67.26	256I.06, subdivisions 1, 3, 4, 
and 6
	group residential housing
	housing support
	
67.27	256I.06, subdivision 7
	group residential housing
	the housing support
	
67.28	256I.08
	group residential housing
	housing support
	
67.29	256P.03, subdivision 1
	group residential housing
	housing support
	
67.30	256P.05, subdivision 1
	group residential housing
	housing support
	
67.31	256P.07, subdivision 1
	group residential housing
	housing support
	
67.32	256P.08, subdivision 1
	group residential housing
	housing support
	
67.3367.34	290A.03, subdivision 8
	accepts group residential 
housing
	accepts housing support
	
67.3567.36	290A.03, subdivision 8
	the group residential housing 
program
	the housing support program

67.37 	EFFECTIVE DATE. This section is effective July 1, 2017.

67.38 	ARTICLE 3
67.39 	CONTINUING CARE

67.40 	Section 1. Minnesota Statutes 2016, section 144.0724, subdivision 6, is amended to read:
68.1 		Subd. 6.Penalties for late or nonsubmission. (a) A facility that fails to complete or 
68.2 	submit an assessment according to subdivisions 4 and 5 for a RUG-IV classification within 
68.3 	seven days of the time requirements listed in the Long-Term Care Facility Resident 
68.4 	Assessment Instrument User's Manual is subject to a reduced rate for that resident. The 
68.5 	reduced rate shall be the lowest rate for that facility. The reduced rate is effective on the 
68.6 	day of admission for new admission assessments, on the ARD for significant change in 
68.7 	status assessments, or on the day that the assessment was due for all other assessments and 
68.8 	continues in effect until the first day of the month following the date of submission and 
68.9 	acceptance of the resident's assessment.
68.10 	(b) If loss of revenue due to penalties incurred by a facility for any period of 92 days 
68.11 	are equal to or greater than 1.0 0.1 percent of the total operating costs on the facility's most 
68.12 	recent annual statistical and cost report, a facility may apply to the commissioner of human 
68.13 	services for a reduction in the total penalty amount. The commissioner of human services, 
68.14 	in consultation with the commissioner of health, may, at the sole discretion of the 
68.15 	commissioner of human services, limit the penalty for residents covered by medical assistance 
68.16 	to 15 ten days.

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

68.18 	Sec. 2. Minnesota Statutes 2016, section 144A.071, subdivision 4d, is amended to read:
68.19 		Subd. 4d.Consolidation of nursing facilities. (a) The commissioner of health, in 
68.20 	consultation with the commissioner of human services, may approve a request for 
68.21 	consolidation of nursing facilities which includes the closure of one or more facilities and 
68.22 	the upgrading of the physical plant of the remaining nursing facility or facilities, the costs 
68.23 	of which exceed the threshold project limit under subdivision 2, clause (a). The 
68.24 	commissioners shall consider the criteria in this section, section 144A.073, and section 
68.25 	256B.437 256R.40, in approving or rejecting a consolidation proposal. In the event the 
68.26 	commissioners approve the request, the commissioner of human services shall calculate an 
68.27 	external fixed costs rate adjustment according to clauses (1) to (3):
68.28 	(1) the closure of beds shall not be eligible for a planned closure rate adjustment under 
68.29 	section 256B.437, subdivision 6 256R.40, subdivision 5;
68.30 	(2) the construction project permitted in this clause shall not be eligible for a threshold 
68.31 	project rate adjustment under section 256B.434, subdivision 4f, or a moratorium exception 
68.32 	adjustment under section 144A.073; and
69.1 	(3) the payment rate for external fixed costs for a remaining facility or facilities shall 
69.2 	be increased by an amount equal to 65 percent of the projected net cost savings to the state 
69.3 	calculated in paragraph (b), divided by the state's medical assistance percentage of medical 
69.4 	assistance dollars, and then divided by estimated medical assistance resident days, as 
69.5 	determined in paragraph (c), of the remaining nursing facility or facilities in the request in 
69.6 	this paragraph. The rate adjustment is effective on the later of the first day of the month 
69.7 	followingfirst day of the month of January or July, whichever date occurs immediately 
69.8 	after the completion of the construction upgrades in the consolidation plan or the first day 
69.9 	of the month following and the complete closure of a facility closure of the facility or 
69.10 	facilities designated for closure in the consolidation plan. If more than one facility is receiving 
69.11 	upgrades in the consolidation plan, each facility's date of construction completion must be 
69.12 	evaluated separately.
69.13 	(b) For purposes of calculating the net cost savings to the state, the commissioner shall 
69.14 	consider clauses (1) to (7):
69.15 	(1) the annual savings from estimated medical assistance payments from the net number 
69.16 	of beds closed taking into consideration only beds that are in active service on the date of 
69.17 	the request and that have been in active service for at least three years;
69.18 	(2) the estimated annual cost of increased case load of individuals receiving services 
69.19 	under the elderly waiver;
69.20 	(3) the estimated annual cost of elderly waiver recipients receiving support under group 
69.21 	residential housing;
69.22 	(4) the estimated annual cost of increased case load of individuals receiving services 
69.23 	under the alternative care program;
69.24 	(5) the annual loss of license surcharge payments on closed beds;
69.25 	(6) the savings from not paying planned closure rate adjustments that the facilities would 
69.26 	otherwise be eligible for under section 256B.437 256R.40; and
69.27 	(7) the savings from not paying external fixed costs payment rate adjustments from 
69.28 	submission of renovation costs that would otherwise be eligible as threshold projects under 
69.29 	section 256B.434, subdivision 4f.
69.30 	(c) For purposes of the calculation in paragraph (a), clause (3), the estimated medical 
69.31 	assistance resident days of the remaining facility or facilities shall be computed assuming 
69.32 	95 percent occupancy multiplied by the historical percentage of medical assistance resident 
69.33 	days of the remaining facility or facilities, as reported on the facility's or facilities' most 
70.1 	recent nursing facility statistical and cost report filed before the plan of closure is submitted, 
70.2 	multiplied by 365.
70.3 	(d) For purposes of net cost of savings to the state in paragraph (b), the average occupancy 
70.4 	percentages will be those reported on the facility's or facilities' most recent nursing facility 
70.5 	statistical and cost report filed before the plan of closure is submitted, and the average 
70.6 	payment rates shall be calculated based on the approved payment rates in effect at the time 
70.7 	the consolidation request is submitted.
70.8 	(e) To qualify for the external fixed costs payment rate adjustment under this subdivision, 
70.9 	the closing facilities shall:
70.10 	(1) submit an application for closure according to section 256B.437, subdivision 3
70.11 	256R.40, subdivision 2; and
70.12 	(2) follow the resident relocation provisions of section 144A.161.
70.13 	(f) The county or counties in which a facility or facilities are closed under this subdivision 
70.14 	shall not be eligible for designation as a hardship area under subdivision 3 for five years 
70.15 	from the date of the approval of the proposed consolidation. The applicant shall notify the 
70.16 	county of this limitation and the county shall acknowledge this in a letter of support.

70.17 	EFFECTIVE DATE. This section is effective for consolidations occurring after July 
70.18 	1, 2017.

70.19 	Sec. 3. Minnesota Statutes 2016, section 144D.03, is amended by adding a subdivision to 
70.20 	read:
70.21 		Subd. 1b.Fee for data collection; assisted living. At the time for the annual registration 
70.22 	under subdivision 1, the commissioner shall assess an annual fee on each establishment 
70.23 	with an assisted living designation as defined in chapter 144G to pay the commissioner of 
70.24 	human services for costs related to collecting data from residents on quality of life and 
70.25 	quality of care. The revenue from the fee shall be deposited in the general fund. The fee is 
70.26 	nonrefundable. The fee for each establishment shall be $28.60 multiplied by the total 
70.27 	maximum resident capacity.

70.28 	EFFECTIVE DATE. This section is effective July 1, 2018.

70.29 	Sec. 4. Minnesota Statutes 2016, section 144G.02, subdivision 2, is amended to read:
70.30 		Subd. 2.Authority of commissioner. (a) The commissioner, upon receipt of information 
70.31 	that may indicate the failure of a housing with services establishment, the arranged home 
71.1 	care provider, an assisted living client, or an assisted living client's representative to comply 
71.2 	with a legal requirement to which one or more of the entities may be subject, shall make 
71.3 	appropriate referrals to other governmental agencies and entities having jurisdiction over 
71.4 	the subject matter. The commissioner may also make referrals to any public or private 
71.5 	agency the commissioner considers available for appropriate assistance to those involved.
71.6 	(b) In addition to the authority with respect to licensed home care providers under section 
71.7 	144A.45 and with respect to housing with services establishments under chapter 144D, the 
71.8 	commissioner shall have standing to bring an action for injunctive relief in the district court 
71.9 	in the district in which a housing with services establishment is located to compel the housing 
71.10 	with services establishment or the arranged home care provider to meet the requirements 
71.11 	of this chapter or other requirements of the state or of any county or local governmental 
71.12 	unit to which the establishment or arranged home care provider is otherwise subject. 
71.13 	Proceedings for securing an injunction may be brought by the commissioner through the 
71.14 	attorney general or through the appropriate county attorney. The sanctions in this section 
71.15 	do not restrict the availability of other sanctions.
71.16 	(c) The commissioner, in consultation with the commissioner of human services, shall 
71.17 	survey establishment residents to gather data on resident quality of life and quality of care.

71.18 	EFFECTIVE DATE. This section is effective July 1, 2019.

71.19 	Sec. 5. Minnesota Statutes 2016, section 245D.03, subdivision 1, is amended to read:
71.20 		Subdivision 1.Applicability.  (a) The commissioner shall regulate the provision of home 
71.21 	and community-based services to persons with disabilities and persons age 65 and older 
71.22 	pursuant to this chapter. The licensing standards in this chapter govern the provision of 
71.23 	basic support services and intensive support services.
71.24 	(b) Basic support services provide the level of assistance, supervision, and care that is 
71.25 	necessary to ensure the health and welfare of the person and do not include services that 
71.26 	are specifically directed toward the training, treatment, habilitation, or rehabilitation of the 
71.27 	person. Basic support services include:
71.28 	(1) in-home and out-of-home respite care services as defined in section 245A.02, 
71.29 	subdivision 15, and under the brain injury, community alternative care, community access 
71.30 	for disability inclusion, developmental disability, and elderly waiver plans, excluding 
71.31 	out-of-home respite care provided to children in a family child foster care home licensed 
71.32 	under Minnesota Rules, parts 2960.3000 to 2960.3100, when the child foster care license 
71.33 	holder complies with the requirements under section 245D.06, subdivisions 5, 6, 7, and 8, 
72.1 	or successor provisions; and section 245D.061 or successor provisions, which must be 
72.2 	stipulated in the statement of intended use required under Minnesota Rules, part 2960.3000, 
72.3 	subpart 4;
72.4 	(2) adult companion services as defined under the brain injury, community access for 
72.5 	disability inclusion, and elderly waiver plans, excluding adult companion services provided 
72.6 	under the Corporation for National and Community Services Senior Companion Program 
72.7 	established under the Domestic Volunteer Service Act of 1973, Public Law 98-288;
72.8 	(3) personal support as defined under the developmental disability waiver plan;
72.9 	(4) 24-hour emergency assistance, personal emergency response as defined under the 
72.10 	community access for disability inclusion and developmental disability waiver plans;
72.11 	(5) night supervision services as defined under the brain injury waiver plan; and
72.12 	(6) homemaker services as defined under the community access for disability inclusion, 
72.13 	brain injury, community alternative care, developmental disability, and elderly waiver plans, 
72.14 	excluding providers licensed by the Department of Health under chapter 144A and those 
72.15 	providers providing cleaning services only.; and
72.16 	(7) individual community living support under section 256B.0915, subdivision 3j.
72.17 	(c) Intensive support services provide assistance, supervision, and care that is necessary 
72.18 	to ensure the health and welfare of the person and services specifically directed toward the 
72.19 	training, habilitation, or rehabilitation of the person. Intensive support services include:
72.20 	(1) intervention services, including:
72.21 	(i) behavioral support services as defined under the brain injury and community access 
72.22 	for disability inclusion waiver plans;
72.23 	(ii) in-home or out-of-home crisis respite services as defined under the developmental 
72.24 	disability waiver plan; and
72.25 	(iii) specialist services as defined under the current developmental disability waiver 
72.26 	plan;
72.27 	(2) in-home support services, including:
72.28 	(i) in-home family support and supported living services as defined under the 
72.29 	developmental disability waiver plan;
72.30 	(ii) independent living services training as defined under the brain injury and community 
72.31 	access for disability inclusion waiver plans; and
73.1 	(iii) semi-independent living services;
73.2 	(3) residential supports and services, including:
73.3 	(i) supported living services as defined under the developmental disability waiver plan 
73.4 	provided in a family or corporate child foster care residence, a family adult foster care 
73.5 	residence, a community residential setting, or a supervised living facility;
73.6 	(ii) foster care services as defined in the brain injury, community alternative care, and 
73.7 	community access for disability inclusion waiver plans provided in a family or corporate 
73.8 	child foster care residence, a family adult foster care residence, or a community residential 
73.9 	setting; and
73.10 	(iii) residential services provided to more than four persons with developmental 
73.11 	disabilities in a supervised living facility, including ICFs/DD;
73.12 	(4) day services, including:
73.13 	(i) structured day services as defined under the brain injury waiver plan;
73.14 	(ii) day training and habilitation services under sections 252.41 to 252.46, and as defined 
73.15 	under the developmental disability waiver plan; and
73.16 	(iii) prevocational services as defined under the brain injury and community access for 
73.17 	disability inclusion waiver plans; and
73.18 	(5) supported employment as defined under the brain injury, developmental disability, 
73.19 	and community access for disability inclusion waiver plans.

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

73.21 	Sec. 6. Minnesota Statutes 2016, section 256.975, subdivision 7, is amended to read:
73.22 		Subd. 7.Consumer information and assistance and long-term care options 
73.23 	counseling; Senior LinkAge Line. (a) The Minnesota Board on Aging shall operate a 
73.24 	statewide service to aid older Minnesotans and their families in making informed choices 
73.25 	about long-term care options and health care benefits. Language services to persons with 
73.26 	limited English language skills may be made available. The service, known as Senior 
73.27 	LinkAge Line, shall serve older adults as the designated Aging and Disability Resource 
73.28 	Center under United States Code, title 42, section 3001, the Older Americans Act 
73.29 	Amendments of 2006 in partnership with the Disability Linkage Line under section 256.01, 
73.30 	subdivision 24, and must be available during business hours through a statewide toll-free 
73.31 	number and the Internet. The Minnesota Board on Aging shall consult with, and when 
73.32 	appropriate work through, the area agencies on aging counties, and other entities that serve 
74.1 	aging and disabled populations of all ages, to provide and maintain the telephone 
74.2 	infrastructure and related support for the Aging and Disability Resource Center partners 
74.3 	which agree by memorandum to access the infrastructure, including the designated providers 
74.4 	of the Senior LinkAge Line and the Disability Linkage Line.
74.5 	(b) The service must provide long-term care options counseling by assisting older adults, 
74.6 	caregivers, and providers in accessing information and options counseling about choices in 
74.7 	long-term care services that are purchased through private providers or available through 
74.8 	public options. The service must:
74.9 	(1) develop and provide for regular updating of a comprehensive database that includes 
74.10 	detailed listings in both consumer- and provider-oriented formats that can provide search 
74.11 	results down to the neighborhood level;
74.12 	(2) make the database accessible on the Internet and through other telecommunication 
74.13 	and media-related tools;
74.14 	(3) link callers to interactive long-term care screening tools and make these tools available 
74.15 	through the Internet by integrating the tools with the database;
74.16 	(4) develop community education materials with a focus on planning for long-term care 
74.17 	and evaluating independent living, housing, and service options;
74.18 	(5) conduct an outreach campaign to assist older adults and their caregivers in finding 
74.19 	information on the Internet and through other means of communication;
74.20 	(6) implement a messaging system for overflow callers and respond to these callers by 
74.21 	the next business day;
74.22 	(7) link callers with county human services and other providers to receive more in-depth 
74.23 	assistance and consultation related to long-term care options;
74.24 	(8) link callers with quality profiles for nursing facilities and other home and 
74.25 	community-based services providers developed by the commissioners of health and human 
74.26 	services;
74.27 	(9) develop an outreach plan to seniors and their caregivers with a particular focus on 
74.28 	establishing a clear presence in places that seniors recognize and:
74.29 	(i) place a significant emphasis on improved outreach and service to seniors and their 
74.30 	caregivers by establishing annual plans by neighborhood, city, and county, as necessary, to 
74.31 	address the unique needs of geographic areas in the state where there are dense populations 
74.32 	of seniors;
75.1 	(ii) establish an efficient workforce management approach and assign community living 
75.2 	specialist staff and volunteers to geographic areas as well as aging and disability resource 
75.3 	center sites so that seniors and their caregivers and professionals recognize the Senior 
75.4 	LinkAge Line as the place to call for aging services and information;
75.5 	(iii) recognize the size and complexity of the metropolitan area service system by working 
75.6 	with metropolitan counties to establish a clear partnership with them, including seeking 
75.7 	county advice on the establishment of local aging and disabilities resource center sites; and
75.8 	(iv) maintain dashboards with metrics that demonstrate how the service is expanding 
75.9 	and extending or enhancing its outreach efforts in dispersed or hard to reach locations in 
75.10 	varied population centers;
75.11 	(10) incorporate information about the availability of housing options, as well as 
75.12 	registered housing with services and consumer rights within the MinnesotaHelp.info network 
75.13 	long-term care database to facilitate consumer comparison of services and costs among 
75.14 	housing with services establishments and with other in-home services and to support financial 
75.15 	self-sufficiency as long as possible. Housing with services establishments and their arranged 
75.16 	home care providers shall provide information that will facilitate price comparisons, including 
75.17 	delineation of charges for rent and for services available. The commissioners of health and 
75.18 	human services shall align the data elements required by section 144G.06, the Uniform 
75.19 	Consumer Information Guide, and this section to provide consumers standardized information 
75.20 	and ease of comparison of long-term care options. The commissioner of human services 
75.21 	shall provide the data to the Minnesota Board on Aging for inclusion in the 
75.22 	MinnesotaHelp.info network long-term care database;
75.23 	(11) provide long-term care options counseling. Long-term care options counselors shall:
75.24 	(i) for individuals not eligible for case management under a public program or public 
75.25 	funding source, provide interactive decision support under which consumers, family 
75.26 	members, or other helpers are supported in their deliberations to determine appropriate 
75.27 	long-term care choices in the context of the consumer's needs, preferences, values, and 
75.28 	individual circumstances, including implementing a community support plan;
75.29 	(ii) provide Web-based educational information and collateral written materials to 
75.30 	familiarize consumers, family members, or other helpers with the long-term care basics, 
75.31 	issues to be considered, and the range of options available in the community;
75.32 	(iii) provide long-term care futures planning, which means providing assistance to 
75.33 	individuals who anticipate having long-term care needs to develop a plan for the more 
75.34 	distant future; and
76.1 	(iv) provide expertise in benefits and financing options for long-term care, including 
76.2 	Medicare, long-term care insurance, tax or employer-based incentives, reverse mortgages, 
76.3 	private pay options, and ways to access low or no-cost services or benefits through 
76.4 	volunteer-based or charitable programs;
76.5 	(12) using risk management and support planning protocols, provide long-term care 
76.6 	options counseling under clause (13) to current residents of nursing homes deemed 
76.7 	appropriate for discharge by the commissioner, former residents of nursing homes who 
76.8 	were discharged to community settings, and older adults who request service after 
76.9 	consultation with the Senior LinkAge Line under clause (13). The Senior LinkAge Line 
76.10 	shall also receive referrals from the residents or staff of nursing homes. who meet a profile 
76.11 	that demonstrates that the consumer is either at risk of readmission to a nursing home or 
76.12 	hospital, or would benefit from long-term care options counseling to age in place. The Senior 
76.13 	LinkAge Line shall identify and contact residents or patients deemed appropriate for 
76.14 	discharge by developing targeting criteria and creating a profile in consultation with the 
76.15 	commissioner who. The commissioner shall provide designated Senior LinkAge Line contact 
76.16 	centers with a list of current or former nursing home residents or people discharged from a 
76.17 	hospital or for whom Medicare home care has ended, that meet the criteria as being 
76.18 	appropriate for discharge planning long-term care options counseling through a referral via 
76.19 	a secure Web portal. Senior LinkAge Line shall provide these residents, if they indicate a 
76.20 	preference to receive long-term care options counseling, with initial assessment and, if 
76.21 	appropriate, a referral to:
76.22 	(i) long-term care consultation services under section 256B.0911;
76.23 	(ii) designated care coordinators of contracted entities under section 256B.035 for persons 
76.24 	who are enrolled in a managed care plan; or
76.25 	(iii) the long-term care consultation team for those who are eligible for relocation service 
76.26 	coordination due to high-risk factors or psychological or physical disability; and
76.27 	(13) develop referral protocols and processes that will assist certified health care homes, 
76.28 	Medicare home care, and hospitals to identify at-risk older adults and determine when to 
76.29 	refer these individuals to the Senior LinkAge Line for long-term care options counseling 
76.30 	under this section. The commissioner is directed to work with the commissioner of health 
76.31 	to develop protocols that would comply with the health care home designation criteria and 
76.32 	protocols available at the time of hospital discharge or the end of Medicare home care. The 
76.33 	commissioner shall keep a record of the number of people who choose long-term care 
76.34 	options counseling as a result of this section.
77.1 	(c) Nursing homes shall provide contact information to the Senior LinkAge Line for 
77.2 	residents identified in paragraph (b), clause (12), to provide long-term care options counseling 
77.3 	pursuant to paragraph (b), clause (11). The contact information for residents shall include 
77.4 	all information reasonably necessary to contact residents, including first and last names, 
77.5 	permanent and temporary addresses, telephone numbers, and e-mail addresses.
77.6 	(d) The Senior LinkAge Line shall determine when it is appropriate to refer a consumer 
77.7 	who receives long-term care options counseling under paragraph (b), clause (12) or (13), 
77.8 	and who uses an unpaid caregiver to the self-directed caregiver service under subdivision 
77.9 	12.

77.10 	EFFECTIVE DATE. This section is effective July 1, 2017.

77.11 	Sec. 7. Minnesota Statutes 2016, section 256.975, is amended by adding a subdivision to 
77.12 	read:
77.13 		Subd. 12.Self-directed caregiver grants. Beginning on July 1, 2019, the Minnesota 
77.14 	Board on Aging shall administer self-directed caregiver grants to support at risk family 
77.15 	caregivers of older adults or others eligible under the Older Americans Act of 1965, United 
77.16 	States Code, title 42, chapter 35, sections 3001 to 3058ff, to sustain family caregivers in 
77.17 	the caregivers' roles so older adults can remain at home longer. The board shall give priority 
77.18 	to consumers referred under section 256.975, subdivision 7, paragraph (d).

77.19 	EFFECTIVE DATE. This section is effective July 1, 2017.

77.20 	Sec. 8. Minnesota Statutes 2016, section 256B.431, subdivision 10, is amended to read:
77.21 		Subd. 10.Property rate adjustments and construction projects. A nursing facility 
77.22 	completing a construction project that is eligible for a rate adjustment under section 
77.23 	256B.434, subdivision 4f, and that was not approved through the moratorium exception 
77.24 	process in section 144A.073 must request from the commissioner a property-related payment 
77.25 	rate adjustment. If the request is made within 60 days after the construction project's 
77.26 	completion date, The effective date of the rate adjustment is the first of the month of January 
77.27 	or July, whichever occurs immediately following the construction project's completion date
77.28 	and submission of the provider's rate adjustment request. If the request is made more than 
77.29 	60 days after the completion date, the rate adjustment is effective on the first of the month 
77.30 	following the request. The commissioner shall provide a rate notice reflecting the allowable 
77.31 	costs within 60 days after receiving all the necessary information to compute the rate 
77.32 	adjustment. No sooner than the effective date of the rate adjustment for the construction 
77.33 	project, a nursing facility may adjust its rates by the amount anticipated to be allowed. Any 
78.1 	amounts collected from private pay residents in excess of the allowable rate must be repaid 
78.2 	to private pay residents with interest at the rate used by the commissioner of revenue for 
78.3 	the late payment of taxes and in effect on the date the rate increase is effective. Construction 
78.4 	projects with completion dates within one year of the completion date associated with the 
78.5 	property rate adjustment request and phased projects with project completion dates within 
78.6 	three years of the last phase of the phased project must be aggregated for purposes of the 
78.7 	minimum thresholds in subdivisions 16 and 17, and the maximum threshold in section 
78.8 	144A.071, subdivision 2. "Construction project" and "project construction costs" have the 
78.9 	meanings given them in Minnesota Statutes, section 144A.071, subdivision 1a.

78.10 	EFFECTIVE DATE. This section is effective for projects completed after January 1, 
78.11 	2018.

78.12 	Sec. 9. Minnesota Statutes 2016, section 256B.431, subdivision 16, is amended to read:
78.13 		Subd. 16.Major additions and replacements; equity incentive. For rate years beginning 
78.14 	after June 30, 1993, if a nursing facility acquires capital assets in connection with a project 
78.15 	approved under the moratorium exception process in section 144A.073 or in connection 
78.16 	with an addition to or replacement of buildings, attached fixtures, or land improvements 
78.17 	for which the total historical cost of those capital asset additions exceeds the lesser of 
78.18 	$150,000 or ten percent of the most recent appraised value, the nursing facility shall be 
78.19 	eligible for an equity incentive payment rate as in paragraphs (a) to (d). This computation 
78.20 	is separate from the determination of the nursing facility's rental rate. An equity incentive 
78.21 	payment rate as computed under this subdivision is limited to one in a 12-month period.
78.22 	(a) An eligible nursing facility shall receive an equity incentive payment rate equal to 
78.23 	the allowable historical cost of the capital asset acquired, minus the allowable debt directly 
78.24 	identified to that capital asset, multiplied by the equity incentive factor as described in 
78.25 	paragraphs (b) and (c), and divided by the nursing facility's occupancy factor under 
78.26 	subdivision 3f, paragraph (c). This amount shall be added to the nursing facility's total 
78.27 	payment rate and shall be effective the same day as the incremental increase in paragraph 
78.28 	(d) or subdivision 17. The allowable historical cost of the capital assets and the allowable 
78.29 	debt shall be determined as provided in Minnesota Rules, parts 9549.0010 to 9549.0080, 
78.30 	and this section.
78.31 	(b) The equity incentive factor shall be determined under clauses (1) to (4):
78.32 	(1) divide the initial allowable debt in paragraph (a) by the initial historical cost of the 
78.33 	capital asset additions referred to in paragraph (a), then cube the quotient,
79.1 	(2) subtract the amount calculated in clause (1) from the number one,
79.2 	(3) determine the difference between the rental factor and the lesser of two percentage 
79.3 	points above the posted yield for standard conventional fixed rate mortgages of the Federal 
79.4 	Home Loan Mortgage Corporation as published in the Wall Street Journal and in effect on 
79.5 	the first day of the month the debt or cost is incurred, or 16 percent,
79.6 	(4) multiply the amount calculated in clause (2) by the amount calculated in clause (3).
79.7 	(c) The equity incentive payment rate shall be limited to the term of the allowable debt 
79.8 	in paragraph (a), not greater than 20 years nor less than ten years. If no debt is incurred in 
79.9 	acquiring the capital asset, the equity incentive payment rate shall be paid for ten years. The 
79.10 	sale of a nursing facility under subdivision 14 shall terminate application of the equity 
79.11 	incentive payment rate effective on the date provided in subdivision 14, paragraph (f), for 
79.12 	the sale.
79.13 	(d) A nursing facility with an addition to or a renovation of its buildings, attached fixtures, 
79.14 	or land improvements meeting the criteria in this subdivision and not receiving the 
79.15 	property-related payment rate adjustment in subdivision 17, shall receive the incremental 
79.16 	increase in the nursing facility's rental rate as determined under Minnesota Rules, parts 
79.17 	9549.0010 to 9549.0080, and this section. The incremental increase shall be added to the 
79.18 	nursing facility's property-related payment rate. The effective date of this incremental 
79.19 	increase shall be the first day of the month of January or July, whichever occurs immediately 
79.20 	following the month in date on which the addition or replacement is completed.

79.21 	EFFECTIVE DATE. This section is effective for additions or replacements completed 
79.22 	after January 1, 2018.

79.23 	Sec. 10. Minnesota Statutes 2016, section 256B.431, subdivision 30, is amended to read:
79.24 		Subd. 30.Bed layaway and delicensure. (a) For rate years beginning on or after July 
79.25 	1, 2000, a nursing facility reimbursed under this section which has placed beds on layaway 
79.26 	shall, for purposes of application of the downsizing incentive in subdivision 3a, paragraph 
79.27 	(c), and calculation of the rental per diem, have those beds given the same effect as if the 
79.28 	beds had been delicensed so long as the beds remain on layaway. At the time of a layaway, 
79.29 	a facility may change its single bed election for use in calculating capacity days under 
79.30 	Minnesota Rules, part 9549.0060, subpart 11. The property payment rate increase shall be 
79.31 	effective the first day of the month of January or July, whichever occurs immediately 
79.32 	following the month date in which the layaway of the beds becomes effective under section 
79.33 	144A.071, subdivision 4b.
80.1 	(b) For rate years beginning on or after July 1, 2000, notwithstanding any provision to 
80.2 	the contrary under section 256B.434, a nursing facility reimbursed under that section which 
80.3 	has placed beds on layaway shall, for so long as the beds remain on layaway, be allowed 
80.4 	to:
80.5 	(1) aggregate the applicable investment per bed limits based on the number of beds 
80.6 	licensed immediately prior to entering the alternative payment system;
80.7 	(2) retain or change the facility's single bed election for use in calculating capacity days 
80.8 	under Minnesota Rules, part 9549.0060, subpart 11; and
80.9 	(3) establish capacity days based on the number of beds immediately prior to the layaway 
80.10 	and the number of beds after the layaway.
80.11 	The commissioner shall increase the facility's property payment rate by the incremental 
80.12 	increase in the rental per diem resulting from the recalculation of the facility's rental per 
80.13 	diem applying only the changes resulting from the layaway of beds and clauses (1), (2), and 
80.14 	(3). If a facility reimbursed under section 256B.434 completes a moratorium exception 
80.15 	project after its base year, the base year property rate shall be the moratorium project property 
80.16 	rate. The base year rate shall be inflated by the factors in section 256B.434, subdivision 4, 
80.17 	paragraph (c). The property payment rate increase shall be effective the first day of the 
80.18 	month of January or July, whichever occurs immediately following the month date in which 
80.19 	the layaway of the beds becomes effective.
80.20 	(c) If a nursing facility removes a bed from layaway status in accordance with section 
80.21 	144A.071, subdivision 4b, the commissioner shall establish capacity days based on the 
80.22 	number of licensed and certified beds in the facility not on layaway and shall reduce the 
80.23 	nursing facility's property payment rate in accordance with paragraph (b).
80.24 	(d) For the rate years beginning on or after July 1, 2000, notwithstanding any provision 
80.25 	to the contrary under section 256B.434, a nursing facility reimbursed under that section, 
80.26 	which has delicensed beds after July 1, 2000, by giving notice of the delicensure to the 
80.27 	commissioner of health according to the notice requirements in section 144A.071, subdivision 
80.28 	4b, shall be allowed to:
80.29 	(1) aggregate the applicable investment per bed limits based on the number of beds 
80.30 	licensed immediately prior to entering the alternative payment system;
80.31 	(2) retain or change the facility's single bed election for use in calculating capacity days 
80.32 	under Minnesota Rules, part 9549.0060, subpart 11; and
81.1 	(3) establish capacity days based on the number of beds immediately prior to the 
81.2 	delicensure and the number of beds after the delicensure.
81.3 	The commissioner shall increase the facility's property payment rate by the incremental 
81.4 	increase in the rental per diem resulting from the recalculation of the facility's rental per 
81.5 	diem applying only the changes resulting from the delicensure of beds and clauses (1), (2), 
81.6 	and (3). If a facility reimbursed under section 256B.434 completes a moratorium exception 
81.7 	project after its base year, the base year property rate shall be the moratorium project property 
81.8 	rate. The base year rate shall be inflated by the factors in section 256B.434, subdivision 4, 
81.9 	paragraph (c). The property payment rate increase shall be effective the first day of the 
81.10 	month of January or July, whichever occurs immediately following the month date in which 
81.11 	the delicensure of the beds becomes effective.
81.12 	(e) For nursing facilities reimbursed under this section or section 256B.434, any beds 
81.13 	placed on layaway shall not be included in calculating facility occupancy as it pertains to 
81.14 	leave days defined in Minnesota Rules, part 9505.0415.
81.15 	(f) For nursing facilities reimbursed under this section or section 256B.434, the rental 
81.16 	rate calculated after placing beds on layaway may not be less than the rental rate prior to 
81.17 	placing beds on layaway.
81.18 	(g) A nursing facility receiving a rate adjustment as a result of this section shall comply 
81.19 	with section 256B.47, subdivision 2 256R.06, subdivision 5.
81.20 	(h) A facility that does not utilize the space made available as a result of bed layaway 
81.21 	or delicensure under this subdivision to reduce the number of beds per room or provide 
81.22 	more common space for nursing facility uses or perform other activities related to the 
81.23 	operation of the nursing facility shall have its property rate increase calculated under this 
81.24 	subdivision reduced by the ratio of the square footage made available that is not used for 
81.25 	these purposes to the total square footage made available as a result of bed layaway or 
81.26 	delicensure.

81.27 	EFFECTIVE DATE. This section is effective for layaways occurring after July 1, 2017.

81.28 	Sec. 11. Minnesota Statutes 2016, section 256B.434, subdivision 4, is amended to read:
81.29 		Subd. 4.Alternate rates for nursing facilities. Effective for the rate years beginning 
81.30 	on and after January 1, 2018, a nursing facility's case mix property payment ratesrate for 
81.31 	the second and subsequent years of a facility's contract under this section are the previous 
81.32 	rate year's contractproperty payment ratesrate plus an inflation adjustment and, for facilities 
81.33 	reimbursed under this section or section 256B.431, an adjustment to include the cost of any 
82.1 	increase in Health Department licensing fees for the facility taking effect on or after July 
82.2 	1, 2001. The index for the inflation adjustment must be based on the change in the Consumer 
82.3 	Price Index-All Items (United States City average) (CPI-U) forecasted by the commissioner 
82.4 	of management and budget's national economic consultant Reports and Forecasts Division 
82.5 	of the Department of Human Services, as forecasted in the fourth quarter of the calendar 
82.6 	year preceding the rate year. The inflation adjustment must be based on the 12-month period 
82.7 	from the midpoint of the previous rate year to the midpoint of the rate year for which the 
82.8 	rate is being determined. For the rate years beginning on July 1, 1999, July 1, 2000, July 1, 
82.9 	2001, July 1, 2002, July 1, 2003, July 1, 2004, July 1, 2005, July 1, 2006, July 1, 2007, July 
82.10 	1, 2008, October 1, 2009, and October 1, 2010, this paragraph shall apply only to the 
82.11 	property-related payment rate. For the rate years beginning on October 1, 2011, October 1, 
82.12 	2012, October 1, 2013, October 1, 2014, October 1, 2015, January 1, 2016, and January 1, 
82.13 	2017, the rate adjustment under this paragraph shall be suspended. Beginning in 2005, 
82.14 	adjustment to the property payment rate under this section and section 256B.431 shall be 
82.15 	effective on October 1. In determining the amount of the property-related payment rate 
82.16 	adjustment under this paragraph, the commissioner shall determine the proportion of the 
82.17 	facility's rates that are property-related based on the facility's most recent cost report.

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

82.19 	Sec. 12. Minnesota Statutes 2016, section 256B.434, subdivision 4f, is amended to read:
82.20 		Subd. 4f.Construction project rate adjustments effective October 1, 2006. (a) 
82.21 	Effective October 1, 2006, facilities reimbursed under this section may receive a property 
82.22 	rate adjustment for construction projects exceeding the threshold in section 256B.431, 
82.23 	subdivision 16, and below the threshold in section 144A.071, subdivision 2, clause (a). For 
82.24 	these projects, capital assets purchased shall be counted as construction project costs for a 
82.25 	rate adjustment request made by a facility if they are: (1) purchased within 24 months of 
82.26 	the completion of the construction project; (2) purchased after the completion date of any 
82.27 	prior construction project; and (3) are not purchased prior to July 14, 2005. Except as 
82.28 	otherwise provided in this subdivision, the definitions, rate calculation methods, and 
82.29 	principles in sections 144A.071 and 256B.431 and Minnesota Rules, parts 9549.0010 to 
82.30 	9549.0080, shall be used to calculate rate adjustments for allowable construction projects 
82.31 	under this subdivision and section 144A.073. Facilities completing construction projects 
82.32 	between October 1, 2005, and October 1, 2006, are eligible to have a property rate adjustment 
82.33 	effective October 1, 2006. Facilities completing projects after October 1, 2006, are eligible 
82.34 	for a property rate adjustment effective on the first day of the month following the completion 
82.35 	date. Facilities completing projects after January 1, 2018, are eligible for a property rate 
83.1 	adjustment effective on the first day of the month of January or July, whichever occurs 
83.2 	immediately following the completion date.
83.3 	(b) Notwithstanding subdivision 18, as of July 14, 2005, facilities with rates set under 
83.4 	section 256B.431 and Minnesota Rules, parts 9549.0010 to 9549.0080, that commenced a 
83.5 	construction project on or after October 1, 2004, and do not have a contract under subdivision 
83.6 	3 by September 30, 2006, are eligible to request a rate adjustment under section 256B.431, 
83.7 	subdivision 10, through September 30, 2006. If the request results in the commissioner 
83.8 	determining a rate adjustment is allowable, the rate adjustment is effective on the first of 
83.9 	the month following project completion. These facilities shall be allowed to accumulate 
83.10 	construction project costs for the period October 1, 2004, to September 30, 2006.
83.11 	(c) Facilities shall be allowed construction project rate adjustments no sooner than 12 
83.12 	months after completing a previous construction project. Facilities must request the rate 
83.13 	adjustment according to section 256B.431, subdivision 10.
83.14 	(d) Capacity days shall be computed according to Minnesota Rules, part 9549.0060, 
83.15 	subpart 11. For rate calculations under this section, the number of licensed beds in the 
83.16 	nursing facility shall be the number existing after the construction project is completed and 
83.17 	the number of days in the nursing facility's reporting period shall be 365.
83.18 	(e) The value of assets to be recognized for a total replacement project as defined in 
83.19 	section 256B.431, subdivision 17d, shall be computed as described in clause (1). The value 
83.20 	of assets to be recognized for all other projects shall be computed as described in clause 
83.21 	(2).
83.22 	(1) Replacement-cost-new limits under section 256B.431, subdivision 17e, and the 
83.23 	number of beds allowed under subdivision 3a, paragraph (c), shall be used to compute the 
83.24 	maximum amount of assets allowable in a facility's property rate calculation. If a facility's 
83.25 	current request for a rate adjustment results from the completion of a construction project 
83.26 	that was previously approved under section 144A.073, the assets to be used in the rate 
83.27 	calculation cannot exceed the lesser of the amount determined under sections 144A.071, 
83.28 	subdivision 2, and 144A.073, subdivision 3b, or the actual allowable costs of the construction 
83.29 	project. A current request that is not the result of a project under section 144A.073 cannot 
83.30 	exceed the limit under section 144A.071, subdivision 2, paragraph (a). Applicable credits 
83.31 	must be deducted from the cost of the construction project.
83.32 	(2)(i) Replacement-cost-new limits under section 256B.431, subdivision 17e, and the 
83.33 	number of beds allowed under section 256B.431, subdivision 3a, paragraph (c), shall be 
84.1 	used to compute the maximum amount of assets allowable in a facility's property rate 
84.2 	calculation.
84.3 	(ii) The value of a facility's assets to be compared to the amount in item (i) begins with 
84.4 	the total appraised value from the last rate notice a facility received when its rates were set 
84.5 	under section 256B.431 and Minnesota Rules, parts 9549.0010 to 9549.0080. This value 
84.6 	shall be indexed by the factor in section 256B.431, subdivision 3f, paragraph (a), for each 
84.7 	rate year the facility received an inflation factor on its property-related rate when its rates 
84.8 	were set under this section. The value of assets listed as previous capital additions, capital 
84.9 	additions, and special projects on the facility's base year rate notice and the value of assets 
84.10 	related to a construction project for which the facility received a rate adjustment when its 
84.11 	rates were determined under this section shall be added to the indexed appraised value.
84.12 	(iii) The maximum amount of assets to be recognized in computing a facility's rate 
84.13 	adjustment after a project is completed is the lesser of the aggregate replacement-cost-new 
84.14 	limit computed in (i) minus the assets recognized in (ii) or the actual allowable costs of the 
84.15 	construction project.
84.16 	(iv) If a facility's current request for a rate adjustment results from the completion of a 
84.17 	construction project that was previously approved under section 144A.073, the assets to be 
84.18 	added to the rate calculation cannot exceed the lesser of the amount determined under 
84.19 	sections 144A.071, subdivision 2, and 144A.073, subdivision 3b, or the actual allowable 
84.20 	costs of the construction project. A current request that is not the result of a project under 
84.21 	section 144A.073 cannot exceed the limit stated in section 144A.071, subdivision 2, 
84.22 	paragraph (a). Assets disposed of as a result of a construction project and applicable credits 
84.23 	must be deducted from the cost of the construction project.
84.24 	(f) For construction projects approved under section 144A.073, allowable debt may 
84.25 	never exceed the lesser of the cost of the assets purchased, the threshold limit in section 
84.26 	144A.071, subdivision 2, or the replacement-cost-new limit less previously existing capital 
84.27 	debt.
84.28 	(g) For construction projects that were not approved under section 144A.073, allowable 
84.29 	debt is limited to the lesser of the threshold in section 144A.071, subdivision 2, for such 
84.30 	construction projects or the applicable limit in paragraph (e), clause (1) or (2), less previously 
84.31 	existing capital debt. Amounts of debt taken out that exceed the costs of a construction 
84.32 	project shall not be allowed regardless of the use of the funds.
84.33 	For all construction projects being recognized, interest expense and average debt shall 
84.34 	be computed based on the first 12 months following project completion. "Previously existing 
85.1 	capital debt" means capital debt recognized on the last rate determined under section 
85.2 	256B.431 and Minnesota Rules, parts 9549.0010 to 9549.0080, and the amount of debt 
85.3 	recognized for a construction project for which the facility received a rate adjustment when 
85.4 	its rates were determined under this section.
85.5 	For a total replacement project as defined in section 256B.431, subdivision 17d, the 
85.6 	value of previously existing capital debt shall be zero.
85.7 	(h) In addition to the interest expense allowed from the application of paragraph (f), the 
85.8 	amounts allowed under section 256B.431, subdivision 17a, paragraph (a), clauses (2) and 
85.9 	(3), will be added to interest expense.
85.10 	(i) The equity portion of the construction project shall be computed as the allowable 
85.11 	assets in paragraph (e), less the average debt in paragraph (f). The equity portion must be 
85.12 	multiplied by 5.66 percent and the allowable interest expense in paragraph (f) must be added. 
85.13 	This sum must be divided by 95 percent of capacity days to compute the construction project 
85.14 	rate adjustment.
85.15 	(j) For projects that are not a total replacement of a nursing facility, the amount in 
85.16 	paragraph (i) is adjusted for nonreimbursable areas and then added to the current property 
85.17 	payment rate of the facility.
85.18 	(k) For projects that are a total replacement of a nursing facility, the amount in paragraph 
85.19 	(i) becomes the new property payment rate after being adjusted for nonreimbursable areas. 
85.20 	Any amounts existing in a facility's rate before the effective date of the construction project 
85.21 	for equity incentives under section 256B.431, subdivision 16; capital repairs and replacements 
85.22 	under section 256B.431, subdivision 15; or refinancing incentives under section 256B.431, 
85.23 	subdivision 19, shall be removed from the facility's rates.
85.24 	(l) No additional equipment allowance is allowed under Minnesota Rules, part 9549.0060, 
85.25 	subpart 10, as the result of construction projects under this section. Allowable equipment 
85.26 	shall be included in the construction project costs.
85.27 	(m) Capital assets purchased after the completion date of a construction project shall be 
85.28 	counted as construction project costs for any future rate adjustment request made by a facility 
85.29 	under section 144A.071, subdivision 2, clause (a), if they are purchased within 24 months 
85.30 	of the completion of the future construction project.
85.31 	(n) In subsequent rate years, the property payment rate for a facility that results from 
85.32 	the application of this subdivision shall be the amount inflated in subdivision 4.
86.1 	(o) Construction projects are eligible for an equity incentive under section 256B.431, 
86.2 	subdivision 16. When computing the equity incentive for a construction project under this 
86.3 	subdivision, only the allowable costs and allowable debt related to the construction project 
86.4 	shall be used. The equity incentive shall not be a part of the property payment rate and not 
86.5 	inflated under subdivision 4. Effective October 1, 2006, all equity incentives for nursing 
86.6 	facilities reimbursed under this section shall be allowed for a duration determined under 
86.7 	section 256B.431, subdivision 16, paragraph (c).

86.8 	EFFECTIVE DATE. This section is effective January 1, 2018.

86.9 	Sec. 13. Minnesota Statutes 2016, section 256B.50, subdivision 1b, is amended to read:
86.10 		Subd. 1b.Filing an appeal. To appeal, the provider shall file with the commissioner a 
86.11 	written notice of appeal; the appeal must be postmarked or received by the commissioner 
86.12 	within 60 days of the publication date the determination of the payment rate was mailed or 
86.13 	personally received by a provider, whichever is earlier printed on the rate notice. The notice 
86.14 	of appeal must specify each disputed item; the reason for the dispute; the total dollar amount 
86.15 	in dispute for each separate disallowance, allocation, or adjustment of each cost item or part 
86.16 	of a cost item; the computation that the provider believes is correct; the authority in statute 
86.17 	or rule upon which the provider relies for each disputed item; the name and address of the 
86.18 	person or firm with whom contacts may be made regarding the appeal; and other information 
86.19 	required by the commissioner.

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

86.21 	Sec. 14. Minnesota Statutes 2016, section 256R.02, subdivision 4, is amended to read:
86.22 		Subd. 4.Administrative costs. "Administrative costs" means the identifiable costs for 
86.23 	administering the overall activities of the nursing home. These costs include salaries and 
86.24 	wages of the administrator, assistant administrator, business office employees, security 
86.25 	guards, and associated fringe benefits and payroll taxes, fees, contracts, or purchases related 
86.26 	to business office functions, licenses, and permits except as provided in the external fixed 
86.27 	costs category, employee recognition, travel including meals and lodging, all training except 
86.28 	as specified in subdivision 17, voice and data communication or transmission, office supplies, 
86.29 	property and liability insurance and other forms of allowable insurance not designated to 
86.30 	other areas, personnel recruitment, legal services, accounting services, management or 
86.31 	business consultants, data processing, information technology, Web site, central or home 
86.32 	office costs, business meetings and seminars, postage, fees for professional organizations, 
87.1 	subscriptions, security services, advertising, board of directors fees, working capital interest 
87.2 	expense, and bad debts and bad debt collection fees.

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

87.4 	Sec. 15. Minnesota Statutes 2016, section 256R.02, subdivision 18, is amended to read:
87.5 		Subd. 18.Employer health insurance costs. "Employer health insurance costs" means 
87.6 	premium expenses for group coverage and reinsurance,; actual expenses incurred for 
87.7 	self-insured plans, including reinsurance; and employer contributions to employee health 
87.8 	reimbursement and health savings accounts. Premium and expense costs and contributions 
87.9 	are allowable for (1) all employees and (2) the spouse and dependents of employees who 
87.10 	meet the definition of full-time employees under the federal Affordable Care Act, Public 
87.11 	Law 111-148.

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

87.13 	Sec. 16. Minnesota Statutes 2016, section 256R.10, is amended by adding a subdivision 
87.14 	to read:
87.15 		Subd. 7.Not specified allowed costs.  When the cost category for allowed cost items 
87.16 	or services is not specified in this chapter or the provider reimbursement manual, the 
87.17 	commissioner, in consultation with stakeholders, shall determine the cost category for the 
87.18 	allowed cost item or service.

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

87.20 	Sec. 17. [256R.18] REPORT BY COMMISSIONER OF HUMAN SERVICES.
87.21 	Beginning January 1, 2019, the commissioner shall provide to the house of representatives 
87.22 	and senate committees with jurisdiction over nursing facility payment rates a biennial report 
87.23 	on the effectiveness of the reimbursement system in improving quality, restraining costs, 
87.24 	and any other features of the system as determined by the commissioner.

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

87.26 	Sec. 18. Minnesota Statutes 2016, section 256R.40, subdivision 5, is amended to read:
87.27 		Subd. 5.Planned closure rate adjustment. (a) The commissioner shall calculate the 
87.28 	amount of the planned closure rate adjustment available under subdivision 6 according to 
87.29 	clauses (1) to (4):
87.30 	(1) the amount available is the net reduction of nursing facility beds multiplied by $2,080;
88.1 	(2) the total number of beds in the nursing facility or facilities receiving the planned 
88.2 	closure rate adjustment must be identified;
88.3 	(3) capacity days are determined by multiplying the number determined under clause 
88.4 	(2) by 365; and
88.5 	(4) the planned closure rate adjustment is the amount available in clause (1), divided by 
88.6 	capacity days determined under clause (3).
88.7 	(b) A planned closure rate adjustment under this section is effective on the first day of 
88.8 	the month of January or July, whichever occurs immediately following completion of closure 
88.9 	of the facility designated for closure in the application and becomes part of the nursing 
88.10 	facility's external fixed payment rate.
88.11 	(c) Upon the request of a closing facility, the commissioner must allow the facility a 
88.12 	closure rate adjustment as provided under section 144A.161, subdivision 10.
88.13 	(d) A facility that has received a planned closure rate adjustment may reassign it to 
88.14 	another facility that is under the same ownership at any time within three years of its effective 
88.15 	date. The amount of the adjustment is computed according to paragraph (a).
88.16 	(e) If the per bed dollar amount specified in paragraph (a), clause (1), is increased, the 
88.17 	commissioner shall recalculate planned closure rate adjustments for facilities that delicense 
88.18 	beds under this section on or after July 1, 2001, to reflect the increase in the per bed dollar 
88.19 	amount. The recalculated planned closure rate adjustment is effective from the date the per 
88.20 	bed dollar amount is increased.

88.21 	EFFECTIVE DATE. This section is effective for closures occurring after July 1, 2017.

88.22 	Sec. 19. Minnesota Statutes 2016, section 256R.41, is amended to read:
88.23 	256R.41 SINGLE-BED ROOM INCENTIVE.
88.24 	(a) Beginning July 1, 2005, the operating payment rate for nursing facilities reimbursed 
88.25 	under this chapter shall be increased by 20 percent multiplied by the ratio of the number of 
88.26 	new single-bed rooms created divided by the number of active beds on July 1, 2005, for 
88.27 	each bed closure that results in the creation of a single-bed room after July 1, 2005. The 
88.28 	commissioner may implement rate adjustments for up to 3,000 new single-bed rooms each 
88.29 	year. For eligible bed closures for which the commissioner receives a notice from a facility 
88.30 	during a calendar quarter that a bed has been delicensed and a new single-bed room has 
88.31 	been established, the rate adjustment in this paragraph shall be effective on either the first 
89.1 	day of the second month following that calendar quarter of January or July, whichever 
89.2 	occurs immediately following the date of the bed delicensure.
89.3 	(b) A nursing facility is prohibited from discharging residents for purposes of establishing 
89.4 	single-bed rooms. A nursing facility must submit documentation to the commissioner in a 
89.5 	form prescribed by the commissioner, certifying the occupancy status of beds closed to 
89.6 	create single-bed rooms. In the event that the commissioner determines that a facility has 
89.7 	discharged a resident for purposes of establishing a single-bed room, the commissioner shall 
89.8 	not provide a rate adjustment under paragraph (a).

89.9 	EFFECTIVE DATE. This section is effective for closures occurring after July 1, 2017.

89.10 	Sec. 20. Minnesota Statutes 2016, section 256R.47, is amended to read:
89.11 	256R.47 RATE ADJUSTMENT FOR CRITICAL ACCESS NURSING 
89.12 	FACILITIES.
89.13 	(a) The commissioner, in consultation with the commissioner of health, may designate 
89.14 	certain nursing facilities as critical access nursing facilities. The designation shall be granted 
89.15 	on a competitive basis, within the limits of funds appropriated for this purpose.
89.16 	(b) The commissioner shall request proposals from nursing facilities every two years. 
89.17 	Proposals must be submitted in the form and according to the timelines established by the 
89.18 	commissioner. In selecting applicants to designate, the commissioner, in consultation with 
89.19 	the commissioner of health, and with input from stakeholders, shall develop criteria designed 
89.20 	to preserve access to nursing facility services in isolated areas, rebalance long-term care, 
89.21 	and improve quality. To the extent practicable, the commissioner shall ensure an even 
89.22 	distribution of designations across the state.
89.23 	(c) The commissioner shall allow the benefits in clauses (1) to (5) for nursing facilities 
89.24 	designated as critical access nursing facilities:
89.25 	(1) partial rebasing, with the commissioner allowing a designated facility operating 
89.26 	payment rates being the sum of up to 60 percent of the operating payment rate determined 
89.27 	in accordance with section 256R.21, subdivision 3, and at least 40 percent, with the sum of 
89.28 	the two portions being equal to 100 percent, of the operating payment rate that would have 
89.29 	been allowed had the facility not been designated. The commissioner may adjust these 
89.30 	percentages by up to 20 percent and may approve a request for less than the amount allowed;
89.31 	(2) enhanced payments for leave days. Notwithstanding section 256R.43, upon 
89.32 	designation as a critical access nursing facility, the commissioner shall limit payment for 
89.33 	leave days to 60 percent of that nursing facility's total payment rate for the involved resident, 
90.1 	and shall allow this payment only when the occupancy of the nursing facility, inclusive of 
90.2 	bed hold days, is equal to or greater than 90 percent;
90.3 	(3) two designated critical access nursing facilities, with up to 100 beds in active service, 
90.4 	may jointly apply to the commissioner of health for a waiver of Minnesota Rules, part 
90.5 	4658.0500, subpart 2, in order to jointly employ a director of nursing. The commissioner 
90.6 	of health shall consider each waiver request independently based on the criteria under 
90.7 	Minnesota Rules, part 4658.0040;
90.8 	(4) the minimum threshold under section 256B.431, subdivision 15, paragraph (e), shall 
90.9 	be 40 percent of the amount that would otherwise apply; and
90.10 	(5) the quality-based rate limits under section 256R.23, subdivisions 5 to 7, apply to 
90.11 	designated critical access nursing facilities.
90.12 	(d) Designation of a critical access nursing facility is for a period of two years, after 
90.13 	which the benefits allowed under paragraph (c) shall be removed. Designated facilities may 
90.14 	apply for continued designation.
90.15 	(e) This section is suspended and no state or federal funding shall be appropriated or 
90.16 	allocated for the purposes of this section from January 1, 2016, to December 31, 2017 2019.

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

90.18 	Sec. 21. Minnesota Statutes 2016, section 256R.49, subdivision 1, is amended to read:
90.19 		Subdivision 1.Rate adjustments for compensation-related costs. (a) Operating payment 
90.20 	rates of all nursing facilities that are reimbursed under this chapter shall be increased effective 
90.21 	for rate years beginning on and after October 1, 2014, to address changes in compensation 
90.22 	costs for nursing facility employees paid less than $14 per hour in accordance with this 
90.23 	section. Rate increases provided under this section before October 1, 2016, expire effective 
90.24 	January 1, 2018, and rate increases provided on or after October 1, 2016, expire effective 
90.25 	January 1, 2019.
90.26 	(b) Nursing facilities that receive approval of the applications in subdivision 2 must 
90.27 	receive rate adjustments according to subdivision 4. The rate adjustments must be used to 
90.28 	pay compensation costs for nursing facility employees paid less than $14 per hour.

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

91.1 	Sec. 22. Minnesota Statutes 2016, section 626.557, subdivision 4, is amended to read:
91.2 		Subd. 4.Reporting. (a) Except as provided in paragraph (b), a mandated reporter shall 
91.3 	immediately make an oral a report to the common entry point. The common entry point 
91.4 	may accept electronic reports submitted through a Web-based reporting system established 
91.5 	by the commissioner. Use of a telecommunications device for the deaf or other similar 
91.6 	device shall be considered an oral report. The common entry point may not require written 
91.7 	reports. To the extent possible, the report must be of sufficient content to identify the 
91.8 	vulnerable adult, the caregiver, the nature and extent of the suspected maltreatment, any 
91.9 	evidence of previous maltreatment, the name and address of the reporter, the time, date, 
91.10 	and location of the incident, and any other information that the reporter believes might be 
91.11 	helpful in investigating the suspected maltreatment. A mandated reporter may disclose not 
91.12 	public data, as defined in section 13.02, and medical records under sections 144.291 to 
91.13 	144.298, to the extent necessary to comply with this subdivision.
91.14 	(b) A boarding care home that is licensed under sections 144.50 to 144.58 and certified 
91.15 	under Title 19 of the Social Security Act, a nursing home that is licensed under section 
91.16 	144A.02 and certified under Title 18 or Title 19 of the Social Security Act, or a hospital 
91.17 	that is licensed under sections 144.50 to 144.58 and has swing beds certified under Code 
91.18 	of Federal Regulations, title 42, section 482.66, may submit a report electronically to the 
91.19 	common entry point instead of submitting an oral report. The report may be a duplicate of 
91.20 	the initial report the facility submits electronically to the commissioner of health to comply 
91.21 	with the reporting requirements under Code of Federal Regulations, title 42, section 483.13. 
91.22 	The commissioner of health may modify these reporting requirements to include items 
91.23 	required under paragraph (a) that are not currently included in the electronic reporting form.

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

91.25 	Sec. 23. Minnesota Statutes 2016, section 626.557, subdivision 9, is amended to read:
91.26 		Subd. 9.Common entry point designation. (a) Each county board shall designate a 
91.27 	common entry point for reports of suspected maltreatment, for use until the commissioner 
91.28 	of human services establishes a common entry point. Two or more county boards may 
91.29 	jointly designate a single common entry point. The commissioner of human services shall 
91.30 	establish operate a common entry point effective July 1, 2015. The common entry point is 
91.31 	the unit responsible for receiving the report of suspected maltreatment under this section.
91.32 	(b) The common entry point must be available 24 hours per day to take calls from 
91.33 	reporters of suspected maltreatment. The common entry point shall use a standard intake 
91.34 	form that includes:
92.1 	(1) the time and date of the report;
92.2 	(2) the name, address, and telephone number of the person reporting; and identifying 
92.3 	and contact information for the alleged victim and the alleged perpetrator;
92.4 	(3) the name and contact information for the reporter, the initial reporter, witnesses, and 
92.5 	other relevant people;
92.6 	(4) the basis of vulnerability for the alleged victim;
92.7 	(3) (5) the time, date, and location of the incident;
92.8 	(4) the names of the persons involved, including but not limited to, perpetrators, alleged 
92.9 	victims, and witnesses;
92.10 	(5) (6) whether there was a is an immediate safety risk of imminent danger to the alleged 
92.11 	victim;
92.12 	(6) (7) a description of the suspected maltreatment;
92.13 	(7) the disability, if any, of the alleged victim;
92.14 	(8) the relationship of the alleged perpetrator to the alleged victim;
92.15 	(9) (8) whether a facility was involved and, if so, which agency licenses the facility;
92.16 	(9) actions taken to protect the alleged victim;
92.17 	(10) any action taken required notifications and referrals made by the common entry 
92.18 	point; and
92.19 	(11) whether law enforcement has been notified;
92.20 	(12) (11) whether the reporter wishes to receive notification of the initial and final reports; 
92.21 	and disposition.
92.22 	(13) if the report is from a facility with an internal reporting procedure, the name, mailing 
92.23 	address, and telephone number of the person who initiated the report internally.
92.24 	(c) The common entry point is not required to complete each item on the form prior to 
92.25 	dispatching the report to the appropriate lead investigative agency.
92.26 	(d) The common entry point shall immediately report to a law enforcement agency any 
92.27 	incident in which there is reason to believe a crime has been committed.
92.28 	(e) If a report is initially made to a law enforcement agency or a lead investigative agency, 
92.29 	those agencies shall take the report on the appropriate common entry point intake forms 
92.30 	and immediately forward a copy to the common entry point.
93.1 	(f) The common entry point staff must receive training on how to screen and dispatch 
93.2 	reports efficiently and in accordance with this section.
93.3 	(g) The commissioner of human services shall maintain a centralized database for the 
93.4 	collection of common entry point data, lead investigative agency data including maltreatment 
93.5 	report disposition, and appeals data. The common entry point shall have access to the 
93.6 	centralized database and must log the reports into the database and immediately identify 
93.7 	and locate prior reports of abuse, neglect, or exploitation.
93.8 	(h) When appropriate, the common entry point staff must refer calls that do not allege 
93.9 	the abuse, neglect, or exploitation of a vulnerable adult to other organizations that might 
93.10 	resolve the reporter's concerns.
93.11 	(i) A common entry point must be operated in a manner that enables the commissioner 
93.12 	of human services to:
93.13 	(1) track critical steps in the reporting, evaluation, referral, response, disposition, and 
93.14 	investigative process to ensure compliance with all requirements for all reports;
93.15 	(2) maintain data to facilitate the production of aggregate statistical reports for monitoring 
93.16 	patterns of abuse, neglect, or exploitation;
93.17 	(3) serve as a resource for the evaluation, management, and planning of preventative 
93.18 	and remedial services for vulnerable adults who have been subject to abuse, neglect, or 
93.19 	exploitation;
93.20 	(4) set standards, priorities, and policies to maximize the efficiency and effectiveness 
93.21 	of the common entry point; and
93.22 	(5) track and manage consumer complaints related to the common entry point.
93.23 	(j) The commissioners of human services and health shall collaborate on the creation of 
93.24 	a system for referring reports to the lead investigative agencies. This system The common 
93.25 	entry point shall enable the commissioner of human services to track critical steps in the 
93.26 	reporting, evaluation, referral, response, disposition, investigation, notification, determination, 
93.27 	and appeal processes.

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

93.29 	Sec. 24. Minnesota Statutes 2016, section 626.557, subdivision 12b, is amended to read:
93.30 		Subd. 12b.Data management. (a) In performing any of the duties of this section as a 
93.31 	lead investigative agency, the county social service agency shall maintain appropriate 
93.32 	records. Data collected by the county social service agency under this section are welfare 
94.1 	data under section 13.46. Notwithstanding section 13.46, subdivision 1, paragraph (a), data 
94.2 	under this paragraph that are inactive investigative data on an individual who is a vendor 
94.3 	of services are private data on individuals, as defined in section 13.02. The identity of the 
94.4 	reporter may only be disclosed as provided in paragraph (c).
94.5 	Data maintained by the common entry point are confidential data on individuals or 
94.6 	protected nonpublic data as defined in section 13.02. Notwithstanding section 138.163, the 
94.7 	common entry point shall maintain data for three calendar years after date of receipt and 
94.8 	then destroy the data unless otherwise directed by federal requirements.
94.9 	(b) The commissioners of health and human services shall prepare an investigation 
94.10 	memorandum for each report alleging maltreatment investigated under this section. County 
94.11 	social service agencies must maintain private data on individuals but are not required to 
94.12 	prepare an investigation memorandum. During an investigation by the commissioner of 
94.13 	health or the commissioner of human services, data collected under this section are 
94.14 	confidential data on individuals or protected nonpublic data as defined in section 13.02. 
94.15 	Upon completion of the investigation, the data are classified as provided in clauses (1) to 
94.16 	(3) and paragraph (c).
94.17 	(1) The investigation memorandum must contain the following data, which are public:
94.18 	(i) the name of the facility investigated;
94.19 	(ii) a statement of the nature of the alleged maltreatment;
94.20 	(iii) pertinent information obtained from medical or other records reviewed;
94.21 	(iv) the identity of the investigator;
94.22 	(v) a summary of the investigation's findings;
94.23 	(vi) statement of whether the report was found to be substantiated, inconclusive, false, 
94.24 	or that no determination will be made;
94.25 	(vii) a statement of any action taken by the facility;
94.26 	(viii) a statement of any action taken by the lead investigative agency; and
94.27 	(ix) when a lead investigative agency's determination has substantiated maltreatment, a 
94.28 	statement of whether an individual, individuals, or a facility were responsible for the 
94.29 	substantiated maltreatment, if known.
94.30 	The investigation memorandum must be written in a manner which protects the identity 
94.31 	of the reporter and of the vulnerable adult and may not contain the names or, to the extent 
94.32 	possible, data on individuals or private data listed in clause (2).
95.1 	(2) Data on individuals collected and maintained in the investigation memorandum are 
95.2 	private data, including:
95.3 	(i) the name of the vulnerable adult;
95.4 	(ii) the identity of the individual alleged to be the perpetrator;
95.5 	(iii) the identity of the individual substantiated as the perpetrator; and
95.6 	(iv) the identity of all individuals interviewed as part of the investigation.
95.7 	(3) Other data on individuals maintained as part of an investigation under this section 
95.8 	are private data on individuals upon completion of the investigation.
95.9 	(c) After the assessment or investigation is completed, the name of the reporter must be 
95.10 	confidential. The subject of the report may compel disclosure of the name of the reporter 
95.11 	only with the consent of the reporter or upon a written finding by a court that the report was 
95.12 	false and there is evidence that the report was made in bad faith. This subdivision does not 
95.13 	alter disclosure responsibilities or obligations under the Rules of Criminal Procedure, except 
95.14 	that where the identity of the reporter is relevant to a criminal prosecution, the district court 
95.15 	shall do an in-camera review prior to determining whether to order disclosure of the identity 
95.16 	of the reporter.
95.17 	(d) Notwithstanding section 138.163, data maintained under this section by the 
95.18 	commissioners of health and human services must be maintained under the following 
95.19 	schedule and then destroyed unless otherwise directed by federal requirements:
95.20 	(1) data from reports determined to be false, maintained for three years after the finding 
95.21 	was made;
95.22 	(2) data from reports determined to be inconclusive, maintained for four years after the 
95.23 	finding was made;
95.24 	(3) data from reports determined to be substantiated, maintained for seven years after 
95.25 	the finding was made; and
95.26 	(4) data from reports which were not investigated by a lead investigative agency and for 
95.27 	which there is no final disposition, maintained for three years from the date of the report.
95.28 	(e) The commissioners of health and human services shall annually publish on their Web 
95.29 	sites the number and type of reports of alleged maltreatment involving licensed facilities 
95.30 	reported under this section, the number of those requiring investigation under this section, 
95.31 	and the resolution of those investigations. On a biennial basis, the commissioners of health 
96.1 	and human services shall jointly report the following information to the legislature and the 
96.2 	governor:
96.3 	(1) the number and type of reports of alleged maltreatment involving licensed facilities 
96.4 	reported under this section, the number of those requiring investigations under this section, 
96.5 	the resolution of those investigations, and which of the two lead agencies was responsible;
96.6 	(2) trends about types of substantiated maltreatment found in the reporting period;
96.7 	(3) if there are upward trends for types of maltreatment substantiated, recommendations 
96.8 	for addressing and responding to them;
96.9 	(4) efforts undertaken or recommended to improve the protection of vulnerable adults;
96.10 	(5) whether and where backlogs of cases result in a failure to conform with statutory 
96.11 	time frames and recommendations for reducing backlogs if applicable;
96.12 	(6) recommended changes to statutes affecting the protection of vulnerable adults; and
96.13 	(7) any other information that is relevant to the report trends and findings.
96.14 	(f) Each lead investigative agency must have a record retention policy.
96.15 	(g) The common entry point, a lead investigative agencies agency, a county agency or 
96.16 	its designee, a prosecuting authorities authority, and a law enforcement agencies agency, a 
96.17 	state licensing board, a federal agency, a state agency, and a tribe may exchange not public 
96.18 	data, as defined in section 13.02, if the agency or authority requesting providing the data 
96.19 	determines that the data are pertinent and necessary to the requesting agency in initiating, 
96.20 	furthering, or completing provide adult protective services or to initiate, further, or complete
96.21 	an investigation under this section. Data collected under this section must be made available 
96.22 	to prosecuting authorities and law enforcement officials, local county agencies, and licensing 
96.23 	agencies investigating the alleged maltreatment under this section. The lead investigative 
96.24 	agency shall exchange not public data with the vulnerable adult maltreatment review panel 
96.25 	established in section 256.021 if the data are pertinent and necessary for a review requested 
96.26 	under that section. Notwithstanding section 138.17, upon completion of the review, not 
96.27 	public data received by the review panel must be destroyed.
96.28 	(h) Each lead investigative agency shall keep records of the length of time it takes to 
96.29 	complete its investigations.
96.30 	(i) A lead investigative agency may notify other affected parties and their authorized 
96.31 	representative if the lead investigative agency has reason to believe maltreatment has occurred 
97.1 	and determines the information will safeguard the well-being of the affected parties or dispel 
97.2 	widespread rumor or unrest in the affected facility.
97.3 	(j) Under any notification provision of this section, where federal law specifically 
97.4 	prohibits the disclosure of patient identifying information, a lead investigative agency may 
97.5 	not provide any notice unless the vulnerable adult has consented to disclosure in a manner 
97.6 	which conforms to federal requirements.

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

97.8 	Sec. 25. Minnesota Statutes 2016, section 626.557, subdivision 18, is amended to read:
97.9 		Subd. 18.Outreach. The commissioner of human services shall maintain an aggressive
97.10 	a program to educate those required to report, as well as the general public, about the 
97.11 	requirements of this section using a variety of media. The commissioner of human services 
97.12 	shall print and make available the form developed under subdivision 9.

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

97.14 	Sec. 26. Minnesota Statutes 2016, section 626.5572, subdivision 2, is amended to read:
97.15 		Subd. 2.Abuse. "Abuse" means:
97.16 	(a) An act against a vulnerable adult that constitutes a violation of, an attempt to violate, 
97.17 	or aiding and abetting a violation of:
97.18 	(1) assault in the first through fifth degrees as defined in sections 609.221 to 609.224;
97.19 	(2) the use of drugs to injure or facilitate crime as defined in section 609.235;
97.20 	(3) the solicitation, inducement, and promotion of prostitution as defined in section 
97.21 	609.322; and
97.22 	(4) criminal sexual conduct in the first through fifth degrees as defined in sections 
97.23 	609.342 to 609.3451.
97.24 	A violation includes any action that meets the elements of the crime, regardless of 
97.25 	whether there is a criminal proceeding or conviction.
97.26 	(b) Conduct which is not an accident or therapeutic conduct as defined in this section, 
97.27 	which produces or could reasonably be expected to produce physical pain or injury or 
97.28 	emotional distress including, but not limited to, the following:
97.29 	(1) hitting, slapping, kicking, pinching, biting, or corporal punishment of a vulnerable 
97.30 	adult;
98.1 	(2) use of repeated or malicious oral, written, or gestured language toward a vulnerable 
98.2 	adult or the treatment of a vulnerable adult which would be considered by a reasonable 
98.3 	person to be disparaging, derogatory, humiliating, harassing, or threatening; or
98.4 	(3) use of any aversive or deprivation procedure, unreasonable confinement, or 
98.5 	involuntary seclusion, including the forced separation of the vulnerable adult from other 
98.6 	persons against the will of the vulnerable adult or the legal representative of the vulnerable 
98.7 	adult; and.
98.8 	(4) use of any aversive or deprivation procedures for persons with developmental 
98.9 	disabilities or related conditions not authorized under section 245.825.
98.10 	(c) Any sexual contact or penetration as defined in section 609.341, between a facility 
98.11 	staff person or a person providing services in the facility and a resident, patient, or client 
98.12 	of that facility.
98.13 	(d) The act of forcing, compelling, coercing, or enticing a vulnerable adult against the 
98.14 	vulnerable adult's will to perform services for the advantage of another.
98.15 	(e) For purposes of this section, a vulnerable adult is not abused for the sole reason that 
98.16 	the vulnerable adult or a person with authority to make health care decisions for the 
98.17 	vulnerable adult under sections 144.651, 144A.44, chapter 145B, 145C or 252A, or section 
98.18 	253B.03 or 524.5-313, refuses consent or withdraws consent, consistent with that authority 
98.19 	and within the boundary of reasonable medical practice, to any therapeutic conduct, including 
98.20 	any care, service, or procedure to diagnose, maintain, or treat the physical or mental condition 
98.21 	of the vulnerable adult or, where permitted under law, to provide nutrition and hydration 
98.22 	parenterally or through intubation. This paragraph does not enlarge or diminish rights 
98.23 	otherwise held under law by:
98.24 	(1) a vulnerable adult or a person acting on behalf of a vulnerable adult, including an 
98.25 	involved family member, to consent to or refuse consent for therapeutic conduct; or
98.26 	(2) a caregiver to offer or provide or refuse to offer or provide therapeutic conduct.
98.27 	(f) For purposes of this section, a vulnerable adult is not abused for the sole reason that 
98.28 	the vulnerable adult, a person with authority to make health care decisions for the vulnerable 
98.29 	adult, or a caregiver in good faith selects and depends upon spiritual means or prayer for 
98.30 	treatment or care of disease or remedial care of the vulnerable adult in lieu of medical care, 
98.31 	provided that this is consistent with the prior practice or belief of the vulnerable adult or 
98.32 	with the expressed intentions of the vulnerable adult.
99.1 	(g) For purposes of this section, a vulnerable adult is not abused for the sole reason that 
99.2 	the vulnerable adult, who is not impaired in judgment or capacity by mental or emotional 
99.3 	dysfunction or undue influence, engages in consensual sexual contact with:
99.4 	(1) a person, including a facility staff person, when a consensual sexual personal 
99.5 	relationship existed prior to the caregiving relationship; or
99.6 	(2) a personal care attendant, regardless of whether the consensual sexual personal 
99.7 	relationship existed prior to the caregiving relationship.

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

99.9 	Sec. 27. Minnesota Statutes 2016, section 626.5572, subdivision 4, is amended to read:
99.10 		Subd. 4.Caregiver. "Caregiver" means an individual or facility who has responsibility 
99.11 	for the care of a vulnerable adult as a result of a family relationship, or who has an assumed 
99.12 	responsibility for all or a portion of the care of a vulnerable adult voluntarily, by contract, 
99.13 	or by agreement.

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

99.15 	ARTICLE 4
99.16 	HEALTH CARE

99.17 	Section 1. Minnesota Statutes 2016, section 13.69, subdivision 1, is amended to read:
99.18 		Subdivision 1.Classifications. (a) The following government data of the Department 
99.19 	of Public Safety are private data:
99.20 	(1) medical data on driving instructors, licensed drivers, and applicants for parking 
99.21 	certificates and special license plates issued to physically disabled persons;
99.22 	(2) other data on holders of a disability certificate under section 169.345, except that (i) 
99.23 	data that are not medical data may be released to law enforcement agencies, and (ii) data 
99.24 	necessary for enforcement of sections 169.345 and 169.346 may be released to parking 
99.25 	enforcement employees or parking enforcement agents of statutory or home rule charter 
99.26 	cities and towns;
99.27 	(3) Social Security numbers in driver's license and motor vehicle registration records, 
99.28 	except that Social Security numbers must be provided to the Department of Revenue for 
99.29 	purposes of tax administration, the Department of Labor and Industry for purposes of 
99.30 	workers' compensation administration and enforcement, the Department of Human Services 
100.1 	for purposes of recovery of Minnesota health care program benefits paid, and the Department 
100.2 	of Natural Resources for purposes of license application administration; and
100.3 	(4) data on persons listed as standby or temporary custodians under section 171.07, 
100.4 	subdivision 11, except that the data must be released to:
100.5 	(i) law enforcement agencies for the purpose of verifying that an individual is a designated 
100.6 	caregiver; or
100.7 	(ii) law enforcement agencies who state that the license holder is unable to communicate 
100.8 	at that time and that the information is necessary for notifying the designated caregiver of 
100.9 	the need to care for a child of the license holder.
100.10 	The department may release the Social Security number only as provided in clause (3) 
100.11 	and must not sell or otherwise provide individual Social Security numbers or lists of Social 
100.12 	Security numbers for any other purpose.
100.13 	(b) The following government data of the Department of Public Safety are confidential 
100.14 	data: data concerning an individual's driving ability when that data is received from a member 
100.15 	of the individual's family.

100.16 	EFFECTIVE DATE. This section is effective July 1, 2017.

100.17 	Sec. 2. Minnesota Statutes 2016, section 256.01, is amended by adding a subdivision to 
100.18 	read:
100.19 		Subd. 18f.Asset verification system. The commissioner shall implement the Asset 
100.20 	Verification System (AVS) according to Public Law 110-252, title VII, section 7001(d), to 
100.21 	verify assets for or renewing an individual applying for health care benefits under section 
100.22 	256B.055, subdivisions 7 and 7b.

100.23 	EFFECTIVE DATE. This section is effective July 1, 2017.

100.24 	Sec. 3. Minnesota Statutes 2016, section 256.045, subdivision 3a, is amended to read:
100.25 		Subd. 3a.Prepaid health plan appeals. (a) All prepaid health plans under contract to 
100.26 	the commissioner under chapter 256B must provide for a complaint system according to 
100.27 	section 62D.11. When a prepaid health plan denies, reduces, or terminates a health service 
100.28 	or denies a request to authorize a previously authorized health service, the prepaid health 
100.29 	plan must notify the recipient of the right to file a complaint or an appeal. The notice must 
100.30 	include the name and telephone number of the ombudsman and notice of the recipient's 
100.31 	right to request a hearing under paragraph (b). Recipients may request the assistance of the 
101.1 	ombudsman in the complaint system process. The prepaid health plan must issue a written 
101.2 	resolution of the complaint to the recipient within 30 days after the complaint is filed with 
101.3 	the prepaid health plan. A recipient is not required to exhaust the complaint system 
101.4 	procedures in order to request a hearing under paragraph (b).
101.5 	(b) Recipients enrolled in a prepaid health plan under chapter 256B may contest a prepaid 
101.6 	health plan's denial, reduction, or termination of health services, a prepaid health plan's 
101.7 	denial of a request to authorize a previously authorized health service, or the prepaid health 
101.8 	plan's written resolution of a complaint by submitting a written request for a hearing 
101.9 	according to subdivision 3. A state human services judge shall conduct a hearing on the 
101.10 	matter and shall recommend an order to the commissioner of human services. The 
101.11 	commissioner need not grant a hearing if the sole issue raised by a recipient is the 
101.12 	commissioner's authority to require mandatory enrollment in a prepaid health plan in a 
101.13 	county where prepaid health plans are under contract with the commissioner. The state 
101.14 	human services judge may order a second medical opinion from the prepaid health plan or 
101.15 	may order a second medical opinion from a nonprepaid health plan provider at the expense 
101.16 	of the prepaid health plan Department of Human Services. Recipients may request the 
101.17 	assistance of the ombudsman in the appeal process.
101.18 	(c) In the written request for a hearing to appeal from a prepaid health plan's denial, 
101.19 	reduction, or termination of a health service, a prepaid health plan's denial of a request to 
101.20 	authorize a previously authorized service, or the prepaid health plan's written resolution to 
101.21 	a complaint, a recipient may request an expedited hearing. If an expedited appeal is 
101.22 	warranted, the state human services judge shall hear the appeal and render a decision within 
101.23 	a time commensurate with the level of urgency involved, based on the individual 
101.24 	circumstances of the case.

101.25 	EFFECTIVE DATE. This section is effective January 1, 2018.

101.26 	Sec. 4. Minnesota Statutes 2016, section 256.962, subdivision 5, is amended to read:
101.27 		Subd. 5.Incentive program. Beginning January 1, 2008, the commissioner shall establish 
101.28 	an incentive program for organizations and licensed insurance producers under chapter 60K 
101.29 	that directly identify and assist potential enrollees in filling out and submitting an application. 
101.30 	For each applicant who is successfully enrolled in MinnesotaCare or medical assistance, 
101.31 	the commissioner, within the available appropriation, shall pay the organization or licensed 
101.32 	insurance producer a $25 $70 application assistance bonus. The organization or licensed 
101.33 	insurance producer may provide an applicant a gift certificate or other incentive upon 
101.34 	enrollment.

102.1 	EFFECTIVE DATE. This section is effective July 1, 2017.

102.2 	Sec. 5. Minnesota Statutes 2016, section 256.962, is amended by adding a subdivision to 
102.3 	read:
102.4 		Subd. 9.Department of Corrections. By January 1, 2018, the commissioner, in 
102.5 	consultation with the commissioner of the Department of Corrections, shall develop and 
102.6 	implement a process to improve access to health care coverage by offering application 
102.7 	assistance to people transitioning from incarceration in a facility operated by the Department 
102.8 	of Corrections to the community.

102.9 	EFFECTIVE DATE. This section is effective July 1, 2017.

102.10 	Sec. 6. Minnesota Statutes 2016, section 256.9686, subdivision 8, is amended to read:
102.11 		Subd. 8.Rate year. "Rate year" means a calendar year from January 1 to December 31.
102.12 	Effective with the 2012 base year, rate year means a state fiscal year from July 1 to June 
102.13 	30.

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

102.15 	Sec. 7. Minnesota Statutes 2016, section 256.969, subdivision 1, is amended to read:
102.16 		Subdivision 1.Hospital cost index. (a) The hospital cost index shall be the change in 
102.17 	the Centers for Medicare and Medicaid Services Inpatient Hospital Market Basket. The 
102.18 	commissioner shall use the indices as forecasted for the midpoint of the prior rate year to 
102.19 	the midpoint of the current rate year.
102.20 	(b) Except as authorized under this section, for fiscal years beginning on or after July 
102.21 	1, 1993, the commissioner of human services shall not provide automatic annual inflation 
102.22 	adjustments for hospital payment rates under medical assistance.

102.23 	EFFECTIVE DATE. This section is effective July 1, 2017.

102.24 	Sec. 8. Minnesota Statutes 2016, section 256.969, subdivision 2b, is amended to read:
102.25 		Subd. 2b.Hospital payment rates. (a) For discharges occurring on or after November 
102.26 	1, 2014, hospital inpatient services for hospitals located in Minnesota shall be paid according 
102.27 	to the following:
102.28 	(1) critical access hospitals as defined by Medicare shall be paid using a cost-based 
102.29 	methodology;
103.1 	(2) long-term hospitals as defined by Medicare shall be paid on a per diem methodology 
103.2 	under subdivision 25;
103.3 	(3) rehabilitation hospitals or units of hospitals that are recognized as rehabilitation 
103.4 	distinct parts as defined by Medicare shall be paid according to the methodology under 
103.5 	subdivision 12; and
103.6 	(4) all other hospitals shall be paid on a diagnosis-related group (DRG) methodology.
103.7 	(b) For the period beginning January 1, 2011, through October 31, 2014, rates shall not 
103.8 	be rebased, except that a Minnesota long-term hospital shall be rebased effective January 
103.9 	1, 2011, based on its most recent Medicare cost report ending on or before September 1, 
103.10 	2008, with the provisions under subdivisions 9 and 23, based on the rates in effect on 
103.11 	December 31, 2010. For rate setting periods after November 1, 2014, in which the base 
103.12 	years are updated, a Minnesota long-term hospital's base year shall remain within the same 
103.13 	period as other hospitals.
103.14 	(c) Effective for discharges occurring on and after November 1, 2014, payment rates 
103.15 	for hospital inpatient services provided by hospitals located in Minnesota or the local trade 
103.16 	area, except for the hospitals paid under the methodologies described in paragraph (a), 
103.17 	clauses (2) and (3), shall be rebased, incorporating cost and payment methodologies in a 
103.18 	manner similar to Medicare. The base year for the rates effective November 1, 2014, shall 
103.19 	be calendar year 2012. The rebasing under this paragraph shall be budget neutral, ensuring 
103.20 	that the total aggregate payments under the rebased system are equal to the total aggregate 
103.21 	payments that were made for the same number and types of services in the base year. Separate 
103.22 	budget neutrality calculations shall be determined for payments made to critical access 
103.23 	hospitals and payments made to hospitals paid under the DRG system. Only the rate increases 
103.24 	or decreases under subdivision 3a or 3c that applied to the hospitals being rebased during 
103.25 	the entire base period shall be incorporated into the budget neutrality calculation.
103.26 	(d) For discharges occurring on or after November 1, 2014, through the next rebasing 
103.27 	that occurs, the rebased rates under paragraph (c) that apply to hospitals under paragraph 
103.28 	(a), clause (4), shall include adjustments to the projected rates that result in no greater than 
103.29 	a five percent increase or decrease from the base year payments for any hospital. Any 
103.30 	adjustments to the rates made by the commissioner under this paragraph and paragraph (e) 
103.31 	shall maintain budget neutrality as described in paragraph (c).
103.32 	(e) For discharges occurring on or after November 1, 2014, through the next two rebasing 
103.33 	that occurs periods the commissioner may make additional adjustments to the rebased rates, 
104.1 	and when evaluating whether additional adjustments should be made, the commissioner 
104.2 	shall consider the impact of the rates on the following:
104.3 	(1) pediatric services;
104.4 	(2) behavioral health services;
104.5 	(3) trauma services as defined by the National Uniform Billing Committee;
104.6 	(4) transplant services;
104.7 	(5) obstetric services, newborn services, and behavioral health services provided by 
104.8 	hospitals outside the seven-county metropolitan area;
104.9 	(6) outlier admissions;
104.10 	(7) low-volume providers; and
104.11 	(8) services provided by small rural hospitals that are not critical access hospitals.
104.12 	(f) Hospital payment rates established under paragraph (c) must incorporate the following:
104.13 	(1) for hospitals paid under the DRG methodology, the base year payment rate per 
104.14 	admission is standardized by the applicable Medicare wage index and adjusted by the 
104.15 	hospital's disproportionate population adjustment;
104.16 	(2) for critical access hospitals, payment rates for discharges between November 1, 2014, 
104.17 	and June 30, 2015, shall be set to the same rate of payment that applied for discharges on 
104.18 	October 31, 2014;
104.19 	(3) the cost and charge data used to establish hospital payment rates must only reflect 
104.20 	inpatient services covered by medical assistance; and
104.21 	(4) in determining hospital payment rates for discharges occurring on or after the rate 
104.22 	year beginning January 1, 2011, through December 31, 2012, the hospital payment rate per 
104.23 	discharge shall be based on the cost-finding methods and allowable costs of the Medicare 
104.24 	program in effect during the base year or years. In determining hospital payment rates for 
104.25 	discharges in subsequent base years, the per discharge rates shall be based on the cost-finding 
104.26 	methods and allowable costs of the Medicare program in effect during the base year or 
104.27 	years.
104.28 	(g) The commissioner shall validate the rates effective November 1, 2014, by applying 
104.29 	the rates established under paragraph (c), and any adjustments made to the rates under 
104.30 	paragraph (d) or (e), to hospital claims paid in calendar year 2013 to determine whether the 
105.1 	total aggregate payments for the same number and types of services under the rebased rates 
105.2 	are equal to the total aggregate payments made during calendar year 2013.
105.3 	(h) Effective for discharges occurring on or after July 1, 2017, and every two years 
105.4 	thereafter, payment rates under this section shall be rebased to reflect only those changes 
105.5 	in hospital costs between the existing base year and the next base year. Changes in costs 
105.6 	between base years shall be measured using the lower of the hospital cost index defined in 
105.7 	subdivision 1, paragraph (a), or the percentage change in the case mix adjusted cost per 
105.8 	claim. The commissioner shall establish the base year for each rebasing period considering 
105.9 	the most recent year for which filed Medicare cost reports are available. The estimated 
105.10 	change in the average payment per hospital discharge resulting from a scheduled rebasing 
105.11 	must be calculated and made available to the legislature by January 15 of each year in which 
105.12 	rebasing is scheduled to occur, and must include by hospital the differential in payment 
105.13 	rates compared to the individual hospital's costs.
105.14 	(i) Effective for discharges occurring on or after July 1, 2015, inpatient payment rates 
105.15 	for critical access hospitals located in Minnesota or the local trade area shall be determined 
105.16 	using a new cost-based methodology. The commissioner shall establish within the 
105.17 	methodology tiers of payment designed to promote efficiency and cost-effectiveness. 
105.18 	Payment rates for hospitals under this paragraph shall be set at a level that does not exceed 
105.19 	the total cost for critical access hospitals as reflected in base year cost reports. Until the 
105.20 	next rebasing that occurs, the new methodology shall result in no greater than a five percent 
105.21 	decrease from the base year payments for any hospital, except a hospital that had payments 
105.22 	that were greater than 100 percent of the hospital's costs in the base year shall have their 
105.23 	rate set equal to 100 percent of costs in the base year. The rates paid for discharges on and 
105.24 	after July 1, 2016, covered under this paragraph shall be increased by the inflation factor 
105.25 	in subdivision 1, paragraph (a). The new cost-based rate shall be the final rate and shall not 
105.26 	be settled to actual incurred costs. Hospitals shall be assigned a payment tier based on the 
105.27 	following criteria:
105.28 	(1) hospitals that had payments at or below 80 percent of their costs in the base year 
105.29 	shall have a rate set that equals 85 percent of their base year costs;
105.30 	(2) hospitals that had payments that were above 80 percent, up to and including 90 
105.31 	percent of their costs in the base year shall have a rate set that equals 95 percent of their 
105.32 	base year costs; and
105.33 	(3) hospitals that had payments that were above 90 percent of their costs in the base year 
105.34 	shall have a rate set that equals 100 percent of their base year costs.
106.1 	(j) The commissioner may refine the payment tiers and criteria for critical access hospitals 
106.2 	to coincide with the next rebasing under paragraph (h). The factors used to develop the new 
106.3 	methodology may include, but are not limited to:
106.4 	(1) the ratio between the hospital's costs for treating medical assistance patients and the 
106.5 	hospital's charges to the medical assistance program;
106.6 	(2) the ratio between the hospital's costs for treating medical assistance patients and the 
106.7 	hospital's payments received from the medical assistance program for the care of medical 
106.8 	assistance patients;
106.9 	(3) the ratio between the hospital's charges to the medical assistance program and the 
106.10 	hospital's payments received from the medical assistance program for the care of medical 
106.11 	assistance patients;
106.12 	(4) the statewide average increases in the ratios identified in clauses (1), (2), and (3);
106.13 	(5) the proportion of that hospital's costs that are administrative and trends in 
106.14 	administrative costs; and
106.15 	(6) geographic location.

106.16 	EFFECTIVE DATE. This section is effective July 1, 2017.

106.17 	Sec. 9. Minnesota Statutes 2016, section 256.969, subdivision 3a, is amended to read:
106.18 		Subd. 3a.Payments. (a) Acute care hospital billings under the medical assistance program 
106.19 	must not be submitted until the recipient is discharged. However, the commissioner shall 
106.20 	establish monthly interim payments for inpatient hospitals that have individual patient 
106.21 	lengths of stay over 30 days regardless of diagnostic category. Except as provided in section 
106.22 	256.9693, medical assistance reimbursement for treatment of mental illness shall be 
106.23 	reimbursed based on diagnostic classifications. Individual hospital payments established 
106.24 	under this section and sections 256.9685, 256.9686, and 256.9695, in addition to third-party 
106.25 	and recipient liability, for discharges occurring during the rate year shall not exceed, in 
106.26 	aggregate, the charges for the medical assistance covered inpatient services paid for the 
106.27 	same period of time to the hospital. Services that have rates established under subdivision 
106.28 	11 or 12, must be limited separately from other services. After consulting with the affected 
106.29 	hospitals, the commissioner may consider related hospitals one entity and may merge the 
106.30 	payment rates while maintaining separate provider numbers. The operating and property 
106.31 	base rates per admission or per day shall be derived from the best Medicare and claims data 
106.32 	available when rates are established. The commissioner shall determine the best Medicare 
106.33 	and claims data, taking into consideration variables of recency of the data, audit disposition, 
107.1 	settlement status, and the ability to set rates in a timely manner. The commissioner shall 
107.2 	notify hospitals of payment rates 30 days prior to implementation. The rate setting data 
107.3 	must reflect the admissions data used to establish relative values. The commissioner may 
107.4 	adjust base year cost, relative value, and case mix index data to exclude the costs of services 
107.5 	that have been discontinued by the October 1 of the year preceding the rate year or that are 
107.6 	paid separately from inpatient services. Inpatient stays that encompass portions of two or 
107.7 	more rate years shall have payments established based on payment rates in effect at the time 
107.8 	of admission unless the date of admission preceded the rate year in effect by six months or 
107.9 	more. In this case, operating payment rates for services rendered during the rate year in 
107.10 	effect and established based on the date of admission shall be adjusted to the rate year in 
107.11 	effect by the hospital cost index.
107.12 	(b) For fee-for-service admissions occurring on or after July 1, 2002, the total payment, 
107.13 	before third-party liability and spenddown, made to hospitals for inpatient services is reduced 
107.14 	by .5 percent from the current statutory rates.
107.15 	(c) In addition to the reduction in paragraph (b), the total payment for fee-for-service 
107.16 	admissions occurring on or after July 1, 2003, made to hospitals for inpatient services before 
107.17 	third-party liability and spenddown, is reduced five percent from the current statutory rates. 
107.18 	Mental health services within diagnosis related groups 424 to 432 or corresponding 
107.19 	APR-DRGs, and facilities defined under subdivision 16 are excluded from this paragraph.
107.20 	(d) In addition to the reduction in paragraphs (b) and (c), the total payment for 
107.21 	fee-for-service admissions occurring on or after August 1, 2005, made to hospitals for 
107.22 	inpatient services before third-party liability and spenddown, is reduced 6.0 percent from 
107.23 	the current statutory rates. Mental health services within diagnosis related groups 424 to 
107.24 	432 or corresponding APR-DRGs, and facilities defined under subdivision 16 are excluded 
107.25 	from this paragraph. Payments made to managed care plans shall be reduced for services 
107.26 	provided on or after January 1, 2006, to reflect this reduction.
107.27 	(e) In addition to the reductions in paragraphs (b), (c), and (d), the total payment for 
107.28 	fee-for-service admissions occurring on or after July 1, 2008, through June 30, 2009, made 
107.29 	to hospitals for inpatient services before third-party liability and spenddown, is reduced 
107.30 	3.46 percent from the current statutory rates. Mental health services with diagnosis related 
107.31 	groups 424 to 432 or corresponding APR-DRGs, and facilities defined under subdivision 
107.32 	16 are excluded from this paragraph. Payments made to managed care plans shall be reduced 
107.33 	for services provided on or after January 1, 2009, through June 30, 2009, to reflect this 
107.34 	reduction.
108.1 	(f) In addition to the reductions in paragraphs (b), (c), and (d), the total payment for 
108.2 	fee-for-service admissions occurring on or after July 1, 2009, through June 30, 2011, made 
108.3 	to hospitals for inpatient services before third-party liability and spenddown, is reduced 1.9 
108.4 	percent from the current statutory rates. Mental health services with diagnosis related groups 
108.5 	424 to 432 or corresponding APR-DRGs, and facilities defined under subdivision 16 are 
108.6 	excluded from this paragraph. Payments made to managed care plans shall be reduced for 
108.7 	services provided on or after July 1, 2009, through June 30, 2011, to reflect this reduction.
108.8 	(g) In addition to the reductions in paragraphs (b), (c), and (d), the total payment for 
108.9 	fee-for-service admissions occurring on or after July 1, 2011, made to hospitals for inpatient 
108.10 	services before third-party liability and spenddown, is reduced 1.79 percent from the current 
108.11 	statutory rates. Mental health services with diagnosis related groups 424 to 432 or 
108.12 	corresponding APR-DRGs, and facilities defined under subdivision 16 are excluded from 
108.13 	this paragraph. Payments made to managed care plans shall be reduced for services provided 
108.14 	on or after July 1, 2011, to reflect this reduction.
108.15 	(h) In addition to the reductions in paragraphs (b), (c), (d), (f), and (g), the total payment 
108.16 	for fee-for-service admissions occurring on or after July 1, 2009, made to hospitals for 
108.17 	inpatient services before third-party liability and spenddown, is reduced one percent from 
108.18 	the current statutory rates. Facilities defined under subdivision 16 are excluded from this 
108.19 	paragraph. Payments made to managed care plans shall be reduced for services provided 
108.20 	on or after October 1, 2009, to reflect this reduction.
108.21 	(i) In addition to the reductions in paragraphs (b), (c), (d), (g), and (h), the total payment 
108.22 	for fee-for-service admissions occurring on or after July 1, 2011, made to hospitals for 
108.23 	inpatient services before third-party liability and spenddown, is reduced 1.96 percent from 
108.24 	the current statutory rates. Facilities defined under subdivision 16 are excluded from this 
108.25 	paragraph. Payments made to managed care plans shall be reduced for services provided 
108.26 	on or after January 1, 2011, to reflect this reduction.
108.27 	(j) Effective for discharges on and after November 1, 2014, from hospitals paid under 
108.28 	subdivision 2b, paragraph (a), clauses (1) and (4), the rate adjustments in this subdivision 
108.29 	must be incorporated into the rebased rates established under subdivision 2b, paragraph (c), 
108.30 	and must not be applied to each claim.
108.31 	(k) Effective for discharges on and after July 1, 2015, from hospitals paid under 
108.32 	subdivision 2b, paragraph (a), clauses (2) and (3), the rate adjustments in this subdivision 
108.33 	must be incorporated into the rates and must not be applied to each claim.
109.1 	(l) Effective for discharges on and after July 1, 2017, from hospitals paid under 
109.2 	subdivision 2b, paragraph (a), clause (2), the rate adjustments in this subdivision must be 
109.3 	incorporated into the rates and must not be applied to each claim.

109.4 	EFFECTIVE DATE. This section is effective July 1, 2017.

109.5 	Sec. 10. Minnesota Statutes 2016, section 256.969, subdivision 3c, is amended to read:
109.6 		Subd. 3c.Rateable Ratable reduction and readmissions reduction. (a) The total 
109.7 	payment for fee for service admissions occurring on or after September 1, 2011, to October 
109.8 	31, 2014, made to hospitals for inpatient services before third-party liability and spenddown, 
109.9 	is reduced ten percent from the current statutory rates. Facilities defined under subdivision 
109.10 	16, long-term hospitals as determined under the Medicare program, children's hospitals 
109.11 	whose inpatients are predominantly under 18 years of age, and payments under managed 
109.12 	care are excluded from this paragraph.
109.13 	(b) Effective for admissions occurring during calendar year 2010 and each year after, 
109.14 	the commissioner shall calculate a readmission rate for admissions to all hospitals occurring 
109.15 	within 30 days of a previous discharge using data from the Reducing Avoidable Readmissions 
109.16 	Effectively (RARE) campaign. The commissioner may adjust the readmission rate taking 
109.17 	into account factors such as the medical relationship, complicating conditions, and sequencing 
109.18 	of treatment between the initial admission and subsequent readmissions.
109.19 	(c) Effective for payments to all hospitals on or after July 1, 2013, through October 31, 
109.20 	2014, the reduction in paragraph (a) is reduced one percentage point for every percentage 
109.21 	point reduction in the overall readmissions rate between the two previous calendar years to 
109.22 	a maximum of five percent.
109.23 	(d) The exclusion from the rate reduction in paragraph (a) shall apply to a hospital located 
109.24 	in Hennepin County with a licensed capacity of 1,700 beds as of September 1, 2011, for 
109.25 	admissions of children under 18 years of age occurring on or after September 1, 2011, 
109.26 	through August 31, 2013, but shall not apply to payments for admissions occurring on or 
109.27 	after September 1, 2013, through October 31, 2014.
109.28 	(e) Effective for discharges on or after November 1, 2014, from hospitals paid under 
109.29 	subdivision 2b, paragraph (a), clauses (1) and (4), the rate adjustments in this subdivision 
109.30 	must be incorporated into the rebased rates established under subdivision 2b, paragraph (c), 
109.31 	and must not be applied to each claim.
110.1 	(f) Effective for discharges on and after July 1, 2015, from hospitals paid under 
110.2 	subdivision 2b, paragraph (a), clauses (2) and (3), the rate adjustments in this subdivision 
110.3 	must be incorporated into the rates and must not be applied to each claim.
110.4 	(g) Effective for discharges on and after July 1, 2017, from hospitals paid under 
110.5 	subdivision 2b, paragraph (a), clause (2), the rate adjustments in this subdivision must be 
110.6 	incorporated into the rates and must not be applied to each claim.

110.7 	EFFECTIVE DATE. This section is effective July 1, 2017.

110.8 	Sec. 11. Minnesota Statutes 2016, section 256.969, subdivision 4b, is amended to read:
110.9 		Subd. 4b.Medical assistance cost reports for services. (a) A hospital that meets one 
110.10 	of the following criteria must annually submit to the commissioner medical assistance cost 
110.11 	reports within six months of the end of the hospital's fiscal year:
110.12 	(1) a hospital designated as a critical access hospital that receives medical assistance 
110.13 	payments; or
110.14 	(2) a Minnesota hospital or out-of-state hospital located within a Minnesota local trade 
110.15 	area that receives a disproportionate population adjustment under subdivision 9; or
110.16 	(3) a Minnesota hospital that is a licensed children's hospital.
110.17 	For purposes of this subdivision, local trade area has the meaning given in subdivision 
110.18 	17.
110.19 	(b) The commissioner shall suspend payments to any hospital that fails to submit a report 
110.20 	required under this subdivision. Payments must remain suspended until the report has been 
110.21 	filed with and accepted by the commissioner.

110.22 	EFFECTIVE DATE. This section is effective July 1, 2017.

110.23 	Sec. 12. Minnesota Statutes 2016, section 256.969, subdivision 8, is amended to read:
110.24 		Subd. 8.Unusual length of stay experience. (a) The commissioner shall establish day 
110.25 	outlier thresholds for each diagnostic category established under subdivision 2 at two standard 
110.26 	deviations beyond the mean length of stay. Payment for the days beyond the outlier threshold 
110.27 	shall be in addition to the operating and property payment rates per admission established 
110.28 	under subdivisions 2 and 2b. Payment for outliers shall be at 70 percent of the allowable 
110.29 	operating cost, after adjustment by the case mix index, hospital cost index, relative values 
110.30 	and the disproportionate population adjustment. The outlier threshold for neonatal and burn 
110.31 	diagnostic categories shall be established at one standard deviation beyond the mean length 
111.1 	of stay, and payment shall be at 90 percent of allowable operating cost calculated in the 
111.2 	same manner as other outliers. A hospital may choose an alternative to the 70 percent outlier 
111.3 	payment that is at a minimum of 60 percent and a maximum of 80 percent if the 
111.4 	commissioner is notified in writing of the request by October 1 of the year preceding the 
111.5 	rate year. The chosen percentage applies to all diagnostic categories except burns and 
111.6 	neonates. The percentage of allowable cost that is unrecognized by the outlier payment shall 
111.7 	be added back to the base year operating payment rate per admission.
111.8 	(b) Effective for admissions and transfers occurring on and after November 1, 2014, the 
111.9 	commissioner shall establish payment rates for outlier payments that are based on Medicare 
111.10 	methodologies.

111.11 	EFFECTIVE DATE. This section is effective July 1, 2017.

111.12 	Sec. 13. Minnesota Statutes 2016, section 256.969, subdivision 8c, is amended to read:
111.13 		Subd. 8c.Hospital residents. (a) For discharges occurring on or after November 1, 
111.14 	2014, payments for hospital residents shall be made as follows:
111.15 	(1) payments for the first 180 days of inpatient care shall be the APR-DRG system plus 
111.16 	any outliers; and
111.17 	(2) payment for all medically necessary patient care subsequent to the first 180 days 
111.18 	shall be reimbursed at a rate computed by multiplying the statewide average cost-to-charge 
111.19 	ratio by the usual and customary charges.
111.20 	(b) For discharges occurring on or after July 1, 2017, payment for hospital residents 
111.21 	shall be equal to the payments under subdivision 8, paragraph (b).

111.22 	EFFECTIVE DATE. This section is effective July 1, 2017.

111.23 	Sec. 14. Minnesota Statutes 2016, section 256.969, subdivision 9, is amended to read:
111.24 		Subd. 9.Disproportionate numbers of low-income patients served. (a) For admissions 
111.25 	occurring on or after July 1, 1993, the medical assistance disproportionate population 
111.26 	adjustment shall comply with federal law and shall be paid to a hospital, excluding regional 
111.27 	treatment centers and facilities of the federal Indian Health Service, with a medical assistance 
111.28 	inpatient utilization rate in excess of the arithmetic mean. The adjustment must be determined 
111.29 	as follows:
111.30 	(1) for a hospital with a medical assistance inpatient utilization rate above the arithmetic 
111.31 	mean for all hospitals excluding regional treatment centers and facilities of the federal Indian 
112.1 	Health Service but less than or equal to one standard deviation above the mean, the 
112.2 	adjustment must be determined by multiplying the total of the operating and property 
112.3 	payment rates by the difference between the hospital's actual medical assistance inpatient 
112.4 	utilization rate and the arithmetic mean for all hospitals excluding regional treatment centers 
112.5 	and facilities of the federal Indian Health Service; and
112.6 	(2) for a hospital with a medical assistance inpatient utilization rate above one standard 
112.7 	deviation above the mean, the adjustment must be determined by multiplying the adjustment 
112.8 	that would be determined under clause (1) for that hospital by 1.1. The commissioner shall 
112.9 	report annually on the number of hospitals likely to receive the adjustment authorized by 
112.10 	this paragraph. The commissioner shall specifically report on the adjustments received by 
112.11 	public hospitals and public hospital corporations located in cities of the first class.
112.12 	(b) Certified public expenditures made by Hennepin County Medical Center shall be 
112.13 	considered Medicaid disproportionate share hospital payments. Hennepin County and 
112.14 	Hennepin County Medical Center shall report by June 15, 2007, on payments made beginning 
112.15 	July 1, 2005, or another date specified by the commissioner, that may qualify for 
112.16 	reimbursement under federal law. Based on these reports, the commissioner shall apply for 
112.17 	federal matching funds.
112.18 	(c) Upon federal approval of the related state plan amendment, paragraph (b) is effective 
112.19 	retroactively from July 1, 2005, or the earliest effective date approved by the Centers for 
112.20 	Medicare and Medicaid Services.
112.21 	(d) Effective July 1, 2015, disproportionate share hospital (DSH) payments shall be paid 
112.22 	in accordance with a new methodology using 2012 as the base year. Annual payments made 
112.23 	under this paragraph shall equal the total amount of payments made for 2012. A licensed 
112.24 	children's hospital shall receive only a single DSH factor for children's hospitals. Other 
112.25 	DSH factors may be combined to arrive at a single factor for each hospital that is eligible 
112.26 	for DSH payments. The new methodology shall make payments only to hospitals located 
112.27 	in Minnesota and include the following factors:
112.28 	(1) a licensed children's hospital with at least 1,000 fee-for-service discharges in the 
112.29 	base year shall receive a factor of 0.868. A licensed children's hospital with less than 1,000 
112.30 	fee-for-service discharges in the base year shall receive a factor of 0.7880;
112.31 	(2) a hospital that has in effect for the initial rate year a contract with the commissioner 
112.32 	to provide extended psychiatric inpatient services under section 256.9693 shall receive a 
112.33 	factor of 0.0160;
113.1 	(3) a hospital that has received payment from the fee-for-service program for at least 20 
113.2 	transplant services in the base year shall receive a factor of 0.0435;
113.3 	(4) a hospital that has a medical assistance utilization rate in the base year between 20 
113.4 	percent up to one standard deviation above the statewide mean utilization rate shall receive 
113.5 	a factor of 0.0468;
113.6 	(5) a hospital that has a medical assistance utilization rate in the base year that is at least 
113.7 	one standard deviation above the statewide mean utilization rate but is less than three standard 
113.8 	deviations above the mean shall receive a factor of 0.2300; and
113.9 	(6) a hospital that has a medical assistance utilization rate in the base year that is at least 
113.10 	three standard deviations above the statewide mean utilization rate shall receive a factor of 
113.11 	0.3711.
113.12 	(e) Any payments or portion of payments made to a hospital under this subdivision that 
113.13 	are subsequently returned to the commissioner because the payments are found to exceed 
113.14 	the hospital-specific DSH limit for that hospital shall be redistributed, proportionate to the 
113.15 	number of fee-for-service discharges, to other DSH-eligible nonchildren's non-children's
113.16 	hospitals that have a medical assistance utilization rate that is at least one standard deviation 
113.17 	above the mean.

113.18 	EFFECTIVE DATE. This section is effective July 1, 2017.

113.19 	Sec. 15. Minnesota Statutes 2016, section 256.969, subdivision 12, is amended to read:
113.20 		Subd. 12.Rehabilitation hospitals and distinct parts. (a) Units of hospitals that are 
113.21 	recognized as rehabilitation distinct parts by the Medicare program shall have separate 
113.22 	provider numbers under the medical assistance program for rate establishment and billing 
113.23 	purposes only. These units shall also have operating payment rates and the disproportionate 
113.24 	population adjustment, if allowed by federal law, established separately from other inpatient 
113.25 	hospital services.
113.26 	(b) The commissioner shall establish separate relative values under subdivision 2 for 
113.27 	rehabilitation hospitals and distinct parts as defined by the Medicare program. Effective for 
113.28 	discharges occurring on and after November 1, 2014, the commissioner, to the extent 
113.29 	possible, shall replicate the existing payment rate methodology under the new diagnostic 
113.30 	classification system. The result must be budget neutral, ensuring that the total aggregate 
113.31 	payments under the new system are equal to the total aggregate payments made for the same 
113.32 	number and types of services in the base year, calendar year 2012.
114.1 	(c) For individual hospitals that did not have separate medical assistance rehabilitation 
114.2 	provider numbers or rehabilitation distinct parts in the base year, hospitals shall provide the 
114.3 	information needed to separate rehabilitation distinct part cost and claims data from other 
114.4 	inpatient service data.
114.5 	(d) Effective with discharges on or after July 1, 2017, payment to rehabilitation hospitals 
114.6 	shall be established under subdivision 2d, paragraph (a), clause (4).

114.7 	EFFECTIVE DATE. This section is effective July 1, 2017.

114.8 	Sec. 16. [256B.0371] ADMINISTRATION OF DENTAL SERVICES.
114.9 		Subdivision 1.Contract for dental administration services. (a) The commissioner 
114.10 	shall contract with up to two dental administrators to administer dental services for all 
114.11 	recipients of medical assistance and MinnesotaCare.
114.12 	(b) The dental administrator must provide administrative services including, but not 
114.13 	limited to:
114.14 	(1) provider recruitment, contracting, and assistance;
114.15 	(2) recipient outreach and assistance;
114.16 	(3) utilization management and review for medical necessity of dental services;
114.17 	(4) dental claims processing, including submission of encounter claims to the department;
114.18 	(5) coordination with other services;
114.19 	(6) management of fraud and abuse;
114.20 	(7) monitoring of access to dental services;
114.21 	(8) performance measurement;
114.22 	(9) quality improvement and evaluation requirements; and
114.23 	(10) management of third party liability requirements.
114.24 	(c) A payment to a contracted dental provider shall be at the rates established under 
114.25 	section 256B.76.

114.26 	EFFECTIVE DATE. This section is effective January 1, 2019.

114.27 	Sec. 17. Minnesota Statutes 2016, section 256B.04, subdivision 21, is amended to read:
114.28 		Subd. 21.Provider enrollment. (a) The commissioner shall enroll providers and conduct 
114.29 	screening activities as required by Code of Federal Regulations, title 42, section 455, subpart 
115.1 	E, including database checks, unannounced pre- and post-enrollment site visits, fingerprinting, 
115.2 	and criminal background studies. A provider providing services from multiple locations 
115.3 	must enroll each location separately. The commissioner may deny a provider's incomplete 
115.4 	application for enrollment if a provider fails to respond to the commissioner's request for 
115.5 	additional information within 60 days of the request.
115.6 	(b) The commissioner must revalidate each provider under this subdivision at least once 
115.7 	every five years. The commissioner may revalidate a personal care assistance agency under 
115.8 	this subdivision once every three years. The commissioner shall conduct revalidation as 
115.9 	follows:
115.10 	(1) provide 30-day notice of revalidation due date to include instructions for revalidation 
115.11 	and a list of materials the provider must submit to revalidate;
115.12 	(2) notify the provider that fails to completely respond within 30 days of any deficiencies 
115.13 	and allow an additional 30 days to comply; and
115.14 	(3) give 60-day notice of termination and immediately suspend a provider's ability to 
115.15 	bill for failure to remedy any deficiencies within the 30-day time period. The provider shall 
115.16 	have no right to appeal suspension of ability to bill.
115.17 	(c) The commissioner shall require that an individual rendering care to a recipient for 
115.18 	the following covered services enroll as an individual provider and be identified on claims:
115.19 	(1) adult rehabilitative mental health services according to section 256B.0623;
115.20 	(2) autism early intensive behavioral intervention benefits according to section 
115.21 	256B.0949;
115.22 	(3) home and community-based waiver services, consumer directed community supports; 
115.23 	and
115.24 	(4) qualified professionals supervising personal care assistant services according to 
115.25 	section 256B.0659.
115.26 	(d) The commissioner may suspend a provider's ability to bill for a failure to comply 
115.27 	with any individual provider requirements or conditions of participation until the provider 
115.28 	comes into compliance. The commissioner's decision to suspend the provider is not subject 
115.29 	to an administrative appeal.
115.30 	(e) Notwithstanding any other provision to the contrary, all correspondence and 
115.31 	notifications, including notifications of termination and other actions, shall be delivered 
116.1 	electronically to a provider's MN-ITS mailbox. For a provider that does not have a MN-ITS 
116.2 	account and mailbox, notice shall be sent by first class mail.
116.3 	(f) If the commissioner or the Centers for Medicare and Medicaid Services determines 
116.4 	that a provider is designated "high-risk," the commissioner may withhold payment from 
116.5 	providers within that category upon initial enrollment for a 90-day period. The withholding 
116.6 	for each provider must begin on the date of the first submission of a claim.
116.7 	(b) (g) An enrolled provider that is also licensed by the commissioner under chapter 
116.8 	245A, or is licensed as a home care provider by the Department of Health under chapter 
116.9 	144A and has a home and community-based services designation on the home care license 
116.10 	under section 144A.484, must designate an individual as the entity's compliance officer. 
116.11 	The compliance officer must:
116.12 	(1) develop policies and procedures to assure adherence to medical assistance laws and 
116.13 	regulations and to prevent inappropriate claims submissions;
116.14 	(2) train the employees of the provider entity, and any agents or subcontractors of the 
116.15 	provider entity including billers, on the policies and procedures under clause (1);
116.16 	(3) respond to allegations of improper conduct related to the provision or billing of 
116.17 	medical assistance services, and implement action to remediate any resulting problems;
116.18 	(4) use evaluation techniques to monitor compliance with medical assistance laws and 
116.19 	regulations;
116.20 	(5) promptly report to the commissioner any identified violations of medical assistance 
116.21 	laws or regulations; and
116.22 	(6) within 60 days of discovery by the provider of a medical assistance reimbursement 
116.23 	overpayment, report the overpayment to the commissioner and make arrangements with 
116.24 	the commissioner for the commissioner's recovery of the overpayment.
116.25 	The commissioner may require, as a condition of enrollment in medical assistance, that a 
116.26 	provider within a particular industry sector or category establish a compliance program that 
116.27 	contains the core elements established by the Centers for Medicare and Medicaid Services.
116.28 	(c) (h) The commissioner may revoke the enrollment of an ordering or rendering provider 
116.29 	for a period of not more than one year, if the provider fails to maintain and, upon request 
116.30 	from the commissioner, provide access to documentation relating to written orders or requests 
116.31 	for payment for durable medical equipment, certifications for home health services, or 
116.32 	referrals for other items or services written or ordered by such provider, when the 
116.33 	commissioner has identified a pattern of a lack of documentation. A pattern means a failure 
117.1 	to maintain documentation or provide access to documentation on more than one occasion. 
117.2 	Nothing in this paragraph limits the authority of the commissioner to sanction a provider 
117.3 	under the provisions of section 256B.064.
117.4 	(d) (i) The commissioner shall terminate or deny the enrollment of any individual or 
117.5 	entity if the individual or entity has been terminated from participation in Medicare or under 
117.6 	the Medicaid program or Children's Health Insurance Program of any other state.
117.7 	(e) (j) As a condition of enrollment in medical assistance, the commissioner shall require 
117.8 	that a provider designated "moderate" or "high-risk" by the Centers for Medicare and 
117.9 	Medicaid Services or the commissioner permit the Centers for Medicare and Medicaid 
117.10 	Services, its agents, or its designated contractors and the state agency, its agents, or its 
117.11 	designated contractors to conduct unannounced on-site inspections of any provider location. 
117.12 	The commissioner shall publish in the Minnesota Health Care Program Provider Manual a 
117.13 	list of provider types designated "limited," "moderate," or "high-risk," based on the criteria 
117.14 	and standards used to designate Medicare providers in Code of Federal Regulations, title 
117.15 	42, section 424.518. The list and criteria are not subject to the requirements of chapter 14. 
117.16 	The commissioner's designations are not subject to administrative appeal.
117.17 	(f) (k) As a condition of enrollment in medical assistance, the commissioner shall require 
117.18 	that a high-risk provider, or a person with a direct or indirect ownership interest in the 
117.19 	provider of five percent or higher, consent to criminal background checks, including 
117.20 	fingerprinting, when required to do so under state law or by a determination by the 
117.21 	commissioner or the Centers for Medicare and Medicaid Services that a provider is designated 
117.22 	high-risk for fraud, waste, or abuse.
117.23 	(g) (l)(1) Upon initial enrollment, reenrollment, and notification of revalidation, all 
117.24 	durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) medical suppliers 
117.25 	meeting the durable medical equipment provider and supplier definition in clause (3), 
117.26 	operating in Minnesota and receiving Medicaid funds must purchase a surety bond that is 
117.27 	annually renewed and designates the Minnesota Department of Human Services as the 
117.28 	obligee, and must be submitted in a form approved by the commissioner. For purposes of 
117.29 	this clause, the following medical suppliers are not required to obtain a surety bond: a 
117.30 	federally qualified health center, a home health agency, the Indian Health Service, a 
117.31 	pharmacy, and a rural health clinic.
117.32 	(2) At the time of initial enrollment or reenrollment, durable medical equipment providers 
117.33 	and suppliers defined in clause (3) must purchase a surety bond of $50,000. If a revalidating 
117.34 	provider's Medicaid revenue in the previous calendar year is up to and including $300,000, 
118.1 	the provider agency must purchase a surety bond of $50,000. If a revalidating provider's 
118.2 	Medicaid revenue in the previous calendar year is over $300,000, the provider agency must 
118.3 	purchase a surety bond of $100,000. The surety bond must allow for recovery of costs and 
118.4 	fees in pursuing a claim on the bond.
118.5 	(3) "Durable medical equipment provider or supplier" means a medical supplier that can 
118.6 	purchase medical equipment or supplies for sale or rental to the general public and is able 
118.7 	to perform or arrange for necessary repairs to and maintenance of equipment offered for 
118.8 	sale or rental.
118.9 	(h) (m) The Department of Human Services may require a provider to purchase a surety 
118.10 	bond as a condition of initial enrollment, reenrollment, reinstatement, or continued enrollment 
118.11 	if: (1) the provider fails to demonstrate financial viability, (2) the department determines 
118.12 	there is significant evidence of or potential for fraud and abuse by the provider, or (3) the 
118.13 	provider or category of providers is designated high-risk pursuant to paragraph (a) (e) and 
118.14 	as per Code of Federal Regulations, title 42, section 455.450. The surety bond must be in 
118.15 	an amount of $100,000 or ten percent of the provider's payments from Medicaid during the 
118.16 	immediately preceding 12 months, whichever is greater. The surety bond must name the 
118.17 	Department of Human Services as an obligee and must allow for recovery of costs and fees 
118.18 	in pursuing a claim on the bond. This paragraph does not apply if the provider currently 
118.19 	maintains a surety bond under the requirements in section 256B.0659 or 256B.85.

118.20 	EFFECTIVE DATE. This section is effective July 1, 2017.

118.21 	Sec. 18. Minnesota Statutes 2016, section 256B.04, subdivision 22, is amended to read:
118.22 		Subd. 22.Application fee. (a) The commissioner must collect and retain federally 
118.23 	required nonrefundable application fees to pay for provider screening activities in accordance 
118.24 	with Code of Federal Regulations, title 42, section 455, subpart E. The enrollment application 
118.25 	must be made under the procedures specified by the commissioner, in the form specified 
118.26 	by the commissioner, and accompanied by an application fee described in paragraph (b), 
118.27 	or a request for a hardship exception as described in the specified procedures. Application 
118.28 	fees must be deposited in the provider screening account in the special revenue fund. 
118.29 	Amounts in the provider screening account are appropriated to the commissioner for costs 
118.30 	associated with the provider screening activities required in Code of Federal Regulations, 
118.31 	title 42, section 455, subpart E. The commissioner shall conduct screening activities as 
118.32 	required by Code of Federal Regulations, title 42, section 455, subpart E, and as otherwise 
118.33 	provided by law, to include database checks, unannounced pre- and postenrollment site 
118.34 	visits, fingerprinting, and criminal background studies. The commissioner must revalidate 
119.1 	all providers under this subdivision at least once every five years must revalidate all personal 
119.2 	care assistance agencies under this subdivision at least once every three years.
119.3 	(b) The application fee under this subdivision is $532 for the calendar year 2013. For 
119.4 	calendar year 2014 and subsequent years, the fee:
119.5 	(1) is adjusted by the percentage change to the Consumer Price Index for all urban 
119.6 	consumers, United States city average, for the 12-month period ending with June of the 
119.7 	previous year. The resulting fee must be announced in the Federal Register;
119.8 	(2) is effective from January 1 to December 31 of a calendar year;
119.9 	(3) is required on the submission of an initial application, an application to establish a 
119.10 	new practice location, an application for reenrollment when the provider is not enrolled at 
119.11 	the time of application of reenrollment, or at revalidation when required by federal regulation; 
119.12 	and
119.13 	(4) must be in the amount in effect for the calendar year during which the application 
119.14 	for enrollment, new practice location, or reenrollment is being submitted.
119.15 	(c) The application fee under this subdivision cannot be charged to:
119.16 	(1) providers who are enrolled in Medicare or who provide documentation of payment 
119.17 	of the fee to, and enrollment with, another state, unless the commissioner is required to 
119.18 	rescreen the provider;
119.19 	(2) providers who are enrolled but are required to submit new applications for purposes 
119.20 	of reenrollment;
119.21 	(3) a provider who enrolls as an individual; and
119.22 	(4) group practices and clinics that bill on behalf of individually enrolled providers 
119.23 	within the practice who have reassigned their billing privileges to the group practice or 
119.24 	clinic.

119.25 	EFFECTIVE DATE. This section is effective July 1, 2017.

119.26 	Sec. 19. Minnesota Statutes 2016, section 256B.055, subdivision 2, is amended to read:
119.27 		Subd. 2.Subsidized foster children. Medical assistance may be paid for a child eligible 
119.28 	for or receiving foster care maintenance payments under Title IV-E of the Social Security 
119.29 	Act, United States Code, title 42, sections 670 to 676, and to any child who is not title IV-E 
119.30 	eligible but who is determined eligible for foster care or kinship assistance under chapter 
119.31 	256N.

120.1 	EFFECTIVE DATE. This section is effective January 1, 2019, or upon federal approval, 
120.2 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
120.3 	when federal approval is obtained.

120.4 	Sec. 20. Minnesota Statutes 2016, section 256B.055, subdivision 7, is amended to read:
120.5 		Subd. 7.Aged, blind, or disabled persons Age 65 or older. (a) Medical assistance may 
120.6 	be paid for a person who is age 65 or older and meets the categorical eligibility requirements 
120.7 	of the Supplemental Security Income program or, who would meet those requirements 
120.8 	except for excess income or assets, and who meets the other eligibility requirements of this 
120.9 	section.
120.10 	(b) Following a determination that the applicant is not aged or blind and does not meet 
120.11 	any other category of eligibility for medical assistance and has not been determined disabled 
120.12 	by the Social Security Administration, applicants under this subdivision shall be referred 
120.13 	to the commissioner's state medical review team for a determination of disability.

120.14 	EFFECTIVE DATE. This section is effective July 1, 2017.

120.15 	Sec. 21. Minnesota Statutes 2016, section 256B.055, is amended by adding a subdivision 
120.16 	to read:
120.17 		Subd. 7b.Persons who are blind or who have been determined disabled. (a) Medical 
120.18 	assistance may be paid for a person who meets the categorical eligibility requirements of 
120.19 	the Supplemental Security Income program or who would meet those requirements except 
120.20 	for excess income or assets and who meets the other eligibility requirements of this section.
120.21 	(b) Following a determination that the applicant is not blind and does not meet any other 
120.22 	category of eligibility for medical assistance and has not been determined disabled by the 
120.23 	Social Security Administration, an applicant under this subdivision shall be referred to the 
120.24 	commissioner's state medical review team for a determination of disability.

120.25 	EFFECTIVE DATE. This section is effective July 1, 2017.

120.26 	Sec. 22. Minnesota Statutes 2016, section 256B.056, subdivision 1b, is amended to read:
120.27 		Subd. 1b.Aged, blind, and disabled Age 65 or older income methodology. The $20 
120.28 	general income disregard allowed under the Supplemental Security Income program is 
120.29 	included in the standard and shall not be allowed as a deduction from income for a person 
120.30 	eligible under section 256B.055, subdivisions subdivision 7, 7a, and 12.

120.31 	EFFECTIVE DATE. This section is effective July 1, 2017.

121.1 	Sec. 23. Minnesota Statutes 2016, section 256B.056, is amended by adding a subdivision 
121.2 	to read:
121.3 		Subd. 1e.Income methodology for persons who are blind or who have been 
121.4 	determined disabled. The $20 general income disregard allowed under the Supplemental 
121.5 	Security Income program is included in the standard and shall not be allowed as a deduction 
121.6 	from income for a person eligible under section 256B.055, subdivisions 7a, 7b, and 12.

121.7 	EFFECTIVE DATE. This section is effective July 1, 2017.

121.8 	Sec. 24. Minnesota Statutes 2016, section 256B.056, subdivision 3b, is amended to read:
121.9 		Subd. 3b.Treatment of trusts. (a) A "medical assistance qualifying trust" is a revocable 
121.10 	or irrevocable trust, or similar legal device, established on or before August 10, 1993, by a 
121.11 	person or the person's spouse under the terms of which the person receives or could receive 
121.12 	payments from the trust principal or income and the trustee has discretion in making payments 
121.13 	to the person from the trust principal or income. Notwithstanding that definition, a medical 
121.14 	assistance qualifying trust does not include: (1) a trust set up by will; (2) a trust set up before 
121.15 	April 7, 1986, solely to benefit a person with a developmental disability living in an 
121.16 	intermediate care facility for persons with developmental disabilities; or (3) a trust set up 
121.17 	by a person with payments made by the Social Security Administration pursuant to the 
121.18 	United States Supreme Court decision in Sullivan v. Zebley, 110 S. Ct. 885 (1990). The 
121.19 	maximum amount of payments that a trustee of a medical assistance qualifying trust may 
121.20 	make to a person under the terms of the trust is considered to be available assets to the 
121.21 	person, without regard to whether the trustee actually makes the maximum payments to the 
121.22 	person and without regard to the purpose for which the medical assistance qualifying trust 
121.23 	was established.
121.24 	(b) Except as provided in paragraphs (c) and (d), Trusts established after August 10, 
121.25 	1993, are treated according to section 13611(b) of the Omnibus Budget Reconciliation Act 
121.26 	of 1993 (OBRA), Public Law 103-66 United States Code, title 42, section 1396p(d).
121.27 	(c) For purposes of paragraph (d), a pooled trust means a trust established under United 
121.28 	States Code, title 42, section 1396p(d)(4)(C).
121.29 	(d) A beneficiary's interest in a pooled trust is considered an available asset unless the 
121.30 	trust provides that upon the death of the beneficiary or termination of the trust during the 
121.31 	beneficiary's lifetime, whichever is sooner, the department receives any amount, up to the 
121.32 	amount of medical assistance benefits paid on behalf of the beneficiary, remaining in the 
121.33 	beneficiary's trust account after a deduction for reasonable administrative fees and expenses, 
122.1 	and an additional remainder amount. The retained remainder amount of the subaccount 
122.2 	must not exceed ten percent of the account value at the time of the beneficiary's death or 
122.3 	termination of the trust, and must only be used for the benefit of disabled individuals who 
122.4 	have a beneficiary interest in the pooled trust.
122.5 	(e) Trusts may be established on or after December 12, 2016, by a person who has been 
122.6 	determined to be disabled, according to United States Code, title 42, section 1396p(d)(4)(A), 
122.7 	as amended by section 5007 of the 21st Century Cures Act, Public Law 114-255.

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

122.9 	Sec. 25. Minnesota Statutes 2016, section 256B.056, subdivision 3c, is amended to read:
122.10 		Subd. 3c.Asset limitations for families and children. (a) A household of two or more 
122.11 	persons must not own more than $20,000 in total net assets, and a household of one person 
122.12 	must not own more than $10,000 in total net assets. In addition to these maximum amounts, 
122.13 	an eligible individual or family may accrue interest on these amounts, but they must be 
122.14 	reduced to the maximum at the time of an eligibility redetermination. The value of assets 
122.15 	that are not considered in determining eligibility for medical assistance for families and 
122.16 	children is the value of those assets excluded under the AFDC state plan as of July 16, 1996, 
122.17 	as required by the Personal Responsibility and Work Opportunity Reconciliation Act of 
122.18 	1996 (PRWORA), Public Law 104-193, with the following exceptions:
122.19 	(1) household goods and personal effects are not considered;
122.20 	(2) capital and operating assets of a trade or business up to $200,000 are not considered, 
122.21 	except that a bank account that contains personal income or assets, or is used to pay personal 
122.22 	expenses, is not considered a capital or operating asset of a trade or business;
122.23 	(3) one motor vehicle is excluded for each person of legal driving age who is employed 
122.24 	or seeking employment;
122.25 	(4) assets designated as burial expenses are excluded to the same extent they are excluded 
122.26 	by the Supplemental Security Income program;
122.27 	(5) court-ordered settlements up to $10,000 are not considered;
122.28 	(6) individual retirement accounts and funds are not considered;
122.29 	(7) assets owned by children are not considered; and
122.30 	(8) effective July 1, 2009, certain assets owned by American Indians are excluded as 
122.31 	required by section 5006 of the American Recovery and Reinvestment Act of 2009, Public 
123.1 	Law 111-5. For purposes of this clause, an American Indian is any person who meets the 
123.2 	definition of Indian according to Code of Federal Regulations, title 42, section 447.50.
123.3 	The assets specified in clause (2) must be disclosed to the local agency at the time of 
123.4 	application and at the time of an eligibility redetermination, and must be verified upon 
123.5 	request of the local agency.
123.6 	(b) Beginning January 1, 2014, this subdivision applies only to parents and caretaker 
123.7 	relatives who qualify for medical assistance under subdivision 5.

123.8 	EFFECTIVE DATE. This section is effective July 1, 2017.

123.9 	Sec. 26. Minnesota Statutes 2016, section 256B.056, subdivision 3d, is amended to read:
123.10 		Subd. 3d.Reduction of excess assets for people age 65 or older. For people age 65 or 
123.11 	older, assets in excess of the limits in subdivisions subdivision 3 to 3c may be reduced to 
123.12 	allowable limits as follows:
123.13 	(a) Assets may be reduced in any of the three calendar months before the month of 
123.14 	application in which the applicant seeks coverage by paying bills for health services that 
123.15 	are incurred in the retroactive period for which the applicant seeks eligibility, starting with 
123.16 	the oldest bill. After assets are reduced to allowable limits, eligibility begins with the next 
123.17 	dollar of MA-covered health services incurred in the retroactive period. Applicants reducing 
123.18 	assets under this subdivision who also have excess income shall first spend excess assets 
123.19 	to pay health service bills and may meet the income spenddown on remaining bills.
123.20 	(b) Assets may be reduced beginning the month of application by paying bills for health 
123.21 	services that are incurred during the period specified in Minnesota Rules, part 9505.0090, 
123.22 	subpart 2, that would otherwise be paid by medical assistance. After assets are reduced to 
123.23 	allowable limits, eligibility begins with the next dollar of medical assistance covered health 
123.24 	services incurred in the period. Applicants reducing assets under this subdivision who also 
123.25 	have excess income shall first spend excess assets to pay health service bills and may meet 
123.26 	the income spenddown on remaining bills.

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

123.28 	Sec. 27. Minnesota Statutes 2016, section 256B.056, is amended by adding a subdivision 
123.29 	to read:
123.30 		Subd. 3f.Reduction of excess assets for people under age 65. (a) For a person younger 
123.31 	than 65 years of age, assets in excess of the limits in subdivision 3 or 3c may be reduced to 
123.32 	allowable limits according to this subdivision.
124.1 	(b) A person's assets may be reduced in any of the three calendar months before the 
124.2 	month of application in which the person seeks coverage by:
124.3 	(1) designating burial funds up to $1,500 for each applicant, the applicant's spouse, and 
124.4 	the applicant's medical assistance-eligible dependent child; and
124.5 	(2) paying bills for health services that are incurred in the retroactive period for which 
124.6 	the person seeks eligibility, starting with the oldest bill. After assets are reduced to allowable 
124.7 	limits, eligibility begins with the next dollar of medical assistance-covered health services 
124.8 	incurred in the retroactive period. An applicant reducing assets under this subdivision who 
124.9 	also has excess income shall first spend excess assets to pay health services bills and may 
124.10 	meet the income spenddown on remaining bills.
124.11 	(c) A person's assets may be reduced beginning the month of application by:
124.12 	(1) paying bills for health services that are incurred during the period specified in 
124.13 	Minnesota Rules, part 9505.0090, subpart 2, that would otherwise be paid by medical 
124.14 	assistance; and
124.15 	(2) using any means other than a transfer of assets for less than fair market value defined 
124.16 	in section 256B.0595, subdivision 1, paragraph (b).

124.17 	EFFECTIVE DATE. This section is effective July 1, 2017.

124.18 	Sec. 28. Minnesota Statutes 2016, section 256B.057, subdivision 9, is amended to read:
124.19 		Subd. 9.Employed persons with disabilities. (a) Medical assistance may be paid for 
124.20 	a person who is employed and who:
124.21 	(1) but for excess earnings or assets, meets the definition of disabled under the 
124.22 	Supplemental Security Income program;
124.23 	(2) meets the asset limits in paragraph (d); and
124.24 	(3) pays a premium and other obligations under paragraph (e).
124.25 	(b) For purposes of eligibility, there is a $65 earned income disregard. To be eligible 
124.26 	for medical assistance under this subdivision, a person must have more than $65 of earned 
124.27 	income. Earned income must have Medicare, Social Security, and applicable state and 
124.28 	federal taxes withheld. The person must document earned income tax withholding. Any 
124.29 	spousal income or assets shall be disregarded for purposes of eligibility and premium 
124.30 	determinations.
125.1 	(c) After the month of enrollment, a person enrolled in medical assistance under this 
125.2 	subdivision who:
125.3 	(1) is temporarily unable to work and without receipt of earned income due to a medical 
125.4 	condition, as verified by a physician; or
125.5 	(2) loses employment for reasons not attributable to the enrollee, and is without receipt 
125.6 	of earned income may retain eligibility for up to four consecutive months after the month 
125.7 	of job loss. To receive a four-month extension, enrollees must verify the medical condition 
125.8 	or provide notification of job loss. All other eligibility requirements must be met and the 
125.9 	enrollee must pay all calculated premium costs for continued eligibility.
125.10 	(d) For purposes of determining eligibility under this subdivision, a person's assets must 
125.11 	not exceed $20,000, excluding:
125.12 	(1) all assets excluded under section 256B.056;
125.13 	(2) retirement accounts, including individual accounts, 401(k) plans, 403(b) plans, Keogh 
125.14 	plans, and pension plans;
125.15 	(3) medical expense accounts set up through the person's employer; and
125.16 	(4) spousal assets, including spouse's share of jointly held assets.
125.17 	(e) All enrollees must pay a premium to be eligible for medical assistance under this 
125.18 	subdivision, except as provided under clause (5).
125.19 	(1) An enrollee must pay the greater of a $35 premium or the premium calculated based 
125.20 	on the person's gross earned and unearned income and the applicable family size using a 
125.21 	sliding fee scale established by the commissioner, which begins at one percent of income 
125.22 	at 100 percent of the federal poverty guidelines and increases to 7.5 percent of income for 
125.23 	those with incomes at or above 300 percent of the federal poverty guidelines.
125.24 	(2) Annual adjustments in the premium schedule based upon changes in the federal 
125.25 	poverty guidelines shall be effective for premiums due in July of each year.
125.26 	(3) All enrollees who receive unearned income must pay one-half of one percent of 
125.27 	unearned income in addition to the premium amount, except as provided under clause (5).
125.28 	(4) Increases in benefits under title II of the Social Security Act shall not be counted as 
125.29 	income for purposes of this subdivision until July 1 of each year.
125.30 	(5) Effective July 1, 2009, American Indians are exempt from paying premiums as 
125.31 	required by section 5006 of the American Recovery and Reinvestment Act of 2009, Public 
126.1 	Law 111-5. For purposes of this clause, an American Indian is any person who meets the 
126.2 	definition of Indian according to Code of Federal Regulations, title 42, section 447.50.
126.3 	(f) A person's eligibility and premium shall be determined by the local county agency. 
126.4 	Premiums must be paid to the commissioner. All premiums are dedicated to the 
126.5 	commissioner.
126.6 	(g) Any required premium shall be determined at application and redetermined at the 
126.7 	enrollee's six-month income review or when a change in income or household size is reported. 
126.8 	Enrollees must report any change in income or household size within ten days of when the 
126.9 	change occurs. A decreased premium resulting from a reported change in income or 
126.10 	household size shall be effective the first day of the next available billing month after the 
126.11 	change is reported. Except for changes occurring from annual cost-of-living increases, a 
126.12 	change resulting in an increased premium shall not affect the premium amount until the 
126.13 	next six-month review.
126.14 	(h) Premium payment is due upon notification from the commissioner of the premium 
126.15 	amount required. Premiums may be paid in installments at the discretion of the commissioner.
126.16 	(i) Nonpayment of the premium shall result in denial or termination of medical assistance 
126.17 	unless the person demonstrates good cause for nonpayment. Good cause exists if the 
126.18 	requirements specified in Minnesota Rules, part 9506.0040, subpart 7, items B to D, are 
126.19 	met "Good cause" means an excuse for the enrollee's failure to pay the required premium 
126.20 	when due because the circumstances were beyond the enrollee's control or not reasonably 
126.21 	foreseeable. The commissioner shall determine whether good cause exists based on the 
126.22 	weight of the supporting evidence submitted by the enrollee to demonstrate good cause. 
126.23 	Except when an installment agreement is accepted by the commissioner, all persons 
126.24 	disenrolled for nonpayment of a premium must pay any past due premiums as well as current 
126.25 	premiums due prior to being reenrolled. Nonpayment shall include payment with a returned, 
126.26 	refused, or dishonored instrument. The commissioner may require a guaranteed form of 
126.27 	payment as the only means to replace a returned, refused, or dishonored instrument.
126.28 	(j) For enrollees whose income does not exceed 200 percent of the federal poverty 
126.29 	guidelines and who are also enrolled in Medicare, the commissioner shall reimburse the 
126.30 	enrollee for Medicare part B premiums under section 256B.0625, subdivision 15, paragraph 
126.31 	(a).

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

127.1 	Sec. 29. Minnesota Statutes 2016, section 256B.059, subdivision 6, is amended to read:
127.2 		Subd. 6.Temporary application. (a) During the period in which rules against spousal 
127.3 	impoverishment are temporarily applied according to section 2404 of the Patient Protection 
127.4 	Affordable Care Act, Public Law 111-148, as amended by the Health Care and Education 
127.5 	Reconciliation Act of 2010, Public Law 111-152, this section applies to an institutionalized 
127.6 	spouse:
127.7 	(1) applying for home and community-based waivers under sections 256B.092, 256B.093, 
127.8 	and 256B.49 on or after June 1, 2016;
127.9 	(2) enrolled in home and community-based waivers under sections 256B.092, 256B.093, 
127.10 	and 256B.49 before June 1, 2016, based on an application submitted on or after January 1, 
127.11 	2014; or
127.12 	(3) applying for services under section 256B.85 upon the effective date of that section.
127.13 	(b) During the applicable period of paragraph (a), the definition of "institutionalized 
127.14 	spouse" in subdivision 1, paragraph (f), also includes an institutionalized spouse referenced 
127.15 	in paragraph (a).

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

127.17 	Sec. 30. Minnesota Statutes 2016, section 256B.0625, is amended by adding a subdivision 
127.18 	to read:
127.19 		Subd. 1b.Medical necessity criteria for inpatient hospital treatment. (a) The medical 
127.20 	review agent shall determine whether:
127.21 	(1) a recipient's admission is medically necessary;
127.22 	(2) the inpatient hospital services provided to the recipient were medically necessary;
127.23 	(3) the recipient's continued stay was or will be medically necessary; and
127.24 	(4) all medically necessary inpatient hospital services were provided to the recipient.
127.25 	(b) The medical review agent shall determine the medical necessity of inpatient hospital 
127.26 	services and inpatient psychiatric treatment services based on a review of the recipient's 
127.27 	medical condition and records in conjunction with an industry-standard, evidence-based 
127.28 	clinical decision tool to ensure consistent and optimal application of medical appropriateness 
127.29 	criteria.

127.30 	EFFECTIVE DATE. This section is effective January 1, 2018.

128.1 	Sec. 31. Minnesota Statutes 2016, section 256B.0625, subdivision 3a, is amended to read:
128.2 		Subd. 3a.Sex reassignment Gender confirmation surgery. Sex reassignment Gender 
128.3 	confirmation surgery is not covered when medically necessary.

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

128.5 	Sec. 32. Minnesota Statutes 2016, section 256B.0625, subdivision 18h, is amended to 
128.6 	read:
128.7 		Subd. 18h.Managed care. (a) The following subdivisions do not apply to managed 
128.8 	care plans and county-based purchasing plans:
128.9 	(1) subdivision 17, paragraphs (d) to (k) (a), (b), (h), and (n);
128.10 	(2) subdivision 18e 18; and
128.11 	(3) subdivision 18g 18a.
128.12 	(b) A nonemergency medical transportation provider must comply with the operating 
128.13 	standards for special transportation service defined in sections 174.29 to 174.30 and 
128.14 	Minnesota Rules, chapter 8840, and in consultation with the Minnesota Department of 
128.15 	Transportation. Publicly operated transit systems, volunteers, and not-for-hire vehicles are 
128.16 	exempt from the requirements in this paragraph.

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

128.18 	Sec. 33. Minnesota Statutes 2016, section 256B.0625, subdivision 30, is amended to read:
128.19 		Subd. 30.Other clinic services. (a) Medical assistance covers rural health clinic services, 
128.20 	federally qualified health center services, nonprofit community health clinic services, and 
128.21 	public health clinic services. Rural health clinic services and federally qualified health center 
128.22 	services mean services defined in United States Code, title 42, section 1396d(a)(2)(B) and 
128.23 	(C). Payment for rural health clinic and federally qualified health center services shall be 
128.24 	made according to applicable federal law and regulation.
128.25 	(b) A federally qualified health center that is beginning initial operation shall submit an 
128.26 	estimate of budgeted costs and visits for the initial reporting period in the form and detail 
128.27 	required by the commissioner. A federally qualified health center that is already in operation 
128.28 	shall submit an initial report using actual costs and visits for the initial reporting period. 
128.29 	Within 90 days of the end of its reporting period, a federally qualified health center shall 
128.30 	submit, in the form and detail required by the commissioner, a report of its operations, 
128.31 	including allowable costs actually incurred for the period and the actual number of visits 
129.1 	for services furnished during the period, and other information required by the commissioner. 
129.2 	Federally qualified health centers that file Medicare cost reports shall provide the 
129.3 	commissioner with a copy of the most recent Medicare cost report filed with the Medicare 
129.4 	program intermediary for the reporting year which support the costs claimed on their cost 
129.5 	report to the state.
129.6 	(c) In order to continue cost-based payment under the medical assistance program 
129.7 	according to paragraphs (a) and (b), a federally qualified health center or rural health clinic 
129.8 	must apply for designation as an essential community provider within six months of final 
129.9 	adoption of rules by the Department of Health according to section 62Q.19, subdivision 7. 
129.10 	For those federally qualified health centers and rural health clinics that have applied for 
129.11 	essential community provider status within the six-month time prescribed, medical assistance 
129.12 	payments will continue to be made according to paragraphs (a) and (b) for the first three 
129.13 	years after application. For federally qualified health centers and rural health clinics that 
129.14 	either do not apply within the time specified above or who have had essential community 
129.15 	provider status for three years, medical assistance payments for health services provided 
129.16 	by these entities shall be according to the same rates and conditions applicable to the same 
129.17 	service provided by health care providers that are not federally qualified health centers or 
129.18 	rural health clinics.
129.19 	(d) Effective July 1, 1999, the provisions of paragraph (c) requiring a federally qualified 
129.20 	health center or a rural health clinic to make application for an essential community provider 
129.21 	designation in order to have cost-based payments made according to paragraphs (a) and (b) 
129.22 	no longer apply.
129.23 	(e) Effective January 1, 2000, payments made according to paragraphs (a) and (b) shall 
129.24 	be limited to the cost phase-out schedule of the Balanced Budget Act of 1997.
129.25 	(f) Effective January 1, 2001, each federally qualified health center and rural health 
129.26 	clinic may elect to be paid either under the prospective payment system established in United 
129.27 	States Code, title 42, section 1396a(aa), or under an alternative payment methodology 
129.28 	consistent with the requirements of United States Code, title 42, section 1396a(aa), and 
129.29 	approved by the Centers for Medicare and Medicaid Services. The alternative payment 
129.30 	methodology shall be 100 percent of cost as determined according to Medicare cost 
129.31 	principles.
129.32 	(g) For purposes of this section, "nonprofit community clinic" is a clinic that:
129.33 	(1) has nonprofit status as specified in chapter 317A;
129.34 	(2) has tax exempt status as provided in Internal Revenue Code, section 501(c)(3);
130.1 	(3) is established to provide health services to low-income population groups, uninsured, 
130.2 	high-risk and special needs populations, underserved and other special needs populations;
130.3 	(4) employs professional staff at least one-half of which are familiar with the cultural 
130.4 	background of their clients;
130.5 	(5) charges for services on a sliding fee scale designed to provide assistance to 
130.6 	low-income clients based on current poverty income guidelines and family size; and
130.7 	(6) does not restrict access or services because of a client's financial limitations or public 
130.8 	assistance status and provides no-cost care as needed.
130.9 	(h) Effective for services provided on or after January 1, 2015, all claims for payment 
130.10 	of clinic services provided by federally qualified health centers and rural health clinics shall 
130.11 	be paid by the commissioner. The commissioner shall determine the most feasible method 
130.12 	for paying claims from the following options:
130.13 	(1) federally qualified health centers and rural health clinics submit claims directly to 
130.14 	the commissioner for payment, and the commissioner provides claims information for 
130.15 	recipients enrolled in a managed care or county-based purchasing plan to the plan, on a 
130.16 	regular basis; or
130.17 	(2) federally qualified health centers and rural health clinics submit claims for recipients 
130.18 	enrolled in a managed care or county-based purchasing plan to the plan, and those claims 
130.19 	are submitted by the plan to the commissioner for payment to the clinic.
130.20 	(i) For clinic services provided prior to January 1, 2015, the commissioner shall calculate 
130.21 	and pay monthly the proposed managed care supplemental payments to clinics, and clinics 
130.22 	shall conduct a timely review of the payment calculation data in order to finalize all 
130.23 	supplemental payments in accordance with federal law. Any issues arising from a clinic's 
130.24 	review must be reported to the commissioner by January 1, 2017. Upon final agreement 
130.25 	between the commissioner and a clinic on issues identified under this subdivision, and in 
130.26 	accordance with United States Code, title 42, section 1396a(bb), no supplemental payments 
130.27 	for managed care plan or county-based purchasing plan claims for services provided prior 
130.28 	to January 1, 2015, shall be made after June 30, 2017. If the commissioner and clinics are 
130.29 	unable to resolve issues under this subdivision, the parties shall submit the dispute to the 
130.30 	arbitration process under section 14.57.
130.31 	(j) The commissioner shall seek a federal waiver, authorized under section 1115 of the 
130.32 	Social Security Act, to obtain federal financial participation at the 100 percent federal 
130.33 	matching percentage available to facilities of the Indian Health Service or tribal organization 
131.1 	in accordance with section 1905(b) of the Social Security Act for expenditures made to 
131.2 	organizations dually certified under Title V of the Indian Health Care Improvement Act, 
131.3 	Public Law 94-437, and as a federally qualified health center under paragraph (a) that 
131.4 	provides services to American Indian and Alaskan Native individuals eligible for services 
131.5 	under this subdivision.
131.6 	(k) Effective for services provided on or after January 1, 2019, all claims for payment 
131.7 	of clinic services provided by federally qualified health centers and rural health clinics shall 
131.8 	be paid by the commissioner according to the current prospective payment system described 
131.9 	in paragraph (f), or an alternative payment methodology with the following requirements:
131.10 	(1) each federally qualified health center and rural health clinic must receive a single 
131.11 	medical and a single dental organization rate;
131.12 	(2) the commissioner shall reimburse federally qualified health centers and rural health 
131.13 	clinics allowable costs, including direct patient care costs and patient-related support services, 
131.14 	based upon Medicare cost principles that apply at the time the alternative payment 
131.15 	methodology is calculated;
131.16 	(3) the 2019 payment rates for federally qualified health centers and rural health clinics:
131.17 	(i) must be determined using each federally qualified health center's and rural health 
131.18 	clinic's Medicare cost reports from 2015 and 2016. A provider must submit the required 
131.19 	cost reports to the commissioner within six months of the second base year calendar or 
131.20 	fiscal year end. Cost reports must be submitted six months before the quarter in which the 
131.21 	base rate will take effect;
131.22 	(ii) must be according to current Medicare cost principles applicable to federally qualified 
131.23 	health centers and rural health clinics at the time of the alternative payment rate calculation 
131.24 	without the application of productivity screens and upper payment limits or the Medicare 
131.25 	prospective payment system federally qualified health center aggregate mean upper payment 
131.26 	limit; and
131.27 	(iii) must provide for a 60-day appeals process;
131.28 	(4) the commissioner shall inflate the base year payment rate for federally qualified 
131.29 	health centers and rural health clinics to the effective date by using the Bureau of Economic 
131.30 	Analysis' personal consumption expenditures medical care inflator;
131.31 	(5) the commissioner shall establish a statewide trend inflator using 2015-2020 costs 
131.32 	replacing the use of the personal consumption expenditures medical care inflator with the 
131.33 	2023 rate calculation forward;
132.1 	(6) federally qualified health center and rural health clinic payment rates shall be rebased 
132.2 	by the commissioner every two years using the methodology described in paragraph (k), 
132.3 	clause (3), using the provider's Medicare cost reports from the previous third and fourth 
132.4 	years. In nonrebasing years, the commissioner shall adjust using the Medicare economic 
132.5 	index until 2023 when the statewide trend inflator is available;
132.6 	(7) the commissioner shall increase payments by two percent according to Laws 2003, 
132.7 	First Special Session chapter 14, article 13C, section 2, subdivision 6. This is an add-on to 
132.8 	the rate and must not be included in the base rate calculation;
132.9 	(8) for federally qualified health centers and rural health clinics seeking a change of 
132.10 	scope of services:
132.11 	(i) the commissioner shall require federally qualified health centers and rural health 
132.12 	clinics to submit requests with the commissioner if the change of scope would result in the 
132.13 	medical or dental payment rate currently received by the federally qualified health center 
132.14 	or rural health clinic increasing or decreasing by at least 2-1/2 percent;
132.15 	(ii) federally qualified health centers and rural health clinics shall submit the request to 
132.16 	the commissioner within seven business days of submission of the scope change to the 
132.17 	federal Health Resources Services Administration;
132.18 	(iii) the effective date of the payment change is the date the Health Resources Services 
132.19 	Administration approves the federally qualified health center's or rural health clinic's change 
132.20 	of scope request;
132.21 	(iv) for change of scope requests that do not require Health Resources Services 
132.22 	Administration approval, federally qualified health centers and rural health clinics shall 
132.23 	submit the request to the commissioner before implementing the change, and the effective 
132.24 	date of the change is the date the commissioner receives the request from the federally 
132.25 	qualified health center or rural health clinic; and
132.26 	(v) the commissioner shall provide a response to the federally qualified health center's 
132.27 	or rural health clinic's change of scope request within 45 days of submission and provide a 
132.28 	final decision regarding approval or disapproval within 120 days of submission. If more 
132.29 	information is needed to evaluate the request, this timeline may be waived at the mutual 
132.30 	agreement of the commissioner and the federally qualified health center or rural health 
132.31 	clinic; and
132.32 	(9) the commissioner shall establish a payment rate for new federally qualified health 
132.33 	center and rural health clinic organizations, considering the following factors:
133.1 	(i) a comparison of patient caseload of federally qualified health centers and rural health 
133.2 	clinics within a 60-mile radius for organizations established outside of the seven-county 
133.3 	metropolitan area and within a 30-mile radius for organizations within the seven-county 
133.4 	metropolitan area; and
133.5 	(ii) if comparison is not feasible under item (i), the commissioner may use Medicare 
133.6 	cost reports or audited financial statements to establish the base rate.

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

133.8 	Sec. 34. Minnesota Statutes 2016, section 256B.0625, subdivision 45a, is amended to 
133.9 	read:
133.10 		Subd. 45a.Psychiatric residential treatment facility services for persons under 21 
133.11 	years of age. (a) Medical assistance covers psychiatric residential treatment facility services 
133.12 	for persons under 21 years of age. Individuals who reach age 21 at the time they are receiving 
133.13 	services are eligible to continue receiving services until they no longer require services or 
133.14 	until they reach age 22, whichever occurs first.
133.15 	(b) For purposes of this subdivision, "psychiatric residential treatment facility" means 
133.16 	a facility other than a hospital that provides psychiatric services, as described in Code of 
133.17 	Federal Regulations, title 42, sections 441.151 to 441.182, to individuals under age 21 in 
133.18 	an inpatient setting.
133.19 	(c) The commissioner shall develop admissions and discharge procedures and establish 
133.20 	rates consistent with guidelines from the federal Centers for Medicare and Medicaid Services.
133.21 	(d) The commissioner shall enroll up to 150 certified psychiatric residential treatment 
133.22 	facility services beds at up to six sites. The commissioner shall select psychiatric residential 
133.23 	treatment facility services providers through a request for proposals process. Providers of 
133.24 	state-operated services may respond to the request for proposals.
133.25 	(e) An individual who is eligible for mental health treatment services in a psychiatric 
133.26 	residential treatment facility is an individual who meets all of the following criteria:
133.27 	(1) has a certificate of need prior to admission, as determined and approved by the state's 
133.28 	medical review agent, to determine medical necessity according to Code of Federal 
133.29 	Regulations, title 42, section 441.152;
133.30 	(2) is younger than 21 years of age at the time of admission. Services may continue until 
133.31 	the individual meets criteria for discharge or reaches 22 years of age, whichever occurs 
133.32 	first;
134.1 	(3) has a mental health diagnosis as defined in the most recent edition of the Diagnostic 
134.2 	and Statistical Manual for Mental Disorders, as well as clinical evidence of severe aggression, 
134.3 	or the individual is a risk to self or others;
134.4 	(4) has functional impairment and a history of difficulty in functioning safely and 
134.5 	successfully in the community, school, home, or job; an inability to adequately care for 
134.6 	one's physical needs; or caregivers, guardians, or family members are unable to safely fulfill 
134.7 	the individual's needs;
134.8 	(5) requires psychiatric residential treatment under the direction of a physician to improve 
134.9 	the individual's condition or prevent further regression so that services will no longer be 
134.10 	needed;
134.11 	(6) has utilized and exhausted other community-based mental health services, or clinical 
134.12 	evidence indicates that such services cannot provide the level of care needed; and
134.13 	(7) has been referred for treatment in a psychiatric residential treatment facility by a 
134.14 	qualified mental health professional licensed as defined in section 245.4871, subdivision 
134.15 	27, clauses (1) to (6).
134.16 	A mental health professional making a referral shall submit documentation to the state's 
134.17 	medical review agent containing all information necessary to determine eligibility for 
134.18 	admission, including a standard diagnostic assessment completed within 180 days of the 
134.19 	individual's admission. Documentation shall include evidence of family participation in the 
134.20 	individual's treatment planning and signed consent for services.
134.21 	(f) The commissioner shall establish a statewide per diem rate for psychiatric residential 
134.22 	treatment facility services for individuals 21 years of age or younger.  The rate for a provider 
134.23 	must not exceed the rate charged by that provider for the same service to other payers. 
134.24 	Except as provided in paragraph (c), payment will not be made to more than one entity for 
134.25 	each individual for services provided under this section on a given day. Rates are set 
134.26 	prospectively for the annual rate period. A provider is required to submit annual cost reports 
134.27 	on a uniform cost reporting form. A submitted cost report is used to inform the rate-setting 
134.28 	process. The cost reporting shall be done according to federal requirements for Medicare 
134.29 	cost reports.
134.30 	(g) "Actual cost" means costs that are allowable, allocable, reasonable, and consistent 
134.31 	with federal reimbursement requirements in Code of Federal Regulations, title 48, chapter 
134.32 	1, part 31, relating to for-profit entities, and the Office of Management and Budget Circular 
134.33 	Number A-122, relating to nonprofit entities. The following are included in the rate:
135.1 	(1) development of the individual plan of care, review of the individual plan of care 
135.2 	every 30 days, and discharge planning by required members of the treatment team according 
135.3 	to Code of Federal Regulations, title 42, sections 441.155 to 441.156;
135.4 	(2) any services provided by a psychiatrist or physician for development of an individual 
135.5 	plan of care, conducting a review of the individual plan of care every 30 days, and discharge 
135.6 	planning by required members of the treatment team according to Code of Federal 
135.7 	Regulations, title 42, sections 441.155 to 441.156;
135.8 	(3) active treatment seven days per week, which includes individual, family, and group 
135.9 	therapy provided by licensed mental health professionals;
135.10 	(4) individual therapy, provided a minimum of twice per week;
135.11 	(5) family engagement activities, provided a minimum of once per week;
135.12 	(6) consultation with other professionals including case managers, primary care 
135.13 	professionals, community-based mental health providers, school staff, or other support 
135.14 	planners;
135.15 	(7) coordination of educational services between local and resident school districts and 
135.16 	the facility;
135.17 	(8) 24-hour nursing;
135.18 	(9) direct care and supervision, supportive services for daily living and safety, and 
135.19 	positive behavior management;
135.20 	(10) lab and pharmacy related to the diagnosed condition of youth and an individualized 
135.21 	plan of care;
135.22 	(11) costs necessary for licensure and accreditation, meeting all staffing standards for 
135.23 	participation, meeting all service standards for participation, meeting all requirements for 
135.24 	active treatment, maintaining medical records, conducting utilization review, meeting 
135.25 	inspection of care, and discharge planning; and
135.26 	(12) payment for room and board provided by facilities meeting all accreditation and 
135.27 	licensing requirements for participation.
135.28 	(h) Facilities may submit claims for payment outside of the per diem for professional 
135.29 	services arranged by and provided at the facility by an appropriately licensed professional 
135.30 	who is enrolled as a provider with Minnesota health care programs. Arranged services shall 
135.31 	be billed by the facility on a separate claim, and the facility shall be responsible for payment 
136.1 	to the provider. These services must be included in the individual plan of care and require 
136.2 	prior authorization by the state's medical review agent:
136.3 	(1) physician or psychiatric services outside of the development of the individual plan 
136.4 	of care, review of the individual plan of care every 30 days, and discharge planning by 
136.5 	required members of the treatment team;
136.6 	(2) psychological testing;
136.7 	(3) neuropsychological testing;
136.8 	(4) health and physical medical consults;
136.9 	(5) occupational therapy;
136.10 	(6) physical therapy; and
136.11 	(7) speech therapy.
136.12 	(i) Medical assistance covers therapeutic and hospital leave days, provided the recipient 
136.13 	was not discharged from the psychiatric residential treatment facility (PRTF) and is expected 
136.14 	to return to the PRTF. A reserved bed must be held for a recipient on hospital leave or 
136.15 	therapeutic leave.
136.16 	(j) A therapeutic leave day to home shall be for the purposes of preparing for discharge 
136.17 	and reintegration and shall be included in the individual plan of care. The state will reimburse 
136.18 	75 percent of the per diem rate for a reserve bed day while the recipient is on therapeutic 
136.19 	leave. A therapeutic leave visit may not exceed three days per visit without prior 
136.20 	authorization.
136.21 	(k) A hospital leave day shall be a day when a recipient requires admission to a hospital 
136.22 	for medical or acute psychiatric care and is temporarily absent from the psychiatric residential 
136.23 	treatment facility. The state shall reimburse 50 percent of the per diem rate for a reserve 
136.24 	bed day while the recipient is receiving medical or psychiatric care in a hospital.
136.25 	(l) Medicaid shall reimburse for concurrent services as approved by the commissioner 
136.26 	to support continuity of care and successful discharge from the facility. "Concurrent services" 
136.27 	means services provided by another entity or provider while the individual is admitted to a 
136.28 	psychiatric residential treatment facility. Payment for concurrent services may be limited 
136.29 	and require prior authorization by the state's medical review agent. Concurrent services may 
136.30 	include targeted case management, assertive community treatment, clinical care consultation, 
136.31 	team consultation, and treatment planning.
136.32 	(m) Payment rates under this subdivision shall not include the costs of providing:
137.1 	(1) educational services;
137.2 	(2) acute medical care or specialty services for other medical conditions;
137.3 	(3) dental services; and
137.4 	(4) pharmacy drug costs for other medical conditions;

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

137.6 	Sec. 35. Minnesota Statutes 2016, section 256B.0625, subdivision 57, is amended to read:
137.7 		Subd. 57.Payment for Part B Medicare crossover claims. (a) Effective for services 
137.8 	provided on or after January 1, 2012, medical assistance payment for an enrollee's 
137.9 	cost-sharing associated with Medicare Part B is limited to an amount up to the medical 
137.10 	assistance total allowed, when the medical assistance rate exceeds the amount paid by 
137.11 	Medicare.
137.12 	(b) Excluded from this limitation are payments for mental health services and payments 
137.13 	for dialysis services provided to end-stage renal disease patients. The exclusion for mental 
137.14 	health services does not apply to payments for physician services provided by psychiatrists 
137.15 	and advanced practice nurses with a specialty in mental health.
137.16 	(c) Excluded from this limitation are payments to federally qualified health centers, 
137.17 	Indian Health Services, and rural health clinics.

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

137.19 	Sec. 36. Minnesota Statutes 2016, section 256B.0659, subdivision 21, is amended to read:
137.20 		Subd. 21.Requirements for provider enrollment of personal care assistance provider 
137.21 	agencies. (a) All personal care assistance provider agencies must provide, at the time of 
137.22 	enrollment, reenrollment, and revalidation as a personal care assistance provider agency in 
137.23 	a format determined by the commissioner, information and documentation that includes, 
137.24 	but is not limited to, the following:
137.25 	(1) the personal care assistance provider agency's current contact information including 
137.26 	address, telephone number, and e-mail address;
137.27 	(2) proof of surety bond coverage for each location providing services. Upon new 
137.28 	enrollment, or if the provider's Medicaid revenue in the previous calendar year is up to and 
137.29 	including $300,000, the provider agency must purchase a surety bond of $50,000. If the 
137.30 	Medicaid revenue in the previous year is over $300,000, the provider agency must purchase 
137.31 	a surety bond of $100,000. The surety bond must be in a form approved by the commissioner, 
138.1 	must be renewed annually, and must allow for recovery of costs and fees in pursuing a claim 
138.2 	on the bond;
138.3 	(3) proof of fidelity bond coverage in the amount of $20,000 for each business location 
138.4 	providing service;
138.5 	(4) proof of workers' compensation insurance coverage identifying the business address 
138.6 	where PCA services are provided from;
138.7 	(5) proof of liability insurance coverage identifying the business address where PCA 
138.8 	services are provided from and naming the department as a certificate holder;
138.9 	(6) a description of the personal care assistance provider agency's organization identifying 
138.10 	the names of all owners, managing employees, staff, board of directors, and the affiliations 
138.11 	of the directors, owners, or staff to other service providers;
138.12 	(7) (6) a copy of the personal care assistance provider agency's written policies and 
138.13 	procedures including: hiring of employees; training requirements; service delivery; and 
138.14 	employee and consumer safety including process for notification and resolution of consumer 
138.15 	grievances, identification and prevention of communicable diseases, and employee 
138.16 	misconduct;
138.17 	(8) (7) copies of all other forms the personal care assistance provider agency uses in the 
138.18 	course of daily business including, but not limited to:
138.19 	(i) a copy of the personal care assistance provider agency's time sheet if the time sheet 
138.20 	varies from the standard time sheet for personal care assistance services approved by the 
138.21 	commissioner, and a letter requesting approval of the personal care assistance provider 
138.22 	agency's nonstandard time sheet;
138.23 	(ii) the personal care assistance provider agency's template for the personal care assistance 
138.24 	care plan; and
138.25 	(iii) the personal care assistance provider agency's template for the written agreement 
138.26 	in subdivision 20 for recipients using the personal care assistance choice option, if applicable;
138.27 	(9) (8) a list of all training and classes that the personal care assistance provider agency 
138.28 	requires of its staff providing personal care assistance services;
138.29 	(10) (9) documentation that the personal care assistance provider agency and staff have 
138.30 	successfully completed all the training required by this section;
138.31 	(11) (10) documentation of the agency's marketing practices;
139.1 	(12) (11) disclosure of ownership, leasing, or management of all residential properties 
139.2 	that is used or could be used for providing home care services;
139.3 	(13) (12) documentation that the agency will use the following percentages of revenue 
139.4 	generated from the medical assistance rate paid for personal care assistance services for 
139.5 	employee personal care assistant wages and benefits: 72.5 percent of revenue in the personal 
139.6 	care assistance choice option and 72.5 percent of revenue from other personal care assistance 
139.7 	providers. The revenue generated by the qualified professional and the reasonable costs 
139.8 	associated with the qualified professional shall not be used in making this calculation; and
139.9 	(14) (13) effective May 15, 2010, documentation that the agency does not burden 
139.10 	recipients' free exercise of their right to choose service providers by requiring personal care 
139.11 	assistants to sign an agreement not to work with any particular personal care assistance 
139.12 	recipient or for another personal care assistance provider agency after leaving the agency 
139.13 	and that the agency is not taking action on any such agreements or requirements regardless 
139.14 	of the date signed.
139.15 	(b) Personal care assistance provider agencies shall provide the information specified 
139.16 	in paragraph (a) to the commissioner at the time the personal care assistance provider agency 
139.17 	enrolls as a vendor or upon request from the commissioner. The commissioner shall collect 
139.18 	the information specified in paragraph (a) from all personal care assistance providers 
139.19 	beginning July 1, 2009.
139.20 	(c) All personal care assistance provider agencies shall require all employees in 
139.21 	management and supervisory positions and owners of the agency who are active in the 
139.22 	day-to-day management and operations of the agency to complete mandatory training as 
139.23 	determined by the commissioner before submitting an application for enrollment of the 
139.24 	agency as a provider. All personal care assistance provider agencies shall also require 
139.25 	qualified professionals to complete the training required by subdivision 13 before submitting 
139.26 	an application for enrollment of the agency as a provider. Employees in management and 
139.27 	supervisory positions and owners who are active in the day-to-day operations of an agency 
139.28 	who have completed the required training as an employee with a personal care assistance 
139.29 	provider agency do not need to repeat the required training if they are hired by another 
139.30 	agency, if they have completed the training within the past three years. By September 1, 
139.31 	2010, the required training must be available with meaningful access according to title VI 
139.32 	of the Civil Rights Act and federal regulations adopted under that law or any guidance from 
139.33 	the United States Health and Human Services Department. The required training must be 
139.34 	available online or by electronic remote connection. The required training must provide for 
139.35 	competency testing. Personal care assistance provider agency billing staff shall complete 
140.1 	training about personal care assistance program financial management. This training is 
140.2 	effective July 1, 2009. Any personal care assistance provider agency enrolled before that 
140.3 	date shall, if it has not already, complete the provider training within 18 months of July 1, 
140.4 	2009. Any new owners or employees in management and supervisory positions involved 
140.5 	in the day-to-day operations are required to complete mandatory training as a requisite of 
140.6 	working for the agency. Personal care assistance provider agencies certified for participation 
140.7 	in Medicare as home health agencies are exempt from the training required in this 
140.8 	subdivision. When available, Medicare-certified home health agency owners, supervisors, 
140.9 	or managers must successfully complete the competency test.
140.10 	(d) All surety bonds, fidelity bonds, workers compensation insurance, and liability 
140.11 	insurance required by this subdivision must be maintained continuously. After initial 
140.12 	enrollment, a provider must submit proof of bonds and required coverages at any time at 
140.13 	the request of the commissioner. Services provided while there are lapses in coverage are 
140.14 	not eligible for payment. Lapses in coverage may result in sanctions, including termination. 
140.15 	The commissioner shall send instructions and a due date to submit the requested information 
140.16 	to the personal care assistance provider agency.

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

140.18 	Sec. 37. Minnesota Statutes 2016, section 256B.0755, subdivision 1, is amended to read:
140.19 		Subdivision 1.Implementation. (a) The commissioner shall develop and authorize a 
140.20 	demonstration project to test alternative and innovative health care delivery systems
140.21 	integrated health partnerships, including accountable care organizations that provide services 
140.22 	to a specified patient population for an agreed-upon total cost of care or risk/gain sharing 
140.23 	payment arrangement. The commissioner shall develop a request for proposals for 
140.24 	participation in the demonstration project in consultation with hospitals, primary care 
140.25 	providers, health plans, and other key stakeholders.
140.26 	(b) In developing the request for proposals, the commissioner shall:
140.27 	(1) establish uniform statewide methods of forecasting utilization and cost of care for 
140.28 	the appropriate Minnesota public program populations, to be used by the commissioner for 
140.29 	the health care delivery system integrated health partnership projects;
140.30 	(2) identify key indicators of quality, access, patient satisfaction, and other performance 
140.31 	indicators that will be measured, in addition to indicators for measuring cost savings;
141.1 	(3) allow maximum flexibility to encourage innovation and variation so that a variety 
141.2 	of provider collaborations are able to become health care delivery systems integrated health 
141.3 	partnerships;
141.4 	(4) encourage and authorize different levels and types of financial risk;
141.5 	(5) encourage and authorize projects representing a wide variety of geographic locations, 
141.6 	patient populations, provider relationships, and care coordination models;
141.7 	(6) encourage projects that involve close partnerships between the health care delivery 
141.8 	system integrated health partnership and counties and nonprofit agencies that provide services 
141.9 	to patients enrolled with the health care delivery system integrated health partnership, 
141.10 	including social services, public health, mental health, community-based services, and 
141.11 	continuing care;
141.12 	(7) encourage projects established by community hospitals, clinics, and other providers 
141.13 	in rural communities;
141.14 	(8) identify required covered services for a total cost of care model or services considered 
141.15 	in whole or partially in an analysis of utilization for a risk/gain sharing model;
141.16 	(9) establish a mechanism to monitor enrollment;
141.17 	(10) establish quality standards for the delivery system demonstrations; and
141.18 	(11) encourage participation of privately insured population so as to create sufficient 
141.19 	alignment in demonstration systems.
141.20 	(c) To be eligible to participate in the demonstration project, a health care delivery system
141.21 	an integrated health partnership must:
141.22 	(1) provide required covered services and care coordination to recipients enrolled in the 
141.23 	health care delivery system;
141.24 	(2) establish a process to monitor enrollment and ensure the quality of care provided;
141.25 	(3) in cooperation with counties and community social service agencies, coordinate the 
141.26 	delivery of health care services with existing social services programs;
141.27 	(4) provide a system for advocacy and consumer protection; and
141.28 	(5) adopt innovative and cost-effective methods of care delivery and coordination, which 
141.29 	may include the use of allied health professionals, telemedicine, patient educators, care 
141.30 	coordinators, and community health workers.
142.1 	(d) A health care delivery system An integrated health partnership demonstration may 
142.2 	be formed by the following groups of providers of services and suppliers if they have 
142.3 	established a mechanism for shared governance:
142.4 	(1) professionals in group practice arrangements;
142.5 	(2) networks of individual practices of professionals;
142.6 	(3) partnerships or joint venture arrangements between hospitals and health care 
142.7 	professionals;
142.8 	(4) hospitals employing professionals; and
142.9 	(5) other groups of providers of services and suppliers as the commissioner determines 
142.10 	appropriate.
142.11 	A managed care plan or county-based purchasing plan may participate in this 
142.12 	demonstration in collaboration with one or more of the entities listed in clauses (1) to (5).
142.13 	A health care delivery system An integrated health partnership may contract with a 
142.14 	managed care plan or a county-based purchasing plan to provide administrative services, 
142.15 	including the administration of a payment system using the payment methods established 
142.16 	by the commissioner for health care delivery systems integrated health partnerships.
142.17 	(e) The commissioner may require a health care delivery system an integrated health 
142.18 	partnership to enter into additional third-party contractual relationships for the assessment 
142.19 	of risk and purchase of stop loss insurance or another form of insurance risk management 
142.20 	related to the delivery of care described in paragraph (c).

142.21 	EFFECTIVE DATE. This section is effective January 1, 2018.

142.22 	Sec. 38. Minnesota Statutes 2016, section 256B.0755, subdivision 2, is amended to read:
142.23 		Subd. 2.Enrollment. (a) Individuals eligible for medical assistance or MinnesotaCare 
142.24 	shall be eligible for enrollment in a health care delivery system an integrated health 
142.25 	partnership.
142.26 	(b) Eligible applicants and recipients may enroll in a health care delivery system an 
142.27 	integrated health partnership if a system serves the county in which the applicant or recipient 
142.28 	resides. If more than one health care delivery system integrated health partnership serves a 
142.29 	county, the applicant or recipient shall be allowed to choose among the delivery systems
142.30 	integrated health partnerships. The commissioner may assign an applicant or recipient to a 
142.31 	health care delivery system an integrated health partnership if a health care delivery system
143.1 	an integrated health partnership is available and no choice has been made by the applicant 
143.2 	or recipient.

143.3 	EFFECTIVE DATE. This section is effective January 1, 2018.

143.4 	Sec. 39. Minnesota Statutes 2016, section 256B.0755, subdivision 3, is amended to read:
143.5 		Subd. 3.Accountability. (a) Health care delivery systems Integrated health partnerships
143.6 	must accept responsibility for the quality of care based on standards established under 
143.7 	subdivision 1, paragraph (b), clause (10), and the cost of care or utilization of services 
143.8 	provided to its enrollees under subdivision 1, paragraph (b), clause (1).
143.9 	(b) A health care delivery system An integrated health partnership may contract and 
143.10 	coordinate with providers and clinics for the delivery of services and shall contract with 
143.11 	community health clinics, federally qualified health centers, community mental health 
143.12 	centers or programs, county agencies, and rural clinics to the extent practicable.
143.13 	(c) A health care delivery system An integrated health partnership must indicate how it 
143.14 	will coordinate with other services affecting its patients' health, quality of care, and cost of 
143.15 	care that are provided by other providers, county agencies, and other organizations in the 
143.16 	local service area. The health care delivery system integrated health partnership must indicate 
143.17 	how it will engage other providers, counties, and organizations, including county-based 
143.18 	purchasing plans, that provide services to patients of the health care delivery system
143.19 	integrated health partnership on issues related to local population health, including applicable 
143.20 	local needs, priorities, and public health goals. The health care delivery system integrated 
143.21 	health partnership must describe how local providers, counties, organizations, including 
143.22 	county-based purchasing plans, and other relevant purchasers were consulted in developing 
143.23 	the application to participate in the demonstration project.

143.24 	EFFECTIVE DATE. This section is effective January 1, 2018.

143.25 	Sec. 40. Minnesota Statutes 2016, section 256B.0755, subdivision 4, is amended to read:
143.26 		Subd. 4.Payment system. (a) In developing a payment system for health care delivery 
143.27 	systems integrated health partnerships, the commissioner shall establish a total cost of care 
143.28 	benchmark or a risk/gain sharing payment model to be paid for services provided to the 
143.29 	recipients enrolled in a health care delivery system an integrated health partnership.
143.30 	(b) The payment system may include incentive payments to health care delivery systems
143.31 	integrated health partnerships that meet or exceed annual quality and performance targets 
143.32 	realized through the coordination of care.
144.1 	(c) An amount equal to the savings realized to the general fund as a result of the 
144.2 	demonstration project shall be transferred each fiscal year to the health care access fund.
144.3 	(d) The payment system may include population-based payments to integrated health 
144.4 	partnerships that incorporate payment for care coordination. Any integrated health partnership 
144.5 	participant certified as a health care home under section 256B.0751 that agrees to a payment 
144.6 	method that includes population-based payments for care coordination is not eligible to 
144.7 	receive a health care home payment or care coordination fee authorized under section 62U.03 
144.8 	or 256B.0753, subdivision 1, or in-reach care coordination under section 256B.0625, 
144.9 	subdivision 56, for any medical assistance or MinnesotaCare beneficiaries enrolled or 
144.10 	attributed to the integrated health partnership under this demonstration.

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

144.12 	Sec. 41. Minnesota Statutes 2016, section 256B.0755, subdivision 7, is amended to read:
144.13 		Subd. 7.Expansion. The commissioner shall expand the demonstration project to include 
144.14 	additional medical assistance and MinnesotaCare enrollees, and shall seek participation of 
144.15 	Medicare in demonstration projects. The commissioner shall seek to include participation 
144.16 	of privately insured persons and Medicare recipients in the health care delivery integrated 
144.17 	health partnership demonstration. As part of the demonstration expansion, the commissioner 
144.18 	may procure the services of the health care delivery systems integrated health partnerships
144.19 	authorized under this section by geographic area, to supplement or replace the services 
144.20 	provided by managed care plans operating under section 256B.69.

144.21 	EFFECTIVE DATE. This section is effective January 1, 2018.

144.22 	Sec. 42. Minnesota Statutes 2016, section 256B.0943, subdivision 9, is amended to read:
144.23 		Subd. 9.Service delivery criteria. (a) In delivering services under this section, a certified 
144.24 	provider entity must ensure that:
144.25 	(1) each individual provider's caseload size permits the provider to deliver services to 
144.26 	both clients with severe, complex needs and clients with less intensive needs. The provider's 
144.27 	caseload size should reasonably enable the provider to play an active role in service planning, 
144.28 	monitoring, and delivering services to meet the client's and client's family's needs, as specified 
144.29 	in each client's individual treatment plan;
144.30 	(2) site-based programs, including day treatment programs, provide staffing and facilities 
144.31 	to ensure the client's health, safety, and protection of rights, and that the programs are able 
144.32 	to implement each client's individual treatment plan; and
145.1 	(3) a day treatment program is provided to a group of clients by a multidisciplinary team 
145.2 	under the clinical supervision of a mental health professional. The day treatment program 
145.3 	must be provided in and by: (i) an outpatient hospital accredited by the Joint Commission 
145.4 	on Accreditation of Health Organizations and licensed under sections 144.50 to 144.55; (ii) 
145.5 	a community mental health center under section 245.62; or (iii) an entity that is certified 
145.6 	under subdivision 4 to operate a program that meets the requirements of section 245.4884, 
145.7 	subdivision 2, and Minnesota Rules, parts 9505.0170 to 9505.0475. The day treatment 
145.8 	program must stabilize the client's mental health status while developing and improving the 
145.9 	client's independent living and socialization skills. The goal of the day treatment program 
145.10 	must be to reduce or relieve the effects of mental illness and provide training to enable the 
145.11 	client to live in the community. The program must be available year-round at least three to 
145.12 	five days per week, two or three hours per day, unless the normal five-day school week is 
145.13 	shortened by a holiday, weather-related cancellation, or other districtwide reduction in a 
145.14 	school week. A child transitioning into or out of day treatment must receive a minimum 
145.15 	treatment of one day a week for a two-hour time block. The two-hour time block must 
145.16 	include at least one hour of patient and/or family or group psychotherapy. The remainder 
145.17 	of the structured treatment program may include patient and/or family or group 
145.18 	psychotherapy, and individual or group skills training, if included in the client's individual 
145.19 	treatment plan. Day treatment programs are not part of inpatient or residential treatment 
145.20 	services. When a day treatment group that meets the minimum group size requirement 
145.21 	temporarily falls below the minimum group size because of a member's temporary absence, 
145.22 	medical assistance covers a group session conducted for the group members in attendance. 
145.23 	A day treatment program may provide fewer than the minimally required hours for a 
145.24 	particular child during a billing period in which the child is transitioning into, or out of, the 
145.25 	program.
145.26 	(b) To be eligible for medical assistance payment, a provider entity must deliver the 
145.27 	service components of children's therapeutic services and supports in compliance with the 
145.28 	following requirements:
145.29 	(1) patient and/or family, family, and group psychotherapy must be delivered as specified 
145.30 	in Minnesota Rules, part 9505.0372, subpart 6. Psychotherapy to address the child's 
145.31 	underlying mental health disorder must be documented as part of the child's ongoing 
145.32 	treatment. A provider must deliver, or arrange for, medically necessary psychotherapy, 
145.33 	unless the child's parent or caregiver chooses not to receive it. When a provider delivering 
145.34 	other services to a child under this section deems it not medically necessary to provide 
145.35 	psychotherapy to the child for a period of 90 days or longer, the provider entity must 
146.1 	document the medical reasons why psychotherapy is not necessary. When a provider 
146.2 	determines that a child needs psychotherapy but psychotherapy cannot be delivered due to 
146.3 	a shortage of licensed mental health professionals in the child's community, the provider 
146.4 	must document the lack of access in the child's medical record;
146.5 	(2) individual, family, or group skills training must be provided by a mental health 
146.6 	professional or a mental health practitioner who is delivering services that fall within the 
146.7 	scope of the provider's practice and is supervised by a mental health professional who 
146.8 	accepts full professional responsibility for the training. Skills training is subject to the 
146.9 	following requirements:
146.10 	(i) a mental health professional, clinical trainee, or mental health practitioner shall provide 
146.11 	skills training;
146.12 	(ii) skills training delivered to a child or the child's family must be targeted to the specific 
146.13 	deficits or maladaptations of the child's mental health disorder and must be prescribed in 
146.14 	the child's individual treatment plan;
146.15 	(iii) the mental health professional delivering or supervising the delivery of skills training 
146.16 	must document any underlying psychiatric condition and must document how skills training 
146.17 	is being used in conjunction with psychotherapy to address the underlying condition;
146.18 	(iv) skills training delivered to the child's family must teach skills needed by parents to 
146.19 	enhance the child's skill development, to help the child utilize daily life skills taught by a 
146.20 	mental health professional, clinical trainee, or mental health practitioner, and to develop or 
146.21 	maintain a home environment that supports the child's progressive use of skills;
146.22 	(v) group skills training may be provided to multiple recipients who, because of the 
146.23 	nature of their emotional, behavioral, or social dysfunction, can derive mutual benefit from 
146.24 	interaction in a group setting, which must be staffed as follows:
146.25 	(A) one mental health professional or one clinical trainee or mental health practitioner 
146.26 	under supervision of a licensed mental health professional must work with a group of three 
146.27 	to eight clients; or
146.28 	(B) two mental health professionals, two clinical trainees or mental health practitioners 
146.29 	under supervision of a licensed mental health professional, or one mental health professional 
146.30 	or clinical trainee and one mental health practitioner must work with a group of nine to 12 
146.31 	clients;
147.1 	(vi) a mental health professional, clinical trainee, or mental health practitioner must have 
147.2 	taught the psychosocial skill before a mental health behavioral aide may practice that skill 
147.3 	with the client; and
147.4 	(vii) for group skills training, when a skills group that meets the minimum group size 
147.5 	requirement temporarily falls below the minimum group size because of a group member's 
147.6 	temporary absence, the provider may conduct the session for the group members in 
147.7 	attendance;
147.8 	(3) crisis assistance to a child and family must include development of a written plan 
147.9 	that anticipates the particular factors specific to the child that may precipitate a psychiatric 
147.10 	crisis for the child in the near future. The written plan must document actions that the family 
147.11 	should be prepared to take to resolve or stabilize a crisis, such as advance arrangements for 
147.12 	direct intervention and support services to the child and the child's family. Crisis assistance 
147.13 	must include preparing resources designed to address abrupt or substantial changes in the 
147.14 	functioning of the child or the child's family when sudden change in behavior or a loss of 
147.15 	usual coping mechanisms is observed, or the child begins to present a danger to self or 
147.16 	others;
147.17 	(4) mental health behavioral aide services must be medically necessary treatment services, 
147.18 	identified in the child's individual treatment plan and individual behavior plan, which are 
147.19 	performed minimally by a paraprofessional qualified according to subdivision 7, paragraph 
147.20 	(b), clause (3), and which are designed to improve the functioning of the child in the 
147.21 	progressive use of developmentally appropriate psychosocial skills. Activities involve 
147.22 	working directly with the child, child-peer groupings, or child-family groupings to practice, 
147.23 	repeat, reintroduce, and master the skills defined in subdivision 1, paragraph (t), as previously 
147.24 	taught by a mental health professional, clinical trainee, or mental health practitioner including:
147.25 	(i) providing cues or prompts in skill-building peer-to-peer or parent-child interactions 
147.26 	so that the child progressively recognizes and responds to the cues independently;
147.27 	(ii) performing as a practice partner or role-play partner;
147.28 	(iii) reinforcing the child's accomplishments;
147.29 	(iv) generalizing skill-building activities in the child's multiple natural settings;
147.30 	(v) assigning further practice activities; and
147.31 	(vi) intervening as necessary to redirect the child's target behavior and to de-escalate 
147.32 	behavior that puts the child or other person at risk of injury.
148.1 	To be eligible for medical assistance payment, mental health behavioral aide services must 
148.2 	be delivered to a child who has been diagnosed with an emotional disturbance or a mental 
148.3 	illness, as provided in subdivision 1, paragraph (a). The mental health behavioral aide must 
148.4 	implement treatment strategies in the individual treatment plan and the individual behavior 
148.5 	plan as developed by the mental health professional, clinical trainee, or mental health 
148.6 	practitioner providing direction for the mental health behavioral aide. The mental health 
148.7 	behavioral aide must document the delivery of services in written progress notes. Progress 
148.8 	notes must reflect implementation of the treatment strategies, as performed by the mental 
148.9 	health behavioral aide and the child's responses to the treatment strategies;
148.10 	(5) direction of a mental health behavioral aide must include the following:
148.11 	(i) ongoing face-to-face observation of the mental health behavioral aide delivering 
148.12 	services to a child by a mental health professional or mental health practitioner for at least 
148.13 	a total of one hour during every 40 hours of service provided to a child; and
148.14 	(ii) immediate accessibility of the mental health professional, clinical trainee, or mental 
148.15 	health practitioner to the mental health behavioral aide during service provision;
148.16 	(6) mental health service plan development must be performed in consultation with the 
148.17 	child's family and, when appropriate, with other key participants in the child's life by the 
148.18 	child's treating mental health professional or clinical trainee or by a mental health practitioner 
148.19 	and approved by the treating mental health professional. Treatment plan drafting consists 
148.20 	of development, review, and revision by face-to-face or electronic communication. The 
148.21 	provider must document events, including the time spent with the family and other key 
148.22 	participants in the child's life to review, revise, and sign the individual treatment plan. 
148.23 	Notwithstanding Minnesota Rules, part 9505.0371, subpart 7, medical assistance covers 
148.24 	service plan development before completion of the child's individual treatment plan. Service 
148.25 	plan development is covered only if a treatment plan is completed for the child. If upon 
148.26 	review it is determined that a treatment plan was not completed for the child, the 
148.27 	commissioner shall recover the payment for the service plan development; and
148.28 	(7) to be eligible for payment, a diagnostic assessment must be complete with regard to 
148.29 	all required components, including multiple assessment appointments required for an 
148.30 	extended diagnostic assessment and the written report. Dates of the multiple assessment 
148.31 	appointments must be noted in the client's clinical record.

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

149.1 	Sec. 43. Minnesota Statutes 2016, section 256B.15, subdivision 1, is amended to read:
149.2 		Subdivision 1.Policy and applicability. (a) It is the policy of this state that individuals 
149.3 	or couples, either or both of whom participate in the medical assistance program, use their 
149.4 	own assets to pay their share of the cost of their care during or after their enrollment in the 
149.5 	program according to applicable federal law and the laws of this state. The following 
149.6 	provisions apply:
149.7 	(1) subdivisions 1c to 1k shall not apply to claims arising under this section which are 
149.8 	presented under section 525.313;
149.9 	(2) the provisions of subdivisions 1c to 1k expanding the interests included in an estate 
149.10 	for purposes of recovery under this section give effect to the provisions of United States 
149.11 	Code, title 42, section 1396p, governing recoveries, but do not give rise to any express or 
149.12 	implied liens in favor of any other parties not named in these provisions;
149.13 	(3) the continuation of a recipient's life estate or joint tenancy interest in real property 
149.14 	after the recipient's death for the purpose of recovering medical assistance under this section 
149.15 	modifies common law principles holding that these interests terminate on the death of the 
149.16 	holder;
149.17 	(4) all laws, rules, and regulations governing or involved with a recovery of medical 
149.18 	assistance shall be liberally construed to accomplish their intended purposes;
149.19 	(5) a deceased recipient's life estate and joint tenancy interests continued under this 
149.20 	section shall be owned by the remainderpersons or surviving joint tenants as their interests 
149.21 	may appear on the date of the recipient's death. They shall not be merged into the remainder 
149.22 	interest or the interests of the surviving joint tenants by reason of ownership. They shall be 
149.23 	subject to the provisions of this section. Any conveyance, transfer, sale, assignment, or 
149.24 	encumbrance by a remainderperson, a surviving joint tenant, or their heirs, successors, and 
149.25 	assigns shall be deemed to include all of their interest in the deceased recipient's life estate 
149.26 	or joint tenancy interest continued under this section; and
149.27 	(6) the provisions of subdivisions 1c to 1k continuing a recipient's joint tenancy interests 
149.28 	in real property after the recipient's death do not apply to a homestead owned of record, on 
149.29 	the date the recipient dies, by the recipient and the recipient's spouse as joint tenants with 
149.30 	a right of survivorship. Homestead means the real property occupied by the surviving joint 
149.31 	tenant spouse as their sole residence on the date the recipient dies and classified and taxed 
149.32 	to the recipient and surviving joint tenant spouse as homestead property for property tax 
149.33 	purposes in the calendar year in which the recipient dies. For purposes of this exemption, 
149.34 	real property the recipient and their surviving joint tenant spouse purchase solely with the 
150.1 	proceeds from the sale of their prior homestead, own of record as joint tenants, and qualify 
150.2 	as homestead property under section 273.124 in the calendar year in which the recipient 
150.3 	dies and prior to the recipient's death shall be deemed to be real property classified and 
150.4 	taxed to the recipient and their surviving joint tenant spouse as homestead property in the 
150.5 	calendar year in which the recipient dies. The surviving spouse, or any person with personal 
150.6 	knowledge of the facts, may provide an affidavit describing the homestead property affected 
150.7 	by this clause and stating facts showing compliance with this clause. The affidavit shall be 
150.8 	prima facie evidence of the facts it states.
150.9 	(b) For purposes of this section, "medical assistance" includes the medical assistance 
150.10 	program under this chapter, the general assistance medical care program formerly codified 
150.11 	under chapter 256D, and alternative care for nonmedical assistance recipients under section 
150.12 	256B.0913.
150.13 	(c) For purposes of this section, beginning January 1, 2010, "medical assistance" does 
150.14 	not include Medicare cost-sharing benefits in accordance with United States Code, title 42, 
150.15 	section 1396p.
150.16 	(d) All provisions in this subdivision, and subdivisions 1d, 1f, 1g, 1h, 1i, and 1j, related 
150.17 	to the continuation of a recipient's life estate or joint tenancy interests in real property after 
150.18 	the recipient's death for the purpose of recovering medical assistance, are effective only for 
150.19 	life estates and joint tenancy interests established on or after August 1, 2003. For purposes 
150.20 	of this paragraph, medical assistance does not include alternative care.

150.21 	EFFECTIVE DATE. This section is effective the day following final enactment and 
150.22 	applies retroactively to estate claims pending on or after July 1, 2016, and to the estates of 
150.23 	people who died on or after July 1, 2016.

150.24 	Sec. 44. Minnesota Statutes 2016, section 256B.15, subdivision 1a, is amended to read:
150.25 		Subd. 1a.Estates subject to claims. (a) If a person receives medical assistance hereunder, 
150.26 	on the person's death, if single, or on the death of the survivor of a married couple, either 
150.27 	or both of whom received medical assistance, or as otherwise provided for in this section, 
150.28 	the amount paid for medical assistance as limited under subdivision 2 for the person and 
150.29 	spouse shall be filed as a claim against the estate of the person or the estate of the surviving 
150.30 	spouse in the court having jurisdiction to probate the estate or to issue a decree of descent 
150.31 	according to sections 525.31 to 525.313.
150.32 	(b) For the purposes of this section, the person's estate must consist of:
150.33 	(1) the person's probate estate;
151.1 	(2) all of the person's interests or proceeds of those interests in real property the person 
151.2 	owned as a life tenant or as a joint tenant with a right of survivorship at the time of the 
151.3 	person's death;
151.4 	(3) all of the person's interests or proceeds of those interests in securities the person 
151.5 	owned in beneficiary form as provided under sections 524.6-301 to 524.6-311 at the time 
151.6 	of the person's death, to the extent the interests or proceeds of those interests become part 
151.7 	of the probate estate under section 524.6-307;
151.8 	(4) all of the person's interests in joint accounts, multiple-party accounts, and pay-on-death 
151.9 	accounts, brokerage accounts, investment accounts, or the proceeds of those accounts, as 
151.10 	provided under sections 524.6-201 to 524.6-214 at the time of the person's death to the 
151.11 	extent the interests become part of the probate estate under section 524.6-207; and
151.12 	(5) assets conveyed to a survivor, heir, or assign of the person through survivorship, 
151.13 	living trust, or other arrangements.
151.14 	(c) For the purpose of this section and recovery in a surviving spouse's estate for medical 
151.15 	assistance paid for a predeceased spouse, the estate must consist of all of the legal title and 
151.16 	interests the deceased individual's predeceased spouse had in jointly owned or marital 
151.17 	property at the time of the spouse's death, as defined in subdivision 2b, and the proceeds of 
151.18 	those interests, that passed to the deceased individual or another individual, a survivor, an 
151.19 	heir, or an assign of the predeceased spouse through a joint tenancy, tenancy in common, 
151.20 	survivorship, life estate, living trust, or other arrangement. A deceased recipient who, at 
151.21 	death, owned the property jointly with the surviving spouse shall have an interest in the 
151.22 	entire property.
151.23 	(d) For the purpose of recovery in a single person's estate or the estate of a survivor of 
151.24 	a married couple, "other arrangement" includes any other means by which title to all or any 
151.25 	part of the jointly owned or marital property or interest passed from the predeceased spouse 
151.26 	to another including, but not limited to, transfers between spouses which are permitted, 
151.27 	prohibited, or penalized for purposes of medical assistance.
151.28 	(e) A claim shall be filed if medical assistance was rendered for either or both persons 
151.29 	under one of the following circumstances:
151.30 	(1) the person was over 55 years of age, and received services under this chapter prior 
151.31 	to January 1, 2014;
151.32 	(2) (1) the person resided in a medical institution for six months or longer, received 
151.33 	services under this chapter, and, at the time of institutionalization or application for medical 
152.1 	assistance, whichever is later, the person could not have reasonably been expected to be 
152.2 	discharged and returned home, as certified in writing by the person's treating physician. For 
152.3 	purposes of this section only, a "medical institution" means a skilled nursing facility, 
152.4 	intermediate care facility, intermediate care facility for persons with developmental 
152.5 	disabilities, nursing facility, or inpatient hospital;
152.6 	(3) (2) the person received general assistance medical care services under the program 
152.7 	formerly codified under chapter 256D; or
152.8 	(4) (3) the person was 55 years of age or older and received medical assistance services 
152.9 	on or after January 1, 2014, that consisted of nursing facility services, home and 
152.10 	community-based services, or related hospital and prescription drug benefits.
152.11 	(f) The claim shall be considered an expense of the last illness of the decedent for the 
152.12 	purpose of section 524.3-805. Notwithstanding any law or rule to the contrary, a state or 
152.13 	county agency with a claim under this section must be a creditor under section 524.6-307. 
152.14 	Any statute of limitations that purports to limit any county agency or the state agency, or 
152.15 	both, to recover for medical assistance granted hereunder shall not apply to any claim made 
152.16 	hereunder for reimbursement for any medical assistance granted hereunder. Notice of the 
152.17 	claim shall be given to all heirs and devisees of the decedent, and to other persons with an 
152.18 	ownership interest in the real property owned by the decedent at the time of the decedent's 
152.19 	death, whose identity can be ascertained with reasonable diligence. The notice must include 
152.20 	procedures and instructions for making an application for a hardship waiver under subdivision 
152.21 	5; time frames for submitting an application and determination; and information regarding 
152.22 	appeal rights and procedures. Counties are entitled to one-half of the nonfederal share of 
152.23 	medical assistance collections from estates that are directly attributable to county effort. 
152.24 	Counties are entitled to ten percent of the collections for alternative care directly attributable 
152.25 	to county effort.

152.26 	EFFECTIVE DATE. This section is effective the day following final enactment and 
152.27 	applies retroactively to estate claims pending on or after July 1, 2016, and to the estates of 
152.28 	people who died on or after July 1, 2016.

152.29 	Sec. 45. Minnesota Statutes 2016, section 256B.15, subdivision 2, is amended to read:
152.30 		Subd. 2.Limitations on claims. (a) For services rendered prior to January 1, 2014, the 
152.31 	claim shall include only the total amount of medical assistance rendered after age 55 or 
152.32 	during a period of institutionalization described in subdivision 1a, paragraph (e), and the 
152.33 	total amount of general assistance medical care rendered under the program formerly codified 
152.34 	under chapter 256D, and shall not include interest.
153.1 	(b) For services rendered on or after January 1, 2014, (a) The claim shall include only:
153.2 	(1) the amount of medical assistance rendered to recipients 55 years of age or older and
153.3 	that consisted of nursing facility services, home and community-based services, and related 
153.4 	hospital and prescription drug services; and
153.5 	(2) the total amount of medical assistance rendered during a period of institutionalization 
153.6 	described in subdivision 1a, paragraph (e), clause (2). (1);
153.7 	(3) the total amount of general assistance medical care rendered under the program 
153.8 	formerly codified under chapter 256D.
153.9 	The claim shall not include interest. For the purposes of this section, "home and 
153.10 	community-based services" has the same meaning it has when used in United States Code, 
153.11 	title 42, section 1396p(b)(1)(B)(i), and includes the alternative care program under section 
153.12 	256B.0913 even for periods when alternative care services receive only state funding.
153.13 	(c) (b) Claims that have been allowed but not paid shall bear interest according to section 
153.14 	524.3-806, paragraph (d). A claim against the estate of a surviving spouse who did not 
153.15 	receive medical assistance, for medical assistance rendered for the predeceased spouse, 
153.16 	shall be payable from the full value of all of the predeceased spouse's assets and interests 
153.17 	which are part of the surviving spouse's estate under subdivisions 1a and 2b. Recovery of 
153.18 	medical assistance expenses in the nonrecipient surviving spouse's estate is limited to the 
153.19 	value of the assets of the estate that were marital property or jointly owned property at any 
153.20 	time during the marriage. The claim is not payable from the value of assets or proceeds of 
153.21 	assets in the estate attributable to a predeceased spouse whom the individual married after 
153.22 	the death of the predeceased recipient spouse for whom the claim is filed or from assets and 
153.23 	the proceeds of assets in the estate which the nonrecipient decedent spouse acquired with 
153.24 	assets which were not marital property or jointly owned property after the death of the 
153.25 	predeceased recipient spouse. Claims for alternative care shall be net of all premiums paid 
153.26 	under section 256B.0913, subdivision 12, on or after July 1, 2003, and shall be limited to 
153.27 	services provided on or after July 1, 2003. Claims against marital property shall be limited 
153.28 	to claims against recipients who died on or after July 1, 2009.

153.29 	EFFECTIVE DATE. This section is effective the day following final enactment and 
153.30 	applies retroactively to estate claims pending on or after July 1, 2016, and to the estates of 
153.31 	people who died on or after July 1, 2016.

154.1 	Sec. 46. Minnesota Statutes 2016, section 256B.199, is amended to read:
154.2 	256B.199 PAYMENTS REPORTED BY GOVERNMENTAL ENTITIES FEDERAL 
154.3 	MATCHING FUNDS.
154.4 	(a) The commissioner shall apply for federal matching funds for the expenditures in 
154.5 	paragraphs (b) and (c).
154.6 	(b) The commissioner shall apply for federal matching funds for certified public 
154.7 	expenditures as follows: for the
154.8 	(1) Hennepin County , Hennepin County Medical Center, Ramsey County, and Regions 
154.9 	Hospital shall report quarterly to the commissioner beginning June 1, 2007, payments made 
154.10 	during the second previous quarter that may qualify for reimbursement under federal law;
154.11 	Mental Health Center.
154.12 	(2) based on these reports, the commissioner shall apply for federal matching funds; and
154.13 	(3) by May 1 of each year, beginning May 1, 2007, the commissioner shall inform the 
154.14 	nonstate entities listed in paragraph (a) of the amount of federal disproportionate share 
154.15 	hospital payment money expected to be available in the current federal fiscal year.
154.16 	(c) For the period from April 1, 2009, to September 30, 2010, the commissioner shall 
154.17 	apply for additional federal matching funds available as disproportionate share hospital 
154.18 	payments under the American Recovery and Reinvestment Act of 2009. These funds shall 
154.19 	be made available as the state share of payments. The entities required to report certified 
154.20 	public expenditures under paragraph (b), clause (1), shall report additional certified public 
154.21 	expenditures as necessary under this paragraph.
154.22 	(d) For services provided on or after September 1, 2011, the commissioner shall apply 
154.23 	for additional federal matching funds available as disproportionate share hospital payments 
154.24 	under the MinnesotaCare program. A hospital may elect on an annual basis to not be a 
154.25 	disproportionate share hospital for purposes of this paragraph, if the hospital does not qualify 
154.26 	for a payment under section 256.969, subdivision 9, paragraph (a).

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

154.28 	Sec. 47. Minnesota Statutes 2016, section 256B.75, is amended to read:
154.29 	256B.75 HOSPITAL OUTPATIENT REIMBURSEMENT.
154.30 	(a) For outpatient hospital facility fee payments for services rendered on or after October 
154.31 	1, 1992, the commissioner of human services shall pay the lower of (1) submitted charge, 
154.32 	or (2) 32 percent above the rate in effect on June 30, 1992, except for those services for 
155.1 	which there is a federal maximum allowable payment. Effective for services rendered on 
155.2 	or after January 1, 2000, payment rates for nonsurgical outpatient hospital facility fees and 
155.3 	emergency room facility fees shall be increased by eight percent over the rates in effect on 
155.4 	December 31, 1999, except for those services for which there is a federal maximum allowable 
155.5 	payment. Services for which there is a federal maximum allowable payment shall be paid 
155.6 	at the lower of (1) submitted charge, or (2) the federal maximum allowable payment. Total 
155.7 	aggregate payment for outpatient hospital facility fee services shall not exceed the Medicare 
155.8 	upper limit. If it is determined that a provision of this section conflicts with existing or 
155.9 	future requirements of the United States government with respect to federal financial 
155.10 	participation in medical assistance, the federal requirements prevail. The commissioner 
155.11 	may, in the aggregate, prospectively reduce payment rates to avoid reduced federal financial 
155.12 	participation resulting from rates that are in excess of the Medicare upper limitations.
155.13 	(b) Notwithstanding paragraph (a), payment for outpatient, emergency, and ambulatory 
155.14 	surgery hospital facility fee services for critical access hospitals designated under section 
155.15 	144.1483, clause (9), shall be paid on a cost-based payment system that is based on the 
155.16 	cost-finding methods and allowable costs of the Medicare program. Effective for services 
155.17 	provided on or after July 1, 2015, rates established for critical access hospitals under this 
155.18 	paragraph for the applicable payment year shall be the final payment and shall not be settled 
155.19 	to actual costs. Effective for services delivered on or after the first day of the hospital's fiscal 
155.20 	year ending in 2016, the rate for outpatient hospital services shall be computed using 
155.21 	information from each hospital's Medicare cost report as filed with Medicare for the year 
155.22 	that is two years before the year that the rate is being computed. Rates shall be computed 
155.23 	using information from Worksheet C series until the department finalizes the medical 
155.24 	assistance cost reporting process for critical access hospitals. After the cost reporting process 
155.25 	is finalized, rates shall be computed using information from Title XIX Worksheet D series. 
155.26 	The outpatient rate shall be equal to ancillary cost plus outpatient cost, excluding costs 
155.27 	related to rural health clinics and federally qualified health clinics, divided by ancillary 
155.28 	charges plus outpatient charges, excluding charges related to rural health clinics and federally 
155.29 	qualified health clinics.
155.30 	(c) Effective for services provided on or after July 1, 2003, rates that are based on the 
155.31 	Medicare outpatient prospective payment system shall be replaced by a budget neutral 
155.32 	prospective payment system that is derived using medical assistance data. The commissioner 
155.33 	shall provide a proposal to the 2003 legislature to define and implement this provision.
156.1 	(d) For fee-for-service services provided on or after July 1, 2002, the total payment, 
156.2 	before third-party liability and spenddown, made to hospitals for outpatient hospital facility 
156.3 	services is reduced by .5 percent from the current statutory rate.
156.4 	(e) In addition to the reduction in paragraph (d), the total payment for fee-for-service 
156.5 	services provided on or after July 1, 2003, made to hospitals for outpatient hospital facility 
156.6 	services before third-party liability and spenddown, is reduced five percent from the current 
156.7 	statutory rates. Facilities defined under section 256.969, subdivision 16, are excluded from 
156.8 	this paragraph.
156.9 	(f) In addition to the reductions in paragraphs (d) and (e), the total payment for 
156.10 	fee-for-service services provided on or after July 1, 2008, made to hospitals for outpatient 
156.11 	hospital facility services before third-party liability and spenddown, is reduced three percent 
156.12 	from the current statutory rates. Mental health services and facilities defined under section 
156.13 	256.969, subdivision 16, are excluded from this paragraph.

156.14 	EFFECTIVE DATE. This section is effective July 1, 2017.

156.15 	Sec. 48. Minnesota Statutes 2016, section 256B.76, subdivision 1, is amended to read:
156.16 		Subdivision 1.Physician reimbursement.  (a) Effective for services rendered on or after 
156.17 	October 1, 1992, the commissioner shall make payments for physician services as follows:
156.18 	(1) payment for level one Centers for Medicare and Medicaid Services' common 
156.19 	procedural coding system codes titled "office and other outpatient services," "preventive 
156.20 	medicine new and established patient," "delivery, antepartum, and postpartum care," "critical 
156.21 	care," cesarean delivery and pharmacologic management provided to psychiatric patients, 
156.22 	and level three codes for enhanced services for prenatal high risk, shall be paid at the lower 
156.23 	of (i) submitted charges, or (ii) 25 percent above the rate in effect on June 30, 1992. If the 
156.24 	rate on any procedure code within these categories is different than the rate that would have 
156.25 	been paid under the methodology in section 256B.74, subdivision 2, then the larger rate 
156.26 	shall be paid;
156.27 	(2) payments for all other services shall be paid at the lower of (i) submitted charges, 
156.28 	or (ii) 15.4 percent above the rate in effect on June 30, 1992; and
156.29 	(3) all physician rates shall be converted from the 50th percentile of 1982 to the 50th 
156.30 	percentile of 1989, less the percent in aggregate necessary to equal the above increases 
156.31 	except that payment rates for home health agency services shall be the rates in effect on 
156.32 	September 30, 1992.
157.1 	(b) Effective for services rendered on or after January 1, 2000, payment rates for physician 
157.2 	and professional services shall be increased by three percent over the rates in effect on 
157.3 	December 31, 1999, except for home health agency and family planning agency services. 
157.4 	The increases in this paragraph shall be implemented January 1, 2000, for managed care.
157.5 	(c) Effective for services rendered on or after July 1, 2009, payment rates for physician 
157.6 	and professional services shall be reduced by five percent, except that for the period July 
157.7 	1, 2009, through June 30, 2010, payment rates shall be reduced by 6.5 percent for the medical 
157.8 	assistance and general assistance medical care programs, over the rates in effect on June 
157.9 	30, 2009. This reduction and the reductions in paragraph (d) do not apply to office or other 
157.10 	outpatient visits, preventive medicine visits and family planning visits billed by physicians, 
157.11 	advanced practice nurses, or physician assistants in a family planning agency or in one of 
157.12 	the following primary care practices: general practice, general internal medicine, general 
157.13 	pediatrics, general geriatrics, and family medicine. This reduction and the reductions in 
157.14 	paragraph (d) do not apply to federally qualified health centers, rural health centers, and 
157.15 	Indian health services. Effective October 1, 2009, payments made to managed care plans 
157.16 	and county-based purchasing plans under sections 256B.69, 256B.692, and 256L.12 shall 
157.17 	reflect the payment reduction described in this paragraph.
157.18 	(d) Effective for services rendered on or after July 1, 2010, payment rates for physician 
157.19 	and professional services shall be reduced an additional seven percent over the five percent 
157.20 	reduction in rates described in paragraph (c). This additional reduction does not apply to 
157.21 	physical therapy services, occupational therapy services, and speech pathology and related 
157.22 	services provided on or after July 1, 2010. This additional reduction does not apply to 
157.23 	physician services billed by a psychiatrist or an advanced practice nurse with a specialty in 
157.24 	mental health. Effective October 1, 2010, payments made to managed care plans and 
157.25 	county-based purchasing plans under sections 256B.69, 256B.692, and 256L.12 shall reflect 
157.26 	the payment reduction described in this paragraph.
157.27 	(e) Effective for services rendered on or after September 1, 2011, through June 30, 2013, 
157.28 	payment rates for physician and professional services shall be reduced three percent from 
157.29 	the rates in effect on August 31, 2011. This reduction does not apply to physical therapy 
157.30 	services, occupational therapy services, and speech pathology and related services.
157.31 	(f) Effective for services rendered on or after September 1, 2014, payment rates for 
157.32 	physician and professional services, including physical therapy, occupational therapy, speech 
157.33 	pathology, and mental health services shall be increased by five percent from the rates in 
157.34 	effect on August 31, 2014. In calculating this rate increase, the commissioner shall not 
157.35 	include in the base rate for August 31, 2014, the rate increase provided under section 
158.1 	256B.76, subdivision 7. This increase does not apply to federally qualified health centers, 
158.2 	rural health centers, and Indian health services. Payments made to managed care plans and 
158.3 	county-based purchasing plans shall not be adjusted to reflect payments under this paragraph.
158.4 	(g) Effective for services rendered on or after July 1, 2015, payment rates for physical 
158.5 	therapy, occupational therapy, and speech pathology and related services provided by a 
158.6 	hospital meeting the criteria specified in section 62Q.19, subdivision 1, paragraph (a), clause 
158.7 	(4), shall be increased by 90 percent from the rates in effect on June 30, 2015. Payments 
158.8 	made to managed care plans and county-based purchasing plans shall not be adjusted to 
158.9 	reflect payments under this paragraph.
158.10 	(h) Any ratables effective before July 1, 2015, do not apply to autism early intensive 
158.11 	intervention benefits described in section 256B.0949.

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

158.13 	Sec. 49. Minnesota Statutes 2016, section 256B.76, subdivision 2, is amended to read:
158.14 		Subd. 2.Dental reimbursement.  (a) Effective for services rendered on or after October 
158.15 	1, 1992, the commissioner shall make payments for dental services as follows:
158.16 	(1) dental services shall be paid at the lower of (i) submitted charges, or (ii) 25 percent 
158.17 	above the rate in effect on June 30, 1992; and
158.18 	(2) dental rates shall be converted from the 50th percentile of 1982 to the 50th percentile 
158.19 	of 1989, less the percent in aggregate necessary to equal the above increases.
158.20 	(b) Beginning October 1, 1999, the payment for tooth sealants and fluoride treatments 
158.21 	shall be the lower of (1) submitted charge, or (2) 80 percent of median 1997 charges.
158.22 	(c) Effective for services rendered on or after January 1, 2000, payment rates for dental 
158.23 	services shall be increased by three percent over the rates in effect on December 31, 1999.
158.24 	(d) Effective for services provided on or after January 1, 2002, payment for diagnostic 
158.25 	examinations and dental x-rays provided to children under age 21 shall be the lower of (1) 
158.26 	the submitted charge, or (2) 85 percent of median 1999 charges.
158.27 	(e) The increases listed in paragraphs (b) and (c) shall be implemented January 1, 2000, 
158.28 	for managed care.
158.29 	(f) Effective for dental services rendered on or after October 1, 2010, by a state-operated 
158.30 	dental clinic, payment shall be paid on a reasonable cost basis that is based on the Medicare 
158.31 	principles of reimbursement. This payment shall be effective for services rendered on or 
159.1 	after January 1, 2011, to recipients enrolled in managed care plans or county-based 
159.2 	purchasing plans.
159.3 	(g) Beginning in fiscal year 2011, if the payments to state-operated dental clinics in 
159.4 	paragraph (f), including state and federal shares, are less than $1,850,000 per fiscal year, a 
159.5 	supplemental state payment equal to the difference between the total payments in paragraph 
159.6 	(f) and $1,850,000 shall be paid from the general fund to state-operated services for the 
159.7 	operation of the dental clinics.
159.8 	(h) If the cost-based payment system for state-operated dental clinics described in 
159.9 	paragraph (f) does not receive federal approval, then state-operated dental clinics shall be 
159.10 	designated as critical access dental providers under subdivision 4, paragraph (b), and shall 
159.11 	receive the critical access dental reimbursement rate as described under subdivision 4, 
159.12 	paragraph (a).
159.13 	(i) (h) Effective for services rendered on or after September 1, 2011, through June 30, 
159.14 	2013, payment rates for dental services shall be reduced by three percent. This reduction 
159.15 	does not apply to state-operated dental clinics in paragraph (f).
159.16 	(j) (i) Effective for services rendered on or after January 1, 2014, payment rates for 
159.17 	dental services shall be increased by five percent from the rates in effect on December 31, 
159.18 	2013. This increase does not apply to state-operated dental clinics in paragraph (f), federally 
159.19 	qualified health centers, rural health centers, and Indian health services. Effective January 
159.20 	1, 2014, payments made to managed care plans and county-based purchasing plans under 
159.21 	sections 256B.69, 256B.692, and 256L.12 shall reflect the payment increase described in 
159.22 	this paragraph.
159.23 	(k) (j) Effective for services rendered on or after July 1, 2015, through December 31, 
159.24 	2016, the commissioner shall increase payment rates for services furnished by dental 
159.25 	providers located outside of the seven-county metropolitan area by the maximum percentage 
159.26 	possible above the rates in effect on June 30, 2015, while remaining within the limits of 
159.27 	funding appropriated for this purpose. This increase does not apply to state-operated dental 
159.28 	clinics in paragraph (f), federally qualified health centers, rural health centers, and Indian 
159.29 	health services. Effective January 1, 2016, through December 31, 2016, payments to managed 
159.30 	care plans and county-based purchasing plans under sections 256B.69 and 256B.692 shall 
159.31 	reflect the payment increase described in this paragraph. The commissioner shall require 
159.32 	managed care and county-based purchasing plans to pass on the full amount of the increase, 
159.33 	in the form of higher payment rates to dental providers located outside of the seven-county 
159.34 	metropolitan area.
160.1 	(l) (k) Effective for services provided on or after January 1, 2017, through December 
160.2 	31, 2018, the commissioner shall increase payment rates by 9.65 percent for dental services 
160.3 	provided outside of the seven-county metropolitan area. This increase does not apply to 
160.4 	state-operated dental clinics in paragraph (f), federally qualified health centers, rural health 
160.5 	centers, or Indian health services. Effective January 1, 2017, through December 31, 2018,
160.6 	payments to managed care plans and county-based purchasing plans under sections 256B.69
160.7 	and 256B.692 shall reflect the payment increase described in this paragraph.
160.8 	(l) Effective for services rendered on or after January 1, 2019, payment rates for dental 
160.9 	services shall be increased by 54 percent. This increase does not apply to state-operated 
160.10 	dental clinics in paragraph (f), federally qualified health centers, rural health centers, and 
160.11 	Indian health services when an encounter rate is paid.

160.12 	EFFECTIVE DATE. This section is effective July 1, 2017.

160.13 	Sec. 50. Minnesota Statutes 2016, section 256B.76, subdivision 4, is amended to read:
160.14 		Subd. 4.Critical access dental providers.  (a) The commissioner shall increase 
160.15 	reimbursements to dentists and dental clinics deemed by the commissioner to be critical 
160.16 	access dental providers. For dental services rendered on or after July 1, 2016, the 
160.17 	commissioner shall increase reimbursement by 37.5 percent above the reimbursement rate 
160.18 	that would otherwise be paid to the critical access dental provider, except as specified under 
160.19 	paragraph (b). The commissioner shall pay the managed care plans and county-based 
160.20 	purchasing plans in amounts sufficient to reflect increased reimbursements to critical access 
160.21 	dental providers as approved by the commissioner.
160.22 	(b) For dental services rendered on or after July 1, 2016, by a dental clinic or dental 
160.23 	group that meets the critical access dental provider designation under paragraph (d), clause 
160.24 	(4), and is owned and operated by a health maintenance organization licensed under chapter 
160.25 	62D, the commissioner shall increase reimbursement by 35 percent above the reimbursement 
160.26 	rate that would otherwise be paid to the critical access provider.
160.27 	(c) Critical access dental payments made under paragraph (a) or (b) for dental services 
160.28 	provided by a critical access dental provider to an enrollee of a managed care plan or 
160.29 	county-based purchasing plan must not reflect any capitated payments or cost-based payments 
160.30 	from the managed care plan or county-based purchasing plan. The managed care plan or 
160.31 	county-based purchasing plan must base the additional critical access dental payment on 
160.32 	the amount that would have been paid for that service had the dental provider been paid 
160.33 	according to the managed care plan or county-based purchasing plan's fee schedule that 
160.34 	applies to dental providers that are not paid under a capitated payment or cost-based payment.
161.1 	(d) The commissioner shall designate the following dentists and dental clinics as critical 
161.2 	access dental providers:
161.3 	(1) nonprofit community clinics that:
161.4 	(i) have nonprofit status in accordance with chapter 317A;
161.5 	(ii) have tax exempt status in accordance with the Internal Revenue Code, section 
161.6 	501(c)(3);
161.7 	(iii) are established to provide oral health services to patients who are low income, 
161.8 	uninsured, have special needs, and are underserved;
161.9 	(iv) have professional staff familiar with the cultural background of the clinic's patients;
161.10 	(v) charge for services on a sliding fee scale designed to provide assistance to low-income 
161.11 	patients based on current poverty income guidelines and family size;
161.12 	(vi) do not restrict access or services because of a patient's financial limitations or public 
161.13 	assistance status; and
161.14 	(vii) have free care available as needed;
161.15 	(2) federally qualified health centers, rural health clinics, and public health clinics;
161.16 	(3) hospital-based dental clinics owned and operated by a city, county, or former state 
161.17 	hospital as defined in section 62Q.19, subdivision 1, paragraph (a), clause (4);
161.18 	(4) a dental clinic or dental group owned and operated by a nonprofit corporation in 
161.19 	accordance with chapter 317A with more than 10,000 patient encounters per year with 
161.20 	patients who are uninsured or covered by medical assistance or MinnesotaCare;
161.21 	(5) a dental clinic owned and operated by the University of Minnesota or the Minnesota 
161.22 	State Colleges and Universities system; and
161.23 	(6) private practicing dentists if:
161.24 	(i) the dentist's office is located within the seven-county metropolitan area and more 
161.25 	than 50 percent of the dentist's patient encounters per year are with patients who are uninsured 
161.26 	or covered by medical assistance or MinnesotaCare; or
161.27 	(ii) the dentist's office is located outside the seven-county metropolitan area and more 
161.28 	than 25 percent of the dentist's patient encounters per year are with patients who are uninsured 
161.29 	or covered by medical assistance or MinnesotaCare.
161.30 	(e) The program established under this subdivision expires January 1, 2019. No payments 
161.31 	under this subdivision shall be made for dates of service on and after January 1, 2019.

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

162.2 	Sec. 51. Minnesota Statutes 2016, section 256B.76, is amended by adding a subdivision 
162.3 	to read:
162.4 		Subd. 8.Payment for certain preventive medical visits. (a) Payment for certain 
162.5 	preventive medical visits rendered on or after July 1, 2017, shall be increased by five percent, 
162.6 	unless otherwise limited by state or federal regulations. This rate increase is not applicable 
162.7 	to federally qualified health centers, rural health centers, Indian health services, other 
162.8 	cost-based rates, rates that are negotiated with the county, or rates that are established by 
162.9 	the federal government. This rate increase under this subdivision does not apply to managed 
162.10 	care.
162.11 	(b) For purposes of paragraph (a), preventive medical visits shall be limited to preventive 
162.12 	medicine visits when provided by a physician, advanced practice registered nurse, or 
162.13 	physician assistant.

162.14 	EFFECTIVE DATE. This section is effective July 1, 2017.

162.15 	Sec. 52. Minnesota Statutes 2016, section 256B.761, is amended to read:
162.16 	256B.761 REIMBURSEMENT FOR MENTAL HEALTH SERVICES.
162.17 	(a) Effective for services rendered on or after July 1, 2001, payment for medication 
162.18 	management provided to psychiatric patients, outpatient mental health services, day treatment 
162.19 	services, home-based mental health services, and family community support services shall 
162.20 	be paid at the lower of (1) submitted charges, or (2) 75.6 percent of the 50th percentile of 
162.21 	1999 charges.
162.22 	(b) Effective July 1, 2001, the medical assistance rates for outpatient mental health 
162.23 	services provided by an entity that operates: (1) a Medicare-certified comprehensive 
162.24 	outpatient rehabilitation facility; and (2) a facility that was certified prior to January 1, 1993, 
162.25 	with at least 33 percent of the clients receiving rehabilitation services in the most recent 
162.26 	calendar year who are medical assistance recipients, will be increased by 38 percent, when 
162.27 	those services are provided within the comprehensive outpatient rehabilitation facility and 
162.28 	provided to residents of nursing facilities owned by the entity.
162.29 	(c) The commissioner shall establish three levels of payment for mental health diagnostic 
162.30 	assessment, based on three levels of complexity. The aggregate payment under the tiered 
162.31 	rates must not exceed the projected aggregate payments for mental health diagnostic 
163.1 	assessment under the previous single rate. The new rate structure is effective January 1, 
163.2 	2011, or upon federal approval, whichever is later.
163.3 	(d) In addition to rate increases otherwise provided, the commissioner may restructure 
163.4 	coverage policy and rates to improve access to adult rehabilitative mental health services 
163.5 	under section 256B.0623 and related mental health support services under section 256B.021, 
163.6 	subdivision 4, paragraph (f), clause (2). For state fiscal years 2015 and 2016, the projected 
163.7 	state share of increased costs due to this paragraph is transferred from adult mental health 
163.8 	grants under sections 245.4661 and 256E.12. The transfer for fiscal year 2016 is a permanent 
163.9 	base adjustment for subsequent fiscal years. Payments made to managed care plans and 
163.10 	county-based purchasing plans under sections 256B.69, 256B.692, and 256L.12 shall reflect 
163.11 	the rate changes described in this paragraph.
163.12 	(e) Any ratables effective before July 1, 2015, do not apply to autism early intensive 
163.13 	intervention benefits described in section 256B.0949.
163.14 	(f) Effective for services provided on or after July 1, 2017, payments for outpatient 
163.15 	mental health services shall be increased by five percent. This rate increase is not applicable 
163.16 	to federally qualified health centers, rural health centers, Indian health services, other 
163.17 	cost-based rates, rates that are negotiated with the county, or rates that are established by 
163.18 	the federal government. This rate increase does not apply to managed care.

163.19 	EFFECTIVE DATE. This section is effective July 1, 2017.

163.20 	Sec. 53. [256B.7625] REIMBURSEMENT FOR EVIDENCE-BASED PUBLIC 
163.21 	HEALTH NURSE HOME VISITS.
163.22 	Prenatal and postpartum follow-up home visits provided by public health nurses or 
163.23 	registered nurses supervised by a public health nurse using evidence-based models shall be 
163.24 	paid $140 per visit. Evidence-based postpartum follow-up home visits must be administered 
163.25 	by home visiting programs that meet the United States Department of Health and Human 
163.26 	Services criteria for evidence-based models and are identified by the commissioner of health 
163.27 	as eligible to be implemented under the maternal, infant, and early childhood home visiting 
163.28 	program. Home visits shall be targeted at mothers and the mothers' children beginning with 
163.29 	prenatal visits through three years of age.

163.30 	EFFECTIVE DATE. This section is effective for services provided on or after January 
163.31 	1, 2018.

164.1 	Sec. 54. Minnesota Statutes 2016, section 256B.766, is amended to read:
164.2 	256B.766 REIMBURSEMENT FOR BASIC CARE SERVICES.
164.3 	(a) Effective for services provided on or after July 1, 2009, total payments for basic care 
164.4 	services, shall be reduced by three percent, except that for the period July 1, 2009, through 
164.5 	June 30, 2011, total payments shall be reduced by 4.5 percent for the medical assistance 
164.6 	and general assistance medical care programs, prior to third-party liability and spenddown 
164.7 	calculation. Effective July 1, 2010, the commissioner shall classify physical therapy services, 
164.8 	occupational therapy services, and speech-language pathology and related services as basic 
164.9 	care services. The reduction in this paragraph shall apply to physical therapy services, 
164.10 	occupational therapy services, and speech-language pathology and related services provided 
164.11 	on or after July 1, 2010.
164.12 	(b) Payments made to managed care plans and county-based purchasing plans shall be 
164.13 	reduced for services provided on or after October 1, 2009, to reflect the reduction effective 
164.14 	July 1, 2009, and payments made to the plans shall be reduced effective October 1, 2010, 
164.15 	to reflect the reduction effective July 1, 2010.
164.16 	(c) Effective for services provided on or after September 1, 2011, through June 30, 2013, 
164.17 	total payments for outpatient hospital facility fees shall be reduced by five percent from the 
164.18 	rates in effect on August 31, 2011.
164.19 	(d) Effective for services provided on or after September 1, 2011, through June 30, 2013, 
164.20 	total payments for ambulatory surgery centers facility fees, medical supplies and durable 
164.21 	medical equipment not subject to a volume purchase contract, prosthetics and orthotics, 
164.22 	renal dialysis services, laboratory services, public health nursing services, physical therapy 
164.23 	services, occupational therapy services, speech therapy services, eyeglasses not subject to 
164.24 	a volume purchase contract, hearing aids not subject to a volume purchase contract, and 
164.25 	anesthesia services shall be reduced by three percent from the rates in effect on August 31, 
164.26 	2011.
164.27 	(e) Effective for services provided on or after September 1, 2014, payments for 
164.28 	ambulatory surgery centers facility fees, hospice services, renal dialysis services, laboratory 
164.29 	services, public health nursing services, eyeglasses not subject to a volume purchase contract, 
164.30 	and hearing aids not subject to a volume purchase contract shall be increased by three percent 
164.31 	and payments for outpatient hospital facility fees shall be increased by three percent. 
164.32 	Payments made to managed care plans and county-based purchasing plans shall not be 
164.33 	adjusted to reflect payments under this paragraph.
165.1 	(f) Payments for medical supplies and durable medical equipment not subject to a volume 
165.2 	purchase contract, and prosthetics and orthotics, provided on or after July 1, 2014, through 
165.3 	June 30, 2015, shall be decreased by .33 percent. Payments for medical supplies and durable 
165.4 	medical equipment not subject to a volume purchase contract, and prosthetics and orthotics, 
165.5 	provided on or after July 1, 2015, shall be increased by three percent from the rates as 
165.6 	determined under paragraphs (i) and (j).
165.7 	(g) Effective for services provided on or after July 1, 2015, payments for outpatient 
165.8 	hospital facility fees, medical supplies and durable medical equipment not subject to a 
165.9 	volume purchase contract, prosthetics and orthotics, and laboratory services to a hospital 
165.10 	meeting the criteria specified in section 62Q.19, subdivision 1, paragraph (a), clause (4), 
165.11 	shall be increased by 90 percent from the rates in effect on June 30, 2015. Payments made 
165.12 	to managed care plans and county-based purchasing plans shall not be adjusted to reflect 
165.13 	payments under this paragraph.
165.14 	(h) This section does not apply to physician and professional services, inpatient hospital 
165.15 	services, family planning services, mental health services, dental services, prescription 
165.16 	drugs, medical transportation, federally qualified health centers, rural health centers, Indian 
165.17 	health services, and Medicare cost-sharing.
165.18 	(i) Effective for services provided on or after July 1, 2015, the following categories of 
165.19 	durable medical equipment shall be individually priced items: enteral nutrition and supplies, 
165.20 	customized and other specialized tracheostomy tubes and supplies, electric patient lifts, and 
165.21 	durable medical equipment repair and service. This paragraph does not apply to medical 
165.22 	supplies and durable medical equipment subject to a volume purchase contract, products 
165.23 	subject to the preferred diabetic testing supply program, and items provided to dually eligible 
165.24 	recipients when Medicare is the primary payer for the item. The commissioner shall not 
165.25 	apply any medical assistance rate reductions to durable medical equipment as a result of 
165.26 	Medicare competitive bidding.
165.27 	(j) Effective for services provided on or after July 1, 2015, medical assistance payment 
165.28 	rates for durable medical equipment, prosthetics, orthotics, or supplies shall be increased 
165.29 	as follows:
165.30 	(1) payment rates for durable medical equipment, prosthetics, orthotics, or supplies that 
165.31 	were subject to the Medicare competitive bid that took effect in January of 2009 shall be 
165.32 	increased by 9.5 percent; and
165.33 	(2) payment rates for durable medical equipment, prosthetics, orthotics, or supplies on 
165.34 	the medical assistance fee schedule, whether or not subject to the Medicare competitive bid 
166.1 	that took effect in January of 2009, shall be increased by 2.94 percent, with this increase 
166.2 	being applied after calculation of any increased payment rate under clause (1).
166.3 	This paragraph does not apply to medical supplies and durable medical equipment subject 
166.4 	to a volume purchase contract, products subject to the preferred diabetic testing supply 
166.5 	program, items provided to dually eligible recipients when Medicare is the primary payer 
166.6 	for the item, and individually priced items identified in paragraph (i). Payments made to 
166.7 	managed care plans and county-based purchasing plans shall not be adjusted to reflect the 
166.8 	rate increases in this paragraph.

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

166.10 	Sec. 55. [256B.90] LONG-ACTING REVERSIBLE CONTRACEPTIVE ACCESS 
166.11 	GRANTS.
166.12 		Subdivision 1.Purpose. The commissioner of human services shall coordinate and 
166.13 	implement a long-acting reversible contraceptive access grant program to reduce rapid 
166.14 	repeat births and improve birth outcomes for adolescents enrolled in medical assistance.
166.15 		Subd. 2.Definitions. (a) For purposes of this section, the terms defined in this subdivision 
166.16 	have the meanings given them.
166.17 	(b) "Commissioner" means the commissioner of human services.
166.18 	(c) "Long-acting reversible contraceptive" means a method of contraception, including 
166.19 	an intrauterine device or a subdermal contraceptive implant, that provides effective 
166.20 	contraception for an extended period of time without requiring user action.
166.21 	(d) "Manufacturer" means the manufacturer of the long-acting reversible contraceptive 
166.22 	defined in section 151.01, subdivision 14a.
166.23 	(e) "Provider" means a hospital or clinic provider enrolled in Minnesota health care 
166.24 	programs.
166.25 		Subd. 3.Grants. (a) The commissioner shall adopt and implement a preferred long-acting 
166.26 	reversible contraceptive list by March 1, 2018. The commissioner shall employ competitive 
166.27 	bidding and negotiation with manufacturers under the provisions of chapter 16C to develop 
166.28 	the preferred long-acting reversible contraceptive list. To be included on the list, the 
166.29 	manufacturer must offer a price for the long-acting reversible contraceptive that is no more 
166.30 	than the payment rate established in section 256B.0625, subdivision 13e, minus the federal 
166.31 	Medicaid drug rebate pursuant to the Social Security Act, title XIX, section 1927.
167.1 	(b) The commissioner shall award through a competitive process contracts for grants to 
167.2 	providers to purchase long-acting reversible contraceptives on the preferred long-acting 
167.3 	reversible contraceptive list at the negotiated manufacturer price. The long-acting reversible 
167.4 	contraceptives purchased through the grant program shall be made available to medical 
167.5 	assistance enrollees receiving services from the participating provider.
167.6 	(c) A provider receiving long-acting reversible contraceptive access grants must  document 
167.7 	the use of the contraceptives and work with the commissioner to track and analyze outcomes.
167.8 	(d) The cost of long-acting reversible contraceptives purchased with grant funds shall 
167.9 	not be billed to medical assistance.
167.10 	(e) The commissioner shall submit a 1115(a) demonstration waiver request to the Centers 
167.11 	for Medicaid and Medicare Services to make available administrative funding at the 90 
167.12 	percent federal matching rate for the long-acting reversible contraceptive access grant 
167.13 	program, as authorized by United States Code, title 42, section 1903, paragraph (a), clause 
167.14 	(5).
167.15 	(f) The grants shall be available by July 1, 2018, or upon federal approval of the 1115(a) 
167.16 	demonstration project, whichever is later.

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

167.18 	Sec. 56. Minnesota Statutes 2016, section 256L.03, subdivision 1, is amended to read:
167.19 		Subdivision 1.Covered health services. (a) "Covered health services" means the health 
167.20 	services reimbursed under chapter 256B, with the exception of special education services, 
167.21 	home care nursing services, adult dental care services other than services covered under 
167.22 	section 256B.0625, subdivision 9, orthodontic services, nonemergency medical transportation 
167.23 	services, personal care assistance and case management services, and nursing home or 
167.24 	intermediate care facilities services.
167.25 	(b) No public funds shall be used for coverage of abortion under MinnesotaCare except 
167.26 	where the life of the female would be endangered or substantial and irreversible impairment 
167.27 	of a major bodily function would result if the fetus were carried to term; or where the 
167.28 	pregnancy is the result of rape or incest.
167.29 	(c) Covered health services shall be expanded as provided in this section.
167.30 	(d) For the purposes of covered health services under this section, "child" means an 
167.31 	individual younger than 19 years of age.

167.32 	EFFECTIVE DATE. This section is effective July 1, 2017.

168.1 	Sec. 57. Minnesota Statutes 2016, section 256L.03, subdivision 1a, is amended to read:
168.2 		Subd. 1a. Children; MinnesotaCare health care reform waiver.  Children are eligible 
168.3 	for coverage of all services that are eligible for reimbursement under the medical assistance 
168.4 	program according to chapter 256B, except special education services and that abortion 
168.5 	services under MinnesotaCare shall be limited as provided under subdivision 1. Children 
168.6 	are exempt from the provisions of subdivision 5, regarding co-payments. Children who are 
168.7 	lawfully residing in the United States but who are not "qualified noncitizens" under title IV 
168.8 	of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996, Public 
168.9 	Law 104-193, Statutes at Large, volume 110, page 2105, are eligible for coverage of all 
168.10 	services provided under the medical assistance program according to chapter 256B.

168.11 	EFFECTIVE DATE. This section is effective July 1, 2017.

168.12 	Sec. 58. Minnesota Statutes 2016, section 256L.03, subdivision 5, is amended to read:
168.13 		Subd. 5.Cost-sharing. (a) Except as otherwise provided in this subdivision, the 
168.14 	MinnesotaCare benefit plan shall include the following cost-sharing requirements for all 
168.15 	enrollees:
168.16 	(1) $3 per prescription for adult enrollees;
168.17 	(2) $25 for eyeglasses for adult enrollees;
168.18 	(3) $3 per nonpreventive visit. For purposes of this subdivision, a "visit" means an 
168.19 	episode of service which is required because of a recipient's symptoms, diagnosis, or 
168.20 	established illness, and which is delivered in an ambulatory setting by a physician or 
168.21 	physician assistant, chiropractor, podiatrist, nurse midwife, advanced practice nurse, 
168.22 	audiologist, optician, or optometrist;
168.23 	(4) $6 for nonemergency visits to a hospital-based emergency room for services provided 
168.24 	through December 31, 2010, and $3.50 effective January 1, 2011; and
168.25 	(5) a family deductible equal to $2.75 per month per family and adjusted annually by 
168.26 	the percentage increase in the medical care component of the CPI-U for the period of 
168.27 	September to September of the preceding calendar year, rounded to the next-higher five 
168.28 	cent increment.
168.29 	(b) Paragraph (a) does (a) Co-payments, coinsurance, and deductibles do not apply to 
168.30 	children under the age of 21 and to American Indians as defined in Code of Federal 
168.31 	Regulations, title 42, section 447.51 600.5.
168.32 	(c) Paragraph (a), clause (3), does not apply to mental health services.
169.1 	(d) MinnesotaCare reimbursements to fee-for-service providers and payments to managed 
169.2 	care plans or county-based purchasing plans shall not be increased as a result of the reduction 
169.3 	of the co-payments in paragraph (a), clause (4), effective January 1, 2011.
169.4 	(e) The commissioner, through the contracting process under section 256L.12, may 
169.5 	allow managed care plans and county-based purchasing plans to waive the family deductible 
169.6 	under paragraph (a), clause (5). The value of the family deductible shall not be included in 
169.7 	the capitation payment to managed care plans and county-based purchasing plans. Managed 
169.8 	care plans and county-based purchasing plans shall certify annually to the commissioner 
169.9 	the dollar value of the family deductible.
169.10 	(f) (b) The commissioner shall increase adjust co-payments, coinsurance, and deductibles
169.11 	for covered services in a manner sufficient to reduce maintain the actuarial value of the 
169.12 	benefit to 94 percent. The cost-sharing changes described in this paragraph do not apply to 
169.13 	eligible recipients or services exempt from cost-sharing under state law. The cost-sharing 
169.14 	changes described in this paragraph shall not be implemented prior to January 1, 2016.
169.15 	(g) (c) The cost-sharing changes authorized under paragraph (f) (b) must satisfy the 
169.16 	requirements for cost-sharing under the Basic Health Program as set forth in Code of Federal 
169.17 	Regulations, title 42, sections 600.510 and 600.520.

169.18 	EFFECTIVE DATE. This section is effective January 1, 2018.

169.19 	Sec. 59. Minnesota Statutes 2016, section 256L.04, is amended by adding a subdivision 
169.20 	to read:
169.21 		Subd. 2b.Federal waiver. The commissioner of human services shall apply for a federal 
169.22 	waiver to allow the state to permit a person who has access to employer-sponsored health 
169.23 	insurance through a spouse or parent that is deemed minimum essential coverage under 
169.24 	Code of Federal Regulations, title 26, section 1.36B-2, and the portion of the annual premium 
169.25 	the person pays for employee and dependent coverage exceeds the required contribution 
169.26 	percentage in Code of Federal Regulations, title 26, section 1.36B-2, to enroll in the 
169.27 	MinnesotaCare program, if the person meets all eligibility requirements, except for section 
169.28 	256L.07, subdivision 2, paragraph (a).

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

170.1 	Sec. 60. Minnesota Statutes 2016, section 256L.05, is amended by adding a subdivision 
170.2 	to read:
170.3 		Subd. 3d.Coverage for gap months. (a) Notwithstanding subdivision 3, MinnesotaCare 
170.4 	coverage may be made available beginning the first day of the month of application for a 
170.5 	new applicant who meets all MinnesotaCare eligibility requirements or beginning the first 
170.6 	day of the month in which an applicant enrolled in medical assistance or a qualified health 
170.7 	plan offered through MNsure under chapter 62V is eligible for MinnesotaCare due to a 
170.8 	change in circumstances.
170.9 	(b) For an applicant required to pay a premium, coverage under paragraph (a) is available 
170.10 	if:
170.11 	(1) the first premium payment for coverage according to subdivision 3 is received within 
170.12 	30 days of the premium billing; and
170.13 	(2) the premiums for coverage under paragraph (a) are paid in full within 30 days of the 
170.14 	premium billing.

170.15 	EFFECTIVE DATE. This section is effective January 1, 2019.

170.16 	Sec. 61. Minnesota Statutes 2016, section 256L.11, subdivision 7, is amended to read:
170.17 		Subd. 7.Critical access dental providers. (a) Effective for dental services provided to 
170.18 	MinnesotaCare enrollees on or after July 1, 2016, the commissioner shall increase payment 
170.19 	rates to dentists and dental clinics deemed by the commissioner to be critical access providers 
170.20 	under section 256B.76, subdivision 4, by 32.5 percent above the payment rate that would 
170.21 	otherwise be paid to the provider, except for a dental clinic or dental group described in 
170.22 	section 256B.76, subdivision 4, paragraph (b), in which the commissioner shall increase 
170.23 	the payment rate by 30 percent above the payment rate that would otherwise be paid to the 
170.24 	provider. The commissioner shall pay the prepaid health plans under contract with the 
170.25 	commissioner amounts sufficient to reflect this rate increase. The prepaid health plan must 
170.26 	pass this rate increase to providers who have been identified by the commissioner as critical 
170.27 	access dental providers under section 256B.76, subdivision 4.
170.28 	(b) The program established under this subdivision expires January 1, 2019. No payments 
170.29 	under this subdivision shall be made for dates of service on and after January 1, 2019.

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

171.1 	Sec. 62. Minnesota Statutes 2016, section 256L.15, subdivision 2, is amended to read:
171.2 		Subd. 2.Sliding fee scale; monthly individual or family income. (a) The commissioner 
171.3 	shall establish a sliding fee scale to determine the percentage of monthly individual or family 
171.4 	income that households at different income levels must pay to obtain coverage through the 
171.5 	MinnesotaCare program. The sliding fee scale must be based on the enrollee's monthly 
171.6 	individual or family income.
171.7 	(b) Beginning January 1, 2014, MinnesotaCare enrollees shall pay premiums according 
171.8 	to the premium scale specified in paragraph (d).
171.9 	(c) Paragraph (b) does not apply to:
171.10 	(1) children 20 years of age or younger; and
171.11 	(2) individuals with household incomes below 35 percent of the federal poverty 
171.12 	guidelines.
171.13 	(d) The following premium scale is established for each individual in the household who 
171.14 	is 21 years of age or older and enrolled in MinnesotaCare:

171.15
171.16	Federal Poverty Guideline 
Greater than or Equal to
	Less than
	Individual Premium 
Amount
	
171.17	35%
	55%
	$4
	
171.18	55%
	80%
	$6
	
171.19	80%
	90%
	$8
	
171.20	90%
	100%
	$10
	
171.21	100%
	110%
	$12
	
171.22	110%
	120%
	$14
	
171.23	120%
	130%
	$15
	
171.24	130%
	140%
	$16
	
171.25	140%
	150%
	$25
	
171.26	150%
	160%
	$29 $37
	
171.27	160%
	170%
	$33 $44
	
171.28	170%
	180%
	$38 $52
	
171.29	180%
	190%
	$43 $61
	
171.30	190%
	200%
	$50 $71
	
171.31	200%
		$80

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

172.1 	Sec. 63. [256L.29] MINNESOTACARE BUY-IN OPTION.
172.2 		Subdivision 1.Request for federal authority and program establishment. (a) The 
172.3 	commissioner of human services shall seek all necessary federal authority to establish a 
172.4 	program that allows individuals who are determined eligible for enrollment in a qualified 
172.5 	health plan with or without advance premium tax credits and cost-sharing reductions 
172.6 	according to the requirements of Code of Federal Regulations, title 45, section 155.305, 
172.7 	paragraphs (a), (f), and (g), to purchase coverage in the MinnesotaCare program pursuant 
172.8 	to this section (MinnesotaCare buy-in option), instead of purchasing a qualified health plan 
172.9 	through MNsure, as defined in section 62V.02.
172.10 	(b) The commissioner shall also seek all necessary federal authority to:
172.11 	(1) allow individuals who qualify under paragraph (a) and who choose to purchase the 
172.12 	MinnesotaCare buy-in option to use advance premium tax credits and cost-sharing reductions, 
172.13 	if eligible, to purchase this option;
172.14 	(2) permit the MinnesotaCare buy-in option to be offered through MNsure as a coverage 
172.15 	option and to be compared with qualified health plans offered through MNsure;
172.16 	(3) allow the commissioner to use any surplus funds in the basic health plan trust fund 
172.17 	under section 16A.724, subdivision 3, for purposes of establishing a special revenue account 
172.18 	that will serve as a reserve to support the payment of claims and liabilities and other financial 
172.19 	needs for the MinnesotaCare program as described in section 256L.04, and the MinnesotaCare 
172.20 	buy-in option as described in this section; and
172.21 	(4) maintain program requirements and funding mechanisms to the MinnesotaCare 
172.22 	program that provides coverage to individuals eligible under section 256L.04.
172.23 	(c) The commissioner is exempt from the requirements in chapter 16C to contract for 
172.24 	actuarial services that satisfy the waiver submission requirements under this subdivision. 
172.25 	The commissioner may utilize existing contracts to satisfy the waiver submission 
172.26 	requirements of this subdivision.
172.27 		Subd. 2.Program establishment and criteria. (a) The commissioner shall establish a 
172.28 	program consistent with this section to offer plans developed for the MinnesotaCare buy-in 
172.29 	option through the MNsure Web site, as defined in section 62V.02, subdivision 13, and 
172.30 	contract with vendors to provide these services, consistent with sections 256L.12 and 
172.31 	256L.121.
172.32 	(b) The commissioner shall coordinate administration of the MinnesotaCare buy-in 
172.33 	option with the MinnesotaCare program, as described in section 256L.04, to maximize 
173.1 	efficiency and improve continuity of care for enrollees. The commissioner shall seek to 
173.2 	implement mechanisms to ensure the long-term financial sustainability of MinnesotaCare 
173.3 	and mitigate any adverse financial impacts to the state and MNsure. These mechanisms 
173.4 	must address issues related to minimizing adverse selection, the state financial risk and 
173.5 	contribution, and negative impacts to premiums in the individual and group health insurance 
173.6 	market both inside and outside of MNsure.
173.7 	(c) The MinnesotaCare buy-in option shall include, at a minimum, the following:
173.8 	(1) establishment of an annual per-enrollee premium rate similar to the average rate paid 
173.9 	by the state to contractors under sections 256L.12 and 256L.121;
173.10 	(2) establishment of a benefit set similar to the benefits covered under section 256L.03;
173.11 	(3) limiting enrollment of eligible individuals to the same annual open and special 
173.12 	enrollment periods established for MNsure as defined in Code of Federal Regulations, title 
173.13 	45, sections 155.410 and 155.420;
173.14 	(4) establishment of two plans to be offered in MNsure with actuarial values of 70 percent 
173.15 	and 80 percent;
173.16 	(5) a cost allocation methodology to reimburse MNsure operations in lieu of the premium 
173.17 	withhold for qualified health plans under section 62V.05; and
173.18 	(6) establishment of mechanisms that mitigate the fiscal impact to the state budget.
173.19 	(d) Individuals who are determined eligible for enrollment in a qualified health plan 
173.20 	with or without advance payments of the premium tax credit and cost-sharing reductions 
173.21 	according to Code of Federal Regulations, title 45, section 155.305, paragraphs (a), (f), and 
173.22 	(g), are eligible to purchase and enroll in a plan established under this section through 
173.23 	MNsure, instead of purchasing a qualified health plan as defined under section 62V.02.
173.24 	(e) Individuals who are eligible under this section, and whose income is less than or 
173.25 	equal to 400 percent of the federal poverty guidelines, may qualify for advance premium 
173.26 	tax credits and cost-sharing reductions to purchase a plan established under this section.
173.27 	(f) There shall be no state subsidy to individuals eligible for the MinnesotaCare buy-in 
173.28 	option.
173.29 	(g) The MinnesotaCare buy-in option established under this section shall be considered 
173.30 	the MinnesotaCare program for purposes of the requirements for health maintenance 
173.31 	organizations under section 62D.04, subdivision 5, and providers under section 256B.0644.
174.1 	(h) The commissioner shall have authority to accept and expend all federal funds made 
174.2 	available under this section upon federal approval.

174.3 	EFFECTIVE DATE. This section is effective upon federal approval. The commissioner 
174.4 	of human services shall notify the revisor of statutes when federal approval is obtained.

174.5 	Sec. 64. RATE-SETTING ANALYSIS REPORT.
 174.6 	The commissioner of human services shall conduct a comprehensive analysis report of 
174.7 	the current rate-setting methodology for outpatient, professional, and physician services 
174.8 	that do not have a cost-based, federally mandated, or contracted rate.  The report shall include 
174.9 	recommendations for changes to the existing fee schedule that utilizes the Resource-Based 
174.10 	Relative Value System (RBRVS), and alternate payment methodologies for services that 
174.11 	do not have relative values, to simplify the fee for service medical assistance rate structure 
174.12 	and to improve consistency and transparency. In developing the report, the commissioner 
174.13 	shall consult with outside experts in Medicaid financing. The commissioner shall provide 
174.14 	a report on the analysis to the chairs of the legislative committees with jurisdiction over 
174.15 	health and human services finance by November 1, 2019.

174.16 	Sec. 65.  REPEALER.
 174.17 	Minnesota Statutes 2016, sections 256.9692; 256B.0625, subdivision 25a; and 256B.0659, 
174.18 	subdivision 22, are repealed.

174.19 	ARTICLE 5
174.20 	MANAGED CARE

174.21 	Section 1. [256B.68] MANAGED CARE.
174.22 		Subdivision 1.Purpose. (a) The commissioner of human services shall utilize managed 
174.23 	care as an effective mechanism to ensure that all eligible individuals receive necessary 
174.24 	health care in a coordinated fashion while containing costs. Each individual who is eligible 
174.25 	for medical assistance must participate in managed care unless the individual meets the 
174.26 	exclusion criteria in subdivision 9.
174.27 	(b) If allowed by the commissioner, a managed care organization (MCO) may contract 
174.28 	with an insurer, health care provider, nonprofit health service plan corporation, or the 
174.29 	commissioner, to provide insurance or similar protection against the cost of care provided 
174.30 	by the managed care organization or to provide coverage against the risks incurred by the 
174.31 	managed care organization under this section. The recipients enrolled with a managed care 
175.1 	organization are a permissible group under group insurance laws and sections 62C.01 to 
175.2 	62C.23. Under this type of contract, the insurer or corporation may make benefit payments 
175.3 	to a participating provider for services rendered or to be rendered to a beneficiary. Any 
175.4 	insurer or nonprofit health service plan corporation licensed to conduct business in the state 
175.5 	is authorized to provide insurance or similar protection.
175.6 		Subd. 2.Definitions. (a) For the purposes of this section, the following terms have the 
175.7 	meanings given.
175.8 	(b) "Abuse" means provider practices that are inconsistent with sound fiscal, business, 
175.9 	beneficiary, or medical practices, and result in an unnecessary cost to the Medicaid program, 
175.10 	or in reimbursement for services that are not medically necessary or that fail to meet 
175.11 	professionally recognized standards for health care.
175.12 	(c) "Access" means the timely use of services to achieve optimal outcomes, as evidenced 
175.13 	by managed care plans.
175.14 	(d) "Actuary" means an individual who meets the qualification standards established by 
175.15 	the American Academy of Actuaries for an actuary and follows the practice standards 
175.16 	established by the Actuarial Standards Board. For purposes of this section, actuary refers 
175.17 	to an individual who is acting on behalf of the state when used in reference to the 
175.18 	development and certification of capitation rates.
175.19 	(e) "Actuarial sound capitation rates" means actuarially sound capitation rates projected 
175.20 	to provide for all reasonable, appropriate, and attainable costs required under the terms of 
175.21 	the contract and for the operation of the MCO for the time period and the populations covered 
175.22 	under the terms of the contract.
175.23 	(f) "Actuarially sound principles" means generally accepted actuarial principles and 
175.24 	practices applied to determine aggregate utilization patterns, appropriate for the population 
175.25 	and services to be covered, and have been certified by an actuary.
175.26 	(g) "Adverse benefit determination" means:
175.27 	(1) denial or limited authorization of a requested service, including determinations based 
175.28 	on the type or level of service, requirements for medical necessity, appropriateness, setting, 
175.29 	or effectiveness of a covered benefit;
175.30 	(2) reduction, suspension, or termination of a previously authorized service;
175.31 	(3) denial, in whole or in part, of payment for a service;
175.32 	(4) failure to provide services in a timely manner, as defined by the commissioner;
176.1 	(5) failure of an MCO to act within the time frames provided in Code of Federal 
176.2 	Regulations, title 42, section 438.408(b)(1) and (2), regarding the standard resolution of 
176.3 	grievances and appeals;
176.4 	(6) For an enrollee of a rural area with only one MCO, the denial of an enrollee's request 
176.5 	to exercise the enrollee's right, under Code of Federal Regulations, title 42, section 
176.6 	438.52(b)(2)(ii), to obtain services outside the network; or
176.7 	(7) denial of an enrollee's request to dispute a financial liability, including cost sharing, 
176.8 	co-payments, premiums, deductibles, coinsurance, and other enrollee financial liabilities.
176.9 	(h) "Appeal" means a review by an MCO of an adverse benefit determination.
176.10 	(i) "Base amount" means the starting amount, calculated according to Code of Federal 
176.11 	Regulations, title 42, section 438.6(d)(2), available for pass-through payments to hospitals 
176.12 	in a contract year subject to the schedule in Code of Federal Regulations, title 42, section 
176.13 	438.6(d)(3).
176.14 	(j) "Beneficiary" means a person that is eligible for medical assistance benefits as defined 
176.15 	in sections 256B.055, 256B.056, and 256B.06. For purposes of this section, beneficiary and 
176.16 	recipient have the same meaning.
176.17 	(k) "Budget neutral" means a standard for any risk-sharing mechanism that recognizes 
176.18 	both higher and lower expected costs among contracted MCOs under a managed care 
176.19 	program and does not create a net aggregate gain or loss across all payments under the 
176.20 	managed care program.
176.21 	(l) "Capitation Payment" means a monthly payment made by the commissioner to an 
176.22 	MCO on behalf of each beneficiary enrolled in a contract and based on the actuarially sound 
176.23 	capitation rate for the provision of services under the state plan. The commissioner must 
176.24 	make the payment regardless of whether the particular beneficiary receives services during 
176.25 	the period covered by the payment.
176.26 	(m) "Choice counseling" means the provision of information and services designed to 
176.27 	assist a beneficiary in making enrollment decision, including answering questions and 
176.28 	identifying factors to consider when choosing a managed care plan. Choice counseling does 
176.29 	not include making recommendations for or against enrollment into a specific MCO.
176.30 	(n) "Cold-call marketing" means any unsolicited personal contact or communication by 
176.31 	the MCO with a Medicaid beneficiary who is not enrolled in that MCO that can reasonably 
176.32 	be interpreted as intended to influence the beneficiary to enroll in that particular MCO's 
176.33 	Medicaid product, or to not enroll in or to disenroll from another MCO's Medicaid product.
177.1 	(o) "Commissioner" means the commissioner of the Department of Human Services.
177.2 	(p) "Comprehensive risk contract" means a risk contract between the commissioner and 
177.3 	an MCO that covers comprehensive services, including inpatient hospital services and any 
177.4 	three or more of the following services:
177.5 	(1) outpatient hospital services;
177.6 	(2) rural health clinic services;
177.7 	(3) Federally Qualified Health Center (FQHC) services;
177.8 	(4) other laboratory and x-ray services;
177.9 	(5) nursing facility services;
177.10 	(6) early and periodic screening, diagnostic, and treatment (EPSDT) services;
177.11 	(7) family planning services;
177.12 	(8) physician services; or
177.13 	(9) home health services.
177.14 	(q) "Cost sharing" means any co-payment, coinsurance, deductible, or other similar 
177.15 	charge.
177.16 	(r) "Credibility adjustment" means an adjustment to the minimum lost ratio (MLR) for 
177.17 	a partially credible MCO to account for the difference between the actual and target MLRs 
177.18 	that may be due to a random statistical variation.
177.19 	(s) "Emergency medical condition" means a medical condition manifesting itself by 
177.20 	acute symptoms of sufficient severity, including severe pain that a prudent layperson, who 
177.21 	possesses an average knowledge of health and medicine could reasonably expect the absence 
177.22 	of immediate medical attention to result in jeopardizing the health of the individual or in 
177.23 	the case of a pregnant women, seriously impairing bodily functions, or serious dysfunction 
177.24 	of a body organ or part.
177.25 	(t) "Emergency services" means covered inpatient and outpatient services that are:
177.26 	(1) furnished by a qualified provider under Code of Federal Regulations, title 42; and
177.27 	(2) needed to evaluate or stabilize an emergency medical condition.
177.28 	(u) "Enrollee" means a medical assistance or MinnesotaCare person who is currently 
177.29 	enrolled in an MCO.
178.1 	(v) "Enrollee encounter data" means the information relating to the receipt of any item 
178.2 	or service by an enrollee under a contract between the commissioner and an MCO that is 
178.3 	subject to Code of Federal Regulations, title 42, sections 438.242 and 438.818.
178.4 	(w) "External quality review (EQR)" means the analysis and evaluation by an EQRO 
178.5 	of the aggregated information on quality, timeliness, and access to the health care services 
178.6 	that an MCO or the MCO's contractor furnish to medical assistance managed care enrollees.
178.7 	(x) "External quality review organization (EQRO)" means an organization that meets 
178.8 	the competence and independence requirements in Code of Federal Regulations, title 42, 
178.9 	section 438.354, and performs external quality review, other EQR-related activities in Code 
178.10 	of Federal Regulations, title 42, section 438.358, or both.
178.11 	(y) "Fraud" means an intentional deception or misrepresentation by a person with the 
178.12 	knowledge that the deception may result in unauthorized benefit to the person or another 
178.13 	person. Fraud includes any act that constitutes health care fraud under federal or state law.
178.14 	(z) "Full credibility" means a standard for which the experience of an MCO for the 
178.15 	calculation of an MLR with a minimal chance that the difference between the actual and 
178.16 	target medical loss ratio is not statistically significant. An MCO is assigned full creditability 
178.17 	must not receive a creditability adjustment to an MCO's MLR.
178.18 	(aa) "Grievance" means an expression of dissatisfaction about any matter other than an 
178.19 	adverse benefit determination. A grievance includes but is not limited to the quality of care 
178.20 	or services provided; and aspects of interpersonal relationships, including rudeness of a 
178.21 	provider or employee; or failure to respect the enrollee's rights regardless of whether an 
178.22 	action is requested; or an enrollee's right to dispute an extension of time proposed by the 
178.23 	MCO to make an authorization decision.
178.24 	(bb) "Grievance and appeal system" means the processes an MCO implements to handle 
178.25 	appeals of an adverse benefit determination and grievances and the processes to collect and 
178.26 	track information about grievances.
178.27 	(cc) "Health care services" means all medical assistance provided by an MCO under 
178.28 	contract with the state Medicaid agency in any setting, including but not limited to medical 
178.29 	care, behavioral health care, and long-term services and supports.
178.30 	(dd) "Incentive arrangement" means any payment mechanism under which an MCO 
178.31 	may receive additional funds over and above the capitation rates an MCO was paid for 
178.32 	meeting targets in the contract.
179.1 	(ee) "Indian" means any individual defined in United States Code, title 25, section 
179.2 	1603(13), 1603(28), or 1679(a), or who was determined eligible as Indian, according to 
179.3 	Code of Federal Regulations, title 42, section 136.12. Indian also means the individual is a 
179.4 	member of a federally recognized tribe or resides in an urban center and is:
179.5 	(1) a member of a tribe, band, or other organized group of Indians, including tribes, 
179.6 	bands, groups terminated since 1940 and tribes recognized now or in the future by the state 
179.7 	in which they reside, or who is a descendant, in the first or second degree, of any such 
179.8 	member;
179.9 	(2) an Eskimo or Aleut or other Alaska native;
179.10 	(3) considered by the Secretary of the Interior to be an Indian for any purpose; or
179.11 	(4) considered by the Secretary of Health and Human Services to be an Indian for 
179.12 	purposes of eligibility for Indian health care services, including a California Indian, Eskimo, 
179.13 	Aleut, or other Alaska native.
179.14 	(ff) "Indian Health Care Provider" or "HCP" means a health care program operated by 
179.15 	the Indian Health Service (IHS) or by an Indian Tribe, Tribal Organization, or Urban Indian 
179.16 	Organization (I/T/U) as those terms are defined in section 4 of the Indian Health Care 
179.17 	Improvement Act, United States Code, title 25, section 1603.
179.18 	(gg) "Limited English proficient" or "LEP" means potential enrollees and enrollees who 
179.19 	do not speak English as the individual's primary language and who have a limited ability 
179.20 	to read, write, speak, or understand English may be LEP and may be eligible to receive 
179.21 	language assistance for a particular type of service, benefit, or encounter.
179.22 	(hh) "Long-term services and supports" or "LTSS" means services and supports provided 
179.23 	to a beneficiary of any age who has functional limitations or chronic illnesses that primarily 
179.24 	support the ability of the beneficiary to live or work in a setting of the beneficiary's choice, 
179.25 	including the beneficiary's home, a work site, a provider owned or controlled residential 
179.26 	setting, a nursing facility, or other institutional setting.
179.27 	(ii) "Managed care organization" or "MCO" means an entity that has, or is seeking to 
179.28 	qualify for, a comprehensive, and that is:
179.29 	(1) a federally qualified health maintenance organization (HMO) that meets the advance 
179.30 	directives requirements of Code of Federal Regulations, title 42, sections 489.100 to 489.104; 
179.31 	or
179.32 	(2) any public or private entity that meets the advance directives requirements and:
180.1 	(i) makes the services the entity provides to medical assistance enrollees as accessible, 
180.2 	including timeliness, amount, duration, and scope of services as services provided to other 
180.3 	medical assistance beneficiaries in the area served by the entity; and
180.4 	(ii) meets the solvency standards of Code of Federal Regulations, title 42, section 438.116. 
180.5 	A participating entity must meet the requirements of this section and section 256B.692.
180.6 	(jj) "Marketing" means any communication from an MCO to a Medicaid beneficiary 
180.7 	who is not enrolled in that MCO, that can reasonably be interpreted as intended to influence 
180.8 	the beneficiary to enroll in a particular MCO, or to not enroll or to disenroll from another 
180.9 	MCO. Marketing does not include communications about the qualified health plan to a 
180.10 	Medicaid beneficiary from the issuer of a qualified health plan, as defined in Code of Federal 
180.11 	Regulations, title 45, section 155.20.
180.12 	(kk) "Marketing materials" means materials that:
180.13 	(1) are produced in any medium, by or on behalf of an MCO; and
180.14 	(2) can reasonably be interpreted as intended to market the MCO to potential enrollees.
180.15 	(ll) "Medical loss ratio" or "MLR" means a basic financial measurement used in the 
180.16 	Affordable Care Act to provide value to enrollees. If an insurer uses 80 cents out of every 
180.17 	premium dollar to pay its enrollees' medical claims and activities that improve the quality 
180.18 	of care, the company has a medical loss ratio of 80 percent. A medical loss ratio of 80 
180.19 	percent indicates that the insurer is using the remaining 20 cents of each premium dollar to 
180.20 	pay overhead expenses, such as marketing, profits, salaries, administrative costs, and agent 
180.21 	commissions.
180.22 	(mm) "Member months" means the number of months an enrollee or a group of enrollees 
180.23 	is covered by an MCO over a specified period of time, such as a year.
180.24 	(nn) "Market loss ratio" or "MLR reporting year" means the period of 12 months 
180.25 	consistent with the rating period selected by the commissioner.
180.26 	(oo) "Network provider" means any provider, group of providers, entity with a network 
180.27 	provider agreement with an MCO, or a subcontractor, and that receives Medicaid funding 
180.28 	directly or indirectly to order, refer, or render covered services as a result of the 
180.29 	commissioner's contract with an MCO. A network provider is not a subcontractor by virtue 
180.30 	of the network provider agreement.
180.31 	(pp) "No credibility" means a standard for which the experience of an MCO is determined 
180.32 	to be insufficient for the calculation of an MLR. An MCO that is assigned no credibility 
180.33 	must not be measured against any MLR requirements.
181.1 	(qq) "Outcomes" means changes in patient health, functional status, satisfaction, or goal 
181.2 	achievement that result from health care or supportive services.
181.3 	(rr) "Overpayment" means any payment made by an MCO to a network provider that 
181.4 	the provider is not entitled to receive, or any payment to an MCO from the commissioner 
181.5 	that the MCO is not entitled to receive under title XIX of the Social Security Act.
181.6 	(ss) "Pass-through payment" means any amount required by the commissioner to be 
181.7 	added to the contracted payment rates, and considered in calculating the actuarially sound 
181.8 	capitation rate, between the MCO and a hospital, physician, or nursing facility that is not 
181.9 	for the following purposes:
181.10 	(1) specific service or benefit provided to a specific enrollee covered under the contract;
181.11 	(2) a provider payment methodology permitted under Code of Federal Regulations, title 
181.12 	42, sections 438.6(c)(1)(i) to (iii),
181.13 	(3) for services and enrollees covered under a contract;
181.14 	(4) a subcapitated payment arrangement for a specific set of services and enrollees 
181.15 	covered under the contract;
181.16 	(5) Graduate Medical Education (GME) payments; or
181.17 	(6) Federally Qualified Health Clinic (FQHC) or Rural Health Clinic (RHC) wrap around 
181.18 	payments.
181.19 	(tt) "Partial credibility" means a standard for which the experience of an MCO is 
181.20 	determined to be sufficient for the calculation of an MLR but with a non-negligible chance 
181.21 	that the difference between the actual and target medical loss ratios is statistically significant. 
181.22 	An MCO that is assigned partial credibility must receive a credibility adjustment to an 
181.23 	MCO's MLR.
181.24 	(uu) "Participating entity" means a health carrier as defined in section 62A.01, subdivision 
181.25 	2; a county-based purchasing plan established under section 256B.692; an accountable care 
181.26 	organization or other entity operating a health care delivery system demonstration project 
181.27 	authorized under section 256B.0755; an entity operating a county integrated health care 
181.28 	delivery network pilot project authorized under section 256B.0756; or a network of health 
181.29 	care providers established to offer services under MinnesotaCare.
181.30 	(vv) "Prevalent" means a non-English language determined to be spoken by a significant 
181.31 	number or percentage of potential enrollees and enrollees that are limited English proficient.
182.1 	(ww) "Primary care" means all health care services and laboratory services customarily 
182.2 	furnished by or through a general practitioner, family physician, internal medicine physician, 
182.3 	obstetrician, gynecologist, pediatrician, or other licensed practitioner as authorized by the 
182.4 	Minnesota medical assistance program, to the extent that providing the services is legally 
182.5 	authorized in the state in which the practitioner furnishes services.
182.6 	(xx) "Potential enrollee" means a medical assistance or MinnesotaCare person who is 
182.7 	subject to mandatory enrollment, or for medical assistance only may voluntarily elect to 
182.8 	enroll in an MCO, but is not yet an enrollee of an MCO.
182.9 	(yy) "Provider" means any individual or entity that is engaged in the delivery of services, 
182.10 	or ordering or referring for those services, and is legally authorized to do so by the state in 
182.11 	which the provider delivers services.
182.12 	(zz) "Post-stabilization care services" means covered services, related to an emergency 
182.13 	medical condition that are provided after an enrollee is stabilized to maintain the stabilized 
182.14 	condition, or according to Code of Federal Regulations, title 42, section 438.114(e).
182.15 	(aaa) "Quality" means the degree that an MCO increases the likelihood of desired 
182.16 	outcomes of an MCO's enrollees through:
182.17 	(1) an MCO's structural and operational characteristics;
182.18 	(2) the provision of services that are consistent with current professional, evidence-based 
182.19 	knowledge; and
182.20 	(3) interventions for performance improvement.
182.21 	(bbb) "Rate cell" means a set of mutually exclusive categories of enrollees that is defined 
182.22 	by one or more characteristics to determine the capitation rate and make a capitation payment. 
182.23 	Characteristics may include age, gender, eligibility category, and region or geographic area. 
182.24 	Each enrollee should be categorized in one of the rate cells for each unique set of mutually 
182.25 	exclusive benefits under the contract.
182.26 	(ccc) "Readily accessible" means electronic information and services which comply 
182.27 	with modern accessibility standards, including section 508 guidelines, section 504 of the 
182.28 	Rehabilitation Act, and W3C's Web Content Accessibility Guidelines (WCAG) 2.0 AA and 
182.29 	successor versions.
182.30 	(ddd) "Risk adjustment" is a methodology to account for the health status of an enrollee 
182.31 	via relative risk factors when predicting or explaining costs of services covered under the 
182.32 	contract for defined populations or for evaluating retrospectively the experience of the 
182.33 	MCOs contracted with the commissioner.
183.1 	(eee) "Risk contract" means a contract between the commissioner and an MCO in which 
183.2 	the contractor:
183.3 	(1) assumes risk for the cost of the services covered under the contract; and
183.4 	(2) incurs loss if the cost of furnishing the services exceeds the payments under the 
183.5 	contract.
183.6 	(fff) "Risk corridor" means a risk-sharing mechanism in which the commissioner and 
183.7 	MCOs may share in profits and losses under the contract outside of a predetermined threshold 
183.8 	amount.
183.9 	(ggg) "Rural area" means any county designated as "micro," "rural," or "County with 
183.10 	Extreme Access Considerations" in the Medicare Advantage Health Services Delivery 
183.11 	(HSD) Reference file for the applicable calendar year.
183.12 	(hhh) "State fair hearing" means the process set forth in subpart E of Code of Federal 
183.13 	Regulations, title 42, section 431.
183.14 	(iii) "Subcontractor" means an individual or entity that has a contract with an MCO that 
183.15 	relates directly or indirectly to the performance of the MCO's obligations under an MCO's 
183.16 	contract with the commissioner.
183.17 	(jjj) "Validation" means the review of information, data, and procedures to determine 
183.18 	the extent that information, data, and procedures are accurate, reliable, free from bias, and 
183.19 	according to standards for data collection and analysis.
183.20 	(kkk) "Withhold arrangement" means any payment mechanism under which a portion 
183.21 	of a capitation rate is withheld from an MCO, and a portion or all of the withheld amount 
183.22 	must be paid to the MCO for meeting targets specified in the contract. An arrangement that 
183.23 	withholds a portion of a capitation rate for noncompliance with general operational 
183.24 	requirements are a penalty and not a withhold arrangement.
183.25 		Subd. 3.Service area. Managed care shall be offered in each county in Minnesota.
183.26 		Subd. 4.Procurement for managed care. (a) The commissioner, when implementing 
183.27 	managed care within a county or a group of counties that have elected county-based 
183.28 	purchasing, must comply with applicable state laws in chapter 16C, and Code of Federal 
183.29 	Regulations, title 45, part 75. These counties shall participate in the procurement according 
183.30 	to this section. The commissioner shall procure for managed care contracts, at a minimum 
183.31 	of every five years according to section 16B.98, subdivision 5, and may conduct a statewide 
183.32 	procurement or procure for a limited number of counties within a specified region.
184.1 	(b) The commissioner shall coordinate the procurement of MinnesotaCare to the extent 
184.2 	practicable with medical assistance according to this subdivision.
184.3 	(c) The commissioner may consider a request from the county or group of counties 
184.4 	representing county-based purchasing to exclude price in the evaluation criteria. The 
184.5 	commissioner shall ensure that the payment made by the commissioner to any managed 
184.6 	care plan in these counties does not exceed payments that would otherwise be paid to any 
184.7 	other managed care organization providing medical assistance services for the same county, 
184.8 	region, or population. The procurement shall also consider the unique nature of the county 
184.9 	or group of counties in county-based purchasing and evaluate the responders on provider 
184.10 	network access, coordination, and integration with county services for the provision of 
184.11 	health care and other local community-based services.
184.12 	(d) The counties must be included in the process of development, and issuance of the 
184.13 	request for proposals to provide services to eligible individuals within the proposed county. 
184.14 	Counties must be given reasonable opportunity to make recommendations regarding the 
184.15 	development, issuance, and changes needed in the request for proposals before publication. 
184.16 	The recommendations must reflect neutrality towards all potential responders and be 
184.17 	reasonably related to the performance of managed care organization functions and within 
184.18 	the scope of the medical assistance benefit set. The commissioner must provide counties 
184.19 	the opportunity to review and score each responder's proposal based on the identification 
184.20 	of the counties' community needs under chapters 145A and 256E and county advocacy 
184.21 	activities. The counties shall consider the respondent's ability to fully and adequately deliver 
184.22 	required health care services, offer an adequate provider network, provide care coordination 
184.23 	with county services, and serve special populations, including enrollees with language and 
184.24 	cultural needs.
184.25 	(e) As part of the procurement process, a county may seek county board recommendations 
184.26 	based on the county's review and score of each proposal. A county board's recommendations 
184.27 	must be submitted to the commissioner for consideration in the overall decision of the 
184.28 	managed care organization selection process.
184.29 	(f) All county and state staff serving as evaluators of the proposals must sign a 
184.30 	confidentiality agreement that complies with the conflict of interest requirements in sections 
184.31 	15.43, 43A.48, 16C.04, and 256B.0914.
184.32 	(g) All responders seeking a contract to provide health care services under this section 
184.33 	are subject to the prohibition against conflict of interest in section 256B.0914, and must 
185.1 	comply with all applicable prohibitions and requirements for safeguards regarding conflict 
185.2 	of interest in Code of Federal Regulations, title 42, section 438.58.
185.3 	(h) Before the commissioner implements a new managed care program, or when an 
185.4 	MCO provides services to a new eligibility group, or contracting with a new MCO, the 
185.5 	commissioner shall conduct a readiness review according to Code of Federal Regulations, 
185.6 	title 42, section 438.66(d). The readiness review must be conducted at least three months 
185.7 	before the program implementation effective date and with sufficient time to ensure a smooth 
185.8 	transition and receive Centers for Medicare and Medicaid approval.
185.9 	(i) The commissioner shall provide a written report under section 3.195 to the chairs of 
185.10 	the legislative committees having jurisdiction over human services if a procurement results 
185.11 	in a significant change of new contracted entities, population shifts, new eligibility groups, 
185.12 	or a change in the number of contracted entities. The report shall be provided 60 days 
185.13 	following the effective date of the change.
185.14 	(j) If a county board or counties and the commissioner cannot reach agreement regarding 
185.15 	the selection of participating managed care organizations in that county or counties, the 
185.16 	commissioner shall resolve the dispute after considering the recommendation of a 
185.17 	three-person mediation panel. The panel shall be composed of three panelists: one designee 
185.18 	of the president of the Association of Minnesota Counties, one designee of the commissioner 
185.19 	of human services, and one designee selected jointly by the designee of the commissioner 
185.20 	of human services and the designee of the Association of Minnesota Counties. Within a 
185.21 	reasonable period of time before the hearing, the panelists must be provided all documents 
185.22 	and information relevant to the mediation. The parties to the mediation must be given 30 
185.23 	days' notice of a hearing before the mediation panel.
185.24 	(k) A contract between the commissioner and a managed care organization is exempt 
185.25 	from the set-aside and preference provisions of section 16C.16, subdivision 6.
185.26 		Subd. 5.Competitive bidding. (a) For managed care contracts, the commissioner may 
185.27 	utilize a competitive price bidding program for nonelderly, nondisabled adults and children 
185.28 	in medical assistance and MinnesotaCare. The managed care program must allow a minimum 
185.29 	of two managed care organizations in each county that is identified as a metropolitan 
185.30 	statistical area (MSA).
185.31 	(b) The pilot programs operating in Hennepin County and Ramsey County under section 
185.32 	256B.0756 are exempt from competitive bid.
185.33 		Subd. 6.Enrollment. (a) For populations required to enroll in a managed care 
185.34 	organization, the commissioner must ensure that an eligible beneficiary has a choice between 
186.1 	two managed care organizations. For an eligible beneficiary residing in a rural area, the 
186.2 	commissioner may limit a rural area beneficiary to a single managed care organization. For 
186.3 	a beneficiary living in a rural county with a single managed care organization, the rural 
186.4 	beneficiary:
186.5 	(1) must be allowed to choose from at least two primary care providers; and
186.6 	(2) is permitted to obtain services from any provider according to Code of Federal 
186.7 	Regulations, title 42, section 438.52(b).
186.8 	(b) The commissioner, in consultation with the tribal governments, shall develop a plan 
186.9 	for tribes to assist in the enrollment process for American Indian beneficiaries enrolled in 
186.10 	managed care under this section. This plan shall address how tribes shall be included in 
186.11 	ensuring the coordination of care for American Indian beneficiaries by Indian Health Care 
186.12 	Providers.
186.13 	(c) Each person who is eligible for medical assistance must participate in managed care 
186.14 	unless the person:
186.15 	(1) meets the exclusion criteria listed in subdivision 8;
186.16 	(2) is 65 years of age or older and eligible for Medicare and elects to enroll in the 
186.17 	Minnesota Senior Health Options program.
186.18 	(3) is 18 to 64 years of age and certified disabled, and does not opt out, is enrolled in 
186.19 	the Special Needs Basic Care Program.
186.20 	(d) A state plan that requires medical assistance beneficiaries to enroll in MCOs must 
186.21 	comply with Code of Federal Regulations, title 42, section 438.50, unless the commissioner 
186.22 	received federal waiver authority.
186.23 	(e) The enrollment system must comply with Code of Federal Regulations, title 42, 
186.24 	section 438.54, as applicable to mandatory, voluntary, and passive enrollments. For a 
186.25 	potential enrollee that does not select an MCO during the period allowed by the 
186.26 	commissioner, the commissioner must have a default enrollment process for assigning the 
186.27 	potential enrollee to an MCO and must consider priority enrollment and existing 
186.28 	provider-beneficiary relationships. The MCO must not be subject to an intermediate sanction 
186.29 	in Code of Federal Regulations, title 42, section 438.702(a)(4), and the MCO's capacity to 
186.30 	accept new enrollment.
186.31 	(1) The commissioner may consider additional reasonable criteria to conduct the default 
186.32 	process including the previous plan assignment of the beneficiary, quality assurance and 
186.33 	improvement performance, procurement evaluation elements, accessibility of provider 
187.1 	offices for people with disabilities, if appropriate, and other reasonable criteria that support 
187.2 	the objectives of the managed care program.
187.3 	(2) The commissioner must send a confirmation of the enrollee's managed care enrollment 
187.4 	to the enrollee within five calendar days of the date enrollment is processed by the 
187.5 	commissioner. The confirmation must clearly explain the enrollee's right to disenroll within 
187.6 	90 days from the effective date of enrollment.
187.7 	(3) The commissioner must provide an informational notice to each potential enrollee 
187.8 	who may enroll in an MCO. The notice must include the MCOs that are available to the 
187.9 	potential enrollee, how to select an MCO, explain the implications of making or not making 
187.10 	an active choice, explain the length of enrollment period and the disenrollment policies, 
187.11 	and comply with Code of Federal Regulations, title 42, sections 438.10 and 438.206.
187.12 		Subd. 7.Prohibition against enrollment discrimination. (a) The commissioner shall 
187.13 	ensure, through its contracts with the managed care organizations, compliance with all 
187.14 	federal and state anti-discrimination laws and regulations. A managed care organization 
187.15 	that contracts with the commissioner cannot discriminate or use any policy that has the 
187.16 	effect of discriminating against people on the basis of medical condition, health status, 
187.17 	receipt of health care services, claims experience, medical history, genetic information, 
187.18 	disability, including mental or physical impairment, marital status, age, race, color, religion, 
187.19 	creed, national origin, sex, including sex stereotypes and gender identity, sexual orientation, 
187.20 	political beliefs, or public assistance status.
187.21 	(b) The managed care organization must accept an individual eligible for enrollment in 
187.22 	the order that the individual applied or are assigned up to the limits set by the contract. The 
187.23 	commissioner may limit the number of enrollees in the MCO if in the commissioner's 
187.24 	judgment the MCO is unable to demonstrate the capacity to serve additional enrollees.
187.25 		Subd. 8.Enrollment exclusions. (a) The commissioner shall exclude the following 
187.26 	persons from enrollment in managed care:
187.27 	(1) a child who is receiving medical assistance through adoption assistance according 
187.28 	to section 256B.055, subdivision 1, is eligible to enroll in managed care on a voluntary 
187.29 	basis;
187.30 	(2) a person under 65 years of age that is eligible for medical assistance because of 
187.31 	blindness or disability as determined by the Social Security Administration or the medical 
187.32 	review team, except as permitted under subdivision 74;
188.1 	(3) a beneficiary who has private health care coverage through a health maintenance 
188.2 	organization (HMO) certified under chapter 62D. A beneficiary with this coverage may 
188.3 	enroll in managed care on a voluntary basis if the private HMO is the same as the managed 
188.4 	care organization the recipient will select under managed care;
188.5 	(4) a beneficiary who is eligible for medical assistance by spending down excess income 
188.6 	for medical expenses other than the nursing facility per diem expense, exceptions apply 
188.7 	under specific managed care programs;
188.8 	(5) a beneficiary who receives benefits under the Refugee Assistance Program, established 
188.9 	under United States Code, title 8, section 1522(e);
188.10 	(6) a child who is determined to be severely emotionally disturbed (SED) and eligible 
188.11 	to receive mental health targeted case management services according to section 245.4881, 
188.12 	is eligible to enroll in managed care on a voluntary basis;
188.13 	(7) an adult who is determined to be seriously and persistently mentally ill, according 
188.14 	to section 256B.0625, subdivision 20, and eligible to receive mental health targeted case 
188.15 	management services according to section 245.4711, is eligible to enroll in managed care 
188.16 	on a voluntary basis;
188.17 	(8) a beneficiary eligible for medical assistance through the breast and cervical cancer 
188.18 	control program according to section 256B.057, subdivision 10;
188.19 	(9) a beneficiary with cost-effective employer-sponsored private health insurance or a 
188.20 	beneficiary enrolled in a non-Medicare individual health plan determined to be cost-effective 
188.21 	according to section 256B.0625, subdivision 15;
188.22 	(10) a beneficiary who, before enrollment, is a resident of a state institution. A beneficiary 
188.23 	already enrolled in managed care who enter state institutions must remain enrolled if the 
188.24 	beneficiary's placement was approved by an MCO, including court ordered placements for 
188.25 	services covered under an MCO contract;
188.26 	(11) a beneficiary who, at the time of enrollment, has a terminal communicable disease 
188.27 	which may exceed six months, and has an established relationship with a primary physician 
188.28 	who is not a network provider in any of the managed care organizations and the physician 
188.29 	certifies that disruption of the physician-patient relationship is likely to result in the patient 
188.30 	becoming noncompliant with medication or other health services;
188.31 	(12) a beneficiary who, at the time of enrollment, has a terminal illness with a medical 
188.32 	prognosis of six months or less life expectancy and has a permanent relationship with a 
188.33 	primary physician who is not a network provider in any of the managed care organizations;
189.1 	(13) beneficiaries who are Qualified Medicare Beneficiaries (QMB) as defined in section 
189.2 	1905(p) of the Social Security Act, United States Code, section 1396d(p), and not eligible 
189.3 	for medical assistance;
189.4 	(14) beneficiaries who are Specified Low-Income Medicare Beneficiaries (SLMB) as 
189.5 	defined in section 1905(p) of the Social Security Act, United States Code, title 42, sections 
189.6 	1396a(a)(10)(E)(iii) and 1396d(p), and not eligible for medical assistance;
189.7 	(15) beneficiaries who are Qualified Working Disabled Adults (QWD) as defined in 
189.8 	United States Code, title 42, section 1396d(s), and not eligible for medical assistance;
189.9 	(16) a beneficiary receiving care and services from a nonprofit center established to 
189.10 	serve victims of torture;
189.11 	(17) a beneficiary who receives emergency medical assistance under section 256B.06, 
189.12 	subdivision 4;
189.13 	(18) a recipient eligible for the Minnesota family planning program (MFPP) under section 
189.14 	256B.78;
189.15 	(19) a beneficiary participating in the navigator pilot under section 254B.13; and
189.16 	(20) a beneficiary participating in the continuum of care pilot under section 254B.14.
189.17 	(b) Unless a newborn is determined to be excluded from managed care enrollment for 
189.18 	any reason identified in this section, the newborn who is determined eligible for and receiving 
189.19 	medical assistance must be enrolled in managed care retroactively from the birth month in 
189.20 	the same MCO as the mother, if applicable. For a birth reported within 90 days of birth 
189.21 	there will be continuous managed care enrollment from the birth month. For a birth reported 
189.22 	after 90 days from the birth month, enrollment will be the next available month following 
189.23 	the month that the birth was reported.
189.24 		Subd. 9.Disenrollment. (a) The commissioner shall establish procedures for when a 
189.25 	beneficiary may disenroll or change the beneficiary's MCO. The effective date of an approved 
189.26 	disenrollment must be no later than the first day of the second month following the month 
189.27 	that the beneficiary requests disenrollment.
189.28 	(b) A beneficiary may disenroll for cause at any time. Cause for disenrollment includes:
189.29 	(1) the enrollee moves outside of the MCO service area;
189.30 	(2) the MCO does not, because of moral or religious objections, cover the service the 
189.31 	enrollee seeks;
190.1 	(3) the enrollee needs related services to be performed at the same time and not all related 
190.2 	services are available within the provider network; and the enrollee's primary care provider 
190.3 	or another provider determines that receiving the services separately would subject the 
190.4 	enrollee to unnecessary risk;
190.5 	(4) an enrollee that uses MLTSS, the enrollee would have to change the enrollee's 
190.6 	residential, institutional, or employment supports provider based on that provider's change 
190.7 	in status from an in-network to an out-of-network provider with the MCO and, as a result, 
190.8 	would experience a disruption in the enrollee's residence or employment; or
190.9 	(5) reasons such as poor quality of care, lack of access to services covered under the 
190.10 	contract, or lack of access to providers experienced with the enrollee's care needs.
190.11 	(c) A beneficiary may disenroll without cause at the following times:
190.12 	(1) within 90 days following the date of the beneficiary's initial enrollment into a new 
190.13 	managed care organization or 90 days following the date the commissioner sends the 
190.14 	beneficiary notice of the enrollment, whichever is later;
190.15 	(2) in a county where there is a single plan, a beneficiary may change the beneficiary's 
190.16 	primary care clinic on a monthly basis;
190.17 	(3) at least once every 12 months following the beneficiary's initial enrollment;
190.18 	(4) upon automatic reenrollment, if the temporary loss of medical assistance eligibility 
190.19 	caused the beneficiary to miss the beneficiary's annual health plan selection opportunity;
190.20 	(5) if the commissioner imposes the intermediate sanction in Code of Federal Regulations, 
190.21 	title 42, section 438.702(a)(4);
190.22 	(6) if a managed care organization ends participation for any reason, a beneficiary 
190.23 	enrolled with that organization must select a new managed care organization but may change 
190.24 	managed care organizations without cause once more within the first 60 days after enrollment 
190.25 	with the second managed care organization;
190.26 	(7) because of substantial travel time or local agency error;
190.27 	(8) the beneficiary elects to change MCOs within 120 days following notice of a material 
190.28 	modification of an MCO's provider network; or
190.29 	(9) the beneficiary has a change in major medical program.
190.30 		Subd. 10.Consumer safeguards. The commissioner shall ensure safeguards against 
190.31 	conflict of interest of an individual who has responsibilities relating to the enrollment 
190.32 	processes.
191.1 		Subd. 11.Transition services. (a) The commissioner must have a transition of care 
191.2 	policy for managed care that ensures a beneficiary has continued access to medical assistance 
191.3 	services during the following transition periods:
191.4 	(1) moving from FFS to enrollment in an MCO;
191.5 	(2) changing from one MCO to another MCO;
191.6 	(3) the beneficiary's MCO contract is terminated; and
191.7 	(4) the beneficiary is disenrolled from managed care for any reason other than ineligibility 
191.8 	for Medicaid.
191.9 	(b) The commissioner's transition of care policy must ensure:
191.10 	(1) that a beneficiary has access to services consistent with the access the beneficiary 
191.11 	previously had and is permitted to retain the beneficiary's current provider for a period of 
191.12 	up to 120 days if that provider is not in the MCO network;
191.13 	(2) within the transition period the beneficiary is referred to appropriate a provider of 
191.14 	services that are in the MCO's network;
191.15 	(3) the commissioner, in the case of FFS, or the MCO that was previously serving the 
191.16 	enrollee, fully and timely complies with requests for historical utilization data from the new 
191.17 	MCO according to federal and state law;
191.18 	(4) the enrollee's new provider is able to obtain copies of the enrollee's medical records, 
191.19 	as appropriate and consistent with state and federal law.
191.20 	(5) access to other necessary procedures as specified by the Centers for Medicare and 
191.21 	Medicaid to ensure continued access to services to prevent serious detriment to the enrollee's 
191.22 	health or reduce the risk of hospitalization or institutionalization; and
191.23 	(6) that the policy is be publicly available to enrollees and potential enrollees on how 
191.24 	to access continued services during transition.
191.25 		Subd. 12.Beneficiary support system. (a) The commissioner shall have a beneficiary 
191.26 	support system that provides support to a beneficiary both before and after enrollment in a 
191.27 	managed care organization.
191.28 	(b) A state beneficiary support system must:
191.29 	(1) provide choice counseling for each potential enrollee, including an enrollee who 
191.30 	disenrolled from an MCO;
191.31 	(2) assist each enrollee in understanding managed care;
192.1 	(3) provide an access point for complaints and concerns about MCO enrollment, covered 
192.2 	services, and other related matters;
192.3 	(4) provide education on enrollee's grievance and appeal rights within the MCO, the 
192.4 	state fair hearing process, enrollee rights and responsibilities, and additional resources 
192.5 	outside of the MCO;
192.6 	(5) assist, if request, navigating the grievance and appeal process within the MCO and 
192.7 	appealing adverse benefit determinations by the MCO to a state fair hearing. The beneficiary 
192.8 	support system may not provide representation to the enrollee at a state fair hearing but may 
192.9 	refer an enrollee to legal representation sources;
192.10 	(6) perform outreach to a beneficiary or an authorized representative and be accessible 
192.11 	in multiple formats including telephone, internet, in-person, and via auxiliary aids and 
192.12 	services if requested; and
192.13 	(7) review and oversee LTSS program data to guide the state Medicaid agency on 
192.14 	identification, remediation, and resolution of systemic issues.
192.15 	(c) Federal financial participation is available only if:
192.16 	(1) costs must be supported by an allocation methodology that appears in the state's 
192.17 	approved Public Assistance Cost Allocation Plan in Code of Federal Regulations, title 42, 
192.18 	section 433.34; and
192.19 	(2) costs do not duplicate payment for activities that are already offered or should be 
192.20 	provided by other entities or paid by other programs.
192.21 	(d) The commissioner may designate a county coordinator to assist the department in 
192.22 	educating beneficiaries about selecting an MCO and providing necessary enrollment 
192.23 	information.
192.24 		Subd. 13.Network adequacy. (a) The commissioner shall develop and enforce time 
192.25 	and distance standards for provider types in clauses (1) to (9) that are covered under the 
192.26 	managed care organization contract with the commissioner and who is permitted to have 
192.27 	varying standards for the same provider type based on geographic areas:
192.28 	(1) primary care, adult and pediatric;
192.29 	(2) obstetrician/gynecologist;
192.30 	(3) adult and pediatric behavioral health, including mental health and substance use 
192.31 	disorder;
192.32 	(4) specialist, adult and pediatric;
193.1 	(5) hospital;
193.2 	(6) pharmacy;
193.3 	(7) pediatric dental;
193.4 	(8) LTSS providers that the enrollee travels to the provider; and for providers traveling 
193.5 	to an enrollee's home, the commissioner may set alternative standards; and
193.6 	(9) additional provider types as determined by the commissioner or the Centers for 
193.7 	Medicare and Medicaid if the commissioner promotes the objectives of the Medicaid 
193.8 	program.
193.9 	(b) In developing network standards for the providers in paragraph (a), the commissioner 
193.10 	must consider the elements in Code of Federal Regulations, title 42, section 438.68(c).
193.11 	(c) The commissioner may allow an exception to any of the provider-specific network 
193.12 	standards. The exception must be identified in the MCO contract and be based, at a minimum, 
193.13 	on the number of providers practicing that specialty in the managed care organization's 
193.14 	service area. The commissioner must monitor enrollee access to the provider on an ongoing 
193.15 	basis and report those findings to the Centers for Medicare and Medicaid in the managed 
193.16 	care program assessment report according to Code of Federal Regulations, title 42, section 
193.17 	438.68(d)(2).
193.18 	(d) The commissioner must publish on the department's Web site the network adequacy 
193.19 	standards developed according to this section. The network adequacy standards must also 
193.20 	be made available, upon request, at no cost to an enrollee with a disability in an alternate 
193.21 	format or through the provision of auxiliary aids and services.
193.22 		Subd. 14.Provider selection. (a) The commissioner must ensure that a contract with 
193.23 	an MCO requires the MCO to have written policies and procedures for selection and retention 
193.24 	of network providers and that the policies and procedures satisfy Code of Federal Regulations, 
193.25 	title 42, section 438.214.
193.26 	(b) The commissioner shall require an MCO to adopt a uniform credentialing and 
193.27 	recredentialing process and comply with the process consistent with state regulations and 
193.28 	current NCQA Standards and Guidelines for the Accreditation of Health Plans. The MCO 
193.29 	must follow the process for acute, primary care, behavioral, substance use, and LTSS 
193.30 	providers. For organizational providers, including hospitals, and Medicare certified home 
193.31 	health care agencies, an MCO shall adopt a uniform credentialing and recredentialing process 
193.32 	and comply with that process consistent with state regulations.
194.1 	(c) An MCO serving a county with a nonprofit community clinic or community health 
194.2 	services agency must contract with the clinic or agency to provide services to a client who 
194.3 	chooses to receive services from the clinic or agency, if the clinic or agency agrees to 
194.4 	payment rates that are competitive with rates paid to other health plan providers for the 
194.5 	same or similar services. For purposes of this subdivision, "nonprofit community clinic" 
194.6 	includes, but is not limited to, a community mental health center as defined in sections 
194.7 	245.62 and 256B.0625, subdivision 5.
194.8 	(d) An MCO may not discriminate in the participation, reimbursement, or indemnification 
194.9 	of any provider who is acting within the scope of the provider's license or certification under 
194.10 	applicable state law, solely on the basis of that license or certification. If an MCO declines 
194.11 	to include provider or groups of providers in an MCO's network, the MCO must give written 
194.12 	notice of the MCO's decision. An MCO is:
194.13 	(1) not required to contract with a provider beyond the amount necessary to meet the 
194.14 	needs of an MCO's enrollees;
194.15 	(2) not prohibited from using different reimbursement amounts for different specialties 
194.16 	or different practitioners in the same specialty; and
194.17 	(3) allowed to establish measures designed to maintain quality of services and control 
194.18 	costs.
194.19 	(e) The MCO may not employ or contract with a provider excluded from participation 
194.20 	in federal health care programs under the Social Security Act, United States Code, section 
194.21 	1128 or 1128A.
194.22 		Subd. 15.Provider screening and enrollment. (a) The commissioner, through the 
194.23 	commissioner's contract with the MCOs, must ensure all network providers are enrolled 
194.24 	with the Medicaid agency as a medical assistance provider and must comply with the provider 
194.25 	disclosure, screening, and enrollment requirements of part 455. A provider network is not 
194.26 	required to render services to a fee-for-service beneficiary.
194.27 	(b) An MCO may execute a network provider agreement pending the outcome of the 
194.28 	medical assistance provider enrollment process up to 120 days. An MCO must terminate 
194.29 	the network provider upon notification that the network provider cannot be enrolled or upon 
194.30 	expiration of the 120-day period and must notify each affected enrollee.
194.31 		Subd. 16.Network and payment requirements for Indian health care providers. (a) 
194.32 	Medical assistance shall cover health care services provided at Indian health services facilities 
194.33 	and facilities operated by a tribe or tribal organization under funding authorized under 
195.1 	United states Code, title 25, sections 450f to 450n, or title III of the Indian Self-Determination 
195.2 	and Education Assistance Act, Public Law 93-638, if services would otherwise be covered 
195.3 	under section 256B.0625. A payment for services provided under this subdivision shall be 
195.4 	made on a fee-for-service basis, and may, at the option of the tribe or tribal organization, 
195.5 	be made according to rates authorized under sections 256.969, subdivision 16, and 
195.6 	256B.0625, subdivision 34.
195.7 	(b) For an American Indian that enrolled in managed care, the commissioner must require 
195.8 	an MCO to ensure timely access to services available under the contract from IHCP providers 
195.9 	for an enrollee who is eligible to receive services. Timely access to services includes:
195.10 	(1) an MCO demonstrating it has sufficient Indian Health Care Providers (IHCP) 
195.11 	participating in the provider network;
195.12 	(2) an IHCP, whether in the network or not, must be paid:
195.13 	(i) at a rate negotiated between the MCO and the IHCP; and
195.14 	(ii) at a rate not less than the level and amount of payment that the MCO would pay for 
195.15 	the services to a participating provider that is not an IHCP;
195.16 	(3) making payment to all IHCPs in an MCO's network in a timely manner as required 
195.17 	for payment to practitioners in individual or group practices according to Code of Federal 
195.18 	Regulations, title 42, sections 447.45 and 447.46;
195.19 	(4) permitting an Indian enrolled in an MCO to choose an IHCP as the enrollee's primary 
195.20 	care provider participating as a network provider as long as the provider has the capacity 
195.21 	to provide the services;
195.22 	(5) permitting an Indian enrollee to obtain services covered under the contract from out 
195.23 	of network IHCPs for whom the enrollee is otherwise eligible to receive services; and
195.24 	(6) permitting an out-of-network IHCP to refer an Indian enrollee to a network provider.
195.25 	(c) In a state where timely access to covered services cannot be assured due to few or 
195.26 	no IHCPs, the MCO must be considered to have met the requirements of this section, if the 
195.27 	Indian enrollee is permitted access to an out of state IHCP or deemed to have good cause 
195.28 	for disenrollment.
195.29 	(d) When an IHCP is enrolled in medical assistance as a FQHC but not a participating 
195.30 	provider with the MCO, the IHCP must be paid an amount equal to the amount the MCO 
195.31 	would pay an FQHC within an MCO's network including any supplemental payment from 
196.1 	the commissioner to cover the difference in the amount the MCO paid and the amount the 
196.2 	IHCP FQHC would receive under FFS.
196.3 	(e) If an IHCP is not enrolled in medical assistance as a FQHC, regardless of an MCO's 
196.4 	participation in an MCO's network, the IHCP has the right to receive the encounter rate 
196.5 	published annually in the Federal Register by the IHS or if not published, the amount the 
196.6 	IHCP would receive if the services were provided under the commissioner's plan's FFS 
196.7 	methodology.
196.8 	(f) When the amount an ICHP receives from an MCO is less than the encounter rate, 
196.9 	the commissioner must pay a supplemental payment to the IHCP to cover the difference.
196.10 		Subd. 17.MCO subcontractual relationships. (a) The commissioner shall ensure that 
196.11 	all managed care organizations maintain ultimate responsibility for adhering to and otherwise 
196.12 	fully complying with all terms and conditions of an MCO's contract with the commissioner. 
196.13 	If an MCO chooses to delegate any of an MCO's responsibilities to a subcontractor, an 
196.14 	MCO must execute a valid contract between the MCO and an MCO's subcontractor. The 
196.15 	contract must be in writing and must specify:
196.16 	(1) the delegated activities or obligations, and related reporting responsibilities;
196.17 	(2) the subcontractor must perform the delegated activities and reporting responsibilities 
196.18 	specified, according to the MCO's contract obligations; and
196.19 	(3) the subcontractor must comply with all applicable Medicaid laws, regulations, 
196.20 	including applicable subregulatory guidance and contract provision.
196.21 	(b) The contract must either provide for revocation of the delegation of activities or 
196.22 	obligations, or specify other remedies and sanctions if the commissioner or the MCO 
196.23 	determines that the subcontractor failed to perform satisfactorily.
196.24 	(c) The commissioner, Centers for Medicare and Medicaid, Department of Health and 
196.25 	Human Services inspector general, comptroller general, or a designee has the right to audit, 
196.26 	evaluate, and inspect any books, records, contracts, computer or other electronic systems 
196.27 	of the subcontractor, or the subcontractor's contractor, that pertain to any aspect of services 
196.28 	and activities performed, or determination of amounts payable under the MCO's contract 
196.29 	with the commissioner.
196.30 	(d) The subcontractor will make available, for purposes of an audit, the subcontractor's 
196.31 	premises, physical facilities, equipment, books, records, contracts, and computer or other 
196.32 	electronic systems relating to the subcontractor's medical assistance enrollees. The right to 
197.1 	audit exists ten years from the final date of the contract or from the date of completion of 
197.2 	any audit, whichever is later.
197.3 	(e) If the commissioner, Centers for Medicare and Medicaid, or Department of Health 
197.4 	and Human Services inspector general determines that there is a reasonable possibility of 
197.5 	fraud or similar risk, the commissioner, Centers for Medicare and Medicaid, or Department 
197.6 	of Health and Human Services inspector general may inspect, evaluate, and audit the 
197.7 	subcontractor at any time.
197.8 		Subd. 18.Information requirements for enrollees and potential enrollees. (a) All 
197.9 	required information to enrollees and potential enrollees must be provided in a manner and 
197.10 	format that is easily understood and readily accessible. The information must be available 
197.11 	through the beneficiary support system, the department's Web site, and may link to individual 
197.12 	MCO Web sites with the required information including, at a minimum, the enrollee 
197.13 	handbook, the provider directory, and drug formulary.
197.14 	(b) The commissioner must ensure that MCOs provide each enrollee with:
197.15 	(1) an enrollee handbook, using the model provided by the department, within a 
197.16 	reasonable time after receiving notice of the beneficiary's enrollment. The handbook must 
197.17 	include information on benefits provided, how and where to access benefits, cost sharing, 
197.18 	how transportation is provided, and must, at a minimum, address other information required 
197.19 	by Code of Federal Regulations, title 42, section 438.10(g);
197.20 	(2) a provider directory that must include the provider's name, group affiliation, street 
197.21 	address, telephone number, Web site, specialty if applicable, whether the provider accepts 
197.22 	new enrollees, the provider's cultural and linguistic capabilities as identified in Code of 
197.23 	Federal Regulations, title 42, section 438.10(h), and whether the provider's office 
197.24 	accommodates people with disabilities. A provider directory must be provided for the 
197.25 	following provider types, physicians, specialists, hospitals, pharmacies, behavioral health 
197.26 	providers, and LTSS providers, as appropriate;
197.27 	(3) a formulary that includes both generic and name brand medications that are covered 
197.28 	and each medication tier;
197.29 	(4) written notice of termination of a contracted provider, within 15 calendar days after 
197.30 	receipt or issuance of the termination notice, to each enrollee who received and the enrollee's 
197.31 	primary care from, or was seen on a regular basis by, the terminated provider; and
197.32 	(5) the MCO's physician incentive plan, upon enrollee request.
198.1 	(c) The commissioner must provide the following information to each potential enrollee 
198.2 	to ensure an enrollee has sufficient information to make an informed selection on:
198.3 	(1) basic features of managed care;
198.4 	(2) whether a populations is excluded from enrollment, subject to mandatory enrollment, 
198.5 	or free to enroll voluntarily. For mandatory and voluntary populations, the length of the 
198.6 	enrollment period and all disenrollment opportunities available to the enrollee;
198.7 	(3) the service area covered by each MCO;
198.8 	(4) covered benefits, including benefits provided by the MCO and benefits provided 
198.9 	directly by the commissioner;
198.10 	(5) the provider directory and drug formulary;
198.11 	(6) cost sharing;
198.12 	(7) requirements for adequate access to network services, including network adequacy 
198.13 	standards;
198.14 	(8) an MCO's responsibility for coordination of enrollee care;
198.15 	(9) quality and performance indicators, including enrollee satisfaction for each MCO, 
198.16 	if available; and
198.17 	(10) information about the potential enrollee's right to disenroll according to Code of 
198.18 	Federal Regulations, title 42, section 438.56.
198.19 	(d) The commissioner and MCO must provide materials electronically to potential 
198.20 	enrollees and enrollees unless the enrollee requests the information in paper form. An 
198.21 	enrollee must be informed that the information is available in paper form without charge 
198.22 	upon request and must be provided within five business days of the request and mailed to 
198.23 	the enrollee's mailing address. Information provided electronically for potential enrollees 
198.24 	and enrollees must:
198.25 	(1) be readily accessible;
198.26 	(2) be placed in a prominent location on the commissioner's and MCO's Web site and 
198.27 	in a format that has the capability to be retained and printed;
198.28 	(3) if provided to the enrollee through e-mail, the MCO receive the enrollee's agreement 
198.29 	before providing the information by e-mail;
198.30 	(4) satisfy the requirements for content and language requirements according to Code 
198.31 	of Federal Regulations, title 42, section 438.10(d); and
199.1 	(5) inform the enrollee that the information is available on the Web site and includes 
199.2 	the applicable URL address in order to access the information. An enrollee with a disability 
199.3 	who cannot access the information online is provided auxiliary aids and services upon 
199.4 	request at no cost.
199.5 		Subd. 19.Language and accessibility standards. (a) Managed care contracts entered 
199.6 	into under sections 256B.69 and 256L.12 must require MCOs to provide language assistance, 
199.7 	auxiliary aids and services, to ensure meaningful access to an MCO's programs and services, 
199.8 	according to title VI of the Civil Rights Act, section 1557 of the Affordable Care Act, and 
199.9 	any other federal regulations or guidance from the United States Department of Health and 
199.10 	Human Services.
199.11 	(b) The commissioner must establish a methodology to identify the prevalent non-English 
199.12 	languages spoken by enrollees and potential enrollees throughout Minnesota and in each 
199.13 	MCO's service area.
199.14 	(c) The commissioner shall ensure that oral interpretation is provided in all languages 
199.15 	and written interpretation is provided in each prevalent non-English language and are 
199.16 	available to both enrollees and potential enrollees free of charge. Oral interpretation services 
199.17 	include the use of auxiliary aids, TTY/TDY, and American sign language.
199.18 	(d) Written materials that target potential enrollees must include "taglines" in an 18-point 
199.19 	font that explains the availability of interpretation services, and includes the toll-free 
199.20 	telephone number for the department's beneficiary support system.
199.21 	(e) All written materials, including a provider directory, enrollee handbook, an appeal 
199.22 	and grievance notice, and denial and termination notice, must:
199.23 	(1) be easily understood;
199.24 	(2) use at least 12-point font size;
199.25 	(3) be available in alternative formats and through the provision of auxiliary aids and 
199.26 	services that consider the special needs of the beneficiary, including a beneficiary with a 
199.27 	disability or limited English proficiency;
199.28 	(4) include taglines in an 18-point font that explains the availability of interpreter services 
199.29 	and how to request auxiliary aids and services, including the provision of the materials in 
199.30 	alternative formats and the TTY/TDY telephone number of the MCO's customer service 
199.31 	unit; and
199.32 	(5) notify a beneficiary on how to access the oral interpretation services, written 
199.33 	translations, and the auxiliary aids and services.
200.1 		Subd. 20.Enrollee communication. (a) The commissioner shall ensure, through contracts 
200.2 	with the MCOs, that the MCOs:
200.3 	(1) submit all marketing materials to the commissioner for approval before distribution;
200.4 	(2) distribute marketing materials to an MCO's entire service area and as otherwise 
200.5 	permitted by contract;
200.6 	(3) comply with the information requirements in Code of Federal Regulations, title 42, 
200.7 	section 438.10;
200.8 	(4) does not seek to influence enrollment with the sale or offering of any private 
200.9 	insurance;
200.10 	(5) does not directly, or indirectly, engage in door-to-door, telephone, e-mail, texting, 
200.11 	or other cold-call marketing activities;
200.12 	(6) marketing materials are accurate, do not mislead, confuse, or defraud a beneficiary 
200.13 	or the department.
200.14 		Subd. 21.State monitoring. (a) The commissioner must establish a monitoring system 
200.15 	that addresses all aspects of managed care programs including each MCO's performance 
200.16 	according to Code of Federal Regulations, title 42, section 438.66(b).
200.17 	(b) The commissioner must use data identified in Code of Federal Regulations, title 45, 
200.18 	section 438.66(c), collected from its monitoring activities to improve the performance of 
200.19 	its managed care program.
200.20 	(c) The commissioner is responsible to assess the readiness of each MCO with which it 
200.21 	contracts as follows:
200.22 	(1) before implementing a managed care program, whether an MCO is voluntary or 
200.23 	mandatory; or
200.24 	(2) if the specific MCO has not previously contracted with the commissioner; or
200.25 	(3) if an MCO currently contracting with the commissioner provides or arranges for the 
200.26 	provision of covered benefits to new eligibility groups.
200.27 	(d) The commissioner shall conduct a readiness review of each MCO that contracts with 
200.28 	the commissioner within the timelines and receives the Centers for Medicare and Medicaid 
200.29 	approval of the resulting contract or amendment.
201.1 	(e) The commissioner's readiness review must assess the areas defined in Code of Federal 
201.2 	Regulations, title 42, section 438.66(d), for the MCO's ability and capacity to perform 
201.3 	satisfactorily in each area.
201.4 	(f) Annually, no later than 180 days after the contract year, the commissioner must 
201.5 	submit a report on each managed care program administered by the commissioner regardless 
201.6 	of the authority that the program operates under, following the release of the Centers for 
201.7 	Medicare and Medicaid guidance. The report:
201.8 	(1) must provide assessment of the operation of the managed care program in the areas 
201.9 	identified in Code of Federal Regulations, title 42, section 438.66(e)(2);
201.10 	(2) may be substituted with the commissioner's obligation to report under the 
201.11 	commissioner's waiver authority for managed care program;
201.12 	(3) must be posted on the department's Web site;
201.13 	(4) must be provided to the Medical Care Advisory Committee according to Code of 
201.14 	Federal Regulations, title 42, section 431.12;
201.15 	(5) must be provided to the stakeholder consultation group according to Code of Federal 
201.16 	Regulations, section 438.70, to the extent the managed care program includes LTSS.
201.17 	(g) The commissioner must have in effect safeguards against conflict of interest on 
201.18 	behalf of state and local officers and employees and agents of the state who have 
201.19 	responsibilities relating to MCO contracts. The safeguards must be at least as effective as 
201.20 	the safeguards specified in section 27 of the Office of Federal Procurement Policy Act, 
201.21 	United States Code, title 41, section 423. The commissioner must comply with Code of 
201.22 	Federal Regulations, title 42, section 438.58, and section 1902(a)(4)(c) of the Social Security 
201.23 	Act applicable to contracting officers, employees, or independent contractors
201.24 		Subd. 22.Enrollee rights and protections. (a) The commissioner shall ensure that each 
201.25 	MCO, an MCO's employees, and contracted providers comply with applicable federal and 
201.26 	state laws that pertain to an enrollee's rights and that each MCO's employees and contracted 
201.27 	providers:
201.28 	(1) receive information according to Code of Federal Regulations, title 42, section 438.10;
201.29 	(2) be treated with respect and with due consideration for the enrollee's dignity and 
201.30 	privacy;
201.31 	(3) receive information on available treatment options and alternatives, presented in a 
201.32 	manner appropriate to the beneficiary's condition and ability to understand;
202.1 	(4) participate in decisions regarding the enrollee's health care, including the right to 
202.2 	refuse treatment;
202.3 	(5) be free from any form of restraint or seclusion used as a means of coercion, discipline, 
202.4 	convenience, or retaliation, as specified in other federal regulations on the use of restraints 
202.5 	and seclusion;
202.6 	(6) receive a copy of the enrollee's medical records, and request that the records be 
202.7 	corrected, according to Code of Federal Regulations, title 45, sections 164.524 and 164.526;
202.8 	(7) receive health care services according to Code of Federal Regulations, title 42, 
202.9 	sections 438.206 to 438.210.
202.10 	(b) The commissioner shall ensure that each enrollee is free to exercise the enrollee's 
202.11 	rights, and that the exercise of the enrollee's rights does not adversely affect the way the 
202.12 	MCO, the MCO's network providers, or the state Medicaid agency treats the enrollee.
202.13 	(c) The commissioner shall ensure that the MCO complies with all federal and state 
202.14 	antidiscrimination laws and regulations. An MCO that contracts with the commissioner 
202.15 	cannot discriminate or use any policy that has the effect of discriminating against people 
202.16 	on the basis of medical condition, health status, receipt of health care services, claims 
202.17 	experience, medical history, genetic information, disability, including mental or physical 
202.18 	impairment, marital status, age, race, color, religion, creed, national origin, sex, including 
202.19 	sex stereotypes and gender identity, sexual orientation, political beliefs, or public assistance 
202.20 	status.
202.21 	(d) The commissioner must ensure, through contracts with the MCO, that for medical 
202.22 	records and any other health and enrollment information that identifies a particular enrollee, 
202.23 	each MCO uses and discloses individually identifiable health information according to the 
202.24 	privacy requirements in Code of Federal Regulations, title 45, parts 160 and 164, subparts 
202.25 	A and E, to the extent that these requirements are applicable.
202.26 		Subd. 23.Liability for payment. (a) The commissioner shall require that the MCO 
202.27 	ensure the enrollee is held harmless of payment liability for covered services provided to 
202.28 	the enrollee, if:
202.29 	(1) MCO debt in the event of insolvency;
202.30 	(2) lack of payment to the MCO;
202.31 	(3) lack of payment to the provider by the MCO or the commissioner for services 
202.32 	furnished under a contract, referral, or other arrangement; or
203.1 	(4) payments for services covered under the contract, referral, or other arrangement, to 
203.2 	the extent that those payments are in excess of the amount that the enrollee would owe if 
203.3 	the MCO covered the services directly.
203.4 	(b) An MCO may limit any reimbursement an MCO may be required to pay to a provider 
203.5 	for services to a beneficiary not enrolled in the MCO.
203.6 	(c) An MCO must comply with the standards for claims settlement under section 72A.201, 
203.7 	subdivisions 4, 5, 7, and 8, if contracting with other health care and social service 
203.8 	practitioners to provide services to enrollees. An MCO must pay a clean claim, as defined 
203.9 	in Code of Federal Regulations, title 42, section 447.45(b), within 30 business days of the 
203.10 	date of acceptance of the claim.
203.11 		Subd. 24.Cost sharing. (a) The commissioner may impose cost sharing according to 
203.12 	Code of Federal Regulations, title 42, sections 447.50 through 447.57, and may set limits 
203.13 	or waive the cost sharing for specific population groups.
203.14 	(b) The commissioner must exempt from cost sharing an American Indian who receives 
203.15 	or has received an item or service furnished by Indian Health Services 638 facilities, IHCP, 
203.16 	or through referral under contract health services according to Code of Federal Regulations, 
203.17 	title 42, section 447.56(a)(1)(x).
203.18 		Subd. 25.Provider enrollee communications. (a) The commissioner shall ensure the 
203.19 	managed care organizations do not prohibit, or otherwise restrict, an MCO provider, who 
203.20 	is acting within the lawful scope of the provider's practice, from advising or advocating on 
203.21 	behalf of the enrollee regarding:
203.22 	(1) the enrollee's health status, medical care, or treatment options, including any 
203.23 	alternative treatment that may be self-administered;
203.24 	(2) any information the enrollee needs to decide among all relevant treatment options;
203.25 	(3) the risks, benefits, and consequences of treatment or nontreatment; or
203.26 	(4) the enrollee's right to participate in decisions regarding the enrollee's health care, 
203.27 	including the right to refuse treatment, and to express preferences about future treatment 
203.28 	decisions.
203.29 	(b) The commissioner must ensure that the MCO inform enrollees of how and where to 
203.30 	obtain any services excluded by MCOs on the basis of moral or religious grounds. The 
203.31 	enrollee notification must satisfy the requirements in Code of Federal Regulations, title 42, 
203.32 	section 438.102(b).
204.1 		Subd. 26.Stakeholder and enrollee engagement. (a) The commissioner shall establish 
204.2 	a stakeholder group to solicit the views of beneficiaries, individuals representing 
204.3 	beneficiaries, providers, and other stakeholders to provide advice on managed care programs 
204.4 	for persons using LTSS. The stakeholder group shall provide advice on:
204.5 	(1) design and implementation efforts;
204.6 	(2) consumer protections; and
204.7 	(3) oversight of the LTSS program, including quality assurance measures, data collection 
204.8 	and reporting, and evaluation of costs, quality, and results.
204.9 	(b) Each MCO under contract shall establish and maintain an enrollee advisory committee 
204.10 	that includes a representative sample of the LTSS population and other individuals 
204.11 	representing this population.
204.12 		Subd. 27.Covered services. (a) The commissioner must ensure that all services covered 
204.13 	under the state plan are available and accessible to each enrollee of the MCOs. The MCO 
204.14 	shall authorize and arrange for the provision of all medically necessary health services, and 
204.15 	unless otherwise specified by law or contract, the MCO is exempt from the commissioner's 
204.16 	authorization requirements.
204.17 	(b) An MCO's provider network must meet the standards developed by the commissioner 
204.18 	according to Code of Federal Regulations, title 42, section 438.68, and an MCO must meet 
204.19 	the following requirements:
204.20 	(1) maintain and monitor a network of appropriate providers that are supported by written 
204.21 	agreements and sufficient to provide adequate access to all services covered under the 
204.22 	contract for each enrollee;
204.23 	(2) provide female enrollees with direct access to a women's health specialist that provides 
204.24 	women's routine and preventive health services. This is in addition to the enrollee's designated 
204.25 	source of primary care if that source is not a women's health specialist;
204.26 	(3) provide for a second medical opinion from a network provider unless otherwise not 
204.27 	available within the network or required by state law, at no cost to the enrollee;
204.28 	(4) adequately and timely provide covered services for an enrollee out of network for 
204.29 	as long as the MCO provider network is unable to provide them;
204.30 	(5) require an out-of-network provider coordinate with the MCO for payment and ensure 
204.31 	that the cost to the enrollee is no greater than the cost would be if the services were furnished 
204.32 	within the MCO's network;
205.1 	(6) provide to the commissioner the MCO's documented process for credentialing and 
205.2 	recredentialing of the MCO's network providers according to Code of Federal Regulations, 
205.3 	title 42, section 438.206(b)(6); and
205.4 	(7) ensure that the MCO's network includes sufficient family planning providers for 
205.5 	timely access to covered services.
205.6 	(c) The commissioner shall ensure through contracts that the managed care organization 
205.7 	is responsible for payment of emergency and post stabilization services. The MCO must 
205.8 	cover and pay for emergency services regardless of whether the provider is within the 
205.9 	managed care organizations network.
205.10 	(d) The MCO may not deny payment for treatment obtained:
205.11 	(1) by an enrollee with an emergency medical condition as defined in subdivision 2; or
205.12 	(2) by an enrollee who was instructed to seek emergency services by a representative 
205.13 	of the MCO.
205.14 	The MCO may not limit what constitutes an emergency medical condition on the basis of 
205.15 	lists of diagnoses or symptoms or refuse to cover emergency services based on the emergency 
205.16 	room provider, hospital, or fiscal agent not notifying the MCO of the enrollee's screening 
205.17 	and treatment within ten calendar days of presentation for emergency services.
205.18 	(e) An enrollee who has an emergency medical condition must not be held liable for 
205.19 	payment of subsequent screening and treatment needed to diagnose the specific condition 
205.20 	or stabilize the enrollee.
205.21 	(f) The attending emergency physician, or provider treating the enrollee, is responsible 
205.22 	for determining when the enrollee is sufficiently stabilized for transfer or discharge, and 
205.23 	that determination is binding on the MCO for coverage and payment. Post stabilization care 
205.24 	services are covered and paid for by the MCO in accordance with the provisions in Code 
205.25 	of Federal Regulations, title 42, section 422.113(c).
205.26 	(g) The commissioner must have methods to promote access and delivery of services in 
205.27 	a culturally competent manner to each beneficiary, including a beneficiary with limited 
205.28 	English proficiency, diverse cultural and ethnic background, disability, and regardless of 
205.29 	gender, sexual orientation, or gender identity. The commissioner must ensure a beneficiary 
205.30 	has access to covered services that are delivered in a manner that meets the beneficiary's 
205.31 	needs.
206.1 	(h) The commissioner must ensure, through contracts, that each MCO meets the standards 
206.2 	for timely access, cultural competency, and accessibility according to Code of Federal 
206.3 	Regulations, title 42, section 438.206(c).
206.4 		Subd. 28.Adequate capacity and services assurances. (a) The MCO must provide 
206.5 	supporting documentation that an MCO has the capacity to serve the expected enrollment 
206.6 	in an MCO's service area according to Code of Federal Regulations, title 42, section 
206.7 	438.207(c), and ensure the commissioner that the MCO:
206.8 	(1) offers an appropriate range of preventive, primary care, specialty services, and LTSS; 
206.9 	and
206.10 	(2) maintains a network of providers that is sufficient in number, mix, and geographic 
206.11 	distribution.
206.12 	(b) After reviewing the MCO's submitted documentation the commissioner must submit 
206.13 	an assurance of compliance to the Centers for Medicare and Medicaid that the MCO meets 
206.14 	the requirements for availability of services according to Code of Federal Regulations, title 
206.15 	42, sections 438.68 and 438.206. The submission to the Centers for Medicare and Medicaid 
206.16 	must include an analysis that supports the assurance of the adequacy of the network for 
206.17 	each contracted MCO's provider network. The Centers for Medicare and Medicaid may 
206.18 	request all documentation collected by the commissioner from the MCO.
206.19 		Subd. 29.Coordination of services and continuity of care. (a) For each MCO that 
206.20 	serves an enrollee who is also enrolled in and receives Medicare benefits from a Medicare 
206.21 	advantage organization, the commissioner shall determine to what extent the MCO meets 
206.22 	the identification, assessment, and treatment planning provisions in this section for a dually 
206.23 	eligible enrollee.
206.24 	(b) The MCO must implement procedures to deliver care to and coordinate services for 
206.25 	each MCO enrollee, including the following:
206.26 	(1) an ongoing source of care appropriate to the enrollee's needs and a person or entity 
206.27 	formally designated as primarily responsible for coordinating the services;
206.28 	(2) coordination of the services the MCO furnishes to the enrollee between settings of 
206.29 	care, including appropriate discharge planning for short-term and long-term hospital and 
206.30 	institutional stays;
206.31 	(3) coordination with any covered services the enrollee receives through a different 
206.32 	managed care organization or on a fee-for-service basis; and
207.1 	(4) coordination with the services the enrollee receives from community and social 
207.2 	support providers.
207.3 	(c) The MCO must make a best effort to conduct an initial screening within 90 days of 
207.4 	enrollment for each enrollee.
207.5 	(d) The MCO must share with the commissioner or another MCO serving the enrollee 
207.6 	the results of any identification and assessment of the enrollee's needs to prevent duplicating 
207.7 	activities.
207.8 	(e) The MCO shall ensure that each provider furnishing services to an enrollee maintains 
207.9 	and shares an enrollee health record and in the process of coordinating care protecting each 
207.10 	enrollee's privacy according to Code of Federal Regulations, title 45, parts 160 and 164.
207.11 		Subd. 30.Additional services for enrollees with special health care needs or who 
207.12 	need LTSS. (a) The commissioner, or the commissioner's designee, must implement 
207.13 	mechanisms to identify persons who need LTSS or persons with special health care needs 
207.14 	to MCOs. The mechanisms must be identified in the commissioner's quality strategy.
207.15 	(b) The MCO must implement mechanisms to assess each identified enrollee needing 
207.16 	LTSS or having special health care needs that require a course of treatment or regular care 
207.17 	monitoring using appropriate providers or individuals for the assessment.
207.18 	(c) The MCO must produce a treatment or service plan for an enrollee who requires 
207.19 	LTSS and, if the commissioner requires, for an enrollee with special health care needs. The 
207.20 	treatment or service plan must:
207.21 	(1) be developed by an appropriate individual of LTSS services, with enrollee 
207.22 	participation, and with each provider caring for the enrollee;
207.23 	(2) be developed by a person trained in person-centered planning using a person-centered 
207.24 	process and plan as defined in Code of Federal Regulations, title 42, section 441.301(c)(1) 
207.25 	and (2);
207.26 	(3) be approved by the MCO, in a timely manner, if approval is required by the MCO;
207.27 	(4) comply with any applicable state quality assurance and utilization review standards; 
207.28 	and
207.29 	(5) be reviewed and revised upon reassessment of functional need, at least annually, or 
207.30 	if the enrollee's circumstances or needs change significantly, or at the request of the enrollee 
207.31 	according to Code of Federal Regulations, title 42, section 441.301(c)(3).
208.1 	(d) The MCO must have a mechanism to allow an enrollee with special health care needs 
208.2 	to directly access a specialist, through a standing referral or approved number of visits, as 
208.3 	appropriate for the enrollee's condition and identified needs.
208.4 		Subd. 31.Coverage and authorization of services. (a) The commissioner must ensure 
208.5 	that all contracts with the MCOs identify, define, and specify the amount, duration, and 
208.6 	scope of each covered service and are furnished in an amount, duration, and scope that is 
208.7 	no less than what is provided under FFS Medicaid.
208.8 	(b) The MCO must ensure that the covered services are sufficient in amount, duration, 
208.9 	or scope to reasonably achieve the purpose for the services and must not arbitrarily deny 
208.10 	or reduce the amount, duration, or scope solely because of diagnosis, type of illness, or 
208.11 	condition of the enrollee.
208.12 	(c) The commissioner shall permit the MCO to limit a service based on criteria applied 
208.13 	under the state plan, including but not limited to medical necessity or utilization control if 
208.14 	the service meets the criteria in Code of Federal Regulations, title 42, section 438.210(a)(4).
208.15 	(d) The commissioner shall identify in the MCO contract what constitutes medically 
208.16 	necessary services that:
208.17 	(1) are no more restrictive than those used in medical assistance, including quantitative 
208.18 	and nonquantitative treatment limits, as indicated in state statutes and regulations, the state 
208.19 	plan, or other state policies and procedures;
208.20 	(2) address the extent to which the MCO is responsible for covering services that address 
208.21 	the criteria in Code of Federal Regulations, title 42, section 438.210(a)(5)(ii).
208.22 	(e) The commissioner must ensure the MCO contract requires the MCO and an MCO's 
208.23 	subcontractors to have and follow written policies and procedures on processing requests 
208.24 	for initial and continuing authorization of services. The MCO must:
208.25 	(1) ensure consistent application of review criteria for authorization decisions;
208.26 	(2) consult with the requesting provider for medical services, if appropriate;
208.27 	(3) authorize LTSS based on an enrollee's current needs assessment and consistent with 
208.28 	the person-centered service plan; and
208.29 	(4) notify the requesting provider and the enrollee of any decision of the MCO to deny 
208.30 	a service authorization or to authorize the service in an amount, duration, or scope that is 
208.31 	less than requested.
209.1 	(f) Any decision to deny a service authorization request or to authorize a service in an 
209.2 	amount, duration, or scope that is less than requested, by an individual who has appropriate 
209.3 	expertise in addressing the enrollee's medical behavioral health or long-term services and 
209.4 	support needs.
209.5 	(g) The MCO contract must include time frames for standard authorizations that are ten 
209.6 	business days following the receipt of the request and no later than 72 hours of a receipt for 
209.7 	an expedited authorization. For both standard and expedited authorizations the MCO may 
209.8 	extend the time frame 14 additional calendar days, if the enrollee or a provider requests an 
209.9 	extension. Upon a request from the commissioner the MCO must justify the need for 
209.10 	additional information and how the extension is in the enrollee's best interest.
209.11 	(h) For all covered outpatient drug authorization decisions, provide notice within 24 
209.12 	hours of a request according to section 1927(d)(5)(A) of the Social Security Act.
209.13 	(i) The contract must ensure that compensation to an individual or entity that conducts 
209.14 	utilization management activities is not structured to provide incentives for the individual 
209.15 	or entity to deny, limit, or discontinue medically necessary services to an enrollee.
209.16 	(j) The commissioner shall require that managed care organizations use the assessment 
209.17 	and authorization processes, forms, timelines, standards, documentation, and data reporting 
209.18 	requirements, protocols, billing processes, and policies consistent with medical assistance 
209.19 	fee-for-service or the Department of Human Services contract requirements consistent with 
209.20 	medical assistance fee-for-service or the Department of Human Services contract 
209.21 	requirements for all personal care assistance services under section 256B.0659.
209.22 		Subd. 32.Prescription drugs. The commissioner may exclude or modify coverage for 
209.23 	prescription drugs from the prepaid managed care contracts entered into under this section 
209.24 	to increase savings to the commissioner by collecting additional prescription drug rebates. 
209.25 	The contracts must maintain incentives for the managed care plan to manage drug costs and 
209.26 	utilization and may require that the managed care plans maintain an open drug formulary. 
209.27 	To manage drug costs and utilization, a contract must authorize the managed care 
209.28 	organizations to use preferred drug lists and prior authorization. This subdivision is contingent 
209.29 	on federal approval of the managed care contract changes and the collection of additional 
209.30 	prescription drug rebates. A contracted MCO must comply with the standards in section 
209.31 	1927 of the Social Security Act.
209.32 		Subd. 33.Additional and in lieu of services. (a) An MCO may choose to provide 
209.33 	services in addition to services required under the terms of the contract. If an MCO chooses 
210.1 	to provide an enrollee eligible for medical assistance with additional services, the cost of 
210.2 	the additional services cannot be included in determining the capitated payment rate.
210.3 	(b) An MCO may provide any service necessary to comply with the Mental Health Parity 
210.4 	Act, Code of Federal Regulations, title 42, section 438.910.
210.5 	(c) An MCO may cover services or settings that are in lieu of services and settings 
210.6 	covered under the state plan as follows:
210.7 	(1) medically appropriate and cost-effective substitute for the covered service or setting 
210.8 	under the state plan;
210.9 	(2) the enrollee is not required by the MCO to use the alternative service or setting;
210.10 	(3) authorized and identified in the MCO contract and must be offered to enrollees at 
210.11 	the option of the MCO; and
210.12 	(4) the utilization and actual cost of the in lieu of service is considered in developing 
210.13 	the component of the capitation rates that represents the covered date plan service.
210.14 		Subd. 34.Prohibition of additional payments for services covered under the MCO 
210.15 	contract. The commissioner must ensure that no payment is made to a network provider 
210.16 	other than by the MCO for services covered under the MCO's contract with the commissioner, 
210.17 	except when payments by the commissioner are required to be made according to title XIX 
210.18 	of the Social Security Act, or if the commissioner makes direct payments to network 
210.19 	providers for graduate medical education costs approved under the state plan.
210.20 		Subd. 35.Quality assessment and performance improvement program. (a) The 
210.21 	commissioner must require the managed care organizations to establish and implement an 
210.22 	ongoing comprehensive quality assessment and performance improvement program for the 
210.23 	services furnished to medical assistance enrollees according to Code of Federal Regulations, 
210.24 	title 42, section 438.330(b).
210.25 	(b) The commissioner shall ensure that the MCO conduct performance improvement 
210.26 	projects that focus on both clinical and nonclinical measures, designed to achieve significant 
210.27 	improvement, sustained over time, in health outcomes and enrollee satisfaction and must 
210.28 	meet the elements in Code of Federal Regulations, title 42, section 438.330(d)(2).
210.29 	(c) The commissioner may permit an MCO exclusively serving dual eligible enrollees 
210.30 	to substitute a Medicare Advantage organization quality improvement project for one or 
210.31 	more of the required performance improvement projects.
211.1 	(d) The commissioner, or the Centers for Medicare and Medicaid, may identify standard 
211.2 	performance measures including measures relating to quality of life, rebalancing, and 
211.3 	community integration activities for enrollees receiving long term services and supports.
211.4 	(e) The MCOs must annually measure and report on the MCO's performance using the 
211.5 	standard measures as required by the commissioner and submit the data to the commissioner 
211.6 	to calculate the MCO's performance.
211.7 	(f) The commissioner shall review annually the impact and the effectiveness of the 
211.8 	quality assessment and performance improvement program of each MCO, outcomes and 
211.9 	trended results of the MCO performance improvement projects, and identify the results of 
211.10 	any efforts to support community integration for an enrollee using LTSS.
211.11 	(g) The commissioner shall ensure, through contracts with MCOs, that each MCO adopt 
211.12 	practice guidelines that satisfy Code of Federal Regulations, title 42, section 438.236(b), 
211.13 	and disseminate the guidelines to each affected provider and upon request, to an enrollee 
211.14 	or potential enrollee.
211.15 		Subd. 36.MCO health information system. (a) The commissioner shall ensure the 
211.16 	MCOs maintain a health information system that collects, analyzes, integrates, and reports 
211.17 	data. The systems must provide information on areas including but not limited to utilizations, 
211.18 	claims, grievances and appeals, and enrollments and disenrollments.
211.19 	(b) The commissioner shall require each MCO to collect data elements necessary to 
211.20 	enable the mechanized claims processing retrieval systems operated by the commissioner 
211.21 	according to section 1903(r)(1)(f) of the Social Security Act.
211.22 	(c) Collect data on enrollee and provider characteristics and on all services furnished to 
211.23 	enrollees through an encounter data system or other methods as specified by the 
211.24 	commissioner. The MCO must ensure that data received from a provider is accurate and 
211.25 	complete, verifying the accuracy and timeliness of the reported data and screening the data 
211.26 	for completeness, logic, and consistency.
211.27 	(d) Collecting data from a provider in a standardized format to the extent feasible and 
211.28 	appropriate, including secure information exchanges and technologies utilized for medical 
211.29 	assistance quality improvement and care coordination efforts.
211.30 	(e) Make all collected data available to the commissioner and upon request to the Centers 
211.31 	for Medicare and Medicaid.
211.32 	(f) The commissioner must ensure through contract with MCOs that an MCO provides 
211.33 	for:
212.1 	(1) collection and maintenance of sufficient enrollee encounter data to identify the 
212.2 	provider who delivers any items or services to enrollees;
212.3 	(2) submission of enrollee encounter data to the commissioner at a frequency and level 
212.4 	of detail to be specified by the Centers for Medicare and Medicaid and the commissioner, 
212.5 	based on program administration, oversight, and program integrity needs;
212.6 	(3) submission of all enrollee encounter data to the commissioner that satisfies Code of 
212.7 	Federal Regulations, title 42, section 438.818. Federal financial participation is available 
212.8 	if the commissioner meets the requirements for providing enrollee encounter data to the 
212.9 	Centers for Medicare and Medicaid.
212.10 	(4) specifications for submitting encounter data to the commissioner in standardized 
212.11 	ASC X12 N837 and NCPDP formats, and the ASC X12 N8355 format.
212.12 	(g) The commissioner must establish procedures and quality assurance protocols to 
212.13 	review and validate the encounter data collected, maintained, and submitted to the 
212.14 	commissioner, and is a complete and accurate representation of the services provided to 
212.15 	enrollees under the contract between the commissioner and MCO.
212.16 		Subd. 37.Accreditation status of MCOs. (a) Each MCO shall notify the commissioner 
212.17 	whether the MCO was accredited by a private independent accrediting entity. The MCO 
212.18 	must authorize the accrediting entity to provide the commissioner with a copy of the MCO's 
212.19 	most recent accreditation review. The accreditation review must include:
212.20 	(1) the accreditation status, survey type, and level, if applicable;
212.21 	(2) accreditation results, including recommended actions or improvements, corrective 
212.22 	action plans, and summaries of findings; and
212.23 	(3) the expiration date of the accreditation.
212.24 	(b) Annually, the commissioner must make available on the department's Web site 
212.25 	whether an MCO was accredited, and if applicable, the name of the accrediting entity, 
212.26 	accreditation program, and accreditation level.
212.27 		Subd. 38.Quality rating system. (a) The commissioner shall adopt and implement a 
212.28 	Medicaid managed care quality rating system developed by the Centers for Medicare and 
212.29 	Medicaid within three years of the date of a final notice being published in the Federal 
212.30 	Register. The commissioner may submit a request to the Centers for Medicare and Medicaid 
212.31 	to use an alternative Medicaid managed care quality rating system that utilizes different 
212.32 	performance measures or applies a different methodology from that published in the Federal 
212.33 	Register provided that:
213.1 	(1) the ratings generated by the alternative Medicaid managed care quality rating system 
213.2 	must yield information regarding the MCO performance that is substantially comparable 
213.3 	to the information yielded by the Centers for Medicare and Medicaid system published in 
213.4 	the Federal Register; and
213.5 	(2) the commissioner receives the Centers for Medicare and Medicaid approval, before 
213.6 	implementing, the quality rating system or modifications.
213.7 	(b) Before submitting for the Centers for Medicare and Medicaid approval, the 
213.8 	commissioner:
213.9 	(1) must obtain input from the Medical Care Advisory Committee; and
213.10 	(2) provide an opportunity for public comment of at least 30 days on the proposed 
213.11 	alternative Medicaid managed care quality rating system or modification; and
213.12 	(3) must document in the commissioner's request for approval comments received from 
213.13 	the public and the Medical Care Advisory Committee and explain any revisions made in 
213.14 	response to comments and rationale for comments not accepted.
213.15 	(c) Once the quality rating system has been implemented, each year the commissioner 
213.16 	must collect data from each MCO and issue an annual quality rating for each MCO based 
213.17 	on the data collected, using the quality rating system that was adopted. Annually, the 
213.18 	commissioner must prominently display the quality rating given by the commissioner to 
213.19 	each MCO on the department's Web site.
213.20 		Subd. 39.State-managed care quality strategy. (a) The commissioner must draft and 
213.21 	implement a written quality strategy for accessing and improving the quality of health care 
213.22 	and services provided by the MCOs. At a minimum, the quality strategy must include the 
213.23 	following:
213.24 	(1) the commissioner's defined network adequacy and availability of services standards 
213.25 	for MCOs and examples of evidence-based clinical practice guidelines;
213.26 	(2) the goals and objectives for continuous quality improvement that are measurable 
213.27 	and consider the health status of all populations in Minnesota served by the MCO;
213.28 	(3) a description of:
213.29 	(i) the quality metrics and performance targets used in measuring the performance and 
213.30 	improvement of each MCO;
213.31 	(ii) the quality measures and performance outcomes that must be annually published on 
213.32 	the department's Web site; and
214.1 	(iii) the performance improvement projects including a description of any interventions 
214.2 	the commissioner proposes to improve access, quality, or timeliness of care for enrollees;
214.3 	(4) annual, external independent reviews, of the quality outcomes and timelines of, and 
214.4 	access to, the services covered by an MCO;
214.5 	(5) a description of the transition of care policy;
214.6 	(6) the commissioner's plan to identify, evaluate, and reduce, to the extent practicable, 
214.7 	health disparities based on age, race, ethnicity, sex, primary language, and disability status, 
214.8 	and must provide this demographic information to the MCO at the time of enrollment;
214.9 	(7) appropriate use of intermediate sanctions imposed on a managed care organization;
214.10 	(8) the mechanisms implemented to identify persons who need LTSS or persons with 
214.11 	special health care needs; and
214.12 	(9) information related to nonduplication of the external quality review activities found 
214.13 	in Code of Federal Regulations, title 42, section 438.360(c).
214.14 	(b) In drafting or revising the quality strategy, the commissioner must:
214.15 	(1) make the strategy available for public comment before submitting to the Centers for 
214.16 	Medicare and Medicaid for review;
214.17 	(2) obtain input from the Medical Care Advisory Committee, beneficiaries, and other 
214.18 	stakeholders; and
214.19 	(3) if an Indian enrolls in the MCO, consult with the tribes according to the tribal 
214.20 	consultation policy;
214.21 	(4) review and update the quality strategy as needed, but no less than once every three 
214.22 	years;
214.23 	(5) evaluate the effectiveness of the quality strategy conducted within the previous three 
214.24 	years;
214.25 	(6) make the results of the review available on the department's Web site;
214.26 	(7) must consider the recommendations from the External Quality Review Organization 
214.27 	for improving the quality of health care services furnished by the MCO;
214.28 	(8) submit a copy of the initial strategy to the Centers for Medicare and Medicaid for 
214.29 	comment and feedback before adopting the initial strategy as final;
214.30 	(9) a copy of the revised strategy whenever significant changes are made; and
215.1 	(10) make the final quality strategy available on the department's Web site.
215.2 		Subd. 40.External quality reviews. (a) The commissioner shall ensure that an annual 
215.3 	external quality review (EQR) is conducted of each managed care organization by an external 
215.4 	quality review organization (EQRO) that satisfies Code of Federal Regulations, title 42, 
215.5 	section 438.354.
215.6 	(1) The commissioner must contract with one EQRO to conduct the EQR and may 
215.7 	contract with the same EQRO or other EQROs to perform other EQR-related activities. The 
215.8 	information provided to the EQRO for the EQRO's review is obtained according to Code 
215.9 	of Federal Regulations, title 42, section 438.352.
215.10 	(2) The EQRO is permitted to use subcontractors that must meet the requirements for 
215.11 	independence, but the EQRO is accountable for and must oversee all subcontractor functions.
215.12 	(3) The commissioner must follow an open, competitive procurement process according 
215.13 	to state and federal law for any contract with an EQRO.
215.14 	(b) The commissioner, the commissioner's agent, or an EQRO may perform the mandatory 
215.15 	and optional EQR activities. The following mandatory EQR-related activities must be 
215.16 	performed for each MCO:
215.17 	(1) using the preceding 12 months, validation of performance improvement projects, 
215.18 	performance measures, and network adequacy, including compliance with a sufficient 
215.19 	number of IHCPs that ensure timely access to services from these providers, if Indians are 
215.20 	enrolled; and
215.21 	(2) review of the MCO's compliance with Code of Federal Regulations, title 42, Subpart 
215.22 	D and section 438.330 for the preceding three years.
215.23 	(c) The commissioner may elect to incorporate any optional activity listed in Code of 
215.24 	Federal Regulations, title 42, section 438.358(c) in the EQR. The commissioner may grant 
215.25 	the EQRO permission to provide technical assistance to the MCOs related to the mandatory 
215.26 	and optional activities included in the EQR.
215.27 	(e) The commissioner may use information from a Medicare or private accreditation 
215.28 	review of an MCO to provide information for the annual EQR instead of conducting one 
215.29 	or more of the mandatory EQR activities to avoid duplication. This information must satisfy 
215.30 	Code of Federal Regulations, title 42, section 438.360(a)(1) to (3), to meet the nonduplication 
215.31 	standard.
215.32 	(f) The commissioner must ensure that all information is furnished to the EQRO for 
215.33 	analysis and inclusion in the EQR technical report.
216.1 	(g) The commissioner may accept the data, correspondence, information, and findings 
216.2 	pertaining to the MCO's compliance with a Medicare quality review if the conditions in 
216.3 	Code of Federal Regulations, title 42, section 438.362, are met in lieu of performing an 
216.4 	EQR.
216.5 	(h) The commissioner must obtain from each MCO that the commissioner exempts from 
216.6 	EQR the most recent Medicare review findings or Medicare information from a private 
216.7 	national accrediting organization that the Centers for Medicare and Medicaid approves and 
216.8 	recognizes for Medicare Advantage Organization deeming.
216.9 	(i) The commissioner must contract with a qualified EQRO to produce an annual EQR 
216.10 	technical report that satisfies Code of Federal Regulations, title 42, section 438.364. The 
216.11 	content of the final EQR report may be revised if there is evidence of error or omission. 
216.12 	The commissioner must post the final technical report to the department's Web site by April 
216.13 	30 of each year. The technical report must summarize findings on access and quality of care 
216.14 	and must make copies of the information available upon request and available in alternative 
216.15 	formats. Information in the report may not disclose the identity or other protected health 
216.16 	information of any enrollee.
216.17 		Subd. 41.Appeals and grievance system. (a) Each MCO must have a grievance and 
216.18 	appeals system for enrollees. An enrollee may file a grievance and request an appeal with 
216.19 	the MCO. The MCO may only offer one level of appeal to enrollees. An enrollee may 
216.20 	request a state fair hearing only after receiving written notice of resolution on the enrollee's 
216.21 	appeal from the MCO, or after the enrollee was deemed to have exhausted the MCO's 
216.22 	appeals process, meaning the MCO has failed to adhere to the notice and timing requirements. 
216.23 	An enrollee is not allowed to request a state fair hearing based on the MCO's resolution of 
216.24 	a grievance.
216.25 	(b) With the enrollee's written consent, the provider or authorized representative may 
216.26 	file an appeal or grievance or request a state fair hearing on behalf of an enrollee. When the 
216.27 	term enrollee is used throughout Code of Federal Regulations, title 42, sections 438.400 to 
216.28 	438.424, it includes providers and authorized representatives with the exception that providers 
216.29 	cannot request continuation of benefits.
216.30 	(c) The commissioner may offer and arrange for an external medical review if the review:
216.31 	(1) is at the enrollee's option and the review must not be required before or used as a 
216.32 	deterrent to proceed to a state fair hearing;
216.33 	(2) is independent of the department and MCO;
217.1 	(3) is offered to the enrollee at no cost to the enrollee; and
217.2 	(4) does not extend any time frame for resolution and does not disrupt the continuation 
217.3 	of benefits.
217.4 	(d) An enrollee may file a grievance at any time either orally or in writing with the MCO.
217.5 	(e) An enrollee must file an appeal with the MCO within 60 calendar days from the date 
217.6 	on the adverse benefit determination notice. An enrollee may file an appeal with the MCO 
217.7 	orally or in writing. Unless the enrollee requested an expedited appeal, the enrollee must 
217.8 	follow an oral appeal with a written, signed appeal.
217.9 		Subd. 42.Timely and adequate notice of adverse benefit determination. (a) An MCO 
217.10 	must give enrollees timely and adequate notice of an adverse benefit determination in writing 
217.11 	consistent this section and Code of Federal Regulations, title 42, section 438.10.
217.12 	(b) The adverse benefit determination notice must contain the following:
217.13 	(1) the adverse benefit determination the MCO made or intends to make;
217.14 	(2) the reasons for the adverse benefit determination, including but not limited to medical 
217.15 	necessity criteria. An enrollee may request, free of charge, reasonable access to and copies 
217.16 	of all documents and records relevant to the enrollee's adverse benefit determination;
217.17 	(3) the enrollee's right to request an appeal of the MCO's adverse benefit determination, 
217.18 	including information about exhausting the MCO's one level of appeal and the enrollee's 
217.19 	right to request a state fair hearing;
217.20 	(4) the procedures for exercising the rights specified in this section;
217.21 	(5) a description of when an appeal can be expedited and how to request an expedited 
217.22 	appeal; and
217.23 	(6) the enrollee's right to have benefits continue pending resolution of the appeal, how 
217.24 	to request continued benefits, and the circumstances under which the enrollee may be 
217.25 	required to pay for the cost of continued benefits.
217.26 	(c) The MCO must mail the notice of adverse benefit determination to the enrollee or 
217.27 	the enrollee's authorized representative according to the following:
217.28 	(1) termination, suspension, or reduction of previously authorized covered services, the 
217.29 	notice of adverse benefit determination must be mailed at least ten days before the proposed 
217.30 	date of termination, suspension, or reduction, unless the MCO satisfies an exception in Code 
217.31 	of Federal Regulations, title 42, section 431.213;
218.1 	(2) denial of payment, at the time of any action affecting the claim; and
218.2 	(3) a standard service authorization decision that denies or limits services, within ten 
218.3 	calendar days from the date the MCO receives the enrollee's request for the service.
218.4 	(d) If the MCO extends the time frame 14 calendar days, the MCO must:
218.5 	(1) provide the enrollee written notice of the reason for the decision to extend the time 
218.6 	frame and inform the enrollee of the right to file a grievance if the enrollee disagrees with 
218.7 	the decision; and
218.8 	(2) issue and carry out the determination as expeditiously as the enrollee's health condition 
218.9 	requires and no later than the date the extension expires.
218.10 	(e) A service authorization decision not made within the required time frame, constitutes 
218.11 	a denial and is an adverse benefit determination by the MCO. For expedited service 
218.12 	authorization decisions within 72 hours from the time of the request.
218.13 	(f) The commissioner must conduct random reviews of each MCO and the MCO's 
218.14 	providers or subcontractors delegated for the responsibility of sending the notice of adverse 
218.15 	benefit determination to ensure that the MCOs are notifying enrollees in a timely manner.
218.16 		Subd. 43.Handling of grievances and appeals. (a) The MCO must give an enrollee 
218.17 	reasonable assistance for filing a grievance or an appeal, including assistance completing 
218.18 	required forms and other required procedural steps. The MCO must provide auxiliary aids 
218.19 	and services upon request, including interpreter services and toll-free TTY/TTD, and 
218.20 	interpreter capability.
218.21 	(b) The MCO must acknowledge the receipt of each grievance and appeal.
218.22 	(c) The MCO must ensure that the individuals who make decisions on grievances and 
218.23 	appeals are individuals:
218.24 	(1) who were neither involved in any previous level of review or decision-making nor 
218.25 	a subordinate of any such individual;
218.26 	(2) who have the appropriate clinical expertise in treating the enrollee's condition or 
218.27 	disease if deciding:
218.28 	(i) an appeal of a denial that is based on lack of medical necessity;
218.29 	(ii) a grievance regarding denial of expedited resolution of an appeal; or
218.30 	(iii) a grievance or appeal that involves clinical issues; and
219.1 	(3) who consider all comments, documents, records, and other information submitted 
219.2 	by the enrollee or the enrollee's representative without regard to whether the information 
219.3 	was submitted or considered in the initial adverse benefit determination.
219.4 	(d) The MCO must provide that oral inquiries seeking to appeal an adverse benefit 
219.5 	determination are treated as appeals to establish the earliest possible filing date for the 
219.6 	appeal.
219.7 	(e) The MCO must provide the enrollee with a reasonable opportunity, in person and in 
219.8 	writing, to present evidence and testimony and make legal and factual arguments. The MCO 
219.9 	must provide the enrollee sufficient notice of the time frame for resolution for appeals, 
219.10 	including expedited appeals.
219.11 	(f) The MCO must provide the enrollee and the enrollee's representative with the enrollee's 
219.12 	case file, including medical records, other documents, and any new or additional evidence 
219.13 	considered, relied upon, or generated by the MCO for the appeal. This information must be 
219.14 	provided free of charge and sufficiently in advance of the resolution time frame for appeals.
219.15 	(g) The MCO must include the following as parties to the appeal:
219.16 	(1) the enrollee and the enrollee's representative; or
219.17 	(2) the legal representative of a deceased enrollee's estate.
219.18 		Subd. 44.Resolution and notification of grievances and appeals. (a) The MCO must 
219.19 	resolve each grievance and appeal, and provide notice of resolution, as expeditiously as the 
219.20 	enrollee's health condition requires within the following time frames:
219.21 	(1) for grievances, within 90 calendar days from the day the MCO receives the grievance;
219.22 	(2) for standard appeals, within 30 calendar days from the day the MCO receives the 
219.23 	appeal; and
219.24 	(3) for expedited appeals, within 72 hours from the time the MCO receives the expedited 
219.25 	appeal.
219.26 	(b) The MCO may extend the time frame for standard and expedited appeals by an 
219.27 	additional 14 calendar days, if:
219.28 	(1) the enrollee requests the extension; or
219.29 	(2) the MCO justifies to the commissioner that there is a need for additional information 
219.30 	and that the delay is in the enrollee's interest.
219.31 	(c) If the extension is not at the request of the enrollee, the MCO must:
220.1 	(1) make reasonable efforts to give the enrollee prompt oral notice of the delay;
220.2 	(2) within two calendar days give the enrollee written notice of the decision to extend 
220.3 	the time frame and if the enrollee disagrees with that decision inform the enrollee of the 
220.4 	right to file a grievance; and
220.5 	(3) resolve the appeal as expeditiously as the enrollee's health condition requires and no 
220.6 	later than the date the extension expires.
220.7 	(d) The commissioner must establish the method that the MCO must use to notify the 
220.8 	enrollee of the resolution of the grievance, and ensure that the notice meets the information 
220.9 	requirements in Code of Federal Regulations, title 42, section 438.10.
220.10 	(e) For appeals, the MCO must provide written notice of the resolution according to 
220.11 	Code of Federal Regulations, title 42, section 438.10.
220.12 	(f) For expedited appeals, the MCO must provide oral notice of the resolution.
220.13 	(g) The written notice for appeals must include the results of the resolution process and 
220.14 	the date it was completed. For appeals not resolved wholly in favor of the enrollee, the 
220.15 	notice must also contain:
220.16 	(1) instructions on how to request a state fair hearing;
220.17 	(2) instructions on the right to receive continued benefits during the pending state fair 
220.18 	hearing; and
220.19 	(3) information on when an enrollee must be held liable for the costs of continued 
220.20 	benefits.
220.21 	(h) An enrollee must request a state fair hearing no later than 120 calendar days from 
220.22 	the date of the MCO's notice of resolution or when the enrollee is deemed to have exhausted 
220.23 	the MCO's appeals process.
220.24 	(i) The parties to the state fair hearing include the MCO, the enrollee and the enrollee's 
220.25 	representative, or the representative of a deceased enrollee's estate.
220.26 		Subd. 45.Expedited resolution of appeals. (a) MCOs must establish and maintain an 
220.27 	expedited review process for appeals. When the MCO determines based on the request of 
220.28 	an enrollee, or the provider indicates when making an appeal on behalf of the enrollee, that 
220.29 	the time frame for a standard appeal could seriously jeopardize the enrollee's life, physical 
220.30 	or mental health, or ability to attain, maintain, or regain maximum function.
220.31 	(b) The MCO must ensure that no punitive action is taken against a provider who requests 
220.32 	an expedited resolution or supports an enrollee's appeal.
221.1 	(c) If the MCO denies a request for an expedited appeal, the MCO must:
221.2 	(1) transfer the appeal to the standard time frame for resolution of appeals; and
221.3 	(2) follow the process for seeking an extension of the standard time frame for resolution 
221.4 	of appeals.
221.5 		Subd. 46.Provider and subcontractor information. The MCO is required to provide 
221.6 	information about the MCO's grievance and appeals systems to the MCO's providers and 
221.7 	subcontractors at the time a contract is entered.
221.8 		Subd. 47.Record-keeping requirements. (a) The commissioner must require MCOs 
221.9 	to maintain records of all grievances and appeals and must monitor the information and 
221.10 	update and revise the quality strategy accordingly.
221.11 	(b) A record of each grievance and appeal must contain, at a minimum, information that 
221.12 	satisfies Code of Federal Regulations, title 42, section 438.4416(b) and (c).
221.13 		Subd. 48.Continuation of benefits. (a) The MCO must continue the enrollee's benefits 
221.14 	if:
221.15 	(1) the enrollee files a request for an appeal timely and requests continued benefits on 
221.16 	or before the later of the following:
221.17 	(i) within ten calendar days of the MCO sending the notice of the adverse benefit 
221.18 	determination; or
221.19 	(ii) the intended effective date of the MCO's proposed adverse benefit determination;
221.20 	(2) the appeal involves the termination, suspension, or reduction of previously authorized 
221.21 	services;
221.22 	(3) the services were ordered by an authorized provider; and
221.23 	(4) the period covered by the original service authorization has not expired.
221.24 	(b) If the MCO continues or reinstates benefits at the enrollee's request while the appeal 
221.25 	or state fair hearing is pending, the benefits must be continued until:
221.26 	(1) the enrollee withdraws the appeal or request for state fair hearing;
221.27 	(2) the enrollee fails to request a state fair hearing and continuation of benefits within 
221.28 	ten calendar days after the MCO sends the notice of an adverse resolution; or
221.29 	(3) a state fair hearing office issues a hearing decision adverse to the enrollee.
222.1 	(c) If the final resolution of the appeal or state fair hearing is adverse to the enrollee, the 
222.2 	MCO may, consistent with the policies on recoveries under Code of Federal Regulations, 
222.3 	title 42, section 431.230(b), and as specified in the commissioner's contract with the MCO, 
222.4 	recover the cost of services furnished to the enrollee while the appeal and state fair hearing 
222.5 	was pending.
222.6 		Subd. 49.Effectuation of reversed appeal resolutions. (a) If the MCO or the state fair 
222.7 	hearing officer reverses a decision to deny, limit, or delay services that were not furnished 
222.8 	while the appeal was pending, the MCO must authorize or provide the disputed services 
222.9 	promptly and as expeditiously as the enrollee's health condition requires but no later than 
222.10 	72 hours from the date the MCO receives notice reversing the MCO's adverse benefit 
222.11 	determination.
222.12 	(b) If the MCO or the state fair hearing officer reverses a decision to deny authorization 
222.13 	of service, and the enrollee received the disputed services while the appeal was pending, 
222.14 	the MCO or the commissioner must pay according to department policy and regulations.
222.15 		Subd. 50.Ombudsperson. (a) The commissioner shall designate an ombudsperson to 
222.16 	advocate for persons required to enroll in an MCO through an appeal and grievance process. 
222.17 	The ombudsperson shall advocate for recipients enrolled in an MCO through complaint and 
222.18 	appeal procedures and ensure that necessary medical services are provided either by the 
222.19 	MCO directly or by referral to appropriate social services. Before enrollment in an MCO, 
222.20 	an enrollee is provided information about managed care including the ombudsman person 
222.21 	program and the enrollee's right to a resolution of an appeal or grievance. The local agency 
222.22 	shall inform a recipient about the ombudsperson program and the recipient right to a 
222.23 	resolution of a complaint by the MCO if recipient experiences a problem with the plan or 
222.24 	the MCO's providers.
222.25 	(b) The provider or MCO must respond directly to the managed care ombudspersons 
222.26 	and county advocates regarding service delivery and must be accountable to the commissioner 
222.27 	regarding contracts with medical assistance funds.
222.28 		Subd. 51.Program integrity. (a) The commissioner must review the ownership and 
222.29 	control disclosures submitted by the MCO and any MCO subcontractors.
222.30 	(b) The commissioner must confirm through routine checks of the Federal databases the 
222.31 	identity and determine the exclusion status of the MCO, any subcontractor, and any person 
222.32 	with an ownership of five percent or control interest, or who is an agent or managing 
222.33 	employee of the MCO. This includes the Social Security Administration's Death Master 
222.34 	File, the National Plan and Provider Enumeration System (NPPES), the list of Excluded 
223.1 	Individuals/Entities (LEIE), the System for Award Management (SAM), and any other 
223.2 	databases that the Centers for Medicare and Medicaid may prescribe. The databases listed 
223.3 	in this paragraph must be consulted upon contract initiation and renewal and monthly 
223.4 	thereafter. If, upon review of the databases listed in this paragraph, an excluded party is 
223.5 	identified, the commissioner must notify the MCO and take action consistent with Code of 
223.6 	Federal Regulations, title 42, section 438.610(d).
223.7 	(c) The commissioner must, at least every three years, conduct, or contract for, an 
223.8 	independent audit of the accuracy, truthfulness, and completeness of the encounter and 
223.9 	financial data submitted by each MCO. The commissioner shall receive and investigate 
223.10 	information from whistleblowers relating to the integrity of the MCO, subcontractors, or 
223.11 	network providers receiving federal funds.
223.12 	(e) The commissioner shall post on the department's Web site:
223.13 	(1) the MCO contract;
223.14 	(2) the documentation required by Code of Federal Regulations, title 42, section 
223.15 	438.207(b), that the commissioner based its certification that the MCO complies with the 
223.16 	commissioner's availability and accessibility of services requirements, including the provider 
223.17 	network adequacy requirements;
223.18 	(3) the name and title of any person with an ownership or control interest of the MCO 
223.19 	or any MCO subcontractors according to Code of Federal Regulations, title 42, section 
223.20 	455.104; and
223.21 	(4) a copy of the audit results conducted pursuant to Code of Federal Regulations, title 
223.22 	42, section 438.602(e).
223.23 	(f) The commissioner must ensure that an MCO is not located outside of the United 
223.24 	States and no claims are paid by an MCO to a network provider, out-of-network provider, 
223.25 	subcontractor, or financial institution located outside of the United States.
223.26 	(g) Federal financial participation is only available if the commissioner excludes from 
223.27 	the MCO contracts all of the entities listed in Code of Federal Regulations, title 42, section 
223.28 	438.808(b).
223.29 		Subd. 52.Data, information, and documentation requirements. (a) The commissioner 
223.30 	must require each MCO to submit the following data:
223.31 	(1) encounter data according to the Health Insurance Portability and Accountability Act 
223.32 	of 1996 (HIPAA) security and privacy standards and must be submitted in the format 
224.1 	required by the Medicaid Statistical Information System or a format required by any successor 
224.2 	system to the Medicaid Statistical Information System;
224.3 	(2) data on the basis that the commissioner certifies the actuarial soundness of capitation 
224.4 	rates to an MCO according to Code of Federal Regulations, title 42, section 438.4, including 
224.5 	base data described in Code of Federal Regulations, title 42, section 438.5(c) that is generated 
224.6 	by the MCO;
224.7 	(3) data on the basis that the commissioner determines MCO compliance with the medical 
224.8 	loss ratio requirements;
224.9 	(4) data on the basis that the commissioner determines that the MCO made adequate 
224.10 	provision against the risk of insolvency as required under Code of Federal Regulations, title 
224.11 	42, section 438.116;
224.12 	(5) documentation, in a format specified by the commissioner according to Code of 
224.13 	Federal Regulations, title 42, section 438.207(b), that the MCO complied with the 
224.14 	commissioner's requirements for availability and accessibility of services, including the 
224.15 	adequacy of the provider network in Code of Federal Regulations, title 42, section 438.206;
224.16 	(6) information from the MCO on ownership and control interest according to Code of 
224.17 	Federal Regulations, title 42, section 455.104, and subcontractors according to Code of 
224.18 	Federal Regulations, title 42, section 438.230; and
224.19 	(7) an annual report of the MCO's recoveries of overpayments.
224.20 	(b) The commissioner shall require that data submitted under Code of Federal 
224.21 	Regulations, title 42, section 438.604, by the MCO must be certified by the MCO's chief 
224.22 	executive officer (CEO), chief financial officer (CFO), or an individual who reports directly 
224.23 	to the CEO or CFO with delegated authority to sign on their behalf. The certification must 
224.24 	include an attestation by the CEO or CFO that the information submitted is based on the 
224.25 	CEO's or CFO's knowledge and belief that the data is accurate, complete, and truthful, and 
224.26 	must be submitted concurrently with the data.
224.27 		Subd. 53.MCO program integrity requirements. (a) The commissioner must require 
224.28 	the MCO, or any MCO subcontractor delegated responsibility for coverage of services and 
224.29 	payment of claims, to implement and maintain procedures designed to detect and prevent 
224.30 	fraud, waste, and abuse. The MCO must include the procedures in a compliance plan that 
224.31 	includes:
225.1 	(1) written policies, procedures, and standards of conduct that articulate the MCO's 
225.2 	commitment to comply with applicable federal and state requirements regarding fraud, 
225.3 	waste, and abuse;
225.4 	(2) the designation of a compliance officer responsible for developing and implementing 
225.5 	policies, procedures, and practices designed to ensure compliance with the requirements of 
225.6 	the contract and who reports directly to the CEO and the board of directors;
225.7 	(3) the establishment of a Regulatory Compliance Committee on the Board of Directors 
225.8 	and at the senior management level charged with overseeing the MCO's compliance program;
225.9 	(4) a system for training and education for the compliance officer, the MCO's senior 
225.10 	management, and employees for federal and state standards and develop a procedure for 
225.11 	effective lines of communication between the groups;
225.12 	(5) enforcement of standards and implementation of procedures for routine internal 
225.13 	monitoring and auditing of compliance according to Code of Federal Regulations, title 42, 
225.14 	section 438.608(a)(1)(vii), to reduce the potential for recurrence and promote ongoing 
225.15 	compliance;
225.16 	(6) a provision for prompt reporting of all overpayments identified or recovered, 
225.17 	specifying the overpayments due to potential fraud, to the commissioner;
225.18 	(7) a provision for prompt reporting to the commissioner when the MCO receives 
225.19 	information that may affect an enrollee's eligibility;
225.20 	(8) a provision for notification to the commissioner if the MCO receives information 
225.21 	about a change in a network provider's circumstances that may affect the network provider's 
225.22 	eligibility to participate in the managed care program, including termination of the provider 
225.23 	agreement with the MCO;
225.24 	(9) a provision for a method to verify, on a regular basis, that services represented as 
225.25 	delivered by a network provider were received by the enrollees;
225.26 	(10) for an MCO contract that has an annual payment or receipt of at least $5,000,000, 
225.27 	a provision for written policies for all employees of the MCO, or subcontractor, that provides 
225.28 	detailed information about the False Claims Act and other federal and state laws described 
225.29 	in section 1902(a)(68) of the Social Security Act, including information about rights of 
225.30 	employees to be protected as whistleblowers;
225.31 	(11) a provision for the prompt referral of any potential fraud, waste, or abuse identified 
225.32 	by the MCO to the Medicaid Program Integrity Unit, and any potential fraud directly to the 
225.33 	Medicaid Fraud Control Unit; and
226.1 	(12) a provision for the suspension of payments to a network provider that the 
226.2 	commissioner determines there is a credible allegation of fraud according to Code of Federal 
226.3 	Regulations, title 42, section 455.23.
226.4 	(b) The commissioner shall ensure that each MCO and any subcontractor:
226.5 	(1) provides written disclosure of any prohibited affiliation according to Code of Federal 
226.6 	Regulations, title 42, section 438.610;
226.7 	(2) provides written disclosures of information on ownership and control required by 
226.8 	Code of Federal Regulations, title 42, section 455.104; and
226.9 	(3) reports to the commissioner within 60 calendar days when the MCO or subcontractor 
226.10 	identifies that capitation payments or other payments were in excess of the amounts specified 
226.11 	in the contract.
226.12 	(c) The commissioner must ensure the MCO contracts specify:
226.13 	(1) the retention policies for treatment of all overpayments from the MCO to a provider, 
226.14 	including the retention policies for the treatment of recoveries of overpayments due to fraud, 
226.15 	waste, and abuse;
226.16 	(2) the process, time frames, and documentation required for reporting the recovery of 
226.17 	all overpayments, including situations of recoveries of overpayments to the commissioner 
226.18 	where the MCO is not permitted to retain some or all of the recoveries of overpayments; 
226.19 	and
226.20 	(3) the treatment of recoveries does not apply to any amount of recovery to be retained 
226.21 	under the False Claims Act or through other investigations.
226.22 	(d) The commissioner shall ensure each MCO has a mechanism for a network provider 
226.23 	to report to the MCO when the MCO has received an overpayment, to return the overpayment 
226.24 	to the MCO within 60 calendar days after the date the overpayment was identified, and to 
226.25 	notify the MCO in writing of the reason for the overpayment.
226.26 	(e) The commissioner shall require each MCO to submit an annual report to the 
226.27 	commissioner on the MCO's recoveries of overpayments. The commissioner must use the 
226.28 	information to set actuarially sound capitation rates.
226.29 	(f) An MCO may not knowingly have a relationship with any of the types identified in 
226.30 	Code of Federal Regulations, title 42, section 438.610(c), if the following occurs:
226.31 	(1) an individual or entity is debarred, suspended, or otherwise excluded from 
226.32 	participating in procurement activities under the Federal Acquisition Regulation or from 
227.1 	participating in nonprocurement activities under regulations issued under Executive Order 
227.2 	No. 12549 or under guidelines implementing Executive Order No. 12549; or
227.3 	(2) an individual or entity is an affiliate, as defined in Code of Federal Regulations, title 
227.4 	42, section 2.101, of a person described in clause (1).
227.5 	(g) An MCO may not have a relationship with an individual or entity that is excluded 
227.6 	from participation in any federal health care program under section 1128 or 1128A of the 
227.7 	Social Security Act.
227.8 	(h) If the commissioner determines that an MCO fails to comply with paragraphs (f) 
227.9 	and (g), the commissioner:
227.10 	(1) must notify the Centers for Medicare and Medicaid of the MCO's noncompliance;
227.11 	(2) may continue an existing agreement with the MCO unless the Centers for Medicare 
227.12 	and Medicaid directs otherwise; and
227.13 	(3) may not renew or otherwise extend the duration of an existing agreement with the 
227.14 	MCO unless the Centers for Medicare and Medicaid provides a written statement to the 
227.15 	commissioner and congress describing compelling reasons that exist for renewing or 
227.16 	extending the agreement despite the prohibited affiliations;
227.17 	Nothing in this section must be construed to limit or otherwise affect any remedies available 
227.18 	under sections 1128, 1128A, or 1128B of the Social Security Act.
227.19 		Subd. 54.Sanctions. (a) The commissioner must establish intermediate sanctions if the 
227.20 	commissioner makes a determination that the MCO :
227.21 	(1) failed to substantially provide medically necessary services to an enrollee that is 
227.22 	covered under law or under the contract with the commissioner;
227.23 	(2) imposed premiums or charges that exceed premiums or charges permitted under 
227.24 	medical assistance;
227.25 	(3) discriminated against an enrollee on the basis of the enrollee's health status or need 
227.26 	for health care services, including:
227.27 	(i) termination of enrollment or refusal to reenroll a beneficiary, except as permitted 
227.28 	under medical assistance; or
227.29 	(ii) any practice that would reasonably be expected to discourage enrollment by a 
227.30 	beneficiary whose medical condition or history indicates probable need for substantial future 
227.31 	medical services;
228.1 	(4) misrepresented or falsified information to the Centers for Medicare and Medicaid 
228.2 	or the commissioner;
228.3 	(5) misrepresented or falsified information furnished to an enrollee, potential enrollee, 
228.4 	or health care provider;
228.5 	(6) failed to comply with the requirements for physician incentive plans, as set forth in 
228.6 	according to Code of Federal Regulations, title 42, sections 422.208 and 422.210;
228.7 	(7) the MCO distributed directly, or indirectly through any agent or independent 
228.8 	contractor, marketing materials that were not approved by the commissioner or that contained 
228.9 	false or materially misleading information; or
228.10 	(8) the MCO violated any of the other requirements of section 1903(m) or 1932 of the 
228.11 	Social Security Act, or any implementing regulations.
228.12 	(b) Only the sanctions listed in Code of Federal Regulations, title 42, section 
228.13 	438.702(a)(3), (4), and (5), may be imposed.
228.14 		Subd. 55.Types of intermediate sanctions. (a) The commissioner may:
228.15 	(1) impose civil money penalties according to Code of Federal Regulations, title 42, 
228.16 	section 438.704;
228.17 	(2) appoint of temporary management for an MCO as provided in Code of Federal 
228.18 	Regulations, title 42, section 438.706;
228.19 	(3) grant an enrollee the right to terminate enrollment without cause and notifying the 
228.20 	affected enrollee of the enrollee's right to disenroll;
228.21 	(4) suspend new enrollment, including default enrollment, after the date the Centers for 
228.22 	Medicare and Medicaid or the commissioner notifies the MCO of a determination of a 
228.23 	violation under sections 1903(m) or 1932 of the Social Security Act; or
228.24 	(5) suspend payment for a beneficiary enrolled after the effective date of the sanction 
228.25 	and until the Centers for Medicare and Medicaid or the commissioner is satisfied that the 
228.26 	reason for imposition of the sanction no longer exists and is not likely to recur.
228.27 	(b) The commissioner may impose additional sanctions for an MCO's noncompliance 
228.28 	according to Code of Federal Regulations, title 42, section 438.700.
228.29 		Subd. 56.Special rules for temporary management. (a) The commissioner may impose 
228.30 	temporary management of the MCO according to Code of Federal Regulations, title 42, 
228.31 	section 438.702(a)(2), only if the commissioner finds through on-site surveys, enrollee or 
228.32 	other complaints, financial status, or any other source the following:
229.1 	(1) continued egregious behavior by the MCO including but not limited to behavior  
229.2 	described in Code of Federal Regulations, title 42, section 438.700, or behavior that violates 
229.3 	sections 1903(m) and 1932 of the Social Security Act;
229.4 	(2) there is substantial risk to the enrollee's health; or
229.5 	(3) the sanction is necessary to ensure the health of the enrollee while improvements 
229.6 	are made to remedy the violations or until there is an orderly termination or reorganization 
229.7 	of the MCO.
229.8 	(b) The commissioner must impose temporary management of the MCO, regardless of 
229.9 	the imposition of any other sanction, if the commissioner finds that an MCO repeatedly 
229.10 	failed to meet substantive requirements of section 1903(m) or 1932 of the Social Security 
229.11 	Act or Code of Federal Regulations, title 42, section 438. The commissioner must grant an 
229.12 	enrollee the right to terminate enrollment without cause and notify the affected enrollee of 
229.13 	the enrollee's right to disenroll.
229.14 	(c) The commissioner shall not delay imposition of temporary management pending a 
229.15 	hearing. Temporary management must remain in place until the commissioner determines 
229.16 	that the sanctioned behavior will not recur.
229.17 		Subd. 57.Termination of the MCO contract. The commissioner may terminate an 
229.18 	MCO contract and enroll that MCO's enrollees in different MCOs, or provide the enrollee's 
229.19 	medical assistance benefits through other options included in the state plan, if the 
229.20 	commissioner determines that the MCO failed to either carry out the substantive terms of 
229.21 	the MCO's contract or satisfy sections 1932, 1903(m), and 1905(t) of the Social Security 
229.22 	Act.
229.23 		Subd. 58.Notice of sanction and pretermination. (a) Except as provided in Code of 
229.24 	Federal Regulations, title 42, section 438.706(c), the commissioner, before imposing any 
229.25 	intermediate sanctions, must give the affected MCO timely written notice that explains the 
229.26 	basis and nature of the sanction and any other appeal rights that the commissioner elects to 
229.27 	provide.
229.28 	(b) Before terminating an MCO contract, the commissioner must provide the MCO:
229.29 	(1) with a pretermination hearing;
229.30 	(2) written notice of its intent to terminate, the reason for termination, and the time and 
229.31 	place of the hearing; and
229.32 	(3) written notice of the decision affirming or reversing the proposed termination of the 
229.33 	contract.
230.1 	(c) If the contract is terminated, the commissioner must specify the effective date of the 
230.2 	termination and provide the MCO's enrollees notice of the termination and information 
230.3 	according to Code of Federal Regulations, title 42, section 438.10, on the enrollee's options 
230.4 	for receiving medical assistance services following the effective date of the termination. 
230.5 	The MCO's enrollees may be allowed to disenroll immediately without cause.
230.6 		Subd. 59.Notice to the Centers for Medicare and Medicaid. (a) The commissioner 
230.7 	must notify the Centers for Medicare and Medicaid in writing if the commissioner imposes 
230.8 	or lifts a sanction for a violation of Code of Federal Regulations, title 42, section 438.700.
230.9 	(b) The notice must be given no later than 30 days after the commissioner imposes or 
230.10 	lifts a sanction and must specify the affected MCO, the kind of sanction, and the reason for 
230.11 	the commissioner's decision.
230.12 		Subd. 60.State plan requirements. (a) The commissioner must include a plan to monitor  
230.13 	MCO violations.
230.14 	(b) The MCO contract must provide that payments made pursuant to the contract must 
230.15 	be denied for a new enrollee if, and for so long as, payment for the enrollee is denied by 
230.16 	the Centers for Medicare and Medicaid according to Code of Federal Regulations, title 42, 
230.17 	section 438.730(e).
230.18 		Subd. 61.Sanctions by the Centers for Medicare and Medicaid. (a) The commissioner 
230.19 	may recommend that the Centers for Medicare and Medicaid impose a denial of payment 
230.20 	sanction on an MCO if the commissioner determines that an MCO acted or failed to act 
230.21 	according to Code of Federal Regulations, title 42, section 438.700(b)(1) to (6). The 
230.22 	commissioner's determination or recommendation to impose the denial of payment sanction 
230.23 	becomes the Centers for Medicare and Medicaid's decision for purposes of section 
230.24 	1903(m)(5)(A)and(B) unless the Centers for Medicare and Medicaid rejects it within 15 
230.25 	days.
230.26 	(b) If the commissioner's determination becomes the Centers for Medicare and Medicaid's 
230.27 	decision, the commissioner must:
230.28 	(1) provide written notice of the nature and basis of the proposed sanction to the MCO;
230.29 	(2) allow the MCO 15 days from the date the MCO receives the notice to provide 
230.30 	evidence that the MCO did not act or failed to act in the manner that is the basis for the 
230.31 	recommended sanction;
230.32 	(c) The initial 15 days may be extended 15 days if:
231.1 	(1) the MCO submits a written request that includes a credible explanation of why the 
231.2 	MCO needs additional time;
231.3 	(2) the request is received by the Centers for Medicare and Medicaid before the end of 
231.4 	the initial period; or
231.5 	(3) the Centers for Medicare and Medicaid has not determined that the MCO's conduct 
231.6 	poses a threat to an enrollee's health or safety.
231.7 	(d) If the MCO submits a timely response to the notice of sanction, the commissioner 
231.8 	must:
231.9 	(1) conduct an informal reconsideration including review of the evidence by a staff 
231.10 	member who did not participate in the original recommendation;
231.11 	(2) provide the MCO a concise written decision setting forth the factual and legal basis 
231.12 	for the decision. The commissioner's decision becomes the Centers for Medicare and 
231.13 	Medicaid's decision unless the Centers for Medicare and Medicaid reverses or modifies the 
231.14 	decision within 15 days of the date of receipt by the Centers for Medicare and Medicaid. If 
231.15 	the Centers for Medicare and Medicaid reverses or modifies the commissioner's decision 
231.16 	the commissioner must send the MCO a copy of the Centers for Medicare and Medicaid's 
231.17 	decision; and
231.18 	(3) provide the decision to the Centers for Medicare and Medicaid.
231.19 	(d) Upon the recommendation of the commissioner, the Centers for Medicare and 
231.20 	Medicaid may deny payment to the department for new enrollees of the MCO under section 
231.21 	1903(m)(5)(B)(ii) of the Social Security Act, if:
231.22 	(1) a Centers for Medicare and Medicaid determination that an MCO has acted or failed 
231.23 	to act is affirmed under review;
231.24 	(2) the Centers for Medicare and Medicaid determination is not timely contested by the 
231.25 	MCO; or
231.26 	(3) the Centers for Medicare and Medicaid's denial of payment for a new enrollee 
231.27 	automatically results in a denial of payment to the MCO for the enrollee.
231.28 	(f) If the MCO does not seek reconsideration, the sanction is effective 15 days following 
231.29 	the MCO's notification of the decision to impose the sanction. If the MCO seeks 
231.30 	reconsideration, the sanction is effective on the date specified in the Centers for Medicare 
231.31 	and Medicaid's reconsideration notice. If the MCO's conduct poses a serious threat to an 
232.1 	enrollee's health or safety, the sanction may be made effective earlier than the date of the 
232.2 	commissioner's reconsideration.
232.3 	(g) If the commissioner sends notice of the sanction to the MCO, the Centers for Medicare 
232.4 	and Medicaid must forward a copy of the notice to the Office of Inspector General for 
232.5 	consideration of possible civil money penalties according to section 1903(m)(5)(A) of the 
232.6 	Social Security Act and Code of Federal Regulations, title 42, section 1003.
232.7 		Subd. 62.Managed care rates. (a) The commissioner shall establish the method and 
232.8 	amount of payments for services covered under the managed care contract. The final 
232.9 	capitation rate must be:
232.10 	(1) specifically identified in the applicable contract submitted for Centers for Medicare 
232.11 	and Medicaid review and approval;
232.12 	(2) based solely upon services covered under the state plan and additional services 
232.13 	deemed by the commissioner to be necessary to comply with mental health parity 
232.14 	requirements; and
232.15 	(3) adequate to allow the MCO to efficiently deliver covered services to individuals 
232.16 	eligible for medical assistance in a manner compliant with contractual requirements.
232.17 	(b) Payments for elderly waiver services and 180 days of nursing home care may be 
232.18 	included in the capitation payments for a beneficiary 65 years of age and older.
232.19 		Subd. 63.Actuarial soundness. (a) Capitation rates for MCOs must be reviewed and 
232.20 	approved by the Centers for Medicare and Medicaid as actuarially sound. To be approved 
232.21 	by the Centers for Medicare and Medicaid, capitation rates must:
232.22 	(1) be developed according to the rates standards in Code of Federal Regulations, title 
232.23 	42, section 438.5, and generally accepted actuarial principles and practices. Any proposed 
232.24 	differences among capitation rates according to covered populations must be based on valid 
232.25 	rate development standards and not based on the rate of federal financial participation 
232.26 	associated with the covered populations;
232.27 	(2) be appropriate for the populations covered and the services furnished under the 
232.28 	contract;
232.29 	(3) meet the requirements on MCOs for availability of services, assurance of adequate 
232.30 	capacity and services, and coordination and continuity of care according to Code of Federal 
232.31 	Regulations, title 42, sections 438.206, 438.207, and 438.208;
233.1 	(4) be specific to payments for each rate cell under the contract, and must not 
233.2 	cross-subsidize or be cross-subsidized by payments for any other rate cell;
233.3 	(5) be certified by an independent actuary. The actuary shall certify that the rates were 
233.4 	developed according to Code of Federal Regulations, title 42, section 438.3(c)(1)(ii)(e);
233.5 	(6) meet any special contract provisions according to Code of Federal Regulations, title 
233.6 	42, section 438.6;
233.7 	(7) be provided to the Centers for Medicare and Medicaid in a format and within a time 
233.8 	frame according to Code of Federal Regulations, title 42, section 438.7; and
233.9 	(8) be developed for the MCO to reasonably achieve a medical loss ratio standard of at 
233.10 	least 85 percent for the rate year. The capitation rates may be developed for the MCO to 
233.11 	achieve a medical loss ratio greater than 85 percent as long as the capitation rates are adequate 
233.12 	for reasonable, appropriate, and attainable nonbenefit costs.
233.13 		Subd. 64.Rate development standards. (a) The commissioner shall establish actuarially 
233.14 	sound capitation rates and must:
233.15 	(1) identify and develop base utilization and price data including validated encounter 
233.16 	data and audited financial reports received from the MCOs that demonstrate experience for 
233.17 	the populations served by the MCOs, for the three most recent and complete years before 
233.18 	the rating period;
233.19 	(2) develop and apply reasonable trend factors, including cost and utilization, to base 
233.20 	data that are developed from actual experience of the Medicaid population or a similar 
233.21 	population according to generally accepted actuarial practices and principles;
233.22 	(3) develop the nonbenefit component of the rate to account for reasonable expenses 
233.23 	related to the MCO's administration; taxes; licensing and regulatory fees; contribution to 
233.24 	reserves; risk margin; cost of capital and other operational costs associated with the MCO's 
233.25 	provision of covered services to beneficiaries;
233.26 	(4) pay administrative costs to MCOs not to exceed 6.6 percent of total payments made 
233.27 	to all MCOs in aggregate across all state public health care programs. The commissioner 
233.28 	may reduce or eliminate administrative requirements to meet the administrative cost limit. 
233.29 	For purposes of this paragraph, administrative costs do not include premium taxes paid 
233.30 	under section 297I.05, subdivision 5, provider surcharges paid under section 256.9657, 
233.31 	subdivision 3, or health insurance fees under section 9010 of the Affordable Care Act;
233.32 	(5) consider investment income and interest earnings as income to the same extent that 
233.33 	investment-related expenses are treated as administrative expenditures;
234.1 	(6) consider the value of cost sharing for rate development purposes, regardless of 
234.2 	whether the MCO imposes the cost sharing on the MCO's beneficiary or the cost sharing 
234.3 	is collected;
234.4 	(7) make appropriate and reasonable adjustments to account for changes to the base data, 
234.5 	programmatic changes, non-benefit components, and any other adjustment necessary to 
234.6 	establish actuarially sound rates. Each adjustment must reasonably support the development 
234.7 	of an accurate base data set for purposes of rate setting, reflect the health status of the 
234.8 	enrolled population, and be developed in accordance with generally accepted actuarial 
234.9 	principles and practices;
234.10 	(8) consider the MCO's past medical loss ratio in the development of the capitation rates 
234.11 	and consider the projected medical loss ratio; and
234.12 	(9) select a prospective or retrospective risk adjustment methodology that must be 
234.13 	developed in a budget-neutral manner consistent with generally accepted actuarial principles 
234.14 	and practices.
234.15 	(b) The base data must be derived from the Medicaid population, or, if data on the 
234.16 	Medicaid population is not available, derived from a similar population and adjusted to 
234.17 	make the utilization and price data comparable to data from the Medicaid population. Data 
234.18 	must be in accordance with actuarial standards for data quality and an explanation of why 
234.19 	that specific data is used must be provided in the rate certification. If the commissioner is 
234.20 	unable to base the rates on data that are within the three most recent and complete years 
234.21 	before the rating period, the commissioner may request an approval for an exception. The 
234.22 	request must describe why an exception is necessary and describe the actions that the 
234.23 	commissioner intends to take to come comply with.
234.24 	(c) Notwithstanding paragraph (a), the commissioner shall reduce administrative expenses 
234.25 	paid to managed care plans by one-half percent for contracts beginning January 1, 2016, 
234.26 	and ending December 31, 2017. To meet the administrative reductions under this paragraph, 
234.27 	the commissioner may reduce or eliminate administrative requirements, exclude additional 
234.28 	unallowable administrative expenses resulting from the financial audits, and utilize 
234.29 	competitive bidding to gain efficiencies through economies of scale from increased 
234.30 	enrollment. If the total reduction cannot be achieved through administrative reduction, the 
234.31 	commissioner may limit total rate increases on payments to MCOs.
234.32 	(d) Where reasonably possible, expenses for an administrative item shall be directly 
234.33 	allocated so as to assign costs for an item to an individual state public health care program 
234.34 	when the cost can be specifically identified with and benefits the individual state public 
235.1 	health care program. For administrative services expensed to the state's public health care 
235.2 	programs, managed care organizations must clearly identify and separately record expense 
235.3 	items in the MCO's accounting systems in a manner that allows for independent verification 
235.4 	of unallowable expenses for purposes of determining payment rates for state public health 
235.5 	care programs.
235.6 	(e) The following expenses are not allowable administrative expenses for rate-setting 
235.7 	purposes under this section:
235.8 	(1) charitable contributions made by the managed care organization. Charitable 
235.9 	contributions include payments for or to any organization or entity selected by the managed 
235.10 	care plan or county-based purchasing plan that is operated for charitable, educational, 
235.11 	political, religious, or scientific purposes, that are not related to medical and administrative 
235.12 	services covered under state public health care programs;
235.13 	(2) compensation of individuals within the organization in excess of $200,000 such that 
235.14 	the allocation of compensation for an individual across all state public health care programs 
235.15 	in total cannot exceed $200,000. For the purposes of this subdivision, compensation includes 
235.16 	salaries, bonuses and incentives, other reportable compensation on an IRS 990 form, 
235.17 	retirement and other deferred compensation, and nontaxable benefits;
235.18 	(3) any penalties or fines assessed against the MCO;
235.19 	(4) any indirect marketing or advertising expenses of the MCO, including but not limited 
235.20 	to costs to promote the MCO, costs of facilities used for special events, and costs of displays, 
235.21 	demonstrations, donations, and promotional items such as memorabilia, models, gifts, and 
235.22 	souvenirs. The commissioner may classify an item listed as an allowable administrative 
235.23 	expense for rate-setting purposes, if the commissioner determines that the expense is 
235.24 	incidental to an activity related to state public health care programs that is an allowable cost 
235.25 	for purposes of rate setting;
235.26 	(5) any lobbying and political activities, events, or contributions;
235.27 	(6) administrative expenses related to the provision of services not covered under the 
235.28 	state plan or waiver;
235.29 	(7) alcoholic beverages and related costs;
235.30 	(8) membership in any social, dining, or country club or organization; and
235.31 	(9) entertainment, including but not limited to amusement, diversion, and social activities, 
235.32 	and any costs directly associated with these costs, tickets to shows or sporting events, meals, 
235.33 	lodging, rentals, transportation, and gratuities.
236.1 	(f) Payments to a quality improvement organization are an allowable administrative 
236.2 	expense for rate-setting purposes under this section, to the extent are allocated to a state 
236.3 	public health care program and approved by the commissioner.
236.4 	(g) Within the limit of available appropriations, the commissioner shall work with the 
236.5 	commissioner of health to identify and collect data on administrative spending for state 
236.6 	public health care programs reported to the commissioner of health by managed care 
236.7 	organizations, provided that data are consistent with guidelines and standards for 
236.8 	administrative spending that are developed by the commissioner of health, and reported to 
236.9 	the legislature under Laws 2008, chapter 364, section 12. Data provided to the commissioner 
236.10 	under this subdivision are nonpublic data as defined in section 13.02.
236.11 	(h) The commissioner, in consultation with an actuary, shall evaluate the regional rate 
236.12 	relationships based on actual health plan costs for state public health care programs. The 
236.13 	commissioner shall establish, based on the actuary's recommendation, new rate regions that 
236.14 	recognize metropolitan areas outside of the seven-county metropolitan area.
236.15 		Subd. 65.Payment limits. (a) The commissioner shall reduce payments and limit future 
236.16 	rate increases paid to managed care plans and county-based purchasing plans. The limits 
236.17 	in paragraphs (a) to (f) shall be achieved on a statewide aggregate basis by program. The 
236.18 	commissioner may use competitive bidding, payment reductions, or other reductions to 
236.19 	achieve the reductions and limits in this subdivision.
236.20 	(b) The commissioner shall reduce payments to managed care organizations as follows:
236.21 	(1) 2.0 percent for medical assistance elderly basic care. This shall not apply to Medicare 
236.22 	cost-sharing, nursing facility, personal care assistance, and elderly waiver services;
236.23 	(2) 2.82 percent for medical assistance families and children;
236.24 	(3) 10.1 percent for medical assistance adults without children; and
236.25 	(4) 6.0 percent for MinnesotaCare families and children.
236.26 	(c) The commissioner shall limit rates paid to managed care plans and county-based 
236.27 	purchasing plans for calendar year 2012 to a percentage of the rates in effect on August 31, 
236.28 	2011, as follows:
236.29 	(1) 98 percent for medical assistance elderly basic care. This shall not apply to Medicare 
236.30 	cost-sharing, nursing facility, personal care assistance, and elderly waiver services;
236.31 	(2) 97.18 percent for medical assistance families and children;
236.32 	(3) 89.9 percent for medical assistance adults without children; and
237.1 	(4) 94 percent for MinnesotaCare families and children.
237.2 	(d) Beginning January 1, 2013, to December 31, 2013, the commissioner shall limit the 
237.3 	maximum annual trend increases to rates paid to managed care plans and county-based 
237.4 	purchasing plans as follows:
237.5 	(1) 7.5 percent for medical assistance elderly basic care. This shall not apply to Medicare 
237.6 	cost-sharing, nursing facility, personal care assistance, and elderly waiver services;
237.7 	(2) 5.0 percent for medical assistance special needs basic care;
237.8 	(3) 2.0 percent for medical assistance families and children;
237.9 	(4) 3.0 percent for medical assistance adults without children;
237.10 	(5) 3.0 percent for MinnesotaCare families and children; and
237.11 	(6) 3.0 percent for MinnesotaCare adults without children.
237.12 	(e) The commissioner may limit trend increases to less than the maximum. Beginning 
237.13 	July 1, 2014, the commissioner shall limit the maximum annual trend increases to rates paid 
237.14 	to managed care plans and county-based purchasing plans as follows for calendar years 
237.15 	2014 and 2015:
237.16 	(1) 7.5 percent for medical assistance elderly basic care. This shall not apply to Medicare 
237.17 	cost-sharing, nursing facility, personal care assistance, and elderly waiver services;
237.18 	(2) 5.0 percent for medical assistance special needs basic care;
237.19 	(3) 2.0 percent for medical assistance families and children;
237.20 	(4) 3.0 percent for medical assistance adults without children; (5) 3.0 percent for 
237.21 	MinnesotaCare families and children; and
237.22 	(6) 4.0 percent for MinnesotaCare adults without children. The commissioner may limit 
237.23 	trend increases to less than the maximum. For calendar year 2014, the commissioner shall 
237.24 	reduce the maximum aggregate trend increases by $47,000,000 in state and federal funds 
237.25 	to account for the reductions in administrative expenses in subdivision 15b.
237.26 		Subd. 66.Special contract requirements related to payment. (a) If the commissioner 
237.27 	uses risk-sharing mechanisms such as reinsurance, risk corridors, or stop-loss limits, they 
237.28 	must be described in the contract, and must be developed according to the rate development 
237.29 	standards and generally accepted actuarial principles and practices.
237.30 	(b) The commissioner may utilize incentive payment arrangements in MCO contracts. 
237.31 	The payment may not exceed 105 percent of the approved capitation payments attributable 
238.1 	to the enrollees or services covered by the incentive arrangement and must be considered 
238.2 	within actuarial soundness. For all incentive arrangements the contract must provide that 
238.3 	the arrangement is:
238.4 	(1) for a fixed period of time and performance is measured during the rating period in 
238.5 	which the incentive arrangement is applied;
238.6 	(2) not to be renewed automatically;
238.7 	(3) made available to both public and private contractors under the same terms of 
238.8 	performance; and
238.9 	(4) specified activities, targets, performance measures, or quality-based outcomes in the 
238.10 	state's quality strategy.
238.11 	The incentive payment arrangement must not condition the MCO's participation in the 
238.12 	incentive arrangement on entering into or adhering to intergovernmental transfer agreements.
238.13 	(c) The commissioner must provide that any withholding arrangement must ensure that 
238.14 	the capitation payment minus any portion of the withheld funds that is not reasonably 
238.15 	achievable is actuarially sound. The total amount of the withheld funds, achievable or not, 
238.16 	must be reasonable and take into consideration each MCO's financial operating needs 
238.17 	accounting for the size and characteristics of the populations covered under the contract, as 
238.18 	well as the MCO's capital reserves, as measured by the risk based capital level, months of 
238.19 	claims reserve, or other appropriate measure of reserves. The data, assumptions, and 
238.20 	methodologies used to determine the portion of the withhold that is reasonably achievable 
238.21 	must be submitted as part of the documentation required by Code of Federal Regulations, 
238.22 	title 42, section 438.7(b)(6); for all withhold arrangements the contract must provide that 
238.23 	the arrangement is :
238.24 	(1) for a fixed period of time and performance is measured during the rating period in 
238.25 	which the withhold arrangement is applied
238.26 	(2) not to be renewed automatically;
238.27 	(3) made available to both public and private contractors under the same terms of 
238.28 	performance;
238.29 	(4) specified activities, targets, performance measures, or quality-based outcomes in the 
238.30 	state's quality strategy.
239.1 	The withhold payment arrangement must not condition the managed care organization's 
239.2 	participation in the withhold arrangement on entering into or adhering to intergovernmental 
239.3 	transfer agreements;
239.4 	(d) Each performance target must be quantifiable, objective, measurable, and reasonably 
239.5 	attainable. The withheld funds must be returned no sooner than July of the following year 
239.6 	if performance targets in the contract are achieved. The commissioner may exclude special 
239.7 	demonstration projects under subdivisions 18 and 19. A managed care plan or a county-based 
239.8 	purchasing plan under section 256B.692 may include as admitted assets under section 
239.9 	62D.044 any amount withheld under this section that is reasonably expected to be returned.
239.10 		Subd. 67.Managed care withhold requirements. (a) The commissioner shall withhold 
239.11 	five percent of managed care plan payments under this section and county-based purchasing 
239.12 	plan payments under section 256B.692 for the prepaid medical assistance program pending 
239.13 	completion of performance targets. Each performance target must be quantifiable, objective, 
239.14 	measurable, and reasonably attainable, except in the case of a performance target based on 
239.15 	a federal or state law or rule. Criteria for assessment of each performance target must be 
239.16 	outlined in writing prior to the contract effective date. Clinical or utilization performance 
239.17 	targets and their related criteria must consider evidence-based research and reasonable 
239.18 	interventions when available or applicable to the populations served, and must be developed 
239.19 	with input from external clinical experts and stakeholders, including managed care plans, 
239.20 	county-based purchasing plans, and providers. The managed care or county-based purchasing 
239.21 	plan must demonstrate, to the commissioner's satisfaction, that the data submitted regarding 
239.22 	attainment of the performance target is accurate. The commissioner shall periodically change 
239.23 	the administrative measures used as performance targets in order to improve plan performance 
239.24 	across a broader range of administrative services. The performance targets must include 
239.25 	measurement of plan efforts to contain spending on health care services and administrative 
239.26 	activities. The commissioner may adopt plan-specific performance targets that take into 
239.27 	account factors affecting only one plan, including characteristics of the plan's enrollee 
239.28 	population. The withheld funds must be returned no sooner than July of the following year 
239.29 	if performance targets in the contract are achieved. The commissioner may exclude special 
239.30 	demonstration projects under subdivisions 75 and 76.
239.31 	(b) The commissioner shall include as part of the performance targets described in 
239.32 	paragraph (a) a reduction in the health plan's emergency department utilization rate for 
239.33 	medical assistance and MinnesotaCare enrollees, as determined by the commissioner. To 
239.34 	earn the return of the withhold each subsequent year, the managed care plan or county-based 
239.35 	purchasing plan must achieve a qualifying reduction of no less than ten percent of the plan's 
240.1 	emergency department utilization rate for medical assistance and MinnesotaCare enrollees, 
240.2 	excluding enrollees in programs described in subdivisions 75 and 76, compared to the 
240.3 	previous measurement year until the final performance target is reached. When measuring 
240.4 	performance, the commissioner must consider the difference in health risk in a managed 
240.5 	care or county-based purchasing plan's membership in the baseline year compared to the 
240.6 	measurement year, and work with the managed care or county-based purchasing plan to 
240.7 	account for differences that they agree are significant.
240.8 	The withheld funds must be returned no sooner than July 1 and no later than July 31 of 
240.9 	the following calendar year if the managed care plan or county-based purchasing plan 
240.10 	demonstrates to the satisfaction of the commissioner that a reduction in the utilization rate 
240.11 	was achieved. The commissioner shall structure the withhold so that the commissioner 
240.12 	returns a portion of the withheld funds in amounts commensurate with achieved reductions 
240.13 	in utilization less than the targeted amount.
240.14 	The withheld funds shall continue for each consecutive contract period until the plan's 
240.15 	emergency room utilization rate for state health care program enrollees is reduced by 25 
240.16 	percent of the plan's emergency room utilization rate for medical assistance and 
240.17 	MinnesotaCare enrollees for calendar year 2009. Hospitals shall cooperate with the health 
240.18 	plans in meeting this performance target and shall accept payment withholds that may be 
240.19 	returned to the hospitals if the performance target is achieved.
240.20 	(c) The commissioner shall include as part of the performance targets described in 
240.21 	paragraph (a) a reduction in the plan's hospitalization admission rate for medical assistance 
240.22 	and MinnesotaCare enrollees, as determined by the commissioner. To earn the return of the 
240.23 	withhold each year, the managed care plan or county-based purchasing plan must achieve 
240.24 	a qualifying reduction of no less than five percent of the plan's hospital admission rate for 
240.25 	medical assistance and MinnesotaCare enrollees, excluding enrollees in programs described 
240.26 	in subdivisions 75 and 76, compared to the previous calendar year until the final performance 
240.27 	target is reached. When measuring performance, the commissioner must consider the 
240.28 	difference in health risk in a managed care or county-based purchasing plan's membership 
240.29 	in the baseline year compared to the measurement year, and work with the managed care 
240.30 	or county-based purchasing plan to account for differences that they agree are significant.
240.31 	The withheld funds must be returned no sooner than July 1 and no later than July 31 of 
240.32 	the following calendar year if the managed care plan or county-based purchasing plan 
240.33 	demonstrates to the satisfaction of the commissioner that this reduction in the hospitalization 
240.34 	rate was achieved. The commissioner shall structure the withhold so that the commissioner 
241.1 	returns a portion of the withheld funds in amounts commensurate with achieved reductions 
241.2 	in utilization less than the targeted amount.
241.3 	The withhold described in this paragraph shall continue until there is a 25 percent 
241.4 	reduction in the hospital admission rate compared to the hospital admission rates in calendar 
241.5 	year 2011, as determined by the commissioner. The hospital admissions in this performance 
241.6 	target do not include the admissions applicable to the subsequent hospital admission 
241.7 	performance target under paragraph (d). Hospitals shall cooperate with the plans in meeting 
241.8 	this performance target and shall accept payment withholds that may be returned to the 
241.9 	hospitals if the performance target is achieved.
241.10 	(d) The commissioner shall include as part of the performance targets described in 
241.11 	paragraph (a) a reduction in the plan's hospitalization admission rates for subsequent 
241.12 	hospitalizations within 30 days of a previous hospitalization of a patient regardless of the 
241.13 	reason, for medical assistance and MinnesotaCare enrollees, as determined by the 
241.14 	commissioner. To earn the return of the withhold each year, the managed care plan or 
241.15 	county-based purchasing plan must achieve a qualifying reduction of the subsequent 
241.16 	hospitalization rate for medical assistance and MinnesotaCare enrollees, excluding enrollees 
241.17 	in programs described in subdivisions 75 and 76, of no less than five percent compared to 
241.18 	the previous calendar year until the final performance target is reached.
241.19 	The withheld funds must be returned no sooner than July 1 and no later than July 31 of 
241.20 	the following calendar year if the managed care plan or county-based purchasing plan 
241.21 	demonstrates to the satisfaction of the commissioner that a qualifying reduction in the 
241.22 	subsequent hospitalization rate was achieved. The commissioner shall structure the withhold 
241.23 	so that the commissioner returns a portion of the withheld funds in amounts commensurate 
241.24 	with achieved reductions in utilization less than the targeted amount.
241.25 	The withheld funds must continue for each consecutive contract period until the plan's 
241.26 	subsequent hospitalization rate for medical assistance and MinnesotaCare enrollees, excluding 
241.27 	enrollees in programs described in subdivisions 74 and 75, is reduced by 25 percent of the 
241.28 	plan's subsequent hospitalization rate for calendar year 2011. Hospitals shall cooperate with 
241.29 	the plans in meeting this performance target and shall accept payment withholds that must 
241.30 	be returned to the hospitals if the performance target is achieved.
241.31 	(e) The commissioner shall withhold 4.5 percent of managed care plan payments under 
241.32 	this section and county-based purchasing plan payments under section 256B.692 for the 
241.33 	prepaid medical assistance program. The withheld funds must be returned no sooner than 
242.1 	July 1 and no later than July 31 of the following year. The commissioner may exclude 
242.2 	special demonstration projects under subdivisions 75 and 76.
242.3 	(f) The commissioner shall withhold three percent of managed care plan payments under 
242.4 	this section and county-based purchasing plan payments under section 256B.692 for the 
242.5 	prepaid medical assistance program. The withheld funds must be returned no sooner than 
242.6 	July 1 and no later than July 31 of the following year. The commissioner may exclude 
242.7 	special demonstration projects under subdivisions 75 and 76.
242.8 	(g) The return of the withhold under paragraphs (d)(v) and (d)(vi) is not subject to the 
242.9 	requirements of paragraph (d)(i).
242.10 		Subd. 68.Medical education and research fund. (a) The commissioner shall transfer 
242.11 	each year to the medical education and research fund established under section 62J.692, an 
242.12 	amount specified in this subdivision.
242.13 	(b) The commissioner shall calculate the following:
242.14 	(1) an amount equal to the reduction in the prepaid medical assistance payments as 
242.15 	specified in this clause. The county medical assistance capitation base rate before plan 
242.16 	specific adjustments is reduced 6.3 percent for Hennepin County, two percent for the 
242.17 	remaining metropolitan counties, and 1.6 percent for nonmetropolitan Minnesota counties. 
242.18 	Nursing facility and elderly waiver payments and demonstration project payments operating 
242.19 	under subdivisions 78 and 79 are excluded from this reduction. The amount calculated under 
242.20 	this clause shall not be adjusted for periods already paid due to subsequent changes to the 
242.21 	capitation payments;
242.22 	(2) beginning July 1, 2003, $4,314,000 from the capitation rates paid under this section;
242.23 	(3) beginning July 1, 2002, an additional $12,700,000 from the capitation rates paid 
242.24 	under this section; and
242.25 	(4) beginning July 1, 2003, an additional $4,700,000 from the capitation rates paid under 
242.26 	this section.
242.27 	(c) This subdivision shall be effective upon approval of a federal waiver which allows 
242.28 	federal financial participation in the medical education and research fund. The amount 
242.29 	specified under paragraph (b) shall not exceed the total amount transferred for fiscal year 
242.30 	2009. Any excess shall first reduce the amounts specified under paragraph (b). Any excess 
242.31 	following this reduction shall proportionally reduce the amount specified under paragraph 
242.32 	(b).
243.1 	(d) Of the amount in clause (1), the commissioner shall transfer $21,714,000 each fiscal 
243.2 	year to the medical education and research fund.
243.3 	(e) Of the amount in clause (1), following the transfer under clause (3), the commissioner 
243.4 	shall transfer to the medical education research fund $23,936,000 in fiscal years 2012 and 
243.5 	2013 and $49,552,000 in fiscal year 2014 and thereafter.
243.6 	(f) Beginning July 1, 2002, the capitation rates paid under this section are increased by 
243.7 	$12,700,000 per year. Beginning July 1, 2003, the capitation rates paid under this section 
243.8 	are increased by $4,700,000 per year.
243.9 	(g) Beginning July 1, 2009, the capitation rates paid under this section are increased 
243.10 	each year by the lesser of $21,714,000 or an amount equal to the difference between the 
243.11 	estimated value of the reductions described in clause (1), item (i), and the amount of the 
243.12 	limit described in clause (2).
243.13 	(h) Capitation payments for services provided in the month of June for which payment 
243.14 	shall be made no earlier than the first day of the following month and no later than the last 
243.15 	day of that month.
243.16 	(i) The commissioner shall not direct MCO expenditures under the contract, except in 
243.17 	the following situations:
243.18 	(1) implementation of a value-based purchasing model for provider reimbursement, such 
243.19 	as pay-for-performance arrangements, bundled payments, or other service payments intended 
243.20 	to recognize value or outcomes over volume of services;
243.21 	(2) participation in a multipayer or medical assistance specific delivery system reform 
243.22 	or performance improvement initiative;
243.23 	(3) implementation of a minimum or maximum fee schedule, or a uniform dollar or 
243.24 	percentage increase for network providers that provide a particular service. The maximum 
243.25 	fee schedule must allow the MCO the ability to reasonably manage risk and provide discretion 
243.26 	in accomplishing the goals of the contract; and
243.27 	(4) the MCO contract that directs the MCO expenditures under clauses (1) to (3) must 
243.28 	be developed according to Code of Federal Regulations, title 42, section 438.5, comply with 
243.29 	actuarial soundness, and generally accepted actuarial principles and practices and have 
243.30 	written approval from the Centers for Medicare and Medicaid before implementation. To 
243.31 	obtain approval the commissioner must demonstrate in writing that the contract arrangements:
243.32 	(i) are based on the utilization and delivery of services;
244.1 	(ii) directs expenditures equally, using the same terms of performance for a class of 
244.2 	providers providing service under the contract;
244.3 	(iii) expects to advance at least one of the goals and objectives in the commissioner's 
244.4 	quality strategy;
244.5 	(iv) has an evaluation plan that measures the degree to which the arrangement advances 
244.6 	at least one of the goals in the commissioner's quality strategy;
244.7 	(v) does not condition network provider participation on the network provider entering 
244.8 	into or adhering to an intergovernmental transfer agreement; and
244.9 	(vi) are not renewed automatically; and
244.10 	(5) for contract arrangements identified in clauses (1) and (2), the commissioner shall:
244.11 	(i) make participation in the value-based purchasing initiative delivery system reform 
244.12 	or performance improvement initiative available, using the same terms of performance, to 
244.13 	a class of providers providing services under the contract related to the reform or 
244.14 	improvement initiatives;
244.15 	(ii) use a common set of performance measures across all of the payers and providers;
244.16 	(iii) not set the amount or frequency of the expenditures; and
244.17 	(iv) not allow the state to recoup from the MCO any unspent funds allocated for these 
244.18 	arrangements.
244.19 	(j) The commissioner may require MCOs to make pass-through payments to network 
244.20 	providers that are hospitals, physicians, and nursing facilities satisfy Code of Federal 
244.21 	Regulations, title 42, section 438.6(d), until the commissioner must phase out pass-through 
244.22 	payments. Pass-through payments for hospitals may be required under the contract but must 
244.23 	be phased out no longer than on the 10-year schedule, beginning with contracts that start 
244.24 	on or after July 1, 2017 and ending on July 1, 2027. Pass-through payments for physicians 
244.25 	and nursing facilities may be required under the contract but must be phased out no longer 
244.26 	than on the 5-year schedule, beginning with contracts that start on or after July 1, 2017 and 
244.27 	ending on July 1, 2022.
244.28 	(k) The commissioner may make a monthly capitation payment to an MCO for an enrollee 
244.29 	21 to 64 years of age receiving inpatient treatment for psychiatric or substance use disorder 
244.30 	in an institution for mental diseases for a short term stay of no more than 15 days during 
244.31 	the period of the monthly capitation payment. The provision of psychiatric or substance use 
245.1 	disorder treatment in an institution for mental diseases must meet the requirements for in 
245.2 	lieu of services in subdivision 33.
245.3 		Subd. 69.Rate certification submission. (a) The commissioner must submit to the 
245.4 	Centers for Medicare and Medicaid for review and approval the commissioner's rate 
245.5 	certifications at the same time as the commissioner's managed care contracts.
245.6 	(b) The rate certification must satisfy Code of Federal Regulations, title 42, section 
245.7 	438.7(b) and must:
245.8 	(1) base data used in the rate setting process;
245.9 	(2) trend, including changes in the utilization and the price of services;
245.10 	(3) nonbenefit component of the rate;
245.11 	(4) adjustments;
245.12 	(5) prospective and retrospective risk adjustment methodology; and
245.13 	(6) special contract provisions related to payment.
245.14 	(c) An actuary must certify the final capitation rates paid per rate cell under each risk 
245.15 	contract and document the underlying data, assumptions and methodologies.
245.16 	(d) The commissioner may pay each MCO a capitation rate under the contract that is 
245.17 	different than the capitation rate paid to a different MCO, if each capitation rate per rate 
245.18 	cell that is paid is independently developed and set in according to Code of Federal 
245.19 	Regulations, title 42, sections 438.4, 438.5, 438.6, and 438.8.
245.20 	(e) If the commissioner determines that a retroactive adjustment to the capitation rate is 
245.21 	necessary, the retroactive adjustment must be supported by a rationale for the adjustment 
245.22 	and the data. Assumptions and methodologies used to develop the adjustment must be 
245.23 	described with enough detail to allow the Centers for Medicare and Medicaid or an actuary 
245.24 	to determine the reasonableness of the adjustment. Any retroactive adjustments must be 
245.25 	certified by an actuary in a revised rate certification and submitted to the Centers for Medicare 
245.26 	and Medicaid for approval as a contract amendment. All adjustments are subject to timely 
245.27 	claim filing requirements.
245.28 	(f) The commissioner may increase or decrease the capitation rate per rate cell according 
245.29 	to Code of Federal Regulations, title 42, sections 438.4(b)(4) and 438.7(c), up to 1.5 percent 
245.30 	without submitting a revised rate certification.
245.31 	(g) The commissioner must, upon request from the Centers for Medicare and Medicaid, 
245.32 	provide additional information if the Centers for Medicare and Medicaid determines the 
246.1 	information is pertinent to certification approval. The commissioner must identify whether 
246.2 	the additional information is offered by the commissioner, the actuary, or another party.
246.3 	(h) Each year, within 30 days of the establishment of MCO rates, the commissioner shall 
246.4 	submit a report on the certification and how each condition is met by the new payment rates 
246.5 	to the chairs and ranking minority members of the legislative committees with jurisdiction 
246.6 	over health and human services finance.
246.7 		Subd. 70.Medical loss ratio. (a) The commissioner must ensure through contracts that 
246.8 	each MCO calculate and report an MLR for each contract year. The commissioner may 
246.9 	mandate a minimum MLR that must be equal to or higher than 85 percent.
246.10 	(b) The calculation of the MLR in a MLR reporting year is the ratio of the numerator to 
246.11 	the denominator. The numerator includes the sum of the MCO's incurred claims, the MCO's 
246.12 	expenditures for activities that improve health care quality, and fraud prevention activities. 
246.13 	The denominator includes the MCO's adjusted premium revenue minus the MCO's federal, 
246.14 	state, and local taxes and licensing and regulatory fees. The MCO must aggregate the data 
246.15 	for all eligibility groups covered under the contract unless the commissioner requires separate 
246.16 	reporting and a separate MLR calculation for specific populations.
246.17 	(c) Incurred claims are identified by the expenditures, liabilities, reserves, deductions, 
246.18 	and exclusions according to Code of Federal Regulations, title 42, section 438.8(e)(2).
246.19 	(d) Activities that improve health care quality must be in one category according to Code 
246.20 	of Federal Regulations, title 42, section 438.8(e)(3).
246.21 	(e) Fraud prevention activities include MCO expenditures on activities related to fraud 
246.22 	prevention according to Code of Federal Regulations, title 45, section 158.
246.23 	(f) Premium revenue includes state capitation payments; state-developed onetime 
246.24 	payments for specific life events of enrollees; other payments to the MCO according to 
246.25 	Code of Federal Regulations, title 42, section 438.6(b)(3); unpaid cost-sharing amounts; 
246.26 	and changes to unearned premium reserves, net payments, and receipts related to risk sharing 
246.27 	mechanisms.
246.28 	(g) Taxes, licensing, and regulatory fees identified in Code of Federal Regulations, title 
246.29 	42, section 438.8(f)(3).
246.30 	(h) The total amount of the denominator for an MCO that is later assumed by another 
246.31 	entity must be reported by the assuming MCO for the entire MLR reporting year.
246.32 	(i) Each expense must be included under only one type of expense, unless a portion of 
246.33 	the expense fits under the definition of, or criteria for, one type of expense and the remainder 
247.1 	fits into a different type of expense, in which case the expense must be prorated between 
247.2 	types of expenses. Expenditures that benefit multiple contracts or populations, or contracts 
247.3 	other than those being reported must be reported on a pro rata basis. Expenses must be 
247.4 	allocated using the methods described in Code of Federal Regulations, title 42, section 
247.5 	438.8(g)(2).
247.6 	(j) Credibility adjustment means an adjustment to the MLR for a partially credible MCO 
247.7 	to account for a difference between the actual and target MLRs that may be due to random 
247.8 	statistical variation. The calculation of an MLR is based on the MCO's member months and 
247.9 	may be determined as credible, partially credible, or no credibility. An MCO that is assigned 
247.10 	no credibility or full credibility to the MCO's MLR calculation must not receive a credibility 
247.11 	adjustment.
247.12 	(k) The commissioner may require the MCO to provide a remittance if the MLR for the 
247.13 	MLR reporting year does not meet the minimum MLR standard of 85 percent or higher as 
247.14 	set by the commissioner.
247.15 	(l) The commissioner through contracts must require each MCO to submit a report to 
247.16 	the commissioner for each MLR reporting year that includes the information identified in 
247.17 	Code of Federal Regulations, title 42, section 438.8(k). The report must be submitted within 
247.18 	12 months of the end of the MLR reporting year. The MCO must require any third-party 
247.19 	vendor providing claims adjudication to provide all underlying data associated with MLR 
247.20 	reporting to the MCO within 180 days of the end of the MLR reporting year or within 30 
247.21 	days of being requested by the MCO to calculate and validate the accuracy of MLR reporting. 
247.22 	The MCO must include an attestation with the MLR report as to the accuracy of the 
247.23 	calculation of the MLR.
247.24 	(m) The commissioner must annually submit to the Centers for Medicare and Medicaid 
247.25 	a summary description of the reports received from the MCOs according to Code of Federal 
247.26 	Regulations, title 42, section 438.8(k), along with the required rate certification. The summary 
247.27 	description must include, at a minimum, the amount of the numerator, the amount of the 
247.28 	denominator, the MLR percentage achieved, the number of member months, and any 
247.29 	remittances owed by each for the MLR reporting year. If the commissioner requires the 
247.30 	MCO to pay remittances through the contract for not meeting the minimum MLR the state 
247.31 	must reimburse the Centers for Medicare and Medicaid the federal share, considering 
247.32 	differences in the federal matching rate. If a remittance is owed, the commissioner must 
247.33 	submit a separate report describing the methodology used to determine the state and federal 
247.34 	shares of the remittance with the required report.
248.1 	(n) The commissioner may exclude a newly contracted MCO from calculating and 
248.2 	reporting an MLR for the first year of the MCO's operation. MCOs must be required to 
248.3 	comply with the requirements in this section during the next MLR reporting year.
248.4 	(o) If the commissioner makes a retroactive change to the capitation payments for a 
248.5 	MLR reporting year where the report was already submitted to the commissioner, the MCO 
248.6 	must recalculate the MLR for all affected by the change and submit a new report meeting 
248.7 	the reporting requirements in paragraph (l).
248.8 		Subd. 71.Solvency standards. (a) Each MCO must provide assurances satisfactory to 
248.9 	the commissioner showing that the MCO's provision against the risk of insolvency is adequate 
248.10 	to ensure that the MCO's medical assistance enrollees are not be liable for the MCO's debts 
248.11 	if the MCO becomes insolvent.
248.12 	(b) The MCO must meet the solvency standards established by the commissioner for 
248.13 	private health maintenance organizations, or be licensed or certified by the commissioner 
248.14 	as a risk-bearing entity.
248.15 		Subd. 72.Managed care financial reporting. (a) The commissioner shall collect detailed 
248.16 	data regarding financials, provider payments, provider rate methodologies, and other data 
248.17 	as determined by the commissioner. The commissioner shall set uniform criteria, definitions, 
248.18 	and standards for the data to be submitted, and shall require managed care organizations to 
248.19 	comply with these criteria, definitions, and standards when submitting data. The 
248.20 	commissioner shall ensure that the data collection is implemented in an integrated and 
248.21 	coordinated manner that avoids unnecessary duplication of effort. To the extent possible, 
248.22 	the commissioner shall use existing data sources and streamline data collection in order to 
248.23 	reduce public and private sector administrative costs. Nothing in this subdivision shall allow 
248.24 	release of information that is nonpublic data pursuant to section 13.02.
248.25 	(b) Each MCO must provide quarterly to the commissioner the following information 
248.26 	on state public programs, in the form and manner specified by the commissioner:
248.27 	(1) an income statement by program;
248.28 	(2) financial statement footnotes;
248.29 	(3) quarterly profitability by program and population group;
248.30 	(4) a medical liability summary by program and population group;
248.31 	(5) received but unpaid claims report by program;
249.1 	(6) services versus payment lags by program for hospital services, outpatient services, 
249.2 	physician services, other medical services, and pharmaceutical benefits;
249.3 	(7) utilization reports that summarize utilization and unit cost information by program 
249.4 	for hospitalization services, outpatient services, physician services, and other medical 
249.5 	services;
249.6 	(8) pharmaceutical statistics by program and population group for measures of price and 
249.7 	utilization of pharmaceutical services;
249.8 	(9) subcapitation expenses by population group;
249.9 	(10) third-party payments by program;
249.10 	(11) all new, active, and closed subrogation cases by program;
249.11 	(12) all new, active, and closed fraud and abuse cases by program;
249.12 	(13) medical loss ratios by program;
249.13 	(14) administrative expenses by category and subcategory by program that reconcile to 
249.14 	other state and federal regulatory agencies, including Minnesota Supplement Report #1A;
249.15 	(15) revenues by program, including investment income;
249.16 	(16) nonadministrative service payments, provider payments, and reimbursement rates 
249.17 	by provider type or service category, by program, paid by the managed care plan under this 
249.18 	section or the county-based purchasing plan under section 256B.692 to providers and vendors 
249.19 	for administrative services under contract with the plan, including but not limited to:
249.20 	(i) individual-level provider payment and reimbursement rate data;
249.21 	(ii) provider reimbursement rate methodologies by provider type, by program, including 
249.22 	a description of alternative payment arrangements and payments outside the claims process;
249.23 	(iii) data on implementation of legislatively mandated provider rate changes; and
249.24 	(iv) individual-level provider payment and reimbursement rate data and plan-specific 
249.25 	provider reimbursement rate methodologies by provider type, by program, including 
249.26 	alternative payment arrangements and payments outside the claims process, provided to the 
249.27 	commissioner under this subdivision are nonpublic data as defined in section 13.02;
249.28 	(17) data on the amount of reinsurance or transfer of risk by program; and
249.29 	(18) contribution to reserve, by program.
250.1 	(c) If a report is published or released based on data provided under this subdivision, 
250.2 	the commissioner shall provide the report to MCOs 15 days before the publication or release 
250.3 	of the report. MCOs shall have 15 days to review the report and provide comment to the 
250.4 	commissioner. The quarterly reports shall be submitted to the commissioner no later than 
250.5 	60 days after the end of the previous quarter, except the fourth-quarter report, which shall 
250.6 	be submitted by April 1 of each year. The fourth-quarter report shall include audited financial 
250.7 	statements, parent company audited financial statements, an income statement reconciliation 
250.8 	report, and any other documentation necessary to reconcile the detailed reports to the audited 
250.9 	financial statements.
250.10 	(d) MCOs shall certify to the commissioner for the purpose of financial reporting for 
250.11 	state public health care programs under this subdivision that costs reported for state public 
250.12 	health care programs include:
250.13 	(1) only services covered under the state plan and waivers, and related allowable 
250.14 	administrative expenses; and
250.15 	(2) the dollar value of unallowable and nonstate plan services, including both medical 
250.16 	and administrative expenditures, that have been excluded.
250.17 		Subd. 73.Financial and data quality assurance audits. (a) The commissioner shall 
250.18 	require, in the request for bids and resulting contracts with MCOs under this section and 
250.19 	section 256B.692, that each MCO submit to and fully cooperate with the independent 
250.20 	third-party financial audits by the legislative auditor under of the information required under 
250.21 	subdivision 70, paragraph (b). Each contract with an MCO under this section or section 
250.22 	256B.692 must provide the commissioner, the legislative auditor, and vendors contracting 
250.23 	with the legislative auditor, access to all data required to complete audits under this 
250.24 	subdivision.
250.25 	(b) The legislative auditor shall conduct or contract with vendors to conduct independent 
250.26 	third-party financial audits of the information required to be provided by managed care 
250.27 	organizations under subdivision 70, paragraph (b). The audits by the vendors shall be 
250.28 	conducted as vendor resources permit and according to generally accepted government 
250.29 	auditing standards issued by the Government Accountability Office. The contract with the 
250.30 	vendors shall be designed and administered to render the independent third-party audits 
250.31 	eligible for a federal subsidy, if available. The contract shall require the audits to include a 
250.32 	determination of compliance with the Medicaid rate certification process. For purposes of 
250.33 	this subdivision, "independent third-party" means a vendor that is independent according 
250.34 	to government auditing standards issued by the Government Accountability Office.
251.1 	(c) Each MCO providing services shall provide to the commissioner biweekly encounter 
251.2 	data and claims data for state public health care programs and shall participate in a quality 
251.3 	assurance program that verifies the timeliness, completeness, accuracy, and consistency of 
251.4 	the data provided. The commissioner shall develop written protocols for the quality assurance 
251.5 	program and shall make the protocols publicly available. The commissioner shall contract 
251.6 	for an independent third-party audit to evaluate the quality assurance protocols as to the 
251.7 	capacity of the protocols to ensure complete and accurate data and to evaluate the 
251.8 	commissioner's implementation of the protocols.
251.9 	(d) Upon completion of the evaluation under paragraph (c), the commissioner shall 
251.10 	provide copies of the report to the legislative auditor and the chairs and ranking minority 
251.11 	members of the legislative committees with jurisdiction over health care policy and financing.
251.12 	(e) Any actuary under contract with the commissioner to provide actuarial services must 
251.13 	meet the independence requirements under the professional code for fellows in the Society 
251.14 	of Actuaries and must not have provided actuarial services to an MCO that is under contract 
251.15 	with the commissioner during the period in which the actuarial services are being provided. 
251.16 	An actuary or actuarial firm meeting the requirements of this paragraph must certify and 
251.17 	attest to the rates paid to the MCOs, and the certification and attestation must be auditable.
251.18 	(f) The commissioner shall conduct or contract for the performance of an audit of state 
251.19 	public health care program administrative and medical expenses reported by the MCOs at 
251.20 	least every three years. This includes: financial and encounter data reported to the 
251.21 	commissioner under subdivision 70, including payments to providers and subcontractors; 
251.22 	supporting documentation for expenditures; categorization of administrative and medical 
251.23 	expenses; and allocation methods used to attribute administrative expenses to state public 
251.24 	health care programs. These audits also must monitor compliance with data and financial 
251.25 	report certification requirements established by the commissioner for the purposes of 
251.26 	managed care capitation payment rate-setting. The MCOs shall fully cooperate with the 
251.27 	audits. The commissioner shall report to the chairs and ranking minority members of the 
251.28 	legislative committees with jurisdiction over health and human services policy and finance 
251.29 	by February 1, 2016, and each February 1 thereafter, the number of ad hoc audits conducted 
251.30 	in the past calendar year and the results of these audits.
251.31 	(g) Nothing in this subdivision shall allow the release of information that is nonpublic 
251.32 	data according to section 13.02.
251.33 		Subd. 74.Prior approval. (a) Federal financial participation (FFP) is available under 
251.34 	a comprehensive risk contract if:
252.1 	(1) the Centers for Medicare and Medicaid confirmed that the contractor meets the 
252.2 	definition of an MCO; and
252.3 	(2) the MCO contract meets all of the requirements of sections 1903(m)(2)(A) and 1932 
252.4 	of the Social Security Act.
252.5 	(b) Prior approval by the Centers for Medicare and Medicaid is a condition for FFP 
252.6 	under any MCO contract that extends for less than one full year or that has a value equal 
252.7 	to or greater than the following threshold amounts:
252.8 	(1) for 1998, the threshold is $1,000,000; or
252.9 	(2) for subsequent years, the amount is increased by the percentage increase in the 
252.10 	Consumer Price Index.
252.11 	(c) The commissioner must submit all MCO contracts to the Centers for Medicare and 
252.12 	Medicaid for review 90 days before the effective date of the contracts.
252.13 		Subd. 75.Standard contract requirements. (a) Managed care contracts under this 
252.14 	section and section 256L.12 shall be entered into or renewed on a calendar year basis.
252.15 	(b) The commissioner may issue separate contracts with requirements specific to services 
252.16 	to medical assistance recipients 65 years of age and older and persons with disabilities 18 
252.17 	to 64 years of age as described in section 256B.055, subdivision 7.
252.18 	(c) Requirements applicable to managed care programs under chapters 256B and 256L 
252.19 	established after the effective date of a contract with the commissioner take effect when the 
252.20 	contract is next issued or renewed.
252.21 	(d) The commissioner shall ensure that contracts with MCOs comply with:
252.22 	(1) all applicable federal and state laws and regulations, including Title VI of the Civil 
252.23 	Rights Act of 1964; Title IX of the Education Amendments of 1972; the Age Discrimination 
252.24 	Act of 1975; the Rehabilitation Act of 1973; the Americans with Disabilities Act of 1990 
252.25 	as amended; and section 1557 of the Patient Protection and Affordable Care Act;
252.26 	(2) conflict of interest safeguards in Code of Federal Regulations, title 42, section 438.58, 
252.27 	and with conflict of interest prohibitions for contracting officers, employees, or independent 
252.28 	contractors in section 1902(a)(4)(C) of the Social Security Act;
252.29 	(3) requirements mandating provider identification of provider-preventable conditions 
252.30 	as a condition of payment, and the prohibition against payment for provider-preventable 
252.31 	conditions in sections 256.969 subdivision 3b, paragraph (c), and 256B.0625 subdivision 
252.32 	3, and Code of Federal Regulations, title 42, sections 434.6(a)(12) and 447.26;
253.1 	(4) inspections and audits of records and access to facilities according to Code of Federal 
253.2 	Regulations, title 42, section 438.3(h);
253.3 	(5) physician incentive requirements according to Code of Federal Regulations, title 42, 
253.4 	sections 422.208 and 422.210;
253.5 	(6) maintaining policies and procedures for advance directives according to Code of 
253.6 	Federal Regulations, title 42, section 422.128. The contract must also provide adult enrollees 
253.7 	with written information on advance directive policies, and include a description of applicable 
253.8 	state law. The information must reflect changes in state law as soon as possible but no later 
253.9 	than 90 days after the effective date of the change;
253.10 	(7) requirements for subcontracts in Code of Federal Regulations, title 42, section 
253.11 	438.230;
253.12 	(8) requirements for enrollee's choice of network provider;
253.13 	(9) annual submission requirements for audited financial reports specific to the medical 
253.14 	assistance contract;
253.15 	(10) parity requirements for mental health and substance use disorders, if applicable;
253.16 	(11) for LTSS services covered under the contract that could be authorized by a waiver 
253.17 	in section 1915(c) of the Social Security Act or a state plan amendment authorized by section 
253.18 	1915(i) or 1915(k) of the Social Security Act must be delivered according to Code of Federal 
253.19 	Regulations, title 42, section 441.301(c)(4);
253.20 	(12) requirements of Code of Federal Regulations, title 42, section 438.3(s), for coverage 
253.21 	of outpatient drugs;
253.22 	(13) responsibility for coordination of benefits for individuals dually eligible for medical 
253.23 	assistance and Medicare. MCOs must enter a coordination of benefits agreement with 
253.24 	Medicare and participate in the automated claims crossover process; and
253.25 	(14) enrollee grievance and appeal records requirements in Code of Federal Regulations, 
253.26 	title 42, section 438.416, base data requirements in Code of Federal Regulations, title 42, 
253.27 	section 438.5(c), MLR reports requirements in Code of Federal Regulations, title 42, 438.8(k), 
253.28 	and the data information and documentation requirements in Code of Federal Regulations, 
253.29 	title 42, sections 438.604, 438.606, 438.608, and 438.610, for a period of ten years plus the 
253.30 	current contract year.
253.31 		Subd. 76.Alternative services; elderly and disabled persons.  (a) The commissioner 
253.32 	may create alternative integrated delivery systems for acute and long-term care services to 
254.1 	elderly persons and people with disabilities that provide increased coordination, improve 
254.2 	access to quality services, and mitigate future cost increases. The commissioner may seek 
254.3 	federal authority to combine Medicare and Medicaid capitation payments for the 
254.4 	demonstrations and may contract with Medicare-approved special needs plans that are 
254.5 	offered by a demonstration provider or by an entity that is directly or indirectly wholly 
254.6 	owned or controlled by a demonstration provider to provide Medicaid services. Medicare 
254.7 	funds and services shall be administered according to the terms and conditions of the federal 
254.8 	contract and demonstration provisions. For the purpose of administering medical assistance 
254.9 	funds, demonstrations under this subdivision are subject to subdivisions 1 to 22. All 
254.10 	enforcement and rulemaking powers available under chapters 62D, 62M, and 62Q are hereby 
254.11 	granted to the commissioner of health with respect to Medicare-approved special needs 
254.12 	plans with which the commissioner contracts to provide Medicaid services under this section. 
254.13 	An initial open enrollment period may be provided. Persons who disenroll from 
254.14 	demonstrations under this subdivision remain subject to Minnesota Rules, parts 9500.1450 
254.15 	to 9500.1464. When a person is enrolled in a health plan under these demonstrations and 
254.16 	the health plan's participation is subsequently terminated for any reason, the person shall 
254.17 	be provided an opportunity to select a new health plan and shall have the right to change 
254.18 	health plans within the first 60 days of enrollment in the second health plan. Persons required 
254.19 	to participate in health plans under this section who fail to make a choice of health plan 
254.20 	shall not be randomly assigned to health plans under these demonstrations. Notwithstanding 
254.21 	section 256L.12, subdivision 5, and Minnesota Rules, part 9505.5220, subpart 1, item A, 
254.22 	if adopted, for the purpose of demonstrations under this subdivision, the commissioner may 
254.23 	contract with MCOs, including counties, to serve only elderly persons eligible for medical 
254.24 	assistance, elderly and disabled persons, or disabled persons only.
254.25 	(b) Before implementation of a demonstration project for persons with a disability, the 
254.26 	commissioner must provide information to appropriate committees of the house of 
254.27 	representatives and senate and must involve representatives of affected disability groups in 
254.28 	the design of the demonstration projects.
254.29 	(c) The commissioner, in consultation with the commissioners of commerce and health, 
254.30 	may approve and implement programs for all-inclusive care for the elderly (PACE) according 
254.31 	to federal laws and regulations governing that program and state laws or rules applicable 
254.32 	to participating providers. A PACE provider is not required to be licensed or certified as a 
254.33 	health plan company as defined in section 62Q.01, subdivision 4. A person 55 years of age 
254.34 	and older who was screened by the county and found eligible for services under the elderly 
254.35 	waiver or community access for disability inclusion or who is already eligible for medical 
255.1 	assistance but meets level of care criteria for receipt of waiver services may choose to enroll 
255.2 	in the PACE program. Medicare and Medicaid services must be provided according to this 
255.3 	subdivision and federal Medicare and Medicaid requirements governing PACE providers 
255.4 	and programs. PACE enrollees must receive Medicaid home and community-based services 
255.5 	through the PACE provider as an alternative to services for which the person would otherwise 
255.6 	be eligible through home and community-based waiver programs and medical assistance. 
255.7 	The commissioner shall establish medical assistance rates for PACE providers that do not 
255.8 	exceed costs that would have been incurred under fee-for-service or other relevant managed 
255.9 	care programs operated by the department.
255.10 	(d) Costs for home and community-based services for people with disabilities must not 
255.11 	exceed costs that would have been incurred under the fee-for-service program. In developing 
255.12 	program specifications for expansion of integrated programs, the commissioner shall involve 
255.13 	and consult the state-level stakeholder group established in subdivision 75, paragraph (d), 
255.14 	including consultation on whether and how to include home and community-based waiver 
255.15 	programs. Plans to create alternative integrated delivery systems shall be presented to the 
255.16 	chairs of the house of representatives and senate committees with jurisdiction over health 
255.17 	and human services policy and finance before implementation.
255.18 	(e) Notwithstanding section 256B.0621, health plans providing services under this section 
255.19 	are responsible for home care targeted case management and relocation targeted case 
255.20 	management. Services must be provided according to the terms of the waivers and contracts 
255.21 	approved by the federal government.
255.22 	(f) Except as applicable to the project's operation, the provisions of sections 256.975 
255.23 	and 256B.0911 are waived for the purposes of this section for recipients enrolled in the 
255.24 	managed care program for seniors.
255.25 	(g) The commissioner shall ensure the views of beneficiaries, individuals representing 
255.26 	beneficiaries, providers, and other stakeholders are solicited and addressed during the design, 
255.27 	implementation, and oversight of the managed LTSS program. The composition of the 
255.28 	stakeholder group and frequency of meetings must be sufficient to ensure meaningful 
255.29 	stakeholder engagement.
255.30 		Subd. 77.Medicare special needs plans; medical assistance basic health care. (a) 
255.31 	The commissioner may contract with demonstration providers and current or former sponsors 
255.32 	of qualified Medicare-approved special needs plans, to provide medical assistance basic 
255.33 	health care services to persons with disabilities, including those with developmental 
255.34 	disabilities. Basic health care services include:
256.1 	(1) services covered by medical assistance, except for ICF/DD services, home and 
256.2 	community-based waiver services, case management for persons with developmental 
256.3 	disabilities under section 256B.0625, subdivision 20a, and personal care and certain home 
256.4 	care services defined by the commissioner in consultation with the stakeholder group 
256.5 	established under paragraph (d); and
256.6 	(2) risk for up to 100 days of nursing facility services for persons who reside in a 
256.7 	noninstitutional setting and home health services related to rehabilitation as defined by the 
256.8 	commissioner after consultation with the stakeholder group.
256.9 	The commissioner may exclude other medical assistance services from the basic health 
256.10 	care benefit set. Enrollees in these plans can access any excluded services on the same basis 
256.11 	as other medical assistance recipients who have not enrolled.
256.12 	(b) The commissioner may contract with demonstration providers and current and former 
256.13 	sponsors of qualified Medicare special needs plans, to provide basic health care services 
256.14 	under medical assistance to persons who are dually eligible for both Medicare and Medicaid 
256.15 	and those Social Security beneficiaries eligible for Medicaid but in the waiting period for 
256.16 	Medicare. The commissioner shall consult with the stakeholder group under paragraph (d) 
256.17 	to develop program specifications for these services. Payment for Medicaid services provided 
256.18 	under this subdivision for the months of May and June will be made no earlier than July 1 
256.19 	of the same calendar year.
256.20 	(c) The commissioner shall enroll a person with a disability in managed care under this 
256.21 	section, unless the person chooses to opt out of enrollment. The commissioner shall establish 
256.22 	enrollment and opt-out procedures consistent with applicable enrollment procedures under 
256.23 	this section.
256.24 	(d) The commissioner shall establish a state-level stakeholder group to provide advice 
256.25 	on managed care programs for persons with disabilities, including both integrated programs 
256.26 	and contracts with special needs plans that provide basic health care services as described 
256.27 	in paragraphs (a) and (b). The stakeholder group shall provide advice on program expansions 
256.28 	under this subdivision and subdivision 18, including:
256.29 	(1) implementation efforts;
256.30 	(2) consumer protections; and
256.31 	(3) program specifications such as quality assurance measures, data collection and 
256.32 	reporting, and evaluation of costs, quality, and results.
257.1 	(e) Each plan under contract to provide medical assistance basic health care services 
257.2 	shall establish a local or regional stakeholder group, including representatives of the counties 
257.3 	covered by the plan, members, consumer advocates, and providers, for advice on issues that 
257.4 	arise in the local or regional area.
257.5 	(f) The commissioner is prohibited from providing the names of potential enrollees to 
257.6 	health plans for marketing purposes. The commissioner shall mail no more than two sets 
257.7 	of marketing materials per contract year to potential enrollees on behalf of health plans, at 
257.8 	the health plan's request. The marketing materials shall be mailed by the commissioner 
257.9 	within 30 days of receipt of these materials from the health plan. The health plans shall 
257.10 	cover any costs incurred by the commissioner for mailing marketing materials.
257.11 		Subd. 78.Home and community-based waiver services. (a) For individuals 65 years 
257.12 	of age and older enrolled in prepaid managed care programs including demonstration projects 
257.13 	authorized under subdivision 74, elderly waiver services shall be covered.
257.14 	(b) For individuals younger than 65 years of age enrolled in demonstrations authorized 
257.15 	under subdivision 18, home and community-based waiver services shall be covered according 
257.16 	to the terms and conditions of the federal agreement governing that demonstration project.
257.17 		Subd. 79.Nursing home services. (a) Notwithstanding Minnesota Rules, part 9500.1457, 
257.18 	subpart 1, item B, up to 180 days of nursing facility services as defined in section 256B.0625, 
257.19 	subdivision 2, which are provided in a nursing facility certified by the Department of Health 
257.20 	for services provided and eligible for payment under Medicaid, shall be covered under the 
257.21 	managed care program for individuals who are not residing in a nursing facility at the time 
257.22 	of enrollment in the managed care program.
257.23 	(b) For individuals enrolled in the Minnesota senior health options project or in other 
257.24 	programs authorized under subdivision 75, nursing facility services shall be covered 
257.25 	according to the terms and conditions of the federal agreement governing that demonstration 
257.26 	project.
257.27 	(c) For individuals enrolled in programs authorized under subdivision 75, services in an 
257.28 	intermediate care facility for persons with developmental disabilities shall be covered 
257.29 	according to the terms and conditions established in the MCO's contract with the 
257.30 	commissioner.
257.31 		Subd. 80.Additional managed care reporting. (a) The commissioner shall require 
257.32 	MCOs, as a condition of contract, to implement strategies that facilitate access to periodic 
257.33 	developmental and social-emotional screenings for children between the ages of one and 
257.34 	three years of age. The commissioner shall also ensure children who do not meet milestones 
258.1 	have access to appropriate evaluation and assessment, including treatment recommendations, 
258.2 	expected to improve the child's functioning, with the goal of meeting milestones by five 
258.3 	years of age.
258.4 	(b) The following information from encounter data provided to the commissioner shall 
258.5 	be reported on the department's public Web site for each MCO annually by July 31 of each 
258.6 	year:
258.7 	(1) the number of children who received a diagnostic assessment;
258.8 	(2) the total number of children one to six years of age with a diagnosis of autism 
258.9 	spectrum disorder who received treatments;
258.10 	(3) the number of children identified under this paragraph reported by each 12-month 
258.11 	age group beginning with age one and ending with age six; and
258.12 	(4) the types of treatments provided to children identified under this paragraph listed by 
258.13 	billing code, including the number of units billed for each child.
258.14 	(c) Each MCO shall also report any barriers to providing screening, diagnosis, and 
258.15 	treatment of children between one and three years of age, any strategies implemented to 
258.16 	address barriers, and make recommendations on how to measure and report on the 
258.17 	effectiveness of the strategies implemented to facilitate access for the children to provide 
258.18 	developmental and social-emotional screening, diagnosis, and treatment as described in 
258.19 	paragraph (a).
258.20 	(d) Each MCO shall submit information as required by the commissioner, including data 
258.21 	required for assessing client satisfaction, quality of care, cost, and utilization of services for 
258.22 	purposes of project evaluation. The commissioner shall develop methods of data reporting 
258.23 	and collection to provide aggregate enrollee information on encounters and outcomes to 
258.24 	determine access and quality assurance. Required information shall be specified before the 
258.25 	commissioner contracts with an MCO.
258.26 	(e) Aggregate nonpersonally identifiable health plan encounter data, aggregate spending 
258.27 	data for major categories of service as reported to the commissioners of health and commerce 
258.28 	under section 62D.08, subdivision 3, clause (a), and criteria for service authorization and 
258.29 	service use are public data that the commissioner shall make available and use in public 
258.30 	reports. The commissioner shall require each MCO to provide:
258.31 	(1) encounter data for each service provided, using standard codes and unit of service 
258.32 	definitions set by the commissioner, in a form that the commissioner can report by age, 
258.33 	eligibility groups, and health plan; and
259.1 	(2) criteria, written policies, and procedures to determine the medical necessity, 
259.2 	appropriateness, and efficacy of a procedure or service required to be disclosed under section 
259.3 	62M.10, subdivision 7, and Code of Federal Regulations, title 42, part 438.210(b)(1), used 
259.4 	for each type of service for which authorization is required.
259.5 	(f) Each MCO shall report to the commissioner the extent that providers employed by 
259.6 	or under contract with the MCO use patient-centered decision-making tools or procedures 
259.7 	designed to engage patients early in the decision-making process and the steps taken by the 
259.8 	MCO to encourage their use.
259.9 	(g) Each MCO shall submit drug utilization data as specified by the commissioner in 
259.10 	the MCO's contract to allow the commissioner to bill drug manufacturers for rebates 
259.11 	according to section 1927 of the Social Security Act, in a time frame established by the 
259.12 	commissioner. Each MCO shall exclude from this report utilization data for covered 
259.13 	outpatient drugs that are subject to discounts under the 340B Drug Pricing Program.
259.14 		Subd. 81.Supplemental recovery program. The commissioner shall conduct a 
259.15 	supplemental recovery program for third-party liabilities identified through coordination 
259.16 	of benefits not recovered by MCOs for state public health programs. Any third-party liability 
259.17 	identified through coordination of benefits and recovered by the commissioner more than 
259.18 	eight months after the date an MCO adjudicates a health care claim shall be retained by the 
259.19 	commissioner and deposited in the general fund. The commissioner shall establish a 
259.20 	mechanism, including a reconciliation process, for MCOs to coordinate third-party liability 
259.21 	collections efforts resulting from coordination of benefits under this subdivision with the 
259.22 	commissioner to ensure there is no duplication of efforts. The coordination mechanism must 
259.23 	be consistent with the reporting requirements in subdivision 70. The commissioner shall 
259.24 	share accurate and timely third-party liability data with MCOs.
259.25 		Subd. 82.Individualized education program and individualized family service plan 
259.26 	services. The commissioner shall separate out individualized education program (IEP) and 
259.27 	individualized family service plan (IFSP) services for children enrolled in the managed care 
259.28 	and the MinnesotaCare program. Medical assistance coverage of eligible IEP and IFSP 
259.29 	services shall not be included in the capitated services for children enrolled in MCOs through 
259.30 	managed care and the MinnesotaCare program. Local school districts shall bill the 
259.31 	commissioner for these services, and claims shall be paid on a fee-for-service basis.

260.1 	Sec. 2.  REPEALER.
 260.2 	Minnesota Statutes 2016, section 256B.69, subdivisions 1, 2, 3, 3a, 3b, 4, 4b, 5, 5a, 5b, 
260.3 	5c, 5d, 5f, 5g, 5h, 5i, 5j, 5k, 6, 6a, 6b, 6d, 7, 8, 9, 9a, 9c, 9d, 9e, 10, 11, 16, 17, 18, 19, 20, 
260.4 	21, 22, 23, 25, 26, 27, 28, 29, 30, 31, 32a, 33, 34, and 35, are repealed.

260.5 	Sec. 3. REVISOR'S INSTRUCTION.
 260.6 	In Minnesota Statutes and Minnesota Rules, the revisor of statutes, in consultation with 
260.7 	the Department of Human Services, shall make necessary cross-reference changes resulting 
260.8 	from implementing this article and repealing Minnesota Statutes, section 256B.69.

260.9 	ARTICLE 6
260.10 	DIRECT CARE AND TREATMENT

260.11 	Section 1. Minnesota Statutes 2016, section 246.014, is amended to read:
260.12 	246.014 SERVICES.
260.13 	The measure of services are:
260.14 	(a) The commissioner of human services shall develop and maintain state-operated 
260.15 	services in a manner consistent with sections 245.461 and 245.487 and chapters 252, 254A, 
260.16 	and 254B. State-operated services shall be provided in coordination with counties and other 
260.17 	vendors. State-operated services shall include regional treatment centers, specialized inpatient 
260.18 	or outpatient treatment programs, enterprise services, community-based services and 
260.19 	programs, community preparation services, consultative services, and other services 
260.20 	consistent with the mission of the Department of Human Services. These services shall may
260.21 	include crisis beds, waivered homes, intermediate care facilities, and day training and 
260.22 	habilitation facilities. The administrative structure of state-operated services must be 
260.23 	statewide in character. The state-operated services staff may deliver services at any location 
260.24 	throughout the state.
260.25 	(b) The commissioner of human services shall create and maintain forensic services 
260.26 	programs. Forensic services shall be provided in coordination with counties and other 
260.27 	vendors. Forensic services shall include specialized inpatient programs at secure treatment 
260.28 	facilities as defined in sections 253B.02, subdivision 18a, and 253D.02, subdivision 13, 
260.29 	consultative services, aftercare services, community-based services and programs, transition 
260.30 	services, nursing home services, or other services consistent with the mission of the 
260.31 	Department of Human Services.
261.1 	(c) Community preparation services as identified in paragraphs (a) and (b) are defined 
261.2 	as specialized inpatient or outpatient services or programs operated outside of a secure 
261.3 	environment but are administered by a secured treatment facility.
261.4 	(d) The commissioner of human services may establish policies and procedures which 
261.5 	govern the operation of the services and programs under the direct administrative authority 
261.6 	of the commissioner.

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

261.8 	Sec. 2. Minnesota Statutes 2016, section 246B.05, is amended to read:
261.9 	246B.05 MINNESOTA SEX OFFENDER PROGRAM; VOCATIONAL WORK 
261.10 	PROGRAM OPTION.
261.11 		Subdivision 1.Vocational work program option. The commissioner of human services
261.12 	shall develop a vocational work program for persons admitted to the Minnesota sex offender 
261.13 	program. The vocational work program is an extension of therapeutic treatment in order for 
261.14 	civilly committed sex offenders to learn valuable work skills and work habits while 
261.15 	contributing to their cost of care. The vocational work program may include work maintaining 
261.16 	the center or work that is brought to the center by an outside source. training and educational 
261.17 	training, and to develop proper work habits and extended treatment services. The industrial 
261.18 	and commercial activities authorized by this section are designated Minnesota state industries.
261.19 	The earnings generated from the vocational work program must be deposited into the account 
261.20 	created in subdivision 2.
261.21 		Subd. 2.Minnesota sex offender program; vocational work program account. A 
261.22 	vocational work program account is created in the state treasury. Money collected by the 
261.23 	commissioner of human services for the program under this section must be deposited in 
261.24 	this account. Money in the account is appropriated to the commissioner for purposes of this 
261.25 	section. to be used for the vocational work program authorized under this section, including 
261.26 	the purchase of equipment and raw materials, the payment of salaries and wages, and other 
261.27 	necessary expenses as determined by the commissioner. The purchase of a service, material, 
261.28 	and commodity used in and held for resale is not subject to the competitive bidding 
261.29 	procedures of section 16C.06, but is subject to all other provisions of chapters 16B and 16C. 
261.30 	If practical, a purchase must be made from a small targeted group business designated under 
261.31 	section 16C.16.
261.32 		Subd. 3.Money. The commissioner has the authority to collect money resulting from 
261.33 	the vocational work program for reinvestment within the program.
262.1 		Subd. 4.Wages. Notwithstanding section 177.24 or any other law, the commissioner 
262.2 	has the discretion to set the pay rate for an individual participating in the vocational work 
262.3 	program. The commissioner has the authority to retain up to 50 percent of a payment made 
262.4 	to an individual participating in the vocational work program to reduce state costs associated 
262.5 	with operating the Minnesota sex offender program.
262.6 		Subd. 5.Status of civilly committed sex offenders. A civilly committed sex offender 
262.7 	participating in the vocational work program is not an employee of the Minnesota sex 
262.8 	offender program, the Department of Human Services, or the state, and is not subject to fair 
262.9 	labor standards under sections 177.21 to 177.35; workers' compensation under sections 
262.10 	176.011 to 176.862; the Minnesota Human Rights Act under sections 363A.01 to 363A.44; 
262.11 	laws governing state employees under chapter 43A; the Public Employment Labor Relations 
262.12 	Act under chapter 179A; or the successors to any of these sections and any other laws 
262.13 	pertaining to employees and employment.
262.14 		Subd. 6.Claims. A claim or demand arising out of injury to or death of a civilly 
262.15 	committed sex offender while the individual is participating in the vocational work program 
262.16 	or performing a work assignment maintaining the facility must be presented to, heard by, 
262.17 	and determined exclusively by the legislature as provided in section 3.738.
262.18 		Subd. 7.Indirect costs and reimbursements. The commissioner is not required to 
262.19 	include indirect costs as defined in section 16A.127 in work activity contracts for a client 
262.20 	of the Minnesota sex offender program and is not required to reimburse the general fund 
262.21 	for indirect costs related to work activity programs.

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

262.23 	Sec. 3. Minnesota Statutes 2016, section 246B.10, is amended to read:
262.24 	246B.10 LIABILITY OF COUNTY; REIMBURSEMENT.
262.25 	(a) The civilly committed sex offender's county shall pay to the state a portion of the 
262.26 	cost of care provided in the Minnesota sex offender program to a civilly committed sex 
262.27 	offender who has legally settled in that county. A county's payment must be made from the 
262.28 	county's own sources of revenue and payments must equal 25 percent of the cost of care, 
262.29 	as determined by the commissioner, for each day or portion of a day, that the for which the 
262.30 	civilly committed sex offender spends at the facility receives services, either within a 
262.31 	Minnesota sex offender program facility or while on provisional discharge.
263.1 	(b) If payments received by the state under this chapter exceed 75 percent of the cost of 
263.2 	care for an individual admitted to the program after August 1, 2011, the county is responsible 
263.3 	for paying the state the remaining amount.
263.4 	(c) If payments received by the state under this chapter exceeds 90 percent of the cost 
263.5 	of care for an individual admitted to the program before August 1, 2011, the county is 
263.6 	responsible for paying the state the remaining amount.
263.7 	(d) The county is not entitled to reimbursement from the civilly committed sex offender, 
263.8 	the civilly committed sex offender's estate, or from the civilly committed sex offender's 
263.9 	relatives, except as provided in section 246B.07.

263.10 	EFFECTIVE DATE. This section is effective July 1, 2017. The inclusion of services 
263.11 	while on provisional discharge applies to services received on or after July 1, 2017, regardless 
263.12 	of the date the civilly committed sex offender was provisionally discharged.

263.13 	Sec. 4. Minnesota Statutes 2016, section 253B.19, subdivision 1, is amended to read:
263.14 		Subdivision 1.Creation. The Supreme Court shall establish an appeal panel composed 
263.15 	of three judges and four alternate judges appointed from among the acting judges of the 
263.16 	state. Panel members shall serve for terms of one year each. Only three judges need hear 
263.17 	any case. One of the regular three appointed judges shall be designated as the chief judge 
263.18 	of the appeal panel. The chief judge is vested with power to fix the time and place of all 
263.19 	hearings before the panel, issue all notices, subpoena witnesses, appoint counsel for the 
263.20 	patient, if necessary, and supervise and direct the operation of the appeal panel. The chief 
263.21 	judge shall designate one of the other judges or an alternate judge to act as chief judge in 
263.22 	any case where the chief judge is unable to act. No member of the appeal panel shall take 
263.23 	part in the consideration of any case in which that judge committed the patient. The chief 
263.24 	justice of the Supreme Court shall determine the compensation of the judges serving on the 
263.25 	appeal panel. The compensation shall be in addition to their regular compensation as judges. 
263.26 	All compensation and expenses of the appeal panel and all allowable fees and costs of the 
263.27 	patient's counsel shall be established and paid by the Department of Human Services.

263.28 	EFFECTIVE DATE. This section is effective July 1, 2017, and applies to all 
263.29 	compensation, costs, and expenses incurred on or after July 1, 2017.

264.1 	Sec. 5. Minnesota Statutes 2016, section 253B.19, is amended by adding a subdivision to 
264.2 	read:
264.3 		Subd. 1b.Compensation, costs, and expenses. (a) The chief justice of the Supreme 
264.4 	Court shall determine the compensation of the judges serving on the appeal panel. The 
264.5 	compensation shall be in addition to the judges' regular compensation as judges.
264.6 	(b) All compensation and expenses of the appeal panel shall be paid by the judicial 
264.7 	branch from judicial branch funds, including the costs of employing law clerks, court 
264.8 	reporters, assistant appellate court clerks, and any other staff, and the costs of courtrooms, 
264.9 	courtroom technology, and courtroom security.
264.10 	(c) For proceedings originating pursuant to section 253D.28, all allowable fees and costs 
264.11 	of the court-appointed counsel for the committed person, as defined in section 253D.02, 
264.12 	subdivision 4, and all allowable fees and costs of a court-appointed examiner shall be 
264.13 	established and paid by the judicial branch from judicial branch funds. Allowable fees and 
264.14 	costs include expenses associated with an appeal of a judicial appeal panel order.
264.15 	(d) For proceedings originating from subdivision 2, the Department of Human Services 
264.16 	shall reimburse the judicial branch for the compensation and expenses described in paragraph 
264.17 	(b). All allowable fees and costs of the court-appointed counsel for the patient, as defined 
264.18 	in section 253B.02, subdivision 15, and all allowable fees and costs of a court-appointed 
264.19 	examiner shall be established and paid by the Department of Human Services from 
264.20 	Department of Human Services funds. Allowable fees and costs include expenses associated 
264.21 	with an appeal of a judicial appeal panel order.

264.22 	EFFECTIVE DATE. This section is effective July 1, 2017, and applies to all 
264.23 	compensation, costs, and expenses incurred on or after July 1, 2017.

264.24 	Sec. 6.  REPEALER.
 264.25 	Minnesota Statutes 2016, section 246B.06, is repealed.

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

264.27 	ARTICLE 7
264.28 	CHILDREN AND FAMILIES SERVICES

264.29 	Section 1. Minnesota Statutes 2016, section 119B.011, subdivision 6, is amended to read:
264.30 		Subd. 6.Child care fund. "Child care fund" means a program under this chapter 
264.31 	providing:
265.1 	(1) financial assistance for child care to support:
265.2 	(i) parents engaged in employment, job search, or education and training leading to 
265.3 	employment, or an at-home infant child care subsidy; and
265.4 	(ii) the development and school readiness of children; and
265.5 	(2) grants to develop, expand, and improve the access and availability of child care 
265.6 	services statewide.

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

265.8 	Sec. 2. Minnesota Statutes 2016, section 119B.011, is amended by adding a subdivision 
265.9 	to read:
265.10 		Subd. 13b.Homeless. "Homeless" means a self-declared housing status as defined in 
265.11 	the McKinney-Vento Act, United States Code, title 42, section 11302, paragraph (a).

265.12 	EFFECTIVE DATE. This section is effective December 18, 2017.

265.13 	Sec. 3. Minnesota Statutes 2016, section 119B.011, is amended by adding a subdivision 
265.14 	to read:
265.15 		Subd. 15b.Law enforcement authority. "Law enforcement authority" means a 
265.16 	government agency or department within or outside Minnesota with jurisdiction to investigate 
265.17 	or bring a civil or criminal action against a child care provider, including a county, city, or 
265.18 	district attorney's office, the Attorney General's Office, a human services agency, a United 
265.19 	States attorney's office, or a law enforcement agency.

265.20 	EFFECTIVE DATE. This section is effective July 1, 2017.

265.21 	Sec. 4. Minnesota Statutes 2016, section 119B.011, is amended by adding a subdivision 
265.22 	to read:
265.23 		Subd. 16a.Legal nonlicensed related provider. "Legal nonlicensed related provider" 
265.24 	means a legal nonlicensed child care provider under subdivision 16 who cares for children 
265.25 	related to the provider and does not care for any child receiving assistance under this chapter 
265.26 	who is not related to the provider. For purposes of this subdivision, "related" means the 
265.27 	provider is, by marriage, blood relationships, or court decrees, a sibling, grandparent, aunt, 
265.28 	or uncle of the child.

265.29 	EFFECTIVE DATE. This section is effective September 25, 2017.

266.1 	Sec. 5. Minnesota Statutes 2016, section 119B.011, is amended by adding a subdivision 
266.2 	to read:
266.3 		Subd. 16b.Legal nonlicensed unrelated provider. "Legal nonlicensed unrelated 
266.4 	provider" means a legal nonlicensed child care provider under subdivision 16 who provides 
266.5 	care in Minnesota for at least one child receiving assistance under this chapter who is not 
266.6 	related to the provider.  For purposes of this subdivision, "related" means the provider is, 
266.7 	by marriage, blood relationships, or court decrees, a sibling, grandparent, aunt, or uncle of 
266.8 	the child.

266.9 	EFFECTIVE DATE. This section is effective September 25, 2017.

266.10 	Sec. 6. Minnesota Statutes 2016, section 119B.011, subdivision 19, is amended to read:
266.11 		Subd. 19.Provider. "Provider" means:
266.12 	(1) an individual or child care center or facility, either licensed or unlicensed, providing 
266.13 	licensed legal child care services as defined under section 245A.03; or
266.14 	(2) a license-exempt center required to be certified under chapter 245G;
266.15 	(2) (3) an individual or child care center or facility holding that:
266.16 	(i) holds a valid child care license issued by another state or a tribe and providing;
266.17 	(ii) provides child care services in the licensing state or in the area under the licensing 
266.18 	tribe's jurisdiction.; and
266.19 	(iii) is in compliance with federal health and safety requirements as certified by the 
266.20 	licensing state or tribe, or as determined by receipt of Child Care Development Block Grant 
266.21 	funds in the licensing state; or
266.22 	(4) a legal nonlicensed child care provider as defined under section 119B.011, subdivision 
266.23 	16, providing legal child care services. A legally unlicensed family legal nonlicensed child 
266.24 	care provider must be at least 18 years of age, and not a member of the MFIP assistance 
266.25 	unit or a member of the family receiving child care assistance to be authorized under this 
266.26 	chapter.

266.27 	EFFECTIVE DATE. This section is effective September 25, 2017.

267.1 	Sec. 7. Minnesota Statutes 2016, section 119B.011, is amended by adding a subdivision 
267.2 	to read:
267.3 		Subd. 19c.Stop payment. "Stop payment" means canceling a payment that was already 
267.4 	issued to a provider.

267.5 	EFFECTIVE DATE. This section is effective July 1, 2017.

267.6 	Sec. 8. Minnesota Statutes 2016, section 119B.011, subdivision 20, is amended to read:
267.7 		Subd. 20.Transition year families. "Transition year families" means families who have 
267.8 	received MFIP assistance, or who were eligible to receive MFIP assistance after choosing 
267.9 	to discontinue receipt of the cash portion of MFIP assistance under section 256J.31, 
267.10 	subdivision 12, or families who have received DWP assistance under section 256J.95 for 
267.11 	at least three one of the last six months before losing eligibility for MFIP or DWP. 
267.12 	Notwithstanding Minnesota Rules, part 3400.0040, subpart 10, and 3400.0090, subpart 2, 
267.13 	transition year child care may be used to support employment, approved education or training 
267.14 	programs, or job search that meets the requirements of section 119B.10. Transition year 
267.15 	child care is not available to families who have been disqualified from MFIP or DWP due 
267.16 	to fraud.

267.17 	EFFECTIVE DATE. This section is effective October 23, 2017.

267.18 	Sec. 9. Minnesota Statutes 2016, section 119B.011, subdivision 20a, is amended to read:
267.19 		Subd. 20a.Transition year extension families. "Transition year extension families" 
267.20 	means families who have completed their transition year of child care assistance under this 
267.21 	subdivision and who are eligible for, but on a waiting list for, services under section 119B.03. 
267.22 	For purposes of sections 119B.03, subdivision 3, and 119B.05, subdivision 1, clause (2), 
267.23 	families participating in extended transition year shall not be considered transition year 
267.24 	families. Notwithstanding Minnesota Rules, parts 3400.0040, subpart 10, and 3400.0090, 
267.25 	subpart 2, transition year extension child care may be used to support employment, approved 
267.26 	education or training programs, or a job search that meets the requirements of section 
267.27 	119B.10 for the length of time necessary for families to be moved from the basic sliding 
267.28 	fee waiting list into the basic sliding fee program.

267.29 	EFFECTIVE DATE. This section is effective October 23, 2017.

268.1 	Sec. 10. Minnesota Statutes 2016, section 119B.02, subdivision 1, is amended to read:
268.2 		Subdivision 1.Child care services. The commissioner shall develop standards for county 
268.3 	and human services boards to provide child care services to enable eligible families to 
268.4 	participate in employment, training, or education programs. Within the limits of available 
268.5 	appropriations, the commissioner shall distribute money to counties to reduce the costs of 
268.6 	child care for eligible families. The commissioner shall adopt rules to govern the program 
268.7 	in accordance with this section. The rules must establish a sliding schedule of fees for parents 
268.8 	receiving child care services. The rules shall provide that funds received as a lump-sum 
268.9 	payment of child support arrearages shall not be counted as income to a family in the month 
268.10 	received but shall be prorated over the 12 months following receipt and added to the family 
268.11 	income during those months. The commissioner may establish limits on how frequently 
268.12 	expedited application processing timelines are used for an applicant who declares that the 
268.13 	applicant is homeless. The commissioner may adopt rules to implement changes under this 
268.14 	subdivision. The commissioner shall maximize the use of federal money under title I and 
268.15 	title IV of Public Law 104-193, the Personal Responsibility and Work Opportunity 
268.16 	Reconciliation Act of 1996, and other programs that provide federal or state reimbursement 
268.17 	for child care services for low-income families who are in education, training, job search, 
268.18 	or other activities allowed under those programs. Money appropriated under this section 
268.19 	must be coordinated with the programs that provide federal reimbursement for child care 
268.20 	services to accomplish this purpose. Federal reimbursement obtained must be allocated to 
268.21 	the county that spent money for child care that is federally reimbursable under programs 
268.22 	that provide federal reimbursement for child care services. The counties shall use the federal 
268.23 	money to expand child care services. The commissioner may adopt rules under chapter 14 
268.24 	to implement and coordinate federal program requirements.

268.25 	EFFECTIVE DATE. This section is effective December 18, 2017.

268.26 	Sec. 11. Minnesota Statutes 2016, section 119B.02, subdivision 5, is amended to read:
268.27 		Subd. 5.Program integrity. For child care assistance programs under this chapter, the 
268.28 	commissioner shall enforce the requirements for program integrity and fraud prevention 
268.29 	investigations under sections 256.046, 256.98, and 256.983 and chapter 245E.

268.30 	EFFECTIVE DATE. This section is effective July 1, 2017.

268.31 	Sec. 12. Minnesota Statutes 2016, section 119B.025, subdivision 1, is amended to read:
268.32 		Subdivision 1.Factors which must be verified Applications. (a) The county shall 
268.33 	verify the following at all initial child care applications using the universal application:
269.1 	(1) identity of adults;
269.2 	(2) presence of the minor child in the home, if questionable;
269.3 	(3) relationship of minor child to the parent, stepparent, legal guardian, eligible relative 
269.4 	caretaker, or the spouses of any of the foregoing;
269.5 	(4) age;
269.6 	(5) immigration status, if related to eligibility;
269.7 	(6) Social Security number, if given;
269.8 	(7) counted income;
269.9 	(8) spousal support and child support payments made to persons outside the household;
269.10 	(9) residence; and
269.11 	(10) inconsistent information, if related to eligibility.
269.12 	(b) If a family did not use the universal application or child care addendum to apply for 
269.13 	child care assistance, the family must complete the universal application or child care 
269.14 	addendum at its next eligibility redetermination and the county must verify the factors listed 
269.15 	in paragraph (a) as part of that redetermination. Once a family has completed a universal 
269.16 	application or child care addendum, the county shall use the redetermination form described 
269.17 	in paragraph (c) for that family's subsequent redeterminations. Eligibility must be 
269.18 	redetermined at least every six months. A family is considered to have met the eligibility 
269.19 	redetermination requirement if a complete redetermination form and all required verifications 
269.20 	are received within 30 days after the date the form was due. When the 30th day after the 
269.21 	date the form was due falls on a Saturday, Sunday, or legal holiday, the 30-day time period 
269.22 	is extended to include the next succeeding day that is not a Saturday, Sunday, or legal 
269.23 	holiday. Assistance shall be payable retroactively from the redetermination due date. For a 
269.24 	family where at least one parent is under the age of 21, does not have a high school or 
269.25 	general equivalency diploma, and is a student in a school district or another similar program 
269.26 	that provides or arranges for child care, as well as parenting, social services, career and 
269.27 	employment supports, and academic support to achieve high school graduation, the 
269.28 	redetermination of eligibility shall be deferred beyond six months, but not to exceed 12 
269.29 	months, to the end of the student's school year. If a family reports a change in an eligibility 
269.30 	factor before the family's next regularly scheduled redetermination, the county must 
269.31 	recalculate eligibility without requiring verification of any eligibility factor that did not 
269.32 	change. Changes must be reported as required by section 256P.07. A change in income 
269.33 	occurs on the day the participant received the first payment reflecting the change in income.
270.1 	The county must mail a notice of approval or denial of assistance to the applicant within 
270.2 	30 calendar days after receiving the application. The county may extend the response time 
270.3 	by 15 calendar days if the applicant is informed of the extension.
270.4 	(c) The commissioner shall develop a redetermination form to redetermine eligibility 
270.5 	and a change report form to report changes that minimize paperwork for the county and the 
270.6 	participant. The county must send a notice of approval or denial of assistance to an applicant 
270.7 	who declares that the applicant is homeless and who meets the definition of homeless under 
270.8 	section 119B.011, subdivision 13b, within five working days after receiving the application. 
270.9 	The county is not required to verify the factors under paragraph (a) before issuing the notice 
270.10 	of approval or denial. An applicant must submit proof of eligibility within three months of 
270.11 	the date the application was received by the county. If the applicant does not submit the 
270.12 	proof of eligibility within three months, the applicant's eligibility ends. The county must 
270.13 	send a 15-day adverse action notice to end an applicant's eligibility.

270.14 	EFFECTIVE DATE. Paragraphs (a) and (b) are effective the day following final 
270.15 	enactment. Paragraph (c) is effective December 18, 2017.

270.16 	Sec. 13. Minnesota Statutes 2016, section 119B.025, is amended by adding a subdivision 
270.17 	to read:
270.18 		Subd. 3.Redeterminations. (a) Notwithstanding Minnesota Rules, part 3400.0180, item 
270.19 	A, the county shall conduct a redetermination according to paragraphs (b) and (c).
270.20 	(b) The county shall use the redetermination form developed by the commissioner. The 
270.21 	county must verify the factors listed in subdivision 1, paragraph (a), as part of the 
270.22 	redetermination.
270.23 	(c) An applicant's eligibility must be redetermined no more frequently than every 12 
270.24 	months. The following criteria apply:
270.25 	(1) a family meets the eligibility redetermination requirements if a complete 
270.26 	redetermination form and all required verifications are received within 30 days after the 
270.27 	date the form was due;
270.28 	(2) if the 30th day after the date the form was due falls on a Saturday, Sunday, or holiday, 
270.29 	the 30-day time period is extended to include the next day that is not a Saturday, Sunday, 
270.30 	or holiday. Assistance shall be payable retroactively from the redetermination due date;
270.31 	(3) for a family where at least one parent is under 21 years of age, does not have a high 
270.32 	school degree or general equivalency diploma, and is a student in a school district or another 
270.33 	similar program that provides or arranges for child care; parenting, social services, career 
271.1 	and employment supports; and academic support to achieve high school graduation, the 
271.2 	redetermination of eligibility may be deferred beyond 12 months, to the end of the student's 
271.3 	school year; and
271.4 	(4) a family and the family's providers must be notified that the family's redetermination 
271.5 	is due at least 45 days before the end of the family's 12-month eligibility period.

271.6 	EFFECTIVE DATE. This section is effective October 23, 2017.

271.7 	Sec. 14. Minnesota Statutes 2016, section 119B.025, is amended by adding a subdivision 
271.8 	to read:
271.9 		Subd. 4.Changes in eligibility. (a) The county shall process a change in eligibility 
271.10 	factors according to paragraphs (b) to (g).
271.11 	(b) A family is subject to the reporting requirements in section 256P.07.
271.12 	(c) If a family reports a change or a change is known to the agency before the family's 
271.13 	regularly scheduled redetermination, the county must act on the change. The commissioner 
271.14 	shall establish standards for verifying changes.
271.15 	(d) A change in income occurs on the day the participant received the first payment 
271.16 	reflecting the change in income.
271.17 	(e) During a family's 12-month eligibility period, if the family's income increases and 
271.18 	remains at or below 85 percent of the state median income, adjusted for family size, there 
271.19 	is no change to the family's eligibility. The county shall not request verification of the 
271.20 	change. The co-payment fee shall not increase during the remaining portion of the family's 
271.21 	12-month eligibility period.
271.22 	(f) During a family's 12-month eligibility period, if the family's income increases and 
271.23 	exceeds 85 percent of the state median income, adjusted for family size, the family is not 
271.24 	eligible for child care assistance. The family must be given 15 calendar days to provide 
271.25 	verification of the change. If the required verification is not returned or confirms ineligibility, 
271.26 	the family's eligibility ends following a subsequent 15-day adverse action notice.
271.27 	(g) Notwithstanding Minnesota Rules, parts 3400.0040, subpart 3, and 3400.0170, 
271.28 	subpart 1, if an applicant or participant reports that employment ended, the agency may 
271.29 	accept a signed statement from the applicant or participant as verification that employment 
271.30 	ended.

271.31 	EFFECTIVE DATE. Paragraphs (a) and (b) are effective the day following final 
271.32 	enactment. Paragraphs (c) to (g) are effective October 23, 2017.

272.1 	Sec. 15. Minnesota Statutes 2016, section 119B.03, subdivision 3, is amended to read:
272.2 		Subd. 3.Eligible participants. Families that meet the eligibility requirements under 
272.3 	sections 119B.07,119B.09, and 119B.10, except MFIP participants, diversionary work 
272.4 	program, and transition year families are eligible for child care assistance under the basic 
272.5 	sliding fee program. Families enrolled in the basic sliding fee program shall be continued 
272.6 	until they are no longer eligible. Child care assistance provided through the child care fund 
272.7 	is considered assistance to the parent.

272.8 	EFFECTIVE DATE. This section is effective December 18, 2017.

272.9 	Sec. 16. Minnesota Statutes 2016, section 119B.03, subdivision 9, is amended to read:
272.10 		Subd. 9.Portability pool. (a) The commissioner shall establish a pool of up to five 
272.11 	percent of the annual appropriation for the basic sliding fee program to provide continuous 
272.12 	child care assistance for eligible families who move between Minnesota counties. At the 
272.13 	end of each allocation period, any unspent funds in the portability pool must be used for 
272.14 	assistance under the basic sliding fee program. If expenditures from the portability pool 
272.15 	exceed the amount of money available, the reallocation pool must be reduced to cover these 
272.16 	shortages.
272.17 	(b) To be eligible for portable basic sliding fee assistance, a family that has moved from 
272.18 	a county in which it was receiving basic sliding fee assistance to a county with a waiting 
272.19 	list for the basic sliding fee program must:
272.20 	(1) meet the income and eligibility guidelines for the basic sliding fee program; and
272.21 	(2) notify the new county of residence within 60 days of moving and submit information 
272.22 	to the new county of residence to verify eligibility for the basic sliding fee program.
272.23 	(c) The receiving county must:
272.24 	(1) accept administrative responsibility for applicants for portable basic sliding fee 
272.25 	assistance at the end of the two months of assistance under the Unitary Residency Act;
272.26 	(2) continue portability pool basic sliding fee assistance for the lesser of six months or
272.27 	until the family is able to receive assistance under the county's regular basic sliding program; 
272.28 	and
272.29 	(3) notify the commissioner through the quarterly reporting process of any family that 
272.30 	meets the criteria of the portable basic sliding fee assistance pool.

272.31 	EFFECTIVE DATE. This section is effective October 23, 2017.

273.1 	Sec. 17. Minnesota Statutes 2016, section 119B.05, subdivision 1, is amended to read:
273.2 		Subdivision 1.Eligible participants. Families eligible for child care assistance under 
273.3 	the MFIP child care program are:
273.4 	(1) MFIP participants who are employed or in job search and meet the requirements of 
273.5 	section 119B.10;
273.6 	(2) persons who are members of transition year families under section 119B.011, 
273.7 	subdivision 20, and meet the requirements of section 119B.10;
273.8 	(3) families who are participating in employment orientation or job search, or other 
273.9 	employment or training activities that are included in an approved employability development 
273.10 	plan under section 256J.95;
273.11 	(4) MFIP families who are participating in work job search, job support, employment, 
273.12 	or training activities as required in their employment plan, or in appeals, hearings, 
273.13 	assessments, or orientations according to chapter 256J;
273.14 	(5) MFIP families who are participating in social services activities under chapter 256J 
273.15 	as required in their employment plan approved according to chapter 256J;
273.16 	(6) families who are participating in services or activities that are included in an approved 
273.17 	family stabilization plan under section 256J.575;
273.18 	(7) families who are participating in programs as required in tribal contracts under section 
273.19 	119B.02, subdivision 2, or 256.01, subdivision 2;
273.20 	(8) families who are participating in the transition year extension under section 119B.011, 
273.21 	subdivision 20a; and
273.22 	(9) student parents as defined under section 119B.011, subdivision 19b.; and
273.23 	(10) student parents who turn 21 years of age and who continue to meet the other 
273.24 	requirements under section 119B.011, subdivision 19b. A student parent continues to be 
273.25 	eligible until the student parent is approved for basic sliding fee child care assistance or 
273.26 	until the student parent's redetermination, whichever comes first. At the student parent's 
273.27 	redetermination, if the student parent was not approved for basic sliding fee child care 
273.28 	assistance, a student parent's eligibility ends following a 15-day adverse action notice.

273.29 	EFFECTIVE DATE. This section is effective October 23, 2017.

274.1 	Sec. 18. Minnesota Statutes 2016, section 119B.09, subdivision 1, is amended to read:
274.2 		Subdivision 1.General eligibility requirements for all applicants for child care 
274.3 	assistance. (a) Child care services must be available to families who need child care to find 
274.4 	or keep employment or to obtain the training or education necessary to find employment 
274.5 	and who:
274.6 	(1) have household income less than or equal to 67 percent of the state median income, 
274.7 	adjusted for family size, at application and redetermination, and meet the requirements of 
274.8 	section 119B.05; receive MFIP assistance; and are participating in employment and training 
274.9 	services under chapter 256J; or
274.10 	(2) have household income less than or equal to 47 percent of the state median income, 
274.11 	adjusted for family size, at program entry application and less than or equal to 67 percent 
274.12 	of the state median income, adjusted for family size, at program exit redetermination.
274.13 	(b) Child care services must be made available as in-kind services.
274.14 	(c) All applicants for child care assistance and families currently receiving child care 
274.15 	assistance must be assisted and required to cooperate in establishment of paternity and 
274.16 	enforcement of child support obligations for all children in the family at application and 
274.17 	redetermination as a condition of program eligibility. For purposes of this section, a family 
274.18 	is considered to meet the requirement for cooperation when the family complies with the 
274.19 	requirements of section 256.741.
274.20 	(d) All applicants for child care assistance and families currently receiving child care 
274.21 	assistance must pay the co-payment fee under section 119B.12, subdivision 2, as a condition 
274.22 	of eligibility. The co-payment fee may include additional recoupment fees due to a child 
274.23 	care assistance program overpayment.
274.24 	(e) At application and redetermination, a family must self-certify that the value of the 
274.25 	family's assets is less than or equal to $1,000,000 as a condition of eligibility. The 
274.26 	commissioner shall establish procedures to determine the value of countable assets when a 
274.27 	family self-certifies that the value of the family's assets is greater than $1,000,000. The 
274.28 	value of countable assets must be less than or equal to $1,000,000 as a condition of eligibility 
274.29 	at application and redetermination.
274.30 	(f) If a family has one child with a child care authorization and the child turns 13 years 
274.31 	of age or the child has a disability and turns 15 years of age, the family remains eligible 
274.32 	until the redetermination.

275.1 	EFFECTIVE DATE. Paragraphs (a) and (c) are effective October 23, 2017. Paragraph 
275.2 	(d) is effective the day following final enactment. Paragraph (e) is effective February 26, 
275.3 	2018. Paragraph (f) is effective December 18, 2017.

275.4 	Sec. 19. Minnesota Statutes 2016, section 119B.09, subdivision 4, is amended to read:
275.5 		Subd. 4.Eligibility; annual income; calculation. (a) Annual income of the applicant 
275.6 	family is the current monthly income of the family multiplied by 12 or the income for the 
275.7 	12-month period immediately preceding the date of application, or income calculated by 
275.8 	the method which provides the most accurate assessment of income available to the family.
275.9 	(b) Self-employment income must be calculated based on gross receipts less operating 
275.10 	expenses. Income must be recalculated when the family's income changes, but no less often 
275.11 	than every six months. For a family where at least one parent is under the age of 21, does 
275.12 	not have a high school or general equivalency diploma, and is a student in a school district 
275.13 	or another similar program that provides or arranges for child care, as well as parenting, 
275.14 	social services, career and employment supports, and academic support to achieve high 
275.15 	school graduation, income must be recalculated when the family's income changes, but 
275.16 	otherwise shall be deferred beyond six months, but not to exceed 12 months, to the end of 
275.17 	the student's school year section 256P.05.
275.18 	(c) Income changes are processed under section 119B.025, subdivision 4. Included lump 
275.19 	sums counted as income under section 256P.06, subdivision 3, must be annualized over 12 
275.20 	months. Income must be verified with documentary evidence. If the applicant does not have 
275.21 	sufficient evidence of income, verification must be obtained from the source of the income.

275.22 	EFFECTIVE DATE. Paragraph (a) is effective the day following final enactment. 
275.23 	Paragraph (b) is effective July 30, 2018. Paragraph (c) is effective October 23, 2017.

275.24 	Sec. 20. Minnesota Statutes 2016, section 119B.09, subdivision 9a, is amended to read:
275.25 		Subd. 9a.Child care centers; assistance. (a) For the purposes of this subdivision, 
275.26 	"qualifying child" means a child who is not a child or dependent of an employee of the child 
275.27 	care provider. A child care center may receive authorizations for 25 or fewer children who 
275.28 	are dependents of the center's employees. If a child care center is authorized for more than 
275.29 	25 children who are dependents of center employees, the county cannot authorize additional 
275.30 	dependents of an employee until the number of children falls below 25.
275.31 	(b) Funds distributed under this chapter must not be paid for child care services that are 
275.32 	provided for a child or dependent of an employee under paragraph (a) unless at all times at 
276.1 	least 50 percent of the children for whom the child care provider is providing care are 
276.2 	qualifying children under paragraph (a).
276.3 	(c) If a child care provider satisfies the requirements for payment under paragraph (b), 
276.4 	but the percentage of qualifying children under paragraph (a) for whom the provider is 
276.5 	providing care falls below 50 percent, the provider shall have four weeks to raise the 
276.6 	percentage of qualifying children for whom the provider is providing care to at least 50 
276.7 	percent before payments to the provider are discontinued for child care services provided 
276.8 	for a child who is not a qualifying child.
276.9 	(d) This subdivision shall be implemented as follows:
276.10 	(1) no later than August 1, 2014, the commissioner shall issue a notice to providers who 
276.11 	have been identified as ineligible for funds distributed under this chapter as described in 
276.12 	paragraph (b); and
276.13 	(2) no later than January 5, 2015, payments to providers who do not comply with 
276.14 	paragraph (c) will be discontinued for child care services provided for children who are not 
276.15 	qualifying children.
276.16 	(e) If a child's authorization for child care assistance is terminated under this subdivision, 
276.17 	the county shall send a notice of adverse action to the provider and to the child's parent or 
276.18 	guardian, including information on the right to appeal, under Minnesota Rules, part 
276.19 	3400.0185.
276.20 	(f) (b) Funds paid to providers during the period of time between the issuance of a notice 
276.21 	under paragraph (d), clause (1), and discontinuation of payments under paragraph (d), clause 
276.22 	(2), when a center is authorized for more than 25 children who are dependents of center 
276.23 	employees must not be treated as overpayments under section 119B.11, subdivision 2a, due 
276.24 	to noncompliance with this subdivision.
276.25 	(g) (c) Nothing in this subdivision precludes the commissioner from conducting fraud 
276.26 	investigations relating to child care assistance, imposing sanctions, and obtaining monetary 
276.27 	recovery as otherwise provided by law.

276.28 	EFFECTIVE DATE. This section is effective April 23, 2018.

276.29 	Sec. 21. [119B.095] CHILD CARE AUTHORIZATIONS.
276.30 		Subdivision 1.General authorization requirements. (a) When authorizing the amount 
276.31 	of child care, the county agency must consider the amount of time the parent reports on the 
277.1 	application or redetermination form that the child attends preschool, a Head Start program, 
277.2 	or school while the parent is participating in an authorized activity.
277.3 	(b) Care must be authorized and scheduled with a provider based on the applicant's or 
277.4 	participant's verified activity schedule when:
277.5 	(1) the family requests care from more than one provider per child;
277.6 	(2) the family requests care from a legal nonlicensed provider; or
277.7 	(3) an applicant or participant is employed by any business that is licensed by the 
277.8 	Department of Human Services or Medicaid-enrolled as verified through the department's 
277.9 	Web site.
277.10 	(c) If the conditions in paragraph (b) do not apply, the county does not need to verify 
277.11 	the applicant's or participant's activity schedule and the amount of child care assistance 
277.12 	authorized may be used at times determined by the family.
277.13 	(d) If the family remains eligible at redetermination, a new authorization with fewer 
277.14 	hours, the same hours, or increased hours may be determined.
277.15 		Subd. 2.Maintain steady child care authorizations. (a) Notwithstanding Minnesota 
277.16 	Rules, chapter 3400, the amount of child care authorized under section 119B.10 for 
277.17 	employment, education, or an MFIP or DWP employment plan shall continue at the same 
277.18 	number of hours or more hours until redetermination, including:
277.19 	(1) when the other parent moves in and is employed or has an education plan under 
277.20 	section 119B.10, subdivision 3, or has an MFIP or DWP employment plan; or
277.21 	(2) when a participant's work hours are reduced or a participant temporarily stops working 
277.22 	or attending an approved education program. Temporary changes include, but are not limited 
277.23 	to, a medical leave, seasonal employment fluctuations, or a school break between semesters.
277.24 	(b) The county may increase the amount of child care authorized at any time if the 
277.25 	participant verifies the need for increased hours for authorized activities.
277.26 	(c) The county may reduce the amount of child care authorized if a parent requests a 
277.27 	reduction or because of a change in:
277.28 	(1) the child's school schedule;
277.29 	(2) the custody schedule; or
277.30 	(3) the provider's availability.
278.1 	(d) When a child reaches 13 years of age or a child with a disability reaches 15 years of 
278.2 	age, the amount of child care authorized shall continue at the same number of hours or more 
278.3 	hours until redetermination.
278.4 	(e) The amount of child care authorized for a family subject to subdivision 1, paragraph 
278.5 	(b), must change when the participant's activity schedule changes. Paragraph (a) does not 
278.6 	apply to a family subject to subdivision 1, paragraph (b).
278.7 		Subd. 3.Assistance for persons who are homeless. An applicant who is homeless and 
278.8 	is eligible for child care assistance under this chapter is eligible for 60 hours of child care 
278.9 	assistance per service period for three months from the date the county receives the 
278.10 	application. Additional hours may be authorized as needed based on the applicant's 
278.11 	participation in an employment, education, or MFIP or DWP employment plan. To continue 
278.12 	receiving child care assistance after the initial three months, the applicant must verify that 
278.13 	the applicant meets eligibility and activity requirements for child care assistance under this 
278.14 	chapter.

278.15 	EFFECTIVE DATE. This section is effective December 18, 2017.

278.16 	Sec. 22. [119B.097] AUTHORIZATION WITH A SECONDARY PROVIDER.
278.17 	(a) If a child uses any combination of the following providers paid by child care 
278.18 	assistance, a parent must choose one primary provider and one secondary provider per child 
278.19 	that can be paid by child care assistance:
278.20 	(1) an individual or child care center licensed under chapter 245A;
278.21 	(2) an individual or child care center or facility holding a valid child care license issued 
278.22 	by another state or tribe; or
278.23 	(3) a child care center exempt from licensing under section 245A.03.
278.24 	(b) The amount of child care authorized with the secondary provider cannot exceed 20 
278.25 	hours per two-week service period, per child, and the amount of care paid to a child's 
278.26 	secondary provider is limited under section 119B.13, subdivision 1. The total amount of 
278.27 	child care authorized with both the primary and secondary provider cannot exceed the 
278.28 	amount of child care allowed based on the parents' eligible activity schedule, the child's 
278.29 	school schedule, and any other factors relevant to the family's child care needs.

278.30 	EFFECTIVE DATE. This section is effective April 23, 2018.

279.1 	Sec. 23. Minnesota Statutes 2016, section 119B.10, subdivision 1, is amended to read:
279.2 		Subdivision 1.Assistance for persons seeking and retaining employment. (a) Persons 
279.3 	who are seeking employment An applicant who is job searching and who is eligible for 
279.4 	child care assistance under this chapter is eligible for 60 hours of child care assistance per 
279.5 	service period for three months from the date of eligibility. Job searching at initial application 
279.6 	is allowed one time per 12-month period. The applicant must meet employment requirements 
279.7 	under paragraph (c) or education requirements under subdivision 3, or have an MFIP or 
279.8 	DWP employment plan, to continue receiving child care assistance after the initial three 
279.9 	months.
279.10 	(b) A participant who meets the employment requirements of paragraph (c) or who is 
279.11 	attending an approved education or training program under subdivision 3 and who are 
279.12 	eligible for is receiving child care assistance under this section are chapter is eligible to 
279.13 	receive up to 240 an additional ten hours of child care assistance per calendar year service 
279.14 	period for job search.
279.15 	(b) (c) At application and redetermination, employed persons who work at least an 
279.16 	average of 20 hours and full-time students who work at least an average of ten hours a week 
279.17 	and receive at least a minimum wage for all hours worked are eligible for continued child 
279.18 	care assistance for employment. For purposes of this section, work-study programs must 
279.19 	be counted as employment. An employed person with an MFIP or DWP employment plan 
279.20 	shall receive child care assistance as specified in the person's employment plan. Child care 
279.21 	assistance during employment must be authorized as provided in paragraphs (c) and (d) and 
279.22 	(e).
279.23 	(c) (d) When the person works for an hourly wage and the hourly wage is equal to or 
279.24 	greater than the applicable minimum wage, child care assistance shall be provided for the 
279.25 	actual hours of employment, break, and mealtime during the employment, and travel time 
279.26 	up to two hours per day.
279.27 	(d) (e) When the person does not work for an hourly wage, child care assistance must 
279.28 	be provided for the lesser of:
279.29 	(1) the amount of child care determined by dividing gross earned income or, for a 
279.30 	self-employed person, the self-employment income determined under section 256P.05, 
279.31 	subdivision 2, by the applicable minimum wage, up to one hour every eight hours for meals 
279.32 	and break time, plus up to two hours per day for travel time; or
280.1 	(2) the amount of child care equal to the actual amount of child care used during 
280.2 	employment, including break and mealtime during employment, and travel time up to two 
280.3 	hours per day.

280.4 	EFFECTIVE DATE. Paragraphs (a) to (d) are effective December 18, 2017. Paragraph 
280.5 	(e) is effective July 30, 2018.

280.6 	Sec. 24. Minnesota Statutes 2016, section 119B.10, is amended by adding a subdivision 
280.7 	to read:
280.8 		Subd. 3.Assistance for persons attending an approved education or training 
280.9 	program. (a) Money for an eligible person according to sections 119B.03, subdivision 3, 
280.10 	and 119B.05, subdivision 1, shall be used to reduce child care costs for a student. The county 
280.11 	shall not limit the duration of child care subsidies for a person in an employment or 
280.12 	educational program unless the person is ineligible for child care funds. Any other limitation 
280.13 	must be based on county policies included in the approved child care fund plan.
280.14 	(b) To be eligible, the student must be in good standing and making satisfactory progress 
280.15 	toward the degree. The maximum length of time a student is eligible for child care assistance 
280.16 	under the child care fund for education and training is no more than the time necessary to 
280.17 	complete the credit requirements for an associate or baccalaureate degree as determined by 
280.18 	the educational institution. Time limitations for child care assistance do not apply to basic 
280.19 	or remedial educational programs needed for postsecondary education or employment. Basic 
280.20 	or remedial educational programs include high school, general equivalency diploma, and 
280.21 	English as a second language programs. A program exempt from this time limit must not 
280.22 	run concurrently with a postsecondary program.
280.23 	(c) If a student meets the conditions of paragraphs (a) and (b), child care assistance must 
280.24 	be authorized for all hours of class time and credit hours, including independent study and 
280.25 	internships, and up to two hours of travel time per day. A postsecondary student shall receive 
280.26 	four hours of child care assistance per credit hour for study time and academic appointments 
280.27 	per service period.
280.28 	(d) For an MFIP or DWP participant, child care assistance must be authorized according 
280.29 	to the person's approved employment plan. If an MFIP or DWP participant receiving MFIP 
280.30 	or DWP child care assistance under this chapter moves to another county, continues to 
280.31 	participate in an authorized educational or training program, and remains eligible for MFIP 
280.32 	or DWP child care assistance, the participant must receive continued child care assistance 
280.33 	from the county responsible for the person's current employment plan under section 256G.07.
281.1 	(e) If a person with an approved education program under section 119B.03, subdivision 
281.2 	3, or 119B.05, subdivision 1, begins receiving MFIP or DWP assistance, the person continues 
281.3 	to receive child care assistance for the approved education program until the person's 
281.4 	education is included in an approved MFIP or DWP employment plan or until 
281.5 	redetermination, whichever occurs first.
281.6 	(f) If a person's MFIP or DWP assistance ends and the approved MFIP or DWP 
281.7 	employment plan included education, the person continues to be eligible for child care 
281.8 	assistance for education under transition year child care assistance until the person's education 
281.9 	is included in an approved education plan or until redetermination.

281.10 	EFFECTIVE DATE. This section is effective December 18, 2017.

281.11 	Sec. 25. [119B.105] EXTENDED ELIGIBILITY AND AUTHORIZATION.
281.12 		Subdivision 1.Three-month extended eligibility period. (a) A family in a situation 
281.13 	under paragraph (b) continues to be eligible for up to three months or until the family's 
281.14 	redetermination, whichever occurs first, rather than losing eligibility or having the family's 
281.15 	eligibility suspended. During extended eligibility, the amount of child care authorized shall 
281.16 	continue at the same number or more hours. The family must continue to meet all other 
281.17 	eligibility requirements under this chapter.
281.18 	(b) The family's three-month extended eligibility period applies when:
281.19 	(1) a participant's employment or education program ends permanently;
281.20 	(2) the other parent moves in and does not participate in an authorized activity;
281.21 	(3) a participant's MFIP assistance ends and the participant is not participating in an 
281.22 	authorized activity or the participant's participation in an authorized activity is unknown;
281.23 	(4) a student parent under section 119B.011, subdivision 19b, stops attending school; 
281.24 	or
281.25 	(5) a participant receiving basic sliding fee child care assistance or transition year child 
281.26 	care assistance applied for MFIP assistance and is not participating in an authorized activity 
281.27 	or the participant's participation in an authorized activity is unknown.
281.28 		Subd. 2.Extended eligibility and redetermination. (a) If the family received three 
281.29 	months of extended eligibility and redetermination is not due, to continue receiving child 
281.30 	care assistance the participant must be employed or have an education plan which meets 
281.31 	the requirements of section 119B.10, subdivision 3, or have an MFIP or DWP employment 
281.32 	plan. If child care assistance continues, the amount of child care authorized shall continue 
282.1 	at the same number or more hours until redetermination, unless a condition in section 
282.2 	119B.095, subdivision 2, paragraph (c), applies. A family subject to section 119B.095, 
282.3 	subdivision 1, paragraph (b), shall have child care authorized based on a verified activity 
282.4 	schedule.
282.5 	(b) If the family's redetermination occurs before the end of the three-month extended 
282.6 	eligibility period to continue receiving child care assistance, the participant must verify that 
282.7 	the participant meets eligibility and activity requirements for child care assistance under 
282.8 	this chapter. If child care assistance continues, the amount of child care authorized is based 
282.9 	on section 119B.10. A family subject to section 119B.095, subdivision 1, paragraph (b), 
282.10 	shall have child care authorized based on a verified activity schedule.

282.11 	EFFECTIVE DATE. This section is effective December 18, 2017.

282.12 	Sec. 26. Minnesota Statutes 2016, section 119B.11, subdivision 2a, is amended to read:
282.13 		Subd. 2a.Recovery of overpayments. (a) An amount of child care assistance paid to a 
282.14 	recipient in excess of the payment due is recoverable by the county agency under paragraphs 
282.15 	(b) and (c), even when the overpayment was caused by agency error or circumstances outside 
282.16 	the responsibility and control of the family or provider.
282.17 	(b)(1)  An overpayment must be recouped or recovered from the family if the 
282.18 	overpayment that benefited the family by causing the family to pay less for child care 
282.19 	expenses than the family otherwise would have been required to pay under child care 
282.20 	assistance program requirements this chapter must be established and recovered according 
282.21 	to clauses (1) to (5), with the following exceptions:
282.22 	(i) an overpayment estimated to be less than $500 must not be established or collected;
282.23 	(ii) the portion of an overpayment that occurred more than one year before the date of 
282.24 	overpayment determination must not be established or collected; or
282.25 	(iii) an overpayment designated solely as agency error must not be established or 
282.26 	collected.
282.27 	(2) If the family remains eligible for child care assistance and an overpayment is 
282.28 	established, the overpayment must be recovered through recoupment as identified in 
282.29 	Minnesota Rules, part 3400.0187, except that the overpayments must be calculated and 
282.30 	collected on a service period basis. If the family no longer remains eligible for child care 
282.31 	assistance, the county may choose to initiate efforts to recover overpayments from the family 
282.32 	for overpayment less than $50. If the overpayment is greater than or equal to $50,
283.1 	(3) If the family is no longer eligible for child care assistance and an overpayment is 
283.2 	established, the county shall seek voluntary repayment of the overpayment from the family.
283.3 	(4) If the county is unable to recoup the overpayment through voluntary repayment, the 
283.4 	county shall initiate civil court proceedings to recover the overpayment unless the county's 
283.5 	costs to recover the overpayment will exceed the amount of the overpayment.
283.6 	(5) A family with an outstanding debt under this subdivision is not eligible for child care 
283.7 	assistance until:
283.8 	(1) (i) the debt is paid in full; or
283.9 	(2)(ii) satisfactory arrangements are made with the county to retire the debt consistent 
283.10 	with the requirements of this chapter and Minnesota Rules, chapter 3400, and the family is 
283.11 	in compliance with the arrangements.
283.12 	(c) The county must recover an overpayment from a provider if the overpayment did 
283.13 	not benefit the family by causing it to receive more child care assistance or to pay less for 
283.14 	child care expenses than the family otherwise would have been eligible to receive or required 
283.15 	to pay under child care assistance program requirements, and benefited the provider by 
283.16 	causing the provider to receive more child care assistance than otherwise would have been 
283.17 	paid on the family's behalf under child care assistance program requirements. If the provider 
283.18 	continues to care for children receiving child care assistance, the overpayment must be 
283.19 	recovered through reductions in child care assistance payments for services as described in 
283.20 	an agreement with the county. The provider may not charge families using that provider 
283.21 	more to cover the cost of recouping the overpayment. If the provider no longer cares for 
283.22 	children receiving child care assistance, the county may choose to initiate efforts to recover 
283.23 	overpayments of less than $50 from the provider. If the overpayment is greater than or equal 
283.24 	to $50, the county shall seek voluntary repayment of the overpayment from the provider. 
283.25 	If the county is unable to recoup the overpayment through voluntary repayment, the county 
283.26 	shall initiate civil court proceedings to recover the overpayment unless the county's costs 
283.27 	to recover the overpayment will exceed the amount of the overpayment. A provider with 
283.28 	an outstanding debt under this subdivision is not eligible to care for children receiving child 
283.29 	care assistance until:
283.30 	(1) the debt is paid in full; or
283.31 	(2) satisfactory arrangements are made with the county to retire the debt consistent with 
283.32 	the requirements of this chapter and Minnesota Rules, chapter 3400, and the provider is in 
283.33 	compliance with the arrangements.
284.1 	(d) When both the family and the provider acted together to intentionally cause the 
284.2 	overpayment, both the family and the provider are jointly liable for the overpayment 
284.3 	regardless of who benefited from the overpayment. The county must recover the overpayment 
284.4 	as provided in paragraphs (b) and (c). When the family or the provider is in compliance 
284.5 	with a repayment agreement, the party in compliance is eligible to receive child care 
284.6 	assistance or to care for children receiving child care assistance despite the other party's 
284.7 	noncompliance with repayment arrangements.
284.8 	(e) A provider overpayment designated as an agency error because of the application of 
284.9 	an incorrect maximum rate must not be established or collected. Any other provider 
284.10 	overpayment designated as agency error must be established and collected.
284.11 	(f) Notwithstanding any provision to the contrary in this subdivision, an overpayment 
284.12 	must be established and collected if the overpayment was caused in any part by wrongfully 
284.13 	obtaining assistance under section 256.98 or by benefits paid while an action is pending 
284.14 	appeal under section 119B.16, if on appeal the commissioner finds that the appellant was 
284.15 	ineligible for the amount of child are assistance paid.

284.16 	EFFECTIVE DATE. This section is effective October 23, 2017.

284.17 	Sec. 27. Minnesota Statutes 2016, section 119B.12, subdivision 2, is amended to read:
284.18 		Subd. 2.Parent fee. A family must be assessed a parent fee for each service period. A 
284.19 	family's parent fee must be a fixed percentage of its annual gross income. Parent fees must 
284.20 	apply to families eligible for child care assistance under sections 119B.03 and 119B.05. 
284.21 	Income must be as defined in section 119B.011, subdivision 15. The fixed percent percentage
284.22 	is based on the relationship of the family's annual gross income to 100 percent of the annual 
284.23 	state median income. Parent fees must begin at 75 percent of the poverty level. The minimum 
284.24 	parent fees for families between 75 percent and 100 percent of poverty level must be $2 per 
284.25 	biweekly period. Parent fees must provide for graduated movement to full payment. At 
284.26 	initial application, the parent fee is established for the family's 12-month eligibility period. 
284.27 	At redetermination, if the family remains eligible, the parent fee is recalculated and is 
284.28 	established for the next 12-month eligibility period. A parent fee shall not increase during 
284.29 	the 12-month eligibility period. Payment of part or all of a family's parent fee directly to 
284.30 	the family's child care provider on behalf of the family by a source other than the family 
284.31 	shall not affect the family's eligibility for child care assistance, and the amount paid shall 
284.32 	be excluded from the family's income. Child care providers who accept third-party payments 
284.33 	must maintain family specific documentation of payment source, amount, and time period 
284.34 	covered by the payment.

285.1 	EFFECTIVE DATE. This section is effective October 23, 2017.

285.2 	Sec. 28. Minnesota Statutes 2016, section 119B.125, subdivision 1b, is amended to read:
285.3 		Subd. 1b.Training required. (a) Effective November 1, 2011, prior to Before initial 
285.4 	authorization as required in subdivision 1, a legal nonlicensed family child care provider 
285.5 	must complete pediatric first aid and CPR training and provide the verification of the pediatric 
285.6 	first aid and CPR training to the county. The training documentation must have valid effective 
285.7 	dates as of the date the registration request is submitted to the county. and the training must 
285.8 	have been provided by an individual approved to provide first aid and CPR instruction and 
285.9 	have included CPR techniques for infants and children.
285.10 	(b) A legal nonlicensed family child care providers with an authorization effective before 
285.11 	November 1, 2011, must be notified of the requirements before October 1, 2011, or at 
285.12 	authorization, and must meet the requirements upon renewal of an authorization that occurs 
285.13 	on or after January 1, 2012 related provider must:
285.14 	(1) complete training on abusive head trauma before being authorized for a child through 
285.15 	four years of age;
285.16 	(2) complete training on reducing the risk of sudden unexpected infant death before 
285.17 	being authorized for a child younger than 12 months old; and
285.18 	(3) meet the training requirements by September 30, 2017, if authorized for a child 
285.19 	before July 1, 2017.
285.20 	(c) A legal nonlicensed unrelated provider must:
285.21 	(1) complete training on abusive head trauma before being authorized for a child through 
285.22 	four years of age;
285.23 	(2) complete training on reducing the risk of sudden unexpected infant death before 
285.24 	being authorized for a child younger than 12 months old;
285.25 	(3) complete a child care provider orientation class, or equivalent training approved by 
285.26 	the commissioner, within 90 days after initial authorization. The commissioner must develop 
285.27 	the child care provider orientation class, which must include training on maintaining health, 
285.28 	safety, and fire standards; and
285.29 	(4) meet the training requirements and complete a child care provider orientation class 
285.30 	by September 30, 2017, if authorized to care for a child before July 1, 2017.
285.31 	(d) Upon each reauthorization after the authorization period when the initial first aid 
285.32 	and CPR training requirements are met, a legal nonlicensed family child care unrelated
286.1 	provider must provide verification of at least eight hours of additional training listed in the 
286.2 	Minnesota Center for Professional Development Registry complete training on the topics 
286.3 	in paragraph (c), clause (3).
286.4 	(d) This subdivision only applies to legal nonlicensed family child care providers.

286.5 	EFFECTIVE DATE. This section is effective September 25, 2017.

286.6 	Sec. 29. Minnesota Statutes 2016, section 119B.125, subdivision 4, is amended to read:
286.7 		Subd. 4.Unsafe care. A county may deny authorization as a child care provider to any 
286.8 	applicant or rescind revoke the authorization of any provider when the county knows or has 
286.9 	reason to believe that the provider is unsafe or that the circumstances of the chosen child 
286.10 	care arrangement are unsafe. The county must include the conditions under which a provider 
286.11 	or care arrangement will be determined to be unsafe in the county's child care fund plan 
286.12 	under section 119B.08, subdivision 3.

286.13 	EFFECTIVE DATE. This section is effective April 23, 2018.

286.14 	Sec. 30. Minnesota Statutes 2016, section 119B.125, subdivision 6, is amended to read:
286.15 		Subd. 6.Record-keeping requirement. (a) As a condition of payment, all providers 
286.16 	receiving child care assistance payments must keep accurate and legible daily attendance 
286.17 	records at the site where services are delivered for children receiving child care assistance 
286.18 	and must make those records available immediately to the county or the commissioner upon 
286.19 	request. The attendance records must be completed daily and include the date, the first and 
286.20 	last name of each child in attendance, and the times when each child is dropped off and 
286.21 	picked up. To the extent possible, the times that the child was dropped off to and picked up 
286.22 	from the child care provider must be entered by the person dropping off or picking up the 
286.23 	child. The daily attendance records must be retained at the site where services are delivered 
286.24 	for six years after the date of service.
286.25 	(b) A county or the commissioner may deny or revoke a provider's authorization as a 
286.26 	child care provider to any applicant, rescind authorization of any provider, to receive child 
286.27 	care assistance payments under section 119B.13, subdivision 6, paragraph (d), pursue a 
286.28 	fraud disqualification under section 256.98, take an action against the provider under chapter 
286.29 	245E, or establish an attendance record overpayment claim in the systemunder paragraph 
286.30 	(c) against a current or former provider, when the county or the commissioner knows or 
286.31 	has reason to believe that the provider has not complied with the record-keeping requirement 
287.1 	in this subdivision. A provider's failure to produce attendance records as requested on more 
287.2 	than one occasion constitutes grounds for disqualification as a provider.
287.3 	(c) To calculate an attendance record overpayment under this subdivision, the 
287.4 	commissioner or county agency subtracts the maximum daily rate from the total amount 
287.5 	paid to a provider for each day that a child's attendance record is missing, unavailable, 
287.6 	incomplete, illegible, inaccurate, or otherwise inadequate.
287.7 	(d) The commissioner shall develop criteria to direct a county when the county must 
287.8 	establish an attendance overpayment under this subdivision.

287.9 	EFFECTIVE DATE. This section is effective April 23, 2018.

287.10 	Sec. 31. Minnesota Statutes 2016, section 119B.125, is amended by adding a subdivision 
287.11 	to read:
287.12 		Subd. 10.Reporting required for child safety. A legal nonlicensed child care provider 
287.13 	must report to the county agency a death, serious injury, or instance of substantiated child 
287.14 	abuse that occurred while a child was in the legal nonlicensed child care provider's care. A 
287.15 	county agency shall report to the commissioner, in a manner prescribed by the commissioner, 
287.16 	the number of deaths, serious injuries, and instances of substantiated child abuse that occurred 
287.17 	in all legal nonlicensed child care providers in the county.

287.18 	EFFECTIVE DATE. This section is effective September 25, 2017.

287.19 	Sec. 32. Minnesota Statutes 2016, section 119B.125, is amended by adding a subdivision 
287.20 	to read:
287.21 		Subd. 11.Emergency preparedness plan. A legal nonlicensed child care provider must 
287.22 	have a written emergency preparedness plan for an emergency. The commissioner shall 
287.23 	develop a form for a provider to create a written emergency preparedness plan.

287.24 	EFFECTIVE DATE. This section is effective September 25, 2017.

287.25 	Sec. 33. Minnesota Statutes 2016, section 119B.125, is amended by adding a subdivision 
287.26 	to read:
287.27 		Subd. 12.Compliance with health and safety requirements. (a) The commissioner 
287.28 	must establish health, safety, and fire standards specific to a legal nonlicensed unrelated 
287.29 	provider. The commissioner must develop a tool for a county agency to conduct an annual 
287.30 	inspection of a legal nonlicensed unrelated provider. The commissioner must develop a 
287.31 	process for a legal nonlicensed unrelated provider to correct violations of the health, safety, 
288.1 	and fire standards. The commissioner must develop a process to revoke authorization of a 
288.2 	legal nonlicensed unrelated provider if the provider fails to correct violations of the health, 
288.3 	safety, and fire standards.
288.4 	(b) A county agency must conduct at least one inspection annually of each legal 
288.5 	nonlicensed unrelated provider. The county agency must be given access to the physical 
288.6 	facility and grounds where care is provided and to children cared for by the legal nonlicensed 
288.7 	unrelated provider. The county agency must be given access without prior notice and as 
288.8 	often as the county agency considers necessary if the county agency is investigating alleged 
288.9 	maltreatment, conducting an inspection, or investigating an alleged violation of applicable 
288.10 	laws or rules. A provider's failure to give access to the county agency may result in 
288.11 	termination of the legal nonlicensed unrelated provider's authorization to care for a child 
288.12 	receiving child care assistance under this section.

288.13 	EFFECTIVE DATE. This section is effective September 25, 2017.

288.14 	Sec. 34. Minnesota Statutes 2016, section 119B.13, subdivision 1, is amended to read:
288.15 		Subdivision 1.Subsidy restrictions. (a) Beginning February 3, 2014, TheBeginning 
288.16 	February 26, 2018, the maximum rate paid for child care assistance in any county or county 
288.17 	price cluster under the child care fund shall be the greater of the 25th percentile of the 2011
288.18 	2016 child care provider rate survey or the maximum rate effective November 28, 2011
288.19 	February 3, 2014. The commissioner may: (1) assign a county with no reported provider 
288.20 	prices to a similar price cluster; and (2) consider county level access when determining final 
288.21 	price clusters.
288.22 	(b) A rate which includes a special needs rate paid under subdivision 3 may be in excess 
288.23 	of the maximum rate allowed under this subdivision.
288.24 	(c) The department shall monitor the effect of this paragraph on provider rates. The 
288.25 	county shall pay the provider's full charges for every child in care up to the maximum 
288.26 	established. The commissioner shall determine the maximum rate for each type of care on 
288.27 	an hourly, full-day, and weekly basis, including special needs and disability care.
288.28 	(d) If a child uses one provider, the maximum payment to a provider for one day of care 
288.29 	must not exceed the daily rate. The maximum payment to a provider for one week of care 
288.30 	must not exceed the weekly rate.
288.31 	(d) (e) If a child uses two providers under section 119B.097, the maximum payment 
288.32 	must not exceed:
288.33 	(1) the daily rate for one day of care;
289.1 	(2) the weekly rate for one week of care by a child's primary provider; and
289.2 	(3) two daily rates during two weeks of care by a child's secondary provider.
289.3 	(f) Child care providers receiving reimbursement under this chapter must not be paid 
289.4 	activity fees or an additional amount above the maximum rates for care provided during 
289.5 	nonstandard hours for families receiving assistance.
289.6 	(e) When (g) If the provider charge is greater than the maximum provider rate allowed, 
289.7 	the parent is responsible for payment of the difference in the rates in addition to any family 
289.8 	co-payment fee.
289.9 	(f) (h) All maximum provider rates changes shall be implemented on the Monday 
289.10 	following the effective date of the maximum provider rate.
289.11 	(g) (i) Notwithstanding Minnesota Rules, part 3400.0130, subpart 7, maximum 
289.12 	registration fees in effect on January 1, 2013, shall remain in effect.

289.13 	EFFECTIVE DATE. Paragraph (a) is effective February 26, 2018. Paragraphs (d) to 
289.14 	(i) are effective April 23, 2018.

289.15 	Sec. 35. Minnesota Statutes 2016, section 119B.13, subdivision 6, is amended to read:
289.16 		Subd. 6.Provider payments. (a) A provider must bill only for services documented 
289.17 	according to section 119B.125, subdivision 6. The provider shall bill for services provided 
289.18 	within ten days of the end of the service period. If bills are submitted within ten days of the 
289.19 	end of the service period, Payments under the child care fund shall be made within 3021 
289.20 	days of receiving a complete bill from the provider. Counties or the state may establish 
289.21 	policies that make payments on a more frequent basis.
289.22 	(b) If a provider has received an authorization of care and been issued a billing form for 
289.23 	an eligible family, the bill must be submitted within 60 days of the last date of service on 
289.24 	the bill. A bill submitted more than 60 days after the last date of service must be paid if the 
289.25 	county determines that the provider has shown good cause why the bill was not submitted 
289.26 	within 60 days. Good cause must be defined in the county's child care fund plan under 
289.27 	section 119B.08, subdivision 3, and the definition of good cause must include county error. 
289.28 	Any bill submitted more than a year after the last date of service on the bill must not be 
289.29 	paid.
289.30 	(c) If a provider provided care for a time period without receiving an authorization of 
289.31 	care and a billing form for an eligible family, payment of child care assistance may only be 
290.1 	made retroactively for a maximum of six months from the date the provider is issued an 
290.2 	authorization of care and billing form.
290.3 	(d) A county or the commissioner may refuse to issue a child care authorization to a 
290.4 	licensed or legal nonlicensed provider, revoke an existing child care authorization to a 
290.5 	licensed or legal nonlicensed provider, stop payment issued to a licensed or legal nonlicensed 
290.6 	provider, or refuse to pay a bill submitted by a licensed or legal nonlicensed provider if:
290.7 	(1) the provider admits to intentionally giving the county materially false information 
290.8 	on the provider's billing forms;
290.9 	(2) a county or the commissioner finds by a preponderance of the evidence that the 
290.10 	provider intentionally gave the county materially false information on the provider's billing 
290.11 	forms, or provided false attendance records to a county or the commissioner;
290.12 	(3) the provider is in violation of child care assistance program rules, until the agency 
290.13 	determines those violations have been corrected;
290.14 	(4) the provider is operating after:
290.15 	(i) an order of suspension of the provider's license issued by the commissioner; or
290.16 	(ii) an order of revocation of the provider's license; or
290.17 	(iii) a final order of conditional license issued by the commissioner for as long as the 
290.18 	conditional license is in effect;
290.19 	(5) the provider submits false an inaccurate attendance reports or refuses to provide 
290.20 	documentation of the child's attendance upon request; or record;
290.21 	(6) the provider gives false child care price information.; or
290.22 	(7) the provider fails to grant access to a county or the commissioner during regular 
290.23 	business hours to examine all records necessary to determine the extent of services provided 
290.24 	to a child care assistance recipient and the appropriateness of a claim for payment.
290.25 	(e) If a county or the commissioner finds that a provider violated paragraph (d), clause 
290.26 	(1) or (2), a county or the commissioner must deny or revoke the provider's authorization 
290.27 	and either pursue a fraud disqualification under section 256.98, subdivision 8, paragraph 
290.28 	(c) or refer the case to a law enforcement authority. A provider's rights related to an 
290.29 	authorization denial or revocation under this paragraph are established in section 119B.161. 
290.30 	If a provider's authorization is revoked or denied under this paragraph, the denial or 
290.31 	revocation lasts until either:
291.1 	(1) all criminal, civil, and administrative proceedings related to the provider's alleged 
291.2 	misconduct conclude and any appeal rights are exhausted; or
291.3 	(2) the commissioner decides, based on written evidence or argument submitted under 
291.4 	section 119B.161, to authorize the provider.
291.5 	(f) If a county or the commissioner denies or revokes a provider's authorization under 
291.6 	paragraph (d), clause (4), the provider shall not be authorized until the order of suspension 
291.7 	or order of revocation against the provider is lifted.
291.8 	(e) For purposes of (g) If a county or the commissioner finds that a provider violated
291.9 	paragraph (d), clauses (3), (5), and or (6), the county or the commissioner may withhold
291.10 	revoke or deny the provider's authorization or payment for a period of time not to exceed 
291.11 	three months beyond the time the condition has been corrected. If a provider's authorization 
291.12 	is revoked or denied under this paragraph, the denial or revocation may last up to 90 days 
291.13 	from the date a county or the commissioner denies or revokes the provider's authorization.
291.14 	(h) If a county or the commissioner determines a provider violated paragraph (d), clause 
291.15 	(7), a county or the commissioner must deny or revoke the provider's authorization until a 
291.16 	county or the commissioner determines whether the records sought comply with this chapter 
291.17 	and chapter 245E. The provider's rights related to an authorization denial or revocation 
291.18 	under this paragraph are established in section 119B.161.
291.19 	(f) (i) A county's payment policies must be included in the county's child care plan under 
291.20 	section 119B.08, subdivision 3. If payments are made by the state, in addition to being in 
291.21 	compliance with this subdivision, the payments must be made in compliance with section 
291.22 	16A.124.

291.23 	EFFECTIVE DATE. Paragraph (a) is effective September 25, 2017. Paragraphs (d) to 
291.24 	(i) are effective April 23, 2018.

291.25 	Sec. 36. Minnesota Statutes 2016, section 119B.16, subdivision 1, is amended to read:
291.26 		Subdivision 1.Fair hearing allowed for applicants and recipients. (a) An applicant 
291.27 	or recipient adversely affected by an action of a county agency action or the commissioner
291.28 	may request and receive a fair hearing in accordance with this subdivision and section 
291.29 	256.045.
291.30 	(b) A county agency must offer an informal conference to an applicant or recipient who 
291.31 	is entitled to a fair hearing under this section. A county agency shall advise an adversely 
291.32 	affected applicant or recipient that a request for a conference is optional and does not delay 
291.33 	or replace the right to a fair hearing.
292.1 	(c) An applicant or recipient does not have a right to a fair hearing if a county agency 
292.2 	or the commissioner takes action against a provider.
292.3 	(d) If a provider's authorization is suspended, denied, or revoked, a county agency or 
292.4 	the commissioner must mail notice to a child care assistance program recipient receiving 
292.5 	care from the provider.

292.6 	EFFECTIVE DATE. This section is effective April 23, 2018.

292.7 	Sec. 37. Minnesota Statutes 2016, section 119B.16, subdivision 1a, is amended to read:
292.8 		Subd. 1a.Fair hearing allowed for providers. (a) This subdivision applies to providers 
292.9 	caring for children receiving child care assistance.
292.10 	(b) A provider to whom a county agency has assigned responsibility for an overpayment 
292.11 	may request a fair hearing in accordance with section 256.045 for the limited purpose of 
292.12 	challenging the assignment of responsibility for the overpayment and the amount of the 
292.13 	overpayment. The scope of the fair hearing does not include the issues of whether the 
292.14 	provider wrongfully obtained public assistance in violation of section 256.98 or was properly 
292.15 	disqualified under section 256.98, subdivision 8, paragraph (c), unless the fair hearing has 
292.16 	been combined with an administrative disqualification hearing brought against the provider 
292.17 	under section 256.046.
292.18 	(b) A provider may request a fair hearing only as specified in this subdivision.
292.19 	(c) A provider may request a fair hearing according to sections 256.045 and 256.046 if 
292.20 	a county agency or the commissioner:
292.21 	(1) denies or revokes a provider's authorization, unless the action entitles the provider 
292.22 	to a consolidated contested case hearing under section 119B.16, subdivision 3, or an 
292.23 	administrative review under section 119B.161;
292.24 	(2) assigns responsibility for an overpayment to a provider under section 119B.11, 
292.25 	subdivision 2a;
292.26 	(3) establishes an overpayment for failure to comply with section 119B.125, subdivision 
292.27 	6;
292.28 	(4) seeks monetary recovery or recoupment under section 245E.02, subdivision 4, 
292.29 	paragraph (c), item (2);
292.30 	(5) initiates an administrative fraud disqualification hearing; or
292.31 	(6) issues a payment and the provider disagrees with the amount of the payment.
293.1 	(d) A provider may request a fair hearing by submitting a written request to the 
293.2 	Department of Human Services, Appeals Division. A provider's request must be received 
293.3 	by the appeals division no later than 30 days after the date a county or the commissioner 
293.4 	mails the notice. The provider's appeal request must contain the following:
293.5 	(1) each disputed item, the reason for the dispute, and, if appropriate, an estimate of the 
293.6 	dollar amount involved for each disputed item;
293.7 	(2) the computation the provider believes to be correct, if appropriate;
293.8 	(3) the statute or rule relied on for each disputed item; and
293.9 	(4) the name, address, and telephone number of the person at the provider's place of 
293.10 	business with whom contact may be made regarding the appeal.

293.11 	EFFECTIVE DATE. This section is effective April 23, 2018.

293.12 	Sec. 38. Minnesota Statutes 2016, section 119B.16, subdivision 1b, is amended to read:
293.13 		Subd. 1b.Joint fair hearings. When a provider requests a fair hearing under subdivision 
293.14 	1a, the family in whose case the overpayment was created must be made a party to the fair 
293.15 	hearing. All other issues raised by the family must be resolved in the same proceeding. 
293.16 	When a family requests a fair hearing and claims that the county should have assigned 
293.17 	responsibility for an overpayment to a provider, the provider must be made a party to the 
293.18 	fair hearing. The human services judge assigned to a fair hearing may join a family or a 
293.19 	provider as a party to the fair hearing whenever joinder of that party is necessary to fully 
293.20 	and fairly resolve overpayment issues raised in the appeal.

293.21 	EFFECTIVE DATE. This section is effective April 23, 2018.

293.22 	Sec. 39. Minnesota Statutes 2016, section 119B.16, is amended by adding a subdivision 
293.23 	to read:
293.24 		Subd. 1c.Notice to providers. (a) Before taking an action appealable under subdivision 
293.25 	1a, paragraph (c), a county agency or the commissioner must mail written notice to the 
293.26 	provider against whom the action is being taken.
293.27 	(b) The notice shall state:
293.28 	(1) the factual basis for the department's determination;
293.29 	(2) the action the department intends to take;
293.30 	(3) the dollar amount of the monetary recovery or recoupment, if known; and
294.1 	(4) the right to appeal the department's proposed action.
294.2 	(c) A county agency or the commissioner must mail the written notice at least 15 calendar 
294.3 	days before the adverse action's effective date.

294.4 	EFFECTIVE DATE. This section is effective April 23, 2018.

294.5 	Sec. 40. Minnesota Statutes 2016, section 119B.16, is amended by adding a subdivision 
294.6 	to read:
294.7 		Subd. 3.Consolidated contested case hearing. If a county agency or the commissioner 
294.8 	denies or revokes a provider's authorization based on a licensing action, the provider may 
294.9 	only appeal the denial or revocation in the same contested case proceeding that the provider 
294.10 	appeals the licensing action.

294.11 	EFFECTIVE DATE. This section is effective April 23, 2018.

294.12 	Sec. 41. Minnesota Statutes 2016, section 119B.16, is amended by adding a subdivision 
294.13 	to read:
294.14 		Subd. 4.Final department action. Unless the commissioner receives a timely and 
294.15 	proper request for an appeal, a county agency's or the commissioner's action shall be 
294.16 	considered a final department action.

294.17 	EFFECTIVE DATE. This section is effective April 23, 2018.

294.18 	Sec. 42. [119B.161] ADMINISTRATIVE REVIEW.
294.19 		Subdivision 1.Temporary denial or revocation of authorization. (a) A provider has 
294.20 	the rights listed under this section if:
294.21 	(1) the provider's authorization was denied or revoked under section 119B.13, subdivision 
294.22 	6, paragraph (d), clause (1), (2), or (7);
294.23 	(2) the provider's authorization was temporarily suspended under paragraph (b); or
294.24 	(3) a payment was suspended under chapter 245E.
294.25 	(b) Unless the commissioner receives a timely and proper request for an appeal, a county's 
294.26 	or the commissioner's action is a final department action.
294.27 	(c) The commissioner may temporarily suspend a provider's authorization without prior 
294.28 	notice and opportunity for hearing if the commissioner determines either that there is a 
294.29 	credible allegation of fraud for which an investigation is pending under the child care 
294.30 	assistance program, or that the suspension is necessary for public safety and the best interests 
295.1 	of the child care assistance program. An allegation is considered credible if the allegation 
295.2 	has indications of reliability. The commissioner may determine that an allegation is credible, 
295.3 	if the commissioner reviewed all allegations, facts, and evidence carefully and acts judiciously 
295.4 	on a case-by-case basis.
295.5 		Subd. 2.Notice. (a) A county or the commissioner must mail a provider notice within 
295.6 	five days of suspending, revoking, or denying a provider's authorization under subdivision 
295.7 	1.
295.8 	(b) The notice must:
295.9 	(1) state the provision under which a county or the commissioner is denying, revoking, 
295.10 	or suspending a provider's authorization or suspending payment to the provider;
295.11 	(2) set forth the general allegations leading to the revocation, denial, or suspension of a 
295.12 	provider's authorization. The notice need not disclose any specific information concerning 
295.13 	an ongoing investigation;
295.14 	(3) state that the suspension, revocation, or denial of a provider's authorization is for a 
295.15 	temporary period and explain the circumstances under which the action expires; and
295.16 	(4) inform the provider of the right to submit written evidence and argument for 
295.17 	consideration by the commissioner.
295.18 	(c) Notwithstanding Minnesota Rules, part 3400.0185, if a county or the commissioner 
295.19 	denies or revokes a provider's authorization under section 119B.13, subdivision 6, paragraph 
295.20 	(d), clause (1), (2), or (7); suspends a payment to a provider under chapter 245E; or 
295.21 	temporarily suspends a payment to a provider under section 119B.161, subdivision 1, a 
295.22 	county or the commissioner must send notice of termination to an affected family. The 
295.23 	termination sent to an affected family is effective on the date the notice is created.
295.24 		Subd. 3.Duration. If a provider's authorization is denied or revoked under section 
295.25 	119B.13, subdivision 6, paragraph (d), clause (1), (2), or (7); authorization is temporarily 
295.26 	suspended under section 119B.161; or payment is suspended under chapter 245E, the 
295.27 	provider's denial, revocation, temporary suspension, or payment suspension remains in 
295.28 	effect until:
295.29 	(1) the commissioner or a law enforcement authority determines that there is insufficient 
295.30 	evidence warranting the action and a county or the commissioner does not pursue an 
295.31 	additional administrative remedy under chapter 245E or section 256.98; or
295.32 	(2) all criminal, civil, and administrative proceedings related to the provider's alleged 
295.33 	misconduct conclude and any appeal rights are exhausted.
296.1 		Subd. 4.Good cause exception. A county or the commissioner may find that good cause 
296.2 	exists not to deny, revoke, or suspend a provider's authorization, or not to continue a denial, 
296.3 	revocation, or suspension of a provider's authorization if any of the following are applicable:
296.4 	(1) a law enforcement authority specifically requested that a provider's authorization 
296.5 	not be denied, revoked, or suspended because it may compromise an ongoing investigation;
296.6 	(2) a county or the commissioner determines that the denial, revocation, or suspension 
296.7 	should be removed based on the provider's written submission; or
296.8 	(3) the commissioner determines that the denial, revocation, or suspension is not in the 
296.9 	best interests of the program.

296.10 	EFFECTIVE DATE. This section is effective April 23, 2018.

296.11 	Sec. 43. Minnesota Statutes 2016, section 144.218, subdivision 5, is amended to read:
296.12 		Subd. 5.Replacement of vital records. Upon the receipt of an order of a court of this 
296.13 	state or a certificate of adjudication form, upon the request of a court of another state, or 
296.14 	upon the filing of a recognition of parentage with the state registrar, a replacement birth 
296.15 	record must be registered consistent with the findings of the court, the certificate of 
296.16 	adjudication, or the recognition of parentage.

296.17 	Sec. 44. Minnesota Statutes 2016, section 144.226, subdivision 1, is amended to read:
296.18 		Subdivision 1.Which services are for fee. The fees for the following services shall be 
296.19 	the following or an amount prescribed by rule of the commissioner:
296.20 	(a) The fee for the administrative review and processing of a request for a certified vital 
296.21 	record or a certification that the vital record cannot be found is $9. The fee is payable at the 
296.22 	time of application and is nonrefundable.
296.23 	(b) The fee for processing a request for the replacement of a birth record for all events, 
296.24 	except when filing a recognition of parentage pursuant to section 257.73, subdivision 1, is 
296.25 	$40. The fee is payable at the time of application and is nonrefundable. To the extent funds 
296.26 	are available, the commissioner of human services shall pay the filing fee for the replacement 
296.27 	of a birth record due to a paternity adjudication.
296.28 	(c) The fee for administrative review and processing of a request for the filing of a 
296.29 	delayed registration of birth, stillbirth, or death is $40. The fee is payable at the time of 
296.30 	application and is nonrefundable.
297.1 	(d) The fee for administrative review and processing of a request for the amendment of 
297.2 	any vital record is $40. The fee is payable at the time of application and is nonrefundable.
297.3 	(e) The fee for administrative review and processing of a request for the verification of 
297.4 	information from vital records is $9 when the applicant furnishes the specific information 
297.5 	to locate the vital record. When the applicant does not furnish specific information, the fee 
297.6 	is $20 per hour for staff time expended. Specific information includes the correct date of 
297.7 	the event and the correct name of the subject of the record. Fees charged shall approximate 
297.8 	the costs incurred in searching and copying the vital records. The fee is payable at the time 
297.9 	of application and is nonrefundable.
297.10 	(f) The fee for administrative review and processing of a request for the issuance of a 
297.11 	copy of any document on file pertaining to a vital record or statement that a related document 
297.12 	cannot be found is $9. The fee is payable at the time of application and is nonrefundable.

297.13 	Sec. 45. Minnesota Statutes 2016, section 245.814, is amended by adding a subdivision 
297.14 	to read:
297.15 		Subd. 5.Foster care parent liability insurance. The commissioner may use federal 
297.16 	reimbursement money earned on an expenditure for foster care parent liability insurance 
297.17 	premiums to offset the costs of the premiums.

297.18 	Sec. 46. Minnesota Statutes 2016, section 245A.04, subdivision 1, is amended to read:
297.19 		Subdivision 1.Application for licensure. (a) An individual, corporation, partnership, 
297.20 	voluntary association, other organization or controlling individual that is subject to licensure 
297.21 	under section 245A.03 must apply for a license. The application must be made on the forms 
297.22 	and in the manner prescribed by the commissioner. The commissioner shall provide the 
297.23 	applicant with instruction in completing the application and provide information about the 
297.24 	rules and requirements of other state agencies that affect the applicant. An applicant seeking 
297.25 	licensure in Minnesota with headquarters outside of Minnesota must have a program office 
297.26 	located within the state.
297.27 	The commissioner shall act on the application within 90 working days after a complete 
297.28 	application and any required reports have been received from other state agencies or 
297.29 	departments, counties, municipalities, or other political subdivisions. The commissioner 
297.30 	shall not consider an application to be complete until the commissioner receives all of the 
297.31 	information required under section 245C.05.
298.1 	When the commissioner receives an application for initial licensure that is incomplete 
298.2 	because the applicant failed to submit required documents or that is substantially deficient 
298.3 	because the documents submitted do not meet licensing requirements, the commissioner 
298.4 	shall provide the applicant written notice that the application is incomplete or substantially 
298.5 	deficient. In the written notice to the applicant the commissioner shall identify documents 
298.6 	that are missing or deficient and give the applicant 45 days to resubmit a second application 
298.7 	that is substantially complete. An applicant's failure to submit a substantially complete 
298.8 	application after receiving notice from the commissioner is a basis for license denial under 
298.9 	section 245A.05.
298.10 	(b) An application for licensure must identify all controlling individuals and must specify 
298.11 	an agent who is responsible for dealing with the commissioner of human services on all 
298.12 	matters provided for in this chapter and on whom service of all notices and orders must be 
298.13 	made. The agent must be authorized to accept service on behalf of all of the controlling 
298.14 	individuals of the program. Service on the agent is service on all of the controlling individuals 
298.15 	of the program. It is not a defense to any action arising under this chapter that service was 
298.16 	not made on each controlling individual of the program. The designation of one or more 
298.17 	controlling individuals as agents under this paragraph does not affect the legal responsibility 
298.18 	of any other controlling individual under this chapter.
298.19 	(c) An applicant or license holder must have a policy that prohibits license holders, 
298.20 	employees, subcontractors, and volunteers, when directly responsible for persons served 
298.21 	by the program, from abusing prescription medication or being in any manner under the 
298.22 	influence of a chemical that impairs the individual's ability to provide services or care. The 
298.23 	license holder must train employees, subcontractors, and volunteers about the program's 
298.24 	drug and alcohol policy.
298.25 	(d) An applicant and license holder must have a program grievance procedure that permits 
298.26 	persons served by the program and their authorized representatives to bring a grievance to 
298.27 	the highest level of authority in the program.
298.28 	(e) The applicant must be able to demonstrate competent knowledge of the applicable 
298.29 	requirements of this chapter and chapter 245C, and the requirements of other licensing 
298.30 	statutes and rules applicable to the program or services for which the applicant is seeking 
298.31 	to be licensed. Effective January 1, 2013, the commissioner may require the applicant, 
298.32 	except for child foster care, to demonstrate competence in the applicable licensing 
298.33 	requirements by successfully completing a written examination. The commissioner may 
298.34 	develop a prescribed written examination format.
299.1 	(f) When an applicant is an individual, the individual must provide:
299.2 	(1) the applicant's taxpayer identification numbers including the Social Security number, 
299.3 	and federal employer identification number if the applicant has employees unless a variance 
299.4 	is provided as permitted in paragraph (j);
299.5 	(2) the complete business name, if any, and if doing business under a different name, 
299.6 	the doing business as (DBA) name, as registered with the secretary of state; and
299.7 	(3) aat the commissioner's request, the notarized signature of the applicant.
299.8 	(g) When an applicant is a nonindividual, the applicant must provide the:
299.9 	(1) applicant's taxpayer identification numbers including the Minnesota tax identification 
299.10 	number and federal employer identification number;
299.11 	(2) complete business name, and if doing business under a different name, the doing 
299.12 	business as (DBA) name, as registered with the secretary of state;
299.13 	(3) first, middle, and last name, and address for all individuals who will be controlling 
299.14 	individuals, including all officers, owners, and managerial officials as defined in section 
299.15 	245A.02, subdivision 5a, and the date that the background study was initiated by the applicant 
299.16 	for each controlling individual; and
299.17 	(4) first, middle, and last name, mailing address, and notarized signature of the agent 
299.18 	authorized by the applicant to accept service on behalf of the controlling individuals.
299.19 	(h) At the time of application for licensure or renewal of a license, the applicant or license 
299.20 	holder, except as provided in paragraph (i),  must acknowledge on the form provided by 
299.21 	the commissioner if the applicant or license holder elects to receive any public funding 
299.22 	reimbursement from the commissioner for services provided under the license that:
299.23 	(1) the applicant's or license holder's compliance with the provider enrollment agreement 
299.24 	or registration requirements for receipt of public funding may be monitored by the 
299.25 	commissioner as part of a licensing investigation or licensing inspection; and
299.26 	(2) noncompliance with the provider enrollment agreement or registration requirements 
299.27 	for receipt of public funding that is identified through a licensing investigation or licensing 
299.28 	inspection, or noncompliance with a licensing requirement that is a basis of enrollment for 
299.29 	reimbursement for a service, may result in:
299.30 	(i) a correction order or a conditional license under section 245A.06, or sanctions under 
299.31 	section 245A.07;
300.1 	(ii) nonpayment of claims submitted by the license holder for public program 
300.2 	reimbursement;
300.3 	(iii) recovery of payments made for the service;
300.4 	(iv) disenrollment in the public payment program; or
300.5 	(v) other administrative, civil, or criminal penalties as provided by law.
300.6 	(i) An applicant to provide child foster care who is an individual must attest on the form 
300.7 	provided by the commissioner that any public funding received for providing child foster 
300.8 	care services must be used for the benefit of the foster children receiving services.
300.9 	(j) The commissioner of human services may grant a variance from the requirements in 
300.10 	paragraph (f), clause (1), to an individual child foster care applicant who is unable to provide 
300.11 	a Social Security number in the application for licensure.

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

300.13 	Sec. 47. Minnesota Statutes 2016, section 245A.18, subdivision 2, is amended to read:
300.14 		Subd. 2.Child passenger restraint systems; training requirement. (a) Programs 
300.15 	licensed by the Department of Human Services under Minnesota Rules, chapter 2960, that 
300.16 	serve a child or children under nine years of age must document training that fulfills the 
300.17 	requirements in this subdivision.
300.18 	(b) For child foster care programs, within 30 days of an emergency placement of a 
300.19 	relative child, and prior to licensure of a foster care home, the relative provider and applicants, 
300.20 	caregivers, and staff persons who will be responsible for transporting children younger than 
300.21 	nine years of age in a motor vehicle that have not completed the training required in paragraph 
300.22 	(c) within 30 days of emergency placement or prior to licensure must view a video, approved 
300.23 	by the Department of Public Safety, on child passenger safety. For all other programs 
300.24 	licensed under Minnesota Rules, chapter 2960, all staff persons who will be responsible for 
300.25 	transporting children younger than nine years of age in a motor vehicle that have not 
300.26 	completed the training required in paragraph (c) must view a video, approved by the 
300.27 	Department of Public Safety, on child passenger safety before transporting children.
300.28 	(b) Before a license holder, staff person, or caregiver transports a child or (c) For child 
300.29 	foster care programs, within the first three months of licensure, license holders, caregivers, 
300.30 	and staff persons who transport foster children under age nine younger than nine years of 
300.31 	age in a motor vehicle, the person transporting the child must satisfactorily complete training 
300.32 	on the proper use and installation of child restraint systems in motor vehicles. Training 
301.1 	completed under this section may be used to meet initial or ongoing training under Minnesota 
301.2 	Rules, part 2960.3070, subparts 1 and 2. For all other programs licensed under Minnesota 
301.3 	Rules, chapter 2960, within three months of hire, all staff persons who transport children 
301.4 	younger than nine years of age in a motor vehicle must satisfactorily complete training on 
301.5 	the proper use and installation of child care restraint systems in motor vehicles.
301.6 	For all providers licensed prior to July 1, 2006, the training required in this subdivision 
301.7 	must be obtained by December 31, 2007.
301.8 	(c) (d)At a minimum, training required under this section must be at least one hour in 
301.9 	length, completed at orientation or initial training, and repeated at least once every five 
301.10 	years. At a minimum, the training paragraph (c) must address the proper use of child restraint 
301.11 	systems based on the child's size, weight, and age, and the proper installation of a car seat 
301.12 	or booster seat in the motor vehicle used by the license holder to transport the child or 
301.13 	children.
301.14 	(d) (e)The training under paragraph (c) must is required to be provided by individuals 
301.15 	who are certified and approved by the Department of Public Safety, Office of Traffic Safety. 
301.16 	License holders may obtain a list of certified and approved trainers through the Department 
301.17 	of Public Safety Web site or by contacting the agency. The training must be repeated at 
301.18 	least once every five years.
301.19 	(e) Child care providers that only transport school age children as defined in section 
301.20 	245A.02, subdivision 16, in school buses as defined in section 169.011, subdivision 71, 
301.21 	paragraphs (c) to (f), are exempt from this subdivision.

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

301.23 	Sec. 48. Minnesota Statutes 2016, section 245E.01, is amended by adding a subdivision 
301.24 	to read:
301.25 		Subd. 6a.Credible allegation of fraud. "Credible allegation of fraud" has the meaning 
301.26 	given in section 256B.064, subdivision 2, paragraph (b), clause (2).

301.27 	EFFECTIVE DATE. This section is effective July 1, 2017.

301.28 	Sec. 49. Minnesota Statutes 2016, section 245E.02, subdivision 1, is amended to read:
301.29 		Subdivision 1.Investigating provider or recipient financial misconduct. The 
301.30 	department shall investigate alleged or suspected financial misconduct by providers and 
301.31 	errors related to payments issued by the child care assistance program under this chapter. 
301.32 	Recipients, employees, agents and consultants, and staff may be investigated when the 
302.1 	evidence shows that their conduct is related to the financial misconduct of a provider, license 
302.2 	holder, or controlling individual. When the alleged or suspected financial misconduct relates 
302.3 	to acting as a recruiter offering conditional employment on behalf of a provider that has 
302.4 	received funds from the child care assistance program, the department may investigate the 
302.5 	provider, center owner, director, manager, license holder, or other controlling individual or 
302.6 	agent, who is alleged to have acted as a recruiter offering conditional employment.

302.7 	EFFECTIVE DATE. This section is effective April 23, 2018.

302.8 	Sec. 50. Minnesota Statutes 2016, section 245E.02, subdivision 3, is amended to read:
302.9 		Subd. 3.Determination of investigation. After completing its investigation, the 
302.10 	department shall issue one of the following determinations determine that:
302.11 	(1) no violation of child care assistance requirements occurred;
302.12 	(2) there is insufficient evidence to show that a violation of child care assistance 
302.13 	requirements occurred;
302.14 	(3) a preponderance of evidence shows a violation of child care assistance program law, 
302.15 	rule, or policy; or
302.16 	(4) there exists a credible allegation of fraud involving the child care assistance program.

302.17 	EFFECTIVE DATE. This section is effective April 23, 2018.

302.18 	Sec. 51. Minnesota Statutes 2016, section 245E.02, subdivision 4, is amended to read:
302.19 		Subd. 4.Actions Referrals or administrative sanctions actions. (a) After completing 
302.20 	the determination under subdivision 3, the department may take one or more of the actions 
302.21 	or sanctions specified in this subdivision.
302.22 	(b) The department may take any of the following actions:
302.23 	(1) refer the investigation to law enforcement or a county attorney for possible criminal 
302.24 	prosecution;
302.25 	(2) refer relevant information to the department's licensing division, the background 
302.26 	studies division, the child care assistance program, the Department of Education, the federal 
302.27 	child and adult care food program, or appropriate child or adult protection agency;
302.28 	(3) enter into a settlement agreement with a provider, license holder, owner, agent, 
302.29 	controlling individual, or recipient; or
303.1 	(4) refer the matter for review by a prosecutorial agency with appropriate jurisdiction 
303.2 	for possible civil action under the Minnesota False Claims Act, chapter 15C.
303.3 	(c) In addition to section 256.98, the department may impose sanctions by:
303.4 	(1) pursuing administrative disqualification through hearings or waivers;
303.5 	(2) establishing and seeking monetary recovery or recoupment;
303.6 	(3) issuing an order of corrective action that states the practices that are violations of 
303.7 	child care assistance program policies, laws, or regulations, and that they must be corrected; 
303.8 	or
303.9 	(4) suspending, denying, or terminating payments to a provider.; or
303.10 	(5) taking an action under section 119B.13, subdivision 6, paragraph (d).
303.11 	(d) Upon a finding by If the commissioner determines that any child care provider, center 
303.12 	owner, director, manager, license holder, or other controlling individual of a child care 
303.13 	center has employed, used, or acted as a recruiter offering conditional employment for a 
303.14 	child care center that has received child care assistance program funding, the commissioner 
303.15 	shall:
303.16 	(1) immediately suspend all program payments to all child care centers in which the 
303.17 	person employing, using, or acting as a recruiter offering conditional employment is an 
303.18 	owner, director, manager, license holder, or other controlling individual. The commissioner 
303.19 	shall suspend program payments under this clause even if services have already been 
303.20 	provided; and
303.21 	(2) immediately and permanently revoke the licenses of all child care centers of which 
303.22 	the person employing, using, or acting as a recruiter offering conditional employment is an 
303.23 	owner, director, manager, license holder, or other controlling individual.

303.24 	EFFECTIVE DATE. This section is effective April 23, 2018.

303.25 	Sec. 52. Minnesota Statutes 2016, section 245E.03, subdivision 2, is amended to read:
303.26 		Subd. 2.Failure to provide access. Failure to provide access may result in denial or 
303.27 	termination of authorizations for or payments to a recipient, provider, license holder, or 
303.28 	controlling individual in the child care assistance program. If a provider fails to grant the 
303.29 	department immediate access to records, the department may immediately suspend payments 
303.30 	under section 119B.161, or the department may deny or revoke the provider's authorization. 
303.31 	A provider, license holder, controlling individual, employee, or staff member must grant 
303.32 	the department access during any hours that the program is open to examine the provider's 
304.1 	program or the records listed in section 245E.05. A provider shall make records immediately 
304.2 	available at the provider's place of business at the time the department requests access, 
304.3 	unless the provider and the department both agree otherwise.

304.4 	EFFECTIVE DATE. This section is effective April 23, 2018.

304.5 	Sec. 53. Minnesota Statutes 2016, section 245E.03, subdivision 4, is amended to read:
304.6 		Subd. 4.Continued or repeated failure to provide access. If the provider continues 
304.7 	to fail to provide access at the expiration of the 15-day notice period, child care assistance 
304.8 	program payments to the provider must be denied suspended beginning the 16th day 
304.9 	following notice of the initial failure or refusal to provide access. The department may 
304.10 	rescind the denial based upon good cause if the provider submits in writing a good cause 
304.11 	basis for having failed or refused to provide access. The writing must be postmarked no 
304.12 	later than the 15th day following the provider's notice of initial failure to provide access. A 
304.13 	provider's, license holder's, controlling individual's, employee's, staff member's, or recipient's 
304.14 	duty to provide access in this section continues after the provider's authorization is denied, 
304.15 	revoked, or suspended. Additionally, the provider, license holder, or controlling individual 
304.16 	must immediately provide complete, ongoing access to the department. Repeated failures 
304.17 	to provide access must, after the initial failure or for any subsequent failure, result in 
304.18 	termination from participation in the child care assistance program.

304.19 	EFFECTIVE DATE. This section is effective April 23, 2018.

304.20 	Sec. 54. Minnesota Statutes 2016, section 245E.04, is amended to read:
304.21 	245E.04 HONEST AND TRUTHFUL STATEMENTS.
304.22 	It shall be unlawful for a provider, license holder, controlling individual, or recipient to:
304.23 	(1) falsify, conceal, or cover up by any trick, scheme, or device a material fact means;
304.24 	(2) make any materially false, fictitious, or fraudulent statement or representation; or
304.25 	(3) make or use any false writing or document knowing the same to contain any materially 
304.26 	false, fictitious, or fraudulent statement or entry related to any child care assistance program 
304.27 	services that the provider, license holder, or controlling individual supplies or in relation to 
304.28 	any child care assistance payments received by a provider, license holder, or controlling 
304.29 	individual or to any fraud investigator or law enforcement officer conducting a financial 
304.30 	misconduct investigation.

304.31 	EFFECTIVE DATE. This section is effective April 23, 2018.

305.1 	Sec. 55. Minnesota Statutes 2016, section 245E.05, subdivision 1, is amended to read:
305.2 		Subdivision 1.Records required to be retained. The following records must be 
305.3 	maintained, controlled, and made immediately accessible to license holders, providers, and 
305.4 	controlling individuals. The records must be organized and labeled to correspond to categories 
305.5 	that make them easy to identify so that they can be made available immediately upon request 
305.6 	to an investigator acting on behalf of the commissioner at the provider's place of business:
305.7 	(1) payroll ledgers, canceled checks, bank deposit slips, and any other accounting records;
305.8 	(2) daily attendance records required by and that comply with section 119B.125, 
305.9 	subdivision 6;
305.10 	(3) billing transmittal forms requesting payments from the child care assistance program 
305.11 	and billing adjustments related to child care assistance program payments;
305.12 	(4) records identifying all persons, corporations, partnerships, and entities with an 
305.13 	ownership or controlling interest in the provider's child care business;
305.14 	(5) employee or contractor records identifying those persons currently employed by the 
305.15 	provider's child care business or who have been employed by the business at any time within 
305.16 	the previous five years. The records must include each employee's name, hourly and annual 
305.17 	salary, qualifications, position description, job title, and dates of employment. In addition, 
305.18 	employee records that must be made available include the employee's time sheets, current 
305.19 	home address of the employee or last known address of any former employee, and 
305.20 	documentation of background studies required under chapter 119B or 245C;
305.21 	(6) records related to transportation of children in care, including but not limited to:
305.22 	(i) the dates and times that transportation is provided to children for transportation to 
305.23 	and from the provider's business location for any purpose. For transportation related to field 
305.24 	trips or locations away from the provider's business location, the names and addresses of 
305.25 	those field trips and locations must also be provided;
305.26 	(ii) the name, business address, phone number, and Web site address, if any, of the 
305.27 	transportation service utilized; and
305.28 	(iii) all billing or transportation records related to the transportation.

305.29 	EFFECTIVE DATE. This section is effective April 23, 2018.

306.1 	Sec. 56. Minnesota Statutes 2016, section 245E.06, subdivision 1, is amended to read:
306.2 		Subdivision 1.Factors regarding imposition of administrative sanctions actions. (a) 
306.3 	The department shall consider the following factors in determining the administrative 
306.4 	sanctions actions to be imposed:
306.5 	(1) nature and extent of financial misconduct;
306.6 	(2) history of financial misconduct;
306.7 	(3) actions taken or recommended by other state agencies, other divisions of the 
306.8 	department, and court and administrative decisions;
306.9 	(4) prior imposition of sanctions actions;
306.10 	(5) size and type of provider;
306.11 	(6) information obtained through an investigation from any source;
306.12 	(7) convictions or pending criminal charges; and
306.13 	(8) any other information relevant to the acts or omissions related to the financial 
306.14 	misconduct.
306.15 	(b) Any single factor under paragraph (a) may be determinative of the department's 
306.16 	decision of whether and what sanctions are imposed actions to take.

306.17 	EFFECTIVE DATE. This section is effective April 23, 2018.

306.18 	Sec. 57. Minnesota Statutes 2016, section 245E.06, subdivision 2, is amended to read:
306.19 		Subd. 2.Written notice of department sanction action; sanction action effective 
306.20 	date; informal meeting. (a) The department shall give notice in writing to a person of an 
306.21 	administrative sanction that is to be imposed. The notice shall be sent by mail as defined in 
306.22 	section 245E.01, subdivision 11.
306.23 	(b) The notice shall state:
306.24 	(1) the factual basis for the department's determination;
306.25 	(2) the sanction the department intends to take;
306.26 	(3) the dollar amount of the monetary recovery or recoupment, if any;
306.27 	(4) how the dollar amount was computed;
306.28 	(5) the right to dispute the department's determination and to provide evidence;
306.29 	(6) the right to appeal the department's proposed sanction; and
307.1 	(7) the option to meet informally with department staff, and to bring additional 
307.2 	documentation or information, to resolve the issues.
307.3 	(c) In cases of determinations resulting in denial or termination of payments, in addition 
307.4 	to the requirements of paragraph (b), the notice must state:
307.5 	(1) the length of the denial or termination;
307.6 	(2) the requirements and procedures for reinstatement; and
307.7 	(3) the provider's right to submit documents and written arguments against the denial 
307.8 	or termination of payments for review by the department before the effective date of denial 
307.9 	or termination.
307.10 	(d) The submission of documents and written argument for review by the department 
307.11 	under paragraph (b), clause (5) or (7), or paragraph (c), clause (3), does not stay the deadline 
307.12 	for filing an appeal.
307.13 	(a) When taking an action against a provider, the department must give notice to:
307.14 	(1) the provider as specified in section 119B.16 or 119B.161; and
307.15 	(2) a family as specified under Minnesota Rules, part 3400.0185, or section 119B.161.
307.16 	(e) (b) Notwithstanding section 245E.03, subdivision 4, and except for a payment 
307.17 	suspension or action under section 119B.161, subdivision 1, the effective date of the proposed 
307.18 	sanction action under this chapter shall be 30 days after the license holder's, provider's, 
307.19 	controlling individual's, or recipient's receipt of the notice, unless timely appealed. If a 
307.20 	timely appeal is made, the proposed sanction action shall be delayed pending the final 
307.21 	outcome of the appeal. Implementation of a proposed sanction action following the resolution 
307.22 	of a timely appeal may be postponed if, in the opinion of the department, the delay of 
307.23 	sanction action is necessary to protect the health or safety of children in care. The department 
307.24 	may consider the economic hardship of a person in implementing the proposed sanction, 
307.25 	but economic hardship shall not be a determinative factor in implementing the proposed 
307.26 	sanction.
307.27 	(f) Requests for an informal meeting to attempt to resolve issues and requests for appeals 
307.28 	must be sent or delivered to the department's Office of Inspector General, Financial Fraud 
307.29 	and Abuse Division.

307.30 	EFFECTIVE DATE. This section is effective April 23, 2018.

308.1 	Sec. 58. Minnesota Statutes 2016, section 245E.06, subdivision 3, is amended to read:
308.2 		Subd. 3.Appeal of department sanction action. (a) If the department does not pursue 
308.3 	a criminal action against a provider, license holder, controlling individual, or recipient for 
308.4 	financial misconduct, but the department imposes an administrative sanction under section 
308.5 	245E.02, subdivision 4, paragraph (c), any individual or entity against whom the sanction 
308.6 	was imposed may appeal the department's administrative sanction under this section pursuant 
308.7 	to section 119B.16 or 256.045 with the additional requirements in clauses (1) to (4). An 
308.8 	appeal must specify:
308.9 	(1) each disputed item, the reason for the dispute, and an estimate of the dollar amount 
308.10 	involved for each disputed item, if appropriate;
308.11 	(2) the computation that is believed to be correct, if appropriate;
308.12 	(3) the authority in the statute or rule relied upon for each disputed item; and
308.13 	(4) the name, address, and phone number of the person at the provider's place of business 
308.14 	with whom contact may be made regarding the appeal.
308.15 	(b) Notwithstanding section 245E.03, subdivision 4, an appeal is considered timely only 
308.16 	if postmarked or received by the department's Appeals Division within 30 days after receiving 
308.17 	a notice of department sanction.
308.18 	(c) Before the appeal hearing, the department may deny or terminate authorizations or 
308.19 	payment to the entity or individual if the department determines that the action is necessary 
308.20 	to protect the public welfare or the interests of the child care assistance program.
308.21 	A provider's rights related to an action taken under this chapter are established in sections 
308.22 	119B.16 and 119B.161.

308.23 	EFFECTIVE DATE. This section is effective April 23, 2018.

308.24 	Sec. 59. Minnesota Statutes 2016, section 245E.07, subdivision 1, is amended to read:
308.25 		Subdivision 1.Grounds for and methods of monetary recovery. (a) The department 
308.26 	may obtain monetary recovery from a provider who has been improperly paid by the child 
308.27 	care assistance program, regardless of whether the error was on the part of the provider, the 
308.28 	department, or the county and regardless of whether the error was intentional or county 
308.29 	error. The department does not need to establish a pattern as a precondition of monetary 
308.30 	recovery of erroneous or false billing claims, duplicate billing claims, or billing claims 
308.31 	based on false statements or financial misconduct.
309.1 	(b) The department shall obtain monetary recovery from providers by the following 
309.2 	means:
309.3 	(1) permitting voluntary repayment of money, either in lump-sum payment or installment 
309.4 	payments;
309.5 	(2) using any legal collection process;
309.6 	(3) deducting or withholding program payments; or
309.7 	(4) utilizing the means set forth in chapter 16D.

309.8 	EFFECTIVE DATE. This section is effective April 23, 2018.

309.9 	Sec. 60. Minnesota Statutes 2016, section 256.98, subdivision 8, is amended to read:
309.10 		Subd. 8.Disqualification from program. (a) Any person found to be guilty of 
309.11 	wrongfully obtaining assistance by a federal or state court or by an administrative hearing 
309.12 	determination, or waiver thereof, through a disqualification consent agreement, or as part 
309.13 	of any approved diversion plan under section 401.065, or any court-ordered stay which 
309.14 	carries with it any probationary or other conditions, in the Minnesota family investment 
309.15 	program and any affiliated program to include the diversionary work program and the work 
309.16 	participation cash benefit program, the food stamp or food support program, the general 
309.17 	assistance program, the group residential housing program, or the Minnesota supplemental 
309.18 	aid program shall be disqualified from that program. In addition, any person disqualified 
309.19 	from the Minnesota family investment program shall also be disqualified from the food 
309.20 	stamp or food support program. The needs of that individual shall not be taken into 
309.21 	consideration in determining the grant level for that assistance unit:
309.22 	(1) for one year after the first offense;
309.23 	(2) for two years after the second offense; and
309.24 	(3) permanently after the third or subsequent offense.
309.25 	The period of program disqualification shall begin on the date stipulated on the advance 
309.26 	notice of disqualification without possibility of postponement for administrative stay or 
309.27 	administrative hearing and shall continue through completion unless and until the findings 
309.28 	upon which the sanctions were imposed are reversed by a court of competent jurisdiction. 
309.29 	The period for which sanctions are imposed is not subject to review. The sanctions provided 
309.30 	under this subdivision are in addition to, and not in substitution for, any other sanctions that 
309.31 	may be provided for by law for the offense involved. A disqualification established through 
309.32 	hearing or waiver shall result in the disqualification period beginning immediately unless 
310.1 	the person has become otherwise ineligible for assistance. If the person is ineligible for 
310.2 	assistance, the disqualification period begins when the person again meets the eligibility 
310.3 	criteria of the program from which they were disqualified and makes application for that 
310.4 	program.
310.5 	(b) A family receiving assistance through child care assistance programs under chapter 
310.6 	119B with a family member who is found to be guilty of wrongfully obtaining child care 
310.7 	assistance by a federal court, state court, or an administrative hearing determination or 
310.8 	waiver, through a disqualification consent agreement, as part of an approved diversion plan 
310.9 	under section 401.065, or a court-ordered stay with probationary or other conditions, is 
310.10 	disqualified from child care assistance programs. The disqualifications must be for periods 
310.11 	of one year and two years for the first and second offenses, respectively. Subsequent 
310.12 	violations must result in permanent disqualification. During the disqualification period, 
310.13 	disqualification from any child care program must extend to all child care programs and 
310.14 	must be immediately applied.
310.15 	(c) A provider caring for children receiving assistance through child care assistance 
310.16 	programs under chapter 119B is disqualified from receiving payment for child care services 
310.17 	from the child care assistance program under chapter 119B when the provider is found to 
310.18 	have wrongfully obtained child care assistance by a federal court, state court, or an 
310.19 	administrative hearing determination or waiver under section 256.046, through a 
310.20 	disqualification consent agreement, as part of an approved diversion plan under section 
310.21 	401.065, or a court-ordered stay with probationary or other conditions. The disqualification 
310.22 	must be for a period of one year two years for the first offense and two years for the second 
310.23 	offense. Any subsequent violation must result in permanent disqualification. The 
310.24 	disqualification period must be imposed immediately after a determination is made under 
310.25 	this paragraph. During the disqualification period, the provider is disqualified from receiving 
310.26 	payment from any child care program under chapter 119B.
310.27 	(d) Any person found to be guilty of wrongfully obtaining MinnesotaCare for adults 
310.28 	without children and upon federal approval, all categories of medical assistance and 
310.29 	remaining categories of MinnesotaCare, except for children through age 18, by a federal or 
310.30 	state court or by an administrative hearing determination, or waiver thereof, through a 
310.31 	disqualification consent agreement, or as part of any approved diversion plan under section 
310.32 	401.065, or any court-ordered stay which carries with it any probationary or other conditions, 
310.33 	is disqualified from that program. The period of disqualification is one year after the first 
310.34 	offense, two years after the second offense, and permanently after the third or subsequent 
310.35 	offense. The period of program disqualification shall begin on the date stipulated on the 
311.1 	advance notice of disqualification without possibility of postponement for administrative 
311.2 	stay or administrative hearing and shall continue through completion unless and until the 
311.3 	findings upon which the sanctions were imposed are reversed by a court of competent 
311.4 	jurisdiction. The period for which sanctions are imposed is not subject to review. The 
311.5 	sanctions provided under this subdivision are in addition to, and not in substitution for, any 
311.6 	other sanctions that may be provided for by law for the offense involved.

311.7 	EFFECTIVE DATE. This section is effective April 23, 2018.

311.8 	Sec. 61. Minnesota Statutes 2016, section 256N.26, subdivision 5, is amended to read:
311.9 		Subd. 5.Alternate rates for preschool entry and certain transitioned children. A 
311.10 	child who entered enters the Northstar kinship assistance or adoption assistance components 
311.11 	of Northstar Care for Children while under the age of six shall receive 50 percent of the 
311.12 	amount the child would otherwise be entitled to under subdivisions 3 and 4 the full amount 
311.13 	under subdivisions 3 and 4. The commissioner may also use the 50 percent rate for a child 
311.14 	who was transitioned into those components through declaration of the commissioner under 
311.15 	section 256N.28, subdivision 7.

311.16 	EFFECTIVE DATE. This section is effective February 21, 2018.

311.17 	Sec. 62. Minnesota Statutes 2016, section 256N.27, subdivision 2, is amended to read:
311.18 		Subd. 2.State share. The commissioner shall pay the state share of the maintenance 
311.19 	payments as determined under subdivision 4, and an identical share of the pre-Northstar 
311.20 	Care foster care program under section 260C.4411, subdivision 1, the relative custody 
311.21 	assistance program under section 257.85, and the pre-Northstar Care for Children adoption 
311.22 	assistance program under chapter 259A. The state share shall include the cost of eliminating 
311.23 	the alternate rate for preschool entry under section 256N.26, subdivision 5.

311.24 	EFFECTIVE DATE. This section is effective February 21, 2018.

311.25 	Sec. 63. Minnesota Statutes 2016, section 256N.27, subdivision 4, is amended to read:
311.26 		Subd. 4.Nonfederal share. (a) The commissioner shall establish a percentage share of 
311.27 	the maintenance payments, reduced by federal reimbursements under title IV-E of the Social 
311.28 	Security Act, to be paid by the state and to be paid by the financially responsible agency.
311.29 	(b) These state and local shares must initially be calculated based on the ratio of the 
311.30 	average appropriate expenditures made by the state and all financially responsible agencies 
311.31 	during calendar years 2011, 2012, 2013, and 2014. For purposes of this calculation, 
312.1 	appropriate expenditures for the financially responsible agencies must include basic and 
312.2 	difficulty of care payments for foster care reduced by federal reimbursements, but not 
312.3 	including any initial clothing allowance, administrative payments to child care agencies 
312.4 	specified in section 317A.907, child care, or other support or ancillary expenditures. For 
312.5 	purposes of this calculation, appropriate expenditures for the state shall include adoption 
312.6 	assistance and relative custody assistance, reduced by federal reimbursements.
312.7 	(c) For each of the periods January 1, 2015, to June 30, 2016, and fiscal years 2017, 
312.8 	2018, and 2019, the commissioner shall adjust this initial percentage of state and local shares 
312.9 	to reflect the relative expenditure trends during calendar years 2011, 2012, 2013, and 2014, 
312.10 	taking into account appropriations for Northstar Care for Children, the cost of eliminating 
312.11 	the alternate rates for preschool entry under section 256N.26, subdivision 5, and the turnover 
312.12 	rates of the components. In making these adjustments, the commissioner's goal shall be to 
312.13 	make these state and local expenditures other than the appropriations for Northstar Care for 
312.14 	Children to be the same as they would have been had Northstar Care for Children not been 
312.15 	implemented, or if that is not possible, proportionally higher or lower, as appropriate. Except 
312.16 	for adjustments so that the costs of the phase-in, the cost of eliminating the alternate rates 
312.17 	for preschool entry under section 256N.26, subdivision 5, are borne by the state, the state 
312.18 	and local share percentages for fiscal year 2019 must be used for all subsequent years.

312.19 	EFFECTIVE DATE. This section is effective February 21, 2018.

312.20 	Sec. 64. Minnesota Statutes 2016, section 256P.05, subdivision 1, is amended to read:
312.21 		Subdivision 1.Exempted programs. Participants A participant who qualify qualifies
312.22 	for child care assistance programs under chapter 119B, Minnesota supplemental aid under 
312.23 	chapter 256D, and group residential housing under chapter 256I on the basis of eligibility 
312.24 	for Supplemental Security Income are exempt from this section. A participant who qualifies 
312.25 	for a child care assistance program under chapter 119B is subject to subdivision 2 of this 
312.26 	section.

312.27 	EFFECTIVE DATE. This section is effective July 30, 2018.

312.28 	Sec. 65. Minnesota Statutes 2016, section 256P.07, subdivision 3, is amended to read:
312.29 		Subd. 3.Changes that must be reported. An assistance unit must report the changes 
312.30 	or anticipated changes specified in clauses (1) to (12) within ten days of the date they occur, 
312.31 	at the time of recertification of eligibility under section 256P.04, subdivisions 8 and 9, or 
312.32 	within eight calendar days of a reporting period, whichever occurs first. An assistance unit 
312.33 	must report other changes at the time of recertification of eligibility under section 256P.04, 
313.1 	subdivisions 8 and 9, or at the end of a reporting period, as applicable. When an agency 
313.2 	could have reduced or terminated assistance for one or more payment months if a delay in 
313.3 	reporting a change specified under clauses (1) to (12) had not occurred, the agency must 
313.4 	determine whether a timely notice could have been issued on the day that the change 
313.5 	occurred. When a timely notice could have been issued, each month's overpayment 
313.6 	subsequent to that notice must be considered a client error overpayment under section 
313.7 	119B.11, subdivision 2a, or 256P.08. Changes in circumstances that must be reported within 
313.8 	ten days must also be reported for the reporting period in which those changes occurred. 
313.9 	Within ten days, an assistance unit must report:
313.10 	(1) a change in earned income of $100 per month or greater with the exception of a 
313.11 	program under chapter 119B;
313.12 	(2) a change in unearned income of $50 per month or greater with the exception of a 
313.13 	program under chapter 119B;
313.14 	(3) a change in employment status and hours with the exception of a program under a 
313.15 	chapter 119B;
313.16 	(4) a change in address or residence;
313.17 	(5) a change in household composition with the exception of programs under chapter 
313.18 	256I;
313.19 	(6) a receipt of a lump-sum payment with the exception of a program under chapter 
313.20 	119B;
313.21 	(7) an increase in assets if over $9,000 with the exception of programs under chapter 
313.22 	119B;
313.23 	(8) a change in citizenship or immigration status;
313.24 	(9) a change in family status with the exception of programs under chapter 256I;
313.25 	(10) a change in disability status of a unit member, with the exception of programs under 
313.26 	chapter 119B;
313.27 	(11) a new rent subsidy or a change in rent subsidy with the exception of a program 
313.28 	under chapter 119B; and
313.29 	(12) a sale, purchase, or transfer of real property with the exception of a program under 
313.30 	chapter 119B.

313.31 	EFFECTIVE DATE. This section is effective December 18, 2017.

314.1 	Sec. 66. Minnesota Statutes 2016, section 256P.07, subdivision 6, is amended to read:
314.2 		Subd. 6.Child care assistance programs-specific reporting. (a) In addition to 
314.3 	subdivision 3, an assistance unit under chapter 119B, within ten days of the change, must 
314.4 	report:
314.5 	(1) a change in a parentally responsible individual's visitation schedule or custody 
314.6 	arrangement schedule for any child receiving child care assistance program benefits; and
314.7 	(2) a change in permanent end in a parentally responsible individual's authorized activity 
314.8 	status.; and
314.9 	(3) if the unit's family's annual included income exceeds 85 percent of the state median 
314.10 	income, adjusted for family size.
314.11 	(b) An assistance unit subject to chapter 119B.095, subdivision 1, paragraph (b), must 
314.12 	report a change in the unit's authorized activity status.
314.13 	(c) An assistance unit must notify the county when the unit wants to reduce the number 
314.14 	of authorized hours for children in the unit.

314.15 	EFFECTIVE DATE. This section is effective December 18, 2017.

314.16 	Sec. 67. Minnesota Statutes 2016, section 257.73, subdivision 1, is amended to read:
314.17 		Subdivision 1.Replacement birth record. Upon an adjudication of paternity in a IV-D 
314.18 	matter, the court shall provide a certificate of adjudication form for children who were born 
314.19 	in Minnesota to the Office of Vital Records at the Department of Health.
314.20 	Upon compliance with the provisions of section 257.55, subdivision 1, paragraph (e),
314.21 	or a recognition of parentage pursuant to section 257.75, or upon receipt of a certificate of 
314.22 	adjudication form or an order of a court of this state or upon request of a court of another 
314.23 	state, the state registrar of vital records shall prepare a replacement record of birth consistent 
314.24 	with the acknowledgment, the certificate of adjudication form, or the findings of the court 
314.25 	and shall substitute the replacement certificate for the original record of birth as required 
314.26 	under section 144.218.

314.27 	Sec. 68. Minnesota Statutes 2016, section 257.73, is amended by adding a subdivision to 
314.28 	read:
314.29 		Subd. 1a.Certificate of adjudication forms. The commissioner of health, in consultation 
314.30 	with the commissioner of human services, shall prepare a certificate of adjudication form 
314.31 	that includes all information necessary for the registrar of vital records to prepare a 
315.1 	replacement birth record that is consistent with the order or findings of the court, and 
315.2 	identifies whether paternity was adjudicated as part of an IV-D case.

315.3 	Sec. 69. Minnesota Statutes 2016, section 518.68, subdivision 2, is amended to read:
315.4 		Subd. 2.Contents.  The required notices must be substantially as follows:
315.5 	IMPORTANT NOTICE
315.6 	1. PAYMENTS TO PUBLIC AGENCY
315.7 	According to Minnesota Statutes, section 518A.50, payments ordered for maintenance 
315.8 	and support must be paid to the public agency responsible for child support enforcement 
315.9 	as long as the person entitled to receive the payments is receiving or has applied for 
315.10 	public assistance or has applied for support and maintenance collection services. MAIL 
315.11 	PAYMENTS TO:
315.12 	2. DEPRIVING ANOTHER OF CUSTODIAL OR PARENTAL RIGHTS -- A FELONY
315.13 	A person may be charged with a felony who conceals a minor child or takes, obtains, 
315.14 	retains, or fails to return a minor child from or to the child's parent (or person with 
315.15 	custodial or visitation rights), according to Minnesota Statutes, section 609.26. A copy 
315.16 	of that section is available from any district court clerk.
315.17 	3. NONSUPPORT OF A SPOUSE OR CHILD -- CRIMINAL PENALTIES
315.18 	A person who fails to pay court-ordered child support or maintenance may be charged 
315.19 	with a crime, which may include misdemeanor, gross misdemeanor, or felony charges, 
315.20 	according to Minnesota Statutes, section 609.375. A copy of that section is available 
315.21 	from any district court clerk.
315.22 	4. RULES OF SUPPORT, MAINTENANCE, PARENTING TIME
315.23 	(a) Payment of support or spousal maintenance is to be as ordered, and the giving of 
315.24 	gifts or making purchases of food, clothing, and the like will not fulfill the obligation.
315.25 	(b) Payment of support must be made as it becomes due, and failure to secure or denial 
315.26 	of parenting time is NOT an excuse for nonpayment, but the aggrieved party must seek 
315.27 	relief through a proper motion filed with the court.
315.28 	(c) Nonpayment of support is not grounds to deny parenting time. The party entitled to 
315.29 	receive support may apply for support and collection services, file a contempt motion, 
315.30 	or obtain a judgment as provided in Minnesota Statutes, section 548.091.
316.1 	(d) The payment of support or spousal maintenance takes priority over payment of debts 
316.2 	and other obligations.
316.3 	(e) A party who accepts additional obligations of support does so with the full knowledge 
316.4 	of the party's prior obligation under this proceeding.
316.5 	(f) Child support or maintenance is based on annual income, and it is the responsibility 
316.6 	of a person with seasonal employment to budget income so that payments are made 
316.7 	throughout the year as ordered.
316.8 	(g) Reasonable parenting time guidelines are contained in Appendix B, which is available 
316.9 	from the court administrator.
316.10 	(h) The nonpayment of support may be enforced through the denial of student grants; 
316.11 	interception of state and federal tax refunds; suspension of driver's, recreational, and 
316.12 	occupational licenses; referral to the department of revenue or private collection agencies; 
316.13 	seizure of assets, including bank accounts and other assets held by financial institutions; 
316.14 	reporting to credit bureaus; interest charging, income withholding, and contempt 
316.15 	proceedings; and other enforcement methods allowed by law.
316.16 	(i) The public authority may suspend or resume collection of the amount allocated for 
316.17 	child care expenses if the conditions of section 518A.40, subdivision 4, are met.
316.18 	(j) Child care support automatically terminates when the youngest child reaches 13 years 
316.19 	of age unless child care assistance under chapter 119B continues on behalf of the child. 
316.20 	If child care support is calculated separately for each child, child care support for the 
316.21 	child shall automatically terminate when the child turns 13 years of age. If a child 
316.22 	continues to receive child care assistance under chapter 119B after 13 years of age, child 
316.23 	care assistance terminates on the first of the month following the termination of child 
316.24 	care support payments on behalf of the child. The court may order a different age or 
316.25 	event that terminates child care support.
316.26 	(j) (k) The public authority may remove or resume a medical support offset if the 
316.27 	conditions of section 518A.41, subdivision 16, are met.
316.28 	(k) (l) The public authority may suspend or resume interest charging on child support 
316.29 	judgments if the conditions of section 548.091, subdivision 1a, are met.
316.30 	5. MODIFYING CHILD SUPPORT
316.31 	If either the obligor or obligee is laid off from employment or receives a pay reduction, 
316.32 	child support may be modified, increased, or decreased. Any modification will only take 
316.33 	effect when it is ordered by the court, and will only relate back to the time that a motion 
317.1 	is filed. Either the obligor or obligee may file a motion to modify child support, and may 
317.2 	request the public agency for help. UNTIL A MOTION IS FILED, THE CHILD 
317.3 	SUPPORT OBLIGATION WILL CONTINUE AT THE CURRENT LEVEL. THE 
317.4 	COURT IS NOT PERMITTED TO REDUCE SUPPORT RETROACTIVELY.
317.5 	6. PARENTAL RIGHTS FROM MINNESOTA STATUTES, SECTION 518.17, 
317.6 	SUBDIVISION 3
317.7 	Unless otherwise provided by the Court:
317.8 	(a) Each party has the right of access to, and to receive copies of, school, medical, dental, 
317.9 	religious training, and other important records and information about the minor children. 
317.10 	Each party has the right of access to information regarding health or dental insurance 
317.11 	available to the minor children. Presentation of a copy of this order to the custodian of 
317.12 	a record or other information about the minor children constitutes sufficient authorization 
317.13 	for the release of the record or information to the requesting party.
317.14 	(b) Each party shall keep the other informed as to the name and address of the school 
317.15 	of attendance of the minor children. Each party has the right to be informed by school 
317.16 	officials about the children's welfare, educational progress and status, and to attend 
317.17 	school and parent teacher conferences. The school is not required to hold a separate 
317.18 	conference for each party.
317.19 	(c) In case of an accident or serious illness of a minor child, each party shall notify the 
317.20 	other party of the accident or illness, and the name of the health care provider and the 
317.21 	place of treatment.
317.22 	(d) Each party has the right of reasonable access and telephone contact with the minor 
317.23 	children.
317.24 	7. WAGE AND INCOME DEDUCTION OF SUPPORT AND MAINTENANCE
317.25 	Child support and/or spousal maintenance may be withheld from income, with or without 
317.26 	notice to the person obligated to pay, when the conditions of Minnesota Statutes, section 
317.27 	518A.53 have been met. A copy of those sections is available from any district court 
317.28 	clerk.
317.29 	8. CHANGE OF ADDRESS OR RESIDENCE
317.30 	Unless otherwise ordered, each party shall notify the other party, the court, and the public 
317.31 	authority responsible for collection, if applicable, of the following information within 
317.32 	ten days of any change: the residential and mailing address, telephone number, driver's 
318.1 	license number, Social Security number, and name, address, and telephone number of 
318.2 	the employer.
318.3 	9. COST OF LIVING INCREASE OF SUPPORT AND MAINTENANCE
318.4 	Basic support and/or spousal maintenance may be adjusted every two years based upon 
318.5 	a change in the cost of living (using Department of Labor Consumer Price Index .........., 
318.6 	unless otherwise specified in this order) when the conditions of Minnesota Statutes, 
318.7 	section 518A.75, are met. Cost of living increases are compounded. A copy of Minnesota 
318.8 	Statutes, section 518A.75, and forms necessary to request or contest a cost of living 
318.9 	increase are available from any district court clerk.
318.10 	10. JUDGMENTS FOR UNPAID SUPPORT
318.11 	If a person fails to make a child support payment, the payment owed becomes a judgment 
318.12 	against the person responsible to make the payment by operation of law on or after the 
318.13 	date the payment is due, and the person entitled to receive the payment or the public 
318.14 	agency may obtain entry and docketing of the judgment WITHOUT NOTICE to the 
318.15 	person responsible to make the payment under Minnesota Statutes, section 548.091. 
318.16 	Interest begins to accrue on a payment or installment of child support whenever the 
318.17 	unpaid amount due is greater than the current support due, according to Minnesota 
318.18 	Statutes, section 548.091, subdivision 1a.
318.19 	11. JUDGMENTS FOR UNPAID MAINTENANCE
318.20 	A judgment for unpaid spousal maintenance may be entered when the conditions of 
318.21 	Minnesota Statutes, section 548.091, are met. A copy of that section is available from 
318.22 	any district court clerk.
318.23 	12. ATTORNEY FEES AND COLLECTION COSTS FOR ENFORCEMENT OF CHILD 
318.24 	SUPPORT
318.25 	A judgment for attorney fees and other collection costs incurred in enforcing a child 
318.26 	support order will be entered against the person responsible to pay support when the 
318.27 	conditions of section 518A.735, are met. A copy of sections 518.14 and 518A.735 and 
318.28 	forms necessary to request or contest these attorney fees and collection costs are available 
318.29 	from any district court clerk.
318.30 	13. PARENTING TIME EXPEDITOR PROCESS
318.31 	On request of either party or on its own motion, the court may appoint a parenting time 
318.32 	expeditor to resolve parenting time disputes under Minnesota Statutes, section 518.1751. 
319.1 	A copy of that section and a description of the expeditor process is available from any 
319.2 	district court clerk.
319.3 	14. PARENTING TIME REMEDIES AND PENALTIES
319.4 	Remedies and penalties for the wrongful denial of parenting time are available under 
319.5 	Minnesota Statutes, section 518.175, subdivision 6. These include compensatory parenting 
319.6 	time; civil penalties; bond requirements; contempt; and reversal of custody. A copy of 
319.7 	that subdivision and forms for requesting relief are available from any district court 
319.8 	clerk.

319.9 	EFFECTIVE DATE. This section is effective July 1, 2018.

319.10 	Sec. 70. Minnesota Statutes 2016, section 518A.40, subdivision 4, is amended to read:
319.11 		Subd. 4.Change in child care. (a) When a court order provides for child care expenses, 
319.12 	and child care support is not assigned under section 256.741, the public authority, if the 
319.13 	public authority provides child support enforcement services, may suspend collecting the 
319.14 	amount allocated for child care expenses when either party informs the public authority that 
319.15 	no child care costs are being incurred and:
319.16 	(1) the public authority verifies the accuracy of the information with the obligee; or
319.17 	(2) the obligee fails to respond within 30 days of the date of a written request from the 
319.18 	public authority for information regarding child care costs. A written or oral response from 
319.19 	the obligee that child care costs are being incurred is sufficient for the public authority to 
319.20 	continue collecting child care expenses.
319.21 	The suspension is effective as of the first day of the month following the date that the public 
319.22 	authority either verified the information with the obligee or the obligee failed to respond. 
319.23 	The public authority will resume collecting child care expenses when either party provides 
319.24 	information that child care costs are incurred, or when a child care support assignment takes 
319.25 	effect under section 256.741, subdivision 4. The resumption is effective as of the first day 
319.26 	of the month after the date that the public authority received the information.
319.27 	(b) If the parties provide conflicting information to the public authority regarding whether 
319.28 	child care expenses are being incurred, the public authority will continue or resume collecting 
319.29 	child care expenses. Either party, by motion to the court, may challenge the suspension, 
319.30 	continuation, or resumption of the collection of child care expenses under this subdivision. 
319.31 	If the public authority suspends collection activities for the amount allocated for child care 
319.32 	expenses, all other provisions of the court order remain in effect.
320.1 	(c) In cases where there is a substantial increase or decrease in child care expenses, the 
320.2 	parties may modify the order under section 518A.39.
320.3 	(d) Unless otherwise ordered by the court, if the obligor has arrearages for basic, medical, 
320.4 	or child care support at the time a child care support obligation is suspended under this 
320.5 	subdivision, the public authority shall continue to collect the child care support obligation 
320.6 	until the arrearages are paid in full. After a child care support obligation has terminated, the 
320.7 	20 percent arrears payback under section 518A.53, subdivision 10, shall be calculated 
320.8 	without including the amount of the child care support obligation.

320.9 	EFFECTIVE DATE. This section is effective July 1, 2018.

320.10 	Sec. 71. Minnesota Statutes 2016, section 518A.40, is amended by adding a subdivision 
320.11 	to read:
320.12 		Subd. 5.Automatic termination of child care support. (a) Unless child care assistance 
320.13 	under chapter 119B continues to be paid on behalf of a child 13 years of age or older, or a 
320.14 	court orders otherwise, if a child care support obligation is ordered in a specific amount per 
320.15 	child, the child care support obligation for each child terminates automatically and without 
320.16 	any action by the obligor to reduce, modify, or terminate the order upon the first of the 
320.17 	month following the month in which that child reaches 13 years of age. If child care 
320.18 	assistance is paid on behalf of a child, the obligation to pay child care support on behalf of 
320.19 	that child terminates on the first of the month following the month in which the child care 
320.20 	assistance terminates.
320.21 	(b) Unless child care assistance under chapter 119B continues to be paid on behalf of a 
320.22 	child 13 years of age or older, a child care support obligation for two or more children that 
320.23 	is not a child care support obligation in a specific amount per child continues in the full 
320.24 	amount until the first of the month following the month in which the youngest child reaches 
320.25 	13 years of age or until further order of the court. If child care assistance is paid on behalf 
320.26 	of a child, the obligation to pay child care support on behalf of that child terminates on the 
320.27 	first of the month following the month in which the child care assistance terminates.
320.28 	(c) Either party, or the public authority if child care assistance under chapter 119B is 
320.29 	provided on behalf of the supported child, by motion to the court, may challenge the 
320.30 	termination of child care support.
320.31 	(d) The obligor may request a modification of the obligor's child care support order 
320.32 	when a child reaches 13 years of age if there is still a minor child under the child care support 
321.1 	order. The child care support obligation shall be determined based on the income of the 
321.2 	parties and the costs of work-related child care at the time the modification is sought.
321.3 	(e) Unless otherwise ordered by the court, if the obligor has arrearages for basic, medical, 
321.4 	or child care support at the time child care support is terminated under this subdivision, the 
321.5 	public authority shall continue to collect the child care support obligation until the arrearages 
321.6 	are paid in full. After a child care support obligation has terminated, the 20 percent arrears 
321.7 	payback under section 518A.23, subdivision 10, shall be calculated without including the 
321.8 	amount of the child care support obligation.
321.9 	(f) If the public authority provides child support services at the time child care support 
321.10 	is set to terminate under this subdivision, the public authority shall send the parties 90 days' 
321.11 	notice of the child care support obligation termination. The notice shall state that the child 
321.12 	care support obligation must continue to be collected in full until any existing arrears have 
321.13 	been paid in full, and that collection of the child care support obligation is in addition to 
321.14 	the 20 percent paid under section 518A.53.

321.15 	EFFECTIVE DATE. This section is effective July 1, 2018.

321.16 	Sec. 72. Minnesota Statutes 2016, section 626.556, subdivision 3c, is amended to read:
321.17 		Subd. 3c.Local welfare agency, Department of Human Services or Department of 
321.18 	Health responsible for assessing or investigating reports of maltreatment or death. (a) 
321.19 	Except as provided in paragraph (b), the county local welfare agency is the agency 
321.20 	responsible for assessing or investigating allegations of maltreatment in child foster care,
321.21 	and family child care that do not involve the death of a child, legally unlicensed child care, 
321.22 	juvenile correctional facilities licensed under section 241.021 located in the local welfare 
321.23 	agency's county, and reports involving children served by an unlicensed personal care 
321.24 	provider organization under section 256B.0659. Copies of findings related to personal care 
321.25 	provider organizations under section 256B.0659 must be forwarded to the Department of 
321.26 	Human Services provider enrollment.
321.27 	(b) The Department of Human Services is the agency responsible for assessing or 
321.28 	investigating allegations of maltreatment in:
321.29 	(1) facilities licensed under chapters 245A and 245D, except for child foster care and
321.30 	in family child care. and child foster care homes that are monitored by county agencies 
321.31 	according to section 245A.16, subdivision 1;
322.1 	(2) child foster care homes that are monitored by private agencies and homes are licensed 
322.2 	by the commissioner to perform licensing functions and activities according to section 
322.3 	245A.16, subdivision 1; and
322.4 	(3) child foster care and family child care homes that are monitored by county agencies 
322.5 	according to section 245A.16, subdivision 1, upon agreement by the county and the 
322.6 	Department of Human Services for a specific case, or when the commissioner identifies 
322.7 	cause.
322.8 	(c) The Department of Human Services is responsible for investigating the death of a 
322.9 	child in a child foster care program or family child care program.
322.10 	(c) (d) The Department of Health is the agency responsible for assessing or investigating 
322.11 	allegations of child maltreatment in facilities licensed under sections 144.50 to 144.58 and 
322.12 	144A.43 to 144A.482.

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

322.14 	Sec. 73. Minnesota Statutes 2016, section 626.556, subdivision 10b, is amended to read:
322.15 		Subd. 10b.Duties of commissioner; neglect or, abuse, or death in a facility. (a) This 
322.16 	section applies to the commissioners of human services, health, and education. The 
322.17 	commissioner of the agency responsible for assessing or investigating the report shall 
322.18 	immediately assess or investigate if the report alleges that:
322.19 	(1) a child who is in the care of a facility as defined in subdivision 2 is neglected, 
322.20 	physically abused, sexually abused, or is the victim of maltreatment in a facility by an 
322.21 	individual in that facility, or has been so neglected or abused, or been the victim of 
322.22 	maltreatment in a facility by an individual in that facility within the three years preceding 
322.23 	the report; or
322.24 	(2) a child was neglected, physically abused, sexually abused, or is the victim of 
322.25 	maltreatment in a facility by an individual in a facility defined in subdivision 2, while in 
322.26 	the care of that facility within the three years preceding the report.
322.27 	The commissioner of the agency responsible for assessing or investigating the report 
322.28 	shall arrange for the transmittal to the commissioner of reports received by local agencies 
322.29 	and may delegate to a local welfare agency the duty to investigate reports. In conducting 
322.30 	an investigation under this section, the commissioner has the powers and duties specified 
322.31 	for local welfare agencies under this section. The commissioner of the agency responsible 
322.32 	for assessing or investigating the report or local welfare agency may interview any children 
323.1 	who are or have been in the care of a facility under investigation and their parents, guardians, 
323.2 	or legal custodians.
323.3 	(b) Prior to any interview, the commissioner of the agency responsible for assessing or 
323.4 	investigating the report or local welfare agency shall notify the parent, guardian, or legal 
323.5 	custodian of a child who will be interviewed in the manner provided for in subdivision 10d, 
323.6 	paragraph (a). If reasonable efforts to reach the parent, guardian, or legal custodian of a 
323.7 	child in an out-of-home placement have failed, the child may be interviewed if there is 
323.8 	reason to believe the interview is necessary to protect the child or other children in the 
323.9 	facility. The commissioner of the agency responsible for assessing or investigating the report 
323.10 	or local agency must provide the information required in this subdivision to the parent, 
323.11 	guardian, or legal custodian of a child interviewed without parental notification as soon as 
323.12 	possible after the interview. When the investigation is completed, any parent, guardian, or 
323.13 	legal custodian notified under this subdivision shall receive the written memorandum 
323.14 	provided for in subdivision 10d, paragraph (c).
323.15 	(c) In conducting investigations under this subdivision the commissioner or local welfare 
323.16 	agency shall obtain access to information consistent with subdivision 10, paragraphs (h), 
323.17 	(i), and (j). In conducting assessments or investigations under this subdivision, the 
323.18 	commissioner of education shall obtain access to reports and investigative data that are 
323.19 	relevant to a report of maltreatment and are in the possession of a school facility as defined 
323.20 	in subdivision 2, paragraph (c), notwithstanding the classification of the data as educational 
323.21 	or personnel data under chapter 13. This includes, but is not limited to, school investigative 
323.22 	reports, information concerning the conduct of school personnel alleged to have committed 
323.23 	maltreatment of students, information about witnesses, and any protective or corrective 
323.24 	action taken by the school facility regarding the school personnel alleged to have committed 
323.25 	maltreatment.
323.26 	(d) The commissioner may request assistance from the local social services agency.
323.27 	(e) The commissioner of human services shall investigate every incident involving the 
323.28 	death of a child during placement in a child foster care home licensed under chapter 245A 
323.29 	and Minnesota Rules, chapter 2960. The investigation, notifications, and data classifications 
323.30 	are governed by this section, even if abuse or neglect is not alleged in the report.
323.31 	(f) The commissioner of human services shall investigate every incident involving the 
323.32 	death of a child in a family child care program licensed under chapter 245A and Minnesota 
323.33 	Rules, chapter 9502. The investigation, notifications, and data classifications are governed 
323.34 	by this section, even if abuse or neglect is not alleged in the report.

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

324.2 	Sec. 74. Minnesota Statutes 2016, section 626.559, subdivision 1, is amended to read:
324.3 		Subdivision 1.Job classification; continuing education. The commissioner of human 
324.4 	services, for employees subject to the Minnesota Merit System, and directors of county 
324.5 	personnel systems, for counties not subject to the Minnesota Merit System, shall establish 
324.6 	a job classification consisting exclusively of persons with the specialized knowledge, skills, 
324.7 	and experience required to satisfactorily perform child protection duties pursuant to section 
324.8 	626.556, subdivisions 10, 10a, and 10b.
324.9 	All child protection workers or social services staff having responsibility for child 
324.10 	protective duties under section 626.556 shall receive 15 20 hours of continuing education 
324.11 	or in-service training each year relevant to providing child protective services. At least ten 
324.12 	of the hours shall include advanced training in topics to be decided and developed by the 
324.13 	commissioner of human services. The local social service agency shall maintain a record 
324.14 	of training completed by each employee having responsibility for performing child protective 
324.15 	duties.

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

324.17 	Sec. 75.  REPEALER.
 324.18 	(a) Minnesota Statutes 2016, section 119B.07, is repealed effective December 18, 2017.
324.19 	(b) Minnesota Statutes 2016, section 119B.125, subdivision 5, is repealed effective the 
324.20 	day following final enactment.
324.21 	(c) Minnesota Statutes 2016, sections 119B.16, subdivision 2; 245E.03, subdivision 3; 
324.22 	and 245E.06, subdivisions 4 and 5, and Minnesota Rules, part 3400.0185, subpart 5, are 
324.23 	repealed effective April 23, 2018.

324.24 	ARTICLE 8
324.25 	CHEMICAL AND MENTAL HEALTH SERVICES

324.26 	Section 1. Minnesota Statutes 2016, section 245.4661, subdivision 9, is amended to read:
324.27 		Subd. 9.Services and programs. (a) The following three distinct grant programs are 
324.28 	funded under this section:
324.29 	(1) mental health crisis services;
324.30 	(2) housing with supports for adults with serious mental illness; and
325.1 	(3) projects for assistance in transitioning from homelessness (PATH program).; and
325.2 	(4) community-based mental health infrastructure development grants.
325.3 	(b) In addition, the following are eligible for grant funds:
325.4 	(1) community education and prevention;
325.5 	(2) client outreach;
325.6 	(3) early identification and intervention;
325.7 	(4) adult outpatient diagnostic assessment and psychological testing;
325.8 	(5) peer support services;
325.9 	(6) community support program services (CSP);
325.10 	(7) adult residential crisis stabilization;
325.11 	(8) supported employment;
325.12 	(9) assertive community treatment (ACT);
325.13 	(10) housing subsidies;
325.14 	(11) basic living, social skills, and community intervention;
325.15 	(12) emergency response services;
325.16 	(13) adult outpatient psychotherapy;
325.17 	(14) adult outpatient medication management;
325.18 	(15) adult mobile crisis services;
325.19 	(16) adult day treatment;
325.20 	(17) partial hospitalization;
325.21 	(18) adult residential treatment;
325.22 	(19) adult mental health targeted case management;
325.23 	(20) intensive community rehabilitative services (ICRS); and
325.24 	(21) transportation.

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

326.1 	Sec. 2. Minnesota Statutes 2016, section 245.4889, subdivision 1, is amended to read:
326.2 		Subdivision 1.Establishment and authority. (a) The commissioner is authorized to 
326.3 	make grants from available appropriations to assist:
326.4 	(1) counties;
326.5 	(2) Indian tribes;
326.6 	(3) children's collaboratives under section 124D.23 or 245.493; or
326.7 	(4) mental health service providers.
326.8 	(b) The following services are eligible for grants under this section:
326.9 	(1) services to children with emotional disturbances as defined in section 245.4871, 
326.10 	subdivision 15, and their families;
326.11 	(2) transition services under section 245.4875, subdivision 8, for young adults under 
326.12 	age 21 and their families;
326.13 	(3) respite care services for children with severe emotional disturbances who are at risk 
326.14 	of out-of-home placement;
326.15 	(4) children's mental health crisis services;
326.16 	(5) mental health services for people from cultural and ethnic minorities;
326.17 	(6) children's mental health screening and follow-up diagnostic assessment and treatment;
326.18 	(7) services to promote and develop the capacity of providers to use evidence-based 
326.19 	practices in providing children's mental health services;
326.20 	(8) school-linked mental health services;
326.21 	(9) building evidence-based mental health intervention capacity for children birth to age 
326.22 	five;
326.23 	(10) suicide prevention and counseling services that use text messaging statewide;
326.24 	(11) mental health first aid training;
326.25 	(12) training for parents, collaborative partners, and mental health providers on the 
326.26 	impact of adverse childhood experiences and trauma and development of an interactive 
326.27 	Web site to share information and strategies to promote resilience and prevent trauma;
326.28 	(13) transition age services to develop or expand mental health treatment and supports 
326.29 	for adolescents and young adults 26 years of age or younger;
327.1 	(14) early childhood mental health consultation;
327.2 	(15) evidence-based interventions for youth at risk of developing or experiencing a first 
327.3 	episode of psychosis, and a public awareness campaign on the signs and symptoms of 
327.4 	psychosis; and
327.5 	(16) psychiatric consultation for primary care practitioners.; and
327.6 	(17) start-up funding to establish new childrens' mental health programs to support 
327.7 	providers to meet all program requirements and begin operations.
327.8 	(c) Services under paragraph (b) must be designed to help each child to function and 
327.9 	remain with the child's family in the community and delivered consistent with the child's 
327.10 	treatment plan. Transition services to eligible young adults under paragraph (b) must be 
327.11 	designed to foster independent living in the community.

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

327.13 	Sec. 3. Minnesota Statutes 2016, section 245A.03, subdivision 2, is amended to read:
327.14 		Subd. 2.Exclusion from licensure. (a) This chapter does not apply to:
327.15 	(1) residential or nonresidential programs that are provided to a person by an individual 
327.16 	who is related unless the residential program is a child foster care placement made by a 
327.17 	local social services agency or a licensed child-placing agency, except as provided in 
327.18 	subdivision 2a;
327.19 	(2) nonresidential programs that are provided by an unrelated individual to persons from 
327.20 	a single related family;
327.21 	(3) residential or nonresidential programs that are provided to adults who do not abuse 
327.22 	chemicals or who do not have a chemical dependency misuse substances or have a substance 
327.23 	use disorder, a mental illness, a developmental disability, a functional impairment, or a 
327.24 	physical disability;
327.25 	(4) sheltered workshops or work activity programs that are certified by the commissioner 
327.26 	of employment and economic development;
327.27 	(5) programs operated by a public school for children 33 months or older;
327.28 	(6) nonresidential programs primarily for children that provide care or supervision for 
327.29 	periods of less than three hours a day while the child's parent or legal guardian is in the 
327.30 	same building as the nonresidential program or present within another building that is 
327.31 	directly contiguous to the building in which the nonresidential program is located;
328.1 	(7) nursing homes or hospitals licensed by the commissioner of health except as specified 
328.2 	under section 245A.02;
328.3 	(8) board and lodge facilities licensed by the commissioner of health that do not provide 
328.4 	children's residential services under Minnesota Rules, chapter 2960, mental health or chemical 
328.5 	dependency treatment;
328.6 	(9) homes providing programs for persons placed by a county or a licensed agency for 
328.7 	legal adoption, unless the adoption is not completed within two years;
328.8 	(10) programs licensed by the commissioner of corrections;
328.9 	(11) recreation programs for children or adults that are operated or approved by a park 
328.10 	and recreation board whose primary purpose is to provide social and recreational activities;
328.11 	(12) programs operated by a school as defined in section 120A.22, subdivision 4; YMCA 
328.12 	as defined in section 315.44; YWCA as defined in section 315.44; or JCC as defined in 
328.13 	section 315.51, whose primary purpose is to provide child care or services to school-age 
328.14 	children;
328.15 	(13) Head Start nonresidential programs which operate for less than 45 days in each 
328.16 	calendar year;
328.17 	(14) noncertified boarding care homes unless they provide services for five or more 
328.18 	persons whose primary diagnosis is mental illness or a developmental disability;
328.19 	(15) programs for children such as scouting, boys clubs, girls clubs, and sports and art 
328.20 	programs, and nonresidential programs for children provided for a cumulative total of less 
328.21 	than 30 days in any 12-month period;
328.22 	(16) residential programs for persons with mental illness, that are located in hospitals;
328.23 	(17) the religious instruction of school-age children; Sabbath or Sunday schools; or the 
328.24 	congregate care of children by a church, congregation, or religious society during the period 
328.25 	used by the church, congregation, or religious society for its regular worship;
328.26 	(18) camps licensed by the commissioner of health under Minnesota Rules, chapter 
328.27 	4630;
328.28 	(19) mental health outpatient services for adults with mental illness or children with 
328.29 	emotional disturbance;
328.30 	(20) residential programs serving school-age children whose sole purpose is cultural or 
328.31 	educational exchange, until the commissioner adopts appropriate rules;
329.1 	(21) community support services programs as defined in section 245.462, subdivision 
329.2 	6, and family community support services as defined in section 245.4871, subdivision 17;
329.3 	(22) the placement of a child by a birth parent or legal guardian in a preadoptive home 
329.4 	for purposes of adoption as authorized by section 259.47;
329.5 	(23) settings registered under chapter 144D which provide home care services licensed 
329.6 	by the commissioner of health to fewer than seven adults;
329.7 	(24) chemical dependency or substance abuse use disorder treatment activities of licensed 
329.8 	professionals in private practice as defined in Minnesota Rules, part 9530.6405, subpart 15, 
329.9 	when the treatment activities are not paid for by the consolidated chemical dependency 
329.10 	treatment fund section 245G.01, subdivision 17;
329.11 	(25) consumer-directed community support service funded under the Medicaid waiver 
329.12 	for persons with developmental disabilities when the individual who provided the service 
329.13 	is:
329.14 	(i) the same individual who is the direct payee of these specific waiver funds or paid by 
329.15 	a fiscal agent, fiscal intermediary, or employer of record; and
329.16 	(ii) not otherwise under the control of a residential or nonresidential program that is 
329.17 	required to be licensed under this chapter when providing the service;
329.18 	(26) a program serving only children who are age 33 months or older, that is operated 
329.19 	by a nonpublic school, for no more than four hours per day per child, with no more than 20 
329.20 	children at any one time, and that is accredited by:
329.21 	(i) an accrediting agency that is formally recognized by the commissioner of education 
329.22 	as a nonpublic school accrediting organization; or
329.23 	(ii) an accrediting agency that requires background studies and that receives and 
329.24 	investigates complaints about the services provided.
329.25 	A program that asserts its exemption from licensure under item (ii) shall, upon request 
329.26 	from the commissioner, provide the commissioner with documentation from the accrediting 
329.27 	agency that verifies: that the accreditation is current; that the accrediting agency investigates 
329.28 	complaints about services; and that the accrediting agency's standards require background 
329.29 	studies on all people providing direct contact services; or
329.30 	(27) a program operated by a nonprofit organization incorporated in Minnesota or another 
329.31 	state that serves youth in kindergarten through grade 12; provides structured, supervised 
329.32 	youth development activities; and has learning opportunities take place before or after 
330.1 	school, on weekends, or during the summer or other seasonal breaks in the school calendar. 
330.2 	A program exempt under this clause is not eligible for child care assistance under chapter 
330.3 	119B. A program exempt under this clause must:
330.4 	(i) have a director or supervisor on site who is responsible for overseeing written policies 
330.5 	relating to the management and control of the daily activities of the program, ensuring the 
330.6 	health and safety of program participants, and supervising staff and volunteers;
330.7 	(ii) have obtained written consent from a parent or legal guardian for each youth 
330.8 	participating in activities at the site; and
330.9 	(iii) have provided written notice to a parent or legal guardian for each youth at the site 
330.10 	that the program is not licensed or supervised by the state of Minnesota and is not eligible 
330.11 	to receive child care assistance payments.
330.12 	(b) For purposes of paragraph (a), clause (6), a building is directly contiguous to a 
330.13 	building in which a nonresidential program is located if it shares a common wall with the 
330.14 	building in which the nonresidential program is located or is attached to that building by 
330.15 	skyway, tunnel, atrium, or common roof.
330.16 	(c) Except for the home and community-based services identified in section 245D.03, 
330.17 	subdivision 1, nothing in this chapter shall be construed to require licensure for any services 
330.18 	provided and funded according to an approved federal waiver plan where licensure is 
330.19 	specifically identified as not being a condition for the services and funding.

330.20 	EFFECTIVE DATE. This section is effective July 1, 2017.

330.21 	Sec. 4. Minnesota Statutes 2016, section 245A.03, subdivision 7, is amended to read:
330.22 		Subd. 7.Licensing moratorium. (a) The commissioner shall not issue an initial license 
330.23 	for child foster care licensed under Minnesota Rules, parts 2960.3000 to 2960.3340, or adult 
330.24 	foster care licensed under Minnesota Rules, parts 9555.5105 to 9555.6265, under this chapter 
330.25 	for a physical location that will not be the primary residence of the license holder for the 
330.26 	entire period of licensure. If a license is issued during this moratorium, and the license 
330.27 	holder changes the license holder's primary residence away from the physical location of 
330.28 	the foster care license, the commissioner shall revoke the license according to section 
330.29 	245A.07. The commissioner shall not issue an initial license for a community residential 
330.30 	setting licensed under chapter 245D. Exceptions to the moratorium include:
330.31 	(1) foster care settings that are required to be registered under chapter 144D;
331.1 	(2) foster care licenses replacing foster care licenses in existence on May 15, 2009, or 
331.2 	community residential setting licenses replacing adult foster care licenses in existence on 
331.3 	December 31, 2013, and determined to be needed by the commissioner under paragraph 
331.4 	(b);
331.5 	(3) new foster care licenses or community residential setting licenses determined to be 
331.6 	needed by the commissioner under paragraph (b) for the closure of a nursing facility, ICF/DD, 
331.7 	or regional treatment center; restructuring of state-operated services that limits the capacity 
331.8 	of state-operated facilities; or allowing movement to the community for people who no 
331.9 	longer require the level of care provided in state-operated facilities as provided under section 
331.10 	256B.092, subdivision 13, or 256B.49, subdivision 24;
331.11 	(4) new foster care licenses or community residential setting licenses determined to be 
331.12 	needed by the commissioner under paragraph (b) for persons requiring hospital level care; 
331.13 	or
331.14 	(5) new foster care licenses or community residential setting licenses determined to be 
331.15 	needed by the commissioner for the transition of people from personal care assistance to 
331.16 	the home and community-based services.
331.17 	(b) The commissioner shall determine the need for newly licensed foster care homes or 
331.18 	community residential settings as defined under this subdivision. As part of the determination, 
331.19 	the commissioner shall consider the availability of foster care capacity in the area in which 
331.20 	the licensee seeks to operate, and the recommendation of the local county board. The 
331.21 	determination by the commissioner must be final. A determination of need is not required 
331.22 	for a change in ownership at the same address.
331.23 	(c) When an adult resident served by the program moves out of a foster home that is not 
331.24 	the primary residence of the license holder according to section 256B.49, subdivision 15, 
331.25 	paragraph (f), or the adult community residential setting, the county shall immediately 
331.26 	inform the Department of Human Services Licensing Division. The department shall decrease 
331.27 	the statewide licensed capacity for adult foster care settings where the physical location is 
331.28 	not the primary residence of the license holder, or for adult community residential settings, 
331.29 	if the voluntary changes described in paragraph (e) are not sufficient to meet the savings 
331.30 	required by reductions in licensed bed capacity under Laws 2011, First Special Session 
331.31 	chapter 9, article 7, sections 1 and 40, paragraph (f), and maintain statewide long-term care 
331.32 	residential services capacity within budgetary limits. Implementation of the statewide 
331.33 	licensed capacity reduction shall begin on July 1, 2013. The commissioner shall delicense 
331.34 	up to 128 beds by June 30, 2014, using the needs determination process. Prior to any 
332.1 	involuntary reduction of licensed capacity, the commissioner shall consult with lead agencies 
332.2 	and license holders to determine which adult foster care settings, where the physical location 
332.3 	is not the primary residence of the license holder, or community residential settings, are 
332.4 	licensed for up to five beds, but have operated at less than full capacity for 12 or more 
332.5 	months as of March 1, 2014. The settings that meet these criteria must be the first to be 
332.6 	considered for an involuntary decrease in statewide licensed capacity, up to a maximum of 
332.7 	35 beds. If more than 35 beds are identified that meet these criteria, the commissioner shall 
332.8 	prioritize the selection of those beds to be closed based on the length of time the beds have 
332.9 	been vacant. The longer a bed has been vacant, the higher priority it must be given for 
332.10 	closure. Under this paragraph, the commissioner has the authority to reduce unused licensed 
332.11 	capacity of a current foster care program, or the community residential settings, to accomplish 
332.12 	the consolidation or closure of settings. Under this paragraph, the commissioner has the 
332.13 	authority to manage statewide capacity, including adjusting the capacity available to each 
332.14 	county and adjusting statewide available capacity, to meet the statewide needs identified 
332.15 	through the process in paragraph (e). A decreased licensed capacity according to this 
332.16 	paragraph is not subject to appeal under this chapter.
332.17 	(d) Residential settings that would otherwise be subject to the decreased license capacity 
332.18 	established in paragraph (c) shall be exempt if the license holder's beds are occupied by 
332.19 	residents whose primary diagnosis is mental illness and the license holder is certified under 
332.20 	the requirements in subdivision 6a or section 245D.33.
332.21 	(e) A resource need determination process, managed at the state level, using the available 
332.22 	reports required by section 144A.351, and other data and information shall be used to 
332.23 	determine where the reduced capacity required under paragraph (c) will be implemented. 
332.24 	The commissioner shall consult with the stakeholders described in section 144A.351, and 
332.25 	employ a variety of methods to improve the state's capacity to meet long-term care service 
332.26 	needs within budgetary limits, including seeking proposals from service providers or lead 
332.27 	agencies to change service type, capacity, or location to improve services, increase the 
332.28 	independence of residents, and better meet needs identified by the long-term care services 
332.29 	reports and statewide data and information. By February 1, 2013, and August 1, 2014, and 
332.30 	each following year, the commissioner shall provide information and data on the overall 
332.31 	capacity of licensed long-term care services, actions taken under this subdivision to manage 
332.32 	statewide long-term care services and supports resources, and any recommendations for 
332.33 	change to the legislative committees with jurisdiction over health and human services budget.
332.34 	(f) At the time of application and reapplication for licensure, the applicant and the license 
332.35 	holder that are subject to the moratorium or an exclusion established in paragraph (a) are 
333.1 	required to inform the commissioner whether the physical location where the foster care 
333.2 	will be provided is or will be the primary residence of the license holder for the entire period 
333.3 	of licensure. If the primary residence of the applicant or license holder changes, the applicant 
333.4 	or license holder must notify the commissioner immediately. The commissioner shall print 
333.5 	on the foster care license certificate whether or not the physical location is the primary 
333.6 	residence of the license holder.
333.7 	(g) License holders of foster care homes identified under paragraph (f) that are not the 
333.8 	primary residence of the license holder and that also provide services in the foster care home 
333.9 	that are covered by a federally approved home and community-based services waiver, as 
333.10 	authorized under section 256B.0915, 256B.092, or 256B.49, must inform the human services 
333.11 	licensing division that the license holder provides or intends to provide these waiver-funded 
333.12 	services.
333.13 	(h) The commissioner shall not issue an initial license for children's residential treatment 
333.14 	services licensed under Minnesota Rules, parts 2960.0580 to 2960.0700, under this chapter 
333.15 	for a program that Centers for Medicare and Medicaid Services would consider an institution 
333.16 	for mental diseases.

333.17 	EFFECTIVE DATE. This section is effective July 1, 2017.

333.18 	Sec. 5. Minnesota Statutes 2016, section 245A.191, is amended to read:
333.19 	245A.191 PROVIDER ELIGIBILITY FOR PAYMENTS FROM THE CHEMICAL 
333.20 	DEPENDENCY CONSOLIDATED TREATMENT FUND.
333.21 	(a) When a chemical dependency substance use disorder treatment provider licensed 
333.22 	under chapter 245G or Minnesota Rules, parts 2960.0430 to 2960.0490or 9530.6405 to 
333.23 	9530.6505, agrees to meet the applicable requirements under section 254B.05, subdivision 
333.24 	5, paragraphs (b), clauses (1) to (4) and (6), (c), and (e), to be eligible for enhanced funding 
333.25 	from the chemical dependency consolidated treatment fund, the applicable requirements 
333.26 	under section 254B.05 are also licensing requirements that may be monitored for compliance 
333.27 	through licensing investigations and licensing inspections.
333.28 	(b) Noncompliance with the requirements identified under paragraph (a) may result in:
333.29 	(1) a correction order or a conditional license under section 245A.06, or sanctions under 
333.30 	section 245A.07;
333.31 	(2) nonpayment of claims submitted by the license holder for public program 
333.32 	reimbursement;
334.1 	(3) recovery of payments made for the service;
334.2 	(4) disenrollment in the public payment program; or
334.3 	(5) other administrative, civil, or criminal penalties as provided by law.

334.4 	EFFECTIVE DATE. This section is effective July 1, 2017.

334.5 	Sec. 6. [245G.01] DEFINITIONS.
334.6 		Subdivision 1.Scope. The terms used in this chapter have the meanings given them.
334.7 		Subd. 2.Administration of medication. "Administration of medication" means providing 
334.8 	a medication to a client, and includes the following tasks, performed in the following order:
334.9 	(1) checking the client's medication record;
334.10 	(2) preparing the medication for administration;
334.11 	(3) administering the medication to the client;
334.12 	(4) documenting the administration of the medication, or the reason for not administering 
334.13 	a medication as prescribed; and
334.14 	(5) reporting information to a licensed practitioner or a nurse regarding a problem with 
334.15 	the administration of medication or the client's refusal to take the medication, if applicable.
334.16 		Subd. 3.Adolescent. "Adolescent" means an individual under 18 years of age.
334.17 		Subd. 4.Alcohol and drug counselor. "Alcohol and drug counselor" has the meaning 
334.18 	given in section 148F.01, subdivision 5.
334.19 		Subd. 5.Applicant. "Applicant" means an individual, corporation, partnership, voluntary 
334.20 	association, controlling individual, or other organization that applied for a license under 
334.21 	this chapter.
334.22 		Subd. 6.Capacity management system. "Capacity management system" means a 
334.23 	database maintained by the department to compile and make information available to the 
334.24 	public about the waiting list status and current admission capability of each opioid treatment 
334.25 	program.
334.26 		Subd. 7.Central registry. "Central registry" means a database maintained by the 
334.27 	department to collect identifying information from two or more programs about an individual 
334.28 	applying for maintenance treatment or detoxification treatment for opioid addiction to 
334.29 	prevent an individual's concurrent enrollment in more than one program.
335.1 		Subd. 8.Client. "Client" means an individual accepted by a license holder for assessment 
335.2 	or treatment of a substance use disorder. An individual remains a client until the license 
335.3 	holder no longer provides or intends to provide the individual with treatment service.
335.4 		Subd. 9.Commissioner. "Commissioner" means the commissioner of human services.
335.5 		Subd. 10.Co-occurring disorders. "Co-occurring disorders" means a diagnosis of both 
335.6 	a substance use disorder and a mental health disorder.
335.7 		Subd. 11.Department. "Department" means the Department of Human Services.
335.8 		Subd. 12.Direct contact. "Direct contact" has the meaning given for "direct contact" 
335.9 	in section 245C.02, subdivision 11.
335.10 		Subd. 13.Face-to-face. "Face-to-face" means two-way, real-time, interactive and visual 
335.11 	communication between a client and a treatment service provider and includes services 
335.12 	delivered via telemedicine.
335.13 		Subd. 14.License. "License" means a certificate issued by the commissioner authorizing 
335.14 	the license holder to provide a specific program for a specified period of time according to 
335.15 	the terms of the license and the rules of the commissioner.
335.16 		Subd. 15.License holder. "License holder" means an individual, corporation, partnership, 
335.17 	voluntary organization, or other organization that is legally responsible for the operation of 
335.18 	the program, was granted a license by the commissioner under this chapter, and is a 
335.19 	controlling individual.
335.20 		Subd. 16.Licensed practitioner. "Licensed practitioner" means an individual who is 
335.21 	authorized to prescribe medication as defined in section 151.01, subdivision 23.
335.22 		Subd. 17.Licensed professional in private practice. "Licensed professional in private 
335.23 	practice" means an individual who:
335.24 	(1) is licensed under chapter 148F, or is exempt from licensure under that chapter but 
335.25 	is otherwise licensed to provide alcohol and drug counseling services;
335.26 	(2) practices solely within the permissible scope of the individual's license as defined 
335.27 	in the law authorizing licensure; and
335.28 	(3) does not affiliate with other licensed or unlicensed professionals to provide alcohol 
335.29 	and drug counseling services. Affiliation does not include conferring with another 
335.30 	professional or making a client referral.
336.1 		Subd. 18.Nurse. "Nurse" means an individual licensed and currently registered to 
336.2 	practice professional or practical nursing as defined in section 148.171, subdivisions 14 and 
336.3 	15.
336.4 		Subd. 19.Opioid treatment program. "Opioid treatment program" or "OTP" means a 
336.5 	program or practitioner engaged in opioid treatment of an individual that provides dispensing 
336.6 	of an opioid agonist treatment medication, along with a comprehensive range of medical 
336.7 	and rehabilitative services, when clinically necessary, to an individual to alleviate the adverse 
336.8 	medical, psychological, or physical effects of an opioid addiction. OTP includes 
336.9 	detoxification treatment, short-term detoxification treatment, long-term detoxification 
336.10 	treatment, maintenance treatment, comprehensive maintenance treatment, and interim 
336.11 	maintenance treatment.
336.12 		Subd. 20.Paraprofessional. "Paraprofessional" means an employee, agent, or 
336.13 	independent contractor of the license holder who performs tasks to support treatment service. 
336.14 	A paraprofessional may be referred to by a variety of titles including but not limited to 
336.15 	technician, case aide, or counselor assistant. If currently a client of the license holder, the 
336.16 	client cannot be a paraprofessional for the license holder.
336.17 		Subd. 21.Student intern. "Student intern" means an individual who is authorized by a 
336.18 	licensing board to provide services under supervision of a licensed professional.
336.19 		Subd. 22.Substance. "Substance" means alcohol, solvents, controlled substances as 
336.20 	defined in section 152.01, subdivision 4, and other mood-altering substances.
336.21 		Subd. 23.Substance use disorder. "Substance use disorder" has the meaning given in 
336.22 	the current Diagnostic and Statistical Manual of Mental Disorders.
336.23 		Subd. 24.Substance use disorder treatment. "Substance use disorder treatment" means 
336.24 	treatment of a substance use disorder, including the process of assessment of a client's needs, 
336.25 	development of planned methods, including interventions or services to address a client's 
336.26 	needs, provision of services, facilitation of services provided by other service providers, 
336.27 	and ongoing reassessment by a qualified professional when indicated. The goal of substance 
336.28 	use disorder treatment is to assist or support the client's efforts to recover from a substance 
336.29 	use disorder.
336.30 		Subd. 25.Target population. "Target population" means individuals with a substance 
336.31 	use disorder and the specified characteristics that a license holder proposes to serve.
337.1 		Subd. 26.Telemedicine. "Telemedicine" means the delivery of a substance use disorder 
337.2 	treatment service while the client is at an originating site and the licensed health care provider 
337.3 	is at a distant site as specified in section 254B.05, subdivision 5, paragraph (f).
337.4 		Subd. 27.Treatment director. "Treatment director" means an individual who meets 
337.5 	the qualifications specified in section 245G.11, subdivisions 1 and 3, and is designated by 
337.6 	the license holder to be responsible for all aspects of the delivery of treatment service.

337.7 	EFFECTIVE DATE. This section is effective July 1, 2017.

337.8 	Sec. 7. [245G.02] APPLICABILITY.
337.9 		Subdivision 1.Applicability. Except as provided in subdivisions 2 and 3, no person, 
337.10 	corporation, partnership, voluntary association, controlling individual, or other organization 
337.11 	may provide a substance use disorder treatment service to an individual with a substance 
337.12 	use disorder unless licensed by the commissioner.
337.13 		Subd. 2.Exemption from license requirement. This chapter does not apply to a county 
337.14 	or recovery community organization that is a vendor under section 254B.05 or to an 
337.15 	organization whose primary functions are information, referral, diagnosis, case management, 
337.16 	and assessment for the purposes of client placement, education, support group services, or 
337.17 	self-help programs. This chapter does not apply to the activities of a licensed professional 
337.18 	in private practice.
337.19 		Subd. 3.Excluded hospitals. This chapter does not apply to substance use disorder 
337.20 	treatment provided by a hospital licensed under chapter 62J, or under sections 144.50 to 
337.21 	144.56, unless the hospital accepts funds for substance use disorder treatment from the 
337.22 	consolidated chemical dependency treatment fund under chapter 254B, medical assistance 
337.23 	under chapter 256B, or MinnesotaCare or health care cost containment under chapter 256L, 
337.24 	or general assistance medical care formerly codified in chapter 256D.
337.25 		Subd. 4.Applicability of Minnesota Rules, chapter 2960. A residential adolescent 
337.26 	substance use disorder treatment program serving an individual younger than 16 years of 
337.27 	age must be licensed according to Minnesota Rules, chapter 2960.

337.28 	EFFECTIVE DATE. This section is effective July 1, 2017.

337.29 	Sec. 8. [245G.03] LICENSING REQUIREMENTS.
337.30 		Subdivision 1.License requirements. (a) An applicant for a license to provide substance 
337.31 	use disorder treatment must comply with the general requirements in chapters 245A and 
337.32 	245C, sections 626.556 and 626.557, and Minnesota Rules, chapter 9544.
338.1 	(b) The commissioner may grant variances to the requirements in this chapter that do 
338.2 	not affect the client's health or safety if the conditions in section 245A.04, subdivision 9, 
338.3 	are met.
338.4 		Subd. 2.Application. Before the commissioner issues a license, an applicant must 
338.5 	submit, on forms provided by the commissioner, any documents the commissioner requires 
338.6 	to demonstrate the following:
338.7 	(1) compliance with this chapter;
338.8 	(2) compliance with applicable building, fire and safety codes, health rules, zoning 
338.9 	ordinances, and other applicable rules and regulations or documentation that a waiver was 
338.10 	granted. An applicant's receipt of a waiver does not constitute modification of any 
338.11 	requirement in this chapter;
338.12 	(3) completion of an assessment of need for a new or expanded program according to 
338.13 	Minnesota Rules, part 9530.6800, subpart 1. If an application proposes a program that would 
338.14 	be subject to the federal Institution for Mental Diseases (IMD) exclusion, the applicant must 
338.15 	demonstrate the need for the proposed bed capacity and that the program would be more 
338.16 	cost-effective for the state than a non-IMD model; and
338.17 	(4) insurance coverage, including bonding, sufficient to cover all client funds, property, 
338.18 	and interests.
338.19 		Subd. 3.Change in license terms. (a) The commissioner must determine whether a 
338.20 	new license is needed when a change in clauses (1) to (4) occurs. A license holder must 
338.21 	notify the commissioner before a change in one of the following occurs:
338.22 	(1) the Department of Health's licensure of the program;
338.23 	(2) whether the license holder provides services specified in sections 245G.18 to 245G.22;
338.24 	(3) location; or
338.25 	(4) capacity if the license holder meets the requirements of section 245G.21.
338.26 	(b) A license holder must notify the commissioner and must apply for a new license if 
338.27 	there is a change in program ownership.

338.28 	EFFECTIVE DATE. This section is effective July 1, 2017.

338.29 	Sec. 9. [245G.04] INITIAL SERVICES PLAN.
338.30 	(a) The license holder must complete an initial services plan on the day of service 
338.31 	initiation. The plan must address the client's immediate health and safety concerns, identify 
339.1 	the needs to be addressed in the first treatment session, and make treatment suggestions for 
339.2 	the client during the time between intake and completion of the individual treatment plan.
339.3 	(b) The initial services plan must include a determination of whether a client is a 
339.4 	vulnerable adult as defined in section 626.5572, subdivision 21. An adult client of a 
339.5 	residential program is a vulnerable adult. An individual abuse prevention plan, according 
339.6 	to sections 245A.65, subdivision 2, paragraph (b), and 626.557, subdivision 14, paragraph 
339.7 	(b), is required for a client who meets the definition of vulnerable adult.

339.8 	EFFECTIVE DATE. This section is effective July 1, 2017.

339.9 	Sec. 10. [245G.05] COMPREHENSIVE ASSESSMENT AND ASSESSMENT 
339.10 	SUMMARY.
339.11 		Subdivision 1.Comprehensive assessment. (a) A comprehensive assessment of the 
339.12 	client's substance use disorder must be administered face-to-face by an alcohol and drug 
339.13 	counselor within three calendar days after service initiation for a residential program or 
339.14 	during the initial session for all other programs. If the comprehensive assessment is not 
339.15 	completed during the initial session, the client-centered reason for the delay must be 
339.16 	documented in the client's file and the planned completion date. If the client received a 
339.17 	comprehensive assessment that authorized the treatment service, an alcohol and drug 
339.18 	counselor must review the assessment to determine compliance with this subdivision, 
339.19 	including applicable timelines. If available, the alcohol and drug counselor may use current 
339.20 	information provided by a referring agency or other source as a supplement. Information 
339.21 	gathered more than 45 days before the date of admission is not considered current. If the 
339.22 	comprehensive assessment cannot be completed in the time specified, the treatment plan 
339.23 	must indicate a person-centered reason for the delay, and how and when the comprehensive 
339.24 	assessment will be completed. The comprehensive assessment must include sufficient 
339.25 	information to complete the assessment summary according to subdivision 2 and the 
339.26 	individual treatment plan according to section 245G.06. The comprehensive assessment 
339.27 	must include information about the client's needs that relate to substance use and personal 
339.28 	strengths that support recovery, including:
339.29 	(1) age, sex, cultural background, sexual orientation, living situation, economic status, 
339.30 	and level of education;
339.31 	(2) circumstances of service initiation;
339.32 	(3) previous attempts at treatment for substance misuse or substance use disorder, 
339.33 	compulsive gambling, or mental illness;
340.1 	(4) substance use history including amounts and types of substances used, frequency 
340.2 	and duration of use, periods of abstinence, and circumstances of relapse, if any. For each 
340.3 	substance used within the previous 30 days, the information must include the date and time 
340.4 	of the most recent use and previous withdrawal symptoms;
340.5 	(5) specific problem behaviors exhibited by the client when under the influence of 
340.6 	substances;
340.7 	(6) family status, family history, including history or presence of physical or sexual 
340.8 	abuse, level of family support, and substance misuse or substance use disorder of a family 
340.9 	member or significant other;
340.10 	(7) physical concerns or diagnoses, the severity of the concerns, and whether the concerns 
340.11 	are being addressed by a health care professional;
340.12 	(8) mental health history and psychiatric status, including symptoms, disability, current 
340.13 	treatment supports, and psychotropic medication needed to maintain stability; the assessment 
340.14 	must utilize screening tools approved by the commissioner pursuant to section 245.4863 to 
340.15 	identify whether the client screens positive for co-occurring disorders;
340.16 	(9) arrests and legal interventions related to substance use;
340.17 	(10) ability to function appropriately in work and educational settings;
340.18 	(11) ability to understand written treatment materials, including rules and the client's 
340.19 	rights;
340.20 	(12) risk-taking behavior, including behavior that puts the client at risk of exposure to 
340.21 	blood-borne or sexually transmitted diseases;
340.22 	(13) social network in relation to expected support for recovery and leisure time activities 
340.23 	that are associated with substance use;
340.24 	(14) whether the client is pregnant and, if so, the health of the unborn child and the 
340.25 	client's current involvement in prenatal care;
340.26 	(15) whether the client recognizes problems related to substance use and is willing to 
340.27 	follow treatment recommendations; and
340.28 	(16) collateral information. If the assessor gathered sufficient information from the 
340.29 	referral source or the client to apply the criteria in parts 9530.6620 and 9530.6622, a collateral 
340.30 	contact is not required.
340.31 	(b) If the client is identified as having opioid use disorder or seeking treatment for opioid 
340.32 	use disorder, the program must provide educational information to the client concerning:
341.1 	(1) risks for opioid use disorder and dependence;
341.2 	(2) treatment options, including the use of a medication for opioid use disorder;
341.3 	(3) the risk of and recognizing opioid overdose; and
341.4 	(4) the use, availability, and administration of naloxone to respond to opioid overdose.
341.5 	(c) The commissioner shall develop educational materials that are supported by research 
341.6 	and updated periodically. The license holder must use the educational materials that are 
341.7 	approved by the commissioner to comply with this requirement.
341.8 	(d) If the comprehensive assessment is completed to authorize treatment service for the 
341.9 	client, at the earliest opportunity during the assessment interview the assessor shall determine 
341.10 	if:
341.11 	(1) the client is in severe withdrawal and likely to be a danger to self or others;
341.12 	(2) the client has severe medical problems that require immediate attention; or
341.13 	(3) the client has severe emotional or behavioral symptoms that place the client or others 
341.14 	at risk of harm.
341.15 	If one or more of the conditions in clauses (1) to (3) are present, the assessor must end the 
341.16 	assessment interview and follow the procedures in the program's medical services plan 
341.17 	under section 245G.08, subdivision 2, to help the client obtain the appropriate services. The 
341.18 	assessment interview may resume when the condition is resolved.
341.19 		Subd. 2.Assessment summary. (a) An alcohol and drug counselor must complete an 
341.20 	assessment summary within three calendar days after service initiation for a residential 
341.21 	program and within three sessions for all other programs. If the comprehensive assessment 
341.22 	is used to authorize the treatment service, the alcohol and drug counselor must prepare an 
341.23 	assessment summary on the same date the comprehensive assessment is completed. If the 
341.24 	comprehensive assessment and assessment summary are to authorize treatment services, 
341.25 	the assessor must determine appropriate services for the client using the dimensions in 
341.26 	Minnesota Rules, part 9530.6622, and document the recommendations.
341.27 	(b) An assessment summary must include:
341.28 	(1) a risk description according to section 245G.05 for each dimension listed in paragraph 
341.29 	(c);
341.30 	(2) a narrative summary supporting the risk descriptions; and
341.31 	(3) a determination of whether the client has a substance use disorder.
342.1 	(c) An assessment summary must contain information relevant to treatment service 
342.2 	planning and recorded in the dimensions in clauses (1) to (6). The license holder must 
342.3 	consider:
342.4 	(1) Dimension 1, acute intoxication/withdrawal potential; the client's ability to cope with 
342.5 	withdrawal symptoms and current state of intoxication;
342.6 	(2) Dimension 2, biomedical conditions and complications; the degree to which any 
342.7 	physical disorder of the client would interfere with treatment for substance use, and the 
342.8 	client's ability to tolerate any related discomfort. The license holder must determine the 
342.9 	impact of continued chemical use on the unborn child, if the client is pregnant;
342.10 	(3) Dimension 3, emotional, behavioral, and cognitive conditions and complications; 
342.11 	the degree to which any condition or complication is likely to interfere with treatment for 
342.12 	substance use or with functioning in significant life areas and the likelihood of harm to self 
342.13 	or others;
342.14 	(4) Dimension 4, readiness for change; the support necessary to keep the client involved 
342.15 	in treatment service;
342.16 	(5) Dimension 5, relapse, continued use, and continued problem potential; the degree 
342.17 	to which the client recognizes relapse issues and has the skills to prevent relapse of either 
342.18 	substance use or mental health problems; and
342.19 	(6) Dimension 6, recovery environment; whether the areas of the client's life are 
342.20 	supportive of or antagonistic to treatment participation and recovery.

342.21 	EFFECTIVE DATE. This section is effective July 1, 2017.

342.22 	Sec. 11. [245G.06] INDIVIDUAL TREATMENT PLAN.
342.23 		Subdivision 1.General. Each client must have an individual treatment plan developed 
342.24 	by an alcohol and drug counselor within seven days of service initiation for a residential 
342.25 	program and within three sessions for all other programs. The client must have active, direct 
342.26 	involvement in selecting the anticipated outcomes of the treatment process and developing 
342.27 	the treatment plan. The individual treatment plan must be signed by the client and the alcohol 
342.28 	and drug counselor and document the client's involvement in the development of the plan. 
342.29 	The plan may be a continuation of the initial services plan required in section 245G.04. 
342.30 	Treatment planning must include ongoing assessment of client needs. An individual treatment 
342.31 	plan must be updated based on new information gathered about the client's condition and 
342.32 	on whether methods identified have the intended effect. A change to the plan must be signed 
342.33 	by the client and the alcohol and drug counselor. The plan must provide for the involvement 
343.1 	of the client's family and people selected by the client as important to the success of treatment 
343.2 	at the earliest opportunity, consistent with the client's treatment needs and written consent.
343.3 		Subd. 2.Plan contents. An individual treatment plan must be recorded in the six 
343.4 	dimensions listed in section 245G.05, subdivision 2, paragraph (c), must address each issue 
343.5 	identified in the assessment summary, prioritized according to the client's needs and focus, 
343.6 	and must include:
343.7 	(1) specific methods to address each identified need, including amount, frequency, and 
343.8 	anticipated duration of treatment service. The methods must be appropriate to the client's 
343.9 	language, reading skills, cultural background, and strengths;
343.10 	(2) resources to refer the client to when the client's needs are to be addressed concurrently 
343.11 	by another provider; and
343.12 	(3) goals the client must reach to complete treatment and terminate services.
343.13 		Subd. 3.Daily documentation; residential programs. For a client receiving residential 
343.14 	services licensed under section 245G.21, notes must be entered in a client's file every calendar 
343.15 	day. The note must include observations about the client's behavior, incidents involving the 
343.16 	client, absences from the program, and treatment services received that day. The note may 
343.17 	be entered by nontreatment staff unless the note is a clinical observation or record.
343.18 		Subd. 4.Documentation of treatment services; treatment plan review. (a) A review 
343.19 	of all treatment services must be documented weekly and include a review of:
343.20 	(1) care coordination activities;
343.21 	(2) medical and other appointments the client attended;
343.22 	(3) issues related to medications that are not documented in the medication administration 
343.23 	record; and
343.24 	(4) issues related to attendance for treatment services, including the reason for any client 
343.25 	absence from a treatment service.
343.26 	(b) A note must be entered immediately following any significant event. A significant 
343.27 	event is an event that impacts the client's relationship with other clients, staff, the client's 
343.28 	family, or the client's treatment plan.
343.29 	(c) A treatment plan review must be entered in a client's file weekly or after each treatment 
343.30 	service, whichever is less frequent, by the staff member providing the service. The review 
343.31 	must indicate the span of time covered by the review and each of the six dimensions listed 
343.32 	in section 245G.05, subdivision 2, paragraph (c). The review must:
344.1 	(1) indicate the date, type, and amount of each treatment service provided and the client's 
344.2 	response to each service;
344.3 	(2) address each goal in the treatment plan and whether the methods to address the goals 
344.4 	are effective;
344.5 	(3) include monitoring of any physical and mental health problems;
344.6 	(4) document the participation of others;
344.7 	(5) document staff recommendations for changes in the methods identified in the treatment 
344.8 	plan and whether the client agrees with the change; and
344.9 	(6) include a review and evaluation of the individual abuse prevention plan according 
344.10 	to section 245A.65.
344.11 	(d) Each entry in a client's record must be accurate, legible, signed, and dated. A late 
344.12 	entry must be clearly labeled "late entry." A correction to an entry must be made in a way 
344.13 	in which the original entry can still be read.
344.14 		Subd. 5.Service discharge summary. (a) An alcohol and drug counselor must write a 
344.15 	service discharge summary for each client. For a planned discharge, the service discharge 
344.16 	summary must be completed within 24 hours before the client's discharge and provided to 
344.17 	the client at discharge. For an unplanned discharge, the service discharge summary must 
344.18 	be completed and provided to the client at discharge or within five days following the client's 
344.19 	discharge, or document why providing the discharge summary was not possible.
344.20 	(b) The service discharge summary must be recorded in the six dimensions listed in 
344.21 	section 245G.05, subdivision 2, paragraph (c), and include the following information:
344.22 	(1) the client's issues, strengths, and needs while participating in treatment, including 
344.23 	services provided;
344.24 	(2) the client's progress toward achieving each goal identified in the individual treatment 
344.25 	plan;
344.26 	(3) a risk description according to section 245G.05; and
344.27 	(4) the reasons for and circumstances of service termination. If a program discharges a 
344.28 	client at staff request, the reason for discharge and the procedure followed for the decision 
344.29 	to discharge must be documented and comply with the program's policies on staff-initiated 
344.30 	client discharge. If a client is discharged at staff request, the program must give the client 
344.31 	crisis and other referrals appropriate for the client's needs and offer assistance to the client 
344.32 	to access the services.
345.1 	(c) For a client who successfully completes treatment, the summary must also include:
345.2 	(1) the client's living arrangements at service termination;
345.3 	(2) continuing care recommendations, including transitions between more or less intense 
345.4 	services, or more frequent to less frequent services, and referrals made with specific attention 
345.5 	to continuity of care for mental health, as needed;
345.6 	(3) service termination diagnosis; and
345.7 	(4) the client's prognosis.

345.8 	EFFECTIVE DATE. This section is effective July 1, 2017.

345.9 	Sec. 12. [245G.07] TREATMENT SERVICE.
345.10 		Subdivision 1.Treatment service. (a) A license holder must offer the following treatment 
345.11 	services, unless clinically inappropriate and the justifying clinical rationale is documented:
345.12 	(1) individual and group counseling to help the client identify and address needs related 
345.13 	to substance use and develop strategies to avoid harmful substance use after discharge and 
345.14 	to help the client obtain the services necessary to establish a lifestyle free of the harmful 
345.15 	effects of substance use disorder;
345.16 	(2) client education strategies to avoid inappropriate substance use and health problems 
345.17 	related to substance use and the necessary lifestyle changes to regain and maintain health. 
345.18 	Client education must include information on tuberculosis education on a form approved 
345.19 	by the commissioner, the human immunodeficiency virus according to Minnesota Statutes, 
345.20 	section 245A.19, other sexually transmitted diseases, drug and alcohol use during pregnancy, 
345.21 	and hepatitis;
345.22 	(3) a service to help the client integrate gains made during treatment into daily living 
345.23 	and to reduce the client's reliance on a staff member for support;
345.24 	(4) a service to address issues related to co-occurring disorders, including client education 
345.25 	on symptoms of mental illness, the possibility of comorbidity, and the need for continued 
345.26 	medication compliance while recovering from substance use disorder. A group must address 
345.27 	co-occurring disorders, as needed. When treatment for mental health problems is indicated, 
345.28 	the treatment must be integrated into the client's individual treatment plan;
345.29 	(5) on July 1, 2018, or upon federal approval, whichever is later, peer recovery support 
345.30 	services provided one-to-one by an individual in recovery. Peer support services include 
345.31 	education, advocacy, mentoring through self-disclosure of personal recovery experiences, 
345.32 	attending recovery and other support groups with a client, accompanying the client to 
346.1 	appointments that support recovery, assistance accessing resources to obtain housing, 
346.2 	employment, education, and advocacy services, and nonclinical recovery support to assist 
346.3 	the transition from treatment into the recovery community; and
346.4 	(6) on July 1, 2018, or upon federal approval, whichever is later, care coordination 
346.5 	provided by an individual who meets the staff qualifications in section 245G.11, subdivision 
346.6 	7. Care coordination services include:
346.7 	(i) assistance in coordination with significant others to help in the treatment planning 
346.8 	process whenever possible;
346.9 	(ii) assistance in coordination with and follow up for medical services as identified in 
346.10 	the treatment plan;
346.11 	(iii) facilitation of referrals to substance use disorder services as indicated by a client's 
346.12 	medical provider, comprehensive assessment, or treatment plan;
346.13 	(iv) facilitation of referrals to mental health services as identified by a client's 
346.14 	comprehensive assessment or treatment plan;
346.15 	(v) assistance with referrals to economic assistance, social services, housing resources, 
346.16 	and prenatal care according to the client's needs;
346.17 	(vi) life skills advocacy and support accessing treatment follow-up, disease management, 
346.18 	and education services, including referral and linkages to long-term services and supports 
346.19 	as needed; and
346.20 	(vii) documentation of the provision of care coordination services in the client's file.
346.21 	(b) A treatment service provided to a client must be provided according to the individual 
346.22 	treatment plan and must consider cultural differences and special needs of a client.
346.23 		Subd. 2.Additional treatment service. A license holder may provide or arrange the 
346.24 	following additional treatment service as a part of the client's individual treatment plan:
346.25 	(1) relationship counseling provided by a qualified professional to help the client identify 
346.26 	the impact of the client's substance use disorder on others and to help the client and persons 
346.27 	in the client's support structure identify and change behaviors that contribute to the client's 
346.28 	substance use disorder;
346.29 	(2) therapeutic recreation to allow the client to participate in recreational activities 
346.30 	without the use of mood-altering chemicals and to plan and select leisure activities that do 
346.31 	not involve the inappropriate use of chemicals;
347.1 	(3) stress management and physical well-being to help the client reach and maintain an 
347.2 	appropriate level of health, physical fitness, and well-being;
347.3 	(4) living skills development to help the client learn basic skills necessary for independent 
347.4 	living;
347.5 	(5) employment or educational services to help the client become financially independent;
347.6 	(6) socialization skills development to help the client live and interact with others in a 
347.7 	positive and productive manner; and
347.8 	(7) room, board, and supervision at the treatment site to provide the client with a safe 
347.9 	and appropriate environment to gain and practice new skills.
347.10 		Subd. 3.Counselors. A treatment service, including therapeutic recreation, must be 
347.11 	provided by an alcohol and drug counselor according to section 245G.11, unless the 
347.12 	individual providing the service is specifically qualified according to the accepted credential 
347.13 	required to provide the service. Therapeutic recreation does not include planned leisure 
347.14 	activities.
347.15 		Subd. 4.Location of service provision. The license holder may provide services at any 
347.16 	of the license holder's licensed locations or at another suitable location including a school, 
347.17 	government building, medical or behavioral health facility, or social service organization. 
347.18 	If services are provided off site from the licensed site, the reason for the provision of services 
347.19 	remotely must be documented.

347.20 	EFFECTIVE DATE. This section is effective July 1, 2017.

347.21 	Sec. 13. [245G.08] MEDICAL SERVICES.
347.22 		Subdivision 1.Health care services. An applicant or license holder must maintain a 
347.23 	complete description of the health care services, nursing services, dietary services, and 
347.24 	emergency physician services offered by the applicant or license holder.
347.25 		Subd. 2.Procedures. The applicant or license holder must have written procedures for 
347.26 	obtaining a medical intervention for a client, that are approved in writing by a physician 
347.27 	who is licensed under chapter 147, unless:
347.28 	(1) the license holder does not provide a service under section 245G.21; and
347.29 	(2) a medical intervention is referred to 911, the emergency telephone number, or the 
347.30 	client's physician.
348.1 		Subd. 3.Standing order protocol. A license holder that maintains a supply of naloxone 
348.2 	available for emergency treatment of opioid overdose must have a written standing order 
348.3 	protocol by a physician who is licensed under chapter 147, that permits the license holder 
348.4 	to maintain a supply of naloxone on site, and must require staff to undergo specific training 
348.5 	in administration of naloxone.
348.6 		Subd. 4.Consultation services. The license holder must have access to and document 
348.7 	the availability of a licensed mental health professional to provide diagnostic assessment 
348.8 	and treatment planning assistance.
348.9 		Subd. 5.Administration of medication and assistance with self-medication. (a) A 
348.10 	license holder must meet the requirements in this subdivision if a service provided includes 
348.11 	the administration of medication.
348.12 	(b) A staff member, other than a licensed practitioner or nurse, who is delegated by a 
348.13 	licensed practitioner or a registered nurse the task of administration of medication or assisting 
348.14 	with self-medication, must:
348.15 	(1) successfully complete a medication administration training program for unlicensed 
348.16 	personnel through an accredited Minnesota postsecondary educational institution. A staff 
348.17 	member's completion of the course must be documented in writing and placed in the staff 
348.18 	member's personnel file;
348.19 	(2) be trained according to a formalized training program that is taught by a registered 
348.20 	nurse and offered by the license holder. The training must include the process for 
348.21 	administration of naloxone, if naloxone is kept on site. A staff member's completion of the 
348.22 	training must be documented in writing and placed in the staff member's personnel records; 
348.23 	or
348.24 	(3) demonstrate to a registered nurse competency to perform the delegated activity. A 
348.25 	registered nurse must be employed or contracted to develop the policies and procedures for 
348.26 	administration of medication or assisting with self-administration of medication, or both.
348.27 	(c) A registered nurse must provide supervision as defined in section 148.171, subdivision 
348.28 	23. The registered nurse's supervision must include, at a minimum, monthly on-site 
348.29 	supervision or more often if warranted by a client's health needs. The policies and procedures 
348.30 	must include:
348.31 	(1) a provision that a delegation of administration of medication is limited to the 
348.32 	administration of a medication that is administered orally, topically, or as a suppository, an 
348.33 	eye drop, an ear drop, or an inhalant;
349.1 	(2) a provision that each client's file must include documentation indicating whether 
349.2 	staff must conduct the administration of medication or the client must self-administer 
349.3 	medication, or both;
349.4 	(3) a provision that a client may carry emergency medication such as nitroglycerin as 
349.5 	instructed by the client's physician;
349.6 	(4) a provision for the client to self-administer medication when a client is scheduled to 
349.7 	be away from the facility;
349.8 	(5) a provision that if a client self-administers medication when the client is present in 
349.9 	the facility, the client must self-administer medication under the observation of a trained 
349.10 	staff member;
349.11 	(6) a provision that when a license holder serves a client who is a parent with a child, 
349.12 	the parent may only administer medication to the child under a staff member's supervision;
349.13 	(7) requirements for recording the client's use of medication, including staff signatures 
349.14 	with date and time;
349.15 	(8) guidelines for when to inform a nurse of problems with self-administration of 
349.16 	medication, including a client's failure to administer, refusal of a medication, adverse 
349.17 	reaction, or error; and
349.18 	(9) procedures for acceptance, documentation, and implementation of a prescription, 
349.19 	whether written, verbal, telephonic, or electronic.
349.20 		Subd. 6.Control of drugs. A license holder must have and implement written policies 
349.21 	and procedures developed by a registered nurse that contain:
349.22 	(1) a requirement that each drug must be stored in a locked compartment. A Schedule 
349.23 	II drug, as defined by section 152.02, subdivision 3, must be stored in a separately locked 
349.24 	compartment, permanently affixed to the physical plant or medication cart;
349.25 	(2) a system which accounts for all scheduled drugs each shift;
349.26 	(3) a procedure for recording the client's use of medication, including the signature of 
349.27 	the staff member who completed the administration of the medication with the time and 
349.28 	date;
349.29 	(4) a procedure to destroy a discontinued, outdated, or deteriorated medication;
349.30 	(5) a statement that only authorized personnel are permitted access to the keys to a locked 
349.31 	compartment;
350.1 	(6) a statement that no legend drug supply for one client shall be given to another client; 
350.2 	and
350.3 	(7) a procedure for monitoring the available supply of naloxone on site, replenishing 
350.4 	the naloxone supply when needed, and destroying naloxone according to clause (4).

350.5 	EFFECTIVE DATE. This section is effective July 1, 2017.

350.6 	Sec. 14. [245G.09] CLIENT RECORDS.
350.7 		Subdivision 1.Client records required. (a) A license holder must maintain a file of 
350.8 	current and accurate client records on the premises where the treatment service is provided 
350.9 	or coordinated. For services provided off site, client records must be available at the program 
350.10 	and adhere to the same clinical and administrative policies and procedures as services 
350.11 	provided on site. A program using an electronic health record must maintain virtual access 
350.12 	to client records on the premises where the treatment service is delivered. The content and 
350.13 	format of client records must be uniform and entries in each record must be signed and 
350.14 	dated by the staff member making the entry. Client records must be protected against loss, 
350.15 	tampering, or unauthorized disclosure according to section 254A.09, chapter 13, and Code 
350.16 	of Federal Regulations, title 42, chapter 1, part 2, subpart B, sections 2.1 to 2.67, and title 
350.17 	45, parts 160 to 164.
350.18 	(b) The program must have a policy and procedure that identifies how the program will 
350.19 	track and record client attendance at treatment activities, including the date, duration, and 
350.20 	nature of each treatment service provided to the client.
350.21 		Subd. 2.Record retention. The client records of a discharged client must be retained 
350.22 	by a license holder for seven years. A license holder that ceases to provide treatment service 
350.23 	must retain client records for seven years from the date of facility closure and must notify 
350.24 	the commissioner of the location of the client records and the name of the individual 
350.25 	responsible for maintaining the client's records.
350.26 		Subd. 3.Contents. Client records must contain the following:
350.27 	(1) documentation that the client was given information on client rights and 
350.28 	responsibilities, grievance procedures, tuberculosis, and HIV, and that the client was provided 
350.29 	an orientation to the program abuse prevention plan required under section 245A.65, 
350.30 	subdivision 2, paragraph (a), clause (4);
350.31 	(2) an initial services plan completed according to section 245G.04;
350.32 	(3) a comprehensive assessment completed according to section 245G.05;
351.1 	(4) an assessment summary completed according to section 245G.05, subdivision 2;
351.2 	(5) an individual abuse prevention plan according to sections 245A.65, subdivision 2, 
351.3 	and 626.557, subdivision 14, when applicable;
351.4 	(6) an individual treatment plan according to section 245G.06, subdivisions 1 and 2;
351.5 	(7) daily documentation, according to section 245G.06, subdivision 3;
351.6 	(8) documentation of treatment services and treatment plan review according to section 
351.7 	245G.06, subdivision 4; and
351.8 	(9) a summary at the time of service termination according to section 245G.06, 
351.9 	subdivision 5.

351.10 	EFFECTIVE DATE. This section is effective July 1, 2017.

351.11 	Sec. 15. [245G.10] STAFF REQUIREMENTS.
351.12 		Subdivision 1.Treatment director. A license holder must have a treatment director.
351.13 		Subd. 2.Alcohol and drug counselor supervisor. A license holder must employ an 
351.14 	alcohol and drug counselor supervisor who meets the requirements of section 245G.11, 
351.15 	subdivision 4. An individual may be simultaneously employed as a treatment director, 
351.16 	alcohol and drug counselor supervisor, and an alcohol and drug counselor if the individual 
351.17 	meets the qualifications for each position. If an alcohol and drug counselor is simultaneously 
351.18 	employed as an alcohol and drug counselor supervisor or treatment director, that individual 
351.19 	must be considered a 0.5 full-time equivalent alcohol and drug counselor for staff 
351.20 	requirements under subdivision 4.
351.21 		Subd. 3.Responsible staff member. A treatment director must designate a staff member 
351.22 	who, when present in the facility, is responsible for the delivery of treatment service. A 
351.23 	license holder must have a designated staff member during all hours of operation. A license 
351.24 	holder providing room and board and treatment at the same site must have a responsible 
351.25 	staff member on duty 24 hours a day. The designated staff member must know and understand 
351.26 	the implications of this chapter and sections 245A.65, 626.556, 626.557, and 626.5572.
351.27 		Subd. 4.Staff requirement.  It is the responsibility of the license holder to determine 
351.28 	an acceptable group size based on each client's needs except that treatment services provided 
351.29 	in a group shall not exceed 16 clients. A counselor in an opioid treatment program must not 
351.30 	supervise more than 50 clients. The license holder must maintain a record that documents 
351.31 	compliance with this subdivision.
352.1 		Subd. 5.Medical emergency. When a client is present, a license holder must have at 
352.2 	least one staff member on the premises who has a current American Red Cross standard 
352.3 	first aid certificate or an equivalent certificate and at least one staff member on the premises 
352.4 	who has a current American Red Cross community, American Heart Association, or 
352.5 	equivalent CPR certificate. A single staff member with both certifications satisfies this 
352.6 	requirement.

352.7 	EFFECTIVE DATE. This section is effective July 1, 2017.

352.8 	Sec. 16. [245G.11] STAFF QUALIFICATIONS.
352.9 		Subdivision 1.General qualifications. (a) All staff members who have direct contact 
352.10 	must be 18 years of age or older. At the time of employment, each staff member must meet 
352.11 	the qualifications in this subdivision. For purposes of this subdivision, "problematic substance 
352.12 	use" means a behavior or incident listed by the license holder in the personnel policies and 
352.13 	procedures according to section 245G.13, subdivision 1, clause (5).
352.14 	(b) A treatment director, supervisor, nurse, counselor, student intern, or other professional 
352.15 	must be free of problematic substance use for at least the two years immediately preceding 
352.16 	employment and must sign a statement attesting to that fact.
352.17 	(c) A paraprofessional, recovery peer, or any other staff member with direct contact 
352.18 	must be free of problematic substance use for at least one year immediately preceding 
352.19 	employment and must sign a statement attesting to that fact.
352.20 		Subd. 2.Employment; prohibition on problematic substance use. A staff member 
352.21 	with direct contact must be free from problematic substance use as a condition of 
352.22 	employment, but is not required to sign additional statements. A staff member with direct 
352.23 	contact who is not free from problematic substance use must be removed from any 
352.24 	responsibilities that include direct contact for the time period specified in subdivision 1. 
352.25 	The time period begins to run on the date of the last incident of problematic substance use 
352.26 	as described in the facility's policies and procedures according to section 245G.13, 
352.27 	subdivision 1, clause (5).
352.28 		Subd. 3.Treatment directors. A treatment director must:
352.29 	(1) have at least one year of work experience in direct service to an individual with 
352.30 	substance use disorder or one year of work experience in the management or administration 
352.31 	of direct service to an individual with substance use disorder;
352.32 	(2) have a baccalaureate degree or three years of work experience in administration or 
352.33 	personnel supervision in human services; and
353.1 	(3) know and understand the implications of this chapter, chapter 245A, and sections 
353.2 	626.556, 626.557, and 626.5572. Demonstration of the treatment director's knowledge must 
353.3 	be documented in the personnel record.
353.4 		Subd. 4.Alcohol and drug counselor supervisors. An alcohol and drug counselor 
353.5 	supervisor must:
353.6 	(1) meet the qualification requirements in subdivision 5;
353.7 	(2) have three or more years of experience providing individual and group counseling 
353.8 	to individuals with substance use disorder; and
353.9 	(3) know and understand the implications of this chapter and sections 245A.65, 626.556, 
353.10 	626.557, and 626.5572.
353.11 		Subd. 5.Alcohol and drug counselor qualifications. (a) An alcohol and drug counselor 
353.12 	must either be: (1) licensed under chapter 148F; or (2) exempt from licensure under chapter 
353.13 	148F and be a mental health professional as defined in section 245.462, subdivision 18.
353.14 	(b) An alcohol and drug counselor must document competence in screening for and 
353.15 	working with clients with mental health disorders through education, training, and experience, 
353.16 	according to section 245G.13, subdivision 2, clause (5). For the purposes of enforcing this 
353.17 	section, the commissioner has the authority to monitor a service provider's compliance with 
353.18 	the relevant standards of a service provider's profession and may issue licensing actions 
353.19 	according to sections 245A.05, 245A.06, and 245A.07 based on the commissioner's 
353.20 	determination of noncompliance.
353.21 	(c) A mental health professional identified in section 245.462, subdivision 18, must meet 
353.22 	one of the following criteria:
353.23 	(1) completion of 270 hours of alcohol and drug counselor training that covers each of 
353.24 	the core functions listed in section 148F.01, subdivision 10, and successful completion of 
353.25 	880 hours of supervised experience as an alcohol and drug counselor, either as a student or 
353.26 	as a staff member; or
353.27 	(2) current certification as an alcohol and drug counselor or alcohol and drug counselor 
353.28 	reciprocal, through the evaluation process established by the International Certification and 
353.29 	Reciprocity Consortium Alcohol and Other Drug Abuse, Inc.
353.30 	(d) An individual who is currently certified as an alcohol and drug counselor by the 
353.31 	Upper Midwest Indian Council on Addictive Disorders meets the qualifications of an alcohol 
353.32 	and drug counselor when providing services to Native American people.
354.1 		Subd. 6.Paraprofessionals. A paraprofessional must have knowledge of client rights, 
354.2 	according to section 148F.165, and staff member responsibilities. A paraprofessional may 
354.3 	not admit, transfer, or discharge a client but may be responsible for the delivery of treatment 
354.4 	service according to section 245G.10, subdivision 3.
354.5 		Subd. 7.Care coordination provider qualifications. (a) Care coordination must be 
354.6 	provided by qualified staff. An individual is qualified to provide care coordination if the 
354.7 	individual:
354.8 	(1) is skilled in the process of identifying and assessing a wide range of client needs;
354.9 	(2) is knowledgeable about local community resources and how to use those resources 
354.10 	for the benefit of the client;
354.11 	(3) has successfully completed 30 hours of classroom instruction on care coordination 
354.12 	for an individual with substance use disorder;
354.13 	(4) has either:
354.14 	(i) a bachelor's degree in one of the behavioral sciences or related fields; or
354.15 	(ii) current certification as an alcohol and drug counselor, level I, by the Upper Midwest 
354.16 	Indian Council on Addictive Disorders; and
354.17 	(5) has at least 2,000 hours of supervised experience working with individuals with 
354.18 	substance use disorder.
354.19 	(b) A care coordinator must receive at least one hour of supervision regarding individual 
354.20 	service delivery from an alcohol and drug counselor weekly.
354.21 		Subd. 8.Recovery peer qualifications. A recovery peer must:
354.22 	(1) be at least 21 years of age and have a high school diploma or its equivalent;
354.23 	(2) have a minimum of one year in recovery from substance use disorder;
354.24 	(3) hold a current credential from a certification body approved by the commissioner 
354.25 	that demonstrates skills and training in the domains of ethics and boundaries, advocacy, 
354.26 	mentoring and education, and recovery and wellness support; and
354.27 	(4) receive ongoing supervision in areas specific to the domains of the recovery peer's 
354.28 	role by an alcohol and drug counselor or an individual with a certification approved by the 
354.29 	commissioner.
354.30 		Subd. 9.Volunteers. A volunteer may provide treatment service when the volunteer is 
354.31 	supervised and can be seen or heard by a staff member meeting the criteria in subdivision 
355.1 	4 or 5, but may not practice alcohol and drug counseling unless qualified under subdivision 
355.2 	5.
355.3 		Subd. 10.Student interns. A qualified staff member must supervise and be responsible 
355.4 	for a treatment service performed by a student intern and must review and sign each 
355.5 	assessment, progress note, and individual treatment plan prepared by a student intern. A 
355.6 	student intern must receive the orientation and training required in section 245G.13, 
355.7 	subdivisions 1, clause (7), and 2. No more than 50 percent of the treatment staff may be 
355.8 	students or licensing candidates with time documented to be directly related to the provision 
355.9 	of treatment services for which the staff are authorized.
355.10 		Subd. 11.Individuals with temporary permit. (a) An individual with a temporary 
355.11 	permit from the Board of Behavioral Health and Therapy may provide chemical dependency 
355.12 	treatment service according to this subdivision.
355.13 	(b) An individual with a temporary permit must be supervised by a licensed alcohol and 
355.14 	drug counselor assigned by the license holder. The supervising licensed alcohol and drug 
355.15 	counselor must document the amount and type of supervision provided at least on a weekly 
355.16 	basis. The supervision must relate to the clinical practice.
355.17 	(c) An individual with a temporary permit must be supervised by a clinical supervisor 
355.18 	approved by the Board of Behavioral Health and Therapy. The supervision must be 
355.19 	documented and meet the requirements of section 148F.04, subdivision 4.

355.20 	EFFECTIVE DATE. This section is effective July 1, 2017.

355.21 	Sec. 17. [245G.12] PROVIDER POLICIES AND PROCEDURES.
355.22 	A license holder must develop a written policies and procedures manual, indexed 
355.23 	according to section 245A.04, subdivision 14, paragraph (c), that provides staff members 
355.24 	immediate access to all policies and procedures and provides a client and other authorized 
355.25 	parties access to all policies and procedures. The manual must contain the following 
355.26 	materials:
355.27 	(1) assessment and treatment planning policies, including screening for mental health 
355.28 	concerns and treatment objectives related to the client's identified mental health concerns 
355.29 	in the client's treatment plan;
355.30 	(2) policies and procedures regarding HIV according to section 245A.19;
356.1 	(3) the license holder's methods and resources to provide information on tuberculosis 
356.2 	and tuberculosis screening to each client and to report a known tuberculosis infection 
356.3 	according to section 144.4804;
356.4 	(4) personnel policies according to section 245G.13;
356.5 	(5) policies and procedures that protect a client's rights according to section 245G.15;
356.6 	(6) a medical services plan according to section 245G.08;
356.7 	(7) emergency procedures according to section 245G.16;
356.8 	(8) policies and procedures for maintaining client records according to section 245G.09;
356.9 	(9) procedures for reporting the maltreatment of minors according to section 626.556, 
356.10 	and vulnerable adults according to sections 245A.65, 626.557, and 626.5572;
356.11 	(10) a description of treatment services, including the amount and type of services 
356.12 	provided;
356.13 	(11) the methods used to achieve desired client outcomes;
356.14 	(12) the hours of operation; and
356.15 	(13) the target population served.

356.16 	EFFECTIVE DATE. This section is effective July 1, 2017.

356.17 	Sec. 18. [245G.13] PROVIDER PERSONNEL POLICIES.
356.18 		Subdivision 1.Personnel policy requirements. A license holder must have written 
356.19 	personnel policies that are available to each staff member. The personnel policies must:
356.20 	(1) ensure that staff member retention, promotion, job assignment, or pay are not affected 
356.21 	by a good faith communication between a staff member and the department, the Department 
356.22 	of Health, the ombudsman for mental health and developmental disabilities, law enforcement, 
356.23 	or a local agency for the investigation of a complaint regarding a client's rights, health, or 
356.24 	safety;
356.25 	(2) contain a job description for each staff member position specifying responsibilities, 
356.26 	degree of authority to execute job responsibilities, and qualification requirements;
356.27 	(3) provide for a job performance evaluation based on standards of job performance 
356.28 	conducted on a regular and continuing basis, including a written annual review;
356.29 	(4) describe behavior that constitutes grounds for disciplinary action, suspension, or 
356.30 	dismissal, including policies that address staff member problematic substance use and the 
357.1 	requirements of section 245G.11, subdivision 1, policies prohibiting personal involvement 
357.2 	with a client in violation of chapter 604, and policies prohibiting client abuse described in 
357.3 	sections 245A.65, 626.556, 626.557, and 626.5572;
357.4 	(5) identify how the program will identify whether behaviors or incidents are problematic 
357.5 	substance use, including a description of how the facility must address:
357.6 	(i) receiving treatment for substance use within the period specified for the position in 
357.7 	the staff qualification requirements, including medication-assisted treatment;
357.8 	(ii) substance use that negatively impacts the staff member's job performance;
357.9 	(iii) chemical use that affects the credibility of treatment services with a client, referral 
357.10 	source, or other member of the community;
357.11 	(iv) symptoms of intoxication or withdrawal on the job; and
357.12 	(v) the circumstances under which an individual who participates in monitoring by the 
357.13 	health professional services program for a substance use or mental health disorder is able 
357.14 	to provide services to the program's clients;
357.15 	(6) include a chart or description of the organizational structure indicating lines of 
357.16 	authority and responsibilities;
357.17 	(7) include orientation within 24 working hours of starting for each new staff member 
357.18 	based on a written plan that, at a minimum, must provide training related to the staff member's 
357.19 	specific job responsibilities, policies and procedures, client confidentiality, HIV minimum 
357.20 	standards, and client needs; and
357.21 	(8) include policies outlining the license holder's response to a staff member with a 
357.22 	behavior problem that interferes with the provision of treatment service.
357.23 		Subd. 2.Staff development. (a) A license holder must ensure that each staff member 
357.24 	has the training described in this subdivision.
357.25 	(b) Each staff member must be trained every two years in:
357.26 	(1) client confidentiality rules and regulations and client ethical boundaries; and
357.27 	(2) emergency procedures and client rights as specified in sections 144.651, 148F.165, 
357.28 	and 253B.03.
357.29 	(c) Annually each staff member with direct contact must be trained on mandatory 
357.30 	reporting as specified in sections 245A.65, 626.556, 626.5561, 626.557, and 626.5572, 
358.1 	including specific training covering the license holder's policies for obtaining a release of 
358.2 	client information.
358.3 	(d) Upon employment and annually thereafter, each staff member with direct contact 
358.4 	must receive training on HIV minimum standards according to section 245A.19.
358.5 	(e) A treatment director, supervisor, nurse, or counselor must have a minimum of 12 
358.6 	hours of training in co-occurring disorders that includes competencies related to philosophy, 
358.7 	trauma-informed care, screening, assessment, diagnosis and person-centered treatment 
358.8 	planning, documentation, programming, medication, collaboration, mental health 
358.9 	consultation, and discharge planning. A new staff member who has not obtained the training 
358.10 	must complete the training within six months of employment. A staff member may request, 
358.11 	and the license holder may grant, credit for relevant training obtained before employment, 
358.12 	which must be documented in the staff member's personnel file.
358.13 		Subd. 3.Personnel files. The license holder must maintain a separate personnel file for 
358.14 	each staff member. At a minimum, the personnel file must conform to the requirements of 
358.15 	this chapter. A personnel file must contain the following:
358.16 	(1) a completed application for employment signed by the staff member and containing 
358.17 	the staff member's qualifications for employment;
358.18 	(2) documentation related to the staff member's background study data, according to 
358.19 	chapter 245C;
358.20 	(3) for a staff member who provides psychotherapy services, employer names and 
358.21 	addresses for the past five years for which the staff member provided psychotherapy services, 
358.22 	and documentation of an inquiry required by sections 604.20 to 604.205 made to the staff 
358.23 	member's former employer regarding substantiated sexual contact with a client;
358.24 	(4) documentation that the staff member completed orientation and training;
358.25 	(5) documentation that the staff member meets the requirements in section 245G.11;
358.26 	(6) documentation demonstrating the staff member's compliance with section 245G.08, 
358.27 	subdivision 3, for a staff member who conducts administration of medication; and
358.28 	(7) documentation demonstrating the staff member's compliance with section 245G.18, 
358.29 	subdivision 2, for a staff member that treats an adolescent client.

358.30 	EFFECTIVE DATE. This section is effective July 1, 2017.

359.1 	Sec. 19. [245G.14] SERVICE INITIATION AND TERMINATION POLICIES.
359.2 		Subdivision 1.Service initiation policy. A license holder must have a written service 
359.3 	initiation policy containing service initiation preferences that comply with this section and 
359.4 	Code of Federal Regulations, title 45, part 96.131, and specific service initiation criteria. 
359.5 	The license holder must not initiate services for an individual who does not meet the service 
359.6 	initiation criteria. The service initiation criteria must be either posted in the area of the 
359.7 	facility where services for a client are initiated, or given to each interested person upon 
359.8 	request. Titles of each staff member authorized to initiate services for a client must be listed 
359.9 	in the services initiation and termination policies.
359.10 		Subd. 2.License holder responsibilities. (a) The license holder must have and comply 
359.11 	with a written protocol for (1) assisting a client in need of care not provided by the license 
359.12 	holder, and (2) a client who poses a substantial likelihood of harm to the client or others, if 
359.13 	the behavior is beyond the behavior management capabilities of the staff members.
359.14 	(b) A service termination and denial of service initiation that poses an immediate threat 
359.15 	to the health of any individual or requires immediate medical intervention must be referred 
359.16 	to a medical facility capable of admitting the client.
359.17 	(c) A service termination policy and a denial of service initiation that involves the 
359.18 	commission of a crime against a license holder's staff member or on a license holder's 
359.19 	premises, as provided under Code of Federal Regulations, title 42, section 2.12(c)(5), and 
359.20 	title 45, parts 160 to 164, must be reported to a law enforcement agency with jurisdiction.
359.21 		Subd. 3.Service termination policies. A license holder must have a written policy 
359.22 	specifying the conditions when a client must be terminated from service. The service 
359.23 	termination policy must include:
359.24 	(1) procedures for a client whose services were terminated under subdivision 2;
359.25 	(2) a description of client behavior that constitutes reason for a staff-requested service 
359.26 	termination and a process for providing this information to a client;
359.27 	(3) a requirement that before discharging a client from a residential setting, for not 
359.28 	reaching treatment plan goals, the license holder must confer with other interested persons 
359.29 	to review the issues involved in the decision. The documentation requirements for a 
359.30 	staff-requested service termination must describe why the decision to discharge is warranted, 
359.31 	the reasons for the discharge, and the alternatives considered or attempted before discharging 
359.32 	the client;
360.1 	(4) procedures consistent with section 253B.16, subdivision 2, that staff members must 
360.2 	follow when a client admitted under chapter 253B is to have services terminated;
360.3 	(5) procedures a staff member must follow when a client leaves against staff or medical 
360.4 	advice and when the client may be dangerous to the client or others, including a policy that 
360.5 	requires a staff member to assist the client with assessing needs of care or other resources;
360.6 	(6) procedures for communicating staff-approved service termination criteria to a client, 
360.7 	including the expectations in the client's individual treatment plan according to section 
360.8 	245G.06; and
360.9 	(7) titles of each staff member authorized to terminate a client's service must be listed 
360.10 	in the service initiation and service termination policies.

360.11 	EFFECTIVE DATE. This section is effective July 1, 2017.

360.12 	Sec. 20. [245G.15] CLIENT RIGHTS PROTECTION.
360.13 		Subdivision 1.Explanation. A client has the rights identified in sections 144.651, 
360.14 	148F.165, 253B.03, and 254B.02, subdivision 2, as applicable. The license holder must 
360.15 	give each client at service initiation a written statement of the client's rights and 
360.16 	responsibilities. A staff member must review the statement with a client at that time.
360.17 		Subd. 2.Grievance procedure. At service initiation, the license holder must explain 
360.18 	the grievance procedure to the client or the client's representative. The grievance procedure 
360.19 	must be posted in a place visible to clients, and made available upon a client's or former 
360.20 	client's request. The grievance procedure must require that:
360.21 	(1) a staff member helps the client develop and process a grievance;
360.22 	(2) current telephone numbers and addresses of the Department of Human Services, 
360.23 	Licensing Division; the Office of Ombudsman for Mental Health and Developmental 
360.24 	Disabilities; the Department of Health Office of Health Facilities Complaints; and the Board 
360.25 	of Behavioral Health and Therapy, when applicable, be made available to a client; and
360.26 	(3) a license holder responds to the client's grievance within three days of a staff member's 
360.27 	receipt of the grievance, and the client may bring the grievance to the highest level of 
360.28 	authority in the program if not resolved by another staff member.
360.29 		Subd. 3.Photographs of client. (a) A photograph, video, or motion picture of a client 
360.30 	taken in the provision of treatment service is considered client records. A photograph for 
360.31 	identification and a recording by video or audio technology to enhance either therapy or 
360.32 	staff member supervision may be required of a client, but may only be available for use as 
361.1 	communications within a program. A client must be informed when the client's actions are 
361.2 	being recorded by camera or other technology, and the client must have the right to refuse 
361.3 	any recording or photography, except as authorized by this subdivision.
361.4 	(b) A license holder must have a written policy regarding the use of any personal 
361.5 	electronic device that can record, transmit, or make images of another client. A license 
361.6 	holder must inform each client of this policy and the client's right to refuse being 
361.7 	photographed or recorded.

361.8 	EFFECTIVE DATE. This section is effective July 1, 2017.

361.9 	Sec. 21. [245G.16] BEHAVIORAL EMERGENCY PROCEDURES.
361.10 	(a) A license holder or applicant must have written behavioral emergency procedures 
361.11 	that staff must follow when responding to a client who exhibits behavior that is threatening 
361.12 	to the safety of the client or others. Programs must incorporate person-centered planning 
361.13 	and trauma-informed care in the program's behavioral emergency procedure policies. The 
361.14 	procedures must include:
361.15 	(1) a plan designed to prevent a client from hurting themselves or others;
361.16 	(2) contact information for emergency resources that staff must consult when a client's 
361.17 	behavior cannot be controlled by the behavioral emergency procedures;
361.18 	(3) types of procedures that may be used;
361.19 	(4) circumstances under which behavioral emergency procedures may be used; and
361.20 	(5) staff members authorized to implement behavioral emergency procedures.
361.21 	(b) Behavioral emergency procedures must not be used to enforce facility rules or for 
361.22 	the convenience of staff. Behavioral emergency procedures must not be part of any client's 
361.23 	treatment plan, or used at any time for any reason except in response to specific current 
361.24 	behavior that threatens the safety of the client or others. Behavioral emergency procedures 
361.25 	may not include the use of seclusion or restraint.

361.26 	EFFECTIVE DATE. This section is effective July 1, 2017.

361.27 	Sec. 22. [245G.17] EVALUATION.
361.28 	A license holder must participate in the drug and alcohol abuse normative evaluation 
361.29 	system by submitting information about each client to the commissioner in a manner 
361.30 	prescribed by the commissioner. A license holder must submit additional information 
362.1 	requested by the commissioner that is necessary to meet statutory or federal funding 
362.2 	requirements.

362.3 	EFFECTIVE DATE. This section is effective July 1, 2017.

362.4 	Sec. 23. [245G.18] LICENSE HOLDERS SERVING ADOLESCENTS.
362.5 		Subdivision 1.License. A residential treatment program that serves an adolescent younger 
362.6 	than 16 years of age must be licensed as a residential program for a child in out-of-home 
362.7 	placement by the department unless the license holder is exempt under section 245A.03, 
362.8 	subdivision 2.
362.9 		Subd. 2.Alcohol and drug counselor qualifications. In addition to the requirements 
362.10 	specified in section 245G.11, subdivisions 1 and 5, an alcohol and drug counselor providing 
362.11 	treatment service to an adolescent must have:
362.12 	(1) an additional 30 hours of classroom instruction or one three-credit semester college 
362.13 	course in adolescent development. This training need only be completed one time; and
362.14 	(2) at least 150 hours of supervised experience as an adolescent counselor, either as a 
362.15 	student or as a staff member.
362.16 		Subd. 3.Staff ratios. At least 25 percent of a counselor's scheduled work hours must 
362.17 	be allocated to indirect services, including documentation of client services, coordination 
362.18 	of services with others, treatment team meetings, and other duties. A counseling group 
362.19 	consisting entirely of adolescents must not exceed 16 adolescents. It is the responsibility of 
362.20 	the license holder to determine an acceptable group size based on the needs of the clients.
362.21 		Subd. 4.Academic program requirements. A client who is required to attend school 
362.22 	must be enrolled and attending an educational program that was approved by the Department 
362.23 	of Education.
362.24 		Subd. 5.Program requirements. In addition to the requirements specified in the client's 
362.25 	treatment plan under section 245G.06, programs serving an adolescent must include:
362.26 	(1) coordination with the school system to address the client's academic needs;
362.27 	(2) when appropriate, a plan that addresses the client's leisure activities without chemical 
362.28 	use; and
362.29 	(3) a plan that addresses family involvement in the adolescent's treatment.

362.30 	EFFECTIVE DATE. This section is effective July 1, 2017.

363.1 	Sec. 24. [245G.19] LICENSE HOLDERS SERVING CLIENTS WITH CHILDREN.
363.2 		Subdivision 1.Health license requirements. In addition to the requirements of sections 
363.3 	245G.01 to 245G.17, a license holder that offers supervision of a child of a client is subject 
363.4 	to the requirements of this section. A license holder providing room and board for a client 
363.5 	and the client's child must have an appropriate facility license from the Department of 
363.6 	Health.
363.7 		Subd. 2.Supervision of a child. "Supervision of a child" means a caregiver is within 
363.8 	sight or hearing of an infant, toddler, or preschooler at all times so that the caregiver can 
363.9 	intervene to protect the child's health and safety. For a school-age child it means a caregiver 
363.10 	is available to help and care for the child to protect the child's health and safety.
363.11 		Subd. 3.Policy and schedule required. A license holder must meet the following 
363.12 	requirements:
363.13 	(1) have a policy and schedule delineating the times and circumstances when the license 
363.14 	holder is responsible for supervision of a child in the program and when the child's parents 
363.15 	are responsible for supervision of a child. The policy must explain how the program will 
363.16 	communicate its policy about supervision of a child responsibility to the parent; and
363.17 	(2) have written procedures addressing the actions a staff member must take if a child 
363.18 	is neglected or abused, including while the child is under the supervision of the child's 
363.19 	parent.
363.20 		Subd. 4.Additional licensing requirements. During the times the license holder is 
363.21 	responsible for the supervision of a child, the license holder must meet the following 
363.22 	standards:
363.23 	(1) child and adult ratios in Minnesota Rules, part 9502.0367;
363.24 	(2) day care training in section 245A.50;
363.25 	(3) behavior guidance in Minnesota Rules, part 9502.0395;
363.26 	(4) activities and equipment in Minnesota Rules, part 9502.0415;
363.27 	(5) physical environment in Minnesota Rules, part 9502.0425; and
363.28 	(6) water, food, and nutrition in Minnesota Rules, part 9502.0445, unless the license 
363.29 	holder has a license from the Department of Health.

363.30 	EFFECTIVE DATE. This section is effective July 1, 2017.

364.1 	Sec. 25. [245G.20] LICENSE HOLDERS SERVING PERSONS WITH 
364.2 	CO-OCCURRING DISORDERS.
364.3 	A license holder specializing in the treatment of a person with co-occurring disorders 
364.4 	must:
364.5 	(1) demonstrate that staff levels are appropriate for treating a client with a co-occurring 
364.6 	disorder, and that there are adequate staff members with mental health training;
364.7 	(2) have continuing access to a medical provider with appropriate expertise in prescribing 
364.8 	psychotropic medication;
364.9 	(3) have a mental health professional available for staff member supervision and 
364.10 	consultation;
364.11 	(4) determine group size, structure, and content considering the special needs of a client 
364.12 	with a co-occurring disorder;
364.13 	(5) have documentation of active interventions to stabilize mental health symptoms 
364.14 	present in the individual treatment plans and progress notes;
364.15 	(6) have continuing documentation of collaboration with continuing care mental health 
364.16 	providers, and involvement of the providers in treatment planning meetings;
364.17 	(7) have available program materials adapted to a client with a mental health problem;
364.18 	(8) have policies that provide flexibility for a client who may lapse in treatment or may 
364.19 	have difficulty adhering to established treatment rules as a result of a mental illness, with 
364.20 	the goal of helping a client successfully complete treatment; and
364.21 	(9) have individual psychotherapy and case management available during treatment 
364.22 	service.

364.23 	EFFECTIVE DATE. This section is effective July 1, 2017.

364.24 	Sec. 26. [245G.21] REQUIREMENTS FOR LICENSED RESIDENTIAL 
364.25 	TREATMENT.
364.26 		Subdivision 1.Applicability. A license holder who provides supervised room and board 
364.27 	at the licensed program site as a treatment component is defined as a residential program 
364.28 	according to section 245A.02, subdivision 14, and is subject to this section.
364.29 		Subd. 2.Visitors. A client must be allowed to receive visitors at times prescribed by 
364.30 	the license holder. The license holder must set and post a notice of visiting rules and hours, 
364.31 	including both day and evening times. A client's right to receive visitors other than a personal 
365.1 	physician, religious adviser, county case manager, parole or probation officer, or attorney 
365.2 	may be subject to visiting hours established by the license holder for all clients. The treatment 
365.3 	director or designee may impose limitations as necessary for the welfare of a client provided 
365.4 	the limitation and the reasons for the limitation are documented in the client's file. A client 
365.5 	must be allowed to receive visits at all reasonable times from the client's personal physician, 
365.6 	religious adviser, county case manager, parole or probation officer, and attorney.
365.7 		Subd. 3.Client property management. A license holder who provides room and board 
365.8 	and treatment services to a client in the same facility, and any license holder that accepts 
365.9 	client property must meet the requirements for handling client funds and property in section 
365.10 	245A.04, subdivision 13. License holders:
365.11 	(1) may establish policies regarding the use of personal property to ensure that treatment 
365.12 	activities and the rights of other clients are not infringed upon;
365.13 	(2) may take temporary custody of a client's property for violation of a facility policy;
365.14 	(3) must retain the client's property for a minimum of seven days after the client's service 
365.15 	termination if the client does not reclaim property upon service termination, or for a minimum 
365.16 	of 30 days if the client does not reclaim property upon service termination and has received 
365.17 	room and board services from the license holder; and
365.18 	(4) must return all property held in trust to the client at service termination regardless 
365.19 	of the client's service termination status, except that:
365.20 	(i) a drug, drug paraphernalia, or drug container that is subject to forfeiture under section 
365.21 	609.5316, must be given to the custody of a local law enforcement agency. If giving the 
365.22 	property to the custody of a local law enforcement agency violates Code of Federal 
365.23 	Regulations, title 42, sections 2.1 to 2.67, or title 45, parts 160 to 164, a drug, drug 
365.24 	paraphernalia, or drug container must be destroyed by a staff member designated by the 
365.25 	program director; and
365.26 	(ii) a weapon, explosive, and other property that can cause serious harm to the client or 
365.27 	others must be given to the custody of a local law enforcement agency, and the client must 
365.28 	be notified of the transfer and of the client's right to reclaim any lawful property transferred; 
365.29 	and
365.30 	(iii) a medication that was determined by a physician to be harmful after examining the 
365.31 	client must be destroyed, except when the client's personal physician approves the medication 
365.32 	for continued use.
366.1 		Subd. 4.Health facility license. A license holder who provides room and board and 
366.2 	treatment services in the same facility must have the appropriate license from the Department 
366.3 	of Health.
366.4 		Subd. 5.Facility abuse prevention plan. A license holder must establish and enforce 
366.5 	an ongoing facility abuse prevention plan consistent with sections 245A.65 and 626.557, 
366.6 	subdivision 14.
366.7 		Subd. 6.Individual abuse prevention plan. A license holder must prepare an individual 
366.8 	abuse prevention plan for each client as specified under sections 245A.65, subdivision 2, 
366.9 	and 626.557, subdivision 14.
366.10 		Subd. 7.Health services. A license holder must have written procedures for assessing 
366.11 	and monitoring a client's health, including a standardized data collection tool for collecting 
366.12 	health-related information about each client. The policies and procedures must be approved 
366.13 	and signed by a registered nurse.
366.14 		Subd. 8.Administration of medication. A license holder must meet the administration 
366.15 	of medications requirements of section 245G.08, subdivision 5, if services include medication 
366.16 	administration.

366.17 	EFFECTIVE DATE. This section is effective July 1, 2017.

366.18 	Sec. 27. [245G.22] OPIOID TREATMENT PROGRAMS.
366.19 		Subdivision 1.Additional requirements. (a) An opioid treatment program licensed 
366.20 	under this chapter must also comply with the requirements of this section and Code of 
366.21 	Federal Regulations, title 42, part 8. When federal guidance or interpretations are issued on 
366.22 	federal standards or requirements also required under this section, the federal guidance or 
366.23 	interpretations shall apply.
366.24 	(b) Where a standard in this section differs from a standard in an otherwise applicable 
366.25 	administrative rule or statute, the standard of this section applies.
366.26 		Subd. 2.Definitions. (a) For purposes of this section, the terms defined in this subdivision 
366.27 	have the meanings given them.
366.28 	(b) "Diversion" means the use of a medication for the treatment of opioid addiction being 
366.29 	diverted from intended use of the medication.
366.30 	(c) "Guest dose" means administration of a medication used for the treatment of opioid 
366.31 	addiction to a person who is not a client of the program that is administering or dispensing 
366.32 	the medication.
367.1 	(d) "Medical director" means a physician licensed to practice medicine in the jurisdiction 
367.2 	that the opioid treatment program is located who assumes responsibility for administering 
367.3 	all medical services performed by the program, either by performing the services directly 
367.4 	or by delegating specific responsibility to authorized program physicians and health care 
367.5 	professionals functioning under the medical director's direct supervision.
367.6 	(e) "Medication used for the treatment of opioid use disorder" means a medication 
367.7 	approved by the Food and Drug Administration for the treatment of opioid use disorder.
367.8 	(f) "Minnesota health care programs" has the meaning given in section 256B.0636.
367.9 	(g) "Opioid treatment program" has the meaning given in Code of Federal Regulations, 
367.10 	title 42, section 8.12, and includes programs licensed under this chapter.
367.11 	(h) "Placing authority" has the meaning given in Minnesota Rules, part 9530.6605, 
367.12 	subpart 21a.
367.13 	(i) "Unsupervised use" means the use of a medication for the treatment of opioid use 
367.14 	disorder dispensed for use by a client outside of the program setting.
367.15 		Subd. 3.Medication orders. Before the program may administer or dispense a medication 
367.16 	used for the treatment of opioid use disorder:
367.17 	(1) a client-specific order must be received from an appropriately credentialed physician 
367.18 	who is enrolled as a Minnesota health care programs provider and meets all applicable 
367.19 	provider standards;
367.20 	(2) the signed order must be documented in the client's record; and
367.21 	(3) if the physician that issued the order is not able to sign the order when issued, the 
367.22 	unsigned order must be entered in the client record at the time it was received, and the 
367.23 	physician must review the documentation and sign the order in the client's record within 72 
367.24 	hours of the medication being ordered. The license holder must report to the commissioner 
367.25 	any medication error that endangers a client's health, as determined by the medical director.
367.26 		Subd. 4.High dose requirements. A client being administered or dispensed a dose 
367.27 	beyond that set forth in subdivision 6, paragraph (a), clause (1), that exceeds 150 milligrams 
367.28 	of methadone or 24 milligrams of buprenorphine daily, and for each subsequent increase, 
367.29 	must meet face-to-face with a prescribing physician. The meeting must occur before the 
367.30 	administration or dispensing of the increased medication dose.
367.31 		Subd. 5.Drug testing. Each client enrolled in the program must receive a minimum of 
367.32 	eight random drug abuse tests per 12 months of treatment. Drug abuse tests must be 
368.1 	reasonably disbursed over the 12-month period. A license holder may elect to conduct more 
368.2 	drug abuse tests.
368.3 		Subd. 6.Criteria for unsupervised use. (a) To limit the potential for diversion of 
368.4 	medication used for the treatment of opioid use disorder to the illicit market, medication 
368.5 	dispensed to a client for unsupervised use shall be subject to the following requirements:
368.6 	(1) any client in an opioid treatment program may receive a single unsupervised use 
368.7 	dose for a day that the clinic is closed for business, including Sundays and state and federal 
368.8 	holidays; and
368.9 	(2) other treatment program decisions on dispensing medications used for the treatment 
368.10 	of opioid use disorder to a client for unsupervised use shall be determined by the medical 
368.11 	director.
368.12 	(b) In determining whether a client may be permitted unsupervised use of medications, 
368.13 	a physician with authority to prescribe must consider the criteria in this paragraph. The 
368.14 	criteria in this paragraph must also be considered when determining whether dispensing 
368.15 	medication for a client's unsupervised use is appropriate to increase or to extend the amount 
368.16 	of time between visits to the program. The criteria are:
368.17 	(1) absence of recent abuse of drugs including but not limited to opioids, nonnarcotics, 
368.18 	and alcohol;
368.19 	(2) regularity of program attendance;
368.20 	(3) absence of serious behavioral problems at the program;
368.21 	(4) absence of known recent criminal activity such as drug dealing;
368.22 	(5) stability of the client's home environment and social relationships;
368.23 	(6) length of time in comprehensive maintenance treatment;
368.24 	(7) reasonable assurance that unsupervised use medication will be safely stored within 
368.25 	the client's home; and
368.26 	(8) whether the rehabilitative benefit the client derived from decreasing the frequency 
368.27 	of program attendance outweighs the potential risks of diversion or unsupervised use.
368.28 	(c) The determination, including the basis of the determination must be documented in 
368.29 	the client's medical record.
368.30 		Subd. 7.Restrictions for unsupervised use of methadone hydrochloride. (a) If a 
368.31 	physician with authority to prescribe determines that a client meets the criteria in subdivision 
369.1 	6 and may be dispensed a medication used for the treatment of opioid addiction, the 
369.2 	restrictions in this subdivision must be followed when the medication to be dispensed is 
369.3 	methadone hydrochloride.
369.4 	(b) During the first 90 days of treatment, the unsupervised use medication supply must 
369.5 	be limited to a maximum of a single dose each week and the client shall ingest all other 
369.6 	doses under direct supervision.
369.7 	(c) In the second 90 days of treatment, the unsupervised use medication supply must be 
369.8 	limited to two doses per week.
369.9 	(d) In the third 90 days of treatment, the unsupervised use medication supply must not 
369.10 	exceed three doses per week.
369.11 	(e) In the remaining months of the first year, a client may be given a maximum six-day 
369.12 	unsupervised use medication supply.
369.13 	(f) After one year of continuous treatment, a client may be given a maximum two-week 
369.14 	unsupervised use medication supply.
369.15 	(g) After two years of continuous treatment, a client may be given a maximum one-month 
369.16 	unsupervised use medication supply, but must make monthly visits to the program.
369.17 		Subd. 8.Restriction exceptions. When a license holder has reason to accelerate the 
369.18 	number of unsupervised use doses of methadone hydrochloride, the license holder must 
369.19 	comply with the requirements of Code of Federal Regulations, title 42, section 8.12, the 
369.20 	criteria for unsupervised use and must use the exception process provided by the federal 
369.21 	Center for Substance Abuse Treatment Division of Pharmacologic Therapies. For the 
369.22 	purposes of enforcement of this subdivision, the commissioner has the authority to monitor 
369.23 	a program for compliance with federal regulations and may issue licensing actions according 
369.24 	to sections 245A.05, 245A.06, and 245A.07 based on the commissioner's determination of 
369.25 	noncompliance.
369.26 		Subd. 9.Guest dose. To receive a guest dose, the client must be enrolled in an opioid 
369.27 	treatment program elsewhere in the state or country and be receiving the medication on a 
369.28 	temporary basis because the client is not able to receive the medication at the program in 
369.29 	which the client is enrolled. Such arrangements shall not exceed 30 consecutive days in any 
369.30 	one program and must not be for the convenience or benefit of either program. A guest dose 
369.31 	may also occur when the client's primary clinic is not open and the client is not receiving 
369.32 	unsupervised use doses.
370.1 		Subd. 10.Capacity management and waiting list system compliance. An opioid 
370.2 	treatment program must notify the department within seven days of the program reaching 
370.3 	both 90 and 100 percent of the program's capacity to care for clients. Each week, the program 
370.4 	must report its capacity, currently enrolled dosing clients, and any waiting list. A program 
370.5 	reporting 90 percent of capacity must also notify the department when the program's census 
370.6 	increases or decreases from the 90 percent level.
370.7 		Subd. 11.Waiting list. An opioid treatment program must have a waiting list system. 
370.8 	If the person seeking admission cannot be admitted within 14 days of the date of application, 
370.9 	each person seeking admission must be placed on the waiting list, unless the person seeking 
370.10 	admission is assessed by the program and found ineligible for admission according to this 
370.11 	chapter and Code of Federal Regulations, title 42, part 1, subchapter A, section 8.12(e), and 
370.12 	title 45, parts 160 to 164. The waiting list must assign a unique client identifier for each 
370.13 	person seeking treatment while awaiting admission. A person seeking admission on a waiting 
370.14 	list who receives no services under section 245G.07, subdivision 1, must not be considered 
370.15 	a "client" as defined in section 245G.01, subdivision 9.
370.16 		Subd. 12.Client referral. An opioid treatment program must consult the capacity 
370.17 	management system to ensure that a person on a waiting list is admitted at the earliest time 
370.18 	to a program providing appropriate treatment within a reasonable geographic area. If the 
370.19 	client was referred through a public payment system and if the program is not able to serve 
370.20 	the client within 14 days of the date of application for admission, the program must contact 
370.21 	and inform the referring agency of any available treatment capacity listed in the state capacity 
370.22 	management system.
370.23 		Subd. 13.Outreach. An opioid treatment program must carry out activities to encourage 
370.24 	an individual in need of treatment to undergo treatment. The program's outreach model 
370.25 	must:
370.26 	(1) select, train, and supervise outreach workers;
370.27 	(2) contact, communicate, and follow up with individuals with high-risk substance 
370.28 	misuse, individuals with high-risk substance misuse associates, and neighborhood residents 
370.29 	within the constraints of federal and state confidentiality requirements;
370.30 	(3) promote awareness among individuals who engage in substance misuse by injection 
370.31 	about the relationship between injecting substances and communicable diseases such as 
370.32 	HIV; and
370.33 	(4) recommend steps to prevent HIV transmission.
371.1 		Subd. 14.Central registry. (a) A license holder must comply with requirements to 
371.2 	submit information and necessary consents to the state central registry for each client 
371.3 	admitted, as specified by the commissioner. The license holder must submit data concerning 
371.4 	medication used for the treatment of opioid use disorder. The data must be submitted in a 
371.5 	method determined by the commissioner and the original information must be kept in the 
371.6 	client's record. The information must be submitted for each client at admission and discharge. 
371.7 	The program must document the date the information was submitted. The client's failure to 
371.8 	provide the information shall prohibit participation in an opioid treatment program. The 
371.9 	information submitted must include the client's:
371.10 	(1) full name and all aliases;
371.11 	(2) date of admission;
371.12 	(3) date of birth;
371.13 	(4) Social Security number or Alien Registration Number, if any;
371.14 	(5) current or previous enrollment status in another opioid treatment program;
371.15 	(6) government-issued photo identification card number; and
371.16 	(7) driver's license number, if any.
371.17 	(b) The requirements in paragraph (a) are effective upon the commissioner's 
371.18 	implementation of changes to the drug and alcohol abuse normative evaluation system or 
371.19 	development of an electronic system by which to submit the data.
371.20 		Subd. 15.Nonmedication treatment services; documentation. (a) The program must 
371.21 	offer at least 50 consecutive minutes of individual or group therapy treatment services as 
371.22 	defined in section 245G.07, subdivision 1, paragraph (a), clause (1), per week, for the first 
371.23 	ten weeks following admission, and at least 50 consecutive minutes per month thereafter. 
371.24 	As clinically appropriate, the program may offer these services cumulatively and not 
371.25 	consecutively in increments of no less than 15 minutes over the required time period, and 
371.26 	for a total of 60 minutes of treatment services over the time period, and must document the 
371.27 	reason for providing services cumulatively in the client's record. The program may offer 
371.28 	additional levels of service when deemed clinically necessary.
371.29 	(b) Notwithstanding the requirements of comprehensive assessments in section 245G.05, 
371.30 	the assessment must be completed within 21 days of service initiation.
371.31 	(c) Notwithstanding the requirements of individual treatment plans set forth in section 
371.32 	245G.06:
372.1 	(1) treatment plan contents for a maintenance client are not required to include goals 
372.2 	the client must reach to complete treatment and have services terminated;
372.3 	(2) treatment plans for a client in a taper or detox status must include goals the client 
372.4 	must reach to complete treatment and have services terminated;
372.5 	(3) for the initial ten weeks after admission for all new admissions, readmissions, and 
372.6 	transfers, progress notes must be entered in a client's file at least weekly and be recorded 
372.7 	in each of the six dimensions upon the development of the treatment plan and thereafter. 
372.8 	Subsequently, the counselor must document progress in the six dimensions at least once 
372.9 	monthly or, when clinical need warrants, more frequently; and
372.10 	(4) upon the development of the treatment plan and thereafter, treatment plan reviews 
372.11 	must occur weekly, or after each treatment service, whichever is less frequent, for the first 
372.12 	ten weeks after the treatment plan is developed. Following the first ten weeks of treatment 
372.13 	plan reviews, reviews may occur monthly, unless the client's needs warrant more frequent 
372.14 	revisions or documentation.
372.15 		Subd. 16.Prescription monitoring program. (a) The program must develop and 
372.16 	maintain a policy and procedure that requires the ongoing monitoring of the data from the 
372.17 	prescription monitoring program (PMP) for each client. The policy and procedure must 
372.18 	include how the program meets the requirements in paragraph (b).
372.19 	(b) If a medication used for the treatment of substance use disorder is administered or 
372.20 	dispensed to a client, the license holder shall be subject to the following requirements:
372.21 	(1) upon admission to a methadone clinic outpatient treatment program, a client must 
372.22 	be notified in writing that the commissioner of human services and the medical director 
372.23 	must monitor the PMP to review the prescribed controlled drugs a client received;
372.24 	(2) the medical director or the medical director's delegate must review the data from the 
372.25 	PMP described in section 152.126 before the client is ordered any controlled substance, as 
372.26 	defined under section 152.126, subdivision 1, paragraph (c), including medications used 
372.27 	for the treatment of opioid addiction, and the medical director's or the medical director's 
372.28 	delegate's subsequent reviews of the PMP data must occur at least every 90 days;
372.29 	(3) a copy of the PMP data reviewed must be maintained in the client's file;
372.30 	(4) when the PMP data contains a recent history of multiple prescribers or multiple 
372.31 	prescriptions for controlled substances, the physician's review of the data and subsequent 
372.32 	actions must be documented in the client's file within 72 hours and must contain the medical 
372.33 	director's determination of whether or not the prescriptions place the client at risk of harm 
373.1 	and the actions to be taken in response to the PMP findings. The provider must conduct 
373.2 	subsequent reviews of the PMP on a monthly basis; and
373.3 	(5) if at any time the medical director believes the use of the controlled substances places 
373.4 	the client at risk of harm, the program must seek the client's consent to discuss the client's 
373.5 	opioid treatment with other prescribers and must seek the client's consent for the other 
373.6 	prescriber to disclose to the opioid treatment program's medical director the client's condition 
373.7 	that formed the basis of the other prescriptions. If the information is not obtained within 
373.8 	seven days, the medical director must document whether or not changes to the client's 
373.9 	medication dose or number of unsupervised use doses are necessary until the information 
373.10 	is obtained.
373.11 	(c) The commissioner shall collaborate with the Minnesota Board of Pharmacy to develop 
373.12 	and implement an electronic system for the commissioner to routinely access the PMP data 
373.13 	to determine whether any client enrolled in an opioid addiction treatment program licensed 
373.14 	according to this section was prescribed or dispensed a controlled substance in addition to 
373.15 	that administered or dispensed by the opioid addiction treatment program. When the 
373.16 	commissioner determines there have been multiple prescribers or multiple prescriptions of 
373.17 	controlled substances for a client, the commissioner shall:
373.18 	(1) inform the medical director of the opioid treatment program only that the 
373.19 	commissioner determined the existence of multiple prescribers or multiple prescriptions of 
373.20 	controlled substances; and
373.21 	(2) direct the medical director of the opioid treatment program to access the data directly, 
373.22 	review the effect of the multiple prescribers or multiple prescriptions, and document the 
373.23 	review.
373.24 	(d) If determined necessary, the commissioner shall seek a federal waiver of, or exception 
373.25 	to, any applicable provision of Code of Federal Regulations, title 42, section 2.34(c), before 
373.26 	implementing this subdivision.
373.27 		Subd. 17.Policies and procedures. (a) A license holder must develop and maintain the 
373.28 	policies and procedures required in this subdivision.
373.29 	(b) For a program that is not open every day of the year, the license holder must maintain 
373.30 	a policy and procedure that permits a client to receive a single unsupervised use of medication 
373.31 	used for the treatment of opioid use disorder for days that the program is closed for business, 
373.32 	including, but not limited to, Sundays and state and federal holidays as required under 
373.33 	subdivision 6, paragraph (a), clause (1).
374.1 	(c) The license holder must maintain a policy and procedure that includes specific 
374.2 	measures to reduce the possibility of diversion. The policy and procedure must:
374.3 	(1) specifically identify and define the responsibilities of the medical and administrative 
374.4 	staff for performing diversion control measures; and
374.5 	(2) include a process for contacting no less than five percent of clients who have 
374.6 	unsupervised use of medication, excluding clients approved solely under subdivision 6, 
374.7 	paragraph (a), clause (1), to require clients to physically return to the program each month. 
374.8 	The system must require clients to return to the program within a stipulated time frame and 
374.9 	turn in all unused medication containers related to opioid use disorder treatment. The license 
374.10 	holder must document all related contacts on a central log and the outcome of the contact 
374.11 	for each client in the client's record.
374.12 	(d) Medication used for the treatment of opioid use disorder must be ordered, 
374.13 	administered, and dispensed according to applicable state and federal regulations and the 
374.14 	standards set by applicable accreditation entities. If a medication order requires assessment 
374.15 	by the person administering or dispensing the medication to determine the amount to be 
374.16 	administered or dispensed, the assessment must be completed by an individual whose 
374.17 	professional scope of practice permits an assessment. For the purposes of enforcement of 
374.18 	this paragraph, the commissioner has the authority to monitor the person administering or 
374.19 	dispensing the medication for compliance with state and federal regulations and the relevant 
374.20 	standards of the license holder's accreditation agency and may issue licensing actions 
374.21 	according to sections 245A.05, 245A.06, and 245A.07, based on the commissioner's 
374.22 	determination of noncompliance.
374.23 		Subd. 18.Quality improvement plan. The license holder must develop and maintain 
374.24 	a quality improvement plan that:
374.25 	(1) includes evaluation of the services provided to clients to identify issues that may 
374.26 	improve service delivery and client outcomes;
374.27 	(2) includes goals for the program to accomplish based on the evaluation;
374.28 	(3) is reviewed annually by the management of the program to determine whether the 
374.29 	goals were met and, if not, whether additional action is required;
374.30 	(4) is updated at least annually to include new or continued goals based on an updated 
374.31 	evaluation of services; and
374.32 	(5) identifies two specific goal areas, in addition to others identified by the program, 
374.33 	including:
375.1 	(i) a goal concerning oversight and monitoring of the premises around and near the 
375.2 	exterior of the program to reduce the possibility of medication used for the treatment of 
375.3 	opioid use disorder being inappropriately used by a client, including but not limited to the 
375.4 	sale or transfer of the medication to others; and
375.5 	(ii) a goal concerning community outreach, including but not limited to communications 
375.6 	with local law enforcement and county human services agencies, to increase coordination 
375.7 	of services and identification of areas of concern to be addressed in the plan.
375.8 		Subd. 19.Placing authorities. A program must provide certain notification and 
375.9 	client-specific updates to placing authorities for a client who is enrolled in Minnesota health 
375.10 	care programs. At the request of the placing authority, the program must provide 
375.11 	client-specific updates, including but not limited to informing the placing authority of 
375.12 	positive drug screenings and changes in medications used for the treatment of opioid use 
375.13 	disorder ordered for the client.
375.14 		Subd. 20.Duty to report suspected drug diversion. (a) To the fullest extent permitted 
375.15 	under Code of Federal Regulations, title 42, sections 2.1 to 2.67, a program shall report to 
375.16 	law enforcement any credible evidence that the program or its personnel knows, or reasonably 
375.17 	should know, that is directly related to a diversion crime on the premises of the program, 
375.18 	or a threat to commit a diversion crime.
375.19 	(b) "Diversion crime," for the purposes of this section, means diverting, attempting to 
375.20 	divert, or conspiring to divert Schedule I, II, III, or IV drugs, as defined in section 152.02, 
375.21 	on the program's premises.
375.22 	(c) The program must document the program's compliance with the requirement in 
375.23 	paragraph (a) in either a client's record or an incident report. A program's failure to comply 
375.24 	with paragraph (a) may result in sanctions as provided in sections 245A.06 and 245A.07.

375.25 	EFFECTIVE DATE. This section is effective July 1, 2017.

375.26 	Sec. 28. Minnesota Statutes 2016, section 254A.01, is amended to read:
375.27 	254A.01 PUBLIC POLICY.
375.28 	It is hereby declared to be the public policy of this state that scientific evidence shows 
375.29 	that addiction to alcohol or other drugs is a chronic brain disorder with potential for 
375.30 	recurrence, and as with many other chronic conditions, people with substance use disorders 
375.31 	can be effectively treated and can enter recovery. The interests of society are best served 
375.32 	by reducing the stigma of substance use disorder and providing persons who are dependent 
375.33 	upon alcohol or other drugs with a comprehensive range of rehabilitative and social services
376.1 	that span intensity levels and are not restricted to a particular point in time. Further, it is 
376.2 	declared that treatment under these services shall be voluntary when possible: treatment 
376.3 	shall not be denied on the basis of prior treatment; treatment shall be based on an individual 
376.4 	treatment plan for each person undergoing treatment; treatment shall include a continuum 
376.5 	of services available for a person leaving a program of treatment; treatment shall include 
376.6 	all family members at the earliest possible phase of the treatment process.

376.7 	EFFECTIVE DATE. This section is effective July 1, 2017.

376.8 	Sec. 29. Minnesota Statutes 2016, section 254A.02, subdivision 2, is amended to read:
376.9 		Subd. 2.Approved treatment program. "Approved treatment program" means care 
376.10 	and treatment services provided by any individual, organization or association to drug 
376.11 	dependent persons with a substance use disorder, which meets the standards established by 
376.12 	the commissioner of human services.

376.13 	EFFECTIVE DATE. This section is effective July 1, 2017.

376.14 	Sec. 30. Minnesota Statutes 2016, section 254A.02, subdivision 3, is amended to read:
376.15 		Subd. 3.Comprehensive program. "Comprehensive program" means the range of 
376.16 	services which are to be made available for the purpose of prevention, care and treatment 
376.17 	of alcohol and drug abuse substance misuse and substance use disorder.

376.18 	EFFECTIVE DATE. This section is effective July 1, 2017.

376.19 	Sec. 31. Minnesota Statutes 2016, section 254A.02, subdivision 5, is amended to read:
376.20 		Subd. 5.Drug dependent person. "Drug dependent person" means any inebriate person 
376.21 	or any person incapable of self-management or management of personal affairs or unable 
376.22 	to function physically or mentally in an effective manner because of the abuse of a drug, 
376.23 	including alcohol.

376.24 	EFFECTIVE DATE. This section is effective July 1, 2017.

376.25 	Sec. 32. Minnesota Statutes 2016, section 254A.02, subdivision 6, is amended to read:
376.26 		Subd. 6.Facility. "Facility" means any treatment facility administered under an approved 
376.27 	treatment program established under Laws 1973, chapter 572.

376.28 	EFFECTIVE DATE. This section is effective July 1, 2017.

377.1 	Sec. 33. Minnesota Statutes 2016, section 254A.02, is amended by adding a subdivision 
377.2 	to read:
377.3 		Subd. 6a.Substance misuse. "Substance misuse" means the use of any psychoactive 
377.4 	or mood-altering substance, without compelling medical reason, in a manner that results in 
377.5 	mental, emotional, or physical impairment and causes socially dysfunctional or socially 
377.6 	disordering behavior and that results in psychological dependence or physiological addiction 
377.7 	as a function of continued use. Substance misuse has the same meaning as "drug abuse" or 
377.8 	"abuse of drugs."

377.9 	EFFECTIVE DATE. This section is effective July 1, 2017.

377.10 	Sec. 34. Minnesota Statutes 2016, section 254A.02, subdivision 8, is amended to read:
377.11 		Subd. 8.Other drugs. "Other drugs" means any psychoactive chemical substance other 
377.12 	than alcohol.

377.13 	EFFECTIVE DATE. This section is effective July 1, 2017.

377.14 	Sec. 35. Minnesota Statutes 2016, section 254A.02, subdivision 10, is amended to read:
377.15 		Subd. 10.State authority. "State authority" is a division established within the 
377.16 	Department of Human Services for the purpose of relating the authority of state government 
377.17 	in the area of alcohol and drug abuse substance misuse and substance use disorder to the 
377.18 	alcohol and drug abuse substance misuse and substance use disorder-related activities within 
377.19 	the state.

377.20 	EFFECTIVE DATE. This section is effective July 1, 2017.

377.21 	Sec. 36. Minnesota Statutes 2016, section 254A.02, is amended by adding a subdivision 
377.22 	to read:
377.23 		Subd. 10a.Substance use disorder. "Substance use disorder" has the meaning given 
377.24 	in the current Diagnostic and Statistical Manual of Mental Disorders.

377.25 	EFFECTIVE DATE. This section is effective July 1, 2017.

377.26 	Sec. 37. Minnesota Statutes 2016, section 254A.03, is amended to read:
377.27 	254A.03 STATE AUTHORITY ON ALCOHOL AND DRUG ABUSE.
377.28 		Subdivision 1.Alcohol and Other Drug Abuse Section. There is hereby created an 
377.29 	Alcohol and Other Drug Abuse Section in the Department of Human Services. This section 
378.1 	shall be headed by a director. The commissioner may place the director's position in the 
378.2 	unclassified service if the position meets the criteria established in section 43A.08, 
378.3 	subdivision 1a. The section shall:
378.4 	(1) conduct and foster basic research relating to the cause, prevention and methods of 
378.5 	diagnosis, treatment and rehabilitation of alcoholic and other drug dependent persons with 
378.6 	substance misuse and substance use disorder;
378.7 	(2) coordinate and review all activities and programs of all the various state departments 
378.8 	as they relate to alcohol and other drug dependency and abuse problems associated with 
378.9 	substance misuse and substance use disorder;
378.10 	(3) develop, demonstrate, and disseminate new methods and techniques for the prevention, 
378.11 	early intervention, treatment and rehabilitation of alcohol and other drug abuse and 
378.12 	dependency problems recovery support for substance misuse and substance use disorder;
378.13 	(4) gather facts and information about alcoholism and other drug dependency and abuse
378.14 	substance misuse and substance use disorder, and about the efficiency and effectiveness of 
378.15 	prevention, treatment, and rehabilitation recovery support services from all comprehensive 
378.16 	programs, including programs approved or licensed by the commissioner of human services 
378.17 	or the commissioner of health or accredited by the Joint Commission on Accreditation of 
378.18 	Hospitals. The state authority is authorized to require information from comprehensive 
378.19 	programs which is reasonable and necessary to fulfill these duties. When required information 
378.20 	has been previously furnished to a state or local governmental agency, the state authority 
378.21 	shall collect the information from the governmental agency. The state authority shall 
378.22 	disseminate facts and summary information about alcohol and other drug abuse dependency
378.23 	problems associated with substance misuse and substance use disorder to public and private 
378.24 	agencies, local governments, local and regional planning agencies, and the courts for guidance 
378.25 	to and assistance in prevention, treatment and rehabilitation recovery support;
378.26 	(5) inform and educate the general public on alcohol and other drug dependency and 
378.27 	abuse problems substance misuse and substance use disorder;
378.28 	(6) serve as the state authority concerning alcohol and other drug dependency and abuse
378.29 	substance misuse and substance use disorder by monitoring the conduct of diagnosis and 
378.30 	referral services, research and comprehensive programs. The state authority shall submit a 
378.31 	biennial report to the governor and the legislature containing a description of public services 
378.32 	delivery and recommendations concerning increase of coordination and quality of services, 
378.33 	and decrease of service duplication and cost;
379.1 	(7) establish a state plan which shall set forth goals and priorities for a comprehensive 
379.2 	alcohol and other drug dependency and abuse program continuum of care for substance 
379.3 	misuse and substance use disorder for Minnesota. All state agencies operating alcohol and 
379.4 	other drug abuse or dependency substance misuse or substance use disorder programs or 
379.5 	administering state or federal funds for such programs shall annually set their program goals 
379.6 	and priorities in accordance with the state plan. Each state agency shall annually submit its 
379.7 	plans and budgets to the state authority for review. The state authority shall certify whether 
379.8 	proposed services comply with the comprehensive state plan and advise each state agency 
379.9 	of review findings;
379.10 	(8) make contracts with and grants to public and private agencies and organizations, 
379.11 	both profit and nonprofit, and individuals, using federal funds, and state funds as authorized 
379.12 	to pay for costs of state administration, including evaluation, statewide programs and services, 
379.13 	research and demonstration projects, and American Indian programs;
379.14 	(9) receive and administer monies money available for alcohol and drug abuse substance 
379.15 	misuse and substance use disorder programs under the alcohol, drug abuse, and mental 
379.16 	health services block grant, United States Code, title 42, sections 300X to 300X-9;
379.17 	(10) solicit and accept any gift of money or property for purposes of Laws 1973, chapter 
379.18 	572, and any grant of money, services, or property from the federal government, the state, 
379.19 	any political subdivision thereof, or any private source;
379.20 	(11) with respect to alcohol and other drug abuse substance misuse and substance use 
379.21 	disorder programs serving the American Indian community, establish guidelines for the 
379.22 	employment of personnel with considerable practical experience in alcohol and other drug 
379.23 	abuse problems substance misuse and substance use disorder, and understanding of social 
379.24 	and cultural problems related to alcohol and other drug abuse substance misuse and substance 
379.25 	use disorder, in the American Indian community.
379.26 		Subd. 2.American Indian programs. There is hereby created a section of American 
379.27 	Indian programs, within the Alcohol and Drug Abuse Section of the Department of Human 
379.28 	Services, to be headed by a special assistant for American Indian programs on alcoholism 
379.29 	and drug abuse substance misuse and substance use disorder and two assistants to that 
379.30 	position. The section shall be staffed with all personnel necessary to fully administer 
379.31 	programming for alcohol and drug abuse substance misuse and substance use disorder 
379.32 	services for American Indians in the state. The special assistant position shall be filled by 
379.33 	a person with considerable practical experience in and understanding of alcohol and other 
379.34 	drug abuse problems substance misuse and substance use disorder in the American Indian 
380.1 	community, who shall be responsible to the director of the Alcohol and Drug Abuse Section 
380.2 	created in subdivision 1 and shall be in the unclassified service. The special assistant shall 
380.3 	meet and consult with the American Indian Advisory Council as described in section 
380.4 	254A.035 and serve as a liaison to the Minnesota Indian Affairs Council and tribes to report 
380.5 	on the status of alcohol and other drug abuse substance misuse and substance use disorder
380.6 	among American Indians in the state of Minnesota. The special assistant with the approval 
380.7 	of the director shall:
380.8 	(1) administer funds appropriated for American Indian groups, organizations and 
380.9 	reservations within the state for American Indian alcoholism and drug abuse substance 
380.10 	misuse and substance use disorder programs;
380.11 	(2) establish policies and procedures for such American Indian programs with the 
380.12 	assistance of the American Indian Advisory Board; and
380.13 	(3) hire and supervise staff to assist in the administration of the American Indian program 
380.14 	section within the Alcohol and Drug Abuse Section of the Department of Human Services.
380.15 		Subd. 3.Rules for chemical dependency substance use disorder care. (a) The 
380.16 	commissioner of human services shall establish by rule criteria to be used in determining 
380.17 	the appropriate level of chemical dependency care for each recipient of public assistance 
380.18 	seeking treatment for alcohol or other drug dependency and abuse problems. substance 
380.19 	misuse or substance use disorder. On July 1, 2018, or upon federal approval, whichever is 
380.20 	later, of comprehensive assessment as a Medicaid benefit and notwithstanding the criteria 
380.21 	in Minnesota Rules, parts 9530 6600 to 9530.6655, an eligible vendor of comprehensive 
380.22 	assessments under section 254B.05 may determine and approve the appropriate level of 
380.23 	substance use disorder treatment for a recipient of public assistance. The process for 
380.24 	determining an individual's financial eligibility for the consolidated chemical dependency 
380.25 	treatment fund or determining an individual's enrollment in or eligibility for a publicly 
380.26 	subsidized health plan is not affected by the individual's choice to access a comprehensive 
380.27 	assessment for placement.
380.28 	(b) The commissioner shall develop and implement a utilization review process for 
380.29 	publicly funded treatment placements to monitor and review the clinical appropriateness 
380.30 	and timeliness of all publicly funded placements in treatment.

380.31 	EFFECTIVE DATE. This section is effective July 1, 2017.

381.1 	Sec. 38. Minnesota Statutes 2016, section 254A.035, subdivision 1, is amended to read:
381.2 		Subdivision 1.Establishment. There is created an American Indian Advisory Council 
381.3 	to assist the state authority on alcohol and drug abuse substance misuse and substance use 
381.4 	disorder in proposal review and formulating policies and procedures relating to chemical 
381.5 	dependency and the abuse of alcohol and other drugs substance misuse and substance use 
381.6 	disorder by American Indians.

381.7 	EFFECTIVE DATE. This section is effective July 1, 2017.

381.8 	Sec. 39. Minnesota Statutes 2016, section 254A.04, is amended to read:
381.9 	254A.04 CITIZENS ADVISORY COUNCIL.
381.10 	There is hereby created an Alcohol and Other Drug Abuse Advisory Council to advise 
381.11 	the Department of Human Services concerning the problems of alcohol and other drug 
381.12 	dependency and abuse substance misuse and substance use disorder, composed of ten 
381.13 	members. Five members shall be individuals whose interests or training are in the field of 
381.14 	alcohol dependency alcohol-specific substance use disorder and abuse alcohol misuse; and 
381.15 	five members whose interests or training are in the field of dependency substance use 
381.16 	disorder and abuse of drugs misuse of substances other than alcohol. The terms, compensation 
381.17 	and removal of members shall be as provided in section 15.059. The council expires June 
381.18 	30, 2018. The commissioner of human services shall appoint members whose terms end in 
381.19 	even-numbered years. The commissioner of health shall appoint members whose terms end 
381.20 	in odd-numbered years.

381.21 	EFFECTIVE DATE. This section is effective July 1, 2017.

381.22 	Sec. 40. Minnesota Statutes 2016, section 254A.08, is amended to read:
381.23 	254A.08 DETOXIFICATION CENTERS.
381.24 		Subdivision 1.Detoxification services. Every county board shall provide detoxification 
381.25 	services for drug dependent persons any person incapable of self-management or management 
381.26 	of personal affairs or unable to function physically or mentally in an effective manner 
381.27 	because of the use of a drug, including alcohol. The board may utilize existing treatment 
381.28 	programs and other agencies to meet this responsibility.
381.29 		Subd. 2.Program requirements. For the purpose of this section, a detoxification 
381.30 	program means a social rehabilitation program licensed by the Department of Human 
381.31 	Services under Minnesota Rules, parts 9530.6510 to 9530.6590, and established for the 
381.32 	purpose of facilitating access into care and treatment by detoxifying and evaluating the 
382.1 	person and providing entrance into a comprehensive program. Evaluation of the person 
382.2 	shall include verification by a professional, after preliminary examination, that the person 
382.3 	is intoxicated or has symptoms of chemical dependency substance misuse or substance use 
382.4 	disorder and appears to be in imminent danger of harming self or others. A detoxification 
382.5 	program shall have available the services of a licensed physician for medical emergencies 
382.6 	and routine medical surveillance. A detoxification program licensed by the Department of 
382.7 	Human Services to serve both adults and minors at the same site must provide for separate 
382.8 	sleeping areas for adults and minors.

382.9 	EFFECTIVE DATE. This section is effective July 1, 2017.

382.10 	Sec. 41. Minnesota Statutes 2016, section 254A.09, is amended to read:
382.11 	254A.09 CONFIDENTIALITY OF RECORDS.
382.12 	The Department of Human Services shall assure confidentiality to individuals who are 
382.13 	the subject of research by the state authority or are recipients of alcohol or drug abuse
382.14 	substance misuse or substance use disorder information, assessment, or treatment from a 
382.15 	licensed or approved program. The commissioner shall withhold from all persons not 
382.16 	connected with the conduct of the research the names or other identifying characteristics 
382.17 	of a subject of research unless the individual gives written permission that information 
382.18 	relative to treatment and recovery may be released. Persons authorized to protect the privacy 
382.19 	of subjects of research may not be compelled in any federal, state or local, civil, criminal, 
382.20 	administrative or other proceeding to identify or disclose other confidential information 
382.21 	about the individuals. Identifying information and other confidential information related to 
382.22 	alcohol or drug abuse substance misuse or substance use disorder information, assessment, 
382.23 	treatment, or aftercare services may be ordered to be released by the court for the purpose 
382.24 	of civil or criminal investigations or proceedings if, after review of the records considered 
382.25 	for disclosure, the court determines that the information is relevant to the purpose for which 
382.26 	disclosure is requested. The court shall order disclosure of only that information which is 
382.27 	determined relevant. In determining whether to compel disclosure, the court shall weigh 
382.28 	the public interest and the need for disclosure against the injury to the patient, to the treatment 
382.29 	relationship in the program affected and in other programs similarly situated, and the actual 
382.30 	or potential harm to the ability of programs to attract and retain patients if disclosure occurs. 
382.31 	This section does not exempt any person from the reporting obligations under section 
382.32 	626.556, nor limit the use of information reported in any proceeding arising out of the abuse 
382.33 	or neglect of a child. Identifying information and other confidential information related to 
382.34 	alcohol or drug abuse information substance misuse or substance use disorder, assessment, 
383.1 	treatment, or aftercare services may be ordered to be released by the court for the purpose 
383.2 	of civil or criminal investigations or proceedings. No information may be released pursuant 
383.3 	to this section that would not be released pursuant to section 595.02, subdivision 2.

383.4 	EFFECTIVE DATE. This section is effective July 1, 2017.

383.5 	Sec. 42. Minnesota Statutes 2016, section 254A.19, subdivision 3, is amended to read:
383.6 		Subd. 3.Financial conflicts of interest. (a) Except as provided in paragraph (b) or (c), 
383.7 	an assessor conducting a chemical use assessment under Minnesota Rules, parts 9530.6600
383.8 	to 9530.6655, may not have any direct or shared financial interest or referral relationship 
383.9 	resulting in shared financial gain with a treatment provider.
383.10 	(b) A county may contract with an assessor having a conflict described in paragraph (a) 
383.11 	if the county documents that:
383.12 	(1) the assessor is employed by a culturally specific service provider or a service provider 
383.13 	with a program designed to treat individuals of a specific age, sex, or sexual preference;
383.14 	(2) the county does not employ a sufficient number of qualified assessors and the only 
383.15 	qualified assessors available in the county have a direct or shared financial interest or a 
383.16 	referral relationship resulting in shared financial gain with a treatment provider; or
383.17 	(3) the county social service agency has an existing relationship with an assessor or 
383.18 	service provider and elects to enter into a contract with that assessor to provide both 
383.19 	assessment and treatment under circumstances specified in the county's contract, provided 
383.20 	the county retains responsibility for making placement decisions.
383.21 	(c) The county may contract with a hospital to conduct chemical assessments if the 
383.22 	requirements in subdivision 1a are met.
383.23 	An assessor under this paragraph may not place clients in treatment. The assessor shall 
383.24 	gather required information and provide it to the county along with any required 
383.25 	documentation. The county shall make all placement decisions for clients assessed by 
383.26 	assessors under this paragraph.
383.27 	(d) An eligible vendor under section 254B.05 conducting a comprehensive assessment 
383.28 	for an individual seeking treatment shall approve the nature, intensity level, and duration 
383.29 	of treatment service if a need for services is indicated, but the individual assessed can access 
383.30 	any enrolled provider that is licensed to provide the level of service authorized, including 
383.31 	the provider or program that completed the assessment. If an individual is enrolled in a 
384.1 	prepaid health plan, the individual must comply with any provider network requirements 
384.2 	or limitations.

384.3 	EFFECTIVE DATE. This section is effective July 1, 2017.

384.4 	Sec. 43. Minnesota Statutes 2016, section 254B.01, subdivision 3, is amended to read:
384.5 		Subd. 3.Chemical dependency Substance use disorder treatment services. "Chemical 
384.6 	dependency Substance use disorder treatment services" means a planned program of care 
384.7 	for the treatment of chemical dependency substance misuse or chemical abuse substance 
384.8 	use disorder to minimize or prevent further chemical abuse substance misuse by the person. 
384.9 	Diagnostic, evaluation, prevention, referral, detoxification, and aftercare services that are 
384.10 	not part of a program of care licensable as a residential or nonresidential chemical dependency
384.11 	substance use disorder treatment program are not chemical dependency substance use 
384.12 	disorder services for purposes of this section. For pregnant and postpartum women, chemical 
384.13 	dependency substance use disorder services include halfway house services, aftercare 
384.14 	services, psychological services, and case management.

384.15 	EFFECTIVE DATE. This section is effective July 1, 2017.

384.16 	Sec. 44. Minnesota Statutes 2016, section 254B.01, is amended by adding a subdivision 
384.17 	to read:
384.18 		Subd. 8.Recovery community organization. "Recovery community organization" 
384.19 	means a community-based organization that promotes a recovery-orientation as an underlying 
384.20 	concept of healthy communities. A key role of a recovery community organization is the 
384.21 	training of recovery peers, who provide mentorship and ongoing support to persons dealing 
384.22 	with a substance use disorder, connecting them with the resources that can support that 
384.23 	person's recovery.

384.24 	EFFECTIVE DATE. This section is effective July 1, 2017.

384.25 	Sec. 45. Minnesota Statutes 2016, section 254B.03, subdivision 2, is amended to read:
384.26 		Subd. 2.Chemical dependency fund payment. (a) Payment from the chemical 
384.27 	dependency fund is limited to payments for services other than detoxification licensed under 
384.28 	Minnesota Rules, parts 9530.6510 to 9530.6590, that, if located outside of federally 
384.29 	recognized tribal lands, would be required to be licensed by the commissioner as a chemical 
384.30 	dependency treatment or rehabilitation program under sections 245A.01 to 245A.16, and 
384.31 	services other than detoxification provided in another state that would be required to be 
384.32 	licensed as a chemical dependency program if the program were in the state. Out of state 
385.1 	vendors must also provide the commissioner with assurances that the program complies 
385.2 	substantially with state licensing requirements and possesses all licenses and certifications 
385.3 	required by the host state to provide chemical dependency treatment. Except for chemical 
385.4 	dependency transitional rehabilitation programs, Vendors receiving payments from the 
385.5 	chemical dependency fund must not require co-payment from a recipient of benefits for 
385.6 	services provided under this subdivision. This includes but is not limited to cash or SNAP 
385.7 	benefits. Retention of SNAP benefits is a right of a client receiving services through the 
385.8 	consolidated chemical dependency treatment fund or through state contracted managed care 
385.9 	entities. Payment from the chemical dependency fund shall be made for necessary room 
385.10 	and board costs provided by vendors certified according to section 254B.05, or in a 
385.11 	community hospital licensed by the commissioner of health according to sections 144.50
385.12 	to 144.56 to a client who is:
385.13 	(1) determined to meet the criteria for placement in a residential chemical dependency 
385.14 	treatment program according to rules adopted under section 254A.03, subdivision 3; and
385.15 	(2) concurrently receiving a chemical dependency treatment service in a program licensed 
385.16 	by the commissioner and reimbursed by the chemical dependency fund.
385.17 	(b) A county may, from its own resources, provide chemical dependency services for 
385.18 	which state payments are not made. A county may elect to use the same invoice procedures 
385.19 	and obtain the same state payment services as are used for chemical dependency services 
385.20 	for which state payments are made under this section if county payments are made to the 
385.21 	state in advance of state payments to vendors. When a county uses the state system for 
385.22 	payment, the commissioner shall make monthly billings to the county using the most recent 
385.23 	available information to determine the anticipated services for which payments will be made 
385.24 	in the coming month. Adjustment of any overestimate or underestimate based on actual 
385.25 	expenditures shall be made by the state agency by adjusting the estimate for any succeeding 
385.26 	month.
385.27 	(c) The commissioner shall coordinate chemical dependency services and determine 
385.28 	whether there is a need for any proposed expansion of chemical dependency treatment 
385.29 	services. The commissioner shall deny vendor certification to any provider that has not 
385.30 	received prior approval from the commissioner for the creation of new programs or the 
385.31 	expansion of existing program capacity. The commissioner shall consider the provider's 
385.32 	capacity to obtain clients from outside the state based on plans, agreements, and previous 
385.33 	utilization history, when determining the need for new treatment services.

385.34 	EFFECTIVE DATE. This section is effective July 1, 2017.

386.1 	Sec. 46. Minnesota Statutes 2016, section 254B.04, subdivision 1, is amended to read:
386.2 		Subdivision 1.Eligibility. (a) Persons eligible for benefits under Code of Federal 
386.3 	Regulations, title 25, part 20, and persons eligible for medical assistance benefits under 
386.4 	sections 256B.055, 256B.056, and 256B.057, subdivisions 1, 5, and 6, or who meet the 
386.5 	income standards of section 256B.056, subdivision 4, are entitled to chemical dependency 
386.6 	fund services. State money appropriated for this paragraph must be placed in a separate 
386.7 	account established for this purpose.
386.8 	Persons with dependent children who are determined to be in need of chemical 
386.9 	dependency treatment pursuant to an assessment under section 626.556, subdivision 10, or 
386.10 	a case plan under section 260C.201, subdivision 6, or 260C.212, shall be assisted by the 
386.11 	local agency to access needed treatment services. Treatment services must be appropriate 
386.12 	for the individual or family, which may include long-term care treatment or treatment in a 
386.13 	facility that allows the dependent children to stay in the treatment facility. The county shall 
386.14 	pay for out-of-home placement costs, if applicable.
386.15 	(b) A person not entitled to services under paragraph (a), but with family income that 
386.16 	is less than 215 percent of the federal poverty guidelines for the applicable family size, shall 
386.17 	be eligible to receive chemical dependency fund services within the limit of funds 
386.18 	appropriated for this group for the fiscal year. If notified by the state agency of limited 
386.19 	funds, a county must give preferential treatment to persons with dependent children who 
386.20 	are in need of chemical dependency treatment pursuant to an assessment under section 
386.21 	626.556, subdivision 10, or a case plan under section 260C.201, subdivision 6, or 260C.212. 
386.22 	A county may spend money from its own sources to serve persons under this paragraph. 
386.23 	State money appropriated for this paragraph must be placed in a separate account established 
386.24 	for this purpose.
386.25 	(c) Persons whose income is between 215 percent and 412 percent of the federal poverty 
386.26 	guidelines for the applicable family size shall be eligible for chemical dependency services 
386.27 	on a sliding fee basis, within the limit of funds appropriated for this group for the fiscal 
386.28 	year. Persons eligible under this paragraph must contribute to the cost of services according 
386.29 	to the sliding fee scale established under subdivision 3. A county may spend money from 
386.30 	its own sources to provide services to persons under this paragraph. State money appropriated 
386.31 	for this paragraph must be placed in a separate account established for this purpose.

386.32 	EFFECTIVE DATE. This section is effective July 1, 2017.

387.1 	Sec. 47. Minnesota Statutes 2016, section 254B.04, subdivision 2b, is amended to read:
387.2 		Subd. 2b.Eligibility for placement in opioid treatment programs. (a) Notwithstanding 
387.3 	provisions of Minnesota Rules, part 9530.6622, subpart 5, related to a placement authority's 
387.4 	requirement to authorize services or service coordination in a program that complies with 
387.5 	Minnesota Rules, part 9530.6500, or Code of Federal Regulations, title 42, part 8, and after 
387.6 	taking into account an individual's preference for placement in an opioid treatment program, 
387.7 	a placement authority may, but is not required to, authorize services or service coordination 
387.8 	or otherwise place an individual in an opioid treatment program. Prior to making a 
387.9 	determination of placement for an individual, the placing authority must consult with the 
387.10 	current treatment provider, if any.
387.11 	(b) Prior to placement of an individual who is determined by the assessor to require 
387.12 	treatment for opioid addiction, the assessor must provide educational information concerning 
387.13 	treatment options for opioid addiction, including the use of a medication for the use of 
387.14 	opioid addiction. The commissioner shall develop educational materials supported by 
387.15 	research and updated periodically that must be used by assessors to comply with this 
387.16 	requirement.

387.17 	EFFECTIVE DATE. This section is effective July 1, 2017.

387.18 	Sec. 48. Minnesota Statutes 2016, section 254B.05, subdivision 1, is amended to read:
387.19 		Subdivision 1.Licensure required. (a) Programs licensed by the commissioner are 
387.20 	eligible vendors. Hospitals may apply for and receive licenses to be eligible vendors, 
387.21 	notwithstanding the provisions of section 245A.03. American Indian programs that provide 
387.22 	chemical dependency primary substance use disorder treatment, extended care, transitional 
387.23 	residence, or outpatient treatment services, and are licensed by tribal government are eligible 
387.24 	vendors.
387.25 	(b) On July 1, 2018, or upon federal approval, whichever is later, a licensed professional 
387.26 	in private practice who meets the requirements of section 245G.11, subdivisions 1 and 4, 
387.27 	is an eligible vendor of a comprehensive assessment and assessment summary provided 
387.28 	according to section 245G.05, and treatment services provided according to sections 245G.06 
387.29 	and 245G.07, subdivision 1, paragraphs (a), clauses (1) to (5), and (b); and subdivision 2.
387.30 	(c) On July 1, 2018, or upon federal approval, whichever is later, a county is an eligible 
387.31 	vendor for a comprehensive assessment and assessment summary when provided by an 
387.32 	individual who meets the staffing credentials of section 245G.11, subdivisions 1 and 4, and 
387.33 	completed according to the requirements of section 245G.05. A county is an eligible vendor 
388.1 	of care coordination services when provided by an individual who meets the staffing 
388.2 	credentials of section 245G.11, subdivisions 1 and 7, and provided according to the 
388.3 	requirements of section 245G.07, subdivision 1, clause (7).
388.4 	(d) On July 1, 2018, or upon federal approval, whichever is later, a recovery community 
388.5 	organization that meets certification requirements identified by the commissioner is an 
388.6 	eligible vendor of peer support services.
388.7 	(e) Detoxification programs licensed under Minnesota Rules, parts 9530.6510 to 
388.8 	9530.6590, are not eligible vendors. Programs that are not licensed as a chemical dependency
388.9 	residential or nonresidential substance use disorder treatment or withdrawal management 
388.10 	program by the commissioner or by tribal government or do not meet the requirements of 
388.11 	subdivisions 1a and 1b are not eligible vendors.

388.12 	EFFECTIVE DATE. This section is effective July 1, 2017.

388.13 	Sec. 49. Minnesota Statutes 2016, section 254B.05, subdivision 1a, is amended to read:
388.14 		Subd. 1a.Room and board provider requirements. (a) Effective January 1, 2000, 
388.15 	vendors of room and board are eligible for chemical dependency fund payment if the vendor:
388.16 	(1) has rules prohibiting residents bringing chemicals into the facility or using chemicals 
388.17 	while residing in the facility and provide consequences for infractions of those rules;
388.18 	(2) is determined to meet applicable health and safety requirements;
388.19 	(3) is not a jail or prison;
388.20 	(4) is not concurrently receiving funds under chapter 256I for the recipient;
388.21 	(5) admits individuals who are 18 years of age or older;
388.22 	(6) is registered as a board and lodging or lodging establishment according to section 
388.23 	157.17;
388.24 	(7) has awake staff on site 24 hours per day;
388.25 	(8) has staff who are at least 18 years of age and meet the requirements of Minnesota 
388.26 	Rules, part 9530.6450, subpart 1, item A section 245G.11, subdivision 1, paragraph (a);
388.27 	(9) has emergency behavioral procedures that meet the requirements of Minnesota Rules, 
388.28 	part 9530.6475 section 245G.16;
388.29 	(10) meets the requirements of Minnesota Rules, part 9530.6435, subparts 3 and 4, items 
388.30 	A and B section 245G.08, subdivision 5, if administering medications to clients;
389.1 	(11) meets the abuse prevention requirements of section 245A.65, including a policy on 
389.2 	fraternization and the mandatory reporting requirements of section 626.557;
389.3 	(12) documents coordination with the treatment provider to ensure compliance with 
389.4 	section 254B.03, subdivision 2;
389.5 	(13) protects client funds and ensures freedom from exploitation by meeting the 
389.6 	provisions of section 245A.04, subdivision 13;
389.7 	(14) has a grievance procedure that meets the requirements of Minnesota Rules, part 
389.8 	9530.6470, subpart 2 section 245G.15, subdivision 2; and
389.9 	(15) has sleeping and bathroom facilities for men and women separated by a door that 
389.10 	is locked, has an alarm, or is supervised by awake staff.
389.11 	(b) Programs licensed according to Minnesota Rules, chapter 2960, are exempt from 
389.12 	paragraph (a), clauses (5) to (15).

389.13 	EFFECTIVE DATE. This section is effective July 1, 2017.

389.14 	Sec. 50. Minnesota Statutes 2016, section 254B.05, subdivision 5, is amended to read:
389.15 		Subd. 5.Rate requirements. (a) The commissioner shall establish rates for chemical 
389.16 	dependencysubstance use disorder services and service enhancements funded under this 
389.17 	chapter.
389.18 	(b) Eligible chemical dependency substance use disorder treatment services include:
389.19 	(1) outpatient treatment services that are licensed according to Minnesota Rules, parts 
389.20 	9530.6405 to 9530.6480 sections 245G.01 to 245G.17, or applicable tribal license;
389.21 	(2) on July 1, 2018, or upon federal approval, whichever is later, comprehensive 
389.22 	assessments provided according to sections 245.4863, paragraph (a), and 245G.05, and 
389.23 	Minnesota Rules, part 9530.6422;
389.24 	(3) on July 1, 2018, or upon federal approval, whichever is later, care coordination 
389.25 	services provided according to section 245G.07, subdivision 1, paragraph (a), clause (6);
389.26 	(4) on July 1, 2018, or upon federal approval, whichever is later, peer recovery support 
389.27 	services provided according to section 245G.07, subdivision 1, paragraph (a), clause (5);
389.28 	(5) on July 1, 2018, or upon federal approval, whichever is later, withdrawal management 
389.29 	services provided according to chapter 245F;
390.1 	(2) (6) medication-assisted therapy services that are licensed according to Minnesota 
390.2 	Rules, parts 9530.6405 to 9530.6480 and 9530.6500 section 245G.07, subdivision 1, or 
390.3 	applicable tribal license;
390.4 	(3) (7) medication-assisted therapy plus enhanced treatment services that meet the 
390.5 	requirements of clause (2) (6) and provide nine hours of clinical services each week;
390.6 	(4) (8) high, medium, and low intensity residential treatment services that are licensed 
390.7 	according to Minnesota Rules, parts 9530.6405 to 9530.6480 and 9530.6505, sections 
390.8 	245G.01 to 245G.17 and 245G.22 or applicable tribal license which provide, respectively, 
390.9 	30, 15, and five hours of clinical services each week;
390.10 	(5) (9) hospital-based treatment services that are licensed according to Minnesota Rules, 
390.11 	parts 9530.6405 to 9530.6480,sections 245G.01 to 245G.17 or applicable tribal license and 
390.12 	licensed as a hospital under sections 144.50 to 144.56;
390.13 	(6) (10) adolescent treatment programs that are licensed as outpatient treatment programs 
390.14 	according to Minnesota Rules, parts 9530.6405 to 9530.6485, sections 245G.01 to 245G.18
390.15 	or as residential treatment programs according to Minnesota Rules, parts 2960.0010 to 
390.16 	2960.0220, and 2960.0430 to 2960.0490, or applicable tribal license;
390.17 	(7) (11) high-intensity residential treatment services that are licensed according to 
390.18 	Minnesota Rules, parts 9530.6405 to 9530.6480 and 9530.6505, sections 245G.01 to 245G.17 
390.19 	and 245G.21 or applicable tribal license, which provide 30 hours of clinical services each 
390.20 	week provided by a state-operated vendor or to clients who have been civilly committed to 
390.21 	the commissioner, present the most complex and difficult care needs, and are a potential 
390.22 	threat to the community; and
390.23 	(8) (12) room and board facilities that meet the requirements of subdivision 1a.
390.24 	(c) The commissioner shall establish higher rates for programs that meet the requirements 
390.25 	of paragraph (b) and one of the following additional requirements:
390.26 	(1) programs that serve parents with their children if the program:
390.27 	(i) provides on-site child care during the hours of treatment activity that:
390.28 	(A) is licensed under chapter 245A as a child care center under Minnesota Rules, chapter 
390.29 	9503; or
390.30 	(B) meets the licensure exclusion criteria of section 245A.03, subdivision 2, paragraph 
390.31 	(a), clause (6), and meets the requirements under Minnesota Rules, part 9530.6490, subpart 
390.32 	4 section 245G.19, subdivision 4; or
391.1 	(ii) arranges for off-site child care during hours of treatment activity at a facility that is 
391.2 	licensed under chapter 245A as:
391.3 	(A) a child care center under Minnesota Rules, chapter 9503; or
391.4 	(B) a family child care home under Minnesota Rules, chapter 9502;
391.5 	(2) culturally specific programs as defined in section 254B.01, subdivision 4a, or 
391.6 	programs or subprograms serving special populations, if the program or subprogram meets 
391.7 	the following requirements:
391.8 	(i) is designed to address the unique needs of individuals who share a common language, 
391.9 	racial, ethnic, or social background;
391.10 	(ii) is governed with significant input from individuals of that specific background; and
391.11 	(iii) employs individuals to provide individual or group therapy, at least 50 percent of 
391.12 	whom are of that specific background, except when the common social background of the 
391.13 	individuals served is a traumatic brain injury or cognitive disability and the program employs 
391.14 	treatment staff who have the necessary professional training, as approved by the 
391.15 	commissioner, to serve clients with the specific disabilities that the program is designed to 
391.16 	serve;
391.17 	(3) programs that offer medical services delivered by appropriately credentialed health 
391.18 	care staff in an amount equal to two hours per client per week if the medical needs of the 
391.19 	client and the nature and provision of any medical services provided are documented in the 
391.20 	client file; and
391.21 	(4) programs that offer services to individuals with co-occurring mental health and 
391.22 	chemical dependency problems if:
391.23 	(i) the program meets the co-occurring requirements in Minnesota Rules, part 9530.6495
391.24 	section 245G.20;
391.25 	(ii) 25 percent of the counseling staff are licensed mental health professionals, as defined 
391.26 	in section 245.462, subdivision 18, clauses (1) to (6), or are students or licensing candidates 
391.27 	under the supervision of a licensed alcohol and drug counselor supervisor and licensed 
391.28 	mental health professional, except that no more than 50 percent of the mental health staff 
391.29 	may be students or licensing candidates with time documented to be directly related to 
391.30 	provisions of co-occurring services;
391.31 	(iii) clients scoring positive on a standardized mental health screen receive a mental 
391.32 	health diagnostic assessment within ten days of admission;
392.1 	(iv) the program has standards for multidisciplinary case review that include a monthly 
392.2 	review for each client that, at a minimum, includes a licensed mental health professional 
392.3 	and licensed alcohol and drug counselor, and their involvement in the review is documented;
392.4 	(v) family education is offered that addresses mental health and substance abuse disorders 
392.5 	and the interaction between the two; and
392.6 	(vi) co-occurring counseling staff shall receive eight hours of co-occurring disorder 
392.7 	training annually.
392.8 	(d) In order to be eligible for a higher rate under paragraph (c), clause (1), a program 
392.9 	that provides arrangements for off-site child care must maintain current documentation at 
392.10 	the chemical dependency facility of the child care provider's current licensure to provide 
392.11 	child care services. Programs that provide child care according to paragraph (c), clause (1), 
392.12 	must be deemed in compliance with the licensing requirements in Minnesota Rules, part 
392.13 	9530.6490 section 245G.19.
392.14 	(e) Adolescent residential programs that meet the requirements of Minnesota Rules, 
392.15 	parts 2960.0430 to 2960.0490 and 2960.0580 to 2960.0690, are exempt from the requirements 
392.16 	in paragraph (c), clause (4), items (i) to (iv).
392.17 	(f) Subject to federal approval, chemical dependency services that are otherwise covered 
392.18 	as direct face-to-face services may be provided via two-way interactive video. The use of 
392.19 	two-way interactive video must be medically appropriate to the condition and needs of the 
392.20 	person being served. Reimbursement shall be at the same rates and under the same conditions 
392.21 	that would otherwise apply to direct face-to-face services. The interactive video equipment 
392.22 	and connection must comply with Medicare standards in effect at the time the service is 
392.23 	provided.

392.24 	EFFECTIVE DATE. This section is effective July 1, 2017.

392.25 	Sec. 51. Minnesota Statutes 2016, section 254B.051, is amended to read:
392.26 	254B.051 SUBSTANCE ABUSE USE DISORDER TREATMENT 
392.27 	EFFECTIVENESS.
392.28 	In addition to the substance abuse use disorder treatment program performance outcome 
392.29 	measures that the commissioner of human services collects annually from treatment providers, 
392.30 	the commissioner shall request additional data from programs that receive appropriations 
392.31 	from the consolidated chemical dependency treatment fund. This data shall include number 
392.32 	of client readmissions six months after release from inpatient treatment, and the cost of 
393.1 	treatment per person for each program receiving consolidated chemical dependency treatment 
393.2 	funds. The commissioner may post this data on the department Web site.

393.3 	EFFECTIVE DATE. This section is effective July 1, 2017.

393.4 	Sec. 52. Minnesota Statutes 2016, section 254B.07, is amended to read:
393.5 	254B.07 THIRD-PARTY LIABILITY.
393.6 	The state agency provision and payment of, or liability for, chemical dependency
393.7 	substance use disorder medical care is the same as in section 256B.042.

393.8 	EFFECTIVE DATE. This section is effective July 1, 2017.

393.9 	Sec. 53. Minnesota Statutes 2016, section 254B.08, is amended to read:
393.10 	254B.08 FEDERAL WAIVERS.
393.11 	The commissioner shall apply for any federal waivers necessary to secure, to the extent 
393.12 	allowed by law, federal financial participation for the provision of services to persons who 
393.13 	need chemical dependency substance use disorder services. The commissioner may seek 
393.14 	amendments to the waivers or apply for additional waivers to contain costs. The 
393.15 	commissioner shall ensure that payment for the cost of providing chemical dependency
393.16 	substance use disorder services under the federal waiver plan does not exceed the cost of 
393.17 	chemical dependency substance use disorder services that would have been provided without 
393.18 	the waivered services.

393.19 	EFFECTIVE DATE. This section is effective July 1, 2017.

393.20 	Sec. 54. Minnesota Statutes 2016, section 254B.09, is amended to read:
393.21 	254B.09 INDIAN RESERVATION ALLOCATION OF CHEMICAL 
393.22 	DEPENDENCY FUND.
393.23 		Subdivision 1.Vendor payments. The commissioner shall pay eligible vendors for 
393.24 	chemical dependency substance use disorder services to American Indians on the same 
393.25 	basis as other payments, except that no local match is required when an invoice is submitted 
393.26 	by the governing authority of a federally recognized American Indian tribal body or a county 
393.27 	if the tribal governing body has not entered into an agreement under subdivision 2 on behalf 
393.28 	of a current resident of the reservation under this section.
393.29 		Subd. 2.American Indian agreements. The commissioner may enter into agreements 
393.30 	with federally recognized tribal units to pay for chemical dependency substance use disorder
394.1 	treatment services provided under Laws 1986, chapter 394, sections 8 to 20. The agreements 
394.2 	must clarify how the governing body of the tribal unit fulfills local agency responsibilities 
394.3 	regarding:
394.4 	(1) the form and manner of invoicing; and
394.5 	(2) provide that only invoices for eligible vendors according to section 254B.05 will be 
394.6 	included in invoices sent to the commissioner for payment, to the extent that money allocated 
394.7 	under subdivisions 4 and 5 is used.
394.8 		Subd. 6.American Indian tribal placements. After entering into an agreement under 
394.9 	subdivision 2, the governing authority of each reservation may submit invoices to the state 
394.10 	for the cost of providing chemical dependency substance use disorder services to residents 
394.11 	of the reservation according to the placement rules governing county placements, except 
394.12 	that local match requirements are waived. The governing body may designate an agency to 
394.13 	act on its behalf to provide placement services and manage invoices by written notice to 
394.14 	the commissioner and evidence of agreement by the agency designated.
394.15 		Subd. 8.Payments to improve services to American Indians. The commissioner may 
394.16 	set rates for chemical dependency substance use disorder services to American Indians 
394.17 	according to the American Indian Health Improvement Act, Public Law 94-437, for eligible 
394.18 	vendors. These rates shall supersede rates set in county purchase of service agreements 
394.19 	when payments are made on behalf of clients eligible according to Public Law 94-437.

394.20 	EFFECTIVE DATE. This section is effective July 1, 2017.

394.21 	Sec. 55. Minnesota Statutes 2016, section 254B.12, subdivision 2, is amended to read:
394.22 		Subd. 2.Payment methodology for highly specialized vendors. Notwithstanding 
394.23 	subdivision 1, the commissioner shall seek federal authority to develop separate payment 
394.24 	methodologies for chemical dependency substance use disorder treatment services provided 
394.25 	under the consolidated chemical dependency treatment fund: (1) by a state-operated vendor; 
394.26 	or (2) for persons who have been civilly committed to the commissioner, present the most 
394.27 	complex and difficult care needs, and are a potential threat to the community. A payment 
394.28 	methodology under this subdivision is effective for services provided on or after October 
394.29 	1, 2015, or on or after the receipt of federal approval, whichever is later.

394.30 	EFFECTIVE DATE. This section is effective July 1, 2017.

395.1 	Sec. 56. Minnesota Statutes 2016, section 254B.13, subdivision 2a, is amended to read:
395.2 		Subd. 2a.Eligibility for navigator pilot program. (a) To be considered for participation 
395.3 	in a navigator pilot program, an individual must:
395.4 	(1) be a resident of a county with an approved navigator program;
395.5 	(2) be eligible for consolidated chemical dependency treatment fund services;
395.6 	(3) be a voluntary participant in the navigator program;
395.7 	(4) satisfy one of the following items:
395.8 	(i) have at least one severity rating of three or above in dimension four, five, or six in a 
395.9 	comprehensive assessment under Minnesota Rules, part 9530.6422 section 245G.05, 
395.10 	paragraph (c), clauses (4) to (6); or
395.11 	(ii) have at least one severity rating of two or above in dimension four, five, or six in a 
395.12 	comprehensive assessment under Minnesota Rules, part 9530.6422, section 245G.05, 
395.13 	paragraph (c), clauses (4) to (6), and be currently participating in a Rule 31 treatment program 
395.14 	under Minnesota Rules, parts 9530.6405 to 9530.6505, chapter 245G or be within 60 days 
395.15 	following discharge after participation in a Rule 31 treatment program; and
395.16 	(5) have had at least two treatment episodes in the past two years, not limited to episodes 
395.17 	reimbursed by the consolidated chemical dependency treatment funds. An admission to an 
395.18 	emergency room, a detoxification program, or a hospital may be substituted for one treatment 
395.19 	episode if it resulted from the individual's substance use disorder.
395.20 	(b) New eligibility criteria may be added as mutually agreed upon by the commissioner 
395.21 	and participating navigator programs.

395.22 	EFFECTIVE DATE. This section is effective July 1, 2017.

395.23 	Sec. 57. Minnesota Statutes 2016, section 256B.0945, subdivision 2, is amended to read:
395.24 		Subd. 2.Covered services. All services must be included in a child's individualized 
395.25 	treatment or multiagency plan of care as defined in chapter 245.
395.26 	For facilities that are not institutions for mental diseases according to federal statute and 
395.27 	regulation, medical assistance covers mental health-related services that are required to be 
395.28 	provided by a residential facility under section 245.4882 and administrative rules promulgated 
395.29 	thereunder, except for room and board. For residential facilities determined by the federal 
395.30 	Centers for Medicare and Medicaid Services to be an institution for mental diseases, medical 
396.1 	assistance covers medically necessary mental health services provided by the facility 
396.2 	according to section 256B.055, subdivision 13, except for room and board.

396.3 	EFFECTIVE DATE. This section is effective for services provided on July 1, 2017, 
396.4 	through June 30, 2020, and expires effective July 1, 2020.

396.5 	Sec. 58. Minnesota Statutes 2016, section 256B.0945, subdivision 4, is amended to read:
396.6 		Subd. 4.Payment rates. (a) Notwithstanding sections 256B.19 and 256B.041, payments 
396.7 	to counties for residential services provided under this section by a residential facility shall:
396.8 	(1) for services provided by a residential facility that is not an institution for mental 
396.9 	diseases, only be made of federal earnings for services provided under this section, and the 
396.10 	nonfederal share of costs for services provided under this section shall be paid by the county 
396.11 	from sources other than federal funds or funds used to match other federal funds. Payment 
396.12 	to counties for services provided according to this section shall be a proportion of the per 
396.13 	day contract rate that relates to rehabilitative mental health services and shall not include 
396.14 	payment for costs or services that are billed to the IV-E program as room and board.; and
396.15 	(2) for services provided by a residential facility that is determined to be an institution 
396.16 	for mental diseases, be equivalent to the federal share of the payment that would have been 
396.17 	made if the residential facility were not an institution for mental diseases. The portion of 
396.18 	the payment representing what would be the nonfederal share shall be paid by the county. 
396.19 	Payment to counties for services provided according to this section shall be a proportion of 
396.20 	the per-day contract rate that relates to rehabilitative mental health services and shall not 
396.21 	include payment for costs or services that are billed to the IV-E program as room and board.
396.22 	(b) Per diem rates paid to providers under this section by prepaid plans shall be the 
396.23 	proportion of the per-day contract rate that relates to rehabilitative mental health services 
396.24 	and shall not include payment for group foster care costs or services that are billed to the 
396.25 	county of financial responsibility. Services provided in facilities located in bordering states 
396.26 	are eligible for reimbursement on a fee-for-service basis only as described in paragraph (a) 
396.27 	and are not covered under prepaid health plans.
396.28 	(c) Payment for mental health rehabilitative services provided under this section by or 
396.29 	under contract with an American Indian tribe or tribal organization or by agencies operated 
396.30 	by or under contract with an American Indian tribe or tribal organization must be made 
396.31 	according to section 256B.0625, subdivision 34, or other relevant federally approved 
396.32 	rate-setting methodology.
397.1 	(d) The commissioner shall set aside a portion not to exceed five percent of the federal 
397.2 	funds earned for county expenditures under this section to cover the state costs of 
397.3 	administering this section. Any unexpended funds from the set-aside shall be distributed to 
397.4 	the counties in proportion to their earnings under this section.

397.5 	EFFECTIVE DATE. This section is effective for services provided on July 1, 2017, 
397.6 	through June 30, 2020, and expires effective July 1, 2020.

397.7 	Sec. 59. RESIDENTIAL TREATMENT AND PAYMENT RATE REFORM.
 397.8 	The commissioner shall contract with an outside expert to identify recommendations 
397.9 	for the development of a substance use disorder residential treatment program model and 
397.10 	payment structure that is not subject to the federal institutions for mental diseases exclusion 
397.11 	and that is financially sustainable for providers, while incentivizing best practices and 
397.12 	improved treatment outcomes. The analysis and report must include recommendations and 
397.13 	a timeline for supporting providers to transition to the new models of care delivery. No later 
397.14 	than December 15, 2018, a report with recommendations must be delivered to members of 
397.15 	the legislative committees in the house of representatives and senate with jurisdiction over 
397.16 	health and human services policy and finance.

397.17 	EFFECTIVE DATE. This section is effective July 1, 2017.

397.18 	Sec. 60. CHILDREN'S MENTAL HEALTH REPORT AND RECOMMENDATIONS.
 397.19 	The commissioner of human services shall conduct a comprehensive analysis of 
397.20 	Minnesota's continuum of intensive mental health services and shall develop 
397.21 	recommendations for a sustainable and community-driven continuum of care for children 
397.22 	with serious mental health needs, including children currently being served in residential 
397.23 	treatment. The commissioner's analysis shall include, but not be limited to:
397.24 	(1) data related to access, utilization, efficacy, and outcomes for Minnesota's current 
397.25 	system of residential mental health treatment for a child with a severe emotional disturbance;
397.26 	(2) potential expansion of the state's psychiatric residential treatment facility (PRTF) 
397.27 	capacity, including increasing the number of PRTF beds and conversion of existing children's 
397.28 	mental health residential treatment programs into PRTFs;
397.29 	(3) the capacity need for PRTF and other group settings within the state if adequate 
397.30 	community-based alternatives are accessible, equitable, and effective statewide;
397.31 	(4) recommendations for expanding alternative community-based service models to 
397.32 	meet the needs of a child with a serious mental health disorder who would otherwise require 
398.1 	residential treatment and potential service models that could be utilized, including data 
398.2 	related to access, utilization, efficacy, and outcomes;
398.3 	(5) models of care used in other states; and
398.4 	(6) analysis and specific recommendations for the design and implementation of new 
398.5 	service models, including analysis to inform rate setting as necessary.
398.6 	The analysis shall be supported and informed by extensive stakeholder engagement. 
398.7 	Stakeholders include individuals who receive services, family members of individuals who 
398.8 	receive services, providers, counties, health plans, advocates and others. Stakeholder 
398.9 	engagement shall include interviews with key stakeholders, intentional outreach to individuals 
398.10 	who receive services and the individual's family members, and regional listening sessions.
398.11 	The commissioner shall provide a report with specific recommendations and timelines 
398.12 	for implementation to the legislative committees with jurisdiction over children's mental 
398.13 	health policy and finance by November 15, 2018.

398.14 	EFFECTIVE DATE. This section is effective July 1, 2017.

398.15 	Sec. 61. REVISOR'S INSTRUCTION.
 398.16 	In Minnesota Statutes and Minnesota Rules, the revisor of statutes, in consultation with 
398.17 	the with the Department of Human Services, shall make necessary cross-reference changes 
398.18 	that are needed as a result of the enactment of sections 5 to 26 and 56. The revisor shall 
398.19 	make any necessary technical and grammatical changes to preserve the meaning of the text.

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

398.21 	Sec. 62.  REPEALER.
 398.22 	(a) Minnesota Statutes 2016, sections 245A.1915; 245A.192; and 254A.02, subdivision 
398.23 	4, are repealed.
398.24 	(b) Minnesota Rules, parts 9530.6405, subparts 1, 1a, 2, 3, 4, 5, 6, 7, 7a, 8, 9, 10, 11, 
398.25 	12, 13, 14, 14a, 15, 15a, 16, 17, 17a, 17b, 17c, 18, 20, and 21; 9530.6410; 9530.6415; 
398.26 	9530.6420; 9530.6422; 9530.6425; 9530.6430; 9530.6435; 9530.6440; 9530.6445; 
398.27 	9530.6450; 9530.6455; 9530.6460; 9530.6465; 9530.6470; 9530.6475; 9530.6480; 
398.28 	9530.6485; 9530.6490; 9530.6495; 9530.6500; and 9530.6505, are repealed.

398.29 	EFFECTIVE DATE. This section is effective July 1, 2017.

399.1 	ARTICLE 9
399.2 	OPERATIONS

399.3 	Section 1. Minnesota Statutes 2016, section 245A.04, subdivision 4, is amended to read:
399.4 		Subd. 4.Inspections; waiver. (a) Before issuing an initial license, the commissioner 
399.5 	shall conduct an inspection of the program. The inspection must include but is not limited 
399.6 	to:
399.7 	(1) an inspection of the physical plant;
399.8 	(2) an inspection of records and documents;
399.9 	(3) an evaluation of the program by consumers of the program; and
399.10 	(4) observation of the program in operation.; and
399.11 	(5) an inspection for the health, safety, and fire standards in licensing requirements for 
399.12 	a child care license holder.
399.13 	For the purposes of this subdivision, "consumer" means a person who receives the 
399.14 	services of a licensed program, the person's legal guardian, or the parent or individual having 
399.15 	legal custody of a child who receives the services of a licensed program.
399.16 	(b) The evaluation required in paragraph (a), clause (3) or the observation in paragraph 
399.17 	(a), clause (4) is not required prior to issuing an initial license under subdivision 7. If the 
399.18 	commissioner issues an initial license under subdivision 7, these requirements must be 
399.19 	completed within one year after the issuance of an initial license.
399.20 	(c) The commissioner or the county shall inspect at least annually a child care provider 
399.21 	licensed under this chapter and Minnesota Rules, chapter 9502 or 9503, for compliance 
399.22 	with applicable licensing standards.
399.23 	(d) No later than November 19, 2017, the commissioner shall make publicly available 
399.24 	on the department's Web site the results of inspection reports of all child care providers 
399.25 	licensed under this chapter and under Minnesota Rules, chapter 9502 or 9503, and the 
399.26 	number of deaths, serious injuries, and instances of substantiated child maltreatment that 
399.27 	occurred in licensed child care settings each year.

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

400.1 	Sec. 2. Minnesota Statutes 2016, section 245A.07, subdivision 3, is amended to read:
400.2 		Subd. 3.License suspension, revocation, or fine. (a) The commissioner may suspend 
400.3 	or revoke a license, or impose a fine if:
400.4 	(1) a license holder fails to comply fully with applicable laws or rules;
400.5 	(2) a license holder, a controlling individual, or an individual living in the household 
400.6 	where the licensed services are provided or is otherwise subject to a background study has 
400.7 	a disqualification which has not been set aside under section 245C.22;
400.8 	(3) a license holder knowingly withholds relevant information from or gives false or 
400.9 	misleading information to the commissioner in connection with an application for a license, 
400.10 	in connection with the background study status of an individual, during an investigation, 
400.11 	or regarding compliance with applicable laws or rules; or
400.12 	(4) after July 1, 2012, and upon request by the commissioner, a license holder fails to 
400.13 	submit the information required of an applicant under section 245A.04, subdivision 1, 
400.14 	paragraph (f) or (g).
400.15 	A license holder who has had a license suspended, revoked, or has been ordered to pay 
400.16 	a fine must be given notice of the action by certified mail or personal service. If mailed, the 
400.17 	notice must be mailed to the address shown on the application or the last known address of 
400.18 	the license holder. The notice must state the reasons the license was suspended, revoked, 
400.19 	or a fine was ordered.
400.20 	(b) If the license was suspended or revoked, the notice must inform the license holder 
400.21 	of the right to a contested case hearing under chapter 14 and Minnesota Rules, parts 
400.22 	1400.8505 to 1400.8612. The license holder may appeal an order suspending or revoking 
400.23 	a license. The appeal of an order suspending or revoking a license must be made in writing 
400.24 	by certified mail or personal service. If mailed, the appeal must be postmarked and sent to 
400.25 	the commissioner within ten calendar days after the license holder receives notice that the 
400.26 	license has been suspended or revoked. If a request is made by personal service, it must be 
400.27 	received by the commissioner within ten calendar days after the license holder received the 
400.28 	order. Except as provided in subdivision 2a, paragraph (c), if a license holder submits a 
400.29 	timely appeal of an order suspending or revoking a license, the license holder may continue 
400.30 	to operate the program as provided in section 245A.04, subdivision 7, paragraphs (g) and 
400.31 	(h), until the commissioner issues a final order on the suspension or revocation.
400.32 	(c)(1) If the license holder was ordered to pay a fine, the notice must inform the license 
400.33 	holder of the responsibility for payment of fines and the right to a contested case hearing 
401.1 	under chapter 14 and Minnesota Rules, parts 1400.8505 to 1400.8612. The appeal of an 
401.2 	order to pay a fine must be made in writing by certified mail or personal service. If mailed, 
401.3 	the appeal must be postmarked and sent to the commissioner within ten calendar days after 
401.4 	the license holder receives notice that the fine has been ordered. If a request is made by 
401.5 	personal service, it must be received by the commissioner within ten calendar days after 
401.6 	the license holder received the order.
401.7 	(2) The license holder shall pay the fines assessed on or before the payment date specified. 
401.8 	If the license holder fails to fully comply with the order, the commissioner may issue a 
401.9 	second fine or suspend the license until the license holder complies. If the license holder 
401.10 	receives state funds, the state, county, or municipal agencies or departments responsible for 
401.11 	administering the funds shall withhold payments and recover any payments made while the 
401.12 	license is suspended for failure to pay a fine. A timely appeal shall stay payment of the fine 
401.13 	until the commissioner issues a final order.
401.14 	(3) A license holder shall promptly notify the commissioner of human services, in writing, 
401.15 	when a violation specified in the order to forfeit a fine is corrected. If upon reinspection the 
401.16 	commissioner determines that a violation has not been corrected as indicated by the order 
401.17 	to forfeit a fine, the commissioner may issue a second fine. The commissioner shall notify 
401.18 	the license holder by certified mail or personal service that a second fine has been assessed. 
401.19 	The license holder may appeal the second fine as provided under this subdivision.
401.20 	(4) Fines shall be assessed as follows:
401.21 	(i) the license holder shall forfeit $1,000 for each determination of maltreatment of a 
401.22 	child under section 626.556 or the maltreatment of a vulnerable adult under section 626.557
401.23 	for which the license holder is determined responsible for the maltreatment under section 
401.24 	626.556, subdivision 10e, paragraph (i), or 626.557, subdivision 9c, paragraph (c);
401.25 	(ii) if the commissioner determines that a license holder is responsible for more than 
401.26 	one determination of maltreatment at the same site within a 12-month period, the license 
401.27 	holder shall forfeit $2,000 for each additional determination of maltreatment for which the 
401.28 	license holder is responsible;
401.29 	(iii) if the commissioner determines that a determination of maltreatment for which the 
401.30 	license holder is responsible is the result of systemic failure and the underlying facts that 
401.31 	constitute maltreatment meet the definition of "serious maltreatment" in section 245C.02, 
401.32 	subdivision 18, the license holder shall forfeit $5,000;
402.1 	(iv) for a program that operates out of the license holder's home and a program licensed 
402.2 	under Minnesota Rules, parts 9502.0300 to 9502.0455, the fine assessed against the license 
402.3 	holder shall not exceed $1,000 for each determination of maltreatment;
402.4 	(v) the license holder shall forfeit $200 for each occurrence of a violation of law or rule 
402.5 	governing matters of health, safety, or supervision, including but not limited to the provision 
402.6 	of adequate staff-to-child or adult ratios, and failure to comply with background study 
402.7 	requirements under chapter 245C; and
402.8 	(vi) the license holder shall forfeit $100 for each occurrence of a violation of law or rule 
402.9 	other than those subject to a $200, $1,000, $2,000, or $200 $5,000 fine above in items (i) 
402.10 	to (v).
402.11 	For purposes of this section, "occurrence" means each violation identified in the 
402.12 	commissioner's fine order. Fines assessed against a license holder that holds a license to 
402.13 	provide home and community-based services, as identified in section 245D.03, subdivision 
402.14 	1, and a community residential setting or day services facility license under chapter 245D 
402.15 	where the services are provided, may be assessed against both licenses for the same 
402.16 	occurrence, but the combined amount of the fines shall not exceed the amount specified in 
402.17 	this clause for that occurrence.
402.18 	(5) When a fine has been assessed, the license holder may not avoid payment by closing, 
402.19 	selling, or otherwise transferring the licensed program to a third party. In such an event, the 
402.20 	license holder will be personally liable for payment. In the case of a corporation, each 
402.21 	controlling individual is personally and jointly liable for payment.
402.22 	(d) Except for background study violations involving the failure to comply with an order 
402.23 	to immediately remove an individual or an order to provide continuous, direct supervision, 
402.24 	the commissioner shall not issue a fine under paragraph (c) relating to a background study 
402.25 	violation to a license holder who self-corrects a background study violation before the 
402.26 	commissioner discovers the violation. A license holder who has previously exercised the 
402.27 	provisions of this paragraph to avoid a fine for a background study violation may not avoid 
402.28 	a fine for a subsequent background study violation unless at least 365 days have passed 
402.29 	since the license holder self-corrected the earlier background study violation.

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

403.1 	Sec. 3. Minnesota Statutes 2016, section 245A.09, subdivision 7, is amended to read:
403.2 		Subd. 7.Regulatory methods. (a) Where appropriate and feasible the commissioner 
403.3 	shall identify and implement alternative methods of regulation and enforcement to the extent 
403.4 	authorized in this subdivision. These methods shall include:
403.5 	(1) expansion of the types and categories of licenses that may be granted;
403.6 	(2) when the standards of another state or federal governmental agency or an independent 
403.7 	accreditation body have been shown to require the same standards, methods, or alternative 
403.8 	methods to achieve substantially the same intended outcomes as the licensing standards, 
403.9 	the commissioner shall consider compliance with the governmental or accreditation standards 
403.10 	to be equivalent to partial compliance with the licensing standards; and
403.11 	(3) use of an abbreviated inspection that employs key standards that have been shown 
403.12 	to predict full compliance with the rules.
403.13 	(b) If the commissioner accepts accreditation as documentation of compliance with a 
403.14 	licensing standard under paragraph (a), the commissioner shall continue to investigate 
403.15 	complaints related to noncompliance with all licensing standards. The commissioner may 
403.16 	take a licensing action for noncompliance under this chapter and shall recognize all existing 
403.17 	appeal rights regarding any licensing actions taken under this chapter.
403.18 	(c) The commissioner shall work with the commissioners of health, public safety, 
403.19 	administration, and education in consolidating duplicative licensing and certification rules 
403.20 	and standards if the commissioner determines that consolidation is administratively feasible, 
403.21 	would significantly reduce the cost of licensing, and would not reduce the protection given 
403.22 	to persons receiving services in licensed programs. Where administratively feasible and 
403.23 	appropriate, the commissioner shall work with the commissioners of health, public safety, 
403.24 	administration, and education in conducting joint agency inspections of programs.
403.25 	(d) The commissioner shall work with the commissioners of health, public safety, 
403.26 	administration, and education in establishing a single point of application for applicants 
403.27 	who are required to obtain concurrent licensure from more than one of the commissioners 
403.28 	listed in this clause.
403.29 	(e) Unless otherwise specified in statute, the commissioner may conduct routine 
403.30 	inspections biennially.
403.31 	(f) For a licensed child care center, the commissioner shall conduct one unannounced 
403.32 	licensing inspection at least annually.

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

404.1 	Sec. 4. Minnesota Statutes 2016, section 245A.10, subdivision 2, is amended to read:
404.2 		Subd. 2.County fees for background studies and licensing inspections. (a) Before 
404.3 	the implementation of NETStudy 2.0, for purposes of family and group family child care 
404.4 	licensing under this chapter, a county agency may charge a fee to an applicant or license 
404.5 	holder to recover the actual cost of background studies, but in any case not to exceed $100 
404.6 	annually. A county agency may also charge a license fee to an applicant or license holder 
404.7 	not to exceed $50 for a one-year license or $100 for a two-year license.
404.8 	(b) Before the implementation of NETStudy 2.0, a county agency may charge a fee to 
404.9 	a legal nonlicensed child care provider or applicant for authorization to recover the actual 
404.10 	cost of background studies completed under section 119B.125, but in any case not to exceed 
404.11 	$100 annually.
404.12 	(c) Counties may elect to reduce or waive the fees in paragraph (a) or (b):
404.13 	(1) in cases of financial hardship;
404.14 	(2) if the county has a shortage of providers in the county's area;
404.15 	(3) for new providers; or
404.16 	(4) for providers who have attained at least 16 hours of training before seeking initial 
404.17 	licensure.
404.18 	(d) Counties may allow providers to pay the applicant fees in paragraph (a) or (b) on an 
404.19 	installment basis for up to one year. If the provider is receiving child care assistance payments 
404.20 	from the state, the provider may have the fees under paragraph (a) or (b) deducted from the 
404.21 	child care assistance payments for up to one year and the state shall reimburse the county 
404.22 	for the county fees collected in this manner.
404.23 	(e) For purposes of adult foster care and child foster care licensing, and licensing the 
404.24 	physical plant of a community residential setting, under this chapter, a county agency may 
404.25 	charge a fee to a corporate applicant or corporate license holder to recover the actual cost 
404.26 	of licensing inspections, not to exceed $500 annually.
404.27 	(f) Counties may elect to reduce or waive the fees in paragraph (e) under the following 
404.28 	circumstances:
404.29 	(1) in cases of financial hardship;
404.30 	(2) if the county has a shortage of providers in the county's area; or
404.31 	(3) for new providers.

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

405.2 	Sec. 5. Minnesota Statutes 2016, section 245A.10, subdivision 4, is amended to read:
405.3 		Subd. 4.License or certification fee for certain programs. (a) Child care centers shall 
405.4 	pay an annual nonrefundable license fee based on the following schedule:

405.6405.5
		Licensed Capacity
	Child Care Center
License Fee
	
405.7		1 to 24 persons
	$200
	
405.8		25 to 49 persons
	$300
	
405.9		50 to 74 persons
	$400
	
405.10		75 to 99 persons
	$500
	
405.11		100 to 124 persons
	$600
	
405.12		125 to 149 persons
	$700
	
405.13		150 to 174 persons
	$800
	
405.14		175 to 199 persons
	$900
	
405.15		200 to 224 persons
	$1,000
	
405.16		225 or more persons
	$1,100
	
405.17 	(b)(1) A program licensed to provide one or more of the home and community-based 
405.18 	services and supports identified under chapter 245D to persons with disabilities or age 65 
405.19 	and older, shall pay an annual nonrefundable license fee based on that is the greater of either 
405.20 	$400 or 0.34 percent of revenues derived from the provision of services that would require 
405.21 	licensure under this chapter 245D and that are specified under section 245D.03, subdivision 
405.22 	1, during the calendar year immediately preceding the year in which the license fee is paid, 
405.23 	according to the following schedule:.

405.24	License Holder Annual Revenue
		License Fee
	
405.25	less than or equal to $10,000
		$200
	
405.26
405.27	greater than $10,000 but less than or 
equal to $25,000
		$300
	
405.28
405.29	greater than $25,000 but less than or 
equal to $50,000
		$400
	
405.30
405.31	greater than $50,000 but less than or 
equal to $100,000
		$500
	
405.32
405.33	greater than $100,000 but less than or 
equal to $150,000
		$600
	
405.34
405.35	greater than $150,000 but less than or 
equal to $200,000
		$800
	
405.36
405.37	greater than $200,000 but less than or 
equal to $250,000
		$1,000
	
406.1
406.2	greater than $250,000 but less than or 
equal to $300,000
		$1,200
	
406.3
406.4	greater than $300,000 but less than or 
equal to $350,000
		$1,400
	
406.5
406.6	greater than $350,000 but less than or 
equal to $400,000
		$1,600
	
406.7
406.8	greater than $400,000 but less than or 
equal to $450,000
		$1,800
	
406.9406.10
	greater than $450,000 but less than or 
equal to $500,000
		$2,000
	
406.11
406.12	greater than $500,000 but less than or 
equal to $600,000
		$2,250
	
406.13
406.14	greater than $600,000 but less than or 
equal to $700,000
		$2,500
	
406.15
406.16	greater than $700,000 but less than or 
equal to $800,000
		$2,750
	
406.17
406.18	greater than $800,000 but less than or 
equal to $900,000
		$3,000
	
406.19
406.20	greater than $900,000 but less than or 
equal to $1,000,000
		$3,250
	
406.21
406.22	greater than $1,000,000 but less than or 
equal to $1,250,000
		$3,500
	
406.23
406.24	greater than $1,250,000 but less than or 
equal to $1,500,000
		$3,750
	
406.25
406.26	greater than $1,500,000 but less than or 
equal to $1,750,000
		$4,000
	
406.27
406.28	greater than $1,750,000 but less than or 
equal to $2,000,000
		$4,250
	
406.29
406.30	greater than $2,000,000 but less than or 
equal to $2,500,000
		$4,500
	
406.31
406.32	greater than $2,500,000 but less than or 
equal to $3,000,000
		$4,750
	
406.33
406.34	greater than $3,000,000 but less than or 
equal to $3,500,000
		$5,000
	
406.35
406.36	greater than $3,500,000 but less than or 
equal to $4,000,000
		$5,500
	
406.37
406.38	greater than $4,000,000 but less than or 
equal to $4,500,000
		$6,000
	
406.39
406.40	greater than $4,500,000 but less than or 
equal to $5,000,000
		$6,500
	
406.41
406.42	greater than $5,000,000 but less than or 
equal to $7,500,000
		$7,000
	
406.43
406.44	greater than $7,500,000 but less than or 
equal to $10,000,000
		$8,500
	
406.45
406.46	greater than $10,000,000 but less than or 
equal to $12,500,000
		$10,000
	
407.1
407.2	greater than $12,500,000 but less than or 
equal to $15,000,000
		$14,000
	
407.3	greater than $15,000,000
		$18,000
	
407.4 	(2) If requested, the license holder shall provide the commissioner information to verify 
407.5 	the license holder's annual revenues or other information as needed, including copies of 
407.6 	documents submitted to the Department of Revenue.
407.7 	(3) At each annual renewal, a license holder may elect to pay the highest renewal fee, 
407.8 	and not provide annual revenue information to the commissioner.
407.9 	(4) (3) A license holder that knowingly provides the commissioner incorrect revenue 
407.10 	amounts for the purpose of paying a lower license fee shall be subject to a civil penalty in 
407.11 	the amount of double the fee the provider should have paid.
407.12 	(5) Notwithstanding clause (1), a license holder providing services under one or more 
407.13 	licenses under chapter 245B that are in effect on May 15, 2013, shall pay an annual license 
407.14 	fee for calendar years 2014, 2015, and 2016, equal to the total license fees paid by the license 
407.15 	holder for all licenses held under chapter 245B for calendar year 2013. For calendar year 
407.16 	2017 and thereafter, the license holder shall pay an annual license fee according to clause 
407.17 	(1).
407.18 	(4) The commissioner shall calculate the licensing fee for a provider of home and 
407.19 	community-based services and supports under this paragraph and invoice the license holder 
407.20 	annually. If the license holder challenges the fee amount invoiced, the commissioner shall 
407.21 	provide the license holder with a report identifying the medical assistance claims paid by 
407.22 	the commissioner to the license holder that formed the basis for the licensing fee calculation.
407.23 	(c) A chemical dependency treatment program licensed under Minnesota Rules, parts 
407.24 	9530.6405 to 9530.6505, to provide chemical dependency treatment shall pay an annual 
407.25 	nonrefundable license fee based on the following schedule:

407.26		Licensed Capacity
	License Fee
	
407.27		1 to 24 persons
	$600
	
407.28		25 to 49 persons
	$800
	
407.29		50 to 74 persons
	$1,000
	
407.30		75 to 99 persons
	$1,200
	
407.31		100 or more persons
	$1,400
	
407.32 	(d) A chemical dependency program licensed under Minnesota Rules, parts 9530.6510
407.33 	to 9530.6590, to provide detoxification services shall pay an annual nonrefundable license 
407.34 	fee based on the following schedule:

408.1		Licensed Capacity
	License Fee
	
408.2		1 to 24 persons
	$760
	
408.3		25 to 49 persons
	$960
	
408.4		50 or more persons
	$1,160
	
408.5 	(e) Except for child foster care, a residential facility licensed under Minnesota Rules, 
408.6 	chapter 2960, to serve children shall pay an annual nonrefundable license fee based on the 
408.7 	following schedule:

408.8		Licensed Capacity
	License Fee
	
408.9		1 to 24 persons
	$1,000
	
408.10		25 to 49 persons
	$1,100
	
408.11		50 to 74 persons
	$1,200
	
408.12		75 to 99 persons
	$1,300
	
408.13		100 or more persons
	$1,400
	
408.14 	(f) A residential facility licensed under Minnesota Rules, parts 9520.0500 to 9520.0670, 
408.15 	to serve persons with mental illness shall pay an annual nonrefundable license fee based on 
408.16 	the following schedule:

408.17		Licensed Capacity
	License Fee
	
408.18		1 to 24 persons
	$2,525
	
408.19		25 or more persons
	$2,725
	
408.20 	(g) A residential facility licensed under Minnesota Rules, parts 9570.2000 to 9570.3400, 
408.21 	to serve persons with physical disabilities shall pay an annual nonrefundable license fee 
408.22 	based on the following schedule:

408.23		Licensed Capacity
	License Fee
	
408.24		1 to 24 persons
	$450
	
408.25		25 to 49 persons
	$650
	
408.26		50 to 74 persons
	$850
	
408.27		75 to 99 persons
	$1,050
	
408.28		100 or more persons
	$1,250
	
408.29 	(h) A program licensed to provide independent living assistance for youth under section 
408.30 	245A.22 shall pay an annual nonrefundable license fee of $1,500.
408.31 	(i) A private agency licensed to provide foster care and adoption services under Minnesota 
408.32 	Rules, parts 9545.0755 to 9545.0845, shall pay an annual nonrefundable license fee of $875.
409.1 	(j) A program licensed as an adult day care center licensed under Minnesota Rules, parts 
409.2 	9555.9600 to 9555.9730, shall pay an annual nonrefundable license fee based on the 
409.3 	following schedule:

409.4		Licensed Capacity
	License Fee
	
409.5		1 to 24 persons
	$500
	
409.6		25 to 49 persons
	$700
	
409.7		50 to 74 persons
	$900
	
409.8		75 to 99 persons
	$1,100
	
409.9		100 or more persons
	$1,300
	
409.10 	(k) A program licensed to provide treatment services to persons with sexual psychopathic 
409.11 	personalities or sexually dangerous persons under Minnesota Rules, parts 9515.3000 to 
409.12 	9515.3110, shall pay an annual nonrefundable license fee of $20,000.
409.13 	(l) A mental health center or mental health clinic requesting certification for purposes 
409.14 	of insurance and subscriber contract reimbursement under Minnesota Rules, parts 9520.0750
409.15 	to 9520.0870, shall pay a certification fee of $1,550 per year. If the mental health center or 
409.16 	mental health clinic provides services at a primary location with satellite facilities, the 
409.17 	satellite facilities shall be certified with the primary location without an additional charge.

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

409.19 	Sec. 6. Minnesota Statutes 2016, section 245A.14, is amended by adding a subdivision to 
409.20 	read:
409.21 		Subd. 15.Parental access in child care programs. An enrolled child's parent or legal 
409.22 	guardian must be allowed access to the parent's or legal guardian's child any time while the 
409.23 	child is in care.

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

409.25 	Sec. 7. Minnesota Statutes 2016, section 245A.151, is amended to read:
409.26 	245A.151 FIRE MARSHAL INSPECTION.
409.27 	When licensure under this chapter requires an inspection by a fire marshal to determine 
409.28 	compliance with the State Fire Code under section 299F.011, a local fire code inspector 
409.29 	approved trained by the state fire marshal may conduct the inspection. If a community does 
409.30 	not have a local fire code inspector or if the local fire code inspector does not perform the 
409.31 	inspection, the state fire marshal must conduct the inspection. A local fire code inspector 
409.32 	or the state fire marshal may recover the cost of these inspections through a fee of no more 
410.1 	than $50 per inspection charged to the applicant or license holder. The fees collected by the 
410.2 	state fire marshal under this section are appropriated to the commissioner of public safety 
410.3 	for the purpose of conducting the inspections.

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

410.5 	Sec. 8. Minnesota Statutes 2016, section 245A.16, subdivision 1, is amended to read:
410.6 		Subdivision 1.Delegation of authority to agencies. (a) County agencies and private 
410.7 	agencies that have been designated or licensed by the commissioner to perform licensing 
410.8 	functions and activities under section 245A.04 and background studies for family child care 
410.9 	under chapter 245C; to recommend denial of applicants under section 245A.05; to issue 
410.10 	correction orders, to issue variances, and recommend a conditional license under section 
410.11 	245A.06; or to recommend suspending or revoking a license or issuing a fine under section 
410.12 	245A.07, shall comply with rules and directives of the commissioner governing those 
410.13 	functions and with this section. The following variances are excluded from the delegation 
410.14 	of variance authority and may be issued only by the commissioner:
410.15 	(1) dual licensure of family child care and child foster care, dual licensure of child and 
410.16 	adult foster care, and adult foster care and family child care;
410.17 	(2) adult foster care maximum capacity;
410.18 	(3) adult foster care minimum age requirement;
410.19 	(4) child foster care maximum age requirement;
410.20 	(5) variances regarding disqualified individuals except that, before the implementation 
410.21 	of NETStudy 2.0, county agencies may issue variances under section 245C.30 regarding 
410.22 	disqualified individuals when the county is responsible for conducting a consolidated 
410.23 	reconsideration according to sections 245C.25 and 245C.27, subdivision 2, clauses (a) and 
410.24 	(b), of a county maltreatment determination and a disqualification based on serious or 
410.25 	recurring maltreatment;
410.26 	(6) the required presence of a caregiver in the adult foster care residence during normal 
410.27 	sleeping hours; and
410.28 	(7) variances to requirements relating to chemical use problems of a license holder or a 
410.29 	household member of a license holder.
410.30 	Except as provided in section 245A.14, subdivision 4, paragraph (e), a county agency must 
410.31 	not grant a license holder a variance to exceed the maximum allowable family child care 
410.32 	license capacity of 14 children.
411.1 	(b) Before the implementation of NETStudy 2.0, county agencies must report information 
411.2 	about disqualification reconsiderations under sections 245C.25 and 245C.27, subdivision 
411.3 	2, paragraphs (a) and (b), and variances granted under paragraph (a), clause (5), to the 
411.4 	commissioner at least monthly in a format prescribed by the commissioner.
411.5 	(c) For family day child care programs, the commissioner may authorize shall require 
411.6 	a county agency to conduct one unannounced licensing reviews every two years after a 
411.7 	licensee has had at least one annual review at least annually.
411.8 	(d) For family adult day services programs, the commissioner may authorize licensing 
411.9 	reviews every two years after a licensee has had at least one annual review.
411.10 	(e) A license issued under this section may be issued for up to two years.
411.11 	(f) During implementation of chapter 245D, the commissioner shall consider:
411.12 	(1) the role of counties in quality assurance;
411.13 	(2) the duties of county licensing staff; and
411.14 	(3) the possible use of joint powers agreements, according to section 471.59, with counties 
411.15 	through which some licensing duties under chapter 245D may be delegated by the 
411.16 	commissioner to the counties.
411.17 	Any consideration related to this paragraph must meet all of the requirements of the corrective 
411.18 	action plan ordered by the federal Centers for Medicare and Medicaid Services.
411.19 	(g) Licensing authority specific to section 245D.06, subdivisions 5, 6, 7, and 8, or 
411.20 	successor provisions; and section 245D.061 or successor provisions, for family child foster 
411.21 	care programs providing out-of-home respite, as identified in section 245D.03, subdivision 
411.22 	1, paragraph (b), clause (1), is excluded from the delegation of authority to county and 
411.23 	private agencies.
411.24 	(h) A county agency shall report to the commissioner, in a manner prescribed by the 
411.25 	commissioner, the following information for a licensed family child care program:
411.26 	(1) the results of each licensing review completed, including the date of the review, any 
411.27 	licensing correction order issued; and
411.28 	(2) any death, serious injury, or determination of substantiated maltreatment.

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

412.1 	Sec. 9. Minnesota Statutes 2016, section 245A.16, is amended by adding a subdivision to 
412.2 	read:
412.3 		Subd. 7.Family child care licensing oversight. (a) Only county staff trained by the 
412.4 	commissioner on the family child care licensing standards in this chapter and Minnesota 
412.5 	Rules, chapter 9502, shall perform family child care licensing functions under subdivision 
412.6 	1. Training must occur within 90 days of a staff person's employment.
412.7 	(b) The commissioner shall consult with county agencies to develop a formula to allocate 
412.8 	county family child care licensing grant funding.
412.9 	(c) If a county fails to perform the family child care licensing functions of this section, 
412.10 	the commissioner may reduce or delay the county's licensing grant payment until compliance 
412.11 	is achieved.

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

412.13 	Sec. 10. Minnesota Statutes 2016, section 245A.40, subdivision 1, is amended to read:
412.14 		Subdivision 1.Orientation. The child care center license holder must ensure that every 
412.15 	staff person and volunteer is given orientation training and successfully completes the 
412.16 	training before starting assigned duties. The orientation training in this subdivision applies 
412.17 	to volunteers who will have direct contact with or access to children and who are not under 
412.18 	the direct supervision of a staff person. Completion of the orientation must be documented 
412.19 	in the individual's personnel record. The orientation training must include information about:
412.20 	(1) the center's philosophy, child care program, and procedures for maintaining health 
412.21 	and safety according to section 245A.41 and Minnesota Rules, part 9503.0140, and handling 
412.22 	emergencies and accidents according to Minnesota Rules, part 9503.0110;
412.23 	(2) specific job responsibilities;
412.24 	(3) the behavior guidance standards in Minnesota Rules, part 9503.0055; and
412.25 	(4) the reporting responsibilities in section 626.556, and Minnesota Rules, part 9503.0130.

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

412.27 	Sec. 11. Minnesota Statutes 2016, section 245A.40, subdivision 2, is amended to read:
412.28 		Subd. 2.Child growth and development and learning training. (a) For purposes of 
412.29 	child care centers, the director and all staff hired after July 1, 2006, shall complete and 
412.30 	document at least two hours of child growth and development and learning training within 
412.31 	the first year of employment. For purposes of this subdivision, "child growth and development
413.1 	and learning training" means training in understanding how children acquire language and
413.2 	develop physically, cognitively, emotionally, and socially and learn as part of the children's 
413.3 	family, culture, and community. Training completed under this subdivision may be used to 
413.4 	meet the orientation training requirements under subdivision 1 and the in-service training 
413.5 	requirements under subdivision 7.
413.6 	(b) Notwithstanding paragraph (a), individuals are exempt from this requirement if they:
413.7 	(1) have taken a three-credit college course on early childhood development within the 
413.8 	past five years;
413.9 	(2) have received a baccalaureate or master's degree in early childhood education or 
413.10 	school-age child care within the past five years;
413.11 	(3) are licensed in Minnesota as a prekindergarten teacher, an early childhood educator, 
413.12 	a kindergarten to sixth grade teacher with a prekindergarten specialty, an early childhood 
413.13 	special education teacher, or an elementary teacher with a kindergarten endorsement; or
413.14 	(4) have received a baccalaureate degree with a Montessori certificate within the past 
413.15 	five years.

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

413.17 	Sec. 12. Minnesota Statutes 2016, section 245A.40, subdivision 3, is amended to read:
413.18 		Subd. 3.First aid. (a) All teachers and assistant teachers in a child care center governed 
413.19 	by Minnesota Rules, parts 9503.0005 to 9503.0170, and at least one staff person during 
413.20 	field trips and when transporting children in care, must satisfactorily complete first aid 
413.21 	training within 90 days of the start of work, unless the training has been completed within 
413.22 	the previous three two years.
413.23 	(b) Notwithstanding paragraph (a), which allows 90 days to complete training, at least 
413.24 	one staff person who has satisfactorily completed first aid training must be present at all 
413.25 	times in the center, during field trips, and when transporting children in care.
413.26 	(c) The first aid training must be repeated at least every three two years, documented in 
413.27 	the person's personnel record and indicated on the center's staffing chart, and provided by 
413.28 	an individual approved as a first aid instructor. This training may be less than eight hours.

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

414.1 	Sec. 13. Minnesota Statutes 2016, section 245A.40, subdivision 4, is amended to read:
414.2 		Subd. 4.Cardiopulmonary resuscitation. (a) All teachers and assistant teachers in a 
414.3 	child care center governed by Minnesota Rules, parts 9503.0005 to 9503.0170, and at least 
414.4 	one staff person during field trips and when transporting children in care, must satisfactorily 
414.5 	complete training in cardiopulmonary resuscitation (CPR) that includes CPR techniques 
414.6 	for infants and children and in the treatment of obstructed airways. The CPR training must 
414.7 	be completed within 90 days of the start of work, unless the training has been completed 
414.8 	within the previous three two years. The CPR training must have been provided by an 
414.9 	individual approved to provide CPR instruction, must be repeated at least once every three
414.10 	two years, and must be documented in the staff person's records.
414.11 	(b) Notwithstanding paragraph (a), which allows 90 days to complete training, at least 
414.12 	one staff person who has satisfactorily completed cardiopulmonary resuscitation training 
414.13 	must be present at all times in the center, during field trips, and when transporting children 
414.14 	in care.
414.15 	(c) CPR training may be provided for less than four hours.
414.16 	(d) Persons providing CPR training must use CPR training that has been developed:
414.17 	(1) by the American Heart Association or the American Red Cross and incorporates 
414.18 	psychomotor skills to support the instruction; or
414.19 	(2) using nationally recognized, evidence-based guidelines for CPR and incorporates 
414.20 	psychomotor skills to support the instruction.

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

414.22 	Sec. 14. Minnesota Statutes 2016, section 245A.40, subdivision 7, is amended to read:
414.23 		Subd. 7.In-service. (a) A license holder must ensure that an annual in-service training 
414.24 	plan is developed and carried out and that it meets the requirements in clauses (1) to (7). 
414.25 	The in-service training plan must: the center director and all staff who have direct contact 
414.26 	with a child complete annual in-service training. In-service training requirements must be 
414.27 	met by a staff person's participation in the following training areas:
414.28 	(1) be consistent with the center's child care program plan;
414.29 	(2) meet the training needs of individual staff persons as specified in each staff person's 
414.30 	annual evaluation report;
414.31 	(3) provide training, at least one-fourth of which is by a resource not affiliated with the 
414.32 	license holder;
415.1 	(4) include Minnesota Rules, parts 9503.0005 to 9503.0170, relevant to the staff person's 
415.2 	position and must occur within two weeks of initial employment;
415.3 	(5) provide that at least one-half of the annual in-service training completed by a staff 
415.4 	person each year pertains to the age of children for which the person is providing care;
415.5 	(6) provide that no more than four hours of each annual in-service training requirement 
415.6 	relate to administration, finances, and records training for a teacher, assistant teacher, or 
415.7 	aide; and
415.8 	(7) provide that the remainder of the in-service training requirement be met by 
415.9 	participation in training in child growth and development; learning environment and 
415.10 	curriculum; assessment and planning for individual needs; interactions with children; families 
415.11 	and communities; health, safety, and nutrition; and program planning and evaluation.
415.12 	(1) child development and learning;
415.13 	(2) developmentally appropriate learning experiences;
415.14 	(3) relationships with families;
415.15 	(4) assessment, evaluation, and individualization;
415.16 	(5) historical and contemporary development of early childhood education;
415.17 	(6) professionalism; and
415.18 	(7) health, safety, and nutrition.
415.19 	(b) For purposes of this subdivision, the following terms have the meanings given them.
415.20 	(1) "Child growth and development and learning training" has the meaning given it in 
415.21 	subdivision 2, paragraph (a).
415.22 	(2) "Learning environment and curriculum" means training in establishing an environment 
415.23 	that provides learning experiences to meet each child's needs, capabilities, and interests, 
415.24 	including early childhood education methods or theory, recreation, sports, promoting 
415.25 	creativity in the arts, arts and crafts methods or theory, and early childhood special education 
415.26 	methods or theory.
415.27 	(3) "Assessment and planning for individual needs" means training in observing and 
415.28 	assessing what children know and can do in order to provide curriculum and instruction 
415.29 	that addresses their developmental and learning needs, including children with special needs.
416.1 	(4) "Interactions with children" means training in establishing supportive relationships 
416.2 	with children and guiding them as individuals and as part of a group, including child study 
416.3 	techniques and behavior guidance.
416.4 	(5) "Families and communities" means training in working collaboratively with families, 
416.5 	agencies, and organizations to meet children's needs and to encourage the community's 
416.6 	involvement, including family studies and parent involvement.
416.7 	(6) "Health, safety, and nutrition" means training in establishing and maintaining an 
416.8 	environment that ensures children's health, safety, and nourishment, including first aid, 
416.9 	cardiopulmonary resuscitation, child nutrition, and child abuse and neglect prevention.
416.10 	(7) "Program planning and evaluation" means training in establishing, implementing, 
416.11 	evaluating, and enhancing program operations.
416.12 	(2) "Developmentally appropriate learning experiences" means creating positive learning 
416.13 	experiences, promoting cognitive development, promoting social and emotional development, 
416.14 	promoting physical development, and promoting creative development.
416.15 	(3) "Relationships with families" means training on building a positive, respectful 
416.16 	relationship with the child's family.
416.17 	(4) "Assessment, evaluation, and individualization" means training in observing, 
416.18 	recording, and assessing development; assessing and using information to plan; and assessing 
416.19 	and using information to enhance and maintain program quality.
416.20 	(5) "Historical and contemporary development of early childhood education" means 
416.21 	training in past and current practices in early childhood education and how current events 
416.22 	and issues affect children, families, and programs.
416.23 	(6) "Professionalism" means training in knowledge, skills, and abilities that promote 
416.24 	ongoing professional development.
416.25 	(7) "Health, safety, and nutrition" means training in establishing health practices, ensuring 
416.26 	safety, and providing healthy nutrition.
416.27 	(c) The director and all program staff persons must annually complete a number of hours 
416.28 	of in-service training equal to at least two percent of the hours for which the director or 
416.29 	program staff person is annually paid, unless one of the following is applicable.
416.30 	(1) A teacher at a child care center must complete one percent of working hours of 
416.31 	in-service training annually if the teacher:
417.1 	(i) possesses a baccalaureate or master's degree in early childhood education or school-age 
417.2 	care;
417.3 	(ii) is licensed in Minnesota as a prekindergarten teacher, an early childhood educator, 
417.4 	a kindergarten to sixth grade teacher with a prekindergarten specialty, an early childhood 
417.5 	special education teacher, or an elementary teacher with a kindergarten endorsement; or
417.6 	(iii) possesses a baccalaureate degree with a Montessori certificate.
417.7 	(2) A teacher or assistant teacher at a child care center must complete one and one-half 
417.8 	percent of working hours of in-service training annually if the individual is:
417.9 	(i) a registered nurse or licensed practical nurse with experience working with infants;
417.10 	(ii) possesses a Montessori certificate, a technical college certificate in early childhood 
417.11 	development, or a child development associate certificate; or
417.12 	(iii) possesses an associate of arts degree in early childhood education, a baccalaureate 
417.13 	degree in child development, or a technical college diploma in early childhood development.
417.14 	(d) The number of required training hours may be prorated for individuals not employed 
417.15 	full time or for an entire year.
417.16 	(e) The annual in-service training must be completed within the calendar year for which 
417.17 	it was required. In-service training completed by staff persons is transferable upon a staff 
417.18 	person's change in employment to another child care program.
417.19 	(f) The license holder must ensure that, when a staff person completes in-service training, 
417.20 	the training is documented in the staff person's personnel record. The documentation must 
417.21 	include the date training was completed, the goal of the training and topics covered, trainer's 
417.22 	name and organizational affiliation, trainer's signed statement that training was successfully 
417.23 	completed, and the director's approval of the training.

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

417.25 	Sec. 15. Minnesota Statutes 2016, section 245A.40, is amended by adding a subdivision 
417.26 	to read:
417.27 		Subd. 9.Ongoing health and safety training. A staff person's orientation training on 
417.28 	maintaining health and safety and handling emergencies and accidents, as required in 
417.29 	subdivision 1, must be repeated at least once each calendar year by each staff person. The 
417.30 	completion of the annual training must be documented in the staff person's personnel record.

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

418.1 	Sec. 16. [245A.41] CHILD CARE CENTER HEALTH AND SAFETY 
418.2 	REQUIREMENTS.
418.3 		Subdivision 1.Allergy prevention and response. (a) Before admitting a child for care, 
418.4 	the license holder must obtain documentation of any known allergy from the child's parent 
418.5 	or legal guardian or the child's source of medical care. If a child has a known allergy, the 
418.6 	license holder must maintain current information about the allergy in the child's record and 
418.7 	develop an individual child care program plan as specified in Minnesota Rules, part 
418.8 	9503.0065, subpart 3. The individual child care program plan must include but not be limited 
418.9 	to a description of the allergy, specific triggers, avoidance techniques, symptoms of an 
418.10 	allergic reaction, and procedures for responding to an allergic reaction, including medication, 
418.11 	dosages, and a doctor's contact information.
418.12 	(b) The license holder must ensure that each staff person who is responsible for carrying 
418.13 	out the individual child care program plan review and follow the plan. Documentation of a 
418.14 	staff person's review must be kept on site.
418.15 	(c) At least annually or following any changes made to allergy-related information in 
418.16 	the child's record, the license holder must update the child's individual child care program 
418.17 	plan and inform each staff person who is responsible for carrying out the individual child 
418.18 	care program plan of the change. The license holder must keep on site documentation that 
418.19 	a staff person was informed of a change.
418.20 	(d) A child's allergy information must be available at all times including on site, when 
418.21 	on field trips, or during transportation. A child's food allergy information must be readily 
418.22 	available to a staff person in the area where food is prepared and served to the child.
418.23 	(e) The license holder must contact the child's parent or legal guardian as soon as possible 
418.24 	in any instance of exposure or allergic reaction that requires medication or medical 
418.25 	intervention. The license holder must call emergency medical services when epinephrine 
418.26 	is administered to a child in the license holder's care.
418.27 		Subd. 2.Handling and disposal of bodily fluids. The licensed child care center must 
418.28 	comply with the following procedures for safely handling and disposing of bodily fluids:
418.29 	(1) surfaces that come in contact with potentially infectious bodily fluids, including 
418.30 	blood and vomit, must be cleaned and disinfected according to Minnesota Rules, part 
418.31 	9503.0005, subpart 11;
418.32 	(2) blood-contaminated material must be disposed of in a plastic bag with a secure tie;
419.1 	(3) sharp items used for a child with special care needs must be disposed of in a "sharps 
419.2 	container." The sharps container must be stored out of reach of a child;
419.3 	(4) the license holder must have the following bodily fluid disposal supplies in the center: 
419.4 	disposable gloves, disposal bags, and eye protection; and
419.5 	(5) the license holder must ensure that each staff person is trained on universal precautions 
419.6 	to reduce the risk of spreading infectious disease. A staff person's completion of the training 
419.7 	must be documented in the staff person's personnel record.
419.8 		Subd. 3.Emergency preparedness. (a) No later than September 30, 2017, a licensed 
419.9 	child care center must have a written emergency plan for emergencies that require evacuation, 
419.10 	sheltering, or other protection of a child, such as fire, natural disaster, intruder, or other 
419.11 	threatening situation that may pose a health or safety hazard to a child. The plan must be 
419.12 	written on a form developed by the commissioner and must include:
419.13 	(1) procedures for an evacuation, relocation, shelter-in-place, or lockdown;
419.14 	(2) a designated relocation site and evacuation route;
419.15 	(3) procedures for notifying a child's parent or legal guardian of the evacuation, relocation,  
419.16 	shelter-in-place, or lockdown, including procedures for reunification with families;
419.17 	(4) accommodations for a child with a disability or a chronic medical condition;
419.18 	(5) procedures for storing a child's medically necessary medicine that facilitates easy 
419.19 	removal during an evacuation or relocation;
419.20 	(6) procedures for continuing operations in the period during and after a crisis; and
419.21 	(7) procedures for communicating with local emergency management officials, law 
419.22 	enforcement officials, or other appropriate state or local authorities.
419.23 	(b) The license holder must train staff persons on the emergency plan at orientation, 
419.24 	when changes are made to the plan, and at least once each calendar year. Training must be 
419.25 	documented in each staff person's personnel file.
419.26 	(c) The license holder must conduct drills according to the requirements in Minnesota 
419.27 	Rules, part 9503.0110, subpart 3. The date and time of the drills must be documented.
419.28 	(d) The license holder must review and update the emergency plan annually. 
419.29 	Documentation of the annual emergency plan review shall be maintained in the program's 
419.30 	administrative records.
420.1 	(e) The license holder must include the emergency plan in the program's policies and 
420.2 	procedures as specified under section 245A.04, subdivision 14. The license holder must 
420.3 	provide a physical or electronic copy of the emergency plan to the child's parent or legal 
420.4 	guardian upon enrollment.
420.5 	(f) The relocation site and evacuation route must be posted in a visible place as part of 
420.6 	the written procedures for emergencies and accidents in Minnesota Rules, part 9503.0140, 
420.7 	subpart 21.

420.8 	Sec. 17. Minnesota Statutes 2016, section 245A.50, subdivision 2, is amended to read:
420.9 		Subd. 2.Child growth and development and learning and behavior guidance 
420.10 	training. (a) For purposes of family and group family child care, the license holder and 
420.11 	each adult caregiver who provides care in the licensed setting for more than 30 days in any 
420.12 	12-month period shall complete and document at least four hours of child growth and 
420.13 	development learning and behavior guidance training prior to initial licensure, and before 
420.14 	caring for children. For purposes of this subdivision, "child growth and development and 
420.15 	learning training" means training in understanding how children acquire language and
420.16 	develop physically, cognitively, emotionally, and socially and learn as part of the children's 
420.17 	family, culture, and community. "Behavior guidance training" means training in the 
420.18 	understanding of the functions of child behavior and strategies for managing challenging 
420.19 	situations. At least two hours of child growth and development and learning or behavior 
420.20 	guidance training must be repeated annually. Training curriculum shall be developed or 
420.21 	approved by the commissioner of human services by January 1, 2014.
420.22 	(b) Notwithstanding paragraph (a), individuals are exempt from this requirement if they:
420.23 	(1) have taken a three-credit course on early childhood development within the past five 
420.24 	years;
420.25 	(2) have received a baccalaureate or master's degree in early childhood education or 
420.26 	school-age child care within the past five years;
420.27 	(3) are licensed in Minnesota as a prekindergarten teacher, an early childhood educator, 
420.28 	a kindergarten to grade 6 teacher with a prekindergarten specialty, an early childhood special 
420.29 	education teacher, or an elementary teacher with a kindergarten endorsement; or
420.30 	(4) have received a baccalaureate degree with a Montessori certificate within the past 
420.31 	five years.

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

421.1 	Sec. 18. Minnesota Statutes 2016, section 245A.50, subdivision 7, is amended to read:
421.2 		Subd. 7.Training requirements for family and group family child care. For purposes 
421.3 	of family and group family child care, the license holder and each primary caregiver must 
421.4 	complete 16 hours of ongoing training each year. For purposes of this subdivision, a primary 
421.5 	caregiver is an adult caregiver who provides services in the licensed setting for more than 
421.6 	30 days in any 12-month period. Repeat of topical training requirements in subdivisions 2 
421.7 	to 8 shall count toward the annual 16-hour training requirement. Additional ongoing training 
421.8 	subjects to meet the annual 16-hour training requirement must be selected from the following 
421.9 	areas:
421.10 	(1) child growth and development and learning training under subdivision 2, paragraph 
421.11 	(a);
421.12 	(2) learning environment and curriculum, including training in establishing an 
421.13 	environment and providing activities that provide learning experiences to meet each child's 
421.14 	needs, capabilities, and interests;
421.15 	(3) assessment and planning for individual needs, including training in observing and 
421.16 	assessing what children know and can do in order to provide curriculum and instruction 
421.17 	that addresses their developmental and learning needs, including children with special needs 
421.18 	and bilingual children or children for whom English is not their primary language;
421.19 	(4) interactions with children, including training in establishing supportive relationships 
421.20 	with children, guiding them as individuals and as part of a group;
421.21 	(5) families and communities, including training in working collaboratively with families 
421.22 	and agencies or organizations to meet children's needs and to encourage the community's 
421.23 	involvement;
421.24 	(6) health, safety, and nutrition, including training in establishing and maintaining an 
421.25 	environment that ensures children's health, safety, and nourishment, including child abuse, 
421.26 	maltreatment, prevention, and reporting; home and fire safety; child injury prevention; 
421.27 	communicable disease prevention and control; first aid; and CPR;
421.28 	(7) program planning and evaluation, including training in establishing, implementing, 
421.29 	evaluating, and enhancing program operations; and
421.30 	(8) behavior guidance, including training in the understanding of the functions of child 
421.31 	behavior and strategies for managing behavior.
421.32 	(2) developmentally appropriate learning experiences, including training in creating 
421.33 	positive learning experiences, promoting cognitive development, promoting social and 
422.1 	emotional development, promoting physical development, promoting creative development; 
422.2 	and behavior guidance;
422.3 	(3) relationships with families, including training in building a positive, respectful 
422.4 	relationship with the child's family;
422.5 	(4) assessment, evaluation, and individualization, including training in observing, 
422.6 	recording, and assessing development; assessing and using information to plan; and assessing 
422.7 	and using information to enhance and maintain program quality;
422.8 	(5) historical and contemporary development of early childhood education, including 
422.9 	training in past and current practices in early childhood education and how current events 
422.10 	and issues affect children, families, and programs;
422.11 	(6) professionalism, including training in knowledge, skills, and abilities that promote 
422.12 	ongoing professional development; and
422.13 	(7) health, safety, and nutrition, including training in establishing healthy practices; 
422.14 	ensuring safety; and providing healthy nutrition.

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

422.16 	Sec. 19. Minnesota Statutes 2016, section 245A.50, subdivision 9, is amended to read:
422.17 		Subd. 9.Supervising for safety; training requirement. Effective July 1, 2014 (a) 
422.18 	Before initial licensure and before caring for a child, all family child care license holders 
422.19 	and each adult caregiver who provides care in the licensed family child care home for more 
422.20 	than 30 days in any 12-month period shall complete and document at least six hours of 
422.21 	approved training on supervising for safety prior to initial licensure, and before caring for 
422.22 	children. At least two hours of training on supervising for safety must be repeated annually. 
422.23 	For purposes of this subdivision, "supervising for safety" includes supervision basics, 
422.24 	supervision outdoors, equipment and materials, illness, injuries, and disaster preparedness. 
422.25 	The commissioner shall develop the supervising for safety curriculum by January 1, 2014.
422.26 	the completion of the six-hour Supervising for Safety for Family Child Care course developed 
422.27 	by the commissioner.
422.28 	(b) The family child care license holder and each adult caregiver who provides care in 
422.29 	the licensed family child care home for more than 30 days in any 12-month period shall 
422.30 	complete and document:
422.31 	(1) the annual completion of a two-hour active supervision course developed by the 
422.32 	commissioner; and
423.1 	(2) the completion at least once every five years of the two-hour courses Health and 
423.2 	Safety I and Health and Safety II. A license holder's or adult caregiver's completion of each 
423.3 	of these trainings meets the annual active supervision training requirement in clause (1).

423.4 	Sec. 20. [245A.51] FAMILY CHILD CARE HEALTH AND SAFETY 
423.5 	REQUIREMENTS.
423.6 		Subdivision 1.Allergy prevention and response. (a) Before admitting a child for care, 
423.7 	the license holder must obtain information about any known allergy from the child's parent 
423.8 	or legal guardian. The license holder must maintain current allergy information in each 
423.9 	child's record. The allergy information must include a description of the allergy, specific 
423.10 	triggers, avoidance techniques, symptoms of an allergic reaction, and procedures for 
423.11 	responding to an allergic reaction, including medication, dosages, and a doctor's contact 
423.12 	information.
423.13 	(b) The child's allergy information must be documented on a form approved by the 
423.14 	commissioner, readily available to all caregivers, and reviewed annually by the license 
423.15 	holder and each caregiver.
423.16 		Subd. 2.Handling and disposal of bodily fluids. The licensed family child care provider 
423.17 	must comply with the following procedures for safely handling and disposing of bodily 
423.18 	fluids:
423.19 	(1) surfaces that come in contact with potentially infectious bodily fluids, including 
423.20 	blood and vomit, must be cleaned and disinfected as described in section 245A.148;
423.21 	(2) blood-contaminated material must be disposed of in a plastic bag with a secure tie;
423.22 	(3) sharp items used for a child with special care needs must be disposed of in a "sharps 
423.23 	container." The sharps container must be stored out of reach of a child; and
423.24 	(4) the license holder must have the following bodily fluid disposal supplies available: 
423.25 	disposable gloves, disposal bags, and eye protection.
423.26 		Subd. 3.Emergency preparedness plan. (a) No later than September 30, 2017, a 
423.27 	licensed family child care provider must have a written emergency preparedness plan for 
423.28 	emergencies that require evacuation, sheltering, or other protection of children, such as fire, 
423.29 	natural disaster, intruder, or other threatening situation that may pose a health or safety 
423.30 	hazard to children. The plan must be written on a form developed by the commissioner and 
423.31 	updated at least annually. The plan must include:
423.32 	(1) procedures for an evacuation, relocation, shelter-in-place, or lockdown;
424.1 	(2) a designated relocation site and evacuation route;
424.2 	(3) procedures for notifying a child's parent or legal guardian of the evacuation, 
424.3 	shelter-in-place, or lockdown, including procedures for reunification with families;
424.4 	(4) accommodations for a child with a disability or a chronic medical condition;
424.5 	(5) procedures for storing a child's medically necessary medicine that facilitate easy 
424.6 	removal during an evacuation or relocation;
424.7 	(6) procedures for continuing operations in the period during and after a crisis; and
424.8 	(7) procedures for communicating with local emergency management officials, law 
424.9 	enforcement officials, or other appropriate state or local authorities.
424.10 	(b) The license holder must train caregivers before the caregiver provides care and at 
424.11 	least annually on the emergency preparedness plan and document completion of this training.
424.12 	(c) The license holder must conduct drills according to the requirements in Minnesota 
424.13 	Rules, part 9502.0435, subpart 8. The date and time of the drills must be documented.
424.14 	(d) The license holder must have the emergency preparedness plan available for review 
424.15 	and posted in a prominent location. The license holder must provide a physical or electronic 
424.16 	copy of the plan to the child's parent or legal guardian upon enrollment.

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

424.18 	Sec. 21. Minnesota Statutes 2016, section 245C.02, is amended by adding a subdivision 
424.19 	to read:
424.20 		Subd. 6a.Child care staff person. "Child care staff person" means an individual other 
424.21 	than an individual who is related to all children for whom child care services are provided 
424.22 	and:
424.23 	(1) who is employed by a child care provider for compensation;
424.24 	(2) whose activities involve the care or supervision of a child for a child care provider 
424.25 	or unsupervised access to a child who is cared for or supervised by a child care provider; 
424.26 	or
424.27 	(3) an individual 13 years of age or older residing in a licensed family child care home 
424.28 	or legal nonlicensed child care program.

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

425.1 	Sec. 22. Minnesota Statutes 2016, section 245C.03, subdivision 1, is amended to read:
425.2 		Subdivision 1.Licensed programs. (a) The commissioner shall conduct a background 
425.3 	study on:
425.4 	(1) the person or persons applying for a license;
425.5 	(2) an individual age 13 and over living in the household where the licensed program 
425.6 	will be provided who is not receiving licensed services from the program;
425.7 	(3) current or prospective employees or contractors of the applicant who will have direct 
425.8 	contact with persons served by the facility, agency, or program;
425.9 	(4) volunteers or student volunteers who will have direct contact with persons served 
425.10 	by the program to provide program services if the contact is not under the continuous, direct 
425.11 	supervision by an individual listed in clause (1) or (3);
425.12 	(5) an individual age ten to 12 living in the household where the licensed services will 
425.13 	be provided when the commissioner has reasonable cause;
425.14 	(6) an individual who, without providing direct contact services at a licensed program, 
425.15 	may have unsupervised access to children or vulnerable adults receiving services from a 
425.16 	program, when the commissioner has reasonable cause; and
425.17 	(7) all managerial officials controlling individuals as defined under in section 245A.02, 
425.18 	subdivision 5a.; and
425.19 	(8) child care staff persons as defined in section 245C.02, subdivision 6a.
425.20 	(b) Paragraph (a), clauses (5) and (6), apply to legal nonlicensed child care and certified 
425.21 	license-exempt child care programs.
425.22 	(b) (c) For family child foster care settings, a short-term substitute caregiver providing 
425.23 	direct contact services for a child for less than 72 hours of continuous care is not required 
425.24 	to receive a background study under this chapter.

425.25 	EFFECTIVE DATE. This section is effective when the Department of Human Services 
425.26 	implements NETStudy 2.0 or October 1, 2017, whichever is later. The commissioner of 
425.27 	human services shall notify the revisor of statutes when the department implements 
425.28 	NETStudy 2.0.

426.1 	Sec. 23. Minnesota Statutes 2016, section 245C.03, is amended by adding a subdivision 
426.2 	to read:
426.3 		Subd. 6a.Legal nonlicensed and certified child care programs. The commissioner 
426.4 	shall conduct background studies on an individual required under sections 119B.125 and 
426.5 	245G.10 to complete a background study under this chapter.

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

426.7 	Sec. 24. Minnesota Statutes 2016, section 245C.04, subdivision 1, is amended to read:
426.8 		Subdivision 1.Licensed programs; other child care programs. (a) The commissioner 
426.9 	shall conduct a background study of an individual required to be studied under section 
426.10 	245C.03, subdivision 1, at least upon application for initial license for all license types.
426.11 	(b) The commissioner shall conduct a background study of an individual required to be 
426.12 	studied under section 245C.03, subdivision 1, including a child care staff person as defined 
426.13 	in section 245C.02, subdivision 6a, in a family child care program, licensed child care center, 
426.14 	certified license-exempt child care center, or legal nonlicensed child care provider, on a 
426.15 	schedule determined by the commissioner. The background study must include submission 
426.16 	of fingerprints for a national criminal history record check and a review of the information 
426.17 	under section 245C.08. A background study for a child care program must be repeated 
426.18 	within five years from the most recent study conducted under this paragraph.
426.19 	(c) At reapplication for a license for a family child care. license:
426.20 	(1) for a background study affiliated with a licensed family child care center or legal 
426.21 	nonlicensed child care provider, the individual shall provide information required under 
426.22 	section 245C.05, subdivision 1, paragraphs (a), (b), and (d), to the county agency, and be 
426.23 	fingerprinted and photographed under section 245C.05, subdivision 5;
426.24 	(2) the county agency shall verify the information received under clause (1) and forward 
426.25 	the information to the commissioner to complete the background study; and
426.26 	(3) the background study conducted by the commissioner under this paragraph must 
426.27 	include a review of the information required under section 245C.08.
426.28 	(c) (d) The commissioner is not required to conduct a study of an individual at the time 
426.29 	of reapplication for a license if the individual's background study was completed by the 
426.30 	commissioner of human services and the following conditions are met:
426.31 	(1) a study of the individual was conducted either at the time of initial licensure or when 
426.32 	the individual became affiliated with the license holder;
427.1 	(2) the individual has been continuously affiliated with the license holder since the last 
427.2 	study was conducted; and
427.3 	(3) the last study of the individual was conducted on or after October 1, 1995.
427.4 	(d) (e) The commissioner of human services shall conduct a background study of an 
427.5 	individual specified under section 245C.03, subdivision 1, paragraph (a), clauses (2) to (6), 
427.6 	who is newly affiliated with a child foster care license holder. The county or private agency 
427.7 	shall collect and forward to the commissioner the information required under section 245C.05, 
427.8 	subdivisions 1 and 5. The background study conducted by the commissioner of human 
427.9 	services under this paragraph must include a review of the information required under 
427.10 	section 245C.08, subdivisions 1, 3, and 4.
427.11 	(e) (f) The commissioner shall conduct a background study of an individual specified 
427.12 	under section 245C.03, subdivision 1, paragraph (a), clauses (2) to (6), who is newly affiliated 
427.13 	with an adult foster care or family adult day services and with a family child care license 
427.14 	holder or a legal nonlicensed child care provider authorized under chapter 119B: (1) the 
427.15 	county shall collect and forward to the commissioner the information required under section 
427.16 	245C.05, subdivision 1, paragraphs (a) and (b), and subdivision 5, paragraphs (a) and, (b),
427.17 	and (d), for background studies conducted by the commissioner for all family adult day 
427.18 	services and, for adult foster care when the adult foster care license holder resides in the 
427.19 	adult foster care residence, and for family child care and legal nonlicensed child care 
427.20 	authorized under chapter 119B; (2) the license holder shall collect and forward to the 
427.21 	commissioner the information required under section 245C.05, subdivisions 1, paragraphs 
427.22 	(a) and (b); and 5, paragraphs (a) and (b), for background studies conducted by the 
427.23 	commissioner for adult foster care when the license holder does not reside in the adult foster 
427.24 	care residence; and (3) the background study conducted by the commissioner under this 
427.25 	paragraph must include a review of the information required under section 245C.08, 
427.26 	subdivision 1, paragraph (a), and subdivisions 3 and 4.
427.27 	(f) (g) Applicants for licensure, license holders, and other entities as provided in this 
427.28 	chapter must submit completed background study requests to the commissioner using the 
427.29 	electronic system known as NETStudy before individuals specified in section 245C.03, 
427.30 	subdivision 1, begin positions allowing direct contact in any licensed program.
427.31 	(g) (h) For an individual who is not on the entity's active roster, the entity must initiate 
427.32 	a new background study through NETStudy when:
427.33 	(1) an individual returns to a position requiring a background study following an absence 
427.34 	of 120 or more consecutive days; or
428.1 	(2) a program that discontinued providing licensed direct contact services for 120 or 
428.2 	more consecutive days begins to provide direct contact licensed services again.
428.3 	The license holder shall maintain a copy of the notification provided to the commissioner 
428.4 	under this paragraph in the program's files. If the individual's disqualification was previously 
428.5 	set aside for the license holder's program and the new background study results in no new 
428.6 	information that indicates the individual may pose a risk of harm to persons receiving 
428.7 	services from the license holder, the previous set-aside shall remain in effect.
428.8 	(h) (i) For purposes of this section, a physician licensed under chapter 147 is considered 
428.9 	to be continuously affiliated upon the license holder's receipt from the commissioner of 
428.10 	health or human services of the physician's background study results.
428.11 	(i) (j) For purposes of family child care, a substitute caregiver must receive repeat 
428.12 	background studies at the time of each license renewal.
428.13 	(k) A repeat background study at the time of license renewal is not required if the family 
428.14 	child care substitute caregiver's background study was completed by the commissioner on 
428.15 	or after October 1, 2017, and the substitute caregiver is on the license holder's active roster 
428.16 	in NETStudy 2.0.

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

428.18 	Sec. 25. Minnesota Statutes 2016, section 245C.04, subdivision 8, is amended to read:
428.19 		Subd. 8.Current or prospective contractors serving multiple family child care 
428.20 	license holders. (a) Before the implementation of NETStudy 2.0, current or prospective 
428.21 	contractors who are required to have a background study under section 245C.03, subdivision 
428.22 	1, who provide services for multiple family child care license holders in a single county, 
428.23 	and will have direct contact with children served in the family child care setting are required 
428.24 	to have only one background study which is transferable to all family child care programs 
428.25 	in that county if:
428.26 	(1) the county agency maintains a record of the contractor's background study results 
428.27 	which verify the contractor is approved to have direct contact with children receiving 
428.28 	services;
428.29 	(2) the license holder contacts the county agency and obtains notice that the current or 
428.30 	prospective contractor is in compliance with background study requirements and approved 
428.31 	to have direct contact; and
428.32 	(3) the contractor's background study is repeated every two years.
429.1 	(b) For a family child care license holder operating under NETStudy 2.0, the license 
429.2 	holder's active roster shall be the system used to document when a background study subject 
429.3 	is affiliated with the license holder.

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

429.5 	Sec. 26. Minnesota Statutes 2016, section 245C.05, subdivision 2b, is amended to read:
429.6 		Subd. 2b.County agency to collect and forward information to commissioner. (a) 
429.7 	For background studies related to all family adult day services and to adult foster care when 
429.8 	the adult foster care license holder resides in the adult foster care residence, the county 
429.9 	agency must collect the information required under subdivision 1 and forward it to the 
429.10 	commissioner.
429.11 	(b) Upon implementation of NETStudy 2.0, for background studies related to family 
429.12 	child care and legal nonlicensed child care authorized under chapter 119B, the county agency 
429.13 	must collect the information required under subdivision 1 and provide the information to 
429.14 	the commissioner.

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

429.16 	Sec. 27. Minnesota Statutes 2016, section 245C.05, subdivision 4, is amended to read:
429.17 		Subd. 4.Electronic transmission. (a) For background studies conducted by the 
429.18 	Department of Human Services, the commissioner shall implement a secure system for the 
429.19 	electronic transmission of:
429.20 	(1) background study information to the commissioner;
429.21 	(2) background study results to the license holder;
429.22 	(3) background study results to county and private agencies for background studies 
429.23 	conducted by the commissioner for child foster care; and
429.24 	(4) background study results to county agencies for background studies conducted by 
429.25 	the commissioner for adult foster care and family adult day services and, upon 
429.26 	implementation of NETStudy 2.0, family child care and legal nonlicensed child care 
429.27 	authorized under chapter 119B.
429.28 	(b) Unless the commissioner has granted a hardship variance under paragraph (c), a 
429.29 	license holder or an applicant must use the electronic transmission system known as 
429.30 	NETStudy or NETStudy 2.0 to submit all requests for background studies to the 
429.31 	commissioner as required by this chapter.
430.1 	(c) A license holder or applicant whose program is located in an area in which high-speed 
430.2 	Internet is inaccessible may request the commissioner to grant a variance to the electronic 
430.3 	transmission requirement.

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

430.5 	Sec. 28. Minnesota Statutes 2016, section 245C.05, subdivision 5, is amended to read:
430.6 		Subd. 5.Fingerprints and photograph. (a) Before the implementation of NETStudy 
430.7 	2.0, except as provided in paragraph (c), for any background study completed under this 
430.8 	chapter, when the commissioner has reasonable cause to believe that further pertinent 
430.9 	information may exist on the subject of the background study, the subject shall provide the 
430.10 	commissioner with a set of classifiable fingerprints obtained from an authorized agency.
430.11 	(b) Before the implementation of NETStudy 2.0, for purposes of requiring fingerprints, 
430.12 	the commissioner has reasonable cause when, but not limited to, the:
430.13 	(1) information from the Bureau of Criminal Apprehension indicates that the subject is 
430.14 	a multistate offender;
430.15 	(2) information from the Bureau of Criminal Apprehension indicates that multistate 
430.16 	offender status is undetermined; or
430.17 	(3) commissioner has received a report from the subject or a third party indicating that 
430.18 	the subject has a criminal history in a jurisdiction other than Minnesota.
430.19 	(c) Notwithstanding paragraph (d), for background studies conducted by the commissioner 
430.20 	for child foster care, adoptions, or a transfer of permanent legal and physical custody of a 
430.21 	child, the subject of the background study, who is 18 years of age or older, shall provide 
430.22 	the commissioner with a set of classifiable fingerprints obtained from an authorized agency
430.23 	for a national criminal history record check.
430.24 	(d) For background studies initiated on or after the implementation of NETStudy 2.0, 
430.25 	every subject of a background study must provide the commissioner with a set of the 
430.26 	background study subject's classifiable fingerprints and photograph. The photograph and 
430.27 	fingerprints must be recorded at the same time by the commissioner's authorized fingerprint 
430.28 	collection vendor and sent to the commissioner through the commissioner's secure data 
430.29 	system described in section 245C.32, subdivision 1a, paragraph (b). The fingerprints shall 
430.30 	not be retained by the Department of Public Safety, Bureau of Criminal Apprehension, or 
430.31 	the commissioner, but will be retained by the Federal Bureau of Investigation. The 
430.32 	commissioner's authorized fingerprint collection vendor shall, for purposes of verifying the 
430.33 	identity of the background study subject, be able to view the identifying information entered 
431.1 	into NETStudy 2.0 by the entity that initiated the background study, but shall not retain the 
431.2 	subject's fingerprints, photograph, or information from NETStudy 2.0. The authorized 
431.3 	fingerprint collection vendor shall retain no more than the name and date and time the 
431.4 	subject's fingerprints were recorded and sent, only as necessary for auditing and billing 
431.5 	activities.
431.6 	(e) When specifically required by law, fingerprints collected under this section must be 
431.7 	submitted for a national criminal history record check.

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

431.9 	Sec. 29. Minnesota Statutes 2016, section 245C.05, subdivision 7, is amended to read:
431.10 		Subd. 7.Probation officer and corrections agent. (a) A probation officer or corrections 
431.11 	agent shall notify the commissioner of an individual's conviction if the individual:
431.12 	(1) has been affiliated with a program or facility regulated by the Department of Human 
431.13 	Services or Department of Health, a facility serving children or youth licensed by the 
431.14 	Department of Corrections, or any type of home care agency or provider of personal care 
431.15 	assistance services within the preceding year; and
431.16 	(2) has been convicted of a crime constituting a disqualification under section 245C.14.
431.17 	(b) For the purpose of this subdivision, "conviction" has the meaning given it in section 
431.18 	609.02, subdivision 5.
431.19 	(c) The commissioner, in consultation with the commissioner of corrections, shall develop 
431.20 	forms and information necessary to implement this subdivision and shall provide the forms 
431.21 	and information to the commissioner of corrections for distribution to local probation officers 
431.22 	and corrections agents.
431.23 	(d) The commissioner shall inform individuals subject to a background study that criminal 
431.24 	convictions for disqualifying crimes will shall be reported to the commissioner by the 
431.25 	corrections system.
431.26 	(e) A probation officer, corrections agent, or corrections agency is not civilly or criminally 
431.27 	liable for disclosing or failing to disclose the information required by this subdivision.
431.28 	(f) Upon receipt of disqualifying information, the commissioner shall provide the notice 
431.29 	required under section 245C.17, as appropriate, to agencies on record as having initiated a 
431.30 	background study or making a request for documentation of the background study status 
431.31 	of the individual.
432.1 	(g) This subdivision does not apply to family child care programs or legal nonlicensed 
432.2 	child care programs for individuals whose background study was completed in NETStudy 
432.3 	2.0.

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

432.5 	Sec. 30. Minnesota Statutes 2016, section 245C.08, subdivision 1, is amended to read:
432.6 		Subdivision 1.Background studies conducted by Department of Human Services.
 432.7 	(a) For a background study conducted by the Department of Human Services, the 
432.8 	commissioner shall review:
432.9 	(1) information related to names of substantiated perpetrators of maltreatment of 
432.10 	vulnerable adults that has been received by the commissioner as required under section 
432.11 	626.557, subdivision 9c, paragraph (j);
432.12 	(2) the commissioner's records relating to the maltreatment of minors in licensed 
432.13 	programs, and from findings of maltreatment of minors as indicated through the social 
432.14 	service information system;
432.15 	(3) information from juvenile courts as required in subdivision 4 for individuals listed 
432.16 	in section 245C.03, subdivision 1, paragraph (a), when there is reasonable cause;
432.17 	(4) information from the Bureau of Criminal Apprehension, including information 
432.18 	regarding a background study subject's registration in Minnesota as a predatory offender 
432.19 	under section 243.166;
432.20 	(5) except as provided in clause (6), information from the national crime information 
432.21 	system received as a result of submission of fingerprints for a national criminal history 
432.22 	record check, when the commissioner has reasonable cause as defined under section 245C.05, 
432.23 	subdivision 5, or as required under section 144.057, subdivision 1, clause (2); and
432.24 	(6) for a background study related to a child foster care application for licensure, a 
432.25 	transfer of permanent legal and physical custody of a child under sections 260C.503 to 
432.26 	260C.515, or adoptions, and for a background study required for family child care, certified 
432.27 	license-exempt child care, child care centers, and legal nonlicensed child care authorized 
432.28 	under chapter 119B, the commissioner shall also review:
432.29 	(i) information from the child abuse and neglect registry for any state in which the 
432.30 	background study subject has resided for the past five years; and
433.1 	(ii) information from national crime information databases, when the background study 
433.2 	subject is 18 years of age or older., information received following submission of fingerprints 
433.3 	for a national criminal history record check; and
433.4 	(7) for a background study required for family child care, certified license-exempt child 
433.5 	care centers, licensed child care centers, and legal nonlicensed child care authorized under 
433.6 	chapter 119B. The background study shall also include a name and date-of-birth search of 
433.7 	the National Sex Offender Public Web site.
433.8 	(b) Notwithstanding expungement by a court, the commissioner may consider information 
433.9 	obtained under paragraph (a), clauses (3) and (4), unless the commissioner received notice 
433.10 	of the petition for expungement and the court order for expungement is directed specifically 
433.11 	to the commissioner.
433.12 	(c) The commissioner shall also review criminal case information received according 
433.13 	to section 245C.04, subdivision 4a, from the Minnesota court information system that relates 
433.14 	to individuals who have already been studied under this chapter and who remain affiliated 
433.15 	with the agency that initiated the background study.
433.16 	(d) When the commissioner has reasonable cause to believe that the identity of a 
433.17 	background study subject is uncertain, the commissioner may require the subject to provide 
433.18 	a set of classifiable fingerprints for purposes of completing a fingerprint-based record check 
433.19 	with the Bureau of Criminal Apprehension. Fingerprints collected under this paragraph 
433.20 	shall not be saved by the commissioner after they have been used to verify the identity of 
433.21 	the background study subject against the particular criminal record in question.
433.22 	(e) The commissioner may inform the entity that initiated a background study under 
433.23 	NETStudy 2.0 of the status of processing of the subject's fingerprints.

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

433.25 	Sec. 31. Minnesota Statutes 2016, section 245C.08, subdivision 2, is amended to read:
433.26 		Subd. 2.Background studies conducted by a county agency for family child care.
 433.27 	(a) Before the implementation of NETStudy 2.0, for a background study conducted by a 
433.28 	county agency for family child care services, the commissioner shall review:
433.29 	(1) information from the county agency's record of substantiated maltreatment of adults 
433.30 	and the maltreatment of minors;
433.31 	(2) information from juvenile courts as required in subdivision 4 for:
434.1 	(i) individuals listed in section 245C.03, subdivision 1, paragraph (a), who are ages 13 
434.2 	through 23 living in the household where the licensed services will be provided; and
434.3 	(ii) any other individual listed under section 245C.03, subdivision 1, when there is 
434.4 	reasonable cause; and
434.5 	(3) information from the Bureau of Criminal Apprehension.
434.6 	(b) If the individual has resided in the county for less than five years, the study shall 
434.7 	include the records specified under paragraph (a) for the previous county or counties of 
434.8 	residence for the past five years.
434.9 	(c) Notwithstanding expungement by a court, the county agency may consider information 
434.10 	obtained under paragraph (a), clause (3), unless the commissioner received notice of the 
434.11 	petition for expungement and the court order for expungement is directed specifically to 
434.12 	the commissioner.

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

434.14 	Sec. 32. Minnesota Statutes 2016, section 245C.08, subdivision 4, is amended to read:
434.15 		Subd. 4.Juvenile court records. (a) For a background study conducted by the 
434.16 	Department of Human Services, the commissioner shall review records from the juvenile 
434.17 	courts for an individual studied under section 245C.03, subdivision 1, paragraph (a), when 
434.18 	the commissioner has reasonable cause.
434.19 	(b) For a background study conducted by a county agency for family child care before 
434.20 	the implementation of NETStudy 2.0, the commissioner shall review records from the 
434.21 	juvenile courts for individuals listed in section 245C.03, subdivision 1, who are ages 13 
434.22 	through 23 living in the household where the licensed services will be provided. The 
434.23 	commissioner shall also review records from juvenile courts for any other individual listed 
434.24 	under section 245C.03, subdivision 1, when the commissioner has reasonable cause.
434.25 	(c) The juvenile courts shall help with the study by giving the commissioner existing 
434.26 	juvenile court records relating to delinquency proceedings held on individuals described in 
434.27 	section 245C.03, subdivision 1, paragraph (a), when requested pursuant to this subdivision.
434.28 	(d) For purposes of this chapter, a finding that a delinquency petition is proven in juvenile 
434.29 	court shall be considered a conviction in state district court.
434.30 	(e) Juvenile courts shall provide orders of involuntary and voluntary termination of 
434.31 	parental rights under section 260C.301 to the commissioner upon request for purposes of 
434.32 	conducting a background study under this chapter.

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

435.2 	Sec. 33. Minnesota Statutes 2016, section 245C.09, is amended by adding a subdivision 
435.3 	to read:
435.4 		Subd. 3.False statement in connection with a background study. An individual shall 
435.5 	be disqualified for knowingly making a materially false statement in connection with a 
435.6 	background study.

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

435.8 	Sec. 34. Minnesota Statutes 2016, section 245C.10, subdivision 9, is amended to read:
435.9 		Subd. 9.Human services licensed programs. The commissioner shall recover the cost 
435.10 	of background studies required under section 245C.03, subdivision 1, for all programs that 
435.11 	are licensed by the commissioner, except child foster care and for certified license-exempt 
435.12 	child care centers, licensed child care centers, and legal nonlicensed care authorized under 
435.13 	chapter 119B, and licensed family child care, through a fee of no more than $20 per study 
435.14 	charged to the license holder. The fees collected under this subdivision are appropriated to 
435.15 	the commissioner for the purpose of conducting background studies.

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

435.17 	Sec. 35. Minnesota Statutes 2016, section 245C.10, is amended by adding a subdivision 
435.18 	to read:
435.19 		Subd. 9a.Child care programs. The commissioner shall recover the cost of a background 
435.20 	study required for family child care, certified license-exempt child care centers, licensed 
435.21 	child care centers, and legal nonlicensed child care providers authorized under chapter 119B 
435.22 	through a fee of no more than $30 per study charged to the license holder. The fees collected 
435.23 	under this subdivision are appropriated to the commissioner to conduct background studies.

435.24 	Sec. 36. Minnesota Statutes 2016, section 245C.11, subdivision 3, is amended to read:
435.25 		Subd. 3.Criminal history data. County agencies shall have access to the criminal 
435.26 	history data in the same manner as county licensing agencies under this chapter for purposes 
435.27 	of background studies completed before the implementation of NETStudy 2.0 by county 
435.28 	agencies on legal nonlicensed child care providers to determine eligibility for child care 
435.29 	funds under chapter 119B.

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

436.1 	Sec. 37. Minnesota Statutes 2016, section 245C.15, is amended to read:
436.2 	245C.15 DISQUALIFYING CRIMES OR CONDUCT.
436.3 		Subdivision 1.Permanent disqualification. (a) An individual is disqualified under 
436.4 	section 245C.14 if: (1) regardless of how much time has passed since the discharge of the 
436.5 	sentence imposed, if any, for the offense; and (2) unless otherwise specified, regardless of 
436.6 	the level of the offense, the individual has committed any of the following offenses: sections 
436.7 	243.166 (violation of predatory offender registration law); 609.185 (murder in the first 
436.8 	degree); 609.19 (murder in the second degree); 609.195 (murder in the third degree); 609.20
436.9 	(manslaughter in the first degree); 609.205 (manslaughter in the second degree); a felony 
436.10 	offense under 609.221 or 609.222 (assault in the first or second degree); a felony conviction 
436.11 	under section 609.223 or 609.2231 (assault in the third or fourth degree); a felony offense 
436.12 	under sections 609.2242 and 609.2243 (domestic assault), spousal abuse, child abuse or 
436.13 	neglect, or a crime against children; 609.2247 (domestic assault by strangulation); any 
436.14 	conviction under section 609.224 or 609.2242 (assault in the fifth degree or domestic assault) 
436.15 	for an offense committed by an adult against a child;609.228 (great bodily harm caused by 
436.16 	distribution of drugs); 609.245 (aggravated robbery); 609.25 (kidnapping); 609.2661 (murder 
436.17 	of an unborn child in the first degree); 609.2662 (murder of an unborn child in the second 
436.18 	degree); 609.2663 (murder of an unborn child in the third degree); 609.282 (labor trafficking);
436.19 	609.322 (solicitation, inducement, and promotion of prostitution); 609.324, subdivision 1
436.20 	(other prohibited acts); 609.342 (criminal sexual conduct in the first degree); 609.343
436.21 	(criminal sexual conduct in the second degree); 609.344 (criminal sexual conduct in the 
436.22 	third degree); 609.345 (criminal sexual conduct in the fourth degree); 609.3451 (criminal 
436.23 	sexual conduct in the fifth degree); 609.3453 (criminal sexual predatory conduct); 609.352
436.24 	(solicitation of children to engage in sexual conduct); 609.365 (incest); a felony offense 
436.25 	under 609.377 (malicious punishment of a child); a felony offense under 609.378 (neglect 
436.26 	or endangerment of a child); 609.561 (arson in the first degree); a felony conviction under 
436.27 	section 609.562 or 609.563 (arson in the second or third degree);609.66, subdivision 1e
436.28 	(drive-by shooting); 609.746, subdivision 1, paragraph (e) (interference with privacy 
436.29 	involving a minor);609.749, subdivision 3, 4, or 5 (felony-level stalking); 609.855, 
436.30 	subdivision 5 (shooting at or in a public transit vehicle or facility); 617.23, subdivision 2, 
436.31 	clause (1), or subdivision 3, clause (1) (indecent exposure involving a minor); 617.246 (use 
436.32 	of minors in sexual performance prohibited); or 617.247 (possession of pictorial 
436.33 	representations of minors); a felony-level conviction for a crime against a child or involving 
436.34 	child pornography. For a background study required for family child care, child care centers, 
437.1 	and legal nonlicensed child care authorized under chapter 119B, an individual is permanently 
437.2 	disqualified for a conviction at any level for child abuse or child neglect.
437.3 	(b) An individual's aiding and abetting, attempt, or conspiracy to commit any of the 
437.4 	offenses listed in paragraph (a), as each of these offenses is defined in Minnesota Statutes, 
437.5 	permanently disqualifies the individual under section 245C.14.
437.6 	(c) An individual's offense in any other state or country, where the elements of the offense 
437.7 	are substantially similar to any of the offenses listed in paragraph (a), permanently disqualifies 
437.8 	the individual under section 245C.14.
437.9 	(d) When a disqualification is based on a judicial determination other than a conviction, 
437.10 	the disqualification period begins from the date of the court order. When a disqualification 
437.11 	is based on an admission, the disqualification period begins from the date of an admission 
437.12 	in court. When a disqualification is based on an Alford Plea, the disqualification period 
437.13 	begins from the date the Alford Plea is entered in court. When a disqualification is based 
437.14 	on a preponderance of evidence of a disqualifying act, the disqualification date begins from 
437.15 	the date of the dismissal, the date of discharge of the sentence imposed for a conviction for 
437.16 	a disqualifying crime of similar elements, or the date of the incident, whichever occurs last.
437.17 	(e) If the individual studied commits one of the offenses listed in paragraph (a) that is 
437.18 	specified as a felony-level only offense, but the sentence or level of offense is a gross 
437.19 	misdemeanor or misdemeanor, the individual is disqualified, but the disqualification 
437.20 	look-back period for the offense is the period applicable to gross misdemeanor or 
437.21 	misdemeanor offenses.
437.22 	(f) An individual shall be disqualified as long as the individual is registered, or required 
437.23 	to be registered, on a state sex offender registry or repository or the National Sex Offender 
437.24 	Registry.
437.25 		Subd. 2.15-year disqualification. (a) An individual is disqualified under section 245C.14
437.26 	if: (1) less than 15 years have passed since the discharge of the sentence imposed, if any, 
437.27 	for the offense; and (2) the individual has committed a felony-level violation of any of the 
437.28 	following offenses: sections 256.98 (wrongfully obtaining assistance); 268.182 (false 
437.29 	representation; concealment of facts); 393.07, subdivision 10, paragraph (c) (federal Food 
437.30 	Stamp Program fraud); 609.165 (felon ineligible to possess firearm); 609.2112, 609.2113, 
437.31 	or 609.2114 (criminal vehicular homicide or injury); 609.215 (suicide); a preponderance 
437.32 	of evidence of609.223 or 609.2231 (assault in the third or fourth degree); repeat offenses 
437.33 	under 609.224 (assault in the fifth degree); 609.229 (crimes committed for benefit of a 
437.34 	gang); 609.2325 (criminal abuse of a vulnerable adult); 609.2335 (financial exploitation of 
438.1 	a vulnerable adult); 609.235 (use of drugs to injure or facilitate crime); 609.24 (simple 
438.2 	robbery); 609.255 (false imprisonment); 609.2664 (manslaughter of an unborn child in the 
438.3 	first degree); 609.2665 (manslaughter of an unborn child in the second degree); 609.267
438.4 	(assault of an unborn child in the first degree); 609.2671 (assault of an unborn child in the 
438.5 	second degree); 609.268 (injury or death of an unborn child in the commission of a crime); 
438.6 	609.27 (coercion); 609.275 (attempt to coerce); 609.466 (medical assistance fraud); 609.495
438.7 	(aiding an offender); 609.498, subdivision 1 or 1b (aggravated first-degree or first-degree 
438.8 	tampering with a witness); 609.52 (theft); 609.521 (possession of shoplifting gear); 609.525
438.9 	(bringing stolen goods into Minnesota); 609.527 (identity theft); 609.53 (receiving stolen 
438.10 	property); 609.535 (issuance of dishonored checks); a preponderance of evidence of609.562
438.11 	(arson in the second degree); a preponderance of evidence of609.563 (arson in the third 
438.12 	degree); 609.582 (burglary); 609.59 (possession of burglary tools); 609.611 (insurance 
438.13 	fraud); 609.625 (aggravated forgery); 609.63 (forgery); 609.631 (check forgery; offering a 
438.14 	forged check); 609.635 (obtaining signature by false pretense); 609.66 (dangerous weapons); 
438.15 	609.67 (machine guns and short-barreled shotguns); 609.687 (adulteration); 609.71 (riot); 
438.16 	609.713 (terroristic threats); 609.82 (fraud in obtaining credit); 609.821 (financial transaction 
438.17 	card fraud); 617.23 (indecent exposure), not involving a minor; repeat offenses under 617.241
438.18 	(obscene materials and performances; distribution and exhibition prohibited; penalty); 
438.19 	624.713 (certain persons not to possess firearms); chapter 152 (drugs; controlled substance); 
438.20 	or Minnesota Statutes 2012, section 609.21; or a felony-level conviction involving alcohol 
438.21 	or drug use.
438.22 	(b) An individual is disqualified under section 245C.14 if less than 15 years has passed 
438.23 	since the individual's aiding and abetting, attempt, or conspiracy to commit any of the 
438.24 	offenses listed in paragraph (a), as each of these offenses is defined in Minnesota Statutes.
438.25 	(c) An individual is disqualified under section 245C.14 if less than 15 years has passed 
438.26 	since the termination of the individual's parental rights under section 260C.301, subdivision 
438.27 	1, paragraph (b), or subdivision 3.
438.28 	(d) An individual is disqualified under section 245C.14 if less than 15 years has passed 
438.29 	since the discharge of the sentence imposed for an offense in any other state or country, the 
438.30 	elements of which are substantially similar to the elements of the offenses listed in paragraph 
438.31 	(a).
438.32 	(e) If the individual studied commits one of the offenses listed in paragraph (a), but the 
438.33 	sentence or level of offense is a gross misdemeanor or misdemeanor, the individual is 
438.34 	disqualified but the disqualification look-back period for the offense is the period applicable 
438.35 	to the gross misdemeanor or misdemeanor disposition.
439.1 	(f) When a disqualification is based on a judicial determination other than a conviction, 
439.2 	the disqualification period begins from the date of the court order. When a disqualification 
439.3 	is based on an admission, the disqualification period begins from the date of an admission 
439.4 	in court. When a disqualification is based on an Alford Plea, the disqualification period 
439.5 	begins from the date the Alford Plea is entered in court. When a disqualification is based 
439.6 	on a preponderance of evidence of a disqualifying act, the disqualification date begins from 
439.7 	the date of the dismissal, the date of discharge of the sentence imposed for a conviction for 
439.8 	a disqualifying crime of similar elements, or the date of the incident, whichever occurs last.
439.9 		Subd. 3.Ten-year disqualification. (a) An individual is disqualified under section 
439.10 	245C.14 if: (1) less than ten years have passed since the discharge of the sentence imposed, 
439.11 	if any, for the offense; and (2) the individual has committed a gross misdemeanor-level 
439.12 	violation of any of the following offenses: sections 256.98 (wrongfully obtaining assistance); 
439.13 	268.182 (false representation; concealment of facts); 393.07, subdivision 10, paragraph (c) 
439.14 	(federal Food Stamp Program fraud); 609.2112, 609.2113, or 609.2114 (criminal vehicular 
439.15 	homicide or injury); 609.221 or 609.222 (assault in the first or second degree); 609.223 or 
439.16 	609.2231 (assault in the third or fourth degree); 609.224 (assault in the fifth degree not by 
439.17 	an adult against a minor); 609.224, subdivision 2, paragraph (c) (assault in the fifth degree 
439.18 	by a caregiver against a vulnerable adult); 609.2242 and 609.2243 (domestic assault not by 
439.19 	an adult against a minor); 609.23 (mistreatment of persons confined); 609.231 (mistreatment 
439.20 	of residents or patients); 609.2325 (criminal abuse of a vulnerable adult); 609.233 (criminal 
439.21 	neglect of a vulnerable adult); 609.2335 (financial exploitation of a vulnerable adult); 
439.22 	609.234 (failure to report maltreatment of a vulnerable adult); 609.265 (abduction); 609.275
439.23 	(attempt to coerce); 609.324, subdivision 1a (other prohibited acts; minor engaged in 
439.24 	prostitution); 609.33 (disorderly house); 609.377 (malicious punishment of a child); 609.378
439.25 	(neglect or endangerment of a child); 609.466 (medical assistance fraud); 609.52 (theft); 
439.26 	609.525 (bringing stolen goods into Minnesota); 609.527 (identity theft); 609.53 (receiving 
439.27 	stolen property); 609.535 (issuance of dishonored checks); 609.582 (burglary); 609.59
439.28 	(possession of burglary tools); 609.611 (insurance fraud); 609.631 (check forgery; offering 
439.29 	a forged check); 609.66 (dangerous weapons); 609.71 (riot); 609.72, subdivision 3 (disorderly 
439.30 	conduct against a vulnerable adult); repeat gross-misdemeanor level offenses under 609.746
439.31 	(interference with privacy); 609.749, subdivision 2 (stalking); 609.82 (fraud in obtaining 
439.32 	credit); 609.821 (financial transaction card fraud); 617.23 (indecent exposure), not involving 
439.33 	a minor; 617.241 (obscene materials and performances); 617.243 (indecent literature, 
439.34 	distribution); 617.293 (harmful materials; dissemination and display to minors prohibited); 
439.35 	or Minnesota Statutes 2012, section 609.21; or violation of an order for protection under 
439.36 	section 518B.01, subdivision 14.
440.1 	(b) An individual is disqualified under section 245C.14 if less than ten years has passed 
440.2 	since the individual's aiding and abetting, attempt, or conspiracy to commit any of the 
440.3 	offenses listed in paragraph (a), as each of these offenses is defined in Minnesota Statutes.
440.4 	(c) An individual is disqualified under section 245C.14 if less than ten years has passed 
440.5 	since the discharge of the sentence imposed for an offense in any other state or country, the 
440.6 	elements of which are substantially similar to the elements of any of the offenses listed in 
440.7 	paragraph (a).
440.8 	(d) If the individual studied commits one of the offenses listed in paragraph (a), but the 
440.9 	sentence or level of offense is a misdemeanor disposition, the individual is disqualified but 
440.10 	the disqualification lookback period for the offense is the period applicable to misdemeanors.
440.11 	(e) When a disqualification is based on a judicial determination other than a conviction, 
440.12 	the disqualification period begins from the date of the court order. When a disqualification 
440.13 	is based on an admission, the disqualification period begins from the date of an admission 
440.14 	in court. When a disqualification is based on an Alford Plea, the disqualification period 
440.15 	begins from the date the Alford Plea is entered in court. When a disqualification is based 
440.16 	on a preponderance of evidence of a disqualifying act, the disqualification date begins from 
440.17 	the date of the dismissal, the date of discharge of the sentence imposed for a conviction for 
440.18 	a disqualifying crime of similar elements, or the date of the incident, whichever occurs last.
440.19 		Subd. 4.Seven-year disqualification. (a) An individual is disqualified under section 
440.20 	245C.14 if: (1) less than seven years has passed since the discharge of the sentence imposed, 
440.21 	if any, for the offense; and (2) the individual has committed a misdemeanor-level violation 
440.22 	of any of the following offenses: sections 256.98 (wrongfully obtaining assistance); 268.182
440.23 	(false representation; concealment of facts); 393.07, subdivision 10, paragraph (c) (federal 
440.24 	Food Stamp Program fraud); 609.2112, 609.2113, or 609.2114 (criminal vehicular homicide 
440.25 	or injury); 609.221 (assault in the first degree); 609.222 (assault in the second degree); 
440.26 	609.223 (assault in the third degree); 609.2231 (assault in the fourth degree); 609.224 (assault 
440.27 	in the fifth degree not by an adult against a minor); 609.2242 (domestic assault not by an 
440.28 	adult against a minor); 609.2335 (financial exploitation of a vulnerable adult); 609.234
440.29 	(failure to report maltreatment of a vulnerable adult); 609.2672 (assault of an unborn child 
440.30 	in the third degree); 609.27 (coercion); violation of an order for protection under 609.3232
440.31 	(protective order authorized; procedures; penalties); 609.466 (medical assistance fraud); 
440.32 	609.52 (theft); 609.525 (bringing stolen goods into Minnesota); 609.527 (identity theft); 
440.33 	609.53 (receiving stolen property); 609.535 (issuance of dishonored checks); 609.611
440.34 	(insurance fraud); 609.66 (dangerous weapons); 609.665 (spring guns); 609.746 (interference 
440.35 	with privacy); 609.79 (obscene or harassing telephone calls); 609.795 (letter, telegram, or 
441.1 	package; opening; harassment); 609.82 (fraud in obtaining credit); 609.821 (financial 
441.2 	transaction card fraud); 617.23 (indecent exposure), not involving a minor; 617.293 (harmful 
441.3 	materials; dissemination and display to minors prohibited); or Minnesota Statutes 2012, 
441.4 	section 609.21; or violation of an order for protection under section 518B.01 (Domestic 
441.5 	Abuse Act).
441.6 	(b) An individual is disqualified under section 245C.14 if less than seven years has 
441.7 	passed since a determination or disposition of the individual's:
441.8 	(1) failure to make required reports under section 626.556, subdivision 3, or 626.557, 
441.9 	subdivision 3, for incidents in which: (i) the final disposition under section 626.556 or 
441.10 	626.557 was substantiated maltreatment, and (ii) the maltreatment was recurring or serious; 
441.11 	or
441.12 	(2) substantiated serious or recurring maltreatment of a minor under section 626.556, a 
441.13 	vulnerable adult under section 626.557, or serious or recurring maltreatment in any other 
441.14 	state, the elements of which are substantially similar to the elements of maltreatment under 
441.15 	section 626.556 or 626.557 for which: (i) there is a preponderance of evidence that the 
441.16 	maltreatment occurred, and (ii) the subject was responsible for the maltreatment.
441.17 	(c) An individual is disqualified under section 245C.14 if less than seven years has 
441.18 	passed since the individual's aiding and abetting, attempt, or conspiracy to commit any of 
441.19 	the offenses listed in paragraphs (a) and (b), as each of these offenses is defined in Minnesota 
441.20 	Statutes.
441.21 	(d) An individual is disqualified under section 245C.14 if less than seven years has 
441.22 	passed since the discharge of the sentence imposed for an offense in any other state or 
441.23 	country, the elements of which are substantially similar to the elements of any of the offenses 
441.24 	listed in paragraphs (a) and (b).
441.25 	(e) When a disqualification is based on a judicial determination other than a conviction, 
441.26 	the disqualification period begins from the date of the court order. When a disqualification 
441.27 	is based on an admission, the disqualification period begins from the date of an admission 
441.28 	in court. When a disqualification is based on an Alford Plea, the disqualification period 
441.29 	begins from the date the Alford Plea is entered in court. When a disqualification is based 
441.30 	on a preponderance of evidence of a disqualifying act, the disqualification date begins from 
441.31 	the date of the dismissal, the date of discharge of the sentence imposed for a conviction for 
441.32 	a disqualifying crime of similar elements, or the date of the incident, whichever occurs last.
441.33 	(f) An individual is disqualified under section 245C.14 if less than seven years has passed 
441.34 	since the individual was disqualified under section 256.98, subdivision 8.
442.1 		Subd. 5.Mental illness. The commissioner may not disqualify an individual subject to 
442.2 	a background study under this chapter because that individual has, or has had, a mental 
442.3 	illness as defined in section 245.462, subdivision 20.

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

442.5 	Sec. 38. Minnesota Statutes 2016, section 245C.16, subdivision 1, is amended to read:
442.6 		Subdivision 1.Determining immediate risk of harm. (a) If the commissioner determines 
442.7 	that the individual studied has a disqualifying characteristic, the commissioner shall review 
442.8 	the information immediately available and make a determination as to the subject's immediate 
442.9 	risk of harm to persons served by the program where the individual studied will have direct 
442.10 	contact with, or access to, people receiving services.
442.11 	(b) The commissioner shall consider all relevant information available, including the 
442.12 	following factors in determining the immediate risk of harm:
442.13 	(1) the recency of the disqualifying characteristic;
442.14 	(2) the recency of discharge from probation for the crimes;
442.15 	(3) the number of disqualifying characteristics;
442.16 	(4) the intrusiveness or violence of the disqualifying characteristic;
442.17 	(5) the vulnerability of the victim involved in the disqualifying characteristic;
442.18 	(6) the similarity of the victim to the persons served by the program where the individual 
442.19 	studied will have direct contact;
442.20 	(7) whether the individual has a disqualification from a previous background study that 
442.21 	has not been set aside; and
442.22 	(8) if the individual has a disqualification which may not be set aside because it is a 
442.23 	permanent bar under section 245C.24, subdivision 1, or the individual has a felony-level 
442.24 	conviction for a drug-related offense in the last five years, the commissioner may order the 
442.25 	immediate removal of the individual from any position allowing direct contact with, or 
442.26 	access to, persons receiving services from the program.
442.27 	(c) This section does not apply when the subject of a background study is regulated by 
442.28 	a health-related licensing board as defined in chapter 214, and the subject is determined to 
442.29 	be responsible for substantiated maltreatment under section 626.556 or 626.557.
442.30 	(d) This section does not apply to a background study related to an initial application 
442.31 	for a child foster care license.
443.1 	(e) Except for paragraph (f), this section does not apply to a background study that is 
443.2 	also subject to the requirements under section 256B.0659, subdivisions 11 and 13, for a 
443.3 	personal care assistant or a qualified professional as defined in section 256B.0659, 
443.4 	subdivision 1.
443.5 	(f) If the commissioner has reason to believe, based on arrest information or an active 
443.6 	maltreatment investigation, that an individual poses an imminent risk of harm to persons 
443.7 	receiving services, the commissioner may order that the person be continuously supervised 
443.8 	or immediately removed pending the conclusion of the maltreatment investigation or criminal 
443.9 	proceedings.

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

443.11 	Sec. 39. Minnesota Statutes 2016, section 245C.17, subdivision 6, is amended to read:
443.12 		Subd. 6.Notice to county agency. For studies on individuals related to a license to 
443.13 	provide adult foster care and family adult day services and, effective upon implementation 
443.14 	of NETStudy 2.0, family child care and legal nonlicensed child care authorized under chapter 
443.15 	119B, the commissioner shall also provide a notice of the background study results to the 
443.16 	county agency that initiated the background study.

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

443.18 	Sec. 40. Minnesota Statutes 2016, section 245C.21, subdivision 1, is amended to read:
443.19 		Subdivision 1.Who may request reconsideration. An individual who is the subject of 
443.20 	a disqualification may request a reconsideration of the disqualification pursuant to this 
443.21 	section. The individual must submit the request for reconsideration to the commissioner in 
443.22 	writing.

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

443.24 	Sec. 41. Minnesota Statutes 2016, section 245C.22, subdivision 5, is amended to read:
443.25 		Subd. 5.Scope of set-aside. (a) If the commissioner sets aside a disqualification under 
443.26 	this section, the disqualified individual remains disqualified, but may hold a license and 
443.27 	have direct contact with or access to persons receiving services. Except as provided in 
443.28 	paragraph (b), the commissioner's set-aside of a disqualification is limited solely to the 
443.29 	licensed program, applicant, or agency specified in the set aside notice under section 245C.23. 
443.30 	For personal care provider organizations, the commissioner's set-aside may further be limited 
443.31 	to a specific individual who is receiving services. For new background studies required 
444.1 	under section 245C.04, subdivision 1, paragraph (g) (h), if an individual's disqualification 
444.2 	was previously set aside for the license holder's program and the new background study 
444.3 	results in no new information that indicates the individual may pose a risk of harm to persons 
444.4 	receiving services from the license holder, the previous set-aside shall remain in effect.
444.5 	(b) If the commissioner has previously set aside an individual's disqualification for one 
444.6 	or more programs or agencies, and the individual is the subject of a subsequent background 
444.7 	study for a different program or agency, the commissioner shall determine whether the 
444.8 	disqualification is set aside for the program or agency that initiated the subsequent 
444.9 	background study. A notice of a set-aside under paragraph (c) shall be issued within 15 
444.10 	working days if all of the following criteria are met:
444.11 	(1) the subsequent background study was initiated in connection with a program licensed 
444.12 	or regulated under the same provisions of law and rule for at least one program for which 
444.13 	the individual's disqualification was previously set aside by the commissioner;
444.14 	(2) the individual is not disqualified for an offense specified in section 245C.15, 
444.15 	subdivision 1 or 2;
444.16 	(3) the commissioner has received no new information to indicate that the individual 
444.17 	may pose a risk of harm to any person served by the program; and
444.18 	(4) the previous set-aside was not limited to a specific person receiving services.
444.19 	(c) When a disqualification is set aside under paragraph (b), the notice of background 
444.20 	study results issued under section 245C.17, in addition to the requirements under section 
444.21 	245C.17, shall state that the disqualification is set aside for the program or agency that 
444.22 	initiated the subsequent background study. The notice must inform the individual that the 
444.23 	individual may request reconsideration of the disqualification under section 245C.21 on the 
444.24 	basis that the information used to disqualify the individual is incorrect.

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

444.26 	Sec. 42. Minnesota Statutes 2016, section 245C.22, subdivision 7, is amended to read:
444.27 		Subd. 7.Classification of certain data. (a) Notwithstanding section 13.46, except as 
444.28 	provided in paragraph (f), upon setting aside a disqualification under this section, the identity 
444.29 	of the disqualified individual who received the set-aside and the individual's disqualifying 
444.30 	characteristics are public data if the set-aside was:
444.31 	(1) for any disqualifying characteristic under section 245C.15, except a felony-level 
444.32 	conviction for a drug-related offense within the past five years, when the set-aside relates 
445.1 	to a child care center or a family child care provider licensed under chapter 245A, certified 
445.2 	license-exempt child care center, or legal nonlicensed family child care center; or
445.3 	(2) for a disqualifying characteristic under section 245C.15, subdivision 2.
445.4 	(b) Notwithstanding section 13.46, upon granting a variance to a license holder under 
445.5 	section 245C.30, the identity of the disqualified individual who is the subject of the variance, 
445.6 	the individual's disqualifying characteristics under section 245C.15, and the terms of the 
445.7 	variance are public data, except as provided in paragraph (c), clause (6), when the variance:
445.8 	(1) is issued to a child care center or a family child care provider licensed under chapter 
445.9 	245A; or
445.10 	(2) relates to an individual with a disqualifying characteristic under section 245C.15, 
445.11 	subdivision 2.
445.12 	(c) The identity of a disqualified individual and the reason for disqualification remain 
445.13 	private data when:
445.14 	(1) a disqualification is not set aside and no variance is granted, except as provided under 
445.15 	section 13.46, subdivision 4;
445.16 	(2) the data are not public under paragraph (a) or (b);
445.17 	(3) the disqualification is rescinded because the information relied upon to disqualify 
445.18 	the individual is incorrect;
445.19 	(4) the disqualification relates to a license to provide relative child foster care. As used 
445.20 	in this clause, "relative" has the meaning given it under section 260C.007, subdivision 26b 
445.21 	or 27; or
445.22 	(5) the disqualified individual is a household member of a licensed foster care provider 
445.23 	and:
445.24 	(i) the disqualified individual previously received foster care services from this licensed 
445.25 	foster care provider;
445.26 	(ii) the disqualified individual was subsequently adopted by this licensed foster care 
445.27 	provider; and
445.28 	(iii) the disqualifying act occurred before the adoption; or
445.29 	(6) a variance is granted to a child care center or family child care license holder for an 
445.30 	individual's disqualification that is based on a felony-level conviction for a drug-related 
445.31 	offense that occurred within the past five years.
446.1 	(d) Licensed family child care providers and child care centers must provide notices as 
446.2 	required under section 245C.301.
446.3 	(e) Notwithstanding paragraphs (a) and (b), the identity of household members who are 
446.4 	the subject of a disqualification related set-aside or variance is not public data if:
446.5 	(1) the household member resides in the residence where the family child care is provided;
446.6 	(2) the subject of the set-aside or variance is under the age of 18 years; and
446.7 	(3) the set-aside or variance only relates to a disqualification under section 245C.15, 
446.8 	subdivision 4, for a misdemeanor-level theft crime as defined in section 609.52.
446.9 	(f) When the commissioner has reason to know that a disqualified individual has received 
446.10 	an order for expungement for the disqualifying record that does not limit the commissioner's 
446.11 	access to the record, and the record was opened or exchanged with the commissioner for 
446.12 	purposes of a background study under this chapter, the data that would otherwise become 
446.13 	public under paragraph (a) or (b) remain private data.

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

446.15 	Sec. 43. Minnesota Statutes 2016, section 245C.23, is amended to read:
446.16 	245C.23 COMMISSIONER'S RECONSIDERATION NOTICE.
446.17 		Subdivision 1.Disqualification that is rescinded or set aside. (a) If the commissioner 
446.18 	rescinds or sets aside a disqualification, the commissioner shall notify the applicant, license 
446.19 	holder, or other entity in writing or by electronic transmission of the decision.
446.20 	(b) In the notice from the commissioner that a disqualification has been rescinded, the 
446.21 	commissioner must inform the applicant, license holder, or other entity that the information 
446.22 	relied upon to disqualify the individual was incorrect.
446.23 	(c) Except as provided in paragraph paragraphs (d) and (e), in the notice from the 
446.24 	commissioner that a disqualification has been set aside, the commissioner must inform the 
446.25 	applicant, license holder, or other entity of the reason for the individual's disqualification 
446.26 	and that information about which factors under section 245C.22, subdivision 4, were the 
446.27 	basis of the decision to set aside the disqualification are available to the license holder upon 
446.28 	request without the consent of the background study subject.
446.29 	(d) When the commissioner has reason to know that a disqualified individual has received 
446.30 	an order for expungement for the disqualifying record that does not limit the commissioner's 
446.31 	access to the record, and the record was opened or exchanged with the commissioner for 
446.32 	purposes of a background study under this chapter, the information provided under paragraph 
447.1 	(c) must only inform the applicant, license holder, or other entity that the disqualifying 
447.2 	criminal record is sealed under a court order.
447.3 	(e) The notification requirements in paragraph (c) do not apply when the set aside is 
447.4 	granted to an individual related to a background study for a licensed child care center, 
447.5 	certified license-exempt child care center, or family child care license holder, or for a legal 
447.6 	nonlicensed child care provider authorized under chapter 119B, and the individual is 
447.7 	disqualified for a felony-level conviction for a drug-related offense that occurred within the 
447.8 	past five years. The notice that the individual's disqualification is set aside must inform the 
447.9 	applicant, license holder, or legal nonlicensed child care provider that the disqualifying 
447.10 	criminal record is not public.
447.11 		Subd. 2.Commissioner's notice of disqualification that is not set aside. (a) The 
447.12 	commissioner shall notify the license holder of the disqualification and order the license 
447.13 	holder to immediately remove the individual from any position allowing direct contact with 
447.14 	persons receiving services from the license holder if:
447.15 	(1) the individual studied does not submit a timely request for reconsideration under 
447.16 	section 245C.21;
447.17 	(2) the individual submits a timely request for reconsideration, but the commissioner 
447.18 	does not set aside the disqualification for that license holder under section 245C.22, unless 
447.19 	the individual has a right to request a hearing under section 245C.27, 245C.28, or 256.045;
447.20 	(3) an individual who has a right to request a hearing under sections 245C.27 and 256.045, 
447.21 	or 245C.28 and chapter 14 for a disqualification that has not been set aside, does not request 
447.22 	a hearing within the specified time; or
447.23 	(4) an individual submitted a timely request for a hearing under sections 245C.27 and 
447.24 	256.045, or 245C.28 and chapter 14, but the commissioner does not set aside the 
447.25 	disqualification under section 245A.08, subdivision 5, or 256.045.
447.26 	(b) If the commissioner does not set aside the disqualification under section 245C.22, 
447.27 	and the license holder was previously ordered under section 245C.17 to immediately remove 
447.28 	the disqualified individual from direct contact with persons receiving services or to ensure 
447.29 	that the individual is under continuous, direct supervision when providing direct contact 
447.30 	services, the order remains in effect pending the outcome of a hearing under sections 245C.27
447.31 	and 256.045, or 245C.28 and chapter 14.
447.32 	(c) If the commissioner does not set aside the disqualification under section 245C.22, 
447.33 	and the license holder was not previously ordered under section 245C.17 to immediately 
448.1 	remove the disqualified individual from direct contact with persons receiving services or 
448.2 	to ensure that the individual is under continuous direct supervision when providing direct 
448.3 	contact services, the commissioner shall order the individual to remain under continuous 
448.4 	direct supervision pending the outcome of a hearing under sections 245C.27 and 256.045, 
448.5 	or 245C.28 and chapter 14.
448.6 	(d) For background studies related to child foster care, the commissioner shall also notify 
448.7 	the county or private agency that initiated the study of the results of the reconsideration.
448.8 	(e) For background studies related to family child care, legal nonlicensed child care, 
448.9 	adult foster care, and family adult day services, the commissioner shall also notify the county 
448.10 	that initiated the study of the results of the reconsideration.

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

448.12 	Sec. 44. Minnesota Statutes 2016, section 245C.24, subdivision 3, is amended to read:
448.13 		Subd. 3.Ten-year bar to set aside disqualification. (a) The commissioner may not set 
448.14 	aside the disqualification of an individual in connection with a license to provide family 
448.15 	child care for children, foster care for children in the provider's home, or foster care or day 
448.16 	care services for adults in the provider's home if: (1) less than ten years has passed since 
448.17 	the discharge of the sentence imposed, if any, for the offense; or (2) when disqualified based 
448.18 	on a preponderance of evidence determination under section 245C.14, subdivision 1, 
448.19 	paragraph (a), clause (2), or an admission under section 245C.14, subdivision 1, paragraph 
448.20 	(a), clause (1), and less than ten years has passed since the individual committed the act or 
448.21 	admitted to committing the act, whichever is later; and (3) the individual has committed a 
448.22 	violation of any of the following offenses: sections 609.165 (felon ineligible to possess 
448.23 	firearm); criminal vehicular homicide or criminal vehicular operation causing death under 
448.24 	609.2112, 609.2113, or 609.2114 (criminal vehicular homicide or injury); 609.215 (aiding 
448.25 	suicide or aiding attempted suicide); preponderance of evidence of felony violations under 
448.26 	609.223 or 609.2231 (assault in the third or fourth degree); 609.229 (crimes committed for 
448.27 	benefit of a gang); 609.713 (terroristic threats); 609.235 (use of drugs to injure or to facilitate 
448.28 	crime); 609.24 (simple robbery); 609.255 (false imprisonment); 609.562 (arson in the second 
448.29 	degree); 609.71 (riot); 609.498, subdivision 1 or 1b (aggravated first-degree or first-degree 
448.30 	tampering with a witness); burglary in the first or second degree under 609.582 (burglary); 
448.31 	609.66 (dangerous weapon); 609.665 (spring guns); 609.67 (machine guns and short-barreled 
448.32 	shotguns); 609.749, subdivision 2 (gross misdemeanor stalking); 152.021 or 152.022
448.33 	(controlled substance crime in the first or second degree); 152.023, subdivision 1, clause 
448.34 	(3) or (4) or subdivision 2, clause (4) (controlled substance crime in the third degree); 
449.1 	152.024, subdivision 1, clause (2), (3), or (4) (controlled substance crime in the fourth 
449.2 	degree); 609.224, subdivision 2, paragraph (c) (fifth-degree assault by a caregiver against 
449.3 	a vulnerable adult); 609.23 (mistreatment of persons confined); 609.231 (mistreatment of 
449.4 	residents or patients); 609.2325 (criminal abuse of a vulnerable adult); 609.233 (criminal 
449.5 	neglect of a vulnerable adult); 609.2335 (financial exploitation of a vulnerable adult); 
449.6 	609.234 (failure to report); 609.265 (abduction); 609.2664 to 609.2665 (manslaughter of 
449.7 	an unborn child in the first or second degree); 609.267 to 609.2672 (assault of an unborn 
449.8 	child in the first, second, or third degree); 609.268 (injury or death of an unborn child in 
449.9 	the commission of a crime); repeat offenses under 617.23 (indecent exposure); 617.293
449.10 	(disseminating or displaying harmful material to minors); a felony-level conviction involving 
449.11 	alcohol or drug use, a gross misdemeanor offense under 609.324, subdivision 1 (other 
449.12 	prohibited acts); a gross misdemeanor offense under 609.378 (neglect or endangerment of 
449.13 	a child); a gross misdemeanor offense under 609.377 (malicious punishment of a child); 
449.14 	609.72, subdivision 3 (disorderly conduct against a vulnerable adult); or 624.713 (certain 
449.15 	persons not to possess firearms); or Minnesota Statutes 2012, section 609.21.
449.16 	(b) The commissioner may not set aside the disqualification of an individual if less than 
449.17 	ten years have passed since the individual's aiding and abetting, attempt, or conspiracy to 
449.18 	commit any of the offenses listed in paragraph (a) as each of these offenses is defined in 
449.19 	Minnesota Statutes.
449.20 	(c) The commissioner may not set aside the disqualification of an individual if less than 
449.21 	ten years have passed since the discharge of the sentence imposed for an offense in any 
449.22 	other state or country, the elements of which are substantially similar to the elements of any 
449.23 	of the offenses listed in paragraph (a).

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

449.25 	Sec. 45. Minnesota Statutes 2016, section 245C.25, is amended to read:
449.26 	245C.25 CONSOLIDATED RECONSIDERATION OF MALTREATMENT 
449.27 	DETERMINATION AND DISQUALIFICATION.
449.28 	(a) If an individual is disqualified on the basis of a determination of maltreatment under 
449.29 	section 626.556 or 626.557, which was serious or recurring, and the individual requests 
449.30 	reconsideration of the maltreatment determination under section 626.556, subdivision 10i, 
449.31 	or 626.557, subdivision 9d, and also requests reconsideration of the disqualification under 
449.32 	section 245C.21, the commissioner shall consolidate the reconsideration of the maltreatment 
449.33 	determination and the disqualification into a single reconsideration.
450.1 	(b) For maltreatment and disqualification determinations made by county agencies, the 
450.2 	county agency shall conduct the consolidated reconsideration. If the county agency has 
450.3 	disqualified an individual on multiple bases, one of which is a county maltreatment 
450.4 	determination for which the individual has a right to request reconsideration, the county 
450.5 	shall conduct the reconsideration of all disqualifications.
450.6 	(c) If the county has previously conducted a consolidated reconsideration under paragraph 
450.7 	(b) of a maltreatment determination and a disqualification based on serious or recurring 
450.8 	maltreatment, and the county subsequently disqualifies the individual based on that 
450.9 	determination, the county shall conduct the reconsideration of the subsequent disqualification. 
450.10 	The scope of the subsequent disqualification shall be limited to whether the individual poses 
450.11 	a risk of harm in accordance with section 245C.22, subdivision 4. If the commissioner 
450.12 	subsequently disqualifies the individual in connection with a child foster care license based 
450.13 	on the county's previous maltreatment determination, the commissioner shall conduct the 
450.14 	reconsideration of the subsequent disqualification.

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

450.16 	Sec. 46. Minnesota Statutes 2016, section 245C.30, subdivision 2, is amended to read:
450.17 		Subd. 2.Disclosure of reason for disqualification. (a) The commissioner may not grant 
450.18 	a variance for a disqualified individual unless the applicant or license holder requests the 
450.19 	variance and the disqualified individual provides written consent for the commissioner to 
450.20 	disclose to the applicant or license holder the reason for the disqualification.
450.21 	(b) This subdivision does not apply to programs licensed to provide family child care 
450.22 	for children, foster care for children in the provider's own home, or foster care or day care 
450.23 	services for adults in the provider's own home. When the commissioner grants a variance 
450.24 	for a disqualified individual in connection with a license to provide the services specified 
450.25 	in this paragraph, the disqualified individual's consent is not required to disclose the reason 
450.26 	for the disqualification to the license holder in the variance issued under subdivision 1, 
450.27 	provided that the commissioner may not disclose the reason for the disqualification if the 
450.28 	disqualification is based on a felony-level conviction for a drug-related offense within the 
450.29 	past five years.

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

451.1 	Sec. 47. [245G.01] DEFINITIONS.
451.2 		Subdivision 1.Scope. The terms used in this chapter have the meanings given in this 
451.3 	section.
451.4 		Subd. 2.Applicant. "Applicant" means an individual or organization that is subject to 
451.5 	certification under this chapter and that applied for but is not yet granted certification under 
451.6 	this chapter.
451.7 		Subd. 3.Center operator or program operator. "Center operator" or "program operator" 
451.8 	means the person exercising supervision or control over the center's or program's operations, 
451.9 	planning, and functioning. There may be more than one designated center operator or 
451.10 	program operator.
451.11 		Subd. 4.Certification holder. "Certification holder" means the individual or organization 
451.12 	that is legally responsible for the operation of the center, and granted certification by the 
451.13 	commissioner under this chapter.
451.14 		Subd. 5.Certified license-exempt child care center. "Certified license-exempt child 
451.15 	care center" means the commissioner's written authorization for a child care center excluded 
451.16 	from licensure under section 245A.03, subdivision 2, paragraph (a), clause (5), (11) to (13), 
451.17 	(15), (18), or (26), to register to receive child care assistance payments under chapter 119B.
451.18 		Subd. 6.Disinfecting. "Disinfecting" means the use of a product capable of destroying 
451.19 	or inactivating harmful germs, except bacterial spores, consistent with label directions on 
451.20 	environmental surfaces including bathroom toilets and floors, diaper-changing surfaces, 
451.21 	and surfaces exposed to blood or other bodily fluids.

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

451.23 	Sec. 48. [245G.02] WHO MUST BE CERTIFIED.
451.24 	A program that is exempt from licensure under section 245A.03, subdivision 2, paragraph 
451.25 	(a), clause (5), (11) to (13), (15), (18), or (26), and is authorized to receive child care 
451.26 	assistance payments under chapter 119B, must be a certified license-exempt child care 
451.27 	center according to this section.

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

452.1 	Sec. 49. [245G.03] APPLICATION PROCEDURES.
452.2 		Subdivision 1.Schedule. The certification of license-exempt child care centers shall be 
452.3 	implemented by September 30, 2017. Certification applications shall be received and 
452.4 	processed on a phased-in schedule as determined by the commissioner.
452.5 		Subd. 2.Application submission. The commissioner shall provide application 
452.6 	instructions and information about the rules and requirements of other state agencies that 
452.7 	affect the applicant. The certification application must be submitted in a manner prescribed 
452.8 	by the commissioner. The commissioner shall act on the application within 90 working days 
452.9 	of receiving a completed application.
452.10 		Subd. 3.Incomplete applications. When the commissioner receives an application for 
452.11 	initial certification that is incomplete because the applicant failed to submit required 
452.12 	documents or is deficient because the documents submitted do not meet certification 
452.13 	requirements, the commissioner shall provide the applicant written notice that the application 
452.14 	is incomplete or deficient. In the notice, the commissioner shall identify documents that are 
452.15 	missing or deficient and give the applicant 45 days to resubmit a second application that is 
452.16 	complete. An applicant's failure to submit a complete application after receiving notice from 
452.17 	the commissioner is basis for certification denial.

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

452.19 	Sec. 50. [245G.04] COMMISSIONER'S RIGHT OF ACCESS.
452.20 	(a) When the commissioner is exercising the powers conferred by this chapter, whenever 
452.21 	the center is in operation and the information is relevant to the commissioner's inspection 
452.22 	or investigation, the commissioner must be given access to:
452.23 	(1) the physical facility and grounds where the program is provided;
452.24 	(2) documentation and records, including electronically maintained records;
452.25 	(3) children served by the center; and
452.26 	(4) staff and personnel records of current and former staff.
452.27 	(b) The commissioner must be given access without prior notice and as often as the 
452.28 	commissioner considers necessary if the commissioner is investigating alleged maltreatment 
452.29 	or a violation of a law or rule, or conducting an inspection. When conducting an inspection, 
452.30 	the commissioner may request and shall receive assistance from other state, county, and 
452.31 	municipal governmental agencies and departments. The applicant or certification holder 
453.1 	shall allow the commissioner, at the commissioner's expense, to photocopy, photograph, 
453.2 	and make audio and video recordings during an inspection at the commissioner's expense.

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

453.4 	Sec. 51. [245G.05] MONITORING AND INSPECTIONS.
453.5 	(a) The commissioner must conduct an on-site inspection of a certified license-exempt 
453.6 	child care center at least annually to determine compliance with the health, safety, and fire 
453.7 	standards specific to a certified license-exempt child care center.
453.8 	(b) No later than November 19, 2017, the commissioner shall make publicly available 
453.9 	on the department's Web site the results of inspection reports for all certified centers including 
453.10 	the number of deaths, serious injuries, and instances of substantiated child maltreatment 
453.11 	that occurred in certified centers each year.

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

453.13 	Sec. 52. [245G.06] CORRECTION ORDER.
453.14 		Subdivision 1.Correction order requirements. If the applicant or certification holder 
453.15 	failed to comply with a law or rule, the commissioner may issue a correction order. The 
453.16 	correction order must state:
453.17 	(1) the condition that constitutes a violation of the law or rule;
453.18 	(2) the specific law or rule violated; and
453.19 	(3) the time allowed to correct each violation.
453.20 		Subd. 2.Reconsideration request. (a) If the applicant or certification holder believes 
453.21 	that the commissioner's correction order is erroneous, the applicant or certification holder 
453.22 	may ask the commissioner to reconsider the part of the correction order that is allegedly 
453.23 	erroneous. A request for reconsideration must be made in writing, postmarked, and sent to 
453.24 	the commissioner within 20 calendar days after the applicant or certification holder received 
453.25 	the correction order, and must:
453.26 	(1) specify the part of the correction order that is allegedly erroneous;
453.27 	(2) explain why the specified part is erroneous; and
453.28 	(3) include documentation to support the allegation of error.
454.1 	(b) A request for reconsideration does not stay any provision or requirement of the 
454.2 	correction order. The commissioner's disposition of a request for reconsideration is final 
454.3 	and not subject to appeal.
454.4 		Subd. 3.Decertification following a correction order. (a) If the commissioner finds 
454.5 	that the applicant or certification holder failed to correct the violation specified in the 
454.6 	correction order, the commissioner may decertify the license-exempt center pursuant to 
454.7 	section 245G.07.
454.8 	(b) Nothing in this section prohibits the commissioner from decertifying a center 
454.9 	according to section 245G.07.

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

454.11 	Sec. 53. [245G.07] DECERTIFICATION.
454.12 	(a) The commissioner may decertify a center if a certification holder:
454.13 	(1) failed to comply with an applicable law or rule; or
454.14 	(2) knowingly withheld relevant information from or gave false or misleading information 
454.15 	to the commissioner in connection with an application for certification, in connection with 
454.16 	the background study status of an individual, during an investigation, or regarding compliance 
454.17 	with applicable laws or rules.
454.18 	(b) When considering decertification, the commissioner shall consider the nature, 
454.19 	chronicity, or severity of the violation of law or rule.
454.20 	(c) When a center is decertified, the center is ineligible to receive a child care assistance 
454.21 	payment.

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

454.23 	Sec. 54. [245G.08] STAFFING REQUIREMENTS.
454.24 		Subdivision 1.Staffing requirements. During hours of operation, a certified center 
454.25 	must have a director or designee on site who is responsible for overseeing implementation 
454.26 	of written policies relating to the management and control of the daily activities of the 
454.27 	program, ensuring the health and safety of program participants, and supervising staff and 
454.28 	volunteers.
454.29 		Subd. 2.Director qualifications. The director must be 18 years of age or older and have 
454.30 	completed at least 16 hours of training in any of the following topic areas: child development 
454.31 	and learning; developmentally appropriate learning experiences; relationships with families; 
455.1 	assessment, evaluation, and individualization; historical and contemporary development of 
455.2 	early childhood education; professionalism; and health, safety, and nutrition.
455.3 		Subd. 3.Staff qualifications. A staff person must be 16 years of age or older before 
455.4 	providing direct, unsupervised care to a child.
455.5 		Subd. 4.Maximum group size. (a) For a child six weeks old through 16 months old, 
455.6 	the maximum group size shall be no more than eight children.
455.7 	(b) For a child 16 months old through 33 months old, the maximum group size shall be 
455.8 	no more than 14 children.
455.9 	(c) For a child 33 months old through prekindergarten, a maximum group size shall be 
455.10 	no more than 20 children.
455.11 	(d) For a child in kindergarten through 13 years old, a maximum group size shall be no 
455.12 	more than 30 children.
455.13 	(e) The maximum group size applies at all times except during group activity coordination 
455.14 	time not exceeding 15 minutes, during a meal, outdoor activity, field trip, nap and rest, and 
455.15 	special activity including a film, guest speaker, indoor large muscle activity, or holiday 
455.16 	program.
455.17 		Subd. 5.Ratios. (a) The minimally acceptable staff-to-child ratios are:

455.18	six weeks old through 16 months old
	1:4
	
455.19	16 months old through 33 months old
	1:7
	
455.20	33 months old through prekindergarten
	1:10
	
455.21	kindergarten through 13 years old
	1:15
	
455.22 	(b) Kindergarten includes a child of sufficient age to have attended the first day of 
455.23 	kindergarten or who is eligible to enter kindergarten within the next four months.
455.24 	(c) For mixed groups, the ratio for the age group of the youngest child applies.

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

455.26 	Sec. 55. [245G.10] BACKGROUND STUDIES.
455.27 		Subdivision 1.Documentation. (a) The applicant or certification holder must submit 
455.28 	and maintain documentation of a completed background study for:
455.29 	(1) each person applying for the certification;
455.30 	(2) each person identified as a center operator or program operator as defined in section 
455.31 	245G.01, subdivision 5;
456.1 	(3) each current or prospective staff person or contractor of the certified center who will 
456.2 	have direct contact with a child served by the center;
456.3 	(4) each volunteer who has direct contact with a child served by the center if the contact 
456.4 	is not under the continuous, direct supervision by an individual listed in clause (1), (2), or 
456.5 	(3); and
456.6 	(5) each managerial staff of the certification holder with oversight and supervision of 
456.7 	the certified center.
456.8 	(b) To be accepted for certification, a background study on every individual in subdivision 
456.9 	1, clause (1), must be completed under chapter 245C and result in a not disqualified 
456.10 	determination under section 245C.14 or a disqualification that was set aside under section 
456.11 	245C.22.
456.12 		Subd. 2.Direct contact. (a) The subject of the background study may not provide direct 
456.13 	contact services to a child served by a certified center unless the subject is under continuous 
456.14 	direct supervision pending completion of the background study.
456.15 	(b) The certified center must document in the staff person's personnel file the date the 
456.16 	program initiates a background study and the date the subject of the study first had direct 
456.17 	contact with a child served by the center.

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

456.19 	Sec. 56. [245G.11] REPORTING.
456.20 	(a) The certification holder must comply with the reporting requirements for abuse and 
456.21 	neglect specified in section 626.556. A person mandated to report physical or sexual child 
456.22 	abuse or neglect occurring within a certified center shall report the information to the 
456.23 	commissioner.
456.24 	(b) The certification holder must inform the commissioner within 24 hours of:
456.25 	(1) the death of a child in the program; and
456.26 	(2) any injury to a child in the program that required treatment by a physician.

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

456.28 	Sec. 57. [245G.12] FEES.
456.29 	The commissioner shall consult with stakeholders to develop an administrative fee to 
456.30 	implement this chapter. By February 15, 2019, the commissioner shall provide 
457.1 	recommendations on the amount of an administrative fee to the legislative committees with 
457.2 	jurisdiction over health and human services policy and finance.

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

457.4 	Sec. 58. [245G.13] HEALTH AND SAFETY REQUIREMENTS.
457.5 		Subdivision 1.Exclusion of sick children and infectious disease outbreak control.
 457.6 	(a) A certified center must supervise and isolate a child from other children in the program 
457.7 	when a child becomes sick and immediately notify the sick child's parent or legal guardian.
457.8 	(b) A certified center must post or give notice to the parent or legal guardian of an 
457.9 	exposed child the same day the program is notified of a child's contagious reportable disease 
457.10 	specified in Minnesota Rules, part 4605.7040, or scabies, impetigo, ringworm, or chicken 
457.11 	pox.
457.12 		Subd. 2.Immunizations. By a child's date of attendance, the certified center must 
457.13 	maintain or have access to a record detailing the child's current immunizations or applicable 
457.14 	exemption.
457.15 		Subd. 3.Administration of medication. (a) A certified center that chooses to administer 
457.16 	medicine must meet the requirements in this subdivision.
457.17 	(b) The certified center must obtain written permission from the child's parent or legal 
457.18 	guardian before administering prescription medicine, diapering product, sunscreen lotion, 
457.19 	and insect repellent.
457.20 	(c) The certified center must administer nonprescription medicine, diapering product, 
457.21 	sunscreen lotion, and insect repellent according to the manufacturer's instructions unless 
457.22 	provided written instructions by a licensed health professional to use a product differently.
457.23 	(d) The certified center must obtain and follow written instructions from the prescribing 
457.24 	health professional before administering prescription medicine. Medicine with the child's 
457.25 	first and last name and current prescription information on the label is considered written 
457.26 	instructions.
457.27 	(e) The certified center must ensure all medicine is:
457.28 	(1) kept in the medicine's original container with a legible label stating the child's first 
457.29 	and last name;
457.30 	(2) given only to the child whose name is on the label;
457.31 	(3) not given after an expiration date on the label; and
458.1 	(4) returned to the child's parent or legal guardian or destroyed, if unused.
458.2 	(f) The certified center must document in the child's record the administration of 
458.3 	medication, including the child's first and last name; the name of the medication or 
458.4 	prescription number; the date, time, and dosage; and the name and signature of the person 
458.5 	who administered the medicine. This documentation must be available to the child's parent 
458.6 	or legal guardian.
458.7 	(g) The certified center must store medicines, insect repellents, and diapering products 
458.8 	according to directions on the original container.
458.9 		Subd. 4.Preventing and responding to allergies. (a) Before admitting a child for care, 
458.10 	the certified center must obtain documentation of any known allergies from the child's parent 
458.11 	or legal guardian. The certified center must maintain current allergy information in each 
458.12 	child's record. The allergy information must include:
458.13 	(1) a description of the allergy, specific triggers, avoidance techniques, and symptoms 
458.14 	of an allergic reaction; and
458.15 	(2) procedures for responding to an allergic reaction, including medication, dosages, 
458.16 	and a doctor's contact information.
458.17 	(b) The certified center must inform staff of each child's current allergy information. At 
458.18 	least annually and when a change is made to allergy-related information in a child's record, 
458.19 	the certified center must inform staff of any change. Documentation that staff were informed 
458.20 	of the child's current allergy information must be kept on site.
458.21 	(c) A child's allergy information must be available at all times including on site, when 
458.22 	on field trips, or during transportation. Food allergy information must be readily available 
458.23 	to staff in the area where food is prepared and served to the child.
458.24 		Subd. 5.Building and physical premises; free of hazards. (a) The certified center 
458.25 	must document compliance with the State Fire Code by providing documentation of a fire 
458.26 	marshal inspection completed within the previous three years by a state fire marshal or a 
458.27 	local fire code inspector trained by the state fire marshal.
458.28 	(b) The certified center must designate a primary indoor and outdoor space used for 
458.29 	child care on a facility site floor plan.
458.30 	(c) The certified center must ensure the areas used by a child are clean and in good repair, 
458.31 	with structurally sound and functional furniture and equipment that is appropriate to the 
458.32 	age and size of a child who uses the area.
459.1 	(d) The certified center must ensure hazardous items including but not limited to sharp 
459.2 	objects, medicines, cleaning supplies, poisonous plants, and chemicals are out of reach of 
459.3 	a child.
459.4 	(e) The certified center must safely handle and dispose of bodily fluids and other 
459.5 	potentially infectious fluids by using gloves, disinfecting surfaces that come in contact with 
459.6 	potentially infectious bodily fluids, and disposing of bodily fluid in a securely sealed plastic 
459.7 	bag.
459.8 		Subd. 6.Transporting children. (a) If a certified center chooses to transport a child, 
459.9 	the certified center must ensure that the driver of the vehicle holds a valid driver's license, 
459.10 	appropriate to the vehicle driven.
459.11 	(b) If a certified center chooses to transport a child, the center must comply with all seat 
459.12 	belt and child passenger restraint system requirements under sections 169.685 and 169.686.

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

459.14 	Sec. 59. [245G.14] TRAINING REQUIREMENTS.
459.15 		Subdivision 1.First aid and cardiopulmonary resuscitation. At least one designated 
459.16 	staff person who completed first aid training and cardiopulmonary resuscitation (CPR) 
459.17 	training must be present at all times at the program, during field trips, and when transporting 
459.18 	a child. The designated staff person must repeat first aid training and CPR training at least 
459.19 	once every two years.
459.20 		Subd. 2.Sudden unexpected infant death. A certified center that cares for an infant 
459.21 	who is younger than one year of age must ensure that staff persons and volunteers receive 
459.22 	training according to section 245A.1435 on reducing the risk of sudden unexpected infant 
459.23 	death before assisting in the care of an infant.
459.24 		Subd. 3.Abusive head trauma. A certified center that cares for a child through four 
459.25 	years of age must ensure that staff persons and volunteers receive training on abusive head 
459.26 	trauma from shaking infants and young children before assisting in the care of a child through 
459.27 	four years of age.
459.28 		Subd. 4.Child development. The certified center must ensure each staff person completes 
459.29 	at least two hours of child development and learning training within 14 days of employment 
459.30 	and annually thereafter. For purposes of this subdivision, "child development and learning 
459.31 	training" means how a child develops physically, cognitively, emotionally, and socially and 
459.32 	learns as part of the child's family, culture, and community.
460.1 		Subd. 5.Orientation. The certified center must ensure each staff person is trained at 
460.2 	orientation on health and safety requirements in sections 245G.11, 245G.13, 245G.14, and 
460.3 	245G.15. The certified center must provide staff with an orientation within 14 days of 
460.4 	employment. Before the completion of orientation, a staff person must be supervised while 
460.5 	providing direct care to a child.
460.6 		Subd. 6.In service. (a) The certified center must ensure each staff person is trained at 
460.7 	least annually on health and safety requirements in sections 245G.11, 245G.13, 245G.14, 
460.8 	and 245G.15.
460.9 	(b) Each staff person must annually complete at least six hours of training. Training 
460.10 	required under paragraph (a) may be used toward the hourly training requirements of this 
460.11 	subdivision.
460.12 		Subd. 7.Documentation. A certified center must document the date of a completed 
460.13 	training required by this section in the personnel record of each staff person.

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

460.15 	Sec. 60. [245G.15] EMERGENCY PREPAREDNESS.
460.16 		Subdivision 1.Written emergency plan. (a) A certified center must have a written 
460.17 	emergency plan for emergencies that require evacuation, sheltering, or other protection of 
460.18 	children, such as fire, natural disaster, intruder, or other threatening situation that may pose 
460.19 	a health or safety hazard to children. The plan must be written on a form developed by the 
460.20 	commissioner and reviewed and updated at least once each calendar year. The annual review 
460.21 	of the emergency plan must be documented.
460.22 	(b) The plan must include:
460.23 	(1) procedures for an evacuation, relocation, shelter-in-place, or lockdown;
460.24 	(2) a designated relocation site and evacuation route;
460.25 	(3) procedures for notifying a child's parent or legal guardian of the relocation and 
460.26 	reunification with families;
460.27 	(4) accommodations for a child with a disability or a chronic medical condition;
460.28 	(5) procedures for storing a child's medically necessary medicine that facilitates easy 
460.29 	removal during an evacuation or relocation;
460.30 	(6) procedures for continuing operations in the period during and after a crisis; and
461.1 	(7) procedures for communicating with local emergency management officials, law 
461.2 	enforcement officials, or other appropriate state or local authorities.
461.3 	(c) The certification holder must have an emergency plan available for review upon 
461.4 	request by the child's parent or legal guardian.
461.5 		Subd. 2.Staff person training. The certification holder must train a staff person at 
461.6 	orientation and at least once each calendar year on the emergency plan and document training 
461.7 	in each personnel file. The certified center must conduct at least quarterly one evacuation 
461.8 	drill and one shelter-in-place drill. The date and time of the drills must be documented.

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

461.10 	Sec. 61. [245G.16] PERSONNEL RECORD.
461.11 	The certification holder must maintain a personnel record for each staff person at the 
461.12 	program that must contain:
461.13 	(1) the staff person's name, home address, telephone number, and date of birth;
461.14 	(2) documentation that the staff person completed training required by section 245G.14;
461.15 	(3) documentation of the date the program initiated a background study for the staff 
461.16 	person; and
461.17 	(4) documentation of the date the staff person first had direct contact and access to a 
461.18 	child while supervised, and the date the staff person first had direct contact and access to a 
461.19 	child while unsupervised.

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

461.21 	Sec. 62. [245G.17] CERTIFICATION STANDARDS.
461.22 	The commissioner shall regularly consult with stakeholders for input related to 
461.23 	implementing the standards in this chapter.

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

461.25 	Sec. 63. [245G.18] PARENTAL ACCESS.
461.26 	An enrolled child's parent or legal guardian must be allowed access to the parent's or 
461.27 	legal guardian's child at any time while the child is in care.

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

462.1 	Sec. 64. Minnesota Statutes 2016, section 256.98, subdivision 8, is amended to read:
462.2 		Subd. 8.Disqualification from program. (a) Any person found to be guilty of 
462.3 	wrongfully obtaining assistance by a federal or state court or by an administrative hearing 
462.4 	determination, or waiver thereof, through a disqualification consent agreement, or as part 
462.5 	of any approved diversion plan under section 401.065, or any court-ordered stay which 
462.6 	carries with it any probationary or other conditions, in the Minnesota family investment 
462.7 	program and any affiliated program to include the diversionary work program and the work 
462.8 	participation cash benefit program, the food stamp or food support program, the general 
462.9 	assistance program, the group residential housing program, or the Minnesota supplemental 
462.10 	aid program shall be disqualified from that program. In addition, any person disqualified 
462.11 	from the Minnesota family investment program shall also be disqualified from the food 
462.12 	stamp or food support program. The needs of that individual shall not be taken into 
462.13 	consideration in determining the grant level for that assistance unit:
462.14 	(1) for one year after the first offense;
462.15 	(2) for two years after the second offense; and
462.16 	(3) permanently after the third or subsequent offense.
462.17 	The period of program disqualification shall begin on the date stipulated on the advance 
462.18 	notice of disqualification without possibility of postponement for administrative stay or 
462.19 	administrative hearing and shall continue through completion unless and until the findings 
462.20 	upon which the sanctions were imposed are reversed by a court of competent jurisdiction. 
462.21 	The period for which sanctions are imposed is not subject to review. The sanctions provided 
462.22 	under this subdivision are in addition to, and not in substitution for, any other sanctions that 
462.23 	may be provided for by law for the offense involved. A disqualification established through 
462.24 	hearing or waiver shall result in the disqualification period beginning immediately unless 
462.25 	the person has become otherwise ineligible for assistance. If the person is ineligible for 
462.26 	assistance, the disqualification period begins when the person again meets the eligibility 
462.27 	criteria of the program from which they were disqualified and makes application for that 
462.28 	program.
462.29 	(b) A family receiving assistance through child care assistance programs under chapter 
462.30 	119B with a family member who is found to be guilty of wrongfully obtaining child care 
462.31 	assistance by a federal court, state court, or an administrative hearing determination or 
462.32 	waiver, through a disqualification consent agreement, as part of an approved diversion plan 
462.33 	under section 401.065, or a court-ordered stay with probationary or other conditions, is 
462.34 	disqualified from child care assistance programs. The disqualifications must be for periods 
463.1 	of one year and two years for the first and second offenses, respectively. Subsequent 
463.2 	violations must result in permanent disqualification. During the disqualification period, 
463.3 	disqualification from any child care program must extend to all child care programs and 
463.4 	must be immediately applied.
463.5 	(c) A provider caring for children receiving assistance through child care assistance 
463.6 	programs under chapter 119B is disqualified from receiving payment for child care services 
463.7 	from the child care assistance program under chapter 119B when the provider is found to 
463.8 	have wrongfully obtained child care assistance by a federal court, state court, or an 
463.9 	administrative hearing determination or waiver under section 256.046, through a 
463.10 	disqualification consent agreement, as part of an approved diversion plan under section 
463.11 	401.065, or a court-ordered stay with probationary or other conditions. The disqualification 
463.12 	must be for a period of one year two years for the first offense and two years for the second 
463.13 	offense. Any subsequent violation must result in permanent disqualification. The 
463.14 	disqualification period must be imposed immediately after a determination is made under 
463.15 	this paragraph. During the disqualification period, the provider is disqualified from receiving 
463.16 	payment from any child care program under chapter 119B.
463.17 	(d) Any person found to be guilty of wrongfully obtaining MinnesotaCare for adults 
463.18 	without children and upon federal approval, all categories of medical assistance and 
463.19 	remaining categories of MinnesotaCare, except for children through age 18, by a federal or 
463.20 	state court or by an administrative hearing determination, or waiver thereof, through a 
463.21 	disqualification consent agreement, or as part of any approved diversion plan under section 
463.22 	401.065, or any court-ordered stay which carries with it any probationary or other conditions, 
463.23 	is disqualified from that program. The period of disqualification is one year after the first 
463.24 	offense, two years after the second offense, and permanently after the third or subsequent 
463.25 	offense. The period of program disqualification shall begin on the date stipulated on the 
463.26 	advance notice of disqualification without possibility of postponement for administrative 
463.27 	stay or administrative hearing and shall continue through completion unless and until the 
463.28 	findings upon which the sanctions were imposed are reversed by a court of competent 
463.29 	jurisdiction. The period for which sanctions are imposed is not subject to review. The 
463.30 	sanctions provided under this subdivision are in addition to, and not in substitution for, any 
463.31 	other sanctions that may be provided for by law for the offense involved.

463.32 	EFFECTIVE DATE. This section is effective June 5, 2017.

464.1 	Sec. 65. Minnesota Statutes 2016, section 626.556, subdivision 2, is amended to read:
464.2 		Subd. 2.Definitions. As used in this section, the following terms have the meanings 
464.3 	given them unless the specific content indicates otherwise:
464.4 	(a) "Accidental" means a sudden, not reasonably foreseeable, and unexpected occurrence 
464.5 	or event which:
464.6 	(1) is not likely to occur and could not have been prevented by exercise of due care; and
464.7 	(2) if occurring while a child is receiving services from a facility, happens when the 
464.8 	facility and the employee or person providing services in the facility are in compliance with 
464.9 	the laws and rules relevant to the occurrence or event.
464.10 	(b) "Commissioner" means the commissioner of human services.
464.11 	(c) "Facility" means:
464.12 	(1) a licensed or unlicensed day care facility, certified license-exempt child care center,
464.13 	residential facility, agency, hospital, sanitarium, or other facility or institution required to 
464.14 	be licensed under sections 144.50 to 144.58, 241.021, or 245A.01 to 245A.16, or chapter 
464.15 	245D or 245G;
464.16 	(2) a school as defined in section 120A.05, subdivisions 9, 11, and 13; and chapter 124E; 
464.17 	or
464.18 	(3) a nonlicensed personal care provider organization as defined in section 256B.0625, 
464.19 	subdivision 19a.
464.20 	(d) "Family assessment" means a comprehensive assessment of child safety, risk of 
464.21 	subsequent child maltreatment, and family strengths and needs that is applied to a child 
464.22 	maltreatment report that does not allege sexual abuse or substantial child endangerment. 
464.23 	Family assessment does not include a determination as to whether child maltreatment 
464.24 	occurred but does determine the need for services to address the safety of family members 
464.25 	and the risk of subsequent maltreatment.
464.26 	(e) "Investigation" means fact gathering related to the current safety of a child and the 
464.27 	risk of subsequent maltreatment that determines whether child maltreatment occurred and 
464.28 	whether child protective services are needed. An investigation must be used when reports 
464.29 	involve sexual abuse or substantial child endangerment, and for reports of maltreatment in 
464.30 	facilities required to be licensed or certified under chapter 245A or, 245D, or 245G; under 
464.31 	sections 144.50 to 144.58 and 241.021; in a school as defined in section 120A.05, 
465.1 	subdivisions 9, 11, and 13, and chapter 124E; or in a nonlicensed personal care provider 
465.2 	association as defined in section 256B.0625, subdivision 19a.
465.3 	(f) "Mental injury" means an injury to the psychological capacity or emotional stability 
465.4 	of a child as evidenced by an observable or substantial impairment in the child's ability to 
465.5 	function within a normal range of performance and behavior with due regard to the child's 
465.6 	culture.
465.7 	(g) "Neglect" means the commission or omission of any of the acts specified under 
465.8 	clauses (1) to (9), other than by accidental means:
465.9 	(1) failure by a person responsible for a child's care to supply a child with necessary 
465.10 	food, clothing, shelter, health, medical, or other care required for the child's physical or 
465.11 	mental health when reasonably able to do so;
465.12 	(2) failure to protect a child from conditions or actions that seriously endanger the child's 
465.13 	physical or mental health when reasonably able to do so, including a growth delay, which 
465.14 	may be referred to as a failure to thrive, that has been diagnosed by a physician and is due 
465.15 	to parental neglect;
465.16 	(3) failure to provide for necessary supervision or child care arrangements appropriate 
465.17 	for a child after considering factors as the child's age, mental ability, physical condition, 
465.18 	length of absence, or environment, when the child is unable to care for the child's own basic 
465.19 	needs or safety, or the basic needs or safety of another child in their care;
465.20 	(4) failure to ensure that the child is educated as defined in sections 120A.22 and 
465.21 	260C.163, subdivision 11, which does not include a parent's refusal to provide the parent's 
465.22 	child with sympathomimetic medications, consistent with section 125A.091, subdivision 
465.23 	5;
465.24 	(5) nothing in this section shall be construed to mean that a child is neglected solely 
465.25 	because the child's parent, guardian, or other person responsible for the child's care in good 
465.26 	faith selects and depends upon spiritual means or prayer for treatment or care of disease or 
465.27 	remedial care of the child in lieu of medical care; except that a parent, guardian, or caretaker, 
465.28 	or a person mandated to report pursuant to subdivision 3, has a duty to report if a lack of 
465.29 	medical care may cause serious danger to the child's health. This section does not impose 
465.30 	upon persons, not otherwise legally responsible for providing a child with necessary food, 
465.31 	clothing, shelter, education, or medical care, a duty to provide that care;
465.32 	(6) prenatal exposure to a controlled substance, as defined in section 253B.02, subdivision 
465.33 	2, used by the mother for a nonmedical purpose, as evidenced by withdrawal symptoms in 
466.1 	the child at birth, results of a toxicology test performed on the mother at delivery or the 
466.2 	child at birth, medical effects or developmental delays during the child's first year of life 
466.3 	that medically indicate prenatal exposure to a controlled substance, or the presence of a 
466.4 	fetal alcohol spectrum disorder;
466.5 	(7) "medical neglect" as defined in section 260C.007, subdivision 6, clause (5);
466.6 	(8) chronic and severe use of alcohol or a controlled substance by a parent or person 
466.7 	responsible for the care of the child that adversely affects the child's basic needs and safety; 
466.8 	or
466.9 	(9) emotional harm from a pattern of behavior which contributes to impaired emotional 
466.10 	functioning of the child which may be demonstrated by a substantial and observable effect 
466.11 	in the child's behavior, emotional response, or cognition that is not within the normal range 
466.12 	for the child's age and stage of development, with due regard to the child's culture.
466.13 	(h) "Nonmaltreatment mistake" means:
466.14 	(1) at the time of the incident, the individual was performing duties identified in the 
466.15 	center's child care program plan required under Minnesota Rules, part 9503.0045;
466.16 	(2) the individual has not been determined responsible for a similar incident that resulted 
466.17 	in a finding of maltreatment for at least seven years;
466.18 	(3) the individual has not been determined to have committed a similar nonmaltreatment 
466.19 	mistake under this paragraph for at least four years;
466.20 	(4) any injury to a child resulting from the incident, if treated, is treated only with 
466.21 	remedies that are available over the counter, whether ordered by a medical professional or 
466.22 	not; and
466.23 	(5) except for the period when the incident occurred, the facility and the individual 
466.24 	providing services were both in compliance with all licensing requirements relevant to the 
466.25 	incident.
466.26 	This definition only applies to child care centers licensed under Minnesota Rules, chapter 
466.27 	9503. If clauses (1) to (5) apply, rather than making a determination of substantiated 
466.28 	maltreatment by the individual, the commissioner of human services shall determine that a 
466.29 	nonmaltreatment mistake was made by the individual.
466.30 	(i) "Operator" means an operator or agency as defined in section 245A.02.
466.31 	(j) "Person responsible for the child's care" means (1) an individual functioning within 
466.32 	the family unit and having responsibilities for the care of the child such as a parent, guardian, 
467.1 	or other person having similar care responsibilities, or (2) an individual functioning outside 
467.2 	the family unit and having responsibilities for the care of the child such as a teacher, school 
467.3 	administrator, other school employees or agents, or other lawful custodian of a child having 
467.4 	either full-time or short-term care responsibilities including, but not limited to, day care, 
467.5 	babysitting whether paid or unpaid, counseling, teaching, and coaching.
467.6 	(k) "Physical abuse" means any physical injury, mental injury, or threatened injury, 
467.7 	inflicted by a person responsible for the child's care on a child other than by accidental 
467.8 	means, or any physical or mental injury that cannot reasonably be explained by the child's 
467.9 	history of injuries, or any aversive or deprivation procedures, or regulated interventions, 
467.10 	that have not been authorized under section 125A.0942 or 245.825.
467.11 	Abuse does not include reasonable and moderate physical discipline of a child 
467.12 	administered by a parent or legal guardian which does not result in an injury. Abuse does 
467.13 	not include the use of reasonable force by a teacher, principal, or school employee as allowed 
467.14 	by section 121A.582. Actions which are not reasonable and moderate include, but are not 
467.15 	limited to, any of the following:
467.16 	(1) throwing, kicking, burning, biting, or cutting a child;
467.17 	(2) striking a child with a closed fist;
467.18 	(3) shaking a child under age three;
467.19 	(4) striking or other actions which result in any nonaccidental injury to a child under 18 
467.20 	months of age;
467.21 	(5) unreasonable interference with a child's breathing;
467.22 	(6) threatening a child with a weapon, as defined in section 609.02, subdivision 6;
467.23 	(7) striking a child under age one on the face or head;
467.24 	(8) striking a child who is at least age one but under age four on the face or head, which 
467.25 	results in an injury;
467.26 	(9) purposely giving a child poison, alcohol, or dangerous, harmful, or controlled 
467.27 	substances which were not prescribed for the child by a practitioner, in order to control or 
467.28 	punish the child; or other substances that substantially affect the child's behavior, motor 
467.29 	coordination, or judgment or that results in sickness or internal injury, or subjects the child 
467.30 	to medical procedures that would be unnecessary if the child were not exposed to the 
467.31 	substances;
468.1 	(10) unreasonable physical confinement or restraint not permitted under section 609.379, 
468.2 	including but not limited to tying, caging, or chaining; or
468.3 	(11) in a school facility or school zone, an act by a person responsible for the child's 
468.4 	care that is a violation under section 121A.58.
468.5 	(l) "Practice of social services," for the purposes of subdivision 3, includes but is not 
468.6 	limited to employee assistance counseling and the provision of guardian ad litem and 
468.7 	parenting time expeditor services.
468.8 	(m) "Report" means any communication received by the local welfare agency, police 
468.9 	department, county sheriff, or agency responsible for child protection pursuant to this section 
468.10 	that describes neglect or physical or sexual abuse of a child and contains sufficient content 
468.11 	to identify the child and any person believed to be responsible for the neglect or abuse, if 
468.12 	known.
468.13 	(n) "Sexual abuse" means the subjection of a child by a person responsible for the child's 
468.14 	care, by a person who has a significant relationship to the child, as defined in section 609.341, 
468.15 	or by a person in a position of authority, as defined in section 609.341, subdivision 10, to 
468.16 	any act which constitutes a violation of section 609.342 (criminal sexual conduct in the first 
468.17 	degree), 609.343 (criminal sexual conduct in the second degree), 609.344 (criminal sexual 
468.18 	conduct in the third degree), 609.345 (criminal sexual conduct in the fourth degree), or 
468.19 	609.3451 (criminal sexual conduct in the fifth degree). Sexual abuse also includes any act 
468.20 	which involves a minor which constitutes a violation of prostitution offenses under sections 
468.21 	609.321 to 609.324 or 617.246. Effective May 29, 2017, sexual abuse includes all reports 
468.22 	of known or suspected child sex trafficking involving a child who is identified as a victim 
468.23 	of sex trafficking. Sexual abuse includes child sex trafficking as defined in section 609.321, 
468.24 	subdivisions 7a and 7b. Sexual abuse includes threatened sexual abuse which includes the 
468.25 	status of a parent or household member who has committed a violation which requires 
468.26 	registration as an offender under section 243.166, subdivision 1b, paragraph (a) or (b), or 
468.27 	required registration under section 243.166, subdivision 1b, paragraph (a) or (b).
468.28 	(o) "Substantial child endangerment" means a person responsible for a child's care, by 
468.29 	act or omission, commits or attempts to commit an act against a child under their care that 
468.30 	constitutes any of the following:
468.31 	(1) egregious harm as defined in section 260C.007, subdivision 14;
468.32 	(2) abandonment under section 260C.301, subdivision 2;
469.1 	(3) neglect as defined in paragraph (g), clause (2), that substantially endangers the child's 
469.2 	physical or mental health, including a growth delay, which may be referred to as failure to 
469.3 	thrive, that has been diagnosed by a physician and is due to parental neglect;
469.4 	(4) murder in the first, second, or third degree under section 609.185, 609.19, or 609.195;
469.5 	(5) manslaughter in the first or second degree under section 609.20 or 609.205;
469.6 	(6) assault in the first, second, or third degree under section 609.221, 609.222, or 609.223;
469.7 	(7) solicitation, inducement, and promotion of prostitution under section 609.322;
469.8 	(8) criminal sexual conduct under sections 609.342 to 609.3451;
469.9 	(9) solicitation of children to engage in sexual conduct under section 609.352;
469.10 	(10) malicious punishment or neglect or endangerment of a child under section 609.377
469.11 	or 609.378;
469.12 	(11) use of a minor in sexual performance under section 617.246; or
469.13 	(12) parental behavior, status, or condition which mandates that the county attorney file 
469.14 	a termination of parental rights petition under section 260C.503, subdivision 2.
469.15 	(p) "Threatened injury" means a statement, overt act, condition, or status that represents 
469.16 	a substantial risk of physical or sexual abuse or mental injury. Threatened injury includes, 
469.17 	but is not limited to, exposing a child to a person responsible for the child's care, as defined 
469.18 	in paragraph (j), clause (1), who has:
469.19 	(1) subjected a child to, or failed to protect a child from, an overt act or condition that 
469.20 	constitutes egregious harm, as defined in section 260C.007, subdivision 14, or a similar law 
469.21 	of another jurisdiction;
469.22 	(2) been found to be palpably unfit under section 260C.301, subdivision 1, paragraph 
469.23 	(b), clause (4), or a similar law of another jurisdiction;
469.24 	(3) committed an act that has resulted in an involuntary termination of parental rights 
469.25 	under section 260C.301, or a similar law of another jurisdiction; or
469.26 	(4) committed an act that has resulted in the involuntary transfer of permanent legal and 
469.27 	physical custody of a child to a relative under Minnesota Statutes 2010, section 260C.201, 
469.28 	subdivision 11, paragraph (d), clause (1), section 260C.515, subdivision 4, or a similar law 
469.29 	of another jurisdiction.
470.1 	A child is the subject of a report of threatened injury when the responsible social services 
470.2 	agency receives birth match data under paragraph (q) from the Department of Human 
470.3 	Services.
470.4 	(q) Upon receiving data under section 144.225, subdivision 2b, contained in a birth 
470.5 	record or recognition of parentage identifying a child who is subject to threatened injury 
470.6 	under paragraph (p), the Department of Human Services shall send the data to the responsible 
470.7 	social services agency. The data is known as "birth match" data. Unless the responsible 
470.8 	social services agency has already begun an investigation or assessment of the report due 
470.9 	to the birth of the child or execution of the recognition of parentage and the parent's previous 
470.10 	history with child protection, the agency shall accept the birth match data as a report under 
470.11 	this section. The agency may use either a family assessment or investigation to determine 
470.12 	whether the child is safe. All of the provisions of this section apply. If the child is determined 
470.13 	to be safe, the agency shall consult with the county attorney to determine the appropriateness 
470.14 	of filing a petition alleging the child is in need of protection or services under section 
470.15 	260C.007, subdivision 6, clause (16), in order to deliver needed services. If the child is 
470.16 	determined not to be safe, the agency and the county attorney shall take appropriate action 
470.17 	as required under section 260C.503, subdivision 2.
470.18 	(r) Persons who conduct assessments or investigations under this section shall take into 
470.19 	account accepted child-rearing practices of the culture in which a child participates and 
470.20 	accepted teacher discipline practices, which are not injurious to the child's health, welfare, 
470.21 	and safety.

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

470.23 	Sec. 66. Minnesota Statutes 2016, section 626.556, subdivision 3, is amended to read:
470.24 		Subd. 3.Persons mandated to report; persons voluntarily reporting. (a) A person 
470.25 	who knows or has reason to believe a child is being neglected or physically or sexually 
470.26 	abused, as defined in subdivision 2, or has been neglected or physically or sexually abused 
470.27 	within the preceding three years, shall immediately report the information to the local welfare 
470.28 	agency, agency responsible for assessing or investigating the report, police department, 
470.29 	county sheriff, tribal social services agency, or tribal police department if the person is:
470.30 	(1) a professional or professional's delegate who is engaged in the practice of the healing 
470.31 	arts, social services, hospital administration, psychological or psychiatric treatment, child 
470.32 	care, education, correctional supervision, probation and correctional services, or law 
470.33 	enforcement; or
471.1 	(2) employed as a member of the clergy and received the information while engaged in 
471.2 	ministerial duties, provided that a member of the clergy is not required by this subdivision 
471.3 	to report information that is otherwise privileged under section 595.02, subdivision 1, 
471.4 	paragraph (c).
471.5 	(b) Any person may voluntarily report to the local welfare agency, agency responsible 
471.6 	for assessing or investigating the report, police department, county sheriff, tribal social 
471.7 	services agency, or tribal police department if the person knows, has reason to believe, or 
471.8 	suspects a child is being or has been neglected or subjected to physical or sexual abuse.
471.9 	(c) A person mandated to report physical or sexual child abuse or neglect occurring 
471.10 	within a licensed facility shall report the information to the agency responsible for licensing
471.11 	or certifying the facility under sections 144.50 to 144.58; 241.021; 245A.01 to 245A.16; 
471.12 	or chapter 245D or 245G; or a nonlicensed personal care provider organization as defined 
471.13 	in section 256B.0625, subdivision 19. A health or corrections agency receiving a report 
471.14 	may request the local welfare agency to provide assistance pursuant to subdivisions 10, 10a, 
471.15 	and 10b. A board or other entity whose licensees perform work within a school facility, 
471.16 	upon receiving a complaint of alleged maltreatment, shall provide information about the 
471.17 	circumstances of the alleged maltreatment to the commissioner of education. Section 13.03, 
471.18 	subdivision 4, applies to data received by the commissioner of education from a licensing 
471.19 	entity.
471.20 	(d) Notification requirements under subdivision 10 apply to all reports received under 
471.21 	this section.
471.22 	(e) For purposes of this section, "immediately" means as soon as possible but in no event 
471.23 	longer than 24 hours.

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

471.25 	Sec. 67. Minnesota Statutes 2016, section 626.556, subdivision 3c, is amended to read:
471.26 		Subd. 3c.Local welfare agency, Department of Human Services or Department of 
471.27 	Health responsible for assessing or investigating reports of maltreatment. (a) The county
471.28 	local welfare agency is the agency responsible for assessing or investigating allegations of 
471.29 	maltreatment in child foster care, family child care, legally unlicensed nonlicensed child 
471.30 	care, juvenile correctional facilities licensed under section 241.021 located in the local 
471.31 	welfare agency's county, and reports involving children served by an unlicensed personal 
471.32 	care provider organization under section 256B.0659. Copies of findings related to personal 
472.1 	care provider organizations under section 256B.0659 must be forwarded to the Department 
472.2 	of Human Services provider enrollment.
472.3 	(b) The Department of Human Services is the agency responsible for assessing or 
472.4 	investigating allegations of maltreatment in juvenile correctional facilities listed under 
472.5 	section 241.021 located in the local welfare agency's county and in facilities licensed or 
472.6 	certified under chapters 245A and, 245D, and 245G, except for child foster care and family 
472.7 	child care.
472.8 	(c) The Department of Health is the agency responsible for assessing or investigating 
472.9 	allegations of child maltreatment in facilities licensed under sections 144.50 to 144.58 and 
472.10 	144A.43 to 144A.482.

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

472.12 	Sec. 68. Minnesota Statutes 2016, section 626.556, subdivision 4, is amended to read:
472.13 		Subd. 4.Immunity from liability. (a) The following persons are immune from any civil 
472.14 	or criminal liability that otherwise might result from their actions, if they are acting in good 
472.15 	faith:
472.16 	(1) any person making a voluntary or mandated report under subdivision 3 or under 
472.17 	section 626.5561 or assisting in an assessment under this section or under section 626.5561;
472.18 	(2) any person with responsibility for performing duties under this section or supervisor 
472.19 	employed by a local welfare agency, the commissioner of an agency responsible for operating 
472.20 	or supervising a licensed or unlicensed day care facility, residential facility, agency, hospital, 
472.21 	sanitarium, or other facility or institution required to be licensed or certified under sections 
472.22 	144.50 to 144.58; 241.021; 245A.01 to 245A.16; or chapter 245B, or 245G; or a school as 
472.23 	defined in section 120A.05, subdivisions 9, 11, and 13; and chapter 124E; or a nonlicensed 
472.24 	personal care provider organization as defined in section 256B.0625, subdivision 19a, 
472.25 	complying with subdivision 10d; and
472.26 	(3) any public or private school, facility as defined in subdivision 2, or the employee of 
472.27 	any public or private school or facility who permits access by a local welfare agency, the 
472.28 	Department of Education, or a local law enforcement agency and assists in an investigation 
472.29 	or assessment pursuant to subdivision 10 or under section 626.5561.
472.30 	(b) A person who is a supervisor or person with responsibility for performing duties 
472.31 	under this section employed by a local welfare agency, the commissioner of human services, 
472.32 	or the commissioner of education complying with subdivisions 10 and 11 or section 626.5561
472.33 	or any related rule or provision of law is immune from any civil or criminal liability that 
473.1 	might otherwise result from the person's actions, if the person is (1) acting in good faith 
473.2 	and exercising due care, or (2) acting in good faith and following the information collection 
473.3 	procedures established under subdivision 10, paragraphs (h), (i), and (j).
473.4 	(c) This subdivision does not provide immunity to any person for failure to make a 
473.5 	required report or for committing neglect, physical abuse, or sexual abuse of a child.
473.6 	(d) If a person who makes a voluntary or mandatory report under subdivision 3 prevails 
473.7 	in a civil action from which the person has been granted immunity under this subdivision, 
473.8 	the court may award the person attorney fees and costs.

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

473.10 	Sec. 69. Minnesota Statutes 2016, section 626.556, subdivision 10d, is amended to read:
473.11 		Subd. 10d.Notification of neglect or abuse in facility. (a) When a report is received 
473.12 	that alleges neglect, physical abuse, sexual abuse, or maltreatment of a child while in the 
473.13 	care of a licensed or unlicensed day care facility, residential facility, agency, hospital, 
473.14 	sanitarium, or other facility or institution required to be licensed or certified according to 
473.15 	sections 144.50 to 144.58; 241.021; or 245A.01 to 245A.16; or chapter 245D or 245G, or 
473.16 	a school as defined in section 120A.05, subdivisions 9, 11, and 13; and chapter 124E; or a 
473.17 	nonlicensed personal care provider organization as defined in section 256B.0625, subdivision 
473.18 	19a, the commissioner of the agency responsible for assessing or investigating the report 
473.19 	or local welfare agency investigating the report shall provide the following information to 
473.20 	the parent, guardian, or legal custodian of a child alleged to have been neglected, physically 
473.21 	abused, sexually abused, or the victim of maltreatment of a child in the facility: the name 
473.22 	of the facility; the fact that a report alleging neglect, physical abuse, sexual abuse, or 
473.23 	maltreatment of a child in the facility has been received; the nature of the alleged neglect, 
473.24 	physical abuse, sexual abuse, or maltreatment of a child in the facility; that the agency is 
473.25 	conducting an assessment or investigation; any protective or corrective measures being 
473.26 	taken pending the outcome of the investigation; and that a written memorandum will be 
473.27 	provided when the investigation is completed.
473.28 	(b) The commissioner of the agency responsible for assessing or investigating the report 
473.29 	or local welfare agency may also provide the information in paragraph (a) to the parent, 
473.30 	guardian, or legal custodian of any other child in the facility if the investigative agency 
473.31 	knows or has reason to believe the alleged neglect, physical abuse, sexual abuse, or 
473.32 	maltreatment of a child in the facility has occurred. In determining whether to exercise this 
473.33 	authority, the commissioner of the agency responsible for assessing or investigating the 
473.34 	report or local welfare agency shall consider the seriousness of the alleged neglect, physical 
474.1 	abuse, sexual abuse, or maltreatment of a child in the facility; the number of children 
474.2 	allegedly neglected, physically abused, sexually abused, or victims of maltreatment of a 
474.3 	child in the facility; the number of alleged perpetrators; and the length of the investigation. 
474.4 	The facility shall be notified whenever this discretion is exercised.
474.5 	(c) When the commissioner of the agency responsible for assessing or investigating the 
474.6 	report or local welfare agency has completed its investigation, every parent, guardian, or 
474.7 	legal custodian previously notified of the investigation by the commissioner or local welfare 
474.8 	agency shall be provided with the following information in a written memorandum: the 
474.9 	name of the facility investigated; the nature of the alleged neglect, physical abuse, sexual 
474.10 	abuse, or maltreatment of a child in the facility; the investigator's name; a summary of the 
474.11 	investigation findings; a statement whether maltreatment was found; and the protective or 
474.12 	corrective measures that are being or will be taken. The memorandum shall be written in a 
474.13 	manner that protects the identity of the reporter and the child and shall not contain the name, 
474.14 	or to the extent possible, reveal the identity of the alleged perpetrator or of those interviewed 
474.15 	during the investigation. If maltreatment is determined to exist, the commissioner or local 
474.16 	welfare agency shall also provide the written memorandum to the parent, guardian, or legal 
474.17 	custodian of each child in the facility who had contact with the individual responsible for 
474.18 	the maltreatment. When the facility is the responsible party for maltreatment, the 
474.19 	commissioner or local welfare agency shall also provide the written memorandum to the 
474.20 	parent, guardian, or legal custodian of each child who received services in the population 
474.21 	of the facility where the maltreatment occurred. This notification must be provided to the 
474.22 	parent, guardian, or legal custodian of each child receiving services from the time the 
474.23 	maltreatment occurred until either the individual responsible for maltreatment is no longer 
474.24 	in contact with a child or children in the facility or the conclusion of the investigation. In 
474.25 	the case of maltreatment within a school facility, as defined in section 120A.05, subdivisions 
474.26 	9, 11, and 13, and chapter 124E, the commissioner of education need not provide notification 
474.27 	to parents, guardians, or legal custodians of each child in the facility, but shall, within ten 
474.28 	days after the investigation is completed, provide written notification to the parent, guardian, 
474.29 	or legal custodian of any student alleged to have been maltreated. The commissioner of 
474.30 	education may notify the parent, guardian, or legal custodian of any student involved as a 
474.31 	witness to alleged maltreatment.

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

475.1 	Sec. 70. Minnesota Statutes 2016, section 626.556, subdivision 10e, is amended to read:
475.2 		Subd. 10e.Determinations. (a) The local welfare agency shall conclude the family 
475.3 	assessment or the investigation within 45 days of the receipt of a report. The conclusion of 
475.4 	the assessment or investigation may be extended to permit the completion of a criminal 
475.5 	investigation or the receipt of expert information requested within 45 days of the receipt of 
475.6 	the report.
475.7 	(b) After conducting a family assessment, the local welfare agency shall determine 
475.8 	whether services are needed to address the safety of the child and other family members 
475.9 	and the risk of subsequent maltreatment.
475.10 	(c) After conducting an investigation, the local welfare agency shall make two 
475.11 	determinations: first, whether maltreatment has occurred; and second, whether child 
475.12 	protective services are needed. No determination of maltreatment shall be made when the 
475.13 	alleged perpetrator is a child under the age of ten.
475.14 	(d) If the commissioner of education conducts an assessment or investigation, the 
475.15 	commissioner shall determine whether maltreatment occurred and what corrective or 
475.16 	protective action was taken by the school facility. If a determination is made that 
475.17 	maltreatment has occurred, the commissioner shall report to the employer, the school board, 
475.18 	and any appropriate licensing entity the determination that maltreatment occurred and what 
475.19 	corrective or protective action was taken by the school facility. In all other cases, the 
475.20 	commissioner shall inform the school board or employer that a report was received, the 
475.21 	subject of the report, the date of the initial report, the category of maltreatment alleged as 
475.22 	defined in paragraph (f), the fact that maltreatment was not determined, and a summary of 
475.23 	the specific reasons for the determination.
475.24 	(e) When maltreatment is determined in an investigation involving a facility, the 
475.25 	investigating agency shall also determine whether the facility or individual was responsible, 
475.26 	or whether both the facility and the individual were responsible for the maltreatment using 
475.27 	the mitigating factors in paragraph (i). Determinations under this subdivision must be made 
475.28 	based on a preponderance of the evidence and are private data on individuals or nonpublic 
475.29 	data as maintained by the commissioner of education.
475.30 	(f) For the purposes of this subdivision, "maltreatment" means any of the following acts 
475.31 	or omissions:
475.32 	(1) physical abuse as defined in subdivision 2, paragraph (k);
475.33 	(2) neglect as defined in subdivision 2, paragraph (g);
476.1 	(3) sexual abuse as defined in subdivision 2, paragraph (n);
476.2 	(4) mental injury as defined in subdivision 2, paragraph (f); or
476.3 	(5) maltreatment of a child in a facility as defined in subdivision 2, paragraph (c).
476.4 	(g) For the purposes of this subdivision, a determination that child protective services 
476.5 	are needed means that the local welfare agency has documented conditions during the 
476.6 	assessment or investigation sufficient to cause a child protection worker, as defined in 
476.7 	section 626.559, subdivision 1, to conclude that a child is at significant risk of maltreatment 
476.8 	if protective intervention is not provided and that the individuals responsible for the child's 
476.9 	care have not taken or are not likely to take actions to protect the child from maltreatment 
476.10 	or risk of maltreatment.
476.11 	(h) This subdivision does not mean that maltreatment has occurred solely because the 
476.12 	child's parent, guardian, or other person responsible for the child's care in good faith selects 
476.13 	and depends upon spiritual means or prayer for treatment or care of disease or remedial care 
476.14 	of the child, in lieu of medical care. However, if lack of medical care may result in serious 
476.15 	danger to the child's health, the local welfare agency may ensure that necessary medical 
476.16 	services are provided to the child.
476.17 	(i) When determining whether the facility or individual is the responsible party, or 
476.18 	whether both the facility and the individual are responsible for determined maltreatment in 
476.19 	a facility, the investigating agency shall consider at least the following mitigating factors:
476.20 	(1) whether the actions of the facility or the individual caregivers were according to, 
476.21 	and followed the terms of, an erroneous physician order, prescription, individual care plan, 
476.22 	or directive; however, this is not a mitigating factor when the facility or caregiver was 
476.23 	responsible for the issuance of the erroneous order, prescription, individual care plan, or 
476.24 	directive or knew or should have known of the errors and took no reasonable measures to 
476.25 	correct the defect before administering care;
476.26 	(2) comparative responsibility between the facility, other caregivers, and requirements 
476.27 	placed upon an employee, including the facility's compliance with related regulatory standards 
476.28 	and the adequacy of facility policies and procedures, facility training, an individual's 
476.29 	participation in the training, the caregiver's supervision, and facility staffing levels and the 
476.30 	scope of the individual employee's authority and discretion; and
476.31 	(3) whether the facility or individual followed professional standards in exercising 
476.32 	professional judgment.
477.1 	The evaluation of the facility's responsibility under clause (2) must not be based on the 
477.2 	completeness of the risk assessment or risk reduction plan required under section 245A.66, 
477.3 	but must be based on the facility's compliance with the regulatory standards for policies 
477.4 	and procedures, training, and supervision as cited in Minnesota Statutes and Minnesota 
477.5 	Rules.
477.6 	(j) Notwithstanding paragraph (i), when maltreatment is determined to have been 
477.7 	committed by an individual who is also the facility license or certification holder, both the 
477.8 	individual and the facility must be determined responsible for the maltreatment, and both 
477.9 	the background study disqualification standards under section 245C.15, subdivision 4, and 
477.10 	the licensing or certification actions under sections section245A.06or,245A.07, 245G.06, 
477.11 	or 245G.07 apply.

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

477.13 	Sec. 71. Minnesota Statutes 2016, section 626.556, subdivision 10f, is amended to read:
477.14 		Subd. 10f.Notice of determinations. Within ten working days of the conclusion of a 
477.15 	family assessment, the local welfare agency shall notify the parent or guardian of the child 
477.16 	of the need for services to address child safety concerns or significant risk of subsequent 
477.17 	child maltreatment. The local welfare agency and the family may also jointly agree that 
477.18 	family support and family preservation services are needed. Within ten working days of the 
477.19 	conclusion of an investigation, the local welfare agency or agency responsible for 
477.20 	investigating the report shall notify the parent or guardian of the child, the person determined 
477.21 	to be maltreating the child, and, if applicable, the director of the facility, of the determination 
477.22 	and a summary of the specific reasons for the determination. When the investigation involves 
477.23 	a child foster care setting that is monitored by a private licensing agency under section 
477.24 	245A.16, the local welfare agency responsible for investigating the report shall notify the 
477.25 	private licensing agency of the determination and shall provide a summary of the specific 
477.26 	reasons for the determination. The notice to the private licensing agency must include 
477.27 	identifying private data, but not the identity of the reporter of maltreatment. The notice must 
477.28 	also include a certification that the information collection procedures under subdivision 10, 
477.29 	paragraphs (h), (i), and (j), were followed and a notice of the right of a data subject to obtain 
477.30 	access to other private data on the subject collected, created, or maintained under this section. 
477.31 	In addition, the notice shall include the length of time that the records will be kept under 
477.32 	subdivision 11c. The investigating agency shall notify the parent or guardian of the child 
477.33 	who is the subject of the report, and any person or facility determined to have maltreated a 
477.34 	child, of their appeal or review rights under this section. The notice must also state that a 
478.1 	finding of maltreatment may result in denial of a license or certification application or 
478.2 	background study disqualification under chapter 245C related to employment or services 
478.3 	that are licensed or certified by the Department of Human Services under chapter 245A or 
478.4 	245G, the Department of Health under chapter 144 or 144A, the Department of Corrections 
478.5 	under section 241.021, and from providing services related to an unlicensed personal care 
478.6 	provider organization under chapter 256B.

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

478.8 	Sec. 72. Minnesota Statutes 2016, section 626.556, subdivision 10i, is amended to read:
478.9 		Subd. 10i.Administrative reconsideration; review panel. (a) Administrative 
478.10 	reconsideration is not applicable in family assessments since no determination concerning 
478.11 	maltreatment is made. For investigations, except as provided under paragraph (e), an 
478.12 	individual or facility that the commissioner of human services, a local social service agency, 
478.13 	or the commissioner of education determines has maltreated a child, an interested person 
478.14 	acting on behalf of the child, regardless of the determination, who contests the investigating 
478.15 	agency's final determination regarding maltreatment, may request the investigating agency 
478.16 	to reconsider its final determination regarding maltreatment. The request for reconsideration 
478.17 	must be submitted in writing to the investigating agency within 15 calendar days after receipt 
478.18 	of notice of the final determination regarding maltreatment or, if the request is made by an 
478.19 	interested person who is not entitled to notice, within 15 days after receipt of the notice by 
478.20 	the parent or guardian of the child. If mailed, the request for reconsideration must be 
478.21 	postmarked and sent to the investigating agency within 15 calendar days of the individual's 
478.22 	or facility's receipt of the final determination. If the request for reconsideration is made by 
478.23 	personal service, it must be received by the investigating agency within 15 calendar days 
478.24 	after the individual's or facility's receipt of the final determination. Effective January 1, 
478.25 	2002, an individual who was determined to have maltreated a child under this section and 
478.26 	who was disqualified on the basis of serious or recurring maltreatment under sections 
478.27 	245C.14 and 245C.15, may request reconsideration of the maltreatment determination and 
478.28 	the disqualification. The request for reconsideration of the maltreatment determination and 
478.29 	the disqualification must be submitted within 30 calendar days of the individual's receipt 
478.30 	of the notice of disqualification under sections 245C.16 and 245C.17. If mailed, the request 
478.31 	for reconsideration of the maltreatment determination and the disqualification must be 
478.32 	postmarked and sent to the investigating agency within 30 calendar days of the individual's 
478.33 	receipt of the maltreatment determination and notice of disqualification. If the request for 
478.34 	reconsideration is made by personal service, it must be received by the investigating agency 
478.35 	within 30 calendar days after the individual's receipt of the notice of disqualification.
479.1 	(b) Except as provided under paragraphs (e) and (f), if the investigating agency denies 
479.2 	the request or fails to act upon the request within 15 working days after receiving the request 
479.3 	for reconsideration, the person or facility entitled to a fair hearing under section 256.045
479.4 	may submit to the commissioner of human services or the commissioner of education a 
479.5 	written request for a hearing under that section. Section 256.045 also governs hearings 
479.6 	requested to contest a final determination of the commissioner of education. The investigating 
479.7 	agency shall notify persons who request reconsideration of their rights under this paragraph. 
479.8 	The hearings specified under this section are the only administrative appeal of a decision 
479.9 	issued under paragraph (a). Determinations under this section are not subject to accuracy 
479.10 	and completeness challenges under section 13.04.
479.11 	(c) If, as a result of a reconsideration or review, the investigating agency changes the 
479.12 	final determination of maltreatment, that agency shall notify the parties specified in 
479.13 	subdivisions 10b, 10d, and 10f.
479.14 	(d) Except as provided under paragraph (f), if an individual or facility contests the 
479.15 	investigating agency's final determination regarding maltreatment by requesting a fair 
479.16 	hearing under section 256.045, the commissioner of human services shall assure that the 
479.17 	hearing is conducted and a decision is reached within 90 days of receipt of the request for 
479.18 	a hearing. The time for action on the decision may be extended for as many days as the 
479.19 	hearing is postponed or the record is held open for the benefit of either party.
479.20 	(e) If an individual was disqualified under sections 245C.14 and 245C.15, on the basis 
479.21 	of a determination of maltreatment, which was serious or recurring, and the individual has 
479.22 	requested reconsideration of the maltreatment determination under paragraph (a) and 
479.23 	requested reconsideration of the disqualification under sections 245C.21 to 245C.27, 
479.24 	reconsideration of the maltreatment determination and reconsideration of the disqualification 
479.25 	shall be consolidated into a single reconsideration. If reconsideration of the maltreatment 
479.26 	determination is denied and the individual remains disqualified following a reconsideration 
479.27 	decision, the individual may request a fair hearing under section 256.045. If an individual 
479.28 	requests a fair hearing on the maltreatment determination and the disqualification, the scope 
479.29 	of the fair hearing shall include both the maltreatment determination and the disqualification.
479.30 	(f) If a maltreatment determination or a disqualification based on serious or recurring 
479.31 	maltreatment is the basis for a denial of a license under section 245A.05 or a licensing 
479.32 	sanction under section 245A.07, the license holder has the right to a contested case hearing 
479.33 	under chapter 14 and Minnesota Rules, parts 1400.8505 to 1400.8612. As provided for 
479.34 	under section 245A.08, subdivision 2a, the scope of the contested case hearing shall include 
479.35 	the maltreatment determination, disqualification, and licensing sanction or denial of a license. 
480.1 	In such cases, a fair hearing regarding the maltreatment determination and disqualification 
480.2 	shall not be conducted under section 256.045. Except for family child care and child foster 
480.3 	care, reconsideration of a maltreatment determination as provided under this subdivision, 
480.4 	and reconsideration of a disqualification as provided under section 245C.22, shall also not 
480.5 	be conducted when:
480.6 	(1) a denial of a license under section 245A.05 or a licensing sanction under section 
480.7 	245A.07, is based on a determination that the license holder is responsible for maltreatment 
480.8 	or the disqualification of a license holder based on serious or recurring maltreatment;
480.9 	(2) the denial of a license or licensing sanction is issued at the same time as the 
480.10 	maltreatment determination or disqualification; and
480.11 	(3) the license holder appeals the maltreatment determination or disqualification, and 
480.12 	denial of a license or licensing sanction.
480.13 	Notwithstanding clauses (1) to (3), if the license holder appeals the maltreatment 
480.14 	determination or disqualification, but does not appeal the denial of a license or a licensing 
480.15 	sanction, reconsideration of the maltreatment determination shall be conducted under sections 
480.16 	626.556, subdivision 10i, and 626.557, subdivision 9d, and reconsideration of the 
480.17 	disqualification shall be conducted under section 245C.22. In such cases, a fair hearing shall 
480.18 	also be conducted as provided under sections 245C.27, 626.556, subdivision 10i, and 
480.19 	626.557, subdivision 9d.
480.20 	If the disqualified subject is an individual other than the license holder and upon whom 
480.21 	a background study must be conducted under chapter 245C, the hearings of all parties may 
480.22 	be consolidated into a single contested case hearing upon consent of all parties and the 
480.23 	administrative law judge.
480.24 	(g) For purposes of this subdivision, "interested person acting on behalf of the child" 
480.25 	means a parent or legal guardian; stepparent; grandparent; guardian ad litem; adult 
480.26 	stepbrother, stepsister, or sibling; or adult aunt or uncle; unless the person has been 
480.27 	determined to be the perpetrator of the maltreatment.
480.28 	(h) If a maltreatment determination is the basis for a correction order under section 
480.29 	245G.06 or decertification under section 245G.07, the certification holder has the right to 
480.30 	request reconsideration under sections 245G.06 and 245G.07. If the certification holder 
480.31 	appeals the maltreatment determination or disqualification, but does not appeal the correction 
480.32 	order or decertification, reconsideration of the maltreatment determination shall be conducted 
480.33 	under section 626.556, subdivision 10i, and reconsideration of the disqualification shall be 
480.34 	conducted under section 245C.22.

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

481.2 	Sec. 73. Laws 2012, chapter 247, article 6, section 2, subdivision 2, is amended to read:

481.3	Subd. 2.Central Office Operations

481.4	(a) Operations
		118,000
		356,000
	
481.5 	Base Level Adjustment. The general fund 
481.6 	base is increased by $91,000 in fiscal year 
481.7 	2014 and $44,000 in fiscal year 2015.

481.8	(b) Health Care
		24,000
		346,000
	
481.9 	This is a onetime appropriation.
481.10 	Managed Care Audit Activities. In fiscal 
481.11 	year 2014, and in each even-numbered year 
481.12 	thereafter, the commissioner shall transfer 
481.13 	from the health care access fund $1,740,000 
481.14 	to the legislative auditor for managed care 
481.15 	audit services under Minnesota Statutes, 
481.16 	section 256B.69, subdivision 9d. This is a 
481.17 	biennial appropriation. The health care access 
481.18 	fund base is increased by $1,842,000 in fiscal 
481.19 	year 2014. Notwithstanding any contrary 
481.20 	provision in this article, this paragraph does 
481.21 	not expire.

481.22	(c) Continuing Care
		19,000
		375,000
	
481.23 	Base Level Adjustment. The general fund 
481.24 	base is decreased by $159,000 in fiscal years 
481.25 	2014 and 2015.

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

481.27 	Sec. 74.  REPEALER.
 481.28 	(a) Minnesota Statutes 2016, sections 245C.11, subdivision 4; 245C.16, subdivision 3; 
481.29 	and 245C.17, subdivision 4, are repealed.
481.30 	(b) Minnesota Rules, part 9503.0145, subpart 6, is repealed.

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

482.1 	ARTICLE 10
482.2 	DEPARTMENT OF HEALTH

482.3 	Section 1. Minnesota Statutes 2016, section 103I.005, subdivision 2, is amended to read:
482.4 		Subd. 2.Boring. "Boring" means a hole or excavation that is not used to extract water 
482.5 	and includes exploratory borings, environmental bore holes, bored geothermal heat 
482.6 	exchangers, and elevator shafts borings.

482.7 	Sec. 2. Minnesota Statutes 2016, section 103I.005, subdivision 2a, is amended to read:
482.8 		Subd. 2a.Certified representative. "Certified representative" means a person certified 
482.9 	by the commissioner to represent a well contractor, limited well/boring contractor, monitoring
482.10 	environmental well contractor, or elevator boring contractor.

482.11 	Sec. 3. Minnesota Statutes 2016, section 103I.005, is amended by adding a subdivision 
482.12 	to read:
482.13 		Subd. 8a.Environmental well. "Environmental well" means an excavation 15 or more 
482.14 	feet in depth that is drilled, cored, bored, washed, driven, dug, jetted, or otherwise constructed 
482.15 	to:
482.16 	(1) conduct physical, chemical, or biological testing of groundwater, and includes a 
482.17 	groundwater quality monitoring or sampling well;
482.18 	(2) lower a groundwater level to control or remove contamination in groundwater, and 
482.19 	includes a remedial well and excludes horizontal trenches; or
482.20 	(3) monitor or measure physical, chemical, radiological, or biological parameters of the 
482.21 	earth and earth fluids, or for vapor recovery or venting systems. An environmental well 
482.22 	includes an excavation used to:
482.23 	(i) measure groundwater levels, including a piezometer;
482.24 	(ii) determine groundwater flow direction or velocity;
482.25 	(iii) measure earth properties such as hydraulic conductivity, bearing capacity, or 
482.26 	resistance;
482.27 	(iv) obtain samples of geologic materials for testing or classification; or
482.28 	(v) remove or remediate pollution or contamination from groundwater or soil through 
482.29 	the use of a vent, vapor recovery system, or sparge point.

483.1 	Sec. 4. Minnesota Statutes 2016, section 103I.005, is amended by adding a subdivision 
483.2 	to read:
483.3 		Subd. 8b.Environmental well contractor. "Environmental well contractor" means a 
483.4 	person with an environmental well contractor's license issued by the commissioner.

483.5 	Sec. 5. Minnesota Statutes 2016, section 103I.005, subdivision 12, is amended to read:
483.6 		Subd. 12.Limited well/boring contractor. "Limited well/boring contractor" means a 
483.7 	person with a limited well/boring contractor's license issued by the commissioner. Limited 
483.8 	well/boring contractor's licenses are issued for:
483.9 	(1) constructing, repairing, and sealing bored geothermal heat exchangers;
483.10 	(2) installing, repairing, and modifying pitless units and pitless adaptors, well casings 
483.11 	above the pitless unit or pitless adaptor, well screens, or well diameters; constructing, 
483.12 	repairing, and sealing drive point wells or dug wells, and well pumps and pumping 
483.13 	equipment;
483.14 	(3) constructing, repairing, and sealing dewatering wells; and
483.15 	(4) sealing wells; and installing well pumps or pumping equipment and borings.

483.16 	Sec. 6. Minnesota Statutes 2016, section 103I.005, is amended by adding a subdivision 
483.17 	to read:
483.18 		Subd. 17a.Temporary environmental well. "Temporary environmental well" means 
483.19 	an environmental well as defined in section 103I.005, subdivision 8a, that is sealed within 
483.20 	72 hours of the time construction on the well begins.

483.21 	Sec. 7. Minnesota Statutes 2016, section 103I.005, subdivision 20a, is amended to read:
483.22 		Subd. 20a.Water supply well. "Water supply well" means a well that is not a dewatering 
483.23 	well or monitoring environmental well and includes wells used:
483.24 	(1) for potable water supply;
483.25 	(2) for irrigation;
483.26 	(3) for agricultural, commercial, or industrial water supply;
483.27 	(4) for heating or cooling; and
483.28 	(5) as a remedial well; and
484.1 	(6) for testing water yield for irrigation, commercial or industrial uses, residential supply, 
484.2 	or public water supply.

484.3 	Sec. 8. Minnesota Statutes 2016, section 103I.005, subdivision 21, is amended to read:
484.4 		Subd. 21.Well. "Well" means an excavation that is drilled, cored, bored, washed, driven, 
484.5 	dug, jetted, or otherwise constructed if the excavation is intended for the location, diversion, 
484.6 	artificial recharge, monitoring, testing, remediation, or acquisition of groundwater. Well 
484.7 	includes monitoring environmental wells, drive point wells, and dewatering wells. "Well" 
484.8 	does not include:
484.9 	(1) an excavation by backhoe, or otherwise for temporary dewatering of groundwater 
484.10 	for nonpotable use during construction, if the depth of the excavation is 25 feet or less;
484.11 	(2) an excavation made to obtain or prospect for oil, natural gas, minerals, or products 
484.12 	of mining or quarrying;
484.13 	(3) an excavation to insert media to repressure oil or natural gas bearing formations or 
484.14 	to store petroleum, natural gas, or other products;
484.15 	(4) an excavation for nonpotable use for wildfire suppression activities; or
484.16 	(5) borings.

484.17 	Sec. 9. Minnesota Statutes 2016, section 103I.101, subdivision 2, is amended to read:
484.18 		Subd. 2.Duties. The commissioner shall:
484.19 	(1) regulate the drilling, construction, modification, repair, and sealing of wells and 
484.20 	borings;
484.21 	(2) examine and license:
484.22 	(i) well contractors;
484.23 	(ii) persons constructing, repairing, and sealing bored geothermal heat exchangers;
484.24 	(iii) persons modifying or repairing well casings above the pitless unit or adaptor, well 
484.25 	screens, or well diameters; persons constructing, repairing, and sealing drive point wells or 
484.26 	dug wells, and installing well pumps or pumping equipment;
484.27 	(iv) persons constructing, repairing, and sealing dewatering wells;
484.28 	(v) persons sealing wells; persons installing well pumps or pumping equipment or 
484.29 	borings; and
485.1 	(vi) persons excavating or drilling holes for the installation of elevator borings or 
485.2 	hydraulic cylinders;
485.3 	(3) register examine and examine monitoring license environmental well contractors;
485.4 	(4) license explorers engaged in exploratory boring and examine individuals who 
485.5 	supervise or oversee exploratory boring;
485.6 	(5) after consultation with the commissioner of natural resources and the Pollution 
485.7 	Control Agency, establish standards for the design, location, construction, repair, and sealing 
485.8 	of wells and borings within the state; and
485.9 	(6) issue permits for wells, groundwater thermal devices, bored geothermal heat 
485.10 	exchangers, and elevator borings.

485.11 	Sec. 10. Minnesota Statutes 2016, section 103I.101, subdivision 5, is amended to read:
485.12 		Subd. 5.Commissioner to adopt rules. The commissioner shall adopt rules including:
485.13 	(1) issuance of licenses for:
485.14 	(i) qualified well contractors, persons modifying or repairing well casings, well screens, 
485.15 	or well diameters;
485.16 	(ii) persons constructing, repairing, and sealing drive point wells or dug wells;
485.17 	(iii) persons constructing, repairing, and sealing dewatering wells;
485.18 	(iv) (iii) persons sealing wells or borings;
485.19 	(v) (iv) persons installing, modifying, or repairing well casings, well screens, well 
485.20 	diameters, and well pumps or pumping equipment;
485.21 	(vi) (v) persons constructing, repairing, and sealing bored geothermal heat exchangers; 
485.22 	and
485.23 	(vii) (vi) persons constructing, repairing, and sealing elevator borings; and
485.24 	(vii) persons constructing, repairing, and sealing environmental wells;
485.25 	(2) issuance of registration for monitoring well contractors;
485.26 	(3) establishment of conditions for examination and review of applications for license 
485.27 	and registration certification;
485.28 	(4) (3) establishment of conditions for revocation and suspension of license and 
485.29 	registration certification;
486.1 	(5) (4) establishment of minimum standards for design, location, construction, repair, 
486.2 	and sealing of wells and borings to implement the purpose and intent of this chapter;
486.3 	(6) (5) establishment of a system for reporting on wells and borings drilled and sealed;
486.4 	(7) (6) establishment of standards for the construction, maintenance, sealing, and water 
486.5 	quality monitoring of wells in areas of known or suspected contamination;
486.6 	(8) (7) establishment of wellhead protection measures for wells serving public water 
486.7 	supplies;
486.8 	(9) (8) establishment of procedures to coordinate collection of well and boring data with 
486.9 	other state and local governmental agencies;
486.10 	(10) (9) establishment of criteria and procedures for submission of well and boring logs, 
486.11 	formation samples or well or boring cuttings, water samples, or other special information 
486.12 	required for and water resource mapping; and
486.13 	(11) (10) establishment of minimum standards for design, location, construction, 
486.14 	maintenance, repair, sealing, safety, and resource conservation related to borings, including 
486.15 	exploratory borings as defined in section 103I.005, subdivision 9.

486.16 	Sec. 11. Minnesota Statutes 2016, section 103I.101, subdivision 6, is amended to read:
486.17 		Subd. 6.Fees for variances. The commissioner shall charge a nonrefundable application 
486.18 	fee of $235 $275 to cover the administrative cost of processing a request for a variance or 
486.19 	modification of rules adopted by the commissioner under this chapter.

486.20 	Sec. 12. Minnesota Statutes 2016, section 103I.105, is amended to read:
486.21 	103I.105 ADVISORY COUNCIL ON WELLS AND BORINGS.
486.22 	(a) The Advisory Council on Wells and Borings is established as an advisory council 
486.23 	to the commissioner. The advisory council shall consist of 18 voting members. Of the 18 
486.24 	voting members:
486.25 	(1) one member must be from the Department of Health, appointed by the commissioner 
486.26 	of health;
486.27 	(2) one member must be from the Department of Natural Resources, appointed by the 
486.28 	commissioner of natural resources;
486.29 	(3) one member must be a member of the Minnesota Geological Survey of the University 
486.30 	of Minnesota, appointed by the director;
487.1 	(4) one member must be a responsible individual for a licensed explorer;
487.2 	(5) one member must be a certified representative of a licensed elevator boring contractor;
487.3 	(6) two members must be members of the public who are not connected with the boring 
487.4 	or well drilling industry;
487.5 	(7) one member must be from the Pollution Control Agency, appointed by the 
487.6 	commissioner of the Pollution Control Agency;
487.7 	(8) one member must be from the Department of Transportation, appointed by the 
487.8 	commissioner of transportation;
487.9 	(9) one member must be from the Board of Water and Soil Resources appointed by its 
487.10 	chair;
487.11 	(10) one member must be a certified representative of a monitoring an environmental
487.12 	well contractor;
487.13 	(11) six members must be residents of this state appointed by the commissioner, who 
487.14 	are certified representatives of licensed well contractors, with not more than two from the 
487.15 	seven-county metropolitan area and at least four from other areas of the state who represent 
487.16 	different geographical regions; and
487.17 	(12) one member must be a certified representative of a licensed bored geothermal heat 
487.18 	exchanger contractor.
487.19 	(b) An appointee of the well drilling industry may not serve more than two consecutive 
487.20 	terms.
487.21 	(c) The appointees to the advisory council from the well drilling industry must:
487.22 	(1) have been residents of this state for at least three years before appointment; and
487.23 	(2) have at least five years' experience in the well drilling business.
487.24 	(d) The terms of the appointed members and the compensation and removal of all 
487.25 	members are governed by section 15.059.

487.26 	Sec. 13. Minnesota Statutes 2016, section 103I.111, subdivision 6, is amended to read:
487.27 		Subd. 6.Unsealed wells and borings are public health nuisances. A well or boring 
487.28 	that is required to be sealed under section 103I.301 but is not sealed is a public health 
487.29 	nuisance. A county may abate the unsealed well or boring with the same authority of a 
487.30 	community health board to abate a public health nuisance under section 145A.04, subdivision 
487.31 	8.

488.1 	Sec. 14. Minnesota Statutes 2016, section 103I.111, subdivision 8, is amended to read:
488.2 		Subd. 8.Municipal regulation of drilling. A municipality may regulate all drilling, 
488.3 	except well, elevator shaft boring, and exploratory drilling that is subject to the provisions 
488.4 	of this chapter, above, in, through, and adjacent to subsurface areas designated for mined 
488.5 	underground space development and existing mined underground space. The regulations 
488.6 	may prohibit, restrict, control, and require permits for the drilling.

488.7 	Sec. 15. Minnesota Statutes 2016, section 103I.205, subdivision 1, is amended to read:
488.8 		Subdivision 1.Notification required. (a) Except as provided in paragraphs paragraph
488.9 	(d) and (e), a person may not construct a water-supply, dewatering, or environmental well 
488.10 	until a notification of the proposed well on a form prescribed by the commissioner is filed 
488.11 	with the commissioner with the filing fee in section 103I.208, and, when applicable, the 
488.12 	person has met the requirements of paragraph (f) (e). If after filing the well notification an 
488.13 	attempt to construct a well is unsuccessful, a new notification is not required unless the 
488.14 	information relating to the successful well has substantially changed. A notification is not 
488.15 	required prior to construction of a temporary environmental well.
488.16 	(b) The property owner, the property owner's agent, or the well licensed contractor where 
488.17 	a well is to be located must file the well notification with the commissioner.
488.18 	(c) The well notification under this subdivision preempts local permits and notifications, 
488.19 	and counties or home rule charter or statutory cities may not require a permit or notification 
488.20 	for wells unless the commissioner has delegated the permitting or notification authority 
488.21 	under section 103I.111.
488.22 	(d) A person who is an individual that constructs a drive point water-supply well on 
488.23 	property owned or leased by the individual for farming or agricultural purposes or as the 
488.24 	individual's place of abode must notify the commissioner of the installation and location of 
488.25 	the well. The person must complete the notification form prescribed by the commissioner 
488.26 	and mail it to the commissioner by ten days after the well is completed. A fee may not be 
488.27 	charged for the notification. A person who sells drive point wells at retail must provide 
488.28 	buyers with notification forms and informational materials including requirements regarding 
488.29 	wells, their location, construction, and disclosure. The commissioner must provide the 
488.30 	notification forms and informational materials to the sellers.
488.31 	(e) A person may not construct a monitoring well until a permit is issued by the 
488.32 	commissioner for the construction. If after obtaining a permit an attempt to construct a well 
489.1 	is unsuccessful, a new permit is not required as long as the initial permit is modified to 
489.2 	indicate the location of the successful well.
489.3 	(f) (e) When the operation of a well will require an appropriation permit from the 
489.4 	commissioner of natural resources, a person may not begin construction of the well until 
489.5 	the person submits the following information to the commissioner of natural resources:
489.6 	(1) the location of the well;
489.7 	(2) the formation or aquifer that will serve as the water source;
489.8 	(3) the maximum daily, seasonal, and annual pumpage rates and volumes that will be 
489.9 	requested in the appropriation permit; and
489.10 	(4) other information requested by the commissioner of natural resources that is necessary 
489.11 	to conduct the preliminary assessment required under section 103G.287, subdivision 1, 
489.12 	paragraph (c).
489.13 	The person may begin construction after receiving preliminary approval from the 
489.14 	commissioner of natural resources.

489.15 	Sec. 16. Minnesota Statutes 2016, section 103I.205, subdivision 2, is amended to read:
489.16 		Subd. 2.Emergency permit and notification exemptions. The commissioner may 
489.17 	adopt rules that modify the procedures for filing a well notification or well or boring permit 
489.18 	if conditions occur that:
489.19 	(1) endanger the public health and welfare or cause a need to protect the groundwater; 
489.20 	or
489.21 	(2) require the monitoring environmental well contractor, limited well/boring contractor, 
489.22 	or well contractor to begin constructing a well or boring before obtaining a permit or 
489.23 	notification.

489.24 	Sec. 17. Minnesota Statutes 2016, section 103I.205, subdivision 3, is amended to read:
489.25 		Subd. 3.Maintenance permit. (a) Except as provided under paragraph (b), a well that 
489.26 	is not in use must be sealed or have a maintenance permit.
489.27 	(b) If a monitoring an environmental well or a dewatering well is not sealed by 14 months 
489.28 	after completion of construction, the owner of the property on which the well is located 
489.29 	must obtain and annually renew a maintenance permit from the commissioner.

490.1 	Sec. 18. Minnesota Statutes 2016, section 103I.205, subdivision 4, is amended to read:
490.2 		Subd. 4.License required. (a) Except as provided in paragraph (b), (c), (d), or (e), 
490.3 	section 103I.401, subdivision 2, or 103I.601, subdivision 2, a person may not drill, construct, 
490.4 	repair, or seal a well or boring unless the person has a well contractor's license in possession.
490.5 	(b) A person may construct, repair, and seal a monitoring an environmental well if the 
490.6 	person:
490.7 	(1) is a professional engineer licensed under sections 326.02 to 326.15 in the branches 
490.8 	of civil or geological engineering;
490.9 	(2) is a hydrologist or hydrogeologist certified by the American Institute of Hydrology;
490.10 	(3) is a professional geoscientist licensed under sections 326.02 to 326.15;
490.11 	(4) is a geologist certified by the American Institute of Professional Geologists; or
490.12 	(5) meets the qualifications established by the commissioner in rule.
490.13 	A person must register with be licensed by the commissioner as a monitoring an 
490.14 	environmental well contractor on forms provided by the commissioner.
490.15 	(c) A person may do the following work with a limited well/boring contractor's license 
490.16 	in possession. A separate license is required for each of the six four activities:
490.17 	(1) installing or, repairing, and modifying well screens or, pitless units or and pitless 
490.18 	adaptors, well pumps and pumping equipment, and well casings from the pitless adaptor or 
490.19 	pitless unit to the upper termination of the well casing;
490.20 	(2) constructing, repairing, and sealing drive point wells or dug wells;
490.21 	(3) installing well pumps or pumping equipment;
490.22 	(4) sealing wells and borings;
490.23 	(5) (3) constructing, repairing, or and sealing dewatering wells; or
490.24 	(6) (4) constructing, repairing, or and sealing bored geothermal heat exchangers.
490.25 	(d) A person may construct, repair, and seal an elevator boring with an elevator boring 
490.26 	contractor's license.
490.27 	(e) Notwithstanding other provisions of this chapter requiring a license or registration, 
490.28 	a license or registration is not required for a person who complies with the other provisions 
490.29 	of this chapter if the person is:
491.1 	(1) an individual who constructs a water-supply well on land that is owned or leased by 
491.2 	the individual and is used by the individual for farming or agricultural purposes or as the 
491.3 	individual's place of abode;
491.4 	(2) an individual who performs labor or services for a contractor licensed or registered
491.5 	under the provisions of this chapter in connection with the construction, sealing, or repair 
491.6 	of a well or boring at the direction and under the personal supervision of a contractor licensed 
491.7 	or registered under the provisions of this chapter; or
491.8 	(3) a licensed plumber who is repairing submersible pumps or water pipes associated 
491.9 	with well water systems if: (i) the repair location is within an area where there is no licensed 
491.10 	or registered well contractor within 50 miles, and (ii) the licensed plumber complies with 
491.11 	all relevant sections of the plumbing code.

491.12 	Sec. 19. Minnesota Statutes 2016, section 103I.205, subdivision 5, is amended to read:
491.13 		Subd. 5.At-grade monitoring environmental wells. At-grade monitoring environmental
491.14 	wells are authorized without variance and may be installed for the purpose of evaluating 
491.15 	groundwater conditions or for use as a leak detection device. An at-grade monitoring
491.16 	environmental well must be installed in accordance with the rules of the commissioner. The 
491.17 	at-grade monitoring environmental wells must be installed with an impermeable double 
491.18 	locking cap approved by the commissioner and must be labeled environmental or monitoring 
491.19 	wells.

491.20 	Sec. 20. Minnesota Statutes 2016, section 103I.205, subdivision 6, is amended to read:
491.21 		Subd. 6.Distance requirements for sources of contamination buildings, gas pipes, 
491.22 	liquid propane tanks, and electric lines. (a) A person may not place, construct, or install 
491.23 	an actual or potential source of contamination, building, gas pipe, liquid propane tank, or 
491.24 	electric line any closer to a well or boring than the isolation distances prescribed by the 
491.25 	commissioner by rule unless a variance has been prescribed by rule.
491.26 	(b) The commissioner shall establish by rule reduced isolation distances for facilities 
491.27 	which have safeguards in accordance with sections 18B.01, subdivision 26, and 18C.005, 
491.28 	subdivision 29.

491.29 	Sec. 21. Minnesota Statutes 2016, section 103I.208, subdivision 1, is amended to read:
491.30 		Subdivision 1.Well notification fee. The well notification fee to be paid by a property 
491.31 	owner is:
492.1 	(1) for construction of a new water supply well, $235 $275, which includes the state 
492.2 	core function fee;
492.3 	(2) for a well sealing, $65 $75 for each well, which includes the state core function fee, 
492.4 	except that a single fee of $75 is required for monitoring all temporary environmental wells 
492.5 	constructed on recorded on the sealing notification for a single property, having depths 
492.6 	within a 25 foot range, and sealed within 48 72 hours of start of construction, a single fee 
492.7 	of $65; and
492.8 	(3) for construction of a dewatering well, $235 $275, which includes the state core 
492.9 	function fee, for each dewatering well except a dewatering project comprising five or more 
492.10 	dewatering wells shall be assessed a single fee of $1,175 $1,375 for the dewatering wells 
492.11 	recorded on the notification.; and
492.12 	(4) for construction of an environmental well, $275, which includes the state core function 
492.13 	fee, except that a single fee of $275 is required for all environmental wells recorded on the 
492.14 	notification that are located on a single property, and except that no fee is required for 
492.15 	construction of a temporary environmental well.

492.16 	Sec. 22. Minnesota Statutes 2016, section 103I.208, subdivision 2, is amended to read:
492.17 		Subd. 2.Permit fee. The permit fee to be paid by a property owner is:
492.18 	(1) for a water supply well that is not in use under a maintenance permit, $175 annually;
492.19 	(2) for construction of a monitoring well, $235, which includes the state core function 
492.20 	fee;
492.21 	(3) for a monitoring an environmental well that is unsealed under a maintenance permit, 
492.22 	$175 annually except no fee is required for an environmental well owned by a federal 
492.23 	agency, state agency, or local unit of government that is unsealed under a maintenance 
492.24 	permit. "Local unit of government" means a statutory or home rule charter city, town, county, 
492.25 	or soil and water conservation district, watershed district, an organization formed for the 
492.26 	joint exercise of powers under section 471.59, a community health board, or other special 
492.27 	purpose district or authority with local jurisdiction in water and related land resources 
492.28 	management;
492.29 	(4) for a monitoring well owned by a federal agency, state agency, or local unit of 
492.30 	government that is unsealed under a maintenance permit, $50 annually. "Local unit of 
492.31 	government" means a statutory or home rule charter city, town, county, or soil and water 
492.32 	conservation district, watershed district, an organization formed for the joint exercise of 
493.1 	powers under section 471.59, a community health board, or other special purpose district 
493.2 	or authority with local jurisdiction in water and related land resources management;
493.3 	(5) (3) for monitoring environmental wells used as a leak detection device at a single 
493.4 	motor fuel retail outlet, a single petroleum bulk storage site excluding tank farms, or a single 
493.5 	agricultural chemical facility site, the construction permit fee is $235, which includes the 
493.6 	state core function fee, per site regardless of the number of wells constructed on the site, 
493.7 	and the annual fee for that are unsealed under a maintenance permit for unsealed monitoring 
493.8 	wells is, $175 annually per site regardless of the number of monitoring environmental wells 
493.9 	located on site;
493.10 	(6) (4) for a groundwater thermal exchange device, in addition to the notification fee 
493.11 	for water supply wells, $235 $275, which includes the state core function fee;
493.12 	(7) (5) for a bored geothermal heat exchanger with less than ten tons of heating/cooling 
493.13 	capacity, $235 $275;
493.14 	(8) (6) for a bored geothermal heat exchanger with ten to 50 tons of heating/cooling 
493.15 	capacity, $475 $515;
493.16 	(9) (7) for a bored geothermal heat exchanger with greater than 50 tons of heating/cooling 
493.17 	capacity, $700 $740;
493.18 	(10) (8) for a dewatering well that is unsealed under a maintenance permit, $175 annually 
493.19 	for each dewatering well, except a dewatering project comprising more than five dewatering 
493.20 	wells shall be issued a single permit for $875 annually for dewatering wells recorded on 
493.21 	the permit; and
493.22 	(11) (9) for an elevator boring, $235 $275 for each boring.

493.23 	Sec. 23. Minnesota Statutes 2016, section 103I.235, is amended by adding a subdivision 
493.24 	to read:
493.25 		Subd. 3.Temporary environmental well and unsuccessful well exemption. This 
493.26 	section does not apply to temporary environmental wells or unsuccessful wells that have 
493.27 	been sealed by a licensed contractor in compliance with this chapter.

493.28 	Sec. 24. Minnesota Statutes 2016, section 103I.301, subdivision 1, is amended to read:
493.29 		Subdivision 1.Wells and borings. (a) A property owner must have a well or boring 
493.30 	sealed if:
493.31 	(1) the well or boring is contaminated or may contribute to the spread of contamination;
494.1 	(2) the well or boring was attempted to be sealed but was not sealed according to the 
494.2 	provisions of this chapter; or
494.3 	(3) the well or boring is located, constructed, or maintained in a manner that its continued 
494.4 	use or existence endangers groundwater quality or is a safety or health hazard.
494.5 	(b) A well or boring that is not in use must be sealed unless the property owner has a 
494.6 	maintenance permit for the well.
494.7 	(c) The property owner must have a well or boring sealed by a registered or licensed 
494.8 	person authorized to seal the well or boring, consistent with provisions of this chapter.

494.9 	Sec. 25. Minnesota Statutes 2016, section 103I.301, subdivision 2, is amended to read:
494.10 		Subd. 2.MonitoringEnvironmental wells. The owner of the property where a 
494.11 	monitoring an environmental well is located must have the monitoring environmental well 
494.12 	sealed when the well is no longer in use. The owner must have a well contractor, limited 
494.13 	well/boring sealing contractor, or a monitoring an environmental well contractor seal the 
494.14 	monitoring environmental well.

494.15 	Sec. 26. Minnesota Statutes 2016, section 103I.315, subdivision 1, is amended to read:
494.16 		Subdivision 1.Order to seal well or boring. The commissioner may order a property 
494.17 	owner to seal a well or boring if:
494.18 	(1) the commissioner determines that without being sealed the well or boring is an 
494.19 	imminent threat to public health or public safety;
494.20 	(2) the well or boring is required to be sealed under section 103I.301; or
494.21 	(3) a well is a monitoring an environmental well or dewatering well and by 14 months 
494.22 	after construction of the well, the owner has not obtained a maintenance permit, or after a 
494.23 	maintenance permit has been issued the owner has not renewed a maintenance permit.

494.24 	Sec. 27. Minnesota Statutes 2016, section 103I.501, is amended to read:
494.25 	103I.501 LICENSING AND REGULATION OF WELLS AND BORINGS.
494.26 	(a) The commissioner shall regulate and license:
494.27 	(1) drilling, constructing, and repair of wells;
494.28 	(2) sealing of wells;
494.29 	(3) installing of well pumps and pumping equipment;
495.1 	(4) excavating, drilling, repairing, and sealing of elevator borings;
495.2 	(5) construction, repair, and sealing of environmental bore holes wells; and
495.3 	(6) construction, repair, and sealing of bored geothermal heat exchangers.
495.4 	(b) The commissioner shall examine and license well contractors, limited well/boring 
495.5 	contractors, and elevator boring contractors, and examine and register monitoring
495.6 	environmental well contractors.
495.7 	(c) The commissioner shall license explorers engaged in exploratory boring and shall 
495.8 	examine persons who supervise or oversee exploratory boring.

495.9 	Sec. 28. Minnesota Statutes 2016, section 103I.505, subdivision 1, is amended to read:
495.10 		Subdivision 1.Reciprocity authorized. The commissioner may issue a license or register
495.11 	certify a person under this chapter, without giving an examination, if the person is licensed 
495.12 	or registered certified in another state and:
495.13 	(1) the requirements for licensing or registration certification under which the well or 
495.14 	boring contractor was licensed or registered person was certified do not conflict with this 
495.15 	chapter;
495.16 	(2) the requirements are of a standard not lower than that specified by the rules adopted 
495.17 	under this chapter; and
495.18 	(3) equal reciprocal privileges are granted to licensees or registrants certified persons
495.19 	of this state.

495.20 	Sec. 29. Minnesota Statutes 2016, section 103I.505, subdivision 2, is amended to read:
495.21 		Subd. 2.Fees required. A well or boring contractor or certified person must apply for 
495.22 	the license or registration certification and pay the fees under the provisions of this chapter 
495.23 	to receive a license or registration certification under this section.

495.24 	Sec. 30. Minnesota Statutes 2016, section 103I.515, is amended to read:
495.25 	103I.515 LICENSES NOT TRANSFERABLE.
495.26 	A license or registration certification issued under this chapter is not transferable.

495.27 	Sec. 31. Minnesota Statutes 2016, section 103I.525, subdivision 1, is amended to read:
495.28 		Subdivision 1.Certification application. (a) A person must file an application and 
495.29 	application fee with the commissioner to represent a well contractor.
496.1 	(b) The application must state the applicant's qualifications for certification as a 
496.2 	representative, and other information required by the commissioner. The application must 
496.3 	be on forms prescribed by the commissioner.
496.4 	(c) A person may apply as an individual if the person:
496.5 	(1) is not representing a firm, sole proprietorship, partnership, association, corporation, 
496.6 	or other entity including the United States government, any interstate body, the state, and 
496.7 	an agency, department, or political subdivision of the state; and
496.8 	(2) meets the well contractor certification and license requirements under this chapter.

496.9 	Sec. 32. Minnesota Statutes 2016, section 103I.525, subdivision 2, is amended to read:
496.10 		Subd. 2.Certification fee. (a) The application fee for certification as a representative 
496.11 	of a well contractor is $75. The commissioner may not act on an application until the 
496.12 	application fee is paid.
496.13 	(b) The renewal fee for certification as a representative of a well contractor is $75. The 
496.14 	commissioner may not renew a certification until the renewal fee is paid.
496.15 	(c) A certified representative must file an application and a renewal application fee to 
496.16 	renew the certification by the date stated in the certification. The renewal application must 
496.17 	include information that the certified representative has met continuing education 
496.18 	requirements established by the commissioner by rule.

496.19 	Sec. 33. Minnesota Statutes 2016, section 103I.525, subdivision 5, is amended to read:
496.20 		Subd. 5.Bond. (a) As a condition of being issued a well contractor's license, the applicant, 
496.21 	except a person applying for an individual well contractor's license, must submit a corporate 
496.22 	surety bond for $25,000 approved by the commissioner. The bond must be conditioned to 
496.23 	pay the state on performance of work in this state that is not in compliance with this chapter 
496.24 	or rules adopted under this chapter. The bond is in lieu of other license bonds required by 
496.25 	a political subdivision of the state.
496.26 	(b) From proceeds of the bond, the commissioner may compensate persons injured or 
496.27 	suffering financial loss because of a failure of the applicant to perform work or duties in 
496.28 	compliance with this chapter or rules adopted under this chapter.

496.29 	Sec. 34. Minnesota Statutes 2016, section 103I.525, subdivision 6, is amended to read:
496.30 		Subd. 6.License fee. The fee for a well contractor's license is $250, except the fee for 
496.31 	an individual well contractor's license is $75.

497.1 	Sec. 35. Minnesota Statutes 2016, section 103I.525, subdivision 8, is amended to read:
497.2 		Subd. 8.Renewal. (a) A licensee must file an application and a renewal application fee 
497.3 	to renew the license by the date stated in the license.
497.4 	(b) The renewal application fee for a well contractor's license is $250, except the fee for 
497.5 	an individual well contractor's license is $75.
497.6 	(c) The renewal application must include information that the certified representative 
497.7 	of the applicant has met continuing education requirements established by the commissioner 
497.8 	by rule.
497.9 	(d) At the time of the renewal, the commissioner must have on file all properly completed 
497.10 	well and boring construction reports, well and boring sealing reports, reports of elevator 
497.11 	borings, water sample analysis reports, well and boring permits, and well notifications for 
497.12 	work conducted by the licensee since the last license renewal.

497.13 	Sec. 36. Minnesota Statutes 2016, section 103I.531, subdivision 2, is amended to read:
497.14 		Subd. 2.Certification fee. (a) The application fee for certification as a representative 
497.15 	of a limited well/boring contractor is $75. The commissioner may not act on an application 
497.16 	until the application fee is paid.
497.17 	(b) The renewal fee for certification as a representative of a limited well/boring contractor 
497.18 	is $75. The commissioner may not renew a certification until the renewal fee is paid.
497.19 	(c) The fee for three or more limited well/boring contractor certifications is $225.
497.20 	(d) A certified representative must file an application and a renewal application fee to 
497.21 	renew the certification by the date stated in the certification. The renewal application must 
497.22 	include information that the certified representative has met continuing education 
497.23 	requirements established by the commissioner by rule.

497.24 	Sec. 37. Minnesota Statutes 2016, section 103I.531, subdivision 5, is amended to read:
497.25 		Subd. 5.Bond. (a) As a condition of being issued a limited well/boring contractor's 
497.26 	license for constructing, repairing, and sealing drive point wells or dug wells, sealing wells 
497.27 	or and borings, constructing, repairing, and sealing dewatering wells, or constructing, 
497.28 	repairing, and sealing bored geothermal heat exchangers, the applicant must submit a 
497.29 	corporate surety bond for $10,000 approved by the commissioner. As a condition of being 
497.30 	issued a limited well/boring contractor's license for installing or, repairing, and modifying 
497.31 	well pumps and pumping equipment, well screens or, pitless units or and pitless adaptors,
498.1 	and well casings from the pitless adaptor or pitless unit to the upper termination of the well 
498.2 	casing, or installing well pumps or pumping equipment, the applicant must submit a corporate 
498.3 	surety bond for $2,000 approved by the commissioner. The bonds required in this paragraph 
498.4 	must be conditioned to pay the state on performance of work in this state that is not in 
498.5 	compliance with this chapter or rules adopted under this chapter. The bonds are in lieu of 
498.6 	other license bonds required by a political subdivision of the state.
498.7 	(b) From proceeds of a bond required in paragraph (a), the commissioner may compensate 
498.8 	persons injured or suffering financial loss because of a failure of the applicant to perform 
498.9 	work or duties in compliance with this chapter or rules adopted under this chapter.

498.10 	Sec. 38. Minnesota Statutes 2016, section 103I.535, subdivision 2, is amended to read:
498.11 		Subd. 2.Certification fee. (a) The application fee for certification as a representative 
498.12 	of an elevator boring contractor is $75. The commissioner may not act on an application 
498.13 	until the application fee is paid.
498.14 	(b) The renewal fee for certification as a representative of an elevator boring contractor 
498.15 	is $75. The commissioner may not renew a certification until the renewal fee is paid.
498.16 	(c) A certified representative must file an application and a renewal application fee to 
498.17 	renew the certification by the date stated in the certification. The renewal application must 
498.18 	include information that the certified representative has met continuing education 
498.19 	requirements established by the commissioner by rule.

498.20 	Sec. 39. Minnesota Statutes 2016, section 103I.535, subdivision 6, is amended to read:
498.21 		Subd. 6.License fee. The fee for an elevator shaft boring contractor's license is $75.

498.22 	Sec. 40. Minnesota Statutes 2016, section 103I.541, subdivision 1, is amended to read:
498.23 		Subdivision 1.Registration Certification. A person seeking registration as a monitoring
498.24 	certification to represent an environmental well contractor must meet examination and 
498.25 	experience requirements adopted by the commissioner by rule.

498.26 	Sec. 41. Minnesota Statutes 2016, section 103I.541, subdivision 2, is amended to read:
498.27 		Subd. 2.Validity. A monitoring An environmental well contractor's registration
498.28 	certification is valid until the date prescribed in the registration certification by the 
498.29 	commissioner.

499.1 	Sec. 42. Minnesota Statutes 2016, section 103I.541, subdivision 2a, is amended to read:
499.2 		Subd. 2a.Certification application. (a) An individual must submit an application and 
499.3 	application fee to the commissioner to apply for certification as a representative of a 
499.4 	monitoring an environmental well contractor.
499.5 	(b) The application must be on forms prescribed by the commissioner. The application 
499.6 	must state the applicant's qualifications for the certification, and other information required 
499.7 	by the commissioner.

499.8 	Sec. 43. Minnesota Statutes 2016, section 103I.541, subdivision 2b, is amended to read:
499.9 		Subd. 2b.Issuance of registration license. If a person employs a certified representative, 
499.10 	submits the bond under subdivision 3, and pays the registration license fee of $75 for a 
499.11 	monitoring an environmental well contractor registration license, the commissioner shall 
499.12 	issue a monitoring an environmental well contractor registration license to the applicant. 
499.13 	The fee for an individual registration is $75. The commissioner may not act on an application 
499.14 	until the application fee is paid.

499.15 	Sec. 44. Minnesota Statutes 2016, section 103I.541, subdivision 2c, is amended to read:
499.16 		Subd. 2c.Certification fee. (a) The application fee for certification as a representative 
499.17 	of a monitoring an environmental well contractor is $75. The commissioner may not act on 
499.18 	an application until the application fee is paid.
499.19 	(b) The renewal fee for certification as a representative of a monitoring an environmental
499.20 	well contractor is $75. The commissioner may not renew a certification until the renewal 
499.21 	fee is paid.
499.22 	(c) A certified representative must file an application and a renewal application fee to 
499.23 	renew the certification by the date stated in the certification. The renewal application must 
499.24 	include information that the certified representative has met continuing education 
499.25 	requirements established by the commissioner by rule.

499.26 	Sec. 45. Minnesota Statutes 2016, section 103I.541, subdivision 2e, is amended to read:
499.27 		Subd. 2e.Issuance of certification. If the applicant meets the experience requirements 
499.28 	established by rule and passes the examination as determined by the commissioner, the 
499.29 	commissioner shall issue the applicant a certification to represent a monitoring an 
499.30 	environmental well contractor.

500.1 	Sec. 46. Minnesota Statutes 2016, section 103I.541, subdivision 3, is amended to read:
500.2 		Subd. 3.Bond. (a) As a condition of being issued a monitoring an environmental well 
500.3 	contractor's registration license, the applicant must submit a corporate surety bond for 
500.4 	$10,000 approved by the commissioner. The bond must be conditioned to pay the state on 
500.5 	performance of work in this state that is not in compliance with this chapter or rules adopted 
500.6 	under this chapter. The bond is in lieu of other license bonds required by a political 
500.7 	subdivision of the state.
500.8 	(b) From proceeds of the bond, the commissioner may compensate persons injured or 
500.9 	suffering financial loss because of a failure of the applicant to perform work or duties in 
500.10 	compliance with this chapter or rules adopted under this chapter.

500.11 	Sec. 47. Minnesota Statutes 2016, section 103I.541, subdivision 4, is amended to read:
500.12 		Subd. 4.License renewal. (a) A person must file an application and a renewal application 
500.13 	fee to renew the registration license by the date stated in the registration license.
500.14 	(b) The renewal application fee for a monitoring an environmental  well contractor's 
500.15 	registration license is $75.
500.16 	(c) The renewal application must include information that the certified representative 
500.17 	of the applicant has met continuing education requirements established by the commissioner 
500.18 	by rule.
500.19 	(d) At the time of the renewal, the commissioner must have on file all well and boring 
500.20 	construction reports, well and boring sealing reports, well permits, and notifications for 
500.21 	work conducted by the registered licensed person since the last registration license renewal.

500.22 	Sec. 48. Minnesota Statutes 2016, section 103I.541, subdivision 5, is amended to read:
500.23 		Subd. 5.Incomplete or late renewal. If a registered licensed person submits a renewal 
500.24 	application after the required renewal date:
500.25 	(1) the registered licensed person must include a late fee of $75; and
500.26 	(2) the registered licensed person may not conduct activities authorized by the monitoring
500.27 	environmental well contractor's registration license until the renewal application, renewal 
500.28 	application fee, late fee, and all other information required in subdivision 4 are submitted.

501.1 	Sec. 49. Minnesota Statutes 2016, section 103I.545, is amended to read:
501.2 	103I.545 REGISTRATION OF DRILLING MACHINES AND HOISTS 
501.3 	REQUIRED.
501.4 		Subdivision 1.Drilling machine. (a) A person may not use a drilling machine such as 
501.5 	a cable tool, rotary tool, hollow rod tool, or auger for a drilling activity requiring a license 
501.6 	or registration under this chapter unless the drilling machine is registered with the 
501.7 	commissioner.
501.8 	(b) A person must apply for the registration on forms prescribed by the commissioner 
501.9 	and submit a $75 registration fee.
501.10 	(c) A registration is valid for one year.
501.11 		Subd. 2.Hoist. (a) A person may not use a machine such as a hoist for an activity 
501.12 	requiring a license or registration under this chapter to repair wells or borings, seal wells 
501.13 	or borings, or install pumps unless the machine is registered with the commissioner.
501.14 	(b) A person must apply for the registration on forms prescribed by the commissioner 
501.15 	and submit a $75 registration fee.
501.16 	(c) A registration is valid for one year.

501.17 	Sec. 50. [103I.550] LIMITED PUMP, PITLESS, OR DUG WELL/DRIVE POINT 
501.18 	CONTRACTOR.
501.19 		Subdivision 1.Limited pump or pitless license or certification. A person with a limited 
501.20 	well/boring contractor's license or certification to install well pumps and pumping equipment; 
501.21 	or a person with a limited well/boring contractor's license or certification to install, repair, 
501.22 	and modify pitless units and pitless adapters, well casings above the pitless unit or pitless 
501.23 	adapter, and well screens and well diameters, will be issued a combined license or 
501.24 	certification to: (1) install well pumps and pumping equipment; and (2) install, repair, and 
501.25 	modify pitless units and pitless adapters, well casings above the pitless unit or pitless adapter, 
501.26 	well screens, and well diameters.
501.27 		Subd. 2.Limited dug well/drive point license or certification. A person with a limited 
501.28 	well/boring contractor's license or certification to construct, repair, and seal drive point 
501.29 	wells and dug wells will be issued a well contractor's license or certification.

502.1 	Sec. 51. Minnesota Statutes 2016, section 103I.601, subdivision 2, is amended to read:
502.2 		Subd. 2.License required to make borings. (a) Except as provided in paragraph (d), 
502.3 	a person must not make an exploratory boring without an explorer's license. The fee for an 
502.4 	explorer's license is $75. The explorer's license is valid until the date prescribed in the license 
502.5 	by the commissioner.
502.6 	(b) A person must file an application and renewal application fee to renew the explorer's 
502.7 	license by the date stated in the license. The renewal application fee is $75.
502.8 	(c) If the licensee submits an application fee after the required renewal date, the licensee:
502.9 	(1) must include a late fee of $75; and
502.10 	(2) may not conduct activities authorized by an explorer's license until the renewal 
502.11 	application, renewal application fee, late fee, and sealing reports required in subdivision 9 
502.12 	are submitted.
502.13 	(d) An explorer must designate a responsible individual to supervise and oversee the 
502.14 	making of exploratory borings.
502.15 	(1) Before an individual supervises or oversees an exploratory boring, the individual 
502.16 	must file an application and application fee of $75 to qualify as a certified responsible 
502.17 	individual.
502.18 	(2) The individual must take and pass an examination relating to construction, location, 
502.19 	and sealing of exploratory borings. A professional engineer or geoscientist licensed under 
502.20 	sections 326.02 to 326.15 or a professional geologist certified by the American Institute of 
502.21 	Professional Geologists is not required to take the examination required in this subdivision, 
502.22 	but must be certified as a responsible individual to supervise an exploratory boring.
502.23 	(3) The individual must file an application and a renewal fee of $75 to renew the 
502.24 	responsible individual's certification by the date stated in the certification. If the certified 
502.25 	responsible individual submits an application fee after the renewal date, the certified 
502.26 	responsible individual must include a late fee of $75 and may not supervise or oversee 
502.27 	exploratory borings until the renewal application, application fee, and late fee are submitted.

502.28 	Sec. 52. Minnesota Statutes 2016, section 103I.601, subdivision 4, is amended to read:
502.29 		Subd. 4.Notification and map of borings. (a) By ten days before beginning exploratory 
502.30 	boring, an explorer must submit to the commissioner of health a notification of the proposed 
502.31 	boring on a form prescribed by the commissioner, and a fee of $275 for each exploratory 
502.32 	boring.
503.1 	(b) By ten days before beginning exploratory boring, an explorer must submit to the 
503.2 	commissioners of health and natural resources a county road map having a scale of one-half 
503.3 	inch equal to one mile, as prepared by the Department of Transportation, or a 7.5 minute 
503.4 	series topographic map (1:24,000 scale), as prepared by the United States Geological Survey, 
503.5 	showing the location of each proposed exploratory boring to the nearest estimated 40 acre 
503.6 	parcel. Exploratory boring that is proposed on the map may not be commenced later than 
503.7 	180 days after submission of the map, unless a new map is submitted.

503.8 	Sec. 53. Minnesota Statutes 2016, section 103I.711, subdivision 1, is amended to read:
503.9 		Subdivision 1.Impoundment. The commissioner may apply to district court for a 
503.10 	warrant authorizing seizure and impoundment of all drilling machines or hoists owned or 
503.11 	used by a person. The court shall issue an impoundment order upon the commissioner's 
503.12 	showing that a person is constructing, repairing, or sealing wells or borings or installing 
503.13 	pumps or pumping equipment or excavating holes for installing elevator shafts borings
503.14 	without a license or registration as required under this chapter. A sheriff on receipt of the 
503.15 	warrant must seize and impound all drilling machines and hoists owned or used by the 
503.16 	person. A person from whom equipment is seized under this subdivision may file an action 
503.17 	in district court for the purpose of establishing that the equipment was wrongfully seized.

503.18 	Sec. 54. Minnesota Statutes 2016, section 103I.715, subdivision 2, is amended to read:
503.19 		Subd. 2.Gross misdemeanors. A person is guilty of a gross misdemeanor who:
503.20 	(1) willfully violates a provision of this chapter or order of the commissioner;
503.21 	(2) engages in the business of drilling or making wells, sealing wells, installing pumps 
503.22 	or pumping equipment, or constructing elevator shafts borings without a license required 
503.23 	by this chapter; or
503.24 	(3) engages in the business of exploratory boring without an exploratory borer's license 
503.25 	under this chapter.

503.26 	Sec. 55. [144.0572] CRIMINAL HISTORY BACKGROUND CHECKS ON 
503.27 	APPLICANTS, LICENSEES, AND OTHER OCCUPATIONS REGULATED BY 
503.28 	COMMISSIONER OF HEALTH.
503.29 		Subdivision 1.Criminal history background check requirements. (a) Beginning 
503.30 	January 1, 2018, an applicant for initial licensure, temporary licensure, or relicensure after 
503.31 	a lapse in licensure as an occupational therapist, occupational therapy assistant, audiologist, 
503.32 	or speech-language pathologist, or an applicant for initial certification as a hearing instrument 
504.1 	dispenser, must submit to a criminal history records check of state data completed by the 
504.2 	Bureau of Criminal Apprehension (BCA) and a national criminal history records check, 
504.3 	including a search of the records of the Federal Bureau of Investigation (FBI).
504.4 	(b) Beginning January 1, 2020, an applicant for a renewal license or certificate as an 
504.5 	occupational therapist, occupational therapy assistant, audiologist, speech-language 
504.6 	pathologist, or hearing instrument dispenser who was licensed or obtained a certificate 
504.7 	before January 1, 2018, must submit to a criminal history records check of state data 
504.8 	completed by the BCA and a national criminal history records check, including a search of 
504.9 	the records of the FBI.
504.10 	(c) An applicant must submit to a background study under chapter 245C.
504.11 	(d) The criminal history records check must be structured so that any new crimes that 
504.12 	an applicant or licensee or certificate holder commits after the initial background check are 
504.13 	flagged in the BCA's or FBI's database and reported back to the commissioner of human 
504.14 	services.
504.15 		Subd. 2.Procedures. (a) The commissioner shall contract with the Department of Human 
504.16 	Services to process the criminal history background check requirements through NETStudy 
504.17 	2.0, as defined in section 245C.02.
504.18 	(b) The Department of Human Services shall conduct the criminal history background 
504.19 	checks according to section 144.057, except that:
504.20 	(1) all applicants must submit to a fingerprint-based criminal history records check of 
504.21 	state data completed by the BCA and a national criminal history records check, including 
504.22 	a search of the records of the FBI;
504.23 	(2) the Department of Human Services shall complete the check and the study and notify 
504.24 	the commissioner of health if the applicant, licensee, or certificate holder has a criminal 
504.25 	history as defined in section 245C.15; and
504.26 	(3) the Department of Human Services shall simultaneously conduct a background study 
504.27 	on each applicant according to chapter 245C.
504.28 	(c) When making a determination whether to issue a license, deny a license, or issue a 
504.29 	conditional license or other credential to practice an occupation regulated by the Department 
504.30 	of Health, the commissioner or the commissioner's designee shall evaluate a criminal 
504.31 	conviction, guilty plea, Alford plea, judicial determination, or preponderance of evidence 
504.32 	to determine an applicant's risk of harm using the criteria in section 364.03.
505.1 	(d) Before taking disciplinary action against an applicant or a licensee based on a criminal 
505.2 	conviction, judicial determination, admission in court, Alford plea, or preponderance of 
505.3 	evidence, the commissioner of health shall provide the applicant or licensee an opportunity 
505.4 	to complete or challenge the accuracy of the criminal history information. The applicant or 
505.5 	licensee shall have 30 calendar days following notice from the commissioner of the intent 
505.6 	to deny licensure or take disciplinary action to request an opportunity to correct or complete 
505.7 	the record prior to the commissioner taking disciplinary action. The commissioner shall 
505.8 	provide the applicant up to 180 days to challenge the accuracy or completeness of the report 
505.9 	with the agency responsible for the record. This subdivision does not affect the right of the 
505.10 	subject of the data to contest the accuracy or completeness under section 13.04, subdivision 
505.11 	4.
505.12 	(e) The checks and studies must be structured so that any new crimes that an applicant 
505.13 	or licensee commits after the initial background check are flagged in the BCA's or FBI's 
505.14 	database and reported back to the commissioner of human services.
505.15 		Subd. 3.Applicant, licensee, or other regulated individual's responsibilities. (a) 
505.16 	Applicants, licensees, and individuals seeking a credential to practice one of the public 
505.17 	health occupations listed in subdivision 1 must submit a complete criminal history records 
505.18 	check consent form, a complete background study consent form, and a full set of fingerprints 
505.19 	as required by the Department of Human Services in section 245C.05.
505.20 	(b) The applicant or license holder is responsible for paying to the Department of Human 
505.21 	Services all fees associated with the preparation of the fingerprints, the criminal records 
505.22 	check consent form, and the criminal background check.

505.23 	Sec. 56. Minnesota Statutes 2016, section 144.122, is amended to read:
505.24 	144.122 LICENSE, PERMIT, AND SURVEY FEES.
505.25 	(a) The state commissioner of health, by rule, may prescribe procedures and fees for 
505.26 	filing with the commissioner as prescribed by statute and for the issuance of original and 
505.27 	renewal permits, licenses, registrations, and certifications issued under authority of the 
505.28 	commissioner. The expiration dates of the various licenses, permits, registrations, and 
505.29 	certifications as prescribed by the rules shall be plainly marked thereon. Fees may include 
505.30 	application and examination fees and a penalty fee for renewal applications submitted after 
505.31 	the expiration date of the previously issued permit, license, registration, and certification. 
505.32 	The commissioner may also prescribe, by rule, reduced fees for permits, licenses, 
505.33 	registrations, and certifications when the application therefor is submitted during the last 
505.34 	three months of the permit, license, registration, or certification period. Fees proposed to 
506.1 	be prescribed in the rules shall be first approved by the Department of Management and 
506.2 	Budget. All fees proposed to be prescribed in rules shall be reasonable. The fees shall be 
506.3 	in an amount so that the total fees collected by the commissioner will, where practical, 
506.4 	approximate the cost to the commissioner in administering the program. All fees collected 
506.5 	shall be deposited in the state treasury and credited to the state government special revenue 
506.6 	fund unless otherwise specifically appropriated by law for specific purposes.
506.7 	(b) The commissioner may charge a fee for voluntary certification of medical laboratories 
506.8 	and environmental laboratories, and for environmental and medical laboratory services 
506.9 	provided by the department, without complying with paragraph (a) or chapter 14. Fees 
506.10 	charged for environment and medical laboratory services provided by the department must 
506.11 	be approximately equal to the costs of providing the services.
506.12 	(c) The commissioner may develop a schedule of fees for diagnostic evaluations 
506.13 	conducted at clinics held by the services for children with disabilities program. All receipts 
506.14 	generated by the program are annually appropriated to the commissioner for use in the 
506.15 	maternal and child health program.
506.16 	(d) The commissioner shall set license fees for hospitals and nursing homes that are not 
506.17 	boarding care homes at the following levels:

506.18
506.19
506.20
506.21	Joint Commission on Accreditation of 
Healthcare Organizations (JCAHO) and 
American Osteopathic Association (AOA) 
hospitals
	$7,655 plus $16 per bed
	
506.22	Non-JCAHO and non-AOA hospitals
	$5,280 plus $250 per bed
	
506.23506.24
506.25	Nursing home
	$183 plus $91 $100 per bed between July 1, 
2017, and June 30, 2019. $183 plus $105 per 
bed beginning July 1, 2019.
	
506.26 	The commissioner shall set license fees for outpatient surgical centers, boarding care 
506.27 	homes, and supervised living facilities at the following levels:

506.28	Outpatient surgical centers
	$3,712
	
506.29	Boarding care homes
	$183 plus $91 per bed
	
506.30	Supervised living facilities
	$183 plus $91 per bed.
	
506.31 	Fees collected under this paragraph are nonrefundable. The fees are nonrefundable even if 
506.32 	received before July 1, 2017, for licenses or registrations being issued effective July 1, 2017, 
506.33 	or later.
506.34 	(e) Unless prohibited by federal law, the commissioner of health shall charge applicants 
506.35 	the following fees to cover the cost of any initial certification surveys required to determine 
506.36 	a provider's eligibility to participate in the Medicare or Medicaid program:

507.1	Prospective payment surveys for hospitals
	$
	900
	
507.2	Swing bed surveys for nursing homes
	$
	1,200
	
507.3	Psychiatric hospitals
	$
	1,400
	
507.4	Rural health facilities
	$
	1,100
	
507.5	Portable x-ray providers
	$
	500
	
507.6	Home health agencies
	$
	1,800
	
507.7	Outpatient therapy agencies
	$
	800
	
507.8	End stage renal dialysis providers
	$
	2,100
	
507.9	Independent therapists
	$
	800
	
507.10	Comprehensive rehabilitation outpatient facilities
	$
	1,200
	
507.11	Hospice providers
	$
	1,700
	
507.12	Ambulatory surgical providers
	$
	1,800
	
507.13	Hospitals
	$
	4,200
	
507.14
507.15
507.16	Other provider categories or additional
resurveys required to complete initial
certification
	Actual surveyor costs: average 
surveyor cost x number of hours for 
the survey process.
	
507.17 	These fees shall be submitted at the time of the application for federal certification and 
507.18 	shall not be refunded. All fees collected after the date that the imposition of fees is not 
507.19 	prohibited by federal law shall be deposited in the state treasury and credited to the state 
507.20 	government special revenue fund.

507.21 	Sec. 57. Minnesota Statutes 2016, section 144.3831, subdivision 1, is amended to read:
507.22 		Subdivision 1.Fee setting. The commissioner of health may assess an annual fee of 
507.23 	$6.36 $9 for every service connection to a public water supply that is owned or operated 
507.24 	by a home rule charter city, a statutory city, a city of the first class, or a town. The 
507.25 	commissioner of health may also assess an annual fee for every service connection served 
507.26 	by a water user district defined in section 110A.02.

507.27 	EFFECTIVE DATE. This section is effective January 1, 2018.

507.28 	Sec. 58. Minnesota Statutes 2016, section 144A.472, subdivision 7, is amended to read:
507.29 		Subd. 7.Fees; application, change of ownership, and renewal. (a) An initial applicant 
507.30 	seeking temporary home care licensure must submit the following application fee to the 
507.31 	commissioner along with a completed application:
507.32 	(1) for a basic home care provider, $2,100; or
507.33 	(2) for a comprehensive home care provider, $4,200.
508.1 	(b) A home care provider who is filing a change of ownership as required under 
508.2 	subdivision 5 must submit the following application fee to the commissioner, along with 
508.3 	the documentation required for the change of ownership:
508.4 	(1) for a basic home care provider, $2,100; or
508.5 	(2) for a comprehensive home care provider, $4,200.
508.6 	(c) A home care provider who is seeking to renew the provider's license shall pay a fee 
508.7 	to the commissioner based on revenues derived from the provision of home care services 
508.8 	during the calendar year prior to the year in which the application is submitted, according 
508.9 	to the following schedule for the period between July 1, 2017, and June 30, 2019:
508.10 	License Renewal Fee

508.11	Provider Annual Revenue
	Fee
		
508.12508.13	greater than $1,500,000
	$6,625
$7,287
		
508.14
508.15	greater than $1,275,000 and no more than 
$1,500,000
	$5,797
$6,376
		
508.16
508.17	greater than $1,100,000 and no more than 
$1,275,000
	$4,969
$5,466
		
508.18
508.19	greater than $950,000 and no more than 
$1,100,000
	$4,141
$4,555
		
508.20508.21	greater than $850,000 and no more than $950,000
	$3,727
$4,099
		
508.22508.23	greater than $750,000 and no more than $850,000
	$3,313
$3,644
		
508.24508.25	greater than $650,000 and no more than $750,000
	$2,898
$3,188
		
508.26508.27	greater than $550,000 and no more than $650,000
	$2,485
$2,733
		
508.28508.29	greater than $450,000 and no more than $550,000
	$2,070
$2,277
		
508.30508.31	greater than $350,000 and no more than $450,000
	$1,656
$1,822
		
508.32508.33	greater than $250,000 and no more than $350,000
	$1,242
$1,366
		
508.34508.35	greater than $100,000 and no more than $250,000
	$828
$911
		
508.36508.37	greater than $50,000 and no more than $100,000
	$500
$550
		
508.38508.39	greater than $25,000 and no more than $50,000
	$400
$440
		
508.40508.41	no more than $25,000
	$200
$220
		
509.1 	(d) Beginning July 1, 2019, a home care provider who is seeking to renew the provider's 
509.2 	license shall pay a fee to the commissioner based on revenues derived from the provision 
509.3 	of home care services during the calendar year prior to the year in which the application is 
509.4 	submitted, according to the following schedule:
509.5 	License Renewal Fee

509.6	Provider Annual Revenue
	Fee
		
509.7	greater than $1,500,000
	$7,651
		
509.8
509.9	greater than $1,275,000 and no more than 
$1,500,000
	$6,695
		
509.10
509.11	greater than $1,100,000 and no more than 
$1,275,000
	$5,739
		
509.12
509.13	greater than $950,000 and no more than 
$1,100,000
	$4,783
		
509.14	greater than $850,000 and no more than $950,000
	$4,304
		
509.15	greater than $750,000 and no more than $850,000
	$3,826
		
509.16	greater than $650,000 and no more than $750,000
	$3,347
		
509.17	greater than $550,000 and no more than $650,000
	$2,870
		
509.18	greater than $450,000 and no more than $550,000
	$2,391
		
509.19	greater than $350,000 and no more than $450,000
	$1,913
		
509.20	greater than $250,000 and no more than $350,000
	$1,434
		
509.21	greater than $100,000 and no more than $250,000
	$957
		
509.22	greater than $50,000 and no more than $100,000
	$577
		
509.23	greater than $25,000 and no more than $50,000
	$462
		
509.24	no more than $25,000
	$231
		
509.25 	(d) (e) If requested, the home care provider shall provide the commissioner information 
509.26 	to verify the provider's annual revenues or other information as needed, including copies 
509.27 	of documents submitted to the Department of Revenue.
509.28 	(e) (f) At each annual renewal, a home care provider may elect to pay the highest renewal 
509.29 	fee for its license category, and not provide annual revenue information to the commissioner.
509.30 	(f) (g) A temporary license or license applicant, or temporary licensee or licensee that 
509.31 	knowingly provides the commissioner incorrect revenue amounts for the purpose of paying 
509.32 	a lower license fee, shall be subject to a civil penalty in the amount of double the fee the 
509.33 	provider should have paid.
509.34 	(g) (h) Fees and penalties collected under this section shall be deposited in the state 
509.35 	treasury and credited to the state government special revenue fund. All fees are 
509.36 	nonrefundable. Fees collected under paragraphs (c) and (d) are nonrefundable even if 
510.1 	received before July 1, 2017, for temporary licenses or licenses being issued effective July 
510.2 	1, 2017, or later.
510.3 	(h) The license renewal fee schedule in this subdivision is effective July 1, 2016.

510.4 	Sec. 59. Minnesota Statutes 2016, section 146B.02, subdivision 2, is amended to read:
510.5 		Subd. 2.Requirements and term of license. (a) Each application for an initial mobile 
510.6 	or fixed-site establishment license and for renewal must be submitted to the commissioner 
510.7 	on a form provided by the commissioner accompanied with the applicable fee required 
510.8 	under section 146B.10. The application must contain:
510.9 	(1) the name(s) of the owner(s) and operator(s) of the establishment;
510.10 	(2) the location of the establishment;
510.11 	(3) verification of compliance with all applicable local and state codes;
510.12 	(4) a description of the general nature of the business; and
510.13 	(5) any other relevant information deemed necessary by the commissioner.
510.14 	(b) If the information submitted is complete and complies with the requirements of this 
510.15 	chapter, the commissioner shall issue a provisional establishment license. The provisional 
510.16 	license is effective until the commissioner determines, after inspection, that the applicant 
510.17 	has met the requirements of this chapter. Upon approval, the commissioner shall issue a 
510.18 	body art establishment license effective for three years.
510.19 	(c) An establishment license must be renewed every two years.

510.20 	Sec. 60. Minnesota Statutes 2016, section 146B.02, subdivision 3, is amended to read:
510.21 		Subd. 3.Inspection. (a) Within the period of the provisional establishment license, and 
510.22 	The commissioner must inspect an establishment issued a provisional license within one 
510.23 	year of the date the license was issued. Thereafter at least one time during each three-year
510.24 	two-year licensure period, the commissioner shall conduct an inspection of the body art 
510.25 	establishment and a review of any records necessary to ensure that the standards required 
510.26 	under this chapter are met.
510.27 	(b) The commissioner shall have the authority to enter a premises to make an inspection. 
510.28 	Refusal to permit an inspection constitutes valid grounds for licensure denial or revocation.
510.29 	(c) If the establishment seeking licensure is new construction or if a licensed establishment 
510.30 	is remodeling, the establishment must meet all local building and zoning codes.

511.1 	Sec. 61. Minnesota Statutes 2016, section 146B.02, subdivision 5, is amended to read:
511.2 		Subd. 5.Transfer of ownership, relocation, and display of license. (a) A body art 
511.3 	establishment license must be issued to a specific person and location and is not transferable. 
511.4 	A license must be prominently displayed in a public area of the establishment.
511.5 	(b) An owner who has purchased a body art establishment licensed under the previous 
511.6 	owner must submit an application to license the establishment within two weeks of the date 
511.7 	of sale. Notwithstanding subdivision 1, the new owner may continue to operate for 60 days 
511.8 	after the sale while waiting for a new license to be issued.
511.9 	(c) An owner of a licensed body art establishment who is relocating the establishment 
511.10 	must submit an application for the new location. The owner may request that the new 
511.11 	application become effective at a specified date in the future. If the relocation is not 
511.12 	accomplished by the date expected, and the license at the existing location expires, the 
511.13 	owner may apply for a temporary event permit to continue to operate at the old location. 
511.14 	The owner may apply for no more than four temporary event permits to continue operating 
511.15 	at the old location.

511.16 	Sec. 62. Minnesota Statutes 2016, section 146B.02, is amended by adding a subdivision 
511.17 	to read:
511.18 		Subd. 7a.Supervisors. (a) Only a technician who has been licensed as a body artist for 
511.19 	at least two years in Minnesota or in a jurisdiction with which Minnesota has reciprocity 
511.20 	may supervise a temporary technician.
511.21 	(b) Any technician who agrees to supervise more than two temporary technicians during 
511.22 	the same time period must explain, to the satisfaction of the commissioner, how the technician 
511.23 	will provide supervision to each temporary technician in accordance with section 146B.01, 
511.24 	subdivision 28.
511.25 	(c) The commissioner may refuse to approve as a supervisor a technician who has been 
511.26 	disciplined in Minnesota or in another jurisdiction.

511.27 	Sec. 63. Minnesota Statutes 2016, section 146B.02, subdivision 8, is amended to read:
511.28 		Subd. 8.Temporary events event permit. (a) An owner or operator of a applicant for 
511.29 	a permit to hold a temporary body art establishment event shall submit an application for a 
511.30 	temporary events permit to the commissioner. The application must be received at least 14 
511.31 	days before the start of the event. The application must include the specific days and hours 
512.1 	of operation. The owner or operator An applicant issued a temporary event permit shall 
512.2 	comply with the requirements of this chapter.
512.3 	(b) Applications received less than 14 days prior to the start of the event may be processed 
512.4 	if the commissioner determines it is possible to conduct the all required work, including an 
512.5 	inspection.
512.6 	(c) The temporary events event permit must be prominently displayed in a public area 
512.7 	at the location.
512.8 	(d) The temporary events event permit, if approved, is valid for the specified dates and 
512.9 	hours listed on the application. No temporary events permit shall be issued for longer than 
512.10 	a 21-day period, and may not be extended.
512.11 	(e) No individual who does not hold a current body art establishment license may be 
512.12 	issued a temporary event permit more than four times within the same calendar year.
512.13 	(f) No individual who has been disciplined for a serious violation of this chapter within 
512.14 	three years preceding the intended start date of a temporary event may be issued a license 
512.15 	for a temporary event. Violations that preclude issuance of a temporary event permit include 
512.16 	unlicensed practice; practice in an unlicensed location; any of the conditions listed in section 
512.17 	146B.05, clauses (1) to (8), (12), or (13); 146B.08, subdivision 3, clauses (4), (5), and (10) 
512.18 	to (12); or any other violation that places the health or safety of a client at risk.

512.19 	Sec. 64. Minnesota Statutes 2016, section 146B.02, is amended by adding a subdivision 
512.20 	to read:
512.21 		Subd. 10.Licensure precluded. (a) The commissioner may choose to deny a body art 
512.22 	establishment license to an applicant who has been disciplined for a serious violation under 
512.23 	this chapter. Violations that constitute grounds for denial of license are any of the conditions 
512.24 	listed in section 146B.05, subdivision 1, clauses (1) to (8), (12), or (13); 146B.08, subdivision 
512.25 	3, clauses (4), (5), or (10) to (12); or any other violation that places the health or safety of 
512.26 	a client at risk.
512.27 	(b) In considering whether to grant a license to an applicant who has been disciplined 
512.28 	for a violation described in this subdivision, the commissioner shall consider evidence of 
512.29 	rehabilitation, including the nature and seriousness of the violation, circumstances relative 
512.30 	to the violation, the length of time elapsed since the violation, and evidence that demonstrates 
512.31 	that the applicant has maintained safe, ethical, and responsible body art practice since the 
512.32 	time of the most recent violation.

513.1 	Sec. 65. Minnesota Statutes 2016, section 146B.02, is amended by adding a subdivision 
513.2 	to read:
513.3 		Subd. 11.Penalties. Any person who violates the provisions of subdivision 1 or who 
513.4 	performs body art in an unlicensed location is guilty of a gross misdemeanor.

513.5 	Sec. 66. Minnesota Statutes 2016, section 146B.03, subdivision 6, is amended to read:
513.6 		Subd. 6.Licensure term; renewal. (a) A technician's license is valid for two years from 
513.7 	the date of issuance and may be renewed upon payment of the renewal fee established under 
513.8 	section 146B.10.
513.9 	(b) At renewal, a licensee must submit proof of continuing education approved by the 
513.10 	commissioner in the areas identified in subdivision 4.
513.11 	(c) The commissioner shall notify the technician of the pending expiration of a technician 
513.12 	license at least 60 days prior to license expiration.
513.13 	(d) A technician previously licensed in Minnesota whose license has lapsed for less than 
513.14 	six years may apply to renew. A technician previously licensed in Minnesota whose license 
513.15 	has lapsed for less than ten years and who was licensed in another jurisdiction or jurisdictions 
513.16 	during the entire time of lapse may apply to renew, but must submit proof of licensure in 
513.17 	good standing in all other jurisdictions in which the technician was licensed as a body artist 
513.18 	during the time of lapse. A technician previously licensed in Minnesota whose license has 
513.19 	lapsed for more than six years and who was not continuously licensed in another jurisdiction 
513.20 	during the period of Minnesota lapse must reapply for licensure under subdivision 4.

513.21 	Sec. 67. Minnesota Statutes 2016, section 146B.03, subdivision 7, is amended to read:
513.22 		Subd. 7.Temporary licensure. (a) The commissioner may issue a temporary license 
513.23 	to an applicant who submits to the commissioner on a form provided by the commissioner:
513.24 	(1) proof that the applicant is over the age of 18;
513.25 	(2) all fees required under section 148B.10; and
513.26 	(3) a letter from a licensed technician who has agreed to provide the supervision to meet 
513.27 	the supervised experience requirement under subdivision 4.
513.28 	(b) Upon completion of the required supervised experience, the temporary licensee shall 
513.29 	submit documentation of satisfactorily completing the requirements under subdivision 4, 
513.30 	and the applicable fee under section 146B.10. The commissioner shall issue a new license 
513.31 	in accordance with subdivision 4.
514.1 	(c) A temporary license issued under this subdivision is valid for one year and may be 
514.2 	renewed for one additional year twice.

514.3 	Sec. 68. Minnesota Statutes 2016, section 146B.07, subdivision 2, is amended to read:
514.4 		Subd. 2.Parent or legal guardian consent; prohibitions. (a) A technician may perform 
514.5 	body piercings on an individual under the age of 18 if:
514.6 	(1) the individual's parent or legal guardian is present;
514.7 	(2) the individual's parent or legal guardian provides personal identification by using 
514.8 	one of the methods described in subdivision 1, paragraph (a), clauses (1) to (5), and provides 
514.9 	documentation that reasonably establishes that the individual is the parent or legal guardian 
514.10 	of the individual who is seeking the body piercing;
514.11 	(3) the individual seeking the body piercing provides proof of identification by using 
514.12 	one of the methods described in subdivision 1, paragraph (a), clauses (1) to (5), a current 
514.13 	student identification, or another official source that includes the name and a photograph 
514.14 	of the individual;
514.15 	(4) a consent form and the authorization form under subdivision 1, paragraph (b) is 
514.16 	signed by the parent or legal guardian in the presence of the technician; and
514.17 	(5) the piercing is not prohibited under paragraph (c).
514.18 	(b) No technician shall tattoo any Tattooing an individual under the age of 18 is a gross 
514.19 	misdemeanor, regardless of parental or guardian consent.
514.20 	(c) No nipple or genital piercing, branding, scarification, suspension, subdermal 
514.21 	implantation, microdermal, or tongue bifurcation shall be performed by any technician on 
514.22 	any individual under the age of 18 regardless of parental or guardian consent.
514.23 	(d) No technician shall perform body art procedures on any individual who appears to 
514.24 	be under the influence of alcohol, controlled substances as defined in section 152.01, 
514.25 	subdivision 4, or hazardous substances as defined in rules adopted under chapter 182.
514.26 	(e) No technician shall perform body art procedures while under the influence of alcohol, 
514.27 	controlled substances as defined under section 152.01, subdivision 4, or hazardous substances 
514.28 	as defined in the rules adopted under chapter 182.
514.29 	(f) No technician shall administer anesthetic injections or other medications.

515.1 	Sec. 69. Minnesota Statutes 2016, section 146B.07, subdivision 4, is amended to read:
515.2 		Subd. 4.Client record maintenance. (a) For each client, the body art establishment 
515.3 	operator shall maintain proper records of each procedure. The records of the procedure must 
515.4 	be kept for three years and must be available for inspection by the commissioner upon 
515.5 	request. The record must include the following:
515.6 	(1) the date of the procedure;
515.7 	(2) the information on the required picture identification showing the name, age, and 
515.8 	current address of the client;
515.9 	(3) a copy of the authorization form signed and dated by the client required under 
515.10 	subdivision 1, paragraph (b);
515.11 	(4) a description of the body art procedure performed;
515.12 	(5) the name and license number of the technician performing the procedure;
515.13 	(6) a copy of the consent form required under subdivision 3; and
515.14 	(7) if the client is under the age of 18 years, a copy of the consent form signed by the 
515.15 	parent or legal guardian as required under subdivision 2.
515.16 	(b) Each body artist shall maintain a copy of the informed consent required under 
515.17 	subdivision 3 for three years.

515.18 	Sec. 70. Minnesota Statutes 2016, section 146B.10, subdivision 1, is amended to read:
515.19 		Subdivision 1. Licensing fees. (a) The fee for the initial technician licensure and biennial 
515.20 	licensure renewal is $100 $420.
515.21 	(b) The fee for temporary technician licensure is $100 $240.
515.22 	(c) The fee for the temporary guest artist license is $50 $140.
515.23 	(d) The fee for a dual body art technician license is $100 $420.
515.24 	(e) The fee for a provisional establishment license is $1,000 $1,500.
515.25 	(f) The fee for an initial establishment license and the three-year two-year license renewal 
515.26 	period required in section 146B.02, subdivision 2, paragraph (b), is $1,000 $1,500.
515.27 	(g) The fee for a temporary body art establishment event permit is $75 $200.
515.28 	(h) The commissioner shall prorate the initial two-year technician license fee and the 
515.29 	initial three-year body art establishment license fee based on the number of months in the 
515.30 	initial licensure period. The commissioner shall prorate the first renewal fee for the 
516.1 	establishment license based on the number of months from issuance of the provisional 
516.2 	license to the first renewal.
516.3 	(i) The fee for verification of licensure to other states is $25.
516.4 	(j) The fee to reissue a provisional establishment license that relocates prior to inspection 
516.5 	and removal of provisional status is $350. The expiration date of the provisional license 
516.6 	does not change.
516.7 	(k) The fee to change an establishment name or establishment type, such as tattoo, 
516.8 	piercing, or dual, is $50.

516.9 	Sec. 71. Minnesota Statutes 2016, section 146B.10, subdivision 2, is amended to read:
516.10 		Subd. 2.Penalty for Late renewals renewal fee. (a) The penalty fee for late submission 
516.11 	forof a technician renewal applications application is $75 $150.
516.12 	(b) The fee for late submission of an establishment renewal application is $300.

516.13 	Sec. 72. Minnesota Statutes 2016, section 146B.10, is amended by adding a subdivision 
516.14 	to read:
516.15 		Subd. 2a.Technical violation fee for practice after lapse. (a) The technical violation 
516.16 	fee for practicing body art after a body art license has expired and before it is renewed is 
516.17 	$200 for any part of the first month, plus $200 for any part of any subsequent month up to 
516.18 	one year. Continued practice or operation after one year becomes a disciplinary violation.
516.19 	(b) The technical violation fee for practicing body art after a temporary body art license 
516.20 	has expired and before it is renewed is $100 for any part of the first month, plus $100 for 
516.21 	any part of any subsequent month up to six months. Continued practice or operation after 
516.22 	six months becomes a disciplinary violation.
516.23 	(c) The technical violation fee for operating a body art establishment after the license 
516.24 	has expired and before it is renewed is $300 for any part of the first month, plus $300 for 
516.25 	any part of any subsequent month up to six months. Continued practice or operation after 
516.26 	six months becomes a disciplinary violation.

516.27 	Sec. 73. Minnesota Statutes 2016, section 148.514, subdivision 1, is amended to read:
516.28 		Subdivision 1.General licensure procedures. An applicant for licensure must:
516.29 	(1) submit an application as required under section 148.519, subdivision 1; and
516.30 	(2) submit all fees required under section 148.5194.; and
517.1 	(3) consent to a fingerprint-based background check as required under section 148.519.

517.2 	Sec. 74. Minnesota Statutes 2016, section 148.519, subdivision 1, is amended to read:
517.3 		Subdivision 1.Applications for licensure. (a) An applicant for licensure must:
517.4 	(1) submit a completed application for licensure on forms provided by the commissioner. 
517.5 	The application must include the applicant's name, certification number under chapter 153A, 
517.6 	if applicable, business address and telephone number, or home address and telephone number 
517.7 	if the applicant practices speech-language pathology or audiology out of the home, and a 
517.8 	description of the applicant's education, training, and experience, including previous work 
517.9 	history for the five years immediately preceding the date of application. The commissioner 
517.10 	may ask the applicant to provide additional information necessary to clarify information 
517.11 	submitted in the application; and
517.12 	(2) submit documentation of the certificate of clinical competence issued by the American 
517.13 	Speech-Language-Hearing Association, board certification by the American Board of 
517.14 	Audiology, or satisfy the following requirements:
517.15 	(i) submit a transcript showing the completion of a master's or doctoral degree or its 
517.16 	equivalent meeting the requirements of section 148.515, subdivision 2;
517.17 	(ii) submit documentation of the required hours of supervised clinical training;
517.18 	(iii) submit documentation of the postgraduate clinical or doctoral clinical experience 
517.19 	meeting the requirements of section 148.515, subdivision 4; and
517.20 	(iv) submit documentation of receiving a qualifying score on an examination meeting 
517.21 	the requirements of section 148.515, subdivision 6.
517.22 	(b) In addition, an applicant must:
517.23 	(1) sign a statement that the information in the application is true and correct to the best 
517.24 	of the applicant's knowledge and belief;
517.25 	(2) submit with the application all fees required by section 148.5194; and
517.26 	(3) sign a waiver authorizing the commissioner to obtain access to the applicant's records 
517.27 	in this or any other state in which the applicant has engaged in the practice of speech-language 
517.28 	pathology or audiology.; and
517.29 	(4) consent to a fingerprint-based criminal history background check as required under 
517.30 	section 144.0572, pay all required fees, and cooperate with all requests for information. An 
518.1 	applicant must complete a new criminal history background check if more than one year 
518.2 	has elapsed since the applicant last applied for a license.

518.3 	Sec. 75. Minnesota Statutes 2016, section 148.519, subdivision 2, is amended to read:
518.4 		Subd. 2.Action on applications for licensure. (a) The commissioner shall act on an 
518.5 	application for licensure according to paragraphs (b) to (d) (e).
518.6 	(b) The commissioner shall determine if the applicant meets the requirements for 
518.7 	licensure. The commissioner or advisory council may investigate information provided by 
518.8 	an applicant to determine whether the information is accurate and complete.
518.9 	(c) The commissioner shall not issue a license to an applicant who refuses to consent to 
518.10 	a background study within 90 days after submission of an application or fails to submit 
518.11 	fingerprints to the Department of Human Services. Any fees paid by the applicant to the 
518.12 	Department of Health shall be forfeited if the applicant refuses to consent to the background 
518.13 	study.
518.14 	(c) (d) The commissioner shall notify an applicant, via certified mail, of action taken on 
518.15 	the application and of the grounds for denying licensure if licensure is denied.
518.16 	(d) (e) An applicant denied licensure may make a written request to the commissioner, 
518.17 	within 30 days of the date of notification to the applicant, for reconsideration of the denial. 
518.18 	Individuals requesting reconsideration may submit information that the applicant wants 
518.19 	considered in the reconsideration. After reconsideration of the commissioner's determination 
518.20 	to deny licensure, the commissioner shall determine whether the original determination 
518.21 	should be affirmed or modified. An applicant may make only one request in any one biennial 
518.22 	license period for reconsideration of the commissioner's determination to deny licensure.

518.23 	Sec. 76. Minnesota Statutes 2016, section 148.5194, subdivision 2, is amended to read:
518.24 		Subd. 2.Speech-language pathologist biennial licensure fee fees. (a) The fee for initial 
518.25 	licensure and biennial licensure, clinical fellowship licensure, temporary licensure, or 
518.26 	renewal for a speech-language pathologist is $200 $210.50.
518.27 	(b) The fee for clinical fellowship licensure, doctoral externship, temporary license, or 
518.28 	renewal for a speech-language pathologist is $200.

518.29 	Sec. 77. Minnesota Statutes 2016, section 148.5194, subdivision 3, is amended to read:
518.30 		Subd. 3.Biennial Licensure fee fees for dual licensure as a speech-language 
518.31 	pathologist and audiologist. (a) The fee for initial dual licensure and biennial licensure, 
519.1 	clinical fellowship licensure, doctoral externship, temporary license, or renewal as a 
519.2 	speech-language pathologist and audiologist is $435 $523.
519.3 	(b) The fee for clinical fellowship licensure, doctoral externship, temporary license, or 
519.4 	renewal for dual licensure as a speech-language pathologist and audiologist is $510.

519.5 	Sec. 78. Minnesota Statutes 2016, section 148.5194, subdivision 4, is amended to read:
519.6 		Subd. 4.Penalty fee for late renewals. The penalty fee for late submission of a renewal 
519.7 	application is $45 $60.

519.8 	Sec. 79. Minnesota Statutes 2016, section 148.5194, subdivision 7, is amended to read:
519.9 		Subd. 7.Audiologist biennial licensure fee. (a) The licensure fee for initial applicants 
519.10 	is $523. The biennial licensure fee for audiologists for clinical fellowship, doctoral externship, 
519.11 	temporary, initial applicants, and renewal licensees licenses is $435 $510.
519.12 	(b) The audiologist fee is for practical examination costs greater than audiologist exam 
519.13 	fee receipts and for complaint investigation, enforcement action, and consumer information 
519.14 	and assistance expenditures related to hearing instrument dispensing.

519.15 	Sec. 80. Minnesota Statutes 2016, section 148.5194, is amended by adding a subdivision 
519.16 	to read:
519.17 		Subd. 7a.Surcharge. Speech-language pathologists who were licensed prior to January 
519.18 	1, 2018, shall pay a onetime surcharge of $10.50 to renew when their license first expires 
519.19 	after January 1, 2020. Audiologists who were licensed before January 1, 2018, shall pay a 
519.20 	onetime surcharge of $13 to renew when their license first expires after January 1, 2020. 
519.21 	The surcharge shall cover the commissioner's costs associated with criminal background 
519.22 	checks.

519.23 	Sec. 81. Minnesota Statutes 2016, section 148.5195, subdivision 2, is amended to read:
519.24 		Subd. 2.Rights of applicants and licensees. The rights of an applicant denied licensure 
519.25 	are stated in section 148.519, subdivision 2, paragraph (d) (e). A licensee shall not be 
519.26 	subjected to disciplinary action under this section without first having an opportunity for a 
519.27 	contested case hearing under chapter 14.

519.28 	Sec. 82. Minnesota Statutes 2016, section 148.6405, is amended to read:
519.29 	148.6405 LICENSURE APPLICATION REQUIREMENTS: PROCEDURES AND 
519.30 	QUALIFICATIONS.
520.1 	(a) An applicant for licensure must comply with the application requirements in section 
520.2 	148.6420. To qualify for licensure, an applicant must satisfy one of the requirements in 
520.3 	paragraphs (b) to (f) and not be subject to denial of licensure under section 148.6448.
520.4 	(b) A person who applies for licensure as an occupational therapist and who has not 
520.5 	been credentialed by the National Board for Certification in Occupational Therapy or another 
520.6 	jurisdiction must meet the requirements in section 148.6408.
520.7 	(c) A person who applies for licensure as an occupational therapy assistant and who has 
520.8 	not been credentialed by the National Board for Certification in Occupational Therapy or 
520.9 	another jurisdiction must meet the requirements in section 148.6410.
520.10 	(d) A person who is certified by the National Board for Certification in Occupational 
520.11 	Therapy may apply for licensure by equivalency and must meet the requirements in section 
520.12 	148.6412.
520.13 	(e) A person who is credentialed in another jurisdiction may apply for licensure by 
520.14 	reciprocity and must meet the requirements in section 148.6415.
520.15 	(f) A person who applies for temporary licensure must meet the requirements in section 
520.16 	148.6418.
520.17 	(g) A person who applies for licensure under paragraph (b), (c), or (f) more than two 
520.18 	and less than four years after meeting the requirements in section 148.6408 or 148.6410 
520.19 	must submit the following:
520.20 	(1) a completed and signed application for licensure on forms provided by the 
520.21 	commissioner;
520.22 	(2) the license application fee required under section 148.6445;
520.23 	(3) consent to a fingerprint-based criminal history records check required under section 
520.24 	148.6420;
520.25 	(3) (4) if applying for occupational therapist licensure, proof of having met a minimum 
520.26 	of 24 contact hours of continuing education in the two years preceding licensure application, 
520.27 	or if applying for occupational therapy assistant licensure, proof of having met a minimum 
520.28 	of 18 contact hours of continuing education in the two years preceding licensure application;
520.29 	(4) (5) verified documentation of successful completion of 160 hours of supervised 
520.30 	practice approved by the commissioner under a limited license specified in section 148.6425, 
520.31 	subdivision 3, paragraph (c); and
521.1 	(5) (6) additional information as requested by the commissioner to clarify information 
521.2 	in the application, including information to determine whether the individual has engaged 
521.3 	in conduct warranting disciplinary action under section 148.6448. The information must be 
521.4 	submitted within 30 days after the commissioner's request.
521.5 	(h) A person who applied for licensure under paragraph (b), (c), or (f) four years or more 
521.6 	after meeting the requirements in section 148.6408 or 148.6410 must meet all the 
521.7 	requirements in paragraph (g) except clauses (3) (4) and (4) (5), submit documentation of 
521.8 	having retaken and passed the credentialing examination for occupational therapist or 
521.9 	occupational therapy assistant, or of having completed an occupational therapy refresher 
521.10 	program that contains both a theoretical and clinical component approved by the 
521.11 	commissioner, and verified documentation of successful completion of 480 hours of 
521.12 	supervised practice approved by the commissioner under a limited license specified in 
521.13 	section 148.6425, subdivision 3, paragraph (c). The 480 hours of supervised practice must 
521.14 	be completed in six months and may be completed at the applicant's place of work. Only 
521.15 	refresher courses completed within one year prior to the date of application qualify for 
521.16 	approval.

521.17 	Sec. 83. Minnesota Statutes 2016, section 148.6420, subdivision 1, is amended to read:
521.18 		Subdivision 1.Applications for licensure. An applicant for licensure must:
521.19 	(1) submit a completed application for licensure on forms provided by the commissioner 
521.20 	and must supply the information requested on the application, including:
521.21 	(i) the applicant's name, business address and business telephone number, business 
521.22 	setting, and daytime telephone number;
521.23 	(ii) the name and location of the occupational therapy program the applicant completed;
521.24 	(iii) a description of the applicant's education and training, including a list of degrees 
521.25 	received from educational institutions;
521.26 	(iv) the applicant's work history for the six years preceding the application, including 
521.27 	the number of hours worked;
521.28 	(v) a list of all credentials currently and previously held in Minnesota and other 
521.29 	jurisdictions;
521.30 	(vi) a description of any jurisdiction's refusal to credential the applicant;
521.31 	(vii) a description of all professional disciplinary actions initiated against the applicant 
521.32 	in any jurisdiction;
522.1 	(viii) information on any physical or mental condition or chemical dependency that 
522.2 	impairs the person's ability to engage in the practice of occupational therapy with reasonable 
522.3 	judgment or safety;
522.4 	(ix) a description of any misdemeanor or felony conviction that relates to honesty or to 
522.5 	the practice of occupational therapy;
522.6 	(x) a description of any state or federal court order, including a conciliation court 
522.7 	judgment or a disciplinary order, related to the individual's occupational therapy practice; 
522.8 	and
522.9 	(xi) a statement indicating the physical agent modalities the applicant will use and 
522.10 	whether the applicant will use the modalities as an occupational therapist or an occupational 
522.11 	therapy assistant under direct supervision;
522.12 	(2) submit with the application all fees required by section 148.6445;
522.13 	(3) sign a statement that the information in the application is true and correct to the best 
522.14 	of the applicant's knowledge and belief;
522.15 	(4) sign a waiver authorizing the commissioner to obtain access to the applicant's records 
522.16 	in this or any other state in which the applicant holds or previously held a credential for the 
522.17 	practice of an occupation, has completed an accredited occupational therapy education 
522.18 	program, or engaged in the practice of occupational therapy;
522.19 	(5) submit additional information as requested by the commissioner consent to a 
522.20 	fingerprint-based criminal background records check required under section 144.0572, pay 
522.21 	all required fees, and cooperate with all requests for information. An applicant must complete 
522.22 	a new criminal background check if more than one year has elapsed since the applicant last 
522.23 	applied for a license; and
522.24 	(6) submit the additional information required for licensure by equivalency, licensure 
522.25 	by reciprocity, and temporary licensure as specified in sections 148.6408 to 148.6418.

522.26 	Sec. 84. Minnesota Statutes 2016, section 148.6420, subdivision 5, is amended to read:
522.27 		Subd. 5.Action on applications for licensure. (a) The commissioner shall approve, 
522.28 	approve with conditions, or deny licensure. The commissioner shall act on an application 
522.29 	for licensure according to paragraphs (b) to (d).
522.30 	(b) The commissioner shall determine if the applicant meets the requirements for 
522.31 	licensure. The commissioner, or the advisory council at the commissioner's request, may 
523.1 	investigate information provided by an applicant to determine whether the information is 
523.2 	accurate and complete.
523.3 	(c) The commissioner shall notify an applicant of action taken on the application and, 
523.4 	if licensure is denied or approved with conditions, the grounds for the commissioner's 
523.5 	determination.
523.6 	(d) An applicant denied licensure or granted licensure with conditions may make a 
523.7 	written request to the commissioner, within 30 days of the date of the commissioner's 
523.8 	determination, for reconsideration of the commissioner's determination. Individuals 
523.9 	requesting reconsideration may submit information which the applicant wants considered 
523.10 	in the reconsideration. After reconsideration of the commissioner's determination to deny 
523.11 	licensure or grant licensure with conditions, the commissioner shall determine whether the 
523.12 	original determination should be affirmed or modified. An applicant is allowed no more 
523.13 	than one request in any one biennial licensure period for reconsideration of the 
523.14 	commissioner's determination to deny licensure or approve licensure with conditions.
523.15 	(e) The commissioner shall not issue a license to an applicant who refuses to consent to 
523.16 	a background study within 90 days after submission of an application or fails to submit 
523.17 	fingerprints to the Department of Human Services. Any fees paid by the applicant to the 
523.18 	Department of Health shall be forfeited if the applicant refuses to consent to the background 
523.19 	study.

523.20 	Sec. 85. Minnesota Statutes 2016, section 148.6445, subdivision 1, is amended to read:
523.21 		Subdivision 1.Initial licensure fee. The initial licensure fee for occupational therapists 
523.22 	is $145 $188.50. The initial licensure fee for occupational therapy assistants is $80 $112.50. 
523.23 	The commissioner shall prorate fees based on the number of quarters remaining in the 
523.24 	biennial licensure period.

523.25 	Sec. 86. Minnesota Statutes 2016, section 148.6445, subdivision 2, is amended to read:
523.26 		Subd. 2.Licensure renewal fee. The biennial licensure renewal fee for occupational 
523.27 	therapists is $145 $173. The biennial licensure renewal fee for occupational therapy assistants 
523.28 	is $80 $96.

523.29 	Sec. 87. Minnesota Statutes 2016, section 148.6445, subdivision 3, is amended to read:
523.30 		Subd. 3.Late fee. The fee for late submission of a renewal application is $25 $32.

524.1 	Sec. 88. Minnesota Statutes 2016, section 148.6445, is amended by adding a subdivision 
524.2 	to read:
524.3 		Subd. 10a.Surcharge. Practitioners who were licensed before January 1, 2018, shall 
524.4 	pay a onetime surcharge of $16.50 to renew when their license first expires after January 
524.5 	1, 2020. The surcharge shall cover the commissioner's costs associated with criminal 
524.6 	background checks.

524.7 	Sec. 89. Minnesota Statutes 2016, section 148.997, subdivision 1, is amended to read:
524.8 		Subdivision 1.Fees. (a) The application fee is $130 $185.
524.9 	(b) The criminal background check fee is $6 $15.

524.10 	Sec. 90. Minnesota Statutes 2016, section 153A.14, subdivision 1, is amended to read:
524.11 		Subdivision 1.Application for certificate. An applicant must:
524.12 	(1) be 21 years of age or older;
524.13 	(2) apply to the commissioner for a certificate to dispense hearing instruments on 
524.14 	application forms provided by the commissioner;
524.15 	(3) at a minimum, provide the applicant's name, Social Security number, business address 
524.16 	and phone number, employer, and information about the applicant's education, training, 
524.17 	and experience in testing human hearing and fitting hearing instruments;
524.18 	(4) include with the application a statement that the statements in the application are 
524.19 	true and correct to the best of the applicant's knowledge and belief;
524.20 	(5) include with the application a written and signed authorization that authorizes the 
524.21 	commissioner to make inquiries to appropriate regulatory agencies in this or any other state 
524.22 	where the applicant has sold hearing instruments;
524.23 	(6) submit certification to the commissioner that the applicant's audiometric equipment 
524.24 	has been calibrated to meet current ANSI standards within 12 months of the date of the 
524.25 	application;
524.26 	(7) submit evidence of continuing education credits, if required; and
524.27 	(8) submit all fees as required under section 153A.17.; and
524.28 	(9) consent to a fingerprint-based criminal history records check required under section 
524.29 	144.0572, pay all required fees, and cooperate with all requests for information. An applicant 
525.1 	must complete a new criminal background check if more than one year has elapsed since 
525.2 	the applicant last applied for a license.

525.3 	Sec. 91. Minnesota Statutes 2016, section 153A.14, subdivision 2, is amended to read:
525.4 		Subd. 2.Issuance of certificate. (a) The commissioner shall issue a certificate to each 
525.5 	dispenser of hearing instruments who applies under subdivision 1 if the commissioner 
525.6 	determines that the applicant is in compliance with this chapter, has passed an examination 
525.7 	administered by the commissioner, has met the continuing education requirements, if 
525.8 	required, and has paid the fee set by the commissioner. The commissioner may reject or 
525.9 	deny an application for a certificate if there is evidence of a violation or failure to comply 
525.10 	with this chapter.
525.11 	(b) The commissioner shall not issue a certificate to an applicant who refuses to consent 
525.12 	to a criminal history background check as required by section 144.0572 within 90 days after 
525.13 	submission of an application or fails to submit fingerprints to the Department of Human 
525.14 	Services. Any fees paid by the applicant to the Department of Health shall be forfeited if 
525.15 	the applicant refuses to consent to the background study.

525.16 	Sec. 92. Minnesota Statutes 2016, section 153A.17, is amended to read:
525.17 	153A.17 EXPENSES; FEES.
525.18 	(a) The expenses for administering the certification requirements, including the complaint 
525.19 	handling system for hearing aid dispensers in sections 153A.14 and 153A.15, and the 
525.20 	Consumer Information Center under section 153A.18, must be paid from initial application 
525.21 	and examination fees, renewal fees, penalties, and fines. The commissioner shall only use 
525.22 	fees collected under this section for the purposes of administering this chapter. The legislature 
525.23 	must not transfer money generated by these fees from the state government special revenue 
525.24 	fund to the general fund. Surcharges collected by the commissioner of health under section 
525.25 	16E.22 are not subject to this paragraph.
525.26 	(b) The fees are as follows:
525.27 	(1) the initial and annual renewal certification application fee is $600 $772.50;
525.28 	(2) the initial examination fee for the written portion is $500, and for each time it is 
525.29 	taken, thereafter the annual renewal certification application fee is $750;
525.30 	(3) the initial examination fee for the practical portion is $1,200, and $600 for each time 
525.31 	it is taken, thereafter; for individuals meeting the requirements of section 148.515, subdivision 
526.1 	2, the fee for the practical portion of the hearing instrument dispensing examination is $250
526.2 	$600 each time it is taken;
526.3 	(4) the trainee application fee is $200 $230;
526.4 	(5) the penalty fee for late submission of a renewal application is $200 $260; and
526.5 	(6) the fee for verification of certification to other jurisdictions or entities is $25.
526.6 	(c) The commissioner may prorate the certification fee for new applicants based on the 
526.7 	number of quarters remaining in the annual certification period.
526.8 	(d) All fees are nonrefundable. All fees, penalties, and fines received must be deposited 
526.9 	in the state government special revenue fund.
526.10 	(e) Beginning July 1, 2009, until June 30, 2016, a surcharge of $100 shall be paid at the 
526.11 	time of initial certification application or renewal to recover the commissioner's accumulated 
526.12 	direct expenditures for administering the requirements of this chapter. Hearing instrument 
526.13 	dispensers who were certified before January 1, 2018, shall pay a onetime surcharge of 
526.14 	$22.50 to renew their certification when it expires after October 31, 2020. The surcharge 
526.15 	shall cover the commissioner's costs associated with criminal background checks.

526.16 	Sec. 93. Minnesota Statutes 2016, section 157.16, subdivision 1, is amended to read:
526.17 		Subdivision 1.License required annually. A license is required annually for every 
526.18 	person, firm, or corporation engaged in the business of conducting a food and beverage 
526.19 	service establishment, youth camp, hotel, motel, lodging establishment, public pool, or 
526.20 	resort. Any person wishing to operate a place of business licensed in this section shall first 
526.21 	make application, pay the required fee specified in this section, and receive approval for 
526.22 	operation, including plan review approval. Special event food stands are not required to 
526.23 	submit plans. Nonprofit organizations operating a special event food stand with multiple 
526.24 	locations at an annual one-day event shall be issued only one license. Application shall be 
526.25 	made on forms provided by the commissioner and shall require the applicant to state the 
526.26 	full name and address of the owner of the building, structure, or enclosure, the lessee and 
526.27 	manager of the food and beverage service establishment, hotel, motel, lodging establishment, 
526.28 	public pool, or resort; the name under which the business is to be conducted; and any other 
526.29 	information as may be required by the commissioner to complete the application for license.
526.30 	All fees collected under this section shall be deposited in the state government special 
526.31 	revenue fund.

527.1 	Sec. 94. Minnesota Statutes 2016, section 157.16, subdivision 3, is amended to read:
527.2 		Subd. 3.Establishment fees; definitions. (a) The following fees are required for food 
527.3 	and beverage service establishments, youth camps, hotels, motels, lodging establishments, 
527.4 	public pools, and resorts licensed under this chapter. Food and beverage service 
527.5 	establishments must pay the highest applicable fee under paragraph (d), clause (1), (2), (3), 
527.6 	or (4), and establishments serving alcohol must pay the highest applicable fee under paragraph 
527.7 	(d), clause (6) or (7). The license fee for new operators previously licensed under this chapter 
527.8 	for the same calendar year is one-half of the appropriate annual license fee, plus any penalty 
527.9 	that may be required. The license fee for operators opening on or after October 1 is one-half 
527.10 	of the appropriate annual license fee, plus any penalty that may be required.
527.11 	(b) All food and beverage service establishments, except special event food stands, and 
527.12 	all hotels, motels, lodging establishments, public pools, and resorts shall pay an annual base 
527.13 	fee of $150 $165.
527.14 	(c) A special event food stand shall pay a flat fee of $50 $55 annually. "Special event 
527.15 	food stand" means a fee category where food is prepared or served in conjunction with 
527.16 	celebrations, county fairs, or special events from a special event food stand as defined in 
527.17 	section 157.15.
527.18 	(d) In addition to the base fee in paragraph (b), each food and beverage service 
527.19 	establishment, other than a special event food stand and a school concession stand, and each 
527.20 	hotel, motel, lodging establishment, public pool, and resort shall pay an additional annual 
527.21 	fee for each fee category, additional food service, or required additional inspection specified 
527.22 	in this paragraph:
527.23 	(1) Limited food menu selection, $60. "Limited food menu selection" Category 1 
527.24 	establishment, $110. "Category 1 establishment" means a fee category that provides one or 
527.25 	more of the following items or is one of the listed establishments or facilities:
527.26 	(i) serves prepackaged food that receives heat treatment and is served in the package;
527.27 	(ii) frozen pizza that is heated and served;
527.28 	(iii) serves a continental breakfast such as rolls, coffee, juice, milk, and cold cereal;
527.29 	(iv) (iii) serves soft drinks, coffee, or nonalcoholic beverages; or
527.30 	(v) (iv) provides cleaning for eating, drinking, or cooking utensils, when the only food 
527.31 	served is prepared off site.;
528.1 	(v) a food establishment where the method of food preparation meets the definition of 
528.2 	a low-risk establishment in section 157.20; or
528.3 	(vi) operates as a child care facility licensed under section 245A.03 and Minnesota Rules, 
528.4 	chapter 9503.
528.5 	(2) Small establishment, including boarding establishments, $120. "Small establishment" 
528.6 	means a fee category that has no salad bar and meets one or more of the following:
528.7 	(i) possesses food service equipment that consists of no more than a deep fat fryer, a 
528.8 	grill, two hot holding containers, and one or more microwave ovens;
528.9 	(ii) serves dipped ice cream or soft serve frozen desserts;
528.10 	(iii) serves breakfast in an owner-occupied bed and breakfast establishment;
528.11 	(iv) is a boarding establishment; or
528.12 	(v) meets the equipment criteria in clause (3), item (i) or (ii), and has a maximum patron 
528.13 	seating capacity of not more than 50.
528.14 	(3) Medium establishment, $310. "Medium establishment" (2) Category 2 establishment, 
528.15 	$245. "Category 2 establishment" means a fee category that meets one or more of the 
528.16 	following an establishment that is not a Category 1 establishment and is either:
528.17 	(i) possesses food service equipment that includes a range, oven, steam table, salad bar, 
528.18 	or salad preparation area; a food establishment where the method of food preparation meets 
528.19 	the definition of a medium-risk establishment in section 157.20; or
528.20 	(ii) possesses food service equipment that includes more than one deep fat fryer, one 
528.21 	grill, or two hot holding containers; or an elementary or secondary school as defined in 
528.22 	section 120A.05.
528.23 	(iii) is an establishment where food is prepared at one location and served at one or more 
528.24 	separate locations.
528.25 	Establishments meeting criteria in clause (2), item (v), are not included in this fee 
528.26 	category.
528.27 	(4) Large establishment, $540. "Large establishment" (3) Category 3 establishment, 
528.28 	$385. "Category 3 establishment" means an establishment that is not a Category 1 or Category 
528.29 	2 establishment and is either:
528.30 	(i) a fee category that (A) meets the criteria in clause (3), items (i) or (ii), for a medium 
528.31 	establishment, (B) seats more than 175 people, and (C) offers the full menu selection an 
529.1 	average of five or more days a week during the weeks of operation a food establishment 
529.2 	where the method of food preparation meets the definition of a high-risk establishment in 
529.3 	section 157.20; or
529.4 	(ii) a fee category that (A) meets the criteria in clause (3), item (iii), for a medium 
529.5 	establishment, and (B) prepares and serves 500 or more meals per day. an establishment 
529.6 	where 500 or more meals are prepared per day and served at one or more separate locations.
529.7 	(5) (4) Other food and beverage service, including food carts, mobile food units, seasonal 
529.8 	temporary food stands, and seasonal permanent food stands, $60 $85.
529.9 	(6) Beer or wine table service, $60. "Beer or wine table service" means a fee category 
529.10 	where the only alcoholic beverage service is beer or wine, served to customers seated at 
529.11 	tables.
529.12 	(7) Alcoholic beverage service, other than beer or wine table service, $165.
529.13 	"Alcohol beverage service, other than beer or wine table service" means a fee category 
529.14 	where alcoholic mixed drinks are served or where beer or wine are served from a bar.
529.15 	(8) (5) Lodging per sleeping accommodation unit, $10 $11, including hotels, motels, 
529.16 	lodging establishments, and resorts, up to a maximum of $1,000 $1,100. "Lodging per 
529.17 	sleeping accommodation unit" means a fee category including the number of guest rooms, 
529.18 	cottages, or other rental units of a hotel, motel, lodging establishment, or resort; or the 
529.19 	number of beds in a dormitory.
529.20 	(9) (6) First public pool, $325 $355; each additional public pool, $175 $200. "Public 
529.21 	pool" means a fee category that has the meaning given in section 144.1222, subdivision 4.
529.22 	(10) (7) First spa, $175 $200; each additional spa, $100 $110. "Spa pool" means a fee 
529.23 	category that has the meaning given in Minnesota Rules, part 4717.0250, subpart 9.
529.24 	(11) (8) Private sewer or water, $60. "Individual private water" means a fee category 
529.25 	with a water supply other than a community public water supply as defined in Minnesota 
529.26 	Rules, chapter 4720. "Individual private sewer" means a fee category with an individual 
529.27 	sewage treatment system which uses subsurface treatment and disposal.
529.28 	(12) (9) Additional food service, $150 $175. "Additional food service" means a location 
529.29 	at a food service establishment, other than the primary food preparation and service area, 
529.30 	used to prepare or serve beverages or food to the public. Additional food service does not 
529.31 	apply to school concession stands.
530.1 	(13) (10) Additional inspection fee, $360 $250. "Additional inspection fee" means a fee 
530.2 	to conduct the second inspection each year for elementary and secondary education facility 
530.3 	school lunch programs when required by the Richard B. Russell National School Lunch 
530.4 	Act.
530.5 	(11) HACCP verification, $175. "HACCP verification" means an annual fee category 
530.6 	for a business that performs one or more specialized process that requires an HACCP plan 
530.7 	as required in chapter 31 and Minnesota Rules, chapter 4626.
530.8 	(e) A fee for review of construction plans must accompany the initial license application 
530.9 	for restaurants, hotels, motels, lodging establishments, resorts, seasonal food stands, and 
530.10 	mobile food units. A fee for review of an HACCP plan for specialized processing must be 
530.11 	submitted and approved prior to preparing and serving the specialized processed food for 
530.12 	human consumption. The fee fees for this construction plan review is reviews and HACCP 
530.13 	plan reviews are as follows:

530.14	Service Area
	Type
	Fee
	
530.15	Food
	limited food menu
	$275
	
530.16		small category 1 establishment
	$400
	
530.17		medium category 2 establishment
	$450
	
530.18		large category 3 food establishment
	$500
	
530.20530.19
		additional food service
	$150
$250
	
530.21		HACCP Plan Review
	$500
	
530.22	Transient food service
	food cart
	$250
	
530.23		seasonal permanent food stand
	$250
	
530.24		seasonal temporary food stand
	$250
	
530.25		mobile food unit
	$350
	
530.26	Alcohol
	beer or wine table service
	$150
	
530.27		alcohol service from bar
	$250
	
530.28	Lodging
	less than 25 rooms
	$375
	
530.29		25 to less than 100 rooms
	$400
	
530.30		100 rooms or more
	$500
	
530.31		less than five cabins
	$350
	
530.32		five to less than ten cabins
	$400
	
530.33		ten cabins or more
	$450
	
530.34 	(f) When existing food and beverage service establishments, hotels, motels, lodging 
530.35 	establishments, resorts, seasonal food stands, and mobile food units are extensively 
531.1 	remodeled, a fee must be submitted with the remodeling plans. The fee for this construction 
531.2 	plan review is as follows:

531.3	Service Area
	Type
	Fee
	
531.4	Food
	limited food menu
	$250
	
531.5		small category 1 establishment
	$300
	
531.6		medium category 2 establishment
	$350
	
531.7		large food category 3 establishment
	$400
	
531.9531.8
		additional food service
	$150
$250
	
531.10	Transient food service
	food cart
	$250
	
531.11		seasonal permanent food stand
	$250
	
531.12		seasonal temporary food stand
	$250
	
531.13		mobile food unit
	$250
	
531.14	Alcohol
	beer or wine table service
	$150
	
531.15		alcohol service from bar
	$250
	
531.16	Lodging
	less than 25 rooms
	$250
	
531.17		25 to less than 100 rooms
	$300
	
531.18		100 rooms or more
	$450
	
531.19		less than five cabins
	$250
	
531.20		five to less than ten cabins
	$350
	
531.21		ten cabins or more
	$400
	
531.22 	(g) Special event food stands are not required to submit construction or remodeling plans 
531.23 	for review.
531.24 	(h) Youth camps shall pay an annual single fee for food and lodging as follows:
531.25 	(1) camps with up to 99 campers, $325;
531.26 	(2) camps with 100 to 199 campers, $550; and
531.27 	(3) camps with 200 or more campers, $750.
531.28 	(i) A youth camp which pays fees under paragraph (d) is not required to pay fees under 
531.29 	paragraph (h).

531.30 	Sec. 95. Minnesota Statutes 2016, section 157.16, subdivision 3a, is amended to read:
531.31 		Subd. 3a.Statewide hospitality fee. Every person, firm, or corporation that operates a 
531.32 	licensed boarding establishment, food and beverage service establishment, seasonal temporary 
531.33 	or permanent food stand, special event food stand, mobile food unit, food cart, resort, hotel, 
531.34 	motel, or lodging establishment in Minnesota must submit to the commissioner a $35 $40
532.1 	annual statewide hospitality fee for each licensed activity. The fee for establishments licensed 
532.2 	by the Department of Health is required at the same time the licensure fee is due. For 
532.3 	establishments licensed by local governments, the fee is due by July 1 of each year.

532.4 	Sec. 96. Minnesota Statutes 2016, section 245C.10, is amended by adding a subdivision 
532.5 	to read:
532.6 		Subd. 2a.Occupations regulated by commissioner of health. The commissioner shall 
532.7 	set fees to recover the cost of combined background studies and criminal background checks 
532.8 	initiated by applicants, licensees, and certified practitioners regulated under sections 148.511 
532.9 	to 148.5198 and 148.6401 to 148.6450 and chapter 153A. The fees collected under this 
532.10 	subdivision shall be deposited in the special revenue fund and are appropriated to the 
532.11 	commissioner for the purpose of conducting background studies and criminal background 
532.12 	checks.

532.13 	Sec. 97. Minnesota Statutes 2016, section 327.15, subdivision 3, is amended to read:
532.14 		Subd. 3.Fees, manufactured home parks and recreational camping areas. (a) The 
532.15 	following fees are required for manufactured home parks and recreational camping areas 
532.16 	licensed under this chapter. Fees collected under this section shall be deposited in the state 
532.17 	government special revenue fund. Recreational camping areas and manufactured home 
532.18 	parks shall pay the highest applicable base fee under paragraph (b). The license fee for new 
532.19 	operators of a manufactured home park or recreational camping area previously licensed 
532.20 	under this chapter for the same calendar year is one-half of the appropriate annual license 
532.21 	fee, plus any penalty that may be required. The license fee for operators opening on or after 
532.22 	October 1 is one-half of the appropriate annual license fee, plus any penalty that may be 
532.23 	required.
532.24 	(b) All manufactured home parks and recreational camping areas shall pay the following 
532.25 	annual base fee:
532.26 	(1) a manufactured home park, $150 $165; and
532.27 	(2) a recreational camping area with:
532.28 	(i) 24 or less sites, $50 $55;
532.29 	(ii) 25 to 99 sites, $212 $230; and
532.30 	(iii) 100 or more sites, $300 $330.
533.1 	In addition to the base fee, manufactured home parks and recreational camping areas shall 
533.2 	pay $4 $5 for each licensed site. This paragraph does not apply to special event recreational 
533.3 	camping areas. Operators of a manufactured home park or a recreational camping area also 
533.4 	licensed under section 157.16 for the same location shall pay only one base fee, whichever 
533.5 	is the highest of the base fees found in this section or section 157.16.
533.6 	(c) In addition to the fee in paragraph (b), each manufactured home park or recreational 
533.7 	camping area shall pay an additional annual fee for each fee category specified in this 
533.8 	paragraph:
533.9 	(1) Manufactured home parks and recreational camping areas with public swimming 
533.10 	pools and spas shall pay the appropriate fees specified in section 157.16.
533.11 	(2) Individual private sewer or water, $60. "Individual private water" means a fee category 
533.12 	with a water supply other than a community public water supply as defined in Minnesota 
533.13 	Rules, chapter 4720. "Individual private sewer" means a fee category with a subsurface 
533.14 	sewage treatment system which uses subsurface treatment and disposal.
533.15 	(d) The following fees must accompany a plan review application for initial construction 
533.16 	of a manufactured home park or recreational camping area:
533.17 	(1) for initial construction of less than 25 sites, $375;
533.18 	(2) for initial construction of 25 to 99 sites, $400; and
533.19 	(3) for initial construction of 100 or more sites, $500.
533.20 	(e) The following fees must accompany a plan review application when an existing 
533.21 	manufactured home park or recreational camping area is expanded:
533.22 	(1) for expansion of less than 25 sites, $250;
533.23 	(2) for expansion of 25 to 99 sites, $300; and
533.24 	(3) for expansion of 100 or more sites, $450.

533.25 	Sec. 98. Minnesota Statutes 2016, section 364.09, is amended to read:
533.26 	364.09 EXCEPTIONS.
533.27 	(a) This chapter does not apply to the licensing process for peace officers; to law 
533.28 	enforcement agencies as defined in section 626.84, subdivision 1, paragraph (f); to fire 
533.29 	protection agencies; to eligibility for a private detective or protective agent license; to the 
533.30 	licensing and background study process under chapters 245A and 245C; to the licensing 
533.31 	and background investigation process under chapter 240; to eligibility for school bus driver 
534.1 	endorsements; to eligibility for special transportation service endorsements; to eligibility 
534.2 	for a commercial driver training instructor license, which is governed by section 171.35
534.3 	and rules adopted under that section; to emergency medical services personnel, or to the 
534.4 	licensing by political subdivisions of taxicab drivers, if the applicant for the license has 
534.5 	been discharged from sentence for a conviction within the ten years immediately preceding 
534.6 	application of a violation of any of the following:
534.7 	(1) sections 609.185 to 609.2114, 609.221 to 609.223, 609.342 to 609.3451, or 617.23, 
534.8 	subdivision 2 or 3; or Minnesota Statutes 2012, section 609.21;
534.9 	(2) any provision of chapter 152 that is punishable by a maximum sentence of 15 years 
534.10 	or more; or
534.11 	(3) a violation of chapter 169 or 169A involving driving under the influence, leaving 
534.12 	the scene of an accident, or reckless or careless driving.
534.13 	This chapter also shall not apply to eligibility for juvenile corrections employment, where 
534.14 	the offense involved child physical or sexual abuse or criminal sexual conduct.
534.15 	(b) This chapter does not apply to a school district or to eligibility for a license issued 
534.16 	or renewed by the Board of Teaching or the commissioner of education.
534.17 	(c) Nothing in this section precludes the Minnesota Police and Peace Officers Training 
534.18 	Board or the state fire marshal from recommending policies set forth in this chapter to the 
534.19 	attorney general for adoption in the attorney general's discretion to apply to law enforcement 
534.20 	or fire protection agencies.
534.21 	(d) This chapter does not apply to a license to practice medicine that has been denied or 
534.22 	revoked by the Board of Medical Practice pursuant to section 147.091, subdivision 1a.
534.23 	(e) This chapter does not apply to any person who has been denied a license to practice 
534.24 	chiropractic or whose license to practice chiropractic has been revoked by the board in 
534.25 	accordance with section 148.10, subdivision 7.
534.26 	(f) This chapter does not apply to any license, registration, or permit that has been denied 
534.27 	or revoked by the Board of Nursing in accordance with section 148.261, subdivision 1a.
534.28 	(g) This chapter does not apply to any license, registration, permit, or certificate that has 
534.29 	been denied or revoked by the commissioner of health according to section 148.5195, 
534.30 	subdivision 5; 148.6448, subdivision 3; or 153A.15, subdivision 2.
535.1 	(g)(h) This chapter does not supersede a requirement under law to conduct a criminal 
535.2 	history background investigation or consider criminal history records in hiring for particular 
535.3 	types of employment.

535.4 	Sec. 99.  REPEALER.
 535.5 	Minnesota Statutes 2016, sections 103I.005, subdivisions 8, 14, and 15; 103I.451; and 
535.6 	144.0571, are repealed.

535.7 	ARTICLE 11
535.8 	HEALTH LICENSING BOARDS

535.9 	Section 1. Minnesota Statutes 2016, section 144E.35, subdivision 1, is amended to read:
535.10 		Subdivision 1.Repayment for volunteer education.  A licensed ambulance service 
535.11 	shall be reimbursed by the board for the necessary expense of the initial education of a 
535.12 	volunteer ambulance attendant upon successful completion by the attendant of an EMT 
535.13 	education course, or a continuing renewal education course for EMT care, or both, which 
535.14 	has been approved by the board, pursuant to section 144E.285. Reimbursement may include 
535.15 	tuition, transportation, food, lodging, hourly payment for the time spent in at the education 
535.16 	course, and other necessary expenditures, except that in no instance shall a volunteer 
535.17 	ambulance attendant be reimbursed more than $600 $900 for successful completion of an 
535.18 	initial education course, and $275 $350 for successful completion of a continuing renewal
535.19 	education course.

535.20 	Sec. 2. Minnesota Statutes 2016, section 147.01, subdivision 7, is amended to read:
535.21 		Subd. 7.Physician application fee and license fees. (a) The board may charge a the 
535.22 	following nonrefundable application and license fees processed pursuant to sections 147.02, 
535.23 	147.03, 147.037, 147.0375, and 147.38:
535.24 	(1) physician application fee of, $200.;
535.25 	(2) physician annual registration renewal fee, $192;
535.26 	(3) physician endorsement to other states, $40;
535.27 	(4) physician emeritus license, $50;
535.28 	(5) physician temporary licenses, $60;
535.29 	(6) physician late fee, $60;
535.30 	(7) duplicate license fee, $20;
536.1 	(8) certification letter fee, $25;
536.2 	(9) education or training program approval fee, $100;
536.3 	(10) report creation and generation fee, $60;
536.4 	(11) examination administration fee (half day), $50;
536.5 	(12) examination administration fee (full day), $80; and
536.6 	(13) fees developed by the Interstate Commission for determining physician qualification 
536.7 	to register and participate in the interstate medical licensure compact, as established in rules 
536.8 	authorized in and pursuant to section 147.38, not to exceed $1,000.
536.9 	(b) The board may prorate the initial annual license fee. All licensees are required to 
536.10 	pay the full fee upon license renewal. The revenue generated from the fee must be deposited 
536.11 	in an account in the state government special revenue fund.

536.12 	Sec. 3. Minnesota Statutes 2016, section 147.02, subdivision 1, is amended to read:
536.13 		Subdivision 1.United States or Canadian medical school graduates. The board shall 
536.14 	issue a license to practice medicine to a person not currently licensed in another state or 
536.15 	Canada and who meets the requirements in paragraphs (a) to (i).
536.16 	(a) An applicant for a license shall file a written application on forms provided by the 
536.17 	board, showing to the board's satisfaction that the applicant is of good moral character and 
536.18 	satisfies the requirements of this section.
536.19 	(b) The applicant shall present evidence satisfactory to the board of being a graduate of 
536.20 	a medical or osteopathic medical school located in the United States, its territories or Canada, 
536.21 	and approved by the board based upon its faculty, curriculum, facilities, accreditation by a 
536.22 	recognized national accrediting organization approved by the board, and other relevant data, 
536.23 	or is currently enrolled in the final year of study at the school.
536.24 	(c) The applicant must have passed an examination as described in clause (1) or (2).
536.25 	(1) The applicant must have passed a comprehensive examination for initial licensure 
536.26 	prepared and graded by the National Board of Medical Examiners, the Federation of State 
536.27 	Medical Boards, the Medical Council of Canada, the National Board of Osteopathic 
536.28 	Examiners, or the appropriate state board that the board determines acceptable. The board 
536.29 	shall by rule determine what constitutes a passing score in the examination.
536.30 	(2) The applicant taking the United States Medical Licensing Examination (USMLE) 
536.31 	or Comprehensive Osteopathic Medical Licensing Examination (COMLEX-USA) must 
537.1 	have passed steps or levels one, two, and three. Step or level three must be passed within 
537.2 	five years of passing step or level two, or before the end of residency training. The applicant 
537.3 	must pass each of steps or levels one, two, and three with passing scores as recommended 
537.4 	by the USMLE program or National Board of Osteopathic Medical Examiners within three 
537.5 	attempts. The applicant taking combinations of Federation of State Medical Boards, National 
537.6 	Board of Medical Examiners, and USMLE may be accepted only if the combination is 
537.7 	approved by the board as comparable to existing comparable examination sequences and 
537.8 	all examinations are completed prior to the year 2000.
537.9 	(d) The applicant shall present evidence satisfactory to the board of the completion of 
537.10 	one year of graduate, clinical medical training in a program accredited by a national 
537.11 	accrediting organization approved by the board or other graduate training approved in 
537.12 	advance by the board as meeting standards similar to those of a national accrediting 
537.13 	organization.
537.14 	(e) The applicant may make arrangements with the executive director to appear in person 
537.15 	before the board or its designated representative to show that the applicant satisfies the 
537.16 	requirements of this section. The board may establish as internal operating procedures the 
537.17 	procedures or requirements for the applicant's personal presentation.
537.18 	(f) The applicant shall pay a nonrefundable fee established by the board by rule. The 
537.19 	fee may not be refunded. Upon application or notice of license renewal, the board must 
537.20 	provide notice to the applicant and to the person whose license is scheduled to be issued or 
537.21 	renewed of any additional fees, surcharges, or other costs which the person is obligated to 
537.22 	pay as a condition of licensure. The notice must:
537.23 	(1) state the dollar amount of the additional costs; and
537.24 	(2) clearly identify to the applicant the payment schedule of additional costs.
537.25 	(g) The applicant must not be under license suspension or revocation by the licensing 
537.26 	board of the state or jurisdiction in which the conduct that caused the suspension or revocation 
537.27 	occurred.
537.28 	(h) The applicant must not have engaged in conduct warranting disciplinary action 
537.29 	against a licensee, or have been subject to disciplinary action other than as specified in 
537.30 	paragraph (g). If the applicant does not satisfy the requirements stated in this paragraph, 
537.31 	the board may issue a license only on the applicant's showing that the public will be protected 
537.32 	through issuance of a license with conditions and limitations the board considers appropriate.
538.1 	(i) If the examination in paragraph (c) was passed more than ten years ago, the applicant 
538.2 	must either:
538.3 	(1) pass the special purpose examination of the Federation of State Medical Boards with 
538.4 	a score of 75 or better within three attempts; or
538.5 	(2) have a current certification by a specialty board of the American Board of Medical 
538.6 	Specialties, of the American Osteopathic Association, the Royal College of Physicians and 
538.7 	Surgeons of Canada, or of the College of Family Physicians of Canada.

538.8 	Sec. 4. Minnesota Statutes 2016, section 147.03, subdivision 1, is amended to read:
538.9 		Subdivision 1.Endorsement; reciprocity. (a) The board may issue a license to practice 
538.10 	medicine to any person who satisfies the requirements in paragraphs (b) to (f).
538.11 	(b) The applicant shall satisfy all the requirements established in section 147.02, 
538.12 	subdivision 1, paragraphs (a), (b), (d), (e), and (f).
538.13 	(c) The applicant shall:
538.14 	(1) have passed an examination prepared and graded by the Federation of State Medical 
538.15 	Boards, the National Board of Medical Examiners, or the United States Medical Licensing 
538.16 	Examination (USMLE) program in accordance with section 147.02, subdivision 1, paragraph 
538.17 	(c), clause (2); the National Board of Osteopathic Medical Examiners; or the Medical Council 
538.18 	of Canada; and
538.19 	(2) have a current license from the equivalent licensing agency in another state or Canada 
538.20 	and, if the examination in clause (1) was passed more than ten years ago, either:
538.21 	(i) pass the Special Purpose Examination of the Federation of State Medical Boards with 
538.22 	a score of 75 or better within three attempts; or
538.23 	(ii) have a current certification by a specialty board of the American Board of Medical 
538.24 	Specialties, of the American Osteopathic Association, the Royal College of Physicians and 
538.25 	Surgeons of Canada, or of the College of Family Physicians of Canada; or
538.26 	(3) if the applicant fails to meet the requirement established in section 147.02, subdivision 
538.27 	1, paragraph (c), clause (2), because the applicant failed to pass each of steps one, two, and 
538.28 	three of the USMLE within the required three attempts, the applicant may be granted a 
538.29 	license provided the applicant:
538.30 	(i) has passed each of steps one, two, and three with passing scores as recommended by 
538.31 	the USMLE program within no more than four attempts for any of the three steps;
539.1 	(ii) is currently licensed in another state; and
539.2 	(iii) has current certification by a specialty board of the American Board of Medical 
539.3 	Specialties, the American Osteopathic Association Bureau of Professional Education, the 
539.4 	Royal College of Physicians and Surgeons of Canada, or the College of Family Physicians 
539.5 	of Canada.
539.6 	(d) The applicant shall pay a fee established by the board by rule. The fee may not be 
539.7 	refunded.
539.8 	(e) (d) The applicant must not be under license suspension or revocation by the licensing 
539.9 	board of the state or jurisdiction in which the conduct that caused the suspension or revocation 
539.10 	occurred.
539.11 	(f) (e) The applicant must not have engaged in conduct warranting disciplinary action 
539.12 	against a licensee, or have been subject to disciplinary action other than as specified in 
539.13 	paragraph (e). If an applicant does not satisfy the requirements stated in this paragraph, the 
539.14 	board may issue a license only on the applicant's showing that the public will be protected 
539.15 	through issuance of a license with conditions or limitations the board considers appropriate.
539.16 	(g) (f) Upon the request of an applicant, the board may conduct the final interview of 
539.17 	the applicant by teleconference.

539.18 	Sec. 5. [147A.28] PHYSICIAN ASSISTANT APPLICATION AND LICENSE FEES.
539.19 	(a) The board may charge the following nonrefundable fees:
539.20 	(1) physician assistant application fee, $120;
539.21 	(2) physician assistant annual registration renewal fee (prescribing authority), $135;
539.22 	(3) physician assistant annual registration renewal fee (no prescribing authority), $115;
539.23 	(4) physician assistant temporary registration, $115;
539.24 	(5) physician assistant temporary permit, $60;
539.25 	(6) physician assistant locum tenens permit, $25;
539.26 	(7) physician assistant late fee, $50;
539.27 	(8) duplicate license fee, $20;
539.28 	(9) certification letter fee, $25;
539.29 	(10) education or training program approval fee, $100; and
539.30 	(11) report creation and generation fee, $60.
540.1 	(b) The board may prorate the initial annual license fee. All licensees are required to 
540.2 	pay the full fee upon license renewal. The revenue generated from the fees must be deposited 
540.3 	in an account in the state government special revenue fund.

540.4 	Sec. 6. Minnesota Statutes 2016, section 147B.08, is amended by adding a subdivision to 
540.5 	read:
540.6 		Subd. 4.Acupuncturist application and license fees. (a) The board may charge the 
540.7 	following nonrefundable fees:
540.8 	(1) acupuncturist application fee, $150;
540.9 	(2) acupuncturist annual registration renewal fee, $150;
540.10 	(3) acupuncturist temporary registration fee, $60;
540.11 	(4) acupuncturist inactive status fee, $50;
540.12 	(5) acupuncturist late fee, $50;
540.13 	(6) duplicate license fee, $20;
540.14 	(7) certification letter fee, $25;
540.15 	(8) education or training program approval fee, $100; and
540.16 	(9) report creation and generation fee, $60.
540.17 	(b) The board may prorate the initial annual license fee. All licensees are required to 
540.18 	pay the full fee upon license renewal. The revenue generated from the fees must be deposited 
540.19 	in an account in the state government special revenue fund.

540.20 	Sec. 7. Minnesota Statutes 2016, section 147C.40, is amended by adding a subdivision to 
540.21 	read:
540.22 		Subd. 5.Respiratory therapist application and license fees. (a) The board may charge 
540.23 	the following nonrefundable fees:
540.24 	(1) respiratory therapist application fee, $100;
540.25 	(2) respiratory therapist annual registration renewal fee, $90;
540.26 	(3) respiratory therapist inactive status fee, $50;
540.27 	(4) respiratory therapist temporary registration fee, $90;
540.28 	(5) respiratory therapist temporary permit, $60;
541.1 	(6) respiratory therapist late fee, $50;
541.2 	(7) duplicate license fee, $20;
541.3 	(8) certification letter fee, $25;
541.4 	(9) education or training program approval fee, $100; and
541.5 	(10) report creation and generation fee, $60.
541.6 	(b) The board may prorate the initial annual license fee. All licensees are required to 
541.7 	pay the full fee upon license renewal. The revenue generated from the fees must be deposited 
541.8 	in an account in the state government special revenue fund.

541.9 	Sec. 8. Minnesota Statutes 2016, section 148.59, is amended to read:
541.10 	148.59 LICENSE RENEWAL; LICENSE AND REGISTRATION FEES.
541.11 	A licensed optometrist shall pay to the state Board of Optometry a fee as set by the board 
541.12 	in order to renew a license as provided by board rule. No fees shall be refunded. Fees may 
541.13 	not exceed the following amounts but may be adjusted lower by board direction and are for 
541.14 	the exclusive use of the board:
541.15 	(1) optometry licensure application, $160;
541.16 	(2) optometry annual licensure renewal, $135 $170;
541.17 	(3) optometry late penalty fee, $75;
541.18 	(4) annual license renewal card, $10;
541.19 	(5) continuing education provider application, $45;
541.20 	(6) emeritus registration, $10;
541.21 	(7) endorsement/reciprocity application, $160;
541.22 	(8) replacement of initial license, $12; and
541.23 	(9) license verification, $50.;
541.24 	(10) jurisprudence state examination, $75;
541.25 	(11) Optometric Education Continuing Education data bank registration, $20; and
541.26 	(12) data requests and labels, $50.

541.27 	Sec. 9. Minnesota Statutes 2016, section 148E.180, is amended to read:
541.28 	148E.180 FEE AMOUNTS.
542.1 		Subdivision 1.Application fees. Nonrefundable application fees for licensure are as 
542.2 	follows may not exceed the following amounts but may be adjusted lower by board action:
542.3 	(1) for a licensed social worker, $45 $75;
542.4 	(2) for a licensed graduate social worker, $45 $75;
542.5 	(3) for a licensed independent social worker, $45 $75;
542.6 	(4) for a licensed independent clinical social worker, $45 $75;
542.7 	(5) for a temporary license, $50; and
542.8 	(6) for a licensure license by endorsement, $85 $115.
542.9 	The fee for criminal background checks is the fee charged by the Bureau of Criminal 
542.10 	Apprehension. The criminal background check fee must be included with the application 
542.11 	fee as required according to section 148E.055.
542.12 		Subd. 2.License fees. Nonrefundable license fees are as follows may not exceed the 
542.13 	following amounts but may be adjusted lower by board action:
542.14 	(1) for a licensed social worker, $81 $115;
542.15 	(2) for a licensed graduate social worker, $144 $210;
542.16 	(3) for a licensed independent social worker, $216 $305;
542.17 	(4) for a licensed independent clinical social worker, $238.50 $335;
542.18 	(5) for an emeritus inactive license, $43.20 $65;
542.19 	(6) for an emeritus active license, one-half of the renewal fee specified in subdivision 
542.20 	3; and
542.21 	(7) for a temporary leave fee, the same as the renewal fee specified in subdivision 3.
542.22 	If the licensee's initial license term is less or more than 24 months, the required license 
542.23 	fees must be prorated proportionately.
542.24 		Subd. 3.Renewal fees. Nonrefundable renewal fees for licensure are as follows the 
542.25 	two-year renewal term may not exceed the following amounts but may be adjusted lower 
542.26 	by board action:
542.27 	(1) for a licensed social worker, $81 $115;
542.28 	(2) for a licensed graduate social worker, $144 $210;
542.29 	(3) for a licensed independent social worker, $216 $305; and
543.1 	(4) for a licensed independent clinical social worker, $238.50 $335.
543.2 		Subd. 4.Continuing education provider fees. Continuing education provider fees are 
543.3 	as follows the following nonrefundable amounts:
543.4 	(1) for a provider who offers programs totaling one to eight clock hours in a one-year 
543.5 	period according to section 148E.145, $50;
543.6 	(2) for a provider who offers programs totaling nine to 16 clock hours in a one-year 
543.7 	period according to section 148E.145, $100;
543.8 	(3) for a provider who offers programs totaling 17 to 32 clock hours in a one-year period 
543.9 	according to section 148E.145, $200;
543.10 	(4) for a provider who offers programs totaling 33 to 48 clock hours in a one-year period 
543.11 	according to section 148E.145, $400; and
543.12 	(5) for a provider who offers programs totaling 49 or more clock hours in a one-year 
543.13 	period according to section 148E.145, $600.
543.14 		Subd. 5.Late fees. Late fees are as follows the following nonrefundable amounts:
543.15 	(1) renewal late fee, one-fourth of the renewal fee specified in subdivision 3;
543.16 	(2) supervision plan late fee, $40; and
543.17 	(3) license late fee, $100 plus the prorated share of the license fee specified in subdivision 
543.18 	2 for the number of months during which the individual practiced social work without a 
543.19 	license.
543.20 		Subd. 6.License cards and wall certificates. (a) The fee for a license card as specified 
543.21 	in section 148E.095 is $10.
543.22 	(b) The fee for a license wall certificate as specified in section 148E.095 is $30.
543.23 		Subd. 7.Reactivation fees. Reactivation fees are as follows the following nonrefundable 
543.24 	amounts:
543.25 	(1) reactivation from a temporary leave or emeritus status, the prorated share of the 
543.26 	renewal fee specified in subdivision 3; and
543.27 	(2) reactivation of an expired license, 1-1/2 times the renewal fees specified in subdivision 
543.28 	3.

544.1 	Sec. 10.  REPEALER.
 544.2 	(a) Minnesota Statutes 2016, sections 147A.21; 147B.08, subdivisions 1, 2, and 3; and 
544.3 	147C.40, subdivisions 1, 2, 3, and 4, are repealed.
544.4 	(b) Minnesota Rules, part 5600.2500, is repealed.

544.5 	ARTICLE 12
544.6 	APPROPRIATIONS

544.7	Section 1. HEALTH AND HUMAN SERVICES APPROPRIATIONS.
 	
544.8 	The sums shown in the columns marked "Appropriations" are appropriated to the agencies 
544.9 	and for the purposes specified in this article. The appropriations are from the general fund, 
544.10 	or another named fund, and are available for the fiscal years indicated for each purpose. 
544.11 	The figures "2018" and "2019" used in this article mean that the appropriations listed under 
544.12 	them are available for the fiscal year ending June 30, 2018, or June 30, 2019, respectively. 
544.13 	"The first year" is fiscal year 2018. "The second year" is fiscal year 2019. "The biennium" 
544.14 	is fiscal years 2018 and 2019.

544.15				APPROPRIATIONS
	
544.16				Available for the Year
	
544.17				Ending June 30
	
544.18					2018
		2019

544.19
544.20	Sec. 2. COMMISSIONER OF HUMAN 
SERVICES

544.21	Subdivision 1.Total Appropriation
 	$
	7,591,115,000
	$
	7,941,222,000

544.22	Appropriations by Fund
	
544.23		2018
	2019
	
544.24	General
	6,663,399,000
	7,027,393,000
	
544.25
544.26	State Government 
Special Revenue
	8,194,000
	7,994,000
	
544.27	Health Care Access
	639,575,000
	643,442,000
	
544.28	Federal TANF
	278,051,000
	260,497,000
	
544.29	Lottery Prize
	1,896,000
	1,896,000
	
545.1 	The amounts that may be spent for each 
545.2 	purpose are specified in the following 
545.3 	subdivisions.

545.4	Subd. 2.TANF Maintenance of Effort
 					
545.5 	(a) The commissioner shall ensure that 
545.6 	sufficient qualified nonfederal expenditures 
545.7 	are made each year to meet the state's 
545.8 	maintenance of effort (MOE) requirements of 
545.9 	the TANF block grant specified under Code 
545.10 	of Federal Regulations, title 45, section 263.1. 
545.11 	In order to meet these basic TANF/MOE 
545.12 	requirements, the commissioner may report 
545.13 	as TANF/MOE expenditures only nonfederal 
545.14 	money expended for allowable activities listed 
545.15 	in the following clauses:
545.16 	(1) MFIP cash, diversionary work program, 
545.17 	and food assistance benefits under Minnesota 
545.18 	Statutes, chapter 256J;
545.19 	(2) the child care assistance programs under 
545.20 	Minnesota Statutes, sections 119B.03 and 
545.21 	119B.05, and county child care administrative 
545.22 	costs under Minnesota Statutes, section 
545.23 	119B.15;
545.24 	(3) state and county MFIP administrative costs 
545.25 	under Minnesota Statutes, chapters 256J and 
545.26 	256K;
545.27 	(4) state, county, and tribal MFIP employment 
545.28 	services under Minnesota Statutes, chapters 
545.29 	256J and 256K;
545.30 	(5) expenditures made on behalf of legal 
545.31 	noncitizen MFIP recipients who qualify for 
545.32 	the MinnesotaCare program under Minnesota 
545.33 	Statutes, chapter 256L;
546.1 	(6) qualifying working family credit 
546.2 	expenditures under Minnesota Statutes, section 
546.3 	290.0671;
546.4 	(7) qualifying Minnesota education credit 
546.5 	expenditures under Minnesota Statutes, section 
546.6 	290.0674; and
546.7 	(8) qualifying Head Start expenditures under 
546.8 	Minnesota Statutes, section 119A.50.
546.9 	(b) For the activities listed in paragraph (a), 
546.10 	clauses (2) to (8), the commissioner may 
546.11 	report only expenditures that are excluded 
546.12 	from the definition of assistance under Code 
546.13 	of Federal Regulations, title 45, section 
546.14 	260.31.
546.15 	(c) The commissioner shall ensure that the 
546.16 	MOE used by the commissioner of 
546.17 	management and budget for the February and 
546.18 	November forecasts required under Minnesota 
546.19 	Statutes, section 16A.103, contains 
546.20 	expenditures under paragraph (a), clause (1), 
546.21 	equal to at least 16 percent of the total required 
546.22 	under Code of Federal Regulations, title 45, 
546.23 	section 263.1.
546.24 	(d) The commissioner may not claim an 
546.25 	amount of TANF/MOE in excess of the 75 
546.26 	percent standard in Code of Federal 
546.27 	Regulations, title 45, section 263.1(a)(2), 
546.28 	except:
546.29 	(1) to the extent necessary to meet the 80 
546.30 	percent standard under Code of Federal 
546.31 	Regulations, title 45, section 263.1(a)(1), if it 
546.32 	is determined by the commissioner that the 
546.33 	state will not meet the TANF work 
546.34 	participation target rate for the current year;
547.1 	(2) to provide any additional amounts under 
547.2 	Code of Federal Regulations, title 45, section 
547.3 	264.5, that relate to replacement of TANF 
547.4 	funds due to the operation of TANF penalties; 
547.5 	and
547.6 	(3) to provide any additional amounts that may 
547.7 	contribute to avoiding or reducing TANF work 
547.8 	participation penalties through the operation 
547.9 	of the excess MOE provisions of Code of 
547.10 	Federal Regulations, title 45, section 261.43 
547.11 	(a)(2).
547.12 	(e) For the purposes of paragraph (d), the 
547.13 	commissioner may supplement the MOE claim 
547.14 	with working family credit expenditures or 
547.15 	other qualified expenditures to the extent such 
547.16 	expenditures are otherwise available after 
547.17 	considering the expenditures allowed in this 
547.18 	subdivision.
547.19 	(f) The requirement in Minnesota Statutes, 
547.20 	section 256.011, subdivision 3, that federal 
547.21 	grants or aids secured or obtained under that 
547.22 	subdivision be used to reduce any direct 
547.23 	appropriations provided by law, does not apply 
547.24 	if the grants or aids are federal TANF funds.
547.25 	(g) IT Appropriations Generally. This 
547.26 	appropriation includes funds for information 
547.27 	technology projects, services, and support. 
547.28 	Notwithstanding Minnesota Statutes, section 
547.29 	16E.0466, funding for information technology 
547.30 	project costs shall be incorporated into the 
547.31 	service level agreement and paid to the Office 
547.32 	of MN.IT Services by the Department of 
547.33 	Human Services under the rates and 
547.34 	mechanism specified in that agreement.
548.1 	(h) Receipts for Systems Project.
548.2 	Appropriations and federal receipts for 
548.3 	information systems projects for MAXIS, 
548.4 	PRISM, MMIS, ISDS, METS, and SSIS must 
548.5 	be deposited in the state systems account 
548.6 	authorized in Minnesota Statutes, section 
548.7 	256.014. Money appropriated for computer 
548.8 	projects approved by the commissioner of the 
548.9 	Office of MN.IT Services, funded by the 
548.10 	legislature, and approved by the commissioner 
548.11 	of management and budget may be transferred 
548.12 	from one project to another and from 
548.13 	development to operations as the 
548.14 	commissioner of human services considers 
548.15 	necessary. Any unexpended balance in the 
548.16 	appropriation for these projects does not 
548.17 	cancel and is available for ongoing 
548.18 	development and operations.

548.19	Subd. 3.Central Office; Operations

548.20	Appropriations by Fund
	
548.21	General
	133,248,000
	133,652,000
	
548.22
548.23	State Government 
Special Revenue
	8,069,000
	7,869,000
	
548.24	Health Care Access
	23,618,000
	21,516,000
	
548.25	Federal TANF
	100,000
	100,000
	
548.26 	(a) Administrative Recovery; Set-Aside. The 
548.27 	commissioner may invoice local entities 
548.28 	through the SWIFT accounting system as an 
548.29 	alternative means to recover the actual cost of 
548.30 	administering the following provisions:
548.31 	(1) Minnesota Statutes, section 125A.744, 
548.32 	subdivision 3;
548.33 	(2) Minnesota Statutes, section 245.495, 
548.34 	paragraph (b);
549.1 	(3) Minnesota Statutes, section 256B.0625, 
549.2 	subdivision 20, paragraph (k);
549.3 	(4) Minnesota Statutes, section 256B.0924, 
549.4 	subdivision 6, paragraph (g);
549.5 	(5) Minnesota Statutes, section 256B.0945, 
549.6 	subdivision 4, paragraph (d); and
549.7 	(6) Minnesota Statutes, section 256F.10, 
549.8 	subdivision 6, paragraph (b).
549.9 	(b) Base Level Adjustments. The general 
549.10 	fund base is $139,064,000 in fiscal year 2020 
549.11 	and $139,010,000 in fiscal year 2021.

549.12	Subd. 4.Central Office; Children and Families

549.13	Appropriations by Fund
	
549.14	General
	10,520,000
	10,331,000
	
549.15	Federal TANF
	2,582,000
	2,582,000
	
549.16 	(a) Financial Institution Data Match and 
549.17 	Payment of Fees. The commissioner is 
549.18 	authorized to allocate up to $310,000 each 
549.19 	year in fiscal year 2018 and fiscal year 2019 
549.20 	from the systems special revenue account to 
549.21 	make payments to financial institutions in 
549.22 	exchange for performing data matches 
549.23 	between account information held by financial 
549.24 	institutions and the public authority's database 
549.25 	of child support obligors as authorized by 
549.26 	Minnesota Statutes, section 13B.06, 
549.27 	subdivision 7.
549.28 	(b) Base Level Adjustment. The general fund 
549.29 	base is $11,129,000 in fiscal year 2020 and 
549.30 	$11,042,000 in fiscal year 2021.

549.31	Subd. 5.Central Office; Health Care

549.32	Appropriations by Fund
	
549.33	General
	21,709,000
	21,714,000
	
549.34	Health Care Access
	33,931,000
	23,984,000
	
550.1 	Rates Study. $350,000 in fiscal year 2018 is 
550.2 	for the medical assistance payment rate study 
550.3 	required under article 4, section 64. This is a 
550.4 	onetime appropriation.
550.5 	Trust Guide. $200,000 in fiscal year 2018 
550.6 	and $150,000 in fiscal year 2019 are for the 
550.7 	development of a special needs trust guide that 
550.8 	directs the state medical assistance program's 
550.9 	trust recovery process and establishes 
550.10 	guidelines for the public. This is a onetime 
550.11 	appropriation.
550.12 	Base Level Adjustments. The general fund 
550.13 	base is $21,470,000 in fiscal year 2020 and 
550.14 	$21,515,000 in fiscal year 2021. The health 
550.15 	care access fund base is  $24,000,000 in fiscal 
550.16 	year 2020 and $24,000,000 in fiscal year 2021.

550.17
550.18	Subd. 6.Central Office; Continuing Care for 
Older Adults

550.19	Appropriations by Fund
	
550.20	General
	17,652,000
	18,089,000
	
550.21
550.22	State Government 
Special Revenue
	125,000
	125,000
	
550.23 	Base Level Adjustment. The general fund 
550.24 	base is $21,352,000 in fiscal year 2020 and 
550.25 	$17,045,000 in fiscal year 2021.
550.26 	Assisted Living Report Card. Of these 
550.27 	amounts, $4,402,000 in fiscal year 2020 is to 
550.28 	collect data from residents of housing with 
550.29 	services establishments with an assisted living 
550.30 	designation on quality of life and quality of 
550.31 	care to produce a report card under Minnesota 
550.32 	Statutes, section 144G.02, subdivision 2. 
550.33 	$4,402,000 is the base in each even year 
550.34 	starting in fiscal year 2022.

550.35	Subd. 7.Central Office; Community Supports

551.1	Appropriations by Fund
	
551.2	General
	31,028,000
	28,675,000
	
551.3	Lottery Prize
	163,000
	163,000
	
551.4 	Transportation Study. $250,000 in fiscal 
551.5 	year 2018 and $250,000 in fiscal year 2019 
551.6 	are for the transportation study required under 
551.7 	article 1, section 36. This is a onetime 
551.8 	appropriation.
551.9 	Waiver Consolidation Study. $110,000 in 
551.10 	fiscal year 2018 and $140,000 in fiscal year 
551.11 	2019 are to conduct a study on consolidating 
551.12 	the four disability home and community-based 
551.13 	services waivers into one program. The 
551.14 	commissioner of human services shall submit 
551.15 	recommendations to the chairs and ranking 
551.16 	minority members of the legislative 
551.17 	committees with oversight over health and 
551.18 	human services by January 15, 2019. This is 
551.19 	a onetime appropriation.
551.20 	Children's Mental Health Study. $125,000 
551.21 	in fiscal year 2018 and $125,000 in fiscal year 
551.22 	2019 are for children's mental health study 
551.23 	under article 8, section 60. This is a onetime 
551.24 	appropriation.
551.25 	Substance Use Disorder System Study. 
551.26 	$150,000 in fiscal year 2018 and $150,000 in 
551.27 	fiscal year 2019 are for the substance use 
551.28 	disorder system study required under article 
551.29 	8, section 59. This is a onetime appropriation.
551.30 	Base Level Adjustment. The general fund 
551.31 	base is $28,381,000 in fiscal year 2020 and 
551.32 	$27,705,000 in fiscal year 2021. Of these 
551.33 	amounts, $500,000 in fiscal year 2020 is to 
551.34 	study and develop an individual budgeting 
552.1 	model for disability waiver recipients and 
552.2 	those accessing services through 
552.3 	consumer-directed community supports. The 
552.4 	commissioner shall submit recommendations 
552.5 	to the chairs and ranking minority members 
552.6 	of the legislative committees with jurisdiction 
552.7 	over these programs by January 15, 2021. This 
552.8 	is a onetime appropriation.

552.9	Subd. 8.Forecasted Programs; MFIP/DWP

552.10	Appropriations by Fund
	
552.11	General
	88,930,000
	106,340,000
	
552.12	Federal TANF
	92,732,000
	75,025,000

552.13
552.14	Subd. 9.Forecasted Programs; MFIP Child Care 
Assistance
 		115,067,000
		142,287,000

552.15
552.16	Subd. 10.Forecasted Programs; General 
Assistance
 		56,650,000
		58,365,000
	
552.17 	(a) General Assistance Standard. The 
552.18 	commissioner shall set the monthly standard 
552.19 	of assistance for general assistance units 
552.20 	consisting of an adult recipient who is 
552.21 	childless and unmarried or living apart from 
552.22 	parents or a legal guardian at $203. The 
552.23 	commissioner may reduce this amount 
552.24 	according to Laws 1997, chapter 85, article 3, 
552.25 	section 54.
552.26 	(b) Emergency General Assistance. The 
552.27 	amount appropriated for emergency general 
552.28 	assistance is limited to no more than 
552.29 	$6,729,812 in fiscal year 2018 and $6,729,812 
552.30 	in fiscal year 2019. Funds to counties shall be 
552.31 	allocated by the commissioner using the 
552.32 	allocation method under Minnesota Statutes, 
552.33 	section 256D.06.

552.34
552.35	Subd. 11.Forecasted Programs; Minnesota 
Supplemental Aid
 		40,484,000
		41,634,000

553.1
553.2	Subd. 12.Forecasted Programs; Group 
Residential Housing
 		167,426,000
		177,460,000

553.3
553.4	Subd. 13.Forecasted Programs; Northstar Care 
for Children
 		83,622,000
		111,432,000

553.5	Subd. 14.Forecasted Programs; MinnesotaCare
 		9,652,000
		10,798,000
	
553.6 	This appropriation is from the health care 
553.7 	access fund.

553.8
553.9	Subd. 15.Forecasted Programs; Medical 
Assistance

553.10	Appropriations by Fund
	
553.11	General
	4,988,270,000
	5,221,647,000
	
553.12	Health Care Access
	568,159,000
	582,929,000
	
553.13 	(a) Behavioral Health Services. $1,000,000 
553.14 	each fiscal year is for behavioral health 
553.15 	services provided by hospitals identified under 
553.16 	Minnesota Statutes, section 256.969, 
553.17 	subdivision 2b, paragraph (a), clause (4). The 
553.18 	increase in payments shall be made by 
553.19 	increasing the adjustment under Minnesota 
553.20 	Statutes, section 256.969, subdivision 2b, 
553.21 	paragraph (e), clause (2).
553.22 	(b) Base Level Adjustment. The health care 
553.23 	access fund base for medical assistance is  
553.24 	$798,429,000 in fiscal year 2020 and 
553.25 	$798,429,000 in fiscal year 2021.

553.26
553.27	Subd. 16.Forecasted Programs; Alternative 
Care
 		44,442,000
		45,123,000
	
553.28 	Alternative Care Transfer. Any money 
553.29 	allocated to the alternative care program that 
553.30 	is not spent for the purposes indicated does 
553.31 	not cancel but must be transferred to the 
553.32 	medical assistance account.

553.33
553.34	Subd. 17.Forecasted Programs; Chemical 
Dependency Treatment Fund
 		111,844,000
		131,445,000

553.35
553.36	Subd. 18.Grant Programs; Support Services 
Grants

554.1	Appropriations by Fund
	
554.2	General
	8,715,000
	8,715,000
	
554.3	Federal TANF
	96,311,000
	96,311,000

554.4
554.5	Subd. 19.Grant Programs; Basic Sliding Fee 
Child Care Assistance Grants
 		55,879,000
		68,609,000
	
554.6 	Base Level Adjustment. The general fund 
554.7 	base is $63,813,000 in fiscal year 2020 and 
554.8 	$63,943,000 in fiscal year 2021.

554.9554.10
	Subd. 20.Grant Programs; Child Care 
Development Grants
 		1,737,000
		1,737,000

554.11
554.12	Subd. 21.Grant Programs; Child Support 
Enforcement Grants
 		50,000
		50,000

554.13
554.14	Subd. 22.Grant Programs; Children's Services 
Grants

554.15	Appropriations by Fund
	
554.16	General
	39,965,000
	39,165,000
	
554.17	Federal TANF
	140,000
	140,000
	
554.18 	(a) Title IV-E Adoption Assistance.
554.19 	Additional federal reimbursement to the state 
554.20 	as a result of the Fostering Connections to 
554.21 	Success and Increasing Adoptions Act's 
554.22 	expanded eligibility for title IV-E adoption 
554.23 	assistance is appropriated to the commissioner 
554.24 	for postadoption services, including a 
554.25 	parent-to-parent support network.
554.26 	(b) Adoption Assistance Incentive Grants. 
554.27 	Federal funds available during fiscal years 
554.28 	2018 and 2019 for adoption incentive grants 
554.29 	are appropriated to the commissioner for 
554.30 	postadoption services, including a 
554.31 	parent-to-parent support network.
554.32 	(c) American Indian Child Welfare 
554.33 	Initiative. $800,000 in fiscal year 2018 is for 
554.34 	planning efforts to expand the American 
554.35 	Indian Child Welfare Initiative under 
555.1 	Minnesota Statutes, section 256.01, 
555.2 	subdivision 14b. Of this amount, $400,000 is 
555.3 	for a grant to the Mille Lacs Band of Ojibwe 
555.4 	and $400,000 is for a grant to the Red Lake 
555.5 	Nation. This is a onetime appropriation.

555.6
555.7	Subd. 23.Grant Programs; Children and 
Community Service Grants
 		58,201,000
		58,201,000

555.8
555.9	Subd. 24.Grant Programs; Children and 
Economic Support Grants
 		32,430,000
		32,640,000
	
555.10 	(a) Minnesota Food Assistance Program. 
555.11 	Unexpended funds for the Minnesota food 
555.12 	assistance program for fiscal year 2018 do not 
555.13 	cancel but are available for this purpose in 
555.14 	fiscal year 2019.
555.15 	(b) Community Living Infrastructure. 
555.16 	$1,400,000 in fiscal year 2018 and $1,400,000 
555.17 	in fiscal year 2019 are for community living 
555.18 	infrastructure grant allocations under article 
555.19 	2, section 17.
555.20 	(c) Housing Web Site Grant. $150,000 in 
555.21 	fiscal year 2018 and $150,000 in fiscal year 
555.22 	2019 are for a grant to a public or private 
555.23 	entity to create and maintain a Web site and 
555.24 	application to track real-time housing openings 
555.25 	for people with disabilities.
555.26 	(d) Housing Benefit Web Site. $130,000 in 
555.27 	fiscal year 2018 and $130,000 in fiscal year 
555.28 	2019 are to operate the housing benefit 101 
555.29 	Web site to help people who need affordable 
555.30 	housing, and supports to maintain that 
555.31 	housing, understand the range of housing 
555.32 	options and support services available.
555.33 	(e) Child Care Inspections. $2,400,000 in 
555.34 	fiscal year 2018 and $2,400,000 in fiscal year 
555.35 	2019 are for grants to counties to conduct 
556.1 	annual inspections of family child care 
556.2 	providers licensed under Minnesota Statutes, 
556.3 	chapter 245A, and Minnesota Rules, chapter 
556.4 	9502.
556.5 	(f) Base Level Adjustment. The general fund 
556.6 	base is $32,740,000 in fiscal year 2020 and 
556.7 	$33,840,000 in fiscal year 2021.

556.8	Subd. 25.Grant Programs; Health Care Grants

556.9	Appropriations by Fund
	
556.10	General
	4,244,000
	3,961,000
	
556.11	Health Care Access
	3,465,000
	3,465,000
	
556.12 	Health Information Exchanges. $125,000 
556.13 	in fiscal year 2018 and $250,000 in fiscal year 
556.14 	2019 are for the nonfederal share of health 
556.15 	information exchange grants to eligible health 
556.16 	care providers.
556.17 	Navigator Payments. The health care access 
556.18 	fund base for navigator grants is decreased by 
556.19 	$1,000,000 in fiscal year 2018 and $1,000,000 
556.20 	in fiscal year 2019. The health care access 
556.21 	fund base for navigator grants is increased by 
556.22 	$1,000,000 in fiscal year 2018 and $1,000,000 
556.23 	in fiscal year 2019 for increased navigator 
556.24 	payments as required under article 4, section 
556.25 	5.

556.26
556.27	Subd. 26.Grant Programs; Other Long-Term 
Care Grants
 		1,500,000
		1,925,000

556.28
556.29	Subd. 27.Grant Programs; Aging and Adult 
Services Grants
 		31,339,000
		32,594,000
	
556.30 	Individual Provider Registry. $375,000 in 
556.31 	fiscal year 2018 and $375,000 in fiscal year 
556.32 	2019 are for the registry of individual 
556.33 	providers of direct support services as defined 
556.34 	in Minnesota Statutes, section 256B.0711, 
556.35 	subdivision 1.
557.1 	Base Level Adjustment. The general fund 
557.2 	base is $33,403,000 in fiscal year 2020 and 
557.3 	$33,152,000 in fiscal year 2021. Of these 
557.4 	amounts, $334,000 in fiscal year 2020 and 
557.5 	$477,000 in fiscal year 2021 are appropriated 
557.6 	to the Minnesota Board on Aging for 
557.7 	self-directed caregiver grants under article 3, 
557.8 	section 7.

557.9557.10
	Subd. 28.Grant Programs; Deaf and 
Hard-of-Hearing Grants
 		2,675,000
		2,675,000
	
557.11 	Expanded Services Grants. $800,000 in 
557.12 	fiscal year 2018 and $800,000 in fiscal year 
557.13 	2019 are for deaf and hard-of-hearing grants. 
557.14 	The funds must be used to:
557.15 	(1) provide linguistically and culturally 
557.16 	appropriate mental health services for children 
557.17 	who are deaf, children who are deafblind, and 
557.18 	children who are hard-of-hearing in 
557.19 	northwestern and northeastern Minnesota;
557.20 	(2) provide psychiatric services statewide for 
557.21 	people who are deaf, people who are 
557.22 	deafblind, and people who are hard-of-hearing; 
557.23 	and
557.24 	(3) provide services and assistive technology 
557.25 	for people who are deafblind throughout 
557.26 	Minnesota.

557.27	Subd. 29.Grant Programs; Disabilities Grants
 		21,372,000
		24,122,000
	
557.28 	Training of Direct Support Services 
557.29 	Providers. $400,000 in fiscal year 2018 and 
557.30 	$400,000 in fiscal year 2019 are for training 
557.31 	and orientation of individual providers of 
557.32 	direct support services as defined in Minnesota 
557.33 	Statutes, section 256B.0711, subdivision 1. 
557.34 	This is a onetime appropriation. This 
558.1 	appropriation is not available until the labor 
558.2 	agreement between the state of Minnesota and 
558.3 	the Service Employees International Union 
558.4 	Healthcare Minnesota under Minnesota 
558.5 	Statutes, section 179A.54, is implemented 
558.6 	under Minnesota Statutes, sections 3.855 and 
558.7 	179A.22. The funding is available in either 
558.8 	year of the biennium and is available until 
558.9 	June 30, 2021.
558.10 	Stipends for Direct Support Services 
558.11 	Providers. $2,750,000 in fiscal year 2019 is 
558.12 	for training of individual providers of direct 
558.13 	support services as defined in Minnesota 
558.14 	Statutes, section 256B.0711, subdivision 1. 
558.15 	Of this amount, $2,500,000 shall only be used 
558.16 	for stipends of $500 for up to 5,000 individual 
558.17 	providers who have completed designated, 
558.18 	voluntary trainings. Up to $250,000 may be 
558.19 	used by the grantee for grant administration. 
558.20 	This appropriation is not available until the 
558.21 	labor agreement between the state of 
558.22 	Minnesota and the Service Employees 
558.23 	International Union Healthcare Minnesota 
558.24 	under Minnesota Statutes, section 179A.54, 
558.25 	is implemented under Minnesota Statutes, 
558.26 	sections 3.855 and 179A.22. If made available, 
558.27 	this appropriation is onetime and is available 
558.28 	until June 30, 2021.
558.29 	Base Level Adjustment. The general fund 
558.30 	base is $20,972,000 in fiscal year 2020 and 
558.31 	$20,972,000 in fiscal year 2021.

558.32
558.33	Subd. 30.Grant Programs; Adult Mental Health 
Grants

558.34	Appropriations by Fund
	
558.35	General
	82,622,000
	82,622,000
	
559.1	Health Care Access
	750,000
	750,000
	
559.2 	Community Mental Health Grants. 
559.3 	$2,820,000 in fiscal year 2018 and $2,820,000 
559.4 	in fiscal year 2019 are for grants to counties 
559.5 	to build and expand community-based mental 
559.6 	health infrastructure under Minnesota Statutes, 
559.7 	section 245.4661, subdivision 9.

559.8
559.9	Subd. 31.Grant Programs; Child Mental Health 
Grants
 		20,761,000
		20,826,000

559.10
559.11	Subd. 32.Grant Programs; Chemical 
Dependency Treatment Support Grants

559.12	Appropriations by Fund
	
559.13	General
	2,136,000
	2,136,000
	
559.14	Lottery Prize
	1,733,000
	1,733,000
	
559.15 	Problem Gambling. $225,000 in fiscal year 
559.16 	2018 and $225,000 in fiscal year 2019 are 
559.17 	from the lottery prize fund for a grant to the 
559.18 	state affiliate recognized by the National 
559.19 	Council on Problem Gambling. The affiliate 
559.20 	must provide services to increase public 
559.21 	awareness of problem gambling, education, 
559.22 	and training for individuals and organizations 
559.23 	providing effective treatment services to 
559.24 	problem gamblers and their families, and 
559.25 	research related to problem gambling.

559.26	Subd. 33.Direct Care and Treatment - Generally
 					
559.27 	(a) Transfer Authority. Money appropriated 
559.28 	to budget activities under subdivisions 34, 35, 
559.29 	36, 37, and 38 may be transferred between 
559.30 	budget activities and between years of the 
559.31 	biennium with the approval of the 
559.32 	commissioner of management and budget.
559.33 	(b) Dedicated Receipts Available. Of the 
559.34 	revenue received under Minnesota Statutes, 
559.35 	section 246.18, subdivision 8, paragraph (a), 
560.1 	up to $1,000,000 each year is available for the 
560.2 	purposes of Minnesota Statutes, section 
560.3 	246.18, subdivision 8, paragraph (b), clause 
560.4 	(1); and up to $2,713,000 each year is 
560.5 	available for the purposes of Minnesota 
560.6 	Statutes, section 246.18, subdivision 8, 
560.7 	paragraph (b), clause (2).

560.8
560.9	Subd. 34.Direct Care and Treatment - Mental 
Health and Substance Abuse
 		119,711,000
		123,004,000
	
560.10 	DCT Operating Adjustment (CARE). 
560.11 	$431,000 in fiscal year 2018 and $835,000 in 
560.12 	fiscal year 2019 are from the general fund for 
560.13 	Community Addiction Recover Enterprise 
560.14 	(CARE) operating adjustments. The 
560.15 	commissioner must transfer $431,000 in fiscal 
560.16 	year 2018 and $835,000 in fiscal year 2019 to 
560.17 	the enterprise fund for CARE.
560.18 	Base Level Adjustment. The general fund 
560.19 	base is $128,143,000 in fiscal year 2020 and 
560.20 	$128,143,000 in fiscal year 2021.

560.21
560.22	Subd. 35.Direct Care and Treatment - 
Community-Based Services
 		25,806,000
		23,099,000
	
560.23 	DCT Operating Adjustment (MSOCS). 
560.24 	$2,284,000 in fiscal year 2018 and $4,448,000 
560.25 	in fiscal year 2019 are from the general fund 
560.26 	for Minnesota State Operated Community 
560.27 	Services (MSOCS) operating adjustments. 
560.28 	The commissioner must transfer $2,284,000 
560.29 	in fiscal year 2018 and $4,448,000 in fiscal 
560.30 	year 2019 to the enterprise fund for MSOCS.
560.31 	MSOCS Sustainability. $7,697,000 in fiscal 
560.32 	year 2018 and $2,588,000 in fiscal year 2019 
560.33 	are from the general fund for the Minnesota 
560.34 	State Operated Community Services program. 
560.35 	Of this amount, the commissioner must 
561.1 	transfer $6,697,000 in fiscal year 2018 and 
561.2 	$1,588,000 in fiscal year 2019 to the enterprise 
561.3 	fund for Minnesota State Operated Community 
561.4 	Services. $1,000,000 is available each year of 
561.5 	the biennium for start-up expenses for new 
561.6 	residential homes to be operated by Minnesota 
561.7 	State Operated Community Services.
561.8 	Base Level Adjustment. The general fund 
561.9 	base is $23,099,000 in fiscal year 2020 and 
561.10 	$21,511,000 in fiscal year 2021.

561.11
561.12	Subd. 36.Direct Care and Treatment - Forensic 
Services
 		103,080,000
		109,567,000
	
561.13 	Base Level Adjustment. The general fund 
561.14 	base is $112,437,000 in fiscal year 2020 and 
561.15 	$115,046,000 in fiscal year 2021.

561.16
561.17	Subd. 37.Direct Care and Treatment - Sex 
Offender Program
 		91,283,000
		93,137,000
	
561.18 	Transfer Authority. Money appropriated for 
561.19 	the Minnesota sex offender program may be 
561.20 	transferred between fiscal years of the 
561.21 	biennium with the approval of the 
561.22 	commissioner of management and budget.
561.23 	Minnesota State Industries Enterprise 
561.24 	Fund. Funds remaining in the Minnesota state 
561.25 	industries enterprise fund on September 30, 
561.26 	2017, shall be transferred to the Minnesota 
561.27 	sex offender program vocational work 
561.28 	program established under Minnesota Statutes, 
561.29 	section 246B.05.

561.30
561.31	Subd. 38.Direct Care and Treatment - 
Operations
 		49,001,000
		50,415,000
	
561.32 	Base Level Adjustment. The general fund 
561.33 	base is $51,202,000 in fiscal year 2020 and 
561.34 	$51,463,000 in fiscal year 2021.

561.35	Subd. 39.Technical Activities
 		86,186,000
		86,339,000
	
562.1 	(a) This appropriation is from the federal 
562.2 	TANF fund.
562.3 	(b) Base Level Adjustment. The TANF fund 
562.4 	appropriation is $86,346,000 in fiscal year 
562.5 	2020 and $86,355,000 in fiscal year 2021.

562.6	Sec. 3. COMMISSIONER OF HEALTH

562.7	Subdivision 1.Total Appropriation
 	$
	216,850,000
	$
	220,396,000

562.8	Appropriations by Fund
	
562.9		2018
	2019
	
562.10	General
	112,229,000
	114,430,000
	
562.11
562.12	State Government 
Special Revenue
	56,265,000
	57,995,000
	
562.13	Health Care Access
	36,643,000
	36,258,000
	
562.14	Federal TANF
	11,713,000
	11,713,000
	
562.15 	The amounts that may be spent for each 
562.16 	purpose are specified in the following 
562.17 	subdivisions.

562.18	Subd. 2.Health Improvement

562.19	Appropriations by Fund
	
562.20	General
	87,066,000
	88,388,000
	
562.21
562.22	State Government 
Special Revenue
	6,319,000
	6,286,000
	
562.23	Health Care Access
	36,643,000
	36,258,000
	
562.24	Federal TANF
	11,713,000
	11,713,000
	
562.25 	(a) Home Visiting for Pregnant and 
562.26 	Parenting Teens. $12,478,000 in fiscal year 
562.27 	2018 and $18,522,000 in fiscal year 2019 are 
562.28 	from the general fund for home visiting 
562.29 	services to pregnant and parenting teens.
562.30 	(b) Opioid Overdose Prevention. $4,000,000 
562.31 	in fiscal year 2018 is from the general fund 
562.32 	for a root-cause approach to reduce opioid 
562.33 	misuse in American Indian communities. This 
562.34 	is a onetime appropriation.
563.1 	(c) Community-Driven Data. $1,000,000 in 
563.2 	fiscal year 2018 is from the general fund to 
563.3 	align public health data with community 
563.4 	needs. This is a onetime appropriation.
563.5 	(d) Medical Cannabis. $150,000 in fiscal year 
563.6 	2018 and $150,000 in fiscal year 2019 are 
563.7 	added to the general fund appropriation for 
563.8 	the medical cannabis program.
563.9 	(e) TANF Appropriations. (1) $1,156,000 
563.10 	of the TANF fund is appropriated each year 
563.11 	of the biennium to the commissioner for 
563.12 	family planning grants under Minnesota 
563.13 	Statutes, section 145.925.
563.14 	(2) $3,579,000 of the TANF fund is 
563.15 	appropriated each year of the biennium to the 
563.16 	commissioner for home visiting and nutritional 
563.17 	services listed under Minnesota Statutes, 
563.18 	section 145.882, subdivision 7, clauses (6) and 
563.19 	(7). Funds must be distributed to community 
563.20 	health boards according to Minnesota Statutes, 
563.21 	section 145A.131, subdivision 1.
563.22 	(3) $2,000,000 of the TANF fund is 
563.23 	appropriated each year of the biennium to the 
563.24 	commissioner for decreasing racial and ethnic 
563.25 	disparities in infant mortality rates under 
563.26 	Minnesota Statutes, section 145.928, 
563.27 	subdivision 7.
563.28 	(4) $4,978,000 of the TANF fund is 
563.29 	appropriated each year of the biennium to the 
563.30 	commissioner for the family home visiting 
563.31 	grant program according to Minnesota 
563.32 	Statutes, section 145A.17. $4,000,000 of the 
563.33 	funding must be distributed to community 
563.34 	health boards according to Minnesota Statutes, 
564.1 	section 145A.131, subdivision 1. $978,000 of 
564.2 	the funding must be distributed to tribal 
564.3 	governments as provided in Minnesota 
564.4 	Statutes, section 145A.14, subdivision 2a.
564.5 	(5) The commissioner may use up to 6.23 
564.6 	percent of the funds appropriated each fiscal 
564.7 	year to conduct the ongoing evaluations 
564.8 	required under Minnesota Statutes, section 
564.9 	145A.17, subdivision 7, and training and 
564.10 	technical assistance as required under 
564.11 	Minnesota Statutes, section 145A.17, 
564.12 	subdivisions 4 and 5.
564.13 	(f) TANF Carryforward. Any unexpended 
564.14 	balance of the TANF appropriation in the first 
564.15 	year of the biennium does not cancel but is 
564.16 	available for the second year.
564.17 	(g) Base Level Adjustments. The general 
564.18 	fund base is $95,316,000 in fiscal year 2020 
564.19 	and $95,366,000 in fiscal year 2021. The 
564.20 	health care access fund base is $36,858,000 
564.21 	in fiscal year 2020 and $36,258,000 in fiscal 
564.22 	year 2021.

564.23	Subd. 3.Health Protection

564.24	Appropriations by Fund
	
564.25	General
	15,700,000
	16,207,000
	
564.26
564.27	State Government 
Special Revenue
	49,946,000
	51,709,000
	
564.28 	(a) Water Infrastructure Review. $230,000 
564.29 	in fiscal year 2018 and $230,000 in fiscal year 
564.30 	2019 are from the general fund for reviewing 
564.31 	and inspecting drinking water improvement 
564.32 	projects.
564.33 	(b) Vulnerable Adults in Health Care 
564.34 	Settings. $633,000 in fiscal year 2018 and 
565.1 	$559,000 in fiscal year 2019 are added to the 
565.2 	appropriation from the general fund for 
565.3 	regulating health care and home care settings.
565.4 	(c) Base Level Adjustment. The general fund 
565.5 	base is $16,596,000 in fiscal year 2020 and 
565.6 	$16,506,000 in fiscal year 2021. The state 
565.7 	government special revenue fund base is 
565.8 	$52,083,000 in fiscal year 2020 and 
565.9 	$52,119,000 in fiscal year 2021.

565.10	Subd. 4.Health Operations

565.11	Appropriations by Fund
	
565.12	General
	9,463,000
	9,835,000

565.13	Sec. 4. HEALTH-RELATED BOARDS

565.14	Subdivision 1.Total Appropriation
 	$
	25,126,000
	$
	23,319,000
	
565.15 	This appropriation is from the state 
565.16 	government special revenue fund. The 
565.17 	amounts that may be spent for each purpose 
565.18 	are specified in the following subdivisions.

565.19	Subd. 2.Board of Chiropractic Examiners
 		565,000
		571,000
	
565.20 	Base Level Adjustment. The base is $576,000 
565.21 	in fiscal year 2020 and $576,000 in fiscal year 
565.22 	2021.

565.23	Subd. 3.Board of Dentistry
 		1,396,000
		1,408,000

565.24
565.25	Subd. 4.Board of Dietetics and Nutrition 
Practice
 		130,000
		132,000

565.26	Subd. 5.Board of Marriage and Family Therapy
 		360,000
		357,000
	
565.27 	Base Level Adjustment. The base is $360,000 
565.28 	in fiscal year 2020 and $361,000 in fiscal year 
565.29 	2021.

565.30	Subd. 6.Board of Medical Practice
 		5,207,000
		5,243,000
	
565.31 	This appropriation includes $955,000 in fiscal 
565.32 	year 2018 and $964,000 in fiscal year 2019 
565.33 	for the health professional services program. 
566.1 	The base for this program is $924,000 in fiscal 
566.2 	year 2020 and $924,000 in fiscal year 2021.
566.3 	Base Level Adjustment. The base is 
566.4 	$5,205,000 in fiscal year 2020 and $5,205,000 
566.5 	in fiscal year 2021.

566.6	Subd. 7.Board of Nursing
 		6,380,000
		4,783,000

566.7	Subd. 8.Board of Nursing Home Administrators
 		3,397,000
		3,202,000
	
566.8 	(a) Administrative Services Unit - Operating 
566.9 	Costs. Of this appropriation, $2,260,000 in 
566.10 	fiscal year 2018 and $2,287,000 in fiscal year 
566.11 	2019 are for operating costs of the 
566.12 	administrative services unit. The 
566.13 	administrative services unit may receive and 
566.14 	expend reimbursements for services it 
566.15 	performs for other agencies.
566.16 	(b) Administrative Services Unit - Volunteer 
566.17 	Health Care Provider Program. Of this 
566.18 	appropriation, $150,000 in fiscal year 2018 
566.19 	and $150,000 in fiscal year 2019 are to pay 
566.20 	for medical professional liability coverage 
566.21 	required under Minnesota Statutes, section 
566.22 	214.40.
566.23 	(c) Administrative Services Unit - 
566.24 	Retirement Costs. Of this appropriation, 
566.25 	$378,000 in fiscal year 2019 is a onetime 
566.26 	appropriation to the administrative services 
566.27 	unit to pay for the retirement costs of 
566.28 	health-related board employees. This funding 
566.29 	may be transferred to the health board 
566.30 	incurring retirement costs. Any board that has 
566.31 	an unexpended balance for an amount 
566.32 	transferred under this paragraph shall transfer 
566.33 	the unexpended amount to the administrative 
567.1 	services unit. These funds are available either 
567.2 	year of the biennium.
567.3 	(d) Administrative Services Unit - 
567.4 	Health-Related Licensing Boards Operating 
567.5 	Costs. Of this appropriation, $194,000 in 
567.6 	fiscal year 2018 and $350,000 in fiscal year 
567.7 	2019 shall be transferred to the health-related 
567.8 	boards funded under this section for operating 
567.9 	costs. The administrative services unit shall 
567.10 	determine transfer amounts in consultation 
567.11 	with the health-related boards funded under 
567.12 	this section.
567.13 	(e) Administrative Services Unit - Contested 
567.14 	Cases and Other Legal Proceedings. Of this 
567.15 	appropriation, $200,000 in fiscal year 2018 
567.16 	and $200,000 in fiscal year 2019 are for costs 
567.17 	of contested case hearings and other 
567.18 	unanticipated costs of legal proceedings 
567.19 	involving health-related boards funded under 
567.20 	this section. Upon certification by a 
567.21 	health-related board to the administrative 
567.22 	services unit that costs will be incurred and 
567.23 	that there is insufficient money available to 
567.24 	pay for the costs out of money currently 
567.25 	available to that board, the administrative 
567.26 	services unit is authorized to transfer money 
567.27 	from this appropriation to the board for 
567.28 	payment of those costs with the approval of 
567.29 	the commissioner of management and budget. 
567.30 	The commissioner of management and budget 
567.31 	must require any board that has an unexpended 
567.32 	balance for an amount transferred under this 
567.33 	paragraph to transfer the unexpended amount 
567.34 	to the administrative services unit to be 
568.1 	deposited in the state government special 
568.2 	revenue fund.

568.3	Subd. 9.Board of Optometry
 		173,000
		174,000

568.4	Subd. 10.Board of Pharmacy
 		3,254,000
		3,294,000
	
568.5 	Base Level Adjustment. The base is 
568.6 	$3,319,000 in fiscal year 2020 and $3,356,000 
568.7 	in fiscal year 2021.

568.8	Subd. 11.Board of Physical Therapy
 		507,000
		508,000
	
568.9 	Base Level Adjustment. The base is $510,000 
568.10 	in fiscal year 2020 and $512,000 in fiscal year 
568.11 	2021.

568.12	Subd. 12.Board of Podiatric Medicine
 		198,000
		198,000

568.13	Subd. 13.Board of Psychology
 		1,220,000
		1,240,000
	
568.14 	Base Level Adjustment. The base is 
568.15 	$1,247,000 in fiscal year 2020 and $1,247,000 
568.16 	in fiscal year 2021.

568.17	Subd. 14.Board of Social Work
 		1,254,000
		1,246,000
	
568.18 	Base Level Adjustment. The base is 
568.19 	$1,248,000 in fiscal year 2020 and $1,250,000 
568.20 	in fiscal year 2021.

568.21	Subd. 15.Board of Veterinary Medicine
 		314,000
		320,000
	
568.22 	Base Level Adjustment. The base is $327,000 
568.23 	in fiscal year 2020 and $333,000 in fiscal year 
568.24 	2021.

568.25
568.26	Subd. 16.Board of Behavioral Health and 
Therapy
 		771,000
		643,000

568.27
568.28	Sec. 5. EMERGENCY MEDICAL SERVICES 
REGULATORY BOARD
 	$
	4,159,000
	$
	4,088,000
	
568.29 	(a) Cooper/Sams Volunteer Ambulance 
568.30 	Program. $950,000 in fiscal year 2018 and 
568.31 	$950,000 in fiscal year 2019 are for the 
568.32 	Cooper/Sams volunteer ambulance program 
568.33 	under Minnesota Statutes, section 144E.40.
569.1 	(1) Of this amount, $861,000 in fiscal year 
569.2 	2018 and $861,000 in fiscal year 2019 are for 
569.3 	the ambulance service personnel longevity 
569.4 	award and incentive program under Minnesota 
569.5 	Statutes, section 144E.40.
569.6 	(2) Of this amount, $89,000 in fiscal year 2018 
569.7 	and $89,000 in fiscal year 2019 are for the 
569.8 	operations of the ambulance service personnel 
569.9 	longevity award and incentive program under 
569.10 	Minnesota Statutes, section 144E.40.
569.11 	(b) EMSRB Board Operations. $1,954,000 
569.12 	in fiscal year 2018 and $1,883,000 in fiscal 
569.13 	year 2019 are for board operations. The base 
569.14 	for this program is $1,885,000 in fiscal year 
569.15 	2020 and $1,885,000 in fiscal year 2021.
569.16 	(c) Base Level Adjustment. The base is 
569.17 	$4,090,000 in fiscal year 2020 and $4,090,000 
569.18 	in fiscal year 2021.
569.19 	(d) Regional Grants. $785,000 in fiscal year 
569.20 	2018 and $785,000 in fiscal year 2019 are for 
569.21 	regional emergency medical services 
569.22 	programs, to be distributed equally to the eight 
569.23 	emergency medical service regions under 
569.24 	Minnesota Statutes, section 144E.52.
569.25 	(e) Ambulance Training Grant. $470,000 
569.26 	in fiscal year 2018 and $470,000 in fiscal year 
569.27 	2019 are for training grants under Minnesota 
569.28 	Statutes, section 144E.35.

569.29	Sec. 6. COUNCIL ON DISABILITY
 	$
	1,002,000
	$
	1,002,000
	
569.30 	Base Level Adjustment. The base is $966,000 
569.31 	in fiscal year 2020 and $968,000 in fiscal year 
569.32 	2021.

570.1
570.2
570.3	Sec. 7. OMBUDSMAN FOR MENTAL 
HEALTH AND DEVELOPMENTAL 
DISABILITIES
 	$
	2,307,000
	$
	2,327,000

570.4	Sec. 8. OMBUDSPERSONS FOR FAMILIES
 	$
	543,000
	$
	551,000

570.5 	Sec. 9. TRANSFERS.
 570.6 		Subdivision 1.Grants. The commissioner of human services, with the approval of the 
570.7 	commissioner of management and budget, may transfer unencumbered appropriation balances 
570.8 	for the biennium ending June 30, 2019, within fiscal years among the MFIP, general 
570.9 	assistance, medical assistance, MinnesotaCare, MFIP child care assistance under Minnesota 
570.10 	Statutes, section 119B.05, Minnesota supplemental aid, and group residential housing 
570.11 	programs, the entitlement portion of Northstar Care for Children under Minnesota Statutes, 
570.12 	chapter 256N, and the entitlement portion of the chemical dependency consolidated treatment 
570.13 	fund, and between fiscal years of the biennium. The commissioner shall inform the chairs 
570.14 	and ranking minority members of the senate Health and Human Services Finance Division 
570.15 	and the house of representatives Health and Human Services Finance Committee quarterly 
570.16 	about transfers made under this subdivision.
570.17 		Subd. 2.Administration. Positions, salary money, and nonsalary administrative money 
570.18 	may be transferred within the Departments of Health and Human Services as the 
570.19 	commissioners consider necessary, with the advance approval of the commissioner of 
570.20 	management and budget. The commissioner shall inform the chairs and ranking minority 
570.21 	members of the senate Health and Human Services Finance Division and the house of 
570.22 	representatives Health and Human Services Finance Committee quarterly about transfers 
570.23 	made under this subdivision.

570.24 	Sec. 10. INDIRECT COSTS NOT TO FUND PROGRAMS.
 570.25 	The commissioners of health and human services shall not use indirect cost allocations 
570.26 	to pay for the operational costs of any program for which they are responsible.

570.27 	Sec. 11. EXPIRATION OF UNCODIFIED LANGUAGE.
 570.28 	All uncodified language contained in this article expires on June 30, 2019, unless a 
570.29 	different expiration date is explicit.

570.30 	Sec. 12. EFFECTIVE DATE.
 570.31 	This article is effective July 1, 2017, unless a different effective date is specified.

APPENDIX 

Repealed Minnesota Statutes: 17-2331 

103I.005 DEFINITIONS.Subd. 8.Environmental bore hole. 
"Environmental bore hole" means a hole or excavation in the ground that penetrates a confining layer or is greater than 25 feet in depth and enters or goes through a water bearing layer and is used to monitor or measure physical, chemical, radiological, or biological parameters without extracting water. An environmental bore hole also includes bore holes constructed for vapor recovery or venting systems. An environmental bore hole does not include a well, elevator shaft, exploratory boring, or monitoring well. 

Subd. 14.Monitoring well. 
"Monitoring well" means an excavation that is drilled, cored, bored, washed, driven, dug, jetted, or otherwise constructed to extract groundwater for physical, chemical, or biological testing. "Monitoring well" includes a groundwater quality sampling well. 

Subd. 15.Monitoring well contractor. 
"Monitoring well contractor" means a person who is registered by the commissioner to construct monitoring wells. 

103I.451 ENVIRONMENTAL BORE HOLES.
An environmental bore hole must be constructed, sealed, and reported as prescribed by rule of the commissioner by a well contractor or a monitoring well contractor. 

119B.07 USE OF MONEY.
(a) Money for persons listed in sections 119B.03, subdivision 3, and 119B.05, subdivision 1, shall be used to reduce the costs of child care for students, including the costs of child care for students while employed if enrolled in an eligible education program at the same time and making satisfactory progress towards completion of the program. Counties may not limit the duration of child care subsidies for a person in an employment or educational program, except when the person is found to be ineligible under the child care fund eligibility standards. Any limitation must be based on a person's employment plan in the case of an MFIP participant, and county policies included in the child care fund plan. The maximum length of time a student is eligible for child care assistance under the child care fund for education and training is no more than the time necessary to complete the credit requirements for an associate or baccalaureate degree as determined by the educational institution, excluding basic or remedial education programs needed to prepare for postsecondary education or employment. 

(b) To be eligible, the student must be in good standing and be making satisfactory progress toward the degree. Time limitations for child care assistance do not apply to basic or remedial educational programs needed to prepare for postsecondary education or employment. These programs include: high school, general equivalency diploma, and English as a second language. Programs exempt from this time limit must not run concurrently with a postsecondary program. If an MFIP participant who is receiving MFIP child care assistance under this chapter moves to another county, continues to participate in educational or training programs authorized in their employment plans, and continues to be eligible for MFIP child care assistance under this chapter, the MFIP participant must receive continued child care assistance from the county responsible for their current employment plan, under section 256G.07. 

119B.125 PROVIDER REQUIREMENTS.Subd. 5.Provisional payment. 
After a county receives a completed application from a provider, the county may issue provisional authorization and payment to the provider during the time needed to determine whether to give final authorization to the provider. 

119B.16 FAIR HEARING PROCESS.Subd. 2.Informal conference. 
The county agency shall offer an informal conference to applicants and recipients adversely affected by an agency action to attempt to resolve the dispute. The county agency shall offer an informal conference to providers to whom the county agency has assigned responsibility for an overpayment in an attempt to resolve the dispute. The county agency or the provider may ask the family in whose case the overpayment arose to participate in the informal conference, but the family may refuse to do so. The county agency shall advise adversely affected applicants, recipients, and providers that a request for a conference with the agency is optional and does not delay or replace the right to a fair hearing. 

144.0571 INCLUSION OF OTHER HEALTH-RELATED OCCUPATIONS TO CRIMINAL BACKGROUND CHECKS.
(a) If the Department of Health is not reviewed by the Sunset Advisory Commission according to the schedule in section 3D.21, the commissioner of health, as the regulator for occupational therapy practitioners, speech-language pathologists, audiologists, and hearing instrument dispensers, shall require applicants for licensure or renewal to submit to a criminal history records check as required under section 214.075 for other health-related licensed occupations regulated by the health-related licensing boards. 

(b) Any statutory changes necessary to include the commissioner of health to section 214.075 shall be included in the plan required in section 214.075, subdivision 8. 

147A.21 RULEMAKING AUTHORITY.
The board shall adopt rules: 

(1) setting license fees; 

(2) setting renewal fees; 

(3) setting fees for temporary licenses; and 

(4) establishing renewal dates. 

147B.08 FEES.Subdivision 1.Annual registration fee. 
The board shall establish the fee of $150 for initial licensure and $150 annual licensure renewal. The board may prorate the initial licensure fee. 

Subd. 2.Penalty fee for late renewals. 
The penalty fee for late submission for renewal application is $50. 

Subd. 3.Deposit. 
Fees collected by the board under this section must be deposited in the state government special revenue fund. 

147C.40 FEES.Subdivision 1.Fees. 
The board shall adopt rules setting: 

(1) licensure fees; 

(2) renewal fees; 

(3) late fees; 

(4) inactive status fees; and 

(5) fees for temporary permits. 

Subd. 2.Proration of fees. 
The board may prorate the initial annual license fee. All licensees are required to pay the full fee upon license renewal. 

Subd. 3.Penalty fee for late renewals. 
An application for license renewal submitted after the deadline must be accompanied by a late fee in addition to the required fees. 

Subd. 4.Nonrefundable fees. 
All of the fees in subdivision 1 are nonrefundable. 

245A.1915 OPIOID ADDICTION TREATMENT EDUCATION REQUIREMENT FOR PROVIDERS LICENSED TO PROVIDE CHEMICAL DEPENDENCY TREATMENT SERVICES.
All programs serving persons with substance use issues licensed by the commissioner must provide educational information concerning: treatment options for opioid addiction, including the use of a medication for the use of opioid addiction; and recognition of and response to opioid overdose and the use and administration of naloxone, to clients identified as having or seeking treatment for opioid addiction. The commissioner shall develop educational materials that are supported by research and updated periodically that must be used by programs to comply with this requirement. 

245A.192 PROVIDERS LICENSED TO PROVIDE TREATMENT OF OPIOID ADDICTION.Subdivision 1.Scope. 
(a) This section applies to services licensed under this chapter to provide treatment for opioid addiction. In addition to the requirements under Minnesota Rules, parts 9530.6405 to 9530.6505, a program licensed to provide treatment of opioid addiction must meet the requirements in this section. 

(b) Where a standard in this section differs from a standard in an otherwise applicable administrative rule, the standards of this section apply. 

(c) When federal guidance or interpretations have been issued on federal standards or requirements also required under this section, the federal guidance or interpretations shall apply. 

Subd. 2.Definitions. 
(a) For purposes of this section, the terms defined in this subdivision have the meanings given them. 

(b) "Diversion" means the use of a medication for the treatment of opioid addiction being diverted from its intended use. 

(c) "Guest dose or dosing" means the practice of administering a medication used for the treatment of opioid addiction to a person who is not a client of the program that is administering or dispensing the medication. 

(d) "Medical director" means a physician, licensed to practice medicine in the jurisdiction in which the opioid treatment program is located, who assumes responsibility for administering all medical services performed by the program, either by performing them directly or by delegating specific responsibility to authorized program physicians and health care professionals functioning under the medical director's direct supervision. 

(e) "Medication used for the treatment of opioid addiction" means a medication approved by the Food and Drug Administration for the treatment of opioid addiction. 

(f) "Opioid treatment program" has the meaning given in Code of Federal Regulations, title 42, section 8.12, and includes programs licensed under Minnesota Rules, part 9530.6500. 

(g) "Program" means an entity that is licensed under Minnesota Rules, part 9530.6500. 

(h) "Unsupervised use" means the use of a medication for the treatment of opioid addiction dispensed for use by a client outside of the program setting. This is also referred to as a "take-home" dose. 

(i) "Placing authority" has the meaning given in Minnesota Rules, part 9530.6605, subpart 21a. 

(j) "Minnesota health care programs" has the meaning given in section 256B.0636. 

Subd. 3.Medication orders. 
Prior to the program administering or dispensing a medication used for the treatment of opioid addiction: 

(1) a client-specific order must be received from an appropriately credentialed physician who is enrolled as a Minnesota health care programs provider and meets all applicable provider standards; 

(2) the signed order must be documented in the client's record; and 

(3) if the physician that issued the order is not able to sign the order when issued, the unsigned order must be entered in the client record at the time it was received, and the physician must review the documentation and sign the order in the client's record within 72 hours of the medication being ordered. The license holder must report to the commissioner any medication error that endangers a patient's health, as determined by the medical director. 

Subd. 3a.High dose requirements. 
A client being administered or dispensed a dose beyond that set forth in subdivision 5, paragraph (a), clause (1), that exceeds 150 milligrams of methadone or 24 milligrams of buprenorphine daily, and for each subsequent increase, must meet face-to-face with a prescribing physician. The meeting must occur before the administering or dispensing of the increased dose. 

Subd. 4.Drug testing. 
Each client enrolled in the program must receive a minimum of eight random drug abuse tests per 12 months of treatment. These tests must be reasonably disbursed over the 12-month period. A license holder may elect to conduct more drug abuse tests. 

Subd. 5.Criteria for unsupervised use. 
(a) To limit the potential for diversion of medication used for the treatment of opioid addiction to the illicit market, any such medications dispensed to patients for unsupervised use shall be subject to the following requirements: 

(1) any patient in an opioid treatment program may receive a single take-home dose for a day that the clinic is closed for business, including Sundays and state and federal holidays; and 

(2) treatment program decisions on dispensing medications used to treat opioid addiction to patients for unsupervised use beyond that set forth in clause (1) shall be determined by the medical director. 

(b) A physician with authority to prescribe must consider the criteria in this subdivision in determining whether a client may be permitted unsupervised or take-home use of such medications. The criteria must also be considered when determining whether dispensing medication for a client's unsupervised use is appropriate to increase or to extend the amount of time between visits to the program. The criteria include: 

(1) absence of recent abuse of drugs including but not limited to opioids, nonnarcotics, and alcohol; 

(2) regularity of program attendance; 

(3) absence of serious behavioral problems at the program; 

(4) absence of known recent criminal activity such as drug dealing; 

(5) stability of the client's home environment and social relationships; 

(6) length of time in comprehensive maintenance treatment; 

(7) reasonable assurance that take-home medication will be safely stored within the client's home; and 

(8) whether the rehabilitative benefit the client derived from decreasing the frequency of program attendance outweighs the potential risks of diversion or unsupervised use. 

(c) The determination, including the basis of the determination, must be consistent with the criteria in this subdivision and must be documented in the client's medical record. 

Subd. 6.Restrictions for unsupervised or take-home use of methadone hydrochloride. 
(a) In cases where it is determined that a client meets the criteria in subdivision 5 and may be dispensed a medication used for the treatment of opioid addiction, the restrictions in paragraphs (b) to (g) must be followed when the medication to be dispensed is methadone hydrochloride. 

(b) During the first 90 days of treatment, the take-home supply must be limited to a maximum of a single dose each week and the client shall ingest all other doses under direct supervision. 

(c) In the second 90 days of treatment, the take-home supply must be limited to two doses per week. 

(d) In the third 90 days of treatment, the take-home supply must not exceed three doses per week. 

(e) In the remaining months of the first year, a client may be given a maximum six-day supply of take-home medication. 

(f) After one year of continuous treatment, a client may be given a maximum two-week supply of take-home medication. 

(g) After two years of continuous treatment, a client may be given a maximum one-month supply of take-home medication, but must make monthly visits. 

Subd. 7.Restriction exceptions. 
When a license holder has reason to accelerate the number of unsupervised or take-home doses of methadone hydrochloride, the license holder must comply with the requirements of Code of Federal Regulations, title 42, section 8.12, the criteria for unsupervised use in subdivision 5, and must use the exception process provided by the federal Center for Substance Abuse Treatment Division of Pharmacologic Therapies. For the purposes of enforcement of this subdivision, the commissioner has the authority to monitor for compliance with these federal regulations and may issue licensing actions according to sections 245A.05, 245A.06, and 245A.07 based on the commissioner's determination of noncompliance. 

Subd. 8.Guest dosing. 
In order to receive a guest dose, the client must be enrolled in an opioid treatment program elsewhere in the state or country and be receiving the medication on a temporary basis because the client is not able to receive the medication at the program in which the client is enrolled. Such arrangements shall not exceed 30 consecutive days in any one program and must not be for the convenience or benefit of either program. Guest dosing may also occur when the client's primary clinic is not open and the client is not receiving take-home doses. 

Subd. 9.Data and reporting. 
The license holder must submit data concerning medication used for the treatment of opioid addiction to a central registry. The data must be submitted in a method determined by the commissioner and must be submitted for each client at the time of admission and discharge. The program must document the date the information was submitted. This requirement is effective upon implementation of changes to the Drug and Alcohol Abuse Normative Evaluation System (DAANES) or development of an electronic system by which to submit the data. 

Subd. 10.Nonmedication treatment services; documentation. 
(a) The program must offer at least 50 consecutive minutes of individual or group therapy treatment services as defined in Minnesota Rules, part 9530.6430, subpart 1, item A, subitem (1), per week, for the first ten weeks following admission, and at least 50 consecutive minutes per month thereafter. As clinically appropriate, the program may offer these services cumulatively and not consecutively in increments of no less than 15 minutes over the required time period, and for a total of 60 minutes of treatment services over the time period, and must document the reason for providing services cumulatively in the client's record. The program may offer additional levels of service when deemed clinically necessary. 

(b) Notwithstanding the requirements of comprehensive assessments in Minnesota Rules, part 9530.6422, the assessment must be completed within 21 days of service initiation. 

(c) Notwithstanding the requirements of individual treatment plans set forth in Minnesota Rules, part 9530.6425: 

(1) treatment plan contents for maintenance clients are not required to include goals the client must reach to complete treatment and have services terminated; 

(2) treatment plans for clients in a taper or detox status must include goals the client must reach to complete treatment and have services terminated; 

(3) for the initial ten weeks after admission for all new admissions, readmissions, and transfers, progress notes must be entered in a client's file at least weekly and be recorded in each of the six dimensions upon the development of the treatment plan and thereafter. Subsequently, the counselor must document progress no less than one time monthly, recorded in the six dimensions or when clinical need warrants more frequent notations; and 

(4) upon the development of the treatment plan and thereafter, treatment plan reviews must occur weekly, or after each treatment service, whichever is less frequent, for the first ten weeks after the treatment plan is developed. Following the first ten weeks of treatment plan reviews, reviews may occur monthly, unless the client has needs that warrant more frequent revisions or documentation. 

Subd. 11.Prescription monitoring program. 
(a) The program must develop and maintain a policy and procedure that requires the ongoing monitoring of the data from the prescription monitoring program for each client. The policy and procedure must include how the program will meet the requirements in paragraph (b). 

(b) If a medication used for the treatment of opioid addiction is administered or dispensed to a client, the license holder shall be subject to the following requirements: 

(1) upon admission to a methadone clinic outpatient treatment program, clients must be notified in writing that the commissioner of human services and the medical director will monitor the prescription monitoring program to review the prescribed controlled drugs the clients have received; 

(2) the medical director or the medical director's delegate must review the data from the Minnesota Board of Pharmacy prescription monitoring program (PMP) established under section 152.126 prior to the client being ordered any controlled substance, as defined under section 152.126, subdivision 1, paragraph (c), including medications used for the treatment of opioid addiction, and subsequent reviews of the PMP data must occur at least every 90 days; 

(3) a copy of the PMP data reviewed must be maintained in the client file; 

(4) when the PMP data contains a recent history of multiple prescribers or multiple prescriptions for controlled substances, the physician's review of the data and subsequent actions must be documented in the client's individual file within 72 hours and must contain the medical director's determination of whether or not the prescriptions place the client at risk of harm and the actions to be taken in response to the PMP findings. In addition, the provider must conduct subsequent reviews of the PMP on a monthly basis; and 

(5) if at any time the medical director believes the use of the controlled substances places the client at risk of harm, the program must seek the client's consent to discuss the client's opioid treatment with other prescribers and must seek consent for the other prescriber to disclose to the opioid treatment program's medical director the client's condition that formed the basis of the other prescriptions. If the information is not obtained within seven days, the medical director must document whether or not changes to the client's medication dose or number of take-home doses are necessary until the information is obtained. 

(c) The commissioner shall collaborate with the Minnesota Board of Pharmacy to develop and implement an electronic system through which the commissioner shall routinely access the data from the Minnesota Board of Pharmacy prescription monitoring program established under section 152.126 for the purpose of determining whether any client enrolled in an opioid addiction treatment program licensed according to this section has also been prescribed or dispensed a controlled substance in addition to that administered or dispensed by the opioid addiction treatment program. When the commissioner determines there have been multiple prescribers or multiple prescriptions of controlled substances, the commissioner shall: 

(1) inform the medical director of the opioid treatment program only that the commissioner determined the existence of multiple prescribers or multiple prescriptions of controlled substances; and 

(2) direct the medical director of the opioid treatment program to access the data directly, review the effect of the multiple prescribers or multiple prescriptions, and document the review. 

(d) If determined necessary, the commissioner shall seek a federal waiver of, or exception to, any applicable provision of Code of Federal Regulations, title 42, section 2.34(c), prior to implementing this subdivision. 

Subd. 12.Policies and procedures. 
(a) License holders must develop and maintain the policies and procedures required in this subdivision. 

(b) For programs that are not open every day of the year, the license holder must maintain a policy and procedure that permits clients to receive a single unsupervised use of medication used for the treatment of opioid addiction for days that the program is closed for business, including, but not limited to, Sundays and state and federal holidays as required under subdivision 5, paragraph (a), clause (1). 

(c) The license holder must maintain a policy and procedure that includes specific measures to reduce the possibility of medication used for the treatment of opioid addiction being diverted from its intended treatment use. The policy and procedure must: 

(1) specifically identify and define the responsibilities of the medical and administrative staff for carrying out diversion control measures; and 

(2) include a process for contacting no less than five percent of clients who have unsupervised use of medication used for the treatment of opioid addiction, excluding those approved solely under subdivision 5, paragraph (a), clause (1), to require them to physically return to the program each month. The system must require clients to return to the program within a stipulated time frame and turn in all unused medication containers related to opioid addiction treatment. The license holder must document all related contacts on a central log and the outcome of the contact for each client in the individual client's record. 

(d) Medications used for the treatment of opioid addictions must be ordered, administered, and dispensed according to applicable state and federal regulations and the standards set by applicable accreditation entities. In addition, when an order requires assessment by the person administering or dispensing the medication to determine the amount to be administered or dispensed, the assessment must be completed by an individual whose professional scope of practice permits such assessment. For the purposes of enforcement of this paragraph, the commissioner has the authority to monitor for compliance with these state and federal regulations and the relevant standards of the license holder's accreditation agency and may issue licensing actions according to sections 245A.05, 245A.06, and 245A.07 based on the commissioner's determination of noncompliance. 

Subd. 13.Quality improvement plan. 
The license holder must develop and maintain a quality improvement process and plan. The plan must: 

(1) include evaluation of the services provided to clients with the goal of identifying issues that may improve service delivery and client outcomes; 

(2) include goals for the program to accomplish based on the evaluation; 

(3) be reviewed annually by the management of the program to determine whether the goals were met and, if not, whether additional action is required; 

(4) be updated at least annually to include new or continued goals based on an updated evaluation of services; and 

(5) identify two specific goal areas, in addition to others identified by the program, including: 

(i) a goal concerning oversight and monitoring of the premises around and near the exterior of the program to reduce the possibility of medication used for the treatment of opioid addiction being inappropriately used by clients, including but not limited to the sale or transfer of the medication to others; and 

(ii) a goal concerning community outreach, including but not limited to communications with local law enforcement and county human services agencies, with the goal of increasing coordination of services and identification of areas of concern to be addressed in the plan. 

Subd. 14.Placing authorities. 
Programs must provide certain notification and client-specific updates to placing authorities for clients who are enrolled in Minnesota health care programs. At the request of the placing authority, the program must provide client-specific updates, including but not limited to informing the placing authority of positive drug screenings and changes in medications used for the treatment of opioid addiction ordered for the client. 

Subd. 15.A program's duty to report suspected drug diversion. 
(a) To the fullest extent permitted under Code of Federal Regulations, title 42, sections 2.1 to 2.67, a program shall report to law enforcement any credible evidence that the program or its personnel knows, or reasonably should know, that is directly related to a diversion crime on the premises of the program, or a threat to commit a diversion crime. 

(b) "Diversion crime," for the purposes of this section, means diverting, attempting to divert, or conspiring to divert Schedule I, II, III, or IV drugs, as defined in section 152.02, on the program's premises. 

(c) The program must document its compliance with the requirement in paragraph (a) in either a client's record or an incident report. 

(d) Failure to comply with the duty in paragraph (a) may result in sanctions as provided in sections 245A.06 and 245A.07. 

Subd. 16.Variance. 
The commissioner may grant a variance to the requirements of this section. 

245C.11 BACKGROUND STUDY; COUNTY AGENCIES.Subd. 4.Background study. 
A county agency may accept a background study completed by the commissioner under this chapter in place of the background study required under section 245A.16, subdivision 3, for educational programs that train individuals by providing direct contact services in licensed programs. 

245C.16 DISQUALIFIED INDIVIDUAL'S RISK OF HARM.Subd. 3.County agency. 
(a) County licensing agencies performing duties under this section may develop an alternative system for determining the subject's immediate risk of harm to persons served by the program, providing the notices under subdivision 2, paragraph (b), and documenting the action taken by the county licensing agency. 

(b) Each county licensing agency's implementation of the alternative system is subject to approval by the commissioner. 

(c) Notwithstanding this alternative system, county licensing agencies shall complete the requirements of section 245C.17. 

245C.17 NOTICE OF BACKGROUND STUDY RESULTS.Subd. 4.Disqualification notice to family child care or foster care provider. 
For studies on individuals pertaining to a license to provide family child care or group family child care, foster care for children in the provider's own home, or foster care or day care services for adults in the provider's own home, the commissioner is not required to provide a separate notice of the background study results to the individual who is the subject of the study unless the study results in a disqualification of the individual. 

245E.03 DUTY TO PROVIDE ACCESS.Subd. 3.Notice of denial or termination. 
When a provider fails to provide access, a 15-day notice of denial or termination must be issued to the provider, which prohibits the provider from participating in the child care assistance program. Notice must be sent to recipients whose children are under the provider's care pursuant to Minnesota Rules, part 3400.0185. 

245E.06 ADMINISTRATIVE SANCTIONS.Subd. 4.Consolidated hearings with licensing sanction. 
If a financial misconduct sanction has an appeal hearing right and it is timely appealed, and a licensing sanction exists for which there is an appeal hearing right and the sanction is timely appealed, and the overpayment recovery action and licensing sanction involve the same set of facts, the overpayment recovery action and licensing sanction must be consolidated in the contested case hearing related to the licensing sanction. 

Subd. 5.Effect of department's administrative determination or sanction. 
Unless a timely and proper appeal is received by the department, the department's administrative determination or sanction shall be considered a final department determination. 

246B.06 VOCATIONAL WORK PROGRAM.Subdivision 1.Establishment; purpose. 
(a) The commissioner of human services may establish, equip, maintain, and operate a vocational work program at any Minnesota sex offender program facility under this chapter. The commissioner may establish vocational activities for sex offender treatment for civilly committed sex offenders as the commissioner deems necessary and suitable to the meaningful work skills training, educational training, and development of proper work habits and extended treatment services for civilly committed sex offenders consistent with the requirements in section 246B.05. The industrial and commercial activities authorized by this section are designated Minnesota State Industries and must be for the primary purpose of sustaining and ensuring Minnesota State Industries' self-sufficiency, providing educational training, meaningful employment, and the teaching of proper work habits to the individuals in the Minnesota sex offender program under this chapter, and not solely as competitive business ventures. 

(b) The net profits from the vocational work program must be used for the benefit of the civilly committed sex offenders as it relates to building education and self-sufficiency skills. Prior to the establishment of any vocational activity, the commissioner of human services shall consult with stakeholders including representatives of business, industry, organized labor, the commissioner of education, the state Apprenticeship Council, the commissioner of labor and industry, the commissioner of employment and economic development, the commissioner of administration, and other stakeholders the commissioner deems qualified. The purpose of the stakeholder consultation is to determine the quantity and nature of the goods, wares, merchandise, and services to be made or provided, and the types of processes to be used in their manufacture, processing, repair, and production consistent with the greatest opportunity for the reform and educational training of the civilly committed sex offenders, and with the best interests of the state, business, industry, and labor. 

(c) The commissioner of human services shall, at all times in the conduct of any vocational activity authorized by this section, utilize civilly committed sex offender labor to the greatest extent feasible, provided that the commissioner may employ all administrative, supervisory, and other skilled workers necessary to the proper instruction of the civilly committed sex offenders and the efficient operation of the vocational activities authorized by this section. 

(d) The commissioner of human services may authorize the director of any Minnesota sex offender treatment facility under the commissioner's control to accept work projects from outside sources for processing, fabrication, or repair, provided that preference is given to the performance of work projects for state departments and agencies. 

Subd. 2.Revolving fund. 
As described in section 246B.05, subdivision 2, there is established a vocational work program revolving fund under the control of the commissioner of human services. The revolving fund must be used for the vocational work program authorized under this section, including, but not limited to, the purchase of equipment and raw materials, the payment of salaries and wages, and other necessary expenses as determined by the commissioner of human services. The purchase of services, materials, and commodities used in and held for resale are not subject to the competitive bidding procedures of section 16C.06, but are subject to all other provisions of chapters 16B and 16C. When practical, purchases must be made from small targeted group businesses designated under section 16C.16. Additionally, the expenses of client educational training and self-sufficiency skills may be financed from the revolving fund in an amount to be determined by the commissioner or designee. The proceeds and income from all vocational work program activities conducted at the Minnesota sex offender treatment facilities must be deposited in the revolving fund subject to disbursement under subdivision 3. The commissioner of human services may request that money in the fund be invested pursuant to section 11A.25. Proceeds from the investment not currently needed must be accounted for separately and credited to the revolving fund. 

Subd. 3.Disbursement from fund. 
The vocational work program revolving fund must be deposited in the state treasury and paid out only on proper vouchers as authorized and approved by the commissioner of human services, and in the same manner and under the same restrictions as are now provided by law for the disbursement of funds by the commissioner. An amount deposited in the state treasury equal to six months of net operating cash as determined by the prior 12 months of revenue and cash flow statements must be restricted for use only by the vocational work program as described under subdivision 2. For purposes of this subdivision, "net operating cash" means net income, minus sales, plus cost of goods sold. Cost of goods sold include all direct costs of products attributable to the goods' production. 

Subd. 4.Revolving fund; borrowing. 
The commissioner of human services is authorized to borrow sums of money as the commissioner deems necessary to meet current demands on the vocational work program revolving fund. The sums borrowed must not exceed, in any calendar year, six months of net operating cash as determined by the previous 12 months of the vocational program's revenue and cash flow statements. If the commissioner of human services determines that borrowing of funds is necessary, the commissioner of human services shall certify this need to the commissioner of management and budget. Funds may be borrowed from general fund appropriations to the Minnesota sex offender program with the authorization of the commissioner of management and budget. Upon authorization of the commissioner of management and budget, the transfer must be made and credited to the vocational work program revolving fund. The sum transferred to the vocational work program revolving fund must be repaid by the commissioner of human services from the revolving fund to the fund from which it was transferred in a time period specified by the commissioner of management and budget, but by no later than the end of the biennium, as defined in section 16A.011, in which the loan is made. When any transfer is made to the vocational work program revolving fund, the commissioner of management and budget shall notify the commissioner of human services of the amount transferred to the fund and the date the transfer is to be repaid. 

Subd. 5.Federal grant fund transfers. 
Grants received by the commissioner of human services from the federal government for any vocational training program or for administration by the commissioner of human services must (1) be credited to a federal grant fund and then (2) be transferred from the federal grant fund to the credit of the commissioner of human services in the appropriate account upon certification by the commissioner of human services that the amounts requested to be transferred have been earned or are required for the purposes of this section. Funds received by the federal grant fund need not be budgeted as such, provided transfers from the fund are budgeted for allotment purposes in the appropriate appropriation. 

Subd. 6.Wages. 
Notwithstanding section 177.24 or any other law to the contrary, the commissioner of human services has the discretion to set the pay rate for individuals participating in the vocational work program. The commissioner has the authority to retain up to 50 percent of any payments made to an individual participating in the vocational work program for the purpose of reducing state costs associated with operating the Minnesota sex offender program. 

Subd. 7.Status of civilly committed sex offenders. 
Civilly committed sex offenders participating in the vocational work program are not employees of the Minnesota sex offender program, the Department of Human Services, or the state, and are not subject to fair labor standards under sections 177.21 to 177.35; workers compensation under sections 176.011 to 176.862; the Minnesota Human Rights Act under sections 363A.01 to 363A.41; laws governing state employees under chapter 43A; labor relations under chapter 179A; or the successors to any of these sections and any other laws pertaining to employees and employment. 

Subd. 8.Claims. 
Claims and demands arising out of injury to or death of a civilly committed sex offender while that individual is participating in the vocational work program or performing a work assignment maintaining the facility must be presented to, heard by, and determined exclusively by the legislature as provided in section 3.738. 

252.41 DEFINITIONS.Subd. 8.Supported employment. 
"Supported employment" means employment of a person with a disability so severe that the person needs ongoing training and support to get and keep a job in which: 

(1) the person engages in paid work at a work site where individuals without disabilities who do not require public subsidies also may be employed; 

(2) public funds are necessary to provide ongoing training and support services throughout the period of the person's employment; and 

(3) the person has the opportunity for social interaction with individuals who do not have disabilities and who are not paid caregivers. 

252.451 BUSINESS AGREEMENTS; SUPPORT AND SUPERVISION OF DISABLED PERSONS.Subdivision 1.Definition. 
For the purposes of this section, "qualified business" means a business that employs primarily nondisabled persons and will employ persons with developmental disabilities. For purposes of this section, licensed providers of residential services for persons with developmental disabilities are not a qualified business. A qualified business and its employees are exempt from Minnesota Rules, parts 9525.1800 to 9525.1930. 

Subd. 2.Vendor participation and reimbursement. 
Notwithstanding requirements in chapters 245A and 245D, and sections 252.28, 252.41 to 252.46, and 256B.501, vendors of day training and habilitation services may enter into written agreements with qualified businesses to provide additional training and supervision needed by individuals to maintain their employment. 

Subd. 3.Agreement specifications. 
Agreements must include the following: 

(1) the type and amount of supervision and support to be provided by the business to the individual in accordance with their needs as identified in their individual service plan; 

(2) the methods used to periodically assess the individual's satisfaction with their work, training, and support; 

(3) the measures taken by the qualified business and the vendor to ensure the health, safety, and protection of the individual during working hours, including the reporting of abuse and neglect under state law and rules; 

(4) the training and support services the vendor will provide to the qualified business, including the frequency of on-site supervision and support; and 

(5) any payment to be made to the qualified business by the vendor. Payment to the business must be limited to: 

(i) additional costs of training coworkers and managers that exceed ordinary and customary training costs and are a direct result of employing a person with a developmental disability; and 

(ii) additional costs for training, supervising, and assisting the person with a developmental disability that exceed normal and customary costs required for performing similar tasks or duties. 

Payments made to a qualified business under this section must not include incentive payments to the qualified business or salary supplementation for the person with a developmental disability. 

Subd. 4.Client protection. 
Persons receiving training and support under this section may not be denied their rights or procedural protections under section 256.045, subdivision 4a, or 256B.092, including the county agency's responsibility to arrange for appropriate services, as necessary, in the event that persons lose their job or the contract with the qualified business is terminated. 

Subd. 5.Vendor payment. 
(a) For purposes of this section, the vendor shall bill and the commissioner shall reimburse the vendor for full-day or partial-day services to a client that would otherwise have been paid to the vendor for providing direct services, provided that both of the following criteria are met: 

(1) the vendor provides services and payments to the qualified business that enable the business to perform support and supervision services for the client that the vendor would otherwise need to perform; and 

(2) the client for whom a rate will be billed will receive full-day or partial-day services from the vendor and the rate to be paid the vendor will allow the client to work with this support and supervision at the qualified business instead of receiving these services from the vendor. 

(b) Medical assistance reimbursement of services provided to persons receiving day training and habilitation services under this section is subject to the limitations on reimbursement for vocational services under federal law and regulation. 

254A.02 DEFINITIONS.Subd. 4.Drug abuse or abuse of drugs. 
"Drug abuse or abuse of drugs" is the use of any psychoactive or mood altering chemical substance, without compelling medical reason, in such a manner as to induce mental, emotional or physical impairment and cause socially dysfunctional or socially disordering behavior and which results in psychological or physiological dependency as a function of continued use. 

256.9692 EFFECT OF INTEGRATION AGREEMENT ON DIVISION OF COST.
Beginning in the first calendar month after there is a definitive integration agreement affecting the University of Minnesota hospital and clinics and Fairview hospital and health care services, Fairview hospital and health care services shall pay the University of Minnesota $505,000 on the 15th of each month, after receiving the state payment, provided that the University of Minnesota has fulfilled the requirements of section 256B.19, subdivision 1c. 

256B.0625 COVERED SERVICES.Subd. 25a.Prior authorization of diagnostic imaging services. 
(a) Effective January 1, 2010, the commissioner shall require prior authorization or decision support for the ordering providers at the time the service is ordered for the following outpatient diagnostic imaging services: computerized tomography (CT), magnetic resonance imaging (MRI), magnetic resonance angiography (MRA), positive emission tomography (PET), cardiac imaging, and ultrasound diagnostic imaging. 

(b) Prior authorization under this subdivision is not required for diagnostic imaging services performed as part of a hospital emergency room visit, inpatient hospitalization, or if concurrent with or on the same day as an urgent care facility visit. 

(c) This subdivision does not apply to services provided to recipients who are enrolled in Medicare, the prepaid medical assistance program, or the MinnesotaCare program. 

(d) The commissioner may contract with a private entity to provide the prior authorization or decision support required under this subdivision. The contracting entity must incorporate clinical guidelines that are based on evidence-based medical literature, if available. By January 1, 2012, the contracting entity shall report to the commissioner the results of prior authorization or decision support. 

256B.0659 PERSONAL CARE ASSISTANCE PROGRAM.Subd. 22.Annual review for personal care providers. 
(a) All personal care assistance provider agencies shall resubmit, on an annual basis, the information specified in subdivision 21, in a format determined by the commissioner, and provide a copy of the personal care assistance provider agency's most current version of its grievance policies and procedures along with a written record of grievances and resolutions of the grievances that the personal care assistance provider agency has received in the previous year and any other information requested by the commissioner. 

(b) The commissioner shall send annual review notification to personal care assistance provider agencies 30 days prior to renewal. The notification must: 

(1) list the materials and information the personal care assistance provider agency is required to submit; 

(2) provide instructions on submitting information to the commissioner; and 

(3) provide a due date by which the commissioner must receive the requested information. 

Personal care assistance provider agencies shall submit required documentation for annual review within 30 days of notification from the commissioner. If no documentation is submitted, the personal care assistance provider agency enrollment number must be terminated or suspended. 

(c) Personal care assistance provider agencies also currently licensed under section 144A.471, subdivision 6 or 7, or currently certified for participation in Medicare as a home health agency are deemed in compliance with the personal care assistance requirements for enrollment, annual review process, and documentation. 

256B.4914 HOME AND COMMUNITY-BASED SERVICES WAIVERS; RATE SETTING.Subd. 16.Budget neutrality adjustments. 
(a) The commissioner shall use the following adjustments to the rate generated by the framework to assure budget neutrality until the rate information is available to implement paragraph (b). The rate generated by the framework shall be multiplied by the appropriate factor, as designated below: 

(1) for residential services: 1.003; 

(2) for day services: 1.000; 

(3) for unit-based services with programming: 0.941; and 

(4) for unit-based services without programming: 0.796. 

(b) Within 12 months of January 1, 2014, the commissioner shall compare estimated spending for all home and community-based waiver services under the new payment rates defined in subdivisions 6 to 9 with estimated spending for the same recipients and services under the rates in effect on July 1, 2013. This comparison must distinguish spending under each of subdivisions 6, 7, 8, and 9. The comparison must be based on actual recipients and services for one or more service months after the new rates have gone into effect. The commissioner shall consult with the commissioner of management and budget on this analysis to ensure budget neutrality. If estimated spending under the new rates for services under one or more subdivisions differs in this comparison by 0.3 percent or more, the commissioner shall assure aggregate budget neutrality across all service areas by adjusting the budget neutrality factor in paragraph (a) in each subdivision so that total estimated spending for each subdivision under the new rates matches estimated spending under the rates in effect on July 1, 2013. 

256B.64 ATTENDANTS TO VENTILATOR-DEPENDENT RECIPIENTS.
A ventilator-dependent recipient of medical assistance who has been receiving the services of a home care nurse or personal care assistant in the recipient's home may continue to have a home care nurse or personal care assistant present upon admission to a hospital licensed under chapter 144. The personal care assistant or home care nurse shall perform only the services of communicator or interpreter for the ventilator-dependent patient during a transition period of up to 120 hours to assure adequate training of the hospital staff to communicate with the patient and to understand the unique comfort, safety, and personal care needs of the patient. The personal care assistant or home care nurse may offer nonbinding advice to the health care professionals in charge of the ventilator-dependent patient's care and treatment on matters pertaining to the comfort and safety of the patient. Within 36 hours of the end of the 120-hour transition period, an assessment may be made by the ventilator-dependent recipient, the attending physician, and the hospital staff caring for the recipient. If the persons making the assessment determine that additional communicator or interpreter services are medically necessary, the hospital must contact the commissioner 24 hours prior to the end of the 120-hour transition period and submit the assessment information to the commissioner. The commissioner shall review the request and determine if it is medically necessary to continue the interpreter services or if the hospital staff has had sufficient opportunity to adequately determine the needs of the patient. The commissioner shall determine if continued service is necessary and appropriate and whether or not payments shall continue. The commissioner may not authorize services beyond the limits of the available appropriations for this section. The commissioner may adopt rules necessary to implement this section. Reimbursement under this section must be at the payment rate and in a manner consistent with the payment rate and manner used in reimbursing these providers for home care services for the ventilator-dependent recipient under the medical assistance program. 

256B.69 PREPAID HEALTH PLANS.Subdivision 1.Purpose. 
The commissioner of human services shall establish a medical assistance demonstration project to determine whether prepayment combined with better management of health care services is an effective mechanism to ensure that all eligible individuals receive necessary health care in a coordinated fashion while containing costs. For the purposes of this project, waiver of certain statutory provisions is necessary in accordance with this section. 

Subd. 2.Definitions. 
For the purposes of this section, the following terms have the meanings given. 

(a) "Commissioner" means the commissioner of human services. For the remainder of this section, the commissioner's responsibilities for methods and policies for implementing the project will be proposed by the project advisory committees and approved by the commissioner. 

(b) "Demonstration provider" means a health maintenance organization, community integrated service network, or accountable provider network authorized and operating under chapter 62D, 62N, or 62T that participates in the demonstration project according to criteria, standards, methods, and other requirements established for the project and approved by the commissioner. For purposes of this section, a county board, or group of county boards operating under a joint powers agreement, is considered a demonstration provider if the county or group of county boards meets the requirements of section 256B.692. 

(c) "Eligible individuals" means those persons eligible for medical assistance benefits as defined in sections 256B.055, 256B.056, and 256B.06. 

(d) "Limitation of choice" means suspending freedom of choice while allowing eligible individuals to choose among the demonstration providers. 

Subd. 3.Geographic area. 
The commissioner shall designate the geographic areas in which eligible individuals may be included in the medical assistance prepayment programs. 

Subd. 3a.County authority. 
(a) The commissioner, when implementing the medical assistance prepayment program within a county, must include the county board in the process of development, approval, and issuance of the request for proposals to provide services to eligible individuals within the proposed county. County boards must be given reasonable opportunity to make recommendations regarding the development, issuance, review of responses, and changes needed in the request for proposals. The commissioner must provide county boards the opportunity to review each proposal based on the identification of community needs under chapters 145A and 256E and county advocacy activities. If a county board finds that a proposal does not address certain community needs, the county board and commissioner shall continue efforts for improving the proposal and network prior to the approval of the contract. The county board shall make recommendations regarding the approval of local networks and their operations to ensure adequate availability and access to covered services. The provider or health plan must respond directly to county advocates and the state prepaid medical assistance ombudsperson regarding service delivery and must be accountable to the state regarding contracts with medical assistance funds. The county board may recommend a maximum number of participating health plans after considering the size of the enrolling population; ensuring adequate access and capacity; considering the client and county administrative complexity; and considering the need to promote the viability of locally developed health plans. The county board or a single entity representing a group of county boards and the commissioner shall mutually select health plans for participation at the time of initial implementation of the prepaid medical assistance program in that county or group of counties and at the time of contract renewal. The commissioner shall also seek input for contract requirements from the county or single entity representing a group of county boards at each contract renewal and incorporate those recommendations into the contract negotiation process. 

(b) At the option of the county board, the board may develop contract requirements related to the achievement of local public health goals to meet the health needs of medical assistance enrollees. These requirements must be reasonably related to the performance of health plan functions and within the scope of the medical assistance benefit set. If the county board and the commissioner mutually agree to such requirements, the department shall include such requirements in all health plan contracts governing the prepaid medical assistance program in that county at initial implementation of the program in that county and at the time of contract renewal. The county board may participate in the enforcement of the contract provisions related to local public health goals. 

(c) For counties in which a prepaid medical assistance program has not been established, the commissioner shall not implement that program if a county board submits an acceptable and timely preliminary and final proposal under section 256B.692, until county-based purchasing is no longer operational in that county. For counties in which a prepaid medical assistance program is in existence on or after September 1, 1997, the commissioner must terminate contracts with health plans according to section 256B.692, subdivision 5, if the county board submits and the commissioner accepts a preliminary and final proposal according to that subdivision. The commissioner is not required to terminate contracts that begin on or after September 1, 1997, according to section 256B.692 until two years have elapsed from the date of initial enrollment. 

(d) In the event that a county board or a single entity representing a group of county boards and the commissioner cannot reach agreement regarding: (i) the selection of participating health plans in that county; (ii) contract requirements; or (iii) implementation and enforcement of county requirements including provisions regarding local public health goals, the commissioner shall resolve all disputes after taking into account the recommendations of a three-person mediation panel. The panel shall be composed of one designee of the president of the association of Minnesota counties, one designee of the commissioner of human services, and one person selected jointly by the designee of the commissioner of human services and the designee of the Association of Minnesota Counties. Within a reasonable period of time before the hearing, the panelists must be provided all documents and information relevant to the mediation. The parties to the mediation must be given 30 days' notice of a hearing before the mediation panel. 

(e) If a county which elects to implement county-based purchasing ceases to implement county-based purchasing, it is prohibited from assuming the responsibility of county-based purchasing for a period of five years from the date it discontinues purchasing. 

(f) The commissioner shall not require that contractual disputes between county-based purchasing entities and the commissioner be mediated by a panel that includes a representative of the Minnesota Council of Health Plans. 

(g) At the request of a county-purchasing entity, the commissioner shall adopt a contract reprocurement or renewal schedule under which all counties included in the entity's service area are reprocured or renewed at the same time. 

(h) The commissioner shall provide a written report under section 3.195 to the chairs of the legislative committees having jurisdiction over human services in the senate and the house of representatives describing in detail the activities undertaken by the commissioner to ensure full compliance with this section. The report must also provide an explanation for any decisions of the commissioner not to accept the recommendations of a county or group of counties required to be consulted under this section. The report must be provided at least 30 days prior to the effective date of a new or renewed prepaid or managed care contract in a county. 

Subd. 3b.Provision of data to county boards. 
The commissioner, in consultation with representatives of county boards of commissioners shall identify program information and data necessary on an ongoing basis for county boards to: (1) make recommendations to the commissioner related to state purchasing under the prepaid medical assistance program; and (2) effectively administer county-based purchasing. This information and data must include, but is not limited to, county-specific, individual-level fee-for-service and prepaid health plan claims information. 

Subd. 4.Limitation of choice. 
(a) The commissioner shall develop criteria to determine when limitation of choice may be implemented in the experimental counties. The criteria shall ensure that all eligible individuals in the county have continuing access to the full range of medical assistance services as specified in subdivision 6. 

(b) The commissioner shall exempt the following persons from participation in the project, in addition to those who do not meet the criteria for limitation of choice: 

(1) persons eligible for medical assistance according to section 256B.055, subdivision 1; 

(2) persons eligible for medical assistance due to blindness or disability as determined by the Social Security Administration or the state medical review team, unless: 

(i) they are 65 years of age or older; or 

(ii) they reside in Itasca County or they reside in a county in which the commissioner conducts a pilot project under a waiver granted pursuant to section 1115 of the Social Security Act; 

(3) recipients who currently have private coverage through a health maintenance organization; 

(4) recipients who are eligible for medical assistance by spending down excess income for medical expenses other than the nursing facility per diem expense; 

(5) recipients who receive benefits under the Refugee Assistance Program, established under United States Code, title 8, section 1522(e); 

(6) children who are both determined to be severely emotionally disturbed and receiving case management services according to section 256B.0625, subdivision 20, except children who are eligible for and who decline enrollment in an approved preferred integrated network under section 245.4682; 

(7) adults who are both determined to be seriously and persistently mentally ill and received case management services according to section 256B.0625, subdivision 20; 

(8) persons eligible for medical assistance according to section 256B.057, subdivision 10; and 

(9) persons with access to cost-effective employer-sponsored private health insurance or persons enrolled in a non-Medicare individual health plan determined to be cost-effective according to section 256B.0625, subdivision 15. 

Children under age 21 who are in foster placement may enroll in the project on an elective basis. Individuals excluded under clauses (1), (6), and (7) may choose to enroll on an elective basis. The commissioner may enroll recipients in the prepaid medical assistance program for seniors who are (1) age 65 and over, and (2) eligible for medical assistance by spending down excess income. 

(c) The commissioner may allow persons with a one-month spenddown who are otherwise eligible to enroll to voluntarily enroll or remain enrolled, if they elect to prepay their monthly spenddown to the state. 

(d) The commissioner may require those individuals to enroll in the prepaid medical assistance program who otherwise would have been excluded under paragraph (b), clauses (1), (3), and (8), and under Minnesota Rules, part 9500.1452, subpart 2, items H, K, and L. 

(e) Before limitation of choice is implemented, eligible individuals shall be notified and after notification, shall be allowed to choose only among demonstration providers. The commissioner may assign an individual with private coverage through a health maintenance organization, to the same health maintenance organization for medical assistance coverage, if the health maintenance organization is under contract for medical assistance in the individual's county of residence. After initially choosing a provider, the recipient is allowed to change that choice only at specified times as allowed by the commissioner. If a demonstration provider ends participation in the project for any reason, a recipient enrolled with that provider must select a new provider but may change providers without cause once more within the first 60 days after enrollment with the second provider. 

(f) An infant born to a woman who is eligible for and receiving medical assistance and who is enrolled in the prepaid medical assistance program shall be retroactively enrolled to the month of birth in the same managed care plan as the mother once the child is enrolled in medical assistance unless the child is determined to be excluded from enrollment in a prepaid plan under this section. 

Subd. 4b.Individualized education program and individualized family service plan services. 
The commissioner shall amend the federal waiver allowing the state to separate out individualized education program and individualized family service plan services for children enrolled in the prepaid medical assistance program and the MinnesotaCare program. Medical assistance coverage of eligible individualized education program and individualized family service plan services shall not be included in the capitated services for children enrolled in health plans through the prepaid medical assistance program and the MinnesotaCare program. Local school districts shall bill the commissioner for these services, and claims shall be paid on a fee-for-service basis. 

Subd. 5.Prospective per capita payment. 
The commissioner shall establish the method and amount of payments for services. The commissioner shall annually contract with demonstration providers to provide services consistent with these established methods and amounts for payment. 

If allowed by the commissioner, a demonstration provider may contract with an insurer, health care provider, nonprofit health service plan corporation, or the commissioner, to provide insurance or similar protection against the cost of care provided by the demonstration provider or to provide coverage against the risks incurred by demonstration providers under this section. The recipients enrolled with a demonstration provider are a permissible group under group insurance laws and chapter 62C, the Nonprofit Health Service Plan Corporations Act. Under this type of contract, the insurer or corporation may make benefit payments to a demonstration provider for services rendered or to be rendered to a recipient. Any insurer or nonprofit health service plan corporation licensed to do business in this state is authorized to provide this insurance or similar protection. 

 The commissioner shall complete development of capitation rates for payments before delivery of services under this section is begun. The commissioner shall contract with an independent actuary to establish prepayment rates. 

Beginning July 1, 2004, the commissioner may include payments for elderly waiver services and 180 days of nursing home care in capitation payments for the prepaid medical assistance program for recipients age 65 and older. 

Subd. 5a.Managed care contracts. 
(a) Managed care contracts under this section and section 256L.12 shall be entered into or renewed on a calendar year basis. The commissioner may issue separate contracts with requirements specific to services to medical assistance recipients age 65 and older. 

(b) A prepaid health plan providing covered health services for eligible persons pursuant to chapters 256B and 256L is responsible for complying with the terms of its contract with the commissioner. Requirements applicable to managed care programs under chapters 256B and 256L established after the effective date of a contract with the commissioner take effect when the contract is next issued or renewed. 

(c) The commissioner shall withhold five percent of managed care plan payments under this section and county-based purchasing plan payments under section 256B.692 for the prepaid medical assistance program pending completion of performance targets. Each performance target must be quantifiable, objective, measurable, and reasonably attainable, except in the case of a performance target based on a federal or state law or rule. Criteria for assessment of each performance target must be outlined in writing prior to the contract effective date. Clinical or utilization performance targets and their related criteria must consider evidence-based research and reasonable interventions when available or applicable to the populations served, and must be developed with input from external clinical experts and stakeholders, including managed care plans, county-based purchasing plans, and providers. The managed care or county-based purchasing plan must demonstrate, to the commissioner's satisfaction, that the data submitted regarding attainment of the performance target is accurate. The commissioner shall periodically change the administrative measures used as performance targets in order to improve plan performance across a broader range of administrative services. The performance targets must include measurement of plan efforts to contain spending on health care services and administrative activities. The commissioner may adopt plan-specific performance targets that take into account factors affecting only one plan, including characteristics of the plan's enrollee population. The withheld funds must be returned no sooner than July of the following year if performance targets in the contract are achieved. The commissioner may exclude special demonstration projects under subdivision 23. 

(d) The commissioner shall require that managed care plans use the assessment and authorization processes, forms, timelines, standards, documentation, and data reporting requirements, protocols, billing processes, and policies consistent with medical assistance fee-for-service or the Department of Human Services contract requirements consistent with medical assistance fee-for-service or the Department of Human Services contract requirements for all personal care assistance services under section 256B.0659. 

(e) Effective for services rendered on or after January 1, 2012, the commissioner shall include as part of the performance targets described in paragraph (c) a reduction in the health plan's emergency department utilization rate for medical assistance and MinnesotaCare enrollees, as determined by the commissioner. For 2012, the reduction shall be based on the health plan's utilization in 2009. To earn the return of the withhold each subsequent year, the managed care plan or county-based purchasing plan must achieve a qualifying reduction of no less than ten percent of the plan's emergency department utilization rate for medical assistance and MinnesotaCare enrollees, excluding enrollees in programs described in subdivisions 23 and 28, compared to the previous measurement year until the final performance target is reached. When measuring performance, the commissioner must consider the difference in health risk in a managed care or county-based purchasing plan's membership in the baseline year compared to the measurement year, and work with the managed care or county-based purchasing plan to account for differences that they agree are significant. 

The withheld funds must be returned no sooner than July 1 and no later than July 31 of the following calendar year if the managed care plan or county-based purchasing plan demonstrates to the satisfaction of the commissioner that a reduction in the utilization rate was achieved. The commissioner shall structure the withhold so that the commissioner returns a portion of the withheld funds in amounts commensurate with achieved reductions in utilization less than the targeted amount. 

The withhold described in this paragraph shall continue for each consecutive contract period until the plan's emergency room utilization rate for state health care program enrollees is reduced by 25 percent of the plan's emergency room utilization rate for medical assistance and MinnesotaCare enrollees for calendar year 2009. Hospitals shall cooperate with the health plans in meeting this performance target and shall accept payment withholds that may be returned to the hospitals if the performance target is achieved. 

(f) Effective for services rendered on or after January 1, 2012, the commissioner shall include as part of the performance targets described in paragraph (c) a reduction in the plan's hospitalization admission rate for medical assistance and MinnesotaCare enrollees, as determined by the commissioner. To earn the return of the withhold each year, the managed care plan or county-based purchasing plan must achieve a qualifying reduction of no less than five percent of the plan's hospital admission rate for medical assistance and MinnesotaCare enrollees, excluding enrollees in programs described in subdivisions 23 and 28, compared to the previous calendar year until the final performance target is reached. When measuring performance, the commissioner must consider the difference in health risk in a managed care or county-based purchasing plan's membership in the baseline year compared to the measurement year, and work with the managed care or county-based purchasing plan to account for differences that they agree are significant. 

The withheld funds must be returned no sooner than July 1 and no later than July 31 of the following calendar year if the managed care plan or county-based purchasing plan demonstrates to the satisfaction of the commissioner that this reduction in the hospitalization rate was achieved. The commissioner shall structure the withhold so that the commissioner returns a portion of the withheld funds in amounts commensurate with achieved reductions in utilization less than the targeted amount. 

The withhold described in this paragraph shall continue until there is a 25 percent reduction in the hospital admission rate compared to the hospital admission rates in calendar year 2011, as determined by the commissioner. The hospital admissions in this performance target do not include the admissions applicable to the subsequent hospital admission performance target under paragraph (g). Hospitals shall cooperate with the plans in meeting this performance target and shall accept payment withholds that may be returned to the hospitals if the performance target is achieved. 

(g) Effective for services rendered on or after January 1, 2012, the commissioner shall include as part of the performance targets described in paragraph (c) a reduction in the plan's hospitalization admission rates for subsequent hospitalizations within 30 days of a previous hospitalization of a patient regardless of the reason, for medical assistance and MinnesotaCare enrollees, as determined by the commissioner. To earn the return of the withhold each year, the managed care plan or county-based purchasing plan must achieve a qualifying reduction of the subsequent hospitalization rate for medical assistance and MinnesotaCare enrollees, excluding enrollees in programs described in subdivisions 23 and 28, of no less than five percent compared to the previous calendar year until the final performance target is reached. 

The withheld funds must be returned no sooner than July 1 and no later than July 31 of the following calendar year if the managed care plan or county-based purchasing plan demonstrates to the satisfaction of the commissioner that a qualifying reduction in the subsequent hospitalization rate was achieved. The commissioner shall structure the withhold so that the commissioner returns a portion of the withheld funds in amounts commensurate with achieved reductions in utilization less than the targeted amount. 

The withhold described in this paragraph must continue for each consecutive contract period until the plan's subsequent hospitalization rate for medical assistance and MinnesotaCare enrollees, excluding enrollees in programs described in subdivisions 23 and 28, is reduced by 25 percent of the plan's subsequent hospitalization rate for calendar year 2011. Hospitals shall cooperate with the plans in meeting this performance target and shall accept payment withholds that must be returned to the hospitals if the performance target is achieved. 

(h) Effective for services rendered on or after January 1, 2013, through December 31, 2013, the commissioner shall withhold 4.5 percent of managed care plan payments under this section and county-based purchasing plan payments under section 256B.692 for the prepaid medical assistance program. The withheld funds must be returned no sooner than July 1 and no later than July 31 of the following year. The commissioner may exclude special demonstration projects under subdivision 23. 

(i) Effective for services rendered on or after January 1, 2014, the commissioner shall withhold three percent of managed care plan payments under this section and county-based purchasing plan payments under section 256B.692 for the prepaid medical assistance program. The withheld funds must be returned no sooner than July 1 and no later than July 31 of the following year. The commissioner may exclude special demonstration projects under subdivision 23. 

(j) A managed care plan or a county-based purchasing plan under section 256B.692 may include as admitted assets under section 62D.044 any amount withheld under this section that is reasonably expected to be returned. 

(k) Contracts between the commissioner and a prepaid health plan are exempt from the set-aside and preference provisions of section 16C.16, subdivisions 6, paragraph (a), and 7. 

(l) The return of the withhold under paragraphs (h) and (i) is not subject to the requirements of paragraph (c). 

(m) Managed care plans and county-based purchasing plans shall maintain current and fully executed agreements for all subcontractors, including bargaining groups, for administrative services that are expensed to the state's public health care programs. Subcontractor agreements determined to be material, as defined by the commissioner after taking into account state contracting and relevant statutory requirements, must be in the form of a written instrument or electronic document containing the elements of offer, acceptance, consideration, payment terms, scope, duration of the contract, and how the subcontractor services relate to state public health care programs. Upon request, the commissioner shall have access to all subcontractor documentation under this paragraph. Nothing in this paragraph shall allow release of information that is nonpublic data pursuant to section 13.02. 

Subd. 5b.Prospective reimbursement rates. 
(a) For prepaid medical assistance program contract rates set by the commissioner under subdivision 5, capitation rates for nonmetropolitan counties shall on a weighted average be no less than 87 percent of the capitation rates for metropolitan counties, excluding Hennepin County. The commissioner shall make a pro rata adjustment in capitation rates paid to counties other than nonmetropolitan counties in order to make this provision budget neutral. The commissioner, in consultation with a health care actuary, shall evaluate the regional rate relationships based on actual health plan costs for Minnesota health care programs. The commissioner may establish, based on the actuary's recommendation, new rate regions that recognize metropolitan areas outside of the seven-county metropolitan area. 

(b) This subdivision shall not affect the nongeographically based risk adjusted rates established under section 62Q.03, subdivision 5a. 

Subd. 5c.Medical education and research fund. 
(a) The commissioner of human services shall transfer each year to the medical education and research fund established under section 62J.692, an amount specified in this subdivision. The commissioner shall calculate the following: 

(1) an amount equal to the reduction in the prepaid medical assistance payments as specified in this clause. After January 1, 2002, the county medical assistance capitation base rate prior to plan specific adjustments is reduced 6.3 percent for Hennepin County, two percent for the remaining metropolitan counties, and 1.6 percent for nonmetropolitan Minnesota counties. Nursing facility and elderly waiver payments and demonstration project payments operating under subdivision 23 are excluded from this reduction. The amount calculated under this clause shall not be adjusted for periods already paid due to subsequent changes to the capitation payments; 

(2) beginning July 1, 2003, $4,314,000 from the capitation rates paid under this section; 

(3) beginning July 1, 2002, an additional $12,700,000 from the capitation rates paid under this section; and 

(4) beginning July 1, 2003, an additional $4,700,000 from the capitation rates paid under this section. 

(b) This subdivision shall be effective upon approval of a federal waiver which allows federal financial participation in the medical education and research fund. The amount specified under paragraph (a), clauses (1) to (4), shall not exceed the total amount transferred for fiscal year 2009. Any excess shall first reduce the amounts specified under paragraph (a), clauses (2) to (4). Any excess following this reduction shall proportionally reduce the amount specified under paragraph (a), clause (1). 

(c) Beginning September 1, 2011, of the amount in paragraph (a), the commissioner shall transfer $21,714,000 each fiscal year to the medical education and research fund. 

(d) Beginning September 1, 2011, of the amount in paragraph (a), following the transfer under paragraph (c), the commissioner shall transfer to the medical education research fund $23,936,000 in fiscal years 2012 and 2013 and $49,552,000 in fiscal year 2014 and thereafter. 

Subd. 5d.Modification of payment dates effective January 1, 2001. 
Effective for services rendered on or after January 1, 2001, capitation payments under this section for services provided in the month of June shall be made no earlier than the first day after the month of service. 

Subd. 5f.Capitation rates. 
(a) Beginning July 1, 2002, the capitation rates paid under this section are increased by $12,700,000 per year. Beginning July 1, 2003, the capitation rates paid under this section are increased by $4,700,000 per year. 

(b) Beginning July 1, 2009, the capitation rates paid under this section are increased each year by the lesser of $21,714,000 or an amount equal to the difference between the estimated value of the reductions described in subdivision 5c, paragraph (a), clause (1), and the amount of the limit described in subdivision 5c, paragraph (b). 

Subd. 5g.Payment for covered services. 
For services rendered on or after January 1, 2003, the total payment made to managed care plans for providing covered services under the medical assistance program is reduced by .5 percent from their current statutory rates. This provision excludes payments for nursing home services, home and community-based waivers, payments to demonstration projects for persons with disabilities, and mental health services added as covered benefits after December 31, 2007. 

Subd. 5h.Payment reduction. 
In addition to the reduction in subdivision 5g, the total payment made to managed care plans under the medical assistance program is reduced 1.0 percent for services provided on or after October 1, 2003, and an additional 1.0 percent for services provided on or after January 1, 2004. This provision excludes payments for nursing home services, home and community-based waivers, payments to demonstration projects for persons with disabilities, and mental health services added as covered benefits after December 31, 2007. 

Subd. 5i.Administrative expenses. 
(a) Administrative costs paid to managed care plans and county-based purchasing plans under this section, section 256B.692, and section 256L.12 must not exceed 6.6 percent of total payments made to all managed care plans and county-based purchasing plans in aggregate across all state public health care programs, based on payments expected to be made at the beginning of each calendar year. The commissioner may reduce or eliminate administrative requirements to meet the administrative cost limit. For purposes of this paragraph, administrative costs do not include premium taxes paid under section 297I.05, subdivision 5, provider surcharges paid under section 256.9657, subdivision 3, and health insurance fees under section 9010 of the Affordable Care Act. 

(b) The following expenses are not allowable administrative expenses for rate-setting purposes under this section: 

(1) charitable contributions made by the managed care plan or the county-based purchasing plan; 

(2) compensation of individuals within the organization in excess of $200,000 such that the allocation of compensation for an individual across all state public health care programs in total cannot exceed $200,000; 

(3) any penalties or fines assessed against the managed care plan or county-based purchasing plan; 

(4) any indirect marketing or advertising expenses of the managed care plan or county-based purchasing plan, including but not limited to costs to promote the managed care or county-based purchasing plan, costs of facilities used for special events, and costs of displays, demonstrations, donations, and promotional items such as memorabilia, models, gifts, and souvenirs. The commissioner may classify an item listed in this clause as an allowable administrative expense for rate-setting purposes, if the commissioner determines that the expense is incidental to an activity related to state public health care programs that is an allowable cost for purposes of rate setting; 

(5) any lobbying and political activities, events, or contributions; 

(6) administrative expenses related to the provision of services not covered under the state plan or waiver; 

(7) alcoholic beverages and related costs; 

(8) membership in any social, dining, or country club or organization; and 

(9) entertainment, including amusement, diversion, and social activities, and any costs directly associated with these costs, including but not limited to tickets to shows or sporting events, meals, lodging, rentals, transportation, and gratuities. 

For the purposes of this subdivision, compensation includes salaries, bonuses and incentives, other reportable compensation on an IRS 990 form, retirement and other deferred compensation, and nontaxable benefits. Charitable contributions under clause (1) include payments for or to any organization or entity selected by the managed care plan or county-based purchasing plan that is operated for charitable, educational, political, religious, or scientific purposes, that are not related to medical and administrative services covered under state public health care programs. 

(c) Payments to a quality improvement organization are an allowable administrative expense for rate-setting purposes under this section, to the extent they are allocated to a state public health care program and approved by the commissioner. 

(d) Where reasonably possible, expenses for an administrative item shall be directly allocated so as to assign costs for an item to an individual state public health care program when the cost can be specifically identified with and benefits the individual state public health care program. For administrative services expensed to the state's public health care programs, managed care plans and county-based purchasing plans must clearly identify and separately record expense items listed under paragraph (b) in their accounting systems in a manner that allows for independent verification of unallowable expenses for purposes of determining payment rates for state public health care programs. 

(e) Notwithstanding paragraph (a), the commissioner shall reduce administrative expenses paid to managed care plans and county-based purchasing plans by .50 of a percentage point for contracts beginning January 1, 2016, and ending December 31, 2017. To meet the administrative reductions under this paragraph, the commissioner may reduce or eliminate administrative requirements, exclude additional unallowable administrative expenses identified under this section and resulting from the financial audits conducted under subdivision 9d, and utilize competitive bidding to gain efficiencies through economies of scale from increased enrollment. If the total reduction cannot be achieved through administrative reduction, the commissioner may limit total rate increases on payments to managed care plans and county-based purchasing plans. 

Subd. 5j.Treatment of investment earnings. 
Capitation rates shall treat investment income and interest earnings as income to the same extent that investment-related expenses are treated as administrative expenditures. 

Subd. 5k.Actuarial soundness. 
(a) Rates paid to managed care plans and county-based purchasing plans shall satisfy requirements for actuarial soundness. In order to comply with this subdivision, the rates must: 

(1) be neither inadequate nor excessive; 

(2) satisfy federal requirements; 

(3) in the case of contracts with incentive arrangements, not exceed 105 percent of the approved capitation payments attributable to the enrollees or services covered by the incentive arrangement; 

(4) be developed in accordance with generally accepted actuarial principles and practices; 

(5) be appropriate for the populations to be covered and the services to be furnished under the contract; and 

(6) be certified as meeting the requirements of federal regulations by actuaries who meet the qualification standards established by the American Academy of Actuaries and follow the practice standards established by the Actuarial Standards Board. 

(b) Each year within 30 days of the establishment of plan rates the commissioner shall report to the chairs and ranking minority members of the senate Health and Human Services Budget Division and the house of representatives Health Care and Human Services Finance Division to certify how each of these conditions have been met by the new payment rates. 

Subd. 6.Service delivery. 
(a) Each demonstration provider shall be responsible for the health care coordination for eligible individuals. Demonstration providers: 

(1) shall authorize and arrange for the provision of all needed health services including but not limited to the full range of services listed in sections 256B.02, subdivision 8, and 256B.0625 in order to ensure appropriate health care is delivered to enrollees. Notwithstanding section 256B.0621, demonstration providers that provide nursing home and community-based services under this section shall provide relocation service coordination to enrolled persons age 65 and over; 

(2) shall accept the prospective, per capita payment from the commissioner in return for the provision of comprehensive and coordinated health care services for eligible individuals enrolled in the program; 

(3) may contract with other health care and social service practitioners to provide services to enrollees; and 

(4) shall institute recipient grievance procedures according to the method established by the project, utilizing applicable requirements of chapter 62D. Disputes not resolved through this process shall be appealable to the commissioner as provided in subdivision 11. 

(b) Demonstration providers must comply with the standards for claims settlement under section 72A.201, subdivisions 4, 5, 7, and 8, when contracting with other health care and social service practitioners to provide services to enrollees. A demonstration provider must pay a clean claim, as defined in Code of Federal Regulations, title 42, section 447.45(b), within 30 business days of the date of acceptance of the claim. 

Subd. 6a.Nursing home services. 
(a) Notwithstanding Minnesota Rules, part 9500.1457, subpart 1, item B, up to 180 days of nursing facility services as defined in section 256B.0625, subdivision 2, which are provided in a nursing facility certified by the Minnesota Department of Health for services provided and eligible for payment under Medicaid, shall be covered under the prepaid medical assistance program for individuals who are not residing in a nursing facility at the time of enrollment in the prepaid medical assistance program. The commissioner may develop a schedule to phase in implementation of the 180-day provision. 

(b) For individuals enrolled in the Minnesota senior health options project or in other demonstrations authorized under subdivision 23, nursing facility services shall be covered according to the terms and conditions of the federal agreement governing that demonstration project. 

(c) For individuals enrolled in demonstrations authorized under subdivision 23, services in an intermediate care facility for persons with developmental disabilities shall be covered according to the terms and conditions of the federal agreement governing the demonstration project. 

Subd. 6b.Home and community-based waiver services. 
(a) For individuals enrolled in the Minnesota senior health options project authorized under subdivision 23, elderly waiver services shall be covered according to the terms and conditions of the federal agreement governing that demonstration project. 

(b) For individuals under age 65 enrolled in demonstrations authorized under subdivision 23, home and community-based waiver services shall be covered according to the terms and conditions of the federal agreement governing that demonstration project. 

(c) The commissioner of human services shall issue requests for proposals for collaborative service models between counties and managed care organizations to integrate the home and community-based elderly waiver services and additional nursing home services into the prepaid medical assistance program. 

(d) Notwithstanding Minnesota Rules, part 9500.1457, subpart 1, item C, elderly waiver services shall be covered statewide under the prepaid medical assistance program for all individuals who are eligible according to section 256B.0915. The commissioner may develop a schedule to phase in implementation of these waiver services, including collaborative service models under paragraph (c). The commissioner shall phase in implementation beginning with those counties participating under section 256B.692, and those counties where a viable collaborative service model has been developed. In consultation with counties and all managed care organizations that have expressed an interest in participating in collaborative service models, the commissioner shall evaluate the models. The commissioner shall consider the evaluation in selecting the most appropriate models for statewide implementation. 

Subd. 6d.Prescription drugs. 
 The commissioner may exclude or modify coverage for prescription drugs from the prepaid managed care contracts entered into under this section in order to increase savings to the state by collecting additional prescription drug rebates. The contracts must maintain incentives for the managed care plan to manage drug costs and utilization and may require that the managed care plans maintain an open drug formulary. In order to manage drug costs and utilization, the contracts may authorize the managed care plans to use preferred drug lists and prior authorization. This subdivision is contingent on federal approval of the managed care contract changes and the collection of additional prescription drug rebates. 

Subd. 7.Enrollee benefits. 
All eligible individuals enrolled by demonstration providers shall receive all needed health care services as defined in subdivision 6. 

All enrolled individuals have the right to appeal if necessary services are not being authorized as defined in subdivision 11. 

Subd. 8.Preadmission screening waiver. 
Except as applicable to the project's operation, the provisions of sections 256.975 and 256B.0911 are waived for the purposes of this section for recipients enrolled with demonstration providers or in the prepaid medical assistance program for seniors. 

Subd. 9.Reporting. 
(a) Each demonstration provider shall submit information as required by the commissioner, including data required for assessing client satisfaction, quality of care, cost, and utilization of services for purposes of project evaluation. The commissioner shall also develop methods of data reporting and collection in order to provide aggregate enrollee information on encounters and outcomes to determine access and quality assurance. Required information shall be specified before the commissioner contracts with a demonstration provider. 

(b) Aggregate nonpersonally identifiable health plan encounter data, aggregate spending data for major categories of service as reported to the commissioners of health and commerce under section 62D.08, subdivision 3, clause (a), and criteria for service authorization and service use are public data that the commissioner shall make available and use in public reports. The commissioner shall require each health plan and county-based purchasing plan to provide: 

(1) encounter data for each service provided, using standard codes and unit of service definitions set by the commissioner, in a form that the commissioner can report by age, eligibility groups, and health plan; and 

(2) criteria, written policies, and procedures required to be disclosed under section 62M.10, subdivision 7, and Code of Federal Regulations, title 42, part 438.210 (b)(1), used for each type of service for which authorization is required. 

(c) Each demonstration provider shall report to the commissioner on the extent to which providers employed by or under contract with the demonstration provider use patient-centered decision-making tools or procedures designed to engage patients early in the decision-making process and the steps taken by the demonstration provider to encourage their use. 

Subd. 9a.Administrative expense reporting. 
Within the limit of available appropriations, the commissioner shall work with the commissioner of health to identify and collect data on administrative spending for state health care programs reported to the commissioner of health by managed care plans under section 62D.08 and county-based purchasing plans under section 256B.692, provided that such data are consistent with guidelines and standards for administrative spending that are developed by the commissioner of health, and reported to the legislature under Laws 2008, chapter 364, section 12. Data provided to the commissioner under this subdivision are nonpublic data as defined under section 13.02. 

Subd. 9c.Managed care financial reporting. 
(a) The commissioner shall collect detailed data regarding financials, provider payments, provider rate methodologies, and other data as determined by the commissioner. The commissioner, in consultation with the commissioners of health and commerce, and in consultation with managed care plans and county-based purchasing plans, shall set uniform criteria, definitions, and standards for the data to be submitted, and shall require managed care and county-based purchasing plans to comply with these criteria, definitions, and standards when submitting data under this section. In carrying out the responsibilities of this subdivision, the commissioner shall ensure that the data collection is implemented in an integrated and coordinated manner that avoids unnecessary duplication of effort. To the extent possible, the commissioner shall use existing data sources and streamline data collection in order to reduce public and private sector administrative costs. Nothing in this subdivision shall allow release of information that is nonpublic data pursuant to section 13.02. 

(b) Effective January 1, 2014, each managed care and county-based purchasing plan must quarterly provide to the commissioner the following information on state public programs, in the form and manner specified by the commissioner, according to guidelines developed by the commissioner in consultation with managed care plans and county-based purchasing plans under contract: 

(1) an income statement by program; 

(2) financial statement footnotes; 

(3) quarterly profitability by program and population group; 

(4) a medical liability summary by program and population group; 

(5) received but unpaid claims report by program; 

(6) services versus payment lags by program for hospital services, outpatient services, physician services, other medical services, and pharmaceutical benefits; 

(7) utilization reports that summarize utilization and unit cost information by program for hospitalization services, outpatient services, physician services, and other medical services; 

(8) pharmaceutical statistics by program and population group for measures of price and utilization of pharmaceutical services; 

(9) subcapitation expenses by population group; 

(10) third-party payments by program; 

(11) all new, active, and closed subrogation cases by program; 

(12) all new, active, and closed fraud and abuse cases by program; 

(13) medical loss ratios by program; 

(14) administrative expenses by category and subcategory by program that reconcile to other state and federal regulatory agencies, including Minnesota Supplement Report #1A; 

(15) revenues by program, including investment income; 

(16) nonadministrative service payments, provider payments, and reimbursement rates by provider type or service category, by program, paid by the managed care plan under this section or the county-based purchasing plan under section 256B.692 to providers and vendors for administrative services under contract with the plan, including but not limited to: 

(i) individual-level provider payment and reimbursement rate data; 

(ii) provider reimbursement rate methodologies by provider type, by program, including a description of alternative payment arrangements and payments outside the claims process; 

(iii) data on implementation of legislatively mandated provider rate changes; and 

(iv) individual-level provider payment and reimbursement rate data and plan-specific provider reimbursement rate methodologies by provider type, by program, including alternative payment arrangements and payments outside the claims process, provided to the commissioner under this subdivision are nonpublic data as defined in section 13.02; 

(17) data on the amount of reinsurance or transfer of risk by program; and 

(18) contribution to reserve, by program. 

(c) In the event a report is published or released based on data provided under this subdivision, the commissioner shall provide the report to managed care plans and county-based purchasing plans 15 days prior to the publication or release of the report. Managed care plans and county-based purchasing plans shall have 15 days to review the report and provide comment to the commissioner. 

The quarterly reports shall be submitted to the commissioner no later than 60 days after the end of the previous quarter, except the fourth-quarter report, which shall be submitted by April 1 of each year. The fourth-quarter report shall include audited financial statements, parent company audited financial statements, an income statement reconciliation report, and any other documentation necessary to reconcile the detailed reports to the audited financial statements. 

(d) Managed care plans and county-based purchasing plans shall certify to the commissioner for the purpose of financial reporting for state public health care programs under this subdivision that costs reported for state public health care programs include: 

(1) only services covered under the state plan and waivers, and related allowable administrative expenses; and 

(2) the dollar value of unallowable and nonstate plan services, including both medical and administrative expenditures, that have been excluded. 

Subd. 9d.Financial and quality assurance audits. 
(a) The commissioner shall require, in the request for bids and resulting contracts with managed care plans and county-based purchasing plans under this section and section 256B.692, that each managed care plan and county-based purchasing plan submit to and fully cooperate with the independent third-party financial audits by the legislative auditor under subdivision 9e of the information required under subdivision 9c, paragraph (b). Each contract with a managed care plan or county-based purchasing plan under this section or section 256B.692 must provide the commissioner, the legislative auditor, and vendors contracting with the legislative auditor, access to all data required to complete audits under subdivision 9e. 

(b) Each managed care plan and county-based purchasing plan providing services under this section shall provide to the commissioner biweekly encounter data and claims data for state public health care programs and shall participate in a quality assurance program that verifies the timeliness, completeness, accuracy, and consistency of the data provided. The commissioner shall develop written protocols for the quality assurance program and shall make the protocols publicly available. The commissioner shall contract for an independent third-party audit to evaluate the quality assurance protocols as to the capacity of the protocols to ensure complete and accurate data and to evaluate the commissioner's implementation of the protocols. 

(c) Upon completion of the evaluation under paragraph (b), the commissioner shall provide copies of the report to the legislative auditor and the chairs and ranking minority members of the legislative committees with jurisdiction over health care policy and financing. 

(d) Any actuary under contract with the commissioner to provide actuarial services must meet the independence requirements under the professional code for fellows in the Society of Actuaries and must not have provided actuarial services to a managed care plan or county-based purchasing plan that is under contract with the commissioner pursuant to this section and section 256B.692 during the period in which the actuarial services are being provided. An actuary or actuarial firm meeting the requirements of this paragraph must certify and attest to the rates paid to the managed care plans and county-based purchasing plans under this section and section 256B.692, and the certification and attestation must be auditable. 

(e) The commissioner, to the extent of available funding, shall conduct ad hoc audits of state public health care program administrative and medical expenses reported by managed care plans and county-based purchasing plans. This includes: financial and encounter data reported to the commissioner under subdivision 9c, including payments to providers and subcontractors; supporting documentation for expenditures; categorization of administrative and medical expenses; and allocation methods used to attribute administrative expenses to state public health care programs. These audits also must monitor compliance with data and financial report certification requirements established by the commissioner for the purposes of managed care capitation payment rate-setting. The managed care plans and county-based purchasing plans shall fully cooperate with the audits in this subdivision. The commissioner shall report to the chairs and ranking minority members of the legislative committees with jurisdiction over health and human services policy and finance by February 1, 2016, and each February 1 thereafter, the number of ad hoc audits conducted in the past calendar year and the results of these audits. 

(f) Nothing in this subdivision shall allow the release of information that is nonpublic data pursuant to section 13.02. 

Subd. 9e.Financial audits. 
(a) The legislative auditor shall conduct or contract with vendors to conduct independent third-party financial audits of the information required to be provided by managed care plans and county-based purchasing plans under subdivision 9c, paragraph (b). The audits by the vendors shall be conducted as vendor resources permit and in accordance with generally accepted government auditing standards issued by the United States Government Accountability Office. The contract with the vendors shall be designed and administered so as to render the independent third-party audits eligible for a federal subsidy, if available. The contract shall require the audits to include a determination of compliance with the federal Medicaid rate certification process. 

(b) For purposes of this subdivision, "independent third-party" means a vendor that is independent in accordance with government auditing standards issued by the United States Government Accountability Office. 

Subd. 10.Information. 
Notwithstanding any law or rule to the contrary, the commissioner may allow disclosure of the recipient's identity solely for the purposes of (a) allowing demonstration providers to provide the information to the recipient regarding services, access to services, and other provider characteristics, and (b) facilitating monitoring of recipient satisfaction and quality of care. The commissioner shall develop and implement measures to protect recipients from invasions of privacy and from harassment. 

Subd. 11.Appeals. 
A recipient may appeal to the commissioner a demonstration provider's delay or refusal to provide services, according to section 256.045. 

Subd. 16.Project extension. 
Minnesota Rules, parts 9500.1450; 9500.1451; 9500.1452; 9500.1453; 9500.1454; 9500.1455; 9500.1457; 9500.1458; 9500.1459; 9500.1460; 9500.1461; 9500.1462; 9500.1463; and 9500.1464, are extended. 

Subd. 17.Continuation of prepaid medical assistance. 
The commissioner may continue the provisions of this section in any or all of the participating counties if necessary federal authority is granted. The commissioner may adopt permanent rules to continue prepaid medical assistance in these areas. 

Subd. 18.Services pending appeal. 
If the recipient appeals in writing to the state agency on or before the tenth day after the decision of the prepaid health plan to reduce, suspend, or terminate services which the recipient had been receiving, and the treating physician or another plan physician orders the services to be continued at the previous level, the prepaid health plan must continue to provide services at a level equal to the level ordered by the plan's physician until the state agency renders its decision. 

Subd. 19.Limitation on reimbursement; providers not with prepaid health plan. 
A prepaid health plan may limit any reimbursement it may be required to pay to providers not employed by or under contract with the prepaid health plan to the medical assistance rates for medical assistance enrollees paid by the commissioner of human services to providers for services to recipients not enrolled in a prepaid health plan. 

Subd. 20.Ombudsperson. 
 The commissioner shall designate an ombudsperson to advocate for persons required to enroll in prepaid health plans under this section. The ombudsperson shall advocate for recipients enrolled in prepaid health plans through complaint and appeal procedures and ensure that necessary medical services are provided either by the prepaid health plan directly or by referral to appropriate social services. At the time of enrollment in a prepaid health plan, the local agency shall inform recipients about the ombudsperson program and their right to a resolution of a complaint by the prepaid health plan if they experience a problem with the plan or its providers. 

Subd. 21.Prepayment coordinator. 
The county board shall designate a prepayment coordinator to assist the state agency in implementing this section. Assistance must include educating recipients about available health care options, enrolling recipients under subdivision 5, providing necessary eligibility and enrollment information to health plans and the state agency, and coordinating complaints and appeals with the ombudsman established in subdivision 18. 

Subd. 22.Impact on public or teaching hospitals and community clinics. 
(a) Before implementing prepaid programs in counties with a county operated or affiliated public teaching hospital or a hospital or clinic operated by the University of Minnesota, the commissioner shall consider the risks the prepaid program creates for the hospital and allow the county or hospital the opportunity to participate in the program, provided the terms of participation in the program are competitive with the terms of other participants. 

(b) Prepaid health plans serving counties with a nonprofit community clinic or community health services agency must contract with the clinic or agency to provide services to clients who choose to receive services from the clinic or agency, if the clinic or agency agrees to payment rates that are competitive with rates paid to other health plan providers for the same or similar services. 

(c) For purposes of this subdivision, "nonprofit community clinic" includes, but is not limited to, a community mental health center as defined in sections 245.62 and 256B.0625, subdivision 5. 

Subd. 23.Alternative services; elderly and disabled persons. 
(a) The commissioner may implement demonstration projects to create alternative integrated delivery systems for acute and long-term care services to elderly persons and persons with disabilities as defined in section 256B.77, subdivision 7a, that provide increased coordination, improve access to quality services, and mitigate future cost increases. The commissioner may seek federal authority to combine Medicare and Medicaid capitation payments for the purpose of such demonstrations and may contract with Medicare-approved special needs plans that are offered by a demonstration provider or by an entity that is directly or indirectly wholly owned or controlled by a demonstration provider to provide Medicaid services. Medicare funds and services shall be administered according to the terms and conditions of the federal contract and demonstration provisions. For the purpose of administering medical assistance funds, demonstrations under this subdivision are subject to subdivisions 1 to 22. The provisions of Minnesota Rules, parts 9500.1450 to 9500.1464, apply to these demonstrations, with the exceptions of parts 9500.1452, subpart 2, item B; and 9500.1457, subpart 1, items B and C, which do not apply to persons enrolling in demonstrations under this section. All enforcement and rulemaking powers available under chapters 62D, 62M, and 62Q are hereby granted to the commissioner of health with respect to Medicare-approved special needs plans with which the commissioner contracts to provide Medicaid services under this section. An initial open enrollment period may be provided. Persons who disenroll from demonstrations under this subdivision remain subject to Minnesota Rules, parts 9500.1450 to 9500.1464. When a person is enrolled in a health plan under these demonstrations and the health plan's participation is subsequently terminated for any reason, the person shall be provided an opportunity to select a new health plan and shall have the right to change health plans within the first 60 days of enrollment in the second health plan. Persons required to participate in health plans under this section who fail to make a choice of health plan shall not be randomly assigned to health plans under these demonstrations. Notwithstanding section 256L.12, subdivision 5, and Minnesota Rules, part 9505.5220, subpart 1, item A, if adopted, for the purpose of demonstrations under this subdivision, the commissioner may contract with managed care organizations, including counties, to serve only elderly persons eligible for medical assistance, elderly and disabled persons, or disabled persons only. For persons with a primary diagnosis of developmental disability, serious and persistent mental illness, or serious emotional disturbance, the commissioner must ensure that the county authority has approved the demonstration and contracting design. Enrollment in these projects for persons with disabilities shall be voluntary. The commissioner shall not implement any demonstration project under this subdivision for persons with a primary diagnosis of developmental disabilities, serious and persistent mental illness, or serious emotional disturbance, without approval of the county board of the county in which the demonstration is being implemented. 

(b) MS 2009 Supplement [Expired, 2003 c 47 s 4; 2007 c 147 art 7 s 60] 

(c) Before implementation of a demonstration project for disabled persons, the commissioner must provide information to appropriate committees of the house of representatives and senate and must involve representatives of affected disability groups in the design of the demonstration projects. 

(d) A nursing facility reimbursed under the alternative reimbursement methodology in section 256B.434 may, in collaboration with a hospital, clinic, or other health care entity provide services under paragraph (a). The commissioner shall amend the state plan and seek any federal waivers necessary to implement this paragraph. 

(e) The commissioner, in consultation with the commissioners of commerce and health, may approve and implement programs for all-inclusive care for the elderly (PACE) according to federal laws and regulations governing that program and state laws or rules applicable to participating providers. A PACE provider is not required to be licensed or certified as a health plan company as defined in section 62Q.01, subdivision 4. Persons age 55 and older who have been screened by the county and found to be eligible for services under the elderly waiver or community access for disability inclusion or who are already eligible for Medicaid but meet level of care criteria for receipt of waiver services may choose to enroll in the PACE program. Medicare and Medicaid services will be provided according to this subdivision and federal Medicare and Medicaid requirements governing PACE providers and programs. PACE enrollees will receive Medicaid home and community-based services through the PACE provider as an alternative to services for which they would otherwise be eligible through home and community-based waiver programs and Medicaid State Plan Services. The commissioner shall establish Medicaid rates for PACE providers that do not exceed costs that would have been incurred under fee-for-service or other relevant managed care programs operated by the state. 

(f) The commissioner shall seek federal approval to expand the Minnesota disability health options (MnDHO) program established under this subdivision in stages, first to regional population centers outside the seven-county metro area and then to all areas of the state. Until July 1, 2009, expansion for MnDHO projects that include home and community-based services is limited to the two projects and service areas in effect on March 1, 2006. Enrollment in integrated MnDHO programs that include home and community-based services shall remain voluntary. Costs for home and community-based services included under MnDHO must not exceed costs that would have been incurred under the fee-for-service program. Notwithstanding whether expansion occurs under this paragraph, in determining MnDHO payment rates and risk adjustment methods, the commissioner must consider the methods used to determine county allocations for home and community-based program participants. If necessary to reduce MnDHO rates to comply with the provision regarding MnDHO costs for home and community-based services, the commissioner shall achieve the reduction by maintaining the base rate for contract year 2010 for services provided under the community access for disability inclusion waiver at the same level as for contract year 2009. The commissioner may apply other reductions to MnDHO rates to implement decreases in provider payment rates required by state law. Effective January 1, 2011, enrollment and operation of the MnDHO program in effect during 2010 shall cease. The commissioner may reopen the program provided all applicable conditions of this section are met. In developing program specifications for expansion of integrated programs, the commissioner shall involve and consult the state-level stakeholder group established in subdivision 28, paragraph (d), including consultation on whether and how to include home and community-based waiver programs. Plans to reopen MnDHO projects shall be presented to the chairs of the house of representatives and senate committees with jurisdiction over health and human services policy and finance prior to implementation. 

(g) Notwithstanding section 256B.0621, health plans providing services under this section are responsible for home care targeted case management and relocation targeted case management. Services must be provided according to the terms of the waivers and contracts approved by the federal government. 

Subd. 25.Continuation of payments through discharge. 
In the event a medical assistance recipient or beneficiary enrolled in a health plan under this section is denied nursing facility services after residing in the facility for more than 180 days, any denial of medical assistance payment to a provider under this section shall be prospective only and payments to the provider shall continue until the resident is discharged or 30 days after the effective date of the service denial, whichever is sooner. 

Subd. 26.American Indian recipients. 
(a) For American Indian recipients of medical assistance who are required to enroll with a demonstration provider under subdivision 4 or in a county-based purchasing entity, if applicable, under section 256B.692, medical assistance shall cover health care services provided at Indian health services facilities and facilities operated by a tribe or tribal organization under funding authorized by United States Code, title 25, sections 450f to 450n, or title III of the Indian Self-Determination and Education Assistance Act, Public Law 93-638, if those services would otherwise be covered under section 256B.0625. Payments for services provided under this subdivision shall be made on a fee-for-service basis, and may, at the option of the tribe or tribal organization, be made according to rates authorized under sections 256.969, subdivision 16, and 256B.0625, subdivision 34. Implementation of this purchasing model is contingent on federal approval. 

(b) The commissioner of human services, in consultation with the tribal governments, shall develop a plan for tribes to assist in the enrollment process for American Indian recipients enrolled in the prepaid medical assistance program under this section. This plan also shall address how tribes will be included in ensuring the coordination of care for American Indian recipients between Indian health service or tribal providers and other providers. 

(c) For purposes of this subdivision, "American Indian" has the meaning given to persons to whom services will be provided for in Code of Federal Regulations, title 42, section 36.12. 

Subd. 27.Information for persons with limited English-language proficiency. 
Managed care contracts entered into under this section and section 256L.12 must require demonstration providers to provide language assistance to enrollees that ensures meaningful access to its programs and services according to Title VI of the Civil Rights Act and federal regulations adopted under that law or any guidance from the United States Department of Health and Human Services. 

Subd. 28.Medicare special needs plans; medical assistance basic health care. 
(a) The commissioner may contract with demonstration providers and current or former sponsors of qualified Medicare-approved special needs plans, to provide medical assistance basic health care services to persons with disabilities, including those with developmental disabilities. Basic health care services include: 

(1) those services covered by the medical assistance state plan except for ICF/DD services, home and community-based waiver services, case management for persons with developmental disabilities under section 256B.0625, subdivision 20a, and personal care and certain home care services defined by the commissioner in consultation with the stakeholder group established under paragraph (d); and 

(2) basic health care services may also include risk for up to 100 days of nursing facility services for persons who reside in a noninstitutional setting and home health services related to rehabilitation as defined by the commissioner after consultation with the stakeholder group. 

The commissioner may exclude other medical assistance services from the basic health care benefit set. Enrollees in these plans can access any excluded services on the same basis as other medical assistance recipients who have not enrolled. 

(b) The commissioner may contract with demonstration providers and current and former sponsors of qualified Medicare special needs plans, to provide basic health care services under medical assistance to persons who are dually eligible for both Medicare and Medicaid and those Social Security beneficiaries eligible for Medicaid but in the waiting period for Medicare. The commissioner shall consult with the stakeholder group under paragraph (d) in developing program specifications for these services. Payment for Medicaid services provided under this subdivision for the months of May and June will be made no earlier than July 1 of the same calendar year. 

(c) Notwithstanding subdivision 4, beginning January 1, 2012, the commissioner shall enroll persons with disabilities in managed care under this section, unless the individual chooses to opt out of enrollment. The commissioner shall establish enrollment and opt out procedures consistent with applicable enrollment procedures under this section. 

(d) The commissioner shall establish a state-level stakeholder group to provide advice on managed care programs for persons with disabilities, including both MnDHO and contracts with special needs plans that provide basic health care services as described in paragraphs (a) and (b). The stakeholder group shall provide advice on program expansions under this subdivision and subdivision 23, including: 

(1) implementation efforts; 

(2) consumer protections; and 

(3) program specifications such as quality assurance measures, data collection and reporting, and evaluation of costs, quality, and results. 

(e) Each plan under contract to provide medical assistance basic health care services shall establish a local or regional stakeholder group, including representatives of the counties covered by the plan, members, consumer advocates, and providers, for advice on issues that arise in the local or regional area. 

(f) The commissioner is prohibited from providing the names of potential enrollees to health plans for marketing purposes. The commissioner shall mail no more than two sets of marketing materials per contract year to potential enrollees on behalf of health plans, at the health plan's request. The marketing materials shall be mailed by the commissioner within 30 days of receipt of these materials from the health plan. The health plans shall cover any costs incurred by the commissioner for mailing marketing materials. 

Subd. 29.Prepaid health plan rates. 
In negotiating prepaid health plan contract rates, the commissioner of human services shall take into consideration, and the rates shall reflect, the anticipated savings in the medical assistance program due to extending medical assistance coverage to services provided in licensed birth centers, the anticipated use of these services within the medical assistance population, and the reduced medical assistance costs associated with the use of birth centers for normal, low-risk deliveries. 

Subd. 30.Provision of required materials in alternative formats. 
(a) For the purposes of this subdivision, "alternative format" means a medium other than paper and "prepaid health plan" means managed care plans and county-based purchasing plans. 

(b) A prepaid health plan may provide in an alternative format a provider directory and certificate of coverage, or materials otherwise required to be available in writing under Code of Federal Regulations, title 42, section 438.10, or under the commissioner's contract with the prepaid health plan, if the following conditions are met: 

(1) the prepaid health plan, local agency, or commissioner, as applicable, informs the enrollee that: 

(i) an alternative format is available and the enrollee affirmatively requests of the prepaid health plan that the provider directory, certificate of coverage, or materials otherwise required under Code of Federal Regulations, title 42, section 438.10, or under the commissioner's contract with the prepaid health plan be provided in an alternative format; and 

(ii) a record of the enrollee request is retained by the prepaid health plan in the form of written direction from the enrollee or a documented telephone call followed by a confirmation letter to the enrollee from the prepaid health plan that explains that the enrollee may change the request at any time; 

(2) the materials are sent to a secure electronic mailbox and are made available at a password-protected secure electronic Web site or on a data storage device if the materials contain enrollee data that is individually identifiable; 

(3) the enrollee is provided a customer service number on the enrollee's membership card that may be called to request a paper version of the materials provided in an alternative format; and 

(4) the materials provided in an alternative format meets all other requirements of the commissioner regarding content, size of the typeface, and any required time frames for distribution. "Required time frames for distribution" must permit sufficient time for prepaid health plans to distribute materials in alternative formats upon receipt of enrollees' requests for the materials. 

(c) A prepaid health plan may provide in an alternative format its primary care network list to the commissioner and to local agencies within its service area. The commissioner or local agency, as applicable, shall inform a potential enrollee of the availability of a prepaid health plan's primary care network list in an alternative format. If the potential enrollee requests an alternative format of the prepaid health plan's primary care network list, a record of that request shall be retained by the commissioner or local agency. The potential enrollee is permitted to withdraw the request at any time. 

The prepaid health plan shall submit sufficient paper versions of the primary care network list to the commissioner and to local agencies within its service area to accommodate potential enrollee requests for paper versions of the primary care network list. 

(d) A prepaid health plan may provide in an alternative format materials otherwise required to be available in writing under Code of Federal Regulations, title 42, section 438.10, or under the commissioner's contract with the prepaid health plan, if the conditions of paragraphs (b) and (c) are met for persons who are eligible for enrollment in managed care. 

(e) The commissioner shall consult with managed care plans, county-based purchasing plans, counties, and other interested parties to determine how materials required to be made available to enrollees under Code of Federal Regulations, title 42, section 438.10, or under the commissioner's contract with a prepaid health plan may be provided in an alternative format on the basis that the enrollee has not opted in to receive the alternative format. The commissioner shall consult with managed care plans, county-based purchasing plans, counties, and other interested parties to develop recommendations relating to the conditions that must be met for an opt-out process to be granted. 

Subd. 31.Payment reduction. 
(a) Beginning September 1, 2011, the commissioner shall reduce payments and limit future rate increases paid to managed care plans and county-based purchasing plans. The limits in paragraphs (a) to (f) shall be achieved on a statewide aggregate basis by program. The commissioner may use competitive bidding, payment reductions, or other reductions to achieve the reductions and limits in this subdivision. 

(b) Beginning September 1, 2011, the commissioner shall reduce payments to managed care plans and county-based purchasing plans as follows: 

(1) 2.0 percent for medical assistance elderly basic care. This shall not apply to Medicare cost-sharing, nursing facility, personal care assistance, and elderly waiver services; 

(2) 2.82 percent for medical assistance families and children; 

(3) 10.1 percent for medical assistance adults without children; and 

(4) 6.0 percent for MinnesotaCare families and children. 

(c) Beginning January 1, 2012, the commissioner shall limit rates paid to managed care plans and county-based purchasing plans for calendar year 2012 to a percentage of the rates in effect on August 31, 2011, as follows: 

(1) 98 percent for medical assistance elderly basic care. This shall not apply to Medicare cost-sharing, nursing facility, personal care assistance, and elderly waiver services; 

(2) 97.18 percent for medical assistance families and children; 

(3) 89.9 percent for medical assistance adults without children; and 

(4) 94 percent for MinnesotaCare families and children. 

(d) Beginning January 1, 2013, to December 31, 2013, the commissioner shall limit the maximum annual trend increases to rates paid to managed care plans and county-based purchasing plans as follows: 

(1) 7.5 percent for medical assistance elderly basic care. This shall not apply to Medicare cost-sharing, nursing facility, personal care assistance, and elderly waiver services; 

(2) 5.0 percent for medical assistance special needs basic care; 

(3) 2.0 percent for medical assistance families and children; 

(4) 3.0 percent for medical assistance adults without children; 

(5) 3.0 percent for MinnesotaCare families and children; and 

(6) 3.0 percent for MinnesotaCare adults without children. 

(e) The commissioner may limit trend increases to less than the maximum. Beginning July 1, 2014, the commissioner shall limit the maximum annual trend increases to rates paid to managed care plans and county-based purchasing plans as follows for calendar years 2014 and 2015: 

(1) 7.5 percent for medical assistance elderly basic care. This shall not apply to Medicare cost-sharing, nursing facility, personal care assistance, and elderly waiver services; 

(2) 5.0 percent for medical assistance special needs basic care; 

(3) 2.0 percent for medical assistance families and children; 

(4) 3.0 percent for medical assistance adults without children; 

(5) 3.0 percent for MinnesotaCare families and children; and 

(6) 4.0 percent for MinnesotaCare adults without children. 

The commissioner may limit trend increases to less than the maximum. For calendar year 2014, the commissioner shall reduce the maximum aggregate trend increases by $47,000,000 in state and federal funds to account for the reductions in administrative expenses in subdivision 5i. 

Subd. 32a.Initiatives to improve early screening, diagnosis, and treatment of children with autism spectrum disorder and other developmental conditions. 
(a) The commissioner shall require managed care plans and county-based purchasing plans, as a condition of contract, to implement strategies that facilitate access for young children between the ages of one and three years to periodic developmental and social-emotional screenings, as recommended by the Minnesota Interagency Developmental Screening Task Force, and that those children who do not meet milestones are provided access to appropriate evaluation and assessment, including treatment recommendations, expected to improve the child's functioning, with the goal of meeting milestones by age five. 

(b) The following information from encounter data provided to the commissioner shall be reported on the department's public Web site for each managed care plan and county-based purchasing plan annually by July 31 of each year beginning in 2014: 

(1) the number of children who received a diagnostic assessment; 

(2) the total number of children ages one to six with a diagnosis of autism spectrum disorder who received treatments; 

(3) the number of children identified under clause (2) reported by each 12-month age group beginning with age one and ending with age six; and 

(4) the types of treatments provided to children identified under clause (2) listed by billing code, including the number of units billed for each child. 

(c) The managed care plans and county-based purchasing plans shall also report on any barriers to providing screening, diagnosis, and treatment of young children between the ages of one and three years, any strategies implemented to address those barriers, and make recommendations on how to measure and report on the effectiveness of the strategies implemented to facilitate access for young children to provide developmental and social-emotional screening, diagnosis, and treatment as described in paragraph (a). 

Subd. 33.Competitive bidding. 
(a) For managed care contracts effective on or after January 1, 2014, the commissioner may utilize a competitive price bidding program for nonelderly, nondisabled adults and children in medical assistance and MinnesotaCare in the seven-county metropolitan area. The program must allow a minimum of two managed care plans to serve the metropolitan area. 

(b) In designing the competitive bid program, the commissioner shall consider, and incorporate where appropriate, the procedures and criteria used in the competitive bidding pilot authorized under Laws 2011, First Special Session chapter 9, article 6, section 96. The pilot program operating in Hennepin County under the authority of section 256B.0756 shall continue to be exempt from competitive bid. 

(c) The commissioner shall use past performance data as a factor in selecting vendors and shall consider this information, along with competitive bid and other information, in determining whether to contract with a managed care plan under this subdivision. Where possible, the assessment of past performance in serving persons on public programs shall be based on encounter data submitted to the commissioner. The commissioner shall evaluate past performance based on both the health outcomes of care and success rates in securing participation in recommended preventive and early diagnostic care. Data provided by managed care plans must be provided in a uniform manner as specified by the commissioner and must include only data on medical assistance and MinnesotaCare enrollees. The data submitted must include health outcome measures on reducing the incidence of low birth weight established by the managed care plan under subdivision 32. 

Subd. 34.Supplemental recovery program. 
The commissioner shall conduct a supplemental recovery program for third-party liabilities identified through coordination of benefits not recovered by managed care plans and county-based purchasing plans for state public health programs. Any third-party liability identified through coordination of benefits and recovered by the commissioner more than eight months after the date a managed care plan or county-based purchasing plan adjudicates a health care claim shall be retained by the commissioner and deposited in the general fund. The commissioner shall establish a mechanism, including a reconciliation process, for managed care plans and county-based purchasing plans to coordinate third-party liability collections efforts resulting from coordination of benefits under this subdivision with the commissioner to ensure there is no duplication of efforts. The coordination mechanism must be consistent with the reporting requirements in subdivision 9c. The commissioner shall share accurate and timely third-party liability data with managed care plans and county-based purchasing plans. 

Subd. 35.Statewide procurement. 
(a) For calendar year 2015, the commissioner may extend a demonstration provider's contract under this section for a sixth year after the most recent procurement. For calendar year 2015, section 16B.98, subdivision 5, paragraph (b), and section 16C.05, subdivision 2, paragraph (b), shall not apply to contracts under this section. 

(b) For calendar year 2016 contracts under this section, the commissioner shall procure through a statewide procurement, which includes all 87 counties, demonstration providers, and participating entities as defined in section 256L.01, subdivision 7. The commissioner shall publish a request for proposals by January 5, 2015. As part of the procurement process, the commissioner shall: 

(1) seek each individual county's input; 

(2) organize counties into regional groups, and consider single counties for the largest and most diverse counties; and 

(3) seek regional and county input regarding the respondent's ability to fully and adequately deliver required health care services, offer an adequate provider network, provide care coordination with county services, and serve special populations, including enrollees with language and cultural needs. 

256C.23 DEFINITIONS.Subd. 3.Regional service center. 
"Regional service center" means a facility designed to provide an entry point for deaf, deafblind, and hard-of-hearing persons of that region in need of education, employment, social, human, or other services. 

256C.25 INTERPRETER SERVICES.Subd. 2.Duties. 
Interpreting or interpreter referral services must include: 

(1) statewide access to interpreter referral and direct interpreting services, coordinated with the regional service centers; 

(2) maintenance of a statewide directory of qualified interpreters; 

(3) assessment of the present and projected supply and demand for interpreter services statewide; and 

(4) coordination with the regional service centers on projects to train interpreters and advocate for and evaluate interpreter services. 

3400.0185TERMINATION AND ADVERSE ACTIONS; NOTICE REQUIRED.   Subp. 5.Notice to providers of actions adverse to the provider.  
The county must give a provider written notice of the following actions adverse to the provider: a denial of authorization, a termination of authorization, a reduction in the number of hours of care with that provider, and a determination that the provider has an overpayment. The notice must include the following information: 

A. 
a description of the adverse action; 

B. 
the effective date of the adverse action; and 

C. 
a statement that unless a family appeals the adverse action before the effective date or the provider appeals the overpayment determination, the adverse action will occur on the effective date. The notice must be mailed to the provider at least 15 calendar days before the effective date of the adverse action. 

5600.2500FEES. 
The fees charged by the board are fixed at the following rates: 

A.
 physician application fee, $200; 

B.
 physician annual license, $192; 

C.
 physician endorsement to other states, $40; 

D.
 physician emeritus license, $50; 

E.
 physician temporary licenses, $60; 

F.
 physician late fee, $60; 

G.
 physician assistant application fee, $120; 

H.
 physician assistant annual registration (prescribing), $135; 

I.
 physician assistant annual registration (nonprescribing), $115; 

J.
 physician assistant temporary registration, $115; 

K.
 physician assistant temporary permit, $60; 

L.
 physician assistant locum tenens permit, $25; 

M.
 physician assistant late fee, $50; 

N.
 acupuncture temporary permit, $60; 

O.
 acupuncture inactive status fee, $50; 

P.
 respiratory care annual registration, $90; 

Q.
 respiratory care application fee, $100; 

R.
 respiratory care late fee, $50; 

S.
 respiratory care inactive status, $50; 

T.
 respiratory care temporary permit, $60; 

U.
 respiratory care temporary registration, $90; 

V.
 duplicate license or registration fee, $20; 

W.
 certification letter, $25; 

X.
 verification of status, $10; 

Y.
 education or training program approval fee, $100; 

Z.
 report creation and generation, $60 per hour billed in quarter-hour increments with a quarter-hour minimum; and 

AA.
 examination administrative fee: 

(1)
 half day, $50; and 

(2)
 full day, $80. 

The renewal cycle for physician assistants under items H and I begins July 1. The duration of the permit issued under item L is one year. 

9503.0145FOOD AND WATER.   Subp. 6.Food allergy information.  
Information about food allergies of the children in the center must be available in the area where food is prepared or served to children with allergies. All staff providing care to the child must be informed of the allergy. 

9530.6405DEFINITIONS.   Subpart 1.Scope.  
As used in parts 9530.6405 to 9530.6505, the following terms have the meanings given to them. 

9530.6405DEFINITIONS.   Subp. 1a.Administration of medications.  
"Administration of medications" means performing a task to provide medications to a client, and includes the following tasks, performed in the following order: 

A.
 checking the client's medication record; 

B.
 preparing the medication for administration; 

C.
 administering the medication to the client; 

D.
 documenting the administration, or the reason for not administering medications as prescribed; and 

E.
 reporting information to a licensed practitioner or a nurse regarding problems with the administration of the medication or the client's refusal to take the medication. 

9530.6405DEFINITIONS.   Subp. 2.Adolescent.  
"Adolescent" means an individual under 18 years of age. 

9530.6405DEFINITIONS.   Subp. 3.Alcohol and drug counselor.  
"Alcohol and drug counselor" has the meaning given in Minnesota Statutes, section 148C.01, subdivision 2. 

9530.6405DEFINITIONS.   Subp. 4.Applicant.  
"Applicant" means an individual, corporation, partnership, voluntary association, controlling individual, or other organization that has applied for licensure under this chapter. 

9530.6405DEFINITIONS.   Subp. 5.Capacity management system.  
"Capacity management system" means a database operated by the Department of Human Services to compile and make information available to the public about the waiting list status and current admission capability of each program serving intravenous drug abusers. 

9530.6405DEFINITIONS.   Subp. 6.Central registry.  
"Central registry" means a database maintained by the department that collects identifying information from two or more programs about individuals applying for maintenance treatment or detoxification treatment for addiction to opiates for the purpose of avoiding an individual's concurrent enrollment in more than one program. 

9530.6405DEFINITIONS.   Subp. 7.Chemical.  
"Chemical" means alcohol, solvents, controlled substances as defined by Minnesota Statutes, section 152.01, subdivision 4, and other mood altering substances. 

9530.6405DEFINITIONS.   Subp. 7a.Chemical dependency treatment.  
"Chemical dependency treatment" means treatment of a substance use disorder, including the process of assessment of a client's needs, development of planned interventions or services to address those needs, provision of services, facilitation of services provided by other service providers, and reassessment by a qualified professional. The goal of treatment is to assist or support the client's efforts to recover from substance use disorder. 

9530.6405DEFINITIONS.   Subp. 8.Client.  
"Client" means an individual accepted by a license holder for assessment or treatment of a substance use disorder. An individual remains a client until the license holder no longer provides or plans to provide the individual with treatment services. 

9530.6405DEFINITIONS.   Subp. 9.Commissioner.  
"Commissioner" means the commissioner of the Department of Human Services or the commissioner's designee. 

9530.6405DEFINITIONS.   Subp. 10.Co-occurring or co-occurring client.  
"Co-occurring" or "co-occurring client" means a diagnosis that indicates a client suffers from a substance use disorder and a mental health problem. 

9530.6405DEFINITIONS.   Subp. 11.Department.  
"Department" means the Department of Human Services. 

9530.6405DEFINITIONS.   Subp. 12.Direct client contact.  
"Direct client contact" has the meaning given for "direct contact" in Minnesota Statutes, section 245C.02, subdivision 11. 

9530.6405DEFINITIONS.   Subp. 13.License.  
"License" means a certificate issued by the commissioner authorizing the license holder to provide a specific program for a specified period of time in accordance with the terms of the license and the rules of the commissioner. 

9530.6405DEFINITIONS.   Subp. 14.License holder.  
"License holder" means an individual, corporation, partnership, voluntary organization, or other organization that is legally responsible for the operation of the program, has been granted a license by the commissioner under this chapter, and is a controlling individual. 

9530.6405DEFINITIONS.   Subp. 14a.Licensed practitioner.  
"Licensed practitioner" means a person who is authorized to prescribe as defined in Minnesota Statutes, section 151.01, subdivision 23. 

9530.6405DEFINITIONS.   Subp. 15.Licensed professional in private practice.  
"Licensed professional in private practice" means an individual who meets the following criteria: 

A.
 is licensed under Minnesota Statutes, chapter 148C, or is exempt from licensure under that chapter but is otherwise licensed to provide alcohol and drug counseling services; 

B.
 practices solely within the permissible scope of the individual's license as defined in the law authorizing licensure; and 

C.
 does not affiliate with other licensed or unlicensed professionals for the purpose of providing alcohol and drug counseling services. Affiliation does not include conferring with other professionals or making client referrals. 

9530.6405DEFINITIONS.   Subp. 15a.Nurse.  
"Nurse" means a person licensed and currently registered to practice professional or practical nursing as defined in Minnesota Statutes, section 148.171, subdivisions 14 and 15. 

9530.6405DEFINITIONS.   Subp. 16.Paraprofessional.  
"Paraprofessional" means an employee, agent, or independent contractor of the license holder who performs tasks in support of the provision of treatment services. Paraprofessionals may be referred to by a variety of titles including technician, case aide, or counselor assistant. An individual may not be a paraprofessional employed by the license holder if the individual is a client of the license holder. 

9530.6405DEFINITIONS.   Subp. 17.Program serving intravenous drug abusers.  
"Program serving intravenous drug abusers" means a program whose primary purpose is providing agonist medication-assisted therapy to clients who are narcotic dependent, regardless of whether the client's narcotic use was intravenous or by other means. 

9530.6405DEFINITIONS.   Subp. 17a.Student intern.  
"Student intern" means a person who is enrolled in an alcohol and drug counselor education program at an accredited school or educational program and is earning a minimum of nine semester credits per calendar year toward the completion of an associate's, bachelor's, master's, or doctorate degree requirements. Degree requirements must include an additional 18 semester credits or 270 hours of alcohol and drug counseling related course work and 440 hours of practicum. 

9530.6405DEFINITIONS.   Subp. 17b.Substance.  
"Substance" means a "chemical" as defined in subpart 7. 

9530.6405DEFINITIONS.   Subp.  17c.Substance use disorder.  
"Substance use disorder" means a pattern of substance use as defined in the Diagnostic and Statistical Manual of Mental Disorders-IV-TR (DSM), et seq. The DSM-IV-TR is incorporated by reference. The DSM was published by the American Psychiatric Association in 1994, in Washington D.C., and is not subject to frequent change. The DSM-IV-TR is available through the Minitex interlibrary loan system. 

9530.6405DEFINITIONS.   Subp. 18.Target population.  
"Target population" means individuals experiencing problems with a substance use disorder having the specified characteristics that a license holder proposes to serve. 

9530.6405DEFINITIONS.   Subp. 20.Treatment director.  
"Treatment director" means an individual who meets the qualifications specified under part 9530.6450, subparts 1 and 3, and is designated by the license holder to be responsible for all aspects of the delivery of treatment services. 

9530.6405DEFINITIONS.   Subp. 21.Treatment service.  
"Treatment service" means a therapeutic intervention or series of interventions. 

9530.6410APPLICABILITY. Subpart 1.Applicability.  
Except as provided in subparts 2 and 3, no person, corporation, partnership, voluntary association, controlling individual, or other organization may provide chemical dependency treatment services to an individual who has a substance use disorder unless licensed by the commissioner. 

Subp. 2.Activities exempt from license requirement.  
Parts 9530.6405 to 9530.6505 do not apply to organizations whose primary functions are information, referral, diagnosis, case management, and assessment for the purposes of placement, education, support group services, or self-help programs. Parts 9530.6405 to 9530.6505do not apply to the activities of licensed professionals in private practice which are not paid for by the consolidated chemical dependency treatment fund. 

Subp. 3.Certain hospitals excluded from license requirement.  
Parts 9530.6405 to 9530.6505 do not apply to chemical dependency treatment provided by hospitals licensed under Minnesota Statutes, chapter 62J, or under Minnesota Statutes, sections 144.50 to 144.56, unless the hospital accepts funds for chemical dependency treatment under the consolidated chemical dependency treatment fund under Minnesota Statutes, chapter 254B, medical assistance under Minnesota Statutes, chapter 256B, MinnesotaCare or health care cost containment under Minnesota Statutes, chapter 256L, or general assistance medical care under Minnesota Statutes, chapter 256D. 

Subp. 4.Applicability of chapter 2960.  
Beginning July 1, 2005, residential adolescent chemical dependency treatment programs must be licensed according to chapter 2960. 

9530.6415LICENSING REQUIREMENTS. Subpart 1.General application and license requirements.  
An applicant for a license to provide treatment must comply with the general requirements in Minnesota Statutes, chapters 245A and 245C, and Minnesota Statutes, sections 626.556 and 626.557. 

Subp. 2.Contents of application.  
Prior to issuance of a license, an applicant must submit, on forms provided by the commissioner, any documents the commissioner requires to demonstrate the following: 

A.
 compliance with parts 9530.6405 to 9530.6505; 

B.
 compliance with applicable building, fire and safety codes, health rules, zoning ordinances, and other applicable rules and regulations or documentation that a waiver has been granted. The granting of a waiver does not constitute modification of any requirement of parts 9530.6405 to 9530.6505; 

C.
 completion of an assessment of need for a new or expanded program according to part 9530.6800; and 

D.
 insurance coverage, including bonding, sufficient to cover all client funds, property, and interests. 

Subp. 3.Changes in license terms. A.
 A license holder must notify the commissioner before one of the following occurs and the commissioner must determine the need for a new license: 

(1)
 a change in the Department of Health's licensure of the program; 

(2)
 a change in whether the license holder provides services specified in parts 9530.6485 to 9530.6505; 

(3)
 a change in location; or 

(4)
 a change in capacity if the license holder meets the requirements of part 9530.6505. 

B.
 A license holder must notify the commissioner and must apply for a new license if there is a change in program ownership. 

9530.6420INITIAL SERVICES PLAN. 
The license holder must complete an initial services plan during or immediately following the intake interview. The plan must address the client's immediate health and safety concerns, identify the issues to be addressed in the first treatment sessions, and make treatment suggestions for the client during the time between intake and completion of the treatment plan. The initial services plan must include a determination whether a client is a vulnerable adult as defined in Minnesota Statutes, section 626.5572, subdivision 21. All adult clients of a residential program are vulnerable adults. An individual abuse prevention plan, according to Minnesota Statutes, sections 245A.65, subdivision 2, paragraph (b), and 626.557, subdivision 14, paragraph (b), is required for all clients who meet the definition of "vulnerable adult." 

9530.6422COMPREHENSIVE ASSESSMENT. Subpart 1.Comprehensive assessment of substance use disorder.  
A comprehensive assessment of the client's substance use disorder must be coordinated by an alcohol and drug counselor and completed within three calendar days after service initiation for a residential program or three sessions of the client's initiation to services for all other programs. The alcohol and drug counselor may rely on current information provided by a referring agency or other sources as a supplement when information is available. Information gathered more than 45 days before the date of admission is not current. If the comprehensive assessment cannot be completed in the time specified, the treatment plan must indicate how and when it will be completed. The assessment must include sufficient information to complete the assessment summary according to subpart 2 and part 9530.6425. The comprehensive assessment must include information about the client's problems that relate to chemical use and personal strengths that support recovery, including: 

A.
 age, sex, cultural background, sexual orientation, living situation, economic status, and level of education; 

B.
 circumstances of service initiation; 

C.
 previous attempts at treatment for chemical use or dependency, compulsive gambling, or mental illness; 

D.
 chemical use history including amounts and types of chemicals used, frequency and duration of use, periods of abstinence, and circumstances of relapse, if any. For each chemical used within the previous 30 days, the information must include the date and time of the most recent use and any previous experience with withdrawal; 

E.
 specific problem behaviors exhibited by the client when under the influence of chemicals; 

F.
 current family status, family history, including history or presence of physical or sexual abuse, level of family support, and chemical use, abuse, or dependency among family members and significant others; 

G. 
 physical concerns or diagnoses, the severity of the concerns, and whether or not the concerns are being addressed by a health care professional; 

H.
 mental health history and current psychiatric status, including symptoms, disability, current treatment supports, and psychotropic medication needed to maintain stability; 

I.
 arrests and legal interventions related to chemical use; 

J.
 ability to function appropriately in work and educational settings; 

K.
 ability to understand written treatment materials, including rules and client rights; 

L.
 risk-taking behavior, including behavior that puts the client at risk of exposure to blood borne or sexually transmitted diseases; 

M.
 social network in relation to expected support for recovery and leisure time activities that have been associated with chemical use;  

N.
 whether the client is pregnant and if so, the health of the unborn child and current involvement in prenatal care; and 

O.
 whether the client recognizes problems related to substance use and is willing to follow treatment recommendations. 

Subp. 2.Assessment summary.  
An alcohol and drug counselor must prepare an assessment summary within three calendar days for a residential program or within three treatment sessions of service initiation. The narrative summary of the comprehensive assessment results must meet the requirements of items A and B: 

A.
 An assessment summary must be prepared by an alcohol and drug counselor and include: 

(1)
 a risk description according to part 9530.6622 for each dimension listed in item B; 

(2)
 narrative supporting the risk descriptions; and 

(3)
 a determination of whether the client meets the DSM criteria for a person with a substance use disorder. 

B.
 Contain information relevant to treatment planning and recorded in the dimensions in subitems (1) to (6): 

(1)
 Dimension 1, acute intoxication/withdrawal potential. The license holder must consider the client's ability to cope with withdrawal symptoms and current state of intoxication. 

(2)
 Dimension 2, biomedical conditions and complications. The license holder must consider the degree to which any physical disorder would interfere with treatment for substance abuse, and the client's ability to tolerate any related discomfort. The license holder must determine the impact of continued chemical use on the unborn child if the client is pregnant. 

(3)
 Dimension 3, emotional, behavioral, and cognitive conditions and complications. The license holder must determine the degree to which any condition or complications are likely to interfere with treatment for substance abuse or with functioning in significant life areas and the likelihood of risk of harm to self or others. 

(4)
 Dimension 4, readiness for change. The license holder must also consider the amount of support and encouragement necessary to keep the client involved in treatment. 

(5)
 Dimension 5, relapse, continued use, and continued problem potential. The license holder must consider the degree to which the client recognizes relapse issues and has the skills to prevent relapse of either substance use or mental health problems. 

(6)
 Dimension 6, recovery environment. The license holder must consider the degree to which key areas of the client's life are supportive of or antagonistic to treatment participation and recovery. 

9530.6425INDIVIDUAL TREATMENT PLANS. Subpart 1.General.  
Individual treatment plans for clients in treatment must be completed within seven calendar days of completion of the assessment summary. Treatment plans must continually be updated, based on new information gathered about the client's condition and on whether planned treatment interventions have had the intended effect. Treatment planning must include ongoing assessment in each of the six dimensions according to part 9530.6422, subpart 2. The plan must provide for the involvement of the client's family and those people selected by the client as being important to the success of the treatment experience at the earliest opportunity, consistent with the client's treatment needs and written consent. The plan must be developed after completion of the comprehensive assessment and is subject to amendment until services to the client are terminated. The client must have an opportunity to have active, direct involvement in selecting the anticipated outcomes of the treatment process and in developing the individual treatment plan. The individual treatment plan must be signed by the client and the alcohol and drug counselor. The individual treatment plan may be a continuation of the initial services plan required in part 9530.6420. 

Subp. 2.Plan contents.  
An individual treatment plan must be recorded in the six dimensions listed in part 9530.6422, subpart 2, item B, and address each problem identified in the assessment summary, and include: 

A.
 specific methods to be used to address identified problems, including amount, frequency, and anticipated duration of treatment service. The methods must be appropriate to the client's language, reading skills, cultural background, and strengths; 

B.
 resources to which the client is being referred for problems when problems are to be addressed concurrently by another provider; and 

C.
 goals the client must reach to complete treatment and have services terminated. 

Subp. 3.Progress notes and plan review. A.
 Progress notes must be entered in a client's file weekly or after each treatment service, whichever is less frequent, by the staff person providing the service. The note must reference the treatment plan. Progress notes must be recorded and address each of the six dimensions listed in part 9530.6422, subpart 2, item B. Progress notes must: 

(1)
 be entered immediately following any significant event. Significant events include those events which have an impact on the client's relationship with other clients, staff, the client's family, or the client's treatment plan; 

(2)
 indicate the type and amount of each treatment service the client has received; 

(3)
 include monitoring of any physical and mental health problems and the participation of others in the treatment plan; 

(4)
 document the participation of others; and 

(5)
 document that the client has been notified of each treatment plan change and that the client either does or does not agree with the change. 

B.
 Treatment plan review must: 

(1)
 occur weekly or after each treatment service, whichever is less frequent; 

(2)
 address each goal in the treatment plan that has been worked on since the last review; 

(3)
 address whether the strategies to address the goals are effective, and if not, must include changes to the treatment plan; and 

(4)
 include a review and evaluation of the individual abuse prevention plan according to Minnesota Statutes, section 245A.65. 

C.
 All entries in a client's record must be legible, signed, and dated. Late entries must be clearly labeled "late entry." Corrections to an entry must be made in a way in which the original entry can still be read. 

Subp. 3a.Documentation.  
Progress notes and plan review do not require separate documentation if the information in the client file meets the requirements of subpart 3, items A and B. 

Subp. 4.Summary at termination of services.  
An alcohol and drug counselor must write a discharge summary for each client. The summary must be completed within five days of the client's service termination or within five days from the client's or program's decision to terminate services, whichever is earlier. 

A.
 The summary at termination of services must be recorded in the six dimensions listed in part 9530.6422, subpart 2, item B, and include the following information: 

(1)
 client's problems, strengths, and needs while participating in treatment, including services provided; 

(2)
 client's progress toward achieving each of the goals identified in the individual treatment plan; 

(3)
 reasons for and circumstances of service termination; and 

(4)
 risk description according to part 9530.6622. 

B.
 For clients who successfully complete treatment, the summary must also include: 

(1)
 living arrangements upon discharge; 

(2)
 continuing care recommendations, including referrals made with specific attention to continuity of care for mental health problems, as needed; 

(3)
 service termination diagnosis; and 

(4)
 client's prognosis. 

9530.6430TREATMENT SERVICES. Subpart 1.Treatment services offered by license holder. A.
 A license holder must offer the following treatment services unless clinically inappropriate and the justifying clinical rationale is documented: 

(1)
 individual and group counseling to help the client identify and address problems related to chemical use and develop strategies to avoid inappropriate chemical use after discharge; 

(2)
 client education strategies to avoid inappropriate chemical use and health problems related to chemical use and the necessary changes in lifestyle to regain and maintain health. Client education must include information concerning the human immunodeficiency virus, according to Minnesota Statutes, section 245A.19, other sexually transmitted diseases, drug and alcohol use during pregnancy, hepatitis, and tuberculosis; 

(3)
 transition services to help the client integrate gains made during treatment into daily living and to reduce reliance on the license holder's staff for support; 

(4)
 services to address issues related to co-occurring mental illness, including education for clients on basic symptoms of mental illness, the possibility of comorbidity, and the need for continued medication compliance while working on recovery from substance use disorder. Groups must address co-occurring mental illness issues, as needed. When treatment for mental health problems is indicated, it is integrated into the client's treatment plan; and 

(5)
 service coordination to help the client obtain the services and to support the client's need to establish a lifestyle free of the harmful effects of substance use disorder. 

B.
 Treatment services provided to individual clients must be provided according to the individual treatment plan and must address cultural differences and special needs of all clients. 

Subp. 2.Additional treatment services.  
A license holder may provide or arrange the following additional treatment services as a part of the individual treatment plan: 

A.
 relationship counseling provided by a qualified professional to help the client identify the impact of the client's substance use disorder on others and to help the client and persons in the client's support structure identify and change behaviors that contribute to the client's substance use disorder; 

B.
 therapeutic recreation to provide the client with an opportunity to participate in recreational activities without the use of mood-altering chemicals and to learn to plan and select leisure activities that do not involve the inappropriate use of chemicals; 

C.
 stress management and physical well-being to help the client reach and maintain an acceptable level of health, physical fitness, and well-being; 

D.
 living skills development to help the client learn basic skills necessary for independent living; 

E.
 employment or educational services to help the client become financially independent; 

F.
 socialization skills development to help the client live and interact with others in a positive and productive manner; and 

G.
 room, board, and supervision provided at the treatment site to give the client a safe and appropriate environment in which to gain and practice new skills. 

Subp. 3.Counselors to provide treatment services.  
Treatment services, including therapeutic recreation, must be provided by alcohol and drug counselors qualified according to part 9530.6450, unless the individual providing the service is specifically qualified according to the accepted standards of that profession. Therapeutic recreation does not include planned leisure activities. 

Subp. 4.Location of service provision.  
A client of a license holder may only receive services at any of the license holder's licensed locations or at the client's home, except that services under subpart 1, item A, subitems (3) and (5), and subpart 2, items B and E, may be provided in another suitable location. 

9530.6435MEDICAL SERVICES. Subpart 1.Health care services description.  
An applicant or license holder must maintain a complete description of the health care services, nursing services, dietary services, and emergency physician services offered by the license holder. 

Subp. 1a.Procedures.  
The applicant or license holder must have written procedures for obtaining medical interventions when needed for a client, that are approved in writing by a physician who is licensed under Minnesota Statutes, chapter 147, unless: 

A.
 the license holder does not provide services under part 9530.6505; and 

B. 
 all medical interventions are referred to 911, the emergency telephone number, or the client's physician. 

Subp. 2.Consultation services.  
The license holder must have access to and document the availability of a licensed mental health professional to provide diagnostic assessment and treatment planning assistance. 

Subp. 3.Administration of medications and assistance with self-medication.  
A license holder must meet the requirements in items A and B if services include medication administration. 

A.
 A staff member, other than a licensed practitioner or nurse, who is delegated by a licensed practitioner or a registered nurse the task of administration of medication or assistance with self-medication must: 

(1)
 document that the staff member has successfully completed a medication administration training program for unlicensed personnel through an accredited Minnesota postsecondary educational institution. Completion of the course must be documented in writing and placed in the staff member's personnel file; or 

(2)
 be trained according to a formalized training program which is taught by a registered nurse and offered by the license holder. Completion of the course must be documented in writing and placed in the staff member's personnel records; or 

(3)
 demonstrate to a registered nurse competency to perform the delegated activity. 

B.
 A registered nurse must be employed or contracted to develop the policies and procedures for medication administration or assistance with self-administration of medication or both. A registered nurse must provide supervision as defined in part 6321.0100. The registered nurse supervision must include monthly on-site supervision or more often as warranted by client health needs. The policies and procedures must include: 

(1)
 a provision that delegations of administration of medication are limited to administration of those medications which are oral, suppository, eye drops, ear drops, inhalant, or topical; 

(2)
 a provision that each client's file must include documentation indicating whether staff will be administering medication or the client will be doing self-administration or a combination of both; 

(3)
 a provision that clients may carry emergency medication such as nitroglycerin as instructed by their physician; 

(4)
 a provision for medication to be self-administered when a client is scheduled not to be at the facility; 

(5)
 a provision that if medication is to be self-administered at a time when the client is present in the facility, medication will be self-administered under observation of a trained staff person; 

(6)
 a provision that when a license holder serves clients who are parents with children, the parent may only administer medication to the child under staff supervision; 

(7)
 requirements for recording the client's use of medication, including staff signatures with date and time; 

(8)
 guidelines for when to inform a registered nurse of problems with self-administration, including failure to administer, client refusal of a medication, adverse reactions, or errors; and 

(9)
 procedures for acceptance, documentation, and implementation of prescriptions, whether written, verbal, telephonic, or electronic. 

Subp. 4.Control of drugs.  
A license holder must have in place and implement written policies and procedures developed by a registered nurse that contains the following provisions: 

A.
 a requirement that all drugs must be stored in a locked compartment. Schedule II drugs, as defined by Minnesota Statutes, section 152.02, must be stored in a separately locked compartment, permanently affixed to the physical plant or medication cart; 

B.
 a system which accounts for all scheduled drugs each shift; 

C.
 a procedure for recording the client's use of medication, including the signature of the administrator of the medication with the time and date; 

D.
 a procedure for destruction of discontinued, outdated, or deteriorated medications; 

E.
 a statement that only authorized personnel are permitted to have access to the keys to the locked drug compartments; and 

F.
 a statement that no legend drug supply for one client will be given to another client. 

9530.6440CLIENT RECORDS. Subpart 1.Client records required.  
A license holder must maintain a file of current client records on the premises where the treatment services are provided or coordinated. The content and format of client records must be uniform and entries in each case must be signed and dated by the staff member making the entry. Client records must be protected against loss, tampering, or unauthorized disclosure in compliance with Minnesota Statutes, section 254A.09, Code of Federal Regulations, title 42, chapter 1, part 2, subpart B, sections 2.1 to 2.67, and Code of Federal Regulations, title 45, parts 160 to 164, and, if applicable, Minnesota Statutes, chapter 13. 

Subp. 2.Records retention.  
Records of discharged clients must be retained by a license holder for seven years. License holders that cease to provide treatment services must retain client records for seven years from the date of facility closure and must notify the commissioner of the location of the records and the name of a person responsible for maintaining the records. 

Subp. 3.Client records, contents.  
Client records must contain the following: 

A.
 documentation that the client was given information on client rights, responsibilities, grievance procedures, tuberculosis, and HIV, and that the client was provided an orientation to the program abuse prevention plan as required under Minnesota Statutes, section 245A.65, subdivision 2, paragraph (a), clause (4); 

B.
 an initial services plan completed according to part 9530.6420; 

C.
 a comprehensive assessment completed according to part 9530.6422; 

D. 
 an assessment summary completed according to part 9530.6422, subpart 2; 

E. 
 an individual abuse prevention plan that complies with Minnesota Statutes, sections 245A.65, subdivision 2, and 626.557, subdivision 14, when applicable; 

F. 
 an individual treatment plan, as required under part 9530.6425, subparts 1 and 2; 

G. 
 progress notes, as required in part 9530.6425, subpart 3; and  

H. 
 a summary of termination of services, written according to part 9530.6425, subpart 4. 

Subp. 4.Electronic records.  
A license holder who intends to use electronic record keeping or electronic signatures to comply with parts 9530.6405 to 9530.6505 must first obtain written permission from the commissioner. The commissioner must grant permission after the license holder provides documentation demonstrating the license holder's use of a system for ensuring security of electronic records. Use of electronic record keeping or electronic signatures does not alter the license holder's obligations under state or federal law, regulation, or rule. 

9530.6445STAFFING REQUIREMENTS. Subpart 1.Treatment director required.  
A license holder must have a treatment director. 

Subp. 2.Alcohol and drug counselor supervisor requirements.  
A license holder must employ an alcohol and drug counselor supervisor who meets the requirements under part 9530.6450, subpart 4. An individual may be simultaneously employed as a treatment director, alcohol and drug counselor supervisor, and an alcohol and drug counselor if the individual meets the qualifications for each position. If an alcohol and drug counselor is simultaneously an alcohol and drug counselor supervisor or treatment director, that individual must be considered a 0.5 full-time equivalent alcohol and drug counselor for purposes of meeting the staffing requirements under subpart 4. 

Subp. 3.Responsible staff person.  
A treatment director must designate a staff member who, when present in the facility, is responsible for the delivery of treatment services. A license holder must have a designated staff person during all hours of operation. A license holder providing room and board and treatment at the same site must have a responsible staff person on duty 24 hours a day. The designated staff person must know and understand the implications of parts 9530.6405 to 9530.6505 and Minnesota Statutes, sections 245A.65, 626.556, 626.557, and 626.5572. 

Subp. 4.Staffing requirements.  
At least 25 percent of a counselor's scheduled work hours must be allocated to indirect services, including documentation of client services, coordination of services with others, treatment team meetings, and other duties. A counseling group shall not exceed an average of 16 clients during any 30 consecutive calendar days. It is the responsibility of the license holder to determine an acceptable group size based on the client's needs. A counselor in a program treating intravenous drug abusers must not supervise more than 50 clients. The license holder must maintain a record that documents compliance with this subpart. 

Subp. 5.Medical emergencies.  
When clients are present, a license holder must have at least one staff person on the premises who has a current American Red Cross standard first aid certificate or an equivalent certificate and at least one staff person on the premises who has a current American Red Cross community, American Heart Association, or equivalent CPR certificate. A single staff person with both certifications satisfies this requirement. 

9530.6450STAFF QUALIFICATIONS. Subpart 1.Qualifications of all staff members with direct client contact.  
All staff members who have direct client contact must be at least 18 years of age. At the time of hiring, all staff members must meet the qualifications in item A or B. A chemical use problem for purposes of this subpart is a problem listed by the license holder in the personnel policies and procedures according to part 9530.6460, subpart 1, item E. 

A.
 Treatment directors, supervisors, nurses, counselors, and other professionals must be free of chemical use problems for at least the two years immediately preceding their hiring and must sign a statement attesting to that fact. 

B.
 Paraprofessionals and all other staff members with direct client contact must be free of chemical use problems for at least one year immediately preceding their hiring and must sign a statement attesting to that fact. 

Subp. 2.Employment; prohibition on chemical use problems.  
Staff members with direct client contact must be free from chemical use problems as a condition of employment, but are not required to sign additional statements. Staff members with direct client contact who are not free from chemical use problems must be removed from any responsibilities that include direct client contact for the time period specified in subpart 1. The time period begins to run on the date the employee begins receiving treatment services or the date of the last incident as described in the list developed according to part 9530.6460, subpart 1, item E. 

Subp. 3.Treatment director qualifications.  
In addition to meeting the requirements of subpart 1, a treatment director must know and understand the implications of parts 9530.6405 to 9530.6505 and Minnesota Statutes, chapter 245A, and sections 626.556, 626.557, and 626.5572. A treatment director must: 

A.
 have at least one year of work experience in direct service to individuals with chemical use problems or one year of work experience in the management or administration of direct service to individuals with chemical use problems; and 

B.
 have a baccalaureate degree or three years of work experience in administration or personnel supervision in human services. 

Subp. 4.Alcohol and drug counselor supervisor qualifications.  
In addition to meeting the requirements of subpart 1, an alcohol and drug counselor supervisor must meet the following qualifications: 

A.
 the individual is competent in the areas specified in subpart 5; 

B.
 the individual has three or more years of experience providing individual and group counseling to chemically dependent clients except that, prior to January 1, 2005, an individual employed in a program formerly licensed under parts 9530.5000 to 9530.6400is required to have one or more years experience; and 

C.
 the individual knows and understands the implications of parts 9530.6405 to 9530.6505 and Minnesota Statutes, sections 245A.65, 626.556, 626.557, and 626.5572. 

Subp. 5.Alcohol and drug counselor qualifications.  
In addition to meeting the requirements of subpart 1, an alcohol and drug counselor must be either licensed or exempt from licensure under Minnesota Statutes, chapter 148C. An alcohol and drug counselor must document competence in screening for and working with clients with mental health problems, through education, training, and experience. 

A.
 Alcohol and drug counselors licensed under Minnesota Statutes, chapter 148C, must comply with rules adopted under Minnesota Statutes, chapter 148C. 

B.
 Counselors exempt under Minnesota Statutes, chapter 148C, must be competent, as evidenced by one of the following: 

(1)
 completion of at least a baccalaureate degree with a major or concentration in social work, nursing, sociology, human services, or psychology, or licensure as a registered nurse; successful completion of a minimum of 120 hours of classroom instruction in which each of the core functions listed in Minnesota Statutes, chapter 148C, is covered; and successful completion of 440 hours of supervised experience as an alcohol and drug counselor, either as a student or as a staff member; 

(2)
 completion of 270 hours of alcohol and drug counselor training in which each of the core functions listed in Minnesota Statutes, chapter 148C, is covered, and successful completion of 880 hours of supervised experience as an alcohol and drug counselor, either as a student, or as a staff member; 

(3)
 current certification as an alcohol and drug counselor or alcohol and drug counselor reciprocal, through the evaluation process established by the International Certification and Reciprocity Consortium Alcohol and Other Drug Abuse, Inc., and published in the Case Presentation Method Trainer's Manual, copyright 1993. The manual is incorporated by reference. It is available at the State Law Library, Judicial Center, 25 Reverend Dr. Martin Luther King Jr. Blvd., St. Paul, Minnesota 55155; 

(4)
 completion of a bachelor's degree including 480 hours of alcohol and drug counseling education from an accredited school or educational program and 880 hours of alcohol and drug counseling practicum; or 

(5)
 employment in a program formerly licensed under parts 9530.5000 to 9530.6400 and successful completion of 6,000 hours of supervised work experience in a licensed program as an alcohol and drug counselor prior to January 1, 2005. 

Subp. 6.Paraprofessional qualifications and duties.  
A paraprofessional must comply with subpart 1 and have knowledge of client rights, outlined in Minnesota Statutes, section 148F.165, and of staff responsibilities. A paraprofessional may not admit, transfer, or discharge clients but may be the person responsible for the delivery of treatment services as required in part 9530.6445, subpart 3. 

Subp. 7.Volunteers.  
Volunteers may provide treatment services when they are supervised and can be seen or heard by a staff member meeting the criteria in subpart 4 or 5, but may not practice alcohol and drug counseling unless qualified under subpart 5. 

Subp. 8.Student interns.  
A qualified staff person must supervise and be responsible for all treatment services performed by student interns and must review and sign all assessments, progress notes, and treatment plans prepared by the intern. Student interns must meet the requirements in subpart 1, item A, and receive the orientation and training required in part 9530.6460, subpart 1, item G, and subpart 2. 

Subp. 9.Individuals with temporary permit.  
Individuals with a temporary permit from the Board of Behavioral Health and Therapy may provide chemical dependency treatment services under the conditions in either item A or B. 

A.
 The individual is supervised by a licensed alcohol and drug counselor assigned by the license holder. The licensed alcohol and drug counselor must document the amount and type of supervision at least weekly. The supervision must relate to clinical practices. One licensed alcohol and drug counselor may not supervise more than three individuals with temporary permits, according to Minnesota Statutes, section 148C.01, subdivision 12a. 

B.
 The individual is supervised by a clinical supervisor approved by the Board of Behavioral Health and Therapy. The supervision must be documented and meet the requirements of Minnesota Statutes, section 148C.044, subdivision 4. 

9530.6455PROVIDER POLICIES AND PROCEDURES. 
License holders must develop a written policy and procedures manual indexed according to Minnesota Statutes, section 245A.04, subdivision 14, paragraph (c), so that staff may have immediate access to all policies and procedures and so that consumers of the services and other authorized parties may have access to all policies and procedures. The manual must contain the following materials: 

A.
 assessment and treatment planning policies, which include screening for mental health concerns, and the inclusion of treatment objectives related to identified mental health concerns in the client's treatment plan; 

B.
 policies and procedures regarding HIV that comply with Minnesota Statutes, section 245A.19; 

C.
 the methods and resources used by the license holder to provide information on tuberculosis and tuberculosis screening to all clients and to report known cases of tuberculosis infection according to Minnesota Statutes, section 144.4804; 

D.
 personnel policies that comply with part 9530.6460; 

E.
 policies and procedures that protect client rights as required under part 9530.6470; 

F.
 a medical services plan that complies with part 9530.6435; 

G.
 emergency procedures that comply with part 9530.6475; 

H.
 policies and procedures for maintaining client records under part 9530.6440; 

I.
 procedures for reporting the maltreatment of minors under Minnesota Statutes, section 626.556, and vulnerable adults under Minnesota Statutes, sections 245A.65, 626.557, and 626.5572; 

J.
 a description of treatment services including the amount and type of client services provided; 

K.
 the methods used to achieve desired client outcomes; and 

L.
 the hours of operation and target population served. 

9530.6460PERSONNEL POLICIES AND PROCEDURES. Subpart 1.Policy requirements.  
License holders must have written personnel policies and must make them available to each staff member. The policies must: 

A.
 assure that staff member retention, promotion, job assignment, or pay are not affected by a good faith communication between a staff member and the Department of Health, the Department of Human Services, the ombudsman for mental health and developmental disabilities, law enforcement, or local agencies for the investigation of complaints regarding a client's rights, health, or safety; 

B.
 contain job descriptions for each position specifying responsibilities, degree of authority to execute job responsibilities, and qualifications; 

C.
 provide for job performance evaluations based on standards of job performance to be conducted on a regular and continuing basis, including a written annual review; 

D.
 describe behavior that constitutes grounds for disciplinary action, suspension or dismissal, including policies that address chemical use problems and meet the requirements of part 9530.6450, subpart 1, policies prohibiting personal involvement with clients in violation of Minnesota Statutes, chapter 604, and policies prohibiting client abuse as specified under Minnesota Statutes, sections 245A.65, 626.556, 626.557, and 626.5572; 

E.
 list behaviors or incidents that are considered chemical use problems. The list must include: 

(1)
 receiving treatment for chemical use within the period specified for the position in the staff qualification requirements; 

(2)
 chemical use that has a negative impact on the staff member's job performance; 

(3)
 chemical use that affects the credibility of treatment services with clients, referral sources, or other members of the community; and 

(4)
 symptoms of intoxication or withdrawal on the job; 

F.
 include a chart or description of the organizational structure indicating lines of authority and responsibilities; 

G.
 include orientation within 24 working hours of starting for all new staff based on a written plan that, at a minimum, must provide for training related to the specific job functions for which the staff member was hired, policies and procedures, client confidentiality, the human immunodeficiency virus minimum standards, and client needs; and 

H.
 policies outlining the license holder's response to staff members with behavior problems that interfere with the provision of treatment services. 

Subp. 2.Staff development.  
A license holder must ensure that each staff person has the training required in items A to E.  

A.
 All staff must be trained every two years in client confidentiality rules and regulations and client ethical boundaries. 

B.
 All staff must be trained every two years in emergency procedures and client rights as specified in Minnesota Statutes, sections 144.651, 148F.165, and 253B.03. 

C.
 All staff with direct client contact must be trained every year on mandatory reporting as specified under Minnesota Statutes, sections 245A.65, 626.556, 626.5561, 626.5563, 626.557, and 626.5572, including specific training covering the facility's policies concerning obtaining client releases of information. 

D.
 All staff with direct client contact must receive training upon hiring and annually thereafter on the human immunodeficiency virus minimum standards according to Minnesota Statutes, section 245A.19. 

E.
 Treatment directors, supervisors, nurses, and counselors must obtain 12 hours of training in co-occurring mental health problems and substance use disorder that includes competencies related to philosophy, screening, assessment, diagnosis and treatment planning, documentation, programming, medication, collaboration, mental health consultation, and discharge planning. Staff employed by a license holder on the date this rule is adopted must obtain the training within 12 months of the date of adoption. New staff who have not obtained such training must obtain it within 12 months of the date this rule is adopted or within six months of hire, whichever is later. Staff may request, and the license holder may grant credit for, relevant training obtained prior to January 1, 2005. 

Subp. 3.Personnel files.  
The license holder must maintain a separate personnel file for each staff member. At a minimum, the personnel file must be maintained to meet the requirements under parts 9530.6405 to 9530.6505 and contain the following: 

A.
 a completed application for employment signed by the staff member and containing the staff member's qualifications for employment; 

B.
 documentation related to the applicant's background study data, as defined in Minnesota Statutes, chapter 245C; 

C.
 for staff members who will be providing psychotherapy services, employer names and addresses for the past five years for which the staff member provided psychotherapy services, and documentation of an inquiry made to these former employers regarding substantiated sexual contact with a client as required by Minnesota Statutes, chapter 604; 

D.
 documentation of completed orientation and training; 

E.
 documentation demonstrating compliance with parts 9530.6450 and 9530.6485, subpart 2; and 

F.
 documentation demonstrating compliance with part 9530.6435, subpart 3, for staff members who administer medications. 

9530.6465SERVICE INITIATION AND TERMINATION POLICIES. Subpart 1.Service initiation policy.  
A license holder must have a written service initiation policy containing service initiation preferences which comply with this rule and Code of Federal Regulations, title 45, part 96.131, and specific service initiation criteria. The license holder must not initiate services for individuals who do not meet the service initiation criteria. The service initiation criteria must be either posted in the area of the facility where services for clients are initiated, or given to all interested persons upon request. Titles of all staff members authorized to initiate services for clients must be listed in the services initiation and termination policies. A license holder that serves intravenous drug abusers must have a written policy that provides service initiation preference as required by Code of Federal Regulations, title 45, part 96.131. 

Subp. 2.License holder responsibilities; terminating or denying services.  
A license holder has specific responsibilities when terminating services or denying treatment service initiation to clients for reasons of health, behavior, or criminal activity. 

A.
 The license holder must have and comply with a written protocol for assisting clients in need of care not provided by the license holder, and for clients who pose a substantial likelihood of harm to themselves or others, if the behavior is beyond the behavior management capabilities of the staff. All service terminations and denials of service initiation which pose an immediate threat to the health of any individual or require immediate medical intervention must be referred to a medical facility capable of admitting the individual. 

B.
 All service termination policies and denials of service initiation that involve the commission of a crime against a license holder's staff member or on a license holder's property, as provided under Code of Federal Regulations, title 42, section 2.12(c)(5), and Code of Federal Regulations, title 45, parts 160 to 164, must be reported to a law enforcement agency with proper jurisdiction. 

Subp. 3.Service termination and transfer policies.  
A license holder must have a written policy specifying the conditions under which clients must be discharged. The policy must include: 

A.
 procedures for individuals whose services have been terminated under subpart 2; 

B.
 a description of client behavior that constitutes reason for a staff-requested service termination and a process for providing this information to clients; 

C.
 procedures consistent with Minnesota Statutes, section 253B.16, subdivision 2, that staff must follow when a client admitted under Minnesota Statutes, chapter 253B, is to have services terminated; 

D.
 procedures staff must follow when a client leaves against staff or medical advice and when the client may be dangerous to self or others; 

E.
 procedures for communicating staff-approved service termination criteria to clients, including the expectations in the client's individual treatment plan according to part 9530.6425; and 

F.
 titles of staff members authorized to terminate client services must be listed in the service initiation and termination policies. 

9530.6470POLICIES AND PROCEDURES THAT PROTECT CLIENT RIGHTS. Subpart 1.Client rights; explanation.  
Clients have the rights identified in Minnesota Statutes, sections 144.651, 148F.165, and 253B.03, as applicable. The license holder must give each client upon service initiation a written statement of client's rights and responsibilities. Staff must review the statement with clients at that time. 

Subp. 2.Grievance procedure.  
Upon service initiation, the license holder must explain the grievance procedure to the client or their representative. The grievance procedure must be posted in a place visible to clients, and made available upon a client's request. The grievance procedure must also be made available to former clients upon request. The grievance procedure must require that: 

A.
 staff help the client develop and process a grievance; 

B.
 telephone numbers and addresses of the Department of Human Services, licensing division; the Office of Ombudsman for Mental Health and Developmental Disabilities; the Minnesota Department of Health, Office of Alcohol and Drug Counselor Licensing Program, and Office of Health Facilities Complaints; when applicable, be made available to clients; and 

C.
 a license holder be obligated to respond to the client's grievance within three days of a staff member's receipt of the grievance, and the client be permitted to bring the grievance to the highest level of authority in the program if not resolved by other staff members. 

Subp. 3.Photographs of client.  
All photographs, video tapes, and motion pictures of clients taken in the provision of treatment services are considered client records. Photographs for identification and recordings by video and audio tape for the purpose of enhancing either therapy or staff supervision may be required of clients, but may only be available for use as communications within a program. Clients must be informed when their actions are being recorded by camera or tape, and have the right to deny any taping or photography, except as authorized by this subpart. 

9530.6475BEHAVIORAL EMERGENCY PROCEDURES. A.
 A license holder or applicant must have written procedures that staff must follow when responding to a client who exhibits behavior that is threatening to the safety of the client or others. The procedures must include: 

(1)
 a plan designed to prevent the client from hurting themselves or others; 

(2)
 contact information for emergency resources that staff must consult when a client's behavior cannot be controlled by the procedures established in the plan; 

(3)
 types of procedures that may be used; 

(4)
 circumstances under which emergency procedures may be used; and 

(5)
 staff members authorized to implement emergency procedures. 

B.
 Behavioral emergency procedures must not be used to enforce facility rules or for the convenience of staff. Behavioral emergency procedures must not be part of any client's treatment plan, or used at any time for any reason except in response to specific current behaviors that threaten the safety of the client or others. Behavioral emergency procedures may not include the use of seclusion or restraint. 

9530.6480EVALUATION. Subpart 1.Participation in drug and alcohol abuse normative evaluation system.  
License holders must participate in the drug and alcohol abuse normative evaluation system by submitting information about each client to the commissioner in a format specified by the commissioner. 

Subp. 2.Commissioner requests.  
A license holder must submit additional information requested by the commissioner that is necessary to meet statutory or federal funding requirements. 

9530.6485LICENSE HOLDERS SERVING ADOLESCENTS. Subpart 1.License holders serving adolescents.  
A residential treatment program that serves persons under 18 years of age must be licensed as a residential program for children in out-of-home placement by the department unless the license holder is exempt under Minnesota Statutes, section 245A.03, subdivision 2. 

Subp. 2.Alcohol and drug counselor qualifications.  
In addition to the requirements specified in part 9530.6450, subparts 1 and 5, an alcohol and drug counselor providing treatment services to adolescents must have: 

A.
 an additional 30 hours of classroom instruction or one three-credit semester college course in adolescent development. This training need only be completed one time; and 

B.
 at least 150 hours of supervised experience as an adolescent counselor, either as a student or as a staff member. 

Subp. 3.Staffing ratios.  
At least 25 percent of a counselor's scheduled work hours must be allocated to indirect services, including documentation of client services, coordination of services with others, treatment team meetings, and other duties. A counseling group consisting entirely of adolescents must not exceed 16 clients. It is the responsibility of the license holder to determine an acceptable group size based on the needs of the clients. 

Subp. 4.Academic program requirements.  
Clients who are required to attend school must be enrolled and attending an educational program that has been approved by the Minnesota Department of Education. 

Subp. 5.Program requirements.  
In addition to the requirements specified in the client's treatment plan under part 9530.6425, programs serving adolescents must include the following: 

A.
 coordination with the school system to address the client's academic needs; 

B.
 when appropriate, a plan that addresses the client's leisure activities without chemical use; and 

C.
 a plan that addresses family involvement in the adolescent's treatment. 

9530.6490LICENSE HOLDERS SERVING CLIENTS WITH CHILDREN. Subpart 1.Health license requirements.  
In addition to the requirements of parts 9530.6405 to 9530.6480, all license holders that offer supervision of children of clients are subject to the requirements of this part. License holders providing room and board for clients and their children must have an appropriate facility license from the Minnesota Department of Health. 

Subp. 2.Supervision of children defined.  
"Supervision of children" means a caregiver is within sight or hearing of an infant, toddler, or preschooler at all times so that the caregiver can intervene to protect the health and safety of the child. For the school age child it means a caregiver is available to help and care for the child so that the child's health and safety is protected. 

Subp. 3.Policy and schedule required.  
License holders must meet the following requirements: 

A.
 license holders must have a policy and schedule delineating the times and circumstances under which the license holder is responsible for supervision of children in the program and when the child's parents are responsible for child supervision. The policy must explain how the program will communicate its policy about child supervision responsibility to the parents; and 

B.
 license holders must have written procedures addressing the actions to be taken by staff if children are neglected or abused including while the children are under the supervision of their parents. 

Subp. 4.Additional licensing requirements.  
During the times the license holder is responsible for the supervision of children, the license holder must meet the following standards: 

A.
 child and adult ratios in part 9502.0367; 

B.
 day care training in Minnesota Statutes, section 245A.50; 

C.
 behavior guidance in part 9502.0395; 

D.
 activities and equipment in part 9502.0415; 

E.
 physical environment in part 9502.0425; and 

F.
 water, food, and nutrition in part 9502.0445, unless the license holder has a license from the Minnesota Department of Health. 

9530.6495LICENSE HOLDERS SERVING PERSONS WITH SUBSTANCE USE AND MENTAL HEALTH DISORDERS. 
In addition to meeting the requirements of parts 9530.6405 to 9530.6490, license holders specializing in the treatment of persons with substance use disorder and mental health problems must: 

A.
 demonstrate that staffing levels are appropriate for treating clients with substance use disorder and mental health problems, and that there is adequate staff with mental health training; 

B.
 have continuing access to a medical provider with appropriate expertise in prescribing psychotropic medications; 

C.
 have a mental health professional available for staff supervision and consultation; 

D.
 determine group size, structure, and content with consideration for the special needs of those with substance use disorder and mental health disorders; 

E.
 have documentation of active interventions to stabilize mental health symptoms present in treatment plans and progress notes; 

F.
 have continuing documentation of collaboration with continuing care mental health providers, and involvement of those providers in treatment planning meetings; 

G.
 have available program materials adapted to individuals with mental health problems; 

H.
 have policies that provide flexibility for clients who may lapse in treatment or may have difficulty adhering to established treatment rules as a result of a mental illness, with the goal of helping clients successfully complete treatment; and 

I.
 have individual psychotherapy and case management available during the treatment process. 

9530.6500PROGRAMS SERVING INTRAVENOUS DRUG ABUSERS. Subpart 1.Additional requirements.  
In addition to the requirements of parts 9530.6405 to 9530.6505, programs serving intravenous drug abusers must comply with the requirements of this part. 

Subp. 2.Capacity management and waiting list system compliance.  
A program serving intravenous drug abusers must notify the department within seven days of when the program reaches both 90 and 100 percent of the program's capacity to care for clients. Each week, the program must report its capacity, current enrolled dosing clients, and any waiting list. A program reporting 90 percent of capacity must also notify the department when its census has increased or decreased from the 90 percent level. 

Subp. 3.Waiting list.  
A program serving intravenous drug abusers must have a waiting list system. Each person seeking admission must be placed on the waiting list if the person cannot be admitted within 14 days of the date of application, unless the applicant is assessed by the program and found not to be eligible for admission according to parts 9530.6405 to 9530.6505, and Code of Federal Regulations, title 42, part 1, subchapter A, section 8.12(e), and Code of Federal Regulations, title 45, parts 160 to 164. The waiting list must assign a unique patient identifier for each intravenous drug abuser seeking treatment while awaiting admission. An applicant on a waiting list who receives no services under part 9530.6430, subpart 1, must not be considered a "client" as defined in part 9530.6405, subpart 8. 

Subp. 4.Client referral.  
Programs serving intravenous drug abusers must consult the capacity management system so that persons on waiting lists are admitted at the earliest time to a program providing appropriate treatment within a reasonable geographic area. If the patient has been referred through a public payment system and if the program is not able to serve the client within 14 days of the date of application for admission, the program must contact and inform the referring agency of any available treatment capacity listed in the state capacity management system. 

Subp. 5.Outreach.  
Programs serving intravenous drug abusers must carry out activities to encourage individuals in need of treatment to undergo treatment. The program's outreach model must: 

A.
 select, train, and supervise outreach workers; 

B.
 contact, communicate, and follow up with high risk substance abusers, their associates, and neighborhood residents within the constraints of federal and state confidentiality requirements, including Code of Federal Regulations, title 42, sections 2.1 to 2.67, and Code of Federal Regulations, title 45, parts 160 to 164; 

C.
 promote awareness among injecting drug abusers about the relationship between injecting drug abuse and communicable diseases such as HIV; and 

D.
 recommend steps that can be taken to ensure that HIV transmission does not occur. 

Subp. 6.Central registry.  
Programs serving intravenous drug abusers must comply with requirements to submit information and necessary consents to the state central registry for each client admitted, as specified by the commissioner. The client's failure to provide the information will prohibit involvement in an opiate treatment program. The information submitted must include the client's: 

A.
 full name and all aliases; 

B.
 date of admission; 

C.
 date of birth; 

D.
 Social Security number or INS number, if any; 

E.
 enrollment status in other current or last known opiate treatment programs; 

F.
 government-issued photo-identification card number; and 

G.
 driver's license number, if any. 

The information in items A to G must be submitted in a format prescribed by the commissioner, with the original kept in the client's chart, whenever a client is accepted for treatment, the client's type or dosage of a drug is changed, or the client's treatment is interrupted, resumed, or terminated. 

9530.6505REQUIREMENTS FOR LICENSED RESIDENTIAL TREATMENT. Subpart 1.Applicability.  
A license holder who provides supervised room and board at the licensed program site as a treatment component is defined as a residential program according to Minnesota Statutes, section 245A.02, subdivision 14, and is subject to this part. 

Subp. 2.Visitors.  
Clients must be allowed to receive visitors at times prescribed by the license holder. The license holder must set and post a notice of visiting rules and hours, including both day and evening times. A client's right to receive visitors other than a personal physician, religious advisor, county case manager, parole or probation officer, or attorney may be subject to visiting hours established by the license holder for all clients. The treatment director or designee may impose limitations as necessary for the welfare of a client provided that limitations and the reasons for them are documented in the client's file. Clients must be allowed to receive visits at all reasonable times from their personal physicians, religious advisors, county case managers, parole or probation officers, and attorneys. 

Subp. 3.Client property management.  
A license holder who provides room and board and treatment services to clients in the same facility, and any license holder that accepts client property must meet the requirements in Minnesota Statutes, section 245A.04, subdivision 13, for handling resident funds and property. In the course of client property management, license holders: 

A.
 may establish policies regarding the use of personal property to assure that treatment activities and the rights of other patients are not infringed; 

B.
 may take temporary custody of property for violation of facility policies; 

C.
 must retain the client's property for a minimum of seven days after discharge if the client does not reclaim property upon service termination, or for a minimum of 30 days if the client does not reclaim property upon service termination and has received room and board services from the license holder; and 

D.
 must return all property held in trust to the client upon service termination regardless of the client's service termination status, except: 

(1)
 drugs, drug paraphernalia, and drug containers that are forfeited under Minnesota Statutes, section 609.5316, must be destroyed by staff or given over to the custody of a local law enforcement agency, according to Code of Federal Regulations, title 42, chapter 1, part 2, subpart B, sections 2.1 to 2.67, and Code of Federal Regulations, title 45, parts 160 to 164; 

(2)
 weapons, explosives, and other property which can cause serious harm to self or others must be given over to the custody of a local law enforcement agency, and the client must be notified of the transfer and of the right to reclaim any lawful property transferred; and 

(3)
 medications that have been determined by a physician to be harmful after examining the client, except when the client's personal physician approves the medication for continued use. 

Subp. 4.Health facility license.  
A license holder who provides room and board and treatment services in the same facility must have the appropriate license from the Department of Health. 

Subp. 5.Facility abuse prevention plan.  
A license holder must establish and enforce an ongoing facility abuse prevention plan consistent with Minnesota Statutes, sections 245A.65 and 626.557, subdivision 14. 

Subp. 6.Individual abuse prevention plan.  
A license holder must prepare an individual abuse prevention plan for each client as specified under Minnesota Statutes, sections 245A.65, subdivision 2, and 626.557, subdivision 14. 

Subp. 7.Health services.  
License holders must have written procedures for assessing and monitoring client health, including a standardized data collection tool for collecting health-related information about each client. The policies and procedures must be approved and signed by a registered nurse. 

Subp. 8.Administration of medications.  
License holders must meet the administration of medications requirements of part 9530.6435, subpart 3.