1.1 	A bill for an act
1.2 	relating to human services; modifying provisions governing children and families, 
1.3 	licensing, state-operated services, chemical and mental health, community supports 
1.4 	and continuing care, and health care; requiring reports; appropriating money;
1.5 	amending Minnesota Statutes 2016, sections 119B.011, subdivision 19, by adding 
1.6 	a subdivision; 119B.02, subdivision 7; 119B.03, subdivision 9; 245.4889, by adding 
1.7 	a subdivision; 245A.175; 245D.071, subdivision 5; 245D.091, subdivisions 2, 3, 
1.8 	4; 254A.035, subdivision 2; 254B.02, subdivision 1; 254B.06, subdivision 1; 
1.9 	256B.0625, by adding subdivisions; 256B.0659, subdivisions 3a, 11, 21, 24, 28, 
1.10 	by adding a subdivision; 256B.0915, subdivision 6; 256B.092, subdivisions 1b, 
1.11 	1g; 256B.4914, subdivision 4; 256I.04, by adding subdivisions; 256K.45, 
1.12 	subdivision 2; 256M.41, subdivision 3, by adding a subdivision; 256N.24, by 
1.13 	adding a subdivision; 260.835, subdivision 2; 626.556, by adding a subdivision; 
1.14 	Minnesota Statutes 2017 Supplement, sections 119B.011, subdivision 20; 119B.025, 
1.15 	subdivision 1; 119B.06, subdivision 1; 119B.09, subdivision 1; 119B.095, 
1.16 	subdivision 2; 119B.13, subdivision 1; 245.4889, subdivision 1; 245A.03, 
1.17 	subdivision 7; 245A.06, subdivision 8; 245A.11, subdivision 2a; 245D.03, 
1.18 	subdivision 1; 256B.0625, subdivision 17; 256B.0911, subdivisions 1a, 3a, 3f, 5; 
1.19 	256B.49, subdivision 13; 256B.4914, subdivisions 2, 3, 5, 10, 10a; 256I.03, 
1.20 	subdivision 8; 256I.04, subdivision 2b; 256I.05, subdivision 3; Laws 2014, chapter 
1.21 	312, article 27, section 76; Laws 2017, First Special Session chapter 6, article 1, 
1.22 	section 52; article 3, section 49; proposing coding for new law in Minnesota 
1.23 	Statutes, chapters 246; 260C; repealing Minnesota Statutes 2016, sections 
1.24 	256B.0625, subdivision 18b; 256B.0705.
1.25 	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

1.26 	ARTICLE 1
1.27 	CHILDREN AND FAMILIES; LICENSING

1.28 	Section 1. Minnesota Statutes 2016, section 119B.011, is amended by adding a subdivision 
1.29 	to read:
2.1 		Subd. 13b.Homeless. "Homeless" means a self-declared housing status as defined in 
2.2 	the McKinney-Vento Homeless Assistance Act and United States Code, title 42, section 
2.3 	11302, paragraph (a).

2.4 	EFFECTIVE DATE. This section is effective August 12, 2019.

2.5 	Sec. 2. Minnesota Statutes 2016, section 119B.011, subdivision 19, is amended to read:
2.6 		Subd. 19.Provider. "Provider" means: (1) an individual or child care center or facility, 
2.7 	either licensed or unlicensed, providing licensed legal child care services as defined under 
2.8 	section 245A.03; or (2) a license exempt center required to be certified under chapter 245G;
2.9 	(3) an individual or child care center or facility holdingthat:
2.10 	(i) holds a valid child care license issued by another state or a tribe and providing;
2.11 	(ii) provides child care services in the licensing state or in the area under the licensing 
2.12 	tribe's jurisdiction; and
2.13 	(iii) is in compliance with federal health and safety requirements as certified by the 
2.14 	licensing state or tribe, or as determined by receipt of child care development block grant 
2.15 	funds in the licensing state; or
2.16 	(4) a legal nonlicensed child care provider as defined under section 119B.011, subdivision 
2.17 	16, providing legal child care services. A legally unlicensed familylegal nonlicensed child 
2.18 	care provider must be at least 18 years of age, and not a member of the MFIP assistance 
2.19 	unit or a member of the family receiving child care assistance to be authorized under this 
2.20 	chapter.

2.21 	EFFECTIVE DATE. This section is effective September 24, 2018.

2.22 	Sec. 3. Minnesota Statutes 2017 Supplement, section 119B.011, subdivision 20, is amended 
2.23 	to read:
2.24 		Subd. 20.Transition year families. "Transition year families" means families who have 
2.25 	received MFIP assistance, or who were eligible to receive MFIP assistance after choosing 
2.26 	to discontinue receipt of the cash portion of MFIP assistance under section 256J.31, 
2.27 	subdivision 12, or families who have received DWP assistance under section 256J.95 for 
2.28 	at least three one of the last six months before losing eligibility for MFIP or DWP. 
2.29 	Notwithstanding Minnesota Rules, parts 3400.0040, subpart 10, and 3400.0090, subpart 2, 
2.30 	transition year child care may be used to support employment, approved education or training 
2.31 	programs, or job search that meets the requirements of section 119B.10. Transition year 
3.1 	child care is not available to families who have been disqualified from MFIP or DWP due 
3.2 	to fraud.

3.3 	EFFECTIVE DATE. This section is effective October 8, 2018.

3.4 	Sec. 4. Minnesota Statutes 2016, section 119B.02, subdivision 7, is amended to read:
3.5 		Subd. 7.Child care market rate survey. Biennially, The commissioner shall conduct 
3.6 	the next survey of prices charged by child care providers in Minnesota in state fiscal year 
3.7 	2021 and every three years thereafter to determine the 75th percentile for like-care 
3.8 	arrangements in county price clusters.

3.9 	Sec. 5. Minnesota Statutes 2017 Supplement, section 119B.025, subdivision 1, is amended 
3.10 	to read:
3.11 		Subdivision 1.Applications. (a) Except as provided in paragraph (c), clause (4), the 
3.12 	county shall verify the following at all initial child care applications using the universal 
3.13 	application:
3.14 	(1) identity of adults;
3.15 	(2) presence of the minor child in the home, if questionable;
3.16 	(3) relationship of minor child to the parent, stepparent, legal guardian, eligible relative 
3.17 	caretaker, or the spouses of any of the foregoing;
3.18 	(4) age;
3.19 	(5) immigration status, if related to eligibility;
3.20 	(6) Social Security number, if given;
3.21 	(7) counted income;
3.22 	(8) spousal support and child support payments made to persons outside the household;
3.23 	(9) residence; and
3.24 	(10) inconsistent information, if related to eligibility.
3.25 	(b) The county must mail a notice of approval or denial of assistance to the applicant 
3.26 	within 30 calendar days after receiving the application. The county may extend the response 
3.27 	time by 15 calendar days if the applicant is informed of the extension.
3.28 	(c) For an applicant who declares that the applicant is homeless and who meets the 
3.29 	definition of homeless in section 119B.011, subdivision 13b, the county must:
4.1 	(1) if information is needed to determine eligibility, send a request for information to 
4.2 	the applicant within five working days after receiving the application;
4.3 	(2) if the applicant is eligible, send a notice of approval of assistance within five working 
4.4 	days after receiving the application;
4.5 	(3) if the applicant is ineligible, send a notice of denial of assistance within 30 days after 
4.6 	receiving the application. The county may extend the response time by 15 calendar days if 
4.7 	the applicant is informed of the extension;
4.8 	(4) not require verifications required by paragraph (a) before issuing the notice of approval 
4.9 	or denial; and
4.10 	(5) follow limits set by the commissioner for how frequently expedited application 
4.11 	processing may be used for an applicant who declares that the applicant is homeless.
4.12 	(d) An applicant who declares that the applicant is homeless must submit proof of 
4.13 	eligibility within three months of the date the application was received. If proof of eligibility 
4.14 	is not submitted within three months, eligibility ends. A 15-day adverse action notice is 
4.15 	required to end eligibility.

4.16 	EFFECTIVE DATE. This section is effective August 12, 2019.

4.17 	Sec. 6. Minnesota Statutes 2016, section 119B.03, subdivision 9, is amended to read:
4.18 		Subd. 9.Portability pool. (a) The commissioner shall establish a pool of up to five 
4.19 	percent of the annual appropriation for the basic sliding fee program to provide continuous 
4.20 	child care assistance for eligible families who move between Minnesota counties. At the 
4.21 	end of each allocation period, any unspent funds in the portability pool must be used for 
4.22 	assistance under the basic sliding fee program. If expenditures from the portability pool 
4.23 	exceed the amount of money available, the reallocation pool must be reduced to cover these 
4.24 	shortages.
4.25 	(b) To be eligible for portable basic sliding fee assistance, A family that has moved from 
4.26 	a county in which it was receiving basic sliding fee assistance to a county with a waiting 
4.27 	list for the basic sliding fee program must:
4.28 	(1) meet the income and eligibility guidelines for the basic sliding fee program; and
4.29 	(2) notify the new county of residence within 60 days of moving and submit information 
4.30 	to the new county of residence to verify eligibility for the basic sliding fee program the 
4.31 	family's previous county of residence of the family's move to a new county of residence.
4.32 	(c) The receiving county must:
5.1 	(1) accept administrative responsibility for applicants for portable basic sliding fee 
5.2 	assistance at the end of the two months of assistance under the Unitary Residency Act;
5.3 	(2) continue portability pool basic sliding fee assistance for the lesser of six months or
5.4 	until the family is able to receive assistance under the county's regular basic sliding program; 
5.5 	and
5.6 	(3) notify the commissioner through the quarterly reporting process of any family that 
5.7 	meets the criteria of the portable basic sliding fee assistance pool.

5.8 	EFFECTIVE DATE. This section is effective October 8, 2018.

5.9 	Sec. 7. Minnesota Statutes 2017 Supplement, section 119B.06, subdivision 1, is amended 
5.10 	to read:
5.11 		Subdivision 1.Commissioner to administer block grant. The commissioner is 
5.12 	authorized and directed to receive, administer, and expend child care funds available under 
5.13 	the child care and development block grant authorized under the Child Care and Development 
5.14 	Block Grant Act of 2014, Public Law 113-186. From the discretionary amounts provided 
5.15 	for federal fiscal year 2018 and reserved for quality activities, the commissioner shall ensure 
5.16 	that funds are prioritized to increase the availability of training and business planning 
5.17 	assistance for child care providers.

5.18 	Sec. 8. Minnesota Statutes 2017 Supplement, section 119B.09, subdivision 1, is amended 
5.19 	to read:
5.20 		Subdivision 1.General eligibility requirements. (a) Child care services must be 
5.21 	available to families who need child care to find or keep employment or to obtain the training 
5.22 	or education necessary to find employment and who:
5.23 	(1) have household income less than or equal to 67 percent of the state median income, 
5.24 	adjusted for family size, at application and redetermination, and meet the requirements of 
5.25 	section 119B.05; receive MFIP assistance; and are participating in employment and training 
5.26 	services under chapter 256J; or
5.27 	(2) have household income less than or equal to 47 percent of the state median income, 
5.28 	adjusted for family size, at application and less than or equal to 67 percent of the state 
5.29 	median income, adjusted for family size, at redetermination.
5.30 	(b) Child care services must be made available as in-kind services.
6.1 	(c) All applicants for child care assistance and families currently receiving child care 
6.2 	assistance must be assisted and required to cooperate in establishment of paternity and 
6.3 	enforcement of child support obligations for all children in the family at application and 
6.4 	redetermination as a condition of program eligibility. For purposes of this section, a family 
6.5 	is considered to meet the requirement for cooperation when the family complies with the 
6.6 	requirements of section 256.741.
6.7 	(d) All applicants for child care assistance and families currently receiving child care 
6.8 	assistance must pay the co-payment fee under section 119B.12, subdivision 2, as a condition 
6.9 	of eligibility. The co-payment fee may include additional recoupment fees due to a child 
6.10 	care assistance program overpayment.
6.11 	(e) If a family has one child with a child care authorization and the child turns 13 years 
6.12 	of age or the child has a disability and turns 15 years of age, the family remains eligible 
6.13 	until the redetermination.

6.14 	Sec. 9. Minnesota Statutes 2017 Supplement, section 119B.095, subdivision 2, is amended 
6.15 	to read:
6.16 		Subd. 2.Maintain steady child care authorizations. (a) Notwithstanding Minnesota 
6.17 	Rules, chapter 3400, the amount of child care authorized under section 119B.10 for 
6.18 	employment, education, or an MFIP or DWP employment plan shall continue at the same 
6.19 	number of hours or more hours until redetermination, including:
6.20 	(1) when the other parent moves in and is employed or has an education plan under 
6.21 	section 119B.10, subdivision 3, or has an MFIP or DWP employment plan; or
6.22 	(2) when the participant's work hours are reduced or a participant temporarily stops 
6.23 	working or attending an approved education program. Temporary changes include, but are 
6.24 	not limited to, a medical leave, seasonal employment fluctuations, or a school break between 
6.25 	semesters.
6.26 	(b) The county may increase the amount of child care authorized at any time if the 
6.27 	participant verifies the need for increased hours for authorized activities.
6.28 	(c) The county may reduce the amount of child care authorized if a parent requests a 
6.29 	reduction or because of a change in:
6.30 	(1) the child's school schedule;
6.31 	(2) the custody schedule; or
6.32 	(3) the provider's availability.
7.1 	(d) The amount of child care authorized for a family subject to subdivision 1, paragraph 
7.2 	(b), must change when the participant's activity schedule changes. Paragraph (a) does not 
7.3 	apply to a family subject to subdivision 1, paragraph (b).
7.4 	(e) When a child reaches 13 years of age or a child with a disability reaches 15 years of 
7.5 	age, the amount of child care authorized shall continue at the same number of hours or more 
7.6 	hours until redetermination.

7.7 	Sec. 10. Minnesota Statutes 2017 Supplement, section 119B.13, subdivision 1, is amended 
7.8 	to read:
7.9 		Subdivision 1.Subsidy restrictions. (a) Beginning February 3, 2014, The maximum 
7.10 	rate paid for child care assistance in any county or county price cluster under the child care 
7.11 	fund shall be the greater of the 25th percentile calculated by the commissioner of the 2011
7.12 	most recent child care provider rate survey under section 119B.02, subdivision 7, or the 
7.13 	maximum rate effective November 28, 2011 rates in effect at the time of the update:
7.14 	(1) for the first update on February 22, 2019, the commissioner shall determine the 
7.15 	percentile of the most recent child care provider rate survey, not to exceed the 25th percentile, 
7.16 	that can be funded using Minnesota's increase in federal child care and development funds 
7.17 	appropriated in the federal Consolidated Appropriations Act of 2018, Public Law 115-141, 
7.18 	and any subsequent federal appropriation for federal fiscal year 2019, after complying with 
7.19 	other requirements of the reauthorization of the Child Care Development Block Grant 
7.20 	(CCDBG) Act of 2014, enacted in state law in 2018; and
7.21 	(2) beginning in fiscal year 2022, the commissioner, in consultation with the 
7.22 	commissioner of management and budget, shall determine the amount of federal funding 
7.23 	for child care assistance programs to use in setting maximum rates for child care programs 
7.24 	based on the most recent market survey, not to exceed the 25th percentile, so that the cost 
7.25 	of compliance with child care development block grant requirements enacted in state law 
7.26 	in 2018, including the rate adjustment, are paid only with federal CCDBG funds. If federal 
7.27 	CCDBG funds are not sufficient to maintain the enacted compliance requirements and the 
7.28 	maximum rates in effect at the time of the rate change, the commissioner must adjust 
7.29 	maximum rates to remain within the limits of available funds.
7.30 	(b) For a child care provider located within the boundaries of a city located in two or 
7.31 	more of the counties of Benton, Sherburne, and Stearns, the maximum rate paid for child 
7.32 	care assistance shall be equal to the maximum rate paid in the county with the highest 
7.33 	maximum reimbursement rates or the provider's charge, whichever is less.
8.1 	(c) The commissioner may: (1) assign a county with no reported provider prices to a 
8.2 	similar price cluster; and (2) consider county level access when determining final price 
8.3 	clusters.
8.4 	(b)(d) A rate which includes a special needs rate paid under subdivision 3 may be in 
8.5 	excess of the maximum rate allowed under this subdivision.
8.6 	(c)(e) The department shall monitor the effect of this paragraph on provider rates. The 
8.7 	county shall pay the provider's full charges for every child in care up to the maximum 
8.8 	established. The commissioner shall determine the maximum rate for each type of care on 
8.9 	an hourly, full-day, and weekly basis, including special needs and disability care.
8.10 	(d)(f) If a child uses one provider, the maximum payment for one day of care must not 
8.11 	exceed the daily rate. The maximum payment for one week of care must not exceed the 
8.12 	weekly rate.
8.13 	(e)(g) If a child uses two providers under section 119B.097, the maximum payment 
8.14 	must not exceed:
8.15 	(1) the daily rate for one day of care;
8.16 	(2) the weekly rate for one week of care by the child's primary provider; and
8.17 	(3) two daily rates during two weeks of care by a child's secondary provider.
8.18 	(f)(h) Child care providers receiving reimbursement under this chapter must not be paid 
8.19 	activity fees or an additional amount above the maximum rates for care provided during 
8.20 	nonstandard hours for families receiving assistance.
8.21 	(g)(i) If the provider charge is greater than the maximum provider rate allowed, the 
8.22 	parent is responsible for payment of the difference in the rates in addition to any family 
8.23 	co-payment fee.
8.24 	(h)(j) All maximum provider rates changes shall be implemented on the Monday 
8.25 	following the effective date of the maximum provider rate.
8.26 	(i)(k) Notwithstanding Minnesota Rules, part 3400.0130, subpart 7, maximum 
8.27 	registration fees in effect on January 1, 2013, shall remain in effect.

8.28 	EFFECTIVE DATE. This section is effective February 22, 2019.

9.1 	Sec. 11. Minnesota Statutes 2017 Supplement, section 245A.06, subdivision 8, is amended 
9.2 	to read:
9.3 		Subd. 8.Requirement to post correction order conditional license. (a) For licensed 
9.4 	family child care providers and child care centers, upon receipt of any correction order or
9.5 	order of conditional license issued by the commissioner under this section, and 
9.6 	notwithstanding a pending request for reconsideration of the correction order or order of 
9.7 	conditional license by the license holder, the license holder shall post the correction order 
9.8 	or order of conditional license in a place that is conspicuous to the people receiving services 
9.9 	and all visitors to the facility for two years. When the correction order or order of conditional 
9.10 	license is accompanied by a maltreatment investigation memorandum prepared under section 
9.11 	626.556 or 626.557, the investigation memoranda must be posted with the correction order 
9.12 	or order of conditional license.
9.13 	(b) If the commissioner reverses or rescinds a violation in a correction order upon 
9.14 	reconsideration under subdivision 2, the commissioner shall issue an amended correction 
9.15 	order and the license holder shall post the amended order according to paragraph (a).
9.16 	(c) If the correction order is rescinded or reversed in full upon reconsideration under 
9.17 	subdivision 2, the license holder shall remove the original correction order posted according 
9.18 	to paragraph (a).

9.19 	Sec. 12. Minnesota Statutes 2016, section 245A.175, is amended to read:
9.20 	245A.175 CHILD FOSTER CARE TRAINING REQUIREMENT; MENTAL 
9.21 	HEALTH TRAINING; FETAL ALCOHOL SPECTRUM DISORDERS TRAINING.
9.22 	Prior to a nonemergency placement of a child in a foster care home, the child foster care 
9.23 	license holder and caregivers in foster family and treatment foster care settings, and all staff 
9.24 	providing care in foster residence settings must complete two hours of training that addresses 
9.25 	the causes, symptoms, and key warning signs of mental health disorders; cultural 
9.26 	considerations; and effective approaches for dealing with a child's behaviors. At least one 
9.27 	hour of the annual training requirement for the foster family license holder and caregivers, 
9.28 	and foster residence staff must be on children's mental health issues and treatment. Except 
9.29 	for providers and services under chapter 245D, the annual training must also include at least 
9.30 	one hour of training on fetal alcohol spectrum disorders within the first 12 months of 
9.31 	licensure. After the first 12 months of licensure, training on fetal alcohol spectrum disorders 
9.32 	may count, which must be counted toward the 12 hours of required in-service training per 
9.33 	year. Short-term substitute caregivers are exempt from these requirements. Training 
9.34 	curriculum shall be approved by the commissioner of human services.

10.1 	Sec. 13. Minnesota Statutes 2016, section 254A.035, subdivision 2, is amended to read:
10.2 		Subd. 2.Membership terms, compensation, removal and expiration. The membership 
10.3 	of this council shall be composed of 17 persons who are American Indians and who are 
10.4 	appointed by the commissioner. The commissioner shall appoint one representative from 
10.5 	each of the following groups: Red Lake Band of Chippewa Indians; Fond du Lac Band, 
10.6 	Minnesota Chippewa Tribe; Grand Portage Band, Minnesota Chippewa Tribe; Leech Lake 
10.7 	Band, Minnesota Chippewa Tribe; Mille Lacs Band, Minnesota Chippewa Tribe; Bois Forte 
10.8 	Band, Minnesota Chippewa Tribe; White Earth Band, Minnesota Chippewa Tribe; Lower 
10.9 	Sioux Indian Reservation; Prairie Island Sioux Indian Reservation; Shakopee Mdewakanton 
10.10 	Sioux Indian Reservation; Upper Sioux Indian Reservation; International Falls Northern 
10.11 	Range; Duluth Urban Indian Community; and two representatives from the Minneapolis 
10.12 	Urban Indian Community and two from the St. Paul Urban Indian Community. The terms, 
10.13 	compensation, and removal of American Indian Advisory Council members shall be as 
10.14 	provided in section 15.059. The council expires June 30, 2018 2023.

10.15 	Sec. 14. Minnesota Statutes 2016, section 256K.45, subdivision 2, is amended to read:
10.16 		Subd. 2.Homeless youth report. The commissioner shall prepare a biennial report, 
10.17 	beginning in February 2015, which provides meaningful information to the legislative 
10.18 	committees having jurisdiction over the issue of homeless youth, that includes, but is not 
10.19 	limited to: (1) a list of the areas of the state with the greatest need for services and housing 
10.20 	for homeless youth, and the level and nature of the needs identified; (2) details about grants 
10.21 	made; (3) the distribution of funds throughout the state based on population need; (4) 
10.22 	follow-up information, if available, on the status of homeless youth and whether they have 
10.23 	stable housing two years after services are provided; and (5) any other outcomes for 
10.24 	populations served to determine the effectiveness of the programs and use of funding. The 
10.25 	commissioner is exempt from preparing this report in 2019 and must instead update the 
10.26 	2007 report on homeless youth under section 22.

10.27 	Sec. 15. Minnesota Statutes 2016, section 256M.41, subdivision 3, is amended to read:
10.28 		Subd. 3.Payments based on performance. (a) The commissioner shall make payments 
10.29 	under this section to each county board on a calendar year basis in an amount determined 
10.30 	under paragraph (b) on or before July 10 of each year.
10.31 	(b) Calendar year allocations under subdivision 1 shall be paid to counties in the following 
10.32 	manner:
11.1 	(1) 80 percent of the allocation as determined in subdivision 1 must be paid to counties 
11.2 	on or before July 10 of each year;
11.3 	(2) ten percent of the allocation shall be withheld until the commissioner determines if 
11.4 	the county has met the performance outcome threshold of 90 percent based on face-to-face 
11.5 	contact with alleged child victims. In order to receive the performance allocation, the county 
11.6 	child protection workers must have a timely face-to-face contact with at least 90 percent of 
11.7 	all alleged child victims of screened-in maltreatment reports. The standard requires that 
11.8 	each initial face-to-face contact occur consistent with timelines defined in section 626.556, 
11.9 	subdivision 10, paragraph (i). The commissioner shall make threshold determinations in 
11.10 	January of each year and payments to counties meeting the performance outcome threshold 
11.11 	shall occur in February of each year. Any withheld funds from this appropriation for counties 
11.12 	that do not meet this requirement shall be reallocated by the commissioner to those counties 
11.13 	meeting the requirement; and
11.14 	(3) ten percent of the allocation shall be withheld until the commissioner determines 
11.15 	that the county has met the performance outcome threshold of 90 percent based on 
11.16 	face-to-face visits by the case manager. In order to receive the performance allocation, the 
11.17 	total number of visits made by caseworkers on a monthly basis to children in foster care 
11.18 	and children receiving child protection services while residing in their home must be at least 
11.19 	90 percent of the total number of such visits that would occur if every child were visited 
11.20 	once per month. The commissioner shall make such determinations in January of each year 
11.21 	and payments to counties meeting the performance outcome threshold shall occur in February 
11.22 	of each year. Any withheld funds from this appropriation for counties that do not meet this 
11.23 	requirement shall be reallocated by the commissioner to those counties meeting the 
11.24 	requirement. For 2015, the commissioner shall only apply the standard for monthly foster 
11.25 	care visits.
11.26 	(c) The commissioner shall work with stakeholders and the Human Services Performance 
11.27 	Council under section 402A.16 to develop recommendations for specific outcome measures 
11.28 	that counties should meet in order to receive funds withheld under paragraph (b), and include 
11.29 	in those recommendations a determination as to whether the performance measures under 
11.30 	paragraph (b) should be modified or phased out. The commissioner shall report the 
11.31 	recommendations to the legislative committees having jurisdiction over child protection 
11.32 	issues by January 1, 2018.

12.1 	Sec. 16. Minnesota Statutes 2016, section 256M.41, is amended by adding a subdivision 
12.2 	to read:
12.3 		Subd. 4.County performance on child protection measures. The commissioner shall 
12.4 	set child protection measures and standards. The commissioner shall require an 
12.5 	underperforming county to demonstrate that the county designated sufficient funds and 
12.6 	implemented a reasonable strategy to improve child protection performance, including the 
12.7 	provision of a performance improvement plan and additional remedies identified by the 
12.8 	commissioner. The commissioner may redirect up to 20 percent of a county's funds under 
12.9 	this section toward the performance improvement plan for a county not meeting child 
12.10 	protection standards and not demonstrating significant improvement. Sanctions under section 
12.11 	256M.20, subdivision 3, related to noncompliance with federal performance standards also 
12.12 	apply.

12.13 	Sec. 17. Minnesota Statutes 2016, section 256N.24, is amended by adding a subdivision 
12.14 	to read:
12.15 		Subd. 2a.Minnesota assessment of parenting for children and youth (MAPCY) 
12.16 	revision. The commissioner, in consultation with representatives from communities of 
12.17 	color, including but not limited to advisory councils and ombudspersons, shall review and 
12.18 	revise the MAPCY tool and incorporate changes that take into consideration different 
12.19 	cultures and the diverse needs of communities of color.

12.20 	Sec. 18. Minnesota Statutes 2016, section 260.835, subdivision 2, is amended to read:
12.21 		Subd. 2.Expiration. The American Indian Child Welfare Advisory Council expires 
12.22 	June 30, 2018 2023.

12.23 	Sec. 19. [260C.008] FOSTER CARE SIBLING BILL OF RIGHTS.
12.24 		Subdivision 1.Statement of rights. (a) A child placed in foster care who has a sibling 
12.25 	has the right to:
12.26 	(1) be placed in foster care homes with the child's siblings, when possible and when it 
12.27 	is in the best interest of each sibling, in order to sustain family relationships;
12.28 	(2) be placed in close geographical distance to the child's siblings, if placement together 
12.29 	is not possible, to facilitate frequent and meaningful contact;
12.30 	(3) have frequent contact with the child's siblings in foster care and, whenever possible, 
12.31 	with the child's siblings who are not in foster care, unless the responsible social services 
13.1 	agency has documented that contact is not in the best interest of any sibling. Contact includes, 
13.2 	but is not limited to, telephone calls, text messaging, social media and other Internet use, 
13.3 	and video calls;
13.4 	(4) annually receive a telephone number, address, and e-mail address for all siblings in 
13.5 	foster care, and receive updated photographs of siblings regularly, by regular mail or e-mail;
13.6 	(5) participate in regular face-to-face visits with the child's siblings in foster care and, 
13.7 	whenever possible, with the child's siblings who are not in foster care. Participation in these 
13.8 	visits shall not be withheld or restricted as a consequence for behavior, and shall only be 
13.9 	restricted if the responsible social services agency documents that the visits are contrary to 
13.10 	the safety or well-being of any sibling. Social workers, parents, foster care providers, and 
13.11 	older children must cooperate to ensure regular visits and must coordinate dates, times, 
13.12 	transportation, and other accommodations as necessary. The timing and regularity of visits 
13.13 	shall be outlined in each sibling's service plan, based on the individual circumstances and 
13.14 	needs of each child. A social worker need not give explicit permission for each visit or 
13.15 	possible overnight visit, but foster care providers shall communicate with social workers 
13.16 	about these visits;
13.17 	(6) be actively involved in each other's lives and share celebrations, if they choose to 
13.18 	do so, including but not limited to birthdays, holidays, graduations, school and extracurricular 
13.19 	activities, cultural customs in the siblings' native language, and other milestones;
13.20 	(7) be promptly informed about changes in sibling placements or circumstances, including 
13.21 	but not limited to new placements, discharge from placements, significant life events, and 
13.22 	discharge from foster care;
13.23 	(8) be included in permanency planning decisions for siblings, if appropriate; and
13.24 	(9) be informed of the expectations for and possibility of continued contact with a sibling 
13.25 	after an adoption or transfer of permanent physical and legal custody to a relative.
13.26 	(b) Adult siblings of children in foster care shall have the right to be considered as foster 
13.27 	care providers, adoptive parents, and relative custodians for their siblings, if they choose 
13.28 	to do so.
13.29 		Subd. 2.Interpretation. The rights under this section are established for the benefit of 
13.30 	siblings in foster care. This statement of rights does not replace or diminish other rights, 
13.31 	liberties, and responsibilities that may exist relative to children in foster care, adult siblings 
13.32 	of children in foster care, foster care providers, parents, relatives, or responsible social 
13.33 	services agencies.
14.1 		Subd. 3.Disclosure. Child welfare agency staff shall provide a copy of these rights to 
14.2 	a child who has a sibling at the time the child enters foster care, to any adult siblings of a 
14.3 	child entering foster care, if known, and to the foster care provider, in a format specified 
14.4 	by the commissioner of human services. The copy shall contain the address and telephone 
14.5 	number of the Office of Ombudsman for Families and a brief statement describing how to 
14.6 	file a complaint with the office.

14.7 	EFFECTIVE DATE. This section is effective for children entering foster care on or 
14.8 	after August 1, 2018. Subdivision 3 is effective August 1, 2018, and applies to all children 
14.9 	in foster care on that date, regardless of when the child entered foster care.

14.10 	Sec. 20. [260C.81] CHILD WELFARE TRAINING SYSTEM.
14.11 		Subdivision 1.Child welfare training system. (a) The commissioner of human services 
14.12 	shall modify the Child Welfare Training System developed pursuant to section 626.5591, 
14.13 	subdivision 2, as provided in this section. The new training framework shall be known as 
14.14 	the Child Welfare Training Academy.
14.15 	(b) The Child Welfare Training Academy shall be administered through five regional 
14.16 	hubs in northwest, northeast, southwest, southeast, and central Minnesota. Each hub shall 
14.17 	deliver training targeted to the needs of its particular region, taking into account varying 
14.18 	demographics, resources, and practice outcomes.
14.19 	(c) The Child Welfare Training Academy shall use training methods best suited to the 
14.20 	training content. National best practices in adult learning must be used to the greatest extent 
14.21 	possible, including online learning methodologies, coaching, mentoring, and simulated skill 
14.22 	application.
14.23 	(d) Each child welfare worker and supervisor shall be required to complete a certification, 
14.24 	including a competency-based knowledge test and a skills demonstration, at the completion 
14.25 	of the worker's initial training and biennially thereafter. The commissioner shall develop 
14.26 	ongoing training requirements and a method for tracking certifications.
14.27 	(e) Each regional hub shall have a regional organizational effectiveness specialist trained 
14.28 	in continuous quality improvement strategies. The specialist shall provide organizational 
14.29 	change assistance to counties and tribes, with priority given to efforts intended to impact 
14.30 	child safety.
14.31 	(f) The Child Welfare Training Academy shall include training and resources that address 
14.32 	worker well-being and secondary traumatic stress.
15.1 	(g) The Child Welfare Training Academy shall serve the primary training audiences of: 
15.2 	(1) county and tribal child welfare workers; (2) county and tribal child welfare supervisors; 
15.3 	and (3) staff at private agencies providing out-of-home placement services for children 
15.4 	involved in Minnesota's county and tribal child welfare system.
15.5 	(h) The commissioner of human services shall enter: (1) into a partnership with the 
15.6 	University of Minnesota to collaborate in the administration of workforce training; and (2) 
15.7 	enter into a partnership with one or more agencies to provide consultation, subject matter 
15.8 	expertise, and capacity building in organizational resilience and child welfare workforce 
15.9 	well-being.
15.10 		Subd. 2.Rulemaking. The commissioner of human services may adopt rules by 
15.11 	December 31, 2020, as necessary to establish the Child Welfare Training Academy. If the 
15.12 	commissioner of human services does not adopt rules by December 31, 2020, rulemaking 
15.13 	authority under this section is repealed. Rulemaking authority under this section is not 
15.14 	continuing authority to amend or repeal rules. Any additional action on rules after adoption 
15.15 	must be under specific statutory authority to take the additional action.

15.16 	Sec. 21. Minnesota Statutes 2016, section 626.556, is amended by adding a subdivision 
15.17 	to read:
15.18 		Subd. 17.Child protection safety and risk-based framework response system 
15.19 	planning initiative. (a) The commissioner shall partner with select Minnesota counties and 
15.20 	tribal child welfare agencies, including Hennepin County and at least one rural county, and 
15.21 	other counties that must represent a balance around the state, to make recommendations for 
15.22 	the creation of a safety and risk-based framework that will improve appropriate, timely, and 
15.23 	adequate responses to a child's safety needs using a trauma-informed lens. As part of this 
15.24 	work, the commissioner, county, and tribal child welfare agencies shall review Minnesota's 
15.25 	child maltreatment statutes, administrative rules, guidelines, and practices, and make 
15.26 	recommendations on modifications needed to implement a safety and risk-based framework 
15.27 	and a response system that enhances the protection of children and best focuses county and 
15.28 	tribal child protection resources in accordance with the risk and safety needs of children. 
15.29 	In forming these recommendations, the commissioner shall consult with county attorneys, 
15.30 	law enforcement, parents, attorneys representing parents, the guardian ad litem program, 
15.31 	mental and physical health care providers, child development experts, and other stakeholders 
15.32 	that the commissioner deems appropriate.
15.33 	(b) By January 31, 2019, the commissioner shall make recommendations regarding the 
15.34 	creation of a safety and risk-based framework to the relevant legislative committees.

16.1 	Sec. 22. 2018 REPORT TO LEGISLATURE ON HOMELESS YOUTH.
 16.2 		Subdivision 1.Report development. In lieu of the biennial homeless youth report under 
16.3 	Minnesota Statutes, section 256K.45, subdivision 2, the commissioner of human services 
16.4 	shall update the information in the 2007 legislative report on runaway and homeless youth. 
16.5 	In developing the updated report, the commissioner may use existing data, studies, and 
16.6 	analysis provided by state, county, and other entities including, but not limited to:
16.7 	(1) Minnesota Housing Finance Agency analysis on housing availability;
16.8 	(2) Minnesota state plan to end homelessness;
16.9 	(3) continuum of care counts of youth experiencing homelessness and assessments as 
16.10 	provided by Department of Housing and Urban Development (HUD)-required coordinated 
16.11 	entry systems;
16.12 	(4) data collected through the Department of Human Services Homeless Youth Act grant 
16.13 	program;
16.14 	(5) Wilder Research homeless study;
16.15 	(6) Voices of Youth Count sponsored by Hennepin County; and
16.16 	(7) privately funded analysis, including:
16.17 	(i) nine evidence-based principles to support youth in overcoming homelessness;
16.18 	(ii) return on investment analysis conducted for YouthLink by Foldes Consulting; and
16.19 	(iii) evaluation of Homeless Youth Act resources conducted by Rainbow Research.
16.20 		Subd. 2.Key elements; due date. (a) The report may include three key elements where 
16.21 	significant learning has occurred in the state since the 2007 report, including:
16.22 	(1) unique causes of youth homelessness;
16.23 	(2) targeted responses to youth homelessness, including significance of positive youth 
16.24 	development as fundamental to each targeted response; and
16.25 	(3) recommendations based on existing reports and analysis on what it will take to end 
16.26 	youth homelessness.
16.27 	(b) To the extent data is available, the report must include:
16.28 	(1) general accounting of the federal and philanthropic funds leveraged to support 
16.29 	homeless youth activities;
17.1 	(2) general accounting of the increase in volunteer responses to support youth 
17.2 	experiencing homelessness; and
17.3 	(3) data-driven accounting of geographic areas or distinct populations that have gaps in 
17.4 	service or are not yet served by homeless youth responses.
17.5 	(c) The commissioner of human services may consult with  community-based providers 
17.6 	of homeless youth services and other expert stakeholders to complete the report. The 
17.7 	commissioner shall submit the report to the chairs and ranking minority members of the 
17.8 	legislative committees with jurisdiction over youth homelessness by February 15, 2019.

17.9 	Sec. 23. AFRICAN AMERICAN CHILD WELFARE WORK GROUP.
 17.10 	The commissioner of human services shall form an African American child welfare 
17.11 	work group within the implementation work group for the Governor's Child Protection Task 
17.12 	Force to help formulate policies and procedures relating to African American child welfare 
17.13 	services and to ensure that African American families are provided with all possible services 
17.14 	and opportunities to care for their children in their homes. The work group shall include 
17.15 	child welfare policy and social work professionals and paraprofessionals, community 
17.16 	members, community leaders, and parents representing all regions of the state. By February 
17.17 	1, 2019, the work group shall report its findings and recommendations to the chairs and 
17.18 	ranking minority members of the legislative committees with jurisdiction over child 
17.19 	protection issues.

17.20 	Sec. 24. REVIEW OF BACKGROUND STUDIES AND LICENSING PROCESSES 
17.21 	FOR RELATIVE FOSTER CARE.
 17.22 	(a) The commissioner shall work with six counties, which must include Hennepin County, 
17.23 	at least one rural county, and other counties that must represent a balance around the state, 
17.24 	to review the background study and licensing processes for relative child foster care. The 
17.25 	review must analyze past reports on foster care, licensing data, barriers to timely licensure 
17.26 	for relatives, child safety, well-being, and permanency outcomes of children placed in foster 
17.27 	care with relatives.
17.28 	(b) By January 31, 2019, the commissioner shall make recommendations for improving 
17.29 	the background study and licensing processes for children placed in foster care with relatives 
17.30 	to the relevant legislative committees.

18.1 	Sec. 25. DEPARTMENT OF LICENSING, BACKGROUND STUDIES, AND 
18.2 	OVERSIGHT.
 18.3 	(a) It is the goal of the legislature to consolidate into one new state agency the licensing, 
18.4 	background study, and related oversight functions currently in the Department of Human 
18.5 	Services and Department of Health, including the Office of Inspector General, the Minnesota 
18.6 	Adult Abuse Reporting Center (MAARC), and the Office of Health Facility Complaints 
18.7 	(OHFC).
18.8 	(b) The commissioners of human services and health shall work with the revisor of 
18.9 	statutes to draft legislation establishing the new state agency, and provide the legislation to 
18.10 	the chairs and ranking minority members of the senate and house of representatives 
18.11 	committees with jurisdiction over health and human services by December 15, 2018, with 
18.12 	the goal of the new state agency to begin operations on July 1, 2019.

18.13 	ARTICLE 2
18.14 	STATE-OPERATED SERVICES; CHEMICAL AND MENTAL HEALTH

18.15 	Section 1. Minnesota Statutes 2017 Supplement, section 245.4889, subdivision 1, is 
18.16 	amended to read:
18.17 		Subdivision 1.Establishment and authority. (a) The commissioner is authorized to 
18.18 	make grants from available appropriations to assist:
18.19 	(1) counties;
18.20 	(2) Indian tribes;
18.21 	(3) children's collaboratives under section 124D.23 or 245.493; or
18.22 	(4) mental health service providers.
18.23 	(b) The following services are eligible for grants under this section:
18.24 	(1) services to children with emotional disturbances as defined in section 245.4871, 
18.25 	subdivision 15, and their families;
18.26 	(2) transition services under section 245.4875, subdivision 8, for young adults under 
18.27 	age 21 and their families;
18.28 	(3) respite care services for children with severe emotional disturbances who are at risk 
18.29 	of out-of-home placement;
18.30 	(4) children's mental health crisis services;
19.1 	(5) mental health services for people from cultural and ethnic minorities;
19.2 	(6) children's mental health screening and follow-up diagnostic assessment and treatment;
19.3 	(7) services to promote and develop the capacity of providers to use evidence-based 
19.4 	practices in providing children's mental health services;
19.5 	(8) school-linked mental health services, including transportation for children receiving 
19.6 	school-linked mental health services when school is not in session;
19.7 	(9) building evidence-based mental health intervention capacity for children birth to age 
19.8 	five;
19.9 	(10) suicide prevention and counseling services that use text messaging statewide;
19.10 	(11) mental health first aid training;
19.11 	(12) training for parents, collaborative partners, and mental health providers on the 
19.12 	impact of adverse childhood experiences and trauma and development of an interactive 
19.13 	Web site to share information and strategies to promote resilience and prevent trauma;
19.14 	(13) transition age services to develop or expand mental health treatment and supports 
19.15 	for adolescents and young adults 26 years of age or younger;
19.16 	(14) early childhood mental health consultation;
19.17 	(15) evidence-based interventions for youth at risk of developing or experiencing a first 
19.18 	episode of psychosis, and a public awareness campaign on the signs and symptoms of 
19.19 	psychosis;
19.20 	(16) psychiatric consultation for primary care practitioners; and
19.21 	(17) providers to begin operations and meet program requirements when establishing a 
19.22 	new children's mental health program. These may be start-up grants.
19.23 	(c) Services under paragraph (b) must be designed to help each child to function and 
19.24 	remain with the child's family in the community and delivered consistent with the child's 
19.25 	treatment plan. Transition services to eligible young adults under this paragraph must be 
19.26 	designed to foster independent living in the community.
19.27 	(d) As a condition of receiving grant funds, a grantee must obtain all available third-party 
19.28 	reimbursement sources, if applicable.

20.1 	Sec. 2. Minnesota Statutes 2016, section 245.4889, is amended by adding a subdivision 
20.2 	to read:
20.3 		Subd. 1a.School-linked mental health services grants. (a) An eligible applicant for 
20.4 	school-linked mental health services grants under subdivision 1, paragraph (b), clause (8), 
20.5 	is an entity that is:
20.6 	(1) certified under Minnesota Rules, parts 9520.0750 to 9520.0870;
20.7 	(2) a community mental health center under section 256B.0625, subdivision 5;
20.8 	(3) an Indian health service facility or facility owned and operated by a tribe or tribal 
20.9 	organization operating under United States Code, title 25, section 5321;
20.10 	(4) a provider of children's therapeutic services and supports as defined in section 
20.11 	256B.0943; or
20.12 	(5) enrolled in medical assistance as a mental health or substance use disorder provider 
20.13 	agency and employs at least two full-time equivalent mental health professionals as defined 
20.14 	in section 245.4871, subdivision 27, clauses (1) to (6), or two alcohol and drug counselors 
20.15 	licensed or exempt from licensure under chapter 148F who are qualified to provide clinical 
20.16 	services to children and families.
20.17 	(b) Allowable grant expenses include transportation for children receiving school-linked 
20.18 	mental health services when school is not in session, and may be used to purchase equipment, 
20.19 	connection charges, set-up fees, and site fees in order to deliver school-linked mental health 
20.20 	services defined in subdivision 1a, via telemedicine consistent with section 256B.0625, 
20.21 	subdivision 3b.

20.22 	Sec. 3. [246.0415] PLACEMENT OF CLIENTS WHO EXHIBIT ASSAULTIVE OR 
20.23 	VIOLENT BEHAVIOR.
20.24 	Clients who exhibit assaultive or violent behavior, have severe behavior issues, or are 
20.25 	involved with or are at risk of being involved with the criminal justice system must be placed 
20.26 	in or moved to a setting that meets the client's needs and ensures the safety of the public. 
20.27 	The commissioner shall balance the needs of the client to live in the most integrated setting 
20.28 	with public safety. The commissioner shall provide an appropriate placement for clients 
20.29 	who have a medium or high risk for committing violent acts, and clients must not be placed 
20.30 	in a residential setting that jeopardizes the safety of others until the commissioner determines 
20.31 	that the client is low risk for committing violent acts.

21.1 	Sec. 4. Minnesota Statutes 2016, section 254B.02, subdivision 1, is amended to read:
21.2 		Subdivision 1.Chemical dependency treatment allocation. The chemical dependency 
21.3 	treatment appropriation shall be placed in a special revenue account. The commissioner 
21.4 	shall annually transfer funds from the chemical dependency fund to pay for operation of 
21.5 	the drug and alcohol abuse normative evaluation system and to pay for all costs incurred 
21.6 	by adding two positions for licensing of chemical dependency treatment and rehabilitation 
21.7 	programs located in hospitals for which funds are not otherwise appropriated. The remainder 
21.8 	of the money in the special revenue account must be used according to the requirements in 
21.9 	this chapter.

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

21.11 	Sec. 5. Minnesota Statutes 2016, section 254B.06, subdivision 1, is amended to read:
21.12 		Subdivision 1.State collections. The commissioner is responsible for all collections 
21.13 	from persons determined to be partially responsible for the cost of care of an eligible person 
21.14 	receiving services under Laws 1986, chapter 394, sections 8 to 20. The commissioner may 
21.15 	initiate, or request the attorney general to initiate, necessary civil action to recover the unpaid 
21.16 	cost of care. The commissioner may collect all third-party payments for chemical dependency 
21.17 	services provided under Laws 1986, chapter 394, sections 8 to 20, including private insurance 
21.18 	and federal Medicaid and Medicare financial participation. The commissioner shall deposit 
21.19 	in a dedicated account a percentage of collections to pay for the cost of operating the chemical 
21.20 	dependency consolidated treatment fund invoice processing and vendor payment system, 
21.21 	billing, and collections. The remaining receipts must be deposited in the chemical dependency 
21.22 	fund.

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

21.24 	Sec. 6. PERSON-CENTERED TELEPRESENCE PLATFORM EXPANSION WORK 
21.25 	GROUP.
 21.26 		Subdivision 1.Membership. (a) The commissioner of human services shall convene a 
21.27 	work group for the purpose of exploring opportunities to collaborate and expand strategies 
21.28 	for person-centered innovation using Internet telepresence in delivering health and human 
21.29 	services, as well as related educational and correctional services. The commissioner, in 
21.30 	consultation with the commissioner of health, shall appoint the following members:
22.1 	(1) three members representing county services in the areas of human services, health, 
22.2 	and corrections or law enforcement. These members must represent counties outside the 
22.3 	metropolitan area defined in Minnesota Statutes, section 473.121;
22.4 	(2) one member representing public health;
22.5 	(3) one member recommended by the Minnesota American Indian Mental Health 
22.6 	Advisory Council;
22.7 	(4) one member recommended by the Minnesota Medical Association who is a primary 
22.8 	care provider practicing in outstate Minnesota;
22.9 	(5) one member recommended by NAMI of Minnesota;
22.10 	(6) two members recommended by the Minnesota School Boards Association;
22.11 	(7) one member recommended by the Minnesota Hospital Association representing rural 
22.12 	hospital emergency departments;
22.13 	(8) one member representing community mental health centers;
22.14 	(9) one member representing adolescent treatment centers;
22.15 	(10) one member representing child advocacy centers; and
22.16 	(11) one member recommended by the chief justice of the Supreme Court representing 
22.17 	the judicial system.
22.18 	(b) In addition to the members identified in paragraph (a), the work group shall include:
22.19 	(1) the commissioner of MN.IT services or a designee;
22.20 	(2) the commissioner of corrections or a designee;
22.21 	(3) the commissioner of health or a designee; and
22.22 	(4) the commissioner of education or a designee.
22.23 		Subd. 2.First meeting; chair. The commissioner shall serve as the chair, and make 
22.24 	appointments and convene the first meeting of the work group by September 1, 2018.
22.25 		Subd. 3.Duties. The work group shall:
22.26 	(1) explore opportunities for improving behavioral health and other health care service 
22.27 	delivery through the use of a common interoperable person-centered telepresence platform 
22.28 	that provides connectivity and technical support to potential users;
22.29 	(2) review and coordinate state and local innovation initiatives and investments designed 
22.30 	to leverage telepresence connectivity and collaboration;
23.1 	(3) identify standards and capabilities for a single interoperable telepresence platform;
23.2 	(4) identify barriers to providing a telepresence technology, including limited availability 
23.3 	of bandwidth, limitations in providing certain services via telepresence, and broadband 
23.4 	infrastructure needs;
23.5 	(5) identify and make recommendations for governance to assure person-centered 
23.6 	responsiveness;
23.7 	(6) identify how the business model itself can be innovated to provide an incentive for 
23.8 	ongoing innovation in Minnesota's health and human service ecosystems;
23.9 	(7) evaluate and make recommendations for a potential vendor that could provide a 
23.10 	single telepresence platform in terms of delivering the identified standards and capabilities;
23.11 	(8) identify sustainable financial support for a single telepresence platform, including 
23.12 	infrastructure costs and start-up costs for potential users; and
23.13 	(9) identify the benefits to the state, political subdivisions, and tribal governments, and 
23.14 	the constituents they serve in using a common person-centered telepresence platform for 
23.15 	delivering behavioral health services.
23.16 		Subd. 4.Report. The commissioner shall report to the chairs and ranking minority 
23.17 	members of the committees in the senate and the house of representatives with primary 
23.18 	jurisdiction over health and state information technology by January 15, 2019, with 
23.19 	recommendations related to expanding the state's telepresence platform and any legislation 
23.20 	required to implement the recommendations.
23.21 		Subd. 5.Expiration. The work group expires January 16, 2019.

23.22 	ARTICLE 3
23.23 	COMMUNITY SUPPORTS AND CONTINUING CARE

23.24 	Section 1. Minnesota Statutes 2017 Supplement, section 245A.03, subdivision 7, is 
23.25 	amended to read:
23.26 		Subd. 7.Licensing moratorium. (a) The commissioner shall not issue an initial license 
23.27 	for child foster care licensed under Minnesota Rules, parts 2960.3000 to 2960.3340, or adult 
23.28 	foster care licensed under Minnesota Rules, parts 9555.5105 to 9555.6265, under this chapter 
23.29 	for a physical location that will not be the primary residence of the license holder for the 
23.30 	entire period of licensure. If a license is issued during this moratorium, and the license 
23.31 	holder changes the license holder's primary residence away from the physical location of 
23.32 	the foster care license, the commissioner shall revoke the license according to section 
24.1 	245A.07. The commissioner shall not issue an initial license for a community residential 
24.2 	setting licensed under chapter 245D. When approving an exception under this paragraph, 
24.3 	the commissioner shall consider the resource need determination process in paragraph (h), 
24.4 	the availability of foster care licensed beds in the geographic area in which the licensee 
24.5 	seeks to operate, the results of a person's choices during their annual assessment and service 
24.6 	plan review, and the recommendation of the local county board. The determination by the 
24.7 	commissioner is final and not subject to appeal. Exceptions to the moratorium include:
24.8 	(1) foster care settings that are required to be registered under chapter 144D;
24.9 	(2) foster care licenses replacing foster care licenses in existence on May 15, 2009, or 
24.10 	community residential setting licenses replacing adult foster care licenses in existence on 
24.11 	December 31, 2013, and determined to be needed by the commissioner under paragraph 
24.12 	(b);
24.13 	(3) new foster care licenses or community residential setting licenses determined to be 
24.14 	needed by the commissioner under paragraph (b) for the closure of a nursing facility, ICF/DD, 
24.15 	or regional treatment center; restructuring of state-operated services that limits the capacity 
24.16 	of state-operated facilities; or allowing movement to the community for people who no 
24.17 	longer require the level of care provided in state-operated facilities as provided under section 
24.18 	256B.092, subdivision 13, or 256B.49, subdivision 24;
24.19 	(4) new foster care licenses or community residential setting licenses determined to be 
24.20 	needed by the commissioner under paragraph (b) for persons requiring hospital level care;
24.21 	(5) new foster care licenses or community residential setting licenses determined to be 
24.22 	needed by the commissioner for the transition of people from personal care assistance to 
24.23 	the home and community-based services;
24.24 	(6) new foster care licenses or community residential setting licenses determined to be 
24.25 	needed by the commissioner for the transition of people from the residential care waiver 
24.26 	services to foster care services. This exception applies only when:
24.27 	(i) the person's case manager provided the person with information about the choice of 
24.28 	service, service provider, and location of service to help the person make an informed choice; 
24.29 	and
24.30 	(ii) the person's foster care services are less than or equal to the cost of the person's 
24.31 	services delivered in the residential care waiver service setting as determined by the lead 
24.32 	agency; or
25.1 	(7) new foster care licenses or community residential setting licenses for people receiving 
25.2 	services under chapter 245D and residing in an unlicensed setting before May 1, 2017, and 
25.3 	for which a license is required. This exception does not apply to people living in their own 
25.4 	home. For purposes of this clause, there is a presumption that a foster care or community 
25.5 	residential setting license is required for services provided to three or more people in a 
25.6 	dwelling unit when the setting is controlled by the provider. A license holder subject to this 
25.7 	exception may rebut the presumption that a license is required by seeking a reconsideration 
25.8 	of the commissioner's determination. The commissioner's disposition of a request for 
25.9 	reconsideration is final and not subject to appeal under chapter 14. The exception is available 
25.10 	until June 30, 2018 2019. This exception is available when:
25.11 	(i) the person's case manager provided the person with information about the choice of 
25.12 	service, service provider, and location of service, including in the person's home, to help 
25.13 	the person make an informed choice; and
25.14 	(ii) the person's services provided in the licensed foster care or community residential 
25.15 	setting are less than or equal to the cost of the person's services delivered in the unlicensed 
25.16 	setting as determined by the lead agency.; or
25.17 	(8) a vacancy in a setting granted an exception under clause (7), created between January 
25.18 	1, 2017, and the date of the exception request, by the departure of a person receiving services 
25.19 	under chapter 245D and residing in the unlicensed setting between January 1, 2017, and 
25.20 	May 1, 2017. This exception is available when the lead agency provides documentation to 
25.21 	the commissioner on the eligibility criteria being met. This exception is available until June 
25.22 	30, 2019.
25.23 	(b) The commissioner shall determine the need for newly licensed foster care homes or 
25.24 	community residential settings as defined under this subdivision. As part of the determination, 
25.25 	the commissioner shall consider the availability of foster care capacity in the area in which 
25.26 	the licensee seeks to operate, and the recommendation of the local county board. The 
25.27 	determination by the commissioner must be final. A determination of need is not required 
25.28 	for a change in ownership at the same address.
25.29 	(c) When an adult resident served by the program moves out of a foster home that is not 
25.30 	the primary residence of the license holder according to section 256B.49, subdivision 15, 
25.31 	paragraph (f), or the adult community residential setting, the county shall immediately 
25.32 	inform the Department of Human Services Licensing Division. The department may decrease 
25.33 	the statewide licensed capacity for adult foster care settings.
26.1 	(d) Residential settings that would otherwise be subject to the decreased license capacity 
26.2 	established in paragraph (c) shall be exempt if the license holder's beds are occupied by 
26.3 	residents whose primary diagnosis is mental illness and the license holder is certified under 
26.4 	the requirements in subdivision 6a or section 245D.33.
26.5 	(e) A resource need determination process, managed at the state level, using the available 
26.6 	reports required by section 144A.351, and other data and information shall be used to 
26.7 	determine where the reduced capacity determined under section 256B.493 will be 
26.8 	implemented. The commissioner shall consult with the stakeholders described in section 
26.9 	144A.351, and employ a variety of methods to improve the state's capacity to meet the 
26.10 	informed decisions of those people who want to move out of corporate foster care or 
26.11 	community residential settings, long-term service needs within budgetary limits, including 
26.12 	seeking proposals from service providers or lead agencies to change service type, capacity, 
26.13 	or location to improve services, increase the independence of residents, and better meet 
26.14 	needs identified by the long-term services and supports reports and statewide data and 
26.15 	information.
26.16 	(f) At the time of application and reapplication for licensure, the applicant and the license 
26.17 	holder that are subject to the moratorium or an exclusion established in paragraph (a) are 
26.18 	required to inform the commissioner whether the physical location where the foster care 
26.19 	will be provided is or will be the primary residence of the license holder for the entire period 
26.20 	of licensure. If the primary residence of the applicant or license holder changes, the applicant 
26.21 	or license holder must notify the commissioner immediately. The commissioner shall print 
26.22 	on the foster care license certificate whether or not the physical location is the primary 
26.23 	residence of the license holder.
26.24 	(g) License holders of foster care homes identified under paragraph (f) that are not the 
26.25 	primary residence of the license holder and that also provide services in the foster care home 
26.26 	that are covered by a federally approved home and community-based services waiver, as 
26.27 	authorized under section 256B.0915, 256B.092, or 256B.49, must inform the human services 
26.28 	licensing division that the license holder provides or intends to provide these waiver-funded 
26.29 	services.
26.30 	(h) The commissioner may adjust capacity to address needs identified in section 
26.31 	144A.351. Under this authority, the commissioner may approve new licensed settings or 
26.32 	delicense existing settings. Delicensing of settings will be accomplished through a process 
26.33 	identified in section 256B.493. Annually, by August 1, the commissioner shall provide 
26.34 	information and data on capacity of licensed long-term services and supports, actions taken 
26.35 	under the subdivision to manage statewide long-term services and supports resources, and 
27.1 	any recommendations for change to the legislative committees with jurisdiction over the 
27.2 	health and human services budget.
27.3 	(i) The commissioner must notify a license holder when its corporate foster care or 
27.4 	community residential setting licensed beds are reduced under this section. The notice of 
27.5 	reduction of licensed beds must be in writing and delivered to the license holder by certified 
27.6 	mail or personal service. The notice must state why the licensed beds are reduced and must 
27.7 	inform the license holder of its right to request reconsideration by the commissioner. The 
27.8 	license holder's request for reconsideration must be in writing. If mailed, the request for 
27.9 	reconsideration must be postmarked and sent to the commissioner within 20 calendar days 
27.10 	after the license holder's receipt of the notice of reduction of licensed beds. If a request for 
27.11 	reconsideration is made by personal service, it must be received by the commissioner within 
27.12 	20 calendar days after the license holder's receipt of the notice of reduction of licensed beds.
27.13 	(j) The commissioner shall not issue an initial license for children's residential treatment 
27.14 	services licensed under Minnesota Rules, parts 2960.0580 to 2960.0700, under this chapter 
27.15 	for a program that Centers for Medicare and Medicaid Services would consider an institution 
27.16 	for mental diseases. Facilities that serve only private pay clients are exempt from the 
27.17 	moratorium described in this paragraph. The commissioner has the authority to manage 
27.18 	existing statewide capacity for children's residential treatment services subject to the 
27.19 	moratorium under this paragraph and may issue an initial license for such facilities if the 
27.20 	initial license would not increase the statewide capacity for children's residential treatment 
27.21 	services subject to the moratorium under this paragraph.

27.22 	EFFECTIVE DATE. This section is effective June 29, 2018.

27.23 	Sec. 2. Minnesota Statutes 2017 Supplement, section 245A.11, subdivision 2a, is amended 
27.24 	to read:
27.25 		Subd. 2a.Adult foster care and community residential setting license capacity. (a) 
27.26 	The commissioner shall issue adult foster care and community residential setting licenses 
27.27 	with a maximum licensed capacity of four beds, including nonstaff roomers and boarders, 
27.28 	except that the commissioner may issue a license with a capacity of five beds, including 
27.29 	roomers and boarders, according to paragraphs (b) to (g).
27.30 	(b) The license holder may have a maximum license capacity of five if all persons in 
27.31 	care are age 55 or over and do not have a serious and persistent mental illness or a 
27.32 	developmental disability.
28.1 	(c) The commissioner may grant variances to paragraph (b) to allow a facility with a 
28.2 	licensed capacity of up to five persons to admit an individual under the age of 55 if the 
28.3 	variance complies with section 245A.04, subdivision 9, and approval of the variance is 
28.4 	recommended by the county in which the licensed facility is located.
28.5 	(d) The commissioner may grant variances to paragraph (a) to allow the use of an 
28.6 	additional bed, up to five, for emergency crisis services for a person with serious and 
28.7 	persistent mental illness or a developmental disability, regardless of age, if the variance 
28.8 	complies with section 245A.04, subdivision 9, and approval of the variance is recommended 
28.9 	by the county in which the licensed facility is located.
28.10 	(e) The commissioner may grant a variance to paragraph (b) to allow for the use of an 
28.11 	additional bed, up to five, for respite services, as defined in section 245A.02, for persons 
28.12 	with disabilities, regardless of age, if the variance complies with sections 245A.03, 
28.13 	subdivision 7, and 245A.04, subdivision 9, and approval of the variance is recommended 
28.14 	by the county in which the licensed facility is located. Respite care may be provided under 
28.15 	the following conditions:
28.16 	(1) staffing ratios cannot be reduced below the approved level for the individuals being 
28.17 	served in the home on a permanent basis;
28.18 	(2) no more than two different individuals can be accepted for respite services in any 
28.19 	calendar month and the total respite days may not exceed 120 days per program in any 
28.20 	calendar year;
28.21 	(3) the person receiving respite services must have his or her own bedroom, which could 
28.22 	be used for alternative purposes when not used as a respite bedroom, and cannot be the 
28.23 	room of another person who lives in the facility; and
28.24 	(4) individuals living in the facility must be notified when the variance is approved. The 
28.25 	provider must give 60 days' notice in writing to the residents and their legal representatives 
28.26 	prior to accepting the first respite placement. Notice must be given to residents at least two 
28.27 	days prior to service initiation, or as soon as the license holder is able if they receive notice 
28.28 	of the need for respite less than two days prior to initiation, each time a respite client will 
28.29 	be served, unless the requirement for this notice is waived by the resident or legal guardian.
28.30 	(f) The commissioner may issue an adult foster care or community residential setting 
28.31 	license with a capacity of five adults if the fifth bed does not increase the overall statewide 
28.32 	capacity of licensed adult foster care or community residential setting beds in homes that 
28.33 	are not the primary residence of the license holder, as identified in a plan submitted to the 
28.34 	commissioner by the county, when the capacity is recommended by the county licensing 
29.1 	agency of the county in which the facility is located and if the recommendation verifies 
29.2 	that:
29.3 	(1) the facility meets the physical environment requirements in the adult foster care 
29.4 	licensing rule;
29.5 	(2) the five-bed living arrangement is specified for each resident in the resident's:
29.6 	(i) individualized plan of care;
29.7 	(ii) individual service plan under section 256B.092, subdivision 1b, if required; or
29.8 	(iii) individual resident placement agreement under Minnesota Rules, part 9555.5105, 
29.9 	subpart 19, if required;
29.10 	(3) the license holder obtains written and signed informed consent from each resident 
29.11 	or resident's legal representative documenting the resident's informed choice to remain 
29.12 	living in the home and that the resident's refusal to consent would not have resulted in 
29.13 	service termination; and
29.14 	(4) the facility was licensed for adult foster care before March 1, 2011 June 30, 2016.
29.15 	(g) The commissioner shall not issue a new adult foster care license under paragraph (f) 
29.16 	after June 30, 2019 2021. The commissioner shall allow a facility with an adult foster care 
29.17 	license issued under paragraph (f) before June 30, 2019 2021, to continue with a capacity 
29.18 	of five adults if the license holder continues to comply with the requirements in paragraph 
29.19 	(f).

29.20 	Sec. 3. Minnesota Statutes 2017 Supplement, section 245D.03, subdivision 1, is amended 
29.21 	to read:
29.22 		Subdivision 1.Applicability.  (a) The commissioner shall regulate the provision of home 
29.23 	and community-based services to persons with disabilities and persons age 65 and older 
29.24 	pursuant to this chapter. The licensing standards in this chapter govern the provision of 
29.25 	basic support services and intensive support services.
29.26 	(b) Basic support services provide the level of assistance, supervision, and care that is 
29.27 	necessary to ensure the health and welfare of the person and do not include services that 
29.28 	are specifically directed toward the training, treatment, habilitation, or rehabilitation of the 
29.29 	person. Basic support services include:
29.30 	(1) in-home and out-of-home respite care services as defined in section 245A.02, 
29.31 	subdivision 15, and under the brain injury, community alternative care, community access 
29.32 	for disability inclusion, developmental disability, and elderly waiver plans, excluding 
30.1 	out-of-home respite care provided to children in a family child foster care home licensed 
30.2 	under Minnesota Rules, parts 2960.3000 to 2960.3100, when the child foster care license 
30.3 	holder complies with the requirements under section 245D.06, subdivisions 5, 6, 7, and 8, 
30.4 	or successor provisions; and section 245D.061 or successor provisions, which must be 
30.5 	stipulated in the statement of intended use required under Minnesota Rules, part 2960.3000, 
30.6 	subpart 4;
30.7 	(2) adult companion services as defined under the brain injury, community access for 
30.8 	disability inclusion, community alternative care, and elderly waiver plans, excluding adult 
30.9 	companion services provided under the Corporation for National and Community Services 
30.10 	Senior Companion Program established under the Domestic Volunteer Service Act of 1973, 
30.11 	Public Law 98-288;
30.12 	(3) personal support as defined under the developmental disability waiver plan;
30.13 	(4) 24-hour emergency assistance, personal emergency response as defined under the 
30.14 	community access for disability inclusion and developmental disability waiver plans;
30.15 	(5) night supervision services as defined under the brain injury, community access for 
30.16 	disability inclusion, community alternative care, and developmental disability waiver plan
30.17 	plans;
30.18 	(6) homemaker services as defined under the community access for disability inclusion, 
30.19 	brain injury, community alternative care, developmental disability, and elderly waiver plans, 
30.20 	excluding providers licensed by the Department of Health under chapter 144A and those 
30.21 	providers providing cleaning services only; and
30.22 	(7) individual community living support under section 256B.0915, subdivision 3j.
30.23 	(c) Intensive support services provide assistance, supervision, and care that is necessary 
30.24 	to ensure the health and welfare of the person and services specifically directed toward the 
30.25 	training, habilitation, or rehabilitation of the person. Intensive support services include:
30.26 	(1) intervention services, including:
30.27 	(i) behavioral positive support services as defined under the brain injury and, community 
30.28 	access for disability inclusion, community alternative care, and developmental disability
30.29 	waiver plans;
30.30 	(ii) in-home or out-of-home crisis respite services as defined under the brain injury, 
30.31 	community access for disability inclusion, community alternative care, and developmental 
30.32 	disability waiver plan plans; and
31.1 	(iii) specialist services as defined under the current brain injury, community access for 
31.2 	disability inclusion, community alternative care, and developmental disability waiver plan
31.3 	plans;
31.4 	(2) in-home support services, including:
31.5 	(i) in-home family support and supported living services as defined under the 
31.6 	developmental disability waiver plan;
31.7 	(ii) independent living services training as defined under the brain injury and community 
31.8 	access for disability inclusion waiver plans;
31.9 	(iii) semi-independent living services; and
31.10 	(iv) individualized home supports services as defined under the brain injury, community 
31.11 	alternative care, and community access for disability inclusion waiver plans;
31.12 	(3) residential supports and services, including:
31.13 	(i) supported living services as defined under the developmental disability waiver plan 
31.14 	provided in a family or corporate child foster care residence, a family adult foster care 
31.15 	residence, a community residential setting, or a supervised living facility;
31.16 	(ii) foster care services as defined in the brain injury, community alternative care, and 
31.17 	community access for disability inclusion waiver plans provided in a family or corporate 
31.18 	child foster care residence, a family adult foster care residence, or a community residential 
31.19 	setting; and
31.20 	(iii) residential services provided to more than four persons with developmental 
31.21 	disabilities in a supervised living facility, including ICFs/DD;
31.22 	(4) day services, including:
31.23 	(i) structured day services as defined under the brain injury waiver plan;
31.24 	(ii) day training and habilitation services under sections 252.41 to 252.46, and as defined 
31.25 	under the developmental disability waiver plan; and
31.26 	(iii) prevocational services as defined under the brain injury and community access for 
31.27 	disability inclusion waiver plans; and
31.28 	(5) employment exploration services as defined under the brain injury, community 
31.29 	alternative care, community access for disability inclusion, and developmental disability 
31.30 	waiver plans;
32.1 	(6) employment development services as defined under the brain injury, community 
32.2 	alternative care, community access for disability inclusion, and developmental disability 
32.3 	waiver plans; and
32.4 	(7) employment support services as defined under the brain injury, community alternative 
32.5 	care, community access for disability inclusion, and developmental disability waiver plans.

32.6 	Sec. 4. Minnesota Statutes 2016, section 245D.071, subdivision 5, is amended to read:
32.7 		Subd. 5.Service plan review and evaluation. (a) The license holder must give the 
32.8 	person or the person's legal representative and case manager an opportunity to participate 
32.9 	in the ongoing review and development of the service plan and the methods used to support 
32.10 	the person and accomplish outcomes identified in subdivisions 3 and 4. At least once per 
32.11 	year, or within 30 days of a written request by the person, the person's legal representative, 
32.12 	or the case manager, the license holder, in coordination with the person's support team or 
32.13 	expanded support team, must meet with the person, the person's legal representative, and 
32.14 	the case manager, and participate in service plan review meetings following stated timelines 
32.15 	established in the person's coordinated service and support plan or coordinated service and 
32.16 	support plan addendum or within 30 days of a written request by the person, the person's 
32.17 	legal representative, or the case manager, at a minimum of once per year. The purpose of 
32.18 	the service plan review is to determine whether changes are needed to the service plan based 
32.19 	on the assessment information, the license holder's evaluation of progress towards 
32.20 	accomplishing outcomes, or other information provided by the support team or expanded 
32.21 	support team.
32.22 	(b) At least once per year, the license holder, in coordination with the person's support 
32.23 	team or expanded support team, must meet with the person, the person's legal representative, 
32.24 	and the case manager to discuss how technology might be used to meet the person's desired 
32.25 	outcomes. The coordinated service and support plan or support plan addendum must include 
32.26 	a summary of this discussion. The summary must include a statement regarding any decision 
32.27 	made related to the use of technology and a description of any further research that must 
32.28 	be completed before a decision regarding the use of technology can be made. Nothing in 
32.29 	this paragraph requires the coordinated service and support plan to include the use of 
32.30 	technology for the provision of services.
32.31 	(b) (c) The license holder must summarize the person's status and progress toward 
32.32 	achieving the identified outcomes and make recommendations and identify the rationale 
32.33 	for changing, continuing, or discontinuing implementation of supports and methods identified 
32.34 	in subdivision 4 in a report available at the time of the progress review meeting. The report 
33.1 	must be sent at least five working days prior to the progress review meeting if requested by 
33.2 	the team in the coordinated service and support plan or coordinated service and support 
33.3 	plan addendum.
33.4 	(c) (d) The license holder must send the coordinated service and support plan addendum 
33.5 	to the person, the person's legal representative, and the case manager by mail within ten 
33.6 	working days of the progress review meeting. Within ten working days of the mailing of 
33.7 	the coordinated service and support plan addendum, the license holder must obtain dated 
33.8 	signatures from the person or the person's legal representative and the case manager to 
33.9 	document approval of any changes to the coordinated service and support plan addendum.
33.10 	(d) (e) If, within ten working days of submitting changes to the coordinated service and 
33.11 	support plan and coordinated service and support plan addendum, the person or the person's 
33.12 	legal representative or case manager has not signed and returned to the license holder the 
33.13 	coordinated service and support plan or coordinated service and support plan addendum or 
33.14 	has not proposed written modifications to the license holder's submission, the submission 
33.15 	is deemed approved and the coordinated service and support plan addendum becomes 
33.16 	effective and remains in effect until the legal representative or case manager submits a 
33.17 	written request to revise the coordinated service and support plan addendum.

33.18 	Sec. 5. Minnesota Statutes 2016, section 245D.091, subdivision 2, is amended to read:
33.19 		Subd. 2.Behavior Positive support professional qualifications. A behavior positive 
33.20 	support professional providing behavioral positive support services as identified in section 
33.21 	245D.03, subdivision 1, paragraph (c), clause (1), item (i), must have competencies in the 
33.22 	following areas as required under the brain injury and, community access for disability 
33.23 	inclusion, community alternative care, and developmental disability waiver plans or successor 
33.24 	plans:
33.25 	(1) ethical considerations;
33.26 	(2) functional assessment;
33.27 	(3) functional analysis;
33.28 	(4) measurement of behavior and interpretation of data;
33.29 	(5) selecting intervention outcomes and strategies;
33.30 	(6) behavior reduction and elimination strategies that promote least restrictive approved 
33.31 	alternatives;
33.32 	(7) data collection;
34.1 	(8) staff and caregiver training;
34.2 	(9) support plan monitoring;
34.3 	(10) co-occurring mental disorders or neurocognitive disorder;
34.4 	(11) demonstrated expertise with populations being served; and
34.5 	(12) must be a:
34.6 	(i) psychologist licensed under sections 148.88 to 148.98, who has stated to the Board 
34.7 	of Psychology competencies in the above identified areas;
34.8 	(ii) clinical social worker licensed as an independent clinical social worker under chapter 
34.9 	148D, or a person with a master's degree in social work from an accredited college or 
34.10 	university, with at least 4,000 hours of post-master's supervised experience in the delivery 
34.11 	of clinical services in the areas identified in clauses (1) to (11);
34.12 	(iii) physician licensed under chapter 147 and certified by the American Board of 
34.13 	Psychiatry and Neurology or eligible for board certification in psychiatry with competencies 
34.14 	in the areas identified in clauses (1) to (11);
34.15 	(iv) licensed professional clinical counselor licensed under sections 148B.29 to 148B.39
34.16 	with at least 4,000 hours of post-master's supervised experience in the delivery of clinical 
34.17 	services who has demonstrated competencies in the areas identified in clauses (1) to (11);
34.18 	(v) person with a master's degree from an accredited college or university in one of the 
34.19 	behavioral sciences or related fields, with at least 4,000 hours of post-master's supervised 
34.20 	experience in the delivery of clinical services with demonstrated competencies in the areas 
34.21 	identified in clauses (1) to (11); or
34.22 	(vi) person with a master's degree or PhD in one of the behavioral sciences or related 
34.23 	fields with demonstrated expertise in positive support services; or
34.24 	(vii) registered nurse who is licensed under sections 148.171 to 148.285, and who is 
34.25 	certified as a clinical specialist or as a nurse practitioner in adult or family psychiatric and 
34.26 	mental health nursing by a national nurse certification organization, or who has a master's 
34.27 	degree in nursing or one of the behavioral sciences or related fields from an accredited 
34.28 	college or university or its equivalent, with at least 4,000 hours of post-master's supervised 
34.29 	experience in the delivery of clinical services.

35.1 	Sec. 6. Minnesota Statutes 2016, section 245D.091, subdivision 3, is amended to read:
35.2 		Subd. 3.Behavior Positive support analyst qualifications. (a) A behavior positive 
35.3 	support analyst providing behavioral positive support services as identified in section 
35.4 	245D.03, subdivision 1, paragraph (c), clause (1), item (i), must have competencies in the 
35.5 	following areas as required under the brain injury and, community access for disability 
35.6 	inclusion, community alternative care, and developmental disability waiver plans or successor 
35.7 	plans:
35.8 	(1) have obtained a baccalaureate degree, master's degree, or PhD in a social services 
35.9 	discipline; or
35.10 	(2) meet the qualifications of a mental health practitioner as defined in section 245.462, 
35.11 	subdivision 17.; or
35.12 	(3) be a board certified behavior analyst or board certified assistant behavior analyst by 
35.13 	the Behavior Analyst Certification Board, Incorporated.
35.14 	(b) In addition, a behavior positive support analyst must:
35.15 	(1) have four years of supervised experience working with individuals who exhibit 
35.16 	challenging behaviors as well as co-occurring mental disorders or neurocognitive disorder
35.17 	conducting functional behavior assessments and designing, implementing, and evaluating 
35.18 	effectiveness of positive practices behavior support strategies for people who exhibit 
35.19 	challenging behaviors as well as co-occurring mental disorders and neurocognitive disorder;
35.20 	(2) have received ten hours of instruction in functional assessment and functional analysis;
35.21 	training prior to hire or within 90 calendar days of hire that includes:
35.22 	(i) ten hours of instruction in functional assessment and functional analysis;
35.23 	(ii) 20 hours of instruction in the understanding of the function of behavior;
35.24 	(iii) ten hours of instruction on design of positive practices behavior support strategies;
35.25 	(iv) 20 hours of instruction preparing written intervention strategies, designing data 
35.26 	collection protocols, training other staff to implement positive practice strategies, 
35.27 	summarizing and reporting program evaluation data, analyzing program evaluation data to 
35.28 	identify design flaws in behavioral interventions or failures in implementation fidelity, and 
35.29 	recommending enhancements based on evaluation data; and
35.30 	(v) eight hours of instruction on principles of person-centered thinking;
35.31 	(3) have received 20 hours of instruction in the understanding of the function of behavior;
36.1 	(4) have received ten hours of instruction on design of positive practices behavior support 
36.2 	strategies;
36.3 	(5) have received 20 hours of instruction on the use of behavior reduction approved 
36.4 	strategies used only in combination with behavior positive practices strategies;
36.5 	(6) (3) be determined by a behavior positive support professional to have the training 
36.6 	and prerequisite skills required to provide positive practice strategies as well as behavior 
36.7 	reduction approved and permitted intervention to the person who receives behavioral positive
36.8 	support; and
36.9 	(7) (4) be under the direct supervision of a behavior positive support professional.
36.10 	(c) Meeting the qualifications for a positive support professional under subdivision 2 
36.11 	shall substitute for meeting the qualifications listed in paragraph (b).

36.12 	Sec. 7. Minnesota Statutes 2016, section 245D.091, subdivision 4, is amended to read:
36.13 		Subd. 4.Behavior Positive support specialist qualifications. (a) A behavior positive 
36.14 	support specialist providing behavioral positive support services as identified in section 
36.15 	245D.03, subdivision 1, paragraph (c), clause (1), item (i), must have competencies in the 
36.16 	following areas as required under the brain injury and, community access for disability 
36.17 	inclusion, community alternative care, and developmental disability waiver plans or successor 
36.18 	plans:
36.19 	(1) have an associate's degree in a social services discipline; or
36.20 	(2) have two years of supervised experience working with individuals who exhibit 
36.21 	challenging behaviors as well as co-occurring mental disorders or neurocognitive disorder.
36.22 	(b) In addition, a behavior specialist must:
36.23 	(1) have received training prior to hire or within 90 calendar days of hire that includes:
36.24 	(i) a minimum of four hours of training in functional assessment;
36.25 	(2) have received (ii) 20 hours of instruction in the understanding of the function of 
36.26 	behavior;
36.27 	(3) have received (iii) ten hours of instruction on design of positive practices behavioral 
36.28 	support strategies; and
36.29 	(iv) eight hours of instruction on principles of person-centered thinking;
36.30 	(4) (2) be determined by a behavior positive support professional to have the training 
36.31 	and prerequisite skills required to provide positive practices strategies as well as behavior 
37.1 	reduction approved intervention to the person who receives behavioral positive support; 
37.2 	and
37.3 	(5) (3) be under the direct supervision of a behavior positive support professional.
37.4 	(c) Meeting the qualifications for a positive support professional under subdivision 2 
37.5 	shall substitute for meeting the qualifications listed in paragraphs (a) and (b).

37.6 	Sec. 8. Minnesota Statutes 2016, section 256B.0659, subdivision 3a, is amended to read:
37.7 		Subd. 3a.Assessment; defined. (a) "Assessment" means a review and evaluation of a 
37.8 	recipient's need for personal care assistance services conducted in person. Assessments for 
37.9 	personal care assistance services shall be conducted by the county public health nurse or a 
37.10 	certified public health nurse under contract with the county except when a long-term care 
37.11 	consultation assessment is being conducted for the purposes of determining a person's 
37.12 	eligibility for home and community-based waiver services including personal care assistance 
37.13 	services according to section 256B.0911. During the transition to MnCHOICES, a certified 
37.14 	assessor may complete the assessment defined in this subdivision. An in-person assessment 
37.15 	must include: documentation of health status, determination of need, evaluation of service 
37.16 	effectiveness, identification of appropriate services, service plan development or modification, 
37.17 	coordination of services, referrals and follow-up to appropriate payers and community 
37.18 	resources, completion of required reports, recommendation of service authorization, and 
37.19 	consumer education. Once the need for personal care assistance services is determined under 
37.20 	this section, the county public health nurse or certified public health nurse under contract 
37.21 	with the county is responsible for communicating this recommendation to the commissioner 
37.22 	and the recipient. An in-person assessment must occur at least annually or when there is a 
37.23 	significant change in the recipient's condition or when there is a change in the need for 
37.24 	personal care assistance services. A service update may substitute for the annual face-to-face 
37.25 	assessment when there is not a significant change in recipient condition or a change in the 
37.26 	need for personal care assistance service. A service update may be completed by telephone, 
37.27 	used when there is no need for an increase in personal care assistance services, and used 
37.28 	for two consecutive assessments if followed by a face-to-face assessment. A service update 
37.29 	must be completed on a form approved by the commissioner. A service update or review 
37.30 	for temporary increase includes a review of initial baseline data, evaluation of service 
37.31 	effectiveness, redetermination of service need, modification of service plan and appropriate 
37.32 	referrals, update of initial forms, obtaining service authorization, and on going consumer 
37.33 	education. Assessments or reassessments must be completed on forms provided by the 
38.1 	commissioner within 30 days of a request for home care services by a recipient or responsible 
38.2 	party.
38.3 	(b) This subdivision expires when notification is given by the commissioner as described 
38.4 	in section 256B.0911, subdivision 3a.

38.5 	Sec. 9. Minnesota Statutes 2016, section 256B.0659, subdivision 11, is amended to read:
38.6 		Subd. 11.Personal care assistant; requirements. (a) A personal care assistant must 
38.7 	meet the following requirements:
38.8 	(1) be at least 18 years of age with the exception of persons who are 16 or 17 years of 
38.9 	age with these additional requirements:
38.10 	(i) supervision by a qualified professional every 60 days; and
38.11 	(ii) employment by only one personal care assistance provider agency responsible for 
38.12 	compliance with current labor laws;
38.13 	(2) be employed by a personal care assistance provider agency;
38.14 	(3) enroll with the department as a personal care assistant after clearing a background 
38.15 	study. Except as provided in subdivision 11a, before a personal care assistant provides 
38.16 	services, the personal care assistance provider agency must initiate a background study on 
38.17 	the personal care assistant under chapter 245C, and the personal care assistance provider 
38.18 	agency must have received a notice from the commissioner that the personal care assistant 
38.19 	is:
38.20 	(i) not disqualified under section 245C.14; or
38.21 	(ii) is disqualified, but the personal care assistant has received a set aside of the 
38.22 	disqualification under section 245C.22;
38.23 	(4) be able to effectively communicate with the recipient and personal care assistance 
38.24 	provider agency;
38.25 	(5) be able to provide covered personal care assistance services according to the recipient's 
38.26 	personal care assistance care plan, respond appropriately to recipient needs, and report 
38.27 	changes in the recipient's condition to the supervising qualified professional or physician;
38.28 	(6) not be a consumer of personal care assistance services;
38.29 	(7) maintain daily written records including, but not limited to, time sheets under 
38.30 	subdivision 12;
39.1 	(8) effective January 1, 2010, complete standardized training as determined by the 
39.2 	commissioner before completing enrollment. The training must be available in languages 
39.3 	other than English and to those who need accommodations due to disabilities. Personal care 
39.4 	assistant training must include successful completion of the following training components: 
39.5 	basic first aid, vulnerable adult, child maltreatment, OSHA universal precautions, basic 
39.6 	roles and responsibilities of personal care assistants including information about assistance 
39.7 	with lifting and transfers for recipients, emergency preparedness, orientation to positive 
39.8 	behavioral practices, fraud issues, and completion of time sheets. Upon completion of the 
39.9 	training components, the personal care assistant must demonstrate the competency to provide 
39.10 	assistance to recipients;
39.11 	(9) complete training and orientation on the needs of the recipient; and
39.12 	(10) be limited to providing and being paid for up to 275 hours per month of personal 
39.13 	care assistance services regardless of the number of recipients being served or the number 
39.14 	of personal care assistance provider agencies enrolled with. The number of hours worked 
39.15 	per day shall not be disallowed by the department unless in violation of the law.
39.16 	(b) A legal guardian may be a personal care assistant if the guardian is not being paid 
39.17 	for the guardian services and meets the criteria for personal care assistants in paragraph (a).
39.18 	(c) Persons who do not qualify as a personal care assistant include parents, stepparents, 
39.19 	and legal guardians of minors; spouses; paid legal guardians of adults; family foster care 
39.20 	providers, except as otherwise allowed in section 256B.0625, subdivision 19a; and staff of 
39.21 	a residential setting.
39.22 	(d) Personal care services qualify for the enhanced rate described in subdivision 17a if 
39.23 	the personal care assistant providing the services:
39.24 	(1) provides services, according to the care plan in subdivision 7, to a recipient who 
39.25 	qualifies for 12 or more hours per day of PCA services; and
39.26 	(2) satisfies the current requirements of Medicare for training and competency or 
39.27 	competency evaluation of home health aides or nursing assistants, as provided in the Code 
39.28 	of Federal Regulations, title 42, section 483.151 or 484.36, or alternative state approved 
39.29 	training or competency requirements.

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

40.1 	Sec. 10. Minnesota Statutes 2016, section 256B.0659, is amended by adding a subdivision 
40.2 	to read:
40.3 		Subd. 17a.Enhanced rate. An enhanced rate of 105 percent of the rate paid for PCA 
40.4 	services shall be paid for services provided to persons who qualify for 12 or more hours of 
40.5 	PCA service per day when provided by a PCA who meets the requirements of subdivision 
40.6 	11, paragraph (d). The enhanced rate for PCA services includes, and is not in addition to, 
40.7 	any rate adjustments implemented by the commissioner on July 1, 2018, to comply with 
40.8 	the terms of a collective bargaining agreement between the state of Minnesota and an 
40.9 	exclusive representative of individual providers under section 179A.54 that provides for 
40.10 	wage increases for individual providers who serve participants assessed to need 12 or more 
40.11 	hours of PCA services per day.

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

40.13 	Sec. 11. Minnesota Statutes 2016, section 256B.0659, subdivision 21, is amended to read:
40.14 		Subd. 21.Requirements for provider enrollment of personal care assistance provider 
40.15 	agencies. (a) All personal care assistance provider agencies must provide, at the time of 
40.16 	enrollment, reenrollment, and revalidation as a personal care assistance provider agency in 
40.17 	a format determined by the commissioner, information and documentation that includes, 
40.18 	but is not limited to, the following:
40.19 	(1) the personal care assistance provider agency's current contact information including 
40.20 	address, telephone number, and e-mail address;
40.21 	(2) proof of surety bond coverage. Upon new enrollment, or if the provider's Medicaid 
40.22 	revenue in the previous calendar year is up to and including $300,000, the provider agency 
40.23 	must purchase a surety bond of $50,000. If the Medicaid revenue in the previous year is 
40.24 	over $300,000, the provider agency must purchase a surety bond of $100,000. The surety 
40.25 	bond must be in a form approved by the commissioner, must be renewed annually, and must 
40.26 	allow for recovery of costs and fees in pursuing a claim on the bond;
40.27 	(3) proof of fidelity bond coverage in the amount of $20,000;
40.28 	(4) proof of workers' compensation insurance coverage;
40.29 	(5) proof of liability insurance;
40.30 	(6) a description of the personal care assistance provider agency's organization identifying 
40.31 	the names of all owners, managing employees, staff, board of directors, and the affiliations 
40.32 	of the directors, owners, or staff to other service providers;
41.1 	(7) a copy of the personal care assistance provider agency's written policies and 
41.2 	procedures including: hiring of employees; training requirements; service delivery; and 
41.3 	employee and consumer safety including process for notification and resolution of consumer 
41.4 	grievances, identification and prevention of communicable diseases, and employee 
41.5 	misconduct;
41.6 	(8) copies of all other forms the personal care assistance provider agency uses in the 
41.7 	course of daily business including, but not limited to:
41.8 	(i) a copy of the personal care assistance provider agency's time sheet if the time sheet 
41.9 	varies from the standard time sheet for personal care assistance services approved by the 
41.10 	commissioner, and a letter requesting approval of the personal care assistance provider 
41.11 	agency's nonstandard time sheet;
41.12 	(ii) the personal care assistance provider agency's template for the personal care assistance 
41.13 	care plan; and
41.14 	(iii) the personal care assistance provider agency's template for the written agreement 
41.15 	in subdivision 20 for recipients using the personal care assistance choice option, if applicable;
41.16 	(9) a list of all training and classes that the personal care assistance provider agency 
41.17 	requires of its staff providing personal care assistance services;
41.18 	(10) documentation that the personal care assistance provider agency and staff have 
41.19 	successfully completed all the training required by this section, including the requirements 
41.20 	under subdivision 11, paragraph (d), if enhanced PCA services are provided and submitted 
41.21 	for an enhanced rate under subdivision 17a;
41.22 	(11) documentation of the agency's marketing practices;
41.23 	(12) disclosure of ownership, leasing, or management of all residential properties that 
41.24 	is used or could be used for providing home care services;
41.25 	(13) documentation that the agency will use the following percentages of revenue 
41.26 	generated from the medical assistance rate paid for personal care assistance services for 
41.27 	employee personal care assistant wages and benefits: 72.5 percent of revenue in the personal 
41.28 	care assistance choice option and 72.5 percent of revenue from other personal care assistance 
41.29 	providers. The revenue generated by the qualified professional and the reasonable costs 
41.30 	associated with the qualified professional shall not be used in making this calculation; and
41.31 	(14) effective May 15, 2010, documentation that the agency does not burden recipients' 
41.32 	free exercise of their right to choose service providers by requiring personal care assistants 
41.33 	to sign an agreement not to work with any particular personal care assistance recipient or 
42.1 	for another personal care assistance provider agency after leaving the agency and that the 
42.2 	agency is not taking action on any such agreements or requirements regardless of the date 
42.3 	signed.
42.4 	(b) Personal care assistance provider agencies shall provide the information specified 
42.5 	in paragraph (a) to the commissioner at the time the personal care assistance provider agency 
42.6 	enrolls as a vendor or upon request from the commissioner. The commissioner shall collect 
42.7 	the information specified in paragraph (a) from all personal care assistance providers 
42.8 	beginning July 1, 2009.
42.9 	(c) All personal care assistance provider agencies shall require all employees in 
42.10 	management and supervisory positions and owners of the agency who are active in the 
42.11 	day-to-day management and operations of the agency to complete mandatory training as 
42.12 	determined by the commissioner before enrollment of the agency as a provider. Employees 
42.13 	in management and supervisory positions and owners who are active in the day-to-day 
42.14 	operations of an agency who have completed the required training as an employee with a 
42.15 	personal care assistance provider agency do not need to repeat the required training if they 
42.16 	are hired by another agency, if they have completed the training within the past three years. 
42.17 	By September 1, 2010, the required training must be available with meaningful access 
42.18 	according to title VI of the Civil Rights Act and federal regulations adopted under that law 
42.19 	or any guidance from the United States Health and Human Services Department. The 
42.20 	required training must be available online or by electronic remote connection. The required 
42.21 	training must provide for competency testing. Personal care assistance provider agency 
42.22 	billing staff shall complete training about personal care assistance program financial 
42.23 	management. This training is effective July 1, 2009. Any personal care assistance provider 
42.24 	agency enrolled before that date shall, if it has not already, complete the provider training 
42.25 	within 18 months of July 1, 2009. Any new owners or employees in management and 
42.26 	supervisory positions involved in the day-to-day operations are required to complete 
42.27 	mandatory training as a requisite of working for the agency. Personal care assistance provider 
42.28 	agencies certified for participation in Medicare as home health agencies are exempt from 
42.29 	the training required in this subdivision. When available, Medicare-certified home health 
42.30 	agency owners, supervisors, or managers must successfully complete the competency test.

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

42.32 	Sec. 12. Minnesota Statutes 2016, section 256B.0659, subdivision 24, is amended to read:
42.33 		Subd. 24.Personal care assistance provider agency; general duties. A personal care 
42.34 	assistance provider agency shall:
43.1 	(1) enroll as a Medicaid provider meeting all provider standards, including completion 
43.2 	of the required provider training;
43.3 	(2) comply with general medical assistance coverage requirements;
43.4 	(3) demonstrate compliance with law and policies of the personal care assistance program 
43.5 	to be determined by the commissioner;
43.6 	(4) comply with background study requirements;
43.7 	(5) verify and keep records of hours worked by the personal care assistant and qualified 
43.8 	professional;
43.9 	(6) not engage in any agency-initiated direct contact or marketing in person, by phone, 
43.10 	or other electronic means to potential recipients, guardians, or family members;
43.11 	(7) pay the personal care assistant and qualified professional based on actual hours of 
43.12 	services provided;
43.13 	(8) withhold and pay all applicable federal and state taxes;
43.14 	(9) effective January 1, 2010, document that the agency uses a minimum of 72.5 percent 
43.15 	of the revenue generated by the medical assistance rate for personal care assistance services 
43.16 	for employee personal care assistant wages and benefits. The revenue generated by the 
43.17 	qualified professional and the reasonable costs associated with the qualified professional 
43.18 	shall not be used in making this calculation;
43.19 	(10) make the arrangements and pay unemployment insurance, taxes, workers' 
43.20 	compensation, liability insurance, and other benefits, if any;
43.21 	(11) enter into a written agreement under subdivision 20 before services are provided;
43.22 	(12) report suspected neglect and abuse to the common entry point according to section 
43.23 	256B.0651;
43.24 	(13) provide the recipient with a copy of the home care bill of rights at start of service; 
43.25 	and
43.26 	(14) request reassessments at least 60 days prior to the end of the current authorization 
43.27 	for personal care assistance services, on forms provided by the commissioner; and
43.28 	(15) document that the agency uses the additional revenue due to the enhanced rate under 
43.29 	subdivision 17a for the wages and benefits of the PCAs whose services meet the requirements 
43.30 	under subdivision 11, paragraph (d).

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

44.1 	Sec. 13. Minnesota Statutes 2016, section 256B.0659, subdivision 28, is amended to read:
44.2 		Subd. 28.Personal care assistance provider agency; required documentation. (a) 
44.3 	Required documentation must be completed and kept in the personal care assistance provider 
44.4 	agency file or the recipient's home residence. The required documentation consists of:
44.5 	(1) employee files, including:
44.6 	(i) applications for employment;
44.7 	(ii) background study requests and results;
44.8 	(iii) orientation records about the agency policies;
44.9 	(iv) trainings completed with demonstration of competence, including verification of 
44.10 	the completion of training required under subdivision 11, paragraph (d), for any billing of 
44.11 	the enhanced rate under subdivision 17a;
44.12 	(v) supervisory visits;
44.13 	(vi) evaluations of employment; and
44.14 	(vii) signature on fraud statement;
44.15 	(2) recipient files, including:
44.16 	(i) demographics;
44.17 	(ii) emergency contact information and emergency backup plan;
44.18 	(iii) personal care assistance service plan;
44.19 	(iv) personal care assistance care plan;
44.20 	(v) month-to-month service use plan;
44.21 	(vi) all communication records;
44.22 	(vii) start of service information, including the written agreement with recipient; and
44.23 	(viii) date the home care bill of rights was given to the recipient;
44.24 	(3) agency policy manual, including:
44.25 	(i) policies for employment and termination;
44.26 	(ii) grievance policies with resolution of consumer grievances;
44.27 	(iii) staff and consumer safety;
44.28 	(iv) staff misconduct; and
45.1 	(v) staff hiring, service delivery, staff and consumer safety, staff misconduct, and 
45.2 	resolution of consumer grievances;
45.3 	(4) time sheets for each personal care assistant along with completed activity sheets for 
45.4 	each recipient served; and
45.5 	(5) agency marketing and advertising materials and documentation of marketing activities 
45.6 	and costs.
45.7 	(b) The commissioner may assess a fine of up to $500 on provider agencies that do not 
45.8 	consistently comply with the requirements of this subdivision.

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

45.10 	Sec. 14. Minnesota Statutes 2017 Supplement, section 256B.0911, subdivision 1a, is 
45.11 	amended to read:
45.12 		Subd. 1a.Definitions. For purposes of this section, the following definitions apply:
45.13 	(a) Until additional requirements apply under paragraph (b), "long-term care consultation 
45.14 	services" means:
45.15 	(1) intake for and access to assistance in identifying services needed to maintain an 
45.16 	individual in the most inclusive environment;
45.17 	(2) providing recommendations for and referrals to cost-effective community services 
45.18 	that are available to the individual;
45.19 	(3) development of an individual's person-centered community support plan;
45.20 	(4) providing information regarding eligibility for Minnesota health care programs;
45.21 	(5) face-to-face long-term care consultation assessments, which may be completed in a 
45.22 	hospital, nursing facility, intermediate care facility for persons with developmental disabilities 
45.23 	(ICF/DDs), regional treatment centers, or the person's current or planned residence;
45.24 	(6) determination of home and community-based waiver and other service eligibility as 
45.25 	required under sections 256B.0913, 256B.0915, and 256B.49, including level of care 
45.26 	determination for individuals who need an institutional level of care as determined under 
45.27 	subdivision 4e, based on assessment and community support plan development, appropriate 
45.28 	referrals to obtain necessary diagnostic information, and including an eligibility determination 
45.29 	for consumer-directed community supports;
45.30 	(7) providing recommendations for institutional placement when there are no 
45.31 	cost-effective community services available;
46.1 	(8) providing access to assistance to transition people back to community settings after 
46.2 	institutional admission; and
46.3 	(9) providing information about competitive employment, with or without supports, for 
46.4 	school-age youth and working-age adults and referrals to the Disability Linkage Line and 
46.5 	Disability Benefits 101 to ensure that an informed choice about competitive employment 
46.6 	can be made. For the purposes of this subdivision, "competitive employment" means work 
46.7 	in the competitive labor market that is performed on a full-time or part-time basis in an 
46.8 	integrated setting, and for which an individual is compensated at or above the minimum 
46.9 	wage, but not less than the customary wage and level of benefits paid by the employer for 
46.10 	the same or similar work performed by individuals without disabilities.
46.11 	(b) Upon statewide implementation of lead agency requirements in subdivisions 2b, 2c, 
46.12 	and 3a, "long-term care consultation services" also means:
46.13 	(1) service eligibility determination for state plan home care services identified in:
46.14 	(i) section 256B.0625, subdivisions 7, 19a, and 19c;
46.15 	(ii) consumer support grants under section 256.476; or
46.16 	(iii) section 256B.85;
46.17 	(2) notwithstanding provisions in Minnesota Rules, parts 9525.0004 to 9525.0024, 
46.18 	determination of eligibility for case management services available under sections 256B.0621, 
46.19 	subdivision 2, paragraph clause (4), and 256B.0924and Minnesota Rules, part 9525.0016;
46.20 	(3) determination of institutional level of care, home and community-based service 
46.21 	waiver, and other service eligibility as required under section 256B.092, determination of 
46.22 	eligibility for family support grants under section 252.32, semi-independent living services 
46.23 	under section 252.275, and day training and habilitation services under section 256B.092; 
46.24 	and
46.25 	(4) obtaining necessary diagnostic information to determine eligibility under clauses (2) 
46.26 	and (3); and
46.27 	(5) notwithstanding Minnesota Rules, parts 9525.0004 to 9525.0024, initial eligibility 
46.28 	determination for case management services available under Minnesota Rules, part 
46.29 	9525.0016.
46.30 	(c) "Long-term care options counseling" means the services provided by the linkage 
46.31 	lines as mandated by sections 256.01, subdivision 24, and 256.975, subdivision 7, and also 
47.1 	includes telephone assistance and follow up once a long-term care consultation assessment 
47.2 	has been completed.
47.3 	(d) "Minnesota health care programs" means the medical assistance program under this 
47.4 	chapter and the alternative care program under section 256B.0913.
47.5 	(e) "Lead agencies" means counties administering or tribes and health plans under 
47.6 	contract with the commissioner to administer long-term care consultation assessment and 
47.7 	support planning services.
47.8 	(f) "Person-centered planning" is a process that includes the active participation of a 
47.9 	person in the planning of the person's services, including in making meaningful and informed 
47.10 	choices about the person's own goals, talents, and objectives, as well as making meaningful 
47.11 	and informed choices about the services the person receives. For the purposes of this section, 
47.12 	"informed choice" means a voluntary choice of services by a person from all available 
47.13 	service options based on accurate and complete information concerning all available service 
47.14 	options and concerning the person's own preferences, abilities, goals, and objectives. In 
47.15 	order for a person to make an informed choice, all available options must be developed and 
47.16 	presented to the person to empower the person to make decisions.

47.17 	Sec. 15. Minnesota Statutes 2017 Supplement, section 256B.0911, subdivision 3a, is 
47.18 	amended to read:
47.19 		Subd. 3a.Assessment and support planning. (a) Persons requesting assessment, services 
47.20 	planning, or other assistance intended to support community-based living, including persons 
47.21 	who need assessment in order to determine waiver or alternative care program eligibility, 
47.22 	must be visited by a long-term care consultation team within 20 calendar days after the date 
47.23 	on which an assessment was requested or recommended. Upon statewide implementation 
47.24 	of subdivisions 2b, 2c, and 5, this requirement also applies to an assessment of a person 
47.25 	requesting personal care assistance services and home care nursing. The commissioner shall 
47.26 	provide at least a 90-day notice to lead agencies prior to the effective date of this requirement. 
47.27 	Face-to-face assessments must be conducted according to paragraphs (b) to (i).
47.28 	(b) Upon implementation of subdivisions 2b, 2c, and 5, lead agencies shall use certified 
47.29 	assessors to conduct the assessment. For a person with complex health care needs, a public 
47.30 	health or registered nurse from the team must be consulted.
47.31 	(c) The MnCHOICES assessment provided by the commissioner to lead agencies must 
47.32 	be used to complete a comprehensive, conversation-based, person-centered assessment. 
47.33 	The assessment must include the health, psychological, functional, environmental, and 
48.1 	social needs of the individual necessary to develop a community support plan that meets 
48.2 	the individual's needs and preferences.
48.3 	(d) The assessment must be conducted in a face-to-face conversational interview with 
48.4 	the person being assessed and. The person's legal representative must provide input during 
48.5 	the assessment process and may do so remotely if requested. At the request of the person, 
48.6 	other individuals may participate in the assessment to provide information on the needs, 
48.7 	strengths, and preferences of the person necessary to develop a community support plan 
48.8 	that ensures the person's health and safety. Except for legal representatives or family members 
48.9 	invited by the person, persons participating in the assessment may not be a provider of 
48.10 	service or have any financial interest in the provision of services. For persons who are to 
48.11 	be assessed for elderly waiver customized living or adult day services under section 
48.12 	256B.0915, with the permission of the person being assessed or the person's designated or 
48.13 	legal representative, the client's current or proposed provider of services may submit a copy 
48.14 	of the provider's nursing assessment or written report outlining its recommendations regarding 
48.15 	the client's care needs. The person conducting the assessment must notify the provider of 
48.16 	the date by which this information is to be submitted. This information shall be provided 
48.17 	to the person conducting the assessment prior to the assessment. For a person who is to be 
48.18 	assessed for waiver services under section 256B.092 or 256B.49, with the permission of 
48.19 	the person being assessed or the person's designated legal representative, the person's current 
48.20 	provider of services may submit a written report outlining recommendations regarding the 
48.21 	person's care needs prepared by a direct service employee with at least 20 hours of service 
48.22 	to that client. The person conducting the assessment or reassessment must notify the provider 
48.23 	of the date by which this information is to be submitted. This information shall be provided 
48.24 	to the person conducting the assessment and the person or the person's legal representative, 
48.25 	and must be considered prior to the finalization of the assessment or reassessment.
48.26 	(e) The person or the person's legal representative must be provided with a written 
48.27 	community support plan within 40 calendar days of the assessment visit the timelines 
48.28 	established by the commissioner, regardless of whether the individual is eligible for 
48.29 	Minnesota health care programs. The timeline for completing the community support plan 
48.30 	and any required coordinated service and support plan must not exceed 56 calendar days 
48.31 	from the assessment visit.
48.32 	(f) For a person being assessed for elderly waiver services under section 256B.0915, a 
48.33 	provider who submitted information under paragraph (d) shall receive the final written 
48.34 	community support plan when available and the Residential Services Workbook.
48.35 	(g) The written community support plan must include:
49.1 	(1) a summary of assessed needs as defined in paragraphs (c) and (d);
49.2 	(2) the individual's options and choices to meet identified needs, including all available 
49.3 	options for case management services and providers, including service provided in a 
49.4 	non-disability-specific setting;
49.5 	(3) identification of health and safety risks and how those risks will be addressed, 
49.6 	including personal risk management strategies;
49.7 	(4) referral information; and
49.8 	(5) informal caregiver supports, if applicable.
49.9 	For a person determined eligible for state plan home care under subdivision 1a, paragraph 
49.10 	(b), clause (1), the person or person's representative must also receive a copy of the home 
49.11 	care service plan developed by the certified assessor.
49.12 	(h) A person may request assistance in identifying community supports without 
49.13 	participating in a complete assessment. Upon a request for assistance identifying community 
49.14 	support, the person must be transferred or referred to long-term care options counseling 
49.15 	services available under sections 256.975, subdivision 7, and 256.01, subdivision 24, for 
49.16 	telephone assistance and follow up.
49.17 	(i) The person has the right to make the final decision between institutional placement 
49.18 	and community placement after the recommendations have been provided, except as provided 
49.19 	in section 256.975, subdivision 7a, paragraph (d).
49.20 	(j) The lead agency must give the person receiving assessment or support planning, or 
49.21 	the person's legal representative, materials, and forms supplied by the commissioner 
49.22 	containing the following information:
49.23 	(1) written recommendations for community-based services and consumer-directed 
49.24 	options;
49.25 	(2) documentation that the most cost-effective alternatives available were offered to the 
49.26 	individual. For purposes of this clause, "cost-effective" means community services and 
49.27 	living arrangements that cost the same as or less than institutional care. For an individual 
49.28 	found to meet eligibility criteria for home and community-based service programs under 
49.29 	section 256B.0915 or 256B.49, "cost-effectiveness" has the meaning found in the federally 
49.30 	approved waiver plan for each program;
49.31 	(3) the need for and purpose of preadmission screening conducted by long-term care 
49.32 	options counselors according to section 256.975, subdivisions 7a to 7c, if the person selects 
50.1 	nursing facility placement. If the individual selects nursing facility placement, the lead 
50.2 	agency shall forward information needed to complete the level of care determinations and 
50.3 	screening for developmental disability and mental illness collected during the assessment 
50.4 	to the long-term care options counselor using forms provided by the commissioner;
50.5 	(4) the role of long-term care consultation assessment and support planning in eligibility 
50.6 	determination for waiver and alternative care programs, and state plan home care, case 
50.7 	management, and other services as defined in subdivision 1a, paragraphs (a), clause (6), 
50.8 	and (b);
50.9 	(5) information about Minnesota health care programs;
50.10 	(6) the person's freedom to accept or reject the recommendations of the team;
50.11 	(7) the person's right to confidentiality under the Minnesota Government Data Practices 
50.12 	Act, chapter 13;
50.13 	(8) the certified assessor's decision regarding the person's need for institutional level of 
50.14 	care as determined under criteria established in subdivision 4e and the certified assessor's 
50.15 	decision regarding eligibility for all services and programs as defined in subdivision 1a, 
50.16 	paragraphs (a), clause (6), and (b); and
50.17 	(9) the person's right to appeal the certified assessor's decision regarding eligibility for 
50.18 	all services and programs as defined in subdivision 1a, paragraphs (a), clauses (6), (7), and 
50.19 	(8), and (b), and incorporating the decision regarding the need for institutional level of care 
50.20 	or the lead agency's final decisions regarding public programs eligibility according to section 
50.21 	256.045, subdivision 3. The certified assessor must verbally communicate this appeal right 
50.22 	to the person and must visually point out where in the document the right to appeal is stated.
50.23 	(k) Face-to-face assessment completed as part of eligibility determination for the 
50.24 	alternative care, elderly waiver, developmental disabilities, community access for disability 
50.25 	inclusion, community alternative care, and brain injury waiver programs under sections 
50.26 	256B.0913, 256B.0915, 256B.092, and 256B.49 is valid to establish service eligibility for 
50.27 	no more than 60 calendar days after the date of assessment.
50.28 	(l) The effective eligibility start date for programs in paragraph (k) can never be prior 
50.29 	to the date of assessment. If an assessment was completed more than 60 days before the 
50.30 	effective waiver or alternative care program eligibility start date, assessment and support 
50.31 	plan information must be updated and documented in the department's Medicaid Management 
50.32 	Information System (MMIS). Notwithstanding retroactive medical assistance coverage of 
51.1 	state plan services, the effective date of eligibility for programs included in paragraph (k) 
51.2 	cannot be prior to the date the most recent updated assessment is completed.
51.3 	(m) If an eligibility update is completed within 90 days of the previous face-to-face 
51.4 	assessment and documented in the department's Medicaid Management Information System 
51.5 	(MMIS), the effective date of eligibility for programs included in paragraph (k) is the date 
51.6 	of the previous face-to-face assessment when all other eligibility requirements are met.
51.7 	(n) At the time of reassessment, the certified assessor shall assess each person receiving 
51.8 	waiver services currently residing in a community residential setting, or licensed adult foster 
51.9 	care home that is not the primary residence of the license holder, or in which the license 
51.10 	holder is not the primary caregiver, to determine if that person would prefer to be served in 
51.11 	a community-living setting as defined in section 256B.49, subdivision 23. The certified 
51.12 	assessor shall offer the person, through a person-centered planning process, the option to 
51.13 	receive alternative housing and service options.

51.14 	Sec. 16. Minnesota Statutes 2017 Supplement, section 256B.0911, subdivision 3f, is 
51.15 	amended to read:
51.16 		Subd. 3f.Long-term care reassessments and community support plan updates. (a) 
51.17 	Prior to a face-to-face reassessment, the certified assessor must review the person's most 
51.18 	recent assessment. Reassessments must be tailored using the professional judgment of the 
51.19 	assessor to the person's known needs, strengths, preferences, and circumstances. 
51.20 	Reassessments provide information to support the person's informed choice and opportunities 
51.21 	to express choice regarding activities that contribute to quality of life, as well as information 
51.22 	and opportunity to identify goals related to desired employment, community activities, and 
51.23 	preferred living environment. Reassessments allow forrequire a review of the most recent 
51.24 	assessment, review of the current coordinated service and support plan's effectiveness, 
51.25 	monitoring of services, and the development of an updated person-centered community 
51.26 	support plan. Reassessments verify continued eligibility or offer alternatives as warranted 
51.27 	and provide an opportunity for quality assurance of service delivery. Face-to-face assessments
51.28 	reassessments must be conducted annually or as required by federal and state laws and rules.
51.29 	For reassessments, the certified assessor and the individual responsible for developing the 
51.30 	coordinated service and support plan must ensure the continuity of care for the person 
51.31 	receiving services and complete the updated community support plan and the updated 
51.32 	coordinated service and support plan within the timelines established by the commissioner.
52.1 	(b) The commissioner shall develop mechanisms for providers and case managers to 
52.2 	share information with the assessor to facilitate a reassessment and support planning process 
52.3 	tailored to the person's current needs and preferences.

52.4 	Sec. 17. Minnesota Statutes 2017 Supplement, section 256B.0911, subdivision 5, is 
52.5 	amended to read:
52.6 		Subd. 5.Administrative activity. (a) The commissioner shall streamline the processes, 
52.7 	including timelines for when assessments need to be completed, required to provide the 
52.8 	services in this section and shall implement integrated solutions to automate the business 
52.9 	processes to the extent necessary for community support plan approval, reimbursement, 
52.10 	program planning, evaluation, and policy development.
52.11 	(b) The commissioner of human services shall work with lead agencies responsible for 
52.12 	conducting long-term consultation services to modify the MnCHOICES application and 
52.13 	assessment policies to create efficiencies while ensuring federal compliance with medical 
52.14 	assistance and long-term services and supports eligibility criteria.
52.15 	(c) The commissioner shall work with lead agencies responsible for conducting long-term 
52.16 	consultation services to develop a set of measurable benchmarks sufficient to demonstrate 
52.17 	quarterly improvement in the average time per assessment and other mutually agreed upon 
52.18 	measures of increasing efficiency. The commissioner shall collect data on these benchmarks 
52.19 	and provide to the lead agencies and the chairs and ranking minority members of the 
52.20 	legislative committees with jurisdiction over human services an annual trend analysis of 
52.21 	the data in order to demonstrate the commissioner's compliance with the requirements of 
52.22 	this subdivision.

52.23 	Sec. 18. Minnesota Statutes 2016, section 256B.0915, subdivision 6, is amended to read:
52.24 		Subd. 6.Implementation of coordinated service and support plan. (a) Each elderly 
52.25 	waiver client shall be provided a copy of a written coordinated service and support plan 
52.26 	which that:
52.27 	(1) is developed with and signed by the recipient within ten working days after the case 
52.28 	manager receives the assessment information and written community support plan as 
52.29 	described in section 256B.0911, subdivision 3a, from the certified assessor the timelines 
52.30 	established by the commissioner. The timeline for completing the community support plan 
52.31 	under section 256B.0911, subdivision 3a, and the coordinated service and support plan must 
52.32 	not exceed 56 calendar days from the assessment visit;
53.1 	(2) includes the person's need for service and identification of service needs that will be 
53.2 	or that are met by the person's relatives, friends, and others, as well as community services 
53.3 	used by the general public;
53.4 	(3) reasonably ensures the health and welfare of the recipient;
53.5 	(4) identifies the person's preferences for services as stated by the person or the person's 
53.6 	legal guardian or conservator;
53.7 	(5) reflects the person's informed choice between institutional and community-based 
53.8 	services, as well as choice of services, supports, and providers, including available case 
53.9 	manager providers;
53.10 	(6) identifies long-range and short-range goals for the person;
53.11 	(7) identifies specific services and the amount, frequency, duration, and cost of the 
53.12 	services to be provided to the person based on assessed needs, preferences, and available 
53.13 	resources;
53.14 	(8) includes information about the right to appeal decisions under section 256.045; and
53.15 	(9) includes the authorized annual and estimated monthly amounts for the services.
53.16 	(b) In developing the coordinated service and support plan, the case manager should 
53.17 	also include the use of volunteers, religious organizations, social clubs, and civic and service 
53.18 	organizations to support the individual in the community. The lead agency must be held 
53.19 	harmless for damages or injuries sustained through the use of volunteers and agencies under 
53.20 	this paragraph, including workers' compensation liability.

53.21 	Sec. 19. Minnesota Statutes 2016, section 256B.092, subdivision 1b, is amended to read:
53.22 		Subd. 1b.Coordinated service and support plan. (a) Each recipient of home and 
53.23 	community-based waivered services shall be provided a copy of the written coordinated 
53.24 	service and support plan which that:
53.25 	(1) is developed with and signed by the recipient within ten working days after the case 
53.26 	manager receives the assessment information and written community support plan as 
53.27 	described in section 256B.0911, subdivision 3a, from the certified assessor the timelines 
53.28 	established by the commissioner. The timeline for completing the community support plan 
53.29 	under section 256B.0911, subdivision 3a, and the coordinated service and support plan must 
53.30 	not exceed 56 calendar days from the assessment visit;
54.1 	(2) includes the person's need for service, including identification of service needs that 
54.2 	will be or that are met by the person's relatives, friends, and others, as well as community 
54.3 	services used by the general public;
54.4 	(3) reasonably ensures the health and welfare of the recipient;
54.5 	(4) identifies the person's preferences for services as stated by the person, the person's 
54.6 	legal guardian or conservator, or the parent if the person is a minor, including the person's 
54.7 	choices made on self-directed options and on services and supports to achieve employment 
54.8 	goals;
54.9 	(5) provides for an informed choice, as defined in section 256B.77, subdivision 2, 
54.10 	paragraph (o), of service and support providers, and identifies all available options for case 
54.11 	management services and providers;
54.12 	(6) identifies long-range and short-range goals for the person;
54.13 	(7) identifies specific services and the amount and frequency of the services to be provided 
54.14 	to the person based on assessed needs, preferences, and available resources. The coordinated 
54.15 	service and support plan shall also specify other services the person needs that are not 
54.16 	available;
54.17 	(8) identifies the need for an individual program plan to be developed by the provider 
54.18 	according to the respective state and federal licensing and certification standards, and 
54.19 	additional assessments to be completed or arranged by the provider after service initiation;
54.20 	(9) identifies provider responsibilities to implement and make recommendations for 
54.21 	modification to the coordinated service and support plan;
54.22 	(10) includes notice of the right to request a conciliation conference or a hearing under 
54.23 	section 256.045;
54.24 	(11) is agreed upon and signed by the person, the person's legal guardian or conservator, 
54.25 	or the parent if the person is a minor, and the authorized county representative;
54.26 	(12) is reviewed by a health professional if the person has overriding medical needs that 
54.27 	impact the delivery of services; and
54.28 	(13) includes the authorized annual and monthly amounts for the services.
54.29 	(b) In developing the coordinated service and support plan, the case manager is 
54.30 	encouraged to include the use of volunteers, religious organizations, social clubs, and civic 
54.31 	and service organizations to support the individual in the community. The lead agency must 
55.1 	be held harmless for damages or injuries sustained through the use of volunteers and agencies 
55.2 	under this paragraph, including workers' compensation liability.
55.3 	(c) Approved, written, and signed changes to a consumer's services that meet the criteria 
55.4 	in this subdivision shall be an addendum to that consumer's individual service plan.

55.5 	Sec. 20. Minnesota Statutes 2016, section 256B.092, subdivision 1g, is amended to read:
55.6 		Subd. 1g.Conditions not requiring development of coordinated service and support 
55.7 	plan. (a) Unless otherwise required by federal law, the county agency is not required to 
55.8 	complete a coordinated service and support plan as defined in subdivision 1b for:
55.9 	(1) persons whose families are requesting respite care for their family member who 
55.10 	resides with them, or whose families are requesting a family support grant and are not 
55.11 	requesting purchase or arrangement of habilitative services; and
55.12 	(2) persons with developmental disabilities, living independently without authorized 
55.13 	services or receiving funding for services at a rehabilitation facility as defined in section 
55.14 	268A.01, subdivision 6, and not in need of or requesting additional services.
55.15 	(b) Unless otherwise required by federal law, the county agency is not required to conduct 
55.16 	or arrange for an annual needs reassessment by a certified assessor. The case manager who 
55.17 	works on behalf of the person to identify the person's needs and to minimize the impact of 
55.18 	the disability on the person's life must develop a person-centered service plan based on the 
55.19 	person's assessed needs and preferences. The person-centered service plan must be reviewed 
55.20 	annually. This paragraph applies to persons with developmental disabilities who are receiving 
55.21 	case management services under Minnesota Rules, part 9525.0036, and who make an 
55.22 	informed choice to decline an assessment under section 256B.0911.

55.23 	Sec. 21. Minnesota Statutes 2017 Supplement, section 256B.49, subdivision 13, is amended 
55.24 	to read:
55.25 		Subd. 13.Case management. (a) Each recipient of a home and community-based waiver 
55.26 	shall be provided case management services by qualified vendors as described in the federally 
55.27 	approved waiver application. The case management service activities provided must include:
55.28 	(1) finalizing the written coordinated service and support plan within ten working days 
55.29 	after the case manager receives the plan from the certified assessor the timelines established 
55.30 	by the commissioner. The timeline for completing the community support plan under section 
55.31 	256B.0911, subdivision 3a, and the coordinated service and support plan must not exceed 
55.32 	56 calendar days from the assessment visit;
56.1 	(2) informing the recipient or the recipient's legal guardian or conservator of service 
56.2 	options;
56.3 	(3) assisting the recipient in the identification of potential service providers and available 
56.4 	options for case management service and providers, including services provided in a 
56.5 	non-disability-specific setting;
56.6 	(4) assisting the recipient to access services and assisting with appeals under section 
56.7 	256.045; and
56.8 	(5) coordinating, evaluating, and monitoring of the services identified in the service 
56.9 	plan.
56.10 	(b) The case manager may delegate certain aspects of the case management service 
56.11 	activities to another individual provided there is oversight by the case manager. The case 
56.12 	manager may not delegate those aspects which require professional judgment including:
56.13 	(1) finalizing the coordinated service and support plan;
56.14 	(2) ongoing assessment and monitoring of the person's needs and adequacy of the 
56.15 	approved coordinated service and support plan; and
56.16 	(3) adjustments to the coordinated service and support plan.
56.17 	(c) Case management services must be provided by a public or private agency that is 
56.18 	enrolled as a medical assistance provider determined by the commissioner to meet all of 
56.19 	the requirements in the approved federal waiver plans. Case management services must not 
56.20 	be provided to a recipient by a private agency that has any financial interest in the provision 
56.21 	of any other services included in the recipient's coordinated service and support plan. For 
56.22 	purposes of this section, "private agency" means any agency that is not identified as a lead 
56.23 	agency under section 256B.0911, subdivision 1a, paragraph (e).
56.24 	(d) For persons who need a positive support transition plan as required in chapter 245D, 
56.25 	the case manager shall participate in the development and ongoing evaluation of the plan 
56.26 	with the expanded support team. At least quarterly, the case manager, in consultation with 
56.27 	the expanded support team, shall evaluate the effectiveness of the plan based on progress 
56.28 	evaluation data submitted by the licensed provider to the case manager. The evaluation must 
56.29 	identify whether the plan has been developed and implemented in a manner to achieve the 
56.30 	following within the required timelines:
56.31 	(1) phasing out the use of prohibited procedures;
57.1 	(2) acquisition of skills needed to eliminate the prohibited procedures within the plan's 
57.2 	timeline; and
57.3 	(3) accomplishment of identified outcomes.
57.4 	If adequate progress is not being made, the case manager shall consult with the person's 
57.5 	expanded support team to identify needed modifications and whether additional professional 
57.6 	support is required to provide consultation.

57.7 	Sec. 22. Minnesota Statutes 2017 Supplement, section 256B.4914, subdivision 2, is 
57.8 	amended to read:
57.9 		Subd. 2.Definitions. (a) For purposes of this section, the following terms have the 
57.10 	meanings given them, unless the context clearly indicates otherwise.
57.11 	(b) "Commissioner" means the commissioner of human services.
57.12 	(c) "Component value" means underlying factors that are part of the cost of providing 
57.13 	services that are built into the waiver rates methodology to calculate service rates.
57.14 	(d) "Customized living tool" means a methodology for setting service rates that delineates 
57.15 	and documents the amount of each component service included in a recipient's customized 
57.16 	living service plan.
57.17 	(e) "Direct care staff" means employees providing direct service provision to people 
57.18 	receiving services under this section. Direct care staff does not include executive, managerial, 
57.19 	and administrative staff.
57.20 	(f)  "Disability waiver rates system" means a statewide system that establishes rates that 
57.21 	are based on uniform processes and captures the individualized nature of waiver services 
57.22 	and recipient needs.
57.23 	(f) (g) "Individual staffing" means the time spent as a one-to-one interaction specific to 
57.24 	an individual recipient by staff to provide direct support and assistance with activities of 
57.25 	daily living, instrumental activities of daily living, and training to participants, and is based 
57.26 	on the requirements in each individual's coordinated service and support plan under section 
57.27 	245D.02, subdivision 4b; any coordinated service and support plan addendum under section 
57.28 	245D.02, subdivision 4c; and an assessment tool. Provider observation of an individual's 
57.29 	needs must also be considered.
57.30 	(g) (h) "Lead agency" means a county, partnership of counties, or tribal agency charged 
57.31 	with administering waivered services under sections 256B.092 and 256B.49.
58.1 	(h) (i) "Median" means the amount that divides distribution into two equal groups, 
58.2 	one-half above the median and one-half below the median.
58.3 	(i) (j) "Payment or rate" means reimbursement to an eligible provider for services 
58.4 	provided to a qualified individual based on an approved service authorization.
58.5 	(j) (k) "Rates management system" means a Web-based software application that uses 
58.6 	a framework and component values, as determined by the commissioner, to establish service 
58.7 	rates.
58.8 	(k) (l) "Recipient" means a person receiving home and community-based services funded 
58.9 	under any of the disability waivers.
58.10 	(l) (m) "Shared staffing" means time spent by employees, not defined under paragraph 
58.11 	(f) (g), providing or available to provide more than one individual with direct support and 
58.12 	assistance with activities of daily living as defined under section 256B.0659, subdivision 
58.13 	1, paragraph (b); instrumental activities of daily living as defined under section 256B.0659, 
58.14 	subdivision 1, paragraph (i); ancillary activities needed to support individual services; and 
58.15 	training to participants, and is based on the requirements in each individual's coordinated 
58.16 	service and support plan under section 245D.02, subdivision 4b; any coordinated service 
58.17 	and support plan addendum under section 245D.02, subdivision 4c; an assessment tool; and 
58.18 	provider observation of an individual's service need. Total shared staffing hours are divided 
58.19 	proportionally by the number of individuals who receive the shared service provisions.
58.20 	(m) (n) "Staffing ratio" means the number of recipients a service provider employee 
58.21 	supports during a unit of service based on a uniform assessment tool, provider observation, 
58.22 	case history, and the recipient's services of choice, and not based on the staffing ratios under 
58.23 	section 245D.31.
58.24 	(n) (o) "Unit of service" means the following:
58.25 	(1) for residential support services under subdivision 6, a unit of service is a day. Any 
58.26 	portion of any calendar day, within allowable Medicaid rules, where an individual spends 
58.27 	time in a residential setting is billable as a day;
58.28 	(2) for day services under subdivision 7:
58.29 	(i) for day training and habilitation services, a unit of service is either:
58.30 	(A) a day unit of service is defined as six or more hours of time spent providing direct 
58.31 	services and transportation; or
59.1 	(B) a partial day unit of service is defined as fewer than six hours of time spent providing 
59.2 	direct services and transportation; and
59.3 	(C) for new day service recipients after January 1, 2014, 15 minute units of service must 
59.4 	be used for fewer than six hours of time spent providing direct services and transportation;
59.5 	(ii) for adult day and structured day services, a unit of service is a day or 15 minutes. A 
59.6 	day unit of service is six or more hours of time spent providing direct services;
59.7 	(iii) for prevocational services, a unit of service is a day or an hour. A day unit of service 
59.8 	is six or more hours of time spent providing direct service;
59.9 	(3) for unit-based services with programming under subdivision 8:
59.10 	(i) for supported living services, a unit of service is a day or 15 minutes. When a day 
59.11 	rate is authorized, any portion of a calendar day where an individual receives services is 
59.12 	billable as a day; and
59.13 	(ii) for all other services, a unit of service is 15 minutes; and
59.14 	(4) for unit-based services without programming under subdivision 9, a unit of service 
59.15 	is 15 minutes.

59.16 	Sec. 23. Minnesota Statutes 2017 Supplement, section 256B.4914, subdivision 3, is 
59.17 	amended to read:
59.18 		Subd. 3.Applicable services. Applicable services are those authorized under the state's 
59.19 	home and community-based services waivers under sections 256B.092 and 256B.49, 
59.20 	including the following, as defined in the federally approved home and community-based 
59.21 	services plan:
59.22 	(1) 24-hour customized living;
59.23 	(2) adult day care;
59.24 	(3) adult day care bath;
59.25 	(4) behavioral programming;
59.26 	(5) (4) companion services;
59.27 	(6) (5) customized living;
59.28 	(7) (6) day training and habilitation;
59.29 	(7) employment development services;
59.30 	(8) employment exploration services;
60.1 	(9) employment support services;
60.2 	(8) (10) housing access coordination;
60.3 	(9) (11) independent living skills;
60.4 	(12) independent living skills specialist services;
60.5 	(13) individualized home supports;
60.6 	(10) (14) in-home family support;
60.7 	(11) (15) night supervision;
60.8 	(12) (16) personal support;
60.9 	(17) positive support service;
60.10 	(13) (18) prevocational services;
60.11 	(14) (19) residential care services;
60.12 	(15) (20) residential support services;
60.13 	(16) (21) respite services;
60.14 	(17) (22) structured day services;
60.15 	(18) (23) supported employment services;
60.16 	(19) (24) supported living services;
60.17 	(20) (25) transportation services;
60.18 	(21) individualized home supports;
60.19 	(22) independent living skills specialist services;
60.20 	(23) employment exploration services;
60.21 	(24) employment development services;
60.22 	(25) employment support services; and
60.23 	(26) other services as approved by the federal government in the state home and 
60.24 	community-based services plan.

60.25 	Sec. 24. Minnesota Statutes 2016, section 256B.4914, subdivision 4, is amended to read:
60.26 		Subd. 4.Data collection for rate determination. (a) Rates for applicable home and 
60.27 	community-based waivered services, including rate exceptions under subdivision 12, are 
60.28 	set by the rates management system.
61.1 	(b) Data for services under section 256B.4913, subdivision 4a, shall be collected in a 
61.2 	manner prescribed by the commissioner.
61.3 	(c) Data and information in the rates management system may be used to calculate an 
61.4 	individual's rate.
61.5 	(d) Service providers, with information from the community support plan and oversight 
61.6 	by lead agencies, shall provide values and information needed to calculate an individual's 
61.7 	rate into the rates management system. The determination of service levels must be part of 
61.8 	a discussion with members of the support team as defined in section 245D.02, subdivision 
61.9 	34. This discussion must occur prior to the final establishment of each individual's rate. The 
61.10 	values and information include:
61.11 	(1) shared staffing hours;
61.12 	(2) individual staffing hours;
61.13 	(3) direct registered nurse hours;
61.14 	(4) direct licensed practical nurse hours;
61.15 	(5) staffing ratios;
61.16 	(6) information to document variable levels of service qualification for variable levels 
61.17 	of reimbursement in each framework;
61.18 	(7) shared or individualized arrangements for unit-based services, including the staffing 
61.19 	ratio;
61.20 	(8) number of trips and miles for transportation services; and
61.21 	(9) service hours provided through monitoring technology.
61.22 	(e) Updates to individual data must include:
61.23 	(1) data for each individual that is updated annually when renewing service plans; and
61.24 	(2) requests by individuals or lead agencies to update a rate whenever there is a change 
61.25 	in an individual's service needs, with accompanying documentation.
61.26 	(f) Lead agencies shall review and approve all services reflecting each individual's needs, 
61.27 	and the values to calculate the final payment rate for services with variables under 
61.28 	subdivisions 6, 7, 8, and 9 for each individual. Lead agencies must notify the individual and 
61.29 	the service provider of the final agreed-upon values and rate, and provide information that 
61.30 	is identical to what was entered into the rates management system. If a value used was 
61.31 	mistakenly or erroneously entered and used to calculate a rate, a provider may petition lead 
62.1 	agencies to correct it. Lead agencies must respond to these requests. When responding to 
62.2 	the request, the lead agency must consider:
62.3 	(1) meeting the health and welfare needs of the individual or individuals receiving 
62.4 	services by service site, identified in their coordinated service and support plan under section 
62.5 	245D.02, subdivision 4b, and any addendum under section 245D.02, subdivision 4c;
62.6 	(2) meeting the requirements for staffing under subdivision 2, paragraphs (f) (g), (i) (m), 
62.7 	and (m) (n); and meeting or exceeding the licensing standards for staffing required under 
62.8 	section 245D.09, subdivision 1; and
62.9 	(3) meeting the staffing ratio requirements under subdivision 2, paragraph (n), and 
62.10 	meeting or exceeding the licensing standards for staffing required under section 245D.31.

62.11 	Sec. 25. Minnesota Statutes 2017 Supplement, section 256B.4914, subdivision 5, is 
62.12 	amended to read:
62.13 		Subd. 5.Base wage index and standard component values. (a) The base wage index 
62.14 	is established to determine staffing costs associated with providing services to individuals 
62.15 	receiving home and community-based services. For purposes of developing and calculating 
62.16 	the proposed base wage, Minnesota-specific wages taken from job descriptions and standard 
62.17 	occupational classification (SOC) codes from the Bureau of Labor Statistics as defined in 
62.18 	the most recent edition of the Occupational Handbook must be used. The base wage index 
62.19 	must be calculated as follows:
62.20 	(1) for residential direct care staff, the sum of:
62.21 	(i) 15 percent of the subtotal of 50 percent of the median wage for personal and home 
62.22 	health aide (SOC code 39-9021); 30 percent of the median wage for nursing assistant (SOC 
62.23 	code 31-1014); and 20 percent of the median wage for social and human services aide (SOC 
62.24 	code 21-1093); and
62.25 	(ii) 85 percent of the subtotal of 20 percent of the median wage for home health aide 
62.26 	(SOC code 31-1011); 20 percent of the median wage for personal and home health aide 
62.27 	(SOC code 39-9021); 20 percent of the median wage for nursing assistant (SOC code 
62.28 	31-1014); 20 percent of the median wage for psychiatric technician (SOC code 29-2053); 
62.29 	and 20 percent of the median wage for social and human services aide (SOC code 21-1093);
62.30 	(2) for day services, 20 percent of the median wage for nursing assistant (SOC code 
62.31 	31-1014); 20 percent of the median wage for psychiatric technician (SOC code 29-2053); 
62.32 	and 60 percent of the median wage for social and human services aide (SOC code 21-1093);
63.1 	(3) for residential asleep-overnight staff, the wage is the minimum wage in Minnesota 
63.2 	for large employers, except in a family foster care setting, the wage is 36 percent of the 
63.3 	minimum wage in Minnesota for large employers;
63.4 	(4) for behavior program analyst staff, 100 percent of the median wage for mental health 
63.5 	counselors (SOC code 21-1014);
63.6 	(5) for behavior program professional staff, 100 percent of the median wage for clinical 
63.7 	counseling and school psychologist (SOC code 19-3031);
63.8 	(6) for behavior program specialist staff, 100 percent of the median wage for psychiatric 
63.9 	technicians (SOC code 29-2053);
63.10 	(7) for supportive living services staff, 20 percent of the median wage for nursing assistant 
63.11 	(SOC code 31-1014); 20 percent of the median wage for psychiatric technician (SOC code 
63.12 	29-2053); and 60 percent of the median wage for social and human services aide (SOC code 
63.13 	21-1093);
63.14 	(8) for housing access coordination staff, 100 percent of the median wage for community 
63.15 	and social services specialist (SOC code 21-1099);
63.16 	(9) for in-home family support staff, 20 percent of the median wage for nursing aide 
63.17 	(SOC code 31-1012); 30 percent of the median wage for community social service specialist 
63.18 	(SOC code 21-1099); 40 percent of the median wage for social and human services aide 
63.19 	(SOC code 21-1093); and ten percent of the median wage for psychiatric technician (SOC 
63.20 	code 29-2053);
63.21 	(10) for individualized home supports services staff, 40 percent of the median wage for 
63.22 	community social service specialist (SOC code 21-1099); 50 percent of the median wage 
63.23 	for social and human services aide (SOC code 21-1093); and ten percent of the median 
63.24 	wage for psychiatric technician (SOC code 29-2053);
63.25 	(11) for independent living skills staff, 40 percent of the median wage for community 
63.26 	social service specialist (SOC code 21-1099); 50 percent of the median wage for social and 
63.27 	human services aide (SOC code 21-1093); and ten percent of the median wage for psychiatric 
63.28 	technician (SOC code 29-2053);
63.29 	(12) for independent living skills specialist staff, 100 percent of mental health and 
63.30 	substance abuse social worker (SOC code 21-1023);
63.31 	(13) for supported employment staff, 20 percent of the median wage for nursing assistant 
63.32 	(SOC code 31-1014); 20 percent of the median wage for psychiatric technician (SOC code 
64.1 	29-2053); and 60 percent of the median wage for social and human services aide (SOC code 
64.2 	21-1093);
64.3 	(14) for employment support services staff, 50 percent of the median wage for 
64.4 	rehabilitation counselor (SOC code 21-1015); and 50 percent of the median wage for 
64.5 	community and social services specialist (SOC code 21-1099);
64.6 	(15) for employment exploration services staff, 50 percent of the median wage for 
64.7 	rehabilitation counselor (SOC code 21-1015); and 50 percent of the median wage for 
64.8 	community and social services specialist (SOC code 21-1099);
64.9 	(16) for employment development services staff, 50 percent of the median wage for 
64.10 	education, guidance, school, and vocational counselors (SOC code 21-1012); and 50 percent 
64.11 	of the median wage for community and social services specialist (SOC code 21-1099);
64.12 	(17) for adult companion staff, 50 percent of the median wage for personal and home 
64.13 	care aide (SOC code 39-9021); and 50 percent of the median wage for nursing assistant 
64.14 	(SOC code 31-1014);
64.15 	(18) for night supervision staff, 20 percent of the median wage for home health aide 
64.16 	(SOC code 31-1011); 20 percent of the median wage for personal and home health aide 
64.17 	(SOC code 39-9021); 20 percent of the median wage for nursing assistant (SOC code 
64.18 	31-1014); 20 percent of the median wage for psychiatric technician (SOC code 29-2053); 
64.19 	and 20 percent of the median wage for social and human services aide (SOC code 21-1093);
64.20 	(19) for respite staff, 50 percent of the median wage for personal and home care aide 
64.21 	(SOC code 39-9021); and 50 percent of the median wage for nursing assistant (SOC code 
64.22 	31-1014);
64.23 	(20) for personal support staff, 50 percent of the median wage for personal and home 
64.24 	care aide (SOC code 39-9021); and 50 percent of the median wage for nursing assistant 
64.25 	(SOC code 31-1014);
64.26 	(21) for supervisory staff, 100 percent of the median wage for community and social 
64.27 	services specialist (SOC code 21-1099), with the exception of the supervisor of behavior 
64.28 	professional, behavior analyst, and behavior specialists, which is 100 percent of the median 
64.29 	wage for clinical counseling and school psychologist (SOC code 19-3031);
64.30 	(22) for registered nurse staff, 100 percent of the median wage for registered nurses 
64.31 	(SOC code 29-1141); and
64.32 	(23) for licensed practical nurse staff, 100 percent of the median wage for licensed 
64.33 	practical nurses (SOC code 29-2061).
65.1 	(b) Component values for residential support services are:
65.2 	(1) supervisory span of control ratio: 11 percent;
65.3 	(2) employee vacation, sick, and training allowance ratio: 8.71 percent;
65.4 	(3) employee-related cost ratio: 23.6 percent;
65.5 	(4) general administrative support ratio: 13.25 percent;
65.6 	(5) program-related expense ratio: 1.3 percent; and
65.7 	(6) absence and utilization factor ratio: 3.9 percent.
65.8 	(c) Component values for family foster care are:
65.9 	(1) supervisory span of control ratio: 11 percent;
65.10 	(2) employee vacation, sick, and training allowance ratio: 8.71 percent;
65.11 	(3) employee-related cost ratio: 23.6 percent;
65.12 	(4) general administrative support ratio: 3.3 percent;
65.13 	(5) program-related expense ratio: 1.3 percent; and
65.14 	(6) absence factor: 1.7 percent.
65.15 	(d) Component values for day services for all services are:
65.16 	(1) supervisory span of control ratio: 11 percent;
65.17 	(2) employee vacation, sick, and training allowance ratio: 8.71 percent;
65.18 	(3) employee-related cost ratio: 23.6 percent;
65.19 	(4) program plan support ratio: 5.6 percent;
65.20 	(5) client programming and support ratio: ten percent;
65.21 	(6) general administrative support ratio: 13.25 percent;
65.22 	(7) program-related expense ratio: 1.8 percent; and
65.23 	(8) absence and utilization factor ratio: 9.4 percent.
65.24 	(e) Component values for unit-based services with programming are:
65.25 	(1) supervisory span of control ratio: 11 percent;
65.26 	(2) employee vacation, sick, and training allowance ratio: 8.71 percent;
65.27 	(3) employee-related cost ratio: 23.6 percent;
66.1 	(4) program plan supports ratio: 15.5 percent;
66.2 	(5) client programming and supports ratio: 4.7 percent;
66.3 	(6) general administrative support ratio: 13.25 percent;
66.4 	(7) program-related expense ratio: 6.1 percent; and
66.5 	(8) absence and utilization factor ratio: 3.9 percent.
66.6 	(f) Component values for unit-based services without programming except respite are:
66.7 	(1) supervisory span of control ratio: 11 percent;
66.8 	(2) employee vacation, sick, and training allowance ratio: 8.71 percent;
66.9 	(3) employee-related cost ratio: 23.6 percent;
66.10 	(4) program plan support ratio: 7.0 percent;
66.11 	(5) client programming and support ratio: 2.3 percent;
66.12 	(6) general administrative support ratio: 13.25 percent;
66.13 	(7) program-related expense ratio: 2.9 percent; and
66.14 	(8) absence and utilization factor ratio: 3.9 percent.
66.15 	(g) Component values for unit-based services without programming for respite are:
66.16 	(1) supervisory span of control ratio: 11 percent;
66.17 	(2) employee vacation, sick, and training allowance ratio: 8.71 percent;
66.18 	(3) employee-related cost ratio: 23.6 percent;
66.19 	(4) general administrative support ratio: 13.25 percent;
66.20 	(5) program-related expense ratio: 2.9 percent; and
66.21 	(6) absence and utilization factor ratio: 3.9 percent.
66.22 	(h) On July 1, 2017, the commissioner shall update the base wage index in paragraph 
66.23 	(a) based on the wage data by standard occupational code (SOC) from the Bureau of Labor 
66.24 	Statistics available on December 31, 2016. The commissioner shall publish these updated 
66.25 	values and load them into the rate management system. On July 1, 2022, and every five 
66.26 	years thereafter, the commissioner shall update the base wage index in paragraph (a) based 
66.27 	on the most recently available wage data by SOC from the Bureau of Labor Statistics. The 
66.28 	commissioner shall publish these updated values and load them into the rate management 
66.29 	system.
67.1 	(i) On July 1, 2017, the commissioner shall update the framework components in 
67.2 	paragraph (d), clause (5); paragraph (e), clause (5); and paragraph (f), clause (5); subdivision 
67.3 	6, clauses (8) and (9); and subdivision 7, clauses (10), (16), and (17), for changes in the 
67.4 	Consumer Price Index. The commissioner will adjust these values higher or lower by the 
67.5 	percentage change in the Consumer Price Index-All Items, United States city average 
67.6 	(CPI-U) from January 1, 2014, to January 1, 2017. The commissioner shall publish these 
67.7 	updated values and load them into the rate management system. On July 1, 2022, and every 
67.8 	five years thereafter, the commissioner shall update the framework components in paragraph 
67.9 	(d), clause (5); paragraph (e), clause (5); and paragraph (f), clause (5); subdivision 6, clauses 
67.10 	(8) and (9); and subdivision 7, clauses (10), (16), and (17), for changes in the Consumer 
67.11 	Price Index. The commissioner shall adjust these values higher or lower by the percentage 
67.12 	change in the CPI-U from the date of the previous update to the date of the data most recently 
67.13 	available prior to the scheduled update. The commissioner shall publish these updated values 
67.14 	and load them into the rate management system.
67.15 	(j) In this subdivision, if Bureau of Labor Statistics occupational codes or Consumer 
67.16 	Price Index items are unavailable in the future, the commissioner shall recommend to the 
67.17 	legislature codes or items to update and replace missing component values.
67.18 	(k) The commissioner shall increase the updated base wage index in paragraph (h) with 
67.19 	a competitive workforce factor as follows:
67.20 	(1) effective January 1, 2019, the competitive workforce factor is 8.35 percent;
67.21 	(2) effective July 1, 2019, the competitive workforce factor is decreased to 5.5 percent; 
67.22 	and
67.23 	(3) effective July 1, 2020, the competitive workforce factor is decreased to 1.8 percent.
67.24 	The lead agencies must implement changes to the competitive workforce factor on the dates 
67.25 	listed in clauses (1) to (3), and not as reassessments and reauthorizations occur.

67.26 	EFFECTIVE DATE. This section is effective January 1, 2019, or upon federal approval, 
67.27 	whichever occurs later. The commissioner shall inform the revisor of statutes when federal 
67.28 	approval is obtained.

67.29 	Sec. 26. Minnesota Statutes 2017 Supplement, section 256B.4914, subdivision 10, is 
67.30 	amended to read:
67.31 		Subd. 10.Updating payment values and additional information. (a) From January 
67.32 	1, 2014, through December 31, 2017, the commissioner shall develop and implement uniform 
67.33 	procedures to refine terms and adjust values used to calculate payment rates in this section.
68.1 	(b) No later than July 1, 2014, the commissioner shall, within available resources, begin 
68.2 	to conduct research and gather data and information from existing state systems or other 
68.3 	outside sources on the following items:
68.4 	(1) differences in the underlying cost to provide services and care across the state; and
68.5 	(2) mileage, vehicle type, lift requirements, incidents of individual and shared rides, and 
68.6 	units of transportation for all day services, which must be collected from providers using 
68.7 	the rate management worksheet and entered into the rates management system; and
68.8 	(3) the distinct underlying costs for services provided by a license holder under sections 
68.9 	245D.05, 245D.06, 245D.07, 245D.071, 245D.081, and 245D.09, and for services provided 
68.10 	by a license holder certified under section 245D.33.
68.11 	(c) Beginning January 1, 2014, through December 31, 2018, using a statistically valid 
68.12 	set of rates management system data, the commissioner, in consultation with stakeholders, 
68.13 	shall analyze for each service the average difference in the rate on December 31, 2013, and 
68.14 	the framework rate at the individual, provider, lead agency, and state levels. The 
68.15 	commissioner shall issue semiannual reports to the stakeholders on the difference in rates 
68.16 	by service and by county during the banding period under section 256B.4913, subdivision 
68.17 	4a. The commissioner shall issue the first report by October 1, 2014, and the final report 
68.18 	shall be issued by December 31, 2018.
68.19 	(d) No later than July 1, 2014, the commissioner, in consultation with stakeholders, shall 
68.20 	begin the review and evaluation of the following values already in subdivisions 6 to 9, or 
68.21 	issues that impact all services, including, but not limited to:
68.22 	(1) values for transportation rates;
68.23 	(2) values for services where monitoring technology replaces staff time;
68.24 	(3) values for indirect services;
68.25 	(4) values for nursing;
68.26 	(5) values for the facility use rate in day services, and the weightings used in the day 
68.27 	service ratios and adjustments to those weightings;
68.28 	(6) values for workers' compensation as part of employee-related expenses;
68.29 	(7) values for unemployment insurance as part of employee-related expenses;
68.30 	(8) any changes in state or federal law with a direct impact on the underlying cost of 
68.31 	providing home and community-based services; and
69.1 	(9) direct care staff labor market measures; and
69.2 	(10) outcome measures, determined by the commissioner, for home and community-based 
69.3 	services rates determined under this section.
69.4 	(e) The commissioner shall report to the chairs and the ranking minority members of 
69.5 	the legislative committees and divisions with jurisdiction over health and human services 
69.6 	policy and finance with the information and data gathered under paragraphs (b) to (d), and 
69.7 	subdivision 10, paragraph (g), clause (6), on the following dates:
69.8 	(1) January 15, 2015, with preliminary results and data;
69.9 	(2) January 15, 2016, with a status implementation update, and additional data and 
69.10 	summary information;
69.11 	(3) January 15, 2017, with the full report; and
69.12 	(4) January 15, 2020, with another full report, and a full report once every four years 
69.13 	thereafter.
69.14 	(f) The commissioner shall implement a regional adjustment factor to all rate calculations 
69.15 	in subdivisions 6 to 9, effective no later than January 1, 2015. Beginning July 1, 2017, the 
69.16 	commissioner shall renew analysis and implement changes to the regional adjustment factors 
69.17 	when adjustments required under subdivision 5, paragraph (h), occur. Prior to 
69.18 	implementation, the commissioner shall consult with stakeholders on the methodology to 
69.19 	calculate the adjustment.
69.20 	(g) The commissioner shall provide a public notice via LISTSERV in October of each 
69.21 	year beginning October 1, 2014, containing information detailing legislatively approved 
69.22 	changes in:
69.23 	(1) calculation values including derived wage rates and related employee and 
69.24 	administrative factors;
69.25 	(2) service utilization;
69.26 	(3) county and tribal allocation changes; and
69.27 	(4) information on adjustments made to calculation values and the timing of those 
69.28 	adjustments.
69.29 	The information in this notice must be effective January 1 of the following year.
69.30 	(h) When the available shared staffing hours in a residential setting are insufficient to 
69.31 	meet the needs of an individual who enrolled in residential services after January 1, 2014, 
70.1 	or insufficient to meet the needs of an individual with a service agreement adjustment 
70.2 	described in section 256B.4913, subdivision 4a, paragraph (f), then individual staffing hours 
70.3 	shall be used.
70.4 	(i) The commissioner shall study the underlying cost of absence and utilization for day 
70.5 	services. Based on the commissioner's evaluation of the data collected under this paragraph, 
70.6 	the commissioner shall make recommendations to the legislature by January 15, 2018, for 
70.7 	changes, if any, to the absence and utilization factor ratio component value for day services.
70.8 	(j) Beginning July 1, 2017, the commissioner shall collect transportation and trip 
70.9 	information for all day services through the rates management system.

70.10 	Sec. 27. Minnesota Statutes 2017 Supplement, section 256B.4914, subdivision 10a, is 
70.11 	amended to read:
70.12 		Subd. 10a.Reporting and analysis of cost data. (a) The commissioner must ensure 
70.13 	that wage values and component values in subdivisions 5 to 9 reflect the cost to provide the 
70.14 	service. As determined by the commissioner, in consultation with stakeholders identified 
70.15 	in section 256B.4913, subdivision 5, a provider enrolled to provide services with rates 
70.16 	determined under this section must submit requested cost data to the commissioner to support 
70.17 	research on the cost of providing services that have rates determined by the disability waiver 
70.18 	rates system. Requested cost data may include, but is not limited to:
70.19 	(1) worker wage costs;
70.20 	(2) benefits paid;
70.21 	(3) supervisor wage costs;
70.22 	(4) executive wage costs;
70.23 	(5) vacation, sick, and training time paid;
70.24 	(6) taxes, workers' compensation, and unemployment insurance costs paid;
70.25 	(7) administrative costs paid;
70.26 	(8) program costs paid;
70.27 	(9) transportation costs paid;
70.28 	(10) vacancy rates; and
70.29 	(11) other data relating to costs required to provide services requested by the 
70.30 	commissioner.
71.1 	(b) At least once in any five-year period, a provider must submit cost data for a fiscal 
71.2 	year that ended not more than 18 months prior to the submission date. The commissioner 
71.3 	shall provide each provider a 90-day notice prior to its submission due date. If a provider 
71.4 	fails to submit required reporting data, the commissioner shall provide notice to providers 
71.5 	that have not provided required data 30 days after the required submission date, and a second 
71.6 	notice for providers who have not provided required data 60 days after the required 
71.7 	submission date. The commissioner shall temporarily suspend payments to the provider if 
71.8 	cost data is not received 90 days after the required submission date. Withheld payments 
71.9 	shall be made once data is received by the commissioner.
71.10 	(c) The commissioner shall conduct a random validation of data submitted under 
71.11 	paragraph (a) to ensure data accuracy. The commissioner shall analyze cost documentation 
71.12 	in paragraph (a) and provide recommendations for adjustments to cost components.
71.13 	(d) The commissioner shall analyze cost documentation in paragraph (a) and, in 
71.14 	consultation with stakeholders identified in section 256B.4913, subdivision 5, may submit 
71.15 	recommendations on component values and inflationary factor adjustments to the chairs 
71.16 	and ranking minority members of the legislative committees with jurisdiction over human 
71.17 	services every four years beginning January 1, 2020. The commissioner shall make 
71.18 	recommendations in conjunction with reports submitted to the legislature according to 
71.19 	subdivision 10, paragraph (e). The commissioner shall release cost data in an aggregate 
71.20 	form, and cost data from individual providers shall not be released except as provided for 
71.21 	in current law.
71.22 	(e) The commissioner, in consultation with stakeholders identified in section 256B.4913, 
71.23 	subdivision 5, shall develop and implement a process for providing training and technical 
71.24 	assistance necessary to support provider submission of cost documentation required under 
71.25 	paragraph (a).
71.26 	(f) Beginning January 1, 2019, providers enrolled to provide services with rates 
71.27 	determined under this section shall submit labor market data to the commissioner annually.
71.28 	(g) Beginning January 15, 2020, the commissioner shall publish annual reports on 
71.29 	provider and state-level labor market data, including, but not limited to:
71.30 	(1) number of direct care staff;
71.31 	(2) wages of direct care staff;
71.32 	(3) benefits provided to direct care staff;
71.33 	(4) direct care staff job vacancies;
72.1 	(5) direct care staff retention rates; and
72.2 	(6) an evaluation of the effectiveness of the competitive workforce factors.

72.3 	Sec. 28. Minnesota Statutes 2017 Supplement, section 256I.03, subdivision 8, is amended 
72.4 	to read:
72.5 		Subd. 8.Supplementary services. "Supplementary services" means housing support 
72.6 	services provided to individuals in addition to room and board including, but not limited 
72.7 	to, oversight and up to 24-hour supervision, medication reminders, assistance with 
72.8 	transportation, arranging for meetings and appointments, and arranging for medical and 
72.9 	social services. Providers must comply with section 256I.04, subdivision 2h.

72.10 	Sec. 29. Minnesota Statutes 2017 Supplement, section 256I.04, subdivision 2b, is amended 
72.11 	to read:
72.12 		Subd. 2b.Housing support agreements. (a) Agreements between agencies and providers 
72.13 	of housing support must be in writing on a form developed and approved by the commissioner 
72.14 	and must specify the name and address under which the establishment subject to the 
72.15 	agreement does business and under which the establishment, or service provider, if different 
72.16 	from the group residential housing establishment, is licensed by the Department of Health 
72.17 	or the Department of Human Services; the specific license or registration from the 
72.18 	Department of Health or the Department of Human Services held by the provider and the 
72.19 	number of beds subject to that license; the address of the location or locations at which 
72.20 	group residential housing is provided under this agreement; the per diem and monthly rates 
72.21 	that are to be paid from housing support funds for each eligible resident at each location; 
72.22 	the number of beds at each location which are subject to the agreement; whether the license 
72.23 	holder is a not-for-profit corporation under section 501(c)(3) of the Internal Revenue Code; 
72.24 	and a statement that the agreement is subject to the provisions of sections 256I.01 to 256I.06
72.25 	and subject to any changes to those sections.
72.26 	(b) Providers are required to verify the following minimum requirements in the 
72.27 	agreement:
72.28 	(1) current license or registration, including authorization if managing or monitoring 
72.29 	medications;
72.30 	(2) all staff who have direct contact with recipients meet the staff qualifications;
72.31 	(3) the provision of housing support;
72.32 	(4) the provision of supplementary services, if applicable;
73.1 	(5) reports of adverse events, including recipient death or serious injury; and
73.2 	(6) submission of residency requirements that could result in recipient eviction.; and
73.3 	(7) confirmation that the provider will not limit or restrict the number of hours an 
73.4 	applicant or recipient chooses to be employed, as specified in subdivision 5.
73.5 	(c) Agreements may be terminated with or without cause by the commissioner, the 
73.6 	agency, or the provider with two calendar months prior notice. The commissioner may 
73.7 	immediately terminate an agreement under subdivision 2d.

73.8 	Sec. 30. Minnesota Statutes 2016, section 256I.04, is amended by adding a subdivision 
73.9 	to read:
73.10 		Subd. 2h.Required supplementary services. Providers of supplementary services shall 
73.11 	ensure that recipients have, at a minimum, assistance with services as identified in the 
73.12 	recipient's professional statement of need under section 256I.03, subdivision 12. Providers 
73.13 	of supplementary services shall maintain case notes with the date and description of services 
73.14 	provided to individual recipients.

73.15 	Sec. 31. Minnesota Statutes 2016, section 256I.04, is amended by adding a subdivision 
73.16 	to read:
73.17 		Subd. 5.Employment. A provider is prohibited from limiting or restricting the number 
73.18 	of hours an applicant or recipient is employed.

73.19 	Sec. 32. Minnesota Statutes 2017 Supplement, section 256I.05, subdivision 3, is amended 
73.20 	to read:
73.21 		Subd. 3.Limits on rates. When a room and board rate is used to pay for an individual's 
73.22 	room and board, the rate payable to the residence must not exceed the rate paid by an 
73.23 	individual not receiving a room and board rate under this chapter but who is eligible under 
73.24 	section 256I.04, subdivision 1.

73.25 	Sec. 33. Laws 2014, chapter 312, article 27, section 76, is amended to read:
73.26 	Sec. 76. DISABILITY WAIVER REIMBURSEMENT RATE ADJUSTMENTS.
 73.27 		Subdivision 1.Historical rate. The commissioner of human services shall adjust the 
73.28 	historical rates calculated in Minnesota Statutes, section 256B.4913, subdivision 4a, 
73.29 	paragraph (b), in effect during the banding period under Minnesota Statutes, section 
74.1 	256B.4913, subdivision 4a, paragraph (a), for the reimbursement rate increases effective 
74.2 	April 1, 2014, and any rate modification enacted during the 2014 legislative session.
74.3 		Subd. 2.Residential support services. The commissioner of human services shall adjust 
74.4 	the rates calculated in Minnesota Statutes, section 256B.4914, subdivision 6, paragraphs 
74.5 	(b), clause (4), and (c), for the reimbursement rate increases effective April 1, 2014, and 
74.6 	any rate modification enacted during the 2014 legislative session.
74.7 		Subd. 3.Day programs. The commissioner of human services shall adjust the rates 
74.8 	calculated in Minnesota Statutes, section 256B.4914, subdivision 7, paragraph (a), clauses 
74.9 	(15) to (17), for the reimbursement rate increases effective April 1, 2014, and any rate 
74.10 	modification enacted during the 2014 legislative session.
74.11 		Subd. 4.Unit-based services with programming. The commissioner of human services 
74.12 	shall adjust the rate calculated in Minnesota Statutes, section 256B.4914, subdivision 8, 
74.13 	paragraph (a), clause (14), for the reimbursement rate increases effective April 1, 2014, and 
74.14 	any rate modification enacted during the 2014 legislative session.
74.15 		Subd. 5.Unit-based services without programming. The commissioner of human 
74.16 	services shall adjust the rate calculated in Minnesota Statutes, section 256B.4914, subdivision 
74.17 	9, paragraph (a), clause (23), for the reimbursement rate increases effective April 1, 2014, 
74.18 	and any rate modification enacted during the 2014 legislative session.

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

74.20 	Sec. 34. Laws 2017, First Special Session chapter 6, article 1, section 52, is amended to 
74.21 	read:
74.22 	Sec. 52. RANDOM MOMENT TIME STUDY EVALUATION REQUIRED.
 74.23 	The commissioner of human services shall implement administrative efficiencies and 
74.24 	evaluate the random moment time study methodology for reimbursement of costs associated 
74.25 	with county duties required under Minnesota Statutes, section 256B.0911. The evaluation 
74.26 	must determine whether random moment is efficient and effective in supporting functions 
74.27 	of assessment and support planning and the purpose under Minnesota Statutes, section 
74.28 	256B.0911, subdivision 1. The commissioner shall submit a report to the chairs and ranking 
74.29 	minority members of the house of representatives and senate committees with jurisdiction 
74.30 	over health and human services by January 15, 2019. The report must include at least one 
74.31 	option for a flat-rate payment methodology for long-term care consultation assessment and 
74.32 	support planning services, draft legislation to implement the flat-rate options, a fiscal analysis 
74.33 	of the flat-rate options, and a policy analysis of the flat-rate options, including the 
75.1 	commissioner's rationale for supporting or opposing the option that is, in the commissioner's 
75.2 	opinion, the best of the flat-rate options.

75.3 	Sec. 35. Laws 2017, First Special Session chapter 6, article 3, section 49, is amended to 
75.4 	read:
75.5 	Sec. 49. ELECTRONIC SERVICE DELIVERY DOCUMENTATION SYSTEM
75.6 	VISIT VERIFICATION.
 75.7 		Subdivision 1.Documentation; establishment. The commissioner of human services 
75.8 	shall establish implementation requirements and standards for an electronic service delivery 
75.9 	documentation system visit verification to comply with the 21st Century Cures Act, Public 
75.10 	Law 114-255. Within available appropriations, the commissioner shall take steps to comply 
75.11 	with the electronic visit verification requirements in the 21st Century Cures Act, Public 
75.12 	Law 114-255.
75.13 		Subd. 2.Definitions. (a) For purposes of this section, the terms in this subdivision have 
75.14 	the meanings given them.
75.15 	(b) "Electronic service delivery documentation visit verification" means the electronic 
75.16 	documentation of the:
75.17 	(1) type of service performed;
75.18 	(2) individual receiving the service;
75.19 	(3) date of the service;
75.20 	(4) location of the service delivery;
75.21 	(5) individual providing the service; and
75.22 	(6) time the service begins and ends.
75.23 	(c) "Electronic service delivery documentation visit verification system" means a system 
75.24 	that provides electronic service delivery documentation verification of services that complies 
75.25 	with the 21st Century Cures Act, Public Law 114-255, and the requirements of subdivision 
75.26 	3.
75.27 	(d) "Service" means one of the following:
75.28 	(1) personal care assistance services as defined in Minnesota Statutes, section 256B.0625, 
75.29 	subdivision 19a, and provided according to Minnesota Statutes, section 256B.0659; or
75.30 	(2) community first services and supports under Minnesota Statutes, section 256B.85;
76.1 	(3) home health services under Minnesota Statutes, section 256B.0625, subdivision 6a; 
76.2 	or
76.3 	(4) other medical supplies and equipment or home and community-based services that 
76.4 	are required to be electronically verified by the 21st Century Cures Act, Public Law 114-255.
76.5 		Subd. 3.System requirements. (a) In developing implementation requirements for an
76.6 	electronic service delivery documentation system visit verification, the commissioner shall 
76.7 	consider electronic visit verification systems and other electronic service delivery 
76.8 	documentation methods. The commissioner shall convene stakeholders that will be impacted 
76.9 	by an electronic service delivery system, including service providers and their representatives, 
76.10 	service recipients and their representatives, and, as appropriate, those with expertise in the 
76.11 	development and operation of an electronic service delivery documentation system, to ensure 
76.12 	that the requirements:
76.13 	(1) are minimally administratively and financially burdensome to a provider;
76.14 	(2) are minimally burdensome to the service recipient and the least disruptive to the 
76.15 	service recipient in receiving and maintaining allowed services;
76.16 	(3) consider existing best practices and use of electronic service delivery documentation
76.17 	visit verification;
76.18 	(4) are conducted according to all state and federal laws;
76.19 	(5) are effective methods for preventing fraud when balanced against the requirements 
76.20 	of clauses (1) and (2); and
76.21 	(6) are consistent with the Department of Human Services' policies related to covered 
76.22 	services, flexibility of service use, and quality assurance.
76.23 	(b) The commissioner shall make training available to providers on the electronic service 
76.24 	delivery documentation visit verification system requirements.
76.25 	(c) The commissioner shall establish baseline measurements related to preventing fraud 
76.26 	and establish measures to determine the effect of electronic service delivery documentation
76.27 	visit verification requirements on program integrity.
76.28 	(d) The commissioner shall make a state-selected electronic visit verification system 
76.29 	available to providers of services.
76.30 		Subd. 3a.Provider requirements. (a) Providers of services may select their own 
76.31 	electronic visit verification system that meets the requirements established by the 
76.32 	commissioner.
77.1 	(b) All electronic visit verification systems used by providers to comply with the 
77.2 	requirements established by the commissioner must provide data to the commissioner in a 
77.3 	format and at a frequency to be established by the commissioner.
77.4 	(c) Providers must implement the electronic visit verification systems required under 
77.5 	this section by January 1, 2019, for personal care services and by January 1, 2023, for home 
77.6 	health services in accordance with the 21st Century Cures Act, Public Law 114-255, and 
77.7 	the Centers for Medicare and Medicaid Services guidelines. For the purposes of this 
77.8 	paragraph, "personal care services" and "home health services" have the meanings given 
77.9 	in United States Code, title 42, section 1396b(l)(5).
77.10 		Subd. 4.Legislative report. (a) The commissioner shall submit a report by January 15, 
77.11 	2018, to the chairs and ranking minority members of the legislative committees with 
77.12 	jurisdiction over human services with recommendations, based on the requirements of 
77.13 	subdivision 3, to establish electronic service delivery documentation system requirements 
77.14 	and standards. The report shall identify:
77.15 	(1) the essential elements necessary to operationalize a base-level electronic service 
77.16 	delivery documentation system to be implemented by January 1, 2019; and
77.17 	(2) enhancements to the base-level electronic service delivery documentation system to 
77.18 	be implemented by January 1, 2019, or after, with projected operational costs and the costs 
77.19 	and benefits for system enhancements.
77.20 	(b) The report must also identify current regulations on service providers that are either 
77.21 	inefficient, minimally effective, or will be unnecessary with the implementation of an 
77.22 	electronic service delivery documentation system.

77.23 	Sec. 36. ANALYSIS OF LICENSING ADULT FOSTER CARE.
 77.24 	The commissioner shall complete an analysis of settings identified by the commissioner, 
77.25 	in collaboration with county licensing agencies, as needing a license under Minnesota 
77.26 	Statutes, section 245A.03, subdivision 7, paragraph (a), clause (7), to determine if revisions 
77.27 	to the definition of residential program for recipients of home and community-based waiver 
77.28 	services are needed. The commissioner shall engage stakeholders, including licensed 
77.29 	providers of services governed by Minnesota Statutes, chapter 245D, and family members 
77.30 	who own and maintain control of the residence in which the service recipients live, in the 
77.31 	process of determining if revisions are needed and developing recommendations. The 
77.32 	commissioner shall provide a summary of the analysis and stakeholder input along with 
77.33 	recommendations, if any, to revise the definition of residential program under Minnesota 
78.1 	Statutes, section 245A.02, subdivision 14, to the chairs and ranking minorities members of 
78.2 	the legislative committees with jurisdiction over human services by February 15, 2019.

78.3 	Sec. 37. DIRECTION TO COMMISSIONER.
 78.4 	Between July 1, 2018, and December 31, 2018, the commissioner of human services 
78.5 	shall continue to reimburse the Centers for Medicare and Medicaid Services for the 
78.6 	disallowed federal share of the rate increases described in Laws 2014, chapter 312, article 
78.7 	27, section 76, subdivisions 2 to 5.

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

78.9 	Sec. 38. DIRECTION TO COMMISSIONER; BI AND CADI WAIVER 
78.10 	CUSTOMIZED LIVING SERVICES PROVIDER LOCATED IN HENNEPIN 
78.11 	COUNTY.
 78.12 	(a) The commissioner of human services shall allow a housing with services establishment 
78.13 	located in Minneapolis that provides customized living and 24-hour customized living 
78.14 	services for clients enrolled in the brain injury (BI) or community access for disability 
78.15 	inclusion (CADI) waiver and had a capacity to serve 66 clients as of July 1, 2017, to transfer 
78.16 	service capacity of up to 66 clients to no more than three new housing with services 
78.17 	establishments located in Hennepin County.
78.18 	(b) Notwithstanding Minnesota Statutes, section 256B.492, the commissioner shall 
78.19 	determine whether the new housing with services establishments described under paragraph 
78.20 	(a) meet the BI and CADI waiver customized living and 24-hour customized living size 
78.21 	limitation exception for clients receiving those services at the new housing with services 
78.22 	establishments described under paragraph (a).

78.23 	Sec. 39. DIRECTION TO COMMISSIONER.
 78.24 	(a) The commissioner of human services must ensure that the MnCHOICES 2.0 
78.25 	assessment and support planning tool incorporates a qualitative approach with open-ended 
78.26 	questions and a conversational, culturally sensitive approach to interviewing that captures 
78.27 	the assessor's professional judgment based on the person's responses.
78.28 	(b) If the commissioner of human services convenes a working group or consults with 
78.29 	stakeholders for the purposes of modifying the assessment and support planning process or 
78.30 	tool, the commissioner must include members of the disability community, including 
78.31 	representatives of organizations and individuals involved in assessment and support planning.

79.1 	Sec. 40. REVISOR'S INSTRUCTION.
 79.2 	The revisor of statutes shall codify Laws 2017, First Special Session chapter 6, article 
79.3 	3, section 49, as amended in this act, in Minnesota Statutes, chapter 256B.

79.4 	Sec. 41.  REPEALER.
 79.5 	Minnesota Statutes 2016, section 256B.0705, is repealed.

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

79.7 	ARTICLE 4
79.8 	HEALTH CARE

79.9 	Section 1. Minnesota Statutes 2017 Supplement, section 256B.0625, subdivision 17, is 
79.10 	amended to read:
79.11 		Subd. 17.Transportation costs. (a) "Nonemergency medical transportation service" 
79.12 	means motor vehicle transportation provided by a public or private person that serves 
79.13 	Minnesota health care program beneficiaries who do not require emergency ambulance 
79.14 	service, as defined in section 144E.001, subdivision 3, to obtain covered medical services.
79.15 	(b) Medical assistance covers medical transportation costs incurred solely for obtaining 
79.16 	emergency medical care or transportation costs incurred by eligible persons in obtaining 
79.17 	emergency or nonemergency medical care when paid directly to an ambulance company, 
79.18 	nonemergency medical transportation company, or other recognized providers of 
79.19 	transportation services. Medical transportation must be provided by:
79.20 	(1) nonemergency medical transportation providers who meet the requirements of this 
79.21 	subdivision;
79.22 	(2) ambulances, as defined in section 144E.001, subdivision 2;
79.23 	(3) taxicabs that meet the requirements of this subdivision;
79.24 	(4) public transit, as defined in section 174.22, subdivision 7; or
79.25 	(5) not-for-hire vehicles, including volunteer drivers.
79.26 	(c) Medical assistance covers nonemergency medical transportation provided by 
79.27 	nonemergency medical transportation providers enrolled in the Minnesota health care 
79.28 	programs. All nonemergency medical transportation providers must comply with the 
79.29 	operating standards for special transportation service as defined in sections 174.29 to 174.30 
79.30 	and Minnesota Rules, chapter 8840, and in consultation with the Minnesota Department of 
80.1 	Transportation. All drivers providing nonemergency medical transportation must be 
80.2 	individually enrolled with the commissioner if the driver is a subcontractor for or employed 
80.3 	by a provider that both has a base of operation located within a metropolitan county listed 
80.4 	in section 437.121, subdivision 4, and is listed in paragraph (b), clause (1) or (3). All 
80.5 	nonemergency medical transportation providers shall bill for nonemergency medical 
80.6 	transportation services in accordance with Minnesota health care programs criteria. Publicly 
80.7 	operated transit systems, volunteers, and not-for-hire vehicles are exempt from the 
80.8 	requirements outlined in this paragraph.
80.9 	(d) An organization may be terminated, denied, or suspended from enrollment if:
80.10 	(1) the provider has not initiated background studies on the individuals specified in 
80.11 	section 174.30, subdivision 10, paragraph (a), clauses (1) to (3); or
80.12 	(2) the provider has initiated background studies on the individuals specified in section 
80.13 	174.30, subdivision 10, paragraph (a), clauses (1) to (3), and:
80.14 	(i) the commissioner has sent the provider a notice that the individual has been 
80.15 	disqualified under section 245C.14; and
80.16 	(ii) the individual has not received a disqualification set-aside specific to the special 
80.17 	transportation services provider under sections 245C.22 and 245C.23.
80.18 	(e) The administrative agency of nonemergency medical transportation must:
80.19 	(1) adhere to the policies defined by the commissioner in consultation with the 
80.20 	Nonemergency Medical Transportation Advisory Committee;
80.21 	(2) pay nonemergency medical transportation providers for services provided to 
80.22 	Minnesota health care programs beneficiaries to obtain covered medical services;
80.23 	(3) provide data monthly to the commissioner on appeals, complaints, no-shows, canceled 
80.24 	trips, and number of trips by mode; and
80.25 	(4) by July 1, 2016, in accordance with subdivision 18e, utilize a Web-based single 
80.26 	administrative structure assessment tool that meets the technical requirements established 
80.27 	by the commissioner, reconciles trip information with claims being submitted by providers, 
80.28 	and ensures prompt payment for nonemergency medical transportation services.
80.29 	(f) Until the commissioner implements the single administrative structure and delivery 
80.30 	system under subdivision 18e, clients shall obtain their level-of-service certificate from the 
80.31 	commissioner or an entity approved by the commissioner that does not dispatch rides for 
80.32 	clients using modes of transportation under paragraph (i), clauses (4), (5), (6), and (7).
81.1 	(g) The commissioner may use an order by the recipient's attending physician or a medical 
81.2 	or mental health professional to certify that the recipient requires nonemergency medical 
81.3 	transportation services. Nonemergency medical transportation providers shall perform 
81.4 	driver-assisted services for eligible individuals, when appropriate. Driver-assisted service 
81.5 	includes passenger pickup at and return to the individual's residence or place of business, 
81.6 	assistance with admittance of the individual to the medical facility, and assistance in 
81.7 	passenger securement or in securing of wheelchairs, child seats, or stretchers in the vehicle.
81.8 	Nonemergency medical transportation providers must take clients to the health care 
81.9 	provider using the most direct route, and must not exceed 30 miles for a trip to a primary 
81.10 	care provider or 60 miles for a trip to a specialty care provider, unless the client receives 
81.11 	authorization from the local agency.
81.12 	Nonemergency medical transportation providers may not bill for separate base rates for 
81.13 	the continuation of a trip beyond the original destination. Nonemergency medical 
81.14 	transportation providers must maintain trip logs, which include pickup and drop-off times, 
81.15 	signed by the medical provider or client, whichever is deemed most appropriate, attesting 
81.16 	to mileage traveled to obtain covered medical services. Clients requesting client mileage 
81.17 	reimbursement must sign the trip log attesting mileage traveled to obtain covered medical 
81.18 	services.
81.19 	(h) The administrative agency shall use the level of service process established by the 
81.20 	commissioner in consultation with the Nonemergency Medical Transportation Advisory 
81.21 	Committee to determine the client's most appropriate mode of transportation. If public transit 
81.22 	or a certified transportation provider is not available to provide the appropriate service mode 
81.23 	for the client, the client may receive a onetime service upgrade.
81.24 	(i) The covered modes of transportation are:
81.25 	(1) client reimbursement, which includes client mileage reimbursement provided to 
81.26 	clients who have their own transportation, or to family or an acquaintance who provides 
81.27 	transportation to the client;
81.28 	(2) volunteer transport, which includes transportation by volunteers using their own 
81.29 	vehicle;
81.30 	(3) unassisted transport, which includes transportation provided to a client by a taxicab 
81.31 	or public transit. If a taxicab or public transit is not available, the client can receive 
81.32 	transportation from another nonemergency medical transportation provider;
82.1 	(4) assisted transport, which includes transport provided to clients who require assistance 
82.2 	by a nonemergency medical transportation provider;
82.3 	(5) lift-equipped/ramp transport, which includes transport provided to a client who is 
82.4 	dependent on a device and requires a nonemergency medical transportation provider with 
82.5 	a vehicle containing a lift or ramp;
82.6 	(6) protected transport, which includes transport provided to a client who has received 
82.7 	a prescreening that has deemed other forms of transportation inappropriate and who requires 
82.8 	a provider: (i) with a protected vehicle that is not an ambulance or police car and has safety 
82.9 	locks, a video recorder, and a transparent thermoplastic partition between the passenger and 
82.10 	the vehicle driver; and (ii) who is certified as a protected transport provider; and
82.11 	(7) stretcher transport, which includes transport for a client in a prone or supine position 
82.12 	and requires a nonemergency medical transportation provider with a vehicle that can transport 
82.13 	a client in a prone or supine position.
82.14 	(j) The local agency shall be the single administrative agency and shall administer and 
82.15 	reimburse for modes defined in paragraph (i) according to paragraphs (m) and (n) when the 
82.16 	commissioner has developed, made available, and funded the Web-based single 
82.17 	administrative structure, assessment tool, and level of need assessment under subdivision 
82.18 	18e. The local agency's financial obligation is limited to funds provided by the state or 
82.19 	federal government.
82.20 	(k) The commissioner shall:
82.21 	(1) in consultation with the Nonemergency Medical Transportation Advisory Committee, 
82.22 	verify that the mode and use of nonemergency medical transportation is appropriate;
82.23 	(2) verify that the client is going to an approved medical appointment; and
82.24 	(3) investigate all complaints and appeals.
82.25 	(l) The administrative agency shall pay for the services provided in this subdivision and 
82.26 	seek reimbursement from the commissioner, if appropriate. As vendors of medical care, 
82.27 	local agencies are subject to the provisions in section 256B.041, the sanctions and monetary 
82.28 	recovery actions in section 256B.064, and Minnesota Rules, parts 9505.2160 to 9505.2245.
82.29 	(m) Payments for nonemergency medical transportation must be paid based on the client's 
82.30 	assessed mode under paragraph (h), not the type of vehicle used to provide the service. The 
82.31 	medical assistance reimbursement rates for nonemergency medical transportation services 
82.32 	that are payable by or on behalf of the commissioner for nonemergency medical 
82.33 	transportation services are:
83.1 	(1) $0.22 per mile for client reimbursement;
83.2 	(2) up to 100 percent of the Internal Revenue Service business deduction rate for volunteer 
83.3 	transport;
83.4 	(3) equivalent to the standard fare for unassisted transport when provided by public 
83.5 	transit, and $11 for the base rate and $1.30 per mile when provided by a nonemergency 
83.6 	medical transportation provider;
83.7 	(4) $13 for the base rate and $1.30 per mile for assisted transport;
83.8 	(5) $18 for the base rate and $1.55 per mile for lift-equipped/ramp transport;
83.9 	(6) $75 for the base rate and $2.40 per mile for protected transport; and
83.10 	(7) $60 for the base rate and $2.40 per mile for stretcher transport, and $9 per trip for 
83.11 	an additional attendant if deemed medically necessary.
83.12 	(n) The base rate for nonemergency medical transportation services in areas defined 
83.13 	under RUCA to be super rural is equal to 111.3 percent of the respective base rate in 
83.14 	paragraph (m), clauses (1) to (7). The mileage rate for nonemergency medical transportation 
83.15 	services in areas defined under RUCA to be rural or super rural areas is:
83.16 	(1) for a trip equal to 17 miles or less, equal to 125 percent of the respective mileage 
83.17 	rate in paragraph (m), clauses (1) to (7); and
83.18 	(2) for a trip between 18 and 50 miles, equal to 112.5 percent of the respective mileage 
83.19 	rate in paragraph (m), clauses (1) to (7).
83.20 	(o) For purposes of reimbursement rates for nonemergency medical transportation 
83.21 	services under paragraphs (m) and (n), the zip code of the recipient's place of residence 
83.22 	shall determine whether the urban, rural, or super rural reimbursement rate applies.
83.23 	(p) For purposes of this subdivision, "rural urban commuting area" or "RUCA" means 
83.24 	a census-tract based classification system under which a geographical area is determined 
83.25 	to be urban, rural, or super rural.
83.26 	(q) The commissioner, when determining reimbursement rates for nonemergency medical 
83.27 	transportation under paragraphs (m) and (n), shall exempt all modes of transportation listed 
83.28 	under paragraph (i) from Minnesota Rules, part 9505.0445, item R, subitem (2).

83.29 	EFFECTIVE DATE. Paragraph (c) is effective January 1, 2019.

84.1 	Sec. 2. Minnesota Statutes 2016, section 256B.0625, is amended by adding a subdivision 
84.2 	to read:
84.3 		Subd. 17d.Transportation services oversight. The commissioner shall contract with 
84.4 	a vendor or dedicate staff for oversight of providers of nonemergency medical transportation 
84.5 	services pursuant to the commissioner's authority in section 256B.04 and Minnesota Rules, 
84.6 	parts 9505.2160 to 9505.2245.

84.7 	EFFECTIVE DATE. This section is July 1, 2018.

84.8 	Sec. 3. Minnesota Statutes 2016, section 256B.0625, is amended by adding a subdivision 
84.9 	to read:
84.10 		Subd. 17e.Transportation provider termination. (a) A terminated nonemergency 
84.11 	medical transportation provider, including all named individuals on the current enrollment 
84.12 	disclosure form and known or discovered affiliates of the nonemergency medical 
84.13 	transportation provider, is not eligible to enroll as a nonemergency medical transportation 
84.14 	provider for five years following the termination.
84.15 	(b) After the five-year period in paragraph (a), if a provider seeks to reenroll as a 
84.16 	nonemergency medical transportation provider, the nonemergency medical transportation 
84.17 	provider must be placed on a one-year probation period. During a provider's probation 
84.18 	period, the commissioner shall complete unannounced site visits and request documentation 
84.19 	to review compliance with program requirements.

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

84.21 	Sec. 4. Minnesota Statutes 2016, section 256B.0625, is amended by adding a subdivision 
84.22 	to read:
84.23 		Subd. 17f.Transportation provider training. The commissioner shall make available 
84.24 	to providers of nonemergency medical transportation and all drivers training materials and 
84.25 	online training opportunities regarding documentation requirements, documentation 
84.26 	procedures, and penalties for failing to meet documentation requirements.

84.27 	Sec. 5. DIRECTION TO COMMISSIONER.
 84.28 	By August 1, 2020, the commissioner of human services shall issue a report to the chairs 
84.29 	and ranking minority members of the house of representatives and senate committees with 
84.30 	jurisdiction over health and human services. The commissioner must include in the report 
84.31 	the commissioner's findings regarding the impact of driver enrollment under Minnesota 
85.1 	Statutes, section 256B.0625, subdivision 17, paragraph (c), on the program integrity of the 
85.2 	nonemergency medical transportation program. The commission must include a 
85.3 	recommendation, based on the findings in the report, regarding expanding the driver 
85.4 	enrollment requirement.

85.5 	Sec. 6.  REPEALER.
 85.6 	Minnesota Statutes 2016, section 256B.0625, subdivision 18b, is repealed.

85.7 	ARTICLE 5
85.8 	APPROPRIATIONS

85.9	Section 1. HEALTH AND HUMAN SERVICES APPROPRIATIONS.
 	
85.10 	The sums shown in the columns marked "Appropriations" are added to or, if shown in 
85.11 	parentheses, subtracted from the appropriations in Laws 2017, First Special Session chapter 
85.12 	6, article 18, to the agencies and for the purposes specified in this article. The appropriations 
85.13 	are from the general fund, or another named fund, and are available for the fiscal years 
85.14 	indicated for each purpose. The figures "2018" and "2019" used in this article mean that 
85.15 	the addition to or subtraction from appropriations listed under them are available for the 
85.16 	fiscal year ending June 30, 2018, or June 30, 2019, respectively. Base level adjustments 
85.17 	mean the addition or subtraction from the base level adjustments in Laws 2017, First Special 
85.18 	Session chapter 6, article 18. "The first year" is fiscal year 2018. "The second year" is fiscal 
85.19 	year 2019. "The biennium" is fiscal years 2018 and 2019. Supplemental appropriations and 
85.20 	reductions to appropriations for the fiscal year ending June 30, 2018, are effective the day 
85.21 	following final enactment unless a different effective date is specified.

85.22				APPROPRIATIONS
	
85.23				Available for the Year
	
85.24				Ending June 30
	
85.25					2018
		2019

85.26
85.27	Sec. 2. COMMISSIONER OF HUMAN 
SERVICES

85.28	Subdivision 1.Total Appropriation
 	$
	-0-
	$
	26,941,000
	
86.1 	The amounts that may be spent for each 
86.2 	purpose are specified in the following 
86.3 	subdivisions.

86.4	Subd. 2.Central Office; Operations
 		-0-
		5,289,000
	
86.5 	(a) Transfers. By June 30, 2019, the 
86.6 	commissioner of management and budget shall 
86.7 	transfer $4,149,000 from the general fund to 
86.8 	the health care access fund. By June 30, 2020, 
86.9 	the commissioner of management and budget 
86.10 	shall transfer $4,149,000 from the health care 
86.11 	access fund to the general fund.
86.12 	(b) Base Level Adjustment. The general fund 
86.13 	base is increased by $6,558,000 in fiscal year 
86.14 	2020 and increased by $6,581,000 in fiscal 
86.15 	year 2021.

86.16	Subd. 3.Central Office; Children and Families
 		-0-
		633,000
	
86.17 	(a) Child Welfare Training. $1,933,000 in 
86.18 	fiscal year 2019 is for initial costs for the child 
86.19 	welfare training in Minnesota Statutes, section 
86.20 	260C.81. No money from this appropriation 
86.21 	may be used for indirect costs by an entity 
86.22 	under contract to implement Minnesota 
86.23 	Statutes, section 260C.81.
86.24 	(b) Base Level Adjustment. The general fund 
86.25 	base is increased by $650,000 in fiscal year 
86.26 	2020 and increased by $650,000 in fiscal year 
86.27 	2021.

86.28	Subd. 4.Central Office; Health Care
 		-0-
		1,024,000
	
86.29 	Base Level Adjustment. The general fund 
86.30 	base is increased by $1,507,000 in fiscal year 
86.31 	2020 and increased by $1,513,000 in fiscal 
86.32 	year 2021.

86.33
86.34	Subd. 5.Central Office; Continuing Care for 
Older Adults
 		-0-
		418,000
	
87.1 	Base Level Adjustment. The general fund 
87.2 	base is increased by $425,000 in fiscal year 
87.3 	2020 and increased by $425,000 in fiscal year 
87.4 	2021.

87.5	Subd. 6.Central Office; Community Supports
 		-0-
		4,280,000
	
87.6 	Base Level Adjustment. The general fund 
87.7 	base is increased by $4,280,000 in fiscal year 
87.8 	2020 and increased by $4,260,000 in fiscal 
87.9 	year 2021.

87.10
87.11	Subd. 7.Forecasted Programs; Medical 
Assistance
 		-0-
		25,101,000

87.12	Subd. 8.Forecasted Programs; Alternative Care
 		-0-
		(28,000)

87.13
87.14	Subd. 9.Forecasted Programs; Chemical 
Dependency Treatment Fund
 		-0-
		(14,243,000)

87.15
87.16	Subd. 10.Grant Programs; Child Mental Health 
Grants
 		-0-
		4,467,000
	
87.17 	(a) School-Linked Mental Health Services 
87.18 	by Telemedicine. $4,467,000 in fiscal year 
87.19 	2019 is to sustain and expand grants under 
87.20 	Minnesota Statutes, section 245.4889, 
87.21 	subdivision 1, paragraph (b), clause (8), 
87.22 	including the delivery of school-linked mental 
87.23 	health services by telemedicine. This 
87.24 	appropriation is available until June 30, 2021.
87.25 	(b) Base Level Adjustment. The general fund 
87.26 	base is increased by $9,467,000 in fiscal year 
87.27 	2020.

87.28 	Sec. 3. EXPIRATION OF UNCODIFIED LANGUAGE.
 87.29 	All uncodified language contained in this article expires on June 30, 2019, unless a 
87.30 	different expiration date is specified.

87.31 	Sec. 4. EFFECTIVE DATE.
 87.32 	This article is effective July 1, 2018, unless a different effective date is specified.

APPENDIX 

Repealed Minnesota Statutes: S3937-1 

256B.0625 COVERED SERVICES.Subd. 18b.Broker dispatching prohibition. 
Except for establishing level of service process, the commissioner shall not use a broker or coordinator for any purpose related to nonemergency medical transportation services under subdivision 18. 

256B.0705 PERSONAL CARE ASSISTANCE SERVICES; MANDATED SERVICE VERIFICATION.Subdivision 1.Definitions. 
(a) For purposes of this section, the following terms have the meanings given them. 

(b) "Personal care assistance services" or "PCA services" means services provided according to section 256B.0659. 

(c) "Personal care assistant" or "PCA" has the meaning given in section 256B.0659, subdivision 1. 

(d) "Service verification" means a random, unscheduled telephone call made for the purpose of verifying that the individual personal care assistant is present at the location where personal care assistance services are being provided and is providing services as scheduled. 

Subd. 2.Verification schedule. 
An agency that submits claims for reimbursement for PCA services under this chapter must develop and implement administrative policies and procedures by which the agency verifies the services provided by a PCA. For each service recipient, the agency must conduct at least one service verification every 90 days. If more than one PCA provides services to a single service recipient, the agency must conduct a service verification for each PCA providing services before conducting a service verification for a PCA whose services were previously verified by the agency. Service verification must occur on an ongoing basis while the agency provides PCA services to the recipient. During service verification, the agency must speak with both the PCA and the service recipient or recipient's authorized representative. Only qualified professional service verifications are eligible for reimbursement. An agency may substitute a visit by a qualified professional that is eligible for reimbursement under section 256B.0659, subdivision 14 or 19. 

Subd. 3.Documentation of verification. 
An agency must fully document service verifications in a legible manner and must maintain the documentation on site for at least five years from the date of documentation. For each service verification, documentation must include: 

(1) the names and signatures of the service recipient or recipient's authorized representative, the PCA and any other agency staff present with the PCA during the service verification, and the staff person conducting the service verification; and 

(2) the start and end time, day, month, and year of the service verification, and the corresponding PCA time sheet. 

Subd. 4.Variance. 
The Office of Inspector General at the Department of Human Services may grant a variance to the service verification requirements in this section if an agency uses an electronic monitoring system or other methods that verify a PCA is present at the location where services are provided and is providing services according to the prescribed schedule. A decision to grant or deny a variance request is final and not subject to appeal under chapter 14.