1.1 	A bill for an act
1.2 	relating to state government; establishing a portion of the health and human services 
1.3 	budget; modifying provisions governing program integrity, children and family 
1.4 	services, chemical and mental health, continuing care for older adults, disability 
1.5 	services, direct care and treatment, operations, and health care; modifying penalties; 
1.6 	establishing asset limits; establishing electronic visit verification system; eliminating 
1.7 	TEFRA fees; repealing MFIP child care assistance program and basic sliding fee 
1.8 	child care assistance program; directing the commissioner of human services to 
1.9 	propose a redesigned child care assistance program; directing closure of a MSOCS 
1.10 	residential facility; repealing statutes relating to the state-operated services account; 
1.11 	establishing a background study set-aside for individuals working in the substance 
1.12 	use disorder treatment field; requiring reports; making technical changes; 
1.13 	appropriating money;amending Minnesota Statutes 2018, sections 13.69, 
1.14 	subdivision 1; 13.851, by adding a subdivision; 15C.02; 119B.09, subdivisions 1, 
1.15 	4, 7, 9, 9a; 119B.125, subdivision 6, by adding subdivisions; 119B.13, subdivisions 
1.16 	6, 7; 144.057, subdivision 3; 144A.073, by adding a subdivision; 144A.479, by 
1.17 	adding a subdivision; 245.095; 245.4889, subdivision 1; 245A.03, subdivision 7; 
1.18 	245A.04, subdivision 7, by adding a subdivision; 245A.065; 245A.11, subdivision 
1.19 	2a; 245C.02, by adding a subdivision; 245C.22, subdivisions 4, 5; 245D.03, 
1.20 	subdivision 1; 245D.071, subdivision 5; 245D.09, subdivisions 5, 5a; 245D.091, 
1.21 	subdivisions 2, 3, 4; 245E.02, by adding a subdivision; 246.54, by adding a 
1.22 	subdivision; 252.27, subdivision 2a; 252.275, subdivision 3; 254A.03, subdivision 
1.23 	3; 254A.19, by adding a subdivision; 254B.02, subdivision 1; 254B.03, subdivisions 
1.24 	2, 4; 254B.04, subdivision 1; 254B.05, subdivision 1a; 254B.06, subdivisions 1, 
1.25 	2; 256.9365; 256.98, subdivisions 1, 8; 256.987, subdivisions 1, 2; 256B.02, 
1.26 	subdivision 7, by adding a subdivision; 256B.04, subdivision 21; 256B.056, 
1.27 	subdivisions 3, 4, 5c, 7a; 256B.0625, subdivisions 17, 18d, 18h, 19a, 24, 43, by 
1.28 	adding subdivisions; 256B.064, subdivisions 1b, 2, by adding a subdivision; 
1.29 	256B.0651, subdivision 17; 256B.0652, subdivision 6; 256B.0658; 256B.0659, 
1.30 	subdivisions 3, 3a, 11, 12, 13, 14, 19, 21, 24, 28, by adding a subdivision; 
1.31 	256B.0757, subdivisions 1, 2, 4, by adding subdivisions; 256B.0911, subdivisions 
1.32 	1a, 3a, 3f, 5, by adding a subdivision; 256B.0915, subdivisions 6, 10, by adding 
1.33 	a subdivision; 256B.092, subdivision 1b, by adding a subdivision; 256B.0921; 
1.34 	256B.14, subdivision 2; 256B.27, subdivision 3; 256B.49, subdivisions 13, 14, by 
1.35 	adding a subdivision; 256B.4912, by adding subdivisions; 256B.4914, subdivisions 
1.36 	2, 3, 5, 10, 10a; 256B.493, subdivision 1; 256B.5013, subdivisions 1, 6; 256B.5014; 
1.37 	256B.5015, subdivision 2; 256B.85, subdivisions 3, 8, 10; 256C.23, by adding a 
1.38 	subdivision; 256C.261; 256D.024, subdivision 3; 256D.0515; 256D.0516, 
2.1 	subdivision 2; 256I.03, subdivision 8; 256I.04, subdivisions 1, 2b, 2f, by adding 
2.2 	subdivisions; 256I.05, subdivision 1r; 256I.06, subdivision 8; 256J.08, subdivision 
2.3 	47; 256J.21, subdivision 2; 256J.26, subdivision 3; 256L.01, subdivision 5; 
2.4 	256M.41, subdivision 3, by adding a subdivision; 256P.04, subdivision 4; 256P.06, 
2.5 	subdivision 3; 256R.25; 518A.32, subdivision 3; 518A.51; 641.15, subdivision 
2.6 	3a; Laws 2017, First Special Session chapter 6, article 1, sections 44; 45; article 
2.7 	3, section 49; article 18, section 7; proposing coding for new law in Minnesota 
2.8 	Statutes, chapters 245A; 256; 256B; 256D; 256J; 256R; 260C; 268A; repealing 
2.9 	Minnesota Statutes 2018, sections 16A.724, subdivision 2; 119B.011, subdivisions 
2.10 	1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 10a, 11, 12, 13, 13a, 14, 15, 16, 17, 18, 19, 19a, 19b, 
2.11 	20, 20a, 21, 22; 119B.02; 119B.025, subdivisions 1, 2, 3, 4; 119B.03, subdivisions 
2.12 	1, 2, 3, 4, 5, 6, 6a, 6b, 8, 9, 10; 119B.035; 119B.04; 119B.05, subdivisions 1, 4, 
2.13 	5; 119B.06, subdivisions 1, 2, 3; 119B.08, subdivisions 1, 2, 3; 119B.09, 
2.14 	subdivisions 1, 3, 4, 4a, 5, 6, 7, 8, 9, 9a, 10, 11, 12, 13; 119B.095; 119B.097; 
2.15 	119B.10, subdivisions 1, 2, 3; 119B.105; 119B.11, subdivisions 1, 2a, 3, 4; 
2.16 	119B.12, subdivisions 1, 2; 119B.125; 119B.13, subdivisions 1, 1a, 3, 3a, 3b, 3c, 
2.17 	4, 5, 6, 7; 119B.14; 119B.15; 119B.16; 245G.11, subdivisions 1, 4, 7; 246.18, 
2.18 	subdivisions 8, 9; 254B.03, subdivision 4a; 256B.0705; 256I.05, subdivision 3; 
2.19 	256R.53, subdivision 2; Laws 2017, First Special Session chapter 6, article 7, 
2.20 	section 34; Minnesota Rules, parts 3400.0010; 3400.0020, subparts 1, 4, 5, 8, 9a, 
2.21 	10a, 12, 17a, 18, 18a, 20, 24, 25, 26, 28, 29a, 31b, 32b, 33, 34a, 35, 37, 38, 38a, 
2.22 	38b, 39, 40, 40a, 44; 3400.0030; 3400.0035; 3400.0040, subparts 1, 3, 4, 5, 5a, 
2.23 	6a, 6b, 6c, 7, 8, 9, 10, 11, 12, 13, 14, 15, 15a, 17, 18; 3400.0060, subparts 2, 4, 5, 
2.24 	6, 6a, 7, 8, 9, 10; 3400.0080, subparts 1, 1a, 1b, 8; 3400.0090, subparts 1, 2, 3, 4; 
2.25 	3400.0100, subparts 2a, 2b, 2c, 5; 3400.0110, subparts 1, 1a, 2, 2a, 3, 4a, 7, 8, 9, 
2.26 	10, 11; 3400.0120, subparts 1, 1a, 2, 2a, 3, 5; 3400.0130, subparts 1, 1a, 2, 3, 3a, 
2.27 	3b, 5, 5a, 7; 3400.0140, subparts 1, 2, 4, 5, 6, 7, 8, 9, 9a, 10, 14; 3400.0150; 
2.28 	3400.0170, subparts 1, 3, 4, 6a, 7, 8, 9, 10, 11; 3400.0180; 3400.0183, subparts 1, 
2.29 	2, 5; 3400.0185; 3400.0187, subparts 1, 2, 3, 4, 6; 3400.0200; 3400.0220; 
2.30 	3400.0230, subpart 3; 3400.0235, subparts 1, 2, 3, 4, 5, 6; 9530.6800; 9530.6810.
2.31 	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

2.32 	ARTICLE 1
2.33 	PROGRAM INTEGRITY

2.34 	Section 1. Minnesota Statutes 2018, section 15C.02, is amended to read:
2.35 	15C.02 LIABILITY FOR CERTAIN ACTS.
2.36 	(a) A person who commits any act described in clauses (1) to (7) is liable to the state or 
2.37 	the political subdivision for a civil penalty of not less than $5,500 and not more than $11,000 
2.38 	per false or fraudulent claim in the amounts set forth in the federal False Claims Act, United 
2.39 	States Code, title 31, section 3729, and as modified by the federal Civil Penalties Inflation 
2.40 	Adjustment Act Improvements Act of 2015, plus three times the amount of damages that 
2.41 	the state or the political subdivision sustains because of the act of that person, except as 
2.42 	otherwise provided in paragraph (b):
2.43 	(1) knowingly presents, or causes to be presented, a false or fraudulent claim for payment 
2.44 	or approval;
3.1 	(2) knowingly makes or uses, or causes to be made or used, a false record or statement 
3.2 	material to a false or fraudulent claim;
3.3 	(3) knowingly conspires to commit a violation of clause (1), (2), (4), (5), (6), or (7);
3.4 	(4) has possession, custody, or control of property or money used, or to be used, by the 
3.5 	state or a political subdivision and knowingly delivers or causes to be delivered less than 
3.6 	all of that money or property;
3.7 	(5) is authorized to make or deliver a document certifying receipt for money or property 
3.8 	used, or to be used, by the state or a political subdivision and, intending to defraud the state 
3.9 	or a political subdivision, makes or delivers the receipt without completely knowing that 
3.10 	the information on the receipt is true;
3.11 	(6) knowingly buys, or receives as a pledge of an obligation or debt, public property 
3.12 	from an officer or employee of the state or a political subdivision who lawfully may not 
3.13 	sell or pledge the property; or
3.14 	(7) knowingly makes or uses, or causes to be made or used, a false record or statement 
3.15 	material to an obligation to pay or transmit money or property to the state or a political 
3.16 	subdivision, or knowingly conceals or knowingly and improperly avoids or decreases an 
3.17 	obligation to pay or transmit money or property to the state or a political subdivision.
3.18 	(b) Notwithstanding paragraph (a), the court may assess not less than two times the 
3.19 	amount of damages that the state or the political subdivision sustains because of the act of 
3.20 	the person if:
3.21 	(1) the person committing a violation under paragraph (a) furnished an officer or 
3.22 	employee of the state or the political subdivision responsible for investigating the false or 
3.23 	fraudulent claim violation with all information known to the person about the violation 
3.24 	within 30 days after the date on which the person first obtained the information;
3.25 	(2) the person fully cooperated with any investigation by the state or the political 
3.26 	subdivision of the violation; and
3.27 	(3) at the time the person furnished the state or the political subdivision with information 
3.28 	about the violation, no criminal prosecution, civil action, or administrative action had been 
3.29 	commenced under this chapter with respect to the violation and the person did not have 
3.30 	actual knowledge of the existence of an investigation into the violation.
3.31 	(c) A person violating this section is also liable to the state or the political subdivision 
3.32 	for the costs of a civil action brought to recover any penalty or damages.
4.1 	(d) A person is not liable under this section for mere negligence, inadvertence, or mistake 
4.2 	with respect to activities involving a false or fraudulent claim.

4.3 	Sec. 2. Minnesota Statutes 2018, section 119B.09, subdivision 1, is amended to read:
4.4 		Subdivision 1.General eligibility requirements. (a) Child care services must be 
4.5 	available to families with financial resources, excluding vehicles, of less than $100,000, 
4.6 	who need child care to find or keep employment or to obtain the training or education 
4.7 	necessary to find employment and who:
4.8 	(1) have household income less than or equal to 67 percent of the state median income, 
4.9 	adjusted for family size, at application and redetermination, and meet the requirements of 
4.10 	section 119B.05; receive MFIP assistance; and are participating in employment and training 
4.11 	services under chapter 256J; or
4.12 	(2) have household income less than or equal to 47 percent of the state median income, 
4.13 	adjusted for family size, at application and less than or equal to 67 percent of the state 
4.14 	median income, adjusted for family size, at redetermination.
4.15 	(b) Child care services must be made available as in-kind services.
4.16 	(c) All applicants for child care assistance and families currently receiving child care 
4.17 	assistance must be assisted and required to cooperate in establishment of paternity and 
4.18 	enforcement of child support obligations for all children in the family at application and 
4.19 	redetermination as a condition of program eligibility. For purposes of this section, a family 
4.20 	is considered to meet the requirement for cooperation when the family complies with the 
4.21 	requirements of section 256.741.
4.22 	(d) All applicants for child care assistance and families currently receiving child care 
4.23 	assistance must pay the co-payment fee under section 119B.12, subdivision 2, as a condition 
4.24 	of eligibility. The co-payment fee may include additional recoupment fees due to a child 
4.25 	care assistance program overpayment.

4.26 	Sec. 3. Minnesota Statutes 2018, section 119B.09, subdivision 4, is amended to read:
4.27 		Subd. 4.Eligibility; annual income; calculation. (a) Annual income of the applicant 
4.28 	family is the current monthly income of the family multiplied by 12 or the income for the 
4.29 	12-month period immediately preceding the date of application, or income calculated by 
4.30 	the method which provides the most accurate assessment of income available to the family.
4.31 	(b) Self-employment income must be calculated based on gross receipts less operating 
4.32 	expenses authorized by the Internal Revenue Service.
5.1 	(c) Income changes are processed under section 119B.025, subdivision 4. Included lump 
5.2 	sums counted as income under section 256P.06, subdivision 3, must be annualized over 12 
5.3 	months. Income includes all deposits into accounts owned or controlled by the applicant, 
5.4 	including amounts spent on personal expenses including rent, mortgage, automobile-related 
5.5 	expenses, utilities, and food and amounts received as salary or draws from business accounts. 
5.6 	Income does not include a deposit specifically identified by the applicant as a loan or gift, 
5.7 	for which the applicant provides the source, date, amount, and repayment terms. Income 
5.8 	and assets must be verified with documentary evidence. If the applicant does not have 
5.9 	sufficient evidence of income or assets, verification must be obtained from the source of 
5.10 	the income or assets.

5.11 	Sec. 4. Minnesota Statutes 2018, section 119B.09, subdivision 7, is amended to read:
5.12 		Subd. 7.Date of eligibility for assistance. (a) The date of eligibility for child care 
5.13 	assistance under this chapter is the later of the date the application was received by the 
5.14 	county; the beginning date of employment, education, or training; the date the infant is born 
5.15 	for applicants to the at-home infant care program; or the date a determination has been made 
5.16 	that the applicant is a participant in employment and training services under Minnesota 
5.17 	Rules, part 3400.0080, or chapter 256J.
5.18 	(b) Payment ceases for a family under the at-home infant child care program when a 
5.19 	family has used a total of 12 months of assistance as specified under section 119B.035. 
5.20 	Payment of child care assistance for employed persons on MFIP is effective the date of 
5.21 	employment or the date of MFIP eligibility, whichever is later. Payment of child care 
5.22 	assistance for MFIP or DWP participants in employment and training services is effective 
5.23 	the date of commencement of the services or the date of MFIP or DWP eligibility, whichever 
5.24 	is later. Payment of child care assistance for transition year child care must be made 
5.25 	retroactive to the date of eligibility for transition year child care.
5.26 	(c) Notwithstanding paragraph (b), payment of child care assistance for participants 
5.27 	eligible under section 119B.05 may only be made retroactive for a maximum of six zero
5.28 	months from the date of application for child care assistance.

5.29 	EFFECTIVE DATE. This section is effective for applications processed on or after 
5.30 	July 1, 2019.

5.31 	Sec. 5. Minnesota Statutes 2018, section 119B.09, subdivision 9, is amended to read:
5.32 		Subd. 9.Licensed and legal nonlicensed family child care providers; assistance. This 
5.33 	subdivision applies to any provider providing care in a setting other than a licensed or 
6.1 	license-exempt child care center. Licensed and legal nonlicensed family child care providers 
6.2 	and their employees are not eligible to receive child care assistance subsidies under this 
6.3 	chapter for their own children or children in their family during the hours they are providing 
6.4 	child care or being paid to provide child care. Child care providers and their employees are 
6.5 	eligible to receive child care assistance subsidies for their children when they are engaged 
6.6 	in other activities that meet the requirements of this chapter and for which child care 
6.7 	assistance can be paid. The hours for which the provider or their employee receives a child 
6.8 	care subsidy for their own children must not overlap with the hours the provider provides 
6.9 	child care services.

6.10 	Sec. 6. Minnesota Statutes 2018, section 119B.09, subdivision 9a, is amended to read:
6.11 		Subd. 9a.Child care centers authorizations; assistance dependents of employees 
6.12 	and controlling individuals. (a) A licensed or license-exempt child care center may must 
6.13 	not receive authorizations for 25 or fewer children more than seven children who are 
6.14 	dependents of the center's employees or controlling individuals. If a child care center is 
6.15 	authorized for more than 25 children who are dependents of center employees, the county 
6.16 	cannot authorize additional dependents of an employee until the number of children falls 
6.17 	below 25.
6.18 	(b) Funds paid to providers during the period of time when a center is authorized for 
6.19 	more than 25 children who are dependents of center employees must not be treated as 
6.20 	overpayments under section 119B.11, subdivision 2a, due to noncompliance with this 
6.21 	subdivision.
6.22 	(c) (b) Nothing in this subdivision precludes the commissioner from conducting fraud 
6.23 	investigations relating to child care assistance, imposing sanctions, and obtaining monetary 
6.24 	recovery as otherwise provided by law.

6.25 	Sec. 7. Minnesota Statutes 2018, section 119B.125, subdivision 6, is amended to read:
6.26 		Subd. 6.Record-keeping requirement. (a) As a condition of payment, all providers 
6.27 	receiving child care assistance payments must keep accurate and legible daily attendance 
6.28 	records at the site where services are delivered for children receiving child care assistance 
6.29 	and must make those records available immediately to the county or the commissioner upon 
6.30 	request. The attendance records must be completed daily and include the date, the first and 
6.31 	last name of each child in attendance, and the times when each child is dropped off and 
6.32 	picked up. To the extent possible, the times that the child was dropped off to and picked up 
6.33 	from the child care provider must be entered by the person dropping off or picking up the 
7.1 	child. The daily attendance records must be retained at the site where services are delivered 
7.2 	for six years after the date of service.
7.3 	(b) Records that are not produced immediately under paragraph (a), unless a delay is 
7.4 	agreed upon by the commissioner and provider, shall not be valid for purposes of establishing 
7.5 	a child's attendance and shall result in an overpayment under paragraph (d).
7.6 	(c) A county or the commissioner may deny or revoke a provider's authorization as a 
7.7 	child care provider to any applicant, rescind authorization of any provider, to receive child 
7.8 	care assistance payments under section 119B.13, subdivision 6, paragraph (d), pursue a 
7.9 	fraud disqualification under section 256.98, take an action against the provider under chapter 
7.10 	245E, or establish an attendance record overpayment claim in the systemunder paragraph 
7.11 	(d) against a current or former provider, when the county or the commissioner knows or 
7.12 	has reason to believe that the provider has not complied with the record-keeping requirement 
7.13 	in this subdivision. A provider's failure to produce attendance records as requested on more 
7.14 	than one occasion constitutes grounds for disqualification as a provider.
7.15 	(d) To calculate an attendance record overpayment under this subdivision, the 
7.16 	commissioner or county agency subtracts the maximum daily rate from the total amount 
7.17 	paid to a provider for each day that a child's attendance record is missing, unavailable, 
7.18 	incomplete, illegible, inaccurate, or otherwise inadequate.
7.19 	(e) The commissioner shall develop criteria to direct a county when the county must 
7.20 	establish an attendance overpayment under this subdivision.

7.21 	Sec. 8. Minnesota Statutes 2018, section 119B.125, is amended by adding a subdivision 
7.22 	to read:
7.23 		Subd. 10.Proof of surety bond coverage. All licensed child care centers authorized 
7.24 	for reimbursement under this chapter that received child care assistance program revenue 
7.25 	equal to or greater than $250,000 in the previous calendar year must provide to the 
7.26 	commissioner at least once per year proof of surety bond coverage of $100,000 in a format 
7.27 	determined by the commissioner. The surety bond must be in a form approved by the 
7.28 	commissioner, be renewed annually, and allow for recovery of costs and fees in pursuing 
7.29 	a claim on the bond.

7.30 	EFFECTIVE DATE. This section is effective January 1, 2020.

8.1 	Sec. 9. Minnesota Statutes 2018, section 119B.125, is amended by adding a subdivision 
8.2 	to read:
8.3 		Subd. 11.Financial misconduct. (a) County agencies may conduct investigations of 
8.4 	financial misconduct by child care providers as described in section 245E.02, subdivisions 
8.5 	1 and 2, only after receiving verification that the department is not investigating a provider 
8.6 	under chapter 245E.
8.7 	(b) If, upon investigation, a preponderance of evidence shows financial misconduct by 
8.8 	a provider, the county may immediately suspend the provider's authorization to receive 
8.9 	child care assistance payments under section 119B.13, subdivision 6, paragraph (d), prior 
8.10 	to pursuing other available remedies.
8.11 	(c) The county shall give immediate notice in writing to a provider and any affected 
8.12 	families of any suspension of the provider's child care authorization under paragraph (b). 
8.13 	The notice shall state:
8.14 	(1) the factual basis for the county's determination;
8.15 	(2) the date of the suspension;
8.16 	(3) the length of the suspension;
8.17 	(4) the requirements and procedures for reinstatement;
8.18 	(5) the right to dispute the county's determination and to provide evidence; and
8.19 	(6) the right to appeal the county's determination.
8.20 	(d) The county's determination under paragraph (b) is subject to the fair hearing 
8.21 	requirements under section 119B.16, subdivisions 1a, 1b, and 2. A provider that requests a 
8.22 	fair hearing is entitled to a hearing within ten days of the request.

8.23 	Sec. 10. Minnesota Statutes 2018, section 119B.13, subdivision 6, is amended to read:
8.24 		Subd. 6.Provider payments. (a) A provider shall bill only for services documented 
8.25 	according to section 119B.125, subdivision 6. The provider shall bill for services provided 
8.26 	within ten days of the end of the service period. Payments under the child care fund shall 
8.27 	be made within 21 days of receiving a complete bill from the provider. Counties or the state 
8.28 	may establish policies that make payments on a more frequent basis.
8.29 	(b) If a provider has received an authorization of care and been issued a billing form for 
8.30 	an eligible family, the bill must be submitted within 60 days of the last date of service on 
8.31 	the bill. A bill submitted more than 60 days after the last date of service must be paid if the 
9.1 	county determines that the provider has shown good cause why the bill was not submitted 
9.2 	within 60 days. Good cause must be defined in the county's child care fund plan under 
9.3 	section 119B.08, subdivision 3, and the definition of good cause must include county error. 
9.4 	Any bill submitted more than a year after the last date of service on the bill must not be 
9.5 	paid.
9.6 	(c) If a provider provided care for a time period without receiving an authorization of 
9.7 	care and a billing form for an eligible family, payment of child care assistance may only be 
9.8 	made retroactively for a maximum of six months from the date the provider is issued an 
9.9 	authorization of care and billing form.
9.10 	(d) A county or the commissioner may refuse to issue a child care authorization to a 
9.11 	licensed or legal nonlicensed provider, revoke an existing child care authorization to a 
9.12 	licensed or legal nonlicensed provider, stop payment issued to a licensed or legal nonlicensed 
9.13 	provider, or refuse to pay a bill submitted by a licensed or legal nonlicensed provider if:
9.14 	(1) the provider admits to intentionally giving the county materially false information 
9.15 	on the provider's billing forms;
9.16 	(2) a county or the commissioner finds by a preponderance of the evidence that the 
9.17 	provider intentionally gave the county materially false information on the provider's billing 
9.18 	forms, or provided false attendance records to a county or the commissioner;
9.19 	(3) the provider is in violation of child care assistance program rules, until the agency 
9.20 	determines those violations have been corrected;
9.21 	(4) the provider is operating after:
9.22 	(i) an order of suspension of the provider's license issued by the commissioner;
9.23 	(ii) an order of revocation of the provider's license; or
9.24 	(iii) a final order of conditional license issued by the commissioner for as long as the 
9.25 	conditional license is in effect;
9.26 	(5) the provider submits false attendance reports or refuses to provide documentation 
9.27 	of the child's attendance upon request; or
9.28 	(6) the provider gives false child care price information.; or
9.29 	(7) the provider fails to report decreases in a child's attendance, as required under section 
9.30 	119B.125, subdivision 9.
10.1 	(e) For purposes of paragraph (d), clauses (3), (5), and (6), and (7), the county or the 
10.2 	commissioner may withhold the provider's authorization or payment for a period of time 
10.3 	not to exceed three months beyond the time the condition has been corrected.
10.4 	(f) A county's payment policies must be included in the county's child care plan under 
10.5 	section 119B.08, subdivision 3. If payments are made by the state, in addition to being in 
10.6 	compliance with this subdivision, the payments must be made in compliance with section 
10.7 	16A.124.

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

10.9 	Sec. 11. Minnesota Statutes 2018, section 119B.13, subdivision 7, is amended to read:
10.10 		Subd. 7.Absent days. (a) Licensed child care providers and license-exempt centers 
10.11 	must not be reimbursed for more than 25 full-day absent days per child, excluding holidays, 
10.12 	in a fiscal calendar year, or for more than ten consecutive full-day absent days. "Absent 
10.13 	day" means any day that the child is authorized and scheduled to be in care with a licensed 
10.14 	provider or license exempt center and the child is absent from the care for the entire day. 
10.15 	Legal nonlicensed family child care providers must not be reimbursed for absent days. If a 
10.16 	child attends for part of the time authorized to be in care in a day, but is absent for part of 
10.17 	the time authorized to be in care in that same day, the absent time must be reimbursed but 
10.18 	the time must not count toward the absent days limit. Child care providers must only be 
10.19 	reimbursed for absent days if the provider has a written policy for child absences and charges 
10.20 	all other families in care for similar absences.
10.21 	(b) Notwithstanding paragraph (a), children with documented medical conditions that 
10.22 	cause more frequent absences may exceed the 25 absent days limit, or ten consecutive 
10.23 	full-day absent days limit. Absences due to a documented medical condition of a parent or 
10.24 	sibling who lives in the same residence as the child receiving child care assistance do not 
10.25 	count against the absent days limit in a fiscal calendar year. Documentation of medical 
10.26 	conditions must be on the forms and submitted according to the timelines established by 
10.27 	the commissioner. A public health nurse or school nurse may verify the illness in lieu of a 
10.28 	medical practitioner. If a provider sends a child home early due to a medical reason, 
10.29 	including, but not limited to, fever or contagious illness, the child care center director or 
10.30 	lead teacher may verify the illness in lieu of a medical practitioner.
10.31 	(c) Notwithstanding paragraph (a), children in families may exceed the absent days limit 
10.32 	if at least one parent: (1) is under the age of 21; (2) does not have a high school diploma or 
10.33 	commissioner of education-selected high school equivalency certification; and (3) is a 
10.34 	student in a school district or another similar program that provides or arranges for child 
11.1 	care, parenting support, social services, career and employment supports, and academic 
11.2 	support to achieve high school graduation, upon request of the program and approval of the 
11.3 	county. If a child attends part of an authorized day, payment to the provider must be for the 
11.4 	full amount of care authorized for that day.
11.5 	(d) Child care providers must be reimbursed for up to ten federal or state holidays or 
11.6 	designated holidays per year when the provider charges all families for these days and the 
11.7 	holiday or designated holiday falls on a day when the child is authorized to be in attendance. 
11.8 	Parents may substitute other cultural or religious holidays for the ten recognized state and 
11.9 	federal holidays. Holidays do not count toward the absent days limit.
11.10 	(e) A family or child care provider must not be assessed an overpayment for an absent 
11.11 	day payment unless (1) there was an error in the amount of care authorized for the family, 
11.12 	(2) all of the allowed full-day absent payments for the child have been paid, or (3) the family 
11.13 	or provider did not timely report a change as required under law.
11.14 	(f) The provider and family shall receive notification of the number of absent days used 
11.15 	upon initial provider authorization for a family and ongoing notification of the number of 
11.16 	absent days used as of the date of the notification.
11.17 	(g) For purposes of this subdivision, "absent days limit" means 25 full-day absent days 
11.18 	per child, excluding holidays, in a fiscal calendar year; and ten consecutive full-day absent 
11.19 	days.
11.20 	(h) For purposes of this subdivision, "holidays limit" means ten full-day holidays per 
11.21 	child, excluding absent days, in a calendar year.
11.22 	(i) If a day meets the criteria of an absent day or a holiday under this subdivision, the 
11.23 	provider must bill that day as an absent day or holiday. A provider's failure to properly bill 
11.24 	an absent day or a holiday results in an overpayment, regardless of whether the child reached, 
11.25 	or is exempt from, the absent days limit or holidays limit for the calendar year.

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

11.27 	Sec. 12. Minnesota Statutes 2018, section 144A.479, is amended by adding a subdivision 
11.28 	to read:
11.29 		Subd. 8.Labor market reporting. A home care provider shall comply with the labor 
11.30 	market reporting requirements described in section 256B.4912, subdivision 1a.

12.1 	Sec. 13. Minnesota Statutes 2018, section 245.095, is amended to read:
12.2 	245.095 LIMITS ON RECEIVING PUBLIC FUNDS.
12.3 		Subdivision 1.Prohibition. (a) If a provider, vendor, or individual enrolled, licensed, 
12.4 	or receiving funds under a grant contract, or registered in any program administered by the 
12.5 	commissioner, including under the commissioner's powers and authorities in section 256.01,
12.6 	is excluded from any that program administered by the commissioner, including under the 
12.7 	commissioner's powers and authorities in section 256.01, the commissioner shall:
12.8 	(1) prohibit the excluded provider, vendor, or individual from enrolling or, becoming 
12.9 	licensed, receiving grant funds, or registering in any other program administered by the 
12.10 	commissioner.; and
12.11 	(2) disenroll, revoke or suspend a license, disqualify, or debar the excluded provider, 
12.12 	vendor, or individual in any other program administered by the commissioner.
12.13 	(b) The duration of this prohibition, disenrollment, revocation, suspension, 
12.14 	disqualification, or debarment must last for the longest applicable sanction or disqualifying 
12.15 	period in effect for the provider, vendor, or individual permitted by state or federal law.
12.16 		Subd. 2.Definitions. (a) For purposes of this section, the following definitions have the 
12.17 	meanings given them.
12.18 	(b) "Excluded" means disenrolled, subject to license revocation or suspension, 
12.19 	disqualified, or subject to vendor debarmentdisqualified, has a license that has been revoked 
12.20 	or suspended under chapter 245A, has been debarred or suspended under Minnesota Rules, 
12.21 	part 1230.1150, or terminated from participation in medical assistance under section 
12.22 	256B.064.
12.23 	(c) "Individual" means a natural person providing products or services as a provider or 
12.24 	vendor.
12.25 	(d) "Provider" means an owner, controlling individual, license holder, director, or 
12.26 	managerial official.

12.27 	Sec. 14. [245A.24] MANDATORY REPORTING.
12.28 	All licensors employed by a county or the Department of Human Services must 
12.29 	immediately report any suspected fraud to county human services investigators or the 
12.30 	Department of Human Services Office of the Inspector General.

13.1 	Sec. 15. Minnesota Statutes 2018, section 245E.02, is amended by adding a subdivision 
13.2 	to read:
13.3 		Subd. 1a.Provider definitions. For the purposes of this section, "provider" includes:
13.4 	(1) individuals or entities meeting the definition of provider in section 245E.01, 
13.5 	subdivision 12; and
13.6 	(2) owners and controlling individuals of entities identified in clause (1).

13.7 	Sec. 16. Minnesota Statutes 2018, section 256.98, subdivision 1, is amended to read:
13.8 		Subdivision 1.Wrongfully obtaining assistance. A person who commits any of the 
13.9 	following acts or omissions with intent to defeat the purposes of sections 145.891 to 145.897, 
13.10 	the MFIP program formerly codified in sections 256.031 to 256.0361, the AFDC program 
13.11 	formerly codified in sections 256.72 to 256.871, chapter 256B, 256D, 256I, 256J, 256K, or 
13.12 	256L, child care assistance programs, and emergency assistance programs under section 
13.13 	256D.06, is guilty of theft and shall be sentenced under section 609.52, subdivision 3, clauses 
13.14 	(1) to (5):
13.15 	(1) obtains or attempts to obtain, or aids or abets any person to obtain by means of a 
13.16 	willfully false statement or representation, by intentional concealment of any material fact, 
13.17 	or by impersonation or other fraudulent device, assistance or the continued receipt of 
13.18 	assistance, to include child care assistance or vouchers produced according to sections 
13.19 	145.891 to 145.897 and MinnesotaCare services according to sections 256.9365, 256.94, 
13.20 	and 256L.01 to 256L.15, to which the person is not entitled or assistance greater than that 
13.21 	to which the person is entitled;
13.22 	(2) knowingly aids or abets in buying or in any way disposing of the property of a 
13.23 	recipient or applicant of assistance without the consent of the county agency; or
13.24 	(3) obtains or attempts to obtain, alone or in collusion with others, the receipt of payments 
13.25 	to which the individual is not entitled as a provider of subsidized child care, or by furnishing 
13.26 	or concurring in a willfully false claim for child care assistance.
13.27 	The continued receipt of assistance to which the person is not entitled or greater than 
13.28 	that to which the person is entitled as a result of any of the acts, failure to act, or concealment 
13.29 	described in this subdivision shall be deemed to be continuing offenses from the date that 
13.30 	the first act or failure to act occurred.

14.1 	Sec. 17. Minnesota Statutes 2018, section 256.98, subdivision 8, is amended to read:
14.2 		Subd. 8.Disqualification from program. (a) Any person found to be guilty of 
14.3 	wrongfully obtaining assistance by a federal or state court or by an administrative hearing 
14.4 	determination, or waiver thereof, through a disqualification consent agreement, or as part 
14.5 	of any approved diversion plan under section 401.065, or any court-ordered stay which 
14.6 	carries with it any probationary or other conditions, in the Minnesota family investment 
14.7 	program and any affiliated program to include the diversionary work program and the work 
14.8 	participation cash benefit program, the food stamp or food support program, the general 
14.9 	assistance program, housing support under chapter 256I, or the Minnesota supplemental 
14.10 	aid program shall be disqualified from that program. The disqualification based on a finding 
14.11 	or action by a federal or state court is a permanent disqualification. The disqualification 
14.12 	based on an administrative hearing, or waiver thereof, through a disqualification consent 
14.13 	agreement, or as part of any approved diversion plan under section 401.065, or any 
14.14 	court-ordered stay which carries with it any probationary or other conditions must be for a 
14.15 	period of two years for the first offense and a permanent disqualification for the second 
14.16 	offense. In addition, any person disqualified from the Minnesota family investment program 
14.17 	shall also be disqualified from the food stamp or food support program. The needs of that 
14.18 	individual shall not be taken into consideration in determining the grant level for that 
14.19 	assistance unit:.
14.20 	(1) for one year after the first offense;
14.21 	(2) for two years after the second offense; and
14.22 	(3) permanently after the third or subsequent offense.
14.23 	The period of program disqualification shall begin on the date stipulated on the advance 
14.24 	notice of disqualification without possibility of postponement for administrative stay or 
14.25 	administrative hearing and shall continue through completion unless and until the findings 
14.26 	upon which the sanctions were imposed are reversed by a court of competent jurisdiction. 
14.27 	The period for which sanctions are imposed is not subject to review. The sanctions provided 
14.28 	under this subdivision are in addition to, and not in substitution for, any other sanctions that 
14.29 	may be provided for by law for the offense involved. A disqualification established through 
14.30 	hearing or waiver shall result in the disqualification period beginning immediately unless 
14.31 	the person has become otherwise ineligible for assistance. If the person is ineligible for 
14.32 	assistance, the disqualification period begins when the person again meets the eligibility 
14.33 	criteria of the program from which they were disqualified and makes application for that 
14.34 	program.
15.1 	(b) A family receiving assistance through child care assistance programs under chapter 
15.2 	119B with a family member who is found to be guilty of wrongfully obtaining child care 
15.3 	assistance by a federal court, state court, or an administrative hearing determination or 
15.4 	waiver, through a disqualification consent agreement, as part of an approved diversion plan 
15.5 	under section 401.065, or a court-ordered stay with probationary or other conditions, is 
15.6 	disqualified from child care assistance programs. The disqualifications must be for periods 
15.7 	of one year and two years for the first and second offenses, respectively. Subsequent 
15.8 	violations must result inbased on a finding or action by a federal or state court is a permanent 
15.9 	disqualification. The disqualification based on an administrative hearing determination or 
15.10 	waiver, through a disqualification consent agreement, as part of an approved diversion plan 
15.11 	under section 401.065, or a court-ordered stay with probationary or other conditions must 
15.12 	be for a period of two years for the first offense and a permanent disqualification for the 
15.13 	second offense. During the disqualification period, disqualification from any child care 
15.14 	program must extend to all child care programs and must be immediately applied.
15.15 	(c) A provider caring for children receiving assistance through child care assistance 
15.16 	programs under chapter 119B is disqualified from receiving payment for child care services 
15.17 	from the child care assistance program under chapter 119B when the provider is found to 
15.18 	have wrongfully obtained child care assistance by a federal court, state court, or an 
15.19 	administrative hearing determination or waiver under section 256.046, through a 
15.20 	disqualification consent agreement, as part of an approved diversion plan under section 
15.21 	401.065, or a court-ordered stay with probationary or other conditions. The disqualification 
15.22 	must be for a period of one year for the first offense and two years for the second offense. 
15.23 	Any subsequent violation must result in based on a finding or action by a federal or state 
15.24 	court is a permanent disqualification. The disqualification based on an administrative hearing 
15.25 	determination or waiver under section 256.045, as part of an approved diversion plan under 
15.26 	section 401.065, or a court-ordered stay with probationary or other conditions must be for 
15.27 	a period of two years for the first offense and a permanent disqualification for the second 
15.28 	offense. The disqualification period must be imposed immediately after a determination is 
15.29 	made under this paragraph. During the disqualification period, the provider is disqualified 
15.30 	from receiving payment from any child care program under chapter 119B.
15.31 	(d) Any person found to be guilty of wrongfully obtaining MinnesotaCare for adults 
15.32 	without children and upon federal approval, all categories of medical assistance and 
15.33 	remaining categories of MinnesotaCare, except for children through age 18, by a federal or 
15.34 	state court or by an administrative hearing determination, or waiver thereof, through a 
15.35 	disqualification consent agreement, or as part of any approved diversion plan under section 
16.1 	401.065, or any court-ordered stay which carries with it any probationary or other conditions, 
16.2 	is disqualified from that program. The period of disqualification is one year after the first 
16.3 	offense, two years after the second offense, and permanently after the third or subsequent 
16.4 	offense. The period of program disqualification shall begin on the date stipulated on the 
16.5 	advance notice of disqualification without possibility of postponement for administrative 
16.6 	stay or administrative hearing and shall continue through completion unless and until the 
16.7 	findings upon which the sanctions were imposed are reversed by a court of competent 
16.8 	jurisdiction. The period for which sanctions are imposed is not subject to review. The 
16.9 	sanctions provided under this subdivision are in addition to, and not in substitution for, any 
16.10 	other sanctions that may be provided for by law for the offense involved.

16.11 	Sec. 18. Minnesota Statutes 2018, section 256.987, subdivision 1, is amended to read:
16.12 		Subdivision 1.Electronic benefit transfer (EBT) card. Cash benefits for the general 
16.13 	assistance and Minnesota supplemental aid programs under chapter 256D and programs 
16.14 	under chapter 256J must be issued on an EBT card with. The name and photograph of the 
16.15 	head of household and a list of family members authorized to use the EBT card must be 
16.16 	printed on the card. The cardholder must show identification before making a purchase. 
16.17 	The card must include the following statement: "It is unlawful to use this card to purchase 
16.18 	tobacco products or alcoholic beverages." This card must be issued within 30 calendar days 
16.19 	of an eligibility determination. During the initial 30 calendar days of eligibility, a recipient 
16.20 	may have cash benefits issued on an EBT card without a name printed on the card. This 
16.21 	card may be the same card on which food support benefits are issued and does not need to 
16.22 	meet the requirements of this section.

16.23 	Sec. 19. Minnesota Statutes 2018, section 256.987, subdivision 2, is amended to read:
16.24 		Subd. 2.Prohibited purchases and returns. (a) An individual with an EBT card issued 
16.25 	for one of the programs listed under subdivision 1 is prohibited from using the EBT debit 
16.26 	card to purchase tobacco products and alcoholic beverages, as defined in section 340A.101, 
16.27 	subdivision 2. Any prohibited purchases made under this subdivision shall constitute unlawful 
16.28 	use and result in disqualification of the cardholder from the program as provided in 
16.29 	subdivision 4.
16.30 	(b) An item purchased with an EBT card that is returned must be credited back to the 
16.31 	EBT card. It is prohibited to give the EBT cardholder cash for returned items purchased 
16.32 	with an EBT card.

17.1 	Sec. 20. Minnesota Statutes 2018, section 256B.02, subdivision 7, is amended to read:
17.2 		Subd. 7.Vendor of medical care. (a) "Vendor of medical care" means any person or 
17.3 	persons furnishing, within the scope of the vendor's respective license, any or all of the 
17.4 	following goods or services: medical, surgical, hospital, ambulatory surgical center services, 
17.5 	optical, visual, dental and nursing services; drugs and medical supplies; appliances; 
17.6 	laboratory, diagnostic, and therapeutic services; nursing home and convalescent care; 
17.7 	screening and health assessment services provided by public health nurses as defined in 
17.8 	section 145A.02, subdivision 18; health care services provided at the residence of the patient 
17.9 	if the services are performed by a public health nurse and the nurse indicates in a statement 
17.10 	submitted under oath that the services were actually provided; and such other medical 
17.11 	services or supplies provided or prescribed by persons authorized by state law to give such 
17.12 	services and supplies, including services under section 256B.4912. For purposes of this 
17.13 	chapter, the term includes a person or entity that furnishes a good or service eligible for 
17.14 	medical assistance or federally approved waiver plan payments under this chapter. The term 
17.15 	includes, but is not limited to, directors and officers of corporations or members of 
17.16 	partnerships who, either individually or jointly with another or others, have the legal control, 
17.17 	supervision, or responsibility of submitting claims for reimbursement to the medical 
17.18 	assistance program. The term only includes directors and officers of corporations who 
17.19 	personally receive a portion of the distributed assets upon liquidation or dissolution, and 
17.20 	their liability is limited to the portion of the claim that bears the same proportion to the total 
17.21 	claim as their share of the distributed assets bears to the total distributed assets.
17.22 	(b) "Vendor of medical care" also includes any person who is credentialed as a health 
17.23 	professional under standards set by the governing body of a federally recognized Indian 
17.24 	tribe authorized under an agreement with the federal government according to United States 
17.25 	Code, title 25, section 450f, to provide health services to its members, and who through a 
17.26 	tribal facility provides covered services to American Indian people within a contract health 
17.27 	service delivery area of a Minnesota reservation, as defined under Code of Federal 
17.28 	Regulations, title 42, section 36.22.
17.29 	(c) A federally recognized Indian tribe that intends to implement standards for 
17.30 	credentialing health professionals must submit the standards to the commissioner of human 
17.31 	services, along with evidence of meeting, exceeding, or being exempt from corresponding 
17.32 	state standards. The commissioner shall maintain a copy of the standards and supporting 
17.33 	evidence, and shall use those standards to enroll tribal-approved health professionals as 
17.34 	medical assistance providers. For purposes of this section, "Indian" and "Indian tribe" mean 
17.35 	persons or entities that meet the definition in United States Code, title 25, section 450b.

18.1 	Sec. 21. Minnesota Statutes 2018, section 256B.02, is amended by adding a subdivision 
18.2 	to read:
18.3 		Subd. 20.Income. Income is calculated using the adjusted gross income methodology 
18.4 	under the Affordable Care Act. Income includes funds in personal or business accounts 
18.5 	used to pay personal expenses including rent, mortgage, automobile-related expenses, 
18.6 	utilities, food, and other personal expenses not directly related to the business, unless the 
18.7 	funds are directly attributable to an exception to the income requirement specifically 
18.8 	identified by the applicant.

18.9 	Sec. 22. Minnesota Statutes 2018, section 256B.04, subdivision 21, is amended to read:
18.10 		Subd. 21.Provider enrollment. (a) The commissioner shall enroll providers and conduct 
18.11 	screening activities as required by Code of Federal Regulations, title 42, section 455, subpart 
18.12 	E, including database checks, unannounced pre- and post-enrollment site visits, fingerprinting, 
18.13 	and criminal background studies. A provider providing services from multiple licensed 
18.14 	locations must enroll each licensed location separately. The commissioner may deny a 
18.15 	provider's incomplete application for enrollment if a provider fails to respond to the 
18.16 	commissioner's request for additional information within 60 days of the request.
18.17 	(b) The commissioner must revalidate each provider under this subdivision at least once 
18.18 	every five years. The commissioner may revalidate a personal care assistance agency under 
18.19 	this subdivision once every three years. The commissioner shall conduct revalidation as 
18.20 	follows:
18.21 	(1) provide 30-day notice of revalidation due date to include instructions for revalidation 
18.22 	and a list of materials the provider must submit to revalidate;
18.23 	(2) notify the provider that fails to completely respond within 30 days of any deficiencies 
18.24 	and allow an additional 30 days to comply; and
18.25 	(3) give 60-day notice of termination and immediately suspend a provider's ability to 
18.26 	bill for failure to remedy any deficiencies within the 30-day time period. The commissioner's 
18.27 	decision to suspend the provider's ability to bill is not subject to an administrative appeal.
18.28 	(c) The commissioner shall require that an individual rendering care to a recipient for 
18.29 	the following covered services enroll as an individual provider and be identified on claims:
18.30 	(1) consumer directed community supports; and
18.31 	(2) qualified professionals supervising personal care assistant services according to 
18.32 	section 256B.0659.
19.1 	(d) The commissioner may suspend a provider's ability to bill for a failure to comply 
19.2 	with any individual provider requirements or conditions of participation until the provider 
19.3 	comes into compliance. The commissioner's decision to suspend the provider's ability to 
19.4 	bill is not subject to an administrative appeal.
19.5 	(e) Notwithstanding any other provision to the contrary, all correspondence and 
19.6 	notifications, including notifications of termination and other actions, shall be delivered 
19.7 	electronically to a provider's MN-ITS mailbox. For a provider that does not have a MN-ITS 
19.8 	account and mailbox, notice shall be sent by first class mail.
19.9 	(f) If the commissioner or the Centers for Medicare and Medicaid Services determines 
19.10 	that a provider is designated "high-risk," the commissioner may withhold payment from 
19.11 	providers within that category upon initial enrollment for a 90-day period. The withholding 
19.12 	for each provider must begin on the date of the first submission of a claim.
19.13 	(b) (g) An enrolled provider that is also licensed by the commissioner under chapter 
19.14 	245A, or is licensed as a home care provider by the Department of Health under chapter 
19.15 	144A and has a home and community-based services designation on the home care license 
19.16 	under section 144A.484, must designate an individual as the entity's compliance officer. 
19.17 	The compliance officer must:
19.18 	(1) develop policies and procedures to assure adherence to medical assistance laws and 
19.19 	regulations and to prevent inappropriate claims submissions;
19.20 	(2) train the employees of the provider entity, and any agents or subcontractors of the 
19.21 	provider entity including billers, on the policies and procedures under clause (1);
19.22 	(3) respond to allegations of improper conduct related to the provision or billing of 
19.23 	medical assistance services, and implement action to remediate any resulting problems;
19.24 	(4) use evaluation techniques to monitor compliance with medical assistance laws and 
19.25 	regulations;
19.26 	(5) promptly report to the commissioner any identified violations of medical assistance 
19.27 	laws or regulations; and
19.28 	(6) within 60 days of discovery by the provider of a medical assistance reimbursement 
19.29 	overpayment, report the overpayment to the commissioner and make arrangements with 
19.30 	the commissioner for the commissioner's recovery of the overpayment.
19.31 	The commissioner may require, as a condition of enrollment in medical assistance, that a 
19.32 	provider within a particular industry sector or category establish a compliance program that 
19.33 	contains the core elements established by the Centers for Medicare and Medicaid Services.
20.1 	(c) (h) The commissioner may revoke the enrollment of an ordering or rendering provider 
20.2 	for a period of not more than one year, if the provider fails to maintain and, upon request 
20.3 	from the commissioner, provide access to documentation relating to written orders or requests 
20.4 	for payment for durable medical equipment, certifications for home health services, or 
20.5 	referrals for other items or services written or ordered by such provider, when the 
20.6 	commissioner has identified a pattern of a lack of documentation. A pattern means a failure 
20.7 	to maintain documentation or provide access to documentation on more than one occasion. 
20.8 	Nothing in this paragraph limits the authority of the commissioner to sanction a provider 
20.9 	under the provisions of section 256B.064.
20.10 	(d) (i) The commissioner shall terminate or deny the enrollment of any individual or 
20.11 	entity if the individual or entity has been terminated from participation in Medicare or under 
20.12 	the Medicaid program or Children's Health Insurance Program of any other state.
20.13 	(e) (j) As a condition of enrollment in medical assistance, the commissioner shall require 
20.14 	that a provider designated "moderate" or "high-risk" by the Centers for Medicare and 
20.15 	Medicaid Services or the commissioner permit the Centers for Medicare and Medicaid 
20.16 	Services, its agents, or its designated contractors and the state agency, its agents, or its 
20.17 	designated contractors to conduct unannounced on-site inspections of any provider location. 
20.18 	The commissioner shall publish in the Minnesota Health Care Program Provider Manual a 
20.19 	list of provider types designated "limited," "moderate," or "high-risk," based on the criteria 
20.20 	and standards used to designate Medicare providers in Code of Federal Regulations, title 
20.21 	42, section 424.518. The list and criteria are not subject to the requirements of chapter 14. 
20.22 	The commissioner's designations are not subject to administrative appeal.
20.23 	(f) (k) As a condition of enrollment in medical assistance, the commissioner shall require 
20.24 	that a high-risk provider, or a person with a direct or indirect ownership interest in the 
20.25 	provider of five percent or higher, consent to criminal background checks, including 
20.26 	fingerprinting, when required to do so under state law or by a determination by the 
20.27 	commissioner or the Centers for Medicare and Medicaid Services that a provider is designated 
20.28 	high-risk for fraud, waste, or abuse.
20.29 	(g) (l)(1) Upon initial enrollment, reenrollment, and notification of revalidation, all 
20.30 	durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) medical suppliers 
20.31 	meeting the durable medical equipment provider and supplier definition in clause (3), 
20.32 	operating in Minnesota and receiving Medicaid funds must purchase a surety bond that is 
20.33 	annually renewed and designates the Minnesota Department of Human Services as the 
20.34 	obligee, and must be submitted in a form approved by the commissioner. For purposes of 
20.35 	this clause, the following medical suppliers are not required to obtain a surety bond: a 
21.1 	federally qualified health center, a home health agency, the Indian Health Service, a 
21.2 	pharmacy, and a rural health clinic.
21.3 	(2) At the time of initial enrollment or reenrollment, durable medical equipment providers 
21.4 	and suppliers defined in clause (3) must purchase a surety bond of $50,000. If a revalidating 
21.5 	provider's Medicaid revenue in the previous calendar year is up to and including $300,000, 
21.6 	the provider agency must purchase a surety bond of $50,000. If a revalidating provider's 
21.7 	Medicaid revenue in the previous calendar year is over $300,000, the provider agency must 
21.8 	purchase a surety bond of $100,000. The surety bond must allow for recovery of costs and 
21.9 	fees in pursuing a claim on the bond be in a form approved by the commissioner, renewed 
21.10 	annually, and must allow for recovery of costs and fees in pursing a claim on the bond.
21.11 	(3) "Durable medical equipment provider or supplier" means a medical supplier that can 
21.12 	purchase medical equipment or supplies for sale or rental to the general public and is able 
21.13 	to perform or arrange for necessary repairs to and maintenance of equipment offered for 
21.14 	sale or rental.
21.15 	(h) (m) The Department of Human Services may require a provider to purchase a surety 
21.16 	bond as a condition of initial enrollment, reenrollment, reinstatement, or continued enrollment 
21.17 	if: (1) the provider fails to demonstrate financial viability, (2) the department determines 
21.18 	there is significant evidence of or potential for fraud and abuse by the provider, or (3) the 
21.19 	provider or category of providers is designated high-risk pursuant to paragraph (a) (e) and 
21.20 	as per Code of Federal Regulations, title 42, section 455.450. The surety bond must be in 
21.21 	an amount of $100,000 or ten percent of the provider's payments from Medicaid during the 
21.22 	immediately preceding 12 months, whichever is greater. The surety bond must name the 
21.23 	Department of Human Services as an obligee and must allow for recovery of costs and fees 
21.24 	in pursuing a claim on the bond. This paragraph does not apply if the provider currently 
21.25 	maintains a surety bond under the requirements in section 256B.0659 or 256B.85.

21.26 	EFFECTIVE DATE. This section is effective July 1, 2019, with the exception that the 
21.27 	amendments to paragraph (l), clause (2), are effective January 1, 2020.

21.28 	Sec. 23. Minnesota Statutes 2018, section 256B.056, subdivision 3, is amended to read:
21.29 		Subd. 3.Asset limitations for certain individuals. (a) To be eligible for medical 
21.30 	assistance, a person must not individually own more than $3,000 in assets, or if a member 
21.31 	of a household with two family members, husband and wife, or parent and child, the 
21.32 	household must not own more than $6,000 in assets, plus $200 for each additional legal 
21.33 	dependent. In addition to these maximum amounts, an eligible individual or family may 
21.34 	accrue interest on these amounts, but they must be reduced to the maximum at the time of 
22.1 	an eligibility redetermination. The accumulation of the clothing and personal needs allowance 
22.2 	according to section 256B.35 must also be reduced to the maximum at the time of the 
22.3 	eligibility redetermination. The value of assets that are not considered in determining 
22.4 	eligibility for medical assistance is the value of those assets excluded under the Supplemental 
22.5 	Security Income program for aged, blind, and disabled persons, with the following 
22.6 	exceptions:
22.7 	(1) household goods and personal effects are not considered;
22.8 	(2) capital and operating assets of a trade or business that the local agency determines 
22.9 	are necessary to the person's ability to earn an income are not considered. A bank account 
22.10 	that contains personal income or assets or is used to pay personal expenses is not a capital 
22.11 	or operating asset of a trade or business;
22.12 	(3) motor vehicles are excluded to the same extent excluded by the Supplemental Security 
22.13 	Income program;
22.14 	(4) assets designated as burial expenses are excluded to the same extent excluded by the 
22.15 	Supplemental Security Income program. Burial expenses funded by annuity contracts or 
22.16 	life insurance policies must irrevocably designate the individual's estate as contingent 
22.17 	beneficiary to the extent proceeds are not used for payment of selected burial expenses;
22.18 	(5) for a person who no longer qualifies as an employed person with a disability due to 
22.19 	loss of earnings, assets allowed while eligible for medical assistance under section 256B.057, 
22.20 	subdivision 9, are not considered for 12 months, beginning with the first month of ineligibility 
22.21 	as an employed person with a disability, to the extent that the person's total assets remain 
22.22 	within the allowed limits of section 256B.057, subdivision 9, paragraph (d);
22.23 	(6) when a person enrolled in medical assistance under section 256B.057, subdivision 
22.24 	9, is age 65 or older and has been enrolled during each of the 24 consecutive months before 
22.25 	the person's 65th birthday, the assets owned by the person and the person's spouse must be 
22.26 	disregarded, up to the limits of section 256B.057, subdivision 9, paragraph (d), when 
22.27 	determining eligibility for medical assistance under section 256B.055, subdivision 7. The 
22.28 	income of a spouse of a person enrolled in medical assistance under section 256B.057, 
22.29 	subdivision 9, during each of the 24 consecutive months before the person's 65th birthday 
22.30 	must be disregarded when determining eligibility for medical assistance under section 
22.31 	256B.055, subdivision 7. Persons eligible under this clause are not subject to the provisions 
22.32 	in section 256B.059; and
22.33 	(7) effective July 1, 2009, certain assets owned by American Indians are excluded as 
22.34 	required by section 5006 of the American Recovery and Reinvestment Act of 2009, Public 
23.1 	Law 111-5. For purposes of this clause, an American Indian is any person who meets the 
23.2 	definition of Indian according to Code of Federal Regulations, title 42, section 447.50.
23.3 	(b) No asset limit shall apply to persons eligible under section 256B.055, subdivision 
23.4 	15.

23.5 	Sec. 24. Minnesota Statutes 2018, section 256B.056, subdivision 4, is amended to read:
23.6 		Subd. 4.Income. (a) To be eligible for medical assistance, a person eligible under section 
23.7 	256B.055, subdivisions 7, 7a, and 12, may have income up to 100 percent of the federal 
23.8 	poverty guidelines. Effective January 1, 2000, and each successive January, recipients of 
23.9 	Supplemental Security Income may have an income up to the Supplemental Security Income 
23.10 	standard in effect on that date.
23.11 	(b) Effective January 1, 2014, to be eligible for medical assistance, under section 
23.12 	256B.055, subdivision 3a, a parent or caretaker relative may have an income up to 133 
23.13 	percent of the federal poverty guidelines for the household size.
23.14 	(c) To be eligible for medical assistance under section 256B.055, subdivision 15, a 
23.15 	person may have an income up to 133 percent of federal poverty guidelines for the household 
23.16 	size.
23.17 	(d) To be eligible for medical assistance under section 256B.055, subdivision 16, a child 
23.18 	age 19 to 20 may have an income up to 133 percent of the federal poverty guidelines for 
23.19 	the household size.
23.20 	(e) To be eligible for medical assistance under section 256B.055, subdivision 3a, a child 
23.21 	under age 19 may have income up to 275 percent of the federal poverty guidelines for the 
23.22 	household size or an equivalent standard when converted using modified adjusted gross 
23.23 	income methodology as required under the Affordable Care Act. Children who are enrolled 
23.24 	in medical assistance as of December 31, 2013, and are determined ineligible for medical 
23.25 	assistance because of the elimination of income disregards under modified adjusted gross 
23.26 	income methodology as defined in subdivision 1a remain eligible for medical assistance 
23.27 	under the Children's Health Insurance Program Reauthorization Act of 2009, Public Law 
23.28 	111-3, until the date of their next regularly scheduled eligibility redetermination as required 
23.29 	in subdivision 7a.
23.30 	(f) In computing income to determine eligibility of persons under paragraphs (a) to (e) 
23.31 	who are not residents of long-term care facilities, the commissioner shall: (1) disregard 
23.32 	increases in income as required by Public Laws 94-566, section 503; 99-272; and 99-509. 
23.33 	For persons eligible under paragraph (a), veteran aid and attendance benefits and Veterans 
24.1 	Administration unusual medical expense payments are considered income to the recipient.; 
24.2 	and (2) include all assets available to the applicant that are considered income according to 
24.3 	the Internal Revenue Service. Income includes all deposits into accounts owned or controlled 
24.4 	by the applicant, including amounts spent on personal expenses, including rent, mortgage, 
24.5 	automobile-related expenses, utilities, and food and amounts received as salary or draws 
24.6 	from business accounts and not otherwise excluded by federal or state laws. Income does 
24.7 	not include a deposit specifically identified by the applicant as a loan or gift, for which the 
24.8 	applicant provides the source, date, amount, and repayment terms.

24.9 	Sec. 25. Minnesota Statutes 2018, section 256B.056, subdivision 7a, is amended to read:
24.10 		Subd. 7a.Periodic renewal of eligibility. (a) The commissioner shall make an annual 
24.11 	redetermination of eligibility based on information contained in the enrollee's case file and 
24.12 	other information available to the agency, including but not limited to information accessed 
24.13 	through an electronic database, without requiring the enrollee to submit any information 
24.14 	when sufficient data is available for the agency to renew eligibility.
24.15 	(b) If the commissioner cannot renew eligibility in accordance with paragraph (a), The 
24.16 	commissioner must provide the enrollee with a prepopulated renewal form containing 
24.17 	eligibility information available to the agency and permit the enrollee to must submit the 
24.18 	form with any corrections or additional information to the agency and sign the renewal form 
24.19 	via any of the modes of submission specified in section 256B.04, subdivision 18.
24.20 	(c) An enrollee who is terminated for failure to complete the renewal process may 
24.21 	subsequently submit the renewal form and required information within four months after 
24.22 	the date of termination and have coverage reinstated without a lapse, if otherwise eligible 
24.23 	under this chapter.
24.24 	(d) Notwithstanding paragraph (a), individuals eligible under subdivision 5 shall be 
24.25 	required to renew eligibility every six months.

24.26 	Sec. 26. Minnesota Statutes 2018, section 256B.0625, subdivision 17, is amended to read:
24.27 		Subd. 17.Transportation costs. (a) "Nonemergency medical transportation service" 
24.28 	means motor vehicle transportation provided by a public or private person that serves 
24.29 	Minnesota health care program beneficiaries who do not require emergency ambulance 
24.30 	service, as defined in section 144E.001, subdivision 3, to obtain covered medical services.
24.31 	(b) Medical assistance covers medical transportation costs incurred solely for obtaining 
24.32 	emergency medical care or transportation costs incurred by eligible persons in obtaining 
25.1 	emergency or nonemergency medical care when paid directly to an ambulance company, 
25.2 	nonemergency medical transportation company, or other recognized providers of 
25.3 	transportation services. Medical transportation must be provided by:
25.4 	(1) nonemergency medical transportation providers who meet the requirements of this 
25.5 	subdivision;
25.6 	(2) ambulances, as defined in section 144E.001, subdivision 2;
25.7 	(3) taxicabs that meet the requirements of this subdivision;
25.8 	(4) public transit, as defined in section 174.22, subdivision 7; or
25.9 	(5) not-for-hire vehicles, including volunteer drivers.
25.10 	(c) Medical assistance covers nonemergency medical transportation provided by 
25.11 	nonemergency medical transportation providers enrolled in the Minnesota health care 
25.12 	programs. All nonemergency medical transportation providers must comply with the 
25.13 	operating standards for special transportation service as defined in sections 174.29 to 174.30 
25.14 	and Minnesota Rules, chapter 8840, and in consultation with the Minnesota Department of 
25.15 	Transportation. All drivers providing nonemergency medical transportation must be 
25.16 	individually enrolled with the commissioner if the driver is a subcontractor for or employed 
25.17 	by a provider that both has a base of operation located within a metropolitan county listed 
25.18 	in section 473.121, subdivision 4, and is listed in paragraph (b), clause (1) or (3). All 
25.19 	nonemergency medical transportation providers shall bill for nonemergency medical 
25.20 	transportation services in accordance with Minnesota health care programs criteria. Publicly 
25.21 	operated transit systems, volunteers, and not-for-hire vehicles are exempt from the 
25.22 	requirements outlined in this paragraph.
25.23 	(d) An organization may be terminated, denied, or suspended from enrollment if:
25.24 	(1) the provider has not initiated background studies on the individuals specified in 
25.25 	section 174.30, subdivision 10, paragraph (a), clauses (1) to (3); or
25.26 	(2) the provider has initiated background studies on the individuals specified in section 
25.27 	174.30, subdivision 10, paragraph (a), clauses (1) to (3), and:
25.28 	(i) the commissioner has sent the provider a notice that the individual has been 
25.29 	disqualified under section 245C.14; and
25.30 	(ii) the individual has not received a disqualification set-aside specific to the special 
25.31 	transportation services provider under sections 245C.22 and 245C.23.
25.32 	(e) The administrative agency of nonemergency medical transportation must:
26.1 	(1) adhere to the policies defined by the commissioner in consultation with the 
26.2 	Nonemergency Medical Transportation Advisory Committee;
26.3 	(2) pay nonemergency medical transportation providers for services provided to 
26.4 	Minnesota health care programs beneficiaries to obtain covered medical services;
26.5 	(3) provide data monthly to the commissioner on appeals, complaints, no-shows, canceled 
26.6 	trips, and number of trips by mode; and
26.7 	(4) by July 1, 2016, in accordance with subdivision 18e, utilize a web-based single 
26.8 	administrative structure assessment tool that meets the technical requirements established 
26.9 	by the commissioner, reconciles trip information with claims being submitted by providers, 
26.10 	and ensures prompt payment for nonemergency medical transportation services.
26.11 	(f) Until the commissioner implements the single administrative structure and delivery 
26.12 	system under subdivision 18e, clients shall obtain their level-of-service certificate from the 
26.13 	commissioner or an entity approved by the commissioner that does not dispatch rides for 
26.14 	clients using modes of transportation under paragraph (i), clauses (4), (5), (6), and (7).
26.15 	(g) The commissioner may use an order by the recipient's attending physician or a medical 
26.16 	or mental health professional to certify that the recipient requires nonemergency medical 
26.17 	transportation services. Nonemergency medical transportation providers shall perform 
26.18 	driver-assisted services for eligible individuals, when appropriate. Driver-assisted service 
26.19 	includes passenger pickup at and return to the individual's residence or place of business, 
26.20 	assistance with admittance of the individual to the medical facility, and assistance in 
26.21 	passenger securement or in securing of wheelchairs, child seats, or stretchers in the vehicle.
26.22 	Nonemergency medical transportation providers must take clients to the health care 
26.23 	provider using the most direct route, and must not exceed 30 miles for a trip to a primary 
26.24 	care provider or 60 miles for a trip to a specialty care provider, unless the client receives 
26.25 	authorization from the local agency.
26.26 	Nonemergency medical transportation providers may not bill for separate base rates for 
26.27 	the continuation of a trip beyond the original destination. Nonemergency medical 
26.28 	transportation providers must maintain trip logs, which include pickup and drop-off times, 
26.29 	signed by the medical provider or client, whichever is deemed most appropriate, attesting 
26.30 	to mileage traveled to obtain covered medical services. Clients requesting client mileage 
26.31 	reimbursement must sign the trip log attesting mileage traveled to obtain covered medical 
26.32 	services.
27.1 	(h) The administrative agency shall use the level of service process established by the 
27.2 	commissioner in consultation with the Nonemergency Medical Transportation Advisory 
27.3 	Committee to determine the client's most appropriate mode of transportation. If public transit 
27.4 	or a certified transportation provider is not available to provide the appropriate service mode 
27.5 	for the client, the client may receive a onetime service upgrade.
27.6 	(i) The covered modes of transportation are:
27.7 	(1) client reimbursement, which includes client mileage reimbursement provided to 
27.8 	clients who have their own transportation, or to family or an acquaintance who provides 
27.9 	transportation to the client;
27.10 	(2) volunteer transport, which includes transportation by volunteers using their own 
27.11 	vehicle;
27.12 	(3) unassisted transport, which includes transportation provided to a client by a taxicab 
27.13 	or public transit. If a taxicab or public transit is not available, the client can receive 
27.14 	transportation from another nonemergency medical transportation provider;
27.15 	(4) assisted transport, which includes transport provided to clients who require assistance 
27.16 	by a nonemergency medical transportation provider;
27.17 	(5) lift-equipped/ramp transport, which includes transport provided to a client who is 
27.18 	dependent on a device and requires a nonemergency medical transportation provider with 
27.19 	a vehicle containing a lift or ramp;
27.20 	(6) protected transport, which includes transport provided to a client who has received 
27.21 	a prescreening that has deemed other forms of transportation inappropriate and who requires 
27.22 	a provider: (i) with a protected vehicle that is not an ambulance or police car and has safety 
27.23 	locks, a video recorder, and a transparent thermoplastic partition between the passenger and 
27.24 	the vehicle driver; and (ii) who is certified as a protected transport provider; and
27.25 	(7) stretcher transport, which includes transport for a client in a prone or supine position 
27.26 	and requires a nonemergency medical transportation provider with a vehicle that can transport 
27.27 	a client in a prone or supine position.
27.28 	(j) The local agency shall be the single administrative agency and shall administer and 
27.29 	reimburse for modes defined in paragraph (i) according to paragraphs (m) and (n) when the 
27.30 	commissioner has developed, made available, and funded the web-based single administrative 
27.31 	structure, assessment tool, and level of need assessment under subdivision 18e. The local 
27.32 	agency's financial obligation is limited to funds provided by the state or federal government.
27.33 	(k) The commissioner shall:
28.1 	(1) in consultation with the Nonemergency Medical Transportation Advisory Committee, 
28.2 	verify that the mode and use of nonemergency medical transportation is appropriate;
28.3 	(2) verify that the client is going to an approved medical appointment; and
28.4 	(3) investigate all complaints and appeals.
28.5 	(l) The administrative agency shall pay for the services provided in this subdivision and 
28.6 	seek reimbursement from the commissioner, if appropriate. As vendors of medical care, 
28.7 	local agencies are subject to the provisions in section 256B.041, the sanctions and monetary 
28.8 	recovery actions in section 256B.064, and Minnesota Rules, parts 9505.2160 to 9505.2245.
28.9 	(m) Payments for nonemergency medical transportation must be paid based on the client's 
28.10 	assessed mode under paragraph (h), not the type of vehicle used to provide the service. The 
28.11 	medical assistance reimbursement rates for nonemergency medical transportation services 
28.12 	that are payable by or on behalf of the commissioner for nonemergency medical 
28.13 	transportation services are:
28.14 	(1) $0.22 per mile for client reimbursement;
28.15 	(2) up to 100 percent of the Internal Revenue Service business deduction rate for volunteer 
28.16 	transport;
28.17 	(3) equivalent to the standard fare for unassisted transport when provided by public 
28.18 	transit, and $11 for the base rate and $1.30 per mile when provided by a nonemergency 
28.19 	medical transportation provider;
28.20 	(4) $13 for the base rate and $1.30 per mile for assisted transport;
28.21 	(5) $18 for the base rate and $1.55 per mile for lift-equipped/ramp transport;
28.22 	(6) $75 for the base rate and $2.40 per mile for protected transport; and
28.23 	(7) $60 for the base rate and $2.40 per mile for stretcher transport, and $9 per trip for 
28.24 	an additional attendant if deemed medically necessary.
28.25 	(n) The base rate for nonemergency medical transportation services in areas defined 
28.26 	under RUCA to be super rural is equal to 111.3 percent of the respective base rate in 
28.27 	paragraph (m), clauses (1) to (7). The mileage rate for nonemergency medical transportation 
28.28 	services in areas defined under RUCA to be rural or super rural areas is:
28.29 	(1) for a trip equal to 17 miles or less, equal to 125 percent of the respective mileage 
28.30 	rate in paragraph (m), clauses (1) to (7); and
29.1 	(2) for a trip between 18 and 50 miles, equal to 112.5 percent of the respective mileage 
29.2 	rate in paragraph (m), clauses (1) to (7).
29.3 	(o) For purposes of reimbursement rates for nonemergency medical transportation 
29.4 	services under paragraphs (m) and (n), the zip code of the recipient's place of residence 
29.5 	shall determine whether the urban, rural, or super rural reimbursement rate applies.
29.6 	(p) For purposes of this subdivision, "rural urban commuting area" or "RUCA" means 
29.7 	a census-tract based classification system under which a geographical area is determined 
29.8 	to be urban, rural, or super rural.
29.9 	(q) The commissioner, when determining reimbursement rates for nonemergency medical 
29.10 	transportation under paragraphs (m) and (n), shall exempt all modes of transportation listed 
29.11 	under paragraph (i) from Minnesota Rules, part 9505.0445, item R, subitem (2).

29.12 	EFFECTIVE DATE. This section is effective January 1, 2020.

29.13 	Sec. 27. Minnesota Statutes 2018, section 256B.0625, is amended by adding a subdivision 
29.14 	to read:
29.15 		Subd. 17d.Transportation services oversight. The commissioner shall contract with 
29.16 	a vendor or dedicate staff for oversight of providers of nonemergency medical transportation 
29.17 	services pursuant to the commissioner's authority in section 256B.04 and Minnesota Rules, 
29.18 	parts 9505.2160 to 9505.2245.

29.19 	EFFECTIVE DATE. This section is effective January 1, 2020.

29.20 	Sec. 28. Minnesota Statutes 2018, section 256B.0625, is amended by adding a subdivision 
29.21 	to read:
29.22 		Subd. 17e.Transportation provider termination. (a) A terminated nonemergency 
29.23 	medical transportation provider, including all named individuals on the current enrollment 
29.24 	disclosure form and known or discovered affiliates of the nonemergency medical 
29.25 	transportation provider, is not eligible to enroll as a nonemergency medical transportation 
29.26 	provider for five years following the termination.
29.27 	(b) After the five-year period in paragraph (a), if a provider seeks to reenroll as a 
29.28 	nonemergency medical transportation provider, the nonemergency medical transportation 
29.29 	provider must be placed on a one-year probation period. During a provider's probation 
29.30 	period, the commissioner shall complete unannounced site visits and request documentation 
29.31 	to review compliance with program requirements.

30.1 	Sec. 29. Minnesota Statutes 2018, section 256B.0625, is amended by adding a subdivision 
30.2 	to read:
30.3 		Subd. 17f.Transportation provider training. The commissioner shall make available 
30.4 	to providers of nonemergency medical transportation and all drivers training materials and 
30.5 	online training opportunities regarding documentation requirements, documentation 
30.6 	procedures, and penalties for failing to meet documentation requirements.

30.7 	Sec. 30. Minnesota Statutes 2018, section 256B.0625, subdivision 18h, is amended to 
30.8 	read:
30.9 		Subd. 18h.Managed care. (a) The following subdivisions apply to managed care plans 
30.10 	and county-based purchasing plans:
30.11 	(1) subdivision 17, paragraphs (a), (b), (c), (i), and (n);
30.12 	(2) subdivision 18; and
30.13 	(3) subdivision 18a.
30.14 	(b) A nonemergency medical transportation provider must comply with the operating 
30.15 	standards for special transportation service specified in sections 174.29 to 174.30 and 
30.16 	Minnesota Rules, chapter 8840. Publicly operated transit systems, volunteers, and not-for-hire 
30.17 	vehicles are exempt from the requirements in this paragraph.

30.18 	Sec. 31. Minnesota Statutes 2018, section 256B.0625, subdivision 43, is amended to read:
30.19 		Subd. 43.Mental health provider travel time. (a) Medical assistance covers provider 
30.20 	travel time if a recipient's individual treatment plan recipient requires the provision of mental 
30.21 	health services outside of the provider's normalusual place of business. This does not include 
30.22 	any travel time which is included in other billable services, and is only covered when the 
30.23 	mental health service being provided to a recipient is covered under medical assistance.
30.24 	(b) Medical assistance covers under this subdivision the time a provider is in transit to 
30.25 	provide a covered mental health service to a recipient at a location that is not the provider's 
30.26 	usual place of business. A provider must travel the most direct route available. Mental health 
30.27 	provider travel time does not include time for scheduled or unscheduled stops, meal breaks, 
30.28 	or vehicle maintenance or repair, including refueling or vehicle emergencies. Recipient 
30.29 	transportation is not covered under this subdivision.
30.30 	(c) Mental health provider travel time under this subdivision is only covered when the 
30.31 	mental health service being provided is covered under medical assistance and only when 
31.1 	the covered mental health service is delivered and billed. Mental health provider travel time 
31.2 	is not covered when the mental health service being provided otherwise includes provider 
31.3 	travel time or when the service is site based.
31.4 	(d) A provider must document each trip for which the provider seeks reimbursement 
31.5 	under this subdivision in a compiled travel record. Required documentation may be collected 
31.6 	and maintained electronically or in paper form but must be made available and produced 
31.7 	upon request by the commissioner. The travel record must be written in English and must 
31.8 	be legible according to the standard of a reasonable person. The recipient's individual 
31.9 	identification number must be on each page of the record. The reason the provider must 
31.10 	travel to provide services must be included in the record, if not otherwise documented in 
31.11 	the recipient's individual treatment plan. Each entry in the record must document:
31.12 	(1) start and stop time (with a.m. and p.m. notations);
31.13 	(2) printed name of the recipient;
31.14 	(3) date the entry is made;
31.15 	(4) date the service is provided;
31.16 	(5) origination site and destination site;
31.17 	(6) who provided the service;
31.18 	(7) the electronic source used to calculate driving directions and distance between 
31.19 	locations; and
31.20 	(8) the medically necessary mental health service delivered.
31.21 	(e) Mental health providers identified by the commissioner to have submitted a fraudulent 
31.22 	report may be excluded from participation in Minnesota health care programs.

31.23 	Sec. 32. Minnesota Statutes 2018, section 256B.064, subdivision 1b, is amended to read:
31.24 		Subd. 1b.Sanctions available. The commissioner may impose the following sanctions 
31.25 	for the conduct described in subdivision 1a: suspension or withholding of payments to a 
31.26 	vendor and suspending or terminating participation in the program, or imposition of a fine 
31.27 	under subdivision 2, paragraph (f). When imposing sanctions under this section, the 
31.28 	commissioner shall consider the nature, chronicity, or severity of the conduct and the effect 
31.29 	of the conduct on the health and safety of persons served by the vendor. The commissioner 
31.30 	shall suspend a vendor's participation in the program for a minimum of five years if the 
31.31 	vendor is convicted of a crime, received a stay of adjudication, or entered a court-ordered 
31.32 	diversion program for an offense related to a provision of a health service under medical 
32.1 	assistance or health care fraud. Regardless of imposition of sanctions, the commissioner 
32.2 	may make a referral to the appropriate state licensing board.

32.3 	Sec. 33. Minnesota Statutes 2018, section 256B.064, subdivision 2, is amended to read:
32.4 		Subd. 2.Imposition of monetary recovery and sanctions. (a) The commissioner shall 
32.5 	determine any monetary amounts to be recovered and sanctions to be imposed upon a vendor 
32.6 	of medical care under this section. Except as provided in paragraphs (b) and (d), neither a 
32.7 	monetary recovery nor a sanction will be imposed by the commissioner without prior notice 
32.8 	and an opportunity for a hearing, according to chapter 14, on the commissioner's proposed 
32.9 	action, provided that the commissioner may suspend or reduce payment to a vendor of 
32.10 	medical care, except a nursing home or convalescent care facility, after notice and prior to 
32.11 	the hearing if in the commissioner's opinion that action is necessary to protect the public 
32.12 	welfare and the interests of the program.
32.13 	(b) Except when the commissioner finds good cause not to suspend payments under 
32.14 	Code of Federal Regulations, title 42, section 455.23 (e) or (f), the commissioner shall 
32.15 	withhold or reduce payments to a vendor of medical care without providing advance notice 
32.16 	of such withholding or reduction if either of the following occurs:
32.17 	(1) the vendor is convicted of a crime involving the conduct described in subdivision 
32.18 	1a; or
32.19 	(2) the commissioner determines there is a credible allegation of fraud for which an 
32.20 	investigation is pending under the program. A credible allegation of fraud is an allegation 
32.21 	which has been verified by the state, from any source, including but not limited to:
32.22 	(i) fraud hotline complaints;
32.23 	(ii) claims data mining; and
32.24 	(iii) patterns identified through provider audits, civil false claims cases, and law 
32.25 	enforcement investigations.
32.26 	Allegations are considered to be credible when they have an indicia of reliability and 
32.27 	the state agency has reviewed all allegations, facts, and evidence carefully and acts 
32.28 	judiciously on a case-by-case basis.
32.29 	(c) The commissioner must send notice of the withholding or reduction of payments 
32.30 	under paragraph (b) within five days of taking such action unless requested in writing by a 
32.31 	law enforcement agency to temporarily withhold the notice. The notice must:
32.32 	(1) state that payments are being withheld according to paragraph (b);
33.1 	(2) set forth the general allegations as to the nature of the withholding action, but need 
33.2 	not disclose any specific information concerning an ongoing investigation;
33.3 	(3) except in the case of a conviction for conduct described in subdivision 1a, state that 
33.4 	the withholding is for a temporary period and cite the circumstances under which withholding 
33.5 	will be terminated;
33.6 	(4) identify the types of claims to which the withholding applies; and
33.7 	(5) inform the vendor of the right to submit written evidence for consideration by the 
33.8 	commissioner.
33.9 	The withholding or reduction of payments will not continue after the commissioner 
33.10 	determines there is insufficient evidence of fraud by the vendor, or after legal proceedings 
33.11 	relating to the alleged fraud are completed, unless the commissioner has sent notice of 
33.12 	intention to impose monetary recovery or sanctions under paragraph (a). Upon conviction 
33.13 	for a crime related to the provision, management, or administration of a health service under 
33.14 	medical assistance, a payment held pursuant to this section by the commissioner or a managed 
33.15 	care organization that contracts with the commissioner under section 256B.035 is forfeited 
33.16 	to the commissioner or managed care organization, regardless of the amount charged in the 
33.17 	criminal complaint or the amount of criminal restitution ordered.
33.18 	(d) The commissioner shall suspend or terminate a vendor's participation in the program 
33.19 	without providing advance notice and an opportunity for a hearing when the suspension or 
33.20 	termination is required because of the vendor's exclusion from participation in Medicare. 
33.21 	Within five days of taking such action, the commissioner must send notice of the suspension 
33.22 	or termination. The notice must:
33.23 	(1) state that suspension or termination is the result of the vendor's exclusion from 
33.24 	Medicare;
33.25 	(2) identify the effective date of the suspension or termination; and
33.26 	(3) inform the vendor of the need to be reinstated to Medicare before reapplying for 
33.27 	participation in the program.
33.28 	(e) Upon receipt of a notice under paragraph (a) that a monetary recovery or sanction is 
33.29 	to be imposed, a vendor may request a contested case, as defined in section 14.02, subdivision 
33.30 	3, by filing with the commissioner a written request of appeal. The appeal request must be 
33.31 	received by the commissioner no later than 30 days after the date the notification of monetary 
33.32 	recovery or sanction was mailed to the vendor. The appeal request must specify:
34.1 	(1) each disputed item, the reason for the dispute, and an estimate of the dollar amount 
34.2 	involved for each disputed item;
34.3 	(2) the computation that the vendor believes is correct;
34.4 	(3) the authority in statute or rule upon which the vendor relies for each disputed item;
34.5 	(4) the name and address of the person or entity with whom contacts may be made 
34.6 	regarding the appeal; and
34.7 	(5) other information required by the commissioner.
34.8 	(f) The commissioner may order a vendor to forfeit a fine for failure to fully document 
34.9 	services according to standards in this chapter and Minnesota Rules, chapter 9505. The 
34.10 	commissioner may assess fines if specific required components of documentation are 
34.11 	missing. The fine for incomplete documentation shall equal 20 percent of the amount paid 
34.12 	on the claims for reimbursement submitted by the vendor, or up to $5,000, whichever is 
34.13 	less. If the commissioner determines that a vendor repeatedly violated this chapter or 
34.14 	Minnesota Rules, chapter 9505, related to the provision of services to program recipients 
34.15 	and the submission of claims for payment, the commissioner may order a vendor to forfeit 
34.16 	a fine based on the nature, severity, and chronicity of the violations, in an amount of up to 
34.17 	$5,000 or 20 percent of the value of the claims, whichever is greater.
34.18 	(g) The vendor shall pay the fine assessed on or before the payment date specified. If 
34.19 	the vendor fails to pay the fine, the commissioner may withhold or reduce payments and 
34.20 	recover the amount of the fine. A timely appeal shall stay payment of the fine until the 
34.21 	commissioner issues a final order.

34.22 	Sec. 34. Minnesota Statutes 2018, section 256B.064, is amended by adding a subdivision 
34.23 	to read:
34.24 		Subd. 3.Vendor mandates on prohibited hiring. (a) The commissioner shall maintain 
34.25 	and publish a list of each excluded individual and entity that was convicted of a crime related 
34.26 	to the provision, management, or administration of a medical assistance health service, or 
34.27 	where participation in the program was suspended or terminated under subdivision 2. A 
34.28 	vendor that receives funding from medical assistance shall not: (1) employ an individual 
34.29 	or entity who is on the exclusion list; or (2) enter into or maintain a business relationship 
34.30 	with an individual or entity that is on the exclusion list.
34.31 	(b) Before hiring or entering into a business transaction, a vendor shall check the 
34.32 	exclusion list. The vendor shall check the exclusion list on a monthly basis and document 
34.33 	the date and time with a.m. and p.m. designations that the exclusion list was checked and 
35.1 	the name and title of the person who checked the exclusion list. The vendor shall: (1) 
35.2 	immediately terminate a current employee on the exclusion list; and (2) immediately 
35.3 	terminate a business relationship with an individual or entity on the exclusion list.
35.4 	(c) A vendor's requirement to check the exclusion list and to terminate an employee on 
35.5 	the exclusion list applies to each employee, even if the named employee is not responsible 
35.6 	for direct patient care or direct submission of a claim to medical assistance. A vendor's 
35.7 	requirement to check the exclusion list and terminate a business relationship with an 
35.8 	individual or entity on the exclusion list applies to each business relationship, even if the 
35.9 	named individual or entity is not responsible for direct patient care or direct submission of 
35.10 	a claim to medical assistance.
35.11 	(d) A vendor that employs or enters into or maintains a business relationship with an 
35.12 	individual or entity on the exclusion list shall refund any payment related to a service 
35.13 	rendered by an individual or entity on the exclusion list from the date the individual is 
35.14 	employed or the date the individual is placed on the exclusion list, whichever is later, and 
35.15 	a vendor may be subject to:
35.16 	(1) sanctions under subdivision 2;
35.17 	(2) a civil monetary penalty of up to $25,000 for each determination by the department 
35.18 	that the vendor employed or contracted with an individual or entity on the exclusion list; 
35.19 	and
35.20 	(3) other fines or penalties allowed by law.

35.21 	Sec. 35. [256B.0646] CORRECTIVE ACTIONS FOR PEOPLE USING PERSONAL 
35.22 	CARE ASSISTANCE SERVICES; MINNESOTA RESTRICTED RECIPIENT 
35.23 	PROGRAM.
35.24 	(a) When there is abusive or fraudulent billing of personal care assistance services or 
35.25 	community first services and supports under section 256B.85, the commissioner may place 
35.26 	a recipient in the Minnesota restricted recipient program as defined in Minnesota Rules, 
35.27 	part 9505.2165. A recipient placed in the Minnesota restricted recipient program under this 
35.28 	section must:
35.29 	(1) use a designated traditional personal care assistance provider agency;
35.30 	(2) obtain a new assessment as described in section 256B.0911, including consultation 
35.31 	with a registered or public health nurse on the long-term care consultation team under section 
35.32 	256B.0911, subdivision 3, paragraph (b), clause (2); and
36.1 	(3) comply with additional conditions for the use of personal care assistance services or 
36.2 	community first services and supports if the commissioner determines it is necessary to 
36.3 	prevent future misuse of personal care assistance services or abusive or fraudulent billing 
36.4 	related to personal care assistance services. These additional conditions may include, but 
36.5 	are not limited to:
36.6 	(i) the restriction of service authorizations to a duration of no more than one month; and
36.7 	(ii) requiring a qualified professional to monitor and report services on a monthly basis.
36.8 	(b) Placement in the Minnesota restricted recipient program under this section is subject 
36.9 	to appeal according to section 256B.045.

36.10 	Sec. 36. Minnesota Statutes 2018, section 256B.0651, subdivision 17, is amended to read:
36.11 		Subd. 17.Recipient protection. (a) Providers of home care services must provide each 
36.12 	recipient with a copy of the home care bill of rights under section 144A.44 at least 30 days 
36.13 	prior to terminating services to a recipient, if the termination results from provider sanctions 
36.14 	under section 256B.064, such as a payment withhold, a suspension of participation, or a 
36.15 	termination of participation. If a home care provider determines it is unable to continue 
36.16 	providing services to a recipient, the provider must notify the recipient, the recipient's 
36.17 	responsible party, and the commissioner 30 days prior to terminating services to the recipient 
36.18 	because of an action under section 256B.064, and must assist the commissioner and lead 
36.19 	agency in supporting the recipient in transitioning to another home care provider of the 
36.20 	recipient's choice.
36.21 	(b) In the event of a payment withhold from a home care provider, a suspension of 
36.22 	participation, or a termination of participation of a home care provider under section 
36.23 	256B.064, the commissioner may inform the Office of Ombudsman for Long-Term Care 
36.24 	and the lead agencies for all recipients with active service agreements with the provider. At 
36.25 	the commissioner's request, the lead agencies must contact recipients to ensure that the 
36.26 	recipients are continuing to receive needed care, and that the recipients have been given 
36.27 	free choice of provider if they transfer to another home care provider. In addition, the 
36.28 	commissioner or the commissioner's delegate may directly notify recipients who receive 
36.29 	care from the provider that payments have been or will be withheld or that the provider's 
36.30 	participation in medical assistance has been or will be suspended or terminated, if the 
36.31 	commissioner determines that notification is necessary to protect the welfare of the recipients. 
36.32 	For purposes of this subdivision, "lead agencies" means counties, tribes, and managed care 
36.33 	organizations.

37.1 	Sec. 37. Minnesota Statutes 2018, section 256B.0659, subdivision 3, is amended to read:
37.2 		Subd. 3.Noncovered Personal care assistance services not covered. (a) Personal care 
37.3 	assistance services are not eligible for medical assistance payment under this section when 
37.4 	provided:
37.5 	(1) by the recipient's spouse, parent of a recipient under the age of 18, paid legal guardian, 
37.6 	licensed foster provider, except as allowed under section 256B.0652, subdivision 10, or 
37.7 	responsible party;
37.8 	(2) in order to meet staffing or license requirements in a residential or child care setting;
37.9 	(3) solely as a child care or babysitting service; or
37.10 	(4) without authorization by the commissioner or the commissioner's designee.; or
37.11 	(5) on dates not within the frequency requirements of subdivision 14, paragraph (c), and 
37.12 	subdivision 19, paragraph (a).
37.13 	(b) The following personal care services are not eligible for medical assistance payment 
37.14 	under this section when provided in residential settings:
37.15 	(1) when the provider of home care services who is not related by blood, marriage, or 
37.16 	adoption owns or otherwise controls the living arrangement, including licensed or unlicensed 
37.17 	services; or
37.18 	(2) when personal care assistance services are the responsibility of a residential or 
37.19 	program license holder under the terms of a service agreement and administrative rules.
37.20 	(c) Other specific tasks not covered under paragraph (a) or (b) that are not eligible for 
37.21 	medical assistance reimbursement for personal care assistance services under this section 
37.22 	include:
37.23 	(1) sterile procedures;
37.24 	(2) injections of fluids and medications into veins, muscles, or skin;
37.25 	(3) home maintenance or chore services;
37.26 	(4) homemaker services not an integral part of assessed personal care assistance services 
37.27 	needed by a recipient;
37.28 	(5) application of restraints or implementation of procedures under section 245.825;
37.29 	(6) instrumental activities of daily living for children under the age of 18, except when 
37.30 	immediate attention is needed for health or hygiene reasons integral to the personal care 
37.31 	services and the need is listed in the service plan by the assessor; and
38.1 	(7) assessments for personal care assistance services by personal care assistance provider 
38.2 	agencies or by independently enrolled registered nurses.

38.3 	Sec. 38. Minnesota Statutes 2018, section 256B.0659, subdivision 12, is amended to read:
38.4 		Subd. 12.Documentation of personal care assistance services provided. (a) Personal 
38.5 	care assistance services for a recipient must be documented daily by each personal care 
38.6 	assistant, on a time sheet form approved by the commissioner. All documentation may be 
38.7 	web-based, electronic, or paper documentation. The completed form must be submitted on 
38.8 	a monthly basis to the provider and kept in the recipient's health record.
38.9 	(b) The activity documentation must correspond to the personal care assistance care plan 
38.10 	and be reviewed by the qualified professional.
38.11 	(c) The personal care assistant time sheet must be on a form approved by the 
38.12 	commissioner documenting time the personal care assistant provides services in the home. 
38.13 	The following criteria must be included in the time sheet:
38.14 	(1) full name of personal care assistant and individual provider number;
38.15 	(2) provider name and telephone numbers;
38.16 	(3) full name of recipient and either the recipient's medical assistance identification 
38.17 	number or date of birth;
38.18 	(4) consecutive dates, including month, day, and year, and arrival and departure times 
38.19 	with a.m. or p.m. notations;
38.20 	(5) signatures of recipient or the responsible party;
38.21 	(6) personal signature of the personal care assistant;
38.22 	(7) any shared care provided, if applicable;
38.23 	(8) a statement that it is a federal crime to provide false information on personal care 
38.24 	service billings for medical assistance payments; and
38.25 	(9) dates and location of recipient stays in a hospital, care facility, or incarceration.

38.26 	Sec. 39. Minnesota Statutes 2018, section 256B.0659, subdivision 13, is amended to read:
38.27 		Subd. 13.Qualified professional; qualifications. (a) The qualified professional must 
38.28 	work for a personal care assistance provider agency and, meet the definition of qualified 
38.29 	professional under section 256B.0625, subdivision 19c, and enroll with the department as 
38.30 	a qualified professional after clearing a background study. Before a qualified professional 
39.1 	provides services, the personal care assistance provider agency must initiate a background 
39.2 	study on the qualified professional under chapter 245C, and the personal care assistance 
39.3 	provider agency must have received a notice from the commissioner that the qualified 
39.4 	professional:
39.5 	(1) is not disqualified under section 245C.14; or
39.6 	(2) is disqualified, but the qualified professional has received a set aside of the 
39.7 	disqualification under section 245C.22.
39.8 	(b) The qualified professional shall perform the duties of training, supervision, and 
39.9 	evaluation of the personal care assistance staff and evaluation of the effectiveness of personal 
39.10 	care assistance services. The qualified professional shall:
39.11 	(1) develop and monitor with the recipient a personal care assistance care plan based on 
39.12 	the service plan and individualized needs of the recipient;
39.13 	(2) develop and monitor with the recipient a monthly plan for the use of personal care 
39.14 	assistance services;
39.15 	(3) review documentation of personal care assistance services provided;
39.16 	(4) provide training and ensure competency for the personal care assistant in the individual 
39.17 	needs of the recipient; and
39.18 	(5) document all training, communication, evaluations, and needed actions to improve 
39.19 	performance of the personal care assistants.
39.20 	(c) Effective July 1, 2011, the qualified professional shall complete the provider training 
39.21 	with basic information about the personal care assistance program approved by the 
39.22 	commissioner. Newly hired qualified professionals must complete the training within six 
39.23 	months of the date hired by a personal care assistance provider agency. Qualified 
39.24 	professionals who have completed the required training as a worker from a personal care 
39.25 	assistance provider agency do not need to repeat the required training if they are hired by 
39.26 	another agency, if they have completed the training within the last three years. The required 
39.27 	training must be available with meaningful access according to title VI of the Civil Rights 
39.28 	Act and federal regulations adopted under that law or any guidance from the United States 
39.29 	Health and Human Services Department. The required training must be available online or 
39.30 	by electronic remote connection. The required training must provide for competency testing 
39.31 	to demonstrate an understanding of the content without attending in-person training. A 
39.32 	qualified professional is allowed to be employed and is not subject to the training requirement 
39.33 	until the training is offered online or through remote electronic connection. A qualified 
40.1 	professional employed by a personal care assistance provider agency certified for 
40.2 	participation in Medicare as a home health agency is exempt from the training required in 
40.3 	this subdivision. When available, the qualified professional working for a Medicare-certified 
40.4 	home health agency must successfully complete the competency test. The commissioner 
40.5 	shall ensure there is a mechanism in place to verify the identity of persons completing the 
40.6 	competency testing electronically.

40.7 	Sec. 40. Minnesota Statutes 2018, section 256B.0659, subdivision 14, is amended to read:
40.8 		Subd. 14.Qualified professional; duties. (a) Effective January 1, 2010 2020, all personal 
40.9 	care assistants must be supervised by a qualified professional who is enrolled as an individual 
40.10 	provider with the commissioner under section 256B.04, subdivision 21, paragraph (c).
40.11 	(b) Through direct training, observation, return demonstrations, and consultation with 
40.12 	the staff and the recipient, the qualified professional must ensure and document that the 
40.13 	personal care assistant is:
40.14 	(1) capable of providing the required personal care assistance services;
40.15 	(2) knowledgeable about the plan of personal care assistance services before services 
40.16 	are performed; and
40.17 	(3) able to identify conditions that should be immediately brought to the attention of the 
40.18 	qualified professional.
40.19 	(c) The qualified professional shall evaluate the personal care assistant within the first 
40.20 	14 days of starting to provide regularly scheduled services for a recipient, or sooner as 
40.21 	determined by the qualified professional, except for the personal care assistance choice 
40.22 	option under subdivision 19, paragraph (a), clause (4). For the initial evaluation, the qualified 
40.23 	professional shall evaluate the personal care assistance services for a recipient through direct 
40.24 	observation of a personal care assistant's work. The qualified professional may conduct 
40.25 	additional training and evaluation visits, based upon the needs of the recipient and the 
40.26 	personal care assistant's ability to meet those needs. Subsequent visits to evaluate the personal 
40.27 	care assistance services provided to a recipient do not require direct observation of each 
40.28 	personal care assistant's work and shall occur:
40.29 	(1) at least every 90 days thereafter for the first year of a recipient's services;
40.30 	(2) every 120 days after the first year of a recipient's service or whenever needed for 
40.31 	response to a recipient's request for increased supervision of the personal care assistance 
40.32 	staff; and
41.1 	(3) after the first 180 days of a recipient's service, supervisory visits may alternate 
41.2 	between unscheduled phone or Internet technology and in-person visits, unless the in-person 
41.3 	visits are needed according to the care plan.
41.4 	(d) Communication with the recipient is a part of the evaluation process of the personal 
41.5 	care assistance staff.
41.6 	(e) At each supervisory visit, the qualified professional shall evaluate personal care 
41.7 	assistance services including the following information:
41.8 	(1) satisfaction level of the recipient with personal care assistance services;
41.9 	(2) review of the month-to-month plan for use of personal care assistance services;
41.10 	(3) review of documentation of personal care assistance services provided;
41.11 	(4) whether the personal care assistance services are meeting the goals of the service as 
41.12 	stated in the personal care assistance care plan and service plan;
41.13 	(5) a written record of the results of the evaluation and actions taken to correct any 
41.14 	deficiencies in the work of a personal care assistant; and
41.15 	(6) revision of the personal care assistance care plan as necessary in consultation with 
41.16 	the recipient or responsible party, to meet the needs of the recipient.
41.17 	(f) The qualified professional shall complete the required documentation in the agency 
41.18 	recipient and employee files and the recipient's home, including the following documentation:
41.19 	(1) the personal care assistance care plan based on the service plan and individualized 
41.20 	needs of the recipient;
41.21 	(2) a month-to-month plan for use of personal care assistance services;
41.22 	(3) changes in need of the recipient requiring a change to the level of service and the 
41.23 	personal care assistance care plan;
41.24 	(4) evaluation results of supervision visits and identified issues with personal care 
41.25 	assistance staff with actions taken;
41.26 	(5) all communication with the recipient and personal care assistance staff; and
41.27 	(6) hands-on training or individualized training for the care of the recipient.
41.28 	(g) The documentation in paragraph (f) must be done on agency templates.
41.29 	(h) The services that are not eligible for payment as qualified professional services 
41.30 	include:
42.1 	(1) direct professional nursing tasks that could be assessed and authorized as skilled 
42.2 	nursing tasks;
42.3 	(2) agency administrative activities;
42.4 	(3) training other than the individualized training required to provide care for a recipient; 
42.5 	and
42.6 	(4) any other activity that is not described in this section.
42.7 	(i) The qualified professional shall notify the commissioner on a form prescribed by the 
42.8 	commissioner, within 30 days of when a qualified professional is no longer employed by 
42.9 	or otherwise affiliated with the personal care assistance agency for whom the qualified 
42.10 	professional previously provided qualified professional services.

42.11 	Sec. 41. Minnesota Statutes 2018, section 256B.0659, subdivision 19, is amended to read:
42.12 		Subd. 19.Personal care assistance choice option; qualifications; duties. (a) Under 
42.13 	personal care assistance choice, the recipient or responsible party shall:
42.14 	(1) recruit, hire, schedule, and terminate personal care assistants according to the terms 
42.15 	of the written agreement required under subdivision 20, paragraph (a);
42.16 	(2) develop a personal care assistance care plan based on the assessed needs and 
42.17 	addressing the health and safety of the recipient with the assistance of a qualified professional 
42.18 	as needed;
42.19 	(3) orient and train the personal care assistant with assistance as needed from the qualified 
42.20 	professional;
42.21 	(4) effective January 1, 2010, supervise and evaluate the personal care assistant with the 
42.22 	qualified professional, who is required to visit the recipient at least every 180 days;
42.23 	(5) monitor and verify in writing and report to the personal care assistance choice agency 
42.24 	the number of hours worked by the personal care assistant and the qualified professional;
42.25 	(6) engage in an annual face-to-face reassessment to determine continuing eligibility 
42.26 	and service authorization; and
42.27 	(7) use the same personal care assistance choice provider agency if shared personal 
42.28 	assistance care is being used.
42.29 	(b) The personal care assistance choice provider agency shall:
42.30 	(1) meet all personal care assistance provider agency standards;
43.1 	(2) enter into a written agreement with the recipient, responsible party, and personal 
43.2 	care assistants;
43.3 	(3) not be related as a parent, child, sibling, or spouse to the recipient or the personal 
43.4 	care assistant; and
43.5 	(4) ensure arm's-length transactions without undue influence or coercion with the recipient 
43.6 	and personal care assistant.
43.7 	(c) The duties of the personal care assistance choice provider agency are to:
43.8 	(1) be the employer of the personal care assistant and the qualified professional for 
43.9 	employment law and related regulations including, but not limited to, purchasing and 
43.10 	maintaining workers' compensation, unemployment insurance, surety and fidelity bonds, 
43.11 	and liability insurance, and submit any or all necessary documentation including, but not 
43.12 	limited to, workers' compensation and, unemployment insurance, and labor market data 
43.13 	required under section 256B.4912, subdivision 1a;
43.14 	(2) bill the medical assistance program for personal care assistance services and qualified 
43.15 	professional services;
43.16 	(3) request and complete background studies that comply with the requirements for 
43.17 	personal care assistants and qualified professionals;
43.18 	(4) pay the personal care assistant and qualified professional based on actual hours of 
43.19 	services provided;
43.20 	(5) withhold and pay all applicable federal and state taxes;
43.21 	(6) verify and keep records of hours worked by the personal care assistant and qualified 
43.22 	professional;
43.23 	(7) make the arrangements and pay taxes and other benefits, if any, and comply with 
43.24 	any legal requirements for a Minnesota employer;
43.25 	(8) enroll in the medical assistance program as a personal care assistance choice agency; 
43.26 	and
43.27 	(9) enter into a written agreement as specified in subdivision 20 before services are 
43.28 	provided.

43.29 	Sec. 42. Minnesota Statutes 2018, section 256B.0659, subdivision 21, is amended to read:
43.30 		Subd. 21.Requirements for provider enrollment of personal care assistance provider 
43.31 	agencies. (a) All personal care assistance provider agencies must provide, at the time of 
44.1 	enrollment, reenrollment, and revalidation as a personal care assistance provider agency in 
44.2 	a format determined by the commissioner, information and documentation that includes, 
44.3 	but is not limited to, the following:
44.4 	(1) the personal care assistance provider agency's current contact information including 
44.5 	address, telephone number, and e-mail address;
44.6 	(2) proof of surety bond coverage. Upon new enrollment, or if the provider's Medicaid 
44.7 	revenue in the previous calendar year is up to and including $300,000, the provider agency 
44.8 	must purchase a surety bond of $50,000. If the Medicaid revenue in the previous year is 
44.9 	over $300,000, the provider agency must purchase a surety bond of $100,000. The surety 
44.10 	bond must be in a form approved by the commissioner, must be renewed annually, and must 
44.11 	allow for recovery of costs and fees in pursuing a claim on the bond;
44.12 	(3) proof of fidelity bond coverage in the amount of $20,000;
44.13 	(4) proof of workers' compensation insurance coverage;
44.14 	(5) proof of liability insurance;
44.15 	(6) a description of the personal care assistance provider agency's organization identifying 
44.16 	the names of all owners, managing employees, staff, board of directors, and the affiliations 
44.17 	of the directors, owners, or staff to other service providers;
44.18 	(7) a copy of the personal care assistance provider agency's written policies and 
44.19 	procedures including: hiring of employees; training requirements; service delivery; 
44.20 	identification, prevention, detection, and reporting of fraud or any billing, record-keeping, 
44.21 	or other administrative noncompliance; and employee and consumer safety including process 
44.22 	for notification and resolution of consumer grievances, identification and prevention of 
44.23 	communicable diseases, and employee misconduct;
44.24 	(8) copies of all other forms the personal care assistance provider agency uses in the 
44.25 	course of daily business including, but not limited to:
44.26 	(i) a copy of the personal care assistance provider agency's time sheet if the time sheet 
44.27 	varies from the standard time sheet for personal care assistance services approved by the 
44.28 	commissioner, and a letter requesting approval of the personal care assistance provider 
44.29 	agency's nonstandard time sheet;
44.30 	(ii) the personal care assistance provider agency's template for the personal care assistance 
44.31 	care plan; and
45.1 	(iii) the personal care assistance provider agency's template for the written agreement 
45.2 	in subdivision 20 for recipients using the personal care assistance choice option, if applicable;
45.3 	(9) a list of all training and classes that the personal care assistance provider agency 
45.4 	requires of its staff providing personal care assistance services;
45.5 	(10) documentation that the personal care assistance provider agency and staff have 
45.6 	successfully completed all the training required by this section;
45.7 	(11) documentation of the agency's marketing practices;
45.8 	(12) disclosure of ownership, leasing, or management of all residential properties that 
45.9 	is used or could be used for providing home care services;
45.10 	(13) documentation that the agency will use the following percentages of revenue 
45.11 	generated from the medical assistance rate paid for personal care assistance services for 
45.12 	employee personal care assistant wages and benefits: 72.5 percent of revenue in the personal 
45.13 	care assistance choice option and 72.5 percent of revenue from other personal care assistance 
45.14 	providers. The revenue generated by the qualified professional and the reasonable costs 
45.15 	associated with the qualified professional shall not be used in making this calculation; and
45.16 	(14) effective May 15, 2010, documentation that the agency does not burden recipients' 
45.17 	free exercise of their right to choose service providers by requiring personal care assistants 
45.18 	to sign an agreement not to work with any particular personal care assistance recipient or 
45.19 	for another personal care assistance provider agency after leaving the agency and that the 
45.20 	agency is not taking action on any such agreements or requirements regardless of the date 
45.21 	signed; and
45.22 	(15) a copy of the personal care assistance provider agency's self-auditing policy and 
45.23 	other materials demonstrating the personal care assistance provider agency's internal program 
45.24 	integrity procedures.
45.25 	(b) Personal care assistance provider agencies enrolling for the first time must also 
45.26 	provide, at the time of enrollment as a personal care assistance provider agency in a format 
45.27 	determined by the commissioner, information and documentation that includes proof of 
45.28 	sufficient initial operating capital to support the infrastructure necessary to allow for ongoing 
45.29 	compliance with the requirements of this section. Sufficient operating capital can be 
45.30 	demonstrated as follows:
45.31 	(1) copies of business bank account statements with at least $5,000 in cash reserves;
45.32 	(2) proof of a cash reserve or business line of credit sufficient to equal three payrolls of 
45.33 	the agency's current or projected business; and
46.1 	(3) any other manner proscribed by the commissioner.
46.2 	(c) Personal care assistance provider agencies shall provide the information specified 
46.3 	in paragraph (a) to the commissioner at the time the personal care assistance provider agency 
46.4 	enrolls as a vendor or upon request from the commissioner. The commissioner shall collect 
46.5 	the information specified in paragraph (a) from all personal care assistance providers 
46.6 	beginning July 1, 2009.
46.7 	(c) (d) All personal care assistance provider agencies shall require all employees in 
46.8 	management and supervisory positions and owners of the agency who are active in the 
46.9 	day-to-day management and operations of the agency to complete mandatory training as 
46.10 	determined by the commissioner before enrollment of the agency as a provider. Employees 
46.11 	in management and supervisory positions and owners who are active in the day-to-day 
46.12 	operations of an agency who have completed the required training as an employee with a 
46.13 	personal care assistance provider agency do not need to repeat the required training if they 
46.14 	are hired by another agency, if they have completed the training within the past three years. 
46.15 	By September 1, 2010, the required training must be available with meaningful access 
46.16 	according to title VI of the Civil Rights Act and federal regulations adopted under that law 
46.17 	or any guidance from the United States Health and Human Services Department. The 
46.18 	required training must be available online or by electronic remote connection. The required 
46.19 	training must provide for competency testing. Personal care assistance provider agency 
46.20 	billing staff shall complete training about personal care assistance program financial 
46.21 	management. This training is effective July 1, 2009. Any personal care assistance provider 
46.22 	agency enrolled before that date shall, if it has not already, complete the provider training 
46.23 	within 18 months of July 1, 2009. Any new owners or employees in management and 
46.24 	supervisory positions involved in the day-to-day operations are required to complete 
46.25 	mandatory training as a requisite of working for the agency. Personal care assistance provider 
46.26 	agencies certified for participation in Medicare as home health agencies are exempt from 
46.27 	the training required in this subdivision. When available, Medicare-certified home health 
46.28 	agency owners, supervisors, or managers must successfully complete the competency test.
46.29 	(e) All personal care assistance provider agencies must provide, at the time of revalidation 
46.30 	as a personal care assistance provider agency in a format determined by the commissioner, 
46.31 	information and documentation that includes, but is not limited to, the following:
46.32 	(1) documentation of the payroll paid for the preceding 12 months or other period as 
46.33 	proscribed by the commissioner; and
46.34 	(2) financial statements demonstrating compliance with paragraph (a), clause (13).

47.1 	Sec. 43. Minnesota Statutes 2018, section 256B.0659, subdivision 24, is amended to read:
47.2 		Subd. 24.Personal care assistance provider agency; general duties. A personal care 
47.3 	assistance provider agency shall:
47.4 	(1) enroll as a Medicaid provider meeting all provider standards, including completion 
47.5 	of the required provider training;
47.6 	(2) comply with general medical assistance coverage requirements;
47.7 	(3) demonstrate compliance with law and policies of the personal care assistance program 
47.8 	to be determined by the commissioner;
47.9 	(4) comply with background study requirements;
47.10 	(5) verify and keep records of hours worked by the personal care assistant and qualified 
47.11 	professional;
47.12 	(6) not engage in any agency-initiated direct contact or marketing in person, by phone, 
47.13 	or other electronic means to potential recipients, guardians, or family members;
47.14 	(7) pay the personal care assistant and qualified professional based on actual hours of 
47.15 	services provided;
47.16 	(8) withhold and pay all applicable federal and state taxes;
47.17 	(9) effective January 1, 2010, document that the agency uses a minimum of 72.5 percent 
47.18 	of the revenue generated by the medical assistance rate for personal care assistance services 
47.19 	for employee personal care assistant wages and benefits. The revenue generated by the 
47.20 	qualified professional and the reasonable costs associated with the qualified professional 
47.21 	shall not be used in making this calculation;
47.22 	(10) make the arrangements and pay unemployment insurance, taxes, workers' 
47.23 	compensation, liability insurance, and other benefits, if any;
47.24 	(11) enter into a written agreement under subdivision 20 before services are provided;
47.25 	(12) report suspected neglect and abuse to the common entry point according to section 
47.26 	256B.0651;
47.27 	(13) provide the recipient with a copy of the home care bill of rights at start of service; 
47.28 	and
47.29 	(14) request reassessments at least 60 days prior to the end of the current authorization 
47.30 	for personal care assistance services, on forms provided by the commissioner.; and
48.1 	(15) comply with the labor market reporting requirements described in section 256B.4912, 
48.2 	subdivision 1a.

48.3 	Sec. 44. Minnesota Statutes 2018, section 256B.27, subdivision 3, is amended to read:
48.4 		Subd. 3.Access to medical records. The commissioner of human services, with the 
48.5 	written consent of the recipient, on file with the local welfare agency, shall be allowed 
48.6 	access to all personal medical records of medical assistance recipients solely for the purposes 
48.7 	of investigating whether or not: (a) a vendor of medical care has submitted a claim for 
48.8 	reimbursement, a cost report or a rate application which is duplicative, erroneous, or false 
48.9 	in whole or in part, or which results in the vendor obtaining greater compensation than the 
48.10 	vendor is legally entitled to; or (b) the medical care was medically necessary. The vendor 
48.11 	of medical care shall receive notification from the commissioner at least 24 hours before 
48.12 	the commissioner gains access to such records. When the commissioner is investigating a 
48.13 	suspected overpayment of Medicaid funds, only after first conferring with the department's 
48.14 	Office of Inspector General, and documenting the evidentiary basis for any decision to 
48.15 	demand immediate access to medical records, the commissioner must be given immediate 
48.16 	access without prior notice to the vendor's office during regular business hours and to 
48.17 	documentation and records related to services provided and submission of claims for services 
48.18 	provided. Denying the commissioner access to records is cause for the vendor's immediate 
48.19 	suspension of payment or termination according to section 256B.064. The determination 
48.20 	of provision of services not medically necessary shall be made by the commissioner. 
48.21 	Notwithstanding any other law to the contrary, a vendor of medical care shall not be subject 
48.22 	to any civil or criminal liability for providing access to medical records to the commissioner 
48.23 	of human services pursuant to this section.

48.24 	Sec. 45. Minnesota Statutes 2018, section 256B.4912, is amended by adding a subdivision 
48.25 	to read:
48.26 		Subd. 1a.Annual labor market reporting. (a) As determined by the commissioner, a 
48.27 	provider of home and community-based services for the elderly under sections 256B.0913 
48.28 	and 256B.0915, home and community-based services for people with developmental 
48.29 	disabilities under section 256B.092, and home and community-based services for people 
48.30 	with disabilities under section 256B.49 shall submit data to the commissioner on the 
48.31 	following:
48.32 	(1) number of direct-care staff;
48.33 	(2) wages of direct-care staff;
49.1 	(3) hours worked by direct-care staff;
49.2 	(4) overtime wages of direct-care staff;
49.3 	(5) overtime hours worked by direct-care staff;
49.4 	(6) benefits paid and accrued by direct-care staff;
49.5 	(7) direct-care staff retention rates;
49.6 	(8) direct-care staff job vacancies;
49.7 	(9) amount of travel time paid;
49.8 	(10) program vacancy rates; and
49.9 	(11) other related data requested by the commissioner.
49.10 	(b) The commissioner may adjust reporting requirements for a self-employed direct-care 
49.11 	staff.
49.12 	(c) For the purposes of this subdivision, "direct-care staff" means employees, including 
49.13 	self-employed individuals and individuals directly employed by a participant in a 
49.14 	consumer-directed service delivery option, providing direct service provision to people 
49.15 	receiving services under this section. Direct-care staff does not include executive, managerial, 
49.16 	or administrative staff.
49.17 	(d) This subdivision also applies to a provider of personal care assistance services under 
49.18 	section 256B.0625, subdivision 19a; community first services and supports under section 
49.19 	256B.85; nursing services and home health services under section 256B.0625, subdivision 
49.20 	6a; home care nursing services under section 256B.0625, subdivision 7; or day training and 
49.21 	habilitation services for residents of intermediate care facilities for persons with 
49.22 	developmental disabilities under section 256B.501.
49.23 	(e) This subdivision also applies to financial management services providers for 
49.24 	participants who directly employ direct-care staff through consumer support grants under 
49.25 	section 256.476; the personal care assistance choice program under section 256B.0657, 
49.26 	subdivisions 18 to 20; community first services and supports under section 256B.85; and 
49.27 	the consumer-directed community supports option available under the alternative care 
49.28 	program, the brain injury waiver, the community alternative care waiver, the community 
49.29 	alternatives for disabled individuals waiver, the developmental disabilities waiver, the 
49.30 	elderly waiver, and the Minnesota senior health option, except financial management services 
49.31 	providers are not required to submit the data listed in paragraph (a), clauses (7) to (11).
50.1 	(f) The commissioner shall ensure that data submitted under this subdivision is not 
50.2 	duplicative of data submitted under any other section of this chapter or any other chapter.
50.3 	(g) A provider shall submit the data annually on a date specified by the commissioner. 
50.4 	The commissioner shall give a provider at least 30 calendar days to submit the data. If a 
50.5 	provider fails to submit the requested data by the date specified by the commissioner, the 
50.6 	commissioner may delay medical assistance reimbursement until the requested data is 
50.7 	submitted.
50.8 	(h) Individually identifiable data submitted to the commissioner in this section are 
50.9 	considered private data on an individual, as defined by section 13.02, subdivision 12.
50.10 	(i) The commissioner shall analyze data annually for workforce assessments and how 
50.11 	the data impact service access.

50.12 	EFFECTIVE DATE. This section is effective January 1, 2020.

50.13 	Sec. 46. Minnesota Statutes 2018, section 256B.4912, is amended by adding a subdivision 
50.14 	to read:
50.15 		Subd. 11.Home and community-based service billing requirements. (a) A home and 
50.16 	community-based service is eligible for reimbursement if:
50.17 	(1) it is a service provided as specified in a federally approved waiver plan, as authorized 
50.18 	under sections 256B.0913, 256B.0915, 256B.092, and 256B.49;
50.19 	(2) if applicable, it is provided on days and times during the days and hours of operation 
50.20 	specified on any license that is required under chapter 245A or 245D; or
50.21 	(3) the home and community-based service provider has met the documentation 
50.22 	requirements under section 256B.4912, subdivision 12, 13, 14, or 15.
50.23 	A service that does not meet the criteria in this subdivision may be recovered by the 
50.24 	department according to section 256B.064 and Minnesota Rules, parts 9505.2160 to 
50.25 	9505.2245.
50.26 	(b) The provider must maintain documentation that all individuals providing service 
50.27 	have attested to reviewing and understanding the following statement upon employment 
50.28 	and annually thereafter.
50.29 	"It is a federal crime to provide materially false information on service billings for 
50.30 	medical assistance or services provided under a federally approved waiver plan, as authorized 
50.31 	under Minnesota Statutes, sections 256B.0913, 256B.0915, 256B.092, and 256B.49."

51.1 	Sec. 47. Minnesota Statutes 2018, section 256B.4912, is amended by adding a subdivision 
51.2 	to read:
51.3 		Subd. 12.Home and community-based service documentation requirements. (a) 
51.4 	Documentation may be collected and maintained electronically or in paper form by providers, 
51.5 	but must be made available and produced upon the request of the commissioner. 
51.6 	Documentation of delivered services that comply with the electronic visit verification 
51.7 	requirements under Laws 2017, First Special Session chapter 6, article 3, section 49, satisfy 
51.8 	the requirements of this subdivision.
51.9 	(b) Documentation of a delivered service must be in English and must be legible according 
51.10 	to the standard of a reasonable person.
51.11 	(c) If the service is reimbursed at an hourly or specified minute-based rate, each 
51.12 	documentation of the provision of a service, unless otherwise specified, must include:
51.13 	(1) the date the documentation occurred;
51.14 	(2) the day, month, and year when the service was provided;
51.15 	(3) the start and stop times with a.m. and p.m. designations, except for case management 
51.16 	services as defined under sections 256B.0913, subdivision 7, 256B.0915, subdivision 1a, 
51.17 	256B.092, subdivision 1a, and 256B.49, subdivision 13;
51.18 	(4) the service name or description of the service provided; and
51.19 	(5) the name, signature, and title, if any, of the provider of service. If the service is 
51.20 	provided by multiple staff members, the provider may designate a staff member responsible 
51.21 	for verifying services and completing the documentation required by this paragraph.
51.22 	(d) If the service is reimbursed at a daily rate or does not meet the requirements of 
51.23 	subdivision 12, paragraph (c), each documentation of the provision of a service, unless 
51.24 	otherwise specified, must include:
51.25 	(1) the date the documentation occurred;
51.26 	(2) the day, month, and year when the service was provided;
51.27 	(3) the service name or description of the service provided; and
51.28 	(4) the name, signature, and title, if any, of the person providing the service. If the service 
51.29 	is provided by multiple staff, the provider may designate a staff person responsible for 
51.30 	verifying services and completing the documentation required by this paragraph.

52.1 	Sec. 48. Minnesota Statutes 2018, section 256B.4912, is amended by adding a subdivision 
52.2 	to read:
52.3 		Subd. 13.Waiver transportation documentation and billing requirements. (a) A 
52.4 	waiver transportation service must meet the billing requirements under section 256B.4912, 
52.5 	subdivision 11, to be eligible for reimbursement and must:
52.6 	(1) be a waiver transportation service that is not covered by medical transportation under 
52.7 	the Medicaid state plan; and
52.8 	(2) be a waiver transportation service that is not included as a component of another 
52.9 	waiver service.
52.10 	(b) A waiver transportation service provider must meet the documentation requirements 
52.11 	under section 256B.4912, subdivision 12, and must maintain:
52.12 	(1) odometer and other records as provided in section 256B.0625, subdivision 17b, 
52.13 	paragraph (b), clause (3), sufficient to distinguish an individual trip with a specific vehicle 
52.14 	and driver for a waiver transportation service that is billed directly by the mile, except if 
52.15 	the provider is a common carrier as defined by Minnesota Rules, part 9505.0315, subpart 
52.16 	1, item B, or a publicly operated transit system; and
52.17 	(2) documentation demonstrating that a vehicle and a driver meets the standards 
52.18 	determined by the Department of Human Services on vehicle and driver qualifications as 
52.19 	described in section 256B.0625, subdivision 17, paragraph (c).

52.20 	Sec. 49. Minnesota Statutes 2018, section 256B.4912, is amended by adding a subdivision 
52.21 	to read:
52.22 		Subd. 14.Equipment and supply documentation requirements. (a) An equipment 
52.23 	and supply services provider must meet the documentation requirements under section 
52.24 	256B.4912, subdivision 12, and must, for each documentation of the provision of a service, 
52.25 	include:
52.26 	(1) the recipient's assessed need for the equipment or supply and the reason the equipment 
52.27 	or supply is not covered by the Medicaid state plan;
52.28 	(2) the type and brand name of the equipment or supply delivered to or purchased by 
52.29 	the recipient, including whether the equipment or supply was rented or purchased;
52.30 	(3) the quantity of the equipment or supplies delivered or purchased; and
52.31 	(4) the cost of equipment or supplies if the amount paid for the service depends on the 
52.32 	cost.
53.1 	(b) A provider must maintain a copy of the shipping invoice or a delivery service tracking 
53.2 	log or other documentation showing the date of delivery that proves the equipment or supply 
53.3 	was delivered to the recipient or a receipt if the equipment or supply was purchased by the 
53.4 	recipient.

53.5 	Sec. 50. Minnesota Statutes 2018, section 256B.4912, is amended by adding a subdivision 
53.6 	to read:
53.7 		Subd. 15.Adult day service documentation and billing requirements. (a) A service 
53.8 	defined as "adult day care" under section 245A.02, subdivision 2a, and licensed under 
53.9 	Minnesota Rules, parts 9555.9600 to 9555.9730, must meet the documentation requirements 
53.10 	under section 256B.4912, subdivision 12, and must maintain documentation of:
53.11 	(1) a needs assessment and current plan of care according to section 245A.143, 
53.12 	subdivisions 4 to 7, or Minnesota Rules, part 9555.9700, if applicable, for each recipient;
53.13 	(2) attendance records as specified under section 245A.14, subdivision 14, paragraph 
53.14 	(c); the date of attendance must be documented on the attendance record with the day, 
53.15 	month, and year; and the pickup and drop-off time must be noted on the attendance record 
53.16 	in hours and minutes with a.m. and p.m. designations;
53.17 	(3) the monthly and quarterly program requirements in Minnesota Rules, part 9555.9710, 
53.18 	subparts 1, items E and H, 3, 4, and 6, if applicable;
53.19 	(4) the names and qualifications of the registered physical therapists, registered nurses, 
53.20 	and registered dietitians who provide services to the adult day care or nonresidential program; 
53.21 	and
53.22 	(5) the location where the service was provided and, if the location is an alternate location 
53.23 	from the primary place of service, the address, or if an address is not available, a description 
53.24 	of both the origin and destination location, the length of time at the alternate location with 
53.25 	a.m. and p.m. designations, and a list of participants who went to the alternate location.
53.26 	(b) A provider cannot exceed its licensed capacity; if licensed capacity is exceeded, all 
53.27 	Minnesota health care program payments for that date shall be recovered by the department.

53.28 	EFFECTIVE DATE. This section is effective August 1, 2019.

54.1 	Sec. 51. Minnesota Statutes 2018, section 256B.5014, is amended to read:
54.2 	256B.5014 FINANCIAL REPORTING REQUIREMENTS.
54.3 		Subdivision 1.Financial reporting. All facilities shall maintain financial records and 
54.4 	shall provide annual income and expense reports to the commissioner of human services 
54.5 	on a form prescribed by the commissioner no later than April 30 of each year in order to 
54.6 	receive medical assistance payments. The reports for the reporting year ending December 
54.7 	31 must include:
54.8 	(1) salaries and related expenses, including program salaries, administrative salaries, 
54.9 	other salaries, payroll taxes, and fringe benefits;
54.10 	(2) general operating expenses, including supplies, training, repairs, purchased services 
54.11 	and consultants, utilities, food, licenses and fees, real estate taxes, insurance, and working 
54.12 	capital interest;
54.13 	(3) property related costs, including depreciation, capital debt interest, rent, and leases; 
54.14 	and
54.15 	(4) total annual resident days.
54.16 		Subd. 2.Labor market reporting. All intermediate care facilities shall comply with 
54.17 	the labor market reporting requirements described in section 256B.4912, subdivision 1a.

54.18 	Sec. 52. Minnesota Statutes 2018, section 256B.85, subdivision 10, is amended to read:
54.19 		Subd. 10.Agency-provider and FMS provider qualifications and duties. (a) 
54.20 	Agency-providers identified in subdivision 11 and FMS providers identified in subdivision 
54.21 	13a shall:
54.22 	(1) enroll as a medical assistance Minnesota health care programs provider and meet all 
54.23 	applicable provider standards and requirements;
54.24 	(2) demonstrate compliance with federal and state laws and policies for CFSS as 
54.25 	determined by the commissioner;
54.26 	(3) comply with background study requirements under chapter 245C and maintain 
54.27 	documentation of background study requests and results;
54.28 	(4) verify and maintain records of all services and expenditures by the participant, 
54.29 	including hours worked by support workers;
55.1 	(5) not engage in any agency-initiated direct contact or marketing in person, by telephone, 
55.2 	or other electronic means to potential participants, guardians, family members, or participants' 
55.3 	representatives;
55.4 	(6) directly provide services and not use a subcontractor or reporting agent;
55.5 	(7) meet the financial requirements established by the commissioner for financial 
55.6 	solvency;
55.7 	(8) have never had a lead agency contract or provider agreement discontinued due to 
55.8 	fraud, or have never had an owner, board member, or manager fail a state or FBI-based 
55.9 	criminal background check while enrolled or seeking enrollment as a Minnesota health care 
55.10 	programs provider; and
55.11 	(9) have an office located in Minnesota.
55.12 	(b) In conducting general duties, agency-providers and FMS providers shall:
55.13 	(1) pay support workers based upon actual hours of services provided;
55.14 	(2) pay for worker training and development services based upon actual hours of services 
55.15 	provided or the unit cost of the training session purchased;
55.16 	(3) withhold and pay all applicable federal and state payroll taxes;
55.17 	(4) make arrangements and pay unemployment insurance, taxes, workers' compensation, 
55.18 	liability insurance, and other benefits, if any;
55.19 	(5) enter into a written agreement with the participant, participant's representative, or 
55.20 	legal representative that assigns roles and responsibilities to be performed before services, 
55.21 	supports, or goods are provided;
55.22 	(6) report maltreatment as required under sections 626.556 and 626.557; and
55.23 	(7) comply with the labor market reporting requirements described in section 256B.4912, 
55.24 	subdivision 1a; and
55.25 	(8) comply with any data requests from the department consistent with the Minnesota 
55.26 	Government Data Practices Act under chapter 13.

55.27 	Sec. 53. Minnesota Statutes 2018, section 256D.024, subdivision 3, is amended to read:
55.28 		Subd. 3.Fleeing felons offenders. An individual who is fleeing to avoid prosecution, 
55.29 	or custody, or confinement after conviction for a crime that is a felony under the laws of 
55.30 	the jurisdiction from which the individual flees, or in the case of New Jersey, is a high 
55.31 	misdemeanor, is ineligible to receive benefits under this chapter.

56.1 	Sec. 54. [256D.0245] DRUG TESTING INFORMATION FROM PROBATION 
56.2 	OFFICERS.
56.3 	The local probation agency shall regularly provide a list of probationers who tested 
56.4 	positive for an illegal controlled substance to the local social services agency, specifically 
56.5 	the welfare fraud division, for purposes of section 256D.024.

56.6 	Sec. 55. Minnesota Statutes 2018, section 256D.0515, is amended to read:
56.7 	256D.0515 ASSET LIMITATIONS FOR FOOD STAMP HOUSEHOLDS.
56.8 	All food stamp households must be determined eligible for the benefit discussed under 
56.9 	section 256.029. Food stamp households must demonstrate that: (1) their gross income is 
56.10 	equal to or less than 165 percent of the federal poverty guidelines for the same family size; 
56.11 	and (2) they have financial resources, excluding vehicles, of less than $100,000.

56.12 	Sec. 56. Minnesota Statutes 2018, section 256D.0516, subdivision 2, is amended to read:
56.13 		Subd. 2.Food support reporting requirements. The commissioner of human services 
56.14 	shall implement simplified reporting as permitted under the Food Stamp Act of 1977, as 
56.15 	amended, and the food stamp regulations in Code of Federal Regulations, title 7, part 273. 
56.16 	Food support recipient households are required to report periodically shall not be required 
56.17 	to report more often than one time every six months, and must report any changes in income, 
56.18 	assets, or employment that affects eligibility within ten days of the date the change occurs. 
56.19 	This provision shall not apply to households receiving food benefits under the Minnesota 
56.20 	family investment program waiver.

56.21 	Sec. 57. Minnesota Statutes 2018, section 256J.08, subdivision 47, is amended to read:
56.22 		Subd. 47.Income. "Income" means cash or in-kind benefit, whether earned or unearned, 
56.23 	received by or available to an applicant or participant that is not property under section 
56.24 	256P.02. An applicant must document that the property is not available to the applicant.

56.25 	Sec. 58. Minnesota Statutes 2018, section 256J.21, subdivision 2, is amended to read:
56.26 		Subd. 2.Income exclusions. The following must be excluded in determining a family's 
56.27 	available income:
56.28 	(1) payments for basic care, difficulty of care, and clothing allowances received for 
56.29 	providing family foster care to children or adults under Minnesota Rules, parts 9555.5050 
56.30 	to 9555.6265, 9560.0521, and 9560.0650 to 9560.0654, payments for family foster care for 
57.1 	children under section 260C.4411 or chapter 256N, and payments received and used for 
57.2 	care and maintenance of a third-party beneficiary who is not a household member;
57.3 	(2) reimbursements for employment training received through the Workforce Investment 
57.4 	Act of 1998, United States Code, title 20, chapter 73, section 9201;
57.5 	(3) reimbursement for out-of-pocket expenses incurred while performing volunteer 
57.6 	services, jury duty, employment, or informal carpooling arrangements directly related to 
57.7 	employment;
57.8 	(4) all educational assistance, except the county agency must count graduate student 
57.9 	teaching assistantships, fellowships, and other similar paid work as earned income and, 
57.10 	after allowing deductions for any unmet and necessary educational expenses, shall count 
57.11 	scholarships or grants awarded to graduate students that do not require teaching or research 
57.12 	as unearned income;
57.13 	(5) loans, regardless of purpose, from public or private lending institutions, governmental 
57.14 	lending institutions, or governmental agencies;
57.15 	(6) loans from private individuals, regardless of purpose, provided an applicant or 
57.16 	participant documents that the lender expects repayment provides documentation of the 
57.17 	source of the loan, dates, amount of the loan, and terms of repayment;
57.18 	(7)(i) state income tax refunds; and
57.19 	(ii) federal income tax refunds;
57.20 	(8)(i) federal earned income credits;
57.21 	(ii) Minnesota working family credits;
57.22 	(iii) state homeowners and renters credits under chapter 290A; and
57.23 	(iv) federal or state tax rebates;
57.24 	(9) funds received for reimbursement, replacement, or rebate of personal or real property 
57.25 	when these payments are made by public agencies, awarded by a court, solicited through 
57.26 	public appeal, or made as a grant by a federal agency, state or local government, or disaster 
57.27 	assistance organizations, subsequent to a presidential declaration of disaster;
57.28 	(10) the portion of an insurance settlement that is used to pay medical, funeral, and burial 
57.29 	expenses, or to repair or replace insured property;
57.30 	(11) reimbursements for medical expenses that cannot be paid by medical assistance;
58.1 	(12) payments by a vocational rehabilitation program administered by the state under 
58.2 	chapter 268A, except those payments that are for current living expenses;
58.3 	(13) in-kind income, including any payments directly made by a third party to a provider 
58.4 	of goods and services. In-kind income does not include in-kind payments of living expenses;
58.5 	(14) assistance payments to correct underpayments, but only for the month in which the 
58.6 	payment is received;
58.7 	(15) payments for short-term emergency needs under section 256J.626, subdivision 2;
58.8 	(16) funeral and cemetery payments as provided by section 256.935;
58.9 	(17) nonrecurring cash gifts of $30 or less, not exceeding $30 per participant in a calendar 
58.10 	month;
58.11 	(18) any form of energy assistance payment made through Public Law 97-35, 
58.12 	Low-Income Home Energy Assistance Act of 1981, payments made directly to energy 
58.13 	providers by other public and private agencies, and any form of credit or rebate payment 
58.14 	issued by energy providers;
58.15 	(19) Supplemental Security Income (SSI), including retroactive SSI payments and other 
58.16 	income of an SSI recipient;
58.17 	(20) Minnesota supplemental aid, including retroactive payments;
58.18 	(21) proceeds from the sale of real or personal property;
58.19 	(22) adoption or kinship assistance payments under chapter 256N or 259A and Minnesota 
58.20 	permanency demonstration title IV-E waiver payments;
58.21 	(23) state-funded family subsidy program payments made under section 252.32 to help 
58.22 	families care for children with developmental disabilities, consumer support grant funds 
58.23 	under section 256.476, and resources and services for a disabled household member under 
58.24 	one of the home and community-based waiver services programs under chapter 256B;
58.25 	(24) interest payments and dividends from property that is not excluded from and that 
58.26 	does not exceed the asset limit;
58.27 	(25) rent rebates;
58.28 	(26) income earned by a minor caregiver, minor child through age 6, or a minor child 
58.29 	who is at least a half-time student in an approved elementary or secondary education program;
58.30 	(27) income earned by a caregiver under age 20 who is at least a half-time student in an 
58.31 	approved elementary or secondary education program;
59.1 	(28) MFIP child care payments under section 119B.05;
59.2 	(29) all other payments made through MFIP to support a caregiver's pursuit of greater 
59.3 	economic stability;
59.4 	(30) income a participant receives related to shared living expenses;
59.5 	(31) reverse mortgages;
59.6 	(32) benefits provided by the Child Nutrition Act of 1966, United States Code, title 42, 
59.7 	chapter 13A, sections 1771 to 1790;
59.8 	(33) benefits provided by the women, infants, and children (WIC) nutrition program, 
59.9 	United States Code, title 42, chapter 13A, section 1786;
59.10 	(34) benefits from the National School Lunch Act, United States Code, title 42, chapter 
59.11 	13, sections 1751 to 1769e;
59.12 	(35) relocation assistance for displaced persons under the Uniform Relocation Assistance 
59.13 	and Real Property Acquisition Policies Act of 1970, United States Code, title 42, chapter 
59.14 	61, subchapter II, section 4636, or the National Housing Act, United States Code, title 12, 
59.15 	chapter 13, sections 1701 to 1750jj;
59.16 	(36) benefits from the Trade Act of 1974, United States Code, title 19, chapter 12, part 
59.17 	2, sections 2271 to 2322;
59.18 	(37) war reparations payments to Japanese Americans and Aleuts under United States 
59.19 	Code, title 50, sections 1989 to 1989d;
59.20 	(38) payments to veterans or their dependents as a result of legal settlements regarding 
59.21 	Agent Orange or other chemical exposure under Public Law 101-239, section 10405, 
59.22 	paragraph (a)(2)(E);
59.23 	(39) income that is otherwise specifically excluded from MFIP consideration in federal 
59.24 	law, state law, or federal regulation;
59.25 	(40) security and utility deposit refunds;
59.26 	(41) American Indian tribal land settlements excluded under Public Laws 98-123, 98-124, 
59.27 	and 99-377 to the Mississippi Band Chippewa Indians of White Earth, Leech Lake, and 
59.28 	Mille Lacs reservations and payments to members of the White Earth Band, under United 
59.29 	States Code, title 25, chapter 9, section 331, and chapter 16, section 1407;
60.1 	(42) all income of the minor parent's parents and stepparents when determining the grant 
60.2 	for the minor parent in households that include a minor parent living with parents or 
60.3 	stepparents on MFIP with other children;
60.4 	(43) income of the minor parent's parents and stepparents equal to 200 percent of the 
60.5 	federal poverty guideline for a family size not including the minor parent and the minor 
60.6 	parent's child in households that include a minor parent living with parents or stepparents 
60.7 	not on MFIP when determining the grant for the minor parent. The remainder of income is 
60.8 	deemed as specified in section 256J.37, subdivision 1b;
60.9 	(44) payments made to children eligible for relative custody assistance under section 
60.10 	257.85;
60.11 	(45) vendor payments for goods and services made on behalf of a client unless the client 
60.12 	has the option of receiving the payment in cash;
60.13 	(46) the principal portion of a contract for deed payment;
60.14 	(47) cash payments to individuals enrolled for full-time service as a volunteer under 
60.15 	AmeriCorps programs including AmeriCorps VISTA, AmeriCorps State, AmeriCorps 
60.16 	National, and AmeriCorps NCCC;
60.17 	(48) housing assistance grants under section 256J.35, paragraph (a); and
60.18 	(49) child support payments of up to $100 for an assistance unit with one child and up 
60.19 	to $200 for an assistance unit with two or more children.

60.20 	Sec. 59. Minnesota Statutes 2018, section 256J.26, subdivision 3, is amended to read:
60.21 		Subd. 3.Fleeing felons offenders. An individual who is fleeing to avoid prosecution, 
60.22 	or custody, or confinement after conviction for a crime that is a felony under the laws of 
60.23 	the jurisdiction from which the individual flees, or in the case of New Jersey, is a high 
60.24 	misdemeanor, is disqualified from receiving MFIP.

60.25 	Sec. 60. [256J.265] DRUG TESTING INFORMATION FROM PROBATION 
60.26 	OFFICERS.
60.27 	The local probation agency shall regularly provide a list of probationers who tested 
60.28 	positive for an illegal controlled substance to the local social services agency, specifically 
60.29 	the welfare fraud division, for purposes of section 256J.26.

61.1 	Sec. 61. Minnesota Statutes 2018, section 256L.01, subdivision 5, is amended to read:
61.2 		Subd. 5.Income.  "Income" has the meaning given for modified adjusted gross income, 
61.3 	as defined in Code of Federal Regulations, title 26, section 1.36B-1, and means a household's 
61.4 	current income, or if income fluctuates month to month, the income for the 12-month 
61.5 	eligibility period. Income includes amounts deposited into checking and savings accounts 
61.6 	for personal expenses including rent, mortgage, automobile-related expenses, utilities, and 
61.7 	food.

61.8 	Sec. 62. Minnesota Statutes 2018, section 256P.04, subdivision 4, is amended to read:
61.9 		Subd. 4.Factors to be verified. (a) The agency shall verify the following at application:
61.10 	(1) identity of adults;
61.11 	(2) age, if necessary to determine eligibility;
61.12 	(3) immigration status;
61.13 	(4) income;
61.14 	(5) spousal support and child support payments made to persons outside the household;
61.15 	(6) vehicles;
61.16 	(7) checking and savings accounts;. Verification of checking and savings accounts must 
61.17 	include the source of deposits into accounts; identification of any loans, including the date, 
61.18 	source, amount, and terms of repayment; identification of deposits for personal expenses 
61.19 	including rent, mortgage, automobile-related expenses, utilities, and food;
61.20 	(8) inconsistent information, if related to eligibility;
61.21 	(9) residence;
61.22 	(10) Social Security number; and
61.23 	(11) use of nonrecurring income under section 256P.06, subdivision 3, clause (2), item 
61.24 	(ix), for the intended purpose for which it was given and received.;
61.25 	(12) loans. Verification of loans must include the source, the full amount, and repayment 
61.26 	terms; and
61.27 	(13) direct or indirect gifts of money.
61.28 	(b) Applicants who are qualified noncitizens and victims of domestic violence as defined 
61.29 	under section 256J.08, subdivision 73, clause (7), are not required to verify the information 
61.30 	in paragraph (a), clause (10). When a Social Security number is not provided to the agency 
62.1 	for verification, this requirement is satisfied when each member of the assistance unit 
62.2 	cooperates with the procedures for verification of Social Security numbers, issuance of 
62.3 	duplicate cards, and issuance of new numbers which have been established jointly between 
62.4 	the Social Security Administration and the commissioner.

62.5 	Sec. 63. Minnesota Statutes 2018, section 256P.06, subdivision 3, is amended to read:
62.6 		Subd. 3.Income inclusions. The following must be included in determining the income 
62.7 	of an assistance unit:
62.8 	(1) earned income:
62.9 	(i) calculated according to Minnesota Rules, part 3400.0170, subpart 7, for earned income 
62.10 	from self-employment, except if the participant is drawing a salary, taking a draw from the 
62.11 	business, or using the business account to pay personal expenses including rent, mortgage, 
62.12 	automobile-related expenses, utilities, or food, not directly related to the business, the salary 
62.13 	or payment must be treated as earned income; and
62.14 	(ii) excluding expenses listed in Minnesota Rules, part 3400.0170, subpart 8, items A 
62.15 	to I and M to P; and
62.16 	(2) unearned income, which includes:
62.17 	(i) interest and dividends from investments and savings;
62.18 	(ii) capital gains as defined by the Internal Revenue Service from any sale of real property;
62.19 	(iii) proceeds from rent and contract for deed payments in excess of the principal and 
62.20 	interest portion owed on property;
62.21 	(iv) income from trusts, excluding special needs and supplemental needs trusts;
62.22 	(v) interest income from loans made by the participant or household;
62.23 	(vi) cash prizes and winnings;
62.24 	(vii) unemployment insurance income;
62.25 	(viii) retirement, survivors, and disability insurance payments;
62.26 	(ix) nonrecurring income over $60 per quarter unless earmarked and used for the purpose 
62.27 	for which it is intended. Income and use of this income is subject to verification requirements 
62.28 	under section 256P.04;
62.29 	(x) retirement benefits;
63.1 	(xi) cash assistance benefits, as defined by each program in chapters 119B, 256D, 256I, 
63.2 	and 256J;
63.3 	(xii) tribal per capita payments unless excluded by federal and state law;
63.4 	(xiii) income and payments from service and rehabilitation programs that meet or exceed 
63.5 	the state's minimum wage rate;
63.6 	(xiv) income from members of the United States armed forces unless excluded from 
63.7 	income taxes according to federal or state law;
63.8 	(xv) all child support payments for programs under chapters 119B, 256D, and 256I;
63.9 	(xvi) the amount of child support received that exceeds $100 for assistance units with 
63.10 	one child and $200 for assistance units with two or more children for programs under chapter 
63.11 	256J; and
63.12 	(xvii) spousal support.

63.13 	Sec. 64. Laws 2017, First Special Session chapter 6, article 3, section 49, is amended to 
63.14 	read:
63.15 	Sec. 49. ELECTRONIC SERVICE DELIVERY DOCUMENTATION SYSTEM
63.16 	VISIT VERIFICATION.
 63.17 		Subdivision 1.Documentation; establishment. The commissioner of human services 
63.18 	shall establish implementation requirements and standards for an electronic service delivery 
63.19 	documentation system visit verification to comply with the 21st Century Cures Act, Public 
63.20 	Law 114-255. Within available appropriations, the commissioner shall take steps to comply 
63.21 	with the electronic visit verification requirements in the 21st Century Cures Act, Public 
63.22 	Law 114-255.
63.23 		Subd. 2.Definitions. (a) For purposes of this section, the terms in this subdivision have 
63.24 	the meanings given them.
63.25 	(b) "Electronic service delivery documentation visit verification" means the electronic 
63.26 	documentation of the:
63.27 	(1) type of service performed;
63.28 	(2) individual receiving the service;
63.29 	(3) date of the service;
63.30 	(4) location of the service delivery;
64.1 	(5) individual providing the service; and
64.2 	(6) time the service begins and ends.
64.3 	(c) "Electronic service delivery documentation visit verification system" means a system 
64.4 	that provides electronic service delivery documentation verification of services that complies 
64.5 	with the 21st Century Cures Act, Public Law 114-255, and the requirements of subdivision 
64.6 	3.
64.7 	(d) "Service" means one of the following:
64.8 	(1) personal care assistance services as defined in Minnesota Statutes, section 256B.0625, 
64.9 	subdivision 19a, and provided according to Minnesota Statutes, section 256B.0659; or
64.10 	(2) community first services and supports under Minnesota Statutes, section 256B.85;
64.11 	(3) home health services under Minnesota Statutes, section 256B.0625, subdivision 6a; 
64.12 	or
64.13 	(4) other medical supplies and equipment or home and community-based services that 
64.14 	are required to be electronically verified by the 21st Century Cures Act, Public Law 114-255.
64.15 		Subd. 3.System requirements. (a) In developing implementation requirements for an
64.16 	electronic service delivery documentation system visit verification, the commissioner shall 
64.17 	consider electronic visit verification systems and other electronic service delivery 
64.18 	documentation methods. The commissioner shall convene stakeholders that will be impacted 
64.19 	by an electronic service delivery system, including service providers and their representatives, 
64.20 	service recipients and their representatives, and, as appropriate, those with expertise in the 
64.21 	development and operation of an electronic service delivery documentation system, to ensure 
64.22 	that the requirements:
64.23 	(1) are minimally administratively and financially burdensome to a provider;
64.24 	(2) are minimally burdensome to the service recipient and the least disruptive to the 
64.25 	service recipient in receiving and maintaining allowed services;
64.26 	(3) consider existing best practices and use of electronic service delivery documentation
64.27 	visit verification;
64.28 	(4) are conducted according to all state and federal laws;
64.29 	(5) are effective methods for preventing fraud when balanced against the requirements 
64.30 	of clauses (1) and (2); and
65.1 	(6) are consistent with the Department of Human Services' policies related to covered 
65.2 	services, flexibility of service use, and quality assurance.
65.3 	(b) The commissioner shall make training available to providers on the electronic service 
65.4 	delivery documentation visit verification system requirements.
65.5 	(c) The commissioner shall establish baseline measurements related to preventing fraud 
65.6 	and establish measures to determine the effect of electronic service delivery documentation
65.7 	visit verification requirements on program integrity.
65.8 	(d) The commissioner shall make a state-selected electronic visit verification system 
65.9 	available to providers of services.
65.10 		Subd. 3a.Provider requirements. (a) Providers of services may select their own 
65.11 	electronic visit verification system that meets the requirements established by the 
65.12 	commissioner.
65.13 	(b) All electronic visit verification systems used by providers to comply with the 
65.14 	requirements established by the commissioner must provide data to the commissioner in a 
65.15 	format and at a frequency to be established by the commissioner.
65.16 	(c) Providers must implement the electronic visit verification systems required under 
65.17 	this section by January 1, 2020, for personal care services and by January 1, 2023, for home 
65.18 	health services in accordance with the 21st Century Cures Act, Public Law 114-255, and 
65.19 	the Centers for Medicare and Medicaid Services guidelines. For the purposes of this 
65.20 	paragraph, "personal care services" and "home health services" have the meanings given 
65.21 	in United States Code, title 42, section 1396b(l)(5). Reimbursement rates for providers must 
65.22 	not be reduced as a result of federal action to reduce the federal medical assistance percentage 
65.23 	under the 21st Century Cures Act, Public Law 114.255, Code of Federal Regulations, title 
65.24 	32, section 310.32.
65.25 		Subd. 4.Legislative report. (a) The commissioner shall submit a report by January 15, 
65.26 	2018, to the chairs and ranking minority members of the legislative committees with 
65.27 	jurisdiction over human services with recommendations, based on the requirements of 
65.28 	subdivision 3, to establish electronic service delivery documentation system requirements 
65.29 	and standards. The report shall identify:
65.30 	(1) the essential elements necessary to operationalize a base-level electronic service 
65.31 	delivery documentation system to be implemented by January 1, 2019; and
66.1 	(2) enhancements to the base-level electronic service delivery documentation system to 
66.2 	be implemented by January 1, 2019, or after, with projected operational costs and the costs 
66.3 	and benefits for system enhancements.
66.4 	(b) The report must also identify current regulations on service providers that are either 
66.5 	inefficient, minimally effective, or will be unnecessary with the implementation of an 
66.6 	electronic service delivery documentation system.

66.7 	Sec. 65. DIRECTIONS TO COMMISSIONER; NEMT DRIVER ENROLLMENT 
66.8 	IMPACT.
 66.9 	By August 1, 2021, the commissioner of human services shall issue a report to the chairs 
66.10 	and ranking minority members of the house of representatives and senate committees with 
66.11 	jurisdiction over health and human services. The commissioner must include in the report 
66.12 	the commissioner's findings regarding the impact of driver enrollment under Minnesota 
66.13 	Statutes, section 256B.0625, subdivision 17, paragraph (c), on the program integrity of the 
66.14 	nonemergency medical transportation program. The commissioner must include a 
66.15 	recommendation, based on the findings in the report, regarding expanding the driver 
66.16 	enrollment requirement.

66.17 	Sec. 66. UNIVERSAL IDENTIFICATION NUMBER FOR CHILDREN IN EARLY 
66.18 	CHILDHOOD PROGRAMS.
 66.19 	By July 1, 2020, the commissioners of the Departments of Education, Health, and Human 
66.20 	Services shall  identify a process to establish and implement a universal identification number 
66.21 	for children participating in early childhood programs to eliminate potential duplication in 
66.22 	programs. The commissioners shall report the identified process and any associated fiscal 
66.23 	cost to the chairs and ranking minority members of the legislative committees with 
66.24 	jurisdiction over health, human services, and education. A universal identification number 
66.25 	established and implemented under this section is private data on individuals, as defined in 
66.26 	Minnesota Statutes, section 13.02, subdivision 12, except that the commissioners of 
66.27 	education, health, and human services may share the universal identification number with 
66.28 	each other pursuant to their data sharing authority under Minnesota Statutes, section 13.46, 
66.29 	subdivision 2, clause (9), and Minnesota Statutes, section 145A.17, subdivision 3, paragraph 
66.30 	(e).

67.1 	Sec. 67. DIRECTION TO COMMISSIONER; FEDERAL WAIVER FOR MEDICAL 
67.2 	ASSISTANCE SELF-ATTESTATION REMOVAL.
 67.3 	The commissioner of human services shall seek all necessary federal waivers to 
67.4 	implement the removal of the self-attestation when establishing eligibility for medical 
67.5 	assistance.

67.6 	Sec. 68. REVISOR'S INSTRUCTION.
 67.7 	The revisor of statutes shall codify Laws 2017, First Special Session chapter 6, article 
67.8 	3, section 49, as amended in this act, in Minnesota Statutes, chapter 256B.

67.9 	Sec. 69. REPEALER.
 67.10 	Minnesota Statutes 2018, section 256B.0705, is repealed.

67.11 	EFFECTIVE DATE. This section is effective January 1, 2020.

67.12 	ARTICLE 2
67.13 	CHILDREN AND FAMILIES SERVICES

67.14 	Section 1. Minnesota Statutes 2018, section 252.27, subdivision 2a, is amended to read:
67.15 		Subd. 2a.Contribution amount. (a) The natural or adoptive parents of a minor child, 
67.16 	not including a child determined eligible for medical assistance without consideration of 
67.17 	parental income under the TEFRA option or for the purposes of accessing home and 
67.18 	community-based waiver services, must contribute to the cost of services used by making 
67.19 	monthly payments on a sliding scale based on income, unless the child is married or has 
67.20 	been married, parental rights have been terminated, or the child's adoption is subsidized 
67.21 	according to chapter 259A or through title IV-E of the Social Security Act. The parental 
67.22 	contribution is a partial or full payment for medical services provided for diagnostic, 
67.23 	therapeutic, curing, treating, mitigating, rehabilitation, maintenance, and personal care 
67.24 	services as defined in United States Code, title 26, section 213, needed by the child with a 
67.25 	chronic illness or disability.
67.26 	(b) For households with adjusted gross income equal to or greater than 275 percent of 
67.27 	federal poverty guidelines, the parental contribution shall be computed by applying the 
67.28 	following schedule of rates to the adjusted gross income of the natural or adoptive parents:
67.29 	(1) if the adjusted gross income is equal to or greater than 275 percent of federal poverty 
67.30 	guidelines and less than or equal to 545 percent of federal poverty guidelines, the parental 
67.31 	contribution shall be determined using a sliding fee scale established by the commissioner 
68.1 	of human services which begins at 1.94 percent of adjusted gross income at 275 percent of 
68.2 	federal poverty guidelines and increases to 5.29 percent of adjusted gross income for those 
68.3 	with adjusted gross income up to 545 percent of federal poverty guidelines;
68.4 	(2) if the adjusted gross income is greater than 545 percent of federal poverty guidelines 
68.5 	and less than 675 percent of federal poverty guidelines, the parental contribution shall be 
68.6 	5.29 percent of adjusted gross income;
68.7 	(3) if the adjusted gross income is equal to or greater than 675 percent of federal poverty 
68.8 	guidelines and less than 975 percent of federal poverty guidelines, the parental contribution 
68.9 	shall be determined using a sliding fee scale established by the commissioner of human 
68.10 	services which begins at 5.29 percent of adjusted gross income at 675 percent of federal 
68.11 	poverty guidelines and increases to 7.05 percent of adjusted gross income for those with 
68.12 	adjusted gross income up to 975 percent of federal poverty guidelines; and
68.13 	(4) if the adjusted gross income is equal to or greater than 975 percent of federal poverty 
68.14 	guidelines, the parental contribution shall be 8.81 percent of adjusted gross income.
68.15 	If the child lives with the parent, the annual adjusted gross income is reduced by $2,400 
68.16 	prior to calculating the parental contribution. If the child resides in an institution specified 
68.17 	in section 256B.35, the parent is responsible for the personal needs allowance specified 
68.18 	under that section in addition to the parental contribution determined under this section. 
68.19 	The parental contribution is reduced by any amount required to be paid directly to the child 
68.20 	pursuant to a court order, but only if actually paid.
68.21 	(c) The household size to be used in determining the amount of contribution under 
68.22 	paragraph (b) includes natural and adoptive parents and their dependents, including the 
68.23 	child receiving services. Adjustments in the contribution amount due to annual changes in 
68.24 	the federal poverty guidelines shall be implemented on the first day of July following 
68.25 	publication of the changes.
68.26 	(d) For purposes of paragraph (b), "income" means the adjusted gross income of the 
68.27 	natural or adoptive parents determined according to the previous year's federal tax form, 
68.28 	except, effective retroactive to July 1, 2003, taxable capital gains to the extent the funds 
68.29 	have been used to purchase a home shall not be counted as income.
68.30 	(e) The contribution shall be explained in writing to the parents at the time eligibility 
68.31 	for services is being determined. The contribution shall be made on a monthly basis effective 
68.32 	with the first month in which the child receives services. Annually upon redetermination 
68.33 	or at termination of eligibility, if the contribution exceeded the cost of services provided, 
68.34 	the local agency or the state shall reimburse that excess amount to the parents, either by 
69.1 	direct reimbursement if the parent is no longer required to pay a contribution, or by a 
69.2 	reduction in or waiver of parental fees until the excess amount is exhausted. All 
69.3 	reimbursements must include a notice that the amount reimbursed may be taxable income 
69.4 	if the parent paid for the parent's fees through an employer's health care flexible spending 
69.5 	account under the Internal Revenue Code, section 125, and that the parent is responsible 
69.6 	for paying the taxes owed on the amount reimbursed.
69.7 	(f) The monthly contribution amount must be reviewed at least every 12 months; when 
69.8 	there is a change in household size; and when there is a loss of or gain in income from one 
69.9 	month to another in excess of ten percent. The local agency shall mail a written notice 30 
69.10 	days in advance of the effective date of a change in the contribution amount. A decrease in 
69.11 	the contribution amount is effective in the month that the parent verifies a reduction in 
69.12 	income or change in household size.
69.13 	(g) Parents of a minor child who do not live with each other shall each pay the 
69.14 	contribution required under paragraph (a). An amount equal to the annual court-ordered 
69.15 	child support payment actually paid on behalf of the child receiving services shall be deducted 
69.16 	from the adjusted gross income of the parent making the payment prior to calculating the 
69.17 	parental contribution under paragraph (b).
69.18 	(h) The contribution under paragraph (b) shall be increased by an additional five percent 
69.19 	if the local agency determines that insurance coverage is available but not obtained for the 
69.20 	child. For purposes of this section, "available" means the insurance is a benefit of employment 
69.21 	for a family member at an annual cost of no more than five percent of the family's annual 
69.22 	income. For purposes of this section, "insurance" means health and accident insurance 
69.23 	coverage, enrollment in a nonprofit health service plan, health maintenance organization, 
69.24 	self-insured plan, or preferred provider organization.
69.25 	Parents who have more than one child receiving services shall not be required to pay 
69.26 	more than the amount for the child with the highest expenditures. There shall be no resource 
69.27 	contribution from the parents. The parent shall not be required to pay a contribution in 
69.28 	excess of the cost of the services provided to the child, not counting payments made to 
69.29 	school districts for education-related services. Notice of an increase in fee payment must 
69.30 	be given at least 30 days before the increased fee is due.
69.31 	(i) The contribution under paragraph (b) shall be reduced by $300 per fiscal year if, in 
69.32 	the 12 months prior to July 1:
69.33 	(1) the parent applied for insurance for the child;
69.34 	(2) the insurer denied insurance;
70.1 	(3) the parents submitted a complaint or appeal, in writing to the insurer, submitted a 
70.2 	complaint or appeal, in writing, to the commissioner of health or the commissioner of 
70.3 	commerce, or litigated the complaint or appeal; and
70.4 	(4) as a result of the dispute, the insurer reversed its decision and granted insurance.
70.5 	For purposes of this section, "insurance" has the meaning given in paragraph (h).
70.6 	A parent who has requested a reduction in the contribution amount under this paragraph 
70.7 	shall submit proof in the form and manner prescribed by the commissioner or county agency, 
70.8 	including, but not limited to, the insurer's denial of insurance, the written letter or complaint 
70.9 	of the parents, court documents, and the written response of the insurer approving insurance. 
70.10 	The determinations of the commissioner or county agency under this paragraph are not rules 
70.11 	subject to chapter 14.

70.12 	Sec. 2. [256.4751] PARENT-TO-PARENT PEER SUPPORT GRANTS.
70.13 	(a) The commissioner shall make available grants to organizations to support 
70.14 	parent-to-parent peer support programs that provide information and emotional support for 
70.15 	families of children and youth with special health care needs.
70.16 	(b) For the purposes of this section, "special health care needs" means disabilities, chronic 
70.17 	illnesses or conditions, health-related educational or behavioral problems, or the risk of 
70.18 	developing disabilities, conditions, illnesses, or problems.
70.19 	(c) Eligible organizations must have an established parent-to-parent program that:
70.20 	(1) conducts outreach and support to parents or guardians of a child or youth with special 
70.21 	health care needs;
70.22 	(2) provides to parents and guardians information, tools, and training to support their 
70.23 	child and to successfully navigate the health and human services systems;
70.24 	(3) facilitates ongoing peer support for parents and guardians from trained volunteer 
70.25 	support parents;
70.26 	(4) has staff and volunteers located statewide; and
70.27 	(5) is affiliated with and communicates regularly with other parent-to-parent programs 
70.28 	and national organizations to ensure best practices are implemented.
70.29 	(d) Grant recipients must use grant funds for the purposes in paragraph (c).
70.30 	(e) Grant recipients must report to the commissioner of human services annually by 
70.31 	January 15 on the services and programs funded by the appropriation. The report must 
71.1 	include measurable outcomes from the previous year, including the number of families 
71.2 	served and the number of volunteer support parents trained.

71.3 	Sec. 3. Minnesota Statutes 2018, section 256B.14, subdivision 2, is amended to read:
71.4 		Subd. 2.Actions to obtain payment. The state agency shall promulgate rules to 
71.5 	determine the ability of responsible relatives to contribute partial or complete payment or 
71.6 	repayment of medical assistance furnished to recipients for whom they are responsible. All 
71.7 	medical assistance exclusions shall be allowed, and a resource limit of $10,000 for 
71.8 	nonexcluded resources shall be implemented. Above these limits, a contribution of one-third 
71.9 	of the excess resources shall be required. These rules shall not require payment or repayment 
71.10 	when payment would cause undue hardship to the responsible relative or that relative's 
71.11 	immediate family. These rules shall be consistent with the requirements of section 252.27
71.12 	for not apply to parents of children whose eligibility for medical assistance was determined 
71.13 	without deeming of the parents' resources and income under the TEFRA option or for the 
71.14 	purposes of accessing home and community-based waiver services. The county agency 
71.15 	shall give the responsible relative notice of the amount of the payment or repayment. If the 
71.16 	state agency or county agency finds that notice of the payment obligation was given to the 
71.17 	responsible relative, but that the relative failed or refused to pay, a cause of action exists 
71.18 	against the responsible relative for that portion of medical assistance granted after notice 
71.19 	was given to the responsible relative, which the relative was determined to be able to pay.
71.20 	The action may be brought by the state agency or the county agency in the county where 
71.21 	assistance was granted, for the assistance, together with the costs of disbursements incurred 
71.22 	due to the action.
71.23 	In addition to granting the county or state agency a money judgment, the court may, 
71.24 	upon a motion or order to show cause, order continuing contributions by a responsible 
71.25 	relative found able to repay the county or state agency. The order shall be effective only 
71.26 	for the period of time during which the recipient receives medical assistance from the county 
71.27 	or state agency.

71.28 	Sec. 4. Minnesota Statutes 2018, section 256M.41, subdivision 3, is amended to read:
71.29 		Subd. 3.Payments based on performance. (a) The commissioner shall make payments 
71.30 	under this section to each county board on a calendar year basis in an amount determined 
71.31 	under paragraph (b) on or before July 10 of each year.
71.32 	(b) Calendar year allocations under subdivision 1 shall be paid to counties in the following 
71.33 	manner:
72.1 	(1) 80 percent of the allocation as determined in subdivision 1 must be paid to counties 
72.2 	on or before July 10 of each year;
72.3 	(2) ten percent of the allocation shall be withheld until the commissioner determines if 
72.4 	the county has met the performance outcome threshold of 90 percent based on face-to-face 
72.5 	contact with alleged child victims. In order to receive the performance allocation, the county 
72.6 	child protection workers must have a timely face-to-face contact with at least 90 percent of 
72.7 	all alleged child victims of screened-in maltreatment reports. The standard requires that 
72.8 	each initial face-to-face contact occur consistent with timelines defined in section 626.556, 
72.9 	subdivision 10, paragraph (i). The commissioner shall make threshold determinations in 
72.10 	January of each year and payments to counties meeting the performance outcome threshold 
72.11 	shall occur in February of each year. Any withheld funds from this appropriation for counties 
72.12 	that do not meet this requirement shall be reallocated by the commissioner to those counties 
72.13 	meeting the requirement; and
72.14 	(3) ten percent of the allocation shall be withheld until the commissioner determines 
72.15 	that the county has met the performance outcome threshold of 90 percent based on 
72.16 	face-to-face visits by the case manager. In order to receive the performance allocation, the 
72.17 	total number of visits made by caseworkers on a monthly basis to children in foster care 
72.18 	and children receiving child protection services while residing in their home must be at least 
72.19 	90 percent of the total number of such visits that would occur if every child were visited 
72.20 	once per month. The commissioner shall make such determinations in January of each year 
72.21 	and payments to counties meeting the performance outcome threshold shall occur in February 
72.22 	of each year. Any withheld funds from this appropriation for counties that do not meet this 
72.23 	requirement shall be reallocated by the commissioner to those counties meeting the 
72.24 	requirement. For 2015, the commissioner shall only apply the standard for monthly foster 
72.25 	care visits.
72.26 	(c) The commissioner shall work with stakeholders and the Human Services Performance 
72.27 	Council under section 402A.16 to develop recommendations for specific outcome measures 
72.28 	that counties should meet in order to receive funds withheld under paragraph (b), and include 
72.29 	in those recommendations a determination as to whether the performance measures under 
72.30 	paragraph (b) should be modified or phased out. The commissioner shall report the 
72.31 	recommendations to the legislative committees having jurisdiction over child protection 
72.32 	issues by January 1, 2018.

73.1 	Sec. 5. Minnesota Statutes 2018, section 256M.41, is amended by adding a subdivision 
73.2 	to read:
73.3 		Subd. 4.County performance on child protection measures. The commissioner shall 
73.4 	set child protection measures and standards. The commissioner shall require an 
73.5 	underperforming county to demonstrate that the county designated sufficient funds and 
73.6 	implemented a reasonable strategy to improve child protection performance, including the 
73.7 	provision of a performance improvement plan and additional remedies identified by the 
73.8 	commissioner. The commissioner may redirect up to 20 percent of a county's funds under 
73.9 	this section toward the performance improvement plan. Sanctions under section 256M.20, 
73.10 	subdivision 3, related to noncompliance with federal performance standards also apply.

73.11 	Sec. 6. [260C.216] FOSTER CARE RECRUITMENT GRANT PROGRAM.
73.12 		Subdivision 1.Establishment and authority. The commissioner of human services 
73.13 	shall make grants to facilitate partnerships between counties and community groups or faith 
73.14 	communities to develop and utilize innovative, nontraditional shared recruitment methods 
73.15 	to increase and stabilize the number of available foster care families.
73.16 		Subd. 2.Eligibility. An eligible applicant for a foster care recruitment grant under 
73.17 	subdivision 1 is an organization or entity that:
73.18 	(1) provides a written description identifying the county and community organizations 
73.19 	or faith communities that will partner to develop innovative shared methods to recruit 
73.20 	families through their community or faith organizations for foster care in the county;
73.21 	(2) agrees to incorporate efforts by the partnership or a third party to offer additional 
73.22 	support services including host families, family coaches, or resource referrals for families 
73.23 	in crisis such as homelessness, unemployment, hospitalization, substance abuse treatment, 
73.24 	incarceration, or domestic violence, as an alternative to foster care; and
73.25 	(3) describes how the proposed partnership model can be generalized to be used in other 
73.26 	areas of the state.
73.27 		Subd. 3.Allowable grant activities. Grant recipients may use grant funds to:
73.28 	(1) develop materials that promote the partnership's innovative methods of nontraditional 
73.29 	recruitment of foster care families through the partner community organizations or faith 
73.30 	communities;
74.1 	(2) develop an onboarding vehicle or training program for recruited foster care families 
74.2 	that is accessible, relatable, and easy to understand, to be used by the partner community 
74.3 	organizations or faith communities;
74.4 	(3) establish sustainable communication between the partnership and the recruited 
74.5 	families for ongoing support; or
74.6 	(4) provide support services including host families, family coaches, or resource referrals 
74.7 	for families in crisis such as homelessness, unemployment, hospitalization, substance abuse 
74.8 	treatment, incarceration, or domestic violence, as an alternative to the foster care system.
74.9 		Subd. 4.Reporting The commissioner shall report on the use of foster care recruitment 
74.10 	grants to the chairs and ranking minority members of the legislative committees with 
74.11 	jurisdiction over human services by December 31, 2020. The report shall include the name 
74.12 	and location of grant recipients, the amount of each grant, the services provided, and the 
74.13 	effects on the foster care system. The commissioner shall determine the form required for 
74.14 	the report and may specify additional reporting requirements.
74.15 		Subd. 5.Funding. The commissioner of human services may use available parent support 
74.16 	outreach program funds for foster care recruitment grants under Minnesota Statutes, section 
74.17 	260C.216.

74.18 	Sec. 7. [260C.218] PARENT SUPPORT FOR BETTER OUTCOMES GRANTS.
74.19 	The commissioner of human services may use available parent support outreach program 
74.20 	funds to provide mentoring, guidance, and support services to parents navigating the child 
74.21 	welfare system in Minnesota, in order to promote the development of safe, stable, and 
74.22 	healthy families, including  parent mentoring, peer-to-peer support groups, housing support 
74.23 	services, training, staffing, and administrative costs.

74.24 	Sec. 8. Minnesota Statutes 2018, section 518A.32, subdivision 3, is amended to read:
74.25 		Subd. 3.Parent not considered voluntarily unemployed, underemployed, or employed 
74.26 	on a less than full-time basis. A parent is not considered voluntarily unemployed, 
74.27 	underemployed, or employed on a less than full-time basis upon a showing by the parent 
74.28 	that:
74.29 	(1) the unemployment, underemployment, or employment on a less than full-time basis 
74.30 	is temporary and will ultimately lead to an increase in income;
75.1 	(2) the unemployment, underemployment, or employment on a less than full-time basis 
75.2 	represents a bona fide career change that outweighs the adverse effect of that parent's 
75.3 	diminished income on the child; or
75.4 	(3) the unemployment, underemployment, or employment on a less than full-time basis 
75.5 	is because a parent is physically or mentally incapacitated or due to incarceration, except 
75.6 	where the reason for incarceration is the parent's nonpayment of support.

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

75.8 	Sec. 9. Minnesota Statutes 2018, section 518A.51, is amended to read:
75.9 	518A.51 FEES FOR IV-D SERVICES.
75.10 	(a) When a recipient of IV-D services is no longer receiving assistance under the state's 
75.11 	title IV-A, IV-E foster care, or medical assistance programs, the public authority responsible 
75.12 	for child support enforcement must notify the recipient, within five working days of the 
75.13 	notification of ineligibility, that IV-D services will be continued unless the public authority 
75.14 	is notified to the contrary by the recipient. The notice must include the implications of 
75.15 	continuing to receive IV-D services, including the available services and fees, cost recovery 
75.16 	fees, and distribution policies relating to fees.
75.17 	(b) In the case of an individual who has never received assistance under a state program 
75.18 	funded under title IV-A of the Social Security Act and for whom the public authority has 
75.19 	collected at least $500 $550 of support, the public authority must impose an annual federal 
75.20 	collections fee of $25 $35 for each case in which services are furnished. This fee must be 
75.21 	retained by the public authority from support collected on behalf of the individual, but not 
75.22 	from the first $500 $550 collected.
75.23 	(c) When the public authority provides full IV-D services to an obligee who has applied 
75.24 	for those services, upon written notice to the obligee, the public authority must charge a 
75.25 	cost recovery fee of two percent of the amount collected. This fee must be deducted from 
75.26 	the amount of the child support and maintenance collected and not assigned under section 
75.27 	256.741 before disbursement to the obligee. This fee does not apply to an obligee who:
75.28 	(1) is currently receiving assistance under the state's title IV-A, IV-E foster care, or 
75.29 	medical assistance programs; or
75.30 	(2) has received assistance under the state's title IV-A or IV-E foster care programs, 
75.31 	until the person has not received this assistance for 24 consecutive months.
76.1 	(d) When the public authority provides full IV-D services to an obligor who has applied 
76.2 	for such services, upon written notice to the obligor, the public authority must charge a cost 
76.3 	recovery fee of two percent of the monthly court-ordered child support and maintenance 
76.4 	obligation. The fee may be collected through income withholding, as well as by any other 
76.5 	enforcement remedy available to the public authority responsible for child support 
76.6 	enforcement.
76.7 	(e) Fees assessed by state and federal tax agencies for collection of overdue support 
76.8 	owed to or on behalf of a person not receiving public assistance must be imposed on the 
76.9 	person for whom these services are provided. The public authority upon written notice to 
76.10 	the obligee shall assess a fee of $25 to the person not receiving public assistance for each 
76.11 	successful federal tax interception. The fee must be withheld prior to the release of the funds 
76.12 	received from each interception and deposited in the general fund.
76.13 	(f) Federal collections fees collected under paragraph (b) and cost recovery fees collected 
76.14 	under paragraphs (c) and (d) retained by the commissioner of human services shall be 
76.15 	considered child support program income according to Code of Federal Regulations, title 
76.16 	45, section 304.50, and shall be deposited in the special revenue fund account established 
76.17 	under paragraph (h). The commissioner of human services must elect to recover costs based 
76.18 	on either actual or standardized costs.
76.19 	(g) The limitations of this section on the assessment of fees shall not apply to the extent 
76.20 	inconsistent with the requirements of federal law for receiving funds for the programs under 
76.21 	title IV-A and title IV-D of the Social Security Act, United States Code, title 42, sections 
76.22 	601 to 613 and United States Code, title 42, sections 651 to 662.
76.23 	(h) The commissioner of human services is authorized to establish a special revenue 
76.24 	fund account to receive the federal collections fees collected under paragraph (b) and cost 
76.25 	recovery fees collected under paragraphs (c) and (d).
76.26 	(i) The nonfederal share of the cost recovery fee revenue must be retained by the 
76.27 	commissioner and distributed as follows:
76.28 	(1) one-half of the revenue must be transferred to the child support system special revenue 
76.29 	account to support the state's administration of the child support enforcement program and 
76.30 	its federally mandated automated system;
76.31 	(2) an additional portion of the revenue must be transferred to the child support system 
76.32 	special revenue account for expenditures necessary to administer the fees; and
77.1 	(3) the remaining portion of the revenue must be distributed to the counties to aid the 
77.2 	counties in funding their child support enforcement programs.
77.3 	(j) The nonfederal share of the federal collections fees must be distributed to the counties 
77.4 	to aid them in funding their child support enforcement programs.
77.5 	(k) The commissioner of human services shall distribute quarterly any of the funds 
77.6 	dedicated to the counties under paragraphs (i) and (j) using the methodology specified in 
77.7 	section 256.979, subdivision 11. The funds received by the counties must be reinvested in 
77.8 	the child support enforcement program and the counties must not reduce the funding of 
77.9 	their child support programs by the amount of the funding distributed.

77.10 	EFFECTIVE DATE. This section is effective October 1, 2019.

77.11 	Sec. 10. DIRECTION TO COMMISSIONER OF HUMAN SERVICES; TEFRA 
77.12 	OPTION IMPROVEMENT MEASURES.
 77.13 	(a) The commissioner of human services shall, using existing appropriations, develop 
77.14 	content to be included on the MNsure website explaining the TEFRA option under medical 
77.15 	assistance for applicants who indicate during the application process that a child in the 
77.16 	family has a disability.
77.17 	(b) The commissioner shall develop a cover letter explaining the TEFRA option under 
77.18 	medical assistance, as well as the application and renewal process, to be disseminated with 
77.19 	the DHS-6696A form to applicants who may qualify for medical assistance under the TEFRA 
77.20 	option. The commissioner shall provide the content and the form to the executive director 
77.21 	of MNsure for inclusion on the MNsure website. The commissioner shall also develop and 
77.22 	implement education and training for lead agency staff statewide to improve understanding 
77.23 	of the medical assistance-TEFRA enrollment and renewal processes and procedures.
77.24 	(c) The commissioner shall convene a stakeholder group that shall consider improvements 
77.25 	to the TEFRA option enrollment and renewal processes, including but not limited to revisions 
77.26 	to, or the development of, application and renewal paperwork specific to the TEFRA option; 
77.27 	possible technology solutions; and county processes.
77.28 	(d) The stakeholder group must include representatives from the Department of Human 
77.29 	Services Health Care Division, MNsure, representatives from at least two counties in the 
77.30 	metropolitan area and from at least one county in greater Minnesota, the Arc Minnesota, 
77.31 	Gillette Children's Specialty Healthcare, the Autism Society of Minnesota, Proof Alliance, 
77.32 	the Minnesota Consortium for Citizens with Disabilities, and other interested stakeholders 
77.33 	as identified by the commissioner of human services.
78.1 	(e) The stakeholder group shall submit a report of the group's recommended 
78.2 	improvements and any associated costs to the commissioner by December 31, 2020. The 
78.3 	group shall also provide copies of the report to each stakeholder group member. The 
78.4 	commissioner shall provide a copy of the report to the legislative committees with jurisdiction 
78.5 	over medical assistance.

78.6 	Sec. 11. MINNESOTA PATHWAYS TO PROSPERITY AND WELL-BEING PILOT 
78.7 	PROJECT.
 78.8 		Subdivision 1.Authorization. (a) The commissioner of human services shall develop 
78.9 	a pilot project that tests an alternative benefit delivery system for the distribution of public 
78.10 	assistance benefits. The commissioner shall work with Dakota County and Olmsted County 
78.11 	to develop the pilot project in accordance with this section. The commissioner shall apply 
78.12 	for any federal waivers necessary to implement the pilot project.
78.13 	(b) Prior to authorizing the pilot project, Dakota and Olmsted Counties must provide 
78.14 	the following information to the commissioner:
78.15 	(1) identification of any federal waivers required to implement the pilot project and a 
78.16 	timeline for obtaining the waivers;
78.17 	(2) identification of data sharing requirements between the counties and the commissioner 
78.18 	to administer the pilot project and evaluate the outcome measures under subdivision 4, 
78.19 	including the technology systems that will be developed to administer the pilot project and 
78.20 	a description of the elements of the technology systems that will ensure the privacy of the 
78.21 	data of the participants and provide financial oversight and accountability for expended 
78.22 	funds;
78.23 	(3) documentation that demonstrates receipt of private donations or grants totaling at 
78.24 	least $2,800,000 per year for three years to support implementation of the pilot project;
78.25 	(4) a complete plan for implementing the pilot project, including an assurance that each 
78.26 	participant's unified benefit amount is proportionate to and in no event exceeds the total 
78.27 	amount that the participant would have received by participating in the underlying programs 
78.28 	for which they are eligible upon entering the pilot project, information about the 
78.29 	administration of the unified benefit amount to ensure that the benefit is used by participants 
78.30 	for the services provided through the underlying programs included in the unified benefit, 
78.31 	an explanation of which funds will be issued directly to providers and which funds will be 
78.32 	available on an EBT card, and information about consequences and remedies for improper 
78.33 	use of the unified benefit;
79.1 	(5) an evaluation plan developed in consultation with the commissioner of management 
79.2 	and budget to ensure that the pilot project includes an evaluation using an experimental or 
79.3 	quasi-experimental design and a formal evaluation of the results of the pilot project; and
79.4 	(6) documentation that demonstrates the receipt of a formal commitment of grants or 
79.5 	contracts with the federal government to complete a comprehensive evaluation of the pilot 
79.6 	project.
79.7 	(c) The commissioner may authorize the pilot project only after reviewing the information 
79.8 	submitted under paragraph (b) and issuing a formal written approval of the proposed project.
79.9 		Subd. 2.Pilot project goals. The goals of the pilot project are to:
79.10 	(1) reduce the historical separation among the state programs and systems affecting 
79.11 	families who may receive public assistance;
79.12 	(2) eliminate, where possible, regulatory or program restrictions to allow a comprehensive 
79.13 	approach to meeting the needs of the families in the pilot project; and
79.14 	(3) focus on prevention-oriented supports and interventions.
79.15 		Subd. 3.Pilot project participants. The pilot project developed by the commissioner 
79.16 	must include requirements that participants:
79.17 	(1) be 30 years of age or younger with a minimum of one child and income below 200 
79.18 	percent of federal poverty guidelines;
79.19 	(2) voluntarily agree to participate in the pilot project;
79.20 	(3) be informed of the right to voluntarily discontinue participation in the pilot project;
79.21 	(4) be eligible for or receiving assistance under the Minnesota family investment program 
79.22 	under Minnesota Statutes, chapter 256J, and at least one of the following programs: (i) the 
79.23 	child care assistance program under Minnesota Statutes, chapter 119B; (ii) the diversionary 
79.24 	work program under Minnesota Statutes, section 256J.95; (iii) the supplemental nutrition 
79.25 	assistance program under Minnesota Statutes, chapter 256D; or (iv) state or federal housing 
79.26 	support;
79.27 	(5) provide informed, written consent that the participant waives eligibility for the 
79.28 	programs included in the unified benefit set for the duration of their participation in the 
79.29 	pilot project;
79.30 	(6) be enrolled in an education program that is focused on obtaining a career that will 
79.31 	result in a livable wage;
80.1 	(7) receive as the unified benefit only an amount that is proportionate to and does not 
80.2 	exceed the total value of the benefits the participant would be eligible to receive under the 
80.3 	underlying programs upon entering the pilot project; and
80.4 	(8) shall not have the unified benefit amount counted as income for child support or tax 
80.5 	purposes.
80.6 		Subd. 4.Outcomes. (a) The outcome measures for the pilot project must be developed 
80.7 	in consultation with the commissioner of management and budget, and must include:
80.8 	(1) improvement in the affordability, safety, and permanence of suitable housing;
80.9 	(2) improvement in family functioning and stability, including the areas of behavioral 
80.10 	health, incarceration, involvement with the child welfare system;
80.11 	(3) improvement in education readiness and outcomes for parents and children from 
80.12 	early childhood through high school, including reduction in absenteeism, preschool readiness 
80.13 	scores, third grade reading competency, graduation, grade point average, and standardized 
80.14 	test improvement;
80.15 	(4) improvement in attachment to the workforce of one or both parents, including 
80.16 	enhanced job stability; wage gains; career advancement; and progress in career preparation; 
80.17 	and
80.18 	(5) improvement in health care access and health outcomes for parents and children and 
80.19 	other outcomes determined in consultation with the commissioner of human services and 
80.20 	the commissioner of management and budget.
80.21 	(b) Dakota and Olmsted Counties shall report on the progress and outcomes of the pilot 
80.22 	project to the chairs and ranking minority members of the legislative committees with 
80.23 	jurisdiction over human services by January 15 of each year that the pilot project operates, 
80.24 	beginning January 15, 2021.

80.25 	Sec. 12. DIRECTION TO COMMISSIONER; CHILD CARE ASSISTANCE 
80.26 	PROGRAM REDESIGN.
 80.27 	(a) By January 15, 2020, the commissioner of human services shall, following 
80.28 	consultation with families, providers, and county agencies, report to the chairs and ranking 
80.29 	minority members of the legislative committees having jurisdiction over child care with a 
80.30 	proposal, for implementation by July 1, 2020, that redesigns the child care assistance program 
80.31 	to meet all applicable federal requirements, achieve at least the following objectives, and 
80.32 	include at least the following features:
81.1 	(1) eliminates fraud;
81.2 	(2) eliminates program inefficiencies;
81.3 	(3) eliminates barriers to families entering the program;
81.4 	(4) improves accessibility to child care for families in greater Minnesota and in the 
81.5 	metropolitan area;
81.6 	(5) improves the quality of available child care;
81.7 	(6) eliminates assistance rate disparities between greater Minnesota and the metropolitan 
81.8 	area;
81.9 	(7) ensures future access to assistance and child care for families in greater Minnesota 
81.10 	and in the metropolitan area;
81.11 	(8) develops additional options for providers to complete required training including 
81.12 	through online or remote access;
81.13 	(9) improves ease of provider access to required training and quality improvement 
81.14 	resources;
81.15 	(10) reforms the Parent Aware program, including by removing barriers to participation 
81.16 	for family child care providers, by implementing a method for evaluating the quality and 
81.17 	effectiveness of four-star rated programs, and by incorporating licensing violations, sanctions, 
81.18 	or maltreatment determinations into the star-rating program standards;
81.19 	(11) proposes legislation that codifies Parent Aware program standards;
81.20 	(12) implements a licensing and inspection structure based on differential monitoring;
81.21 	(13) amends licensing requirements that have led to closure of child care programs, 
81.22 	especially family child care programs;
81.23 	(14) recommends business development and technical assistance resources to promote 
81.24 	provider recruitment and retention;
81.25 	(15) allows for family child care licensing alternatives, including permitting multiple 
81.26 	family child care providers to operate in a commercial or other building other than the 
81.27 	providers' residences; and
81.28 	(16) improves family child care licensing efficiencies, including by adding a variance 
81.29 	structure and updating child ratios.
81.30 	(b) The commissioner shall seek all necessary federal waivers to implement the proposed 
81.31 	redesign described in paragraph (a), including to authorize use of existing federal funding.

82.1 	Sec. 13. APPROPRIATION; CHILD CARE ASSISTANCE PROGRAM REDESIGN.
 82.2 	$236,453,000 is appropriated in fiscal year 2022 from the general fund to the 
82.3 	commissioner of human services for the redesigned child care assistance program. This is 
82.4 	a onetime appropriation and is available until June 30, 2023.

82.5 	Sec. 14. REVISOR INSTRUCTION.
 82.6 	The revisor of statutes, in consultation with the Department of Human Services, House 
82.7 	Research Department, and Senate Counsel, Research and Fiscal Analysis shall change the 
82.8 	terms "food support" and "food stamps" to "Supplemental Nutrition Assistance Program" 
82.9 	or "SNAP" in Minnesota Statutes when appropriate. The revisor may make technical and 
82.10 	other necessary changes to sentence structure to preserve the meaning of the text.

82.11 	Sec. 15. REVISOR INSTRUCTION.
 82.12 	The revisor of statutes shall remove the terms "child care assistance program," "basic 
82.13 	sliding fee child care," and "MFIP child care," or similar terms wherever the terms appear 
82.14 	in Minnesota Statutes. The revisor shall also make technical and other necessary changes 
82.15 	to sentence structure to preserve the meaning of the text.

82.16 	EFFECTIVE DATE. This section is effective July 1, 2020.

82.17 	Sec. 16. REPEALER.
 82.18 	(a) Minnesota Statutes 2018, sections 119B.011, subdivisions 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 
82.19 	10a, 11, 12, 13, 13a, 14, 15, 16, 17, 18, 19, 19a, 19b, 20, 20a, 21, and 22; 119B.02; 119B.025, 
82.20 	subdivisions 1, 2, 3, and 4; 119B.03, subdivisions 1, 2, 3, 4, 5, 6, 6a, 6b, 8, 9, and 10; 
82.21 	119B.035; 119B.04; 119B.05, subdivisions 1, 4, and 5; 119B.06, subdivisions 1, 2, and 3; 
82.22 	119B.08, subdivisions 1, 2, and 3; 119B.09, subdivisions 1, 3, 4, 4a, 5, 6, 7, 8, 9, 9a, 10, 
82.23 	11, 12, and 13; 119B.095; 119B.097; 119B.10, subdivisions 1, 2, and 3; 119B.105; 119B.11, 
82.24 	subdivisions 1, 2a, 3, and 4; 119B.12, subdivisions 1 and 2; 119B.125; 119B.13, subdivisions 
82.25 	1, 1a, 3, 3a, 3b, 3c, 4, 5, 6, and 7; 119B.14; 119B.15; and 119B.16, are repealed effective 
82.26 	July 1, 2020.
82.27 	(b) Minnesota Rules, parts 3400.0010; 3400.0020, subparts 1, 4, 5, 8, 9a, 10a, 12, 17a, 
82.28 	18, 18a, 20, 24, 25, 26, 28, 29a, 31b, 32b, 33, 34a, 35, 37, 38, 38a, 38b, 39, 40, 40a, and 
82.29 	44; 3400.0030; 3400.0035; 3400.0040, subparts 1, 3, 4, 5, 5a, 6a, 6b, 6c, 7, 8, 9, 10, 11, 12, 
82.30 	13, 14, 15, 15a, 17, and 18; 3400.0060, subparts 2, 4, 5, 6, 6a, 7, 8, 9, and 10; 3400.0080, 
82.31 	subparts 1, 1a, 1b, and 8; 3400.0090, subparts 1, 2, 3, and 4; 3400.0100, subparts 2a, 2b, 
82.32 	2c, and 5; 3400.0110, subparts 1, 1a, 2, 2a, 3, 4a, 7, 8, 9, 10, and 11; 3400.0120, subparts 
83.1 	1, 1a, 2, 2a, 3, and 5; 3400.0130, subparts 1, 1a, 2, 3, 3a, 3b, 5, 5a, and 7; 3400.0140, subparts 
83.2 	1, 2, 4, 5, 6, 7, 8, 9, 9a, 10, and 14; 3400.0150; 3400.0170, subparts 1, 3, 4, 6a, 7, 8, 9, 10, 
83.3 	and 11; 3400.0180; 3400.0183, subparts 1, 2, and 5; 3400.0185; 3400.0187, subparts 1, 2, 
83.4 	3, 4, and 6; 3400.0200; 3400.0220; 3400.0230, subpart 3; and 3400.0235, subparts 1, 2, 3, 
83.5 	4, 5, and 6, are repealed are  effective July 1, 2020.
83.6 	(c) Laws 2017, First Special Session chapter 6, article 7, section 34, is repealed effective 
83.7 	July 1, 2019.

83.8 	ARTICLE 3
83.9 	CHEMICAL AND MENTAL HEALTH

83.10 	Section 1. Minnesota Statutes 2018, section 13.851, is amended by adding a subdivision 
83.11 	to read:
83.12 		Subd. 11.Mental health data sharing. Section 641.15, subdivision 3a, governs the 
83.13 	sharing of data on prisoners who may have a mental illness or need services with county 
83.14 	social service agencies or welfare system personnel.

83.15 	Sec. 2. Minnesota Statutes 2018, section 245.4889, subdivision 1, is amended to read:
83.16 		Subdivision 1.Establishment and authority. (a) The commissioner is authorized to 
83.17 	make grants from available appropriations to assist:
83.18 	(1) counties;
83.19 	(2) Indian tribes;
83.20 	(3) children's collaboratives under section 124D.23 or 245.493; or
83.21 	(4) mental health service providers.
83.22 	(b) The following services are eligible for grants under this section:
83.23 	(1) services to children with emotional disturbances as defined in section 245.4871, 
83.24 	subdivision 15, and their families;
83.25 	(2) transition services under section 245.4875, subdivision 8, for young adults under 
83.26 	age 21 and their families;
83.27 	(3) respite care services for children with severe emotional disturbances who are at risk 
83.28 	of out-of-home placement, whether or not the child is receiving case management services;
83.29 	(4) children's mental health crisis services;
83.30 	(5) mental health services for people from cultural and ethnic minorities;
84.1 	(6) children's mental health screening and follow-up diagnostic assessment and treatment;
84.2 	(7) services to promote and develop the capacity of providers to use evidence-based 
84.3 	practices in providing children's mental health services;
84.4 	(8) school-linked mental health services, including transportation for children receiving 
84.5 	school-linked mental health services when school is not in session;
84.6 	(9) building evidence-based mental health intervention capacity for children birth to age 
84.7 	five;
84.8 	(10) suicide prevention and counseling services that use text messaging statewide;
84.9 	(11) mental health first aid training;
84.10 	(12) training for parents, collaborative partners, and mental health providers on the 
84.11 	impact of adverse childhood experiences and trauma and development of an interactive 
84.12 	website to share information and strategies to promote resilience and prevent trauma;
84.13 	(13) transition age services to develop or expand mental health treatment and supports 
84.14 	for adolescents and young adults 26 years of age or younger;
84.15 	(14) early childhood mental health consultation;
84.16 	(15) evidence-based interventions for youth at risk of developing or experiencing a first 
84.17 	episode of psychosis, and a public awareness campaign on the signs and symptoms of 
84.18 	psychosis;
84.19 	(16) psychiatric consultation for primary care practitioners; and
84.20 	(17) providers to begin operations and meet program requirements when establishing a 
84.21 	new children's mental health program. These may be start-up grants.; and
84.22 	(18) promoting and developing a provider's capacity to deliver multigenerational mental 
84.23 	health treatment and services.
84.24 	(c) Services under paragraph (b) must be designed to help each child to function and 
84.25 	remain with the child's family in the community and delivered consistent with the child's 
84.26 	treatment plan. Transition services to eligible young adults under this paragraph must be 
84.27 	designed to foster independent living in the community.

84.28 	Sec. 3. Minnesota Statutes 2018, section 254A.03, subdivision 3, is amended to read:
84.29 		Subd. 3.Rules for substance use disorder care. (a) The commissioner of human 
84.30 	services shall establish by rule criteria to be used in determining the appropriate level of 
84.31 	chemical dependency care for each recipient of public assistance seeking treatment for 
85.1 	substance misuse or substance use disorder. Upon federal approval of a comprehensive 
85.2 	assessment as a Medicaid benefit, or on July 1, 2018, whichever is later, and notwithstanding 
85.3 	the criteria in Minnesota Rules, parts 9530.6600 to 9530.6655, an eligible vendor of 
85.4 	comprehensive assessments under section 254B.05 may determine and approve the 
85.5 	appropriate level of substance use disorder treatment for a recipient of public assistance. 
85.6 	The process for determining an individual's financial eligibility for the consolidated chemical 
85.7 	dependency treatment fund or determining an individual's enrollment in or eligibility for a 
85.8 	publicly subsidized health plan is not affected by the individual's choice to access a 
85.9 	comprehensive assessment for placement.
85.10 	(b) The commissioner shall develop and implement a utilization review process for 
85.11 	publicly funded treatment placements to monitor and review the clinical appropriateness 
85.12 	and timeliness of all publicly funded placements in treatment.
85.13 	(c) If a screen result is positive for alcohol or substance misuse, a brief screening for 
85.14 	alcohol or substance use disorder that is provided to a recipient of public assistance within 
85.15 	a primary care clinic, hospital, or other medical setting or school setting establishes medical 
85.16 	necessity and approval for an initial set of substance use disorder services identified in 
85.17 	section 254B.05, subdivision 5. The initial set of services approved for a recipient whose 
85.18 	screen result is positive may include four hours of individual or group substance use disorder 
85.19 	treatment, two hours of substance use disorder treatment coordination, or two hours of 
85.20 	substance use disorder peer support services provided by a qualified individual according 
85.21 	to chapter 245G. A recipient must obtain an assessment pursuant to paragraph (a) to be 
85.22 	approved for additional treatment services.

85.23 	EFFECTIVE DATE. Contingent upon federal approval, this section is effective July 
85.24 	1, 2019. The commissioner of human services shall notify the revisor of statutes when 
85.25 	federal approval is obtained or denied.

85.26 	Sec. 4. Minnesota Statutes 2018, section 254A.19, is amended by adding a subdivision to 
85.27 	read:
85.28 		Subd. 5.Assessment via telemedicine. Notwithstanding Minnesota Rules, part 
85.29 	9530.6615, subpart 3, item A, a chemical use assessment may be conducted via telemedicine.

85.30 	Sec. 5. Minnesota Statutes 2018, section 254B.02, subdivision 1, is amended to read:
85.31 		Subdivision 1.Chemical dependency treatment allocation. The chemical dependency 
85.32 	treatment appropriation shall be placed in a special revenue account. The commissioner 
85.33 	shall annually transfer funds from the chemical dependency fund to pay for operation of 
86.1 	the drug and alcohol abuse normative evaluation system and to pay for all costs incurred 
86.2 	by adding two positions for licensing of chemical dependency treatment and rehabilitation 
86.3 	programs located in hospitals for which funds are not otherwise appropriated. The remainder 
86.4 	of the money in the special revenue account must be used according to the requirements in 
86.5 	this chapter.

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

86.7 	Sec. 6. Minnesota Statutes 2018, section 254B.03, subdivision 2, is amended to read:
86.8 		Subd. 2.Chemical dependency fund payment. (a) Payment from the chemical 
86.9 	dependency fund is limited to payments for services other than detoxification licensed under 
86.10 	Minnesota Rules, parts 9530.6510 to 9530.6590, that, if located outside of federally 
86.11 	recognized tribal lands, would be required to be licensed by the commissioner as a chemical 
86.12 	dependency treatment or rehabilitation program under sections 245A.01 to 245A.16, and 
86.13 	services other than detoxification provided in another state that would be required to be 
86.14 	licensed as a chemical dependency program if the program were in the state. Out of state 
86.15 	vendors must also provide the commissioner with assurances that the program complies 
86.16 	substantially with state licensing requirements and possesses all licenses and certifications 
86.17 	required by the host state to provide chemical dependency treatment. Vendors receiving 
86.18 	payments from the chemical dependency fund must not require co-payment from a recipient 
86.19 	of benefits for services provided under this subdivision. The vendor is prohibited from using 
86.20 	the client's public benefits to offset the cost of services paid under this section. The vendor 
86.21 	shall not require the client to use public benefits for room or board costs. This includes but 
86.22 	is not limited to cash assistance benefits under chapters 119B, 256D, and 256J, or SNAP 
86.23 	benefits. Retention of SNAP benefits is a right of a client receiving services through the 
86.24 	consolidated chemical dependency treatment fund or through state contracted managed care 
86.25 	entities. Payment from the chemical dependency fund shall be made for necessary room 
86.26 	and board costs provided by vendors certified according tomeeting the criteria under section 
86.27 	254B.05, subdivision 1a, or in a community hospital licensed by the commissioner of health 
86.28 	according to sections 144.50 to 144.56 to a client who is:
86.29 	(1) determined to meet the criteria for placement in a residential chemical dependency 
86.30 	treatment program according to rules adopted under section 254A.03, subdivision 3; and
86.31 	(2) concurrently receiving a chemical dependency treatment service in a program licensed 
86.32 	by the commissioner and reimbursed by the chemical dependency fund.
86.33 	(b) A county may, from its own resources, provide chemical dependency services for 
86.34 	which state payments are not made. A county may elect to use the same invoice procedures 
87.1 	and obtain the same state payment services as are used for chemical dependency services 
87.2 	for which state payments are made under this section if county payments are made to the 
87.3 	state in advance of state payments to vendors. When a county uses the state system for 
87.4 	payment, the commissioner shall make monthly billings to the county using the most recent 
87.5 	available information to determine the anticipated services for which payments will be made 
87.6 	in the coming month. Adjustment of any overestimate or underestimate based on actual 
87.7 	expenditures shall be made by the state agency by adjusting the estimate for any succeeding 
87.8 	month.
87.9 	(c) The commissioner shall coordinate chemical dependency services and determine 
87.10 	whether there is a need for any proposed expansion of chemical dependency treatment 
87.11 	services. The commissioner shall deny vendor certification to any provider that has not 
87.12 	received prior approval from the commissioner for the creation of new programs or the 
87.13 	expansion of existing program capacity. The commissioner shall consider the provider's 
87.14 	capacity to obtain clients from outside the state based on plans, agreements, and previous 
87.15 	utilization history, when determining the need for new treatment services The commissioner 
87.16 	may deny vendor certification to a provider if the commissioner determines that the services 
87.17 	currently available in the local area are sufficient to meet local need and that the addition 
87.18 	of new services would be detrimental to individuals seeking these services.

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

87.20 	Sec. 7. Minnesota Statutes 2018, section 254B.03, subdivision 4, is amended to read:
87.21 		Subd. 4.Division of costs. (a) Except for services provided by a county under section 
87.22 	254B.09, subdivision 1, or services provided under section 256B.69, the county shall, out 
87.23 	of local money, pay the state for 22.95 percent of the cost of chemical dependency services, 
87.24 	including those except that the county shall pay the state for ten percent of the nonfederal 
87.25 	share of the cost of chemical dependency services provided to persons eligible for enrolled 
87.26 	in medical assistance under chapter 256B, and ten percent of the cost of room and board 
87.27 	services under section 254B.05, subdivision 5, paragraph (b), clause (12). Counties may 
87.28 	use the indigent hospitalization levy for treatment and hospital payments made under this 
87.29 	section.
87.30 	(b) 22.95 percent of any state collections from private or third-party pay, less 15 percent 
87.31 	for the cost of payment and collections, must be distributed to the county that paid for a 
87.32 	portion of the treatment under this section.
87.33 	(c) For fiscal year 2017 only, the 22.95 percentages under paragraphs (a) and (b) are 
87.34 	equal to 20.2 percent.

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

88.2 	Sec. 8. Minnesota Statutes 2018, section 254B.04, subdivision 1, is amended to read:
88.3 		Subdivision 1.Eligibility. (a) Persons eligible for benefits under Code of Federal 
88.4 	Regulations, title 25, part 20, and persons eligible for medical assistance benefits under 
88.5 	sections 256B.055, 256B.056, and 256B.057, subdivisions 1, 5, and 6, or who meet the 
88.6 	income standards of section 256B.056, subdivision 4, and are not enrolled in medical 
88.7 	assistance, are entitled to chemical dependency fund services. State money appropriated 
88.8 	for this paragraph must be placed in a separate account established for this purpose.
88.9 	(b) Persons with dependent children who are determined to be in need of chemical 
88.10 	dependency treatment pursuant to an assessment under section 626.556, subdivision 10, or 
88.11 	a case plan under section 260C.201, subdivision 6, or 260C.212, shall be assisted by the 
88.12 	local agency to access needed treatment services. Treatment services must be appropriate 
88.13 	for the individual or family, which may include long-term care treatment or treatment in a 
88.14 	facility that allows the dependent children to stay in the treatment facility. The county shall 
88.15 	pay for out-of-home placement costs, if applicable.
88.16 	(c) Notwithstanding paragraph (a), persons enrolled in medical assistance are eligible 
88.17 	for room and board services under section 254B.05, subdivision 5, paragraph (b), clause 
88.18 	(12).

88.19 	EFFECTIVE DATE. This section is effective September 1, 2019.

88.20 	Sec. 9. Minnesota Statutes 2018, section 254B.05, subdivision 1a, is amended to read:
88.21 		Subd. 1a.Room and board provider requirements. (a) Effective January 1, 2000, 
88.22 	vendors of room and board are eligible for chemical dependency fund payment if the vendor:
88.23 	(1) has rules prohibiting residents bringing chemicals into the facility or using chemicals 
88.24 	while residing in the facility and provide consequences for infractions of those rules;
88.25 	(2) is determined to meet applicable health and safety requirements;
88.26 	(3) is not a jail or prison;
88.27 	(4) is not concurrently receiving funds under chapter 256I for the recipient;
88.28 	(5) admits individuals who are 18 years of age or older;
88.29 	(6) is registered as a board and lodging or lodging establishment according to section 
88.30 	157.17;
89.1 	(7) has awake staff on site 24 hours per day;
89.2 	(8) has staff who are at least 18 years of age and meet the requirements of section 
89.3 	245G.11, subdivision 1, paragraph (b);
89.4 	(9) has emergency behavioral procedures that meet the requirements of section 245G.16;
89.5 	(10) meets the requirements of section 245G.08, subdivision 5, if administering 
89.6 	medications to clients;
89.7 	(11) meets the abuse prevention requirements of section 245A.65, including a policy on 
89.8 	fraternization and the mandatory reporting requirements of section 626.557;
89.9 	(12) documents coordination with the treatment provider to ensure compliance with 
89.10 	section 254B.03, subdivision 2;
89.11 	(13) protects client funds and ensures freedom from exploitation by meeting the 
89.12 	provisions of section 245A.04, subdivision 13;
89.13 	(14) has a grievance procedure that meets the requirements of section 245G.15, 
89.14 	subdivision 2; and
89.15 	(15) has sleeping and bathroom facilities for men and women separated by a door that 
89.16 	is locked, has an alarm, or is supervised by awake staff.
89.17 	(b) Programs licensed according to Minnesota Rules, chapter 2960, are exempt from 
89.18 	paragraph (a), clauses (5) to (15).
89.19 	(c) Licensed programs providing intensive residential treatment services or residential 
89.20 	crisis stabilization services pursuant to section 256B.0622 or 256B.0624 are eligible vendors 
89.21 	of room and board and are exempt from paragraph (a), clauses (6) to (15).

89.22 	EFFECTIVE DATE. This section is effective September 1, 2019.

89.23 	Sec. 10. Minnesota Statutes 2018, section 254B.06, subdivision 1, is amended to read:
89.24 		Subdivision 1.State collections. The commissioner is responsible for all collections 
89.25 	from persons determined to be partially responsible for the cost of care of an eligible person 
89.26 	receiving services under Laws 1986, chapter 394, sections 8 to 20. The commissioner may 
89.27 	initiate, or request the attorney general to initiate, necessary civil action to recover the unpaid 
89.28 	cost of care. The commissioner may collect all third-party payments for chemical dependency 
89.29 	services provided under Laws 1986, chapter 394, sections 8 to 20, including private insurance 
89.30 	and federal Medicaid and Medicare financial participation. The commissioner shall deposit 
89.31 	in a dedicated account a percentage of collections to pay for the cost of operating the chemical 
90.1 	dependency consolidated treatment fund invoice processing and vendor payment system, 
90.2 	billing, and collections. The remaining receipts must be deposited in the chemical dependency 
90.3 	fund.

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

90.5 	Sec. 11. Minnesota Statutes 2018, section 254B.06, subdivision 2, is amended to read:
90.6 		Subd. 2.Allocation of collections. (a) The commissioner shall allocate all federal 
90.7 	financial participation collections to a special revenue account. The commissioner shall 
90.8 	allocate 77.05 percent of patient payments and third-party payments to the special revenue 
90.9 	account and 22.95 percent to the county financially responsible for the patient.
90.10 	(b) For fiscal year 2017 only, the commissioner's allocation to the special revenue account 
90.11 	shall be increased from 77.05 percent to 79.8 percent and the county financial responsibility 
90.12 	shall be reduced from 22.95 percent to 20.2 percent.

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

90.14 	Sec. 12. Minnesota Statutes 2018, section 256B.0625, subdivision 24, is amended to read:
90.15 		Subd. 24.Other medical or remedial care. Medical assistance covers any other medical 
90.16 	or remedial care licensed and recognized under state law unless otherwise prohibited by 
90.17 	law, except licensed chemical dependency treatment programs or primary treatment or 
90.18 	extended care treatment units in hospitals that are covered under chapter 254B. The 
90.19 	commissioner shall include chemical dependency services in the state medical assistance 
90.20 	plan for federal reporting purposes, but payment must be made under chapter 254B. The 
90.21 	commissioner shall publish in the State Register a list of elective surgeries that require a 
90.22 	second medical opinion before medical assistance reimbursement, and the criteria and 
90.23 	standards for deciding whether an elective surgery should require a second medical opinion. 
90.24 	The list and criteria and standards are not subject to the requirements of sections 14.01 to 
90.25 	14.69.

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

90.27 	Sec. 13. Minnesota Statutes 2018, section 256B.0625, is amended by adding a subdivision 
90.28 	to read:
90.29 		Subd. 24a.Substance use disorder services. Medical assistance covers substance use 
90.30 	disorder treatment services according to section 254B.05, subdivision 5, except for room 
90.31 	and board.

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

91.2 	Sec. 14. Minnesota Statutes 2018, section 256B.0757, subdivision 1, is amended to read:
91.3 		Subdivision 1.Provision of coverage. (a) The commissioner shall provide medical 
91.4 	assistance coverage of health home services for eligible individuals with chronic conditions 
91.5 	who select a designated provider as the individual's health home.
91.6 	(b) The commissioner shall implement this section in compliance with the requirements 
91.7 	of the state option to provide health homes for enrollees with chronic conditions, as provided 
91.8 	under the Patient Protection and Affordable Care Act, Public Law 111-148, sections 2703 
91.9 	and 3502. Terms used in this section have the meaning provided in that act.
91.10 	(c) The commissioner shall establish health homes to serve populations with serious 
91.11 	mental illness who meet the eligibility requirements described under subdivision 2, clause 
91.12 	(4). The health home services provided by health homes shall focus on both the behavioral 
91.13 	and the physical health of these populations.

91.14 	Sec. 15. Minnesota Statutes 2018, section 256B.0757, subdivision 2, is amended to read:
91.15 		Subd. 2.Eligible individual. (a) The commissioner may elect to develop health home 
91.16 	models in accordance with United States Code, title 42, section 1396w-4.
91.17 	(b) An individual is eligible for health home services under this section if the individual 
91.18 	is eligible for medical assistance under this chapter and has at least:
91.19 	(1) two chronic conditions;
91.20 	(2) one chronic condition and is at risk of having a second chronic condition;
91.21 	(3) one serious and persistent mental health condition; or
91.22 	(4) a condition that meets the definition of mental illness as described in section 245.462, 
91.23 	subdivision 20, paragraph (a), or emotional disturbance as defined in section 245.4871, 
91.24 	subdivision 15, clause (2); and has a current diagnostic assessment as defined in Minnesota 
91.25 	Rules, part 9505.0372, subpart 1, item B or C, as performed or reviewed by a mental health 
91.26 	professional employed by or under contract with the behavioral health home. The 
91.27 	commissioner shall establish criteria for determining continued eligibility.

91.28 	Sec. 16. Minnesota Statutes 2018, section 256B.0757, subdivision 4, is amended to read:
91.29 		Subd. 4.Designated provider. (a) Health home services are voluntary and an eligible 
91.30 	individual may choose any designated provider. The commissioner shall establish designated 
92.1 	providers to serve as health homes and provide the services described in subdivision 3 to 
92.2 	individuals eligible under subdivision 2. The commissioner shall apply for grants as provided 
92.3 	under section 3502 of the Patient Protection and Affordable Care Act to establish health 
92.4 	homes and provide capitated payments to designated providers. For purposes of this section, 
92.5 	"designated provider" means a provider, clinical practice or clinical group practice, rural 
92.6 	clinic, community health center, community mental health center, or any other entity that 
92.7 	is determined by the commissioner to be qualified to be a health home for eligible individuals. 
92.8 	This determination must be based on documentation evidencing that the designated provider 
92.9 	has the systems and infrastructure in place to provide health home services and satisfies the 
92.10 	qualification standards established by the commissioner in consultation with stakeholders 
92.11 	and approved by the Centers for Medicare and Medicaid Services.
92.12 	(b) The commissioner shall develop and implement certification standards for designated 
92.13 	providers under this subdivision.

92.14 	Sec. 17. Minnesota Statutes 2018, section 256B.0757, is amended by adding a subdivision 
92.15 	to read:
92.16 		Subd. 9.Discharge criteria.  (a) An individual may be discharged from behavioral health 
92.17 	home services if:
92.18 	(1) the behavioral health home services provider is unable to locate, contact, and engage 
92.19 	the individual for a period of greater than three months after persistent efforts by the 
92.20 	behavioral health home services provider; or
92.21 	(2) the individual is unwilling to participate in behavioral health home services as 
92.22 	demonstrated by the individual's refusal to meet with the behavioral health home services 
92.23 	provider, or refusal to identify the individual's goals or the activities or support necessary 
92.24 	to achieve the individual's health and wellness goals.
92.25 	(b) Before discharge from behavioral health home services, the behavioral health home 
92.26 	services provider must offer a face-to-face meeting with the individual, the individual's 
92.27 	identified supports, and the behavioral health home services provider to discuss options 
92.28 	available to the individual, including maintaining behavioral health home services.

92.29 	Sec. 18. Minnesota Statutes 2018, section 256B.0757, is amended by adding a subdivision 
92.30 	to read:
92.31 		Subd. 10.Behavioral health home services provider requirements. A behavioral 
92.32 	health home services provider must:
93.1 	(1) be an enrolled Minnesota Health Care Programs provider;
93.2 	(2) provide a medical assistance covered primary care or behavioral health service;
93.3 	(3) utilize an electronic health record;
93.4 	(4) utilize an electronic patient registry that contains data elements required by the 
93.5 	commissioner;
93.6 	(5) demonstrate the organization's capacity to administer screenings approved by the 
93.7 	commissioner for substance use disorder or alcohol and tobacco use;
93.8 	(6) demonstrate the organization's capacity to refer an individual to resources appropriate 
93.9 	to the individual's screening results;
93.10 	(7) have policies and procedures to track referrals to ensure that the referral met the 
93.11 	individual's needs;
93.12 	(8) conduct a brief needs assessment when an individual begins receiving behavioral 
93.13 	health home services. The brief needs assessment must be completed with input from the 
93.14 	individual and the individual's identified supports. The brief needs assessment must address 
93.15 	the individual's immediate safety and transportation needs and potential barriers to 
93.16 	participating in behavioral health home services;
93.17 	(9) conduct a health wellness assessment within 60 days after intake that contains all 
93.18 	required elements identified by the commissioner;
93.19 	(10) conduct a health action plan that contains all required elements identified by the 
93.20 	commissioner within 90 days after intake and updated at least once every six months or 
93.21 	more frequently if significant changes to an individual's needs or goals occur;
93.22 	(11) agree to cooperate and participate with the state's monitoring and evaluation of 
93.23 	behavioral health home services; and
93.24 	(12) utilize the form approved by the commissioner to obtain the individual's written 
93.25 	consent to begin receiving behavioral health home services.

93.26 	Sec. 19. Minnesota Statutes 2018, section 256B.0757, is amended by adding a subdivision 
93.27 	to read:
93.28 		Subd. 11.Provider training and practice transformation requirements. (a) The 
93.29 	behavioral health home services provider must ensure that all staff delivering behavioral 
93.30 	health home services receive adequate preservice and ongoing training including:
94.1 	(1) training approved by the commissioner that describes the goals and principles of 
94.2 	behavioral health home services; and
94.3 	(2) training on evidence-based practices to promote an individual's ability to successfully 
94.4 	engage with medical, behavioral health, and social services to reach the individual's health 
94.5 	and wellness goals.
94.6 	(b) The behavioral health home services provider must ensure that staff are capable of 
94.7 	implementing culturally responsive services as determined by the individual's culture, 
94.8 	beliefs, values, and language as identified in the individual's health wellness assessment.
94.9 	(c) The behavioral health home services provider must participate in the department's 
94.10 	practice transformation activities to support continued skill and competency development 
94.11 	in the provision of integrated medical, behavioral health, and social services.

94.12 	Sec. 20. Minnesota Statutes 2018, section 256B.0757, is amended by adding a subdivision 
94.13 	to read:
94.14 		Subd. 12.Staff qualifications. (a) A behavioral health home services provider must 
94.15 	maintain staff with required professional qualifications appropriate to the setting.
94.16 	(b) If behavioral health home services are offered in a mental health setting, the 
94.17 	integration specialist must be a registered nurse licensed under the Minnesota Nurse Practice 
94.18 	Act, sections 148.171 to 148.285.
94.19 	(c) If behavioral health home services are offered in a primary care setting, the integration 
94.20 	specialist must be a mental health professional as defined in section 245.462, subdivision 
94.21 	18, clauses (1) to (6), or 245.4871, subdivision 27, clauses (1) to (6).
94.22 	(d) If behavioral health home services are offered in either a primary care setting or 
94.23 	mental health setting, the systems navigator must be a mental health practitioner as defined 
94.24 	in section 245.462, subdivision 17, or a community health worker as defined in section 
94.25 	256B.0625, subdivision 49.
94.26 	(e) If behavioral health home services are offered in either a primary care setting or 
94.27 	mental health setting, the qualified health home specialist must be one of the following:
94.28 	(1) a peer support specialist as defined in section 256B.0615;
94.29 	(2) a family peer support specialist as defined in section 256B.0616;
94.30 	(3) a case management associate as defined in section 245.462, subdivision 4, paragraph 
94.31 	(g), or 245.4871, subdivision 4, paragraph (j);
95.1 	(4) a mental health rehabilitation worker as defined in section 256B.0623, subdivision 
95.2 	5, clause (4);
95.3 	(5) a community paramedic as defined in section 144E.28, subdivision 9;
95.4 	(6) a peer recovery specialist as defined in section 245G.07, subdivision 1, clause (5); 
95.5 	or
95.6 	(7) a community health worker as defined in section 256B.0625, subdivision 49.

95.7 	Sec. 21. Minnesota Statutes 2018, section 256B.0757, is amended by adding a subdivision 
95.8 	to read:
95.9 		Subd. 13.Service delivery standards.  (a) A behavioral health home services provider 
95.10 	must meet the following service delivery standards:
95.11 	(1) establish and maintain processes to support the coordination of an individual's primary 
95.12 	care, behavioral health, and dental care;
95.13 	(2) maintain a team-based model of care, including regular coordination and 
95.14 	communication between behavioral health home services team members;
95.15 	(3) use evidence-based practices that recognize and are tailored to the medical, social, 
95.16 	economic, behavioral health, functional impairment, cultural, and environmental factors 
95.17 	affecting the individual's health and health care choices;
95.18 	(4) use person-centered planning practices to ensure the individual's health action plan 
95.19 	accurately reflects the individual's preferences, goals, resources, and optimal outcomes for 
95.20 	the individual and the individual's identified supports;
95.21 	(5) use the patient registry to identify individuals and population subgroups requiring 
95.22 	specific levels or types of care and provide or refer the individual to needed treatment, 
95.23 	intervention, or service;
95.24 	(6) utilize Department of Human Services Partner Portal to identify past and current 
95.25 	treatment or services and to identify potential gaps in care;
95.26 	(7) deliver services consistent with standards for frequency and face-to-face contact as 
95.27 	required by the commissioner;
95.28 	(8) ensure that all individuals receiving behavioral health home services have a diagnostic 
95.29 	assessment completed within six months of when the individual begins receiving behavioral 
95.30 	health home services;
95.31 	(9) deliver services in locations and settings that meet the needs of the individual;
96.1 	(10) provide a central point of contact to ensure that individuals and the individual's 
96.2 	identified supports can successfully navigate the array of services that impact the individual's 
96.3 	health and well-being;
96.4 	(11) have capacity to assess an individual's readiness for change and the individual's 
96.5 	capacity to integrate new health care or community supports into the individual's life;
96.6 	(12) offer or facilitate the provision of wellness and prevention education on 
96.7 	evidenced-based curriculums specific to the prevention and management of common chronic 
96.8 	conditions;
96.9 	(13) help an individual set up and prepare for appointments, including accompanying 
96.10 	the individual to appointments as appropriate, and follow up with the individual after medical, 
96.11 	behavioral health, social service, or community support appointments;
96.12 	(14) offer or facilitate the provision of health coaching related to chronic disease 
96.13 	management and how to navigate complex systems of care to the individual, the individual's 
96.14 	family, and identified supports;
96.15 	(15) connect an individual, the individual's family, and identified supports to appropriate 
96.16 	support services that help the individual overcome access or service barriers, increase 
96.17 	self-sufficiency skills, and improve overall health;
96.18 	(16) provide effective referrals and timely access to services; and
96.19 	(17) establish a continuous quality improvement process for providing behavioral health 
96.20 	home services.
96.21 	(b) The behavioral health home services provider must also create a plan, in partnership 
96.22 	with the individual and the individual's identified supports, to support the individual after 
96.23 	discharge from a hospital, residential treatment program, or other setting. The plan must 
96.24 	include protocols for:
96.25 	(1) maintaining contact between the behavioral health home services team member and 
96.26 	the individual and the individual's identified supports during and after discharge;
96.27 	(2) linking the individual to new resources as needed;
96.28 	(3) reestablishing the individual's existing services and community and social supports; 
96.29 	and
96.30 	(4) following up with appropriate entities to transfer or obtain the individual's service 
96.31 	records as necessary for continued care.
97.1 	(c) If the individual is enrolled in a managed care plan, a behavioral health home services 
97.2 	provider must:
97.3 	(1) notify the behavioral health home services contact designated by the managed care 
97.4 	plan within 30 days of when the individual begins behavioral health home services; and
97.5 	(2) adhere to the managed care plan communication and coordination requirements 
97.6 	described in the behavioral health home services manual.
97.7 	(d) Before terminating behavioral health home services, the behavioral health home 
97.8 	services provider must:
97.9 	(1) provide a 60-day notice of termination of behavioral health home services to all 
97.10 	individuals receiving behavioral health home services, the department, and managed care 
97.11 	plans, if applicable; and
97.12 	(2) refer individuals receiving behavioral health home services to a new behavioral 
97.13 	health home services provider.

97.14 	Sec. 22. Minnesota Statutes 2018, section 256B.0757, is amended by adding a subdivision 
97.15 	to read:
97.16 		Subd. 14.Provider variances. (a) The commissioner may grant a variance to specific 
97.17 	requirements under subdivision 10, 11, 12, or 13 for a behavioral health home services 
97.18 	provider according to this subdivision.
97.19 	(b) The commissioner may grant a variance if the commissioner finds that (1) failure to 
97.20 	grant the variance would result in hardship or injustice to the applicant, (2) the variance 
97.21 	would be consistent with the public interest, and (3) the variance would not reduce the level 
97.22 	of services provided to individuals served by the organization.
97.23 	(c) The commissioner may grant a variance from one or more requirements to permit 
97.24 	an applicant to offer behavioral health home services of a type or in a manner that is 
97.25 	innovative if the commissioner finds that the variance does not impede the achievement of 
97.26 	the criteria in subdivision 10, 11, 12, or 13 and may improve the behavioral health home 
97.27 	services provided by the applicant.
97.28 	(d) The commissioner's decision to grant or deny a variance request is final and not 
97.29 	subject to appeal.

98.1 	Sec. 23. [256B.0759] SUBSTANCE USE DISORDER DEMONSTRATION PROJECT.
98.2 		Subdivision 1.Establishment. The commissioner shall develop and implement a medical 
98.3 	assistance demonstration project to test reforms of Minnesota's substance use disorder 
98.4 	treatment system to ensure individuals with substance use disorders have access to a full 
98.5 	continuum of high quality care.
98.6 		Subd. 2.Provider participation. Substance use disorder treatment providers may elect 
98.7 	to participate in the demonstration project and fulfill the requirements under subdivision 3. 
98.8 	To participate, a provider must notify the commissioner of the provider's intent to participate 
98.9 	in a format required by the commissioner and enroll as a demonstration project provider.
98.10 		Subd. 3.Provider standards. (a) The commissioner shall establish requirements for 
98.11 	participating providers that are consistent with the federal requirements of the demonstration 
98.12 	project.
98.13 	(b) Participating residential providers must obtain applicable licensure under chapters 
98.14 	245F, 245G, or other applicable standards for the services provided and must:
98.15 	(1) deliver services in accordance with American Society of Addiction Medicine (ASAM) 
98.16 	standards;
98.17 	(2) maintain formal patient referral arrangements with providers delivering step-up or 
98.18 	step-down levels of care in accordance with ASAM standards; and
98.19 	(3) provide or arrange for medication-assisted treatment services if requested by a client 
98.20 	for whom an effective medication exists.
98.21 	(c) Participating outpatient providers must be licensed and must:
98.22 	(1) deliver services in accordance with ASAM standards; and
98.23 	(2) maintain formal patient referral arrangements with providers delivering step-up or 
98.24 	step-down levels of care in accordance with ASAM standards.
98.25 	(d) If the provider standards under chapter 245G or other applicable standards conflict 
98.26 	or are duplicative, the commissioner may grant variances to the standards if the variances 
98.27 	do not conflict with federal requirements. The commissioner shall publish service 
98.28 	components, service standards, and staffing requirements for participating providers that 
98.29 	are consistent with ASAM standards and federal requirements.
98.30 		Subd. 4.Provider payment rates. (a) Payment rates for participating providers must 
98.31 	be increased for services provided to medical assistance enrollees.
99.1 	(b) For substance use disorder services under section 254B.05, subdivision 5, paragraph 
99.2 	(b), clause (8), payment rates must be increased by 15 percent over the rates in effect on 
99.3 	January 1, 2020.
99.4 	(c) For substance use disorder services under section 254B.05, subdivision 5, paragraph 
99.5 	(b), clauses (1), (6), (7), and (10), payment rates must be increased by ten percent over the 
99.6 	rates in effect on January 1, 2021.
99.7 		Subd. 5.Federal approval. The commissioner shall seek federal approval to implement 
99.8 	the demonstration project under this section and to receive federal financial participation.

99.9 	Sec. 24. Minnesota Statutes 2018, section 256I.04, subdivision 1, is amended to read:
99.10 		Subdivision 1.Individual eligibility requirements. An individual is eligible for and 
99.11 	entitled to a housing support payment to be made on the individual's behalf if the agency 
99.12 	has approved the setting where the individual will receive housing support and the individual 
99.13 	meets the requirements in paragraph (a), (b), or (c).
99.14 	(a) The individual is aged, blind, or is over 18 years of age with a disability as determined 
99.15 	under the criteria used by the title II program of the Social Security Act, and meets the 
99.16 	resource restrictions and standards of section 256P.02, and the individual's countable income 
99.17 	after deducting the (1) exclusions and disregards of the SSI program, (2) the medical 
99.18 	assistance personal needs allowance under section 256B.35, and (3) an amount equal to the 
99.19 	income actually made available to a community spouse by an elderly waiver participant 
99.20 	under the provisions of sections 256B.0575, paragraph (a), clause (4), and 256B.058, 
99.21 	subdivision 2, is less than the monthly rate specified in the agency's agreement with the 
99.22 	provider of housing support in which the individual resides.
99.23 	(b) The individual meets a category of eligibility under section 256D.05, subdivision 1, 
99.24 	paragraph (a), clauses (1), (3), (4) to (8), and (13), and paragraph (b), if applicable, and the 
99.25 	individual's resources are less than the standards specified by section 256P.02, and the 
99.26 	individual's countable income as determined under section 256P.06, less the medical 
99.27 	assistance personal needs allowance under section 256B.35 is less than the monthly rate 
99.28 	specified in the agency's agreement with the provider of housing support in which the 
99.29 	individual resides.
99.30 	(c) The individual receives licensed residential crisis stabilization services under section 
99.31 	256B.0624, subdivision 7, and is receiving medical assistance. The individual may receive 
99.32 	concurrent housing support payments if receiving licensed residential crisis stabilization 
99.33 	services under section 256B.0624, subdivision 7. lacks a fixed, adequate, nighttime residence 
100.1 	upon discharge from a residential behavioral health treatment program, as determined by 
100.2 	treatment staff from the residential behavioral health treatment program. An individual is 
100.3 	eligible under this paragraph for up to three months, including a full or partial month from 
100.4 	the individual's move-in date at a setting approved for housing support following discharge 
100.5 	from treatment, plus two full months.

100.6 	EFFECTIVE DATE. This section is effective September 1, 2019.

100.7 	Sec. 25. Minnesota Statutes 2018, section 256I.04, subdivision 2f, is amended to read:
100.8 		Subd. 2f.Required services. (a) In licensed and registered settings under subdivision 
100.9 	2a, providers shall ensure that participants have at a minimum:
100.10 	(1) food preparation and service for three nutritional meals a day on site;
100.11 	(2) a bed, clothing storage, linen, bedding, laundering, and laundry supplies or service;
100.12 	(3) housekeeping, including cleaning and lavatory supplies or service; and
100.13 	(4) maintenance and operation of the building and grounds, including heat, water, garbage 
100.14 	removal, electricity, telephone for the site, cooling, supplies, and parts and tools to repair 
100.15 	and maintain equipment and facilities.
100.16 	(b) Providers serving participants described in subdivision 1, paragraph (c), shall assist 
100.17 	participants in applying for continuing housing support payments before the end of the 
100.18 	eligibility period.

100.19 	EFFECTIVE DATE. This section is effective September 1, 2019.

100.20 	Sec. 26. Minnesota Statutes 2018, section 256I.06, subdivision 8, is amended to read:
100.21 		Subd. 8.Amount of housing support payment. (a) The amount of a room and board 
100.22 	payment to be made on behalf of an eligible individual is determined by subtracting the 
100.23 	individual's countable income under section 256I.04, subdivision 1, for a whole calendar 
100.24 	month from the room and board rate for that same month. The housing support payment is 
100.25 	determined by multiplying the housing support rate times the period of time the individual 
100.26 	was a resident or temporarily absent under section 256I.05, subdivision 1c, paragraph (d).
100.27 	(b) For an individual with earned income under paragraph (a), prospective budgeting 
100.28 	must be used to determine the amount of the individual's payment for the following six-month 
100.29 	period. An increase in income shall not affect an individual's eligibility or payment amount 
100.30 	until the month following the reporting month. A decrease in income shall be effective the 
100.31 	first day of the month after the month in which the decrease is reported.
101.1 	(c) For an individual who receives licensed residential crisis stabilization services under 
101.2 	section 256B.0624, subdivision 7, housing support payments under section 256I.04, 
101.3 	subdivision 1, paragraph (c), the amount of housing support payment amount is determined 
101.4 	by multiplying the housing support rate times the period of time the individual was a resident.

101.5 	EFFECTIVE DATE. This section is effective September 1, 2019.

101.6 	Sec. 27. Minnesota Statutes 2018, section 641.15, subdivision 3a, is amended to read:
101.7 		Subd. 3a.Intake procedure; approved mental health screening; data sharing. As 
101.8 	part of its intake procedure for new prisoners, the sheriff or local corrections shall use a 
101.9 	mental health screening tool approved by the commissioner of corrections, in consultation 
101.10 	with the commissioner of human services and local corrections staff, to identify persons 
101.11 	who may have a mental illness. Notwithstanding section 13.85, the sheriff or local corrections 
101.12 	may share the names of persons who have screened positive for or may have a mental illness 
101.13 	with the local county social services agency. The sheriff or local corrections may refer a 
101.14 	person to county personnel of the welfare system, as defined in section 13.46, subdivision 
101.15 	1, paragraph (c), in order to arrange for services upon discharge and may share private data 
101.16 	on the individual as necessary to:
101.17 	(1) provide assistance in filling out an application for medical assistance or 
101.18 	MinnesotaCare;
101.19 	(2) make a referral for case management as provided under section 245.467, subdivision 
101.20 	4;
101.21 	(3) provide assistance in obtaining a state photo identification;
101.22 	(4) secure a timely appointment with a psychiatrist or other appropriate community 
101.23 	mental health provider;
101.24 	(5) provide prescriptions for a 30-day supply of all necessary medications; or
101.25 	(6) provide for behavioral health service coordination.

101.26 	Sec. 28. REPEALER.
 101.27 	(a) Minnesota Statutes 2018, section 254B.03, subdivision 4a, is repealed.
101.28 	(b) Minnesota Rules, parts 9530.6800; and 9530.6810, are repealed.

102.1 	ARTICLE 4
102.2 	CONTINUING CARE FOR OLDER ADULTS

102.3 	Section 1. Minnesota Statutes 2018, section 144A.073, is amended by adding a subdivision 
102.4 	to read:
102.5 		Subd. 16.Moratorium exception funding. In fiscal year 2020, the commissioner may 
102.6 	approve moratorium exception projects under this section for which the full annualized state 
102.7 	share of medical assistance costs does not exceed $2,000,000 plus any carryover of previous 
102.8 	appropriations for this purpose.

102.9 	Sec. 2. Minnesota Statutes 2018, section 256R.25, is amended to read:
102.10 	256R.25 EXTERNAL FIXED COSTS PAYMENT RATE.
102.11 	(a) The payment rate for external fixed costs is the sum of the amounts in paragraphs 
102.12 	(b) to (n) (o).
102.13 	(b) For a facility licensed as a nursing home, the portion related to the provider surcharge 
102.14 	under section 256.9657 is equal to $8.86 per resident day. For a facility licensed as both a 
102.15 	nursing home and a boarding care home, the portion related to the provider surcharge under 
102.16 	section 256.9657 is equal to $8.86 per resident day multiplied by the result of its number 
102.17 	of nursing home beds divided by its total number of licensed beds.
102.18 	(c) The portion related to the licensure fee under section 144.122, paragraph (d), is the 
102.19 	amount of the fee divided by the sum of the facility's resident days.
102.20 	(d) The portion related to development and education of resident and family advisory 
102.21 	councils under section 144A.33 is $5 per resident day divided by 365.
102.22 	(e) The portion related to scholarships is determined under section 256R.37.
102.23 	(f) The portion related to planned closure rate adjustments is as determined under section 
102.24 	256R.40, subdivision 5, and Minnesota Statutes 2010, section 256B.436.
102.25 	(g) The portion related to consolidation rate adjustments shall be as determined under 
102.26 	section 144A.071, subdivisions 4c, paragraph (a), clauses (5) and (6), and 4d.
102.27 	(h) The portion related to single-bed room incentives is as determined under section 
102.28 	256R.41.
102.29 	(i) The portions related to real estate taxes, special assessments, and payments made in 
102.30 	lieu of real estate taxes directly identified or allocated to the nursing facility are the actual 
102.31 	amounts divided by the sum of the facility's resident days. Allowable costs under this 
103.1 	paragraph for payments made by a nonprofit nursing facility that are in lieu of real estate 
103.2 	taxes shall not exceed the amount which the nursing facility would have paid to a city or 
103.3 	township and county for fire, police, sanitation services, and road maintenance costs had 
103.4 	real estate taxes been levied on that property for those purposes.
103.5 	(j) The portion related to employer health insurance costs is the allowable costs divided 
103.6 	by the sum of the facility's resident days.
103.7 	(k) The portion related to the Public Employees Retirement Association is actual costs 
103.8 	divided by the sum of the facility's resident days.
103.9 	(l) The portion related to quality improvement incentive payment rate adjustments is 
103.10 	the amount determined under section 256R.39.
103.11 	(m) The portion related to performance-based incentive payments is the amount 
103.12 	determined under section 256R.38.
103.13 	(n) The portion related to special dietary needs is the amount determined under section 
103.14 	256R.51.
103.15 	(o) The portion related to the rate adjustments for border city facilities is the amount 
103.16 	determined under section 256R.481.

103.17 	Sec. 3. [256R.481] RATE ADJUSTMENTS FOR BORDER CITY FACILITIES.
103.18 	(a)The commissioner shall allow each nonprofit nursing facility located within the 
103.19 	boundaries of the city of Breckenridge or Moorhead prior to January 1, 2015, to apply once 
103.20 	annually for a rate add-on to the facility's external fixed costs payment rate.
103.21 	(b) A facility seeking an add-on to its external fixed costs payment rate under this section 
103.22 	must apply annually to the commissioner to receive the add-on. A facility must submit the 
103.23 	application within 60 calendar days of the effective date of any add-on under this section.  
103.24 	The commissioner may waive the deadlines required by this paragraph under extraordinary 
103.25 	circumstances.
103.26 	(c) The commissioner shall provide the add-on to each eligible facility that applies by 
103.27 	the application deadline.
103.28 	(d) The add-on to the external fixed costs payment rate is the difference on January 1 
103.29 	of the median total payment rate for case mix classification PA1 of the nonprofit facilities 
103.30 	located in an adjacent city in another state and in cities contiguous to the adjacent city minus 
103.31 	the eligible nursing facility's total payment rate for case mix classification PA1 as determined 
103.32 	under section 256R.22, subdivision 4.

104.1 	EFFECTIVE DATE. The add-on to the external fixed costs payment rate described in 
104.2 	Minnesota Statutes, section 256R.481, is available for the rate years beginning on and after 
104.3 	January 1, 2021.

104.4 	Sec. 4. REPEALER.
 104.5 	Minnesota Statutes 2018, section 256R.53, subdivision 2, is repealed effective January 
104.6 	1, 2021.

104.7 	ARTICLE 5
104.8 	DISABILITY SERVICES

104.9 	Section 1. Minnesota Statutes 2018, section 245A.03, subdivision 7, is amended to read:
104.10 		Subd. 7.Licensing moratorium. (a) The commissioner shall not issue an initial license 
104.11 	for child foster care licensed under Minnesota Rules, parts 2960.3000 to 2960.3340, or adult 
104.12 	foster care licensed under Minnesota Rules, parts 9555.5105 to 9555.6265, under this chapter 
104.13 	for a physical location that will not be the primary residence of the license holder for the 
104.14 	entire period of licensure. If a license is issued during this moratorium, and the license 
104.15 	holder changes the license holder's primary residence away from the physical location of 
104.16 	the foster care license, the commissioner shall revoke the license according to section 
104.17 	245A.07. The commissioner shall not issue an initial license for a community residential 
104.18 	setting licensed under chapter 245D. When approving an exception under this paragraph, 
104.19 	the commissioner shall consider the resource need determination process in paragraph (h), 
104.20 	the availability of foster care licensed beds in the geographic area in which the licensee 
104.21 	seeks to operate, the results of a person's choices during their annual assessment and service 
104.22 	plan review, and the recommendation of the local county board. The determination by the 
104.23 	commissioner is final and not subject to appeal. Exceptions to the moratorium include:
104.24 	(1) foster care settings that are required to be registered under chapter 144D;
104.25 	(2) foster care licenses replacing foster care licenses in existence on May 15, 2009, or 
104.26 	community residential setting licenses replacing adult foster care licenses in existence on 
104.27 	December 31, 2013, and determined to be needed by the commissioner under paragraph 
104.28 	(b);
104.29 	(3) new foster care licenses or community residential setting licenses determined to be 
104.30 	needed by the commissioner under paragraph (b) for the closure of a nursing facility, ICF/DD, 
104.31 	or regional treatment center; restructuring of state-operated services that limits the capacity 
104.32 	of state-operated facilities; or allowing movement to the community for people who no 
105.1 	longer require the level of care provided in state-operated facilities as provided under section 
105.2 	256B.092, subdivision 13, or 256B.49, subdivision 24;
105.3 	(4) new foster care licenses or community residential setting licenses determined to be 
105.4 	needed by the commissioner under paragraph (b) for persons requiring hospital level care;
105.5 	(5) new foster care licenses or community residential setting licenses determined to be 
105.6 	needed by the commissioner for the transition of people from personal care assistance to 
105.7 	the home and community-based services;
105.8 	(6) new foster care licenses or community residential setting licenses determined to be 
105.9 	needed by the commissioner for the transition of people from the residential care waiver 
105.10 	services to foster care services. This exception applies only when:
105.11 	(i) the person's case manager provided the person with information about the choice of 
105.12 	service, service provider, and location of service to help the person make an informed choice; 
105.13 	and
105.14 	(ii) the person's foster care services are less than or equal to the cost of the person's 
105.15 	services delivered in the residential care waiver service setting as determined by the lead 
105.16 	agency; or
105.17 	(7) new foster care licenses or community residential setting licenses for people receiving 
105.18 	services under chapter 245D and residing in an unlicensed setting before May 1, 2017, and 
105.19 	for which a license is required. This exception does not apply to people living in their own 
105.20 	home. For purposes of this clause, there is a presumption that a foster care or community 
105.21 	residential setting license is required for services provided to three or more people in a 
105.22 	dwelling unit when the setting is controlled by the provider. A license holder subject to this 
105.23 	exception may rebut the presumption that a license is required by seeking a reconsideration 
105.24 	of the commissioner's determination. The commissioner's disposition of a request for 
105.25 	reconsideration is final and not subject to appeal under chapter 14. The exception is available 
105.26 	until June 30, 2018 2019. This exception is available when:
105.27 	(i) the person's case manager provided the person with information about the choice of 
105.28 	service, service provider, and location of service, including in the person's home, to help 
105.29 	the person make an informed choice; and
105.30 	(ii) the person's services provided in the licensed foster care or community residential 
105.31 	setting are less than or equal to the cost of the person's services delivered in the unlicensed 
105.32 	setting as determined by the lead agency; or
106.1 	(8) a vacancy in a setting granted an exception under clause (7), created between January 
106.2 	1, 2017, and the date of the exception request, by the departure of a person receiving services 
106.3 	under chapter 245D and residing in the unlicensed setting between January 1, 2017, and 
106.4 	May 1, 2017. This exception is available when the lead agency provides documentation to 
106.5 	the commissioner on the eligibility criteria being met. This exception is available until June 
106.6 	30, 2019.
106.7 	(b) The commissioner shall determine the need for newly licensed foster care homes or 
106.8 	community residential settings as defined under this subdivision. As part of the determination, 
106.9 	the commissioner shall consider the availability of foster care capacity in the area in which 
106.10 	the licensee seeks to operate, and the recommendation of the local county board. The 
106.11 	determination by the commissioner must be final. A determination of need is not required 
106.12 	for a change in ownership at the same address.
106.13 	(c) When an adult resident served by the program moves out of afor any reason 
106.14 	permanently vacates a bed in an adult foster care home that is not the primary residence of 
106.15 	the license holder according to section 256B.49, subdivision 15, paragraph (f), or the a bed 
106.16 	in an adult community residential setting, the county shall immediately inform the 
106.17 	Department of Human Services Licensing Division commissioner. Within six months of 
106.18 	the second bed being permanently vacated, the department maycommissioner shall decrease 
106.19 	the statewide licensed capacity for adult foster care settings by one bed for every two beds 
106.20 	vacated.
106.21 	(d) Residential settings that would otherwise be subject to the decreased license capacity 
106.22 	established in paragraph (c) shall be exempt if the license holder's beds are occupied by 
106.23 	residents whose primary diagnosis is mental illness and the license holder is certified under 
106.24 	the requirements in subdivision 6a or section 245D.33.
106.25 	(e) A resource need determination process, managed at the state level, using the available 
106.26 	reports required by section 144A.351, and other data and information shall be used to 
106.27 	determine where the reduced capacity determined under section 256B.493 will be 
106.28 	implemented. The commissioner shall consult with the stakeholders described in section 
106.29 	144A.351, and employ a variety of methods to improve the state's capacity to meet the 
106.30 	informed decisions of those people who want to move out of corporate foster care or 
106.31 	community residential settings, long-term service needs within budgetary limits, including 
106.32 	seeking proposals from service providers or lead agencies to change service type, capacity, 
106.33 	or location to improve services, increase the independence of residents, and better meet 
106.34 	needs identified by the long-term services and supports reports and statewide data and 
106.35 	information.
107.1 	(f) At the time of application and reapplication for licensure, the applicant and the license 
107.2 	holder that are subject to the moratorium or an exclusion established in paragraph (a) are 
107.3 	required to inform the commissioner whether the physical location where the foster care 
107.4 	will be provided is or will be the primary residence of the license holder for the entire period 
107.5 	of licensure. If the primary residence of the applicant or license holder changes, the applicant 
107.6 	or license holder must notify the commissioner immediately. The commissioner shall print 
107.7 	on the foster care license certificate whether or not the physical location is the primary 
107.8 	residence of the license holder.
107.9 	(g) License holders of foster care homes identified under paragraph (f) that are not the 
107.10 	primary residence of the license holder and that also provide services in the foster care home 
107.11 	that are covered by a federally approved home and community-based services waiver, as 
107.12 	authorized under section 256B.0915, 256B.092, or 256B.49, must inform the human services 
107.13 	licensing division that the license holder provides or intends to provide these waiver-funded 
107.14 	services.
107.15 	(h) The commissioner may adjust capacity to address needs identified in section 
107.16 	144A.351. Under this authority, the commissioner may approve new licensed settings or 
107.17 	delicense existing settings. Delicensing of settings will be accomplished through a process 
107.18 	identified in section 256B.493. Annually, by August 1, the commissioner shall provide 
107.19 	information and data on capacity of licensed long-term services and supports, actions taken 
107.20 	under the subdivision to manage statewide long-term services and supports resources, and 
107.21 	any recommendations for change to the legislative committees with jurisdiction over the 
107.22 	health and human services budget.
107.23 	(i) The commissioner must notify a license holder when its corporate foster care or 
107.24 	community residential setting licensed beds are reduced under this section. The notice of 
107.25 	reduction of licensed beds must be in writing and delivered to the license holder by certified 
107.26 	mail or personal service. The notice must state why the licensed beds are reduced and must 
107.27 	inform the license holder of its right to request reconsideration by the commissioner. The 
107.28 	license holder's request for reconsideration must be in writing. If mailed, the request for 
107.29 	reconsideration must be postmarked and sent to the commissioner within 20 calendar days 
107.30 	after the license holder's receipt of the notice of reduction of licensed beds. If a request for 
107.31 	reconsideration is made by personal service, it must be received by the commissioner within 
107.32 	20 calendar days after the license holder's receipt of the notice of reduction of licensed beds.
107.33 	(j) The commissioner shall not issue an initial license for children's residential treatment 
107.34 	services licensed under Minnesota Rules, parts 2960.0580 to 2960.0700, under this chapter 
107.35 	for a program that Centers for Medicare and Medicaid Services would consider an institution 
108.1 	for mental diseases. Facilities that serve only private pay clients are exempt from the 
108.2 	moratorium described in this paragraph. The commissioner has the authority to manage 
108.3 	existing statewide capacity for children's residential treatment services subject to the 
108.4 	moratorium under this paragraph and may issue an initial license for such facilities if the 
108.5 	initial license would not increase the statewide capacity for children's residential treatment 
108.6 	services subject to the moratorium under this paragraph.

108.7 	EFFECTIVE DATE. This section is effective July 1, 2019, except the amendment to 
108.8 	paragraph (a) adding clause (8) is effective retroactively from July 1, 2018, and applies to 
108.9 	exception requests made on or after that date.

108.10 	Sec. 2. Minnesota Statutes 2018, section 245A.11, subdivision 2a, is amended to read:
108.11 		Subd. 2a.Adult foster care and community residential setting license capacity. (a) 
108.12 	The commissioner shall issue adult foster care and community residential setting licenses 
108.13 	with a maximum licensed capacity of four beds, including nonstaff roomers and boarders, 
108.14 	except that the commissioner may issue a license with a capacity of five up to six beds, 
108.15 	including roomers and boarders, according to paragraphs (b) to (g).
108.16 	(b) The license holder may have a maximum license capacity of five if all persons in 
108.17 	care are age 55 or over and do not have a serious and persistent mental illness or a 
108.18 	developmental disability.
108.19 	(c) The commissioner may grant variances to paragraph (b) to allow a facility with a 
108.20 	licensed capacity of up to five persons to admit an individual under the age of 55 if the 
108.21 	variance complies with section 245A.04, subdivision 9, and approval of the variance is 
108.22 	recommended by the county in which the licensed facility is located.
108.23 	(d) The commissioner may grant variances to paragraph (a) to allow the use of an 
108.24 	additional bed, up to five, for emergency crisis services for a person with serious and 
108.25 	persistent mental illness or a developmental disability, regardless of age, if the variance 
108.26 	complies with section 245A.04, subdivision 9, and approval of the variance is recommended 
108.27 	by the county in which the licensed facility is located.
108.28 	(e) The commissioner may grant a variance to paragraph (b) to allow for the use of an 
108.29 	additional bed, up to five, for respite services, as defined in section 245A.02, for persons 
108.30 	with disabilities, regardless of age, if the variance complies with sections 245A.03, 
108.31 	subdivision 7, and 245A.04, subdivision 9, and approval of the variance is recommended 
108.32 	by the county in which the licensed facility is located. Respite care may be provided under 
108.33 	the following conditions:
109.1 	(1) staffing ratios cannot be reduced below the approved level for the individuals being 
109.2 	served in the home on a permanent basis;
109.3 	(2) no more than two different individuals can be accepted for respite services in any 
109.4 	calendar month and the total respite days may not exceed 120 days per program in any 
109.5 	calendar year;
109.6 	(3) the person receiving respite services must have his or her own bedroom, which could 
109.7 	be used for alternative purposes when not used as a respite bedroom, and cannot be the 
109.8 	room of another person who lives in the facility; and
109.9 	(4) individuals living in the facility must be notified when the variance is approved. The 
109.10 	provider must give 60 days' notice in writing to the residents and their legal representatives 
109.11 	prior to accepting the first respite placement. Notice must be given to residents at least two 
109.12 	days prior to service initiation, or as soon as the license holder is able if they receive notice 
109.13 	of the need for respite less than two days prior to initiation, each time a respite client will 
109.14 	be served, unless the requirement for this notice is waived by the resident or legal guardian.
109.15 	(f) The commissioner may issue an adult foster care or community residential setting 
109.16 	license with a capacity of five six adults if the fifth bed does and sixth beds do not increase 
109.17 	the overall statewide capacity of licensed adult foster care or community residential setting 
109.18 	beds in homes that are not the primary residence of the license holder, as identified in a plan 
109.19 	submitted to the commissioner by the county, when the capacity is recommended by the 
109.20 	county licensing agency of the county in which the facility is located and if the 
109.21 	recommendation verifies that:
109.22 	(1) the facility meets the physical environment requirements in the adult foster care 
109.23 	licensing rule;
109.24 	(2) the five-bed or six-bed living arrangement is specified for each resident in the 
109.25 	resident's:
109.26 	(i) individualized plan of care;
109.27 	(ii) individual service plan under section 256B.092, subdivision 1b, if required; or
109.28 	(iii) individual resident placement agreement under Minnesota Rules, part 9555.5105, 
109.29 	subpart 19, if required;
109.30 	(3) the license holder obtains written and signed informed consent from each resident 
109.31 	or resident's legal representative documenting the resident's informed choice to remain 
109.32 	living in the home and that the resident's refusal to consent would not have resulted in 
109.33 	service termination; and
110.1 	(4) the facility was licensed for adult foster care before March 1, 2011 June 30, 2016.
110.2 	(g) The commissioner shall not issue a new adult foster care license under paragraph (f) 
110.3 	after June 30, 2019 2021. The commissioner shall allow a facility with an adult foster care 
110.4 	license issued under paragraph (f) before June 30, 2019 2021, to continue with a capacity 
110.5 	of five or six adults if the license holder continues to comply with the requirements in 
110.6 	paragraph (f).

110.7 	Sec. 3. Minnesota Statutes 2018, section 245D.03, subdivision 1, is amended to read:
110.8 		Subdivision 1.Applicability.  (a) The commissioner shall regulate the provision of home 
110.9 	and community-based services to persons with disabilities and persons age 65 and older 
110.10 	pursuant to this chapter. The licensing standards in this chapter govern the provision of 
110.11 	basic support services and intensive support services.
110.12 	(b) Basic support services provide the level of assistance, supervision, and care that is 
110.13 	necessary to ensure the health and welfare of the person and do not include services that 
110.14 	are specifically directed toward the training, treatment, habilitation, or rehabilitation of the 
110.15 	person. Basic support services include:
110.16 	(1) in-home and out-of-home respite care services as defined in section 245A.02, 
110.17 	subdivision 15, and under the brain injury, community alternative care, community access 
110.18 	for disability inclusion, developmental disability disabilities, and elderly waiver plans, 
110.19 	excluding out-of-home respite care provided to children in a family child foster care home 
110.20 	licensed under Minnesota Rules, parts 2960.3000 to 2960.3100, when the child foster care 
110.21 	license holder complies with the requirements under section 245D.06, subdivisions 5, 6, 7, 
110.22 	and 8, or successor provisions; and section 245D.061 or successor provisions, which must 
110.23 	be stipulated in the statement of intended use required under Minnesota Rules, part 
110.24 	2960.3000, subpart 4;
110.25 	(2) adult companion services as defined under the brain injury, community access for 
110.26 	disability inclusion, community alternative care, and elderly waiver plans, excluding adult 
110.27 	companion services provided under the Corporation for National and Community Services 
110.28 	Senior Companion Program established under the Domestic Volunteer Service Act of 1973, 
110.29 	Public Law 98-288;
110.30 	(3) personal support as defined under the developmental disability disabilities waiver 
110.31 	plan;
111.1 	(4) 24-hour emergency assistance, personal emergency response as defined under the 
111.2 	community access for disability inclusion and developmental disability disabilities waiver 
111.3 	plans;
111.4 	(5) night supervision services as defined under the brain injury, community access for 
111.5 	disability inclusion, community alternative care, and developmental disabilities waiver plan
111.6 	plans;
111.7 	(6) homemaker services as defined under the community access for disability inclusion, 
111.8 	brain injury, community alternative care, developmental disability disabilities, and elderly 
111.9 	waiver plans, excluding providers licensed by the Department of Health under chapter 144A 
111.10 	and those providers providing cleaning services only; and
111.11 	(7) individual community living support under section 256B.0915, subdivision 3j.
111.12 	(c) Intensive support services provide assistance, supervision, and care that is necessary 
111.13 	to ensure the health and welfare of the person and services specifically directed toward the 
111.14 	training, habilitation, or rehabilitation of the person. Intensive support services include:
111.15 	(1) intervention services, including:
111.16 	(i) behavioral positive support services as defined under the brain injury and community 
111.17 	access for disability inclusion, community alternative care, and developmental disabilities
111.18 	waiver plans;
111.19 	(ii) in-home or out-of-home crisis respite services as defined under the brain injury, 
111.20 	community access for disability inclusion, community alternative care, and developmental 
111.21 	disability disabilities waiver plan plans; and
111.22 	(iii) specialist services as defined under the current brain injury, community access for 
111.23 	disability inclusion, community alternative care, and developmental disability disabilities
111.24 	waiver plan plans;
111.25 	(2) in-home support services, including:
111.26 	(i) in-home family support and supported living services as defined under the 
111.27 	developmental disability disabilities waiver plan;
111.28 	(ii) independent living services training as defined under the brain injury and community 
111.29 	access for disability inclusion waiver plans;
111.30 	(iii) semi-independent living services; and
111.31 	(iv) individualized home supports services as defined under the brain injury, community 
111.32 	alternative care, and community access for disability inclusion waiver plans;
112.1 	(3) residential supports and services, including:
112.2 	(i) supported living services as defined under the developmental disability disabilities
112.3 	waiver plan provided in a family or corporate child foster care residence, a family adult 
112.4 	foster care residence, a community residential setting, or a supervised living facility;
112.5 	(ii) foster care services as defined in the brain injury, community alternative care, and 
112.6 	community access for disability inclusion waiver plans provided in a family or corporate 
112.7 	child foster care residence, a family adult foster care residence, or a community residential 
112.8 	setting; and
112.9 	(iii) residential services provided to more than four persons with developmental 
112.10 	disabilities in a supervised living facility, including ICFs/DD;
112.11 	(4) day services, including:
112.12 	(i) structured day services as defined under the brain injury waiver plan;
112.13 	(ii) day training and habilitation services under sections 252.41 to 252.46, and as defined 
112.14 	under the developmental disability disabilities waiver plan; and
112.15 	(iii) prevocational services as defined under the brain injury and community access for 
112.16 	disability inclusion waiver plans; and
112.17 	(5) employment exploration services as defined under the brain injury, community 
112.18 	alternative care, community access for disability inclusion, and developmental disability
112.19 	disabilities waiver plans;
112.20 	(6) employment development services as defined under the brain injury, community 
112.21 	alternative care, community access for disability inclusion, and developmental disability
112.22 	disabilities waiver plans; and
112.23 	(7) employment support services as defined under the brain injury, community alternative 
112.24 	care, community access for disability inclusion, and developmental disability disabilities
112.25 	waiver plans.

112.26 	Sec. 4. Minnesota Statutes 2018, section 245D.071, subdivision 5, is amended to read:
112.27 		Subd. 5.Service plan review and evaluation. (a) The license holder must give the 
112.28 	person or the person's legal representative and case manager an opportunity to participate 
112.29 	in the ongoing review and development of the service plan and the methods used to support 
112.30 	the person and accomplish outcomes identified in subdivisions 3 and 4. At least once per 
112.31 	year, or within 30 days of a written request by the person, the person's legal representative, 
112.32 	or the case manager, the license holder, in coordination with the person's support team or 
113.1 	expanded support team, must meet with the person, the person's legal representative, and 
113.2 	the case manager, and participate in service plan review meetings following stated timelines 
113.3 	established in the person's coordinated service and support plan or coordinated service and 
113.4 	support plan addendum or within 30 days of a written request by the person, the person's 
113.5 	legal representative, or the case manager, at a minimum of once per year. The purpose of 
113.6 	the service plan review is to determine whether changes are needed to the service plan based 
113.7 	on the assessment information, the license holder's evaluation of progress towards 
113.8 	accomplishing outcomes, or other information provided by the support team or expanded 
113.9 	support team.
113.10 	(b) At least once per year, the license holder, in coordination with the person's support 
113.11 	team or expanded support team, must meet with the person, the person's legal representative, 
113.12 	and the case manager to discuss how technology might be used to meet the person's desired 
113.13 	outcomes. The coordinated service and support plan addendum must include a summary of 
113.14 	this discussion. The summary must include a statement regarding any decision made related 
113.15 	to the use of technology and a description of any further research that must be completed 
113.16 	before a decision regarding the use of technology can be made. Nothing in this paragraph 
113.17 	requires the coordinated service and support plan addendum to include the use of technology 
113.18 	for the provision of services.
113.19 	(b) (c) The license holder must summarize the person's status and progress toward 
113.20 	achieving the identified outcomes and make recommendations and identify the rationale 
113.21 	for changing, continuing, or discontinuing implementation of supports and methods identified 
113.22 	in subdivision 4 in a report available at the time of the progress review meeting. The report 
113.23 	must be sent at least five working days prior to the progress review meeting if requested by 
113.24 	the team in the coordinated service and support plan or coordinated service and support 
113.25 	plan addendum.
113.26 	(c) (d) The license holder must send the coordinated service and support plan addendum 
113.27 	to the person, the person's legal representative, and the case manager by mail within ten 
113.28 	working days of the progress review meeting. Within ten working days of the mailing of 
113.29 	the coordinated service and support plan addendum, the license holder must obtain dated 
113.30 	signatures from the person or the person's legal representative and the case manager to 
113.31 	document approval of any changes to the coordinated service and support plan addendum.
113.32 	(d) (e) If, within ten working days of submitting changes to the coordinated service and 
113.33 	support plan and coordinated service and support plan addendum, the person or the person's 
113.34 	legal representative or case manager has not signed and returned to the license holder the 
113.35 	coordinated service and support plan or coordinated service and support plan addendum or 
114.1 	has not proposed written modifications to the license holder's submission, the submission 
114.2 	is deemed approved and the coordinated service and support plan addendum becomes 
114.3 	effective and remains in effect until the legal representative or case manager submits a 
114.4 	written request to revise the coordinated service and support plan addendum.

114.5 	Sec. 5. Minnesota Statutes 2018, section 245D.09, subdivision 5, is amended to read:
114.6 		Subd. 5.Annual training.  A license holder must provide annual training to direct support 
114.7 	staff on the topics identified in subdivision 4, clauses (3) to (10). If the direct support staff 
114.8 	has a first aid certification, annual training under subdivision 4, clause (9), is not required 
114.9 	as long as the certification remains current. A license holder must provide a minimum of 
114.10 	24 hours of annual training to direct service staff providing intensive services and having 
114.11 	fewer than five years of documented experience and 12 hours of annual training to direct 
114.12 	service staff providing intensive services and having five or more years of documented 
114.13 	experience in topics described in subdivisions 4 and 4a, paragraphs (a) to (f). Training on 
114.14 	relevant topics received from sources other than the license holder may count toward training 
114.15 	requirements. A license holder must provide a minimum of 12 hours of annual training to 
114.16 	direct service staff providing basic services and having fewer than five years of documented 
114.17 	experience and six hours of annual training to direct service staff providing basic services 
114.18 	and having five or more years of documented experience.

114.19 	Sec. 6. Minnesota Statutes 2018, section 245D.09, subdivision 5a, is amended to read:
114.20 		Subd. 5a.Alternative sources of training. The commissioner may approve online 
114.21 	training and competency-based assessments in place of a specific number of hours of training 
114.22 	in the topics covered in subdivision 4. The commissioner must provide a list of preapproved 
114.23 	trainings that do not need approval for each individual license holder.
114.24 	Orientation or training received by the staff person from sources other than the license 
114.25 	holder in the same subjects as identified in subdivision 4 may count toward the orientation 
114.26 	and annual training requirements if received in the 12-month period before the staff person's 
114.27 	date of hire. The license holder must maintain documentation of the training received from 
114.28 	other sources and of each staff person's competency in the required area according to the 
114.29 	requirements in subdivision 3.

114.30 	Sec. 7. Minnesota Statutes 2018, section 245D.091, subdivision 2, is amended to read:
114.31 		Subd. 2.Behavior Positive support professional qualifications. A behavior positive 
114.32 	support professional providing behavioral positive support services as identified in section 
115.1 	245D.03, subdivision 1, paragraph (c), clause (1), item (i), must have competencies in the 
115.2 	following areas as required under the brain injury and, community access for disability 
115.3 	inclusion, community alternative care, and developmental disabilities waiver plans or 
115.4 	successor plans:
115.5 	(1) ethical considerations;
115.6 	(2) functional assessment;
115.7 	(3) functional analysis;
115.8 	(4) measurement of behavior and interpretation of data;
115.9 	(5) selecting intervention outcomes and strategies;
115.10 	(6) behavior reduction and elimination strategies that promote least restrictive approved 
115.11 	alternatives;
115.12 	(7) data collection;
115.13 	(8) staff and caregiver training;
115.14 	(9) support plan monitoring;
115.15 	(10) co-occurring mental disorders or neurocognitive disorder;
115.16 	(11) demonstrated expertise with populations being served; and
115.17 	(12) must be a:
115.18 	(i) psychologist licensed under sections 148.88 to 148.98, who has stated to the Board 
115.19 	of Psychology competencies in the above identified areas;
115.20 	(ii) clinical social worker licensed as an independent clinical social worker under chapter 
115.21 	148D, or a person with a master's degree in social work from an accredited college or 
115.22 	university, with at least 4,000 hours of post-master's supervised experience in the delivery 
115.23 	of clinical services in the areas identified in clauses (1) to (11);
115.24 	(iii) physician licensed under chapter 147 and certified by the American Board of 
115.25 	Psychiatry and Neurology or eligible for board certification in psychiatry with competencies 
115.26 	in the areas identified in clauses (1) to (11);
115.27 	(iv) licensed professional clinical counselor licensed under sections 148B.29 to 148B.39
115.28 	with at least 4,000 hours of post-master's supervised experience in the delivery of clinical 
115.29 	services who has demonstrated competencies in the areas identified in clauses (1) to (11);
116.1 	(v) person with a master's degree from an accredited college or university in one of the 
116.2 	behavioral sciences or related fields, with at least 4,000 hours of post-master's supervised 
116.3 	experience in the delivery of clinical services with demonstrated competencies in the areas 
116.4 	identified in clauses (1) to (11); or
116.5 	(vi) person with a master's degree or PhD in one of the behavioral sciences or related 
116.6 	fields with demonstrated expertise in positive support services; or
116.7 	(vii) registered nurse who is licensed under sections 148.171 to 148.285, and who is 
116.8 	certified as a clinical specialist or as a nurse practitioner in adult or family psychiatric and 
116.9 	mental health nursing by a national nurse certification organization, or who has a master's 
116.10 	degree in nursing or one of the behavioral sciences or related fields from an accredited 
116.11 	college or university or its equivalent, with at least 4,000 hours of post-master's supervised 
116.12 	experience in the delivery of clinical services.

116.13 	Sec. 8. Minnesota Statutes 2018, section 245D.091, subdivision 3, is amended to read:
116.14 		Subd. 3.Behavior Positive support analyst qualifications. (a) A behavior positive 
116.15 	support analyst providing behavioral positive support services as identified in section 
116.16 	245D.03, subdivision 1, paragraph (c), clause (1), item (i), must have competencies in the 
116.17 	following areas as required under the brain injury and, community access for disability 
116.18 	inclusion, community alternative care, and developmental disabilities waiver plans or 
116.19 	successor plans:
116.20 	(1) have obtained a baccalaureate degree, master's degree, or PhD in a social services 
116.21 	discipline; or
116.22 	(2) meet the qualifications of a mental health practitioner as defined in section 245.462, 
116.23 	subdivision 17; or
116.24 	(3) be a board-certified behavior analyst or board-certified assistant behavior analyst by 
116.25 	the Behavior Analyst Certification Board, Incorporated.
116.26 	(b) In addition, a behavior positive support analyst must:
116.27 	(1) have four years of supervised experience working with individuals who exhibit 
116.28 	challenging behaviors as well as co-occurring mental disorders or neurocognitive disorder
116.29 	conducting functional behavior assessments and designing, implementing, and evaluating 
116.30 	effectiveness of positive practices behavior support strategies for people who exhibit 
116.31 	challenging behaviors as well as co-occurring mental disorders and neurocognitive disorder;
117.1 	(2) have received ten hours of instruction in functional assessment and functional analysis;
117.2 	training prior to hire or within 90 calendar days of hire that includes:
117.3 	(i) ten hours of instruction in functional assessment and functional analysis;
117.4 	(ii) 20 hours of instruction in the understanding of the function of behavior;
117.5 	(iii) ten hours of instruction on design of positive practices behavior support strategies;
117.6 	(iv) 20 hours of instruction preparing written intervention strategies, designing data 
117.7 	collection protocols, training other staff to implement positive practice strategies, 
117.8 	summarizing and reporting program evaluation data, analyzing program evaluation data to 
117.9 	identify design flaws in behavioral interventions or failures in implementation fidelity, and 
117.10 	recommending enhancements based on evaluation data; and
117.11 	(v) eight hours of instruction on principles of person-centered thinking;
117.12 	(3) have received 20 hours of instruction in the understanding of the function of behavior;
117.13 	(4) have received ten hours of instruction on design of positive practices behavior support 
117.14 	strategies;
117.15 	(5) have received 20 hours of instruction on the use of behavior reduction approved 
117.16 	strategies used only in combination with behavior positive practices strategies;
117.17 	(6) (3) be determined by a behavior positive support professional to have the training 
117.18 	and prerequisite skills required to provide positive practice strategies as well as behavior 
117.19 	reduction approved and permitted intervention to the person who receives behavioral positive
117.20 	support; and
117.21 	(7) (4) be under the direct supervision of a behavior positive support professional.
117.22 	(c) Meeting the qualifications for a positive support professional under subdivision 2 
117.23 	shall substitute for meeting the qualifications listed in paragraph (b).

117.24 	Sec. 9. Minnesota Statutes 2018, section 245D.091, subdivision 4, is amended to read:
117.25 		Subd. 4.Behavior Positive support specialist qualifications. (a) A behavior positive 
117.26 	support specialist providing behavioral positive support services as identified in section 
117.27 	245D.03, subdivision 1, paragraph (c), clause (1), item (i), must have competencies in the 
117.28 	following areas as required under the brain injury and, community access for disability 
117.29 	inclusion, community alternative care, and developmental disabilities waiver plans or 
117.30 	successor plans:
117.31 	(1) have an associate's degree in a social services discipline; or
118.1 	(2) have two years of supervised experience working with individuals who exhibit 
118.2 	challenging behaviors as well as co-occurring mental disorders or neurocognitive disorder.
118.3 	(b) In addition, a behavior specialist must:
118.4 	(1) have received training prior to hire or within 90 calendar days of hire that includes:
118.5 	(i) a minimum of four hours of training in functional assessment;
118.6 	(2) have received (ii) 20 hours of instruction in the understanding of the function of 
118.7 	behavior;
118.8 	(3) have received (iii) ten hours of instruction on design of positive practices behavioral 
118.9 	support strategies; and
118.10 	(iv) eight hours of instruction on principles of person-centered thinking;
118.11 	(4) (2) be determined by a behavior positive support professional to have the training 
118.12 	and prerequisite skills required to provide positive practices strategies as well as behavior 
118.13 	reduction approved intervention to the person who receives behavioral positive support; 
118.14 	and
118.15 	(5) (3) be under the direct supervision of a behavior positive support professional.
118.16 	(c) Meeting the qualifications for a positive support professional under subdivision 2 
118.17 	shall substitute for meeting the qualifications listed in paragraphs (a) and (b).

118.18 	Sec. 10. Minnesota Statutes 2018, section 252.275, subdivision 3, is amended to read:
118.19 		Subd. 3.Reimbursement. Counties shall be reimbursed for all expenditures made 
118.20 	pursuant to subdivision 1 at a rate of 70 85 percent, up to the allocation determined pursuant 
118.21 	to subdivisions 4 and 4b. However, the commissioner shall not reimburse costs of services 
118.22 	for any person if the costs exceed the state share of the average medical assistance costs for 
118.23 	services provided by intermediate care facilities for a person with a developmental disability 
118.24 	for the same fiscal year, and shall not reimburse costs of a onetime living allowance for any 
118.25 	person if the costs exceed $1,500 in a state fiscal year. The commissioner may make 
118.26 	payments to each county in quarterly installments. The commissioner may certify an advance 
118.27 	of up to 25 percent of the allocation. Subsequent payments shall be made on a reimbursement 
118.28 	basis for reported expenditures and may be adjusted for anticipated spending patterns.

118.29 	Sec. 11. [256.488] ADAPTIVE FITNESS ACCESS GRANT.
118.30 		Subdivision 1.Definitions. (a) "Adaptive fitness" means the practice of physical fitness 
118.31 	by an individual with primary physical disabilities, either as a consequence of the natural 
119.1 	aging process or due to a developmental disability, mental health issue, congenital condition, 
119.2 	trauma, injury, or disease.
119.3 	(b) "Adaptive fitness center" means a center with modified equipment, equipment 
119.4 	arrangement and space for access, and trainers with skills in modifying exercise programs 
119.5 	specific to the physical and cognitive needs of individuals with disabilities.
119.6 	(c) "Commissioner" means the commissioner of human services.
119.7 	(d) "Disability" has the meaning given in the Americans with Disabilities Act.
119.8 		Subd. 2.Establishment. A statewide adaptive fitness access grant program is established 
119.9 	under the Department of Human Services to award grants to promote access to adaptive 
119.10 	fitness for individuals with disabilities.
119.11 		Subd. 3.Application and review. (a) The commissioner must develop a grant application 
119.12 	that must contain, at a minimum:
119.13 	(1) a description of the purpose or project for which the grant will be used;
119.14 	(2) a description of the specific problem the grant intends to address;
119.15 	(3) a description of achievable objectives, a work plan, and a timeline for implementation 
119.16 	and completion of processes or projects enabled by the grant;
119.17 	(4) a description of the existing frameworks and experience providing adaptive fitness; 
119.18 	and
119.19 	(5) a proposed process for documenting and evaluating results of the grant.
119.20 	(b) An applicant must apply using the grant application developed by the commissioner.
119.21 	(c) The commissioner shall review each application. The commissioner shall establish 
119.22 	criteria to evaluate applications, including but not limited to:
119.23 	(1) the application is complete;
119.24 	(2) the eligibility of the applicant;
119.25 	(3) the thoroughness and clarity in identifying the specific problem the grant intends to 
119.26 	address;
119.27 	(4) a description of the population demographics and service area of the proposed project;
119.28 	(5) documentation the grant applicant has received cash or in-kind contributions of value 
119.29 	equal to the requested grant amount; and
120.1 	(6) the proposed project's longevity and demonstrated financial sustainability after the 
120.2 	initial grant period.
120.3 	(d) In evaluating applications, the commissioner may request additional information 
120.4 	regarding a proposed project, including information on project cost. An applicant's failure 
120.5 	to timely provide the information requested disqualifies an applicant.
120.6 		Subd. 4.Awards. (a) The commissioner shall award grants to eligible applicants to 
120.7 	provide adaptive fitness for individuals with disabilities.
120.8 	(b) The commissioner shall award grants to qualifying nonprofit organizations that 
120.9 	provide adaptive fitness in adaptive fitness centers. Grants must be used to assist one or 
120.10 	more qualified nonprofit organizations to provide adaptive fitness, including: (1) stay fit; 
120.11 	(2) activity-based locomotor exercise; (3) equipment necessary for adaptive fitness programs; 
120.12 	(4) operating expenses related to staffing of adaptive fitness programs; and (5) other adaptive 
120.13 	fitness programs as deemed appropriate by the commissioner.
120.14 	(c) An applicant may apply for and the commissioner may award grants for two-year 
120.15 	periods, and the commissioner shall determine the number of grants awarded. The 
120.16 	commissioner may reallocate underspending among grantees within the same grant period.
120.17 		Subd. 5.Report. Beginning December 1, 2020, and every two years thereafter, the 
120.18 	commissioner of human services shall submit a report to the chairs and ranking minority 
120.19 	members of the legislative committees with jurisdiction over health and human services. 
120.20 	The report shall, at a minimum, include the amount of funding awarded for each project, a 
120.21 	description of the programs and services funded, plans for the long-term sustainability of 
120.22 	the projects, and data on outcomes for the programs and services funded. Grantees must 
120.23 	provide information and data requested by the commissioner to support the development 
120.24 	of this report.

120.25 	Sec. 12. Minnesota Statutes 2018, section 256B.0625, subdivision 19a, is amended to 
120.26 	read:
120.27 		Subd. 19a.Personal care assistance services. Medical assistance covers personal care 
120.28 	assistance services in a recipient's home. Effective January 1, 2010 2020, to qualify for 
120.29 	personal care assistance services, a recipient must require assistance and be determined 
120.30 	dependent in one critical activity of daily living as defined in section 256B.0659, subdivision 
120.31 	1, paragraph (b) (e), or in a Level I behavior as defined in section 256B.0659, subdivision 
120.32 	1, paragraph (c), or have a behavior that shows increased vulnerability due to cognitive 
120.33 	deficits or socially inappropriate behavior that requires assistance at least four times per 
121.1 	week. Recipients or responsible parties must be able to identify the recipient's needs, direct 
121.2 	and evaluate task accomplishment, and provide for health and safety. Approved hours may 
121.3 	be used outside the home when normal life activities take them outside the home. To use 
121.4 	personal care assistance services at school, the recipient or responsible party must provide 
121.5 	written authorization in the care plan identifying the chosen provider and the daily amount 
121.6 	of services to be used at school. Total hours for services, whether actually performed inside 
121.7 	or outside the recipient's home, cannot exceed that which is otherwise allowed for personal 
121.8 	care assistance services in an in-home setting according to sections 256B.0651 to 256B.0654. 
121.9 	Medical assistance does not cover personal care assistance services for residents of a hospital, 
121.10 	nursing facility, intermediate care facility, health care facility licensed by the commissioner 
121.11 	of health, or unless a resident who is otherwise eligible is on leave from the facility and the 
121.12 	facility either pays for the personal care assistance services or forgoes the facility per diem 
121.13 	for the leave days that personal care assistance services are used. All personal care assistance 
121.14 	services must be provided according to sections 256B.0651 to 256B.0654. Personal care 
121.15 	assistance services may not be reimbursed if the personal care assistant is the spouse or paid 
121.16 	guardian of the recipient or the parent of a recipient under age 18, or the responsible party 
121.17 	or the family foster care provider of a recipient who cannot direct the recipient's own care 
121.18 	unless, in the case of a foster care provider, a county or state case manager visits the recipient 
121.19 	as needed, but not less than every six months, to monitor the health and safety of the recipient 
121.20 	and to ensure the goals of the care plan are met. Notwithstanding the provisions of section 
121.21 	256B.0659, the unpaid guardian or conservator of an adult, who is not the responsible party 
121.22 	and not the personal care provider organization, may be reimbursed to provide personal 
121.23 	care assistance services to the recipient if the guardian or conservator meets all criteria for 
121.24 	a personal care assistant according to section 256B.0659, and shall not be considered to 
121.25 	have a service provider interest for purposes of participation on the screening team under 
121.26 	section 256B.092, subdivision 7.

121.27 	EFFECTIVE DATE. This section is effective January 1, 2020, or upon federal approval, 
121.28 	whichever is later. The commissioner shall implement the modified eligibility criteria as 
121.29 	annual assessments occur. The commissioner shall notify the revisor of statutes when federal 
121.30 	approval is obtained.

121.31 	Sec. 13. Minnesota Statutes 2018, section 256B.0652, subdivision 6, is amended to read:
121.32 		Subd. 6. Authorization; personal care assistance and qualified professional. (a) All 
121.33 	personal care assistance services, supervision by a qualified professional, and additional 
121.34 	services beyond the limits established in subdivision 11, must be authorized by the 
121.35 	commissioner or the commissioner's designee before services begin except for the 
122.1 	assessments established in subdivision 11 and section 256B.0911. The authorization for 
122.2 	personal care assistance and qualified professional services under section 256B.0659 must 
122.3 	be completed within 30 days after receiving a complete request.
122.4 	(b) The amount of personal care assistance services authorized must be based on the 
122.5 	recipient's home care rating. The home care rating shall be determined by the commissioner 
122.6 	or the commissioner's designee based on information submitted to the commissioner 
122.7 	identifying the following for recipients with dependencies in two or more activities of daily 
122.8 	living:
122.9 	(1) total number of dependencies of activities of daily living as defined in section 
122.10 	256B.0659;
122.11 	(2) presence of complex health-related needs as defined in section 256B.0659; and
122.12 	(3) presence of Level I behavior as defined in section 256B.0659.
122.13 	(c) For purposes meeting the criteria in paragraph (b), the methodology to determine 
122.14 	total time for personal care assistance services for each home care rating is based on the 
122.15 	median paid units per day for each home care rating from fiscal year 2007 data for the 
122.16 	personal care assistance program. Each home care rating has a base level of hours assigned. 
122.17 	Additional time is added through the assessment and identification of the following:
122.18 	(1) 30 additional minutes per day for a dependency in each critical activity of daily living 
122.19 	as defined in section 256B.0659;
122.20 	(2) 30 additional minutes per day for each complex health-related function as defined 
122.21 	in section 256B.0659; and
122.22 	(3) 30 additional minutes per day for each behavior issue as defined in section 256B.0659, 
122.23 	subdivision 4, paragraph (d).
122.24 	(d) Effective July 1, 2011, the home care rating for recipients who have a dependency 
122.25 	in one activity of daily living or Level I behavior shall equal no more than two units per 
122.26 	day. Effective January 1, 2020, the home care rating for recipients who have a dependency 
122.27 	in one critical activity of daily living or one Level I behavior or that require assistance with 
122.28 	a behavior that shows increased vulnerability due to cognitive deficits or socially 
122.29 	inappropriate behavior at least four times per week shall equal no more than two units per 
122.30 	day. Recipients with this home care rating are not subject to the methodology in paragraph 
122.31 	(c) and are not eligible for more than two units per day.
122.32 	(e) A limit of 96 units of qualified professional supervision may be authorized for each 
122.33 	recipient receiving personal care assistance services. A request to the commissioner to 
123.1 	exceed this total in a calendar year must be requested by the personal care provider agency 
123.2 	on a form approved by the commissioner.

123.3 	EFFECTIVE DATE. This section is effective January 1, 2020, or upon federal approval, 
123.4 	whichever is later. The commissioner shall implement the modified eligibility criteria as 
123.5 	annual assessments occur. The commissioner shall notify the revisor of statutes when federal 
123.6 	approval is obtained.

123.7 	Sec. 14. Minnesota Statutes 2018, section 256B.0658, is amended to read:
123.8 	256B.0658 HOUSING ACCESS GRANTS.
123.9 	The commissioner of human services shall award through a competitive process contracts 
123.10 	for grants to public and private agencies to support and assist individuals eligible for publicly 
123.11 	funded home and community-based services, including state plan home care with a disability 
123.12 	as defined in section 256B.051, subdivision 2, paragraph (e), to access housing. Grants may 
123.13 	be awarded to agencies that may include, but are not limited to, the following supports: 
123.14 	assessment to ensure suitability of housing, accompanying an individual to look at housing, 
123.15 	filling out applications and rental agreements, meeting with landlords, helping with Section 
123.16 	8 or other program applications, helping to develop a budget, obtaining furniture and 
123.17 	household goods, if necessary, and assisting with any problems that may arise with housing.

123.18 	Sec. 15. Minnesota Statutes 2018, section 256B.0659, subdivision 3a, is amended to read:
123.19 		Subd. 3a.Assessment; defined. (a) "Assessment" means a review and evaluation of a 
123.20 	recipient's need for personal care assistance services conducted in person. Assessments for 
123.21 	personal care assistance services shall be conducted by the county public health nurse or a 
123.22 	certified public health nurse under contract with the county except when a long-term care 
123.23 	consultation assessment is being conducted for the purposes of determining a person's 
123.24 	eligibility for home and community-based waiver services including personal care assistance 
123.25 	services according to section 256B.0911. During the transition to MnCHOICES, a certified 
123.26 	assessor may complete the assessment defined in this subdivision. An in-person assessment 
123.27 	must include: documentation of health status, determination of need, evaluation of service 
123.28 	effectiveness, identification of appropriate services, service plan development or modification, 
123.29 	coordination of services, referrals and follow-up to appropriate payers and community 
123.30 	resources, completion of required reports, recommendation of service authorization, and 
123.31 	consumer education. Once the need for personal care assistance services is determined under 
123.32 	this section, the county public health nurse or certified public health nurse under contract 
123.33 	with the county is responsible for communicating this recommendation to the commissioner 
124.1 	and the recipient. An in-person assessment must occur at least annually or when there is a 
124.2 	significant change in the recipient's condition or when there is a change in the need for 
124.3 	personal care assistance services. A service update may substitute for the annual face-to-face 
124.4 	assessment when there is not a significant change in recipient condition or a change in the 
124.5 	need for personal care assistance service. A service update may be completed by telephone, 
124.6 	used when there is no need for an increase in personal care assistance services, and used 
124.7 	for two consecutive assessments if followed by a face-to-face assessment. A service update 
124.8 	must be completed on a form approved by the commissioner. A service update or review 
124.9 	for temporary increase includes a review of initial baseline data, evaluation of service 
124.10 	effectiveness, redetermination of service need, modification of service plan and appropriate 
124.11 	referrals, update of initial forms, obtaining service authorization, and on going consumer 
124.12 	education. Assessments or reassessments must be completed on forms provided by the 
124.13 	commissioner within 30 days of a request for home care services by a recipient or responsible 
124.14 	party.
124.15 	(b) This subdivision expires when notification is given by the commissioner as described 
124.16 	in section 256B.0911, subdivision 3a.

124.17 	Sec. 16. Minnesota Statutes 2018, section 256B.0659, subdivision 11, is amended to read:
124.18 		Subd. 11.Personal care assistant; requirements. (a) A personal care assistant must 
124.19 	meet the following requirements:
124.20 	(1) be at least 18 years of age with the exception of persons who are 16 or 17 years of 
124.21 	age with these additional requirements:
124.22 	(i) supervision by a qualified professional every 60 days; and
124.23 	(ii) employment by only one personal care assistance provider agency responsible for 
124.24 	compliance with current labor laws;
124.25 	(2) be employed by a personal care assistance provider agency;
124.26 	(3) enroll with the department as a personal care assistant after clearing a background 
124.27 	study. Except as provided in subdivision 11a, before a personal care assistant provides 
124.28 	services, the personal care assistance provider agency must initiate a background study on 
124.29 	the personal care assistant under chapter 245C, and the personal care assistance provider 
124.30 	agency must have received a notice from the commissioner that the personal care assistant 
124.31 	is:
124.32 	(i) not disqualified under section 245C.14; or
125.1 	(ii) is disqualified, but the personal care assistant has received a set aside of the 
125.2 	disqualification under section 245C.22;
125.3 	(4) be able to effectively communicate with the recipient and personal care assistance 
125.4 	provider agency;
125.5 	(5) be able to provide covered personal care assistance services according to the recipient's 
125.6 	personal care assistance care plan, respond appropriately to recipient needs, and report 
125.7 	changes in the recipient's condition to the supervising qualified professional or physician;
125.8 	(6) not be a consumer of personal care assistance services;
125.9 	(7) maintain daily written records including, but not limited to, time sheets under 
125.10 	subdivision 12;
125.11 	(8) effective January 1, 2010, complete standardized training as determined by the 
125.12 	commissioner before completing enrollment. The training must be available in languages 
125.13 	other than English and to those who need accommodations due to disabilities. Personal care 
125.14 	assistant training must include successful completion of the following training components: 
125.15 	basic first aid, vulnerable adult, child maltreatment, OSHA universal precautions, basic 
125.16 	roles and responsibilities of personal care assistants including information about assistance 
125.17 	with lifting and transfers for recipients, emergency preparedness, orientation to positive 
125.18 	behavioral practices, fraud issues, and completion of time sheets. Upon completion of the 
125.19 	training components, the personal care assistant must demonstrate the competency to provide 
125.20 	assistance to recipients;
125.21 	(9) complete training and orientation on the needs of the recipient; and
125.22 	(10) be limited to providing and being paid for up to 275 hours per month of personal 
125.23 	care assistance services regardless of the number of recipients being served or the number 
125.24 	of personal care assistance provider agencies enrolled with. The number of hours worked 
125.25 	per day shall not be disallowed by the department unless in violation of the law.
125.26 	(b) A legal guardian may be a personal care assistant if the guardian is not being paid 
125.27 	for the guardian services and meets the criteria for personal care assistants in paragraph (a).
125.28 	(c) Persons who do not qualify as a personal care assistant include parents, stepparents, 
125.29 	and legal guardians of minors; spouses; paid legal guardians of adults; family foster care 
125.30 	providers, except as otherwise allowed in section 256B.0625, subdivision 19a; and staff of 
125.31 	a residential setting.
125.32 	(d) Personal care assistance services qualify for the enhanced rate described in subdivision 
125.33 	17a if the personal care assistant providing the services:
126.1 	(1) provides services, according to the care plan in subdivision 7, to a recipient who 
126.2 	qualifies for ten or more hours per day of personal care assistance services; and
126.3 	(2) satisfies the current requirements of Medicare for training and competency or 
126.4 	competency evaluation of home health aides or nursing assistants, as provided in Code of 
126.5 	Federal Regulations, title 42, section 483.151 or 484.36, or alternative state-approved training 
126.6 	or competency requirements.

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

126.8 	Sec. 17. Minnesota Statutes 2018, section 256B.0659, is amended by adding a subdivision 
126.9 	to read:
126.10 		Subd. 17a.Enhanced rate. An enhanced rate of 110 percent of the rate paid for personal 
126.11 	care assistance services shall be paid for services provided to persons who qualify for ten 
126.12 	or more hours of personal care assistance service per day when provided by a personal care 
126.13 	assistant who meets the requirements of subdivision 11, paragraph (d). The enhanced rate 
126.14 	for personal care assistance services includes, and is not in addition to, any rate adjustments 
126.15 	implemented by the commissioner to comply with the terms of a collective bargaining 
126.16 	agreement between the state of Minnesota and an exclusive representative of individual 
126.17 	providers under section 179A.54 for increased financial incentives for providing services 
126.18 	to people with complex needs.

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

126.20 	Sec. 18. Minnesota Statutes 2018, section 256B.0659, subdivision 21, is amended to read:
126.21 		Subd. 21.Requirements for provider enrollment of personal care assistance provider 
126.22 	agencies. (a) All personal care assistance provider agencies must provide, at the time of 
126.23 	enrollment, reenrollment, and revalidation as a personal care assistance provider agency in 
126.24 	a format determined by the commissioner, information and documentation that includes, 
126.25 	but is not limited to, the following:
126.26 	(1) the personal care assistance provider agency's current contact information including 
126.27 	address, telephone number, and e-mail address;
126.28 	(2) proof of surety bond coverage. Upon new enrollment, or if the provider's Medicaid 
126.29 	revenue in the previous calendar year is up to and including $300,000, the provider agency 
126.30 	must purchase a surety bond of $50,000. If the Medicaid revenue in the previous year is 
126.31 	over $300,000, the provider agency must purchase a surety bond of $100,000. The surety 
127.1 	bond must be in a form approved by the commissioner, must be renewed annually, and must 
127.2 	allow for recovery of costs and fees in pursuing a claim on the bond;
127.3 	(3) proof of fidelity bond coverage in the amount of $20,000;
127.4 	(4) proof of workers' compensation insurance coverage;
127.5 	(5) proof of liability insurance;
127.6 	(6) a description of the personal care assistance provider agency's organization identifying 
127.7 	the names of all owners, managing employees, staff, board of directors, and the affiliations 
127.8 	of the directors, owners, or staff to other service providers;
127.9 	(7) a copy of the personal care assistance provider agency's written policies and 
127.10 	procedures including: hiring of employees; training requirements; service delivery; and 
127.11 	employee and consumer safety including process for notification and resolution of consumer 
127.12 	grievances, identification and prevention of communicable diseases, and employee 
127.13 	misconduct;
127.14 	(8) copies of all other forms the personal care assistance provider agency uses in the 
127.15 	course of daily business including, but not limited to:
127.16 	(i) a copy of the personal care assistance provider agency's time sheet if the time sheet 
127.17 	varies from the standard time sheet for personal care assistance services approved by the 
127.18 	commissioner, and a letter requesting approval of the personal care assistance provider 
127.19 	agency's nonstandard time sheet;
127.20 	(ii) the personal care assistance provider agency's template for the personal care assistance 
127.21 	care plan; and
127.22 	(iii) the personal care assistance provider agency's template for the written agreement 
127.23 	in subdivision 20 for recipients using the personal care assistance choice option, if applicable;
127.24 	(9) a list of all training and classes that the personal care assistance provider agency 
127.25 	requires of its staff providing personal care assistance services;
127.26 	(10) documentation that the personal care assistance provider agency and staff have 
127.27 	successfully completed all the training required by this section, including the requirements 
127.28 	under subdivision 11, paragraph (d), if enhanced personal care assistance services are 
127.29 	provided and submitted for an enhanced rate under subdivision 17a;
127.30 	(11) documentation of the agency's marketing practices;
127.31 	(12) disclosure of ownership, leasing, or management of all residential properties that 
127.32 	is used or could be used for providing home care services;
128.1 	(13) documentation that the agency will use the following percentages of revenue 
128.2 	generated from the medical assistance rate paid for personal care assistance services for 
128.3 	employee personal care assistant wages and benefits: 72.5 percent of revenue in the personal 
128.4 	care assistance choice option and 72.5 percent of revenue from other personal care assistance 
128.5 	providers. The revenue generated by the qualified professional and the reasonable costs 
128.6 	associated with the qualified professional shall not be used in making this calculation; and
128.7 	(14) effective May 15, 2010, documentation that the agency does not burden recipients' 
128.8 	free exercise of their right to choose service providers by requiring personal care assistants 
128.9 	to sign an agreement not to work with any particular personal care assistance recipient or 
128.10 	for another personal care assistance provider agency after leaving the agency and that the 
128.11 	agency is not taking action on any such agreements or requirements regardless of the date 
128.12 	signed.
128.13 	(b) Personal care assistance provider agencies shall provide the information specified 
128.14 	in paragraph (a) to the commissioner at the time the personal care assistance provider agency 
128.15 	enrolls as a vendor or upon request from the commissioner. The commissioner shall collect 
128.16 	the information specified in paragraph (a) from all personal care assistance providers 
128.17 	beginning July 1, 2009.
128.18 	(c) All personal care assistance provider agencies shall require all employees in 
128.19 	management and supervisory positions and owners of the agency who are active in the 
128.20 	day-to-day management and operations of the agency to complete mandatory training as 
128.21 	determined by the commissioner before enrollment of the agency as a provider. Employees 
128.22 	in management and supervisory positions and owners who are active in the day-to-day 
128.23 	operations of an agency who have completed the required training as an employee with a 
128.24 	personal care assistance provider agency do not need to repeat the required training if they 
128.25 	are hired by another agency, if they have completed the training within the past three years. 
128.26 	By September 1, 2010, the required training must be available with meaningful access 
128.27 	according to title VI of the Civil Rights Act and federal regulations adopted under that law 
128.28 	or any guidance from the United States Health and Human Services Department. The 
128.29 	required training must be available online or by electronic remote connection. The required 
128.30 	training must provide for competency testing. Personal care assistance provider agency 
128.31 	billing staff shall complete training about personal care assistance program financial 
128.32 	management. This training is effective July 1, 2009. Any personal care assistance provider 
128.33 	agency enrolled before that date shall, if it has not already, complete the provider training 
128.34 	within 18 months of July 1, 2009. Any new owners or employees in management and 
128.35 	supervisory positions involved in the day-to-day operations are required to complete 
129.1 	mandatory training as a requisite of working for the agency. Personal care assistance provider 
129.2 	agencies certified for participation in Medicare as home health agencies are exempt from 
129.3 	the training required in this subdivision. When available, Medicare-certified home health 
129.4 	agency owners, supervisors, or managers must successfully complete the competency test.

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

129.6 	Sec. 19. Minnesota Statutes 2018, section 256B.0659, subdivision 24, is amended to read:
129.7 		Subd. 24.Personal care assistance provider agency; general duties. A personal care 
129.8 	assistance provider agency shall:
129.9 	(1) enroll as a Medicaid provider meeting all provider standards, including completion 
129.10 	of the required provider training;
129.11 	(2) comply with general medical assistance coverage requirements;
129.12 	(3) demonstrate compliance with law and policies of the personal care assistance program 
129.13 	to be determined by the commissioner;
129.14 	(4) comply with background study requirements;
129.15 	(5) verify and keep records of hours worked by the personal care assistant and qualified 
129.16 	professional;
129.17 	(6) not engage in any agency-initiated direct contact or marketing in person, by phone, 
129.18 	or other electronic means to potential recipients, guardians, or family members;
129.19 	(7) pay the personal care assistant and qualified professional based on actual hours of 
129.20 	services provided;
129.21 	(8) withhold and pay all applicable federal and state taxes;
129.22 	(9) effective January 1, 2010, document that the agency uses a minimum of 72.5 percent 
129.23 	of the revenue generated by the medical assistance rate for personal care assistance services 
129.24 	for employee personal care assistant wages and benefits. The revenue generated by the 
129.25 	qualified professional and the reasonable costs associated with the qualified professional 
129.26 	shall not be used in making this calculation;
129.27 	(10) make the arrangements and pay unemployment insurance, taxes, workers' 
129.28 	compensation, liability insurance, and other benefits, if any;
129.29 	(11) enter into a written agreement under subdivision 20 before services are provided;
129.30 	(12) report suspected neglect and abuse to the common entry point according to section 
129.31 	256B.0651;
130.1 	(13) provide the recipient with a copy of the home care bill of rights at start of service; 
130.2 	and
130.3 	(14) request reassessments at least 60 days prior to the end of the current authorization 
130.4 	for personal care assistance services, on forms provided by the commissioner.; and
130.5 	(15) document that the agency uses the additional revenue due to the enhanced rate under 
130.6 	subdivision 17a for the wages and benefits of the PCAs whose services meet the requirements 
130.7 	under subdivision 11, paragraph (d).

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

130.9 	Sec. 20. Minnesota Statutes 2018, section 256B.0659, subdivision 28, is amended to read:
130.10 		Subd. 28.Personal care assistance provider agency; required documentation. (a) 
130.11 	Required documentation must be completed and kept in the personal care assistance provider 
130.12 	agency file or the recipient's home residence. The required documentation consists of:
130.13 	(1) employee files, including:
130.14 	(i) applications for employment;
130.15 	(ii) background study requests and results;
130.16 	(iii) orientation records about the agency policies;
130.17 	(iv) trainings completed with demonstration of competence, including verification of 
130.18 	the completion of training required under subdivision 11, paragraph (d), for any services 
130.19 	billed at the enhanced rate under subdivision 17a;
130.20 	(v) supervisory visits;
130.21 	(vi) evaluations of employment; and
130.22 	(vii) signature on fraud statement;
130.23 	(2) recipient files, including:
130.24 	(i) demographics;
130.25 	(ii) emergency contact information and emergency backup plan;
130.26 	(iii) personal care assistance service plan;
130.27 	(iv) personal care assistance care plan;
130.28 	(v) month-to-month service use plan;
130.29 	(vi) all communication records;
131.1 	(vii) start of service information, including the written agreement with recipient; and
131.2 	(viii) date the home care bill of rights was given to the recipient;
131.3 	(3) agency policy manual, including:
131.4 	(i) policies for employment and termination;
131.5 	(ii) grievance policies with resolution of consumer grievances;
131.6 	(iii) staff and consumer safety;
131.7 	(iv) staff misconduct; and
131.8 	(v) staff hiring, service delivery, staff and consumer safety, staff misconduct, and 
131.9 	resolution of consumer grievances;
131.10 	(4) time sheets for each personal care assistant along with completed activity sheets for 
131.11 	each recipient served; and
131.12 	(5) agency marketing and advertising materials and documentation of marketing activities 
131.13 	and costs.
131.14 	(b) The commissioner may assess a fine of up to $500 on provider agencies that do not 
131.15 	consistently comply with the requirements of this subdivision.

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

131.17 	Sec. 21. Minnesota Statutes 2018, section 256B.0911, subdivision 1a, is amended to read:
131.18 		Subd. 1a.Definitions. For purposes of this section, the following definitions apply:
131.19 	(a) Until additional requirements apply under paragraph (b), "long-term care consultation 
131.20 	services" means:
131.21 	(1) intake for and access to assistance in identifying services needed to maintain an 
131.22 	individual in the most inclusive environment;
131.23 	(2) providing recommendations for and referrals to cost-effective community services 
131.24 	that are available to the individual;
131.25 	(3) development of an individual's person-centered community support plan;
131.26 	(4) providing information regarding eligibility for Minnesota health care programs;
131.27 	(5) face-to-face long-term care consultation assessments, which may be completed in a 
131.28 	hospital, nursing facility, intermediate care facility for persons with developmental disabilities 
131.29 	(ICF/DDs), regional treatment centers, or the person's current or planned residence;
132.1 	(6) determination of home and community-based waiver and other service eligibility as 
132.2 	required under sections 256B.0913, 256B.0915, 256B.092, and 256B.49, including level 
132.3 	of care determination for individuals who need an institutional level of care as determined 
132.4 	under subdivision 4e, based on assessment and community support plan development, 
132.5 	appropriate referrals to obtain necessary diagnostic information, and including an eligibility 
132.6 	determination for consumer-directed community supports;
132.7 	(7) providing recommendations for institutional placement when there are no 
132.8 	cost-effective community services available;
132.9 	(8) providing access to assistance to transition people back to community settings after 
132.10 	institutional admission; and
132.11 	(9) providing information about competitive employment, with or without supports, for 
132.12 	school-age youth and working-age adults and referrals to the Disability Linkage Line and 
132.13 	Disability Benefits 101 to ensure that an informed choice about competitive employment 
132.14 	can be made. For the purposes of this subdivision, "competitive employment" means work 
132.15 	in the competitive labor market that is performed on a full-time or part-time basis in an 
132.16 	integrated setting, and for which an individual is compensated at or above the minimum 
132.17 	wage, but not less than the customary wage and level of benefits paid by the employer for 
132.18 	the same or similar work performed by individuals without disabilities.
132.19 	(b) Upon statewide implementation of lead agency requirements in subdivisions 2b, 2c, 
132.20 	and 3a, "long-term care consultation services" also means:
132.21 	(1) service eligibility determination for state plan home care services identified in:
132.22 	(i) section 256B.0625, subdivisions 7, 19a, and 19c;
132.23 	(ii) consumer support grants under section 256.476; or
132.24 	(iii) section 256B.85;
132.25 	(2) notwithstanding provisions in Minnesota Rules, parts 9525.0004 to 9525.0024, 
132.26 	determination of eligibility for gaining access to case management services available under 
132.27 	sections 256B.0621, subdivision 2, paragraph clause (4), and256B.0924, and Minnesota 
132.28 	Rules, part 9525.0016;
132.29 	(3) determination of institutional level of care, home and community-based service 
132.30 	waiver, and other serviceof eligibility as required under section 256B.092, determination 
132.31 	of eligibility for family support grants under section 252.32,for semi-independent living 
132.32 	services under section 252.275, and day training and habilitation services under section 
132.33 	256B.092; and
133.1 	(4) obtaining necessary diagnostic information to determine eligibility under clauses (2) 
133.2 	and (3).
133.3 	(c) "Long-term care options counseling" means the services provided by the linkage 
133.4 	lines as mandated by sections 256.01, subdivision 24, and 256.975, subdivision 7, and also 
133.5 	includes telephone assistance and follow up once a long-term care consultation assessment 
133.6 	has been completed.
133.7 	(d) "Minnesota health care programs" means the medical assistance program under this 
133.8 	chapter and the alternative care program under section 256B.0913.
133.9 	(e) "Lead agencies" means counties administering or tribes and health plans under 
133.10 	contract with the commissioner to administer long-term care consultation assessment and 
133.11 	support planning services.
133.12 	(f) "Person-centered planning" is a process that includes the active participation of a 
133.13 	person in the planning of the person's services, including in making meaningful and informed 
133.14 	choices about the person's own goals, talents, and objectives, as well as making meaningful 
133.15 	and informed choices about the services the person receives. For the purposes of this section, 
133.16 	"informed choice" means a voluntary choice of services by a person from all available 
133.17 	service options based on accurate and complete information concerning all available service 
133.18 	options and concerning the person's own preferences, abilities, goals, and objectives. In 
133.19 	order for a person to make an informed choice, all available options must be developed and 
133.20 	presented to the person to empower the person to make decisions.

133.21 	Sec. 22. Minnesota Statutes 2018, section 256B.0911, subdivision 3a, is amended to read:
133.22 		Subd. 3a.Assessment and support planning. (a) Persons requesting assessment, services 
133.23 	planning, or other assistance intended to support community-based living, including persons 
133.24 	who need assessment in order to determine waiver or alternative care program eligibility, 
133.25 	must be visited by a long-term care consultation team within 20 calendar days after the date 
133.26 	on which an assessment was requested or recommended. Upon statewide implementation 
133.27 	of subdivisions 2b, 2c, and 5, this requirement also applies to an assessment of a person 
133.28 	requesting personal care assistance services and home care nursing. The commissioner shall 
133.29 	provide at least a 90-day notice to lead agencies prior to the effective date of this requirement. 
133.30 	Face-to-face assessments must be conducted according to paragraphs (b) to (i).
133.31 	(b) Upon implementation of subdivisions 2b, 2c, and 5, lead agencies shall use certified 
133.32 	assessors to conduct the assessment. For a person with complex health care needs, a public 
133.33 	health or registered nurse from the team must be consulted.
134.1 	(c) The MnCHOICES assessment provided by the commissioner to lead agencies must 
134.2 	be used to complete a comprehensive, conversation-based, person-centered assessment. 
134.3 	The assessment must include the health, psychological, functional, environmental, and 
134.4 	social needs of the individual necessary to develop a community support plan that meets 
134.5 	the individual's needs and preferences.
134.6 	(d) The assessment must be conducted in a face-to-face conversational interview with 
134.7 	the person being assessed and. The person's legal representative must provide input during 
134.8 	the assessment process and may do so remotely if requested. At the request of the person, 
134.9 	other individuals may participate in the assessment to provide information on the needs, 
134.10 	strengths, and preferences of the person necessary to develop a community support plan 
134.11 	that ensures the person's health and safety. Except for legal representatives or family members 
134.12 	invited by the person, persons participating in the assessment may not be a provider of 
134.13 	service or have any financial interest in the provision of services. For persons who are to 
134.14 	be assessed for elderly waiver customized living or adult day services under section 
134.15 	256B.0915, with the permission of the person being assessed or the person's designated or 
134.16 	legal representative, the client's current or proposed provider of services may submit a copy 
134.17 	of the provider's nursing assessment or written report outlining its recommendations regarding 
134.18 	the client's care needs. The person conducting the assessment must notify the provider of 
134.19 	the date by which this information is to be submitted. This information shall be provided 
134.20 	to the person conducting the assessment prior to the assessment. For a person who is to be 
134.21 	assessed for waiver services under section 256B.092 or 256B.49, with the permission of 
134.22 	the person being assessed or the person's designated legal representative, the person's current 
134.23 	provider of services may submit a written report outlining recommendations regarding the 
134.24 	person's care needs prepared by a direct service employee with at least 20 hours of service 
134.25 	to that client. The person conducting the assessment or reassessment must notify the provider 
134.26 	of the date by which this information is to be submitted. This information shall be provided 
134.27 	to the person conducting the assessment and the person or the person's legal representative, 
134.28 	and must be considered prior to the finalization of the assessment or reassessment the person 
134.29 	completed in consultation with someone who is known to the person and has interaction 
134.30 	with the person on a regular basis. The provider must submit the report at least 60 days 
134.31 	before the end of the person's current service agreement. The certified assessor must consider 
134.32 	the content of the submitted report prior to finalizing the person's assessment or reassessment.
134.33 	(e) The certified assessor and the individual responsible for developing the coordinated 
134.34 	service and support plan must complete the community support plan and the coordinated 
134.35 	service and support plan no more than 60 calendar days from the assessment visit. The 
135.1 	person or the person's legal representative must be provided with a written community 
135.2 	support plan within 40 calendar days of the assessment visit the timelines established by 
135.3 	the commissioner, regardless of whether the individualperson is eligible for Minnesota 
135.4 	health care programs.
135.5 	(f) For a person being assessed for elderly waiver services under section 256B.0915, a 
135.6 	provider who submitted information under paragraph (d) shall receive the final written 
135.7 	community support plan when available and the Residential Services Workbook.
135.8 	(g) The written community support plan must include:
135.9 	(1) a summary of assessed needs as defined in paragraphs (c) and (d);
135.10 	(2) the individual's options and choices to meet identified needs, including all available 
135.11 	options for case management services and providers, including service provided in a 
135.12 	non-disability-specific setting;
135.13 	(3) identification of health and safety risks and how those risks will be addressed, 
135.14 	including personal risk management strategies;
135.15 	(4) referral information; and
135.16 	(5) informal caregiver supports, if applicable.
135.17 	For a person determined eligible for state plan home care under subdivision 1a, paragraph 
135.18 	(b), clause (1), the person or person's representative must also receive a copy of the home 
135.19 	care service plan developed by the certified assessor.
135.20 	(h) A person may request assistance in identifying community supports without 
135.21 	participating in a complete assessment. Upon a request for assistance identifying community 
135.22 	support, the person must be transferred or referred to long-term care options counseling 
135.23 	services available under sections 256.975, subdivision 7, and 256.01, subdivision 24, for 
135.24 	telephone assistance and follow up.
135.25 	(i) The person has the right to make the final decision between institutional placement 
135.26 	and community placement after the recommendations have been provided, except as provided 
135.27 	in section 256.975, subdivision 7a, paragraph (d).
135.28 	(j) The lead agency must give the person receiving assessment or support planning, or 
135.29 	the person's legal representative, materials, and forms supplied by the commissioner 
135.30 	containing the following information:
135.31 	(1) written recommendations for community-based services and consumer-directed 
135.32 	options;
136.1 	(2) documentation that the most cost-effective alternatives available were offered to the 
136.2 	individual. For purposes of this clause, "cost-effective" means community services and 
136.3 	living arrangements that cost the same as or less than institutional care. For an individual 
136.4 	found to meet eligibility criteria for home and community-based service programs under 
136.5 	section 256B.0915 or 256B.49, "cost-effectiveness" has the meaning found in the federally 
136.6 	approved waiver plan for each program;
136.7 	(3) the need for and purpose of preadmission screening conducted by long-term care 
136.8 	options counselors according to section 256.975, subdivisions 7a to 7c, if the person selects 
136.9 	nursing facility placement. If the individual selects nursing facility placement, the lead 
136.10 	agency shall forward information needed to complete the level of care determinations and 
136.11 	screening for developmental disability and mental illness collected during the assessment 
136.12 	to the long-term care options counselor using forms provided by the commissioner;
136.13 	(4) the role of long-term care consultation assessment and support planning in eligibility 
136.14 	determination for waiver and alternative care programs, and state plan home care, case 
136.15 	management, and other services as defined in subdivision 1a, paragraphs (a), clause (6), 
136.16 	and (b);
136.17 	(5) information about Minnesota health care programs;
136.18 	(6) the person's freedom to accept or reject the recommendations of the team;
136.19 	(7) the person's right to confidentiality under the Minnesota Government Data Practices 
136.20 	Act, chapter 13;
136.21 	(8) the certified assessor's decision regarding the person's need for institutional level of 
136.22 	care as determined under criteria established in subdivision 4e and the certified assessor's 
136.23 	decision regarding eligibility for all services and programs as defined in subdivision 1a, 
136.24 	paragraphs (a), clause (6), and (b); and
136.25 	(9) the person's right to appeal the certified assessor's decision regarding eligibility for 
136.26 	all services and programs as defined in subdivision 1a, paragraphs (a), clauses (6), (7), and 
136.27 	(8), and (b), and incorporating the decision regarding the need for institutional level of care 
136.28 	or the lead agency's final decisions regarding public programs eligibility according to section 
136.29 	256.045, subdivision 3. The certified assessor must verbally communicate this appeal right 
136.30 	to the person and must visually point out where in the document the right to appeal is stated.
136.31 	(k) Face-to-face assessment completed as part of eligibility determination for the 
136.32 	alternative care, elderly waiver, developmental disabilities, community access for disability 
136.33 	inclusion, community alternative care, and brain injury waiver programs under sections 
137.1 	256B.0913, 256B.0915, 256B.092, and 256B.49 is valid to establish service eligibility for 
137.2 	no more than 60 calendar days after the date of assessment.
137.3 	(l) The effective eligibility start date for programs in paragraph (k) can never be prior 
137.4 	to the date of assessment. If an assessment was completed more than 60 days before the 
137.5 	effective waiver or alternative care program eligibility start date, assessment and support 
137.6 	plan information must be updated and documented in the department's Medicaid Management 
137.7 	Information System (MMIS). Notwithstanding retroactive medical assistance coverage of 
137.8 	state plan services, the effective date of eligibility for programs included in paragraph (k) 
137.9 	cannot be prior to the date the most recent updated assessment is completed.
137.10 	(m) If an eligibility update is completed within 90 days of the previous face-to-face 
137.11 	assessment and documented in the department's Medicaid Management Information System 
137.12 	(MMIS), the effective date of eligibility for programs included in paragraph (k) is the date 
137.13 	of the previous face-to-face assessment when all other eligibility requirements are met.
137.14 	(n) At the time of reassessment, the certified assessor shall assess each person receiving 
137.15 	waiver services currently residing in a community residential setting, or licensed adult foster 
137.16 	care home that is not the primary residence of the license holder, or in which the license 
137.17 	holder is not the primary caregiver, to determine if that person would prefer to be served in 
137.18 	a community-living setting as defined in section 256B.49, subdivision 23. The certified 
137.19 	assessor shall offer the person, through a person-centered planning process, the option to 
137.20 	receive alternative housing and service options.

137.21 	Sec. 23. Minnesota Statutes 2018, section 256B.0911, subdivision 3f, is amended to read:
137.22 		Subd. 3f.Long-term care reassessments and community support plan updates. (a) 
137.23 	Prior to a face-to-face reassessment, the certified assessor must review the person's most 
137.24 	recent assessment. Reassessments must be tailored using the professional judgment of the 
137.25 	assessor to the person's known needs, strengths, preferences, and circumstances. 
137.26 	Reassessments provide information to support the person's informed choice and opportunities 
137.27 	to express choice regarding activities that contribute to quality of life, as well as information 
137.28 	and opportunity to identify goals related to desired employment, community activities, and 
137.29 	preferred living environment. Reassessments allow forrequire a review of the most recent 
137.30 	assessment, review of the current coordinated service and support plan's effectiveness, 
137.31 	monitoring of services, and the development of an updated person-centered community 
137.32 	support plan. Reassessments verify continued eligibility or offer alternatives as warranted 
137.33 	and provide an opportunity for quality assurance of service delivery. Face-to-face assessments
137.34 	reassessments must be conducted annually or as required by federal and state laws and rules.
138.1 	For reassessments, the certified assessor and the individual responsible for developing the 
138.2 	coordinated service and support plan must ensure the continuity of care for the person 
138.3 	receiving services and complete the updated community support plan and the updated 
138.4 	coordinated service and support plan no more than 60 days from the reassessment visit.
138.5 	(b) The commissioner shall develop mechanisms for providers and case managers to 
138.6 	share information with the assessor to facilitate a reassessment and support planning process 
138.7 	tailored to the person's current needs and preferences.

138.8 	Sec. 24. Minnesota Statutes 2018, section 256B.0911, is amended by adding a subdivision 
138.9 	to read:
138.10 		Subd. 3g.Assessments for Rule 185 case management. Unless otherwise required by 
138.11 	federal law, the county agency is not required to conduct or arrange for an annual needs 
138.12 	reassessment by a certified assessor. The case manager who works on behalf of the person 
138.13 	to identify the person's needs and to minimize the impact of the disability on the person's 
138.14 	life must instead develop a person-centered service plan based on the person's assessed 
138.15 	needs and preferences. The person-centered service plan must be reviewed annually for 
138.16 	persons with developmental disabilities who are receiving only case management services 
138.17 	under Minnesota Rules, part 9525.0036, and who make an informed choice to decline an 
138.18 	assessment under this section.

138.19 	Sec. 25. Minnesota Statutes 2018, section 256B.0911, subdivision 5, is amended to read:
138.20 		Subd. 5.Administrative activity. (a) The commissioner shall streamline the processes, 
138.21 	including timelines for when assessments need to be completed, required to provide the 
138.22 	services in this section and shall implement integrated solutions to automate the business 
138.23 	processes to the extent necessary for community support plan approval, reimbursement, 
138.24 	program planning, evaluation, and policy development.
138.25 	(b) The commissioner of human services shall work with lead agencies responsible for 
138.26 	conducting long-term consultation services to modify the MnCHOICES application and 
138.27 	assessment policies to create efficiencies while ensuring federal compliance with medical 
138.28 	assistance and long-term services and supports eligibility criteria.
138.29 	(c) The commissioner shall work with lead agencies responsible for conducting long-term 
138.30 	consultation services to develop a set of measurable benchmarks sufficient to demonstrate 
138.31 	quarterly improvement in the average time per assessment and other mutually agreed upon 
138.32 	measures of increasing efficiency. The commissioner shall collect data on these benchmarks 
138.33 	and provide to the lead agencies and the chairs and ranking minority members of the 
139.1 	legislative committees with jurisdiction over human services an annual trend analysis of 
139.2 	the data in order to demonstrate the commissioner's compliance with the requirements of 
139.3 	this subdivision.

139.4 	Sec. 26. Minnesota Statutes 2018, section 256B.0915, subdivision 6, is amended to read:
139.5 		Subd. 6.Implementation of coordinated service and support plan. (a) Each elderly 
139.6 	waiver client shall be provided a copy of a written coordinated service and support plan 
139.7 	which that:
139.8 	(1) is developed with and signed by the recipient within ten working days after the case 
139.9 	manager receives the assessment information and written community support plan as 
139.10 	described in section 256B.0911, subdivision 3a, from the certified assessor the timelines 
139.11 	established by the commissioner. The timeline for completing the community support plan 
139.12 	under section 256B.0911, subdivision 3a, and the coordinated service and support plan must 
139.13 	not exceed 60 calendar days from the assessment visit;
139.14 	(2) includes the person's need for service and identification of service needs that will be 
139.15 	or that are met by the person's relatives, friends, and others, as well as community services 
139.16 	used by the general public;
139.17 	(3) reasonably ensures the health and welfare of the recipient;
139.18 	(4) identifies the person's preferences for services as stated by the person or the person's 
139.19 	legal guardian or conservator;
139.20 	(5) reflects the person's informed choice between institutional and community-based 
139.21 	services, as well as choice of services, supports, and providers, including available case 
139.22 	manager providers;
139.23 	(6) identifies long-range and short-range goals for the person;
139.24 	(7) identifies specific services and the amount, frequency, duration, and cost of the 
139.25 	services to be provided to the person based on assessed needs, preferences, and available 
139.26 	resources;
139.27 	(8) includes information about the right to appeal decisions under section 256.045; and
139.28 	(9) includes the authorized annual and estimated monthly amounts for the services.
139.29 	(b) In developing the coordinated service and support plan, the case manager should 
139.30 	also include the use of volunteers, religious organizations, social clubs, and civic and service 
139.31 	organizations to support the individual in the community. The lead agency must be held 
140.1 	harmless for damages or injuries sustained through the use of volunteers and agencies under 
140.2 	this paragraph, including workers' compensation liability.

140.3 	Sec. 27. Minnesota Statutes 2018, section 256B.0915, subdivision 10, is amended to read:
140.4 		Subd. 10.Waiver payment rates; managed care organizations. The commissioner 
140.5 	shall adjust the elderly waiver capitation payment rates for managed care organizations paid 
140.6 	under section 256B.69, subdivisions 6b and 23, to reflect the maximum service rate limits 
140.7 	for customized living services and 24-hour customized living services under subdivisions 
140.8 	3e and 3h, and the rate adjustment under subdivision 18. Medical assistance rates paid to 
140.9 	customized living providers by managed care organizations under this section shall not 
140.10 	exceed the maximum service rate limits and component rates as determined by the 
140.11 	commissioner under subdivisions 3e and 3h, plus any rate adjustment under subdivision 
140.12 	18.

140.13 	Sec. 28. Minnesota Statutes 2018, section 256B.0915, is amended by adding a subdivision 
140.14 	to read:
140.15 		Subd. 18.Disproportionate share establishment customized living rate 
140.16 	adjustment. (a) For purposes of this section, "designated disproportionate share 
140.17 	establishment" means a housing with services establishment registered under chapter 144D 
140.18 	that meets the requirements of  paragraph (d).
140.19 	(b) A housing with services establishment registered under chapter 144D may apply 
140.20 	annually between June 1 and June 15 to the commissioner to be designated as a 
140.21 	disproportionate share establishment. The applying housing with services establishment 
140.22 	must apply to the commissioner in the manner determined by the commissioner. The applying 
140.23 	housing with services establishment must document as a percentage the census of elderly 
140.24 	waiver participants residing in the establishment on May 31 of the year of application.
140.25 	(c) Only a housing with services establishment registered under chapter 144D with a 
140.26 	census of at least 50 percent elderly waiver participants on May 31 of the application year 
140.27 	is eligible under this section for designation as a disproportionate share establishment.
140.28 	(d) By June 30, the commissioner shall designate as a disproportionate share establishment 
140.29 	any housing with services establishment that complies with the requirements of paragraph 
140.30 	(b) and meets the eligibility criteria described in paragraph (c).
140.31 	(e) A designated disproportionate share establishment's customized living rate adjustment 
140.32 	is the sum of 0.83 plus the product of 0.36 multiplied by the percentage of elderly waiver 
141.1 	participants residing in the establishment as reported on the establishment's most recent 
141.2 	application for designation as a disproportionate share establishment. No establishment may 
141.3 	receive a customized living rate adjustment greater than 1.10.
141.4 	(f) The commissioner shall multiply the customized living rate and 24-hour customized 
141.5 	living rate for a designated disproportionate share establishment by the amount determined 
141.6 	under paragraph (e).
141.7 	(g) The value of the rate adjustment under paragraph (e) shall not be included in an 
141.8 	individual elderly waiver client's monthly case mix budget cap.

141.9 	EFFECTIVE DATE. This section is effective January 1, 2020, or upon federal approval, 
141.10 	whichever is later, and applies to rates paid on or after January 1, 2021. The commissioner 
141.11 	of human services shall inform the revisor of statutes when federal approval is obtained.

141.12 	Sec. 29. Minnesota Statutes 2018, section 256B.092, subdivision 1b, is amended to read:
141.13 		Subd. 1b.Coordinated service and support plan. (a) Each recipient of home and 
141.14 	community-based waivered services shall be provided a copy of the written coordinated 
141.15 	service and support plan which that:
141.16 	(1) is developed with and signed by the recipient within ten working days after the case 
141.17 	manager receives the assessment information and written community support plan as 
141.18 	described in section 256B.0911, subdivision 3a, from the certified assessor the timelines 
141.19 	established by the commissioner. The timeline for completing the community support plan 
141.20 	under section 256B.0911, subdivision 3a, and the coordinated service and support plan must 
141.21 	not exceed 60 calendar days from the assessment visit;
141.22 	(2) includes the person's need for service, including identification of service needs that 
141.23 	will be or that are met by the person's relatives, friends, and others, as well as community 
141.24 	services used by the general public;
141.25 	(3) reasonably ensures the health and welfare of the recipient;
141.26 	(4) identifies the person's preferences for services as stated by the person, the person's 
141.27 	legal guardian or conservator, or the parent if the person is a minor, including the person's 
141.28 	choices made on self-directed options and on services and supports to achieve employment 
141.29 	goals;
141.30 	(5) provides for an informed choice, as defined in section 256B.77, subdivision 2, 
141.31 	paragraph (o), of service and support providers, and identifies all available options for case 
141.32 	management services and providers;
142.1 	(6) identifies long-range and short-range goals for the person;
142.2 	(7) identifies specific services and the amount and frequency of the services to be provided 
142.3 	to the person based on assessed needs, preferences, and available resources. The coordinated 
142.4 	service and support plan shall also specify other services the person needs that are not 
142.5 	available;
142.6 	(8) identifies the need for an individual program plan to be developed by the provider 
142.7 	according to the respective state and federal licensing and certification standards, and 
142.8 	additional assessments to be completed or arranged by the provider after service initiation;
142.9 	(9) identifies provider responsibilities to implement and make recommendations for 
142.10 	modification to the coordinated service and support plan;
142.11 	(10) includes notice of the right to request a conciliation conference or a hearing under 
142.12 	section 256.045;
142.13 	(11) is agreed upon and signed by the person, the person's legal guardian or conservator, 
142.14 	or the parent if the person is a minor, and the authorized county representative;
142.15 	(12) is reviewed by a health professional if the person has overriding medical needs that 
142.16 	impact the delivery of services; and
142.17 	(13) includes the authorized annual and monthly amounts for the services.
142.18 	(b) In developing the coordinated service and support plan, the case manager is 
142.19 	encouraged to include the use of volunteers, religious organizations, social clubs, and civic 
142.20 	and service organizations to support the individual in the community. The lead agency must 
142.21 	be held harmless for damages or injuries sustained through the use of volunteers and agencies 
142.22 	under this paragraph, including workers' compensation liability.
142.23 	(c) Approved, written, and signed changes to a consumer's services that meet the criteria 
142.24 	in this subdivision shall be an addendum to that consumer's individual service plan.

142.25 	Sec. 30. Minnesota Statutes 2018, section 256B.092, is amended by adding a subdivision 
142.26 	to read:
142.27 		Subd. 12a.Developmental disabilities waiver growth limit. The commissioner shall 
142.28 	limit the total number of people receiving developmental disabilities waiver services to the 
142.29 	number of people receiving developmental disabilities waiver services on June 30, 2019. 
142.30 	The commissioner shall only add new recipients when an existing recipient permanently 
142.31 	leaves the program. The commissioner shall reserve capacity, within enrollment limits, to 
142.32 	re-enroll persons who temporarily discontinue and then resume waiver services within 90 
143.1 	days of the date that services were discontinued. When adding a new recipient, the 
143.2 	commissioner shall target persons who meet the priorities for accessing waiver services 
143.3 	identified in subdivision 12. The allocation limits include conversions from intermediate 
143.4 	care facilities for persons with developmental disabilities unless capacity at the facility is 
143.5 	permanently converted to home and community-based services through the developmental 
143.6 	disabilities waiver.

143.7 	Sec. 31. Minnesota Statutes 2018, section 256B.0921, is amended to read:
143.8 	256B.0921 HOME AND COMMUNITY-BASED SERVICES INCENTIVE
143.9 	INNOVATION POOL.
143.10 	The commissioner of human services shall develop an initiative to provide incentives 
143.11 	for innovation in: (1) achieving integrated competitive employment; (2) achieving integrated 
143.12 	competitive employment for youth under age 25 upon their graduation from school; (3) 
143.13 	living in the most integrated setting; and (4) other outcomes determined by the commissioner. 
143.14 	The commissioner shall seek requests for proposals and shall contract with one or more 
143.15 	entities to provide incentive payments for meeting identified outcomes.

143.16 	Sec. 32. Minnesota Statutes 2018, section 256B.49, is amended by adding a subdivision 
143.17 	to read:
143.18 		Subd. 11b.Community access for disability inclusion waiver growth limit. The 
143.19 	commissioner shall limit the total number of people receiving community access for disability 
143.20 	inclusion waiver services to the number of people receiving community access for disability 
143.21 	inclusion waiver services on June 30, 2019. The commissioner shall only add new recipients 
143.22 	when an existing recipient permanently leaves the program. The commissioner shall reserve 
143.23 	capacity, within enrollment limits, to re-enroll persons who temporarily discontinue and 
143.24 	then resume waiver services within 90 days of the date that services were discontinued. 
143.25 	When adding a new recipient, the commissioner shall target individuals who meet the 
143.26 	priorities for accessing waiver services identified in subdivision 11a. The allocation limits 
143.27 	includes conversions and diversions from nursing facilities.

143.28 	Sec. 33. Minnesota Statutes 2018, section 256B.49, subdivision 13, is amended to read:
143.29 		Subd. 13.Case management. (a) Each recipient of a home and community-based waiver 
143.30 	shall be provided case management services by qualified vendors as described in the federally 
143.31 	approved waiver application. The case management service activities provided must include:
144.1 	(1) finalizing the written coordinated service and support plan within ten working days 
144.2 	after the case manager receives the plan from the certified assessor the timelines established 
144.3 	by the commissioner. The timeline for completing the community support plan under section 
144.4 	256B.0911, subdivision 3a, and the coordinated service and support plan must not exceed 
144.5 	60 calendar days from the assessment visit;
144.6 	(2) informing the recipient or the recipient's legal guardian or conservator of service 
144.7 	options;
144.8 	(3) assisting the recipient in the identification of potential service providers and available 
144.9 	options for case management service and providers, including services provided in a 
144.10 	non-disability-specific setting;
144.11 	(4) assisting the recipient to access services and assisting with appeals under section 
144.12 	256.045; and
144.13 	(5) coordinating, evaluating, and monitoring of the services identified in the service 
144.14 	plan.
144.15 	(b) The case manager may delegate certain aspects of the case management service 
144.16 	activities to another individual provided there is oversight by the case manager. The case 
144.17 	manager may not delegate those aspects which require professional judgment including:
144.18 	(1) finalizing the coordinated service and support plan;
144.19 	(2) ongoing assessment and monitoring of the person's needs and adequacy of the 
144.20 	approved coordinated service and support plan; and
144.21 	(3) adjustments to the coordinated service and support plan.
144.22 	(c) Case management services must be provided by a public or private agency that is 
144.23 	enrolled as a medical assistance provider determined by the commissioner to meet all of 
144.24 	the requirements in the approved federal waiver plans. Case management services must not 
144.25 	be provided to a recipient by a private agency that has any financial interest in the provision 
144.26 	of any other services included in the recipient's coordinated service and support plan. For 
144.27 	purposes of this section, "private agency" means any agency that is not identified as a lead 
144.28 	agency under section 256B.0911, subdivision 1a, paragraph (e).
144.29 	(d) For persons who need a positive support transition plan as required in chapter 245D, 
144.30 	the case manager shall participate in the development and ongoing evaluation of the plan 
144.31 	with the expanded support team. At least quarterly, the case manager, in consultation with 
144.32 	the expanded support team, shall evaluate the effectiveness of the plan based on progress 
144.33 	evaluation data submitted by the licensed provider to the case manager. The evaluation must 
145.1 	identify whether the plan has been developed and implemented in a manner to achieve the 
145.2 	following within the required timelines:
145.3 	(1) phasing out the use of prohibited procedures;
145.4 	(2) acquisition of skills needed to eliminate the prohibited procedures within the plan's 
145.5 	timeline; and
145.6 	(3) accomplishment of identified outcomes.
145.7 	If adequate progress is not being made, the case manager shall consult with the person's 
145.8 	expanded support team to identify needed modifications and whether additional professional 
145.9 	support is required to provide consultation.

145.10 	Sec. 34. Minnesota Statutes 2018, section 256B.49, subdivision 14, is amended to read:
145.11 		Subd. 14.Assessment and reassessment. (a) Assessments and reassessments shall be 
145.12 	conducted by certified assessors according to section 256B.0911, subdivision 2b. The 
145.13 	certified assessor, with the permission of the recipient or the recipient's designated legal 
145.14 	representative, may invite other individuals to attend the assessment. With the permission 
145.15 	of the recipient or the recipient's designated legal representative, the recipient's current 
145.16 	provider of services may submit a written report outlining their recommendations regarding 
145.17 	the recipient's care needs prepared by a direct service employee with at least 20 hours of 
145.18 	service to that client. The certified assessor must notify the provider of the date by which 
145.19 	this information is to be submitted. This information shall be provided to the certified 
145.20 	assessor and the person or the person's legal representative and must be considered prior to 
145.21 	the finalization of the assessment or reassessment who is familiar with the person. The 
145.22 	provider must submit the report at least 60 days before the end of the person's current service 
145.23 	agreement. The certified assessor must consider the content of the submitted report prior 
145.24 	to finalizing the person's assessment or reassessment.
145.25 	(b) There must be a determination that the client requires a hospital level of care or a 
145.26 	nursing facility level of care as defined in section 256B.0911, subdivision 4e, at initial and 
145.27 	subsequent assessments to initiate and maintain participation in the waiver program.
145.28 	(c) Regardless of other assessments identified in section 144.0724, subdivision 4, as 
145.29 	appropriate to determine nursing facility level of care for purposes of medical assistance 
145.30 	payment for nursing facility services, only face-to-face assessments conducted according 
145.31 	to section 256B.0911, subdivisions 3a, 3b, and 4d, that result in a hospital level of care 
145.32 	determination or a nursing facility level of care determination must be accepted for purposes 
145.33 	of initial and ongoing access to waiver services payment.
146.1 	(d) Recipients who are found eligible for home and community-based services under 
146.2 	this section before their 65th birthday may remain eligible for these services after their 65th 
146.3 	birthday if they continue to meet all other eligibility factors.

146.4 	Sec. 35. Minnesota Statutes 2018, section 256B.4914, subdivision 2, is amended to read:
146.5 		Subd. 2.Definitions. (a) For purposes of this section, the following terms have the 
146.6 	meanings given them, unless the context clearly indicates otherwise.
146.7 	(b) "Commissioner" means the commissioner of human services.
146.8 	(c) "Component value" means underlying factors that are part of the cost of providing 
146.9 	services that are built into the waiver rates methodology to calculate service rates.
146.10 	(d) "Customized living tool" means a methodology for setting service rates that delineates 
146.11 	and documents the amount of each component service included in a recipient's customized 
146.12 	living service plan.
146.13 	(e) "Direct care staff" means employees providing direct services to an individual 
146.14 	receiving services under this section. Direct care staff excludes executive, managerial, or 
146.15 	administrative staff.
146.16 	(e) (f) "Disability waiver rates system" means a statewide system that establishes rates 
146.17 	that are based on uniform processes and captures the individualized nature of waiver services 
146.18 	and recipient needs.
146.19 	(f) (g) "Individual staffing" means the time spent as a one-to-one interaction specific to 
146.20 	an individual recipient by staff to provide direct support and assistance with activities of 
146.21 	daily living, instrumental activities of daily living, and training to participants, and is based 
146.22 	on the requirements in each individual's coordinated service and support plan under section 
146.23 	245D.02, subdivision 4b; any coordinated service and support plan addendum under section 
146.24 	245D.02, subdivision 4c; and an assessment tool. Provider observation of an individual's 
146.25 	needs must also be considered.
146.26 	(g) (h) "Lead agency" means a county, partnership of counties, or tribal agency charged 
146.27 	with administering waivered services under sections 256B.092 and 256B.49.
146.28 	(h) (i) "Median" means the amount that divides distribution into two equal groups, 
146.29 	one-half above the median and one-half below the median.
146.30 	(i) (j) "Payment or rate" means reimbursement to an eligible provider for services 
146.31 	provided to a qualified individual based on an approved service authorization.
147.1 	(j) (k) "Rates management system" means a web-based software application that uses a 
147.2 	framework and component values, as determined by the commissioner, to establish service 
147.3 	rates.
147.4 	(k) (l) "Recipient" means a person receiving home and community-based services funded 
147.5 	under any of the disability waivers.
147.6 	(l) (m) "Shared staffing" means time spent by employees, not defined under paragraph 
147.7 	(f), providing or available to provide more than one individual with direct support and 
147.8 	assistance with activities of daily living as defined under section 256B.0659, subdivision 
147.9 	1, paragraph (b); instrumental activities of daily living as defined under section 256B.0659, 
147.10 	subdivision 1, paragraph (i); ancillary activities needed to support individual services; and 
147.11 	training to participants, and is based on the requirements in each individual's coordinated 
147.12 	service and support plan under section 245D.02, subdivision 4b; any coordinated service 
147.13 	and support plan addendum under section 245D.02, subdivision 4c; an assessment tool; and 
147.14 	provider observation of an individual's service need. Total shared staffing hours are divided 
147.15 	proportionally by the number of individuals who receive the shared service provisions.
147.16 	(m) (n) "Staffing ratio" means the number of recipients a service provider employee 
147.17 	supports during a unit of service based on a uniform assessment tool, provider observation, 
147.18 	case history, and the recipient's services of choice, and not based on the staffing ratios under 
147.19 	section 245D.31.
147.20 	(n) (o) "Unit of service" means the following:
147.21 	(1) for residential support services under subdivision 6, a unit of service is a day. Any 
147.22 	portion of any calendar day, within allowable Medicaid rules, where an individual spends 
147.23 	time in a residential setting is billable as a day;
147.24 	(2) for day services under subdivision 7:
147.25 	(i) for day training and habilitation services, a unit of service is either:
147.26 	(A) a day unit of service is defined as six or more hours of time spent providing direct 
147.27 	services and transportation; or
147.28 	(B) a partial day unit of service is defined as fewer than six hours of time spent providing 
147.29 	direct services and transportation; and
147.30 	(C) for new day service recipients after January 1, 2014, 15 minute units of service must 
147.31 	be used for fewer than six hours of time spent providing direct services and transportation;
148.1 	(ii) for adult day and structured day services, a unit of service is a day or 15 minutes. A 
148.2 	day unit of service is six or more hours of time spent providing direct services;
148.3 	(iii) for prevocational services, a unit of service is a day or an hour 15 minutes. A day 
148.4 	unit of service is six or more hours of time spent providing direct service;
148.5 	(3) for unit-based services with programming under subdivision 8:
148.6 	(i) for supported living services, a unit of service is a day or 15 minutes. When a day 
148.7 	rate is authorized, any portion of a calendar day where an individual receives services is 
148.8 	billable as a day; and
148.9 	(ii) for all other services, a unit of service is 15 minutes; and
148.10 	(4) for unit-based services without programming under subdivision 9, a unit of service 
148.11 	is 15 minutes.

148.12 	Sec. 36. Minnesota Statutes 2018, section 256B.4914, subdivision 3, is amended to read:
148.13 		Subd. 3.Applicable services. Applicable services are those authorized under the state's 
148.14 	home and community-based services waivers under sections 256B.092 and 256B.49, 
148.15 	including the following, as defined in the federally approved home and community-based 
148.16 	services plan:
148.17 	(1) 24-hour customized living;
148.18 	(2) adult day care;
148.19 	(3) adult day care bath;
148.20 	(4) behavioral programming;
148.21 	(5) (4) companion services;
148.22 	(6) (5) customized living;
148.23 	(7) (6) day training and habilitation;
148.24 	(7) employment development services;
148.25 	(8) employment exploration services;
148.26 	(9) employment support services;
148.27 	(8) (10) housing access coordination;
148.28 	(9) (11) independent living skills;
148.29 	(12) independent living skills specialist services;
149.1 	(13) individualized home supports;
149.2 	(10) (14) in-home family support;
149.3 	(11) (15) night supervision;
149.4 	(12) (16) personal support;
149.5 	(17) positive support service;
149.6 	(13) (18) prevocational services;
149.7 	(14) (19) residential care services;
149.8 	(15) (20) residential support services;
149.9 	(16) (21) respite services;
149.10 	(17) (22) structured day services;
149.11 	(18) (23) supported employment services;
149.12 	(19) (24) supported living services;
149.13 	(20) (25) transportation services; and
149.14 	(21) individualized home supports;
149.15 	(22) independent living skills specialist services;
149.16 	(23) employment exploration services;
149.17 	(24) employment development services;
149.18 	(25) employment support services; and
149.19 	(26) other services as approved by the federal government in the state home and 
149.20 	community-based services plan.

149.21 	Sec. 37. Minnesota Statutes 2018, section 256B.4914, subdivision 5, is amended to read:
149.22 		Subd. 5.Base wage index and standard component values. (a) The base wage index 
149.23 	is established to determine staffing costs associated with providing services to individuals 
149.24 	receiving home and community-based services. For purposes of developing and calculating 
149.25 	the proposed base wage, Minnesota-specific wages taken from job descriptions and standard 
149.26 	occupational classification (SOC) codes from the Bureau of Labor Statistics as defined in 
149.27 	the most recent edition of the Occupational Handbook must be used. The base wage index 
149.28 	must be calculated as follows:
149.29 	(1) for residential direct care staff, the sum of:
150.1 	(i) 15 percent of the subtotal of 50 percent of the median wage for personal and home 
150.2 	health aide (SOC code 39-9021); 30 percent of the median wage for nursing assistant (SOC 
150.3 	code 31-1014); and 20 percent of the median wage for social and human services aide (SOC 
150.4 	code 21-1093); and
150.5 	(ii) 85 percent of the subtotal of 20 percent of the median wage for home health aide 
150.6 	(SOC code 31-1011); 20 percent of the median wage for personal and home health aide 
150.7 	(SOC code 39-9021); 20 percent of the median wage for nursing assistant (SOC code 
150.8 	31-1014); 20 percent of the median wage for psychiatric technician (SOC code 29-2053); 
150.9 	and 20 percent of the median wage for social and human services aide (SOC code 21-1093);
150.10 	(2) for day services, 20 percent of the median wage for nursing assistant (SOC code 
150.11 	31-1014); 20 percent of the median wage for psychiatric technician (SOC code 29-2053); 
150.12 	and 60 percent of the median wage for social and human services aide (SOC code 21-1093);
150.13 	(3) for residential asleep-overnight staff, the wage is the minimum wage in Minnesota 
150.14 	for large employers, except in a family foster care setting, the wage is 36 percent of the 
150.15 	minimum wage in Minnesota for large employers;
150.16 	(4) for behavior program analyst staff, 100 percent of the median wage for mental health 
150.17 	counselors (SOC code 21-1014);
150.18 	(5) for behavior program professional staff, 100 percent of the median wage for clinical 
150.19 	counseling and school psychologist (SOC code 19-3031);
150.20 	(6) for behavior program specialist staff, 100 percent of the median wage for psychiatric 
150.21 	technicians (SOC code 29-2053);
150.22 	(7) for supportive living services staff, 20 percent of the median wage for nursing assistant 
150.23 	(SOC code 31-1014); 20 percent of the median wage for psychiatric technician (SOC code 
150.24 	29-2053); and 60 percent of the median wage for social and human services aide (SOC code 
150.25 	21-1093);
150.26 	(8) for housing access coordination staff, 100 percent of the median wage for community 
150.27 	and social services specialist (SOC code 21-1099);
150.28 	(9) for in-home family support staff, 20 percent of the median wage for nursing aide 
150.29 	(SOC code 31-1012); 30 percent of the median wage for community social service specialist 
150.30 	(SOC code 21-1099); 40 percent of the median wage for social and human services aide 
150.31 	(SOC code 21-1093); and ten percent of the median wage for psychiatric technician (SOC 
150.32 	code 29-2053);
151.1 	(10) for individualized home supports services staff, 40 percent of the median wage for 
151.2 	community social service specialist (SOC code 21-1099); 50 percent of the median wage 
151.3 	for social and human services aide (SOC code 21-1093); and ten percent of the median 
151.4 	wage for psychiatric technician (SOC code 29-2053);
151.5 	(11) for independent living skills staff, 40 percent of the median wage for community 
151.6 	social service specialist (SOC code 21-1099); 50 percent of the median wage for social and 
151.7 	human services aide (SOC code 21-1093); and ten percent of the median wage for psychiatric 
151.8 	technician (SOC code 29-2053);
151.9 	(12) for independent living skills specialist staff, 100 percent of mental health and 
151.10 	substance abuse social worker (SOC code 21-1023);
151.11 	(13) for supported employment staff, 20 percent of the median wage for nursing assistant 
151.12 	(SOC code 31-1014); 20 percent of the median wage for psychiatric technician (SOC code 
151.13 	29-2053); and 60 percent of the median wage for social and human services aide (SOC code 
151.14 	21-1093);
151.15 	(14) for employment support services staff, 50 percent of the median wage for 
151.16 	rehabilitation counselor (SOC code 21-1015); and 50 percent of the median wage for 
151.17 	community and social services specialist (SOC code 21-1099);
151.18 	(15) for employment exploration services staff, 50 percent of the median wage for 
151.19 	rehabilitation counselor (SOC code 21-1015); and 50 percent of the median wage for 
151.20 	community and social services specialist (SOC code 21-1099);
151.21 	(16) for employment development services staff, 50 percent of the median wage for 
151.22 	education, guidance, school, and vocational counselors (SOC code 21-1012); and 50 percent 
151.23 	of the median wage for community and social services specialist (SOC code 21-1099);
151.24 	(17) for adult companion staff, 50 percent of the median wage for personal and home 
151.25 	care aide (SOC code 39-9021); and 50 percent of the median wage for nursing assistant 
151.26 	(SOC code 31-1014);
151.27 	(18) for night supervision staff, 20 percent of the median wage for home health aide 
151.28 	(SOC code 31-1011); 20 percent of the median wage for personal and home health aide 
151.29 	(SOC code 39-9021); 20 percent of the median wage for nursing assistant (SOC code 
151.30 	31-1014); 20 percent of the median wage for psychiatric technician (SOC code 29-2053); 
151.31 	and 20 percent of the median wage for social and human services aide (SOC code 21-1093);
152.1 	(19) for respite staff, 50 percent of the median wage for personal and home care aide 
152.2 	(SOC code 39-9021); and 50 percent of the median wage for nursing assistant (SOC code 
152.3 	31-1014);
152.4 	(20) for personal support staff, 50 percent of the median wage for personal and home 
152.5 	care aide (SOC code 39-9021); and 50 percent of the median wage for nursing assistant 
152.6 	(SOC code 31-1014);
152.7 	(21) for supervisory staff, 100 percent of the median wage for community and social 
152.8 	services specialist (SOC code 21-1099), with the exception of the supervisor of behavior 
152.9 	professional, behavior analyst, and behavior specialists, which is 100 percent of the median 
152.10 	wage for clinical counseling and school psychologist (SOC code 19-3031);
152.11 	(22) for registered nurse staff, 100 percent of the median wage for registered nurses 
152.12 	(SOC code 29-1141); and
152.13 	(23) for licensed practical nurse staff, 100 percent of the median wage for licensed 
152.14 	practical nurses (SOC code 29-2061).
152.15 	(b) The commissioner shall adjust the base wage index in paragraph (j) with a competitive 
152.16 	workforce factor of 4.7 percent to provide increased compensation to direct care staff. A 
152.17 	provider shall use the additional revenue from the competitive workforce factor to increase 
152.18 	wages for or to improve benefits provided to direct care staff.
152.19 	(c) Beginning February 1, 2021, and every two years thereafter, the commissioner shall 
152.20 	report to the chairs and ranking minority members of the legislative committees and divisions 
152.21 	with jurisdiction over health and human services policy and finance an analysis of the 
152.22 	competitive workforce factor. The report shall include recommendations to adjust the 
152.23 	competitive workforce factor using (1) the most recently available wage data by SOC code 
152.24 	of the weighted average wage for direct care staff for residential services and direct care 
152.25 	staff for day services; (2) the most recently available wage data by SOC code of the weighted 
152.26 	average wage of comparable occupations; and (3) labor market data as required under 
152.27 	subdivision 10a, paragraph (g). The commissioner shall not recommend in any biennial 
152.28 	report an increase or decrease of the competitive workforce factor by more than two 
152.29 	percentage points from the current value. If, after a biennial analysis for the next report, the 
152.30 	competitive workforce factor is less than or equal to zero, the commissioner shall recommend 
152.31 	a competitive workforce factor of zero.
152.32 	(b) (d) Component values for residential support services are:
152.33 	(1) supervisory span of control ratio: 11 percent;
153.1 	(2) employee vacation, sick, and training allowance ratio: 8.71 percent;
153.2 	(3) employee-related cost ratio: 23.6 percent;
153.3 	(4) general administrative support ratio: 13.25 percent;
153.4 	(5) program-related expense ratio: 1.3 percent; and
153.5 	(6) absence and utilization factor ratio: 3.9 percent.
153.6 	(c) (e) Component values for family foster care are:
153.7 	(1) supervisory span of control ratio: 11 percent;
153.8 	(2) employee vacation, sick, and training allowance ratio: 8.71 percent;
153.9 	(3) employee-related cost ratio: 23.6 percent;
153.10 	(4) general administrative support ratio: 3.3 percent;
153.11 	(5) program-related expense ratio: 1.3 percent; and
153.12 	(6) absence factor: 1.7 percent.
153.13 	(d) (f) Component values for day services for all services are:
153.14 	(1) supervisory span of control ratio: 11 percent;
153.15 	(2) employee vacation, sick, and training allowance ratio: 8.71 percent;
153.16 	(3) employee-related cost ratio: 23.6 percent;
153.17 	(4) program plan support ratio: 5.6 percent;
153.18 	(5) client programming and support ratio: ten percent;
153.19 	(6) general administrative support ratio: 13.25 percent;
153.20 	(7) program-related expense ratio: 1.8 percent; and
153.21 	(8) absence and utilization factor ratio: 9.4 percent.
153.22 	(e) (g) Component values for unit-based services with programming are:
153.23 	(1) supervisory span of control ratio: 11 percent;
153.24 	(2) employee vacation, sick, and training allowance ratio: 8.71 percent;
153.25 	(3) employee-related cost ratio: 23.6 percent;
153.26 	(4) program plan supports ratio: 15.5 percent;
153.27 	(5) client programming and supports ratio: 4.7 percent;
154.1 	(6) general administrative support ratio: 13.25 percent;
154.2 	(7) program-related expense ratio: 6.1 percent; and
154.3 	(8) absence and utilization factor ratio: 3.9 percent.
154.4 	(f) (h) Component values for unit-based services without programming except respite 
154.5 	are:
154.6 	(1) supervisory span of control ratio: 11 percent;
154.7 	(2) employee vacation, sick, and training allowance ratio: 8.71 percent;
154.8 	(3) employee-related cost ratio: 23.6 percent;
154.9 	(4) program plan support ratio: 7.0 percent;
154.10 	(5) client programming and support ratio: 2.3 percent;
154.11 	(6) general administrative support ratio: 13.25 percent;
154.12 	(7) program-related expense ratio: 2.9 percent; and
154.13 	(8) absence and utilization factor ratio: 3.9 percent.
154.14 	(g) (i) Component values for unit-based services without programming for respite are:
154.15 	(1) supervisory span of control ratio: 11 percent;
154.16 	(2) employee vacation, sick, and training allowance ratio: 8.71 percent;
154.17 	(3) employee-related cost ratio: 23.6 percent;
154.18 	(4) general administrative support ratio: 13.25 percent;
154.19 	(5) program-related expense ratio: 2.9 percent; and
154.20 	(6) absence and utilization factor ratio: 3.9 percent.
154.21 	(h) On July 1, 2017, the commissioner shall update the base wage index in paragraph 
154.22 	(a) based on the wage data by standard occupational code (SOC) from the Bureau of Labor 
154.23 	Statistics available on December 31, 2016. The commissioner shall publish these updated 
154.24 	values and load them into the rate management system. (j) On July 1, 2022, and every five
154.25 	two years thereafter, the commissioner shall update the base wage index in paragraph (a) 
154.26 	based on the most recently available wage data by SOC from the Bureau of Labor Statistics
154.27 	available 30 months and one day prior to the scheduled update. The commissioner shall 
154.28 	publish these updated values and load them into the rate management system.
155.1 	(i) On July 1, 2017, the commissioner shall update the framework components in 
155.2 	paragraph (d), clause (5); paragraph (e), clause (5); and paragraph (f), clause (5); subdivision 
155.3 	6, clauses (8) and (9); and subdivision 7, clauses (10), (16), and (17), for changes in the 
155.4 	Consumer Price Index. The commissioner will adjust these values higher or lower by the 
155.5 	percentage change in the Consumer Price Index-All Items, United States city average 
155.6 	(CPI-U) from January 1, 2014, to January 1, 2017. The commissioner shall publish these 
155.7 	updated values and load them into the rate management system. (k) On July 1, 2022, and 
155.8 	every five two years thereafter, the commissioner shall update the framework components 
155.9 	in paragraph (d) (f), clause (5); paragraph (e) (g), clause (5); and paragraph (f) (h), clause 
155.10 	(5); subdivision 6, clauses (8) and (9); and subdivision 7, clauses (10), (16), and (17), for 
155.11 	changes in the Consumer Price Index. The commissioner shall adjust these values higher 
155.12 	or lower by the percentage change in the CPI-U from the date of the previous update to the 
155.13 	date of the data most recently available 30 months and one day prior to the scheduled update. 
155.14 	The commissioner shall publish these updated values and load them into the rate management 
155.15 	system.
155.16 	(l) Upon the implementation of automatic inflation adjustments under paragraphs (j) 
155.17 	and (k), rate adjustments authorized under section 256B.439, subdivision 7; Laws 2013, 
155.18 	chapter 108, article 7, section 60; and Laws 2014, chapter 312, article 27, section 75, shall 
155.19 	be removed from service rates calculated under this section.
155.20 	(m) Any rate adjustments applied to the service rates calculated under this section outside 
155.21 	of the cost components and rate methodology specified in this section shall be removed 
155.22 	from rate calculations upon implementation of automatic inflation adjustments under 
155.23 	paragraphs (j) and (k).
155.24 	(j) (n) In this subdivision, if Bureau of Labor Statistics occupational codes or Consumer 
155.25 	Price Index items are unavailable in the future, the commissioner shall recommend to the 
155.26 	legislature codes or items to update and replace missing component values.
155.27 	(o) The commissioner shall update the general administrative support ratio in paragraph 
155.28 	(b), clause (4); paragraph (c), clause (4); paragraph (d), clause (6); paragraph (e), clause 
155.29 	(6); paragraph (f), clause (6); and paragraph (g), clause (4), for any changes to the annual 
155.30 	licensing fee under section 245A.10, subdivision 4, paragraph (b). The commissioner shall 
155.31 	adjust these ratios higher or lower by an amount equal in value to the percent change in 
155.32 	general administrative support costs attributable to the change in the licensing fee. The 
155.33 	commissioner shall publish these updated ratios and load them into the rate management 
155.34 	system.

156.1 	EFFECTIVE DATE. This section is effective January 1, 2021, or upon federal approval, 
156.2 	whichever is later, except the new paragraphs (b) and (o) are effective January 1, 2020, or 
156.3 	upon federal approval, whichever is later. The commissioner of human services shall notify 
156.4 	the revisor of statutes when federal approval is obtained.

156.5 	Sec. 38. Minnesota Statutes 2018, section 256B.4914, subdivision 10, is amended to read:
156.6 		Subd. 10.Updating payment values and additional information. (a) From January 
156.7 	1, 2014, through December 31, 2017, the commissioner shall develop and implement uniform 
156.8 	procedures to refine terms and adjust values used to calculate payment rates in this section.
156.9 	(b) (a) No later than July 1, 2014, the commissioner shall, within available resources, 
156.10 	begin to conduct research and gather data and information from existing state systems or 
156.11 	other outside sources on the following items:
156.12 	(1) differences in the underlying cost to provide services and care across the state; and
156.13 	(2) mileage, vehicle type, lift requirements, incidents of individual and shared rides, and 
156.14 	units of transportation for all day services, which must be collected from providers using 
156.15 	the rate management worksheet and entered into the rates management system; and
156.16 	(3) the distinct underlying costs for services provided by a license holder under sections 
156.17 	245D.05, 245D.06, 245D.07, 245D.071, 245D.081, and 245D.09, and for services provided 
156.18 	by a license holder certified under section 245D.33.
156.19 	(c) Beginning January 1, 2014, through December 31, 2018, using a statistically valid 
156.20 	set of rates management system data, the commissioner, in consultation with stakeholders, 
156.21 	shall analyze for each service the average difference in the rate on December 31, 2013, and 
156.22 	the framework rate at the individual, provider, lead agency, and state levels. The 
156.23 	commissioner shall issue semiannual reports to the stakeholders on the difference in rates 
156.24 	by service and by county during the banding period under section 256B.4913, subdivision 
156.25 	4a. The commissioner shall issue the first report by October 1, 2014, and the final report 
156.26 	shall be issued by December 31, 2018.
156.27 	(d) (b) No later than July 1, 2014, the commissioner, in consultation with stakeholders, 
156.28 	shall begin the review and evaluation of the following values already in subdivisions 6 5 to 
156.29 	9, or issues that impact all services, including, but not limited to:
156.30 	(1) values for transportation rates;
156.31 	(2) values for services where monitoring technology replaces staff time;
156.32 	(3) values for indirect services;
157.1 	(4) values for nursing;
157.2 	(5) values for the facility use rate in day services, and the weightings used in the day 
157.3 	service ratios and adjustments to those weightings;
157.4 	(6) values for workers' compensation as part of employee-related expenses;
157.5 	(7) values for unemployment insurance as part of employee-related expenses;
157.6 	(8) direct care workforce labor market measures;
157.7 	(9) any changes in state or federal law with a direct impact on the underlying cost of 
157.8 	providing home and community-based services; and
157.9 	(9) (10) outcome measures, determined by the commissioner, for home and 
157.10 	community-based services rates determined under this section.; and
157.11 	(11) different competitive workforce factors by service.
157.12 	(e) (c) The commissioner shall report to the chairs and the ranking minority members 
157.13 	of the legislative committees and divisions with jurisdiction over health and human services 
157.14 	policy and finance with the information and data gathered under paragraphs (b) to (d) (a) 
157.15 	and (b) on the following dates:
157.16 	(1) January 15, 2015, with preliminary results and data;
157.17 	(2) January 15, 2016, with a status implementation update, and additional data and 
157.18 	summary information;
157.19 	(3) January 15, 2017, with the full report; and
157.20 	(4) January 15, 2020 2021, with another full report, and a full report once every four 
157.21 	years thereafter.
157.22 	(f) The commissioner shall implement a regional adjustment factor to all rate calculations 
157.23 	in subdivisions 6 to 9, effective no later than January 1, 2015. (d) Beginning July 1, 2017
157.24 	January 1, 2022, the commissioner shall renew analysis and implement changes to the 
157.25 	regional adjustment factors when adjustments required under subdivision 5, paragraph (h), 
157.26 	occur once every six years. Prior to implementation, the commissioner shall consult with 
157.27 	stakeholders on the methodology to calculate the adjustment.
157.28 	(g) (e) The commissioner shall provide a public notice via LISTSERV in October of 
157.29 	each year beginning October 1, 2014, containing information detailing legislatively approved 
157.30 	changes in:
158.1 	(1) calculation values including derived wage rates and related employee and 
158.2 	administrative factors;
158.3 	(2) service utilization;
158.4 	(3) county and tribal allocation changes; and
158.5 	(4) information on adjustments made to calculation values and the timing of those 
158.6 	adjustments.
158.7 	The information in this notice must be effective January 1 of the following year.
158.8 	(h) (f) When the available shared staffing hours in a residential setting are insufficient 
158.9 	to meet the needs of an individual who enrolled in residential services after January 1, 2014, 
158.10 	or insufficient to meet the needs of an individual with a service agreement adjustment 
158.11 	described in section 256B.4913, subdivision 4a, paragraph (f), then individual staffing hours 
158.12 	shall be used.
158.13 	(i) The commissioner shall study the underlying cost of absence and utilization for day 
158.14 	services. Based on the commissioner's evaluation of the data collected under this paragraph, 
158.15 	the commissioner shall make recommendations to the legislature by January 15, 2018, for 
158.16 	changes, if any, to the absence and utilization factor ratio component value for day services.
158.17 	(j) (g) Beginning July 1, 2017, the commissioner shall collect transportation and trip 
158.18 	information for all day services through the rates management system.
158.19 	(h) The commissioner, in consultation with stakeholders, shall study value-based models 
158.20 	and outcome-based payment strategies for fee-for-service home and community-based 
158.21 	services and report to the legislative committees with jurisdiction over the disability waiver 
158.22 	rate system by October 1, 2020, with recommended strategies to improve the quality, 
158.23 	efficiency, and effectiveness of services.

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

158.25 	Sec. 39. Minnesota Statutes 2018, section 256B.4914, subdivision 10a, is amended to 
158.26 	read:
158.27 		Subd. 10a.Reporting and analysis of cost data. (a) The commissioner must ensure 
158.28 	that wage values and component values in subdivisions 5 to 9 reflect the cost to provide the 
158.29 	service. As determined by the commissioner, in consultation with stakeholders identified 
158.30 	in section 256B.4913, subdivision 5, a provider enrolled to provide services with rates 
158.31 	determined under this section must submit requested cost data to the commissioner to support 
159.1 	research on the cost of providing services that have rates determined by the disability waiver 
159.2 	rates system. Requested cost data may include, but is not limited to:
159.3 	(1) worker wage costs;
159.4 	(2) benefits paid;
159.5 	(3) supervisor wage costs;
159.6 	(4) executive wage costs;
159.7 	(5) vacation, sick, and training time paid;
159.8 	(6) taxes, workers' compensation, and unemployment insurance costs paid;
159.9 	(7) administrative costs paid;
159.10 	(8) program costs paid;
159.11 	(9) transportation costs paid;
159.12 	(10) vacancy rates; and
159.13 	(11) other data relating to costs required to provide services requested by the 
159.14 	commissioner.
159.15 	(b) At least once in any five-year period, a provider must submit cost data for a fiscal 
159.16 	year that ended not more than 18 months prior to the submission date. The commissioner 
159.17 	shall provide each provider a 90-day notice prior to its submission due date. If a provider 
159.18 	fails to submit required reporting data, the commissioner shall provide notice to providers 
159.19 	that have not provided required data 30 days after the required submission date, and a second 
159.20 	notice for providers who have not provided required data 60 days after the required 
159.21 	submission date. The commissioner shall temporarily suspend payments to the provider if 
159.22 	cost data is not received 90 days after the required submission date. Withheld payments 
159.23 	shall be made once data is received by the commissioner.
159.24 	(c) The commissioner shall conduct a random validation of data submitted under 
159.25 	paragraph (a) to ensure data accuracy. The commissioner shall analyze cost documentation 
159.26 	in paragraph (a) and provide recommendations for adjustments to cost components.
159.27 	(d) The commissioner shall analyze cost documentation in paragraph (a) and, in 
159.28 	consultation with stakeholders identified in section 256B.4913, subdivision 5, may submit 
159.29 	recommendations on component values and inflationary factor adjustments to the chairs 
159.30 	and ranking minority members of the legislative committees with jurisdiction over human 
159.31 	services every four years beginning January 1, 2020 2021. The commissioner shall make 
160.1 	recommendations in conjunction with reports submitted to the legislature according to 
160.2 	subdivision 10, paragraph (e) (c). The commissioner shall release cost data in an aggregate 
160.3 	form, and cost data from individual providers shall not be released except as provided for 
160.4 	in current law.
160.5 	(e) The commissioner, in consultation with stakeholders identified in section 256B.4913, 
160.6 	subdivision 5, shall develop and implement a process for providing training and technical 
160.7 	assistance necessary to support provider submission of cost documentation required under 
160.8 	paragraph (a).
160.9 	(f) By December 31, 2020, providers paid with rates calculated under subdivision 5, 
160.10 	paragraph (b), shall identify additional revenues from the competitive workforce factor and 
160.11 	prepare a written distribution plan for the revenues. A provider shall make the provider's 
160.12 	distribution plan available and accessible to all direct care staff for a minimum of one 
160.13 	calendar year. Upon request, a provider shall submit the written distribution plan to the 
160.14 	commissioner.
160.15 	(g) Providers enrolled to provide services with rates determined under section 256B.4914, 
160.16 	subdivision 3, shall submit labor market data to the commissioner annually on or before 
160.17 	November 1, including but not limited to:
160.18 	(1) number of direct care staff;
160.19 	(2) wages of direct care staff;
160.20 	(3) overtime wages of direct care staff;
160.21 	(4) hours worked by direct care staff;
160.22 	(5) overtime hours worked by direct care staff;
160.23 	(6) benefits provided to direct care staff;
160.24 	(7) direct care staff job vacancies; and
160.25 	(8) direct care staff retention rates.
160.26 	(h) The commissioner shall publish annual reports on provider and state-level labor 
160.27 	market data, including but not limited to the data obtained under paragraph (g).
160.28 	(i) The commissioner shall temporarily suspend payments to the provider if data requested 
160.29 	under paragraph (g) is not received 90 days after the required submission date. Withheld 
160.30 	payments shall be made once data is received by the commissioner.

161.1 	EFFECTIVE DATE. This section is effective the day following final enactment except 
161.2 	paragraph (g) is effective November 1, 2019, and paragraph (h) is effective February 1, 
161.3 	2020.

161.4 	Sec. 40. Minnesota Statutes 2018, section 256B.493, subdivision 1, is amended to read:
161.5 		Subdivision 1.Commissioner's duties; report. The commissioner of human services 
161.6 	has the authority to manage statewide licensed corporate foster care or community residential 
161.7 	settings capacity, including the reduction and realignment of licensed capacity of a current 
161.8 	foster care or community residential setting to accomplish the consolidation or closure of 
161.9 	settings. The commissioner shall implement a program for planned closure of licensed 
161.10 	corporate adult foster care or community residential settings, necessary as a preferred method 
161.11 	to: (1) respond to the informed decisions of those individuals who want to move out of these 
161.12 	settings into other types of community settings; and (2) achieve necessary budgetary savings
161.13 	the reduction of statewide licensed capacity required in section 245A.03, subdivision 7, 
161.14 	paragraphs (c) and (d). Closure determinations by the commissioner are final and not subject 
161.15 	to appeal.

161.16 	Sec. 41. Minnesota Statutes 2018, section 256B.5013, subdivision 1, is amended to read:
161.17 		Subdivision 1.Variable rate adjustments. (a) For rate years beginning on or after 
161.18 	October 1, 2000, When there is a documented increase in the needs of a current ICF/DD 
161.19 	recipient, the county of financial responsibility may recommend a variable rate to enable 
161.20 	the facility to meet the individual's increased needs. Variable rate adjustments made under 
161.21 	this subdivision replace payments for persons with special needs for crisis intervention 
161.22 	services under section 256B.501, subdivision 8a. Effective July 1, 2003, facilities with a 
161.23 	base rate above the 50th percentile of the statewide average reimbursement rate for a Class 
161.24 	A facility or Class B facility, whichever matches the facility licensure, are not eligible for 
161.25 	a variable rate adjustment. Variable rate adjustments may not exceed a 12-month period, 
161.26 	except when approved for purposes established in paragraph (b), clause (1). Once approved, 
161.27 	variable rate adjustments must continue to remain in place unless there is an identified 
161.28 	change in need. A review of needed resources must be done at the time of the individual's 
161.29 	annual support plan meeting. A request to adjust the resources of the individual must be 
161.30 	submitted if any change in need is identified. Variable rate adjustments approved solely on 
161.31 	the basis of changes on a developmental disabilities screening document will end June 30, 
161.32 	2002.
162.1 	(b) The county of financial responsibility must act on a variable rate request within 30 
162.2 	days and notify the initiator of the request of the county's recommendation in writing.
162.3 	(b) (c) A variable rate may be recommended by the county of financial responsibility 
162.4 	for increased needs in the following situations:
162.5 	(1) a need for resources due to an individual's full or partial retirement from participation 
162.6 	in a day training and habilitation service when the individual: (i) has reached the age of 65 
162.7 	or has a change in health condition that makes it difficult for the person to participate in 
162.8 	day training and habilitation services over an extended period of time because it is medically 
162.9 	contraindicated; and (ii) has expressed a desire for change through the developmental 
162.10 	disability screening process under section 256B.092;
162.11 	(2) a need for additional resources for intensive short-term programming which is 
162.12 	necessary prior to an individual's discharge to a less restrictive, more integrated setting;
162.13 	(3) a demonstrated medical need that significantly impacts the type or amount of services 
162.14 	needed by the individual; or
162.15 	(4) a demonstrated behavioral or cognitive need that significantly impacts the type or 
162.16 	amount of services needed by the individual.; or
162.17 	(c) The county of financial responsibility must justify the purpose, the projected length 
162.18 	of time, and the additional funding needed for the facility to meet the needs of the individual.
162.19 	(d) The facility shall provide an annual report to the county case manager on the use of 
162.20 	the variable rate funds and the status of the individual on whose behalf the funds were 
162.21 	approved. The county case manager will forward the facility's report with a recommendation 
162.22 	to the commissioner to approve or disapprove a continuation of the variable rate.
162.23 	(e) Funds made available through the variable rate process that are not used by the facility 
162.24 	to meet the needs of the individual for whom they were approved shall be returned to the 
162.25 	state.
162.26 	(5) a demonstrated increased need for staff assistance, changes in the type of staff 
162.27 	credentials needed, or a need for expert consultation based on assessments conducted prior 
162.28 	to the annual support plan meeting.
162.29 	(d) Variable rate requests must include the following information:
162.30 	(1) the service needs change;
162.31 	(2) the variable rate requested and the difference from the current rate;
163.1 	(3) a basis for the underlying costs used for the variable rate and any accompanying 
163.2 	documentation; and
163.3 	(4) documentation of the expected outcomes to be achieved and the frequency of progress 
163.4 	monitoring associated with the rate increase.

163.5 	EFFECTIVE DATE. This section is effective July 1, 2019, or upon federal approval, 
163.6 	whichever is later. The commissioner of human services shall inform the revisor of statutes 
163.7 	when federal approval is obtained.

163.8 	Sec. 42. Minnesota Statutes 2018, section 256B.5013, subdivision 6, is amended to read:
163.9 		Subd. 6.Commissioner's responsibilities. The commissioner shall:
163.10 	(1) make a determination to approve, deny, or modify a request for a variable rate 
163.11 	adjustment within 30 days of the receipt of the completed application;
163.12 	(2) notify the ICF/DD facility and county case manager of the duration and conditions 
163.13 	of variable rate adjustment approvals determination; and
163.14 	(3) modify MMIS II service agreements to reimburse ICF/DD facilities for approved 
163.15 	variable rates.

163.16 	Sec. 43. Minnesota Statutes 2018, section 256B.5015, subdivision 2, is amended to read:
163.17 		Subd. 2.Services during the day. (a) Services during the day, as defined in section 
163.18 	256B.501, but excluding day training and habilitation services, shall be paid as a pass-through 
163.19 	payment no later than January 1, 2004. The commissioner shall establish rates for these 
163.20 	services, other than day training and habilitation services, at levels that do not exceed 75
163.21 	100 percent of a recipient's day training and habilitation service costs prior to the service 
163.22 	change.
163.23 	(b) An individual qualifies for services during the day under paragraph (a) if:
163.24 	(1) through consultation with the individual and their support team or interdisciplinary 
163.25 	team, it has been determined that the individual's needs can best be met through partial or 
163.26 	full retirement from:
163.27 	(i) participation in a day training and habilitation service; or
163.28 	(ii) the use of services during the day in the individual's home environment; and
163.29 	(2) in consultation with the individual and their support team or interdisciplinary team, 
163.30 	an individualized plan has been developed with designated outcomes that:
164.1 	(i) addresses the support needs and desires contained in the person-centered plan or 
164.2 	individual support plan; and
164.3 	(ii) includes goals that focus on community integration as appropriate for the individual.
164.4 	(c) When establishing a rate for these services, the commissioner shall also consider an 
164.5 	individual recipient's needs as identified in the individualized service individual support
164.6 	plan and the person's need for active treatment as defined under federal regulations. The 
164.7 	pass-through payments for services during the day shall be paid separately by the 
164.8 	commissioner and shall not be included in the computation of the ICF/DD facility total 
164.9 	payment rate.

164.10 	Sec. 44. Minnesota Statutes 2018, section 256B.85, subdivision 3, is amended to read:
164.11 		Subd. 3.Eligibility. (a) CFSS is available to a person who meets one of the following:
164.12 	(1) is an enrollee of medical assistance as determined under section 256B.055, 256B.056, 
164.13 	or 256B.057, subdivisions 5 and 9;
164.14 	(2) is a participant in the alternative care program under section 256B.0913;
164.15 	(3) is a waiver participant as defined under section 256B.0915, 256B.092, 256B.093, or 
164.16 	256B.49; or
164.17 	(4) has medical services identified in a person's individualized education program and 
164.18 	is eligible for services as determined in section 256B.0625, subdivision 26.
164.19 	(b) In addition to meeting the eligibility criteria in paragraph (a), a person must also 
164.20 	meet all of the following:
164.21 	(1) based on an assessment under section 256B.0911, require assistance and be determined 
164.22 	dependent in one critical activity of daily living or one Level I behavior based on assessment 
164.23 	under section 256B.0911 or have a behavior that shows increased vulnerability due to 
164.24 	cognitive deficits or socially inappropriate behavior that requires assistance at least four 
164.25 	times per week; and
164.26 	(2) is not a participant under a family support grant under section 252.32.
164.27 	(c) A pregnant woman eligible for medical assistance under section 256B.055, subdivision 
164.28 	6, is eligible for CFSS without federal financial participation if the woman: (1) is eligible 
164.29 	for CFSS under paragraphs (a) and (b); and (2) does not meet institutional level of care, as 
164.30 	determined under section 256B.0911.

165.1 	Sec. 45. Minnesota Statutes 2018, section 256B.85, subdivision 8, is amended to read:
165.2 		Subd. 8.Determination of CFSS service authorization amount. (a) All community 
165.3 	first services and supports must be authorized by the commissioner or the commissioner's 
165.4 	designee before services begin. The authorization for CFSS must be completed as soon as 
165.5 	possible following an assessment but no later than 40 calendar days from the date of the 
165.6 	assessment.
165.7 	(b) The amount of CFSS authorized must be based on the participant's home care rating 
165.8 	described in paragraphs (d) and (e) and any additional service units for which the participant 
165.9 	qualifies as described in paragraph (f).
165.10 	(c) The home care rating shall be determined by the commissioner or the commissioner's 
165.11 	designee based on information submitted to the commissioner identifying the following for 
165.12 	a participant:
165.13 	(1) the total number of dependencies of activities of daily living;
165.14 	(2) the presence of complex health-related needs; and
165.15 	(3) the presence of Level I behavior.
165.16 	(d) The methodology to determine the total service units for CFSS for each home care 
165.17 	rating is based on the median paid units per day for each home care rating from fiscal year 
165.18 	2007 data for the PCA program.
165.19 	(e) Each home care rating is designated by the letters P LT through Z and EN and has 
165.20 	the following base number of service units assigned:
165.21 	(1) PLT home care rating requires Level I behavior or one to three dependencies in 
165.22 	ADLs and qualifies the person for five service units the presence of increased vulnerability 
165.23 	due to cognitive deficits and socially inappropriate behavior that requires assistance at least 
165.24 	four times per week, the presence of a Level I behavior, or a dependency in one critical 
165.25 	activity of daily living, and qualifies the person for two service units;
165.26 	(2) P home care rating requires two to three dependencies in ADLs, one of which must 
165.27 	be a critical ADL, and qualifies the person for five services units;
165.28 	(3) Q home care rating requires Level I behavior and one two to three dependencies in 
165.29 	ADLs, one of which must be a critical ADL, and qualifies the person for six service units;
165.30 	(3) (4) R home care rating requires a complex health-related need and one two to three 
165.31 	dependencies in ADLs, one of which must be a critical ADL, and qualifies the person for 
165.32 	seven service units;
166.1 	(4) (5) S home care rating requires four to six dependencies in ADLs, one of which must 
166.2 	be a critical ADL, and qualifies the person for ten service units;
166.3 	(5) (6) T home care rating requires Level I behavior and four to six dependencies in 
166.4 	ADLs and Level I behavior, one of which must be a critical ADL,  and qualifies the person 
166.5 	for 11 service units;
166.6 	(6) (7) U home care rating requires four to six dependencies in ADLs, one of which 
166.7 	must be a critical ADL, and a complex health-related need and qualifies the person for 14 
166.8 	service units;
166.9 	(7) (8) V home care rating requires seven to eight dependencies in ADLs and qualifies 
166.10 	the person for 17 service units;
166.11 	(8) (9) W home care rating requires seven to eight dependencies in ADLs and Level I 
166.12 	behavior and qualifies the person for 20 service units;
166.13 	(9) (10) Z home care rating requires seven to eight dependencies in ADLs and a complex 
166.14 	health-related need and qualifies the person for 30 service units; and
166.15 	(10) (11) EN home care rating includes ventilator dependency as defined in section 
166.16 	256B.0651, subdivision 1, paragraph (g). A person who meets the definition of 
166.17 	ventilator-dependent and the EN home care rating and utilize a combination of CFSS and 
166.18 	home care nursing services is limited to a total of 96 service units per day for those services 
166.19 	in combination. Additional units may be authorized when a person's assessment indicates 
166.20 	a need for two staff to perform activities. Additional time is limited to 16 service units per 
166.21 	day.
166.22 	(f) Additional service units are provided through the assessment and identification of 
166.23 	the following:
166.24 	(1) 30 additional minutes per day for a dependency in each critical activity of daily 
166.25 	living;
166.26 	(2) 30 additional minutes per day for each complex health-related need; and
166.27 	(3) 30 additional minutes per day when the behavior requires assistance at least four 
166.28 	times per week for one or more of the following behaviors:
166.29 	(i) level I behavior;
166.30 	(ii) increased vulnerability due to cognitive deficits or socially inappropriate behavior; 
166.31 	or
167.1 	(iii) increased need for assistance for participants who are verbally aggressive or resistive 
167.2 	to care so that the time needed to perform activities of daily living is increased.
167.3 	(g) The service budget for budget model participants shall be based on:
167.4 	(1) assessed units as determined by the home care rating; and
167.5 	(2) an adjustment needed for administrative expenses.

167.6 	Sec. 46. Minnesota Statutes 2018, section 256C.23, is amended by adding a subdivision 
167.7 	to read:
167.8 		Subd. 7.Family and community intervener. "Family and community intervener" 
167.9 	means a paraprofessional, specifically trained in deafblindness, who works one-on-one with 
167.10 	a child who is deafblind to provide critical connections to people and the environment.

167.11 	Sec. 47. Minnesota Statutes 2018, section 256C.261, is amended to read:
167.12 	256C.261 SERVICES FOR PERSONS WHO ARE DEAFBLIND.
167.13 	(a) The commissioner of human services shall use at least 35 percent of the deafblind 
167.14 	services biennial base level grant funding for services and other supports for a child who is 
167.15 	deafblind and the child's family. The commissioner shall use at least 25 percent of the 
167.16 	deafblind services biennial base level grant funding for services and other supports for an 
167.17 	adult who is deafblind.
167.18 	The commissioner shall award grants for the purposes of:
167.19 	(1) providing services and supports to persons who are deafblind; and
167.20 	(2) developing and providing training to counties and the network of senior citizen 
167.21 	service providers. The purpose of the training grants is to teach counties how to use existing 
167.22 	programs that capture federal financial participation to meet the needs of eligible persons 
167.23 	who are deafblind and to build capacity of senior service programs to meet the needs of 
167.24 	seniors with a dual sensory hearing and vision loss.
167.25 	(b) The commissioner may make grants:
167.26 	(1) for services and training provided by organizations; and
167.27 	(2) to develop and administer consumer-directed services.
167.28 	(c) Consumer-directed services shall be provided in whole by grant-funded providers. 
167.29 	The Deaf and Hard-of-Hearing Services Division's regional service centers shall not provide 
167.30 	any aspect of a grant-funded consumer-directed services program.
168.1 	(d) Any entity that is able to satisfy the grant criteria is eligible to receive a grant under 
168.2 	paragraph (a).
168.3 	(e) Deafblind service providers may, but are not required to, provide intervenor services 
168.4 	as part of the service package provided with grant funds under this section. Intervener 
168.5 	services include services provided by a family and community intervener as described in 
168.6 	paragraph (f).
168.7 	(f) The family and community intervener, as defined in section 256C.23, subdivision 7, 
168.8 	provides services to open channels of communication between the child and others; facilitate 
168.9 	the development or use of receptive and expressive communication skills by the child; and 
168.10 	develop and maintain a trusting, interactive relationship that promotes social and emotional 
168.11 	well-being. The family and community intervener also provides access to information and 
168.12 	the environment, and facilitates opportunities for learning and development. A family and 
168.13 	community intervener must have specific training in deafblindness, building language and 
168.14 	communication skills, and intervention strategies.

168.15 	Sec. 48. Minnesota Statutes 2018, section 256I.03, subdivision 8, is amended to read:
168.16 		Subd. 8.Supplementary services. "Supplementary services" means housing support 
168.17 	services provided to individuals in addition to room and board including, but not limited 
168.18 	to, oversight and up to 24-hour supervision, medication reminders, assistance with 
168.19 	transportation, arranging for meetings and appointments, and arranging for medical and 
168.20 	social services, and services identified in section 256I.03, subdivision 12.

168.21 	Sec. 49. Minnesota Statutes 2018, section 256I.04, subdivision 2b, is amended to read:
168.22 		Subd. 2b.Housing support agreements. (a) Agreements between agencies and providers 
168.23 	of housing support must be in writing on a form developed and approved by the commissioner 
168.24 	and must specify the name and address under which the establishment subject to the 
168.25 	agreement does business and under which the establishment, or service provider, if different 
168.26 	from the group residential housing establishment, is licensed by the Department of Health 
168.27 	or the Department of Human Services; the specific license or registration from the 
168.28 	Department of Health or the Department of Human Services held by the provider and the 
168.29 	number of beds subject to that license; the address of the location or locations at which 
168.30 	group residential housing is provided under this agreement; the per diem and monthly rates 
168.31 	that are to be paid from housing support funds for each eligible resident at each location; 
168.32 	the number of beds at each location which are subject to the agreement; whether the license 
168.33 	holder is a not-for-profit corporation under section 501(c)(3) of the Internal Revenue Code; 
169.1 	and a statement that the agreement is subject to the provisions of sections 256I.01 to 256I.06
169.2 	and subject to any changes to those sections.
169.3 	(b) Providers are required to verify the following minimum requirements in the 
169.4 	agreement:
169.5 	(1) current license or registration, including authorization if managing or monitoring 
169.6 	medications;
169.7 	(2) all staff who have direct contact with recipients meet the staff qualifications;
169.8 	(3) the provision of housing support;
169.9 	(4) the provision of supplementary services, if applicable;
169.10 	(5) reports of adverse events, including recipient death or serious injury; and
169.11 	(6) submission of residency requirements that could result in recipient eviction.; and
169.12 	(7) confirmation that the provider will not limit or restrict the number of hours an 
169.13 	applicant or recipient chooses to be employed, as specified in subdivision 5.
169.14 	(c) Agreements may be terminated with or without cause by the commissioner, the 
169.15 	agency, or the provider with two calendar months prior notice. The commissioner may 
169.16 	immediately terminate an agreement under subdivision 2d.

169.17 	Sec. 50. Minnesota Statutes 2018, section 256I.04, is amended by adding a subdivision 
169.18 	to read:
169.19 		Subd. 2h.Required supplementary services. Providers of supplementary services shall 
169.20 	ensure that recipients have, at a minimum, assistance with services as identified in the 
169.21 	recipient's professional statement of need under section 256I.03, subdivision 12. Providers 
169.22 	of supplementary services shall maintain case notes with the date and description of services 
169.23 	provided to individual recipients.

169.24 	Sec. 51. Minnesota Statutes 2018, section 256I.04, is amended by adding a subdivision 
169.25 	to read:
169.26 		Subd. 5.Employment. A provider is prohibited from limiting or restricting the number 
169.27 	of hours an applicant or recipient is employed.

169.28 	Sec. 52. Minnesota Statutes 2018, section 256I.05, subdivision 1r, is amended to read:
169.29 		Subd. 1r.Supplemental rate; Anoka County. (a) Notwithstanding the provisions in 
169.30 	this section, a county agency shall negotiate a supplemental rate for 42 beds in addition to 
170.1 	the rate specified in subdivision 1, not to exceed the maximum rate allowed under subdivision 
170.2 	1a, including any legislatively authorized inflationary adjustments, for a housing support 
170.3 	provider that is located in Anoka County and provides emergency housing on the former 
170.4 	Anoka Regional Treatment Center campus.
170.5 	(b) Notwithstanding the provisions in this section, a county agency shall negotiate a 
170.6 	supplemental rate for six beds in addition to the rate specified in subdivision 1, not to exceed 
170.7 	the maximum rate allowed under subdivision 1a, including any legislatively authorized 
170.8 	inflationary adjustments, for a housing support provider located in Anoka County that 
170.9 	operates a 12-bed facility and provides room and board and supplementary services to 
170.10 	individuals 18 to 24 years of age.

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

170.12 	Sec. 53. [268A.061] HOME AND COMMUNITY-BASED PROVIDERS.
170.13 		Subdivision 1.Home and community-based provider eligibility for 
170.14 	payments. Notwithstanding Minnesota Rules, part 3300.5060, subparts 14 to 16, the 
170.15 	commissioner shall make payments for job-related services, vocational adjustment training, 
170.16 	and vocational evaluation services to any home and community-based services provider 
170.17 	licensed as an intensive support services provider under chapter 245D with whom the 
170.18 	commissioner has signed a limited-use vendor operating agreement.
170.19 		Subd. 2.Limited-use agreements with home and community-based providers. A 
170.20 	limited-use vendor operating agreement under this section may not limit the dollar amount 
170.21 	the provider may receive annually. The limited-use vendor operating agreement available 
170.22 	under this section must specify at a minimum that payments under the agreement are limited 
170.23 	to vocational rehabilitation services provided to individuals to whom the provider has 
170.24 	previously provided day services as described under section 245D.03, subdivision 1, 
170.25 	paragraph (c), clause (4), or any of the employment services described under section 245D.03, 
170.26 	subdivision 1, paragraph (c), clauses (5) to (7).
170.27 		Subd. 3.Required limited-use agreements. The commissioner must enter into a 
170.28 	limited-use vendor operating agreement that meets at least the minimal requirements of 
170.29 	subdivision 2 with a provider eligible under subdivision 1 if:
170.30 	(1) the home and community-based provider is not a current vocational rehabilitation 
170.31 	services provider;
171.1 	(2) each individual to be served under the limited-use vendor operating agreement was 
171.2 	receiving day or employment services from the provider immediately prior to the provider 
171.3 	serving the individual under the terms of the agreement; and
171.4 	(3) each individual to be served under the limited-use vendor operating agreement has 
171.5 	made an informed choice to remain with the provider.

171.6 	Sec. 54. Laws 2017, First Special Session chapter 6, article 1, section 44, is amended to 
171.7 	read:
171.8 	Sec. 44. EXPANSION OF CONSUMER-DIRECTED COMMUNITY SUPPORTS 
171.9 	BUDGET METHODOLOGY EXCEPTION.
 171.10 	(a) No later than September 30, 2017, if necessary, the commissioner of human services 
171.11 	shall submit an amendment to the Centers for Medicare and Medicaid Services for the home 
171.12 	and community-based services waivers authorized under Minnesota Statutes, sections 
171.13 	256B.092 and 256B.49, to expand the exception to the consumer-directed community 
171.14 	supports budget methodology under Laws 2015, chapter 71, article 7, section 54, to provide 
171.15 	up to 30 percent more funds for either:
171.16 	(1) consumer-directed community supports participants who have a coordinated service 
171.17 	and support plan which identifies the need for an increased amount of services or supports 
171.18 	under consumer-directed community supports than the amount they are currently receiving 
171.19 	under the consumer-directed community supports budget methodology:
171.20 	(i) to increase the amount of time a person works or otherwise improves employment 
171.21 	opportunities;
171.22 	(ii) to plan a transition to, move to, or live in a setting described in Minnesota Statutes, 
171.23 	section 256D.44, subdivision 5, paragraph (f), clause (1), item (ii), or paragraph (g), clause 
171.24 	(1), item (iii); or
171.25 	(iii) to develop and implement a positive behavior support plan; or
171.26 	(2) home and community-based waiver participants who are currently using licensed 
171.27 	providers for (i) employment supports or services during the day; or (ii) residential services, 
171.28 	either of which cost more annually than the person would spend under a consumer-directed 
171.29 	community supports plan for any or all of the supports needed to meet the goals identified 
171.30 	in paragraph (a), clause (1), items (i), (ii), and (iii).
171.31 	(b) The exception under paragraph (a), clause (1), is limited to those persons who can 
171.32 	demonstrate that they will have to discontinue using consumer-directed community supports 
172.1 	and accept other non-self-directed waiver services because their supports needed for the 
172.2 	goals described in paragraph (a), clause (1), items (i), (ii), and (iii), cannot be met within 
172.3 	the consumer-directed community supports budget limits.
172.4 	(c) The exception under paragraph (a), clause (2), is limited to those persons who can 
172.5 	demonstrate that, upon choosing to become a consumer-directed community supports 
172.6 	participant, the total cost of services, including the exception, will be less than the cost of 
172.7 	current waiver services.

172.8 	Sec. 55. Laws 2017, First Special Session chapter 6, article 1, section 45, is amended to 
172.9 	read:
172.10 	Sec. 45. CONSUMER-DIRECTED COMMUNITY SUPPORTS BUDGET 
172.11 	METHODOLOGY EXCEPTION FOR PERSONS LEAVING INSTITUTIONS AND 
172.12 	CRISIS RESIDENTIAL SETTINGS.
172.13 		Subdivision 1.Exception for persons leaving institutions and crisis residential 
172.14 	settings. (a) By September 30, 2017, the commissioner shall establish an institutional and 
172.15 	crisis bed consumer-directed community supports budget exception process in the home 
172.16 	and community-based services waivers under Minnesota Statutes, sections 256B.092 and 
172.17 	256B.49. This budget exception process shall be available for any individual who:
172.18 	(1) is not offered available and appropriate services within 60 days since approval for 
172.19 	discharge from the individual's current institutional setting; and
172.20 	(2) requires services that are more expensive than appropriate services provided in a 
172.21 	noninstitutional setting using the consumer-directed community supports option.
172.22 	(b) Institutional settings for purposes of this exception include intermediate care facilities 
172.23 	for persons with developmental disabilities; nursing facilities; acute care hospitals; Anoka 
172.24 	Metro Regional Treatment Center; Minnesota Security Hospital; and crisis beds. The budget 
172.25 	exception shall be limited to no more than the amount of appropriate services provided in 
172.26 	a noninstitutional setting as determined by the lead agency managing the individual's home 
172.27 	and community-based services waiver. The lead agency shall notify the Department of 
172.28 	Human Services of the budget exception.
172.29 		Subd. 2.Shared services. (a) Medical assistance payments for shared services under 
172.30 	consumer-directed community supports are limited to this subdivision.
173.1 	(b) For purposes of this subdivision, "shared services" means services provided at the 
173.2 	same time by the same direct care worker for individuals who have entered into an agreement 
173.3 	to share consumer-directed community support services.
173.4 	(c) Shared services may include services in the personal assistance category as outlined 
173.5 	in the consumer-directed community supports community support plan and shared services 
173.6 	agreement, except:
173.7 	(1) services for more than three individuals provided by one worker at one time;
173.8 	(2) use of more than one worker for the shared services; and
173.9 	(3) a child care program licensed under chapter 245A or operated by a local school 
173.10 	district or private school.
173.11 	(d) The individuals or, as needed, their representatives shall develop the plan for shared 
173.12 	services when developing or amending the consumer-directed community supports plan, 
173.13 	and must follow the consumer-directed community supports process for approval of the 
173.14 	plan by the lead agency. The plan for shared services in an individual's consumer-directed 
173.15 	community supports plan shall include the intention to utilize shared services based on 
173.16 	individuals' needs and preferences.
173.17 	(e) Individuals sharing services must use the same financial management services 
173.18 	provider.
173.19 	(f) Individuals whose consumer-directed community supports community support plans 
173.20 	include the intention to utilize shared services must also jointly develop, with the support 
173.21 	of their representatives as needed, a shared services agreement. This agreement must include:
173.22 	(1) the names of the individuals receiving shared services;
173.23 	(2) the individuals' representative, if identified in their consumer-directed community 
173.24 	supports plans, and their duties;
173.25 	(3) the names of the case managers;
173.26 	(4) the financial management services provider;
173.27 	(5) the shared services that must be provided;
173.28 	(6) the schedule for shared services;
173.29 	(7) the location where shared services must be provided;
173.30 	(8) the training specific to each individual served;
174.1 	(9) the training specific to providing shared services to the individuals identified in the 
174.2 	agreement;
174.3 	(10) instructions to follow all required documentation for time and services provided;
174.4 	(11) a contingency plan for each of the individuals that accounts for service provision 
174.5 	and billing in the absence of one of the individuals in a shared services setting due to illness 
174.6 	or other circumstances;
174.7 	(12) signatures of all parties involved in the shared services; and
174.8 	(13) agreement by each of the individuals who are sharing services on the number of 
174.9 	shared hours for services provided.
174.10 	(g) Any individual or any individual's representative may withdraw from participating 
174.11 	in a shared services agreement at any time.
174.12 	(h) The lead agency for each individual must authorize the use of the shared services 
174.13 	option based on the criteria that the shared service is appropriate to meet the needs, health, 
174.14 	and safety of each individual for whom they provide case management or care coordination.
174.15 	(i) Nothing in this subdivision must be construed to reduce the total authorized 
174.16 	consumer-directed community supports budget for an individual.
174.17 	(j) No later than September 30, 2019, the commissioner of human services shall:
174.18 	(1) submit an amendment to the Centers for Medicare and Medicaid Services for the 
174.19 	home and community-based services waivers authorized under Minnesota Statutes, sections 
174.20 	256B.092 and 256B.49, to allow for a shared services option under consumer-directed 
174.21 	community supports; and
174.22 	(2) with stakeholder input, develop guidance for shared services in consumer-directed 
174.23 	community-supports within the Community Based Services Manual. Guidance must include:
174.24 	(i) recommendations for negotiating payment for one-to-two and one-to-three services; 
174.25 	and
174.26 	(ii) a template of the shared services agreement.

174.27 	EFFECTIVE DATE. This section is effective October 1, 2019, or upon federal approval, 
174.28 	whichever is later, except for subdivision 2, paragraph (j), which is effective the day 
174.29 	following final enactment. The commissioner of human services shall notify the revisor of 
174.30 	statutes when federal approval is obtained.

175.1 	Sec. 56. DAY TRAINING AND HABILITATION DISABILITY WAIVER RATE 
175.2 	SYSTEM TRANSITION GRANTS.
 175.3 	(a) The commissioner of human services shall establish annual grants to day training 
175.4 	and habilitation providers that are projected to experience a funding gap upon the full 
175.5 	implementation of Minnesota Statutes, section 256B.4914.
175.6 	(b) In order to be eligible for a grant under this section, a day training and habilitation 
175.7 	disability waiver provider must:
175.8 	(1) serve at least 100 waiver service participants;
175.9 	(2) be projected to receive a reduction in annual revenue from medical assistance for 
175.10 	day services during the first year of full implementation of disability waiver rate system 
175.11 	framework rates under Minnesota Statutes, section 256B.4914, of at least 15 percent and 
175.12 	at least $300,000 compared to the annual  medical assistance revenue for day services the 
175.13 	provider received during the last full year during which banded rates under Minnesota 
175.14 	Statutes, section 256B.4913, subdivision 4a, were effective; and
175.15 	(3) agree to develop, submit, and implement a sustainability plan as provided in paragraph
175.16 	(c) A recipient of a grant under this section must develop a sustainability plan in 
175.17 	partnership with the commissioner of human services. The sustainability plan must include:
175.18 	(1) a review of all the provider's costs and an assessment of whether the provider is 
175.19 	implementing available cost-control options appropriately;
175.20 	(2) a review of all the provider's revenue and an assessment of whether the provider is 
175.21 	leveraging available resources appropriately; and
175.22 	(3) a practical strategy for closing the funding gap described in paragraph (b), clause 
175.23 	(2).
175.24 	(d) The commissioner of human services shall provide technical assistance and financial 
175.25 	management advice to grant recipients as they develop and implement their sustainability 
175.26 	plans.
175.27 	(e) In order to be eligible for an annual grant renewal, a grant recipient must demonstrate 
175.28 	to the commissioner of human services that it made a good faith effort to close the revenue 
175.29 	gap described in paragraph (b), clause (2).

176.1 	Sec. 57. DIRECTION TO COMMISSIONER OF HUMAN SERVICES; 
176.2 	MNCHOICES 2.0.
 176.3 	(a) The commissioner of human services must ensure that the MnCHOICES 2.0 
176.4 	assessment and support planning tool incorporates a qualitative approach with open-ended 
176.5 	questions and a conversational, culturally sensitive approach to interviewing that captures 
176.6 	the assessor's professional judgment based on the person's responses.
176.7 	(b) If the commissioner of human services convenes a working group or consults with 
176.8 	stakeholders for the purposes of modifying the assessment and support planning process or 
176.9 	tool, the commissioner must include members of the disability community, including 
176.10 	representatives of organizations and individuals involved in assessment and support planning.
176.11 	(c) Until MnCHOICES 2.0 is fully implemented, the commissioner shall permit counties 
176.12 	to use the most recent legacy documents related to long-term service and supports 
176.13 	assessments and shall reimburse counties in the same amount as the commissioner would 
176.14 	were the county using the MnCHOICES assessment tool.

176.15 	Sec. 58. DIRECTION TO THE COMMISSIONER OF HUMAN SERVICES; 
176.16 	CAPITATION PAYMENTS FOR LONG-TERM SERVICES AND SUPPORTS 
176.17 	ASSESSMENT ACTIVITIES.
 176.18 	By December 1, 2019, the commissioner of human services shall provide a report to the 
176.19 	chairs and ranking minority members of the legislative committees with jurisdiction over 
176.20 	human services finance and policy proposing a rate per assessment to be paid to counties 
176.21 	and tribes for all medical assistance and county human services activities currently reimbursed 
176.22 	via a random moment time study. The commissioner, in developing the proposal, shall use 
176.23 	past estimates of time spent on each relevant activity.  The commissioner's report shall 
176.24 	include an explanation of how the commissioner determines the portion of capitated rates 
176.25 	paid to health plans attributable to each type of activity also performed by a county or tribe. 
176.26 	The commissioner's proposal must include a single rate per activity for each activity for all 
176.27 	populations, but may also include an alternative proposal for different rates per activity for 
176.28 	each activity for different populations.

176.29 	Sec. 59. DIRECTION TO THE COMMISSIONER OF HUMAN SERVICES; 
176.30 	BARRIERS TO INDEPENDENT LIVING.
 176.31 	By December 1, 2019, the commissioner of human services shall submit to the chairs 
176.32 	and ranking minority members of the legislative committees with jurisdiction over human 
176.33 	services finance and policy a report describing state and federal regulatory barriers, including 
177.1 	provisions of the Fair Housing Act, that create barriers to independent living for persons 
177.2 	with disabilities. In developing the report, the commissioner shall consult with stakeholders, 
177.3 	including individuals with disabilities, advocacy organizations, and service providers.

177.4 	Sec. 60. ADULT FOSTER CARE  MORATORIUM EXEMPTION.
 177.5 	An adult foster care setting located in Elk River, Sherburne County, and licensed in 
177.6 	2003 to serve four people is exempt from the moratorium under Minnesota Statutes, section 
177.7 	245A.03, subdivision 7, until July 1, 2020.

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

177.9 	Sec. 61. DIRECTION TO COMMISSIONER; BI AND CADI WAIVER 
177.10 	CUSTOMIZED LIVING SERVICES PROVIDER LOCATED IN HENNEPIN 
177.11 	COUNTY.
 177.12 	(a) The commissioner of human services shall allow a housing with services establishment 
177.13 	located in Minneapolis that provides customized living and 24-hour customized living 
177.14 	services for clients enrolled in the brain injury (BI) or community access for disability 
177.15 	inclusion (CADI) waiver and had a capacity to serve 66 clients as of July 1, 2017, to transfer 
177.16 	service capacity of up to 66 clients to no more than three new housing with services 
177.17 	establishments located in Hennepin County.
177.18 	(b) Notwithstanding Minnesota Statutes, section 256B.492, the commissioner shall 
177.19 	determine that the new housing with services establishments described under paragraph (a) 
177.20 	meet the BI and CADI waiver customized living and 24-hour customized living size 
177.21 	limitation exception for clients receiving those services at the new housing with services 
177.22 	establishments described under paragraph (a).

177.23 	Sec. 62. DIRECTION TO THE COMMISSIONER OF HUMAN SERVICES; 
177.24 	PERSONAL CARE ASSISTANCE SERVICES COMPARABILITY WAIVER.
 177.25 	The commissioner of human services shall submit by July 1, 2019, a waiver request to 
177.26 	the Centers for Medicare and Medicaid Services to allow people receiving personal care 
177.27 	assistance services as of December 31, 2019, to continue their eligibility for personal care 
177.28 	assistance services under the personal care assistance service eligibility criteria in effect on 
177.29 	December 31, 2019.

178.1 	Sec. 63. DIRECTION TO THE COMMISSIONER OF HUMAN SERVICES; 
178.2 	TRANSITION PERIOD FOR MODIFIED ELIGIBILITY OF PERSONAL CARE 
178.3 	ASSISTANCE.
 178.4 	(a) Beginning at the latest date permissible under federal law, the modified eligibility  
178.5 	criteria under Minnesota Statutes, section 256B.0625, subdivision 19a, and Minnesota 
178.6 	Statutes, section 256B.0652, subdivision 6, paragraphs (b) and (d), shall apply on a rolling 
178.7 	basis, at the time of annual assessments, to people receiving personal care assistance as of 
178.8 	December 31, 2019.
178.9 	(b) The commissioner shall establish a transition period for people receiving personal 
178.10 	care assistance services as of December 31, 2019, who, at the time of the annual assessment 
178.11 	described in paragraph (a), are determined to be ineligible for personal care assistance 
178.12 	services. Service authorizations for this transition period shall not exceed one year.

178.13 	EFFECTIVE DATE. This section is effective January 1, 2020, or upon federal approval, 
178.14 	whichever is later. The commissioner shall notify the revisor of statutes when federal 
178.15 	approval is obtained and when personal care assistance services provided under paragraph 
178.16 	(b) have expired.

178.17 	Sec. 64. DIRECTION TO THE COMMISSIONER; REPORT ON ELIGIBILITY 
178.18 	FOR PERSONAL CARE ASSISTANCE AND ACCESS TO DEVELOPMENTAL 
178.19 	DISABILITIES AND COMMUNITY ACCESS FOR DISABILITY INCLUSION 
178.20 	WAIVERS.
 178.21 	By December 15, 2020, the commissioner shall submit a report to chairs and ranking 
178.22 	minority members of the legislative committees with jurisdiction over human services on 
178.23 	modifications to the eligibility criteria for the personal care assistance program and limits 
178.24 	on the growth of the developmental disabilities and community access for disability inclusion 
178.25 	waivers enacted following the 2019 legislative session. The report shall include the impact 
178.26 	on people receiving or requesting services and any recommendations. By February 15, 2021, 
178.27 	the commissioner shall supplement the December 15, 2020, report with updated data and 
178.28 	information.

178.29 	Sec. 65. DIRECTION TO THE COMMISSIONER OF HUMAN SERVICES; 
178.30 	INTERMEDIATE CARE FACILITY FOR PERSONS WITH DEVELOPMENTAL 
178.31 	DISABILITIES LEVEL OF CARE CRITERIA.
 178.32 	By February 1, 2020, the commissioner of human services shall submit to the chairs and 
178.33 	ranking minority members of the legislative committees with jurisdiction over health and 
179.1 	human services finance and policy recommended language to codify in Minnesota Statutes 
179.2 	the commissioner's existing criteria for the determination of need for intermediate care 
179.3 	facility for persons with developmental disabilities level of care. The recommended language 
179.4 	shall include language clarifying "at risk of placement," "reasonable indication," and "might 
179.5 	require" as those expressions are used in Minnesota Statutes, section 256B.092, subdivision 
179.6 	7, paragraph (b).  The recommended statutory language shall also include the commissioner's 
179.7 	current guidance with respect to the interpretation and application of the federal standard 
179.8 	under Code of Federal Regulations, title 42, section 483.440, that a person receiving the 
179.9 	services of an intermediate care facility for persons with developmental disabilities require 
179.10 	a continuous active treatment plan, including which characteristics are necessary or sufficient 
179.11 	for a determination of a need for active treatment. The commissioner shall submit the 
179.12 	recommended statutory language with a letter listing, with statutory references,  all the 
179.13 	programs and services for which an intermediate care facility for persons with developmental 
179.14 	disabilities level of care is required.

179.15 	Sec. 66. DIRECTION TO THE COMMISSIONER OF HUMAN SERVICES; 
179.16 	DIRECT CARE WORKFORCE RATE METHODOLOGY STUDY.
 179.17 	The commissioner of human services, in consultation with stakeholders, shall evaluate 
179.18 	the feasibility of developing a rate methodology for the personal care assistance program 
179.19 	under Minnesota Statutes, section 256B.0659, and community first services and supports 
179.20 	under Minnesota Statutes, section 256B.85, similar to the disability waiver rate system 
179.21 	under Minnesota Statutes, section 256B.4914, including determining the component values 
179.22 	and factors to include in such a rate methodology; consider aligning any rate methodology 
179.23 	with the collective bargaining agreement and negotiation cycle under Minnesota Statutes, 
179.24 	section 179A.54; recommend strategies for ensuring adequate, competitive wages for direct 
179.25 	care workers; develop methods and determine the necessary resources for the commissioner 
179.26 	to more consistently collect and audit data from the direct care industry; and report 
179.27 	recommendations, including proposed draft legislation, to the chairs and ranking minority 
179.28 	members of the legislative committees with jurisdiction over human services policy and 
179.29 	finance by February 1, 2020.

179.30 	Sec. 67. DIRECTION TO THE COMMISSIONER OF HUMAN SERVICES; HOME 
179.31 	CARE SERVICES PAYMENT REFORM PROPOSAL.
 179.32 	The commissioner of human services shall submit to the chairs and ranking minority 
179.33 	members of the legislative committees with jurisdiction over human services finance and 
179.34 	policy a proposal to adopt a budget-neutral prospective payment system for nursing services 
180.1 	and home health services under Minnesota Statutes, sections 256B.0625, subdivision 6a, 
180.2 	and 256B.0653, and home care nursing services under Minnesota Statutes, sections 
180.3 	256B.0625, subdivision 7, and 256B.0624, modeled on the Medicare fee-for-service home 
180.4 	health prospective payment system. The commissioner shall include in the proposal a case 
180.5 	mix adjusted episodic rate, including services, therapies and supplies, minimum visits 
180.6 	required for an episodic rate, consolidated billing requirements, outlier payments, 
180.7 	low-utilization payments, and other criteria at the commissioner's discretion. In addition to 
180.8 	the budget-neutral payment reform proposal, the commissioner shall also submit a proposed 
180.9 	mechanism for updating the payment rates to reflect inflation in health care costs.

180.10 	Sec. 68. REVISOR INSTRUCTION.
 180.11 	(a) The revisor of statutes shall change the term "developmental disability waiver" or 
180.12 	similar terms to "developmental disabilities waiver" or similar terms wherever they appear 
180.13 	in Minnesota Statutes. The revisor shall also make technical and other necessary changes 
180.14 	to sentence structure to preserve the meaning of the text.
180.15 	(b) The revisor of statutes, in consultation with the House Research Department, Office 
180.16 	of Senate Counsel, Research and Fiscal Analysis, and Department of Human Services, shall 
180.17 	prepare legislation for the 2020 legislative session to codify existing session laws governing 
180.18 	consumer-directed community supports in Minnesota Statutes, chapter 256B.

180.19 	Sec. 69.  REPEALER.
 180.20 	Minnesota Statutes 2018, section 256I.05, subdivision 3, is repealed.

180.21 	ARTICLE 6
180.22 	DIRECT CARE AND TREATMENT

180.23 	Section 1. Minnesota Statutes 2018, section 246.54, is amended by adding a subdivision 
180.24 	to read:
180.25 		Subd. 3.Administrative review of county liability for cost of care. (a) The county of 
180.26 	financial responsibility may submit a written request for administrative review by the 
180.27 	commissioner of the county's payment of the cost of care when a delay in discharge of a 
180.28 	client from a regional treatment center, state-operated community-based behavioral health 
180.29 	hospital, or other state-operated facility results from the following actions by the facility:
180.30 	(1) the facility did not provide notice to the county that the facility has determined that 
180.31 	it is clinically appropriate for a client to be discharged;
181.1 	(2) the notice to the county that the facility has determined that it is clinically appropriate 
181.2 	for a client to be discharged was communicated on a holiday or weekend;
181.3 	(3) the required documentation or procedures for discharge were not completed in order 
181.4 	for the discharge to occur in a timely manner; or
181.5 	(4) the facility disagrees with the county's discharge plan.
181.6 	(b) The county of financial responsibility may not appeal the determination that it is 
181.7 	clinically appropriate for a client to be discharged from a regional treatment center, 
181.8 	state-operated community-based behavioral health hospital, or other state-operated facility.
181.9 	(c) The commissioner must evaluate the request for administrative review and determine 
181.10 	if the facility's actions listed in paragraph (a) caused undue delay in discharging the client. 
181.11 	If the commissioner determines that the facility's actions listed in paragraph (a) caused 
181.12 	undue delay in discharging the client, the county's liability will be reduced to the level of 
181.13 	the cost of care for a client whose stay in a facility is determined to be clinically appropriate, 
181.14 	effective on the date of the facility's action or failure to act that caused the delay. The 
181.15 	commissioner's determination under this subdivision is final.
181.16 	(d) If a county's liability is reduced pursuant to paragraph (c), a county's liability will 
181.17 	return to the level of the cost of care for a client whose stay in a facility is determined to no 
181.18 	longer be appropriate effective on the date the facility rectifies the action or failure to act 
181.19 	that caused the delay under paragraph (a).
181.20 	(e) Any difference in the county cost of care liability resulting from administrative review 
181.21 	under this subdivision shall not be billed to the client or applied to future reimbursement 
181.22 	from the client's estate or relatives.

181.23 	Sec. 2. DIRECTION TO COMMISSIONER; REPORT REQUIRED; DISCHARGE 
181.24 	DELAY REDUCTION.
 181.25 	No later than January 1, 2023, the commissioner of human services must submit a report 
181.26 	to the chairs and ranking minority members of the legislative committees with jurisdiction 
181.27 	over human services that provides an update on county and state efforts to reduce the number 
181.28 	of days clients spend in state-operated facilities after discharge from the facility has been 
181.29 	determined to be clinically appropriate. The report must also include information on the 
181.30 	fiscal impact of clinically inappropriate stays in these facilities.

182.1 	Sec. 3. DIRECTION TO COMMISSIONER; MSOCS COON RAPIDS ILEX 
182.2 	CLOSURE.
 182.3 	The commissioner of human services shall close the Minnesota state-operated community 
182.4 	services program known as MSOCS Coon Rapids Ilex. The commissioner must not reopen 
182.5 	or redesign the program. For the purposes of this section:
182.6 	(1) a program is considered closed if the commissioner discontinues providing services 
182.7 	at a given location;
182.8 	(2) a program is considered reopened if the commissioner opens a new program or begins 
182.9 	providing a new service at a location that was previously closed; and
182.10 	(3) a program is considered redesigned if the commissioner does not change the nature 
182.11 	of the services provided, but does change the focus of the population served by the program.

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

182.13 	Sec. 4. REPEALER.
 182.14 	Minnesota Statutes 2018, section 246.18, subdivisions 8 and 9, are repealed.

182.15 	ARTICLE 7
182.16 	OPERATIONS

182.17 	Section 1. Minnesota Statutes 2018, section 144.057, subdivision 3, is amended to read:
182.18 		Subd. 3.Reconsiderations. The commissioner of health shall review and decide 
182.19 	reconsideration requests, including the granting of variances, in accordance with the 
182.20 	procedures and criteria contained in chapter 245C. The commissioner must set aside a 
182.21 	disqualification for an individual who requests reconsideration and who meets the criteria 
182.22 	described in section 245C.22, subdivision 4, paragraph (d). The commissioner's decision 
182.23 	shall be provided to the individual and to the Department of Human Services. The 
182.24 	commissioner's decision to grant or deny a reconsideration of disqualification is the final 
182.25 	administrative agency action, except for the provisions under sections 245C.25, 245C.27, 
182.26 	and 245C.28, subdivision 3.

182.27 	Sec. 2. Minnesota Statutes 2018, section 245A.04, subdivision 7, is amended to read:
182.28 		Subd. 7.Grant of license; license extension. (a) If the commissioner determines that 
182.29 	the program complies with all applicable rules and laws, the commissioner shall issue a 
183.1 	license consistent with this section or, if applicable, a temporary change of ownership license 
183.2 	under section 245A.043. At minimum, the license shall state:
183.3 	(1) the name of the license holder;
183.4 	(2) the address of the program;
183.5 	(3) the effective date and expiration date of the license;
183.6 	(4) the type of license;
183.7 	(5) the maximum number and ages of persons that may receive services from the program; 
183.8 	and
183.9 	(6) any special conditions of licensure.
183.10 	(b) The commissioner may issue an initiala license for a period not to exceed two years 
183.11 	if:
183.12 	(1) the commissioner is unable to conduct the evaluation or observation required by 
183.13 	subdivision 4, paragraph (a), clauses (3) and (4), because the program is not yet operational;
183.14 	(2) certain records and documents are not available because persons are not yet receiving 
183.15 	services from the program; and
183.16 	(3) the applicant complies with applicable laws and rules in all other respects.
183.17 	(c) A decision by the commissioner to issue a license does not guarantee that any person 
183.18 	or persons will be placed or cared for in the licensed program. A license shall not be 
183.19 	transferable to another individual, corporation, partnership, voluntary association, other 
183.20 	organization, or controlling individual or to another location.
183.21 	(d) A license holder must notify the commissioner and obtain the commissioner's approval 
183.22 	before making any changes that would alter the license information listed under paragraph 
183.23 	(a).
183.24 	(e) (d) Except as provided in paragraphs (g) (f) and (h) (g), the commissioner shall not 
183.25 	issue or reissue a license if the applicant, license holder, or controlling individual has:
183.26 	(1) been disqualified and the disqualification was not set aside and no variance has been 
183.27 	granted;
183.28 	(2) been denied a license within the past two years;
183.29 	(3) had a license issued under this chapter revoked within the past five years;
184.1 	(4) an outstanding debt related to a license fee, licensing fine, or settlement agreement 
184.2 	for which payment is delinquent; or
184.3 	(5) failed to submit the information required of an applicant under subdivision 1, 
184.4 	paragraph (f) or (g), after being requested by the commissioner.
184.5 	When a license issued under this chapter is revoked under clause (1) or (3), the license 
184.6 	holder and controlling individual may not hold any license under chapter 245A or 245D for 
184.7 	five years following the revocation, and other licenses held by the applicant, license holder, 
184.8 	or controlling individual shall also be revoked.
184.9 	(f) (e) The commissioner shall not issue or reissue a license under this chapter if an 
184.10 	individual living in the household where the licensed services will be provided as specified 
184.11 	under section 245C.03, subdivision 1, has been disqualified and the disqualification has not 
184.12 	been set aside and no variance has been granted.
184.13 	(g) (f) Pursuant to section 245A.07, subdivision 1, paragraph (b), when a license issued 
184.14 	under this chapter has been suspended or revoked and the suspension or revocation is under 
184.15 	appeal, the program may continue to operate pending a final order from the commissioner. 
184.16 	If the license under suspension or revocation will expire before a final order is issued, a 
184.17 	temporary provisional license may be issued provided any applicable license fee is paid 
184.18 	before the temporary provisional license is issued.
184.19 	(h) (g) Notwithstanding paragraph (g) (f), when a revocation is based on the 
184.20 	disqualification of a controlling individual or license holder, and the controlling individual 
184.21 	or license holder is ordered under section 245C.17 to be immediately removed from direct 
184.22 	contact with persons receiving services or is ordered to be under continuous, direct 
184.23 	supervision when providing direct contact services, the program may continue to operate 
184.24 	only if the program complies with the order and submits documentation demonstrating 
184.25 	compliance with the order. If the disqualified individual fails to submit a timely request for 
184.26 	reconsideration, or if the disqualification is not set aside and no variance is granted, the 
184.27 	order to immediately remove the individual from direct contact or to be under continuous, 
184.28 	direct supervision remains in effect pending the outcome of a hearing and final order from 
184.29 	the commissioner.
184.30 	(i) (h) For purposes of reimbursement for meals only, under the Child and Adult Care 
184.31 	Food Program, Code of Federal Regulations, title 7, subtitle B, chapter II, subchapter A, 
184.32 	part 226, relocation within the same county by a licensed family day care provider, shall 
184.33 	be considered an extension of the license for a period of no more than 30 calendar days or 
185.1 	until the new license is issued, whichever occurs first, provided the county agency has 
185.2 	determined the family day care provider meets licensure requirements at the new location.
185.3 	(j) (i) Unless otherwise specified by statute, all licenses issued under this chapter expire 
185.4 	at 12:01 a.m. on the day after the expiration date stated on the license. A license holder must 
185.5 	apply for and be granted a new license to operate the program or the program must not be 
185.6 	operated after the expiration date.
185.7 	(k) (j) The commissioner shall not issue or reissue a license under this chapter if it has 
185.8 	been determined that a tribal licensing authority has established jurisdiction to license the 
185.9 	program or service.

185.10 	EFFECTIVE DATE. This section is effective January 1, 2020.

185.11 	Sec. 3. Minnesota Statutes 2018, section 245A.04, is amended by adding a subdivision to 
185.12 	read:
185.13 		Subd. 7a.Notification required. (a) A license holder must notify the commissioner and 
185.14 	obtain the commissioner's approval before making any change that would alter the license 
185.15 	information listed under subdivision 7, paragraph (a).
185.16 	(b) At least 30 days before the effective date of a change, the license holder must notify 
185.17 	the commissioner in writing of any change:
185.18 	(1) to the license holder's controlling individual as defined in section 245A.02, subdivision 
185.19 	5a;
185.20 	(2) to license holder information on file with the secretary of state;
185.21 	(3) in the location of the program or service licensed under this chapter; and
185.22 	(4) in the federal or state tax identification number associated with the license holder.
185.23 	(c) When a license holder notifies the commissioner of a change to the business structure 
185.24 	governing the licensed program or services but is not selling the business, the license holder 
185.25 	must provide amended articles of incorporation and other documentation of the change and 
185.26 	any other information requested by the commissioner.

185.27 	EFFECTIVE DATE. This section is effective January 1, 2020.

186.1 	Sec. 4. [245A.043] LICENSE APPLICATION AFTER CHANGE OF OWNERSHIP.
186.2 		Subdivision 1.Transfer prohibited. A license issued under this chapter is only valid 
186.3 	for a premises and individual, organization, or government entity identified by the 
186.4 	commissioner on the license. A license is not transferable or assignable.
186.5 		Subd. 2.Change of ownership. If the commissioner determines that there will be a 
186.6 	change of ownership, the commissioner shall require submission of a new license application. 
186.7 	A change of ownership occurs when:
186.8 	(1) the license holder sells or transfers 100 percent of the property, stock, or assets;
186.9 	(2) the license holder merges with another organization;
186.10 	(3) the license holder consolidates with two or more organizations, resulting in the 
186.11 	creation of a new organization;
186.12 	(4) there is a change in the federal tax identification number associated with the license 
186.13 	holder; or
186.14 	(5) there is a turnover of each controlling individual associated with the license within 
186.15 	a 12-month period. A change to the license holder's controlling individuals, including a 
186.16 	change due to a transfer of stock, is not a change of ownership if at least one controlling 
186.17 	individual who was listed on the license for at least 12 consecutive months continues to be 
186.18 	a controlling individual after the reported change.
186.19 		Subd. 3.Change of ownership requirements. (a) A license holder who intends to 
186.20 	change the ownership of the program or service under subdivision 2 to a party that intends 
186.21 	to assume operation without an interruption in service longer than 60 days after acquiring 
186.22 	the program or service must provide the commissioner with written notice of the proposed 
186.23 	sale or change, on a form provided by the commissioner, at least 60 days before the 
186.24 	anticipated date of the change in ownership. For purposes of this subdivision and subdivision 
186.25 	4, "party" means the party that intends to operate the service or program.
186.26 	(b) The party must submit a license application under this chapter on the form and in 
186.27 	the manner prescribed by the commissioner at least 30 days before the change of ownership 
186.28 	is complete and must include documentation to support the upcoming change. The form 
186.29 	and manner of the application prescribed by the commissioner shall require only information 
186.30 	which is specifically required by statute or rule. The party must comply with background 
186.31 	study requirements under chapter 245C and shall pay the application fee required in section 
186.32 	245A.10. A party that intends to assume operation without an interruption in service longer 
187.1 	than 60 days after acquiring the program or service is exempt from the requirements of 
187.2 	Minnesota Rules, part 9530.6800.
187.3 	(c) The commissioner may develop streamlined application procedures when the party 
187.4 	is an existing license holder under this chapter and is acquiring a program licensed under 
187.5 	this chapter or service in the same service class as one or more licensed programs or services 
187.6 	the party operates and those licenses are in substantial compliance according to the licensing 
187.7 	standards in this chapter and applicable rules. For purposes of this subdivision, "substantial 
187.8 	compliance" means within the past 12 months the commissioner did not: (i) issue a sanction 
187.9 	under section 245A.07 against a license held by the party or (ii) make a license held by the 
187.10 	party conditional according to section 245A.06.
187.11 	(d) Except when a temporary change of ownership license is issued pursuant to 
187.12 	subdivision 4, the existing license holder is solely responsible for operating the program 
187.13 	according to applicable rules and statutes until a license under this chapter is issued to the 
187.14 	party.
187.15 	(e) If a licensing inspection of the program or service was conducted within the previous 
187.16 	12 months and the existing license holder's license record demonstrates substantial 
187.17 	compliance with the applicable licensing requirements, the commissioner may waive the 
187.18 	party's inspection required by section 245A.04, subdivision 4. The party must submit to the 
187.19 	commissioner proof that the premises was inspected by a fire marshal or that the fire marshal 
187.20 	deemed that an inspection was not warranted and proof that the premises was inspected for 
187.21 	compliance with the building code or that no inspection was deemed warranted.
187.22 	(f) If the party is seeking a license for a program or service that has an outstanding 
187.23 	correction order, the party must submit a letter with the license application identifying how 
187.24 	and within what length of time the party shall resolve the outstanding correction order and 
187.25 	come into full compliance with the licensing requirements.
187.26 	(g) Any action taken under section 245A.06 or 245A.07 against the existing license 
187.27 	holder's license at the time the party is applying for a license, including when the existing 
187.28 	license holder is operating under a conditional license or is subject to a revocation, shall 
187.29 	remain in effect until the commissioner determines that the grounds for the action are 
187.30 	corrected or no longer exist.
187.31 	(h) The commissioner shall evaluate the application of the party according to section 
187.32 	245A.04, subdivision 6. Pursuant to section 245A.04, subdivision 7, if the commissioner 
187.33 	determines that the party complies with applicable laws and rules, the commissioner may 
187.34 	issue a license or a temporary change of ownership license.
188.1 	(i) The commissioner may deny an application as provided in section 245A.05. An 
188.2 	applicant whose application was denied by the commissioner may appeal the denial according 
188.3 	to section 245A.05.
188.4 	(j) This subdivision does not apply to a licensed program or service located in a home 
188.5 	where the license holder resides.
188.6 		Subd. 4.Temporary change of ownership license. (a) After receiving the party's 
188.7 	application and upon the written request of the existing license holder and the party, the 
188.8 	commissioner may issue a temporary change of ownership license to the party while the 
188.9 	commissioner evaluates the party's application. Until a decision is made to grant or deny a 
188.10 	license under this chapter, the existing license holder and the party shall both be responsible 
188.11 	for operating the program or service according to applicable laws and rules, and the sale or 
188.12 	transfer of the license holder's ownership interest in the licensed program or service does 
188.13 	not terminate the existing license.
188.14 	(b) The commissioner may establish criteria to issue a temporary change of ownership 
188.15 	license, if a license holder's death, divorce, or other event affects the ownership of the 
188.16 	program, when an applicant seeks to assume operation of the program or service to ensure 
188.17 	continuity of the program or service while a license application is evaluated. This subdivision 
188.18 	applies to any program or service licensed under this chapter.

188.19 	EFFECTIVE DATE. This section is effective January 1, 2020.

188.20 	Sec. 5. Minnesota Statutes 2018, section 245A.065, is amended to read:
188.21 	245A.065 CHILD CARE FIX-IT TICKET.
188.22 		Subdivision 1.Contents of fix-it tickets. (a) In lieu of a correction order under section 
188.23 	245A.06, the commissioner shall may issue a fix-it ticket to a family child care or child care 
188.24 	center license holder if the commissioner finds that:
188.25 	(1) the license holder has failed to comply with a requirement in this chapter or Minnesota 
188.26 	Rules, chapter 9502 or 9503, that the commissioner determines to be eligible for a fix-it 
188.27 	ticket;
188.28 	(2) the violation does not imminently endanger the health, safety, or rights of the persons 
188.29 	served by the program;
188.30 	(3) the license holder did not receive a fix-it ticket or correction order for the violation 
188.31 	at the license holder's last licensing inspection; and
189.1 	(4) the violation can cannot be corrected at the time of inspection or within 48 hours, 
189.2 	excluding Saturdays, Sundays, and holidays; and
189.3 	(5) the license holder corrects the violation at the time of inspection or agrees to correct 
189.4 	the violation within 48 hours, excluding Saturdays, Sundays, and holidays.
189.5 	(b) The commissioner shall not issue a fix-it ticket for violations that are corrected at 
189.6 	the time of the inspection.
189.7 	(c) The fix-it ticket must state:
189.8 	(1) the conditions that constitute a violation of the law or rule;
189.9 	(2) the specific law or rule violated; and
189.10 	(3) that the violation was corrected at the time of inspection or must be corrected within 
189.11 	48 hours, excluding Saturdays, Sundays, and holidays.
189.12 	(c) (d) The commissioner shall not publicly publish a fix-it ticket on the department's 
189.13 	website.
189.14 	(d) (e) Within 48 hours, excluding Saturdays, Sundays, and holidays, of receiving a fix-it 
189.15 	ticket, the license holder must correct the violation and within one week submit evidence 
189.16 	to the licensing agency that the violation was corrected.
189.17 	(e) (f) If the violation is not corrected at the time of inspection or within 48 hours, 
189.18 	excluding Saturdays, Sundays, and holidays, or the evidence submitted is insufficient to 
189.19 	establish that the license holder corrected the violation, the commissioner must issue a 
189.20 	correction order, according to section 245A.06, for the violation of Minnesota law or rule 
189.21 	identified in the fix-it ticket according to section 245A.06.
189.22 	(f) The commissioner shall, following consultation with family child care license holders, 
189.23 	child care center license holders, and county agencies, issue a report by October 1, 2017, 
189.24 	that identifies the violations of this chapter and Minnesota Rules, chapters 9502 and 9503, 
189.25 	that are eligible for a fix-it ticket. The commissioner shall provide the report to county 
189.26 	agencies and the chairs and ranking minority members of the legislative committees with 
189.27 	jurisdiction over child care, and shall post the report to the department's website.
189.28 		Subd. 2.Fix-it ticket laws and rules. (a) For family child care license holders, violations 
189.29 	of the following laws and rules may qualify only for a fix-it ticket: 9502.0335, subpart 10; 
189.30 	9502.0375, subpart 2; 9502.0395; 9502.0405, subpart 3; 9502.0405, subpart 4, item A; 
189.31 	9502.0415, subpart 3; 9502.0425, subpart 2 (outdoor play spaces must be free from litter, 
189.32 	rubbish, unlocked vehicles, or human or animal waste); 9502.0425, subpart 3 (wading pools 
190.1 	must be kept clean); 9502.0425, subpart 5; 9502.0425, subpart 7, item F (screens on exterior 
190.2 	doors and windows when biting insects are prevalent); 9502.0425, subpart 8; 9502.0425, 
190.3 	subpart 10; 9502.0425, subpart 11 (decks free of splinters); 9502.0425, subpart 13 (toilets 
190.4 	flush thoroughly); 9502.0425, subpart 16; 9502.0435, subpart 1; 9502.0435, subpart 3; 
190.5 	9502.0435, subpart 7; 9502.0435, subpart 8, item B; 9502.0435, subpart 8, item E; 9502.0435, 
190.6 	subpart 12, items A through E; 9502.0435, subpart 13; 9502.0435, subpart 14; 9502.0435, 
190.7 	subpart 15; 9502.0435, subpart 15, items A and B; 9502.0445, subpart 1, item B; 9502.0445, 
190.8 	subpart 3, items B through D; 9502.0445, subpart 4, items A through C; 245A.04, subdivision 
190.9 	14, paragraph (c); 245A.06, subdivision 8; 245A.07, subdivision 5; 245A.146, subdivision 
190.10 	3, paragraph (c); 245A.148; 245A.152; 245A.50, subdivision 7; 245A.51, subdivision 3, 
190.11 	paragraph (d) (emergency preparedness plan available for review and posted in prominent 
190.12 	location).
190.13 	(b) For child care center license holders, violations of the following laws and rules may 
190.14 	qualify only for a fix-it ticket: 9503.0120, item B; 9503.0120, item E; 9503.0125, item E; 
190.15 	9503.0125, item F; 9503.0125, item I; 9503.0125, item M; 9503.0140, subpart 2; 9503.0140, 
190.16 	subpart 7, item D; 9503.0140, subpart 9; 9503.0140, subpart 10; 9503.0140, subpart 13; 
190.17 	9503.0140, subpart 14; 9503.0140, subpart 15; 9503.0140, subpart 16 (item missing from 
190.18 	first-aid kit); 9503.0140, subpart 18; 9503.0140, subpart 19; 9503.0140, subpart 20; 
190.19 	9503.0140, subpart 21 (emergency plan not posted in prominent place); 9503.0145, subpart 
190.20 	2; 9503.0145, subpart 3; 9503.0145, subpart 4, item D; 9503.0145, subpart 8 (drinking water 
190.21 	provided in single service cups or at an accessible drinking fountain); 9503.0155, subpart 
190.22 	7, item D; 9503.0155, subpart 13; 9503.0155, subpart 16; 9503.0155, subpart 17; 9503.0155, 
190.23 	subpart 18, item D; 9503.0170, subpart 3; 9503.0145, subpart 7, item D; 245A.04, subdivision 
190.24 	14, paragraph (c); 245A.06, subdivision 8; 245A.07, subdivision 5; 245A.14, subdivision 
190.25 	8, paragraph (b) (experienced aide identification posting); 245A.146, subdivision 3, paragraph 
190.26 	(c); 245A.152; 245A.41, subdivision 3, paragraph (d); 245A.41, subdivision 3, paragraph 
190.27 	(e); 245A.41, subdivision 3, paragraph (f).

190.28 	Sec. 6. Minnesota Statutes 2018, section 245C.02, is amended by adding a subdivision to 
190.29 	read:
190.30 		Subd. 20.Substance use disorder treatment field. "Substance use disorder treatment 
190.31 	field" means a program exclusively serving individuals 18 years of age and older and that 
190.32 	is required to be:
190.33 	(1) licensed under chapter 245G; or
191.1 	(2) registered under section 157.17 as a board and lodge establishment that predominantly 
191.2 	serves individuals being treated for or recovering from a substance use disorder.

191.3 	Sec. 7. Minnesota Statutes 2018, section 245C.22, subdivision 4, is amended to read:
191.4 		Subd. 4.Risk of harm; set aside. (a) The commissioner may set aside the disqualification 
191.5 	if the commissioner finds that the individual has submitted sufficient information to 
191.6 	demonstrate that the individual does not pose a risk of harm to any person served by the 
191.7 	applicant, license holder, or other entities as provided in this chapter.
191.8 	(b) In determining whether the individual has met the burden of proof by demonstrating 
191.9 	the individual does not pose a risk of harm, the commissioner shall consider:
191.10 	(1) the nature, severity, and consequences of the event or events that led to the 
191.11 	disqualification;
191.12 	(2) whether there is more than one disqualifying event;
191.13 	(3) the age and vulnerability of the victim at the time of the event;
191.14 	(4) the harm suffered by the victim;
191.15 	(5) vulnerability of persons served by the program;
191.16 	(6) the similarity between the victim and persons served by the program;
191.17 	(7) the time elapsed without a repeat of the same or similar event;
191.18 	(8) documentation of successful completion by the individual studied of training or 
191.19 	rehabilitation pertinent to the event; and
191.20 	(9) any other information relevant to reconsideration.
191.21 	(c) If the individual requested reconsideration on the basis that the information relied 
191.22 	upon to disqualify the individual was incorrect or inaccurate and the commissioner determines 
191.23 	that the information relied upon to disqualify the individual is correct, the commissioner 
191.24 	must also determine if the individual poses a risk of harm to persons receiving services in 
191.25 	accordance with paragraph (b).
191.26 	(d) For an individual seeking employment in the substance use disorder treatment field, 
191.27 	the commissioner shall set aside the disqualification if the following criteria are met:
191.28 	(1) the individual is not disqualified for a crime of violence as listed under section 
191.29 	624.712, subdivision 5, except that the following crimes are prohibitory offenses: crimes 
191.30 	listed under section 152.021, subdivision 2 or 2a; 152.022, subdivision 2; 152.023, 
191.31 	subdivision 2; 152.024; or 152.025;
192.1 	(2) the individual is not disqualified under section 245C.15, subdivision 1;
192.2 	(3) the individual is not disqualified under section 245C.15, subdivision 4, paragraph 
192.3 	(b);
192.4 	(4) the individual provided documentation of successful completion of treatment, at least 
192.5 	one year prior to the date of the request for reconsideration, at a program licensed under 
192.6 	chapter 245G, and has had no disqualifying crimes or conduct under section 245C.15 after 
192.7 	the successful completion of treatment;
192.8 	(5) the individual provided documentation demonstrating abstinence from controlled 
192.9 	substances, as defined in section 152.01, subdivision 4, for the period of one year prior to 
192.10 	the date of the request for reconsideration; and
192.11 	(6) the individual is seeking employment in the substance use disorder treatment field.

192.12 	Sec. 8. Minnesota Statutes 2018, section 245C.22, subdivision 5, is amended to read:
192.13 		Subd. 5.Scope of set-aside. (a) If the commissioner sets aside a disqualification under 
192.14 	this section, the disqualified individual remains disqualified, but may hold a license and 
192.15 	have direct contact with or access to persons receiving services. Except as provided in 
192.16 	paragraph (b), the commissioner's set-aside of a disqualification is limited solely to the 
192.17 	licensed program, applicant, or agency specified in the set aside notice under section 245C.23. 
192.18 	For personal care provider organizations, the commissioner's set-aside may further be limited 
192.19 	to a specific individual who is receiving services. For new background studies required 
192.20 	under section 245C.04, subdivision 1, paragraph (h), if an individual's disqualification was 
192.21 	previously set aside for the license holder's program and the new background study results 
192.22 	in no new information that indicates the individual may pose a risk of harm to persons 
192.23 	receiving services from the license holder, the previous set-aside shall remain in effect.
192.24 	(b) If the commissioner has previously set aside an individual's disqualification for one 
192.25 	or more programs or agencies, and the individual is the subject of a subsequent background 
192.26 	study for a different program or agency, the commissioner shall determine whether the 
192.27 	disqualification is set aside for the program or agency that initiated the subsequent 
192.28 	background study. A notice of a set-aside under paragraph (c) shall be issued within 15 
192.29 	working days if all of the following criteria are met:
192.30 	(1) the subsequent background study was initiated in connection with a program licensed 
192.31 	or regulated under the same provisions of law and rule for at least one program for which 
192.32 	the individual's disqualification was previously set aside by the commissioner;
193.1 	(2) the individual is not disqualified for an offense specified in section 245C.15, 
193.2 	subdivision 1 or 2;
193.3 	(3) the commissioner has received no new information to indicate that the individual 
193.4 	may pose a risk of harm to any person served by the program; and
193.5 	(4) the previous set-aside was not limited to a specific person receiving services.
193.6 	(c) Notwithstanding paragraph (b), clause (2), for an individual who is employed in the 
193.7 	substance use disorder field, if the commissioner has previously set aside an individual's 
193.8 	disqualification for one or more programs or agencies in the substance use disorder treatment 
193.9 	field, and the individual is the subject of a subsequent background study for a different 
193.10 	program or agency in the substance use disorder treatment field, the commissioner shall set 
193.11 	aside the disqualification for the program or agency in the substance use disorder treatment 
193.12 	field that initiated the subsequent background study when the criteria under paragraph (b), 
193.13 	clauses (1), (3), and (4), are met and the individual is not disqualified for an offense specified 
193.14 	in section 254C.15, subdivision 1. A notice of a set-aside under paragraph (d) shall be issued 
193.15 	within 15 working days.
193.16 	(c) (d) When a disqualification is set aside under paragraph (b), the notice of background 
193.17 	study results issued under section 245C.17, in addition to the requirements under section 
193.18 	245C.17, shall state that the disqualification is set aside for the program or agency that 
193.19 	initiated the subsequent background study. The notice must inform the individual that the 
193.20 	individual may request reconsideration of the disqualification under section 245C.21 on the 
193.21 	basis that the information used to disqualify the individual is incorrect.

193.22 	Sec. 9. [256.0113] COUNTY HUMAN SERVICES STATE FUNDING 
193.23 	REALLOCATION.
193.24 	(a) Beginning October 1, 2019, counties and tribes or tribal agencies receiving human 
193.25 	services grants funded exclusively with state general fund dollars may allocate any 
193.26 	unexpended grant amounts to any county or tribal human services activity for the fourth 
193.27 	quarter of the county or tribe's fiscal year.
193.28 	(b) Any proposed reallocation of unspent funds must be approved by majority vote of 
193.29 	the county board or the tribe or tribal agency's governing body.
193.30 	(c) Each county, tribe, or tribal agency shall report any approved reallocation of unspent 
193.31 	grant funds to the commissioner of human services by March 31 of each year following a 
193.32 	reallocation under this section. The report shall describe the use of the reallocated human 
194.1 	services grant funds, compare how the funds were allocated prior to the reallocation, and 
194.2 	explain the advantages or disadvantages of the reallocation.

194.3 	Sec. 10. Minnesota Statutes 2018, section 256B.04, subdivision 21, is amended to read:
194.4 		Subd. 21.Provider enrollment. (a) If the commissioner or the Centers for Medicare 
194.5 	and Medicaid Services determines that a provider is designated "high-risk," the commissioner 
194.6 	may withhold payment from providers within that category upon initial enrollment for a 
194.7 	90-day period. The withholding for each provider must begin on the date of the first 
194.8 	submission of a claim.
194.9 	(b) An enrolled provider that is also licensed by the commissioner under chapter 245A, 
194.10 	or is licensed as a home care provider by the Department of Health under chapter 144A and 
194.11 	has a home and community-based services designation on the home care license under 
194.12 	section 144A.484, must designate an individual as the entity's compliance officer. The 
194.13 	compliance officer must:
194.14 	(1) develop policies and procedures to assure adherence to medical assistance laws and 
194.15 	regulations and to prevent inappropriate claims submissions;
194.16 	(2) train the employees of the provider entity, and any agents or subcontractors of the 
194.17 	provider entity including billers, on the policies and procedures under clause (1);
194.18 	(3) respond to allegations of improper conduct related to the provision or billing of 
194.19 	medical assistance services, and implement action to remediate any resulting problems;
194.20 	(4) use evaluation techniques to monitor compliance with medical assistance laws and 
194.21 	regulations;
194.22 	(5) promptly report to the commissioner any identified violations of medical assistance 
194.23 	laws or regulations; and
194.24 	(6) within 60 days of discovery by the provider of a medical assistance reimbursement 
194.25 	overpayment, report the overpayment to the commissioner and make arrangements with 
194.26 	the commissioner for the commissioner's recovery of the overpayment.
194.27 	The commissioner may require, as a condition of enrollment in medical assistance, that a 
194.28 	provider within a particular industry sector or category establish a compliance program that 
194.29 	contains the core elements established by the Centers for Medicare and Medicaid Services.
194.30 	(c) The commissioner may revoke the enrollment of an ordering or rendering provider 
194.31 	for a period of not more than one year, if the provider fails to maintain and, upon request 
194.32 	from the commissioner, provide access to documentation relating to written orders or requests 
195.1 	for payment for durable medical equipment, certifications for home health services, or 
195.2 	referrals for other items or services written or ordered by such provider, when the 
195.3 	commissioner has identified a pattern of a lack of documentation. A pattern means a failure 
195.4 	to maintain documentation or provide access to documentation on more than one occasion. 
195.5 	Nothing in this paragraph limits the authority of the commissioner to sanction a provider 
195.6 	under the provisions of section 256B.064.
195.7 	(d) The commissioner shall terminate or deny the enrollment of any individual or entity 
195.8 	if the individual or entity has been terminated from participation in Medicare or under the 
195.9 	Medicaid program or Children's Health Insurance Program of any other state. The 
195.10 	commissioner may exempt a rehabilitation agency from termination or denial that would 
195.11 	otherwise be required under this paragraph, if the agency:
195.12 	(1) is unable to retain Medicare certification and enrollment solely due to a lack of billing 
195.13 	to the Medicare program;
195.14 	(2) meets all other applicable Medicare certification requirements based on an on-site 
195.15 	review completed by the commissioner of health; and
195.16 	(3) serves primarily a pediatric population.
195.17 	(e) As a condition of enrollment in medical assistance, the commissioner shall require 
195.18 	that a provider designated "moderate" or "high-risk" by the Centers for Medicare and 
195.19 	Medicaid Services or the commissioner permit the Centers for Medicare and Medicaid 
195.20 	Services, its agents, or its designated contractors and the state agency, its agents, or its 
195.21 	designated contractors to conduct unannounced on-site inspections of any provider location. 
195.22 	The commissioner shall publish in the Minnesota Health Care Program Provider Manual a 
195.23 	list of provider types designated "limited," "moderate," or "high-risk," based on the criteria 
195.24 	and standards used to designate Medicare providers in Code of Federal Regulations, title 
195.25 	42, section 424.518. The list and criteria are not subject to the requirements of chapter 14. 
195.26 	The commissioner's designations are not subject to administrative appeal.
195.27 	(f) As a condition of enrollment in medical assistance, the commissioner shall require 
195.28 	that a high-risk provider, or a person with a direct or indirect ownership interest in the 
195.29 	provider of five percent or higher, consent to criminal background checks, including 
195.30 	fingerprinting, when required to do so under state law or by a determination by the 
195.31 	commissioner or the Centers for Medicare and Medicaid Services that a provider is designated 
195.32 	high-risk for fraud, waste, or abuse.
195.33 	(g)(1) Upon initial enrollment, reenrollment, and notification of revalidation, all durable 
195.34 	medical equipment, prosthetics, orthotics, and supplies (DMEPOS) medical suppliers 
196.1 	meeting the durable medical equipment provider and supplier definition in clause (3), 
196.2 	operating in Minnesota and receiving Medicaid funds must purchase a surety bond that is 
196.3 	annually renewed and designates the Minnesota Department of Human Services as the 
196.4 	obligee, and must be submitted in a form approved by the commissioner. For purposes of 
196.5 	this clause, the following medical suppliers are not required to obtain a surety bond: a 
196.6 	federally qualified health center, a home health agency, the Indian Health Service, a 
196.7 	pharmacy, and a rural health clinic.
196.8 	(2) At the time of initial enrollment or reenrollment, durable medical equipment providers 
196.9 	and suppliers defined in clause (3) must purchase a surety bond of $50,000. If a revalidating 
196.10 	provider's Medicaid revenue in the previous calendar year is up to and including $300,000, 
196.11 	the provider agency must purchase a surety bond of $50,000. If a revalidating provider's 
196.12 	Medicaid revenue in the previous calendar year is over $300,000, the provider agency must 
196.13 	purchase a surety bond of $100,000. The surety bond must allow for recovery of costs and 
196.14 	fees in pursuing a claim on the bond.
196.15 	(3) "Durable medical equipment provider or supplier" means a medical supplier that can 
196.16 	purchase medical equipment or supplies for sale or rental to the general public and is able 
196.17 	to perform or arrange for necessary repairs to and maintenance of equipment offered for 
196.18 	sale or rental.
196.19 	(h) The Department of Human Services may require a provider to purchase a surety 
196.20 	bond as a condition of initial enrollment, reenrollment, reinstatement, or continued enrollment 
196.21 	if: (1) the provider fails to demonstrate financial viability, (2) the department determines 
196.22 	there is significant evidence of or potential for fraud and abuse by the provider, or (3) the 
196.23 	provider or category of providers is designated high-risk pursuant to paragraph (a) and as 
196.24 	per Code of Federal Regulations, title 42, section 455.450. The surety bond must be in an 
196.25 	amount of $100,000 or ten percent of the provider's payments from Medicaid during the 
196.26 	immediately preceding 12 months, whichever is greater. The surety bond must name the 
196.27 	Department of Human Services as an obligee and must allow for recovery of costs and fees 
196.28 	in pursuing a claim on the bond. This paragraph does not apply if the provider currently 
196.29 	maintains a surety bond under the requirements in section 256B.0659 or 256B.85.

196.30 	Sec. 11. REPEALER.
 196.31 	Minnesota Statutes 2018, sections 16A.724, subdivision 2; and 245G.11, subdivisions 
196.32 	1, 4, and 7, are repealed.

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

197.1 	ARTICLE 8
197.2 	HEALTH CARE

197.3 	Section 1. Minnesota Statutes 2018, section 13.69, subdivision 1, is amended to read:
197.4 		Subdivision 1.Classifications. (a) The following government data of the Department 
197.5 	of Public Safety are private data:
197.6 	(1) medical data on driving instructors, licensed drivers, and applicants for parking 
197.7 	certificates and special license plates issued to physically disabled persons;
197.8 	(2) other data on holders of a disability certificate under section 169.345, except that (i) 
197.9 	data that are not medical data may be released to law enforcement agencies, and (ii) data 
197.10 	necessary for enforcement of sections 169.345 and 169.346 may be released to parking 
197.11 	enforcement employees or parking enforcement agents of statutory or home rule charter 
197.12 	cities and towns;
197.13 	(3) Social Security numbers in driver's license and motor vehicle registration records, 
197.14 	except that Social Security numbers must be provided to the Department of Revenue for 
197.15 	purposes of tax administration, the Department of Labor and Industry for purposes of 
197.16 	workers' compensation administration and enforcement, the judicial branch for purposes of 
197.17 	debt collection, and the Department of Natural Resources for purposes of license application 
197.18 	administration, and except that the last four digits of the Social Security number must be 
197.19 	provided to the Department of Human Services for purposes of recovery of Minnesota health 
197.20 	care program benefits paid; and
197.21 	(4) data on persons listed as standby or temporary custodians under section 171.07, 
197.22 	subdivision 11, except that the data must be released to:
197.23 	(i) law enforcement agencies for the purpose of verifying that an individual is a designated 
197.24 	caregiver; or
197.25 	(ii) law enforcement agencies who state that the license holder is unable to communicate 
197.26 	at that time and that the information is necessary for notifying the designated caregiver of 
197.27 	the need to care for a child of the license holder.
197.28 	The department may release the Social Security number only as provided in clause (3) 
197.29 	and must not sell or otherwise provide individual Social Security numbers or lists of Social 
197.30 	Security numbers for any other purpose.
197.31 	(b) The following government data of the Department of Public Safety are confidential 
197.32 	data: data concerning an individual's driving ability when that data is received from a member 
197.33 	of the individual's family.

198.1 	Sec. 2. Minnesota Statutes 2018, section 256.9365, is amended to read:
198.2 	256.9365 PURCHASE OF CONTINUATION HEALTH CARE COVERAGE FOR 
198.3 	AIDS PATIENTS PEOPLE LIVING WITH HIV.
198.4 		Subdivision 1.Program established. The commissioner of human services shall establish 
198.5 	a program to pay private the cost of health plan premiums and cost sharing for prescriptions, 
198.6 	including co-payments, deductibles, and coinsurance for persons who have contracted human 
198.7 	immunodeficiency virus (HIV) to enable them to continue coverage under or enroll in a 
198.8 	group or individual health plan. If a person is determined to be eligible under subdivision 
198.9 	2, the commissioner shall pay the portion of the group plan premium for which the individual 
198.10 	is responsible, if the individual is responsible for at least 50 percent of the cost of the 
198.11 	premium, or pay the individual plan premium health insurance premiums and prescription 
198.12 	cost sharing, including co-payments and deductibles required under section 256B.0631. 
198.13 	The commissioner shall not pay for that portion of a premium that is attributable to other 
198.14 	family members or dependents or is paid by the individual's employer.
198.15 		Subd. 2.Eligibility requirements. To be eligible for the program, an applicant must 
198.16 	satisfy the following requirements: meet all eligibility requirements for and enroll in Part 
198.17 	B of the Ryan White HIV/AIDS Treatment Extension Act of 2009, Public Law 111-87.
198.18 	(1) the applicant must provide a physician's, advanced practice registered nurse's, or 
198.19 	physician assistant's statement verifying that the applicant is infected with HIV and is, or 
198.20 	within three months is likely to become, too ill to work in the applicant's current employment 
198.21 	because of HIV-related disease;
198.22 	(2) the applicant's monthly gross family income must not exceed 300 percent of the 
198.23 	federal poverty guidelines, after deducting medical expenses and insurance premiums;
198.24 	(3) the applicant must not own assets with a combined value of more than $25,000; and
198.25 	(4) if applying for payment of group plan premiums, the applicant must be covered by 
198.26 	an employer's or former employer's group insurance plan.
198.27 		Subd. 3.Cost-effective coverage. Requirements for the payment of individual plan 
198.28 	premiums under subdivision 2, clause (5), this section must be designed to ensure that the 
198.29 	state cost of paying an individual plan premium does not exceed the estimated state cost 
198.30 	that would otherwise be incurred in the medical assistance program. The commissioner 
198.31 	shall purchase the most cost-effective coverage available for eligible individuals.

199.1 	Sec. 3. Minnesota Statutes 2018, section 256B.056, subdivision 3, is amended to read:
199.2 		Subd. 3.Asset limitations for certain individuals. (a) To be eligible for medical 
199.3 	assistance, a person must not individually own more than $3,000 in assets, or if a member 
199.4 	of a household with two family members, husband and wife, or parent and child, the 
199.5 	household must not own more than $6,000 in assets, plus $200 for each additional legal 
199.6 	dependent. In addition to these maximum amounts, an eligible individual or family may 
199.7 	accrue interest on these amounts, but they must be reduced to the maximum at the time of 
199.8 	an eligibility redetermination. The accumulation of the clothing and personal needs allowance 
199.9 	according to section 256B.35 must also be reduced to the maximum at the time of the 
199.10 	eligibility redetermination. The value of assets that are not considered in determining 
199.11 	eligibility for medical assistance is the value of those assets excluded under the Supplemental 
199.12 	Security Income program for aged, blind, and disabled persons, with the following 
199.13 	exceptions:
199.14 	(1) household goods and personal effects are not considered;
199.15 	(2) capital and operating assets of a trade or business that the local agency determines 
199.16 	are necessary to the person's ability to earn an income are not considered;
199.17 	(3) motor vehicles are excluded to the same extent excluded by the Supplemental Security 
199.18 	Income program;
199.19 	(4) assets designated as burial expenses are excluded to the same extent excluded by the 
199.20 	Supplemental Security Income program. Burial expenses funded by annuity contracts or 
199.21 	life insurance policies must irrevocably designate the individual's estate as contingent 
199.22 	beneficiary to the extent proceeds are not used for payment of selected burial expenses;
199.23 	(5) for a person who no longer qualifies as an employed person with a disability due to 
199.24 	loss of earnings, assets allowed while eligible for medical assistance under section 256B.057, 
199.25 	subdivision 9, are not considered for 12 months, beginning with the first month of ineligibility 
199.26 	as an employed person with a disability, to the extent that the person's total assets remain 
199.27 	within the allowed limits of section 256B.057, subdivision 9, paragraph (d);
199.28 	(6) when a person enrolled in medical assistance under section 256B.057, subdivision 
199.29 	9, is age 65 or older and has been enrolled during each of the 24 consecutive months before 
199.30 	the person's 65th birthday, the assets owned by the person and the person's spouse must be 
199.31 	disregarded, up to the limits of section 256B.057, subdivision 9, paragraph (d), when 
199.32 	determining eligibility for medical assistance under section 256B.055, subdivision 7. a 
199.33 	designated employment incentives asset account is disregarded when determining eligibility 
199.34 	for medical assistance for a person age 65 years or older under section 256B.055, subdivision 
200.1 	7. An employment incentives asset account must only be designated by a person who has 
200.2 	been enrolled in medical assistance under section 256B.057, subdivision 9, for a 
200.3 	24-consecutive-month period. A designated employment incentives asset account contains 
200.4 	qualified assets owned by the person and the person's spouse in the last month of enrollment 
200.5 	in medical assistance under section 256B.057, subdivision 9. Qualified assets include 
200.6 	retirement and pension accounts, medical expense accounts, and up to $17,000 of the person's 
200.7 	other nonexcluded assets. An employment incentives asset account is no longer designated 
200.8 	when a person loses medical assistance eligibility for a calendar month or more before 
200.9 	turning age 65. A person who loses medical assistance eligibility before age 65 can establish 
200.10 	a new designated employment incentives asset account by establishing a new 
200.11 	24-consecutive-month period of enrollment under section 256B.057, subdivision 9. The 
200.12 	income of a spouse of a person enrolled in medical assistance under section 256B.057, 
200.13 	subdivision 9, during each of the 24 consecutive months before the person's 65th birthday 
200.14 	must be disregarded when determining eligibility for medical assistance under section 
200.15 	256B.055, subdivision 7. Persons eligible under this clause are not subject to the provisions 
200.16 	in section 256B.059; and
200.17 	(7) effective July 1, 2009, certain assets owned by American Indians are excluded as 
200.18 	required by section 5006 of the American Recovery and Reinvestment Act of 2009, Public 
200.19 	Law 111-5. For purposes of this clause, an American Indian is any person who meets the 
200.20 	definition of Indian according to Code of Federal Regulations, title 42, section 447.50.
200.21 	(b) No asset limit shall apply to persons eligible under section 256B.055, subdivision 
200.22 	15.

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

200.24 	Sec. 4. Minnesota Statutes 2018, section 256B.056, subdivision 5c, is amended to read:
200.25 		Subd. 5c.Excess income standard. (a) The excess income standard for parents and 
200.26 	caretaker relatives, pregnant women, infants, and children ages two through 20 is the standard 
200.27 	specified in subdivision 4, paragraph (b).
200.28 	(b) The excess income standard for a person whose eligibility is based on blindness, 
200.29 	disability, or age of 65 or more years shall equal 81 82 percent of the federal poverty 
200.30 	guidelines. Effective July 1, 2021, the excess income standard for a person whose eligibility 
200.31 	is based on blindness disability, or age of 65 or more years, is the standard specified in 
200.32 	subdivision 4, paragraph (a).

200.33 	EFFECTIVE DATE. This section is effective January 1, 2020.

201.1 	Sec. 5. Minnesota Statutes 2018, section 256B.0625, subdivision 18d, is amended to read:
201.2 		Subd. 18d.Advisory committee members. (a) The Nonemergency Medical 
201.3 	Transportation Advisory Committee consists of:
201.4 	(1) four voting members who represent counties, utilizing the rural urban commuting 
201.5 	area classification system. As defined in subdivision 17, these members shall be designated 
201.6 	as follows:
201.7 	(i) two counties within the 11-county metropolitan area;
201.8 	(ii) one county representing the rural area of the state; and
201.9 	(iii) one county representing the super rural area of the state.
201.10 	The Association of Minnesota Counties shall appoint one county within the 11-county 
201.11 	metropolitan area and one county representing the super rural area of the state. The Minnesota 
201.12 	Inter-County Association shall appoint one county within the 11-county metropolitan area 
201.13 	and one county representing the rural area of the state;
201.14 	(2) three voting members who represent medical assistance recipients, including persons 
201.15 	with physical and developmental disabilities, persons with mental illness, seniors, children, 
201.16 	and low-income individuals;
201.17 	(3) four five voting members who represent providers that deliver nonemergency medical 
201.18 	transportation services to medical assistance enrollees, one of whom is a taxicab owner or 
201.19 	operator;
201.20 	(4) two voting members of the house of representatives, one from the majority party and 
201.21 	one from the minority party, appointed by the speaker of the house, and two voting members 
201.22 	from the senate, one from the majority party and one from the minority party, appointed by 
201.23 	the Subcommittee on Committees of the Committee on Rules and Administration;
201.24 	(5) one voting member who represents demonstration providers as defined in section 
201.25 	256B.69, subdivision 2;
201.26 	(6) one voting member who represents an organization that contracts with state or local 
201.27 	governments to coordinate transportation services for medical assistance enrollees;
201.28 	(7) one voting member who represents the Minnesota State Council on Disability;
201.29 	(8) the commissioner of transportation or the commissioner's designee, who shall serve 
201.30 	as a voting member;
201.31 	(9) one voting member appointed by the Minnesota Ambulance Association; and
202.1 	(10) one voting member appointed by the Minnesota Hospital Association.
202.2 	(b) Members of the advisory committee shall not be employed by the Department of 
202.3 	Human Services. Members of the advisory committee shall receive no compensation.

202.4 	Sec. 6. PAIN MANAGEMENT.
 202.5 	(a) The Health Services Policy Committee established under Minnesota Statutes, section 
202.6 	256B.0625, subdivision 3c, shall evaluate and make recommendations on the integration 
202.7 	of nonpharmacologic pain management that are clinically viable and sustainable; reduce or 
202.8 	eliminate chronic pain conditions; improve functional status; and prevent addiction and 
202.9 	reduce dependence on opiates or other pain medications. The recommendations must be 
202.10 	based on best practices for the effective treatment of musculoskeletal pain provided by 
202.11 	health practitioners identified in paragraph (b), and covered under medical assistance. Each 
202.12 	health practitioner represented under paragraph (b) shall present the minimum best integrated 
202.13 	practice recommendations, policies, and scientific evidence for nonpharmacologic treatment 
202.14 	options for eliminating pain and improving functional status within their full professional 
202.15 	scope. Recommendations for integration of services may include guidance regarding 
202.16 	screening for co-occurring behavioral health diagnoses; protocols for communication between 
202.17 	all providers treating a unique individual, including protocols for follow-up; and universal 
202.18 	mechanisms to assess improvements in functional status.
202.19 	(b) In evaluating and making recommendations, the Health Services Policy Committee 
202.20 	shall consult and collaborate with the following health practitioners: acupuncture practitioners 
202.21 	licensed under Minnesota Statutes, chapter 147B; chiropractors licensed under Minnesota 
202.22 	Statutes, sections 148.01 to 148.10; physical therapists licensed under Minnesota Statutes, 
202.23 	sections 148.68 to 148.78; medical and osteopathic physicians licensed under Minnesota 
202.24 	Statutes, chapter 147, and advanced practice registered nurses licensed under Minnesota 
202.25 	Statutes, sections 148.171 to 148.285, with experience in providing primary care 
202.26 	collaboratively within a multidisciplinary team of health care practitioners who employ 
202.27 	nonpharmacologic pain therapies; and psychologists licensed under Minnesota Statutes, 
202.28 	section 148.907.
202.29 	(c) The commissioner shall submit a progress report to the chairs and ranking minority 
202.30 	members of the legislative committees with jurisdiction over health and human services 
202.31 	policy and finance by January 15, 2020, and shall report final recommendations by August 
202.32 	1, 2020. The final report may also contain recommendations for developing and implementing 
202.33 	a pilot program to assess the clinical viability, sustainability, and effectiveness of integrated 
203.1 	nonpharmacologic, multidisciplinary treatments for managing musculoskeletal pain and 
203.2 	improving functional status.

203.3 	ARTICLE 9
203.4 	APPROPRIATIONS

203.5	Section 1. HEALTH AND HUMAN SERVICES APPROPRIATIONS.
 	
203.6 	The sums shown in the columns marked "Appropriations" are appropriated to the agencies 
203.7 	and for the purposes specified in this article. The appropriations are from the general fund, 
203.8 	or another named fund, and are available for the fiscal years indicated for each purpose. 
203.9 	The figures "2020" and "2021" used in this article mean that the appropriations listed under 
203.10 	them are available for the fiscal year ending June 30, 2020, or June 30, 2021, respectively. 
203.11 	"The first year" is fiscal year 2020. "The second year" is fiscal year 2021. "The biennium" 
203.12 	is fiscal years 2020 and 2021.

203.13				APPROPRIATIONS
	
203.14				Available for the Year
	
203.15				Ending June 30
	
203.16					2020
		2021

203.17
203.18	Sec. 2. COMMISSIONER OF HUMAN 
SERVICES
 	$
	(17,122,000)
	$
	(154,855,000)

203.19	Appropriations by Fund
	
203.20		2020
	2021
	
203.21	General
	(17,115,000)
	(155,846,000)
	
203.22	Health Care Access
	(7,000)
	(9,000)
	
203.23	Federal TANF
	-0-
	1,000,000
	
203.24 	(a) Gun Violence Prevention Grants.
203.25 	$100,000 in fiscal year 2020 is from the 
203.26 	general fund for gun violence prevention 
203.27 	grants to nonprofit organizations with 
203.28 	expertise in gun violence prevention to 
203.29 	conduct gun violence prevention initiatives or 
203.30 	public awareness and education campaigns on 
203.31 	gun violence prevention. This is a onetime 
203.32 	appropriation.
204.1 	(b) Semi-Independent Living Services 
204.2 	Grants. $1,000,000 in fiscal year 2020 and 
204.3 	$1,000,000 in fiscal year 2021 are from the 
204.4 	general fund for reimbursement to lead 
204.5 	agencies under Minnesota Statutes, section 
204.6 	252.275.
204.7 	(c) Social Functioning Measurement Tool.
204.8 	$100,000 in fiscal year 2020 is from the 
204.9 	general fund for the commissioner to 
204.10 	determine whether the Center for Victims of 
204.11 	Torture's social functioning measurement tool 
204.12 	can be adapted for other populations that 
204.13 	receive targeted case management and other 
204.14 	medical assistance services. This is a onetime 
204.15 	appropriation and is available until June 30, 
204.16 	2023.
204.17 	(d) Homeless Youth Drop-In Program 
204.18 	Grant. Notwithstanding Minnesota Statutes, 
204.19 	section 16B.97, $100,000 in fiscal year 2020 
204.20 	is from the general fund for a grant to an 
204.21 	organization in Anoka County providing 
204.22 	services and programming through a drop-in 
204.23 	program to meet the basic needs, including 
204.24 	mental health needs, of homeless youth in the 
204.25 	north metropolitan suburbs, to develop a 
204.26 	model of its homeless youth drop-in program 
204.27 	that can be shared and replicated in other 
204.28 	communities throughout Minnesota. This is a 
204.29 	onetime appropriation.
204.30 	(e) Pathways to Prosperity. $1,000,000 in 
204.31 	fiscal year 2021 is from the federal TANF 
204.32 	fund for the unified benefit amount of the 
204.33 	Minnesota Pathways to Prosperity and 
204.34 	Well-Being pilot project. The commissioner 
204.35 	may award the grant only upon issuance of 
205.1 	formal approval of the pilot project plan as 
205.2 	required under article ..., section ..., 
205.3 	subdivision 1, paragraph (c), and after 
205.4 	fulfillment of the condition in article ..., 
205.5 	section ..., subdivision 1, paragraph (b), clause 
205.6 	(3). No amount of the appropriation may be 
205.7 	used for any other purpose of the pilot project. 
205.8 	The base for this appropriation is $1,000,000 
205.9 	in fiscal year 2022 and $1,000,000 in fiscal 
205.10 	year 2023. This is not an ongoing 
205.11 	appropriation. The commissioner of 
205.12 	management and budget shall not include a 
205.13 	base amount for this appropriation in fiscal 
205.14 	year 2024. This section expires June 30, 2023.
205.15 	(f) Community-Based Housing and 
205.16 	Behavioral Health Services for Opiate 
205.17 	Addiction. Notwithstanding Minnesota 
205.18 	Statutes, section 16B.97, $25,000 in fiscal year 
205.19 	2020 and $25,000 in fiscal year 2021 are from 
205.20 	the general fund for a grant to Oasis Central 
205.21 	Minnesota, Inc., serving Morrison County to 
205.22 	provide opioid programming, behavioral 
205.23 	health services, and residential housing with 
205.24 	employment services.
205.25 	(g) Parent-to-Parent Peer Support Grants.
205.26 	$100,000 in fiscal year 2020 and $100,000 in 
205.27 	fiscal year 2021 are from the general fund for 
205.28 	grants under Minnesota Statutes, section 
205.29 	256.4751.
205.30 	(h) Children's Mental Health Grant.
205.31 	Notwithstanding Minnesota Statutes, section 
205.32 	16B.97, $193,000 in fiscal year 2020 is from 
205.33 	the general fund for a grant to the Family 
205.34 	Enhancement Center for staffing and 
205.35 	administrative support to provide children 
206.1 	access to expert mental health services 
206.2 	regardless of a child's insurance status or 
206.3 	income. This is a onetime appropriation and 
206.4 	is available until June 30, 2021.
206.5 	(i) Transitional Housing Program.
206.6 	Notwithstanding Minnesota Statutes, section 
206.7 	16B.97, $50,000 in fiscal year 2020 is from 
206.8 	the general fund for a transitional housing and 
206.9 	support program located in Rice County that 
206.10 	serves women and children in crisis to enhance 
206.11 	current services and supports and to determine 
206.12 	if the program's model can be expanded 
206.13 	statewide. The commissioner of human 
206.14 	services shall report by February 1, 2020, to 
206.15 	the chairs and ranking minority members of 
206.16 	the legislative committees with jurisdiction 
206.17 	over transitional housing programs on the 
206.18 	outcomes of the program and provide 
206.19 	recommendations on expanding the program's 
206.20 	model statewide. This is a onetime 
206.21 	appropriation.
206.22 	(j) Fraud Prevention Investigations.
206.23 	$425,000 in fiscal year 2020 and $425,000 in 
206.24 	fiscal year 2021 are from the general fund for 
206.25 	the fraud prevention investigation project 
206.26 	under Minnesota Statutes, section 256.983.
206.27 	(k) Adaptive Fitness Access Grants.
206.28 	$125,000 in fiscal year 2020 and $125,000 in 
206.29 	fiscal year 2021 are from the general fund for 
206.30 	the grant program under Minnesota Statutes, 
206.31 	section 256.488.
206.32 	(l) Day Training and Habilitation Disability 
206.33 	Waiver Rate System Transition Grants.
206.34 	$200,000 in fiscal year 2020 and $200,000 in 
206.35 	fiscal year 2021 are from the general fund for 
207.1 	day training and habilitation disability waiver 
207.2 	rate system transition grants under article ..., 
207.3 	section ....
207.4 	(m) Family Support Grants. The general 
207.5 	fund base for family support grants under 
207.6 	Minnesota Statutes, section 252.32, is 
207.7 	$10,278,000 in fiscal year 2022 and 
207.8 	$8,278,000 in fiscal year 2023. The 
207.9 	commissioner may use up to $2,000,000 of 
207.10 	the 2022 fiscal year base funding to reimburse 
207.11 	counties that issue family support grants in an 
207.12 	amount that exceeds the county's allocation in 
207.13 	fiscal year 2021. This paragraph expires June 
207.14 	20, 2023.

207.15	Sec. 3. COUNCIL ON DISABILITY
 	$
	156,000
	$
	146,000

207.16
207.17
207.18	Sec. 4. OMBUDSMAN FOR MENTAL 
HEALTH AND DEVELOPMENTAL 
DISABILITIES
 	$
	250,000
	$
	-0-
	
207.19 	Department of Psychiatry Monitoring.
207.20 	$100,000 in fiscal year 2020 and $100,000 in 
207.21 	fiscal year 2021 are for monitoring the 
207.22 	Department of Psychiatry at the University of 
207.23 	Minnesota.

207.24 	Sec. 5. Laws 2017, First Special Session chapter 6, article 18, section 7, is amended to 
207.25 	read:

207.26
207.27
207.28	Sec. 7. OMBUDSMAN FOR MENTAL 
HEALTH AND DEVELOPMENTAL 
DISABILITIES
 	$
	2,407,000
	$
	2,427,000
2,177,000
	
207.29 	Department of Psychiatry Monitoring.
207.30 	$100,000 in fiscal year 2018 and $100,000 in 
207.31 	fiscal year 2019 are for monitoring the 
207.32 	Department of Psychiatry at the University of 
207.33 	Minnesota.