1.1 	A bill for an act
1.2 	relating to health and human services; modifying provisions relating to children 
1.3 	and families, operations, direct care and treatment, continuing care for older adults, 
1.4 	disability services, chemical and mental health, health care, health coverage, 
1.5 	prescription drugs, health-related licensing boards, Health Department, and 
1.6 	additional miscellaneous provisions; modifying provisions governing child care 
1.7 	providers, child care assistance program, and medical assistance; establishing 
1.8 	Child Welfare Training Academy; modifying sections relating to data; establishing 
1.9 	Family Child Care Task Force; modifying provisions governing nursing facility 
1.10 	property payment rates, disability waiver rate-setting, and home and 
1.11 	community-based services; modifying requirements for substance use disorder 
1.12 	treatment; establishing Community Competency Restoration Task Force; modifying 
1.13 	step therapy exceptions; requiring certain coverage for PANDAS and PANS; 
1.14 	establishing cost-sharing limits for prescription insulin drugs; establishing 
1.15 	prescription drug repository program; requiring licensure of wholesale distributors 
1.16 	and third-party logistics providers; modifying sections relating to borings; 
1.17 	modifying provisions relating to hemp, cannabinoid products, and medical cannabis; 
1.18 	designating Maternal Mental Health Awareness Month; establishing grant programs; 
1.19 	modifying fees; making technical changes; requiring studies and reports; adjusting 
1.20 	the forecast; appropriating money;amending Minnesota Statutes 2018, sections 
1.21 	13.46, subdivisions 2, 3, 4; 13.461, subdivision 28; 13.69, subdivision 1; 13.851, 
1.22 	by adding a subdivision; 15C.02; 16A.055, subdivision 1a; 16A.724, subdivision 
1.23 	2; 18K.03; 62A.30, by adding a subdivision; 62D.12, by adding a subdivision; 
1.24 	62D.124, subdivision 3, by adding a subdivision; 62E.23, subdivision 3; 62E.24, 
1.25 	subdivision 2; 62J.23, subdivision 2; 62J.495, subdivisions 1, 3; 62K.07; 62K.075; 
1.26 	62K.10, subdivision 5; 62Q.01, by adding a subdivision; 62Q.184, subdivisions 
1.27 	1, 3; 62Q.47; 62U.04, subdivision 4; 103I.005, subdivisions 2, 8a, 17a; 103I.205, 
1.28 	subdivisions 1, 4, 9; 103I.208, subdivision 1; 103I.235, subdivision 3; 103I.301, 
1.29 	subdivision 6, by adding a subdivision; 103I.601, subdivision 4; 119B.011, 
1.30 	subdivisions 19, 20, by adding a subdivision; 119B.02, subdivisions 6, 7; 119B.025, 
1.31 	subdivision 1, by adding a subdivision; 119B.03, subdivision 9; 119B.09, 
1.32 	subdivisions 1, 7; 119B.095, subdivision 2, by adding a subdivision; 119B.125, 
1.33 	subdivision 6; 119B.13, subdivisions 6, 7; 119B.16, subdivisions 1, 1a, 1b, by 
1.34 	adding subdivisions; 144.057, subdivision 3; 144.121, subdivision 1a, by adding 
1.35 	a subdivision; 144.1506, subdivision 2; 144.225, subdivisions 2, 2a, 7; 144.3831, 
1.36 	subdivision 1; 144.412; 144.413, subdivisions 1, 4; 144.414, subdivisions 2, 3; 
1.37 	144.416; 144.4165; 144.4167, subdivision 4; 144.417, subdivision 4; 144.552; 
1.38 	144.562, subdivision 2; 144.586, by adding a subdivision; 144.966, subdivision 
2.1 	2; 144.99, subdivision 1; 144A.071, subdivisions 1a, 2, 3, 4a, 4c, 4d, 5a; 144A.073, 
2.2 	subdivision 3c, by adding a subdivision; 144A.43, subdivisions 11, 30, by adding 
2.3 	a subdivision; 144A.472, subdivisions 5, 7; 144A.473; 144A.474, subdivision 2; 
2.4 	144A.475, subdivisions 1, 2, 5; 144A.476, subdivision 1; 144A.479, subdivision 
2.5 	7, by adding a subdivision; 144A.4791, subdivisions 1, 3, 6, 7, 8, 9; 144A.4792, 
2.6 	subdivisions 1, 2, 5, 10; 144A.4793, subdivision 6; 144A.4796, subdivision 2; 
2.7 	144A.4797, subdivision 3; 144A.4798; 144A.4799, subdivisions 1, 3; 144A.484, 
2.8 	subdivision 1; 145.908, subdivision 1; 145.928, subdivisions 1, 7; 145.986, 
2.9 	subdivisions 1, 1a, 4, 5, 6; 147.037, subdivision 1; 147.0375, subdivision 1; 
2.10 	147D.27, by adding a subdivision; 147E.40, subdivision 1, as amended; 147F.17, 
2.11 	subdivision 1, as amended; 148.59; 148.6445, subdivisions 1, 2, 2a, 3, 4, 5, 6, 10; 
2.12 	148.7815, subdivision 1, as amended; 148E.180; 150A.06, subdivision 3, by adding 
2.13 	subdivisions; 150A.091, by adding subdivisions; 151.01, subdivisions 23, 31, 35; 
2.14 	151.06, by adding a subdivision; 151.065, subdivisions 1, 2, 3, 6; 151.071, 
2.15 	subdivision 2; 151.15, subdivision 1, by adding subdivisions; 151.19, subdivisions 
2.16 	1, 3; 151.211, subdivision 2, by adding a subdivision; 151.252, subdivisions 1, 1a, 
2.17 	3; 151.253, by adding a subdivision; 151.32; 151.40, subdivisions 1, 2; 151.43; 
2.18 	151.46; 151.47, subdivision 1, by adding a subdivision; 152.01, subdivision 9; 
2.19 	152.126, subdivisions 6, 7, by adding a subdivision; 152.22, subdivisions 6, 11, 
2.20 	13, by adding subdivisions; 152.25, subdivisions 1, 1a, 1c, 4; 152.27, subdivisions 
2.21 	2, 3, 4, 5, 6; 152.28, subdivision 1; 152.29, subdivisions 1, 2, 3, 3a; 152.31; 152.32, 
2.22 	subdivision 2; 152.33, subdivisions 1, 2; 152.34; 152.36, subdivision 2; 157.22; 
2.23 	214.25, subdivision 2; 237.50, subdivisions 4a, 6a, 10a, 11, by adding subdivisions; 
2.24 	237.51, subdivisions 1, 5a; 237.52, subdivision 5; 237.53; 245.095; 245.4889, 
2.25 	subdivision 1; 245.735, subdivision 3; 245A.02, subdivisions 3, 5a, 8, 9, 12, 14, 
2.26 	18, by adding subdivisions; 245A.03, subdivisions 1, 3; 245A.04, subdivisions 1, 
2.27 	2, 4, 6, 7, 10, by adding subdivisions; 245A.05; 245A.07, subdivisions 1, 2, 2a, 3; 
2.28 	245A.14, subdivisions 4, 8, by adding subdivisions; 245A.145, subdivisions 1, 2; 
2.29 	245A.151; 245A.16, subdivision 1; 245A.18, subdivision 2; 245A.40; 245A.41; 
2.30 	245A.50, subdivision 1; 245A.51, subdivision 3, by adding subdivisions; 245A.66, 
2.31 	subdivisions 2, 3; 245C.02, subdivision 6a, by adding subdivisions; 245C.03, 
2.32 	subdivision 1; 245C.05, subdivisions 4, 5, 5a; 245C.08, subdivisions 1, 3; 245C.10, 
2.33 	by adding a subdivision; 245C.13, subdivision 2, by adding a subdivision; 245C.22, 
2.34 	subdivisions 4, 5; 245C.24, subdivisions 1, 2, by adding a subdivision; 245C.30, 
2.35 	subdivisions 1, 2, 3; 245D.03, subdivision 1; 245D.071, subdivisions 1, 5; 
2.36 	245D.081, subdivision 3; 245D.09, subdivisions 5, 5a; 245D.091, subdivisions 2, 
2.37 	3, 4; 245E.02, by adding a subdivision; 245E.06, subdivision 3; 245F.05, 
2.38 	subdivision 2; 245G.01, subdivisions 8, 21, by adding subdivisions; 245G.04; 
2.39 	245G.05; 245G.06, subdivisions 1, 2, 4; 245G.07; 245G.08, subdivision 3; 245G.10, 
2.40 	subdivision 4; 245G.11, subdivisions 7, 8; 245G.12; 245G.13, subdivision 1; 
2.41 	245G.15, subdivisions 1, 2; 245G.18, subdivisions 3, 5; 245G.19, subdivision 4; 
2.42 	245G.22, subdivisions 1, 2, 3, 4, 6, 7, 15, 16, 17, 19; 245H.01, by adding 
2.43 	subdivisions; 245H.03, by adding a subdivision; 245H.07; 245H.10, subdivision 
2.44 	1; 245H.11; 245H.13, subdivision 5, by adding subdivisions; 245H.14, subdivisions 
2.45 	1, 2, 3, 4, 5, 6; 245H.15, subdivision 1; 246.54, by adding a subdivision; 246B.10; 
2.46 	252.27, subdivision 2a; 252.275, subdivision 3; 252.32, subdivision 1a; 252.41, 
2.47 	subdivisions 3, 4, 5, 6, 7, 9; 252.42; 252.43; 252.44; 252.45; 254A.03, subdivision 
2.48 	3; 254A.19, by adding a subdivision; 254B.02, subdivision 1; 254B.03, subdivisions 
2.49 	2, 4; 254B.04, subdivision 1, by adding a subdivision; 254B.05, subdivisions 1, 
2.50 	1a, 1b, 5; 254B.06, subdivisions 1, 2; 256.01, subdivision 14b; 256.043, as added; 
2.51 	256.046, subdivision 1, by adding a subdivision; 256.9365; 256.962, subdivision 
2.52 	5; 256.969, subdivisions 2b, 3a, 9, 17, 19; 256.98, subdivisions 1, 8; 256.983, by 
2.53 	adding a subdivision; 256B.02, subdivision 7; 256B.04, subdivisions 14, 21, 22, 
2.54 	by adding a subdivision; 256B.055, subdivision 2; 256B.056, subdivisions 1, 3, 
2.55 	5c, 7a; 256B.0625, subdivisions 3b, 13, 13e, 13f, 17, 24, 30, 43, 45a, 57, by adding 
2.56 	subdivisions; 256B.064, subdivisions 1a, 1b, 2, by adding subdivisions; 256B.0651, 
2.57 	subdivision 17; 256B.0658; 256B.0659, subdivisions 3a, 11, 12, 13, 19, 21, 24, 
2.58 	28, by adding a subdivision; 256B.0757, subdivisions 1, 2, 4, by adding 
3.1 	subdivisions; 256B.0911, subdivisions 1a, 3a, 3f, 5, by adding a subdivision; 
3.2 	256B.0915, subdivisions 3a, 6; 256B.092, subdivision 1b; 256B.0921; 256B.27, 
3.3 	subdivision 3; 256B.434, subdivisions 1, 3; 256B.49, subdivisions 13, 14; 
3.4 	256B.4912, by adding subdivisions; 256B.4913, subdivision 4a; 256B.4914, 
3.5 	subdivisions 2, 3, as amended, 4, 5, 6, 7, 8, 9, 10, 10a, 14, 15, by adding a 
3.6 	subdivision; 256B.5014; 256B.69, subdivision 4, by adding a subdivision; 
3.7 	256B.766; 256B.79, subdivisions 2, 3, 4, 5, 6; 256B.85, subdivisions 3, 10, 11, 
3.8 	12, 16, by adding a subdivision; 256I.03, subdivision 8; 256I.04, subdivisions 1, 
3.9 	2b, 2f, by adding subdivisions; 256I.06, subdivision 8; 256J.24, subdivision 5; 
3.10 	256K.45, subdivision 2; 256L.11, subdivision 2; 256M.41, subdivision 3, by adding 
3.11 	a subdivision; 256R.02, subdivisions 8, 19, 33, by adding subdivisions; 256R.21, 
3.12 	by adding a subdivision; 256R.25; 256R.26; 256R.44; 256R.50, subdivision 6; 
3.13 	260C.007, subdivision 18, by adding a subdivision; 260C.178, subdivision 1; 
3.14 	260C.201, subdivisions 1, 2, 6; 260C.212, subdivision 2; 260C.452, subdivision 
3.15 	4; 260C.503, subdivision 1; 518A.32, subdivision 3; 518A.51; 641.15, subdivision 
3.16 	3a; Laws 2017, chapter 13, article 1, section 15, as amended; Laws 2017, First 
3.17 	Special Session chapter 6, article 1, sections 44; 45; article 3, section 49; article 
3.18 	5, section 11; article 8, sections 71, as amended; 72, as amended; Laws 2019, 
3.19 	chapter 60, article 3, section 1, subdivision 5; proposing coding for new law in 
3.20 	Minnesota Statutes, chapters 10; 62A; 62K; 62Q; 119B; 144; 144A; 148; 151; 
3.21 	214; 245; 245A; 245D; 256B; 256K; 256R; 260C; repealing Minnesota Statutes 
3.22 	2018, sections 119B.125, subdivision 8; 119B.16, subdivision 2; 144.414, 
3.23 	subdivision 5; 144A.45, subdivision 6; 144A.481; 151.42; 151.44; 151.49; 151.50; 
3.24 	151.51; 151.55; 214.17; 214.18; 214.19; 214.20; 214.21; 214.22; 214.23; 214.24; 
3.25 	245E.06, subdivisions 2, 4, 5; 245H.10, subdivision 2; 246.18, subdivisions 8, 9; 
3.26 	252.41, subdivision 8; 252.431; 252.451; 254B.03, subdivision 4a; 256B.0625, 
3.27 	subdivisions 31c, 63; 256B.0659, subdivision 22; 256B.0705; 256B.431, 
3.28 	subdivisions 3i, 15, 16; 256B.434, subdivisions 6, 10; 256B.4913, subdivisions 
3.29 	4a, 5, 6, 7; 256B.79, subdivision 7; 256I.05, subdivision 3; 256L.11, subdivision 
3.30 	2a; 256R.53, subdivision 2; Laws 2010, First Special Session chapter 1, article 
3.31 	25, section 3, subdivision 10; Minnesota Rules, parts 2960.3030, subpart 3; 
3.32 	3400.0185, subpart 5; 6400.6970; 7200.6100; 7200.6105; 9502.0425, subparts 4, 
3.33 	16, 17; 9503.0155, subpart 8; 9549.0057; 9549.0060, subpart 14.
3.34 	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

3.35 	ARTICLE 1
3.36 	CHILDREN AND FAMILIES

3.37 	Section 1. Minnesota Statutes 2018, section 119B.011, is amended by adding a subdivision 
3.38 	to read:
3.39 		Subd. 13b.Homeless. "Homeless" means a self-declared housing status as defined in 
3.40 	the McKinney-Vento Homeless Assistance Act and United States Code, title 42, section 
3.41 	11302, paragraph (a).

3.42 	EFFECTIVE DATE. This section is effective September 21, 2020.

3.43 	Sec. 2. Minnesota Statutes 2018, section 119B.011, subdivision 19, is amended to read:
3.44 		Subd. 19.Provider. "Provider" means:
4.1 	(1) an individual or child care center or facility, either licensed or unlicensed, providing 
4.2 	legal child care services as defined licensed to provide child care under section 245A.03
4.3 	chapter 245A when operating within the terms of the license; or
4.4 	(2) a license exempt center required to be certified under chapter 245H;
4.5 	(3) an individual or child care center or facility holdingthat: (i) holds a valid child care 
4.6 	license issued by another state or a tribe and providing; (ii) provides child care services in 
4.7 	the licensing state or in the area under the licensing tribe's jurisdiction; and (iii) is in 
4.8 	compliance with federal health and safety requirements as certified by the licensing state 
4.9 	or tribe, or as determined by receipt of child care development block grant funds in the 
4.10 	licensing state; or
4.11 	(4) a legal nonlicensed child care provider as defined under section 119B.011, subdivision 
4.12 	16, providing legal child care services. A legally unlicensed familylegal nonlicensed child 
4.13 	care provider must be at least 18 years of age, and not a member of the MFIP assistance 
4.14 	unit or a member of the family receiving child care assistance to be authorized under this 
4.15 	chapter.

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

4.17 	Sec. 3. Minnesota Statutes 2018, section 119B.011, subdivision 20, is amended to read:
4.18 		Subd. 20.Transition year families. "Transition year families" means families who have 
4.19 	received MFIP assistance, or who were eligible to receive MFIP assistance after choosing 
4.20 	to discontinue receipt of the cash portion of MFIP assistance under section 256J.31, 
4.21 	subdivision 12, or families who have received DWP assistance under section 256J.95 for 
4.22 	at least three one of the last six months before losing eligibility for MFIP or DWP. 
4.23 	Notwithstanding Minnesota Rules, parts 3400.0040, subpart 10, and 3400.0090, subpart 2, 
4.24 	transition year child care may be used to support employment, approved education or training 
4.25 	programs, or job search that meets the requirements of section 119B.10. Transition year 
4.26 	child care is not available to families who have been disqualified from MFIP or DWP due 
4.27 	to fraud.

4.28 	EFFECTIVE DATE. This section is effective March 23, 2020.

4.29 	Sec. 4. Minnesota Statutes 2018, section 119B.02, subdivision 7, is amended to read:
4.30 		Subd. 7.Child care market rate survey. Biennially, The commissioner shall conduct 
4.31 	the next survey of prices charged by child care providers in Minnesota in state fiscal year 
5.1 	2021 and every three years thereafter to determine the 75th percentile for like-care 
5.2 	arrangements in county price clusters.

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

5.4 	Sec. 5. Minnesota Statutes 2018, section 119B.025, subdivision 1, is amended to read:
5.5 		Subdivision 1.Applications. (a) Except as provided in paragraph (c), clause (4), the 
5.6 	county shall verify the following at all initial child care applications using the universal 
5.7 	application:
5.8 	(1) identity of adults;
5.9 	(2) presence of the minor child in the home, if questionable;
5.10 	(3) relationship of minor child to the parent, stepparent, legal guardian, eligible relative 
5.11 	caretaker, or the spouses of any of the foregoing;
5.12 	(4) age;
5.13 	(5) immigration status, if related to eligibility;
5.14 	(6) Social Security number, if given;
5.15 	(7) counted income;
5.16 	(8) spousal support and child support payments made to persons outside the household;
5.17 	(9) residence; and
5.18 	(10) inconsistent information, if related to eligibility.
5.19 	(b) The county must mail a notice of approval or denial of assistance to the applicant 
5.20 	within 30 calendar days after receiving the application. The county may extend the response 
5.21 	time by 15 calendar days if the applicant is informed of the extension.
5.22 	(c) For an applicant who declares that the applicant is homeless and who meets the 
5.23 	definition of homeless in section 119B.011, subdivision 13b, the county must:
5.24 	(1) if information is needed to determine eligibility, send a request for information to 
5.25 	the applicant within five working days after receiving the application;
5.26 	(2) if the applicant is eligible, send a notice of approval of assistance within five working 
5.27 	days after receiving the application;
5.28 	(3) if the applicant is ineligible, send a notice of denial of assistance within 30 days after 
5.29 	receiving the application. The county may extend the response time by 15 calendar days if 
5.30 	the applicant is informed of the extension;
6.1 	(4) not require verifications required by paragraph (a) before issuing the notice of approval 
6.2 	or denial; and
6.3 	(5) follow limits set by the commissioner for how frequently expedited application 
6.4 	processing may be used for an applicant under this paragraph.
6.5 	(d) An applicant who declares that the applicant is homeless must submit proof of 
6.6 	eligibility within three months of the date the application was received. If proof of eligibility 
6.7 	is not submitted within three months, eligibility ends. A 15-day adverse action notice is 
6.8 	required to end eligibility.

6.9 	EFFECTIVE DATE. This section is effective September 21, 2020.

6.10 	Sec. 6. Minnesota Statutes 2018, section 119B.025, is amended by adding a subdivision 
6.11 	to read:
6.12 		Subd. 5.Information to applicants; child care fraud. At the time of initial application 
6.13 	and at redetermination, the county must provide written notice to the applicant or participant 
6.14 	listing the activities that constitute child care fraud and the consequences of committing 
6.15 	child care fraud. An applicant or participant shall acknowledge receipt of the child care 
6.16 	fraud notice in writing.

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

6.18 	Sec. 7. Minnesota Statutes 2018, section 119B.03, subdivision 9, is amended to read:
6.19 		Subd. 9.Portability pool. (a) The commissioner shall establish a pool of up to five 
6.20 	percent of the annual appropriation for the basic sliding fee program to provide continuous 
6.21 	child care assistance for eligible families who move between Minnesota counties. At the 
6.22 	end of each allocation period, any unspent funds in the portability pool must be used for 
6.23 	assistance under the basic sliding fee program. If expenditures from the portability pool 
6.24 	exceed the amount of money available, the reallocation pool must be reduced to cover these 
6.25 	shortages.
6.26 	(b) To be eligible for portable basic sliding fee assistance, A family that has moved from 
6.27 	a county in which it was receiving basic sliding fee assistance to a county with a waiting 
6.28 	list for the basic sliding fee program must:
6.29 	(1) meet the income and eligibility guidelines for the basic sliding fee program; and
7.1 	(2) notify the new county of residence within 60 days of moving and submit information 
7.2 	to the new county of residence to verify eligibility for the basic sliding fee program the 
7.3 	family's previous county of residence of the family's move to a new county of residence.
7.4 	(c) The receiving county must:
7.5 	(1) accept administrative responsibility for applicants for portable basic sliding fee 
7.6 	assistance at the end of the two months of assistance under the Unitary Residency Act;
7.7 	(2) continue portability pool basic sliding fee assistance for the lesser of six months or
7.8 	until the family is able to receive assistance under the county's regular basic sliding program; 
7.9 	and
7.10 	(3) notify the commissioner through the quarterly reporting process of any family that 
7.11 	meets the criteria of the portable basic sliding fee assistance pool.

7.12 	EFFECTIVE DATE. This section is effective December 2, 2019.

7.13 	Sec. 8. Minnesota Statutes 2018, section 119B.09, subdivision 1, is amended to read:
7.14 		Subdivision 1.General eligibility requirements. (a) Child care services must be 
7.15 	available to families who need child care to find or keep employment or to obtain the training 
7.16 	or education necessary to find employment and who:
7.17 	(1) have household income less than or equal to 67 percent of the state median income, 
7.18 	adjusted for family size, at application and redetermination, and meet the requirements of 
7.19 	section 119B.05; receive MFIP assistance; and are participating in employment and training 
7.20 	services under chapter 256J; or
7.21 	(2) have household income less than or equal to 47 percent of the state median income, 
7.22 	adjusted for family size, at application and less than or equal to 67 percent of the state 
7.23 	median income, adjusted for family size, at redetermination.
7.24 	(b) Child care services must be made available as in-kind services.
7.25 	(c) All applicants for child care assistance and families currently receiving child care 
7.26 	assistance must be assisted and required to cooperate in establishment of paternity and 
7.27 	enforcement of child support obligations for all children in the family at application and 
7.28 	redetermination as a condition of program eligibility. For purposes of this section, a family 
7.29 	is considered to meet the requirement for cooperation when the family complies with the 
7.30 	requirements of section 256.741.
7.31 	(d) All applicants for child care assistance and families currently receiving child care 
7.32 	assistance must pay the co-payment fee under section 119B.12, subdivision 2, as a condition 
8.1 	of eligibility. The co-payment fee may include additional recoupment fees due to a child 
8.2 	care assistance program overpayment.
8.3 	(e) If a family has one child with a child care authorization and the child reaches 13 
8.4 	years of age or the child has a disability and reaches 15 years of age, the family remains 
8.5 	eligible until the redetermination.

8.6 	EFFECTIVE DATE. This section is effective June 29, 2020.

8.7 	Sec. 9. Minnesota Statutes 2018, section 119B.095, subdivision 2, is amended to read:
8.8 		Subd. 2.Maintain steady child care authorizations. (a) Notwithstanding Minnesota 
8.9 	Rules, chapter 3400, the amount of child care authorized under section 119B.10 for 
8.10 	employment, education, or an MFIP or DWP employment plan shall continue at the same 
8.11 	number of hours or more hours until redetermination, including:
8.12 	(1) when the other parent moves in and is employed or has an education plan under 
8.13 	section 119B.10, subdivision 3, or has an MFIP or DWP employment plan; or
8.14 	(2) when the participant's work hours are reduced or a participant temporarily stops 
8.15 	working or attending an approved education program. Temporary changes include, but are 
8.16 	not limited to, a medical leave, seasonal employment fluctuations, or a school break between 
8.17 	semesters.
8.18 	(b) The county may increase the amount of child care authorized at any time if the 
8.19 	participant verifies the need for increased hours for authorized activities.
8.20 	(c) The county may reduce the amount of child care authorized if a parent requests a 
8.21 	reduction or because of a change in:
8.22 	(1) the child's school schedule;
8.23 	(2) the custody schedule; or
8.24 	(3) the provider's availability.
8.25 	(d) The amount of child care authorized for a family subject to subdivision 1, paragraph 
8.26 	(b), must change when the participant's activity schedule changes. Paragraph (a) does not 
8.27 	apply to a family subject to subdivision 1, paragraph (b).
8.28 	(e) When a child reaches 13 years of age or a child with a disability reaches 15 years of 
8.29 	age, the amount of child care authorized shall continue at the same number of hours or more 
8.30 	hours until redetermination.

8.31 	EFFECTIVE DATE. This section is effective June 29, 2020.

9.1 	Sec. 10. Minnesota Statutes 2018, section 119B.095, is amended by adding a subdivision 
9.2 	to read:
9.3 		Subd. 3.Assistance for persons who are homeless. An applicant who is homeless and 
9.4 	eligible for child care assistance is exempt from the activity participation requirements under 
9.5 	this chapter for three months. The applicant under this subdivision is eligible for 60 hours 
9.6 	of child care assistance per service period for three months from the date the county receives 
9.7 	the application. Additional hours may be authorized as needed based on the applicant's 
9.8 	participation in employment, education, or MFIP or DWP employment plan. To continue 
9.9 	receiving child care assistance after the initial three months, the applicant must verify that 
9.10 	the applicant meets eligibility and activity requirements for child care assistance under this 
9.11 	chapter.

9.12 	EFFECTIVE DATE. This section is effective September 21, 2020.

9.13 	Sec. 11. Minnesota Statutes 2018, section 119B.16, subdivision 1, is amended to read:
9.14 		Subdivision 1.Fair hearing allowed for applicants and recipients. (a) An applicant 
9.15 	or recipient adversely affected by an action of a county agency action or the commissioner, 
9.16 	for an action taken directly against the applicant or recipient, may request and receive a fair 
9.17 	hearing in accordance with this subdivision and section 256.045. An applicant or recipient 
9.18 	does not have a right to a fair hearing if a county agency or the commissioner takes action 
9.19 	against a provider.
9.20 	(b) A county agency must offer an informal conference to an applicant or recipient who 
9.21 	is entitled to a fair hearing under this section. A county agency must advise an applicant or 
9.22 	recipient that a request for a conference is optional and does not delay or replace the right 
9.23 	to a fair hearing.
9.24 	(c) If a provider's authorization is suspended, denied, or revoked, a county agency or 
9.25 	the commissioner must mail notice to each child care assistance program recipient receiving 
9.26 	care from the provider.

9.27 	EFFECTIVE DATE. This section is effective February 26, 2021.

9.28 	Sec. 12. Minnesota Statutes 2018, section 119B.16, subdivision 1a, is amended to read:
9.29 		Subd. 1a.Fair hearing allowed for providers. (a) This subdivision applies to providers 
9.30 	caring for children receiving child care assistance.
9.31 	(b) A provider to whom a county agency has assigned responsibility for an overpayment 
9.32 	may request a fair hearing in accordance with section 256.045 for the limited purpose of 
10.1 	challenging the assignment of responsibility for the overpayment and the amount of the 
10.2 	overpayment. The scope of the fair hearing does not include the issues of whether the 
10.3 	provider wrongfully obtained public assistance in violation of section 256.98 or was properly 
10.4 	disqualified under section 256.98, subdivision 8, paragraph (c), unless the fair hearing has 
10.5 	been combined with an administrative disqualification hearing brought against the provider 
10.6 	under section 256.046.
10.7 	(b) A provider may request a fair hearing according to sections 256.045 and 256.046 
10.8 	only if a county agency or the commissioner:
10.9 	(1) denies or revokes a provider's authorization, unless the action entitles the provider 
10.10 	to an administrative review under section 119B.161;
10.11 	(2) assigns responsibility for an overpayment to a provider under section 119B.11, 
10.12 	subdivision 2a;
10.13 	(3) establishes an overpayment for failure to comply with section 119B.125, subdivision 
10.14 	6;
10.15 	(4) seeks monetary recovery or recoupment under section 245E.02, subdivision 4, 
10.16 	paragraph (c), clause (2);
10.17 	(5) initiates an administrative fraud disqualification hearing; or
10.18 	(6) issues a payment and the provider disagrees with the amount of the payment.
10.19 	(c) A provider may request a fair hearing by submitting a written request to the 
10.20 	Department of Human Services, Appeals Division. A provider's request must be received 
10.21 	by the Appeals Division no later than 30 days after the date a county or the commissioner 
10.22 	mails the notice.
10.23 	(d) The provider's appeal request must contain the following:
10.24 	(1) each disputed item, the reason for the dispute, and, if applicable, an estimate of the 
10.25 	dollar amount involved for each disputed item;
10.26 	(2) the computation the provider believes to be correct, if applicable;
10.27 	(3) the statute or rule relied on for each disputed item; and
10.28 	(4) the name, address, and telephone number of the person at the provider's place of 
10.29 	business with whom contact may be made regarding the appeal.

10.30 	EFFECTIVE DATE. This section is effective February 26, 2021.

11.1 	Sec. 13. Minnesota Statutes 2018, section 119B.16, subdivision 1b, is amended to read:
11.2 		Subd. 1b.Joint fair hearings. When a provider requests a fair hearing under subdivision 
11.3 	1a, the family in whose case the overpayment was created must be made a party to the fair 
11.4 	hearing. All other issues raised by the family must be resolved in the same proceeding. 
11.5 	When a family requests a fair hearing and claims that the county should have assigned 
11.6 	responsibility for an overpayment to a provider, the provider must be made a party to the 
11.7 	fair hearing. The human services judge assigned to a fair hearing may join a family or a 
11.8 	provider as a party to the fair hearing whenever joinder of that party is necessary to fully 
11.9 	and fairly resolve overpayment issues raised in the appeal.

11.10 	EFFECTIVE DATE. This section is effective February 26, 2021.

11.11 	Sec. 14. Minnesota Statutes 2018, section 119B.16, is amended by adding a subdivision 
11.12 	to read:
11.13 		Subd. 1c.Notice to providers. (a) Before taking an action appealable under subdivision 
11.14 	1a, paragraph (b), a county agency or the commissioner must mail written notice to the 
11.15 	provider against whom the action is being taken. Unless otherwise specified under chapter 
11.16 	119B or 245E or Minnesota Rules, chapter 3400, a county agency or the commissioner must 
11.17 	mail the written notice at least 15 calendar days before the adverse action's effective date.
11.18 	(b) The notice shall state (1) the factual basis for the department's determination, (2) the 
11.19 	action the department intends to take, (3) the dollar amount of the monetary recovery or 
11.20 	recoupment, if known, and (4) the provider's right to appeal the department's proposed 
11.21 	action.

11.22 	EFFECTIVE DATE. This section is effective February 26, 2021.

11.23 	Sec. 15. Minnesota Statutes 2018, section 119B.16, is amended by adding a subdivision 
11.24 	to read:
11.25 		Subd. 3.Fair hearing stayed. (a) If a county agency or the commissioner denies or 
11.26 	revokes a provider's authorization based on a licensing action under section 245A.07, and 
11.27 	the provider appeals, the provider's fair hearing must be stayed until the commissioner issues 
11.28 	an order as required under section 245A.08, subdivision 5.
11.29 	(b) If the commissioner denies or revokes a provider's authorization based on 
11.30 	decertification under section 245H.07, and the provider appeals, the provider's fair hearing 
11.31 	must be stayed until the commissioner issues a final order as required under section 245H.07.

11.32 	EFFECTIVE DATE. This section is effective February 26, 2021.

12.1 	Sec. 16. Minnesota Statutes 2018, section 119B.16, is amended by adding a subdivision 
12.2 	to read:
12.3 		Subd. 4.Final department action. Unless the commissioner receives a timely and 
12.4 	proper request for an appeal, a county agency's or the commissioner's action shall be 
12.5 	considered a final department action.

12.6 	EFFECTIVE DATE. This section is effective February 26, 2021.

12.7 	Sec. 17. [119B.161] ADMINISTRATIVE REVIEW.
12.8 		Subdivision 1.Applicability. A provider has the right to an administrative review under 
12.9 	this section if (1) a payment was suspended under chapter 245E, or (2) the provider's 
12.10 	authorization was denied or revoked under section 119B.13, subdivision 6, paragraph (d), 
12.11 	clause (1) or (2).
12.12 		Subd. 2.Notice. (a) A county agency or the commissioner must mail written notice to 
12.13 	a provider within five days of suspending payment or denying or revoking the provider's 
12.14 	authorization under subdivision 1.
12.15 	(b) The notice must:
12.16 	(1) state the provision under which a county agency or the commissioner is denying, 
12.17 	revoking, or suspending the provider's authorization or suspending payment to the provider;
12.18 	(2) set forth the general allegations leading to the denial, revocation, or suspension of 
12.19 	the provider's authorization. The notice need not disclose any specific information concerning 
12.20 	an ongoing investigation;
12.21 	(3) state that the denial, revocation, or suspension of the provider's authorization is for 
12.22 	a temporary period and explain the circumstances under which the action expires; and
12.23 	(4) inform the provider of the right to submit written evidence and argument for 
12.24 	consideration by the commissioner.
12.25 	(c) Notwithstanding Minnesota Rules, part 3400.0185, if a county agency or the 
12.26 	commissioner suspends payment to a provider under chapter 245E or denies or revokes a 
12.27 	provider's authorization under section 119B.13, subdivision 6, paragraph (d), clause (1) or 
12.28 	(2), a county agency or the commissioner must send notice of service authorization closure 
12.29 	to each affected family. The notice sent to an affected family is effective on the date the 
12.30 	notice is created.
12.31 		Subd. 3.Duration. If a provider's payment is suspended under chapter 245E or a 
12.32 	provider's authorization is denied or revoked under section 119B.13, subdivision 6, paragraph 
13.1 	(d), clause (1) or (2), the provider's denial, revocation, temporary suspension, or payment 
13.2 	suspension remains in effect until:
13.3 	(1) the commissioner or a law enforcement authority determines that there is insufficient 
13.4 	evidence warranting the action and a county agency or the commissioner does not pursue 
13.5 	an additional administrative remedy under chapter 245E or section 256.98; or
13.6 	(2) all criminal, civil, and administrative proceedings related to the provider's alleged 
13.7 	misconduct conclude and any appeal rights are exhausted.
13.8 		Subd. 4.Good cause exception. The commissioner may find that good cause exists not 
13.9 	to deny, revoke, or suspend a provider's authorization, or not to continue a denial, revocation, 
13.10 	or suspension of a provider's authorization if any of the following are applicable:
13.11 	(1) a law enforcement authority specifically requested that a provider's authorization 
13.12 	not be denied, revoked, or suspended because that action may compromise an ongoing 
13.13 	investigation;
13.14 	(2) the commissioner determines that the denial, revocation, or suspension should be 
13.15 	removed based on the provider's written submission; or
13.16 	(3) the commissioner determines that the denial, revocation, or suspension is not in the 
13.17 	best interests of the program.

13.18 	EFFECTIVE DATE. This section is effective February 26, 2021.

13.19 	Sec. 18. Minnesota Statutes 2018, section 245E.06, subdivision 3, is amended to read:
13.20 		Subd. 3.Appeal of department sanction action. (a) If the department does not pursue 
13.21 	a criminal action against a provider, license holder, controlling individual, or recipient for 
13.22 	financial misconduct, but the department imposes an administrative sanction under section 
13.23 	245E.02, subdivision 4, paragraph (c), any individual or entity against whom the sanction 
13.24 	was imposed may appeal the department's administrative sanction under this section pursuant 
13.25 	to section 119B.16 or 256.045 with the additional requirements in clauses (1) to (4). An 
13.26 	appeal must specify:
13.27 	(1) each disputed item, the reason for the dispute, and an estimate of the dollar amount 
13.28 	involved for each disputed item, if appropriate;
13.29 	(2) the computation that is believed to be correct, if appropriate;
13.30 	(3) the authority in the statute or rule relied upon for each disputed item; and
14.1 	(4) the name, address, and phone number of the person at the provider's place of business 
14.2 	with whom contact may be made regarding the appeal.
14.3 	(b) Notwithstanding section 245E.03, subdivision 4, an appeal is considered timely only 
14.4 	if postmarked or received by the department's Appeals Division within 30 days after receiving 
14.5 	a notice of department sanction.
14.6 	(c) Before the appeal hearing, the department may deny or terminate authorizations or 
14.7 	payment to the entity or individual if the department determines that the action is necessary 
14.8 	to protect the public welfare or the interests of the child care assistance program. A provider's 
14.9 	rights related to the department's action taken under this chapter against a provider are 
14.10 	established in sections 119B.16 and 119B.161.

14.11 	EFFECTIVE DATE. This section is effective February 26, 2021.

14.12 	Sec. 19. Minnesota Statutes 2018, section 256.01, subdivision 14b, is amended to read:
14.13 		Subd. 14b.American Indian child welfare projects. (a) The commissioner of human 
14.14 	services may authorize projects to test initiate tribal delivery of child welfare services to 
14.15 	American Indian children and their parents and custodians living on the reservation. The 
14.16 	commissioner has authority to solicit and determine which tribes may participate in a project. 
14.17 	Grants may be issued to Minnesota Indian tribes to support the projects. The commissioner 
14.18 	may waive existing state rules as needed to accomplish the projects. The commissioner may 
14.19 	authorize projects to use alternative methods of (1) screening, investigating, and assessing 
14.20 	reports of child maltreatment, and (2) administrative reconsideration, administrative appeal, 
14.21 	and judicial appeal of maltreatment determinations, provided the alternative methods used 
14.22 	by the projects comply with the provisions of sections 256.045 and 626.556dealing that 
14.23 	deal with the rights of individuals who are the subjects of reports or investigations, including 
14.24 	notice and appeal rights and data practices requirements. The commissioner shall only 
14.25 	authorize alternative methods that comply with the public policy under section 626.556, 
14.26 	subdivision 1. The commissioner may seek any federal approvals necessary to carry out the 
14.27 	projects as well as seek and use any funds available to the commissioner, including use of 
14.28 	federal funds, foundation funds, existing grant funds, and other funds. The commissioner 
14.29 	is authorized to advance state funds as necessary to operate the projects. Federal 
14.30 	reimbursement applicable to the projects is appropriated to the commissioner for the purposes 
14.31 	of the projects. The projects must be required to address responsibility for safety, permanency, 
14.32 	and well-being of children.
15.1 	(b) For the purposes of this section, "American Indian child" means a person under 21 
15.2 	years old and who is a tribal member or eligible for membership in one of the tribes chosen 
15.3 	for a project under this subdivision and who is residing on the reservation of that tribe.
15.4 	(c) In order to qualify for an American Indian child welfare project, a tribe must:
15.5 	(1) be one of the existing tribes with reservation land in Minnesota;
15.6 	(2) have a tribal court with jurisdiction over child custody proceedings;
15.7 	(3) have a substantial number of children for whom determinations of maltreatment have 
15.8 	occurred;
15.9 	(4)(i) have capacity to respond to reports of abuse and neglect under section 626.556;
15.10 	or (ii) have codified the tribe's screening, investigation, and assessment of reports of child 
15.11 	maltreatment procedures, if authorized to use an alternative method by the commissioner 
15.12 	under paragraph (a);
15.13 	(5) provide a wide range of services to families in need of child welfare services; and
15.14 	(6) have a tribal-state title IV-E agreement in effect.
15.15 	(d) Grants awarded under this section may be used for the nonfederal costs of providing 
15.16 	child welfare services to American Indian children on the tribe's reservation, including costs 
15.17 	associated with:
15.18 	(1) assessment and prevention of child abuse and neglect;
15.19 	(2) family preservation;
15.20 	(3) facilitative, supportive, and reunification services;
15.21 	(4) out-of-home placement for children removed from the home for child protective 
15.22 	purposes; and
15.23 	(5) other activities and services approved by the commissioner that further the goals of 
15.24 	providing safety, permanency, and well-being of American Indian children.
15.25 	(e) When a tribe has initiated a project and has been approved by the commissioner to 
15.26 	assume child welfare responsibilities for American Indian children of that tribe under this 
15.27 	section, the affected county social service agency is relieved of responsibility for responding 
15.28 	to reports of abuse and neglect under section 626.556 for those children during the time 
15.29 	within which the tribal project is in effect and funded. The commissioner shall work with 
15.30 	tribes and affected counties to develop procedures for data collection, evaluation, and 
15.31 	clarification of ongoing role and financial responsibilities of the county and tribe for child 
16.1 	welfare services prior to initiation of the project. Children who have not been identified by 
16.2 	the tribe as participating in the project shall remain the responsibility of the county. Nothing 
16.3 	in this section shall alter responsibilities of the county for law enforcement or court services.
16.4 	(f) Participating tribes may conduct children's mental health screenings under section 
16.5 	245.4874, subdivision 1, paragraph (a), clause (12), for children who are eligible for the 
16.6 	initiative and living on the reservation and who meet one of the following criteria:
16.7 	(1) the child must be receiving child protective services;
16.8 	(2) the child must be in foster care; or
16.9 	(3) the child's parents must have had parental rights suspended or terminated.
16.10 	Tribes may access reimbursement from available state funds for conducting the screenings. 
16.11 	Nothing in this section shall alter responsibilities of the county for providing services under 
16.12 	section 245.487.
16.13 	(g) Participating tribes may establish a local child mortality review panel. In establishing 
16.14 	a local child mortality review panel, the tribe agrees to conduct local child mortality reviews 
16.15 	for child deaths or near-fatalities occurring on the reservation under subdivision 12. Tribes 
16.16 	with established child mortality review panels shall have access to nonpublic data and shall 
16.17 	protect nonpublic data under subdivision 12, paragraphs (c) to (e). The tribe shall provide 
16.18 	written notice to the commissioner and affected counties when a local child mortality review 
16.19 	panel has been established and shall provide data upon request of the commissioner for 
16.20 	purposes of sharing nonpublic data with members of the state child mortality review panel 
16.21 	in connection to an individual case.
16.22 	(h) The commissioner shall collect information on outcomes relating to child safety, 
16.23 	permanency, and well-being of American Indian children who are served in the projects. 
16.24 	Participating tribes must provide information to the state in a format and completeness 
16.25 	deemed acceptable by the state to meet state and federal reporting requirements.
16.26 	(i) In consultation with the White Earth Band, the commissioner shall develop and submit 
16.27 	to the chairs and ranking minority members of the legislative committees with jurisdiction 
16.28 	over health and human services a plan to transfer legal responsibility for providing child 
16.29 	protective services to White Earth Band member children residing in Hennepin County to 
16.30 	the White Earth Band. The plan shall include a financing proposal, definitions of key terms, 
16.31 	statutory amendments required, and other provisions required to implement the plan. The 
16.32 	commissioner shall submit the plan by January 15, 2012.

17.1 	Sec. 20. Minnesota Statutes 2018, section 256J.24, subdivision 5, is amended to read:
17.2 		Subd. 5.MFIP transitional standard. (a) The MFIP transitional standard is based on 
17.3 	the number of persons in the assistance unit eligible for both food and cash assistance. The 
17.4 	amount of the transitional standard is published annually by the Department of Human 
17.5 	Services.
17.6 	(b) The amount of the MFIP cash assistance portion of the transitional standard is 
17.7 	increased $100 per month per household. This increase shall be reflected in the MFIP cash 
17.8 	assistance portion of the transitional standard published annually by the commissioner.

17.9 	EFFECTIVE DATE. This section is effective February 1, 2020.

17.10 	Sec. 21. Minnesota Statutes 2018, section 256M.41, subdivision 3, is amended to read:
17.11 		Subd. 3.Payments based on performance. (a) The commissioner shall make payments 
17.12 	under this section to each county board on a calendar year basis in an amount determined 
17.13 	under paragraph (b) on or before July 10 of each year.
17.14 	(b) Calendar year allocations under subdivision 1 shall be paid to counties in the following 
17.15 	manner:
17.16 	(1) 80 percent of the allocation as determined in subdivision 1 must be paid to counties 
17.17 	on or before July 10 of each year;
17.18 	(2) ten percent of the allocation shall be withheld until the commissioner determines if 
17.19 	the county has met the performance outcome threshold of 90 percent based on face-to-face 
17.20 	contact with alleged child victims. In order to receive the performance allocation, the county 
17.21 	child protection workers must have a timely face-to-face contact with at least 90 percent of 
17.22 	all alleged child victims of screened-in maltreatment reports. The standard requires that 
17.23 	each initial face-to-face contact occur consistent with timelines defined in section 626.556, 
17.24 	subdivision 10, paragraph (i). The commissioner shall make threshold determinations in 
17.25 	January of each year and payments to counties meeting the performance outcome threshold 
17.26 	shall occur in February of each year. Any withheld funds from this appropriation for counties 
17.27 	that do not meet this requirement shall be reallocated by the commissioner to those counties 
17.28 	meeting the requirement; and
17.29 	(3) ten percent of the allocation shall be withheld until the commissioner determines 
17.30 	that the county has met the performance outcome threshold of 90 percent based on 
17.31 	face-to-face visits by the case manager. In order to receive the performance allocation, the 
17.32 	total number of visits made by caseworkers on a monthly basis to children in foster care 
17.33 	and children receiving child protection services while residing in their home must be at least 
18.1 	90 percent of the total number of such visits that would occur if every child were visited 
18.2 	once per month. The commissioner shall make such determinations in January of each year 
18.3 	and payments to counties meeting the performance outcome threshold shall occur in February 
18.4 	of each year. Any withheld funds from this appropriation for counties that do not meet this 
18.5 	requirement shall be reallocated by the commissioner to those counties meeting the 
18.6 	requirement. For 2015, the commissioner shall only apply the standard for monthly foster 
18.7 	care visits.
18.8 	(c) The commissioner shall work with stakeholders and the Human Services Performance 
18.9 	Council under section 402A.16 to develop recommendations for specific outcome measures 
18.10 	that counties should meet in order to receive funds withheld under paragraph (b), and include 
18.11 	in those recommendations a determination as to whether the performance measures under 
18.12 	paragraph (b) should be modified or phased out. The commissioner shall report the 
18.13 	recommendations to the legislative committees having jurisdiction over child protection 
18.14 	issues by January 1, 2018.

18.15 	Sec. 22. Minnesota Statutes 2018, section 256M.41, is amended by adding a subdivision 
18.16 	to read:
18.17 		Subd. 4.County performance on child protection measures. The commissioner shall 
18.18 	set child protection measures and standards. The commissioner shall require an 
18.19 	underperforming county to demonstrate that the county designated sufficient funds and 
18.20 	implemented a reasonable strategy to improve child protection performance, including the 
18.21 	provision of a performance improvement plan and additional remedies identified by the 
18.22 	commissioner. The commissioner may redirect up to 20 percent of a county's funds under 
18.23 	this section toward the performance improvement plan. Sanctions under section 256M.20, 
18.24 	subdivision 3, related to noncompliance with federal performance standards also apply.

18.25 	Sec. 23. Minnesota Statutes 2018, section 260C.007, subdivision 18, is amended to read:
18.26 		Subd. 18.Foster care. (a) "Foster care" means 24 hour 24-hour substitute care for 
18.27 	children placed away from their parents or guardian and a child for whom a responsible 
18.28 	social services agency has placement and care responsibility. "Foster care" includes, but is 
18.29 	not limited to, placement and:
18.30 	(1) who is placed away from the child's parent or guardian in foster family homes, foster 
18.31 	homes of relatives, group homes, emergency shelters, residential facilities not excluded in 
18.32 	this subdivision, child care institutions, and preadoptive homes.; or
19.1 	(2) who is colocated with the child's parent or guardian in a licensed residential 
19.2 	family-based substance use disorder treatment program as defined in subdivision 22a; or
19.3 	(3) who is returned to the care of the child's parent or guardian from whom the child 
19.4 	was removed under a trial home visit pursuant to section 260C.201, subdivision 1, paragraph 
19.5 	(a), clause (3).
19.6 	(b) A child is in foster care under this definition regardless of whether the facility is 
19.7 	licensed and payments are made for the cost of care. Nothing in this definition creates any 
19.8 	authority to place a child in a home or facility that is required to be licensed which is not 
19.9 	licensed. "Foster care" does not include placement in any of the following facilities: hospitals, 
19.10 	inpatient chemical dependency treatment facilities where the child is the recipient of the 
19.11 	treatment, facilities that are primarily for delinquent children, any corrections facility or 
19.12 	program within a particular correction's facility not meeting requirements for title IV-E 
19.13 	facilities as determined by the commissioner, facilities to which a child is committed under 
19.14 	the provision of chapter 253B, forestry camps, or jails. Foster care is intended to provide 
19.15 	for a child's safety or to access treatment. Foster care must not be used as a punishment or 
19.16 	consequence for a child's behavior.

19.17 	Sec. 24. Minnesota Statutes 2018, section 260C.007, is amended by adding a subdivision 
19.18 	to read:
19.19 		Subd. 22a.Licensed residential family-based substance use disorder treatment 
19.20 	program. "Licensed residential family-based substance use disorder treatment program" 
19.21 	means a residential treatment facility that provides the parent or guardian with parenting 
19.22 	skills training, parent education, or individual and family counseling, under an organizational 
19.23 	structure and treatment framework that involves understanding, recognizing, and responding 
19.24 	to the effects of all types of trauma according to recognized principles of a trauma-informed 
19.25 	approach and trauma-specific interventions to address the consequences of trauma and 
19.26 	facilitate healing. The residential program must be licensed by the Department of Human 
19.27 	Services under chapter 245A and sections 245G.01 to 245G.16, 245G.19, and 245G.21 as 
19.28 	a residential substance use disorder treatment program specializing in the treatment of clients 
19.29 	with children.

19.30 	Sec. 25. Minnesota Statutes 2018, section 260C.178, subdivision 1, is amended to read:
19.31 		Subdivision 1.Hearing and release requirements. (a) If a child was taken into custody 
19.32 	under section 260C.175, subdivision 1, clause (1) or (2), item (ii), the court shall hold a 
20.1 	hearing within 72 hours of the time the child was taken into custody, excluding Saturdays, 
20.2 	Sundays, and holidays, to determine whether the child should continue in custody.
20.3 	(b) Unless there is reason to believe that the child would endanger self or others or not 
20.4 	return for a court hearing, or that the child's health or welfare would be immediately 
20.5 	endangered, the child shall be released to the custody of a parent, guardian, custodian, or 
20.6 	other suitable person, subject to reasonable conditions of release including, but not limited 
20.7 	to, a requirement that the child undergo a chemical use assessment as provided in section 
20.8 	260C.157, subdivision 1.
20.9 	(c) If the court determines there is reason to believe that the child would endanger self 
20.10 	or others or not return for a court hearing, or that the child's health or welfare would be 
20.11 	immediately endangered if returned to the care of the parent or guardian who has custody 
20.12 	and from whom the child was removed, the court shall order the child into foster care as 
20.13 	defined in section 260C.007, subdivision 18, under the legal responsibility of the responsible 
20.14 	social services agency or responsible probation or corrections agency for the purposes of 
20.15 	protective care as that term is used in the juvenile court rules or into the home of a 
20.16 	noncustodial parent and order the noncustodial parent to comply with any conditions the 
20.17 	court determines to be appropriate to the safety and care of the child, including cooperating 
20.18 	with paternity establishment proceedings in the case of a man who has not been adjudicated 
20.19 	the child's father. The court shall not give the responsible social services legal custody and 
20.20 	order a trial home visit at any time prior to adjudication and disposition under section 
20.21 	260C.201, subdivision 1, paragraph (a), clause (3), but may order the child returned to the 
20.22 	care of the parent or guardian who has custody and from whom the child was removed and 
20.23 	order the parent or guardian to comply with any conditions the court determines to be 
20.24 	appropriate to meet the safety, health, and welfare of the child.
20.25 	(d) In determining whether the child's health or welfare would be immediately 
20.26 	endangered, the court shall consider whether the child would reside with a perpetrator of 
20.27 	domestic child abuse.
20.28 	(e) The court, before determining whether a child should be placed in or continue in 
20.29 	foster care under the protective care of the responsible agency, shall also make a 
20.30 	determination, consistent with section 260.012 as to whether reasonable efforts were made 
20.31 	to prevent placement or whether reasonable efforts to prevent placement are not required. 
20.32 	In the case of an Indian child, the court shall determine whether active efforts, according 
20.33 	to section 260.762 and the Indian Child Welfare Act of 1978, United States Code, title 25, 
20.34 	section 1912(d), were made to prevent placement. The court shall enter a finding that the 
21.1 	responsible social services agency has made reasonable efforts to prevent placement when 
21.2 	the agency establishes either:
21.3 	(1) that it has actually provided services or made efforts in an attempt to prevent the 
21.4 	child's removal but that such services or efforts have not proven sufficient to permit the 
21.5 	child to safely remain in the home; or
21.6 	(2) that there are no services or other efforts that could be made at the time of the hearing 
21.7 	that could safely permit the child to remain home or to return home. When reasonable efforts 
21.8 	to prevent placement are required and there are services or other efforts that could be ordered 
21.9 	which would permit the child to safely return home, the court shall order the child returned 
21.10 	to the care of the parent or guardian and the services or efforts put in place to ensure the 
21.11 	child's safety. When the court makes a prima facie determination that one of the 
21.12 	circumstances under paragraph (g) exists, the court shall determine that reasonable efforts 
21.13 	to prevent placement and to return the child to the care of the parent or guardian are not 
21.14 	required.
21.15 	If the court finds the social services agency's preventive or reunification efforts have 
21.16 	not been reasonable but further preventive or reunification efforts could not permit the child 
21.17 	to safely remain at home, the court may nevertheless authorize or continue the removal of 
21.18 	the child.
21.19 	(f) The court may not order or continue the foster care placement of the child unless the 
21.20 	court makes explicit, individualized findings that continued custody of the child by the 
21.21 	parent or guardian would be contrary to the welfare of the child and that placement is in the 
21.22 	best interest of the child.
21.23 	(g) At the emergency removal hearing, or at any time during the course of the proceeding, 
21.24 	and upon notice and request of the county attorney, the court shall determine whether a 
21.25 	petition has been filed stating a prima facie case that:
21.26 	(1) the parent has subjected a child to egregious harm as defined in section 260C.007, 
21.27 	subdivision 14;
21.28 	(2) the parental rights of the parent to another child have been involuntarily terminated;
21.29 	(3) the child is an abandoned infant under section 260C.301, subdivision 2, paragraph 
21.30 	(a), clause (2);
21.31 	(4) the parents' custodial rights to another child have been involuntarily transferred to a 
21.32 	relative under Minnesota Statutes 2010, section 260C.201, subdivision 11, paragraph (e), 
21.33 	clause (1); section 260C.515, subdivision 4; or a similar law of another jurisdiction;
22.1 	(5) the parent has committed sexual abuse as defined in section 626.556, subdivision 2, 
22.2 	against the child or another child of the parent;
22.3 	(6) the parent has committed an offense that requires registration as a predatory offender 
22.4 	under section 243.166, subdivision 1b, paragraph (a) or (b); or
22.5 	(7) the provision of services or further services for the purpose of reunification is futile 
22.6 	and therefore unreasonable.
22.7 	(h) When a petition to terminate parental rights is required under section 260C.301, 
22.8 	subdivision 4, or 260C.503, subdivision 2, but the county attorney has determined not to 
22.9 	proceed with a termination of parental rights petition, and has instead filed a petition to 
22.10 	transfer permanent legal and physical custody to a relative under section 260C.507, the 
22.11 	court shall schedule a permanency hearing within 30 days of the filing of the petition.
22.12 	(i) If the county attorney has filed a petition under section 260C.307, the court shall 
22.13 	schedule a trial under section 260C.163 within 90 days of the filing of the petition except 
22.14 	when the county attorney determines that the criminal case shall proceed to trial first under 
22.15 	section 260C.503, subdivision 2, paragraph (c).
22.16 	(j) If the court determines the child should be ordered into foster care and the child's 
22.17 	parent refuses to give information to the responsible social services agency regarding the 
22.18 	child's father or relatives of the child, the court may order the parent to disclose the names, 
22.19 	addresses, telephone numbers, and other identifying information to the responsible social 
22.20 	services agency for the purpose of complying with sections 260C.151, 260C.212, 260C.215,
22.21 	and 260C.221.
22.22 	(k) If a child ordered into foster care has siblings, whether full, half, or step, who are 
22.23 	also ordered into foster care, the court shall inquire of the responsible social services agency 
22.24 	of the efforts to place the children together as required by section 260C.212, subdivision 2, 
22.25 	paragraph (d), if placement together is in each child's best interests, unless a child is in 
22.26 	placement for treatment or a child is placed with a previously noncustodial parent who is 
22.27 	not a parent to all siblings. If the children are not placed together at the time of the hearing, 
22.28 	the court shall inquire at each subsequent hearing of the agency's reasonable efforts to place 
22.29 	the siblings together, as required under section 260.012. If any sibling is not placed with 
22.30 	another sibling or siblings, the agency must develop a plan to facilitate visitation or ongoing 
22.31 	contact among the siblings as required under section 260C.212, subdivision 1, unless it is 
22.32 	contrary to the safety or well-being of any of the siblings to do so.
22.33 	(l) When the court has ordered the child into foster care or into the home of a noncustodial 
22.34 	parent, the court may order a chemical dependency evaluation, mental health evaluation, 
23.1 	medical examination, and parenting assessment for the parent as necessary to support the 
23.2 	development of a plan for reunification required under subdivision 7 and section 260C.212, 
23.3 	subdivision 1, or the child protective services plan under section 626.556, subdivision 10, 
23.4 	and Minnesota Rules, part 9560.0228.

23.5 	Sec. 26. [260C.190] FAMILY-FOCUSED RESIDENTIAL PLACEMENT.
23.6 		Subdivision 1.Placement. (a) An agency with legal responsibility for a child under 
23.7 	section 260C.178, subdivision 1, paragraph (c), or legal custody of a child under section 
23.8 	260C.201, subdivision 1, paragraph (a), clause (3), may colocate a child with a parent who 
23.9 	is receiving services in a licensed residential family-based substance use disorder treatment 
23.10 	program for up to 12 months.
23.11 	(b) During the child's placement under paragraph (a), the agency: (1) may visit the child 
23.12 	as the agency deems necessary and appropriate; (2) shall continue to have access to 
23.13 	information under section 260C.208; and (3) shall continue to provide appropriate services 
23.14 	to both the parent and the child.
23.15 	(c) The agency may terminate the child's placement under paragraph (a) to protect the 
23.16 	child's health, safety, or welfare and may remove the child to foster care without a prior 
23.17 	court order or authorization.
23.18 		Subd. 2.Case plans. (a) Before a child may be colocated with a parent in a licensed 
23.19 	residential family-based substance use disorder treatment program, a recommendation that 
23.20 	the child's placement with a parent is in the child's best interests must be documented in the 
23.21 	child's case plan. Each child must have a written case plan developed with the parent and 
23.22 	the treatment program staff that describes the safety plan for the child and the treatment 
23.23 	program's responsibilities if the parent leaves or is discharged without completing the 
23.24 	program. The treatment program must be provided with a copy of the case plan that includes 
23.25 	the recommendations and safety plan at the time the child is colocated with the parent.
23.26 	(b) An out-of-home placement plan under section 260C.212, subdivision 1, must be 
23.27 	completed no later than 30 days from when a child is colocated with a parent in a licensed 
23.28 	residential family-based substance use disorder treatment program. The written plan 
23.29 	developed with parent and treatment program staff in paragraph (a) may be updated and 
23.30 	must be incorporated into the out-of-home placement plan. The treatment program must be 
23.31 	provided with a copy of the child's out-of-home placement plan.
23.32 		Subd. 3.Required reviews and permanency proceedings. (a) For a child colocated 
23.33 	with a parent under subdivision 1, court reviews must occur according to section 260C.202.
24.1 	(b) If a child has been in foster care for six months, a court review under section 260C.202 
24.2 	may be conducted in lieu of a permanency progress review hearing under section 260C.204 
24.3 	when the child is colocated with a parent consistent with section 260C.503, subdivision 3, 
24.4 	paragraph (c), in a licensed residential family-based substance use disorder treatment 
24.5 	program.
24.6 	(c) If the child is colocated with a parent in a licensed residential family-based substance 
24.7 	use disorder treatment program 12 months after the child was placed in foster care, the 
24.8 	agency must file a report with the court regarding the parent's progress in the treatment 
24.9 	program and the agency's reasonable efforts to finalize the child's safe and permanent return 
24.10 	to the care and custody of the parent consistent with section 260C.503, subdivision 3, 
24.11 	paragraph (c), in lieu of filing a petition required under section 260C.505.
24.12 	(d) The court shall make findings regarding the reasonable efforts of the agency to 
24.13 	finalize the child's return home as the permanency disposition order in the child's best 
24.14 	interests. The court may continue the child's foster care placement colocated with a parent 
24.15 	in a licensed residential family-based substance use disorder treatment program for up to 
24.16 	12 months. When a child has been in foster care placement for 12 months, but the duration 
24.17 	of the colocation with a parent in a licensed residential family-based substance use disorder 
24.18 	treatment program is less than 12 months, the court may continue the colocation with the 
24.19 	total time spent in foster care not exceeding 15 out of the most recent 22 months. If the 
24.20 	court finds that the agency fails to make reasonable efforts to finalize the child's return home 
24.21 	as the permanency disposition order in the child's best interests, the court may order additional 
24.22 	efforts to support the child remaining in the care of the parent.
24.23 	(e) If a parent leaves or is discharged from a licensed residential family-based substance 
24.24 	use disorder treatment program without completing the program, the child's placement under 
24.25 	this section is terminated and the agency may remove the child to foster care without a prior 
24.26 	court order or authorization. Within three days of any termination of a child's placement, 
24.27 	the agency shall notify the court and each party.
24.28 	(f) If a parent leaves or is discharged from a licensed residential family-based substance 
24.29 	use disorder treatment program without completing the program and the child has been in 
24.30 	foster care for less than six months, the court must hold a review hearing within ten days 
24.31 	of receiving notice of a termination of a child's placement and must order an alternative 
24.32 	disposition under section 260C.201.
24.33 	(g) If a parent leaves or is discharged from a licensed residential family-based substance 
24.34 	use disorder treatment program without completing the program and the child is colocated 
25.1 	with a parent and the child has been in foster care for more than six months but less than 
25.2 	12 months, the court must conduct a permanency progress review hearing under section 
25.3 	260C.204 no later than 30 days after the day the parent leaves or is discharged.
25.4 	(h) If a parent leaves or is discharged from a licensed residential family-based substance 
25.5 	use disorder treatment program without completing the program and the child is colocated 
25.6 	with a parent and the child has been in foster care for more than 12 months, the court shall 
25.7 	begin permanency proceedings under sections 260C.503 to 260C.521.

25.8 	Sec. 27. Minnesota Statutes 2018, section 260C.201, subdivision 1, is amended to read:
25.9 		Subdivision 1.Dispositions. (a) If the court finds that the child is in need of protection 
25.10 	or services or neglected and in foster care, it shall enter an order making any of the following 
25.11 	dispositions of the case:
25.12 	(1) place the child under the protective supervision of the responsible social services 
25.13 	agency or child-placing agency in the home of a parent of the child under conditions 
25.14 	prescribed by the court directed to the correction of the child's need for protection or services:
25.15 	(i) the court may order the child into the home of a parent who does not otherwise have 
25.16 	legal custody of the child, however, an order under this section does not confer legal custody 
25.17 	on that parent;
25.18 	(ii) if the court orders the child into the home of a father who is not adjudicated, the 
25.19 	father must cooperate with paternity establishment proceedings regarding the child in the 
25.20 	appropriate jurisdiction as one of the conditions prescribed by the court for the child to 
25.21 	continue in the father's home; and
25.22 	(iii) the court may order the child into the home of a noncustodial parent with conditions 
25.23 	and may also order both the noncustodial and the custodial parent to comply with the 
25.24 	requirements of a case plan under subdivision 2; or
25.25 	(2) transfer legal custody to one of the following:
25.26 	(i) a child-placing agency; or
25.27 	(ii) the responsible social services agency. In making a foster care placement for a child 
25.28 	whose custody has been transferred under this subdivision, the agency shall make an 
25.29 	individualized determination of how the placement is in the child's best interests using the 
25.30 	consideration for relatives and, the best interest factors in section 260C.212, subdivision 2, 
25.31 	paragraph (b), and may include a child colocated with a parent in a licensed residential 
25.32 	family-based substance use disorder treatment program under section 260C.190; or
26.1 	(3) order a trial home visit without modifying the transfer of legal custody to the 
26.2 	responsible social services agency under clause (2). Trial home visit means the child is 
26.3 	returned to the care of the parent or guardian from whom the child was removed for a period 
26.4 	not to exceed six months. During the period of the trial home visit, the responsible social 
26.5 	services agency:
26.6 	(i) shall continue to have legal custody of the child, which means the agency may see 
26.7 	the child in the parent's home, at school, in a child care facility, or other setting as the agency 
26.8 	deems necessary and appropriate;
26.9 	(ii) shall continue to have the ability to access information under section 260C.208;
26.10 	(iii) shall continue to provide appropriate services to both the parent and the child during 
26.11 	the period of the trial home visit;
26.12 	(iv) without previous court order or authorization, may terminate the trial home visit in 
26.13 	order to protect the child's health, safety, or welfare and may remove the child to foster care;
26.14 	(v) shall advise the court and parties within three days of the termination of the trial 
26.15 	home visit when a visit is terminated by the responsible social services agency without a 
26.16 	court order; and
26.17 	(vi) shall prepare a report for the court when the trial home visit is terminated whether 
26.18 	by the agency or court order which describes the child's circumstances during the trial home 
26.19 	visit and recommends appropriate orders, if any, for the court to enter to provide for the 
26.20 	child's safety and stability. In the event a trial home visit is terminated by the agency by 
26.21 	removing the child to foster care without prior court order or authorization, the court shall 
26.22 	conduct a hearing within ten days of receiving notice of the termination of the trial home 
26.23 	visit by the agency and shall order disposition under this subdivision or conduct a permanency 
26.24 	hearing under subdivision 11 or 11a commence permanency proceedings under sections 
26.25 	260C.503 to 260C.515. The time period for the hearing may be extended by the court for 
26.26 	good cause shown and if it is in the best interests of the child as long as the total time the 
26.27 	child spends in foster care without a permanency hearing does not exceed 12 months;
26.28 	(4) if the child has been adjudicated as a child in need of protection or services because 
26.29 	the child is in need of special services or care to treat or ameliorate a physical or mental 
26.30 	disability or emotional disturbance as defined in section 245.4871, subdivision 15, the court 
26.31 	may order the child's parent, guardian, or custodian to provide it. The court may order the 
26.32 	child's health plan company to provide mental health services to the child. Section 62Q.535
26.33 	applies to an order for mental health services directed to the child's health plan company. 
26.34 	If the health plan, parent, guardian, or custodian fails or is unable to provide this treatment 
27.1 	or care, the court may order it provided. Absent specific written findings by the court that 
27.2 	the child's disability is the result of abuse or neglect by the child's parent or guardian, the 
27.3 	court shall not transfer legal custody of the child for the purpose of obtaining special 
27.4 	treatment or care solely because the parent is unable to provide the treatment or care. If the 
27.5 	court's order for mental health treatment is based on a diagnosis made by a treatment 
27.6 	professional, the court may order that the diagnosing professional not provide the treatment 
27.7 	to the child if it finds that such an order is in the child's best interests; or
27.8 	(5) if the court believes that the child has sufficient maturity and judgment and that it is 
27.9 	in the best interests of the child, the court may order a child 16 years old or older to be 
27.10 	allowed to live independently, either alone or with others as approved by the court under 
27.11 	supervision the court considers appropriate, if the county board, after consultation with the 
27.12 	court, has specifically authorized this dispositional alternative for a child.
27.13 	(b) If the child was adjudicated in need of protection or services because the child is a 
27.14 	runaway or habitual truant, the court may order any of the following dispositions in addition 
27.15 	to or as alternatives to the dispositions authorized under paragraph (a):
27.16 	(1) counsel the child or the child's parents, guardian, or custodian;
27.17 	(2) place the child under the supervision of a probation officer or other suitable person 
27.18 	in the child's own home under conditions prescribed by the court, including reasonable rules 
27.19 	for the child's conduct and the conduct of the parents, guardian, or custodian, designed for 
27.20 	the physical, mental, and moral well-being and behavior of the child;
27.21 	(3) subject to the court's supervision, transfer legal custody of the child to one of the 
27.22 	following:
27.23 	(i) a reputable person of good moral character. No person may receive custody of two 
27.24 	or more unrelated children unless licensed to operate a residential program under sections 
27.25 	245A.01 to 245A.16; or
27.26 	(ii) a county probation officer for placement in a group foster home established under 
27.27 	the direction of the juvenile court and licensed pursuant to section 241.021;
27.28 	(4) require the child to pay a fine of up to $100. The court shall order payment of the 
27.29 	fine in a manner that will not impose undue financial hardship upon the child;
27.30 	(5) require the child to participate in a community service project;
27.31 	(6) order the child to undergo a chemical dependency evaluation and, if warranted by 
27.32 	the evaluation, order participation by the child in a drug awareness program or an inpatient 
27.33 	or outpatient chemical dependency treatment program;
28.1 	(7) if the court believes that it is in the best interests of the child or of public safety that 
28.2 	the child's driver's license or instruction permit be canceled, the court may order the 
28.3 	commissioner of public safety to cancel the child's license or permit for any period up to 
28.4 	the child's 18th birthday. If the child does not have a driver's license or permit, the court 
28.5 	may order a denial of driving privileges for any period up to the child's 18th birthday. The 
28.6 	court shall forward an order issued under this clause to the commissioner, who shall cancel 
28.7 	the license or permit or deny driving privileges without a hearing for the period specified 
28.8 	by the court. At any time before the expiration of the period of cancellation or denial, the 
28.9 	court may, for good cause, order the commissioner of public safety to allow the child to 
28.10 	apply for a license or permit, and the commissioner shall so authorize;
28.11 	(8) order that the child's parent or legal guardian deliver the child to school at the 
28.12 	beginning of each school day for a period of time specified by the court; or
28.13 	(9) require the child to perform any other activities or participate in any other treatment 
28.14 	programs deemed appropriate by the court.
28.15 	To the extent practicable, the court shall enter a disposition order the same day it makes 
28.16 	a finding that a child is in need of protection or services or neglected and in foster care, but 
28.17 	in no event more than 15 days after the finding unless the court finds that the best interests 
28.18 	of the child will be served by granting a delay. If the child was under eight years of age at 
28.19 	the time the petition was filed, the disposition order must be entered within ten days of the 
28.20 	finding and the court may not grant a delay unless good cause is shown and the court finds 
28.21 	the best interests of the child will be served by the delay.
28.22 	(c) If a child who is 14 years of age or older is adjudicated in need of protection or 
28.23 	services because the child is a habitual truant and truancy procedures involving the child 
28.24 	were previously dealt with by a school attendance review board or county attorney mediation 
28.25 	program under section 260A.06 or 260A.07, the court shall order a cancellation or denial 
28.26 	of driving privileges under paragraph (b), clause (7), for any period up to the child's 18th 
28.27 	birthday.
28.28 	(d) In the case of a child adjudicated in need of protection or services because the child 
28.29 	has committed domestic abuse and been ordered excluded from the child's parent's home, 
28.30 	the court shall dismiss jurisdiction if the court, at any time, finds the parent is able or willing 
28.31 	to provide an alternative safe living arrangement for the child, as defined in Laws 1997, 
28.32 	chapter 239, article 10, section 2.
28.33 	(e) When a parent has complied with a case plan ordered under subdivision 6 and the 
28.34 	child is in the care of the parent, the court may order the responsible social services agency 
29.1 	to monitor the parent's continued ability to maintain the child safely in the home under such 
29.2 	terms and conditions as the court determines appropriate under the circumstances.

29.3 	Sec. 28. Minnesota Statutes 2018, section 260C.201, subdivision 2, is amended to read:
29.4 		Subd. 2.Written findings. (a) Any order for a disposition authorized under this section 
29.5 	shall contain written findings of fact to support the disposition and case plan ordered and 
29.6 	shall also set forth in writing the following information:
29.7 	(1) why the best interests and safety of the child are served by the disposition and case 
29.8 	plan ordered;
29.9 	(2) what alternative dispositions or services under the case plan were considered by the 
29.10 	court and why such dispositions or services were not appropriate in the instant case;
29.11 	(3) when legal custody of the child is transferred, the appropriateness of the particular 
29.12 	placement made or to be made by the placing agency using the factors in section 260C.212, 
29.13 	subdivision 2, paragraph (b), or the appropriateness of a child colocated with a parent in a 
29.14 	licensed residential family-based substance use disorder treatment program under section 
29.15 	260C.190;
29.16 	(4) whether reasonable efforts to finalize the permanent plan for the child consistent 
29.17 	with section 260.012 were made including reasonable efforts:
29.18 	(i) to prevent the child's placement and to reunify the child with the parent or guardian 
29.19 	from whom the child was removed at the earliest time consistent with the child's safety. 
29.20 	The court's findings must include a brief description of what preventive and reunification 
29.21 	efforts were made and why further efforts could not have prevented or eliminated the 
29.22 	necessity of removal or that reasonable efforts were not required under section 260.012 or 
29.23 	260C.178, subdivision 1;
29.24 	(ii) to identify and locate any noncustodial or nonresident parent of the child and to 
29.25 	assess such parent's ability to provide day-to-day care of the child, and, where appropriate, 
29.26 	provide services necessary to enable the noncustodial or nonresident parent to safely provide 
29.27 	day-to-day care of the child as required under section 260C.219, unless such services are 
29.28 	not required under section 260.012 or 260C.178, subdivision 1;
29.29 	(iii) to make the diligent search for relatives and provide the notices required under 
29.30 	section 260C.221; a finding made pursuant to a hearing under section 260C.202 that the 
29.31 	agency has made diligent efforts to conduct a relative search and has appropriately engaged 
29.32 	relatives who responded to the notice under section 260C.221 and other relatives, who came 
30.1 	to the attention of the agency after notice under section 260C.221 was sent, in placement 
30.2 	and case planning decisions fulfills the requirement of this item;
30.3 	(iv) to identify and make a foster care placement in the home of an unlicensed relative, 
30.4 	according to the requirements of section 245A.035, a licensed relative, or other licensed 
30.5 	foster care provider who will commit to being the permanent legal parent or custodian for 
30.6 	the child in the event reunification cannot occur, but who will actively support the 
30.7 	reunification plan for the child; and
30.8 	(v) to place siblings together in the same home or to ensure visitation is occurring when 
30.9 	siblings are separated in foster care placement and visitation is in the siblings' best interests 
30.10 	under section 260C.212, subdivision 2, paragraph (d); and
30.11 	(5) if the child has been adjudicated as a child in need of protection or services because 
30.12 	the child is in need of special services or care to treat or ameliorate a mental disability or 
30.13 	emotional disturbance as defined in section 245.4871, subdivision 15, the written findings 
30.14 	shall also set forth:
30.15 	(i) whether the child has mental health needs that must be addressed by the case plan;
30.16 	(ii) what consideration was given to the diagnostic and functional assessments performed 
30.17 	by the child's mental health professional and to health and mental health care professionals' 
30.18 	treatment recommendations;
30.19 	(iii) what consideration was given to the requests or preferences of the child's parent or 
30.20 	guardian with regard to the child's interventions, services, or treatment; and
30.21 	(iv) what consideration was given to the cultural appropriateness of the child's treatment 
30.22 	or services.
30.23 	(b) If the court finds that the social services agency's preventive or reunification efforts 
30.24 	have not been reasonable but that further preventive or reunification efforts could not permit 
30.25 	the child to safely remain at home, the court may nevertheless authorize or continue the 
30.26 	removal of the child.
30.27 	(c) If the child has been identified by the responsible social services agency as the subject 
30.28 	of concurrent permanency planning, the court shall review the reasonable efforts of the 
30.29 	agency to develop a permanency plan for the child that includes a primary plan which is 
30.30 	for reunification with the child's parent or guardian and a secondary plan which is for an 
30.31 	alternative, legally permanent home for the child in the event reunification cannot be achieved 
30.32 	in a timely manner.

31.1 	Sec. 29. Minnesota Statutes 2018, section 260C.201, subdivision 6, is amended to read:
31.2 		Subd. 6.Case plan. (a) For each disposition ordered where the child is placed away 
31.3 	from a parent or guardian, the court shall order the responsible social services agency to 
31.4 	prepare a written out-of-home placement plan according to the requirements of section 
31.5 	260C.212, subdivision 1. When a foster child is colocated with a parent in a licensed 
31.6 	residential family-based substance use disorder treatment program under section 260C.190, 
31.7 	the case plan must specify the recommendation for the colocation before the child is colocated 
31.8 	with the parent.
31.9 	(b) In cases where the child is not placed out of the home or is ordered into the home of 
31.10 	a noncustodial parent, the responsible social services agency shall prepare a plan for delivery 
31.11 	of social services to the child and custodial parent under section 626.556, subdivision 10, 
31.12 	or any other case plan required to meet the needs of the child. The plan shall be designed 
31.13 	to safely maintain the child in the home or to reunite the child with the custodial parent.
31.14 	(c) The court may approve the case plan as presented or modify it after hearing from 
31.15 	the parties. Once the plan is approved, the court shall order all parties to comply with it. A 
31.16 	copy of the approved case plan shall be attached to the court's order and incorporated into 
31.17 	it by reference.
31.18 	(d) A party has a right to request a court review of the reasonableness of the case plan 
31.19 	upon a showing of a substantial change of circumstances.

31.20 	Sec. 30. Minnesota Statutes 2018, section 260C.212, subdivision 2, is amended to read:
31.21 		Subd. 2.Placement decisions based on best interests of the child. (a) The policy of 
31.22 	the state of Minnesota is to ensure that the child's best interests are met by requiring an 
31.23 	individualized determination of the needs of the child and of how the selected placement 
31.24 	will serve the needs of the child being placed. The authorized child-placing agency shall 
31.25 	place a child, released by court order or by voluntary release by the parent or parents, in a 
31.26 	family foster home selected by considering placement with relatives and important friends 
31.27 	in the following order:
31.28 	(1) with an individual who is related to the child by blood, marriage, or adoption; or
31.29 	(2) with an individual who is an important friend with whom the child has resided or 
31.30 	had significant contact.
31.31 	For an Indian child, the agency shall follow the order of placement preferences in the Indian 
31.32 	Child Welfare Act of 1978, United States Code, title 25, section 1915.
32.1 	(b) Among the factors the agency shall consider in determining the needs of the child 
32.2 	are the following:
32.3 	(1) the child's current functioning and behaviors;
32.4 	(2) the medical needs of the child;
32.5 	(3) the educational needs of the child;
32.6 	(4) the developmental needs of the child;
32.7 	(5) the child's history and past experience;
32.8 	(6) the child's religious and cultural needs;
32.9 	(7) the child's connection with a community, school, and faith community;
32.10 	(8) the child's interests and talents;
32.11 	(9) the child's relationship to current caretakers, parents, siblings, and relatives;
32.12 	(10) the reasonable preference of the child, if the court, or the child-placing agency in 
32.13 	the case of a voluntary placement, deems the child to be of sufficient age to express 
32.14 	preferences; and
32.15 	(11) for an Indian child, the best interests of an Indian child as defined in section 260.755, 
32.16 	subdivision 2a.
32.17 	(c) Placement of a child cannot be delayed or denied based on race, color, or national 
32.18 	origin of the foster parent or the child.
32.19 	(d) Siblings should be placed together for foster care and adoption at the earliest possible 
32.20 	time unless it is documented that a joint placement would be contrary to the safety or 
32.21 	well-being of any of the siblings or unless it is not possible after reasonable efforts by the 
32.22 	responsible social services agency. In cases where siblings cannot be placed together, the 
32.23 	agency is required to provide frequent visitation or other ongoing interaction between 
32.24 	siblings unless the agency documents that the interaction would be contrary to the safety 
32.25 	or well-being of any of the siblings.
32.26 	(e) Except for emergency placement as provided for in section 245A.035, the following 
32.27 	requirements must be satisfied before the approval of a foster or adoptive placement in a 
32.28 	related or unrelated home: (1) a completed background study under section 245C.08; and 
32.29 	(2) a completed review of the written home study required under section 260C.215, 
32.30 	subdivision 4, clause (5), or 260C.611, to assess the capacity of the prospective foster or 
32.31 	adoptive parent to ensure the placement will meet the needs of the individual child.
33.1 	(f) The agency must determine whether colocation with a parent who is receiving services 
33.2 	in a licensed residential family-based substance use disorder treatment program is in the 
33.3 	child's best interests according to paragraph (b) and include that determination in the child's 
33.4 	case plan. The agency may consider additional factors not identified in paragraph (b). The 
33.5 	agency's determination must be documented in the child's case plan before the child is 
33.6 	colocated with a parent.

33.7 	Sec. 31. [260C.228] VOLUNTARY FOSTER CARE; CHILD IS COLOCATED 
33.8 	WITH PARENT IN TREATMENT PROGRAM.
33.9 		Subdivision 1.Generally. When a parent requests assistance from an agency and both 
33.10 	the parent and agency agree that a child's placement in foster care and colocation with a 
33.11 	parent in a licensed residential family-based substance use treatment facility as defined by 
33.12 	section 260C.007, subdivision 22a, is in the child's best interests, the agency must specify 
33.13 	the recommendation for the placement in the child's case plan. After the child's case plan 
33.14 	includes the recommendation, the agency and the parent may enter into a written voluntary 
33.15 	placement agreement on a form approved by the commissioner.
33.16 		Subd. 2.Judicial review. (a) A judicial review of a child's voluntary placement is 
33.17 	required within 165 days of the date the voluntary agreement was signed. The agency 
33.18 	responsible for the child's placement in foster care shall request the judicial review.
33.19 	(b) The agency must forward a written report to the court at least five business days 
33.20 	prior to the judicial review in paragraph (a). The report must contain:
33.21 	(i) a statement regarding whether the colocation of the child with a parent in a licensed 
33.22 	residential family-based substance use disorder treatment program meets the child's needs 
33.23 	and continues to be in the child's best interests;
33.24 	(ii) the child's name, dates of birth, race, gender, and current address;
33.25 	(iii) the names, race, dates of birth, residences, and post office addresses of the child's 
33.26 	parents or custodian;
33.27 	(iv) a statement regarding the child's eligibility for membership or enrollment in an 
33.28 	Indian tribe and the agency's compliance with applicable provisions of sections 260.751 to 
33.29 	260.835;
33.30 	(v) the name and address of the licensed residential family-based substance use disorder 
33.31 	treatment program where the child and parent or custodian are colocated;
34.1 	(vi) a copy of the out-of-home placement plan under section 260C.212, subdivisions 1 
34.2 	and 3;
34.3 	(vii) a written summary of the proceedings of any administrative review required under 
34.4 	section 260C.203; and
34.5 	(viii) any other information the agency, parent or custodian, child, or licensed residential 
34.6 	family-based substance use disorder treatment program wants the court to consider.
34.7 	(c) The agency must inform a child, if the child is 12 years of age or older; the child's 
34.8 	parent; and the licensed residential family-based substance use disorder treatment program 
34.9 	of the reporting and court review requirements of this section and of their rights to submit 
34.10 	information to the court as follows:
34.11 	(1) if the child, the child's parent, or the licensed residential family-based substance use 
34.12 	disorder treatment program wants to send information to the court, the agency shall advise 
34.13 	those persons of the reporting date and the date by which the agency must receive the 
34.14 	information to submit to the court with the agency's report; and
34.15 	(2) the agency must inform the child, the child's parent, and the licensed residential 
34.16 	family-based substance use disorder treatment program that they have the right to be heard 
34.17 	in person by the court. An in-person hearing must be held if requested by the child, parent 
34.18 	or legal guardian, or licensed residential family-based substance use disorder treatment 
34.19 	program.
34.20 	(d) If, at the time required for the agency's report under this section, a child 12 years of 
34.21 	age or older disagrees about the placement colocating the child with the parent in a licensed 
34.22 	residential family-based substance use disorder treatment program or services provided 
34.23 	under the out-of-home placement plan under section 260C.212, subdivision 1, the agency 
34.24 	shall include information regarding the child's disagreement and to the extent possible the 
34.25 	basis for the child's disagreement in the report.
34.26 	(e) Regardless of whether an in-person hearing is requested within ten days of receiving 
34.27 	the agency's report, the court has jurisdiction to and must determine:
34.28 	(i) whether the voluntary foster care arrangement is in the child's best interests;
34.29 	(ii) whether the parent and agency are appropriately planning for the child; and
34.30 	(iii) if a child 12 years of age or older disagrees with the foster care placement colocating 
34.31 	the child with the parent in a licensed residential family-based substance use disorder 
34.32 	treatment program or services provided under the out-of-home placement plan, whether to 
34.33 	appoint counsel and a guardian ad litem for the child according to section 260C.163.
35.1 	(f) Unless requested by the parent, representative of the licensed residential family-based 
35.2 	substance use disorder treatment program, or child, an in-person hearing is not required for 
35.3 	the court to make findings and issue an order.
35.4 	(g) If the court finds the voluntary foster care arrangement is in the child's best interests 
35.5 	and that the agency and parent are appropriately planning for the child, the court shall issue 
35.6 	an order containing explicit individualized findings to support the court's determination. 
35.7 	The individual findings shall be based on the agency's written report and other materials 
35.8 	submitted to the court. The court may make this determination notwithstanding the child's 
35.9 	disagreement, if any, reported to the court under paragraph (d).
35.10 	(h) The court shall send a copy of the order to the county attorney, the agency, the parent, 
35.11 	a child 12 years of age or older, and the licensed residential family-based substance use 
35.12 	disorder treatment program.
35.13 	(i) If the court finds continuing the voluntary foster care arrangement is not in the child's 
35.14 	best interests or that the agency or the parent is not appropriately planning for the child, the 
35.15 	court shall notify the agency, the parent, the licensed residential family-based substance 
35.16 	use disorder treatment program, a child 12 years of age or older, and the county attorney of 
35.17 	the court's determination and the basis for the court's determination. The court shall set the 
35.18 	matter for hearing and appoint a guardian ad litem for the child under section 260C.163, 
35.19 	subdivision 5.
35.20 		Subd. 3.Termination. The voluntary placement agreement terminates at the parent's 
35.21 	discharge from the licensed residential family-based substance use disorder treatment 
35.22 	program, or upon receipt of a written and dated request from the parent, unless the request 
35.23 	specifies a later date. If the child's voluntary foster care placement meets the calculated time 
35.24 	to require a permanency proceeding under section 260C.503, subdivision 3, paragraph (a), 
35.25 	and the child is not returned home, the agency must file a petition according to section 
35.26 	260C.141 or 260C.505.

35.27 	Sec. 32. Minnesota Statutes 2018, section 260C.452, subdivision 4, is amended to read:
35.28 		Subd. 4.Administrative or court review of placements. (a) When the child is 14 years 
35.29 	of age or older, the court, in consultation with the child, shall review the independent living 
35.30 	plan according to section 260C.203, paragraph (d).
35.31 	(b) The responsible social services agency shall file a copy of the notification required 
35.32 	in subdivision 3 with the court. If the responsible social services agency does not file the 
36.1 	notice by the time the child is 17-1/2 years of age, the court shall require the responsible 
36.2 	social services agency to file the notice.
36.3 	(c) The court shall ensure that the responsible social services agency assists the child in 
36.4 	obtaining the following documents before the child leaves foster care: a Social Security 
36.5 	card; an official or certified copy of the child's birth certificate; a state identification card 
36.6 	or driver's license, tribal enrollment identification card, green card, or school visa; health 
36.7 	insurance information; the child's school, medical, and dental records; a contact list of the 
36.8 	child's medical, dental, and mental health providers; and contact information for the child's 
36.9 	siblings, if the siblings are in foster care.
36.10 	(d) For a child who will be discharged from foster care at 18 years of age or older, the 
36.11 	responsible social services agency must develop a personalized transition plan as directed 
36.12 	by the child during the 90-day period immediately prior to the expected date of discharge. 
36.13 	The transition plan must be as detailed as the child elects and include specific options, 
36.14 	including but not limited to:
36.15 	(1) affordable housing with necessary supports that does not include a homeless shelter;
36.16 	(2) health insurance, including eligibility for medical assistance as defined in section 
36.17 	256B.055, subdivision 17;
36.18 	(3) education, including application to the Education and Training Voucher Program;
36.19 	(4) local opportunities for mentors and continuing support services, including the Healthy 
36.20 	Transitions and Homeless Prevention program, if available;
36.21 	(5) workforce supports and employment services;
36.22 	(6) a copy of the child's consumer credit report as defined in section 13C.001 and 
36.23 	assistance in interpreting and resolving any inaccuracies in the report, at no cost to the child;
36.24 	(7) information on executing a health care directive under chapter 145C and on the 
36.25 	importance of designating another individual to make health care decisions on behalf of the 
36.26 	child if the child becomes unable to participate in decisions; and
36.27 	(8) appropriate contact information through 21 years of age if the child needs information 
36.28 	or help dealing with a crisis situation.; and
36.29 	(9) official documentation that the youth was previously in foster care.

37.1 	Sec. 33. Minnesota Statutes 2018, section 260C.503, subdivision 1, is amended to read:
37.2 		Subdivision 1.Required permanency proceedings. (a) Except for children in foster 
37.3 	care pursuant to chapter 260D, where the child is in foster care or in the care of a noncustodial 
37.4 	or nonresident parent, the court shall commence proceedings to determine the permanent 
37.5 	status of a child by holding the admit-deny hearing required under section 260C.507 not 
37.6 	later than 12 months after the child is placed in foster care or in the care of a noncustodial 
37.7 	or nonresident parent. Permanency proceedings for children in foster care pursuant to chapter 
37.8 	260D shall be according to section 260D.07.
37.9 	(b) Permanency proceedings for a foster child who is colocated with a parent in a licensed 
37.10 	residential family-based substance use disorder treatment program shall be conducted 
37.11 	according to section 260C.190.

37.12 	Sec. 34. Minnesota Statutes 2018, section 518A.32, subdivision 3, is amended to read:
37.13 		Subd. 3.Parent not considered voluntarily unemployed, underemployed, or employed 
37.14 	on a less than full-time basis. A parent is not considered voluntarily unemployed, 
37.15 	underemployed, or employed on a less than full-time basis upon a showing by the parent 
37.16 	that:
37.17 	(1) the unemployment, underemployment, or employment on a less than full-time basis 
37.18 	is temporary and will ultimately lead to an increase in income;
37.19 	(2) the unemployment, underemployment, or employment on a less than full-time basis 
37.20 	represents a bona fide career change that outweighs the adverse effect of that parent's 
37.21 	diminished income on the child; or
37.22 	(3) the unemployment, underemployment, or employment on a less than full-time basis 
37.23 	is because a parent is physically or mentally incapacitated or due to incarceration, except 
37.24 	where the reason for incarceration is the parent's nonpayment of support.

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

37.26 	Sec. 35. Minnesota Statutes 2018, section 518A.51, is amended to read:
37.27 	518A.51 FEES FOR IV-D SERVICES.
37.28 	(a) When a recipient of IV-D services is no longer receiving assistance under the state's 
37.29 	title IV-A, IV-E foster care, or medical assistance programs, the public authority responsible 
37.30 	for child support enforcement must notify the recipient, within five working days of the 
37.31 	notification of ineligibility, that IV-D services will be continued unless the public authority 
38.1 	is notified to the contrary by the recipient. The notice must include the implications of 
38.2 	continuing to receive IV-D services, including the available services and fees, cost recovery 
38.3 	fees, and distribution policies relating to fees.
38.4 	(b) In the case of an individual who has never received assistance under a state program 
38.5 	funded under title IV-A of the Social Security Act and for whom the public authority has 
38.6 	collected at least $500 $550 of support, the public authority must impose an annual federal 
38.7 	collections fee of $25 $35 for each case in which services are furnished. This fee must be 
38.8 	retained by the public authority from support collected on behalf of the individual, but not 
38.9 	from the first $500 $550 collected.
38.10 	(c) When the public authority provides full IV-D services to an obligee who has applied 
38.11 	for those services, upon written notice to the obligee, the public authority must charge a 
38.12 	cost recovery fee of two percent of the amount collected. This fee must be deducted from 
38.13 	the amount of the child support and maintenance collected and not assigned under section 
38.14 	256.741 before disbursement to the obligee. This fee does not apply to an obligee who:
38.15 	(1) is currently receiving assistance under the state's title IV-A, IV-E foster care, or 
38.16 	medical assistance programs; or
38.17 	(2) has received assistance under the state's title IV-A or IV-E foster care programs, 
38.18 	until the person has not received this assistance for 24 consecutive months.
38.19 	(d) When the public authority provides full IV-D services to an obligor who has applied 
38.20 	for such services, upon written notice to the obligor, the public authority must charge a cost 
38.21 	recovery fee of two percent of the monthly court-ordered child support and maintenance 
38.22 	obligation. The fee may be collected through income withholding, as well as by any other 
38.23 	enforcement remedy available to the public authority responsible for child support 
38.24 	enforcement.
38.25 	(e) Fees assessed by state and federal tax agencies for collection of overdue support 
38.26 	owed to or on behalf of a person not receiving public assistance must be imposed on the 
38.27 	person for whom these services are provided. The public authority upon written notice to 
38.28 	the obligee shall assess a fee of $25 to the person not receiving public assistance for each 
38.29 	successful federal tax interception. The fee must be withheld prior to the release of the funds 
38.30 	received from each interception and deposited in the general fund.
38.31 	(f) Federal collections fees collected under paragraph (b) and cost recovery fees collected 
38.32 	under paragraphs (c) and (d) retained by the commissioner of human services shall be 
38.33 	considered child support program income according to Code of Federal Regulations, title 
38.34 	45, section 304.50, and shall be deposited in the special revenue fund account established 
39.1 	under paragraph (h). The commissioner of human services must elect to recover costs based 
39.2 	on either actual or standardized costs.
39.3 	(g) The limitations of this section on the assessment of fees shall not apply to the extent 
39.4 	inconsistent with the requirements of federal law for receiving funds for the programs under 
39.5 	title IV-A and title IV-D of the Social Security Act, United States Code, title 42, sections 
39.6 	601 to 613 and United States Code, title 42, sections 651 to 662.
39.7 	(h) The commissioner of human services is authorized to establish a special revenue 
39.8 	fund account to receive the federal collections fees collected under paragraph (b) and cost 
39.9 	recovery fees collected under paragraphs (c) and (d).
39.10 	(i) The nonfederal share of the cost recovery fee revenue must be retained by the 
39.11 	commissioner and distributed as follows:
39.12 	(1) one-half of the revenue must be transferred to the child support system special revenue 
39.13 	account to support the state's administration of the child support enforcement program and 
39.14 	its federally mandated automated system;
39.15 	(2) an additional portion of the revenue must be transferred to the child support system 
39.16 	special revenue account for expenditures necessary to administer the fees; and
39.17 	(3) the remaining portion of the revenue must be distributed to the counties to aid the 
39.18 	counties in funding their child support enforcement programs.
39.19 	(j) The nonfederal share of the federal collections fees must be distributed to the counties 
39.20 	to aid them in funding their child support enforcement programs.
39.21 	(k) The commissioner of human services shall distribute quarterly any of the funds 
39.22 	dedicated to the counties under paragraphs (i) and (j) using the methodology specified in 
39.23 	section 256.979, subdivision 11. The funds received by the counties must be reinvested in 
39.24 	the child support enforcement program and the counties must not reduce the funding of 
39.25 	their child support programs by the amount of the funding distributed.

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

39.27 	Sec. 36. INSTRUCTION TO COMMISSIONER.
 39.28 	All individuals in connection with a licensed children's residential facility required to 
39.29 	complete a background study under Minnesota Statutes, chapter 245C, must complete a 
39.30 	new background study consistent with the obligations and requirements of this article. The 
39.31 	commissioner of human services shall establish a schedule for (1) individuals in connection 
39.32 	with a licensed children's residential facility that serves children eligible to receive federal 
40.1 	Title IV-E funding to complete the new background study by March 1, 2020, and (2) 
40.2 	individuals in connection with a licensed children's residential facility that serves children 
40.3 	not eligible to receive federal Title IV-E funding to complete the new background study by 
40.4 	March 1, 2021.

40.5 	Sec. 37. CHILD WELFARE TRAINING ACADEMY.
 40.6 		Subdivision 1.Establishment; purpose. The commissioner of human services shall 
40.7 	modify the Child Welfare Training System developed pursuant to Minnesota Statutes, 
40.8 	section 626.5591, subdivision 2, according to this section. The new training framework 
40.9 	shall be known as the Child Welfare Training Academy.
40.10 		Subd. 2.Administration. (a) The Child Welfare Training Academy must be administered 
40.11 	through five regional hubs in northwest, northeast, southwest, southeast, and central 
40.12 	Minnesota. Each hub must deliver training targeted to the needs of the hub's particular 
40.13 	region, taking into account varying demographics, resources, and practice outcomes.
40.14 	(b) The Child Welfare Training Academy must use training methods best suited to the 
40.15 	training content. National best practices in adult learning must be used to the greatest extent 
40.16 	possible, including online learning methodologies, coaching, mentoring, and simulated skill 
40.17 	application.
40.18 	(c) Content of training delivered by the Child Welfare Training Academy must be 
40.19 	informed using multidisciplinary approaches and must include input from stakeholders, 
40.20 	including but not limited to child welfare professionals, resource parents, biological parents 
40.21 	and caregivers, and other community members with expertise in child welfare racial 
40.22 	disparities and implicit bias. Content must be structured to reflect the variety of communities 
40.23 	served by the child welfare system in Minnesota and must be informed with attention to 
40.24 	both child safety and the evidence-based understanding that maintaining family relationships 
40.25 	and preventing out-of-home placement are essential to child well-being. Training delivered 
40.26 	by the Child Welfare Training Academy must emphasize racial disparities and 
40.27 	disproportionate child welfare outcomes that exist in Minnesota and must include specific 
40.28 	content on recognizing and addressing implicit bias.
40.29 	(d) Each child welfare worker and supervisor must complete a certification, including 
40.30 	a competency-based knowledge test and a skills demonstration, at the completion of the 
40.31 	worker's or supervisor's initial training and biennially thereafter. The commissioner shall 
40.32 	develop ongoing training requirements and a method for tracking certifications.
41.1 	(e) The Child Welfare Training Academy must serve the primary training audiences of 
41.2 	(1) county and tribal child welfare workers, (2) county and tribal child welfare supervisors, 
41.3 	and (3) staff at private agencies providing out-of-home placement services for children 
41.4 	involved in Minnesota's county and tribal child welfare system.
41.5 		Subd. 3.Partnerships.  The commissioner of human services shall enter into a partnership 
41.6 	with the University of Minnesota to collaborate in the administration of workforce training.
41.7 		Subd. 4.Rulemaking. The commissioner of human services may adopt rules as necessary 
41.8 	to establish the Child Welfare Training Academy.

41.9 	Sec. 38. CHILD WELFARE CASELOAD STUDY.
 41.10 	(a) The commissioner of human services shall conduct a child welfare caseload study 
41.11 	to collect data on (1) the number of child welfare workers in Minnesota, and (2) the amount 
41.12 	of time that child welfare workers spend on different components of child welfare work. 
41.13 	The study must be completed by October 1, 2020.
41.14 	(b) The commissioner shall report the results of the child welfare caseload study to the 
41.15 	governor and to the chairs and ranking minority members of the committees in the house 
41.16 	of representatives and senate with jurisdiction over human services by December 1, 2020.
41.17 	(c) After the child welfare caseload study is complete, the commissioner shall work with 
41.18 	counties and other stakeholders to develop a process for ongoing monitoring of child welfare 
41.19 	workers' caseloads.

41.20 	Sec. 39. DIRECTION TO COMMISSIONER; HOMELESS YOUTH ACCESS TO 
41.21 	BIRTH RECORDS AND MINNESOTA IDENTIFICATION CARDS.
 41.22 	No later than January 15, 2020, the commissioner of human services, in consultation 
41.23 	with the commissioners of health and public safety, shall report to the chairs and ranking 
41.24 	minority members of the legislative committees and divisions with jurisdiction over the 
41.25 	Homeless Youth Act with recommendations on providing homeless youth with access to 
41.26 	birth records and Minnesota identification cards at no cost.

41.27 	Sec. 40. DIRECTION TO COMMISSIONER; FAMILY FIRST PREVENTION 
41.28 	KINSHIP SERVICES.
 41.29 	The commissioner of human services shall review opportunities to implement kinship 
41.30 	navigator models that support placement of children with relative foster parents in anticipation 
41.31 	of reimbursement for eligible services under the Family First Prevention Services Act. 
42.1 	Kinship navigator models would assist relative foster parents with home studies and licensing 
42.2 	requirements and provide ongoing support to the relative caregivers and children  in 
42.3 	out-of-home placement with relatives.

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

42.5 	Sec. 41. DIRECTION TO COMMISSIONER; RELATIVE SEARCH.
 42.6 	The commissioner of human services shall develop and provide guidance to assist local 
42.7 	social services agencies in conducting relative searches under Minnesota Statutes, section 
42.8 	260C.221. The commissioner shall issue a bulletin containing relative search guidance by 
42.9 	January 1, 2020. Guidance from the commissioner shall relate to:
42.10 	(1) easily understandable methods of relative notification;
42.11 	(2) resources for local social services agency child welfare staff to improve engagement 
42.12 	and communication with relatives and kin; and
42.13 	(3) providing information to relatives and kin about all permanency options, sustaining 
42.14 	relationships, visitation options, and supporting permanency.

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

42.16 	Sec. 42. REVISOR INSTRUCTION.
 42.17 	The revisor of statutes, in consultation with the Department of Human Services, House 
42.18 	Research Department, and Senate Counsel, Research and Fiscal Analysis shall change the 
42.19 	terms "food support" and "food stamps" to "Supplemental Nutrition Assistance Program" 
42.20 	or "SNAP" in Minnesota Statutes when appropriate. The revisor may make technical and 
42.21 	other necessary changes to sentence structure to preserve the meaning of the text.

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

42.23 	Sec. 43. REPEALER.
 42.24 	Minnesota Statutes 2018, sections 119B.16, subdivision 2; and 245E.06, subdivisions 
42.25 	2, 4, and 5, and Minnesota Rules, part 3400.0185, subpart 5, are repealed effective February 
42.26 	26, 2021.

43.1 	ARTICLE 2
43.2 	OPERATIONS

43.3 	Section 1. Minnesota Statutes 2018, section 13.46, subdivision 2, is amended to read:
43.4 		Subd. 2.General. (a) Data on individuals collected, maintained, used, or disseminated 
43.5 	by the welfare system are private data on individuals, and shall not be disclosed except:
43.6 	(1) according to section 13.05;
43.7 	(2) according to court order;
43.8 	(3) according to a statute specifically authorizing access to the private data;
43.9 	(4) to an agent of the welfare system and an investigator acting on behalf of a county, 
43.10 	the state, or the federal government, including a law enforcement person or attorney in the 
43.11 	investigation or prosecution of a criminal, civil, or administrative proceeding relating to the 
43.12 	administration of a program;
43.13 	(5) to personnel of the welfare system who require the data to verify an individual's 
43.14 	identity; determine eligibility, amount of assistance, and the need to provide services to an 
43.15 	individual or family across programs; coordinate services for an individual or family; 
43.16 	evaluate the effectiveness of programs; assess parental contribution amounts; and investigate 
43.17 	suspected fraud;
43.18 	(6) to administer federal funds or programs;
43.19 	(7) between personnel of the welfare system working in the same program;
43.20 	(8) to the Department of Revenue to assess parental contribution amounts for purposes 
43.21 	of section 252.27, subdivision 2a, administer and evaluate tax refund or tax credit programs 
43.22 	and to identify individuals who may benefit from these programs. The following information 
43.23 	may be disclosed under this paragraph: an individual's and their dependent's names, dates 
43.24 	of birth, Social Security numbers, income, addresses, and other data as required, upon 
43.25 	request by the Department of Revenue. Disclosures by the commissioner of revenue to the 
43.26 	commissioner of human services for the purposes described in this clause are governed by 
43.27 	section 270B.14, subdivision 1. Tax refund or tax credit programs include, but are not limited 
43.28 	to, the dependent care credit under section 290.067, the Minnesota working family credit 
43.29 	under section 290.0671, the property tax refund and rental credit under section 290A.04, 
43.30 	and the Minnesota education credit under section 290.0674;
44.1 	(9) between the Department of Human Services, the Department of Employment and 
44.2 	Economic Development, and when applicable, the Department of Education, for the following 
44.3 	purposes:
44.4 	(i) to monitor the eligibility of the data subject for unemployment benefits, for any 
44.5 	employment or training program administered, supervised, or certified by that agency;
44.6 	(ii) to administer any rehabilitation program or child care assistance program, whether 
44.7 	alone or in conjunction with the welfare system;
44.8 	(iii) to monitor and evaluate the Minnesota family investment program or the child care 
44.9 	assistance program by exchanging data on recipients and former recipients of food support, 
44.10 	cash assistance under chapter 256, 256D, 256J, or 256K, child care assistance under chapter 
44.11 	119B, medical programs under chapter 256B or 256L, or a medical program formerly 
44.12 	codified under chapter 256D; and
44.13 	(iv) to analyze public assistance employment services and program utilization, cost, 
44.14 	effectiveness, and outcomes as implemented under the authority established in Title II, 
44.15 	Sections 201-204 of the Ticket to Work and Work Incentives Improvement Act of 1999. 
44.16 	Health records governed by sections 144.291 to 144.298 and "protected health information" 
44.17 	as defined in Code of Federal Regulations, title 45, section 160.103, and governed by Code 
44.18 	of Federal Regulations, title 45, parts 160-164, including health care claims utilization 
44.19 	information, must not be exchanged under this clause;
44.20 	(10) to appropriate parties in connection with an emergency if knowledge of the 
44.21 	information is necessary to protect the health or safety of the individual or other individuals 
44.22 	or persons;
44.23 	(11) data maintained by residential programs as defined in section 245A.02 may be 
44.24 	disclosed to the protection and advocacy system established in this state according to Part 
44.25 	C of Public Law 98-527 to protect the legal and human rights of persons with developmental 
44.26 	disabilities or other related conditions who live in residential facilities for these persons if 
44.27 	the protection and advocacy system receives a complaint by or on behalf of that person and 
44.28 	the person does not have a legal guardian or the state or a designee of the state is the legal 
44.29 	guardian of the person;
44.30 	(12) to the county medical examiner or the county coroner for identifying or locating 
44.31 	relatives or friends of a deceased person;
45.1 	(13) data on a child support obligor who makes payments to the public agency may be 
45.2 	disclosed to the Minnesota Office of Higher Education to the extent necessary to determine 
45.3 	eligibility under section 136A.121, subdivision 2, clause (5);
45.4 	(14) participant Social Security numbers and names collected by the telephone assistance 
45.5 	program may be disclosed to the Department of Revenue to conduct an electronic data 
45.6 	match with the property tax refund database to determine eligibility under section 237.70, 
45.7 	subdivision 4a;
45.8 	(15) the current address of a Minnesota family investment program participant may be 
45.9 	disclosed to law enforcement officers who provide the name of the participant and notify 
45.10 	the agency that:
45.11 	(i) the participant:
45.12 	(A) is a fugitive felon fleeing to avoid prosecution, or custody or confinement after 
45.13 	conviction, for a crime or attempt to commit a crime that is a felony under the laws of the 
45.14 	jurisdiction from which the individual is fleeing; or
45.15 	(B) is violating a condition of probation or parole imposed under state or federal law;
45.16 	(ii) the location or apprehension of the felon is within the law enforcement officer's 
45.17 	official duties; and
45.18 	(iii) the request is made in writing and in the proper exercise of those duties;
45.19 	(16) the current address of a recipient of general assistance may be disclosed to probation 
45.20 	officers and corrections agents who are supervising the recipient and to law enforcement 
45.21 	officers who are investigating the recipient in connection with a felony level offense;
45.22 	(17) information obtained from food support applicant or recipient households may be 
45.23 	disclosed to local, state, or federal law enforcement officials, upon their written request, for 
45.24 	the purpose of investigating an alleged violation of the Food Stamp Act, according to Code 
45.25 	of Federal Regulations, title 7, section 272.1(c);
45.26 	(18) the address, Social Security number, and, if available, photograph of any member 
45.27 	of a household receiving food support shall be made available, on request, to a local, state, 
45.28 	or federal law enforcement officer if the officer furnishes the agency with the name of the 
45.29 	member and notifies the agency that:
45.30 	(i) the member:
45.31 	(A) is fleeing to avoid prosecution, or custody or confinement after conviction, for a 
45.32 	crime or attempt to commit a crime that is a felony in the jurisdiction the member is fleeing;
46.1 	(B) is violating a condition of probation or parole imposed under state or federal law; 
46.2 	or
46.3 	(C) has information that is necessary for the officer to conduct an official duty related 
46.4 	to conduct described in subitem (A) or (B);
46.5 	(ii) locating or apprehending the member is within the officer's official duties; and
46.6 	(iii) the request is made in writing and in the proper exercise of the officer's official duty;
46.7 	(19) the current address of a recipient of Minnesota family investment program, general 
46.8 	assistance, or food support may be disclosed to law enforcement officers who, in writing, 
46.9 	provide the name of the recipient and notify the agency that the recipient is a person required 
46.10 	to register under section 243.166, but is not residing at the address at which the recipient is 
46.11 	registered under section 243.166;
46.12 	(20) certain information regarding child support obligors who are in arrears may be 
46.13 	made public according to section 518A.74;
46.14 	(21) data on child support payments made by a child support obligor and data on the 
46.15 	distribution of those payments excluding identifying information on obligees may be 
46.16 	disclosed to all obligees to whom the obligor owes support, and data on the enforcement 
46.17 	actions undertaken by the public authority, the status of those actions, and data on the income 
46.18 	of the obligor or obligee may be disclosed to the other party;
46.19 	(22) data in the work reporting system may be disclosed under section 256.998, 
46.20 	subdivision 7;
46.21 	(23) to the Department of Education for the purpose of matching Department of Education 
46.22 	student data with public assistance data to determine students eligible for free and 
46.23 	reduced-price meals, meal supplements, and free milk according to United States Code, 
46.24 	title 42, sections 1758, 1761, 1766, 1766a, 1772, and 1773; to allocate federal and state 
46.25 	funds that are distributed based on income of the student's family; and to verify receipt of 
46.26 	energy assistance for the telephone assistance plan;
46.27 	(24) the current address and telephone number of program recipients and emergency 
46.28 	contacts may be released to the commissioner of health or a community health board as 
46.29 	defined in section 145A.02, subdivision 5, when the commissioner or community health 
46.30 	board has reason to believe that a program recipient is a disease case, carrier, suspect case, 
46.31 	or at risk of illness, and the data are necessary to locate the person;
46.32 	(25) to other state agencies, statewide systems, and political subdivisions of this state, 
46.33 	including the attorney general, and agencies of other states, interstate information networks, 
47.1 	federal agencies, and other entities as required by federal regulation or law for the 
47.2 	administration of the child support enforcement program;
47.3 	(26) to personnel of public assistance programs as defined in section 256.741, for access 
47.4 	to the child support system database for the purpose of administration, including monitoring 
47.5 	and evaluation of those public assistance programs;
47.6 	(27) to monitor and evaluate the Minnesota family investment program by exchanging 
47.7 	data between the Departments of Human Services and Education, on recipients and former 
47.8 	recipients of food support, cash assistance under chapter 256, 256D, 256J, or 256K, child 
47.9 	care assistance under chapter 119B, medical programs under chapter 256B or 256L, or a 
47.10 	medical program formerly codified under chapter 256D;
47.11 	(28) to evaluate child support program performance and to identify and prevent fraud 
47.12 	in the child support program by exchanging data between the Department of Human Services, 
47.13 	Department of Revenue under section 270B.14, subdivision 1, paragraphs (a) and (b), 
47.14 	without regard to the limitation of use in paragraph (c), Department of Health, Department 
47.15 	of Employment and Economic Development, and other state agencies as is reasonably 
47.16 	necessary to perform these functions;
47.17 	(29) counties and the Department of Human Services operating child care assistance 
47.18 	programs under chapter 119B may disseminate data on program participants, applicants, 
47.19 	and providers to the commissioner of education;
47.20 	(30) child support data on the child, the parents, and relatives of the child may be 
47.21 	disclosed to agencies administering programs under titles IV-B and IV-E of the Social 
47.22 	Security Act, as authorized by federal law;
47.23 	(31) to a health care provider governed by sections 144.291 to 144.298, to the extent 
47.24 	necessary to coordinate services;
47.25 	(32) to the chief administrative officer of a school to coordinate services for a student 
47.26 	and family; data that may be disclosed under this clause are limited to name, date of birth, 
47.27 	gender, and address; or
47.28 	(33) to county correctional agencies to the extent necessary to coordinate services and 
47.29 	diversion programs; data that may be disclosed under this clause are limited to name, client 
47.30 	demographics, program, case status, and county worker information.
47.31 	(b) Information on persons who have been treated for drug or alcohol abuse may only 
47.32 	be disclosed according to the requirements of Code of Federal Regulations, title 42, sections 
47.33 	2.1 to 2.67.
48.1 	(c) Data provided to law enforcement agencies under paragraph (a), clause (15), (16), 
48.2 	(17), or (18), or paragraph (b), are investigative data and are confidential or protected 
48.3 	nonpublic while the investigation is active. The data are private after the investigation 
48.4 	becomes inactive under section 13.82, subdivision 5, paragraph (a) or (b).
48.5 	(d) Mental health data shall be treated as provided in subdivisions 7, 8, and 9, but are 
48.6 	not subject to the access provisions of subdivision 10, paragraph (b).
48.7 	For the purposes of this subdivision, a request will be deemed to be made in writing if 
48.8 	made through a computer interface system.

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

48.10 	Sec. 2. Minnesota Statutes 2018, section 13.46, subdivision 3, is amended to read:
48.11 		Subd. 3.Investigative data. (a) Data on persons, including data on vendors of services, 
48.12 	licensees, and applicants that is collected, maintained, used, or disseminated by the welfare 
48.13 	system in an investigation, authorized by statute, and relating to the enforcement of rules 
48.14 	or law are confidential data on individuals pursuant to section 13.02, subdivision 3, or 
48.15 	protected nonpublic data not on individuals pursuant to section 13.02, subdivision 13, and 
48.16 	shall not be disclosed except:
48.17 	(1) pursuant to section 13.05;
48.18 	(2) pursuant to statute or valid court order;
48.19 	(3) to a party named in a civil or criminal proceeding, administrative or judicial, for 
48.20 	preparation of defense; or
48.21 	(4) to an agent of the welfare system or an investigator acting on behalf of a county, 
48.22 	state, or federal government, including a law enforcement officer or attorney in the 
48.23 	investigation or prosecution of a criminal, civil, or administrative proceeding, unless the 
48.24 	commissioner of human services determines that disclosure may compromise a Department 
48.25 	of Human Services ongoing investigation; or
48.26 	(4) (5) to provide notices required or permitted by statute.
48.27 	The data referred to in this subdivision shall be classified as public data upon submission 
48.28 	to an administrative law judge or court in an administrative or judicial proceeding. Inactive 
48.29 	welfare investigative data shall be treated as provided in section 13.39, subdivision 3.
48.30 	(b) Notwithstanding any other provision in law, the commissioner of human services 
48.31 	shall provide all active and inactive investigative data, including the name of the reporter 
49.1 	of alleged maltreatment under section 626.556 or 626.557, to the ombudsman for mental 
49.2 	health and developmental disabilities upon the request of the ombudsman.
49.3 	(c) Notwithstanding paragraph (a) and section 13.39, the existence of an investigation 
49.4 	by the commissioner of human services of possible overpayments of public funds to a service 
49.5 	provider or recipient may be disclosed if the commissioner determines that it will not 
49.6 	compromise the investigation.

49.7 	Sec. 3. Minnesota Statutes 2018, section 13.46, subdivision 4, is amended to read:
49.8 		Subd. 4.Licensing data. (a) As used in this subdivision:
49.9 	(1) "licensing data" are all data collected, maintained, used, or disseminated by the 
49.10 	welfare system pertaining to persons licensed or registered or who apply for licensure or 
49.11 	registration or who formerly were licensed or registered under the authority of the 
49.12 	commissioner of human services;
49.13 	(2) "client" means a person who is receiving services from a licensee or from an applicant 
49.14 	for licensure; and
49.15 	(3) "personal and personal financial data" are Social Security numbers, identity of and 
49.16 	letters of reference, insurance information, reports from the Bureau of Criminal 
49.17 	Apprehension, health examination reports, and social/home studies.
49.18 	(b)(1)(i) Except as provided in paragraph (c), the following data on applicants, license 
49.19 	holders, and former licensees are public: name, address, telephone number of licensees, 
49.20 	date of receipt of a completed application, dates of licensure, licensed capacity, type of 
49.21 	client preferred, variances granted, record of training and education in child care and child 
49.22 	development, type of dwelling, name and relationship of other family members, previous 
49.23 	license history, class of license, the existence and status of complaints, and the number of 
49.24 	serious injuries to or deaths of individuals in the licensed program as reported to the 
49.25 	commissioner of human services, the local social services agency, or any other county 
49.26 	welfare agency. For purposes of this clause, a serious injury is one that is treated by a 
49.27 	physician.
49.28 	(ii) Except as provided in item (v), when a correction order, an order to forfeit a fine, 
49.29 	an order of license suspension, an order of temporary immediate suspension, an order of 
49.30 	license revocation, an order of license denial, or an order of conditional license has been 
49.31 	issued, or a complaint is resolved, the following data on current and former licensees and 
49.32 	applicants are public: the general nature of the complaint or allegations leading to the 
49.33 	temporary immediate suspension; the substance and investigative findings of the licensing 
50.1 	or maltreatment complaint, licensing violation, or substantiated maltreatment; the existence 
50.2 	of settlement negotiations; the record of informal resolution of a licensing violation; orders 
50.3 	of hearing; findings of fact; conclusions of law; specifications of the final correction order, 
50.4 	fine, suspension, temporary immediate suspension, revocation, denial, or conditional license 
50.5 	contained in the record of licensing action; whether a fine has been paid; and the status of 
50.6 	any appeal of these actions.
50.7 	(iii) When a license denial under section 245A.05 or a sanction under section 245A.07
50.8 	is based on a determination that a license holder, applicant, or controlling individual is 
50.9 	responsible for maltreatment under section 626.556 or 626.557, the identity of the applicant, 
50.10 	license holder, or controlling individual as the individual responsible for maltreatment is 
50.11 	public data at the time of the issuance of the license denial or sanction.
50.12 	(iv) When a license denial under section 245A.05 or a sanction under section 245A.07
50.13 	is based on a determination that a license holder, applicant, or controlling individual is 
50.14 	disqualified under chapter 245C, the identity of the license holder, applicant, or controlling 
50.15 	individual as the disqualified individual and the reason for the disqualification are public 
50.16 	data at the time of the issuance of the licensing sanction or denial. If the applicant, license 
50.17 	holder, or controlling individual requests reconsideration of the disqualification and the 
50.18 	disqualification is affirmed, the reason for the disqualification and the reason to not set aside 
50.19 	the disqualification are public data.
50.20 	(v) A correction order or fine issued to a child care provider for a licensing violation is 
50.21 	private data on individuals under section 13.02, subdivision 12, or nonpublic data under 
50.22 	section 13.02, subdivision 9, if the correction order or fine is seven years old or older.
50.23 	(2) For applicants who withdraw their application prior to licensure or denial of a license, 
50.24 	the following data are public: the name of the applicant, the city and county in which the 
50.25 	applicant was seeking licensure, the dates of the commissioner's receipt of the initial 
50.26 	application and completed application, the type of license sought, and the date of withdrawal 
50.27 	of the application.
50.28 	(3) For applicants who are denied a license, the following data are public: the name and 
50.29 	address of the applicant, the city and county in which the applicant was seeking licensure, 
50.30 	the dates of the commissioner's receipt of the initial application and completed application, 
50.31 	the type of license sought, the date of denial of the application, the nature of the basis for 
50.32 	the denial, the existence of settlement negotiations, the record of informal resolution of a 
50.33 	denial, orders of hearings, findings of fact, conclusions of law, specifications of the final 
50.34 	order of denial, and the status of any appeal of the denial.
51.1 	(4) When maltreatment is substantiated under section 626.556 or 626.557 and the victim 
51.2 	and the substantiated perpetrator are affiliated with a program licensed under chapter 245A, 
51.3 	the commissioner of human services, local social services agency, or county welfare agency 
51.4 	may inform the license holder where the maltreatment occurred of the identity of the 
51.5 	substantiated perpetrator and the victim.
51.6 	(5) Notwithstanding clause (1), for child foster care, only the name of the license holder 
51.7 	and the status of the license are public if the county attorney has requested that data otherwise 
51.8 	classified as public data under clause (1) be considered private data based on the best interests 
51.9 	of a child in placement in a licensed program.
51.10 	(c) The following are private data on individuals under section 13.02, subdivision 12, 
51.11 	or nonpublic data under section 13.02, subdivision 9: personal and personal financial data 
51.12 	on family day care program and family foster care program applicants and licensees and 
51.13 	their family members who provide services under the license.
51.14 	(d) The following are private data on individuals: the identity of persons who have made 
51.15 	reports concerning licensees or applicants that appear in inactive investigative data, and the 
51.16 	records of clients or employees of the licensee or applicant for licensure whose records are 
51.17 	received by the licensing agency for purposes of review or in anticipation of a contested 
51.18 	matter. The names of reporters of complaints or alleged violations of licensing standards 
51.19 	under chapters 245A, 245B, 245C, and 245D, and applicable rules and alleged maltreatment 
51.20 	under sections 626.556 and 626.557, are confidential data and may be disclosed only as 
51.21 	provided in section 626.556, subdivision 11, or 626.557, subdivision 12b.
51.22 	(e) Data classified as private, confidential, nonpublic, or protected nonpublic under this 
51.23 	subdivision become public data if submitted to a court or administrative law judge as part 
51.24 	of a disciplinary proceeding in which there is a public hearing concerning a license which 
51.25 	has been suspended, immediately suspended, revoked, or denied.
51.26 	(f) Data generated in the course of licensing investigations that relate to an alleged 
51.27 	violation of law are investigative data under subdivision 3.
51.28 	(g) Data that are not public data collected, maintained, used, or disseminated under this 
51.29 	subdivision that relate to or are derived from a report as defined in section 626.556, 
51.30 	subdivision 2, or 626.5572, subdivision 18, are subject to the destruction provisions of 
51.31 	sections 626.556, subdivision 11c, and 626.557, subdivision 12b.
51.32 	(h) Upon request, not public data collected, maintained, used, or disseminated under 
51.33 	this subdivision that relate to or are derived from a report of substantiated maltreatment as 
51.34 	defined in section 626.556 or 626.557 may be exchanged with the Department of Health 
52.1 	for purposes of completing background studies pursuant to section 144.057 and with the 
52.2 	Department of Corrections for purposes of completing background studies pursuant to 
52.3 	section 241.021.
52.4 	(i) Data on individuals collected according to licensing activities under chapters 245A 
52.5 	and 245C, data on individuals collected by the commissioner of human services according 
52.6 	to investigations under chapters 245A, 245B, 245C, and 245D, and sections 626.556 and 
52.7 	626.557 may be shared with the Department of Human Rights, the Department of Health, 
52.8 	the Department of Corrections, the ombudsman for mental health and developmental 
52.9 	disabilities, and the individual's professional regulatory board when there is reason to believe 
52.10 	that laws or standards under the jurisdiction of those agencies may have been violated or 
52.11 	the information may otherwise be relevant to the board's regulatory jurisdiction. Background 
52.12 	study data on an individual who is the subject of a background study under chapter 245C 
52.13 	for a licensed service for which the commissioner of human services is the license holder 
52.14 	may be shared with the commissioner and the commissioner's delegate by the licensing 
52.15 	division. Unless otherwise specified in this chapter, the identity of a reporter of alleged 
52.16 	maltreatment or licensing violations may not be disclosed.
52.17 	(j) In addition to the notice of determinations required under section 626.556, subdivision 
52.18 	10f, if the commissioner or the local social services agency has determined that an individual 
52.19 	is a substantiated perpetrator of maltreatment of a child based on sexual abuse, as defined 
52.20 	in section 626.556, subdivision 2, and the commissioner or local social services agency 
52.21 	knows that the individual is a person responsible for a child's care in another facility, the 
52.22 	commissioner or local social services agency shall notify the head of that facility of this 
52.23 	determination. The notification must include an explanation of the individual's available 
52.24 	appeal rights and the status of any appeal. If a notice is given under this paragraph, the 
52.25 	government entity making the notification shall provide a copy of the notice to the individual 
52.26 	who is the subject of the notice.
52.27 	(k) All not public data collected, maintained, used, or disseminated under this subdivision 
52.28 	and subdivision 3 may be exchanged between the Department of Human Services, Licensing 
52.29 	Division, and the Department of Corrections for purposes of regulating services for which 
52.30 	the Department of Human Services and the Department of Corrections have regulatory 
52.31 	authority.

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

53.1 	Sec. 4. Minnesota Statutes 2018, section 13.461, subdivision 28, is amended to read:
53.2 		Subd. 28.Child care assistance program. Data collected, maintained, used, or 
53.3 	disseminated by the welfare system pertaining to persons selected as legal nonlicensed child 
53.4 	care providers by families receiving child care assistance are classified under section 119B.02, 
53.5 	subdivision 6, paragraph (a). Child care assistance program payment data is classified under 
53.6 	section 119B.02, subdivision 6, paragraph (b).

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

53.8 	Sec. 5. Minnesota Statutes 2018, section 15C.02, is amended to read:
53.9 	15C.02 LIABILITY FOR CERTAIN ACTS.
53.10 	(a) A person who commits any act described in clauses (1) to (7) is liable to the state or 
53.11 	the political subdivision for a civil penalty of not less than $5,500 and not more than $11,000 
53.12 	per false or fraudulent claim in the amounts set forth in the federal False Claims Act, United 
53.13 	States Code, title 31, section 3729, and as modified by the federal Civil Penalties Inflation 
53.14 	Adjustment Act Improvements Act of 2015, plus three times the amount of damages that 
53.15 	the state or the political subdivision sustains because of the act of that person, except as 
53.16 	otherwise provided in paragraph (b):
53.17 	(1) knowingly presents, or causes to be presented, a false or fraudulent claim for payment 
53.18 	or approval;
53.19 	(2) knowingly makes or uses, or causes to be made or used, a false record or statement 
53.20 	material to a false or fraudulent claim;
53.21 	(3) knowingly conspires to commit a violation of clause (1), (2), (4), (5), (6), or (7);
53.22 	(4) has possession, custody, or control of property or money used, or to be used, by the 
53.23 	state or a political subdivision and knowingly delivers or causes to be delivered less than 
53.24 	all of that money or property;
53.25 	(5) is authorized to make or deliver a document certifying receipt for money or property 
53.26 	used, or to be used, by the state or a political subdivision and, intending to defraud the state 
53.27 	or a political subdivision, makes or delivers the receipt without completely knowing that 
53.28 	the information on the receipt is true;
53.29 	(6) knowingly buys, or receives as a pledge of an obligation or debt, public property 
53.30 	from an officer or employee of the state or a political subdivision who lawfully may not 
53.31 	sell or pledge the property; or
54.1 	(7) knowingly makes or uses, or causes to be made or used, a false record or statement 
54.2 	material to an obligation to pay or transmit money or property to the state or a political 
54.3 	subdivision, or knowingly conceals or knowingly and improperly avoids or decreases an 
54.4 	obligation to pay or transmit money or property to the state or a political subdivision.
54.5 	(b) Notwithstanding paragraph (a), the court may assess not less than two times the 
54.6 	amount of damages that the state or the political subdivision sustains because of the act of 
54.7 	the person if:
54.8 	(1) the person committing a violation under paragraph (a) furnished an officer or 
54.9 	employee of the state or the political subdivision responsible for investigating the false or 
54.10 	fraudulent claim violation with all information known to the person about the violation 
54.11 	within 30 days after the date on which the person first obtained the information;
54.12 	(2) the person fully cooperated with any investigation by the state or the political 
54.13 	subdivision of the violation; and
54.14 	(3) at the time the person furnished the state or the political subdivision with information 
54.15 	about the violation, no criminal prosecution, civil action, or administrative action had been 
54.16 	commenced under this chapter with respect to the violation and the person did not have 
54.17 	actual knowledge of the existence of an investigation into the violation.
54.18 	(c) A person violating this section is also liable to the state or the political subdivision 
54.19 	for the costs of a civil action brought to recover any penalty or damages.
54.20 	(d) A person is not liable under this section for mere negligence, inadvertence, or mistake 
54.21 	with respect to activities involving a false or fraudulent claim.

54.22 	Sec. 6. Minnesota Statutes 2018, section 16A.055, subdivision 1a, is amended to read:
54.23 		Subd. 1a.Additional duties. The commissioner may assist state agencies by providing 
54.24 	analytical, statistical, program evaluation using experimental or quasi-experimental design, 
54.25 	and organizational development services to state agencies in order to assist the agency to 
54.26 	achieve the agency's mission and to operate efficiently and effectively. For purposes of this 
54.27 	section, "experimental design" means a method of evaluating the impact of a service that 
54.28 	uses random assignment to assign participants into groups that respectively receive the 
54.29 	studied service and those that receive service as usual, so that any difference in outcomes 
54.30 	found at the end of the evaluation can be attributed to the studied service; and 
54.31 	"quasi-experimental design" means a method of evaluating the impact of a service that uses 
54.32 	strategies other than random assignment to establish statistically similar groups that 
55.1 	respectively receive the service and those that receive service as usual, so that any difference 
55.2 	in outcomes found at the end of the evaluation can be attributed to the studied service.

55.3 	Sec. 7. Minnesota Statutes 2018, section 119B.02, subdivision 6, is amended to read:
55.4 		Subd. 6.Data. (a) Data collected, maintained, used, or disseminated by the welfare 
55.5 	system pertaining to persons selected as legal nonlicensed child care providers by families 
55.6 	receiving child care assistance shall be treated as licensing data as provided in section 13.46, 
55.7 	subdivision 4.
55.8 	(b) For purposes of this paragraph, "child care assistance program payment data" means 
55.9 	data for a specified time period showing (1) that a child care assistance program payment 
55.10 	under this chapter was made, and (2) the amount of child care assistance payments made 
55.11 	to a child care center. Child care assistance program payment data may include the number 
55.12 	of families and children on whose behalf payments were made for the specified time period. 
55.13 	Any child care assistance program payment data that may identify a specific child care 
55.14 	assistance recipient or benefit paid on behalf of a specific child care assistance recipient, 
55.15 	as determined by the commissioner, is private data on individuals as defined in section 
55.16 	13.02, subdivision 12. Data related to a child care assistance payment is public if the data 
55.17 	relates to a child care assistance payment made to a licensed child care center or a child 
55.18 	care center exempt from licensure and:
55.19 	(1) the child care center receives payment of more than $100,000 from the child care 
55.20 	assistance program under this chapter in a period of one year or less; or
55.21 	(2) when the commissioner or county agency either:
55.22 	(i) disqualified the center from receipt of a payment from the child care assistance 
55.23 	program under this chapter for wrongfully obtaining child care assistance under section 
55.24 	256.98, subdivision 8, paragraph (c);
55.25 	(ii) refused a child care authorization, revoked a child care authorization, stopped 
55.26 	payment, or denied payment for a bill for the center under section 119B.13, subdivision 6, 
55.27 	paragraph (d); or
55.28 	(iii) made a finding of financial misconduct under section 245E.02.

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

56.1 	Sec. 8. Minnesota Statutes 2018, section 119B.09, subdivision 7, is amended to read:
56.2 		Subd. 7.Date of eligibility for assistance. (a) The date of eligibility for child care 
56.3 	assistance under this chapter is the later of the date the application was received by the 
56.4 	county; the beginning date of employment, education, or training; the date the infant is born 
56.5 	for applicants to the at-home infant care program; or the date a determination has been made 
56.6 	that the applicant is a participant in employment and training services under Minnesota 
56.7 	Rules, part 3400.0080, or chapter 256J.
56.8 	(b) Payment ceases for a family under the at-home infant child care program when a 
56.9 	family has used a total of 12 months of assistance as specified under section 119B.035. 
56.10 	Payment of child care assistance for employed persons on MFIP is effective the date of 
56.11 	employment or the date of MFIP eligibility, whichever is later. Payment of child care 
56.12 	assistance for MFIP or DWP participants in employment and training services is effective 
56.13 	the date of commencement of the services or the date of MFIP or DWP eligibility, whichever 
56.14 	is later. Payment of child care assistance for transition year child care must be made 
56.15 	retroactive to the date of eligibility for transition year child care.
56.16 	(c) Notwithstanding paragraph (b), payment of child care assistance for participants 
56.17 	eligible under section 119B.05 may only be made retroactive for a maximum of six three
56.18 	months from the date of application for child care assistance.

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

56.20 	Sec. 9. Minnesota Statutes 2018, section 119B.125, subdivision 6, is amended to read:
56.21 		Subd. 6.Record-keeping requirement. (a) As a condition of payment, all providers 
56.22 	receiving child care assistance payments must:
56.23 	(1) keep accurate and legible daily attendance records at the site where services are 
56.24 	delivered for children receiving child care assistance; and
56.25 	must(2) make those records available immediately to the county or the commissioner 
56.26 	upon request. Any records not provided to a county or the commissioner at the date and 
56.27 	time of the request are deemed inadmissible if offered as evidence by the provider in any 
56.28 	proceeding to contest an overpayment or disqualification of the provider.
56.29 	The (b) As a condition of payment, attendance records must be completed daily and 
56.30 	include the date, the first and last name of each child in attendance, and the times when 
56.31 	each child is dropped off and picked up. To the extent possible, the times that the child was 
56.32 	dropped off to and picked up from the child care provider must be entered by the person 
57.1 	dropping off or picking up the child. The daily attendance records must be retained at the 
57.2 	site where services are delivered for six years after the date of service.
57.3 	(c) A county or the commissioner may deny or revoke a provider's authorization as a 
57.4 	child care provider to any applicant, rescind authorization of any provider, to receive child 
57.5 	care assistance payments under section 119B.13, subdivision 6, paragraph (d), pursue a 
57.6 	fraud disqualification under section 256.98, take an action against the provider under chapter 
57.7 	245E, or establish an attendance record overpayment claim in the system under paragraph 
57.8 	(d) against a current or former provider, when the county or the commissioner knows or 
57.9 	has reason to believe that the provider has not complied with the record-keeping requirement 
57.10 	in this subdivision. A provider's failure to produce attendance records as requested on more 
57.11 	than one occasion constitutes grounds for disqualification as a provider.
57.12 	(d) To calculate an attendance record overpayment under this subdivision, the 
57.13 	commissioner or county agency shall subtract the maximum daily rate from the total amount 
57.14 	paid to a provider for each day that a child's attendance record is missing, unavailable, 
57.15 	incomplete, inaccurate, or otherwise inadequate.
57.16 	(e) The commissioner shall develop criteria for a county to determine an attendance 
57.17 	record overpayment under this subdivision.

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

57.19 	Sec. 10. Minnesota Statutes 2018, section 119B.13, subdivision 6, is amended to read:
57.20 		Subd. 6.Provider payments. (a) A provider shall bill only for services documented 
57.21 	according to section 119B.125, subdivision 6. The provider shall bill for services provided 
57.22 	within ten days of the end of the service period. Payments under the child care fund shall 
57.23 	be made within 21 days of receiving a complete bill from the provider. Counties or the state 
57.24 	may establish policies that make payments on a more frequent basis.
57.25 	(b) If a provider has received an authorization of care and been issued a billing form for 
57.26 	an eligible family, the bill must be submitted within 60 days of the last date of service on 
57.27 	the bill. A bill submitted more than 60 days after the last date of service must be paid if the 
57.28 	county determines that the provider has shown good cause why the bill was not submitted 
57.29 	within 60 days. Good cause must be defined in the county's child care fund plan under 
57.30 	section 119B.08, subdivision 3, and the definition of good cause must include county error. 
57.31 	Any bill submitted more than a year after the last date of service on the bill must not be 
57.32 	paid.
58.1 	(c) If a provider provided care for a time period without receiving an authorization of 
58.2 	care and a billing form for an eligible family, payment of child care assistance may only be 
58.3 	made retroactively for a maximum of six months from the date the provider is issued an 
58.4 	authorization of care and billing form.
58.5 	(d) A county or the commissioner may refuse to issue a child care authorization to a 
58.6 	licensed or legal nonlicensed provider, revoke an existing child care authorization to a 
58.7 	licensed or legal nonlicensed provider, stop payment issued to a licensed or legal nonlicensed 
58.8 	provider, or refuse to pay a bill submitted by a licensed or legal nonlicensed provider if:
58.9 	(1) the provider admits to intentionally giving the county materially false information 
58.10 	on the provider's billing forms;
58.11 	(2) a county or the commissioner finds by a preponderance of the evidence that the 
58.12 	provider intentionally gave the county materially false information on the provider's billing 
58.13 	forms, or provided false attendance records to a county or the commissioner;
58.14 	(3) the provider is in violation of child care assistance program rules, until the agency 
58.15 	determines those violations have been corrected;
58.16 	(4) the provider is operating after:
58.17 	(i) an order of suspension of the provider's license issued by the commissioner;
58.18 	(ii) an order of revocation of the provider's license; or
58.19 	(iii) a final order of conditional license issued by the commissioner for as long as the 
58.20 	conditional license is in effect;
58.21 	(5) the provider submits false attendance reports or refuses to provide documentation 
58.22 	of the child's attendance upon request; or
58.23 	(6) the provider gives false child care price information.; or
58.24 	(7) the provider fails to report decreases in a child's attendance as required under section 
58.25 	119B.125, subdivision 9.
58.26 	(e) For purposes of paragraph (d), clauses (3), (5), and (6), and (7), the county or the 
58.27 	commissioner may withhold the provider's authorization or payment for a period of time 
58.28 	not to exceed three months beyond the time the condition has been corrected.
58.29 	(f) A county's payment policies must be included in the county's child care plan under 
58.30 	section 119B.08, subdivision 3. If payments are made by the state, in addition to being in 
58.31 	compliance with this subdivision, the payments must be made in compliance with section 
58.32 	16A.124.

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

59.2 	Sec. 11. Minnesota Statutes 2018, section 119B.13, subdivision 7, is amended to read:
59.3 		Subd. 7.Absent days. (a) Licensed child care providers and license-exempt centers 
59.4 	must not be reimbursed for more than 25 full-day absent days per child, excluding holidays, 
59.5 	in a fiscal calendar year, or for more than ten consecutive full-day absent days. "Absent 
59.6 	day" means any day that the child is authorized and scheduled to be in care with a licensed 
59.7 	provider or license-exempt center, and the child is absent from the care for the entire day. 
59.8 	Legal nonlicensed family child care providers must not be reimbursed for absent days. If a 
59.9 	child attends for part of the time authorized to be in care in a day, but is absent for part of 
59.10 	the time authorized to be in care in that same day, the absent time must be reimbursed but 
59.11 	the time must not count toward the absent days limit. Child care providers must only be 
59.12 	reimbursed for absent days if the provider has a written policy for child absences and charges 
59.13 	all other families in care for similar absences.
59.14 	(b) Notwithstanding paragraph (a), children with documented medical conditions that 
59.15 	cause more frequent absences may exceed the 25 absent days limit, or ten consecutive 
59.16 	full-day absent days limit. Absences due to a documented medical condition of a parent or 
59.17 	sibling who lives in the same residence as the child receiving child care assistance do not 
59.18 	count against the absent days limit in a fiscal calendar year. Documentation of medical 
59.19 	conditions must be on the forms and submitted according to the timelines established by 
59.20 	the commissioner. A public health nurse or school nurse may verify the illness in lieu of a 
59.21 	medical practitioner. If a provider sends a child home early due to a medical reason, 
59.22 	including, but not limited to, fever or contagious illness, the child care center director or 
59.23 	lead teacher may verify the illness in lieu of a medical practitioner.
59.24 	(c) Notwithstanding paragraph (a), children in families may exceed the absent days limit 
59.25 	if at least one parent: (1) is under the age of 21; (2) does not have a high school diploma or 
59.26 	commissioner of education-selected high school equivalency certification; and (3) is a 
59.27 	student in a school district or another similar program that provides or arranges for child 
59.28 	care, parenting support, social services, career and employment supports, and academic 
59.29 	support to achieve high school graduation, upon request of the program and approval of the 
59.30 	county. If a child attends part of an authorized day, payment to the provider must be for the 
59.31 	full amount of care authorized for that day.
59.32 	(d) Child care providers must be reimbursed for up to ten federal or state holidays or 
59.33 	designated holidays per year when the provider charges all families for these days and the 
59.34 	holiday or designated holiday falls on a day when the child is authorized to be in attendance. 
60.1 	Parents may substitute other cultural or religious holidays for the ten recognized state and 
60.2 	federal holidays. Holidays do not count toward the absent days limit.
60.3 	(e) A family or child care provider must not be assessed an overpayment for an absent 
60.4 	day payment unless (1) there was an error in the amount of care authorized for the family, 
60.5 	(2) all of the allowed full-day absent payments for the child have been paid, or (3) the family 
60.6 	or provider did not timely report a change as required under law.
60.7 	(f) The provider and family shall receive notification of the number of absent days used 
60.8 	upon initial provider authorization for a family and ongoing notification of the number of 
60.9 	absent days used as of the date of the notification.
60.10 	(g) For purposes of this subdivision, "absent days limit" means 25 full-day absent days 
60.11 	per child, excluding holidays, in a fiscal calendar year; and ten consecutive full-day absent 
60.12 	days.
60.13 	(h) For purposes of this subdivision, "holidays limit" means ten full-day holidays per 
60.14 	child, excluding absent days, in a calendar year.
60.15 	(i) If a day meets the criteria of an absent day or a holiday under this subdivision, the 
60.16 	provider must bill that day as an absent day or holiday. A provider's failure to properly bill 
60.17 	an absent day or a holiday results in an overpayment, regardless of whether the child reached, 
60.18 	or is exempt from, the absent days limit or holidays limit for the calendar year.

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

60.20 	Sec. 12. Minnesota Statutes 2018, section 144.057, subdivision 3, is amended to read:
60.21 		Subd. 3.Reconsiderations. The commissioner of health shall review and decide 
60.22 	reconsideration requests, including the granting of variances, in accordance with the 
60.23 	procedures and criteria contained in chapter 245C. The commissioner must set aside a 
60.24 	disqualification for an individual who requests reconsideration and who meets the criteria 
60.25 	described in section 245C.22, subdivision 4, paragraph (d). The commissioner's decision 
60.26 	shall be provided to the individual and to the Department of Human Services. The 
60.27 	commissioner's decision to grant or deny a reconsideration of disqualification is the final 
60.28 	administrative agency action, except for the provisions under sections 245C.25, 245C.27, 
60.29 	and 245C.28, subdivision 3.

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

61.1 	Sec. 13. Minnesota Statutes 2018, section 245.095, is amended to read:
61.2 	245.095 LIMITS ON RECEIVING PUBLIC FUNDS.
61.3 		Subdivision 1.Prohibition. (a) If a provider, vendor, or individual enrolled, licensed, 
61.4 	or receiving funds under a grant contract, or registered in any program administered by the 
61.5 	commissioner, including under the commissioner's powers and authorities in section 256.01,
61.6 	is excluded from any that program administered by the commissioner, including under the 
61.7 	commissioner's powers and authorities in section 256.01, the commissioner shall:
61.8 	(1) prohibit the excluded provider, vendor, or individual from enrolling or, becoming 
61.9 	licensed, receiving grant funds, or registering in any other program administered by the 
61.10 	commissioner.; and
61.11 	(2) disenroll, revoke or suspend a license, disqualify, or debar the excluded provider, 
61.12 	vendor, or individual in any other program administered by the commissioner.
61.13 	(b) The duration of this prohibition, disenrollment, revocation, suspension, 
61.14 	disqualification, or debarment must last for the longest applicable sanction or disqualifying 
61.15 	period in effect for the provider, vendor, or individual permitted by state or federal law.
61.16 		Subd. 2.Definitions. (a) For purposes of this section, the following definitions have the 
61.17 	meanings given them.
61.18 	(b) "Excluded" means disenrolled, subject to license revocation or suspension, 
61.19 	disqualified, or subject to vendor debarment disqualified, having a license that has been 
61.20 	revoked or suspended under chapter 245A, or debarred or suspended under Minnesota Rules, 
61.21 	part 1230.1150, or excluded pursuant to section 256B.064, subdivision 3.
61.22 	(c) "Individual" means a natural person providing products or services as a provider or 
61.23 	vendor.
61.24 	(d) "Provider" means includes any entity or individual receiving payment from a program 
61.25 	administered by the Department of Human Services, and an owner, controlling individual, 
61.26 	license holder, director, or managerial official of an entity receiving payment from a program 
61.27 	administered by the Department of Human Services.

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

61.29 	Sec. 14. Minnesota Statutes 2018, section 245A.02, subdivision 3, is amended to read:
61.30 		Subd. 3.Applicant. "Applicant" means an individual, corporation, partnership, voluntary 
61.31 	association, controlling individual, or other organization, or government entity, as defined 
61.32 	in section 13.02, subdivision 7a, that has applied for licensure under this chapter and the 
62.1 	rules of the commissioner is subject to licensure under this chapter and that has applied for 
62.2 	but not yet been granted a license under this chapter.

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

62.4 	Sec. 15. Minnesota Statutes 2018, section 245A.02, is amended by adding a subdivision 
62.5 	to read:
62.6 		Subd. 3b.Authorized agent. "Authorized agent" means the controlling individual 
62.7 	designated by the license holder responsible for communicating with the commissioner of 
62.8 	human services on all matters related to this chapter and on whom service of all notices and 
62.9 	orders must be made pursuant to section 245A.04, subdivision 1.

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

62.11 	Sec. 16. Minnesota Statutes 2018, section 245A.02, subdivision 8, is amended to read:
62.12 		Subd. 8.License. "License" means a certificate issued by the commissioner under section 
62.13 	245A.04 authorizing the license holder to provide a specified program for a specified period 
62.14 	of time and in accordance with the terms of the license and the rules of the commissioner.

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

62.16 	Sec. 17. Minnesota Statutes 2018, section 245A.02, subdivision 9, is amended to read:
62.17 		Subd. 9.License holder. "License holder" means an individual, corporation, partnership, 
62.18 	voluntary association, or other organization, or government entity that is legally responsible 
62.19 	for the operation of the program or service, and has been granted a license by the 
62.20 	commissioner under this chapter or chapter 245D and the rules of the commissioner, and 
62.21 	is a controlling individual.

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

62.23 	Sec. 18. Minnesota Statutes 2018, section 245A.02, is amended by adding a subdivision 
62.24 	to read:
62.25 		Subd. 10c.Organization. "Organization" means a domestic or foreign corporation, 
62.26 	nonprofit corporation, limited liability company, partnership, limited partnership, limited 
62.27 	liability partnership, association, voluntary association, and any other legal or commercial 
62.28 	entity. For purposes of this chapter, organization does not include a government entity.

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

63.1 	Sec. 19. Minnesota Statutes 2018, section 245A.02, subdivision 12, is amended to read:
63.2 		Subd. 12.Private agency. "Private agency" means an individual, corporation, partnership, 
63.3 	voluntary association or other organization, other than a county agency, or a court with 
63.4 	jurisdiction, that places persons who cannot remain in their own homes in residential 
63.5 	programs, foster care, or adoptive homes. A private agency is designated to perform the 
63.6 	commissioner's licensing functions under section 245A.16.

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

63.8 	Sec. 20. Minnesota Statutes 2018, section 245A.02, subdivision 14, is amended to read:
63.9 		Subd. 14.Residential program. (a) Except as provided in paragraph (b), "residential 
63.10 	program" means a program that provides 24-hour-a-day care, supervision, food, lodging, 
63.11 	rehabilitation, training, education, habilitation, or treatment outside a person's own home, 
63.12 	including a program in an intermediate care facility for four or more persons with 
63.13 	developmental disabilities; and chemical dependency or chemical abuse programs that are 
63.14 	located in a hospital or nursing home and receive public funds for providing chemical abuse 
63.15 	or chemical dependency treatment services under chapter 254B. Residential programs 
63.16 	include home and community-based services for persons with disabilities or persons age 
63.17 	65 and older that are provided in or outside of a person's own home under chapter 245D.
63.18 	(b) For a residential program under chapter 245D, "residential program" means a single 
63.19 	or multifamily dwelling that is under the control, either directly or indirectly, of the service 
63.20 	provider licensed under chapter 245D and in which at least one person receives services 
63.21 	under chapter 245D, including residential supports and services under section 245D.03, 
63.22 	subdivision 1, paragraph (c), clause (3); out-of-home crisis respite services under section 
63.23 	245D.03, subdivision 1, paragraph (c), clause (1), item (ii); and out-of-home respite services 
63.24 	under section 245D.03, subdivision 1, paragraph (b), clause (1). A residential program does 
63.25 	not include out-of-home respite services when a case manager has determined that an 
63.26 	unlicensed site meets the assessed needs of the person. A residential program also does not 
63.27 	include multifamily dwellings where persons receive integrated community supports, even 
63.28 	if authorization to provide these supports is granted under chapter 245D and approved in 
63.29 	the federal waiver.

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

64.1 	Sec. 21. Minnesota Statutes 2018, section 245A.02, subdivision 18, is amended to read:
64.2 		Subd. 18.Supervision.  (a) For purposes of licensed child care centers, "supervision" 
64.3 	means when a program staff person:
64.4 	(1) is within sight and hearing of a child at all times so that the program staff accountable 
64.5 	for the child's care;
64.6 	(2) can intervene to protect the health and safety of the child.; and
64.7 	(3) is within sight and hearing of the child at all times except as described in paragraphs 
64.8 	(b) to (d).
64.9 	(b) When an infant is placed in a crib room to sleep, supervision occurs when a program
64.10 	staff person is within sight or hearing of the infant. When supervision of a crib room is 
64.11 	provided by sight or hearing, the center must have a plan to address the other supervision 
64.12 	component components.
64.13 	(c) When a single school-age child uses the restroom within the licensed space, 
64.14 	supervision occurs when a program staff person has knowledge of the child's activity and 
64.15 	location and checks on the child at least every five minutes. When a school-age child uses 
64.16 	the restroom outside the licensed space, including but not limited to field trips, supervision 
64.17 	occurs when staff accompany children to the restroom.
64.18 	(d) When a school-age child leaves the classroom but remains within the licensed space 
64.19 	to deliver or retrieve items from the child's personal storage space, supervision occurs when 
64.20 	a program staff person has knowledge of the child's activity and location and checks on the 
64.21 	child at least every five minutes.

64.22 	EFFECTIVE DATE. This section is effective September 30, 2019.

64.23 	Sec. 22. Minnesota Statutes 2018, section 245A.03, subdivision 1, is amended to read:
64.24 		Subdivision 1.License required. Unless licensed by the commissioner under this chapter, 
64.25 	an individual, corporation, partnership, voluntary association, other organization, or 
64.26 	controlling individual government entity must not:
64.27 	(1) operate a residential or a nonresidential program;
64.28 	(2) receive a child or adult for care, supervision, or placement in foster care or adoption;
64.29 	(3) help plan the placement of a child or adult in foster care or adoption or engage in 
64.30 	placement activities as defined in section 259.21, subdivision 9, in this state, whether or not 
64.31 	the adoption occurs in this state; or
65.1 	(4) advertise a residential or nonresidential program.

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

65.3 	Sec. 23. Minnesota Statutes 2018, section 245A.03, subdivision 3, is amended to read:
65.4 		Subd. 3.Unlicensed programs. (a) It is a misdemeanor for an individual, corporation, 
65.5 	partnership, voluntary association, other organization, or a controlling individual government 
65.6 	entity to provide a residential or nonresidential program without a license issued under this 
65.7 	chapter and in willful disregard of this chapter unless the program is excluded from licensure 
65.8 	under subdivision 2.
65.9 	(b) The commissioner may ask the appropriate county attorney or the attorney general 
65.10 	to begin proceedings to secure a court order against the continued operation of the program, 
65.11 	if an individual, corporation, partnership, voluntary association, other organization, or 
65.12 	controlling individual government entity has:
65.13 	(1) failed to apply for a license under this chapter after receiving notice that a license is 
65.14 	required or continues to operate without a license after receiving notice that a license is 
65.15 	required;
65.16 	(2) continued to operate without a license after the a license issued under this chapter 
65.17 	has been revoked or suspended under section 245A.07 this chapter, and the commissioner 
65.18 	has issued a final order affirming the revocation or suspension, or the license holder did not 
65.19 	timely appeal the sanction; or
65.20 	(3) continued to operate without a license after the a temporary immediate suspension 
65.21 	of a license has been temporarily suspended under section 245A.07 issued under this chapter.
65.22 	(c) The county attorney and the attorney general have a duty to cooperate with the 
65.23 	commissioner.

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

65.25 	Sec. 24. Minnesota Statutes 2018, section 245A.04, subdivision 1, is amended to read:
65.26 		Subdivision 1.Application for licensure. (a) An individual, corporation, partnership, 
65.27 	voluntary association, other organization or controlling individual, or government entity
65.28 	that is subject to licensure under section 245A.03 must apply for a license. The application 
65.29 	must be made on the forms and in the manner prescribed by the commissioner. The 
65.30 	commissioner shall provide the applicant with instruction in completing the application and 
65.31 	provide information about the rules and requirements of other state agencies that affect the 
66.1 	applicant. An applicant seeking licensure in Minnesota with headquarters outside of 
66.2 	Minnesota must have a program office located within 30 miles of the state Minnesota border.
66.3 	An applicant who intends to buy or otherwise acquire a program or services licensed under 
66.4 	this chapter that is owned by another license holder must apply for a license under this 
66.5 	chapter and comply with the application procedures in this section and section 245A.03.
66.6 	The commissioner shall act on the application within 90 working days after a complete 
66.7 	application and any required reports have been received from other state agencies or 
66.8 	departments, counties, municipalities, or other political subdivisions. The commissioner 
66.9 	shall not consider an application to be complete until the commissioner receives all of the 
66.10 	information required under section 245C.05 information.
66.11 	When the commissioner receives an application for initial licensure that is incomplete 
66.12 	because the applicant failed to submit required documents or that is substantially deficient 
66.13 	because the documents submitted do not meet licensing requirements, the commissioner 
66.14 	shall provide the applicant written notice that the application is incomplete or substantially 
66.15 	deficient. In the written notice to the applicant the commissioner shall identify documents 
66.16 	that are missing or deficient and give the applicant 45 days to resubmit a second application 
66.17 	that is substantially complete. An applicant's failure to submit a substantially complete 
66.18 	application after receiving notice from the commissioner is a basis for license denial under 
66.19 	section 245A.05.
66.20 	(b) An application for licensure must identify all controlling individuals as defined in 
66.21 	section 245A.02, subdivision 5a, and must specify an designate one individual to be the 
66.22 	authorized agent who is responsible for dealing with the commissioner of human services 
66.23 	on all matters provided for in this chapter and on whom service of all notices and orders 
66.24 	must be made. The application must be signed by the authorized agent and must include 
66.25 	the authorized agent's first, middle, and last name; mailing address; and e-mail address. By 
66.26 	submitting an application for licensure, the authorized agent consents to electronic 
66.27 	communication with the commissioner throughout the application process. The authorized 
66.28 	agent must be authorized to accept service on behalf of all of the controlling individuals of 
66.29 	the program. A government entity that holds multiple licenses under this chapter may 
66.30 	designate one authorized agent for all licenses issued under this chapter or may designate 
66.31 	a different authorized agent for each license. Service on the authorized agent is service on 
66.32 	all of the controlling individuals of the program. It is not a defense to any action arising 
66.33 	under this chapter that service was not made on each controlling individual of the program. 
66.34 	The designation of one or more a controlling individuals individual as agents the authorized 
67.1 	agent under this paragraph does not affect the legal responsibility of any other controlling 
67.2 	individual under this chapter.
67.3 	(c) An applicant or license holder must have a policy that prohibits license holders, 
67.4 	employees, subcontractors, and volunteers, when directly responsible for persons served 
67.5 	by the program, from abusing prescription medication or being in any manner under the 
67.6 	influence of a chemical that impairs the individual's ability to provide services or care. The 
67.7 	license holder must train employees, subcontractors, and volunteers about the program's 
67.8 	drug and alcohol policy.
67.9 	(d) An applicant and license holder must have a program grievance procedure that permits 
67.10 	persons served by the program and their authorized representatives to bring a grievance to 
67.11 	the highest level of authority in the program.
67.12 	(e) The applicant must be able to demonstrate competent knowledge of the applicable 
67.13 	requirements of this chapter and chapter 245C, and the requirements of other licensing 
67.14 	statutes and rules applicable to the program or services for which the applicant is seeking 
67.15 	to be licensed. Effective January 1, 2013, The commissioner may limit communication 
67.16 	during the application process to the authorized agent or the controlling individuals identified 
67.17 	on the license application and for whom a background study was initiated under chapter 
67.18 	245C. The commissioner may require the applicant, except for child foster care, to 
67.19 	demonstrate competence in the applicable licensing requirements by successfully completing 
67.20 	a written examination. The commissioner may develop a prescribed written examination 
67.21 	format.
67.22 	(f) When an applicant is an individual, the individual applicant must provide:
67.23 	(1) the applicant's taxpayer identification numbers including the Social Security number
67.24 	or Minnesota tax identification number, and federal employer identification number if the 
67.25 	applicant has employees;
67.26 	(2) at the request of the commissioner, a copy of the most recent filing with the secretary 
67.27 	of state that includes the complete business name, if any, and;
67.28 	(3) if doing business under a different name, the doing business as (DBA) name, as 
67.29 	registered with the secretary of state; and
67.30 	(3) a notarized signature of the applicant. (4) if applicable, the applicant's National 
67.31 	Provider Identifier (NPI) number and Unique Minnesota Provider Identifier (UMPI) number; 
67.32 	and
68.1 	(5) at the request of the commissioner, the notarized signature of the applicant or 
68.2 	authorized agent.
68.3 	(g) When an applicant is a nonindividual an organization, the applicant must provide 
68.4 	the:
68.5 	(1) the applicant's taxpayer identification numbers including the Minnesota tax 
68.6 	identification number and federal employer identification number;
68.7 	(2) at the request of the commissioner, a copy of the most recent filing with the secretary 
68.8 	of state that includes the complete business name, and if doing business under a different 
68.9 	name, the doing business as (DBA) name, as registered with the secretary of state;
68.10 	(3) the first, middle, and last name, and address for all individuals who will be controlling 
68.11 	individuals, including all officers, owners, and managerial officials as defined in section 
68.12 	245A.02, subdivision 5a, and the date that the background study was initiated by the applicant 
68.13 	for each controlling individual; and
68.14 	(4) first, middle, and last name, mailing address, and notarized signature of the agent 
68.15 	authorized by the applicant to accept service on behalf of the controlling individuals.
68.16 	(4) if applicable, the applicant's NPI number and UMPI number;
68.17 	(5) the documents that created the organization and that determine the organization's 
68.18 	internal governance and the relations among the persons that own the organization, have 
68.19 	an interest in the organization, or are members of the organization, in each case as provided 
68.20 	or authorized by the organization's governing statute, which may include a partnership 
68.21 	agreement, bylaws, articles of organization, organizational chart, and operating agreement, 
68.22 	or comparable documents as provided in the organization's governing statute; and
68.23 	(6) the notarized signature of the applicant or authorized agent.
68.24 	(h) When the applicant is a government entity, the applicant must provide:
68.25 	(1) the name of the government agency, political subdivision, or other unit of government 
68.26 	seeking the license and the name of the program or services that will be licensed;
68.27 	(2) the applicant's taxpayer identification numbers including the Minnesota tax 
68.28 	identification number and federal employer identification number;
68.29 	(3) a letter signed by the manager, administrator, or other executive of the government 
68.30 	entity authorizing the submission of the license application; and
68.31 	(4) if applicable, the applicant's NPI number and UMPI number.
69.1 	(h) (i) At the time of application for licensure or renewal of a license under this chapter, 
69.2 	the applicant or license holder must acknowledge on the form provided by the commissioner 
69.3 	if the applicant or license holder elects to receive any public funding reimbursement from 
69.4 	the commissioner for services provided under the license that:
69.5 	(1) the applicant's or license holder's compliance with the provider enrollment agreement 
69.6 	or registration requirements for receipt of public funding may be monitored by the 
69.7 	commissioner as part of a licensing investigation or licensing inspection; and
69.8 	(2) noncompliance with the provider enrollment agreement or registration requirements 
69.9 	for receipt of public funding that is identified through a licensing investigation or licensing 
69.10 	inspection, or noncompliance with a licensing requirement that is a basis of enrollment for 
69.11 	reimbursement for a service, may result in:
69.12 	(i) a correction order or a conditional license under section 245A.06, or sanctions under 
69.13 	section 245A.07;
69.14 	(ii) nonpayment of claims submitted by the license holder for public program 
69.15 	reimbursement;
69.16 	(iii) recovery of payments made for the service;
69.17 	(iv) disenrollment in the public payment program; or
69.18 	(v) other administrative, civil, or criminal penalties as provided by law.

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

69.20 	Sec. 25. Minnesota Statutes 2018, section 245A.04, subdivision 2, is amended to read:
69.21 		Subd. 2.Notification of affected municipality. The commissioner must not issue a 
69.22 	license under this chapter without giving 30 calendar days' written notice to the affected 
69.23 	municipality or other political subdivision unless the program is considered a permitted 
69.24 	single-family residential use under sections 245A.11 and 245A.14. The commissioner may 
69.25 	provide notice through electronic communication. The notification must be given before 
69.26 	the first issuance of a license under this chapter and annually after that time if annual 
69.27 	notification is requested in writing by the affected municipality or other political subdivision. 
69.28 	State funds must not be made available to or be spent by an agency or department of state, 
69.29 	county, or municipal government for payment to a residential or nonresidential program 
69.30 	licensed under this chapter until the provisions of this subdivision have been complied with 
69.31 	in full. The provisions of this subdivision shall not apply to programs located in hospitals.

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

70.1 	Sec. 26. Minnesota Statutes 2018, section 245A.04, subdivision 4, is amended to read:
70.2 		Subd. 4.Inspections; waiver. (a) Before issuing an initial a license under this chapter, 
70.3 	the commissioner shall conduct an inspection of the program. The inspection must include 
70.4 	but is not limited to:
70.5 	(1) an inspection of the physical plant;
70.6 	(2) an inspection of records and documents;
70.7 	(3) an evaluation of the program by consumers of the program;
70.8 	(4) (3) observation of the program in operation; and
70.9 	(5) (4) an inspection for the health, safety, and fire standards in licensing requirements 
70.10 	for a child care license holder.
70.11 	For the purposes of this subdivision, "consumer" means a person who receives the 
70.12 	services of a licensed program, the person's legal guardian, or the parent or individual having 
70.13 	legal custody of a child who receives the services of a licensed program.
70.14 	(b) The evaluation required in paragraph (a), clause (3), or the observation in paragraph 
70.15 	(a), clause (4) (3), is not required prior to issuing an initial a license under subdivision 7. If 
70.16 	the commissioner issues an initial a license under subdivision 7 this chapter, these 
70.17 	requirements must be completed within one year after the issuance of an initial the license.
70.18 	(c) Before completing a licensing inspection in a family child care program or child care 
70.19 	center, the licensing agency must offer the license holder an exit interview to discuss 
70.20 	violations or potential violations of law or rule observed during the inspection and offer 
70.21 	technical assistance on how to comply with applicable laws and rules. Nothing in this 
70.22 	paragraph limits the ability of the commissioner to issue a correction order or negative 
70.23 	action for violations of law or rule not discussed in an exit interview or in the event that a 
70.24 	license holder chooses not to participate in an exit interview. The commissioner shall not 
70.25 	issue a correction order or negative licensing action for violations of law or rule not discussed 
70.26 	in an exit interview, unless a license holder chooses not to participate in an exit interview 
70.27 	or not to complete the exit interview. If the license holder is unable to complete the exit 
70.28 	interview, the licensing agency must offer an alternate time for the license holder to complete 
70.29 	the exit interview.
70.30 	(d) If a family child care license holder disputes a county licensor's interpretation of a 
70.31 	licensing requirement during a licensing inspection or exit interview, the license holder 
70.32 	may, within five business days after the exit interview or licensing inspection, request 
70.33 	clarification from the commissioner, in writing, in a manner prescribed by the commissioner. 
71.1 	The license holder's request must describe the county licensor's interpretation of the licensing 
71.2 	requirement at issue, and explain why the license holder believes the county licensor's 
71.3 	interpretation is inaccurate. The commissioner and the county must include the license 
71.4 	holder in all correspondence regarding the disputed interpretation, and must provide an 
71.5 	opportunity for the license holder to contribute relevant information that may impact the 
71.6 	commissioner's decision. The county licensor must not issue a correction order related to 
71.7 	the disputed licensing requirement until the commissioner has provided clarification to the 
71.8 	license holder about the licensing requirement.
71.9 	(d) (e) The commissioner or the county shall inspect at least annually a child care provider 
71.10 	licensed under this chapter and Minnesota Rules, chapter 9502 or 9503, for compliance 
71.11 	with applicable licensing standards.
71.12 	(e) (f) No later than November 19, 2017, the commissioner shall make publicly available 
71.13 	on the department's website the results of inspection reports of all child care providers 
71.14 	licensed under this chapter and under Minnesota Rules, chapter 9502 or 9503, and the 
71.15 	number of deaths, serious injuries, and instances of substantiated child maltreatment that 
71.16 	occurred in licensed child care settings each year.

71.17 	EFFECTIVE DATE. The amendments to paragraphs (a) and (b) are effective January 
71.18 	1, 2020. The amendments to paragraphs (c) to (f) are effective September 30, 2019.

71.19 	Sec. 27. Minnesota Statutes 2018, section 245A.04, subdivision 6, is amended to read:
71.20 		Subd. 6.Commissioner's evaluation. (a) Before issuing, denying, suspending, revoking, 
71.21 	or making conditional a license, the commissioner shall evaluate information gathered under 
71.22 	this section. The commissioner's evaluation shall consider the applicable requirements of 
71.23 	statutes and rules for the program or services for which the applicant seeks a license, 
71.24 	including the disqualification standards set forth in chapter 245C, and shall evaluate facts, 
71.25 	conditions, or circumstances concerning:
71.26 	(1) the program's operation,;
71.27 	(2) the well-being of persons served by the program,;
71.28 	(3) available consumer evaluations of the program, and by persons receiving services;
71.29 	(4) information about the qualifications of the personnel employed by the applicant or 
71.30 	license holder.; and
72.1 	(5) the applicant's or license holder's ability to demonstrate competent knowledge of the 
72.2 	applicable requirements of statutes and rules, including this chapter and chapter 245C, for 
72.3 	which the applicant seeks a license or the license holder is licensed.
72.4 	(b) The commissioner shall also evaluate the results of the study required in subdivision 
72.5 	3 and determine whether a risk of harm to the persons served by the program exists. In 
72.6 	conducting this evaluation, the commissioner shall apply the disqualification standards set 
72.7 	forth in chapter 245C.

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

72.9 	Sec. 28. Minnesota Statutes 2018, section 245A.04, subdivision 7, is amended to read:
72.10 		Subd. 7.Grant of license; license extension. (a) If the commissioner determines that 
72.11 	the program complies with all applicable rules and laws, the commissioner shall issue a 
72.12 	license consistent with this section or, if applicable, a temporary change of ownership license 
72.13 	under section 245A.043. At minimum, the license shall state:
72.14 	(1) the name of the license holder;
72.15 	(2) the address of the program;
72.16 	(3) the effective date and expiration date of the license;
72.17 	(4) the type of license;
72.18 	(5) the maximum number and ages of persons that may receive services from the program; 
72.19 	and
72.20 	(6) any special conditions of licensure.
72.21 	(b) The commissioner may issue an initial a license for a period not to exceed two years 
72.22 	if:
72.23 	(1) the commissioner is unable to conduct the evaluation or observation required by 
72.24 	subdivision 4, paragraph (a), clauses (3) and clause (4), because the program is not yet 
72.25 	operational;
72.26 	(2) certain records and documents are not available because persons are not yet receiving 
72.27 	services from the program; and
72.28 	(3) the applicant complies with applicable laws and rules in all other respects.
72.29 	(c) A decision by the commissioner to issue a license does not guarantee that any person 
72.30 	or persons will be placed or cared for in the licensed program. A license shall not be 
73.1 	transferable to another individual, corporation, partnership, voluntary association, other 
73.2 	organization, or controlling individual or to another location.
73.3 	(d) A license holder must notify the commissioner and obtain the commissioner's approval 
73.4 	before making any changes that would alter the license information listed under paragraph 
73.5 	(a).
73.6 	(e) (d) Except as provided in paragraphs (g) (f) and (h) (g), the commissioner shall not 
73.7 	issue or reissue a license if the applicant, license holder, or controlling individual has:
73.8 	(1) been disqualified and the disqualification was not set aside and no variance has been 
73.9 	granted;
73.10 	(2) been denied a license under this chapter, within the past two years;
73.11 	(3) had a license issued under this chapter revoked within the past five years;
73.12 	(4) an outstanding debt related to a license fee, licensing fine, or settlement agreement 
73.13 	for which payment is delinquent; or
73.14 	(5) failed to submit the information required of an applicant under subdivision 1, 
73.15 	paragraph (f) or (g), after being requested by the commissioner.
73.16 	When a license issued under this chapter is revoked under clause (1) or (3), the license 
73.17 	holder and controlling individual may not hold any license under chapter 245A or 245D for 
73.18 	five years following the revocation, and other licenses held by the applicant, license holder, 
73.19 	or controlling individual shall also be revoked.
73.20 	(f)(e) The commissioner shall not issue or reissue a license under this chapter if an 
73.21 	individual living in the household where the licensed services will be provided as specified 
73.22 	under section 245C.03, subdivision 1, has been disqualified and the disqualification has not 
73.23 	been set aside and no variance has been granted.
73.24 	(g) (f) Pursuant to section 245A.07, subdivision 1, paragraph (b), when a license issued 
73.25 	under this chapter has been suspended or revoked and the suspension or revocation is under 
73.26 	appeal, the program may continue to operate pending a final order from the commissioner. 
73.27 	If the license under suspension or revocation will expire before a final order is issued, a 
73.28 	temporary provisional license may be issued provided any applicable license fee is paid 
73.29 	before the temporary provisional license is issued.
73.30 	(h) (g) Notwithstanding paragraph (g) (f), when a revocation is based on the 
73.31 	disqualification of a controlling individual or license holder, and the controlling individual 
73.32 	or license holder is ordered under section 245C.17 to be immediately removed from direct 
74.1 	contact with persons receiving services or is ordered to be under continuous, direct 
74.2 	supervision when providing direct contact services, the program may continue to operate 
74.3 	only if the program complies with the order and submits documentation demonstrating 
74.4 	compliance with the order. If the disqualified individual fails to submit a timely request for 
74.5 	reconsideration, or if the disqualification is not set aside and no variance is granted, the 
74.6 	order to immediately remove the individual from direct contact or to be under continuous, 
74.7 	direct supervision remains in effect pending the outcome of a hearing and final order from 
74.8 	the commissioner.
74.9 	(i) (h) For purposes of reimbursement for meals only, under the Child and Adult Care 
74.10 	Food Program, Code of Federal Regulations, title 7, subtitle B, chapter II, subchapter A, 
74.11 	part 226, relocation within the same county by a licensed family day care provider, shall 
74.12 	be considered an extension of the license for a period of no more than 30 calendar days or 
74.13 	until the new license is issued, whichever occurs first, provided the county agency has 
74.14 	determined the family day care provider meets licensure requirements at the new location.
74.15 	(j) (i) Unless otherwise specified by statute, all licenses issued under this chapter expire 
74.16 	at 12:01 a.m. on the day after the expiration date stated on the license. A license holder must 
74.17 	apply for and be granted a new license to operate the program or the program must not be 
74.18 	operated after the expiration date.
74.19 	(k) (j) The commissioner shall not issue or reissue a license under this chapter if it has 
74.20 	been determined that a tribal licensing authority has established jurisdiction to license the 
74.21 	program or service.

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

74.23 	Sec. 29. Minnesota Statutes 2018, section 245A.04, is amended by adding a subdivision 
74.24 	to read:
74.25 		Subd. 7a.Notification required. (a) A license holder must notify the commissioner, in 
74.26 	a manner prescribed by the commissioner, and obtain the commissioner's approval before 
74.27 	making any change that would alter the license information listed under subdivision 7, 
74.28 	paragraph (a).
74.29 	(b) A license holder must also notify the commissioner, in a manner prescribed by the 
74.30 	commissioner, before making any change:
74.31 	(1) to the license holder's authorized agent as defined in section 245A.02, subdivision 
74.32 	3b;
75.1 	(2) to the license holder's controlling individual as defined in section 245A.02, subdivision 
75.2 	5a;
75.3 	(3) to the license holder information on file with the secretary of state;
75.4 	(4) in the location of the program or service licensed under this chapter; and
75.5 	(5) to the federal or state tax identification number associated with the license holder.
75.6 	(c) When, for reasons beyond the license holder's control, a license holder cannot provide 
75.7 	the commissioner with prior notice of the changes in paragraph (b), clauses (1) to (3), the 
75.8 	license holder must notify the commissioner by the tenth business day after the change and 
75.9 	must provide any additional information requested by the commissioner.
75.10 	(d) When a license holder notifies the commissioner of a change to the license holder 
75.11 	information on file with the secretary of state, the license holder must provide amended 
75.12 	articles of incorporation and other documentation of the change.

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

75.14 	Sec. 30. Minnesota Statutes 2018, section 245A.04, is amended by adding a subdivision 
75.15 	to read:
75.16 		Subd. 9a.Child foster home variances for capacity. (a) The commissioner, or the 
75.17 	commissioner of corrections under section 241.021, may grant a variance for a licensed 
75.18 	family foster parent to allow additional foster children if:
75.19 	(1) the variance is needed to allow: (i) a parenting youth in foster care to remain with 
75.20 	the child of the parenting youth; (ii) siblings to remain together; (iii) a child with an 
75.21 	established meaningful relationship with the family to remain with the family; or (iv) a 
75.22 	family with special training or skills to provide care to a child who has a severe disability;
75.23 	(2) there is no risk of harm to a child currently in the home;
75.24 	(3) the structural characteristics of the home, including sleeping space, accommodates 
75.25 	additional foster children;
75.26 	(4) the home remains in compliance with applicable zoning, health, fire, and building 
75.27 	codes; and
75.28 	(5) the statement of intended use specifies conditions for an exception to capacity limits 
75.29 	and specifies how the license holder will maintain a ratio of adults to children that ensures 
75.30 	the safety and appropriate supervision of all the children in the home.
76.1 	(b) A variance granted to a family foster home under Minnesota Rules, part 2960.3030, 
76.2 	subpart 3, prior to October 1, 2019, remains in effect until January 1, 2020.

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

76.4 	Sec. 31. Minnesota Statutes 2018, section 245A.04, subdivision 10, is amended to read:
76.5 		Subd. 10.Adoption agency; additional requirements. In addition to the other 
76.6 	requirements of this section, an individual, corporation, partnership, voluntary association, 
76.7 	other or organization, or controlling individual applying for a license to place children for 
76.8 	adoption must:
76.9 	(1) incorporate as a nonprofit corporation under chapter 317A;
76.10 	(2) file with the application for licensure a copy of the disclosure form required under 
76.11 	section 259.37, subdivision 2;
76.12 	(3) provide evidence that a bond has been obtained and will be continuously maintained 
76.13 	throughout the entire operating period of the agency, to cover the cost of transfer of records 
76.14 	to and storage of records by the agency which has agreed, according to rule established by 
76.15 	the commissioner, to receive the applicant agency's records if the applicant agency voluntarily 
76.16 	or involuntarily ceases operation and fails to provide for proper transfer of the records. The 
76.17 	bond must be made in favor of the agency which has agreed to receive the records; and
76.18 	(4) submit a certified audit to the commissioner each year the license is renewed as 
76.19 	required under section 245A.03, subdivision 1.

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

76.21 	Sec. 32. Minnesota Statutes 2018, section 245A.04, is amended by adding a subdivision 
76.22 	to read:
76.23 		Subd. 18.Plain-language handbook. By January 1, 2020, the commissioner of human 
76.24 	services shall, following consultation with family child care license holders, parents, and 
76.25 	county agencies, develop a plain-language handbook that describes the process and 
76.26 	requirements to become a licensed family child care provider. The handbook shall include 
76.27 	a list of the applicable statutory provisions and rules that apply to licensed family child care 
76.28 	providers. The commissioner shall electronically publish the handbook on the Department 
76.29 	of Human Services website, available at no charge to the public. Each county human services 
76.30 	office and the Department of Human Services shall maintain physical copies of the handbook 
76.31 	for public use.

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

77.2 	Sec. 33. [245A.043] LICENSE APPLICATION AFTER CHANGE OF OWNERSHIP.
77.3 		Subdivision 1.Transfer prohibited. A license issued under this chapter is only valid 
77.4 	for a premises and individual, organization, or government entity identified by the 
77.5 	commissioner on the license. A license is not transferable or assignable.
77.6 		Subd. 2.Change in ownership. (a) If the commissioner determines that there is a change 
77.7 	in ownership, the commissioner shall require submission of a new license application. This 
77.8 	subdivision does not apply to a licensed program or service located in a home where the 
77.9 	license holder resides. A change in ownership occurs when:
77.10 	(1) the license holder sells or transfers 100 percent of the property, stock, or assets;
77.11 	(2) the license holder merges with another organization;
77.12 	(3) the license holder consolidates with two or more organizations, resulting in the 
77.13 	creation of a new organization;
77.14 	(4) there is a change to the federal tax identification number associated with the license 
77.15 	holder; or
77.16 	(5) all controlling individuals associated with the original application have changed.
77.17 	(b) Notwithstanding paragraph (a), clauses (1) and (5), no change in ownership has 
77.18 	occurred if at least one controlling individual has been listed as a controlling individual for 
77.19 	the license for at least the previous 12 months.
77.20 		Subd. 3.Change of ownership process. (a) When a change in ownership is proposed 
77.21 	and the party intends to assume operation without an interruption in service longer than 60 
77.22 	days after acquiring the program or service, the license holder must provide the commissioner 
77.23 	with written notice of the proposed change on a form provided by the commissioner at least 
77.24 	60 days before the anticipated date of the change in ownership. For purposes of this 
77.25 	subdivision and subdivision 4, "party" means the party that intends to operate the service 
77.26 	or program.
77.27 	(b) The party must submit a license application under this chapter on the form and in 
77.28 	the manner prescribed by the commissioner at least 30 days before the change in ownership 
77.29 	is complete, and must include documentation to support the upcoming change. The party 
77.30 	must comply with background study requirements under chapter 245C and shall pay the 
77.31 	application fee required under section 245A.10. A party that intends to assume operation 
78.1 	without an interruption in service longer than 60 days after acquiring the program or service 
78.2 	is exempt from the requirements of Minnesota Rules, part 9530.6800.
78.3 	(c) The commissioner may streamline application procedures when the party is an existing 
78.4 	license holder under this chapter and is acquiring a program licensed under this chapter or 
78.5 	service in the same service class as one or more licensed programs or services the party 
78.6 	operates and those licenses are in substantial compliance. For purposes of this subdivision, 
78.7 	"substantial compliance" means within the previous 12 months the commissioner did not 
78.8 	(1) issue a sanction under section 245A.07 against a license held by the party, or (2) make 
78.9 	a license held by the party conditional according to section 245A.06.
78.10 	(d) Except when a temporary change in ownership license is issued pursuant to 
78.11 	subdivision 4, the existing license holder is solely responsible for operating the program 
78.12 	according to applicable laws and rules until a license under this chapter is issued to the 
78.13 	party.
78.14 	(e) If a licensing inspection of the program or service was conducted within the previous 
78.15 	12 months and the existing license holder's license record demonstrates substantial 
78.16 	compliance with the applicable licensing requirements, the commissioner may waive the 
78.17 	party's inspection required by section 245A.04, subdivision 4. The party must submit to the 
78.18 	commissioner (1) proof that the premises was inspected by a fire marshal or that the fire 
78.19 	marshal deemed that an inspection was not warranted, and (2) proof that the premises was 
78.20 	inspected for compliance with the building code or that no inspection was deemed warranted.
78.21 	(f) If the party is seeking a license for a program or service that has an outstanding action 
78.22 	under section 245A.06 or 245A.07, the party must submit a letter as part of the application 
78.23 	process identifying how the party has or will come into full compliance with the licensing 
78.24 	requirements.
78.25 	(g) The commissioner shall evaluate the party's application according to section 245A.04, 
78.26 	subdivision 6. If the commissioner determines that the party has remedied or demonstrates 
78.27 	the ability to remedy the outstanding actions under section 245A.06 or 245A.07 and has 
78.28 	determined that the program otherwise complies with all applicable laws and rules, the 
78.29 	commissioner shall issue a license or conditional license under this chapter. The conditional 
78.30 	license remains in effect until the commissioner determines that the grounds for the action 
78.31 	are corrected or no longer exist.
78.32 	(h) The commissioner may deny an application as provided in section 245A.05. An 
78.33 	applicant whose application was denied by the commissioner may appeal the denial according 
78.34 	to section 245A.05.
79.1 	(i) This subdivision does not apply to a licensed program or service located in a home 
79.2 	where the license holder resides.
79.3 		Subd. 4.Temporary change in ownership license. (a) After receiving the party's 
79.4 	application pursuant to subdivision 3, upon the written request of the existing license holder 
79.5 	and the party, the commissioner may issue a temporary change in ownership license to the 
79.6 	party while the commissioner evaluates the party's application. Until a decision is made to 
79.7 	grant or deny a license under this chapter, the existing license holder and the party shall 
79.8 	both be responsible for operating the program or service according to applicable laws and 
79.9 	rules, and the sale or transfer of the existing license holder's ownership interest in the licensed 
79.10 	program or service does not terminate the existing license.
79.11 	(b) The commissioner may issue a temporary change in ownership license when a license 
79.12 	holder's death, divorce, or other event affects the ownership of the program and an applicant 
79.13 	seeks to assume operation of the program or service to ensure continuity of the program or 
79.14 	service while a license application is evaluated.
79.15 	(c) This subdivision applies to any program or service licensed under this chapter.

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

79.17 	Sec. 34. Minnesota Statutes 2018, section 245A.05, is amended to read:
79.18 	245A.05 DENIAL OF APPLICATION.
79.19 	(a) The commissioner may deny a license if an applicant or controlling individual:
79.20 	(1) fails to submit a substantially complete application after receiving notice from the 
79.21 	commissioner under section 245A.04, subdivision 1;
79.22 	(2) fails to comply with applicable laws or rules;
79.23 	(3) knowingly withholds relevant information from or gives false or misleading 
79.24 	information to the commissioner in connection with an application for a license or during 
79.25 	an investigation;
79.26 	(4) has a disqualification that has not been set aside under section 245C.22 and no 
79.27 	variance has been granted;
79.28 	(5) has an individual living in the household who received a background study under 
79.29 	section 245C.03, subdivision 1, paragraph (a), clause (2), who has a disqualification that 
79.30 	has not been set aside under section 245C.22, and no variance has been granted;
80.1 	(6) is associated with an individual who received a background study under section 
80.2 	245C.03, subdivision 1, paragraph (a), clause (6), who may have unsupervised access to 
80.3 	children or vulnerable adults, and who has a disqualification that has not been set aside 
80.4 	under section 245C.22, and no variance has been granted; or
80.5 	(7) fails to comply with section 245A.04, subdivision 1, paragraph (f) or (g).;
80.6 	(8) fails to demonstrate competent knowledge as required by section 245A.04, subdivision 
80.7 	6;
80.8 	(9) has a history of noncompliance as a license holder or controlling individual with 
80.9 	applicable laws or rules, including but not limited to this chapter and chapters 119B and 
80.10 	245C; or
80.11 	(10) is prohibited from holding a license according to section 245.095.
80.12 	(b) An applicant whose application has been denied by the commissioner must be given 
80.13 	notice of the denial, which must state the reasons for the denial in plain language. Notice 
80.14 	must be given by certified mail or personal service. The notice must state the reasons the 
80.15 	application was denied and must inform the applicant of the right to a contested case hearing 
80.16 	under chapter 14 and Minnesota Rules, parts 1400.8505 to 1400.8612. The applicant may 
80.17 	appeal the denial by notifying the commissioner in writing by certified mail or personal 
80.18 	service. If mailed, the appeal must be postmarked and sent to the commissioner within 20 
80.19 	calendar days after the applicant received the notice of denial. If an appeal request is made 
80.20 	by personal service, it must be received by the commissioner within 20 calendar days after 
80.21 	the applicant received the notice of denial. Section 245A.08 applies to hearings held to 
80.22 	appeal the commissioner's denial of an application.

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

80.24 	Sec. 35. [245A.055] CLOSING A LICENSE.
80.25 		Subdivision 1.Inactive programs. The commissioner may close a license if the 
80.26 	commissioner determines that a licensed program has not been serving any client for a 
80.27 	consecutive period of 12 months or longer. The license holder is not prohibited from 
80.28 	reapplying for a license if the license holder's license was closed under this chapter.
80.29 		Subd. 2.Reconsideration of closure. If a license is closed, the commissioner must 
80.30 	notify the license holder of closure by certified mail or personal service. If mailed, the notice 
80.31 	of closure must be mailed to the last known address of the license holder and must inform 
80.32 	the license holder why the license was closed and that the license holder has the right to 
80.33 	request reconsideration of the closure. If the license holder believes that the license was 
81.1 	closed in error, the license holder may ask the commissioner to reconsider the closure. The 
81.2 	license holder's request for reconsideration must be made in writing and must include 
81.3 	documentation that the licensed program has served a client in the previous 12 months. The 
81.4 	request for reconsideration must be postmarked and sent to the commissioner within 20 
81.5 	calendar days after the license holder receives the notice of closure. A timely request for 
81.6 	reconsideration stays imposition of the license closure until the commissioner issues a 
81.7 	decision on the request for reconsideration.
81.8 		Subd. 3.Reconsideration final. The commissioner's disposition of a request for 
81.9 	reconsideration is final and not subject to appeal under chapter 14.

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

81.11 	Sec. 36. Minnesota Statutes 2018, section 245A.07, subdivision 1, is amended to read:
81.12 		Subdivision 1.Sanctions; appeals; license. (a) In addition to making a license conditional 
81.13 	under section 245A.06, the commissioner may suspend or revoke the license, impose a fine, 
81.14 	or secure an injunction against the continuing operation of the program of a license holder 
81.15 	who does not comply with applicable law or rule. When applying sanctions authorized under 
81.16 	this section, the commissioner shall consider the nature, chronicity, or severity of the violation 
81.17 	of law or rule and the effect of the violation on the health, safety, or rights of persons served 
81.18 	by the program.
81.19 	(b) If a license holder appeals the suspension or revocation of a license and the license 
81.20 	holder continues to operate the program pending a final order on the appeal, the commissioner 
81.21 	shall issue the license holder a temporary provisional license. Unless otherwise specified 
81.22 	by the commissioner, variances in effect on the date of the license sanction under appeal 
81.23 	continue under the temporary provisional license. If a license holder fails to comply with 
81.24 	applicable law or rule while operating under a temporary provisional license, the 
81.25 	commissioner may impose additional sanctions under this section and section 245A.06, and 
81.26 	may terminate any prior variance. If a temporary provisional license is set to expire, a new 
81.27 	temporary provisional license shall be issued to the license holder upon payment of any fee 
81.28 	required under section 245A.10. The temporary provisional license shall expire on the date 
81.29 	the final order is issued. If the license holder prevails on the appeal, a new nonprovisional 
81.30 	license shall be issued for the remainder of the current license period.
81.31 	(c) If a license holder is under investigation and the license issued under this chapter is 
81.32 	due to expire before completion of the investigation, the program shall be issued a new 
81.33 	license upon completion of the reapplication requirements and payment of any applicable 
82.1 	license fee. Upon completion of the investigation, a licensing sanction may be imposed 
82.2 	against the new license under this section, section 245A.06, or 245A.08.
82.3 	(d) Failure to reapply or closure of a license issued under this chapter by the license 
82.4 	holder prior to the completion of any investigation shall not preclude the commissioner 
82.5 	from issuing a licensing sanction under this section, or section 245A.06, or 245A.08 at the 
82.6 	conclusion of the investigation.

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

82.8 	Sec. 37. Minnesota Statutes 2018, section 245A.07, subdivision 2, is amended to read:
82.9 		Subd. 2.Temporary immediate suspension. (a) The commissioner shall act immediately 
82.10 	to temporarily suspend a license issued under this chapter if:
82.11 	(1) the license holder's actions or failure to comply with applicable law or rule, or the 
82.12 	actions of other individuals or conditions in the program, pose an imminent risk of harm to 
82.13 	the health, safety, or rights of persons served by the program; or
82.14 	(2) while the program continues to operate pending an appeal of an order of revocation, 
82.15 	the commissioner identifies one or more subsequent violations of law or rule which may 
82.16 	adversely affect the health or safety of persons served by the program.; or
82.17 	(3) the license holder is criminally charged in state or federal court with an offense that 
82.18 	involves fraud or theft against a program administered by the commissioner.
82.19 	(b) No state funds shall be made available or be expended by any agency or department 
82.20 	of state, county, or municipal government for use by a license holder regulated under this 
82.21 	chapter while a license issued under this chapter is under immediate suspension. A notice 
82.22 	stating the reasons for the immediate suspension and informing the license holder of the 
82.23 	right to an expedited hearing under chapter 14 and Minnesota Rules, parts 1400.8505 to 
82.24 	1400.8612, must be delivered by personal service to the address shown on the application 
82.25 	or the last known address of the license holder. The license holder may appeal an order 
82.26 	immediately suspending a license. The appeal of an order immediately suspending a license 
82.27 	must be made in writing by certified mail or, personal service, or other means expressly set 
82.28 	forth in the commissioner's order. If mailed, the appeal must be postmarked and sent to the 
82.29 	commissioner within five calendar days after the license holder receives notice that the 
82.30 	license has been immediately suspended. If a request is made by personal service, it must 
82.31 	be received by the commissioner within five calendar days after the license holder received 
82.32 	the order. A license holder and any controlling individual shall discontinue operation of the 
82.33 	program upon receipt of the commissioner's order to immediately suspend the license.

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

83.2 	Sec. 38. Minnesota Statutes 2018, section 245A.07, subdivision 2a, is amended to read:
83.3 		Subd. 2a.Immediate suspension expedited hearing. (a) Within five working days of 
83.4 	receipt of the license holder's timely appeal, the commissioner shall request assignment of 
83.5 	an administrative law judge. The request must include a proposed date, time, and place of 
83.6 	a hearing. A hearing must be conducted by an administrative law judge within 30 calendar 
83.7 	days of the request for assignment, unless an extension is requested by either party and 
83.8 	granted by the administrative law judge for good cause. The commissioner shall issue a 
83.9 	notice of hearing by certified mail or personal service at least ten working days before the 
83.10 	hearing. The scope of the hearing shall be limited solely to the issue of whether the temporary 
83.11 	immediate suspension should remain in effect pending the commissioner's final order under 
83.12 	section 245A.08, regarding a licensing sanction issued under subdivision 3 following the 
83.13 	immediate suspension. For suspensions under subdivision 2, paragraph (a), clause (1), the 
83.14 	burden of proof in expedited hearings under this subdivision shall be limited to the 
83.15 	commissioner's demonstration that reasonable cause exists to believe that the license holder's 
83.16 	actions or failure to comply with applicable law or rule poses, or the actions of other 
83.17 	individuals or conditions in the program poses an imminent risk of harm to the health, safety, 
83.18 	or rights of persons served by the program. "Reasonable cause" means there exist specific 
83.19 	articulable facts or circumstances which provide the commissioner with a reasonable 
83.20 	suspicion that there is an imminent risk of harm to the health, safety, or rights of persons 
83.21 	served by the program. When the commissioner has determined there is reasonable cause 
83.22 	to order the temporary immediate suspension of a license based on a violation of safe sleep 
83.23 	requirements, as defined in section 245A.1435, the commissioner is not required to 
83.24 	demonstrate that an infant died or was injured as a result of the safe sleep violations. For 
83.25 	suspensions under subdivision 2, paragraph (a), clause (2), the burden of proof in expedited 
83.26 	hearings under this subdivision shall be limited to the commissioner's demonstration by a 
83.27 	preponderance of the evidence that, since the license was revoked, the license holder 
83.28 	committed additional violations of law or rule which may adversely affect the health or 
83.29 	safety of persons served by the program.
83.30 	(b) The administrative law judge shall issue findings of fact, conclusions, and a 
83.31 	recommendation within ten working days from the date of hearing. The parties shall have 
83.32 	ten calendar days to submit exceptions to the administrative law judge's report. The record 
83.33 	shall close at the end of the ten-day period for submission of exceptions. The commissioner's 
83.34 	final order shall be issued within ten working days from the close of the record. When an 
83.35 	appeal of a temporary immediate suspension is withdrawn or dismissed, the commissioner 
84.1 	shall issue a final order affirming the temporary immediate suspension within ten calendar 
84.2 	days of the commissioner's receipt of the withdrawal or dismissal. Within 90 calendar days 
84.3 	after a final order affirming an immediate suspension, the commissioner shall make a 
84.4 	determination regarding whether a final licensing sanction shall be issued under subdivision 
84.5 	3. The license holder shall continue to be prohibited from operation of the program during 
84.6 	this 90-day period.
84.7 	(c) When the final order under paragraph (b) affirms an immediate suspension, and a 
84.8 	final licensing sanction is issued under subdivision 3 and the license holder appeals that 
84.9 	sanction, the license holder continues to be prohibited from operation of the program pending 
84.10 	a final commissioner's order under section 245A.08, subdivision 5, regarding the final 
84.11 	licensing sanction.
84.12 	(d) For suspensions under subdivision 2, paragraph (a), clause (3), the burden of proof 
84.13 	in expedited hearings under this subdivision shall be limited to the commissioner's 
84.14 	demonstration by a preponderance of the evidence that a criminal complaint and warrant 
84.15 	or summons was issued for the license holder that was not dismissed, and that the criminal 
84.16 	charge is an offense that involves fraud or theft against a program administered by the 
84.17 	commissioner.

84.18 	Sec. 39. Minnesota Statutes 2018, section 245A.07, subdivision 3, is amended to read:
84.19 		Subd. 3.License suspension, revocation, or fine. (a) The commissioner may suspend 
84.20 	or revoke a license, or impose a fine if:
84.21 	(1) a license holder fails to comply fully with applicable laws or rules including but not 
84.22 	limited to the requirements of this chapter and chapter 245C;
84.23 	(2) a license holder, a controlling individual, or an individual living in the household 
84.24 	where the licensed services are provided or is otherwise subject to a background study has 
84.25 	a been disqualified and the disqualification which has was not been set aside under section 
84.26 	245C.22 and no variance has been granted;
84.27 	(3) a license holder knowingly withholds relevant information from or gives false or 
84.28 	misleading information to the commissioner in connection with an application for a license, 
84.29 	in connection with the background study status of an individual, during an investigation, 
84.30 	or regarding compliance with applicable laws or rules; or
84.31 	(4) after July 1, 2012, and upon request by the commissioner, a license holder fails to 
84.32 	submit the information required of an applicant under section 245A.04, subdivision 1, 
85.1 	paragraph (f) or (g). a license holder is excluded from any program administered by the 
85.2 	commissioner under section 245.095; or
85.3 	(5) revocation is required under section 245A.04, subdivision 7, paragraph (d).
85.4 	A license holder who has had a license issued under this chapter suspended, revoked, 
85.5 	or has been ordered to pay a fine must be given notice of the action by certified mail or 
85.6 	personal service. If mailed, the notice must be mailed to the address shown on the application 
85.7 	or the last known address of the license holder. The notice must state in plain language the 
85.8 	reasons the license was suspended or revoked, or a fine was ordered.
85.9 	(b) If the license was suspended or revoked, the notice must inform the license holder 
85.10 	of the right to a contested case hearing under chapter 14 and Minnesota Rules, parts 
85.11 	1400.8505 to 1400.8612. The license holder may appeal an order suspending or revoking 
85.12 	a license. The appeal of an order suspending or revoking a license must be made in writing 
85.13 	by certified mail or personal service. If mailed, the appeal must be postmarked and sent to 
85.14 	the commissioner within ten calendar days after the license holder receives notice that the 
85.15 	license has been suspended or revoked. If a request is made by personal service, it must be 
85.16 	received by the commissioner within ten calendar days after the license holder received the 
85.17 	order. Except as provided in subdivision 2a, paragraph (c), if a license holder submits a 
85.18 	timely appeal of an order suspending or revoking a license, the license holder may continue 
85.19 	to operate the program as provided in section 245A.04, subdivision 7, paragraphs (g) (f)
85.20 	and (h) (g), until the commissioner issues a final order on the suspension or revocation.
85.21 	(c)(1) If the license holder was ordered to pay a fine, the notice must inform the license 
85.22 	holder of the responsibility for payment of fines and the right to a contested case hearing 
85.23 	under chapter 14 and Minnesota Rules, parts 1400.8505 to 1400.8612. The appeal of an 
85.24 	order to pay a fine must be made in writing by certified mail or personal service. If mailed, 
85.25 	the appeal must be postmarked and sent to the commissioner within ten calendar days after 
85.26 	the license holder receives notice that the fine has been ordered. If a request is made by 
85.27 	personal service, it must be received by the commissioner within ten calendar days after 
85.28 	the license holder received the order.
85.29 	(2) The license holder shall pay the fines assessed on or before the payment date specified. 
85.30 	If the license holder fails to fully comply with the order, the commissioner may issue a 
85.31 	second fine or suspend the license until the license holder complies. If the license holder 
85.32 	receives state funds, the state, county, or municipal agencies or departments responsible for 
85.33 	administering the funds shall withhold payments and recover any payments made while the 
86.1 	license is suspended for failure to pay a fine. A timely appeal shall stay payment of the fine 
86.2 	until the commissioner issues a final order.
86.3 	(3) A license holder shall promptly notify the commissioner of human services, in writing, 
86.4 	when a violation specified in the order to forfeit a fine is corrected. If upon reinspection the 
86.5 	commissioner determines that a violation has not been corrected as indicated by the order 
86.6 	to forfeit a fine, the commissioner may issue a second fine. The commissioner shall notify 
86.7 	the license holder by certified mail or personal service that a second fine has been assessed. 
86.8 	The license holder may appeal the second fine as provided under this subdivision.
86.9 	(4) Fines shall be assessed as follows:
86.10 	(i) the license holder shall forfeit $1,000 for each determination of maltreatment of a 
86.11 	child under section 626.556 or the maltreatment of a vulnerable adult under section 626.557 
86.12 	for which the license holder is determined responsible for the maltreatment under section 
86.13 	626.556, subdivision 10e, paragraph (i), or 626.557, subdivision 9c, paragraph (c);
86.14 	(ii) if the commissioner determines that a determination of maltreatment for which the 
86.15 	license holder is responsible is the result of maltreatment that meets the definition of serious 
86.16 	maltreatment as defined in section 245C.02, subdivision 18, the license holder shall forfeit 
86.17 	$5,000;
86.18 	(iii) for a program that operates out of the license holder's home and a program licensed 
86.19 	under Minnesota Rules, parts 9502.0300 to 9502.0495 9502.0445, the fine assessed against 
86.20 	the license holder shall not exceed $1,000 for each determination of maltreatment;
86.21 	(iv) the license holder shall forfeit $200 for each occurrence of a violation of law or rule 
86.22 	governing matters of health, safety, or supervision, including but not limited to the provision 
86.23 	of adequate staff-to-child or adult ratios, and failure to comply with background study 
86.24 	requirements under chapter 245C; and
86.25 	(v) the license holder shall forfeit $100 for each occurrence of a violation of law or rule 
86.26 	other than those subject to a $5,000, $1,000, or $200 fine in items (i) to (iv).
86.27 	For purposes of this section, "occurrence" means each violation identified in the 
86.28 	commissioner's fine order. Fines assessed against a license holder that holds a license to 
86.29 	provide home and community-based services, as identified in section 245D.03, subdivision 
86.30 	1, and a community residential setting or day services facility license under chapter 245D
86.31 	where the services are provided, may be assessed against both licenses for the same 
86.32 	occurrence, but the combined amount of the fines shall not exceed the amount specified in 
86.33 	this clause for that occurrence.
87.1 	(5) When a fine has been assessed, the license holder may not avoid payment by closing, 
87.2 	selling, or otherwise transferring the licensed program to a third party. In such an event, the 
87.3 	license holder will be personally liable for payment. In the case of a corporation, each 
87.4 	controlling individual is personally and jointly liable for payment.
87.5 	(d) Except for background study violations involving the failure to comply with an order 
87.6 	to immediately remove an individual or an order to provide continuous, direct supervision, 
87.7 	the commissioner shall not issue a fine under paragraph (c) relating to a background study 
87.8 	violation to a license holder who self-corrects a background study violation before the 
87.9 	commissioner discovers the violation. A license holder who has previously exercised the 
87.10 	provisions of this paragraph to avoid a fine for a background study violation may not avoid 
87.11 	a fine for a subsequent background study violation unless at least 365 days have passed 
87.12 	since the license holder self-corrected the earlier background study violation.

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

87.14 	Sec. 40. Minnesota Statutes 2018, section 245A.14, subdivision 4, is amended to read:
87.15 		Subd. 4.Special family day care homes. Nonresidential child care programs serving 
87.16 	14 or fewer children that are conducted at a location other than the license holder's own 
87.17 	residence shall be licensed under this section and the rules governing family day care or 
87.18 	group family day care if:
87.19 	(a) the license holder is the primary provider of care and the nonresidential child care 
87.20 	program is conducted in a dwelling that is located on a residential lot;
87.21 	(b) the license holder is an employer who may or may not be the primary provider of 
87.22 	care, and the purpose for the child care program is to provide child care services to children 
87.23 	of the license holder's employees;
87.24 	(c) the license holder is a church or religious organization;
87.25 	(d) the license holder is a community collaborative child care provider. For purposes of 
87.26 	this subdivision, a community collaborative child care provider is a provider participating 
87.27 	in a cooperative agreement with a community action agency as defined in section 256E.31;
87.28 	(e) the license holder is a not-for-profit agency that provides child care in a dwelling 
87.29 	located on a residential lot and the license holder maintains two or more contracts with 
87.30 	community employers or other community organizations to provide child care services. 
87.31 	The county licensing agency may grant a capacity variance to a license holder licensed 
87.32 	under this paragraph to exceed the licensed capacity of 14 children by no more than five 
88.1 	children during transition periods related to the work schedules of parents, if the license 
88.2 	holder meets the following requirements:
88.3 	(1) the program does not exceed a capacity of 14 children more than a cumulative total 
88.4 	of four hours per day;
88.5 	(2) the program meets a one to seven staff-to-child ratio during the variance period;
88.6 	(3) all employees receive at least an extra four hours of training per year than required 
88.7 	in the rules governing family child care each year;
88.8 	(4) the facility has square footage required per child under Minnesota Rules, part 
88.9 	9502.0425;
88.10 	(5) the program is in compliance with local zoning regulations;
88.11 	(6) the program is in compliance with the applicable fire code as follows:
88.12 	(i) if the program serves more than five children older than 2-1/2 years of age, but no 
88.13 	more than five children 2-1/2 years of age or less, the applicable fire code is educational 
88.14 	occupancy, as provided in Group E Occupancy under the Minnesota State Fire Code 2003
88.15 	2015, Section 202; or
88.16 	(ii) if the program serves more than five children 2-1/2 years of age or less, the applicable 
88.17 	fire code is Group I-4 Occupancies, as provided in the Minnesota State Fire Code 2003
88.18 	2015, Section 202, unless the rooms in which the children are cared for are located on a 
88.19 	level of exit discharge and each of these child care rooms has an exit door directly to the 
88.20 	exterior, then the applicable fire code is Group E occupancies, as provided in the Minnesota 
88.21 	State Fire Code 2015, Section 202; and
88.22 	(7) any age and capacity limitations required by the fire code inspection and square 
88.23 	footage determinations shall be printed on the license; or
88.24 	(f) the license holder is the primary provider of care and has located the licensed child 
88.25 	care program in a commercial space, if the license holder meets the following requirements:
88.26 	(1) the program is in compliance with local zoning regulations;
88.27 	(2) the program is in compliance with the applicable fire code as follows:
88.28 	(i) if the program serves more than five children older than 2-1/2 years of age, but no 
88.29 	more than five children 2-1/2 years of age or less, the applicable fire code is educational 
88.30 	occupancy, as provided in Group E Occupancy under the Minnesota State Fire Code 2003
88.31 	2015, Section 202; or
89.1 	(ii) if the program serves more than five children 2-1/2 years of age or less, the applicable 
89.2 	fire code is Group I-4 Occupancies, as provided under the Minnesota State Fire Code 2003
89.3 	2015, Section 202;
89.4 	(3) any age and capacity limitations required by the fire code inspection and square 
89.5 	footage determinations are printed on the license; and
89.6 	(4) the license holder prominently displays the license issued by the commissioner which 
89.7 	contains the statement "This special family child care provider is not licensed as a child 
89.8 	care center."
89.9 	(g) The commissioner may approve two or more licenses under paragraphs (a) to (f) to 
89.10 	be issued at the same location or under one contiguous roof, if each license holder is able 
89.11 	to demonstrate compliance with all applicable rules and laws. Each license holder must 
89.12 	operate the license holder's respective licensed program as a distinct program and within 
89.13 	the capacity, age, and ratio distributions of each license.
89.14 	(h) The commissioner may grant variances to this section to allow a primary provider 
89.15 	of care, a not-for-profit organization, a church or religious organization, an employer, or a 
89.16 	community collaborative to be licensed to provide child care under paragraphs (e) and (f) 
89.17 	if the license holder meets the other requirements of the statute.

89.18 	EFFECTIVE DATE. This section is effective September 30, 2019.

89.19 	Sec. 41. Minnesota Statutes 2018, section 245A.14, subdivision 8, is amended to read:
89.20 		Subd. 8.Experienced aides; child care centers. (a) An individual employed as an aide 
89.21 	at a child care center may work with children without being directly supervised for an 
89.22 	amount of time that does not exceed 25 percent of the child care center's daily hours if:
89.23 	(1) a teacher is in the facility;
89.24 	(2) the individual has received within the last three years first aid training that meets the 
89.25 	requirements under section 245A.40, subdivision 3, and CPR training that meets the 
89.26 	requirements under section 245A.40, subdivision 4;
89.27 	(3) (2) the individual is at least 20 years old; and
89.28 	(4) (3) the individual has at least 4,160 hours of child care experience as a staff member 
89.29 	in a licensed child care center or as the license holder of a family day care home, 120 days 
89.30 	of which must be in the employment of the current company.
89.31 	(b) A child care center that uses experienced aides under this subdivision must notify 
89.32 	parents or guardians by posting the notification in each classroom that uses experienced 
90.1 	aides, identifying which staff member is the experienced aide. Records of experienced aide 
90.2 	usage must be kept on site and given to the commissioner upon request.
90.3 	(c) A child care center may not use the experienced aide provision for one year following 
90.4 	two determined experienced aide violations within a one-year period.
90.5 	(d) A child care center may use one experienced aide per every four full-time child care 
90.6 	classroom staff.

90.7 	EFFECTIVE DATE. This section is effective September 30, 2019.

90.8 	Sec. 42. Minnesota Statutes 2018, section 245A.14, is amended by adding a subdivision 
90.9 	to read:
90.10 		Subd. 16.Valid driver's license. Notwithstanding any law to the contrary, when a 
90.11 	licensed child care center provides transportation for children or contracts to provide 
90.12 	transportation for children, a person who has a current, valid driver's license appropriate to 
90.13 	the vehicle driven may transport the child.

90.14 	EFFECTIVE DATE. This section is effective September 30, 2019.

90.15 	Sec. 43. Minnesota Statutes 2018, section 245A.14, is amended by adding a subdivision 
90.16 	to read:
90.17 		Subd. 17.Reusable water bottles or cups. Notwithstanding any law to the contrary, a 
90.18 	licensed child care center may provide drinking water to a child in a reusable water bottle 
90.19 	or reusable cup if the center develops and ensures implementation of a written policy that 
90.20 	at a minimum includes the following procedures:
90.21 	(1) each day the water bottle or cup is used, the child care center cleans and sanitizes 
90.22 	the water bottle or cup using procedures that comply with the Food Code under Minnesota 
90.23 	Rules, chapter 4626;
90.24 	(2) a water bottle or cup is assigned to a specific child and labeled with the child's first 
90.25 	and last name;
90.26 	(3) water bottles and cups are stored in a manner that reduces the risk of a child using 
90.27 	the wrong water bottle or cup; and
90.28 	(4) a water bottle or cup is used only for water.

90.29 	EFFECTIVE DATE. This section is effective September 30, 2019.

91.1 	Sec. 44. Minnesota Statutes 2018, section 245A.145, subdivision 1, is amended to read:
91.2 		Subdivision 1.Policies and procedures. (a) All licensed child care providers The 
91.3 	Department of Human Services must develop policies and procedures for reporting suspected 
91.4 	child maltreatment that fulfill the requirements in section 626.556 and must develop policies 
91.5 	and procedures for reporting complaints about the operation of a child care program. The 
91.6 	policies and procedures must include the telephone numbers of the local county child 
91.7 	protection agency for reporting suspected maltreatment; the county licensing agency for 
91.8 	family and group family child care providers; and the state licensing agency for child care 
91.9 	centers. provide the policies and procedures to all licensed child care providers. The policies 
91.10 	and procedures must be written in plain language.
91.11 	(b) The policies and procedures required in paragraph (a) must:
91.12 	(1) be provided to the parents of all children at the time of enrollment in the child care 
91.13 	program; and
91.14 	(2) be made available upon request.

91.15 	EFFECTIVE DATE. This section is effective September 30, 2019.

91.16 	Sec. 45. Minnesota Statutes 2018, section 245A.145, subdivision 2, is amended to read:
91.17 		Subd. 2.Licensing agency phone number displayed. By July 1, 2002, A new or 
91.18 	renewed child care license must include the licensing agency's telephone number and a 
91.19 	statement that informs parents who have concerns questions about their child's care that 
91.20 	they may call the licensing agency. The commissioner shall print the telephone number for 
91.21 	the licensing agency in bold and large font on the license issued to child care providers.

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

91.23 	Sec. 46. [245A.149] SUPERVISION OF FAMILY CHILD CARE LICENSE 
91.24 	HOLDER'S OWN CHILD.
91.25 	(a) Notwithstanding Minnesota Rules, part 9502.0365, subpart 5, an individual may be 
91.26 	present in the licensed space, may supervise the family child care license holder's own child 
91.27 	both inside and outside of the licensed space, and is exempt from the training and supervision 
91.28 	requirements of this chapter and Minnesota Rules, chapter 9502, if the individual:
91.29 	(1) is related to the license holder, as defined in section 245A.02, subdivision 13;
91.30 	(2) is not a designated caregiver, helper, or substitute for the licensed program;
91.31 	(3) is involved only in the care of the license holder's own child; and
92.1 	(4) does not have direct, unsupervised contact with any nonrelative children receiving 
92.2 	services.
92.3 	(b) If the individual in paragraph (a) is not a household member, the individual is also 
92.4 	exempt from background study requirements under chapter 245C.

92.5 	EFFECTIVE DATE. This section is effective September 30, 2019.

92.6 	Sec. 47. Minnesota Statutes 2018, section 245A.151, is amended to read:
92.7 	245A.151 FIRE MARSHAL INSPECTION.
92.8 	When licensure under this chapter or certification under chapter 245H requires an 
92.9 	inspection by a fire marshal to determine compliance with the State Fire Code under section 
92.10 	299F.011, a local fire code inspector approved by the state fire marshal may conduct the 
92.11 	inspection. If a community does not have a local fire code inspector or if the local fire code 
92.12 	inspector does not perform the inspection, the state fire marshal must conduct the inspection. 
92.13 	A local fire code inspector or the state fire marshal may recover the cost of these inspections 
92.14 	through a fee of no more than $50 per inspection charged to the applicant or license holder
92.15 	or license-exempt child care center certification holder. The fees collected by the state fire 
92.16 	marshal under this section are appropriated to the commissioner of public safety for the 
92.17 	purpose of conducting the inspections.

92.18 	EFFECTIVE DATE. This section is effective September 30, 2019.

92.19 	Sec. 48. Minnesota Statutes 2018, section 245A.16, subdivision 1, is amended to read:
92.20 		Subdivision 1.Delegation of authority to agencies. (a) County agencies and private 
92.21 	agencies that have been designated or licensed by the commissioner to perform licensing 
92.22 	functions and activities under section 245A.04 and background studies for family child care 
92.23 	under chapter 245C; to recommend denial of applicants under section 245A.05; to issue 
92.24 	correction orders, to issue variances, and recommend a conditional license under section 
92.25 	245A.06; or to recommend suspending or revoking a license or issuing a fine under section 
92.26 	245A.07, shall comply with rules and directives of the commissioner governing those 
92.27 	functions and with this section. The following variances are excluded from the delegation 
92.28 	of variance authority and may be issued only by the commissioner:
92.29 	(1) dual licensure of family child care and child foster care, dual licensure of child and 
92.30 	adult foster care, and adult foster care and family child care;
92.31 	(2) adult foster care maximum capacity;
93.1 	(3) adult foster care minimum age requirement;
93.2 	(4) child foster care maximum age requirement;
93.3 	(5) variances regarding disqualified individuals except that, before the implementation 
93.4 	of NETStudy 2.0, county agencies may issue variances under section 245C.30 regarding 
93.5 	disqualified individuals when the county is responsible for conducting a consolidated 
93.6 	reconsideration according to sections 245C.25 and 245C.27, subdivision 2, clauses (a) and 
93.7 	(b), of a county maltreatment determination and a disqualification based on serious or 
93.8 	recurring maltreatment;
93.9 	(6) the required presence of a caregiver in the adult foster care residence during normal 
93.10 	sleeping hours; and
93.11 	(7) variances to requirements relating to chemical use problems of a license holder or a 
93.12 	household member of a license holder.; and
93.13 	(8) variances to section 245A.53 for a time-limited period. If the commissioner grants 
93.14 	a variance under this clause, the license holder must provide notice of the variance to all 
93.15 	parents and guardians of the children in care.
93.16 	Except as provided in section 245A.14, subdivision 4, paragraph (e), a county agency must 
93.17 	not grant a license holder a variance to exceed the maximum allowable family child care 
93.18 	license capacity of 14 children.
93.19 	(b) Before the implementation of NETStudy 2.0, county agencies must report information 
93.20 	about disqualification reconsiderations under sections 245C.25 and 245C.27, subdivision 
93.21 	2, paragraphs (a) and (b), and variances granted under paragraph (a), clause (5), to the 
93.22 	commissioner at least monthly in a format prescribed by the commissioner.
93.23 	(c) For family child care programs, the commissioner shall require a county agency to 
93.24 	conduct one unannounced licensing review at least annually.
93.25 	(d) For family adult day services programs, the commissioner may authorize licensing 
93.26 	reviews every two years after a licensee has had at least one annual review.
93.27 	(e) A license issued under this section may be issued for up to two years.
93.28 	(f) During implementation of chapter 245D, the commissioner shall consider:
93.29 	(1) the role of counties in quality assurance;
93.30 	(2) the duties of county licensing staff; and
94.1 	(3) the possible use of joint powers agreements, according to section 471.59, with counties 
94.2 	through which some licensing duties under chapter 245D may be delegated by the 
94.3 	commissioner to the counties.
94.4 	Any consideration related to this paragraph must meet all of the requirements of the corrective 
94.5 	action plan ordered by the federal Centers for Medicare and Medicaid Services.
94.6 	(g) Licensing authority specific to section 245D.06, subdivisions 5, 6, 7, and 8, or 
94.7 	successor provisions; and section 245D.061 or successor provisions, for family child foster 
94.8 	care programs providing out-of-home respite, as identified in section 245D.03, subdivision 
94.9 	1, paragraph (b), clause (1), is excluded from the delegation of authority to county and 
94.10 	private agencies.
94.11 	(h) A county agency shall report to the commissioner, in a manner prescribed by the 
94.12 	commissioner, the following information for a licensed family child care program:
94.13 	(1) the results of each licensing review completed, including the date of the review, and 
94.14 	any licensing correction order issued; and
94.15 	(2) any death, serious injury, or determination of substantiated maltreatment.; and
94.16 	(3) any fires that require the service of a fire department within 48 hours of the fire. The 
94.17 	information under this clause must also be reported to the State Fire Marshal within two 
94.18 	business days of receiving notice from a licensed family child care provider.

94.19 	EFFECTIVE DATE. This section is effective September 30, 2019.

94.20 	Sec. 49. Minnesota Statutes 2018, section 245A.18, subdivision 2, is amended to read:
94.21 		Subd. 2.Child passenger restraint systems; training requirement. (a) Programs 
94.22 	licensed by the Department of Human Services under Minnesota Rules, chapter 2960, that 
94.23 	serve a child or children under nineeight years of age must document training that fulfills 
94.24 	the requirements in this subdivision.
94.25 	(b) Before a license holder, staff person, or caregiver transports a child or children under 
94.26 	age nineeight in a motor vehicle, the person transporting the child must satisfactorily 
94.27 	complete training on the proper use and installation of child restraint systems in motor 
94.28 	vehicles. Training completed under this section may be used to meet initial or ongoing 
94.29 	training under Minnesota Rules, part 2960.3070, subparts 1 and 2.
94.30 	For all providers licensed prior to July 1, 2006, the training required in this subdivision 
94.31 	must be obtained by December 31, 2007.
95.1 	(c) Training required under this section must be at least one hour in length, completed 
95.2 	at orientation or initial training, and repeated at least once every five years. At a minimum, 
95.3 	the training must address the proper use of child restraint systems based on the child's size, 
95.4 	weight, and age, and the proper installation of a car seat or booster seat in the motor vehicle 
95.5 	used by the license holder to transport the child or children.
95.6 	(d) Training under paragraph (c) must be provided by individuals who are certified and 
95.7 	approved by the Department of Public Safety, Office of Traffic Safety. License holders may 
95.8 	obtain a list of certified and approved trainers through the Department of Public Safety 
95.9 	website or by contacting the agency.
95.10 	(e) Child care providers that only transport school age children as defined in section 
95.11 	245A.02, subdivision 16, in school buses as defined in section 169.011, subdivision 71, 
95.12 	paragraphs (c) to (f), are exempt from this subdivision.
95.13 	(e) Notwithstanding paragraph (a), for an emergency relative placement under section 
95.14 	245A.035, the commissioner may grant a variance to the training required by this subdivision 
95.15 	for a relative who completes a child seat safety check up. The child seat safety check up 
95.16 	trainer must be approved by the Department of Public Safety, Office of Traffic Safety, and 
95.17 	must provide one-on-one instruction on placing a child of a specific age in the exact child 
95.18 	passenger restraint in the motor vehicle in which the child will be transported. Once granted 
95.19 	a variance, and if all other licensing requirements are met, the relative applicant may receive 
95.20 	a license and may transport a relative foster child younger than eight years of age. A child 
95.21 	seat safety check up must be completed each time a child requires a different size car seat 
95.22 	according to car seat and vehicle manufacturer guidelines. A relative license holder must 
95.23 	complete training that meets the other requirements of this subdivision prior to placement 
95.24 	of another foster child younger than eight years of age in the home or prior to the renewal 
95.25 	of the child foster care license.

95.26 	EFFECTIVE DATE. This section is effective September 30, 2019.

95.27 	Sec. 50. [245A.24] MANDATORY REPORTING.
95.28 	Any individual engaging in licensing functions and activities under this chapter, including 
95.29 	authorities delegated under section 245A.16, must immediately report any suspected fraud 
95.30 	to county human services investigators or the Department of Human Services Office of 
95.31 	Inspector General.

96.1 	Sec. 51. Minnesota Statutes 2018, section 245A.40, is amended to read:
96.2 	245A.40 CHILD CARE CENTER TRAINING REQUIREMENTS.
96.3 		Subdivision 1.Orientation. (a) The child care center license holder must ensure that 
96.4 	every the director, staff person and volunteer is persons, substitutes, and unsupervised 
96.5 	volunteers are given orientation training and successfully completes complete the training 
96.6 	before starting assigned duties. The orientation training in this subdivision applies to 
96.7 	volunteers who will have direct contact with or access to children and who are not under 
96.8 	the direct supervision of a staff person. Completion of the orientation must be documented 
96.9 	in the individual's personnel record. The orientation training must include information about:
96.10 	(1) the center's philosophy, child care program, and procedures for maintaining health 
96.11 	and safety according to section 245A.41 and Minnesota Rules, part 9503.0140, and handling 
96.12 	emergencies and accidents according to Minnesota Rules, part 9503.0110;
96.13 	(2) specific job responsibilities;
96.14 	(3) the behavior guidance standards in Minnesota Rules, part 9503.0055; and
96.15 	(4) the reporting responsibilities in section 626.556, and Minnesota Rules, part 
96.16 	9503.0130.;
96.17 	(5) the center's drug and alcohol policy under section 245A.04, subdivision 1, paragraph 
96.18 	(c);
96.19 	(6) the center's risk reduction plan as required under section 245A.66, subdivision 2;
96.20 	(7) at least one-half hour of training on the standards under section 245A.1435 and on 
96.21 	reducing the risk of sudden unexpected infant death as required in subdivision 5, if applicable;
96.22 	(8) at least one-half hour of training on the risk of abusive head trauma as required for 
96.23 	the director and staff under subdivision 5a, if applicable; and
96.24 	(9) training required by a child's individual child care program plan as required under 
96.25 	Minnesota Rules, part 9503.0065, subpart 3, if applicable.
96.26 	(b) In addition to paragraph (a), before having unsupervised direct contact with a child, 
96.27 	the director and staff persons within the first 90 days of employment, and substitutes and 
96.28 	unsupervised volunteers within 90 days after the first date of direct contact with a child, 
96.29 	must complete:
96.30 	(1) pediatric first aid, in accordance with subdivision 3; and
96.31 	(2) pediatric cardiopulmonary resuscitation, in accordance with subdivision 4.
97.1 	(c) In addition to paragraph (b), the director and staff persons within the first 90 days 
97.2 	of employment, and substitutes and unsupervised volunteers within 90 days from the first 
97.3 	date of direct contact with a child, must complete training in child development, in accordance 
97.4 	with subdivision 2.
97.5 	(d) The license holder must ensure that documentation, as required in subdivision 10, 
97.6 	identifies the number of hours completed for each topic with a minimum training time 
97.7 	identified, if applicable, and that all required content is included.
97.8 	(e) Training in this subdivision must not be used to meet in-service training requirements 
97.9 	in subdivision 7.
97.10 	(f) Training completed within the previous 12 months under paragraphs (a), clauses (7) 
97.11 	and (8), and (c) are transferable to another child care center.
97.12 		Subd. 1a.Definitions. (a) For the purposes of this section, the following terms have the 
97.13 	meanings given.
97.14 	(b) "Substitute" means an adult who is temporarily filling a position as a director, teacher, 
97.15 	assistant teacher, or aide in a licensed child care center for less than 240 hours total in a 
97.16 	calendar year due to the absence of a regularly employed staff person.
97.17 	(c) "Staff person" means an employee of a child care center who provides direct contact 
97.18 	services to children.
97.19 	(d) "Unsupervised volunteer" means an individual who:
97.20 	(1) assists in the care of a child in care;
97.21 	(2) is not under the continuous direct supervision of a staff person; and
97.22 	(3) is not employed by the child care center.
97.23 		Subd. 2.Child development and learning training. (a) For purposes of child care 
97.24 	centers, The director and all staff hired after July 1, 2006, persons, substitutes, and 
97.25 	unsupervised volunteers shall complete and document at least two hours of child development 
97.26 	and learning training within the first 90 days of employment. The director and staff persons, 
97.27 	not including substitutes, must complete at least two hours of training on child development 
97.28 	and learning. The training for substitutes and unsupervised volunteers is not required to be 
97.29 	of a minimum length. For purposes of this subdivision, "child development and learning 
97.30 	training" means any training in Knowledge and Competency Area I: Child Development 
97.31 	and Learning, which is training in understanding how children develop physically, 
97.32 	cognitively, emotionally, and socially and learn as part of the children's family, culture, and 
98.1 	community. Training completed under this subdivision may be used to meet the in-service 
98.2 	training requirements under subdivision 7.
98.3 	(b) Notwithstanding paragraph (a), individuals are exempt from this requirement if they:
98.4 	(1) have taken a three-credit college course on early childhood development within the 
98.5 	past five years;
98.6 	(2) have received a baccalaureate or master's degree in early childhood education or 
98.7 	school-age child care within the past five years;
98.8 	(3) are licensed in Minnesota as a prekindergarten teacher, an early childhood educator, 
98.9 	a kindergarten to sixth grade teacher with a prekindergarten specialty, an early childhood 
98.10 	special education teacher, or an elementary teacher with a kindergarten endorsement; or
98.11 	(4) have received a baccalaureate degree with a Montessori certificate within the past 
98.12 	five years.
98.13 	(c) The director and staff persons, not including substitutes, must complete at least two 
98.14 	hours of child development and learning training every second calendar year.
98.15 	(d) Substitutes and unsupervised volunteers must complete child development and 
98.16 	learning training every second calendar year. There is no minimum number of training hours 
98.17 	required.
98.18 	(e) Except for training required under paragraph (a), training completed under this 
98.19 	subdivision may be used to meet the in-service training requirements under subdivision 7.
98.20 		Subd. 3.First aid. (a) All teachers and assistant teachers in a child care center governed 
98.21 	by Minnesota Rules, parts 9503.0005 to 9503.0170, and at least one staff person during 
98.22 	field trips and when transporting children in care, must satisfactorily complete pediatric 
98.23 	first aid training within 90 days of the start of work, unless the training has been completed 
98.24 	within the previous two years. Unless training has been completed within the previous two 
98.25 	years, the director, staff persons, substitutes, and unsupervised volunteers must satisfactorily 
98.26 	complete pediatric first aid training prior to having unsupervised direct contact with a child, 
98.27 	but not to exceed the first 90 days of employment.
98.28 	(b) Notwithstanding paragraph (a), which allows 90 days to complete training, at least 
98.29 	one staff person who has satisfactorily completed pediatric first aid training must be present 
98.30 	at all times in the center, during field trips, and when transporting children in care. Pediatric 
98.31 	first aid training must be repeated at least every second calendar year. First aid training 
98.32 	under this subdivision must be provided by an individual approved as a first aid instructor 
98.33 	and must not be used to meet in-service training requirements under subdivision 7.
99.1 	(c) The pediatric first aid training must be repeated at least every two years, documented 
99.2 	in the person's personnel record and indicated on the center's staffing chart, and provided 
99.3 	by an individual approved as a first aid instructor. This training may be less than eight hours.
99.4 		Subd. 4.Cardiopulmonary resuscitation. (a) All teachers and assistant teachers in a 
99.5 	child care center governed by Minnesota Rules, parts 9503.0005 to 9503.0170, and at least 
99.6 	one staff person during field trips and when transporting children in care, must satisfactorily 
99.7 	complete training in cardiopulmonary resuscitation (CPR) that includes CPR techniques 
99.8 	for infants and children and in the treatment of obstructed airways. The CPR training must 
99.9 	be completed within 90 days of the start of work, unless the training has been completed 
99.10 	within the previous two years. The CPR training must have been provided by an individual 
99.11 	approved to provide CPR instruction, must be repeated at least once every two years, and 
99.12 	must be documented in the staff person's records.
99.13 	(b) Notwithstanding paragraph (a), which allows 90 days to complete training, at least 
99.14 	one staff person who has satisfactorily completed cardiopulmonary resuscitation training 
99.15 	must be present at all times in the center, during field trips, and when transporting children 
99.16 	in care.
99.17 	(c) CPR training may be provided for less than four hours.
99.18 	(d) Persons providing CPR training must use CPR training that has been developed:
99.19 	(1) by the American Heart Association or the American Red Cross and incorporates 
99.20 	psychomotor skills to support the instruction; or
99.21 	(2) using nationally recognized, evidence-based guidelines for CPR and incorporates 
99.22 	psychomotor skills to support the instruction.
99.23 	(a) Unless training has been completed within the previous two years, the director, staff 
99.24 	persons, substitutes, and unsupervised volunteers must satisfactorily complete pediatric 
99.25 	cardiopulmonary resuscitation (CPR) training that meets the requirements of this subdivision. 
99.26 	Pediatric CPR training must be completed prior to having unsupervised direct contact with 
99.27 	a child, but not to exceed the first 90 days of employment.
99.28 	(b) Pediatric CPR training must be provided by an individual approved to provide 
99.29 	pediatric CPR instruction.
99.30 	(c) The Pediatric CPR training must:
99.31 	(1) cover CPR techniques for infants and children and the treatment of obstructed airways;
100.1 	(2) include instruction, hands-on practice, and an in-person, observed skills assessment 
100.2 	under the direct supervision of a CPR instructor; and
100.3 	(3) be developed by the American Heart Association, the American Red Cross, or another 
100.4 	organization that uses nationally recognized, evidence-based guidelines for CPR.
100.5 	(d) Pediatric CPR training must be repeated at least once every second calendar year.
100.6 	(e) Pediatric CPR training in this subdivision must not be used to meet in-service training 
100.7 	requirements under subdivision 7.
100.8 		Subd. 5.Sudden unexpected infant death and abusive head trauma training. (a) 
100.9 	Before caring for infants, the director, staff persons, substitutes, unsupervised volunteers, 
100.10 	and any other volunteers must receive training on the standards under section 245A.1435 
100.11 	and on reducing the risk of sudden unexpected infant death during orientation and each 
100.12 	calendar year thereafter.
100.13 	(b) Sudden unexpected infant death reduction training required under this subdivision 
100.14 	must be at least one-half hour in length. At a minimum, the training must address the risk 
100.15 	factors related to sudden unexpected infant death, means of reducing the risk of sudden 
100.16 	unexpected infant death in child care, and license holder communication with parents 
100.17 	regarding reducing the risk of sudden unexpected infant death.
100.18 	(c) Except if completed during orientation, training taken under this subdivision may 
100.19 	be used to meet the in-service training requirements under subdivision 7.
100.20 		Subd. 5a.Abusive head trauma training. (a) License holders must document that 
100.21 	before staff persons and volunteers care for infants, they are instructed on the standards in 
100.22 	section 245A.1435 and receive training on reducing the risk of sudden unexpected infant 
100.23 	death. In addition, license holders must document that before staff persons care for infants 
100.24 	or children under school age, they receive training on the risk of abusive head trauma from 
100.25 	shaking infants and young children. The training in this subdivision may be provided as 
100.26 	orientation training under subdivision 1 and in-service training under subdivision 7. (a) 
100.27 	Before caring for children under school age, the director, staff persons, substitutes, and 
100.28 	unsupervised volunteers must receive training on the risk of abusive head trauma during 
100.29 	orientation and each calendar year thereafter.
100.30 	(b) Sudden unexpected infant death reduction training required under this subdivision 
100.31 	must be at least one-half hour in length and must be completed at least once every year. At 
100.32 	a minimum, the training must address the risk factors related to sudden unexpected infant 
100.33 	death, means of reducing the risk of sudden unexpected infant death in child care, and license 
101.1 	holder communication with parents regarding reducing the risk of sudden unexpected infant 
101.2 	death.
101.3 	(c) (b) Abusive head trauma training under this subdivision must be at least one-half 
101.4 	hour in length and must be completed at least once every year. At a minimum, the training 
101.5 	must address the risk factors related to shaking infants and young children, means to reduce 
101.6 	the risk of abusive head trauma in child care, and license holder communication with parents 
101.7 	regarding reducing the risk of abusive head trauma.
101.8 	(c) Except if completed during orientation, training taken under this subdivision may 
101.9 	be used to meet the in-service training requirements under subdivision 7.
101.10 	(d) The commissioner shall make available for viewing a video presentation on the 
101.11 	dangers associated with shaking infants and young children, which may be used in 
101.12 	conjunction with the annual training required under paragraph (c) (a).
101.13 		Subd. 6.Child passenger restraint systems; training requirement. (a) A license 
101.14 	holder must comply with all seat belt and child passenger restraint system requirements 
101.15 	under section 169.685. (b) Child care centers that serve a child or children under nine years 
101.16 	of age must document training that fulfills the requirements in this subdivision.
101.17 	(1) (a) Before a license holder transports a child or children under age nine eight in a 
101.18 	motor vehicle, the person placing the child or children in a passenger restraint must 
101.19 	satisfactorily complete training on the proper use and installation of child restraint systems 
101.20 	in motor vehicles. Training completed under this subdivision may be used to meet orientation 
101.21 	training under subdivision 1 and in-service training under subdivision 7.
101.22 	(2) (b) Training required under this subdivision must be at least one hour in length, 
101.23 	completed at orientation, and repeated at least once every five years. At a minimum, the 
101.24 	training must address the proper use of child restraint systems based on the child's size, 
101.25 	weight, and age, and the proper installation of a car seat or booster seat in the motor vehicle 
101.26 	used by the license holder to transport the child or children.
101.27 	(3) (c) Training required under this subdivision must be provided by individuals who 
101.28 	are certified and approved by the Department of Public Safety, Office of Traffic Safety. 
101.29 	License holders may obtain a list of certified and approved trainers through the Department 
101.30 	of Public Safety website or by contacting the agency.
101.31 	(4) (d) Child care providers that only transport school-age children as defined in section 
101.32 	245A.02, subdivision 16, in child care buses as defined in section 169.448, subdivision 1, 
101.33 	paragraph (e), are exempt from this subdivision.
102.1 	(e) Training completed under this subdivision may be used to meet in-service training 
102.2 	requirements under subdivision 7. Training completed within the previous five years is 
102.3 	transferable upon a staff person's change in employment to another child care center.
102.4 		Subd. 7.In-service. (a) A license holder must ensure that the center director and all staff 
102.5 	who have direct contact with a child complete annual in-service training. In-service training 
102.6 	requirements must be met by a staff person's participation in the following training areas:, 
102.7 	staff persons, substitutes, and unsupervised volunteers complete in-service training each 
102.8 	calendar year.
102.9 	(b) The center director and staff persons who work more than 20 hours per week must 
102.10 	complete 24 hours of in-service training each calendar year. Staff persons who work 20 
102.11 	hours or less per week must complete 12 hours of in-service training each calendar year. 
102.12 	Substitutes and unsupervised volunteers must complete the requirements of paragraphs (e) 
102.13 	to (h) and do not otherwise have a minimum number of hours of training to complete.
102.14 	(c) The number of in-service training hours may be prorated for individuals not employed 
102.15 	for an entire year.
102.16 	(d) Each year, in-service training must include:
102.17 	(1) the center's procedures for maintaining health and safety according to section 245A.41 
102.18 	and Minnesota Rules, part 9503.0140, and handling emergencies and accidents according 
102.19 	to Minnesota Rules, part 9503.0110;
102.20 	(2) the reporting responsibilities under section 626.556 and Minnesota Rules, part 
102.21 	9503.0130;
102.22 	(3) at least one-half hour of training on the standards under section 245A.1435 and on 
102.23 	reducing the risk of sudden unexpected infant death as required under subdivision 5, if 
102.24 	applicable; and
102.25 	(4) at least one-half hour of training on the risk of abusive head trauma from shaking 
102.26 	infants and young children as required under subdivision 5a, if applicable.
102.27 	(e) Each year, or when a change is made, whichever is more frequent, in-service training 
102.28 	must be provided on: (1) the center's risk reduction plan under section 245A.66, subdivision 
102.29 	2; and (2) a child's individual child care program plan as required under Minnesota Rules, 
102.30 	part 9503.0065, subpart 3.
102.31 	(f) At least once every two calendar years, the in-service training must include:
102.32 	(1) child development and learning training under subdivision 2;
103.1 	(2) pediatric first aid that meets the requirements of subdivision 3;
103.2 	(3) pediatric cardiopulmonary resuscitation training that meets the requirements of 
103.3 	subdivision 4;
103.4 	(4) cultural dynamics training to increase awareness of cultural differences; and
103.5 	(5) disabilities training to increase awareness of differing abilities of children.
103.6 	(g) At least once every five years, in-service training must include child passenger 
103.7 	restraint training that meets the requirements of subdivision 6, if applicable.
103.8 	(h) The remaining hours of the in-service training requirement must be met by completing 
103.9 	training in the following content areas of the Minnesota Knowledge and Competency 
103.10 	Framework:
103.11 	(1) Content area I: child development and learning;
103.12 	(2) Content area II: developmentally appropriate learning experiences;
103.13 	(3) Content area III: relationships with families;
103.14 	(4) Content area IV: assessment, evaluation, and individualization;
103.15 	(5) Content area V: historical and contemporary development of early childhood 
103.16 	education;
103.17 	(6) Content area VI: professionalism; and
103.18 	(7) Content area VII: health, safety, and nutrition; and
103.19 	(8) Content area VIII: application through clinical experiences.
103.20 	(b) (i) For purposes of this subdivision, the following terms have the meanings given 
103.21 	them.
103.22 	(1) "Child development and learning training" has the meaning given it in subdivision 
103.23 	2, paragraph (a). means training in understanding how children develop physically, 
103.24 	cognitively, emotionally, and socially and learn as part of the children's family, culture, and 
103.25 	community.
103.26 	(2) "Developmentally appropriate learning experiences" means creating positive learning 
103.27 	experiences, promoting cognitive development, promoting social and emotional development, 
103.28 	promoting physical development, and promoting creative development.
103.29 	(3) "Relationships with families" means training on building a positive, respectful 
103.30 	relationship with the child's family.
104.1 	(4) "Assessment, evaluation, and individualization" means training in observing, 
104.2 	recording, and assessing development; assessing and using information to plan; and assessing 
104.3 	and using information to enhance and maintain program quality.
104.4 	(5) "Historical and contemporary development of early childhood education" means 
104.5 	training in past and current practices in early childhood education and how current events 
104.6 	and issues affect children, families, and programs.
104.7 	(6) "Professionalism" means training in knowledge, skills, and abilities that promote 
104.8 	ongoing professional development.
104.9 	(7) "Health, safety, and nutrition" means training in establishing health practices, ensuring 
104.10 	safety, and providing healthy nutrition.
104.11 	(8) "Application through clinical experiences" means clinical experiences in which a 
104.12 	person applies effective teaching practices using a range of educational programming models.
104.13 	(c) The director and all program staff persons must annually complete a number of hours 
104.14 	of in-service training equal to at least two percent of the hours for which the director or 
104.15 	program staff person is annually paid, unless one of the following is applicable.
104.16 	(1) A teacher at a child care center must complete one percent of working hours of 
104.17 	in-service training annually if the teacher:
104.18 	(i) possesses a baccalaureate or master's degree in early childhood education or school-age 
104.19 	care;
104.20 	(ii) is licensed in Minnesota as a prekindergarten teacher, an early childhood educator, 
104.21 	a kindergarten to sixth grade teacher with a prekindergarten specialty, an early childhood 
104.22 	special education teacher, or an elementary teacher with a kindergarten endorsement; or
104.23 	(iii) possesses a baccalaureate degree with a Montessori certificate.
104.24 	(2) A teacher or assistant teacher at a child care center must complete one and one-half 
104.25 	percent of working hours of in-service training annually if the individual is:
104.26 	(i) a registered nurse or licensed practical nurse with experience working with infants;
104.27 	(ii) possesses a Montessori certificate, a technical college certificate in early childhood 
104.28 	development, or a child development associate certificate; or
104.29 	(iii) possesses an associate of arts degree in early childhood education, a baccalaureate 
104.30 	degree in child development, or a technical college diploma in early childhood development.
105.1 	(d) The number of required training hours may be prorated for individuals not employed 
105.2 	full time or for an entire year.
105.3 	(e) The annual in-service training must be completed within the calendar year for which 
105.4 	it was required. In-service training completed by staff persons is transferable upon a staff 
105.5 	person's change in employment to another child care program.
105.6 	(f) (j) The license holder must ensure that, when a staff person completes in-service 
105.7 	training, the training is documented in the staff person's personnel record. The documentation 
105.8 	must include the date training was completed, the goal of the training and topics covered, 
105.9 	trainer's name and organizational affiliation, trainer's signed statement that training was 
105.10 	successfully completed, documentation, as required in subdivision 10, includes the number 
105.11 	of total training hours required to be completed, name of the training, the Minnesota 
105.12 	Knowledge and Competency Framework content area, number of hours completed, and the 
105.13 	director's approval of the training.
105.14 	(k) In-service training completed by a staff person that is not specific to that child care 
105.15 	center is transferable upon a staff person's change in employment to another child care 
105.16 	program.
105.17 		Subd. 8.Cultural dynamics and disabilities training for child care providers. (a) 
105.18 	The training required of licensed child care center staff must include training in the cultural 
105.19 	dynamics of early childhood development and child care. The cultural dynamics and 
105.20 	disabilities training and skills development of child care providers must be designed to 
105.21 	achieve outcomes for providers of child care that include, but are not limited to:
105.22 	(1) an understanding and support of the importance of culture and differences in ability 
105.23 	in children's identity development;
105.24 	(2) understanding the importance of awareness of cultural differences and similarities 
105.25 	in working with children and their families;
105.26 	(3) understanding and support of the needs of families and children with differences in 
105.27 	ability;
105.28 	(4) developing skills to help children develop unbiased attitudes about cultural differences 
105.29 	and differences in ability;
105.30 	(5) developing skills in culturally appropriate caregiving; and
105.31 	(6) developing skills in appropriate caregiving for children of different abilities.
106.1 	(b) Curriculum for cultural dynamics and disability training shall be approved by the 
106.2 	commissioner.
106.3 	(c) The commissioner shall amend current rules relating to the training of the licensed 
106.4 	child care center staff to require cultural dynamics training. Timelines established in the 
106.5 	rule amendments for complying with the cultural dynamics training requirements must be 
106.6 	based on the commissioner's determination that curriculum materials and trainers are available 
106.7 	statewide.
106.8 	(d) For programs caring for children with special needs, the license holder shall ensure 
106.9 	that any additional staff training required by the child's individual child care program plan 
106.10 	required under Minnesota Rules, part 9503.0065, subpart 3, is provided.
106.11 		Subd. 9.Ongoing health and safety training. A staff person's orientation training on 
106.12 	maintaining health and safety and handling emergencies and accidents, as required in 
106.13 	subdivision 1, must be repeated at least once each calendar year by each staff person. The 
106.14 	completion of the annual training must be documented in the staff person's personnel record.
106.15 		Subd. 10.Documentation. All training must be documented and maintained on site in 
106.16 	each personnel record. In addition to any requirements for each training provided in this 
106.17 	section, documentation for each staff person must include the staff person's first date of 
106.18 	direct contact and first date of unsupervised contact with a child in care.

106.19 	EFFECTIVE DATE. This section is effective September 30, 2019.

106.20 	Sec. 52. Minnesota Statutes 2018, section 245A.41, is amended to read:
106.21 	245A.41 CHILD CARE CENTER HEALTH AND SAFETY REQUIREMENTS.
106.22 		Subdivision 1.Allergy prevention and response. (a) Before admitting a child for care, 
106.23 	the license holder must obtain documentation of any known allergy from the child's parent 
106.24 	or legal guardian or the child's source of medical care. If a child has a known allergy, the 
106.25 	license holder must maintain current information about the allergy in the child's record and 
106.26 	develop an individual child care program plan as specified in Minnesota Rules, part 
106.27 	9503.0065, subpart 3. The individual child care program plan must include but not be limited 
106.28 	to a description of the allergy, specific triggers, avoidance techniques, symptoms of an 
106.29 	allergic reaction, and procedures for responding to an allergic reaction, including medication, 
106.30 	dosages, and a doctor's contact information.
106.31 	(b) The license holder must ensure that each staff person who is responsible for carrying 
106.32 	out the individual child care program plan review and follow the plan. Documentation of a 
106.33 	staff person's review must be kept on site.
107.1 	(c) At least annually once each calendar year or following any changes made to 
107.2 	allergy-related information in the child's record, the license holder must update the child's 
107.3 	individual child care program plan and inform each staff person who is responsible for 
107.4 	carrying out the individual child care program plan of the change. The license holder must 
107.5 	keep on site documentation that a staff person was informed of a change.
107.6 	(d) A child's allergy information must be available at all times including on site, when 
107.7 	on field trips, or during transportation. A child's food allergy information must be readily 
107.8 	available to a staff person in the area where food is prepared and served to the child.
107.9 	(e) The license holder must contact the child's parent or legal guardian as soon as possible 
107.10 	in any instance of exposure or allergic reaction that requires medication or medical 
107.11 	intervention. The license holder must call emergency medical services when epinephrine 
107.12 	is administered to a child in the license holder's care.
107.13 		Subd. 2.Handling and disposal of bodily fluids. The licensed child care center must 
107.14 	comply with the following procedures for safely handling and disposing of bodily fluids:
107.15 	(1) surfaces that come in contact with potentially infectious bodily fluids, including 
107.16 	blood and vomit, must be cleaned and disinfected according to Minnesota Rules, part 
107.17 	9503.0005, subpart 11;
107.18 	(2) blood-contaminated material must be disposed of in a plastic bag with a secure tie;
107.19 	(3) sharp items used for a child with special care needs must be disposed of in a "sharps 
107.20 	container." The sharps container must be stored out of reach of a child;
107.21 	(4) the license holder must have the following bodily fluid disposal supplies in the center: 
107.22 	disposable gloves, disposal bags, and eye protection; and
107.23 	(5) the license holder must ensure that each staff person is trained on follows universal 
107.24 	precautions to reduce the risk of spreading infectious disease. A staff person's completion 
107.25 	of the training must be documented in the staff person's personnel record.
107.26 		Subd. 3.Emergency preparedness. (a) No later than September 30, 2017, A licensed 
107.27 	child care center must have a written emergency plan for emergencies that require evacuation, 
107.28 	sheltering, or other protection of a child, such as fire, natural disaster, intruder, or other 
107.29 	threatening situation that may pose a health or safety hazard to a child. The plan must be 
107.30 	written on a form developed by the commissioner and must include:
107.31 	(1) procedures for an evacuation, relocation, shelter-in-place, or lockdown;
107.32 	(2) a designated relocation site and evacuation route;
108.1 	(3) procedures for notifying a child's parent or legal guardian of the evacuation, relocation, 
108.2 	shelter-in-place, or lockdown, including procedures for reunification with families;
108.3 	(4) accommodations for a child with a disability or a chronic medical condition;
108.4 	(5) procedures for storing a child's medically necessary medicine that facilitates easy 
108.5 	removal during an evacuation or relocation;
108.6 	(6) procedures for continuing operations in the period during and after a crisis; and
108.7 	(7) procedures for communicating with local emergency management officials, law 
108.8 	enforcement officials, or other appropriate state or local authorities; and
108.9 	(8) accommodations for infants and toddlers.
108.10 	(b) The license holder must train staff persons on the emergency plan at orientation, 
108.11 	when changes are made to the plan, and at least once each calendar year. Training must be 
108.12 	documented in each staff person's personnel file.
108.13 	(c) The license holder must conduct drills according to the requirements in Minnesota 
108.14 	Rules, part 9503.0110, subpart 3. The date and time of the drills must be documented.
108.15 	(d) The license holder must review and update the emergency plan annually. 
108.16 	Documentation of the annual emergency plan review shall be maintained in the program's 
108.17 	administrative records.
108.18 	(e) The license holder must include the emergency plan in the program's policies and 
108.19 	procedures as specified under section 245A.04, subdivision 14. The license holder must 
108.20 	provide a physical or electronic copy of the emergency plan to the child's parent or legal 
108.21 	guardian upon enrollment.
108.22 	(f) The relocation site and evacuation route must be posted in a visible place as part of 
108.23 	the written procedures for emergencies and accidents in Minnesota Rules, part 9503.0140, 
108.24 	subpart 21.
108.25 		Subd. 4.Child passenger restraint requirements. A license holder must comply with 
108.26 	all seat belt and child passenger restraint system requirements under section 169.685.
108.27 		Subd. 5.Telephone requirement in licensed child care centers. (a) A working telephone 
108.28 	which is capable of making outgoing calls and receiving incoming calls must be located 
108.29 	within the licensed child care center at all times. Staff must have access to a working 
108.30 	telephone while providing care and supervision to children in care, even if the care occurs 
108.31 	outside of the child care facility. A license holder may use a cellular telephone to meet the 
108.32 	requirements of this subdivision.
109.1 	(b) If a cellular telephone is used to satisfy the requirements of this subdivision, the 
109.2 	cellular telephone must be accessible to staff, be stored in a centrally located area when not 
109.3 	in use, and be sufficiently charged for use at all times.

109.4 	EFFECTIVE DATE. This section is effective September 30, 2019.

109.5 	Sec. 53. Minnesota Statutes 2018, section 245A.50, subdivision 1, is amended to read:
109.6 		Subdivision 1.Initial training. (a) License holders, caregivers, and substitutes must 
109.7 	comply with the training requirements in this section.
109.8 	(b) Helpers who assist with care on a regular basis must complete six hours of training 
109.9 	within one year after the date of initial employment.
109.10 	(c) Training requirements established under this section that must be completed prior 
109.11 	to initial licensure must be satisfied only by a newly licensed child care provider or by a 
109.12 	child care provider who has not held an active child care license in Minnesota in the previous 
109.13 	12 months. A child care provider who relocates within the state or who voluntarily cancels 
109.14 	a license or allows the license to lapse for a period of less than 12 months and who seeks 
109.15 	reinstatement of the lapsed or canceled license within 12 months of the lapse or cancellation 
109.16 	must satisfy the annual, ongoing training requirements, and is not required to satisfy the 
109.17 	training requirements that must be completed prior to initial licensure. A child care provider 
109.18 	who relocates within the state must (1) satisfy the annual, ongoing training requirements 
109.19 	according to the schedules established in this section and (2) not be required to satisfy the 
109.20 	training requirements under this section that the child care provider completed prior to initial 
109.21 	licensure. If a licensed provider moves to a new county, the new county is prohibited from 
109.22 	requiring the provider to complete any orientation class or training for new providers.

109.23 	EFFECTIVE DATE. This section is effective September 30, 2019.

109.24 	Sec. 54. Minnesota Statutes 2018, section 245A.51, subdivision 3, is amended to read:
109.25 		Subd. 3.Emergency preparedness plan. (a) No later than September 30, 2017, A 
109.26 	licensed family child care provider must have a written emergency preparedness plan for 
109.27 	emergencies that require evacuation, sheltering, or other protection of children, such as fire, 
109.28 	natural disaster, intruder, or other threatening situation that may pose a health or safety 
109.29 	hazard to children. The plan must be written on a form developed by the commissioner and 
109.30 	updated at least annually. The plan must include:
109.31 	(1) procedures for an evacuation, relocation, shelter-in-place, or lockdown;
109.32 	(2) a designated relocation site and evacuation route;
110.1 	(3) procedures for notifying a child's parent or legal guardian of the evacuation, 
110.2 	shelter-in-place, or lockdown, including procedures for reunification with families;
110.3 	(4) accommodations for a child with a disability or a chronic medical condition;
110.4 	(5) procedures for storing a child's medically necessary medicine that facilitate easy 
110.5 	removal during an evacuation or relocation;
110.6 	(6) procedures for continuing operations in the period during and after a crisis; and
110.7 	(7) procedures for communicating with local emergency management officials, law 
110.8 	enforcement officials, or other appropriate state or local authorities; and
110.9 	(8) accommodations for infants and toddlers.
110.10 	(b) The license holder must train caregivers before the caregiver provides care and at 
110.11 	least annually on the emergency preparedness plan and document completion of this training.
110.12 	(c) The license holder must conduct drills according to the requirements in Minnesota 
110.13 	Rules, part 9502.0435, subpart 8. The date and time of the drills must be documented.
110.14 	(d) The license holder must have the emergency preparedness plan available for review 
110.15 	and posted in a prominent location. The license holder must provide a physical or electronic 
110.16 	copy of the plan to the child's parent or legal guardian upon enrollment.

110.17 	EFFECTIVE DATE. This section is effective September 30, 2019.

110.18 	Sec. 55. Minnesota Statutes 2018, section 245A.51, is amended by adding a subdivision 
110.19 	to read:
110.20 		Subd. 4.Transporting children. A license holder must ensure compliance with all seat 
110.21 	belt and child passenger restraint system requirements under section 169.685.

110.22 	EFFECTIVE DATE. This section is effective September 30, 2019.

110.23 	Sec. 56. Minnesota Statutes 2018, section 245A.51, is amended by adding a subdivision 
110.24 	to read:
110.25 		Subd. 5.Telephone requirement. Notwithstanding Minnesota Rules, part 9502.0435, 
110.26 	subpart 8, item B, a license holder is not required to post a list of emergency numbers. A 
110.27 	license holder may use a cellular telephone to meet the requirements of Minnesota Rules, 
110.28 	part 9502.0435, subpart 8, if the cellular telephone is sufficiently charged for use at all times.

110.29 	EFFECTIVE DATE. This section is effective September 30, 2019.

111.1 	Sec. 57. [245A.52] FAMILY CHILD CARE PHYSICAL SPACE REQUIREMENTS.
111.2 		Subdivision 1.Means of escape. (a)(1) At least one emergency escape route separate 
111.3 	from the main exit from the space must be available in each room used for sleeping by 
111.4 	anyone receiving licensed care, and (2) a basement used for child care. One means of escape 
111.5 	must be a stairway or door leading to the floor of exit discharge. The other must be a door 
111.6 	or window leading directly outside. A window used as an emergency escape route must be 
111.7 	openable without special knowledge.
111.8 	(b) In homes with construction that began before May 2, 2016, the interior of the window 
111.9 	leading directly outside must have a net clear opening area of not less than 4.5 square feet 
111.10 	or 648 square inches and have minimum clear opening dimensions of 20 inches wide and 
111.11 	20 inches high. The opening must be no higher than 48 inches from the floor. The height 
111.12 	to the window may be measured from a platform if a platform is located below the window.
111.13 	(c) In homes with construction that began on or after May 2, 2016, the interior of the 
111.14 	window leading directly outside must have minimum clear opening dimensions of 20 inches 
111.15 	wide and 24 inches high. The net clear opening dimensions shall be the result of normal 
111.16 	operation of the opening. The opening must be no higher than 44 inches from the floor.
111.17 	(d) Additional requirements are dependent on the distance of the openings from the 
111.18 	ground outside the window: (1) windows or other openings with a sill height not more than 
111.19 	44 inches above or below the finished ground level adjacent to the opening (grade-floor 
111.20 	emergency escape and rescue openings) must have a minimum opening of five square feet; 
111.21 	and (2) non-grade floor emergency escape and rescue openings must have a minimum 
111.22 	opening of 5.7 square feet.
111.23 		Subd. 2.Door to attached garage. Notwithstanding Minnesota Rules, part 9502.0425, 
111.24 	subpart 5, day care residences with an attached garage are not required to have a self-closing 
111.25 	door to the residence. The door to the residence may be a steel insulated door if the door is 
111.26 	at least 1-3/8 inches thick.
111.27 		Subd. 3.Heating and venting systems. Notwithstanding Minnesota Rules, part 
111.28 	9502.0425, subpart 7, items that can be ignited and support combustion, including but not 
111.29 	limited to plastic, fabric, and wood products must not be located within 18 inches of a gas 
111.30 	or fuel-oil heater or furnace. If a license holder produces manufacturer instructions listing 
111.31 	a smaller distance, then the manufacturer instructions control the distance combustible items 
111.32 	must be from gas, fuel-oil, or solid-fuel burning heaters or furnaces.
111.33 		Subd. 4.Fire extinguisher. A portable, operational, multipurpose, dry chemical fire 
111.34 	extinguisher with a minimum 2 A 10 BC rating must be located in or near the kitchen and 
112.1 	cooking areas of the residence at all times. The fire extinguisher must be serviced annually 
112.2 	by a qualified inspector. All caregivers must know how to properly use the fire extinguisher.
112.3 		Subd. 5.Carbon monoxide and smoke alarms. (a) All homes must have an approved 
112.4 	and operational carbon monoxide alarm installed within ten feet of each room used for 
112.5 	sleeping children in care.
112.6 	(b) Smoke alarms that have been listed by the Underwriter Laboratory must be properly 
112.7 	installed and maintained on all levels including basements, but not including crawl spaces 
112.8 	and uninhabitable attics, and in hallways outside rooms used for sleeping children in care.
112.9 	(c) In homes with construction that began on or after May 2, 2016, smoke alarms must 
112.10 	be installed and maintained in each room used for sleeping children in care.
112.11 		Subd. 6.Updates. After readoption of the Minnesota State Fire Code, the fire marshal 
112.12 	must notify the commissioner of any changes that conflict with this section and Minnesota 
112.13 	Rules, chapter 9502. The state fire marshal must identify necessary statutory changes to 
112.14 	align statutes with the revised code. The commissioner must recommend updates to sections 
112.15 	of chapter 245A that are derived from the Minnesota State Fire Code in the legislative 
112.16 	session following readoption of the code.

112.17 	EFFECTIVE DATE. This section is effective September 30, 2019.

112.18 	Sec. 58. [245A.53] SUBSTITUTE CAREGIVERS AND REPLACEMENTS IN 
112.19 	FAMILY CHILD CARE.
112.20 		Subdivision 1.Total hours allowed. Notwithstanding Minnesota Rules, part 9502.0365, 
112.21 	subpart 5, the use of a substitute caregiver in a licensed family child care program must be 
112.22 	limited to a cumulative total of not more than 500 hours annually. The license holder must 
112.23 	document the name, dates, and number of hours of the substitute who provided care.
112.24 		Subd. 2.Emergency replacement supervision. (a) A license holder may allow an adult 
112.25 	who has not completed the training requirements under this chapter or the background study 
112.26 	requirements under chapter 245C to supervise children in a family child care program in 
112.27 	an emergency. For purposes of this subdivision, an emergency is a situation in which:
112.28 	(1) the license holder has begun operating the family child care program for the day and 
112.29 	for reasons beyond the license holder's control, including, but not limited to a serious illness 
112.30 	or injury, accident, or situation requiring the license holder's immediate attention, the license 
112.31 	holder needs to leave the licensed space and close the program for the day; and
113.1 	(2) the parents or guardians of the children attending the program are contacted to pick 
113.2 	up their children as soon as is practicable.
113.3 	(b) The license holder must make reasonable efforts to minimize the time the emergency 
113.4 	replacement has unsupervised contact with the children in care, not to exceed 24 hours per 
113.5 	emergency incident.
113.6 	(c) The license holder shall not knowingly use a person as an emergency replacement 
113.7 	who has committed an action or has been convicted of a crime that would cause the person 
113.8 	to be disqualified from providing care to children, if a background study was conducted 
113.9 	under chapter 245C.
113.10 	(d) To the extent practicable, the license holder must attempt to arrange for emergency 
113.11 	care by a substitute caregiver before using an emergency replacement.
113.12 	(e) To the extent practicable, the license holder must notify the county licensing agency 
113.13 	within seven days that an emergency replacement was used, and specify the circumstances 
113.14 	that led to the use of the emergency replacement. The county licensing agency must notify 
113.15 	the commissioner within three business days after receiving the license holder's notice that 
113.16 	an emergency replacement was used, and specify the circumstances that led to the use of 
113.17 	the emergency replacement.
113.18 	(f) Notwithstanding the requirements in Minnesota Rules, part 9502.0405, a license 
113.19 	holder is not required to provide the names of persons who may be used as replacements 
113.20 	in emergencies to parents or the county licensing agency.

113.21 	EFFECTIVE DATE. This section is effective September 30, 2019.

113.22 	Sec. 59. Minnesota Statutes 2018, section 245A.66, subdivision 2, is amended to read:
113.23 		Subd. 2.Child care centers; risk reduction plan. (a) Child care centers licensed under 
113.24 	this chapter and Minnesota Rules, chapter 9503, must develop a risk reduction plan that 
113.25 	identifies the general risks to children served by the child care center. The license holder 
113.26 	must establish procedures to minimize identified risks, train staff on the procedures, and 
113.27 	annually review the procedures.
113.28 	(b) The risk reduction plan must include an assessment of risk to children the center 
113.29 	serves or intends to serve and identify specific risks based on the outcome of the assessment. 
113.30 	The assessment of risk must be based on the following:
113.31 	(1) an assessment of the risks presented by the physical plant where the licensed services 
113.32 	are provided, including an evaluation of the following factors: the condition and design of 
114.1 	the facility and its outdoor space, bathrooms, storage areas, and accessibility of medications 
114.2 	and cleaning products that are harmful to children when children are not supervised and the 
114.3 	existence of areas that are difficult to supervise; and
114.4 	(2) an assessment of the risks presented by the environment for each facility and for 
114.5 	each site, including an evaluation of the following factors: the type of grounds and terrain 
114.6 	surrounding the building and the proximity to hazards, busy roads, and publicly accessed 
114.7 	businesses.
114.8 	(c) The risk reduction plan must include a statement of measures that will be taken to 
114.9 	minimize the risk of harm presented to children for each risk identified in the assessment 
114.10 	required under paragraph (b) related to the physical plant and environment. At a minimum, 
114.11 	the stated measures must include the development and implementation of specific policies 
114.12 	and procedures or reference to existing policies and procedures that minimize the risks 
114.13 	identified.
114.14 	(d) In addition to any program-specific risks identified in paragraph (b), the plan must 
114.15 	include development and implementation of specific policies and procedures or refer to 
114.16 	existing policies and procedures that minimize the risk of harm or injury to children, 
114.17 	including:
114.18 	(1) closing children's fingers in doors, including cabinet doors;
114.19 	(2) leaving children in the community without supervision;
114.20 	(3) children leaving the facility without supervision;
114.21 	(4) caregiver dislocation of children's elbows;
114.22 	(5) burns from hot food or beverages, whether served to children or being consumed by 
114.23 	caregivers, and the devices used to warm food and beverages;
114.24 	(6) injuries from equipment, such as scissors and glue guns;
114.25 	(7) sunburn;
114.26 	(8) feeding children foods to which they are allergic;
114.27 	(9) children falling from changing tables; and
114.28 	(10) children accessing dangerous items or chemicals or coming into contact with residue 
114.29 	from harmful cleaning products.
114.30 	(e) The plan shall prohibit the accessibility of hazardous items to children.
115.1 	(f) The plan must include specific policies and procedures to ensure adequate supervision 
115.2 	of children at all times as defined under section 245A.02, subdivision 18, with particular 
115.3 	emphasis on:
115.4 	(1) times when children are transitioned from one area within the facility to another;
115.5 	(2) nap-time supervision, including infant crib rooms as specified under section 245A.02, 
115.6 	subdivision 18, which requires that when an infant is placed in a crib to sleep, supervision 
115.7 	occurs when a staff person is within sight or hearing of the infant. When supervision of a 
115.8 	crib room is provided by sight or hearing, the center must have a plan to address the other 
115.9 	supervision components;
115.10 	(3) child drop-off and pick-up times;
115.11 	(4) supervision during outdoor play and on community activities, including but not 
115.12 	limited to field trips and neighborhood walks; and
115.13 	(5) supervision of children in hallways.; and
115.14 	(6) supervision of school-age children when using the restroom and visiting the child's 
115.15 	personal storage space.

115.16 	EFFECTIVE DATE. This section is effective September 30, 2019.

115.17 	Sec. 60. Minnesota Statutes 2018, section 245A.66, subdivision 3, is amended to read:
115.18 		Subd. 3.Orientation to Yearly review of risk reduction plan and annual review of 
115.19 	plan. (a) The license holder shall ensure that all mandated reporters, as defined in section 
115.20 	626.556, subdivision 3, who are under the control of the license holder, receive an orientation 
115.21 	to the risk reduction plan prior to first providing unsupervised direct contact services, as 
115.22 	defined in section 245C.02, subdivision 11, to children, not to exceed 14 days from the first 
115.23 	supervised direct contact, and annually thereafter. The license holder must document the 
115.24 	orientation to the risk reduction plan in the mandated reporter's personnel records.
115.25 	(b) The license holder must review the risk reduction plan annually each calendar year
115.26 	and document the annual review. When conducting the review, the license holder must 
115.27 	consider incidents that have occurred in the center since the last review, including:
115.28 	(1) the assessment factors in the plan;
115.29 	(2) the internal reviews conducted under this section, if any;
115.30 	(3) substantiated maltreatment findings, if any; and
116.1 	(4) incidents that caused injury or harm to a child, if any, that occurred since the last 
116.2 	review.
116.3 	Following any change to the risk reduction plan, the license holder must inform mandated 
116.4 	reporters staff persons, under the control of the license holder, of the changes in the risk 
116.5 	reduction plan, and document that the mandated reporters staff were informed of the changes.

116.6 	EFFECTIVE DATE. This section is effective September 30, 2019.

116.7 	Sec. 61. Minnesota Statutes 2018, section 245C.02, is amended by adding a subdivision 
116.8 	to read:
116.9 		Subd. 5a.License-exempt child care center certification holder. "License-exempt 
116.10 	child care center certification holder" has the meaning given for "certification holder" in 
116.11 	section 245H.01, subdivision 4.

116.12 	EFFECTIVE DATE. This section is effective September 30, 2019.

116.13 	Sec. 62. Minnesota Statutes 2018, section 245C.02, subdivision 6a, is amended to read:
116.14 		Subd. 6a.Child care background study subject. (a) "Child care background study 
116.15 	subject" means an individual who is affiliated with a licensed child care center, certified 
116.16 	license exempt child care center, licensed family child care program, or legal nonlicensed 
116.17 	child care provider authorized under chapter 119B, and who is:
116.18 	(1) who is employed by a child care provider for compensation;
116.19 	(2) whose activities involve assisting in the supervision care of a child for a child care 
116.20 	provider; or
116.21 	(3) who is required to have a background study under section 245C.03, subdivision 1.
116.22 	(3) a person applying for licensure, certification, or enrollment;
116.23 	(4) a controlling individual as defined in section 245A.02, subdivision 5a;
116.24 	(5) an individual 13 years of age or older who lives in the household where the licensed 
116.25 	program will be provided and who is not receiving licensed services from the program;
116.26 	(6) an individual ten to 12 years of age who lives in the household where the licensed 
116.27 	services will be provided when the commissioner has reasonable cause as defined in section 
116.28 	245C.02, subdivision 15;
116.29 	(7) an individual who, without providing direct contact services at a licensed program, 
116.30 	certified program, or program authorized under chapter 119B, may have unsupervised access 
117.1 	to a child receiving services from a program when the commissioner has reasonable cause 
117.2 	as defined in section 245C.02, subdivision 15; or
117.3 	(8) a volunteer, contractor, prospective employee, or other individual who has 
117.4 	unsupervised physical access to a child served by a program and who is not under supervision 
117.5 	by an individual listed in clause (1) or (5), regardless of whether the individual provides 
117.6 	program services.
117.7 	(b) Notwithstanding paragraph (a), an individual who is providing services that are not 
117.8 	part of the child care program is not required to have a background study if:
117.9 	(1) the child receiving services is signed out of the child care program for the duration 
117.10 	that the services are provided;
117.11 	(2) the licensed child care center, certified license exempt child care center, licensed 
117.12 	family child care program, or legal nonlicensed child care provider authorized under chapter 
117.13 	119B has obtained advanced written permission from the parent authorizing the child to 
117.14 	receive the services, which is maintained in the child's record;
117.15 	(3) the licensed child care center, certified license exempt child care center, licensed 
117.16 	family child care program, or legal nonlicensed child care provider authorized under chapter 
117.17 	119B maintains documentation on-site that identifies the individual service provider and 
117.18 	the services being provided; and
117.19 	(4) the licensed child care center, certified license exempt child care center, licensed 
117.20 	family child care program, or legal nonlicensed child care provider authorized under chapter 
117.21 	119B ensures that the service provider does not have unsupervised access to a child not 
117.22 	receiving the provider's services.

117.23 	Sec. 63. Minnesota Statutes 2018, section 245C.02, is amended by adding a subdivision 
117.24 	to read:
117.25 		Subd. 6b.Children's residential facility. "Children's residential facility" means a 
117.26 	children's residential facility licensed by the commissioner of corrections or the commissioner 
117.27 	of human services under Minnesota Rules, chapter 2960.

117.28 	EFFECTIVE DATE. This section is effective July 1, 2019, for background studies 
117.29 	initiated on or after that date.

118.1 	Sec. 64. Minnesota Statutes 2018, section 245C.02, is amended by adding a subdivision 
118.2 	to read:
118.3 		Subd. 20.Substance use disorder treatment field. "Substance use disorder treatment 
118.4 	field" means a program exclusively serving individuals 18 years of age and older and that 
118.5 	is required to be:
118.6 	(1) licensed under chapter 245G; or
118.7 	(2) registered under section 157.17 as a board and lodge establishment that predominantly 
118.8 	serves individuals being treated for or recovering from a substance use disorder.

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

118.10 	Sec. 65. Minnesota Statutes 2018, section 245C.03, subdivision 1, is amended to read:
118.11 		Subdivision 1.Licensed programs. (a) The commissioner shall conduct a background 
118.12 	study on:
118.13 	(1) the person or persons applying for a license;
118.14 	(2) an individual age 13 and over living in the household where the licensed program 
118.15 	will be provided who is not receiving licensed services from the program;
118.16 	(3) current or prospective employees or contractors of the applicant who will have direct 
118.17 	contact with persons served by the facility, agency, or program;
118.18 	(4) volunteers or student volunteers who will have direct contact with persons served 
118.19 	by the program to provide program services if the contact is not under the continuous, direct 
118.20 	supervision by an individual listed in clause (1) or (3);
118.21 	(5) an individual age ten to 12 living in the household where the licensed services will 
118.22 	be provided when the commissioner has reasonable cause as defined in section 245C.02, 
118.23 	subdivision 15;
118.24 	(6) an individual who, without providing direct contact services at a licensed program, 
118.25 	may have unsupervised access to children or vulnerable adults receiving services from a 
118.26 	program, when the commissioner has reasonable cause as defined in section 245C.02, 
118.27 	subdivision 15;
118.28 	(7) all controlling individuals as defined in section 245A.02, subdivision 5a; and
118.29 	(8) notwithstanding the other requirements in this subdivision, child care background 
118.30 	study subjects as defined in section 245C.02, subdivision 6a.; and
119.1 	(9) notwithstanding clause (3), for children's residential facilities, any adult working in 
119.2 	the facility, whether or not the individual will have direct contact with persons served by 
119.3 	the facility.
119.4 	(b) Paragraph (a), clauses (2), (5), and (6), apply to legal nonlicensed child care and 
119.5 	certified license-exempt child care programs.
119.6 	(c) (b) For child foster care when the license holder resides in the home where foster 
119.7 	care services are provided, a short-term substitute caregiver providing direct contact services 
119.8 	for a child for less than 72 hours of continuous care is not required to receive a background 
119.9 	study under this chapter.

119.10 	Sec. 66. Minnesota Statutes 2018, section 245C.05, subdivision 4, is amended to read:
119.11 		Subd. 4.Electronic transmission. (a) For background studies conducted by the 
119.12 	Department of Human Services, the commissioner shall implement a secure system for the 
119.13 	electronic transmission of:
119.14 	(1) background study information to the commissioner;
119.15 	(2) background study results to the license holder;
119.16 	(3) background study results to county and private agencies for background studies 
119.17 	conducted by the commissioner for child foster care; and
119.18 	(4) background study results to county agencies for background studies conducted by 
119.19 	the commissioner for adult foster care and family adult day services and, upon 
119.20 	implementation of NETStudy 2.0, family child care and legal nonlicensed child care 
119.21 	authorized under chapter 119B.
119.22 	(b) Unless the commissioner has granted a hardship variance under paragraph (c), a 
119.23 	license holder or an applicant must use the electronic transmission system known as 
119.24 	NETStudy or NETStudy 2.0 to submit all requests for background studies to the 
119.25 	commissioner as required by this chapter.
119.26 	(c) A license holder or applicant whose program is located in an area in which high-speed 
119.27 	Internet is inaccessible may request the commissioner to grant a variance to the electronic 
119.28 	transmission requirement.
119.29 	(d) Section 245C.08, subdivision 3, paragraph (c), applies to results transmitted under 
119.30 	this subdivision.

120.1 	Sec. 67. Minnesota Statutes 2018, section 245C.05, subdivision 5, is amended to read:
120.2 		Subd. 5.Fingerprints and photograph. (a) Notwithstanding paragraph (b), for 
120.3 	background studies conducted by the commissioner for child foster care, children's residential 
120.4 	facilities, adoptions, or a transfer of permanent legal and physical custody of a child, the 
120.5 	subject of the background study, who is 18 years of age or older, shall provide the 
120.6 	commissioner with a set of classifiable fingerprints obtained from an authorized agency for 
120.7 	a national criminal history record check.
120.8 	(b) For background studies initiated on or after the implementation of NETStudy 2.0, 
120.9 	except as provided under subdivision 5a, every subject of a background study must provide 
120.10 	the commissioner with a set of the background study subject's classifiable fingerprints and 
120.11 	photograph. The photograph and fingerprints must be recorded at the same time by the 
120.12 	commissioner's authorized fingerprint collection vendor and sent to the commissioner 
120.13 	through the commissioner's secure data system described in section 245C.32, subdivision 
120.14 	1a, paragraph (b).
120.15 	(c) The fingerprints shall be submitted by the commissioner to the Bureau of Criminal 
120.16 	Apprehension and, when specifically required by law, submitted to the Federal Bureau of 
120.17 	Investigation for a national criminal history record check.
120.18 	(d) The fingerprints must not be retained by the Department of Public Safety, Bureau 
120.19 	of Criminal Apprehension, or the commissioner. The Federal Bureau of Investigation will 
120.20 	only retain fingerprints of subjects with a criminal history not retain background study 
120.21 	subjects' fingerprints.
120.22 	(e) The commissioner's authorized fingerprint collection vendor shall, for purposes of 
120.23 	verifying the identity of the background study subject, be able to view the identifying 
120.24 	information entered into NETStudy 2.0 by the entity that initiated the background study, 
120.25 	but shall not retain the subject's fingerprints, photograph, or information from NETStudy 
120.26 	2.0. The authorized fingerprint collection vendor shall retain no more than the name and 
120.27 	date and time the subject's fingerprints were recorded and sent, only as necessary for auditing 
120.28 	and billing activities.
120.29 	(f) For any background study conducted under this chapter, the subject shall provide the 
120.30 	commissioner with a set of classifiable fingerprints when the commissioner has reasonable 
120.31 	cause to require a national criminal history record check as defined in section 245C.02, 
120.32 	subdivision 15a.

120.33 	EFFECTIVE DATE. Paragraph (a) is effective July 1, 2019, for background studies 
120.34 	initiated on or after that date.

121.1 	Sec. 68. Minnesota Statutes 2018, section 245C.05, subdivision 5a, is amended to read:
121.2 		Subd. 5a.Background study requirements for minors. (a) A background study 
121.3 	completed under this chapter on a subject who is required to be studied under section 
121.4 	245C.03, subdivision 1, and is 17 years of age or younger shall be completed by the 
121.5 	commissioner for:
121.6 	(1) a legal nonlicensed child care provider authorized under chapter 119B;
121.7 	(2) a licensed family child care program; or
121.8 	(3) a licensed foster care home.
121.9 	(b) The subject shall submit to the commissioner only the information under subdivision 
121.10 	1, paragraph (a).
121.11 	(c) A subject who is 17 years of age or younger is required to submit fingerprints and a 
121.12 	photograph, and the commissioner shall conduct a national criminal history record check, 
121.13 	if:
121.14 	(1) the commissioner has reasonable cause to require a national criminal history record 
121.15 	check defined in section 245C.02, subdivision 15a; or
121.16 	(2) under paragraph (a), clauses (1) and (2), the subject is employed by the provider or 
121.17 	supervises children served by the program.
121.18 	(d) A subject who is 17 years of age or younger is required to submit 
121.19 	non-fingerprint-based data according to section 245C.08, subdivision 1, paragraph (a), 
121.20 	clause (6), item (iii), and the commissioner shall conduct the check if:
121.21 	(1) the commissioner has reasonable cause to require a national criminal history record 
121.22 	check defined in section 245C.02, subdivision 15a; or
121.23 	(2) the subject is employed by the provider or supervises children served by the program 
121.24 	under paragraph (a), clauses (1) and (2).

121.25 	Sec. 69. Minnesota Statutes 2018, section 245C.08, subdivision 1, is amended to read:
121.26 		Subdivision 1.Background studies conducted by Department of Human Services. (a) 
121.27 	For a background study conducted by the Department of Human Services, the commissioner 
121.28 	shall review:
121.29 	(1) information related to names of substantiated perpetrators of maltreatment of 
121.30 	vulnerable adults that has been received by the commissioner as required under section 
121.31 	626.557, subdivision 9c, paragraph (j);
122.1 	(2) the commissioner's records relating to the maltreatment of minors in licensed 
122.2 	programs, and from findings of maltreatment of minors as indicated through the social 
122.3 	service information system;
122.4 	(3) information from juvenile courts as required in subdivision 4 for individuals listed 
122.5 	in section 245C.03, subdivision 1, paragraph (a), when there is reasonable cause;
122.6 	(4) information from the Bureau of Criminal Apprehension, including information 
122.7 	regarding a background study subject's registration in Minnesota as a predatory offender 
122.8 	under section 243.166;
122.9 	(5) except as provided in clause (6), information received as a result of submission of 
122.10 	fingerprints for a national criminal history record check, as defined in section 245C.02, 
122.11 	subdivision 13c, when the commissioner has reasonable cause for a national criminal history 
122.12 	record check as defined under section 245C.02, subdivision 15a, or as required under section 
122.13 	144.057, subdivision 1, clause (2);
122.14 	(6) for a background study related to a child foster care application for licensure, children's 
122.15 	residential facilities, a transfer of permanent legal and physical custody of a child under 
122.16 	sections 260C.503 to 260C.515, or adoptions, and for a background study required for 
122.17 	family child care, certified license-exempt child care, child care centers, and legal nonlicensed 
122.18 	child care authorized under chapter 119B, the commissioner shall also review:
122.19 	(i) information from the child abuse and neglect registry for any state in which the 
122.20 	background study subject has resided for the past five years; and
122.21 	(ii) when the background study subject is 18 years of age or older, or a minor under 
122.22 	section 245C.05, subdivision 5a, paragraph (c), information received following submission 
122.23 	of fingerprints for a national criminal history record check; and
122.24 	(iii) when the background study subject is 18 years of age or older or a minor under 
122.25 	section 245C.05, subdivision 5a, paragraph (d), for licensed family child care, certified 
122.26 	license-exempt child care, licensed child care centers, and legal nonlicensed child care 
122.27 	authorized under chapter 119B, information obtained using non-fingerprint-based data 
122.28 	including information from the criminal and sex offender registries for any state in which 
122.29 	the background study subject resided for the past five years and information from the national 
122.30 	crime information database and the national sex offender registry; and
122.31 	(7) for a background study required for family child care, certified license-exempt child 
122.32 	care centers, licensed child care centers, and legal nonlicensed child care authorized under 
123.1 	chapter 119B, the background study shall also include, to the extent practicable, a name 
123.2 	and date-of-birth search of the National Sex Offender Public website.
123.3 	(b) Notwithstanding expungement by a court, the commissioner may consider information 
123.4 	obtained under paragraph (a), clauses (3) and (4), unless the commissioner received notice 
123.5 	of the petition for expungement and the court order for expungement is directed specifically 
123.6 	to the commissioner.
123.7 	(c) The commissioner shall also review criminal case information received according 
123.8 	to section 245C.04, subdivision 4a, from the Minnesota court information system that relates 
123.9 	to individuals who have already been studied under this chapter and who remain affiliated 
123.10 	with the agency that initiated the background study.
123.11 	(d) When the commissioner has reasonable cause to believe that the identity of a 
123.12 	background study subject is uncertain, the commissioner may require the subject to provide 
123.13 	a set of classifiable fingerprints for purposes of completing a fingerprint-based record check 
123.14 	with the Bureau of Criminal Apprehension. Fingerprints collected under this paragraph 
123.15 	shall not be saved by the commissioner after they have been used to verify the identity of 
123.16 	the background study subject against the particular criminal record in question.
123.17 	(e) The commissioner may inform the entity that initiated a background study under 
123.18 	NETStudy 2.0 of the status of processing of the subject's fingerprints.

123.19 	EFFECTIVE DATE. Paragraph (a) is effective July 1, 2019, for background studies 
123.20 	initiated on or after that date.

123.21 	Sec. 70. Minnesota Statutes 2018, section 245C.08, subdivision 3, is amended to read:
123.22 		Subd. 3.Arrest and investigative information. (a) For any background study completed 
123.23 	under this section, if the commissioner has reasonable cause to believe the information is 
123.24 	pertinent to the disqualification of an individual, the commissioner also may review arrest 
123.25 	and investigative information from:
123.26 	(1) the Bureau of Criminal Apprehension;
123.27 	(2) the commissioner commissioners of health and human services;
123.28 	(3) a county attorney;
123.29 	(4) a county sheriff;
123.30 	(5) a county agency;
123.31 	(6) a local chief of police;
124.1 	(7) other states;
124.2 	(8) the courts;
124.3 	(9) the Federal Bureau of Investigation;
124.4 	(10) the National Criminal Records Repository; and
124.5 	(11) criminal records from other states.
124.6 	(b) Except when specifically required by law, the commissioner is not required to conduct 
124.7 	more than one review of a subject's records from the Federal Bureau of Investigation if a 
124.8 	review of the subject's criminal history with the Federal Bureau of Investigation has already 
124.9 	been completed by the commissioner and there has been no break in the subject's affiliation 
124.10 	with the license holder who entity that initiated the background study.
124.11 	(c) If the commissioner conducts a national criminal history record check when required 
124.12 	by law and uses the information from the national criminal history record check to make a 
124.13 	disqualification determination, the data obtained is private data and cannot be shared with 
124.14 	county agencies, private agencies, or prospective employers of the background study subject.
124.15 	(d) If the commissioner conducts a national criminal history record check when required 
124.16 	by law and uses the information from the national criminal history record check to make a 
124.17 	disqualification determination, the license holder or entity that submitted the study is not 
124.18 	required to obtain a copy of the background study subject's disqualification letter under 
124.19 	section 245C.17, subdivision 3.

124.20 	EFFECTIVE DATE. This section is effective for background studies requested on or 
124.21 	after October 1, 2019.

124.22 	Sec. 71. Minnesota Statutes 2018, section 245C.10, is amended by adding a subdivision 
124.23 	to read:
124.24 		Subd. 14.Children's residential facilities. The commissioner shall recover the cost of 
124.25 	background studies initiated by a licensed children's residential facility through a fee of no 
124.26 	more than $51 per study. Fees collected under this subdivision are appropriated to the 
124.27 	commissioner for purposes of conducting background studies.

124.28 	EFFECTIVE DATE. This section is effective July 1, 2019, for background studies 
124.29 	initiated on or after that date.

125.1 	Sec. 72. Minnesota Statutes 2018, section 245C.13, subdivision 2, is amended to read:
125.2 		Subd. 2.Direct contact pending completion of background study. The subject of a 
125.3 	background study may not perform any activity requiring a background study under 
125.4 	paragraph (b) (c) until the commissioner has issued one of the notices under paragraph (a).
125.5 	(a) Notices from the commissioner required prior to activity under paragraph (b) include:
125.6 	(1) a notice of the study results under section 245C.17 stating that:
125.7 	(i) the individual is not disqualified; or
125.8 	(ii) more time is needed to complete the study but the individual is not required to be 
125.9 	removed from direct contact or access to people receiving services prior to completion of 
125.10 	the study as provided under section 245C.17, subdivision 1, paragraph (b) or (c). The notice 
125.11 	that more time is needed to complete the study must also indicate whether the individual is 
125.12 	required to be under continuous direct supervision prior to completion of the background 
125.13 	study;
125.14 	(2) a notice that a disqualification has been set aside under section 245C.23; or
125.15 	(3) a notice that a variance has been granted related to the individual under section 
125.16 	245C.30.
125.17 	(b) For a background study affiliated with a licensed child care center or certified license 
125.18 	exempt child care center, the notice sent under paragraph (a), clause (1), item (ii), must 
125.19 	require the individual to be under continuous direct supervision prior to completion of the 
125.20 	background study except as permitted in subdivision 3.
125.21 	(c) Activities prohibited prior to receipt of notice under paragraph (a) include:
125.22 	(1) being issued a license;
125.23 	(2) living in the household where the licensed program will be provided;
125.24 	(3) providing direct contact services to persons served by a program unless the subject 
125.25 	is under continuous direct supervision; or
125.26 	(4) having access to persons receiving services if the background study was completed 
125.27 	under section 144.057, subdivision 1, or 245C.03, subdivision 1, paragraph (a), clause (2), 
125.28 	(5), or (6), unless the subject is under continuous direct supervision.; or
125.29 	(5) for licensed child care center and certified license exempt child care centers, providing 
125.30 	direct contact services to persons served by the program.

126.1 	Sec. 73. Minnesota Statutes 2018, section 245C.13, is amended by adding a subdivision 
126.2 	to read:
126.3 		Subd. 3.Other state information. If the commissioner has not received criminal, sex 
126.4 	offender, or maltreatment information from another state that is required to be reviewed 
126.5 	under this chapter within ten days of requesting the information, and the lack of the 
126.6 	information is the only reason that a notice is issued under subdivision 2, paragraph (a), 
126.7 	clause (1), item (ii), the commissioner may issue a notice under subdivision 2, paragraph 
126.8 	(a), clause (1), item (i). The commissioner may take action on information received from 
126.9 	other states after issuing a notice under subdivision 2, paragraph (a), clause (1), item (ii).

126.10 	Sec. 74. Minnesota Statutes 2018, section 245C.22, subdivision 4, is amended to read:
126.11 		Subd. 4.Risk of harm; set aside. (a) The commissioner may set aside the disqualification 
126.12 	if the commissioner finds that the individual has submitted sufficient information to 
126.13 	demonstrate that the individual does not pose a risk of harm to any person served by the 
126.14 	applicant, license holder, or other entities as provided in this chapter.
126.15 	(b) In determining whether the individual has met the burden of proof by demonstrating 
126.16 	the individual does not pose a risk of harm, the commissioner shall consider:
126.17 	(1) the nature, severity, and consequences of the event or events that led to the 
126.18 	disqualification;
126.19 	(2) whether there is more than one disqualifying event;
126.20 	(3) the age and vulnerability of the victim at the time of the event;
126.21 	(4) the harm suffered by the victim;
126.22 	(5) vulnerability of persons served by the program;
126.23 	(6) the similarity between the victim and persons served by the program;
126.24 	(7) the time elapsed without a repeat of the same or similar event;
126.25 	(8) documentation of successful completion by the individual studied of training or 
126.26 	rehabilitation pertinent to the event; and
126.27 	(9) any other information relevant to reconsideration.
126.28 	(c) If the individual requested reconsideration on the basis that the information relied 
126.29 	upon to disqualify the individual was incorrect or inaccurate and the commissioner determines 
126.30 	that the information relied upon to disqualify the individual is correct, the commissioner 
127.1 	must also determine if the individual poses a risk of harm to persons receiving services in 
127.2 	accordance with paragraph (b).
127.3 	(d) For an individual seeking employment in the substance use disorder treatment field, 
127.4 	the commissioner shall set aside the disqualification if the following criteria are met:
127.5 	(1) the individual is not disqualified for a crime of violence as listed under section 
127.6 	624.712, subdivision 5, except for the following crimes: crimes listed under section 152.021, 
127.7 	subdivision 2 or 2a; 152.022, subdivision 2; 152.023, subdivision 2; 152.024; or 152.025;
127.8 	(2) the individual is not disqualified under section 245C.15, subdivision 1;
127.9 	(3) the individual is not disqualified under section 245C.15, subdivision 4, paragraph 
127.10 	(b);
127.11 	(4) the individual provided documentation of successful completion of treatment, at least 
127.12 	one year prior to the date of the request for reconsideration, at a program licensed under 
127.13 	chapter 245G, and has had no disqualifying crimes or conduct under section 245C.15 after 
127.14 	the successful completion of treatment;
127.15 	(5) the individual provided documentation demonstrating abstinence from controlled 
127.16 	substances, as defined in section 152.01, subdivision 4, for the period of one year prior to 
127.17 	the date of the request for reconsideration; and
127.18 	(6) the individual is seeking employment in the substance use disorder treatment field.

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

127.20 	Sec. 75. Minnesota Statutes 2018, section 245C.22, subdivision 5, is amended to read:
127.21 		Subd. 5.Scope of set-aside. (a) If the commissioner sets aside a disqualification under 
127.22 	this section, the disqualified individual remains disqualified, but may hold a license and 
127.23 	have direct contact with or access to persons receiving services. Except as provided in 
127.24 	paragraph (b), the commissioner's set-aside of a disqualification is limited solely to the 
127.25 	licensed program, applicant, or agency specified in the set aside notice under section 245C.23. 
127.26 	For personal care provider organizations, the commissioner's set-aside may further be limited 
127.27 	to a specific individual who is receiving services. For new background studies required 
127.28 	under section 245C.04, subdivision 1, paragraph (h), if an individual's disqualification was 
127.29 	previously set aside for the license holder's program and the new background study results 
127.30 	in no new information that indicates the individual may pose a risk of harm to persons 
127.31 	receiving services from the license holder, the previous set-aside shall remain in effect.
128.1 	(b) If the commissioner has previously set aside an individual's disqualification for one 
128.2 	or more programs or agencies, and the individual is the subject of a subsequent background 
128.3 	study for a different program or agency, the commissioner shall determine whether the 
128.4 	disqualification is set aside for the program or agency that initiated the subsequent 
128.5 	background study. A notice of a set-aside under paragraph (c) shall be issued within 15 
128.6 	working days if all of the following criteria are met:
128.7 	(1) the subsequent background study was initiated in connection with a program licensed 
128.8 	or regulated under the same provisions of law and rule for at least one program for which 
128.9 	the individual's disqualification was previously set aside by the commissioner;
128.10 	(2) the individual is not disqualified for an offense specified in section 245C.15, 
128.11 	subdivision 1 or 2;
128.12 	(3) the commissioner has received no new information to indicate that the individual 
128.13 	may pose a risk of harm to any person served by the program; and
128.14 	(4) the previous set-aside was not limited to a specific person receiving services.
128.15 	(c) Notwithstanding paragraph (b), clause (2), for an individual who is employed in the 
128.16 	substance use disorder field, if the commissioner has previously set aside an individual's 
128.17 	disqualification for one or more programs or agencies in the substance use disorder treatment 
128.18 	field, and the individual is the subject of a subsequent background study for a different 
128.19 	program or agency in the substance use disorder treatment field, the commissioner shall set 
128.20 	aside the disqualification for the program or agency in the substance use disorder treatment 
128.21 	field that initiated the subsequent background study when the criteria under paragraph (b), 
128.22 	clauses (1), (3), and (4), are met and the individual is not disqualified for an offense specified 
128.23 	in section 254C.15, subdivision 1. A notice of a set-aside under paragraph (d) shall be issued 
128.24 	within 15 working days.
128.25 	(c) (d) When a disqualification is set aside under paragraph (b), the notice of background 
128.26 	study results issued under section 245C.17, in addition to the requirements under section 
128.27 	245C.17, shall state that the disqualification is set aside for the program or agency that 
128.28 	initiated the subsequent background study. The notice must inform the individual that the 
128.29 	individual may request reconsideration of the disqualification under section 245C.21 on the 
128.30 	basis that the information used to disqualify the individual is incorrect.

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

129.1 	Sec. 76. Minnesota Statutes 2018, section 245C.24, subdivision 1, is amended to read:
129.2 		Subdivision 1.Minimum disqualification periods. The disqualification periods under 
129.3 	subdivisions 3 and 4 to 5 are the minimum applicable disqualification periods. The 
129.4 	commissioner may determine that an individual should continue to be disqualified from 
129.5 	licensure because the individual continues to pose a risk of harm to persons served by that 
129.6 	individual, even after the minimum disqualification period has passed.

129.7 	EFFECTIVE DATE. This section is effective March 1, 2020.

129.8 	Sec. 77. Minnesota Statutes 2018, section 245C.24, subdivision 2, is amended to read:
129.9 		Subd. 2.Permanent bar to set aside a disqualification. (a) Except as provided in 
129.10 	paragraph paragraphs (b), to (e), the commissioner may not set aside the disqualification 
129.11 	of any individual disqualified pursuant to this chapter, regardless of how much time has 
129.12 	passed, if the individual was disqualified for a crime or conduct listed in section 245C.15, 
129.13 	subdivision 1.
129.14 	(b) For an individual in the chemical dependency or corrections field who was disqualified 
129.15 	for a crime or conduct listed under section 245C.15, subdivision 1, and whose disqualification 
129.16 	was set aside prior to July 1, 2005, the commissioner must consider granting a variance 
129.17 	pursuant to section 245C.30 for the license holder for a program dealing primarily with 
129.18 	adults. A request for reconsideration evaluated under this paragraph must include a letter 
129.19 	of recommendation from the license holder that was subject to the prior set-aside decision 
129.20 	addressing the individual's quality of care to children or vulnerable adults and the 
129.21 	circumstances of the individual's departure from that service.
129.22 	(c) If an individual who requires a background study for nonemergency medical 
129.23 	transportation services under section 245C.03, subdivision 12, was disqualified for a crime 
129.24 	or conduct listed under section 245C.15, subdivision 1, and if more than 40 years have 
129.25 	passed since the discharge of the sentence imposed, the commissioner may consider granting 
129.26 	a set aside pursuant to section 245C.22. A request for reconsideration evaluated under this 
129.27 	paragraph must include a letter of recommendation from the employer. This paragraph does 
129.28 	not apply to a person disqualified based on a violation of sections 243.166; 609.185 to 
129.29 	609.205; 609.25; 609.342 to 609.3453; 609.352; 617.23, subdivision 2, clause (1), or 3, 
129.30 	clause (1); 617.246; or 617.247.
129.31 	(c) (d) When a licensed foster care provider adopts an individual who had received foster 
129.32 	care services from the provider for over six months, and the adopted individual is required 
129.33 	to receive a background study under section 245C.03, subdivision 1, paragraph (a), clause 
130.1 	(2) or (6), the commissioner may grant a variance to the license holder under section 245C.30
130.2 	to permit the adopted individual with a permanent disqualification to remain affiliated with 
130.3 	the license holder under the conditions of the variance when the variance is recommended 
130.4 	by the county of responsibility for each of the remaining individuals in placement in the 
130.5 	home and the licensing agency for the home.

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

130.7 	Sec. 78. Minnesota Statutes 2018, section 245C.24, is amended by adding a subdivision 
130.8 	to read:
130.9 		Subd. 5.Five-year bar to set aside disqualification; children's residential 
130.10 	facilities. The commissioner shall not set aside the disqualification of an individual in 
130.11 	connection with a license for a children's residential facility who was convicted of a felony 
130.12 	within the past five years for: (1) physical assault or battery; or (2) a drug-related offense.

130.13 	EFFECTIVE DATE. This section is effective for background studies initiated on or 
130.14 	after July 1, 2019.

130.15 	Sec. 79. Minnesota Statutes 2018, section 245C.30, subdivision 1, is amended to read:
130.16 		Subdivision 1.License holder and license-exempt child care center certification 
130.17 	holder variance. (a) Except for any disqualification under section 245C.15, subdivision 1, 
130.18 	when the commissioner has not set aside a background study subject's disqualification, and 
130.19 	there are conditions under which the disqualified individual may provide direct contact 
130.20 	services or have access to people receiving services that minimize the risk of harm to people 
130.21 	receiving services, the commissioner may grant a time-limited variance to a license holder
130.22 	or license-exempt child care center certification holder.
130.23 	(b) The variance shall state the reason for the disqualification, the services that may be 
130.24 	provided by the disqualified individual, and the conditions with which the license holder, 
130.25 	license-exempt child care center certification holder, or applicant must comply for the 
130.26 	variance to remain in effect.
130.27 	(c) Except for programs licensed to provide family child care, foster care for children 
130.28 	in the provider's own home, or foster care or day care services for adults in the provider's 
130.29 	own home, the variance must be requested by the license holder or license-exempt child 
130.30 	care center certification holder.

130.31 	EFFECTIVE DATE. This section is effective September 30, 2019.

131.1 	Sec. 80. Minnesota Statutes 2018, section 245C.30, subdivision 2, is amended to read:
131.2 		Subd. 2.Disclosure of reason for disqualification. (a) The commissioner may not grant 
131.3 	a variance for a disqualified individual unless the applicant, license-exempt child care center 
131.4 	certification holder, or license holder requests the variance and the disqualified individual 
131.5 	provides written consent for the commissioner to disclose to the applicant, license-exempt 
131.6 	child care center certification holder, or license holder the reason for the disqualification.
131.7 	(b) This subdivision does not apply to programs licensed to provide family child care 
131.8 	for children, foster care for children in the provider's own home, or foster care or day care 
131.9 	services for adults in the provider's own home. When the commissioner grants a variance 
131.10 	for a disqualified individual in connection with a license to provide the services specified 
131.11 	in this paragraph, the disqualified individual's consent is not required to disclose the reason 
131.12 	for the disqualification to the license holder in the variance issued under subdivision 1, 
131.13 	provided that the commissioner may not disclose the reason for the disqualification if the 
131.14 	disqualification is based on a felony-level conviction for a drug-related offense within the 
131.15 	past five years.

131.16 	EFFECTIVE DATE. This section is effective September 30, 2019.

131.17 	Sec. 81. Minnesota Statutes 2018, section 245C.30, subdivision 3, is amended to read:
131.18 		Subd. 3.Consequences for failing to comply with conditions of variance. When a 
131.19 	license holder or license-exempt child care center certification holder permits a disqualified 
131.20 	individual to provide any services for which the subject is disqualified without complying 
131.21 	with the conditions of the variance, the commissioner may terminate the variance effective 
131.22 	immediately and subject the license holder to a licensing action under sections 245A.06
131.23 	and 245A.07 or a license-exempt child care center certification holder to an action under 
131.24 	sections 245H.06 and 245H.07.

131.25 	EFFECTIVE DATE. This section is effective September 30, 2019.

131.26 	Sec. 82. Minnesota Statutes 2018, section 245E.02, is amended by adding a subdivision 
131.27 	to read:
131.28 		Subd. 1a.Provider definitions. For the purposes of this section, "provider" includes:
131.29 	(1) individuals or entities meeting the definition of provider in section 245E.01, 
131.30 	subdivision 12; and
131.31 	(2) owners and controlling individuals of entities identified in clause (1).

132.1 	Sec. 83. Minnesota Statutes 2018, section 245G.11, subdivision 7, is amended to read:
132.2 		Subd. 7.Care coordination provider qualifications. (a) Care coordination must be 
132.3 	provided by qualified staff. An individual is qualified to provide care coordination if the 
132.4 	individual:
132.5 	(1) is skilled in the process of identifying and assessing a wide range of client needs;
132.6 	(2) is knowledgeable about local community resources and how to use those resources 
132.7 	for the benefit of the client;
132.8 	(3) has successfully completed 30 hours of classroom instruction on care coordination 
132.9 	for an individual with substance use disorder;
132.10 	(4) has either:
132.11 	(i) a bachelor's degree in one of the behavioral sciences or related fields; or
132.12 	(ii) current certification as an alcohol and drug counselor, level I, by the Upper Midwest 
132.13 	Indian Council on Addictive Disorders; and
132.14 	(5) has at least 2,000 hours of supervised experience working with individuals with 
132.15 	substance use disorder.
132.16 	(b) A care coordinator must receive at least one hour of supervision regarding individual 
132.17 	service delivery from an alcohol and drug counselor weekly, or a mental health professional 
132.18 	who has substance use treatment and assessments within the scope of their practice, on a 
132.19 	monthly basis.

132.20 	Sec. 84. Minnesota Statutes 2018, section 245G.19, subdivision 4, is amended to read:
132.21 		Subd. 4.Additional licensing requirements. During the times the license holder is 
132.22 	responsible for the supervision of a child, the license holder must meet the following 
132.23 	standards:
132.24 	(1) child and adult ratios in Minnesota Rules, part 9502.0367;
132.25 	(2) day care training in section 245A.50;
132.26 	(3) behavior guidance in Minnesota Rules, part 9502.0395;
132.27 	(4) activities and equipment in Minnesota Rules, part 9502.0415;
132.28 	(5) physical environment in Minnesota Rules, part 9502.0425; and
132.29 	(6) physical space requirements in section 245A.52; and
133.1 	(7) water, food, and nutrition in Minnesota Rules, part 9502.0445, unless the license 
133.2 	holder has a license from the Department of Health.

133.3 	EFFECTIVE DATE. This section is effective September 30, 2019.

133.4 	Sec. 85. Minnesota Statutes 2018, section 245H.01, is amended by adding a subdivision 
133.5 	to read:
133.6 		Subd. 7.Substitute. "Substitute" means an adult who is temporarily filling a position 
133.7 	as a staff person for less than 240 hours total in a calendar year due to the absence of a 
133.8 	regularly employed staff person who provides direct contact services to a child.

133.9 	EFFECTIVE DATE. This section is effective September 30, 2019.

133.10 	Sec. 86. Minnesota Statutes 2018, section 245H.01, is amended by adding a subdivision 
133.11 	to read:
133.12 		Subd. 8.Staff person. "Staff person" means an employee of a certified center who 
133.13 	provides direct contact services to children.

133.14 	EFFECTIVE DATE. This section is effective September 30, 2019.

133.15 	Sec. 87. Minnesota Statutes 2018, section 245H.01, is amended by adding a subdivision 
133.16 	to read:
133.17 		Subd. 9.Unsupervised volunteer. "Unsupervised volunteer" means an individual who: 
133.18 	(1) assists in the care of a child in care; (2) is not under the continuous direct supervision 
133.19 	of a staff person; and (3) is not employed by the certified center.

133.20 	EFFECTIVE DATE. This section is effective September 30, 2019.

133.21 	Sec. 88. Minnesota Statutes 2018, section 245H.03, is amended by adding a subdivision 
133.22 	to read:
133.23 		Subd. 4.Reconsideration of certification denial. (a) The applicant may request 
133.24 	reconsideration of the denial by notifying the commissioner by certified mail or personal 
133.25 	service. The request must be made in writing. If sent by certified mail, the request must be 
133.26 	postmarked and sent to the commissioner within 20 calendar days after the applicant received 
133.27 	the order. If a request is made by personal service, it must be received by the commissioner 
133.28 	within 20 calendar days after the applicant received the order. The applicant may submit 
133.29 	with the request for reconsideration a written argument or evidence in support of the request 
133.30 	for reconsideration.
134.1 	(b) The commissioner's disposition of a request for reconsideration is final and not 
134.2 	subject to appeal under chapter 14.

134.3 	EFFECTIVE DATE. This section is effective September 30, 2019.

134.4 	Sec. 89. Minnesota Statutes 2018, section 245H.07, is amended to read:
134.5 	245H.07 DECERTIFICATION.
134.6 		Subdivision 1.Generally. (a) The commissioner may decertify a center if a certification 
134.7 	holder:
134.8 	(1) failed to comply with an applicable law or rule; or
134.9 	(2) knowingly withheld relevant information from or gave false or misleading information 
134.10 	to the commissioner in connection with an application for certification, in connection with 
134.11 	the background study status of an individual, during an investigation, or regarding compliance 
134.12 	with applicable laws or rules.; or
134.13 	(3) has authorization to receive child care assistance payments revoked pursuant to 
134.14 	chapter 119B.
134.15 	(b) When considering decertification, the commissioner shall consider the nature, 
134.16 	chronicity, or severity of the violation of law or rule.
134.17 	(c) When a center is decertified, the center is ineligible to receive a child care assistance 
134.18 	payment under chapter 119B.
134.19 		Subd. 2.Reconsideration of decertification. (a) The certification holder may request 
134.20 	reconsideration of the decertification by notifying the commissioner by certified mail or 
134.21 	personal service. The request must be made in writing. If sent by certified mail, the request 
134.22 	must be postmarked and sent to the commissioner within 20 calendar days after the 
134.23 	certification holder received the order. If a request is made by personal service, it must be 
134.24 	received by the commissioner within 20 calendar days after the certification holder received 
134.25 	the order. With the request for reconsideration, the certification holder may submit a written 
134.26 	argument or evidence in support of the request for reconsideration.
134.27 	(b) The commissioner's disposition of a request for reconsideration is final and not 
134.28 	subject to appeal under chapter 14.
134.29 		Subd. 3.Decertification due to maltreatment. If the commissioner decertifies a center 
134.30 	pursuant to subdivision 1, paragraph (a), clause (1), based on a determination that the center 
134.31 	was responsible for maltreatment, and if the center requests reconsideration of the 
134.32 	decertification according to subdivision 2, paragraph (a), and appeals the maltreatment 
135.1 	determination under section 626.556, subdivision 10i, the final decertification determination 
135.2 	is stayed until the commissioner issues a final decision regarding the maltreatment appeal.
135.3 		Subd. 4.Decertification due to revocation of child care assistance. If the commissioner 
135.4 	decertifies a center that had payments revoked pursuant to chapter 119B, and if the center 
135.5 	appeals the revocation of the center's authorization to receive child care assistance payments, 
135.6 	the final decertification determination is stayed until the appeal of the center's authorization 
135.7 	under chapter 119B is resolved. If the center also requests reconsideration of the 
135.8 	decertification, the center must do so according to subdivision 2, paragraph (a). The final 
135.9 	decision on reconsideration is stayed until the appeal of the center's authorization under 
135.10 	chapter 119B is resolved.

135.11 	EFFECTIVE DATE.  Subdivisions 1 to 3 are effective September 30, 2019. Subdivision 
135.12 	4 is effective February 26, 2021.

135.13 	Sec. 90. Minnesota Statutes 2018, section 245H.10, subdivision 1, is amended to read:
135.14 		Subdivision 1.Documentation Individuals to be studied. (a) The applicant or 
135.15 	certification holder must submit and maintain documentation of a completed background 
135.16 	study for: each child care background study subject as defined in section 245C.02, subdivision 
135.17 	6a.
135.18 	(1) each person applying for the certification;
135.19 	(2) each person identified as a center operator or program operator as defined in section 
135.20 	245H.01, subdivision 3;
135.21 	(3) each current or prospective staff person or contractor of the certified center who will 
135.22 	have direct contact with a child served by the center;
135.23 	(4) each volunteer who has direct contact with a child served by the center if the contact 
135.24 	is not under the continuous, direct supervision by an individual listed in clause (1), (2), or 
135.25 	(3); and
135.26 	(5) each managerial staff person of the certification holder with oversight and supervision 
135.27 	of the certified center.
135.28 	(b) To be accepted for certification, a background study on every individual in paragraph 
135.29 	(a), clause (1), applying for certification must be completed under chapter 245C and result 
135.30 	in a not disqualified determination under section 245C.14 or a disqualification that was set 
135.31 	aside under section 245C.22.

136.1 	Sec. 91. Minnesota Statutes 2018, section 245H.11, is amended to read:
136.2 	245H.11 REPORTING.
136.3 	(a) The certification holder must comply and must have written policies for staff to 
136.4 	comply with the reporting requirements for abuse and neglect specified in section 626.556. 
136.5 	A person mandated to report physical or sexual child abuse or neglect occurring within a 
136.6 	certified center shall report the information to the commissioner.
136.7 	(b) The certification holder must inform the commissioner within 24 hours of:
136.8 	(1) the death of a child in the program; and
136.9 	(2) any injury to a child in the program that required treatment by a physician.

136.10 	EFFECTIVE DATE. This section is effective September 30, 2019.

136.11 	Sec. 92. Minnesota Statutes 2018, section 245H.13, subdivision 5, is amended to read:
136.12 		Subd. 5.Building and physical premises; free of hazards. (a) The certified center 
136.13 	must document compliance with the State Fire Code by providing To be accepted for 
136.14 	certification, the applicant must demonstrate compliance with the State Fire Code, section 
136.15 	299F.011, by either:
136.16 	(1) providing documentation of a fire marshal inspection completed within the previous 
136.17 	three years by a state fire marshal or a local fire code inspector trained by the state fire 
136.18 	marshal.; or
136.19 	(2) complying with the fire marshal inspection requirements according to section 
136.20 	245A.151.
136.21 	(b) The certified center must designate a primary indoor and outdoor space used for 
136.22 	child care on a facility site floor plan.
136.23 	(c) The certified center must ensure the areas used by a child are clean and in good repair, 
136.24 	with structurally sound and functional furniture and equipment that is appropriate to the 
136.25 	age and size of a child who uses the area.
136.26 	(d) The certified center must ensure hazardous items including but not limited to sharp 
136.27 	objects, medicines, cleaning supplies, poisonous plants, and chemicals are out of reach of 
136.28 	a child.
136.29 	(e) The certified center must safely handle and dispose of bodily fluids and other 
136.30 	potentially infectious fluids by using gloves, disinfecting surfaces that come in contact with 
137.1 	potentially infectious bodily fluids, and disposing of bodily fluid in a securely sealed plastic 
137.2 	bag.

137.3 	EFFECTIVE DATE. This section is effective September 30, 2019.

137.4 	Sec. 93. Minnesota Statutes 2018, section 245H.13, is amended by adding a subdivision 
137.5 	to read:
137.6 		Subd. 7.Risk reduction plan. (a) The certified center must develop a risk reduction 
137.7 	plan that identifies risks to children served by the child care center. The assessment of risk 
137.8 	must include risks presented by (1) the physical plant where the certified services are 
137.9 	provided, including electrical hazards; and (2) the environment, including the proximity to 
137.10 	busy roads and bodies of water.
137.11 	(b) The certification holder must establish policies and procedures to minimize identified 
137.12 	risks. After any change to the risk reduction plan, the certification holder must inform staff 
137.13 	of the change in the risk reduction plan and document that staff were informed of the change.

137.14 	EFFECTIVE DATE. This section is effective September 30, 2019.

137.15 	Sec. 94. Minnesota Statutes 2018, section 245H.13, is amended by adding a subdivision 
137.16 	to read:
137.17 		Subd. 8.Required policies. A certified center must have written policies for health and 
137.18 	safety items in subdivisions 1 to 6.

137.19 	EFFECTIVE DATE. This section is effective September 30, 2019.

137.20 	Sec. 95. Minnesota Statutes 2018, section 245H.13, is amended by adding a subdivision 
137.21 	to read:
137.22 		Subd. 9.Behavior guidance. The certified center must ensure that staff and volunteers 
137.23 	use positive behavior guidance and do not subject children to:
137.24 	(1) corporal punishment, including but not limited to rough handling, shoving, hair 
137.25 	pulling, ear pulling, shaking, slapping, kicking, biting, pinching, hitting, and spanking;
137.26 	(2) humiliation;
137.27 	(3) abusive language;
137.28 	(4) the use of mechanical restraints, including tying;
137.29 	(5) the use of physical restraints other than to physically hold a child when containment 
137.30 	is necessary to protect a child or others from harm; or
138.1 	(6) the withholding or forcing of food and other basic needs.

138.2 	EFFECTIVE DATE. This section is effective September 30, 2019.

138.3 	Sec. 96. Minnesota Statutes 2018, section 245H.13, is amended by adding a subdivision 
138.4 	to read:
138.5 		Subd. 10.Supervision. Staff must supervise each child at all times. Staff are responsible 
138.6 	for the ongoing activity of each child, appropriate visual or auditory awareness, physical 
138.7 	proximity, and knowledge of activity requirements and each child's needs. Staff must 
138.8 	intervene when necessary to ensure a child's safety. In determining the appropriate level of 
138.9 	supervision of a child, staff must consider: (1) the age of a child; (2) individual differences 
138.10 	and abilities; (3) indoor and outdoor layout of the child care program; and (4) environmental 
138.11 	circumstances, hazards, and risks.

138.12 	EFFECTIVE DATE. This section is effective September 30, 2019.

138.13 	Sec. 97. Minnesota Statutes 2018, section 245H.14, subdivision 1, is amended to read:
138.14 		Subdivision 1.First aid and cardiopulmonary resuscitation. At least one designated 
138.15 	staff person who completed pediatric first aid training and pediatric cardiopulmonary 
138.16 	resuscitation (CPR) training must be present at all times at the program, during field trips, 
138.17 	and when transporting a child. The designated staff person must repeat pediatric first aid 
138.18 	training and pediatric CPR training at least once every two years.
138.19 	(a) Before having unsupervised direct contact with a child, but within the first 90 days 
138.20 	of employment for the director and all staff persons, and within 90 days after the first date 
138.21 	of direct contact with a child for substitutes and unsupervised volunteers, each person must 
138.22 	successfully complete pediatric first aid and pediatric cardiopulmonary resuscitation (CPR) 
138.23 	training, unless the training has been completed within the previous two calendar years. 
138.24 	Staff must complete the pediatric first aid and pediatric CPR training at least every other 
138.25 	calendar year and the center must document the training in the staff person's personnel 
138.26 	record.
138.27 	(b) Training completed under this subdivision may be used to meet the in-service training 
138.28 	requirements under subdivision 6.

138.29 	EFFECTIVE DATE. This section is effective September 30, 2019.

139.1 	Sec. 98. Minnesota Statutes 2018, section 245H.14, subdivision 2, is amended to read:
139.2 		Subd. 2.Sudden unexpected infant death. A certified center that cares for an infant 
139.3 	who is younger than one year of age must ensure that the director, all staff persons, including 
139.4 	substitutes, unsupervised volunteers, and any other volunteers receive training according 
139.5 	to section 245A.1435 on reducing the risk of sudden unexpected infant death before assisting 
139.6 	in the care of an infant.

139.7 	EFFECTIVE DATE. This section is effective September 30, 2019.

139.8 	Sec. 99. Minnesota Statutes 2018, section 245H.14, subdivision 3, is amended to read:
139.9 		Subd. 3.Abusive head trauma. A certified center that cares for a child through four 
139.10 	years of age under school age must ensure that the director and all staff persons and 
139.11 	volunteers, including substitutes and unsupervised volunteers, receive training on abusive 
139.12 	head trauma from shaking infants and young children before assisting in the care of a child 
139.13 	through four years of age under school age.

139.14 	EFFECTIVE DATE. This section is effective September 30, 2019.

139.15 	Sec. 100. Minnesota Statutes 2018, section 245H.14, subdivision 4, is amended to read:
139.16 		Subd. 4.Child development. The certified center must ensure each staff person completes 
139.17 	at least two hours of that the director and all staff persons complete child development and 
139.18 	learning training within 14 90 days of employment and annually every second calendar year
139.19 	thereafter. Substitutes and unsupervised volunteers must complete child development and 
139.20 	learning training within 90 days after the first date of direct contact with a child and every 
139.21 	second calendar year thereafter. The director and staff persons not including substitutes 
139.22 	must complete at least two hours of training on child development. The training for substitutes 
139.23 	and unsupervised volunteers is not required to be of a minimum length. For purposes of 
139.24 	this subdivision, "child development and learning training" means how a child develops 
139.25 	physically, cognitively, emotionally, and socially and learns as part of the child's family, 
139.26 	culture, and community.

139.27 	EFFECTIVE DATE. This section is effective September 30, 2019.

139.28 	Sec. 101. Minnesota Statutes 2018, section 245H.14, subdivision 5, is amended to read:
139.29 		Subd. 5.Orientation. The certified center must ensure each staff person is the director 
139.30 	and all staff persons, substitutes, and unsupervised volunteers are trained at orientation on 
139.31 	health and safety requirements in sections 245H.11, 245H.13, 245H.14, and 245H.15. The 
140.1 	certified center must provide staff with an orientation within 14 days of employment after 
140.2 	the first date of direct contact with a child. Before the completion of orientation, a staff 
140.3 	person these individuals must be supervised while providing direct care to a child.

140.4 	EFFECTIVE DATE. This section is effective September 30, 2019.

140.5 	Sec. 102. Minnesota Statutes 2018, section 245H.14, subdivision 6, is amended to read:
140.6 		Subd. 6.In service. (a) The certified center must ensure each that the director and all
140.7 	staff person is persons, including substitutes and unsupervised volunteers, are trained at 
140.8 	least annually once each calendar year on health and safety requirements in sections 245H.11, 
140.9 	245H.13, 245H.14, and 245H.15.
140.10 	(b) The director and each staff person, not including substitutes, must annually complete 
140.11 	at least six hours of training each calendar year. Training required under paragraph (a) may 
140.12 	be used toward the hourly training requirements of this subdivision.

140.13 	EFFECTIVE DATE. This section is effective September 30, 2019.

140.14 	Sec. 103. Minnesota Statutes 2018, section 245H.15, subdivision 1, is amended to read:
140.15 		Subdivision 1.Written emergency plan. (a) A certified center must have a written 
140.16 	emergency plan for emergencies that require evacuation, sheltering, or other protection of 
140.17 	children, such as fire, natural disaster, intruder, or other threatening situation that may pose 
140.18 	a health or safety hazard to children. The plan must be written on a form developed by the 
140.19 	commissioner and reviewed and updated at least once each calendar year. The annual review 
140.20 	of the emergency plan must be documented.
140.21 	(b) The plan must include:
140.22 	(1) procedures for an evacuation, relocation, shelter-in-place, or lockdown;
140.23 	(2) a designated relocation site and evacuation route;
140.24 	(3) procedures for notifying a child's parent or legal guardian of the relocation and 
140.25 	reunification with families;
140.26 	(4) accommodations for a child with a disability or a chronic medical condition;
140.27 	(5) procedures for storing a child's medically necessary medicine that facilitates easy 
140.28 	removal during an evacuation or relocation;
140.29 	(6) procedures for continuing operations in the period during and after a crisis; and
141.1 	(7) procedures for communicating with local emergency management officials, law 
141.2 	enforcement officials, or other appropriate state or local authorities.; and
141.3 	(8) accommodations for infants and toddlers.
141.4 	(c) The certification holder must have an emergency plan available for review upon 
141.5 	request by the child's parent or legal guardian.

141.6 	EFFECTIVE DATE. This section is effective September 30, 2019.

141.7 	Sec. 104. Minnesota Statutes 2018, section 254B.05, subdivision 1, is amended to read:
141.8 		Subdivision 1.Licensure required. (a) Programs licensed by the commissioner are 
141.9 	eligible vendors. Hospitals may apply for and receive licenses to be eligible vendors, 
141.10 	notwithstanding the provisions of section 245A.03. American Indian programs that provide 
141.11 	substance use disorder treatment, extended care, transitional residence, or outpatient treatment 
141.12 	services, and are licensed by tribal government are eligible vendors.
141.13 	(b) On July 1, 2018, or upon federal approval, whichever is later, a licensed professional 
141.14 	in private practice who meets the requirements of section 245G.11, subdivisions 1 and 4, 
141.15 	is an eligible vendor of a comprehensive assessment and assessment summary provided 
141.16 	according to section 245G.05, and treatment services provided according to sections 245G.06 
141.17 	and 245G.07, subdivision 1, paragraphs (a), clauses (1) to (5), and (b); and subdivision 2.
141.18 	(c) On July 1, 2018, or upon federal approval, whichever is later, a county is an eligible 
141.19 	vendor for a comprehensive assessment and assessment summary when provided by an 
141.20 	individual who meets the staffing credentials of section 245G.11, subdivisions 1 and 4 5, 
141.21 	and completed according to the requirements of section 245G.05. A county is an eligible 
141.22 	vendor of care coordination services when provided by an individual who meets the staffing 
141.23 	credentials of section 245G.11, subdivisions 1 and 7, and provided according to the 
141.24 	requirements of section 245G.07, subdivision 1, clause (7).
141.25 	(d) On July 1, 2018, or upon federal approval, whichever is later, a recovery community 
141.26 	organization that meets certification requirements identified by the commissioner is an 
141.27 	eligible vendor of peer support services.
141.28 	(e) Detoxification programs licensed under Minnesota Rules, parts 9530.6510 to 
141.29 	9530.6590, are not eligible vendors. Programs that are not licensed as a residential or 
141.30 	nonresidential substance use disorder treatment or withdrawal management program by the 
141.31 	commissioner or by tribal government or do not meet the requirements of subdivisions 1a 
141.32 	and 1b are not eligible vendors.

142.1 	Sec. 105. Minnesota Statutes 2018, section 254B.05, subdivision 1b, is amended to read:
142.2 		Subd. 1b.Additional vendor requirements. Vendors must comply with the following 
142.3 	duties:
142.4 	(1) maintain a provider agreement with the department;
142.5 	(2) continually comply with the standards in the agreement;
142.6 	(3) participate in the Drug Alcohol Normative Evaluation System;
142.7 	(4) submit an annual financial statement which reports functional expenses of chemical 
142.8 	dependency treatment costs in a form approved by the commissioner;
142.9 	(5) report information about the vendor's current capacity in a manner prescribed by the 
142.10 	commissioner; and
142.11 	(6) maintain adequate and appropriate insurance coverage necessary to provide chemical 
142.12 	dependency treatment services, and at a minimum:
142.13 	(i) employee dishonesty in the amount of $10,000 if the vendor has or had custody or 
142.14 	control of money or property belonging to clients; and
142.15 	(ii) bodily injury and property damage in the amount of $2,000,000 for each occurrence, 
142.16 	except that a county or a county joint powers entity who is otherwise an eligible vendor 
142.17 	shall be subject to the limits on liability under section 466.04.

142.18 	Sec. 106. Minnesota Statutes 2018, section 256.046, subdivision 1, is amended to read:
142.19 		Subdivision 1.Hearing authority. A local agency must initiate an administrative fraud 
142.20 	disqualification hearing for individuals, including child care providers caring for children 
142.21 	receiving child care assistance, accused of wrongfully obtaining assistance or intentional 
142.22 	program violations, in lieu of a criminal action when it has not been pursued, in the Minnesota 
142.23 	family investment program and any affiliated program to include the diversionary work 
142.24 	program and the work participation cash benefit program, child care assistance programs, 
142.25 	general assistance, family general assistance program formerly codified in section 256D.05, 
142.26 	subdivision 1, clause (15), Minnesota supplemental aid, food stamp programs, MinnesotaCare 
142.27 	for adults without children, and upon federal approval, all categories of medical assistance 
142.28 	and remaining categories of MinnesotaCare except for children through age 18. The 
142.29 	Department of Human Services, in lieu of a local agency, may initiate an administrative 
142.30 	fraud disqualification hearing when the state agency is directly responsible for administration 
142.31 	or investigation of the program for which benefits were wrongfully obtained. The hearing 
143.1 	is subject to the requirements of section sections256.045 and 256.0451 and the requirements 
143.2 	in Code of Federal Regulations, title 7, section 273.16.

143.3 	Sec. 107. Minnesota Statutes 2018, section 256.046, is amended by adding a subdivision 
143.4 	to read:
143.5 		Subd. 3.Administrative disqualification of child care providers caring for children 
143.6 	receiving child care assistance. (a) The department or local agency shall pursue an 
143.7 	administrative disqualification, if the child care provider is accused of committing an 
143.8 	intentional program violation, in lieu of a criminal action when it has not been pursued. 
143.9 	Intentional program violations include intentionally making false or misleading statements; 
143.10 	intentionally misrepresenting, concealing, or withholding facts; and repeatedly and 
143.11 	intentionally violating program regulations under chapters 119B and 245E. Intent may be 
143.12 	proven by demonstrating a pattern of conduct that violates program rules under chapters 
143.13 	119B and 245E.
143.14 	(b) To initiate an administrative disqualification, a local agency or the commissioner 
143.15 	must mail written notice by certified mail to the provider against whom the action is being 
143.16 	taken. Unless otherwise specified under chapter 119B or 245E or Minnesota Rules, chapter 
143.17 	3400, a local agency or the commissioner must mail the written notice at least 15 calendar 
143.18 	days before the adverse action's effective date. The notice shall state (1) the factual basis 
143.19 	for the agency's determination, (2) the action the agency intends to take, (3) the dollar amount 
143.20 	of the monetary recovery or recoupment, if known, and (4) the provider's right to appeal 
143.21 	the agency's proposed action.
143.22 	(c) The provider may appeal an administrative disqualification by submitting a written 
143.23 	request to the Department of Human Services, Appeals Division. A provider's request must 
143.24 	be received by the Appeals Division no later than 30 days after the date a local agency or 
143.25 	the commissioner mails the notice.
143.26 	(d) The provider's appeal request must contain the following:
143.27 	(1) each disputed item, the reason for the dispute, and, if applicable, an estimate of the 
143.28 	dollar amount involved for each disputed item;
143.29 	(2) the computation the provider believes to be correct, if applicable;
143.30 	(3) the statute or rule relied on for each disputed item; and
143.31 	(4) the name, address, and telephone number of the person at the provider's place of 
143.32 	business with whom contact may be made regarding the appeal.
144.1 	(e) On appeal, the issuing agency bears the burden of proof to demonstrate by a 
144.2 	preponderance of the evidence that the provider committed an intentional program violation.
144.3 	(f) The hearing is subject to the requirements of sections 256.045 and 256.0451. The 
144.4 	human services judge may combine a fair hearing and administrative disqualification hearing 
144.5 	into a single hearing if the factual issues arise out of the same or related circumstances and 
144.6 	the provider receives prior notice that the hearings will be combined.
144.7 	(g) A provider found to have committed an intentional program violation and is 
144.8 	administratively disqualified shall be disqualified, for a period of three years for the first 
144.9 	offense and permanently for any subsequent offense, from receiving any payments from 
144.10 	any child care program under chapter 119B.
144.11 	(h) Unless a timely and proper appeal made under this section is received by the 
144.12 	department, the administrative determination of the department is final and binding.

144.13 	Sec. 108. Minnesota Statutes 2018, section 256.98, subdivision 1, is amended to read:
144.14 		Subdivision 1.Wrongfully obtaining assistance. A person who commits any of the 
144.15 	following acts or omissions with intent to defeat the purposes of sections 145.891 to 145.897, 
144.16 	the MFIP program formerly codified in sections 256.031 to 256.0361, the AFDC program 
144.17 	formerly codified in sections 256.72 to 256.871, chapter 256B, 256D, 256I, 256J, 256K, or 
144.18 	256L, child care assistance programs, and emergency assistance programs under section 
144.19 	256D.06, is guilty of theft and shall be sentenced under section 609.52, subdivision 3, clauses 
144.20 	(1) to (5):
144.21 	(1) obtains or attempts to obtain, or aids or abets any person to obtain by means of a 
144.22 	willfully false statement or representation, by intentional concealment of any material fact, 
144.23 	or by impersonation or other fraudulent device, assistance or the continued receipt of 
144.24 	assistance, to include child care assistance or vouchers produced according to sections 
144.25 	145.891 to 145.897 and MinnesotaCare services according to sections 256.9365, 256.94, 
144.26 	and 256L.01 to 256L.15, to which the person is not entitled or assistance greater than that 
144.27 	to which the person is entitled;
144.28 	(2) knowingly aids or abets in buying or in any way disposing of the property of a 
144.29 	recipient or applicant of assistance without the consent of the county agency; or
144.30 	(3) obtains or attempts to obtain, alone or in collusion with others, the receipt of payments 
144.31 	to which the individual is not entitled as a provider of subsidized child care, or by furnishing 
144.32 	or concurring in a willfully false claim for child care assistance.
145.1 	The continued receipt of assistance to which the person is not entitled or greater than 
145.2 	that to which the person is entitled as a result of any of the acts, failure to act, or concealment 
145.3 	described in this subdivision shall be deemed to be continuing offenses from the date that 
145.4 	the first act or failure to act occurred.

145.5 	Sec. 109. Minnesota Statutes 2018, section 256.98, subdivision 8, is amended to read:
145.6 		Subd. 8.Disqualification from program. (a) Any person found to be guilty of 
145.7 	wrongfully obtaining assistance by a federal or state court or by an administrative hearing 
145.8 	determination, or waiver thereof, through a disqualification consent agreement, or as part 
145.9 	of any approved diversion plan under section 401.065, or any court-ordered stay which 
145.10 	carries with it any probationary or other conditions, in the Minnesota family investment 
145.11 	program and any affiliated program to include the diversionary work program and the work 
145.12 	participation cash benefit program, the food stamp or food support program, the general 
145.13 	assistance program, housing support under chapter 256I, or the Minnesota supplemental 
145.14 	aid program shall be disqualified from that program. In addition, any person disqualified 
145.15 	from the Minnesota family investment program shall also be disqualified from the food 
145.16 	stamp or food support program. The needs of that individual shall not be taken into 
145.17 	consideration in determining the grant level for that assistance unit:
145.18 	(1) for one year after the first offense;
145.19 	(2) for two years after the second offense; and
145.20 	(3) permanently after the third or subsequent offense.
145.21 	The period of program disqualification shall begin on the date stipulated on the advance 
145.22 	notice of disqualification without possibility of postponement for administrative stay or 
145.23 	administrative hearing and shall continue through completion unless and until the findings 
145.24 	upon which the sanctions were imposed are reversed by a court of competent jurisdiction. 
145.25 	The period for which sanctions are imposed is not subject to review. The sanctions provided 
145.26 	under this subdivision are in addition to, and not in substitution for, any other sanctions that 
145.27 	may be provided for by law for the offense involved. A disqualification established through 
145.28 	hearing or waiver shall result in the disqualification period beginning immediately unless 
145.29 	the person has become otherwise ineligible for assistance. If the person is ineligible for 
145.30 	assistance, the disqualification period begins when the person again meets the eligibility 
145.31 	criteria of the program from which they were disqualified and makes application for that 
145.32 	program.
146.1 	(b) A family receiving assistance through child care assistance programs under chapter 
146.2 	119B with a family member who is found to be guilty of wrongfully obtaining child care 
146.3 	assistance by a federal court, state court, or an administrative hearing determination or 
146.4 	waiver, through a disqualification consent agreement, as part of an approved diversion plan 
146.5 	under section 401.065, or a court-ordered stay with probationary or other conditions, is 
146.6 	disqualified from child care assistance programs. The disqualifications must be for periods 
146.7 	of one year and two years for the first and second offenses, respectively. Subsequent 
146.8 	violations must result in permanent disqualification. During the disqualification period, 
146.9 	disqualification from any child care program must extend to all child care programs and 
146.10 	must be immediately applied.
146.11 	(c) A provider caring for children receiving assistance through child care assistance 
146.12 	programs under chapter 119B is disqualified from receiving payment for child care services 
146.13 	from the child care assistance program under chapter 119B when the provider is found to 
146.14 	have wrongfully obtained child care assistance by a federal court, state court, or an 
146.15 	administrative hearing determination or waiver under section 256.046, through a 
146.16 	disqualification consent agreement, as part of an approved diversion plan under section 
146.17 	401.065, or a court-ordered stay with probationary or other conditions. The disqualification 
146.18 	must be for a period of one year three years for the first offense and two years for the second 
146.19 	offense. Any subsequent violation must result in permanent disqualification. The 
146.20 	disqualification period must be imposed immediately after a determination is made under 
146.21 	this paragraph. During the disqualification period, the provider is disqualified from receiving 
146.22 	payment from any child care program under chapter 119B.
146.23 	(d) Any person found to be guilty of wrongfully obtaining MinnesotaCare for adults 
146.24 	without children and upon federal approval, all categories of medical assistance and 
146.25 	remaining categories of MinnesotaCare, except for children through age 18, by a federal or 
146.26 	state court or by an administrative hearing determination, or waiver thereof, through a 
146.27 	disqualification consent agreement, or as part of any approved diversion plan under section 
146.28 	401.065, or any court-ordered stay which carries with it any probationary or other conditions, 
146.29 	is disqualified from that program. The period of disqualification is one year after the first 
146.30 	offense, two years after the second offense, and permanently after the third or subsequent 
146.31 	offense. The period of program disqualification shall begin on the date stipulated on the 
146.32 	advance notice of disqualification without possibility of postponement for administrative 
146.33 	stay or administrative hearing and shall continue through completion unless and until the 
146.34 	findings upon which the sanctions were imposed are reversed by a court of competent 
146.35 	jurisdiction. The period for which sanctions are imposed is not subject to review. The 
147.1 	sanctions provided under this subdivision are in addition to, and not in substitution for, any 
147.2 	other sanctions that may be provided for by law for the offense involved.

147.3 	Sec. 110. Minnesota Statutes 2018, section 256.983, is amended by adding a subdivision 
147.4 	to read:
147.5 		Subd. 5.Child care providers; financial misconduct. (a) A county or tribal agency 
147.6 	may conduct investigations of financial misconduct by child care providers as described in 
147.7 	chapter 245E. Prior to opening an investigation, a county or tribal agency must contact the 
147.8 	commissioner to determine whether an investigation under this chapter may compromise 
147.9 	an ongoing investigation.
147.10 	(b) If, upon investigation, a preponderance of evidence shows a provider committed an 
147.11 	intentional program violation, intentionally gave the county or tribe materially false 
147.12 	information on the provider's billing forms, provided false attendance records to a county, 
147.13 	tribe, or the commissioner, or committed financial misconduct as described in section 
147.14 	245E.01, subdivision 8, the county or tribal agency may suspend a provider's payment 
147.15 	pursuant to chapter 245E, or deny or revoke a provider's authorization pursuant to section 
147.16 	119B.13, subdivision 6, paragraph (d), clause (2), prior to pursuing other available remedies. 
147.17 	The county must send notice in accordance with the requirements of section 119B.161, 
147.18 	subdivision 2. If a provider's payment is suspended under this section, the payment suspension 
147.19 	shall remain in effect until: (1) the commissioner, county, or a law enforcement authority 
147.20 	determines that there is insufficient evidence warranting the action and a county, tribe, or 
147.21 	the commissioner does not pursue an additional administrative remedy under chapter 119B 
147.22 	or 245E, or section 256.046 or 256.98; or (2) all criminal, civil, and administrative 
147.23 	proceedings related to the provider's alleged misconduct conclude and any appeal rights are 
147.24 	exhausted.
147.25 	(c) For the purposes of this section, an intentional program violation includes intentionally 
147.26 	making false or misleading statements; intentionally misrepresenting, concealing, or 
147.27 	withholding facts; and repeatedly and intentionally violating program regulations under 
147.28 	chapters 119B and 245E.
147.29 	(d) A provider has the right to administrative review under section 119B.161 if: (1) 
147.30 	payment is suspended under chapter 245E; or (2) the provider's authorization was denied 
147.31 	or revoked under section 119B.13, subdivision 6, paragraph (d), clause (2).

147.32 	EFFECTIVE DATE. This section is effective February 26, 2021.

148.1 	Sec. 111. Minnesota Statutes 2018, section 256B.02, subdivision 7, is amended to read:
148.2 		Subd. 7.Vendor of medical care. (a) "Vendor of medical care" means any person or 
148.3 	persons furnishing, within the scope of the vendor's respective license, any or all of the 
148.4 	following goods or services: medical, surgical, hospital, ambulatory surgical center services, 
148.5 	optical, visual, dental and nursing services; drugs and medical supplies; appliances; 
148.6 	laboratory, diagnostic, and therapeutic services; nursing home and convalescent care; 
148.7 	screening and health assessment services provided by public health nurses as defined in 
148.8 	section 145A.02, subdivision 18; health care services provided at the residence of the patient 
148.9 	if the services are performed by a public health nurse and the nurse indicates in a statement 
148.10 	submitted under oath that the services were actually provided; and such other medical
148.11 	services or supplies provided or prescribed by persons authorized by state law to give such 
148.12 	services and supplies. The term includes, but is not limited to, directors and officers of 
148.13 	corporations or members of partnerships who, either individually or jointly with another or 
148.14 	others, have the legal control, supervision, or responsibility of submitting claims for 
148.15 	reimbursement to the medical assistance program. The term only includes directors and 
148.16 	officers of corporations who personally receive a portion of the distributed assets upon 
148.17 	liquidation or dissolution, and their liability is limited to the portion of the claim that bears 
148.18 	the same proportion to the total claim as their share of the distributed assets bears to the 
148.19 	total distributed assets.
148.20 	(b) "Vendor of medical care" also includes any person who is credentialed as a health 
148.21 	professional under standards set by the governing body of a federally recognized Indian 
148.22 	tribe authorized under an agreement with the federal government according to United States 
148.23 	Code, title 25, section 450f, to provide health services to its members, and who through a 
148.24 	tribal facility provides covered services to American Indian people within a contract health 
148.25 	service delivery area of a Minnesota reservation, as defined under Code of Federal 
148.26 	Regulations, title 42, section 36.22.
148.27 	(c) A federally recognized Indian tribe that intends to implement standards for 
148.28 	credentialing health professionals must submit the standards to the commissioner of human 
148.29 	services, along with evidence of meeting, exceeding, or being exempt from corresponding 
148.30 	state standards. The commissioner shall maintain a copy of the standards and supporting 
148.31 	evidence, and shall use those standards to enroll tribal-approved health professionals as 
148.32 	medical assistance providers. For purposes of this section, "Indian" and "Indian tribe" mean 
148.33 	persons or entities that meet the definition in United States Code, title 25, section 450b.

149.1 	Sec. 112. Minnesota Statutes 2018, section 256B.04, subdivision 21, is amended to read:
149.2 		Subd. 21.Provider enrollment. (a) If the commissioner or the Centers for Medicare 
149.3 	and Medicaid Services determines that a provider is designated "high-risk," the commissioner 
149.4 	may withhold payment from providers within that category upon initial enrollment for a 
149.5 	90-day period. The withholding for each provider must begin on the date of the first 
149.6 	submission of a claim.
149.7 	(b) An enrolled provider that is also licensed by the commissioner under chapter 245A, 
149.8 	or is licensed as a home care provider by the Department of Health under chapter 144A and 
149.9 	has a home and community-based services designation on the home care license under 
149.10 	section 144A.484, must designate an individual as the entity's compliance officer. The 
149.11 	compliance officer must:
149.12 	(1) develop policies and procedures to assure adherence to medical assistance laws and 
149.13 	regulations and to prevent inappropriate claims submissions;
149.14 	(2) train the employees of the provider entity, and any agents or subcontractors of the 
149.15 	provider entity including billers, on the policies and procedures under clause (1);
149.16 	(3) respond to allegations of improper conduct related to the provision or billing of 
149.17 	medical assistance services, and implement action to remediate any resulting problems;
149.18 	(4) use evaluation techniques to monitor compliance with medical assistance laws and 
149.19 	regulations;
149.20 	(5) promptly report to the commissioner any identified violations of medical assistance 
149.21 	laws or regulations; and
149.22 	(6) within 60 days of discovery by the provider of a medical assistance reimbursement 
149.23 	overpayment, report the overpayment to the commissioner and make arrangements with 
149.24 	the commissioner for the commissioner's recovery of the overpayment.
149.25 	The commissioner may require, as a condition of enrollment in medical assistance, that a 
149.26 	provider within a particular industry sector or category establish a compliance program that 
149.27 	contains the core elements established by the Centers for Medicare and Medicaid Services.
149.28 	(c) The commissioner may revoke the enrollment of an ordering or rendering provider 
149.29 	for a period of not more than one year, if the provider fails to maintain and, upon request 
149.30 	from the commissioner, provide access to documentation relating to written orders or requests 
149.31 	for payment for durable medical equipment, certifications for home health services, or 
149.32 	referrals for other items or services written or ordered by such provider, when the 
149.33 	commissioner has identified a pattern of a lack of documentation. A pattern means a failure 
150.1 	to maintain documentation or provide access to documentation on more than one occasion. 
150.2 	Nothing in this paragraph limits the authority of the commissioner to sanction a provider 
150.3 	under the provisions of section 256B.064.
150.4 	(d) The commissioner shall terminate or deny the enrollment of any individual or entity 
150.5 	if the individual or entity has been terminated from participation in Medicare or under the 
150.6 	Medicaid program or Children's Health Insurance Program of any other state. The 
150.7 	commissioner may exempt a rehabilitation agency from termination or denial that would 
150.8 	otherwise be required under this paragraph, if the agency:
150.9 	(1) is unable to retain Medicare certification and enrollment solely due to a lack of billing 
150.10 	to the Medicare program;
150.11 	(2) meets all other applicable Medicare certification requirements based on an on-site 
150.12 	review completed by the commissioner of health; and
150.13 	(3) serves primarily a pediatric population.
150.14 	(e) As a condition of enrollment in medical assistance, the commissioner shall require 
150.15 	that a provider designated "moderate" or "high-risk" by the Centers for Medicare and 
150.16 	Medicaid Services or the commissioner permit the Centers for Medicare and Medicaid 
150.17 	Services, its agents, or its designated contractors and the state agency, its agents, or its 
150.18 	designated contractors to conduct unannounced on-site inspections of any provider location. 
150.19 	The commissioner shall publish in the Minnesota Health Care Program Provider Manual a 
150.20 	list of provider types designated "limited," "moderate," or "high-risk," based on the criteria 
150.21 	and standards used to designate Medicare providers in Code of Federal Regulations, title 
150.22 	42, section 424.518. The list and criteria are not subject to the requirements of chapter 14. 
150.23 	The commissioner's designations are not subject to administrative appeal.
150.24 	(f) As a condition of enrollment in medical assistance, the commissioner shall require 
150.25 	that a high-risk provider, or a person with a direct or indirect ownership interest in the 
150.26 	provider of five percent or higher, consent to criminal background checks, including 
150.27 	fingerprinting, when required to do so under state law or by a determination by the 
150.28 	commissioner or the Centers for Medicare and Medicaid Services that a provider is designated 
150.29 	high-risk for fraud, waste, or abuse.
150.30 	(g)(1) Upon initial enrollment, reenrollment, and notification of revalidation, all durable 
150.31 	medical equipment, prosthetics, orthotics, and supplies (DMEPOS) medical suppliers 
150.32 	meeting the durable medical equipment provider and supplier definition in clause (3), 
150.33 	operating in Minnesota and receiving Medicaid funds must purchase a surety bond that is 
150.34 	annually renewed and designates the Minnesota Department of Human Services as the 
151.1 	obligee, and must be submitted in a form approved by the commissioner. For purposes of 
151.2 	this clause, the following medical suppliers are not required to obtain a surety bond: a 
151.3 	federally qualified health center, a home health agency, the Indian Health Service, a 
151.4 	pharmacy, and a rural health clinic.
151.5 	(2) At the time of initial enrollment or reenrollment, durable medical equipment providers 
151.6 	and suppliers defined in clause (3) must purchase a surety bond of $50,000. If a revalidating 
151.7 	provider's Medicaid revenue in the previous calendar year is up to and including $300,000, 
151.8 	the provider agency must purchase a surety bond of $50,000. If a revalidating provider's 
151.9 	Medicaid revenue in the previous calendar year is over $300,000, the provider agency must 
151.10 	purchase a surety bond of $100,000. The surety bond must allow for recovery of costs and 
151.11 	fees in pursuing a claim on the bond.
151.12 	(3) "Durable medical equipment provider or supplier" means a medical supplier that can 
151.13 	purchase medical equipment or supplies for sale or rental to the general public and is able 
151.14 	to perform or arrange for necessary repairs to and maintenance of equipment offered for 
151.15 	sale or rental.
151.16 	(h) The Department of Human Services may require a provider to purchase a surety 
151.17 	bond as a condition of initial enrollment, reenrollment, reinstatement, or continued enrollment 
151.18 	if: (1) the provider fails to demonstrate financial viability, (2) the department determines 
151.19 	there is significant evidence of or potential for fraud and abuse by the provider, or (3) the 
151.20 	provider or category of providers is designated high-risk pursuant to paragraph (a) and as 
151.21 	per Code of Federal Regulations, title 42, section 455.450. The surety bond must be in an 
151.22 	amount of $100,000 or ten percent of the provider's payments from Medicaid during the 
151.23 	immediately preceding 12 months, whichever is greater. The surety bond must name the 
151.24 	Department of Human Services as an obligee and must allow for recovery of costs and fees 
151.25 	in pursuing a claim on the bond. This paragraph does not apply if the provider currently 
151.26 	maintains a surety bond under the requirements in section 256B.0659 or 256B.85.

151.27 	Sec. 113. Minnesota Statutes 2018, section 256B.064, subdivision 1b, is amended to read:
151.28 		Subd. 1b.Sanctions available. The commissioner may impose the following sanctions 
151.29 	for the conduct described in subdivision 1a: suspension or withholding of payments to a 
151.30 	vendor and suspending or terminating participation in the program, or imposition of a fine 
151.31 	under subdivision 2, paragraph (f). When imposing sanctions under this section, the 
151.32 	commissioner shall consider the nature, chronicity, or severity of the conduct and the effect 
151.33 	of the conduct on the health and safety of persons served by the vendor. The commissioner 
151.34 	shall suspend a vendor's participation in the program for a minimum of five years if the 
152.1 	vendor is convicted of a crime, received a stay of adjudication, or entered a court-ordered 
152.2 	diversion program for an offense related to a provision of a health service under medical 
152.3 	assistance or health care fraud. Regardless of imposition of sanctions, the commissioner 
152.4 	may make a referral to the appropriate state licensing board.

152.5 	Sec. 114. Minnesota Statutes 2018, section 256B.064, subdivision 2, is amended to read:
152.6 		Subd. 2.Imposition of monetary recovery and sanctions. (a) The commissioner shall 
152.7 	determine any monetary amounts to be recovered and sanctions to be imposed upon a vendor 
152.8 	of medical care under this section. Except as provided in paragraphs (b) and (d), neither a 
152.9 	monetary recovery nor a sanction will be imposed by the commissioner without prior notice 
152.10 	and an opportunity for a hearing, according to chapter 14, on the commissioner's proposed 
152.11 	action, provided that the commissioner may suspend or reduce payment to a vendor of 
152.12 	medical care, except a nursing home or convalescent care facility, after notice and prior to 
152.13 	the hearing if in the commissioner's opinion that action is necessary to protect the public 
152.14 	welfare and the interests of the program.
152.15 	(b) Except when the commissioner finds good cause not to suspend payments under 
152.16 	Code of Federal Regulations, title 42, section 455.23 (e) or (f), the commissioner shall 
152.17 	withhold or reduce payments to a vendor of medical care without providing advance notice 
152.18 	of such withholding or reduction if either of the following occurs:
152.19 	(1) the vendor is convicted of a crime involving the conduct described in subdivision 
152.20 	1a; or
152.21 	(2) the commissioner determines there is a credible allegation of fraud for which an 
152.22 	investigation is pending under the program. A credible allegation of fraud is an allegation 
152.23 	which has been verified by the state, from any source, including but not limited to:
152.24 	(i) fraud hotline complaints;
152.25 	(ii) claims data mining; and
152.26 	(iii) patterns identified through provider audits, civil false claims cases, and law 
152.27 	enforcement investigations.
152.28 	Allegations are considered to be credible when they have an indicia of reliability and 
152.29 	the state agency has reviewed all allegations, facts, and evidence carefully and acts 
152.30 	judiciously on a case-by-case basis.
153.1 	(c) The commissioner must send notice of the withholding or reduction of payments 
153.2 	under paragraph (b) within five days of taking such action unless requested in writing by a 
153.3 	law enforcement agency to temporarily withhold the notice. The notice must:
153.4 	(1) state that payments are being withheld according to paragraph (b);
153.5 	(2) set forth the general allegations as to the nature of the withholding action, but need 
153.6 	not disclose any specific information concerning an ongoing investigation;
153.7 	(3) except in the case of a conviction for conduct described in subdivision 1a, state that 
153.8 	the withholding is for a temporary period and cite the circumstances under which withholding 
153.9 	will be terminated;
153.10 	(4) identify the types of claims to which the withholding applies; and
153.11 	(5) inform the vendor of the right to submit written evidence for consideration by the 
153.12 	commissioner.
153.13 	The withholding or reduction of payments will not continue after the commissioner 
153.14 	determines there is insufficient evidence of fraud by the vendor, or after legal proceedings 
153.15 	relating to the alleged fraud are completed, unless the commissioner has sent notice of 
153.16 	intention to impose monetary recovery or sanctions under paragraph (a). Upon conviction 
153.17 	for a crime related to the provision, management, or administration of a health service under 
153.18 	medical assistance, a payment held pursuant to this section by the commissioner or a managed 
153.19 	care organization that contracts with the commissioner under section 256B.035 is forfeited 
153.20 	to the commissioner or managed care organization, regardless of the amount charged in the 
153.21 	criminal complaint or the amount of criminal restitution ordered.
153.22 	(d) The commissioner shall suspend or terminate a vendor's participation in the program 
153.23 	without providing advance notice and an opportunity for a hearing when the suspension or 
153.24 	termination is required because of the vendor's exclusion from participation in Medicare. 
153.25 	Within five days of taking such action, the commissioner must send notice of the suspension 
153.26 	or termination. The notice must:
153.27 	(1) state that suspension or termination is the result of the vendor's exclusion from 
153.28 	Medicare;
153.29 	(2) identify the effective date of the suspension or termination; and
153.30 	(3) inform the vendor of the need to be reinstated to Medicare before reapplying for 
153.31 	participation in the program.
154.1 	(e) Upon receipt of a notice under paragraph (a) that a monetary recovery or sanction is 
154.2 	to be imposed, a vendor may request a contested case, as defined in section 14.02, subdivision 
154.3 	3, by filing with the commissioner a written request of appeal. The appeal request must be 
154.4 	received by the commissioner no later than 30 days after the date the notification of monetary 
154.5 	recovery or sanction was mailed to the vendor. The appeal request must specify:
154.6 	(1) each disputed item, the reason for the dispute, and an estimate of the dollar amount 
154.7 	involved for each disputed item;
154.8 	(2) the computation that the vendor believes is correct;
154.9 	(3) the authority in statute or rule upon which the vendor relies for each disputed item;
154.10 	(4) the name and address of the person or entity with whom contacts may be made 
154.11 	regarding the appeal; and
154.12 	(5) other information required by the commissioner.
154.13 	(f) The commissioner may order a vendor to forfeit a fine for failure to fully document 
154.14 	services according to standards in this chapter and Minnesota Rules, chapter 9505. The 
154.15 	commissioner may assess fines if specific required components of documentation are 
154.16 	missing. The fine for incomplete documentation shall equal 20 percent of the amount paid 
154.17 	on the claims for reimbursement submitted by the vendor, or up to $5,000, whichever is 
154.18 	less. If the commissioner determines that a vendor repeatedly violated this chapter or 
154.19 	Minnesota Rules, chapter 9505, related to the provision of services to program recipients 
154.20 	and the submission of claims for payment, the commissioner may order a vendor to forfeit 
154.21 	a fine based on the nature, severity, and chronicity of the violations, in an amount of up to 
154.22 	$5,000 or 20 percent of the value of the claims, whichever is greater.
154.23 	(g) The vendor shall pay the fine assessed on or before the payment date specified. If 
154.24 	the vendor fails to pay the fine, the commissioner may withhold or reduce payments and 
154.25 	recover the amount of the fine. A timely appeal shall stay payment of the fine until the 
154.26 	commissioner issues a final order.

154.27 	Sec. 115. Minnesota Statutes 2018, section 256B.064, is amended by adding a subdivision 
154.28 	to read:
154.29 		Subd. 3.Vendor mandates on prohibited payments.  (a) The commissioner shall 
154.30 	maintain and publish a list of each excluded individual and entity that was convicted of a 
154.31 	crime related to the provision, management, or administration of a medical assistance health 
154.32 	service, or suspended or terminated under subdivision 2. Medical assistance payments cannot 
155.1 	be made by a vendor for items or services furnished either directly or indirectly by an 
155.2 	excluded individual or entity, or at the direction of excluded individuals or entities.
155.3 	(b) The vendor must check the exclusion list on a monthly basis and document the date 
155.4 	and time the exclusion list was checked and the name and title of the person who checked 
155.5 	the exclusion list. The vendor must immediately terminate payments to an individual or 
155.6 	entity on the exclusion list.
155.7 	(c) A vendor's requirement to check the exclusion list and to terminate payments to 
155.8 	individuals or entities on the exclusion list applies to each individual or entity on the 
155.9 	exclusion list, even if the named individual or entity is not responsible for direct patient 
155.10 	care or direct submission of a claim to medical assistance.
155.11 	(d) A vendor that pays medical assistance program funds to an individual or entity on 
155.12 	the exclusion list must refund any payment related to either items or services rendered by 
155.13 	an individual or entity on the exclusion list from the date the individual or entity is first paid 
155.14 	or the date the individual or entity is placed on the exclusion list, whichever is later, and a 
155.15 	vendor may be subject to:
155.16 	(1) sanctions under subdivision 2;
155.17 	(2) a civil monetary penalty of up to $25,000 for each determination by the department 
155.18 	that the vendor employed or contracted with an individual or entity on the exclusion list; 
155.19 	and
155.20 	(3) other fines or penalties allowed by law.

155.21 	Sec. 116. Minnesota Statutes 2018, section 256B.064, is amended by adding a subdivision 
155.22 	to read:
155.23 		Subd. 4.Notice. (a) The notice required under subdivision 2 shall be served by certified 
155.24 	mail at the address submitted to the department by the vendor. Service is complete upon 
155.25 	mailing. The commissioner shall place an affidavit of the certified mailing in the vendor's 
155.26 	file as an indication of the address and the date of mailing.
155.27 	(b) The department shall give notice in writing to a recipient placed in the Minnesota 
155.28 	restricted recipient program under section 256B.0646 and Minnesota Rules, part 9505.2200. 
155.29 	The notice shall be sent by first class mail to the recipient's current address on file with the 
155.30 	department. A recipient placed in the Minnesota restricted recipient program may contest 
155.31 	the placement by submitting a written request for a hearing to the department within 90 
155.32 	days of the notice being mailed.

156.1 	Sec. 117. Minnesota Statutes 2018, section 256B.064, is amended by adding a subdivision 
156.2 	to read:
156.3 		Subd. 5.Immunity; good faith reporters. (a) A person who makes a good faith report 
156.4 	is immune from any civil or criminal liability that might otherwise arise from reporting or 
156.5 	participating in the investigation. Nothing in this subdivision affects a vendor's responsibility 
156.6 	for an overpayment established under this subdivision.
156.7 	(b) A person employed by a lead investigative agency who is conducting or supervising 
156.8 	an investigation or enforcing the law according to the applicable law or rule is immune from 
156.9 	any civil or criminal liability that might otherwise arise from the person's actions, if the 
156.10 	person is acting in good faith and exercising due care.
156.11 	(c) For purposes of this subdivision, "person" includes a natural person or any form of 
156.12 	a business or legal entity.
156.13 	(d) After an investigation is complete, the reporter's name must be kept confidential. 
156.14 	The subject of the report may compel disclosure of the reporter's name only with the consent 
156.15 	of the reporter or upon a written finding by a district court that the report was false and there 
156.16 	is evidence that the report was made in bad faith. This subdivision does not alter disclosure 
156.17 	responsibilities or obligations under the Rules of Criminal Procedure, except that when the 
156.18 	identity of the reporter is relevant to a criminal prosecution the district court shall conduct 
156.19 	an in-camera review before determining whether to order disclosure of the reporter's identity.

156.20 	Sec. 118. [256B.0646] MINNESOTA RESTRICTED RECIPIENT PROGRAM; 
156.21 	PERSONAL CARE ASSISTANCE SERVICES.
156.22 	(a) When a recipient's use of personal care assistance services or community first services 
156.23 	and supports under section 256B.85 results in abusive or fraudulent billing, the commissioner 
156.24 	may place a recipient in the Minnesota restricted recipient program under Minnesota Rules, 
156.25 	part 9505.2165. A recipient placed in the Minnesota restricted recipient program under this 
156.26 	section must: (1) use a designated traditional personal care assistance provider agency; and 
156.27 	(2) obtain a new assessment under section 256B.0911, including consultation with a registered 
156.28 	or public health nurse on the long-term care consultation team pursuant to section 256B.0911, 
156.29 	subdivision 3, paragraph (b), clause (2).
156.30 	(b) A recipient must comply with additional conditions for the use of personal care 
156.31 	assistance services or community first services and supports if the commissioner determines 
156.32 	it is necessary to prevent future misuse of personal care assistance services or abusive or 
156.33 	fraudulent billing. Additional conditions may include but are not limited to restricting service 
157.1 	authorizations for a duration of no more than one month and requiring a qualified professional 
157.2 	to monitor and report services on a monthly basis.
157.3 	(c) A recipient placed in the Minnesota restricted recipient program under this section 
157.4 	may appeal the placement according to section 256.045.

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

157.6 	Sec. 119. Minnesota Statutes 2018, section 256B.0651, subdivision 17, is amended to 
157.7 	read:
157.8 		Subd. 17.Recipient protection. (a) Providers of home care services must provide each 
157.9 	recipient with a copy of the home care bill of rights under section 144A.44 at least 30 days 
157.10 	prior to terminating services to a recipient, if the termination results from provider sanctions 
157.11 	under section 256B.064, such as a payment withhold, a suspension of participation, or a 
157.12 	termination of participation. If a home care provider determines it is unable to continue 
157.13 	providing services to a recipient, the provider must notify the recipient, the recipient's 
157.14 	responsible party, and the commissioner 30 days prior to terminating services to the recipient 
157.15 	because of an action under section 256B.064, and must assist the commissioner and lead 
157.16 	agency in supporting the recipient in transitioning to another home care provider of the 
157.17 	recipient's choice.
157.18 	(b) In the event of a payment withhold from a home care provider, a suspension of 
157.19 	participation, or a termination of participation of a home care provider under section 
157.20 	256B.064, the commissioner may inform the Office of Ombudsman for Long-Term Care 
157.21 	and the lead agencies for all recipients with active service agreements with the provider. At 
157.22 	the commissioner's request, the lead agencies must contact recipients to ensure that the 
157.23 	recipients are continuing to receive needed care, and that the recipients have been given 
157.24 	free choice of provider if they transfer to another home care provider. In addition, the 
157.25 	commissioner or the commissioner's delegate may directly notify recipients who receive 
157.26 	care from the provider that payments have been or will be withheld or that the provider's 
157.27 	participation in medical assistance has been or will be suspended or terminated, if the 
157.28 	commissioner determines that notification is necessary to protect the welfare of the recipients. 
157.29 	For purposes of this subdivision, "lead agencies" means counties, tribes, and managed care 
157.30 	organizations.

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

158.1 	Sec. 120. Minnesota Statutes 2018, section 256B.0659, subdivision 12, is amended to 
158.2 	read:
158.3 		Subd. 12.Documentation of personal care assistance services provided. (a) Personal 
158.4 	care assistance services for a recipient must be documented daily by each personal care 
158.5 	assistant, on a time sheet form approved by the commissioner. All documentation may be 
158.6 	web-based, electronic, or paper documentation. The completed form must be submitted on 
158.7 	a monthly basis to the provider and kept in the recipient's health record.
158.8 	(b) The activity documentation must correspond to the personal care assistance care plan 
158.9 	and be reviewed by the qualified professional.
158.10 	(c) The personal care assistant time sheet must be on a form approved by the 
158.11 	commissioner documenting time the personal care assistant provides services in the home. 
158.12 	The following criteria must be included in the time sheet:
158.13 	(1) full name of personal care assistant and individual provider number;
158.14 	(2) provider name and telephone numbers;
158.15 	(3) full name of recipient and either the recipient's medical assistance identification 
158.16 	number or date of birth;
158.17 	(4) consecutive dates, including month, day, and year, and arrival and departure times 
158.18 	with a.m. or p.m. notations;
158.19 	(5) signatures of recipient or the responsible party;
158.20 	(6) personal signature of the personal care assistant;
158.21 	(7) any shared care provided, if applicable;
158.22 	(8) a statement that it is a federal crime to provide false information on personal care 
158.23 	service billings for medical assistance payments; and
158.24 	(9) dates and location of recipient stays in a hospital, care facility, or incarceration.

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

158.26 	Sec. 121. Minnesota Statutes 2018, section 256B.27, subdivision 3, is amended to read:
158.27 		Subd. 3.Access to medical records. The commissioner of human services, with the 
158.28 	written consent of the recipient, on file with the local welfare agency, shall be allowed 
158.29 	access to all personal medical records of medical assistance recipients solely for the purposes 
158.30 	of investigating whether or not: (a) a vendor of medical care has submitted a claim for 
158.31 	reimbursement, a cost report or a rate application which is duplicative, erroneous, or false 
159.1 	in whole or in part, or which results in the vendor obtaining greater compensation than the 
159.2 	vendor is legally entitled to; or (b) the medical care was medically necessary. The vendor 
159.3 	of medical care shall receive notification from the commissioner at least 24 hours before 
159.4 	the commissioner gains access to such records. When the commissioner is investigating a 
159.5 	possible overpayment of Medicaid funds, the commissioner must be given immediate access 
159.6 	without prior notice to the vendor's office during regular business hours and to documentation 
159.7 	and records related to services provided and submission of claims for services provided. 
159.8 	The department shall document in writing the need for immediate access to records related 
159.9 	to a specific investigation. Denying the commissioner access to records is cause for the 
159.10 	vendor's immediate suspension of payment or termination according to section 256B.064.
159.11 	The determination of provision of services not medically necessary shall be made by the 
159.12 	commissioner. Notwithstanding any other law to the contrary, a vendor of medical care 
159.13 	shall not be subject to any civil or criminal liability for providing access to medical records 
159.14 	to the commissioner of human services pursuant to this section.

159.15 	Sec. 122. Minnesota Statutes 2018, section 256B.4912, is amended by adding a subdivision 
159.16 	to read:
159.17 		Subd. 11.Home and community-based service billing requirements. (a) A home and 
159.18 	community-based service is eligible for reimbursement if:
159.19 	(1) the service is provided according to a federally approved waiver plan as authorized 
159.20 	under sections 256B.0913, 256B.0915, 256B.092, and 256B.49;
159.21 	(2) if applicable, the service is provided on days and times during the days and hours of 
159.22 	operation specified on any license required under chapter 245A or 245D; and
159.23 	(3) the provider complies with subdivisions 12 to 15, if applicable.
159.24 	(b) The provider must maintain documentation that, upon employment and annually 
159.25 	thereafter, staff providing a service have attested to reviewing and understanding the 
159.26 	following statement: "It is a federal crime to provide materially false information on service 
159.27 	billings for medical assistance or services provided under a federally approved waiver plan 
159.28 	as authorized under Minnesota Statutes, sections 256B.0913, 256B.0915, 256B.092, and 
159.29 	256B.49."
159.30 	(c) The department may recover payment according to section 256B.064 and Minnesota 
159.31 	Rules, parts 9505.2160 to 9505.2245, for a service that does not satisfy this subdivision.

160.1 	Sec. 123. Minnesota Statutes 2018, section 256B.4912, is amended by adding a subdivision 
160.2 	to read:
160.3 		Subd. 12.Home and community-based service documentation requirements. (a) 
160.4 	Documentation may be collected and maintained electronically or in paper form by providers 
160.5 	and must be produced upon request by the commissioner.
160.6 	(b) Documentation of a delivered service must be in English and must be legible according 
160.7 	to the standard of a reasonable person.
160.8 	(c) If the service is reimbursed at an hourly or specified minute-based rate, each 
160.9 	documentation of the provision of a service, unless otherwise specified, must include:
160.10 	(1) the date the documentation occurred;
160.11 	(2) the day, month, and year when the service was provided;
160.12 	(3) the start and stop times with a.m. and p.m. designations, except for case management 
160.13 	services as defined under sections 256B.0913, subdivision 7; 256B.0915, subdivision 1a; 
160.14 	256B.092, subdivision 1a; and 256B.49, subdivision 13;
160.15 	(4) the service name or description of the service provided; and
160.16 	(5) the name, signature, and title, if any, of the provider of service. If the service is 
160.17 	provided by multiple staff members, the provider may designate a staff member responsible 
160.18 	for verifying services and completing the documentation required by this paragraph.
160.19 	(d) If the service is reimbursed at a daily rate or does not meet the requirements in 
160.20 	paragraph (c), each documentation of the provision of a service, unless otherwise specified, 
160.21 	must include:
160.22 	(1) the date the documentation occurred;
160.23 	(2) the day, month, and year when the service was provided;
160.24 	(3) the service name or description of the service provided; and
160.25 	(4) the name, signature, and title, if any, of the person providing the service. If the service 
160.26 	is provided by multiple staff, the provider may designate a staff member responsible for 
160.27 	verifying services and completing the documentation required by this paragraph.

160.28 	Sec. 124. Minnesota Statutes 2018, section 256B.4912, is amended by adding a subdivision 
160.29 	to read:
160.30 		Subd. 13.Waiver transportation documentation and billing requirements. (a) A 
160.31 	waiver transportation service must be a waiver transportation service that: (1) is not covered 
161.1 	by medical transportation under the Medicaid state plan; and (2) is not included as a 
161.2 	component of another waiver service.
161.3 	(b) In addition to the documentation requirements in subdivision 12, a waiver 
161.4 	transportation service provider must maintain:
161.5 	(1) odometer and other records pursuant to section 256B.0625, subdivision 17b, paragraph 
161.6 	(b), clause (3), sufficient to distinguish an individual trip with a specific vehicle and driver 
161.7 	for a waiver transportation service that is billed directly by the mile. A common carrier as 
161.8 	defined by Minnesota Rules, part 9505.0315, subpart 1, item B, or a publicly operated transit 
161.9 	system provider are exempt from this clause; and
161.10 	(2) documentation demonstrating that a vehicle and a driver meet the standards determined 
161.11 	by the Department of Human Services on vehicle and driver qualifications in section 
161.12 	256B.0625, subdivision 17, paragraph (c).

161.13 	Sec. 125. Minnesota Statutes 2018, section 256B.4912, is amended by adding a subdivision 
161.14 	to read:
161.15 		Subd. 14.Equipment and supply documentation requirements. (a) In addition to the 
161.16 	requirements in subdivision 12, an equipment and supply services provider must for each 
161.17 	documentation of the provision of a service include:
161.18 	(1) the recipient's assessed need for the equipment or supply;
161.19 	(2) the reason the equipment or supply is not covered by the Medicaid state plan;
161.20 	(3) the type and brand name of the equipment or supply delivered to or purchased by 
161.21 	the recipient, including whether the equipment or supply was rented or purchased;
161.22 	(4) the quantity of the equipment or supply delivered or purchased; and
161.23 	(5) the cost of the equipment or supply if the amount paid for the service depends on 
161.24 	the cost.
161.25 	(b) A provider must maintain a copy of the shipping invoice or a delivery service tracking 
161.26 	log or other documentation showing the date of delivery that proves the equipment or supply 
161.27 	was delivered to the recipient or a receipt if the equipment or supply was purchased by the 
161.28 	recipient.

162.1 	Sec. 126. Minnesota Statutes 2018, section 256B.4912, is amended by adding a subdivision 
162.2 	to read:
162.3 		Subd. 15.Adult day service documentation and billing requirements. (a) In addition 
162.4 	to the requirements in subdivision 12, a provider of adult day services as defined in section 
162.5 	245A.02, subdivision 2a, and licensed under Minnesota Rules, parts 9555.9600 to 9555.9730, 
162.6 	must maintain documentation of:
162.7 	(1) a needs assessment and current plan of care according to section 245A.143, 
162.8 	subdivisions 4 to 7, or Minnesota Rules, part 9555.9700, for each recipient, if applicable;
162.9 	(2) attendance records as specified under section 245A.14, subdivision 14, paragraph 
162.10 	(c), including the date of attendance with the day, month, and year; and the pickup and 
162.11 	drop-off time in hours and minutes with a.m. and p.m. designations;
162.12 	(3) the monthly and quarterly program requirements in Minnesota Rules, part 9555.9710, 
162.13 	subparts 1, items E and H; 3; 4; and 6, if applicable;
162.14 	(4) the name and qualification of each registered physical therapist, registered nurse, 
162.15 	and registered dietitian who provides services to the adult day services or nonresidential 
162.16 	program; and
162.17 	(5) the location where the service was provided. If the location is an alternate location 
162.18 	from the usual place of service, the documentation must include the address, or a description 
162.19 	if the address is not available, of both the origin site and destination site; the length of time 
162.20 	at the alternate location with a.m. and p.m. designations; and a list of participants who went 
162.21 	to the alternate location.
162.22 	(b) A provider must not exceed the provider's licensed capacity. If a provider exceeds 
162.23 	the provider's licensed capacity, the department must recover all Minnesota health care 
162.24 	programs payments from the date the provider exceeded licensed capacity.

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

162.26 	Sec. 127. EVALUATION OF GRANT PROGRAMS; PROVEN-EFFECTIVE 
162.27 	PRACTICES.
 162.28 	(a) The commissioner of management and budget shall consult with the commissioner 
162.29 	of human services to establish a plan to review the services delivered under grant programs 
162.30 	administered by the commissioner of human services to determine whether the grant programs 
162.31 	prioritize proven-effective or promising practices.
163.1 	(b) In accordance with the plan established in paragraph (a), the commissioner of 
163.2 	management and budget, in consultation with the commissioner of human services, shall 
163.3 	identify services to evaluate using an experimental or quasi-experimental design to provide 
163.4 	information needed to modify or develop grant programs to promote proven-effective 
163.5 	practices to improve the intended outcomes of the grant program.
163.6 	(c) The commissioner of management and budget, in consultation with the commissioner 
163.7 	of human services, shall develop reports for the legislature and other stakeholders to provide 
163.8 	information on incorporating proven-effective practices in program and budget decisions. 
163.9 	The commissioner of management and budget, under Minnesota Statutes, section 15.08, 
163.10 	may obtain additional relevant data to support the evaluation activities under this section.
163.11 	(d) For purposes of this section, the following terms have the meanings given:
163.12 	(1) "proven-effective practice" means a service or practice that offers a high level of 
163.13 	research on effectiveness for at least one outcome of interest, as determined through multiple  
163.14 	evaluations outside of Minnesota or one or more local evaluation in Minnesota. The research 
163.15 	on effectiveness used to determine whether a service is proven-effective must use rigorously 
163.16 	implemented experimental or quasi-experimental designs; and
163.17 	(2) "promising practices" means a service or practice that is supported by research 
163.18 	demonstrating effectiveness for at least one outcome of interest, and includes a single  
163.19 	evaluation that is not contradicted by other studies, but does not meet the full criteria for 
163.20 	the proven-effective designation. The research on effectiveness used to determine whether 
163.21 	a service is a promising practice must use rigorously implemented experimental or 
163.22 	quasi-experimental designs.

163.23 	Sec. 128. DIRECTION TO COMMISSIONER; CORRECTION ORDER 
163.24 	ENFORCEMENT REVIEW.
 163.25 	By January 1, 2020, the commissioner of human services shall develop and implement 
163.26 	a process to review licensing inspection results provided under Minnesota Statutes, section 
163.27 	245A.16, subdivision 1, paragraph (h), clause (1), by county to identify trends in correction 
163.28 	order enforcement. The commissioner shall develop guidance and training as needed to 
163.29 	address any imbalance or inaccuracy in correction order enforcement. The commissioner 
163.30 	shall include the results in the annual report on child care under Minnesota Statutes, section 
163.31 	245A.153, provided that the results are limited to summary data as defined in Minnesota 
163.32 	Statutes, section 13.02, subdivision 19.

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

164.1 	Sec. 129. DIRECTION TO COMMISSIONER; RESPONSIBILITY FOR FRAUD 
164.2 	INVESTIGATIONS IN PUBLIC PROGRAMS.
 164.3 	No later than January 15, 2020, the commissioner of human services, in consultation 
164.4 	with counties, shall report to the chairs and ranking minority members of the legislative 
164.5 	committees and divisions with jurisdiction over human services on recommendations for 
164.6 	legislation that identifies and clarifies the responsibilities of the department and counties 
164.7 	for fraud investigations in public programs administered by the commissioner.

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

164.9 	Sec. 130. DIRECTION TO COMMISSIONER; SELF-EMPLOYMENT INCOME 
164.10 	IN PUBLIC ASSISTANCE PROGRAMS.
 164.11 	No later than January 15, 2020, the commissioner of human services, in consultation 
164.12 	with counties and other relevant stakeholders, shall report to the chairs and ranking minority 
164.13 	members of the legislative committees and divisions with jurisdiction over human services 
164.14 	with recommendations for legislation on how to count self-employment income for purposes 
164.15 	of determining eligibility for and maintaining the integrity of public assistance programs.

164.16 	Sec. 131. DIRECTION TO COMMISSIONER; SUBSTANCE USE DISORDER 
164.17 	COUNTY STAFF QUALIFICATIONS.
 164.18 	The commissioner of human services shall, in consultation with county agencies, identify 
164.19 	specific training, education, and experience requirements that would qualify individuals 
164.20 	employed by a county who are not alcohol and drug counselors to perform comprehensive 
164.21 	assessments and treatment coordination. The commissioner shall provide a list of resources 
164.22 	available to meet the necessary training and education requirements. By December 1, 2019, 
164.23 	the commissioner shall provide a progress update to the chairs and ranking minority members 
164.24 	of the legislative committees with jurisdiction over substance use disorder services and 
164.25 	provide recommendations on any statutory changes needed to implement this section.

164.26 	Sec. 132. FAMILY CHILD CARE TASK FORCE.
 164.27 		Subdivision 1.Membership. (a) The Family Child Care Task Force shall consist of 25 
164.28 	members, appointed as follows:
164.29 	(1) two members representing family child care providers from greater Minnesota,  
164.30 	including one appointed by the speaker of the house and one appointed by the senate majority 
164.31 	leader;
165.1 	(2) two members representing family care providers from the metropolitan area as defined 
165.2 	in Minnesota Statutes, section 473.121, subdivision 2, including one appointed by the speaker 
165.3 	of the house and one appointed by the senate majority leader;
165.4 	(3) one member appointed by the Minnesota Association of Child Care Professionals;
165.5 	(4) one member appointed by the Minnesota Child Care Provider Information Network;
165.6 	(5) two members from the house of representatives, including one appointed by the 
165.7 	speaker of the house and one appointed by the minority leader;
165.8 	(6) two members from the senate, including one appointed by the senate majority leader 
165.9 	and one appointed by the senate minority leader;
165.10 	(7) the commissioner of human services or designee;
165.11 	(8) two members representing Department of Human Services-recognized family child 
165.12 	care associations from greater Minnesota, appointed by the commissioner of human services;
165.13 	(9) two members appointed by the Association of Minnesota Child Care Licensors, 
165.14 	including one from greater Minnesota and one from the metropolitan area, as defined in 
165.15 	Minnesota Statutes, section 473.121, subdivision 2;
165.16 	(10) four parents of children enrolled in family child care programs, appointed by the 
165.17 	commissioner of human services;
165.18 	(11) one member appointed by the Greater Minnesota Partnership;
165.19 	(12) one member appointed by the Minnesota Chamber of Commerce;
165.20 	(13) one member appointed by Child Care Aware of Minnesota;
165.21 	(14) one member appointed by the Minnesota Initiative Foundation;
165.22 	(15) one member appointed by Minnesota's Children's Cabinet; and
165.23 	(16) one member appointed by First Children's Finance.
165.24 	(b) Appointments to the task force must be made by July 15, 2019.
165.25 		Subd. 2.Compensation. Public members of the task force may be compensated as 
165.26 	provided by Minnesota Statutes, section 15.059, subdivision 3.
165.27 		Subd. 3.Duties. The task force shall:
165.28 	(1) identify difficulties that providers face regarding licensing and inspection, including 
165.29 	specific licensing requirements that have led to the closure of family child care programs, 
165.30 	by reviewing previous survey results and conducting follow-up surveys, if necessary;
166.1 	(2) propose regulatory reforms to improve licensing efficiency, including discussion of 
166.2 	criteria that would qualify a provider for an abbreviated licensing review based on statistically 
166.3 	significant key indicators that predict full compliance with all applicable rules and statutes, 
166.4 	and discussion of the development of a risk-based, data driven, tiered violation system with 
166.5 	corresponding enforcement mechanisms that are appropriate to the risk presented by a 
166.6 	violation;
166.7 	(3) review existing variance authority delegated to counties and recommend changes, 
166.8 	if needed;
166.9 	(4) recommend business development and technical assistance resources to promote 
166.10 	provider recruitment and retention, including the potential need for mentors, a family child 
166.11 	care provider network, or shared services;
166.12 	(5) develop recommendations for alternative child care delivery systems that could be 
166.13 	more financially viable in smaller communities with unmet child care capacity needs in 
166.14 	greater Minnesota, which could include new licensure models for large group family child 
166.15 	care or small capacity child care centers;
166.16 	(6) review Parent Aware program participation and identify obstacles and suggested 
166.17 	improvements;
166.18 	(7) review how trainings for licensed family child care providers are offered, provided, 
166.19 	coordinated, and approved, and make a recommendation on the establishment of a family 
166.20 	child care continuing education training committee, to advise on compliance with federal 
166.21 	and state training requirements; and
166.22 	(8) consider methods to improve access to and understanding of the rules and statutes 
166.23 	governing family child care providers.
166.24 		Subd. 4.Officers; meetings. (a) The task force shall be cochaired by the task force 
166.25 	member from the majority party of the house of representatives and the task force member 
166.26 	from the majority party of the senate, and may elect other officers as necessary.
166.27 	(b) The commissioner of human services shall convene the first meeting by August 15, 
166.28 	2019.
166.29 	(c) The cochairs shall alternate possession of the gavel between meetings.
166.30 	(d) Each meeting shall be moderated by a neutral third-party facilitator.
166.31 	(e) The agenda for each meeting shall be determined by the cochairs, the commissioner 
166.32 	of human services or designee, and the facilitator.
167.1 	(d) Meetings of the task force are subject to the Minnesota Open Meeting Law under 
167.2 	Minnesota Statutes, chapter 13D.
167.3 		Subd. 5.Report required. The task force shall submit an interim written report by 
167.4 	March 1, 2020, and a final written report by February 1, 2021, to the chairs and ranking 
167.5 	minority members of the committees in the house of representatives and the senate with 
167.6 	jurisdiction over child care. The reports shall explain the task force's findings and 
167.7 	recommendations relating to each of the duties under subdivision 3, and include any draft 
167.8 	legislation necessary to implement the recommendations.
167.9 		Subd. 6.Expiration. The task force expires upon submission of the final report in 
167.10 	subdivision 5 or February 1, 2021, whichever is later.

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

167.12 	Sec. 133. INSTRUCTION TO COMMISSIONER; REVIEW OF CHILD CARE 
167.13 	LICENSING AND BACKGROUND STUDY PROVISIONS.
 167.14 	The commissioner of human services shall review existing statutes and rules relating to 
167.15 	child care licensing and background study requirements and propose legislation for the 2020 
167.16 	legislative session that eliminates unnecessary and duplicative record keeping or 
167.17 	documentation requirements for child care providers. The commissioner shall also establish 
167.18 	a process for child care providers to electronically submit requested information to the 
167.19 	commissioner.

167.20 	Sec. 134. REPEALER.
 167.21 	(a) Minnesota Rules, parts 9502.0425, subparts 4, 16, and 17; and 9503.0155, subpart 
167.22 	8, are repealed.
167.23 	(b) Minnesota Statutes 2018, sections 119B.125, subdivision 8; and 245H.10, subdivision 
167.24 	2, are repealed.
167.25 	(c) Minnesota Rules, part 2960.3030, subpart 3, is repealed.

167.26 	EFFECTIVE DATE. Paragraphs (a) and (b) are effective September 30, 2019. Paragraph 
167.27 	(c) is effective October 1, 2019.

168.1 	ARTICLE 3
168.2 	DIRECT CARE AND TREATMENT

168.3 	Section 1. Minnesota Statutes 2018, section 246.54, is amended by adding a subdivision 
168.4 	to read:
168.5 		Subd. 3.Administrative review of county liability for cost of care. (a) The county of 
168.6 	financial responsibility may submit a written request for administrative review by the 
168.7 	commissioner of the county's payment of the cost of care when a delay in discharge of a 
168.8 	client from a regional treatment center, state-operated community-based behavioral health 
168.9 	hospital, or other state-operated facility results from the following actions by the facility:
168.10 	(1) the facility did not provide notice to the county that the facility has determined that 
168.11 	it is clinically appropriate for a client to be discharged;
168.12 	(2) the notice to the county that the facility has determined that it is clinically appropriate 
168.13 	for a client to be discharged was communicated on a holiday or weekend;
168.14 	(3) the required documentation or procedures for discharge were not completed in order 
168.15 	for the discharge to occur in a timely manner; or
168.16 	(4) the facility disagrees with the county's discharge plan.
168.17 	(b) The county of financial responsibility may not appeal the determination that it is 
168.18 	clinically appropriate for a client to be discharged from a regional treatment center, 
168.19 	state-operated community-based behavioral health hospital, or other state-operated facility.
168.20 	(c) The commissioner must evaluate the request for administrative review and determine 
168.21 	if the facility's actions listed in paragraph (a) caused undue delay in discharging the client. 
168.22 	If the commissioner determines that the facility's actions listed in paragraph (a) caused 
168.23 	undue delay in discharging the client, the county's liability must be reduced to the level of 
168.24 	the cost of care for a client whose stay in a facility is determined to be clinically appropriate, 
168.25 	effective on the date of the facility's action or failure to act that caused the delay. The 
168.26 	commissioner's determination under this subdivision is final and not subject to appeal.
168.27 	(d) If a county's liability is reduced pursuant to paragraph (c), a county's liability must 
168.28 	return to the level of the cost of care for a client whose stay in a facility is determined to no 
168.29 	longer be appropriate effective on the date the facility rectifies the action or failure to act 
168.30 	that caused the delay under paragraph (a).
168.31 	(e) Any difference in the county cost of care liability resulting from administrative review 
168.32 	under this subdivision must not be billed to the client or applied to future reimbursement 
168.33 	from the client's estate or relatives.

169.1 	Sec. 2. Minnesota Statutes 2018, section 246B.10, is amended to read:
169.2 	246B.10 LIABILITY OF COUNTY; REIMBURSEMENT.
169.3 	(a) The civilly committed sex offender's county shall pay to the state a portion of the 
169.4 	cost of care provided in the Minnesota sex offender program to a civilly committed sex 
169.5 	offender who has legally settled in that county.
169.6 	(b) A county's payment must be made from the county's own sources of revenue and 
169.7 	payments must:
169.8 	(1) equal ten percent of the cost of care, as determined by the commissioner, for each 
169.9 	day or portion of a day that the civilly committed sex offender spends at the facility for 
169.10 	individuals admitted to the Minnesota sex offender program before August 1, 2011; or
169.11 	(2) equal 25 percent of the cost of care, as determined by the commissioner, for each 
169.12 	day or portion of a day, that the civilly committed sex offender:
169.13 	(i) spends at the facility. for individuals admitted to the Minnesota sex offender program 
169.14 	on or after August 1, 2011; or
169.15 	(ii) receives services within a program operated by the Minnesota sex offender program 
169.16 	while on provisional discharge.
169.17 	(c) The county is responsible for paying the state the remaining amount if payments 
169.18 	received by the state under this chapter exceed:
169.19 	(1) 90 percent of the cost of care for individuals admitted to the Minnesota sex offender 
169.20 	program before August 1, 2011; or
169.21 	(2) 75 percent of the cost of care, the county is responsible for paying the state the 
169.22 	remaining amount for individuals:
169.23 	(i) admitted to the Minnesota sex offender program on or after August 1, 2011; or
169.24 	(ii) receiving services within a program operated by the Minnesota sex offender program 
169.25 	while on provisional discharge.
169.26 	(d) The county is not entitled to reimbursement from the civilly committed sex offender, 
169.27 	the civilly committed sex offender's estate, or from the civilly committed sex offender's 
169.28 	relatives, except as provided in section 246B.07.

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

170.1 	Sec. 3. DIRECTION TO COMMISSIONER; REPORT REQUIRED; DISCHARGE 
170.2 	DELAY REDUCTION.
 170.3 	No later than January 1, 2023, the commissioner of human services must submit a report 
170.4 	to the chairs and ranking minority members of the legislative committees with jurisdiction 
170.5 	over human services that provides an update on county and state efforts to reduce the number 
170.6 	of days clients spend in state-operated facilities after discharge from the facility has been 
170.7 	determined to be clinically appropriate. The report must also include information on the 
170.8 	fiscal impact of clinically inappropriate stays in these facilities.

170.9 	Sec. 4. REPEALER.
 170.10 	(a) Minnesota Statutes 2018, section 246.18, subdivisions 8 and 9, are repealed.
170.11 	(b) Laws 2010, First Special Session chapter 1, article 25, section 3, subdivision 10, is 
170.12 	repealed.

170.13 	ARTICLE 4
170.14 	CONTINUING CARE FOR OLDER ADULTS

170.15 	Section 1. Minnesota Statutes 2018, section 144A.071, subdivision 1a, is amended to read:
170.16 		Subd. 1a.Definitions. For purposes of sections 144A.071 to 144A.073, the following 
170.17 	terms have the meanings given them:
170.18 	(a) "Attached fixtures" has the meaning given in Minnesota Rules, part 9549.0020, 
170.19 	subpart 6.
170.20 	(b) "Buildings" "Building" has the meaning given in Minnesota Rules, part 9549.0020, 
170.21 	subpart 7 section 256R.261, subdivision 4.
170.22 	(c) "Capital assets" has the meaning given in section 256B.421, subdivision 16 256R.02, 
170.23 	subdivision 8.
170.24 	(d) "Commenced construction" means that all of the following conditions were met: the 
170.25 	final working drawings and specifications were approved by the commissioner of health; 
170.26 	the construction contracts were let; a timely construction schedule was developed, stipulating 
170.27 	dates for beginning, achieving various stages, and completing construction; and all zoning 
170.28 	and building permits were applied for.
170.29 	(e) "Completion date" means the date on which clearance for the construction project 
170.30 	is issued, or if a clearance for the construction project is not required, the date on which the 
170.31 	construction project assets are available for facility use.
171.1 	(f) "Construction" means any erection, building, alteration, reconstruction, modernization, 
171.2 	or improvement necessary to comply with the nursing home licensure rules.
171.3 	(g) "Construction project" means:
171.4 	(1) a capital asset addition to, or replacement of a nursing home or certified boarding 
171.5 	care home that results in new space or the remodeling of or renovations to existing facility 
171.6 	space; and
171.7 	(2) the remodeling or renovation of existing facility space the use of which is modified 
171.8 	as a result of the project described in clause (1). This existing space and the project described 
171.9 	in clause (1) must be used for the functions as designated on the construction plans on 
171.10 	completion of the project described in clause (1) for a period of not less than 24 months.
171.11 	(h) "Depreciation guidelines" means the most recent publication of "The Estimated 
171.12 	Useful Lives of Depreciable Hospital Assets," issued by the American Hospital Association, 
171.13 	840 North Lake Shore Drive, Chicago, Illinois, 60611 has the meaning given in section 
171.14 	256R.261, subdivision 11.
171.15 	(i) "New licensed" or "new certified beds" means:
171.16 	(1) newly constructed beds in a facility or the construction of a new facility that would 
171.17 	increase the total number of licensed nursing home beds or certified boarding care or nursing 
171.18 	home beds in the state; or
171.19 	(2) newly licensed nursing home beds or newly certified boarding care or nursing home 
171.20 	beds that result from remodeling of the facility that involves relocation of beds but does not 
171.21 	result in an increase in the total number of beds, except when the project involves the upgrade 
171.22 	of boarding care beds to nursing home beds, as defined in section 144A.073, subdivision 
171.23 	1. "Remodeling" includes any of the type of conversion, renovation, replacement, or 
171.24 	upgrading projects as defined in section 144A.073, subdivision 1.
171.25 	(j) "Project construction costs" means the cost of the following items that have a 
171.26 	completion date within 12 months before or after the completion date of the project described 
171.27 	in item (g), clause (1):
171.28 	(1) facility capital asset additions;
171.29 	(2) replacements;
171.30 	(3) renovations;
171.31 	(4) remodeling projects;
171.32 	(5) construction site preparation costs;
172.1 	(6) related soft costs; and
172.2 	(7) the cost of new technology implemented as part of the construction project and 
172.3 	depreciable equipment directly identified to the project, if the construction costs for clauses 
172.4 	(1) to (6) exceed the threshold for additions and replacements stated in section 256B.431, 
172.5 	subdivision 16. Technology and depreciable equipment shall be included in the project 
172.6 	construction costs unless a written election is made by the facility, to not include it in the 
172.7 	facility's appraised value for purposes of Minnesota Rules, part 9549.0020, subpart 5. Debt 
172.8 	incurred for purchase of technology and depreciable equipment shall be included as allowable 
172.9 	debt for purposes of Minnesota Rules, part 9549.0060, subpart 5, items A and C, unless the 
172.10 	written election is to not include it. Any new technology and depreciable equipment included 
172.11 	in the project construction costs that the facility elects not to include in its appraised value 
172.12 	and allowable debt shall be treated as provided in section 256B.431, subdivision 17, 
172.13 	paragraph (b). Written election under this paragraph must be included in the facility's request 
172.14 	for the rate change related to the project, and this election may not be changed.
172.15 	(k) "Technology" means information systems or devices that make documentation, 
172.16 	charting, and staff time more efficient or encourage and allow for care through alternative 
172.17 	settings including, but not limited to, touch screens, monitors, hand-helds, swipe cards, 
172.18 	motion detectors, pagers, telemedicine, medication dispensers, and equipment to monitor 
172.19 	vital signs and self-injections, and to observe skin and other conditions.

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

172.21 	Sec. 2. Minnesota Statutes 2018, section 144A.071, subdivision 2, is amended to read:
172.22 		Subd. 2.Moratorium. The commissioner of health, in coordination with the 
172.23 	commissioner of human services, shall deny each request for new licensed or certified 
172.24 	nursing home or certified boarding care beds except as provided in subdivision 3 or 4a, or 
172.25 	section 144A.073. "Certified bed" means a nursing home bed or a boarding care bed certified 
172.26 	by the commissioner of health for the purposes of the medical assistance program, under 
172.27 	United States Code, title 42, sections 1396 et seq. Certified beds in facilities which do not 
172.28 	allow medical assistance intake shall be deemed to be decertified for purposes of this section 
172.29 	only.
172.30 	The commissioner of human services, in coordination with the commissioner of health, 
172.31 	shall deny any request to issue a license under section 252.28 and chapter 245A to a nursing 
172.32 	home or boarding care home, if that license would result in an increase in the medical 
172.33 	assistance reimbursement amount.
173.1 	In addition, the commissioner of health must not approve any construction project whose 
173.2 	cost exceeds $1,000,000, unless:
173.3 	(a) any construction costs exceeding $1,000,000 are not added to the facility's appraised 
173.4 	value and are not included in the facility's payment rate for reimbursement under the medical 
173.5 	assistance program; or
173.6 	(b) the project:
173.7 	(1) has been approved through the process described in section 144A.073;
173.8 	(2) meets an exception in subdivision 3 or 4a;
173.9 	(3) is necessary to correct violations of state or federal law issued by the commissioner 
173.10 	of health;
173.11 	(4) is necessary to repair or replace a portion of the facility that was damaged by fire, 
173.12 	lightning, ground shifts, or other such hazards, including environmental hazards, provided 
173.13 	that the provisions of subdivision 4a, clause (a), are met; or
173.14 	(5) as of May 1, 1992, the facility has submitted to the commissioner of health written 
173.15 	documentation evidencing that the facility meets the "commenced construction" definition 
173.16 	as specified in subdivision 1a, paragraph (d), or that substantial steps have been taken prior 
173.17 	to April 1, 1992, relating to the construction project. "Substantial steps" require that the 
173.18 	facility has made arrangements with outside parties relating to the construction project and 
173.19 	include the hiring of an architect or construction firm, submission of preliminary plans to 
173.20 	the Department of Health or documentation from a financial institution that financing 
173.21 	arrangements for the construction project have been made; or
173.22 	(6) (5) is being proposed by a licensed nursing facility that is not certified to participate 
173.23 	in the medical assistance program and will not result in new licensed or certified beds.
173.24 	Prior to the final plan approval of any construction project, the commissioner
173.25 	commissioners of health and human services shall be provided with an itemized cost estimate 
173.26 	for the project construction costs. If a construction project is anticipated to be completed in 
173.27 	phases, the total estimated cost of all phases of the project shall be submitted to the 
173.28 	commissioner commissioners and shall be considered as one construction project. Once the 
173.29 	construction project is completed and prior to the final clearance by the commissioner
173.30 	commissioners, the total project construction costs for the construction project shall be 
173.31 	submitted to the commissioner commissioners. If the final project construction cost exceeds 
173.32 	the dollar threshold in this subdivision, the commissioner of human services shall not 
174.1 	recognize any of the project construction costs or the related financing costs in excess of 
174.2 	this threshold in establishing the facility's property-related payment rate.
174.3 	The dollar thresholds for construction projects are as follows: for construction projects 
174.4 	other than those authorized in clauses (1) to (6), the dollar threshold is $1,000,000. For 
174.5 	projects authorized after July 1, 1993, under clause (1), the dollar threshold is the cost 
174.6 	estimate submitted with a proposal for an exception under section 144A.073, plus inflation 
174.7 	as calculated according to section 256B.431, subdivision 3f, paragraph (a). For projects 
174.8 	authorized under clauses (2) to (4), the dollar threshold is the itemized estimate project 
174.9 	construction costs submitted to the commissioner of health at the time of final plan approval, 
174.10 	plus inflation as calculated according to section 256B.431, subdivision 3f, paragraph (a).
174.11 	The commissioner of health shall adopt rules to implement this section or to amend the 
174.12 	emergency rules for granting exceptions to the moratorium on nursing homes under section 
174.13 	144A.073.

174.14 	Sec. 3. Minnesota Statutes 2018, section 144A.071, subdivision 3, is amended to read:
174.15 		Subd. 3.Exceptions authorizing increase in beds; hardship areas. (a) The 
174.16 	commissioner of health, in coordination with the commissioner of human services, may 
174.17 	approve the addition of new licensed and Medicare and Medicaid certified nursing home 
174.18 	beds, using the criteria and process set forth in this subdivision.
174.19 	(b) The commissioner, in cooperation with the commissioner of human services, shall 
174.20 	consider the following criteria when determining that an area of the state is a hardship area 
174.21 	with regard to access to nursing facility services:
174.22 	(1) a low number of beds per thousand in a specified area using as a standard the beds 
174.23 	per thousand people age 65 and older, in five year age groups, using data from the most 
174.24 	recent census and population projections, weighted by each group's most recent nursing 
174.25 	home utilization, of the county at the 20th percentile, as determined by the commissioner 
174.26 	of human services;
174.27 	(2) a high level of out-migration for nursing facility services associated with a described 
174.28 	area from the county or counties of residence to other Minnesota counties, as determined 
174.29 	by the commissioner of human services, using as a standard an amount greater than the 
174.30 	out-migration of the county ranked at the 50th percentile;
174.31 	(3) an adequate level of availability of noninstitutional long-term care services measured 
174.32 	as public spending for home and community-based long-term care services per individual 
174.33 	age 65 and older, in five year age groups, using data from the most recent census and 
175.1 	population projections, weighted by each group's most recent nursing home utilization, as 
175.2 	determined by the commissioner of human services using as a standard an amount greater 
175.3 	than the 50th percentile of counties;
175.4 	(4) there must be a declaration of hardship resulting from insufficient access to nursing 
175.5 	home beds by local county agencies and area agencies on aging; and
175.6 	(5) other factors that may demonstrate the need to add new nursing facility beds.
175.7 	(c) On August 15 of odd-numbered years, the commissioner, in cooperation with the 
175.8 	commissioner of human services, may publish in the State Register a request for information 
175.9 	in which interested parties, using the data provided under section 144A.351, along with any 
175.10 	other relevant data, demonstrate that a specified area is a hardship area with regard to access 
175.11 	to nursing facility services. For a response to be considered, the commissioner must receive 
175.12 	it by November 15. The commissioner shall make responses to the request for information 
175.13 	available to the public and shall allow 30 days for comment. The commissioner shall review 
175.14 	responses and comments and determine if any areas of the state are to be declared hardship 
175.15 	areas.
175.16 	(d) For each designated hardship area determined in paragraph (c), the commissioner 
175.17 	shall publish a request for proposals in accordance with section 144A.073 and Minnesota 
175.18 	Rules, parts 4655.1070 to 4655.1098. The request for proposals must be published in the 
175.19 	State Register by March 15 following receipt of responses to the request for information. 
175.20 	The request for proposals must specify the number of new beds which may be added in the 
175.21 	designated hardship area, which must not exceed the number which, if added to the existing 
175.22 	number of beds in the area, including beds in layaway status, would have prevented it from 
175.23 	being determined to be a hardship area under paragraph (b), clause (1). Beginning July 1, 
175.24 	2011, the number of new beds approved must not exceed 200 beds statewide per biennium. 
175.25 	After June 30, 2019, the number of new beds that may be approved in a biennium must not 
175.26 	exceed 300 statewide. For a proposal to be considered, the commissioner must receive it 
175.27 	within six months of the publication of the request for proposals. The commissioner shall 
175.28 	review responses to the request for proposals and shall approve or disapprove each proposal 
175.29 	by the following July 15, in accordance with section 144A.073 and Minnesota Rules, parts 
175.30 	4655.1070 to 4655.1098. The commissioner shall base approvals or disapprovals on a 
175.31 	comparison and ranking of proposals using only the criteria in subdivision 4a. Approval of 
175.32 	a proposal expires after 18 months unless the facility has added the new beds using existing 
175.33 	space, subject to approval by the commissioner, or has commenced construction as defined 
175.34 	in subdivision 1a, paragraph (d). If, after the approved beds have been added, fewer than 
175.35 	50 percent of the beds in a facility are newly licensed, the operating payment rates previously 
176.1 	in effect shall remain. If, after the approved beds have been added, 50 percent or more of 
176.2 	the beds in a facility are newly licensed, operating and external fixed payment rates shall 
176.3 	be determined according to Minnesota Rules, part 9549.0057, using the limits under sections 
176.4 	256R.23, subdivision 5, and 256R.24, subdivision 3. External fixed costs payment rates 
176.5 	must be determined according to section 256R.25 section 256R.21, subdivision 5. Property 
176.6 	payment rates for facilities with beds added under this subdivision must be determined in 
176.7 	the same manner as rate determinations resulting from projects approved and completed 
176.8 	under section 144A.073 under section 256R.26.
176.9 	(e) The commissioner may:
176.10 	(1) certify or license new beds in a new facility that is to be operated by the commissioner 
176.11 	of veterans affairs or when the costs of constructing and operating the new beds are to be 
176.12 	reimbursed by the commissioner of veterans affairs or the United States Veterans 
176.13 	Administration; and
176.14 	(2) license or certify beds in a facility that has been involuntarily delicensed or decertified 
176.15 	for participation in the medical assistance program, provided that an application for 
176.16 	relicensure or recertification is submitted to the commissioner by an organization that is 
176.17 	not a related organization as defined in section 256R.02, subdivision 43, to the prior licensee 
176.18 	within 120 days after delicensure or decertification.

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

176.20 	Sec. 4. Minnesota Statutes 2018, section 144A.071, subdivision 4a, is amended to read:
176.21 		Subd. 4a.Exceptions for replacement beds.  It is in the best interest of the state to 
176.22 	ensure that nursing homes and boarding care homes continue to meet the physical plant 
176.23 	licensing and certification requirements by permitting certain construction projects. Facilities 
176.24 	should be maintained in condition to satisfy the physical and emotional needs of residents 
176.25 	while allowing the state to maintain control over nursing home expenditure growth.
176.26 	The commissioner of health in coordination with the commissioner of human services, 
176.27 	may approve the renovation, replacement, upgrading, or relocation of a nursing home or 
176.28 	boarding care home, under the following conditions:
176.29 	(a) to license or certify beds in a new facility constructed to replace a facility or to make 
176.30 	repairs in an existing facility that was destroyed or damaged after June 30, 1987, by fire, 
176.31 	lightning, or other hazard provided:
176.32 	(i) destruction was not caused by the intentional act of or at the direction of a controlling 
176.33 	person of the facility;
177.1 	(ii) at the time the facility was destroyed or damaged the controlling persons of the 
177.2 	facility maintained insurance coverage for the type of hazard that occurred in an amount 
177.3 	that a reasonable person would conclude was adequate;
177.4 	(iii) the net proceeds from an insurance settlement for the damages caused by the hazard 
177.5 	are applied to the cost of the new facility or repairs;
177.6 	(iv) the number of licensed and certified beds in the new facility does not exceed the 
177.7 	number of licensed and certified beds in the destroyed facility; and
177.8 	(v) the commissioner determines that the replacement beds are needed to prevent an 
177.9 	inadequate supply of beds.
177.10 	Project construction costs incurred for repairs authorized under this clause shall not be 
177.11 	considered in the dollar threshold amount defined in subdivision 2;
177.12 	(b) to license or certify beds that are moved from one location to another within a nursing 
177.13 	home facility, provided the total costs of remodeling performed in conjunction with the 
177.14 	relocation of beds does not exceed $1,000,000;
177.15 	(c) to license or certify beds in a project recommended for approval under section 
177.16 	144A.073;
177.17 	(d) to license or certify beds that are moved from an existing state nursing home to a 
177.18 	different state facility, provided there is no net increase in the number of state nursing home 
177.19 	beds;
177.20 	(e) to certify and license as nursing home beds boarding care beds in a certified boarding 
177.21 	care facility if the beds meet the standards for nursing home licensure, or in a facility that 
177.22 	was granted an exception to the moratorium under section 144A.073, and if the cost of any 
177.23 	remodeling of the facility does not exceed $1,000,000. If boarding care beds are licensed 
177.24 	as nursing home beds, the number of boarding care beds in the facility must not increase 
177.25 	beyond the number remaining at the time of the upgrade in licensure. The provisions 
177.26 	contained in section 144A.073 regarding the upgrading of the facilities do not apply to 
177.27 	facilities that satisfy these requirements;
177.28 	(f) to license and certify up to 40 beds transferred from an existing facility owned and 
177.29 	operated by the Amherst H. Wilder Foundation in the city of St. Paul to a new unit at the 
177.30 	same location as the existing facility that will serve persons with Alzheimer's disease and 
177.31 	other related disorders. The transfer of beds may occur gradually or in stages, provided the 
177.32 	total number of beds transferred does not exceed 40. At the time of licensure and certification 
177.33 	of a bed or beds in the new unit, the commissioner of health shall delicense and decertify 
178.1 	the same number of beds in the existing facility. As a condition of receiving a license or 
178.2 	certification under this clause, the facility must make a written commitment to the 
178.3 	commissioner of human services that it will not seek to receive an increase in its 
178.4 	property-related payment rate as a result of the transfers allowed under this paragraph;
178.5 	(g) to license and certify nursing home beds to replace currently licensed and certified 
178.6 	boarding care beds which may be located either in a remodeled or renovated boarding care 
178.7 	or nursing home facility or in a remodeled, renovated, newly constructed, or replacement 
178.8 	nursing home facility within the identifiable complex of health care facilities in which the 
178.9 	currently licensed boarding care beds are presently located, provided that the number of 
178.10 	boarding care beds in the facility or complex are decreased by the number to be licensed as 
178.11 	nursing home beds and further provided that, if the total costs of new construction, 
178.12 	replacement, remodeling, or renovation exceed ten percent of the appraised value of the 
178.13 	facility or $200,000, whichever is less, the facility makes a written commitment to the 
178.14 	commissioner of human services that it will not seek to receive an increase in its 
178.15 	property-related payment rate by reason of the new construction, replacement, remodeling, 
178.16 	or renovation. The provisions contained in section 144A.073 regarding the upgrading of 
178.17 	facilities do not apply to facilities that satisfy these requirements;
178.18 	(h) to license as a nursing home and certify as a nursing facility a facility that is licensed 
178.19 	as a boarding care facility but not certified under the medical assistance program, but only 
178.20 	if the commissioner of human services certifies to the commissioner of health that licensing 
178.21 	the facility as a nursing home and certifying the facility as a nursing facility will result in 
178.22 	a net annual savings to the state general fund of $200,000 or more;
178.23 	(i) to certify, after September 30, 1992, and prior to July 1, 1993, existing nursing home 
178.24 	beds in a facility that was licensed and in operation prior to January 1, 1992;
178.25 	(j) to license and certify new nursing home beds to replace beds in a facility acquired 
178.26 	by the Minneapolis Community Development Agency as part of redevelopment activities 
178.27 	in a city of the first class, provided the new facility is located within three miles of the site 
178.28 	of the old facility. Operating and property costs for the new facility must be determined and 
178.29 	allowed under section 256B.431 or 256B.434 or chapter 256R;
178.30 	(k) to license and certify up to 20 new nursing home beds in a community-operated 
178.31 	hospital and attached convalescent and nursing care facility with 40 beds on April 21, 1991, 
178.32 	that suspended operation of the hospital in April 1986. The commissioner of human services 
178.33 	shall provide the facility with the same per diem property-related payment rate for each 
178.34 	additional licensed and certified bed as it will receive for its existing 40 beds;
179.1 	(l) to license or certify beds in renovation, replacement, or upgrading projects as defined 
179.2 	in section 144A.073, subdivision 1, so long as the cumulative total costs of the facility's 
179.3 	remodeling projects do not exceed $1,000,000;
179.4 	(m) to license and certify beds that are moved from one location to another for the 
179.5 	purposes of converting up to five four-bed wards to single or double occupancy rooms in 
179.6 	a nursing home that, as of January 1, 1993, was county-owned and had a licensed capacity 
179.7 	of 115 beds;
179.8 	(n) to allow a facility that on April 16, 1993, was a 106-bed licensed and certified nursing 
179.9 	facility located in Minneapolis to layaway all of its licensed and certified nursing home 
179.10 	beds. These beds may be relicensed and recertified in a newly constructed teaching nursing 
179.11 	home facility affiliated with a teaching hospital upon approval by the legislature. The 
179.12 	proposal must be developed in consultation with the interagency committee on long-term 
179.13 	care planning. The beds on layaway status shall have the same status as voluntarily delicensed 
179.14 	and decertified beds, except that beds on layaway status remain subject to the surcharge in 
179.15 	section 256.9657. This layaway provision expires July 1, 1998;
179.16 	(o) to allow a project which will be completed in conjunction with an approved 
179.17 	moratorium exception project for a nursing home in southern Cass County and which is 
179.18 	directly related to that portion of the facility that must be repaired, renovated, or replaced, 
179.19 	to correct an emergency plumbing problem for which a state correction order has been 
179.20 	issued and which must be corrected by August 31, 1993;
179.21 	(p) to allow a facility that on April 16, 1993, was a 368-bed licensed and certified nursing 
179.22 	facility located in Minneapolis to layaway, upon 30 days prior written notice to the 
179.23 	commissioner, up to 30 of the facility's licensed and certified beds by converting three-bed 
179.24 	wards to single or double occupancy. Beds on layaway status shall have the same status as 
179.25 	voluntarily delicensed and decertified beds except that beds on layaway status remain subject 
179.26 	to the surcharge in section 256.9657, remain subject to the license application and renewal 
179.27 	fees under section 144A.07 and shall be subject to a $100 per bed reactivation fee. In 
179.28 	addition, at any time within three years of the effective date of the layaway, the beds on 
179.29 	layaway status may be:
179.30 	(1) relicensed and recertified upon relocation and reactivation of some or all of the beds 
179.31 	to an existing licensed and certified facility or facilities located in Pine River, Brainerd, or 
179.32 	International Falls; provided that the total project construction costs related to the relocation 
179.33 	of beds from layaway status for any facility receiving relocated beds may not exceed the 
180.1 	dollar threshold provided in subdivision 2 unless the construction project has been approved 
180.2 	through the moratorium exception process under section 144A.073;
180.3 	(2) relicensed and recertified, upon reactivation of some or all of the beds within the 
180.4 	facility which placed the beds in layaway status, if the commissioner has determined a need 
180.5 	for the reactivation of the beds on layaway status.
180.6 	The property-related payment rate of a facility placing beds on layaway status must be 
180.7 	adjusted by the incremental change in its rental per diem after recalculating the rental per 
180.8 	diem as provided in section 256B.431, subdivision 3a, paragraph (c). The property-related 
180.9 	payment rate for a facility relicensing and recertifying beds from layaway status must be 
180.10 	adjusted by the incremental change in its rental per diem after recalculating its rental per 
180.11 	diem using the number of beds after the relicensing to establish the facility's capacity day 
180.12 	divisor, which shall be effective the first day of the month following the month in which 
180.13 	the relicensing and recertification became effective. Any beds remaining on layaway status 
180.14 	more than three years after the date the layaway status became effective must be removed 
180.15 	from layaway status and immediately delicensed and decertified;
180.16 	(q) to license and certify beds in a renovation and remodeling project to convert 12 
180.17 	four-bed wards into 24 two-bed rooms, expand space, and add improvements in a nursing 
180.18 	home that, as of January 1, 1994, met the following conditions: the nursing home was located 
180.19 	in Ramsey County; had a licensed capacity of 154 beds; and had been ranked among the 
180.20 	top 15 applicants by the 1993 moratorium exceptions advisory review panel. The total 
180.21 	project construction cost estimate for this project must not exceed the cost estimate submitted 
180.22 	in connection with the 1993 moratorium exception process;
180.23 	(r) to license and certify up to 117 beds that are relocated from a licensed and certified 
180.24 	138-bed nursing facility located in St. Paul to a hospital with 130 licensed hospital beds 
180.25 	located in South St. Paul, provided that the nursing facility and hospital are owned by the 
180.26 	same or a related organization and that prior to the date the relocation is completed the 
180.27 	hospital ceases operation of its inpatient hospital services at that hospital. After relocation, 
180.28 	the nursing facility's status shall be the same as it was prior to relocation. The nursing 
180.29 	facility's property-related payment rate resulting from the project authorized in this paragraph 
180.30 	shall become effective no earlier than April 1, 1996. For purposes of calculating the 
180.31 	incremental change in the facility's rental per diem resulting from this project, the allowable 
180.32 	appraised value of the nursing facility portion of the existing health care facility physical 
180.33 	plant prior to the renovation and relocation may not exceed $2,490,000;
181.1 	(s) to license and certify two beds in a facility to replace beds that were voluntarily 
181.2 	delicensed and decertified on June 28, 1991;
181.3 	(t) to allow 16 licensed and certified beds located on July 1, 1994, in a 142-bed nursing 
181.4 	home and 21-bed boarding care home facility in Minneapolis, notwithstanding the licensure 
181.5 	and certification after July 1, 1995, of the Minneapolis facility as a 147-bed nursing home 
181.6 	facility after completion of a construction project approved in 1993 under section 144A.073, 
181.7 	to be laid away upon 30 days' prior written notice to the commissioner. Beds on layaway 
181.8 	status shall have the same status as voluntarily delicensed or decertified beds except that 
181.9 	they shall remain subject to the surcharge in section 256.9657. The 16 beds on layaway 
181.10 	status may be relicensed as nursing home beds and recertified at any time within five years 
181.11 	of the effective date of the layaway upon relocation of some or all of the beds to a licensed 
181.12 	and certified facility located in Watertown, provided that the total project construction costs 
181.13 	related to the relocation of beds from layaway status for the Watertown facility may not 
181.14 	exceed the dollar threshold provided in subdivision 2 unless the construction project has 
181.15 	been approved through the moratorium exception process under section 144A.073.
181.16 	The property-related payment rate of the facility placing beds on layaway status must 
181.17 	be adjusted by the incremental change in its rental per diem after recalculating the rental 
181.18 	per diem as provided in section 256B.431, subdivision 3a, paragraph (c). The property-related 
181.19 	payment rate for the facility relicensing and recertifying beds from layaway status must be 
181.20 	adjusted by the incremental change in its rental per diem after recalculating its rental per 
181.21 	diem using the number of beds after the relicensing to establish the facility's capacity day 
181.22 	divisor, which shall be effective the first day of the month following the month in which 
181.23 	the relicensing and recertification became effective. Any beds remaining on layaway status 
181.24 	more than five years after the date the layaway status became effective must be removed 
181.25 	from layaway status and immediately delicensed and decertified;
181.26 	(u) to license and certify beds that are moved within an existing area of a facility or to 
181.27 	a newly constructed addition which is built for the purpose of eliminating three- and four-bed 
181.28 	rooms and adding space for dining, lounge areas, bathing rooms, and ancillary service areas 
181.29 	in a nursing home that, as of January 1, 1995, was located in Fridley and had a licensed 
181.30 	capacity of 129 beds;
181.31 	(v) to relocate 36 beds in Crow Wing County and four beds from Hennepin County to 
181.32 	a 160-bed facility in Crow Wing County, provided all the affected beds are under common 
181.33 	ownership;
182.1 	(w) to license and certify a total replacement project of up to 49 beds located in Norman 
182.2 	County that are relocated from a nursing home destroyed by flood and whose residents were 
182.3 	relocated to other nursing homes. The operating cost payment rates for the new nursing 
182.4 	facility shall be determined based on the interim and settle-up payment provisions of 
182.5 	Minnesota Rules, part 9549.0057, section 256R.27 and the reimbursement provisions of 
182.6 	chapter 256R. Property-related reimbursement rates shall be determined under section 
182.7 	256R.26, taking into account any federal or state flood-related loans or grants provided to 
182.8 	the facility;
182.9 	(x) to license and certify to the licensee of a nursing home in Polk County that was 
182.10 	destroyed by flood in 1997 replacement projects with a total of up to 129 beds, with at least 
182.11 	25 beds to be located in Polk County and up to 104 beds distributed among up to three other 
182.12 	counties. These beds may only be distributed to counties with fewer than the median number 
182.13 	of age intensity adjusted beds per thousand, as most recently published by the commissioner 
182.14 	of human services. If the licensee chooses to distribute beds outside of Polk County under 
182.15 	this paragraph, prior to distributing the beds, the commissioner of health must approve the 
182.16 	location in which the licensee plans to distribute the beds. The commissioner of health shall 
182.17 	consult with the commissioner of human services prior to approving the location of the 
182.18 	proposed beds. The licensee may combine these beds with beds relocated from other nursing 
182.19 	facilities as provided in section 144A.073, subdivision 3c. The operating payment rates for 
182.20 	the new nursing facilities shall be determined based on the interim and settle-up payment 
182.21 	provisions of Minnesota Rules, parts 9549.0010 to 9549.0080. Property-related 
182.22 	reimbursement rates shall be determined under section 256R.26. If the replacement beds 
182.23 	permitted under this paragraph are combined with beds from other nursing facilities, the 
182.24 	rates shall be calculated as the weighted average of rates determined as provided in this 
182.25 	paragraph and section 256R.50;
182.26 	(y) to license and certify beds in a renovation and remodeling project to convert 13 
182.27 	three-bed wards into 13 two-bed rooms and 13 single-bed rooms, expand space, and add 
182.28 	improvements in a nursing home that, as of January 1, 1994, met the following conditions: 
182.29 	the nursing home was located in Ramsey County, was not owned by a hospital corporation, 
182.30 	had a licensed capacity of 64 beds, and had been ranked among the top 15 applicants by 
182.31 	the 1993 moratorium exceptions advisory review panel. The total project construction cost 
182.32 	estimate for this project must not exceed the cost estimate submitted in connection with the 
182.33 	1993 moratorium exception process;
182.34 	(z) to license and certify up to 150 nursing home beds to replace an existing 285 bed 
182.35 	nursing facility located in St. Paul. The replacement project shall include both the renovation 
183.1 	of existing buildings and the construction of new facilities at the existing site. The reduction 
183.2 	in the licensed capacity of the existing facility shall occur during the construction project 
183.3 	as beds are taken out of service due to the construction process. Prior to the start of the 
183.4 	construction process, the facility shall provide written information to the commissioner of 
183.5 	health describing the process for bed reduction, plans for the relocation of residents, and 
183.6 	the estimated construction schedule. The relocation of residents shall be in accordance with 
183.7 	the provisions of law and rule;
183.8 	(aa) to allow the commissioner of human services to license an additional 36 beds to 
183.9 	provide residential services for the physically disabled under Minnesota Rules, parts 
183.10 	9570.2000 to 9570.3400, in a 198-bed nursing home located in Red Wing, provided that 
183.11 	the total number of licensed and certified beds at the facility does not increase;
183.12 	(bb) to license and certify a new facility in St. Louis County with 44 beds constructed 
183.13 	to replace an existing facility in St. Louis County with 31 beds, which has resident rooms 
183.14 	on two separate floors and an antiquated elevator that creates safety concerns for residents 
183.15 	and prevents nonambulatory residents from residing on the second floor. The project shall 
183.16 	include the elimination of three- and four-bed rooms;
183.17 	(cc) to license and certify four beds in a 16-bed certified boarding care home in 
183.18 	Minneapolis to replace beds that were voluntarily delicensed and decertified on or before 
183.19 	March 31, 1992. The licensure and certification is conditional upon the facility periodically 
183.20 	assessing and adjusting its resident mix and other factors which may contribute to a potential 
183.21 	institution for mental disease declaration. The commissioner of human services shall retain 
183.22 	the authority to audit the facility at any time and shall require the facility to comply with 
183.23 	any requirements necessary to prevent an institution for mental disease declaration, including 
183.24 	delicensure and decertification of beds, if necessary;
183.25 	(dd) to license and certify 72 beds in an existing facility in Mille Lacs County with 80 
183.26 	beds as part of a renovation project. The renovation must include construction of an addition 
183.27 	to accommodate ten residents with beginning and midstage dementia in a self-contained 
183.28 	living unit; creation of three resident households where dining, activities, and support spaces 
183.29 	are located near resident living quarters; designation of four beds for rehabilitation in a 
183.30 	self-contained area; designation of 30 private rooms; and other improvements;
183.31 	(ee) to license and certify beds in a facility that has undergone replacement or remodeling 
183.32 	as part of a planned closure under section 256R.40;
183.33 	(ff) to license and certify a total replacement project of up to 124 beds located in Wilkin 
183.34 	County that are in need of relocation from a nursing home significantly damaged by flood. 
184.1 	The operating cost payment rates for the new nursing facility shall be determined based on 
184.2 	the interim and settle-up payment provisions of Minnesota Rules, part 9549.0057, section 
184.3 	256R.27 and the reimbursement provisions of chapter 256R. Property-related reimbursement 
184.4 	rates shall be determined under section 256R.26, taking into account any federal or state 
184.5 	flood-related loans or grants provided to the facility;
184.6 	(gg) to allow the commissioner of human services to license an additional nine beds to 
184.7 	provide residential services for the physically disabled under Minnesota Rules, parts 
184.8 	9570.2000 to 9570.3400, in a 240-bed nursing home located in Duluth, provided that the 
184.9 	total number of licensed and certified beds at the facility does not increase;
184.10 	(hh) to license and certify up to 120 new nursing facility beds to replace beds in a facility 
184.11 	in Anoka County, which was licensed for 98 beds as of July 1, 2000, provided the new 
184.12 	facility is located within four miles of the existing facility and is in Anoka County. Operating 
184.13 	and property rates shall be determined and allowed under chapter 256R and Minnesota 
184.14 	Rules, parts 9549.0010 to 9549.0080; or
184.15 	(ii) to transfer up to 98 beds of a 129-licensed bed facility located in Anoka County that, 
184.16 	as of March 25, 2001, is in the active process of closing, to a 122-licensed bed nonprofit 
184.17 	nursing facility located in the city of Columbia Heights or its affiliate. The transfer is effective 
184.18 	when the receiving facility notifies the commissioner in writing of the number of beds 
184.19 	accepted. The commissioner shall place all transferred beds on layaway status held in the 
184.20 	name of the receiving facility. The layaway adjustment provisions of section 256B.431, 
184.21 	subdivision 30, do not apply to this layaway. The receiving facility may only remove the 
184.22 	beds from layaway for recertification and relicensure at the receiving facility's current site, 
184.23 	or at a newly constructed facility located in Anoka County. The receiving facility must 
184.24 	receive statutory authorization before removing these beds from layaway status, or may 
184.25 	remove these beds from layaway status if removal from layaway status is part of a 
184.26 	moratorium exception project approved by the commissioner under section 144A.073.

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

184.28 	Sec. 5. Minnesota Statutes 2018, section 144A.071, subdivision 4c, is amended to read:
184.29 		Subd. 4c.Exceptions for replacement beds after June 30, 2003. (a) The commissioner 
184.30 	of health, in coordination with the commissioner of human services, may approve the 
184.31 	renovation, replacement, upgrading, or relocation of a nursing home or boarding care home, 
184.32 	under the following conditions:
185.1 	(1) to license and certify an 80-bed city-owned facility in Nicollet County to be 
185.2 	constructed on the site of a new city-owned hospital to replace an existing 85-bed facility 
185.3 	attached to a hospital that is also being replaced. The threshold allowed for this project 
185.4 	under section 144A.073 shall be the maximum amount available to pay the additional 
185.5 	medical assistance costs of the new facility;
185.6 	(2) to license and certify 29 beds to be added to an existing 69-bed facility in St. Louis 
185.7 	County, provided that the 29 beds must be transferred from active or layaway status at an 
185.8 	existing facility in St. Louis County that had 235 beds on April 1, 2003.
185.9 	The licensed capacity at the 235-bed facility must be reduced to 206 beds, but the payment 
185.10 	rate at that facility shall not be adjusted as a result of this transfer. The operating payment 
185.11 	rate of the facility adding beds after completion of this project shall be the same as it was 
185.12 	on the day prior to the day the beds are licensed and certified. This project shall not proceed 
185.13 	unless it is approved and financed under the provisions of section 144A.073;
185.14 	(3) to license and certify a new 60-bed facility in Austin, provided that: (i) 45 of the new 
185.15 	beds are transferred from a 45-bed facility in Austin under common ownership that is closed 
185.16 	and 15 of the new beds are transferred from a 182-bed facility in Albert Lea under common 
185.17 	ownership; (ii) the commissioner of human services is authorized by the 2004 legislature 
185.18 	to negotiate budget-neutral planned nursing facility closures; and (iii) money is available 
185.19 	from planned closures of facilities under common ownership to make implementation of 
185.20 	this clause budget-neutral to the state. The bed capacity of the Albert Lea facility shall be 
185.21 	reduced to 167 beds following the transfer. Of the 60 beds at the new facility, 20 beds shall 
185.22 	be used for a special care unit for persons with Alzheimer's disease or related dementias;
185.23 	(4) to license and certify up to 80 beds transferred from an existing state-owned nursing 
185.24 	facility in Cass County to a new facility located on the grounds of the Ah-Gwah-Ching 
185.25 	campus. The operating cost payment rates for the new facility shall be determined based 
185.26 	on the interim and settle-up payment provisions of Minnesota Rules, part 9549.0057, section 
185.27 	256R.27 and the reimbursement provisions of chapter 256R. The property payment rate for 
185.28 	the first three years of operation shall be $35 per day. For subsequent years, the property 
185.29 	payment rate of $35 per day shall be adjusted for inflation as provided in section 256B.434, 
185.30 	subdivision 4, paragraph (c), as long as the facility has a contract under section 256B.434;
185.31 	(5) to initiate a pilot program to license and certify up to 80 beds transferred from an 
185.32 	existing county-owned nursing facility in Steele County relocated to the site of a new acute 
185.33 	care facility as part of the county's Communities for a Lifetime comprehensive plan to create 
185.34 	innovative responses to the aging of its population. Upon relocation to the new site, the 
186.1 	nursing facility shall delicense 28 beds. The payment rate for external fixed costs for the 
186.2 	new facility shall be increased by an amount as calculated according to items (i) to (v):
186.3 	(i) compute the estimated decrease in medical assistance residents served by the nursing 
186.4 	facility by multiplying the decrease in licensed beds by the historical percentage of medical 
186.5 	assistance resident days;
186.6 	(ii) compute the annual savings to the medical assistance program from the delicensure 
186.7 	of 28 beds by multiplying the anticipated decrease in medical assistance residents, determined 
186.8 	in item (i), by the existing facility's weighted average payment rate multiplied by 365;
186.9 	(iii) compute the anticipated annual costs for community-based services by multiplying 
186.10 	the anticipated decrease in medical assistance residents served by the nursing facility, 
186.11 	determined in item (i), by the average monthly elderly waiver service costs for individuals 
186.12 	in Steele County multiplied by 12;
186.13 	(iv) subtract the amount in item (iii) from the amount in item (ii);
186.14 	(v) divide the amount in item (iv) by an amount equal to the relocated nursing facility's 
186.15 	occupancy factor under section 256B.431, subdivision 3f, paragraph (c), multiplied by the 
186.16 	historical percentage of medical assistance resident days; and
186.17 	(6) to consolidate and relocate nursing facility beds to a new site in Goodhue County 
186.18 	and to integrate these services with other community-based programs and services under a 
186.19 	communities for a lifetime pilot program and comprehensive plan to create innovative 
186.20 	responses to the aging of its population. Two nursing facilities, one for 84 beds and one for 
186.21 	65 beds, in the city of Red Wing licensed on July 1, 2015, shall be consolidated into a newly 
186.22 	renovated 64-bed nursing facility resulting in the delicensure of 85 beds. Notwithstanding 
186.23 	the carryforward of the approval authority in section 144A.073, subdivision 11, the funding 
186.24 	approved in April 2009 by the commissioner of health for a project in Goodhue County 
186.25 	shall not carry forward. The closure of the 85 beds shall not be eligible for a planned closure 
186.26 	rate adjustment under section 256R.40. The construction project permitted in this clause 
186.27 	shall not be eligible for a threshold project rate adjustment under section 256B.434, 
186.28 	subdivision 4f. The payment rate for external fixed costs for the new facility shall be 
186.29 	increased by an amount as calculated according to items (i) to (vi):
186.30 	(i) compute the estimated decrease in medical assistance residents served by both nursing 
186.31 	facilities by multiplying the difference between the occupied beds of the two nursing facilities 
186.32 	for the reporting year ending September 30, 2009, and the projected occupancy of the facility 
186.33 	at 95 percent occupancy by the historical percentage of medical assistance resident days;
187.1 	(ii) compute the annual savings to the medical assistance program from the delicensure 
187.2 	by multiplying the anticipated decrease in the medical assistance residents, determined in 
187.3 	item (i), by the hospital-owned nursing facility weighted average payment rate multiplied 
187.4 	by 365;
187.5 	(iii) compute the anticipated annual costs for community-based services by multiplying 
187.6 	the anticipated decrease in medical assistance residents served by the facilities, determined 
187.7 	in item (i), by the average monthly elderly waiver service costs for individuals in Goodhue 
187.8 	County multiplied by 12;
187.9 	(iv) subtract the amount in item (iii) from the amount in item (ii);
187.10 	(v) multiply the amount in item (iv) by 57.2 percent; and
187.11 	(vi) divide the difference of the amount in item (iv) and the amount in item (v) by an 
187.12 	amount equal to the relocated nursing facility's occupancy factor under section 256B.431, 
187.13 	subdivision 3f, paragraph (c), multiplied by the historical percentage of medical assistance 
187.14 	resident days.
187.15 	(b) Projects approved under this subdivision shall be treated in a manner equivalent to 
187.16 	projects approved under subdivision 4a.

187.17 	EFFECTIVE DATE. This section is effective for rate years beginning on or after 
187.18 	January 1, 2020.

187.19 	Sec. 6. Minnesota Statutes 2018, section 144A.071, subdivision 4d, is amended to read:
187.20 		Subd. 4d.Consolidation of nursing facilities. (a) The commissioner of health, in 
187.21 	consultation with the commissioner of human services, may approve a request for 
187.22 	consolidation of nursing facilities which includes the closure of one or more facilities and 
187.23 	the upgrading of the physical plant of the remaining nursing facility or facilities, the costs 
187.24 	of which exceed the threshold project limit under subdivision 2, clause (a). The 
187.25 	commissioners shall consider the criteria in this section, section 144A.073, and section 
187.26 	256R.40, in approving or rejecting a consolidation proposal. In the event the commissioners 
187.27 	approve the request, the commissioner of human services shall calculate an external fixed 
187.28 	costs rate adjustment according to clauses (1) to (3):
187.29 	(1) the closure of beds shall not be eligible for a planned closure rate adjustment under 
187.30 	section 256R.40, subdivision 5;
188.1 	(2) the construction project permitted in this clause shall not be eligible for a threshold 
188.2 	project rate adjustment under section 256B.434, subdivision 4f, or a moratorium exception 
188.3 	adjustment under section 144A.073; and
188.4 	(3) the payment rate for external fixed costs for a remaining facility or facilities shall 
188.5 	be increased by an amount equal to 65 percent of the projected net cost savings to the state 
188.6 	calculated in paragraph (b), divided by the state's medical assistance percentage of medical 
188.7 	assistance dollars, and then divided by estimated medical assistance resident days, as 
188.8 	determined in paragraph (c), of the remaining nursing facility or facilities in the request in 
188.9 	this paragraph. The rate adjustment is effective on the first day of the month of January or 
188.10 	July, whichever date occurs first following both the completion of the construction upgrades 
188.11 	in the consolidation plan and the complete closure of the facility or facilities designated for 
188.12 	closure in the consolidation plan. If more than one facility is receiving upgrades in the 
188.13 	consolidation plan, each facility's date of construction completion must be evaluated 
188.14 	separately.
188.15 	(b) For purposes of calculating the net cost savings to the state, the commissioner shall 
188.16 	consider clauses (1) to (7):
188.17 	(1) the annual savings from estimated medical assistance payments from the net number 
188.18 	of beds closed taking into consideration only beds that are in active service on the date of 
188.19 	the request and that have been in active service for at least three years;
188.20 	(2) the estimated annual cost of increased case load of individuals receiving services 
188.21 	under the elderly waiver;
188.22 	(3) the estimated annual cost of elderly waiver recipients receiving support under housing 
188.23 	support under chapter 256I;
188.24 	(4) the estimated annual cost of increased case load of individuals receiving services 
188.25 	under the alternative care program;
188.26 	(5) the annual loss of license surcharge payments on closed beds;
188.27 	(6) the savings from not paying planned closure rate adjustments that the facilities would 
188.28 	otherwise be eligible for under section 256R.40; and
188.29 	(7) the savings from not paying external fixed costs payment rate adjustments from 
188.30 	submission of renovation costs that would otherwise be eligible as threshold projects under 
188.31 	section 256B.434, subdivision 4f.
188.32 	(c) For purposes of the calculation in paragraph (a), clause (3), the estimated medical 
188.33 	assistance resident days of the remaining facility or facilities shall be computed assuming 
189.1 	95 percent occupancy multiplied by the historical percentage of medical assistance resident 
189.2 	days of the remaining facility or facilities, as reported on the facility's or facilities' most 
189.3 	recent nursing facility statistical and cost report filed before the plan of closure is submitted, 
189.4 	multiplied by 365.
189.5 	(d) For purposes of net cost of savings to the state in paragraph (b), the average occupancy 
189.6 	percentages will be those reported on the facility's or facilities' most recent nursing facility 
189.7 	statistical and cost report filed before the plan of closure is submitted, and the average 
189.8 	payment rates shall be calculated based on the approved payment rates in effect at the time 
189.9 	the consolidation request is submitted.
189.10 	(e) To qualify for the external fixed costs payment rate adjustment under this subdivision, 
189.11 	the closing facilities shall:
189.12 	(1) submit an application for closure according to section 256R.40, subdivision 2; and
189.13 	(2) follow the resident relocation provisions of section 144A.161.
189.14 	(f) The county or counties in which a facility or facilities are closed under this subdivision 
189.15 	shall not be eligible for designation as a hardship area under subdivision 3 for five years 
189.16 	from the date of the approval of the proposed consolidation. The applicant shall notify the 
189.17 	county of this limitation and the county shall acknowledge this in a letter of support.
189.18 	(g) Projects approved on or after March 1, 2020, are not subject to paragraph (a), clauses 
189.19 	(2) and (3), and paragraph (c). The 65 percent projected net cost savings to the state calculated 
189.20 	in paragraph (b) must be applied to the moratorium cost of the project and the remainder 
189.21 	must be added to the moratorium funding under section 144A.073, subdivision 11.
189.22 	(h) Consolidation project applications not approved by the commissioner prior to March 
189.23 	1, 2020, are subject to the moratorium process under section 144A.073, subdivision 2. Upon 
189.24 	request by the applicant, the commissioner may extend this deadline to August 1, 2020, so 
189.25 	long as the facilities, bed numbers, and counties specified in the original application are not 
189.26 	altered. Proposals from facilities seeking approval for a consolidation project prior to March 
189.27 	1, 2020, must be received by the commissioner no later than January 1, 2020. This paragraph 
189.28 	expires August 1, 2020.

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

189.30 	Sec. 7. Minnesota Statutes 2018, section 144A.071, subdivision 5a, is amended to read:
189.31 		Subd. 5a.Cost estimate of a moratorium exception project. (a) For the purposes of 
189.32 	this section and section 144A.073, the cost estimate of a moratorium exception project shall 
190.1 	include the effects of the proposed project on the costs of the state subsidy for 
190.2 	community-based services, nursing services, and housing in institutional and noninstitutional 
190.3 	settings. The commissioner of health, in cooperation with the commissioner of human 
190.4 	services, shall define the method for estimating these costs in the permanent rule 
190.5 	implementing section 144A.073. The commissioner of human services shall prepare an 
190.6 	estimate of the property payment rate to be established upon completion of the project and
190.7 	total state annual long-term costs of each moratorium exception proposal. The property 
190.8 	payment rate estimate shall be based upon the estimated costs and total building valuation 
190.9 	to be used in the total property payment rate calculation under section 256R.26. For the 
190.10 	purposes of determining the actual total property payment rate under section 256R.26 upon 
190.11 	completion of the project, the final building valuation is the lesser of the limited depreciated 
190.12 	replacement cost as determined under section 256R.26, subdivision 3, following a physical 
190.13 	building appraisal or 105 percent of the estimated total building valuation from the 
190.14 	moratorium application.
190.15 	(b) The interest rate to be used for estimating the cost of each moratorium exception 
190.16 	project proposal shall be the lesser of either the prime rate plus two percentage points, or 
190.17 	the posted yield for standard conventional fixed rate mortgages of the Federal Home Loan 
190.18 	Mortgage Corporation plus two percentage points as published in the Wall Street Journal 
190.19 	and in effect 56 days prior to the application deadline. If the applicant's proposal uses this 
190.20 	interest rate, the commissioner of human services, in determining the facility's actual 
190.21 	property-related payment rate to be established upon completion of the project must use the 
190.22 	actual interest rate obtained by the facility for the project's permanent financing up to the 
190.23 	maximum permitted under Minnesota Rules, part 9549.0060, subpart 6.
190.24 	The applicant may choose an alternate interest rate for estimating the project's cost. If 
190.25 	the applicant makes this election, the commissioner of human services, in determining the 
190.26 	facility's actual property-related payment rate to be established upon completion of the 
190.27 	project, must use the lesser of the actual interest rate obtained for the project's permanent 
190.28 	financing or the interest rate which was used to estimate the proposal's project cost. For 
190.29 	succeeding rate years, the applicant is at risk for financing costs in excess of the interest 
190.30 	rate selected.

190.31 	EFFECTIVE DATE. This section is effective for projects approved by the commissioner 
190.32 	of health on or after March 1, 2020.

191.1 	Sec. 8. Minnesota Statutes 2018, section 144A.073, subdivision 3c, is amended to read:
191.2 		Subd. 3c.Cost neutral Bed relocation threshold projects. (a) Notwithstanding 
191.3 	subdivision 3, the commissioner may at any time accept proposals, or amendments to 
191.4 	proposals previously approved under this section, for relocations that are cost neutral with 
191.5 	respect to state costs as defined in section 144A.071, subdivision 5a to existing licensed 
191.6 	nursing facilities when costs are less than the maximum threshold limit determined under 
191.7 	section 256R.267, paragraph (a). The commissioner, in consultation with the commissioner 
191.8 	of human services, shall evaluate proposals according to subdivision 4a, clauses (1), (4), 
191.9 	(5), (6), and (8), and other criteria established in rule or law. The commissioner of human 
191.10 	services shall determine the allowable payment rates of the facility receiving the beds in 
191.11 	accordance with section 256R.50 The commissioner of human services shall determine the 
191.12 	allowable payment rates of the facility receiving the beds in accordance with section 256R.21. 
191.13 	No part of the source facility rates are transferred to the receiving facility. The commissioner 
191.14 	shall approve or disapprove a project within 90 days.
191.15 	(b) For the purposes of paragraph (a), cost neutrality shall be measured over the first 
191.16 	three 12-month periods of operation after completion of the project. Bed relocation threshold 
191.17 	projects seeking reimbursement for costs that exceed the moratorium limit or that result in 
191.18 	a newly constructed or newly licensed building must apply to relocate beds as part of the 
191.19 	competitive moratorium application and review process under subdivisions 2 and 3.

191.20 	EFFECTIVE DATE. This section is effective for project proposals received by the 
191.21 	commissioner of health after January 1, 2020, and approved by the commissioner on or 
191.22 	after March 1, 2020.

191.23 	Sec. 9. Minnesota Statutes 2018, section 144A.073, is amended by adding a subdivision 
191.24 	to read:
191.25 		Subd. 16.Moratorium exception funding. In fiscal year 2020, the commissioner may 
191.26 	approve moratorium exception projects under this section for which the full annualized state 
191.27 	share of medical assistance costs does not exceed $1,250,000 plus any carryover of previous 
191.28 	appropriations for this purpose.

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

191.30 	Sec. 10. Minnesota Statutes 2018, section 256B.434, subdivision 1, is amended to read:
191.31 		Subdivision 1.Alternative payment demonstration project established Contractual 
191.32 	agreements. The commissioner of human services shall establish a contractual alternative 
192.1 	payment demonstration project for paying for nursing facility services under the medical 
192.2 	assistance program. A nursing facility may apply to be paid under the contractual alternative 
192.3 	payment demonstration project instead of the cost-based payment system established under 
192.4 	section 256B.431. A nursing facilityA nursing facility located in Minnesota electing to use 
192.5 	the alternative payment demonstration projectenroll as a medical assistance provider must 
192.6 	enter into a contract with the commissioner. Payment rates and procedures for facilities 
192.7 	electing to use the alternative payment demonstration project are determined and governed 
192.8 	by this section and by the terms of the contract. The commissioner may negotiate different 
192.9 	contract terms for different nursing facilities.

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

192.11 	Sec. 11. Minnesota Statutes 2018, section 256B.434, subdivision 3, is amended to read:
192.12 		Subd. 3.Duration and termination of contracts. (a) Subject to available resources, 
192.13 	the commissioner may begin to execute contracts with nursing facilities November 1, 1995.
192.14 	(b) (a) All contracts entered into under this section are for a term not to exceed four 
192.15 	years. Either party may terminate a contract at any time without cause by providing 90 
192.16 	calendar days advance written notice to the other party. The decision to terminate a contract 
192.17 	is not appealable. Notwithstanding section 16C.05, subdivision 2, paragraph (a), clause (5), 
192.18 	the contract shall be renegotiated for additional terms of up to four years, unless either party 
192.19 	provides written notice of termination. The provisions of the contract shall be renegotiated 
192.20 	at a minimum of every four years by the parties prior to the expiration date of the contract. 
192.21 	The parties may voluntarily renegotiate amend the terms of the contract at any time by 
192.22 	mutual agreement.
192.23 	(c) (b) If a nursing facility fails to comply with the terms of a contract, the commissioner 
192.24 	shall provide reasonable notice regarding the breach of contract and a reasonable opportunity 
192.25 	for the facility to come into compliance. If the facility fails to come into compliance or to 
192.26 	remain in compliance, the commissioner may terminate the contract. If a contract is 
192.27 	terminated, the contract payment remains in effect for the remainder of the rate year in 
192.28 	which the contract was terminated, but in all other respects the provisions of this section 
192.29 	do not apply to that facility effective the date the contract is terminated. The contract shall 
192.30 	contain a provision governing the transition back to the cost-based reimbursement system 
192.31 	established under section 256B.431 and Minnesota Rules, parts 9549.0010 to 9549.0080. 
192.32 	A contract entered into under this section may be amended by mutual agreement of the 
192.33 	parties.

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

193.1 	Sec. 12. Minnesota Statutes 2018, section 256R.02, subdivision 8, is amended to read:
193.2 		Subd. 8.Capital assets. "Capital assets" means a nursing facility's buildings, attached 
193.3 	fixtures fixed equipment, land improvements, leasehold improvements, and all additions to 
193.4 	or replacements of those assets used directly for resident care.

193.5 	EFFECTIVE DATE. This section is effective for rate years beginning on or after 
193.6 	January 1, 2020.

193.7 	Sec. 13. Minnesota Statutes 2018, section 256R.02, subdivision 19, is amended to read:
193.8 		Subd. 19.External fixed costs. "External fixed costs" means costs related to the nursing 
193.9 	home surcharge under section 256.9657, subdivision 1; licensure fees under section 144.122; 
193.10 	family advisory council fee under section 144A.33; scholarships under section 256R.37; 
193.11 	planned closure rate adjustments under section 256R.40; consolidation rate adjustments 
193.12 	under section 144A.071, subdivisions 4c, paragraph (a), clauses (5) and (6), and 4d; 
193.13 	single-bed room incentives under section 256R.41; property taxes, special assessments, and 
193.14 	payments in lieu of taxes; employer health insurance costs; quality improvement incentive 
193.15 	payment rate adjustments under section 256R.39; performance-based incentive payments 
193.16 	under section 256R.38; special dietary needs under section 256R.51; rate adjustments for 
193.17 	compensation-related costs for minimum wage changes under section 256R.49 provided 
193.18 	on or after January 1, 2018; and Public Employees Retirement Association employer costs; 
193.19 	and border city rate adjustments under section 256R.481.

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

193.21 	Sec. 14. Minnesota Statutes 2018, section 256R.02, is amended by adding a subdivision 
193.22 	to read:
193.23 		Subd. 25a.Interim payment rates. "Interim payment rates" means the total operating 
193.24 	and external fixed costs payment rates determined by anticipated costs and resident days 
193.25 	reported on an interim cost report as described in section 256R.27.

193.26 	EFFECTIVE DATE. This section is effective for rate years beginning on or after 
193.27 	January 1, 2020.

193.28 	Sec. 15. Minnesota Statutes 2018, section 256R.02, subdivision 33, is amended to read:
193.29 		Subd. 33.Nursing facility. "Nursing facility" or "facility" means a facility with a medical 
193.30 	assistance provider agreement that is licensed as a nursing home under chapter 144A or as 
193.31 	a boarding care home under sections 144.50 to 144.56.

194.1 	EFFECTIVE DATE. This section is effective for rate years beginning on or after 
194.2 	January 1, 2020.

194.3 	Sec. 16. Minnesota Statutes 2018, section 256R.02, is amended by adding a subdivision 
194.4 	to read:
194.5 		Subd. 47a.Settle-up payment rates. "Settle-up payment rates" means the total operating 
194.6 	and external fixed costs payment rates determined by actual allowable costs and resident 
194.7 	days reported on a settle-up cost report as described under section 256R.27.

194.8 	EFFECTIVE DATE. This section is effective for rate years beginning on or after 
194.9 	January 1, 2020.

194.10 	Sec. 17. Minnesota Statutes 2018, section 256R.21, is amended by adding a subdivision 
194.11 	to read:
194.12 		Subd. 5.Total payment rate for new facilities. For a new nursing facility created under 
194.13 	section 144A.071, subdivisions 2 and 3, the total payment rate must be determined according 
194.14 	to section 256R.27.

194.15 	EFFECTIVE DATE. This section is effective for projects approved by the commissioner 
194.16 	of health on or after March 1, 2020.

194.17 	Sec. 18. Minnesota Statutes 2018, section 256R.25, is amended to read:
194.18 	256R.25 EXTERNAL FIXED COSTS PAYMENT RATE.
194.19 	(a) The payment rate for external fixed costs is the sum of the amounts in paragraphs 
194.20 	(b) to (n) (o).
194.21 	(b) For a facility licensed as a nursing home, the portion related to the provider surcharge 
194.22 	under section 256.9657 is equal to $8.86 per resident day. For a facility licensed as both a 
194.23 	nursing home and a boarding care home, the portion related to the provider surcharge under 
194.24 	section 256.9657 is equal to $8.86 per resident day multiplied by the result of its number 
194.25 	of nursing home beds divided by its total number of licensed beds.
194.26 	(c) The portion related to the licensure fee under section 144.122, paragraph (d), is the 
194.27 	amount of the fee divided by the sum of the facility's resident days.
194.28 	(d) The portion related to development and education of resident and family advisory 
194.29 	councils under section 144A.33 is $5 per resident day divided by 365.
194.30 	(e) The portion related to scholarships is determined under section 256R.37.
195.1 	(f) The portion related to planned closure rate adjustments is as determined under section 
195.2 	256R.40, subdivision 5, and Minnesota Statutes 2010, section 256B.436.
195.3 	(g) The portion related to consolidation rate adjustments shall be as determined under 
195.4 	section 144A.071, subdivisions 4c, paragraph (a), clauses (5) and (6), and 4d.
195.5 	(h) The portion related to single-bed room incentives is as determined under section 
195.6 	256R.41.
195.7 	(i) The portions related to real estate taxes, special assessments, and payments made in 
195.8 	lieu of real estate taxes directly identified or allocated to the nursing facility are the actual
195.9 	allowable amounts divided by the sum of the facility's resident days. Allowable costs under 
195.10 	this paragraph for payments made by a nonprofit nursing facility that are in lieu of real 
195.11 	estate taxes shall not exceed the amount which the nursing facility would have paid to a 
195.12 	city or township and county for fire, police, sanitation services, and road maintenance costs 
195.13 	had real estate taxes been levied on that property for those purposes.
195.14 	(j) The portion related to employer health insurance costs is the allowable costs divided 
195.15 	by the sum of the facility's resident days.
195.16 	(k) The portion related to the Public Employees Retirement Association is actual
195.17 	allowable costs divided by the sum of the facility's resident days.
195.18 	(l) The portion related to quality improvement incentive payment rate adjustments is 
195.19 	the amount determined under section 256R.39.
195.20 	(m) The portion related to performance-based incentive payments is the amount 
195.21 	determined under section 256R.38.
195.22 	(n) The portion related to special dietary needs is the amount determined under section 
195.23 	256R.51.
195.24 	(o) The portion related to the rate adjustments for border city facilities is the amount 
195.25 	determined under section 256R.481.

195.26 	EFFECTIVE DATE. This section is effective for rate years beginning on or after 
195.27 	January 1, 2020, except paragraph (o) is effective for rate years beginning on or after January 
195.28 	1, 2021.

196.1 	Sec. 19. Minnesota Statutes 2018, section 256R.26, is amended to read:
196.2 	256R.26 PROPERTY PAYMENT RATE.
196.3 		Subdivision 1.Determination of the limited undepreciated replacement cost. The 
196.4 	property payment rate for a nursing facility is the property rate established for the facility 
196.5 	under sections 256B.431 and 256B.434. A facility's limited URC is the lesser of:
196.6 	(1) the facility's URC from the appraisal; or
196.7 	(2) the product of (i) the number of the facility's licensed beds three months prior to the 
196.8 	beginning of the rate year, (ii) the construction cost per square foot value, and (iii) 1,000 
196.9 	square feet.
196.10 		Subd. 2.Determination of limited undepreciated replacement cost ratio. A facility's 
196.11 	limited URC ratio is the facility's limited URC as determined in subdivision 1 divided by 
196.12 	the facility's URC.
196.13 		Subd. 3.Determination of limited depreciated replacement cost. A facility's limited 
196.14 	DRC is the product of the facility's DRC and the facility's limited URC ratio as determined 
196.15 	in subdivision 2.
196.16 		Subd. 4.Determination of land and land improvement value. A facility's land and 
196.17 	land improvement value is the facility's limited URC as determined in subdivision 1 
196.18 	multiplied by 0.05.
196.19 		Subd. 5.Determination of annual fair rental value. A facility's annual fair rental value 
196.20 	is the product of:
196.21 	(1) the sum of the facility's limited DRC as determined in subdivision 3 and the land 
196.22 	and land improvement value as determined in subdivision 4; multiplied by
196.23 	(2) the rental rate.
196.24 		Subd. 6.Determination of fair rental value property rate. A facility's fair rental value 
196.25 	property rate is the quotient of:
196.26 	(1) the facility's annual fair rental value as determined in subdivision 5; divided by
196.27 	(2) the product of the facility's capacity days and 0.88.
196.28 		Subd. 7.Determination of equipment allowance rate. A facility's equipment allowance 
196.29 	rate is the quotient of:
196.30 	(1) the product of (i) the equipment allowance per bed value, (ii) the facility's number 
196.31 	of licensed beds, and (iii) the rental rate; divided by
197.1 	(2) the product of the facility's capacity days and 0.88.
197.2 		Subd. 8.Determination of total property payment rate. Except as provided in 
197.3 	subdivision 9, paragraph (a), a facility's total property payment rate is the sum of the facility's 
197.4 	fair rental value property rate as determined in subdivision 6 and the facility's equipment 
197.5 	allowance rate as determined in subdivision 7.
197.6 		Subd. 9.Transition period. (a) A facility's property payment rate is the property rate 
197.7 	established for the facility under sections 256B.431 and 256B.434 until the facility's property 
197.8 	rate is transitioned  upon completion of any project authorized under section 144A.071, 
197.9 	subdivision 3 or 4d; or 144A.073, subdivision 3, to the fair rental value property rate 
197.10 	calculated under this chapter.
197.11 	(b) Effective the first day of the first month of the calendar quarter after the completion 
197.12 	of the project described in paragraph (a), the commissioner shall transition a facility to the 
197.13 	property payment rate calculated under this chapter. The initial rate year ends on December 
197.14 	31 and may be less than a full 12-month period. The commissioner shall schedule an appraisal 
197.15 	within 90 days of the commissioner receiving notification from the facility that the project 
197.16 	is completed. The commissioner shall apply the property payment rate determined after the 
197.17 	appraisal retroactively to the first day of the first month of the calendar quarter after the 
197.18 	completion of the project.
197.19 	(c) Upon a facility's transition to the fair rental value property rates calculated under this 
197.20 	chapter, the facility's total property payment rate under subdivision 8 shall be the only 
197.21 	payment for costs related to capital assets, including depreciation, interest and lease expenses 
197.22 	for all depreciable assets, including moveable equipment, land improvements, and land. 
197.23 	Facilities with property payment rates established under subdivisions 1 to 8 are not eligible 
197.24 	for planned closure rate adjustments under section 256R.40; consolidation rate adjustments 
197.25 	under section 144A.071, subdivisions 4c, paragraph (a), clauses (5) and (6), and 4d; 
197.26 	single-bed room incentives under section 256R.41; and the property rate inflation adjustment 
197.27 	under section 256B.434, subdivision 4. The commissioner shall remove any of these 
197.28 	incentives from the facility's existing rate upon the facility transitioning to the fair rental 
197.29 	value property rates calculated under this chapter.
197.30 		Subd. 10.New nursing facilities. A nursing facility new to the medical assistance 
197.31 	program must, upon completion of construction of the nursing facility, have the building 
197.32 	and fixed equipment appraised by a property appraisal firm selected by the commissioner 
197.33 	or, if not newly constructed, upon entering the medical assistance program. The commissioner 
197.34 	shall schedule an appraisal within 90 days of notification from the facility that the facility 
198.1 	has become Medicaid certified. The commissioner shall apply the property payment rate 
198.2 	determined after the initial appraisal retroactively to the Medicaid certification date.

198.3 	EFFECTIVE DATE. Subdivisions 1 to 10 are effective for rate years beginning on or 
198.4 	after January 1, 2020, for nursing facilities that completed projects authorized after March 
198.5 	1, 2020, under Minnesota Statutes, section 144A.071, subdivision 3 or 4d; or 144A.073, 
198.6 	subdivision 3.

198.7 	Sec. 20. [256R.261] PROPERTY RATE DEFINITIONS.
198.8 		Subdivision 1.Definitions. For purposes of sections 256R.26 to 256R.267, the terms 
198.9 	in this section have the meanings given unless otherwise provided for in this chapter.
198.10 		Subd. 2.Addition. "Addition" means an extension, enlargement, or expansion of the 
198.11 	nursing facility for the purpose of increasing the number of licensed beds or improving 
198.12 	resident care.
198.13 		Subd. 3.Appraisal. "Appraisal" means an evaluation of the nursing facility's physical 
198.14 	real estate conducted by a property appraisal firm selected by the commissioner to establish 
198.15 	the valuation of a building and fixed equipment. An appraisal does not include an evaluation 
198.16 	of moveable equipment, land, or land improvements. An appraisal may include an evaluation 
198.17 	of shared space provided the valuation is subsequently adjusted for any shared area included 
198.18 	in the depreciated replacement cost and undepreciated replacement cost that is not used 
198.19 	exclusively for nursing facility purposes.
198.20 		Subd. 4.Building. "Building" means the physical plant and fixed equipment used directly 
198.21 	for resident care and licensed under chapter 144A or sections 144.50 to 144.56. Building 
198.22 	excludes buildings or portions of buildings used by central, affiliated, or corporate offices.
198.23 		Subd. 5.Capacity days. "Capacity days" means the number of licensed beds within the 
198.24 	nursing facility multiplied by 365 days.
198.25 		Subd. 6.Construction cost per square foot value. "Construction cost per square foot 
198.26 	value" means the RSMeans nursing home cost per square foot of floor area for a 40,000 
198.27 	square foot nursing home with precast concrete and bearing walls multiplied by the 
198.28 	commercial location factor for Minneapolis as indicated in the most recently available 
198.29 	edition of the Square Foot Costs with RSMeans Data, as published by Gordian.
198.30 		Subd. 7.Commercial valuation system. "Commercial valuation system" means the 
198.31 	commercially available building valuation system selected by the commissioner for use in 
198.32 	all appraisals.
199.1 		Subd. 8.Depreciable movable equipment. "Depreciable movable equipment" means 
199.2 	the standard movable care equipment and support service equipment generally used in 
199.3 	nursing facilities. Depreciable movable equipment includes equipment specified in the major 
199.4 	movable equipment table of the depreciation guidelines.
199.5 		Subd. 9.Depreciated replacement cost or DRC. "Depreciated replacement cost" or 
199.6 	"DRC" means the depreciated replacement cost determined by an appraisal using the 
199.7 	commercial valuation system selected by the commissioner. DRC excludes costs related to 
199.8 	parking structures.
199.9 		Subd. 10.Depreciation expense. "Depreciation expense" means the portion of a capital 
199.10 	asset deemed to be consumed or expired over the life of the asset.
199.11 		Subd. 11.Depreciation guidelines. "Depreciation guidelines" means the most recent 
199.12 	publication of "Estimated Useful Lives of Depreciable Hospital Assets" issued by the 
199.13 	American Hospital Association.
199.14 		Subd. 12.Equipment allowance. "Equipment allowance" means the component of the 
199.15 	property payment rate that is a payment for the use of depreciable movable equipment.
199.16 		Subd. 13.Equipment allowance per bed value. The equipment allowance per bed 
199.17 	value is $10,000 adjusted annually for rate years beginning on or after January 1, 2021, by 
199.18 	the percentage change indicated by the urban consumer price index for Minneapolis-St. 
199.19 	Paul, as published by the Bureau of Labor Statistics (series 1967=100)  for the two previous 
199.20 	Julys. The computation for this annual adjustment is based on the data that is publicly 
199.21 	available on November 1 immediately preceding the start of the rate year.
199.22 		Subd. 14.Fair rental value system. "Fair rental value system" means a system that 
199.23 	establishes a price for the use of a space based on an appraised value of the property. The 
199.24 	price is established without consideration of the actual accounting cost to construct or 
199.25 	remodel the property. The price is the nursing facility value, subject to limits, multiplied 
199.26 	by an established rental rate.
199.27 		Subd. 15.Fixed equipment. "Fixed equipment" means equipment affixed to the building 
199.28 	and not subject to transfer, including but not limited to wiring, electrical fixtures, plumbing, 
199.29 	elevators, and heating and air conditioning systems.
199.30 		Subd. 16.Land improvement. "Land improvement" means improvement to the land 
199.31 	surrounding the nursing facility directly used for nursing facility operations as specified in 
199.32 	the land improvements table of the depreciation guidelines, if replacement of the land 
199.33 	improvement is the responsibility of the nursing facility. Land improvement includes 
200.1 	construction of auxiliary buildings including sheds, garages, storage buildings, and parking 
200.2 	structures. Parking structures are a land improvement and included only in the land and 
200.3 	land improvement value under section 256R.26, subdivision 4. Parking structures are not 
200.4 	to be included in either the undepreciated replacement cost or depreciated replacement cost.
200.5 		Subd. 17.Rental rate. (a) "Rental rate" means the percentage applied to the allowable 
200.6 	value of the building, moveable, and fixed equipment per year in the property payment rate 
200.7 	calculation.
200.8 	(b) The rental rate is the sum of the 20-year treasury bond rate as published in the Federal 
200.9 	Reserve Bulletin using the average for the calendar year preceding the rate year based on 
200.10 	data publicly available on November 1 each year, plus a risk value of three percent.
200.11 	(c) Regardless of the result in paragraph (b), the rental rate must not be less than 7.5 
200.12 	percent or more than 12 percent.
200.13 		Subd. 18.Shared area. "Shared area" means square footage that a nursing facility shares 
200.14 	with a nonnursing facility operation to provide a support service. The appraisals initially 
200.15 	may include the full value of all shared areas. The undepreciated replacement cost and 
200.16 	depreciated replacement cost established by the appraisals must be adjusted in the final 
200.17 	nursing facility values to reflect only the nursing facility usage. The adjustment must be 
200.18 	based on a Medicare-approved allocation basis for the type of service provided by each 
200.19 	area. Shared areas outside the appraised space must be added to DRC, URC, and related 
200.20 	square footage using the average of each value from the space in the appraisal.
200.21 		Subd. 19.Threshold project. "Threshold project" means additions to a building or fixed 
200.22 	equipment that are subject to the threshold project limits under section 256R.267, paragraph 
200.23 	(a).  Threshold project excludes land, land improvements, and depreciable movable equipment 
200.24 	purchases.
200.25 		Subd. 20.Undepreciated replacement cost or URC. "Undepreciated replacement cost" 
200.26 	or "URC" means the undepreciated replacement cost determined by the appraisal for building 
200.27 	and fixed equipment using the commercial valuation system and appraisal firm.

200.28 	EFFECTIVE DATE. This section is effective for rate years beginning on or after 
200.29 	January 1, 2020.

200.30 	Sec. 21. [256R.265] APPRAISALS AND DETERMINATION OF REPLACEMENT 
200.31 	COSTS.
200.32 		Subdivision 1.Selection of valuation system and appraisal firms. The commissioner 
200.33 	shall select a commercial valuation system that property appraisal firms selected by the 
201.1 	commissioner must utilize for all nursing facility property appraisals. The commissioner 
201.2 	shall use appraisal reports produced by commissioner-selected appraisal firms using the 
201.3 	commissioner-selected commercial valuation system for the purposes of rate setting under 
201.4 	section 256R.26, subdivisions 1 to 8. The commissioner shall not adjust or substitute any 
201.5 	alternative appraisal of properties.
201.6 		Subd. 2.Appraised valuations generally. The property appraisal firm selected by the 
201.7 	commissioner shall determine the appraised valuation of a building and fixed equipment. 
201.8 	The appraisal firm shall not include depreciable movable equipment, land, land 
201.9 	improvements, or the physical plant for central office operations in the appraised valuation 
201.10 	of the nursing facility. Appraisals are not intended to exactly reflect market value.
201.11 		Subd. 3.Appraisal reports. Appraisal firms selected by the commissioner shall produce 
201.12 	a report detailing both the DRC and URC of the nursing facility.
201.13 		Subd. 4.Appraised valuations of shared space. Selected appraisal firms may include 
201.14 	the full value of all shared areas in an initial appraisal but must adjust the nursing facility 
201.15 	valuation of any shared area included in the square footage, DRC, and URC that are not 
201.16 	used for nursing facility purposes to reflect only the nursing facility usage of shared areas. 
201.17 	Selected appraisal firms shall adjust facility valuation for shared areas using a 
201.18 	Medicare-approved allocation basis for the type of service provided in each area. Shared 
201.19 	areas outside the appraised space must be added to the DRC, URC, and related square 
201.20 	footage using the average of each value from the space in the appraisal.
201.21 		Subd. 5.Review and appeal of appraisal reports. A nursing facility may appeal a 
201.22 	finding of fact in the appraisal report to the appraiser within 20 calendar days after receipt 
201.23 	of the appraisal report and request revision.
201.24 		Subd. 6.Update of replacement costs. When a facility's most recent physical appraisal 
201.25 	was completed more than 12 months before the start of the rate year, the appraisal firm shall 
201.26 	use the commercial valuation system to update the most recent DRC and URC of the nursing 
201.27 	facility and the commissioner shall use the updated DRC and URC to determine the total 
201.28 	property payment rate under section 256R.26. Updated DRC and URC are updates only 
201.29 	and not subject to revisions of any of the original valuations or appeal to the appraiser by 
201.30 	the facility.
201.31 		Subd. 7.Appraisal frequency. After a facility's initial rate year described in section 
201.32 	256R.26, subdivision 9, paragraph (b), the commissioner shall ensure that a selected appraisal 
201.33 	firm conducts a new physical appraisal of the facility at least once every three years using 
201.34 	a commercial valuation system.
202.1 		Subd. 8.Limitation on appraisal values. After the initial rate year described in section 
202.2 	256R.26, subdivision 9, paragraph (b), the increase in the URC for each subsequent appraisal 
202.3 	shall not exceed $2,000 per bed per year since the most recent physical appraisal, plus any 
202.4 	projects completed under section 256R.267 since the most recent appraisal. Any limitation 
202.5 	to the URC must be applied in the same proportion to the DRC. The commissioner shall 
202.6 	update annually on January 1 the per-bed per-year limit on the increase in the URC in this 
202.7 	subdivision by the annual percent change in the construction cost per square foot value.

202.8 	EFFECTIVE DATE. This section is effective for rate years beginning on or after 
202.9 	January 1, 2020.

202.10 	Sec. 22. [256R.267] THRESHOLD PROJECT PROPERTY PAYMENT RATE 
202.11 	INTERIM ADJUSTMENTS.
202.12 	(a) A facility reimbursed under section 256R.26, subdivisions 1 to 8, may receive a 
202.13 	property payment rate interim adjustment for threshold projects the cumulative cost of which 
202.14 	during the three years between physical appraisals is between the following threshold project 
202.15 	cost limits:
202.16 	(1) the lesser of $316,816 or $10,000 per bed in service; and
202.17 	(2) the greater of $1,620,943 or $20,000 per bed in service.
202.18 	The commissioner shall update the threshold project cost limits each January 1 by the annual 
202.19 	percent change in the construction cost per square foot value based on the information that 
202.20 	is publicly available on November 1 immediately preceding the rate year.
202.21 	(b) A facility seeking a property payment rate interim adjustment must request an 
202.22 	adjustment after the threshold project is completed. The nursing facility or the lease holder 
202.23 	must have incurred the threshold project cost subsequent to the facility's last physical 
202.24 	appraisal. The nursing facility must submit to the commissioner all building and fixed 
202.25 	equipment cost data related to the project within 90 days of completing the project.
202.26 	(c) Effective January 1 or July 1, whichever occurs first after a facility completes a 
202.27 	threshold project and requests the property payment rate interim adjustment, the 
202.28 	commissioner shall add the allowable reported threshold project costs to the facility's  URC 
202.29 	under section 256R.26, subdivision 1, and to the DRC under section 256R.26, subdivision 
202.30 	3, before calculating an adjusted property payment rate under section 256R.26. The 
202.31 	commissioner shall not include in the facility's limited URC threshold project costs reported 
202.32 	to the commissioner between physical appraisals that exceed the maximum cumulative 
202.33 	project cost limits described in paragraph (a).
203.1 	(d) In subsequent property payment rate calculations following the completion of a 
203.2 	physical appraisal, the commissioner shall eliminate any interim adjustment to the DRC 
203.3 	and URC under paragraph (c).
203.4 	(e) At the option of the commissioner, the commissioner may adjust the appraisal schedule 
203.5 	for a nursing facility that has completed a threshold project.
203.6 	(f) If more or less than three years pass between a facility's physical appraisals, the 
203.7 	commissioner shall prorate the facility's threshold project cost limits accordingly.
203.8 	(g) After the initial rate year project adjustments are allowed once annually based on 
203.9 	the previous project completion date.
203.10 	(h) Two threshold projects may not be conducted at the same time. Purchases for a 
203.11 	second project must be made after the completion date of the first project.

203.12 	EFFECTIVE DATE. This section is effective for rate years beginning on or after 
203.13 	January 1, 2020.

203.14 	Sec. 23. [256R.27] INTERIM AND SETTLE-UP PAYMENT RATES.
203.15 		Subdivision 1.Generally. (a) The commissioner shall determine the interim payment 
203.16 	rates and settle-up payment rates for a newly constructed nursing facility, or a nursing 
203.17 	facility with an increase in licensed capacity of 50 percent or more, according to subdivisions 
203.18 	2 and 3.
203.19 	(b) The nursing facility must submit a written application to the commissioner to receive 
203.20 	interim payment rates. In its application, the nursing facility must state any reasons for 
203.21 	noncompliance with this chapter.
203.22 	(c) The effective date of the interim payment rates is the date the nursing facility is 
203.23 	certified for the medical assistance program.
203.24 	(d) The nursing facility must continue to receive the interim payment rates until the 
203.25 	settle-up payment rates are determined under subdivision 3.
203.26 	(e) For the 15-month period following the settle-up reporting period, the settle-up payment 
203.27 	rates must be determined according to subdivision 3, paragraph (c).
203.28 	(f) The settle-up payment rates are effective retroactively to the beginning of the interim 
203.29 	payment rates and are effective until the end of the interim rate period.
204.1 	(g) The total operating and external fixed costs payment rate for the rate year beginning 
204.2 	January 1 following the 15-month period in paragraph (e) must be determined under this 
204.3 	chapter.
204.4 		Subd. 2.Determination of interim payment rates. (a) The nursing facility shall submit 
204.5 	an interim cost report in a format similar to the Minnesota Statistical and Cost Report and 
204.6 	other supporting information as required by this chapter for the reporting year in which the 
204.7 	nursing facility plans to begin operation at least 60 days before the first day a resident is 
204.8 	admitted to the newly constructed nursing facility bed. The interim cost report must include 
204.9 	the nursing facility's anticipated interim costs and anticipated interim resident days for each 
204.10 	resident class in the interim cost report. The anticipated interim resident days for each 
204.11 	resident class is multiplied by the weight for that resident class to determine the anticipated 
204.12 	interim standardized days as defined in section 256R.02, subdivision 50, and resident days 
204.13 	as defined in section 256R.02, subdivision 45, for the reporting period.
204.14 	(b) The interim payment rates are determined according to sections 256R.21 to 256R.25, 
204.15 	except that:
204.16 	(1) the anticipated interim costs and anticipated interim resident days reported on the 
204.17 	interim cost report and the anticipated interim standardized days as defined by section 
204.18 	256R.02, subdivision 50, must be used for the interim;
204.19 	(2) the commissioner shall use anticipated interim costs and anticipated interim 
204.20 	standardized days in determining the allowable historical direct care cost per standardized 
204.21 	day as determined under section 256R.23, subdivision 2;
204.22 	(3) the commissioner shall use anticipated interim costs and anticipated interim resident 
204.23 	days in determining the allowable historical other care-related cost per resident day as 
204.24 	determined under section 256R.23, subdivision 3;
204.25 	(4) the commissioner shall use anticipated interim costs and anticipated interim resident 
204.26 	days to determine the allowable historical external fixed costs per day under section 256R.25, 
204.27 	paragraphs (b) to (k);
204.28 	(5) the total care-related payment rate limits established in section 256R.23, subdivision 
204.29 	5, and in effect at the beginning of the interim period must be increased by ten percent; and
204.30 	(6) the other operating payment rate as determined under section 256R.24 in effect for 
204.31 	the rate year must be used for the other operating cost per day.
204.32 		Subd. 3.Determination of settle-up payment rates. (a) When the interim payment 
204.33 	rates begin between May 1 and September 30, the nursing facility shall file settle-up cost 
205.1 	reports for the period from the beginning of the interim payment rates through September 
205.2 	30 of the following year.
205.3 	(b) When the interim payment rates begin between October 1 and April 30, the nursing 
205.4 	facility shall file settle-up cost reports for the period from the beginning of the interim 
205.5 	payment rates to the first September 30 following the beginning of the interim payment 
205.6 	rates.
205.7 	(c) The settle-up payment rates are determined according to sections 256R.21 to 256R.25, 
205.8 	except that:
205.9 	(1) the allowable costs and resident days reported on the settle-up cost report and the 
205.10 	standardized days as defined by section 256R.02, subdivision 50, must be used for the 
205.11 	interim and settle-up period;
205.12 	(2) the commissioner shall use the allowable costs and standardized days in clause (1) 
205.13 	to determine the allowable historical direct care cost per standardized day as determined 
205.14 	under section 256R.23, subdivision 2;
205.15 	(3) the commissioner shall use the allowable costs and the allowable resident days to 
205.16 	determine both the allowable historical other care-related cost per resident day as determined 
205.17 	under section 256R.23, subdivision 3;
205.18 	(4) the commissioner shall use the allowable costs and the allowable resident days to 
205.19 	determine the allowable historical external fixed costs per day under section 256R.25, 
205.20 	paragraphs (b) to (k);
205.21 	(5) the total care-related payment limits established in section 256R.23, subdivision 5, 
205.22 	are the limits for the settle-up reporting periods. If the interim period includes more than 
205.23 	one July 1 date, the commissioner shall use the total care-related payment rate limit 
205.24 	established in section 256R.23, subdivision 5, increased by ten percent for the second July 
205.25 	1 date; and
205.26 	(6) the other operating payment rate as determined under section 256R.24 in effect for 
205.27 	the rate year must be used for the other operating cost per day.

205.28 	EFFECTIVE DATE. This section is effective for rate years beginning on or after 
205.29 	January 1, 2020.

206.1 	Sec. 24. Minnesota Statutes 2018, section 256R.44, is amended to read:
206.2 	256R.44 RATE ADJUSTMENT FOR PRIVATE ROOMS FOR MEDICAL 
206.3 	NECESSITY.
206.4 	(a) The amount paid for a private room is 111.5 percent of the established total payment 
206.5 	rate for a resident if the resident is a medical assistance recipient and the private room is 
206.6 	considered a medical necessity for the resident or others who are affected by the resident's 
206.7 	condition, except as provided in Minnesota Rules, part 9549.0060, subpart 11, item C. 
206.8 	Conditions requiring a private room must be determined by the resident's attending physician 
206.9 	and submitted to the commissioner for approval or denial by the commissioner on the basis 
206.10 	of medical necessity.
206.11 	(b) For a nursing facility with a total property payment rate determined under section 
206.12 	256R.26, subdivision 8, the amount paid for a private room is 111.5 percent of the established 
206.13 	total payment rate for a resident if the resident is a medical assistance recipient and the 
206.14 	private room is considered a medical necessity for the resident or others who are affected 
206.15 	by the resident's condition. Conditions requiring a private room must be determined by the 
206.16 	resident's attending physician and submitted to the commissioner for approval or denial by 
206.17 	the commissioner on the basis of medical necessity.

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

206.19 	Sec. 25. [256R.481] RATE ADJUSTMENTS FOR BORDER CITY FACILITIES.
206.20 	(a) The commissioner shall allow each nonprofit nursing facility located within the 
206.21 	boundaries of the city of Breckenridge or Moorhead prior to January 1, 2015, to apply once 
206.22 	annually for a rate add-on to the facility's external fixed costs payment rate.
206.23 	(b) A facility seeking an add-on to its external fixed costs payment rate under this section 
206.24 	must apply annually to the commissioner to receive the add-on. A facility must submit the 
206.25 	application within 60 calendar days of the effective date of any add-on under this section.  
206.26 	The commissioner may waive the deadlines required by this paragraph under extraordinary 
206.27 	circumstances.
206.28 	(c) The commissioner shall provide the add-on to each eligible facility that applies by 
206.29 	the application deadline.
206.30 	(d) The add-on to the external fixed costs payment rate is the difference on January 1 
206.31 	of the median total payment rate for case mix classification PA1 of the nonprofit facilities 
206.32 	located in an adjacent city in another state and in cities contiguous to the adjacent city minus 
207.1 	the eligible nursing facility's total payment rate for case mix classification PA1 as determined 
207.2 	under section 256R.22, subdivision 4.

207.3 	EFFECTIVE DATE. This section is effective for rate years beginning on or after 
207.4 	January 1, 2021.

207.5 	Sec. 26. Minnesota Statutes 2018, section 256R.50, subdivision 6, is amended to read:
207.6 		Subd. 6.Determination of rate adjustment. (a) If the amount determined in subdivision 
207.7 	5 is less than or equal to the amount determined in subdivision 4, the commissioner shall 
207.8 	allow a total payment rate equal to the amount used in subdivision 5, clause (3).
207.9 	(b) If the amount determined in subdivision 5 is greater than the amount determined in 
207.10 	subdivision 4, the commissioner shall allow a rate with a case mix index of 1.0 that when 
207.11 	used in subdivision 5, clause (3), results in the amount determined in subdivision 5 being 
207.12 	equal to the amount determined in subdivision 4.
207.13 	(c) If the commissioner relies upon provider estimates in subdivision 5, clause (1) or 
207.14 	(2), then annually, for three years after the rates determined in this section take effect, the 
207.15 	commissioner shall determine the accuracy of the alternative factors of medical assistance 
207.16 	case load and the facility average case mix index used in this section and shall reduce the 
207.17 	total payment rate if the factors used result in medical assistance costs exceeding the amount 
207.18 	in subdivision 4. If the actual medical assistance costs exceed the estimates by more than 
207.19 	five percent, the commissioner shall also recover the difference between the estimated costs 
207.20 	in subdivision 5 and the actual costs according to section 256B.0641. The commissioner 
207.21 	may require submission of data from the receiving facility needed to implement this 
207.22 	paragraph.
207.23 	(d) When beds approved for relocation are put into active service at the destination 
207.24 	facility, rates determined in this section must be adjusted by any adjustment amounts that 
207.25 	were implemented after the date of the letter of approval.
207.26 	(e) Rate adjustments determined under this subdivision expire after three full rate years 
207.27 	following the effective date of the rate adjustment. This subdivision expires when the final 
207.28 	rate adjustment determined under this subdivision expires.

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

208.1 	Sec. 27. DIRECTION TO COMMISSIONER; CLEAN ENERGY PILOT PROJECT.
208.2 	(a) The commissioner shall develop a pilot project to reduce overall energy consumption 
208.3 	and evaluate the financial impacts associated with property assessed clean energy (PACE) 
208.4 	approved projects in nursing facilities.
208.5 	(b) Notwithstanding Minnesota Statutes, section 256R.02, subdivision 48a, the 
208.6 	commissioner may make payments to facilities for the allowable costs of special assessments 
208.7 	for approved energy-related program payments authorized under Minnesota Statutes, sections 
208.8 	216C.435 and 216C.436.
208.9 	(c) The commissioner shall approve proposals through a contract which shall specify 
208.10 	the level of payment, provided that each facility demonstrates:
208.11 	(1) completion of a facility-specific energy assessment or energy audit and recommended 
208.12 	energy conservation measures that, in aggregate, meet the cost-effectiveness requirements 
208.13 	of Minnesota Statutes, section 216B.241;
208.14 	(2) a completed PACE application and recommended approval by a PACE program 
208.15 	administrator authorized under Minnesota Statutes, sections 216C.435 and 216C.436; and
208.16 	(3) the facility's reported spending on utilities per resident day since calendar year 2016 
208.17 	is higher than average for similar facilities.
208.18 	(d) Payments to facilities under this section shall be in the form of time-limited rate 
208.19 	adjustments which shall be included in the external fixed costs payment rate under Minnesota 
208.20 	Statutes, section 256R.25. The commissioner shall select from facilities that meet the 
208.21 	requirements of paragraph (c) using a competitive application process.
208.22 	(e) Allowable costs for special assessments for approved energy-related program 
208.23 	payments cannot exceed the amount of debt service for net expenditures for the project and 
208.24 	must meet the cost-effective energy improvements requirements described in Minnesota 
208.25 	Statutes, section 216C.435, subdivision 3a. Any credits or rebates related to the project must 
208.26 	be offset. A project cost is not an allowable cost on the cost report as a special assessment 
208.27 	if it has been or will be used to increase the facility's property rate.
208.28 	(f) The external fixed costs payment rate for the PACE allowable costs shall be reduced 
208.29 	by an amount equal to the utility per diem included in the other operating payment rate 
208.30 	under Minnesota Statutes, section 256R.24, that is associated with the energy project.
208.31 	(g) In fiscal years 2020 and 2021, the commissioner of human services may approve 
208.32 	assessed clean energy pilot projects under this section, for which the cumulative state share 
208.33 	of medical assistance costs does not exceed $125,000.
209.1 	(h) Notwithstanding any other law to the contrary, money available under Minnesota 
209.2 	Statutes, section 144A.073, shall be used to pay the medical assistance cost for the external 
209.3 	fixed rate increase in this section.

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

209.5 	Sec. 28. DIRECTION TO COMMISSIONER; ELDERLY WAIVER CUSTOMIZED 
209.6 	LIVING SERVICE PROVIDERS.
 209.7 	(a) The commissioner of human services shall develop incentive-based grants to be 
209.8 	available during fiscal years 2020 and 2021 only for elderly waiver customized living service 
209.9 	providers for achieving outcomes specified in a contract. The commissioner may solicit 
209.10 	proposals from providers and implement those that, on a competitive basis, best meet the 
209.11 	state's policy objectives, giving preference to providers that serve at least 75 percent elderly 
209.12 	waiver participants. The commissioner shall limit expenditures under this subdivision to 
209.13 	the amount appropriated for this purpose.
209.14 	(b) In establishing the specified outcomes and related criteria, the commissioner shall 
209.15 	consider the following state policy objectives:
209.16 	(1) provide more efficient, higher quality services;
209.17 	(2) encourage home and community-based services providers to innovate;
209.18 	(3) equip home and community-based services providers with organizational tools and 
209.19 	expertise to improve their quality;
209.20 	(4) incentivize home and community-based services providers to invest in better services; 
209.21 	and
209.22 	(5) disseminate successful performance improvement strategies statewide.

209.23 	Sec. 29. REVISOR INSTRUCTION.
 209.24 	In Minnesota Statutes, the revisor of statutes shall renumber the nursing facility 
209.25 	contracting provisions that are currently coded as section 256B.434, subdivisions 1 and 3, 
209.26 	as amended by this act, as a section in chapter 256R and revise any statutory cross-references 
209.27 	consistent with that recodification.

209.28 	Sec. 30. REPEALER.
 209.29 	(a) Minnesota Statutes 2018, section 256B.431, subdivisions 3i, 15, and 16, are repealed 
209.30 	effective January 1, 2020.
210.1 	(b) Minnesota Statutes 2018, section 256B.434, subdivisions 6 and 10, are repealed 
210.2 	effective the day following final enactment.
210.3 	(c) Minnesota Statutes 2018, section 256R.53, subdivision 2, is repealed effective January 
210.4 	1, 2021.
210.5 	(d) Minnesota Rules, parts 9549.0057; and 9549.0060, subpart 14, are repealed effective 
210.6 	January 1, 2020.

210.7 	ARTICLE 5
210.8 	DISABILITY SERVICES

210.9 	Section 1. Minnesota Statutes 2018, section 237.50, subdivision 4a, is amended to read:
210.10 		Subd. 4a.Deaf. "Deaf" means a hearing loss of such severity that the individual person
210.11 	must depend primarily upon visual communication such as writing, lip reading, sign language, 
210.12 	and gestures.

210.13 	EFFECTIVE DATE. This section is effective July 1, 2019, and must be implemented 
210.14 	by October 1, 2019.

210.15 	Sec. 2. Minnesota Statutes 2018, section 237.50, is amended by adding a subdivision to 
210.16 	read:
210.17 		Subd. 4c.Discounted telecommunications or Internet services. "Discounted 
210.18 	telecommunications or Internet services" means private, nonprofit, and public programs 
210.19 	intended to subsidize or reduce the monthly costs of telecommunications or Internet services 
210.20 	for a person who meets a program's eligibility requirements.

210.21 	EFFECTIVE DATE. This section is effective July 1, 2019, and must be implemented 
210.22 	by October 1, 2019.

210.23 	Sec. 3. Minnesota Statutes 2018, section 237.50, subdivision 6a, is amended to read:
210.24 		Subd. 6a.Hard-of-hearing. "Hard-of-hearing" means a hearing loss resulting in a 
210.25 	functional limitation, but not to the extent that the individual person must depend primarily 
210.26 	upon visual communication in all interactions.

210.27 	EFFECTIVE DATE. This section is effective July 1, 2019, and must be implemented 
210.28 	by October 1, 2019.

211.1 	Sec. 4. Minnesota Statutes 2018, section 237.50, is amended by adding a subdivision to 
211.2 	read:
211.3 		Subd. 6b.Interconnectivity product. "Interconnectivity product" means a device, 
211.4 	accessory, or application for which the primary function is use with a telecommunications 
211.5 	device. Interconnectivity product may include a cell phone amplifier, hearing aid streamer, 
211.6 	Bluetooth-enabled device that connects to a wireless telecommunications device, advanced 
211.7 	communications application for a smartphone, or other applicable technology.

211.8 	EFFECTIVE DATE. This section is effective July 1, 2019, and must be implemented 
211.9 	by October 1, 2019.

211.10 	Sec. 5. Minnesota Statutes 2018, section 237.50, subdivision 10a, is amended to read:
211.11 		Subd. 10a.Telecommunications device. "Telecommunications device" means a device 
211.12 	that (1) allows a person with a communication disability to have access to 
211.13 	telecommunications services as defined in subdivision 13, and (2) is specifically selected 
211.14 	by the Department of Human Services for its capacity to allow persons with communication 
211.15 	disabilities to use telecommunications services in a manner that is functionally equivalent 
211.16 	to the ability of an individual a person who does not have a communication disability. A 
211.17 	telecommunications device may include a ring signaler, an amplified telephone, a hands-free 
211.18 	telephone, a text telephone, a captioned telephone, a wireless device, a device that produces 
211.19 	Braille output for use with a telephone, and any other device the Department of Human 
211.20 	Services deems appropriate.

211.21 	EFFECTIVE DATE. This section is effective July 1, 2019, and must be implemented 
211.22 	by October 1, 2019.

211.23 	Sec. 6. Minnesota Statutes 2018, section 237.50, subdivision 11, is amended to read:
211.24 		Subd. 11.Telecommunications Relay Services. "Telecommunications Relay Services" 
211.25 	or "TRS" means the telecommunications transmission services required under Federal 
211.26 	Communications Commission regulations at Code of Federal Regulations, title 47, sections 
211.27 	64.604 to 64.606. TRS allows an individual a person who has a communication disability 
211.28 	to use telecommunications services in a manner that is functionally equivalent to the ability 
211.29 	of an individual a person who does not have a communication disability.

211.30 	EFFECTIVE DATE. This section is effective July 1, 2019, and must be implemented 
211.31 	by October 1, 2019.

212.1 	Sec. 7. Minnesota Statutes 2018, section 237.51, subdivision 1, is amended to read:
212.2 		Subdivision 1.Creation. (a) The commissioner of commerce shall:
212.3 	(1) administer through interagency agreement with the commissioner of human services 
212.4 	a program to distribute telecommunications devices and interconnectivity products to eligible 
212.5 	persons who have communication disabilities; and
212.6 	(2) contract with one or more qualified vendors that serve persons who have 
212.7 	communication disabilities to provide telecommunications relay services.
212.8 	(b) For purposes of sections 237.51 to 237.56, the Department of Commerce and any 
212.9 	organization with which it contracts pursuant to this section or section 237.54, subdivision 
212.10 	2, are not telephone companies or telecommunications carriers as defined in section 237.01.

212.11 	EFFECTIVE DATE. This section is effective July 1, 2019, and must be implemented 
212.12 	by October 1, 2019.

212.13 	Sec. 8. Minnesota Statutes 2018, section 237.51, subdivision 5a, is amended to read:
212.14 		Subd. 5a.Commissioner of human services duties. (a) In addition to any duties specified 
212.15 	elsewhere in sections 237.51 to 237.56, the commissioner of human services shall:
212.16 	(1) define economic hardship, special needs, and household criteria so as to determine 
212.17 	the priority of eligible applicants for initial distribution of devices and products and to 
212.18 	determine circumstances necessitating provision of more than one telecommunications 
212.19 	device per household;
212.20 	(2) establish a method to verify eligibility requirements;
212.21 	(3) establish specifications for telecommunications devices and interconnectivity products
212.22 	to be provided under section 237.53, subdivision 3;
212.23 	(4) inform the public and specifically persons who have communication disabilities of 
212.24 	the program; and
212.25 	(5) provide devices and products based on the assessed need of eligible applicants.; and
212.26 	(6) assist a person with completing an application for discounted telecommunications 
212.27 	or Internet services.
212.28 	(b) The commissioner may establish an advisory board to advise the department in 
212.29 	carrying out the duties specified in this section and to advise the commissioner of commerce 
212.30 	in carrying out duties under section 237.54. If so established, the advisory board must 
212.31 	include, at a minimum, the following persons:
213.1 	(1) at least one member who is deaf;
213.2 	(2) at least one member who has a speech disability;
213.3 	(3) at least one member who has a physical disability that makes it difficult or impossible 
213.4 	for the person to access telecommunications services; and
213.5 	(4) at least one member who is hard-of-hearing.
213.6 	(c) The membership terms, compensation, and removal of members and the filling of 
213.7 	membership vacancies are governed by section 15.059. Advisory board meetings shall be 
213.8 	held at the discretion of the commissioner.

213.9 	EFFECTIVE DATE. This section is effective July 1, 2019, and must be implemented 
213.10 	by October 1, 2019.

213.11 	Sec. 9. Minnesota Statutes 2018, section 237.52, subdivision 5, is amended to read:
213.12 		Subd. 5.Expenditures. (a) Money in the fund may only be used for:
213.13 	(1) expenses of the Department of Commerce, including personnel cost, public relations, 
213.14 	advisory board members' expenses, preparation of reports, and other reasonable expenses 
213.15 	not to exceed ten percent of total program expenditures;
213.16 	(2) reimbursing the commissioner of human services for purchases made or services 
213.17 	provided pursuant to section 237.53; and
213.18 	(3) contracting for the provision of TRS required by section 237.54.
213.19 	(b) All costs directly associated with the establishment of the program, the purchase and 
213.20 	distribution of telecommunications devices,and interconnectivity products, and the provision 
213.21 	of TRS are either reimbursable or directly payable from the fund after authorization by the 
213.22 	commissioner of commerce. The commissioner of commerce shall contract with one or 
213.23 	more TRS providers to indemnify the telecommunications service providers for any fines 
213.24 	imposed by the Federal Communications Commission related to the failure of the relay 
213.25 	service to comply with federal service standards. Notwithstanding section 16A.41, the 
213.26 	commissioner may advance money to the TRS providers if the providers establish to the 
213.27 	commissioner's satisfaction that the advance payment is necessary for the provision of the 
213.28 	service. The advance payment may be used only for working capital reserve for the operation 
213.29 	of the service. The advance payment must be offset or repaid by the end of the contract 
213.30 	fiscal year together with interest accrued from the date of payment.

213.31 	EFFECTIVE DATE. This section is effective July 1, 2019, and must be implemented 
213.32 	by October 1, 2019.

214.1 	Sec. 10. Minnesota Statutes 2018, section 237.53, is amended to read:
214.2 	237.53 TELECOMMUNICATIONS DEVICE DEVICES AND 
214.3 	INTERCONNECTIVITY PRODUCTS.
214.4 		Subdivision 1.Application. A person applying for a telecommunications device or 
214.5 	interconnectivity product under this section must apply to the program administrator on a 
214.6 	form prescribed by the Department of Human Services.
214.7 		Subd. 2.Eligibility. To be eligible to obtain a telecommunications device or 
214.8 	interconnectivity product under this section, a person must:
214.9 	(1) be able to benefit from and use the equipment for its intended purpose;
214.10 	(2) have a communication disability;
214.11 	(3) be a resident of the state;
214.12 	(4) be a resident in a household that has a median income at or below the applicable 
214.13 	median household income in the state, except a person who is deafblind applying for a 
214.14 	Braille device may reside in a household that has a median income no more than 150 percent 
214.15 	of the applicable median household income in the state; and
214.16 	(5) be a resident in a household that has telecommunications service or that has made 
214.17 	application for service and has been assigned a telephone number; or a resident in a residential 
214.18 	care facility, such as a nursing home or group home where telecommunications service is 
214.19 	not included as part of overall service provision.
214.20 		Subd. 2a.Assessment of needs. After a person is determined to be eligible for the 
214.21 	program, the commissioner of human services shall assess the person's telecommunications 
214.22 	needs to determine: (1) the type of telecommunications device that provides the person with 
214.23 	functionally equivalent access to telecommunications services; and (2) appropriate 
214.24 	interconnectivity products for the person.
214.25 		Subd. 3.Distribution. The commissioner of human services shall (1) purchase and 
214.26 	distribute a sufficient number of telecommunications devices and interconnectivity products
214.27 	so that each eligible household receives appropriate devices and products as determined 
214.28 	under section 237.51, subdivision 5a. The commissioner of human services shall, and (2)
214.29 	distribute the devices and products to eligible households free of charge.
214.30 		Subd. 4.Training; information; maintenance. The commissioner of human services 
214.31 	shall maintain the telecommunications devices and interconnectivity products until the 
214.32 	warranty period expires, and provide training, without charge, to first-time users of the 
215.1 	devices. and products. The commissioner shall provide information about assistive 
215.2 	communications devices and products that may benefit a program participant and about 
215.3 	where a person may obtain or purchase assistive communications devices and products. 
215.4 	Assistive communications devices and products include a pocket talker for a person who 
215.5 	is hard-of-hearing, a communication board for a person with a speech disability, a one-to-one 
215.6 	video communication application for a person who is deaf, and other devices and products 
215.7 	designed to facilitate effective communication for a person with a communication disability.
215.8 		Subd. 6.Ownership. Telecommunications devices and interconnectivity products
215.9 	purchased pursuant to subdivision 3, clause (1), are the property of the state of Minnesota. 
215.10 	Policies and procedures for the return of distributed devices from individuals who withdraw 
215.11 	from the program or whose eligibility status changes and products shall be determined by 
215.12 	the commissioner of human services.
215.13 		Subd. 7.Standards. The telecommunications devices distributed under this section must 
215.14 	comply with the electronic industries alliance standards and be approved by the Federal 
215.15 	Communications Commission. The commissioner of human services must provide each 
215.16 	eligible person a choice of several models of devices, the retail value of which may not 
215.17 	exceed $600 for a text telephone, and a retail value of $7,000 for a Braille device, or an 
215.18 	amount authorized by the Department of Human Services for all other telecommunications 
215.19 	devices and, auxiliary equipment, and interconnectivity products it deems cost-effective 
215.20 	and appropriate to distribute according to sections 237.51 to 237.56.
215.21 		Subd. 9.Discounted telecommunications or Internet services assistance. The 
215.22 	commissioner of human services shall assist a person who is applying for telecommunication 
215.23 	devices and products in applying for discounted telecommunications or Internet services.

215.24 	EFFECTIVE DATE. This section is effective July 1, 2019, and must be implemented 
215.25 	by October 1, 2019.

215.26 	Sec. 11. Minnesota Statutes 2018, section 245D.03, subdivision 1, is amended to read:
215.27 		Subdivision 1.Applicability. (a) The commissioner shall regulate the provision of home 
215.28 	and community-based services to persons with disabilities and persons age 65 and older 
215.29 	pursuant to this chapter. The licensing standards in this chapter govern the provision of 
215.30 	basic support services and intensive support services.
215.31 	(b) Basic support services provide the level of assistance, supervision, and care that is 
215.32 	necessary to ensure the health and welfare of the person and do not include services that 
216.1 	are specifically directed toward the training, treatment, habilitation, or rehabilitation of the 
216.2 	person. Basic support services include:
216.3 	(1) in-home and out-of-home respite care services as defined in section 245A.02, 
216.4 	subdivision 15, and under the brain injury, community alternative care, community access 
216.5 	for disability inclusion, developmental disability disabilities, and elderly waiver plans, 
216.6 	excluding out-of-home respite care provided to children in a family child foster care home 
216.7 	licensed under Minnesota Rules, parts 2960.3000 to 2960.3100, when the child foster care 
216.8 	license holder complies with the requirements under section 245D.06, subdivisions 5, 6, 7, 
216.9 	and 8, or successor provisions; and section 245D.061 or successor provisions, which must 
216.10 	be stipulated in the statement of intended use required under Minnesota Rules, part 
216.11 	2960.3000, subpart 4;
216.12 	(2) adult companion services as defined under the brain injury, community access for 
216.13 	disability inclusion, community alternative care, and elderly waiver plans, excluding adult 
216.14 	companion services provided under the Corporation for National and Community Services 
216.15 	Senior Companion Program established under the Domestic Volunteer Service Act of 1973, 
216.16 	Public Law 98-288;
216.17 	(3) personal support as defined under the developmental disability disabilities waiver 
216.18 	plan;
216.19 	(4) 24-hour emergency assistance, personal emergency response as defined under the 
216.20 	community access for disability inclusion and developmental disability disabilities waiver 
216.21 	plans;
216.22 	(5) night supervision services as defined under the brain injury, community access for 
216.23 	disability inclusion, community alternative care, and developmental disabilities waiver plan
216.24 	plans;
216.25 	(6) homemaker services as defined under the community access for disability inclusion, 
216.26 	brain injury, community alternative care, developmental disability disabilities, and elderly 
216.27 	waiver plans, excluding providers licensed by the Department of Health under chapter 144A 
216.28 	and those providers providing cleaning services only; and
216.29 	(7) individual community living support under section 256B.0915, subdivision 3j.; and
216.30 	(8) individualized home supports services as defined under the brain injury, community 
216.31 	alternative care, and community access for disability inclusion, and developmental disability 
216.32 	waiver plans.
217.1 	(c) Intensive support services provide assistance, supervision, and care that is necessary 
217.2 	to ensure the health and welfare of the person and services specifically directed toward the 
217.3 	training, habilitation, or rehabilitation of the person. Intensive support services include:
217.4 	(1) intervention services, including:
217.5 	(i) behavioral positive support services as defined under the brain injury and community 
217.6 	access for disability inclusion, community alternative care, and developmental disabilities
217.7 	waiver plans;
217.8 	(ii) in-home or out-of-home crisis respite services as defined under the brain injury, 
217.9 	community access for disability inclusion, community alternative care, and developmental 
217.10 	disability disabilities waiver plan plans; and
217.11 	(iii) specialist services as defined under the current brain injury, community access for 
217.12 	disability inclusion, community alternative care, and developmental disability disabilities
217.13 	waiver plan plans;
217.14 	(2) in-home support services, including:
217.15 	(i) in-home family support and supported living services as defined under the 
217.16 	developmental disability disabilities waiver plan;
217.17 	(ii) independent living services training as defined under the brain injury and community 
217.18 	access for disability inclusion waiver plans;
217.19 	(iii) semi-independent living services; and
217.20 	(iv) individualized home supports services as defined under the brain injury, community 
217.21 	alternative care, and community access for disability inclusion waiver plans;
217.22 	(iv) individualized home support with training services as defined under the brain injury, 
217.23 	community alternative care, community access for disability inclusion, and developmental 
217.24 	disability waiver plans; and
217.25 	(v) individualized home support with family training services as defined under the brain 
217.26 	injury, community alternative care, community access for disability inclusion, and 
217.27 	developmental disability waiver plans;
217.28 	(3) residential supports and services, including:
217.29 	(i) supported living services as defined under the developmental disability disabilities
217.30 	waiver plan provided in a family or corporate child foster care residence, a family adult 
217.31 	foster care residence, a community residential setting, or a supervised living facility;
218.1 	(ii) foster care services as defined in the brain injury, community alternative care, and 
218.2 	community access for disability inclusion waiver plans provided in a family or corporate 
218.3 	child foster care residence, a family adult foster care residence, or a community residential 
218.4 	setting; and
218.5 	(iii) community residential services as defined under the brain injury, community 
218.6 	alternative care, community access for disability inclusion, and developmental disability 
218.7 	waiver plans provided in a corporate child foster care residence, a community residential 
218.8 	setting, or a supervised living facility;
218.9 	(iv) family residential services as defined in the brain injury, community alternative 
218.10 	care, community access for disability inclusion, and developmental disability waiver plans 
218.11 	provided in a family child foster care residence or a family adult foster care residence; and
218.12 	(v) residential services provided to more than four persons with developmental disabilities 
218.13 	in a supervised living facility, including ICFs/DD;
218.14 	(4) day services, including:
218.15 	(i) structured day services as defined under the brain injury waiver plan;
218.16 	(ii) day services under sections 252.41 to 252.46, and as defined under the brain injury, 
218.17 	community alternative care, community access for disability inclusion, and developmental 
218.18 	disability waiver plans;
218.19 	(iii) day training and habilitation services under sections 252.41 to 252.46, and as defined 
218.20 	under the developmental disability disabilities waiver plan; and
218.21 	(iii) (iv) prevocational services as defined under the brain injury and, community 
218.22 	alternative care, community access for disability inclusion, and developmental disability
218.23 	waiver plans; and
218.24 	(5) employment exploration services as defined under the brain injury, community 
218.25 	alternative care, community access for disability inclusion, and developmental disability
218.26 	disabilities waiver plans;
218.27 	(6) employment development services as defined under the brain injury, community 
218.28 	alternative care, community access for disability inclusion, and developmental disability
218.29 	disabilities waiver plans; and
218.30 	(7) employment support services as defined under the brain injury, community alternative 
218.31 	care, community access for disability inclusion, and developmental disability disabilities
218.32 	waiver plans.; and
219.1 	(8) integrated community support as defined under the brain injury and community 
219.2 	access for disability inclusion waiver plans beginning January 1, 2021, and community 
219.3 	alternative care and developmental disability waiver plans beginning January 1, 2023.

219.4 	EFFECTIVE DATE. This section is effective January 1, 2021, or upon federal approval, 
219.5 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
219.6 	when federal approval is obtained.

219.7 	Sec. 12. Minnesota Statutes 2018, section 245D.071, subdivision 1, is amended to read:
219.8 		Subdivision 1.Requirements for intensive support services.  Except for services 
219.9 	identified in section 245D.03, subdivision 1, paragraph (c), clauses (1) and (2), item (ii), a 
219.10 	license holder providing intensive support services identified in section 245D.03, subdivision 
219.11 	1, paragraph (c), must comply with the requirements in this section and section 245D.07, 
219.12 	subdivisions 1, 1a, and 3. Services identified in section 245D.03, subdivision 1, paragraph 
219.13 	(c), clauses (1) and (2), item (ii), must comply with the requirements in section 245D.07, 
219.14 	subdivision 2.

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

219.16 	Sec. 13. Minnesota Statutes 2018, section 245D.071, subdivision 5, is amended to read:
219.17 		Subd. 5.Service plan review and evaluation. (a) The license holder must give the 
219.18 	person or the person's legal representative and case manager an opportunity to participate 
219.19 	in the ongoing review and development of the service plan and the methods used to support 
219.20 	the person and accomplish outcomes identified in subdivisions 3 and 4. At least once per 
219.21 	year, or within 30 days of a written request by the person, the person's legal representative, 
219.22 	or the case manager, the license holder, in coordination with the person's support team or 
219.23 	expanded support team, must meet with the person, the person's legal representative, and 
219.24 	the case manager, and participate in service plan review meetings following stated timelines 
219.25 	established in the person's coordinated service and support plan or coordinated service and 
219.26 	support plan addendum or within 30 days of a written request by the person, the person's 
219.27 	legal representative, or the case manager, at a minimum of once per year. The purpose of 
219.28 	the service plan review is to determine whether changes are needed to the service plan based 
219.29 	on the assessment information, the license holder's evaluation of progress towards 
219.30 	accomplishing outcomes, or other information provided by the support team or expanded 
219.31 	support team.
219.32 	(b) At least once per year, the license holder, in coordination with the person's support 
219.33 	team or expanded support team, must meet with the person, the person's legal representative, 
220.1 	and the case manager to discuss how technology might be used to meet the person's desired 
220.2 	outcomes. The coordinated service and support plan addendum must include a summary of 
220.3 	this discussion. The summary must include a statement regarding any decision made related 
220.4 	to the use of technology and a description of any further research that must be completed 
220.5 	before a decision regarding the use of technology can be made. Nothing in this paragraph 
220.6 	requires the coordinated service and support plan addendum to include the use of technology 
220.7 	for the provision of services.
220.8 	(b) (c) The license holder must summarize the person's status and progress toward 
220.9 	achieving the identified outcomes and make recommendations and identify the rationale 
220.10 	for changing, continuing, or discontinuing implementation of supports and methods identified 
220.11 	in subdivision 4 in a report available at the time of the progress review meeting. The report 
220.12 	must be sent at least five working days prior to the progress review meeting if requested by 
220.13 	the team in the coordinated service and support plan or coordinated service and support 
220.14 	plan addendum.
220.15 	(c) (d) The license holder must send the coordinated service and support plan addendum 
220.16 	to the person, the person's legal representative, and the case manager by mail within ten 
220.17 	working days of the progress review meeting. Within ten working days of the mailing of 
220.18 	the coordinated service and support plan addendum, the license holder must obtain dated 
220.19 	signatures from the person or the person's legal representative and the case manager to 
220.20 	document approval of any changes to the coordinated service and support plan addendum.
220.21 	(d) (e) If, within ten working days of submitting changes to the coordinated service and 
220.22 	support plan and coordinated service and support plan addendum, the person or the person's 
220.23 	legal representative or case manager has not signed and returned to the license holder the 
220.24 	coordinated service and support plan or coordinated service and support plan addendum or 
220.25 	has not proposed written modifications to the license holder's submission, the submission 
220.26 	is deemed approved and the coordinated service and support plan addendum becomes 
220.27 	effective and remains in effect until the legal representative or case manager submits a 
220.28 	written request to revise the coordinated service and support plan addendum.

220.29 	Sec. 14. Minnesota Statutes 2018, section 245D.09, subdivision 5, is amended to read:
220.30 		Subd. 5.Annual training.  A license holder must provide annual training to direct support 
220.31 	staff on the topics identified in subdivision 4, clauses (3) to (10). If the direct support staff 
220.32 	has a first aid certification, annual training under subdivision 4, clause (9), is not required 
220.33 	as long as the certification remains current. A license holder must provide a minimum of 
220.34 	24 hours of annual training to direct service staff providing intensive services and having 
221.1 	fewer than five years of documented experience and 12 hours of annual training to direct 
221.2 	service staff providing intensive services and having five or more years of documented 
221.3 	experience in topics described in subdivisions 4 and 4a, paragraphs (a) to (f). Training on 
221.4 	relevant topics received from sources other than the license holder may count toward training 
221.5 	requirements. A license holder must provide a minimum of 12 hours of annual training to 
221.6 	direct service staff providing basic services and having fewer than five years of documented 
221.7 	experience and six hours of annual training to direct service staff providing basic services 
221.8 	and having five or more years of documented experience.

221.9 	Sec. 15. Minnesota Statutes 2018, section 245D.09, subdivision 5a, is amended to read:
221.10 		Subd. 5a.Alternative sources of training. The commissioner may approve online 
221.11 	training and competency-based assessments in place of a specific number of hours of training 
221.12 	in the topics covered in subdivision 4. The commissioner must provide a list of preapproved 
221.13 	trainings that do not need approval for each individual license holder.
221.14 	Orientation or training received by the staff person from sources other than the license 
221.15 	holder in the same subjects as identified in subdivision 4 may count toward the orientation 
221.16 	and annual training requirements if received in the 12-month period before the staff person's 
221.17 	date of hire. The license holder must maintain documentation of the training received from 
221.18 	other sources and of each staff person's competency in the required area according to the 
221.19 	requirements in subdivision 3.

221.20 	Sec. 16. Minnesota Statutes 2018, section 245D.091, subdivision 2, is amended to read:
221.21 		Subd. 2.Behavior Positive support professional qualifications. A behavior positive 
221.22 	support professional providing behavioral positive support services as identified in section 
221.23 	245D.03, subdivision 1, paragraph (c), clause (1), item (i), must have competencies in the 
221.24 	following areas as required under the brain injury and, community access for disability 
221.25 	inclusion, community alternative care, and developmental disabilities waiver plans or 
221.26 	successor plans:
221.27 	(1) ethical considerations;
221.28 	(2) functional assessment;
221.29 	(3) functional analysis;
221.30 	(4) measurement of behavior and interpretation of data;
221.31 	(5) selecting intervention outcomes and strategies;
222.1 	(6) behavior reduction and elimination strategies that promote least restrictive approved 
222.2 	alternatives;
222.3 	(7) data collection;
222.4 	(8) staff and caregiver training;
222.5 	(9) support plan monitoring;
222.6 	(10) co-occurring mental disorders or neurocognitive disorder;
222.7 	(11) demonstrated expertise with populations being served; and
222.8 	(12) must be a:
222.9 	(i) psychologist licensed under sections 148.88 to 148.98, who has stated to the Board 
222.10 	of Psychology competencies in the above identified areas;
222.11 	(ii) clinical social worker licensed as an independent clinical social worker under chapter 
222.12 	148D, or a person with a master's degree in social work from an accredited college or 
222.13 	university, with at least 4,000 hours of post-master's supervised experience in the delivery 
222.14 	of clinical services in the areas identified in clauses (1) to (11);
222.15 	(iii) physician licensed under chapter 147 and certified by the American Board of 
222.16 	Psychiatry and Neurology or eligible for board certification in psychiatry with competencies 
222.17 	in the areas identified in clauses (1) to (11);
222.18 	(iv) licensed professional clinical counselor licensed under sections 148B.29 to 148B.39
222.19 	with at least 4,000 hours of post-master's supervised experience in the delivery of clinical 
222.20 	services who has demonstrated competencies in the areas identified in clauses (1) to (11);
222.21 	(v) person with a master's degree from an accredited college or university in one of the 
222.22 	behavioral sciences or related fields, with at least 4,000 hours of post-master's supervised 
222.23 	experience in the delivery of clinical services with demonstrated competencies in the areas 
222.24 	identified in clauses (1) to (11); or
222.25 	(vi) person with a master's degree or PhD in one of the behavioral sciences or related 
222.26 	fields with demonstrated expertise in positive support services, as determined by the person's 
222.27 	needs as outlined in the person's community support plan; or
222.28 	(vii) registered nurse who is licensed under sections 148.171 to 148.285, and who is 
222.29 	certified as a clinical specialist or as a nurse practitioner in adult or family psychiatric and 
222.30 	mental health nursing by a national nurse certification organization, or who has a master's 
222.31 	degree in nursing or one of the behavioral sciences or related fields from an accredited 
223.1 	college or university or its equivalent, with at least 4,000 hours of post-master's supervised 
223.2 	experience in the delivery of clinical services.

223.3 	Sec. 17. Minnesota Statutes 2018, section 245D.091, subdivision 3, is amended to read:
223.4 		Subd. 3.Behavior Positive support analyst qualifications. (a) A behavior positive 
223.5 	support analyst providing behavioral positive support services as identified in section 
223.6 	245D.03, subdivision 1, paragraph (c), clause (1), item (i), must have competencies in the 
223.7 	following areas as required under the brain injury and, community access for disability 
223.8 	inclusion, community alternative care, and developmental disabilities waiver plans or 
223.9 	successor plans:
223.10 	(1) have obtained a baccalaureate degree, master's degree, or PhD in a social services 
223.11 	discipline; or
223.12 	(2) meet the qualifications of a mental health practitioner as defined in section 245.462, 
223.13 	subdivision 17; or
223.14 	(3) be a board-certified behavior analyst or board-certified assistant behavior analyst by 
223.15 	the Behavior Analyst Certification Board, Incorporated.
223.16 	(b) In addition, a behavior positive support analyst must:
223.17 	(1) have four years of supervised experience working with individuals who exhibit 
223.18 	challenging behaviors as well as co-occurring mental disorders or neurocognitive disorder
223.19 	conducting functional behavior assessments and designing, implementing, and evaluating 
223.20 	effectiveness of positive practices behavior support strategies for people who exhibit 
223.21 	challenging behaviors as well as co-occurring mental disorders and neurocognitive disorder;
223.22 	(2) have received ten hours of instruction in functional assessment and functional analysis;
223.23 	training prior to hire or within 90 calendar days of hire that includes:
223.24 	(i) ten hours of instruction in functional assessment and functional analysis;
223.25 	(ii) 20 hours of instruction in the understanding of the function of behavior;
223.26 	(iii) ten hours of instruction on design of positive practices behavior support strategies;
223.27 	(iv) 20 hours of instruction preparing written intervention strategies, designing data 
223.28 	collection protocols, training other staff to implement positive practice strategies, 
223.29 	summarizing and reporting program evaluation data, analyzing program evaluation data to 
223.30 	identify design flaws in behavioral interventions or failures in implementation fidelity, and 
223.31 	recommending enhancements based on evaluation data; and
224.1 	(v) eight hours of instruction on principles of person-centered thinking;
224.2 	(3) have received 20 hours of instruction in the understanding of the function of behavior;
224.3 	(4) have received ten hours of instruction on design of positive practices behavior support 
224.4 	strategies;
224.5 	(5) have received 20 hours of instruction on the use of behavior reduction approved 
224.6 	strategies used only in combination with behavior positive practices strategies;
224.7 	(6) (3) be determined by a behavior positive support professional to have the training 
224.8 	and prerequisite skills required to provide positive practice strategies as well as behavior 
224.9 	reduction approved and permitted intervention to the person who receives behavioral positive
224.10 	support; and
224.11 	(7) (4) be under the direct supervision of a behavior positive support professional.
224.12 	(c) Meeting the qualifications for a positive support professional under subdivision 2 
224.13 	shall substitute for meeting the qualifications listed in paragraph (b).

224.14 	Sec. 18. Minnesota Statutes 2018, section 245D.091, subdivision 4, is amended to read:
224.15 		Subd. 4.Behavior Positive support specialist qualifications. (a) A behavior positive 
224.16 	support specialist providing behavioral positive support services as identified in section 
224.17 	245D.03, subdivision 1, paragraph (c), clause (1), item (i), must have competencies in the 
224.18 	following areas as required under the brain injury and, community access for disability 
224.19 	inclusion, community alternative care, and developmental disabilities waiver plans or 
224.20 	successor plans:
224.21 	(1) have an associate's degree in a social services discipline; or
224.22 	(2) have two years of supervised experience working with individuals who exhibit 
224.23 	challenging behaviors as well as co-occurring mental disorders or neurocognitive disorder.
224.24 	(b) In addition, a behavior specialist must:
224.25 	(1) have received training prior to hire or within 90 calendar days of hire that includes:
224.26 	(i) a minimum of four hours of training in functional assessment;
224.27 	(2) have received (ii) 20 hours of instruction in the understanding of the function of 
224.28 	behavior;
224.29 	(3) have received (iii) ten hours of instruction on design of positive practices behavioral 
224.30 	support strategies; and
225.1 	(iv) eight hours of instruction on principles of person-centered thinking;
225.2 	(4) (2) be determined by a behavior positive support professional to have the training 
225.3 	and prerequisite skills required to provide positive practices strategies as well as behavior 
225.4 	reduction approved intervention to the person who receives behavioral positive support; 
225.5 	and
225.6 	(5) (3) be under the direct supervision of a behavior positive support professional.
225.7 	(c) Meeting the qualifications for a positive support professional under subdivision 2 
225.8 	shall substitute for meeting the qualifications listed in paragraphs (a) and (b).

225.9 	Sec. 19. [245D.12] INTEGRATED COMMUNITY SUPPORTS; SETTING 
225.10 	CAPACITY REPORT.
225.11 	(a) The license holder providing integrated community support, as defined in section 
225.12 	245D.03, subdivision 1, paragraph (c), clause (8), must submit a setting capacity report to 
225.13 	the commissioner to ensure the identified location of service delivery meets the criteria of 
225.14 	the home and community-based service requirements as specified in section 256B.492.
225.15 	(b) The license holder shall provide the setting capacity report on the forms and in the 
225.16 	manner prescribed by the commissioner. The report must include:
225.17 	(1) the address of the multifamily housing building where the license holder delivers 
225.18 	integrated community supports and owns, leases, or has a direct or indirect financial 
225.19 	relationship with the property owner;
225.20 	(2) the total number of living units in the multifamily housing building described in 
225.21 	clause (1) where integrated community supports are delivered;
225.22 	(3) the total number of living units in the multifamily housing building described in 
225.23 	clause (1), including the living units identified in clause (2); and
225.24 	(4) the percentage of living units that are controlled by the license holder in the 
225.25 	multifamily housing building by dividing clause (2) by clause (3).
225.26 	(c) Only one license holder may deliver integrated community supports at the address 
225.27 	of the multifamily housing building.

225.28 	EFFECTIVE DATE. This section is effective upon the date of federal approval. The 
225.29 	commissioner of human services shall notify the revisor of statutes when federal approval 
225.30 	is obtained.

226.1 	Sec. 20. Minnesota Statutes 2018, section 252.27, subdivision 2a, is amended to read:
226.2 		Subd. 2a.Contribution amount. (a) The natural or adoptive parents of a minor child, 
226.3 	including a child determined eligible for medical assistance without consideration of parental 
226.4 	income, must contribute to the cost of services used by making monthly payments on a 
226.5 	sliding scale based on income, unless the child is married or has been married, parental 
226.6 	rights have been terminated, or the child's adoption is subsidized according to chapter 259A 
226.7 	or through title IV-E of the Social Security Act. The parental contribution is a partial or full 
226.8 	payment for medical services provided for diagnostic, therapeutic, curing, treating, mitigating, 
226.9 	rehabilitation, maintenance, and personal care services as defined in United States Code, 
226.10 	title 26, section 213, needed by the child with a chronic illness or disability.
226.11 	(b) For households with adjusted gross income equal to or greater than 275 percent of 
226.12 	federal poverty guidelines, the parental contribution shall be computed by applying the 
226.13 	following schedule of rates to the adjusted gross income of the natural or adoptive parents:
226.14 	(1) if the adjusted gross income is equal to or greater than 275 percent of federal poverty 
226.15 	guidelines and less than or equal to 545 percent of federal poverty guidelines, the parental 
226.16 	contribution shall be determined using a sliding fee scale established by the commissioner 
226.17 	of human services which begins at 1.94 1.65 percent of adjusted gross income at 275 percent 
226.18 	of federal poverty guidelines and increases to 5.29 4.5 percent of adjusted gross income for 
226.19 	those with adjusted gross income up to 545 percent of federal poverty guidelines;
226.20 	(2) if the adjusted gross income is greater than 545 percent of federal poverty guidelines 
226.21 	and less than 675 percent of federal poverty guidelines, the parental contribution shall be 
226.22 	5.29 4.5 percent of adjusted gross income;
226.23 	(3) if the adjusted gross income is equal to or greater than 675 percent of federal poverty 
226.24 	guidelines and less than 975 percent of federal poverty guidelines, the parental contribution 
226.25 	shall be determined using a sliding fee scale established by the commissioner of human 
226.26 	services which begins at 5.29 4.5 percent of adjusted gross income at 675 percent of federal 
226.27 	poverty guidelines and increases to 7.05 5.99 percent of adjusted gross income for those 
226.28 	with adjusted gross income up to 975 percent of federal poverty guidelines; and
226.29 	(4) if the adjusted gross income is equal to or greater than 975 percent of federal poverty 
226.30 	guidelines, the parental contribution shall be 8.81 7.49 percent of adjusted gross income.
226.31 	If the child lives with the parent, the annual adjusted gross income is reduced by $2,400 
226.32 	prior to calculating the parental contribution. If the child resides in an institution specified 
226.33 	in section 256B.35, the parent is responsible for the personal needs allowance specified 
226.34 	under that section in addition to the parental contribution determined under this section. 
227.1 	The parental contribution is reduced by any amount required to be paid directly to the child 
227.2 	pursuant to a court order, but only if actually paid.
227.3 	(c) The household size to be used in determining the amount of contribution under 
227.4 	paragraph (b) includes natural and adoptive parents and their dependents, including the 
227.5 	child receiving services. Adjustments in the contribution amount due to annual changes in 
227.6 	the federal poverty guidelines shall be implemented on the first day of July following 
227.7 	publication of the changes.
227.8 	(d) For purposes of paragraph (b), "income" means the adjusted gross income of the 
227.9 	natural or adoptive parents determined according to the previous year's federal tax form, 
227.10 	except, effective retroactive to July 1, 2003, taxable capital gains to the extent the funds 
227.11 	have been used to purchase a home shall not be counted as income.
227.12 	(e) The contribution shall be explained in writing to the parents at the time eligibility 
227.13 	for services is being determined. The contribution shall be made on a monthly basis effective 
227.14 	with the first month in which the child receives services. Annually upon redetermination 
227.15 	or at termination of eligibility, if the contribution exceeded the cost of services provided, 
227.16 	the local agency or the state shall reimburse that excess amount to the parents, either by 
227.17 	direct reimbursement if the parent is no longer required to pay a contribution, or by a 
227.18 	reduction in or waiver of parental fees until the excess amount is exhausted. All 
227.19 	reimbursements must include a notice that the amount reimbursed may be taxable income 
227.20 	if the parent paid for the parent's fees through an employer's health care flexible spending 
227.21 	account under the Internal Revenue Code, section 125, and that the parent is responsible 
227.22 	for paying the taxes owed on the amount reimbursed.
227.23 	(f) The monthly contribution amount must be reviewed at least every 12 months; when 
227.24 	there is a change in household size; and when there is a loss of or gain in income from one 
227.25 	month to another in excess of ten percent. The local agency shall mail a written notice 30 
227.26 	days in advance of the effective date of a change in the contribution amount. A decrease in 
227.27 	the contribution amount is effective in the month that the parent verifies a reduction in 
227.28 	income or change in household size.
227.29 	(g) Parents of a minor child who do not live with each other shall each pay the 
227.30 	contribution required under paragraph (a). An amount equal to the annual court-ordered 
227.31 	child support payment actually paid on behalf of the child receiving services shall be deducted 
227.32 	from the adjusted gross income of the parent making the payment prior to calculating the 
227.33 	parental contribution under paragraph (b).
228.1 	(h) The contribution under paragraph (b) shall be increased by an additional five percent 
228.2 	if the local agency determines that insurance coverage is available but not obtained for the 
228.3 	child. For purposes of this section, "available" means the insurance is a benefit of employment 
228.4 	for a family member at an annual cost of no more than five percent of the family's annual 
228.5 	income. For purposes of this section, "insurance" means health and accident insurance 
228.6 	coverage, enrollment in a nonprofit health service plan, health maintenance organization, 
228.7 	self-insured plan, or preferred provider organization.
228.8 	Parents who have more than one child receiving services shall not be required to pay 
228.9 	more than the amount for the child with the highest expenditures. There shall be no resource 
228.10 	contribution from the parents. The parent shall not be required to pay a contribution in 
228.11 	excess of the cost of the services provided to the child, not counting payments made to 
228.12 	school districts for education-related services. Notice of an increase in fee payment must 
228.13 	be given at least 30 days before the increased fee is due.
228.14 	(i) The contribution under paragraph (b) shall be reduced by $300 per fiscal year if, in 
228.15 	the 12 months prior to July 1:
228.16 	(1) the parent applied for insurance for the child;
228.17 	(2) the insurer denied insurance;
228.18 	(3) the parents submitted a complaint or appeal, in writing to the insurer, submitted a 
228.19 	complaint or appeal, in writing, to the commissioner of health or the commissioner of 
228.20 	commerce, or litigated the complaint or appeal; and
228.21 	(4) as a result of the dispute, the insurer reversed its decision and granted insurance.
228.22 	For purposes of this section, "insurance" has the meaning given in paragraph (h).
228.23 	A parent who has requested a reduction in the contribution amount under this paragraph 
228.24 	shall submit proof in the form and manner prescribed by the commissioner or county agency, 
228.25 	including, but not limited to, the insurer's denial of insurance, the written letter or complaint 
228.26 	of the parents, court documents, and the written response of the insurer approving insurance. 
228.27 	The determinations of the commissioner or county agency under this paragraph are not rules 
228.28 	subject to chapter 14.

228.29 	Sec. 21. Minnesota Statutes 2018, section 252.275, subdivision 3, is amended to read:
228.30 		Subd. 3.Reimbursement. Counties shall be reimbursed for all expenditures made 
228.31 	pursuant to subdivision 1 at a rate of 7085 percent, up to the allocation determined pursuant 
228.32 	to subdivisions 4 and 4b. However, the commissioner shall not reimburse costs of services 
229.1 	for any person if the costs exceed the state share of the average medical assistance costs for 
229.2 	services provided by intermediate care facilities for a person with a developmental disability 
229.3 	for the same fiscal year, and shall not reimburse costs of a onetime living allowance for any 
229.4 	person if the costs exceed $1,500 in a state fiscal year. The commissioner may make 
229.5 	payments to each county in quarterly installments. The commissioner may certify an advance 
229.6 	of up to 25 percent of the allocation. Subsequent payments shall be made on a reimbursement 
229.7 	basis for reported expenditures and may be adjusted for anticipated spending patterns.

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

229.9 	Sec. 22. Minnesota Statutes 2018, section 252.32, subdivision 1a, is amended to read:
229.10 		Subd. 1a.Support grants. (a) Provision of support grants must be limited to families 
229.11 	who require support and whose dependents are under the age of 21 25 and who have been 
229.12 	certified disabled as persons with disabilities under section 256B.055, subdivision 12, 
229.13 	paragraphs (a), (b), (c), (d), and (e). Families who are receiving: home and community-based 
229.14 	waivered services for persons with disabilities authorized under section 256B.092 or 256B.49; 
229.15 	personal care assistance under section 256B.0652; or a consumer support grant under section 
229.16 	256.476 are not eligible for support grants.
229.17 	New grant allocations, beginning July 1, 2019, are intended to support families with 
229.18 	dependents age 14 through 24 to support transition-related activities.
229.19 	Families whose annual adjusted gross income is $60,000 or more are not eligible for 
229.20 	support grants except in cases where extreme hardship is demonstrated. Beginning in state 
229.21 	fiscal year 1994, the commissioner shall adjust the income ceiling annually to reflect the 
229.22 	projected change in the average value in the United States Department of Labor Bureau of 
229.23 	Labor Statistics Consumer Price Index (all urban) for that year.
229.24 	(b) Support grants may be made available as monthly subsidy grants and lump-sum 
229.25 	grants.
229.26 	(c) Support grants may be issued in the form of cash, voucher, and direct county payment 
229.27 	to a vendor.
229.28 	(d) Applications for the support grant shall be made by the legal guardian to the county 
229.29 	social service agency. The application shall specify the needs of the families, the form of 
229.30 	the grant requested by the families, and the items and services to be reimbursed.

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

230.1 	Sec. 23. Minnesota Statutes 2018, section 252.41, subdivision 3, is amended to read:
230.2 		Subd. 3.Day training and habilitation services for adults with developmental
230.3 	disabilities. (a) "Day training and habilitation services for adults with developmental
230.4 	disabilities" means services that:
230.5 	(1) include supervision, training, assistance, support, center-based facility-based
230.6 	work-related activities, or other community-integrated activities designed and implemented 
230.7 	in accordance with the individual service and individual habilitation plans coordinated 
230.8 	service and support plan and coordinated service and support plan addendum required under
230.9 	sections 245D.02, subdivision 4, paragraphs (b) and (c), and 256B.092, subdivision 1b, and
230.10 	Minnesota Rules, parts part9525.0004to 9525.0036, subpart 12, to help an adult reach and 
230.11 	maintain the highest possible level of independence, productivity, and integration into the 
230.12 	community; and
230.13 	(2) include day support services, prevocational services, day training and habilitation 
230.14 	services, structured day services, and adult day services as defined in Minnesota's federally 
230.15 	approved disability waiver plans; and
230.16 	(3) are provided by a vendor licensed under sections 245A.01 to 245A.16and, 245D.27 
230.17 	to 245D.31,252.28, subdivision 2, or 252.41 to 252.46, or Minnesota Rules, parts 9525.1200 
230.18 	to 9525.1330, to provide day training and habilitation services.
230.19 	(b) Day training and habilitation services reimbursable under this section do not include 
230.20 	special education and related services as defined in the Education of the Individuals with 
230.21 	Disabilities Act, United States Code, title 20, chapter 33, section 1401, clauses (6) and (17), 
230.22 	or vocational services funded under section 110 of the Rehabilitation Act of 1973, United 
230.23 	States Code, title 29, section 720, as amended.
230.24 	(c) Day training and habilitation services do not include employment exploration, 
230.25 	employment development, or employment support services as defined in the home and 
230.26 	community-based services waivers for people with disabilities authorized under sections 
230.27 	256B.092 and 256B.49.

230.28 	EFFECTIVE DATE. This section is effective January 1, 2021, or upon federal approval, 
230.29 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
230.30 	when federal approval is obtained.

230.31 	Sec. 24. Minnesota Statutes 2018, section 252.41, subdivision 4, is amended to read:
230.32 		Subd. 4.Independence. "Independence" means the extent to which persons with 
230.33 	developmental disabilities exert control and choice over their own lives.

231.1 	EFFECTIVE DATE. This section is effective January 1, 2021.

231.2 	Sec. 25. Minnesota Statutes 2018, section 252.41, subdivision 5, is amended to read:
231.3 		Subd. 5.Integration. "Integration" means that persons with developmental disabilities:
231.4 	(1) use the same community resources that are used by and available to individuals who 
231.5 	are not disabled;
231.6 	(2) participate in the same community activities in which nondisabled individuals 
231.7 	participate; and
231.8 	(3) regularly interact and have contact with nondisabled individuals.

231.9 	EFFECTIVE DATE. This section is effective January 1, 2021.

231.10 	Sec. 26. Minnesota Statutes 2018, section 252.41, subdivision 6, is amended to read:
231.11 		Subd. 6.Productivity. "Productivity" means that persons with developmental disabilities:
231.12 	(1) engage in income-producing work designed to improve their income level, 
231.13 	employment status, or job advancement; or
231.14 	(2) engage in activities that contribute to a business, household, or community.

231.15 	EFFECTIVE DATE. This section is effective January 1, 2021.

231.16 	Sec. 27. Minnesota Statutes 2018, section 252.41, subdivision 7, is amended to read:
231.17 		Subd. 7.Regional center. "Regional center" means any state-operated facility under 
231.18 	the direct administrative authority of the commissioner that serves persons with 
231.19 	developmental disabilities.

231.20 	EFFECTIVE DATE. This section is effective January 1, 2021.

231.21 	Sec. 28. Minnesota Statutes 2018, section 252.41, subdivision 9, is amended to read:
231.22 		Subd. 9.Vendor. "Vendor" means a nonprofit legal entity that:
231.23 	(1) is licensed under sections 245A.01 to 245A.16and, 245D.27 to 245D.31,252.28, 
231.24 	subdivision 2, and 252.41 to 252.46, and Minnesota Rules, parts 9525.1200 to 9525.1330,
231.25 	to provide day training and habilitation services to adults with developmental disabilities; 
231.26 	and
231.27 	(2) does not have a financial interest in the legal entity that provides residential services 
231.28 	to the same person or persons to whom it provides day training and habilitation services. 
232.1 	This clause does not apply to regional treatment centers, state-operated, community-based 
232.2 	programs operating according to section 252.50 until July 1, 2000, or vendors licensed prior 
232.3 	to April 15, 1983.

232.4 	EFFECTIVE DATE. This section is effective January 1, 2021.

232.5 	Sec. 29. Minnesota Statutes 2018, section 252.42, is amended to read:
232.6 	252.42 SERVICE PRINCIPLES.
232.7 	The design and delivery of services eligible for reimbursement should reflect the 
232.8 	following principles:
232.9 	(1) services must suit a person's chronological age and be provided in the least restrictive 
232.10 	environment possible, consistent with the needs identified in the person's individual service 
232.11 	and individual habilitation plans under coordinated service and support plan and coordinated 
232.12 	service and support plan addendum required under sections 256B.092, subdivision 1b, and 
232.13 	245D.02, subdivision 4, paragraphs (b) and (c), and Minnesota Rules, parts 9525.0004to 
232.14 	9525.0036, subpart 12;
232.15 	(2) a person with a developmental disability whose individual service and individual 
232.16 	habilitation plans coordinated service and support plans and coordinated service and support 
232.17 	plan addendums authorize employment or employment-related activities shall be given the 
232.18 	opportunity to participate in employment and employment-related activities in which 
232.19 	nondisabled persons participate;
232.20 	(3) a person with a developmental disability participating in work shall be paid wages 
232.21 	commensurate with the rate for comparable work and productivity except as regional centers 
232.22 	are governed by section 246.151;
232.23 	(4) a person with a developmental disability shall receive services which include services 
232.24 	offered in settings used by the general public and designed to increase the person's active 
232.25 	participation in ordinary community activities;
232.26 	(5) a person with a developmental disability shall participate in the patterns, conditions, 
232.27 	and rhythms of everyday living and working that are consistent with the norms of the 
232.28 	mainstream of society.

232.29 	EFFECTIVE DATE. This section is effective January 1, 2021.

233.1 	Sec. 30. Minnesota Statutes 2018, section 252.43, is amended to read:
233.2 	252.43 COMMISSIONER'S DUTIES.
233.3 	The commissioner shall supervise county boards' lead agencies' provision of day training 
233.4 	and habilitation services to adults with developmental disabilities. The commissioner shall:
233.5 	(1) determine the need for day training and habilitation services under section 252.28
233.6 	256B.4914;
233.7 	(2) establish payment rates as provided under section 256B.4914;
233.8 	(3) adopt rules for the administration and provision of day training and habilitation
233.9 	services under sections 252.41 to 252.46 and sections 245A.01 to 245A.16and,252.28, 
233.10 	subdivision 2, or 252.41 to 252.46, or Minnesota Rules, parts 9525.1200 to 9525.1330;
233.11 	(4) enter into interagency agreements necessary to ensure effective coordination and 
233.12 	provision of day training and habilitation services;
233.13 	(5) monitor and evaluate the costs and effectiveness of day training and habilitation
233.14 	services; and
233.15 	(6) provide information and technical help to county boards lead agencies and vendors 
233.16 	in their administration and provision of day training and habilitation services.

233.17 	EFFECTIVE DATE. This section is effective January 1, 2021.

233.18 	Sec. 31. Minnesota Statutes 2018, section 252.44, is amended to read:
233.19 	252.44 COUNTY LEAD AGENCY BOARD RESPONSIBILITIES.
233.20 	When the need for day training and habilitation services in a county or tribe has been 
233.21 	determined under section 252.28, the board of commissioners for that county lead agency
233.22 	shall:
233.23 	(1) authorize the delivery of services according to the individual service and habilitation 
233.24 	plans coordinated service and support plans and coordinated service and support plan 
233.25 	addendums required as part of the county's lead agency's provision of case management 
233.26 	services under sections 256B.0913, subdivision 8; 256B.0915, subdivision 6; 256B.092, 
233.27 	subdivision 1b; and 256B.49, subdivision 15, and Minnesota Rules, parts 9525.0004 to 
233.28 	9525.0036. For calendar years for which section 252.46, subdivisions 2 to 10, apply, the 
233.29 	county board shall not authorize a change in service days from the number of days authorized 
233.30 	for the previous calendar year unless there is documentation for the change in the individual 
233.31 	service plan. An increase in service days must also be supported by documentation that the 
234.1 	goals and objectives assigned to the vendor cannot be met more economically and effectively 
234.2 	by other available community services and that without the additional days of service the 
234.3 	individual service plan could not be implemented in a manner consistent with the service 
234.4 	principles in section 252.42;
234.5 	(2) ensure that transportation is provided or arranged by the vendor in the most efficient 
234.6 	and reasonable way possible; and
234.7 	(3) monitor and evaluate the cost and effectiveness of the services.

234.8 	EFFECTIVE DATE. This section is effective January 1, 2021.

234.9 	Sec. 32. Minnesota Statutes 2018, section 252.45, is amended to read:
234.10 	252.45 VENDOR'S DUTIES.
234.11 	A day service vendor enrolled with the commissioner is responsible for items under 
234.12 	clauses (1), (2), and (3), and extends only to the provision of services that are reimbursable 
234.13 	under state and federal law. A vendor providing day training and habilitation services shall:
234.14 	(1) provide the amount and type of services authorized in the individual service plan 
234.15 	under coordinated service and support plan and coordinated service and support plan 
234.16 	addendum required under sections 245D.02, subdivision 4, paragraphs (b) and (c), and 
234.17 	256B.092, subdivision 1b, and Minnesota Rules, parts part9525.0004to 9525.0036, subpart 
234.18 	12;
234.19 	(2) design the services to achieve the outcomes assigned to the vendor in the individual 
234.20 	service plan coordinated service and support plan and coordinated service and support plan 
234.21 	addendum required under sections 245D.02, subdivision 4, paragraphs (a) and (b), and 
234.22 	256B.092, subdivision 1b, and Minnesota Rules, part 9525.0004, subpart 12;
234.23 	(3) provide or arrange for transportation of persons receiving services to and from service 
234.24 	sites;
234.25 	(4) enter into agreements with community-based intermediate care facilities for persons 
234.26 	with developmental disabilities to ensure compliance with applicable federal regulations; 
234.27 	and
234.28 	(5) comply with state and federal law.

234.29 	EFFECTIVE DATE. This section is effective January 1, 2021.

235.1 	Sec. 33. Minnesota Statutes 2018, section 256.9365, is amended to read:
235.2 	256.9365 PURCHASE OF CONTINUATION HEALTH CARE COVERAGE FOR 
235.3 	AIDS PATIENTS PEOPLE LIVING WITH HIV.
235.4 		Subdivision 1.Program established. The commissioner of human services shall establish 
235.5 	a program to pay private the cost of health plan premiums and cost sharing for prescriptions, 
235.6 	including co-payments, deductibles, and coinsurance for persons who have contracted human 
235.7 	immunodeficiency virus (HIV) to enable them to continue coverage under or enroll in a 
235.8 	group or individual health plan. If a person is determined to be eligible under subdivision 
235.9 	2, the commissioner shall pay the portion of the group plan premium for which the individual 
235.10 	is responsible, if the individual is responsible for at least 50 percent of the cost of the 
235.11 	premium, or pay the individual plan premium health insurance premiums and prescription 
235.12 	cost sharing, including co-payments and deductibles required under section 256B.0631. 
235.13 	The commissioner shall not pay for that portion of a premium that is attributable to other 
235.14 	family members or dependents or is paid by the individual's employer.
235.15 		Subd. 2.Eligibility requirements. To be eligible for the program, an applicant must 
235.16 	satisfy the following requirements: meet all eligibility requirements for Part B of the Ryan 
235.17 	White HIV/AIDS Treatment Extension Act of 2009, Public Law 111-87, and enroll in the 
235.18 	Minnesota Ryan White program.
235.19 	(1) the applicant must provide a physician's, advanced practice registered nurse's, or 
235.20 	physician assistant's statement verifying that the applicant is infected with HIV and is, or 
235.21 	within three months is likely to become, too ill to work in the applicant's current employment 
235.22 	because of HIV-related disease;
235.23 	(2) the applicant's monthly gross family income must not exceed 300 percent of the 
235.24 	federal poverty guidelines, after deducting medical expenses and insurance premiums;
235.25 	(3) the applicant must not own assets with a combined value of more than $25,000; and
235.26 	(4) if applying for payment of group plan premiums, the applicant must be covered by 
235.27 	an employer's or former employer's group insurance plan.
235.28 		Subd. 3.Cost-effective coverage. Requirements for the payment of individual plan 
235.29 	premiums under subdivision 2, clause (5), this section must be designed to ensure that the 
235.30 	state cost of paying an individual plan premium does not exceed the estimated state cost 
235.31 	that would otherwise be incurred in the medical assistance program. The commissioner 
235.32 	shall purchase the most cost-effective coverage available for eligible individuals.

236.1 	Sec. 34. Minnesota Statutes 2018, section 256B.0658, is amended to read:
236.2 	256B.0658 HOUSING ACCESS GRANTS.
236.3 	The commissioner of human services shall award through a competitive process contracts 
236.4 	for grants to public and private agencies to support and assist individuals eligible for publicly 
236.5 	funded home and community-based services, including state plan home care with a disability 
236.6 	as defined in section 256B.051, subdivision 2, paragraph (e), to access housing. Grants may 
236.7 	be awarded to agencies that may include, but are not limited to, the following supports: 
236.8 	assessment to ensure suitability of housing, accompanying an individual to look at housing, 
236.9 	filling out applications and rental agreements, meeting with landlords, helping with Section 
236.10 	8 or other program applications, helping to develop a budget, obtaining furniture and 
236.11 	household goods, if necessary, and assisting with any problems that may arise with housing.

236.12 	Sec. 35. Minnesota Statutes 2018, section 256B.0659, subdivision 3a, is amended to read:
236.13 		Subd. 3a.Assessment; defined. (a) "Assessment" means a review and evaluation of a 
236.14 	recipient's need for personal care assistance services conducted in person. Assessments for 
236.15 	personal care assistance services shall be conducted by the county public health nurse or a 
236.16 	certified public health nurse under contract with the county except when a long-term care 
236.17 	consultation assessment is being conducted for the purposes of determining a person's 
236.18 	eligibility for home and community-based waiver services including personal care assistance 
236.19 	services according to section 256B.0911. During the transition to MnCHOICES, a certified 
236.20 	assessor may complete the assessment defined in this subdivision. An in-person assessment 
236.21 	must include: documentation of health status, determination of need, evaluation of service 
236.22 	effectiveness, identification of appropriate services, service plan development or modification, 
236.23 	coordination of services, referrals and follow-up to appropriate payers and community 
236.24 	resources, completion of required reports, recommendation of service authorization, and 
236.25 	consumer education. Once the need for personal care assistance services is determined under 
236.26 	this section, the county public health nurse or certified public health nurse under contract 
236.27 	with the county is responsible for communicating this recommendation to the commissioner 
236.28 	and the recipient. An in-person assessment must occur at least annually or when there is a 
236.29 	significant change in the recipient's condition or when there is a change in the need for 
236.30 	personal care assistance services. A service update may substitute for the annual face-to-face 
236.31 	assessment when there is not a significant change in recipient condition or a change in the 
236.32 	need for personal care assistance service. A service update may be completed by telephone, 
236.33 	used when there is no need for an increase in personal care assistance services, and used 
236.34 	for two consecutive assessments if followed by a face-to-face assessment. A service update 
237.1 	must be completed on a form approved by the commissioner. A service update or review 
237.2 	for temporary increase includes a review of initial baseline data, evaluation of service 
237.3 	effectiveness, redetermination of service need, modification of service plan and appropriate 
237.4 	referrals, update of initial forms, obtaining service authorization, and on going consumer 
237.5 	education. Assessments or reassessments must be completed on forms provided by the 
237.6 	commissioner within 30 days of a request for home care services by a recipient or responsible 
237.7 	party.
237.8 	(b) This subdivision expires when notification is given by the commissioner as described 
237.9 	in section 256B.0911, subdivision 3a.

237.10 	Sec. 36. Minnesota Statutes 2018, section 256B.0659, subdivision 11, is amended to read:
237.11 		Subd. 11.Personal care assistant; requirements. (a) A personal care assistant must 
237.12 	meet the following requirements:
237.13 	(1) be at least 18 years of age with the exception of persons who are 16 or 17 years of 
237.14 	age with these additional requirements:
237.15 	(i) supervision by a qualified professional every 60 days; and
237.16 	(ii) employment by only one personal care assistance provider agency responsible for 
237.17 	compliance with current labor laws;
237.18 	(2) be employed by a personal care assistance provider agency;
237.19 	(3) enroll with the department as a personal care assistant after clearing a background 
237.20 	study. Except as provided in subdivision 11a, before a personal care assistant provides 
237.21 	services, the personal care assistance provider agency must initiate a background study on 
237.22 	the personal care assistant under chapter 245C, and the personal care assistance provider 
237.23 	agency must have received a notice from the commissioner that the personal care assistant 
237.24 	is:
237.25 	(i) not disqualified under section 245C.14; or
237.26 	(ii) is disqualified, but the personal care assistant has received a set aside of the 
237.27 	disqualification under section 245C.22;
237.28 	(4) be able to effectively communicate with the recipient and personal care assistance 
237.29 	provider agency;
237.30 	(5) be able to provide covered personal care assistance services according to the recipient's 
237.31 	personal care assistance care plan, respond appropriately to recipient needs, and report 
237.32 	changes in the recipient's condition to the supervising qualified professional or physician;
238.1 	(6) not be a consumer of personal care assistance services;
238.2 	(7) maintain daily written records including, but not limited to, time sheets under 
238.3 	subdivision 12;
238.4 	(8) effective January 1, 2010, complete standardized training as determined by the 
238.5 	commissioner before completing enrollment. The training must be available in languages 
238.6 	other than English and to those who need accommodations due to disabilities. Personal care 
238.7 	assistant training must include successful completion of the following training components: 
238.8 	basic first aid, vulnerable adult, child maltreatment, OSHA universal precautions, basic 
238.9 	roles and responsibilities of personal care assistants including information about assistance 
238.10 	with lifting and transfers for recipients, emergency preparedness, orientation to positive 
238.11 	behavioral practices, fraud issues, and completion of time sheets. Upon completion of the 
238.12 	training components, the personal care assistant must demonstrate the competency to provide 
238.13 	assistance to recipients;
238.14 	(9) complete training and orientation on the needs of the recipient; and
238.15 	(10) be limited to providing and being paid for up to 275 hours per month of personal 
238.16 	care assistance services regardless of the number of recipients being served or the number 
238.17 	of personal care assistance provider agencies enrolled with. The number of hours worked 
238.18 	per day shall not be disallowed by the department unless in violation of the law.
238.19 	(b) A legal guardian may be a personal care assistant if the guardian is not being paid 
238.20 	for the guardian services and meets the criteria for personal care assistants in paragraph (a).
238.21 	(c) Persons who do not qualify as a personal care assistant include parents, stepparents, 
238.22 	and legal guardians of minors; spouses; paid legal guardians of adults; family foster care 
238.23 	providers, except as otherwise allowed in section 256B.0625, subdivision 19a; and staff of 
238.24 	a residential setting.
238.25 	(d) Personal care assistance services qualify for the enhanced rate described in subdivision 
238.26 	17a if the personal care assistant providing the services:
238.27 	(1) provides covered services to a recipient who qualifies for 12 or more hours per day 
238.28 	of personal care assistance services; and
238.29 	(2) satisfies the current requirements of Medicare for training and competency or 
238.30 	competency evaluation of home health aides or nursing assistants, as provided in the Code 
238.31 	of Federal Regulations, title 42, section 483.151 or 484.36, or alternative state-approved 
238.32 	training or competency requirements.

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

239.1 	Sec. 37. Minnesota Statutes 2018, section 256B.0659, subdivision 13, is amended to read:
239.2 		Subd. 13.Qualified professional; qualifications. (a) The qualified professional must 
239.3 	work for a personal care assistance provider agency and, meet the definition of qualified 
239.4 	professional under section 256B.0625, subdivision 19c, and enroll with the department as 
239.5 	a qualified professional after clearing a background study. Before a qualified professional 
239.6 	provides services, the personal care assistance provider agency must initiate a background 
239.7 	study on the qualified professional under chapter 245C, and the personal care assistance 
239.8 	provider agency must have received a notice from the commissioner that the qualified 
239.9 	professional:
239.10 	(1) is not disqualified under section 245C.14; or
239.11 	(2) is disqualified, but the qualified professional has received a set aside of the 
239.12 	disqualification under section 245C.22.
239.13 	(b) The qualified professional shall perform the duties of training, supervision, and 
239.14 	evaluation of the personal care assistance staff and evaluation of the effectiveness of personal 
239.15 	care assistance services. The qualified professional shall:
239.16 	(1) develop and monitor with the recipient a personal care assistance care plan based on 
239.17 	the service plan and individualized needs of the recipient;
239.18 	(2) develop and monitor with the recipient a monthly plan for the use of personal care 
239.19 	assistance services;
239.20 	(3) review documentation of personal care assistance services provided;
239.21 	(4) provide training and ensure competency for the personal care assistant in the individual 
239.22 	needs of the recipient; and
239.23 	(5) document all training, communication, evaluations, and needed actions to improve 
239.24 	performance of the personal care assistants.
239.25 	(c) Effective July 1, 2011, the qualified professional shall complete the provider training 
239.26 	with basic information about the personal care assistance program approved by the 
239.27 	commissioner. Newly hired qualified professionals must complete the training within six 
239.28 	months of the date hired by a personal care assistance provider agency. Qualified 
239.29 	professionals who have completed the required training as a worker from a personal care 
239.30 	assistance provider agency do not need to repeat the required training if they are hired by 
239.31 	another agency, if they have completed the training within the last three years. The required 
239.32 	training must be available with meaningful access according to title VI of the Civil Rights 
239.33 	Act and federal regulations adopted under that law or any guidance from the United States 
240.1 	Health and Human Services Department. The required training must be available online or 
240.2 	by electronic remote connection. The required training must provide for competency testing 
240.3 	to demonstrate an understanding of the content without attending in-person training. A 
240.4 	qualified professional is allowed to be employed and is not subject to the training requirement 
240.5 	until the training is offered online or through remote electronic connection. A qualified 
240.6 	professional employed by a personal care assistance provider agency certified for 
240.7 	participation in Medicare as a home health agency is exempt from the training required in 
240.8 	this subdivision. When available, the qualified professional working for a Medicare-certified 
240.9 	home health agency must successfully complete the competency test. The commissioner 
240.10 	shall ensure there is a mechanism in place to verify the identity of persons completing the 
240.11 	competency testing electronically.

240.12 	Sec. 38. Minnesota Statutes 2018, section 256B.0659, is amended by adding a subdivision 
240.13 	to read:
240.14 		Subd. 17a.Enhanced rate. An enhanced rate of 107.5 percent of the rate paid for 
240.15 	personal care assistance services shall be paid for services provided to persons who qualify 
240.16 	for 12 or more hours of personal care assistance services per day when provided by a personal 
240.17 	care assistant who meets the requirements of subdivision 11, paragraph (d). The enhanced 
240.18 	rate for personal care assistance services includes, and is not in addition to, any rate 
240.19 	adjustments implemented by the commissioner on July 1, 2019, to comply with the terms 
240.20 	of a collective bargaining agreement between the state of Minnesota and an exclusive 
240.21 	representative of individual providers under section 179A.54, that provides for wage increases 
240.22 	for individual providers who serve participants assessed to need 12 or more hours of personal 
240.23 	care assistance services per day.

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

240.25 	Sec. 39. Minnesota Statutes 2018, section 256B.0659, subdivision 19, is amended to read:
240.26 		Subd. 19.Personal care assistance choice option; qualifications; duties. (a) Under 
240.27 	personal care assistance choice, the recipient or responsible party shall:
240.28 	(1) recruit, hire, schedule, and terminate personal care assistants according to the terms 
240.29 	of the written agreement required under subdivision 20, paragraph (a);
240.30 	(2) develop a personal care assistance care plan based on the assessed needs and 
240.31 	addressing the health and safety of the recipient with the assistance of a qualified professional 
240.32 	as needed;
241.1 	(3) orient and train the personal care assistant with assistance as needed from the qualified 
241.2 	professional;
241.3 	(4) effective January 1, 2010, supervise and evaluate the personal care assistant with the 
241.4 	qualified professional, who is required to visit the recipient at least every 180 days;
241.5 	(5) monitor and verify in writing and report to the personal care assistance choice agency 
241.6 	the number of hours worked by the personal care assistant and the qualified professional;
241.7 	(6) engage in an annual face-to-face reassessment to determine continuing eligibility 
241.8 	and service authorization; and
241.9 	(7) use the same personal care assistance choice provider agency if shared personal 
241.10 	assistance care is being used.
241.11 	(b) The personal care assistance choice provider agency shall:
241.12 	(1) meet all personal care assistance provider agency standards;
241.13 	(2) enter into a written agreement with the recipient, responsible party, and personal 
241.14 	care assistants;
241.15 	(3) not be related as a parent, child, sibling, or spouse to the recipient or the personal 
241.16 	care assistant; and
241.17 	(4) ensure arm's-length transactions without undue influence or coercion with the recipient 
241.18 	and personal care assistant.
241.19 	(c) The duties of the personal care assistance choice provider agency are to:
241.20 	(1) be the employer of the personal care assistant and the qualified professional for 
241.21 	employment law and related regulations including, but not limited to, purchasing and 
241.22 	maintaining workers' compensation, unemployment insurance, surety and fidelity bonds, 
241.23 	and liability insurance, and submit any or all necessary documentation including, but not 
241.24 	limited to, workers' compensation and, unemployment insurance, and labor market data 
241.25 	required under section 256B.4912, subdivision 1a;
241.26 	(2) bill the medical assistance program for personal care assistance services and qualified 
241.27 	professional services;
241.28 	(3) request and complete background studies that comply with the requirements for 
241.29 	personal care assistants and qualified professionals;
241.30 	(4) pay the personal care assistant and qualified professional based on actual hours of 
241.31 	services provided;
242.1 	(5) withhold and pay all applicable federal and state taxes;
242.2 	(6) verify and keep records of hours worked by the personal care assistant and qualified 
242.3 	professional;
242.4 	(7) make the arrangements and pay taxes and other benefits, if any, and comply with 
242.5 	any legal requirements for a Minnesota employer;
242.6 	(8) enroll in the medical assistance program as a personal care assistance choice agency; 
242.7 	and
242.8 	(9) enter into a written agreement as specified in subdivision 20 before services are 
242.9 	provided.

242.10 	Sec. 40. Minnesota Statutes 2018, section 256B.0659, subdivision 21, is amended to read:
242.11 		Subd. 21.Requirements for provider enrollment of personal care assistance provider 
242.12 	agencies. (a) All personal care assistance provider agencies must provide, at the time of 
242.13 	enrollment, reenrollment, and revalidation as a personal care assistance provider agency in 
242.14 	a format determined by the commissioner, information and documentation that includes, 
242.15 	but is not limited to, the following:
242.16 	(1) the personal care assistance provider agency's current contact information including 
242.17 	address, telephone number, and e-mail address;
242.18 	(2) proof of surety bond coverage. Upon new enrollment, or if the provider's Medicaid 
242.19 	revenue in the previous calendar year is up to and including $300,000, the provider agency 
242.20 	must purchase a surety bond of $50,000. If the Medicaid revenue in the previous year is 
242.21 	over $300,000, the provider agency must purchase a surety bond of $100,000. The surety 
242.22 	bond must be in a form approved by the commissioner, must be renewed annually, and must 
242.23 	allow for recovery of costs and fees in pursuing a claim on the bond;
242.24 	(3) proof of fidelity bond coverage in the amount of $20,000;
242.25 	(4) proof of workers' compensation insurance coverage;
242.26 	(5) proof of liability insurance;
242.27 	(6) a description of the personal care assistance provider agency's organization identifying 
242.28 	the names of all owners, managing employees, staff, board of directors, and the affiliations 
242.29 	of the directors, owners, or staff to other service providers;
242.30 	(7) a copy of the personal care assistance provider agency's written policies and 
242.31 	procedures including: hiring of employees; training requirements; service delivery; and 
243.1 	employee and consumer safety including process for notification and resolution of consumer 
243.2 	grievances, identification and prevention of communicable diseases, and employee 
243.3 	misconduct;
243.4 	(8) copies of all other forms the personal care assistance provider agency uses in the 
243.5 	course of daily business including, but not limited to:
243.6 	(i) a copy of the personal care assistance provider agency's time sheet if the time sheet 
243.7 	varies from the standard time sheet for personal care assistance services approved by the 
243.8 	commissioner, and a letter requesting approval of the personal care assistance provider 
243.9 	agency's nonstandard time sheet;
243.10 	(ii) the personal care assistance provider agency's template for the personal care assistance 
243.11 	care plan; and
243.12 	(iii) the personal care assistance provider agency's template for the written agreement 
243.13 	in subdivision 20 for recipients using the personal care assistance choice option, if applicable;
243.14 	(9) a list of all training and classes that the personal care assistance provider agency 
243.15 	requires of its staff providing personal care assistance services;
243.16 	(10) documentation that the personal care assistance provider agency and staff have 
243.17 	successfully completed all the training required by this section, including the requirements 
243.18 	under subdivision 11, paragraph (d), if enhanced personal care assistance services are 
243.19 	provided and submitted for an enhanced rate under subdivision 17a;
243.20 	(11) documentation of the agency's marketing practices;
243.21 	(12) disclosure of ownership, leasing, or management of all residential properties that 
243.22 	is used or could be used for providing home care services;
243.23 	(13) documentation that the agency will use the following percentages of revenue 
243.24 	generated from the medical assistance rate paid for personal care assistance services for 
243.25 	employee personal care assistant wages and benefits: 72.5 percent of revenue in the personal 
243.26 	care assistance choice option and 72.5 percent of revenue from other personal care assistance 
243.27 	providers. The revenue generated by the qualified professional and the reasonable costs 
243.28 	associated with the qualified professional shall not be used in making this calculation; and
243.29 	(14) effective May 15, 2010, documentation that the agency does not burden recipients' 
243.30 	free exercise of their right to choose service providers by requiring personal care assistants 
243.31 	to sign an agreement not to work with any particular personal care assistance recipient or 
243.32 	for another personal care assistance provider agency after leaving the agency and that the 
244.1 	agency is not taking action on any such agreements or requirements regardless of the date 
244.2 	signed.
244.3 	(b) Personal care assistance provider agencies shall provide the information specified 
244.4 	in paragraph (a) to the commissioner at the time the personal care assistance provider agency 
244.5 	enrolls as a vendor or upon request from the commissioner. The commissioner shall collect 
244.6 	the information specified in paragraph (a) from all personal care assistance providers 
244.7 	beginning July 1, 2009.
244.8 	(c) All personal care assistance provider agencies shall require all employees in 
244.9 	management and supervisory positions and owners of the agency who are active in the 
244.10 	day-to-day management and operations of the agency to complete mandatory training as 
244.11 	determined by the commissioner before enrollment of the agency as a provider. Employees 
244.12 	in management and supervisory positions and owners who are active in the day-to-day 
244.13 	operations of an agency who have completed the required training as an employee with a 
244.14 	personal care assistance provider agency do not need to repeat the required training if they 
244.15 	are hired by another agency, if they have completed the training within the past three years. 
244.16 	By September 1, 2010, the required training must be available with meaningful access 
244.17 	according to title VI of the Civil Rights Act and federal regulations adopted under that law 
244.18 	or any guidance from the United States Health and Human Services Department. The 
244.19 	required training must be available online or by electronic remote connection. The required 
244.20 	training must provide for competency testing. Personal care assistance provider agency 
244.21 	billing staff shall complete training about personal care assistance program financial 
244.22 	management. This training is effective July 1, 2009. Any personal care assistance provider 
244.23 	agency enrolled before that date shall, if it has not already, complete the provider training 
244.24 	within 18 months of July 1, 2009. Any new owners or employees in management and 
244.25 	supervisory positions involved in the day-to-day operations are required to complete 
244.26 	mandatory training as a requisite of working for the agency. Personal care assistance provider 
244.27 	agencies certified for participation in Medicare as home health agencies are exempt from 
244.28 	the training required in this subdivision. When available, Medicare-certified home health 
244.29 	agency owners, supervisors, or managers must successfully complete the competency test.

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

244.31 	Sec. 41. Minnesota Statutes 2018, section 256B.0659, subdivision 24, is amended to read:
244.32 		Subd. 24.Personal care assistance provider agency; general duties. A personal care 
244.33 	assistance provider agency shall:
245.1 	(1) enroll as a Medicaid provider meeting all provider standards, including completion 
245.2 	of the required provider training;
245.3 	(2) comply with general medical assistance coverage requirements;
245.4 	(3) demonstrate compliance with law and policies of the personal care assistance program 
245.5 	to be determined by the commissioner;
245.6 	(4) comply with background study requirements;
245.7 	(5) verify and keep records of hours worked by the personal care assistant and qualified 
245.8 	professional;
245.9 	(6) not engage in any agency-initiated direct contact or marketing in person, by phone, 
245.10 	or other electronic means to potential recipients, guardians, or family members;
245.11 	(7) pay the personal care assistant and qualified professional based on actual hours of 
245.12 	services provided;
245.13 	(8) withhold and pay all applicable federal and state taxes;
245.14 	(9) effective January 1, 2010, document that the agency uses a minimum of 72.5 percent 
245.15 	of the revenue generated by the medical assistance rate for personal care assistance services 
245.16 	for employee personal care assistant wages and benefits. The revenue generated by the 
245.17 	qualified professional and the reasonable costs associated with the qualified professional 
245.18 	shall not be used in making this calculation;
245.19 	(10) make the arrangements and pay unemployment insurance, taxes, workers' 
245.20 	compensation, liability insurance, and other benefits, if any;
245.21 	(11) enter into a written agreement under subdivision 20 before services are provided;
245.22 	(12) report suspected neglect and abuse to the common entry point according to section 
245.23 	256B.0651;
245.24 	(13) provide the recipient with a copy of the home care bill of rights at start of service; 
245.25 	and
245.26 	(14) request reassessments at least 60 days prior to the end of the current authorization 
245.27 	for personal care assistance services, on forms provided by the commissioner.;
245.28 	(15) comply with the labor market reporting requirements described in section 256B.4912, 
245.29 	subdivision 1a; and
246.1 	(16) document that the agency uses the additional revenue due to the enhanced rate under 
246.2 	subdivision 17a for the wages and benefits of the PCAs whose services meet the requirements 
246.3 	under subdivision 11, paragraph (d).

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

246.5 	Sec. 42. Minnesota Statutes 2018, section 256B.0659, subdivision 28, is amended to read:
246.6 		Subd. 28.Personal care assistance provider agency; required documentation. (a) 
246.7 	Required documentation must be completed and kept in the personal care assistance provider 
246.8 	agency file or the recipient's home residence. The required documentation consists of:
246.9 	(1) employee files, including:
246.10 	(i) applications for employment;
246.11 	(ii) background study requests and results;
246.12 	(iii) orientation records about the agency policies;
246.13 	(iv) trainings completed with demonstration of competence, including verification of 
246.14 	the completion of training required under subdivision 11, paragraph (d), if personal care 
246.15 	assistance services eligible for the enhanced rate are provided and submitted for 
246.16 	reimbursement under subdivision 17a;
246.17 	(v) supervisory visits;
246.18 	(vi) evaluations of employment; and
246.19 	(vii) signature on fraud statement;
246.20 	(2) recipient files, including:
246.21 	(i) demographics;
246.22 	(ii) emergency contact information and emergency backup plan;
246.23 	(iii) personal care assistance service plan;
246.24 	(iv) personal care assistance care plan;
246.25 	(v) month-to-month service use plan;
246.26 	(vi) all communication records;
246.27 	(vii) start of service information, including the written agreement with recipient; and
246.28 	(viii) date the home care bill of rights was given to the recipient;
246.29 	(3) agency policy manual, including:
247.1 	(i) policies for employment and termination;
247.2 	(ii) grievance policies with resolution of consumer grievances;
247.3 	(iii) staff and consumer safety;
247.4 	(iv) staff misconduct; and
247.5 	(v) staff hiring, service delivery, staff and consumer safety, staff misconduct, and 
247.6 	resolution of consumer grievances;
247.7 	(4) time sheets for each personal care assistant along with completed activity sheets for 
247.8 	each recipient served; and
247.9 	(5) agency marketing and advertising materials and documentation of marketing activities 
247.10 	and costs.
247.11 	(b) The commissioner may assess a fine of up to $500 on provider agencies that do not 
247.12 	consistently comply with the requirements of this subdivision.

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

247.14 	Sec. 43. Minnesota Statutes 2018, section 256B.0911, subdivision 1a, is amended to read:
247.15 		Subd. 1a.Definitions. For purposes of this section, the following definitions apply:
247.16 	(a) Until additional requirements apply under paragraph (b), "long-term care consultation 
247.17 	services" means:
247.18 	(1) intake for and access to assistance in identifying services needed to maintain an 
247.19 	individual in the most inclusive environment;
247.20 	(2) providing recommendations for and referrals to cost-effective community services 
247.21 	that are available to the individual;
247.22 	(3) development of an individual's person-centered community support plan;
247.23 	(4) providing information regarding eligibility for Minnesota health care programs;
247.24 	(5) face-to-face long-term care consultation assessments, which may be completed in a 
247.25 	hospital, nursing facility, intermediate care facility for persons with developmental disabilities 
247.26 	(ICF/DDs), regional treatment centers, or the person's current or planned residence;
247.27 	(6) determination of home and community-based waiver and other service eligibility as 
247.28 	required under sections 256B.0913, 256B.0915, 256B.092, and 256B.49, including level 
247.29 	of care determination for individuals who need an institutional level of care as determined 
247.30 	under subdivision 4e, based on assessment and community support plan development, 
248.1 	appropriate referrals to obtain necessary diagnostic information, and including an eligibility 
248.2 	determination for consumer-directed community supports;
248.3 	(7) providing recommendations for institutional placement when there are no 
248.4 	cost-effective community services available;
248.5 	(8) providing access to assistance to transition people back to community settings after 
248.6 	institutional admission; and
248.7 	(9) providing information about competitive employment, with or without supports, for 
248.8 	school-age youth and working-age adults and referrals to the Disability Linkage Line and 
248.9 	Disability Benefits 101 to ensure that an informed choice about competitive employment 
248.10 	can be made. For the purposes of this subdivision, "competitive employment" means work 
248.11 	in the competitive labor market that is performed on a full-time or part-time basis in an 
248.12 	integrated setting, and for which an individual is compensated at or above the minimum 
248.13 	wage, but not less than the customary wage and level of benefits paid by the employer for 
248.14 	the same or similar work performed by individuals without disabilities.
248.15 	(b) Upon statewide implementation of lead agency requirements in subdivisions 2b, 2c, 
248.16 	and 3a, "long-term care consultation services" also means:
248.17 	(1) service eligibility determination for state plan home care services identified in:
248.18 	(i) section 256B.0625, subdivisions 7, 19a, and 19c;
248.19 	(ii) consumer support grants under section 256.476; or
248.20 	(iii) section 256B.85;
248.21 	(2) notwithstanding provisions in Minnesota Rules, parts 9525.0004 to 9525.0024, 
248.22 	determination of eligibility for gaining access to case management services available under 
248.23 	sections 256B.0621, subdivision 2, paragraph clause (4), and256B.0924, and Minnesota 
248.24 	Rules, part 9525.0016;
248.25 	(3) determination of institutional level of care, home and community-based service 
248.26 	waiver, and other serviceof eligibility as required under section 256B.092, determination 
248.27 	of eligibility for family support grants under section 252.32,for semi-independent living 
248.28 	services under section 252.275, and day training and habilitation services under section 
248.29 	256B.092; and
248.30 	(4) obtaining necessary diagnostic information to determine eligibility under clauses (2) 
248.31 	and (3).
249.1 	(c) "Long-term care options counseling" means the services provided by the linkage 
249.2 	lines as mandated by sections 256.01, subdivision 24, and 256.975, subdivision 7, and also 
249.3 	includes telephone assistance and follow up once a long-term care consultation assessment 
249.4 	has been completed.
249.5 	(d) "Minnesota health care programs" means the medical assistance program under this 
249.6 	chapter and the alternative care program under section 256B.0913.
249.7 	(e) "Lead agencies" means counties administering or tribes and health plans under 
249.8 	contract with the commissioner to administer long-term care consultation assessment and 
249.9 	support planning services.
249.10 	(f) "Person-centered planning" is a process that includes the active participation of a 
249.11 	person in the planning of the person's services, including in making meaningful and informed 
249.12 	choices about the person's own goals, talents, and objectives, as well as making meaningful 
249.13 	and informed choices about the services the person receives. For the purposes of this section, 
249.14 	"informed choice" means a voluntary choice of services by a person from all available 
249.15 	service options based on accurate and complete information concerning all available service 
249.16 	options and concerning the person's own preferences, abilities, goals, and objectives. In 
249.17 	order for a person to make an informed choice, all available options must be developed and 
249.18 	presented to the person to empower the person to make decisions.

249.19 	Sec. 44. Minnesota Statutes 2018, section 256B.0911, subdivision 3a, is amended to read:
249.20 		Subd. 3a.Assessment and support planning. (a) Persons requesting assessment, services 
249.21 	planning, or other assistance intended to support community-based living, including persons 
249.22 	who need assessment in order to determine waiver or alternative care program eligibility, 
249.23 	must be visited by a long-term care consultation team within 20 calendar days after the date 
249.24 	on which an assessment was requested or recommended. Upon statewide implementation 
249.25 	of subdivisions 2b, 2c, and 5, this requirement also applies to an assessment of a person 
249.26 	requesting personal care assistance services and home care nursing. The commissioner shall 
249.27 	provide at least a 90-day notice to lead agencies prior to the effective date of this requirement. 
249.28 	Face-to-face assessments must be conducted according to paragraphs (b) to (i).
249.29 	(b) Upon implementation of subdivisions 2b, 2c, and 5, lead agencies shall use certified 
249.30 	assessors to conduct the assessment. For a person with complex health care needs, a public 
249.31 	health or registered nurse from the team must be consulted.
249.32 	(c) The MnCHOICES assessment provided by the commissioner to lead agencies must 
249.33 	be used to complete a comprehensive, conversation-based, person-centered assessment. 
250.1 	The assessment must include the health, psychological, functional, environmental, and 
250.2 	social needs of the individual necessary to develop a community support plan that meets 
250.3 	the individual's needs and preferences.
250.4 	(d) The assessment must be conducted in a face-to-face conversational interview with 
250.5 	the person being assessed and. The person's legal representative must provide input during 
250.6 	the assessment process and may do so remotely if requested. At the request of the person, 
250.7 	other individuals may participate in the assessment to provide information on the needs, 
250.8 	strengths, and preferences of the person necessary to develop a community support plan 
250.9 	that ensures the person's health and safety. Except for legal representatives or family members 
250.10 	invited by the person, persons participating in the assessment may not be a provider of 
250.11 	service or have any financial interest in the provision of services. For persons who are to 
250.12 	be assessed for elderly waiver customized living or adult day services under section 
250.13 	256B.0915, with the permission of the person being assessed or the person's designated or 
250.14 	legal representative, the client's current or proposed provider of services may submit a copy 
250.15 	of the provider's nursing assessment or written report outlining its recommendations regarding 
250.16 	the client's care needs. The person conducting the assessment must notify the provider of 
250.17 	the date by which this information is to be submitted. This information shall be provided 
250.18 	to the person conducting the assessment prior to the assessment. For a person who is to be 
250.19 	assessed for waiver services under section 256B.092 or 256B.49, with the permission of 
250.20 	the person being assessed or the person's designated legal representative, the person's current 
250.21 	provider of services may submit a written report outlining recommendations regarding the 
250.22 	person's care needs prepared by a direct service employee with at least 20 hours of service 
250.23 	to that client. The person conducting the assessment or reassessment must notify the provider 
250.24 	of the date by which this information is to be submitted. This information shall be provided 
250.25 	to the person conducting the assessment and the person or the person's legal representative, 
250.26 	and must be considered prior to the finalization of the assessment or reassessment the person 
250.27 	completed in consultation with someone who is known to the person and has interaction 
250.28 	with the person on a regular basis. The provider must submit the report at least 60 days 
250.29 	before the end of the person's current service agreement. The certified assessor must consider 
250.30 	the content of the submitted report prior to finalizing the person's assessment or reassessment.
250.31 	(e) The certified assessor and the individual responsible for developing the coordinated 
250.32 	service and support plan must complete the community support plan and the coordinated 
250.33 	service and support plan no more than 60 calendar days from the assessment visit. The 
250.34 	person or the person's legal representative must be provided with a written community 
250.35 	support plan within 40 calendar days of the assessment visit the timelines established by 
251.1 	the commissioner, regardless of whether the individualperson is eligible for Minnesota 
251.2 	health care programs.
251.3 	(f) For a person being assessed for elderly waiver services under section 256B.0915, a 
251.4 	provider who submitted information under paragraph (d) shall receive the final written 
251.5 	community support plan when available and the Residential Services Workbook.
251.6 	(g) The written community support plan must include:
251.7 	(1) a summary of assessed needs as defined in paragraphs (c) and (d);
251.8 	(2) the individual's options and choices to meet identified needs, including all available 
251.9 	options for case management services and providers, including service provided in a 
251.10 	non-disability-specific setting;
251.11 	(3) identification of health and safety risks and how those risks will be addressed, 
251.12 	including personal risk management strategies;
251.13 	(4) referral information; and
251.14 	(5) informal caregiver supports, if applicable.
251.15 	For a person determined eligible for state plan home care under subdivision 1a, paragraph 
251.16 	(b), clause (1), the person or person's representative must also receive a copy of the home 
251.17 	care service plan developed by the certified assessor.
251.18 	(h) A person may request assistance in identifying community supports without 
251.19 	participating in a complete assessment. Upon a request for assistance identifying community 
251.20 	support, the person must be transferred or referred to long-term care options counseling 
251.21 	services available under sections 256.975, subdivision 7, and 256.01, subdivision 24, for 
251.22 	telephone assistance and follow up.
251.23 	(i) The person has the right to make the final decision between institutional placement 
251.24 	and community placement after the recommendations have been provided, except as provided 
251.25 	in section 256.975, subdivision 7a, paragraph (d).
251.26 	(j) The lead agency must give the person receiving assessment or support planning, or 
251.27 	the person's legal representative, materials, and forms supplied by the commissioner 
251.28 	containing the following information:
251.29 	(1) written recommendations for community-based services and consumer-directed 
251.30 	options;
251.31 	(2) documentation that the most cost-effective alternatives available were offered to the 
251.32 	individual. For purposes of this clause, "cost-effective" means community services and 
252.1 	living arrangements that cost the same as or less than institutional care. For an individual 
252.2 	found to meet eligibility criteria for home and community-based service programs under 
252.3 	section 256B.0915 or 256B.49, "cost-effectiveness" has the meaning found in the federally 
252.4 	approved waiver plan for each program;
252.5 	(3) the need for and purpose of preadmission screening conducted by long-term care 
252.6 	options counselors according to section 256.975, subdivisions 7a to 7c, if the person selects 
252.7 	nursing facility placement. If the individual selects nursing facility placement, the lead 
252.8 	agency shall forward information needed to complete the level of care determinations and 
252.9 	screening for developmental disability and mental illness collected during the assessment 
252.10 	to the long-term care options counselor using forms provided by the commissioner;
252.11 	(4) the role of long-term care consultation assessment and support planning in eligibility 
252.12 	determination for waiver and alternative care programs, and state plan home care, case 
252.13 	management, and other services as defined in subdivision 1a, paragraphs (a), clause (6), 
252.14 	and (b);
252.15 	(5) information about Minnesota health care programs;
252.16 	(6) the person's freedom to accept or reject the recommendations of the team;
252.17 	(7) the person's right to confidentiality under the Minnesota Government Data Practices 
252.18 	Act, chapter 13;
252.19 	(8) the certified assessor's decision regarding the person's need for institutional level of 
252.20 	care as determined under criteria established in subdivision 4e and the certified assessor's 
252.21 	decision regarding eligibility for all services and programs as defined in subdivision 1a, 
252.22 	paragraphs (a), clause (6), and (b); and
252.23 	(9) the person's right to appeal the certified assessor's decision regarding eligibility for 
252.24 	all services and programs as defined in subdivision 1a, paragraphs (a), clauses (6), (7), and 
252.25 	(8), and (b), and incorporating the decision regarding the need for institutional level of care 
252.26 	or the lead agency's final decisions regarding public programs eligibility according to section 
252.27 	256.045, subdivision 3. The certified assessor must verbally communicate this appeal right 
252.28 	to the person and must visually point out where in the document the right to appeal is stated.
252.29 	(k) Face-to-face assessment completed as part of eligibility determination for the 
252.30 	alternative care, elderly waiver, developmental disabilities, community access for disability 
252.31 	inclusion, community alternative care, and brain injury waiver programs under sections 
252.32 	256B.0913, 256B.0915, 256B.092, and 256B.49 is valid to establish service eligibility for 
252.33 	no more than 60 calendar days after the date of assessment.
253.1 	(l) The effective eligibility start date for programs in paragraph (k) can never be prior 
253.2 	to the date of assessment. If an assessment was completed more than 60 days before the 
253.3 	effective waiver or alternative care program eligibility start date, assessment and support 
253.4 	plan information must be updated and documented in the department's Medicaid Management 
253.5 	Information System (MMIS). Notwithstanding retroactive medical assistance coverage of 
253.6 	state plan services, the effective date of eligibility for programs included in paragraph (k) 
253.7 	cannot be prior to the date the most recent updated assessment is completed.
253.8 	(m) If an eligibility update is completed within 90 days of the previous face-to-face 
253.9 	assessment and documented in the department's Medicaid Management Information System 
253.10 	(MMIS), the effective date of eligibility for programs included in paragraph (k) is the date 
253.11 	of the previous face-to-face assessment when all other eligibility requirements are met.
253.12 	(n) At the time of reassessment, the certified assessor shall assess each person receiving 
253.13 	waiver services currently residing in a community residential setting, or licensed adult foster 
253.14 	care home that is not the primary residence of the license holder, or in which the license 
253.15 	holder is not the primary caregiver, to determine if that person would prefer to be served in 
253.16 	a community-living setting as defined in section 256B.49, subdivision 23. The certified 
253.17 	assessor shall offer the person, through a person-centered planning process, the option to 
253.18 	receive alternative housing and service options.

253.19 	Sec. 45. Minnesota Statutes 2018, section 256B.0911, subdivision 3f, is amended to read:
253.20 		Subd. 3f.Long-term care reassessments and community support plan updates. (a) 
253.21 	Prior to a face-to-face reassessment, the certified assessor must review the person's most 
253.22 	recent assessment. Reassessments must be tailored using the professional judgment of the 
253.23 	assessor to the person's known needs, strengths, preferences, and circumstances. 
253.24 	Reassessments provide information to support the person's informed choice and opportunities 
253.25 	to express choice regarding activities that contribute to quality of life, as well as information 
253.26 	and opportunity to identify goals related to desired employment, community activities, and 
253.27 	preferred living environment. Reassessments allow forrequire a review of the most recent 
253.28 	assessment, review of the current coordinated service and support plan's effectiveness, 
253.29 	monitoring of services, and the development of an updated person-centered community 
253.30 	support plan. Reassessments verify continued eligibility or offer alternatives as warranted 
253.31 	and provide an opportunity for quality assurance of service delivery. Face-to-face assessments
253.32 	reassessments must be conducted annually or as required by federal and state laws and rules.
253.33 	For reassessments, the certified assessor and the individual responsible for developing the 
253.34 	coordinated service and support plan must ensure the continuity of care for the person 
254.1 	receiving services and complete the updated community support plan and the updated 
254.2 	coordinated service and support plan no more than 60 days from the reassessment visit.
254.3 	(b) The commissioner shall develop mechanisms for providers and case managers to 
254.4 	share information with the assessor to facilitate a reassessment and support planning process 
254.5 	tailored to the person's current needs and preferences.

254.6 	Sec. 46. Minnesota Statutes 2018, section 256B.0911, is amended by adding a subdivision 
254.7 	to read:
254.8 		Subd. 3g.Assessments for Rule 185 case management. Unless otherwise required by 
254.9 	federal law, the county agency is not required to conduct or arrange for an annual needs 
254.10 	reassessment by a certified assessor. The case manager who works on behalf of the person 
254.11 	to identify the person's needs and to minimize the impact of the disability on the person's 
254.12 	life must instead develop a person-centered service plan based on the person's assessed 
254.13 	needs and preferences. The person-centered service plan must be reviewed annually for 
254.14 	persons with developmental disabilities who are receiving only case management services 
254.15 	under Minnesota Rules, part 9525.0016, and who make an informed choice to decline an 
254.16 	assessment under this section.

254.17 	Sec. 47. Minnesota Statutes 2018, section 256B.0911, subdivision 5, is amended to read:
254.18 		Subd. 5.Administrative activity. (a) The commissioner shall streamline the processes, 
254.19 	including timelines for when assessments need to be completed, required to provide the 
254.20 	services in this section and shall implement integrated solutions to automate the business 
254.21 	processes to the extent necessary for community support plan approval, reimbursement, 
254.22 	program planning, evaluation, and policy development.
254.23 	(b) The commissioner of human services shall work with lead agencies responsible for 
254.24 	conducting long-term consultation services to modify the MnCHOICES application and 
254.25 	assessment policies to create efficiencies while ensuring federal compliance with medical 
254.26 	assistance and long-term services and supports eligibility criteria.
254.27 	(c) The commissioner shall work with lead agencies responsible for conducting long-term 
254.28 	consultation services to develop a set of measurable benchmarks sufficient to demonstrate 
254.29 	quarterly improvement in the average time per assessment and other mutually agreed upon 
254.30 	measures of increasing efficiency. The commissioner shall collect data on these benchmarks 
254.31 	and provide to the lead agencies and the chairs and ranking minority members of the 
254.32 	legislative committees with jurisdiction over human services an annual trend analysis of 
255.1 	the data in order to demonstrate the commissioner's compliance with the requirements of 
255.2 	this subdivision.

255.3 	Sec. 48. Minnesota Statutes 2018, section 256B.0915, subdivision 3a, is amended to read:
255.4 		Subd. 3a.Elderly waiver cost limits. (a) Effective on the first day of the state fiscal 
255.5 	year in which the resident assessment system as described in section 256R.17 for nursing 
255.6 	home rate determination is implemented and the first day of each subsequent state fiscal 
255.7 	year, the monthly limit for the cost of waivered services to an individual elderly waiver 
255.8 	client shall be the monthly limit of the case mix resident class to which the waiver client 
255.9 	would be assigned under Minnesota Rules, parts 9549.0051 to 9549.0059, in effect on the 
255.10 	last day of the previous state fiscal year, adjusted by any legislatively adopted home and 
255.11 	community-based services percentage rate adjustment. If a legislatively authorized increase 
255.12 	is service-specific, the monthly cost limit shall be adjusted based on the overall average 
255.13 	increase to the elderly waiver program.
255.14 	(b) The monthly limit for the cost of waivered services under paragraph (a) to an 
255.15 	individual elderly waiver client assigned to a case mix classification A with:
255.16 	(1) no dependencies in activities of daily living; or
255.17 	(2) up to two dependencies in bathing, dressing, grooming, walking, and eating when 
255.18 	the dependency score in eating is three or greater as determined by an assessment performed 
255.19 	under section 256B.0911 shall be $1,750 per month effective on July 1, 2011, for all new 
255.20 	participants enrolled in the program on or after July 1, 2011. This monthly limit shall be 
255.21 	applied to all other participants who meet this criteria at reassessment. This monthly limit 
255.22 	shall be increased annually as described in paragraphs (a) and (e).
255.23 	(c) If extended medical supplies and equipment or environmental modifications are or 
255.24 	will be purchased for an elderly waiver client, the costs may be prorated for up to 12 
255.25 	consecutive months beginning with the month of purchase. If the monthly cost of a recipient's 
255.26 	waivered services exceeds the monthly limit established in paragraph (a), (b), (d), or (e), 
255.27 	the annual cost of all waivered services shall be determined. In this event, the annual cost 
255.28 	of all waivered services shall not exceed 12 times the monthly limit of waivered services 
255.29 	as described in paragraph (a), (b), (d), or (e).
255.30 	(d) Effective July 1, 2013, the monthly cost limit of waiver services, including any 
255.31 	necessary home care services described in section 256B.0651, subdivision 2, for individuals 
255.32 	who meet the criteria as ventilator-dependent given in section 256B.0651, subdivision 1, 
255.33 	paragraph (g), shall be the average of the monthly medical assistance amount established 
256.1 	for home care services as described in section 256B.0652, subdivision 7, and the annual 
256.2 	average contracted amount established by the commissioner for nursing facility services 
256.3 	for ventilator-dependent individuals. This monthly limit shall be increased annually as 
256.4 	described in paragraphs (a) and (e).
256.5 	(e) Effective January 1, 2018, and each January 1 thereafter, the monthly cost limits for 
256.6 	elderly waiver services in effect on the previous December 31 shall be increased by the 
256.7 	difference between any legislatively adopted home and community-based provider rate 
256.8 	increases effective on January 1 or since the previous January 1 and the average statewide 
256.9 	percentage increase in nursing facility operating payment rates under chapter 256R, effective 
256.10 	the previous January 1. This paragraph shall only apply if the average statewide percentage 
256.11 	increase in nursing facility operating payment rates is greater than any legislatively adopted 
256.12 	home and community-based provider rate increases effective on January 1, or occurring 
256.13 	since the previous January 1.
256.14 	(f) The commissioner shall approve an exception to the monthly case mix budget cap 
256.15 	in paragraph (a) to account for the additional cost of providing enhanced rate personal care 
256.16 	assistance services under section 256B.0659 or 256B.85. The exception shall not exceed 
256.17 	107.5 percent of the budget otherwise available to the individual. The exception must be 
256.18 	reapproved on an annual basis at the time of a participant's annual reassessment.

256.19 	EFFECTIVE DATE. This section is effective July 1, 2019, or upon federal approval, 
256.20 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
256.21 	when federal approval is obtained.

256.22 	Sec. 49. Minnesota Statutes 2018, section 256B.0915, subdivision 6, is amended to read:
256.23 		Subd. 6.Implementation of coordinated service and support plan. (a) Each elderly 
256.24 	waiver client shall be provided a copy of a written coordinated service and support plan 
256.25 	which that:
256.26 	(1) is developed with and signed by the recipient within ten working days after the case 
256.27 	manager receives the assessment information and written community support plan as 
256.28 	described in section 256B.0911, subdivision 3a, from the certified assessor the timelines 
256.29 	established by the commissioner and section 256B.0911, subdivision 3a, paragraph (e);
256.30 	(2) includes the person's need for service and identification of service needs that will be 
256.31 	or that are met by the person's relatives, friends, and others, as well as community services 
256.32 	used by the general public;
256.33 	(3) reasonably ensures the health and welfare of the recipient;
257.1 	(4) identifies the person's preferences for services as stated by the person or the person's 
257.2 	legal guardian or conservator;
257.3 	(5) reflects the person's informed choice between institutional and community-based 
257.4 	services, as well as choice of services, supports, and providers, including available case 
257.5 	manager providers;
257.6 	(6) identifies long-range and short-range goals for the person;
257.7 	(7) identifies specific services and the amount, frequency, duration, and cost of the 
257.8 	services to be provided to the person based on assessed needs, preferences, and available 
257.9 	resources;
257.10 	(8) includes information about the right to appeal decisions under section 256.045; and
257.11 	(9) includes the authorized annual and estimated monthly amounts for the services.
257.12 	(b) In developing the coordinated service and support plan, the case manager should 
257.13 	also include the use of volunteers, religious organizations, social clubs, and civic and service 
257.14 	organizations to support the individual in the community. The lead agency must be held 
257.15 	harmless for damages or injuries sustained through the use of volunteers and agencies under 
257.16 	this paragraph, including workers' compensation liability.

257.17 	Sec. 50. Minnesota Statutes 2018, section 256B.092, subdivision 1b, is amended to read:
257.18 		Subd. 1b.Coordinated service and support plan. (a) Each recipient of home and 
257.19 	community-based waivered services shall be provided a copy of the written coordinated 
257.20 	service and support plan which that:
257.21 	(1) is developed with and signed by the recipient within ten working days after the case 
257.22 	manager receives the assessment information and written community support plan as 
257.23 	described in section 256B.0911, subdivision 3a, from the certified assessor the timelines 
257.24 	established by the commissioner and section 256B.0911, subdivision 3a, paragraph (e);
257.25 	(2) includes the person's need for service, including identification of service needs that 
257.26 	will be or that are met by the person's relatives, friends, and others, as well as community 
257.27 	services used by the general public;
257.28 	(3) reasonably ensures the health and welfare of the recipient;
257.29 	(4) identifies the person's preferences for services as stated by the person, the person's 
257.30 	legal guardian or conservator, or the parent if the person is a minor, including the person's 
257.31 	choices made on self-directed options and on services and supports to achieve employment 
257.32 	goals;
258.1 	(5) provides for an informed choice, as defined in section 256B.77, subdivision 2, 
258.2 	paragraph (o), of service and support providers, and identifies all available options for case 
258.3 	management services and providers;
258.4 	(6) identifies long-range and short-range goals for the person;
258.5 	(7) identifies specific services and the amount and frequency of the services to be provided 
258.6 	to the person based on assessed needs, preferences, and available resources. The coordinated 
258.7 	service and support plan shall also specify other services the person needs that are not 
258.8 	available;
258.9 	(8) identifies the need for an individual program plan to be developed by the provider 
258.10 	according to the respective state and federal licensing and certification standards, and 
258.11 	additional assessments to be completed or arranged by the provider after service initiation;
258.12 	(9) identifies provider responsibilities to implement and make recommendations for 
258.13 	modification to the coordinated service and support plan;
258.14 	(10) includes notice of the right to request a conciliation conference or a hearing under 
258.15 	section 256.045;
258.16 	(11) is agreed upon and signed by the person, the person's legal guardian or conservator, 
258.17 	or the parent if the person is a minor, and the authorized county representative;
258.18 	(12) is reviewed by a health professional if the person has overriding medical needs that 
258.19 	impact the delivery of services; and
258.20 	(13) includes the authorized annual and monthly amounts for the services.
258.21 	(b) In developing the coordinated service and support plan, the case manager is 
258.22 	encouraged to include the use of volunteers, religious organizations, social clubs, and civic 
258.23 	and service organizations to support the individual in the community. The lead agency must 
258.24 	be held harmless for damages or injuries sustained through the use of volunteers and agencies 
258.25 	under this paragraph, including workers' compensation liability.
258.26 	(c) Approved, written, and signed changes to a consumer's services that meet the criteria 
258.27 	in this subdivision shall be an addendum to that consumer's individual service plan.

259.1 	Sec. 51. Minnesota Statutes 2018, section 256B.0921, is amended to read:
259.2 	256B.0921 HOME AND COMMUNITY-BASED SERVICES INCENTIVE
259.3 	INNOVATION POOL.
259.4 	The commissioner of human services shall develop an initiative to provide incentives 
259.5 	for innovation in: (1) achieving integrated competitive employment; (2) achieving integrated 
259.6 	competitive employment for youth under age 25 upon their graduation from school; (3) 
259.7 	living in the most integrated setting; and (4) other outcomes determined by the commissioner. 
259.8 	The commissioner shall seek requests for proposals and shall contract with one or more 
259.9 	entities to provide incentive payments for meeting identified outcomes.

259.10 	Sec. 52. Minnesota Statutes 2018, section 256B.49, subdivision 13, is amended to read:
259.11 		Subd. 13.Case management. (a) Each recipient of a home and community-based waiver 
259.12 	shall be provided case management services by qualified vendors as described in the federally 
259.13 	approved waiver application. The case management service activities provided must include:
259.14 	(1) finalizing the written coordinated service and support plan within ten working days 
259.15 	after the case manager receives the plan from the certified assessor the timelines established 
259.16 	by the commissioner and section 256B.0911, subdivision 3a, paragraph (e);
259.17 	(2) informing the recipient or the recipient's legal guardian or conservator of service 
259.18 	options;
259.19 	(3) assisting the recipient in the identification of potential service providers and available 
259.20 	options for case management service and providers, including services provided in a 
259.21 	non-disability-specific setting;
259.22 	(4) assisting the recipient to access services and assisting with appeals under section 
259.23 	256.045; and
259.24 	(5) coordinating, evaluating, and monitoring of the services identified in the service 
259.25 	plan.
259.26 	(b) The case manager may delegate certain aspects of the case management service 
259.27 	activities to another individual provided there is oversight by the case manager. The case 
259.28 	manager may not delegate those aspects which require professional judgment including:
259.29 	(1) finalizing the coordinated service and support plan;
259.30 	(2) ongoing assessment and monitoring of the person's needs and adequacy of the 
259.31 	approved coordinated service and support plan; and
260.1 	(3) adjustments to the coordinated service and support plan.
260.2 	(c) Case management services must be provided by a public or private agency that is 
260.3 	enrolled as a medical assistance provider determined by the commissioner to meet all of 
260.4 	the requirements in the approved federal waiver plans. Case management services must not 
260.5 	be provided to a recipient by a private agency that has any financial interest in the provision 
260.6 	of any other services included in the recipient's coordinated service and support plan. For 
260.7 	purposes of this section, "private agency" means any agency that is not identified as a lead 
260.8 	agency under section 256B.0911, subdivision 1a, paragraph (e).
260.9 	(d) For persons who need a positive support transition plan as required in chapter 245D, 
260.10 	the case manager shall participate in the development and ongoing evaluation of the plan 
260.11 	with the expanded support team. At least quarterly, the case manager, in consultation with 
260.12 	the expanded support team, shall evaluate the effectiveness of the plan based on progress 
260.13 	evaluation data submitted by the licensed provider to the case manager. The evaluation must 
260.14 	identify whether the plan has been developed and implemented in a manner to achieve the 
260.15 	following within the required timelines:
260.16 	(1) phasing out the use of prohibited procedures;
260.17 	(2) acquisition of skills needed to eliminate the prohibited procedures within the plan's 
260.18 	timeline; and
260.19 	(3) accomplishment of identified outcomes.
260.20 	If adequate progress is not being made, the case manager shall consult with the person's 
260.21 	expanded support team to identify needed modifications and whether additional professional 
260.22 	support is required to provide consultation.

260.23 	Sec. 53. Minnesota Statutes 2018, section 256B.49, subdivision 14, is amended to read:
260.24 		Subd. 14.Assessment and reassessment. (a) Assessments and reassessments shall be 
260.25 	conducted by certified assessors according to section 256B.0911, subdivision 2b. The 
260.26 	certified assessor, with the permission of the recipient or the recipient's designated legal 
260.27 	representative, may invite other individuals to attend the assessment. With the permission 
260.28 	of the recipient or the recipient's designated legal representative, the recipient's current 
260.29 	provider of services may submit a written report outlining their recommendations regarding 
260.30 	the recipient's care needs prepared by a direct service employee with at least 20 hours of 
260.31 	service to that client. The certified assessor must notify the provider of the date by which 
260.32 	this information is to be submitted. This information shall be provided to the certified 
260.33 	assessor and the person or the person's legal representative and must be considered prior to 
261.1 	the finalization of the assessment or reassessment who is familiar with the person. The 
261.2 	provider must submit the report at least 60 days before the end of the person's current service 
261.3 	agreement. The certified assessor must consider the content of the submitted report prior 
261.4 	to finalizing the person's assessment or reassessment.
261.5 	(b) There must be a determination that the client requires a hospital level of care or a 
261.6 	nursing facility level of care as defined in section 256B.0911, subdivision 4e, at initial and 
261.7 	subsequent assessments to initiate and maintain participation in the waiver program.
261.8 	(c) Regardless of other assessments identified in section 144.0724, subdivision 4, as 
261.9 	appropriate to determine nursing facility level of care for purposes of medical assistance 
261.10 	payment for nursing facility services, only face-to-face assessments conducted according 
261.11 	to section 256B.0911, subdivisions 3a, 3b, and 4d, that result in a hospital level of care 
261.12 	determination or a nursing facility level of care determination must be accepted for purposes 
261.13 	of initial and ongoing access to waiver services payment.
261.14 	(d) Recipients who are found eligible for home and community-based services under 
261.15 	this section before their 65th birthday may remain eligible for these services after their 65th 
261.16 	birthday if they continue to meet all other eligibility factors.

261.17 	Sec. 54. Minnesota Statutes 2018, section 256B.4912, is amended by adding a subdivision 
261.18 	to read:
261.19 		Subd. 1a.Annual labor market reporting. (a) As determined by the commissioner, a 
261.20 	provider of home and community-based services for the elderly under sections 256B.0913 
261.21 	and 256B.0915, home and community-based services for people with developmental 
261.22 	disabilities under section 256B.092, and home and community-based services for people 
261.23 	with disabilities under section 256B.49 shall submit data to the commissioner on the 
261.24 	following:
261.25 	(1) number of direct-care staff;
261.26 	(2) wages of direct-care staff;
261.27 	(3) hours worked by direct-care staff;
261.28 	(4) overtime wages of direct-care staff;
261.29 	(5) overtime hours worked by direct-care staff;
261.30 	(6) benefits paid and accrued by direct-care staff;
261.31 	(7) direct-care staff retention rates;
262.1 	(8) direct-care staff job vacancies;
262.2 	(9) amount of travel time paid;
262.3 	(10) program vacancy rates; and
262.4 	(11) other related data requested by the commissioner.
262.5 	(b) The commissioner may adjust reporting requirements for a self-employed direct-care 
262.6 	staff.
262.7 	(c) For the purposes of this subdivision, "direct-care staff" means employees, including 
262.8 	self-employed individuals and individuals directly employed by a participant in a 
262.9 	consumer-directed service delivery option, providing direct service provision to people 
262.10 	receiving services under this section. Direct-care staff does not include executive, managerial, 
262.11 	or administrative staff.
262.12 	(d) This subdivision also applies to a provider of personal care assistance services under 
262.13 	section 256B.0625, subdivision 19a; community first services and supports under section 
262.14 	256B.85; nursing services and home health services under section 256B.0625, subdivision 
262.15 	6a; home care nursing services under section 256B.0625, subdivision 7; or day training and 
262.16 	habilitation services for residents of intermediate care facilities for persons with 
262.17 	developmental disabilities under section 256B.501.
262.18 	(e) This subdivision also applies to financial management services providers for 
262.19 	participants who directly employ direct-care staff through consumer support grants under 
262.20 	section 256.476; the personal care assistance choice program under section 256B.0657, 
262.21 	subdivisions 18 to 20; community first services and supports under section 256B.85; and 
262.22 	the consumer-directed community supports option available under the alternative care 
262.23 	program, the brain injury waiver, the community alternative care waiver, the community 
262.24 	access for disability inclusion waiver, the developmental disabilities waiver, the elderly 
262.25 	waiver, and the Minnesota senior health option, except financial management services 
262.26 	providers are not required to submit the data listed in paragraph (a), clauses (7) to (11).
262.27 	(f) The commissioner shall ensure that data submitted under this subdivision is not 
262.28 	duplicative of data submitted under any other section of this chapter or any other chapter.
262.29 	(g) A provider shall submit the data annually on a date specified by the commissioner. 
262.30 	The commissioner shall give a provider at least 30 calendar days to submit the data. If a 
262.31 	provider fails to submit the requested data by the date specified by the commissioner, the 
262.32 	commissioner may delay medical assistance reimbursement until the requested data is 
262.33 	submitted.
263.1 	(h) Individually identifiable data submitted to the commissioner in this section are 
263.2 	considered private data on an individual, as defined by section 13.02, subdivision 12.
263.3 	(i) The commissioner shall analyze data annually for workforce assessments and how 
263.4 	the data impact service access.

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

263.6 	Sec. 55. Minnesota Statutes 2018, section 256B.4913, subdivision 4a, is amended to read:
263.7 		Subd. 4a.Rate stabilization adjustment. (a) For purposes of this subdivision, 
263.8 	"implementation period" means the period beginning January 1, 2014, and ending on the 
263.9 	last day of the month in which the rate management system is populated with the data 
263.10 	necessary to calculate rates for substantially all individuals receiving home and 
263.11 	community-based waiver services under sections 256B.092 and 256B.49. "Banding period" 
263.12 	means the time period beginning on January 1, 2014, and ending upon the expiration of the 
263.13 	12-month period defined in paragraph (c), clause (5).
263.14 	(b) For purposes of this subdivision, the historical rate for all service recipients means 
263.15 	the individual reimbursement rate for a recipient in effect on December 1, 2013, except 
263.16 	that:
263.17 	(1) for a day service recipient who was not authorized to receive these waiver services 
263.18 	prior to January 1, 2014; added a new service or services on or after January 1, 2014; or 
263.19 	changed providers on or after January 1, 2014, the historical rate must be the weighted 
263.20 	average authorized rate for the provider number in the county of service, effective December 
263.21 	1, 2013; or
263.22 	(2) for a unit-based service with programming or a unit-based service without 
263.23 	programming recipient who was not authorized to receive these waiver services prior to 
263.24 	January 1, 2014; added a new service or services on or after January 1, 2014; or changed 
263.25 	providers on or after January 1, 2014, the historical rate must be the weighted average 
263.26 	authorized rate for each provider number in the county of service, effective December 1, 
263.27 	2013; or
263.28 	(3) for residential service recipients who change providers on or after January 1, 2014, 
263.29 	the historical rate must be set by each lead agency within their county aggregate budget 
263.30 	using their respective methodology for residential services effective December 1, 2013, for 
263.31 	determining the provider rate for a similarly situated recipient being served by that provider.
263.32 	(c) The commissioner shall adjust individual reimbursement rates determined under this 
263.33 	section so that the unit rate is no higher or lower than:
264.1 	(1) 0.5 percent from the historical rate for the implementation period;
264.2 	(2) 0.5 percent from the rate in effect in clause (1), for the 12-month period immediately 
264.3 	following the time period of clause (1);
264.4 	(3) 0.5 percent from the rate in effect in clause (2), for the 12-month period immediately 
264.5 	following the time period of clause (2);
264.6 	(4) 1.0 percent from the rate in effect in clause (3), for the 12-month period immediately 
264.7 	following the time period of clause (3);
264.8 	(5) 1.0 percent from the rate in effect in clause (4), for the 12-month period immediately 
264.9 	following the time period of clause (4); and
264.10 	(6) no adjustment to the rate in effect in clause (5) for the 12-month period immediately 
264.11 	following the time period of clause (5). During this banding rate period, the commissioner 
264.12 	shall not enforce any rate decrease or increase that would otherwise result from the end of 
264.13 	the banding period. The commissioner shall, upon enactment, seek federal approval for the 
264.14 	addition of this banding period; and
264.15 	(7) one percent from the rate in effect in clause (6) for the 12-month period immediately 
264.16 	following the time period of clause (6).
264.17 	(d) The commissioner shall review all changes to rates that were in effect on December 
264.18 	1, 2013, to verify that the rates in effect produce the equivalent level of spending and service 
264.19 	unit utilization on an annual basis as those in effect on October 31, 2013.
264.20 	(e) By December 31, 2014, the commissioner shall complete the review in paragraph 
264.21 	(d), adjust rates to provide equivalent annual spending, and make appropriate adjustments.
264.22 	(f) During the banding period, the Medicaid Management Information System (MMIS) 
264.23 	service agreement rate must be adjusted to account for change in an individual's need. The 
264.24 	commissioner shall adjust the Medicaid Management Information System (MMIS) service 
264.25 	agreement rate by:
264.26 	(1) calculating a service rate under section 256B.4914, subdivision 6, 7, 8, or 9, for the 
264.27 	individual with variables reflecting the level of service in effect on December 1, 2013;
264.28 	(2) calculating a service rate under section 256B.4914, subdivision 6, 7, 8, or 9, for the 
264.29 	individual with variables reflecting the updated level of service at the time of application; 
264.30 	and
264.31 	(3) adding to or subtracting from the Medicaid Management Information System (MMIS) 
264.32 	service agreement rate, the difference between the values in clauses (1) and (2).
265.1 	(g) This subdivision must not apply to rates for recipients served by providers new to a 
265.2 	given county after January 1, 2014. Providers of personal supports services who also acted 
265.3 	as fiscal support entities must be treated as new providers as of January 1, 2014.

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

265.5 	Sec. 56. Minnesota Statutes 2018, section 256B.4914, subdivision 2, is amended to read:
265.6 		Subd. 2.Definitions. (a) For purposes of this section, the following terms have the 
265.7 	meanings given them, unless the context clearly indicates otherwise.
265.8 	(b) "Commissioner" means the commissioner of human services.
265.9 	(c) "Comparable occupations" means the occupations, excluding direct care staff, as 
265.10 	represented by the Bureau of Labor Statistics standard occupational classification codes 
265.11 	that have the same classification for:
265.12 	(1) typical education needed for entry;
265.13 	(2) work experience in a related occupation; and
265.14 	(3) typical on-the-job training competency as the most predominant classification for 
265.15 	direct care staff.
265.16 	(c) (d) "Component value" means underlying factors that are part of the cost of providing 
265.17 	services that are built into the waiver rates methodology to calculate service rates.
265.18 	(d) (e) "Customized living tool" means a methodology for setting service rates that 
265.19 	delineates and documents the amount of each component service included in a recipient's 
265.20 	customized living service plan.
265.21 	(f) "Direct care staff" means employees providing direct service to people receiving 
265.22 	services under this section. Direct care staff excludes executive, managerial, and 
265.23 	administrative staff.
265.24 	(e) (g) "Disability waiver rates system" means a statewide system that establishes rates 
265.25 	that are based on uniform processes and captures the individualized nature of waiver services 
265.26 	and recipient needs.
265.27 	(f) (h) "Individual staffing" means the time spent as a one-to-one interaction specific to 
265.28 	an individual recipient by staff to provide direct support and assistance with activities of 
265.29 	daily living, instrumental activities of daily living, and training to participants, and is based 
265.30 	on the requirements in each individual's coordinated service and support plan under section 
265.31 	245D.02, subdivision 4b; any coordinated service and support plan addendum under section 
266.1 	245D.02, subdivision 4c; and an assessment tool. Provider observation of an individual's 
266.2 	needs must also be considered.
266.3 	(g) (i) "Lead agency" means a county, partnership of counties, or tribal agency charged 
266.4 	with administering waivered services under sections 256B.092 and 256B.49.
266.5 	(h) (j) "Median" means the amount that divides distribution into two equal groups, 
266.6 	one-half above the median and one-half below the median.
266.7 	(i) (k) "Payment or rate" means reimbursement to an eligible provider for services 
266.8 	provided to a qualified individual based on an approved service authorization.
266.9 	(j) (l) "Rates management system" means a web-based software application that uses a 
266.10 	framework and component values, as determined by the commissioner, to establish service 
266.11 	rates.
266.12 	(k) (m) "Recipient" means a person receiving home and community-based services 
266.13 	funded under any of the disability waivers.
266.14 	(l) (n) "Shared staffing" means time spent by employees, not defined under paragraph 
266.15 	(f), providing or available to provide more than one individual with direct support and 
266.16 	assistance with activities of daily living as defined under section 256B.0659, subdivision 
266.17 	1, paragraph (b); instrumental activities of daily living as defined under section 256B.0659, 
266.18 	subdivision 1, paragraph (i); ancillary activities needed to support individual services; and 
266.19 	training to participants, and is based on the requirements in each individual's coordinated 
266.20 	service and support plan under section 245D.02, subdivision 4b; any coordinated service 
266.21 	and support plan addendum under section 245D.02, subdivision 4c; an assessment tool; and 
266.22 	provider observation of an individual's service need. Total shared staffing hours are divided 
266.23 	proportionally by the number of individuals who receive the shared service provisions.
266.24 	(m) (o) "Staffing ratio" means the number of recipients a service provider employee 
266.25 	supports during a unit of service based on a uniform assessment tool, provider observation, 
266.26 	case history, and the recipient's services of choice, and not based on the staffing ratios under 
266.27 	section 245D.31.
266.28 	(n) (p) "Unit of service" means the following:
266.29 	(1) for residential support services under subdivision 6, a unit of service is a day. Any 
266.30 	portion of any calendar day, within allowable Medicaid rules, where an individual spends 
266.31 	time in a residential setting is billable as a day;
266.32 	(2) for day services under subdivision 7:
267.1 	(i) for day training and habilitation services, a unit of service is either:
267.2 	(A) a day unit of service is defined as six or more hours of time spent providing direct 
267.3 	services and transportation; or
267.4 	(B) a partial day unit of service is defined as fewer than six hours of time spent providing 
267.5 	direct services and transportation; and
267.6 	(C) for new day service recipients after January 1, 2014, 15 minute units of service must 
267.7 	be used for fewer than six hours of time spent providing direct services and transportation;
267.8 	(ii) for adult day and structured day services, a unit of service is a day or 15 minutes. A 
267.9 	day unit of service is six or more hours of time spent providing direct services;
267.10 	(iii) for day support services, a unit of service is 15 minutes; and
267.11 	(iii) (iv) for prevocational services, a unit of service is a day or an hour 15 minutes. A 
267.12 	day unit of service is six or more hours of time spent providing direct service;
267.13 	(3) for unit-based services with programming under subdivision 8:
267.14 	(i) for supported living services, a unit of service is a day or 15 minutes. When a day 
267.15 	rate is authorized, any portion of a calendar day where an individual receives services is 
267.16 	billable as a day; and
267.17 	(ii) for all other services, a unit of service is 15 minutes; and
267.18 	(4) for unit-based services without programming under subdivision 9, a unit of service 
267.19 	is 15 minutes.

267.20 	Sec. 57. Minnesota Statutes 2018, section 256B.4914, subdivision 3, as amended by Laws 
267.21 	2019, chapter 50, article 2, section 1, is amended to read:
267.22 		Subd. 3.Applicable services. Applicable services are those authorized under the state's 
267.23 	home and community-based services waivers under sections 256B.092 and 256B.49, 
267.24 	including the following, as defined in the federally approved home and community-based 
267.25 	services plan:
267.26 	(1) 24-hour customized living;
267.27 	(2) adult day care services;
267.28 	(3) adult day care services bath;
267.29 	(4) behavioral programming;
267.30 	(5) (4) companion services;
268.1 	(5) community residential services;
268.2 	(6) customized living;
268.3 	(7) day support services;
268.4 	(7) (8) day training and habilitation;
268.5 	(9) employment development services;
268.6 	(10) employment exploration services;
268.7 	(11) employment support services;
268.8 	(12) family residential services;
268.9 	(8) (13) housing access coordination;
268.10 	(9) (14) independent living skills;
268.11 	(15) individualized home supports;
268.12 	(16) individualized home supports with family training;
268.13 	(17) individualized home supports with training;
268.14 	(10) (18) in-home family support;
268.15 	(19) integrated community supports;
268.16 	(11) (20) night supervision;
268.17 	(12) (21) personal support;
268.18 	(22) positive support services;
268.19 	(13) (23) prevocational services;
268.20 	(14) residential care services;
268.21 	(15) (24) residential support services;
268.22 	(16) (25) respite services;
268.23 	(17) (26) structured day services;
268.24 	(18) (27) supported living services;
268.25 	(19) (28) transportation services; and
268.26 	(20) individualized home supports;
268.27 	(21) independent living skills specialist services;
269.1 	(22) employment exploration services;
269.2 	(23) employment development services;
269.3 	(24) employment support services; and
269.4 	(25) (29) other services as approved by the federal government in the state home and 
269.5 	community-based services plan.

269.6 	EFFECTIVE DATE. This section is effective January 1, 2021, or upon federal approval, 
269.7 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
269.8 	when federal approval is obtained.

269.9 	Sec. 58. Minnesota Statutes 2018, section 256B.4914, subdivision 4, is amended to read:
269.10 		Subd. 4.Data collection for rate determination. (a) Rates for applicable home and 
269.11 	community-based waivered services, including rate exceptions under subdivision 12, are 
269.12 	set by the rates management system.
269.13 	(b) Data for services under section 256B.4913, subdivision 4a, shall be collected in a 
269.14 	manner prescribed by the commissioner.
269.15 	(c) (b) Data and information in the rates management system may be used to calculate 
269.16 	an individual's rate.
269.17 	(d) (c) Service providers, with information from the community support plan and 
269.18 	oversight by lead agencies, shall provide values and information needed to calculate an 
269.19 	individual's rate into the rates management system. The determination of service levels must 
269.20 	be part of a discussion with members of the support team as defined in section 245D.02, 
269.21 	subdivision 34. This discussion must occur prior to the final establishment of each individual's 
269.22 	rate. The values and information include:
269.23 	(1) shared staffing hours;
269.24 	(2) individual staffing hours;
269.25 	(3) direct registered nurse hours;
269.26 	(4) direct licensed practical nurse hours;
269.27 	(5) staffing ratios;
269.28 	(6) information to document variable levels of service qualification for variable levels 
269.29 	of reimbursement in each framework;
270.1 	(7) shared or individualized arrangements for unit-based services, including the staffing 
270.2 	ratio;
270.3 	(8) number of trips and miles for transportation services; and
270.4 	(9) service hours provided through monitoring technology.
270.5 	(e) (d) Updates to individual data must include:
270.6 	(1) data for each individual that is updated annually when renewing service plans; and
270.7 	(2) requests by individuals or lead agencies to update a rate whenever there is a change 
270.8 	in an individual's service needs, with accompanying documentation.
270.9 	(f) (e) Lead agencies shall review and approve all services reflecting each individual's 
270.10 	needs, and the values to calculate the final payment rate for services with variables under 
270.11 	subdivisions 6, 7, 8, and 9 for each individual. Lead agencies must notify the individual and 
270.12 	the service provider of the final agreed-upon values and rate, and provide information that 
270.13 	is identical to what was entered into the rates management system. If a value used was 
270.14 	mistakenly or erroneously entered and used to calculate a rate, a provider may petition lead 
270.15 	agencies to correct it. Lead agencies must respond to these requests. When responding to 
270.16 	the request, the lead agency must consider:
270.17 	(1) meeting the health and welfare needs of the individual or individuals receiving 
270.18 	services by service site, identified in their coordinated service and support plan under section 
270.19 	245D.02, subdivision 4b, and any addendum under section 245D.02, subdivision 4c;
270.20 	(2) meeting the requirements for staffing under subdivision 2, paragraphs (f) (h), (i) (n), 
270.21 	and (m) (o); and meeting or exceeding the licensing standards for staffing required under 
270.22 	section 245D.09, subdivision 1; and
270.23 	(3) meeting the staffing ratio requirements under subdivision 2, paragraph (n) (o), and 
270.24 	meeting or exceeding the licensing standards for staffing required under section 245D.31.

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

270.26 	Sec. 59. Minnesota Statutes 2018, section 256B.4914, subdivision 5, is amended to read:
270.27 		Subd. 5.Base wage index and standard component values. (a) The base wage index 
270.28 	is established to determine staffing costs associated with providing services to individuals 
270.29 	receiving home and community-based services. For purposes of developing and calculating 
270.30 	the proposed base wage, Minnesota-specific wages taken from job descriptions and standard 
270.31 	occupational classification (SOC) codes from the Bureau of Labor Statistics as defined in 
271.1 	the most recent edition of the Occupational Handbook must be used. The base wage index 
271.2 	must be calculated as follows:
271.3 	(1) for residential direct care staff, the sum of:
271.4 	(i) 15 percent of the subtotal of 50 percent of the median wage for personal and home 
271.5 	health aide (SOC code 39-9021); 30 percent of the median wage for nursing assistant (SOC 
271.6 	code 31-1014); and 20 percent of the median wage for social and human services aide (SOC 
271.7 	code 21-1093); and
271.8 	(ii) 85 percent of the subtotal of 20 percent of the median wage for home health aide 
271.9 	(SOC code 31-1011); 20 percent of the median wage for personal and home health aide 
271.10 	(SOC code 39-9021); 20 percent of the median wage for nursing assistant (SOC code 
271.11 	31-1014); 20 percent of the median wage for psychiatric technician (SOC code 29-2053); 
271.12 	and 20 percent of the median wage for social and human services aide (SOC code 21-1093);
271.13 	(2) for adult day services, 70 percent of the median wage for nursing assistant (SOC 
271.14 	code 31-1014); and 30 percent of the median wage for personal care aide (SOC code 
271.15 	39-9021);
271.16 	(2) (3) for day services, day support services, and prevocational services, 20 percent of 
271.17 	the median wage for nursing assistant (SOC code 31-1014); 20 percent of the median wage 
271.18 	for psychiatric technician (SOC code 29-2053); and 60 percent of the median wage for 
271.19 	social and human services aide (SOC code 21-1093);
271.20 	(3) (4) for residential asleep-overnight staff, the wage is the minimum wage in Minnesota 
271.21 	for large employers, except in a family foster care setting, the wage is 36 percent of the 
271.22 	minimum wage in Minnesota for large employers;
271.23 	(4) (5) for behavior program positive supports analyst staff, 100 percent of the median 
271.24 	wage for mental health counselors (SOC code 21-1014);
271.25 	(5) (6) for behavior program positive supports professional staff, 100 percent of the 
271.26 	median wage for clinical counseling and school psychologist (SOC code 19-3031);
271.27 	(6) (7) for behavior program positive supports specialist staff, 100 percent of the median 
271.28 	wage for psychiatric technicians (SOC code 29-2053);
271.29 	(7) (8) for supportive living services staff, 20 percent of the median wage for nursing 
271.30 	assistant (SOC code 31-1014); 20 percent of the median wage for psychiatric technician 
271.31 	(SOC code 29-2053); and 60 percent of the median wage for social and human services 
271.32 	aide (SOC code 21-1093);
272.1 	(8) (9) for housing access coordination staff, 100 percent of the median wage for 
272.2 	community and social services specialist (SOC code 21-1099);
272.3 	(9) (10) for in-home family support and individualized home supports with family 
272.4 	training staff, 20 percent of the median wage for nursing aide (SOC code 31-1012); 30 
272.5 	percent of the median wage for community social service specialist (SOC code 21-1099); 
272.6 	40 percent of the median wage for social and human services aide (SOC code 21-1093); 
272.7 	and ten percent of the median wage for psychiatric technician (SOC code 29-2053);
272.8 	(10) (11) for individualized home supports with training services staff, 40 percent of the 
272.9 	median wage for community social service specialist (SOC code 21-1099); 50 percent of 
272.10 	the median wage for social and human services aide (SOC code 21-1093); and ten percent 
272.11 	of the median wage for psychiatric technician (SOC code 29-2053);
272.12 	(11) (12) for independent living skills staff, 40 percent of the median wage for community 
272.13 	social service specialist (SOC code 21-1099); 50 percent of the median wage for social and 
272.14 	human services aide (SOC code 21-1093); and ten percent of the median wage for psychiatric 
272.15 	technician (SOC code 29-2053);
272.16 	(12) for independent living skills specialist staff, 100 percent of mental health and 
272.17 	substance abuse social worker (SOC code 21-1023);
272.18 	(13) for supported employment staff, 20 percent of the median wage for nursing assistant 
272.19 	(SOC code 31-1014); 20 percent of the median wage for psychiatric technician (SOC code 
272.20 	29-2053); and 60 percent of the median wage for social and human services aide (SOC code 
272.21 	21-1093);
272.22 	(14) (13) for employment support services staff, 50 percent of the median wage for 
272.23 	rehabilitation counselor (SOC code 21-1015); and 50 percent of the median wage for 
272.24 	community and social services specialist (SOC code 21-1099);
272.25 	(15) (14) for employment exploration services staff, 50 percent of the median wage for 
272.26 	rehabilitation counselor (SOC code 21-1015); and 50 percent of the median wage for 
272.27 	community and social services specialist (SOC code 21-1099);
272.28 	(16) (15) for employment development services staff, 50 percent of the median wage 
272.29 	for education, guidance, school, and vocational counselors (SOC code 21-1012); and 50 
272.30 	percent of the median wage for community and social services specialist (SOC code 
272.31 	21-1099);
273.1 	(16) for individualized home support staff, 50 percent of the median wage for personal 
273.2 	and home care aide (SOC code 39-9021); and 50 percent of the median wage for nursing 
273.3 	assistant (SOC code 31-1014);
273.4 	(17) for adult companion staff, 50 percent of the median wage for personal and home 
273.5 	care aide (SOC code 39-9021); and 50 percent of the median wage for nursing assistant 
273.6 	(SOC code 31-1014);
273.7 	(18) for night supervision staff, 20 percent of the median wage for home health aide 
273.8 	(SOC code 31-1011); 20 percent of the median wage for personal and home health aide 
273.9 	(SOC code 39-9021); 20 percent of the median wage for nursing assistant (SOC code 
273.10 	31-1014); 20 percent of the median wage for psychiatric technician (SOC code 29-2053); 
273.11 	and 20 percent of the median wage for social and human services aide (SOC code 21-1093);
273.12 	(19) for respite staff, 50 percent of the median wage for personal and home care aide 
273.13 	(SOC code 39-9021); and 50 percent of the median wage for nursing assistant (SOC code 
273.14 	31-1014);
273.15 	(20) for personal support staff, 50 percent of the median wage for personal and home 
273.16 	care aide (SOC code 39-9021); and 50 percent of the median wage for nursing assistant 
273.17 	(SOC code 31-1014);
273.18 	(21) for supervisory staff, 100 percent of the median wage for community and social 
273.19 	services specialist (SOC code 21-1099), with the exception of the supervisor of behavior
273.20 	positive supports professional, behavior positive supports analyst, and behavior positive 
273.21 	supports specialists, which is 100 percent of the median wage for clinical counseling and 
273.22 	school psychologist (SOC code 19-3031);
273.23 	(22) for registered nurse staff, 100 percent of the median wage for registered nurses 
273.24 	(SOC code 29-1141); and
273.25 	(23) for licensed practical nurse staff, 100 percent of the median wage for licensed 
273.26 	practical nurses (SOC code 29-2061).
273.27 	(b) Component values for residential corporate foster care services, corporate supportive 
273.28 	living services daily, community residential services, and integrated community support 
273.29 	services are:
273.30 	(1) competitive workforce factor: 4.7 percent;
273.31 	(1) (2) supervisory span of control ratio: 11 percent;
273.32 	(2) (3) employee vacation, sick, and training allowance ratio: 8.71 percent;
274.1 	(3) (4) employee-related cost ratio: 23.6 percent;
274.2 	(4) (5) general administrative support ratio: 13.25 percent;
274.3 	(5) (6) program-related expense ratio: 1.3 percent; and
274.4 	(6) (7) absence and utilization factor ratio: 3.9 percent.
274.5 	(c) Component values for family foster care are:
274.6 	(1) competitive workforce factor: 4.7 percent;
274.7 	(1) (2) supervisory span of control ratio: 11 percent;
274.8 	(2) (3) employee vacation, sick, and training allowance ratio: 8.71 percent;
274.9 	(3) (4) employee-related cost ratio: 23.6 percent;
274.10 	(4) (5) general administrative support ratio: 3.3 percent;
274.11 	(5) (6) program-related expense ratio: 1.3 percent; and
274.12 	(6) (7) absence factor: 1.7 percent.
274.13 	(d) Component values for day services for all services training and habilitation, day 
274.14 	support services, and prevocational services are:
274.15 	(1) competitive workforce factor: 4.7 percent;
274.16 	(1) (2) supervisory span of control ratio: 11 percent;
274.17 	(2) (3) employee vacation, sick, and training allowance ratio: 8.71 percent;
274.18 	(3) (4) employee-related cost ratio: 23.6 percent;
274.19 	(4) (5) program plan support ratio: 5.6 percent;
274.20 	(5) (6) client programming and support ratio: ten percent;
274.21 	(6) (7) general administrative support ratio: 13.25 percent;
274.22 	(7) (8) program-related expense ratio: 1.8 percent; and
274.23 	(8) (9) absence and utilization factor ratio: 9.4 percent.
274.24 	(e) Component values for adult day services are:
274.25 	(1) competitive workforce factor: 4.7 percent;
274.26 	(2) supervisory span of control ratio: 11 percent;
274.27 	(3) employee vacation, sick, and training allowance ratio: 8.71 percent;
275.1 	(4) employee-related cost ratio: 23.6 percent;
275.2 	(5) program plan support ratio: 5.6 percent;
275.3 	(6) client programming and support ratio: 7.4 percent;
275.4 	(7) general administrative support ratio: 13.25 percent;
275.5 	(8) program-related expense ratio: 1.8 percent; and
275.6 	(9) absence and utilization factor ratio: 9.4 percent.
275.7 	(e) (f) Component values for unit-based services with programming are:
275.8 	(1) competitive workforce factor: 4.7 percent;
275.9 	(1) (2) supervisory span of control ratio: 11 percent;
275.10 	(2) (3) employee vacation, sick, and training allowance ratio: 8.71 percent;
275.11 	(3) (4) employee-related cost ratio: 23.6 percent;
275.12 	(4) (5) program plan supports ratio: 15.5 percent;
275.13 	(5) (6) client programming and supports ratio: 4.7 percent;
275.14 	(6) (7) general administrative support ratio: 13.25 percent;
275.15 	(7) (8) program-related expense ratio: 6.1 percent; and
275.16 	(8) (9) absence and utilization factor ratio: 3.9 percent.
275.17 	(f) (g) Component values for unit-based services without programming except respite 
275.18 	are:
275.19 	(1) competitive workforce factor: 4.7 percent;
275.20 	(1) (2) supervisory span of control ratio: 11 percent;
275.21 	(2) (3) employee vacation, sick, and training allowance ratio: 8.71 percent;
275.22 	(3) (4) employee-related cost ratio: 23.6 percent;
275.23 	(4) (5) program plan support ratio: 7.0 percent;
275.24 	(5) (6) client programming and support ratio: 2.3 percent;
275.25 	(6) (7) general administrative support ratio: 13.25 percent;
275.26 	(7) (8) program-related expense ratio: 2.9 percent; and
275.27 	(8) (9) absence and utilization factor ratio: 3.9 percent.
276.1 	(g) (h) Component values for unit-based services without programming for respite are:
276.2 	(1) competitive workforce factor: 4.7 percent;
276.3 	(1) (2) supervisory span of control ratio: 11 percent;
276.4 	(2) (3) employee vacation, sick, and training allowance ratio: 8.71 percent;
276.5 	(3) (4) employee-related cost ratio: 23.6 percent;
276.6 	(4) (5) general administrative support ratio: 13.25 percent;
276.7 	(5) (6) program-related expense ratio: 2.9 percent; and
276.8 	(6) (7) absence and utilization factor ratio: 3.9 percent.
276.9 	(h) On July 1, 2017, the commissioner shall update the base wage index in paragraph 
276.10 	(a) based on the wage data by standard occupational code (SOC) from the Bureau of Labor 
276.11 	Statistics available on December 31, 2016. The commissioner shall publish these updated 
276.12 	values and load them into the rate management system. (i) On July 1, 2022, and every five
276.13 	two years thereafter, the commissioner shall update the base wage index in paragraph (a) 
276.14 	based on the most recently available wage data by SOC from the Bureau of Labor Statistics
276.15 	available 30 months and one day prior to the scheduled update. The commissioner shall 
276.16 	publish these updated values and load them into the rate management system.
276.17 	(j) Beginning February 1, 2021, and every two years thereafter, the commissioner shall 
276.18 	report to the chairs and ranking minority members of the legislative committees and divisions 
276.19 	with jurisdiction over health and human services policy and finance an analysis of the 
276.20 	competitive workforce factor. The report must include recommendations to update the 
276.21 	competitive workforce factor using:
276.22 	(1) the most recently available wage data by SOC code for the weighted average wage 
276.23 	for direct care staff for residential services and direct care staff for day services;
276.24 	(2) the most recently available wage data by SOC code of the weighted average wage 
276.25 	of comparable occupations; and
276.26 	(3) workforce data as required under subdivision 10a, paragraph (g).
276.27 	The commissioner shall not recommend an increase or decrease of the competitive workforce 
276.28 	factor from the current value by more than two percentage points. If, after a biennial analysis 
276.29 	for the next report, the competitive workforce factor is less than or equal to zero, the 
276.30 	commissioner shall recommend a competitive workforce factor of zero.
277.1 	(i) On July 1, 2017, the commissioner shall update the framework components in 
277.2 	paragraph (d), clause (5); paragraph (e), clause (5); and paragraph (f), clause (5); subdivision 
277.3 	6, clauses (8) and (9); and subdivision 7, clauses (10), (16), and (17), for changes in the 
277.4 	Consumer Price Index. The commissioner will adjust these values higher or lower by the 
277.5 	percentage change in the Consumer Price Index-All Items, United States city average 
277.6 	(CPI-U) from January 1, 2014, to January 1, 2017. The commissioner shall publish these 
277.7 	updated values and load them into the rate management system. (k) On July 1, 2022, and 
277.8 	every five two years thereafter, the commissioner shall update the framework components 
277.9 	in paragraph (d), clause (5) (6); paragraph (e), clause (6); paragraph (e) (f), clause (5) (6); 
277.10 	and paragraph (f) (g), clause (5) (6); subdivision 6, paragraphs (b), clauses (8) (9) and (9)
277.11 	(10), and (e), clause (10); and subdivision 7, clauses (10) (11), (16) (17), and (17) (18), for 
277.12 	changes in the Consumer Price Index. The commissioner shall adjust these values higher 
277.13 	or lower by the percentage change in the CPI-U from the date of the previous update to the 
277.14 	date of the data most recently available 30 months and one day prior to the scheduled update. 
277.15 	The commissioner shall publish these updated values and load them into the rate management 
277.16 	system.
277.17 	(l) Upon the implementation of the updates under paragraphs (i) and (k), rate adjustments 
277.18 	authorized under section 256B.439, subdivision 7; Laws 2013, chapter 108, article 7, section 
277.19 	60; and Laws 2014, chapter 312, article 27, section 75, shall be removed from service rates 
277.20 	calculated under this section.
277.21 	(m) Any rate adjustments applied to the service rates calculated under this section outside 
277.22 	of the cost components and rate methodology specified in this section shall be removed 
277.23 	from rate calculations upon implementation of the updates under paragraphs (i) and (k).
277.24 	(j) (n) In this subdivision, if Bureau of Labor Statistics occupational codes or Consumer 
277.25 	Price Index items are unavailable in the future, the commissioner shall recommend to the 
277.26 	legislature codes or items to update and replace missing component values.

277.27 	EFFECTIVE DATE. This section is effective January 1, 2021, or upon federal approval, 
277.28 	except:
277.29 	(1) paragraph (b), clause (1); paragraph (c), clause (1); paragraph (d), clause (1); 
277.30 	paragraph (f), clause (1); paragraph (g), clause (1); and paragraph (h), clause (1), are effective 
277.31 	January 1, 2020, or upon federal approval, whichever is later;
277.32 	(2) paragraphs (i) and (k) are effective July 1, 2022, or upon federal approval, whichever 
277.33 	is later; and
277.34 	(3) paragraph (l) is effective retroactively from July 1, 2018.
278.1 	The commissioner of human services shall notify the revisor of statutes when federal approval 
278.2 	is obtained or denied.

278.3 	Sec. 60. Minnesota Statutes 2018, section 256B.4914, subdivision 6, is amended to read:
278.4 		Subd. 6.Payments for residential support services. (a) Payments for residential support 
278.5 	services, as defined in sections 256B.092, subdivision 11, and 256B.49, subdivision 22, 
278.6 	must be calculated as follows: For purposes of this subdivision, residential support services 
278.7 	includes 24-hour customized living services, community residential services, customized 
278.8 	living services, family residential services, foster care services, integrated community 
278.9 	supports, and supportive living services daily.
278.10 	(b) Payments for community residential services, corporate foster care services, corporate 
278.11 	supportive living services daily, family residential services, and family foster care services 
278.12 	must be calculated as follows:
278.13 	(1) determine the number of shared staffing and individual direct staff hours to meet a 
278.14 	recipient's needs provided on site or through monitoring technology;
278.15 	(2) personnel hourly wage rate must be based on the 2009 Bureau of Labor Statistics 
278.16 	Minnesota-specific rates or rates derived by the commissioner as provided in subdivision 
278.17 	5. This is defined as the direct-care rate;
278.18 	(3) except for subdivision 5, paragraph (a), clauses (4) and (21) to (23), multiply the 
278.19 	result of clause (2) by the product of one plus the competitive workforce factor in subdivision 
278.20 	5, paragraph (b), clause (1);
278.21 	(3) (4) for a recipient requiring customization for deaf and hard-of-hearing language 
278.22 	accessibility under subdivision 12, add the customization rate provided in subdivision 12 
278.23 	to the result of clause (2) (3). This is defined as the customized direct-care rate;
278.24 	(4) (5) multiply the number of shared and individual direct staff hours provided on site 
278.25 	or through monitoring technology and nursing hours by the appropriate staff wages in 
278.26 	subdivision 5, paragraph (a),  or the customized direct-care rate;
278.27 	(5) (6) multiply the number of shared and individual direct staff hours provided on site 
278.28 	or through monitoring technology and nursing hours by the product of the supervision span 
278.29 	of control ratio in subdivision 5, paragraph (b), clause (1) (2), and the appropriate supervision 
278.30 	wage in subdivision 5, paragraph (a), clause (21);
278.31 	(6) (7) combine the results of clauses (4) and (5) and (6), excluding any shared and 
278.32 	individual direct staff hours provided through monitoring technology, and multiply the 
279.1 	result by one plus the employee vacation, sick, and training allowance ratio in subdivision 
279.2 	5, paragraph (b), clause (2) (3). This is defined as the direct staffing cost;
279.3 	(7) (8) for employee-related expenses, multiply the direct staffing cost, excluding any 
279.4 	shared and individual direct staff hours provided through monitoring technology, by one 
279.5 	plus the employee-related cost ratio in subdivision 5, paragraph (b), clause (3) (4);
279.6 	(8) (9) for client programming and supports, the commissioner shall add $2,179; and
279.7 	(9) (10) for transportation, if provided, the commissioner shall add $1,680, or $3,000 if 
279.8 	customized for adapted transport, based on the resident with the highest assessed need.
279.9 	(b) (c) The total rate must be calculated using the following steps:
279.10 	(1) subtotal paragraph (a) (b), clauses (7) to (9) (8) to (10), and the direct staffing cost 
279.11 	of any shared and individual direct staff hours provided through monitoring technology that 
279.12 	was excluded in clause (7) (8);
279.13 	(2) sum the standard general and administrative rate, the program-related expense ratio, 
279.14 	and the absence and utilization ratio;
279.15 	(3) divide the result of clause (1) by one minus the result of clause (2). This is the total 
279.16 	payment amount; and
279.17 	(4) adjust the result of clause (3) by a factor to be determined by the commissioner to 
279.18 	adjust for regional differences in the cost of providing services.
279.19 	(c) (d) The payment methodology for customized living, 24-hour customized living, and 
279.20 	residential care services must be the customized living tool. Revisions to the customized 
279.21 	living tool must be made to reflect the services and activities unique to disability-related 
279.22 	recipient needs.
279.23 	(e) Payments for integrated community support services must be calculated as follows:
279.24 	(1) the base shared staffing shall be eight hours divided by the number of people receiving 
279.25 	support in the integrated community support setting;
279.26 	(2) the individual staffing hours shall be the average number of direct support hours 
279.27 	provided directly to the service recipient;
279.28 	(3) the personnel hourly wage rate must be based on the most recent Bureau of Labor 
279.29 	Statistics Minnesota-specific rates or rates derived by the commissioner as provided in 
279.30 	subdivision 5;
280.1 	(4) except for subdivision 5, paragraph (a), clauses (4) and (21) to (23), multiply the 
280.2 	result of clause (3) by the product of one plus the competitive workforce factor in subdivision 
280.3 	5, paragraph (b), clause (1);
280.4 	(5) for a recipient requiring customization for deaf and hard-of-hearing language 
280.5 	accessibility under subdivision 12, add the customization rate provided in subdivision 12 
280.6 	to the result of clause (4);
280.7 	(6) multiply the number of shared and individual direct staff hours in clauses (1) and 
280.8 	(2) by the appropriate staff wages;
280.9 	(7) multiply the number of shared and individual direct staff hours in clauses (1) and 
280.10 	(2) by the product of the supervisory span of control ratio in subdivision 5, paragraph (b), 
280.11 	clause (2), and the appropriate supervisory wage in subdivision 5, paragraph (a), clause 
280.12 	(21);
280.13 	(8) combine the results of clauses (6) and (7) and multiply the result by one plus the 
280.14 	employee vacation, sick, and training allowance ratio in subdivision 5, paragraph (b), clause 
280.15 	(3). This is defined as the direct staffing cost;
280.16 	(9) for employee-related expenses, multiply the direct staffing cost by one plus the 
280.17 	employee-related cost ratio in subdivision 5, paragraph (b), clause (4); and
280.18 	(10) for client programming and supports, the commissioner shall add $2,260.21 divided 
280.19 	by 365.
280.20 	(f) The total rate must be calculated as follows:
280.21 	(1) add the results of paragraph (e), clauses (9) and (10);
280.22 	(2) add the standard general and administrative rate, the program-related expense ratio, 
280.23 	and the absence and utilization factor ratio;
280.24 	(3) divide the result of clause (1) by one minus the result of clause (2). This is the total 
280.25 	payment amount; and
280.26 	(4) adjust the result of clause (3) by a factor to be determined by the commissioner to 
280.27 	adjust for regional differences in the cost of providing services.
280.28 	(g) The payment methodology for customized living and 24-hour customized living 
280.29 	services must be the customized living tool. The commissioner shall revise the customized 
280.30 	living tool to reflect the services and activities unique to disability-related recipient needs 
280.31 	and adjust for regional differences in the cost of providing services.
281.1 	(d) For individuals enrolled prior to January 1, 2014, the days of service authorized must 
281.2 	meet or exceed the days of service used to convert service agreements in effect on December 
281.3 	1, 2013, and must not result in a reduction in spending or service utilization due to conversion 
281.4 	during the implementation period under section 256B.4913, subdivision 4a. If during the 
281.5 	implementation period, an individual's historical rate, including adjustments required under 
281.6 	section 256B.4913, subdivision 4a, paragraph (c), is equal to or greater than the rate 
281.7 	determined in this subdivision, the number of days authorized for the individual is 365.
281.8 	(e) (h) The number of days authorized for all individuals enrolling after January 1, 2014,
281.9 	in residential services must include every day that services start and end.

281.10 	EFFECTIVE DATE. This section is effective January 1, 2020, or upon federal approval, 
281.11 	whichever is later, except paragraphs (e) to (g) are effective January 1, 2021, or upon federal 
281.12 	approval, whichever is later. The commissioner of human services shall notify the revisor 
281.13 	of statutes when federal approval is obtained.

281.14 	Sec. 61. Minnesota Statutes 2018, section 256B.4914, subdivision 7, is amended to read:
281.15 		Subd. 7.Payments for day programs. Payments for services with day programs 
281.16 	including adult day care services, day treatment and habilitation, day support services, 
281.17 	prevocational services, and structured day services must be calculated as follows:
281.18 	(1) determine the number of units of service and staffing ratio to meet a recipient's needs:
281.19 	(i) the staffing ratios for the units of service provided to a recipient in a typical week 
281.20 	must be averaged to determine an individual's staffing ratio; and
281.21 	(ii) the commissioner, in consultation with service providers, shall develop a uniform 
281.22 	staffing ratio worksheet to be used to determine staffing ratios under this subdivision;
281.23 	(2) personnel hourly wage rates must be based on the 2009 Bureau of Labor Statistics 
281.24 	Minnesota-specific rates or rates derived by the commissioner as provided in subdivision 
281.25 	5;
281.26 	(3) except for subdivision 5, paragraph (a), clauses (4) and (21) to (23), multiply the 
281.27 	result of clause (2) by the product of one plus the competitive workforce factor in subdivision 
281.28 	5, paragraph (d), clause (1);
281.29 	(3) (4) for a recipient requiring customization for deaf and hard-of-hearing language 
281.30 	accessibility under subdivision 12, add the customization rate provided in subdivision 12 
281.31 	to the result of clause (2) (3). This is defined as the customized direct-care rate;
282.1 	(4) (5) multiply the number of day program direct staff hours and nursing hours by the 
282.2 	appropriate staff wage in subdivision 5, paragraph (a), or the customized direct-care rate;
282.3 	(5) (6) multiply the number of day direct staff hours by the product of the supervision 
282.4 	span of control ratio in subdivision 5, paragraph (d), clause (1) (2), and the appropriate 
282.5 	supervision wage in subdivision 5, paragraph (a), clause (21);
282.6 	(6) (7) combine the results of clauses (4) and (5) and (6), and multiply the result by one 
282.7 	plus the employee vacation, sick, and training allowance ratio in subdivision 5, paragraph 
282.8 	(d), clause (2) (3). This is defined as the direct staffing rate;
282.9 	(7) (8) for program plan support, multiply the result of clause (6) (7) by one plus the 
282.10 	program plan support ratio in subdivision 5, paragraph (d), clause (4) (5);
282.11 	(8) (9) for employee-related expenses, multiply the result of clause (7) (8) by one plus 
282.12 	the employee-related cost ratio in subdivision 5, paragraph (d), clause (3) (4);
282.13 	(9) (10) for client programming and supports, multiply the result of clause (8) (9) by 
282.14 	one plus the client programming and support ratio in subdivision 5, paragraph (d), clause 
282.15 	(5) (6);
282.16 	(10) (11) for program facility costs, add $19.30 per week with consideration of staffing 
282.17 	ratios to meet individual needs;
282.18 	(11) (12) for adult day bath services, add $7.01 per 15 minute unit;
282.19 	(12) (13) this is the subtotal rate;
282.20 	(13) (14) sum the standard general and administrative rate, the program-related expense 
282.21 	ratio, and the absence and utilization factor ratio;
282.22 	(14) (15) divide the result of clause (12) (13) by one minus the result of clause (13) (14). 
282.23 	This is the total payment amount;
282.24 	(15) (16) adjust the result of clause (14) (15) by a factor to be determined by the 
282.25 	commissioner to adjust for regional differences in the cost of providing services;
282.26 	(16) (17) for transportation provided as part of day training and habilitation for an 
282.27 	individual who does not require a lift, add:
282.28 	(i) $10.50 for a trip between zero and ten miles for a nonshared ride in a vehicle without 
282.29 	a lift, $8.83 for a shared ride in a vehicle without a lift, and $9.25 for a shared ride in a 
282.30 	vehicle with a lift;
283.1 	(ii) $15.75 for a trip between 11 and 20 miles for a nonshared ride in a vehicle without 
283.2 	a lift, $10.58 for a shared ride in a vehicle without a lift, and $11.88 for a shared ride in a 
283.3 	vehicle with a lift;
283.4 	(iii) $25.75 for a trip between 21 and 50 miles for a nonshared ride in a vehicle without 
283.5 	a lift, $13.92 for a shared ride in a vehicle without a lift, and $16.88 for a shared ride in a 
283.6 	vehicle with a lift; or
283.7 	(iv) $33.50 for a trip of 51 miles or more for a nonshared ride in a vehicle without a lift, 
283.8 	$16.50 for a shared ride in a vehicle without a lift, and $20.75 for a shared ride in a vehicle 
283.9 	with a lift;
283.10 	(17) (18) for transportation provided as part of day training and habilitation for an 
283.11 	individual who does require a lift, add:
283.12 	(i) $19.05 for a trip between zero and ten miles for a nonshared ride in a vehicle with a 
283.13 	lift, and $15.05 for a shared ride in a vehicle with a lift;
283.14 	(ii) $32.16 for a trip between 11 and 20 miles for a nonshared ride in a vehicle with a 
283.15 	lift, and $28.16 for a shared ride in a vehicle with a lift;
283.16 	(iii) $58.76 for a trip between 21 and 50 miles for a nonshared ride in a vehicle with a 
283.17 	lift, and $58.76 for a shared ride in a vehicle with a lift; or
283.18 	(iv) $80.93 for a trip of 51 miles or more for a nonshared ride in a vehicle with a lift, 
283.19 	and $80.93 for a shared ride in a vehicle with a lift.

283.20 	EFFECTIVE DATE. This section is effective January 1, 2020, or upon federal approval, 
283.21 	whichever is later, except the service name changes are effective January 1, 2021, or upon 
283.22 	federal approval, whichever is later. The commissioner of human services shall notify the 
283.23 	revisor of statutes when federal approval is obtained.

283.24 	Sec. 62. Minnesota Statutes 2018, section 256B.4914, subdivision 8, is amended to read:
283.25 		Subd. 8.Payments for unit-based services with programming. Payments for unit-based 
283.26 	services with programming, including behavior programming employment exploration 
283.27 	services, employment development services, housing access coordination, individualized 
283.28 	home supports with family training, individualized home supports with training, in-home 
283.29 	family support, independent living skills training, independent living skills specialist services, 
283.30 	individualized home supports, hourly supported living services, employment exploration 
283.31 	services, employment development services, supported employment, and employment 
283.32 	support and hourly supported living services provided to an individual outside of any day 
284.1 	or residential service plan must be calculated as follows, unless the services are authorized 
284.2 	separately under subdivision 6 or 7:
284.3 	(1) determine the number of units of service to meet a recipient's needs;
284.4 	(2) personnel hourly wage rate must be based on the 2009 Bureau of Labor Statistics 
284.5 	Minnesota-specific rates or rates derived by the commissioner as provided in subdivision 
284.6 	5;
284.7 	(3) except for subdivision 5, paragraph (a), clauses (4) and (21) to (23), multiply the 
284.8 	result of clause (2) by the product of one plus the competitive workforce factor in subdivision 
284.9 	5, paragraph (f), clause (1);
284.10 	(3) (4) for a recipient requiring customization for deaf and hard-of-hearing language 
284.11 	accessibility under subdivision 12, add the customization rate provided in subdivision 12 
284.12 	to the result of clause (2) (3). This is defined as the customized direct-care rate;
284.13 	(4) (5) multiply the number of direct staff hours by the appropriate staff wage in 
284.14 	subdivision 5, paragraph (a), or the customized direct-care rate;
284.15 	(5) (6) multiply the number of direct staff hours by the product of the supervision span 
284.16 	of control ratio in subdivision 5, paragraph (e) (f), clause (1) (2), and the appropriate 
284.17 	supervision wage in subdivision 5, paragraph (a), clause (21);
284.18 	(6) (7) combine the results of clauses (4) and (5) and (6), and multiply the result by one 
284.19 	plus the employee vacation, sick, and training allowance ratio in subdivision 5, paragraph 
284.20 	(e) (f), clause (2) (3). This is defined as the direct staffing rate;
284.21 	(7) (8) for program plan support, multiply the result of clause (6) (7) by one plus the 
284.22 	program plan supports ratio in subdivision 5, paragraph (e) (f), clause (4) (5);
284.23 	(8) (9) for employee-related expenses, multiply the result of clause (7) (8) by one plus 
284.24 	the employee-related cost ratio in subdivision 5, paragraph (e) (f), clause (3) (4);
284.25 	(9) (10) for client programming and supports, multiply the result of clause (8) (9) by 
284.26 	one plus the client programming and supports ratio in subdivision 5, paragraph (e) (f), clause 
284.27 	(5) (6);
284.28 	(10) (11) this is the subtotal rate;
284.29 	(11) (12) sum the standard general and administrative rate, the program-related expense 
284.30 	ratio, and the absence and utilization factor ratio;
284.31 	(12) (13) divide the result of clause (10) (11) by one minus the result of clause (11) (12). 
284.32 	This is the total payment amount;
285.1 	(13) (14) for supported employment exploration services provided in a shared manner, 
285.2 	divide the total payment amount in clause (12) (13) by the number of service recipients, not 
285.3 	to exceed three five. For employment support services provided in a shared manner, divide 
285.4 	the total payment amount in clause (12) (13) by the number of service recipients, not to 
285.5 	exceed six. For independent living skills training and, individualized home supports with 
285.6 	training, and individualized home supports with family training provided in a shared manner, 
285.7 	divide the total payment amount in clause (12) (13) by the number of service recipients, not 
285.8 	to exceed two; and
285.9 	(14) (15) adjust the result of clause (13) (14) by a factor to be determined by the 
285.10 	commissioner to adjust for regional differences in the cost of providing services.

285.11 	EFFECTIVE DATE. This section is effective January 1, 2020, or upon federal approval, 
285.12 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
285.13 	when federal approval is obtained.

285.14 	Sec. 63. Minnesota Statutes 2018, section 256B.4914, subdivision 9, is amended to read:
285.15 		Subd. 9.Payments for unit-based services without programming. Payments for 
285.16 	unit-based services without programming, including individualized home supports, night 
285.17 	supervision, personal support, respite, and companion care provided to an individual outside 
285.18 	of any day or residential service plan must be calculated as follows unless the services are 
285.19 	authorized separately under subdivision 6 or 7:
285.20 	(1) for all services except respite, determine the number of units of service to meet a 
285.21 	recipient's needs;
285.22 	(2) personnel hourly wage rates must be based on the 2009 Bureau of Labor Statistics 
285.23 	Minnesota-specific rate or rates derived by the commissioner as provided in subdivision 5;
285.24 	(3) except for subdivision 5, paragraph (a), clauses (4) and (21) to (23), multiply the 
285.25 	result of clause (2) by the product of one plus the competitive workforce factor in subdivision 
285.26 	5, paragraph (g), clause (1);
285.27 	(3) (4) for a recipient requiring customization for deaf and hard-of-hearing language 
285.28 	accessibility under subdivision 12, add the customization rate provided in subdivision 12 
285.29 	to the result of clause (2) (3). This is defined as the customized direct care rate;
285.30 	(4) (5) multiply the number of direct staff hours by the appropriate staff wage in 
285.31 	subdivision 5 or the customized direct care rate;
286.1 	(5) (6) multiply the number of direct staff hours by the product of the supervision span 
286.2 	of control ratio in subdivision 5, paragraph (f) (g), clause (1) (2), and the appropriate 
286.3 	supervision wage in subdivision 5, paragraph (a), clause (21);
286.4 	(6) (7) combine the results of clauses (4) and (5) and (6), and multiply the result by one 
286.5 	plus the employee vacation, sick, and training allowance ratio in subdivision 5, paragraph 
286.6 	(f) (g), clause (2) (3). This is defined as the direct staffing rate;
286.7 	(7) (8) for program plan support, multiply the result of clause (6) (7) by one plus the 
286.8 	program plan support ratio in subdivision 5, paragraph (f) (g), clause (4) (5);
286.9 	(8) (9) for employee-related expenses, multiply the result of clause (7) (8) by one plus 
286.10 	the employee-related cost ratio in subdivision 5, paragraph (f) (g), clause (3) (4);
286.11 	(9) (10) for client programming and supports, multiply the result of clause (8) (9) by 
286.12 	one plus the client programming and support ratio in subdivision 5, paragraph (f) (g), clause 
286.13 	(5) (6);
286.14 	(10) (11) this is the subtotal rate;
286.15 	(11) (12) sum the standard general and administrative rate, the program-related expense 
286.16 	ratio, and the absence and utilization factor ratio;
286.17 	(12) (13) divide the result of clause (10) (11) by one minus the result of clause (11) (12). 
286.18 	This is the total payment amount;
286.19 	(13) (14) for respite services, determine the number of day units of service to meet an 
286.20 	individual's needs;
286.21 	(14) (15) personnel hourly wage rates must be based on the 2009 Bureau of Labor 
286.22 	Statistics Minnesota-specific rate or rates derived by the commissioner as provided in 
286.23 	subdivision 5;
286.24 	(16) except for subdivision 5, paragraph (a), clauses (4) and (21) to (23), multiply the 
286.25 	result of clause (15) by the product of one plus the competitive workforce factor in 
286.26 	subdivision 5, paragraph (h), clause (1);
286.27 	(15) (17) for a recipient requiring deaf and hard-of-hearing customization under 
286.28 	subdivision 12, add the customization rate provided in subdivision 12 to the result of clause 
286.29 	(14) (16). This is defined as the customized direct care rate;
286.30 	(16) (18) multiply the number of direct staff hours by the appropriate staff wage in 
286.31 	subdivision 5, paragraph (a);
287.1 	(17) (19) multiply the number of direct staff hours by the product of the supervisory 
287.2 	span of control ratio in subdivision 5, paragraph (g) (h), clause (1) (2), and the appropriate 
287.3 	supervision wage in subdivision 5, paragraph (a), clause (21);
287.4 	(18) (20) combine the results of clauses (16) (18) and (17) (19), and multiply the result 
287.5 	by one plus the employee vacation, sick, and training allowance ratio in subdivision 5, 
287.6 	paragraph (g) (h), clause (2) (3). This is defined as the direct staffing rate;
287.7 	(19) (21) for employee-related expenses, multiply the result of clause (18) (20) by one 
287.8 	plus the employee-related cost ratio in subdivision 5, paragraph (g) (h), clause (3) (4);
287.9 	(20) (22) this is the subtotal rate;
287.10 	(21) (23) sum the standard general and administrative rate, the program-related expense 
287.11 	ratio, and the absence and utilization factor ratio;
287.12 	(22) (24) divide the result of clause (20) (22) by one minus the result of clause (21) (23). 
287.13 	This is the total payment amount; and
287.14 	(25) for individualized home supports provided in a shared manner, divide the total 
287.15 	payment amount in clause (13) by the number of service recipients, not to exceed two;
287.16 	(26) for respite care services provided in a shared manner, divide the total payment 
287.17 	amount in clause (24) by the number of service recipients, not to exceed three; and
287.18 	(23) (27) adjust the result of clauses (12) and (22) (13), (25), and (26) by a factor to be 
287.19 	determined by the commissioner to adjust for regional differences in the cost of providing 
287.20 	services.

287.21 	EFFECTIVE DATE. This section is effective January 1, 2020, or upon federal approval, 
287.22 	whichever is later, except the service name change is effective January 1, 2021, or upon 
287.23 	federal approval, whichever is later. The commissioner of human services shall notify the 
287.24 	revisor of statutes when federal approval is obtained.

287.25 	Sec. 64. Minnesota Statutes 2018, section 256B.4914, subdivision 10, is amended to read:
287.26 		Subd. 10.Updating payment values and additional information. (a) From January 
287.27 	1, 2014, through December 31, 2017, the commissioner shall develop and implement uniform 
287.28 	procedures to refine terms and adjust values used to calculate payment rates in this section.
287.29 	(b) No later than July 1, 2014, (a) The commissioner shall, within available resources, 
287.30 	begin to conduct research and gather data and information from existing state systems or 
287.31 	other outside sources on the following items:
288.1 	(1) differences in the underlying cost to provide services and care across the state; and
288.2 	(2) mileage, vehicle type, lift requirements, incidents of individual and shared rides, and 
288.3 	units of transportation for all day services, which must be collected from providers using 
288.4 	the rate management worksheet and entered into the rates management system; and
288.5 	(3) the distinct underlying costs for services provided by a license holder under sections 
288.6 	245D.05, 245D.06, 245D.07, 245D.071, 245D.081, and 245D.09, and for services provided 
288.7 	by a license holder certified under section 245D.33.
288.8 	(c) Beginning January 1, 2014, through December 31, 2018, using a statistically valid 
288.9 	set of rates management system data, the commissioner, in consultation with stakeholders, 
288.10 	shall analyze for each service the average difference in the rate on December 31, 2013, and 
288.11 	the framework rate at the individual, provider, lead agency, and state levels. The 
288.12 	commissioner shall issue semiannual reports to the stakeholders on the difference in rates 
288.13 	by service and by county during the banding period under section 256B.4913, subdivision 
288.14 	4a. The commissioner shall issue the first report by October 1, 2014, and the final report 
288.15 	shall be issued by December 31, 2018.
288.16 	(d) (b) No later than July 1, 2014, the commissioner, in consultation with stakeholders, 
288.17 	shall begin the review and evaluation of the following values already in subdivisions 6 to 
288.18 	9, or issues that impact all services, including, but not limited to:
288.19 	(1) values for transportation rates;
288.20 	(2) values for services where monitoring technology replaces staff time;
288.21 	(3) values for indirect services;
288.22 	(4) values for nursing;
288.23 	(5) values for the facility use rate in day services, and the weightings used in the day 
288.24 	service ratios and adjustments to those weightings;
288.25 	(6) values for workers' compensation as part of employee-related expenses;
288.26 	(7) values for unemployment insurance as part of employee-related expenses;
288.27 	(8) direct care workforce labor market measures;
288.28 	(9) any changes in state or federal law with a direct impact on the underlying cost of 
288.29 	providing home and community-based services; and
288.30 	(9) (10) outcome measures, determined by the commissioner, for home and 
288.31 	community-based services rates determined under this section.; and
289.1 	(11) different competitive workforce factors by service, as determined under subdivision 
289.2 	5, paragraph (j).
289.3 	(e) (c) The commissioner shall report to the chairs and the ranking minority members 
289.4 	of the legislative committees and divisions with jurisdiction over health and human services 
289.5 	policy and finance with the information and data gathered under paragraphs (b) to (d) (a) 
289.6 	and (b) on the following dates:
289.7 	(1) January 15, 2015, with preliminary results and data;
289.8 	(2) January 15, 2016, with a status implementation update, and additional data and 
289.9 	summary information;
289.10 	(3) January 15, 2017, with the full report; and
289.11 	(4) January 15, 2020 2021, with another a full report, and a full report once every four 
289.12 	years thereafter.
289.13 	(f) The commissioner shall implement a regional adjustment factor to all rate calculations 
289.14 	in subdivisions 6 to 9, effective no later than January 1, 2015. (d) Beginning July 1, 2017
289.15 	July 1, 2022, the commissioner shall renew analysis and implement changes to the regional 
289.16 	adjustment factors when adjustments required under subdivision 5, paragraph (h), occur
289.17 	once every six years. Prior to implementation, the commissioner shall consult with 
289.18 	stakeholders on the methodology to calculate the adjustment.
289.19 	(g) (e) The commissioner shall provide a public notice via LISTSERV in October of 
289.20 	each year beginning October 1, 2014, containing information detailing legislatively approved 
289.21 	changes in:
289.22 	(1) calculation values including derived wage rates and related employee and 
289.23 	administrative factors;
289.24 	(2) service utilization;
289.25 	(3) county and tribal allocation changes; and
289.26 	(4) information on adjustments made to calculation values and the timing of those 
289.27 	adjustments.
289.28 	The information in this notice must be effective January 1 of the following year.
289.29 	(h) (f) When the available shared staffing hours in a residential setting are insufficient 
289.30 	to meet the needs of an individual who enrolled in residential services after January 1, 2014, 
289.31 	or insufficient to meet the needs of an individual with a service agreement adjustment 
290.1 	described in section 256B.4913, subdivision 4a, paragraph (f), then individual staffing hours 
290.2 	shall be used.
290.3 	(i) The commissioner shall study the underlying cost of absence and utilization for day 
290.4 	services. Based on the commissioner's evaluation of the data collected under this paragraph, 
290.5 	the commissioner shall make recommendations to the legislature by January 15, 2018, for 
290.6 	changes, if any, to the absence and utilization factor ratio component value for day services.
290.7 	(j) Beginning July 1, 2017, (g) The commissioner shall collect transportation and trip 
290.8 	information for all day services through the rates management system.
290.9 	(h) The commissioner, in consultation with stakeholders, shall study value-based models 
290.10 	and outcome-based payment strategies for fee-for-service home and community-based 
290.11 	services and report to the legislative committees with jurisdiction over the disability waiver 
290.12 	rate system by October 1, 2020, with recommended strategies to: (1) promote new models 
290.13 	of care, services, and reimbursement structures that require more efficient use of public 
290.14 	dollars while improving the outcomes most valued by the individuals served; (2) assist 
290.15 	clients and their families in evaluating options and stretching individual budget funds; (3) 
290.16 	support individualized, person-centered planning and individual budget choices; and (4) 
290.17 	create a broader range of client options geographically or targeted at culturally competent 
290.18 	models for racial and ethnic minority groups.

290.19 	EFFECTIVE DATE. This section is effective the day following final enactment, except 
290.20 	the amendment to paragraph (f) is effective January 1, 2020.

290.21 	Sec. 65. Minnesota Statutes 2018, section 256B.4914, subdivision 10a, is amended to 
290.22 	read:
290.23 		Subd. 10a.Reporting and analysis of cost data. (a) The commissioner must ensure 
290.24 	that wage values and component values in subdivisions 5 to 9 reflect the cost to provide the 
290.25 	service. As determined by the commissioner, in consultation with stakeholders identified 
290.26 	in section 256B.4913, subdivision 5 17, a provider enrolled to provide services with rates 
290.27 	determined under this section must submit requested cost data to the commissioner to support 
290.28 	research on the cost of providing services that have rates determined by the disability waiver 
290.29 	rates system. Requested cost data may include, but is not limited to:
290.30 	(1) worker wage costs;
290.31 	(2) benefits paid;
290.32 	(3) supervisor wage costs;
291.1 	(4) executive wage costs;
291.2 	(5) vacation, sick, and training time paid;
291.3 	(6) taxes, workers' compensation, and unemployment insurance costs paid;
291.4 	(7) administrative costs paid;
291.5 	(8) program costs paid;
291.6 	(9) transportation costs paid;
291.7 	(10) vacancy rates; and
291.8 	(11) other data relating to costs required to provide services requested by the 
291.9 	commissioner.
291.10 	(b) At least once in any five-year period, a provider must submit cost data for a fiscal 
291.11 	year that ended not more than 18 months prior to the submission date. The commissioner 
291.12 	shall provide each provider a 90-day notice prior to its submission due date. If a provider 
291.13 	fails to submit required reporting data, the commissioner shall provide notice to providers 
291.14 	that have not provided required data 30 days after the required submission date, and a second 
291.15 	notice for providers who have not provided required data 60 days after the required 
291.16 	submission date. The commissioner shall temporarily suspend payments to the provider if 
291.17 	cost data is not received 90 days after the required submission date. Withheld payments 
291.18 	shall be made once data is received by the commissioner.
291.19 	(c) The commissioner shall conduct a random validation of data submitted under 
291.20 	paragraph (a) to ensure data accuracy. The commissioner shall analyze cost documentation 
291.21 	in paragraph (a) and provide recommendations for adjustments to cost components.
291.22 	(d) The commissioner shall analyze cost documentation in paragraph (a) and, in 
291.23 	consultation with stakeholders identified in section 256B.4913, subdivision 5 17, may submit 
291.24 	recommendations on component values and inflationary factor adjustments to the chairs 
291.25 	and ranking minority members of the legislative committees with jurisdiction over human 
291.26 	services every four years beginning January 1, 2020 2021. The commissioner shall make 
291.27 	recommendations in conjunction with reports submitted to the legislature according to 
291.28 	subdivision 10, paragraph (e) (c). The commissioner shall release cost data in an aggregate 
291.29 	form, and cost data from individual providers shall not be released except as provided for 
291.30 	in current law.
291.31 	(e) The commissioner, in consultation with stakeholders identified in section 256B.4913,
291.32 	subdivision 5 17, shall develop and implement a process for providing training and technical 
292.1 	assistance necessary to support provider submission of cost documentation required under 
292.2 	paragraph (a).
292.3 	(f) By December 31, 2020, providers paid with rates calculated under subdivision 5, 
292.4 	paragraph (b), shall identify additional revenues from the competitive workforce factor and 
292.5 	prepare a written distribution plan for the revenues. A provider shall make the provider's 
292.6 	distribution plan available and accessible to all direct care staff for a minimum of one 
292.7 	calendar year. Upon request, a provider shall submit the written distribution plan to the 
292.8 	commissioner.
292.9 	(g) Providers enrolled to provide services with rates determined under section 256B.4914, 
292.10 	subdivision 3, shall submit labor market data to the commissioner annually on or before 
292.11 	November 1, including but not limited to:
292.12 	(1) number of direct care staff;
292.13 	(2) wages of direct care staff;
292.14 	(3) overtime wages of direct care staff;
292.15 	(4) hours worked by direct care staff;
292.16 	(5) overtime hours worked by direct care staff;
292.17 	(6) benefits provided to direct care staff;
292.18 	(7) direct care staff job vacancies; and
292.19 	(8) direct care staff retention rates.
292.20 	(h) The commissioner shall publish annual reports on provider and state-level labor 
292.21 	market data, including but not limited to the data obtained under paragraph (g).
292.22 	(i) The commissioner may temporarily suspend payments to the provider if data requested 
292.23 	under paragraph (g) is not received 90 days after the required submission date. Withheld 
292.24 	payments shall be made once data is received by the commissioner.
292.25 	(j) Providers who receive payment under this section for less than 25 percent of their 
292.26 	clients in the year prior to the report may attest to the commissioner in a manner determined 
292.27 	by the commissioner that they are declining to provide the data required under paragraph 
292.28 	(g) and will not be subject to the payment suspension in paragraph (i).

292.29 	EFFECTIVE DATE. This section is effective the day following final enactment except 
292.30 	paragraph (g) is effective November 1, 2019, and paragraph (h) is effective February 1, 
292.31 	2020.

293.1 	Sec. 66. Minnesota Statutes 2018, section 256B.4914, subdivision 14, is amended to read:
293.2 		Subd. 14.Exceptions. (a) In a format prescribed by the commissioner, lead agencies 
293.3 	must identify individuals with exceptional needs that cannot be met under the disability 
293.4 	waiver rate system. The commissioner shall use that information to evaluate and, if necessary, 
293.5 	approve an alternative payment rate for those individuals. Whether granted, denied, or 
293.6 	modified, the commissioner shall respond to all exception requests in writing. The 
293.7 	commissioner shall include in the written response the basis for the action and provide 
293.8 	notification of the right to appeal under paragraph (h).
293.9 	(b) Lead agencies must act on an exception request within 30 days and notify the initiator 
293.10 	of the request of their recommendation in writing. A lead agency shall submit all exception 
293.11 	requests along with its recommendation to the commissioner.
293.12 	(c) An application for a rate exception may be submitted for the following criteria:
293.13 	(1) an individual has service needs that cannot be met through additional units of service;
293.14 	(2) an individual's rate determined under subdivisions 6, 7, 8, and 9 is so insufficient 
293.15 	that it has resulted in an individual receiving a notice of discharge from the individual's 
293.16 	provider; or
293.17 	(3) an individual's service needs, including behavioral changes, require a level of service 
293.18 	which necessitates a change in provider or which requires the current provider to propose 
293.19 	service changes beyond those currently authorized.
293.20 	(d) Exception requests must include the following information:
293.21 	(1) the service needs required by each individual that are not accounted for in subdivisions 
293.22 	6, 7, 8, and 9;
293.23 	(2) the service rate requested and the difference from the rate determined in subdivisions 
293.24 	6, 7, 8, and 9;
293.25 	(3) a basis for the underlying costs used for the rate exception and any accompanying 
293.26 	documentation; and
293.27 	(4) any contingencies for approval.
293.28 	(e) Approved rate exceptions shall be managed within lead agency allocations under 
293.29 	sections 256B.092 and 256B.49.
293.30 	(f) Individual disability waiver recipients, an interested party, or the license holder that 
293.31 	would receive the rate exception increase may request that a lead agency submit an exception 
293.32 	request. A lead agency that denies such a request shall notify the individual waiver recipient, 
294.1 	interested party, or license holder of its decision and the reasons for denying the request in 
294.2 	writing no later than 30 days after the request has been made and shall submit its denial to 
294.3 	the commissioner in accordance with paragraph (b). The reasons for the denial must be 
294.4 	based on the failure to meet the criteria in paragraph (c).
294.5 	(g) The commissioner shall determine whether to approve or deny an exception request 
294.6 	no more than 30 days after receiving the request. If the commissioner denies the request, 
294.7 	the commissioner shall notify the lead agency and the individual disability waiver recipient, 
294.8 	the interested party, and the license holder in writing of the reasons for the denial.
294.9 	(h) The individual disability waiver recipient may appeal any denial of an exception 
294.10 	request by either the lead agency or the commissioner, pursuant to sections 256.045 and 
294.11 	256.0451. When the denial of an exception request results in the proposed demission of a 
294.12 	waiver recipient from a residential or day habilitation program, the commissioner shall issue 
294.13 	a temporary stay of demission, when requested by the disability waiver recipient, consistent 
294.14 	with the provisions of section 256.045, subdivisions 4a and 6, paragraph (c). The temporary 
294.15 	stay shall remain in effect until the lead agency can provide an informed choice of 
294.16 	appropriate, alternative services to the disability waiver.
294.17 	(i) Providers may petition lead agencies to update values that were entered incorrectly 
294.18 	or erroneously into the rate management system, based on past service level discussions 
294.19 	and determination in subdivision 4, without applying for a rate exception.
294.20 	(j) The starting date for the rate exception will be the later of the date of the recipient's 
294.21 	change in support or the date of the request to the lead agency for an exception.
294.22 	(k) The commissioner shall track all exception requests received and their dispositions. 
294.23 	The commissioner shall issue quarterly public exceptions statistical reports, including the 
294.24 	number of exception requests received and the numbers granted, denied, withdrawn, and 
294.25 	pending. The report shall include the average amount of time required to process exceptions.
294.26 	(l) No later than January 15, 2016, the commissioner shall provide research findings on 
294.27 	the estimated fiscal impact, the primary cost drivers, and common population characteristics 
294.28 	of recipients with needs that cannot be met by the framework rates.
294.29 	(m) No later than July 1, 2016, the commissioner shall develop and implement, in 
294.30 	consultation with stakeholders, a process to determine eligibility for rate exceptions for 
294.31 	individuals with rates determined under the methodology in section 256B.4913, subdivision 
294.32 	4a. Determination of eligibility for an exception will occur as annual service renewals are 
294.33 	completed.
295.1 	(n) (l) Approved rate exceptions will be implemented at such time that the individual's 
295.2 	rate is no longer banded and remain in effect in all cases until an individual's needs change 
295.3 	as defined in paragraph (c).

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

295.5 	Sec. 67. Minnesota Statutes 2018, section 256B.4914, subdivision 15, is amended to read:
295.6 		Subd. 15.County or tribal allocations. (a) Upon implementation of the disability waiver 
295.7 	rates management system on January 1, 2014, The commissioner shall establish a method 
295.8 	of tracking and reporting the fiscal impact of the disability waiver rates management system 
295.9 	on individual lead agencies.
295.10 	(b) Beginning January 1, 2014, The commissioner shall make annual adjustments to 
295.11 	lead agencies' home and community-based waivered service budget allocations to adjust 
295.12 	for rate differences and the resulting impact on county allocations upon implementation of 
295.13 	the disability waiver rates system.
295.14 	(c) Lead agencies exceeding their allocations shall be subject to the provisions under 
295.15 	sections 256B.0916, subdivision 11, and 256B.49, subdivision 26.

295.16 	Sec. 68. Minnesota Statutes 2018, section 256B.4914, is amended by adding a subdivision 
295.17 	to read:
295.18 		Subd. 17.Stakeholder consultation and county training. (a) The commissioner shall 
295.19 	continue consultation at regular intervals with the existing stakeholder group established 
295.20 	as part of the rate-setting methodology process and others, to gather input, concerns, and 
295.21 	data, to assist in the implementation of the rate payment system, and to make pertinent 
295.22 	information available to the public through the department's website.
295.23 	(b) The commissioner shall offer training at least annually for county personnel 
295.24 	responsible for administering the rate-setting framework in a manner consistent with this 
295.25 	section.
295.26 	(c) The commissioner shall maintain an online instruction manual explaining the 
295.27 	rate-setting framework. The manual shall be consistent with this section, and shall be 
295.28 	accessible to all stakeholders including recipients, representatives of recipients, county or 
295.29 	tribal agencies, and license holders.
295.30 	(d) The commissioner shall not defer to the county or tribal agency on matters of technical 
295.31 	application of the rate-setting framework, and a county or tribal agency shall not set rates 
295.32 	in a manner that conflicts with this section.

296.1 	Sec. 69. Minnesota Statutes 2018, section 256B.5014, is amended to read:
296.2 	256B.5014 FINANCIAL REPORTING REQUIREMENTS.
296.3 		Subdivision 1.Financial reporting. All facilities shall maintain financial records and 
296.4 	shall provide annual income and expense reports to the commissioner of human services 
296.5 	on a form prescribed by the commissioner no later than April 30 of each year in order to 
296.6 	receive medical assistance payments. The reports for the reporting year ending December 
296.7 	31 must include:
296.8 	(1) salaries and related expenses, including program salaries, administrative salaries, 
296.9 	other salaries, payroll taxes, and fringe benefits;
296.10 	(2) general operating expenses, including supplies, training, repairs, purchased services 
296.11 	and consultants, utilities, food, licenses and fees, real estate taxes, insurance, and working 
296.12 	capital interest;
296.13 	(3) property related costs, including depreciation, capital debt interest, rent, and leases; 
296.14 	and
296.15 	(4) total annual resident days.
296.16 		Subd. 2.Labor market reporting. All intermediate care facilities shall comply with 
296.17 	the labor market reporting requirements described in section 256B.4912, subdivision 1a.

296.18 	Sec. 70. Minnesota Statutes 2018, section 256B.85, subdivision 3, is amended to read:
296.19 		Subd. 3.Eligibility. (a) CFSS is available to a person who meets one of the following:
296.20 	(1) is an enrollee of medical assistance as determined under section 256B.055, 256B.056, 
296.21 	or 256B.057, subdivisions 5 and 9;
296.22 	(2) is a participant in the alternative care program under section 256B.0913;
296.23 	(3) is a waiver participant as defined under section 256B.0915, 256B.092, 256B.093, or 
296.24 	256B.49; or
296.25 	(4) has medical services identified in a person's individualized education program and 
296.26 	is eligible for services as determined in section 256B.0625, subdivision 26.
296.27 	(b) In addition to meeting the eligibility criteria in paragraph (a), a person must also 
296.28 	meet all of the following:
296.29 	(1) require assistance and be determined dependent in one activity of daily living or 
296.30 	Level I behavior based on assessment under section 256B.0911; and
297.1 	(2) is not a participant under a family support grant under section 252.32.
297.2 	(c) A pregnant woman eligible for medical assistance under section 256B.055, subdivision 
297.3 	6, is eligible for CFSS without federal financial participation if the woman: (1) is eligible 
297.4 	for CFSS under paragraphs (a) and (b); and (2) does not meet institutional level of care, as 
297.5 	determined under section 256B.0911.

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

297.7 	Sec. 71. Minnesota Statutes 2018, section 256B.85, is amended by adding a subdivision 
297.8 	to read:
297.9 		Subd. 7a.Enhanced rate. An enhanced rate of 107.5 percent of the rate paid for CFSS 
297.10 	must be paid for services provided to persons who qualify for 12 or more hours of CFSS 
297.11 	per day when provided by a support worker who meets the requirements of subdivision 16, 
297.12 	paragraph (e). The enhanced rate for CFSS includes, and is not in addition to, any rate 
297.13 	adjustments implemented by the commissioner on July 1, 2019, to comply with the terms 
297.14 	of a collective bargaining agreement between the state of Minnesota and an exclusive 
297.15 	representative of individual providers under section 179A.54 that provides for wage increases 
297.16 	for individual providers who serve participants assessed to need 12 or more hours of CFSS 
297.17 	per day.

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

297.19 	Sec. 72. Minnesota Statutes 2018, section 256B.85, subdivision 10, is amended to read:
297.20 		Subd. 10.Agency-provider and FMS provider qualifications and duties. (a) 
297.21 	Agency-providers identified in subdivision 11 and FMS providers identified in subdivision 
297.22 	13a shall:
297.23 	(1) enroll as a medical assistance Minnesota health care programs provider and meet all 
297.24 	applicable provider standards and requirements;
297.25 	(2) demonstrate compliance with federal and state laws and policies for CFSS as 
297.26 	determined by the commissioner;
297.27 	(3) comply with background study requirements under chapter 245C and maintain 
297.28 	documentation of background study requests and results;
297.29 	(4) verify and maintain records of all services and expenditures by the participant, 
297.30 	including hours worked by support workers;
298.1 	(5) not engage in any agency-initiated direct contact or marketing in person, by telephone, 
298.2 	or other electronic means to potential participants, guardians, family members, or participants' 
298.3 	representatives;
298.4 	(6) directly provide services and not use a subcontractor or reporting agent;
298.5 	(7) meet the financial requirements established by the commissioner for financial 
298.6 	solvency;
298.7 	(8) have never had a lead agency contract or provider agreement discontinued due to 
298.8 	fraud, or have never had an owner, board member, or manager fail a state or FBI-based 
298.9 	criminal background check while enrolled or seeking enrollment as a Minnesota health care 
298.10 	programs provider; and
298.11 	(9) have an office located in Minnesota.
298.12 	(b) In conducting general duties, agency-providers and FMS providers shall:
298.13 	(1) pay support workers based upon actual hours of services provided;
298.14 	(2) pay for worker training and development services based upon actual hours of services 
298.15 	provided or the unit cost of the training session purchased;
298.16 	(3) withhold and pay all applicable federal and state payroll taxes;
298.17 	(4) make arrangements and pay unemployment insurance, taxes, workers' compensation, 
298.18 	liability insurance, and other benefits, if any;
298.19 	(5) enter into a written agreement with the participant, participant's representative, or 
298.20 	legal representative that assigns roles and responsibilities to be performed before services, 
298.21 	supports, or goods are provided;
298.22 	(6) report maltreatment as required under sections 626.556 and 626.557; and
298.23 	(7) comply with the labor market reporting requirements described in section 256B.4912, 
298.24 	subdivision 1a;
298.25 	(7) (8) comply with any data requests from the department consistent with the Minnesota 
298.26 	Government Data Practices Act under chapter 13.; and
298.27 	(9) maintain documentation for the requirements under subdivision 16, paragraph (e), 
298.28 	clause (2), to qualify for an enhanced rate under this section.

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

299.1 	Sec. 73. Minnesota Statutes 2018, section 256B.85, subdivision 11, is amended to read:
299.2 		Subd. 11.Agency-provider model. (a) The agency-provider model includes services 
299.3 	provided by support workers and staff providing worker training and development services 
299.4 	who are employed by an agency-provider that meets the criteria established by the 
299.5 	commissioner, including required training.
299.6 	(b) The agency-provider shall allow the participant to have a significant role in the 
299.7 	selection and dismissal of the support workers for the delivery of the services and supports 
299.8 	specified in the participant's CFSS service delivery plan.
299.9 	(c) A participant may use authorized units of CFSS services as needed within a service 
299.10 	agreement that is not greater than 12 months. Using authorized units in a flexible manner 
299.11 	in either the agency-provider model or the budget model does not increase the total amount 
299.12 	of services and supports authorized for a participant or included in the participant's CFSS 
299.13 	service delivery plan.
299.14 	(d) A participant may share CFSS services. Two or three CFSS participants may share 
299.15 	services at the same time provided by the same support worker.
299.16 	(e) The agency-provider must use a minimum of 72.5 percent of the revenue generated 
299.17 	by the medical assistance payment for CFSS for support worker wages and benefits, except 
299.18 	all of the revenue generated by a medical assistance rate increase due to a collective 
299.19 	bargaining agreement under section 179A.54 must be used for support worker wages and 
299.20 	benefits. The agency-provider must document how this requirement is being met. The 
299.21 	revenue generated by the worker training and development services and the reasonable costs 
299.22 	associated with the worker training and development services must not be used in making 
299.23 	this calculation.
299.24 	(f) The agency-provider model must be used by individuals who are restricted by the 
299.25 	Minnesota restricted recipient program under Minnesota Rules, parts 9505.2160 to 
299.26 	9505.2245.
299.27 	(g) Participants purchasing goods under this model, along with support worker services, 
299.28 	must:
299.29 	(1) specify the goods in the CFSS service delivery plan and detailed budget for 
299.30 	expenditures that must be approved by the consultation services provider, case manager, or 
299.31 	care coordinator; and
299.32 	(2) use the FMS provider for the billing and payment of such goods.

300.1 	Sec. 74. Minnesota Statutes 2018, section 256B.85, subdivision 12, is amended to read:
300.2 		Subd. 12.Requirements for enrollment of CFSS agency-providers. (a) All CFSS 
300.3 	agency-providers must provide, at the time of enrollment, reenrollment, and revalidation 
300.4 	as a CFSS agency-provider in a format determined by the commissioner, information and 
300.5 	documentation that includes, but is not limited to, the following:
300.6 	(1) the CFSS agency-provider's current contact information including address, telephone 
300.7 	number, and e-mail address;
300.8 	(2) proof of surety bond coverage. Upon new enrollment, or if the agency-provider's 
300.9 	Medicaid revenue in the previous calendar year is less than or equal to $300,000, the 
300.10 	agency-provider must purchase a surety bond of $50,000. If the agency-provider's Medicaid 
300.11 	revenue in the previous calendar year is greater than $300,000, the agency-provider must 
300.12 	purchase a surety bond of $100,000. The surety bond must be in a form approved by the 
300.13 	commissioner, must be renewed annually, and must allow for recovery of costs and fees in 
300.14 	pursuing a claim on the bond;
300.15 	(3) proof of fidelity bond coverage in the amount of $20,000;
300.16 	(4) proof of workers' compensation insurance coverage;
300.17 	(5) proof of liability insurance;
300.18 	(6) a description of the CFSS agency-provider's organization identifying the names of 
300.19 	all owners, managing employees, staff, board of directors, and the affiliations of the directors 
300.20 	and owners to other service providers;
300.21 	(7) a copy of the CFSS agency-provider's written policies and procedures including: 
300.22 	hiring of employees; training requirements; service delivery; and employee and consumer 
300.23 	safety, including the process for notification and resolution of participant grievances, incident 
300.24 	response, identification and prevention of communicable diseases, and employee misconduct;
300.25 	(8) copies of all other forms the CFSS agency-provider uses in the course of daily 
300.26 	business including, but not limited to:
300.27 	(i) a copy of the CFSS agency-provider's time sheet; and
300.28 	(ii) a copy of the participant's individual CFSS service delivery plan;
300.29 	(9) a list of all training and classes that the CFSS agency-provider requires of its staff 
300.30 	providing CFSS services;
300.31 	(10) documentation that the CFSS agency-provider and staff have successfully completed 
300.32 	all the training required by this section;
301.1 	(11) documentation of the agency-provider's marketing practices;
301.2 	(12) disclosure of ownership, leasing, or management of all residential properties that 
301.3 	are used or could be used for providing home care services;
301.4 	(13) documentation that the agency-provider will use at least the following percentages 
301.5 	of revenue generated from the medical assistance rate paid for CFSS services for CFSS 
301.6 	support worker wages and benefits: 72.5 percent of revenue from CFSS providers, except 
301.7 	100 percent of the revenue generated by a medical assistance rate increase due to a collective 
301.8 	bargaining agreement under section 179A.54 must be used for support worker wages and 
301.9 	benefits. The revenue generated by the worker training and development services and the 
301.10 	reasonable costs associated with the worker training and development services shall not be 
301.11 	used in making this calculation; and
301.12 	(14) documentation that the agency-provider does not burden participants' free exercise 
301.13 	of their right to choose service providers by requiring CFSS support workers to sign an 
301.14 	agreement not to work with any particular CFSS participant or for another CFSS 
301.15 	agency-provider after leaving the agency and that the agency is not taking action on any 
301.16 	such agreements or requirements regardless of the date signed.
301.17 	(b) CFSS agency-providers shall provide to the commissioner the information specified 
301.18 	in paragraph (a).
301.19 	(c) All CFSS agency-providers shall require all employees in management and 
301.20 	supervisory positions and owners of the agency who are active in the day-to-day management 
301.21 	and operations of the agency to complete mandatory training as determined by the 
301.22 	commissioner. Employees in management and supervisory positions and owners who are 
301.23 	active in the day-to-day operations of an agency who have completed the required training 
301.24 	as an employee with a CFSS agency-provider do not need to repeat the required training if 
301.25 	they are hired by another agency, if they have completed the training within the past three 
301.26 	years. CFSS agency-provider billing staff shall complete training about CFSS program 
301.27 	financial management. Any new owners or employees in management and supervisory 
301.28 	positions involved in the day-to-day operations are required to complete mandatory training 
301.29 	as a requisite of working for the agency.
301.30 	(d) The commissioner shall send annual review notifications to agency-providers 30 
301.31 	days prior to renewal. The notification must:
301.32 	(1) list the materials and information the agency-provider is required to submit;
301.33 	(2) provide instructions on submitting information to the commissioner; and
302.1 	(3) provide a due date by which the commissioner must receive the requested information.
302.2 	Agency-providers shall submit all required documentation for annual review within 30 days 
302.3 	of notification from the commissioner. If an agency-provider fails to submit all the required 
302.4 	documentation, the commissioner may take action under subdivision 23a.

302.5 	Sec. 75. Minnesota Statutes 2018, section 256B.85, subdivision 16, is amended to read:
302.6 		Subd. 16.Support workers requirements. (a) Support workers shall:
302.7 	(1) enroll with the department as a support worker after a background study under chapter 
302.8 	245C has been completed and the support worker has received a notice from the 
302.9 	commissioner that the support worker:
302.10 	(i) is not disqualified under section 245C.14; or
302.11 	(ii) is disqualified, but has received a set-aside of the disqualification under section 
302.12 	245C.22;
302.13 	(2) have the ability to effectively communicate with the participant or the participant's 
302.14 	representative;
302.15 	(3) have the skills and ability to provide the services and supports according to the 
302.16 	participant's CFSS service delivery plan and respond appropriately to the participant's needs;
302.17 	(4) complete the basic standardized CFSS training as determined by the commissioner 
302.18 	before completing enrollment. The training must be available in languages other than English 
302.19 	and to those who need accommodations due to disabilities. CFSS support worker training 
302.20 	must include successful completion of the following training components: basic first aid, 
302.21 	vulnerable adult, child maltreatment, OSHA universal precautions, basic roles and 
302.22 	responsibilities of support workers including information about basic body mechanics, 
302.23 	emergency preparedness, orientation to positive behavioral practices, orientation to 
302.24 	responding to a mental health crisis, fraud issues, time cards and documentation, and an 
302.25 	overview of person-centered planning and self-direction. Upon completion of the training 
302.26 	components, the support worker must pass the certification test to provide assistance to 
302.27 	participants;
302.28 	(5) complete employer-directed training and orientation on the participant's individual 
302.29 	needs;
302.30 	(6) maintain the privacy and confidentiality of the participant; and
302.31 	(7) not independently determine the medication dose or time for medications for the 
302.32 	participant.
303.1 	(b) The commissioner may deny or terminate a support worker's provider enrollment 
303.2 	and provider number if the support worker:
303.3 	(1) does not meet the requirements in paragraph (a);
303.4 	(2) fails to provide the authorized services required by the employer;
303.5 	(3) has been intoxicated by alcohol or drugs while providing authorized services to the 
303.6 	participant or while in the participant's home;
303.7 	(4) has manufactured or distributed drugs while providing authorized services to the 
303.8 	participant or while in the participant's home; or
303.9 	(5) has been excluded as a provider by the commissioner of human services, or by the 
303.10 	United States Department of Health and Human Services, Office of Inspector General, from 
303.11 	participation in Medicaid, Medicare, or any other federal health care program.
303.12 	(c) A support worker may appeal in writing to the commissioner to contest the decision 
303.13 	to terminate the support worker's provider enrollment and provider number.
303.14 	(d) A support worker must not provide or be paid for more than 275 hours of CFSS per 
303.15 	month, regardless of the number of participants the support worker serves or the number 
303.16 	of agency-providers or participant employers by which the support worker is employed. 
303.17 	The department shall not disallow the number of hours per day a support worker works 
303.18 	unless it violates other law.
303.19 	(e) CFSS qualify for an enhanced rate if the support worker providing the services:
303.20 	(1) provides services, within the scope of CFSS described in subdivision 7, to a participant 
303.21 	who qualifies for 12 or more hours per day of CFSS; and
303.22 	(2) satisfies the current requirements of Medicare for training and competency or 
303.23 	competency evaluation of home health aides or nursing assistants, as provided in the Code 
303.24 	of Federal Regulations, title 42, section 483.151 or 484.36, or alternative state-approved 
303.25 	training or competency requirements.

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

303.27 	Sec. 76. Minnesota Statutes 2018, section 256I.03, subdivision 8, is amended to read:
303.28 		Subd. 8.Supplementary services. "Supplementary services" means housing support 
303.29 	services provided to individuals in addition to room and board including, but not limited 
303.30 	to, oversight and up to 24-hour supervision, medication reminders, assistance with 
304.1 	transportation, arranging for meetings and appointments, and arranging for medical and 
304.2 	social services, and services identified in section 256I.03, subdivision 12.

304.3 	Sec. 77. Minnesota Statutes 2018, section 256I.04, subdivision 2b, is amended to read:
304.4 		Subd. 2b.Housing support agreements. (a) Agreements between agencies and providers 
304.5 	of housing support must be in writing on a form developed and approved by the commissioner 
304.6 	and must specify the name and address under which the establishment subject to the 
304.7 	agreement does business and under which the establishment, or service provider, if different 
304.8 	from the group residential housing establishment, is licensed by the Department of Health 
304.9 	or the Department of Human Services; the specific license or registration from the 
304.10 	Department of Health or the Department of Human Services held by the provider and the 
304.11 	number of beds subject to that license; the address of the location or locations at which 
304.12 	group residential housing is provided under this agreement; the per diem and monthly rates 
304.13 	that are to be paid from housing support funds for each eligible resident at each location; 
304.14 	the number of beds at each location which are subject to the agreement; whether the license 
304.15 	holder is a not-for-profit corporation under section 501(c)(3) of the Internal Revenue Code; 
304.16 	and a statement that the agreement is subject to the provisions of sections 256I.01 to 256I.06
304.17 	and subject to any changes to those sections.
304.18 	(b) Providers are required to verify the following minimum requirements in the 
304.19 	agreement:
304.20 	(1) current license or registration, including authorization if managing or monitoring 
304.21 	medications;
304.22 	(2) all staff who have direct contact with recipients meet the staff qualifications;
304.23 	(3) the provision of housing support;
304.24 	(4) the provision of supplementary services, if applicable;
304.25 	(5) reports of adverse events, including recipient death or serious injury; and
304.26 	(6) submission of residency requirements that could result in recipient eviction.; and
304.27 	(7) confirmation that the provider will not limit or restrict the number of hours an 
304.28 	applicant or recipient chooses to be employed, as specified in subdivision 5.
304.29 	(c) Agreements may be terminated with or without cause by the commissioner, the 
304.30 	agency, or the provider with two calendar months prior notice. The commissioner may 
304.31 	immediately terminate an agreement under subdivision 2d.

305.1 	Sec. 78. Minnesota Statutes 2018, section 256I.04, is amended by adding a subdivision 
305.2 	to read:
305.3 		Subd. 2h.Required supplementary services. Providers of supplementary services shall 
305.4 	ensure that recipients have, at a minimum, assistance with services as identified in the 
305.5 	recipient's professional statement of need under section 256I.03, subdivision 12. Providers 
305.6 	of supplementary services shall maintain case notes with the date and description of services 
305.7 	provided to individual recipients.

305.8 	Sec. 79. Minnesota Statutes 2018, section 256I.04, is amended by adding a subdivision 
305.9 	to read:
305.10 		Subd. 5.Employment. A provider is prohibited from limiting or restricting the number 
305.11 	of hours an applicant or recipient is employed.

305.12 	Sec. 80. Laws 2017, First Special Session chapter 6, article 1, section 44, is amended to 
305.13 	read:
305.14 	Sec. 44. EXPANSION OF CONSUMER-DIRECTED COMMUNITY SUPPORTS 
305.15 	BUDGET METHODOLOGY EXCEPTION.
 305.16 	(a) No later than September 30, 2017, if necessary, the commissioner of human services 
305.17 	shall submit an amendment to the Centers for Medicare and Medicaid Services for the home 
305.18 	and community-based services waivers authorized under Minnesota Statutes, sections 
305.19 	256B.092 and 256B.49, to expand the exception to the consumer-directed community 
305.20 	supports budget methodology under Laws 2015, chapter 71, article 7, section 54, to provide 
305.21 	up to 30 percent more funds for either:
305.22 	(1) consumer-directed community supports participants who have a coordinated service 
305.23 	and support plan which identifies the need for an increased amount of services or supports 
305.24 	under consumer-directed community supports than the amount they are currently receiving 
305.25 	under the consumer-directed community supports budget methodology:
305.26 	(i) to increase the amount of time a person works or otherwise improves employment 
305.27 	opportunities;
305.28 	(ii) to plan a transition to, move to, or live in a setting described in Minnesota Statutes, 
305.29 	section 256D.44, subdivision 5, paragraph (f), clause (1), item (ii), or paragraph (g), clause 
305.30 	(1), item (iii); or
305.31 	(iii) to develop and implement a positive behavior support plan; or
306.1 	(2) home and community-based waiver participants who are currently using licensed 
306.2 	providers for (i) employment supports or services during the day; or (ii) residential services, 
306.3 	either of which cost more annually than the person would spend under a consumer-directed 
306.4 	community supports plan for any or all of the supports needed to meet the goals identified 
306.5 	in paragraph (a), clause (1), items (i), (ii), and (iii).
306.6 	(b) The exception under paragraph (a), clause (1), is limited to those persons who can 
306.7 	demonstrate that they will have to discontinue using consumer-directed community supports 
306.8 	and accept other non-self-directed waiver services because their supports needed for the 
306.9 	goals described in paragraph (a), clause (1), items (i), (ii), and (iii), cannot be met within 
306.10 	the consumer-directed community supports budget limits.
306.11 	(c) The exception under paragraph (a), clause (2), is limited to those persons who can 
306.12 	demonstrate that, upon choosing to become a consumer-directed community supports 
306.13 	participant, the total cost of services, including the exception, will be less than the cost of 
306.14 	current waiver services.

306.15 	Sec. 81. Laws 2017, First Special Session chapter 6, article 1, section 45, is amended to 
306.16 	read:
306.17 	Sec. 45. CONSUMER-DIRECTED COMMUNITY SUPPORTS BUDGET 
306.18 	METHODOLOGY EXCEPTION FOR PERSONS LEAVING INSTITUTIONS AND 
306.19 	CRISIS RESIDENTIAL SETTINGS.
306.20 		Subdivision 1.Exception for persons leaving institutions and crisis residential 
306.21 	settings. (a) By September 30, 2017, the commissioner shall establish an institutional and 
306.22 	crisis bed consumer-directed community supports budget exception process in the home 
306.23 	and community-based services waivers under Minnesota Statutes, sections 256B.092 and 
306.24 	256B.49. This budget exception process shall be available for any individual who:
306.25 	(1) is not offered available and appropriate services within 60 days since approval for 
306.26 	discharge from the individual's current institutional setting; and
306.27 	(2) requires services that are more expensive than appropriate services provided in a 
306.28 	noninstitutional setting using the consumer-directed community supports option.
306.29 	(b) Institutional settings for purposes of this exception include intermediate care facilities 
306.30 	for persons with developmental disabilities; nursing facilities; acute care hospitals; Anoka 
306.31 	Metro Regional Treatment Center; Minnesota Security Hospital; and crisis beds. The budget 
306.32 	exception shall be limited to no more than the amount of appropriate services provided in 
307.1 	a noninstitutional setting as determined by the lead agency managing the individual's home 
307.2 	and community-based services waiver. The lead agency shall notify the Department of 
307.3 	Human Services of the budget exception.
307.4 		Subd. 2.Shared services. (a) Medical assistance payments for shared services under 
307.5 	consumer-directed community supports are limited to this subdivision.
307.6 	(b) For purposes of this subdivision, "shared services" means services provided at the 
307.7 	same time by the same direct care worker for individuals who have entered into an agreement 
307.8 	to share consumer-directed community support services.
307.9 	(c) Shared services may include services in the personal assistance category as outlined 
307.10 	in the consumer-directed community supports community support plan and shared services 
307.11 	agreement, except:
307.12 	(1) services for more than three individuals provided by one worker at one time;
307.13 	(2) use of more than one worker for the shared services; and
307.14 	(3) a child care program licensed under chapter 245A or operated by a local school 
307.15 	district or private school.
307.16 	(d) The individuals or, as needed, their representatives shall develop the plan for shared 
307.17 	services when developing or amending the consumer-directed community supports plan, 
307.18 	and must follow the consumer-directed community supports process for approval of the 
307.19 	plan by the lead agency. The plan for shared services in an individual's consumer-directed 
307.20 	community supports plan shall include the intention to utilize shared services based on 
307.21 	individuals' needs and preferences.
307.22 	(e) Individuals sharing services must use the same financial management services 
307.23 	provider.
307.24 	(f) Individuals whose consumer-directed community supports community support plans 
307.25 	include the intention to utilize shared services must also jointly develop, with the support 
307.26 	of their representatives as needed, a shared services agreement. This agreement must include:
307.27 	(1) the names of the individuals receiving shared services;
307.28 	(2) the individuals' representative, if identified in their consumer-directed community 
307.29 	supports plans, and their duties;
307.30 	(3) the names of the case managers;
307.31 	(4) the financial management services provider;
308.1 	(5) the shared services that must be provided;
308.2 	(6) the schedule for shared services;
308.3 	(7) the location where shared services must be provided;
308.4 	(8) the training specific to each individual served;
308.5 	(9) the training specific to providing shared services to the individuals identified in the 
308.6 	agreement;
308.7 	(10) instructions to follow all required documentation for time and services provided;
308.8 	(11) a contingency plan for each of the individuals that accounts for service provision 
308.9 	and billing in the absence of one of the individuals in a shared services setting due to illness 
308.10 	or other circumstances;
308.11 	(12) signatures of all parties involved in the shared services; and
308.12 	(13) agreement by each of the individuals who are sharing services on the number of 
308.13 	shared hours for services provided.
308.14 	(g) Any individual or any individual's representative may withdraw from participating 
308.15 	in a shared services agreement at any time.
308.16 	(h) The lead agency for each individual must authorize the use of the shared services 
308.17 	option based on the criteria that the shared service is appropriate to meet the needs, health, 
308.18 	and safety of each individual for whom they provide case management or care coordination.
308.19 	(i) Nothing in this subdivision must be construed to reduce the total authorized 
308.20 	consumer-directed community supports budget for an individual.
308.21 	(j) No later than September 30, 2019, the commissioner of human services shall:
308.22 	(1) submit an amendment to the Centers for Medicare and Medicaid Services for the 
308.23 	home and community-based services waivers authorized under Minnesota Statutes, sections 
308.24 	256B.0913, 256B.0915, 256B.092, and 256B.49, to allow for a shared services option under 
308.25 	consumer-directed community supports; and
308.26 	(2) with stakeholder input, develop guidance for shared services in consumer-directed 
308.27 	community-supports within the Community Based Services Manual. Guidance must include:
308.28 	(i) recommendations for negotiating payment for one-to-two and one-to-three services; 
308.29 	and
308.30 	(ii) a template of the shared services agreement.

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

309.5 	Sec. 82. Laws 2017, First Special Session chapter 6, article 3, section 49, is amended to 
309.6 	read:
309.7 	Sec. 49. ELECTRONIC SERVICE DELIVERY DOCUMENTATION SYSTEM
309.8 	VISIT VERIFICATION.
 309.9 		Subdivision 1.Documentation; establishment. The commissioner of human services 
309.10 	shall establish implementation requirements and standards for an electronic service delivery 
309.11 	documentation system visit verification to comply with the 21st Century Cures Act, Public 
309.12 	Law 114-255. Within available appropriations, the commissioner shall take steps to comply 
309.13 	with the electronic visit verification requirements in the 21st Century Cures Act, Public 
309.14 	Law 114-255.
309.15 		Subd. 2.Definitions. (a) For purposes of this section, the terms in this subdivision have 
309.16 	the meanings given them.
309.17 	(b) "Electronic service delivery documentation visit verification" means the electronic 
309.18 	documentation of the:
309.19 	(1) type of service performed;
309.20 	(2) individual receiving the service;
309.21 	(3) date of the service;
309.22 	(4) location of the service delivery;
309.23 	(5) individual providing the service; and
309.24 	(6) time the service begins and ends.
309.25 	(c) "Electronic service delivery documentation visit verification system" means a system 
309.26 	that provides electronic service delivery documentation verification of services that complies 
309.27 	with the 21st Century Cures Act, Public Law 114-255, and the requirements of subdivision 
309.28 	3.
309.29 	(d) "Service" means one of the following:
310.1 	(1) personal care assistance services as defined in Minnesota Statutes, section 256B.0625, 
310.2 	subdivision 19a, and provided according to Minnesota Statutes, section 256B.0659; or
310.3 	(2) community first services and supports under Minnesota Statutes, section 256B.85;
310.4 	(3) home health services under Minnesota Statutes, section 256B.0625, subdivision 6a; 
310.5 	or
310.6 	(4) other medical supplies and equipment or home and community-based services that 
310.7 	are required to be electronically verified by the 21st Century Cures Act, Public Law 114-255.
310.8 		Subd. 3.Requirements. (a) In developing implementation requirements for an electronic 
310.9 	service delivery documentation system visit verification, the commissioner shall consider 
310.10 	electronic visit verification systems and other electronic service delivery documentation 
310.11 	methods. The commissioner shall convene stakeholders that will be impacted by an electronic 
310.12 	service delivery system, including service providers and their representatives, service 
310.13 	recipients and their representatives, and, as appropriate, those with expertise in the 
310.14 	development and operation of an electronic service delivery documentation system, to ensure 
310.15 	that the requirements:
310.16 	(1) are minimally administratively and financially burdensome to a provider;
310.17 	(2) are minimally burdensome to the service recipient and the least disruptive to the 
310.18 	service recipient in receiving and maintaining allowed services;
310.19 	(3) consider existing best practices and use of electronic service delivery documentation
310.20 	visit verification;
310.21 	(4) are conducted according to all state and federal laws;
310.22 	(5) are effective methods for preventing fraud when balanced against the requirements 
310.23 	of clauses (1) and (2); and
310.24 	(6) are consistent with the Department of Human Services' policies related to covered 
310.25 	services, flexibility of service use, and quality assurance.
310.26 	(b) The commissioner shall make training available to providers on the electronic service 
310.27 	delivery documentation visit verification system requirements.
310.28 	(c) The commissioner shall establish baseline measurements related to preventing fraud 
310.29 	and establish measures to determine the effect of electronic service delivery documentation
310.30 	visit verification requirements on program integrity.
310.31 	(d) The commissioner shall make a state-selected electronic visit verification system 
310.32 	available to providers of services.
311.1 		Subd. 3a.Provider requirements. (a) A provider of services may select any electronic 
311.2 	visit verification system that meets the requirements established by the commissioner.
311.3 	(b) All electronic visit verification systems used by providers to comply with the 
311.4 	requirements established by the commissioner must provide data to the commissioner in a 
311.5 	format and at a frequency to be established by the commissioner.
311.6 	(c) Providers must implement the electronic visit verification systems required under 
311.7 	this section by a date established by the commissioner to be set after the state-selected 
311.8 	electronic visit verification systems for personal care services and home health services are 
311.9 	in production. For purposes of this paragraph, "personal care services" and "home health 
311.10 	services" have the meanings given in United States Code, title 42, section 1396b(l)(5). 
311.11 	Reimbursement rates for providers must not be reduced as a result of federal action to reduce 
311.12 	the federal medical assistance percentage under the 21st Century Cures Act, Public Law 
311.13 	114-255.
311.14 		Subd. 4.Legislative report. (a) The commissioner shall submit a report by January 15, 
311.15 	2018, to the chairs and ranking minority members of the legislative committees with 
311.16 	jurisdiction over human services with recommendations, based on the requirements of 
311.17 	subdivision 3, to establish electronic service delivery documentation system requirements 
311.18 	and standards. The report shall identify:
311.19 	(1) the essential elements necessary to operationalize a base-level electronic service 
311.20 	delivery documentation system to be implemented by January 1, 2019; and
311.21 	(2) enhancements to the base-level electronic service delivery documentation system to 
311.22 	be implemented by January 1, 2019, or after, with projected operational costs and the costs 
311.23 	and benefits for system enhancements.
311.24 	(b) The report must also identify current regulations on service providers that are either 
311.25 	inefficient, minimally effective, or will be unnecessary with the implementation of an 
311.26 	electronic service delivery documentation system.

311.27 	Sec. 83. INDIVIDUAL PROVIDERS OF DIRECT SUPPORT SERVICES.
 311.28 	The labor agreement between the state of Minnesota and the Service Employees 
311.29 	International Union Healthcare Minnesota, submitted to the Legislative Coordinating 
311.30 	Commission on March 11, 2019, is ratified.

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

312.1 	Sec. 84. RATE INCREASE FOR DIRECT SUPPORT SERVICES PROVIDERS 
312.2 	WORKFORCE NEGOTIATIONS.
 312.3 	(a) Effective July 1, 2019, if the labor agreement between the state of Minnesota and 
312.4 	the Service Employees International Union Healthcare Minnesota under Minnesota Statutes, 
312.5 	section 179A.54, is approved pursuant to Minnesota Statutes, section 3.855, the commissioner 
312.6 	of human services shall:
312.7 	(1) increase reimbursement rates, individual budgets, grants, or allocations by 2.37 
312.8 	percent for services provided on or after July 1, 2019, to implement the minimum hourly 
312.9 	wage, holiday, and paid time off provisions of that agreement; and
312.10 	(2) for services provided on or after July 1, 2019, to eligible service recipients, provide 
312.11 	an enhanced rate of 7.5 percent for personal care assistance and community first services 
312.12 	and supports and an enhanced budget increased by 7.5 percent for consumer-directed 
312.13 	community supports and the consumer support grant. Eligible service recipients are persons 
312.14 	identified by the state through assessment who are eligible for at least 12 hours of personal 
312.15 	care assistance each day and are served by workers who have completed designated training 
312.16 	approved by the commissioner. The enhanced rate and enhanced budget includes, and is 
312.17 	not in addition to, any previously implemented enhanced rates or enhanced budgets for 
312.18 	eligible service recipients.
312.19 	(b) The rate changes described in this section apply to direct support services provided 
312.20 	through a covered program, as defined in Minnesota Statutes, section 256B.0711, subdivision 
312.21 	1.

312.22 	Sec. 85. DIRECTION TO COMMISSIONER; INTERAGENCY AGREEMENTS.
 312.23 	By October 1, 2019, the Department of Commerce, Public Utilities Commission, and 
312.24 	Department of Human Services must amend all interagency agreements necessary to 
312.25 	implement sections 1 to 10.

312.26 	Sec. 86. DISABILITY WAIVER RECONFIGURATION.
 312.27 		Subdivision 1.Intent. It is the intent of the legislature to reform the medical assistance 
312.28 	waiver programs for people with disabilities to simplify administration of the programs, 
312.29 	incentivize inclusive person-centered supports, enhance each person's personal authority 
312.30 	over the person's service choice, align benefits across waivers, encourage equity across 
312.31 	programs and populations, and promote long-term sustainability of needed services. To the 
312.32 	maximum extent possible, the disability waiver reconfiguration must maintain service 
313.1 	stability and continuity of care, while promoting the most independent and integrated 
313.2 	supports of each person's choosing in both short- and long-term planning.
313.3 		Subd. 2.Report. By January 15, 2021, the commissioner of human services shall submit 
313.4 	a report to the members of the legislative committees with jurisdiction over human services 
313.5 	on any necessary waivers, state plan amendments, requests for new funding or realignment 
313.6 	of existing funds, any changes to state statute or rule, and any other federal authority 
313.7 	necessary to implement this section. The report must include information about the 
313.8 	commissioner's work to collect feedback and input from providers, persons accessing home 
313.9 	and community-based services waivers and their families, and client advocacy organizations.
313.10 		Subd. 3.Proposal. By January 15, 2021, the commissioner shall develop a proposal to 
313.11 	reconfigure the medical assistance waivers provided in sections 256B.092 and 256B.49. 
313.12 	The proposal shall include all necessary plans for implementing two home and 
313.13 	community-based services waiver programs, as authorized under section 1915(c) of the 
313.14 	Social Security Act that serve persons who are determined to require the levels of care 
313.15 	provided in a nursing home, a hospital, a neurobehavioral hospital, or an intermediate care 
313.16 	facility for persons with developmental disabilities. Before submitting the final report to 
313.17 	the legislature, the commissioner shall publish a draft report with sufficient time for interested 
313.18 	persons to offer additional feedback.

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

313.20 	Sec. 87. DIRECTION TO COMMISSIONER OF HUMAN SERVICES; DIRECT 
313.21 	CARE WORKFORCE RATE METHODOLOGY STUDY.
 313.22 	The commissioner of human services, in consultation with stakeholders, shall evaluate 
313.23 	the feasibility of developing a rate methodology for the personal care assistance program 
313.24 	under Minnesota Statutes, section 256B.0659, and community first services and supports 
313.25 	under Minnesota Statutes, section 256B.85, similar to the disability waiver rate system 
313.26 	under Minnesota Statutes, section 256B.4914, including determining the component values 
313.27 	and factors to include in such a rate methodology; consider aligning any rate methodology 
313.28 	with the collective bargaining agreement and negotiation cycle under Minnesota Statutes, 
313.29 	section 179A.54; recommend strategies for ensuring adequate, competitive wages for direct 
313.30 	care workers; develop methods and determine the necessary resources for the commissioner 
313.31 	to more consistently collect and audit data from the direct care industry; and report 
313.32 	recommendations, including proposed draft legislation, to the chairs and ranking minority 
313.33 	members of the legislative committees with jurisdiction over human services policy and 
313.34 	finance by February 1, 2020.

314.1 	Sec. 88. DIRECTION TO COMMISSIONER OF HUMAN SERVICES; TEFRA 
314.2 	OPTION IMPROVEMENT MEASURES.
 314.3 	(a) The commissioner of human services shall, using existing appropriations, develop 
314.4 	content to be included on the MNsure website explaining the TEFRA option under medical 
314.5 	assistance for applicants who indicate during the application process that a child in the 
314.6 	family has a disability.
314.7 	(b) The commissioner shall develop a cover letter explaining the TEFRA option under 
314.8 	medical assistance, as well as the application and renewal process, to be disseminated with 
314.9 	the DHS-6696A form to applicants who may qualify for medical assistance under the TEFRA 
314.10 	option. The commissioner shall provide the content and the form to the executive director 
314.11 	of MNsure for inclusion on the MNsure website. The commissioner shall also develop and 
314.12 	implement education and training for lead agency staff statewide to improve understanding 
314.13 	of the medical assistance TEFRA enrollment and renewal processes and procedures.
314.14 	(c) The commissioner shall convene a stakeholder group that shall consider improvements 
314.15 	to the TEFRA option enrollment and renewal processes, including but not limited to revisions 
314.16 	to, or the development of, application and renewal paperwork specific to the TEFRA option; 
314.17 	possible technology solutions; and county processes.
314.18 	(d) The stakeholder group must include representatives from the Department of Human 
314.19 	Services Health Care Division, MNsure, representatives from at least two counties in the 
314.20 	metropolitan area and from at least one county in greater Minnesota, the Arc Minnesota, 
314.21 	Gillette Children's Specialty Healthcare, the Autism Society of Minnesota, Proof Alliance, 
314.22 	the Minnesota Consortium for Citizens with Disabilities, and other interested stakeholders 
314.23 	as identified by the commissioner of human services.
314.24 	(e) The stakeholder group shall submit a report of the group's recommended 
314.25 	improvements and any associated costs to the commissioner by December 31, 2020. The 
314.26 	group shall also provide copies of the report to each stakeholder group member. The 
314.27 	commissioner shall provide a copy of the report to the legislative committees with jurisdiction 
314.28 	over medical assistance.

314.29 	Sec. 89. DIRECTION TO COMMISSIONER; RESIDENTIAL SERVICES RATE 
314.30 	METHODOLOGY.
 314.31 	The commissioner of human services shall develop a new rate methodology for residential 
314.32 	services, reimbursed under Minnesota Statutes, section 256B.4914, in which the service 
314.33 	provider lives in the setting where the service is provided based on levels of support needs. 
315.1 	The commissioner shall submit recommendations to the chairs and ranking minority members 
315.2 	of the legislative committees and divisions with jurisdiction over human services for the 
315.3 	new rate methodology by January 1, 2020.

315.4 	Sec. 90. DAY TRAINING AND HABILITATION DISABILITY WAIVER RATE 
315.5 	SYSTEM TRANSITION GRANTS.
 315.6 	(a) The commissioner of human services shall establish annual grants to day training 
315.7 	and habilitation providers that are projected to experience a funding gap upon the full 
315.8 	implementation of Minnesota Statutes, section 256B.4914.
315.9 	(b) In order to be eligible for a grant under this section, a day training and habilitation 
315.10 	disability waiver provider must:
315.11 	(1) serve at least 100 waiver service participants;
315.12 	(2) be projected to receive a reduction in annual revenue from medical assistance for 
315.13 	day services during the first year of full implementation of disability waiver rate system 
315.14 	framework rates under Minnesota Statutes, section 256B.4914, of at least 15 percent and 
315.15 	at least $300,000 compared to the annual medical assistance revenue for day services the 
315.16 	provider received during the last full year during which banded rates under Minnesota 
315.17 	Statutes, section 256B.4913, subdivision 4a, were effective; and
315.18 	(3) agree to develop, submit, and implement a sustainability plan as provided in paragraph
315.19 	(c) A recipient of a grant under this section must develop a sustainability plan in 
315.20 	partnership with the commissioner of human services. The sustainability plan must include:
315.21 	(1) a review of all the provider's costs and an assessment of whether the provider is 
315.22 	implementing available cost-control options appropriately;
315.23 	(2) a review of all the provider's revenue and an assessment of whether the provider is 
315.24 	leveraging available resources appropriately; and
315.25 	(3) a practical strategy for closing the funding gap described in paragraph (b), clause 
315.26 	(2).
315.27 	(d) The commissioner of human services shall provide technical assistance and financial 
315.28 	management advice to grant recipients as they develop and implement their sustainability 
315.29 	plans.
315.30 	(e) In order to be eligible for an annual grant renewal, a grant recipient must demonstrate 
315.31 	to the commissioner of human services that it made a good faith effort to close the revenue 
315.32 	gap described in paragraph (b), clause (2).

316.1 	Sec. 91. DIRECTION TO COMMISSIONER; BI AND CADI WAIVER 
316.2 	CUSTOMIZED LIVING SERVICES PROVIDER LOCATED IN HENNEPIN 
316.3 	COUNTY.
 316.4 	(a) The commissioner of human services shall allow a housing with services establishment 
316.5 	located in Minneapolis that provides customized living and 24-hour customized living 
316.6 	services for clients enrolled in the brain injury (BI) or community access for disability 
316.7 	inclusion (CADI) waiver and had a capacity to serve 66 clients as of July 1, 2017, to transfer 
316.8 	service capacity of up to 66 clients to no more than three new housing with services 
316.9 	establishments located in Hennepin County.
316.10 	(b) Notwithstanding Minnesota Statutes, section 256B.492, the commissioner shall 
316.11 	determine that the new housing with services establishments described under paragraph (a) 
316.12 	meet the BI and CADI waiver customized living and 24-hour customized living size 
316.13 	limitation exception for clients receiving those services at the new housing with services 
316.14 	establishments described under paragraph (a).

316.15 	Sec. 92. DIRECTION TO COMMISSIONER OF HUMAN SERVICES; 
316.16 	RECOMMENDATIONS TO INCREASE USE OF TECHNOLOGY.
 316.17 	(a) The commissioner shall appoint under Minnesota Statutes, section 256.01, subdivision 
316.18 	6, a Minnesota Technology First Advisory Task Force to advise the commissioner on 
316.19 	strategies to increase the use of supportive technology in services and programs the 
316.20 	commissioner administers for persons with disabilities to enable them to live more 
316.21 	independently in community settings, work in competitive integrated environments, 
316.22 	participate in inclusive community activities, and increase quality of life. The advisory task 
316.23 	force must include:
316.24 	(1) one representative of the Department of Human Services;
316.25 	(2) two representatives of the counties;
316.26 	(3) one representative of the Associations of Residential Resources in Minnesota;
316.27 	(4) one representative from the Minnesota Organization for Habilitation and 
316.28 	Rehabilitation;
316.29 	(5) one representative of the Disability Law Center;
316.30 	(6) one representative of the Arc Minnesota;
316.31 	(7) one representative from STAR Services;
316.32 	(8) one representative from the Traumatic Brain Injury Advisory Committee;
317.1 	(9) one representative from NAMI Minnesota;
317.2 	(10) one representative from Advocating Change Together;
317.3 	(11) two individuals with disabilities accessing supportive technology; and
317.4 	(12) one parent advocate.
317.5 	Meetings will be held quarterly and hosted by the department. Subcommittees may be 
317.6 	developed as necessary by the commissioner. Advisory task force meetings are subject to 
317.7 	the Open Meeting Law under Minnesota Statutes, chapter 13D.
317.8 	(b) The advisory task force will provide an annual written report with recommendations 
317.9 	to the commissioner by June 30 of each year of its existence, beginning June 30, 2020.
317.10 	(c) Persons with disabilities and family members of persons with disabilities are eligible 
317.11 	for compensation for participation in this task force.
317.12 	(d) The advisory task force expires on June 30, 2021.

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

317.14 	Sec. 93. REVISOR INSTRUCTION.
 317.15 	(a) The revisor of statutes shall change the term "developmental disability waiver" or 
317.16 	similar terms to "developmental disabilities waiver" or similar terms wherever they appear 
317.17 	in Minnesota Statutes. The revisor shall also make technical and other necessary changes 
317.18 	to sentence structure to preserve the meaning of the text.
317.19 	(b) The revisor of statutes, in consultation with the House Research Department, Office 
317.20 	of Senate Counsel, Research and Fiscal Analysis, and Department of Human Services, shall 
317.21 	prepare legislation for the 2020 legislative session to codify existing session laws governing 
317.22 	consumer-directed community supports in Minnesota Statutes, chapter 256B.
317.23 	(c) The revisor of statutes shall codify Laws 2017, First Special Session chapter 6, article 
317.24 	3, section 49, as amended in this act, in Minnesota Statutes, chapter 256B.

317.25 	EFFECTIVE DATE. Paragraph (a) is effective July 1, 2020.

317.26 	Sec. 94. REPEALER.
 317.27 	(a) Minnesota Statutes 2018, section 256B.0705, is repealed.
317.28 	(b) Minnesota Statutes 2018, sections 252.431; and 252.451, are repealed.
318.1 	(c) Minnesota Statutes 2018, sections 252.41, subdivision 8; and 256B.4913, subdivisions 
318.2 	4a, 5, 6, and 7, are repealed.
318.3 	(d) Minnesota Statutes 2018, section 256I.05, subdivision 3, is repealed.

318.4 	EFFECTIVE DATE. Paragraph (b) is effective September 1, 2019. Paragraphs (a) and 
318.5 	(c) are effective January 1, 2020. Paragraph (d) is effective July 1, 2019.

318.6 	ARTICLE 6
318.7 	CHEMICAL AND MENTAL HEALTH

318.8 	Section 1. Minnesota Statutes 2018, section 13.851, is amended by adding a subdivision 
318.9 	to read:
318.10 		Subd. 12.Mental health screening. The treatment of data collected by a sheriff or local 
318.11 	corrections agency related to individuals who may have a mental illness is governed by 
318.12 	section 641.15, subdivision 3a.

318.13 	Sec. 2. Minnesota Statutes 2018, section 245.4889, subdivision 1, is amended to read:
318.14 		Subdivision 1.Establishment and authority. (a) The commissioner is authorized to 
318.15 	make grants from available appropriations to assist:
318.16 	(1) counties;
318.17 	(2) Indian tribes;
318.18 	(3) children's collaboratives under section 124D.23 or 245.493; or
318.19 	(4) mental health service providers.
318.20 	(b) The following services are eligible for grants under this section:
318.21 	(1) services to children with emotional disturbances as defined in section 245.4871, 
318.22 	subdivision 15, and their families;
318.23 	(2) transition services under section 245.4875, subdivision 8, for young adults under 
318.24 	age 21 and their families;
318.25 	(3) respite care services for children with severe emotional disturbances who are at risk 
318.26 	of out-of-home placement;
318.27 	(4) children's mental health crisis services;
318.28 	(5) mental health services for people from cultural and ethnic minorities;
318.29 	(6) children's mental health screening and follow-up diagnostic assessment and treatment;
319.1 	(7) services to promote and develop the capacity of providers to use evidence-based 
319.2 	practices in providing children's mental health services;
319.3 	(8) school-linked mental health services, including transportation for children receiving 
319.4 	school-linked mental health services when school is not in session under section 245.4901;
319.5 	(9) building evidence-based mental health intervention capacity for children birth to age 
319.6 	five;
319.7 	(10) suicide prevention and counseling services that use text messaging statewide;
319.8 	(11) mental health first aid training;
319.9 	(12) training for parents, collaborative partners, and mental health providers on the 
319.10 	impact of adverse childhood experiences and trauma and development of an interactive 
319.11 	website to share information and strategies to promote resilience and prevent trauma;
319.12 	(13) transition age services to develop or expand mental health treatment and supports 
319.13 	for adolescents and young adults 26 years of age or younger;
319.14 	(14) early childhood mental health consultation;
319.15 	(15) evidence-based interventions for youth at risk of developing or experiencing a first 
319.16 	episode of psychosis, and a public awareness campaign on the signs and symptoms of 
319.17 	psychosis;
319.18 	(16) psychiatric consultation for primary care practitioners; and
319.19 	(17) providers to begin operations and meet program requirements when establishing a 
319.20 	new children's mental health program. These may be start-up grants.
319.21 	(c) Services under paragraph (b) must be designed to help each child to function and 
319.22 	remain with the child's family in the community and delivered consistent with the child's 
319.23 	treatment plan. Transition services to eligible young adults under this paragraph must be 
319.24 	designed to foster independent living in the community.
319.25 	(d) As a condition of receiving grant funds, a grantee shall obtain all available third-party 
319.26 	reimbursement sources, if applicable.

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

319.28 	Sec. 3. [245.4901] SCHOOL-LINKED MENTAL HEALTH GRANTS.
319.29 		Subdivision 1.Establishment. The commissioner of human services shall establish a 
319.30 	school-linked mental health grant program to provide early identification and intervention 
320.1 	for students with mental health needs and to build the capacity of schools to support students 
320.2 	with mental health needs in the classroom.
320.3 		Subd. 2.Eligible applicants. An eligible applicant for school-linked mental health grants 
320.4 	is an entity that is:
320.5 	(1) certified under Minnesota Rules, parts 9520.0750 to 9520.0870;
320.6 	(2) a community mental health center under section 256B.0625, subdivision 5;
320.7 	(3) an Indian health service facility or a facility owned and operated by a tribe or tribal 
320.8 	organization operating under United States Code, title 25, section 5321;
320.9 	(4) a provider of children's therapeutic services and supports as defined in section 
320.10 	256B.0943; or
320.11 	(5) enrolled in medical assistance as a mental health or substance use disorder provider 
320.12 	agency and employs at least two full-time equivalent mental health professionals qualified 
320.13 	according to section 245I.16, subdivision 2, or two alcohol and drug counselors licensed or 
320.14 	exempt from licensure under chapter 148F who are qualified to provide clinical services to 
320.15 	children and families.
320.16 		Subd. 3.Allowable grant activities and related expenses. (a) Allowable grant activities 
320.17 	and related expenses may include but are not limited to:
320.18 	(1) identifying and diagnosing mental health conditions of students;
320.19 	(2) delivering mental health treatment and services to students and their families, 
320.20 	including via telemedicine consistent with section 256B.0625, subdivision 3b;
320.21 	(3) supporting families in meeting their child's needs, including navigating health care, 
320.22 	social service, and juvenile justice systems;
320.23 	(4) providing transportation for students receiving school-linked mental health services 
320.24 	when school is not in session;
320.25 	(5) building the capacity of schools to meet the needs of students with mental health 
320.26 	concerns, including school staff development activities for licensed and nonlicensed staff; 
320.27 	and
320.28 	(6) purchasing equipment, connection charges, on-site coordination, set-up fees, and 
320.29 	site fees in order to deliver school-linked mental health services via telemedicine.
320.30 	(b) Grantees shall obtain all available third-party reimbursement sources as a condition 
320.31 	of receiving a grant. For purposes of this grant program, a third-party reimbursement source 
321.1 	excludes a public school as defined in section 120A.20, subdivision 1. Grantees shall serve 
321.2 	students regardless of health coverage status or ability to pay.
321.3 		Subd. 4.Data collection and outcome measurement. Grantees shall provide data to 
321.4 	the commissioner for the purpose of evaluating the effectiveness of the school-linked mental 
321.5 	health grant program.

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

321.7 	Sec. 4. Minnesota Statutes 2018, section 245.735, subdivision 3, is amended to read:
321.8 		Subd. 3.Certified community behavioral health clinics. (a) The commissioner shall 
321.9 	establish a state certification process for certified community behavioral health clinics 
321.10 	(CCBHCs) to be eligible for the prospective payment system in paragraph (f). Entities that 
321.11 	choose to be CCBHCs must:
321.12 	(1) comply with the CCBHC criteria published by the United States Department of 
321.13 	Health and Human Services;
321.14 	(2) employ or contract for clinic staff who have backgrounds in diverse disciplines, 
321.15 	including licensed mental health professionals and licensed alcohol and drug counselors, 
321.16 	and staff who are culturally and linguistically trained to serve meet the needs of the clinic's 
321.17 	patient population the clinic serves;
321.18 	(3) ensure that clinic services are available and accessible to patients individuals and 
321.19 	families of all ages and genders and that crisis management services are available 24 hours 
321.20 	per day;
321.21 	(4) establish fees for clinic services for nonmedical assistance patients individuals who 
321.22 	are not enrolled in medical assistance using a sliding fee scale that ensures that services to 
321.23 	patients are not denied or limited due to a patient's an individual's inability to pay for services;
321.24 	(5) comply with quality assurance reporting requirements and other reporting 
321.25 	requirements, including any required reporting of encounter data, clinical outcomes data, 
321.26 	and quality data;
321.27 	(6) provide crisis mental health and substance use services, withdrawal management 
321.28 	services, emergency crisis intervention services, and stabilization services; screening, 
321.29 	assessment, and diagnosis services, including risk assessments and level of care 
321.30 	determinations; patient-centered person- and family-centered treatment planning; outpatient 
321.31 	mental health and substance use services; targeted case management; psychiatric 
321.32 	rehabilitation services; peer support and counselor services and family support services; 
322.1 	and intensive community-based mental health services, including mental health services 
322.2 	for members of the armed forces and veterans;
322.3 	(7) provide coordination of care across settings and providers to ensure seamless 
322.4 	transitions for patients individuals being served across the full spectrum of health services, 
322.5 	including acute, chronic, and behavioral needs. Care coordination may be accomplished 
322.6 	through partnerships or formal contracts with:
322.7 	(i) counties, health plans, pharmacists, pharmacies, rural health clinics, federally qualified 
322.8 	health centers, inpatient psychiatric facilities, substance use and detoxification facilities, or 
322.9 	community-based mental health providers; and
322.10 	(ii) other community services, supports, and providers, including schools, child welfare 
322.11 	agencies, juvenile and criminal justice agencies, Indian health services clinics, tribally 
322.12 	licensed health care and mental health facilities, urban Indian health clinics, Department of 
322.13 	Veterans Affairs medical centers, outpatient clinics, drop-in centers, acute care hospitals, 
322.14 	and hospital outpatient clinics;
322.15 	(8) be certified as mental health clinics under section 245.69, subdivision 2;
322.16 	(9) be certified to provide integrated treatment for co-occurring mental illness and 
322.17 	substance use disorders in adults or children under Minnesota Rules, chapter 9533, effective 
322.18 	July 1, 2017;
322.19 	(10) (9) comply with standards relating to mental health services in Minnesota Rules, 
322.20 	parts 9505.0370 to 9505.0372, and section 256B.0671;
322.21 	(11) (10) be licensed to provide chemical dependency substance use disorder treatment 
322.22 	under chapter 245G;
322.23 	(12) (11) be certified to provide children's therapeutic services and supports under section 
322.24 	256B.0943;
322.25 	(13) (12) be certified to provide adult rehabilitative mental health services under section 
322.26 	256B.0623;
322.27 	(14) (13) be enrolled to provide mental health crisis response services under section
322.28 	sections256B.0624 and 256B.0944;
322.29 	(15) (14) be enrolled to provide mental health targeted case management under section 
322.30 	256B.0625, subdivision 20;
322.31 	(16) (15) comply with standards relating to mental health case management in Minnesota 
322.32 	Rules, parts 9520.0900 to 9520.0926; and
323.1 	(17) (16) provide services that comply with the evidence-based practices described in 
323.2 	paragraph (e).; and
323.3 	(17) comply with standards relating to peer services under sections 256B.0615, 
323.4 	256B.0616, and 245G.07, subdivision 1, paragraph (a), clause (5), as applicable when peer 
323.5 	services are provided.
323.6 	(b) If an entity is unable to provide one or more of the services listed in paragraph (a), 
323.7 	clauses (6) to (17), the commissioner may certify the entity as a CCBHC, if the entity has 
323.8 	a current contract with another entity that has the required authority to provide that service 
323.9 	and that meets federal CCBHC criteria as a designated collaborating organization, or, to 
323.10 	the extent allowed by the federal CCBHC criteria, the commissioner may approve a referral 
323.11 	arrangement. The CCBHC must meet federal requirements regarding the type and scope of 
323.12 	services to be provided directly by the CCBHC.
323.13 	(c) Notwithstanding any other law that requires a county contract or other form of county 
323.14 	approval for certain services listed in paragraph (a), clause (6), a clinic that otherwise meets 
323.15 	CCBHC requirements may receive the prospective payment under paragraph (f) section 
323.16 	256B.0625, subdivision 5m, for those services without a county contract or county approval. 
323.17 	There is no county share when medical assistance pays the CCBHC prospective payment. 
323.18 	As part of the certification process in paragraph (a), the commissioner shall require a letter 
323.19 	of support from the CCBHC's host county confirming that the CCBHC and the county or 
323.20 	counties it serves have an ongoing relationship to facilitate access and continuity of care, 
323.21 	especially for individuals who are uninsured or who may go on and off medical assistance.
323.22 	(d) When the standards listed in paragraph (a) or other applicable standards conflict or 
323.23 	address similar issues in duplicative or incompatible ways, the commissioner may grant 
323.24 	variances to state requirements if the variances do not conflict with federal requirements. 
323.25 	If standards overlap, the commissioner may substitute all or a part of a licensure or 
323.26 	certification that is substantially the same as another licensure or certification. The 
323.27 	commissioner shall consult with stakeholders, as described in subdivision 4, before granting 
323.28 	variances under this provision. For the CCBHC that is certified but not approved for 
323.29 	prospective payment under section 256B.0625, subdivision 5m, the commissioner may 
323.30 	grant a variance under this paragraph if the variance does not increase the state share of 
323.31 	costs.
323.32 	(e) The commissioner shall issue a list of required evidence-based practices to be 
323.33 	delivered by CCBHCs, and may also provide a list of recommended evidence-based practices. 
323.34 	The commissioner may update the list to reflect advances in outcomes research and medical 
324.1 	services for persons living with mental illnesses or substance use disorders. The commissioner 
324.2 	shall take into consideration the adequacy of evidence to support the efficacy of the practice, 
324.3 	the quality of workforce available, and the current availability of the practice in the state. 
324.4 	At least 30 days before issuing the initial list and any revisions, the commissioner shall 
324.5 	provide stakeholders with an opportunity to comment.
324.6 	(f) The commissioner shall establish standards and methodologies for a prospective 
324.7 	payment system for medical assistance payments for services delivered by certified 
324.8 	community behavioral health clinics, in accordance with guidance issued by the Centers 
324.9 	for Medicare and Medicaid Services. During the operation of the demonstration project, 
324.10 	payments shall comply with federal requirements for an enhanced federal medical assistance 
324.11 	percentage. The commissioner may include quality bonus payment in the prospective 
324.12 	payment system based on federal criteria and on a clinic's provision of the evidence-based 
324.13 	practices in paragraph (e). The prospective payment system does not apply to MinnesotaCare. 
324.14 	Implementation of the prospective payment system is effective July 1, 2017, or upon federal 
324.15 	approval, whichever is later.
324.16 	(g) The commissioner shall seek federal approval to continue federal financial 
324.17 	participation in payment for CCBHC services after the federal demonstration period ends 
324.18 	for clinics that were certified as CCBHCs during the demonstration period and that continue 
324.19 	to meet the CCBHC certification standards in paragraph (a). Payment for CCBHC services 
324.20 	shall cease effective July 1, 2019, if continued federal financial participation for the payment 
324.21 	of CCBHC services cannot be obtained.
324.22 	(h) The commissioner may certify at least one CCBHC located in an urban area and at 
324.23 	least one CCBHC located in a rural area, as defined by federal criteria. To the extent allowed 
324.24 	by federal law, the commissioner may limit the number of certified clinics so that the 
324.25 	projected claims for certified clinics will not exceed the funds budgeted for this purpose. 
324.26 	The commissioner shall give preference to clinics that:
324.27 	(1) provide a comprehensive range of services and evidence-based practices for all age 
324.28 	groups, with services being fully coordinated and integrated; and
324.29 	(2) enhance the state's ability to meet the federal priorities to be selected as a CCBHC 
324.30 	demonstration state.
324.31 	(i) (f) The commissioner shall recertify CCBHCs at least every three years. The 
324.32 	commissioner shall establish a process for decertification and shall require corrective action, 
324.33 	medical assistance repayment, or decertification of a CCBHC that no longer meets the 
325.1 	requirements in this section or that fails to meet the standards provided by the commissioner 
325.2 	in the application and certification process.

325.3 	EFFECTIVE DATE. Contingent upon federal approval, this section is effective July 
325.4 	1, 2019. The commissioner of human services shall notify the revisor of statutes when 
325.5 	federal approval is obtained.

325.6 	Sec. 5. Minnesota Statutes 2018, section 245F.05, subdivision 2, is amended to read:
325.7 		Subd. 2.Admission criteria. For an individual to be admitted to a withdrawal 
325.8 	management program, the program must make a determination that the program services 
325.9 	are appropriate to the needs of the individual. A program may only admit individuals who 
325.10 	meet the admission criteria and who, at the time of admission:, meet the criteria for admission 
325.11 	as determined by current American Society of Addiction Medicine standards for appropriate 
325.12 	level of withdrawal management.
325.13 	(1) are impaired as the result of intoxication;
325.14 	(2) are experiencing physical, mental, or emotional problems due to intoxication or 
325.15 	withdrawal from alcohol or other drugs;
325.16 	(3) are being held under apprehend and hold orders under section 253B.07, subdivision 
325.17 	2b;
325.18 	(4) have been committed under chapter 253B and need temporary placement;
325.19 	(5) are held under emergency holds or peace and health officer holds under section 
325.20 	253B.05, subdivision 1 or 2; or
325.21 	(6) need to stay temporarily in a protective environment because of a crisis related to 
325.22 	substance use disorder. Individuals satisfying this clause may be admitted only at the request 
325.23 	of the county of fiscal responsibility, as determined according to section 256G.02, subdivision 
325.24 	4. Individuals admitted according to this clause must not be restricted to the facility.

325.25 	Sec. 6. Minnesota Statutes 2018, section 245G.01, subdivision 8, is amended to read:
325.26 		Subd. 8.Client. "Client" means an individual accepted by a license holder for assessment 
325.27 	or treatment of a substance use disorder. An individual remains a client until the license 
325.28 	holder no longer provides or intends to provide the individual with treatment service. Client 
325.29 	also includes the meaning of patient under section 144.651, subdivision 2.

326.1 	Sec. 7. Minnesota Statutes 2018, section 245G.01, is amended by adding a subdivision to 
326.2 	read:
326.3 		Subd. 10a.Day of service initiation. "Day of service initiation" means the day the 
326.4 	license holder begins the provision of a treatment service identified in section 245G.07.

326.5 	Sec. 8. Minnesota Statutes 2018, section 245G.01, is amended by adding a subdivision to 
326.6 	read:
326.7 		Subd. 13a.Group counseling. "Group counseling" means a professionally led 
326.8 	psychotherapeutic substance use disorder treatment that is delivered in an interactive group 
326.9 	setting.

326.10 	Sec. 9. Minnesota Statutes 2018, section 245G.01, is amended by adding a subdivision to 
326.11 	read:
326.12 		Subd. 20a.Person-centered. "Person-centered" means a client actively participates in 
326.13 	the client's treatment planning of services. This includes a client making meaningful and 
326.14 	informed choices about the client's own goals, objectives, and the services the client receives 
326.15 	in collaboration with the client's identified natural supports.

326.16 	Sec. 10. Minnesota Statutes 2018, section 245G.01, is amended by adding a subdivision 
326.17 	to read:
326.18 		Subd. 20b.Staff or staff member. "Staff" or "staff member" means an individual who 
326.19 	works under the direction of the license holder regardless of the individual's employment 
326.20 	status including but not limited to an intern, consultant, individual who works part time, or 
326.21 	individual who does not provide direct care services.

326.22 	Sec. 11. Minnesota Statutes 2018, section 245G.01, subdivision 21, is amended to read:
326.23 		Subd. 21.Student intern. "Student intern" means an individual who is enrolled in a 
326.24 	program specializing in alcohol and drug counseling or mental health counseling at an 
326.25 	accredited educational institution and is authorized by a licensing board to provide services 
326.26 	under supervision of a licensed professional.

326.27 	Sec. 12. Minnesota Statutes 2018, section 245G.01, is amended by adding a subdivision 
326.28 	to read:
326.29 		Subd. 28.Treatment week. "Treatment week" means the seven-day period that the 
326.30 	program identified in the program's policy and procedure manual as the day of the week 
327.1 	that the treatment program week starts and ends for the purpose of identifying the nature 
327.2 	and number of treatment services an individual receives weekly.

327.3 	Sec. 13. Minnesota Statutes 2018, section 245G.01, is amended by adding a subdivision 
327.4 	to read:
327.5 		Subd. 29.Volunteer. "Volunteer" means an individual who, under the direction of the 
327.6 	license holder, provides services or an activity to a client without compensation.

327.7 	Sec. 14. Minnesota Statutes 2018, section 245G.04, is amended to read:
327.8 	245G.04 INITIAL SERVICES PLAN SERVICE INITIATION.
327.9 		Subdivision 1.Initial services plan. (a) The license holder must complete an initial 
327.10 	services plan on within 24 hours of the day of service initiation. The plan must be 
327.11 	person-centered and client-specific, address the client's immediate health and safety concerns, 
327.12 	and identify the treatment needs of the client to be addressed in the first treatment session, 
327.13 	and make treatment suggestions for the client during the time between intake the day of 
327.14 	service initiation and completion development of the individual treatment plan.
327.15 		Subd. 2.Vulnerable adult status. (b) The initial services plan must include a 
327.16 	determination of(a) Within 24 hours of the day of service initiation, a nonresidential program 
327.17 	must determine whether a client is a vulnerable adult as defined in section 626.5572, 
327.18 	subdivision 21. An adult client of a residential program is a vulnerable adult.
327.19 	(b) An individual abuse prevention plan, according to sections 245A.65, subdivision 2, 
327.20 	paragraph (b), and 626.557, subdivision 14, paragraph (b), is required for a client who meets 
327.21 	the definition of vulnerable adult.

327.22 	Sec. 15. Minnesota Statutes 2018, section 245G.05, is amended to read:
327.23 	245G.05 COMPREHENSIVE ASSESSMENT AND ASSESSMENT SUMMARY.
327.24 		Subdivision 1.Comprehensive assessment. (a) A comprehensive assessment of the 
327.25 	client's substance use disorder must be administered face-to-face by an alcohol and drug 
327.26 	counselor within three calendar days after from the day of service initiation for a residential 
327.27 	program or during the initial session for all other programs within three calendar days on 
327.28 	which a treatment session has been provided of the day of service initiation for a client in 
327.29 	a nonresidential program. If the comprehensive assessment is not completed during the 
327.30 	initial session,within the required time frame, the client-centered person-centered reason 
327.31 	for the delay and the planned completion date must be documented in the client's file and 
328.1 	the planned completion date. The comprehensive assessment is complete upon a qualified 
328.2 	staff member's dated signature. If the client received a comprehensive assessment that 
328.3 	authorized the treatment service, an alcohol and drug counselor may use the comprehensive 
328.4 	assessment for requirements of this subdivision but must document a review theof the 
328.5 	comprehensive assessment and update the comprehensive assessment as clinically necessary
328.6 	to determine ensure compliance with this subdivision, including within applicable timelines. 
328.7 	If available, the alcohol and drug counselor may use current information provided by a 
328.8 	referring agency or other source as a supplement. Information gathered more than 45 days 
328.9 	before the date of admission is not considered current. The comprehensive assessment must 
328.10 	include sufficient information to complete the assessment summary according to subdivision 
328.11 	2 and the individual treatment plan according to section 245G.06. The comprehensive 
328.12 	assessment must include information about the client's needs that relate to substance use 
328.13 	and personal strengths that support recovery, including:
328.14 	(1) age, sex, cultural background, sexual orientation, living situation, economic status, 
328.15 	and level of education;
328.16 	(2) a description of the circumstances on the day of service initiation;
328.17 	(3) a list of previous attempts at treatment for substance misuse or substance use disorder, 
328.18 	compulsive gambling, or mental illness;
328.19 	(4) a list of substance use history including amounts and types of substances used, 
328.20 	frequency and duration of use, periods of abstinence, and circumstances of relapse, if any. 
328.21 	For each substance used within the previous 30 days, the information must include the date 
328.22 	of the most recent use and address the absence or presence of previous withdrawal symptoms;
328.23 	(5) specific problem behaviors exhibited by the client when under the influence of 
328.24 	substances;
328.25 	(6) family status the client's desire for family involvement in the treatment program, 
328.26 	family history of substance use and misuse, including history or presence of physical or 
328.27 	sexual abuse, and level of family support, and substance misuse or substance use disorder 
328.28 	of a family member or significant other;
328.29 	(7) physical and medical concerns or diagnoses, the severity of the concerns, and current 
328.30 	medical treatment needed or being received related to the diagnoses, and whether the 
328.31 	concerns are being addressed by a need to be referred to an appropriate health care 
328.32 	professional;
329.1 	(8) mental health history and psychiatric status, including symptoms, disability, and the 
329.2 	effect on the client's ability to function; current mental health treatment supports,; and 
329.3 	psychotropic medication needed to maintain stability;. The assessment must utilize screening 
329.4 	tools approved by the commissioner pursuant to section 245.4863 to identify whether the 
329.5 	client screens positive for co-occurring disorders;
329.6 	(9) arrests and legal interventions related to substance use;
329.7 	(10) a description of how the client's use affected the client's ability to function 
329.8 	appropriately in work and educational settings;
329.9 	(11) ability to understand written treatment materials, including rules and the client's 
329.10 	rights;
329.11 	(12) a description of any risk-taking behavior, including behavior that puts the client at 
329.12 	risk of exposure to blood-borne or sexually transmitted diseases;
329.13 	(13) social network in relation to expected support for recovery and;
329.14 	(14) leisure time activities that are associated with substance use;
329.15 	(14) (15) whether the client is pregnant and, if so, the health of the unborn child and the 
329.16 	client's current involvement in prenatal care;
329.17 	(15) (16) whether the client recognizes problems needs related to substance use and is 
329.18 	willing to follow treatment recommendations; and
329.19 	(16) collateral (17) information from a collateral contact may be included, but is not 
329.20 	required. If the assessor gathered sufficient information from the referral source or the client 
329.21 	to apply the criteria in Minnesota Rules, parts 9530.6620 and 9530.6622, a collateral contact 
329.22 	is not required.
329.23 	(b) If the client is identified as having opioid use disorder or seeking treatment for opioid 
329.24 	use disorder, the program must provide educational information to the client concerning:
329.25 	(1) risks for opioid use disorder and dependence;
329.26 	(2) treatment options, including the use of a medication for opioid use disorder;
329.27 	(3) the risk of and recognizing opioid overdose; and
329.28 	(4) the use, availability, and administration of naloxone to respond to opioid overdose.
329.29 	(c) The commissioner shall develop educational materials that are supported by research 
329.30 	and updated periodically. The license holder must use the educational materials that are 
329.31 	approved by the commissioner to comply with this requirement.
330.1 	(d) If the comprehensive assessment is completed to authorize treatment service for the 
330.2 	client, at the earliest opportunity during the assessment interview the assessor shall determine 
330.3 	if:
330.4 	(1) the client is in severe withdrawal and likely to be a danger to self or others;
330.5 	(2) the client has severe medical problems that require immediate attention; or
330.6 	(3) the client has severe emotional or behavioral symptoms that place the client or others 
330.7 	at risk of harm.
330.8 	If one or more of the conditions in clauses (1) to (3) are present, the assessor must end the 
330.9 	assessment interview and follow the procedures in the program's medical services plan 
330.10 	under section 245G.08, subdivision 2, to help the client obtain the appropriate services. The 
330.11 	assessment interview may resume when the condition is resolved.
330.12 		Subd. 2.Assessment summary. (a) An alcohol and drug counselor must complete an 
330.13 	assessment summary within three calendar days after from the day of service initiation for 
330.14 	a residential program and within three sessionsfor all other programs calendar days on 
330.15 	which a treatment session has been provided from the day of service initiation for a client 
330.16 	in a nonresidential program. The comprehensive assessment summary is complete upon a 
330.17 	qualified staff member's dated signature. If the comprehensive assessment is used to authorize 
330.18 	the treatment service, the alcohol and drug counselor must prepare an assessment summary 
330.19 	on the same date the comprehensive assessment is completed. If the comprehensive 
330.20 	assessment and assessment summary are to authorize treatment services, the assessor must 
330.21 	determine appropriate services for the client using the dimensions in Minnesota Rules, part 
330.22 	9530.6622, and document the recommendations.
330.23 	(b) An assessment summary must include:
330.24 	(1) a risk description according to section 245G.05 for each dimension listed in paragraph 
330.25 	(c);
330.26 	(2) a narrative summary supporting the risk descriptions; and
330.27 	(3) a determination of whether the client has a substance use disorder.
330.28 	(c) An assessment summary must contain information relevant to treatment service 
330.29 	planning and recorded in the dimensions in clauses (1) to (6). The license holder must 
330.30 	consider:
330.31 	(1) Dimension 1, acute intoxication/withdrawal potential; the client's ability to cope with 
330.32 	withdrawal symptoms and current state of intoxication;
331.1 	(2) Dimension 2, biomedical conditions and complications; the degree to which any 
331.2 	physical disorder of the client would interfere with treatment for substance use, and the 
331.3 	client's ability to tolerate any related discomfort. The license holder must determine the 
331.4 	impact of continued chemical substance use on the unborn child, if the client is pregnant;
331.5 	(3) Dimension 3, emotional, behavioral, and cognitive conditions and complications; 
331.6 	the degree to which any condition or complication is likely to interfere with treatment for 
331.7 	substance use or with functioning in significant life areas and the likelihood of harm to self 
331.8 	or others;
331.9 	(4) Dimension 4, readiness for change; the support necessary to keep the client involved 
331.10 	in treatment service;
331.11 	(5) Dimension 5, relapse, continued use, and continued problem potential; the degree 
331.12 	to which the client recognizes relapse issues and has the skills to prevent relapse of either 
331.13 	substance use or mental health problems; and
331.14 	(6) Dimension 6, recovery environment; whether the areas of the client's life are 
331.15 	supportive of or antagonistic to treatment participation and recovery.

331.16 	Sec. 16. Minnesota Statutes 2018, section 245G.06, subdivision 1, is amended to read:
331.17 		Subdivision 1.General. Each client must have an a person-centered individual treatment 
331.18 	plan developed by an alcohol and drug counselor within seven ten days from the day of 
331.19 	service initiation for a residential program and within three sessions for all other programs
331.20 	five calendar days on which a treatment session has been provided from the day of service 
331.21 	initiation for a client in a nonresidential program. Opioid treatment programs must complete 
331.22 	the individual treatment plan within 21 days from the day of service initiation. The client 
331.23 	must have active, direct involvement in selecting the anticipated outcomes of the treatment 
331.24 	process and developing the treatment plan. The individual treatment plan must be signed 
331.25 	by the client and the alcohol and drug counselor and document the client's involvement in 
331.26 	the development of the plan. The plan may be a continuation of the initial services plan 
331.27 	required in section 245G.04. The individual treatment plan is developed upon the qualified 
331.28 	staff member's dated signature. Treatment planning must include ongoing assessment of 
331.29 	client needs. An individual treatment plan must be updated based on new information 
331.30 	gathered about the client's condition, the client's level of participation, and on whether 
331.31 	methods identified have the intended effect. A change to the plan must be signed by the 
331.32 	client and the alcohol and drug counselor. The plan must provide for the involvement of 
331.33 	the client's family and people selected by the client as important to the success of treatment 
331.34 	at the earliest opportunity, consistent with the client's treatment needs and written consent.
332.1 	If the client chooses to have family or others involved in treatment services, the client's 
332.2 	individual treatment plan must include how the family or others will be involved in the 
332.3 	client's treatment.

332.4 	Sec. 17. Minnesota Statutes 2018, section 245G.06, subdivision 2, is amended to read:
332.5 		Subd. 2.Plan contents. An individual treatment plan must be recorded in the six 
332.6 	dimensions listed in section 245G.05, subdivision 2, paragraph (c), must address each issue 
332.7 	identified in the assessment summary, prioritized according to the client's needs and focus, 
332.8 	and must include:
332.9 	(1) specific goals and methods to address each identified need in the comprehensive 
332.10 	assessment summary, including amount, frequency, and anticipated duration of treatment 
332.11 	service. The methods must be appropriate to the client's language, reading skills, cultural 
332.12 	background, and strengths;
332.13 	(2) resources to refer the client to when the client's needs are to be addressed concurrently 
332.14 	by another provider; and
332.15 	(3) goals the client must reach to complete treatment and terminate services.

332.16 	Sec. 18. Minnesota Statutes 2018, section 245G.06, subdivision 4, is amended to read:
332.17 		Subd. 4.Service discharge summary. (a) An alcohol and drug counselor must write a 
332.18 	service discharge summary for each client. The service discharge summary must be 
332.19 	completed within five days of the client's service termination or within five days from the 
332.20 	client's or program's decision to terminate services, whichever is earlier. A copy of the 
332.21 	client's service discharge summary must be provided to the client upon the client's request.
332.22 	(b) The service discharge summary must be recorded in the six dimensions listed in 
332.23 	section 245G.05, subdivision 2, paragraph (c), and include the following information:
332.24 	(1) the client's issues, strengths, and needs while participating in treatment, including 
332.25 	services provided;
332.26 	(2) the client's progress toward achieving each goal identified in the individual treatment 
332.27 	plan;
332.28 	(3) a risk description according to section 245G.05; and
332.29 	(4) the reasons for and circumstances of service termination. If a program discharges a 
332.30 	client at staff request, the reason for discharge and the procedure followed for the decision 
332.31 	to discharge must be documented and comply with the program's policies on staff-initiated 
333.1 	client discharge. If a client is discharged at staff request, the program must give the client 
333.2 	crisis and other referrals appropriate for the client's needs and offer assistance to the client 
333.3 	to access the services. requirements in section 245G.14, subdivision 3, clause (3);
333.4 	(c) For a client who successfully completes treatment, the summary must also include:
333.5 	(1)(5) the client's living arrangements at service termination;
333.6 	(2)(6) continuing care recommendations, including transitions between more or less 
333.7 	intense services, or more frequent to less frequent services, and referrals made with specific 
333.8 	attention to continuity of care for mental health, as needed; and
333.9 	(3)(7) service termination diagnosis; and.
333.10 	(4) the client's prognosis.

333.11 	Sec. 19. Minnesota Statutes 2018, section 245G.07, is amended to read:
333.12 	245G.07 TREATMENT SERVICE.
333.13 		Subdivision 1.Treatment service. (a) A license holderlicensed residential treatment 
333.14 	program must offer the following treatment services in clauses (1) to (5) to each client, 
333.15 	unless clinically inappropriate and the justifying clinical rationale is documented:. A 
333.16 	nonresidential treatment program must offer all treatment services in clauses (1) to (5) and 
333.17 	document in the individual treatment plan the specific services for which a client has an 
333.18 	assessed need and the plan to provide the services:
333.19 	(1) individual and group counseling to help the client identify and address needs related 
333.20 	to substance use and develop strategies to avoid harmful substance use after discharge and 
333.21 	to help the client obtain the services necessary to establish a lifestyle free of the harmful 
333.22 	effects of substance use disorder;
333.23 	(2) client education strategies to avoid inappropriate substance use and health problems 
333.24 	related to substance use and the necessary lifestyle changes to regain and maintain health. 
333.25 	Client education must include information on tuberculosis education on a form approved 
333.26 	by the commissioner, the human immunodeficiency virus according to section 245A.19, 
333.27 	other sexually transmitted diseases, drug and alcohol use during pregnancy, and hepatitis.
333.28 	A licensed alcohol and drug counselor must be present during an educational group;
333.29 	(3) a service to help the client integrate gains made during treatment into daily living 
333.30 	and to reduce the client's reliance on a staff member for support;
333.31 	(4) a service to address issues related to co-occurring disorders, including client education 
333.32 	on symptoms of mental illness, the possibility of comorbidity, and the need for continued 
334.1 	medication compliance while recovering from substance use disorder. A group must address 
334.2 	co-occurring disorders, as needed. When treatment for mental health problems is indicated, 
334.3 	the treatment must be integrated into the client's individual treatment plan; and
334.4 	(5) on July 1, 2018, or upon federal approval, whichever is later, peer recovery support 
334.5 	services provided one-to-one by an individual in recovery. Peer support services include 
334.6 	education, advocacy, mentoring through self-disclosure of personal recovery experiences, 
334.7 	attending recovery and other support groups with a client, accompanying the client to 
334.8 	appointments that support recovery, assistance accessing resources to obtain housing, 
334.9 	employment, education, and advocacy services, and nonclinical recovery support to assist 
334.10 	the transition from treatment into the recovery community; and
334.11 	(6) on July 1, 2018, or upon federal approval, whichever is later, care (5) treatment
334.12 	coordination provided one-to-one by an individual who meets the staff qualifications in 
334.13 	section 245G.11, subdivision 7. Care Treatment coordination services include:
334.14 	(i) assistance in coordination with significant others to help in the treatment planning 
334.15 	process whenever possible;
334.16 	(ii) assistance in coordination with and follow up for medical services as identified in 
334.17 	the treatment plan;
334.18 	(iii) facilitation of referrals to substance use disorder services as indicated by a client's 
334.19 	medical provider, comprehensive assessment, or treatment plan;
334.20 	(iv) facilitation of referrals to mental health services as identified by a client's 
334.21 	comprehensive assessment or treatment plan;
334.22 	(v) assistance with referrals to economic assistance, social services, housing resources, 
334.23 	and prenatal care according to the client's needs;
334.24 	(vi) life skills advocacy and support accessing treatment follow-up, disease management, 
334.25 	and education services, including referral and linkages to long-term services and supports 
334.26 	as needed; and
334.27 	(vii) documentation of the provision of care treatment coordination services in the client's 
334.28 	file.
334.29 	(b) A treatment service provided to a client must be provided according to the individual 
334.30 	treatment plan and must consider cultural differences and special needs of a client.
334.31 		Subd. 2.Additional treatment service. A license holder may provide or arrange the 
334.32 	following additional treatment service as a part of the client's individual treatment plan:
335.1 	(1) relationship counseling provided by a qualified professional to help the client identify 
335.2 	the impact of the client's substance use disorder on others and to help the client and persons 
335.3 	in the client's support structure identify and change behaviors that contribute to the client's 
335.4 	substance use disorder;
335.5 	(2) therapeutic recreation to allow the client to participate in recreational activities 
335.6 	without the use of mood-altering chemicals and to plan and select leisure activities that do 
335.7 	not involve the inappropriate use of chemicals;
335.8 	(3) stress management and physical well-being to help the client reach and maintain an 
335.9 	appropriate level of health, physical fitness, and well-being;
335.10 	(4) living skills development to help the client learn basic skills necessary for independent 
335.11 	living;
335.12 	(5) employment or educational services to help the client become financially independent;
335.13 	(6) socialization skills development to help the client live and interact with others in a 
335.14 	positive and productive manner; and
335.15 	(7) room, board, and supervision at the treatment site to provide the client with a safe 
335.16 	and appropriate environment to gain and practice new skills; and
335.17 	(8) peer recovery support services provided one-to-one by an individual in recovery 
335.18 	qualified according to section 245G.11, subdivision 8. Peer support services include 
335.19 	education; advocacy; mentoring through self-disclosure of personal recovery experiences; 
335.20 	attending recovery and other support groups with a client; accompanying the client to 
335.21 	appointments that support recovery; assistance accessing resources to obtain housing, 
335.22 	employment, education, and advocacy services; and nonclinical recovery support to assist 
335.23 	the transition from treatment into the recovery community.
335.24 		Subd. 3.Counselors. AAll treatment serviceservices, including therapeutic recreation
335.25 	except peer recovery support services and treatment coordination, must be provided by an 
335.26 	alcohol and drug counselor qualified according to section 245G.11, subdivision 5, unless 
335.27 	the individual providing the service is specifically qualified according to the accepted 
335.28 	credential required to provide the service. Therapeutic recreation does not include planned 
335.29 	leisure activities. The commissioner shall maintain a current list of professionals qualified 
335.30 	to provide treatment services.
335.31 		Subd. 4.Location of service provision. The license holder may provide services at any 
335.32 	of the license holder's licensed locations or at another suitable location including a school, 
335.33 	government building, medical or behavioral health facility, or social service organization, 
336.1 	upon notification and approval of the commissioner. If services are provided off site from 
336.2 	the licensed site, the reason for the provision of services remotely must be documented.
336.3 	The license holder may provide additional services under subdivision 2, clauses (2) to (5), 
336.4 	off-site if the license holder includes a policy and procedure detailing the off-site location 
336.5 	as a part of the treatment service description and the program abuse prevention plan.

336.6 	Sec. 20. Minnesota Statutes 2018, section 245G.08, subdivision 3, is amended to read:
336.7 		Subd. 3.Standing order protocol. A license holder that maintains a supply of naloxone 
336.8 	available for emergency treatment of opioid overdose must have a written standing order 
336.9 	protocol by a physician who is licensed under chapter 147, that permits the license holder 
336.10 	to maintain a supply of naloxone on site, and. A license holder must require staff to undergo 
336.11 	specific training in administration of naloxone the specific mode of administration used at 
336.12 	the program, which may include intranasal administration, intramuscular injection, or both.

336.13 	Sec. 21. Minnesota Statutes 2018, section 245G.10, subdivision 4, is amended to read:
336.14 		Subd. 4.Staff requirement. It is the responsibility of the license holder to determine 
336.15 	an acceptable group size based on each client's needs except that treatment services provided 
336.16 	in a. Group counseling shall not exceed 16 clients. A counselor in an opioid treatment 
336.17 	program must not supervise more than 50 clients. The license holder must maintain a record 
336.18 	that documents compliance with this subdivision.

336.19 	Sec. 22. Minnesota Statutes 2018, section 245G.11, subdivision 7, is amended to read:
336.20 		Subd. 7.Care Treatment coordination provider qualifications. (a) Care Treatment
336.21 	coordination must be provided by qualified staff. An individual is qualified to provide care
336.22 	treatment coordination if the individual: meets the qualifications of an alcohol and drug 
336.23 	counselor under subdivision 5 or if the individual:
336.24 	(1) is skilled in the process of identifying and assessing a wide range of client needs;
336.25 	(2) is knowledgeable about local community resources and how to use those resources 
336.26 	for the benefit of the client;
336.27 	(3) has successfully completed 30 hours of classroom instruction on care treatment
336.28 	coordination for an individual with substance use disorder;
336.29 	(4) has either:
336.30 	(i) a bachelor's degree in one of the behavioral sciences or related fields; or
337.1 	(ii) current certification as an alcohol and drug counselor, level I, by the Upper Midwest 
337.2 	Indian Council on Addictive Disorders; and
337.3 	(5) has at least 2,000 hours of supervised experience working with individuals with 
337.4 	substance use disorder.
337.5 	(b) A care treatment coordinator must receive at least one hour of supervision regarding 
337.6 	individual service delivery from an alcohol and drug counselor weeklymonthly.

337.7 	Sec. 23. Minnesota Statutes 2018, section 245G.11, subdivision 8, is amended to read:
337.8 		Subd. 8.Recovery peer qualifications. A recovery peer must:
337.9 	(1) have a high school diploma or its equivalent;
337.10 	(2) have a minimum of one year in recovery from substance use disorder;
337.11 	(3) hold a current credential from a certification body approved by the commissioner 
337.12 	that demonstrates the Minnesota Certification Board, the Upper Midwest Indian Council 
337.13 	on Addictive Disorders, or the National Association for Alcoholism and Drug Abuse 
337.14 	Counselors. An individual may also receive a credential from a tribal nation when providing 
337.15 	peer recovery support services in a tribally licensed program. The credential must demonstrate
337.16 	skills and training in the domains of ethics and boundaries, advocacy, mentoring and 
337.17 	education, and recovery and wellness support; and
337.18 	(4) receive ongoing supervision in areas specific to the domains of the recovery peer's 
337.19 	role by an alcohol and drug counselor or an individual with a certification approved by the 
337.20 	commissioner.

337.21 	Sec. 24. Minnesota Statutes 2018, section 245G.12, is amended to read:
337.22 	245G.12 PROVIDER POLICIES AND PROCEDURES.
337.23 	A license holder must develop a written policies and procedures manual, indexed 
337.24 	according to section 245A.04, subdivision 14, paragraph (c), that provides staff members 
337.25 	immediate access to all policies and procedures and provides a client and other authorized 
337.26 	parties access to all policies and procedures. The manual must contain the following 
337.27 	materials:
337.28 	(1) assessment and treatment planning policies, including screening for mental health 
337.29 	concerns and treatment objectives related to the client's identified mental health concerns 
337.30 	in the client's treatment plan;
337.31 	(2) policies and procedures regarding HIV according to section 245A.19;
338.1 	(3) the license holder's methods and resources to provide information on tuberculosis 
338.2 	and tuberculosis screening to each client and to report a known tuberculosis infection 
338.3 	according to section 144.4804;
338.4 	(4) personnel policies according to section 245G.13;
338.5 	(5) policies and procedures that protect a client's rights according to section 245G.15;
338.6 	(6) a medical services plan according to section 245G.08;
338.7 	(7) emergency procedures according to section 245G.16;
338.8 	(8) policies and procedures for maintaining client records according to section 245G.09;
338.9 	(9) procedures for reporting the maltreatment of minors according to section 626.556, 
338.10 	and vulnerable adults according to sections 245A.65, 626.557, and 626.5572;
338.11 	(10) a description of treatment services, including the amount and type of services 
338.12 	provided that: (i) includes the amount and type of services provided; (ii) identifies which 
338.13 	services meet the definition of group counseling under section 245G.01, subdivision 13a; 
338.14 	and (iii) defines the program's treatment week;
338.15 	(11) the methods used to achieve desired client outcomes;
338.16 	(12) the hours of operation; and
338.17 	(13) the target population served.

338.18 	Sec. 25. Minnesota Statutes 2018, section 245G.13, subdivision 1, is amended to read:
338.19 		Subdivision 1.Personnel policy requirements. A license holder must have written 
338.20 	personnel policies that are available to each staff member. The personnel policies must:
338.21 	(1) ensure that staff member retention, promotion, job assignment, or pay are not affected 
338.22 	by a good faith communication between a staff member and the department, the Department 
338.23 	of Health, the ombudsman for mental health and developmental disabilities, law enforcement, 
338.24 	or a local agency for the investigation of a complaint regarding a client's rights, health, or 
338.25 	safety;
338.26 	(2) contain a job description for each staff member position specifying responsibilities, 
338.27 	degree of authority to execute job responsibilities, and qualification requirements;
338.28 	(3) provide for a job performance evaluation based on standards of job performance 
338.29 	conducted on a regular and continuing basis, including a written annual review;
339.1 	(4) describe behavior that constitutes grounds for disciplinary action, suspension, or 
339.2 	dismissal, including policies that address staff member problematic substance use and the 
339.3 	requirements of section 245G.11, subdivision 1, policies prohibiting personal involvement 
339.4 	with a client in violation of chapter 604, and policies prohibiting client abuse described in 
339.5 	sections 245A.65, 626.556, 626.557, and 626.5572;
339.6 	(5) identify how the program will identify whether behaviors or incidents are problematic 
339.7 	substance use, including a description of how the facility must address:
339.8 	(i) receiving treatment for substance use within the period specified for the position in 
339.9 	the staff qualification requirements, including medication-assisted treatment;
339.10 	(ii) substance use that negatively impacts the staff member's job performance;
339.11 	(iii) chemical substance use that affects the credibility of treatment services with a client, 
339.12 	referral source, or other member of the community;
339.13 	(iv) symptoms of intoxication or withdrawal on the job; and
339.14 	(v) the circumstances under which an individual who participates in monitoring by the 
339.15 	health professional services program for a substance use or mental health disorder is able 
339.16 	to provide services to the program's clients;
339.17 	(6) include a chart or description of the organizational structure indicating lines of 
339.18 	authority and responsibilities;
339.19 	(7) include orientation within 24 working hours of starting for each new staff member 
339.20 	based on a written plan that, at a minimum, must provide training related to the staff member's 
339.21 	specific job responsibilities, policies and procedures, client confidentiality, HIV minimum 
339.22 	standards, and client needs; and
339.23 	(8) include policies outlining the license holder's response to a staff member with a 
339.24 	behavior problem that interferes with the provision of treatment service.

339.25 	Sec. 26. Minnesota Statutes 2018, section 245G.15, subdivision 1, is amended to read:
339.26 		Subdivision 1.Explanation. A client has the rights identified in sections 144.651, 
339.27 	148F.165, and 253B.03, as applicable. The license holder must give each client at on the 
339.28 	day of service initiation a written statement of the client's rights and responsibilities. A staff 
339.29 	member must review the statement with a client at that time.

340.1 	Sec. 27. Minnesota Statutes 2018, section 245G.15, subdivision 2, is amended to read:
340.2 		Subd. 2.Grievance procedure. At On the day of service initiation, the license holder 
340.3 	must explain the grievance procedure to the client or the client's representative. The grievance 
340.4 	procedure must be posted in a place visible to clients, and made available upon a client's or 
340.5 	former client's request. The grievance procedure must require that:
340.6 	(1) a staff member helps the client develop and process a grievance;
340.7 	(2) current telephone numbers and addresses of the Department of Human Services, 
340.8 	Licensing Division; the Office of Ombudsman for Mental Health and Developmental 
340.9 	Disabilities; the Department of Health Office of Health Facilities Complaints; and the Board 
340.10 	of Behavioral Health and Therapy, when applicable, be made available to a client; and
340.11 	(3) a license holder responds to the client's grievance within three days of a staff member's 
340.12 	receipt of the grievance, and the client may bring the grievance to the highest level of 
340.13 	authority in the program if not resolved by another staff member.

340.14 	Sec. 28. Minnesota Statutes 2018, section 245G.18, subdivision 3, is amended to read:
340.15 		Subd. 3.Staff ratios. At least 25 percent of a counselor's scheduled work hours must 
340.16 	be allocated to indirect services, including documentation of client services, coordination 
340.17 	of services with others, treatment team meetings, and other duties. A counseling group 
340.18 	consisting entirely of adolescents must not exceed 16 adolescents. It is the responsibility of 
340.19 	the license holder to determine an acceptable group size based on the needs of the clients.

340.20 	Sec. 29. Minnesota Statutes 2018, section 245G.18, subdivision 5, is amended to read:
340.21 		Subd. 5.Program requirements. In addition to the requirements specified in the client's 
340.22 	treatment plan under section 245G.06, programs serving an adolescent must include:
340.23 	(1) coordination with the school system to address the client's academic needs;
340.24 	(2) when appropriate, a plan that addresses the client's leisure activities without chemical
340.25 	substance use; and
340.26 	(3) a plan that addresses family involvement in the adolescent's treatment.

340.27 	Sec. 30. Minnesota Statutes 2018, section 245G.22, subdivision 1, is amended to read:
340.28 		Subdivision 1.Additional requirements. (a) An opioid treatment program licensed 
340.29 	under this chapter must also: (1) comply with the requirements of this section and Code of 
340.30 	Federal Regulations, title 42, part 8. When federal guidance or interpretations are issued on 
341.1 	federal standards or requirements also required under this section, the federal guidance or 
341.2 	interpretations shall apply.; (2) be registered as a narcotic treatment program with the Drug 
341.3 	Enforcement Administration; (3) be accredited through an accreditation body approved by 
341.4 	the Division of Pharmacologic Therapy of the Center for Substance Abuse Treatment; (4) 
341.5 	be certified through the Division of Pharmacologic Therapy of the Center for Substance 
341.6 	Abuse Treatment; and (5) hold a license from the Minnesota Board of Pharmacy or equivalent 
341.7 	agency.
341.8 	(b) Where a standard in this section differs from a standard in an otherwise applicable 
341.9 	administrative rule or statute, the standard of this section applies.

341.10 	Sec. 31. Minnesota Statutes 2018, section 245G.22, subdivision 2, is amended to read:
341.11 		Subd. 2.Definitions. (a) For purposes of this section, the terms defined in this subdivision 
341.12 	have the meanings given them.
341.13 	(b) "Diversion" means the use of a medication for the treatment of opioid addiction being 
341.14 	diverted from intended use of the medication.
341.15 	(c) "Guest dose" means administration of a medication used for the treatment of opioid 
341.16 	addiction to a person who is not a client of the program that is administering or dispensing 
341.17 	the medication.
341.18 	(d) "Medical director" means a physician practitioner licensed to practice medicine in 
341.19 	the jurisdiction that the opioid treatment program is located who assumes responsibility for 
341.20 	administering all medical services performed by the program, either by performing the 
341.21 	services directly or by delegating specific responsibility to (1) authorized program physicians; 
341.22 	(2) advanced practice registered nurses, when approved by variance by the State Opioid 
341.23 	Treatment Authority under section 254A.03 and the federal Substance Abuse and Mental 
341.24 	Health Services Administration; or (3) health care professionals functioning under the 
341.25 	medical director's direct supervision a practitioner of the opioid treatment program.
341.26 	(e) "Medication used for the treatment of opioid use disorder" means a medication 
341.27 	approved by the Food and Drug Administration for the treatment of opioid use disorder.
341.28 	(f) "Minnesota health care programs" has the meaning given in section 256B.0636.
341.29 	(g) "Opioid treatment program" has the meaning given in Code of Federal Regulations, 
341.30 	title 42, section 8.12, and includes programs licensed under this chapter.
341.31 	(h) "Placing authority" has the meaning given in Minnesota Rules, part 9530.6605, 
341.32 	subpart 21a.
342.1 	(i) "Practitioner" means a staff member holding a current, unrestricted license to practice 
342.2 	medicine issued by the Board of Medical Practice or nursing issued by the Board of Nursing 
342.3 	and is currently registered with the Drug Enforcement Administration to order or dispense 
342.4 	controlled substances in Schedules II to V under the Controlled Substances Act, United 
342.5 	States Code, title 21, part B, section 821. Practitioner includes an advanced practice registered 
342.6 	nurse and physician assistant if the staff member receives a variance by the state opioid 
342.7 	treatment authority under section 254A.03 and the federal Substance Abuse and Mental 
342.8 	Health Services Administration.
342.9 	(i) (j) "Unsupervised use" means the use of a medication for the treatment of opioid use 
342.10 	disorder dispensed for use by a client outside of the program setting.

342.11 	Sec. 32. Minnesota Statutes 2018, section 245G.22, subdivision 3, is amended to read:
342.12 		Subd. 3.Medication orders. Before the program may administer or dispense a medication 
342.13 	used for the treatment of opioid use disorder:
342.14 	(1) a client-specific order must be received from an appropriately credentialed physician
342.15 	practitioner who is enrolled as a Minnesota health care programs provider and meets all 
342.16 	applicable provider standards;
342.17 	(2) the signed order must be documented in the client's record; and
342.18 	(3) if the physician practitioner that issued the order is not able to sign the order when 
342.19 	issued, the unsigned order must be entered in the client record at the time it was received, 
342.20 	and the physician practitioner must review the documentation and sign the order in the 
342.21 	client's record within 72 hours of the medication being ordered. The license holder must 
342.22 	report to the commissioner any medication error that endangers a client's health, as 
342.23 	determined by the medical director.

342.24 	Sec. 33. Minnesota Statutes 2018, section 245G.22, subdivision 4, is amended to read:
342.25 		Subd. 4.High dose requirements. A client being administered or dispensed a dose 
342.26 	beyond that set forth in subdivision 6, paragraph (a), clause (1), that exceeds 150 milligrams 
342.27 	of methadone or 24 milligrams of buprenorphine daily, and for each subsequent increase, 
342.28 	must meet face-to-face with a prescribing physician practitioner. The meeting must occur 
342.29 	before the administration or dispensing of the increased medication dose.

343.1 	Sec. 34. Minnesota Statutes 2018, section 245G.22, subdivision 6, is amended to read:
343.2 		Subd. 6.Criteria for unsupervised use. (a) To limit the potential for diversion of 
343.3 	medication used for the treatment of opioid use disorder to the illicit market, medication 
343.4 	dispensed to a client for unsupervised use shall be subject to the following requirements:
343.5 	of this subdivision.
343.6 	(1) Any client in an opioid treatment program may receive a single unsupervised use 
343.7 	dose for a day that the clinic is closed for business, including Sundays and state and federal 
343.8 	holidays; and.
343.9 	(2) other treatment program decisions on dispensing medications used for the treatment 
343.10 	of opioid use disorder to a client for unsupervised use shall be determined by the medical 
343.11 	director.
343.12 	(b) In determining whether a client may be permitted unsupervised use of medications, 
343.13 	a physician A practitioner with authority to prescribe must consider review and document
343.14 	the criteria in this paragraph. The criteria in this paragraph must also be considered and 
343.15 	paragraph (c) when determining whether dispensing medication for a client's unsupervised 
343.16 	use is appropriate to implement, increase, or to extend the amount of time between visits 
343.17 	to the program. The criteria are:
343.18 	(1) absence of recent abuse of drugs including but not limited to opioids, non-narcotics, 
343.19 	and alcohol;
343.20 	(2) regularity of program attendance;
343.21 	(3) absence of serious behavioral problems at the program;
343.22 	(4) absence of known recent criminal activity such as drug dealing;
343.23 	(5) stability of the client's home environment and social relationships;
343.24 	(6) length of time in comprehensive maintenance treatment;
343.25 	(7) reasonable assurance that unsupervised use medication will be safely stored within 
343.26 	the client's home; and
343.27 	(8) whether the rehabilitative benefit the client derived from decreasing the frequency 
343.28 	of program attendance outweighs the potential risks of diversion or unsupervised use.
343.29 	(c) The determination, including the basis of the determination must be documented in 
343.30 	the client's medical record.

344.1 	Sec. 35. Minnesota Statutes 2018, section 245G.22, subdivision 7, is amended to read:
344.2 		Subd. 7.Restrictions for unsupervised use of methadone hydrochloride. (a) If a 
344.3 	physician with authority to prescribe medical director or prescribing practitioner assesses 
344.4 	and determines that a client meets the criteria in subdivision 6 and may be dispensed a 
344.5 	medication used for the treatment of opioid addiction, the restrictions in this subdivision 
344.6 	must be followed when the medication to be dispensed is methadone hydrochloride. The 
344.7 	results of the assessment must be contained in the client file.
344.8 	(b) During the first 90 days of treatment, the unsupervised use medication supply must 
344.9 	be limited to a maximum of a single dose each week and the client shall ingest all other 
344.10 	doses under direct supervision.
344.11 	(c) In the second 90 days of treatment, the unsupervised use medication supply must be 
344.12 	limited to two doses per week.
344.13 	(d) In the third 90 days of treatment, the unsupervised use medication supply must not 
344.14 	exceed three doses per week.
344.15 	(e) In the remaining months of the first year, a client may be given a maximum six-day 
344.16 	unsupervised use medication supply.
344.17 	(f) After one year of continuous treatment, a client may be given a maximum two-week 
344.18 	unsupervised use medication supply.
344.19 	(g) After two years of continuous treatment, a client may be given a maximum one-month 
344.20 	unsupervised use medication supply, but must make monthly visits to the program.

344.21 	Sec. 36. Minnesota Statutes 2018, section 245G.22, subdivision 15, is amended to read:
344.22 		Subd. 15.Nonmedication treatment services; documentation. (a) The program must 
344.23 	offer at least 50 consecutive minutes of individual or group therapy treatment services as 
344.24 	defined in section 245G.07, subdivision 1, paragraph (a), clause (1), per week, for the first 
344.25 	ten weeks following admissionthe day of service initiation, and at least 50 consecutive 
344.26 	minutes per month thereafter. As clinically appropriate, the program may offer these services 
344.27 	cumulatively and not consecutively in increments of no less than 15 minutes over the required 
344.28 	time period, and for a total of 60 minutes of treatment services over the time period, and 
344.29 	must document the reason for providing services cumulatively in the client's record. The 
344.30 	program may offer additional levels of service when deemed clinically necessary.
344.31 	(b) Notwithstanding the requirements of comprehensive assessments in section 245G.05, 
344.32 	the assessment must be completed within 21 days from the day of service initiation.
345.1 	(c) Notwithstanding the requirements of individual treatment plans set forth in section 
345.2 	245G.06:
345.3 	(1) treatment plan contents for a maintenance client are not required to include goals 
345.4 	the client must reach to complete treatment and have services terminated;
345.5 	(2) treatment plans for a client in a taper or detox status must include goals the client 
345.6 	must reach to complete treatment and have services terminated; and
345.7 	(3) for the initial ten weeks after admissionfollowing the day of service initiation for 
345.8 	all new admissions, readmissions, and transfers, progress notes a weekly treatment plan 
345.9 	review must be entered in a client's file at least weekly and be recorded in each of the six 
345.10 	dimensions upon the development ofdocumented once the treatment plan and thereafter is 
345.11 	completed. Subsequently, the counselor must document progress treatment plan reviews in 
345.12 	the six dimensions at least once monthly or, when clinical need warrants, more frequently; 
345.13 	and.
345.14 	(4) upon the development of the treatment plan and thereafter, treatment plan reviews 
345.15 	must occur weekly, or after each treatment service, whichever is less frequent, for the first 
345.16 	ten weeks after the treatment plan is developed. Following the first ten weeks of treatment 
345.17 	plan reviews, reviews may occur monthly, unless the client's needs warrant more frequent 
345.18 	revisions or documentation.

345.19 	Sec. 37. Minnesota Statutes 2018, section 245G.22, subdivision 16, is amended to read:
345.20 		Subd. 16.Prescription monitoring program. (a) The program must develop and 
345.21 	maintain a policy and procedure that requires the ongoing monitoring of the data from the 
345.22 	prescription monitoring program (PMP) for each client. The policy and procedure must 
345.23 	include how the program meets the requirements in paragraph (b).
345.24 	(b) If When a medication used for the treatment of substance use disorder is administered 
345.25 	or dispensed to a client, the license holder shall be is subject to the following requirements:
345.26 	(1) upon admission to a methadone clinic outpatient an opioid treatment program, a 
345.27 	client must be notified in writing that the commissioner of human services and the medical 
345.28 	director must monitor the PMP to review the prescribed controlled drugs a client received;
345.29 	(2) the medical director or the medical director's delegate must review the data from the 
345.30 	PMP described in section 152.126 before the client is ordered any controlled substance, as 
345.31 	defined under section 152.126, subdivision 1, paragraph (c), including medications used 
345.32 	for the treatment of opioid addiction, and the medical director's or the medical director's 
345.33 	delegate's subsequent reviews of the PMP data must occur at least every 90 days;
346.1 	(3) a copy of the PMP data reviewed must be maintained in the client's file along with 
346.2 	the licensed practitioner's decision for frequency of ongoing PMP checks;
346.3 	(4) when the PMP data contains a recent history of multiple prescribers or multiple 
346.4 	prescriptions for controlled substances, the physician's review of the data and subsequent 
346.5 	actions must be documented in the client's file within 72 hours and must contain the medical
346.6 	director'slicensed practitioner's determination of whether or not the prescriptions place the 
346.7 	client at risk of harm and the actions to be taken in response to the PMP findings. The 
346.8 	provider must conduct subsequent reviews of the PMP on a monthly basis; and
346.9 	(5) if at any time the medical director licensed practitioner believes the use of the 
346.10 	controlled substances places the client at risk of harm, the program must seek the client's 
346.11 	consent to discuss the client's opioid treatment with other prescribers and must seek the 
346.12 	client's consent for the other prescriber to disclose to the opioid treatment program's medical
346.13 	directorlicensed practitioner the client's condition that formed the basis of the other 
346.14 	prescriptions. If the information is not obtained within seven days, the medical director 
346.15 	must document whether or not changes to the client's medication dose or number of 
346.16 	unsupervised use doses are necessary until the information is obtained.
346.17 	(c) The commissioner shall collaborate with the Minnesota Board of Pharmacy to develop 
346.18 	and implement an electronic system for the commissioner to routinely access the PMP data 
346.19 	to determine whether any client enrolled in an opioid addiction treatment program licensed 
346.20 	according to this section was prescribed or dispensed a controlled substance in addition to 
346.21 	that administered or dispensed by the opioid addiction treatment program. When the 
346.22 	commissioner determines there have been multiple prescribers or multiple prescriptions of 
346.23 	controlled substances for a client, the commissioner shall:
346.24 	(1) inform the medical director of the opioid treatment program only that the 
346.25 	commissioner determined the existence of multiple prescribers or multiple prescriptions of 
346.26 	controlled substances; and
346.27 	(2) direct the medical director of the opioid treatment program to access the data directly, 
346.28 	review the effect of the multiple prescribers or multiple prescriptions, and document the 
346.29 	review.
346.30 	(d) If determined necessary, the commissioner shall seek a federal waiver of, or exception 
346.31 	to, any applicable provision of Code of Federal Regulations, title 42, section 2.34 (c), before 
346.32 	implementing this subdivision.

347.1 	Sec. 38. Minnesota Statutes 2018, section 245G.22, subdivision 17, is amended to read:
347.2 		Subd. 17.Policies and procedures. (a) A license holder must develop and maintain the 
347.3 	policies and procedures required in this subdivision.
347.4 	(b) For a program that is not open every day of the year, the license holder must maintain 
347.5 	a policy and procedure that permits a client to receive a single covers requirements under 
347.6 	section 245G.22, subdivisions 6 and 7. Unsupervised use of medication used for the treatment 
347.7 	of opioid use disorder for days that the program is closed for business, including, but not 
347.8 	limited to, Sundays and state and federal holidays as required under subdivision 6, paragraph 
347.9 	(a), clause (1), must meet the requirements under section 245G.22, subdivisions 6 and 7.
347.10 	(c) The license holder must maintain a policy and procedure that includes specific 
347.11 	measures to reduce the possibility of diversion. The policy and procedure must:
347.12 	(1) specifically identify and define the responsibilities of the medical and administrative 
347.13 	staff for performing diversion control measures; and
347.14 	(2) include a process for contacting no less than five percent of clients who have 
347.15 	unsupervised use of medication, excluding clients approved solely under subdivision 6, 
347.16 	paragraph (a), clause (1), to require clients to physically return to the program each month. 
347.17 	The system must require clients to return to the program within a stipulated time frame and 
347.18 	turn in all unused medication containers related to opioid use disorder treatment. The license 
347.19 	holder must document all related contacts on a central log and the outcome of the contact 
347.20 	for each client in the client's record. The medical director must be informed of each outcome 
347.21 	that results in a situation in which a possible diversion issue was identified.
347.22 	(d) Medication used for the treatment of opioid use disorder must be ordered, 
347.23 	administered, and dispensed according to applicable state and federal regulations and the 
347.24 	standards set by applicable accreditation entities. If a medication order requires assessment 
347.25 	by the person administering or dispensing the medication to determine the amount to be 
347.26 	administered or dispensed, the assessment must be completed by an individual whose 
347.27 	professional scope of practice permits an assessment. For the purposes of enforcement of 
347.28 	this paragraph, the commissioner has the authority to monitor the person administering or 
347.29 	dispensing the medication for compliance with state and federal regulations and the relevant 
347.30 	standards of the license holder's accreditation agency and may issue licensing actions 
347.31 	according to sections 245A.05, 245A.06, and 245A.07, based on the commissioner's 
347.32 	determination of noncompliance.
347.33 	(e) A counselor in an opioid treatment program must not supervise more than 50 clients.

348.1 	Sec. 39. Minnesota Statutes 2018, section 245G.22, subdivision 19, is amended to read:
348.2 		Subd. 19.Placing authorities. A program must provide certain notification and 
348.3 	client-specific updates to placing authorities for a client who is enrolled in Minnesota health 
348.4 	care programs. At the request of the placing authority, the program must provide 
348.5 	client-specific updates, including but not limited to informing the placing authority of 
348.6 	positive drug screenings testings and changes in medications used for the treatment of opioid 
348.7 	use disorder ordered for the client.

348.8 	Sec. 40. Minnesota Statutes 2018, section 254A.03, subdivision 3, is amended to read:
348.9 		Subd. 3.Rules for substance use disorder care. (a) The commissioner of human 
348.10 	services shall establish by rule criteria to be used in determining the appropriate level of 
348.11 	chemical dependency care for each recipient of public assistance seeking treatment for 
348.12 	substance misuse or substance use disorder. Upon federal approval of a comprehensive 
348.13 	assessment as a Medicaid benefit, or on July 1, 2018, whichever is later, and notwithstanding 
348.14 	the criteria in Minnesota Rules, parts 9530.6600 to 9530.6655, an eligible vendor of 
348.15 	comprehensive assessments under section 254B.05 may determine and approve the 
348.16 	appropriate level of substance use disorder treatment for a recipient of public assistance. 
348.17 	The process for determining an individual's financial eligibility for the consolidated chemical 
348.18 	dependency treatment fund or determining an individual's enrollment in or eligibility for a 
348.19 	publicly subsidized health plan is not affected by the individual's choice to access a 
348.20 	comprehensive assessment for placement.
348.21 	(b) The commissioner shall develop and implement a utilization review process for 
348.22 	publicly funded treatment placements to monitor and review the clinical appropriateness 
348.23 	and timeliness of all publicly funded placements in treatment.
348.24 	(c) If a screen result is positive for alcohol or substance misuse, a brief screening for 
348.25 	alcohol or substance use disorder that is provided to a recipient of public assistance within 
348.26 	a primary care clinic, hospital, or other medical setting or school setting establishes medical 
348.27 	necessity and approval for an initial set of substance use disorder services identified in 
348.28 	section 254B.05, subdivision 5. The initial set of services approved for a recipient whose 
348.29 	screen result is positive may include any combination of up to four hours of individual or 
348.30 	group substance use disorder treatment, two hours of substance use disorder treatment 
348.31 	coordination, or two hours of substance use disorder peer support services provided by a 
348.32 	qualified individual according to chapter 245G. A recipient must obtain an assessment 
348.33 	pursuant to paragraph (a) to be approved for additional treatment services.

349.1 	EFFECTIVE DATE. Contingent upon federal approval, this section is effective July 
349.2 	1, 2019. The commissioner of human services shall notify the revisor of statutes when 
349.3 	federal approval is obtained or denied.

349.4 	Sec. 41. Minnesota Statutes 2018, section 254A.19, is amended by adding a subdivision 
349.5 	to read:
349.6 		Subd. 5.Assessment via telemedicine. Notwithstanding Minnesota Rules, part 
349.7 	9530.6615, subpart 3, item A, a chemical use assessment may be conducted via telemedicine.

349.8 	Sec. 42. Minnesota Statutes 2018, section 254B.02, subdivision 1, is amended to read:
349.9 		Subdivision 1.Chemical dependency treatment allocation. The chemical dependency 
349.10 	treatment appropriation shall be placed in a special revenue account. The commissioner 
349.11 	shall annually transfer funds from the chemical dependency fund to pay for operation of 
349.12 	the drug and alcohol abuse normative evaluation system and to pay for all costs incurred 
349.13 	by adding two positions for licensing of chemical dependency treatment and rehabilitation 
349.14 	programs located in hospitals for which funds are not otherwise appropriated. The remainder 
349.15 	of the money in the special revenue account must be used according to the requirements in 
349.16 	this chapter.

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

349.18 	Sec. 43. Minnesota Statutes 2018, section 254B.03, subdivision 2, is amended to read:
349.19 		Subd. 2.Chemical dependency fund payment. (a) Payment from the chemical 
349.20 	dependency fund is limited to payments for services other than detoxification licensed under 
349.21 	Minnesota Rules, parts 9530.6510 to 9530.6590, that, if located outside of federally 
349.22 	recognized tribal lands, would be required to be licensed by the commissioner as a chemical 
349.23 	dependency treatment or rehabilitation program under sections 245A.01 to 245A.16, and 
349.24 	services other than detoxification provided in another state that would be required to be 
349.25 	licensed as a chemical dependency program if the program were in the state. Out of state 
349.26 	vendors must also provide the commissioner with assurances that the program complies 
349.27 	substantially with state licensing requirements and possesses all licenses and certifications 
349.28 	required by the host state to provide chemical dependency treatment. Vendors receiving 
349.29 	payments from the chemical dependency fund must not require co-payment from a recipient 
349.30 	of benefits for services provided under this subdivision. The vendor is prohibited from using 
349.31 	the client's public benefits to offset the cost of services paid under this section. The vendor 
349.32 	shall not require the client to use public benefits for room or board costs. This includes but 
350.1 	is not limited to cash assistance benefits under chapters 119B, 256D, and 256J, or SNAP 
350.2 	benefits. Retention of SNAP benefits is a right of a client receiving services through the 
350.3 	consolidated chemical dependency treatment fund or through state contracted managed care 
350.4 	entities. Payment from the chemical dependency fund shall be made for necessary room 
350.5 	and board costs provided by vendors certified according tomeeting the criteria under section 
350.6 	254B.05, subdivision 1a, or in a community hospital licensed by the commissioner of health 
350.7 	according to sections 144.50 to 144.56 to a client who is:
350.8 	(1) determined to meet the criteria for placement in a residential chemical dependency 
350.9 	treatment program according to rules adopted under section 254A.03, subdivision 3; and
350.10 	(2) concurrently receiving a chemical dependency treatment service in a program licensed 
350.11 	by the commissioner and reimbursed by the chemical dependency fund.
350.12 	(b) A county may, from its own resources, provide chemical dependency services for 
350.13 	which state payments are not made. A county may elect to use the same invoice procedures 
350.14 	and obtain the same state payment services as are used for chemical dependency services 
350.15 	for which state payments are made under this section if county payments are made to the 
350.16 	state in advance of state payments to vendors. When a county uses the state system for 
350.17 	payment, the commissioner shall make monthly billings to the county using the most recent 
350.18 	available information to determine the anticipated services for which payments will be made 
350.19 	in the coming month. Adjustment of any overestimate or underestimate based on actual 
350.20 	expenditures shall be made by the state agency by adjusting the estimate for any succeeding 
350.21 	month.
350.22 	(c) The commissioner shall coordinate chemical dependency services and determine 
350.23 	whether there is a need for any proposed expansion of chemical dependency treatment 
350.24 	services. The commissioner shall deny vendor certification to any provider that has not 
350.25 	received prior approval from the commissioner for the creation of new programs or the 
350.26 	expansion of existing program capacity. The commissioner shall consider the provider's 
350.27 	capacity to obtain clients from outside the state based on plans, agreements, and previous 
350.28 	utilization history, when determining the need for new treatment services.

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

350.30 	Sec. 44. Minnesota Statutes 2018, section 254B.03, subdivision 4, is amended to read:
350.31 		Subd. 4.Division of costs. (a) Except for services provided by a county under section 
350.32 	254B.09, subdivision 1, or services provided under section 256B.69, the county shall, out 
350.33 	of local money, pay the state for 22.95 percent of the cost of chemical dependency services, 
351.1 	including except for those services provided to persons eligible for enrolled in medical 
351.2 	assistance under chapter 256B and room and board services under section 254B.05, 
351.3 	subdivision 5, paragraph (b), clause (12). Counties may use the indigent hospitalization 
351.4 	levy for treatment and hospital payments made under this section.
351.5 	(b) 22.95 percent of any state collections from private or third-party pay, less 15 percent 
351.6 	for the cost of payment and collections, must be distributed to the county that paid for a 
351.7 	portion of the treatment under this section.
351.8 	(c) For fiscal year 2017 only, the 22.95 percentages under paragraphs (a) and (b) are 
351.9 	equal to 20.2 percent.

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

351.11 	Sec. 45. Minnesota Statutes 2018, section 254B.04, subdivision 1, is amended to read:
351.12 		Subdivision 1.Eligibility. (a) Persons eligible for benefits under Code of Federal 
351.13 	Regulations, title 25, part 20, and persons eligible for medical assistance benefits under 
351.14 	sections 256B.055, 256B.056, and 256B.057, subdivisions 1, 5, and 6, or who meet the 
351.15 	income standards of section 256B.056, subdivision 4, and are not enrolled in medical 
351.16 	assistance, are entitled to chemical dependency fund services. State money appropriated 
351.17 	for this paragraph must be placed in a separate account established for this purpose.
351.18 	(b) Persons with dependent children who are determined to be in need of chemical 
351.19 	dependency treatment pursuant to an assessment under section 626.556, subdivision 10, or 
351.20 	a case plan under section 260C.201, subdivision 6, or 260C.212, shall be assisted by the 
351.21 	local agency to access needed treatment services. Treatment services must be appropriate 
351.22 	for the individual or family, which may include long-term care treatment or treatment in a 
351.23 	facility that allows the dependent children to stay in the treatment facility. The county shall 
351.24 	pay for out-of-home placement costs, if applicable.
351.25 	(c) Notwithstanding paragraph (a), persons enrolled in medical assistance are eligible 
351.26 	for room and board services under section 254B.05, subdivision 5, paragraph (b), clause 
351.27 	(12).

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

351.29 	Sec. 46. Minnesota Statutes 2018, section 254B.04, is amended by adding a subdivision 
351.30 	to read:
351.31 		Subd. 2c.Eligibility to receive peer recovery support and treatment service 
351.32 	coordination. Notwithstanding Minnesota Rules, part 9530.6620, subpart 6, a placing 
352.1 	authority may authorize peer recovery support and treatment service coordination for a 
352.2 	person who scores a severity of one or more in dimension 4, 5, or 6, under Minnesota Rules, 
352.3 	part 9530.6622. Authorization for peer recovery support and treatment service coordination 
352.4 	under this subdivision does not need to be provided in conjunction with treatment services 
352.5 	under Minnesota Rules, part 9530.6622, subpart 4, 5, or 6.

352.6 	Sec. 47. Minnesota Statutes 2018, section 254B.05, subdivision 1, is amended to read:
352.7 		Subdivision 1.Licensure required. (a) Programs licensed by the commissioner are 
352.8 	eligible vendors. Hospitals may apply for and receive licenses to be eligible vendors, 
352.9 	notwithstanding the provisions of section 245A.03. American Indian programs that provide 
352.10 	substance use disorder treatment, extended care, transitional residence, or outpatient treatment 
352.11 	services, and are licensed by tribal government are eligible vendors.
352.12 	(b) On July 1, 2018, or upon federal approval, whichever is later, A licensed professional 
352.13 	in private practice who meets the requirements of section 245G.11, subdivisions 1 and 4, 
352.14 	is an eligible vendor of a comprehensive assessment and assessment summary provided 
352.15 	according to section 245G.05, and treatment services provided according to sections 245G.06 
352.16 	and 245G.07, subdivision 1, paragraphs (a), clauses (1) to (5) (4), and (b); and subdivision 
352.17 	2.
352.18 	(c) On July 1, 2018, or upon federal approval, whichever is later, A county is an eligible 
352.19 	vendor for a comprehensive assessment and assessment summary when provided by an 
352.20 	individual who meets the staffing credentials of section 245G.11, subdivisions 1 and 45, 
352.21 	and completed according to the requirements of section 245G.05. A county is an eligible 
352.22 	vendor of care coordination services when provided by an individual who meets the staffing 
352.23 	credentials of section 245G.11, subdivisions 1 and 7, and provided according to the 
352.24 	requirements of section 245G.07, subdivision 1, paragraph (a), clause (7) (5).
352.25 	(d) On July 1, 2018, or upon federal approval, whichever is later, A recovery community 
352.26 	organization that meets certification requirements identified by the commissioner is an 
352.27 	eligible vendor of peer support services.
352.28 	(e) Detoxification programs licensed under Minnesota Rules, parts 9530.6510 to 
352.29 	9530.6590, are not eligible vendors. Programs that are not licensed as a residential or 
352.30 	nonresidential substance use disorder treatment or withdrawal management program by the 
352.31 	commissioner or by tribal government or do not meet the requirements of subdivisions 1a 
352.32 	and 1b are not eligible vendors.

353.1 	Sec. 48. Minnesota Statutes 2018, section 254B.05, subdivision 1a, is amended to read:
353.2 		Subd. 1a.Room and board provider requirements. (a) Effective January 1, 2000, 
353.3 	vendors of room and board are eligible for chemical dependency fund payment if the vendor:
353.4 	(1) has rules prohibiting residents bringing chemicals into the facility or using chemicals 
353.5 	while residing in the facility and provide consequences for infractions of those rules;
353.6 	(2) is determined to meet applicable health and safety requirements;
353.7 	(3) is not a jail or prison;
353.8 	(4) is not concurrently receiving funds under chapter 256I for the recipient;
353.9 	(5) admits individuals who are 18 years of age or older;
353.10 	(6) is registered as a board and lodging or lodging establishment according to section 
353.11 	157.17;
353.12 	(7) has awake staff on site 24 hours per day;
353.13 	(8) has staff who are at least 18 years of age and meet the requirements of section 
353.14 	245G.11, subdivision 1, paragraph (b);
353.15 	(9) has emergency behavioral procedures that meet the requirements of section 245G.16;
353.16 	(10) meets the requirements of section 245G.08, subdivision 5, if administering 
353.17 	medications to clients;
353.18 	(11) meets the abuse prevention requirements of section 245A.65, including a policy on 
353.19 	fraternization and the mandatory reporting requirements of section 626.557;
353.20 	(12) documents coordination with the treatment provider to ensure compliance with 
353.21 	section 254B.03, subdivision 2;
353.22 	(13) protects client funds and ensures freedom from exploitation by meeting the 
353.23 	provisions of section 245A.04, subdivision 13;
353.24 	(14) has a grievance procedure that meets the requirements of section 245G.15, 
353.25 	subdivision 2; and
353.26 	(15) has sleeping and bathroom facilities for men and women separated by a door that 
353.27 	is locked, has an alarm, or is supervised by awake staff.
353.28 	(b) Programs licensed according to Minnesota Rules, chapter 2960, are exempt from 
353.29 	paragraph (a), clauses (5) to (15).
354.1 	(c) Licensed programs providing intensive residential treatment services or residential 
354.2 	crisis stabilization services pursuant to section 256B.0622 or 256B.0624 are eligible vendors 
354.3 	of room and board and are exempt from paragraph (a), clauses (6) to (15).

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

354.5 	Sec. 49. Minnesota Statutes 2018, section 254B.05, subdivision 5, is amended to read:
354.6 		Subd. 5.Rate requirements. (a) The commissioner shall establish rates for substance 
354.7 	use disorder services and service enhancements funded under this chapter.
354.8 	(b) Eligible substance use disorder treatment services include:
354.9 	(1) outpatient treatment services that are licensed according to sections 245G.01 to 
354.10 	245G.17, or applicable tribal license;
354.11 	(2) on July 1, 2018, or upon federal approval, whichever is later, comprehensive 
354.12 	assessments provided according to sections 245.4863, paragraph (a), and 245G.05, and 
354.13 	Minnesota Rules, part 9530.6422;
354.14 	(3) on July 1, 2018, or upon federal approval, whichever is later, care coordination 
354.15 	services provided according to section 245G.07, subdivision 1, paragraph (a), clause (6)
354.16 	(5);
354.17 	(4) on July 1, 2018, or upon federal approval, whichever is later, peer recovery support 
354.18 	services provided according to section 245G.07, subdivision 1, paragraph (a) 2, clause (5)
354.19 	(8);
354.20 	(5) on July 1, 2019, or upon federal approval, whichever is later, withdrawal management 
354.21 	services provided according to chapter 245F;
354.22 	(6) medication-assisted therapy services that are licensed according to sections 245G.01
354.23 	to 245G.17 and 245G.22, or applicable tribal license;
354.24 	(7) medication-assisted therapy plus enhanced treatment services that meet the 
354.25 	requirements of clause (6) and provide nine hours of clinical services each week;
354.26 	(8) high, medium, and low intensity residential treatment services that are licensed 
354.27 	according to sections 245G.01 to 245G.17 and 245G.21 or applicable tribal license which 
354.28 	provide, respectively, 30, 15, and five hours of clinical services each week;
354.29 	(9) hospital-based treatment services that are licensed according to sections 245G.01 to 
354.30 	245G.17 or applicable tribal license and licensed as a hospital under sections 144.50 to 
354.31 	144.56;
355.1 	(10) adolescent treatment programs that are licensed as outpatient treatment programs 
355.2 	according to sections 245G.01 to 245G.18 or as residential treatment programs according 
355.3 	to Minnesota Rules, parts 2960.0010 to 2960.0220, and 2960.0430 to 2960.0490, or 
355.4 	applicable tribal license;
355.5 	(11) high-intensity residential treatment services that are licensed according to sections 
355.6 	245G.01 to 245G.17 and 245G.21 or applicable tribal license, which provide 30 hours of 
355.7 	clinical services each week provided by a state-operated vendor or to clients who have been 
355.8 	civilly committed to the commissioner, present the most complex and difficult care needs, 
355.9 	and are a potential threat to the community; and
355.10 	(12) room and board facilities that meet the requirements of subdivision 1a.
355.11 	(c) The commissioner shall establish higher rates for programs that meet the requirements 
355.12 	of paragraph (b) and one of the following additional requirements:
355.13 	(1) programs that serve parents with their children if the program:
355.14 	(i) provides on-site child care during the hours of treatment activity that:
355.15 	(A) is licensed under chapter 245A as a child care center under Minnesota Rules, chapter 
355.16 	9503; or
355.17 	(B) meets the licensure exclusion criteria of section 245A.03, subdivision 2, paragraph 
355.18 	(a), clause (6), and meets the requirements under section 245G.19, subdivision 4; or
355.19 	(ii) arranges for off-site child care during hours of treatment activity at a facility that is 
355.20 	licensed under chapter 245A as:
355.21 	(A) a child care center under Minnesota Rules, chapter 9503; or
355.22 	(B) a family child care home under Minnesota Rules, chapter 9502;
355.23 	(2) culturally specific programs as defined in section 254B.01, subdivision 4a, or 
355.24 	programs or subprograms serving special populations, if the program or subprogram meets 
355.25 	the following requirements:
355.26 	(i) is designed to address the unique needs of individuals who share a common language, 
355.27 	racial, ethnic, or social background;
355.28 	(ii) is governed with significant input from individuals of that specific background; and
355.29 	(iii) employs individuals to provide individual or group therapy, at least 50 percent of 
355.30 	whom are of that specific background, except when the common social background of the 
355.31 	individuals served is a traumatic brain injury or cognitive disability and the program employs 
356.1 	treatment staff who have the necessary professional training, as approved by the 
356.2 	commissioner, to serve clients with the specific disabilities that the program is designed to 
356.3 	serve;
356.4 	(3) programs that offer medical services delivered by appropriately credentialed health 
356.5 	care staff in an amount equal to two hours per client per week if the medical needs of the 
356.6 	client and the nature and provision of any medical services provided are documented in the 
356.7 	client file; and
356.8 	(4) programs that offer services to individuals with co-occurring mental health and 
356.9 	chemical dependency problems if:
356.10 	(i) the program meets the co-occurring requirements in section 245G.20;
356.11 	(ii) 25 percent of the counseling staff are licensed mental health professionals, as defined 
356.12 	in section 245.462, subdivision 18, clauses (1) to (6), or are students or licensing candidates 
356.13 	under the supervision of a licensed alcohol and drug counselor supervisor and licensed 
356.14 	mental health professional, except that no more than 50 percent of the mental health staff 
356.15 	may be students or licensing candidates with time documented to be directly related to 
356.16 	provisions of co-occurring services;
356.17 	(iii) clients scoring positive on a standardized mental health screen receive a mental 
356.18 	health diagnostic assessment within ten days of admission;
356.19 	(iv) the program has standards for multidisciplinary case review that include a monthly 
356.20 	review for each client that, at a minimum, includes a licensed mental health professional 
356.21 	and licensed alcohol and drug counselor, and their involvement in the review is documented;
356.22 	(v) family education is offered that addresses mental health and substance abuse disorders 
356.23 	and the interaction between the two; and
356.24 	(vi) co-occurring counseling staff shall receive eight hours of co-occurring disorder 
356.25 	training annually.
356.26 	(d) In order to be eligible for a higher rate under paragraph (c), clause (1), a program 
356.27 	that provides arrangements for off-site child care must maintain current documentation at 
356.28 	the chemical dependency facility of the child care provider's current licensure to provide 
356.29 	child care services. Programs that provide child care according to paragraph (c), clause (1), 
356.30 	must be deemed in compliance with the licensing requirements in section 245G.19.
356.31 	(e) Adolescent residential programs that meet the requirements of Minnesota Rules, 
356.32 	parts 2960.0430 to 2960.0490 and 2960.0580 to 2960.0690, are exempt from the requirements 
356.33 	in paragraph (c), clause (4), items (i) to (iv).
357.1 	(f) Subject to federal approval, chemical dependency services that are otherwise covered 
357.2 	as direct face-to-face services may be provided via two-way interactive video. The use of 
357.3 	two-way interactive video must be medically appropriate to the condition and needs of the 
357.4 	person being served. Reimbursement shall be at the same rates and under the same conditions 
357.5 	that would otherwise apply to direct face-to-face services. The interactive video equipment 
357.6 	and connection must comply with Medicare standards in effect at the time the service is 
357.7 	provided.
357.8 	(g) For the purpose of reimbursement under this section, substance use disorder treatment 
357.9 	services provided in a group setting without a group participant maximum or maximum 
357.10 	client to staff ratio under chapter 245G shall not exceed a client to staff ratio of 48 to one. 
357.11 	At least one of the attending staff must meet the qualifications as established under this 
357.12 	chapter for the type of treatment service provided. A recovery peer may not be included as 
357.13 	part of the staff ratio.

357.14 	Sec. 50. Minnesota Statutes 2018, section 254B.06, subdivision 1, is amended to read:
357.15 		Subdivision 1.State collections. The commissioner is responsible for all collections 
357.16 	from persons determined to be partially responsible for the cost of care of an eligible person 
357.17 	receiving services under Laws 1986, chapter 394, sections 8 to 20. The commissioner may 
357.18 	initiate, or request the attorney general to initiate, necessary civil action to recover the unpaid 
357.19 	cost of care. The commissioner may collect all third-party payments for chemical dependency 
357.20 	services provided under Laws 1986, chapter 394, sections 8 to 20, including private insurance 
357.21 	and federal Medicaid and Medicare financial participation. The commissioner shall deposit 
357.22 	in a dedicated account a percentage of collections to pay for the cost of operating the chemical 
357.23 	dependency consolidated treatment fund invoice processing and vendor payment system, 
357.24 	billing, and collections. The remaining receipts must be deposited in the chemical dependency 
357.25 	fund.

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

357.27 	Sec. 51. Minnesota Statutes 2018, section 254B.06, subdivision 2, is amended to read:
357.28 		Subd. 2.Allocation of collections. (a) The commissioner shall allocate all federal 
357.29 	financial participation collections to a special revenue account. The commissioner shall 
357.30 	allocate 77.05 percent of patient payments and third-party payments to the special revenue 
357.31 	account and 22.95 percent to the county financially responsible for the patient.
358.1 	(b) For fiscal year 2017 only, the commissioner's allocation to the special revenue account 
358.2 	shall be increased from 77.05 percent to 79.8 percent and the county financial responsibility 
358.3 	shall be reduced from 22.95 percent to 20.2 percent.

358.4 	EFFECTIVE DATE. Paragraph (a) is effective July 1, 2020, and paragraph (b) is 
358.5 	effective July 1, 2019.

358.6 	Sec. 52. Minnesota Statutes 2018, section 256B.0625, is amended by adding a subdivision 
358.7 	to read:
358.8 		Subd. 5m.Certified community behavioral health clinic services. (a) Medical 
358.9 	assistance covers certified community behavioral health clinic (CCBHC) services that meet 
358.10 	the requirements of section 245.735, subdivision 3.
358.11 	(b) The commissioner shall establish standards and methodologies for a prospective 
358.12 	payment system for medical assistance payments for services delivered by a CCBHC, in 
358.13 	accordance with guidance issued by the Centers for Medicare and Medicaid Services. The 
358.14 	commissioner shall include a quality bonus payment in the prospective payment system 
358.15 	based on federal criteria.
358.16 	(c) To the extent allowed by federal law, the commissioner may limit the number of 
358.17 	CCBHCs for the prospective payment system in paragraph (b) to ensure that the projected 
358.18 	claims do not exceed the money appropriated for this purpose. The commissioner shall 
358.19 	apply the following priorities, in the order listed, to give preference to clinics that:
358.20 	(1) provide a comprehensive range of services and evidence-based practices for all age 
358.21 	groups, with services being fully coordinated and integrated;
358.22 	(2) are certified as CCBHCs during the federal section 223 CCBHC demonstration 
358.23 	period;
358.24 	(3) receive CCBHC grants from the United States Department of Health and Human 
358.25 	Services; or
358.26 	(4) focus on serving individuals in tribal areas and other underserved communities.
358.27 	(d) Unless otherwise indicated in applicable federal requirements, the prospective payment 
358.28 	system must continue to be based on the federal instructions issued for the federal section 
358.29 	223 CCBHC demonstration, except:
358.30 	(1) the commissioner shall rebase CCBHC rates at least every three years;
358.31 	(2) the commissioner shall provide for a 60-day appeals process of the rebasing;
359.1 	(3) the prohibition against inclusion of new facilities in the demonstration does not apply 
359.2 	after the demonstration ends;
359.3 	(4) the prospective payment rate under this section does not apply to services rendered 
359.4 	by CCBHCs to individuals who are dually eligible for Medicare and medical assistance 
359.5 	when Medicare is the primary payer for the service. An entity that receives a prospective 
359.6 	payment system rate that overlaps with the CCBHC rate is not eligible for the CCBHC rate;
359.7 	(5) payments for CCBHC services to individuals enrolled in managed care shall be 
359.8 	coordinated with the state's phase-out of CCBHC wrap payments;
359.9 	(6) initial prospective payment rates for CCBHCs certified after July 1, 2019, shall be 
359.10 	based on rates for comparable CCBHCs. If no comparable provider exists, the commissioner 
359.11 	shall compute a CCBHC-specific rate based upon the CCBHC's audited costs adjusted for 
359.12 	changes in the scope of services; and
359.13 	(7) the prospective payment rate for each CCBHC shall be adjusted annually by the 
359.14 	Medicare Economic Index as defined for the federal section 223 CCBHC demonstration.

359.15 	EFFECTIVE DATE. Contingent upon federal approval, this section is effective July 
359.16 	1, 2019. The commissioner of human services shall notify the revisor of statutes when 
359.17 	federal approval is obtained or denied.

359.18 	Sec. 53. Minnesota Statutes 2018, section 256B.0625, subdivision 24, is amended to read:
359.19 		Subd. 24.Other medical or remedial care. Medical assistance covers any other medical 
359.20 	or remedial care licensed and recognized under state law unless otherwise prohibited by 
359.21 	law, except licensed chemical dependency treatment programs or primary treatment or 
359.22 	extended care treatment units in hospitals that are covered under chapter 254B. The 
359.23 	commissioner shall include chemical dependency services in the state medical assistance 
359.24 	plan for federal reporting purposes, but payment must be made under chapter 254B. The 
359.25 	commissioner shall publish in the State Register a list of elective surgeries that require a 
359.26 	second medical opinion before medical assistance reimbursement, and the criteria and 
359.27 	standards for deciding whether an elective surgery should require a second medical opinion. 
359.28 	The list and criteria and standards are not subject to the requirements of sections 14.01 to 
359.29 	14.69.

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

360.1 	Sec. 54. Minnesota Statutes 2018, section 256B.0625, is amended by adding a subdivision 
360.2 	to read:
360.3 		Subd. 24a.Substance use disorder services. Medical assistance covers substance use 
360.4 	disorder treatment services according to section 254B.05, subdivision 5, except for room 
360.5 	and board.

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

360.7 	Sec. 55. Minnesota Statutes 2018, section 256B.0625, subdivision 43, is amended to read:
360.8 		Subd. 43.Mental health provider travel time. (a) Medical assistance covers provider 
360.9 	travel time if a recipient's individual treatment plan recipient requires the provision of mental 
360.10 	health services outside of the provider's normalusual place of business. This does not include 
360.11 	any travel time which is included in other billable services, and is only covered when the 
360.12 	mental health service being provided to a recipient is covered under medical assistance.
360.13 	(b) Medical assistance covers under this subdivision the time a provider is in transit to 
360.14 	provide a covered mental health service to a recipient at a location that is not the provider's 
360.15 	usual place of business. A provider must travel the most direct route available. Mental health 
360.16 	provider travel time does not include time for scheduled or unscheduled stops, meal breaks, 
360.17 	or vehicle maintenance or repair, including refueling or vehicle emergencies. Recipient 
360.18 	transportation is not covered under this subdivision.
360.19 	(c) Mental health provider travel time under this subdivision is only covered when the 
360.20 	mental health service being provided is covered under medical assistance and only when 
360.21 	the covered mental health service is delivered and billed. Mental health provider travel time 
360.22 	is not covered when the mental health service being provided otherwise includes provider 
360.23 	travel time or when the service is site based.
360.24 	(d) A provider must document each trip for which the provider seeks reimbursement 
360.25 	under this subdivision in a compiled travel record. Required documentation may be collected 
360.26 	and maintained electronically or in paper form but must be made available and produced 
360.27 	upon request by the commissioner. The travel record must be written in English and must 
360.28 	be legible according to the standard of a reasonable person. The recipient's individual 
360.29 	identification number must be on each page of the record. The reason the provider must 
360.30 	travel to provide services must be included in the record, if not otherwise documented in 
360.31 	the recipient's individual treatment plan. Each entry in the record must document:
360.32 	(1) start and stop time (with a.m. and p.m. notations);
360.33 	(2) printed name of the recipient;
361.1 	(3) date the entry is made;
361.2 	(4) date the service is provided;
361.3 	(5) origination site and destination site;
361.4 	(6) who provided the service;
361.5 	(7) the electronic source used to calculate driving directions and distance between 
361.6 	locations; and
361.7 	(8) the medically necessary mental health service delivered.
361.8 	(e) Mental health providers identified by the commissioner to have submitted a fraudulent 
361.9 	report may be excluded from participation in Minnesota health care programs.

361.10 	Sec. 56. Minnesota Statutes 2018, section 256B.0625, subdivision 45a, is amended to 
361.11 	read:
361.12 		Subd. 45a.Psychiatric residential treatment facility services for persons younger 
361.13 	than 21 years of age. (a) Medical assistance covers psychiatric residential treatment facility 
361.14 	services, according to section 256B.0941, for persons younger than 21 years of age. 
361.15 	Individuals who reach age 21 at the time they are receiving services are eligible to continue 
361.16 	receiving services until they no longer require services or until they reach age 22, whichever 
361.17 	occurs first.
361.18 	(b) For purposes of this subdivision, "psychiatric residential treatment facility" means 
361.19 	a facility other than a hospital that provides psychiatric services, as described in Code of 
361.20 	Federal Regulations, title 42, sections 441.151 to 441.182, to individuals under age 21 in 
361.21 	an inpatient setting.
361.22 	(c) The commissioner shall enroll up to 150 certified psychiatric residential treatment 
361.23 	facility services beds at up to six sites. The commissioner may enroll an additional 80 
361.24 	certified psychiatric residential treatment facility services beds beginning July 1, 2020, and 
361.25 	an additional 70 certified psychiatric residential treatment facility services beds beginning 
361.26 	July 1, 2023. The commissioner shall select psychiatric residential treatment facility services 
361.27 	providers through a request for proposals process. Providers of state-operated services may 
361.28 	respond to the request for proposals. The commissioner shall prioritize programs that 
361.29 	demonstrate the capacity to serve children and youth with aggressive and risky behaviors 
361.30 	toward themselves or others, multiple diagnoses, neurodevelopmental disorders, or complex 
361.31 	trauma related issues.

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

362.1 	Sec. 57. Minnesota Statutes 2018, section 256B.0625, subdivision 57, is amended to read:
362.2 		Subd. 57.Payment for Part B Medicare crossover claims. (a) Effective for services 
362.3 	provided on or after January 1, 2012, medical assistance payment for an enrollee's 
362.4 	cost-sharing associated with Medicare Part B is limited to an amount up to the medical 
362.5 	assistance total allowed, when the medical assistance rate exceeds the amount paid by 
362.6 	Medicare.
362.7 	(b) Excluded from this limitation are payments for mental health services and payments 
362.8 	for dialysis services provided to end-stage renal disease patients. The exclusion for mental 
362.9 	health services does not apply to payments for physician services provided by psychiatrists 
362.10 	and advanced practice nurses with a specialty in mental health.
362.11 	(c) Excluded from this limitation are payments to federally qualified health centers and,
362.12 	rural health clinics, and CCBHCs subject to the prospective payment system under 
362.13 	subdivision 5m.

362.14 	EFFECTIVE DATE. Contingent upon federal approval, this section is effective July 
362.15 	1, 2019. The commissioner of human services shall notify the revisor of statutes when 
362.16 	federal approval is obtained or denied.

362.17 	Sec. 58. Minnesota Statutes 2018, section 256B.0757, subdivision 1, is amended to read:
362.18 		Subdivision 1.Provision of coverage. (a) The commissioner shall provide medical 
362.19 	assistance coverage of health home services for eligible individuals with chronic conditions 
362.20 	who select a designated provider as the individual's health home.
362.21 	(b) The commissioner shall implement this section in compliance with the requirements 
362.22 	of the state option to provide health homes for enrollees with chronic conditions, as provided 
362.23 	under the Patient Protection and Affordable Care Act, Public Law 111-148, sections 2703 
362.24 	and 3502. Terms used in this section have the meaning provided in that act.
362.25 	(c) The commissioner shall establish health homes to serve populations with serious 
362.26 	mental illness who meet the eligibility requirements described under subdivision 2, clause 
362.27 	(4). The health home services provided by health homes shall focus on both the behavioral 
362.28 	and the physical health of these populations.

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

363.1 	Sec. 59. Minnesota Statutes 2018, section 256B.0757, subdivision 2, is amended to read:
363.2 		Subd. 2.Eligible individual. (a) The commissioner may elect to develop health home 
363.3 	models in accordance with United States Code, title 42, section 1396w-4.
363.4 	(b) An individual is eligible for health home services under this section if the individual 
363.5 	is eligible for medical assistance under this chapter and has at least:
363.6 	(1) two chronic conditions;
363.7 	(2) one chronic condition and is at risk of having a second chronic condition;
363.8 	(3) one serious and persistent mental health condition; or
363.9 	(4) a condition that meets the definition of mental illness as described in section 245.462, 
363.10 	subdivision 20, paragraph (a), or emotional disturbance as defined in section 245.4871, 
363.11 	subdivision 15, clause (2); and has a current diagnostic assessment as defined in Minnesota 
363.12 	Rules, part 9505.0372, subpart 1, item B or C, as performed or reviewed by a mental health 
363.13 	professional employed by or under contract with the behavioral health home. The 
363.14 	commissioner shall establish criteria for determining continued eligibility.

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

363.17 	Sec. 60. Minnesota Statutes 2018, section 256B.0757, is amended by adding a subdivision 
363.18 	to read:
363.19 		Subd. 2a.Discharge criteria. (a) An individual may be discharged from behavioral 
363.20 	health home services if:
363.21 	(1) the behavioral health home services provider is unable to locate, contact, and engage 
363.22 	the individual for a period of greater than three months after persistent efforts by the 
363.23 	behavioral health home services provider; or
363.24 	(2) the individual is unwilling to participate in behavioral health home services as 
363.25 	demonstrated by the individual's refusal to meet with the behavioral health home services 
363.26 	provider, or refusal to identify the individual's health and wellness goals or the activities or 
363.27 	support necessary to achieve these goals.
363.28 	(b) Before discharge from behavioral health home services, the behavioral health home 
363.29 	services provider must offer a face-to-face meeting with the individual, the individual's 
363.30 	identified supports, and the behavioral health home services provider to discuss options 
363.31 	available to the individual, including maintaining behavioral health home services.

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

364.3 	Sec. 61. Minnesota Statutes 2018, section 256B.0757, subdivision 4, is amended to read:
364.4 		Subd. 4.Designated provider. (a) Health home services are voluntary and an eligible 
364.5 	individual may choose any designated provider. The commissioner shall establish designated 
364.6 	providers to serve as health homes and provide the services described in subdivision 3 to 
364.7 	individuals eligible under subdivision 2. The commissioner shall apply for grants as provided 
364.8 	under section 3502 of the Patient Protection and Affordable Care Act to establish health 
364.9 	homes and provide capitated payments to designated providers. For purposes of this section, 
364.10 	"designated provider" means a provider, clinical practice or clinical group practice, rural 
364.11 	clinic, community health center, community mental health center, or any other entity that 
364.12 	is determined by the commissioner to be qualified to be a health home for eligible individuals. 
364.13 	This determination must be based on documentation evidencing that the designated provider 
364.14 	has the systems and infrastructure in place to provide health home services and satisfies the 
364.15 	qualification standards established by the commissioner in consultation with stakeholders 
364.16 	and approved by the Centers for Medicare and Medicaid Services.
364.17 	(b) The commissioner shall develop and implement certification standards for designated 
364.18 	providers under this subdivision.

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

364.21 	Sec. 62. Minnesota Statutes 2018, section 256B.0757, is amended by adding a subdivision 
364.22 	to read:
364.23 		Subd. 4a.Behavioral health home services provider requirements. A behavioral 
364.24 	health home services provider must:
364.25 	(1) be an enrolled Minnesota Health Care Programs provider;
364.26 	(2) provide a medical assistance covered primary care or behavioral health service;
364.27 	(3) utilize an electronic health record;
364.28 	(4) utilize an electronic patient registry that contains data elements required by the 
364.29 	commissioner;
364.30 	(5) demonstrate the organization's capacity to administer screenings approved by the 
364.31 	commissioner for substance use disorder or alcohol and tobacco use;
365.1 	(6) demonstrate the organization's capacity to refer an individual to resources appropriate 
365.2 	to the individual's screening results;
365.3 	(7) have policies and procedures to track referrals to ensure that the referral met the 
365.4 	individual's needs;
365.5 	(8) conduct a brief needs assessment when an individual begins receiving behavioral 
365.6 	health home services. The brief needs assessment must be completed with input from the 
365.7 	individual and the individual's identified supports. The brief needs assessment must address 
365.8 	the individual's immediate safety and transportation needs and potential barriers to 
365.9 	participating in behavioral health home services;
365.10 	(9) conduct a health wellness assessment within 60 days after intake that contains all 
365.11 	required elements identified by the commissioner;
365.12 	(10) conduct a health action plan that contains all required elements identified by the 
365.13 	commissioner. The plan must be completed within 90 days after intake and must be updated 
365.14 	at least once every six months, or more frequently if significant changes to an individual's 
365.15 	needs or goals occur;
365.16 	(11) agree to cooperate with and participate in the state's monitoring and evaluation of 
365.17 	behavioral health home services; and
365.18 	(12) obtain the individual's written consent to begin receiving behavioral health home 
365.19 	services using a form approved by the commissioner.

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

365.22 	Sec. 63. Minnesota Statutes 2018, section 256B.0757, is amended by adding a subdivision 
365.23 	to read:
365.24 		Subd. 4b.Behavioral health home provider training and practice transformation 
365.25 	requirements. (a) The behavioral health home services provider must ensure that all staff 
365.26 	delivering behavioral health home services receive adequate preservice and ongoing training, 
365.27 	including:
365.28 	(1) training approved by the commissioner that describes the goals and principles of 
365.29 	behavioral health home services; and
365.30 	(2) training on evidence-based practices to promote an individual's ability to successfully 
365.31 	engage with medical, behavioral health, and social services to achieve the individual's health 
365.32 	and wellness goals.
366.1 	(b) The behavioral health home services provider must ensure that staff are capable of 
366.2 	implementing culturally responsive services, as determined by the individual's culture, 
366.3 	beliefs, values, and language as identified in the individual's health wellness assessment.
366.4 	(c) The behavioral health home services provider must participate in the department's 
366.5 	practice transformation activities to support continued skill and competency development 
366.6 	in the provision of integrated medical, behavioral health, and social services.

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

366.9 	Sec. 64. Minnesota Statutes 2018, section 256B.0757, is amended by adding a subdivision 
366.10 	to read:
366.11 		Subd. 4c.Behavioral health home staff qualifications. (a) A behavioral health home 
366.12 	services provider must maintain staff with required professional qualifications appropriate 
366.13 	to the setting.
366.14 	(b) If behavioral health home services are offered in a mental health setting, the 
366.15 	integration specialist must be a registered nurse licensed under the Minnesota Nurse Practice 
366.16 	Act, sections 148.171 to 148.285.
366.17 	(c) If behavioral health home services are offered in a primary care setting, the integration 
366.18 	specialist must be a mental health professional as defined in section 245.462, subdivision 
366.19 	18, clauses (1) to (6), or 245.4871, subdivision 27, clauses (1) to (6).
366.20 	(d) If behavioral health home services are offered in either a primary care setting or 
366.21 	mental health setting, the systems navigator must be a mental health practitioner as defined 
366.22 	in section 245.462, subdivision 17, or a community health worker as defined in section 
366.23 	256B.0625, subdivision 49.
366.24 	(e) If behavioral health home services are offered in either a primary care setting or 
366.25 	mental health setting, the qualified health home specialist must be one of the following:
366.26 	(1) a peer support specialist as defined in section 256B.0615;
366.27 	(2) a family peer support specialist as defined in section 256B.0616;
366.28 	(3) a case management associate as defined in section 245.462, subdivision 4, paragraph 
366.29 	(g), or 245.4871, subdivision 4, paragraph (j);
366.30 	(4) a mental health rehabilitation worker as defined in section 256B.0623, subdivision 
366.31 	5, clause (4);
367.1 	(5) a community paramedic as defined in section 144E.28, subdivision 9;
367.2 	(6) a peer recovery specialist as defined in section 245G.07, subdivision 1, clause (5); 
367.3 	or
367.4 	(7) a community health worker as defined in section 256B.0625, subdivision 49.

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

367.7 	Sec. 65. Minnesota Statutes 2018, section 256B.0757, is amended by adding a subdivision 
367.8 	to read:
367.9 		Subd. 4d.Behavioral health home service delivery standards. (a) A behavioral health 
367.10 	home services provider must meet the following service delivery standards:
367.11 	(1) establish and maintain processes to support the coordination of an individual's primary 
367.12 	care, behavioral health, and dental care;
367.13 	(2) maintain a team-based model of care, including regular coordination and 
367.14 	communication between behavioral health home services team members;
367.15 	(3) use evidence-based practices that recognize and are tailored to the medical, social, 
367.16 	economic, behavioral health, functional impairment, cultural, and environmental factors 
367.17 	affecting the individual's health and health care choices;
367.18 	(4) use person-centered planning practices to ensure the individual's health action plan 
367.19 	accurately reflects the individual's preferences, goals, resources, and optimal outcomes for 
367.20 	the individual and the individual's identified supports;
367.21 	(5) use the patient registry to identify individuals and population subgroups requiring 
367.22 	specific levels or types of care and provide or refer the individual to needed treatment, 
367.23 	intervention, or services;
367.24 	(6) utilize the Department of Human Services Partner Portal to identify past and current 
367.25 	treatment or services and identify potential gaps in care;
367.26 	(7) deliver services consistent with the standards for frequency and face-to-face contact 
367.27 	required by the commissioner;
367.28 	(8) ensure that a diagnostic assessment is completed for each individual receiving 
367.29 	behavioral health home services within six months of the start of behavioral health home 
367.30 	services;
367.31 	(9) deliver services in locations and settings that meet the needs of the individual;
368.1 	(10) provide a central point of contact to ensure that individuals and the individual's 
368.2 	identified supports can successfully navigate the array of services that impact the individual's 
368.3 	health and well-being;
368.4 	(11) have capacity to assess an individual's readiness for change and the individual's 
368.5 	capacity to integrate new health care or community supports into the individual's life;
368.6 	(12) offer or facilitate the provision of wellness and prevention education on 
368.7 	evidenced-based curriculums specific to the prevention and management of common chronic 
368.8 	conditions;
368.9 	(13) help an individual set up and prepare for medical, behavioral health, social service, 
368.10 	or community support appointments, including accompanying the individual to appointments 
368.11 	as appropriate, and providing follow-up with the individual after these appointments;
368.12 	(14) offer or facilitate the provision of health coaching related to chronic disease 
368.13 	management and how to navigate complex systems of care to the individual, the individual's 
368.14 	family, and identified supports;
368.15 	(15) connect an individual, the individual's family, and identified supports to appropriate 
368.16 	support services that help the individual overcome access or service barriers, increase 
368.17 	self-sufficiency skills, and improve overall health;
368.18 	(16) provide effective referrals and timely access to services; and
368.19 	(17) establish a continuous quality improvement process for providing behavioral health 
368.20 	home services.
368.21 	(b) The behavioral health home services provider must also create a plan, in partnership 
368.22 	with the individual and the individual's identified supports, to support the individual after 
368.23 	discharge from a hospital, residential treatment program, or other setting. The plan must 
368.24 	include protocols for:
368.25 	(1) maintaining contact between the behavioral health home services team member, the 
368.26 	individual, and the individual's identified supports during and after discharge;
368.27 	(2) linking the individual to new resources as needed;
368.28 	(3) reestablishing the individual's existing services and community and social supports; 
368.29 	and
368.30 	(4) following up with appropriate entities to transfer or obtain the individual's service 
368.31 	records as necessary for continued care.
369.1 	(c) If the individual is enrolled in a managed care plan, a behavioral health home services 
369.2 	provider must:
369.3 	(1) notify the behavioral health home services contact designated by the managed care 
369.4 	plan within 30 days of when the individual begins behavioral health home services; and
369.5 	(2) adhere to the managed care plan communication and coordination requirements 
369.6 	described in the behavioral health home services manual.
369.7 	(d) Before terminating behavioral health home services, the behavioral health home 
369.8 	services provider must:
369.9 	(1) provide a 60-day notice of termination of behavioral health home services to all 
369.10 	individuals receiving behavioral health home services, the commissioner, and managed care 
369.11 	plans, if applicable; and
369.12 	(2) refer individuals receiving behavioral health home services to a new behavioral 
369.13 	health home services provider.

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

369.16 	Sec. 66. Minnesota Statutes 2018, section 256B.0757, is amended by adding a subdivision 
369.17 	to read:
369.18 		Subd. 4e.Behavioral health home provider variances. (a) The commissioner may 
369.19 	grant a variance to specific requirements under subdivisions 4a, 4b, 4c, or 4d for a behavioral 
369.20 	health home services provider according to this subdivision.
369.21 	(b) The commissioner may grant a variance if the commissioner finds that:
369.22 	(1) failure to grant the variance would result in hardship or injustice to the applicant;
369.23 	(2) the variance would be consistent with the public interest; and
369.24 	(3) the variance would not reduce the level of services provided to individuals served 
369.25 	by the organization.
369.26 	(c) The commissioner may grant a variance from one or more requirements to permit 
369.27 	an applicant to offer behavioral health home services of a type or in a manner that is 
369.28 	innovative, if the commissioner finds that the variance does not impede the achievement of 
369.29 	the criteria in subdivisions 4a, 4b, 4c, or 4d and may improve the behavioral health home 
369.30 	services provided by the applicant.
370.1 	(d) The commissioner's decision to grant or deny a variance request is final and not 
370.2 	subject to appeal.

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

370.5 	Sec. 67. [256B.0759] SUBSTANCE USE DISORDER DEMONSTRATION PROJECT.
370.6 		Subdivision 1.Establishment. The commissioner shall develop and implement a medical 
370.7 	assistance demonstration project to test reforms of Minnesota's substance use disorder 
370.8 	treatment system to ensure individuals with substance use disorders have access to a full 
370.9 	continuum of high quality care.
370.10 		Subd. 2.Provider participation. Substance use disorder treatment providers may elect 
370.11 	to participate in the demonstration project and meet the requirements of subdivision 3. To 
370.12 	participate, a provider must notify the commissioner of the provider's intent to participate 
370.13 	in a format required by the commissioner and enroll as a demonstration project provider.
370.14 		Subd. 3.Provider standards. (a) The commissioner shall establish requirements for 
370.15 	participating providers that are consistent with the federal requirements of the demonstration 
370.16 	project.
370.17 	(b) A participating residential provider must obtain applicable licensure under chapters 
370.18 	245F and 245G or other applicable standards for the services provided and must:
370.19 	(1) deliver services in accordance with standards published by the commissioner pursuant 
370.20 	to paragraph (d);
370.21 	(2) maintain formal patient referral arrangements with providers delivering step-up or 
370.22 	step-down levels of care in accordance with ASAM standards; and
370.23 	(3) provide or arrange for medication-assisted treatment services if requested by a client 
370.24 	for whom an effective medication exists.
370.25 	(c) A participating outpatient provider must obtain applicable licensure under chapter 
370.26 	245G or other applicable standards for the services provided and must:
370.27 	(1) deliver services in accordance with standards published by the commissioner pursuant 
370.28 	to paragraph (d); and
370.29 	(2) maintain formal patient referral arrangements with providers delivering step-up or 
370.30 	step-down levels of care in accordance with ASAM standards.
371.1 	(d) If the provider standards under chapter 245G or other applicable standards conflict 
371.2 	or are duplicative, the commissioner may grant variances to the standards if the variances 
371.3 	do not conflict with federal requirements. The commissioner shall publish service 
371.4 	components, service standards, and staffing requirements for participating providers that 
371.5 	are consistent with ASAM standards and federal requirements by October 1, 2020.
371.6 		Subd. 4.Provider payment rates. (a) Payment rates for participating providers must 
371.7 	be increased for services provided to medical assistance enrollees. To receive a rate increase, 
371.8 	participating providers must meet demonstration project requirements and provide evidence 
371.9 	of formal referral arrangements with providers delivering step-up or step-down levels of 
371.10 	care.
371.11 	(b) For substance use disorder services under section 254B.05, subdivision 5, paragraph 
371.12 	(b), clause (8), provided on or after January 1, 2020, payment rates must be increased by 
371.13 	15 percent over the rates in effect on December 31, 2020.
371.14 	(c) For substance use disorder services under section 254B.05, subdivision 5, paragraph 
371.15 	(b), clauses (1), (6), (7), and (10), provided on or after January 1, 2021, payment rates must 
371.16 	be increased by ten percent over the rates in effect on December 31, 2020.
371.17 		Subd. 5.Federal approval. The commissioner shall seek federal approval to implement 
371.18 	the demonstration project under this section and to receive federal financial participation.

371.19 	Sec. 68. Minnesota Statutes 2018, section 256I.04, subdivision 1, is amended to read:
371.20 		Subdivision 1.Individual eligibility requirements. An individual is eligible for and 
371.21 	entitled to a housing support payment to be made on the individual's behalf if the agency 
371.22 	has approved the setting where the individual will receive housing support and the individual 
371.23 	meets the requirements in paragraph (a), (b), or (c).
371.24 	(a) The individual is aged, blind, or is over 18 years of age with a disability as determined 
371.25 	under the criteria used by the title II program of the Social Security Act, and meets the 
371.26 	resource restrictions and standards of section 256P.02, and the individual's countable income 
371.27 	after deducting the (1) exclusions and disregards of the SSI program, (2) the medical 
371.28 	assistance personal needs allowance under section 256B.35, and (3) an amount equal to the 
371.29 	income actually made available to a community spouse by an elderly waiver participant 
371.30 	under the provisions of sections 256B.0575, paragraph (a), clause (4), and 256B.058, 
371.31 	subdivision 2, is less than the monthly rate specified in the agency's agreement with the 
371.32 	provider of housing support in which the individual resides.
372.1 	(b) The individual meets a category of eligibility under section 256D.05, subdivision 1, 
372.2 	paragraph (a), clauses (1), (3), (4) to (8), and (13), and paragraph (b), if applicable, and the 
372.3 	individual's resources are less than the standards specified by section 256P.02, and the 
372.4 	individual's countable income as determined under section 256P.06, less the medical 
372.5 	assistance personal needs allowance under section 256B.35 is less than the monthly rate 
372.6 	specified in the agency's agreement with the provider of housing support in which the 
372.7 	individual resides.
372.8 	(c) The individual receives licensed residential crisis stabilization services under section 
372.9 	256B.0624, subdivision 7, and is receiving medical assistance. The individual may receive 
372.10 	concurrent housing support payments if receiving licensed residential crisis stabilization 
372.11 	services under section 256B.0624, subdivision 7. lacks a fixed, adequate, nighttime residence 
372.12 	upon discharge from a residential behavioral health treatment program, as determined by 
372.13 	treatment staff from the residential behavioral health treatment program. An individual is 
372.14 	eligible under this paragraph for up to three months, including a full or partial month from 
372.15 	the individual's move-in date at a setting approved for housing support following discharge 
372.16 	from treatment, plus two full months.

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

372.18 	Sec. 69. Minnesota Statutes 2018, section 256I.04, subdivision 2f, is amended to read:
372.19 		Subd. 2f.Required services. (a) In licensed and registered settings under subdivision 
372.20 	2a, providers shall ensure that participants have at a minimum:
372.21 	(1) food preparation and service for three nutritional meals a day on site;
372.22 	(2) a bed, clothing storage, linen, bedding, laundering, and laundry supplies or service;
372.23 	(3) housekeeping, including cleaning and lavatory supplies or service; and
372.24 	(4) maintenance and operation of the building and grounds, including heat, water, garbage 
372.25 	removal, electricity, telephone for the site, cooling, supplies, and parts and tools to repair 
372.26 	and maintain equipment and facilities.
372.27 	(b) In addition, when providers serve participants described in subdivision 1, paragraph 
372.28 	(c), the providers are required to assist the participants in applying for continuing housing 
372.29 	support payments before the end of the eligibility period.

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

373.1 	Sec. 70. Minnesota Statutes 2018, section 256I.06, subdivision 8, is amended to read:
373.2 		Subd. 8.Amount of housing support payment. (a) The amount of a room and board 
373.3 	payment to be made on behalf of an eligible individual is determined by subtracting the 
373.4 	individual's countable income under section 256I.04, subdivision 1, for a whole calendar 
373.5 	month from the room and board rate for that same month. The housing support payment is 
373.6 	determined by multiplying the housing support rate times the period of time the individual 
373.7 	was a resident or temporarily absent under section 256I.05, subdivision 1c, paragraph (d).
373.8 	(b) For an individual with earned income under paragraph (a), prospective budgeting 
373.9 	must be used to determine the amount of the individual's payment for the following six-month 
373.10 	period. An increase in income shall not affect an individual's eligibility or payment amount 
373.11 	until the month following the reporting month. A decrease in income shall be effective the 
373.12 	first day of the month after the month in which the decrease is reported.
373.13 	(c) For an individual who receives licensed residential crisis stabilization services under 
373.14 	section 256B.0624, subdivision 7, housing support payments under section 256I.04, 
373.15 	subdivision 1, paragraph (c), the amount of the housing support payment is determined by 
373.16 	multiplying the housing support rate times the period of time the individual was a resident.

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

373.18 	Sec. 71. Minnesota Statutes 2018, section 256K.45, subdivision 2, is amended to read:
373.19 		Subd. 2.Homeless youth report. The commissioner shall prepare a biennial report, 
373.20 	beginning in February 2015, which provides meaningful information to the legislative 
373.21 	committees having jurisdiction over the issue of homeless youth, that includes, but is not 
373.22 	limited to: (1) a list of the areas of the state with the greatest need for services and housing 
373.23 	for homeless youth, and the level and nature of the needs identified; (2) details about grants 
373.24 	made, including shelter-linked youth mental health grants under section 256K.46; (3) the 
373.25 	distribution of funds throughout the state based on population need; (4) follow-up 
373.26 	information, if available, on the status of homeless youth and whether they have stable 
373.27 	housing two years after services are provided; and (5) any other outcomes for populations 
373.28 	served to determine the effectiveness of the programs and use of funding.

373.29 	Sec. 72. [256K.46] SHELTER-LINKED YOUTH MENTAL HEALTH GRANT 
373.30 	PROGRAM.
373.31 		Subdivision 1.Establishment and authority. (a) The commissioner shall award grants 
373.32 	to provide mental health services to homeless or sexually exploited youth. To be eligible, 
374.1 	housing providers must partner with community-based mental health practitioners to provide 
374.2 	a continuum of mental health services, including short-term crisis response, support for 
374.3 	youth in longer-term housing settings, and ongoing relationships to support youth in other 
374.4 	housing arrangements in the community for homeless or sexually exploited youth.
374.5 	(b) The commissioner shall consult with the commissioner of management and budget 
374.6 	to identify evidence-based mental health services for youth and give priority in awarding 
374.7 	grants to proposals that include evidence-based mental health services for youth.
374.8 	(c) The commissioner may make two-year grants under this section.
374.9 	(d) Money appropriated for this section must be expended on activities described under 
374.10 	subdivision 4, technical assistance, and capacity building to meet the greatest need on a 
374.11 	statewide basis. The commissioner shall provide outreach, technical assistance, and program 
374.12 	development support to increase capacity of new and existing service providers to better 
374.13 	meet needs statewide, particularly in areas where shelter-linked youth mental health services 
374.14 	have not been established, especially in greater Minnesota.
374.15 		Subd. 2.Definitions. (a) The definitions in this subdivision apply to this section.
374.16 	(b) "Commissioner" means the commissioner of human services, unless otherwise 
374.17 	indicated.
374.18 	(c) "Housing provider" means a shelter, housing program, or other entity providing 
374.19 	services under the Homeless Youth Act in section 256K.45 and the Safe Harbor for Sexually 
374.20 	Exploited Youth Act in section 145.4716.
374.21 	(d) "Mental health practitioner" has the meaning given in section 245.462, subdivision 
374.22 	17.
374.23 	(e) "Youth" has the meanings given for "homeless youth," "youth at risk for 
374.24 	homelessness," and "runaway" in section 256K.45, subdivision 1a, "sexually exploited 
374.25 	youth" in section 260C.007, subdivision 31, and "youth eligible for services" in section 
374.26 	145.4716, subdivision 3.
374.27 		Subd. 3.Eligibility. An eligible applicant for shelter-linked youth mental health grants 
374.28 	under subdivision 1 is a housing provider that:
374.29 	(1) demonstrates that the provider received targeted trauma training focused on sexual 
374.30 	exploitation and adolescent experiences of homelessness; and
375.1 	(2) partners with a community-based mental health practitioner who has demonstrated 
375.2 	experience or access to training regarding adolescent development and trauma-informed 
375.3 	responses.
375.4 		Subd. 4.Allowable grant activities. (a) Grant recipients may conduct the following 
375.5 	activities with community-based mental health practitioners:
375.6 	(1) develop programming to prepare youth to receive mental health services;
375.7 	(2) provide on-site mental health services, including group skills and therapy sessions. 
375.8 	Grant recipients are encouraged to use evidence-based mental health services;
375.9 	(3) provide mental health case management, as defined in section 256B.0625, subdivision 
375.10 	20; and
375.11 	(4) consult, train, and educate housing provider staff regarding mental health. Grant 
375.12 	recipients are encouraged to provide staff with access to a mental health crisis line 24 hours 
375.13 	a day, seven days a week.
375.14 	(b) Only after promoting and assisting participants with obtaining health insurance 
375.15 	coverage for which the participant is eligible, and only after mental health practitioners bill 
375.16 	covered services to medical assistance or health plan companies, grant recipients may use 
375.17 	grant funds to fill gaps in insurance coverage for mental health services.
375.18 	(c) Grant funds may be used for purchasing equipment, connection charges, on-site 
375.19 	coordination, set-up fees, and site fees to deliver shelter-linked youth mental health services 
375.20 	defined in this subdivision via telemedicine consistent with section 256B.0625, subdivision 
375.21 	3b.
375.22 		Subd. 5.Reporting. Grant recipients shall report annually on the use of shelter-linked 
375.23 	youth mental health grants to the commissioner by December 31, beginning in 2020. Each 
375.24 	report shall include the name and location of the grant recipient, the amount of each grant, 
375.25 	the youth mental health services provided, and the number of youth receiving services. The 
375.26 	commissioner shall determine the form required for the reports and may specify additional 
375.27 	reporting requirements. The commissioner shall include the shelter-linked youth mental 
375.28 	health services program in the biennial report required under section 256K.45, subdivision 
375.29 	2.

375.30 	Sec. 73. Minnesota Statutes 2018, section 641.15, subdivision 3a, is amended to read:
375.31 		Subd. 3a.Intake procedure; approved mental health screening. (a) As part of its 
375.32 	intake procedure for new prisoners inmates, the sheriff or local corrections shall use a mental 
376.1 	health screening tool approved by the commissioner of corrections in consultation with the 
376.2 	commissioner of human services and local corrections staff to identify persons who may 
376.3 	have mental illness.
376.4 	(b) Names of persons who have screened positive or may have a mental illness may be 
376.5 	shared with the local county social services agency. The jail may refer an offender to county 
376.6 	personnel of the welfare system, as defined in section 13.46, subdivision 1, paragraph (c), 
376.7 	in order to arrange for services upon discharge and may share private data on the offender 
376.8 	as necessary to:
376.9 	(1) provide assistance in filling out an application for medical assistance or 
376.10 	MinnesotaCare;
376.11 	(2) make a referral for case management as provided under section 245.467, subdivision 
376.12 	4;
376.13 	(3) provide assistance in obtaining a state photo identification;
376.14 	(4) secure a timely appointment with a psychiatrist or other appropriate community 
376.15 	mental health provider;
376.16 	(5) provide prescriptions for a 30-day supply of all necessary medications; or
376.17 	(6) coordinate behavioral health services.
376.18 	(c) Notwithstanding section 138.17, if an offender is referred to a government entity 
376.19 	within the welfare system pursuant to paragraph (b), and the offender refuses all services 
376.20 	from the entity, the entity must, within 15 days of the refusal, destroy all private data on 
376.21 	the offender that it created or received because of the referral.

376.22 	Sec. 74. Laws 2017, First Special Session chapter 6, article 8, section 71, the effective 
376.23 	date, as amended by Laws 2019, chapter 12, section 1, is amended to read:

376.24 	EFFECTIVE DATE. This section is effective for services provided on July 1, 2017, 
376.25 	through June 30, 2019, and expires July 1, 2019 and thereafter.

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

376.27 	Sec. 75. Laws 2017, First Special Session chapter 6, article 8, section 72, the effective 
376.28 	date, as amended by Laws 2019, chapter 12, section 2, is amended to read:

376.29 	EFFECTIVE DATE. This section is effective for services provided on July 1, 2017, 
376.30 	through June 30, 2019, and expires July 1, 2019 and thereafter.

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

377.2 	Sec. 76. DIRECTION TO COMMISSIONER; SUBSTANCE USE DISORDER 
377.3 	TREATMENT PROGRAM SYSTEMS IMPROVEMENT.
 377.4 	The commissioner of human services, in consultation with counties, tribes, managed 
377.5 	care organizations, substance use disorder treatment associations, and other relevant 
377.6 	stakeholders, shall develop a plan, proposed timeline, and summary of necessary resources 
377.7 	to make systems improvements to minimize the regulatory paperwork for substance use 
377.8 	disorder programs licensed under Minnesota Statutes, chapter 245A, and regulated under 
377.9 	Minnesota Statutes, chapters 245F and 245G, and Minnesota Rules, parts 2960.0580 to 
377.10 	2960.0700. The plan shall include procedures to ensure that continued input from all 
377.11 	stakeholders is considered and that the planned systems improvements maximize client 
377.12 	benefits and utility for providers, regulatory agencies, and payers.

377.13 	Sec. 77. COMMUNITY COMPETENCY RESTORATION TASK FORCE.
 377.14 		Subdivision 1.Establishment; purpose. The Community Competency Restoration Task 
377.15 	Force is established to evaluate and study community competency restoration programs and 
377.16 	develop recommendations to address the needs of individuals deemed incompetent to stand 
377.17 	trial.
377.18 		Subd. 2.Membership. (a) The Community Competency Restoration Task Force consists 
377.19 	of the following members, appointed as follows:
377.20 	(1) a representative appointed by the governor's office;
377.21 	(2) the commissioner of human services or designee;
377.22 	(3) the commissioner of corrections or designee;
377.23 	(4) a representative from direct care and treatment services with experience in competency 
377.24 	evaluations, appointed by the commissioner of human services;
377.25 	(5) a representative appointed by the designated State Protection and Advocacy system;
377.26 	(6) the ombudsman for mental health and developmental disabilities;
377.27 	(7) a representative appointed by the Minnesota Hospital Association;
377.28 	(8) a representative appointed by the Association of Minnesota Counties;
377.29 	(9) two representatives appointed by the Minnesota Association of County Social Service 
377.30 	Administrators: one from the seven-county metropolitan area, as defined under  Minnesota 
378.1 	Statutes, section 473.121, subdivision 2, and one from outside the seven-county metropolitan 
378.2 	area;
378.3 	(10) a representative appointed by the Minnesota Board of Public Defense;
378.4 	(11) a representative appointed by the Minnesota County Attorneys Association;
378.5 	(12) a representative appointed by the Minnesota Chiefs of Police Association;
378.6 	(13) a representative appointed by the Minnesota Psychiatric Society;
378.7 	(14) a representative appointed by the Minnesota Psychological Association;
378.8 	(15) a representative appointed by the State Court Administrator;
378.9 	(16) a representative appointed by the Minnesota Association of Community Mental 
378.10 	Health Programs;
378.11 	(17) a representative appointed by the Minnesota Sheriffs' Association;
378.12 	(18) a representative appointed by the Minnesota Sentencing Guidelines Commission;
378.13 	(19) a jail administrator appointed by the commissioner of corrections;
378.14 	(20) a representative from an organization providing reentry services appointed by the 
378.15 	commissioner of corrections;
378.16 	(21) a representative from a mental health advocacy organization appointed by the 
378.17 	commissioner of human services;
378.18 	(22) a person with direct experience with competency restoration appointed by the 
378.19 	commissioner of human services;
378.20 	(23) representatives from organizations representing racial and ethnic groups 
378.21 	overrepresented in the justice system appointed by the commissioner of corrections; and
378.22 	(24) a crime victim appointed by the commissioner of corrections.
378.23 	(b) Appointments to the task force must be made no later than July 15, 2019, and members 
378.24 	of the task force may be compensated as provided under Minnesota Statutes, section 15.059, 
378.25 	subdivision 3.
378.26 		Subd. 3.Duties. The task force must:
378.27 	(1) identify current services and resources available for individuals in the criminal justice 
378.28 	system who have been found incompetent to stand trial;
378.29 	(2) analyze current trends of competency referrals by county and the impact of any 
378.30 	diversion projects or stepping-up initiatives;
379.1 	(3) analyze selected case reviews and other data to identify risk levels of those individuals, 
379.2 	service usage, housing status, and health insurance status prior to being jailed;
379.3 	(4) research how other states address this issue, including funding and structure of 
379.4 	community competency restoration programs, and jail-based programs; and
379.5 	(5) develop recommendations to address the growing number of individuals deemed 
379.6 	incompetent to stand trial including increasing prevention and diversion efforts, providing 
379.7 	a timely process for reducing the amount of time individuals remain in the criminal justice 
379.8 	system, determining how to provide and fund competency restoration services in the 
379.9 	community, and defining the role of the counties and state in providing competency 
379.10 	restoration.
379.11 		Subd. 4.Officers; meetings. (a) The commissioner of human services shall convene 
379.12 	the first meeting of the task force no later than August 1, 2019.
379.13 	(b) The task force must elect a chair and vice-chair from among its members and may 
379.14 	elect other officers as necessary.
379.15 	(c) The task force is subject to the Minnesota Open Meeting Law under Minnesota 
379.16 	Statutes, chapter 13D.
379.17 		Subd. 5.Staff. (a) The commissioner of human services must provide staff assistance 
379.18 	to support the task force's work.
379.19 	(b) The task force may utilize the expertise of the Council of State Governments Justice 
379.20 	Center.
379.21 		Subd. 6.Report required. (a) By February 1, 2020, the task force shall submit a report 
379.22 	on its progress and findings to the chairs and ranking minority members of the legislative 
379.23 	committees with jurisdiction over mental health and corrections.
379.24 	(b) By February 1, 2021, the task force must submit a written report including 
379.25 	recommendations to address the growing number of individuals deemed incompetent to 
379.26 	stand trial to the chairs and ranking minority members of the legislative committees with 
379.27 	jurisdiction over mental health and corrections.
379.28 		Subd. 7.Expiration. The task force expires upon submission of the report in subdivision 
379.29 	6, paragraph (b), or February 1, 2021, whichever is later.

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

380.1 	Sec. 78. DIRECTION TO COMMISSIONER; IMPROVING SCHOOL-LINKED 
380.2 	MENTAL HEALTH GRANT PROGRAM.
 380.3 	(a) The commissioner of human services, in collaboration with the commissioner of 
380.4 	education, representatives from the education community, mental health providers, and 
380.5 	advocates, shall assess the school-linked mental health grant program under Minnesota 
380.6 	Statutes, section 245.4901, and develop recommendations for improvements. The assessment 
380.7 	must include but is not limited to the following:
380.8 	(1) promoting stability among current grantees and school partners;
380.9 	(2) assessing the minimum number of full-time equivalents needed per school site to 
380.10 	effectively carry out the program;
380.11 	(3) developing a funding formula that promotes sustainability and consistency across 
380.12 	grant cycles;
380.13 	(4) reviewing current data collection and evaluation; and
380.14 	(5) analyzing the impact on outcomes when a school has a school-linked mental health 
380.15 	program, a multi-tier system of supports, and sufficient school support personnel to meet 
380.16 	the needs of students.
380.17 	(b) The commissioner shall provide a report of the findings of the assessment and 
380.18 	recommendations, including any necessary statutory changes, to the legislative committees 
380.19 	with jurisdiction over mental health and education by January 15, 2020.

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

380.21 	Sec. 79. DIRECTION TO COMMISSIONER; CCBHC RATE METHODOLOGY.
 380.22 	(a) The commissioner of human services shall develop recommendations for a rate 
380.23 	methodology that reflects each CCBHC's reasonable cost of providing the services described 
380.24 	in Minnesota Statutes, section 245.735, subdivision 3, consistent with applicable federal 
380.25 	requirements. In developing the rate methodology, the commissioner shall consider guidance 
380.26 	issued by the Centers for Medicare and Medicaid Services for the Section 223 Demonstration 
380.27 	Program for CCBHC and costs associated with the following:
380.28 	(1) a new CCBHC service that is not incorporated in the baseline prospective payment 
380.29 	system rate, or a deletion of a CCBHC service that is incorporated in the baseline rate;
380.30 	(2) a change in service due to amended regulatory requirements or rules;
381.1 	(3) a change in types of services due to a change in applicable technology and medical 
381.2 	practice utilized by the clinic;
381.3 	(4) a change in the scope of a project approved by the commissioner; and
381.4 	(5) a Minnesota-specific quality incentive program for CCBHCs that achieve target 
381.5 	performance on select quality measures. The commissioner shall develop the quality incentive 
381.6 	program, in consultation with stakeholders, with the following requirements:
381.7 	(i) the same terms of performance must apply to all CCBHCs;
381.8 	(ii) quality payments must be in addition to the prospective payment rate and must not 
381.9 	exceed an amount equal to five percent of total medical assistance payments for CCBHC 
381.10 	services provided during the applicable time period; and
381.11 	(iii) the quality measures must be consistent with measures used by the commissioner 
381.12 	for other health care programs.
381.13 	(b) By February 15, 2020, the commissioner of human services shall consult with CCBHC 
381.14 	providers to develop the rate methodology under paragraph (a). The commissioner shall 
381.15 	report to the chairs and ranking minority members of the legislative committees with 
381.16 	jurisdiction over mental health services and medical assistance on the recommendations to 
381.17 	the CCBHC rate methodology including any necessary statutory updates required for federal 
381.18 	approval.
381.19 	(c) The commissioner shall consult with CCBHCs and other providers receiving a 
381.20 	prospective payment system rate to study a rate methodology that eliminates potential 
381.21 	duplication of payment for CCBHC providers who also receive a separate prospective 
381.22 	payment system rate. By February 15, 2021, the commissioner shall report to the chairs and 
381.23 	ranking minority members of the legislative committees with jurisdiction over mental health 
381.24 	services and medical assistance on findings and recommendations related to the rate 
381.25 	methodology study under this paragraph, including any necessary statutory updates to 
381.26 	implement recommendations.

381.27 	Sec. 80. SPECIALIZED MENTAL HEALTH COMMUNITY SUPERVISION PILOT 
381.28 	PROJECT.
 381.29 		Subdivision 1.Authorization. The commissioner of human services shall award a grant 
381.30 	to Anoka County to develop and implement a pilot project from July 1, 2019, to June 30, 
381.31 	2021, to evaluate the impact of a coordinated, multidisciplinary service delivery approach 
381.32 	for offenders with mental illness who are on probation, parole, supervised release, or pretrial 
381.33 	status in Anoka County.
382.1 		Subd. 2.Pilot project goals and design. (a) The pilot project must provide enhanced 
382.2 	assessment, case management, treatment services, and community supervision for offenders 
382.3 	with mental illness who have symptoms or behavior resulting in heightened risk to harm 
382.4 	themselves or others, to recidivate, to commit violations of supervision, or to face 
382.5 	incarceration or reincarceration.
382.6 	(b) The goals of the pilot project are to:
382.7 	(1) improve mental health service delivery and supervision coordination through 
382.8 	establishment of a multidisciplinary caseload management team that must include at least 
382.9 	one probation officer and social services professional who share case management 
382.10 	responsibilities;
382.11 	(2) provide expedited assessment, diagnosis, and community-based treatment and 
382.12 	programming for acute symptom and behavior management;
382.13 	(3) enhance community supervision through a specialized caseload and team specifically 
382.14 	trained to work with individuals with mental illness;
382.15 	(4) offer community-based mental health treatment and programming alternatives to 
382.16 	incarceration if available and appropriate;
382.17 	(5) reduce incarceration related to unmanaged mental illness and technical violations;
382.18 	(6) eliminate or reduce duplication of services between county social services and 
382.19 	corrections; and
382.20 	(7) improve collaboration among, and reduce barriers between, criminal justice system 
382.21 	partners, county social services, and community service providers.
382.22 		Subd. 3.Target population. The target population of the pilot project is:
382.23 	(1) adult offenders on probation, parole, supervised release, or pretrial status in Anoka 
382.24 	County who have been assessed with significant or unmanaged mental illness or acute 
382.25 	symptoms that pose a risk to harm themselves or others, or increase their risk to recidivate 
382.26 	or commit technical violations of supervision;
382.27 	(2) adult offenders who receive county social service case management for mental illness 
382.28 	while under correctional supervision in Anoka County; and
382.29 	(3) adult offenders incarcerated in jail in Anoka County who have significant or 
382.30 	unmanaged mental illness and may be safely treated in a community setting under 
382.31 	correctional supervision.
383.1 		Subd. 4.Evaluation and report. By October 1, 2021, Anoka County must report to the 
383.2 	commissioner of human services on the impact and outcomes of the project.

383.3 	Sec. 81. REPEALER.
 383.4 	Minnesota Statutes 2018, section 254B.03, subdivision 4a, is repealed.

383.5 	ARTICLE 7
383.6 	HEALTH CARE

383.7 	Section 1. Minnesota Statutes 2018, section 13.69, subdivision 1, is amended to read:
383.8 		Subdivision 1.Classifications. (a) The following government data of the Department 
383.9 	of Public Safety are private data:
383.10 	(1) medical data on driving instructors, licensed drivers, and applicants for parking 
383.11 	certificates and special license plates issued to physically disabled persons;
383.12 	(2) other data on holders of a disability certificate under section 169.345, except that (i) 
383.13 	data that are not medical data may be released to law enforcement agencies, and (ii) data 
383.14 	necessary for enforcement of sections 169.345 and 169.346 may be released to parking 
383.15 	enforcement employees or parking enforcement agents of statutory or home rule charter 
383.16 	cities and towns;
383.17 	(3) Social Security numbers in driver's license and motor vehicle registration records, 
383.18 	except that Social Security numbers must be provided to the Department of Revenue for 
383.19 	purposes of tax administration, the Department of Labor and Industry for purposes of 
383.20 	workers' compensation administration and enforcement, the judicial branch for purposes of 
383.21 	debt collection, and the Department of Natural Resources for purposes of license application 
383.22 	administration, and except that the last four digits of the Social Security number must be 
383.23 	provided to the Department of Human Services for purposes of recovery of Minnesota health 
383.24 	care program benefits paid; and
383.25 	(4) data on persons listed as standby or temporary custodians under section 171.07, 
383.26 	subdivision 11, except that the data must be released to:
383.27 	(i) law enforcement agencies for the purpose of verifying that an individual is a designated 
383.28 	caregiver; or
383.29 	(ii) law enforcement agencies who state that the license holder is unable to communicate 
383.30 	at that time and that the information is necessary for notifying the designated caregiver of 
383.31 	the need to care for a child of the license holder.
384.1 	The department may release the Social Security number only as provided in clause (3) 
384.2 	and must not sell or otherwise provide individual Social Security numbers or lists of Social 
384.3 	Security numbers for any other purpose.
384.4 	(b) The following government data of the Department of Public Safety are confidential 
384.5 	data: data concerning an individual's driving ability when that data is received from a member 
384.6 	of the individual's family.

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

384.8 	Sec. 2. Minnesota Statutes 2018, section 16A.724, subdivision 2, is amended to read:
384.9 		Subd. 2.Transfers. (a) Notwithstanding section 295.581, to the extent available resources 
384.10 	in the health care access fund exceed expenditures in that fund, effective for the biennium 
384.11 	beginning July 1, 2007, the commissioner of management and budget shall transfer the 
384.12 	excess funds from the health care access fund to the general fund on June 30 of each year, 
384.13 	provided that the amount transferred in fiscal year 2016 shall not exceed $48,000,000, the 
384.14 	amount in fiscal year 2017 shall not exceed $122,000,000, and the amount in any fiscal 
384.15 	biennium thereafter shall not exceed $244,000,000. The purpose of this transfer is to meet 
384.16 	the rate increase required under Laws 2003, First Special Session chapter 14, article 13C, 
384.17 	section 2, subdivision 6 section 256B.04, subdivision 25.
384.18 	(b) For fiscal years 2006 to 2011, MinnesotaCare shall be a forecasted program, and, if 
384.19 	necessary, the commissioner shall reduce these transfers from the health care access fund 
384.20 	to the general fund to meet annual MinnesotaCare expenditures or, if necessary, transfer 
384.21 	sufficient funds from the general fund to the health care access fund to meet annual 
384.22 	MinnesotaCare expenditures.

384.23 	Sec. 3. Minnesota Statutes 2018, section 62Q.184, subdivision 1, is amended to read:
384.24 		Subdivision 1.Definitions. (a) For the purposes of this section, the terms in this 
384.25 	subdivision have the meanings given them.
384.26 	(b) "Clinical practice guideline" means a systematically developed statement to assist 
384.27 	health care providers and enrollees in making decisions about appropriate health care services 
384.28 	for specific clinical circumstances and conditions developed independently of a health plan 
384.29 	company, pharmaceutical manufacturer, or any entity with a conflict of interest. A clinical 
384.30 	practice guideline also includes a preferred drug list developed in accordance with section 
384.31 	256B.0625.
385.1 	(c) "Clinical review criteria" means the written screening procedures, decision abstracts, 
385.2 	clinical protocols, and clinical practice guidelines used by a health plan company to determine 
385.3 	the medical necessity and appropriateness of health care services.
385.4 	(d) "Health plan company" has the meaning given in section 62Q.01, subdivision 4, but 
385.5 	does not include a managed care organization or also includes a county-based purchasing 
385.6 	plan participating in a public program under chapter 256B or 256L, orand an integrated 
385.7 	health partnership under section 256B.0755.
385.8 	(e) "Step therapy protocol" means a protocol or program that establishes the specific 
385.9 	sequence in which prescription drugs for a specified medical condition, including 
385.10 	self-administered and physician-administered drugs, are medically appropriate for a particular 
385.11 	enrollee and are covered under a health plan.
385.12 	(f) "Step therapy override" means that the step therapy protocol is overridden in favor 
385.13 	of coverage of the selected prescription drug of the prescribing health care provider because 
385.14 	at least one of the conditions of subdivision 3, paragraph (a), exists.

385.15 	Sec. 4. Minnesota Statutes 2018, section 62Q.184, subdivision 3, is amended to read:
385.16 		Subd. 3.Step therapy override process; transparency. (a) When coverage of a 
385.17 	prescription drug for the treatment of a medical condition is restricted for use by a health 
385.18 	plan company through the use of a step therapy protocol, enrollees and prescribing health 
385.19 	care providers shall have access to a clear, readily accessible, and convenient process to 
385.20 	request a step therapy override. The process shall be made easily accessible on the health 
385.21 	plan company's website. A health plan company may use its existing medical exceptions 
385.22 	process to satisfy this requirement. A health plan company shall grant an override to the 
385.23 	step therapy protocol if at least one of the following conditions exist:
385.24 	(1) the prescription drug required under the step therapy protocol is contraindicated 
385.25 	pursuant to the pharmaceutical manufacturer's prescribing information for the drug or, due 
385.26 	to a documented adverse event with a previous use or a documented medical condition, 
385.27 	including a comorbid condition, is likely to do any of the following:
385.28 	(i) cause an adverse reaction to the enrollee;
385.29 	(ii) decrease the ability of the enrollee to achieve or maintain reasonable functional 
385.30 	ability in performing daily activities; or
385.31 	(iii) cause physical or mental harm to the enrollee;
386.1 	(2) the enrollee has had a trial of the required prescription drug covered by their current 
386.2 	or previous health plan, or another prescription drug in the same pharmacologic class or 
386.3 	with the same mechanism of action, and was adherent during such trial for a period of time 
386.4 	sufficient to allow for a positive treatment outcome, and the prescription drug was 
386.5 	discontinued by the enrollee's health care provider due to lack of effectiveness, or an adverse 
386.6 	event. This clause does not prohibit a health plan company from requiring an enrollee to 
386.7 	try another drug in the same pharmacologic class or with the same mechanism of action if 
386.8 	that therapy sequence is supported by the evidence-based and peer-reviewed clinical practice 
386.9 	guideline, Food and Drug Administration label, or pharmaceutical manufacturer's prescribing 
386.10 	information. This clause does not apply to the commissioner of human services or a managed 
386.11 	care plan, county-based purchasing plan, or integrated health partnership administering a 
386.12 	pharmacy benefit under chapter 256B or 256L; or
386.13 	(3) for the fee-for-service system administered by the commissioner of human services, 
386.14 	or a managed care plan, county-based purchasing plan, or integrated health partnership 
386.15 	administering a pharmacy benefit under chapter 256B or 256L, the enrollee has had a trial 
386.16 	of the required prescription drug covered by their current or previous health plan, or a drug 
386.17 	in the same pharmacological class with the same mechanism of action, and was adherent 
386.18 	during such trial for a period of time sufficient to allow for a positive treatment outcome, 
386.19 	and the prescription drug was discontinued by the enrollee's health care provider due to lack 
386.20 	of effectiveness, or an adverse event, or the prescriber submits an evidence-based and 
386.21 	peer-reviewed clinical practice guideline supporting the use of the requested drug over the 
386.22 	required prescription drug. This clause does not prohibit a managed care plan, county-based 
386.23 	purchasing plan, or integrated health partnership from requiring an enrollee to try another 
386.24 	drug in the same pharmacologic class with the same mechanism of action if that therapy 
386.25 	sequence is supported by the evidence-based and peer-reviewed clinical practice guideline, 
386.26 	Food and Drug Administration label, or pharmaceutical manufacturer's prescribing 
386.27 	information; or
386.28 	(3) (4) the enrollee is currently receiving a positive therapeutic outcome on a prescription 
386.29 	drug for the medical condition under consideration if, while on their current health plan or 
386.30 	the immediately preceding health plan, the enrollee received coverage for the prescription 
386.31 	drug and the enrollee's prescribing health care provider gives documentation to the health 
386.32 	plan company that the change in prescription drug required by the step therapy protocol is 
386.33 	expected to be ineffective or cause harm to the enrollee based on the known characteristics 
386.34 	of the specific enrollee and the known characteristics of the required prescription drug.
387.1 	(b) Upon granting a step therapy override, a health plan company shall authorize coverage 
387.2 	for the prescription drug if the prescription drug is a covered prescription drug under the 
387.3 	enrollee's health plan.
387.4 	(c) The enrollee, or the prescribing health care provider if designated by the enrollee, 
387.5 	may appeal the denial of a step therapy override by a health plan company using the 
387.6 	complaint procedure under sections 62Q.68 to 62Q.73 or 256.045.
387.7 	(d) In a denial of an override request and any subsequent appeal, a health plan company's 
387.8 	decision must specifically state why the step therapy override request did not meet the 
387.9 	condition under paragraph (a) cited by the prescribing health care provider in requesting 
387.10 	the step therapy override and information regarding the procedure to request external review 
387.11 	of the denial pursuant to section 62Q.73. A denial of a request for a step therapy override 
387.12 	that is upheld on appeal is a final adverse determination for purposes of section 62Q.73 and 
387.13 	is eligible for a request for external review by an enrollee pursuant to section 62Q.73.
387.14 	(e) A health plan company shall respond to a step therapy override request or an appeal 
387.15 	within five days of receipt of a complete request. In cases where exigent circumstances 
387.16 	exist, a health plan company shall respond within 72 hours of receipt of a complete request. 
387.17 	If a health plan company does not send a response to the enrollee or prescribing health care 
387.18 	provider if designated by the enrollee within the time allotted, the override request or appeal 
387.19 	is granted and binding on the health plan company.
387.20 	(f) Step therapy override requests must be accessible to and submitted by health care 
387.21 	providers, and accepted by group purchasers electronically through secure electronic 
387.22 	transmission, as described under section 62J.497, subdivision 5.
387.23 	(g) Nothing in this section prohibits a health plan company from:
387.24 	(1) requesting relevant documentation from an enrollee's medical record in support of 
387.25 	a step therapy override request; or
387.26 	(2) requiring an enrollee to try a generic equivalent drug pursuant to section 151.21, or 
387.27 	a biosimilar, as defined under United States Code, chapter 42, section 262(i)(2), prior to 
387.28 	providing coverage for the equivalent branded prescription drug.
387.29 	(h) This section shall not be construed to allow the use of a pharmaceutical sample for 
387.30 	the primary purpose of meeting the requirements for a step therapy override.

388.1 	Sec. 5. Minnesota Statutes 2018, section 245A.02, subdivision 5a, is amended to read:
388.2 		Subd. 5a.Controlling individual. (a) "Controlling individual" means an owner of a 
388.3 	program or service provider licensed under this chapter and the following individuals, if 
388.4 	applicable:
388.5 	(1) each officer of the organization, including the chief executive officer and chief 
388.6 	financial officer;
388.7 	(2) the individual designated as the authorized agent under section 245A.04, subdivision 
388.8 	1, paragraph (b);
388.9 	(3) the individual designated as the compliance officer under section 256B.04, subdivision 
388.10 	21, paragraph (b) (g); and
388.11 	(4) each managerial official whose responsibilities include the direction of the 
388.12 	management or policies of a program.
388.13 	(b) Controlling individual does not include:
388.14 	(1) a bank, savings bank, trust company, savings association, credit union, industrial 
388.15 	loan and thrift company, investment banking firm, or insurance company unless the entity 
388.16 	operates a program directly or through a subsidiary;
388.17 	(2) an individual who is a state or federal official, or state or federal employee, or a 
388.18 	member or employee of the governing body of a political subdivision of the state or federal 
388.19 	government that operates one or more programs, unless the individual is also an officer, 
388.20 	owner, or managerial official of the program, receives remuneration from the program, or 
388.21 	owns any of the beneficial interests not excluded in this subdivision;
388.22 	(3) an individual who owns less than five percent of the outstanding common shares of 
388.23 	a corporation:
388.24 	(i) whose securities are exempt under section 80A.45, clause (6); or
388.25 	(ii) whose transactions are exempt under section 80A.46, clause (2);
388.26 	(4) an individual who is a member of an organization exempt from taxation under section 
388.27 	290.05, unless the individual is also an officer, owner, or managerial official of the program 
388.28 	or owns any of the beneficial interests not excluded in this subdivision. This clause does 
388.29 	not exclude from the definition of controlling individual an organization that is exempt from 
388.30 	taxation; or
389.1 	(5) an employee stock ownership plan trust, or a participant or board member of an 
389.2 	employee stock ownership plan, unless the participant or board member is a controlling 
389.3 	individual according to paragraph (a).
389.4 	(c) For purposes of this subdivision, "managerial official" means an individual who has 
389.5 	the decision-making authority related to the operation of the program, and the responsibility 
389.6 	for the ongoing management of or direction of the policies, services, or employees of the 
389.7 	program. A site director who has no ownership interest in the program is not considered to 
389.8 	be a managerial official for purposes of this definition.

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

389.10 	Sec. 6. Minnesota Statutes 2018, section 245D.081, subdivision 3, is amended to read:
389.11 		Subd. 3.Program management and oversight. (a) The license holder must designate 
389.12 	a managerial staff person or persons to provide program management and oversight of the 
389.13 	services provided by the license holder. The designated manager is responsible for the 
389.14 	following:
389.15 	(1) maintaining a current understanding of the licensing requirements sufficient to ensure 
389.16 	compliance throughout the program as identified in section 245A.04, subdivision 1, paragraph 
389.17 	(e), and when applicable, as identified in section 256B.04, subdivision 21, paragraph (b)
389.18 	(g);
389.19 	(2) ensuring the duties of the designated coordinator are fulfilled according to the 
389.20 	requirements in subdivision 2;
389.21 	(3) ensuring the program implements corrective action identified as necessary by the 
389.22 	program following review of incident and emergency reports according to the requirements 
389.23 	in section 245D.11, subdivision 2, clause (7). An internal review of incident reports of 
389.24 	alleged or suspected maltreatment must be conducted according to the requirements in 
389.25 	section 245A.65, subdivision 1, paragraph (b);
389.26 	(4) evaluation of satisfaction of persons served by the program, the person's legal 
389.27 	representative, if any, and the case manager, with the service delivery and progress towards
389.28 	toward accomplishing outcomes identified in sections 245D.07 and 245D.071, and ensuring 
389.29 	and protecting each person's rights as identified in section 245D.04;
389.30 	(5) ensuring staff competency requirements are met according to the requirements in 
389.31 	section 245D.09, subdivision 3, and ensuring staff orientation and training is provided 
389.32 	according to the requirements in section 245D.09, subdivisions 4, 4a, and 5;
390.1 	(6) ensuring corrective action is taken when ordered by the commissioner and that the 
390.2 	terms and conditions of the license and any variances are met; and
390.3 	(7) evaluating the information identified in clauses (1) to (6) to develop, document, and 
390.4 	implement ongoing program improvements.
390.5 	(b) The designated manager must be competent to perform the duties as required and 
390.6 	must minimally meet the education and training requirements identified in subdivision 2, 
390.7 	paragraph (b), and have a minimum of three years of supervisory level experience in a 
390.8 	program providing direct support services to persons with disabilities or persons age 65 and 
390.9 	older.

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

390.11 	Sec. 7. Minnesota Statutes 2018, section 256.043, as added by Laws 2019, chapter 63, 
390.12 	article 1, section 8, is amended to read:
390.13 	256.043 OPIATE EPIDEMIC RESPONSE ACCOUNT.
390.14 		Subdivision 1.Establishment. The opiate epidemic response account is established in 
390.15 	the special revenue fund in the state treasury. The registration fees assessed by the Board 
390.16 	of Pharmacy under section 151.066 and the license fees identified in section 151.065, 
390.17 	subdivision 7, paragraphs (b) and (c), shall be deposited into the account. Beginning in 
390.18 	fiscal year 2021, for each fiscal year, the funds in the account are appropriated each fiscal 
390.19 	year to the commissioner of human services, unless otherwise specified in law shall be 
390.20 	administered according to this section.
390.21 		Subd. 2.Transfers from account to state agencies. (a) Beginning in fiscal year 2021,
390.22 	The commissioner of human services shall transfer the following amounts each fiscal year 
390.23 	from the account to the agencies specified in this subdivision.
390.24 	(b) $126,000 to the Board of Pharmacy for the collection of the registration fees under 
390.25 	section 151.066.
390.26 	(c) $672,000 to the commissioner of public safety for the Bureau of Criminal 
390.27 	Apprehension. Of this amount, $384,000 is for drug scientists and lab supplies and $288,000 
390.28 	is for special agent positions focused on drug interdiction and drug trafficking.
390.29 		Subd. 3.Appropriations from account. (a) After the transfers described in subdivision 
390.30 	2, and the appropriations in article 3, section 1, paragraphs (e), (f), (g), and (h) are made, 
390.31 	$249,000 shall be allocated by the commissioneris appropriated for the provision of 
391.1 	administrative services to the Opiate Epidemic Response Advisory Council and for the 
391.2 	administration of the grants awarded under paragraph (c).
391.3 	(b) After the transfers in subdivision 2 and the allocation of fundsappropriations in 
391.4 	paragraph (a) are made, 50 percent of the remaining amount shall be distributed by the 
391.5 	commissioner to is appropriated to the commissioner for distribution to county social service 
391.6 	and tribal social service agencies to provide child protection services to children and families 
391.7 	who are affected by addiction. The commissioner shall distribute this money proportionally 
391.8 	to counties and tribal social service agencies based on out-of-home placement episodes 
391.9 	where parental drug abuse is the primary reason for the out-of-home placement using data 
391.10 	from the previous calendar year. County and tribal social service agencies receiving funds 
391.11 	from the opiate epidemic response account must annually report to the commissioner on 
391.12 	how the funds were used to provide child protection services, including measurable outcomes, 
391.13 	as determined by the commissioner. County social service agencies and tribal social service 
391.14 	agencies must not use funds received under this paragraph to supplant current state or local 
391.15 	funding received for child protection services for children and families who are affected by 
391.16 	addiction.
391.17 	(c) After making the transfers in subdivision 2 and the allocation of fundsappropriations 
391.18 	in paragraphs (a) and (b), the remaining funds in the account are appropriated to the 
391.19 	commissioner shall to award grants as specified by the Opiate Epidemic Response Advisory 
391.20 	Council in accordance with section 256.042, unless otherwise appropriated by the legislature.
391.21 		Subd. 4.Settlement; sunset. (a) If the state receives a total sum of $250,000,000 either 
391.22 	as a result of a settlement agreement or an assurance of discontinuance entered into by the 
391.23 	attorney general of the state, or resulting from a court order in litigation brought by the 
391.24 	attorney general of the state on behalf of the state or a state agency, against one or more 
391.25 	opioid manufacturers or opioid wholesale drug distributors related to alleged violations of 
391.26 	consumer fraud laws in the marketing, sale, or distribution of opioids in this state, or other 
391.27 	alleged illegal actions that contributed to the excessive use of opioids, or from the fees 
391.28 	collected under section 151.065, subdivisions 1 and 3, and section 151.066, that are deposited 
391.29 	into the opiate epidemic response account established in section 256.043, or from a 
391.30 	combination of both, the fees specified in section 151.065, subdivision 1, clause (16), and 
391.31 	section 151.065, subdivision 3, clause (14), shall be reduced to $5,260, and the opiate 
391.32 	registration fee in section 151.066, subdivision 3, shall be repealed.
391.33 	(b) The commissioner of management and budget shall inform the board of pharmacy, 
391.34 	the governor, and the legislature when the amount specified in paragraph (a) has been 
391.35 	reached. The board shall apply the reduced license fee for the next licensure period.
392.1 	(c) Notwithstanding paragraph (a), the reduction of the license fee in section 151.065, 
392.2 	subdivisions 1 and 3, and the repeal of the registration fee in section 151.066 shall not occur 
392.3 	before July 1, 2024.

392.4 	Sec. 8. Minnesota Statutes 2018, section 256.962, subdivision 5, is amended to read:
392.5 		Subd. 5.Incentive program. Beginning January 1, 2008, the commissioner shall establish 
392.6 	an incentive program for organizations and licensed insurance producers under chapter 60K 
392.7 	that directly identify and assist potential enrollees in filling out and submitting an application. 
392.8 	For each applicant who is successfully enrolled in MinnesotaCare or medical assistance, 
392.9 	the commissioner, within the available appropriation, shall pay the organization or licensed 
392.10 	insurance producer a $25 $70 application assistance bonus. The organization or licensed 
392.11 	insurance producer may provide an applicant a gift certificate or other incentive upon 
392.12 	enrollment.

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

392.14 	Sec. 9. Minnesota Statutes 2018, section 256.969, subdivision 2b, is amended to read:
392.15 		Subd. 2b.Hospital payment rates. (a) For discharges occurring on or after November 
392.16 	1, 2014, hospital inpatient services for hospitals located in Minnesota shall be paid according 
392.17 	to the following:
392.18 	(1) critical access hospitals as defined by Medicare shall be paid using a cost-based 
392.19 	methodology;
392.20 	(2) long-term hospitals as defined by Medicare shall be paid on a per diem methodology 
392.21 	under subdivision 25;
392.22 	(3) rehabilitation hospitals or units of hospitals that are recognized as rehabilitation 
392.23 	distinct parts as defined by Medicare shall be paid according to the methodology under 
392.24 	subdivision 12; and
392.25 	(4) all other hospitals shall be paid on a diagnosis-related group (DRG) methodology.
392.26 	(b) For the period beginning January 1, 2011, through October 31, 2014, rates shall not 
392.27 	be rebased, except that a Minnesota long-term hospital shall be rebased effective January 
392.28 	1, 2011, based on its most recent Medicare cost report ending on or before September 1, 
392.29 	2008, with the provisions under subdivisions 9 and 23, based on the rates in effect on 
392.30 	December 31, 2010. For rate setting periods after November 1, 2014, in which the base 
392.31 	years are updated, a Minnesota long-term hospital's base year shall remain within the same 
392.32 	period as other hospitals.
393.1 	(c) Effective for discharges occurring on and after November 1, 2014, payment rates 
393.2 	for hospital inpatient services provided by hospitals located in Minnesota or the local trade 
393.3 	area, except for the hospitals paid under the methodologies described in paragraph (a), 
393.4 	clauses (2) and (3), shall be rebased, incorporating cost and payment methodologies in a 
393.5 	manner similar to Medicare. The base year for the rates effective November 1, 2014, shall 
393.6 	be calendar year 2012. The rebasing under this paragraph shall be budget neutral, ensuring 
393.7 	that the total aggregate payments under the rebased system are equal to the total aggregate 
393.8 	payments that were made for the same number and types of services in the base year. Separate 
393.9 	budget neutrality calculations shall be determined for payments made to critical access 
393.10 	hospitals and payments made to hospitals paid under the DRG system. Only the rate increases 
393.11 	or decreases under subdivision 3a or 3c that applied to the hospitals being rebased during 
393.12 	the entire base period shall be incorporated into the budget neutrality calculation.
393.13 	(d) For discharges occurring on or after November 1, 2014, through the next rebasing 
393.14 	that occurs, the rebased rates under paragraph (c) that apply to hospitals under paragraph 
393.15 	(a), clause (4), shall include adjustments to the projected rates that result in no greater than 
393.16 	a five percent increase or decrease from the base year payments for any hospital. Any 
393.17 	adjustments to the rates made by the commissioner under this paragraph and paragraph (e) 
393.18 	shall maintain budget neutrality as described in paragraph (c).
393.19 	(e) For discharges occurring on or after November 1, 2014, through the next two rebasing 
393.20 	periods the commissioner may make additional adjustments to the rebased rates, and when 
393.21 	evaluating whether additional adjustments should be made, the commissioner shall consider 
393.22 	the impact of the rates on the following:
393.23 	(1) pediatric services;
393.24 	(2) behavioral health services;
393.25 	(3) trauma services as defined by the National Uniform Billing Committee;
393.26 	(4) transplant services;
393.27 	(5) obstetric services, newborn services, and behavioral health services provided by 
393.28 	hospitals outside the seven-county metropolitan area;
393.29 	(6) outlier admissions;
393.30 	(7) low-volume providers; and
393.31 	(8) services provided by small rural hospitals that are not critical access hospitals.
393.32 	(f) Hospital payment rates established under paragraph (c) must incorporate the following:
394.1 	(1) for hospitals paid under the DRG methodology, the base year payment rate per 
394.2 	admission is standardized by the applicable Medicare wage index and adjusted by the 
394.3 	hospital's disproportionate population adjustment;
394.4 	(2) for critical access hospitals, payment rates for discharges between November 1, 2014, 
394.5 	and June 30, 2015, shall be set to the same rate of payment that applied for discharges on 
394.6 	October 31, 2014;
394.7 	(3) the cost and charge data used to establish hospital payment rates must only reflect 
394.8 	inpatient services covered by medical assistance; and
394.9 	(4) in determining hospital payment rates for discharges occurring on or after the rate 
394.10 	year beginning January 1, 2011, through December 31, 2012, the hospital payment rate per 
394.11 	discharge shall be based on the cost-finding methods and allowable costs of the Medicare 
394.12 	program in effect during the base year or years. In determining hospital payment rates for 
394.13 	discharges in subsequent base years, the per discharge rates shall be based on the cost-finding 
394.14 	methods and allowable costs of the Medicare program in effect during the base year or 
394.15 	years.
394.16 	(g) The commissioner shall validate the rates effective November 1, 2014, by applying 
394.17 	the rates established under paragraph (c), and any adjustments made to the rates under 
394.18 	paragraph (d) or (e), to hospital claims paid in calendar year 2013 to determine whether the 
394.19 	total aggregate payments for the same number and types of services under the rebased rates 
394.20 	are equal to the total aggregate payments made during calendar year 2013.
394.21 	(h) Effective for discharges occurring on or after July 1, 2017, and every two years 
394.22 	thereafter, payment rates under this section shall be rebased to reflect only those changes 
394.23 	in hospital costs between the existing base year and the next base year. Changes in costs 
394.24 	between base years shall be measured using the lower of the hospital cost index defined in 
394.25 	subdivision 1, paragraph (a), or the percentage change in the case mix adjusted cost per 
394.26 	claim. The commissioner shall establish the base year for each rebasing period considering 
394.27 	the most recent year for which filed Medicare cost reports are available. The estimated 
394.28 	change in the average payment per hospital discharge resulting from a scheduled rebasing 
394.29 	must be calculated and made available to the legislature by January 15 of each year in which 
394.30 	rebasing is scheduled to occur, and must include by hospital the differential in payment 
394.31 	rates compared to the individual hospital's costs.
394.32 	(i) Effective for discharges occurring on or after July 1, 2015, inpatient payment rates 
394.33 	for critical access hospitals located in Minnesota or the local trade area shall be determined 
394.34 	using a new cost-based methodology. The commissioner shall establish within the 
395.1 	methodology tiers of payment designed to promote efficiency and cost-effectiveness. 
395.2 	Payment rates for hospitals under this paragraph shall be set at a level that does not exceed 
395.3 	the total cost for critical access hospitals as reflected in base year cost reports. Until the 
395.4 	next rebasing that occurs, the new methodology shall result in no greater than a five percent 
395.5 	decrease from the base year payments for any hospital, except a hospital that had payments 
395.6 	that were greater than 100 percent of the hospital's costs in the base year shall have their 
395.7 	rate set equal to 100 percent of costs in the base year. The rates paid for discharges on and 
395.8 	after July 1, 2016, covered under this paragraph shall be increased by the inflation factor 
395.9 	in subdivision 1, paragraph (a). The new cost-based rate shall be the final rate and shall not 
395.10 	be settled to actual incurred costs. Hospitals shall be assigned a payment tier based on the 
395.11 	following criteria:
395.12 	(1) hospitals that had payments at or below 80 percent of their costs in the base year 
395.13 	shall have a rate set that equals 85 percent of their base year costs;
395.14 	(2) hospitals that had payments that were above 80 percent, up to and including 90 
395.15 	percent of their costs in the base year shall have a rate set that equals 95 percent of their 
395.16 	base year costs; and
395.17 	(3) hospitals that had payments that were above 90 percent of their costs in the base year 
395.18 	shall have a rate set that equals 100 percent of their base year costs.
395.19 	(j) The commissioner may refine the payment tiers and criteria for critical access hospitals 
395.20 	to coincide with the next rebasing under paragraph (h). The factors used to develop the new 
395.21 	methodology may include, but are not limited to:
395.22 	(1) the ratio between the hospital's costs for treating medical assistance patients and the 
395.23 	hospital's charges to the medical assistance program;
395.24 	(2) the ratio between the hospital's costs for treating medical assistance patients and the 
395.25 	hospital's payments received from the medical assistance program for the care of medical 
395.26 	assistance patients;
395.27 	(3) the ratio between the hospital's charges to the medical assistance program and the 
395.28 	hospital's payments received from the medical assistance program for the care of medical 
395.29 	assistance patients;
395.30 	(4) the statewide average increases in the ratios identified in clauses (1), (2), and (3);
395.31 	(5) the proportion of that hospital's costs that are administrative and trends in 
395.32 	administrative costs; and
395.33 	(6) geographic location.

396.1 	Sec. 10. Minnesota Statutes 2018, section 256.969, subdivision 3a, is amended to read:
396.2 		Subd. 3a.Payments. (a) Acute care hospital billings under the medical assistance program 
396.3 	must not be submitted until the recipient is discharged. However, the commissioner shall 
396.4 	establish monthly interim payments for inpatient hospitals that have individual patient 
396.5 	lengths of stay over 30 days regardless of diagnostic category. Except as provided in section 
396.6 	256.9693, medical assistance reimbursement for treatment of mental illness shall be 
396.7 	reimbursed based on diagnostic classifications. Individual hospital payments established 
396.8 	under this section and sections 256.9685, 256.9686, and 256.9695, in addition to third-party 
396.9 	and recipient liability, for discharges occurring during the rate year shall not exceed, in 
396.10 	aggregate on a per claim basis, the charges for the medical assistance covered inpatient 
396.11 	services paid for the same period of time to the hospital. Services that have rates established 
396.12 	under subdivision 12, must be limited separately from other services. After consulting with 
396.13 	the affected hospitals, the commissioner may consider related hospitals one entity and may 
396.14 	merge the payment rates while maintaining separate provider numbers. The operating and 
396.15 	property base rates per admission or per day shall be derived from the best Medicare and 
396.16 	claims data available when rates are established. The commissioner shall determine the best 
396.17 	Medicare and claims data, taking into consideration variables of recency of the data, audit 
396.18 	disposition, settlement status, and the ability to set rates in a timely manner. The 
396.19 	commissioner shall notify hospitals of payment rates 30 days prior to implementation. The 
396.20 	rate setting data must reflect the admissions data used to establish relative values. The 
396.21 	commissioner may adjust base year cost, relative value, and case mix index data to exclude 
396.22 	the costs of services that have been discontinued by October 1 of the year preceding the 
396.23 	rate year or that are paid separately from inpatient services. Inpatient stays that encompass 
396.24 	portions of two or more rate years shall have payments established based on payment rates 
396.25 	in effect at the time of admission unless the date of admission preceded the rate year in 
396.26 	effect by six months or more. In this case, operating payment rates for services rendered 
396.27 	during the rate year in effect and established based on the date of admission shall be adjusted 
396.28 	to the rate year in effect by the hospital cost index.
396.29 	(b) For fee-for-service admissions occurring on or after July 1, 2002, the total payment, 
396.30 	before third-party liability and spenddown, made to hospitals for inpatient services is reduced 
396.31 	by .5 percent from the current statutory rates.
396.32 	(c) In addition to the reduction in paragraph (b), the total payment for fee-for-service 
396.33 	admissions occurring on or after July 1, 2003, made to hospitals for inpatient services before 
396.34 	third-party liability and spenddown, is reduced five percent from the current statutory rates. 
397.1 	Mental health services within diagnosis related groups 424 to 432 or corresponding 
397.2 	APR-DRGs, and facilities defined under subdivision 16 are excluded from this paragraph.
397.3 	(d) In addition to the reduction in paragraphs (b) and (c), the total payment for 
397.4 	fee-for-service admissions occurring on or after August 1, 2005, made to hospitals for 
397.5 	inpatient services before third-party liability and spenddown, is reduced 6.0 percent from 
397.6 	the current statutory rates. Mental health services within diagnosis related groups 424 to 
397.7 	432 or corresponding APR-DRGs, and facilities defined under subdivision 16 are excluded 
397.8 	from this paragraph. Payments made to managed care plans shall be reduced for services 
397.9 	provided on or after January 1, 2006, to reflect this reduction.
397.10 	(e) In addition to the reductions in paragraphs (b), (c), and (d), the total payment for 
397.11 	fee-for-service admissions occurring on or after July 1, 2008, through June 30, 2009, made 
397.12 	to hospitals for inpatient services before third-party liability and spenddown, is reduced 
397.13 	3.46 percent from the current statutory rates. Mental health services with diagnosis related 
397.14 	groups 424 to 432 or corresponding APR-DRGs, and facilities defined under subdivision 
397.15 	16 are excluded from this paragraph. Payments made to managed care plans shall be reduced 
397.16 	for services provided on or after January 1, 2009, through June 30, 2009, to reflect this 
397.17 	reduction.
397.18 	(f) In addition to the reductions in paragraphs (b), (c), and (d), the total payment for 
397.19 	fee-for-service admissions occurring on or after July 1, 2009, through June 30, 2011, made 
397.20 	to hospitals for inpatient services before third-party liability and spenddown, is reduced 1.9 
397.21 	percent from the current statutory rates. Mental health services with diagnosis related groups 
397.22 	424 to 432 or corresponding APR-DRGs, and facilities defined under subdivision 16 are 
397.23 	excluded from this paragraph. Payments made to managed care plans shall be reduced for 
397.24 	services provided on or after July 1, 2009, through June 30, 2011, to reflect this reduction.
397.25 	(g) In addition to the reductions in paragraphs (b), (c), and (d), the total payment for 
397.26 	fee-for-service admissions occurring on or after July 1, 2011, made to hospitals for inpatient 
397.27 	services before third-party liability and spenddown, is reduced 1.79 percent from the current 
397.28 	statutory rates. Mental health services with diagnosis related groups 424 to 432 or 
397.29 	corresponding APR-DRGs, and facilities defined under subdivision 16 are excluded from 
397.30 	this paragraph. Payments made to managed care plans shall be reduced for services provided 
397.31 	on or after July 1, 2011, to reflect this reduction.
397.32 	(h) In addition to the reductions in paragraphs (b), (c), (d), (f), and (g), the total payment 
397.33 	for fee-for-service admissions occurring on or after July 1, 2009, made to hospitals for 
397.34 	inpatient services before third-party liability and spenddown, is reduced one percent from 
398.1 	the current statutory rates. Facilities defined under subdivision 16 are excluded from this 
398.2 	paragraph. Payments made to managed care plans shall be reduced for services provided 
398.3 	on or after October 1, 2009, to reflect this reduction.
398.4 	(i) In addition to the reductions in paragraphs (b), (c), (d), (g), and (h), the total payment 
398.5 	for fee-for-service admissions occurring on or after July 1, 2011, made to hospitals for 
398.6 	inpatient services before third-party liability and spenddown, is reduced 1.96 percent from 
398.7 	the current statutory rates. Facilities defined under subdivision 16 are excluded from this 
398.8 	paragraph. Payments made to managed care plans shall be reduced for services provided 
398.9 	on or after January 1, 2011, to reflect this reduction.
398.10 	(j) Effective for discharges on and after November 1, 2014, from hospitals paid under 
398.11 	subdivision 2b, paragraph (a), clauses (1) and (4), the rate adjustments in this subdivision 
398.12 	must be incorporated into the rebased rates established under subdivision 2b, paragraph (c), 
398.13 	and must not be applied to each claim.
398.14 	(k) Effective for discharges on and after July 1, 2015, from hospitals paid under 
398.15 	subdivision 2b, paragraph (a), clauses (2) and (3), the rate adjustments in this subdivision 
398.16 	must be incorporated into the rates and must not be applied to each claim.
398.17 	(l) Effective for discharges on and after July 1, 2017, from hospitals paid under 
398.18 	subdivision 2b, paragraph (a), clause (2), the rate adjustments in this subdivision must be 
398.19 	incorporated into the rates and must not be applied to each claim.

398.20 	Sec. 11. Minnesota Statutes 2018, section 256.969, subdivision 9, is amended to read:
398.21 		Subd. 9.Disproportionate numbers of low-income patients served. (a) For admissions 
398.22 	occurring on or after July 1, 1993, the medical assistance disproportionate population 
398.23 	adjustment shall comply with federal law and shall be paid to a hospital, excluding regional 
398.24 	treatment centers and facilities of the federal Indian Health Service, with a medical assistance 
398.25 	inpatient utilization rate in excess of the arithmetic mean. The adjustment must be determined 
398.26 	as follows:
398.27 	(1) for a hospital with a medical assistance inpatient utilization rate above the arithmetic 
398.28 	mean for all hospitals excluding regional treatment centers and facilities of the federal Indian 
398.29 	Health Service but less than or equal to one standard deviation above the mean, the 
398.30 	adjustment must be determined by multiplying the total of the operating and property 
398.31 	payment rates by the difference between the hospital's actual medical assistance inpatient 
398.32 	utilization rate and the arithmetic mean for all hospitals excluding regional treatment centers 
398.33 	and facilities of the federal Indian Health Service; and
399.1 	(2) for a hospital with a medical assistance inpatient utilization rate above one standard 
399.2 	deviation above the mean, the adjustment must be determined by multiplying the adjustment 
399.3 	that would be determined under clause (1) for that hospital by 1.1. The commissioner shall 
399.4 	report annually on the number of hospitals likely to receive the adjustment authorized by 
399.5 	this paragraph. The commissioner shall specifically report on the adjustments received by 
399.6 	public hospitals and public hospital corporations located in cities of the first class.
399.7 	(b) Certified public expenditures made by Hennepin County Medical Center shall be 
399.8 	considered Medicaid disproportionate share hospital payments. Hennepin County and 
399.9 	Hennepin County Medical Center shall report by June 15, 2007, on payments made beginning 
399.10 	July 1, 2005, or another date specified by the commissioner, that may qualify for 
399.11 	reimbursement under federal law. Based on these reports, the commissioner shall apply for 
399.12 	federal matching funds.
399.13 	(c) Upon federal approval of the related state plan amendment, paragraph (b) is effective 
399.14 	retroactively from July 1, 2005, or the earliest effective date approved by the Centers for 
399.15 	Medicare and Medicaid Services.
399.16 	(d) Effective July 1, 2015, disproportionate share hospital (DSH) payments shall be paid 
399.17 	in accordance with a new methodology using 2012 as the base year. Annual payments made 
399.18 	under this paragraph shall equal the total amount of payments made for 2012. A licensed 
399.19 	children's hospital shall receive only a single DSH factor for children's hospitals. Other 
399.20 	DSH factors may be combined to arrive at a single factor for each hospital that is eligible 
399.21 	for DSH payments. The new methodology shall make payments only to hospitals located 
399.22 	in Minnesota and include the following factors:
399.23 	(1) a licensed children's hospital with at least 1,000 fee-for-service discharges in the 
399.24 	base year shall receive a factor of 0.868. A licensed children's hospital with less than 1,000 
399.25 	fee-for-service discharges in the base year shall receive a factor of 0.7880;
399.26 	(2) a hospital that has in effect for the initial rate year a contract with the commissioner 
399.27 	to provide extended psychiatric inpatient services under section 256.9693 shall receive a 
399.28 	factor of 0.0160;
399.29 	(3) a hospital that has received payment from the fee-for-service program for at least 20 
399.30 	transplant services in the base year shall receive a factor of 0.0435;
399.31 	(4) a hospital that has a medical assistance utilization rate in the base year between 20 
399.32 	percent up to one standard deviation above the statewide mean utilization rate shall receive 
399.33 	a factor of 0.0468;
400.1 	(5) a hospital that has a medical assistance utilization rate in the base year that is at least 
400.2 	one standard deviation above the statewide mean utilization rate but is less than three two 
400.3 	and one-half standard deviations above the mean shall receive a factor of 0.2300; and
400.4 	(6) a hospital that has a medical assistance utilization rate in the base year that is at least 
400.5 	three two and one-half standard deviations above the statewide mean utilization rate shall 
400.6 	receive a factor of 0.3711.
400.7 	(e) Any payments or portion of payments made to a hospital under this subdivision that 
400.8 	are subsequently returned to the commissioner because the payments are found to exceed 
400.9 	the hospital-specific DSH limit for that hospital shall be redistributed, proportionate to the 
400.10 	number of fee-for-service discharges, to other DSH-eligible non-children's hospitals that 
400.11 	have a medical assistance utilization rate that is at least one standard deviation above the 
400.12 	mean.
400.13 	(f) An additional payment adjustment shall be established by the commissioner under 
400.14 	this subdivision for a hospital that provides high levels of administering high-cost drugs to 
400.15 	enrollees in fee-for-service medical assistance. The commissioner shall consider factors 
400.16 	including fee-for-service medical assistance utilization rates and payments made for drugs 
400.17 	purchased through the 340B drug purchasing program and administered to fee-for-service 
400.18 	enrollees. If any part of this adjustment exceeds a hospital's hospital-specific disproportionate 
400.19 	share hospital limit, the commissioner shall make a payment to the hospital that equals the 
400.20 	nonfederal share of the amount that exceeds the limit. The total nonfederal share of the 
400.21 	amount of the payment adjustment under this paragraph shall not exceed $1,500,000.

400.22 	EFFECTIVE DATE. This section is effective July 1, 2019, except paragraph (f) is 
400.23 	effective for discharges on or after July 1, 2019.

400.24 	Sec. 12. Minnesota Statutes 2018, section 256.969, subdivision 17, is amended to read:
400.25 		Subd. 17.Out-of-state hospitals in local trade areas. Out-of-state hospitals that are 
400.26 	located within a Minnesota local trade area and that have more than 20 admissions in the 
400.27 	base year or years shall have rates established using the same procedures and methods that 
400.28 	apply to Minnesota hospitals. For this subdivision and subdivision 18, local trade area means 
400.29 	a county contiguous to Minnesota and located in a metropolitan statistical area as determined 
400.30 	by Medicare for October 1 prior to the most current rebased rate year. Hospitals that are 
400.31 	not required by law to file information in a format necessary to establish rates shall have 
400.32 	rates established based on the commissioner's estimates of the information. Relative values 
400.33 	of the diagnostic categories shall not be redetermined under this subdivision until required 
400.34 	by statute. Hospitals affected by this subdivision shall then be included in determining 
401.1 	relative values. However, hospitals that have rates established based upon the commissioner's 
401.2 	estimates of information shall not be included in determining relative values. This subdivision 
401.3 	is effective for hospital fiscal years beginning on or after July 1, 1988. A hospital shall 
401.4 	provide the information necessary to establish rates under this subdivision at least 90 days 
401.5 	before the start of the hospital's fiscal year.

401.6 	Sec. 13. Minnesota Statutes 2018, section 256.969, subdivision 19, is amended to read:
401.7 		Subd. 19.Metabolic disorder testing of medical assistance recipients. Medical 
401.8 	assistance inpatient payment rates must include the cost incurred by hospitals to pay the 
401.9 	Department of Health for metabolic disorder testing of newborns who are medical assistance 
401.10 	recipients, if the cost is not recognized by another payment source. This payment increase 
401.11 	remains in effect until the increase is fully recognized in the base year cost under subdivision 
401.12 	2b.

401.13 	Sec. 14. Minnesota Statutes 2018, section 256B.04, subdivision 14, is amended to read:
401.14 		Subd. 14.Competitive bidding. (a) When determined to be effective, economical, and 
401.15 	feasible, the commissioner may utilize volume purchase through competitive bidding and 
401.16 	negotiation under the provisions of chapter 16C, to provide items under the medical assistance 
401.17 	program including but not limited to the following:
401.18 	(1) eyeglasses;
401.19 	(2) oxygen. The commissioner shall provide for oxygen needed in an emergency situation 
401.20 	on a short-term basis, until the vendor can obtain the necessary supply from the contract 
401.21 	dealer;
401.22 	(3) hearing aids and supplies; and
401.23 	(4) durable medical equipment, including but not limited to:
401.24 	(i) hospital beds;
401.25 	(ii) commodes;
401.26 	(iii) glide-about chairs;
401.27 	(iv) patient lift apparatus;
401.28 	(v) wheelchairs and accessories;
401.29 	(vi) oxygen administration equipment;
401.30 	(vii) respiratory therapy equipment;
402.1 	(viii) electronic diagnostic, therapeutic and life-support systems;
402.2 	(5) nonemergency medical transportation level of need determinations, disbursement of 
402.3 	public transportation passes and tokens, and volunteer and recipient mileage and parking 
402.4 	reimbursements; and
402.5 	(6) drugs.
402.6 	(b) Rate changes and recipient cost-sharing under this chapter and chapter 256L do not 
402.7 	affect contract payments under this subdivision unless specifically identified.
402.8 	(c) The commissioner may not utilize volume purchase through competitive bidding 
402.9 	and negotiation for special transportation services under the provisions of chapter 16C for 
402.10 	special transportation services or incontinence products and related supplies.

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

402.12 	Sec. 15. Minnesota Statutes 2018, section 256B.04, subdivision 21, is amended to read:
402.13 		Subd. 21.Provider enrollment. (a) The commissioner shall enroll providers and conduct 
402.14 	screening activities as required by Code of Federal Regulations, title 42, section 455, subpart 
402.15 	E. A provider must enroll each provider-controlled location where direct services are 
402.16 	provided. The commissioner may deny a provider's incomplete application if a provider 
402.17 	fails to respond to the commissioner's request for additional information within 60 days of 
402.18 	the request. The commissioner must conduct a background study under chapter 245C, 
402.19 	including a review of databases in section 245C.08, subdivision 1, paragraph (a), clauses 
402.20 	(1) to (5), for a provider described in this paragraph. The background study requirement 
402.21 	may be satisfied if the commissioner conducted a fingerprint-based background study on 
402.22 	the provider that includes a review of databases in section 245C.08, subdivision 1, paragraph 
402.23 	(a), clauses (1) to (5).
402.24 	(b) The commissioner shall revalidate each: (1) provider under this subdivision at least 
402.25 	once every five years; and (2) personal care assistance agency under this subdivision once 
402.26 	every three years.
402.27 	(c) The commissioner shall conduct revalidation as follows:
402.28 	(1) provide 30-day notice of the revalidation due date including instructions for 
402.29 	revalidation and a list of materials the provider must submit;
402.30 	(2) if a provider fails to submit all required materials by the due date, notify the provider 
402.31 	of the deficiency within 30 days after the due date and allow the provider an additional 30 
402.32 	days from the notification date to comply; and
403.1 	(3) if a provider fails to remedy a deficiency within the 30-day time period, give 60-day 
403.2 	notice of termination and immediately suspend the provider's ability to bill. The provider 
403.3 	does not have the right to appeal suspension of ability to bill.
403.4 	(d) If a provider fails to comply with any individual provider requirement or condition 
403.5 	of participation, the commissioner may suspend the provider's ability to bill until the provider 
403.6 	comes into compliance. The commissioner's decision to suspend the provider is not subject 
403.7 	to an administrative appeal.
403.8 	(e) Correspondence and notifications, including notifications of termination and other 
403.9 	actions, may be delivered electronically to a provider's MN-ITS mailbox. This paragraph 
403.10 	does not apply to correspondences and notifications related to background studies.
403.11 	(f) If the commissioner or the Centers for Medicare and Medicaid Services determines 
403.12 	that a provider is designated "high-risk," the commissioner may withhold payment from 
403.13 	providers within that category upon initial enrollment for a 90-day period. The withholding 
403.14 	for each provider must begin on the date of the first submission of a claim.
403.15 	(b) (g) An enrolled provider that is also licensed by the commissioner under chapter 
403.16 	245A, or is licensed as a home care provider by the Department of Health under chapter 
403.17 	144A and has a home and community-based services designation on the home care license 
403.18 	under section 144A.484, must designate an individual as the entity's compliance officer. 
403.19 	The compliance officer must:
403.20 	(1) develop policies and procedures to assure adherence to medical assistance laws and 
403.21 	regulations and to prevent inappropriate claims submissions;
403.22 	(2) train the employees of the provider entity, and any agents or subcontractors of the 
403.23 	provider entity including billers, on the policies and procedures under clause (1);
403.24 	(3) respond to allegations of improper conduct related to the provision or billing of 
403.25 	medical assistance services, and implement action to remediate any resulting problems;
403.26 	(4) use evaluation techniques to monitor compliance with medical assistance laws and 
403.27 	regulations;
403.28 	(5) promptly report to the commissioner any identified violations of medical assistance 
403.29 	laws or regulations; and
403.30 	(6) within 60 days of discovery by the provider of a medical assistance reimbursement 
403.31 	overpayment, report the overpayment to the commissioner and make arrangements with 
403.32 	the commissioner for the commissioner's recovery of the overpayment.
404.1 	The commissioner may require, as a condition of enrollment in medical assistance, that a 
404.2 	provider within a particular industry sector or category establish a compliance program that 
404.3 	contains the core elements established by the Centers for Medicare and Medicaid Services.
404.4 	(c) (h) The commissioner may revoke the enrollment of an ordering or rendering provider 
404.5 	for a period of not more than one year, if the provider fails to maintain and, upon request 
404.6 	from the commissioner, provide access to documentation relating to written orders or requests 
404.7 	for payment for durable medical equipment, certifications for home health services, or 
404.8 	referrals for other items or services written or ordered by such provider, when the 
404.9 	commissioner has identified a pattern of a lack of documentation. A pattern means a failure 
404.10 	to maintain documentation or provide access to documentation on more than one occasion. 
404.11 	Nothing in this paragraph limits the authority of the commissioner to sanction a provider 
404.12 	under the provisions of section 256B.064.
404.13 	(d) (i) The commissioner shall terminate or deny the enrollment of any individual or 
404.14 	entity if the individual or entity has been terminated from participation in Medicare or under 
404.15 	the Medicaid program or Children's Health Insurance Program of any other state.
404.16 	(e) (j) As a condition of enrollment in medical assistance, the commissioner shall require 
404.17 	that a provider designated "moderate" or "high-risk" by the Centers for Medicare and 
404.18 	Medicaid Services or the commissioner permit the Centers for Medicare and Medicaid 
404.19 	Services, its agents, or its designated contractors and the state agency, its agents, or its 
404.20 	designated contractors to conduct unannounced on-site inspections of any provider location. 
404.21 	The commissioner shall publish in the Minnesota Health Care Program Provider Manual a 
404.22 	list of provider types designated "limited," "moderate," or "high-risk," based on the criteria 
404.23 	and standards used to designate Medicare providers in Code of Federal Regulations, title 
404.24 	42, section 424.518. The list and criteria are not subject to the requirements of chapter 14. 
404.25 	The commissioner's designations are not subject to administrative appeal.
404.26 	(f) (k) As a condition of enrollment in medical assistance, the commissioner shall require 
404.27 	that a high-risk provider, or a person with a direct or indirect ownership interest in the 
404.28 	provider of five percent or higher, consent to criminal background checks, including 
404.29 	fingerprinting, when required to do so under state law or by a determination by the 
404.30 	commissioner or the Centers for Medicare and Medicaid Services that a provider is designated 
404.31 	high-risk for fraud, waste, or abuse.
404.32 	(g) (l)(1) Upon initial enrollment, reenrollment, and notification of revalidation, all 
404.33 	durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) medical suppliers 
404.34 	meeting the durable medical equipment provider and supplier definition in clause (3), 
405.1 	operating in Minnesota and receiving Medicaid funds must purchase a surety bond that is 
405.2 	annually renewed and designates the Minnesota Department of Human Services as the 
405.3 	obligee, and must be submitted in a form approved by the commissioner. For purposes of 
405.4 	this clause, the following medical suppliers are not required to obtain a surety bond: a 
405.5 	federally qualified health center, a home health agency, the Indian Health Service, a 
405.6 	pharmacy, and a rural health clinic.
405.7 	(2) At the time of initial enrollment or reenrollment, durable medical equipment providers 
405.8 	and suppliers defined in clause (3) must purchase a surety bond of $50,000. If a revalidating 
405.9 	provider's Medicaid revenue in the previous calendar year is up to and including $300,000, 
405.10 	the provider agency must purchase a surety bond of $50,000. If a revalidating provider's 
405.11 	Medicaid revenue in the previous calendar year is over $300,000, the provider agency must 
405.12 	purchase a surety bond of $100,000. The surety bond must allow for recovery of costs and 
405.13 	fees in pursuing a claim on the bond.
405.14 	(3) "Durable medical equipment provider or supplier" means a medical supplier that can 
405.15 	purchase medical equipment or supplies for sale or rental to the general public and is able 
405.16 	to perform or arrange for necessary repairs to and maintenance of equipment offered for 
405.17 	sale or rental.
405.18 	(h) (m) The Department of Human Services may require a provider to purchase a surety 
405.19 	bond as a condition of initial enrollment, reenrollment, reinstatement, or continued enrollment 
405.20 	if: (1) the provider fails to demonstrate financial viability, (2) the department determines 
405.21 	there is significant evidence of or potential for fraud and abuse by the provider, or (3) the 
405.22 	provider or category of providers is designated high-risk pursuant to paragraph (a) (f) and 
405.23 	as per Code of Federal Regulations, title 42, section 455.450. The surety bond must be in 
405.24 	an amount of $100,000 or ten percent of the provider's payments from Medicaid during the 
405.25 	immediately preceding 12 months, whichever is greater. The surety bond must name the 
405.26 	Department of Human Services as an obligee and must allow for recovery of costs and fees 
405.27 	in pursuing a claim on the bond. This paragraph does not apply if the provider currently 
405.28 	maintains a surety bond under the requirements in section 256B.0659 or 256B.85.

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

405.30 	Sec. 16. Minnesota Statutes 2018, section 256B.04, subdivision 22, is amended to read:
405.31 		Subd. 22.Application fee. (a) The commissioner must collect and retain federally 
405.32 	required nonrefundable application fees to pay for provider screening activities in accordance 
405.33 	with Code of Federal Regulations, title 42, section 455, subpart E. The enrollment application 
405.34 	must be made under the procedures specified by the commissioner, in the form specified 
406.1 	by the commissioner, and accompanied by an applicationthe fee described in paragraph 
406.2 	(b), or a request for a hardship exception as described in the specified procedures. Application
406.3 	The fees must be deposited in the provider screening account in the special revenue fund. 
406.4 	Amounts in the provider screening account are appropriated to the commissioner for costs 
406.5 	associated with the provider screening activities required in Code of Federal Regulations, 
406.6 	title 42, section 455, subpart E. The commissioner shall conduct screening activities as 
406.7 	required by Code of Federal Regulations, title 42, section 455, subpart E, and as otherwise 
406.8 	provided by law, to include database checks, unannounced pre- and postenrollment site 
406.9 	visits, fingerprinting, and criminal background studies. The commissioner must revalidate 
406.10 	all providers under this subdivision at least once every five years.
406.11 	(b) The application fee under this subdivision is $532 for the calendar year 2013. For 
406.12 	calendar year 2014 and subsequent years, the fee:
406.13 	(1) is adjusted by the percentage change to the Consumer Price Index for all urban 
406.14 	consumers, United States city average, for the 12-month period ending with June of the 
406.15 	previous year. The resulting fee must be announced in the Federal Register;
406.16 	(2) is effective from January 1 to December 31 of a calendar year;
406.17 	(3) is required on the submission of an initial application, an application to establish a 
406.18 	new practice location, an application for reenrollment when the provider is not enrolled at 
406.19 	the time of application of reenrollment, or at revalidation when required by federal regulation; 
406.20 	and
406.21 	(4) must be in the amount in effect for the calendar year during which the application 
406.22 	for enrollment, new practice location, or reenrollment is being submitted.
406.23 	(c) The application fee under this subdivision cannot be charged to:
406.24 	(1) providers who are enrolled in Medicare or who provide documentation of payment 
406.25 	of the fee to, and enrollment with, another state, unless the commissioner is required to 
406.26 	rescreen the provider;
406.27 	(2) providers who are enrolled but are required to submit new applications for purposes 
406.28 	of reenrollment;
406.29 	(3) a provider who enrolls as an individual; and
406.30 	(4) group practices and clinics that bill on behalf of individually enrolled providers 
406.31 	within the practice who have reassigned their billing privileges to the group practice or 
406.32 	clinic.

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

407.2 	Sec. 17. Minnesota Statutes 2018, section 256B.04, is amended by adding a subdivision 
407.3 	to read:
407.4 		Subd. 25.Medical assistance and MinnesotaCare payment increase. (a) The 
407.5 	commissioner shall increase medical assistance and MinnesotaCare fee-for-service payments 
407.6 	by an amount equal to the tax rate defined for hospitals, surgical centers, or health care 
407.7 	providers under sections 295.50 to 295.57 for all services subject to those taxes.
407.8 	(b) The commissioner shall reflect in the total payments made to managed care 
407.9 	organizations, county-based purchasing plans, and other participating entities contracted 
407.10 	with the commissioner under section 256B.69, the cost of: (1) payments made to providers 
407.11 	for the tax on the services outlined in paragraph (a);  and (2) the taxes imposed under sections 
407.12 	297I.05, subdivision 5, and 256.9657, subdivision 3, on premium revenue paid by the state 
407.13 	for medical assistance and the MinnesotaCare program. Any increase based on clause (2) 
407.14 	must be reflected in provider rates paid by the managed care organization, county-based 
407.15 	purchasing plan, or other participating entity, unless the managed care organization, 
407.16 	county-based purchasing plan, or other participating entity is a staff model health plan 
407.17 	company.

407.18 	Sec. 18. Minnesota Statutes 2018, section 256B.055, subdivision 2, is amended to read:
407.19 		Subd. 2.Subsidized foster children. Medical assistance may be paid for a child eligible 
407.20 	for or receiving foster care maintenance payments under Title IV-E of the Social Security 
407.21 	Act, United States Code, title 42, sections 670 to 676, and for a child who is not eligible for 
407.22 	Title IV-E of the Social Security Act but who is determined eligible for foster care or kinship 
407.23 	assistance under chapter 256N.

407.24 	EFFECTIVE DATE. This section is effective January 1, 2020, or upon federal approval, 
407.25 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
407.26 	when federal approval is obtained.

407.27 	Sec. 19. Minnesota Statutes 2018, section 256B.056, subdivision 1, is amended to read:
407.28 		Subdivision 1.Residency. (a) To be eligible for medical assistance, a person must reside 
407.29 	in Minnesota, or, if absent from the state, be deemed to be a resident of Minnesota, in 
407.30 	accordance with Code of Federal Regulations, title 42, section 435.403.
408.1 	(b) The commissioner shall identify individuals who are enrolled in medical assistance 
408.2 	and who are absent from the state for more than 30 consecutive days, but who continue to 
408.3 	qualify for medical assistance in accordance with paragraph (a).
408.4 	(c) If the individual is absent from the state for more than 30 consecutive days but still 
408.5 	deemed a resident of Minnesota in accordance with paragraph (a), any covered service 
408.6 	provided to the individual must be paid through the fee-for-service system and not through 
408.7 	the managed care capitated rate payment system under section 256B.69 or 256L.12.

408.8 	Sec. 20. Minnesota Statutes 2018, section 256B.056, subdivision 3, is amended to read:
408.9 		Subd. 3.Asset limitations for certain individuals. (a) To be eligible for medical 
408.10 	assistance, a person must not individually own more than $3,000 in assets, or if a member 
408.11 	of a household with two family members, husband and wife, or parent and child, the 
408.12 	household must not own more than $6,000 in assets, plus $200 for each additional legal 
408.13 	dependent. In addition to these maximum amounts, an eligible individual or family may 
408.14 	accrue interest on these amounts, but they must be reduced to the maximum at the time of 
408.15 	an eligibility redetermination. The accumulation of the clothing and personal needs allowance 
408.16 	according to section 256B.35 must also be reduced to the maximum at the time of the 
408.17 	eligibility redetermination. The value of assets that are not considered in determining 
408.18 	eligibility for medical assistance is the value of those assets excluded under the Supplemental 
408.19 	Security Income program for aged, blind, and disabled persons, with the following 
408.20 	exceptions:
408.21 	(1) household goods and personal effects are not considered;
408.22 	(2) capital and operating assets of a trade or business that the local agency determines 
408.23 	are necessary to the person's ability to earn an income are not considered;
408.24 	(3) motor vehicles are excluded to the same extent excluded by the Supplemental Security 
408.25 	Income program;
408.26 	(4) assets designated as burial expenses are excluded to the same extent excluded by the 
408.27 	Supplemental Security Income program. Burial expenses funded by annuity contracts or 
408.28 	life insurance policies must irrevocably designate the individual's estate as contingent 
408.29 	beneficiary to the extent proceeds are not used for payment of selected burial expenses;
408.30 	(5) for a person who no longer qualifies as an employed person with a disability due to 
408.31 	loss of earnings, assets allowed while eligible for medical assistance under section 256B.057, 
408.32 	subdivision 9, are not considered for 12 months, beginning with the first month of ineligibility 
409.1 	as an employed person with a disability, to the extent that the person's total assets remain 
409.2 	within the allowed limits of section 256B.057, subdivision 9, paragraph (d);
409.3 	(6) when a person enrolled in medical assistance under section 256B.057, subdivision 
409.4 	9, is age 65 or older and has been enrolled during each of the 24 consecutive months before 
409.5 	the person's 65th birthday, the assets owned by the person and the person's spouse must be 
409.6 	disregarded, up to the limits of section 256B.057, subdivision 9, paragraph (d), when 
409.7 	determining eligibility for medical assistance under section 256B.055, subdivision 7. a 
409.8 	designated employment incentives asset account is disregarded when determining eligibility 
409.9 	for medical assistance for a person age 65 years or older under section 256B.055, subdivision 
409.10 	7. An employment incentives asset account must only be designated by a person who has 
409.11 	been enrolled in medical assistance under section 256B.057, subdivision 9, for a 
409.12 	24-consecutive-month period. A designated employment incentives asset account contains 
409.13 	qualified assets owned by the person and the person's spouse in the last month of enrollment 
409.14 	in medical assistance under section 256B.057, subdivision 9. Qualified assets include 
409.15 	retirement and pension accounts, medical expense accounts, and up to $17,000 of the person's 
409.16 	other nonexcluded assets. An employment incentives asset account is no longer designated 
409.17 	when a person loses medical assistance eligibility for a calendar month or more before 
409.18 	turning age 65. A person who loses medical assistance eligibility before age 65 can establish 
409.19 	a new designated employment incentives asset account by establishing a new 
409.20 	24-consecutive-month period of enrollment under section 256B.057, subdivision 9. The 
409.21 	income of a spouse of a person enrolled in medical assistance under section 256B.057, 
409.22 	subdivision 9, during each of the 24 consecutive months before the person's 65th birthday 
409.23 	must be disregarded when determining eligibility for medical assistance under section 
409.24 	256B.055, subdivision 7. Persons eligible under this clause are not subject to the provisions 
409.25 	in section 256B.059; and
409.26 	(7) effective July 1, 2009, certain assets owned by American Indians are excluded as 
409.27 	required by section 5006 of the American Recovery and Reinvestment Act of 2009, Public 
409.28 	Law 111-5. For purposes of this clause, an American Indian is any person who meets the 
409.29 	definition of Indian according to Code of Federal Regulations, title 42, section 447.50.
409.30 	(b) No asset limit shall apply to persons eligible under section 256B.055, subdivision 
409.31 	15.

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

410.1 	Sec. 21. Minnesota Statutes 2018, section 256B.056, subdivision 5c, is amended to read:
410.2 		Subd. 5c.Excess income standard. (a) The excess income standard for parents and 
410.3 	caretaker relatives, pregnant women, infants, and children ages two through 20 is the standard 
410.4 	specified in subdivision 4, paragraph (b).
410.5 	(b) The excess income standard for a person whose eligibility is based on blindness, 
410.6 	disability, or age of 65 or more years shall equal:
410.7 	(1) 81 percent of the federal poverty guidelines; and
410.8 	(2) effective July 1, 2022, 100 percent of the federal poverty guidelines.

410.9 	Sec. 22. Minnesota Statutes 2018, section 256B.056, subdivision 7a, is amended to read:
410.10 		Subd. 7a.Periodic renewal of eligibility. (a) The commissioner shall make an annual 
410.11 	redetermination of eligibility based on information contained in the enrollee's case file and 
410.12 	other information available to the agency, including but not limited to information accessed 
410.13 	through an electronic database, without requiring the enrollee to submit any information 
410.14 	when sufficient data is available for the agency to renew eligibility.
410.15 	(b) If the commissioner cannot renew eligibility in accordance with paragraph (a), the 
410.16 	commissioner must provide the enrollee with a prepopulated renewal form containing 
410.17 	eligibility information available to the agency and permit the enrollee to submit the form 
410.18 	with any corrections or additional information to the agency and sign the renewal form via 
410.19 	any of the modes of submission specified in section 256B.04, subdivision 18.
410.20 	(c) An enrollee who is terminated for failure to complete the renewal process may 
410.21 	subsequently submit the renewal form and required information within four months after 
410.22 	the date of termination and have coverage reinstated without a lapse, if otherwise eligible 
410.23 	under this chapter. The local agency may close the enrollee's case file if the required 
410.24 	information is not submitted within four months of termination.
410.25 	(d) Notwithstanding paragraph (a), individuals eligible under subdivision 5 shall be 
410.26 	required to renew eligibility every six months.

410.27 	Sec. 23. Minnesota Statutes 2018, section 256B.0625, subdivision 3b, is amended to read:
410.28 		Subd. 3b.Telemedicine services. (a) Medical assistance covers medically necessary 
410.29 	services and consultations delivered by a licensed health care provider via telemedicine in 
410.30 	the same manner as if the service or consultation was delivered in person. Coverage is 
411.1 	limited to three telemedicine services per enrollee per calendar week, except as provided 
411.2 	in paragraph (f). Telemedicine services shall be paid at the full allowable rate.
411.3 	(b) The commissioner shall establish criteria that a health care provider must attest to 
411.4 	in order to demonstrate the safety or efficacy of delivering a particular service via 
411.5 	telemedicine. The attestation may include that the health care provider:
411.6 	(1) has identified the categories or types of services the health care provider will provide 
411.7 	via telemedicine;
411.8 	(2) has written policies and procedures specific to telemedicine services that are regularly 
411.9 	reviewed and updated;
411.10 	(3) has policies and procedures that adequately address patient safety before, during, 
411.11 	and after the telemedicine service is rendered;
411.12 	(4) has established protocols addressing how and when to discontinue telemedicine 
411.13 	services; and
411.14 	(5) has an established quality assurance process related to telemedicine services.
411.15 	(c) As a condition of payment, a licensed health care provider must document each 
411.16 	occurrence of a health service provided by telemedicine to a medical assistance enrollee. 
411.17 	Health care service records for services provided by telemedicine must meet the requirements 
411.18 	set forth in Minnesota Rules, part 9505.2175, subparts 1 and 2, and must document:
411.19 	(1) the type of service provided by telemedicine;
411.20 	(2) the time the service began and the time the service ended, including an a.m. and p.m. 
411.21 	designation;
411.22 	(3) the licensed health care provider's basis for determining that telemedicine is an 
411.23 	appropriate and effective means for delivering the service to the enrollee;
411.24 	(4) the mode of transmission of the telemedicine service and records evidencing that a 
411.25 	particular mode of transmission was utilized;
411.26 	(5) the location of the originating site and the distant site;
411.27 	(6) if the claim for payment is based on a physician's telemedicine consultation with 
411.28 	another physician, the written opinion from the consulting physician providing the 
411.29 	telemedicine consultation; and
411.30 	(7) compliance with the criteria attested to by the health care provider in accordance 
411.31 	with paragraph (b).
412.1 	(d) For purposes of this subdivision, unless otherwise covered under this chapter, 
412.2 	"telemedicine" is defined as the delivery of health care services or consultations while the 
412.3 	patient is at an originating site and the licensed health care provider is at a distant site. A 
412.4 	communication between licensed health care providers, or a licensed health care provider 
412.5 	and a patient that consists solely of a telephone conversation, e-mail, or facsimile transmission 
412.6 	does not constitute telemedicine consultations or services. Telemedicine may be provided 
412.7 	by means of real-time two-way, interactive audio and visual communications, including the 
412.8 	application of secure video conferencing or store-and-forward technology to provide or 
412.9 	support health care delivery, which facilitate the assessment, diagnosis, consultation, 
412.10 	treatment, education, and care management of a patient's health care.
412.11 	(e) For purposes of this section, "licensed health care provider" means a licensed health 
412.12 	care provider under section 62A.671, subdivision 6, and a mental health practitioner defined 
412.13 	under section 245.462, subdivision 17, or 245.4871, subdivision 26, working under the 
412.14 	general supervision of a mental health professional, and a community health worker who 
412.15 	meets the criteria under subdivision 49, paragraph (a); "health care provider" is defined 
412.16 	under section 62A.671, subdivision 3; and "originating site" is defined under section 62A.671, 
412.17 	subdivision 7.
412.18 	(f) The limit on coverage of three telemedicine services per enrollee per calendar week 
412.19 	does not apply if:
412.20 	(1) the telemedicine services provided by the licensed health care provider are for the 
412.21 	treatment and control of tuberculosis; and
412.22 	(2) the services are provided in a manner consistent with the recommendations and best 
412.23 	practices specified by the Centers for Disease Control and Prevention and the commissioner 
412.24 	of health.

412.25 	Sec. 24. Minnesota Statutes 2018, section 256B.0625, subdivision 13, is amended to read:
412.26 		Subd. 13.Drugs. (a) Medical assistance covers drugs, except for fertility drugs when 
412.27 	specifically used to enhance fertility, if prescribed by a licensed practitioner and dispensed 
412.28 	by a licensed pharmacist, by a physician enrolled in the medical assistance program as a 
412.29 	dispensing physician, or by a physician, physician assistant, or a nurse practitioner employed 
412.30 	by or under contract with a community health board as defined in section 145A.02, 
412.31 	subdivision 5, for the purposes of communicable disease control.
412.32 	(b) The dispensed quantity of a prescription drug must not exceed a 34-day supply, 
412.33 	unless authorized by the commissioner.
413.1 	(c) For the purpose of this subdivision and subdivision 13d, an "active pharmaceutical 
413.2 	ingredient" is defined as a substance that is represented for use in a drug and when used in 
413.3 	the manufacturing, processing, or packaging of a drug becomes an active ingredient of the 
413.4 	drug product. An "excipient" is defined as an inert substance used as a diluent or vehicle 
413.5 	for a drug. The commissioner shall establish a list of active pharmaceutical ingredients and 
413.6 	excipients which are included in the medical assistance formulary. Medical assistance covers 
413.7 	selected active pharmaceutical ingredients and excipients used in compounded prescriptions 
413.8 	when the compounded combination is specifically approved by the commissioner or when 
413.9 	a commercially available product:
413.10 	(1) is not a therapeutic option for the patient;
413.11 	(2) does not exist in the same combination of active ingredients in the same strengths 
413.12 	as the compounded prescription; and
413.13 	(3) cannot be used in place of the active pharmaceutical ingredient in the compounded 
413.14 	prescription.
413.15 	(d) Medical assistance covers the following over-the-counter drugs when prescribed by 
413.16 	a licensed practitioner or by a licensed pharmacist who meets standards established by the 
413.17 	commissioner, in consultation with the board of pharmacy: antacids, acetaminophen, family 
413.18 	planning products, aspirin, insulin, products for the treatment of lice, vitamins for adults 
413.19 	with documented vitamin deficiencies, vitamins for children under the age of seven and 
413.20 	pregnant or nursing women, and any other over-the-counter drug identified by the 
413.21 	commissioner, in consultation with the Formulary Committee, as necessary, appropriate, 
413.22 	and cost-effective for the treatment of certain specified chronic diseases, conditions, or 
413.23 	disorders, and this determination shall not be subject to the requirements of chapter 14. A 
413.24 	pharmacist may prescribe over-the-counter medications as provided under this paragraph 
413.25 	for purposes of receiving reimbursement under Medicaid. When prescribing over-the-counter 
413.26 	drugs under this paragraph, licensed pharmacists must consult with the recipient to determine 
413.27 	necessity, provide drug counseling, review drug therapy for potential adverse interactions, 
413.28 	and make referrals as needed to other health care professionals. Over-the-counter medications 
413.29 	must be dispensed in a quantity that is the lowest of: (1) the number of dosage units contained 
413.30 	in the manufacturer's original package; (2) the number of dosage units required to complete 
413.31 	the patient's course of therapy; or (3) if applicable, the number of dosage units dispensed 
413.32 	from a system using retrospective billing, as provided under subdivision 13e, paragraph 
413.33 	(b).
414.1 	(e) Effective January 1, 2006, medical assistance shall not cover drugs that are coverable 
414.2 	under Medicare Part D as defined in the Medicare Prescription Drug, Improvement, and 
414.3 	Modernization Act of 2003, Public Law 108-173, section 1860D-2(e), for individuals eligible 
414.4 	for drug coverage as defined in the Medicare Prescription Drug, Improvement, and 
414.5 	Modernization Act of 2003, Public Law 108-173, section 1860D-1(a)(3)(A). For these 
414.6 	individuals, medical assistance may cover drugs from the drug classes listed in United States 
414.7 	Code, title 42, section 1396r-8(d)(2), subject to this subdivision and subdivisions 13a to 
414.8 	13g, except that drugs listed in United States Code, title 42, section 1396r-8(d)(2)(E), shall 
414.9 	not be covered.
414.10 	(f) Medical assistance covers drugs acquired through the federal 340B Drug Pricing 
414.11 	Program and dispensed by 340B covered entities and ambulatory pharmacies under common 
414.12 	ownership of the 340B covered entity. Medical assistance does not cover drugs acquired 
414.13 	through the federal 340B Drug Pricing Program and dispensed by 340B contract pharmacies.

414.14 	EFFECTIVE DATE. This section is effective July 1, 2019, or upon federal approval, 
414.15 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
414.16 	when federal approval is obtained.

414.17 	Sec. 25. Minnesota Statutes 2018, section 256B.0625, subdivision 13e, is amended to 
414.18 	read:
414.19 		Subd. 13e.Payment rates. (a) The basis for determining the amount of payment shall 
414.20 	be the lower of the actual acquisition ingredient costs of the drugs or the maximum allowable 
414.21 	cost by the commissioner plus the fixed professional dispensing fee; or the usual and 
414.22 	customary price charged to the public. The usual and customary price means the lowest 
414.23 	price charged by the provider to a patient who pays for the prescription by cash, check, or 
414.24 	charge account and includes prices the pharmacy charges to a patient enrolled in a 
414.25 	prescription savings club or prescription discount club administered by the pharmacy or 
414.26 	pharmacy chain. The amount of payment basis must be reduced to reflect all discount 
414.27 	amounts applied to the charge by any third-party provider/insurer agreement or contract for 
414.28 	submitted charges to medical assistance programs. The net submitted charge may not be 
414.29 	greater than the patient liability for the service. The pharmacy professional dispensing fee 
414.30 	shall be $3.65 $10.48 for legend prescription drugs, except that prescriptions filled with 
414.31 	legend drugs meeting the definition of "covered outpatient drugs" according to United States 
414.32 	Code, title 42, section 1396r-8(k)(2). The dispensing fee for intravenous solutions which
414.33 	that must be compounded by the pharmacist shall be $8 $10.48 per bag, $14 per bag for 
414.34 	cancer chemotherapy products, and $30 per bag for total parenteral nutritional products 
415.1 	dispensed in one liter quantities, or $44 per bag for total parenteral nutritional products 
415.2 	dispensed in quantities greater than one liter.  The professional dispensing fee for 
415.3 	prescriptions filled with over-the-counter drugs meeting the definition of covered outpatient 
415.4 	drugs shall be $10.48 for dispensed quantities equal to or greater than the number of units 
415.5 	contained in the manufacturer's original package. The professional dispensing fee shall be 
415.6 	prorated based on the percentage of the package dispensed when the pharmacy dispenses 
415.7 	a quantity less than the number of units contained in the manufacturer's original package. 
415.8 	The pharmacy dispensing fee for prescribed over-the-counter drugs not meeting the definition 
415.9 	of covered outpatient drugs shall be $3.65, except that the fee shall be $1.31 for 
415.10 	retrospectively billing pharmacies when billing for quantities less than the number of units 
415.11 	contained in the manufacturer's original package. Actual acquisition cost includes quantity 
415.12 	and other special discounts except time and cash discounts. The actual acquisition cost of 
415.13 	a drug shall be estimated by the commissioner at wholesale acquisition cost plus four percent 
415.14 	for independently owned pharmacies located in a designated rural area within Minnesota, 
415.15 	and at wholesale acquisition cost plus two percent for all other pharmacies. A pharmacy is 
415.16 	"independently owned" if it is one of four or fewer pharmacies under the same ownership 
415.17 	nationally. A "designated rural area" means an area defined as a small rural area or isolated 
415.18 	rural area according to the four-category classification of the Rural Urban Commuting Area 
415.19 	system developed for the United States Health Resources and Services Administration. 
415.20 	Effective January 1, 2014, the actual acquisition for quantities equal to or greater than the 
415.21 	number of units contained in the manufacturer's original package and shall be prorated based 
415.22 	on the percentage of the package dispensed when the pharmacy dispenses a quantity less 
415.23 	than the number of units contained in the manufacturer's original package. The National 
415.24 	Average Drug Acquisition Cost (NADAC) shall be used to determine the ingredient cost 
415.25 	of a drug. For drugs for which a NADAC is not reported, the commissioner shall estimate 
415.26 	the ingredient cost at the wholesale acquisition cost minus two percent. The ingredient cost 
415.27 	of a drug acquired through for a provider participating in the federal 340B Drug Pricing 
415.28 	Program shall be estimated by the commissioner at wholesale acquisition cost minus 40 
415.29 	percent either the 340B Drug Pricing Program ceiling price established by the Health 
415.30 	Resources and Services Administration or NADAC, whichever is lower. Wholesale 
415.31 	acquisition cost is defined as the manufacturer's list price for a drug or biological to 
415.32 	wholesalers or direct purchasers in the United States, not including prompt pay or other 
415.33 	discounts, rebates, or reductions in price, for the most recent month for which information 
415.34 	is available, as reported in wholesale price guides or other publications of drug or biological 
415.35 	pricing data. The maximum allowable cost of a multisource drug may be set by the 
415.36 	commissioner and it shall be comparable to, but the actual acquisition cost of the drug 
416.1 	product and no higher than, the maximum amount paid by other third-party payors in this 
416.2 	state who have maximum allowable cost programs the NADAC of the generic product. 
416.3 	Establishment of the amount of payment for drugs shall not be subject to the requirements 
416.4 	of the Administrative Procedure Act.
416.5 	(b) Pharmacies dispensing prescriptions to residents of long-term care facilities using 
416.6 	an automated drug distribution system meeting the requirements of section 151.58, or a 
416.7 	packaging system meeting the packaging standards set forth in Minnesota Rules, part 
416.8 	6800.2700, that govern the return of unused drugs to the pharmacy for reuse, may employ 
416.9 	retrospective billing for prescription drugs dispensed to long-term care facility residents. A 
416.10 	retrospectively billing pharmacy must submit a claim only for the quantity of medication 
416.11 	used by the enrolled recipient during the defined billing period. A retrospectively billing 
416.12 	pharmacy must use a billing period not less than one calendar month or 30 days.
416.13 	(c) An additional dispensing fee of $.30 may be added to the dispensing fee paid to 
416.14 	pharmacists for legend drug prescriptions dispensed to residents of long-term care facilities 
416.15 	when a unit dose blister card system, approved by the department, is used. Under this type 
416.16 	of dispensing system, the pharmacist must dispense a 30-day supply of drug. The National 
416.17 	Drug Code (NDC) from the drug container used to fill the blister card must be identified 
416.18 	on the claim to the department. The unit dose blister card containing the drug must meet 
416.19 	the packaging standards set forth in Minnesota Rules, part 6800.2700, that govern the return 
416.20 	of unused drugs to the pharmacy for reuse. A pharmacy provider using packaging that meets 
416.21 	the standards set forth in Minnesota Rules, part 6800.2700, is required to credit the 
416.22 	department for the actual acquisition cost of all unused drugs that are eligible for reuse, 
416.23 	unless the pharmacy is using retrospective billing. The commissioner may permit the drug 
416.24 	clozapine to be dispensed in a quantity that is less than a 30-day supply.
416.25 	(d) Whenever a maximum allowable cost has been set for If a pharmacy dispenses a 
416.26 	multisource drug, payment shall be the lower of the usual and customary price charged to 
416.27 	the public or the ingredient cost shall be the NADAC of the generic product or the maximum 
416.28 	allowable cost established by the commissioner unless prior authorization for the brand 
416.29 	name product has been granted according to the criteria established by the Drug Formulary 
416.30 	Committee as required by subdivision 13f, paragraph (a), and the prescriber has indicated 
416.31 	"dispense as written" on the prescription in a manner consistent with section 151.21, 
416.32 	subdivision 2.
416.33 	(e) The basis for determining the amount of payment for drugs administered in an 
416.34 	outpatient setting shall be the lower of the usual and customary cost submitted by the 
416.35 	provider, 106 percent of the average sales price as determined by the United States 
417.1 	Department of Health and Human Services pursuant to title XVIII, section 1847a of the 
417.2 	federal Social Security Act, the specialty pharmacy rate, or the maximum allowable cost 
417.3 	set by the commissioner. If average sales price is unavailable, the amount of payment must 
417.4 	be lower of the usual and customary cost submitted by the provider, the wholesale acquisition 
417.5 	cost, the specialty pharmacy rate, or the maximum allowable cost set by the commissioner. 
417.6 	Effective January 1, 2014, The commissioner shall discount the payment rate for drugs 
417.7 	obtained through the federal 340B Drug Pricing Program by 20 28.6 percent. The payment 
417.8 	for drugs administered in an outpatient setting shall be made to the administering facility 
417.9 	or practitioner. A retail or specialty pharmacy dispensing a drug for administration in an 
417.10 	outpatient setting is not eligible for direct reimbursement.
417.11 	(f) The commissioner may negotiate lower reimbursement establish maximum allowable 
417.12 	cost rates for specialty pharmacy products than the rates that are lower than the ingredient 
417.13 	cost formulas specified in paragraph (a). The commissioner may require individuals enrolled 
417.14 	in the health care programs administered by the department to obtain specialty pharmacy 
417.15 	products from providers with whom the commissioner has negotiated lower reimbursement 
417.16 	rates. Specialty pharmacy products are defined as those used by a small number of recipients 
417.17 	or recipients with complex and chronic diseases that require expensive and challenging drug 
417.18 	regimens. Examples of these conditions include, but are not limited to: multiple sclerosis, 
417.19 	HIV/AIDS, transplantation, hepatitis C, growth hormone deficiency, Crohn's Disease, 
417.20 	rheumatoid arthritis, and certain forms of cancer. Specialty pharmaceutical products include 
417.21 	injectable and infusion therapies, biotechnology drugs, antihemophilic factor products, 
417.22 	high-cost therapies, and therapies that require complex care. The commissioner shall consult 
417.23 	with the Formulary Committee to develop a list of specialty pharmacy products subject to 
417.24 	this paragraph maximum allowable cost reimbursement. In consulting with the Formulary 
417.25 	Committee in developing this list, the commissioner shall take into consideration the 
417.26 	population served by specialty pharmacy products, the current delivery system and standard 
417.27 	of care in the state, and access to care issues. The commissioner shall have the discretion 
417.28 	to adjust the reimbursement rate maximum allowable cost to prevent access to care issues.
417.29 	(g) Home infusion therapy services provided by home infusion therapy pharmacies must 
417.30 	be paid at rates according to subdivision 8d.
417.31 	(h) The commissioner shall contract with a vendor to conduct a cost of dispensing survey 
417.32 	for all pharmacies that are physically located in the state of Minnesota that dispense outpatient 
417.33 	drugs under medical assistance. The commissioner shall ensure that the vendor has prior 
417.34 	experience in conducting cost of dispensing surveys. Each pharmacy enrolled with the 
417.35 	department to dispense outpatient prescription drugs to fee-for-service members must 
418.1 	respond to the cost of dispensing survey. The commissioner may sanction a pharmacy under 
418.2 	section 256B.064 for failure to respond. The commissioner shall require the vendor to 
418.3 	measure a single statewide cost of dispensing for all responding pharmacies to measure the 
418.4 	mean, mean weighted by total prescription volume, mean weighted by medical assistance 
418.5 	prescription volume, median, median weighted by total prescription volume, and median 
418.6 	weighted by total medical assistance prescription volume. The commissioner shall post a 
418.7 	copy of the final cost of dispensing survey report on the department's website. The initial 
418.8 	survey must be completed no later than January 1, 2021, and repeated every three years. 
418.9 	The commissioner shall provide a summary of the results of each cost of dispensing survey 
418.10 	and provide recommendations for any changes to the dispensing fee to the chairs and ranking 
418.11 	members of the legislative committees with jurisdiction over medical assistance pharmacy 
418.12 	reimbursement.
418.13 	(i) The commissioner shall increase the ingredient cost reimbursement calculated in 
418.14 	paragraphs (a) and (f) by 1.8 percent for prescription and nonprescription drugs subject to 
418.15 	the wholesale drug distributor tax under section 295.52.

418.16 	EFFECTIVE DATE. This section is effective July 1, 2019, or upon federal approval, 
418.17 	whichever is later. Paragraph (i) expires if federal approval is denied. The commissioner 
418.18 	of human services shall inform the revisor of statutes when federal approval is obtained or 
418.19 	denied.

418.20 	Sec. 26. Minnesota Statutes 2018, section 256B.0625, subdivision 13f, is amended to read:
418.21 		Subd. 13f.Prior authorization. (a) The Formulary Committee shall review and 
418.22 	recommend drugs which require prior authorization. The Formulary Committee shall 
418.23 	establish general criteria to be used for the prior authorization of brand-name drugs for 
418.24 	which generically equivalent drugs are available, but the committee is not required to review 
418.25 	each brand-name drug for which a generically equivalent drug is available.
418.26 	(b) Prior authorization may be required by the commissioner before certain formulary 
418.27 	drugs are eligible for payment. The Formulary Committee may recommend drugs for prior 
418.28 	authorization directly to the commissioner. The commissioner may also request that the 
418.29 	Formulary Committee review a drug for prior authorization. Before the commissioner may 
418.30 	require prior authorization for a drug:
418.31 	(1) the commissioner must provide information to the Formulary Committee on the 
418.32 	impact that placing the drug on prior authorization may have on the quality of patient care 
418.33 	and on program costs, information regarding whether the drug is subject to clinical abuse 
418.34 	or misuse, and relevant data from the state Medicaid program if such data is available;
419.1 	(2) the Formulary Committee must review the drug, taking into account medical and 
419.2 	clinical data and the information provided by the commissioner; and
419.3 	(3) the Formulary Committee must hold a public forum and receive public comment for 
419.4 	an additional 15 days.
419.5 	The commissioner must provide a 15-day notice period before implementing the prior 
419.6 	authorization.
419.7 	(c) Except as provided in subdivision 13j, prior authorization shall not be required or 
419.8 	utilized for any atypical antipsychotic drug prescribed for the treatment of mental illness 
419.9 	if:
419.10 	(1) there is no generically equivalent drug available; and
419.11 	(2) the drug was initially prescribed for the recipient prior to July 1, 2003; or
419.12 	(3) the drug is part of the recipient's current course of treatment.
419.13 	This paragraph applies to any multistate preferred drug list or supplemental drug rebate 
419.14 	program established or administered by the commissioner. Prior authorization shall 
419.15 	automatically be granted for 60 days for brand name drugs prescribed for treatment of mental 
419.16 	illness within 60 days of when a generically equivalent drug becomes available, provided 
419.17 	that the brand name drug was part of the recipient's course of treatment at the time the 
419.18 	generically equivalent drug became available.
419.19 	(d) Prior authorization shall not be required or utilized for any antihemophilic factor 
419.20 	drug prescribed for the treatment of hemophilia and blood disorders where there is no 
419.21 	generically equivalent drug available if the prior authorization is used in conjunction with 
419.22 	any supplemental drug rebate program or multistate preferred drug list established or 
419.23 	administered by the commissioner.
419.24 	(e) (d) The commissioner may require prior authorization for brand name drugs whenever 
419.25 	a generically equivalent product is available, even if the prescriber specifically indicates 
419.26 	"dispense as written-brand necessary" on the prescription as required by section 151.21, 
419.27 	subdivision 2.
419.28 	(f) (e) Notwithstanding this subdivision, the commissioner may automatically require 
419.29 	prior authorization, for a period not to exceed 180 days, for any drug that is approved by 
419.30 	the United States Food and Drug Administration on or after July 1, 2005. The 180-day 
419.31 	period begins no later than the first day that a drug is available for shipment to pharmacies 
419.32 	within the state. The Formulary Committee shall recommend to the commissioner general 
419.33 	criteria to be used for the prior authorization of the drugs, but the committee is not required 
420.1 	to review each individual drug. In order to continue prior authorizations for a drug after the 
420.2 	180-day period has expired, the commissioner must follow the provisions of this subdivision.
420.3 	(f) Prior authorization under this subdivision shall comply with section 62Q.184.

420.4 	EFFECTIVE DATE. This section is effective the day following final enactment, except 
420.5 	that paragraph (f) is effective July 1, 2019.

420.6 	Sec. 27. Minnesota Statutes 2018, section 256B.0625, subdivision 17, is amended to read:
420.7 		Subd. 17.Transportation costs. (a) "Nonemergency medical transportation service" 
420.8 	means motor vehicle transportation provided by a public or private person that serves 
420.9 	Minnesota health care program beneficiaries who do not require emergency ambulance 
420.10 	service, as defined in section 144E.001, subdivision 3, to obtain covered medical services.
420.11 	(b) Medical assistance covers medical transportation costs incurred solely for obtaining 
420.12 	emergency medical care or transportation costs incurred by eligible persons in obtaining 
420.13 	emergency or nonemergency medical care when paid directly to an ambulance company, 
420.14 	nonemergency medical transportation company, or other recognized providers of 
420.15 	transportation services. Medical transportation must be provided by:
420.16 	(1) nonemergency medical transportation providers who meet the requirements of this 
420.17 	subdivision;
420.18 	(2) ambulances, as defined in section 144E.001, subdivision 2;
420.19 	(3) taxicabs that meet the requirements of this subdivision;
420.20 	(4) public transit, as defined in section 174.22, subdivision 7; or
420.21 	(5) not-for-hire vehicles, including volunteer drivers.
420.22 	(c) Medical assistance covers nonemergency medical transportation provided by 
420.23 	nonemergency medical transportation providers enrolled in the Minnesota health care 
420.24 	programs. All nonemergency medical transportation providers must comply with the 
420.25 	operating standards for special transportation service as defined in sections 174.29 to 174.30 
420.26 	and Minnesota Rules, chapter 8840, and in consultation with the Minnesota Department of 
420.27 	Transportation all drivers must be individually enrolled with the commissioner and reported 
420.28 	on the claim as the individual who provided the service. All nonemergency medical 
420.29 	transportation providers shall bill for nonemergency medical transportation services in 
420.30 	accordance with Minnesota health care programs criteria. Publicly operated transit systems, 
420.31 	volunteers, and not-for-hire vehicles are exempt from the requirements outlined in this 
420.32 	paragraph.
421.1 	(d) An organization may be terminated, denied, or suspended from enrollment if:
421.2 	(1) the provider has not initiated background studies on the individuals specified in 
421.3 	section 174.30, subdivision 10, paragraph (a), clauses (1) to (3); or
421.4 	(2) the provider has initiated background studies on the individuals specified in section 
421.5 	174.30, subdivision 10, paragraph (a), clauses (1) to (3), and:
421.6 	(i) the commissioner has sent the provider a notice that the individual has been 
421.7 	disqualified under section 245C.14; and
421.8 	(ii) the individual has not received a disqualification set-aside specific to the special 
421.9 	transportation services provider under sections 245C.22 and 245C.23.
421.10 	(e) The administrative agency of nonemergency medical transportation must:
421.11 	(1) adhere to the policies defined by the commissioner in consultation with the 
421.12 	Nonemergency Medical Transportation Advisory Committee;
421.13 	(2) pay nonemergency medical transportation providers for services provided to 
421.14 	Minnesota health care programs beneficiaries to obtain covered medical services;
421.15 	(3) provide data monthly to the commissioner on appeals, complaints, no-shows, canceled 
421.16 	trips, and number of trips by mode; and
421.17 	(4) by July 1, 2016, in accordance with subdivision 18e, utilize a web-based single 
421.18 	administrative structure assessment tool that meets the technical requirements established 
421.19 	by the commissioner, reconciles trip information with claims being submitted by providers, 
421.20 	and ensures prompt payment for nonemergency medical transportation services.
421.21 	(f) Until the commissioner implements the single administrative structure and delivery 
421.22 	system under subdivision 18e, clients shall obtain their level-of-service certificate from the 
421.23 	commissioner or an entity approved by the commissioner that does not dispatch rides for 
421.24 	clients using modes of transportation under paragraph (i), clauses (4), (5), (6), and (7).
421.25 	(g) The commissioner may use an order by the recipient's attending physician or a medical 
421.26 	or mental health professional to certify that the recipient requires nonemergency medical 
421.27 	transportation services. Nonemergency medical transportation providers shall perform 
421.28 	driver-assisted services for eligible individuals, when appropriate. Driver-assisted service 
421.29 	includes passenger pickup at and return to the individual's residence or place of business, 
421.30 	assistance with admittance of the individual to the medical facility, and assistance in 
421.31 	passenger securement or in securing of wheelchairs, child seats, or stretchers in the vehicle.
422.1 	Nonemergency medical transportation providers must take clients to the health care 
422.2 	provider using the most direct route, and must not exceed 30 miles for a trip to a primary 
422.3 	care provider or 60 miles for a trip to a specialty care provider, unless the client receives 
422.4 	authorization from the local agency.
422.5 	Nonemergency medical transportation providers may not bill for separate base rates for 
422.6 	the continuation of a trip beyond the original destination. Nonemergency medical 
422.7 	transportation providers must maintain trip logs, which include pickup and drop-off times, 
422.8 	signed by the medical provider or client, whichever is deemed most appropriate, attesting 
422.9 	to mileage traveled to obtain covered medical services. Clients requesting client mileage 
422.10 	reimbursement must sign the trip log attesting mileage traveled to obtain covered medical 
422.11 	services.
422.12 	(h) The administrative agency shall use the level of service process established by the 
422.13 	commissioner in consultation with the Nonemergency Medical Transportation Advisory 
422.14 	Committee to determine the client's most appropriate mode of transportation. If public transit 
422.15 	or a certified transportation provider is not available to provide the appropriate service mode 
422.16 	for the client, the client may receive a onetime service upgrade.
422.17 	(i) The covered modes of transportation are:
422.18 	(1) client reimbursement, which includes client mileage reimbursement provided to 
422.19 	clients who have their own transportation, or to family or an acquaintance who provides 
422.20 	transportation to the client;
422.21 	(2) volunteer transport, which includes transportation by volunteers using their own 
422.22 	vehicle;
422.23 	(3) unassisted transport, which includes transportation provided to a client by a taxicab 
422.24 	or public transit. If a taxicab or public transit is not available, the client can receive 
422.25 	transportation from another nonemergency medical transportation provider;
422.26 	(4) assisted transport, which includes transport provided to clients who require assistance 
422.27 	by a nonemergency medical transportation provider;
422.28 	(5) lift-equipped/ramp transport, which includes transport provided to a client who is 
422.29 	dependent on a device and requires a nonemergency medical transportation provider with 
422.30 	a vehicle containing a lift or ramp;
422.31 	(6) protected transport, which includes transport provided to a client who has received 
422.32 	a prescreening that has deemed other forms of transportation inappropriate and who requires 
422.33 	a provider: (i) with a protected vehicle that is not an ambulance or police car and has safety 
423.1 	locks, a video recorder, and a transparent thermoplastic partition between the passenger and 
423.2 	the vehicle driver; and (ii) who is certified as a protected transport provider; and
423.3 	(7) stretcher transport, which includes transport for a client in a prone or supine position 
423.4 	and requires a nonemergency medical transportation provider with a vehicle that can transport 
423.5 	a client in a prone or supine position.
423.6 	(j) The local agency shall be the single administrative agency and shall administer and 
423.7 	reimburse for modes defined in paragraph (i) according to paragraphs (m) and (n) when the 
423.8 	commissioner has developed, made available, and funded the web-based single administrative 
423.9 	structure, assessment tool, and level of need assessment under subdivision 18e. The local 
423.10 	agency's financial obligation is limited to funds provided by the state or federal government.
423.11 	(k) The commissioner shall:
423.12 	(1) in consultation with the Nonemergency Medical Transportation Advisory Committee, 
423.13 	verify that the mode and use of nonemergency medical transportation is appropriate;
423.14 	(2) verify that the client is going to an approved medical appointment; and
423.15 	(3) investigate all complaints and appeals.
423.16 	(l) The administrative agency shall pay for the services provided in this subdivision and 
423.17 	seek reimbursement from the commissioner, if appropriate. As vendors of medical care, 
423.18 	local agencies are subject to the provisions in section 256B.041, the sanctions and monetary 
423.19 	recovery actions in section 256B.064, and Minnesota Rules, parts 9505.2160 to 9505.2245.
423.20 	(m) Payments for nonemergency medical transportation must be paid based on the client's 
423.21 	assessed mode under paragraph (h), not the type of vehicle used to provide the service. The 
423.22 	medical assistance reimbursement rates for nonemergency medical transportation services 
423.23 	that are payable by or on behalf of the commissioner for nonemergency medical 
423.24 	transportation services are:
423.25 	(1) $0.22 per mile for client reimbursement;
423.26 	(2) up to 100 percent of the Internal Revenue Service business deduction rate for volunteer 
423.27 	transport;
423.28 	(3) equivalent to the standard fare for unassisted transport when provided by public 
423.29 	transit, and $11 for the base rate and $1.30 per mile when provided by a nonemergency 
423.30 	medical transportation provider;
423.31 	(4) $13 for the base rate and $1.30 per mile for assisted transport;
423.32 	(5) $18 for the base rate and $1.55 per mile for lift-equipped/ramp transport;
424.1 	(6) $75 for the base rate and $2.40 per mile for protected transport; and
424.2 	(7) $60 for the base rate and $2.40 per mile for stretcher transport, and $9 per trip for 
424.3 	an additional attendant if deemed medically necessary.
424.4 	(n) The base rate for nonemergency medical transportation services in areas defined 
424.5 	under RUCA to be super rural is equal to 111.3 percent of the respective base rate in 
424.6 	paragraph (m), clauses (1) to (7). The mileage rate for nonemergency medical transportation 
424.7 	services in areas defined under RUCA to be rural or super rural areas is:
424.8 	(1) for a trip equal to 17 miles or less, equal to 125 percent of the respective mileage 
424.9 	rate in paragraph (m), clauses (1) to (7); and
424.10 	(2) for a trip between 18 and 50 miles, equal to 112.5 percent of the respective mileage 
424.11 	rate in paragraph (m), clauses (1) to (7).
424.12 	(o) For purposes of reimbursement rates for nonemergency medical transportation 
424.13 	services under paragraphs (m) and (n), the zip code of the recipient's place of residence 
424.14 	shall determine whether the urban, rural, or super rural reimbursement rate applies.
424.15 	(p) For purposes of this subdivision, "rural urban commuting area" or "RUCA" means 
424.16 	a census-tract based classification system under which a geographical area is determined 
424.17 	to be urban, rural, or super rural.
424.18 	(q) The commissioner, when determining reimbursement rates for nonemergency medical 
424.19 	transportation under paragraphs (m) and (n), shall exempt all modes of transportation listed 
424.20 	under paragraph (i) from Minnesota Rules, part 9505.0445, item R, subitem (2).

424.21 	EFFECTIVE DATE. This section is effective July 1, 2021.

424.22 	Sec. 28. Minnesota Statutes 2018, section 256B.0625, is amended by adding a subdivision 
424.23 	to read:
424.24 		Subd. 17d.Transportation services oversight. The commissioner shall contract with 
424.25 	a vendor or dedicate staff to oversee providers of nonemergency medical transportation 
424.26 	services pursuant to the commissioner's authority in section 256B.04 and Minnesota Rules, 
424.27 	parts 9505.2160 to 9505.2245.

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

425.1 	Sec. 29. Minnesota Statutes 2018, section 256B.0625, is amended by adding a subdivision 
425.2 	to read:
425.3 		Subd. 17e.Transportation provider termination. (a) A terminated nonemergency 
425.4 	medical transportation provider, including all named individuals on the current enrollment 
425.5 	disclosure form and known or discovered affiliates of the nonemergency medical 
425.6 	transportation provider, is not eligible to enroll as a nonemergency medical transportation 
425.7 	provider for five years following the termination.
425.8 	(b) After the five-year period in paragraph (a), if a provider seeks to reenroll as a 
425.9 	nonemergency medical transportation provider, the provider must be placed on a one-year 
425.10 	probation period. During a provider's probation period the commissioner shall complete 
425.11 	unannounced site visits and request documentation to review compliance with program 
425.12 	requirements.

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

425.14 	Sec. 30. Minnesota Statutes 2018, section 256B.0625, subdivision 30, is amended to read:
425.15 		Subd. 30.Other clinic services. (a) Medical assistance covers rural health clinic services, 
425.16 	federally qualified health center services, nonprofit community health clinic services, and 
425.17 	public health clinic services. Rural health clinic services and federally qualified health center 
425.18 	services mean services defined in United States Code, title 42, section 1396d(a)(2)(B) and 
425.19 	(C). Payment for rural health clinic and federally qualified health center services shall be 
425.20 	made according to applicable federal law and regulation.
425.21 	(b) A federally qualified health center (FQHC) that is beginning initial operation shall 
425.22 	submit an estimate of budgeted costs and visits for the initial reporting period in the form 
425.23 	and detail required by the commissioner. A federally qualified health center An FQHC that 
425.24 	is already in operation shall submit an initial report using actual costs and visits for the 
425.25 	initial reporting period. Within 90 days of the end of its reporting period, a federally qualified 
425.26 	health center an FQHC shall submit, in the form and detail required by the commissioner, 
425.27 	a report of its operations, including allowable costs actually incurred for the period and the 
425.28 	actual number of visits for services furnished during the period, and other information 
425.29 	required by the commissioner. Federally qualified health centers FQHCs that file Medicare 
425.30 	cost reports shall provide the commissioner with a copy of the most recent Medicare cost 
425.31 	report filed with the Medicare program intermediary for the reporting year which support 
425.32 	the costs claimed on their cost report to the state.
426.1 	(c) In order to continue cost-based payment under the medical assistance program 
426.2 	according to paragraphs (a) and (b), a federally qualified health center an FQHC or rural 
426.3 	health clinic must apply for designation as an essential community provider within six 
426.4 	months of final adoption of rules by the Department of Health according to section 62Q.19, 
426.5 	subdivision 7. For those federally qualified health centers FQHCs and rural health clinics 
426.6 	that have applied for essential community provider status within the six-month time 
426.7 	prescribed, medical assistance payments will continue to be made according to paragraphs 
426.8 	(a) and (b) for the first three years after application. For federally qualified health centers
426.9 	FQHCs and rural health clinics that either do not apply within the time specified above or 
426.10 	who have had essential community provider status for three years, medical assistance 
426.11 	payments for health services provided by these entities shall be according to the same rates 
426.12 	and conditions applicable to the same service provided by health care providers that are not 
426.13 	federally qualified health centers FQHCs or rural health clinics.
426.14 	(d) Effective July 1, 1999, the provisions of paragraph (c) requiring a federally qualified 
426.15 	health center an FQHC or a rural health clinic to make application for an essential community 
426.16 	provider designation in order to have cost-based payments made according to paragraphs 
426.17 	(a) and (b) no longer apply.
426.18 	(e) Effective January 1, 2000, payments made according to paragraphs (a) and (b) shall 
426.19 	be limited to the cost phase-out schedule of the Balanced Budget Act of 1997.
426.20 	(f) Effective January 1, 2001, through December 31, 2020, each federally qualified 
426.21 	health center FQHC and rural health clinic may elect to be paid either under the prospective 
426.22 	payment system established in United States Code, title 42, section 1396a(aa), or under an 
426.23 	alternative payment methodology consistent with the requirements of United States Code, 
426.24 	title 42, section 1396a(aa), and approved by the Centers for Medicare and Medicaid Services. 
426.25 	The alternative payment methodology shall be 100 percent of cost as determined according 
426.26 	to Medicare cost principles.
426.27 	(g) Effective for services provided on or after January 1, 2021, all claims for payment 
426.28 	of clinic services provided by FQHCs and rural health clinics shall be paid by the 
426.29 	commissioner, according to an annual election by the FQHC or rural health clinic, under 
426.30 	the current prospective payment system described in paragraph (f) or the alternative payment 
426.31 	methodology described in paragraph (l).
426.32 	(h) For purposes of this section, "nonprofit community clinic" is a clinic that:
426.33 	(1) has nonprofit status as specified in chapter 317A;
426.34 	(2) has tax exempt status as provided in Internal Revenue Code, section 501(c)(3);
427.1 	(3) is established to provide health services to low-income population groups, uninsured, 
427.2 	high-risk and special needs populations, underserved and other special needs populations;
427.3 	(4) employs professional staff at least one-half of which are familiar with the cultural 
427.4 	background of their clients;
427.5 	(5) charges for services on a sliding fee scale designed to provide assistance to 
427.6 	low-income clients based on current poverty income guidelines and family size; and
427.7 	(6) does not restrict access or services because of a client's financial limitations or public 
427.8 	assistance status and provides no-cost care as needed.
427.9 	(h) (i) Effective for services provided on or after January 1, 2015, all claims for payment 
427.10 	of clinic services provided by federally qualified health centers FQHCs and rural health 
427.11 	clinics shall be paid by the commissioner. the commissioner shall determine the most feasible 
427.12 	method for paying claims from the following options:
427.13 	(1) federally qualified health centers FQHCs and rural health clinics submit claims 
427.14 	directly to the commissioner for payment, and the commissioner provides claims information 
427.15 	for recipients enrolled in a managed care or county-based purchasing plan to the plan, on 
427.16 	a regular basis; or
427.17 	(2) federally qualified health centers FQHCs and rural health clinics submit claims for 
427.18 	recipients enrolled in a managed care or county-based purchasing plan to the plan, and those 
427.19 	claims are submitted by the plan to the commissioner for payment to the clinic.
427.20 	(i) (j) For clinic services provided prior to January 1, 2015, the commissioner shall 
427.21 	calculate and pay monthly the proposed managed care supplemental payments to clinics, 
427.22 	and clinics shall conduct a timely review of the payment calculation data in order to finalize 
427.23 	all supplemental payments in accordance with federal law. Any issues arising from a clinic's 
427.24 	review must be reported to the commissioner by January 1, 2017. Upon final agreement 
427.25 	between the commissioner and a clinic on issues identified under this subdivision, and in 
427.26 	accordance with United States Code, title 42, section 1396a(bb), no supplemental payments 
427.27 	for managed care plan or county-based purchasing plan claims for services provided prior 
427.28 	to January 1, 2015, shall be made after June 30, 2017. If the commissioner and clinics are 
427.29 	unable to resolve issues under this subdivision, the parties shall submit the dispute to the 
427.30 	arbitration process under section 14.57.
427.31 	(j) (k) The commissioner shall seek a federal waiver, authorized under section 1115 of 
427.32 	the Social Security Act, to obtain federal financial participation at the 100 percent federal 
427.33 	matching percentage available to facilities of the Indian Health Service or tribal organization 
428.1 	in accordance with section 1905(b) of the Social Security Act for expenditures made to 
428.2 	organizations dually certified under Title V of the Indian Health Care Improvement Act, 
428.3 	Public Law 94-437, and as a federally qualified health center under paragraph (a) that 
428.4 	provides services to American Indian and Alaskan Native individuals eligible for services 
428.5 	under this subdivision.
428.6 	(l) All claims for payment of clinic services provided by FQHCs and rural health clinics, 
428.7 	that have elected to be paid under this paragraph, shall be paid by the commissioner according 
428.8 	to the following requirements:
428.9 	(1) the commissioner shall establish a single medical and single dental organization 
428.10 	encounter rate for each FQHC and rural health clinic when applicable;
428.11 	(2) each FQHC and rural health clinic is eligible for same day reimbursement of one 
428.12 	medical and one dental organization encounter rate if eligible medical and dental visits are 
428.13 	provided on the same day;
428.14 	(3) the commissioner shall reimburse FQHCs and rural health clinics, in accordance 
428.15 	with current applicable Medicare cost principles, their allowable costs, including direct 
428.16 	patient care costs and patient-related support services. Nonallowable costs include, but are 
428.17 	not limited to:
428.18 	(i) general social services and administrative costs;
428.19 	(ii) retail pharmacy;
428.20 	(iii) patient incentives, food, housing assistance, and utility assistance;
428.21 	(iv) external lab and x-ray;
428.22 	(v) navigation services;
428.23 	(vi) health care taxes;
428.24 	(vii) advertising, public relations, and marketing;
428.25 	(viii) office entertainment costs, food, alcohol, and gifts;
428.26 	(ix) contributions and donations;
428.27 	(x) bad debts or losses on awards or contracts;
428.28 	(xi) fines, penalties, damages, or other settlements;
428.29 	(xii) fund-raising, investment management, and associated administrative costs;
428.30 	(xiii) research and associated administrative costs;
429.1 	(xiv) nonpaid workers;
429.2 	(xv) lobbying;
429.3 	(xvi) scholarships and student aid; and
429.4 	(xvii) nonmedical assistance covered services;
429.5 	(4) the commissioner shall review the list of nonallowable costs in the years between 
429.6 	the rebasing process established in clause (5), in consultation with the Minnesota Association 
429.7 	of Community Health Centers, FQHCs, and rural health clinics. The commissioner shall 
429.8 	publish the list and any updates in the Minnesota health care programs provider manual;
429.9 	(5) the initial applicable base year organization encounter rates for FQHCs and rural 
429.10 	health clinics shall be computed for services delivered on or after January 1, 2021, and:
429.11 	(i) must be determined using each FQHC's and rural health clinic's Medicare cost reports 
429.12 	from 2017 and 2018;
429.13 	(ii) must be according to current applicable Medicare cost principles as applicable to 
429.14 	FQHCs and rural health clinics without the application of productivity screens and upper 
429.15 	payment limits or the Medicare prospective payment system FQHC aggregate mean upper 
429.16 	payment limit;
429.17 	(iii) must be subsequently rebased every two years thereafter using the Medicare cost 
429.18 	reports that are three and four years prior to the rebasing year;
429.19 	(iv) must be inflated to the base year using the inflation factor described in clause (6); 
429.20 	and
429.21 	(v) the commissioner must provide for a 60-day appeals process under section 14.57;
429.22 	(6) the commissioner shall annually inflate the applicable organization encounter rates 
429.23 	for FQHCs and rural health clinics from the base year payment rate to the effective date by 
429.24 	using the CMS FQHC Market Basket inflator established under United States Code, title 
429.25 	42, section 1395m(o), less productivity;
429.26 	(7) FQHCs and rural health clinics that have elected the alternative payment methodology 
429.27 	under this paragraph shall submit all necessary documentation required by the commissioner 
429.28 	to compute the rebased organization encounter rates no later than six months following the 
429.29 	date the applicable Medicare cost reports are due to the Centers for Medicare and Medicaid 
429.30 	Services;
430.1 	(8) the commissioner shall reimburse FQHCs and rural health clinics an additional 
430.2 	amount relative to their medical and dental organization encounter rates that is attributable 
430.3 	to the tax required to be paid according to section 295.52, if applicable;
430.4 	(9) FQHCs and rural health clinics may submit change of scope requests to the 
430.5 	commissioner if the change of scope would result in an increase or decrease of 2.5 percent 
430.6 	or higher in the medical or dental organization encounter rate currently received by the 
430.7 	FQHC or rural health clinic;
430.8 	(10) For FQHCs and rural health clinics seeking a change in scope with the commissioner 
430.9 	under clause (9) that requires the approval of the scope change by the federal Health 
430.10 	Resources Services Administration:
430.11 	(i) FQHCs and rural health clinics shall submit the change of scope request, including 
430.12 	the start date of services, to the commissioner within seven business days of submission of 
430.13 	the scope change to the federal Health Resources Services Administration;
430.14 	(ii) the commissioner shall establish the effective date of the payment change as the 
430.15 	federal Health Resources Services Administration date of approval of the FQHC's or rural 
430.16 	health clinic's scope change request, or the effective start date of services, whichever is 
430.17 	later; and
430.18 	(iii) within 45 days of one year after the effective date established in item (ii), the 
430.19 	commissioner shall conduct a retroactive review to determine if the actual costs established 
430.20 	under clause (3) or encounters result in an increase or decrease of 2.5 percent or higher in 
430.21 	the medical or dental organization encounter rate, and if this is the case, the commissioner 
430.22 	shall revise the rate accordingly and shall adjust payments retrospectively to the effective 
430.23 	date established in item (ii);
430.24 	(11) for change of scope requests that do not require federal Health Resources Services 
430.25 	Administration approval, the FQHC and rural health clinic shall submit the request to the 
430.26 	commissioner before implementing the change, and the effective date of the change is the 
430.27 	date the commissioner received the FQHC's or rural health clinic's request, or the effective 
430.28 	start date of the service, whichever is later. The commissioner shall provide a response to 
430.29 	the FQHC's or rural health clinic's request within 45 days of submission and provide a final 
430.30 	approval within 120 days of submission. This timeline may be waived at the mutual 
430.31 	agreement of the commissioner and the FQHC or rural health clinic if more information is 
430.32 	needed to evaluate the request;
430.33 	(12) the commissioner, when establishing organization encounter rates for new FQHCs 
430.34 	and rural health clinics, shall consider the patient caseload of existing FQHCs and rural 
431.1 	health clinics in a 60-mile radius for organizations established outside of the seven-county 
431.2 	metropolitan area, and in a 30-mile radius for organizations in the seven-county metropolitan 
431.3 	area. If this information is not available, the commissioner may use Medicare cost reports 
431.4 	or audited financial statements to establish base rate;
431.5 	(13) the commissioner shall establish a quality measures workgroup that includes 
431.6 	representatives from the Minnesota Association of Community Health Centers, FQHCs, 
431.7 	and rural health clinics, to evaluate clinical and nonclinical measures; and
431.8 	(14) the commissioner shall not disallow or reduce costs that are related to an FQHC's 
431.9 	or rural health clinic's participation in health care educational programs to the extent that 
431.10 	the costs are not accounted for in the alternative payment methodology encounter rate 
431.11 	established in this paragraph.

431.12 	Sec. 31. Minnesota Statutes 2018, section 256B.0625, subdivision 57, is amended to read:
431.13 		Subd. 57.Payment for Part B Medicare crossover claims. (a) Effective for services 
431.14 	provided on or after January 1, 2012, medical assistance payment for an enrollee's 
431.15 	cost-sharing associated with Medicare Part B is limited to an amount up to the medical 
431.16 	assistance total allowed, when the medical assistance rate exceeds the amount paid by 
431.17 	Medicare.
431.18 	(b) Excluded from this limitation are payments for mental health services and payments 
431.19 	for dialysis services provided to end-stage renal disease patients. The exclusion for mental 
431.20 	health services does not apply to payments for physician services provided by psychiatrists 
431.21 	and advanced practice nurses with a specialty in mental health.
431.22 	(c) Excluded from this limitation are payments to federally qualified health centers, 
431.23 	Indian Health Services, and rural health clinics.

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

431.25 	Sec. 32. Minnesota Statutes 2018, section 256B.064, subdivision 1a, is amended to read:
431.26 		Subd. 1a.Grounds for sanctions against vendors. (a) The commissioner may impose 
431.27 	sanctions against a vendor of medical care for any of the following: (1) fraud, theft, or abuse 
431.28 	in connection with the provision of medical care to recipients of public assistance; (2) a 
431.29 	pattern of presentment of false or duplicate claims or claims for services not medically 
431.30 	necessary; (3) a pattern of making false statements of material facts for the purpose of 
431.31 	obtaining greater compensation than that to which the vendor is legally entitled; (4) 
431.32 	suspension or termination as a Medicare vendor; (5) refusal to grant the state agency access 
432.1 	during regular business hours to examine all records necessary to disclose the extent of 
432.2 	services provided to program recipients and appropriateness of claims for payment; (6) 
432.3 	failure to repay an overpayment or a fine finally established under this section; (7) failure 
432.4 	to correct errors in the maintenance of health service or financial records for which a fine 
432.5 	was imposed or after issuance of a warning by the commissioner; and (8) any reason for 
432.6 	which a vendor could be excluded from participation in the Medicare program under section 
432.7 	1128, 1128A, or 1866(b)(2) of the Social Security Act.
432.8 	(b) The commissioner may impose sanctions against a pharmacy provider for failure to 
432.9 	respond to a cost of dispensing survey under section 256B.0625, subdivision 13e, paragraph 
432.10 	(h).

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

432.12 	Sec. 33. Minnesota Statutes 2018, section 256B.0659, subdivision 21, is amended to read:
432.13 		Subd. 21.Requirements for provider enrollment of personal care assistance provider 
432.14 	agencies. (a) All personal care assistance provider agencies must provide, at the time of 
432.15 	enrollment, reenrollment, and revalidation as a personal care assistance provider agency in 
432.16 	a format determined by the commissioner, information and documentation that includes, 
432.17 	but is not limited to, the following:
432.18 	(1) the personal care assistance provider agency's current contact information including 
432.19 	address, telephone number, and e-mail address;
432.20 	(2) proof of surety bond coverage for each business location providing services. Upon 
432.21 	new enrollment, or if the provider's Medicaid revenue in the previous calendar year is up 
432.22 	to and including $300,000, the provider agency must purchase a surety bond of $50,000. If 
432.23 	the Medicaid revenue in the previous year is over $300,000, the provider agency must 
432.24 	purchase a surety bond of $100,000. The surety bond must be in a form approved by the 
432.25 	commissioner, must be renewed annually, and must allow for recovery of costs and fees in 
432.26 	pursuing a claim on the bond;
432.27 	(3) proof of fidelity bond coverage in the amount of $20,000 for each business location 
432.28 	providing service;
432.29 	(4) proof of workers' compensation insurance coverage identifying the business location 
432.30 	where personal care assistance services are provided;
432.31 	(5) proof of liability insurance coverage identifying the business location where personal 
432.32 	care assistance services are provided and naming the department as a certificate holder;
433.1 	(6) a description of the personal care assistance provider agency's organization identifying 
433.2 	the names of all owners, managing employees, staff, board of directors, and the affiliations 
433.3 	of the directors, owners, or staff to other service providers;
433.4 	(7) (6) a copy of the personal care assistance provider agency's written policies and 
433.5 	procedures including: hiring of employees; training requirements; service delivery; and 
433.6 	employee and consumer safety including process for notification and resolution of consumer 
433.7 	grievances, identification and prevention of communicable diseases, and employee 
433.8 	misconduct;
433.9 	(8) (7) copies of all other forms the personal care assistance provider agency uses in the 
433.10 	course of daily business including, but not limited to:
433.11 	(i) a copy of the personal care assistance provider agency's time sheet if the time sheet 
433.12 	varies from the standard time sheet for personal care assistance services approved by the 
433.13 	commissioner, and a letter requesting approval of the personal care assistance provider 
433.14 	agency's nonstandard time sheet;
433.15 	(ii) the personal care assistance provider agency's template for the personal care assistance 
433.16 	care plan; and
433.17 	(iii) the personal care assistance provider agency's template for the written agreement 
433.18 	in subdivision 20 for recipients using the personal care assistance choice option, if applicable;
433.19 	(9) (8) a list of all training and classes that the personal care assistance provider agency 
433.20 	requires of its staff providing personal care assistance services;
433.21 	(10) (9) documentation that the personal care assistance provider agency and staff have 
433.22 	successfully completed all the training required by this section;
433.23 	(11) (10) documentation of the agency's marketing practices;
433.24 	(12) (11) disclosure of ownership, leasing, or management of all residential properties 
433.25 	that is used or could be used for providing home care services;
433.26 	(13) (12) documentation that the agency will use the following percentages of revenue 
433.27 	generated from the medical assistance rate paid for personal care assistance services for 
433.28 	employee personal care assistant wages and benefits: 72.5 percent of revenue in the personal 
433.29 	care assistance choice option and 72.5 percent of revenue from other personal care assistance 
433.30 	providers. The revenue generated by the qualified professional and the reasonable costs 
433.31 	associated with the qualified professional shall not be used in making this calculation; and
434.1 	(14) (13) effective May 15, 2010, documentation that the agency does not burden 
434.2 	recipients' free exercise of their right to choose service providers by requiring personal care 
434.3 	assistants to sign an agreement not to work with any particular personal care assistance 
434.4 	recipient or for another personal care assistance provider agency after leaving the agency 
434.5 	and that the agency is not taking action on any such agreements or requirements regardless 
434.6 	of the date signed.
434.7 	(b) Personal care assistance provider agencies shall provide the information specified 
434.8 	in paragraph (a) to the commissioner at the time the personal care assistance provider agency 
434.9 	enrolls as a vendor or upon request from the commissioner. The commissioner shall collect 
434.10 	the information specified in paragraph (a) from all personal care assistance providers 
434.11 	beginning July 1, 2009.
434.12 	(c) All personal care assistance provider agencies shall require all employees in 
434.13 	management and supervisory positions and owners of the agency who are active in the 
434.14 	day-to-day management and operations of the agency to complete mandatory training as 
434.15 	determined by the commissioner before submitting an application for enrollment of the 
434.16 	agency as a provider. All personal care assistance provider agencies shall also require 
434.17 	qualified professionals to complete the training required by subdivision 13 before submitting 
434.18 	an application for enrollment of the agency as a provider. Employees in management and 
434.19 	supervisory positions and owners who are active in the day-to-day operations of an agency 
434.20 	who have completed the required training as an employee with a personal care assistance 
434.21 	provider agency do not need to repeat the required training if they are hired by another 
434.22 	agency, if they have completed the training within the past three years. By September 1, 
434.23 	2010, the required training must be available with meaningful access according to title VI 
434.24 	of the Civil Rights Act and federal regulations adopted under that law or any guidance from 
434.25 	the United States Health and Human Services Department. The required training must be 
434.26 	available online or by electronic remote connection. The required training must provide for 
434.27 	competency testing. Personal care assistance provider agency billing staff shall complete 
434.28 	training about personal care assistance program financial management. This training is 
434.29 	effective July 1, 2009. Any personal care assistance provider agency enrolled before that 
434.30 	date shall, if it has not already, complete the provider training within 18 months of July 1, 
434.31 	2009. Any new owners or employees in management and supervisory positions involved 
434.32 	in the day-to-day operations are required to complete mandatory training as a requisite of 
434.33 	working for the agency. Personal care assistance provider agencies certified for participation 
434.34 	in Medicare as home health agencies are exempt from the training required in this 
435.1 	subdivision. When available, Medicare-certified home health agency owners, supervisors, 
435.2 	or managers must successfully complete the competency test.
435.3 	(d) All surety bonds, fidelity bonds, workers compensation insurance, and liability 
435.4 	insurance required by this subdivision must be maintained continuously. After initial 
435.5 	enrollment, a provider must submit proof of bonds and required coverages at any time at 
435.6 	the request of the commissioner. Services provided while there are lapses in coverage are 
435.7 	not eligible for payment. Lapses in coverage may result in sanctions, including termination. 
435.8 	The commissioner shall send instructions and a due date to submit the requested information 
435.9 	to the personal care assistance provider agency.

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

435.11 	Sec. 34. Minnesota Statutes 2018, section 256B.69, subdivision 4, is amended to read:
435.12 		Subd. 4.Limitation of choice. (a) The commissioner shall develop criteria to determine 
435.13 	when limitation of choice may be implemented in the experimental counties. The criteria 
435.14 	shall ensure that all eligible individuals in the county have continuing access to the full 
435.15 	range of medical assistance services as specified in subdivision 6.
435.16 	(b) The commissioner shall exempt the following persons from participation in the 
435.17 	project, in addition to those who do not meet the criteria for limitation of choice:
435.18 	(1) persons eligible for medical assistance according to section 256B.055, subdivision 
435.19 	1;
435.20 	(2) persons eligible for medical assistance due to blindness or disability as determined 
435.21 	by the Social Security Administration or the state medical review team, unless:
435.22 	(i) they are 65 years of age or older; or
435.23 	(ii) they reside in Itasca County or they reside in a county in which the commissioner 
435.24 	conducts a pilot project under a waiver granted pursuant to section 1115 of the Social 
435.25 	Security Act;
435.26 	(3) recipients who currently have private coverage through a health maintenance 
435.27 	organization;
435.28 	(4) recipients who are eligible for medical assistance by spending down excess income 
435.29 	for medical expenses other than the nursing facility per diem expense;
435.30 	(5) recipients who receive benefits under the Refugee Assistance Program, established 
435.31 	under United States Code, title 8, section 1522(e);
436.1 	(6) children who are both determined to be severely emotionally disturbed and receiving 
436.2 	case management services according to section 256B.0625, subdivision 20, except children 
436.3 	who are eligible for and who decline enrollment in an approved preferred integrated network 
436.4 	under section 245.4682;
436.5 	(7) adults who are both determined to be seriously and persistently mentally ill and 
436.6 	received case management services according to section 256B.0625, subdivision 20;
436.7 	(8) persons eligible for medical assistance according to section 256B.057, subdivision 
436.8 	10; and
436.9 	(9) persons with access to cost-effective employer-sponsored private health insurance 
436.10 	or persons enrolled in a non-Medicare individual health plan determined to be cost-effective 
436.11 	according to section 256B.0625, subdivision 15; and
436.12 	(10) persons who are absent from the state for more than 30 consecutive days but still 
436.13 	deemed a resident of Minnesota, identified in accordance with section 256B.056, subdivision 
436.14 	1, paragraph (b).
436.15 	Children under age 21 who are in foster placement may enroll in the project on an elective 
436.16 	basis. Individuals excluded under clauses (1), (6), and (7) may choose to enroll on an elective 
436.17 	basis. The commissioner may enroll recipients in the prepaid medical assistance program 
436.18 	for seniors who are (1) age 65 and over, and (2) eligible for medical assistance by spending 
436.19 	down excess income.
436.20 	(c) The commissioner may allow persons with a one-month spenddown who are otherwise 
436.21 	eligible to enroll to voluntarily enroll or remain enrolled, if they elect to prepay their monthly 
436.22 	spenddown to the state.
436.23 	(d) The commissioner may require those individuals to enroll in the prepaid medical 
436.24 	assistance program who otherwise would have been excluded under paragraph (b), clauses 
436.25 	(1), (3), and (8), and under Minnesota Rules, part 9500.1452, subpart 2, items H, K, and L.
436.26 	(e) Before limitation of choice is implemented, eligible individuals shall be notified and 
436.27 	after notification, shall be allowed to choose only among demonstration providers. The 
436.28 	commissioner may assign an individual with private coverage through a health maintenance 
436.29 	organization, to the same health maintenance organization for medical assistance coverage, 
436.30 	if the health maintenance organization is under contract for medical assistance in the 
436.31 	individual's county of residence. After initially choosing a provider, the recipient is allowed 
436.32 	to change that choice only at specified times as allowed by the commissioner. If a 
436.33 	demonstration provider ends participation in the project for any reason, a recipient enrolled 
437.1 	with that provider must select a new provider but may change providers without cause once 
437.2 	more within the first 60 days after enrollment with the second provider.
437.3 	(f) An infant born to a woman who is eligible for and receiving medical assistance and 
437.4 	who is enrolled in the prepaid medical assistance program shall be retroactively enrolled to 
437.5 	the month of birth in the same managed care plan as the mother once the child is enrolled 
437.6 	in medical assistance unless the child is determined to be excluded from enrollment in a 
437.7 	prepaid plan under this section.

437.8 	Sec. 35. Minnesota Statutes 2018, section 256B.69, is amended by adding a subdivision 
437.9 	to read:
437.10 		Subd. 31a.Trend limit; calculation. (a) Beginning January 1, 2020, and ending June 
437.11 	30, 2024, the commissioner of human services may, to the extent practicable, limit the year 
437.12 	over year increase in rates paid to managed care plans and county-based purchasing plans 
437.13 	under this section and section 256B.692 by an amount equal to the value of a 0.8 percent 
437.14 	reduction in rates in medical assistance across all products. Managed care rates must meet 
437.15 	actuarial soundness and rate development requirements under Code of Federal Regulations, 
437.16 	title 42, part 438, subpart A. Forecast expenditure growth assumptions cannot be part of the 
437.17 	rate-setting process.
437.18 	(b) In the November 2019 forecast, the commissioner of human services, in consultation 
437.19 	with the commissioner of management and budget, shall determine the extent to which the 
437.20 	year over year change in managed care and county-based purchasing plan rates are forecasted 
437.21 	to reduce medical assistance expenditures in fiscal years 2020 through 2024, relative to 
437.22 	projected expenditures from the end of the 2019 legislative session that establish a budget 
437.23 	for the Department of Human Services. To the extent the total value of the reduction is less 
437.24 	than $145,150,000, the commissioner of management and budget shall transfer the difference 
437.25 	from the premium security account established in section 62E.25, subdivision 1, to the 
437.26 	general fund.

437.27 	Sec. 36. [256B.758] REIMBURSEMENT FOR DOULA SERVICES.
437.28 	Effective for services provided on or after July 1, 2019, payments for doula services 
437.29 	provided by a certified doula shall be $47 per prenatal or postpartum visit and $488 for 
437.30 	attending and providing doula services at a birth.

438.1 	Sec. 37. Minnesota Statutes 2018, section 256B.766, is amended to read:
438.2 	256B.766 REIMBURSEMENT FOR BASIC CARE SERVICES.
438.3 	(a) Effective for services provided on or after July 1, 2009, total payments for basic care 
438.4 	services, shall be reduced by three percent, except that for the period July 1, 2009, through 
438.5 	June 30, 2011, total payments shall be reduced by 4.5 percent for the medical assistance 
438.6 	and general assistance medical care programs, prior to third-party liability and spenddown 
438.7 	calculation. Effective July 1, 2010, the commissioner shall classify physical therapy services, 
438.8 	occupational therapy services, and speech-language pathology and related services as basic 
438.9 	care services. The reduction in this paragraph shall apply to physical therapy services, 
438.10 	occupational therapy services, and speech-language pathology and related services provided 
438.11 	on or after July 1, 2010.
438.12 	(b) Payments made to managed care plans and county-based purchasing plans shall be 
438.13 	reduced for services provided on or after October 1, 2009, to reflect the reduction effective 
438.14 	July 1, 2009, and payments made to the plans shall be reduced effective October 1, 2010, 
438.15 	to reflect the reduction effective July 1, 2010.
438.16 	(c) Effective for services provided on or after September 1, 2011, through June 30, 2013, 
438.17 	total payments for outpatient hospital facility fees shall be reduced by five percent from the 
438.18 	rates in effect on August 31, 2011.
438.19 	(d) Effective for services provided on or after September 1, 2011, through June 30, 2013, 
438.20 	total payments for ambulatory surgery centers facility fees, medical supplies and durable 
438.21 	medical equipment not subject to a volume purchase contract, prosthetics and orthotics, 
438.22 	renal dialysis services, laboratory services, public health nursing services, physical therapy 
438.23 	services, occupational therapy services, speech therapy services, eyeglasses not subject to 
438.24 	a volume purchase contract, hearing aids not subject to a volume purchase contract, and 
438.25 	anesthesia services shall be reduced by three percent from the rates in effect on August 31, 
438.26 	2011.
438.27 	(e) Effective for services provided on or after September 1, 2014, payments for 
438.28 	ambulatory surgery centers facility fees, hospice services, renal dialysis services, laboratory 
438.29 	services, public health nursing services, eyeglasses not subject to a volume purchase contract, 
438.30 	and hearing aids not subject to a volume purchase contract shall be increased by three percent 
438.31 	and payments for outpatient hospital facility fees shall be increased by three percent. 
438.32 	Payments made to managed care plans and county-based purchasing plans shall not be 
438.33 	adjusted to reflect payments under this paragraph.
439.1 	(f) Payments for medical supplies and durable medical equipment not subject to a volume 
439.2 	purchase contract, and prosthetics and orthotics, provided on or after July 1, 2014, through 
439.3 	June 30, 2015, shall be decreased by .33 percent. Payments for medical supplies and durable 
439.4 	medical equipment not subject to a volume purchase contract, and prosthetics and orthotics, 
439.5 	provided on or after July 1, 2015, shall be increased by three percent from the rates as 
439.6 	determined under paragraphs (i) and (j).
439.7 	(g) Effective for services provided on or after July 1, 2015, payments for outpatient 
439.8 	hospital facility fees, medical supplies and durable medical equipment not subject to a 
439.9 	volume purchase contract, prosthetics, and orthotics to a hospital meeting the criteria specified 
439.10 	in section 62Q.19, subdivision 1, paragraph (a), clause (4), shall be increased by 90 percent 
439.11 	from the rates in effect on June 30, 2015. Payments made to managed care plans and 
439.12 	county-based purchasing plans shall not be adjusted to reflect payments under this paragraph.
439.13 	(h) This section does not apply to physician and professional services, inpatient hospital 
439.14 	services, family planning services, mental health services, dental services, prescription 
439.15 	drugs, medical transportation, federally qualified health centers, rural health centers, Indian 
439.16 	health services, and Medicare cost-sharing.
439.17 	(i) Effective for services provided on or after July 1, 2015, the following categories of 
439.18 	medical supplies and durable medical equipment shall be individually priced items: enteral 
439.19 	nutrition and supplies, customized and other specialized tracheostomy tubes and supplies, 
439.20 	electric patient lifts, and durable medical equipment repair and service. This paragraph does 
439.21 	not apply to medical supplies and durable medical equipment subject to a volume purchase 
439.22 	contract, products subject to the preferred diabetic testing supply program, and items provided 
439.23 	to dually eligible recipients when Medicare is the primary payer for the item. The 
439.24 	commissioner shall not apply any medical assistance rate reductions to durable medical 
439.25 	equipment as a result of Medicare competitive bidding.
439.26 	(j) Effective for services provided on or after July 1, 2015, medical assistance payment 
439.27 	rates for durable medical equipment, prosthetics, orthotics, or supplies shall be increased 
439.28 	as follows:
439.29 	(1) payment rates for durable medical equipment, prosthetics, orthotics, or supplies that 
439.30 	were subject to the Medicare competitive bid that took effect in January of 2009 shall be 
439.31 	increased by 9.5 percent; and
439.32 	(2) payment rates for durable medical equipment, prosthetics, orthotics, or supplies on 
439.33 	the medical assistance fee schedule, whether or not subject to the Medicare competitive bid 
440.1 	that took effect in January of 2009, shall be increased by 2.94 percent, with this increase 
440.2 	being applied after calculation of any increased payment rate under clause (1).
440.3 	This paragraph does not apply to medical supplies and durable medical equipment subject 
440.4 	to a volume purchase contract, products subject to the preferred diabetic testing supply 
440.5 	program, items provided to dually eligible recipients when Medicare is the primary payer 
440.6 	for the item, and individually priced items identified in paragraph (i). Payments made to 
440.7 	managed care plans and county-based purchasing plans shall not be adjusted to reflect the 
440.8 	rate increases in this paragraph.
440.9 	(k) Effective for nonpressure support ventilators provided on or after January 1, 2016, 
440.10 	the rate shall be the lower of the submitted charge or the Medicare fee schedule rate. Effective 
440.11 	for pressure support ventilators provided on or after January 1, 2016, the rate shall be the 
440.12 	lower of the submitted charge or 47 percent above the Medicare fee schedule rate. For 
440.13 	payments made in accordance with this paragraph, if, and to the extent that, the commissioner 
440.14 	identifies that the state has received federal financial participation for ventilators in excess 
440.15 	of the amount allowed effective January 1, 2018, under United States Code, title 42, section 
440.16 	1396b(i)(27), the state shall repay the excess amount to the Centers for Medicare and 
440.17 	Medicaid Services with state funds and maintain the full payment rate under this paragraph.
440.18 	(l) Payment rates for durable medical equipment, prosthetics, orthotics or supplies, that 
440.19 	are subject to the upper payment limit in accordance with section 1903(i)(27) of the Social 
440.20 	Security Act, shall be paid the Medicare rate. Rate increases provided in this chapter shall 
440.21 	not be applied to the items listed in this paragraph.

440.22 	EFFECTIVE DATE. This section is effective July 1, 2019, subject to federal approval. 
440.23 	The commissioner shall notify the revisor of statutes when federal approval has been 
440.24 	obtained.

440.25 	Sec. 38. Minnesota Statutes 2018, section 256B.79, subdivision 2, is amended to read:
440.26 		Subd. 2.Pilot Grant program established. The commissioner shall implement a pilot
440.27 	grant program to improve birth outcomes and strengthen early parental resilience for pregnant 
440.28 	women who are medical assistance enrollees, are at significantly elevated risk for adverse 
440.29 	outcomes of pregnancy, and are in targeted populations. The program must promote the 
440.30 	provision of integrated care and enhanced services to these pregnant women, including 
440.31 	postpartum coordination to ensure ongoing continuity of care, by qualified integrated 
440.32 	perinatal care collaboratives.

441.1 	Sec. 39. Minnesota Statutes 2018, section 256B.79, subdivision 3, is amended to read:
441.2 		Subd. 3.Grant awards. The commissioner shall award grants to qualifying applicants 
441.3 	to support interdisciplinary, integrated perinatal care. Grants must be awarded beginning 
441.4 	July 1, 2016. Grant funds must be distributed through a request for proposals process to a 
441.5 	designated lead agency within an entity that has been determined to be a qualified integrated 
441.6 	perinatal care collaborative or within an entity in the process of meeting the qualifications 
441.7 	to become a qualified integrated perinatal care collaborative, and priority shall be given to 
441.8 	qualified integrated perinatal care collaboratives that received grants under this section prior 
441.9 	to January 1, 2019. Grant awards must be used to support interdisciplinary, team-based 
441.10 	needs assessments, planning, and implementation of integrated care and enhanced services 
441.11 	for targeted populations. In determining grant award amounts, the commissioner shall 
441.12 	consider the identified health and social risks linked to adverse outcomes and attributed to 
441.13 	enrollees within the identified targeted population.

441.14 	Sec. 40. Minnesota Statutes 2018, section 256B.79, subdivision 4, is amended to read:
441.15 		Subd. 4.Eligibility for grants. To be eligible for a grant under this section, an entity 
441.16 	must show that the entity meets or is in the process of meetingmeet qualifications established 
441.17 	by the commissioner to be a qualified integrated perinatal care collaborative. These 
441.18 	qualifications must include evidence that the entity has or is in the process of developing
441.19 	policies, services, and partnerships to support interdisciplinary, integrated care. The policies, 
441.20 	services, and partnerships must meet specific criteria and be approved by the commissioner. 
441.21 	The commissioner shall establish a process to review the collaborative's capacity for 
441.22 	interdisciplinary, integrated care, to be reviewed at the commissioner's discretion. In 
441.23 	determining whether the entity meets the qualifications for a qualified integrated perinatal 
441.24 	care collaborative, the commissioner shall verify and review whether the entity's policies, 
441.25 	services, and partnerships:
441.26 	(1) optimize early identification of drug and alcohol dependency and abuse during 
441.27 	pregnancy, effectively coordinate referrals and follow-up of identified patients to 
441.28 	evidence-based or evidence-informed treatment, and integrate perinatal care services with 
441.29 	behavioral health and substance abuse services;
441.30 	(2) enhance access to, and effective use of, needed health care or tribal health care 
441.31 	services, public health or tribal public health services, social services, mental health services, 
441.32 	chemical dependency services, or services provided by community-based providers by 
441.33 	bridging cultural gaps within systems of care and by integrating community-based 
442.1 	paraprofessionals such as doulas and community health workers as routinely available 
442.2 	service components;
442.3 	(3) encourage patient education about prenatal care, birthing, and postpartum care, and 
442.4 	document how patient education is provided. Patient education may include information 
442.5 	on nutrition, reproductive life planning, breastfeeding, and parenting;
442.6 	(4) integrate child welfare case planning with substance abuse treatment planning and 
442.7 	monitoring, as appropriate;
442.8 	(5) effectively systematize screening, collaborative care planning, referrals, and follow 
442.9 	up for behavioral and social risks known to be associated with adverse outcomes and known 
442.10 	to be prevalent within the targeted populations;
442.11 	(6) facilitate ongoing continuity of care to include postpartum coordination and referrals 
442.12 	for interconception care, continued treatment for substance abuse, identification and referrals 
442.13 	for maternal depression and other chronic mental health conditions, continued medication 
442.14 	management for chronic diseases, and appropriate referrals to tribal or county-based social 
442.15 	services agencies and tribal or county-based public health nursing services; and
442.16 	(7) implement ongoing quality improvement activities as determined by the commissioner, 
442.17 	including collection and use of data from qualified providers on metrics of quality such as 
442.18 	health outcomes and processes of care, and the use of other data that has been collected by 
442.19 	the commissioner.

442.20 	Sec. 41. Minnesota Statutes 2018, section 256B.79, subdivision 5, is amended to read:
442.21 		Subd. 5.Gaps in communication, support, and care. A collaborative receiving a grant 
442.22 	under this section must develop means of identifying and reportingidentify and report gaps 
442.23 	in the collaborative's communication, administrative support, and direct care, if any, that 
442.24 	must be remedied for the collaborative to continue to effectively provide integrated care 
442.25 	and enhanced services to targeted populations.

442.26 	Sec. 42. Minnesota Statutes 2018, section 256B.79, subdivision 6, is amended to read:
442.27 		Subd. 6.Report. By January 31, 2019 2021, and every two years thereafter, the 
442.28 	commissioner shall report to the chairs and ranking minority members of the legislative 
442.29 	committees with jurisdiction over health and human services policy and finance on the 
442.30 	status and progress outcomes of the pilot grant program. The report must:
442.31 	(1) describe the capacity of collaboratives receiving grants under this section;
443.1 	(2) contain aggregate information about enrollees served within targeted populations;
443.2 	(3) describe the utilization of enhanced prenatal services;
443.3 	(4) for enrollees identified with maternal substance use disorders, describe the utilization 
443.4 	of substance use treatment and dispositions of any child protection cases;
443.5 	(5) contain data on outcomes within targeted populations and compare these outcomes 
443.6 	to outcomes statewide, using standard categories of race and ethnicity; and
443.7 	(6) include recommendations for continuing the program or sustaining improvements 
443.8 	through other means beyond June 30, 2019.

443.9 	Sec. 43. Minnesota Statutes 2018, section 256L.11, subdivision 2, is amended to read:
443.10 		Subd. 2.Payment of certain providers. Services provided by federally qualified health 
443.11 	centers, rural health clinics, and facilities of the Indian health service, and certified 
443.12 	community behavioral health clinics shall be paid for according to the same rates and 
443.13 	conditions applicable to the same service provided by providers that are not federally 
443.14 	qualified health centers, rural health clinics, or facilities of the Indian health service, or 
443.15 	certified community behavioral health clinics. The alternative payment methodology 
443.16 	described under section 256B.0625, subdivision 30, paragraph (l), shall not apply to services 
443.17 	delivered under this chapter by federally qualified health centers, rural health clinics, and 
443.18 	facilities of the Indian Health Services. The prospective payment system for certified 
443.19 	behavioral health clinics under section 256B.0625, subdivision 5m, shall not apply to services 
443.20 	delivered under this chapter.

443.21 	Sec. 44. STUDY OF CLINIC COSTS.
 443.22 	The commissioner of human services shall conduct a five-year comparative analysis of 
443.23 	the actual change in aggregate federally qualified health center (FQHC) and rural health 
443.24 	clinic costs versus the CMS FQHC Market Basket inflator using 2017 through 2022 finalized 
443.25 	Medicare Cost Reports, CMS 2224-14, and report the findings to the chairs and ranking 
443.26 	minority members of the legislative committees with jurisdiction over health and human 
443.27 	services policy and finance, by July 1, 2025.

443.28 	Sec. 45. CORRECTIVE PLAN TO ELIMINATE DUPLICATE PERSONAL 
443.29 	IDENTIFICATION NUMBERS.
 443.30 	(a) The commissioner of human services shall design and implement a corrective plan 
443.31 	to address the issue of medical assistance enrollees being assigned more than one personal 
444.1 	identification number. Any corrections or fixes that are necessary to address this issue are 
444.2 	required to be completed by June 30, 2021.
444.3 	(b) By February 15, 2020, the commissioner shall submit a report to the chairs and 
444.4 	ranking minority members of the legislative committees with jurisdiction over health and 
444.5 	human services policy and finance on the progress of the corrective plan required in paragraph 
444.6 	(a), including an update on meeting the June 30, 2021, deadline. The report must also include 
444.7 	information on:
444.8 	(1) the number of medical assistance enrollees who have been assigned two or more 
444.9 	personal identification numbers;
444.10 	(2) any possible financial effect of enrollees having duplicate personal identification 
444.11 	numbers on health care providers and managed care organizations, including the effect on 
444.12 	reimbursement rates, meeting withhold requirements, and capitated payments; and
444.13 	(3) any effect on federal payments received by the state.

444.14 	Sec. 46. BLUE RIBBON COMMISSION ON HEALTH AND HUMAN SERVICES.
 444.15 		Subdivision 1.Establishment. The commissioners of health and human services shall 
444.16 	convene a Blue Ribbon Commission to advise and assist the legislature and governor in 
444.17 	transforming the health and human services system to build greater efficiencies, savings, 
444.18 	and better outcomes for Minnesotans.
444.19 		Subd. 2.Membership; appointment. (a) The Blue Ribbon Commission consists of 17 
444.20 	members as follows:
444.21 	(1) two members of the house of representatives appointed by the speaker of the house;
444.22 	(2) two members of the senate appointed by the senate majority leader;
444.23 	(3) the commissioner of human services or designee;
444.24 	(4) the commissioner of health or designee;
444.25 	(5) four members appointed by the governor who have demonstrated expertise and 
444.26 	leadership in health care, long-term care, or social service organization, health and human 
444.27 	services technology, or other collaborative health and human services system improvement 
444.28 	activities with a history of providing guidance to state and local governments;
444.29 	(6) two members appointed by the governor who have demonstrated leadership in 
444.30 	employer and group purchaser activities in which the group purchaser is not a health plan 
444.31 	company; one of the members appointed must be from a labor organization; and
445.1 	(7) five members appointed by the governor who have demonstrated public or private 
445.2 	leadership, cultural responsiveness, and innovation in the area of health and human services.
445.3 	(b) The governor is exempt from the requirements of the open appointments process for 
445.4 	purposes of appointing commission members.
445.5 		Subd. 3.Cochairs. The commissioners of health and human services shall serve as 
445.6 	cochairs of the commission. The commissioner of human services shall convene the first 
445.7 	meeting.
445.8 		Subd. 4.Compensation; expenses; reimbursement. Public members shall be 
445.9 	compensated and reimbursed for expenses as provided in Minnesota Statutes, section 
445.10 	15.0575, subdivision 3.
445.11 		Subd. 5.Administrative support. The commissioners of health and human services 
445.12 	shall provide meeting space and administrative support to the commission.
445.13 		Subd. 6.Gifts. The commission may accept gifts and grants on behalf of the state for 
445.14 	the purpose of supporting the commission. Any such gifts or grants shall constitute donations 
445.15 	to the state. Funds received under this subdivision are appropriated to the commissioner of 
445.16 	human services to support the commission in performing its duties.
445.17 		Subd. 7.Public and stakeholder engagement. The commissioners of health and human 
445.18 	services shall review available research to determine Minnesotans' values, preferences, 
445.19 	opinions, and perceptions related to human services and health care benefits and other issues 
445.20 	that may be before the commission and shall present the findings to the commission.
445.21 		Subd. 8.Duties. (a) By October 1, 2020, the commission shall develop and present to 
445.22 	the legislature and the governor an action plan for transforming the health and human 
445.23 	services system to improve program efficiencies, produce savings, and promote better 
445.24 	outcomes for Minnesotans. The action plan must include, but is not limited to, the following:
445.25 	(1) strategies to increase administrative efficiencies and improve program simplification 
445.26 	within health and human services public programs, including examining the roles and 
445.27 	experience of counties and tribes in delivering services and identifying any conflicting and 
445.28 	duplicative roles and responsibilities among health and human services agencies, counties, 
445.29 	and tribes;
445.30 	(2) approaches to reducing health and human services expenditures, including identifying 
445.31 	evidence-based strategies for addressing the significant cost drivers of state spending on 
445.32 	health and human services, including the medical assistance program;
446.1 	(3) opportunities for reducing fraud and improving program integrity in health and human 
446.2 	services; and
446.3 	(4) statewide strategies for improving access to health and human services with a focus 
446.4 	on addressing geographic, racial, and ethnic disparities.
446.5 	(b) The commission may contract with a private entity or consultant as necessary to 
446.6 	complete its duties under this section, and shall be exempt from state procurement process 
446.7 	requirements under Minnesota Statutes, chapter 16C.
446.8 		Subd. 9.Limitations. (a) In developing the action plan, the commission shall take into 
446.9 	consideration the impact of its recommendations on:
446.10 	(1) the existing capacity of state agencies, including staffing needs, technology resources, 
446.11 	and existing agency responsibilities; and
446.12 	(2) the capacity of county and tribal partners.
446.13 	(b) The commission shall not include in the action plan recommendations that may result 
446.14 	in loss of benefits for the individuals eligible for state health and human services public 
446.15 	programs or exacerbate health disparities and inequities in access to health care and human 
446.16 	services.
446.17 		Subd. 10.Expiration. The Blue Ribbon Commission expires October 2, 2020, or the 
446.18 	day after submitting the action plan required under subdivision 8, whichever is earlier.

446.19 	Sec. 47. REPEALER.
 446.20 	(a) Minnesota Statutes 2018, sections 256B.0625, subdivision 63; 256B.0659, subdivision 
446.21 	22; and 256L.11, subdivision 2a, are repealed.
446.22 	(b) Minnesota Statutes 2018, sections 256B.0625, subdivision 31c; and 256B.79, 
446.23 	subdivision 7, are repealed effective the day following final enactment.

446.24 	ARTICLE 8
446.25 	HEALTH COVERAGE

446.26 	Section 1. Minnesota Statutes 2018, section 62A.30, is amended by adding a subdivision 
446.27 	to read:
446.28 		Subd. 4.Mammograms. (a) For purposes of subdivision 2, coverage for a preventive 
446.29 	mammogram screening (1) includes digital breast tomosynthesis for enrollees at risk for 
446.30 	breast cancer, and (2) is covered as a preventive item or service, as described under section 
446.31 	62Q.46.
447.1 	(b) For purposes of this subdivision, "digital breast tomosynthesis" means a radiologic 
447.2 	procedure that involves the acquisition of projection images over the stationary breast to 
447.3 	produce cross-sectional digital three-dimensional images of the breast. "At risk for breast 
447.4 	cancer" means:
447.5 	(1) having a family history with one or more first- or second-degree relatives with breast 
447.6 	cancer;
447.7 	(2) testing positive for BRCA1 or BRCA2 mutations;
447.8 	(3) having heterogeneously dense breasts or extremely dense breasts based on the Breast 
447.9 	Imaging Reporting and Data System established by the American College of Radiology; or
447.10 	(4) having a previous diagnosis of breast cancer.
447.11 	(c) This subdivision does not apply to coverage provided through a public health care 
447.12 	program under chapter 256B or 256L.
447.13 	(d) Nothing in this subdivision limits the coverage of digital breast tomosynthesis in a 
447.14 	policy, plan, certificate, or contract referred to in subdivision 1 that is in effect prior to  
447.15 	January 1, 2020.
447.16 	(e) Nothing in this subdivision prohibits a policy, plan, certificate, or contract referred 
447.17 	to in subdivision 1 from covering digital breast tomosynthesis for an enrollee who is not at 
447.18 	risk for breast cancer.

447.19 	EFFECTIVE DATE. This section is effective January 1, 2020, and applies to health 
447.20 	plans issued, sold, or renewed on or after that date.

447.21 	Sec. 2. [62A.3097] PEDIATRIC AUTOIMMUNE NEUROPSYCHIATRIC 
447.22 	DISORDERS ASSOCIATED WITH STREPTOCOCCAL INFECTIONS (PANDAS) 
447.23 	AND PEDIATRIC ACUTE-ONSET NEUROPSYCHIATRIC SYNDROME (PANS) 
447.24 	TREATMENT; COVERAGE.
447.25 		Subdivision 1.Definitions. (a) The definitions in this subdivision apply to this section.
447.26 	(b) "Pediatric acute-onset neuropsychiatric syndrome" means a class of acute-onset 
447.27 	obsessive compulsive or tic disorders or other behavioral changes presenting in children 
447.28 	and adolescents that are not otherwise explained by another known neurologic or medical 
447.29 	disorder.
447.30 	(c) "Pediatric autoimmune neuropsychiatric disorders associated with streptococcal 
447.31 	infections" means a condition in which a streptococcal infection in a child or adolescent 
447.32 	causes the abrupt onset of clinically significant obsessions, compulsions, tics, or other 
448.1 	neuropsychiatric symptoms or behavioral changes, or a relapsing and remitting course of 
448.2 	symptom severity.
448.3 		Subd. 2.Scope of coverage. This section applies to all health plans that provide coverage 
448.4 	to Minnesota residents.
448.5 		Subd. 3.Required coverage. Every health plan included in subdivision 2 must provide 
448.6 	coverage for treatment for pediatric autoimmune neuropsychiatric disorders associated with 
448.7 	streptococcal infections (PANDAS) and for treatment for pediatric acute-onset 
448.8 	neuropsychiatric syndrome (PANS). Treatments that must be covered under this section 
448.9 	must be recommended by the insured's licensed health care professional and include but 
448.10 	are not limited to antibiotics, medication and behavioral therapies to manage neuropsychiatric 
448.11 	symptoms, plasma exchange, and immunoglobulin.
448.12 		Subd. 4.Reimbursement. The commissioner of commerce shall reimburse health carriers 
448.13 	for coverage under this section. Reimbursement is available only for coverage that would 
448.14 	not have been provided by the health carrier without the requirements of this section. Each 
448.15 	fiscal year an amount necessary to make payments to health carriers to defray the cost of 
448.16 	providing coverage under this section is appropriated to the commissioner of commerce. 
448.17 	Health carriers shall report to the commissioner quantified costs attributable to the additional 
448.18 	benefit under this section in a format developed by the commissioner. The commissioner 
448.19 	shall evaluate submissions and make payments to health carriers as provided in Code of 
448.20 	Federal Regulations, title 45, section 155.170.

448.21 	EFFECTIVE DATE. This section is effective January 1, 2020, and applies to health 
448.22 	plans offered, sold, issued, or renewed on or after that date.

448.23 	Sec. 3. Minnesota Statutes 2018, section 62D.12, is amended by adding a subdivision to 
448.24 	read:
448.25 		Subd. 8a.Net earnings. All net earnings of a nonprofit health maintenance organization 
448.26 	must be devoted to the nonprofit purposes of the health maintenance organization in providing 
448.27 	comprehensive health care. A nonprofit health maintenance organization must not provide 
448.28 	for the payment, whether directly or indirectly, of any part of its net earnings to any person 
448.29 	for a purpose other than providing comprehensive health care, except that the health 
448.30 	maintenance organization may make payments to providers or other persons based on the 
448.31 	efficient provision of services or as incentives to provide quality care. The commissioner 
448.32 	of health shall, pursuant to this chapter, revoke the certificate of authority of any nonprofit 
448.33 	health maintenance organization in violation of this subdivision.

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

449.2 	Sec. 4. Minnesota Statutes 2018, section 62D.124, subdivision 3, is amended to read:
449.3 		Subd. 3.Exception Waiver. The commissioner shall grant an exception to the 
449.4 	requirements of this section according to Minnesota Rules, part 4685.1010, subpart 4, if the 
449.5 	health maintenance organization can demonstrate with specific data that the requirement 
449.6 	of subdivision 1 or 2 is not feasible in a particular service area or part of a service area. (a) 
449.7 	A health maintenance organization may apply to the commissioner of health for a waiver 
449.8 	of the requirements in subdivision 1 or 2 if it is unable to meet those requirements. A waiver 
449.9 	application must be submitted on a form provided by the commissioner, must be accompanied 
449.10 	by an application fee of $500 per county per year, for each application to waive the 
449.11 	requirements in subdivision 1 or 2 for one or more provider types in that county, and must:
449.12 	(1) demonstrate with specific data that the requirements of subdivision 1 or 2 are not 
449.13 	feasible in a particular service area or part of a service area; and
449.14 	(2) include specific information as to the steps that were and will be taken to address 
449.15 	network inadequacy, and for steps that will be taken prospectively to address network 
449.16 	inadequacy, the time frame within which those steps will be taken.
449.17 	(b) Using the guidelines and standards established under section 62K.10, subdivision 5, 
449.18 	paragraph (b), the commissioner shall review each waiver request and shall approve a waiver 
449.19 	only if:
449.20 	(1) the standards for approval established by the commissioner are satisfied; and
449.21 	(2) the steps that were and will be taken to address the network inadequacy and the time 
449.22 	frame for implementing these steps satisfy the standards established by the commissioner.
449.23 	(c) If, in its waiver application, a health maintenance organization demonstrates to the 
449.24 	commissioner that there are no providers of a specific type or specialty in a county, the 
449.25 	commissioner may approve a waiver in which the health maintenance organization is allowed 
449.26 	to address network inadequacy in that county by providing for patient access to providers 
449.27 	of that type or specialty via telemedicine, as defined in section 62A.671, subdivision 9.
449.28 	(d) A waiver shall automatically expire after three years. Upon or prior to expiration of 
449.29 	a waiver, a health maintenance organization unable to meet the requirements in subdivision 
449.30 	1 or 2 must submit a new waiver application under paragraph (a) and must also submit 
449.31 	evidence of steps the organization took to address the network inadequacy. When the 
449.32 	commissioner reviews a waiver application for a network adequacy requirement which has 
449.33 	been waived for the organization for the most recent three-year period, the commissioner 
450.1 	shall also examine the steps the organization took during that three-year period to address 
450.2 	network inadequacy, and shall only approve a subsequent waiver application if it satisfies 
450.3 	the requirements in paragraph (b), demonstrates that the organization took the steps it 
450.4 	proposed to address network inadequacy, and explains why the organization continues to 
450.5 	be unable to satisfy the requirements in subdivision 1 or 2.
450.6 	(e) Application fees collected under this subdivision shall be deposited in the state 
450.7 	government special revenue fund in the state treasury.

450.8 	EFFECTIVE DATE. This section is effective January 1, 2020, for health plans sold, 
450.9 	issued, or renewed on or after January 1, 2021.

450.10 	Sec. 5. Minnesota Statutes 2018, section 62D.124, is amended by adding a subdivision to 
450.11 	read:
450.12 		Subd. 7.Provider network notifications. A health maintenance organization must 
450.13 	provide on the organization's website the provider network for each product offered by the 
450.14 	organization, and must update the organization's website at least once a month with any 
450.15 	changes to the organization's provider network, including provider changes from in-network 
450.16 	status to out-of-network status. A health maintenance organization must also provide on 
450.17 	the organization's website, for each product offered by the organization, a list of the current 
450.18 	waivers of the requirements in subdivision 1 or 2, in a format that is easily accessed and 
450.19 	searchable by enrollees and prospective enrollees.

450.20 	Sec. 6. Minnesota Statutes 2018, section 62E.23, subdivision 3, is amended to read:
450.21 		Subd. 3.Operation. (a) The board shall propose to the commissioner the payment 
450.22 	parameters for the next benefit year by January 15 of the year before the applicable benefit 
450.23 	year. The commissioner shall approve or reject the payment parameters no later than 14 
450.24 	days following the board's proposal. If the commissioner fails to approve or reject the 
450.25 	payment parameters within 14 days following the board's proposal, the proposed payment 
450.26 	parameters are final and effective.
450.27 	(b) If the amount in the premium security plan account in section 62E.25, subdivision 
450.28 	1, is not anticipated to be adequate to fully fund the approved payment parameters as of 
450.29 	July 1 of the year before the applicable benefit year, the board, in consultation with the 
450.30 	commissioner and the commissioner of management and budget, shall propose payment 
450.31 	parameters within the available appropriations. The commissioner must permit an eligible 
450.32 	health carrier to revise an applicable rate filing based on the final payment parameters for 
450.33 	the next benefit year.
451.1 	(c) Notwithstanding paragraph (a), the payment parameters for benefit year 2020 are:
451.2 	(1) an attachment point of $50,000;
451.3 	(2) a coinsurance rate of 80 percent; and
451.4 	(3) a reinsurance cap of $250,000.

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

451.6 	Sec. 7. Minnesota Statutes 2018, section 62E.24, subdivision 2, is amended to read:
451.7 		Subd. 2.Reports. (a) The board must submit to the commissioner and to the chairs and 
451.8 	ranking minority members of the legislative committees with jurisdiction over commerce 
451.9 	and health and make available to the public a quarterly reports on plan operations and an 
451.10 	annual report summarizing the plan operations for each benefit year by. All reports must 
451.11 	be made public by posting the summary report on the Minnesota Comprehensive Health 
451.12 	Association website and making the. The annual summary otherwise must be made available 
451.13 	by November 1 of the year following the applicable benefit year or 60 calendar days 
451.14 	following the final disbursement of reinsurance payments for the applicable benefit year, 
451.15 	whichever is later.
451.16 	(b) The reports must include information about:
451.17 	(1) the reinsurance parameters used;
451.18 	(2) the metal levels affected;
451.19 	(3) the number of claims payments estimated and submitted for payment per products 
451.20 	offered on-exchange and off-exchange and per eligible health carrier;
451.21 	(4) the estimated reinsurance payments by plan type based on carrier submitted templates;
451.22 	(5) funds appropriated for reinsurance payments and administrative and operational 
451.23 	expenses for each year, including the federal and state contributions received, investment 
451.24 	income, and any other revenue or funds received;
451.25 	(6) the total amount of reinsurance payments made to each eligible health carrier; and
451.26 	(7) administrative and operational expenses incurred for the plan, including the total 
451.27 	amount incurred and as a percentage of the plan's operational budget.

452.1 	Sec. 8. Minnesota Statutes 2018, section 62K.07, is amended to read:
452.2 	62K.07 INFORMATION DISCLOSURES.
452.3 		Subdivision 1.In general. (a) A health carrier offering individual or small group health 
452.4 	plans must submit the following information in a format determined by the commissioner 
452.5 	of commerce:
452.6 	(1) claims payment policies and practices;
452.7 	(2) periodic financial disclosures;
452.8 	(3) data on enrollment;
452.9 	(4) data on disenrollment;
452.10 	(5) data on the number of claims that are denied;
452.11 	(6) data on rating practices;
452.12 	(7) information on cost-sharing and payments with respect to out-of-network coverage; 
452.13 	and
452.14 	(8) other information required by the secretary of the United States Department of Health 
452.15 	and Human Services under the Affordable Care Act.
452.16 	(b) A health carrier offering an individual or small group health plan must comply with 
452.17 	all information disclosure requirements of all applicable state and federal law, including 
452.18 	the Affordable Care Act.
452.19 	(c) Except for qualified health plans sold on MNsure, information reported under 
452.20 	paragraph (a), clauses (3) and (4), is nonpublic data as defined under section 13.02, 
452.21 	subdivision 9. Information reported under paragraph (a), clauses (1) through (8), must be 
452.22 	reported by MNsure for qualified health plans sold through MNsure.
452.23 		Subd. 2.Prescription drug costs. (a) Each health carrier that offers a prescription drug 
452.24 	benefit in its individual health plans or small group health plans shall include in the applicable 
452.25 	rate filing required under section 62A.02 the following information about covered prescription 
452.26 	drugs:
452.27 	(1) the 25 most frequently prescribed drugs in the previous plan year;
452.28 	(2) the 25 most costly prescription drugs as a portion of the individual health plan's or 
452.29 	small group health plan's total annual expenditures in the previous plan year;
452.30 	(3) the 25 prescription drugs that have caused the greatest increase in total individual 
452.31 	health plan or small group health plan spending in the previous plan year;
453.1 	(4) the projected impact of the cost of prescription drugs on premium rates;
453.2 	(5) if any health plan offered by the health carrier requires enrollees to pay cost-sharing 
453.3 	on any covered prescription drugs including deductibles, co-payments, or coinsurance in 
453.4 	an amount that is greater than the amount the enrollee's health plan would pay for the drug 
453.5 	absent the applicable enrollee cost-sharing and after accounting for any rebate amount; and
453.6 	(6) if the health carrier prohibits third-party payments including manufacturer drug 
453.7 	discounts or coupons that cover all or a portion of an enrollee's cost-sharing requirements 
453.8 	including deductibles, co-payments, or coinsurance from applying toward the enrollee's 
453.9 	cost-sharing obligations under the enrollee's health plan.
453.10 	(b) The commissioner of commerce, in consultation with the commissioner of health, 
453.11 	shall release a summary of the information reported in paragraph (a) at the same time as 
453.12 	the information required under section 62A.02, subdivision 2, paragraph (c).
453.13 		Subd. 3.Enforcement. (d) The commissioner of commerce shall enforce this section.

453.14 	EFFECTIVE DATE. This section is effective for individual health plans and small 
453.15 	group health plans offered, issued, sold, or renewed on or after January 1, 2021.

453.16 	Sec. 9. Minnesota Statutes 2018, section 62K.075, is amended to read:
453.17 	62K.075 PROVIDER NETWORK NOTIFICATIONS.
453.18 	(a) A health carrier must  provide on the carrier's website the provider network for each 
453.19 	product offered by the carrier, and must update the carrier's website at least once a month 
453.20 	with any changes to the carrier's provider network, including provider changes from 
453.21 	in-network status to out-of-network status. A health carrier must also provide on the carrier's 
453.22 	website, for each product offered by the carrier, a list of the current waivers of the 
453.23 	requirements in section 62K.10, subdivision 2 or 3, in a format that is easily accessed and 
453.24 	searchable by enrollees and prospective enrollees.
453.25 	(b) Upon notification from an enrollee, a health carrier must reprocess any claim for 
453.26 	services provided by a provider whose status has changed from in-network to out-of-network 
453.27 	as an in-network claim if the service was provided after the network change went into effect 
453.28 	but before the change was posted as required under paragraph (a) unless the health carrier 
453.29 	notified the enrollee of the network change prior to the service being provided. This paragraph 
453.30 	does not apply if the health carrier is able to verify that the health carrier's website displayed 
453.31 	the correct provider network status on the health carrier's website at the time the service 
453.32 	was provided.
454.1 	(c) The limitations of section 62Q.56, subdivision 2a, shall apply to payments required 
454.2 	by paragraph (b).

454.3 	Sec. 10. Minnesota Statutes 2018, section 62K.10, subdivision 5, is amended to read:
454.4 		Subd. 5.Waiver. (a) A health carrier or preferred provider organization may apply to 
454.5 	the commissioner of health for a waiver of the requirements in subdivision 2 or 3 if it is 
454.6 	unable to meet the statutory requirements. A waiver application must be submitted on a 
454.7 	form provided by the commissioner, must be accompanied by an application fee of $500 
454.8 	for each application to waive the requirements in subdivision 2 or 3 for one or more provider 
454.9 	types per county, and must:
454.10 	(1) demonstrate with specific data that the requirement of subdivision 2 or 3 is not 
454.11 	feasible in a particular service area or part of a service area; and
454.12 	(2) include specific information as to the steps that were and will be taken to address 
454.13 	the network inadequacy, and for steps that will be taken prospectively to address network 
454.14 	inadequacy, the time frame within which those steps will be taken.
454.15 	(b) The commissioner shall establish guidelines for evaluating waiver applications, 
454.16 	standards governing approval or denial of a waiver application, and standards for steps that 
454.17 	health carriers must take to address the network inadequacy and allow the health carrier to 
454.18 	meet network adequacy requirements within a reasonable time period. The commissioner 
454.19 	shall review each waiver application using these guidelines and standards and shall approve 
454.20 	a waiver application only if:
454.21 	(1) the standards for approval established by the commissioner are satisfied; and
454.22 	(2) the steps that were and will be taken to address the network inadequacy and the time 
454.23 	frame for taking these steps satisfy the standards established by the commissioner.
454.24 	(c) If, in its waiver application, a health carrier demonstrates to the commissioner that 
454.25 	there are no providers of a specific type or specialty in a county, the commissioner may 
454.26 	approve a waiver in which the health carrier is allowed to address network inadequacy in 
454.27 	that county by providing for patient access to providers of that type or specialty via 
454.28 	telemedicine, as defined in section 62A.671, subdivision 9.
454.29 	(d) The waiver shall automatically expire after four years. If a renewal of the waiver is 
454.30 	sought, the commissioner of health shall take into consideration steps that have been taken 
454.31 	to address network adequacy. one year. Upon or prior to expiration of a waiver, a health 
454.32 	carrier unable to meet the requirements in subdivision 2 or 3 must submit a new waiver 
454.33 	application under paragraph (a) and must also submit evidence of steps the carrier took to 
455.1 	address the network inadequacy. When the commissioner reviews a waiver application for 
455.2 	a network adequacy requirement which has been waived for the carrier for the most recent 
455.3 	one-year period, the commissioner shall also examine the steps the carrier took during that 
455.4 	one-year period to address network inadequacy, and shall only approve a subsequent waiver 
455.5 	application that satisfies the requirements in paragraph (b), demonstrates that the carrier 
455.6 	took the steps it proposed to address network inadequacy, and explains why the carrier 
455.7 	continues to be unable to satisfy the requirements in subdivision 2 or 3.
455.8 	(e) Application fees collected under this subdivision shall be deposited in the state 
455.9 	government special revenue fund in the state treasury.

455.10 	EFFECTIVE DATE. This section is effective January 1, 2020, for health plans sold, 
455.11 	issued, or renewed on or after January 1, 2021.

455.12 	Sec. 11. [62K.105] NETWORK ADEQUACY COMPLAINTS.
455.13 	The commissioner of health shall establish a clear, easily accessible process for accepting 
455.14 	complaints from enrollees regarding health carrier compliance with section 62K.10, 
455.15 	subdivision 2, 3, or 4. Using this process, an enrollee may file a complaint with the 
455.16 	commissioner that a health carrier is not in compliance with the requirements of section 
455.17 	62K.10, subdivision 2, 3, or 4. The commissioner of health shall investigate all complaints 
455.18 	received under this section.

455.19 	Sec. 12. Minnesota Statutes 2018, section 62Q.01, is amended by adding a subdivision to 
455.20 	read:
455.21 		Subd. 6b.Nonquantitative treatment limitations or NQTLs. "Nonquantitative treatment 
455.22 	limitations" or "NQTLs" means processes, strategies, or evidentiary standards, or other 
455.23 	factors that are not expressed numerically, but otherwise limit the scope or duration of 
455.24 	benefits for treatment. NQTLs include but are not limited to:
455.25 	(1) medical management standards limiting or excluding benefits based on (i) medical 
455.26 	necessity or medical appropriateness, or (ii) whether the treatment is experimental or 
455.27 	investigative;
455.28 	(2) formulary design for prescription drugs;
455.29 	(3) health plans with multiple network tiers;
455.30 	(4) criteria and parameters for provider inclusion in provider networks, including 
455.31 	credentialing standards and reimbursement rates;
456.1 	(5) health plan methods for determining usual, customary, and reasonable charges;
456.2 	(6) fail-first or step therapy protocols;
456.3 	(7) exclusions based on failure to complete a course of treatment;
456.4 	(8) restrictions based on geographic location, facility type, provider specialty, and other 
456.5 	criteria that limit the scope or duration of benefits for services provided under the health 
456.6 	plan;
456.7 	(9) in- and out-of-network geographic limitations;
456.8 	(10) standards for providing access to out-of-network providers;
456.9 	(11) limitations on inpatient services for situations where the enrollee is a threat to self 
456.10 	or others;
456.11 	(12) exclusions for court-ordered and involuntary holds;
456.12 	(13) experimental treatment limitations;
456.13 	(14) service coding;
456.14 	(15) exclusions for services provided by clinical social workers; and
456.15 	(16) provider reimbursement rates, including rates of reimbursement for mental health 
456.16 	and substance use disorder services in primary care.

456.17 	Sec. 13. [62Q.1841] PROHIBITION ON USE OF STEP THERAPY FOR 
456.18 	METASTATIC CANCER.
456.19 		Subdivision 1.Definitions. (a) For purposes of this section, the following definitions 
456.20 	apply.
456.21 	(b) "Health plan" has the meaning given in section 62Q.01, subdivision 3. Health plan 
456.22 	includes health coverage provided by a county-based purchasing plan participating in a 
456.23 	public program under chapter 256B or 256L or an integrated health partnership under section 
456.24 	256B.0755.
456.25 	(c) "Stage four advanced metastatic cancer" means cancer that has spread from the 
456.26 	primary or original site of the cancer to nearby tissues, lymph nodes, or other parts of the 
456.27 	body.
456.28 	(d) "Step therapy protocol" has the meaning given in section 62Q.184, subdivision 1.
456.29 		Subd. 2.Prohibition on use of step therapy protocols. A health plan that provides 
456.30 	coverage for the treatment of stage four advanced metastatic cancer or associated conditions 
457.1 	must not limit or exclude coverage for a drug approved by the United States Food and Drug 
457.2 	Administration that is on the health plan's prescription drug formulary by mandating that 
457.3 	an enrollee with stage four advanced metastatic cancer or associated conditions follow a 
457.4 	step therapy protocol if the use of the approved drug is consistent with:
457.5 	(1) a United States Food and Drug Administration-approved indication; and
457.6 	(2) a clinical practice guideline published by the National Comprehensive Care Network.

457.7 	EFFECTIVE DATE. This section is effective January 1, 2020, and applies to health 
457.8 	plans offered, issued, or renewed on or after that date.

457.9 	Sec. 14. Minnesota Statutes 2018, section 62Q.47, is amended to read:
457.10 	62Q.47 ALCOHOLISM, MENTAL HEALTH, AND CHEMICAL DEPENDENCY 
457.11 	SERVICES.
457.12 	(a) All health plans, as defined in section 62Q.01, that provide coverage for alcoholism, 
457.13 	mental health, or chemical dependency services, must comply with the requirements of this 
457.14 	section.
457.15 	(b) Cost-sharing requirements and benefit or service limitations for outpatient mental 
457.16 	health and outpatient chemical dependency and alcoholism services, except for persons 
457.17 	placed in chemical dependency services under Minnesota Rules, parts 9530.6600 to 
457.18 	9530.6655, must not place a greater financial burden on the insured or enrollee, or be more 
457.19 	restrictive than those requirements and limitations for outpatient medical services.
457.20 	(c) Cost-sharing requirements and benefit or service limitations for inpatient hospital 
457.21 	mental health and inpatient hospital and residential chemical dependency and alcoholism 
457.22 	services, except for persons placed in chemical dependency services under Minnesota Rules, 
457.23 	parts 9530.6600 to 9530.6655, must not place a greater financial burden on the insured or 
457.24 	enrollee, or be more restrictive than those requirements and limitations for inpatient hospital 
457.25 	medical services.
457.26 	(d) A health plan company must not impose an NQTL with respect to mental health and 
457.27 	substance use disorders in any classification of benefits unless, under the terms of the health 
457.28 	plan as written and in operation, any processes, strategies, evidentiary standards, or other 
457.29 	factors used in applying the NQTL to mental health and substance use disorders in the 
457.30 	classification are comparable to, and are applied no more stringently than, the processes, 
457.31 	strategies, evidentiary standards, or other factors used in applying the NQTL with respect 
457.32 	to medical and surgical benefits in the same classification.
458.1 	(d) (e) All health plans must meet the requirements of the federal Mental Health Parity 
458.2 	Act of 1996, Public Law 104-204; Paul Wellstone and Pete Domenici Mental Health Parity 
458.3 	and Addiction Equity Act of 2008; the Affordable Care Act; and any amendments to, and 
458.4 	federal guidance or regulations issued under, those acts.
458.5 	(f) The commissioner may require information from health plan companies to confirm 
458.6 	that mental health parity is being implemented by the health plan company. Information 
458.7 	required may include comparisons between mental health and substance use disorder 
458.8 	treatment and other medical conditions, including a comparison of prior authorization 
458.9 	requirements, drug formulary design, claim denials, rehabilitation services, and other 
458.10 	information the commissioner deems appropriate.
458.11 	(g) Regardless of the health care provider's professional license, if the service provided 
458.12 	is consistent with the provider's scope of practice and the health plan company's credentialing 
458.13 	and contracting provisions, mental health therapy visits and medication maintenance visits 
458.14 	shall be considered primary care visits for the purpose of applying any enrollee cost-sharing 
458.15 	requirements imposed under the enrollee's health plan.
458.16 	(h) By June 1 of each year, beginning June 1, 2021, the commissioner of commerce, in 
458.17 	consultation with the commissioner of health, shall submit a report on compliance and 
458.18 	oversight to the chairs and ranking minority members of the legislative committees with 
458.19 	jurisdiction over health and commerce. The report must:
458.20 	(1) describe the commissioner's process for reviewing health plan company compliance 
458.21 	with United States Code, title 42, section 18031(j), any federal regulations or guidance 
458.22 	relating to compliance and oversight, and compliance with this section and section 62Q.53;
458.23 	(2) identify any enforcement actions taken by either commissioner during the preceding 
458.24 	12-month period regarding compliance with parity for mental health and substance use 
458.25 	disorders benefits under state and federal law, summarizing the results of any market conduct 
458.26 	examinations. The summary must include: (i) the number of formal enforcement actions 
458.27 	taken; (ii) the benefit classifications examined in each enforcement action; and (iii) the 
458.28 	subject matter of each enforcement action, including quantitative and nonquantitative 
458.29 	treatment limitations;
458.30 	(3) detail any corrective action taken by either commissioner to ensure health plan 
458.31 	company compliance with this section and section 62Q.53, and United States Code, title 
458.32 	42, section 18031(j); and
459.1 	(4) describe the information provided by either commissioner to the public about 
459.2 	alcoholism, mental health, or chemical dependency parity protections under state and federal 
459.3 	law.
459.4 	The report must be written in nontechnical, readily understandable language and must be 
459.5 	made available to the public by, among other means as the commissioners find appropriate, 
459.6 	posting the report on department websites. Individually identifiable information must be 
459.7 	excluded from the report, consistent with state and federal privacy protections.

459.8 	Sec. 15. [62Q.48] COST-SHARING IN PRESCRIPTION INSULIN DRUGS.
459.9 		Subdivision 1.Scope of coverage. This section applies to all health plans issued or 
459.10 	renewed to a Minnesota resident.
459.11 		Subd. 2.Definitions. (a) For the purposes of this section, the terms defined in this 
459.12 	subdivision have the meanings given them.
459.13 	(b) "Cost-sharing" means a deductible payment, co-payment, or coinsurance amount 
459.14 	imposed on an enrollee for a covered prescription drug in accordance with the terms and 
459.15 	conditions of the enrollee's health plan.
459.16 	(c) "Legend drug" has the same meaning as in section 151.01, subdivision 17.
459.17 	(d) "Prescription insulin drug" means a legend drug that contains insulin and is used to 
459.18 	treat diabetes.
459.19 	(e) "Net price" means the health plan company's cost for a prescription insulin drug, 
459.20 	including any rebates or discounts received by or accrued directly or indirectly to the health 
459.21 	plan company from a drug manufacturer or pharmacy benefit manager.
459.22 		Subd. 3.Cost-sharing limits. (a) A health plan that imposes a cost-sharing requirement 
459.23 	on the coverage of a prescription insulin drug shall limit the total amount of cost-sharing 
459.24 	that an enrollee is required to pay at point of sale, including deductible payments and the 
459.25 	cost-sharing amounts charged once the deductible is met at an amount that does not exceed 
459.26 	the net price of the prescription insulin drug.
459.27 	(b) Nothing in this section shall prevent a health plan company from imposing a 
459.28 	cost-sharing requirement that is less than the amount specified in paragraph (a).

459.29 	EFFECTIVE DATE. This section is effective for health plans issued or renewed on or 
459.30 	after January 1, 2020.

460.1 	Sec. 16. Minnesota Statutes 2018, section 62U.04, subdivision 4, is amended to read:
460.2 		Subd. 4.Encounter data. (a) Beginning July 1, 2009, and every six months thereafter, 
460.3 	all health plan companies and third-party administrators shall submit encounter data to a 
460.4 	private entity designated by the commissioner of health. The data shall be submitted in a 
460.5 	form and manner specified by the commissioner subject to the following requirements:
460.6 	(1) the data must be de-identified data as described under the Code of Federal Regulations, 
460.7 	title 45, section 164.514;
460.8 	(2) the data for each encounter must include an identifier for the patient's health care 
460.9 	home if the patient has selected a health care home and, for claims incurred on or after 
460.10 	January 1, 2019, data deemed necessary by the commissioner to uniquely identify claims 
460.11 	in the individual health insurance market; and
460.12 	(3) except for the identifier described in clause (2), the data must not include information 
460.13 	that is not included in a health care claim or equivalent encounter information transaction 
460.14 	that is required under section 62J.536.
460.15 	(b) The commissioner or the commissioner's designee shall only use the data submitted 
460.16 	under paragraph (a) to carry out the commissioner's responsibilities in this section, including 
460.17 	supplying the data to providers so they can verify their results of the peer grouping process 
460.18 	consistent with the recommendations developed pursuant to subdivision 3c, paragraph (d), 
460.19 	and adopted by the commissioner and, if necessary, submit comments to the commissioner 
460.20 	or initiate an appeal.
460.21 	(c) Data on providers collected under this subdivision are private data on individuals or 
460.22 	nonpublic data, as defined in section 13.02. Notwithstanding the definition of summary data 
460.23 	in section 13.02, subdivision 19, summary data prepared under this subdivision may be 
460.24 	derived from nonpublic data. The commissioner or the commissioner's designee shall 
460.25 	establish procedures and safeguards to protect the integrity and confidentiality of any data 
460.26 	that it maintains.
460.27 	(d) The commissioner or the commissioner's designee shall not publish analyses or 
460.28 	reports that identify, or could potentially identify, individual patients.
460.29 	(e) The commissioner shall compile summary information on the data submitted under 
460.30 	this subdivision. The commissioner shall work with its vendors to assess the data submitted 
460.31 	in terms of compliance with the data submission requirements and the completeness of the 
460.32 	data submitted by comparing the data with summary information compiled by the 
461.1 	commissioner and with established and emerging data quality standards to ensure data 
461.2 	quality.

461.3 	Sec. 17. Minnesota Statutes 2018, section 256B.0625, subdivision 13f, is amended to read:
461.4 		Subd. 13f.Prior authorization. (a) The Formulary Committee shall review and 
461.5 	recommend drugs which require prior authorization. The Formulary Committee shall 
461.6 	establish general criteria to be used for the prior authorization of brand-name drugs for 
461.7 	which generically equivalent drugs are available, but the committee is not required to review 
461.8 	each brand-name drug for which a generically equivalent drug is available.
461.9 	(b) Prior authorization may be required by the commissioner before certain formulary 
461.10 	drugs are eligible for payment. The Formulary Committee may recommend drugs for prior 
461.11 	authorization directly to the commissioner. The commissioner may also request that the 
461.12 	Formulary Committee review a drug for prior authorization. Before the commissioner may 
461.13 	require prior authorization for a drug:
461.14 	(1) the commissioner must provide information to the Formulary Committee on the 
461.15 	impact that placing the drug on prior authorization may have on the quality of patient care 
461.16 	and on program costs, information regarding whether the drug is subject to clinical abuse 
461.17 	or misuse, and relevant data from the state Medicaid program if such data is available;
461.18 	(2) the Formulary Committee must review the drug, taking into account medical and 
461.19 	clinical data and the information provided by the commissioner; and
461.20 	(3) the Formulary Committee must hold a public forum and receive public comment for 
461.21 	an additional 15 days.
461.22 	The commissioner must provide a 15-day notice period before implementing the prior 
461.23 	authorization.
461.24 	(c) Except as provided in subdivision 13j, prior authorization shall not be required or 
461.25 	utilized for any atypical antipsychotic drug prescribed for the treatment of mental illness 
461.26 	if:
461.27 	(1) there is no generically equivalent drug available; and
461.28 	(2) the drug was initially prescribed for the recipient prior to July 1, 2003; or
461.29 	(3) the drug is part of the recipient's current course of treatment.
461.30 	This paragraph applies to any multistate preferred drug list or supplemental drug rebate 
461.31 	program established or administered by the commissioner. Prior authorization shall 
461.32 	automatically be granted for 60 days for brand name drugs prescribed for treatment of mental 
462.1 	illness within 60 days of when a generically equivalent drug becomes available, provided 
462.2 	that the brand name drug was part of the recipient's course of treatment at the time the 
462.3 	generically equivalent drug became available.
462.4 	(d) Prior authorization shall not be required or utilized for any antihemophilic factor 
462.5 	drug prescribed for the treatment of hemophilia and blood disorders where there is no 
462.6 	generically equivalent drug available if the prior authorization is used in conjunction with 
462.7 	any supplemental drug rebate program or multistate preferred drug list established or 
462.8 	administered by the commissioner.
462.9 	(e) The commissioner may require prior authorization for brand name drugs whenever 
462.10 	a generically equivalent product is available, even if the prescriber specifically indicates 
462.11 	"dispense as written-brand necessary" on the prescription as required by section 151.21, 
462.12 	subdivision 2.
462.13 	(f) Notwithstanding this subdivision, the commissioner may automatically require prior 
462.14 	authorization, for a period not to exceed 180 days, for any drug that is approved by the 
462.15 	United States Food and Drug Administration on or after July 1, 2005. The 180-day period 
462.16 	begins no later than the first day that a drug is available for shipment to pharmacies within 
462.17 	the state. The Formulary Committee shall recommend to the commissioner general criteria 
462.18 	to be used for the prior authorization of the drugs, but the committee is not required to 
462.19 	review each individual drug. In order to continue prior authorizations for a drug after the 
462.20 	180-day period has expired, the commissioner must follow the provisions of this subdivision.
462.21 	(g) Any step therapy protocol requirements established by the commissioner must comply 
462.22 	with section 62Q.1841.

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

462.24 	Sec. 18. Minnesota Statutes 2018, section 256B.0625, is amended by adding a subdivision 
462.25 	to read:
462.26 		Subd. 66.Coverage for treatment of pediatric autoimmune neuropsychiatric 
462.27 	disorders associated with streptococcal infections (PANDAS) and pediatric acute-onset 
462.28 	neuropsychiatric syndrome (PANS). Medical assistance covers treatment of pediatric 
462.29 	autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS) 
462.30 	and pediatric acute-onset neuropsychiatric syndrome (PANS). Coverage shall be developed 
462.31 	in collaboration with the Health Services Policy Committee established under subdivision 
462.32 	3c.

463.1 	Sec. 19. Laws 2017, chapter 13, article 1, section 15, as amended by Laws 2017, First 
463.2 	Special Session chapter 6, article 5, section 10, is amended to read:
463.3 	Sec. 15. MINNESOTA PREMIUM SECURITY PLAN FUNDING.
 463.4 	(a) The Minnesota Comprehensive Health Association shall fund the operational and 
463.5 	administrative costs and reinsurance payments of the Minnesota security plan and association 
463.6 	using the following amounts deposited in the premium security plan account in Minnesota 
463.7 	Statutes, section 62E.25, subdivision 1, in the following order:
463.8 	(1) any federal funding available;
463.9 	(2) funds deposited under article 1, sections 12 and 13;
463.10 	(3) any state funds from the health care access fund; and
463.11 	(4) any state funds from the general fund.
463.12 	(b) The association shall transfer from the premium security plan account any remaining
463.13 	state funds not used for the Minnesota premium security plan by June 30, 2021 2023, to the 
463.14 	commissioner of commerce. Any amount transferred to the commissioner of commerce 
463.15 	shall be deposited in the health care access fund in Minnesota Statutes, section 16A.724.
463.16 	(c) The Minnesota Comprehensive Health Association may not spend more than 
463.17 	$271,000,000 for benefit year 2018 and not more than $271,000,000 for benefit year 2019 
463.18 	for the operational and administrative costs of, and reinsurance payments under, the 
463.19 	Minnesota premium security plan.

463.20 	Sec. 20. Laws 2017, First Special Session chapter 6, article 5, section 11, is amended to 
463.21 	read:
463.22 	Sec. 11. MORATORIUM ON CONVERSION TRANSACTIONS.
 463.23 	(a) Notwithstanding Laws 2017, chapter 2, article 2, a nonprofit health service plan 
463.24 	corporation operating under Minnesota Statutes, chapter 62C, or a nonprofit health 
463.25 	maintenance organization operating under Minnesota Statutes, chapter 62D, as of January 
463.26 	1, 2017, may only merge or consolidate with; or convert,; or transfer, as part of a single 
463.27 	transaction or a series of transactions within a 24-month period, all or a substantial portion
463.28 	material amount of its assets to an entity that is a corporation organized under Minnesota 
463.29 	Statutes, chapter 317A; or to a Minnesota nonprofit hospital within the same integrated 
463.30 	health system as the health maintenance organization. For purposes of this section, "material 
464.1 	amount" means the lesser of ten percent of such an entity's total admitted net assets as of 
464.2 	December 31 of the previous year, or $50,000,000.
464.3 	(b) Paragraph (a) does not apply if the nonprofit service plan corporation or nonprofit 
464.4 	health maintenance organization files an intent to dissolve due to insolvency of the 
464.5 	corporation in accordance with Minnesota Statutes, chapter 317A, or insolvency proceedings 
464.6 	are commenced under Minnesota Statutes, chapter 60B.
464.7 	(c) Nothing in this section shall be construed to authorize a nonprofit health maintenance 
464.8 	organization or a nonprofit health service plan corporation to engage in any transaction or 
464.9 	activities not otherwise permitted under state law.
464.10 	(d) This section expires July 1, 2019 2023.

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

464.12 	Sec. 21. COVERAGE FOR PANDAS OR PANS.
 464.13 	A health plan's coverage as of January 1, 2019, must be used by the health carrier as the 
464.14 	basis for determining whether coverage would not have been provided by the health carrier 
464.15 	pursuant to Minnesota Statutes, section 62A.3097, subdivision 4. Treatments and services 
464.16 	covered by the health plan as of January 1, 2019, are not eligible for payment as provided 
464.17 	under Minnesota Statutes, section 62A.3097, subdivision 4, by the commissioner of 
464.18 	commerce.

464.19 	Sec. 22. MINNESOTA PREMIUM SECURITY PLAN ADMINISTERED THROUGH 
464.20 	THE 2021 BENEFIT YEAR.
 464.21 	The Minnesota Comprehensive Health Association must administer the Minnesota 
464.22 	premium security plan through the 2021 benefit year.

464.23 	ARTICLE 9
464.24 	PRESCRIPTION DRUGS

464.25 	Section 1. Minnesota Statutes 2018, section 62J.23, subdivision 2, is amended to read:
464.26 		Subd. 2.Restrictions. (a) From July 1, 1992, until rules are adopted by the commissioner 
464.27 	under this section, the restrictions in the federal Medicare antikickback statutes in section 
464.28 	1128B(b) of the Social Security Act, United States Code, title 42, section 1320a-7b(b), and 
464.29 	rules adopted under the federal statutes, apply to all persons in the state, regardless of whether 
464.30 	the person participates in any state health care program.
465.1 	(b) Nothing in paragraph (a) shall be construed to prohibit an individual from receiving 
465.2 	a discount or other reduction in price or a limited-time free supply or samples of a prescription 
465.3 	drug, medical supply, or medical equipment offered by a pharmaceutical manufacturer, 
465.4 	medical supply or device manufacturer, health plan company, or pharmacy benefit manager, 
465.5 	so long as:
465.6 	(1) the discount or reduction in price is provided to the individual in connection with 
465.7 	the purchase of a prescription drug, medical supply, or medical equipment prescribed for 
465.8 	that individual;
465.9 	(2) it otherwise complies with the requirements of state and federal law applicable to 
465.10 	enrollees of state and federal public health care programs;
465.11 	(3) the discount or reduction in price does not exceed the amount paid directly by the 
465.12 	individual for the prescription drug, medical supply, or medical equipment; and
465.13 	(4) the limited-time free supply or samples are provided by a physician or pharmacist, 
465.14 	as provided by the federal Prescription Drug Marketing Act.
465.15 	For purposes of this paragraph, "prescription drug" includes prescription drugs that are 
465.16 	administered through infusion, and related services and supplies.
465.17 	(c) No benefit, reward, remuneration, or incentive for continued product use may be 
465.18 	provided to an individual or an individual's family by a pharmaceutical manufacturer, 
465.19 	medical supply or device manufacturer, or pharmacy benefit manager, except that this 
465.20 	prohibition does not apply to:
465.21 	(1) activities permitted under paragraph (b);
465.22 	(2) a pharmaceutical manufacturer, medical supply or device manufacturer, health plan 
465.23 	company, or pharmacy benefit manager providing to a patient, at a discount or reduced 
465.24 	price or free of charge, ancillary products necessary for treatment of the medical condition 
465.25 	for which the prescription drug, medical supply, or medical equipment was prescribed or 
465.26 	provided; and
465.27 	(3) a pharmaceutical manufacturer, medical supply or device manufacturer, health plan 
465.28 	company, or pharmacy benefit manager providing to a patient a trinket or memento of 
465.29 	insignificant value.
465.30 	(d) Nothing in this subdivision shall be construed to prohibit a health plan company 
465.31 	from offering a tiered formulary with different co-payment or cost-sharing amounts for 
465.32 	different drugs.

466.1 	Sec. 2. [62Q.528] DRUG COVERAGE IN EMERGENCY SITUATIONS.
466.2 	A health plan that provides prescription drug coverage must provide coverage for a 
466.3 	prescription drug dispensed by a pharmacist under section 151.211, subdivision 3, under 
466.4 	the terms of coverage that would apply had the prescription drug been dispensed according 
466.5 	to a prescription.

466.6 	Sec. 3. Minnesota Statutes 2018, section 151.01, subdivision 23, is amended to read:
466.7 		Subd. 23.Practitioner. "Practitioner" means a licensed doctor of medicine, licensed 
466.8 	doctor of osteopathic medicine duly licensed to practice medicine, licensed doctor of 
466.9 	dentistry, licensed doctor of optometry, licensed podiatrist, licensed veterinarian, or licensed 
466.10 	advanced practice registered nurse. For purposes of sections 151.15, subdivision 4; 151.211, 
466.11 	subdivision 3;151.252, subdivision 3; 151.37, subdivision 2, paragraphs (b), (e), and (f); 
466.12 	and 151.461, "practitioner" also means a physician assistant authorized to prescribe, dispense, 
466.13 	and administer under chapter 147A. For purposes of sections 151.15, subdivision 4; 151.211, 
466.14 	subdivision 3;151.252, subdivision 3; 151.37, subdivision 2, paragraph (b); and 151.461, 
466.15 	"practitioner" also means a dental therapist authorized to dispense and administer under 
466.16 	chapter 150A.

466.17 	Sec. 4. Minnesota Statutes 2018, section 151.06, is amended by adding a subdivision to 
466.18 	read:
466.19 		Subd. 6. Information provision; sources of lower cost prescription drugs. (a) The 
466.20 	board shall publish a page on its website that provides regularly updated information 
466.21 	concerning:
466.22 	(1) patient assistance programs offered by drug manufacturers, including information 
466.23 	on how to access the programs;
466.24 	(2) the prescription drug assistance program established by the Minnesota Board of 
466.25 	Aging under section 256.975, subdivision 9;
466.26 	(3) the websites through which individuals can access information concerning eligibility 
466.27 	for and enrollment in Medicare, medical assistance, MinnesotaCare, and other 
466.28 	government-funded programs that help pay for the cost of health care;
466.29 	(4) availability of providers that are authorized to participate under section 340b of the 
466.30 	federal Public Health Services Act, United States Code, title 42, section 256b;
467.1 	(5) having a discussion with the pharmacist or the consumer's health care provider about 
467.2 	alternatives to a prescribed drug, including a lower cost or generic drug if the drug prescribed 
467.3 	is too costly for the consumer; and
467.4 	(6) any other resource that the board deems useful to individuals who are attempting to 
467.5 	purchase prescription drugs at lower costs.
467.6 	(b) The board must prepare educational materials, including brochures and posters, based 
467.7 	on the information it provides on its website under paragraph (a). The  materials must be in 
467.8 	a form that can be downloaded from the board's website and used for patient education by  
467.9 	pharmacists and by health care practitioners who are licensed to prescribe. The board is not 
467.10 	required to provide printed copies of these materials.
467.11 	(c) The board shall require pharmacists and pharmacies to make available to patients 
467.12 	information on sources of lower cost prescription drugs, including information on the 
467.13 	availability of the website established under paragraph (a).

467.14 	Sec. 5. Minnesota Statutes 2018, section 151.211, subdivision 2, is amended to read:
467.15 		Subd. 2.Refill requirements. Except as provided in subdivision 3, a prescription drug 
467.16 	order may be refilled only with the written, electronic, or verbal consent of the prescriber 
467.17 	and in accordance with the requirements of this chapter, the rules of the board, and where 
467.18 	applicable, section 152.11. The date of such refill must be recorded and initialed upon the 
467.19 	original prescription drug order, or within the electronically maintained record of the original 
467.20 	prescription drug order, by the pharmacist, pharmacist intern, or practitioner who refills the 
467.21 	prescription.

467.22 	Sec. 6. Minnesota Statutes 2018, section 151.211, is amended by adding a subdivision to 
467.23 	read:
467.24 		Subd. 3.Emergency prescription refills. (a) A pharmacist may, using sound professional 
467.25 	judgment and in accordance with accepted standards of practice, dispense a legend drug 
467.26 	without a current prescription drug order from a licensed practitioner if all of the following 
467.27 	conditions are met:
467.28 	(1) the patient has been compliant with taking the medication and has consistently had 
467.29 	the drug filled or refilled as demonstrated by records maintained by the pharmacy;
467.30 	(2) the pharmacy from which the legend drug is dispensed has record of a prescription 
467.31 	drug order for the drug in the name of the patient who is requesting it, but the prescription 
468.1 	drug order does not provide for a refill, or the time during which the refills were valid has 
468.2 	elapsed;
468.3 	(3) the pharmacist has tried but is unable to contact the practitioner who issued the 
468.4 	prescription drug order, or another practitioner responsible for the patient's care, to obtain 
468.5 	authorization to refill the prescription;
468.6 	(4) the drug is essential to sustain the life of the patient or to continue therapy for a 
468.7 	chronic condition;
468.8 	(5) failure to dispense the drug to the patient would result in harm to the health of the 
468.9 	patient; and
468.10 	(6) the drug is not a controlled substance listed in section 152.02, subdivisions 3 to 6, 
468.11 	except for a controlled substance that has been specifically prescribed to treat a seizure 
468.12 	disorder, in which case the pharmacist may dispense up to a 72-hour supply.
468.13 	(b) If the conditions in paragraph (a) are met, the amount of the drug dispensed by the 
468.14 	pharmacist to the patient must not exceed a 30-day supply, or the quantity originally 
468.15 	prescribed, whichever is less, except as provided for controlled substances in paragraph (a), 
468.16 	clause (6). If the standard unit of dispensing for the drug exceeds a 30-day supply, the 
468.17 	amount of the drug dispensed or sold must not exceed the standard unit of dispensing.
468.18 	(c) A pharmacist shall not dispense or sell the same drug to the same patient, as provided 
468.19 	in this section, more than one time in any 12-month period.
468.20 	(d) A pharmacist must notify the practitioner who issued the prescription drug order not 
468.21 	later than 72 hours after the drug is sold or dispensed. The pharmacist must request and 
468.22 	receive authorization before any additional refills may be dispensed. If the practitioner 
468.23 	declines to provide authorization for additional refills, the pharmacist must inform the patient 
468.24 	of that fact.
468.25 	(e) The record of a drug sold or dispensed under this section shall be maintained in the 
468.26 	same manner required for prescription drug orders under this section.

468.27 	Sec. 7. [151.555] PRESCRIPTION DRUG REPOSITORY PROGRAM.
468.28 		Subdivision 1.Definitions. (a) For the purposes of this section, the terms defined in this 
468.29 	subdivision have the meanings given.
468.30 	(b) "Central repository" means a wholesale distributor that meets the requirements under 
468.31 	subdivision 3 and enters into a contract with the Board of Pharmacy in accordance with this 
468.32 	section.
469.1 	(c) "Distribute" means to deliver, other than by administering or dispensing.
469.2 	(d) "Donor" means:
469.3 	(1) a health care facility as defined in this subdivision;
469.4 	(2) a skilled nursing facility licensed under chapter 144A;
469.5 	(3) an assisted living facility registered under chapter 144D where there is centralized 
469.6 	storage of drugs and 24-hour on-site licensed nursing coverage provided seven days a week;
469.7 	(4) a pharmacy licensed under section 151.19, and located either in the state or outside 
469.8 	the state;
469.9 	(5) a drug wholesaler licensed under section 151.47;
469.10 	(6) a drug manufacturer licensed under section 151.252; or
469.11 	(7) an individual at least 18 years of age, provided that the drug or medical supply that 
469.12 	is donated was obtained legally and meets the requirements of this section for donation.
469.13 	(e) "Drug" means any prescription drug that has been approved for medical use in the 
469.14 	United States, is listed in the United States Pharmacopoeia or National Formulary, and 
469.15 	meets the criteria established under this section for donation. This definition includes cancer 
469.16 	drugs and antirejection drugs, but does not include controlled substances, as defined in 
469.17 	section 152.01, subdivision 4, or a prescription drug that can only be dispensed to a patient 
469.18 	registered with the drug's manufacturer in accordance with federal Food and Drug 
469.19 	Administration requirements.
469.20 	(f) "Health care facility" means:
469.21 	(1) a physician's office or health care clinic where licensed practitioners provide health 
469.22 	care to patients;
469.23 	(2) a hospital licensed under section 144.50;
469.24 	(3) a pharmacy licensed under section 151.19 and located in Minnesota; or
469.25 	(4) a nonprofit community clinic, including a federally qualified health center; a rural 
469.26 	health clinic; public health clinic; or other community clinic that provides health care utilizing 
469.27 	a sliding fee scale to patients who are low-income, uninsured, or underinsured.
469.28 	(g) "Local repository" means a health care facility that elects to accept donated drugs 
469.29 	and medical supplies and meets the requirements of subdivision 4.
469.30 	(h) "Medical supplies" or "supplies" means any prescription and nonprescription medical 
469.31 	supply needed to administer a prescription drug.
470.1 	(i) "Original, sealed, unopened, tamper-evident packaging" means packaging that is 
470.2 	sealed, unopened, and tamper-evident, including a manufacturer's original unit dose or 
470.3 	unit-of-use container, a repackager's original unit dose or unit-of-use container, or unit-dose 
470.4 	packaging prepared by a licensed pharmacy according to the standards of Minnesota Rules, 
470.5 	part 6800.3750.
470.6 	(j) "Practitioner" has the meaning given in section 151.01, subdivision 23, except that 
470.7 	it does not include a veterinarian.
470.8 		Subd. 2.Establishment. By January 1, 2020, the Board of Pharmacy shall establish a 
470.9 	drug repository program, through which donors may donate a drug or medical supply for 
470.10 	use by an individual who meets the eligibility criteria specified under subdivision 5. The 
470.11 	board shall contract with a central repository that meets the requirements of subdivision 3 
470.12 	to implement and administer the prescription drug repository program.
470.13 		Subd. 3.Central repository requirements. (a) The board shall publish a request for 
470.14 	proposal for participants who meet the requirements of this subdivision and are interested 
470.15 	in acting as the central repository for the drug repository program. The board shall follow 
470.16 	all applicable state procurement procedures in the selection process.
470.17 	(b) To be eligible to act as the central repository, the participant must be a wholesale 
470.18 	drug distributor located in Minnesota, licensed pursuant to section 151.47, and in compliance 
470.19 	with all applicable federal and state statutes, rules, and regulations.
470.20 	(c) The central repository shall be subject to inspection by the board pursuant to section 
470.21 	151.06, subdivision 1.
470.22 	(d) The central repository shall comply with all applicable federal and state laws, rules, 
470.23 	and regulations pertaining to the drug repository program, drug storage, and dispensing. 
470.24 	The facility must maintain in good standing any state license or registration that applies to 
470.25 	the facility.
470.26 		Subd. 4.Local repository requirements. (a) To be eligible for participation in the drug 
470.27 	repository program, a health care facility must agree to comply with all applicable federal 
470.28 	and state laws, rules, and regulations pertaining to the drug repository program, drug storage, 
470.29 	and dispensing. The facility must also agree to maintain in good standing any required state 
470.30 	license or registration that may apply to the facility.
470.31 	(b) A local repository may elect to participate in the program by submitting the following 
470.32 	information to the central repository on a form developed by the board and made available 
470.33 	on the board's website:
471.1 	(1) the name, street address, and telephone number of the health care facility and any 
471.2 	state-issued license or registration number issued to the facility, including the issuing state 
471.3 	agency;
471.4 	(2) the name and telephone number of a responsible pharmacist or practitioner who is 
471.5 	employed by or under contract with the health care facility; and
471.6 	(3) a statement signed and dated by the responsible pharmacist or practitioner indicating 
471.7 	that the health care facility meets the eligibility requirements under this section and agrees 
471.8 	to comply with this section.
471.9 	(c) Participation in the drug repository program is voluntary. A local repository may 
471.10 	withdraw from participation in the drug repository program at any time by providing written 
471.11 	notice to the central repository on a form developed by the board and made available on 
471.12 	the board's website. The central repository shall provide the board with a copy of the 
471.13 	withdrawal notice within ten business days from the date of receipt of the withdrawal notice.
471.14 		Subd. 5.Individual eligibility and application requirements. (a) To be eligible for 
471.15 	the drug repository program, an individual must submit to a local repository an intake 
471.16 	application form that is signed by the individual and attests that the individual:
471.17 	(1) is a resident of Minnesota;
471.18 	(2) is uninsured and is not enrolled in the medical assistance program under chapter 
471.19 	256B or the MinnesotaCare program under chapter 256L, has no prescription drug coverage, 
471.20 	or is underinsured;
471.21 	(3) acknowledges that the drugs or medical supplies to be received through the program 
471.22 	may have been donated; and
471.23 	(4) consents to a waiver of the child-resistant packaging requirements of the federal 
471.24 	Poison Prevention Packaging Act.
471.25 	(b) Upon determining that an individual is eligible for the program, the local repository 
471.26 	shall furnish the individual with an identification card. The card shall be valid for one year 
471.27 	from the date of issuance and may be used at any local repository. A new identification card 
471.28 	may be issued upon expiration once the individual submits a new application form.
471.29 	(c) The local repository shall send a copy of the intake application form to the central 
471.30 	repository by regular mail, facsimile, or secured e-mail within ten days from the date the 
471.31 	application is approved by the local repository.
472.1 	(d) The board shall develop and make available on the board's website an application 
472.2 	form and the format for the identification card.
472.3 		Subd. 6.Standards and procedures for accepting donations of drugs and supplies. (a) 
472.4 	A donor may donate prescription drugs or medical supplies to the central repository or a 
472.5 	local repository if the drug or supply meets the requirements of this section as determined 
472.6 	by a pharmacist or practitioner who is employed by or under contract with the central 
472.7 	repository or a local repository.
472.8 	(b) A prescription drug is eligible for donation under the drug repository program if the 
472.9 	following requirements are met:
472.10 	(1) the donation is accompanied by a drug repository donor form described under 
472.11 	paragraph (d) that is signed by an individual who is authorized by the donor to attest to the 
472.12 	donor's knowledge in accordance with paragraph (d);
472.13 	(2) the drug's expiration date is at least six months after the date the drug was donated. 
472.14 	If a donated drug bears an expiration date that is less than six months from the donation 
472.15 	date, the drug may be accepted and distributed if the drug is in high demand and can be 
472.16 	dispensed for use by a patient before the drug's expiration date;
472.17 	(3) the drug is in its original, sealed, unopened, tamper-evident packaging that includes 
472.18 	the expiration date. Single-unit-dose drugs may be accepted if the single-unit-dose packaging 
472.19 	is unopened;
472.20 	(4) the drug or the packaging does not have any physical signs of tampering, misbranding, 
472.21 	deterioration, compromised integrity, or adulteration;
472.22 	(5) the drug does not require storage temperatures other than normal room temperature 
472.23 	as specified by the manufacturer or United States Pharmacopoeia, unless the drug is being 
472.24 	donated directly by its manufacturer, a wholesale drug distributor, or a pharmacy located 
472.25 	in Minnesota; and
472.26 	(6) the prescription drug is not a controlled substance.
472.27 	(c) A medical supply is eligible for donation under the drug repository program if the 
472.28 	following requirements are met:
472.29 	(1) the supply has no physical signs of tampering, misbranding, or alteration and there 
472.30 	is no reason to believe it has been adulterated, tampered with, or misbranded;
472.31 	(2) the supply is in its original, unopened, sealed packaging;
473.1 	(3) the donation is accompanied by a drug repository donor form described under 
473.2 	paragraph (d) that is signed by an individual who is authorized by the donor to attest to the 
473.3 	donor's knowledge in accordance with paragraph (d); and
473.4 	(4) if the supply bears an expiration date, the date is at least six months later than the 
473.5 	date the supply was donated. If the donated supply bears an expiration date that is less than 
473.6 	six months from the date the supply was donated, the supply may be accepted and distributed 
473.7 	if the supply is in high demand and can be dispensed for use by a patient before the supply's 
473.8 	expiration date.
473.9 	(d) The board shall develop the drug repository donor form and make it available on the 
473.10 	board's website. The form must state that to the best of the donor's knowledge the donated 
473.11 	drug or supply has been properly stored under appropriate temperature and humidity 
473.12 	conditions, and that the drug or supply has never been opened, used, tampered with, 
473.13 	adulterated, or misbranded.
473.14 	(e) Donated drugs and supplies may be shipped or delivered to the premises of the central 
473.15 	repository or a local repository, and shall be inspected by a pharmacist or an authorized 
473.16 	practitioner who is employed by or under contract with the repository and who has been 
473.17 	designated by the repository to accept donations. A drop box must not be used to deliver 
473.18 	or accept donations.
473.19 	(f) The central repository and local repository shall inventory all drugs and supplies 
473.20 	donated to the repository. For each drug, the inventory must include the drug's name, strength, 
473.21 	quantity, manufacturer, expiration date, and the date the drug was donated. For each medical 
473.22 	supply, the inventory must include a description of the supply, its manufacturer, the date 
473.23 	the supply was donated, and, if applicable, the supply's brand name and expiration date.
473.24 		Subd. 7.Standards and procedures for inspecting and storing donated prescription 
473.25 	drugs and supplies. (a) A pharmacist or authorized practitioner who is employed by or 
473.26 	under contract with the central repository or a local repository shall inspect all donated 
473.27 	prescription drugs and supplies before the drug or supply is dispensed to determine, to the 
473.28 	extent reasonably possible in the professional judgment of the pharmacist or practitioner, 
473.29 	that the drug or supply is not adulterated or misbranded, has not been tampered with, is safe 
473.30 	and suitable for dispensing, has not been subject to a recall, and meets the requirements for 
473.31 	donation. The pharmacist or practitioner who inspects the drugs or supplies shall sign an 
473.32 	inspection record stating that the requirements for donation have been met. If a local 
473.33 	repository receives drugs and supplies from the central repository, the local repository does 
473.34 	not need to reinspect the drugs and supplies.
474.1 	(b) The central repository and local repositories shall store donated drugs and supplies 
474.2 	in a secure storage area under environmental conditions appropriate for the drug or supply 
474.3 	being stored. Donated drugs and supplies may not be stored with nondonated inventory. If 
474.4 	donated drugs or supplies are not inspected immediately upon receipt, a repository must 
474.5 	quarantine the donated drugs or supplies separately from all dispensing stock until the 
474.6 	donated drugs or supplies have been inspected and (1) approved for dispensing under the 
474.7 	program; (2) disposed of pursuant to paragraph (c); or (3) returned to the donor pursuant to 
474.8 	paragraph (d).
474.9 	(c) The central repository and local repositories shall dispose of all prescription drugs 
474.10 	and medical supplies that are not suitable for donation in compliance with applicable federal 
474.11 	and state statutes, regulations, and rules concerning hazardous waste.
474.12 	(d) In the event that controlled substances or prescription drugs that can only be dispensed 
474.13 	to a patient registered with the drug's manufacturer are shipped or delivered to a central or 
474.14 	local repository for donation, the shipment delivery must be documented by the repository 
474.15 	and returned immediately to the donor or the donor's representative that provided the drugs.
474.16 	(e) Each repository must develop drug and medical supply recall policies and procedures. 
474.17 	If a repository receives a recall notification, the repository shall destroy all of the drug or 
474.18 	medical supply in its inventory that is the subject of the recall and complete a record of 
474.19 	destruction form in accordance with paragraph (f). If a drug or medical supply that is the 
474.20 	subject of a Class I or Class II recall has been dispensed, the repository shall immediately 
474.21 	notify the recipient of the recalled drug or medical supply. A drug that potentially is subject 
474.22 	to a recall need not be destroyed if its packaging bears a lot number and that lot of the drug 
474.23 	is not subject to the recall. If no lot number is on the drug's packaging, it must be destroyed.
474.24 	(f) A record of destruction of donated drugs and supplies that are not dispensed under 
474.25 	subdivision 8, are subject to a recall under paragraph (e), or are not suitable for donation 
474.26 	shall be maintained by the repository for at least five years. For each drug or supply 
474.27 	destroyed, the record shall include the following information:
474.28 	(1) the date of destruction;
474.29 	(2) the name, strength, and quantity of the drug destroyed; and
474.30 	(3) the name of the person or firm that destroyed the drug.
474.31 		Subd. 8.Dispensing requirements. (a) Donated drugs and supplies may be dispensed 
474.32 	if the drugs or supplies are prescribed by a practitioner for use by an eligible individual and 
474.33 	are dispensed by a pharmacist or practitioner. A repository shall dispense drugs and supplies 
475.1 	to eligible individuals in the following priority order: (1) individuals who are uninsured; 
475.2 	(2) individuals with no prescription drug coverage; and (3) individuals who are underinsured. 
475.3 	A repository shall dispense donated prescription drugs in compliance with applicable federal 
475.4 	and state laws and regulations for dispensing prescription drugs, including all requirements 
475.5 	relating to packaging, labeling, record keeping, drug utilization review, and patient 
475.6 	counseling.
475.7 	(b) Before dispensing or administering a drug or supply, the pharmacist or practitioner 
475.8 	shall visually inspect the drug or supply for adulteration, misbranding, tampering, and date 
475.9 	of expiration. Drugs or supplies that have expired or appear upon visual inspection to be 
475.10 	adulterated, misbranded, or tampered with in any way must not be dispensed or administered.
475.11 	(c) Before a drug or supply is dispensed or administered to an individual, the individual 
475.12 	must sign a drug repository recipient form acknowledging that the individual understands 
475.13 	the information stated on the form. The board shall develop the form and make it available 
475.14 	on the board's website. The form must include the following information:
475.15 	(1) that the drug or supply being dispensed or administered has been donated and may 
475.16 	have been previously dispensed;
475.17 	(2) that a visual inspection has been conducted by the pharmacist or practitioner to ensure 
475.18 	that the drug or supply has not expired, has not been adulterated or misbranded, and is in 
475.19 	its original, unopened packaging; and
475.20 	(3) that the dispensing pharmacist, the dispensing or administering practitioner, the 
475.21 	central repository or local repository, the Board of Pharmacy, and any other participant of 
475.22 	the drug repository program cannot guarantee the safety of the drug or medical supply being 
475.23 	dispensed or administered and that the pharmacist or practitioner has determined that the 
475.24 	drug or supply is safe to dispense or administer based on the accuracy of the donor's form 
475.25 	submitted with the donated drug or medical supply and the visual inspection required to be 
475.26 	performed by the pharmacist or practitioner before dispensing or administering.
475.27 		Subd. 9.Handling fees. (a) The central or local repository may charge the individual 
475.28 	receiving a drug or supply a handling fee of no more than 250 percent of the medical 
475.29 	assistance program dispensing fee for each drug or medical supply dispensed or administered 
475.30 	by that repository.
475.31 	(b) A repository that dispenses or administers a drug or medical supply through the drug 
475.32 	repository program shall not receive reimbursement under the medical assistance program 
475.33 	or the MinnesotaCare program for that dispensed or administered drug or supply.
476.1 		Subd. 10.Distribution of donated drugs and supplies. (a) The central repository and 
476.2 	local repositories may distribute drugs and supplies donated under the drug repository 
476.3 	program to other participating repositories for use pursuant to this program.
476.4 	(b) A local repository that elects not to dispense donated drugs or supplies must transfer 
476.5 	all donated drugs and supplies to the central repository. A copy of the donor form that was 
476.6 	completed by the original donor under subdivision 6 must be provided to the central 
476.7 	repository at the time of transfer.
476.8 		Subd. 11.Forms and record-keeping requirements. (a) The following forms developed 
476.9 	for the administration of this program shall be utilized by the participants of the program 
476.10 	and shall be available on the board's website:
476.11 	(1) intake application form described under subdivision 5;
476.12 	(2) local repository participation form described under subdivision 4;
476.13 	(3) local repository withdrawal form described under subdivision 4;
476.14 	(4) drug repository donor form described under subdivision 6;
476.15 	(5) record of destruction form described under subdivision 7; and
476.16 	(6) drug repository recipient form described under subdivision 8.
476.17 	(b) All records, including drug inventory, inspection, and disposal of donated prescription 
476.18 	drugs and medical supplies must be maintained by a repository for a minimum of five years. 
476.19 	Records required as part of this program must be maintained pursuant to all applicable 
476.20 	practice acts.
476.21 	(c) Data collected by the drug repository program from all local repositories shall be 
476.22 	submitted quarterly or upon request to the central repository. Data collected may consist of 
476.23 	the information, records, and forms required to be collected under this section.
476.24 	(d) The central repository shall submit reports to the board as required by the contract 
476.25 	or upon request of the board.
476.26 		Subd. 12.Liability. (a) The manufacturer of a drug or supply is not subject to criminal 
476.27 	or civil liability for injury, death, or loss to a person or to property for causes of action 
476.28 	described in clauses (1) and (2). A manufacturer is not liable for:
476.29 	(1) the intentional or unintentional alteration of the drug or supply by a party not under 
476.30 	the control of the manufacturer; or
477.1 	(2) the failure of a party not under the control of the manufacturer to transfer or 
477.2 	communicate product or consumer information or the expiration date of the donated drug 
477.3 	or supply.
477.4 	(b) A health care facility participating in the program, a pharmacist dispensing a drug 
477.5 	or supply pursuant to the program, a practitioner dispensing or administering a drug or 
477.6 	supply pursuant to the program, or a donor of a drug or medical supply is immune from 
477.7 	civil liability for an act or omission that causes injury to or the death of an individual to 
477.8 	whom the drug or supply is dispensed and no disciplinary action by a health-related licensing 
477.9 	board shall be taken against a pharmacist or practitioner so long as the drug or supply is 
477.10 	donated, accepted, distributed, and dispensed according to the requirements of this section. 
477.11 	This immunity does not apply if the act or omission involves reckless, wanton, or intentional 
477.12 	misconduct, or malpractice unrelated to the quality of the drug or medical supply.
477.13 		Subd. 13.Drug returned for credit. Nothing in this section allows a long-term care 
477.14 	facility to donate a drug to a central or local repository when federal or state law requires 
477.15 	the drug to be returned to the pharmacy that initially dispensed it, so that the pharmacy can 
477.16 	credit the payer for the amount of the drug returned.

477.17 	Sec. 8. [214.122] INFORMATION PROVISION; PHARMACEUTICAL 
477.18 	ASSISTANCE PROGRAMS.
477.19 	(a) The Board of Medical Practice and the Board of Nursing shall at least annually inform 
477.20 	licensees who are authorized to prescribe prescription drugs of the availability of the Board 
477.21 	of Pharmacy's website that contains information on resources and programs to assist patients 
477.22 	with the cost of prescription drugs. The boards shall provide licensees with the website 
477.23 	address established by the Board of Pharmacy under section 151.06, subdivision 6, and the 
477.24 	materials described under section 151.06, subdivision 6, paragraph (b).
477.25 	(b) Licensees must make available to patients information on sources of lower cost 
477.26 	prescription drugs, including information on the availability of the website established by 
477.27 	the Board of Pharmacy under section 151.06, subdivision 6.

477.28 	ARTICLE 10
477.29 	HEALTH-RELATED LICENSING BOARDS

477.30 	Section 1. [144A.291] FEES.
477.31 		Subdivision 1.Nonrefundable fees. All fees are nonrefundable.
478.1 		Subd. 2.Amounts. (a) Fees may not exceed the following amounts but may be adjusted 
478.2 	lower by board direction and are for the exclusive use of the board as required to sustain 
478.3 	board operations. The maximum amounts of fees are:
478.4 	(1) application for licensure, $200;
478.5 	(2) for a prospective applicant for a review of education and experience advisory to the 
478.6 	license application, $100, to be applied to the fee for application for licensure if the latter 
478.7 	is submitted within one year of the request for review of education and experience;
478.8 	(3) state examination, $125;
478.9 	(4) initial license, $250 if issued between July 1 and December 31, $100 if issued between 
478.10 	January 1 and June 30;
478.11 	(5) acting administrator permit, $400;
478.12 	(6) renewal license, $250;
478.13 	(7) duplicate license, $50;
478.14 	(8) reinstatement fee, $250;
478.15 	(9) health services executive initial license, $200;
478.16 	(10) health services executive renewal license, $200;
478.17 	(11) reciprocity verification fee, $50;
478.18 	(12) second shared administrator assignment, $250;
478.19 	(13) continuing education fees:
478.20 	(i) greater than 6 hours, $50; and
478.21 	(ii) 7 hours or more, $75;
478.22 	(14) education review, $100;
478.23 	(15) fee to a sponsor for review of individual continuing education seminars, institutes, 
478.24 	workshops, or home study courses:
478.25 	(i) for less than seven clock hours, $30; and
478.26 	(ii) for seven or more clock hours, $50;
478.27 	(16) fee to a licensee for review of continuing education seminars, institutes, workshops, 
478.28 	or home study courses not previously approved for a sponsor and submitted with an 
478.29 	application for license renewal:
479.1 	(i) for less than seven clock hours total, $30; and
479.2 	(ii) for seven or more clock hours total, $50;
479.3 	(17) late renewal fee, $75;
479.4 	(18) fee to a licensee for verification of licensure status and examination scores, $30;
479.5 	(19) registration as a registered continuing education sponsor, $1,000; and
479.6 	(20) mail labels, $75.
479.7 	(b) The revenue generated from the fees must be deposited in an account in the state 
479.8 	government special revenue fund.

479.9 	Sec. 2. Minnesota Statutes 2018, section 147.037, subdivision 1, is amended to read:
479.10 		Subdivision 1.Requirements. The board shall issue a license to practice medicine to 
479.11 	any person who satisfies the requirements in paragraphs (a) to (g).
479.12 	(a) The applicant shall satisfy all the requirements established in section 147.02, 
479.13 	subdivision 1, paragraphs (a), (e), (f), (g), and (h).
479.14 	(b) The applicant shall present evidence satisfactory to the board that the applicant is a 
479.15 	graduate of a medical or osteopathic school approved by the board as equivalent to accredited 
479.16 	United States or Canadian schools based upon its faculty, curriculum, facilities, accreditation, 
479.17 	or other relevant data. If the applicant is a graduate of a medical or osteopathic program 
479.18 	that is not accredited by the Liaison Committee for Medical Education or the American 
479.19 	Osteopathic Association, the applicant may use the Federation of State Medical Boards' 
479.20 	Federation Credentials Verification Service (FCVS) or its successor. If the applicant uses 
479.21 	this service as allowed under this paragraph, the physician application fee may be less than 
479.22 	$200 but must not exceed the cost of administering this paragraph.
479.23 	(c) The applicant shall present evidence satisfactory to the board that the applicant has 
479.24 	been awarded a certificate by the Educational Council for Foreign Medical Graduates, and 
479.25 	the applicant has a working ability in the English language sufficient to communicate with 
479.26 	patients and physicians and to engage in the practice of medicine.
479.27 	(d) The applicant shall present evidence satisfactory to the board of the completion of 
479.28 	two years one year of graduate, clinical medical training in a program located in the United 
479.29 	States, its territories, or Canada and accredited by a national accrediting organization 
479.30 	approved by the board accredited by a national accrediting organization approved by the 
479.31 	board or other graduate training approved in advance by the board as meeting standards 
479.32 	similar to those of a national accrediting organization. This requirement does not apply:
480.1 	(1) to an applicant who is admitted as a permanent immigrant to the United States on or 
480.2 	before October 1, 1991, as a person of exceptional ability in the sciences according to Code 
480.3 	of Federal Regulations, title 20, section 656.22(d); or
480.4 	(2) to an applicant holding a valid license to practice medicine in another country and 
480.5 	issued a permanent immigrant visa after October 1, 1991, as a person of extraordinary ability 
480.6 	in the field of science or as an outstanding professor or researcher according to Code of 
480.7 	Federal Regulations, title 8, section 204.5(h) and (i), or a temporary nonimmigrant visa as 
480.8 	a person of extraordinary ability in the field of science according to Code of Federal 
480.9 	Regulations, title 8, section 214.2(o),
480.10 	provided that a person under clause (1) or (2) is admitted pursuant to rules of the United 
480.11 	States Department of Labor; or
480.12 	(3) to an applicant who is licensed in another state, has practiced five years without 
480.13 	disciplinary action in the United States, its territories, or Canada, has completed one year 
480.14 	of the graduate, clinical medical training required by this paragraph, and has passed the 
480.15 	Special Purpose Examination of the Federation of State Medical Boards within three attempts 
480.16 	in the 24 months before licensing.
480.17 	(e) The applicant must:
480.18 	(1) have passed an examination prepared and graded by the Federation of State Medical 
480.19 	Boards, the United States Medical Licensing Examination program in accordance with 
480.20 	section 147.02, subdivision 1, paragraph (c), clause (2), or the Medical Council of Canada; 
480.21 	and
480.22 	(2) have a current license from the equivalent licensing agency in another state or country 
480.23 	and, if the examination in clause (1) was passed more than ten years ago, either:
480.24 	(i) pass the Special Purpose Examination of the Federation of State Medical Boards with 
480.25 	a score of 75 or better within three attempts; or
480.26 	(ii) have a current certification by a specialty board of the American Board of Medical 
480.27 	Specialties, of the American Osteopathic Association, of the Royal College of Physicians 
480.28 	and Surgeons of Canada, or of the College of Family Physicians of Canada; or
480.29 	(3) if the applicant fails to meet the requirement established in section 147.02, subdivision 
480.30 	1, paragraph (c), clause (2), because the applicant failed to pass each of steps one, two, and 
480.31 	three of the USMLE within the required three attempts, the applicant may be granted a 
480.32 	license provided the applicant:
481.1 	(i) has passed each of steps one, two, and three with passing scores as recommended by 
481.2 	the USMLE program within no more than four attempts for any of the three steps;
481.3 	(ii) is currently licensed in another state; and
481.4 	(iii) has current certification by a specialty board of the American Board of Medical 
481.5 	Specialties, the American Osteopathic Association, the Royal College of Physicians and 
481.6 	Surgeons of Canada, or the College of Family Physicians of Canada.
481.7 	(f) The applicant must not be under license suspension or revocation by the licensing 
481.8 	board of the state or jurisdiction in which the conduct that caused the suspension or revocation 
481.9 	occurred.
481.10 	(g) The applicant must not have engaged in conduct warranting disciplinary action 
481.11 	against a licensee, or have been subject to disciplinary action other than as specified in 
481.12 	paragraph (f). If an applicant does not satisfy the requirements stated in this paragraph, the 
481.13 	board may issue a license only on the applicant's showing that the public will be protected 
481.14 	through issuance of a license with conditions or limitations the board considers appropriate.

481.15 	Sec. 3. Minnesota Statutes 2018, section 147.0375, subdivision 1, is amended to read:
481.16 		Subdivision 1.Requirements. The board shall issue a license to practice medicine to 
481.17 	any person who satisfies the requirements in paragraphs (a) to (d).
481.18 	(a) The applicant must satisfy all the requirements established in section 147.02, 
481.19 	subdivision 1, paragraphs (a), (e), (f), (g), and (h).
481.20 	(b) The applicant must present evidence satisfactory to the board that the applicant is a 
481.21 	graduate of a medical or osteopathic school approved by the board as equivalent to accredited 
481.22 	United States or Canadian schools based upon its faculty, curriculum, facilities, accreditation, 
481.23 	or other relevant data. If the applicant is a graduate of a medical or osteopathic program 
481.24 	that is not accredited by the Liaison Committee for Medical Education or the American 
481.25 	Osteopathic Association, the applicant may use the Federation of State Medical Boards' 
481.26 	Federation Credentials Verification Service (FCVS) or its successor. If the applicant uses 
481.27 	this service as allowed under this paragraph, the physician application fee may be less than 
481.28 	$200 but must not exceed the cost of administering this paragraph.
481.29 	(c) The applicant must present evidence satisfactory to the board of the completion of 
481.30 	two years one year of graduate, clinical medical training in a program located in the United 
481.31 	States, its territories, or Canada and accredited by a national accrediting organization 
481.32 	approved by the board accredited by a national accrediting organization approved by the 
482.1 	board or other graduate training approved in advance by the board as meeting standards 
482.2 	similar to those of a national accrediting organization. This requirement does not apply:
482.3 	(1) to an applicant who is admitted as a permanent immigrant to the United States on or 
482.4 	before October 1, 1991, as a person of exceptional ability in the sciences according to Code 
482.5 	of Federal Regulations, title 20, section 656.22 (d); or
482.6 	(2) to an applicant holding a valid license to practice medicine in another state or country 
482.7 	and issued a permanent immigrant visa after October 1, 1991, as a person of extraordinary 
482.8 	ability in the field of science or as an outstanding professor or researcher according to Code 
482.9 	of Federal Regulations, title 8, section 204.5(h) and (i), or a temporary nonimmigrant visa 
482.10 	or status as a person of extraordinary ability in the field of science according to Code of 
482.11 	Federal Regulations, title 8, section 214.2(o); or
482.12 	(3) to an applicant who is licensed in another state, has practiced five years without 
482.13 	disciplinary action in the United States, its territories, or Canada, has completed one year 
482.14 	of the graduate, clinical medical training required by this paragraph, and has passed the 
482.15 	Special Purpose Examination of the Federation of State Medical Boards within three attempts 
482.16 	in the 24 months before licensing.
482.17 	(d) The applicant must present evidence satisfactory to the board that the applicant has 
482.18 	been appointed to serve as a faculty member of a medical school accredited by the Liaison 
482.19 	Committee of Medical Education or an osteopathic medical school accredited by the 
482.20 	American Osteopathic Association.

482.21 	Sec. 4. Minnesota Statutes 2018, section 147D.27, is amended by adding a subdivision to 
482.22 	read:
482.23 		Subd. 6.Additional fees. (a) The following fees also apply:
482.24 	(1) traditional midwifery annual registration fee, $100;
482.25 	(2) traditional midwifery application fee, $100;
482.26 	(3) traditional midwifery late fee, $75;
482.27 	(4) traditional midwifery inactive status, $50;
482.28 	(5) traditional midwifery temporary permit, $75;
482.29 	(6) traditional midwifery certification fee, $25;
482.30 	(7) duplicate license or registration fee, $20;
482.31 	(8) certification letter, $25;
483.1 	(9) education or training program approval fee, $100; and
483.2 	(10) report creation and generation, $60 per hour billed in quarter-hour increments with 
483.3 	a quarter-hour minimum.
483.4 	(b) The revenue generated from the fees must be deposited in an account in the state 
483.5 	government special revenue fund.

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

483.7 	Sec. 5. Minnesota Statutes 2018, section 147E.40, subdivision 1, as amended by Laws 
483.8 	2019, chapter 8, article 7, section 8, is amended to read:
483.9 		Subdivision 1.Fees. (a) Fees are as follows:
483.10 	(1) registration application fee, $200;
483.11 	(2) renewal fee, $150;
483.12 	(3) late fee, $75;
483.13 	(4) inactive status fee, $50;
483.14 	(5) temporary permit fee, $25;
483.15 	(6) naturopathic doctor certification fee, $25;
483.16 	(7) naturopathic doctor duplicate license fee, $20;
483.17 	(6)(8) naturopathic doctor emeritus registration fee, $50;
483.18 	(9) naturopathic doctor certification fee, $25;
483.19 	(7) (10) duplicate license or registration fee, $20;
483.20 	(8) (11) certification letter fee, $25;
483.21 	(9) (12) verification fee, $25;
483.22 	(10) (13) education or training program approval fee, $100; and
483.23 	(11)(14) report creation and generation fee, $60 per hour billed in quarter-hour 
483.24 	increments with a quarter-hour minimum.
483.25 	(b) The revenue generated from the fees must be deposited in an account in the state 
483.26 	government special revenue fund.

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

484.1 	Sec. 6. Minnesota Statutes 2018, section 147F.17, subdivision 1, as amended by Laws 
484.2 	2019, chapter 8, article 7, section 9, is amended to read:
484.3 		Subdivision 1.Fees. (a) Fees are as follows:
484.4 	(1) license application fee, $200;
484.5 	(2) initial licensure and annual renewal, $150;
484.6 	(3) late fee, $75;
484.7 	(4) genetic counselor certification fee, $25;
484.8 	(4) (5) temporary license fee, $60;
484.9 	(5) (6) duplicate license fee, $20;
484.10 	(6) (7) certification letter fee, $25;
484.11 	(7) (8) education or training program approval fee, $100;
484.12 	(8) (9) report creation and generation fee, $60 per hour billed in quarter-hour increments 
484.13 	with a quarter-hour minimum; and
484.14 	(9) (10) criminal background check fee, $32.
484.15 	(b) The revenue generated from the fees must be deposited in an account in the state 
484.16 	government special revenue fund.

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

484.18 	Sec. 7. Minnesota Statutes 2018, section 148.59, is amended to read:
484.19 	148.59 LICENSE RENEWAL; LICENSE AND REGISTRATION FEES.
484.20 	A licensed optometrist shall pay to the state Board of Optometry a fee as set by the board 
484.21 	in order to renew a license as provided by board rule. No fees shall be refunded. Fees may 
484.22 	not exceed the following amounts but may be adjusted lower by board direction and are for 
484.23 	the exclusive use of the board:
484.24 	(1) optometry licensure application, $160;
484.25 	(2) optometry annual licensure renewal, $135 $200;
484.26 	(3) optometry late penalty fee, $75;
484.27 	(4) annual license renewal card, $10;
484.28 	(5) continuing education provider application, $45;
485.1 	(6) emeritus registration, $10;
485.2 	(7) endorsement/reciprocity application, $160;
485.3 	(8) replacement of initial license, $12; and
485.4 	(9) license verification, $50.;
485.5 	(10) state jurisprudence examination, $75;
485.6 	(11) optometric education continuing education data bank registration, $25; and
485.7 	(12) miscellaneous labels and data retrieval, $50.

485.8 	Sec. 8. Minnesota Statutes 2018, section 148.6445, subdivision 1, is amended to read:
485.9 		Subdivision 1.Initial licensure fee. The initial licensure fee for occupational therapists 
485.10 	is $145 $185. The initial licensure fee for occupational therapy assistants is $80 $105. The 
485.11 	board shall prorate fees based on the number of quarters remaining in the biennial licensure 
485.12 	period.

485.13 	Sec. 9. Minnesota Statutes 2018, section 148.6445, subdivision 2, is amended to read:
485.14 		Subd. 2.Licensure renewal fee. The biennial licensure renewal fee for occupational 
485.15 	therapists is $145 $185. The biennial licensure renewal fee for occupational therapy assistants 
485.16 	is $80 $105.

485.17 	Sec. 10. Minnesota Statutes 2018, section 148.6445, subdivision 2a, is amended to read:
485.18 		Subd. 2a.Duplicate license fee. The fee for a duplicate license is $25 $30.

485.19 	Sec. 11. Minnesota Statutes 2018, section 148.6445, subdivision 3, is amended to read:
485.20 		Subd. 3.Late fee. The fee for late submission of a renewal application is $25 $50.

485.21 	Sec. 12. Minnesota Statutes 2018, section 148.6445, subdivision 4, is amended to read:
485.22 		Subd. 4.Temporary licensure fee. The fee for temporary licensure is $50 $75.

485.23 	Sec. 13. Minnesota Statutes 2018, section 148.6445, subdivision 5, is amended to read:
485.24 		Subd. 5.Limited licensure fee. The fee for limited licensure is $96 $100.

486.1 	Sec. 14. Minnesota Statutes 2018, section 148.6445, subdivision 6, is amended to read:
486.2 		Subd. 6.Fee for course approval after lapse of licensure. The fee for course approval 
486.3 	after lapse of licensure is $96 $100.

486.4 	Sec. 15. Minnesota Statutes 2018, section 148.6445, subdivision 10, is amended to read:
486.5 		Subd. 10.Use of fees. (a) All fees are nonrefundable. The board shall only use fees 
486.6 	collected under this section for the purposes of administering this chapter. The legislature 
486.7 	must not transfer money generated by these fees from the state government special revenue 
486.8 	fund to the general fund.
486.9 	(b) Licensure fees are for the exclusive use of the board and shall be established by the 
486.10 	board not to exceed the nonrefundable amounts in this section.

486.11 	Sec. 16. Minnesota Statutes 2018, section 148.7815, subdivision 1, as amended by Laws 
486.12 	2019, chapter 8, article 7, section 10, is amended to read:
486.13 		Subdivision 1.Fees. (a) The board shall establish fees as follows:
486.14 	(1) application fee, $50;
486.15 	(2) annual license fee, $100;
486.16 	(3) athletic trainer certification fee, $25;
486.17 	(4) athletic trainer duplicate license fee, $20;
486.18 	(3) (5) late fee, $15;
486.19 	(4) (6) duplicate license or registration fee, $20;
486.20 	(5) (7) certification letter fee, $25;
486.21 	(6) (8) verification fee, $25;
486.22 	(7) (9) education or training program approval fee, $100; and
486.23 	(8) (10) report creation and generation fee, $60 per hour. billed in quarter-hour increments 
486.24 	with a quarter-hour minimum; and
486.25 	(11) examination administrative fee:
486.26 	(i) half day, $50; and
486.27 	(ii) full day, $80.
487.1 	(b) The revenue generated from the fees must be deposited in an account in the state 
487.2 	government special revenue fund.

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

487.4 	Sec. 17. [148.981] FEES.
487.5 		Subdivision 1.Licensing fees. The nonrefundable fees for licensure shall be established 
487.6 	by the board, not to exceed the following amounts:
487.7 	(1) application for admission to national standardized examination, $150;
487.8 	(2) application for professional responsibility examination, $150;
487.9 	(3) application for licensure as a licensed psychologist, $500;
487.10 	(4) renewal of license for a licensed psychologist, $500;
487.11 	(5) late renewal of license for a licensed psychologist, $250;
487.12 	(6) application for converting from master's to doctoral level licensure, $150;
487.13 	(7) application for guest licensure, $150;
487.14 	(8) certificate replacement fee, $25;
487.15 	(9) mailing and duplication fee, $5;
487.16 	(10) statute and rule book fee, $10;
487.17 	(11) verification fee, $20; and
487.18 	(12) fee for optional preapproval of postdoctoral supervision, $50.
487.19 		Subd. 2.Continuing education sponsor fee. A sponsor applying for approval of a 
487.20 	continuing education activity pursuant to Minnesota Rules, part 7200.3830, subpart 2, shall 
487.21 	submit with the application a fee to be established by the board, not to exceed $80 for each 
487.22 	activity.

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

487.24 	Sec. 18. Minnesota Statutes 2018, section 148E.180, is amended to read:
487.25 	148E.180 FEE AMOUNTS.
487.26 		Subdivision 1.Application fees. Nonrefundable application fees for licensure are as 
487.27 	follows may not exceed the following amounts but may be adjusted lower by board action:
487.28 	(1) for a licensed social worker, $45 $75;
488.1 	(2) for a licensed graduate social worker, $45 $75;
488.2 	(3) for a licensed independent social worker, $45 $75;
488.3 	(4) for a licensed independent clinical social worker, $45 $75;
488.4 	(5) for a temporary license, $50; and
488.5 	(6) for a licensure license by endorsement, $85 $115.
488.6 	The fee for criminal background checks is the fee charged by the Bureau of Criminal 
488.7 	Apprehension. The criminal background check fee must be included with the application 
488.8 	fee as required according to section 148E.055.
488.9 		Subd. 2.License fees. Nonrefundable license fees are as follows may not exceed the 
488.10 	following amounts but may be adjusted lower by board action:
488.11 	(1) for a licensed social worker, $81 $115;
488.12 	(2) for a licensed graduate social worker, $144 $210;
488.13 	(3) for a licensed independent social worker, $216 $305;
488.14 	(4) for a licensed independent clinical social worker, $238.50 $335;
488.15 	(5) for an emeritus inactive license, $43.20 $65;
488.16 	(6) for an emeritus active license, one-half of the renewal fee specified in subdivision 
488.17 	3; and
488.18 	(7) for a temporary leave fee, the same as the renewal fee specified in subdivision 3.
488.19 	If the licensee's initial license term is less or more than 24 months, the required license 
488.20 	fees must be prorated proportionately.
488.21 		Subd. 3.Renewal fees. Nonrefundable renewal fees for licensure are as follows may 
488.22 	not exceed the following amounts but may be adjusted lower by board action:
488.23 	(1) for a licensed social worker, $81 $115;
488.24 	(2) for a licensed graduate social worker, $144 $210;
488.25 	(3) for a licensed independent social worker, $216 $305; and
488.26 	(4) for a licensed independent clinical social worker, $238.50 $335.
488.27 		Subd. 4.Continuing education provider fees. Continuing education provider fees are 
488.28 	as follows the following nonrefundable amounts:
489.1 	(1) for a provider who offers programs totaling one to eight clock hours in a one-year 
489.2 	period according to section 148E.145, $50;
489.3 	(2) for a provider who offers programs totaling nine to 16 clock hours in a one-year 
489.4 	period according to section 148E.145, $100;
489.5 	(3) for a provider who offers programs totaling 17 to 32 clock hours in a one-year period 
489.6 	according to section 148E.145, $200;
489.7 	(4) for a provider who offers programs totaling 33 to 48 clock hours in a one-year period 
489.8 	according to section 148E.145, $400; and
489.9 	(5) for a provider who offers programs totaling 49 or more clock hours in a one-year 
489.10 	period according to section 148E.145, $600.
489.11 		Subd. 5.Late fees. Late fees are as follows the following nonrefundable amounts:
489.12 	(1) renewal late fee, one-fourth of the renewal fee specified in subdivision 3;
489.13 	(2) supervision plan late fee, $40; and
489.14 	(3) license late fee, $100 plus the prorated share of the license fee specified in subdivision 
489.15 	2 for the number of months during which the individual practiced social work without a 
489.16 	license.
489.17 		Subd. 6.License cards and wall certificates. (a) The nonrefundable fee for a license 
489.18 	card as specified in section 148E.095 is $10.
489.19 	(b) The nonrefundable fee for a license wall certificate as specified in section 148E.095
489.20 	is $30.
489.21 		Subd. 7.Reactivation fees. Reactivation fees are as follows the following nonrefundable 
489.22 	amounts:
489.23 	(1) reactivation from a temporary leave or emeritus status, the prorated share of the 
489.24 	renewal fee specified in subdivision 3; and
489.25 	(2) reactivation of an expired license, 1-1/2 times the renewal fees specified in subdivision 
489.26 	3.

489.27 	Sec. 19. Minnesota Statutes 2018, section 150A.06, subdivision 3, is amended to read:
489.28 		Subd. 3.Waiver of examination. (a) All or any part of the examination for dentists, 
489.29 	dental therapists, dental hygienists, or dental assistants, except that pertaining to the law of 
489.30 	Minnesota relating to dentistry and the rules of the board, may, at the discretion of the board, 
489.31 	be waived for an applicant who presents a certificate of having passed all components of 
490.1 	the National Board Dental Examinations or evidence of having maintained an adequate 
490.2 	scholastic standing as determined by the board.
490.3 	(b) The board shall waive the clinical examination required for licensure for any dentist 
490.4 	applicant who is a graduate of a dental school accredited by the Commission on Dental 
490.5 	Accreditation, who has passed all components of the National Board Dental Examinations, 
490.6 	and who has satisfactorily completed a Minnesota-based postdoctoral general dentistry 
490.7 	residency program (GPR) or an advanced education in general dentistry (AEGD) program 
490.8 	after January 1, 2004. The postdoctoral program must be accredited by the Commission on 
490.9 	Dental Accreditation, be of at least one year's duration, and include an outcome assessment 
490.10 	evaluation assessing the resident's competence to practice dentistry. The board may require 
490.11 	the applicant to submit any information deemed necessary by the board to determine whether 
490.12 	the waiver is applicable.

490.13 	Sec. 20. Minnesota Statutes 2018, section 150A.06, is amended by adding a subdivision 
490.14 	to read:
490.15 		Subd. 10.Emeritus inactive license. A person licensed to practice dentistry, dental 
490.16 	therapy, dental hygiene, or dental assisting pursuant to section 150A.05 or Minnesota Rules, 
490.17 	part 3100.8500, who retires from active practice in the state may apply to the board for 
490.18 	emeritus inactive licensure. An application for emeritus inactive licensure may be made on 
490.19 	the biennial licensing form or by petitioning the board, and the applicant must pay a onetime 
490.20 	application fee pursuant to section 150A.091, subdivision 19. In order to receive emeritus 
490.21 	inactive licensure, the applicant must be in compliance with board requirements and cannot 
490.22 	be the subject of current disciplinary action resulting in suspension, revocation, 
490.23 	disqualification, condition, or restriction of the licensee to practice dentistry, dental therapy, 
490.24 	dental hygiene, or dental assisting. An emeritus inactive license is not a license to practice, 
490.25 	but is a formal recognition of completion of a person's dental career in good standing.

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

490.27 	Sec. 21. Minnesota Statutes 2018, section 150A.06, is amended by adding a subdivision 
490.28 	to read:
490.29 		Subd. 11.Emeritus active licensure. (a) A person licensed to practice dentistry, dental 
490.30 	therapy, dental hygiene, or dental assisting may apply for an emeritus active license if the 
490.31 	person is retired from active practice, is in compliance with board requirements, and is not 
490.32 	the subject of current disciplinary action resulting in suspension, revocation, disqualification, 
491.1 	condition, or restriction of the license to practice dentistry, dental therapy, dental hygiene, 
491.2 	or dental assisting.
491.3 	(b) An emeritus active licensee may engage only in the following types of practice:
491.4 	(1) pro bono or volunteer dental practice;
491.5 	(2) paid practice not to exceed 500 hours per calendar year for the exclusive purpose of 
491.6 	providing licensing supervision to meet the board's requirements; or
491.7 	(3) paid consulting services not to exceed 500 hours per calendar year.
491.8 	(c) An emeritus active licensee shall not hold out as a full licensee and may only hold 
491.9 	out as authorized to practice as described in this subdivision. The board may take disciplinary 
491.10 	or corrective action against an emeritus active licensee based on violations of applicable 
491.11 	law or board requirements.
491.12 	(d) A person may apply for an emeritus active license by completing an application form 
491.13 	specified by the board and must pay the application fee pursuant to section 150A.091, 
491.14 	subdivision 20.
491.15 	(e) If an emeritus active license is not renewed every two years, the license expires. The 
491.16 	renewal date is the same as the licensee's renewal date when the licensee was in active 
491.17 	practice. In order to renew an emeritus active license, the licensee must:
491.18 	(1) complete an application form as specified by the board;
491.19 	(2) pay the required renewal fee pursuant to section 150A.091, subdivision 20; and
491.20 	(3) report at least 25 continuing education hours completed since the last renewal, which 
491.21 	must include:
491.22 	(i) at least one hour in two different required CORE areas;
491.23 	(ii) at least one hour of mandatory infection control;
491.24 	(iii) for dentists and dental therapists, at least 15 hours of fundamental credits for dentists 
491.25 	and dental therapists, and for dental hygienists and dental assistants, at least seven hours of 
491.26 	fundamental credits; and
491.27 	(iv) for dentists and dental therapists, no more than ten elective credits, and for dental 
491.28 	hygienists and dental assistants, no more than six elective credits.

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

492.1 	Sec. 22. Minnesota Statutes 2018, section 150A.091, is amended by adding a subdivision 
492.2 	to read:
492.3 		Subd. 19.Emeritus inactive license. An individual applying for emeritus inactive 
492.4 	licensure under section 150A.06, subdivision 10, must pay a onetime fee of $50. There is 
492.5 	no renewal fee for an emeritus inactive license.

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

492.7 	Sec. 23. Minnesota Statutes 2018, section 150A.091, is amended by adding a subdivision 
492.8 	to read:
492.9 		Subd. 20.Emeritus active license. An individual applying for emeritus active licensure 
492.10 	under section 150A.06, subdivision 11, must pay a fee upon application and upon renewal 
492.11 	every two years. The fees for emeritus active license application and renewal are as follows: 
492.12 	dentist, $212; dental therapist, $100; dental hygienist, $75; and dental assistant, $55.

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

492.14 	Sec. 24. Minnesota Statutes 2018, section 151.01, subdivision 31, is amended to read:
492.15 		Subd. 31.Central service pharmacy. "Central service pharmacy" means a pharmacy 
492.16 	that may provideperforms those activities involved in the dispensing functions,of a drug 
492.17 	utilization review, packaging, labeling, or delivery of a prescription product tofor another 
492.18 	pharmacy for the purpose of filling a prescription, pursuant to the requirements of this 
492.19 	chapter and the rules of the board.

492.20 	Sec. 25. Minnesota Statutes 2018, section 151.01, subdivision 35, is amended to read:
492.21 		Subd. 35.Compounding. "Compounding" means preparing, mixing, assembling, 
492.22 	packaging, and labeling a drug for an identified individual patient as a result of a practitioner's 
492.23 	prescription drug order. Compounding also includes anticipatory compounding, as defined 
492.24 	in this section, and the preparation of drugs in which all bulk drug substances and components 
492.25 	are nonprescription substances. Compounding does not include mixing or reconstituting a 
492.26 	drug according to the product's labeling or to the manufacturer's directions, provided that 
492.27 	such labeling has been approved by the United States Food and Drug Administration (FDA) 
492.28 	or the manufacturer is licensed under section 151.252. Compounding does not include the 
492.29 	preparation of a drug for the purpose of, or incident to, research, teaching, or chemical 
492.30 	analysis, provided that the drug is not prepared for dispensing or administration to patients. 
492.31 	All compounding, regardless of the type of product, must be done pursuant to a prescription 
492.32 	drug order unless otherwise permitted in this chapter or by the rules of the board. 
493.1 	Compounding does not include a minor deviation from such directions with regard to 
493.2 	radioactivity, volume, or stability, which is made by or under the supervision of a licensed 
493.3 	nuclear pharmacist or a physician, and which is necessary in order to accommodate 
493.4 	circumstances not contemplated in the manufacturer's instructions, such as the rate of 
493.5 	radioactive decay or geographical distance from the patient.

493.6 	Sec. 26. Minnesota Statutes 2018, section 151.065, subdivision 1, is amended to read:
493.7 		Subdivision 1.Application fees. Application fees for licensure and registration are as 
493.8 	follows:
493.9 	(1) pharmacist licensed by examination, $145 $175;
493.10 	(2) pharmacist licensed by reciprocity, $240 $275;
493.11 	(3) pharmacy intern, $37.50 $50;
493.12 	(4) pharmacy technician, $37.50 $50;
493.13 	(5) pharmacy, $225 $260;
493.14 	(6) drug wholesaler, legend drugs only, $235 $260;
493.15 	(7) drug wholesaler, legend and nonlegend drugs, $235 $260;
493.16 	(8) drug wholesaler, nonlegend drugs, veterinary legend drugs, or both, $210 $260;
493.17 	(9) drug wholesaler, medical gases, $175 $260;
493.18 	(10) drug wholesaler, also licensed as a pharmacy in Minnesota, $150 third-party logistics 
493.19 	provider, $260;
493.20 	(11) drug manufacturer, legend drugs only, $235 $260;
493.21 	(12) drug manufacturer, legend and nonlegend drugs, $235 $260;
493.22 	(13) drug manufacturer, nonlegend or veterinary legend drugs, $210 $260;
493.23 	(14) drug manufacturer, medical gases, $185 $260;
493.24 	(15) drug manufacturer, also licensed as a pharmacy in Minnesota, $150 $260;
493.25 	(16) medical gas distributor, $110 $260;
493.26 	(17) controlled substance researcher, $75; and
493.27 	(18) pharmacy professional corporation, $125 $150.

494.1 	Sec. 27. Minnesota Statutes 2018, section 151.065, subdivision 2, is amended to read:
494.2 		Subd. 2.Original license fee. The pharmacist original licensure fee, $145 $175.

494.3 	Sec. 28. Minnesota Statutes 2018, section 151.065, subdivision 3, is amended to read:
494.4 		Subd. 3.Annual renewal fees. Annual licensure and registration renewal fees are as 
494.5 	follows:
494.6 	(1) pharmacist, $145 $175;
494.7 	(2) pharmacy technician, $37.50 $50;
494.8 	(3) pharmacy, $225 $260;
494.9 	(4) drug wholesaler, legend drugs only, $235 $260;
494.10 	(5) drug wholesaler, legend and nonlegend drugs, $235 $260;
494.11 	(6) drug wholesaler, nonlegend drugs, veterinary legend drugs, or both, $210 $260;
494.12 	(7) drug wholesaler, medical gases, $185 $260;
494.13 	(8) drug wholesaler, also licensed as a pharmacy in Minnesota, $150 third-party logistics 
494.14 	provider, $260;
494.15 	(9) drug manufacturer, legend drugs only, $235 $260;
494.16 	(10) drug manufacturer, legend and nonlegend drugs, $235 $260;
494.17 	(11) drug manufacturer, nonlegend, veterinary legend drugs, or both, $210 $260;
494.18 	(12) drug manufacturer, medical gases, $185 $260;
494.19 	(13) drug manufacturer, also licensed as a pharmacy in Minnesota, $150 $260;
494.20 	(14) medical gas distributor, $110 $260;
494.21 	(15) controlled substance researcher, $75; and
494.22 	(16) pharmacy professional corporation, $75 $100.

494.23 	Sec. 29. Minnesota Statutes 2018, section 151.065, subdivision 6, is amended to read:
494.24 		Subd. 6.Reinstatement fees. (a) A pharmacist who has allowed the pharmacist's license 
494.25 	to lapse may reinstate the license with board approval and upon payment of any fees and 
494.26 	late fees in arrears, up to a maximum of $1,000.
495.1 	(b) A pharmacy technician who has allowed the technician's registration to lapse may 
495.2 	reinstate the registration with board approval and upon payment of any fees and late fees 
495.3 	in arrears, up to a maximum of $90.
495.4 	(c) An owner of a pharmacy, a drug wholesaler, a drug manufacturer, third-party logistics 
495.5 	provider, or a medical gas distributor who has allowed the license of the establishment to 
495.6 	lapse may reinstate the license with board approval and upon payment of any fees and late 
495.7 	fees in arrears.
495.8 	(d) A controlled substance researcher who has allowed the researcher's registration to 
495.9 	lapse may reinstate the registration with board approval and upon payment of any fees and 
495.10 	late fees in arrears.
495.11 	(e) A pharmacist owner of a professional corporation who has allowed the corporation's 
495.12 	registration to lapse may reinstate the registration with board approval and upon payment 
495.13 	of any fees and late fees in arrears.

495.14 	Sec. 30. Minnesota Statutes 2018, section 151.071, subdivision 2, is amended to read:
495.15 		Subd. 2.Grounds for disciplinary action. The following conduct is prohibited and is 
495.16 	grounds for disciplinary action:
495.17 	(1) failure to demonstrate the qualifications or satisfy the requirements for a license or 
495.18 	registration contained in this chapter or the rules of the board. The burden of proof is on 
495.19 	the applicant to demonstrate such qualifications or satisfaction of such requirements;
495.20 	(2) obtaining a license by fraud or by misleading the board in any way during the 
495.21 	application process or obtaining a license by cheating, or attempting to subvert the licensing 
495.22 	examination process. Conduct that subverts or attempts to subvert the licensing examination 
495.23 	process includes, but is not limited to: (i) conduct that violates the security of the examination 
495.24 	materials, such as removing examination materials from the examination room or having 
495.25 	unauthorized possession of any portion of a future, current, or previously administered 
495.26 	licensing examination; (ii) conduct that violates the standard of test administration, such as 
495.27 	communicating with another examinee during administration of the examination, copying 
495.28 	another examinee's answers, permitting another examinee to copy one's answers, or 
495.29 	possessing unauthorized materials; or (iii) impersonating an examinee or permitting an 
495.30 	impersonator to take the examination on one's own behalf;
495.31 	(3) for a pharmacist, pharmacy technician, pharmacist intern, applicant for a pharmacist 
495.32 	or pharmacy license, or applicant for a pharmacy technician or pharmacist intern registration, 
495.33 	conviction of a felony reasonably related to the practice of pharmacy. Conviction as used 
496.1 	in this subdivision includes a conviction of an offense that if committed in this state would 
496.2 	be deemed a felony without regard to its designation elsewhere, or a criminal proceeding 
496.3 	where a finding or verdict of guilt is made or returned but the adjudication of guilt is either 
496.4 	withheld or not entered thereon. The board may delay the issuance of a new license or 
496.5 	registration if the applicant has been charged with a felony until the matter has been 
496.6 	adjudicated;
496.7 	(4) for a facility, other than a pharmacy, licensed or registered by the board, if an owner 
496.8 	or applicant is convicted of a felony reasonably related to the operation of the facility. The 
496.9 	board may delay the issuance of a new license or registration if the owner or applicant has 
496.10 	been charged with a felony until the matter has been adjudicated;
496.11 	(5) for a controlled substance researcher, conviction of a felony reasonably related to 
496.12 	controlled substances or to the practice of the researcher's profession. The board may delay 
496.13 	the issuance of a registration if the applicant has been charged with a felony until the matter 
496.14 	has been adjudicated;
496.15 	(6) disciplinary action taken by another state or by one of this state's health licensing 
496.16 	agencies:
496.17 	(i) revocation, suspension, restriction, limitation, or other disciplinary action against a 
496.18 	license or registration in another state or jurisdiction, failure to report to the board that 
496.19 	charges or allegations regarding the person's license or registration have been brought in 
496.20 	another state or jurisdiction, or having been refused a license or registration by any other 
496.21 	state or jurisdiction. The board may delay the issuance of a new license or registration if an 
496.22 	investigation or disciplinary action is pending in another state or jurisdiction until the 
496.23 	investigation or action has been dismissed or otherwise resolved; and
496.24 	(ii) revocation, suspension, restriction, limitation, or other disciplinary action against a 
496.25 	license or registration issued by another of this state's health licensing agencies, failure to 
496.26 	report to the board that charges regarding the person's license or registration have been 
496.27 	brought by another of this state's health licensing agencies, or having been refused a license 
496.28 	or registration by another of this state's health licensing agencies. The board may delay the 
496.29 	issuance of a new license or registration if a disciplinary action is pending before another 
496.30 	of this state's health licensing agencies until the action has been dismissed or otherwise 
496.31 	resolved;
496.32 	(7) for a pharmacist, pharmacy, pharmacy technician, or pharmacist intern, violation of 
496.33 	any order of the board, of any of the provisions of this chapter or any rules of the board or 
497.1 	violation of any federal, state, or local law or rule reasonably pertaining to the practice of 
497.2 	pharmacy;
497.3 	(8) for a facility, other than a pharmacy, licensed by the board, violations of any order 
497.4 	of the board, of any of the provisions of this chapter or the rules of the board or violation 
497.5 	of any federal, state, or local law relating to the operation of the facility;
497.6 	(9) engaging in any unethical conduct; conduct likely to deceive, defraud, or harm the 
497.7 	public, or demonstrating a willful or careless disregard for the health, welfare, or safety of 
497.8 	a patient; or pharmacy practice that is professionally incompetent, in that it may create 
497.9 	unnecessary danger to any patient's life, health, or safety, in any of which cases, proof of 
497.10 	actual injury need not be established;
497.11 	(10) aiding or abetting an unlicensed person in the practice of pharmacy, except that it 
497.12 	is not a violation of this clause for a pharmacist to supervise a properly registered pharmacy 
497.13 	technician or pharmacist intern if that person is performing duties allowed by this chapter 
497.14 	or the rules of the board;
497.15 	(11) for an individual licensed or registered by the board, adjudication as mentally ill 
497.16 	or developmentally disabled, or as a chemically dependent person, a person dangerous to 
497.17 	the public, a sexually dangerous person, or a person who has a sexual psychopathic 
497.18 	personality, by a court of competent jurisdiction, within or without this state. Such 
497.19 	adjudication shall automatically suspend a license for the duration thereof unless the board 
497.20 	orders otherwise;
497.21 	(12) for a pharmacist or pharmacy intern, engaging in unprofessional conduct as specified 
497.22 	in the board's rules. In the case of a pharmacy technician, engaging in conduct specified in 
497.23 	board rules that would be unprofessional if it were engaged in by a pharmacist or pharmacist 
497.24 	intern or performing duties specifically reserved for pharmacists under this chapter or the 
497.25 	rules of the board;
497.26 	(13) for a pharmacy, operation of the pharmacy without a pharmacist present and on 
497.27 	duty except as allowed by a variance approved by the board;
497.28 	(14) for a pharmacist, the inability to practice pharmacy with reasonable skill and safety 
497.29 	to patients by reason of illness, drunkenness, use of alcohol, drugs, narcotics, chemicals, or 
497.30 	any other type of material or as a result of any mental or physical condition, including 
497.31 	deterioration through the aging process or loss of motor skills. In the case of registered 
497.32 	pharmacy technicians, pharmacist interns, or controlled substance researchers, the inability 
497.33 	to carry out duties allowed under this chapter or the rules of the board with reasonable skill 
497.34 	and safety to patients by reason of illness, drunkenness, use of alcohol, drugs, narcotics, 
498.1 	chemicals, or any other type of material or as a result of any mental or physical condition, 
498.2 	including deterioration through the aging process or loss of motor skills;
498.3 	(15) for a pharmacist, pharmacy, pharmacist intern, pharmacy technician, medical gas 
498.4 	distributor, or controlled substance researcher, revealing a privileged communication from 
498.5 	or relating to a patient except when otherwise required or permitted by law;
498.6 	(16) for a pharmacist or pharmacy, improper management of patient records, including 
498.7 	failure to maintain adequate patient records, to comply with a patient's request made pursuant 
498.8 	to sections 144.291 to 144.298, or to furnish a patient record or report required by law;
498.9 	(17) fee splitting, including without limitation:
498.10 	(i) paying, offering to pay, receiving, or agreeing to receive, a commission, rebate, 
498.11 	kickback, or other form of remuneration, directly or indirectly, for the referral of patients; 
498.12 	and
498.13 	(ii) referring a patient to any health care provider as defined in sections 144.291 to 
498.14 	144.298 in which the licensee or registrant has a financial or economic interest as defined 
498.15 	in section 144.6521, subdivision 3, unless the licensee or registrant has disclosed the 
498.16 	licensee's or registrant's financial or economic interest in accordance with section 144.6521;
498.17 	and
498.18 	(iii) any arrangement through which a pharmacy, in which the prescribing practitioner 
498.19 	does not have a significant ownership interest, fills a prescription drug order and the 
498.20 	prescribing practitioner is involved in any manner, directly or indirectly, in setting the price 
498.21 	for the filled prescription that is charged to the patient, the patient's insurer or pharmacy 
498.22 	benefit manager, or other person paying for the prescription or, in the case of veterinary 
498.23 	patients, the price for the filled prescription that is charged to the client or other person 
498.24 	paying for the prescription, except that a veterinarian and a pharmacy may enter into such 
498.25 	an arrangement provided that the client or other person paying for the prescription is notified, 
498.26 	in writing and with each prescription dispensed, about the arrangement, unless such 
498.27 	arrangement involves pharmacy services provided for livestock, poultry, and agricultural 
498.28 	production systems, in which case client notification would not be required;
498.29 	(18) engaging in abusive or fraudulent billing practices, including violations of the 
498.30 	federal Medicare and Medicaid laws or state medical assistance laws or rules;
498.31 	(19) engaging in conduct with a patient that is sexual or may reasonably be interpreted 
498.32 	by the patient as sexual, or in any verbal behavior that is seductive or sexually demeaning 
498.33 	to a patient;
499.1 	(20) failure to make reports as required by section 151.072 or to cooperate with an 
499.2 	investigation of the board as required by section 151.074;
499.3 	(21) knowingly providing false or misleading information that is directly related to the 
499.4 	care of a patient unless done for an accepted therapeutic purpose such as the dispensing and 
499.5 	administration of a placebo;
499.6 	(22) aiding suicide or aiding attempted suicide in violation of section 609.215 as 
499.7 	established by any of the following:
499.8 	(i) a copy of the record of criminal conviction or plea of guilty for a felony in violation 
499.9 	of section 609.215, subdivision 1 or 2;
499.10 	(ii) a copy of the record of a judgment of contempt of court for violating an injunction 
499.11 	issued under section 609.215, subdivision 4;
499.12 	(iii) a copy of the record of a judgment assessing damages under section 609.215, 
499.13 	subdivision 5; or
499.14 	(iv) a finding by the board that the person violated section 609.215, subdivision 1 or 2. 
499.15 	The board shall investigate any complaint of a violation of section 609.215, subdivision 1 
499.16 	or 2;
499.17 	(23) for a pharmacist, practice of pharmacy under a lapsed or nonrenewed license. For 
499.18 	a pharmacist intern, pharmacy technician, or controlled substance researcher, performing 
499.19 	duties permitted to such individuals by this chapter or the rules of the board under a lapsed 
499.20 	or nonrenewed registration. For a facility required to be licensed under this chapter, operation 
499.21 	of the facility under a lapsed or nonrenewed license or registration; and
499.22 	(24) for a pharmacist, pharmacist intern, or pharmacy technician, termination or discharge 
499.23 	from the health professionals services program for reasons other than the satisfactory 
499.24 	completion of the program.

499.25 	Sec. 31. Minnesota Statutes 2018, section 151.15, subdivision 1, is amended to read:
499.26 		Subdivision 1.Location. It shall be unlawful for any person to compound,or dispense, 
499.27 	vend, or sell drugs, medicines, chemicals, or poisons in any place other than a pharmacy, 
499.28 	except as provided in this chapter; except that a licensed pharmacist or pharmacist intern 
499.29 	working within a licensed hospital may receive a prescription drug order and access the 
499.30 	hospital's pharmacy prescription processing system through secure and encrypted electronic 
499.31 	means in order to process the prescription drug order.

500.1 	Sec. 32. Minnesota Statutes 2018, section 151.15, is amended by adding a subdivision to 
500.2 	read:
500.3 		Subd. 5.Receipt of emergency prescription orders. A pharmacist, when that pharmacist 
500.4 	is not present within a licensed pharmacy, may accept a written, verbal, or electronic 
500.5 	prescription drug order from a practitioner only if:
500.6 	(1) the prescription drug order is for an emergency situation where waiting for the 
500.7 	pharmacist to travel to a licensed pharmacy to accept the prescription drug order would 
500.8 	likely cause the patient to experience significant physical harm or discomfort;
500.9 	(2) the pharmacy from which the prescription drug order will be dispensed is closed for 
500.10 	business;
500.11 	(3) the pharmacist has been designated to be on call for the licensed pharmacy that will 
500.12 	fill the prescription drug order;
500.13 	(4) electronic prescription drug orders are received through secure and encrypted 
500.14 	electronic means;
500.15 	(5) the pharmacist takes reasonable precautions to ensure that the prescription drug order 
500.16 	will be handled in a manner consistent with federal and state statutes regarding the handling 
500.17 	of protected health information; and
500.18 	(6) the pharmacy from which the prescription drug order will be dispensed has relevant 
500.19 	and appropriate policies and procedures in place and makes them available to the board 
500.20 	upon request.

500.21 	Sec. 33. Minnesota Statutes 2018, section 151.15, is amended by adding a subdivision to 
500.22 	read:
500.23 		Subd. 6.Processing of emergency prescription orders. A pharmacist, when that 
500.24 	pharmacist is not present within a licensed pharmacy, may access a pharmacy prescription 
500.25 	processing system through secure and encrypted electronic means in order to process an 
500.26 	emergency prescription accepted pursuant to subdivision 5 only if:
500.27 	(1) the pharmacy from which the prescription drug order will be dispensed is closed for 
500.28 	business;
500.29 	(2) the pharmacist has been designated to be on call for the licensed pharmacy that will 
500.30 	fill the prescription drug order;
500.31 	(3) the prescription drug order is for a patient of a long-term care facility or a county 
500.32 	correctional facility;
501.1 	(4) the prescription drug order is not being processed pursuant to section 151.58;
501.2 	(5) the prescription drug order is processed pursuant to this chapter and the rules 
501.3 	promulgated thereunder; and
501.4 	(6) the pharmacy from which the prescription drug order will be dispensed has relevant 
501.5 	and appropriate policies and procedures in place and makes them available to the board 
501.6 	upon request.

501.7 	Sec. 34. Minnesota Statutes 2018, section 151.19, subdivision 1, is amended to read:
501.8 		Subdivision 1.Pharmacy licensure requirements. (a) No person shall operate a 
501.9 	pharmacy without first obtaining a license from the board and paying any applicable fee 
501.10 	specified in section 151.065. The license shall be displayed in a conspicuous place in the 
501.11 	pharmacy for which it is issued and expires on June 30 following the date of issue. It is 
501.12 	unlawful for any person to operate a pharmacy unless the license has been issued to the 
501.13 	person by the board.
501.14 	(b) Application for a pharmacy license under this section shall be made in a manner 
501.15 	specified by the board.
501.16 	(c) No license shall be issued or renewed for a pharmacy located within the state unless 
501.17 	the applicant agrees to operate the pharmacy in a manner prescribed by federal and state 
501.18 	law and according to rules adopted by the board. No license shall be issued for a pharmacy 
501.19 	located outside of the state unless the applicant agrees to operate the pharmacy in a manner 
501.20 	prescribed by federal law and, when dispensing medications for residents of this state, the 
501.21 	laws of this state, and Minnesota Rules.
501.22 	(d) No license shall be issued or renewed for a pharmacy that is required to be licensed 
501.23 	or registered by the state in which it is physically located unless the applicant supplies the 
501.24 	board with proof of such licensure or registration.
501.25 	(e) The board shall require a separate license for each pharmacy located within the state 
501.26 	and for each pharmacy located outside of the state at which any portion of the dispensing 
501.27 	process occurs for drugs dispensed to residents of this state.
501.28 	(f) The board shall not issuePrior to the issuance of an initial or renewed license for a 
501.29 	pharmacy unless, the board may require the pharmacy passesto pass an inspection conducted 
501.30 	by an authorized representative of the board. In the case of a pharmacy located outside of 
501.31 	the state, the board may require the applicant to pay the cost of the inspection, in addition 
501.32 	to the license fee in section 151.065, unless the applicant furnishes the board with a report, 
501.33 	issued by the appropriate regulatory agency of the state in which the facility is located, of 
502.1 	an inspection that has occurred within the 24 months immediately preceding receipt of the 
502.2 	license application by the board. The board may deny licensure unless the applicant submits 
502.3 	documentation satisfactory to the board that any deficiencies noted in an inspection report 
502.4 	have been corrected.
502.5 	(g) The board shall not issue an initial or renewed license for a pharmacy located outside 
502.6 	of the state unless the applicant discloses and certifies:
502.7 	(1) the location, names, and titles of all principal corporate officers and all pharmacists 
502.8 	who are involved in dispensing drugs to residents of this state;
502.9 	(2) that it maintains its records of drugs dispensed to residents of this state so that the 
502.10 	records are readily retrievable from the records of other drugs dispensed;
502.11 	(3) that it agrees to cooperate with, and provide information to, the board concerning 
502.12 	matters related to dispensing drugs to residents of this state;
502.13 	(4) that, during its regular hours of operation, but no less than six days per week, for a 
502.14 	minimum of 40 hours per week, a toll-free telephone service is provided to facilitate 
502.15 	communication between patients in this state and a pharmacist at the pharmacy who has 
502.16 	access to the patients' records; the toll-free number must be disclosed on the label affixed 
502.17 	to each container of drugs dispensed to residents of this state; and
502.18 	(5) that, upon request of a resident of a long-term care facility located in this state, the 
502.19 	resident's authorized representative, or a contract pharmacy or licensed health care facility 
502.20 	acting on behalf of the resident, the pharmacy will dispense medications prescribed for the 
502.21 	resident in unit-dose packaging or, alternatively, comply with section 151.415, subdivision 
502.22 	5.
502.23 	(h) This subdivision does not apply to a manufacturer licensed under section 151.252, 
502.24 	subdivision 1, a wholesale drug distributor licensed under section 151.47, or a third-party 
502.25 	logistics provider, to the extent the manufacturer, wholesale drug distributor, or third-party 
502.26 	logistics provider is engaged in the distribution of dialysate or devices necessary to perform 
502.27 	home peritoneal dialysis on patients with end-stage renal disease, if:
502.28 	(1) the manufacturer or its agent leases or owns the licensed manufacturing or wholesaling 
502.29 	facility from which the dialysate or devices will be delivered;
502.30 	(2) the dialysate is comprised of dextrose or icodextrin and has been approved by the 
502.31 	United States Food and Drug Administration;
502.32 	(3) the dialysate is stored and delivered in its original, sealed, and unopened  
502.33 	manufacturer's packaging;
503.1 	(4) the dialysate or devices are delivered only upon:
503.2 	(i) receipt of a physician's order by a Minnesota licensed pharmacy; and
503.3 	(ii) the review and processing of the prescription by a pharmacist licensed by the state 
503.4 	in which the pharmacy is located, who is employed by or under contract to the pharmacy;
503.5 	(5) prescriptions, policies, procedures, and records of delivery are maintained by the 
503.6 	manufacturer for a minimum of three years and are made available to the board upon request; 
503.7 	and
503.8 	(6) the manufacturer or the manufacturer's agent delivers the dialysate or devices directly 
503.9 	to:
503.10 	(i) a patient with end-stage renal disease for whom the prescription was written or the 
503.11 	patient's designee, for the patient's self-administration of the dialysis therapy; or
503.12 	(ii) a health care provider or institution, for administration or delivery of the dialysis 
503.13 	therapy to a patient with end-stage renal disease for whom the prescription was written.

503.14 	Sec. 35. Minnesota Statutes 2018, section 151.19, subdivision 3, is amended to read:
503.15 		Subd. 3.Sale of federally restricted medical gases. (a) A person or establishment not 
503.16 	licensed as a pharmacy or a practitioner shall not engage in the retail sale or distribution of 
503.17 	federally restricted medical gases without first obtaining a registration from the board and 
503.18 	paying the applicable fee specified in section 151.065. The registration shall be displayed 
503.19 	in a conspicuous place in the business for which it is issued and expires on the date set by 
503.20 	the board. It is unlawful for a person to sell or distribute federally restricted medical gases 
503.21 	unless a certificate has been issued to that person by the board.
503.22 	(b) Application for a medical gas distributor registration under this section shall be made 
503.23 	in a manner specified by the board.
503.24 	(c) No registration shall be issued or renewed for a medical gas distributor located within 
503.25 	the state unless the applicant agrees to operate in a manner prescribed by federal and state 
503.26 	law and according to the rules adopted by the board. No license shall be issued for a medical 
503.27 	gas distributor located outside of the state unless the applicant agrees to operate in a manner 
503.28 	prescribed by federal law and, when distributing medical gases for residents of this state, 
503.29 	the laws of this state and Minnesota Rules.
503.30 	(d) No registration shall be issued or renewed for a medical gas distributor that is required 
503.31 	to be licensed or registered by the state in which it is physically located unless the applicant 
503.32 	supplies the board with proof of the licensure or registration. The board may, by rule, 
504.1 	establish standards for the registration of a medical gas distributor that is not required to be 
504.2 	licensed or registered by the state in which it is physically located.
504.3 	(e) The board shall require a separate registration for each medical gas distributor located 
504.4 	within the state and for each facility located outside of the state from which medical gases 
504.5 	are distributed to residents of this state.
504.6 	(f) The board shall not issue Prior to the issuance of an initial or renewed registration 
504.7 	for a medical gas distributor unless, the board may require the medical gas distributor passes
504.8 	to pass an inspection conducted by an authorized representative of the board. In the case of 
504.9 	a medical gas distributor located outside of the state, the board may require the applicant 
504.10 	to pay the cost of the inspection, in addition to the license fee in section 151.065, unless the 
504.11 	applicant furnishes the board with a report, issued by the appropriate regulatory agency of 
504.12 	the state in which the facility is located, of an inspection that has occurred within the 24 
504.13 	months immediately preceding receipt of the license application by the board. The board 
504.14 	may deny licensure unless the applicant submits documentation satisfactory to the board 
504.15 	that any deficiencies noted in an inspection report have been corrected.

504.16 	Sec. 36. Minnesota Statutes 2018, section 151.252, subdivision 1, is amended to read:
504.17 		Subdivision 1.Requirements. (a) No person shall act as a drug manufacturer without 
504.18 	first obtaining a license from the board and paying any applicable fee specified in section 
504.19 	151.065.
504.20 	(b) Application for a drug manufacturer license under this section shall be made in a 
504.21 	manner specified by the board.
504.22 	(c) No license shall be issued or renewed for a drug manufacturer unless the applicant 
504.23 	agrees to operate in a manner prescribed by federal and state law and according to Minnesota 
504.24 	Rules.
504.25 	(d) No license shall be issued or renewed for a drug manufacturer that is required to be 
504.26 	registered pursuant to United States Code, title 21, section 360, unless the applicant supplies 
504.27 	the board with proof of registration. The board may establish by rule the standards for 
504.28 	licensure of drug manufacturers that are not required to be registered under United States 
504.29 	Code, title 21, section 360.
504.30 	(e) No license shall be issued or renewed for a drug manufacturer that is required to be 
504.31 	licensed or registered by the state in which it is physically located unless the applicant 
504.32 	supplies the board with proof of licensure or registration. The board may establish, by rule, 
505.1 	standards for the licensure of a drug manufacturer that is not required to be licensed or 
505.2 	registered by the state in which it is physically located.
505.3 	(f) The board shall require a separate license for each facility located within the state at 
505.4 	which drug manufacturing occurs and for each facility located outside of the state at which 
505.5 	drugs that are shipped into the state are manufactured.
505.6 	(g) The board shall not issuePrior to the issuance of an initial or renewed license for a 
505.7 	drug manufacturing facility unless, the board may require the facility passes anto pass a 
505.8 	current good manufacturing practices inspection conducted by an authorized representative 
505.9 	of the board. In the case of a drug manufacturing facility located outside of the state, the 
505.10 	board may require the applicant to pay the cost of the inspection, in addition to the license 
505.11 	fee in section 151.065, unless the applicant furnishes the board with a report, issued by the 
505.12 	appropriate regulatory agency of the state in which the facility is located or by the United 
505.13 	States Food and Drug Administration, of an inspection that has occurred within the 24 
505.14 	months immediately preceding receipt of the license application by the board. The board 
505.15 	may deny licensure unless the applicant submits documentation satisfactory to the board 
505.16 	that any deficiencies noted in an inspection report have been corrected.

505.17 	Sec. 37. Minnesota Statutes 2018, section 151.252, subdivision 1a, is amended to read:
505.18 		Subd. 1a.Outsourcing facility. (a) No person shall act as an outsourcing facility without 
505.19 	first obtaining a license from the board and paying any applicable manufacturer licensing 
505.20 	fee specified in section 151.065.
505.21 	(b) Application for an outsourcing facility license under this section shall be made in a 
505.22 	manner specified by the board and may differ from the application required of other drug 
505.23 	manufacturers.
505.24 	(c) No license shall be issued or renewed for an outsourcing facility unless the applicant 
505.25 	agrees to operate in a manner prescribed for outsourcing facilities by federal and state law 
505.26 	and according to Minnesota Rules.
505.27 	(d) No license shall be issued or renewed for an outsourcing facility unless the applicant 
505.28 	supplies the board with proof of such registration by the United States Food and Drug 
505.29 	Administration as required by United States Code, title 21, section 353b.
505.30 	(e) No license shall be issued or renewed for an outsourcing facility that is required to 
505.31 	be licensed or registered by the state in which it is physically located unless the applicant 
505.32 	supplies the board with proof of such licensure or registration. The board may establish, by 
506.1 	rule, standards for the licensure of an outsourcing facility that is not required to be licensed 
506.2 	or registered by the state in which it is physically located.
506.3 	(f) The board shall require a separate license for each outsourcing facility located within 
506.4 	the state and for each outsourcing facility located outside of the state at which drugs that 
506.5 	are shipped into the state are prepared.
506.6 	(g) The board shall not issue an initial or renewed license for an outsourcing facility 
506.7 	unless the facility passes ana current good manufacturing practices inspection conducted 
506.8 	by an authorized representative of the board. In the case of an outsourcing facility located 
506.9 	outside of the state, the board may require the applicant to pay the cost of the inspection, 
506.10 	in addition to the license fee in section 151.065, unless the applicant furnishes the board 
506.11 	with a report, issued by the appropriate regulatory agency of the state in which the facility 
506.12 	is located or by the United States Food and Drug Administration, of ana current good 
506.13 	manufacturing practices inspection that has occurred within the 24 months immediately 
506.14 	preceding receipt of the license application by the board. The board may deny licensure 
506.15 	unless the applicant submits documentation satisfactory to the board that any deficiencies 
506.16 	noted in an inspection report have been corrected.

506.17 	Sec. 38. Minnesota Statutes 2018, section 151.252, subdivision 3, is amended to read:
506.18 		Subd. 3.Payment to practitioner; reporting. Unless prohibited by United States Code, 
506.19 	title 42, section 1320a-7h, a drug manufacturer or outsourcing facility shall file with the 
506.20 	board an annual report, in a form and on the date prescribed by the board, identifying all 
506.21 	payments, honoraria, reimbursement, or other compensation authorized under section 
506.22 	151.461, clauses (4) and (5), paid to practitioners in Minnesota during the preceding calendar 
506.23 	year. The report shall identify the nature and value of any payments totaling $100 or more 
506.24 	to a particular practitioner during the year, and shall identify the practitioner. Reports filed 
506.25 	under this subdivision are public data.

506.26 	Sec. 39. Minnesota Statutes 2018, section 151.253, is amended by adding a subdivision 
506.27 	to read:
506.28 		Subd. 4.Emergency veterinary compounding. A pharmacist working within a pharmacy 
506.29 	licensed by the board in the veterinary pharmacy license category may compound and 
506.30 	provide a drug product to a veterinarian without first receiving a patient-specific prescription 
506.31 	only when:
507.1 	(1) the compounded drug product is needed to treat animals in urgent or emergency 
507.2 	situations, meaning where the health of an animal is threatened, or where suffering or death 
507.3 	of an animal is likely to result from failure to immediately treat;
507.4 	(2) timely access to a compounding pharmacy is not available, as determined by the 
507.5 	prescribing veterinarian;
507.6 	(3) there is no commercially manufactured drug, approved by the United States Food 
507.7 	and Drug Administration, that is suitable for treating the animal, or there is a documented 
507.8 	shortage of such drug;
507.9 	(4) the compounded drug is to be administered by a veterinarian or a bona fide employee 
507.10 	of the veterinarian, or dispensed to a client of a veterinarian in an amount not to exceed 
507.11 	what is necessary to treat an animal for a period of ten days;
507.12 	(5) the pharmacy has selected the sterile or nonsterile compounding license category, 
507.13 	in addition to the veterinary pharmacy licensing category; and
507.14 	(6) the pharmacy is appropriately registered by the United States Drug Enforcement 
507.15 	Administration when providing compounded products that contain controlled substances.

507.16 	Sec. 40. Minnesota Statutes 2018, section 151.32, is amended to read:
507.17 	151.32 CITATION.
507.18 	The title of sections 151.01 to 151.40151.58 shall be the Pharmacy Practice and 
507.19 	Wholesale Distribution Act.

507.20 	Sec. 41. Minnesota Statutes 2018, section 151.40, subdivision 1, is amended to read:
507.21 		Subdivision 1.Generally. Except as otherwise provided in subdivision 2, It is unlawful 
507.22 	for any person to possess, control, manufacture, sell, furnish, dispense, or otherwise dispose 
507.23 	of hypodermic syringes or needles or any instrument or implement which can be adapted 
507.24 	for subcutaneous injections, except byfor:
507.25 	(1) The following persons when acting in the course of their practice or employment:
507.26 	(i) licensed practitioners, registeredand their employees, agents, or delegates;
507.27 	(ii) licensed pharmacies and their employees or agents,;
507.28 	(iii) licensed pharmacists, licensed doctors of veterinary medicine or their assistants,;
507.29 	(iv) registered nurses,and licensed practical nurses;
507.30 	(v) registered medical technologists,;
508.1 	(vi) medical interns,and residents;
508.2 	(vii) licensed drug wholesalers,and their employees or agents,;
508.3 	(viii) licensed hospitals,;
508.4 	(ix) bona fide hospitals in which animals are treated;
508.5 	(x) licensed nursing homes, bona fide hospitals where animals are treated,;
508.6 	(xi) licensed morticians,;
508.7 	(xii) syringe and needle manufacturers, and their dealers and agents,;
508.8 	(xiii) persons engaged in animal husbandry,;
508.9 	(xiv) clinical laboratories and their employees,;
508.10 	(xv) persons engaged in bona fide research or education or industrial use of hypodermic 
508.11 	syringes and needles provided such persons cannot use hypodermic syringes and needles 
508.12 	for the administration of drugs to human beings unless such drugs are prescribed, dispensed, 
508.13 	and administered by a person lawfully authorized to do so,; and
508.14 	(xvi) persons who administer drugs pursuant to an order or direction of a licensed doctor 
508.15 	of medicine or of a licensed doctor of osteopathic medicine duly licensed to practice 
508.16 	medicine. practitioner;
508.17 	(2) a person who self-administers drugs pursuant to either the prescription or the direction 
508.18 	of a practitioner, or a family member, caregiver, or other individual who is designated by 
508.19 	such person to assist the person in obtaining and using needles and syringes for the 
508.20 	administration of such drugs;
508.21 	(3) a person who is disposing of hypodermic syringes and needles through an activity 
508.22 	or program developed under section 325F.785; or
508.23 	(4) a person who sells, possesses, or handles hypodermic syringes and needles pursuant 
508.24 	to subdivision 2.

508.25 	Sec. 42. Minnesota Statutes 2018, section 151.40, subdivision 2, is amended to read:
508.26 		Subd. 2.Sales of limited quantities of clean needles and syringes. (a) A registered 
508.27 	pharmacy or its agent or a licensed pharmacist may sell, without athe prescription or 
508.28 	direction of a practitioner, unused hypodermic needles and syringes in quantities of ten or 
508.29 	fewer, provided the pharmacy or pharmacist complies with all of the requirements of this 
508.30 	subdivision.
509.1 	(b) At any location where hypodermic needles and syringes are kept for retail sale under 
509.2 	this subdivision, the needles and syringes shall be stored in a manner that makes them 
509.3 	available only to authorized personnel and not openly available to customers.
509.4 	(c) No registered pharmacy or licensed pharmacist may advertise to the public the 
509.5 	availability for retail sale, without a prescription, of hypodermic needles or syringes in 
509.6 	quantities of ten or fewer.
509.7 	(d) (c) A registered pharmacy or licensed pharmacist that sells hypodermic needles or 
509.8 	syringes under this subdivision may give the purchaser the materials developed by the 
509.9 	commissioner of health under section 325F.785.
509.10 	(e)(d) A registered pharmacy or licensed pharmacist that sells hypodermic needles or 
509.11 	syringes under this subdivision must certify to the commissioner of health participation in 
509.12 	an activity, including but not limited to those developed under section 325F.785, that supports 
509.13 	proper disposal of used hypodermic needles or syringes.

509.14 	Sec. 43. Minnesota Statutes 2018, section 151.43, is amended to read:
509.15 	151.43 SCOPE.
509.16 	Sections 151.42151.43 to 151.51 apply to any person, partnership, corporation, or 
509.17 	business firm engaging in the wholesale distribution of prescription drugs within the state, 
509.18 	and to persons operating as third-party logistics providers.

509.19 	Sec. 44. [151.441] DEFINITIONS.
509.20 		Subdivision 1.Scope. As used in sections 151.43 to 151.51, the following terms have 
509.21 	the meanings given in this section.
509.22 		Subd. 2.Dispenser. "Dispenser" means a retail pharmacy, hospital pharmacy, a group 
509.23 	of chain pharmacies under common ownership and control that do not act as a wholesale 
509.24 	distributor, or any other person authorized by law to dispense or administer prescription 
509.25 	drugs, and the affiliated warehouses or distribution centers of such entities under common 
509.26 	ownership and control that do not act as a wholesale distributor, but does not include a 
509.27 	person who dispenses only products to be used in animals in accordance with United States 
509.28 	Code, title 21, section 360b(a)(5).
509.29 		Subd. 3.Disposition. "Disposition," with respect to a product within the possession or 
509.30 	control of an entity, means the removal of such product from the pharmaceutical distribution 
509.31 	supply chain, which may include disposal or return of the product for disposal or other 
509.32 	appropriate handling and other actions, such as retaining a sample of the product for further 
510.1 	additional physical examination or laboratory analysis of the product by a manufacturer or 
510.2 	regulatory or law enforcement agency.
510.3 		Subd. 4.Distribute or distribution. "Distribute" or "distribution" means the sale, 
510.4 	purchase, trade, delivery, handling, storage, or receipt of a product, and does not include 
510.5 	the dispensing of a product pursuant to a prescription executed in accordance with United 
510.6 	States Code, title 21, section 353(b)(1), or the dispensing of a product approved under United 
510.7 	States Code, title 21, section 360b(b).
510.8 		Subd. 5.Manufacturer. "Manufacturer" means, with respect to a product:
510.9 	(1) a person who holds an application approved under United States Code, title 21, 
510.10 	section 355, or a license issued under United States Code, title 42, section 262, for such 
510.11 	product, or if such product is not the subject of an approved application or license, the person 
510.12 	who manufactured the product;
510.13 	(2) a co-licensed partner of the person described in clause (1) that obtains the product 
510.14 	directly from a person described in this subdivision; or
510.15 	(3) an affiliate of a person described in clause (1) or (2) that receives the product directly 
510.16 	from a person described in this subdivision.
510.17 		Subd. 6.Medical convenience kit. "Medical convenience kit" means a collection of 
510.18 	finished medical devices, which may include a product or biological product, assembled in 
510.19 	kit form strictly for the convenience of the purchaser or user.
510.20 		Subd. 7.Package. "Package" means the smallest individual salable unit of product for 
510.21 	distribution by a manufacturer or repackager that is intended by the manufacturer for ultimate 
510.22 	sale to the dispenser of such product. For purposes of this subdivision, an "individual salable 
510.23 	unit" is the smallest container of product introduced into commerce by the manufacturer or 
510.24 	repackager that is intended by the manufacturer or repackager for individual sale to a 
510.25 	dispenser.
510.26 		Subd. 8.Prescription drug. "Prescription drug" means a drug for human use subject 
510.27 	to United States Code, title 21, section 353(b)(1).
510.28 		Subd. 9.Product. "Product" means a prescription drug in a finished dosage form for 
510.29 	administration to a patient without substantial further manufacturing, but does not include 
510.30 	blood or blood components intended for transfusion; radioactive drugs or radioactive 
510.31 	biological products as defined in Code of Federal Regulations, title 21, section 600.3(ee), 
510.32 	that are regulated by the Nuclear Regulatory Commission or by a state pursuant to an 
510.33 	agreement with such commission under United States Code, title 42, section 2021; imaging 
511.1 	drugs; an intravenous product described in subdivision 12, paragraph (b), clauses (14) to 
511.2 	(16); any medical gas defined in United States Code, title 21, section 360ddd; homeopathic 
511.3 	drugs marketed in accordance with applicable federal law; or a drug compounded in 
511.4 	compliance with United States Code, title 21, section 353a or 353b.
511.5 		Subd. 10.Repackager. "Repackager" means a person who owns or operates an 
511.6 	establishment that repacks and relabels a product or package for further sale or for distribution 
511.7 	without a further transaction.
511.8 		Subd. 11.Third-party logistics provider. "Third-party logistics provider" means an 
511.9 	entity that provides or coordinates warehousing or other logistics services of a product in 
511.10 	interstate commerce on behalf of a manufacturer, wholesale distributor, or dispenser of a 
511.11 	product, but does not take ownership of the product nor have responsibility to direct the 
511.12 	sale or disposition of the product.
511.13 		Subd. 12.Transaction. (a) "Transaction" means the transfer of product between persons 
511.14 	in which a change of ownership occurs.
511.15 	(b) The term "transaction" does not include:
511.16 	(1) intracompany distribution of any product between members of an affiliate or within 
511.17 	a manufacturer;
511.18 	(2) the distribution of a product among hospitals or other health care entities that are 
511.19 	under common control;
511.20 	(3) the distribution of a drug or an offer to distribute a drug for emergency medical 
511.21 	reasons, including:
511.22 	(i) a public health emergency declaration pursuant to United States Code, title 42, section 
511.23 	247d;
511.24 	(ii) a national security or peacetime emergency declared by the governor pursuant to 
511.25 	section 12.31; or
511.26 	(iii) a situation involving an action taken by the commissioner of health pursuant to 
511.27 	section 144.4197, 144.4198 or 151.37, subdivisions 2, paragraph (b), and 10, except that, 
511.28 	for purposes of this paragraph, a drug shortage not caused by a public health emergency 
511.29 	shall not constitute an emergency medical reason;
511.30 	(4) the dispensing of a drug pursuant to a valid prescription issued by a licensed 
511.31 	practitioner;
512.1 	(5) the distribution of product samples by a manufacturer or a licensed wholesale 
512.2 	distributor in accordance with United States Code, title 21, section 353(d);
512.3 	(6) the distribution of blood or blood components intended for transfusion;
512.4 	(7) the distribution of minimal quantities of product by a licensed retail pharmacy to a 
512.5 	licensed practitioner for office use;
512.6 	(8) the sale, purchase, or trade of a drug or an offer to sell, purchase, or trade a drug by 
512.7 	a charitable organization described in United States Code, title 26, section 501(c)(3), to a 
512.8 	nonprofit affiliate of the organization to the extent otherwise permitted by law;
512.9 	(9) the distribution of a product pursuant to the sale or merger of a pharmacy or 
512.10 	pharmacies or a wholesale distributor or wholesale distributors, except that any records 
512.11 	required to be maintained for the product shall be transferred to the new owner of the 
512.12 	pharmacy or pharmacies or wholesale distributor or wholesale distributors;
512.13 	(10) the dispensing of a product approved under United States Code, title 21, section 
512.14 	360b(c);
512.15 	(11) transfer of products to or from any facility that is licensed by the Nuclear Regulatory 
512.16 	Commission or by a state pursuant to an agreement with such commission under United 
512.17 	States Code, title 42, section 2021;
512.18 	(12) transfer of a combination product that is not subject to approval under United States 
512.19 	Code, title 21, section 355, or licensure under United States Code, title 42, section 262, and 
512.20 	that is:
512.21 	(i) a product comprised of a device and one or more other regulated components (such 
512.22 	as a drug/device, biologic/device, or drug/device/biologic) that are physically, chemically, 
512.23 	or otherwise combined or mixed and produced as a single entity;
512.24 	(ii) two or more separate products packaged together in a single package or as a unit 
512.25 	and comprised of a drug and device or device and biological product; or
512.26 	(iii) two or more finished medical devices plus one or more drug or biological products 
512.27 	that are packaged together in a medical convenience kit;
512.28 	(13) the distribution of a medical convenience kit if:
512.29 	(i) the medical convenience kit is assembled in an establishment that is registered with 
512.30 	the Food and Drug Administration as a device manufacturer in accordance with United 
512.31 	States Code, title 21, section 360(b)(2);
513.1 	(ii) the medical convenience kit does not contain a controlled substance that appears in 
513.2 	a schedule contained in the Comprehensive Drug Abuse Prevention and Control Act of 
513.3 	1970, United States Code, title 21, section 801, et seq.;
513.4 	(iii) in the case of a medical convenience kit that includes a product, the person who 
513.5 	manufactures the kit:
513.6 	(A) purchased the product directly from the pharmaceutical manufacturer or from a 
513.7 	wholesale distributor that purchased the product directly from the pharmaceutical 
513.8 	manufacturer; and
513.9 	(B) does not alter the primary container or label of the product as purchased from the 
513.10 	manufacturer or wholesale distributor; and
513.11 	(iv) in the case of a medical convenience kit that includes a product, the product is:
513.12 	(A) an intravenous solution intended for the replenishment of fluids and electrolytes;
513.13 	(B) a product intended to maintain the equilibrium of water and minerals in the body;
513.14 	(C) a product intended for irrigation or reconstitution;
513.15 	(D) an anesthetic;
513.16 	(E) an anticoagulant;
513.17 	(F) a vasopressor; or
513.18 	(G) a sympathomimetic;
513.19 	(14) the distribution of an intravenous product that, by its formulation, is intended for 
513.20 	the replenishment of fluids and electrolytes, such as sodium, chloride, and potassium; or 
513.21 	calories, such as dextrose and amino acids;
513.22 	(15) the distribution of an intravenous product used to maintain the equilibrium of water 
513.23 	and minerals in the body, such as dialysis solutions;
513.24 	(16) the distribution of a product that is intended for irrigation, or sterile water, whether 
513.25 	intended for such purposes or for injection;
513.26 	(17) the distribution of a medical gas as defined in United States Code, title 21, section 
513.27 	360ddd; or
513.28 	(18) the distribution or sale of any licensed product under United States Code, title 42, 
513.29 	section 262, that meets the definition of a device under United States Code, title 21, section 
513.30 	321(h).
514.1 		Subd. 13.Wholesale distribution. "Wholesale distribution" means the distribution of 
514.2 	a drug to a person other than a consumer or patient, or receipt of a drug by a person other 
514.3 	than the consumer or patient, but does not include:
514.4 	(1) intracompany distribution of any drug between members of an affiliate or within a 
514.5 	manufacturer;
514.6 	(2) the distribution of a drug or an offer to distribute a drug among hospitals or other 
514.7 	health care entities that are under common control;
514.8 	(3) the distribution of a drug or an offer to distribute a drug for emergency medical 
514.9 	reasons, including:
514.10 	(i) a public health emergency declaration pursuant to United States Code, title 42, section 
514.11 	247d;
514.12 	(ii) a national security or peacetime emergency declared by the governor pursuant to 
514.13 	section 12.31; or
514.14 	(iii) a situation involving an action taken by the commissioner of health pursuant to 
514.15 	sections 144.4197, 144.4198 or 151.37, subdivisions 2, paragraph (b), and 10, except that, 
514.16 	for purposes of this paragraph, a drug shortage not caused by a public health emergency 
514.17 	shall not constitute an emergency medical reason;
514.18 	(4) the dispensing of a drug pursuant to a valid prescription issued by a licensed 
514.19 	practitioner;
514.20 	(5) the distribution of minimal quantities of a drug by a licensed retail pharmacy to a 
514.21 	licensed practitioner for office use;
514.22 	(6) the distribution of a drug or an offer to distribute a drug by a charitable organization 
514.23 	to a nonprofit affiliate of the organization to the extent otherwise permitted by law;
514.24 	(7) the purchase or other acquisition by a dispenser, hospital, or other health care entity 
514.25 	of a drug for use by such dispenser, hospital, or other health care entity;
514.26 	(8) the distribution of a drug by the manufacturer of such drug;
514.27 	(9) the receipt or transfer of a drug by an authorized third-party logistics provider provided 
514.28 	that such third-party logistics provider does not take ownership of the drug;
514.29 	(10) a common carrier that transports a drug, provided that the common carrier does not 
514.30 	take ownership of the drug;
515.1 	(11) the distribution of a drug or an offer to distribute a drug by an authorized repackager 
515.2 	that has taken ownership or possession of the drug and repacks it in accordance with United 
515.3 	States Code, title 21, section 360eee-1(e);
515.4 	(12) salable drug returns when conducted by a dispenser;
515.5 	(13) the distribution of a collection of finished medical devices, which may include a 
515.6 	product  or biological product, assembled in kit form strictly for the convenience of the 
515.7 	purchaser or user, referred to in this section as a medical convenience kit, if:
515.8 	(i) the medical convenience kit is assembled in an establishment that is registered with 
515.9 	the Food and Drug Administration as a device manufacturer in accordance with United 
515.10 	States Code, title 21, section 360(b)(2);
515.11 	(ii) the medical convenience kit does not contain a controlled substance that appears in 
515.12 	a schedule contained in the Comprehensive Drug Abuse Prevention and Control Act of 
515.13 	1970, United States Code, title 21, section 801, et seq.;
515.14 	(iii) in the case of a medical convenience kit that includes a product, the person that 
515.15 	manufactures the kit:
515.16 	(A) purchased such product directly from the pharmaceutical manufacturer or from a 
515.17 	wholesale distributor that purchased the product directly from the pharmaceutical 
515.18 	manufacturer; and
515.19 	(B) does not alter the primary container or label of the product as purchased from the 
515.20 	manufacturer or wholesale distributor; and
515.21 	(iv) in the case of a medical convenience kit that includes a product, the product is:
515.22 	(A) an intravenous solution intended for the replenishment of fluids and electrolytes;
515.23 	(B) a product intended to maintain the equilibrium of water and minerals in the body;
515.24 	(C) a product intended for irrigation or reconstitution;
515.25 	(D) an anesthetic;
515.26 	(E) an anticoagulant;
515.27 	(F) a vasopressor; or
515.28 	(G) a sympathomimetic;
515.29 	(14) the distribution of an intravenous drug that, by its formulation, is intended for the 
515.30 	replenishment of fluids and electrolytes, such as sodium, chloride, and potassium; or calories, 
515.31 	such as dextrose and amino acids;
516.1 	(15) the distribution of an intravenous drug used to maintain the equilibrium of water 
516.2 	and minerals in the body, such as dialysis solutions;
516.3 	(16) the distribution of a drug that is intended for irrigation, or sterile water, whether 
516.4 	intended for such purposes or for injection;
516.5 	(17) the distribution of medical gas, as defined in United States Code, title 21, section 
516.6 	360ddd;
516.7 	(18) facilitating the distribution of a product by providing solely administrative services, 
516.8 	including processing of orders and payments; or
516.9 	(19) the transfer of a product by a hospital or other health care entity, or by a wholesale 
516.10 	distributor or manufacturer operating at the direction of the hospital or other health care 
516.11 	entity, to a repackager described in United States Code, title 21, section 360eee(16)(B), and 
516.12 	registered under United States Code, title 21, section 360, for the purpose of repackaging 
516.13 	the drug for use by that hospital, or other health care entity and other health care entities 
516.14 	that are under common control, if ownership of the drug remains with the hospital or other 
516.15 	health care entity at all times.
516.16 		Subd. 14.Wholesale distributor. "Wholesale distributor" means a person engaged in 
516.17 	wholesale distribution but does not include a manufacturer, a manufacturer's co-licensed 
516.18 	partner, a third-party logistics provider, or a repackager.

516.19 	Sec. 45. Minnesota Statutes 2018, section 151.46, is amended to read:
516.20 	151.46 PROHIBITED DRUG PURCHASES OR RECEIPT.
516.21 	It is unlawful for any person to knowingly purchase or receive a prescription drug from 
516.22 	a source other than a person or entity licensed under the laws of the state, except where 
516.23 	otherwise provided. Licensed wholesale drug distributors other than pharmaciesand licensed 
516.24 	third-party logistics providers shall not dispense or distribute prescription drugs directly to 
516.25 	patients. A person violating the provisions of this section is guilty of a misdemeanor.

516.26 	Sec. 46. Minnesota Statutes 2018, section 151.47, subdivision 1, is amended to read:
516.27 		Subdivision 1.Requirements Generally. (a) All wholesale drug distributors are subject 
516.28 	to the requirements of this subdivision. Each manufacturer, repackager, wholesale distributor, 
516.29 	and dispenser shall comply with the requirements set forth in United States Code, title 21, 
516.30 	section 360eee-1, with respect to the role of such manufacturer, repackager, wholesale 
516.31 	distributor, or dispenser in a transaction involving a product. If an entity meets the definition 
516.32 	of more than one of the entities listed in the preceding sentence, such entity shall comply 
517.1 	with all applicable requirements in United States Code, title 21, section 360eee-1, but shall 
517.2 	not be required to duplicate requirements.
517.3 	(b) No person or distribution outlet shall act as a wholesale drug distributor without first 
517.4 	obtaining a license from the board and paying any applicable fee specified in section 151.065.
517.5 	(c) Application for a wholesale drug distributor license under this section shall be made 
517.6 	in a manner specified by the board.
517.7 	(d) No license shall be issued or renewed for a wholesale drug distributor to operate 
517.8 	unless the applicant agrees to operate in a manner prescribed by federal and state law and 
517.9 	according to the rules adopted by the board.
517.10 	(e) No license may be issued or renewed for a drug wholesale distributor that is required 
517.11 	to be licensed or registered by the state in which it is physically located unless the applicant 
517.12 	supplies the board with proof of licensure or registration. The board may establish, by rule, 
517.13 	standards for the licensure of a drug wholesale distributor that is not required to be licensed 
517.14 	or registered by the state in which it is physically located.
517.15 	(f) The board shall require a separate license for each drug wholesale distributor facility 
517.16 	located within the state and for each drug wholesale distributor facility located outside of 
517.17 	the state from which drugs are shipped into the state or to which drugs are reverse distributed.
517.18 	(g) The board shall not issue an initial or renewed license for a drug wholesale distributor 
517.19 	facility unless the facility passes an inspection conducted by an authorized representative 
517.20 	of the board, or is accredited by an accreditation program approved by the board. In the 
517.21 	case of a drug wholesale distributor facility located outside of the state, the board may 
517.22 	require the applicant to pay the cost of the inspection, in addition to the license fee in section 
517.23 	151.065, unless the applicant furnishes the board with a report, issued by the appropriate 
517.24 	regulatory agency of the state in which the facility is located, of an inspection that has 
517.25 	occurred within the 24 months immediately preceding receipt of the license application by 
517.26 	the board, or furnishes the board with proof of current accreditation. The board may deny 
517.27 	licensure unless the applicant submits documentation satisfactory to the board that any 
517.28 	deficiencies noted in an inspection report have been corrected.
517.29 	(h) As a condition for receiving and retaining a wholesale drug distributor license issued 
517.30 	under sections 151.42 to 151.51, an applicant shall satisfy the board that it has and will 
517.31 	continuously maintain:
517.32 	(1) adequate storage conditions and facilities;
518.1 	(2) minimum liability and other insurance as may be required under any applicable 
518.2 	federal or state law;
518.3 	(3) a viable security system that includes an after hours central alarm, or comparable 
518.4 	entry detection capability; restricted access to the premises; comprehensive employment 
518.5 	applicant screening; and safeguards against all forms of employee theft;
518.6 	(4) a system of records describing all wholesale drug distributor activities set forth in 
518.7 	section 151.44 for at least the most recent two-year period, which shall be reasonably 
518.8 	accessible as defined by board regulations in any inspection authorized by the board;
518.9 	(5) principals and persons, including officers, directors, primary shareholders, and key 
518.10 	management executives, who must at all times demonstrate and maintain their capability 
518.11 	of conducting business in conformity with sound financial practices as well as state and 
518.12 	federal law;
518.13 	(6) complete, updated information, to be provided to the board as a condition for obtaining 
518.14 	and retaining a license, about each wholesale drug distributor to be licensed, including all 
518.15 	pertinent corporate licensee information, if applicable, or other ownership, principal, key 
518.16 	personnel, and facilities information found to be necessary by the board;
518.17 	(7) written policies and procedures that assure reasonable wholesale drug distributor 
518.18 	preparation for, protection against, and handling of any facility security or operation 
518.19 	problems, including, but not limited to, those caused by natural disaster or government 
518.20 	emergency, inventory inaccuracies or product shipping and receiving, outdated product or 
518.21 	other unauthorized product control, appropriate disposition of returned goods, and product 
518.22 	recalls;
518.23 	(8) sufficient inspection procedures for all incoming and outgoing product shipments; 
518.24 	and
518.25 	(9) operations in compliance with all federal requirements applicable to wholesale drug 
518.26 	distribution.
518.27 	(i) An agent or employee of any licensed wholesale drug distributor need not seek 
518.28 	licensure under this section.

518.29 	Sec. 47. Minnesota Statutes 2018, section 151.47, is amended by adding a subdivision to 
518.30 	read:
518.31 		Subd. 1a.Licensing. (a) The board shall license wholesale distributors in a manner that 
518.32 	is consistent with United States Code, title 21, section 360eee-2, and the regulations 
519.1 	promulgated thereunder. In the event that the provisions of this section, or of the rules of 
519.2 	the board, conflict with the provisions of United States Code, title 21, section 360eee-2, or 
519.3 	the rules promulgated thereunder, the federal provisions shall prevail. The board shall not 
519.4 	license a person as a wholesale distributor unless the person is engaged in wholesale 
519.5 	distribution.
519.6 	(b) No person shall act as a wholesale distributor without first obtaining a license from 
519.7 	the board and paying any applicable fee specified in section 151.065.
519.8 	(c) Application for a wholesale distributor license under this section shall be made in a 
519.9 	manner specified by the board.
519.10 	(d) No license shall be issued or renewed for a wholesale distributor unless the applicant 
519.11 	agrees to operate in a manner prescribed by federal and state law and according to the rules 
519.12 	adopted by the board.
519.13 	(e) No license may be issued or renewed for a wholesale distributor facility that is located 
519.14 	in another state unless the applicant supplies the board with proof of licensure or registration 
519.15 	by the state in which the wholesale distributor is physically located or by the United States 
519.16 	Food and Drug Administration.
519.17 	(f) The board shall require a separate license for each drug wholesale distributor facility 
519.18 	located within the state and for each drug wholesale distributor facility located outside of 
519.19 	the state from which drugs are shipped into the state or to which drugs are reverse distributed.
519.20 	(g) The board shall not issue an initial or renewed license for a drug wholesale distributor 
519.21 	facility unless the facility passes an inspection conducted by an authorized representative 
519.22 	of the board or is inspected and accredited by an accreditation program approved by the 
519.23 	board. In the case of a drug wholesale distributor facility located outside of the state, the 
519.24 	board may require the applicant to pay the cost of the inspection, in addition to the license 
519.25 	fee in section 151.065, unless the applicant furnishes the board with a report, issued by the 
519.26 	appropriate regulatory agency of the state in which the facility is located, of an inspection 
519.27 	that has occurred within the 24 months immediately preceding receipt of the license 
519.28 	application by the board, or furnishes the board with proof of current accreditation. The 
519.29 	board may deny licensure unless the applicant submits documentation satisfactory to the 
519.30 	board that any deficiencies noted in an inspection report have been corrected.
519.31 	(h) As a condition for receiving and retaining a wholesale drug distributor license issued 
519.32 	under this section, an applicant shall satisfy the board that it:
520.1 	(1) has adequate storage conditions and facilities to allow for the safe receipt, storage, 
520.2 	handling, and sale of drugs;
520.3 	(2) has minimum liability and other insurance as may be required under any applicable 
520.4 	federal or state law;
520.5 	(3) has a functioning security system that includes an after-hours central alarm or 
520.6 	comparable entry detection capability, and security policies and procedures that include 
520.7 	provisions for restricted access to the premises, comprehensive employee applicant screening, 
520.8 	and safeguards against all forms of employee theft;
520.9 	(4) will maintain appropriate records of the distribution of drugs, which shall be kept 
520.10 	for a minimum of two years and be made available to the board upon request;
520.11 	(5) employs principals and other persons, including officers, directors, primary 
520.12 	shareholders, and key management executives, who will at all times demonstrate and maintain 
520.13 	their capability of conducting business in conformity with state and federal law, at least one 
520.14 	of whom will serve as the primary designated representative for each licensed facility and 
520.15 	who will be responsible for ensuring that the facility operates in a manner consistent with 
520.16 	state and federal law;
520.17 	(6) will ensure that all personnel have sufficient education, training, and experience, in 
520.18 	any combination, so that they may perform assigned duties in a manner that maintains the 
520.19 	quality, safety, and security of drugs;
520.20 	(7) will provide the board with updated information about each wholesale distributor 
520.21 	facility to be licensed, as requested by the board;
520.22 	(8) will develop and, as necessary, update written policies and procedures that assure 
520.23 	reasonable wholesale drug distributor preparation for, protection against, and handling of 
520.24 	any facility security or operation problems, including but not limited to those caused by 
520.25 	natural disaster or government emergency, inventory inaccuracies or drug shipping and 
520.26 	receiving, outdated drugs, appropriate handling of returned goods, and drug recalls;
520.27 	(9) will have sufficient policies and procedures in place for the inspection of all incoming 
520.28 	and outgoing drug shipments;
520.29 	(10) will operate in compliance with all state and federal requirements applicable to 
520.30 	wholesale drug distribution; and
520.31 	(11) will meet the requirements for inspections found in this subdivision.
521.1 	(i) An agent or employee of any licensed wholesale drug distributor need not seek 
521.2 	licensure under this section. Paragraphs (i) to (p) apply to wholesaler personnel.
521.3 	(j) The board is authorized to and shall require fingerprint-based criminal background 
521.4 	checks of facility managers or designated representatives, as required under United States 
521.5 	Code, title 21, section 360eee-2. The criminal background checks shall be conducted as 
521.6 	provided in section 214.075. The board shall use the criminal background check data received 
521.7 	to evaluate the qualifications of persons for ownership of or employment by a licensed 
521.8 	wholesaler and shall not disseminate this data except as allowed by law.
521.9 	(k) A licensed wholesaler shall not be owned by, or employ, a person who has:
521.10 	(1) been convicted of any felony for conduct relating to wholesale distribution, any 
521.11 	felony violation of United States Code, title 21, section 331, subsections (i) or (k), or any 
521.12 	felony violation of United States Code, title 18, section 1365, relating to product tampering; 
521.13 	or
521.14 	(2) engaged in a pattern of violating the requirements of United States Code, title 21, 
521.15 	section 360eee-2, or the regulations promulgated thereunder, or state requirements for 
521.16 	licensure, that presents a threat of serious adverse health consequences or death to humans.
521.17 	(l) An applicant for the issuance or renewal of a wholesale distributor license shall 
521.18 	execute and file with the board a surety bond.
521.19 	(m) Prior to issuing or renewing a wholesale distributor license, the board shall require 
521.20 	an applicant that is not a government owned and operated wholesale distributor to submit 
521.21 	a surety bond of $100,000, except that if the annual gross receipts of the applicant for the 
521.22 	previous tax year is $10,000,000 or less, a surety bond of $25,000 shall be required.
521.23 	(n) If a wholesale distributor can provide evidence satisfactory to the board that it 
521.24 	possesses the required bond in another state, the requirement for a bond shall be waived.
521.25 	(o) The purpose of the surety bond required under this subdivision is to secure payment 
521.26 	of any civil penalty imposed by the board pursuant to section 151.071, subdivision 1. The 
521.27 	board may make a claim against the bond if the licensee fails to pay a civil penalty within 
521.28 	30 days after the order imposing the fine or costs become final.
521.29 	(p) A single surety bond shall satisfy the requirement for the submission of a bond for 
521.30 	all licensed wholesale distributor facilities under common ownership.

522.1 	Sec. 48. [151.471] THIRD-PARTY LOGISTICS PROVIDER REQUIREMENTS.
522.2 		Subdivision 1.Generally. Each third-party logistics provider shall comply with the 
522.3 	requirements set forth in United States Code, title 21, section 360eee to 360eee-4, that are 
522.4 	applicable to third-party logistics providers.
522.5 		Subd. 2.Licensing. (a) The board shall license third-party logistics providers in a manner 
522.6 	that is consistent with United States Code, title 21, section 360eee-3, and the regulations 
522.7 	promulgated thereunder. In the event that the provisions of this section or of the rules of 
522.8 	the board conflict with the provisions of United States Code, title 21, section 360eee-3, or 
522.9 	the rules promulgated thereunder, the federal provisions shall prevail. The board shall not 
522.10 	license a person as a third-party logistics provider unless the person is operating as such.
522.11 	(b) No person shall act as a third-party logistics provider without first obtaining a license 
522.12 	from the board and paying any applicable fee specified in section 151.065.
522.13 	(c) Application for a third-party logistics provider license under this section shall be 
522.14 	made in a manner specified by the board.
522.15 	(d) No license shall be issued or renewed for a third-party logistics provider unless the 
522.16 	applicant agrees to operate in a manner prescribed by federal and state law and according 
522.17 	to the rules adopted by the board.
522.18 	(e) No license may be issued or renewed for a third-party logistics provider facility that 
522.19 	is located in another state unless the applicant supplies the board with proof of licensure or 
522.20 	registration by the state in which the third-party logistics provider facility is physically 
522.21 	located or by the United States Food and Drug Administration.
522.22 	(f) The board shall require a separate license for each third-party logistics provider 
522.23 	facility located within the state and for each third-party logistics provider facility located 
522.24 	outside of the state from which drugs are shipped into the state or to which drugs are reverse 
522.25 	distributed.
522.26 	(g) The board shall not issue an initial or renewed license for a third-party logistics 
522.27 	provider facility unless the facility passes an inspection conducted by an authorized 
522.28 	representative of the board or is inspected and accredited by an accreditation program 
522.29 	approved by the board. In the case of a third-party logistics provider facility located outside 
522.30 	of the state, the board may require the applicant to pay the cost of the inspection, in addition 
522.31 	to the license fee in section 151.065, unless the applicant furnishes the board with a report, 
522.32 	issued by the appropriate regulatory agency of the state in which the facility is located, of 
522.33 	an inspection that has occurred within the 24 months immediately preceding receipt of the 
523.1 	license application by the board, or furnishes the board with proof of current accreditation. 
523.2 	The board may deny licensure unless the applicant submits documentation satisfactory to 
523.3 	the board that any deficiencies noted in an inspection report have been corrected.
523.4 	(h) As a condition for receiving and retaining a third-party logistics provider facility 
523.5 	license issued under this section, an applicant shall satisfy the board that it:
523.6 	(1) has adequate storage conditions and facilities to allow for the safe receipt, storage, 
523.7 	handling, and transfer of drugs;
523.8 	(2) has minimum liability and other insurance as may be required under any applicable 
523.9 	federal or state law;
523.10 	(3) has a functioning security system that includes an after-hours central alarm or 
523.11 	comparable entry detection capability, and security policies and procedures that include 
523.12 	provisions for restricted access to the premises, comprehensive employee applicant screening, 
523.13 	and safeguards against all forms of employee theft;
523.14 	(4) will maintain appropriate records of the handling of drugs, which shall be kept for 
523.15 	a minimum of two years and be made available to the board upon request;
523.16 	(5) employs principals and other persons, including officers, directors, primary 
523.17 	shareholders, and key management executives, who will at all times demonstrate and maintain 
523.18 	their capability of conducting business in conformity with state and federal law, at least one 
523.19 	of whom will serve as the primary designated representative for each licensed facility and 
523.20 	who will be responsible for ensuring that the facility operates in a manner consistent with 
523.21 	state and federal law;
523.22 	(6) will ensure that all personnel have sufficient education, training, and experience, in 
523.23 	any combination, so that they may perform assigned duties in a manner that maintains the 
523.24 	quality, safety, and security of drugs;
523.25 	(7) will provide the board with updated information about each third-party logistics 
523.26 	provider facility to be licensed by the board;
523.27 	(8) will develop and, as necessary, update written policies and procedures that ensure 
523.28 	reasonable preparation for, protection against, and handling of any facility security or 
523.29 	operation problems, including, but not limited to, those caused by natural disaster or 
523.30 	government emergency, inventory inaccuracies or drug shipping and receiving, outdated 
523.31 	drug, appropriate handling of returned goods, and drug recalls;
523.32 	(9) will have sufficient policies and procedures in place for the inspection of all incoming 
523.33 	and outgoing drug shipments;
524.1 	(10) will operate in compliance with all state and federal requirements applicable to 
524.2 	third-party logistics providers; and
524.3 	(11) will meet the requirements for inspections found in this subdivision.
524.4 	(i) An agent or employee of any licensed third-party logistics provider need not seek 
524.5 	licensure under this section. Paragraphs (j) and (k) apply to third-party logistics provider 
524.6 	personnel.
524.7 	(j) The board is authorized to and shall require fingerprint-based criminal background 
524.8 	checks of facility managers or designated representatives. The criminal background checks 
524.9 	shall be conducted as provided in section 214.075. The board shall use the criminal 
524.10 	background check data received to evaluate the qualifications of persons for ownership of 
524.11 	or employment by a licensed third-party logistics provider and shall not disseminate this 
524.12 	data except as allowed by law.
524.13 	(k) A licensed third-party logistics provider shall not have as a facility manager or 
524.14 	designated representative any person who has been convicted of any felony for conduct 
524.15 	relating to wholesale distribution, any felony violation of United States Code, title 21, section 
524.16 	331, subsection (i) or (k), or any felony violation of United States Code, title 18, section 
524.17 	1365, relating to product tampering.

524.18 	Sec. 49. Minnesota Statutes 2018, section 152.126, subdivision 6, is amended to read:
524.19 		Subd. 6.Access to reporting system data. (a) Except as indicated in this subdivision, 
524.20 	the data submitted to the board under subdivision 4 is private data on individuals as defined 
524.21 	in section 13.02, subdivision 12, and not subject to public disclosure.
524.22 	(b) Except as specified in subdivision 5, the following persons shall be considered 
524.23 	permissible users and may access the data submitted under subdivision 4 in the same or 
524.24 	similar manner, and for the same or similar purposes, as those persons who are authorized 
524.25 	to access similar private data on individuals under federal and state law:
524.26 	(1) a prescriber or an agent or employee of the prescriber to whom the prescriber has 
524.27 	delegated the task of accessing the data, to the extent the information relates specifically to 
524.28 	a current patient, to whom the prescriber is:
524.29 	(i) prescribing or considering prescribing any controlled substance;
524.30 	(ii) providing emergency medical treatment for which access to the data may be necessary;
524.31 	(iii) providing care, and the prescriber has reason to believe, based on clinically valid 
524.32 	indications, that the patient is potentially abusing a controlled substance; or
525.1 	(iv) providing other medical treatment for which access to the data may be necessary 
525.2 	for a clinically valid purpose and the patient has consented to access to the submitted data, 
525.3 	and with the provision that the prescriber remains responsible for the use or misuse of data 
525.4 	accessed by a delegated agent or employee;
525.5 	(2) a dispenser or an agent or employee of the dispenser to whom the dispenser has 
525.6 	delegated the task of accessing the data, to the extent the information relates specifically to 
525.7 	a current patient to whom that dispenser is dispensing or considering dispensing any 
525.8 	controlled substance and with the provision that the dispenser remains responsible for the 
525.9 	use or misuse of data accessed by a delegated agent or employee;
525.10 	(3) a licensed pharmacist who is providing pharmaceutical care for which access to the 
525.11 	data may be necessary to the extent that the information relates specifically to a current 
525.12 	patient for whom the pharmacist is providing pharmaceutical care: (i) if the patient has 
525.13 	consented to access to the submitted data; or (ii) if the pharmacist is consulted by a prescriber 
525.14 	who is requesting data in accordance with clause (1);
525.15 	(4) an individual who is the recipient of a controlled substance prescription for which 
525.16 	data was submitted under subdivision 4, or a guardian of the individual, parent or guardian 
525.17 	of a minor, or health care agent of the individual acting under a health care directive under 
525.18 	chapter 145C;
525.19 	(5) personnel or designees of a health-related licensing board listed in section 214.01, 
525.20 	subdivision 2, or of the Emergency Medical Services Regulatory Board, assigned to conduct 
525.21 	a bona fide investigation of a complaint received by that board that alleges that a specific 
525.22 	licensee is impaired by use of a drug for which data is collected under subdivision 4, has 
525.23 	engaged in activity that would constitute a crime as defined in section 152.025, or has 
525.24 	engaged in the behavior specified in subdivision 5, paragraph (a);
525.25 	(6) personnel of the board engaged in the collection, review, and analysis of controlled 
525.26 	substance prescription information as part of the assigned duties and responsibilities under 
525.27 	this section;
525.28 	(7) authorized personnel of a vendor under contract with the state of Minnesota who are 
525.29 	engaged in the design, implementation, operation, and maintenance of the prescription 
525.30 	monitoring program as part of the assigned duties and responsibilities of their employment, 
525.31 	provided that access to data is limited to the minimum amount necessary to carry out such 
525.32 	duties and responsibilities, and subject to the requirement of de-identification and time limit 
525.33 	on retention of data specified in subdivision 5, paragraphs (d) and (e);
526.1 	(8) federal, state, and local law enforcement authorities acting pursuant to a valid search 
526.2 	warrant;
526.3 	(9) personnel of the Minnesota health care programs assigned to use the data collected 
526.4 	under this section to identify and manage recipients whose usage of controlled substances 
526.5 	may warrant restriction to a single primary care provider, a single outpatient pharmacy, and 
526.6 	a single hospital;
526.7 	(10) personnel of the Department of Human Services assigned to access the data pursuant 
526.8 	to paragraph (i);
526.9 	(11) personnel of the health professionals services program established under section 
526.10 	214.31, to the extent that the information relates specifically to an individual who is currently 
526.11 	enrolled in and being monitored by the program, and the individual consents to access to 
526.12 	that information. The health professionals services program personnel shall not provide this 
526.13 	data to a health-related licensing board or the Emergency Medical Services Regulatory 
526.14 	Board, except as permitted under section 214.33, subdivision 3.
526.15 	For purposes of clause (4), access by an individual includes persons in the definition of 
526.16 	an individual under section 13.02; and
526.17 	(12) personnel or designees of a health-related licensing board listed in section 214.01, 
526.18 	subdivision 2, assigned to conduct a bona fide investigation of a complaint received by that 
526.19 	board that alleges that a specific licensee is inappropriately prescribing controlled substances 
526.20 	as defined in this section.
526.21 	(c) By July 1, 2017, every prescriber licensed by a health-related licensing board listed 
526.22 	in section 214.01, subdivision 2, practicing within this state who is authorized to prescribe 
526.23 	controlled substances for humans and who holds a current registration issued by the federal 
526.24 	Drug Enforcement Administration, and every pharmacist licensed by the board and practicing 
526.25 	within the state, shall register and maintain a user account with the prescription monitoring 
526.26 	program. Data submitted by a prescriber, pharmacist, or their delegate during the registration 
526.27 	application process, other than their name, license number, and license type, is classified 
526.28 	as private pursuant to section 13.02, subdivision 12.
526.29 	(d) Only permissible users identified in paragraph (b), clauses (1), (2), (3), (6), (7), (9), 
526.30 	and (10), may directly access the data electronically. No other permissible users may directly 
526.31 	access the data electronically. If the data is directly accessed electronically, the permissible 
526.32 	user shall implement and maintain a comprehensive information security program that 
526.33 	contains administrative, technical, and physical safeguards that are appropriate to the user's 
526.34 	size and complexity, and the sensitivity of the personal information obtained. The permissible 
527.1 	user shall identify reasonably foreseeable internal and external risks to the security, 
527.2 	confidentiality, and integrity of personal information that could result in the unauthorized 
527.3 	disclosure, misuse, or other compromise of the information and assess the sufficiency of 
527.4 	any safeguards in place to control the risks.
527.5 	(e) The board shall not release data submitted under subdivision 4 unless it is provided 
527.6 	with evidence, satisfactory to the board, that the person requesting the information is entitled 
527.7 	to receive the data.
527.8 	(f) The board shall maintain a log of all persons who access the data for a period of at 
527.9 	least three years and shall ensure that any permissible user complies with paragraph (c) (d)
527.10 	prior to attaining direct access to the data.
527.11 	(g) Section 13.05, subdivision 6, shall apply to any contract the board enters into pursuant 
527.12 	to subdivision 2. A vendor shall not use data collected under this section for any purpose 
527.13 	not specified in this section.
527.14 	(h) The board may participate in an interstate prescription monitoring program data 
527.15 	exchange system provided that permissible users in other states have access to the data only 
527.16 	as allowed under this section, and that section 13.05, subdivision 6, applies to any contract 
527.17 	or memorandum of understanding that the board enters into under this paragraph.
527.18 	(i) With available appropriations, the commissioner of human services shall establish 
527.19 	and implement a system through which the Department of Human Services shall routinely 
527.20 	access the data for the purpose of determining whether any client enrolled in an opioid 
527.21 	treatment program licensed according to chapter 245A has been prescribed or dispensed a 
527.22 	controlled substance in addition to that administered or dispensed by the opioid treatment 
527.23 	program. When the commissioner determines there have been multiple prescribers or multiple 
527.24 	prescriptions of controlled substances, the commissioner shall:
527.25 	(1) inform the medical director of the opioid treatment program only that the 
527.26 	commissioner determined the existence of multiple prescribers or multiple prescriptions of 
527.27 	controlled substances; and
527.28 	(2) direct the medical director of the opioid treatment program to access the data directly, 
527.29 	review the effect of the multiple prescribers or multiple prescriptions, and document the 
527.30 	review.
527.31 	If determined necessary, the commissioner of human services shall seek a federal waiver 
527.32 	of, or exception to, any applicable provision of Code of Federal Regulations, title 42, section 
527.33 	2.34, paragraph (c), prior to implementing this paragraph.
528.1 	(j) The board shall review the data submitted under subdivision 4 on at least a quarterly 
528.2 	basis and shall establish criteria, in consultation with the advisory task force, for referring 
528.3 	information about a patient to prescribers and dispensers who prescribed or dispensed the 
528.4 	prescriptions in question if the criteria are met.
528.5 	(k) The board shall conduct random audits, on at least a quarterly basis, of electronic 
528.6 	access by permissible users, as identified in paragraph (b), clauses  (1), (2), (3), (6), (7), (9), 
528.7 	and (10), to the data in subdivision 4, to ensure compliance with permissible use as defined 
528.8 	in this section. A permissible user whose account has been selected for a random audit shall 
528.9 	respond to an inquiry by the board, no later than 30 days after receipt of notice that an audit 
528.10 	is being conducted. Failure to respond may result in deactivation of access to the electronic 
528.11 	system and referral to the appropriate health licensing board, or the commissioner of human 
528.12 	services, for further action. The board shall report the results of random audits to the chairs 
528.13 	and ranking minority members of the legislative committees with jurisdiction over health 
528.14 	and human services policy and finance and government data practices.
528.15 	(l) A permissible user who has delegated the task of accessing the data in subdivision 4 
528.16 	to an agent or employee shall audit the use of the electronic system by delegated agents or 
528.17 	employees on at least a quarterly basis to ensure compliance with permissible use as defined 
528.18 	in this section. When a delegated agent or employee has been identified as inappropriately 
528.19 	accessing data, the permissible user must immediately remove access for that individual 
528.20 	and notify the board within seven days. The board shall notify all permissible users associated 
528.21 	with the delegated agent or employee of the alleged violation.
528.22 	(m) A permissible user who delegates access to the data submitted under subdivision 4 
528.23 	to an agent or employee shall terminate that individual's access to the data within three 
528.24 	business days of the agent or employee leaving employment with the permissible user. The 
528.25 	board may conduct random audits to determine compliance with this requirement.

528.26 	Sec. 50. Minnesota Statutes 2018, section 152.126, subdivision 7, is amended to read:
528.27 		Subd. 7.Disciplinary action. (a) A dispenser who knowingly fails to submit data to the 
528.28 	board as required under this section is subject to disciplinary action by the appropriate 
528.29 	health-related licensing board.
528.30 	(b) A prescriber or dispenser authorized to access the data who knowingly discloses the 
528.31 	data in violation of state or federal laws relating to the privacy of health care data shall be 
528.32 	subject to disciplinary action by the appropriate health-related licensing board, and 
528.33 	appropriate civil penalties.
529.1 	(c) A prescriber or dispenser authorized to access the data who fails to comply with 
529.2 	subdivision 6, paragraph (l) or (m), shall be subject to disciplinary action by the appropriate 
529.3 	health-related licensing board.

529.4 	Sec. 51. Minnesota Statutes 2018, section 152.126, is amended by adding a subdivision 
529.5 	to read:
529.6 		Subd. 10a.Patient information on record access. A patient who has been prescribed 
529.7 	a controlled substance may access the prescription monitoring program database in order 
529.8 	to obtain information on access by permissible users to the patient's data record, including 
529.9 	the name and organizational affiliation of the permissible user and the date of access. In 
529.10 	order to obtain this information, the patient must complete, notarize, and submit a request 
529.11 	form developed by the board. The board shall make this form available to the public on the 
529.12 	board's website.

529.13 	Sec. 52. REVISOR INSTRUCTION.
 529.14 	The fee increases in Minnesota Statutes, section 151.065, subdivisions 1 and 3, in this 
529.15 	article are in addition to any other fee increases in Minnesota Statutes, section 151.065, 
529.16 	subdivisions 1 and 3, enacted in 2019 regular or special sessions. If multiple fees are enacted, 
529.17 	the revisor of statutes shall add the fees together for publication in the 2019 Minnesota 
529.18 	Statutes Supplement to effectuate the intent of the legislature.

529.19 	Sec. 53. REPEALER.
 529.20 	(a) Minnesota Statutes 2018, sections 151.42; 151.44; 151.49; 151.50; 151.51; and 
529.21 	151.55, are repealed.
529.22 	(b) Minnesota Rules, parts 6400.6970; 7200.6100; and 7200.6105, are repealed.

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

529.24 	ARTICLE 11
529.25 	HEALTH DEPARTMENT

529.26 	Section 1. Minnesota Statutes 2018, section 18K.03, is amended to read:
529.27 	18K.03 AGRICULTURAL CROP; POSSESSION AUTHORIZED.
529.28 		Subdivision 1. Industrial hemp. Industrial hemp is an agricultural crop in this state. A 
529.29 	person may possess, transport, process, sell, or buy industrial hemp that is grown pursuant 
529.30 	to this chapter.
530.1 		Subd. 2. Sale to medical cannabis manufacturers. A licensee under this chapter may 
530.2 	sell hemp products derived from industrial hemp grown in this state to medical cannabis 
530.3 	manufacturers as authorized under sections 152.22 to 152.37.

530.4 	Sec. 2. Minnesota Statutes 2018, section 62J.495, subdivision 1, is amended to read:
530.5 		Subdivision 1.Implementation. By January 1, 2015, all hospitals and health care 
530.6 	providers, as defined in section 62J.03, subdivision 8, must have in place an interoperable 
530.7 	electronic health records system within their hospital system or clinical practice setting.
530.8 	The commissioner of health, in consultation with the e-Health Advisory Committee, shall 
530.9 	develop a statewide plan to meet this goal, including uniform standards to be used for the 
530.10 	interoperable electronic health records system for sharing and synchronizing patient data 
530.11 	across systems. The standards must be compatible with federal efforts. The uniform standards 
530.12 	must be developed by January 1, 2009, and updated on an ongoing basis. The commissioner 
530.13 	shall include an update on standards development as part of an annual report to the legislature. 
530.14 	Individual health care providers in private practice with no other providers and health care 
530.15 	providers that do not accept reimbursement from a group purchaser, as defined in section 
530.16 	62J.03, subdivision 6, are excluded from the requirements of this section.

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

530.18 	Sec. 3. Minnesota Statutes 2018, section 62J.495, subdivision 3, is amended to read:
530.19 		Subd. 3.Interoperable electronic health record requirements.  (a) To meet the 
530.20 	requirements of subdivision 1, Hospitals and health care providers must meet the following 
530.21 	criteria when implementing an interoperable electronic health records system within their 
530.22 	hospital system or clinical practice setting.
530.23 	(b) The electronic health record must be a qualified electronic health record.
530.24 	(c) The electronic health record must be certified by the Office of the National 
530.25 	Coordinator pursuant to the HITECH Act. This criterion only applies to hospitals and health 
530.26 	care providers if a certified electronic health record product for the provider's particular 
530.27 	practice setting is available. This criterion shall be considered met if a hospital or health 
530.28 	care provider is using an electronic health records system that has been certified within the 
530.29 	last three years, even if a more current version of the system has been certified within the 
530.30 	three-year period.
530.31 	(d) The electronic health record must meet the standards established according to section 
530.32 	3004 of the HITECH Act as applicable.
531.1 	(e) The electronic health record must have the ability to generate information on clinical 
531.2 	quality measures and other measures reported under sections 4101, 4102, and 4201 of the 
531.3 	HITECH Act.
531.4 	(f) The electronic health record system must be connected to a state-certified health 
531.5 	information organization either directly or through a connection facilitated by a state-certified 
531.6 	health data intermediary as defined in section 62J.498.
531.7 	(g) A health care provider who is a prescriber or dispenser of legend drugs must have 
531.8 	an electronic health record system that meets the requirements of section 62J.497.

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

531.10 	Sec. 4. Minnesota Statutes 2018, section 103I.005, subdivision 2, is amended to read:
531.11 		Subd. 2.Boring. "Boring" means a hole or excavation that is not used to extract water 
531.12 	and includes exploratory borings, bored geothermal heat exchangers, temporary borings, 
531.13 	and elevator borings.

531.14 	Sec. 5. Minnesota Statutes 2018, section 103I.005, subdivision 8a, is amended to read:
531.15 		Subd. 8a.Environmental well. "Environmental well" means an excavation 15 or more 
531.16 	feet in depth that is drilled, cored, bored, washed, driven, dug, jetted, or otherwise constructed 
531.17 	to:
531.18 	(1) conduct physical, chemical, or biological testing of groundwater, and includes a 
531.19 	groundwater quality monitoring or sampling well;
531.20 	(2) lower a groundwater level to control or remove contamination in groundwater, and 
531.21 	includes a remedial well and excludes horizontal trenches; or
531.22 	(3) monitor or measure physical, chemical, radiological, or biological parameters of the 
531.23 	earth and earth fluids, or for vapor recovery or venting systems. An environmental well 
531.24 	includes an excavation used to:
531.25 	(i) measure groundwater levels, including a piezometer;
531.26 	(ii) determine groundwater flow direction or velocity;
531.27 	(iii) measure earth properties such as hydraulic conductivity, bearing capacity, or 
531.28 	resistance;
531.29 	(iv) obtain samples of geologic materials for testing or classification; or
532.1 	(v) remove or remediate pollution or contamination from groundwater or soil through 
532.2 	the use of a vent, vapor recovery system, or sparge point.
532.3 	An environmental well does not include an exploratory boring.

532.4 	Sec. 6. Minnesota Statutes 2018, section 103I.005, subdivision 17a, is amended to read:
532.5 		Subd. 17a.Temporary environmental well boring. "Temporary environmental well" 
532.6 	means an environmental well as defined in section 103I.005, subdivision 8a, that is sealed 
532.7 	within 72 hours of the time construction on the well begins. "Temporary boring" means an 
532.8 	excavation that is 15 feet or more in depth, is sealed within 72 hours of the time of 
532.9 	construction, and is drilled, cored, washed, driven, dug, jetted, or otherwise constructed to:
532.10 	(1) conduct physical, chemical, or biological testing of groundwater, including 
532.11 	groundwater quality monitoring;
532.12 	(2) monitor or measure physical, chemical, radiological, or biological parameters of 
532.13 	earth materials or earth fluids, including hydraulic conductivity, bearing capacity, or 
532.14 	resistance;
532.15 	(3) measure groundwater levels, including use of a piezometer; and
532.16 	(4) determine groundwater flow direction or velocity.

532.17 	Sec. 7. Minnesota Statutes 2018, section 103I.205, subdivision 1, is amended to read:
532.18 		Subdivision 1.Notification required. (a) Except as provided in paragraph (d), a person 
532.19 	may not construct a water-supply, dewatering, or environmental well until a notification of 
532.20 	the proposed well on a form prescribed by the commissioner is filed with the commissioner 
532.21 	with the filing fee in section 103I.208, and, when applicable, the person has met the 
532.22 	requirements of paragraph (e). If after filing the well notification an attempt to construct a 
532.23 	well is unsuccessful, a new notification is not required unless the information relating to 
532.24 	the successful well has substantially changed. A notification is not required prior to 
532.25 	construction of a temporary environmental well boring.
532.26 	(b) The property owner, the property owner's agent, or the licensed contractor where a 
532.27 	well is to be located must file the well notification with the commissioner.
532.28 	(c) The well notification under this subdivision preempts local permits and notifications, 
532.29 	and counties or home rule charter or statutory cities may not require a permit or notification 
532.30 	for wells unless the commissioner has delegated the permitting or notification authority 
532.31 	under section 103I.111.
533.1 	(d) A person who is an individual that constructs a drive point water-supply well on 
533.2 	property owned or leased by the individual for farming or agricultural purposes or as the 
533.3 	individual's place of abode must notify the commissioner of the installation and location of 
533.4 	the well. The person must complete the notification form prescribed by the commissioner 
533.5 	and mail it to the commissioner by ten days after the well is completed. A fee may not be 
533.6 	charged for the notification. A person who sells drive point wells at retail must provide 
533.7 	buyers with notification forms and informational materials including requirements regarding 
533.8 	wells, their location, construction, and disclosure. The commissioner must provide the 
533.9 	notification forms and informational materials to the sellers.
533.10 	(e) When the operation of a well will require an appropriation permit from the 
533.11 	commissioner of natural resources, a person may not begin construction of the well until 
533.12 	the person submits the following information to the commissioner of natural resources:
533.13 	(1) the location of the well;
533.14 	(2) the formation or aquifer that will serve as the water source;
533.15 	(3) the maximum daily, seasonal, and annual pumpage rates and volumes that will be 
533.16 	requested in the appropriation permit; and
533.17 	(4) other information requested by the commissioner of natural resources that is necessary 
533.18 	to conduct the preliminary assessment required under section 103G.287, subdivision 1, 
533.19 	paragraph (c).
533.20 	The person may begin construction after receiving preliminary approval from the 
533.21 	commissioner of natural resources.

533.22 	Sec. 8. Minnesota Statutes 2018, section 103I.205, subdivision 4, is amended to read:
533.23 		Subd. 4.License required. (a) Except as provided in paragraph (b), (c), (d), or (e), 
533.24 	section 103I.401, subdivision 2, or 103I.601, subdivision 2, a person may not drill, construct, 
533.25 	repair, or seal a well or boring unless the person has a well contractor's license in possession.
533.26 	(b) A person may construct, repair, and seal an environmental well or temporary boring 
533.27 	if the person:
533.28 	(1) is a professional engineer licensed under sections 326.02 to 326.15 in the branches 
533.29 	of civil or geological engineering;
533.30 	(2) is a hydrologist or hydrogeologist certified by the American Institute of Hydrology;
533.31 	(3) is a professional geoscientist licensed under sections 326.02 to 326.15;
534.1 	(4) is a geologist certified by the American Institute of Professional Geologists; or
534.2 	(5) meets the qualifications established by the commissioner in rule.
534.3 	A person must be licensed by the commissioner as an environmental well contractor on 
534.4 	forms provided by the commissioner.
534.5 	(c) A person may do the following work with a limited well/boring contractor's license 
534.6 	in possession. A separate license is required for each of the four activities:
534.7 	(1) installing, repairing, and modifying well screens, pitless units and pitless adaptors, 
534.8 	well pumps and pumping equipment, and well casings from the pitless adaptor or pitless 
534.9 	unit to the upper termination of the well casing;
534.10 	(2) sealing wells and borings;
534.11 	(3) constructing, repairing, and sealing dewatering wells; or
534.12 	(4) constructing, repairing, and sealing bored geothermal heat exchangers.
534.13 	(d) A person may construct, repair, and seal an elevator boring with an elevator boring 
534.14 	contractor's license.
534.15 	(e) Notwithstanding other provisions of this chapter requiring a license, a license is not 
534.16 	required for a person who complies with the other provisions of this chapter if the person 
534.17 	is:
534.18 	(1) an individual who constructs a water-supply well on land that is owned or leased by 
534.19 	the individual and is used by the individual for farming or agricultural purposes or as the 
534.20 	individual's place of abode; or
534.21 	(2) an individual who performs labor or services for a contractor licensed under the 
534.22 	provisions of this chapter in connection with the construction, sealing, or repair of a well 
534.23 	or boring at the direction and under the personal supervision of a contractor licensed under 
534.24 	the provisions of this chapter; or.
534.25 	(3) a licensed plumber who is repairing submersible pumps or water pipes associated 
534.26 	with well water systems if: (i) the repair location is within an area where there is no licensed 
534.27 	well contractor within 50 miles, and (ii) the licensed plumber complies with all relevant 
534.28 	sections of the plumbing code.

535.1 	Sec. 9. Minnesota Statutes 2018, section 103I.205, subdivision 9, is amended to read:
535.2 		Subd. 9.Report of work. Within 30 60 days after completion or sealing of a well or 
535.3 	boring, the person doing the work must submit a verified report to the commissioner 
535.4 	containing the information specified by rules adopted under this chapter.
535.5 	Within 30 days after receiving the report, the commissioner shall send or otherwise 
535.6 	provide access to a copy of the report to the commissioner of natural resources, to the local 
535.7 	soil and water conservation district where the well is located, and to the director of the 
535.8 	Minnesota Geological Survey.

535.9 	Sec. 10. Minnesota Statutes 2018, section 103I.208, subdivision 1, is amended to read:
535.10 		Subdivision 1.Well notification fee. The well notification fee to be paid by a property 
535.11 	owner is:
535.12 	(1) for construction of a water supply well, $275, which includes the state core function 
535.13 	fee;
535.14 	(2) for a well sealing, $75 for each well or temporary boring, which includes the state 
535.15 	core function fee, except that: (i) a single notification and fee of $75 is required for all 
535.16 	temporary environmental wells recorded on the sealing notification forborings on a single 
535.17 	property, having depths within a 25 foot range, and sealed within 72 hours of start of 
535.18 	construction; and (ii) temporary borings less than 25 feet in depth are exempt from the 
535.19 	notification and fee requirements in this chapter;
535.20 	(3) for construction of a dewatering well, $275, which includes the state core function 
535.21 	fee, for each dewatering well except a dewatering project comprising five or more dewatering 
535.22 	wells shall be assessed a single fee of $1,375 for the dewatering wells recorded on the 
535.23 	notification; and
535.24 	(4) for construction of an environmental well, $275, which includes the state core function 
535.25 	fee, except that a single fee of $275 is required for all environmental wells recorded on the 
535.26 	notification that are located on a single property, and except that no fee is required for 
535.27 	construction of a temporary environmental well boring.

535.28 	Sec. 11. Minnesota Statutes 2018, section 103I.235, subdivision 3, is amended to read:
535.29 		Subd. 3.Temporary environmental well boring and unsuccessful well exemption. This 
535.30 	section does not apply to temporary environmental wells borings or unsuccessful wells that 
535.31 	have been sealed by a licensed contractor in compliance with this chapter.

536.1 	Sec. 12. Minnesota Statutes 2018, section 103I.301, is amended by adding a subdivision 
536.2 	to read:
536.3 		Subd. 3a.Temporary boring. (a) The owner of the property where a temporary boring 
536.4 	is located must have the temporary boring sealed within 72 hours after the start of 
536.5 	construction of the temporary boring.
536.6 	(b) The owner must have a well contractor, a limited well/boring sealing contractor, or 
536.7 	an environmental well contractor seal the temporary boring.

536.8 	Sec. 13. Minnesota Statutes 2018, section 103I.301, subdivision 6, is amended to read:
536.9 		Subd. 6.Notification required. A person may not seal a well or temporary boring until 
536.10 	a notification of the proposed sealing is filed as prescribed by the commissioner. A single 
536.11 	notification is required for all temporary borings sealed on a single property. Temporary 
536.12 	borings less than 25 feet in depth are exempt from the notification requirements in this 
536.13 	chapter.

536.14 	Sec. 14. Minnesota Statutes 2018, section 103I.601, subdivision 4, is amended to read:
536.15 		Subd. 4.Notification and map of borings. (a) By ten days before beginning exploratory 
536.16 	boring, an explorer must submit to the commissioner of health a notification of the proposed 
536.17 	boring on a form prescribed by the commissioner, map and a fee of $275 for each exploratory 
536.18 	boring.
536.19 	(b) By ten days before beginning exploratory boring, an explorer must submit to the 
536.20 	commissioners of health and natural resources a county road map on a single sheet of paper 
536.21 	that is 8-1/2 by 11 inches in size and having a scale of one-half inch equal to one mile, as 
536.22 	prepared by the Department of Transportation, or a 7.5 minute series topographic map 
536.23 	(1:24,000 scale), as prepared by the United States Geological Survey, showing the location 
536.24 	of each proposed exploratory boring to the nearest estimated 40 acre parcel. Exploratory 
536.25 	boring that is proposed on the map may not be commenced later than 180 days after 
536.26 	submission of the map, unless a new map is submitted.

536.27 	Sec. 15. Minnesota Statutes 2018, section 144.121, subdivision 1a, is amended to read:
536.28 		Subd. 1a.Fees for ionizing radiation-producing equipment. (a) A facility with ionizing 
536.29 	radiation-producing equipment must pay an annual initial or annual renewal registration 
536.30 	fee consisting of a base facility fee of $100 and an additional fee for each radiation source, 
536.31 	as follows:

537.1	(1)
	medical or veterinary equipment
	$
	100
		
537.2	(2)
	dental x-ray equipment
	$
	40
		
537.3537.4	(3)
	x-ray equipment not used on 
humans or animals
	$
	100
		
537.5537.6
537.7	(4)
	devices with sources of ionizing 
radiation not used on humans or 
animals
	$
	100
		
537.8	(5)
	security screening system
	$
	100
		
537.9 	(b) A facility with radiation therapy and accelerator equipment must pay an annual 
537.10 	registration fee of $500. A facility with an industrial accelerator must pay an annual 
537.11 	registration fee of $150.
537.12 	(c) Electron microscopy equipment is exempt from the registration fee requirements of 
537.13 	this section.
537.14 	(d) For purposes of this section, a security screening system means radiation-producing 
537.15 	equipment designed and used for security screening of humans who are in the custody of a 
537.16 	correctional or detention facility, and used by the facility to image and identify contraband 
537.17 	items concealed within or on all sides of a human body. For purposes of this section, a 
537.18 	correctional or detention facility is a facility licensed under section 241.021 and operated 
537.19 	by a state agency or political subdivision charged with detection, enforcement, or 
537.20 	incarceration in respect to state criminal and traffic laws.

537.21 	Sec. 16. Minnesota Statutes 2018, section 144.121, is amended by adding a subdivision 
537.22 	to read:
537.23 		Subd. 9.Exemption from examination requirements; operators of security screening 
537.24 	systems. (a) An employee of a correctional or detention facility who operates a security 
537.25 	screening system and the facility in which the system is being operated are exempt from 
537.26 	the requirements of subdivisions 5 and 6.
537.27 	(b) An employee of a correctional or detention facility who operates a security screening 
537.28 	system and the facility in which the system is being operated must meet the requirements 
537.29 	of a variance to Minnesota Rules, parts 4732.0305 and 4732.0565, issued under Minnesota 
537.30 	Rules, parts 4717.7000 to 4717.7050. This paragraph expires on December 31 of the year 
537.31 	that the permanent rules adopted by the commissioner governing security screening systems 
537.32 	are published in the State Register.

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

538.1 	Sec. 17. Minnesota Statutes 2018, section 144.1506, subdivision 2, is amended to read:
538.2 		Subd. 2.Expansion grant program. (a) The commissioner of health shall award primary 
538.3 	care residency expansion grants to eligible primary care residency programs to plan and 
538.4 	implement new residency slots. A planning grant shall not exceed $75,000, and a training 
538.5 	grant shall not exceed $150,000 per new residency slot for the first year, $100,000 for the 
538.6 	second year, and $50,000 for the third year of the new residency slot. For eligible residency 
538.7 	programs longer than three years, training grants may be awarded for the duration of the 
538.8 	residency, not exceeding an average of $100,000 per residency slot per year.
538.9 	(b) Funds may be spent to cover the costs of:
538.10 	(1) planning related to establishing an accredited primary care residency program;
538.11 	(2) obtaining accreditation by the Accreditation Council for Graduate Medical Education 
538.12 	or another national body that accredits residency programs;
538.13 	(3) establishing new residency programs or new resident training slots;
538.14 	(4) recruitment, training, and retention of new residents and faculty;
538.15 	(5) travel and lodging for new residents;
538.16 	(6) faculty, new resident, and preceptor salaries related to new residency slots;
538.17 	(7) training site improvements, fees, equipment, and supplies required for new primary 
538.18 	care resident training slots; and
538.19 	(8) supporting clinical education in which trainees are part of a primary care team model.

538.20 	Sec. 18. Minnesota Statutes 2018, section 144.225, subdivision 2, is amended to read:
538.21 		Subd. 2.Data about births. (a) Except as otherwise provided in this subdivision, data 
538.22 	pertaining to the birth of a child to a woman who was not married to the child's father when 
538.23 	the child was conceived nor when the child was born, including the original record of birth 
538.24 	and the certified vital record, are confidential data. At the time of the birth of a child to a 
538.25 	woman who was not married to the child's father when the child was conceived nor when 
538.26 	the child was born, the mother may designate demographic data pertaining to the birth as 
538.27 	public. Notwithstanding the designation of the data as confidential, it may be disclosed:
538.28 	(1) to a parent or guardian of the child;
538.29 	(2) to the child when the child is 16 years of age or older;
538.30 	(3) under paragraph (b) or, (e), or (f); or
539.1 	(4) pursuant to a court order. For purposes of this section, a subpoena does not constitute 
539.2 	a court order.
539.3 	(b) Unless the child is adopted, data pertaining to the birth of a child that are not accessible 
539.4 	to the public become public data if 100 years have elapsed since the birth of the child who 
539.5 	is the subject of the data, or as provided under section 13.10, whichever occurs first.
539.6 	(c) If a child is adopted, data pertaining to the child's birth are governed by the provisions 
539.7 	relating to adoption records, including sections 13.10, subdivision 5; 144.218, subdivision 
539.8 	1; 144.2252; and 259.89.
539.9 	(d) The name and address of a mother under paragraph (a) and the child's date of birth 
539.10 	may be disclosed to the county social services, tribal health department, or public health 
539.11 	member of a family services collaborative for purposes of providing services under section 
539.12 	124D.23.
539.13 	(e) The commissioner of human services shall have access to birth records for:
539.14 	(1) the purposes of administering medical assistance and the MinnesotaCare program;
539.15 	(2) child support enforcement purposes; and
539.16 	(3) other public health purposes as determined by the commissioner of health.
539.17 	(f) Tribal child support programs shall have access to birth records for child support 
539.18 	enforcement purposes.

539.19 	Sec. 19. Minnesota Statutes 2018, section 144.225, subdivision 2a, is amended to read:
539.20 		Subd. 2a.Health data associated with birth registration. Information from which an 
539.21 	identification of risk for disease, disability, or developmental delay in a mother or child can 
539.22 	be made, that is collected in conjunction with birth registration or fetal death reporting, is 
539.23 	private data as defined in section 13.02, subdivision 12. The commissioner may disclose to 
539.24 	a tribal health department or community health board, as defined in section 145A.02, 
539.25 	subdivision 5, health data associated with birth registration which identifies a mother or 
539.26 	child at high risk for serious disease, disability, or developmental delay in order to assure 
539.27 	access to appropriate health, social, or educational services. Notwithstanding the designation 
539.28 	of the private data, the commissioner of human services shall have access to health data 
539.29 	associated with birth registration for:
539.30 	(1) purposes of administering medical assistance and the MinnesotaCare program; and
539.31 	(2) for other public health purposes as determined by the commissioner of health.

540.1 	Sec. 20. Minnesota Statutes 2018, section 144.225, subdivision 7, is amended to read:
540.2 		Subd. 7.Certified birth or death record. (a) The state registrar or local issuance office 
540.3 	shall issue a certified birth or death record or a statement of no vital record found to an 
540.4 	individual upon the individual's proper completion of an attestation provided by the 
540.5 	commissioner and payment of the required fee:
540.6 	(1) to a person who has a tangible interest in the requested vital record. A person who 
540.7 	has a tangible interest is:
540.8 	(i) the subject of the vital record;
540.9 	(ii) a child of the subject;
540.10 	(iii) the spouse of the subject;
540.11 	(iv) a parent of the subject;
540.12 	(v) the grandparent or grandchild of the subject;
540.13 	(vi) if the requested record is a death record, a sibling of the subject;
540.14 	(vii) the party responsible for filing the vital record;
540.15 	(viii) the legal custodian, guardian or conservator, or health care agent of the subject;
540.16 	(ix) a personal representative, by sworn affidavit of the fact that the certified copy is 
540.17 	required for administration of the estate;
540.18 	(x) a successor of the subject, as defined in section 524.1-201, if the subject is deceased, 
540.19 	by sworn affidavit of the fact that the certified copy is required for administration of the 
540.20 	estate;
540.21 	(xi) if the requested record is a death record, a trustee of a trust by sworn affidavit of 
540.22 	the fact that the certified copy is needed for the proper administration of the trust;
540.23 	(xii) a person or entity who demonstrates that a certified vital record is necessary for the 
540.24 	determination or protection of a personal or property right, pursuant to rules adopted by the 
540.25 	commissioner; or
540.26 	(xiii) an adoption agency in order to complete confidential postadoption searches as 
540.27 	required by section 259.83;
540.28 	(2) to any local, state, tribal, or federal governmental agency upon request if the certified 
540.29 	vital record is necessary for the governmental agency to perform its authorized duties;
540.30 	(3) to an attorney upon evidence of the attorney's license;
541.1 	(4) pursuant to a court order issued by a court of competent jurisdiction. For purposes 
541.2 	of this section, a subpoena does not constitute a court order; or
541.3 	(5) to a representative authorized by a person under clauses (1) to (4).
541.4 	(b) The state registrar or local issuance office shall also issue a certified death record to 
541.5 	an individual described in paragraph (a), clause (1), items (ii) to (viii), if, on behalf of the 
541.6 	individual, a licensed mortician furnishes the registrar with a properly completed attestation 
541.7 	in the form provided by the commissioner within 180 days of the time of death of the subject 
541.8 	of the death record. This paragraph is not subject to the requirements specified in Minnesota 
541.9 	Rules, part 4601.2600, subpart 5, item B.

541.10 	Sec. 21. Minnesota Statutes 2018, section 144.3831, subdivision 1, is amended to read:
541.11 		Subdivision 1.Fee setting. The commissioner of health may assess an annual fee of 
541.12 	$6.36 $9.72 for every service connection to a public water supply that is owned or operated 
541.13 	by a home rule charter city, a statutory city, a city of the first class, or a town. The 
541.14 	commissioner of health may also assess an annual fee for every service connection served 
541.15 	by a water user district defined in section 110A.02.

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

541.17 	Sec. 22. [144.397] STATEWIDE TOBACCO CESSATION SERVICES.
541.18 	(a) The commissioner of health shall administer, or contract for the administration of, 
541.19 	statewide tobacco cessation services to assist Minnesotans who are seeking advice or services 
541.20 	to help them quit using tobacco products. The commissioner shall establish statewide public 
541.21 	awareness activities to inform the public of the availability of the services and encourage 
541.22 	the public to utilize the services because of the dangers and harm of tobacco use and 
541.23 	dependence.
541.24 	(b) Services to be provided may include but are not limited to:
541.25 	(1) telephone-based coaching and counseling;
541.26 	(2) referrals;
541.27 	(3) written materials mailed upon request;
541.28 	(4) web-based texting or e-mail services; and
541.29 	(5) free Food and Drug Administration-approved tobacco cessation medications.
542.1 	(c) Services provided must be consistent with evidence-based best practices in tobacco 
542.2 	cessation services. Services provided must be coordinated with health plan company tobacco 
542.3 	prevention and cessation services that may be available to individuals depending on their 
542.4 	health coverage.

542.5 	Sec. 23. Minnesota Statutes 2018, section 144.412, is amended to read:
542.6 	144.412 PUBLIC POLICY.
542.7 	The purpose of sections 144.411 to 144.417 is to protect employees and the general 
542.8 	public from the hazards of secondhand smoke and involuntary exposure to aerosol or vapor 
542.9 	from electronic delivery devices by eliminating smoking in public places, places of 
542.10 	employment, public transportation, and at public meetings.

542.11 	Sec. 24. Minnesota Statutes 2018, section 144.413, subdivision 1, is amended to read:
542.12 		Subdivision 1.Scope. As used in sections 144.411 to 144.416 144.417, the terms defined 
542.13 	in this section have the meanings given them.

542.14 	Sec. 25. Minnesota Statutes 2018, section 144.413, subdivision 4, is amended to read:
542.15 		Subd. 4.Smoking. "Smoking" means inhaling or, exhaling smoke from, burning, or 
542.16 	carrying any lighted or heated cigar, cigarette, pipe, or any other lighted tobacco or plant
542.17 	or heated product containing, made, or derived from nicotine, tobacco, marijuana, or other 
542.18 	plant, whether natural or synthetic, that is intended for inhalation. Smoking also includes 
542.19 	carrying a lighted cigar, cigarette, pipe, or any other lighted tobacco or plant product intended 
542.20 	for inhalation carrying or using an activated electronic delivery device, as defined in section 
542.21 	609.685.

542.22 	Sec. 26. Minnesota Statutes 2018, section 144.414, subdivision 2, is amended to read:
542.23 		Subd. 2.Day care premises. (a) Smoking is prohibited in a day care center licensed 
542.24 	under Minnesota Rules, parts 9503.0005 to 9503.0170, or in a family home or in a group 
542.25 	family day care provider home licensed under Minnesota Rules, parts 9502.0300 to 
542.26 	9502.0445, during its hours of operation. The proprietor of a family home or group family 
542.27 	day care provider must disclose to parents or guardians of children cared for on the premises 
542.28 	if the proprietor permits smoking outside of its hours of operation. Disclosure must include 
542.29 	posting on the premises a conspicuous written notice and orally informing parents or 
542.30 	guardians.
543.1 	(b) For purposes of this subdivision, the definition of smoking includes the use of 
543.2 	electronic cigarettes, including the inhaling and exhaling of vapor from any electronic 
543.3 	delivery device as defined in section 609.685, subdivision 1.

543.4 	Sec. 27. Minnesota Statutes 2018, section 144.414, subdivision 3, is amended to read:
543.5 		Subd. 3.Health care facilities and clinics. (a) Smoking is prohibited in any area of a 
543.6 	hospital, health care clinic, doctor's office, licensed residential facility for children, or other 
543.7 	health care-related facility, except that a patient or resident in a nursing home, boarding 
543.8 	care facility, or licensed residential facility for adults may smoke in a designated separate, 
543.9 	enclosed room maintained in accordance with applicable state and federal laws.
543.10 	(b) Except as provided in section 246.0141, smoking by patients in a locked psychiatric 
543.11 	unit may be allowed in a separated well-ventilated area in the unit under a policy established 
543.12 	by the administrator of the program that allows the treating physician to approve smoking 
543.13 	if, in the opinion of the treating physician, the benefits to be gained in obtaining patient 
543.14 	cooperation with treatment outweigh the negative impacts of smoking.
543.15 	(c) For purposes of this subdivision, the definition of smoking includes the use of 
543.16 	electronic cigarettes, including the inhaling and exhaling of vapor from any electronic 
543.17 	delivery device as defined in section 609.685, subdivision 1.

543.18 	Sec. 28. Minnesota Statutes 2018, section 144.416, is amended to read:
543.19 	144.416 RESPONSIBILITIES OF PROPRIETORS.
543.20 	(a) The proprietor or other person, firm, limited liability company, corporation, or other 
543.21 	entity that owns, leases, manages, operates, or otherwise controls the use of a public place, 
543.22 	public transportation, place of employment, or public meeting shall make reasonable efforts 
543.23 	to prevent smoking in the public place, public transportation, place of employment, or public 
543.24 	meeting by:
543.25 	(1) posting appropriate signs or by any other means which may be appropriate; and
543.26 	(2) asking any person who smokes in an area where smoking is prohibited to refrain 
543.27 	from smoking and, if the person does not refrain from smoking after being asked to do so, 
543.28 	asking the person to leave. If the person refuses to leave, the proprietor, person, or entity 
543.29 	in charge shall handle the situation consistent with lawful methods for handling other persons 
543.30 	acting in a disorderly manner or as a trespasser.
543.31 	(b) The proprietor or other person or entity in charge of a public place, public meeting, 
543.32 	public transportation, or place of employment must not provide smoking equipment, including 
544.1 	ashtrays or matches, in areas where smoking is prohibited. Nothing in this section prohibits 
544.2 	the proprietor or other person or entity in charge from taking more stringent measures than 
544.3 	those under sections 144.414 to 144.417 to protect individuals from secondhand smoke or 
544.4 	from involuntary exposure to aerosol or vapor from electronic delivery devices. The 
544.5 	proprietor or other person or entity in charge of a restaurant or bar may not serve an individual 
544.6 	who is in violation of sections 144.411 to 144.417.

544.7 	Sec. 29. Minnesota Statutes 2018, section 144.4165, is amended to read:
544.8 	144.4165 TOBACCO PRODUCTS PROHIBITED IN PUBLIC SCHOOLS.
544.9 	No person shall at any time smoke, chew, or otherwise ingest tobacco or a tobacco 
544.10 	product, or inhale or exhale vapor from carry or use an activated electronic delivery device 
544.11 	as defined in section 609.685, subdivision 1, in a public school, as defined in section 120A.05, 
544.12 	subdivisions 9, 11, and 13, or in a charter school governed by chapter 124E, and no person 
544.13 	under the age of 18 shall possess any of these items. This prohibition extends to all facilities, 
544.14 	whether owned, rented, or leased, and all vehicles that a school district owns, leases, rents, 
544.15 	contracts for, or controls. Nothing in this section shall prohibit the lighting of tobacco by 
544.16 	an adult as a part of a traditional Indian spiritual or cultural ceremony. For purposes of this 
544.17 	section, an Indian is a person who is a member of an Indian tribe as defined in section 
544.18 	260.755 subdivision 12.

544.19 	Sec. 30. Minnesota Statutes 2018, section 144.4167, subdivision 4, is amended to read:
544.20 		Subd. 4.Tobacco products shop. Sections 144.414 to 144.417 do not prohibit the 
544.21 	lighting, heating, or activation of tobacco in a tobacco products shop by a customer or 
544.22 	potential customer for the specific purpose of sampling tobacco products. For the purposes 
544.23 	of this subdivision, a tobacco products shop is a retail establishment with that has an entrance 
544.24 	door opening directly to the outside and that derives more than 90 percent of its gross revenue 
544.25 	from the sale of loose tobacco, plants, or herbs and cigars, cigarettes, pipes, and other 
544.26 	smoking devices for burning tobacco and related smoking accessories tobacco-related 
544.27 	devices, and electronic delivery devices, as defined in section 609.685, and in which the 
544.28 	sale of other products is merely incidental. "Tobacco products shop" does not include a 
544.29 	tobacco department or section of any individual business establishment with any type of 
544.30 	liquor, food, or restaurant license.

545.1 	Sec. 31. Minnesota Statutes 2018, section 144.417, subdivision 4, is amended to read:
545.2 		Subd. 4.Local government ordinances. (a) Nothing in sections 144.414 to 144.417
545.3 	prohibits a statutory or home rule charter city or county from enacting and enforcing more 
545.4 	stringent measures to protect individuals from secondhand smoke or from involuntary 
545.5 	exposure to aerosol or vapor from electronic delivery devices.
545.6 	(b) Except as provided in sections 144.411 to 144.417, smoking is permitted outside of 
545.7 	restaurants, bars, and bingo halls unless limited or prohibited by restrictions adopted in 
545.8 	accordance with paragraph (a).

545.9 	Sec. 32. Minnesota Statutes 2018, section 144.552, is amended to read:
545.10 	144.552 PUBLIC INTEREST REVIEW.
545.11 	(a) The following entities must submit a plan to the commissioner:
545.12 	(1) a hospital seeking to increase its number of licensed beds; or
545.13 	(2) an organization seeking to obtain a hospital license and notified by the commissioner 
545.14 	under section 144.553, subdivision 1, paragraph (c), that it is subject to this section.
545.15 	The plan must include information that includes an explanation of how the expansion will 
545.16 	meet the public's interest. When submitting a plan to the commissioner, an applicant shall 
545.17 	pay the commissioner for the commissioner's cost of reviewing and monitoring the plan, 
545.18 	as determined by the commissioner and notwithstanding section 16A.1283. Money received 
545.19 	by the commissioner under this section is appropriated to the commissioner for the purpose 
545.20 	of administering this section. If the commissioner does not issue a finding within the time 
545.21 	limit specified in paragraph (c), the commissioner must return to the applicant the entire 
545.22 	amount the applicant paid to the commissioner.  For a hospital that is seeking an exception 
545.23 	to the moratorium under section 144.551, the plan must be submitted to the commissioner 
545.24 	no later than August 1 of the calendar year prior to the year when the exception will be 
545.25 	considered by the legislature.
545.26 	(b) Plans submitted under this section shall include detailed information necessary for 
545.27 	the commissioner to review the plan and reach a finding. The commissioner may request 
545.28 	additional information from the hospital submitting a plan under this section and from others 
545.29 	affected by the plan that the commissioner deems necessary to review the plan and make a 
545.30 	finding. If the commissioner determines that additional information is required from the 
545.31 	hospital submitting a plan under this section, the commissioner shall notify the hospital of 
545.32 	the additional information required no more than 30 days after the initial submission of the 
545.33 	plan. A hospital submitting a plan from whom the commissioner has requested additional 
546.1 	information shall submit the requested additional information within 14 calendar days of 
546.2 	the commissioner's request.
546.3 	(c) The commissioner shall review the plan and, within 90 150 calendar days, but no 
546.4 	more than six months if extenuating circumstances apply of the date when the commissioner 
546.5 	sends the applicant organization a notice of complete application letter, issue a finding on 
546.6 	whether the plan is in the public interest. The commissioner shall provide a copy of the 
546.7 	notice of complete application letter to the chairs and ranking minority members of the 
546.8 	house of representatives and senate committees with jurisdiction over health and human 
546.9 	services policy and finance. In making the recommendation, the commissioner shall consider 
546.10 	issues including but not limited to:
546.11 	(1) whether the new hospital or hospital beds are needed to provide timely access to care 
546.12 	or access to new or improved services given the number of available beds. For the purposes 
546.13 	of this clause, "available beds" means the number of licensed acute care beds that are 
546.14 	immediately available for use or could be brought online within 48 hours without significant 
546.15 	facility modifications;
546.16 	(2) the financial impact of the new hospital or hospital beds on existing acute-care 
546.17 	hospitals that have emergency departments in the region;
546.18 	(3) how the new hospital or hospital beds will affect the ability of existing hospitals in 
546.19 	the region to maintain existing staff;
546.20 	(4) the extent to which the new hospital or hospital beds will provide services to 
546.21 	nonpaying or low-income patients relative to the level of services provided to these groups 
546.22 	by existing hospitals in the region; and
546.23 	(5) the views of affected parties.
546.24 	(d) If the plan is being submitted by an existing hospital seeking authority to construct 
546.25 	a new hospital, the commissioner shall also consider:
546.26 	(1) the ability of the applicant to maintain the applicant's current level of community 
546.27 	benefit as defined in section 144.699, subdivision 5, at the existing facility; and
546.28 	(2) the impact on the workforce at the existing facility including the applicant's plan for:
546.29 	(i) transitioning current workers to the new facility;
546.30 	(ii) retraining and employment security for current workers; and
546.31 	(iii) addressing the impact of layoffs at the existing facility on affected workers.
547.1 	(e) If the commissioner receives multiple plan submissions under this section within the 
547.2 	same review period, the commissioner shall review the plans in the order they were received. 
547.3 	Time periods under this section shall begin for each review once the commissioner has sent 
547.4 	the applicant organization a notice of complete application letter. The commissioner shall 
547.5 	provide to the chairs and ranking minority members of the house of representatives and 
547.6 	senate committees having jurisdiction over health and human services policy and finance 
547.7 	updates every 30 days on the progress of the review of any plan submitted under this section.
547.8 	(e) (f) Prior to making a recommendation, the commissioner shall conduct a public 
547.9 	hearing in the affected hospital service area to take testimony from interested persons.
547.10 	(f) (g) Upon making a recommendation under paragraph (c), the commissioner shall 
547.11 	provide a copy of the recommendation to the chairs of the house of representatives and 
547.12 	senate committees having jurisdiction over health and human services policy and finance.
547.13 	(g) (h) If an exception to the moratorium is approved under section 144.551 after a 
547.14 	review under this section, the commissioner shall monitor the implementation of the 
547.15 	exception up to completion of the construction project. Thirty days after completion of the 
547.16 	construction project, the hospital shall submit to the commissioner a report on how the 
547.17 	construction has met the provisions of the plan originally submitted under the public interest 
547.18 	review process or a plan submitted pursuant to section 144.551, subdivision 1, paragraph 
547.19 	(b), clause (20).

547.20 	Sec. 33. Minnesota Statutes 2018, section 144.562, subdivision 2, is amended to read:
547.21 		Subd. 2.Eligibility for license condition. (a) A hospital is not eligible to receive a 
547.22 	license condition for swing beds unless (1) it either has a licensed bed capacity of less than 
547.23 	50 beds defined in the federal Medicare regulations, Code of Federal Regulations, title 42, 
547.24 	section 482.66, or it has a licensed bed capacity of 50 beds or more and has swing beds that 
547.25 	were approved for Medicare reimbursement before May 1, 1985, or it has a licensed bed 
547.26 	capacity of less than 65 beds and the available nursing homes within 50 miles have had, in 
547.27 	the aggregate, an average occupancy rate of 96 percent or higher in the most recent two 
547.28 	years as documented on the statistical reports to the Department of Health; and (2) it is 
547.29 	located in a rural area as defined in the federal Medicare regulations, Code of Federal 
547.30 	Regulations, title 42, section 482.66.
547.31 	(b) Except for those critical access hospitals established under section 144.1483, clause 
547.32 	(9), and section 1820 of the federal Social Security Act, United States Code, title 42, section 
547.33 	1395i-4, that have an attached nursing home or that owned a nursing home located in the 
547.34 	same municipality as of May 1, 2005, eligible hospitals are allowed a total number of 2,000
548.1 	days of swing bed use per year as provided in paragraph (c). Critical access hospitals that 
548.2 	have an attached nursing home or that owned a nursing home located in the same municipality 
548.3 	as of May 1, 2005, are allowed swing bed use as provided in federal law.
548.4 	(c) An eligible hospital is allowed a total of 3,000 days of swing bed use in calendar 
548.5 	year 2020. Beginning in calendar year 2021, and for each subsequent calendar year until 
548.6 	calendar year 2027, the total number of days of swing bed use per year is increased by 200 
548.7 	swing bed use days. Beginning in calendar year 2028, an eligible hospital is allowed a total 
548.8 	of 4,500 days of swing bed use per year.
548.9 	(d) Days of swing bed use for medical care that an eligible hospital has determined are 
548.10 	charity care shall not count toward the applicable limit in paragraph (b) or (c). For purposes 
548.11 	of this paragraph, "charity care" means care that an eligible hospital provided for free or at 
548.12 	a discount to persons who cannot afford to pay and for which the eligible hospital did not 
548.13 	expect payment.
548.14 	(e) Days of swing bed use for care of a person who has been denied admission to every 
548.15 	Medicare-certified skilled nursing facility within 25 miles of the eligible hospital shall not 
548.16 	count toward the applicable limit in paragraphs (b) and (c). Eligible hospitals must maintain 
548.17 	documentation that they have contacted each skilled nursing facility within 25 miles to 
548.18 	determine if any skilled nursing facility beds are available and if the skilled nursing facilities 
548.19 	are willing to admit the patient. Skilled nursing facilities that are contacted must admit the 
548.20 	patient or deny admission within 24 hours of being contacted by the eligible hospital. Failure 
548.21 	to respond within 24 hours is deemed a denial of admission.
548.22 	(c)(f) Except for critical access hospitals that have an attached nursing home or that 
548.23 	owned a nursing home located in the same municipality as of May 1, 2005, the commissioner 
548.24 	of health may approve swing bed use beyond 2,000 days as long as there are no Medicare 
548.25 	certified skilled nursing facility beds available within 25 miles of that hospital that are 
548.26 	willing to admit the patient and the patient agrees to the referral being sent to the skilled 
548.27 	nursing facility. Critical access hospitals exceeding 2,000 swing bed days must maintain 
548.28 	documentation that they have contacted skilled nursing facilities within 25 miles to determine 
548.29 	if any skilled nursing facility beds are available that are willing to admit the patient and the 
548.30 	patient agrees to the referral being sent to the skilled nursing facility. This paragraph expires 
548.31 	January 1, 2020.
548.32 	(d)(g) After reaching 2,000 days of swing bed use in a year, an eligible hospital to which 
548.33 	this limit applies may admit six additional patients to swing beds each year without seeking 
548.34 	approval from the commissioner or being in violation of this subdivision. These six swing 
549.1 	bed admissions are exempt from the limit of 2,000 annual swing bed days for hospitals 
549.2 	subject to this limit. This paragraph expires January 1, 2020.
549.3 	(e)(h) A health care system that is in full compliance with this subdivision may allocate 
549.4 	its total limit of swing bed days among the hospitals within the system, provided that no 
549.5 	hospital in the system without an attached nursing home may exceed 2,000 swing bed days 
549.6 	per year. This paragraph expires January 1, 2020.

549.7 	EFFECTIVE DATE. This section is effective January 1, 2020, except that new 
549.8 	paragraphs (d) and (e) are  effective the day following final enactment.

549.9 	Sec. 34. Minnesota Statutes 2018, section 144.586, is amended by adding a subdivision 
549.10 	to read:
549.11 		Subd. 3.Care coordination implementation. (a) This subdivision applies to hospital 
549.12 	discharges involving a child with a high-cost medical or chronic condition who needs 
549.13 	post-hospital continuing aftercare, including but not limited to home health care services, 
549.14 	post-hospital extended care services, or outpatient services for follow-up or ancillary care, 
549.15 	or is at risk of recurrent hospitalization or emergency room services due to a medical or 
549.16 	chronic condition.
549.17 	(b) In addition to complying with the discharge planning requirements in subdivision 
549.18 	2, the hospital must ensure that the following conditions are met and arrangements made 
549.19 	before discharging any patient described in paragraph (a):
549.20 	(1) the patient's primary care provider and either the health carrier or, if the patient is 
549.21 	enrolled in medical assistance, the managed care organization  are notified of the patient's 
549.22 	date of anticipated discharge and provided a description of the patient's aftercare needs and 
549.23 	a copy of the patient's discharge plan, including any necessary medical information release 
549.24 	forms;
549.25 	(2) the appropriate arrangements for home health care or post-hospital extended care 
549.26 	services are made and the initial services as indicated on the discharge plan are scheduled; 
549.27 	and
549.28 	(3) if the patient is eligible for care coordination services through a health plan or health 
549.29 	certified medical home, the appropriate care coordinator has connected with the patient's 
549.30 	family.

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

550.1 	Sec. 35. [144.591] DISCLOSURE OF HOSPITAL CHARGES.
550.2 	(a) Each hospital, including hospitals designated as critical access hospitals, shall provide 
550.3 	to each discharged patient within 30 calendar days of discharge an itemized description of 
550.4 	billed charges for medical services and goods the patient received during the hospital stay. 
550.5 	The itemized description of billed charges may include technical terms to describe the 
550.6 	medical services and goods if the technical terms are defined on the itemized description  
550.7 	with limited medical nomenclature. The itemized description of billed charges must not 
550.8 	describe a billed charge using only a medical billing code, "miscellaneous charges," or 
550.9 	"supply charges."
550.10 	(b) A hospital may not bill or otherwise charge a patient for the itemized description of 
550.11 	billed charges.
550.12 	(c) A hospital must provide an itemized description by secure e-mail, via a secure online 
550.13 	portal, or, upon request, by mail.
550.14 	(d) This section does not apply to patients enrolled in Medicare, medical assistance, the 
550.15 	MinnesotaCare program, or who receive health care coverage through an employer 
550.16 	self-insured health plan.

550.17 	EFFECTIVE DATE. This section is effective August 1, 2020.

550.18 	Sec. 36. Minnesota Statutes 2018, section 144.966, subdivision 2, is amended to read:
550.19 		Subd. 2.Newborn Hearing Screening Advisory Committee. (a) The commissioner 
550.20 	of health shall establish a Newborn Hearing Screening Advisory Committee to advise and 
550.21 	assist the Department of Health and the Department of Education in:
550.22 	(1) developing protocols and timelines for screening, rescreening, and diagnostic 
550.23 	audiological assessment and early medical, audiological, and educational intervention 
550.24 	services for children who are deaf or hard-of-hearing;
550.25 	(2) designing protocols for tracking children from birth through age three that may have 
550.26 	passed newborn screening but are at risk for delayed or late onset of permanent hearing 
550.27 	loss;
550.28 	(3) designing a technical assistance program to support facilities implementing the 
550.29 	screening program and facilities conducting rescreening and diagnostic audiological 
550.30 	assessment;
550.31 	(4) designing implementation and evaluation of a system of follow-up and tracking; and
551.1 	(5) evaluating program outcomes to increase effectiveness and efficiency and ensure 
551.2 	culturally appropriate services for children with a confirmed hearing loss and their families.
551.3 	(b) The commissioner of health shall appoint at least one member from each of the 
551.4 	following groups with no less than two of the members being deaf or hard-of-hearing:
551.5 	(1) a representative from a consumer organization representing culturally deaf persons;
551.6 	(2) a parent with a child with hearing loss representing a parent organization;
551.7 	(3) a consumer from an organization representing oral communication options;
551.8 	(4) a consumer from an organization representing cued speech communication options;
551.9 	(5) an audiologist who has experience in evaluation and intervention of infants and 
551.10 	young children;
551.11 	(6) a speech-language pathologist who has experience in evaluation and intervention of 
551.12 	infants and young children;
551.13 	(7) two primary care providers who have experience in the care of infants and young 
551.14 	children, one of which shall be a pediatrician;
551.15 	(8) a representative from the early hearing detection intervention teams;
551.16 	(9) a representative from the Department of Education resource center for the deaf and 
551.17 	hard-of-hearing or the representative's designee;
551.18 	(10) a representative of the Commission of the Deaf, DeafBlind and Hard of Hearing;
551.19 	(11) a representative from the Department of Human Services Deaf and Hard-of-Hearing 
551.20 	Services Division;
551.21 	(12) one or more of the Part C coordinators from the Department of Education, the 
551.22 	Department of Health, or the Department of Human Services or the department's designees;
551.23 	(13) the Department of Health early hearing detection and intervention coordinators;
551.24 	(14) two birth hospital representatives from one rural and one urban hospital;
551.25 	(15) a pediatric geneticist;
551.26 	(16) an otolaryngologist;
551.27 	(17) a representative from the Newborn Screening Advisory Committee under this 
551.28 	subdivision; and
551.29 	(18) a representative of the Department of Education regional low-incidence facilitators.;
552.1 	(19) a representative from the deaf mentor program; and
552.2 	(20) a representative of the Minnesota State Academy for the Deaf from the Minnesota 
552.3 	State Academies staff.
552.4 	The commissioner must complete the initial appointments required under this subdivision 
552.5 	by September 1, 2007, and the initial appointments under clauses (19) and (20) by September 
552.6 	1, 2019.
552.7 	(c) The Department of Health member shall chair the first meeting of the committee. At 
552.8 	the first meeting, the committee shall elect a chair from its membership. The committee 
552.9 	shall meet at the call of the chair, at least four times a year. The committee shall adopt 
552.10 	written bylaws to govern its activities. The Department of Health shall provide technical 
552.11 	and administrative support services as required by the committee. These services shall 
552.12 	include technical support from individuals qualified to administer infant hearing screening, 
552.13 	rescreening, and diagnostic audiological assessments.
552.14 	Members of the committee shall receive no compensation for their service, but shall be 
552.15 	reimbursed as provided in section 15.059 for expenses incurred as a result of their duties 
552.16 	as members of the committee.
552.17 	(d) By February 15, 2015, and by February 15 of the odd-numbered years after that date, 
552.18 	the commissioner shall report to the chairs and ranking minority members of the legislative 
552.19 	committees with jurisdiction over health and data privacy on the activities of the committee 
552.20 	that have occurred during the past two years.
552.21 	(e) This subdivision expires June 30, 2019 2025.

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

552.23 	Sec. 37. Minnesota Statutes 2018, section 144.99, subdivision 1, is amended to read:
552.24 		Subdivision 1.Remedies available. The provisions of chapters 103I and 157 and sections 
552.25 	115.71 to 115.77; 144.12, subdivision 1, paragraphs (1), (2), (5), (6), (10), (12), (13), (14), 
552.26 	and (15); 144.1201 to 144.1204; 144.121; 144.1215; 144.1222; 144.35; 144.381 to 144.385; 
552.27 	144.411 to 144.417; 144.495; 144.71 to 144.74; 144.9501 to 144.9512; 144.97 to 144.98; 
552.28 	144.992; 152.22 to 152.37; 326.70 to 326.785; 327.10 to 327.131; and 327.14 to 327.28
552.29 	and all rules, orders, stipulation agreements, settlements, compliance agreements, licenses, 
552.30 	registrations, certificates, and permits adopted or issued by the department or under any 
552.31 	other law now in force or later enacted for the preservation of public health may, in addition 
552.32 	to provisions in other statutes, be enforced under this section.

553.1 	Sec. 38. Minnesota Statutes 2018, section 144A.43, subdivision 11, is amended to read:
553.2 		Subd. 11.Medication administration. "Medication administration" means performing 
553.3 	a set of tasks to ensure a client takes medications, and includes that include the following:
553.4 	(1) checking the client's medication record;
553.5 	(2) preparing the medication as necessary;
553.6 	(3) administering the medication to the client;
553.7 	(4) documenting the administration or reason for not administering the medication; and
553.8 	(5) reporting to a registered nurse or appropriate licensed health professional any concerns 
553.9 	about the medication, the client, or the client's refusal to take the medication.

553.10 	Sec. 39. Minnesota Statutes 2018, section 144A.43, is amended by adding a subdivision 
553.11 	to read:
553.12 		Subd. 12a.Medication reconciliation. "Medication reconciliation" means the process 
553.13 	of identifying the most accurate list of all medications the client is taking, including the 
553.14 	name, dosage, frequency, and route by comparing the client record to an external list of 
553.15 	medications obtained from the client, hospital, prescriber, or other provider.

553.16 	Sec. 40. Minnesota Statutes 2018, section 144A.43, subdivision 30, is amended to read:
553.17 		Subd. 30.Standby assistance. "Standby assistance" means the presence of another 
553.18 	person within arm's reach to minimize the risk of injury while performing daily activities 
553.19 	through physical intervention or cuing to assist a client with an assistive task by providing 
553.20 	cues, oversight, and minimal physical assistance.

553.21 	Sec. 41. Minnesota Statutes 2018, section 144A.472, subdivision 5, is amended to read:
553.22 		Subd. 5.Transfers prohibited; Changes in ownership. Any(a) A home care license 
553.23 	issued by the commissioner may not be transferred to another party. Before acquiring 
553.24 	ownership of or a controlling interest in a home care provider business, a prospective 
553.25 	applicant owner must apply for a new temporary license. A change of ownership is a transfer 
553.26 	of operational control to a different business entityof the home care provider business and 
553.27 	includes:
553.28 	(1) transfer of the business to a different or new corporation;
553.29 	(2) in the case of a partnership, the dissolution or termination of the partnership under 
553.30 	chapter 323A, with the business continuing by a successor partnership or other entity;
554.1 	(3) relinquishment of control of the provider to another party, including to a contract 
554.2 	management firm that is not under the control of the owner of the business' assets;
554.3 	(4) transfer of the business by a sole proprietor to another party or entity; or
554.4 	(5) in the case of a privately held corporation, the change in transfer of ownership or 
554.5 	control of 50 percent or more of the outstanding voting stock controlling interest of a home 
554.6 	care provider business not covered by clauses (1) to (4).
554.7 	(b) An employee who was employed by the previous owner of the home care provider 
554.8 	business prior to the effective date of a change in ownership under paragraph (a), and who 
554.9 	will be employed by the new owner in the same or a similar capacity, shall be treated as if 
554.10 	no change in employer occurred, with respect to orientation, training, tuberculosis testing, 
554.11 	background studies, and competency testing and training on the policies identified in 
554.12 	subdivision 1, clause (14), and subdivision 2, if applicable.
554.13 	(c) Notwithstanding paragraph (b), a new owner of a home care provider business must 
554.14 	ensure that employees of the provider receive and complete training and testing on any 
554.15 	provisions of policies that differ from those of the previous owner within 90 days after the 
554.16 	date of the change in ownership.

554.17 	Sec. 42. Minnesota Statutes 2018, section 144A.472, subdivision 7, is amended to read:
554.18 		Subd. 7.Fees; application, change of ownership, and renewal, and failure to 
554.19 	notify. (a) An initial applicant seeking temporary home care licensure must submit the 
554.20 	following application fee to the commissioner along with a completed application:
554.21 	(1) for a basic home care provider, $2,100; or
554.22 	(2) for a comprehensive home care provider, $4,200.
554.23 	(b) A home care provider who is filing a change of ownership as required under 
554.24 	subdivision 5 must submit the following application fee to the commissioner, along with 
554.25 	the documentation required for the change of ownership:
554.26 	(1) for a basic home care provider, $2,100; or
554.27 	(2) for a comprehensive home care provider, $4,200.
554.28 	(c) For the period ending June 30, 2018, a home care provider who is seeking to renew 
554.29 	the provider's license shall pay a fee to the commissioner based on revenues derived from 
554.30 	the provision of home care services during the calendar year prior to the year in which the 
554.31 	application is submitted, according to the following schedule:
555.1 	License Renewal Fee

555.2	Provider Annual Revenue
	Fee
		
555.3	greater than $1,500,000
	$6,625
		
555.4
555.5	greater than $1,275,000 and no more than 
$1,500,000
	$5,797
		
555.6
555.7	greater than $1,100,000 and no more than 
$1,275,000
	$4,969
		
555.8
555.9	greater than $950,000 and no more than 
$1,100,000
	$4,141
		
555.10	greater than $850,000 and no more than $950,000
	$3,727
		
555.11	greater than $750,000 and no more than $850,000
	$3,313
		
555.12	greater than $650,000 and no more than $750,000
	$2,898
		
555.13	greater than $550,000 and no more than $650,000
	$2,485
		
555.14	greater than $450,000 and no more than $550,000
	$2,070
		
555.15	greater than $350,000 and no more than $450,000
	$1,656
		
555.16	greater than $250,000 and no more than $350,000
	$1,242
		
555.17	greater than $100,000 and no more than $250,000
	$828
		
555.18	greater than $50,000 and no more than $100,000
	$500
		
555.19	greater than $25,000 and no more than $50,000
	$400
		
555.20	no more than $25,000
	$200
		
555.21 	(d) For the period between July 1, 2018, and June 30, 2020, a home care provider who 
555.22 	is seeking to renew the provider's license shall pay a fee to the commissioner in an amount 
555.23 	that is ten percent higher than the applicable fee in paragraph (c). A home care provider's 
555.24 	fee shall be based on revenues derived from the provision of home care services during the 
555.25 	calendar year prior to the year in which the application is submitted.
555.26 	(e) Beginning July 1, 2020, a home care provider who is seeking to renew the provider's 
555.27 	license shall pay a fee to the commissioner based on revenues derived from the provision 
555.28 	of home care services during the calendar year prior to the year in which the application is 
555.29 	submitted, according to the following schedule:
555.30 	License Renewal Fee

555.31	Provider Annual Revenue
	Fee
		
555.32	greater than $1,500,000
	$7,651
		
555.33
555.34	greater than $1,275,000 and no more than 
$1,500,000
	$6,695
		
555.35
555.36	greater than $1,100,000 and no more than 
$1,275,000
	$5,739
		
555.37
555.38	greater than $950,000 and no more than 
$1,100,000
	$4,783
		
556.1	greater than $850,000 and no more than $950,000
	$4,304
		
556.2	greater than $750,000 and no more than $850,000
	$3,826
		
556.3	greater than $650,000 and no more than $750,000
	$3,347
		
556.4	greater than $550,000 and no more than $650,000
	$2,870
		
556.5	greater than $450,000 and no more than $550,000
	$2,391
		
556.6	greater than $350,000 and no more than $450,000
	$1,913
		
556.7	greater than $250,000 and no more than $350,000
	$1,434
		
556.8	greater than $100,000 and no more than $250,000
	$957
		
556.9	greater than $50,000 and no more than $100,000
	$577
		
556.10	greater than $25,000 and no more than $50,000
	$462
		
556.11	no more than $25,000
	$231
		
556.12 	(f) If requested, the home care provider shall provide the commissioner information to 
556.13 	verify the provider's annual revenues or other information as needed, including copies of 
556.14 	documents submitted to the Department of Revenue.
556.15 	(g) At each annual renewal, a home care provider may elect to pay the highest renewal 
556.16 	fee for its license category, and not provide annual revenue information to the commissioner.
556.17 	(h) A temporary license or license applicant, or temporary licensee or licensee that 
556.18 	knowingly provides the commissioner incorrect revenue amounts for the purpose of paying 
556.19 	a lower license fee, shall be subject to a civil penalty in the amount of double the fee the 
556.20 	provider should have paid.
556.21 	(i) The fine for failure to comply with the notification requirements of section 144A.473, 
556.22 	subdivision 2, paragraph (c), is $1,000.
556.23 	(j) Fees and penalties collected under this section shall be deposited in the state treasury 
556.24 	and credited to the state government special revenue fund. All fees are nonrefundable. Fees 
556.25 	collected under paragraphs (c), (d), and (e) are nonrefundable even if received before July 
556.26 	1, 2017, for temporary licenses or licenses being issued effective July 1, 2017, or later.

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

556.28 	Sec. 43. Minnesota Statutes 2018, section 144A.473, is amended to read:
556.29 	144A.473 ISSUANCE OF TEMPORARY LICENSE AND LICENSE RENEWAL.
556.30 		Subdivision 1.Temporary license and renewal of license. (a) The department shall 
556.31 	review each application to determine the applicant's knowledge of and compliance with 
556.32 	Minnesota home care regulations. Before granting a temporary license or renewing a license, 
556.33 	the commissioner may further evaluate the applicant or licensee by requesting additional 
557.1 	information or documentation or by conducting an on-site survey of the applicant to 
557.2 	determine compliance with sections 144A.43 to 144A.482.
557.3 	(b) Within 14 calendar days after receiving an application for a license, the commissioner 
557.4 	shall acknowledge receipt of the application in writing. The acknowledgment must indicate 
557.5 	whether the application appears to be complete or whether additional information is required 
557.6 	before the application will be considered complete.
557.7 	(c) Within 90 days after receiving a complete application, the commissioner shall issue 
557.8 	a temporary license, renew the license, or deny the license.
557.9 	(d) The commissioner shall issue a license that contains the home care provider's name, 
557.10 	address, license level, expiration date of the license, and unique license number. All licenses, 
557.11 	except for temporary licenses issued under subdivision 2, are valid for up to one year from 
557.12 	the date of issuance.
557.13 		Subd. 2.Temporary license. (a) For new license applicants, the commissioner shall 
557.14 	issue a temporary license for either the basic or comprehensive home care level. A temporary 
557.15 	license is effective for up to one year from the date of issuance, except that a temporary 
557.16 	license may be extended according to subdivision 3. Temporary licensees must comply with 
557.17 	sections 144A.43 to 144A.482.
557.18 	(b) During the temporary license year period, the commissioner shall survey the temporary 
557.19 	licensee within 90 calendar days after the commissioner is notified or has evidence that the 
557.20 	temporary licensee is providing home care services.
557.21 	(c) Within five days of beginning the provision of services, the temporary licensee must 
557.22 	notify the commissioner that it is serving clients. The notification to the commissioner may 
557.23 	be mailed or e-mailed to the commissioner at the address provided by the commissioner. If 
557.24 	the temporary licensee does not provide home care services during the temporary license 
557.25 	year period, then the temporary license expires at the end of the year period and the applicant 
557.26 	must reapply for a temporary home care license.
557.27 	(d) A temporary licensee may request a change in the level of licensure prior to being 
557.28 	surveyed and granted a license by notifying the commissioner in writing and providing 
557.29 	additional documentation or materials required to update or complete the changed temporary 
557.30 	license application. The applicant must pay the difference between the application fees 
557.31 	when changing from the basic level to the comprehensive level of licensure. No refund will 
557.32 	be made if the provider chooses to change the license application to the basic level.
558.1 	(e) If the temporary licensee notifies the commissioner that the licensee has clients within 
558.2 	45 days prior to the temporary license expiration, the commissioner may extend the temporary 
558.3 	license for up to 60 days in order to allow the commissioner to complete the on-site survey 
558.4 	required under this section and follow-up survey visits.
558.5 		Subd. 3.Temporary licensee survey. (a) If the temporary licensee is in substantial 
558.6 	compliance with the survey, the commissioner shall issue either a basic or comprehensive 
558.7 	home care license. If the temporary licensee is not in substantial compliance with the survey, 
558.8 	the commissioner shall either: (1) not issue a basic or comprehensive license and there will 
558.9 	be no contested hearing right under chapter 14. terminate the temporary license; or (2) 
558.10 	extend the temporary license for a period not to exceed 90 days and apply conditions, as 
558.11 	permitted under section 144A.475, subdivision 2, to the extension of a temporary license. 
558.12 	If the temporary licensee is not in substantial compliance with the survey within the time 
558.13 	period of the extension, or if the temporary licensee does not satisfy the license conditions, 
558.14 	the commissioner may deny the license.
558.15 	(b) If the temporary licensee whose basic or comprehensive license has been denied or 
558.16 	extended with conditions disagrees with the conclusions of the commissioner, then the 
558.17 	temporary licensee may request a reconsideration by the commissioner or commissioner's 
558.18 	designee. The reconsideration request process must be conducted internally by the 
558.19 	commissioner or commissioner's designee, and chapter 14 does not apply.
558.20 	(c) The temporary licensee requesting reconsideration must make the request in writing 
558.21 	and must list and describe the reasons why the temporary licensee disagrees with the decision 
558.22 	to deny the basic or comprehensive home care license or the decision to extend the temporary 
558.23 	license with conditions.
558.24 	(d) The reconsideration request and supporting documentation must be received by the 
558.25 	commissioner within 15 calendar days after the date the temporary licensee receives the 
558.26 	correction order.
558.27 	(e) A temporary licensee whose license is denied, is permitted to continue operating as 
558.28 	a home care provider during the period of time when:
558.29 	(1) a reconsideration request is in process;
558.30 	(2) an extension of a temporary license is being negotiated;
558.31 	(3) the placement of conditions on a temporary license is being negotiated; or
558.32 	(4) a transfer of home care clients from the temporary licensee to a new home care 
558.33 	provider is in process.
559.1 	(f) A temporary licensee whose license is denied must comply with the requirements 
559.2 	for notification and transfer of clients in section 144A.475, subdivision 5.

559.3 	Sec. 44. Minnesota Statutes 2018, section 144A.474, subdivision 2, is amended to read:
559.4 		Subd. 2.Types of home care surveys. (a) "Initial full survey" means the survey of a 
559.5 	new temporary licensee conducted after the department is notified or has evidence that the 
559.6 	temporary licensee is providing home care services to determine if the provider is in 
559.7 	compliance with home care requirements. Initial full surveys must be completed within 14 
559.8 	months after the department's issuance of a temporary basic or comprehensive license.
559.9 	(b) "Change in ownership survey" means a full survey of a new licensee due to a change 
559.10 	in ownership. Change in ownership surveys must be completed within six months after the 
559.11 	department's issuance of a new license due to a change in ownership.
559.12 	(c) "Core survey" means periodic inspection of home care providers to determine ongoing 
559.13 	compliance with the home care requirements, focusing on the essential health and safety 
559.14 	requirements. Core surveys are available to licensed home care providers who have been 
559.15 	licensed for three years and surveyed at least once in the past three years with the latest 
559.16 	survey having no widespread violations beyond Level 1 as provided in subdivision 11. 
559.17 	Providers must also not have had any substantiated licensing complaints, substantiated 
559.18 	complaints against the agency under the Vulnerable Adults Act or Maltreatment of Minors 
559.19 	Act, or an enforcement action as authorized in section 144A.475 in the past three years.
559.20 	(1) The core survey for basic home care providers must review compliance in the 
559.21 	following areas:
559.22 	(i) reporting of maltreatment;
559.23 	(ii) orientation to and implementation of the home care bill of rights;
559.24 	(iii) statement of home care services;
559.25 	(iv) initial evaluation of clients and initiation of services;
559.26 	(v) client review and monitoring;
559.27 	(vi) service plan implementation and changes to the service plan;
559.28 	(vii) client complaint and investigative process;
559.29 	(viii) competency of unlicensed personnel; and
559.30 	(ix) infection control.
560.1 	(2) For comprehensive home care providers, the core survey must include everything 
560.2 	in the basic core survey plus these areas:
560.3 	(i) delegation to unlicensed personnel;
560.4 	(ii) assessment, monitoring, and reassessment of clients; and
560.5 	(iii) medication, treatment, and therapy management.
560.6 	(c) (d) "Full survey" means the periodic inspection of home care providers to determine 
560.7 	ongoing compliance with the home care requirements that cover the core survey areas and 
560.8 	all the legal requirements for home care providers. A full survey is conducted for all 
560.9 	temporary licensees and, for licensees that receive licenses due to an approved change in 
560.10 	ownership, for providers who do not meet the requirements needed for a core survey, and 
560.11 	when a surveyor identifies unacceptable client health or safety risks during a core survey. 
560.12 	A full survey must include all the tasks identified as part of the core survey and any additional 
560.13 	review deemed necessary by the department, including additional observation, interviewing, 
560.14 	or records review of additional clients and staff.
560.15 	(d) (e) "Follow-up surveys" means surveys conducted to determine if a home care 
560.16 	provider has corrected deficient issues and systems identified during a core survey, full 
560.17 	survey, or complaint investigation. Follow-up surveys may be conducted via phone, e-mail, 
560.18 	fax, mail, or on-site reviews. Follow-up surveys, other than complaint surveys, shall be 
560.19 	concluded with an exit conference and written information provided on the process for 
560.20 	requesting a reconsideration of the survey results.
560.21 	(e) (f) Upon receiving information alleging that a home care provider has violated or is 
560.22 	currently violating a requirement of sections 144A.43 to 144A.482, the commissioner shall 
560.23 	investigate the complaint according to sections 144A.51 to 144A.54.

560.24 	Sec. 45. Minnesota Statutes 2018, section 144A.475, subdivision 1, is amended to read:
560.25 		Subdivision 1.Conditions. (a) The commissioner may refuse to grant a temporary 
560.26 	license, refuse to grant a license as a result of a change in ownership, refuse to renew a 
560.27 	license, suspend or revoke a license, or impose a conditional license if the home care provider 
560.28 	or owner or managerial official of the home care provider:
560.29 	(1) is in violation of, or during the term of the license has violated, any of the requirements 
560.30 	in sections 144A.471 to 144A.482;
560.31 	(2) permits, aids, or abets the commission of any illegal act in the provision of home 
560.32 	care;
561.1 	(3) performs any act detrimental to the health, safety, and welfare of a client;
561.2 	(4) obtains the license by fraud or misrepresentation;
561.3 	(5) knowingly made or makes a false statement of a material fact in the application for 
561.4 	a license or in any other record or report required by this chapter;
561.5 	(6) denies representatives of the department access to any part of the home care provider's 
561.6 	books, records, files, or employees;
561.7 	(7) interferes with or impedes a representative of the department in contacting the home 
561.8 	care provider's clients;
561.9 	(8) interferes with or impedes a representative of the department in the enforcement of 
561.10 	this chapter or has failed to fully cooperate with an inspection, survey, or investigation by 
561.11 	the department;
561.12 	(9) destroys or makes unavailable any records or other evidence relating to the home 
561.13 	care provider's compliance with this chapter;
561.14 	(10) refuses to initiate a background study under section 144.057 or 245A.04;
561.15 	(11) fails to timely pay any fines assessed by the department;
561.16 	(12) violates any local, city, or township ordinance relating to home care services;
561.17 	(13) has repeated incidents of personnel performing services beyond their competency 
561.18 	level; or
561.19 	(14) has operated beyond the scope of the home care provider's license level.
561.20 	(b) A violation by a contractor providing the home care services of the home care provider 
561.21 	is a violation by the home care provider.

561.22 	Sec. 46. Minnesota Statutes 2018, section 144A.475, subdivision 2, is amended to read:
561.23 		Subd. 2.Terms to suspension or conditional license. (a) A suspension or conditional 
561.24 	license designation may include terms that must be completed or met before a suspension 
561.25 	or conditional license designation is lifted. A conditional license designation may include 
561.26 	restrictions or conditions that are imposed on the provider. Terms for a suspension or 
561.27 	conditional license may include one or more of the following and the scope of each will be 
561.28 	determined by the commissioner:
561.29 	(1) requiring a consultant to review, evaluate, and make recommended changes to the 
561.30 	home care provider's practices and submit reports to the commissioner at the cost of the 
561.31 	home care provider;
562.1 	(2) requiring supervision of the home care provider or staff practices at the cost of the 
562.2 	home care provider by an unrelated person who has sufficient knowledge and qualifications 
562.3 	to oversee the practices and who will submit reports to the commissioner;
562.4 	(3) requiring the home care provider or employees to obtain training at the cost of the 
562.5 	home care provider;
562.6 	(4) requiring the home care provider to submit reports to the commissioner;
562.7 	(5) prohibiting the home care provider from taking any new clients for a period of time; 
562.8 	or
562.9 	(6) any other action reasonably required to accomplish the purpose of this subdivision 
562.10 	and section 144A.45, subdivision 2.
562.11 	(b) A home care provider subject to this subdivision may continue operating during the 
562.12 	period of time home care clients are being transferred to other providers.

562.13 	Sec. 47. Minnesota Statutes 2018, section 144A.475, subdivision 5, is amended to read:
562.14 		Subd. 5.Plan required. (a) The process of suspending or revoking a license must include 
562.15 	a plan for transferring affected clients to other providers by the home care provider, which 
562.16 	will be monitored by the commissioner. Within three business days of being notified of the 
562.17 	final revocation or suspension action, the home care provider shall provide the commissioner, 
562.18 	the lead agencies as defined in section 256B.0911, and the ombudsman for long-term care 
562.19 	with the following information:
562.20 	(1) a list of all clients, including full names and all contact information on file;
562.21 	(2) a list of each client's representative or emergency contact person, including full names 
562.22 	and all contact information on file;
562.23 	(3) the location or current residence of each client;
562.24 	(4) the payor sources for each client, including payor source identification numbers; and
562.25 	(5) for each client, a copy of the client's service plan, and a list of the types of services 
562.26 	being provided.
562.27 	(b) The revocation or suspension notification requirement is satisfied by mailing the 
562.28 	notice to the address in the license record. The home care provider shall cooperate with the 
562.29 	commissioner and the lead agencies during the process of transferring care of clients to 
562.30 	qualified providers. Within three business days of being notified of the final revocation or 
562.31 	suspension action, the home care provider must notify and disclose to each of the home 
563.1 	care provider's clients, or the client's representative or emergency contact persons, that the 
563.2 	commissioner is taking action against the home care provider's license by providing a copy 
563.3 	of the revocation or suspension notice issued by the commissioner.
563.4 	(c) A home care provider subject to this subdivision may continue operating during the 
563.5 	period of time home care clients are being transferred to other providers.

563.6 	Sec. 48. Minnesota Statutes 2018, section 144A.476, subdivision 1, is amended to read:
563.7 		Subdivision 1.Prior criminal convictions; owner and managerial officials. (a) Before 
563.8 	the commissioner issues a temporary license, issues a license as a result of an approved 
563.9 	change in ownership, or renews a license, an owner or managerial official is required to 
563.10 	complete a background study under section 144.057. No person may be involved in the 
563.11 	management, operation, or control of a home care provider if the person has been disqualified 
563.12 	under chapter 245C. If an individual is disqualified under section 144.057 or chapter 245C, 
563.13 	the individual may request reconsideration of the disqualification. If the individual requests 
563.14 	reconsideration and the commissioner sets aside or rescinds the disqualification, the individual 
563.15 	is eligible to be involved in the management, operation, or control of the provider. If an 
563.16 	individual has a disqualification under section 245C.15, subdivision 1, and the disqualification 
563.17 	is affirmed, the individual's disqualification is barred from a set aside, and the individual 
563.18 	must not be involved in the management, operation, or control of the provider.
563.19 	(b) For purposes of this section, owners of a home care provider subject to the background 
563.20 	check requirement are those individuals whose ownership interest provides sufficient 
563.21 	authority or control to affect or change decisions related to the operation of the home care 
563.22 	provider. An owner includes a sole proprietor, a general partner, or any other individual 
563.23 	whose individual ownership interest can affect the management and direction of the policies 
563.24 	of the home care provider.
563.25 	(c) For the purposes of this section, managerial officials subject to the background check 
563.26 	requirement are individuals who provide direct contact as defined in section 245C.02, 
563.27 	subdivision 11, or individuals who have the responsibility for the ongoing management or 
563.28 	direction of the policies, services, or employees of the home care provider. Data collected 
563.29 	under this subdivision shall be classified as private data on individuals under section 13.02, 
563.30 	subdivision 12.
563.31 	(d) The department shall not issue any license if the applicant or owner or managerial 
563.32 	official has been unsuccessful in having a background study disqualification set aside under 
563.33 	section 144.057 and chapter 245C; if the owner or managerial official, as an owner or 
563.34 	managerial official of another home care provider, was substantially responsible for the 
564.1 	other home care provider's failure to substantially comply with sections 144A.43 to 
564.2 	144A.482; or if an owner that has ceased doing business, either individually or as an owner 
564.3 	of a home care provider, was issued a correction order for failing to assist clients in violation 
564.4 	of this chapter.

564.5 	Sec. 49. Minnesota Statutes 2018, section 144A.479, subdivision 7, is amended to read:
564.6 		Subd. 7.Employee records. The home care provider must maintain current records of 
564.7 	each paid employee, regularly scheduled volunteers providing home care services, and of 
564.8 	each individual contractor providing home care services. The records must include the 
564.9 	following information:
564.10 	(1) evidence of current professional licensure, registration, or certification, if licensure, 
564.11 	registration, or certification is required by this statute or other rules;
564.12 	(2) records of orientation, required annual training and infection control training, and 
564.13 	competency evaluations;
564.14 	(3) current job description, including qualifications, responsibilities, and identification 
564.15 	of staff providing supervision;
564.16 	(4) documentation of annual performance reviews which identify areas of improvement 
564.17 	needed and training needs;
564.18 	(5) for individuals providing home care services, verification that required any health 
564.19 	screenings required by infection control programs established under section 144A.4798
564.20 	have taken place and the dates of those screenings; and
564.21 	(6) documentation of the background study as required under section 144.057.
564.22 	Each employee record must be retained for at least three years after a paid employee, home 
564.23 	care volunteer, or contractor ceases to be employed by or under contract with the home care 
564.24 	provider. If a home care provider ceases operation, employee records must be maintained 
564.25 	for three years.

564.26 	Sec. 50. Minnesota Statutes 2018, section 144A.479, is amended by adding a subdivision 
564.27 	to read:
564.28 		Subd. 8.Labor market reporting. A home care provider shall comply with the labor 
564.29 	market reporting requirements described in section 256B.4912, subdivision 1a.

565.1 	Sec. 51. Minnesota Statutes 2018, section 144A.4791, subdivision 1, is amended to read:
565.2 		Subdivision 1.Home care bill of rights; notification to client. (a) The home care 
565.3 	provider shall provide the client or the client's representative a written notice of the rights 
565.4 	under section 144A.44 before the initiation of date that services are first provided to that 
565.5 	client. The provider shall make all reasonable efforts to provide notice of the rights to the 
565.6 	client or the client's representative in a language the client or client's representative can 
565.7 	understand.
565.8 	(b) In addition to the text of the home care bill of rights in section 144A.44, subdivision 
565.9 	1, the notice shall also contain the following statement describing how to file a complaint 
565.10 	with these offices.
565.11 	"If you have a complaint about the provider or the person providing your home care 
565.12 	services, you may call, write, or visit the Office of Health Facility Complaints, Minnesota 
565.13 	Department of Health. You may also contact the Office of Ombudsman for Long-Term 
565.14 	Care or the Office of Ombudsman for Mental Health and Developmental Disabilities."
565.15 	The statement should include the telephone number, website address, e-mail address, 
565.16 	mailing address, and street address of the Office of Health Facility Complaints at the 
565.17 	Minnesota Department of Health, the Office of the Ombudsman for Long-Term Care, and 
565.18 	the Office of the Ombudsman for Mental Health and Developmental Disabilities. The 
565.19 	statement should also include the home care provider's name, address, e-mail, telephone 
565.20 	number, and name or title of the person at the provider to whom problems or complaints 
565.21 	may be directed. It must also include a statement that the home care provider will not retaliate 
565.22 	because of a complaint.
565.23 	(c) The home care provider shall obtain written acknowledgment of the client's receipt 
565.24 	of the home care bill of rights or shall document why an acknowledgment cannot be obtained. 
565.25 	The acknowledgment may be obtained from the client or the client's representative. 
565.26 	Acknowledgment of receipt shall be retained in the client's record.

565.27 	Sec. 52. Minnesota Statutes 2018, section 144A.4791, subdivision 3, is amended to read:
565.28 		Subd. 3.Statement of home care services. Prior to the initiation of date that services
565.29 	are first provided to the client, a home care provider must provide to the client or the client's 
565.30 	representative a written statement which identifies if the provider has a basic or 
565.31 	comprehensive home care license, the services the provider is authorized to provide, and 
565.32 	which services the provider cannot provide under the scope of the provider's license. The 
565.33 	home care provider shall obtain written acknowledgment from the clients that the provider 
566.1 	has provided the statement or must document why the provider could not obtain the 
566.2 	acknowledgment.

566.3 	Sec. 53. Minnesota Statutes 2018, section 144A.4791, subdivision 6, is amended to read:
566.4 		Subd. 6.Initiation of services. When a provider initiates provides home care services 
566.5 	and to a client before the individualized review or assessment by a licensed health 
566.6 	professional or registered nurse as required in subdivisions 7 and 8 has not been is completed, 
566.7 	the provider licensed health professional or registered nurse must complete a temporary 
566.8 	plan and agreement with the client for services and orient staff assigned to deliver services 
566.9 	as identified in the temporary plan.

566.10 	Sec. 54. Minnesota Statutes 2018, section 144A.4791, subdivision 7, is amended to read:
566.11 		Subd. 7.Basic individualized client review and monitoring. (a) When services being 
566.12 	provided are basic home care services, an individualized initial review of the client's needs 
566.13 	and preferences must be conducted at the client's residence with the client or client's 
566.14 	representative. This initial review must be completed within 30 days after the initiation of 
566.15 	the date that home care services are first provided.
566.16 	(b) Client monitoring and review must be conducted as needed based on changes in the 
566.17 	needs of the client and cannot exceed 90 days from the date of the last review. The monitoring 
566.18 	and review may be conducted at the client's residence or through the utilization of 
566.19 	telecommunication methods based on practice standards that meet the individual client's 
566.20 	needs.

566.21 	Sec. 55. Minnesota Statutes 2018, section 144A.4791, subdivision 8, is amended to read:
566.22 		Subd. 8.Comprehensive assessment, monitoring, and reassessment. (a) When the 
566.23 	services being provided are comprehensive home care services, an individualized initial 
566.24 	assessment must be conducted in person by a registered nurse. When the services are provided 
566.25 	by other licensed health professionals, the assessment must be conducted by the appropriate 
566.26 	health professional. This initial assessment must be completed within five days after initiation 
566.27 	of the date that home care services are first provided.
566.28 	(b) Client monitoring and reassessment must be conducted in the client's home no more 
566.29 	than 14 days after initiation of the date that home care services are first provided.
566.30 	(c) Ongoing client monitoring and reassessment must be conducted as needed based on 
566.31 	changes in the needs of the client and cannot exceed 90 days from the last date of the 
566.32 	assessment. The monitoring and reassessment may be conducted at the client's residence 
567.1 	or through the utilization of telecommunication methods based on practice standards that 
567.2 	meet the individual client's needs.

567.3 	Sec. 56. Minnesota Statutes 2018, section 144A.4791, subdivision 9, is amended to read:
567.4 		Subd. 9.Service plan, implementation, and revisions to service plan. (a) No later 
567.5 	than 14 days after the initiation of date that home care services are first provided, a home 
567.6 	care provider shall finalize a current written service plan.
567.7 	(b) The service plan and any revisions must include a signature or other authentication 
567.8 	by the home care provider and by the client or the client's representative documenting 
567.9 	agreement on the services to be provided. The service plan must be revised, if needed, based 
567.10 	on client review or reassessment under subdivisions 7 and 8. The provider must provide 
567.11 	information to the client about changes to the provider's fee for services and how to contact 
567.12 	the Office of the Ombudsman for Long-Term Care.
567.13 	(c) The home care provider must implement and provide all services required by the 
567.14 	current service plan.
567.15 	(d) The service plan and revised service plan must be entered into the client's record, 
567.16 	including notice of a change in a client's fees when applicable.
567.17 	(e) Staff providing home care services must be informed of the current written service 
567.18 	plan.
567.19 	(f) The service plan must include:
567.20 	(1) a description of the home care services to be provided, the fees for services, and the 
567.21 	frequency of each service, according to the client's current review or assessment and client 
567.22 	preferences;
567.23 	(2) the identification of the staff or categories of staff who will provide the services;
567.24 	(3) the schedule and methods of monitoring reviews or assessments of the client;
567.25 	(4) the frequency of sessions of supervision of staff and type of personnel who will 
567.26 	supervise staff; and the schedule and methods of monitoring staff providing home care 
567.27 	services; and
567.28 	(5) a contingency plan that includes:
567.29 	(i) the action to be taken by the home care provider and by the client or client's 
567.30 	representative if the scheduled service cannot be provided;
568.1 	(ii) information and a method for a client or client's representative to contact the home 
568.2 	care provider;
568.3 	(iii) names and contact information of persons the client wishes to have notified in an 
568.4 	emergency or if there is a significant adverse change in the client's condition, including 
568.5 	identification of and information as to who has authority to sign for the client in an 
568.6 	emergency; and
568.7 	(iv) the circumstances in which emergency medical services are not to be summoned 
568.8 	consistent with chapters 145B and 145C, and declarations made by the client under those 
568.9 	chapters.

568.10 	Sec. 57. Minnesota Statutes 2018, section 144A.4792, subdivision 1, is amended to read:
568.11 		Subdivision 1.Medication management services; comprehensive home care 
568.12 	license. (a) This subdivision applies only to home care providers with a comprehensive 
568.13 	home care license that provide medication management services to clients. Medication 
568.14 	management services may not be provided by a home care provider who has a basic home 
568.15 	care license.
568.16 	(b) A comprehensive home care provider who provides medication management services 
568.17 	must develop, implement, and maintain current written medication management policies 
568.18 	and procedures. The policies and procedures must be developed under the supervision and 
568.19 	direction of a registered nurse, licensed health professional, or pharmacist consistent with 
568.20 	current practice standards and guidelines.
568.21 	(c) The written policies and procedures must address requesting and receiving 
568.22 	prescriptions for medications; preparing and giving medications; verifying that prescription 
568.23 	drugs are administered as prescribed; documenting medication management activities; 
568.24 	controlling and storing medications; monitoring and evaluating medication use; resolving 
568.25 	medication errors; communicating with the prescriber, pharmacist, and client and client 
568.26 	representative, if any; disposing of unused medications; and educating clients and client 
568.27 	representatives about medications. When controlled substances are being managed, stored, 
568.28 	and secured by the comprehensive home care provider, the policies and procedures must 
568.29 	also identify how the provider will ensure security and accountability for the overall 
568.30 	management, control, and disposition of those substances in compliance with state and 
568.31 	federal regulations and with subdivision 22.

569.1 	Sec. 58. Minnesota Statutes 2018, section 144A.4792, subdivision 2, is amended to read:
569.2 		Subd. 2.Provision of medication management services. (a) For each client who 
569.3 	requests medication management services, the comprehensive home care provider shall, 
569.4 	prior to providing medication management services, have a registered nurse, licensed health 
569.5 	professional, or authorized prescriber under section 151.37 conduct an assessment to 
569.6 	determine what medication management services will be provided and how the services 
569.7 	will be provided. This assessment must be conducted face-to-face with the client. The 
569.8 	assessment must include an identification and review of all medications the client is known 
569.9 	to be taking. The review and identification must include indications for medications, side 
569.10 	effects, contraindications, allergic or adverse reactions, and actions to address these issues.
569.11 	(b) The assessment must:
569.12 	(1) identify interventions needed in management of medications to prevent diversion of 
569.13 	medication by the client or others who may have access to the medications.; and
569.14 	(2) provide instructions to the client or client's representative on interventions to manage 
569.15 	the client's medications and prevent diversion of medications.
569.16 	"Diversion of medications" means the misuse, theft, or illegal or improper disposition of 
569.17 	medications.

569.18 	Sec. 59. Minnesota Statutes 2018, section 144A.4792, subdivision 5, is amended to read:
569.19 		Subd. 5.Individualized medication management plan. (a) For each client receiving 
569.20 	medication management services, the comprehensive home care provider must prepare and 
569.21 	include in the service plan a written statement of the medication management services that 
569.22 	will be provided to the client. The provider must develop and maintain a current 
569.23 	individualized medication management record for each client based on the client's assessment 
569.24 	that must contain the following:
569.25 	(1) a statement describing the medication management services that will be provided;
569.26 	(2) a description of storage of medications based on the client's needs and preferences, 
569.27 	risk of diversion, and consistent with the manufacturer's directions;
569.28 	(3) documentation of specific client instructions relating to the administration of 
569.29 	medications;
569.30 	(4) identification of persons responsible for monitoring medication supplies and ensuring 
569.31 	that medication refills are ordered on a timely basis;
570.1 	(5) identification of medication management tasks that may be delegated to unlicensed 
570.2 	personnel;
570.3 	(6) procedures for staff notifying a registered nurse or appropriate licensed health 
570.4 	professional when a problem arises with medication management services; and
570.5 	(7) any client-specific requirements relating to documenting medication administration, 
570.6 	verifications that all medications are administered as prescribed, and monitoring of 
570.7 	medication use to prevent possible complications or adverse reactions.
570.8 	(b) The medication management record must be current and updated when there are any 
570.9 	changes.
570.10 	(c) Medication reconciliation must be completed when a licensed nurse, licensed health 
570.11 	professional, or authorized prescriber is providing medication management.

570.12 	Sec. 60. Minnesota Statutes 2018, section 144A.4792, subdivision 10, is amended to read:
570.13 		Subd. 10.Medication management for clients who will be away from home. (a) A 
570.14 	home care provider who is providing medication management services to the client and 
570.15 	controls the client's access to the medications must develop and implement policies and 
570.16 	procedures for giving accurate and current medications to clients for planned or unplanned 
570.17 	times away from home according to the client's individualized medication management 
570.18 	plan. The policy and procedures must state that:
570.19 	(1) for planned time away, the medications must be obtained from the pharmacy or set 
570.20 	up by the registered a licensed nurse according to appropriate state and federal laws and 
570.21 	nursing standards of practice;
570.22 	(2) for unplanned time away, when the pharmacy is not able to provide the medications, 
570.23 	a licensed nurse or unlicensed personnel shall give the client or client's representative 
570.24 	medications in amounts and dosages needed for the length of the anticipated absence, not 
570.25 	to exceed 120 hours seven calendar days;
570.26 	(3) the client or client's representative must be provided written information on 
570.27 	medications, including any special instructions for administering or handling the medications, 
570.28 	including controlled substances;
570.29 	(4) the medications must be placed in a medication container or containers appropriate 
570.30 	to the provider's medication system and must be labeled with the client's name and the dates 
570.31 	and times that the medications are scheduled; and
571.1 	(5) the client or client's representative must be provided in writing the home care 
571.2 	provider's name and information on how to contact the home care provider.
571.3 	(b) For unplanned time away when the licensed nurse is not available, the registered 
571.4 	nurse may delegate this task to unlicensed personnel if:
571.5 	(1) the registered nurse has trained the unlicensed staff and determined the unlicensed 
571.6 	staff is competent to follow the procedures for giving medications to clients; and
571.7 	(2) the registered nurse has developed written procedures for the unlicensed personnel, 
571.8 	including any special instructions or procedures regarding controlled substances that are 
571.9 	prescribed for the client. The procedures must address:
571.10 	(i) the type of container or containers to be used for the medications appropriate to the 
571.11 	provider's medication system;
571.12 	(ii) how the container or containers must be labeled;
571.13 	(iii) the written information about the medications to be given to the client or client's 
571.14 	representative;
571.15 	(iv) how the unlicensed staff must document in the client's record that medications have 
571.16 	been given to the client or the client's representative, including documenting the date the 
571.17 	medications were given to the client or the client's representative and who received the 
571.18 	medications, the person who gave the medications to the client, the number of medications 
571.19 	that were given to the client, and other required information;
571.20 	(v) how the registered nurse shall be notified that medications have been given to the 
571.21 	client or client's representative and whether the registered nurse needs to be contacted before 
571.22 	the medications are given to the client or the client's representative; and
571.23 	(vi) a review by the registered nurse of the completion of this task to verify that this task 
571.24 	was completed accurately by the unlicensed personnel.; and
571.25 	(vii) how the unlicensed staff must document in the client's record any unused medications 
571.26 	that are returned to the provider, including the name of each medication and the doses of 
571.27 	each returned medication.

571.28 	Sec. 61. Minnesota Statutes 2018, section 144A.4793, subdivision 6, is amended to read:
571.29 		Subd. 6.Treatment and therapy orders or prescriptions. There must be an up-to-date 
571.30 	written or electronically recorded order or prescription from an authorized prescriber for 
571.31 	all treatments and therapies. The order must contain the name of the client, a description of 
571.32 	the treatment or therapy to be provided, and the frequency, duration, and other information 
572.1 	needed to administer the treatment or therapy. Treatment and therapy orders must be renewed 
572.2 	at least every 12 months.

572.3 	Sec. 62. Minnesota Statutes 2018, section 144A.4796, subdivision 2, is amended to read:
572.4 		Subd. 2.Content. (a) The orientation must contain the following topics:
572.5 	(1) an overview of sections 144A.43 to 144A.4798;
572.6 	(2) introduction and review of all the provider's policies and procedures related to the 
572.7 	provision of home care services by the individual staff person;
572.8 	(3) handling of emergencies and use of emergency services;
572.9 	(4) compliance with and reporting of the maltreatment of minors or vulnerable adults 
572.10 	under sections 626.556 and 626.557;
572.11 	(5) home care bill of rights under section 144A.44;
572.12 	(6) handling of clients' complaints, reporting of complaints, and where to report 
572.13 	complaints including information on the Office of Health Facility Complaints and the 
572.14 	Common Entry Point;
572.15 	(7) consumer advocacy services of the Office of Ombudsman for Long-Term Care, 
572.16 	Office of Ombudsman for Mental Health and Developmental Disabilities, Managed Care 
572.17 	Ombudsman at the Department of Human Services, county managed care advocates, or 
572.18 	other relevant advocacy services; and
572.19 	(8) review of the types of home care services the employee will be providing and the 
572.20 	provider's scope of licensure.
572.21 	(b) In addition to the topics listed in paragraph (a), orientation may also contain training 
572.22 	on providing services to clients with hearing loss. Any training on hearing loss provided 
572.23 	under this subdivision must be high quality and research-based, may include online training, 
572.24 	and must include training on one or more of the following topics:
572.25 	(1) an explanation of age-related hearing loss and how it manifests itself, its prevalence, 
572.26 	and challenges it poses to communication;
572.27 	(2) health impacts related to untreated age-related hearing loss, such as increased 
572.28 	incidence of dementia, falls, hospitalizations, isolation, and depression; or
572.29 	(3) information about strategies and technology that may enhance communication and 
572.30 	involvement, including communication strategies, assistive listening devices, hearing aids, 
572.31 	visual and tactile alerting devices, communication access in real time, and closed captions.

573.1 	Sec. 63. Minnesota Statutes 2018, section 144A.4797, subdivision 3, is amended to read:
573.2 		Subd. 3.Supervision of staff providing delegated nursing or therapy home care 
573.3 	tasks. (a) Staff who perform delegated nursing or therapy home care tasks must be supervised 
573.4 	by an appropriate licensed health professional or a registered nurse periodically where the 
573.5 	services are being provided to verify that the work is being performed competently and to 
573.6 	identify problems and solutions related to the staff person's ability to perform the tasks. 
573.7 	Supervision of staff performing medication or treatment administration shall be provided 
573.8 	by a registered nurse or appropriate licensed health professional and must include observation 
573.9 	of the staff administering the medication or treatment and the interaction with the client.
573.10 	(b) The direct supervision of staff performing delegated tasks must be provided within 
573.11 	30 days after the date on which the individual begins working for the home care provider
573.12 	and first performs delegated tasks for clients and thereafter as needed based on performance. 
573.13 	This requirement also applies to staff who have not performed delegated tasks for one year 
573.14 	or longer.

573.15 	Sec. 64. Minnesota Statutes 2018, section 144A.4798, is amended to read:
573.16 	144A.4798 EMPLOYEE HEALTH STATUS DISEASE PREVENTION AND 
573.17 	INFECTION CONTROL.
573.18 		Subdivision 1.Tuberculosis (TB) prevention and infection control. (a) A home care 
573.19 	provider must establish and maintain a TB prevention andcomprehensive tuberculosis 
573.20 	infection control program based on according to the most current tuberculosis infection 
573.21 	control guidelines issued by the United States Centers for Disease Control and Prevention 
573.22 	(CDC), Division of Tuberculosis Elimination, as published in the CDC's Morbidity and 
573.23 	Mortality Weekly Report. Components of a TB prevention and control program include 
573.24 	screening all staff providing home care services, both paid and unpaid, at the time of hire 
573.25 	for active TB disease and latent TB infection, and developing and implementing a written 
573.26 	TB infection control plan. The commissioner shall make the most recent CDC standards 
573.27 	available to home care providers on the department's website. This program must include 
573.28 	a tuberculosis infection control plan that covers all paid and unpaid employees, contractors, 
573.29 	students, and volunteers. The commissioner shall provide technical assistance regarding 
573.30 	implementation of the guidelines.
573.31 	(b) The home care provider must maintain written evidence of compliance with this 
573.32 	subdivision.
574.1 		Subd. 2.Communicable diseases. A home care provider must follow current federal 
574.2 	or state guidelines state requirements for prevention, control, and reporting of human 
574.3 	immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus, or other
574.4 	communicable diseases as defined in Minnesota Rules, part parts4605.7040, 4605.7044, 
574.5 	4605.7050, 4605.7075, 4605.7080, and 4605.7090.
574.6 		Subd. 3.Infection control program. A home care provider must establish and maintain 
574.7 	an effective infection control program that complies with accepted health care, medical, 
574.8 	and nursing standards for infection control.

574.9 	Sec. 65. Minnesota Statutes 2018, section 144A.4799, subdivision 1, is amended to read:
574.10 		Subdivision 1.Membership. The commissioner of health shall appoint eight persons 
574.11 	to a home care and assisted living program advisory council consisting of the following:
574.12 	(1) three public members as defined in section 214.02 who shall be either persons who 
574.13 	are currently receiving home care services or, persons who have received home care services 
574.14 	within five years of the application date, persons who have family members receiving home 
574.15 	care services, or persons who have family members who have received home care services 
574.16 	within five years of the application date;
574.17 	(2) three Minnesota home care licensees representing basic and comprehensive levels 
574.18 	of licensure who may be a managerial official, an administrator, a supervising registered 
574.19 	nurse, or an unlicensed personnel performing home care tasks;
574.20 	(3) one member representing the Minnesota Board of Nursing; and
574.21 	(4) one member representing the Office of Ombudsman for Long-Term Care.

574.22 	Sec. 66. Minnesota Statutes 2018, section 144A.4799, subdivision 3, is amended to read:
574.23 		Subd. 3.Duties. (a) At the commissioner's request, the advisory council shall provide 
574.24 	advice regarding regulations of Department of Health licensed home care providers in this 
574.25 	chapter, including advice on the following:
574.26 	(1) community standards for home care practices;
574.27 	(2) enforcement of licensing standards and whether certain disciplinary actions are 
574.28 	appropriate;
574.29 	(3) ways of distributing information to licensees and consumers of home care;
574.30 	(4) training standards;
575.1 	(5) identifying emerging issues and opportunities in the home care field, including and 
575.2 	assisted living;
575.3 	(6) identifying the use of technology in home and telehealth capabilities;
575.4 	(6) (7) allowable home care licensing modifications and exemptions, including a method 
575.5 	for an integrated license with an existing license for rural licensed nursing homes to provide 
575.6 	limited home care services in an adjacent independent living apartment building owned by 
575.7 	the licensed nursing home; and
575.8 	(7) (8) recommendations for studies using the data in section 62U.04, subdivision 4, 
575.9 	including but not limited to studies concerning costs related to dementia and chronic disease 
575.10 	among an elderly population over 60 and additional long-term care costs, as described in 
575.11 	section 62U.10, subdivision 6.
575.12 	(b) The advisory council shall perform other duties as directed by the commissioner.
575.13 	(c) The advisory council shall annually review the balance of the account in the state 
575.14 	government special revenue fund described in section 144A.474, subdivision 11, paragraph 
575.15 	(i), and make annual recommendations by January 15 directly to the chairs and ranking 
575.16 	minority members of the legislative committees with jurisdiction over health and human 
575.17 	services regarding appropriations to the commissioner for the purposes in section 144A.474, 
575.18 	subdivision 11, paragraph (i).

575.19 	Sec. 67. Minnesota Statutes 2018, section 144A.484, subdivision 1, is amended to read:
575.20 		Subdivision 1.Integrated licensing established. (a) From January 1, 2014, to June 30, 
575.21 	2015, the commissioner of health shall enforce the home and community-based services 
575.22 	standards under chapter 245D for those providers who also have a home care license pursuant 
575.23 	to this chapter as required under Laws 2013, chapter 108, article 8, section 60, and article 
575.24 	11, section 31. During this period, the commissioner shall provide technical assistance to 
575.25 	achieve and maintain compliance with applicable law or rules governing the provision of 
575.26 	home and community-based services, including complying with the service recipient rights 
575.27 	notice in subdivision 4, clause (4). If during the survey, the commissioner finds that the 
575.28 	licensee has failed to achieve compliance with an applicable law or rule under chapter 245D 
575.29 	and this failure does not imminently endanger the health, safety, or rights of the persons 
575.30 	served by the program, the commissioner may issue a licensing survey report with 
575.31 	recommendations for achieving and maintaining compliance.
575.32 	(b) Beginning July 1, 2015, A home care provider applicant or license holder may apply 
575.33 	to the commissioner of health for a home and community-based services designation for 
576.1 	the provision of basic support services identified under section 245D.03, subdivision 1, 
576.2 	paragraph (b). The designation allows the license holder to provide basic support services 
576.3 	that would otherwise require licensure under chapter 245D, under the license holder's home 
576.4 	care license governed by sections 144A.43 to 144A.481 144A.4799.

576.5 	Sec. 68. Minnesota Statutes 2018, section 145.908, subdivision 1, is amended to read:
576.6 		Subdivision 1.Grant program established. Within the limits of federal funds available 
576.7 	specificallyappropriations for this purpose, the commissioner of health shall establish a 
576.8 	grant program to provide culturally competent programs to screen and treat pregnant women 
576.9 	and women who have given birth in the preceding 12 months for pre- and postpartum mood 
576.10 	and anxiety disorders. Organizations may use grant funds to establish new screening or 
576.11 	treatment programs, or expand or maintain existing screening or treatment programs. In 
576.12 	establishing the grant program, the commissioner shall prioritize expanding or enhancing 
576.13 	screening for pre- and postpartum mood and anxiety disorders in primary care settings. The 
576.14 	commissioner shall determine the types of organizations eligible for grants.

576.15 	Sec. 69. Minnesota Statutes 2018, section 145.928, subdivision 1, is amended to read:
576.16 		Subdivision 1.Goal; establishment. It is the goal of the state, by 2010, to decrease by 
576.17 	50 percent the disparities in infant mortality rates and adult and child immunization rates 
576.18 	for American Indians and populations of color, as compared with rates for whites. To do 
576.19 	so and to achieve other measurable outcomes, the commissioner of health shall establish a 
576.20 	program to close the gap in the health status of American Indians and populations of color 
576.21 	as compared with whites in the following priority areas: infant mortality, access to and 
576.22 	utilization of high-quality prenatal care, breast and cervical cancer screening, HIV/AIDS 
576.23 	and sexually transmitted infections, adult and child immunizations, cardiovascular disease, 
576.24 	diabetes, and accidental injuries and violence.

576.25 	Sec. 70. Minnesota Statutes 2018, section 145.928, subdivision 7, is amended to read:
576.26 		Subd. 7.Community grant program; immunization rates, prenatal care access and 
576.27 	utilization, and infant mortality rates. (a) The commissioner shall award grants to eligible 
576.28 	applicants for local or regional projects and initiatives directed at reducing health disparities 
576.29 	in one or both more of the following priority areas:
576.30 	(1) decreasing racial and ethnic disparities in infant mortality rates; or
576.31 	(2) decreasing racial and ethnic disparities in access to and utilization of high-quality 
576.32 	prenatal care; or
577.1 	(2) (3) increasing adult and child immunization rates in nonwhite racial and ethnic 
577.2 	populations.
577.3 	(b) The commissioner may award up to 20 percent of the funds available as planning 
577.4 	grants. Planning grants must be used to address such areas as community assessment, 
577.5 	coordination activities, and development of community supported strategies.
577.6 	(c) Eligible applicants may include, but are not limited to, faith-based organizations, 
577.7 	social service organizations, community nonprofit organizations, community health boards, 
577.8 	tribal governments, and community clinics. Applicants must submit proposals to the 
577.9 	commissioner. A proposal must specify the strategies to be implemented to address one or 
577.10 	both more of the priority areas listed in paragraph (a) and must be targeted to achieve the 
577.11 	outcomes established according to subdivision 3.
577.12 	(d) The commissioner shall give priority to applicants who demonstrate that their 
577.13 	proposed project or initiative:
577.14 	(1) is supported by the community the applicant will serve;
577.15 	(2) is research-based or based on promising strategies;
577.16 	(3) is designed to complement other related community activities;
577.17 	(4) utilizes strategies that positively impact both two or more priority areas;
577.18 	(5) reflects racially and ethnically appropriate approaches; and
577.19 	(6) will be implemented through or with community-based organizations that reflect the 
577.20 	race or ethnicity of the population to be reached.

577.21 	Sec. 71. Minnesota Statutes 2018, section 145.986, subdivision 1, is amended to read:
577.22 		Subdivision 1.Purpose. The purpose of the statewide health improvement program is 
577.23 	to:
577.24 	(1) address the top three leading preventable causes of illness and death: tobacco use 
577.25 	and exposure, poor diet, and lack of regular physical activity such as tobacco use or exposure, 
577.26 	poor diet, and lack of regular physical activity, and other issues as determined by the 
577.27 	commissioner through the statewide health assessment;
577.28 	(2) promote the development, availability, and use of evidence-based, community level, 
577.29 	comprehensive strategies to create healthy communities; and
577.30 	(3) measure the impact of the evidence-based, community health improvement practices 
577.31 	which over time work to contain health care costs and reduce chronic diseases.

578.1 	Sec. 72. Minnesota Statutes 2018, section 145.986, subdivision 1a, is amended to read:
578.2 		Subd. 1a.Grants to local communities. (a) Beginning July 1, 2009, The commissioner 
578.3 	of health shall award competitive grants to community health boards and tribal governments 
578.4 	to convene, coordinate, and implement evidence-based proven-effective strategies targeted 
578.5 	at reducing the percentage of Minnesotans who are obese or overweight and to reduce the 
578.6 	use of tobacco, promising practice strategies, or theory-based strategies that can be evaluated 
578.7 	using experimental or quasi-experimental design. Grants shall be awarded to all community 
578.8 	health boards and tribal governments whose proposals demonstrate the ability to implement 
578.9 	programs designed to achieve the purposes in subdivision 1 and other requirements of this 
578.10 	section. In each grant cycle, the commissioner may award up to 100 percent of tribal grants 
578.11 	and up to 25 percent of the grants awarded to community health boards to theory-based 
578.12 	strategies that are culturally or ethnically focused.
578.13 	(b) Grantee activities shall:
578.14 	(1) be based on scientific evidence;
578.15 	(2) be based on community input;
578.16 	(3) address behavior change at the individual, community, and systems levels;
578.17 	(4) occur in community, school, work site, and health care settings;
578.18 	(5) be focused on policy, systems, and environmental changes that support healthy 
578.19 	behaviors; and
578.20 	(6) address the health disparities and inequities that exist in the grantee's community.
578.21 	(c) To receive a grant under this section, community health boards and tribal governments 
578.22 	must submit proposals to the commissioner. A local match of ten percent of the total funding 
578.23 	allocation is required. This local match may include funds donated by community partners.
578.24 	(d) In order to receive a grant, community health boards and tribal governments must 
578.25 	submit a health improvement plan to the commissioner of health for approval. The 
578.26 	commissioner may require the plan to identify a community leadership team, community 
578.27 	partners, and a community action plan that includes an assessment of area strengths and 
578.28 	needs, proposed action strategies, technical assistance needs, and a staffing plan.
578.29 	(e) The grant recipient must implement the health improvement plan, evaluate the 
578.30 	effectiveness of the strategies, and modify or discontinue strategies found to be ineffective.
579.1 	(f) Grant recipients shall report their activities and their progress toward the outcomes 
579.2 	established under subdivision 2 to the commissioner in a format and at a time specified by 
579.3 	the commissioner.
579.4 	(g) All grant recipients shall be held accountable for making progress toward the 
579.5 	measurable outcomes established in subdivision 2. The commissioner shall require a 
579.6 	corrective action plan and may reduce the funding level of grant recipients that do not make 
579.7 	adequate progress toward the measurable outcomes.
579.8 	(h) Beginning November 1, 2015, the commissioner shall offer grant recipients the 
579.9 	option of using a grant awarded under this subdivision to implement health improvement 
579.10 	strategies that improve the health status, delay the expression of dementia, or slow the 
579.11 	progression of dementia, for a targeted population at risk for dementia and shall award at 
579.12 	least two of the grants awarded on November 1, 2015, for these purposes. The grants must 
579.13 	meet all other requirements of this section. The commissioner shall coordinate grant planning 
579.14 	activities with the commissioner of human services, the Minnesota Board on Aging, and 
579.15 	community-based organizations with a focus on dementia. Each grant must include selected 
579.16 	outcomes and evaluation measures related to the incidence or progression of dementia 
579.17 	among the targeted population using the procedure described in subdivision 2. For purposes 
579.18 	of this subdivision, "proven-effective" means a strategy or practice that offers a high level 
579.19 	of research on effectiveness for at least one outcome of interest; "promising practice" means 
579.20 	a practice or activity that is supported by research demonstrating effectiveness for at least 
579.21 	one outcome of interest; and "theory-based" means a strategy or activity that has no research 
579.22 	on effectiveness but has a well-constructed logical model or theory of change.
579.23 	(i) Beginning July 1, 2017, the commissioner shall offer grant recipients the option of 
579.24 	using a grant awarded under this subdivision to confront the opioid addiction and overdose 
579.25 	epidemic, and shall award at least two of the grants awarded on or after July 1, 2017, for 
579.26 	these purposes. The grants awarded under this paragraph must meet all other requirements 
579.27 	of this section. The commissioner shall coordinate grant planning activities with the 
579.28 	commissioner of human services. Each grant shall include selected outcomes and evaluation 
579.29 	measures related to addressing the opioid epidemic.

579.30 	Sec. 73. Minnesota Statutes 2018, section 145.986, subdivision 4, is amended to read:
579.31 		Subd. 4.Evaluation. (a) Using the outcome measures established in subdivision 3, the 
579.32 	commissioner shall conduct a biennial evaluation of the statewide health improvement 
579.33 	program grants funded under this section. The evaluation must use the most appropriate 
579.34 	experimental or quasi-experimental design suitable for the grant activity or project. Grant 
580.1 	recipients shall cooperate with the commissioner in the evaluation and provide the 
580.2 	commissioner with the information necessary to conduct the evaluation, including information 
580.3 	on any impact on the health indicators listed in section 62U.10, subdivision 6, within the 
580.4 	geographic area or among the population targeted.
580.5 	(b) Grant recipients will collect, monitor, and submit to the Department of Health baseline 
580.6 	and annual data and provide information to improve the quality and impact of community 
580.7 	health improvement strategies.
580.8 	(c) For the purposes of carrying out the grant program under this section, including for 
580.9 	administrative purposes, the commissioner shall award contracts to appropriate entities to 
580.10 	assist in designing and implementing evaluation systems. The commissioner shall consult 
580.11 	with the commissioner of management and budget to ensure that the evaluation process is 
580.12 	using experimental or quasi-experimental design.
580.13 	(d) Contracts awarded under paragraph (c) may be used to:
580.14 	(1) develop grantee monitoring and reporting systems to track grantee progress, including 
580.15 	aggregated and disaggregated data;
580.16 	(2) manage, analyze, and report program evaluation data results; and
580.17 	(3) utilize innovative support tools to analyze and predict the impact of prevention 
580.18 	strategies on health outcomes and state health care costs over time.
580.19 	(e) For purposes of this subdivision, "experimental design" means a method of evaluating 
580.20 	the impact of a strategy that uses random assignment to establish statistically similar groups, 
580.21 	so that any difference in outcomes found at the end of the evaluation can be attributed to 
580.22 	the strategy being evaluated; and "quasi-experimental design" means a method of evaluating 
580.23 	the impact of a strategy that uses an approach other than random assignment to establish 
580.24 	statistically similar groups, so that any difference in outcomes found at the end of the 
580.25 	evaluation can be attributed to the strategy being evaluated.

580.26 	Sec. 74. Minnesota Statutes 2018, section 145.986, subdivision 5, is amended to read:
580.27 		Subd. 5.Report. The commissioner shall submit a biennial report to the legislature on 
580.28 	the statewide health improvement program funded under this section. The report must 
580.29 	include information on each grant recipient, including the activities that were conducted by 
580.30 	the grantee using grant funds, the grantee's progress toward achieving the measurable 
580.31 	outcomes established under subdivision 2, and the data provided to the commissioner by 
580.32 	the grantee to measure these outcomes for grant activities. The commissioner shall provide 
580.33 	information on grants in which a corrective action plan was required under subdivision 1a, 
581.1 	the types of plan action, and the progress that has been made toward meeting the measurable 
581.2 	outcomes. In addition, the commissioner shall provide recommendations on future areas of 
581.3 	focus for health improvement. These reports are due by January 15 of every other year, 
581.4 	beginning in 2010. In the report due on January 15, 2014,In the reports due beginning 
581.5 	January 15, 2020, the commissioner shall include a description of the contracts awarded 
581.6 	under subdivision 4, paragraph (c), and the monitoring and evaluation systems that were 
581.7 	designed and implemented under these contracts.

581.8 	Sec. 75. Minnesota Statutes 2018, section 145.986, subdivision 6, is amended to read:
581.9 		Subd. 6.Supplantation of existing funds. Community health boards and tribal 
581.10 	governments must use funds received under this section to develop new programs, expand 
581.11 	current programs that work to reduce the percentage of Minnesotans who are obese or 
581.12 	overweight or who use tobacco, or replace discontinued state or federal funds previously 
581.13 	used to reduce the percentage of Minnesotans who are obese or overweight or who use 
581.14 	tobacco. Funds must not be used to supplant current state or local funding to community 
581.15 	health boards or tribal governments used to reduce the percentage of Minnesotans who are 
581.16 	obese or overweight or to reduce tobacco use.

581.17 	Sec. 76. [151.72] SALE OF CERTAIN CANNABINOID PRODUCTS.
581.18 		Subdivision 1.Definitions. (a) For the purposes of this section, the following terms have 
581.19 	the meanings given.
581.20 	(b) "Hemp" has the meaning given to "industrial hemp" in section 18K.02, subdivision 
581.21 	3.
581.22 	(c) "Labeling" means all labels and other written, printed, or graphic matter that are:
581.23 	(1) affixed to the immediate container in which a product regulated under this section 
581.24 	is sold; or
581.25 	(2) provided, in any manner, with the immediate container, including but not limited to 
581.26 	outer containers, wrappers, package inserts, brochures, or pamphlets.
581.27 		Subd. 2.Scope. (a) This section applies to the sale of any product that contains 
581.28 	nonintoxicating cannabinoids extracted from hemp other than food that is intended for 
581.29 	human or animal consumption by any route of administration.
581.30 	(b) This section does not apply to any product dispensed by a registered medical cannabis 
581.31 	manufacturer pursuant to sections 152.22 to 152.37.
582.1 		Subd. 3.Sale of cannabinoids derived from hemp. Notwithstanding any other section 
582.2 	of this chapter, a product containing nonintoxicating cannabinoids may be sold for human 
582.3 	or animal consumption if all of the requirements of this section are met.
582.4 		Subd. 4.Testing requirements. (a) A manufacturer of a product regulated under this 
582.5 	section must submit representative samples of the product to an independent, accredited 
582.6 	laboratory in order to certify that the product complies with the standards adopted by the 
582.7 	board. Testing must be consistent with generally accepted industry standards for herbal and 
582.8 	botanical substances, and at a minimum, the testing must confirm that the product:
582.9 	(1) contains the amount or percentage of cannabinoids that is stated on the label of the 
582.10 	product;
582.11 	(2) does not contain more than trace amounts of any pesticides, fertilizers, or heavy 
582.12 	metals; and
582.13 	(3) does not contain a delta-9 tetrahydrocannabinol concentration that exceeds the 
582.14 	concentration permitted for industrial hemp as defined in section 18K.02, subdivision 3.
582.15 	(b) Upon the request of the board, the manufacturer of the product must provide the 
582.16 	board with the results of the testing required in this section.
582.17 		Subd. 5.Labeling requirements. (a) A product regulated under this section must bear 
582.18 	a label that contains, at a minimum:
582.19 	(1) the name, location, contact phone number, and website of the manufacturer of the 
582.20 	product;
582.21 	(2) the name and address of the independent, accredited laboratory used by the 
582.22 	manufacturer to test the product;
582.23 	(3) an accurate statement of the amount or percentage of cannabinoids found in each 
582.24 	unit of the product meant to be consumed; and
582.25 	(4) a statement stating that this product does not claim to diagnose, treat, cure, or prevent 
582.26 	any disease and has not been evaluated or approved by the United States Food and Drug 
582.27 	Administration (FDA) unless the product has been so approved.
582.28 	(b) The information required to be on the label must be prominently and conspicuously 
582.29 	placed and in terms that can be easily read and understood by the consumer.
582.30 	(c) The label must not contain any claim that the product may be used or is effective for 
582.31 	the prevention, treatment, or cure of a disease or that it may be used to alter the structure 
582.32 	or function of human or animal bodies, unless the claim has been approved by the FDA.
583.1 		Subd. 6.Enforcement. (a) A product sold under this section shall be considered an 
583.2 	adulterated drug if:
583.3 	(1) it consists, in whole or in part, of any filthy, putrid, or decomposed substance;
583.4 	(2) it has been produced, prepared, packed, or held under unsanitary conditions where 
583.5 	it may have been rendered injurious to health, or where it may have been contaminated with 
583.6 	filth;
583.7 	(3) its container is composed, in whole or in part, of any poisonous or deleterious 
583.8 	substance that may render the contents injurious to health;
583.9 	(4) it contains any color additives or excipients that have been found by the FDA to be 
583.10 	unsafe for human or animal consumption; or
583.11 	(5) it contains an amount or percentage of cannabinoids that is different than the amount 
583.12 	or percentage stated on the label.
583.13 	(b) A product sold under this section shall be considered a misbranded drug if the 
583.14 	product's labeling is false or misleading in any manner or in violation of the requirements 
583.15 	of this section.
583.16 	(c) The board's authority to issue cease and desist orders under section 151.06; to embargo 
583.17 	adulterated and misbranded drugs under section 151.38; and to seek injunctive relief under 
583.18 	section 214.11, extends to any violation of this section.

583.19 	EFFECTIVE DATE. This section is effective January 1, 2020, and applies to any 
583.20 	product sold in Minnesota on or after that date.

583.21 	Sec. 77. Minnesota Statutes 2018, section 152.01, subdivision 9, is amended to read:
583.22 		Subd. 9.Marijuana. "Marijuana" means all parts of the plant of any species of the genus 
583.23 	Cannabis, including all agronomical varieties, whether growing or not; the seeds thereof; 
583.24 	the resin extracted from any part of such plant; and every compound, manufacture, salt, 
583.25 	derivative, mixture, or preparation of such plant, its seeds or resin, but shall not include the 
583.26 	mature stalks of such plant, fiber from such stalks, oil or cake made from the seeds of such 
583.27 	plant, any other compound, manufacture, salt, derivative, mixture, or preparation of such 
583.28 	mature stalks, except the resin extracted therefrom, fiber, oil, or cake, or the sterilized seed 
583.29 	of such plant which is incapable of germination. Marijuana does not include hemp as defined 
583.30 	in section 152.22, subdivision 5a.

584.1 	Sec. 78. Minnesota Statutes 2018, section 152.22, is amended by adding a subdivision to 
584.2 	read:
584.3 		Subd. 5a.Hemp. "Hemp" has the meaning given to industrial hemp in section 18K.02, 
584.4 	subdivision 3.

584.5 	Sec. 79. Minnesota Statutes 2018, section 152.22, is amended by adding a subdivision to 
584.6 	read:
584.7 		Subd. 5b.Hemp grower. "Hemp grower" means a person licensed by the commissioner 
584.8 	of agriculture under chapter 18K to grow hemp for commercial purposes.

584.9 	Sec. 80. Minnesota Statutes 2018, section 152.22, subdivision 6, is amended to read:
584.10 		Subd. 6.Medical cannabis. (a) "Medical cannabis" means any species of the genus 
584.11 	cannabis plant, or any mixture or preparation of them, including whole plant extracts and 
584.12 	resins, and is delivered in the form of:
584.13 	(1) liquid, including, but not limited to, oil;
584.14 	(2) pill;
584.15 	(3) vaporized delivery method with use of liquid or oil but which does not require the 
584.16 	use of dried leaves or plant form; or
584.17 	(4) any other method, excluding smoking, approved by the commissioner.
584.18 	(b) This definition includes any part of the genus cannabis plant prior to being processed 
584.19 	into a form allowed under paragraph (a), that is possessed by a person while that person is 
584.20 	engaged in employment duties necessary to carry out a requirement under sections 152.22
584.21 	to 152.37 for a registered manufacturer or a laboratory under contract with a registered 
584.22 	manufacturer. This definition also includes any hemp acquired by a manufacturer by a hemp 
584.23 	grower as permitted under section 152.29, subdivision 1, paragraph (b).

584.24 	Sec. 81. Minnesota Statutes 2018, section 152.22, subdivision 11, is amended to read:
584.25 		Subd. 11.Registered designated caregiver. "Registered designated caregiver" means 
584.26 	a person who:
584.27 	(1) is at least 21 18 years old;
584.28 	(2) does not have a conviction for a disqualifying felony offense;
584.29 	(3) has been approved by the commissioner to assist a patient who has been identified 
584.30 	by a health care practitioner as developmentally or physically disabled and therefore unable 
585.1 	to self-administer medication requires assistance in administering medical cannabis or 
585.2 	acquire obtaining medical cannabis from a distribution facility due to the disability; and
585.3 	(4) is authorized by the commissioner to assist the patient with the use of medical 
585.4 	cannabis.

585.5 	Sec. 82. Minnesota Statutes 2018, section 152.22, subdivision 13, is amended to read:
585.6 		Subd. 13.Registry verification. "Registry verification" means the verification provided 
585.7 	by the commissioner that a patient is enrolled in the registry program and that includes the 
585.8 	patient's name, registry number, and qualifying medical condition and, if applicable, the 
585.9 	name of the patient's registered designated caregiver or parent or, legal guardian, or spouse.

585.10 	Sec. 83. Minnesota Statutes 2018, section 152.25, subdivision 1, is amended to read:
585.11 		Subdivision 1.Medical cannabis manufacturer registration. (a) The commissioner 
585.12 	shall register two in-state manufacturers for the production of all medical cannabis within 
585.13 	the state. A registration agreement between the commissioner and a manufacturer is 
585.14 	nontransferable. The commissioner shall register new manufacturers or reregister the existing 
585.15 	manufacturers by December 1 every two years, using the factors described in this subdivision. 
585.16 	The commissioner shall accept applications after December 1, 2014, if one of the 
585.17 	manufacturers registered before December 1, 2014, ceases to be registered as a manufacturer. 
585.18 	The commissioner's determination that no manufacturer exists to fulfill the duties under 
585.19 	sections 152.22 to 152.37 is subject to judicial review in Ramsey County District Court. 
585.20 	Data submitted during the application process are private data on individuals or nonpublic 
585.21 	data as defined in section 13.02 until the manufacturer is registered under this section. Data 
585.22 	on a manufacturer that is registered are public data, unless the data are trade secret or security 
585.23 	information under section 13.37.
585.24 	(b) As a condition for registration, a manufacturer must agree to:
585.25 	(1) begin supplying medical cannabis to patients by July 1, 2015; and
585.26 	(2) comply with all requirements under sections 152.22 to 152.37.
585.27 	(c) The commissioner shall consider the following factors when determining which 
585.28 	manufacturer to register:
585.29 	(1) the technical expertise of the manufacturer in cultivating medical cannabis and 
585.30 	converting the medical cannabis into an acceptable delivery method under section 152.22, 
585.31 	subdivision 6;
586.1 	(2) the qualifications of the manufacturer's employees;
586.2 	(3) the long-term financial stability of the manufacturer;
586.3 	(4) the ability to provide appropriate security measures on the premises of the 
586.4 	manufacturer;
586.5 	(5) whether the manufacturer has demonstrated an ability to meet the medical cannabis 
586.6 	production needs required by sections 152.22 to 152.37; and
586.7 	(6) the manufacturer's projection and ongoing assessment of fees on patients with a 
586.8 	qualifying medical condition.
586.9 	(d) If an officer, director, or controlling person of the manufacturer pleads or is found 
586.10 	guilty of intentionally diverting medical cannabis to a person other than allowed by law 
586.11 	under section 152.33, subdivision 1, the commissioner may decide not to renew the 
586.12 	registration of the manufacturer, provided the violation occurred while the person was an 
586.13 	officer, director, or controlling person of the manufacturer.
586.14 	(e) The commissioner shall require each medical cannabis manufacturer to contract with 
586.15 	an independent laboratory to test medical cannabis produced by the manufacturer. The 
586.16 	commissioner shall approve the laboratory chosen by each manufacturer and require that 
586.17 	the laboratory report testing results to the manufacturer in a manner determined by the 
586.18 	commissioner.

586.19 	Sec. 84. Minnesota Statutes 2018, section 152.25, subdivision 1a, is amended to read:
586.20 		Subd. 1a.Revocation, or nonrenewal, or denial of consent to transfer of a medical 
586.21 	cannabis manufacturer registration. If the commissioner intends to revoke, or not renew, 
586.22 	or deny consent to transfer a registration issued under this section, the commissioner must 
586.23 	first notify in writing the manufacturer against whom the action is to be taken and provide 
586.24 	the manufacturer with an opportunity to request a hearing under the contested case provisions 
586.25 	of chapter 14. If the manufacturer does not request a hearing by notifying the commissioner 
586.26 	in writing within 20 days after receipt of the notice of proposed action, the commissioner 
586.27 	may proceed with the action without a hearing. For revocations, the registration of a 
586.28 	manufacturer is considered revoked on the date specified in the commissioner's written 
586.29 	notice of revocation.

586.30 	Sec. 85. Minnesota Statutes 2018, section 152.25, subdivision 1c, is amended to read:
586.31 		Subd. 1c.Notice to patients. Upon the revocation or nonrenewal of a manufacturer's 
586.32 	registration under subdivision 1a or implementation of an enforcement action under 
587.1 	subdivision 1b that may affect the ability of a registered patient, registered designated 
587.2 	caregiver, or a registered patient's parent or, legal guardian, or spouse to obtain medical 
587.3 	cannabis from the manufacturer subject to the enforcement action, the commissioner shall 
587.4 	notify in writing each registered patient and the patient's registered designated caregiver or 
587.5 	registered patient's parent or, legal guardian, or spouse about the outcome of the proceeding 
587.6 	and information regarding alternative registered manufacturers. This notice must be provided 
587.7 	two or more business days prior to the effective date of the revocation, nonrenewal, or other 
587.8 	enforcement action.

587.9 	Sec. 86. Minnesota Statutes 2018, section 152.25, subdivision 4, is amended to read:
587.10 		Subd. 4.Reports. (a) The commissioner shall provide regular updates to the task force 
587.11 	on medical cannabis therapeutic research and to the chairs and ranking minority members 
587.12 	of the legislative committees with jurisdiction over health and human services, public safety, 
587.13 	judiciary, and civil law regarding: (1) any changes in federal law or regulatory restrictions 
587.14 	regarding the use of medical cannabis or hemp; and (2) the market demand and supply in 
587.15 	this state for products made from hemp that can be used for medicinal purposes.
587.16 	(b) The commissioner may submit medical research based on the data collected under 
587.17 	sections 152.22 to 152.37 to any federal agency with regulatory or enforcement authority 
587.18 	over medical cannabis to demonstrate the effectiveness of medical cannabis for treating a 
587.19 	qualifying medical condition.

587.20 	Sec. 87. Minnesota Statutes 2018, section 152.27, subdivision 2, is amended to read:
587.21 		Subd. 2.Commissioner duties. (a) The commissioner shall:
587.22 	(1) give notice of the program to health care practitioners in the state who are eligible 
587.23 	to serve as health care practitioners and explain the purposes and requirements of the 
587.24 	program;
587.25 	(2) allow each health care practitioner who meets or agrees to meet the program's 
587.26 	requirements and who requests to participate, to be included in the registry program to 
587.27 	collect data for the patient registry;
587.28 	(3) provide explanatory information and assistance to each health care practitioner in 
587.29 	understanding the nature of therapeutic use of medical cannabis within program requirements;
587.30 	(4) create and provide a certification to be used by a health care practitioner for the 
587.31 	practitioner to certify whether a patient has been diagnosed with a qualifying medical 
587.32 	condition and include in the certification an option for the practitioner to certify whether 
588.1 	the patient, in the health care practitioner's medical opinion, is developmentally or physically 
588.2 	disabled and, as a result of that disability, the patient is unable to self-administer medication
588.3 	requires assistance in administering medical cannabis or acquire obtaining medical cannabis 
588.4 	from a distribution facility;
588.5 	(5) supervise the participation of the health care practitioner in conducting patient 
588.6 	treatment and health records reporting in a manner that ensures stringent security and 
588.7 	record-keeping requirements and that prevents the unauthorized release of private data on 
588.8 	individuals as defined by section 13.02;
588.9 	(6) develop safety criteria for patients with a qualifying medical condition as a 
588.10 	requirement of the patient's participation in the program, to prevent the patient from 
588.11 	undertaking any task under the influence of medical cannabis that would constitute negligence 
588.12 	or professional malpractice on the part of the patient; and
588.13 	(7) conduct research and studies based on data from health records submitted to the 
588.14 	registry program and submit reports on intermediate or final research results to the legislature 
588.15 	and major scientific journals. The commissioner may contract with a third party to complete 
588.16 	the requirements of this clause. Any reports submitted must comply with section 152.28, 
588.17 	subdivision 2.
588.18 	(b) The commissioner may add a delivery method under section 152.22, subdivision 6, 
588.19 	or add or modify a qualifying medical condition under section 152.22, subdivision 14, upon 
588.20 	a petition from a member of the public or the task force on medical cannabis therapeutic 
588.21 	research or as directed by law. The commissioner shall evaluate all petitions to add a 
588.22 	qualifying medical condition or modify an existing qualifying medical condition submitted 
588.23 	by the task force on medical cannabis therapeutic research or as directed by law and shall 
588.24 	make the addition or modification if the commissioner determines the addition or 
588.25 	modification is warranted based on the best available evidence and research. If the 
588.26 	commissioner wishes to add a delivery method under section 152.22, subdivision 6, or a 
588.27 	qualifying medical condition under section 152.22, subdivision 14, the commissioner must 
588.28 	notify the chairs and ranking minority members of the legislative policy committees having 
588.29 	jurisdiction over health and public safety of the addition and the reasons for its addition, 
588.30 	including any written comments received by the commissioner from the public and any 
588.31 	guidance received from the task force on medical cannabis research, by January 15 of the 
588.32 	year in which the commissioner wishes to make the change. The change shall be effective 
588.33 	on August 1 of that year, unless the legislature by law provides otherwise.

589.1 	Sec. 88. Minnesota Statutes 2018, section 152.27, subdivision 3, is amended to read:
589.2 		Subd. 3.Patient application. (a) The commissioner shall develop a patient application 
589.3 	for enrollment into the registry program. The application shall be available to the patient 
589.4 	and given to health care practitioners in the state who are eligible to serve as health care 
589.5 	practitioners. The application must include:
589.6 	(1) the name, mailing address, and date of birth of the patient;
589.7 	(2) the name, mailing address, and telephone number of the patient's health care 
589.8 	practitioner;
589.9 	(3) the name, mailing address, and date of birth of the patient's designated caregiver, if 
589.10 	any, or the patient's parent or, legal guardian, or spouse if the parent or, legal guardian, or 
589.11 	spouse will be acting as a caregiver;
589.12 	(4) a copy of the certification from the patient's health care practitioner that is dated 
589.13 	within 90 days prior to submitting the application which certifies that the patient has been 
589.14 	diagnosed with a qualifying medical condition and, if applicable, that, in the health care 
589.15 	practitioner's medical opinion, the patient is developmentally or physically disabled and, 
589.16 	as a result of that disability, the patient is unable to self-administer medication requires 
589.17 	assistance in administering medical cannabis or acquire obtaining medical cannabis from 
589.18 	a distribution facility; and
589.19 	(5) all other signed affidavits and enrollment forms required by the commissioner under 
589.20 	sections 152.22 to 152.37, including, but not limited to, the disclosure form required under 
589.21 	paragraph (c).
589.22 	(b) The commissioner shall require a patient to resubmit a copy of the certification from 
589.23 	the patient's health care practitioner on a yearly basis and shall require that the recertification 
589.24 	be dated within 90 days of submission.
589.25 	(c) The commissioner shall develop a disclosure form and require, as a condition of 
589.26 	enrollment, all patients to sign a copy of the disclosure. The disclosure must include:
589.27 	(1) a statement that, notwithstanding any law to the contrary, the commissioner, or an 
589.28 	employee of any state agency, may not be held civilly or criminally liable for any injury, 
589.29 	loss of property, personal injury, or death caused by any act or omission while acting within 
589.30 	the scope of office or employment under sections 152.22 to 152.37; and
589.31 	(2) the patient's acknowledgement acknowledgment that enrollment in the patient registry 
589.32 	program is conditional on the patient's agreement to meet all of the requirements of sections 
589.33 	152.22 to 152.37.

590.1 	Sec. 89. Minnesota Statutes 2018, section 152.27, subdivision 4, is amended to read:
590.2 		Subd. 4.Registered designated caregiver. (a) The commissioner shall register a 
590.3 	designated caregiver for a patient if the patient's health care practitioner has certified that 
590.4 	the patient, in the health care practitioner's medical opinion, is developmentally or physically 
590.5 	disabled and, as a result of that disability, the patient is unable to self-administer medication 
590.6 	or acquire requires assistance in administering medical cannabis or obtaining medical 
590.7 	cannabis from a distribution facility and the caregiver has agreed, in writing, to be the 
590.8 	patient's designated caregiver. As a condition of registration as a designated caregiver, the 
590.9 	commissioner shall require the person to:
590.10 	(1) be at least 21 18 years of age;
590.11 	(2) agree to only possess any the patient's medical cannabis for purposes of assisting the 
590.12 	patient; and
590.13 	(3) agree that if the application is approved, the person will not be a registered designated 
590.14 	caregiver for more than one patient, unless the patients reside in the same residence.
590.15 	(b) The commissioner shall conduct a criminal background check on the designated 
590.16 	caregiver prior to registration to ensure that the person does not have a conviction for a 
590.17 	disqualifying felony offense. Any cost of the background check shall be paid by the person 
590.18 	seeking registration as a designated caregiver. A designated caregiver must have the criminal 
590.19 	background check renewed every two years.
590.20 	(c) Nothing in sections 152.22 to 152.37 shall be construed to prevent a person registered 
590.21 	as a designated caregiver from also being enrolled in the registry program as a patient and 
590.22 	possessing and using medical cannabis as a patient.

590.23 	Sec. 90. Minnesota Statutes 2018, section 152.27, subdivision 5, is amended to read:
590.24 		Subd. 5.Parents or, legal guardians, and spouses. A parent or, legal guardian, or 
590.25 	spouse of a patient may act as the caregiver to the patient without having to register as a 
590.26 	designated caregiver. The parent or, legal guardian, or spouse shall follow all of the 
590.27 	requirements of parents and, legal guardians, and spouses listed in sections 152.22 to 152.37. 
590.28 	Nothing in sections 152.22 to 152.37 limits any legal authority a parent or, legal guardian, 
590.29 	or spouse may have for the patient under any other law.

590.30 	Sec. 91. Minnesota Statutes 2018, section 152.27, subdivision 6, is amended to read:
590.31 		Subd. 6.Patient enrollment. (a) After receipt of a patient's application, application fees, 
590.32 	and signed disclosure, the commissioner shall enroll the patient in the registry program and 
591.1 	issue the patient and patient's registered designated caregiver or parent or, legal guardian, 
591.2 	or spouse, if applicable, a registry verification. The commissioner shall approve or deny a 
591.3 	patient's application for participation in the registry program within 30 days after the 
591.4 	commissioner receives the patient's application and application fee. The commissioner may 
591.5 	approve applications up to 60 days after the receipt of a patient's application and application 
591.6 	fees until January 1, 2016. A patient's enrollment in the registry program shall only be 
591.7 	denied if the patient:
591.8 	(1) does not have certification from a health care practitioner that the patient has been 
591.9 	diagnosed with a qualifying medical condition;
591.10 	(2) has not signed and returned the disclosure form required under subdivision 3, 
591.11 	paragraph (c), to the commissioner;
591.12 	(3) does not provide the information required;
591.13 	(4) has previously been removed from the registry program for violations of section 
591.14 	152.30 or 152.33; or
591.15 	(5) provides false information.
591.16 	(b) The commissioner shall give written notice to a patient of the reason for denying 
591.17 	enrollment in the registry program.
591.18 	(c) Denial of enrollment into the registry program is considered a final decision of the 
591.19 	commissioner and is subject to judicial review under the Administrative Procedure Act 
591.20 	pursuant to chapter 14.
591.21 	(d) A patient's enrollment in the registry program may only be revoked upon the death 
591.22 	of the patient or if a patient violates a requirement under section 152.30 or 152.33.
591.23 	(e) The commissioner shall develop a registry verification to provide to the patient, the 
591.24 	health care practitioner identified in the patient's application, and to the manufacturer. The 
591.25 	registry verification shall include:
591.26 	(1) the patient's name and date of birth;
591.27 	(2) the patient registry number assigned to the patient; and
591.28 	(3) the patient's qualifying medical condition as provided by the patient's health care 
591.29 	practitioner in the certification; and
591.30 	(4) (3) the name and date of birth of the patient's registered designated caregiver, if any, 
591.31 	or the name of the patient's parent or, legal guardian, or spouse if the parent or, legal guardian, 
591.32 	or spouse will be acting as a caregiver.

592.1 	Sec. 92. Minnesota Statutes 2018, section 152.28, subdivision 1, is amended to read:
592.2 		Subdivision 1.Health care practitioner duties. (a) Prior to a patient's enrollment in 
592.3 	the registry program, a health care practitioner shall:
592.4 	(1) determine, in the health care practitioner's medical judgment, whether a patient suffers 
592.5 	from a qualifying medical condition, and, if so determined, provide the patient with a 
592.6 	certification of that diagnosis;
592.7 	(2) determine whether a patient is developmentally or physically disabled and, as a result 
592.8 	of that disability, the patient is unable to self-administer medication or acquirerequires 
592.9 	assistance in administering medical cannabis or obtaining medical cannabis from a 
592.10 	distribution facility, and, if so determined, include that determination on the patient's 
592.11 	certification of diagnosis;
592.12 	(3) advise patients, registered designated caregivers, and parents or, legal guardians, or 
592.13 	spouses who are acting as caregivers of the existence of any nonprofit patient support groups 
592.14 	or organizations;
592.15 	(4) provide explanatory information from the commissioner to patients with qualifying 
592.16 	medical conditions, including disclosure to all patients about the experimental nature of 
592.17 	therapeutic use of medical cannabis; the possible risks, benefits, and side effects of the 
592.18 	proposed treatment; the application and other materials from the commissioner; and provide 
592.19 	patients with the Tennessen warning as required by section 13.04, subdivision 2; and
592.20 	(5) agree to continue treatment of the patient's qualifying medical condition and report 
592.21 	medical findings to the commissioner.
592.22 	(b) Upon notification from the commissioner of the patient's enrollment in the registry 
592.23 	program, the health care practitioner shall:
592.24 	(1) participate in the patient registry reporting system under the guidance and supervision 
592.25 	of the commissioner;
592.26 	(2) report health records of the patient throughout the ongoing treatment of the patient 
592.27 	to the commissioner in a manner determined by the commissioner and in accordance with 
592.28 	subdivision 2;
592.29 	(3) determine, on a yearly basis, if the patient continues to suffer from a qualifying 
592.30 	medical condition and, if so, issue the patient a new certification of that diagnosis; and
592.31 	(4) otherwise comply with all requirements developed by the commissioner.
593.1 	(c) A health care practitioner may conduct a patient assessment to issue a recertification 
593.2 	as required under paragraph (b), clause (3), via telemedicine as defined under section 
593.3 	62A.671, subdivision 9.
593.4 	(c) (d) Nothing in this section requires a health care practitioner to participate in the 
593.5 	registry program.

593.6 	Sec. 93. Minnesota Statutes 2018, section 152.29, subdivision 1, is amended to read:
593.7 		Subdivision 1.Manufacturer; requirements. (a) A manufacturer shall operate four
593.8 	eight distribution facilities, which may include the manufacturer's single location for 
593.9 	cultivation, harvesting, manufacturing, packaging, and processing but is not required to 
593.10 	include that location. A manufacturer is required to begin distribution of medical cannabis 
593.11 	from at least one distribution facility by July 1, 2015. All distribution facilities must be 
593.12 	operational and begin distribution of medical cannabis by July 1, 2016. The distribution 
593.13 	facilities shall be located The commissioner shall designate the geographical service areas 
593.14 	to be served by each manufacturer based on geographical need throughout the state to 
593.15 	improve patient access. A manufacturer shall disclose the proposed locations for the 
593.16 	distribution facilities to the commissioner during the registration process.A manufacturer 
593.17 	shall not have more than two distribution facilities in each geographical service area assigned 
593.18 	to the manufacturer by the commissioner. A manufacturer shall operate only one location 
593.19 	where all cultivation, harvesting, manufacturing, packaging, and processing of medical 
593.20 	cannabis shall be conducted. Any This location may be one of the manufacturer's distribution 
593.21 	facility sites. The additional distribution facilities may dispense medical cannabis and 
593.22 	medical cannabis products but may not contain any medical cannabis in a form other than 
593.23 	those forms allowed under section 152.22, subdivision 6, and the manufacturer shall not 
593.24 	conduct any cultivation, harvesting, manufacturing, packaging, or processing at an additional
593.25 	the other distribution facility site sites. Any distribution facility operated by the manufacturer 
593.26 	is subject to all of the requirements applying to the manufacturer under sections 152.22 to 
593.27 	152.37, including, but not limited to, security and distribution requirements.
593.28 	(b) A manufacturer may acquire hemp grown in this state from a hemp grower. A 
593.29 	manufacturer may manufacture or process hemp into an allowable form of medical cannabis 
593.30 	under section 152.22, subdivision 6. Hemp acquired by a manufacturer under this paragraph 
593.31 	is subject to the same quality control program, security and testing requirements, and other 
593.32 	requirements that apply to medical cannabis under sections 152.22 to 152.37 and Minnesota 
593.33 	Rules, chapter 4770.
594.1 	(b) (c) A medical cannabis manufacturer shall contract with a laboratory approved by 
594.2 	the commissioner, subject to any additional requirements set by the commissioner, for 
594.3 	purposes of testing medical cannabis manufactured or hemp acquired by the medical cannabis 
594.4 	manufacturer as to content, contamination, and consistency to verify the medical cannabis 
594.5 	meets the requirements of section 152.22, subdivision 6. The cost of laboratory testing shall 
594.6 	be paid by the manufacturer.
594.7 	(c) (d) The operating documents of a manufacturer must include:
594.8 	(1) procedures for the oversight of the manufacturer and procedures to ensure accurate 
594.9 	record keeping; and
594.10 	(2) procedures for the implementation of appropriate security measures to deter and 
594.11 	prevent the theft of medical cannabis and unauthorized entrance into areas containing medical 
594.12 	cannabis.; and
594.13 	(3) procedures for the delivery and transportation of hemp between hemp growers and 
594.14 	manufacturers.
594.15 	(d) (e) A manufacturer shall implement security requirements, including requirements 
594.16 	for the delivery and transportation of hemp, protection of each location by a fully operational 
594.17 	security alarm system, facility access controls, perimeter intrusion detection systems, and 
594.18 	a personnel identification system.
594.19 	(e) (f) A manufacturer shall not share office space with, refer patients to a health care 
594.20 	practitioner, or have any financial relationship with a health care practitioner.
594.21 	(f) (g) A manufacturer shall not permit any person to consume medical cannabis on the 
594.22 	property of the manufacturer.
594.23 	(g) (h) A manufacturer is subject to reasonable inspection by the commissioner.
594.24 	(h) (i) For purposes of sections 152.22 to 152.37, a medical cannabis manufacturer is 
594.25 	not subject to the Board of Pharmacy licensure or regulatory requirements under chapter 
594.26 	151.
594.27 	(i) (j) A medical cannabis manufacturer may not employ any person who is under 21 
594.28 	years of age or who has been convicted of a disqualifying felony offense. An employee of 
594.29 	a medical cannabis manufacturer must submit a completed criminal history records check 
594.30 	consent form, a full set of classifiable fingerprints, and the required fees for submission to 
594.31 	the Bureau of Criminal Apprehension before an employee may begin working with the 
594.32 	manufacturer. The bureau must conduct a Minnesota criminal history records check and 
594.33 	the superintendent is authorized to exchange the fingerprints with the Federal Bureau of 
595.1 	Investigation to obtain the applicant's national criminal history record information. The 
595.2 	bureau shall return the results of the Minnesota and federal criminal history records checks 
595.3 	to the commissioner.
595.4 	(j) (k) A manufacturer may not operate in any location, whether for distribution or 
595.5 	cultivation, harvesting, manufacturing, packaging, or processing, within 1,000 feet of a 
595.6 	public or private school existing before the date of the manufacturer's registration with the 
595.7 	commissioner.
595.8 	(k) (l) A manufacturer shall comply with reasonable restrictions set by the commissioner 
595.9 	relating to signage, marketing, display, and advertising of medical cannabis.
595.10 	(m) Before a manufacturer acquires hemp from a hemp grower, the manufacturer must 
595.11 	verify that the hemp grower has a valid license issued by the commissioner of agriculture 
595.12 	under chapter 18K.

595.13 	Sec. 94. Minnesota Statutes 2018, section 152.29, subdivision 2, is amended to read:
595.14 		Subd. 2.Manufacturer; production. (a) A manufacturer of medical cannabis shall 
595.15 	provide a reliable and ongoing supply of all medical cannabis needed for the registry program
595.16 	through cultivation by the manufacturer and through the purchase of hemp from hemp 
595.17 	growers.
595.18 	(b) All cultivation, harvesting, manufacturing, packaging, and processing of medical 
595.19 	cannabis must take place in an enclosed, locked facility at a physical address provided to 
595.20 	the commissioner during the registration process.
595.21 	(c) A manufacturer must process and prepare any medical cannabis plant material or 
595.22 	hemp plant material into a form allowable under section 152.22, subdivision 6, prior to 
595.23 	distribution of any medical cannabis.

595.24 	Sec. 95. Minnesota Statutes 2018, section 152.29, subdivision 3, is amended to read:
595.25 		Subd. 3.Manufacturer; distribution. (a) A manufacturer shall require that employees 
595.26 	licensed as pharmacists pursuant to chapter 151 be the only employees to give final approval 
595.27 	for the distribution of medical cannabis to a patient. A manufacturer may transport medical 
595.28 	cannabis or medical cannabis products that have been cultivated, harvested, manufactured, 
595.29 	packaged, and processed by that manufacturer to another registered manufacturer for the 
595.30 	other manufacturer to distribute.
596.1 	(b) A manufacturer may dispense distribute medical cannabis products, whether or not 
596.2 	the products have been manufactured by the that manufacturer, but is not required to dispense 
596.3 	medical cannabis products.
596.4 	(c) Prior to distribution of any medical cannabis, the manufacturer shall:
596.5 	(1) verify that the manufacturer has received the registry verification from the 
596.6 	commissioner for that individual patient;
596.7 	(2) verify that the person requesting the distribution of medical cannabis is the patient, 
596.8 	the patient's registered designated caregiver, or the patient's parent or, legal guardian, or 
596.9 	spouse listed in the registry verification using the procedures described in section 152.11, 
596.10 	subdivision 2d;
596.11 	(3) assign a tracking number to any medical cannabis distributed from the manufacturer;
596.12 	(4) ensure that any employee of the manufacturer licensed as a pharmacist pursuant to 
596.13 	chapter 151 has consulted with the patient to determine the proper dosage for the individual 
596.14 	patient after reviewing the ranges of chemical compositions of the medical cannabis and 
596.15 	the ranges of proper dosages reported by the commissioner. For purposes of this clause, a 
596.16 	consultation may be conducted remotely using a videoconference, so long as the employee 
596.17 	providing the consultation is able to confirm the identity of the patient, the consultation 
596.18 	occurs while the patient is at a distribution facility, and the consultation adheres to patient 
596.19 	privacy requirements that apply to health care services delivered through telemedicine;
596.20 	(5) properly package medical cannabis in compliance with the United States Poison 
596.21 	Prevention Packing Act regarding child-resistant packaging and exemptions for packaging 
596.22 	for elderly patients, and label distributed medical cannabis with a list of all active ingredients 
596.23 	and individually identifying information, including:
596.24 	(i) the patient's name and date of birth;
596.25 	(ii) the name and date of birth of the patient's registered designated caregiver or, if listed 
596.26 	on the registry verification, the name of the patient's parent or legal guardian, if applicable;
596.27 	(iii) the patient's registry identification number;
596.28 	(iv) the chemical composition of the medical cannabis; and
596.29 	(v) the dosage; and
596.30 	(6) ensure that the medical cannabis distributed contains a maximum of a 30-day90-day
596.31 	supply of the dosage determined for that patient.
597.1 	(d) A manufacturer shall require any employee of the manufacturer who is transporting 
597.2 	medical cannabis or medical cannabis products to a distribution facility or to another 
597.3 	registered manufacturer to carry identification showing that the person is an employee of 
597.4 	the manufacturer.

597.5 	Sec. 96. Minnesota Statutes 2018, section 152.29, subdivision 3a, is amended to read:
597.6 		Subd. 3a.Transportation of medical cannabis; staffing. (a) A medical cannabis 
597.7 	manufacturer may staff a transport motor vehicle with only one employee if the medical 
597.8 	cannabis manufacturer is transporting medical cannabis to either a certified laboratory for 
597.9 	the purpose of testing or a facility for the purpose of disposal. If the medical cannabis 
597.10 	manufacturer is transporting medical cannabis for any other purpose or destination, the 
597.11 	transport motor vehicle must be staffed with a minimum of two employees as required by 
597.12 	rules adopted by the commissioner.
597.13 	(b) Notwithstanding paragraph (a), a medical cannabis manufacturer that is only 
597.14 	transporting hemp for any purpose may staff the transport motor vehicle with only one 
597.15 	employee.

597.16 	Sec. 97. Minnesota Statutes 2018, section 152.31, is amended to read:
597.17 	152.31 DATA PRACTICES.
597.18 	(a) Government data in patient files maintained by the commissioner and the health care 
597.19 	practitioner, and data submitted to or by a medical cannabis manufacturer, are private data 
597.20 	on individuals, as defined in section 13.02, subdivision 12, or nonpublic data, as defined in 
597.21 	section 13.02, subdivision 9, but may be used for purposes of complying with chapter 13 
597.22 	and complying with a request from the legislative auditor or the state auditor in the 
597.23 	performance of official duties. The provisions of section 13.05, subdivision 11, apply to a 
597.24 	registration agreement entered between the commissioner and a medical cannabis 
597.25 	manufacturer under section 152.25.
597.26 	(b) Not public data maintained by the commissioner may not be used for any purpose 
597.27 	not provided for in sections 152.22 to 152.37, and may not be combined or linked in any 
597.28 	manner with any other list, dataset, or database.
597.29 	(c) The commissioner may execute data sharing arrangements with the commissioner 
597.30 	of agriculture to verify licensing, inspection, and compliance information related to hemp 
597.31 	growers under chapter 18K.

598.1 	Sec. 98. Minnesota Statutes 2018, section 152.32, subdivision 2, is amended to read:
598.2 		Subd. 2.Criminal and civil protections. (a) Subject to section 152.23, the following 
598.3 	are not violations under this chapter:
598.4 	(1) use or possession of medical cannabis or medical cannabis products by a patient 
598.5 	enrolled in the registry program, or possession by a registered designated caregiver or the 
598.6 	parent or, legal guardian, or spouse of a patient if the parent or, legal guardian, or spouse
598.7 	is listed on the registry verification;
598.8 	(2) possession, dosage determination, or sale of medical cannabis or medical cannabis 
598.9 	products by a medical cannabis manufacturer, employees of a manufacturer, a laboratory 
598.10 	conducting testing on medical cannabis, or employees of the laboratory; and
598.11 	(3) possession of medical cannabis or medical cannabis products by any person while 
598.12 	carrying out the duties required under sections 152.22 to 152.37.
598.13 	(b) Medical cannabis obtained and distributed pursuant to sections 152.22 to 152.37 and 
598.14 	associated property is not subject to forfeiture under sections 609.531 to 609.5316.
598.15 	(c) The commissioner, the commissioner's staff, the commissioner's agents or contractors, 
598.16 	and any health care practitioner are not subject to any civil or disciplinary penalties by the 
598.17 	Board of Medical Practice, the Board of Nursing, or by any business, occupational, or 
598.18 	professional licensing board or entity, solely for the participation in the registry program 
598.19 	under sections 152.22 to 152.37. A pharmacist licensed under chapter 151 is not subject to 
598.20 	any civil or disciplinary penalties by the Board of Pharmacy when acting in accordance 
598.21 	with the provisions of sections 152.22 to 152.37. Nothing in this section affects a professional 
598.22 	licensing board from taking action in response to violations of any other section of law.
598.23 	(d) Notwithstanding any law to the contrary, the commissioner, the governor of 
598.24 	Minnesota, or an employee of any state agency may not be held civilly or criminally liable 
598.25 	for any injury, loss of property, personal injury, or death caused by any act or omission 
598.26 	while acting within the scope of office or employment under sections 152.22 to 152.37.
598.27 	(e) Federal, state, and local law enforcement authorities are prohibited from accessing 
598.28 	the patient registry under sections 152.22 to 152.37 except when acting pursuant to a valid 
598.29 	search warrant.
598.30 	(f) Notwithstanding any law to the contrary, neither the commissioner nor a public 
598.31 	employee may release data or information about an individual contained in any report, 
598.32 	document, or registry created under sections 152.22 to 152.37 or any information obtained 
598.33 	about a patient participating in the program, except as provided in sections 152.22 to 152.37.
599.1 	(g) No information contained in a report, document, or registry or obtained from a patient 
599.2 	under sections 152.22 to 152.37 may be admitted as evidence in a criminal proceeding 
599.3 	unless independently obtained or in connection with a proceeding involving a violation of 
599.4 	sections 152.22 to 152.37.
599.5 	(h) Notwithstanding section 13.09, any person who violates paragraph (e) or (f) is guilty 
599.6 	of a gross misdemeanor.
599.7 	(i) An attorney may not be subject to disciplinary action by the Minnesota Supreme 
599.8 	Court or professional responsibility board for providing legal assistance to prospective or 
599.9 	registered manufacturers or others related to activity that is no longer subject to criminal 
599.10 	penalties under state law pursuant to sections 152.22 to 152.37.
599.11 	(j) Possession of a registry verification or application for enrollment in the program by 
599.12 	a person entitled to possess or apply for enrollment in the registry program does not constitute 
599.13 	probable cause or reasonable suspicion, nor shall it be used to support a search of the person 
599.14 	or property of the person possessing or applying for the registry verification, or otherwise 
599.15 	subject the person or property of the person to inspection by any governmental agency.

599.16 	Sec. 99. Minnesota Statutes 2018, section 152.33, subdivision 1, is amended to read:
599.17 		Subdivision 1.Intentional diversion; criminal penalty. In addition to any other 
599.18 	applicable penalty in law, a manufacturer or an agent of a manufacturer who intentionally 
599.19 	transfers medical cannabis to a person other than another registered manufacturer, a patient, 
599.20 	a registered designated caregiver or, if listed on the registry verification, a parent or, legal 
599.21 	guardian, or spouse of a patient is guilty of a felony punishable by imprisonment for not 
599.22 	more than two years or by payment of a fine of not more than $3,000, or both. A person 
599.23 	convicted under this subdivision may not continue to be affiliated with the manufacturer 
599.24 	and is disqualified from further participation under sections 152.22 to 152.37.

599.25 	Sec. 100. Minnesota Statutes 2018, section 152.33, subdivision 2, is amended to read:
599.26 		Subd. 2.Diversion by patient, registered designated caregiver, or parent, legal 
599.27 	guardian, or patient's spouse; criminal penalty. In addition to any other applicable penalty 
599.28 	in law, a patient, registered designated caregiver or, if listed on the registry verification, a 
599.29 	parent or, legal guardian, or spouse of a patient who intentionally sells or otherwise transfers 
599.30 	medical cannabis to a person other than a patient, designated registered caregiver or, if listed 
599.31 	on the registry verification, a parent or, legal guardian, or spouse of a patient is guilty of a 
599.32 	felony punishable by imprisonment for not more than two years or by payment of a fine of 
599.33 	not more than $3,000, or both.

600.1 	Sec. 101. Minnesota Statutes 2018, section 152.34, is amended to read:
600.2 	152.34 HEALTH CARE FACILITIES.
600.3 	(a) Health care facilities licensed under chapter 144A, hospice providers licensed under 
600.4 	chapter 144A, boarding care homes or supervised living facilities licensed under section 
600.5 	144.50, assisted living facilities, and facilities owned, controlled, managed, or under common 
600.6 	control with hospitals licensed under chapter 144, and other health facilities licensed by the 
600.7 	commissioner of health, may adopt reasonable restrictions on the use of medical cannabis 
600.8 	by a patient enrolled in the registry program who resides at or is actively receiving treatment 
600.9 	or care at the facility. The restrictions may include a provision that the facility will not store 
600.10 	or maintain the patient's supply of medical cannabis, that the facility is not responsible for 
600.11 	providing the medical cannabis for patients, and that medical cannabis be used only in a 
600.12 	place specified by the facility.
600.13 	(b) Any employee or agent of a facility listed in this section or a person licensed under 
600.14 	chapter 144E is not subject to violations under this chapter for possession of medical cannabis 
600.15 	while carrying out employment duties, including providing or supervising care to a registered 
600.16 	patient, or distribution of medical cannabis to a registered patient who resides at or is actively 
600.17 	receiving treatment or care at the facility with which the employee or agent is affiliated. 
600.18 	Nothing in this section shall require the facilities to adopt such restrictions and no facility 
600.19 	shall unreasonably limit a patient's access to or use of medical cannabis to the extent that 
600.20 	use is authorized by the patient under sections 152.22 to 152.37.

600.21 	Sec. 102. Minnesota Statutes 2018, section 152.36, subdivision 2, is amended to read:
600.22 		Subd. 2.Impact assessment. The task force shall hold hearings to evaluate the impact 
600.23 	of the use of medical cannabis and hemp and Minnesota's activities involving medical 
600.24 	cannabis and hemp, including, but not limited to:
600.25 	(1) program design and implementation;
600.26 	(2) the impact on the health care provider community;
600.27 	(3) patient experiences;
600.28 	(4) the impact on the incidence of substance abuse;
600.29 	(5) access to and quality of medical cannabis, hemp, and medical cannabis products;
600.30 	(6) the impact on law enforcement and prosecutions;
600.31 	(7) public awareness and perception; and
601.1 	(8) any unintended consequences.

601.2 	Sec. 103. Minnesota Statutes 2018, section 157.22, is amended to read:
601.3 	157.22 EXEMPTIONS.
601.4 	This chapter does not apply to:
601.5 	(1) interstate carriers under the supervision of the United States Department of Health 
601.6 	and Human Services;
601.7 	(2) weddings, fellowship meals, or funerals conducted by a faith-based organization 
601.8 	using any building constructed and primarily used for religious worship or education;
601.9 	(3) any building owned, operated, and used by a college or university in accordance 
601.10 	with health regulations promulgated by the college or university under chapter 14;
601.11 	(4) any person, firm, or corporation whose principal mode of business is licensed under 
601.12 	sections 28A.04 and 28A.05, is exempt at that premises from licensure as a food or beverage 
601.13 	establishment; provided that the holding of any license pursuant to sections 28A.04 and 
601.14 	28A.05 shall not exempt any person, firm, or corporation from the applicable provisions of 
601.15 	this chapter or the rules of the state commissioner of health relating to food and beverage 
601.16 	service establishments;
601.17 	(5) family day care homes and group family day care homes governed by sections 
601.18 	245A.01 to 245A.16;
601.19 	(6) nonprofit senior citizen centers for the sale of home-baked goods;
601.20 	(7) fraternal, sportsman, or patriotic organizations that are tax exempt under section 
601.21 	501(c)(3), 501(c)(4), 501(c)(6), 501(c)(7), 501(c)(10), or 501(c)(19) of the Internal Revenue 
601.22 	Code of 1986, or organizations related to, affiliated with, or supported by such fraternal, 
601.23 	sportsman, or patriotic organizations for events held in the building or on the grounds of 
601.24 	the organization and at which home-prepared food is donated by organization members for 
601.25 	sale at the events, provided:
601.26 	(i) the event is not a circus, carnival, or fair;
601.27 	(ii) the organization controls the admission of persons to the event, the event agenda, or 
601.28 	both; and
601.29 	(iii) the organization's licensed kitchen is not used in any manner for the event;
601.30 	(8) food not prepared at an establishment and brought in by individuals attending a 
601.31 	potluck event for consumption at the potluck event. An organization sponsoring a potluck 
602.1 	event under this clause may advertise the potluck event to the public through any means. 
602.2 	Individuals who are not members of an organization sponsoring a potluck event under this 
602.3 	clause may attend the potluck event and consume the food at the event. Licensed food 
602.4 	establishments other than schools cannot be sponsors of potluck events. A school may 
602.5 	sponsor and hold potluck events in areas of the school other than the school's kitchen, 
602.6 	provided that the school's kitchen is not used in any manner for the potluck event. For 
602.7 	purposes of this clause, "school" means a public school as defined in section 120A.05, 
602.8 	subdivisions 9, 11, 13, and 17, or a nonpublic school, church, or religious organization at 
602.9 	which a child is provided with instruction in compliance with sections 120A.22 and 120A.24. 
602.10 	Potluck event food shall not be brought into a licensed food establishment kitchen;
602.11 	(9) a home school in which a child is provided instruction at home;
602.12 	(10) school concession stands serving commercially prepared, nonpotentially hazardous 
602.13 	foods, as defined in Minnesota Rules, chapter 4626;
602.14 	(11) group residential facilities of ten or fewer beds licensed by the commissioner of 
602.15 	human services under Minnesota Rules, chapter 2960, provided the facility employs or 
602.16 	contracts with a certified food manager under Minnesota Rules, part 4626.2015;
602.17 	(12) food served at fund-raisers or community events conducted in the building or on 
602.18 	the grounds of a faith-based organization, provided that a certified food manager, or a 
602.19 	volunteer trained in a food safety course, trains the food preparation workers in safe food 
602.20 	handling practices. This exemption does not apply to faith-based organizations at the state 
602.21 	agricultural society or county fairs or to faith-based organizations that choose to apply for 
602.22 	a license;
602.23 	(13) food service events conducted following a disaster for purposes of feeding disaster 
602.24 	relief staff and volunteers serving commercially prepared, nonpotentially hazardous foods, 
602.25 	as defined in Minnesota Rules, chapter 4626; and
602.26 	(14) chili or soup served at a chili or soup cook-off fund-raiser conducted by a 
602.27 	community-based nonprofit organization, provided:
602.28 	(i) the municipality where the event is located approves the event;
602.29 	(ii) the sponsoring organization must develop food safety rules and ensure that participants 
602.30 	follow these rules; and
602.31 	(iii) if the food is not prepared in a kitchen that is licensed or inspected, a visible sign 
602.32 	or placard must be posted that states: "These products are homemade and not subject to 
602.33 	state inspection."
603.1 	Foods exempt under this clause must be labeled to accurately reflect the name and 
603.2 	address of the person preparing the foods.; and
603.3 	(15) a special event food stand or a seasonal temporary food stand provided:
603.4 	(i) the stand is located on private property with the permission of the property owner;
603.5 	(ii) the stand has gross receipts or contributions of $1,000 or less in a calendar year; and
603.6 	(iii) the operator of the stand posts a sign or placard at the site that states "The products 
603.7 	sold at this stand are not subject to state inspection or regulation.", if the stand offers for 
603.8 	sale potentially hazardous food as defined in Minnesota Rules, part 4626.0020, subdivision 
603.9 	62.

603.10 	Sec. 104. Minnesota Statutes 2018, section 214.25, subdivision 2, is amended to read:
603.11 		Subd. 2.Commissioner of health data. (a) All data collected or maintained as part of 
603.12 	the commissioner of health's duties under Minnesota Statutes 2018, sections 214.19, 214.23, 
603.13 	and 214.24, shall be classified as investigative data under section 13.39, except that inactive 
603.14 	investigative data shall be classified as private data under section 13.02, subdivision 12, or 
603.15 	nonpublic data under section 13.02, subdivision 9, in the case of data not on individuals.
603.16 	(b) Notwithstanding section 13.05, subdivision 9, data addressed in this subdivision 
603.17 	shall not be disclosed except as provided in this subdivision or section 13.04; except that 
603.18 	the commissioner may disclose to the boards under section 214.23.
603.19 	(c) The commissioner may disclose data addressed under this subdivision as necessary: 
603.20 	to identify, establish, implement, and enforce a monitoring plan; to investigate a regulated 
603.21 	person; to alert persons who may be threatened by illness as evidenced by epidemiologic 
603.22 	data; to control or prevent the spread of HIV, HBV, or HCV disease; or to diminish an 
603.23 	imminent threat to the public health.

603.24 	EFFECTIVE DATE. This section is effective on January 1, 2020, and no new cases 
603.25 	shall be investigated under this subdivision after June 1, 2019.

603.26 	Sec. 105. Laws 2019, chapter 60, article 3, section 1, subdivision 5, is amended to read:
603.27 		Subd. 5.Notice to facility; exceptions. (a) Electronic monitoring may begin only after 
603.28 	the resident or resident representative who intends to place an electronic monitoring device 
603.29 	and any roommate or roommate's resident representative completes the notification and 
603.30 	consent form and submits the form to the facility.
604.1 	(b) Notwithstanding paragraph (a), the resident or resident representative who intends 
604.2 	to place an electronic monitoring device may do so without submitting a notification and 
604.3 	consent form to the facility for up to 14 days:
604.4 	(1) if the resident or the resident representative reasonably fears retaliation against the 
604.5 	resident by the facility, timely submits the completed notification and consent form to the 
604.6 	Office of Ombudsman for Long-Term Care, and timely submits a Minnesota Adult Abuse 
604.7 	Reporting Center report or police report, or both, upon evidence from the electronic 
604.8 	monitoring device that suspected maltreatment has occurred;
604.9 	(2) if there has not been a timely written response from the facility to a written 
604.10 	communication from the resident or resident representative expressing a concern prompting 
604.11 	the desire for placement of an electronic monitoring device and if the resident or a resident 
604.12 	representative timely submits a completed notification and consent form to the Office of 
604.13 	Ombudsman for Long-Term Care; or
604.14 	(3) if the resident or resident representative has already submitted a Minnesota Adult 
604.15 	Abuse Reporting Center report or police report regarding the resident's concerns prompting 
604.16 	the desire for placement and if the resident or a resident representative timely submits a 
604.17 	completed notification and consent form to the Office of Ombudsman for Long-Term Care.
604.18 	(c) Upon receipt of any completed notification and consent form, the facility must place 
604.19 	the original form in the resident's file or file the original form with the resident's housing 
604.20 	with services contract. The facility must provide a copy to the resident and the resident's 
604.21 	roommate, if applicable.
604.22 	(d) If a resident is conducting electronic monitoring according to paragraph (b) and 
604.23 	obtains a signed notification and consent form from a roommate a new roommate moves 
604.24 	into the room or living unit, the resident or resident representative must submit the signed 
604.25 	notification and consent form to the facility. In the event that a resident or roommate, or 
604.26 	the resident representative or roommate's resident representative if the representative is 
604.27 	consenting on behalf of the resident or roommate, chooses to alter the conditions under 
604.28 	which consent to electronic monitoring is given or chooses to withdraw consent to electronic 
604.29 	monitoring, the facility must make available the original notification and consent form so 
604.30 	that it may be updated. Upon receipt of the updated form, the facility must place the updated 
604.31 	form in the resident's file or file the original form with the resident's signed housing with 
604.32 	services contract. The facility must provide a copy of the updated form to the resident and 
604.33 	the resident's roommate, if applicable.
605.1 	(e) If a new roommate, or the new roommate's resident representative when consenting 
605.2 	on behalf of the new roommate, does not submit to the facility a completed notification and 
605.3 	consent form and the resident conducting the electronic monitoring does not remove or 
605.4 	disable the electronic monitoring device, the facility must remove the electronic monitoring 
605.5 	device.
605.6 	(f) If a roommate, or the roommate's resident representative when withdrawing consent 
605.7 	on behalf of the roommate, submits an updated notification and consent form withdrawing 
605.8 	consent and the resident conducting electronic monitoring does not remove or disable the 
605.9 	electronic monitoring device, the facility must remove the electronic monitoring device.

605.10 	EFFECTIVE DATE. This section is effective January 1, 2020, and applies to all 
605.11 	agreements in effect, entered into, or renewed on or after that date.

605.12 	Sec. 106. PLAN FOR A WORKING GROUP ON LINKS BETWEEN HEALTH 
605.13 	DISPARITIES AND EDUCATIONAL ACHIEVEMENT FOR CHILDREN FROM 
605.14 	AMERICAN INDIAN COMMUNITIES AND COMMUNITIES OF COLOR.
 605.15 	(a) The commissioner of health, in consultation with the commissioner of education, 
605.16 	shall develop a plan to convene one or more working groups to:
605.17 	(1) examine the links between health disparities and disparities in educational achievement 
605.18 	for children from American Indian communities and communities of color; and
605.19 	(2) develop recommendations for programs, services, or funding to address health 
605.20 	disparities and decrease disparities in educational achievement for children from American 
605.21 	Indian communities and communities of color.
605.22 	(b) The plan shall include the possible membership of the proposed working group and 
605.23 	the duties for the proposed working group.
605.24 	(c) The commissioner shall submit the plan for the working group, including proposed 
605.25 	legislation establishing the working group, to the chairs and ranking minority members of 
605.26 	the legislative committees with jurisdiction over health and education by February 15, 2020.

605.27 	Sec. 107. COMMUNITY SOLUTIONS FOR HEALTHY CHILD DEVELOPMENT 
605.28 	GRANT PROGRAM.
 605.29 		Subdivision 1.Establishment. The commissioner of health shall establish the community 
605.30 	solutions for healthy child development grant program. The purposes of the program are 
605.31 	to:
606.1 	(1) improve child development outcomes as related to the well-being of children of color 
606.2 	and American Indian children from prenatal to grade 3 and their families, including but not 
606.3 	limited to the goals outlined by the Department of Human Service's early childhood systems 
606.4 	reform effort: early learning; health and well-being; economic security; and safe, stable, 
606.5 	nurturing relationships and environments by funding community-based solutions for 
606.6 	challenges that are identified by the affected community;
606.7 	(2) reduce racial disparities in children's health and development, from prenatal to grade 
606.8 	3; and
606.9 	(3) promote racial and geographic equity.
606.10 		Subd. 2.Commissioner's duties. The commissioner of health shall:
606.11 	(1) develop a request for proposals for the healthy child development grant program in 
606.12 	consultation with the Community Solutions Advisory Council;
606.13 	(2) provide outreach, technical assistance, and program development support to increase 
606.14 	capacity for new and existing service providers in order to better meet statewide needs, 
606.15 	particularly in greater Minnesota and areas where services to reduce health disparities have 
606.16 	not been established;
606.17 	(3) review responses to requests for proposals, in consultation with the Community 
606.18 	Solutions Advisory Council, and award grants under this section;
606.19 	(4) ensure communication with the ethnic councils, Minnesota Indian Affairs Council, 
606.20 	and the governor's early learning council on the request for proposal process;
606.21 	(5) establish a transparent and objective accountability process, in consultation with the 
606.22 	Community Solutions Advisory Council, focused on outcomes that grantees agree to achieve;
606.23 	(6) provide grantees with access to data to assist grantees in establishing and 
606.24 	implementing effective community-led solutions;
606.25 	(7) maintain data on outcomes reported by grantees; and
606.26 	(8) contract with an independent third-party entity to evaluate the success of the grant 
606.27 	program and to build the evidence base for effective community solutions in reducing health 
606.28 	disparities of children of color and American Indian children from prenatal to grade 3.
606.29 		Subd. 3.Community Solutions Advisory Council; establishment; duties; 
606.30 	compensation. (a) No later than October 1, 2019, the commissioner shall convene a 
606.31 	12-member Community Solutions Advisory Council as follows:
606.32 	(1) two members representing the African Heritage community;
607.1 	(2) two members representing the Latino community;
607.2 	(3) two members representing the Asian-Pacific Islander community;
607.3 	(4) two members representing the American Indian community;
607.4 	(5) two parents of children of color or that are American Indian with children under nine 
607.5 	years of age;
607.6 	(6) one member with research or academic expertise in racial equity and healthy child 
607.7 	development; and
607.8 	(7) one member representing an organization that advocates on behalf of communities 
607.9 	of color or American Indians.
607.10 	(b) At least three of the 12 members of the advisory council must come from outside 
607.11 	the seven-county metropolitan area.
607.12 	(c) The Community Solutions Advisory Council shall:
607.13 	(1) advise the commissioner on the development of the request for proposals for 
607.14 	community solutions healthy child development grants. In advising the commissioner, the 
607.15 	council must consider how to build on the capacity of communities to promote child and 
607.16 	family well-being and address social determinants of healthy child development;
607.17 	(2) review responses to requests for proposals and advise the commissioner on the 
607.18 	selection of grantees and grant awards;
607.19 	(3) advise the commissioner on the establishment of a transparent and objective 
607.20 	accountability process focused on outcomes the grantees agree to achieve;
607.21 	(4) advise the commissioner on ongoing oversight and necessary support in the 
607.22 	implementation of the program; and
607.23 	(5) support the commissioner on other racial equity and early childhood grant efforts.
607.24 	(d) Each advisory council member shall be compensated in accordance with Minnesota 
607.25 	Statutes, section 15.059, subdivision 3.
607.26 		Subd. 4.Eligible grantees. Organizations eligible to receive grant funding under this 
607.27 	section include:
607.28 	(1) organizations or entities that work with communities of color and American Indian 
607.29 	communities;
607.30 	(2) tribal nations and tribal organizations as defined in section 658P of the Child Care 
607.31 	and Development Block Grant Act of 1990; and
608.1 	(3) organizations or entities focused on supporting healthy child development.
608.2 		Subd. 5.Strategic consideration and priority of proposals; eligible populations; 
608.3 	grant awards. (a) The commissioner, in consultation with the Community Solutions 
608.4 	Advisory Council, shall develop a request for proposals for healthy child development 
608.5 	grants. In developing the proposals and awarding the grants, the commissioner shall consider 
608.6 	building on the capacity of communities to promote child and family well-being and address 
608.7 	social determinants of healthy child development. Proposals must focus on increasing racial 
608.8 	equity and healthy child development and reducing health disparities experienced by children 
608.9 	of color and American Indian children from prenatal to grade 3 and their families.
608.10 	(b) In awarding the grants, the commissioner shall provide strategic consideration and 
608.11 	give priority to proposals from:
608.12 	(1) organizations or entities led by people of color and serving communities of color;
608.13 	(2) organizations or entities led by American Indians and serving American Indians, 
608.14 	including tribal nations and tribal organizations;
608.15 	(3) organizations or entities with proposals focused on healthy development from prenatal 
608.16 	to age three;
608.17 	(4) organizations or entities with proposals focusing on multigenerational solutions;
608.18 	(5) organizations or entities located in or with proposals to serve communities located 
608.19 	in counties that are moderate to high risk according to the Wilder Research Risk and Reach 
608.20 	Report; and
608.21 	(6) community-based organizations that have historically served communities of color 
608.22 	and American Indians and have not traditionally had access to state grant funding.
608.23 	The advisory council may recommend additional strategic considerations and priorities to 
608.24 	the commissioner.
608.25 	(c) The first round of grants must be awarded no later than April 15, 2020.
608.26 		Subd. 6.Geographic distribution of grants. The commissioner and the advisory council 
608.27 	shall ensure that grant funds are prioritized and awarded to organizations and entities that 
608.28 	are within counties that have a higher proportion of people of color and American Indians 
608.29 	than the state average, to the extent possible.
608.30 		Subd. 7.Report. Grantees must report grant program outcomes to the commissioner on 
608.31 	the forms and according to the timelines established by the commissioner.

609.1 	Sec. 108. DOMESTIC VIOLENCE AND SEXUAL ASSAULT PREVENTION 
609.2 	PROGRAM.
 609.3 		Subdivision 1. Program establishment. The commissioner of health shall administer 
609.4 	the domestic violence and sexual assault prevention program as established under this 
609.5 	section.
609.6 		Subd. 2.Grant criteria. (a) The commissioner shall award grants to nonprofit 
609.7 	organizations for the purpose of funding programs that incorporate community-driven and 
609.8 	culturally relevant practices to prevent domestic violence and sexual assault. Grants made 
609.9 	pursuant to this section may either (1) encourage the development and deployment of new 
609.10 	prevention efforts, or (2) enhance, sustain, or expand existing prevention efforts.
609.11 	(b) The commissioner of health shall award grants to nonprofit organizations supporting 
609.12 	activities that:
609.13 	(1) promote the general development of domestic violence and sexual assault prevention 
609.14 	programs and activities;
609.15 	(2) implement prevention activities through community outreach that address the root 
609.16 	causes of domestic violence and sexual assault;
609.17 	(3) identify risk and protective factors for developing domestic violence and sexual 
609.18 	assault prevention strategies and outreach activities;
609.19 	(4) provide trauma-informed domestic violence and sexual assault prevention services;
609.20 	(5) educate youth and adults about healthy relationships and changing social norms;
609.21 	(6) develop culturally and linguistically appropriate domestic violence and sexual assault 
609.22 	prevention programs for historically underserved communities;
609.23 	(7) work collaboratively with educational institutions, including school districts, to 
609.24 	implement domestic violence and sexual assault prevention strategies for students, teachers, 
609.25 	and administrators; or
609.26 	(8) work collaboratively with other nonprofit organizations, for-profit organizations, 
609.27 	and other community-based organizations to implement domestic violence and sexual assault 
609.28 	prevention strategies within their communities.
609.29 		Subd. 3.Definition. For purposes of this section, "domestic violence and sexual assault" 
609.30 	includes, but is not limited to, the following:
609.31 	(1) intimate partner violence, including emotional, psychological, and economic abuse;
610.1 	(2) sex trafficking as defined in Minnesota Statutes, section 609.321, subdivision 7a;
610.2 	(3) domestic abuse as defined in Minnesota Statutes, section 518B.01, subdivision 2;
610.3 	(4) any criminal sexual conduct crime in Minnesota Statutes, sections 609.342 to 
610.4 	609.3453;
610.5 	(5) abusive international marriage;
610.6 	(6) forced marriage; and
610.7 	(7) female genital mutilation, as defined in Minnesota Statutes, section 609.2245, 
610.8 	subdivision 1.
610.9 		Subd. 4.Promotion; administration. The commissioner may spend up to 15 percent 
610.10 	of the total program funding for each fiscal year to promote and administer the program 
610.11 	authorized under this section and to provide technical assistance to program grantees.
610.12 		Subd. 5.Nonstate sources. The commissioner may accept contributions from nonstate 
610.13 	sources to supplement state appropriations for the program authorized under this section. 
610.14 	Contributions received under this subdivision are appropriated to the commissioner for 
610.15 	purposes of this section.
610.16 		Subd. 6.Program evaluation. (a) The commissioner of health shall report by February 
610.17 	28 of each even-numbered year to the legislative committees with jurisdiction over health 
610.18 	detailing the expenditures of funds authorized under this section. The commissioner shall 
610.19 	use the data to evaluate the effectiveness of the program. The commissioner must include 
610.20 	in the report:
610.21 	(1) the number of organizations receiving grant money under this section;
610.22 	(2) the number of individuals served by the grant program;
610.23 	(3) a description and analysis of the practices implemented by program grantees; and
610.24 	(4) best practices recommendations to prevent domestic violence and sexual assault, 
610.25 	including best practices recommendations that are culturally relevant to historically 
610.26 	underserved communities.
610.27 	(b) Any organization receiving grant money under this section must collect and make 
610.28 	available to the commissioner of health aggregate data related to the activity funded by the 
610.29 	grant program under this section.
610.30 	(c) The commissioner of health shall use the information and data from the program 
610.31 	evaluation under paragraph (a), including best practices and culturally specific responses, 
611.1 	to inform the administration of existing Department of Health programming and the 
611.2 	development of Department of Health policies, programs, and procedures.

611.3 	Sec. 109. SKIN LIGHTENING PRODUCTS PUBLIC AWARENESS AND 
611.4 	EDUCATION GRANT PROGRAM.
 611.5 		Subdivision 1.Establishment; purpose. The commissioner of health shall develop a  
611.6 	grant program for the purpose of increasing public awareness and education on the health 
611.7 	dangers associated with using skin lightening creams and products that contain mercury 
611.8 	that are manufactured in other countries and brought into this country and sold illegally 
611.9 	online or in stores.
611.10 		Subd. 2.Grants authorized. The commissioner shall award grants through a request 
611.11 	for proposals process to community-based organizations serving ethnic communities, local 
611.12 	public health entities, and nonprofit organizations that focus on providing health care and 
611.13 	public health outreach to minorities. Priority shall be given to organizations that have 
611.14 	historically served ethnic communities at significant risk from these products, but have not 
611.15 	traditionally had access to state grant funding.
611.16 		Subd. 3.Grant allocation. (a) Grantees must use the funds to conduct public awareness 
611.17 	and education activities that are culturally specific and community-based and focus on:
611.18 	(1) the dangers of exposure to mercury through dermal absorption, inhalation, 
611.19 	hand-to-mouth contact, and through contact with individuals who have used these skin 
611.20 	lightening products;
611.21 	(2) the signs and symptoms of mercury poisoning;
611.22 	(3) the health effects of mercury poisoning, including the permanent effects on the central 
611.23 	nervous system and kidneys;
611.24 	(4) the dangers of using these products or being exposed to these products during 
611.25 	pregnancy and breastfeeding to the mother and to the infant;
611.26 	(5) knowing how to identify products that contain mercury; and
611.27 	(6) proper disposal of the product if the product contains mercury.
611.28 	(b) The grant application must include:
611.29 	(1) a description of the purpose or project for which the grant funds will be used;
611.30 	(2) a description of the objectives, a work plan, and a timeline for implementation; and
611.31 	(3) the community or group the grant proposes to focus on.
612.1 	(c) The commissioner shall award 50 percent of the grant funds to community-based 
612.2 	organizations and nonprofit organizations and 50 percent of the funds to local public health 
612.3 	entities.

612.4 	Sec. 110. SALE OF CERTAIN CANNABINOID PRODUCTS WORKGROUP.
 612.5 	(a) The commissioner of health, in consultation with the commissioners of commerce, 
612.6 	agriculture, and public safety, and the executive director of the Board of Pharmacy, shall 
612.7 	convene a workgroup to advise the legislature on how to regulate products that contain 
612.8 	cannabinoids extracted from hemp. For purposes of this section, "hemp" has the meaning 
612.9 	given to "industrial hemp" in Minnesota Statutes, section 18K.02, subdivision 3.
612.10 	(b) The commissioner shall assess the public health and consumer safety impact on the 
612.11 	sale of cannabinoids derived from hemp and shall develop a regulatory framework of what 
612.12 	the legislature would need to consider including, but not limited to:
612.13 	(1) cultivation standards for industrial hemp if the hemp is used for any product intended 
612.14 	for human or animal consumption;
612.15 	(2) labeling requirements for products containing cannabidiol extracted from hemp, 
612.16 	including the amount and percentage of cannabidiol in the product, the name of the 
612.17 	manufacturer of the product, and the ingredients contained in the product;
612.18 	(3) possible restrictions of advertising and marketing of the cannabidiol product;
612.19 	(4) restrictions of false, misleading, or unsubstantiated health claims;
612.20 	(5) requirements for the independent testing of cannabidiol products, including quality 
612.21 	control and chemical identification;
612.22 	(6) safety standards for edible products containing cannabinoids extracted from hemp, 
612.23 	including container and packaging requirements; and
612.24 	(7) any other requirement or procedure the commissioner deems necessary.
612.25 	(c) By January 15, 2020, the commissioner of health shall submit the results of the 
612.26 	workgroup to the chairs and ranking minority members of the legislative committees with 
612.27 	jurisdiction over public health, consumer protection, public safety, and agriculture.

612.28 	Sec. 111. REVISOR INSTRUCTION.
 612.29 	The revisor of statutes shall correct any internal cross-references to Minnesota Statutes, 
612.30 	sections 214.17 to 214.25, that occur as a result of the repealed language and may make 
613.1 	changes necessary to correct punctuation, grammar, or structure of the remaining text and 
613.2 	preserve its meaning.

613.3 	Sec. 112. REPEALER.
 613.4 	(a) Minnesota Statutes 2018, sections 144.414, subdivision 5; 144A.45, subdivision 6; 
613.5 	and 144A.481, are repealed.
613.6 	(b) Minnesota Statutes 2018, sections 214.17; 214.18; 214.19; 214.20; 214.21; 214.22; 
613.7 	214.23; and 214.24, are repealed on January 1, 2020, and no new cases shall be investigated 
613.8 	under these sections after June 1, 2019.

613.9 	ARTICLE 12
613.10 	MISCELLANEOUS

613.11 	Section 1. [10.584] MATERNAL MENTAL HEALTH AWARENESS MONTH.
613.12 	The month of May is designated as Maternal Mental Health Awareness Month in 
613.13 	recognition of the state's desire to recognize the prevalence of pregnancy and postpartum 
613.14 	mental health issues and educate the people of the state about identifying symptoms and 
613.15 	seeking treatment options. Up to one-third of mothers report having symptoms of pregnancy 
613.16 	and postpartum mood and anxiety disorders each year. Many more cases go unreported due 
613.17 	to misunderstanding. Pregnancy and postpartum mood disorders are widespread but treatable 
613.18 	illnesses. Left untreated, pregnancy and postpartum mood and anxiety disorders can lead 
613.19 	to negative effects on birth outcomes, infant development, and the well-being of mothers 
613.20 	and families. The state declares that in order to educate the public, the governor may promote 
613.21 	and encourage the observance of Maternal Mental Health Awareness Month.

613.22 	ARTICLE 13
613.23 	FORECAST ADJUSTMENT

613.24	Section 1. DEPARTMENT OF HUMAN SERVICES FORECAST ADJUSTMENT.
 	
613.25 	The dollar amounts shown in the columns marked "Appropriations" are added to or, if 
613.26 	shown in parentheses, are subtracted from the appropriations in Laws 2017, First Special 
613.27 	Session chapter 6, article 18, from the general fund, or any other fund named, to the 
613.28 	commissioner of human services for the purposes specified in this article, to be available 
613.29 	for the fiscal year indicated for each purpose. The figure "2019" used in this article means 
613.30 	that the appropriations listed are available for the fiscal year ending June 30, 2019.

613.31				APPROPRIATIONS
	
613.32				Available for the Year
	
614.1				Ending June 30
	
614.2					2019

614.3
614.4	Sec. 2. COMMISSIONER OF HUMAN 
SERVICES

614.5	Subdivision 1.Total Appropriation
 	$
	(318,423,000)

614.6	Appropriations by Fund
	
614.7		2019
		
614.8	General
	(317,538,000)
		
614.9	Health Care Access
	8,410,000
		
614.10	Federal TANF
	(9,295,000)

614.11	Subd. 2.Forecasted Programs
 					
614.12
614.13
614.14
614.15	(a) Minnesota Family 
Investment Program 
(MFIP)/Diversionary Work 
Program (DWP)

614.16	Appropriations by Fund
	
614.17	General
	(19,361,000)
		
614.18	Federal TANF
	(8,893,000)

614.19	(b) MFIP Child Care Assistance
		(16,789,000)

614.20	(c) General Assistance
		(7,928,000)

614.21	(d) Minnesota Supplemental Aid
		(549,000)

614.22	(e) Housing Support
		(13,836,000)

614.23	(f) Northstar Care for Children
		(19,027,000)

614.24	(g) MinnesotaCare
		8,410,000
			
614.25 	This appropriation is from the health care 
614.26 	access fund.

614.27	(h) Medical Assistance

614.28	Appropriations by Fund
	
614.29	General
	(222,176,000)
		
614.30	Health Care Access
	-0-

614.31	(i) Alternative Care
		-0-

614.32
614.33	(j) Consolidated Chemical Dependency 
Treatment Fund (CCDTF) Entitlement
		(17,872,000)

615.1	Subd. 3.Technical Activities
 		(402,000)
			
615.2 	This appropriation is from the federal TANF 
615.3 	fund.

615.4 	Sec. 3. EFFECTIVE DATE.
 615.5 	Sections 1 and 2 are effective the day following final enactment.

615.6 	ARTICLE 14
615.7 	APPROPRIATIONS

615.8	Section 1. HEALTH AND HUMAN SERVICES APPROPRIATIONS.
 	
615.9 	The sums shown in the columns marked "Appropriations" are appropriated to the agencies 
615.10 	and for the purposes specified in this article. The appropriations are from the general fund, 
615.11 	or another named fund, and are available for the fiscal years indicated for each purpose. 
615.12 	The figures "2020" and "2021" used in this article mean that the appropriations listed under 
615.13 	them are available for the fiscal year ending June 30, 2020, or June 30, 2021, respectively. 
615.14 	"The first year" is fiscal year 2020. "The second year" is fiscal year 2021. "The biennium" 
615.15 	is fiscal years 2020 and 2021.

615.16				APPROPRIATIONS
	
615.17				Available for the Year
	
615.18				Ending June 30
	
615.19					2020
		2021

615.20
615.21	Sec. 2. COMMISSIONER OF HUMAN 
SERVICES

615.22	Subdivision 1.Total Appropriation
 	$
	8,148,863,000
	$
	8,400,601,000

615.23	Appropriations by Fund
	
615.24		2020
	2021
	
615.25	General
	7,221,990,000
	7,320,071,000
	
615.26
615.27	State Government 
Special Revenue
	4,299,000
	4,299,000
	
615.28	Health Care Access
	661,393,000
	795,115,000
	
615.29	Federal TANF
	259,285,000
	279,220,000
	
615.30	Lottery Prize
	1,896,000
	1,896,000
	
616.1 	The amounts that may be spent for each 
616.2 	purpose are specified in the following 
616.3 	subdivisions.

616.4	Subd. 2.TANF Maintenance of Effort
 					
616.5 	(a) Nonfederal Expenditures. The 
616.6 	commissioner shall ensure that sufficient 
616.7 	qualified nonfederal expenditures are made 
616.8 	each year to meet the state's maintenance of 
616.9 	effort (MOE) requirements of the TANF block 
616.10 	grant specified under Code of Federal 
616.11 	Regulations, title 45, section 263.1. In order 
616.12 	to meet these basic TANF/MOE requirements, 
616.13 	the commissioner may report as TANF/MOE 
616.14 	expenditures only nonfederal money expended 
616.15 	for allowable activities listed in the following 
616.16 	clauses:
616.17 	(1) MFIP cash, diversionary work program, 
616.18 	and food assistance benefits under Minnesota 
616.19 	Statutes, chapter 256J;
616.20 	(2) the child care assistance programs under 
616.21 	Minnesota Statutes, sections 119B.03 and 
616.22 	119B.05, and county child care administrative 
616.23 	costs under Minnesota Statutes, section 
616.24 	119B.15;
616.25 	(3) state and county MFIP administrative costs 
616.26 	under Minnesota Statutes, chapters 256J and 
616.27 	256K;
616.28 	(4) state, county, and tribal MFIP employment 
616.29 	services under Minnesota Statutes, chapters 
616.30 	256J and 256K;
616.31 	(5) expenditures made on behalf of legal 
616.32 	noncitizen MFIP recipients who qualify for 
616.33 	the MinnesotaCare program under Minnesota 
616.34 	Statutes, chapter 256L;
617.1 	(6) qualifying Minnesota education credit 
617.2 	expenditures under Minnesota Statutes, section 
617.3 	290.0674; and
617.4 	(7) qualifying Head Start expenditures under 
617.5 	Minnesota Statutes, section 119A.50.
617.6 	(b) Nonfederal Expenditures; Reporting.
617.7 	For the activities listed in paragraph (a), 
617.8 	clauses (2) to (7), the commissioner may 
617.9 	report only expenditures that are excluded 
617.10 	from the definition of assistance under Code 
617.11 	of Federal Regulations, title 45, section 
617.12 	260.31.
617.13 	(c) Certain Expenditures Required. The 
617.14 	commissioner shall ensure that the MOE used 
617.15 	by the commissioner of management and 
617.16 	budget for the February and November 
617.17 	forecasts required under Minnesota Statutes, 
617.18 	section 16A.103, contains expenditures under 
617.19 	paragraph (a), clause (1), equal to at least 16 
617.20 	percent of the total required under Code of 
617.21 	Federal Regulations, title 45, section 263.1.
617.22 	(d) Limitation; Exceptions. The 
617.23 	commissioner must not claim an amount of 
617.24 	TANF/MOE in excess of the 75 percent 
617.25 	standard in Code of Federal Regulations, title 
617.26 	45, section 263.1(a)(2), except:
617.27 	(1) to the extent necessary to meet the 80 
617.28 	percent standard under Code of Federal 
617.29 	Regulations, title 45, section 263.1(a)(1), if it 
617.30 	is determined by the commissioner that the 
617.31 	state will not meet the TANF work 
617.32 	participation target rate for the current year;
617.33 	(2) to provide any additional amounts under 
617.34 	Code of Federal Regulations, title 45, section 
618.1 	264.5, that relate to replacement of TANF 
618.2 	funds due to the operation of TANF penalties; 
618.3 	and
618.4 	(3) to provide any additional amounts that may 
618.5 	contribute to avoiding or reducing TANF work 
618.6 	participation penalties through the operation 
618.7 	of the excess MOE provisions of Code of 
618.8 	Federal Regulations, title 45, section 261.43 
618.9 	(a)(2).
618.10 	(e) Supplemental Expenditures. For the 
618.11 	purposes of paragraph (d), the commissioner 
618.12 	may supplement the MOE claim with other 
618.13 	qualified expenditures to the extent such 
618.14 	expenditures are otherwise available after 
618.15 	considering the expenditures allowed in this 
618.16 	subdivision.
618.17 	(f) Reduction of Appropriations; Exception.
618.18 	The requirement in Minnesota Statutes, section 
618.19 	256.011, subdivision 3, that federal grants or 
618.20 	aids secured or obtained under that subdivision 
618.21 	be used to reduce any direct appropriations 
618.22 	provided by law, does not apply if the grants 
618.23 	or aids are federal TANF funds.
618.24 	(g) IT Appropriations Generally. This 
618.25 	appropriation includes funds for information 
618.26 	technology projects, services, and support. 
618.27 	Notwithstanding Minnesota Statutes, section 
618.28 	16E.0466, funding for information technology 
618.29 	project costs shall be incorporated into the 
618.30 	service level agreement and paid to the Office 
618.31 	of MN.IT Services by the Department of 
618.32 	Human Services under the rates and 
618.33 	mechanism specified in that agreement.
619.1 	(h) Receipts for Systems Project.
619.2 	Appropriations and federal receipts for 
619.3 	information systems projects for MAXIS, 
619.4 	PRISM, MMIS, ISDS, METS, and SSIS must 
619.5 	be deposited in the state systems account 
619.6 	authorized in Minnesota Statutes, section 
619.7 	256.014. Money appropriated for computer 
619.8 	projects approved by the commissioner of the 
619.9 	Office of MN.IT Services, funded by the 
619.10 	legislature, and approved by the commissioner 
619.11 	of management and budget may be transferred 
619.12 	from one project to another and from 
619.13 	development to operations as the 
619.14 	commissioner of human services considers 
619.15 	necessary. Any unexpended balance in the 
619.16 	appropriation for these projects does not 
619.17 	cancel and is available for ongoing 
619.18 	development and operations.
619.19 	(i) Federal SNAP Education and Training 
619.20 	Grants. Federal funds available during fiscal 
619.21 	years 2020 and 2021 for Supplemental 
619.22 	Nutrition Assistance Program Education and 
619.23 	Training and SNAP Quality Control 
619.24 	Performance Bonus grants are appropriated 
619.25 	to the commissioner of human services for the 
619.26 	purposes allowable under the terms of the 
619.27 	federal award. This paragraph is effective the 
619.28 	day following final enactment.

619.29	Subd. 3.Central Office; Operations

619.30	Appropriations by Fund
	
619.31	General
	152,240,000
	151,012,000
	
619.32
619.33	State Government 
Special Revenue
	4,174,000
	4,174,000
	
619.34	Health Care Access
	20,709,000
	20,724,000
	
619.35	Federal TANF
	100,000
	100,000
	
620.1 	(a) Administrative Recovery; Set-Aside. The 
620.2 	commissioner may invoice local entities 
620.3 	through the SWIFT accounting system as an 
620.4 	alternative means to recover the actual cost of 
620.5 	administering the following provisions:
620.6 	(1) the statewide data management system 
620.7 	authorized in Minnesota Statutes, section 
620.8 	125A.744, subdivision 3;
620.9 	(2) repayment of the special revenue 
620.10 	maximization account as provided under 
620.11 	Minnesota Statutes, section 245.495, 
620.12 	paragraph (b);
620.13 	(3) repayment of the special revenue 
620.14 	maximization account as provided under 
620.15 	Minnesota Statutes, section 256B.0625, 
620.16 	subdivision 20, paragraph (k);
620.17 	(4) targeted case management under 
620.18 	Minnesota Statutes, section 256B.0924, 
620.19 	subdivision 6, paragraph (g);
620.20 	(5) residential services for children with severe 
620.21 	emotional disturbance under Minnesota 
620.22 	Statutes, section 256B.0945, subdivision 4, 
620.23 	paragraph (d); and
620.24 	(6) repayment of the special revenue 
620.25 	maximization account as provided under 
620.26 	Minnesota Statutes, section 256F.10, 
620.27 	subdivision 6, paragraph (b).
620.28 	(b) Child Care Licensing Inspections.
620.29 	$673,000 in fiscal year 2020 and $722,000 in 
620.30 	fiscal year 2021 are from the general fund to 
620.31 	add eight child care licensing staff for the 
620.32 	purpose of increasing the frequency of 
620.33 	inspections of child care centers to ensure the 
620.34 	health and safety of children in care, provide 
621.1 	technical assistance to newly licensed 
621.2 	programs, and monitor struggling programs 
621.3 	more closely to evaluate whether the program 
621.4 	should be referred to the Office of Inspector 
621.5 	General for a potential fraud investigation.
621.6 	(c) Child Care Assistance Programs - Fraud 
621.7 	and Abuse Data Analysts. $317,000 in fiscal 
621.8 	year 2020 and $339,000 in fiscal year 2021 
621.9 	are from the general fund to add two data 
621.10 	analysts to strengthen the commissioner's 
621.11 	ability to identify, detect, and prevent fraud 
621.12 	and abuse in the child care assistance programs 
621.13 	under Minnesota Statutes, chapter 119B.
621.14 	(d) Office of Inspector General 
621.15 	Investigators. $418,000 in fiscal year 2020 
621.16 	and $483,000 in fiscal year 2021 are from the 
621.17 	general fund to add four investigators to the 
621.18 	Office of Inspector General to detect, prevent, 
621.19 	and make recoveries from fraudulent activities 
621.20 	among providers in the medical assistance 
621.21 	program under Minnesota Statutes, chapter 
621.22 	256B.
621.23 	(e) Office of Inspector General Tracking 
621.24 	System. $355,000 in fiscal year 2020 and 
621.25 	$105,000 in fiscal year 2021 are from the 
621.26 	general fund to purchase a system to record, 
621.27 	track, and report on investigative activity for 
621.28 	the Office of Inspector General to strengthen 
621.29 	fraud prevention and investigation activities 
621.30 	for child care assistance programs under 
621.31 	Minnesota Statutes, chapter 119B.
621.32 	(f) Fraud Prevention Investigation Grant 
621.33 	Program. $425,000 in fiscal year 2020 and 
621.34 	$425,000 in fiscal year 2021 are from the 
621.35 	general fund for the fraud prevention 
622.1 	investigation grant program under Minnesota 
622.2 	Statutes, section 256.983.
622.3 	(g) Child Care Assistance Programs - Law 
622.4 	Enforcement. $350,000 in fiscal year 2020 
622.5 	and $350,000 in fiscal year 2021 are from the 
622.6 	general fund to add two additional law 
622.7 	enforcement officers under contract with the 
622.8 	Bureau of Criminal Apprehension to conduct 
622.9 	criminal investigations in child care assistance 
622.10 	program cases.
622.11 	(h) Transfer; Long-Term Care Options 
622.12 	Account. By June 30, 2020, the commissioner 
622.13 	shall transfer $3,242,000 from the long-term 
622.14 	care options account authorized in Minnesota 
622.15 	Statutes, section 256.01, subdivision 34, to the 
622.16 	general fund. This is a onetime transfer.
622.17 	(i) Transfer to Office of Legislative Auditor.
622.18 	$300,000 in fiscal year 2020 and $300,000 in 
622.19 	fiscal year 2021 are from the general fund for 
622.20 	transfer to the Office of the Legislative 
622.21 	Auditor for audit activities under Minnesota 
622.22 	Statutes, section 3.972, subdivision 2b.
622.23 	(j) Transfer to Office of Legislative Auditor.
622.24 	$400,000 in fiscal year 2020 and $400,000 in 
622.25 	fiscal year 2021 are from the general fund for 
622.26 	transfer to the Office of the Legislative 
622.27 	Auditor for audit activities under Minnesota 
622.28 	Statutes, section 3.972, subdivision 2a.
622.29 	(k) Family Child Care Task Force. $121,000 
622.30 	in fiscal year 2020 is from the general fund 
622.31 	for the Family Child Care Task Force under 
622.32 	article 2, section 130. This is a onetime 
622.33 	appropriation.
623.1 	(l) Base Level Adjustment. The general fund 
623.2 	base is $142,929,000 in fiscal year 2022 and 
623.3 	$145,377,000 in fiscal year 2023. The health 
623.4 	care access base is $20,712,000 in fiscal year 
623.5 	2022 and $20,712,000 in fiscal year 2023.

623.6	Subd. 4.Central Office; Children and Families

623.7	Appropriations by Fund
	
623.8	General
	13,558,000
	14,424,000
	
623.9	Federal TANF
	2,582,000
	2,582,000
	
623.10 	(a) Financial Institution Data Match and 
623.11 	Payment of Fees. The commissioner is 
623.12 	authorized to allocate up to $310,000 in fiscal 
623.13 	year 2020 and $310,000 in fiscal year 2021 
623.14 	from the state systems account authorized in 
623.15 	Minnesota Statutes, section 256.014, 
623.16 	subdivision 2, to make payments to financial 
623.17 	institutions in exchange for performing data 
623.18 	matches between account information held by 
623.19 	financial institutions and the public authority's 
623.20 	database of child support obligors as 
623.21 	authorized by Minnesota Statutes, section 
623.22 	13B.06, subdivision 7.
623.23 	(b) Child Welfare Training Academy.
623.24 	$1,371,000 in fiscal year 2020 and $2,517,000 
623.25 	in fiscal year 2021 are from the general fund 
623.26 	for the Child Welfare Training Academy for 
623.27 	the provision of child protection worker 
623.28 	training under Minnesota Statutes, section 
623.29 	626.5591, subdivision 2. The base for this 
623.30 	appropriation is $2,754,000 in fiscal year 2022 
623.31 	and $3,007,000 in fiscal year 2023.
623.32 	(c) Child Care Assistance Programs - 
623.33 	Improvements. $105,000 in fiscal year 2020 
623.34 	and $120,000 in fiscal year 2021 are from the 
623.35 	general fund to add one temporary staff person 
624.1 	to plan for improvements to provider 
624.2 	registration and oversight for the child care 
624.3 	assistance programs under Minnesota Statutes, 
624.4 	chapter 119B. This is a onetime appropriation.
624.5 	(d) Base Level Adjustment. The general fund 
624.6 	base is $14,540,000 in fiscal year 2022 and 
624.7 	$14,793,000 in fiscal year 2023.

624.8	Subd. 5.Central Office; Health Care

624.9	Appropriations by Fund
	
624.10	General
	22,769,000
	23,678,000
	
624.11	Health Care Access
	25,063,000
	24,406,000
	
624.12 	(a) Nonemergency Medical Transportation 
624.13 	Program Audits. $557,000 in fiscal year 2020 
624.14 	and $1,119,000 in fiscal year 2021 are from 
624.15 	the general fund to conduct audits of the 
624.16 	nonemergency medical transportation 
624.17 	program. The base for this appropriation is 
624.18 	$1,123,000 in fiscal year 2022 and $1,123,000 
624.19 	in fiscal year 2023.
624.20 	(b) Outpatient Pharmacy. $113,000 in fiscal 
624.21 	year 2020 and $50,000 in fiscal year 2021 are 
624.22 	from the general fund to contract for 340B 
624.23 	pharmacy data in order to perform the new 
624.24 	pricing calculations and conduct a cost of 
624.25 	dispensing survey. The base for this 
624.26 	appropriation is $50,000 in fiscal year 2022 
624.27 	and $163,000 in fiscal year 2023.
624.28 	(c) Base Level Adjustment. The general fund 
624.29 	base is $24,028,000 in fiscal year 2022 and 
624.30 	$23,697,000 in fiscal year 2023. The health 
624.31 	care access fund base is $24,422,000 in fiscal 
624.32 	year 2022 and $24,422,000 in fiscal year 2023.

624.33
624.34	Subd. 6.Central Office; Continuing Care for 
Older Adults

625.1	Appropriations by Fund
	
625.2	General
	14,670,000
	14,677,000
	
625.3
625.4	State Government 
Special Revenue
	125,000
	125,000

625.5	Subd. 7.Central Office; Community Supports

625.6	Appropriations by Fund
	
625.7	General
	35,722,000
	35,741,000
	
625.8	Lottery Prize
	163,000
	163,000
	
625.9 	(a) Community Competency Restoration 
625.10 	Task Force. $125,000 in fiscal year 2020 and 
625.11 	$75,000 in fiscal year 2021 are for the 
625.12 	Community Competency Restoration Task 
625.13 	Force under article 6, section 78. This is a 
625.14 	onetime appropriation and is available until 
625.15 	June 30, 2023.
625.16 	(b) Base Level Adjustment. The general fund 
625.17 	base is $35,680,000 in fiscal year 2022 and 
625.18 	$35,599,000 in fiscal year 2023.

625.19	Subd. 8.Forecasted Programs; MFIP/DWP

625.20	Appropriations by Fund
	
625.21	General
	83,886,000
	90,149,000
	
625.22	Federal TANF
	84,267,000
	97,771,000

625.23
625.24	Subd. 9.Forecasted Programs; MFIP Child Care 
Assistance
 		102,061,000
		101,855,000

625.25
625.26	Subd. 10.Forecasted Programs; General 
Assistance
 		49,959,000
		50,586,000
	
625.27 	(a) General Assistance Standard. The 
625.28 	commissioner shall set the monthly standard 
625.29 	of assistance for general assistance units 
625.30 	consisting of an adult recipient who is 
625.31 	childless and unmarried or living apart from 
625.32 	parents or a legal guardian at $203. The 
625.33 	commissioner may reduce this amount 
625.34 	according to Laws 1997, chapter 85, article 3, 
625.35 	section 54.
626.1 	(b) Emergency General Assistance Limit.
626.2 	The amount appropriated for emergency 
626.3 	general assistance is limited to no more than 
626.4 	$6,729,812 in fiscal year 2020 and $6,729,812 
626.5 	in fiscal year 2021. Funds to counties shall be 
626.6 	allocated by the commissioner using the 
626.7 	allocation method under Minnesota Statutes, 
626.8 	section 256D.06.

626.9626.10
	Subd. 11.Forecasted Programs; Minnesota 
Supplemental Aid
 		42,348,000
		46,420,000

626.11
626.12	Subd. 12.Forecasted Programs; Housing 
Support
 		169,610,000
		170,218,000

626.13
626.14	Subd. 13.Forecasted Programs; Northstar Care 
for Children
 		86,497,000
		94,095,000

626.15	Subd. 14.Forecasted Programs; MinnesotaCare
 		25,197,000
		143,937,000
	
626.16 	This appropriation is from the health care 
626.17 	access fund.

626.18
626.19	Subd. 15.Forecasted Programs; Medical 
Assistance

626.20	Appropriations by Fund
	
626.21	General
	5,515,098,000
	5,565,150,000
	
626.22	Health Care Access
	586,959,000
	602,583,000
	
626.23 	(a) Behavioral Health Services. $1,000,000 
626.24 	in fiscal year 2020 and $1,000,000 in fiscal 
626.25 	year 2021 are for behavioral health services 
626.26 	provided by hospitals identified under 
626.27 	Minnesota Statutes, section 256.969, 
626.28 	subdivision 2b, paragraph (a), clause (4). The 
626.29 	increase in payments shall be made by 
626.30 	increasing the adjustment under Minnesota 
626.31 	Statutes, section 256.969, subdivision 2b, 
626.32 	paragraph (e), clause (2).
626.33 	(b) Base Level Adjustment. The health care 
626.34 	access fund base is $611,178,000 in fiscal year 
626.35 	2022 and $612,099,000 in fiscal year 2023.

627.1
627.2	Subd. 16.Forecasted Programs; Alternative 
Care
 		45,246,000
		45,276,000
	
627.3 	Alternative Care Transfer. Any money 
627.4 	allocated to the alternative care program that 
627.5 	is not spent for the purposes indicated does 
627.6 	not cancel but must be transferred to the 
627.7 	medical assistance account.

627.8
627.9	Subd. 17.Forecasted Programs; Chemical 
Dependency Treatment Fund
 		124,719,000
		135,609,000
	
627.10 	Transfer; Consolidated Chemical 
627.11 	Dependency Treatment Fund. Any balance 
627.12 	remaining in the consolidated chemical 
627.13 	dependency treatment fund at the end of fiscal 
627.14 	year 2020, estimated to be $23,855,000, shall 
627.15 	be transferred to the general fund.

627.16
627.17	Subd. 18.Grant Programs; Support Services 
Grants

627.18	Appropriations by Fund
	
627.19	General
	8,715,000
	8,715,000
	
627.20	Federal TANF
	96,312,000
	96,311,000

627.21
627.22	Subd. 19.Grant Programs; Basic Sliding Fee 
Child Care Assistance Grants
 		44,655,000
		53,616,000

627.23
627.24	Subd. 20.Grant Programs; Child Care 
Development Grants
 		1,737,000
		1,737,000

627.25
627.26	Subd. 21.Grant Programs; Child Support 
Enforcement Grants
 		50,000
		50,000

627.27
627.28	Subd. 22.Grant Programs; Children's Services 
Grants

627.29	Appropriations by Fund
	
627.30	General
	44,207,000
	48,785,000
	
627.31	Federal TANF
	140,000
	140,000
	
627.32 	(a) Title IV-E Adoption Assistance. The 
627.33 	commissioner shall allocate funds from the 
627.34 	Title IV-E reimbursement to the state from 
627.35 	the Fostering Connections to Success and 
627.36 	Increasing Adoptions Act for adoptive, foster, 
628.1 	and kinship families as required in Minnesota 
628.2 	Statutes, section 256N.261.
628.3 	Additional federal reimbursement to the state 
628.4 	as a result of the Fostering Connections to 
628.5 	Success and Increasing Adoptions Act's 
628.6 	expanded eligibility for title IV-E adoption 
628.7 	assistance is for postadoption, foster care, 
628.8 	adoption, and kinship services, including a 
628.9 	parent-to-parent support network.
628.10 	(b) Parent Support for Better Outcomes 
628.11 	Grants. $150,000 in fiscal year 2020 and 
628.12 	$150,000 in fiscal year 2021 are from the 
628.13 	general fund for grants to Minnesota One-Stop 
628.14 	for Communities to provide mentoring, 
628.15 	guidance, and support services to parents 
628.16 	navigating the child welfare system in 
628.17 	Minnesota in order to promote the 
628.18 	development of safe, stable, and healthy 
628.19 	families. Grant funds may be used for parent 
628.20 	mentoring, peer-to-peer support groups, 
628.21 	housing support services, training, staffing, 
628.22 	and administrative costs. This is a onetime 
628.23 	appropriation.
628.24 	(c) Safe Harbor for Sexually Exploited 
628.25 	Youth. $500,000 in fiscal year 2020 and 
628.26 	$500,000 in fiscal year 2021 are from the 
628.27 	general fund for activities under the safe 
628.28 	harbor program.
628.29 	(d) Base Level Adjustment. The general fund 
628.30 	base is $51,483,000 in fiscal year 2022 and 
628.31 	$51,198,000 in fiscal year 2023.

628.32
628.33	Subd. 23.Grant Programs; Children and 
Community Service Grants
 		58,201,000
		58,201,000

628.34
628.35	Subd. 24.Grant Programs; Children and 
Economic Support Grants
 		24,315,000
		24,315,000
	
629.1 	(a) Minnesota Food Assistance Program. 
629.2 	Unexpended funds for the Minnesota food 
629.3 	assistance program for fiscal year 2020 do not 
629.4 	cancel but are available for this purpose in 
629.5 	fiscal year 2021.
629.6 	(b) Shelter-Linked Youth Mental Health 
629.7 	Grants. $250,000 in fiscal year 2020 and 
629.8 	$250,000 in fiscal year 2021 are from the 
629.9 	general fund for shelter-linked youth mental 
629.10 	health grants under Minnesota Statutes, section 
629.11 	256K.46.
629.12 	(c) Base Level Adjustment. The general fund 
629.13 	base is $22,815,000 in fiscal year 2022 and 
629.14 	$22,815,000 in fiscal year 2023.

629.15	Subd. 25.Grant Programs; Health Care Grants

629.16	Appropriations by Fund
	
629.17	General
	3,711,000
	3,711,000
	
629.18	Health Care Access
	3,465,000
	3,465,000

629.19
629.20	Subd. 26.Grant Programs; Other Long-Term 
Care Grants
 		1,925,000
		1,925,000

629.21
629.22	Subd. 27.Grant Programs; Aging and Adult 
Services Grants
 		32,311,000
		32,495,000
	
629.23 	Incentive-Based Grants for Customized 
629.24 	Living Service Providers. $500,000 in fiscal 
629.25 	year 2020 and $500,000 in fiscal year 2021 
629.26 	are for incentive-based grants to elderly waiver 
629.27 	customized living service providers under 
629.28 	article 4, section 28.

629.29
629.30	Subd. 28.Grant Programs; Deaf and 
Hard-of-Hearing Grants
 		2,886,000
		2,886,000

629.31	Subd. 29.Grant Programs; Disabilities Grants
 		22,431,000
		23,144,000
	
629.32 	(a) Training of Direct Support Services 
629.33 	Providers. $375,000 in fiscal year 2020 and 
629.34 	$375,000 in fiscal year 2021 are for stipends 
630.1 	to pay for training of individual providers of 
630.2 	direct support services as defined in Minnesota 
630.3 	Statutes, section 256B.0711, subdivision 1. 
630.4 	This training is available to individual 
630.5 	providers who have completed designated 
630.6 	voluntary trainings made available through 
630.7 	the State Service Employees International 
630.8 	Union Healthcare Minnesota Committee. This 
630.9 	is a onetime appropriation. This appropriation 
630.10 	is available only if the labor agreement 
630.11 	between the state of Minnesota and the Service 
630.12 	Employees International Union Healthcare 
630.13 	Minnesota under Minnesota Statutes, section 
630.14 	179A.54, is approved under Minnesota 
630.15 	Statutes, section 3.855.
630.16 	(b) Training for New Worker Orientation.
630.17 	$125,000 in fiscal year 2020 and $125,000 in 
630.18 	fiscal year 2021 are for new worker orientation 
630.19 	training and is allocated to the Minnesota State 
630.20 	Service Employees International Union 
630.21 	Healthcare Minnesota Committee. This is a 
630.22 	onetime appropriation. This appropriation is 
630.23 	available only if the labor agreement between 
630.24 	the state of Minnesota and the Service 
630.25 	Employees International Union Healthcare 
630.26 	Minnesota under Minnesota Statutes, section 
630.27 	179A.54, is approved under Minnesota 
630.28 	Statutes, section 3.855.
630.29 	(c) Benefits Planning Grants. $600,000 in 
630.30 	fiscal year 2020 and $600,000 in fiscal year 
630.31 	2021 are to provide grant funding to the 
630.32 	Disability Hub for benefits planning to people 
630.33 	with disabilities.
630.34 	(d) Regional Support for Person-Centered 
630.35 	Practices Grants. $374,000 in fiscal year 
631.1 	2020 and $486,000 in fiscal year 2021 are to 
631.2 	extend and expand regional capacity for 
631.3 	person-centered planning. This grant funding 
631.4 	must be allocated to regional cohorts for 
631.5 	training, coaching, and mentoring for 
631.6 	person-centered and collaborative safety 
631.7 	practices benefiting people with disabilities, 
631.8 	and employees, organizations, and 
631.9 	communities serving people with disabilities.
631.10 	(e) Disability Hub for Families Grants.
631.11 	$100,000 in fiscal year 2020 and $200,000 in 
631.12 	fiscal year 2021 are for grants to connect 
631.13 	families through innovation grants, life 
631.14 	planning tools, and website information as 
631.15 	they support a child or family member with 
631.16 	disabilities.
631.17 	(f) Electronic Visit Verification. $500,000 
631.18 	in fiscal year 2021 is for grants to providers 
631.19 	who use a different vendor than the contract 
631.20 	with the State of Minnesota for electronic visit 
631.21 	verification.
631.22 	(g) Day Training and Habilitation Disability 
631.23 	Waiver Rate System Transition Grants.
631.24 	$200,000 in fiscal year 2020 and $200,000 in 
631.25 	fiscal year 2021 are from the general fund for 
631.26 	day training and habilitation disability waiver 
631.27 	rate system transition grants under article 5, 
631.28 	section 90. This is a onetime appropriation.
631.29 	(h) Base Level Adjustment.  The general fund 
631.30 	base is $22,556,000 in fiscal year 2022 and 
631.31 	$22,168,000 in fiscal year 2023.

632.1
632.2	Subd. 30.Grant Programs; Housing Support 
Grants
 		9,264,000
		10,364,000
	
632.3 	Emergency Services Grants. $1,500,000 in 
632.4 	fiscal year 2020 and $1,500,000 in fiscal year 
632.5 	2021 are to provide emergency services grants 
632.6 	under Minnesota Statutes, section 256E.36. 
632.7 	This is a onetime appropriation.

632.8
632.9	Subd. 31.Grant Programs; Adult Mental Health 
Grants
 		82,302,000
		79,877,000
	
632.10 	(a) Certified Community Behavioral Health 
632.11 	Center (CCBHC) Expansion. $200,000 in 
632.12 	fiscal year 2021 is from the general fund for 
632.13 	grants for planning, staff training, and other 
632.14 	quality improvements that are required to 
632.15 	comply with federal CCBHC criteria for three 
632.16 	expansion sites.
632.17 	(b) Mobile Mental Health Crisis Response 
632.18 	Team Funding. $1,250,000 in fiscal year 
632.19 	2020 and $1,250,000 in fiscal year 2021 are 
632.20 	for adult mental health grants under Minnesota 
632.21 	Statutes, section 245.4661, subdivision 9, 
632.22 	paragraph (a), clause (1), to fund regional 
632.23 	mobile mental health crisis response teams 
632.24 	throughout the state. The base for this 
632.25 	appropriation is $4,896,000 in fiscal year 2022 
632.26 	and $4,897,000 in fiscal year 2023.
632.27 	(c) Specialized Mental Health Community 
632.28 	Supervision Pilot Project. $400,000 in fiscal 
632.29 	year 2020 is for a grant to Anoka County for 
632.30 	establishment of a specialized mental health 
632.31 	community supervision caseload pilot project. 
632.32 	This is a onetime appropriation.
632.33 	(d) Base Level Adjustment. The general fund 
632.34 	base is $83,323,000 in fiscal year 2022 and 
632.35 	$83,324,000 in fiscal year 2023.

633.1
633.2	Subd. 32.Grant Programs; Child Mental Health 
Grants
 		21,826,000
		21,726,000
	
633.3 	(a) Children's Intensive Services Reform.
633.4 	$400,000 in fiscal year 2020 and $400,000 in 
633.5 	fiscal year 2021 are for start-up grants to 
633.6 	prospective psychiatric residential treatment 
633.7 	facility sites for administrative expenses, 
633.8 	consulting services, Health Insurance 
633.9 	Portability and Accountability Act of 1996 
633.10 	compliance, therapeutic resources including 
633.11 	evidence-based, culturally appropriate 
633.12 	curriculums, and training programs for staff 
633.13 	and clients as well as allowable physical 
633.14 	renovations to the property.
633.15 	(b) Community-Based Children's Mental 
633.16 	Health Grant. Notwithstanding Minnesota 
633.17 	Statutes, section 16B.97, $100,000 in fiscal 
633.18 	year 2020 is for a grant to the Family 
633.19 	Enhancement Center for staffing and 
633.20 	administrative support to provide children 
633.21 	access to expert mental health services 
633.22 	regardless of a child's insurance status or 
633.23 	income. This is a onetime appropriation and 
633.24 	is available until June 30, 2021.
633.25 	(c) Base Level Adjustment. The general fund 
633.26 	base is $25,726,000 in fiscal year 2022 and 
633.27 	$25,726,000 in fiscal year 2023.

633.28
633.29	Subd. 33.Grant Programs; Chemical 
Dependency Treatment Support Grants

633.30	Appropriations by Fund
	
633.31	General
	2,636,000
	2,636,000
	
633.32	Lottery Prize
	1,733,000
	1,733,000
	
633.33 	(a) Problem Gambling. $225,000 in fiscal 
633.34 	year 2020 and $225,000 in fiscal year 2021 
633.35 	are from the lottery prize fund for a grant to 
634.1 	the state affiliate recognized by the National 
634.2 	Council on Problem Gambling. The affiliate 
634.3 	must provide services to increase public 
634.4 	awareness of problem gambling, education, 
634.5 	and training for individuals and organizations 
634.6 	providing effective treatment services to 
634.7 	problem gamblers and their families, and 
634.8 	research related to problem gambling.
634.9 	(b) Fetal Alcohol Spectrum Disorders 
634.10 	Grants. (1) $500,000 in fiscal year 2020 and 
634.11 	$500,000 in fiscal year 2021 are from the 
634.12 	general fund for a grant to Proof Alliance. Of 
634.13 	this appropriation, Proof Alliance shall make 
634.14 	grants to eligible regional collaboratives for 
634.15 	the purposes specified in clause (3).
634.16 	(2) "Eligible regional collaboratives" means 
634.17 	a partnership between at least one local 
634.18 	government and at least one community-based 
634.19 	organization and, where available, a family 
634.20 	home visiting program. For purposes of this 
634.21 	clause, a local government includes a county 
634.22 	or multicounty organization, a tribal 
634.23 	government, a county-based purchasing entity, 
634.24 	or a community health board.
634.25 	(3) Eligible regional collaboratives must use 
634.26 	grant funds to reduce the incidence of fetal 
634.27 	alcohol spectrum disorders and other prenatal 
634.28 	drug-related effects in children in Minnesota 
634.29 	by identifying and serving pregnant women 
634.30 	suspected of or known to use or abuse alcohol 
634.31 	or other drugs. Eligible regional collaboratives 
634.32 	must provide intensive services to chemically 
634.33 	dependent women to increase positive birth 
634.34 	outcomes.
635.1 	(4) Proof Alliance must make grants to eligible 
635.2 	regional collaboratives from both rural and 
635.3 	urban areas of the state.
635.4 	(5) An eligible regional collaborative that 
635.5 	receives a grant under this paragraph must 
635.6 	report to Proof Alliance by January 15 of each 
635.7 	year on the services and programs funded by 
635.8 	the grant. The report must include measurable 
635.9 	outcomes for the previous year, including the 
635.10 	number of pregnant women served and the 
635.11 	number of toxic-free babies born. Proof 
635.12 	Alliance must compile the information in these 
635.13 	reports and report that information to the 
635.14 	commissioner of human services by February 
635.15 	15 of each year.

635.16
635.17	Subd. 34.Direct Care and Treatment - 
Generally
 					
635.18 	(a) Transfer Authority. Money appropriated 
635.19 	to budget activities under this subdivision and 
635.20 	subdivisions 35, 36, 37, and 38 may be 
635.21 	transferred between budget activities and 
635.22 	between years of the biennium with the 
635.23 	approval of the commissioner of management 
635.24 	and budget.
635.25 	(b) Transfer; State-Operated Services 
635.26 	Account. Any balance remaining in the state 
635.27 	operated services account at the end of fiscal 
635.28 	year 2019, estimated to be $13,000,000 shall 
635.29 	be transferred to the general fund.

635.30
635.31	Subd. 35.Direct Care and Treatment - Mental 
Health and Substance Abuse
 		129,209,000
		129,201,000
	
635.32 	(a) Transfer Authority. $6,438,000 in fiscal 
635.33 	year 2020 and $6,438,000 in fiscal year 2021 
635.34 	are for operations of the Community Addiction 
636.1 	Enterprise (C.A.R.E.) program and may be 
636.2 	transferred to the enterprise fund for C.A.R.E.
636.3 	(b) Base Level Adjustment.  The general fund 
636.4 	base is $129,197,000 in fiscal year 2022 and 
636.5 	$129,197,000 in fiscal year 2023.

636.6
636.7	Subd. 36.Direct Care and Treatment - 
Community-Based Services
 		16,630,000
		17,177,000
	
636.8 	(a) Transfer Authority. $2,393,000 in fiscal 
636.9 	year 2020 and $2,393,000 in fiscal year 2021 
636.10 	are for operations of the Minnesota State 
636.11 	Operated Community Services (MSOCS) 
636.12 	program and may be transferred to the 
636.13 	enterprise fund for MSOCS.
636.14 	(b) MSOCS Operating Adjustment.
636.15 	$1,594,000 in fiscal year 2020 and $3,729,000 
636.16 	in fiscal year 2021 are from the general fund 
636.17 	for the Minnesota State Operated Community 
636.18 	Services program. The commissioner shall 
636.19 	transfer $1,594,000 in fiscal year 2020 and 
636.20 	$3,729,000 in fiscal year 2021 to the enterprise 
636.21 	fund for MSOCS.
636.22 	(c) Base Level Adjustment. The general fund 
636.23 	base is $17,176,000 in fiscal year 2022 and 
636.24 	$17,176,000 in fiscal year 2023.

636.25
636.26	Subd. 37.Direct Care and Treatment - Forensic 
Services
 		112,126,000
		115,342,000
	
636.27 	Base Level Adjustment. The general fund 
636.28 	base is $115,944,000 in fiscal year 2022 and 
636.29 	$115,944,000 in fiscal year 2023.

636.30
636.31	Subd. 38.Direct Care and Treatment - Sex 
Offender Program
 		97,072,000
		97,621,000
	
636.32 	(a) Transfer Authority. Money appropriated 
636.33 	for the Minnesota sex offender program may 
636.34 	be transferred between fiscal years of the 
637.1 	biennium with the approval of the 
637.2 	commissioner of management and budget.
637.3 	(b) Base Level Adjustment. The general fund 
637.4 	base is $98,166,000 in fiscal year 2022 and 
637.5 	$98,166,000 in fiscal year 2023.

637.6
637.7	Subd. 39.Direct Care and Treatment - 
Operations
 		47,398,000
		47,657,000
	
637.8 	Base Level Adjustment. The general fund 
637.9 	base is $47,656,000 in fiscal year 2022 and 
637.10 	$47,656,000 in fiscal year 2023.

637.11	Subd. 40.Technical Activities
 		75,884,000
		82,316,000
	
637.12 	(a) Generally. This appropriation is from the 
637.13 	federal TANF fund.
637.14 	(b) Base Level Adjustment. The TANF fund 
637.15 	base is $79,198,000 in fiscal year 2022 and 
637.16 	$78,254,000 in fiscal year 2023.

637.17	Sec. 3. COMMISSIONER OF HEALTH

637.18	Subdivision 1.Total Appropriation
 	$
	231,829,000
	$
	236,188,000

637.19	Appropriations by Fund
	
637.20		2020
	2021
	
637.21	General
	124,381,000
	126,276,000
	
637.22
637.23	State Government 
Special Revenue
	58,450,000
	61,367,000
	
637.24	Health Care Access
	37,285,000
	36,832,000
	
637.25	Federal TANF
	11,713,000
	11,713,000
	
637.26 	The amounts that may be spent for each 
637.27 	purpose are specified in the following 
637.28 	subdivisions.

637.29	Subd. 2.Health Improvement

637.30	Appropriations by Fund
	
637.31	General
	94,980,000
	96,117,000
	
637.32
637.33	State Government 
Special Revenue
	7,614,000
	7,558,000
	
638.1	Health Care Access
	37,285,000
	36,832,000
	
638.2	Federal TANF
	11,713,000
	11,713,000
	
638.3 	(a) TANF Appropriations. (1) $3,579,000 in 
638.4 	fiscal year 2020 and $3,579,000 in fiscal year 
638.5 	2021 are from the TANF fund for home 
638.6 	visiting and nutritional services under 
638.7 	Minnesota Statutes, section 145.882, 
638.8 	subdivision 7, clauses (6) and (7). Funds must 
638.9 	be distributed to community health boards 
638.10 	according to Minnesota Statutes, section 
638.11 	145A.131, subdivision 1;
638.12 	(2) $2,000,000 in fiscal year 2020 and 
638.13 	$2,000,000 in fiscal year 2021 are from the 
638.14 	TANF fund for decreasing racial and ethnic 
638.15 	disparities in infant mortality rates under 
638.16 	Minnesota Statutes, section 145.928, 
638.17 	subdivision 7;
638.18 	(3) $4,978,000 in fiscal year 2020 and 
638.19 	$4,978,000 in fiscal year 2021 are from the 
638.20 	TANF fund for the family home visiting grant 
638.21 	program  under Minnesota Statutes, section 
638.22 	145A.17. $4,000,000 of the funding in each 
638.23 	fiscal year must be distributed to community 
638.24 	health boards according to Minnesota Statutes, 
638.25 	section 145A.131, subdivision 1. $978,000 of 
638.26 	the funding in each fiscal year must be 
638.27 	distributed to tribal governments according to 
638.28 	Minnesota Statutes, section 145A.14, 
638.29 	subdivision 2a;
638.30 	(4) $1,156,000 in fiscal year 2020 and 
638.31 	$1,156,000 in fiscal year 2021 are from the 
638.32 	TANF fund for family planning grants under 
638.33 	Minnesota Statutes, section 145.925; and
639.1 	(5) The commissioner may use up to 6.23 
639.2 	percent of the amounts appropriated from the 
639.3 	TANF fund each year to conduct the ongoing 
639.4 	evaluations required under Minnesota Statutes, 
639.5 	section 145A.17, subdivision 7, and training 
639.6 	and technical assistance as required under 
639.7 	Minnesota Statutes, section 145A.17, 
639.8 	subdivisions 4 and 5.
639.9 	(b) TANF Carryforward. Any unexpended 
639.10 	balance of the TANF appropriation in the first 
639.11 	year of the biennium does not cancel but is 
639.12 	available for the second year.
639.13 	(c) Comprehensive Suicide Prevention.
639.14 	$2,730,000 in fiscal year 2020 and $2,730,000 
639.15 	in fiscal year 2021 are from the general fund 
639.16 	for a comprehensive, community-based suicide 
639.17 	prevention strategy. The funds are allocated 
639.18 	as follows:
639.19 	(1) $955,000 in fiscal year 2020 and $955,000 
639.20 	in fiscal year 2021 are for community-based 
639.21 	suicide prevention grants authorized in 
639.22 	Minnesota Statutes, section 145.56, 
639.23 	subdivision 2. Specific emphasis must be 
639.24 	placed on those communities with the greatest 
639.25 	disparities. The base for this appropriation is 
639.26 	$1,291,000 in fiscal year 2022 and $1,291,000 
639.27 	in fiscal year 2023;
639.28 	(2) $683,000 in fiscal year 2020 and $683,000 
639.29 	in fiscal year 2021 are to support 
639.30 	evidence-based training for educators and 
639.31 	school staff and purchase suicide prevention 
639.32 	curriculum for student use statewide, as 
639.33 	authorized in Minnesota Statutes, section 
639.34 	145.56, subdivision 2. The base for this 
640.1 	appropriation is $913,000 in fiscal year 2022 
640.2 	and $913,000 in fiscal year 2023;
640.3 	(3) $137,000 in fiscal year 2020 and $137,000 
640.4 	in fiscal year 2021 are to implement the Zero 
640.5 	Suicide framework with up to 20 behavioral 
640.6 	and health care organizations each year to treat 
640.7 	individuals at risk for suicide and support 
640.8 	those individuals across systems of care upon 
640.9 	discharge. The base for this appropriation is 
640.10 	$205,000 in fiscal year 2022 and $205,000 in 
640.11 	fiscal year 2023;
640.12 	(4) $955,000 in fiscal year 2020 and $955,000 
640.13 	in fiscal year 2021 are to develop and fund a 
640.14 	Minnesota-based network of National Suicide 
640.15 	Prevention Lifeline, providing statewide 
640.16 	coverage. The base for this appropriation is 
640.17 	$1,321,000 in fiscal year 2022 and $1,321,000 
640.18 	in fiscal year 2023; and
640.19 	(5) the commissioner may retain up to 18.23 
640.20 	percent of the appropriation under this 
640.21 	paragraph to administer the comprehensive 
640.22 	suicide prevention strategy.
640.23 	(d) Statewide Tobacco Cessation. $1,598,000 
640.24 	in fiscal year 2020 and $2,748,000 in fiscal 
640.25 	year 2021 are from the general fund for 
640.26 	statewide tobacco cessation services under 
640.27 	Minnesota Statutes, section 144.397. The base 
640.28 	for this appropriation is $2,878,000 in fiscal 
640.29 	year 2022 and $2,878,000 in fiscal year 2023.
640.30 	(e) Health Care Access Survey. $225,000 in 
640.31 	fiscal year 2020 and $225,000 in fiscal year 
640.32 	2021 are from the health care access fund to 
640.33 	continue and improve the Minnesota Health 
641.1 	Care Access Survey. These appropriations 
641.2 	may be used in either year of the biennium.
641.3 	(f) Community Solutions for Healthy Child 
641.4 	Development Grant Program. $1,000,000 
641.5 	in fiscal year 2020 and $1,000,000 in fiscal 
641.6 	year 2021 are for the community solutions for 
641.7 	healthy child development grant program to 
641.8 	promote health and racial equity for young 
641.9 	children and their families under Minnesota 
641.10 	Statutes, section 145.9285. The commissioner 
641.11 	may use up to 23.5 percent of the total 
641.12 	appropriation for administration. The base for 
641.13 	this appropriation is $1,000,000 in fiscal year 
641.14 	2022, $1,000,000 in fiscal year 2023, and $0 
641.15 	in fiscal year 2024.
641.16 	(g) Domestic Violence and Sexual Assault 
641.17 	Prevention Program. $375,000 in fiscal year 
641.18 	2020 and $375,000 in fiscal year 2021 are 
641.19 	from the general fund for the domestic 
641.20 	violence and sexual assault prevention 
641.21 	program under Minnesota Statutes, section 
641.22 	145.987. This is a onetime appropriation.
641.23 	(h) Skin Lightening Products Public 
641.24 	Awareness Grant Program. $100,000 in 
641.25 	fiscal year 2020 and $100,000 in fiscal year 
641.26 	2021 are from the general fund for a skin 
641.27 	lightening products public awareness and 
641.28 	education grant program. This is a onetime 
641.29 	appropriation.
641.30 	(i) Cannabinoid Products Workgroup.
641.31 	$8,000 in fiscal year 2020 is from the state 
641.32 	government special revenue fund for the 
641.33 	cannabinoid products workgroup. This is a 
641.34 	onetime appropriation.
642.1 	(j) Base Level Adjustments. The general fund 
642.2 	base is $96,742,000 in fiscal year 2022 and 
642.3 	$96,742,000 in fiscal year 2023. The health 
642.4 	care access fund base is $37,432,000 in fiscal 
642.5 	year 2022 and $36,832,000 in fiscal year 2023.

642.6	Subd. 3.Health Protection

642.7	Appropriations by Fund
	
642.8	General
	18,803,000
	19,774,000
	
642.9642.10
	State Government 
Special Revenue
	50,836,000
	53,809,000
	
642.11 	(a) Public Health Laboratory Equipment.
642.12 	$840,000 in fiscal year 2020 and $655,000 in 
642.13 	fiscal year 2021 are from the general fund for 
642.14 	equipment for the public health laboratory. 
642.15 	This is a onetime appropriation and is 
642.16 	available until June 30, 2023.
642.17 	(b) Base Level Adjustment. The general fund 
642.18 	base is $19,119,000 in fiscal year 2022 and 
642.19 	$19,119,000 in fiscal year 2023. The state 
642.20 	government special revenue fund base is 
642.21 	$53,782,000 in fiscal year 2022 and 
642.22 	$53,782,000 in fiscal year 2023.

642.23	Subd. 4.Health Operations
 		10,598,000
		10,385,000
	
642.24 	Base Level Adjustment. The general fund 
642.25 	base is $10,912,000 in fiscal year 2022 and 
642.26 	$10,912,000 in fiscal year 2023.

642.27	Sec. 4. HEALTH-RELATED BOARDS

642.28	Subdivision 1.Total Appropriation
 	$
	27,203,000
	$
	26,597,000
	
642.29 	This appropriation is from the state 
642.30 	government special revenue fund unless 
642.31 	specified otherwise. The amounts that may be 
642.32 	spent for each purpose are specified in the 
642.33 	following subdivisions.

643.1	Subd. 2.Board of Chiropractic Examiners
 		629,000
		641,000

643.2	Subd. 3.Board of Dentistry
 		1,503,000
		1,450,000
	
643.3 	Emeritus Licensing Activities. $8,000 in 
643.4 	fiscal year 2020 and $5,000 in fiscal year 2021 
643.5 	are for emeritus licensing activities under 
643.6 	Minnesota Statutes, section 150A.06.

643.7
643.8	Subd. 4.Board of Dietetics and Nutrition 
Practice
 		147,000
		149,000

643.9	Subd. 5.Board of Marriage and Family Therapy
 		384,000
		389,000
	
643.10 	Base Level Adjustment. The base is $384,000 
643.11 	in fiscal year 2022 and $384,000 in fiscal year 
643.12 	2023.

643.13	Subd. 6.Board of Medical Practice
 		6,013,000
		5,996,000
	
643.14 	(a) Health Professional Services Program.
643.15 	This appropriation includes $1,023,000 in 
643.16 	fiscal year 2020 and $1,002,000 in fiscal year 
643.17 	2021 for the health professional services 
643.18 	program.
643.19 	(b) Base Level Adjustment. The base is 
643.20 	$5,912,000 in fiscal year 2022 and $5,868,000 
643.21 	in fiscal year 2023.

643.22	Subd. 7.Board of Nursing
 		4,993,000
		4,993,000

643.23	Subd. 8.Board of Nursing Home Administrators
 		3,733,000
		3,201,000
	
643.24 	(a) Administrative Services Unit - Operating 
643.25 	Costs. Of this appropriation, $3,445,000 in 
643.26 	fiscal year 2020 and $2,910,000 in fiscal year 
643.27 	2021 are for operating costs of the 
643.28 	administrative services unit. The 
643.29 	administrative services unit may receive and 
643.30 	expend reimbursements for services it 
643.31 	performs for other agencies.
643.32 	(b) Administrative Services Unit - Volunteer 
643.33 	Health Care Provider Program. Of this 
644.1 	appropriation, $150,000 in fiscal year 2020 
644.2 	and $150,000 in fiscal year 2021 are to pay 
644.3 	for medical professional liability coverage 
644.4 	required under Minnesota Statutes, section 
644.5 	214.40.
644.6 	(c) Administrative Services Unit - 
644.7 	Retirement Costs. Of this appropriation, 
644.8 	$558,000 in fiscal year 2020 is a onetime 
644.9 	appropriation to the administrative services 
644.10 	unit to pay for the retirement costs of 
644.11 	health-related board employees. This funding 
644.12 	may be transferred to the health board 
644.13 	incurring retirement costs. Any board that has 
644.14 	an unexpended balance for an amount 
644.15 	transferred under this paragraph shall transfer 
644.16 	the unexpended amount to the administrative 
644.17 	services unit. These funds are available either 
644.18 	year of the biennium.
644.19 	(d) Administrative Services Unit - Contested 
644.20 	Cases and Other Legal Proceedings. Of this 
644.21 	appropriation, $200,000 in fiscal year 2020 
644.22 	and $200,000 in fiscal year 2021 are for costs 
644.23 	of contested case hearings and other 
644.24 	unanticipated costs of legal proceedings 
644.25 	involving health-related boards funded under 
644.26 	this section. Upon certification by a 
644.27 	health-related board to the administrative 
644.28 	services unit that costs will be incurred and 
644.29 	that there is insufficient money available to 
644.30 	pay for the costs out of appropriations 
644.31 	currently available to that board, the 
644.32 	administrative services unit is authorized to 
644.33 	transfer money from this appropriation to the 
644.34 	board for payment of those costs with the 
644.35 	approval of the commissioner of management 
645.1 	and budget. The commissioner of management 
645.2 	and budget must require any board that has an 
645.3 	unexpended balance for an amount transferred 
645.4 	under this paragraph to transfer the 
645.5 	unexpended amount to the administrative 
645.6 	services unit to be deposited in the state 
645.7 	government special revenue fund.

645.8	Subd. 9.Board of Optometry
 		222,000
		223,000

645.9	Subd. 10.Board of Pharmacy
 		4,307,000
		4,341,000
	
645.10 	Base Level Adjustment. The base is 
645.11 	$4,338,000 in fiscal year 2022 and $4,338,000 
645.12 	in fiscal year 2023.

645.13	Subd. 11.Board of Physical Therapy
 		547,000
		549,000

645.14	Subd. 12.Board of Podiatric Medicine
 		199,000
		199,000

645.15	Subd. 13.Board of Psychology
 		1,357,000
		1,395,000
	
645.16 	Base Level Adjustment. The base is 
645.17 	$1,355,000 in fiscal year 2022 and $1,355,000 
645.18 	in fiscal year 2023.

645.19	Subd. 14.Board of Social Work
 		1,437,000
		1,404,000

645.20	Subd. 15.Board of Veterinary Medicine
 		345,000
		353,000

645.21
645.22	Subd. 16.Board of Behavioral Health and 
Therapy
 		937,000
		858,000
	
645.23 	Base Level Adjustment. The base is $833,000 
645.24 	in fiscal year 2022 and $833,000 in fiscal year 
645.25 	2023.

645.26
645.27	Subd. 17.Board of Occupational Therapy 
Practice
 		450,000
		456,000

645.28
645.29	Sec. 5. EMERGENCY MEDICAL SERVICES 
REGULATORY BOARD
 	$
	3,747,000
	$
	3,809,000
	
645.30 	(a) Cooper/Sams Volunteer Ambulance 
645.31 	Program. $950,000 in fiscal year 2020 and 
645.32 	$950,000 in fiscal year 2021 are for the 
646.1 	Cooper/Sams volunteer ambulance program 
646.2 	under Minnesota Statutes, section 144E.40.
646.3 	(1) Of this amount, $861,000 in fiscal year 
646.4 	2020 and $861,000 in fiscal year 2021 are for 
646.5 	the ambulance service personnel longevity 
646.6 	award and incentive program under Minnesota 
646.7 	Statutes, section 144E.40.
646.8 	(2) Of this amount, $89,000 in fiscal year 2020 
646.9 	and $89,000 in fiscal year 2021 are for the 
646.10 	operations of the ambulance service personnel 
646.11 	longevity award and incentive program under 
646.12 	Minnesota Statutes, section 144E.40.
646.13 	(b) EMSRB Operations. $1,851,000 in fiscal 
646.14 	year 2020 and $1,913,000 in fiscal year 2021 
646.15 	are for board operations. The base for this 
646.16 	program is $1,880,000 in fiscal year 2022 and 
646.17 	$1,880,000 in fiscal year 2023.
646.18 	(c) Regional Grants. $585,000 in fiscal year 
646.19 	2020 and $585,000 in fiscal year 2021 are for 
646.20 	regional emergency medical services 
646.21 	programs, to be distributed equally to the eight 
646.22 	emergency medical service regions under 
646.23 	Minnesota Statutes, section 144E.52.
646.24 	(d) Ambulance Training Grant. $585,000 
646.25 	in fiscal year 2020 and $585,000 in fiscal year 
646.26 	2021 are for training grants under Minnesota 
646.27 	Statutes, section 144E.35.
646.28 	(e) Base Level Adjustment. The base is 
646.29 	$3,776,000 in fiscal year 2022 and $3,776,000 
646.30 	in fiscal year 2023.

646.31	Sec. 6. COUNCIL ON DISABILITY
 	$
	1,014,000
	$
	1,006,000

646.32
646.33
646.34	Sec. 7. OMBUDSMAN FOR MENTAL 
HEALTH AND DEVELOPMENTAL 
DISABILITIES
 	$
	2,438,000
	$
	2,438,000
	
647.1 	Department of Psychiatry Monitoring.
647.2 	$100,000 in fiscal year 2020 and $100,000 in 
647.3 	fiscal year 2021 are for monitoring the 
647.4 	Department of Psychiatry at the University of 
647.5 	Minnesota.

647.6	Sec. 8. OMBUDSPERSONS FOR FAMILIES
 	$
	714,000
	$
	723,000

647.7	Sec. 9. COMMISSIONER OF COMMERCE
 	$
	27,000
	$
	27,000

647.8
647.9	Sec. 10. BOARD OF DIRECTORS OF 
MNSURE
 	$
	8,000,000
	$
	0
	
647.10 	This appropriation shall be transferred to the 
647.11 	MNsure enterprise fund.

647.12
647.13	Sec. 11. COMMISSIONER OF 
MANAGEMENT AND BUDGET
 	$
	498,000
	$
	498,000
	
647.14 	(a) Proven-Effective Practices Evaluation 
647.15 	Activities. $498,000 in fiscal year 2020 and 
647.16 	$498,000 in fiscal year 2021 are from the 
647.17 	general fund for evaluation activities under 
647.18 	Minnesota Statutes, section 16A.055, 
647.19 	subdivision 1a.
647.20 	(b) Transfer; Premium Security Account.
647.21 	By August 30, 2020, the commissioner of 
647.22 	commerce shall transfer $142,000,000 from 
647.23 	the premium security account to the general 
647.24 	fund. This is a onetime transfer.
647.25 	(c) Transfer Cancellation. The commissioner 
647.26 	of management and budget shall not make the 
647.27 	$50,000,000 transfer authorized under 
647.28 	Minnesota Statutes, section 62U.10, 
647.29 	subdivision 8, in fiscal year 2019 resulting 
647.30 	from the December 2017 report conducted 
647.31 	under Minnesota Statutes, section 62U.10, 
647.32 	subdivision 7.
647.33 	(d) Savings Determination. (1) When 
647.34 	preparing the forecast for state revenues and 
648.1 	expenditures under Minnesota Statutes, section 
648.2 	16A.103, the commissioner of management 
648.3 	and budget shall assume a reduction of health 
648.4 	and human services spending of $100,000,000 
648.5 	for the biennium beginning July 1, 2022, until 
648.6 	the end of the legislative session that enacts a 
648.7 	budget for the Department of Health and the 
648.8 	Department of Human Services for that 
648.9 	biennium.
648.10 	(2) Upon enactment of a budget for the 
648.11 	Department of Health and the Department of 
648.12 	Human Services for the biennium beginning 
648.13 	July 1, 2022, the legislature shall identify 
648.14 	enacted provisions that were recommended 
648.15 	by or based on the recommendation of the 
648.16 	Blue Ribbon Commission on Health and 
648.17 	Human Services.
648.18 	(3) To the extent the net savings attributable 
648.19 	to the provisions in clause (2) for the biennium 
648.20 	beginning July 1, 2022, are less than 
648.21 	$100,000,000, the commissioner shall reduce 
648.22 	the balance of the general fund budget reserve 
648.23 	established under Minnesota Statutes, section 
648.24 	16A.152, subdivision 1a, by an amount equal 
648.25 	to the difference between the savings 
648.26 	identified in clause (2) and the assumed 
648.27 	$100,000,000 of savings in clause (1).

648.28 	Sec. 12. TRANSFERS.
 648.29 		Subdivision 1.Forecasted programs. The commissioner of human services, with the 
648.30 	approval of the commissioner of management and budget, may transfer unencumbered 
648.31 	appropriation balances for the biennium ending June 30, 2021, within fiscal years among 
648.32 	the MFIP, general assistance, medical assistance, MinnesotaCare, MFIP child care assistance 
648.33 	under Minnesota Statutes, section 119B.05, Minnesota supplemental aid program, housing 
648.34 	support, the entitlement portion of Northstar Care for Children under Minnesota Statutes, 
649.1 	chapter 256N, and the entitlement portion of the chemical dependency consolidated treatment 
649.2 	fund, and between fiscal years of the biennium. The commissioner shall inform the chairs 
649.3 	and ranking minority members of the senate Health and Human Services Finance Committee 
649.4 	and the house of representatives Health and Human Services Finance Division quarterly 
649.5 	about transfers made under this subdivision.
649.6 		Subd. 2.Administration. Positions, salary money, and nonsalary administrative money 
649.7 	may be transferred within the Departments of Health and Human Services as the 
649.8 	commissioners consider necessary, with the advance approval of the commissioner of 
649.9 	management and budget. The commissioner shall inform the chairs and ranking minority 
649.10 	members of the senate Health and Human Services Finance Committee and the house of 
649.11 	representatives Health and Human Services Finance Division quarterly about transfers made 
649.12 	under this subdivision.

649.13 	Sec. 13. INDIRECT COSTS NOT TO FUND PROGRAMS.
 649.14 	The commissioners of health and human services shall not use indirect cost allocations 
649.15 	to pay for the operational costs of any program for which they are responsible.

649.16 	Sec. 14. EXPIRATION OF UNCODIFIED LANGUAGE.
 649.17 	All uncodified language contained in this article expires on June 30, 2021, unless a 
649.18 	different expiration date is explicit.

649.19 	Sec. 15. EFFECTIVE DATE.
 649.20 	This article is effective July 1, 2019, unless a different effective date is specified.

APPENDIX 

Repealed Minnesota Statutes: 19-5223 

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

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

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

119B.16 FAIR HEARING PROCESS.Subd. 2.Informal conference. 
The county agency shall offer an informal conference to applicants and recipients adversely affected by an agency action to attempt to resolve the dispute. The county agency shall offer an informal conference to providers to whom the county agency has assigned responsibility for an overpayment in an attempt to resolve the dispute. The county agency or the provider may ask the family in whose case the overpayment arose to participate in the informal conference, but the family may refuse to do so. The county agency shall advise adversely affected applicants, recipients, and providers that a request for a conference with the agency is optional and does not delay or replace the right to a fair hearing. 

144.414 PROHIBITIONS.Subd. 5.Electronic cigarettes. 
(a) The use of electronic cigarettes, including the inhaling or exhaling of vapor from any electronic delivery device, as defined in section 609.685, subdivision 1, is prohibited in the following locations: 

(1) any building owned or operated by the state, home rule charter or statutory city, county, township, school district, or other political subdivision; 

(2) any facility owned by Minnesota State Colleges and Universities and the University of Minnesota; 

(3) any facility licensed by the commissioner of human services; or 

(4) any facility licensed by the commissioner of health, but only if the facility is also subject to federal licensing requirements. 

(b) Nothing in this subdivision shall prohibit political subdivisions or businesses from adopting more stringent prohibitions on the use of electronic cigarettes or electronic delivery devices. 

144A.45 REGULATION OF HOME CARE SERVICES.Subd. 6.Home care providers; tuberculosis prevention and control. 
(a) A home care provider must establish and maintain a comprehensive tuberculosis infection control program according to the most current tuberculosis infection control guidelines issued by the United States Centers for Disease Control and Prevention (CDC), Division of Tuberculosis Elimination, as published in CDC's Morbidity and Mortality Weekly Report (MMWR). This program must include a tuberculosis infection control plan that covers all paid and unpaid employees, contractors, students, and volunteers. The Department of Health shall provide technical assistance regarding implementation of the guidelines. 

(b) Written compliance with this subdivision must be maintained by the home care provider. 

144A.481 HOME CARE LICENSING IMPLEMENTATION FOR NEW LICENSEES AND TRANSITION PERIOD FOR CURRENT LICENSEES.Subdivision 1.Temporary home care licenses and changes of ownership. 
(a) Beginning January 1, 2014, all temporary license applicants must apply for either a temporary basic or comprehensive home care license. 

(b) Temporary home care licenses issued beginning January 1, 2014, shall be issued according to sections 144A.43 to 144A.4798, and the fees in section 144A.472. Temporary licensees must comply with the requirements of this chapter. 

(c) No temporary license applications will be accepted nor temporary licenses issued between December 1, 2013, and December 31, 2013. 

(d) Beginning October 1, 2013, changes in ownership applications will require payment of the new fees listed in section 144A.472. Providers who are providing nursing, delegated nursing, or professional health care services, must submit the fee for comprehensive home care providers, and all other providers must submit the fee for basic home care providers as provided in section 144A.472. Change of ownership applicants will be issued a new home care license based on the licensure law in effect on June 30, 2013. 

Subd. 2.Current home care licensees with licenses as of December 31, 2013. 
(a) Beginning July 1, 2014, department licensed home care providers must apply for either the basic or comprehensive home care license on their regularly scheduled renewal date. 

(b) By June 30, 2015, all home care providers must either have a basic or comprehensive home care license or temporary license. 

Subd. 3.Renewal application of home care licensure during transition period. 
(a) Renewal and change of ownership applications of home care licenses issued beginning July 1, 2014, will be issued according to sections 144A.43 to 144A.4798 and, upon license renewal or issuance of a new license for a change of ownership, providers must comply with sections 144A.43 to 144A.4798. Prior to renewal, providers must comply with the home care licensure law in effect on June 30, 2013. 

(b) The fees charged for licenses renewed between July 1, 2014, and June 30, 2016, shall be the lesser of 200 percent or $1,000, except where the 200 percent or $1,000 increase exceeds the actual renewal fee charged, with a maximum renewal fee of $6,625. 

(c) For fiscal year 2014 only, the fees for providers with revenues greater than $25,000 and no more than $100,000 will be $313 and for providers with revenues no more than $25,000 the fee will be $125. 

151.42 CITATION.
Sections 151.42 to 151.51 may be cited as the "Wholesale Drug Distribution Licensing Act of 1990." 

151.44 DEFINITIONS.
As used in sections 151.43 to 151.51, the following terms have the meanings given in paragraphs (a) to (h): 

(a) "Wholesale drug distribution" means distribution of prescription or nonprescription drugs to persons other than a consumer or patient or reverse distribution of such drugs, but does not include: 

(1) a sale between a division, subsidiary, parent, affiliated, or related company under the common ownership and control of a corporate entity; 

(2) the purchase or other acquisition, by a hospital or other health care entity that is a member of a group purchasing organization, of a drug for its own use from the organization or from other hospitals or health care entities that are members of such organizations; 

(3) the sale, purchase, or trade of a drug or an offer to sell, purchase, or trade a drug by a charitable organization described in section 501(c)(3) of the Internal Revenue Code of 1986, as amended through December 31, 1988, to a nonprofit affiliate of the organization to the extent otherwise permitted by law; 

(4) the sale, purchase, or trade of a drug or offer to sell, purchase, or trade a drug among hospitals or other health care entities that are under common control; 

(5) the sale, purchase, or trade of a drug or offer to sell, purchase, or trade a drug for emergency medical reasons; 

(6) the sale, purchase, or trade of a drug, an offer to sell, purchase, or trade a drug, or the dispensing of a drug pursuant to a prescription; 

(7) the transfer of prescription or nonprescription drugs by a retail pharmacy to another retail pharmacy to alleviate a temporary shortage; 

(8) the distribution of prescription or nonprescription drug samples by manufacturers representatives; or 

(9) the sale, purchase, or trade of blood and blood components. 

(b) "Wholesale drug distributor" means anyone engaged in wholesale drug distribution including, but not limited to, manufacturers; repackagers; own-label distributors; jobbers; brokers; warehouses, including manufacturers' and distributors' warehouses, chain drug warehouses, and wholesale drug warehouses; independent wholesale drug traders; and pharmacies that conduct wholesale drug distribution. A wholesale drug distributor does not include a common carrier or individual hired primarily to transport prescription or nonprescription drugs. 

(c) "Manufacturer" has the meaning provided in section 151.01, subdivision 14a. 

(d) "Prescription drug" means a drug required by federal or state law or regulation to be dispensed only by a prescription, including finished dosage forms and active ingredients subject to United States Code, title 21, sections 811 and 812. 

(e) "Blood" means whole blood collected from a single donor and processed either for transfusion or further manufacturing. 

(f) "Blood components" means that part of blood separated by physical or mechanical means. 

(g) "Reverse distribution" means the receipt of prescription or nonprescription drugs received from or shipped to Minnesota locations for the purpose of returning the drugs to their producers or distributors. 

(h) "Reverse distributor" means a person engaged in the reverse distribution of drugs. 

151.49 LICENSE RENEWAL APPLICATION PROCEDURES.
Application blanks or notices for renewal of a license required by sections 151.42 to 151.51 shall be mailed or otherwise provided to each licensee on or before the first day of the month prior to the month in which the license expires and, if application for renewal of the license with the required fee and supporting documents is not made before the expiration date, the existing license or renewal shall lapse and become null and void upon the date of expiration. 

151.50 RULES.
The board shall adopt rules to carry out the purposes and enforce the provisions of sections 151.42 to 151.51. All rules adopted under this section shall conform to wholesale drug distributor licensing guidelines formally adopted by the United States Food and Drug Administration; and in case of conflict between a rule adopted by the board and a Food and Drug Administration wholesale drug distributor guideline, the latter shall control. 

151.51 BOARD ACCESS TO WHOLESALE DRUG DISTRIBUTOR RECORDS.
Wholesale drug distributors may keep records at a central location apart from the principal office of the wholesale drug distributor or the location at which the drugs were stored and from which they were shipped, provided that the records shall be made available for inspection within two working days of a request by the board. The records may be kept in any form permissible under federal law applicable to prescription drugs record keeping. 

151.55 CANCER DRUG REPOSITORY PROGRAM.Subdivision 1.Definitions. 
(a) For the purposes of this section, the terms defined in this subdivision have the meanings given. 

(b) "Board" means the Board of Pharmacy. 

(c) "Cancer drug" means a prescription drug that is used to treat: 

(1) cancer or the side effects of cancer; or 

(2) the side effects of any prescription drug that is used to treat cancer or the side effects of cancer. 

(d) "Cancer drug repository" means a medical facility or pharmacy that has notified the board of its election to participate in the cancer drug repository program. 

(e) "Cancer supply" or "supplies" means prescription and nonprescription cancer supplies needed to administer a cancer drug. 

(f) "Dispense" has the meaning given in section 151.01, subdivision 30. 

(g) "Distribute" means to deliver, other than by administering or dispensing. 

(h) "Donor" means an individual and not a drug manufacturer or wholesale drug distributor who donates a cancer drug or supply according to the requirements of the cancer drug repository program. 

(i) "Medical facility" means an institution defined in section 144.50, subdivision 2. 

(j) "Medical supplies" means any prescription and nonprescription medical supply needed to administer a cancer drug. 

(k) "Pharmacist" has the meaning given in section 151.01, subdivision 3. 

(l) "Pharmacy" means any pharmacy registered with the Board of Pharmacy according to section 151.19, subdivision 1. 

(m) "Practitioner" has the meaning given in section 151.01, subdivision 23. 

(n) "Prescription drug" means a legend drug as defined in section 151.01, subdivision 17. 

(o) "Side effects of cancer" means symptoms of cancer. 

(p) "Single-unit-dose packaging" means a single-unit container for articles intended for administration as a single dose, direct from the container. 

(q) "Tamper-evident unit dose packaging" means a container within which a drug is sealed so that the contents cannot be opened without obvious destruction of the seal. 

Subd. 2.Establishment. 
The Board of Pharmacy shall establish and maintain a cancer drug repository program, under which any person may donate a cancer drug or supply for use by an individual who meets the eligibility criteria specified under subdivision 4. Under the program, donations may be made on the premises of a medical facility or pharmacy that elects to participate in the program and meets the requirements specified under subdivision 3. 

Subd. 3.Requirements for participation by pharmacies and medical facilities. 
(a) To be eligible for participation in the cancer drug repository program, a pharmacy or medical facility must be licensed and in compliance with all applicable federal and state laws and administrative rules. 

(b) Participation in the cancer drug repository program is voluntary. A pharmacy or medical facility may elect to participate in the cancer drug repository program by submitting the following information to the board, in a form provided by the board: 

(1) the name, street address, and telephone number of the pharmacy or medical facility; 

(2) the name and telephone number of a pharmacist who is employed by or under contract with the pharmacy or medical facility, or other contact person who is familiar with the pharmacy's or medical facility's participation in the cancer drug repository program; and 

(3) a statement indicating that the pharmacy or medical facility meets the eligibility requirements under paragraph (a) and the chosen level of participation under paragraph (c). 

(c) A pharmacy or medical facility may fully participate in the cancer drug repository program by accepting, storing, and dispensing or administering donated drugs and supplies, or may limit its participation to only accepting and storing donated drugs and supplies. If a pharmacy or facility chooses to limit its participation, the pharmacy or facility shall distribute any donated drugs to a fully participating cancer drug repository according to subdivision 8. 

(d) A pharmacy or medical facility may withdraw from participation in the cancer drug repository program at any time upon notification to the board. A notice to withdraw from participation may be given by telephone or regular mail. 

Subd. 4.Individual eligibility requirements. 
Any Minnesota resident who is diagnosed with cancer is eligible to receive drugs or supplies under the cancer drug repository program. Drugs and supplies shall be dispensed or administered according to the priority given under subdivision 6, paragraph (d). 

Subd. 5.Donations of cancer drugs and supplies. 
(a) Any one of the following persons may donate legally obtained cancer drugs or supplies to a cancer drug repository, if the drugs or supplies meet the requirements under paragraph (b) or (c) as determined by a pharmacist who is employed by or under contract with a cancer drug repository: 

(1) an individual who is 18 years old or older; or 

(2) a pharmacy, medical facility, drug manufacturer, or wholesale drug distributor, if the donated drugs have not been previously dispensed. 

(b) A cancer drug is eligible for donation under the cancer drug repository program only if the following requirements are met: 

(1) the donation is accompanied by a cancer drug repository donor form described under paragraph (d) that is signed by the person making the donation or that person's authorized representative; 

(2) the drug's expiration date is at least six months later than the date that the drug was donated; 

(3) the drug is in its original, unopened, tamper-evident unit dose packaging that includes the drug's lot number and expiration date. Single-unit dose drugs may be accepted if the single-unit-dose packaging is unopened; and 

(4) the drug is not adulterated or misbranded. 

(c) Cancer supplies are eligible for donation under the cancer drug repository program only if the following requirements are met: 

(1) the supplies are not adulterated or misbranded; 

(2) the supplies are in their original, unopened, sealed packaging; and 

(3) the donation is accompanied by a cancer drug repository donor form described under paragraph (d) that is signed by the person making the donation or that person's authorized representative. 

(d) The cancer drug repository donor form must be provided by the board and shall state that to the best of the donor's knowledge the donated drug or supply has been properly stored and that the drug or supply has never been opened, used, tampered with, adulterated, or misbranded. The board shall make the cancer drug repository donor form available on the Board of Pharmacy's website. 

(e) Controlled substances and drugs and supplies that do not meet the criteria under this subdivision are not eligible for donation or acceptance under the cancer drug repository program. 

(f) Drugs and supplies may be donated on the premises of a cancer drug repository to a pharmacist designated by the repository. A drop box may not be used to deliver or accept donations. 

(g) Cancer drugs and supplies donated under the cancer drug repository program must be stored in a secure storage area under environmental conditions appropriate for the drugs or supplies being stored. Donated drugs and supplies may not be stored with nondonated inventory. 

Subd. 6.Dispensing requirements. 
(a) Drugs and supplies must be dispensed by a licensed pharmacist pursuant to a prescription by a practitioner or may be dispensed or administered by a practitioner according to the requirements of this chapter and within the practitioner's scope of practice. 

(b) Cancer drugs and supplies shall be visually inspected by the pharmacist or practitioner before being dispensed or administered for adulteration, misbranding, and date of expiration. Drugs or supplies that have expired or appear upon visual inspection to be adulterated, misbranded, or tampered with in any way may not be dispensed or administered. 

(c) Before a cancer drug or supply may be dispensed or administered to an individual, the individual must sign a cancer drug repository recipient form provided by the board acknowledging that the individual understands the information stated on the form. The form shall include the following information: 

(1) that the drug or supply being dispensed or administered has been donated and may have been previously dispensed; 

(2) that a visual inspection has been conducted by the pharmacist or practitioner to ensure that the drug has not expired, has not been adulterated or misbranded, and is in its original, unopened packaging; and 

(3) that the dispensing pharmacist, the dispensing or administering practitioner, the cancer drug repository, the Board of Pharmacy, and any other participant of the cancer drug repository program cannot guarantee the safety of the drug or supply being dispensed or administered and that the pharmacist or practitioner has determined that the drug or supply is safe to dispense or administer based on the accuracy of the donor's form submitted with the donated drug or supply and the visual inspection required to be performed by the pharmacist or practitioner before dispensing or administering. 

The board shall make the cancer drug repository form available on the Board of Pharmacy's website. 

(d) Drugs and supplies shall only be dispensed or administered to individuals who meet the eligibility requirements in subdivision 4 and in the following order of priority: 

(1) individuals who are uninsured; 

(2) individuals who are enrolled in medical assistance, MinnesotaCare, Medicare, or other public assistance health care; and 

(3) all other individuals who are otherwise eligible under subdivision 4 to receive drugs or supplies from a cancer drug repository. 

Subd. 7.Handling fees. 
A cancer drug repository may charge the individual receiving a drug or supply a handling fee of no more than 250 percent of the medical assistance program dispensing fee for each cancer drug or supply dispensed or administered. 

Subd. 8.Distribution of donated cancer drugs and supplies. 
(a) Cancer drug repositories may distribute drugs and supplies donated under the cancer drug repository program to other repositories if requested by a participating repository. 

(b) A cancer drug repository that has elected not to dispense donated drugs or supplies shall distribute any donated drugs and supplies to a participating repository upon request of the repository. 

(c) If a cancer drug repository distributes drugs or supplies under paragraph (a) or (b), the repository shall complete a cancer drug repository donor form provided by the board. The completed form and a copy of the donor form that was completed by the original donor under subdivision 5 shall be provided to the fully participating cancer drug repository at the time of distribution. 

Subd. 9.Resale of donated drugs or supplies. 
Donated drugs and supplies may not be resold. 

Subd. 10.Record-keeping requirements. 
(a) Cancer drug repository donor and recipient forms shall be maintained for at least five years. 

(b) A record of destruction of donated drugs and supplies that are not dispensed under subdivision 6 shall be maintained by the dispensing repository for at least five years. For each drug or supply destroyed, the record shall include the following information: 

(1) the date of destruction; 

(2) the name, strength, and quantity of the cancer drug destroyed; 

(3) the name of the person or firm that destroyed the drug; and 

(4) the source of the drugs or supplies destroyed. 

Subd. 11.Liability. 
(a) The manufacturer of a drug or supply is not subject to criminal or civil liability for injury, death, or loss to a person or to property for causes of action described in clauses (1) and (2). A manufacturer is not liable for: 

(1) the intentional or unintentional alteration of the drug or supply by a party not under the control of the manufacturer; or 

(2) the failure of a party not under the control of the manufacturer to transfer or communicate product or consumer information or the expiration date of the donated drug or supply. 

(b) A medical facility or pharmacy participating in the program, a pharmacist dispensing a drug or supply pursuant to the program, a practitioner dispensing or administering a drug or supply pursuant to the program, or a donor of a cancer drug or supply as defined in subdivision 1 is immune from civil liability for an act or omission that causes injury to or the death of an individual to whom the cancer drug or supply is dispensed and no disciplinary action shall be taken against a pharmacist or practitioner so long as the drug or supply is donated, accepted, distributed, and dispensed according to the requirements of this section. This immunity does not apply if the act or omission involves reckless, wanton, or intentional misconduct, or malpractice unrelated to the quality of the cancer drug or supply. 

214.17 HIV, HBV, AND HCV PREVENTION PROGRAM; PURPOSE AND SCOPE.
Sections 214.17 to 214.25 are intended to promote the health and safety of patients and regulated persons by reducing the risk of infection in the provision of health care. 

214.18 DEFINITIONS.Subdivision 1.Board. 
"Board" means the Boards of Dentistry, Medical Practice, Nursing, and Podiatric Medicine. For purposes of sections 214.19, subdivisions 4 and 5; 214.20, paragraph (1); and 214.24, board also includes the Board of Chiropractic Examiners. 

Subd. 2.Commissioner. 
"Commissioner" means the commissioner of health. 

Subd. 3.HBV. 
"HBV" means the hepatitis B virus with the e antigen present in the most recent blood test. 

Subd. 3a.HCV. 
"HCV" means the hepatitis C virus. 

Subd. 4.HIV. 
"HIV" means the human immunodeficiency virus. 

Subd. 5.Regulated person. 
"Regulated person" means a licensed dental hygienist, dentist, physician, nurse who is currently registered as a registered nurse or licensed practical nurse, podiatrist, a registered dental assistant, a physician assistant, and for purposes of sections 214.19, subdivisions 4 and 5; 214.20, paragraph (a); and 214.24, a chiropractor. 

214.19 REPORTING OBLIGATIONS.Subdivision 1.Permission to report. 
A person with actual knowledge that a regulated person has been diagnosed as infected with HIV, HBV, or HCV may file a report with the commissioner. 

Subd. 2.Self-reporting. 
A regulated person who is diagnosed as infected with HIV, HBV, or HCV shall report that information to the commissioner promptly, and as soon as medically necessary for disease control purposes but no more than 30 days after learning of the diagnosis or 30 days after becoming licensed or registered by the state. 

Subd. 3.Mandatory reporting. 
A person or institution required to report HIV, HBV, or HCV status to the commissioner under Minnesota Rules, parts 4605.7030, subparts 1 to 4 and 6, and 4605.7040, shall, at the same time, notify the commissioner if the person or institution knows that the reported person is a regulated person. 

Subd. 4.Infection control reporting. 
A regulated person shall, within ten days, report to the appropriate board personal knowledge of a serious failure or a pattern of failure by another regulated person to comply with accepted and prevailing infection control procedures related to the prevention of HIV, HBV, and HCV transmission. In lieu of reporting to the board, the regulated person may make the report to a designated official of the hospital, nursing home, clinic, or other institution or agency where the failure to comply with accepted and prevailing infection control procedures occurred. The designated official shall report to the appropriate board within 30 days of receiving a report under this subdivision. The report shall include specific information about the response by the institution or agency to the report. A regulated person shall not be discharged or discriminated against for filing a complaint in good faith under this subdivision. 

Subd. 5.Immunity. 
A person is immune from civil liability or criminal prosecution for submitting a report in good faith to the commissioner or to a board under this section. 

214.20 GROUNDS FOR DISCIPLINARY OR RESTRICTIVE ACTION.
A board may refuse to grant a license or registration or may impose disciplinary or restrictive action against a regulated person who: 

(1) fails to follow accepted and prevailing infection control procedures, including a failure to conform to current recommendations of the Centers for Disease Control for preventing the transmission of HIV, HBV, and HCV, or fails to comply with infection control rules promulgated by the board. Injury to a patient need not be established; 

(2) fails to comply with any requirement of sections 214.17 to 214.24; or 

(3) fails to comply with any monitoring or reporting requirement. 

214.21 TEMPORARY SUSPENSION.
The board may, without hearing, temporarily suspend the right to practice of a regulated person if the board finds that the regulated person has refused to submit to or comply with monitoring under section 214.23. The suspension shall take effect upon written notice to the regulated person specifying the statute or rule violated. The suspension shall remain in effect until the board issues a final order based on a stipulation or after a hearing. At the time the board issues the suspension notice, the board shall schedule a disciplinary hearing to be held under chapter 14. The regulated person shall be provided with at least 20 days' notice of a hearing held under this section. The hearing shall be scheduled to begin no later than 30 days after the issuance of the suspension order. 

214.22 NOTICE; ACTION.
If the board has reasonable grounds to believe a regulated person infected with HIV, HBV, or HCV has done or omitted doing any act that would be grounds for disciplinary action under section 214.20, the board may take action after giving notice three business days before the action, or a lesser time if deemed necessary by the board. The board may: 

(1) temporarily suspend the regulated person's right to practice under section 214.21; 

(2) require the regulated person to appear personally at a conference with representatives of the board and to provide information relating to the regulated person's health or professional practice; and 

(3) take any other lesser action deemed necessary by the board for the protection of the public. 

214.23 MONITORING.Subdivision 1.Commissioner of health. 
The board shall enter into a contract with the commissioner to perform the functions in subdivisions 2 and 3. The contract shall provide that: 

(1) unless requested to do otherwise by a regulated person, a board shall refer all regulated persons infected with HIV, HBV, or HCV to the commissioner; 

(2) the commissioner may choose to refer any regulated person who is infected with HIV, HBV, or HCV as well as all information related thereto to the person's board at any time for any reason, including but not limited to: the degree of cooperation and compliance by the regulated person; the inability to secure information or the medical records of the regulated person; or when the facts may present other possible violations of the regulated persons practices act. Upon request of the regulated person who is infected with HIV, HBV, or HCV the commissioner shall refer the regulated person and all information related thereto to the person's board. Once the commissioner has referred a regulated person to a board, the board may not thereafter submit it to the commissioner to establish a monitoring plan unless the commissioner of health consents in writing; 

(3) a board shall not take action on grounds relating solely to the HIV, HBV, or HCV status of a regulated person until after referral by the commissioner; and 

(4) notwithstanding sections 13.39 and 13.41 and chapters 147, 147A, 148, 150A, 153, and 214, a board shall forward to the commissioner any information on a regulated person who is infected with HIV, HBV, or HCV that the Department of Health requests. 

Subd. 2.Monitoring plan. 
After receiving a report that a regulated person is infected with HIV, HBV, or HCV, the board or the commissioner acting on behalf of the board shall evaluate the past and current professional practice of the regulated person to determine whether there has been a violation under section 214.20. After evaluation of the regulated person's past and current professional practice, the board or the commissioner, acting on behalf of the board, shall establish a monitoring plan for the regulated person. The monitoring plan may: 

(1) address the scope of a regulated person's professional practice when the board or the commissioner, acting on behalf of the board, determines that the practice constitutes an identifiable risk of transmission of HIV, HBV, or HCV from the regulated person to the patient; 

(2) include the submission of regular reports at a frequency determined by the board or the commissioner, acting on behalf of the board, regarding the regulated person's health status; and 

(3) include any other provisions deemed reasonable by the board or the commissioner of health, acting on behalf of the board. 

The board or commissioner, acting on behalf of the board, may enter into agreements with qualified persons to perform monitoring on its behalf. The regulated person shall comply with any monitoring plan established under this subdivision. 

Subd. 3.Expert review panel. 
The board or the commissioner acting on behalf of the board may appoint an expert review panel to assist in the performance of the responsibilities under this section. In consultations with the expert review panel, the commissioner or board shall, to the extent possible, protect the identity of the regulated person. When an expert review panel is appointed, it must contain at least one member appointed by the commissioner and one professional member appointed by the board. The panel shall provide expert assistance to the board, or to the commissioner acting on behalf of the board, in the subjects of infectious diseases, epidemiology, practice techniques used by regulated persons, and other subjects determined by the board or by the commissioner acting on behalf of the board. Members of the expert review panel are subject to those provisions of chapter 13 that restrict the commissioner or the board under Laws 1992, chapter 559, article 1. 

Subd. 4.Immunity. 
Members of the board or the commissioner acting on behalf of the board, and persons who participate on an expert review panel or who assist the board or the commissioner in monitoring the practice of a regulated person, are immune from civil liability or criminal prosecution for any actions, transactions, or publications made in good faith and in execution of, or relating to, their duties under sections 214.17 to 214.24, except that no immunity shall be available for persons who have knowingly violated any provision of chapter 13. 

214.24 INSPECTION OF PRACTICE.Subdivision 1.Authority. 
The board is authorized to conduct inspections of the clinical practice of a regulated person to determine whether the regulated person is following accepted and prevailing infection control procedures. The board shall provide at least three business days' notice to the clinical practice prior to the inspection. The clinical practice of a regulated person includes any location where the regulated person practices that is not an institution licensed and subject to inspection by the commissioner of health. During the course of inspections the privacy and confidentiality of patients and regulated persons shall be maintained. The board may require on license renewal forms that regulated persons inform the board of all locations where they practice. 

Subd. 2.Access; records. 
An inspector from the board shall have access, during reasonable business hours for purposes of inspection, to all areas of the practice setting where patient care is rendered or drugs or instruments are held that come into contact with a patient. An inspector is authorized to interview employees and regulated persons in the performance of an inspection, to observe infection control procedures, test equipment used to sterilize instruments, and to review and copy all relevant records, excluding patient health records. In performing these responsibilities, inspectors shall make reasonable efforts to respect and preserve patient privacy and the privacy of the regulated person. Boards are authorized to conduct joint inspections and to share information obtained under this section. The boards shall contract with the commissioner to perform the duties under this subdivision. 

Subd. 3.Board action. 
If accepted and prevailing infection control techniques are not being followed, the board may educate the regulated person or take other actions. The board and the inspector shall maintain patient confidentiality in any action resulting from the inspection. 

Subd. 4.Rulemaking. 
A board is authorized to adopt rules setting standards for infection control procedures. Boards shall engage in joint rulemaking. Boards must seek and consider the advice of the commissioner of health before adopting rules. No inspections shall be conducted under this section until after infection control rules have been adopted. Each board is authorized to provide educational information and training to regulated persons regarding infection control. All regulated persons who are employers shall make infection control rules available to employees who engage in functions related to infection control. 

245E.06 ADMINISTRATIVE SANCTIONS.Subd. 2.Written notice of department sanction; sanction effective date; informal meeting. 
(a) The department shall give notice in writing to a person of an administrative sanction that is to be imposed. The notice shall be sent by mail as defined in section 245E.01, subdivision 11. 

(b) The notice shall state: 

(1) the factual basis for the department's determination; 

(2) the sanction the department intends to take; 

(3) the dollar amount of the monetary recovery or recoupment, if any; 

(4) how the dollar amount was computed; 

(5) the right to dispute the department's determination and to provide evidence; 

(6) the right to appeal the department's proposed sanction; and 

(7) the option to meet informally with department staff, and to bring additional documentation or information, to resolve the issues. 

(c) In cases of determinations resulting in denial or termination of payments, in addition to the requirements of paragraph (b), the notice must state: 

(1) the length of the denial or termination; 

(2) the requirements and procedures for reinstatement; and 

(3) the provider's right to submit documents and written arguments against the denial or termination of payments for review by the department before the effective date of denial or termination. 

(d) The submission of documents and written argument for review by the department under paragraph (b), clause (5) or (7), or paragraph (c), clause (3), does not stay the deadline for filing an appeal. 

(e) Notwithstanding section 245E.03, subdivision 4, the effective date of the proposed sanction shall be 30 days after the license holder's, provider's, controlling individual's, or recipient's receipt of the notice, unless timely appealed. If a timely appeal is made, the proposed sanction shall be delayed pending the final outcome of the appeal. Implementation of a proposed sanction following the resolution of a timely appeal may be postponed if, in the opinion of the department, the delay of sanction is necessary to protect the health or safety of children in care. The department may consider the economic hardship of a person in implementing the proposed sanction, but economic hardship shall not be a determinative factor in implementing the proposed sanction. 

(f) Requests for an informal meeting to attempt to resolve issues and requests for appeals must be sent or delivered to the department's Office of Inspector General, Financial Fraud and Abuse Division. 

Subd. 4.Consolidated hearings with licensing sanction. 
If a financial misconduct sanction has an appeal hearing right and it is timely appealed, and a licensing sanction exists for which there is an appeal hearing right and the sanction is timely appealed, and the overpayment recovery action and licensing sanction involve the same set of facts, the overpayment recovery action and licensing sanction must be consolidated in the contested case hearing related to the licensing sanction. 

Subd. 5.Effect of department's administrative determination or sanction. 
Unless a timely and proper appeal is received by the department, the department's administrative determination or sanction shall be considered a final department determination. 

245H.10 BACKGROUND STUDIES.Subd. 2.Direct contact. 
(a) The subject of the background study may not provide direct contact services to a child served by a certified center unless the subject is under continuous direct supervision pending completion of the background study. 

(b) The certified center must document in the staff person's personnel file the date the program initiates a background study and the date the subject of the study first had direct contact with a child served by the center. 

246.18 DISPOSAL OF FUNDS.Subd. 8.State-operated services account. 
(a) The state-operated services account is established in the special revenue fund. Revenue generated by new state-operated services listed under this section established after July 1, 2010, that are not enterprise activities must be deposited into the state-operated services account, unless otherwise specified in law: 

(1) intensive residential treatment services; 

(2) foster care services; and 

(3) psychiatric extensive recovery treatment services. 

(b) Funds deposited in the state-operated services account are appropriated to the commissioner of human services for the purposes of: 

(1) providing services needed to transition individuals from institutional settings within state-operated services to the community when those services have no other adequate funding source; and 

(2) funding the operation of the intensive residential treatment service program in Willmar. 

Subd. 9.Transfers. 
The commissioner may transfer state mental health grant funds to the account in subdivision 8 for noncovered allowable costs of a provider certified and licensed under section 256B.0622 and operating under section 246.014. 

252.41 DEFINITIONS.Subd. 8.Supported employment. 
"Supported employment" means employment of a person with a disability so severe that the person needs ongoing training and support to get and keep a job in which: 

(1) the person engages in paid work at a work site where individuals without disabilities who do not require public subsidies also may be employed; 

(2) public funds are necessary to provide ongoing training and support services throughout the period of the person's employment; and 

(3) the person has the opportunity for social interaction with individuals who do not have disabilities and who are not paid caregivers. 

252.431 SUPPORTED EMPLOYMENT SERVICES; DEPARTMENTAL DUTIES; COORDINATION.
The commissioners of employment and economic development, human services, and education shall ensure that supported employment services provided as part of a comprehensive service system will: 

(1) provide the necessary supports to assist persons with severe disabilities to obtain and maintain employment in normalized work settings available to the general work force that: 

(i) maximize community and social integration; and 

(ii) provide job opportunities that meet the individual's career potential and interests; 

(2) allow persons with severe disabilities to actively participate in the planning and delivery of community-based employment services at the individual, local, and state level; and 

(3) be coordinated among the Departments of Human Services, Employment and Economic Development, and Education to: 

(i) promote the most efficient and effective funding; 

(ii) avoid duplication of services; and 

(iii) improve access and transition to employability services. 

The commissioners of employment and economic development, human services, and education shall report to the legislature by January 1993 on the steps taken to implement this section. 

252.451 BUSINESS AGREEMENTS; SUPPORT AND SUPERVISION OF PERSONS WITH DISABILITIES.Subdivision 1.Definition. 
For the purposes of this section, "qualified business" means a business that employs primarily nondisabled persons and will employ persons with developmental disabilities. For purposes of this section, licensed providers of residential services for persons with developmental disabilities are not a qualified business. A qualified business and its employees are exempt from Minnesota Rules, parts 9525.1800 to 9525.1930. 

Subd. 2.Vendor participation and reimbursement. 
Notwithstanding requirements in chapters 245A and 245D, and sections 252.28, 252.41 to 252.46, and 256B.501, vendors of day training and habilitation services may enter into written agreements with qualified businesses to provide additional training and supervision needed by individuals to maintain their employment. 

Subd. 3.Agreement specifications. 
Agreements must include the following: 

(1) the type and amount of supervision and support to be provided by the business to the individual in accordance with their needs as identified in their individual service plan; 

(2) the methods used to periodically assess the individual's satisfaction with their work, training, and support; 

(3) the measures taken by the qualified business and the vendor to ensure the health, safety, and protection of the individual during working hours, including the reporting of abuse and neglect under state law and rules; 

(4) the training and support services the vendor will provide to the qualified business, including the frequency of on-site supervision and support; and 

(5) any payment to be made to the qualified business by the vendor. Payment to the business must be limited to: 

(i) additional costs of training coworkers and managers that exceed ordinary and customary training costs and are a direct result of employing a person with a developmental disability; and 

(ii) additional costs for training, supervising, and assisting the person with a developmental disability that exceed normal and customary costs required for performing similar tasks or duties. 

Payments made to a qualified business under this section must not include incentive payments to the qualified business or salary supplementation for the person with a developmental disability. 

Subd. 4.Client protection. 
Persons receiving training and support under this section may not be denied their rights or procedural protections under section 256.045, subdivision 4a, or 256B.092, including the county agency's responsibility to arrange for appropriate services, as necessary, in the event that persons lose their job or the contract with the qualified business is terminated. 

Subd. 5.Vendor payment. 
(a) For purposes of this section, the vendor shall bill and the commissioner shall reimburse the vendor for full-day or partial-day services to a client that would otherwise have been paid to the vendor for providing direct services, provided that both of the following criteria are met: 

(1) the vendor provides services and payments to the qualified business that enable the business to perform support and supervision services for the client that the vendor would otherwise need to perform; and 

(2) the client for whom a rate will be billed will receive full-day or partial-day services from the vendor and the rate to be paid the vendor will allow the client to work with this support and supervision at the qualified business instead of receiving these services from the vendor. 

(b) Medical assistance reimbursement of services provided to persons receiving day training and habilitation services under this section is subject to the limitations on reimbursement for vocational services under federal law and regulation. 

254B.03 RESPONSIBILITY TO PROVIDE CHEMICAL DEPENDENCY TREATMENT.Subd. 4a.Division of costs for medical assistance services. 
Notwithstanding subdivision 4, for chemical dependency services provided on or after October 1, 2008, and reimbursed by medical assistance, the county share is 30 percent of the nonfederal share. 

256B.0625 COVERED SERVICES.Subd. 31c.Preferred incontinence product program. 
The commissioner shall implement a preferred incontinence product program by July 1, 2018. The program shall require the commissioner to volume purchase incontinence products and related supplies in accordance with section 256B.04, subdivision 14. Medical assistance coverage for incontinence products and related supplies shall conform to the limitations established under the program. 

Subd. 63.Payment for multiple services provided on the same day. 
The commissioner shall not prohibit payment, including supplemental payments, for mental health services or dental services provided to a patient by a clinic or health care professional solely because the mental health or dental services were provided on the same day as other covered health services furnished by the same provider. 

256B.0659 PERSONAL CARE ASSISTANCE PROGRAM.Subd. 22.Annual review for personal care providers. 
(a) All personal care assistance provider agencies shall resubmit, on an annual basis, the information specified in subdivision 21, in a format determined by the commissioner, and provide a copy of the personal care assistance provider agency's most current version of its grievance policies and procedures along with a written record of grievances and resolutions of the grievances that the personal care assistance provider agency has received in the previous year and any other information requested by the commissioner. 

(b) The commissioner shall send annual review notification to personal care assistance provider agencies 30 days prior to renewal. The notification must: 

(1) list the materials and information the personal care assistance provider agency is required to submit; 

(2) provide instructions on submitting information to the commissioner; and 

(3) provide a due date by which the commissioner must receive the requested information. 

Personal care assistance provider agencies shall submit required documentation for annual review within 30 days of notification from the commissioner. If no documentation is submitted, the personal care assistance provider agency enrollment number must be terminated or suspended. 

(c) Personal care assistance provider agencies also currently licensed under section 144A.471, subdivision 6 or 7, or currently certified for participation in Medicare as a home health agency are deemed in compliance with the personal care assistance requirements for enrollment, annual review process, and documentation. 

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

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

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

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

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

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

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

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

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

256B.431 RATE DETERMINATION.Subd. 3i.Property costs for the rate year beginning July 1, 1990. 
Notwithstanding Minnesota Rules, part 9549.0060, subpart 13, item H, the commissioner shall determine property-related payment rates for nursing facilities for the rate year beginning July 1, 1990, as follows: 

(a) The property-related payment rate for a nursing facility that qualifies under subdivision 3g is the greater of the rate determined under that subdivision or the rate determined under paragraph (c), (d), or (e), whichever is applicable. 

(b) Nursing facilities shall be grouped according to the type of property-related payment rate the commissioner determined for the rate year beginning July 1, 1989. A nursing facility whose property-related payment rate was determined under Minnesota Rules, part 9549.0060, subpart 13, item A (full rental reimbursement), shall be considered group A. A nursing facility whose property-related payment rate was determined under Minnesota Rules, part 9549.0060, subpart 13, item B (phase-down to full rental reimbursement), shall be considered group B. A nursing facility whose property-related payment rate was determined under Minnesota Rules, part 9549.0060, subpart 13, item C or D (phase-up to full rental reimbursement), shall be considered group C. 

(c) For the rate year beginning July 1, 1990, a group A nursing facility shall receive its property-related payment rate determined under Minnesota Rules, parts 9549.0010 to 9549.0080, and this section. 

(d) For the rate year beginning July 1, 1990, a Group B nursing facility shall receive the greater of 87 percent of the property-related payment rate in effect on July 1, 1989; or the rental per diem rate determined under Minnesota Rules, parts 9549.0010 to 9549.0080, and this section in effect on July 1, 1990; or the sum of 100 percent of the nursing facility's allowable principal and interest expense, plus its equipment allowance multiplied by the resident days for the reporting year ending September 30, 1989, divided by the nursing facility's capacity days as determined under Minnesota Rules, part 9549.0060, subpart 11, as modified by subdivision 3f, paragraph (c); except that the nursing facility's property-related payment rate must not exceed its property-related payment rate in effect on July 1, 1989. 

(e) For the rate year beginning July 1, 1990, a group C nursing facility shall receive its property-related payment rate determined under Minnesota Rules, parts 9549.0010 to 9549.0080, and this section, except the rate must not exceed the lesser of its property-related payment rate determined for the rate year beginning July 1, 1989, multiplied by 116 percent or its rental per diem rate determined effective July 1, 1990. 

(f) The property-related payment rate for a nursing facility that qualifies for a rate adjustment under Minnesota Rules, part 9549.0060, subpart 13, item G (special reappraisals), shall have the property-related payment rate determined in paragraphs (a) to (e) adjusted according to the provisions in that rule. 

(g) Except as provided in subdivision 4, paragraph (f), and subdivision 11, a nursing facility that has a change in ownership or a reorganization of provider entity is subject to the provisions of Minnesota Rules, part 9549.0060, subpart 13, item F. 

Subd. 15.Capital repair and replacement cost reporting and rate calculation. 
For rate years beginning after June 30, 1993, a nursing facility's capital repair and replacement payment rate shall be established annually as provided in paragraphs (a) to (e). 

(a) Notwithstanding Minnesota Rules, part 9549.0060, subpart 12, the costs of any of the following items not included in the equity incentive computations under subdivision 16 or reported as a capital asset addition under subdivision 18, paragraph (b), including cash payment for equity investment and principal and interest expense for debt financing, must be reported in the capital repair and replacement cost category: 

(1) wall coverings; 

(2) paint; 

(3) floor coverings; 

(4) window coverings; 

(5) roof repair; and 

(6) window repair or replacement. 

(b) Notwithstanding Minnesota Rules, part 9549.0060, subpart 12, the repair or replacement of a capital asset not included in the equity incentive computations under subdivision 16 or reported as a capital asset addition under subdivision 18, paragraph (b), must be reported under this subdivision when the cost of the item exceeds $500, or in the plant operations and maintenance cost category when the cost of the item is equal to or less than $500. 

(c) To compute the capital repair and replacement payment rate, the allowable annual repair and replacement costs for the reporting year must be divided by actual resident days for the reporting year. The annual allowable capital repair and replacement costs shall not exceed $150 per licensed bed. The excess of the allowed capital repair and replacement costs over the capital repair and replacement limit shall be a cost carryover to succeeding cost reporting periods, except that sale of a facility, under subdivision 14, shall terminate the carryover of all costs except those incurred in the most recent cost reporting year. The termination of the carryover shall have effect on the capital repair and replacement rate on the same date as provided in subdivision 14, paragraph (f), for the sale. For rate years beginning after June 30, 1994, the capital repair and replacement limit shall be subject to the index provided in subdivision 3f, paragraph (a). For purposes of this subdivision, the number of licensed beds shall be the number used to calculate the nursing facility's capacity days. The capital repair and replacement rate must be added to the nursing facility's total payment rate. 

(d) Capital repair and replacement costs under this subdivision shall not be counted as either care-related or other operating costs, nor subject to care-related or other operating limits. 

(e) If costs otherwise allowable under this subdivision are incurred as the result of a project approved under the moratorium exception process in section 144A.073, or in connection with an addition to or replacement of buildings, attached fixtures, or land improvements for which the total historical cost of these assets exceeds the lesser of $150,000 or ten percent of the nursing facility's appraised value, these costs must be claimed under subdivision 16 or 17, as appropriate. 

Subd. 16.Major additions and replacements; equity incentive. 
For rate years beginning after June 30, 1993, if a nursing facility acquires capital assets in connection with a project approved under the moratorium exception process in section 144A.073 or in connection with an addition to or replacement of buildings, attached fixtures, or land improvements for which the total historical cost of those capital asset additions exceeds the lesser of $150,000 or ten percent of the most recent appraised value, the nursing facility shall be eligible for an equity incentive payment rate as in paragraphs (a) to (d). This computation is separate from the determination of the nursing facility's rental rate. An equity incentive payment rate as computed under this subdivision is limited to one in a 12-month period. 

(a) An eligible nursing facility shall receive an equity incentive payment rate equal to the allowable historical cost of the capital asset acquired, minus the allowable debt directly identified to that capital asset, multiplied by the equity incentive factor as described in paragraphs (b) and (c), and divided by the nursing facility's occupancy factor under subdivision 3f, paragraph (c). This amount shall be added to the nursing facility's total payment rate and shall be effective the same day as the incremental increase in paragraph (d) or subdivision 17. The allowable historical cost of the capital assets and the allowable debt shall be determined as provided in Minnesota Rules, parts 9549.0010 to 9549.0080, and this section. 

(b) The equity incentive factor shall be determined under clauses (1) to (4): 

(1) divide the initial allowable debt in paragraph (a) by the initial historical cost of the capital asset additions referred to in paragraph (a), then cube the quotient, 

(2) subtract the amount calculated in clause (1) from the number one, 

(3) determine the difference between the rental factor and the lesser of two percentage points above the posted yield for standard conventional fixed rate mortgages of the Federal Home Loan Mortgage Corporation as published in the Wall Street Journal and in effect on the first day of the month the debt or cost is incurred, or 16 percent, 

(4) multiply the amount calculated in clause (2) by the amount calculated in clause (3). 

(c) The equity incentive payment rate shall be limited to the term of the allowable debt in paragraph (a), not greater than 20 years nor less than ten years. If no debt is incurred in acquiring the capital asset, the equity incentive payment rate shall be paid for ten years. The sale of a nursing facility under subdivision 14 shall terminate application of the equity incentive payment rate effective on the date provided in subdivision 14, paragraph (f), for the sale. 

(d) A nursing facility with an addition to or a renovation of its buildings, attached fixtures, or land improvements meeting the criteria in this subdivision and not receiving the property-related payment rate adjustment in subdivision 17, shall receive the incremental increase in the nursing facility's rental rate as determined under Minnesota Rules, parts 9549.0010 to 9549.0080, and this section. The incremental increase shall be added to the nursing facility's property-related payment rate. The effective date of this incremental increase shall be the first day of the month of January or July, whichever occurs first following the date on which the addition or replacement is completed. 

256B.434 ALTERNATIVE PAYMENT DEMONSTRATION PROJECT.Subd. 6.Contract payment rates; appeals. 
If an appeal is pending concerning the cost-based payment rates that are the basis for the calculation of the payment rate under the alternative payment demonstration project, the commissioner and the nursing facility may agree on an interim contract rate to be used until the appeal is resolved. When the appeal is resolved, the contract rate must be adjusted retroactively in accordance with the appeal decision. 

Subd. 10.Exemptions. 
 A facility that is under contract with the commissioner under this section is not subject to the moratorium on licensure or certification of new nursing home beds in section 144A.071, unless the project results in a net increase in bed capacity or involves relocation of beds from one site to another. Contract payment rates must not be adjusted to reflect any additional costs that a nursing facility incurs as a result of a construction project undertaken under this subdivision. In addition, as a condition of entering into a contract under this section, a nursing facility must agree that any future medical assistance payments for nursing facility services will not reflect any additional costs attributable to the sale of a nursing facility under this section and to construction undertaken under this subdivision that otherwise would not be authorized under the moratorium in section 144A.073. Nothing in this section prevents a nursing facility participating in the alternative payment demonstration project under this section from seeking approval of an exception to the moratorium through the process established in section 144A.073, and if approved the facility's rates shall be adjusted to reflect the cost of the project. Nothing in this section prevents a nursing facility participating in the alternative payment demonstration project from seeking legislative approval of an exception to the moratorium under section 144A.071, and, if enacted, the facility's rates shall be adjusted to reflect the cost of the project. 

256B.4913 PAYMENT METHODOLOGY DEVELOPMENT.Subd. 4a.Rate stabilization adjustment. 
(a) For purposes of this subdivision, "implementation period" means the period beginning January 1, 2014, and ending on the last day of the month in which the rate management system is populated with the data necessary to calculate rates for substantially all individuals receiving home and community-based waiver services under sections 256B.092 and 256B.49. "Banding period" means the time period beginning on January 1, 2014, and ending upon the expiration of the 12-month period defined in paragraph (c), clause (5). 

(b) For purposes of this subdivision, the historical rate for all service recipients means the individual reimbursement rate for a recipient in effect on December 1, 2013, except that: 

(1) for a day service recipient who was not authorized to receive these waiver services prior to January 1, 2014; added a new service or services on or after January 1, 2014; or changed providers on or after January 1, 2014, the historical rate must be the weighted average authorized rate for the provider number in the county of service, effective December 1, 2013; or 

(2) for a unit-based service with programming or a unit-based service without programming recipient who was not authorized to receive these waiver services prior to January 1, 2014; added a new service or services on or after January 1, 2014; or changed providers on or after January 1, 2014, the historical rate must be the weighted average authorized rate for each provider number in the county of service, effective December 1, 2013; or 

(3) for residential service recipients who change providers on or after January 1, 2014, the historical rate must be set by each lead agency within their county aggregate budget using their respective methodology for residential services effective December 1, 2013, for determining the provider rate for a similarly situated recipient being served by that provider. 

(c) The commissioner shall adjust individual reimbursement rates determined under this section so that the unit rate is no higher or lower than: 

(1) 0.5 percent from the historical rate for the implementation period; 

(2) 0.5 percent from the rate in effect in clause (1), for the 12-month period immediately following the time period of clause (1); 

(3) 0.5 percent from the rate in effect in clause (2), for the 12-month period immediately following the time period of clause (2); 

(4) 1.0 percent from the rate in effect in clause (3), for the 12-month period immediately following the time period of clause (3); 

(5) 1.0 percent from the rate in effect in clause (4), for the 12-month period immediately following the time period of clause (4); 

(6) no adjustment to the rate in effect in clause (5) for the 12-month period immediately following the time period of clause (5). During this banding rate period, the commissioner shall not enforce any rate decrease or increase that would otherwise result from the end of the banding period. The commissioner shall, upon enactment, seek federal approval for the addition of this banding period; and 

(7) one percent from the rate in effect in clause (6) for the 12-month period immediately following the time period of clause (6). 

(d) The commissioner shall review all changes to rates that were in effect on December 1, 2013, to verify that the rates in effect produce the equivalent level of spending and service unit utilization on an annual basis as those in effect on October 31, 2013. 

(e) By December 31, 2014, the commissioner shall complete the review in paragraph (d), adjust rates to provide equivalent annual spending, and make appropriate adjustments. 

(f) During the banding period, the Medicaid Management Information System (MMIS) service agreement rate must be adjusted to account for change in an individual's need. The commissioner shall adjust the Medicaid Management Information System (MMIS) service agreement rate by: 

(1) calculating a service rate under section 256B.4914, subdivision 6, 7, 8, or 9, for the individual with variables reflecting the level of service in effect on December 1, 2013; 

(2) calculating a service rate under section 256B.4914, subdivision 6, 7, 8, or 9, for the individual with variables reflecting the updated level of service at the time of application; and 

(3) adding to or subtracting from the Medicaid Management Information System (MMIS) service agreement rate, the difference between the values in clauses (1) and (2). 

(g) This subdivision must not apply to rates for recipients served by providers new to a given county after January 1, 2014. Providers of personal supports services who also acted as fiscal support entities must be treated as new providers as of January 1, 2014. 

Subd. 5.Stakeholder consultation and county training. 
(a) The commissioner shall continue consultation on regular intervals with the existing stakeholder group established as part of the rate-setting methodology process and others, to gather input, concerns, and data, to assist in the full implementation of the new rate payment system and to make pertinent information available to the public through the department's website. 

(b) The commissioner shall offer training at least annually for county personnel responsible for administering the rate-setting framework in a manner consistent with this section and section 256B.4914. 

(c) The commissioner shall maintain an online instruction manual explaining the rate-setting framework. The manual shall be consistent with this section and section 256B.4914, and shall be accessible to all stakeholders including recipients, representatives of recipients, county or tribal agencies, and license holders. 

(d) The commissioner shall not defer to the county or tribal agency on matters of technical application of the rate-setting framework, and a county or tribal agency shall not set rates in a manner that conflicts with this section or section 256B.4914. 

Subd. 6.Implementation. 
(a) The commissioner shall implement changes on January 1, 2014, to payment rates for individuals receiving home and community-based waivered services after the enactment of legislation that establishes specific payment methodology frameworks, processes for rate calculations, and specific values to populate the disability waiver rates system. 

(b) On January 1, 2014, all new service authorizations must use the disability waiver rates system. Beginning January 1, 2014, all renewing individual service plans must use the disability waiver rates system as reassessment and reauthorization occurs. By December 31, 2014, data for all recipients must be entered into the disability waiver rates system. 

Subd. 7.New services. 
A service added to section 256B.4914 after January 1, 2014, is not subject to rate stabilization adjustment in this section. 

256B.79 INTEGRATED CARE FOR HIGH-RISK PREGNANT WOMEN.Subd. 7.Expiration. 
This section expires June 30, 2019. 

256I.05 MONTHLY RATES.Subd. 3.Limits on rates. 
When a room and board rate is used to pay for an individual's room and board, the rate payable to the residence must not exceed the rate paid by an individual not receiving a room and board rate under this chapter. 

256L.11 PROVIDER PAYMENT.Subd. 2a.Payment rates; services for families and children under the MinnesotaCare health care reform waiver. 
Subdivision 2 shall not apply to services provided to families with children who are eligible according to section 256L.04, subdivision 1, paragraph (a). 

256R.53 FACILITY SPECIFIC EXEMPTIONS.Subd. 2.Nursing facility in Breckenridge. 
The operating payment rate of a nonprofit nursing facility that exists on January 1, 2015, is located within the boundaries of the city of Breckenridge, and is reimbursed under this chapter, is equal to the greater of: 

(1) the operating payment rate determined under section 256R.21, subdivision 3; or 

(2) the median case mix adjusted rates, including comparable rate components as determined by the median case mix adjusted rates, including comparable rate components as determined by the commissioner, for the equivalent case mix indices of the nonprofit nursing facility or facilities located in an adjacent city in another state and in cities contiguous to the adjacent city. The Minnesota facility's operating payment rate with a case mix index of 1.0 is computed by dividing the adjacent city's nursing facility or facilities' median operating payment rate with an index of 1.02 by 1.02. 

Repealed Minnesota Session Laws: 19-5223 

Laws 2010, First Special Session chapter 1, article 25, section 3, subdivision 10

	Sec. 3. COMMISSIONER OF HUMAN SERVICES 					

	Subd. 10.State-Operated Services 					

Obsolete Laundry Depreciation Account. $669,000, or the balance, whichever is greater, must be transferred from the state-operated services laundry depreciation account in the special revenue fund and deposited into the general fund by June 30, 2010. This paragraph is effective the day following final enactment. 

Operating Budget Reductions. No operating budget reductions enacted in Laws 2010, chapter 200, or in this act shall be allocated to state-operated services. 

Prohibition on Transferring Funds. The commissioner shall not transfer mental health grants to state-operated services without specific legislative approval. Notwithstanding any contrary provision in this article, this paragraph shall not expire. 

	(a) Adult Mental Health Services		-0-		6,888,000	

Base Adjustment. The general fund base is decreased by $12,286,000 in fiscal year 2012 and $12,394,000 in fiscal year 2013. 

Appropriation Requirements.  (a) The general fund appropriation to the commissioner includes funding for the following: 

(1) to a community collaborative to begin providing crisis center services in the Mankato area that are comparable to the crisis services provided prior to the closure of the Mankato Crisis Center. The commissioner shall recruit former employees of the Mankato Crisis Center who were recently laid off to staff the new crisis services. The commissioner shall obtain legislative approval prior to discontinuing this funding; 

(2) to maintain the building in Eveleth that currently houses community transition services and to establish a psychiatric intensive therapeutic foster home as an enterprise activity. The commissioner shall request a waiver amendment to allow CADI funding for psychiatric intensive therapeutic foster care services provided in the same location and building as the community transition services. If the federal government does not approve the waiver amendment, the commissioner shall continue to pay the lease for the building out of the state-operated services budget until the commissioner of administration subleases the space or until the lease expires, and shall establish the psychiatric intensive therapeutic foster home at a different site. The commissioner shall make diligent efforts to sublease the space; 

(3) to convert the community behavioral health hospitals in Wadena and Willmar to facilities that provide more suitable services based on the needs of the community, which may include, but are not limited to, psychiatric extensive recovery treatment services. The commissioner may also establish other community-based services in the Willmar and Wadena areas that deliver the appropriate level of care in response to the express needs of the communities. The services established under this provision must be staffed by state employees. 

(4) to continue the operation of the dental clinics in Brainerd, Cambridge, Faribault, Fergus Falls, and Willmar at the same level of care and staffing that was in effect on March 1, 2010. The commissioner shall not proceed with the planned closure of the dental clinics, and shall not discontinue services or downsize any of the state-operated dental clinics without specific legislative approval. The commissioner shall continue to bill for services provided to obtain medical assistance critical access dental payments and cost-based payment rates as provided in Minnesota Statutes, section 256B.76, subdivision 2, and shall bill for services provided three months retroactively from the date of this act. This appropriation is onetime; 

(5) to convert the Minnesota Neurorehabilitation Hospital in Brainerd to a neurocognitive psychiatric extensive recovery treatment service; and 

(6) to convert the Minnesota extended treatment options (METO) program to the following community-based services provided by state employees: (i) psychiatric extensive recovery treatment services; (ii) intensive transitional foster homes as enterprise activities; and (iii) other community-based support services. The provisions under Minnesota Statutes, section 252.025, subdivision 7, are applicable to the METO services established under this clause. Notwithstanding Minnesota Statutes, section 246.18, subdivision 8, any revenue lost to the general fund by the conversion of METO to new services must be replaced by revenue from the new services to offset the lost revenue to the general fund until June 30, 2013. Any revenue generated in excess of this amount shall be deposited into the special revenue fund under Minnesota Statutes, section 246.18, subdivision 8. 

(b) The commissioner shall not move beds from the Anoka-Metro Regional Treatment Center to the psychiatric nursing facility at St. Peter without specific legislative approval. 

(c) The commissioner shall implement changes, including the following, to save a minimum of $6,006,000 beginning in fiscal year 2011, and report to the legislature the specific initiatives implemented and the savings allocated to each one, including: 

(1) maximizing budget savings through strategic employee staffing; and 

(2) identifying and implementing cost reductions in cooperation with state-operated services employees. 

Base level funding is reduced by $6,006,000 effective fiscal year 2011. 

(d) The commissioner shall seek certification or approval from the federal government for the new services under paragraph (a) that are eligible for federal financial participation and deposit the revenue associated with these new services in the account established under Minnesota Statutes, section 246.18, subdivision 8, unless otherwise specified. 

(e) Notwithstanding any contrary provision in this article, this rider shall not expire. 

	(b) Minnesota Sex Offender Services		-0-		(145,000)	

Sex Offender Services. Base level funding for Minnesota sex offender services is reduced by $418,000 in fiscal year 2012 and $419,000 in fiscal year 2013 for the 50-bed sex offender treatment program within the Moose Lake correctional facility in which Department of Human Services staff from Minnesota sex offender services provide clinical treatment to incarcerated offenders. This reduction shall become part of the base for the Department of Human Services. 

Interagency Agreements. The commissioner of human services may enter into interagency agreements with the commissioner of corrections to continue sex offender treatment and chemical dependency treatment on a cost-sharing basis, in which each department pays 50 percent of the costs of these services. 

Base Adjustment. The general fund base is increased by $418,000 in fiscal year 2012 and $419,000 in fiscal year 2013. 

2960.3030CAPACITY LIMITS. Subp. 3.Exceptions to capacity limits.  
A variance may be granted to allow up to eight foster children in addition to the license holder's own children if the conditions in items A to E are met: 

A.
 placement is necessary to keep a sibling group together, to keep a child in the child's home community, or is necessary because the foster child was formerly living in the home and it would be in the child's best interest to be placed there again; 

B.
 there is no risk of harm to the children currently in the home; 

C.
 the structural characteristics of the home, including sleeping space, can accommodate the additional foster children; 

D.
 the home remains in compliance with applicable zoning, health, fire, and building codes; and 

E.
 the statement of intended use states the conditions for the exception to capacity limits and explains how the license holder will maintain a ratio of adults to children which ensures the safety and appropriate supervision of all the children in the foster home. 

A foster home licensed by the Department of Corrections need not meet the requirement in item A. 

3400.0185TERMINATION AND ADVERSE ACTIONS; NOTICE REQUIRED. Subp. 5.Notice to providers of actions adverse to the provider.  
The county must give a provider written notice of the following actions adverse to the provider: a denial of authorization, a termination of authorization, a reduction in the number of hours of care with that provider, and a determination that the provider has an overpayment. The notice must include the following information: 

A. 
a description of the adverse action; 

B. 
the effective date of the adverse action; and 

C. 
a statement that unless a family appeals the adverse action before the effective date or the provider appeals the overpayment determination, the adverse action will occur on the effective date. The notice must be mailed to the provider at least 15 calendar days before the effective date of the adverse action. 

6400.6970FEES. Subpart 1.Payment types and nonrefundability.  
The fees imposed in this part shall be paid by cash, personal check, bank draft, cashier's check, or money order made payable to the Board of Examiners for Nursing Home Administrators. All fees are nonrefundable. 

Subp. 2.Amounts.  
The amount of fees may be set by the board with the approval of the Department of Management and Budget up to the limits provided in this part depending upon the total amount required to sustain board operations under Minnesota Statutes, section 16A.1285, subdivision 2. Information about fees in effect at any time is available from the board office. The maximum amounts of fees are: 

A.
 application for licensure, $150; 

B.
 for a prospective applicant for a review of education and experience advisory to the license application, $50, to be applied to the fee for application for licensure if the latter is submitted within one year of the request for review of education and experience; 

C.
 state examination, $75; 

D.
 initial license, $200 if issued between July 1 and December 31, $100 if issued between January 1 and June 30; 

E.
 acting administrator permit, $250; 

F.
 renewal license, $200; 

G.
 duplicate license, $10; 

H.
 fee to a sponsor for review of individual continuing education seminars, institutes, workshops, or home study courses: 

(1)
 for less than seven clock hours, $30; and 

(2)
 for seven or more clock hours, $50; 

I.
 fee to a licensee for review of continuing education seminars, institutes, workshops, or home study courses not previously approved for a sponsor and submitted with an application for license renewal: 

(1)
 for less than seven clock hours total, $30; and 

(2)
 for seven or more clock hours total, $50; 

J.
 late renewal fee, $50; 

K.
 fee to a licensee for verification of licensure status and examination scores, $30; and 

L.
 registration as a registered continuing education sponsor, $1,000. 

7200.6100FEES. 
The nonrefundable fees for licensure payable to the board are as follows: 

A. 
application for admission to national standardized examination, $150; 

B. 
application for professional responsibility examination, $150; 

C. 
application for licensure as a licensed psychologist, $500; 

D. 
renewal of license for a licensed psychologist, $500; 

E. 
late renewal of license for a licensed psychologist, $250; 

F. 
application for converting from master's to doctoral level licensure, $150; and 

G. 
application for guest licensure, $150. 

7200.6105CONTINUING EDUCATION SPONSOR FEE. 
A sponsor applying for approval of a continuing education activity pursuant to part 7200.3830, subpart 2, shall submit with the application a fee of $80 for each activity. 

9502.0425PHYSICAL ENVIRONMENT. Subp. 4.Means of escape.  
From each room of the residence used by children, there must be two means of escape. One means of escape must be a stairway or door leading to the floor of exit discharge. The other must be a door or window leading directly outside. The window must be openable without special knowledge. It must have a clear opening of not less than 5.7 square feet and have a minimum clear opening dimension of 20 inches wide and 24 inches high. The window must be within 48 inches from the floor. 

Subp. 16.Extinguishers.  
A portable, operational, multipurpose, dry chemical fire extinguisher with a minimum 2 A 10 BC rating must be maintained in the kitchen and cooking areas of the residence at all times. All caregivers shall know how to use the fire extinguisher. 

Subp. 17.Smoke detection systems.  
Smoke detectors that have been listed by the Underwriter Laboratory must be properly installed and maintained on all levels. 

9503.0155FACILITY. Subp. 8.Telephone; posted numbers.  
A telephone that is not coin operated must be located within the center. A list of emergency numbers must be posted next to the telephone. If a 911 emergency number is not available, the numbers listed must be those of the local fire department, police department, emergency transportation, and poison control center. 

9549.0057DETERMINATION OF INTERIM AND SETTLE UP OPERATING COST PAYMENT RATES. Subpart 1.Conditions.  
To receive an interim payment rate, a nursing facility must comply with the requirements and is subject to the conditions in part 9549.0060, subpart 14, items A to C. The commissioner shall determine interim and settle up operating cost payment rates for a newly constructed nursing facility, or one with an increase in licensed capacity of 50 percent or more according to subparts 2 and 3. 

Subp. 2.Interim operating cost payment rate.  
For the rate year or portion of an interim period beginning on or after July 1, 1986, the interim total operating cost payment rate must be determined according to parts 9549.0050 to 9549.0059 (Temporary) in effect on March 1, 1987. For the rate year or portion of an interim period beginning on or after July 1, 1987, the interim total operating cost payment rate must be determined according to parts 9549.0051 to 9549.0059, except that: 

A.
 The nursing facility must project its anticipated resident days for each resident class. The anticipated resident days for each resident class must be multiplied by the weight for that resident class as listed in part 9549.0058 to determine the anticipated standardized resident days for the reporting period. 

B.
 The commissioner shall use anticipated standardized resident days in determining the allowable historical case mix operating cost standardized per diem. 

C.
 The commissioner shall use the anticipated resident days in determining both the allowable historical other care related operating cost per diem and the allowable historical other operating cost per diem. 

D.
 The annual adjustment factors determined in part 9549.0055, subpart 1, must not be applied to the nursing facility's allowable historical per diems as provided in part 9549.0056, subparts 2 and 4. 

E.
 The limits established in part 9549.0055, subpart 2, items C and E, as indexed in part 9549.0055, subpart 3 and in effect at the beginning of the interim period, must be increased by ten percent. 

F.
 The efficiency incentive in part 9549.0056, subpart 4, item A or B, must not apply. 

G.
 The phase in provisions in part 9549.0056, subpart 7, must not apply. 

Subp. 3.Settle up operating cost payment rate.  
The settle up total operating cost payment rate must be determined according to items A to C. 

A.
 The settle up operating cost payment rate for interim periods before July 1, 1987, is subject to the rule parts that were in effect during the interim period. 

B.
 To determine the settle up operating cost payment rate for interim periods or the portion of an interim period occurring after July 1, 1987, subitems (1) to (7) must be applied. 

(1)
 The standardized resident days as determined in part 9549.0054, subpart 2, must be used for the interim period. 

(2)
 The commissioner shall use the standardized resident days in subitem (1) in determining the allowable historical case mix operating cost standardized per diem. 

(3)
 The commissioner shall use the actual resident days in determining both the allowable historical other care related operating cost per diem and the allowable historical other operating cost per diem. 

(4)
 The annual adjustment factors determined in part 9549.0055, subpart 1, must not be applied to the nursing facility's allowable historical per diems as provided in part 9549.0056, subparts 2 and 4. 

(5)
 The limits established in part 9549.0055, subpart 2, item E, must be the limits for the settle up reporting periods occurring after July 1, 1987. If the interim period includes more than one July 1 date, the commissioner shall use the limit established in part 9549.0055, subpart 2, items C and E, as indexed in part 9549.0055, subpart 3, increased by ten percent for the second July 1 date. 

(6)
 The efficiency incentive in part 9549.0056, subpart 4, item A or B, must not apply. 

(7)
 The phase in provisions in part 9549.0056, subpart 7 must not apply. 

C.
 For the nine month period following the settle up reporting period, the total operating cost payment rate must be determined according to item B except that the efficiency incentive as computed in part 9549.0056, subpart 4, item A or B, applies. 

D.
 The total operating cost payment rate for the rate year beginning July 1 following the nine month period in item C must be determined under parts 9549.0050 to 9549.0059. 

E.
 A newly constructed nursing facility or one with an increase in licensed capacity of 50 percent or more must continue to receive the interim total operating cost payment rate until the settle up total operating cost payment rate is determined under this subpart. 

9549.0060DETERMINATION OF THE PROPERTY-RELATED PAYMENT RATE. Subp. 14.Determination of interim and settle-up payment rates.  
The commissioner shall determine interim and settle-up payment rates according to items A to J. 

A.
 A newly constructed nursing facility, or one with a capacity increase of 50 percent or more, may submit a written application to the commissioner to receive an interim payment rate. The nursing facility shall submit cost reports and other supporting information as required in parts 9549.0010 to 9549.0080 for the reporting year in which the nursing facility plans to begin operation at least 60 days before the first day a resident is admitted to the newly constructed nursing facility bed. The nursing facility shall state the reasons for noncompliance with parts 9549.0010 to 9549.0080. The effective date of the interim payment rate is the earlier of either the first day a resident is admitted to the newly constructed nursing facility or the date the nursing facility bed is certified for medical assistance. The interim payment rate for a newly constructed nursing facility, or a nursing facility with a capacity increase of 50 percent or more, is determined under items B to D. 

B.
 The interim payment rate must not be in effect more than 17 months. When the interim payment rate begins between May 1 and September 30, the nursing facility shall file settle-up cost reports for the period from the beginning of the interim payment rate through September 30 of the following year. When the interim payment rate begins between October 1 and April 30, the nursing facility shall file settle-up cost reports for the period from the beginning of the interim payment rate to the first September 30 following the beginning of the interim payment rate. 

C.
 The interim payment rate for a nursing facility which commenced construction prior to July 1, 1985, is determined by 12 MCAR S 2.05014 [Temporary] except that capital assets must be classified under parts 9549.0010 to 9549.0080. 

D.
 The interim property-related payment rate for a nursing facility which commences construction after June 30, 1985, is determined as follows: 

(1)
 At least 60 days before the first day a resident is admitted to the newly constructed nursing facility bed and upon receipt of written application from the nursing facility, the commissioner shall establish the nursing facility's appraised value according to subparts 1 and 4. 

(2)
 The nursing facility shall project the allowable debt and the allowable interest expense according to subparts 5 and 7. 

(3)
 The interim building capital allowance must be determined under subpart 8 or 9. 

(4)
 The equipment allowance during the interim period must be the equipment allowance computed in accordance with subpart 10 which is in effect on the effective date of the interim property-related payment rate. 

(5)
 The interim property-related payment rate must be the sum of subitems (3) and (4). 

(6)
 Anticipated resident days may be used instead of 96 percent capacity days. 

E.
 The settle-up property-related payment rate and the property-related payment rate for the nine months following the settle up for a nursing facility which commenced construction before July 1, 1985, is determined under 12 MCAR S 2.05014 [Temporary]. The property-related payment rate for the rate year beginning July 1 following the nine month period is determined under part 9549.0060. 

F.
 The settle-up property-related payment rate for a nursing facility which commenced construction after June 30, 1985, shall be established as follows: 

(1)
 The appraised value determined in item D, subitem (1), must be updated in accordance with subpart 2, item B prorated for each rate year, or portion of a rate year, included in the interim payment rate period. 

(2)
 The nursing facility's allowable debt, allowable interest rate, and allowable interest expense for the interim rate period shall be computed in accordance with subparts 5, 6, and 7. 

(3)
 The settle-up building capital allowance shall be determined in accordance with subpart 8 or 9. 

(4)
 The equipment allowance shall be updated in accordance with subpart 10 prorated for each rate year, or portion of a rate year, included in the interim payment rate period. 

(5)
 The settle-up property-related payment rate must be the sum of subitems (3) and (4). 

(6)
 Resident days may be used instead of 96 percent capacity days. 

G.
 The property-related payment rate for the nine months following the settle up for a nursing facility which commenced construction after June 30, 1985, shall be established in accordance with item F except that 96 percent capacity days must be used. 

H.
 The property-related payment rate for the rate year beginning July 1 following the nine month period in item G must be determined under this part. 

I.
 A newly constructed nursing facility or one with a capacity increase of 50 percent or more must continue to receive the interim property-related payment rate until the settle-up property-related payment rate is determined under this subpart. 

J.
 The interim real estate taxes and special assessments payment rate shall be established using the projected real estate taxes and special assessments cost divided by anticipated resident days. The settle-up real estate taxes and special assessments payment rate shall be established using the real estate taxes and special assessments divided by resident days. The real estate and special assessments payment rate for the nine months following the settle up shall be equal to the settle-up real estate taxes and special assessments payment rate.