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Minnesota Legislature

Office of the Revisor of Statutes

HF 1233

1st Unofficial Engrossment - 88th Legislature (2013 - 2014) Posted on 04/26/2013 03:02pm

KEY: stricken = removed, old language.
underscored = added, new language.
1.1A bill for an act
1.2relating to state government; establishing the health and human services budget;
1.3modifying provisions related to health care, continuing care, nursing facility
1.4admission, children and family services, human services licensing, chemical
1.5and mental health, program integrity, managed care organizations, waiver
1.6provider standards, home care, and the Department of Health; redesigning
1.7home and community-based services; establishing community first services and
1.8supports and Northstar Care for Children; providing for fraud investigations
1.9in the child care assistance program; establishing autism early intensive
1.10intervention benefits; creating a human services performance council; making
1.11technical changes; requiring a study; requiring reports; appropriating money;
1.12repealing MinnesotaCare;amending Minnesota Statutes 2012, sections 13.381,
1.13subdivisions 2, 10; 13.411, subdivision 7; 13.461, by adding subdivisions;
1.1416A.724, subdivision 3; 16C.10, subdivision 5; 16C.155, subdivision 1; 62J.692,
1.15subdivisions 1, 3, 4, 5, 7a, 9, by adding a subdivision; 62Q.19, subdivision
1.161; 103I.005, by adding a subdivision; 103I.521; 119B.05, subdivision 1;
1.17119B.09, subdivision 5; 119B.125, subdivision 1; 119B.13, subdivisions 1,
1.187; 144.051, by adding subdivisions; 144.0724, subdivisions 4, 6; 144.123,
1.19subdivision 1; 144.125, subdivision 1; 144.212; 144.213; 144.215, subdivisions
1.203, 4; 144.216, subdivision 1; 144.217, subdivision 2; 144.218, subdivision 5;
1.21144.225, subdivisions 1, 4, 7, 8; 144.226; 144.966, subdivisions 2, 3a; 144.98,
1.22subdivisions 3, 5, by adding subdivisions; 144.99, subdivision 4; 144A.071,
1.23subdivision 4b; 144A.351; 144A.43; 144A.44; 144A.45; 144D.01, subdivision 4;
1.24145.906; 145.986; 145A.17, subdivision 1; 145C.01, subdivision 7; 148B.17,
1.25subdivision 2; 148E.065, subdivision 4a; 149A.02, subdivisions 1a, 2, 3, 4, 5,
1.2616, 23, 27, 34, 35, 37, by adding subdivisions; 149A.03; 149A.65, by adding
1.27subdivisions; 149A.70, subdivisions 1, 2, 3, 5; 149A.71, subdivisions 2, 4;
1.28149A.72, subdivisions 3, 9, by adding a subdivision; 149A.73, subdivisions 1,
1.292, 4; 149A.74; 149A.91, subdivision 9; 149A.93, subdivisions 3, 6; 149A.94;
1.30149A.96, subdivision 9; 151.01, subdivision 27; 151.19, subdivisions 1, 3;
1.31151.26, subdivision 1; 151.37, subdivision 4; 151.47, subdivision 1, by adding
1.32a subdivision; 151.49; 152.126; 174.30, subdivision 1; 214.12, by adding
1.33a subdivision; 214.40, subdivision 1; 243.166, subdivisions 4b, 7; 245.03,
1.34subdivision 1; 245.462, subdivision 20; 245.4661, subdivisions 5, 6; 245.4682,
1.35subdivision 2; 245.4875, subdivision 8; 245.4881, subdivision 1; 245A.02,
1.36subdivisions 1, 9, 10, 14; 245A.03, subdivisions 7, 8, 9; 245A.04, subdivision
1.3713; 245A.042, subdivision 3; 245A.07, subdivisions 2a, 3; 245A.08, subdivision
1.382a; 245A.10; 245A.11, subdivisions 2a, 7, 7a, 7b, 8; 245A.1435; 245A.144;
1.39245A.1444; 245A.16, subdivision 1; 245A.40, subdivision 5; 245A.50; 245C.04,
2.1by adding a subdivision; 245C.08, subdivision 1; 245C.32, subdivision
2.22; 245D.02; 245D.03; 245D.04; 245D.05; 245D.06; 245D.07; 245D.09;
2.3245D.10; 246.18, subdivision 8, by adding a subdivision; 252.27, subdivision
2.42a; 252.291, by adding a subdivision; 253B.10, subdivision 1; 254B.04,
2.5subdivision 1; 254B.13; 256.01, subdivisions 2, 24, 34, by adding subdivisions;
2.6256.82, subdivision 3; 256.9657, subdivision 3; 256.969, subdivisions 3a,
2.729; 256.975, subdivision 7, by adding subdivisions; 256.9754, subdivision
2.85, by adding subdivisions; 256B.02, by adding subdivisions; 256B.021, by
2.9adding subdivisions; 256B.04, subdivisions 18, 21, by adding a subdivision;
2.10256B.055, subdivisions 3a, 6, 10, 14, 15, by adding a subdivision; 256B.056,
2.11subdivisions 1, 1c, 3, 4, as amended, 5c, 10, by adding a subdivision; 256B.057,
2.12subdivisions 1, 10, by adding a subdivision; 256B.059, subdivision 1; 256B.06,
2.13subdivision 4; 256B.0623, subdivision 2; 256B.0625, subdivisions 13e, 19c, 31,
2.1439, 48, 56, 58, by adding subdivisions; 256B.0631, subdivision 1; 256B.064,
2.15subdivisions 1a, 1b, 2; 256B.0659, subdivision 21; 256B.0755, subdivision 3;
2.16256B.0756; 256B.0911, subdivisions 1, 1a, 3a, 4d, 6, 7, by adding a subdivision;
2.17256B.0913, subdivision 4, by adding a subdivision; 256B.0915, subdivisions 3a,
2.185, by adding a subdivision; 256B.0916, by adding a subdivision; 256B.0917,
2.19subdivisions 6, 13, by adding subdivisions; 256B.092, subdivisions 11, 12, by
2.20adding a subdivision; 256B.0943, subdivisions 1, 2, 7, by adding a subdivision;
2.21256B.0946; 256B.095; 256B.0951, subdivisions 1, 4; 256B.0952, subdivisions 1,
2.225; 256B.0955; 256B.097, subdivisions 1, 3; 256B.196, subdivision 2; 256B.431,
2.23subdivision 44; 256B.434, subdivision 4; 256B.437, subdivision 6; 256B.439,
2.24subdivisions 1, 2, 3, 4, by adding a subdivision; 256B.441, subdivisions 13,
2.2553, 55, 56, 62; 256B.49, subdivisions 11a, 12, 14, 15, by adding subdivisions;
2.26256B.4912, subdivisions 1, 2, 3, 7, by adding subdivisions; 256B.4913,
2.27subdivisions 5, 6, by adding a subdivision; 256B.492; 256B.493, subdivision 2;
2.28256B.501, by adding a subdivision; 256B.5011, subdivision 2; 256B.5012, by
2.29adding a subdivision; 256B.69, subdivisions 5c, 31, by adding a subdivision;
2.30256B.694; 256B.76, subdivisions 1, 2, 4, by adding a subdivision; 256B.761;
2.31256B.764; 256B.766; 256D.44, subdivision 5; 256I.05, subdivision 1e, by
2.32adding a subdivision; 256J.08, subdivision 24; 256J.21, subdivision 3; 256J.24,
2.33subdivisions 5, 5a, 7; 256J.621; 256J.626, subdivision 7; 256K.45; 256L.01,
2.34subdivisions 3a, 5, by adding subdivisions; 256L.02, subdivision 2, by adding
2.35subdivisions; 256L.03, subdivisions 1, 1a, 3, 5, 6, by adding a subdivision;
2.36256L.04, subdivisions 1, 7, 8, 10, 12, by adding subdivisions; 256L.05,
2.37subdivisions 1, 2, 3, 3c; 256L.06, subdivision 3; 256L.07, subdivisions 1, 2, 3;
2.38256L.09, subdivision 2; 256L.11, subdivisions 1, 3; 256L.15, subdivisions 1, 2;
2.39256M.40, subdivision 1; 257.75, subdivision 7; 257.85, subdivision 11; 259A.05,
2.40subdivision 5; 259A.20, subdivision 4; 260B.007, subdivisions 6, 16; 260C.007,
2.41subdivisions 6, 31; 260C.635, subdivision 1; 299C.093; 471.59, subdivision 1;
2.42517.001; 518A.60; 524.5-118, subdivision 1, by adding a subdivision; 524.5-303;
2.43524.5-316; 524.5-403; 524.5-420; 626.556, subdivisions 2, 3, 10d; 626.557,
2.44subdivisions 4, 9, 9a, 9e; 626.5572, subdivision 13; Laws 1998, chapter 407,
2.45article 6, section 116; Laws 2011, First Special Session chapter 9, article 7,
2.46section 39, subdivision 14; Laws 2012, chapter 247, article 1, section 28; article
2.476, section 4; Laws 2013, chapter 1, sections 1; 6; proposing coding for new law in
2.48Minnesota Statutes, chapters 144; 144A; 145; 149A; 151; 214; 245; 245A; 245D;
2.49254B; 256B; 256J; 256L; proposing coding for new law as Minnesota Statutes,
2.50chapter 245E; repealing Minnesota Statutes 2012, sections 62J.693; 103I.005,
2.51subdivision 20; 144.123, subdivision 2; 144A.46; 144A.461; 149A.025;
2.52149A.20, subdivision 8; 149A.30, subdivision 2; 149A.40, subdivision 8;
2.53149A.45, subdivision 6; 149A.50, subdivision 6; 149A.51, subdivision 7;
2.54149A.52, subdivision 5a; 149A.53, subdivision 9; 151.19, subdivision 2; 151.25;
2.55151.45; 151.47, subdivision 2; 151.48; 245A.655; 245B.01; 245B.02; 245B.03;
2.56245B.031; 245B.04; 245B.05, subdivisions 1, 2, 3, 5, 6, 7; 245B.055; 245B.06;
2.57245B.07; 245B.08; 245D.08; 256B.055, subdivisions 3, 5, 10b; 256B.056,
2.58subdivision 5b; 256B.057, subdivisions 1c, 2; 256B.0911, subdivisions 4a, 4b,
3.14c; 256B.0917, subdivisions 1, 2, 3, 4, 5, 7, 8, 9, 10, 11, 12, 14; 256B.096,
3.2subdivisions 1, 2, 3, 4; 256B.49, subdivision 16a; 256B.4913, subdivisions 1, 2,
3.33, 4; 256B.5012, subdivision 13; 256J.24, subdivision 6; 256L.01, subdivisions
3.43, 4a; 256L.02, subdivision 3; 256L.03, subdivision 4; 256L.031; 256L.04,
3.5subdivisions 1b, 2a, 7a, 9; 256L.07, subdivisions 1, 4, 5, 8, 9; 256L.09,
3.6subdivisions 1, 4, 5, 6, 7; 256L.11, subdivisions 2a, 5, 6; 256L.12, subdivisions
3.71, 2, 3, 4, 5, 6, 7, 8, 9a, 9b; 256L.17, subdivisions 1, 2, 3, 4, 5; 485.14;
3.8609.093; Laws 2011, First Special Session chapter 9, article 7, section 54, as
3.9amended; Minnesota Rules, parts 4668.0002; 4668.0003; 4668.0005; 4668.0008;
3.104668.0012; 4668.0016; 4668.0017; 4668.0019; 4668.0030; 4668.0035;
3.114668.0040; 4668.0050; 4668.0060; 4668.0065; 4668.0070; 4668.0075;
3.124668.0080; 4668.0100; 4668.0110; 4668.0120; 4668.0130; 4668.0140;
3.134668.0150; 4668.0160; 4668.0170; 4668.0180; 4668.0190; 4668.0200;
3.144668.0218; 4668.0220; 4668.0230; 4668.0240; 4668.0800; 4668.0805;
3.154668.0810; 4668.0815; 4668.0820; 4668.0825; 4668.0830; 4668.0835;
3.164668.0840; 4668.0845; 4668.0855; 4668.0860; 4668.0865; 4668.0870;
3.174669.0001; 4669.0010; 4669.0020; 4669.0030; 4669.0040; 4669.0050.
3.18BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

3.19ARTICLE 1
3.20AFFORDABLE CARE ACT IMPLEMENTATION; BETTER HEALTH
3.21CARE FOR MORE MINNESOTANS

3.22    Section 1. Minnesota Statutes 2012, section 16A.724, subdivision 3, is amended to read:
3.23    Subd. 3. MinnesotaCare federal receipts. Receipts received as a result of federal
3.24participation pertaining to administrative costs of the Minnesota health care reform waiver
3.25shall be deposited as nondedicated revenue in the health care access fund. Receipts
3.26received as a result of federal participation pertaining to grants shall be deposited in the
3.27federal fund and shall offset health care access funds for payments to providers. All federal
3.28funding received by Minnesota for implementation and administration of MinnesotaCare
3.29as a basic health program, as authorized in section 1331 of the Affordable Care Act,
3.30Public Law 111-148, as amended by Public Law 111-152, is dedicated to that program and
3.31shall be deposited into the health care access fund. Federal funding that is received for
3.32implementing and administering MinnesotaCare as a basic health program and deposited in
3.33the fund shall be used only for that program to purchase health care coverage for enrollees
3.34and reduce enrollee premiums and cost-sharing or provide additional enrollee benefits.
3.35EFFECTIVE DATE.This section is effective January 1, 2015.

3.36    Sec. 2. Minnesota Statutes 2012, section 254B.04, subdivision 1, is amended to read:
3.37    Subdivision 1. Eligibility. (a) Persons eligible for benefits under Code of Federal
3.38Regulations, title 25, part 20, persons eligible for medical assistance benefits under
3.39sections 256B.055, 256B.056, and 256B.057, subdivisions 1, 2, 5, and 6, or who meet
3.40the income standards of section 256B.056, subdivision 4, and persons eligible for general
4.1assistance medical care under section 256D.03, subdivision 3, are entitled to chemical
4.2dependency fund services. State money appropriated for this paragraph must be placed in
4.3a separate account established for this purpose.
4.4Persons with dependent children who are determined to be in need of chemical
4.5dependency treatment pursuant to an assessment under section 626.556, subdivision 10, or
4.6a case plan under section 260C.201, subdivision 6, or 260C.212, shall be assisted by the
4.7local agency to access needed treatment services. Treatment services must be appropriate
4.8for the individual or family, which may include long-term care treatment or treatment in a
4.9facility that allows the dependent children to stay in the treatment facility. The county
4.10shall pay for out-of-home placement costs, if applicable.
4.11(b) A person not entitled to services under paragraph (a), but with family income
4.12that is less than 215 percent of the federal poverty guidelines for the applicable family
4.13size, shall be eligible to receive chemical dependency fund services within the limit
4.14of funds appropriated for this group for the fiscal year. If notified by the state agency
4.15of limited funds, a county must give preferential treatment to persons with dependent
4.16children who are in need of chemical dependency treatment pursuant to an assessment
4.17under section 626.556, subdivision 10, or a case plan under section 260C.201, subdivision
4.186
, or 260C.212. A county may spend money from its own sources to serve persons under
4.19this paragraph. State money appropriated for this paragraph must be placed in a separate
4.20account established for this purpose.
4.21(c) Persons whose income is between 215 percent and 412 percent of the federal
4.22poverty guidelines for the applicable family size shall be eligible for chemical dependency
4.23services on a sliding fee basis, within the limit of funds appropriated for this group for the
4.24fiscal year. Persons eligible under this paragraph must contribute to the cost of services
4.25according to the sliding fee scale established under subdivision 3. A county may spend
4.26money from its own sources to provide services to persons under this paragraph. State
4.27money appropriated for this paragraph must be placed in a separate account established
4.28for this purpose.

4.29    Sec. 3. Minnesota Statutes 2012, section 256.01, is amended by adding a subdivision
4.30to read:
4.31    Subd. 35. Federal approval. (a) The commissioner shall seek federal authority
4.32from the U.S. Department of Health and Human Services necessary to operate a health
4.33coverage program for Minnesotans with incomes up to 275 percent of the federal poverty
4.34guidelines (FPG). The proposal shall seek to secure all federal funding available from at
4.35least the following services:
5.1(1) all premium tax credits and cost sharing subsidies available under United States
5.2Code, title 26, section 36B, and United States Code, title 42, section 18071, for individuals
5.3with incomes above 133 percent and at or below 275 percent of the federal poverty
5.4guidelines who would otherwise be enrolled in the Minnesota Insurance Marketplace as
5.5defined in section 62V.02;
5.6(2) Medicaid funding; and
5.7(3) other funding sources identified by the commissioner that support coverage or
5.8care redesign in Minnesota.
5.9(b) Funding received shall be used to design and implement a health coverage
5.10program that creates a single streamlined program and meets the needs of Minnesotans with
5.11incomes up to 275 percent of the federal poverty guidelines. The program must incorporate:
5.12(1) payment reform characteristics included in the health care delivery system and
5.13accountable care organization payment models;
5.14(2) flexibility in benefit set design such that benefits can be targeted to meet enrollee
5.15needs in different income and health status situations and can provide a more seamless
5.16transition from public to private health care coverage;
5.17(3) flexibility in co-payment or premium structures to incent patients to seek
5.18high-quality, low-cost care settings; and
5.19(4) flexibility in premium structures to ease the transition from public to private
5.20health care coverage.
5.21(c) The commissioner shall develop and submit a proposal consistent with the above
5.22criteria and shall seek all federal authority necessary to implement the health coverage
5.23program. In developing the request, the commissioner shall consult with appropriate
5.24stakeholder groups and consumers.
5.25(d) The commissioner is authorized to seek any available waivers or federal
5.26approvals to accomplish the goals under paragraph (b) prior to 2017.
5.27(e) The commissioner shall report to the chairs and ranking minority members of
5.28the legislative committees with jurisdiction over health and human services policy and
5.29financing by January 15, 2015, on the progress of receiving a federal waiver and shall
5.30make recommendations on any legislative changes necessary to accomplish the project
5.31in this subdivision. Any implementation of the waiver that requires a state financial
5.32contribution shall be contingent on legislative action approving the contribution.
5.33(f) The commissioner is authorized to accept and expend federal funds that support
5.34the purposes of this subdivision.

6.1    Sec. 4. Minnesota Statutes 2012, section 256B.02, is amended by adding a subdivision
6.2to read:
6.3    Subd. 18. Caretaker relative. "Caretaker relative" means a relative, by blood,
6.4adoption, or marriage, of a child under age 19 with whom the child is living and who
6.5assumes primary responsibility for the child's care.
6.6EFFECTIVE DATE.This section is effective January 1, 2014.

6.7    Sec. 5. Minnesota Statutes 2012, section 256B.02, is amended by adding a subdivision
6.8to read:
6.9    Subd. 19. Insurance affordability program. "Insurance affordability program"
6.10means one of the following programs:
6.11(1) medical assistance under this chapter;
6.12(2) a program that provides advance payments of the premium tax credits established
6.13under section 36B of the Internal Revenue Code or cost-sharing reductions established
6.14under section 1402 of the Affordable Care Act;
6.15(3) MinnesotaCare as defined in chapter 256L; and
6.16(4) a Basic Health Plan as defined in section 1331 of the Affordable Care Act.
6.17EFFECTIVE DATE.This section is effective the day following final enactment.

6.18    Sec. 6. Minnesota Statutes 2012, section 256B.04, subdivision 18, is amended to read:
6.19    Subd. 18. Applications for medical assistance. (a) The state agency may take
6.20 shall accept applications for medical assistance and conduct eligibility determinations for
6.21MinnesotaCare enrollees by telephone, via mail, in-person, online via an Internet Web
6.22site, and through other commonly available electronic means.
6.23    (b) The commissioner of human services shall modify the Minnesota health care
6.24programs application form to add a question asking applicants whether they have ever
6.25served in the United States military.
6.26    (c) For each individual who submits an application or whose eligibility is subject to
6.27renewal or whose eligibility is being redetermined pursuant to a change in circumstances,
6.28if the agency determines the individual is not eligible for medical assistance, the agency
6.29shall determine potential eligibility for other insurance affordability programs.
6.30EFFECTIVE DATE.This section is effective January 1, 2014.

6.31    Sec. 7. Minnesota Statutes 2012, section 256B.055, subdivision 3a, is amended to read:
7.1    Subd. 3a. Families with children. Beginning July 1, 2002, Medical assistance may
7.2be paid for a person who is a child under the age of 18, or age 18 if a full-time student
7.3in a secondary school, or in the equivalent level of vocational or technical training, and
7.4reasonably expected to complete the program before reaching age 19; the parent or
7.5stepparent of a dependent child under the age of 19, including a pregnant woman; or a
7.6caretaker relative of a dependent child under the age of 19.
7.7EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
7.8approval, whichever is later. The commissioner of human services shall notify the revisor
7.9of statutes when federal approval is obtained.

7.10    Sec. 8. Minnesota Statutes 2012, section 256B.055, subdivision 6, is amended to read:
7.11    Subd. 6. Pregnant women; needy unborn child. Medical assistance may be paid
7.12for a pregnant woman who has written verification of a positive pregnancy test from a
7.13physician or licensed registered nurse, who meets the other eligibility criteria of this
7.14section and whose unborn child would be eligible as a needy child under subdivision 10 if
7.15born and living with the woman. In accordance with Code of Federal Regulations, title
7.1642, section 435.956, the commissioner must accept self-attestation of pregnancy unless
7.17the agency has information that is not reasonably compatible with such attestation. For
7.18purposes of this subdivision, a woman is considered pregnant for 60 days postpartum.
7.19EFFECTIVE DATE.This section is effective January 1, 2014.

7.20    Sec. 9. Minnesota Statutes 2012, section 256B.055, subdivision 10, is amended to read:
7.21    Subd. 10. Infants. Medical assistance may be paid for an infant less than one year
7.22of age, whose mother was eligible for and receiving medical assistance at the time of birth
7.23or who is less than two years of age and is in a family with countable income that is equal
7.24to or less than the income standard established under section 256B.057, subdivision 1.
7.25EFFECTIVE DATE.This section is effective January 1, 2014.

7.26    Sec. 10. Minnesota Statutes 2012, section 256B.055, subdivision 15, is amended to read:
7.27    Subd. 15. Adults without children. Medical assistance may be paid for a person
7.28who is:
7.29(1) at least age 21 and under age 65;
7.30(2) not pregnant;
7.31(3) not entitled to Medicare Part A or enrolled in Medicare Part B under Title XVIII
7.32of the Social Security Act;
8.1(4) not an adult in a family with children as defined in section 256L.01, subdivision
8.23a
; and not otherwise eligible under subdivision 7 as a person who meets the categorical
8.3eligibility requirements of the supplemental security income program;
8.4(5) not enrolled under subdivision 7 as a person who would meet the categorical
8.5eligibility requirements of the supplemental security income program except for excess
8.6income or assets; and
8.7(5) (6) not described in another subdivision of this section.
8.8EFFECTIVE DATE.This section is effective January 1, 2014.

8.9    Sec. 11. Minnesota Statutes 2012, section 256B.055, is amended by adding a
8.10subdivision to read:
8.11    Subd. 17. Adults who were in foster care at the age of 18. Medical assistance may
8.12be paid for a person under 26 years of age who was in foster care under the commissioner's
8.13responsibility on the date of attaining 18 years of age, and who was enrolled in medical
8.14assistance under the state plan or a waiver of the plan while in foster care, in accordance
8.15with section 2004 of the Affordable Care Act.
8.16EFFECTIVE DATE.This section is effective January 1, 2014.

8.17    Sec. 12. Minnesota Statutes 2012, section 256B.056, subdivision 1, is amended to read:
8.18    Subdivision 1. Residency. To be eligible for medical assistance, a person must
8.19reside in Minnesota, or, if absent from the state, be deemed to be a resident of Minnesota,
8.20 in accordance with the rules of the state agency Code of Federal Regulations, title 42,
8.21section 435.403.
8.22EFFECTIVE DATE.This section is effective January 1, 2014.

8.23    Sec. 13. Minnesota Statutes 2012, section 256B.056, subdivision 1c, is amended to read:
8.24    Subd. 1c. Families with children income methodology. (a)(1) [Expired, 1Sp2003
8.25c 14 art 12 s 17]
8.26(2) For applications processed within one calendar month prior to July 1, 2003,
8.27eligibility shall be determined by applying the income standards and methodologies in
8.28effect prior to July 1, 2003, for any months in the six-month budget period before July
8.291, 2003, and the income standards and methodologies in effect on July 1, 2003, for any
8.30months in the six-month budget period on or after that date. The income standards for
8.31each month shall be added together and compared to the applicant's total countable income
8.32for the six-month budget period to determine eligibility.
9.1(3) For children ages one through 18 whose eligibility is determined under section
9.2256B.057, subdivision 2, the following deductions shall be applied to income counted
9.3toward the child's eligibility as allowed under the state's AFDC plan in effect as of July
9.416, 1996: $90 work expense, dependent care, and child support paid under court order.
9.5This clause is effective October 1, 2003.
9.6(b) For families with children whose eligibility is determined using the standard
9.7specified in section 256B.056, subdivision 4, paragraph (c), 17 percent of countable
9.8earned income shall be disregarded for up to four months and the following deductions
9.9shall be applied to each individual's income counted toward eligibility as allowed under
9.10the state's AFDC plan in effect as of July 16, 1996: dependent care and child support paid
9.11under court order.
9.12(c) If the four-month disregard in paragraph (b) has been applied to the wage
9.13earner's income for four months, the disregard shall not be applied again until the wage
9.14earner's income has not been considered in determining medical assistance eligibility for
9.1512 consecutive months.
9.16(d) (b) The commissioner shall adjust the income standards under this section each
9.17July 1 by the annual update of the federal poverty guidelines following publication by the
9.18United States Department of Health and Human Services except that the income standards
9.19shall not go below those in effect on July 1, 2009.
9.20(e) (c) For children age 18 or under, annual gifts of $2,000 or less by a tax-exempt
9.21organization to or for the benefit of the child with a life-threatening illness must be
9.22disregarded from income.

9.23    Sec. 14. Minnesota Statutes 2012, section 256B.056, subdivision 3, is amended to read:
9.24    Subd. 3. Asset limitations for certain individuals and families. (a) To be
9.25eligible for medical assistance, a person must not individually own more than $3,000 in
9.26assets, or if a member of a household with two family members, husband and wife, or
9.27parent and child, the household must not own more than $6,000 in assets, plus $200 for
9.28each additional legal dependent. In addition to these maximum amounts, an eligible
9.29individual or family may accrue interest on these amounts, but they must be reduced to the
9.30maximum at the time of an eligibility redetermination. The accumulation of the clothing
9.31and personal needs allowance according to section 256B.35 must also be reduced to the
9.32maximum at the time of the eligibility redetermination. The value of assets that are not
9.33considered in determining eligibility for medical assistance is the value of those assets
9.34excluded under the supplemental security income program for aged, blind, and disabled
9.35persons, with the following exceptions:
10.1(1) household goods and personal effects are not considered;
10.2(2) capital and operating assets of a trade or business that the local agency determines
10.3are necessary to the person's ability to earn an income are not considered;
10.4(3) motor vehicles are excluded to the same extent excluded by the supplemental
10.5security income program;
10.6(4) assets designated as burial expenses are excluded to the same extent excluded by
10.7the supplemental security income program. Burial expenses funded by annuity contracts
10.8or life insurance policies must irrevocably designate the individual's estate as contingent
10.9beneficiary to the extent proceeds are not used for payment of selected burial expenses;
10.10(5) for a person who no longer qualifies as an employed person with a disability due
10.11to loss of earnings, assets allowed while eligible for medical assistance under section
10.12256B.057, subdivision 9 , are not considered for 12 months, beginning with the first month
10.13of ineligibility as an employed person with a disability, to the extent that the person's total
10.14assets remain within the allowed limits of section 256B.057, subdivision 9, paragraph (d);
10.15    (6) when a person enrolled in medical assistance under section 256B.057, subdivision
10.169
, is age 65 or older and has been enrolled during each of the 24 consecutive months
10.17before the person's 65th birthday, the assets owned by the person and the person's spouse
10.18must be disregarded, up to the limits of section 256B.057, subdivision 9, paragraph (d),
10.19when determining eligibility for medical assistance under section 256B.055, subdivision
10.207
. The income of a spouse of a person enrolled in medical assistance under section
10.21256B.057, subdivision 9 , during each of the 24 consecutive months before the person's
10.2265th birthday must be disregarded when determining eligibility for medical assistance
10.23under section 256B.055, subdivision 7. Persons eligible under this clause are not subject to
10.24the provisions in section 256B.059. A person whose 65th birthday occurs in 2012 or 2013
10.25is required to have qualified for medical assistance under section 256B.057, subdivision 9,
10.26prior to age 65 for at least 20 months in the 24 months prior to reaching age 65; and
10.27(7) effective July 1, 2009, certain assets owned by American Indians are excluded as
10.28required by section 5006 of the American Recovery and Reinvestment Act of 2009, Public
10.29Law 111-5. For purposes of this clause, an American Indian is any person who meets the
10.30definition of Indian according to Code of Federal Regulations, title 42, section 447.50.
10.31(b) No asset limit shall apply to persons eligible under section 256B.055, subdivision
10.3215.
10.33EFFECTIVE DATE.This section is effective January 1, 2014.

10.34    Sec. 15. Minnesota Statutes 2012, section 256B.056, subdivision 4, as amended by
10.35Laws 2013, chapter 1, section 5, is amended to read:
11.1    Subd. 4. Income. (a) To be eligible for medical assistance, a person eligible under
11.2section 256B.055, subdivisions 7, 7a, and 12, may have income up to 100 percent of
11.3the federal poverty guidelines. Effective January 1, 2000, and each successive January,
11.4recipients of supplemental security income may have an income up to the supplemental
11.5security income standard in effect on that date.
11.6(b) To be eligible for medical assistance, families and children may have an income
11.7up to 133-1/3 percent of the AFDC income standard in effect under the July 16, 1996,
11.8AFDC state plan. Effective July 1, 2000, the base AFDC standard in effect on July 16,
11.91996, shall be increased by three percent.
11.10(c) (b) Effective January 1, 2014, to be eligible for medical assistance, under section
11.11256B.055, subdivision 3a , a parent or caretaker relative may have an income up to 133
11.12percent of the federal poverty guidelines for the household size.
11.13(d) (c) To be eligible for medical assistance under section 256B.055, subdivision
11.1415
, a person may have an income up to 133 percent of federal poverty guidelines for
11.15the household size.
11.16(e) (d) To be eligible for medical assistance under section 256B.055, subdivision
11.1716
, a child age 19 to 20 may have an income up to 133 percent of the federal poverty
11.18guidelines for the household size.
11.19(f) (e) To be eligible for medical assistance under section 256B.055, subdivision 3a,
11.20a child under age 19 may have income up to 275 percent of the federal poverty guidelines
11.21for the household size or an equivalent standard when converted using modified adjusted
11.22gross income methodology as required under the Affordable Care Act. Children who are
11.23enrolled in medical assistance as of December 31, 2013, and are determined ineligible
11.24for medical assistance because of the elimination of income disregards under modified
11.25adjusted gross income methodology as defined in subdivision 1a remain eligible for
11.26medical assistance under the Children's Health Insurance Program Reauthorization Act
11.27of 2009, Public Law 111-3, until the date of their next regularly scheduled eligibility
11.28redetermination as required in section 256B.056, subdivision 7a.
11.29(f) In computing income to determine eligibility of persons under paragraphs (a) to
11.30(e) who are not residents of long-term care facilities, the commissioner shall disregard
11.31increases in income as required by Public Laws 94-566, section 503; 99-272; and 99-509.
11.32For persons eligible under paragraph (a), veteran aid and attendance benefits and Veterans
11.33Administration unusual medical expense payments are considered income to the recipient.
11.34EFFECTIVE DATE.This section is effective January 1, 2014.

11.35    Sec. 16. Minnesota Statutes 2012, section 256B.056, subdivision 5c, is amended to read:
12.1    Subd. 5c. Excess income standard. (a) The excess income standard for families
12.2with children parents and caretaker relatives, pregnant women, infants, and children ages
12.3two through 20 is the standard specified in subdivision 4, paragraph (b).
12.4(b) The excess income standard for a person whose eligibility is based on blindness,
12.5disability, or age of 65 or more years is 70 percent of the federal poverty guidelines for the
12.6family size. Effective July 1, 2002, the excess income standard for this paragraph shall
12.7equal 75 percent of the federal poverty guidelines.
12.8EFFECTIVE DATE.This section is effective January 1, 2014.

12.9    Sec. 17. Minnesota Statutes 2012, section 256B.056, is amended by adding a
12.10subdivision to read:
12.11    Subd. 7a. Periodic renewal of eligibility. (a) The commissioner shall make an
12.12annual redetermination of eligibility based on information contained in the enrollee's case
12.13file and other information available to the agency, including but not limited to information
12.14accessed through an electronic database, without requiring the enrollee to submit any
12.15information when sufficient data is available for the agency to renew eligibility.
12.16(b) If the commissioner cannot renew eligibility in accordance with paragraph (a),
12.17the commissioner must provide the enrollee with a prepopulated renewal form containing
12.18eligibility information available to the agency and permit the enrollee to submit the form
12.19with any corrections or additional information to the agency and sign the renewal form via
12.20any of the modes of submission specified in section 256B.04, subdivision 18.
12.21(c) An enrollee who is terminated for failure to complete the renewal process may
12.22subsequently submit the renewal form and required information within four months after
12.23the date of termination and have coverage reinstated without a lapse, if otherwise eligible
12.24under this chapter.
12.25(d) Notwithstanding paragraph (a), individuals eligible under subdivision 5 shall be
12.26required to renew eligibility every six months.
12.27EFFECTIVE DATE.This section is effective January 1, 2014.

12.28    Sec. 18. Minnesota Statutes 2012, section 256B.056, subdivision 10, is amended to read:
12.29    Subd. 10. Eligibility verification. (a) The commissioner shall require women who
12.30are applying for the continuation of medical assistance coverage following the end of the
12.3160-day postpartum period to update their income and asset information and to submit
12.32any required income or asset verification.
13.1    (b) The commissioner shall determine the eligibility of private-sector health care
13.2coverage for infants less than one year of age eligible under section 256B.055, subdivision
13.310
, or 256B.057, subdivision 1, paragraph (d), and shall pay for private-sector coverage
13.4if this is determined to be cost-effective.
13.5    (c) The commissioner shall verify assets and income for all applicants, and for all
13.6recipients upon renewal.
13.7    (d) The commissioner shall utilize information obtained through the electronic
13.8service established by the secretary of the United States Department of Health and Human
13.9Services and other available electronic data sources in Code of Federal Regulations, title
13.1042, sections 435.940 to 435.956, to verify eligibility requirements. The commissioner
13.11shall establish standards to define when information obtained electronically is reasonably
13.12compatible with information provided by applicants and enrollees, including use of
13.13self-attestation, to accomplish real-time eligibility determinations and maintain program
13.14integrity.
13.15EFFECTIVE DATE.This section is effective January 1, 2014.

13.16    Sec. 19. Minnesota Statutes 2012, section 256B.057, subdivision 1, is amended to read:
13.17    Subdivision 1. Infants and pregnant women. (a)(1) An infant less than one year
13.18 two years of age or a pregnant woman who has written verification of a positive pregnancy
13.19test from a physician or licensed registered nurse is eligible for medical assistance if the
13.20individual's countable family household income is equal to or less than 275 percent of the
13.21federal poverty guideline for the same family household size or an equivalent standard
13.22when converted using modified adjusted gross income methodology as required under
13.23the Affordable Care Act. For purposes of this subdivision, "countable family income"
13.24means the amount of income considered available using the methodology of the AFDC
13.25program under the state's AFDC plan as of July 16, 1996, as required by the Personal
13.26Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA), Public
13.27Law 104-193, except for the earned income disregard and employment deductions.
13.28    (2) For applications processed within one calendar month prior to the effective date,
13.29eligibility shall be determined by applying the income standards and methodologies in
13.30effect prior to the effective date for any months in the six-month budget period before
13.31that date and the income standards and methodologies in effect on the effective date for
13.32any months in the six-month budget period on or after that date. The income standards
13.33for each month shall be added together and compared to the applicant's total countable
13.34income for the six-month budget period to determine eligibility.
13.35    (b)(1) [Expired, 1Sp2003 c 14 art 12 s 19]
14.1    (2) For applications processed within one calendar month prior to July 1, 2003,
14.2eligibility shall be determined by applying the income standards and methodologies in
14.3effect prior to July 1, 2003, for any months in the six-month budget period before July 1,
14.42003, and the income standards and methodologies in effect on the expiration date for any
14.5months in the six-month budget period on or after July 1, 2003. The income standards
14.6for each month shall be added together and compared to the applicant's total countable
14.7income for the six-month budget period to determine eligibility.
14.8    (3) An amount equal to the amount of earned income exceeding 275 percent of
14.9the federal poverty guideline, up to a maximum of the amount by which the combined
14.10total of 185 percent of the federal poverty guideline plus the earned income disregards
14.11and deductions allowed under the state's AFDC plan as of July 16, 1996, as required
14.12by the Personal Responsibility and Work Opportunity Act of 1996 (PRWORA), Public
14.13Law 104-193, exceeds 275 percent of the federal poverty guideline will be deducted for
14.14pregnant women and infants less than one year of age.
14.15    (c) Dependent care and child support paid under court order shall be deducted from
14.16the countable income of pregnant women.
14.17    (d) (b) An infant born to a woman who was eligible for and receiving medical
14.18assistance on the date of the child's birth shall continue to be eligible for medical assistance
14.19without redetermination until the child's first birthday.
14.20EFFECTIVE DATE.This section is effective January 1, 2014.

14.21    Sec. 20. Minnesota Statutes 2012, section 256B.057, subdivision 10, is amended to read:
14.22    Subd. 10. Certain persons needing treatment for breast or cervical cancer. (a)
14.23Medical assistance may be paid for a person who:
14.24(1) has been screened for breast or cervical cancer by the Minnesota breast and
14.25cervical cancer control program, and program funds have been used to pay for the person's
14.26screening;
14.27(2) according to the person's treating health professional, needs treatment, including
14.28diagnostic services necessary to determine the extent and proper course of treatment, for
14.29breast or cervical cancer, including precancerous conditions and early stage cancer;
14.30(3) meets the income eligibility guidelines for the Minnesota breast and cervical
14.31cancer control program;
14.32(4) is under age 65;
14.33(5) is not otherwise eligible for medical assistance under United States Code, title
14.3442, section 1396a(a)(10)(A)(i); and
15.1(6) is not otherwise covered under creditable coverage, as defined under United
15.2States Code, title 42, section 1396a(aa).
15.3(b) Medical assistance provided for an eligible person under this subdivision shall
15.4be limited to services provided during the period that the person receives treatment for
15.5breast or cervical cancer.
15.6(c) A person meeting the criteria in paragraph (a) is eligible for medical assistance
15.7without meeting the eligibility criteria relating to income and assets in section 256B.056,
15.8subdivisions 1a to 5b 5a.
15.9EFFECTIVE DATE.This section is effective January 1, 2014.

15.10    Sec. 21. Minnesota Statutes 2012, section 256B.057, is amended by adding a
15.11subdivision to read:
15.12    Subd. 12. Presumptive eligibility determinations made by qualified hospitals.
15.13The commissioner shall establish a process to qualify hospitals that are participating
15.14providers under the medical assistance program to determine presumptive eligibility for
15.15medical assistance for applicants who may have a basis of eligibility using the modified
15.16adjusted gross income methodology as defined in section 256B.056, subdivision 1a,
15.17paragraph (b), clause (1).
15.18EFFECTIVE DATE.This section is effective January 1, 2014.

15.19    Sec. 22. Minnesota Statutes 2012, section 256B.059, subdivision 1, is amended to read:
15.20    Subdivision 1. Definitions. (a) For purposes of this section and sections 256B.058
15.21and 256B.0595, the terms defined in this subdivision have the meanings given them.
15.22    (b) "Community spouse" means the spouse of an institutionalized spouse.
15.23    (c) "Spousal share" means one-half of the total value of all assets, to the extent that
15.24either the institutionalized spouse or the community spouse had an ownership interest at
15.25the time of the first continuous period of institutionalization.
15.26    (d) "Assets otherwise available to the community spouse" means assets individually
15.27or jointly owned by the community spouse, other than assets excluded by subdivision 5,
15.28paragraph (c).
15.29    (e) "Community spouse asset allowance" is the value of assets that can be transferred
15.30under subdivision 3.
15.31    (f) "Institutionalized spouse" means a person who is:
15.32    (1) in a hospital, nursing facility, or intermediate care facility for persons with
15.33developmental disabilities, or receiving home and community-based services under section
16.1256B.0915 , 256B.092, or 256B.49 and is expected to remain in the facility or institution
16.2or receive the home and community-based services for at least 30 consecutive days; and
16.3    (2) married to a person who is not in a hospital, nursing facility, or intermediate
16.4care facility for persons with developmental disabilities, and is not receiving home and
16.5community-based services under section 256B.0915, 256B.092, or 256B.49.
16.6    (g) "For the sole benefit of" means no other individual or entity can benefit in any
16.7way from the assets or income at the time of a transfer or at any time in the future.
16.8    (h) "Continuous period of institutionalization" means a 30-consecutive-day period
16.9of time in which a person is expected to stay in a medical or long-term care facility, or
16.10receive home and community-based services that would qualify for coverage under the
16.11elderly waiver (EW) or alternative care (AC) programs section 256B.0913, 256B.0915,
16.12256B.092, or 256B.49. For a stay in a facility, the 30-consecutive-day period begins
16.13on the date of entry into a medical or long-term care facility. For receipt of home and
16.14community-based services, the 30-consecutive-day period begins on the date that the
16.15following conditions are met:
16.16    (1) the person is receiving services that meet the nursing facility level of care
16.17determined by a long-term care consultation;
16.18    (2) the person has received the long-term care consultation within the past 60 days;
16.19    (3) the services are paid by the EW program under section 256B.0915 or the AC
16.20program under section 256B.0913, 256B.0915, 256B.092, or 256B.49 or would qualify
16.21for payment under the EW or AC programs those sections if the person were otherwise
16.22eligible for either program, and but for the receipt of such services the person would have
16.23resided in a nursing facility; and
16.24    (4) the services are provided by a licensed provider qualified to provide home and
16.25community-based services.
16.26EFFECTIVE DATE.This section is effective January 1, 2014.

16.27    Sec. 23. Minnesota Statutes 2012, section 256B.06, subdivision 4, is amended to read:
16.28    Subd. 4. Citizenship requirements. (a) Eligibility for medical assistance is limited
16.29to citizens of the United States, qualified noncitizens as defined in this subdivision, and
16.30other persons residing lawfully in the United States. Citizens or nationals of the United
16.31States must cooperate in obtaining satisfactory documentary evidence of citizenship or
16.32nationality according to the requirements of the federal Deficit Reduction Act of 2005,
16.33Public Law 109-171.
16.34(b) "Qualified noncitizen" means a person who meets one of the following
16.35immigration criteria:
17.1(1) admitted for lawful permanent residence according to United States Code, title 8;
17.2(2) admitted to the United States as a refugee according to United States Code,
17.3title 8, section 1157;
17.4(3) granted asylum according to United States Code, title 8, section 1158;
17.5(4) granted withholding of deportation according to United States Code, title 8,
17.6section 1253(h);
17.7(5) paroled for a period of at least one year according to United States Code, title 8,
17.8section 1182(d)(5);
17.9(6) granted conditional entrant status according to United States Code, title 8,
17.10section 1153(a)(7);
17.11(7) determined to be a battered noncitizen by the United States Attorney General
17.12according to the Illegal Immigration Reform and Immigrant Responsibility Act of 1996,
17.13title V of the Omnibus Consolidated Appropriations Bill, Public Law 104-200;
17.14(8) is a child of a noncitizen determined to be a battered noncitizen by the United
17.15States Attorney General according to the Illegal Immigration Reform and Immigrant
17.16Responsibility Act of 1996, title V, of the Omnibus Consolidated Appropriations Bill,
17.17Public Law 104-200; or
17.18(9) determined to be a Cuban or Haitian entrant as defined in section 501(e) of Public
17.19Law 96-422, the Refugee Education Assistance Act of 1980.
17.20(c) All qualified noncitizens who were residing in the United States before August
17.2122, 1996, who otherwise meet the eligibility requirements of this chapter, are eligible for
17.22medical assistance with federal financial participation.
17.23(d) Beginning December 1, 1996, qualified noncitizens who entered the United
17.24States on or after August 22, 1996, and who otherwise meet the eligibility requirements
17.25of this chapter are eligible for medical assistance with federal participation for five years
17.26if they meet one of the following criteria:
17.27(1) refugees admitted to the United States according to United States Code, title 8,
17.28section 1157;
17.29(2) persons granted asylum according to United States Code, title 8, section 1158;
17.30(3) persons granted withholding of deportation according to United States Code,
17.31title 8, section 1253(h);
17.32(4) veterans of the United States armed forces with an honorable discharge for
17.33a reason other than noncitizen status, their spouses and unmarried minor dependent
17.34children; or
17.35(5) persons on active duty in the United States armed forces, other than for training,
17.36their spouses and unmarried minor dependent children.
18.1 Beginning July 1, 2010, children and pregnant women who are noncitizens
18.2described in paragraph (b) or who are lawfully present in the United States as defined
18.3in Code of Federal Regulations, title 8, section 103.12, and who otherwise meet
18.4eligibility requirements of this chapter, are eligible for medical assistance with federal
18.5financial participation as provided by the federal Children's Health Insurance Program
18.6Reauthorization Act of 2009, Public Law 111-3.
18.7(e) Nonimmigrants who otherwise meet the eligibility requirements of this chapter
18.8are eligible for the benefits as provided in paragraphs (f) to (h). For purposes of this
18.9subdivision, a "nonimmigrant" is a person in one of the classes listed in United States
18.10Code, title 8, section 1101(a)(15).
18.11(f) Payment shall also be made for care and services that are furnished to noncitizens,
18.12regardless of immigration status, who otherwise meet the eligibility requirements of
18.13this chapter, if such care and services are necessary for the treatment of an emergency
18.14medical condition.
18.15(g) For purposes of this subdivision, the term "emergency medical condition" means
18.16a medical condition that meets the requirements of United States Code, title 42, section
18.171396b(v).
18.18(h)(1) Notwithstanding paragraph (g), services that are necessary for the treatment
18.19of an emergency medical condition are limited to the following:
18.20(i) services delivered in an emergency room or by an ambulance service licensed
18.21under chapter 144E that are directly related to the treatment of an emergency medical
18.22condition;
18.23(ii) services delivered in an inpatient hospital setting following admission from an
18.24emergency room or clinic for an acute emergency condition; and
18.25(iii) follow-up services that are directly related to the original service provided
18.26to treat the emergency medical condition and are covered by the global payment made
18.27to the provider.
18.28    (2) Services for the treatment of emergency medical conditions do not include:
18.29(i) services delivered in an emergency room or inpatient setting to treat a
18.30nonemergency condition;
18.31(ii) organ transplants, stem cell transplants, and related care;
18.32(iii) services for routine prenatal care;
18.33(iv) continuing care, including long-term care, nursing facility services, home health
18.34care, adult day care, day training, or supportive living services;
18.35(v) elective surgery;
19.1(vi) outpatient prescription drugs, unless the drugs are administered or dispensed as
19.2part of an emergency room visit;
19.3(vii) preventative health care and family planning services;
19.4(viii) dialysis;
19.5(ix) chemotherapy or therapeutic radiation services;
19.6(x) rehabilitation services;
19.7(xi) physical, occupational, or speech therapy;
19.8(xii) transportation services;
19.9(xiii) case management;
19.10(xiv) prosthetics, orthotics, durable medical equipment, or medical supplies;
19.11(xv) dental services;
19.12(xvi) hospice care;
19.13(xvii) audiology services and hearing aids;
19.14(xviii) podiatry services;
19.15(xix) chiropractic services;
19.16(xx) immunizations;
19.17(xxi) vision services and eyeglasses;
19.18(xxii) waiver services;
19.19(xxiii) individualized education programs; or
19.20(xxiv) chemical dependency treatment.
19.21(i) Beginning July 1, 2009, Pregnant noncitizens who are undocumented,
19.22nonimmigrants, or lawfully present in the United States as defined in Code of Federal
19.23Regulations, title 8, section 103.12, ineligible for federally funded medical assistance
19.24because of immigration status are not covered by a group health plan or health insurance
19.25coverage according to Code of Federal Regulations, title 42, section 457.310, and who
19.26otherwise meet the eligibility requirements of this chapter, are eligible for medical
19.27assistance through the period of pregnancy, including labor and delivery, and 60 days
19.28postpartum, to the extent federal funds are available under title XXI of the Social Security
19.29Act, and the state children's health insurance program.
19.30(j) Beginning October 1, 2003, persons who are receiving care and rehabilitation
19.31services from a nonprofit center established to serve victims of torture and are otherwise
19.32ineligible for medical assistance under this chapter are eligible for medical assistance
19.33without federal financial participation. These individuals are eligible only for the period
19.34during which they are receiving services from the center. Individuals eligible under this
19.35paragraph shall not be required to participate in prepaid medical assistance.
19.36EFFECTIVE DATE.This section is effective January 1, 2014.

20.1    Sec. 24. Minnesota Statutes 2012, section 256B.0755, subdivision 3, is amended to read:
20.2    Subd. 3. Accountability. (a) Health care delivery systems must accept responsibility
20.3for the quality of care based on standards established under subdivision 1, paragraph (b),
20.4clause (10), and the cost of care or utilization of services provided to its enrollees under
20.5subdivision 1, paragraph (b), clause (1).
20.6(b) A health care delivery system may contract and coordinate with providers and
20.7clinics for the delivery of services and shall contract with community health clinics,
20.8federally qualified health centers, community mental health centers or programs, county
20.9agencies, and rural clinics to the extent practicable.
20.10(c) A health care delivery system must demonstrate how its services will be
20.11coordinated with other services affecting its attributed patients' health, quality of care, and
20.12cost of care that are provided by other providers and county agencies in the local service
20.13area. The health care delivery system must document how other providers and counties,
20.14including county-based purchasing plans, will provide services to attributed patients of
20.15the health care delivery system, and how it will address applicable local needs, priorities,
20.16and public health goals. As part of this documentation, the health care delivery system
20.17must describe the involvement of local providers and counties, including county-based
20.18purchasing plans, in developing the application to participate in the demonstration project.
20.19EFFECTIVE DATE.This section is effective July 1, 2013, and applies to health
20.20care delivery system contracts entered into on or after that date.

20.21    Sec. 25. Minnesota Statutes 2012, section 256B.694, is amended to read:
20.22256B.694 SOLE-SOURCE OR SINGLE-PLAN MANAGED CARE
20.23CONTRACT.
20.24    (a) MS 2010 [Expired, 2008 c 364 s 10]
20.25    (b) The commissioner shall consider, and may approve, contracting on a
20.26single-health plan basis with other county-based purchasing plans, or with other qualified
20.27health plans that have coordination arrangements with counties, to serve persons with a
20.28disability who voluntarily enroll enrolled in state public health care programs, in order
20.29to promote better coordination or integration of health care services, social services and
20.30other community-based services, provided that all requirements applicable to health plan
20.31purchasing, including those in section 256B.69, subdivision 23, are satisfied. Nothing in
20.32this paragraph supersedes or modifies the requirements in paragraph (a).

21.1    Sec. 26. Minnesota Statutes 2012, section 256L.01, is amended by adding a subdivision
21.2to read:
21.3    Subd. 1b. Affordable Care Act. "Affordable Care Act" means Public Law 111-148,
21.4as amended by the federal Health Care and Education Reconciliation Act of 2010, Public
21.5Law 111-152, and any amendments to, or regulations or guidance issued under, those acts.

21.6    Sec. 27. Minnesota Statutes 2012, section 256L.01, subdivision 3a, is amended to read:
21.7    Subd. 3a. Family with children. (a) "Family with children" means:
21.8(1) parents and their children residing in the same household; or
21.9(2) grandparents, foster parents, relative caretakers as defined in the medical
21.10assistance program, or legal guardians; and their wards who are children residing in the
21.11same household. "Family" has the meaning given for family and family size as defined
21.12in Code of Federal Regulations, title 26, section 1.36B-1.
21.13(b) The term includes children who are temporarily absent from the household in
21.14settings such as schools, camps, or parenting time with noncustodial parents.
21.15EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
21.16approval, whichever is later. The commissioner of human services shall notify the revisor
21.17of statutes when federal approval is obtained.

21.18    Sec. 28. Minnesota Statutes 2012, section 256L.01, subdivision 5, is amended to read:
21.19    Subd. 5. Income. (a) "Income" has the meaning given for earned and unearned
21.20income for families and children in the medical assistance program, according to the
21.21state's aid to families with dependent children plan in effect as of July 16, 1996. The
21.22definition does not include medical assistance income methodologies and deeming
21.23requirements. The earned income of full-time and part-time students under age 19 is
21.24not counted as income. Public assistance payments and supplemental security income
21.25are not excluded income modified adjusted gross income, as defined in Code of Federal
21.26Regulations, title 26, section 1.36B-1.
21.27(b) For purposes of this subdivision, and unless otherwise specified in this section,
21.28the commissioner shall use reasonable methods to calculate gross earned and unearned
21.29income including, but not limited to, projecting income based on income received within
21.30the past 30 days, the last 90 days, or the last 12 months.
21.31EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
21.32approval, whichever is later. The commissioner of human services shall notify the revisor
21.33of statutes when federal approval is obtained.

22.1    Sec. 29. Minnesota Statutes 2012, section 256L.01, is amended by adding a subdivision
22.2to read:
22.3    Subd. 6. Minnesota Insurance Marketplace. "Minnesota Insurance Marketplace"
22.4means the Minnesota Insurance Marketplace as defined in section 62V.02.

22.5    Sec. 30. Minnesota Statutes 2012, section 256L.01, is amended by adding a subdivision
22.6to read:
22.7    Subd. 7. Participating entity. "Participating entity" means a health carrier as
22.8defined in section 62A.01, subdivision 2; a county-based purchasing plan established
22.9under section 256B.692; an accountable care organization or other entity operating a
22.10health care delivery systems demonstration project authorized under section 256B.0755;
22.11an entity operating a county integrated health care delivery network pilot project
22.12authorized under section 256B.0756; or a network of health care providers established to
22.13offer services under MinnesotaCare.
22.14EFFECTIVE DATE.This section is effective January 1, 2015.

22.15    Sec. 31. Minnesota Statutes 2012, section 256L.02, subdivision 2, is amended to read:
22.16    Subd. 2. Commissioner's duties. (a) The commissioner shall establish an office
22.17for the state administration of this plan. The plan shall be used to provide covered health
22.18services for eligible persons. Payment for these services shall be made to all eligible
22.19providers participating entities under contract with the commissioner. The commissioner
22.20shall adopt rules to administer the MinnesotaCare program. The commissioner shall
22.21establish marketing efforts to encourage potentially eligible persons to receive information
22.22about the program and about other medical care programs administered or supervised by
22.23the Department of Human Services.
22.24(b) A toll-free telephone number and Web site must be used to provide information
22.25about medical programs and to promote access to the covered services.
22.26EFFECTIVE DATE.Paragraph (a) is effective January 1, 2015. Paragraph (b) is
22.27effective January 1, 2014.

22.28    Sec. 32. Minnesota Statutes 2012, section 256L.02, is amended by adding a subdivision
22.29to read:
22.30    Subd. 6. Federal approval. (a) The commissioner of human services shall seek
22.31federal approval to implement the MinnesotaCare program under this chapter as a basic
22.32health program. In any agreement with the Centers for Medicare and Medicaid Services
23.1to operate MinnesotaCare as a basic health program, the commissioner shall seek to
23.2include procedures to ensure that federal funding is predictable, stable, and sufficient
23.3to sustain ongoing operation of MinnesotaCare. These procedures must address issues
23.4related to the timing of federal payments, payment reconciliation, enrollee risk adjustment,
23.5and minimization of state financial risk. The commissioner shall consult with the
23.6commissioner of management and budget, when developing the proposal for establishing
23.7MinnesotaCare as a basic health program to be submitted to the Centers for Medicare
23.8and Medicaid Services.
23.9(b) The commissioner of human services, in consultation with the commissioner
23.10of management and budget, shall work with the Centers for Medicare and Medicaid
23.11Services to establish a process for reconciliation and adjustment of federal payments that
23.12balances state and federal liability over time. The commissioner of human services shall
23.13request that the United States secretary of health and human services hold the state, and
23.14enrollees, harmless in the reconciliation process for the first three years, to allow the state
23.15to develop a statistically valid methodology for predicting enrollment trends and their
23.16net effect on federal payments.
23.17(c) The commissioner of human services, through December 31, 2015, may modify
23.18the MinnesotaCare program as specified in this chapter, if it is necessary to enhance
23.19health benefits, expand provider access, or reduce cost-sharing and premiums in order
23.20to comply with the terms and conditions of federal approval as a basic health program.
23.21The commissioner may not reduce benefits, impose greater limits on access to providers,
23.22or increase cost-sharing and premiums by enrollees under the authority granted by this
23.23paragraph. If the commissioner modifies the terms and requirements for MinnesotaCare
23.24under this paragraph, the commissioner shall provide the legislature with notice of
23.25implementation of the modifications at least ten working days before notifying enrollees
23.26and participating entities. The costs of any changes to the program necessary to comply
23.27with federal approval shall not become part of the program's base funding for purposes of
23.28future budget forecasts.
23.29EFFECTIVE DATE.This section is effective the day following final enactment.

23.30    Sec. 33. Minnesota Statutes 2012, section 256L.02, is amended by adding a subdivision
23.31to read:
23.32    Subd. 7. Coordination with Minnesota Insurance Marketplace. MinnesotaCare
23.33shall be considered a public health care program for purposes of chapter 62V.
23.34EFFECTIVE DATE.This section is effective January 1, 2014.

24.1    Sec. 34. Minnesota Statutes 2012, section 256L.03, subdivision 1, is amended to read:
24.2    Subdivision 1. Covered health services. (a) "Covered health services" means the
24.3health services reimbursed under chapter 256B, with the exception of inpatient hospital
24.4services, special education services, private duty nursing services, adult dental care
24.5services other than services covered under section 256B.0625, subdivision 9, orthodontic
24.6services, nonemergency medical transportation services, personal care assistance and case
24.7management services, and nursing home or intermediate care facilities services, inpatient
24.8mental health services, and chemical dependency services.
24.9    (b) No public funds shall be used for coverage of abortion under MinnesotaCare
24.10except where the life of the female would be endangered or substantial and irreversible
24.11impairment of a major bodily function would result if the fetus were carried to term; or
24.12where the pregnancy is the result of rape or incest.
24.13    (c) Covered health services shall be expanded as provided in this section.
24.14EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
24.15approval, whichever is later. The commissioner of human services shall notify the revisor
24.16of statutes when federal approval is obtained.

24.17    Sec. 35. Minnesota Statutes 2012, section 256L.03, subdivision 1a, is amended to read:
24.18    Subd. 1a. Pregnant women and Children; MinnesotaCare health care reform
24.19waiver. Beginning January 1, 1999, Children and pregnant women are eligible for coverage
24.20of all services that are eligible for reimbursement under the medical assistance program
24.21according to chapter 256B, except that abortion services under MinnesotaCare shall be
24.22limited as provided under subdivision 1. Pregnant women and Children are exempt from
24.23the provisions of subdivision 5, regarding co-payments. Pregnant women and Children
24.24who are lawfully residing in the United States but who are not "qualified noncitizens" under
24.25title IV of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996,
24.26Public Law 104-193, Statutes at Large, volume 110, page 2105, are eligible for coverage
24.27of all services provided under the medical assistance program according to chapter 256B.
24.28EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
24.29approval, whichever is later. The commissioner of human services shall notify the revisor
24.30of statutes when federal approval is obtained.

24.31    Sec. 36. Minnesota Statutes 2012, section 256L.03, subdivision 3, is amended to read:
24.32    Subd. 3. Inpatient hospital services. (a) Covered health services shall include
24.33inpatient hospital services, including inpatient hospital mental health services and inpatient
25.1hospital and residential chemical dependency treatment, subject to those limitations
25.2necessary to coordinate the provision of these services with eligibility under the medical
25.3assistance spenddown. The inpatient hospital benefit for adult enrollees who qualify under
25.4section 256L.04, subdivision 7, or who qualify under section 256L.04, subdivisions 1 and
25.52
, with family gross income that exceeds 200 percent of the federal poverty guidelines or
25.6215 percent of the federal poverty guidelines on or after July 1, 2009, and who are not
25.7pregnant, is subject to an annual limit of $10,000.
25.8    (b) Admissions for inpatient hospital services paid for under section 256L.11,
25.9subdivision 3
, must be certified as medically necessary in accordance with Minnesota
25.10Rules, parts 9505.0500 to 9505.0540, except as provided in clauses (1) and (2):
25.11    (1) all admissions must be certified, except those authorized under rules established
25.12under section 254A.03, subdivision 3, or approved under Medicare; and
25.13    (2) payment under section 256L.11, subdivision 3, shall be reduced by five percent
25.14for admissions for which certification is requested more than 30 days after the day of
25.15admission. The hospital may not seek payment from the enrollee for the amount of the
25.16payment reduction under this clause.
25.17EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
25.18approval, whichever is later. The commissioner of human services shall notify the revisor
25.19of statutes when federal approval is obtained.

25.20    Sec. 37. Minnesota Statutes 2012, section 256L.03, is amended by adding a subdivision
25.21to read:
25.22    Subd. 4a. Loss ratio. Health coverage provided through the MinnesotaCare
25.23program must have a medical loss ratio of at least 85 percent, as defined using the loss
25.24ratio methodology described in section 1001 of the Affordable Care Act.
25.25EFFECTIVE DATE.This section is effective January 1, 2015.

25.26    Sec. 38. Minnesota Statutes 2012, section 256L.03, subdivision 5, is amended to read:
25.27    Subd. 5. Cost-sharing. (a) Except as otherwise provided in paragraphs (b) and (c)
25.28 this subdivision, the MinnesotaCare benefit plan shall include the following cost-sharing
25.29requirements for all enrollees:
25.30    (1) ten percent of the paid charges for inpatient hospital services for adult enrollees,
25.31subject to an annual inpatient out-of-pocket maximum of $1,000 per individual;
25.32    (2) (1) $3 per prescription for adult enrollees;
25.33    (3) (2) $25 for eyeglasses for adult enrollees;
26.1    (4) (3) $3 per nonpreventive visit. For purposes of this subdivision, a "visit" means
26.2an episode of service which is required because of a recipient's symptoms, diagnosis, or
26.3established illness, and which is delivered in an ambulatory setting by a physician or
26.4physician ancillary, chiropractor, podiatrist, nurse midwife, advanced practice nurse,
26.5audiologist, optician, or optometrist;
26.6    (5) (4) $6 for nonemergency visits to a hospital-based emergency room for services
26.7provided through December 31, 2010, and $3.50 effective January 1, 2011; and
26.8(6) (5) a family deductible equal to the maximum amount allowed under Code of
26.9Federal Regulations, title 42, part 447.54.
26.10    (b) Paragraph (a), clause (1), does not apply to parents and relative caretakers of
26.11children under the age of 21.
26.12    (c) (b) Paragraph (a) does not apply to pregnant women and children under the
26.13age of 21.
26.14    (d) (c) Paragraph (a), clause (4) (3), does not apply to mental health services.
26.15    (e) Adult enrollees with family gross income that exceeds 200 percent of the federal
26.16poverty guidelines or 215 percent of the federal poverty guidelines on or after July 1, 2009,
26.17and who are not pregnant shall be financially responsible for the coinsurance amount, if
26.18applicable, and amounts which exceed the $10,000 inpatient hospital benefit limit.
26.19    (f) When a MinnesotaCare enrollee becomes a member of a prepaid health plan,
26.20or changes from one prepaid health plan to another during a calendar year, any charges
26.21submitted towards the $10,000 annual inpatient benefit limit, and any out-of-pocket
26.22expenses incurred by the enrollee for inpatient services, that were submitted or incurred
26.23prior to enrollment, or prior to the change in health plans, shall be disregarded.
26.24(g) (d) MinnesotaCare reimbursements to fee-for-service providers and payments to
26.25managed care plans or county-based purchasing plans shall not be increased as a result of
26.26the reduction of the co-payments in paragraph (a), clause (5) (4), effective January 1, 2011.
26.27(h) (e) The commissioner, through the contracting process under section 256L.12,
26.28may allow managed care plans and county-based purchasing plans to waive the family
26.29deductible under paragraph (a), clause (6) (5). The value of the family deductible shall not
26.30be included in the capitation payment to managed care plans and county-based purchasing
26.31plans. Managed care plans and county-based purchasing plans shall certify annually to the
26.32commissioner the dollar value of the family deductible.
26.33EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
26.34approval, whichever is later. The commissioner of human services shall notify the revisor
26.35of statutes when federal approval is obtained.

27.1    Sec. 39. Minnesota Statutes 2012, section 256L.03, subdivision 6, is amended to read:
27.2    Subd. 6. Lien. When the state agency provides, pays for, or becomes liable for
27.3covered health services, the agency shall have a lien for the cost of the covered health
27.4services upon any and all causes of action accruing to the enrollee, or to the enrollee's
27.5legal representatives, as a result of the occurrence that necessitated the payment for the
27.6covered health services. All liens under this section shall be subject to the provisions
27.7of section 256.015. For purposes of this subdivision, "state agency" includes prepaid
27.8health plans participating entities, under contract with the commissioner according to
27.9sections 256B.69, 256D.03, subdivision 4, paragraph (c), and 256L.12; and county-based
27.10purchasing entities under section 256B.692 section 256L.121.
27.11EFFECTIVE DATE.This section is effective January 1, 2015.

27.12    Sec. 40. Minnesota Statutes 2012, section 256L.04, subdivision 1, is amended to read:
27.13    Subdivision 1. Families with children. (a) Families with children with family
27.14income above 133 percent of the federal poverty guidelines and equal to or less than
27.15275 200 percent of the federal poverty guidelines for the applicable family size shall be
27.16eligible for MinnesotaCare according to this section. All other provisions of sections
27.17256L.01 to 256L.18, including the insurance-related barriers to enrollment under section
27.18256L.07, shall apply unless otherwise specified.
27.19    (b) Parents who enroll in the MinnesotaCare program must also enroll their children,
27.20if the children are eligible. Children may be enrolled separately without enrollment by
27.21parents. However, if one parent in the household enrolls, both parents must enroll, unless
27.22other insurance is available. If one child from a family is enrolled, all children must
27.23be enrolled, unless other insurance is available. If one spouse in a household enrolls,
27.24the other spouse in the household must also enroll, unless other insurance is available.
27.25Families cannot choose to enroll only certain uninsured members.
27.26    (c) Beginning October 1, 2003, the dependent sibling definition no longer applies
27.27to the MinnesotaCare program. These persons are no longer counted in the parental
27.28household and may apply as a separate household.
27.29    (d) Parents are not eligible for MinnesotaCare if their gross income exceeds $57,500.
27.30(e) Children deemed eligible for MinnesotaCare under section 256L.07, subdivision
27.318
, are exempt from the eligibility requirements of this subdivision.
27.32EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
27.33approval, whichever is later. The commissioner of human services shall notify the revisor
27.34of statutes when federal approval is obtained.

28.1    Sec. 41. Minnesota Statutes 2012, section 256L.04, is amended by adding a subdivision
28.2to read:
28.3    Subd. 1c. General requirements. To be eligible for coverage under MinnesotaCare,
28.4a person must meet the eligibility requirements of this section. A person eligible for
28.5MinnesotaCare shall not be considered a qualified individual under section 1312 of the
28.6Affordable Care Act, and is not eligible for enrollment in a qualified health plan offered
28.7through the Minnesota Insurance Marketplace under chapter 62V.
28.8EFFECTIVE DATE.This section is effective January 1, 2014.

28.9    Sec. 42. Minnesota Statutes 2012, section 256L.04, subdivision 7, is amended to read:
28.10    Subd. 7. Single adults and households with no children. (a) The definition of
28.11eligible persons includes all individuals and households families with no children who
28.12have gross family incomes that are above 133 percent and equal to or less than 200 percent
28.13of the federal poverty guidelines for the applicable family size.
28.14    (b) Effective July 1, 2009, the definition of eligible persons includes all individuals
28.15and households with no children who have gross family incomes that are equal to or less
28.16than 250 percent of the federal poverty guidelines.
28.17EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
28.18approval, whichever is later. The commissioner of human services shall notify the revisor
28.19of statutes when federal approval is obtained.

28.20    Sec. 43. Minnesota Statutes 2012, section 256L.04, subdivision 8, is amended to read:
28.21    Subd. 8. Applicants potentially eligible for medical assistance. (a) Individuals
28.22who receive supplemental security income or retirement, survivors, or disability benefits
28.23due to a disability, or other disability-based pension, who qualify under subdivision 7, but
28.24who are potentially eligible for medical assistance without a spenddown shall be allowed
28.25to enroll in MinnesotaCare for a period of 60 days, so long as the applicant meets all other
28.26conditions of eligibility. The commissioner shall identify and refer the applications of
28.27such individuals to their county social service agency. The county and the commissioner
28.28shall cooperate to ensure that the individuals obtain medical assistance coverage for any
28.29months for which they are eligible.
28.30(b) The enrollee must cooperate with the county social service agency in determining
28.31medical assistance eligibility within the 60-day enrollment period. Enrollees who do not
28.32cooperate with medical assistance within the 60-day enrollment period shall be disenrolled
28.33from the plan within one calendar month. Persons disenrolled for nonapplication for
29.1medical assistance may not reenroll until they have obtained a medical assistance
29.2eligibility determination. Persons disenrolled for noncooperation with medical assistance
29.3may not reenroll until they have cooperated with the county agency and have obtained a
29.4medical assistance eligibility determination.
29.5(c) Beginning January 1, 2000, Counties that choose to become MinnesotaCare
29.6enrollment sites shall consider MinnesotaCare applications to also be applications for
29.7medical assistance. Applicants who are potentially eligible for medical assistance, except
29.8for those described in paragraph (a), may choose to enroll in either MinnesotaCare or
29.9medical assistance.
29.10(d) The commissioner shall redetermine provider payments made under
29.11MinnesotaCare to the appropriate medical assistance payments for those enrollees who
29.12subsequently become eligible for medical assistance.
29.13EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
29.14approval, whichever is later. The commissioner of human services shall notify the revisor
29.15of statutes when federal approval is obtained.

29.16    Sec. 44. Minnesota Statutes 2012, section 256L.04, subdivision 10, is amended to read:
29.17    Subd. 10. Citizenship requirements. (a) Eligibility for MinnesotaCare is limited to
29.18citizens or nationals of the United States, qualified noncitizens, and other persons residing
29.19 lawfully in the United States present noncitizens as defined in Code of Federal Regulations,
29.20title 8, section 103.12. Undocumented noncitizens and nonimmigrants are ineligible for
29.21MinnesotaCare. For purposes of this subdivision, a nonimmigrant is an individual in one
29.22or more of the classes listed in United States Code, title 8, section 1101(a)(15), and an
29.23undocumented noncitizen is an individual who resides in the United States without the
29.24approval or acquiescence of the United States Citizenship and Immigration Services.
29.25Families with children who are citizens or nationals of the United States must cooperate in
29.26obtaining satisfactory documentary evidence of citizenship or nationality according to the
29.27requirements of the federal Deficit Reduction Act of 2005, Public Law 109-171.
29.28(b) Notwithstanding subdivisions 1 and 7, eligible persons include families and
29.29individuals who are lawfully present and ineligible for medical assistance by reason of
29.30immigration status and who have incomes equal to or less than 200 percent of federal
29.31poverty guidelines.
29.32EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
29.33approval, whichever is later. The commissioner of human services shall notify the revisor
29.34of statutes when federal approval is obtained.

30.1    Sec. 45. Minnesota Statutes 2012, section 256L.04, subdivision 12, is amended to read:
30.2    Subd. 12. Persons in detention. Beginning January 1, 1999, An applicant or
30.3enrollee residing in a correctional or detention facility is not eligible for MinnesotaCare,
30.4unless the applicant or enrollee is awaiting disposition of charges. An enrollee residing in
30.5a correctional or detention facility is not eligible at renewal of eligibility under section
30.6256L.05, subdivision 3a.
30.7EFFECTIVE DATE.This section is effective January 1, 2014.

30.8    Sec. 46. Minnesota Statutes 2012, section 256L.04, is amended by adding a subdivision
30.9to read:
30.10    Subd. 14. Coordination with medical assistance. (a) Individuals eligible for
30.11medical assistance under chapter 256B are not eligible for MinnesotaCare under this
30.12section.
30.13(b) The commissioner shall coordinate eligibility and coverage to ensure that
30.14individuals transitioning between medical assistance and MinnesotaCare have seamless
30.15eligibility and access to health care services.
30.16EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
30.17approval, whichever is later. The commissioner of human services shall notify the revisor
30.18of statutes when federal approval is obtained.

30.19    Sec. 47. Minnesota Statutes 2012, section 256L.05, subdivision 1, is amended to read:
30.20    Subdivision 1. Application assistance and information availability. (a) Applicants
30.21may submit applications online, in person, by mail, or by phone in accordance with the
30.22Affordable Care Act, and by any other means by which medical assistance applications
30.23may be submitted. Applicants may submit applications through the Minnesota Insurance
30.24Marketplace or through the MinnesotaCare program. Applications and application
30.25assistance must be made available at provider offices, local human services agencies,
30.26school districts, public and private elementary schools in which 25 percent or more of
30.27the students receive free or reduced price lunches, community health offices, Women,
30.28Infants and Children (WIC) program sites, Head Start program sites, public housing
30.29councils, crisis nurseries, child care centers, early childhood education and preschool
30.30program sites, legal aid offices, and libraries, and at any other locations at which medical
30.31assistance applications must be made available. These sites may accept applications and
30.32forward the forms to the commissioner or local county human services agencies that
31.1choose to participate as an enrollment site. Otherwise, applicants may apply directly to the
31.2commissioner or to participating local county human services agencies.
31.3(b) Application assistance must be available for applicants choosing to file an online
31.4application through the Minnesota Insurance Marketplace.
31.5EFFECTIVE DATE.This section is effective January 1, 2014.

31.6    Sec. 48. Minnesota Statutes 2012, section 256L.05, subdivision 2, is amended to read:
31.7    Subd. 2. Commissioner's duties. The commissioner or county agency shall use
31.8electronic verification through the Minnesota Insurance Marketplace as the primary
31.9method of income verification. If there is a discrepancy between reported income
31.10and electronically verified income, an individual may be required to submit additional
31.11verification to the extent permitted under the Affordable Care Act. In addition, the
31.12commissioner shall perform random audits to verify reported income and eligibility. The
31.13commissioner may execute data sharing arrangements with the Department of Revenue
31.14and any other governmental agency in order to perform income verification related to
31.15eligibility and premium payment under the MinnesotaCare program.
31.16EFFECTIVE DATE.This section is effective January 1, 2014.

31.17    Sec. 49. Minnesota Statutes 2012, section 256L.05, subdivision 3, is amended to read:
31.18    Subd. 3. Effective date of coverage. (a) The effective date of coverage is the
31.19first day of the month following the month in which eligibility is approved and the first
31.20premium payment has been received. As provided in section 256B.057, coverage for
31.21newborns is automatic from the date of birth and must be coordinated with other health
31.22coverage. The effective date of coverage for eligible newly adoptive children added to a
31.23family receiving covered health services is the month of placement. The effective date
31.24of coverage for other new members added to the family is the first day of the month
31.25following the month in which the change is reported. All eligibility criteria must be met
31.26by the family at the time the new family member is added. The income of the new family
31.27member is included with the family's modified adjusted gross income and the adjusted
31.28premium begins in the month the new family member is added.
31.29(b) The initial premium must be received by the last working day of the month for
31.30coverage to begin the first day of the following month.
31.31(c) Benefits are not available until the day following discharge if an enrollee is
31.32hospitalized on the first day of coverage.
32.1(d) (c) Notwithstanding any other law to the contrary, benefits under sections
32.2256L.01 to 256L.18 are secondary to a plan of insurance or benefit program under which
32.3an eligible person may have coverage and the commissioner shall use cost avoidance
32.4techniques to ensure coordination of any other health coverage for eligible persons. The
32.5commissioner shall identify eligible persons who may have coverage or benefits under
32.6other plans of insurance or who become eligible for medical assistance.
32.7(e) (d) The effective date of coverage for individuals or families who are exempt
32.8from paying premiums under section 256L.15, subdivision 1, paragraph (d), is the first
32.9day of the month following the month in which verification of American Indian status
32.10is received or eligibility is approved, whichever is later.
32.11(f) (e) The effective date of coverage for children eligible under section 256L.07,
32.12subdivision 8, is the first day of the month following the date of termination from foster
32.13care or release from a juvenile residential correctional facility.
32.14EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
32.15approval, whichever is later. The commissioner of human services shall notify the revisor
32.16of statutes when federal approval is obtained.

32.17    Sec. 50. Minnesota Statutes 2012, section 256L.05, subdivision 3c, is amended to read:
32.18    Subd. 3c. Retroactive coverage. Notwithstanding subdivision 3, the effective
32.19date of coverage shall be the first day of the month following termination from medical
32.20assistance for families and individuals who are eligible for MinnesotaCare and who
32.21submitted a written request for retroactive MinnesotaCare coverage with a completed
32.22application within 30 days of the mailing of notification of termination from medical
32.23assistance. The applicant must provide all required verifications within 30 days of the
32.24written request for verification. For retroactive coverage, premiums must be paid in full
32.25for any retroactive month, current month, and next month within 30 days of the premium
32.26billing. General assistance medical care recipients may qualify for retroactive coverage
32.27under this subdivision at six-month renewal.
32.28EFFECTIVE DATE.This section is effective January 1, 2014.

32.29    Sec. 51. Minnesota Statutes 2012, section 256L.06, subdivision 3, is amended to read:
32.30    Subd. 3. Commissioner's duties and payment. (a) Premiums are dedicated to the
32.31commissioner for MinnesotaCare.
32.32    (b) The commissioner shall develop and implement procedures to: (1) require
32.33enrollees to report changes in income; (2) adjust sliding scale premium payments, based
33.1upon both increases and decreases in enrollee income, at the time the change in income
33.2is reported; and (3) disenroll enrollees from MinnesotaCare for failure to pay required
33.3premiums. Failure to pay includes payment with a dishonored check, a returned automatic
33.4bank withdrawal, or a refused credit card or debit card payment. The commissioner may
33.5demand a guaranteed form of payment, including a cashier's check or a money order, as
33.6the only means to replace a dishonored, returned, or refused payment.
33.7    (c) Premiums are calculated on a calendar month basis and may be paid on a
33.8monthly, quarterly, or semiannual basis, with the first payment due upon notice from the
33.9commissioner of the premium amount required. The commissioner shall inform applicants
33.10and enrollees of these premium payment options. Premium payment is required before
33.11enrollment is complete and to maintain eligibility in MinnesotaCare. Premium payments
33.12received before noon are credited the same day. Premium payments received after noon
33.13are credited on the next working day.
33.14    (d) Nonpayment of the premium will result in disenrollment from the plan effective
33.15for the calendar month for which the premium was due. Persons disenrolled for
33.16nonpayment or who voluntarily terminate coverage from the program may not reenroll
33.17until four calendar months have elapsed. Persons disenrolled for nonpayment who pay
33.18all past due premiums as well as current premiums due, including premiums due for the
33.19period of disenrollment, within 20 days of disenrollment, shall be reenrolled retroactively
33.20to the first day of disenrollment. Persons disenrolled for nonpayment or who voluntarily
33.21terminate coverage from the program may not reenroll for four calendar months unless
33.22the person demonstrates good cause for nonpayment. Good cause does not exist if a
33.23person chooses to pay other family expenses instead of the premium. The commissioner
33.24shall define good cause in rule.
33.25EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
33.26approval, whichever is later. The commissioner of human services shall notify the revisor
33.27of statutes when federal approval is obtained.

33.28    Sec. 52. Minnesota Statutes 2012, section 256L.07, subdivision 1, is amended to read:
33.29    Subdivision 1. General requirements. (a) Children enrolled in the original
33.30children's health plan as of September 30, 1992, children who enrolled in the
33.31MinnesotaCare program after September 30, 1992, pursuant to Laws 1992, chapter 549,
33.32article 4, section 17, and children who have family gross incomes that are equal to or
33.33less than 200 percent of the federal poverty guidelines are eligible without meeting the
33.34requirements of subdivision 2 and the four-month requirement in subdivision 3, as long as
33.35they maintain continuous coverage in the MinnesotaCare program or medical assistance.
34.1    Parents Families and individuals enrolled in MinnesotaCare under section 256L.04,
34.2subdivision 1
, whose income increases above 275 200 percent of the federal poverty
34.3guidelines, are no longer eligible for the program and shall be disenrolled by the
34.4commissioner. Beginning January 1, 2008, Individuals enrolled in MinnesotaCare under
34.5section 256L.04, subdivision 7, whose income increases above 200 percent of the federal
34.6poverty guidelines or 250 percent of the federal poverty guidelines on or after July 1,
34.72009, are no longer eligible for the program and shall be disenrolled by the commissioner.
34.8 For persons disenrolled under this subdivision, MinnesotaCare coverage terminates the
34.9last day of the calendar month following the month in which the commissioner determines
34.10that the income of a family or individual exceeds program income limits.
34.11    (b) Children may remain enrolled in MinnesotaCare if their gross family income as
34.12defined in section 256L.01, subdivision 4, is greater than 275 percent of federal poverty
34.13guidelines. The premium for children remaining eligible under this paragraph shall be the
34.14maximum premium determined under section 256L.15, subdivision 2, paragraph (b).
34.15    (c) Notwithstanding paragraph (a), parents are not eligible for MinnesotaCare if
34.16gross household income exceeds $57,500 for the 12-month period of eligibility.
34.17EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
34.18approval, whichever is later. The commissioner of human services shall notify the revisor
34.19of statutes when federal approval is obtained.

34.20    Sec. 53. Minnesota Statutes 2012, section 256L.07, subdivision 2, is amended to read:
34.21    Subd. 2. Must not have access to employer-subsidized minimum essential
34.22 coverage. (a) To be eligible, a family or individual must not have access to subsidized
34.23health coverage through an employer and must not have had access to employer-subsidized
34.24coverage through a current employer for 18 months prior to application or reapplication.
34.25A family or individual whose employer-subsidized coverage is lost due to an employer
34.26terminating health care coverage as an employee benefit during the previous 18 months is
34.27not eligible that is affordable and provides minimum value as defined in Code of Federal
34.28Regulations, title 26, section 1.36B-2.
34.29(b) This subdivision does not apply to a family or individual who was enrolled
34.30in MinnesotaCare within six months or less of reapplication and who no longer has
34.31employer-subsidized coverage due to the employer terminating health care coverage as an
34.32employee benefit. This subdivision does not apply to children with family gross incomes
34.33that are equal to or less than 200 percent of federal poverty guidelines.
34.34(c) For purposes of this requirement, subsidized health coverage means health
34.35coverage for which the employer pays at least 50 percent of the cost of coverage for
35.1the employee or dependent, or a higher percentage as specified by the commissioner.
35.2Children are eligible for employer-subsidized coverage through either parent, including
35.3the noncustodial parent. The commissioner must treat employer contributions to Internal
35.4Revenue Code Section 125 plans and any other employer benefits intended to pay
35.5health care costs as qualified employer subsidies toward the cost of health coverage for
35.6employees for purposes of this subdivision.
35.7EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
35.8approval, whichever is later. The commissioner of human services shall notify the revisor
35.9of statutes when federal approval is obtained.

35.10    Sec. 54. Minnesota Statutes 2012, section 256L.07, subdivision 3, is amended to read:
35.11    Subd. 3. Other health coverage. (a) Families and individuals enrolled in the
35.12MinnesotaCare program must have no To be eligible, a family or individual must not have
35.13minimum essential health coverage while enrolled, as defined by section 5000A of the
35.14Internal Revenue Code. Children with family gross incomes equal to or greater than 200
35.15percent of federal poverty guidelines, and adults, must have had no health coverage for
35.16at least four months prior to application and renewal. Children enrolled in the original
35.17children's health plan and children in families with income equal to or less than 200
35.18percent of the federal poverty guidelines, who have other health insurance, are eligible if
35.19the coverage:
35.20(1) lacks two or more of the following:
35.21(i) basic hospital insurance;
35.22(ii) medical-surgical insurance;
35.23(iii) prescription drug coverage;
35.24(iv) dental coverage; or
35.25(v) vision coverage;
35.26(2) requires a deductible of $100 or more per person per year; or
35.27(3) lacks coverage because the child has exceeded the maximum coverage for a
35.28particular diagnosis or the policy excludes a particular diagnosis.
35.29The commissioner may change this eligibility criterion for sliding scale premiums
35.30in order to remain within the limits of available appropriations. The requirement of no
35.31health coverage does not apply to newborns.
35.32(b) Coverage purchased as provided under section 256L.031, subdivision 2, medical
35.33assistance, and the Civilian Health and Medical Program of the Uniformed Service,
35.34CHAMPUS, or other coverage provided under United States Code, title 10, subtitle A,
36.1part II, chapter 55, are not considered insurance or health coverage for purposes of the
36.2four-month requirement described in this subdivision.
36.3(c) (b) For purposes of this subdivision, an applicant or enrollee who is entitled to
36.4Medicare Part A or enrolled in Medicare Part B coverage under title XVIII of the Social
36.5Security Act, United States Code, title 42, sections 1395c to 1395w-152, is considered
36.6to have minimum essential health coverage. An applicant or enrollee who is entitled to
36.7premium-free Medicare Part A may not refuse to apply for or enroll in Medicare coverage
36.8to establish eligibility for MinnesotaCare.
36.9(d) Applicants who were recipients of medical assistance within one month of
36.10application must meet the provisions of this subdivision and subdivision 2.
36.11(e) Cost-effective health insurance that was paid for by medical assistance is not
36.12considered health coverage for purposes of the four-month requirement under this
36.13section, except if the insurance continued after medical assistance no longer considered it
36.14cost-effective or after medical assistance closed.
36.15EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
36.16approval, whichever is later. The commissioner of human services shall notify the revisor
36.17of statutes when federal approval is obtained.

36.18    Sec. 55. Minnesota Statutes 2012, section 256L.09, subdivision 2, is amended to read:
36.19    Subd. 2. Residency requirement. To be eligible for health coverage under the
36.20MinnesotaCare program, pregnant women, individuals, and families with children must
36.21meet the residency requirements as provided by Code of Federal Regulations, title 42,
36.22section 435.403, except that the provisions of section 256B.056, subdivision 1, shall apply
36.23upon receipt of federal approval.
36.24EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
36.25approval, whichever is later. The commissioner of human services shall notify the revisor
36.26of statutes when federal approval is obtained.

36.27    Sec. 56. Minnesota Statutes 2012, section 256L.11, subdivision 1, is amended to read:
36.28    Subdivision 1. Medical assistance rate to be used. (a) Payment to providers
36.29under sections 256L.01 to 256L.11 this chapter shall be at the same rates and conditions
36.30established for medical assistance, except as provided in subdivisions 2 to 6 this section.
36.31(b) Effective for services provided on or after July 1, 2009, total payments for basic
36.32care services shall be reduced by three percent, in accordance with section 256B.766.
37.1Payments made to managed care and county-based purchasing plans shall be reduced for
37.2services provided on or after October 1, 2009, to reflect this reduction.
37.3(c) Effective for services provided on or after July 1, 2009, payment rates for
37.4physician and professional services shall be reduced as described under section 256B.76,
37.5subdivision 1, paragraph (c). Payments made to managed care and county-based
37.6purchasing plans shall be reduced for services provided on or after October 1, 2009,
37.7to reflect this reduction.
37.8EFFECTIVE DATE.This section is effective January 1, 2014.

37.9    Sec. 57. Minnesota Statutes 2012, section 256L.11, subdivision 3, is amended to read:
37.10    Subd. 3. Inpatient hospital services. Inpatient hospital services provided under
37.11section 256L.03, subdivision 3, shall be paid for as provided in subdivisions 4 to 6 at the
37.12medical assistance rate.
37.13EFFECTIVE DATE.This section is effective January 1, 2014.

37.14    Sec. 58. [256L.121] SERVICE DELIVERY.
37.15    Subdivision 1. Competitive process. The commissioner of human services shall
37.16establish a competitive process for entering into contracts with participating entities for
37.17the offering of standard health plans through MinnesotaCare. Coverage through standard
37.18health plans must be available to enrollees beginning January 1, 2015. Each standard health
37.19plan must cover the health services listed in, and meet the requirements of, section 256L.03.
37.20The competitive process must meet the requirements of section 1331 of the Affordable
37.21Care Act and be designed to ensure enrollee access to high-quality health care coverage
37.22options. The commissioner, to the extent feasible, shall seek to ensure that enrollees have
37.23a choice of coverage from more than one participating entity within a geographic area.
37.24    Subd. 2. Other requirements for participating entities. The commissioner shall
37.25require participating entities, as a condition of contract, to document to the commissioner:
37.26(1) the provision of culturally and linguistically appropriate services, including
37.27marketing materials, to MinnesotaCare enrollees; and
37.28(2) the inclusion in provider networks of providers designated as essential
37.29community providers under section 62Q.19.
37.30    Subd. 3. Coordination with state-administered health programs. The
37.31commissioner shall coordinate the administration of the MinnesotaCare program with
37.32medical assistance to maximize efficiency and improve the continuity of care. This
37.33includes, but is not limited to:
38.1(1) establishing geographic areas for MinnesotaCare that are consistent with the
38.2geographic areas of the medical assistance program, within which participating entities
38.3may offer health plans;
38.4(2) requiring, as a condition of participation in MinnesotaCare, participating entities
38.5to also participate in the medical assistance program;
38.6    (3) complying with sections 256B.69, subdivision 3a; 256B.692, subdivision 1; and
38.7256B.694 when contracting with MinnesotaCare participating entities;
38.8(4) providing MinnesotaCare enrollees, to the extent possible, with the option to
38.9remain in the same health plan and provider network, if they later become eligible for
38.10medical assistance or coverage through the Minnesota Insurance Marketplace and if, in
38.11the case of becoming eligible for medical assistance, the enrollee's MinnesotaCare health
38.12plan is also a medical assistance health plan in the enrollee's county of residence; and
38.13(5) establishing requirements and criteria for selection that ensure that covered
38.14health care services will be coordinated with local public health, social services, long-term
38.15care services, mental health services, and other local services affecting enrollees' health,
38.16access, and quality of care.
38.17EFFECTIVE DATE.This section is effective the day following final enactment.

38.18    Sec. 59. Minnesota Statutes 2012, section 256L.15, subdivision 1, is amended to read:
38.19    Subdivision 1. Premium determination. (a) Families with children and individuals
38.20shall pay a premium determined according to subdivision 2.
38.21    (b) Pregnant women and children under age two are exempt from the provisions
38.22of section 256L.06, subdivision 3, paragraph (b), clause (3), requiring disenrollment
38.23for failure to pay premiums. For pregnant women, this exemption continues until the
38.24first day of the month following the 60th day postpartum. Women who remain enrolled
38.25during pregnancy or the postpartum period, despite nonpayment of premiums, shall be
38.26disenrolled on the first of the month following the 60th day postpartum for the penalty
38.27period that otherwise applies under section 256L.06, unless they begin paying premiums.
38.28    (c) (b) Members of the military and their families who meet the eligibility criteria
38.29for MinnesotaCare upon eligibility approval made within 24 months following the end
38.30of the member's tour of active duty shall have their premiums paid by the commissioner.
38.31The effective date of coverage for an individual or family who meets the criteria of this
38.32paragraph shall be the first day of the month following the month in which eligibility is
38.33approved. This exemption applies for 12 months.
38.34(d) (c) Beginning July 1, 2009, American Indians enrolled in MinnesotaCare and
38.35their families shall have their premiums waived by the commissioner in accordance with
39.1section 5006 of the American Recovery and Reinvestment Act of 2009, Public Law 111-5.
39.2An individual must document status as an American Indian, as defined under Code of
39.3Federal Regulations, title 42, section 447.50, to qualify for the waiver of premiums.
39.4EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
39.5approval, whichever is later. The commissioner of human services shall notify the revisor
39.6of statutes when federal approval is obtained.

39.7    Sec. 60. Minnesota Statutes 2012, section 256L.15, subdivision 2, is amended to read:
39.8    Subd. 2. Sliding fee scale; monthly gross individual or family income. (a) The
39.9commissioner shall establish a sliding fee scale to determine the percentage of monthly
39.10 gross individual or family income that households at different income levels must pay to
39.11obtain coverage through the MinnesotaCare program. The sliding fee scale must be based
39.12on the enrollee's monthly gross individual or family income. The sliding fee scale must
39.13contain separate tables based on enrollment of one, two, or three or more persons. Until
39.14June 30, 2009, the sliding fee scale begins with a premium of 1.5 percent of monthly gross
39.15individual or family income for individuals or families with incomes below the limits for
39.16the medical assistance program for families and children in effect on January 1, 1999, and
39.17proceeds through the following evenly spaced steps: 1.8, 2.3, 3.1, 3.8, 4.8, 5.9, 7.4, and
39.188.8 percent. These percentages are matched to evenly spaced income steps ranging from
39.19the medical assistance income limit for families and children in effect on January 1, 1999,
39.20to 275 200 percent of the federal poverty guidelines for the applicable family size, up to a
39.21family size of five. The sliding fee scale for a family of five must be used for families of
39.22more than five. The sliding fee scale and percentages are not subject to the provisions of
39.23chapter 14. If a family or individual reports increased income after enrollment, premiums
39.24shall be adjusted at the time the change in income is reported.
39.25    (b) Children in families whose gross income is above 275 percent of the federal
39.26poverty guidelines shall pay the maximum premium. The maximum premium is defined
39.27as a base charge for one, two, or three or more enrollees so that if all MinnesotaCare
39.28cases paid the maximum premium, the total revenue would equal the total cost of
39.29MinnesotaCare medical coverage and administration. In this calculation, administrative
39.30costs shall be assumed to equal ten percent of the total. The costs of medical coverage
39.31for pregnant women and children under age two and the enrollees in these groups shall
39.32be excluded from the total. The maximum premium for two enrollees shall be twice the
39.33maximum premium for one, and the maximum premium for three or more enrollees shall
39.34be three times the maximum premium for one.
40.1    (c) Beginning July 1, 2009, (b) MinnesotaCare enrollees shall pay premiums
40.2according to the premium scale specified in paragraph (d) (c), with the exception that
40.3children in families with income at or below 200 percent of the federal poverty guidelines
40.4shall pay no premiums. For purposes of paragraph (d) (c), "minimum" means a monthly
40.5premium of $4.
40.6    (d) the following premium scale is established for individuals and families with
40.7gross family incomes of 275 percent of the federal poverty guidelines or less:
40.8
Federal Poverty Guideline Range
Percent of Average Gross Monthly Income
40.9
0-45%
minimum
40.10
40.11
46-54%
$4 or 1.1% of family income, whichever is
greater
40.12
55-81%
1.6%
40.13
82-109%
2.2%
40.14
110-136%
2.9%
40.15
137-164%
3.6%
40.16
165-191%
4.6%
40.17
192-219%
5.6%
40.18
220-248%
6.5%
40.19
249-275%
7.2%
40.20(c) Effective January 1, 2014, the following premium scale is established for
40.21individuals and families with incomes of 200 percent of federal poverty guidelines or less:
40.22
Federal Poverty Guideline Range
Percent of Average Income
40.23
0-45%
minimum
40.24
40.25
46-54%
$4 or .25% of family income, whichever is
greater
40.26
55-81%
.5%
40.27
82-109%
1.0%
40.28
110-136%
1.5%
40.29
137-164%
2.0%
40.30
165-191%
2.5%
40.31
192-200%
3.0%
40.32EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
40.33approval, whichever is later. The commissioner of human services shall notify the revisor
40.34of statutes when federal approval is obtained.

40.35    Sec. 61. Laws 2013, chapter 1, section 1, the effective date, is amended to read:
40.36EFFECTIVE DATE.This section is effective January 1, 2014 July 1, 2013.

41.1    Sec. 62. DETERMINATION OF FUNDING ADEQUACY FOR
41.2MINNESOTACARE.
41.3The commissioners of revenue and management and budget, in consultation with
41.4the commissioner of human services, shall conduct an assessment of health care taxes,
41.5including the gross premiums tax, the provider tax, and Medicaid surcharges, and their
41.6relationship to the long-term solvency of the health care access fund, as part of the state
41.7revenue and expenditure forecast in November 2013. The commissioners shall determine
41.8the amount of state funding that will be required after December 31, 2019, in addition
41.9to the federal payments made available under section 1331 of the Affordable Care Act,
41.10for the MinnesotaCare program. The commissioners shall evaluate the stability and
41.11likelihood of long-term federal funding for the MinnesotaCare program under section
41.121331. The commissioners shall report the results of this assessment to the chairs and
41.13ranking minority members of the legislative committees with jurisdiction over human
41.14services, finances, and taxes by January 15, 2014, along with recommendations for
41.15changes to state revenue for the health care access fund, if state funding continues to
41.16be required beyond December 31, 2019.

41.17    Sec. 63. REVISOR'S INSTRUCTION.
41.18The revisor shall remove cross-references to the sections repealed in this act
41.19wherever they appear in Minnesota Statutes and Minnesota Rules and make changes
41.20necessary to correct the punctuation, grammar, or structure of the remaining text and
41.21preserve its meaning.

41.22    Sec. 64. REPEALER.
41.23(a) Minnesota Statutes 2012, sections 256L.01, subdivision 4a; 256L.02, subdivision
41.243; 256L.031; 256L.04, subdivisions 1b, 7a, and 9; and 256L.11, subdivisions 2a, 5, and
41.256, are repealed, effective January 1, 2014.
41.26(b) Minnesota Statutes 2012, sections 256L.01, subdivision 3; 256L.03, subdivision
41.274; 256L.04, subdivision 2a; 256L.07, subdivisions 1, 4, 5, 8, and 9; 256L.09, subdivisions
41.281, 4, 5, 6, and 7; 256L.12, subdivisions 1, 2, 3, 4, 5, 6, 7, 8, 9a, and 9b; and 256L.17,
41.29subdivisions 1, 2, 3, 4, and 5, are repealed effective January 1, 2015.
41.30(c) Minnesota Statutes 2012, sections 256B.055, subdivisions 3, 5, and 10b;
41.31256B.056, subdivision 5b; and 256B.057, subdivisions 1c and 2, are repealed.

42.1ARTICLE 2
42.2CONTINGENT REFORM 2020; REDESIGNING HOME AND
42.3COMMUNITY-BASED SERVICES

42.4    Section 1. Minnesota Statutes 2012, section 144.0724, subdivision 4, is amended to read:
42.5    Subd. 4. Resident assessment schedule. (a) A facility must conduct and
42.6electronically submit to the commissioner of health case mix assessments that conform
42.7with the assessment schedule defined by Code of Federal Regulations, title 42, section
42.8483.20, and published by the United States Department of Health and Human Services,
42.9Centers for Medicare and Medicaid Services, in the Long Term Care Assessment
42.10Instrument User's Manual, version 3.0, and subsequent updates when issued by the
42.11Centers for Medicare and Medicaid Services. The commissioner of health may substitute
42.12successor manuals or question and answer documents published by the United States
42.13Department of Health and Human Services, Centers for Medicare and Medicaid Services,
42.14to replace or supplement the current version of the manual or document.
42.15(b) The assessments used to determine a case mix classification for reimbursement
42.16include the following:
42.17(1) a new admission assessment must be completed by day 14 following admission;
42.18(2) an annual assessment which must have an assessment reference date (ARD)
42.19within 366 days of the ARD of the last comprehensive assessment;
42.20(3) a significant change assessment must be completed within 14 days of the
42.21identification of a significant change; and
42.22(4) all quarterly assessments must have an assessment reference date (ARD) within
42.2392 days of the ARD of the previous assessment.
42.24(c) In addition to the assessments listed in paragraph (b), the assessments used to
42.25determine nursing facility level of care include the following:
42.26(1) preadmission screening completed under section 256B.0911, subdivision 4a, by a
42.27county, tribe, or managed care organization under contract with the Department of Human
42.28Services 256.975, subdivision 7a, by the Senior LinkAge Line or Disability Linkage Line
42.29or other organization under contract with the Minnesota Board on Aging; and
42.30(2) a nursing facility level of care determination as provided for under section
42.31256B.0911, subdivision 4e, as part of a face-to-face long-term care consultation assessment
42.32completed under section 256B.0911, subdivision 3a, 3b, or 4d, by a county, tribe, or
42.33managed care organization under contract with the Department of Human Services.

43.1    Sec. 2. Minnesota Statutes 2012, section 144A.351, is amended to read:
43.2144A.351 BALANCING LONG-TERM CARE SERVICES AND SUPPORTS:
43.3REPORT AND STUDY REQUIRED.
43.4    Subdivision 1. Report requirements. The commissioners of health and human
43.5services, with the cooperation of counties and in consultation with stakeholders, including
43.6persons who need or are using long-term care services and supports, lead agencies,
43.7regional entities, senior, disability, and mental health organization representatives, service
43.8providers, and community members shall prepare a report to the legislature by August 15,
43.92013, and biennially thereafter, regarding the status of the full range of long-term care
43.10services and supports for the elderly and children and adults with disabilities and mental
43.11illnesses in Minnesota. The report shall address:
43.12    (1) demographics and need for long-term care services and supports in Minnesota;
43.13    (2) summary of county and regional reports on long-term care gaps, surpluses,
43.14imbalances, and corrective action plans;
43.15    (3) status of long-term care services and related mental health services, housing
43.16options, and supports by county and region including:
43.17    (i) changes in availability of the range of long-term care services and housing options;
43.18    (ii) access problems, including access to the least restrictive and most integrated
43.19services and settings, regarding long-term care services; and
43.20    (iii) comparative measures of long-term care services availability, including serving
43.21people in their home areas near family, and changes over time; and
43.22    (4) recommendations regarding goals for the future of long-term care services and
43.23supports, policy and fiscal changes, and resource development and transition needs.
43.24    Subd. 2. Critical access study. The commissioner shall conduct a onetime study to
43.25assess local capacity and availability of home and community-based services for older
43.26adults, people with disabilities, and people with mental illnesses. The study must assess
43.27critical access at the community level and identify potential strategies to build home and
43.28community-based service capacity in critical access areas. The report shall be submitted
43.29to the legislature no later than August 15, 2015.

43.30    Sec. 3. Minnesota Statutes 2012, section 148E.065, subdivision 4a, is amended to read:
43.31    Subd. 4a. City, county, and state social workers. (a) Beginning July 1, 2016, the
43.32licensure of city, county, and state agency social workers is voluntary, except an individual
43.33who is newly employed by a city or state agency after July 1, 2016, must be licensed
43.34if the individual who provides social work services, as those services are defined in
44.1section 148E.010, subdivision 11, paragraph (b), is presented to the public by any title
44.2incorporating the words "social work" or "social worker."
44.3(b) City, county, and state agencies employing social workers and staff who are
44.4designated to perform mandated duties under sections 256.975, subdivisions 7 to 7c and
44.5256.01, subdivision 24, are not required to employ licensed social workers.

44.6    Sec. 4. Minnesota Statutes 2012, section 256.01, subdivision 2, is amended to read:
44.7    Subd. 2. Specific powers. Subject to the provisions of section 241.021, subdivision
44.82
, the commissioner of human services shall carry out the specific duties in paragraphs (a)
44.9through (cc) (dd):
44.10    (a) Administer and supervise all forms of public assistance provided for by state law
44.11and other welfare activities or services as are vested in the commissioner. Administration
44.12and supervision of human services activities or services includes, but is not limited to,
44.13assuring timely and accurate distribution of benefits, completeness of service, and quality
44.14program management. In addition to administering and supervising human services
44.15activities vested by law in the department, the commissioner shall have the authority to:
44.16    (1) require county agency participation in training and technical assistance programs
44.17to promote compliance with statutes, rules, federal laws, regulations, and policies
44.18governing human services;
44.19    (2) monitor, on an ongoing basis, the performance of county agencies in the
44.20operation and administration of human services, enforce compliance with statutes, rules,
44.21federal laws, regulations, and policies governing welfare services and promote excellence
44.22of administration and program operation;
44.23    (3) develop a quality control program or other monitoring program to review county
44.24performance and accuracy of benefit determinations;
44.25    (4) require county agencies to make an adjustment to the public assistance benefits
44.26issued to any individual consistent with federal law and regulation and state law and rule
44.27and to issue or recover benefits as appropriate;
44.28    (5) delay or deny payment of all or part of the state and federal share of benefits and
44.29administrative reimbursement according to the procedures set forth in section 256.017;
44.30    (6) make contracts with and grants to public and private agencies and organizations,
44.31both profit and nonprofit, and individuals, using appropriated funds; and
44.32    (7) enter into contractual agreements with federally recognized Indian tribes with
44.33a reservation in Minnesota to the extent necessary for the tribe to operate a federally
44.34approved family assistance program or any other program under the supervision of the
44.35commissioner. The commissioner shall consult with the affected county or counties in
45.1the contractual agreement negotiations, if the county or counties wish to be included,
45.2in order to avoid the duplication of county and tribal assistance program services. The
45.3commissioner may establish necessary accounts for the purposes of receiving and
45.4disbursing funds as necessary for the operation of the programs.
45.5    (b) Inform county agencies, on a timely basis, of changes in statute, rule, federal law,
45.6regulation, and policy necessary to county agency administration of the programs.
45.7    (c) Administer and supervise all child welfare activities; promote the enforcement of
45.8laws protecting disabled, dependent, neglected and delinquent children, and children born
45.9to mothers who were not married to the children's fathers at the times of the conception
45.10nor at the births of the children; license and supervise child-caring and child-placing
45.11agencies and institutions; supervise the care of children in boarding and foster homes or
45.12in private institutions; and generally perform all functions relating to the field of child
45.13welfare now vested in the State Board of Control.
45.14    (d) Administer and supervise all noninstitutional service to disabled persons,
45.15including those who are visually impaired, hearing impaired, or physically impaired
45.16or otherwise disabled. The commissioner may provide and contract for the care and
45.17treatment of qualified indigent children in facilities other than those located and available
45.18at state hospitals when it is not feasible to provide the service in state hospitals.
45.19    (e) Assist and actively cooperate with other departments, agencies and institutions,
45.20local, state, and federal, by performing services in conformity with the purposes of Laws
45.211939, chapter 431.
45.22    (f) Act as the agent of and cooperate with the federal government in matters of
45.23mutual concern relative to and in conformity with the provisions of Laws 1939, chapter
45.24431, including the administration of any federal funds granted to the state to aid in the
45.25performance of any functions of the commissioner as specified in Laws 1939, chapter 431,
45.26and including the promulgation of rules making uniformly available medical care benefits
45.27to all recipients of public assistance, at such times as the federal government increases its
45.28participation in assistance expenditures for medical care to recipients of public assistance,
45.29the cost thereof to be borne in the same proportion as are grants of aid to said recipients.
45.30    (g) Establish and maintain any administrative units reasonably necessary for the
45.31performance of administrative functions common to all divisions of the department.
45.32    (h) Act as designated guardian of both the estate and the person of all the wards of
45.33the state of Minnesota, whether by operation of law or by an order of court, without any
45.34further act or proceeding whatever, except as to persons committed as developmentally
45.35disabled. For children under the guardianship of the commissioner or a tribe in Minnesota
45.36recognized by the Secretary of the Interior whose interests would be best served by
46.1adoptive placement, the commissioner may contract with a licensed child-placing agency
46.2or a Minnesota tribal social services agency to provide adoption services. A contract
46.3with a licensed child-placing agency must be designed to supplement existing county
46.4efforts and may not replace existing county programs or tribal social services, unless the
46.5replacement is agreed to by the county board and the appropriate exclusive bargaining
46.6representative, tribal governing body, or the commissioner has evidence that child
46.7placements of the county continue to be substantially below that of other counties. Funds
46.8encumbered and obligated under an agreement for a specific child shall remain available
46.9until the terms of the agreement are fulfilled or the agreement is terminated.
46.10    (i) Act as coordinating referral and informational center on requests for service for
46.11newly arrived immigrants coming to Minnesota.
46.12    (j) The specific enumeration of powers and duties as hereinabove set forth shall in no
46.13way be construed to be a limitation upon the general transfer of powers herein contained.
46.14    (k) Establish county, regional, or statewide schedules of maximum fees and charges
46.15which may be paid by county agencies for medical, dental, surgical, hospital, nursing and
46.16nursing home care and medicine and medical supplies under all programs of medical
46.17care provided by the state and for congregate living care under the income maintenance
46.18programs.
46.19    (l) Have the authority to conduct and administer experimental projects to test methods
46.20and procedures of administering assistance and services to recipients or potential recipients
46.21of public welfare. To carry out such experimental projects, it is further provided that the
46.22commissioner of human services is authorized to waive the enforcement of existing specific
46.23statutory program requirements, rules, and standards in one or more counties. The order
46.24establishing the waiver shall provide alternative methods and procedures of administration,
46.25shall not be in conflict with the basic purposes, coverage, or benefits provided by law, and
46.26in no event shall the duration of a project exceed four years. It is further provided that no
46.27order establishing an experimental project as authorized by the provisions of this section
46.28shall become effective until the following conditions have been met:
46.29    (1) the secretary of health and human services of the United States has agreed, for
46.30the same project, to waive state plan requirements relative to statewide uniformity; and
46.31    (2) a comprehensive plan, including estimated project costs, shall be approved by
46.32the Legislative Advisory Commission and filed with the commissioner of administration.
46.33    (m) According to federal requirements, establish procedures to be followed by
46.34local welfare boards in creating citizen advisory committees, including procedures for
46.35selection of committee members.
47.1    (n) Allocate federal fiscal disallowances or sanctions which are based on quality
47.2control error rates for the aid to families with dependent children program formerly
47.3codified in sections 256.72 to 256.87, medical assistance, or food stamp program in the
47.4following manner:
47.5    (1) one-half of the total amount of the disallowance shall be borne by the county
47.6boards responsible for administering the programs. For the medical assistance and the
47.7AFDC program formerly codified in sections 256.72 to 256.87, disallowances shall be
47.8shared by each county board in the same proportion as that county's expenditures for the
47.9sanctioned program are to the total of all counties' expenditures for the AFDC program
47.10formerly codified in sections 256.72 to 256.87, and medical assistance programs. For the
47.11food stamp program, sanctions shall be shared by each county board, with 50 percent of
47.12the sanction being distributed to each county in the same proportion as that county's
47.13administrative costs for food stamps are to the total of all food stamp administrative costs
47.14for all counties, and 50 percent of the sanctions being distributed to each county in the
47.15same proportion as that county's value of food stamp benefits issued are to the total of
47.16all benefits issued for all counties. Each county shall pay its share of the disallowance
47.17to the state of Minnesota. When a county fails to pay the amount due hereunder, the
47.18commissioner may deduct the amount from reimbursement otherwise due the county, or
47.19the attorney general, upon the request of the commissioner, may institute civil action
47.20to recover the amount due; and
47.21    (2) notwithstanding the provisions of clause (1), if the disallowance results from
47.22knowing noncompliance by one or more counties with a specific program instruction, and
47.23that knowing noncompliance is a matter of official county board record, the commissioner
47.24may require payment or recover from the county or counties, in the manner prescribed in
47.25clause (1), an amount equal to the portion of the total disallowance which resulted from the
47.26noncompliance, and may distribute the balance of the disallowance according to clause (1).
47.27    (o) Develop and implement special projects that maximize reimbursements and
47.28result in the recovery of money to the state. For the purpose of recovering state money,
47.29the commissioner may enter into contracts with third parties. Any recoveries that result
47.30from projects or contracts entered into under this paragraph shall be deposited in the
47.31state treasury and credited to a special account until the balance in the account reaches
47.32$1,000,000. When the balance in the account exceeds $1,000,000, the excess shall be
47.33transferred and credited to the general fund. All money in the account is appropriated to
47.34the commissioner for the purposes of this paragraph.
47.35    (p) Have the authority to make direct payments to facilities providing shelter
47.36to women and their children according to section 256D.05, subdivision 3. Upon
48.1the written request of a shelter facility that has been denied payments under section
48.2256D.05, subdivision 3 , the commissioner shall review all relevant evidence and make
48.3a determination within 30 days of the request for review regarding issuance of direct
48.4payments to the shelter facility. Failure to act within 30 days shall be considered a
48.5determination not to issue direct payments.
48.6    (q) Have the authority to establish and enforce the following county reporting
48.7requirements:
48.8    (1) the commissioner shall establish fiscal and statistical reporting requirements
48.9necessary to account for the expenditure of funds allocated to counties for human
48.10services programs. When establishing financial and statistical reporting requirements, the
48.11commissioner shall evaluate all reports, in consultation with the counties, to determine if
48.12the reports can be simplified or the number of reports can be reduced;
48.13    (2) the county board shall submit monthly or quarterly reports to the department
48.14as required by the commissioner. Monthly reports are due no later than 15 working days
48.15after the end of the month. Quarterly reports are due no later than 30 calendar days after
48.16the end of the quarter, unless the commissioner determines that the deadline must be
48.17shortened to 20 calendar days to avoid jeopardizing compliance with federal deadlines
48.18or risking a loss of federal funding. Only reports that are complete, legible, and in the
48.19required format shall be accepted by the commissioner;
48.20    (3) if the required reports are not received by the deadlines established in clause (2),
48.21the commissioner may delay payments and withhold funds from the county board until
48.22the next reporting period. When the report is needed to account for the use of federal
48.23funds and the late report results in a reduction in federal funding, the commissioner shall
48.24withhold from the county boards with late reports an amount equal to the reduction in
48.25federal funding until full federal funding is received;
48.26    (4) a county board that submits reports that are late, illegible, incomplete, or not
48.27in the required format for two out of three consecutive reporting periods is considered
48.28noncompliant. When a county board is found to be noncompliant, the commissioner
48.29shall notify the county board of the reason the county board is considered noncompliant
48.30and request that the county board develop a corrective action plan stating how the
48.31county board plans to correct the problem. The corrective action plan must be submitted
48.32to the commissioner within 45 days after the date the county board received notice
48.33of noncompliance;
48.34    (5) the final deadline for fiscal reports or amendments to fiscal reports is one year
48.35after the date the report was originally due. If the commissioner does not receive a report
48.36by the final deadline, the county board forfeits the funding associated with the report for
49.1that reporting period and the county board must repay any funds associated with the
49.2report received for that reporting period;
49.3    (6) the commissioner may not delay payments, withhold funds, or require repayment
49.4under clause (3) or (5) if the county demonstrates that the commissioner failed to
49.5provide appropriate forms, guidelines, and technical assistance to enable the county to
49.6comply with the requirements. If the county board disagrees with an action taken by the
49.7commissioner under clause (3) or (5), the county board may appeal the action according
49.8to sections 14.57 to 14.69; and
49.9    (7) counties subject to withholding of funds under clause (3) or forfeiture or
49.10repayment of funds under clause (5) shall not reduce or withhold benefits or services to
49.11clients to cover costs incurred due to actions taken by the commissioner under clause
49.12(3) or (5).
49.13    (r) Allocate federal fiscal disallowances or sanctions for audit exceptions when
49.14federal fiscal disallowances or sanctions are based on a statewide random sample in direct
49.15proportion to each county's claim for that period.
49.16    (s) Be responsible for ensuring the detection, prevention, investigation, and
49.17resolution of fraudulent activities or behavior by applicants, recipients, and other
49.18participants in the human services programs administered by the department.
49.19    (t) Require county agencies to identify overpayments, establish claims, and utilize
49.20all available and cost-beneficial methodologies to collect and recover these overpayments
49.21in the human services programs administered by the department.
49.22    (u) Have the authority to administer a drug rebate program for drugs purchased
49.23pursuant to the prescription drug program established under section 256.955 after the
49.24beneficiary's satisfaction of any deductible established in the program. The commissioner
49.25shall require a rebate agreement from all manufacturers of covered drugs as defined in
49.26section 256B.0625, subdivision 13. Rebate agreements for prescription drugs delivered on
49.27or after July 1, 2002, must include rebates for individuals covered under the prescription
49.28drug program who are under 65 years of age. For each drug, the amount of the rebate shall
49.29be equal to the rebate as defined for purposes of the federal rebate program in United
49.30States Code, title 42, section 1396r-8. The manufacturers must provide full payment
49.31within 30 days of receipt of the state invoice for the rebate within the terms and conditions
49.32used for the federal rebate program established pursuant to section 1927 of title XIX of
49.33the Social Security Act. The manufacturers must provide the commissioner with any
49.34information necessary to verify the rebate determined per drug. The rebate program shall
49.35utilize the terms and conditions used for the federal rebate program established pursuant to
49.36section 1927 of title XIX of the Social Security Act.
50.1    (v) Have the authority to administer the federal drug rebate program for drugs
50.2purchased under the medical assistance program as allowed by section 1927 of title XIX
50.3of the Social Security Act and according to the terms and conditions of section 1927.
50.4Rebates shall be collected for all drugs that have been dispensed or administered in an
50.5outpatient setting and that are from manufacturers who have signed a rebate agreement
50.6with the United States Department of Health and Human Services.
50.7    (w) Have the authority to administer a supplemental drug rebate program for drugs
50.8purchased under the medical assistance program. The commissioner may enter into
50.9supplemental rebate contracts with pharmaceutical manufacturers and may require prior
50.10authorization for drugs that are from manufacturers that have not signed a supplemental
50.11rebate contract. Prior authorization of drugs shall be subject to the provisions of section
50.12256B.0625, subdivision 13 .
50.13    (x) Operate the department's communication systems account established in Laws
50.141993, First Special Session chapter 1, article 1, section 2, subdivision 2, to manage shared
50.15communication costs necessary for the operation of the programs the commissioner
50.16supervises. A communications account may also be established for each regional
50.17treatment center which operates communications systems. Each account must be used
50.18to manage shared communication costs necessary for the operations of the programs the
50.19commissioner supervises. The commissioner may distribute the costs of operating and
50.20maintaining communication systems to participants in a manner that reflects actual usage.
50.21Costs may include acquisition, licensing, insurance, maintenance, repair, staff time and
50.22other costs as determined by the commissioner. Nonprofit organizations and state, county,
50.23and local government agencies involved in the operation of programs the commissioner
50.24supervises may participate in the use of the department's communications technology and
50.25share in the cost of operation. The commissioner may accept on behalf of the state any
50.26gift, bequest, devise or personal property of any kind, or money tendered to the state for
50.27any lawful purpose pertaining to the communication activities of the department. Any
50.28money received for this purpose must be deposited in the department's communication
50.29systems accounts. Money collected by the commissioner for the use of communication
50.30systems must be deposited in the state communication systems account and is appropriated
50.31to the commissioner for purposes of this section.
50.32    (y) Receive any federal matching money that is made available through the medical
50.33assistance program for the consumer satisfaction survey. Any federal money received for
50.34the survey is appropriated to the commissioner for this purpose. The commissioner may
50.35expend the federal money received for the consumer satisfaction survey in either year of
50.36the biennium.
51.1    (z) Designate community information and referral call centers and incorporate
51.2cost reimbursement claims from the designated community information and referral
51.3call centers into the federal cost reimbursement claiming processes of the department
51.4according to federal law, rule, and regulations. Existing information and referral centers
51.5provided by Greater Twin Cities United Way or existing call centers for which Greater
51.6Twin Cities United Way has legal authority to represent, shall be included in these
51.7designations upon review by the commissioner and assurance that these services are
51.8accredited and in compliance with national standards. Any reimbursement is appropriated
51.9to the commissioner and all designated information and referral centers shall receive
51.10payments according to normal department schedules established by the commissioner
51.11upon final approval of allocation methodologies from the United States Department of
51.12Health and Human Services Division of Cost Allocation or other appropriate authorities.
51.13    (aa) Develop recommended standards for foster care homes that address the
51.14components of specialized therapeutic services to be provided by foster care homes with
51.15those services.
51.16    (bb) Authorize the method of payment to or from the department as part of the
51.17human services programs administered by the department. This authorization includes the
51.18receipt or disbursement of funds held by the department in a fiduciary capacity as part of
51.19the human services programs administered by the department.
51.20    (cc) Have the authority to administer a drug rebate program for drugs purchased for
51.21persons eligible for general assistance medical care under section 256D.03, subdivision 3.
51.22For manufacturers that agree to participate in the general assistance medical care rebate
51.23program, the commissioner shall enter into a rebate agreement for covered drugs as
51.24defined in section 256B.0625, subdivisions 13 and 13d. For each drug, the amount of the
51.25rebate shall be equal to the rebate as defined for purposes of the federal rebate program in
51.26United States Code, title 42, section 1396r-8. The manufacturers must provide payment
51.27within the terms and conditions used for the federal rebate program established under
51.28section 1927 of title XIX of the Social Security Act. The rebate program shall utilize
51.29the terms and conditions used for the federal rebate program established under section
51.301927 of title XIX of the Social Security Act.
51.31    Effective January 1, 2006, drug coverage under general assistance medical care shall
51.32be limited to those prescription drugs that:
51.33    (1) are covered under the medical assistance program as described in section
51.34256B.0625, subdivisions 13 and 13d ; and
51.35    (2) are provided by manufacturers that have fully executed general assistance
51.36medical care rebate agreements with the commissioner and comply with such agreements.
52.1Prescription drug coverage under general assistance medical care shall conform to
52.2coverage under the medical assistance program according to section 256B.0625,
52.3subdivisions 13 to 13g
.
52.4    The rebate revenues collected under the drug rebate program are deposited in the
52.5general fund.
52.6(dd) Designate the agencies that operate the Senior LinkAge Line under section
52.7256.975, subdivision 7, and the Disability Linkage Line under subdivision 24 as the state
52.8of Minnesota Aging and the Disability Resource Centers under United States Code, title
52.942, section 3001, the Older Americans Act Amendments of 2006, and incorporate cost
52.10reimbursement claims from the designated centers into the federal cost reimbursement
52.11claiming processes of the department according to federal law, rule, and regulations. Any
52.12reimbursement must be appropriated to the commissioner and all Aging and Disability
52.13Resource Center designated agencies shall receive payments of grant funding that supports
52.14the activity and generates the federal financial participation according to Board on Aging
52.15administrative granting mechanisms.

52.16    Sec. 5. Minnesota Statutes 2012, section 256.01, subdivision 24, is amended to read:
52.17    Subd. 24. Disability Linkage Line. The commissioner shall establish the Disability
52.18Linkage Line, to which shall serve people with disabilities as the designated Aging and
52.19Disability Resource Center under United States Code, title 42, section 3001, the Older
52.20Americans Act Amendments of 2006, in partnership with the Senior LinkAge Line and
52.21shall serve as Minnesota's neutral access point for statewide disability information and
52.22assistance and must be available during business hours through a statewide toll-free
52.23number and the Internet. The Disability Linkage Line shall:
52.24(1) deliver information and assistance based on national and state standards;
52.25    (2) provide information about state and federal eligibility requirements, benefits,
52.26and service options;
52.27(3) provide benefits and options counseling;
52.28    (4) make referrals to appropriate support entities;
52.29    (5) educate people on their options so they can make well-informed choices and link
52.30them to quality profiles;
52.31    (6) help support the timely resolution of service access and benefit issues;
52.32(7) inform people of their long-term community services and supports;
52.33(8) provide necessary resources and supports that can lead to employment and
52.34increased economic stability of people with disabilities; and
53.1(9) serve as the technical assistance and help center for the Web-based tool,
53.2Minnesota's Disability Benefits 101.org.; and
53.3(10) provide preadmission screening for individuals under 60 years of age using
53.4the procedures as defined in section 256.975, subdivisions 7a to 7c, and 256B.0911,
53.5subdivision 4d.

53.6    Sec. 6. Minnesota Statutes 2012, section 256.975, subdivision 7, is amended to read:
53.7    Subd. 7. Consumer information and assistance and long-term care options
53.8counseling; Senior LinkAge Line. (a) The Minnesota Board on Aging shall operate a
53.9statewide service to aid older Minnesotans and their families in making informed choices
53.10about long-term care options and health care benefits. Language services to persons
53.11with limited English language skills may be made available. The service, known as
53.12Senior LinkAge Line, shall serve older adults as the designated Aging and Disability
53.13Resource Center under United States Code, title 42, section 3001, the Older Americans
53.14Act Amendments of 2006, in partnership with the Disability LinkAge Line under section
53.15256.01, subdivision 24, and must be available during business hours through a statewide
53.16toll-free number and must also be available through the Internet. The Minnesota Board
53.17on Aging shall consult with, and when appropriate work through, the area agencies on
53.18aging to provide and maintain the telephone infrastructure and related support for the
53.19Aging and Disability Resource Center partners that agree by memorandum to access the
53.20infrastructure, including the designated providers of the Senior LinkAge Line and the
53.21Disability Linkage Line.
53.22    (b) The service must provide long-term care options counseling by assisting older
53.23adults, caregivers, and providers in accessing information and options counseling about
53.24choices in long-term care services that are purchased through private providers or available
53.25through public options. The service must:
53.26    (1) develop a comprehensive database that includes detailed listings in both
53.27consumer- and provider-oriented formats;
53.28    (2) make the database accessible on the Internet and through other telecommunication
53.29and media-related tools;
53.30    (3) link callers to interactive long-term care screening tools and make these tools
53.31available through the Internet by integrating the tools with the database;
53.32    (4) develop community education materials with a focus on planning for long-term
53.33care and evaluating independent living, housing, and service options;
53.34    (5) conduct an outreach campaign to assist older adults and their caregivers in
53.35finding information on the Internet and through other means of communication;
54.1    (6) implement a messaging system for overflow callers and respond to these callers
54.2by the next business day;
54.3    (7) link callers with county human services and other providers to receive more
54.4in-depth assistance and consultation related to long-term care options;
54.5    (8) link callers with quality profiles for nursing facilities and other home and
54.6community-based services providers developed by the commissioner commissioners of
54.7health and human services;
54.8    (9) incorporate information about the availability of housing options, as well as
54.9registered housing with services and consumer rights within the MinnesotaHelp.info
54.10network long-term care database to facilitate consumer comparison of services and costs
54.11among housing with services establishments and with other in-home services and to
54.12support financial self-sufficiency as long as possible. Housing with services establishments
54.13and their arranged home care providers shall provide information that will facilitate price
54.14comparisons, including delineation of charges for rent and for services available. The
54.15commissioners of health and human services shall align the data elements required by
54.16section 144G.06, the Uniform Consumer Information Guide, and this section to provide
54.17consumers standardized information and ease of comparison of long-term care options.
54.18The commissioner of human services shall provide the data to the Minnesota Board on
54.19Aging for inclusion in the MinnesotaHelp.info network long-term care database;
54.20(10) provide long-term care options counseling. Long-term care options counselors
54.21shall:
54.22(i) for individuals not eligible for case management under a public program or public
54.23funding source, provide interactive decision support under which consumers, family
54.24members, or other helpers are supported in their deliberations to determine appropriate
54.25long-term care choices in the context of the consumer's needs, preferences, values, and
54.26individual circumstances, including implementing a community support plan;
54.27(ii) provide Web-based educational information and collateral written materials to
54.28familiarize consumers, family members, or other helpers with the long-term care basics,
54.29issues to be considered, and the range of options available in the community;
54.30(iii) provide long-term care futures planning, which means providing assistance to
54.31individuals who anticipate having long-term care needs to develop a plan for the more
54.32distant future; and
54.33(iv) provide expertise in benefits and financing options for long-term care, including
54.34Medicare, long-term care insurance, tax or employer-based incentives, reverse mortgages,
54.35private pay options, and ways to access low or no-cost services or benefits through
54.36volunteer-based or charitable programs;
55.1(11) using risk management and support planning protocols, provide long-term care
55.2options counseling to current residents of nursing homes deemed appropriate for discharge
55.3by the commissioner and older adults who request service after consultation with the
55.4Senior LinkAge Line under clause (12). In order to meet this requirement, The Senior
55.5LinkAge Line shall also receive referrals from the residents or staff of nursing homes. The
55.6Senior LinkAge Line shall identify and contact residents deemed appropriate for discharge
55.7by developing targeting criteria in consultation with the commissioner who shall provide
55.8designated Senior LinkAge Line contact centers with a list of nursing home residents that
55.9meet the criteria as being appropriate for discharge planning via a secure Web portal.
55.10Senior LinkAge Line shall provide these residents, if they indicate a preference to
55.11receive long-term care options counseling, with initial assessment, review of risk factors,
55.12independent living support consultation, or and, if appropriate, a referral to:
55.13(i) long-term care consultation services under section 256B.0911;
55.14(ii) designated care coordinators of contracted entities under section 256B.035 for
55.15persons who are enrolled in a managed care plan; or
55.16(iii) the long-term care consultation team for those who are appropriate eligible
55.17 for relocation service coordination due to high-risk factors or psychological or physical
55.18disability; and
55.19(12) develop referral protocols and processes that will assist certified health care
55.20homes and hospitals to identify at-risk older adults and determine when to refer these
55.21individuals to the Senior LinkAge Line for long-term care options counseling under this
55.22section. The commissioner is directed to work with the commissioner of health to develop
55.23protocols that would comply with the health care home designation criteria and protocols
55.24available at the time of hospital discharge. The commissioner shall keep a record of the
55.25number of people who choose long-term care options counseling as a result of this section.

55.26    Sec. 7. Minnesota Statutes 2012, section 256.975, is amended by adding a subdivision
55.27to read:
55.28    Subd. 7a. Preadmission screening activities related to nursing facility
55.29admissions. (a) All individuals seeking admission to Medicaid certified nursing facilities,
55.30including certified boarding care facilities, must be screened prior to admission regardless
55.31of income, assets, or funding sources for nursing facility care, except as described in
55.32subdivision 7b, paragraphs (a) and (b). The purpose of the screening is to determine the
55.33need for nursing facility level of care as described in section 256B.0911, subdivision
55.344e, and to complete activities required under federal law related to mental illness and
55.35developmental disability as outlined in paragraph (b).
56.1(b) A person who has a diagnosis or possible diagnosis of mental illness or
56.2developmental disability must receive a preadmission screening before admission
56.3regardless of the exemptions outlined in subdivision 7b, paragraphs (a) and (b), to identify
56.4the need for further evaluation and specialized services, unless the admission prior to
56.5screening is authorized by the local mental health authority or the local developmental
56.6disabilities case manager, or unless authorized by the county agency according to Public
56.7Law 101-508.
56.8(c) The following criteria apply to the preadmission screening:
56.9(1) requests for preadmission screenings must be submitted via an online form
56.10developed by the commissioner;
56.11(2) the Senior LinkAge Line must use forms and criteria developed by the
56.12commissioner to identify persons who require referral for further evaluation and
56.13determination of the need for specialized services; and
56.14(3) the evaluation and determination of the need for specialized services must be
56.15done by:
56.16(i) a qualified independent mental health professional, for persons with a primary or
56.17secondary diagnosis of a serious mental illness; or
56.18(ii) a qualified developmental disability professional, for persons with a primary or
56.19secondary diagnosis of developmental disability. For purposes of this requirement, a
56.20qualified developmental disability professional must meet the standards for a qualified
56.21developmental disability professional under Code of Federal Regulations, title 42, section
56.22483.430.
56.23(d) The local county mental health authority or the state developmental disability
56.24authority under Public Law Numbers 100-203 and 101-508 may prohibit admission to a
56.25nursing facility if the individual does not meet the nursing facility level of care criteria or
56.26needs specialized services as defined in Public Law Numbers 100-203 and 101-508. For
56.27purposes of this section, "specialized services" for a person with developmental disability
56.28means active treatment as that term is defined under Code of Federal Regulations, title
56.2942, section 483.440(a)(1).
56.30(e) In assessing a person's needs, the screener shall:
56.31(1) use an automated system designated by the commissioner;
56.32(2) consult with care transitions coordinators or physician; and
56.33(3) consider the assessment of the individual's physician.
56.34Other personnel may be included in the level of care determination as deemed
56.35necessary by the screener.
56.36EFFECTIVE DATE.This section is effective October 1, 2013.

57.1    Sec. 8. Minnesota Statutes 2012, section 256.975, is amended by adding a subdivision
57.2to read:
57.3    Subd. 7b. Exemptions and emergency admissions. (a) Exemptions from the federal
57.4screening requirements outlined in subdivision 7a, paragraphs (b) and (c), are limited to:
57.5(1) a person who, having entered an acute care facility from a certified nursing
57.6facility, is returning to a certified nursing facility; or
57.7(2) a person transferring from one certified nursing facility in Minnesota to another
57.8certified nursing facility in Minnesota.
57.9(b) Persons who are exempt from preadmission screening for purposes of level of
57.10care determination include:
57.11(1) persons described in paragraph (a);
57.12(2) an individual who has a contractual right to have nursing facility care paid for
57.13indefinitely by the Veterans' Administration;
57.14(3) an individual enrolled in a demonstration project under section 256B.69,
57.15subdivision 8, at the time of application to a nursing facility; and
57.16(4) an individual currently being served under the alternative care program or under
57.17a home and community-based services waiver authorized under section 1915(c) of the
57.18federal Social Security Act.
57.19(c) Persons admitted to a Medicaid-certified nursing facility from the community
57.20on an emergency basis as described in paragraph (d) or from an acute care facility on a
57.21nonworking day must be screened the first working day after admission.
57.22(d) Emergency admission to a nursing facility prior to screening is permitted when
57.23all of the following conditions are met:
57.24(1) a person is admitted from the community to a certified nursing or certified
57.25boarding care facility during Senior LinkAge Line nonworking hours for ages 60 and
57.26older and Disability Linkage Line nonworking hours for under age 60;
57.27(2) a physician has determined that delaying admission until preadmission screening
57.28is completed would adversely affect the person's health and safety;
57.29(3) there is a recent precipitating event that precludes the client from living safely in
57.30the community, such as sustaining an injury, sudden onset of acute illness, or a caregiver's
57.31inability to continue to provide care;
57.32(4) the attending physician has authorized the emergency placement and has
57.33documented the reason that the emergency placement is recommended; and
57.34(5) the Senior LinkAge Line or Disability Linkage Line is contacted on the first
57.35working day following the emergency admission.
58.1Transfer of a patient from an acute care hospital to a nursing facility is not considered
58.2an emergency except for a person who has received hospital services in the following
58.3situations: hospital admission for observation, care in an emergency room without hospital
58.4admission, or following hospital 24-hour bed care and from whom admission is being
58.5sought on a nonworking day.
58.6(e) A nursing facility must provide written information to all persons admitted
58.7regarding the person's right to request and receive long-term care consultation services as
58.8defined in section 256B.0911, subdivision 1a. The information must be provided prior to
58.9the person's discharge from the facility and in a format specified by the commissioner.
58.10EFFECTIVE DATE.This section is effective October 1, 2013.

58.11    Sec. 9. Minnesota Statutes 2012, section 256.975, is amended by adding a subdivision
58.12to read:
58.13    Subd. 7c. Screening requirements. (a) A person may be screened for nursing
58.14facility admission by telephone or in a face-to-face screening interview. The Senior
58.15LinkAge Line shall identify each individual's needs using the following categories:
58.16(1) the person needs no face-to-face long-term care consultation assessment
58.17completed under section 256B.0911, subdivision 3a, 3b, or 4d, by a county, tribe, or
58.18managed care organization under contract with the Department of Human Services to
58.19determine the need for nursing facility level of care based on information obtained from
58.20other health care professionals;
58.21(2) the person needs an immediate face-to-face long-term care consultation
58.22assessment completed under section 256B.0911, subdivision 3a, 3b, or 4d, by a county,
58.23tribe, or managed care organization under contract with the Department of Human
58.24Services to determine the need for nursing facility level of care and complete activities
58.25required under subdivision 7a; or
58.26(3) the person may be exempt from screening requirements as outlined in subdivision
58.277b, but will need transitional assistance after admission or in-person follow-along after
58.28a return home.
58.29(b) Individuals between the ages of 60 and 64 who are admitted to nursing facilities
58.30with only a telephone screening must receive a face-to-face assessment from the long-term
58.31care consultation team member of the county in which the facility is located or from the
58.32recipient's county case manager within 40 calendar days of admission as described in
58.33section 256B.0911, subdivision 4d, paragraph (c).
58.34(c) Persons admitted on a nonemergency basis to a Medicaid-certified nursing
58.35facility must be screened prior to admission.
59.1(d) Screenings provided by the Senior LinkAge Line must include processes
59.2to identify persons who may require transition assistance described in subdivision 7,
59.3paragraph (b), clause (12), and section 256B.0911, subdivision 3b.
59.4EFFECTIVE DATE.This section is effective October 1, 2013.

59.5    Sec. 10. Minnesota Statutes 2012, section 256.975, is amended by adding a subdivision
59.6to read:
59.7    Subd. 7d. Payment for preadmission screening. Funding for preadmission
59.8screening shall be provided to the Minnesota Board on Aging for the population 60
59.9years of age and older by the Department of Human Services to cover screener salaries
59.10and expenses to provide the services described in subdivisions 7a to 7c. The Minnesota
59.11Board on Aging shall employ, or contract with other agencies to employ, within the limits
59.12of available funding, sufficient personnel to provide preadmission screening and level of
59.13care determination services and shall seek to maximize federal funding for the service as
59.14provided under section 256.01, subdivision 2, paragraph (dd).
59.15EFFECTIVE DATE.This section is effective October 1, 2013.

59.16    Sec. 11. Minnesota Statutes 2012, section 256.9754, is amended by adding a
59.17subdivision to read:
59.18    Subd. 3a. Priority for other grants. The commissioner of health shall give
59.19priority to a grantee selected under subdivision 3 when awarding technology-related
59.20grants, if the grantee is using technology as a part of a proposal, unless that priority
59.21conflicts with existing state or federal guidance related to grant awards by the Department
59.22of Health. The commissioner of transportation shall give priority to a grantee selected
59.23under subdivision 3 when distributing transportation-related funds to create transportation
59.24options for older adults.

59.25    Sec. 12. Minnesota Statutes 2012, section 256.9754, is amended by adding a
59.26subdivision to read:
59.27    Subd. 3b. State waivers. The commissioner of health may waive applicable state
59.28laws and rules on a time-limited basis if the commissioner of health determines that a
59.29participating grantee requires a waiver in order to achieve demonstration project goals.

59.30    Sec. 13. Minnesota Statutes 2012, section 256.9754, subdivision 5, is amended to read:
60.1    Subd. 5. Grant preference. The commissioner of human services shall give
60.2preference when awarding grants under this section to areas where nursing facility
60.3closures have occurred or are occurring or areas with service needs identified by section
60.4144A.351. The commissioner may award grants to the extent grant funds are available
60.5and to the extent applications are approved by the commissioner. Denial of approval of an
60.6application in one year does not preclude submission of an application in a subsequent
60.7year. The maximum grant amount is limited to $750,000.

60.8    Sec. 14. Minnesota Statutes 2012, section 256B.021, is amended by adding a
60.9subdivision to read:
60.10    Subd. 4a. Evaluation. The commissioner shall evaluate the projects contained in
60.11subdivision 4, paragraphs (f), clauses (2) and (12), and (h). The evaluation must include:
60.12(1) an impact assessment focusing on program outcomes, especially those
60.13experienced directly by the person receiving services;
60.14(2) study samples drawn from the population of interest for each project; and
60.15(3) a time series analysis to examine aggregate trends in average monthly
60.16utilization, expenditures, and other outcomes in the targeted populations before and after
60.17implementation of the initiatives.

60.18    Sec. 15. Minnesota Statutes 2012, section 256B.021, is amended by adding a
60.19subdivision to read:
60.20    Subd. 6. Work, empower, and encourage independence. As provided under
60.21subdivision 4, paragraph (e), upon federal approval, the commissioner shall establish a
60.22demonstration project to provide navigation, employment supports, and benefits planning
60.23services to a targeted group of federally funded Medicaid recipients to begin July 1, 2014.
60.24This demonstration shall promote economic stability, increase independence, and reduce
60.25applications for disability benefits while providing a positive impact on the health and
60.26future of participants.

60.27    Sec. 16. Minnesota Statutes 2012, section 256B.021, is amended by adding a
60.28subdivision to read:
60.29    Subd. 7. Housing stabilization. As provided under subdivision 4, paragraph (e),
60.30upon federal approval, the commissioner shall establish a demonstration project to provide
60.31service coordination, outreach, in-reach, tenancy support, and community living assistance
60.32to a targeted group of federally funded Medicaid recipients to begin January 1, 2014. This
61.1demonstration shall promote housing stability, reduce costly medical interventions, and
61.2increase opportunities for independent community living.

61.3    Sec. 17. Minnesota Statutes 2012, section 256B.0911, subdivision 1, is amended to read:
61.4    Subdivision 1. Purpose and goal. (a) The purpose of long-term care consultation
61.5services is to assist persons with long-term or chronic care needs in making care
61.6decisions and selecting support and service options that meet their needs and reflect
61.7their preferences. The availability of, and access to, information and other types of
61.8assistance, including assessment and support planning, is also intended to prevent or delay
61.9institutional placements and to provide access to transition assistance after admission.
61.10Further, the goal of these services is to contain costs associated with unnecessary
61.11institutional admissions. Long-term consultation services must be available to any person
61.12regardless of public program eligibility. The commissioner of human services shall seek
61.13to maximize use of available federal and state funds and establish the broadest program
61.14possible within the funding available.
61.15(b) These services must be coordinated with long-term care options counseling
61.16provided under subdivision 4d, section 256.975, subdivision subdivisions 7 to 7c, and
61.17section 256.01, subdivision 24. The lead agency providing long-term care consultation
61.18services shall encourage the use of volunteers from families, religious organizations, social
61.19clubs, and similar civic and service organizations to provide community-based services.

61.20    Sec. 18. Minnesota Statutes 2012, section 256B.0911, subdivision 1a, is amended to
61.21read:
61.22    Subd. 1a. Definitions. For purposes of this section, the following definitions apply:
61.23    (a) Until additional requirements apply under paragraph (b), "long-term care
61.24consultation services" means:
61.25    (1) intake for and access to assistance in identifying services needed to maintain an
61.26individual in the most inclusive environment;
61.27    (2) providing recommendations for and referrals to cost-effective community
61.28services that are available to the individual;
61.29    (3) development of an individual's person-centered community support plan;
61.30    (4) providing information regarding eligibility for Minnesota health care programs;
61.31    (5) face-to-face long-term care consultation assessments, which may be completed
61.32in a hospital, nursing facility, intermediate care facility for persons with developmental
61.33disabilities (ICF/DDs), regional treatment centers, or the person's current or planned
61.34residence;
62.1    (6) federally mandated preadmission screening activities described under
62.2subdivisions 4a and 4b;
62.3    (7) (6) determination of home and community-based waiver and other service
62.4eligibility as required under sections 256B.0913, 256B.0915, and 256B.49, including level
62.5of care determination for individuals who need an institutional level of care as determined
62.6under section 256B.0911, subdivision 4a, paragraph (d) 4e, based on assessment and
62.7community support plan development, appropriate referrals to obtain necessary diagnostic
62.8information, and including an eligibility determination for consumer-directed community
62.9supports;
62.10    (8) (7) providing recommendations for institutional placement when there are no
62.11cost-effective community services available;
62.12    (9) (8) providing access to assistance to transition people back to community settings
62.13after institutional admission; and
62.14(10) (9) providing information about competitive employment, with or without
62.15supports, for school-age youth and working-age adults and referrals to the Disability
62.16Linkage Line and Disability Benefits 101 to ensure that an informed choice about
62.17competitive employment can be made. For the purposes of this subdivision, "competitive
62.18employment" means work in the competitive labor market that is performed on a full-time
62.19or part-time basis in an integrated setting, and for which an individual is compensated at or
62.20above the minimum wage, but not less than the customary wage and level of benefits paid
62.21by the employer for the same or similar work performed by individuals without disabilities.
62.22(b) Upon statewide implementation of lead agency requirements in subdivisions 2b,
62.232c, and 3a, "long-term care consultation services" also means:
62.24(1) service eligibility determination for state plan home care services identified in:
62.25(i) section 256B.0625, subdivisions 7, 19a, and 19c;
62.26(ii) section 256B.0657; or
62.27(iii) consumer support grants under section 256.476;
62.28(2) notwithstanding provisions in Minnesota Rules, parts 9525.0004 to 9525.0024,
62.29determination of eligibility for case management services available under sections
62.30256B.0621, subdivision 2 , paragraph (4), and 256B.0924 and Minnesota Rules, part
62.319525.0016;
62.32(3) determination of institutional level of care, home and community-based service
62.33waiver, and other service eligibility as required under section 256B.092, determination
62.34of eligibility for family support grants under section 252.32, semi-independent living
62.35services under section 252.275, and day training and habilitation services under section
62.36256B.092 ; and
63.1(4) obtaining necessary diagnostic information to determine eligibility under clauses
63.2(2) and (3).
63.3    (c) "Long-term care options counseling" means the services provided by the linkage
63.4lines as mandated by sections 256.01, subdivision 24, and 256.975, subdivision 7, and
63.5also includes telephone assistance and follow up once a long-term care consultation
63.6assessment has been completed.
63.7    (d) "Minnesota health care programs" means the medical assistance program under
63.8chapter 256B and the alternative care program under section 256B.0913.
63.9    (e) "Lead agencies" means counties administering or tribes and health plans under
63.10contract with the commissioner to administer long-term care consultation assessment and
63.11support planning services.

63.12    Sec. 19. Minnesota Statutes 2012, section 256B.0911, subdivision 3a, is amended to
63.13read:
63.14    Subd. 3a. Assessment and support planning. (a) Persons requesting assessment,
63.15services planning, or other assistance intended to support community-based living,
63.16including persons who need assessment in order to determine waiver or alternative care
63.17program eligibility, must be visited by a long-term care consultation team within 20
63.18calendar days after the date on which an assessment was requested or recommended.
63.19Upon statewide implementation of subdivisions 2b, 2c, and 5, this requirement also
63.20applies to an assessment of a person requesting personal care assistance services and
63.21private duty nursing. The commissioner shall provide at least a 90-day notice to lead
63.22agencies prior to the effective date of this requirement. Face-to-face assessments must be
63.23conducted according to paragraphs (b) to (i).
63.24    (b) The lead agency may utilize a team of either the social worker or public health
63.25nurse, or both. Upon implementation of subdivisions 2b, 2c, and 5, lead agencies shall
63.26use certified assessors to conduct the assessment. The consultation team members must
63.27confer regarding the most appropriate care for each individual screened or assessed. For
63.28a person with complex health care needs, a public health or registered nurse from the
63.29team must be consulted.
63.30    (c) The assessment must be comprehensive and include a person-centered assessment
63.31of the health, psychological, functional, environmental, and social needs of referred
63.32individuals and provide information necessary to develop a community support plan that
63.33meets the consumers needs, using an assessment form provided by the commissioner.
63.34    (d) The assessment must be conducted in a face-to-face interview with the person
63.35being assessed and the person's legal representative, and other individuals as requested by
64.1the person, who can provide information on the needs, strengths, and preferences of the
64.2person necessary to develop a community support plan that ensures the person's health and
64.3safety, but who is not a provider of service or has any financial interest in the provision
64.4of services. For persons who are to be assessed for elderly waiver customized living
64.5services under section 256B.0915, with the permission of the person being assessed or
64.6the person's designated or legal representative, the client's current or proposed provider
64.7of services may submit a copy of the provider's nursing assessment or written report
64.8outlining its recommendations regarding the client's care needs. The person conducting
64.9the assessment will notify the provider of the date by which this information is to be
64.10submitted. This information shall be provided to the person conducting the assessment
64.11prior to the assessment.
64.12    (e) If the person chooses to use community-based services, the person or the person's
64.13legal representative must be provided with a written community support plan within 40
64.14calendar days of the assessment visit, regardless of whether the individual is eligible for
64.15Minnesota health care programs. The written community support plan must include:
64.16(1) a summary of assessed needs as defined in paragraphs (c) and (d);
64.17(2) the individual's options and choices to meet identified needs, including all
64.18available options for case management services and providers;
64.19(3) identification of health and safety risks and how those risks will be addressed,
64.20including personal risk management strategies;
64.21(4) referral information; and
64.22(5) informal caregiver supports, if applicable.
64.23For a person determined eligible for state plan home care under subdivision 1a,
64.24paragraph (b), clause (1), the person or person's representative must also receive a copy of
64.25the home care service plan developed by the certified assessor.
64.26(f) A person may request assistance in identifying community supports without
64.27participating in a complete assessment. Upon a request for assistance identifying
64.28community support, the person must be transferred or referred to long-term care options
64.29counseling services available under sections 256.975, subdivision 7, and 256.01,
64.30subdivision 24, for telephone assistance and follow up.
64.31    (g) The person has the right to make the final decision between institutional
64.32placement and community placement after the recommendations have been provided,
64.33except as provided in section 256.975, subdivision 4a, paragraph (c) 7a, paragraph (d).
64.34    (h) The lead agency must give the person receiving assessment or support planning,
64.35or the person's legal representative, materials, and forms supplied by the commissioner
64.36containing the following information:
65.1    (1) written recommendations for community-based services and consumer-directed
65.2options;
65.3(2) documentation that the most cost-effective alternatives available were offered to
65.4the individual. For purposes of this clause, "cost-effective" means community services and
65.5living arrangements that cost the same as or less than institutional care. For an individual
65.6found to meet eligibility criteria for home and community-based service programs under
65.7section 256B.0915 or 256B.49, "cost-effectiveness" has the meaning found in the federally
65.8approved waiver plan for each program;
65.9(3) the need for and purpose of preadmission screening conducted by long-term care
65.10options counselors according to sections 256.975, subdivisions 7a to 7c, and 256.01,
65.11subdivision 24, if the person selects nursing facility placement. If the individual selects
65.12nursing facility placement, the lead agency shall forward information needed to complete
65.13the level of care determinations and screening for developmental disability and mental
65.14illness collected during the assessment to the long-term care options counselor using forms
65.15provided by the commissioner;
65.16    (4) the role of long-term care consultation assessment and support planning in
65.17eligibility determination for waiver and alternative care programs, and state plan home
65.18care, case management, and other services as defined in subdivision 1a, paragraphs (a),
65.19clause (7), and (b);
65.20    (5) information about Minnesota health care programs;
65.21    (6) the person's freedom to accept or reject the recommendations of the team;
65.22    (7) the person's right to confidentiality under the Minnesota Government Data
65.23Practices Act, chapter 13;
65.24    (8) the certified assessor's decision regarding the person's need for institutional level
65.25of care as determined under criteria established in section 256B.0911, subdivision 4a,
65.26paragraph (d) 4e, and the certified assessor's decision regarding eligibility for all services
65.27and programs as defined in subdivision 1a, paragraphs (a), clause (7), and (b); and
65.28    (9) the person's right to appeal the certified assessor's decision regarding eligibility
65.29for all services and programs as defined in subdivision 1a, paragraphs (a), clause (7), and
65.30(b), and incorporating the decision regarding the need for institutional level of care or the
65.31lead agency's final decisions regarding public programs eligibility according to section
65.32256.045, subdivision 3 .
65.33    (i) Face-to-face assessment completed as part of eligibility determination for
65.34the alternative care, elderly waiver, community alternatives for disabled individuals,
65.35community alternative care, and brain injury waiver programs under sections 256B.0913,
66.1256B.0915 , and 256B.49 is valid to establish service eligibility for no more than 60
66.2calendar days after the date of assessment.
66.3(j) The effective eligibility start date for programs in paragraph (i) can never be
66.4prior to the date of assessment. If an assessment was completed more than 60 days
66.5before the effective waiver or alternative care program eligibility start date, assessment
66.6and support plan information must be updated in a face-to-face visit and documented in
66.7the department's Medicaid Management Information System (MMIS). Notwithstanding
66.8retroactive medical assistance coverage of state plan services, the effective date of
66.9eligibility for programs included in paragraph (i) cannot be prior to the date the most
66.10recent updated assessment is completed.

66.11    Sec. 20. Minnesota Statutes 2012, section 256B.0911, subdivision 4d, is amended to
66.12read:
66.13    Subd. 4d. Preadmission screening of individuals under 65 60 years of age. (a)
66.14It is the policy of the state of Minnesota to ensure that individuals with disabilities or
66.15chronic illness are served in the most integrated setting appropriate to their needs and have
66.16the necessary information to make informed choices about home and community-based
66.17service options.
66.18    (b) Individuals under 65 60 years of age who are admitted to a Medicaid-certified
66.19 nursing facility from a hospital must be screened prior to admission as outlined in
66.20subdivisions 4a through 4c according to the requirements outlined in section 256.975,
66.21subdivisions 7a to 7c. This shall be provided by the Disability Linkage Line as required
66.22under section 256.01, subdivision 24.
66.23    (c) Individuals under 65 years of age who are admitted to nursing facilities with
66.24only a telephone screening must receive a face-to-face assessment from the long-term
66.25care consultation team member of the county in which the facility is located or from the
66.26recipient's county case manager within 40 calendar days of admission.
66.27    (d) Individuals under 65 years of age who are admitted to a nursing facility
66.28without preadmission screening according to the exemption described in subdivision 4b,
66.29paragraph (a), clause (3), and who remain in the facility longer than 30 days must receive
66.30a face-to-face assessment within 40 days of admission.
66.31    (e) (d) At the face-to-face assessment, the long-term care consultation team member
66.32or county case manager must perform the activities required under subdivision 3b.
66.33    (f) (e) For individuals under 21 years of age, a screening interview which
66.34recommends nursing facility admission must be face-to-face and approved by the
66.35commissioner before the individual is admitted to the nursing facility.
67.1    (g) (f) In the event that an individual under 65 60 years of age is admitted to a
67.2nursing facility on an emergency basis, the county Disability Linkage Line must be
67.3notified of the admission on the next working day, and a face-to-face assessment as
67.4described in paragraph (c) must be conducted within 40 calendar days of admission.
67.5    (h) (g) At the face-to-face assessment, the long-term care consultation team member
67.6or the case manager must present information about home and community-based options,
67.7including consumer-directed options, so the individual can make informed choices. If the
67.8individual chooses home and community-based services, the long-term care consultation
67.9team member or case manager must complete a written relocation plan within 20 working
67.10days of the visit. The plan shall describe the services needed to move out of the facility
67.11and a time line for the move which is designed to ensure a smooth transition to the
67.12individual's home and community.
67.13    (i) (h) An individual under 65 years of age residing in a nursing facility shall receive
67.14a face-to-face assessment at least every 12 months to review the person's service choices
67.15and available alternatives unless the individual indicates, in writing, that annual visits are
67.16not desired. In this case, the individual must receive a face-to-face assessment at least
67.17once every 36 months for the same purposes.
67.18    (j) (i) Notwithstanding the provisions of subdivision 6, the commissioner may pay
67.19county agencies directly for face-to-face assessments for individuals under 65 years of age
67.20who are being considered for placement or residing in a nursing facility. Until September
67.2130, 2013, payments for individuals under 65 years of age shall be made as described
67.22in this subdivision.
67.23(j) Funding for preadmission screening shall be provided to the Disability Linkage
67.24Line for the under 60 population by the Department of Human Services to cover screener
67.25salaries and expenses to provide the services described in subdivisions 7a to 7c. The
67.26Disability Linkage Line shall employ, or contract with other agencies to employ, within
67.27the limits of available funding, sufficient personnel to provide preadmission screening and
67.28level of care determination services and shall seek to maximize federal funding for the
67.29service as provided under section 256.01, subdivision 2, paragraph (dd).
67.30EFFECTIVE DATE.This section is effective October 1, 2013.

67.31    Sec. 21. Minnesota Statutes 2012, section 256B.0911, is amended by adding a
67.32subdivision to read:
67.33    Subd. 4e. Determination of institutional level of care. The determination of the
67.34need for nursing facility, hospital, and intermediate care facility levels of care must be
67.35made according to criteria developed by the commissioner, and in section 256B.092,
68.1using forms developed by the commissioner. Effective January 1, 2014, for individuals
68.2age 21 and older, the determination of need for nursing facility level of care shall be
68.3based on criteria in section 144.0724, subdivision 11. For individuals under age 21, the
68.4determination of the need for nursing facility level of care must be made according to
68.5criteria developed by the commissioner until criteria in section 144.0724, subdivision 11,
68.6becomes effective on or after October 1, 2019.

68.7    Sec. 22. Minnesota Statutes 2012, section 256B.0911, subdivision 6, is amended to read:
68.8    Subd. 6. Payment for long-term care consultation services. (a) Until September
68.930, 2013, payment for long-term care consultation face-to-face assessment shall be made
68.10as described in this subdivision.
68.11    (b) The total payment for each county must be paid monthly by certified nursing
68.12facilities in the county. The monthly amount to be paid by each nursing facility for each
68.13fiscal year must be determined by dividing the county's annual allocation for long-term
68.14care consultation services by 12 to determine the monthly payment and allocating the
68.15monthly payment to each nursing facility based on the number of licensed beds in the
68.16nursing facility. Payments to counties in which there is no certified nursing facility must be
68.17made by increasing the payment rate of the two facilities located nearest to the county seat.
68.18    (b) (c) The commissioner shall include the total annual payment determined under
68.19paragraph (a) for each nursing facility reimbursed under section 256B.431, 256B.434,
68.20or 256B.441.
68.21    (c) (d) In the event of the layaway, delicensure and decertification, or removal
68.22from layaway of 25 percent or more of the beds in a facility, the commissioner may
68.23adjust the per diem payment amount in paragraph (b) (c) and may adjust the monthly
68.24payment amount in paragraph (a) (b). The effective date of an adjustment made under this
68.25paragraph shall be on or after the first day of the month following the effective date of the
68.26layaway, delicensure and decertification, or removal from layaway.
68.27    (d) (e) Payments for long-term care consultation services are available to the county
68.28or counties to cover staff salaries and expenses to provide the services described in
68.29subdivision 1a. The county shall employ, or contract with other agencies to employ,
68.30within the limits of available funding, sufficient personnel to provide long-term care
68.31consultation services while meeting the state's long-term care outcomes and objectives as
68.32defined in subdivision 1. The county shall be accountable for meeting local objectives
68.33as approved by the commissioner in the biennial home and community-based services
68.34quality assurance plan on a form provided by the commissioner.
69.1    (e) (f) Notwithstanding section 256B.0641, overpayments attributable to payment
69.2of the screening costs under the medical assistance program may not be recovered from
69.3a facility.
69.4    (f) (g) The commissioner of human services shall amend the Minnesota medical
69.5assistance plan to include reimbursement for the local consultation teams.
69.6    (g) (h) Until the alternative payment methodology in paragraph (h) (i) is implemented,
69.7the county may bill, as case management services, assessments, support planning, and
69.8follow-along provided to persons determined to be eligible for case management under
69.9Minnesota health care programs. No individual or family member shall be charged for an
69.10initial assessment or initial support plan development provided under subdivision 3a or 3b.
69.11(h) (i) The commissioner shall develop an alternative payment methodology,
69.12effective on October 1, 2013, for long-term care consultation services that includes
69.13the funding available under this subdivision, and for assessments authorized under
69.14sections 256B.092 and 256B.0659. In developing the new payment methodology, the
69.15commissioner shall consider the maximization of other funding sources, including federal
69.16administrative reimbursement through federal financial participation funding, for all
69.17long-term care consultation and preadmission screening activity. The alternative payment
69.18methodology shall include the use of the appropriate time studies and the state financing
69.19of nonfederal share as part of the state's medical assistance program.

69.20    Sec. 23. Minnesota Statutes 2012, section 256B.0911, subdivision 7, is amended to read:
69.21    Subd. 7. Reimbursement for certified nursing facilities. (a) Medical assistance
69.22reimbursement for nursing facilities shall be authorized for a medical assistance recipient
69.23only if a preadmission screening has been conducted prior to admission or the county has
69.24authorized an exemption. Medical assistance reimbursement for nursing facilities shall
69.25not be provided for any recipient who the local screener has determined does not meet the
69.26level of care criteria for nursing facility placement in section 144.0724, subdivision 11, or,
69.27if indicated, has not had a level II OBRA evaluation as required under the federal Omnibus
69.28Budget Reconciliation Act of 1987 completed unless an admission for a recipient with
69.29mental illness is approved by the local mental health authority or an admission for a
69.30recipient with developmental disability is approved by the state developmental disability
69.31authority.
69.32    (b) The nursing facility must not bill a person who is not a medical assistance
69.33recipient for resident days that preceded the date of completion of screening activities
69.34as required under section 256.975, subdivisions 4a, 4b, and 4c 7a to 7c. The nursing
70.1facility must include unreimbursed resident days in the nursing facility resident day totals
70.2reported to the commissioner.

70.3    Sec. 24. Minnesota Statutes 2012, section 256B.0913, subdivision 4, is amended to read:
70.4    Subd. 4. Eligibility for funding for services for nonmedical assistance recipients.
70.5    (a) Funding for services under the alternative care program is available to persons who
70.6meet the following criteria:
70.7    (1) the person has been determined by a community assessment under section
70.8256B.0911 to be a person who would require the level of care provided in a nursing
70.9facility, as determined under section 256B.0911, subdivision 4a, paragraph (d) 4e, but for
70.10the provision of services under the alternative care program;
70.11    (2) the person is age 65 or older;
70.12    (3) the person would be eligible for medical assistance within 135 days of admission
70.13to a nursing facility;
70.14    (4) the person is not ineligible for the payment of long-term care services by the
70.15medical assistance program due to an asset transfer penalty under section 256B.0595 or
70.16equity interest in the home exceeding $500,000 as stated in section 256B.056;
70.17    (5) the person needs long-term care services that are not funded through other
70.18state or federal funding, or other health insurance or other third-party insurance such as
70.19long-term care insurance;
70.20    (6) except for individuals described in clause (7), the monthly cost of the alternative
70.21care services funded by the program for this person does not exceed 75 percent of the
70.22monthly limit described under section 256B.0915, subdivision 3a. This monthly limit
70.23does not prohibit the alternative care client from payment for additional services, but in no
70.24case may the cost of additional services purchased under this section exceed the difference
70.25between the client's monthly service limit defined under section 256B.0915, subdivision
70.263
, and the alternative care program monthly service limit defined in this paragraph. If
70.27care-related supplies and equipment or environmental modifications and adaptations are or
70.28will be purchased for an alternative care services recipient, the costs may be prorated on a
70.29monthly basis for up to 12 consecutive months beginning with the month of purchase.
70.30If the monthly cost of a recipient's other alternative care services exceeds the monthly
70.31limit established in this paragraph, the annual cost of the alternative care services shall be
70.32determined. In this event, the annual cost of alternative care services shall not exceed 12
70.33times the monthly limit described in this paragraph;
70.34    (7) for individuals assigned a case mix classification A as described under section
70.35256B.0915, subdivision 3a , paragraph (a), with (i) no dependencies in activities of daily
71.1living, or (ii) up to two dependencies in bathing, dressing, grooming, walking, and eating
71.2when the dependency score in eating is three or greater as determined by an assessment
71.3performed under section 256B.0911, the monthly cost of alternative care services funded
71.4by the program cannot exceed $593 per month for all new participants enrolled in
71.5the program on or after July 1, 2011. This monthly limit shall be applied to all other
71.6participants who meet this criteria at reassessment. This monthly limit shall be increased
71.7annually as described in section 256B.0915, subdivision 3a, paragraph (a). This monthly
71.8limit does not prohibit the alternative care client from payment for additional services, but
71.9in no case may the cost of additional services purchased exceed the difference between the
71.10client's monthly service limit defined in this clause and the limit described in clause (6)
71.11for case mix classification A; and
71.12(8) the person is making timely payments of the assessed monthly fee.
71.13A person is ineligible if payment of the fee is over 60 days past due, unless the person
71.14agrees to:
71.15    (i) the appointment of a representative payee;
71.16    (ii) automatic payment from a financial account;
71.17    (iii) the establishment of greater family involvement in the financial management of
71.18payments; or
71.19    (iv) another method acceptable to the lead agency to ensure prompt fee payments.
71.20    The lead agency may extend the client's eligibility as necessary while making
71.21arrangements to facilitate payment of past-due amounts and future premium payments.
71.22Following disenrollment due to nonpayment of a monthly fee, eligibility shall not be
71.23reinstated for a period of 30 days.
71.24    (b) Alternative care funding under this subdivision is not available for a person who
71.25is a medical assistance recipient or who would be eligible for medical assistance without a
71.26spenddown or waiver obligation. A person whose initial application for medical assistance
71.27and the elderly waiver program is being processed may be served under the alternative care
71.28program for a period up to 60 days. If the individual is found to be eligible for medical
71.29assistance, medical assistance must be billed for services payable under the federally
71.30approved elderly waiver plan and delivered from the date the individual was found eligible
71.31for the federally approved elderly waiver plan. Notwithstanding this provision, alternative
71.32care funds may not be used to pay for any service the cost of which: (i) is payable by
71.33medical assistance; (ii) is used by a recipient to meet a waiver obligation; or (iii) is used to
71.34pay a medical assistance income spenddown for a person who is eligible to participate in the
71.35federally approved elderly waiver program under the special income standard provision.
72.1    (c) Alternative care funding is not available for a person who resides in a licensed
72.2nursing home, certified boarding care home, hospital, or intermediate care facility, except
72.3for case management services which are provided in support of the discharge planning
72.4process for a nursing home resident or certified boarding care home resident to assist with
72.5a relocation process to a community-based setting.
72.6    (d) Alternative care funding is not available for a person whose income is greater
72.7than the maintenance needs allowance under section 256B.0915, subdivision 1d, but equal
72.8to or less than 120 percent of the federal poverty guideline effective July 1 in the fiscal
72.9year for which alternative care eligibility is determined, who would be eligible for the
72.10elderly waiver with a waiver obligation.

72.11    Sec. 25. Minnesota Statutes 2012, section 256B.0913, is amended by adding a
72.12subdivision to read:
72.13    Subd. 17. Essential community supports grants. (a) Notwithstanding subdivisions
72.141 to 14, the purpose of the essential community supports grant program is to provide
72.15targeted services to persons age 65 and older who need essential community support, but
72.16whose needs do not meet the level of care required for nursing facility placement under
72.17section 144.0724, subdivision 11.
72.18(b) Essential community supports grants are available not to exceed $400 per person
72.19per month. Essential community supports service grants may be used as authorized within
72.20an authorization period not to exceed 12 months. Grants must be available to a person who:
72.21(1) is age 65 or older;
72.22(2) is not eligible for medical assistance;
72.23(3) would otherwise be financially eligible for the alternative care program under
72.24subdivision 4;
72.25(4) has received a community assessment under section 256B.0911, subdivision 3a
72.26or 3b, and does not require the level of care provided in a nursing facility;
72.27(5) has a community support plan; and
72.28(6) has been determined by a community assessment under section 256B.0911,
72.29subdivision 3a or 3b, to be a person who would require provision of at least one of the
72.30following services, as defined in the approved elderly waiver plan, in order to maintain
72.31their community residence:
72.32(i) caregiver support;
72.33(ii) homemaker support;
72.34(iii) chores; or
72.35(iv) a personal emergency response device or system.
73.1(c) The person receiving any of the essential community supports in this subdivision
73.2must also receive service coordination, not to exceed $600 in a 12-month authorization
73.3period, as part of their community support plan.
73.4(d) A person who has been determined to be eligible for an essential community
73.5supports grant must be reassessed at least annually and continue to meet the criteria in
73.6paragraph (b) to remain eligible for an essential community supports grant.
73.7(e) The commissioner is authorized to use federal matching funds for essential
73.8community supports as necessary and to meet demand for essential community supports
73.9grants as outlined in paragraphs (f) and (g), and that amount of federal funds is
73.10appropriated to the commissioner for this purpose.
73.11(f) Upon federal approval and following a reasonable implementation period
73.12determined by the commissioner, essential community supports are available to an
73.13individual who:
73.14(1) is receiving nursing facility services or home and community-based long-term
73.15services and supports under section 256B.0915 or 256B.49 on the effective date of
73.16implementation of the revised nursing facility level of care under section 144.0724,
73.17subdivision 11;
73.18(2) meets one of the following criteria:
73.19(i) due to the implementation of the revised nursing facility level of care, loses
73.20eligibility for continuing medical assistance payment of nursing facility services at the
73.21first reassessment under section 144.0724, subdivision 11, paragraph (b), that occurs on or
73.22after the effective date of the revised nursing facility level of care criteria under section
73.23144.0724, subdivision 11; or
73.24(ii) due to the implementation of the revised nursing facility level of care, loses
73.25eligibility for continuing medical assistance payment of home and community-based
73.26long-term services and supports under section 256B.0915 or 256B.49 at the first
73.27reassessment required under those sections that occurs on or after the effective date of
73.28implementation of the revised nursing facility level of care under section 144.0724,
73.29subdivision 11;
73.30(3) is not eligible for personal care attendant services; and
73.31(4) has an assessed need for one or more of the supportive services offered under
73.32essential community supports.
73.33Individuals eligible under this paragraph includes individuals who continue to be
73.34eligible for medical assistance state plan benefits and those who are not or are no longer
73.35financially eligible for medical assistance.
74.1(g) Upon federal approval and following a reasonable implementation period
74.2determined by the commissioner, the services available through essential community
74.3supports include the services and grants provided in paragraphs (b) and (c), home-delivered
74.4meals, and community living assistance as defined by the commissioner. These services
74.5are available to all eligible recipients including those outlined in paragraphs (b) and (f).
74.6Recipients are eligible if they have a need for any of these services and meet all other
74.7eligibility criteria.

74.8    Sec. 26. Minnesota Statutes 2012, section 256B.0915, subdivision 5, is amended to read:
74.9    Subd. 5. Assessments and reassessments for waiver clients. (a) Each client
74.10shall receive an initial assessment of strengths, informal supports, and need for services
74.11in accordance with section 256B.0911, subdivisions 3, 3a, and 3b. A reassessment of a
74.12client served under the elderly waiver must be conducted at least every 12 months and at
74.13other times when the case manager determines that there has been significant change in
74.14the client's functioning. This may include instances where the client is discharged from
74.15the hospital. There must be a determination that the client requires nursing facility level
74.16of care as defined in section 256B.0911, subdivision 4a, paragraph (d) 4e, at initial and
74.17subsequent assessments to initiate and maintain participation in the waiver program.
74.18(b) Regardless of other assessments identified in section 144.0724, subdivision
74.194, as appropriate to determine nursing facility level of care for purposes of medical
74.20assistance payment for nursing facility services, only face-to-face assessments conducted
74.21according to section 256B.0911, subdivisions 3a and 3b, that result in a nursing facility
74.22level of care determination will be accepted for purposes of initial and ongoing access to
74.23waiver service payment.

74.24    Sec. 27. Minnesota Statutes 2012, section 256B.0917, is amended by adding a
74.25subdivision to read:
74.26    Subd. 1a. Home and community-based services for older adults. (a) The purpose
74.27of projects selected by the commissioner of human services under this section is to
74.28make strategic changes in the long-term services and supports system for older adults
74.29including statewide capacity for local service development and technical assistance, and
74.30statewide availability of home and community-based services for older adult services,
74.31caregiver support and respite care services, and other supports in the state of Minnesota.
74.32These projects are intended to create incentives for new and expanded home and
74.33community-based services in Minnesota in order to:
75.1(1) reach older adults early in the progression of their need for long-term services
75.2and supports, providing them with low-cost, high-impact services that will prevent or
75.3delay the use of more costly services;
75.4(2) support older adults to live in the most integrated, least restrictive community
75.5setting;
75.6(3) support the informal caregivers of older adults;
75.7(4) develop and implement strategies to integrate long-term services and supports
75.8with health care services, in order to improve the quality of care and enhance the quality
75.9of life of older adults and their informal caregivers;
75.10(5) ensure cost-effective use of financial and human resources;
75.11(6) build community-based approaches and community commitment to delivering
75.12long-term services and supports for older adults in their own homes;
75.13(7) achieve a broad awareness and use of lower-cost in-home services as an
75.14alternative to nursing homes and other residential services;
75.15(8) strengthen and develop additional home and community-based services and
75.16alternatives to nursing homes and other residential services; and
75.17(9) strengthen programs that use volunteers.
75.18(b) The services provided by these projects are available to older adults who are
75.19eligible for medical assistance and the elderly waiver under section 256B.0915, the
75.20alternative care program under section 256B.0913, or essential community supports grant
75.21under subdivision 14, paragraph (b), and to persons who have their own funds to pay for
75.22services.

75.23    Sec. 28. Minnesota Statutes 2012, section 256B.0917, is amended by adding a
75.24subdivision to read:
75.25    Subd. 1b. Definitions. (a) For purposes of this section, the following terms have
75.26the meanings given.
75.27(b) "Community" means a town; township; city; or targeted neighborhood within a
75.28city; or a consortium of towns, townships, cities, or specific neighborhoods within a city.
75.29(c) "Core home and community-based services provider" means a Faith in Action,
75.30Living at Home Block Nurse, Congregational Nurse, or similar community-based
75.31program governed by a board, the majority of whose members reside within the program's
75.32service area, that organizes and uses volunteers and paid staff to deliver nonmedical
75.33services intended to assist older adults to identify and manage risks and to maintain their
75.34community living and integration in the community.
76.1(d) "Eldercare development partnership" means a team of representatives of county
76.2social service and public health agencies, the area agency on aging, local nursing home
76.3providers, local home care providers, and other appropriate home and community-based
76.4providers in the area agency's planning and service area.
76.5(e) "Long-term services and supports" means any service available under the
76.6elderly waiver program or alternative care grant programs, nursing facility services,
76.7transportation services, caregiver support and respite care services, and other home and
76.8community-based services identified as necessary either to maintain lifestyle choices for
76.9older adults or to support them to remain in their own home.
76.10(f) "Older adult" refers to an individual who is 65 years of age or older.

76.11    Sec. 29. Minnesota Statutes 2012, section 256B.0917, is amended by adding a
76.12subdivision to read:
76.13    Subd. 1c. Eldercare development partnerships. The commissioner of human
76.14services shall select and contract with eldercare development partnerships sufficient to
76.15provide statewide availability of service development and technical assistance using a
76.16request for proposals process. Eldercare development partnerships shall:
76.17(1) develop a local long-term services and supports strategy consistent with state
76.18goals and objectives;
76.19(2) identify and use existing local skills, knowledge, and relationships, and build
76.20on these assets;
76.21(3) coordinate planning for funds to provide services to older adults, including funds
76.22received under Title III of the Older Americans Act, Title XX of the Social Security Act,
76.23and the Local Public Health Act;
76.24(4) target service development and technical assistance where nursing facility
76.25closures have occurred or are occurring or in areas where service needs have been
76.26identified through activities under section 144A.351;
76.27(5) provide sufficient staff for development and technical support in its designated
76.28area; and
76.29(6) designate a single public or nonprofit member of the eldercare development
76.30partnerships to apply grant funding and manage the project.

76.31    Sec. 30. Minnesota Statutes 2012, section 256B.0917, subdivision 6, is amended to read:
76.32    Subd. 6. Caregiver support and respite care projects. (a) The commissioner
76.33shall establish up to 36 projects to expand the respite care network in the state and to
76.34support caregivers in their responsibilities for care. The purpose of each project shall
77.1be to availability of caregiver support and respite care services for family and other
77.2caregivers. The commissioner shall use a request for proposals to select nonprofit entities
77.3to administer the projects. Projects shall:
77.4(1) establish a local coordinated network of volunteer and paid respite workers;
77.5(2) coordinate assignment of respite workers care services to clients and care
77.6receivers and assure the health and safety of the client; and caregivers of older adults;
77.7(3) provide training for caregivers and ensure that support groups are available
77.8in the community.
77.9(b) The caregiver support and respite care funds shall be available to the four to six
77.10local long-term care strategy projects designated in subdivisions 1 to 5.
77.11(c) The commissioner shall publish a notice in the State Register to solicit proposals
77.12from public or private nonprofit agencies for the projects not included in the four to six
77.13local long-term care strategy projects defined in subdivision 2. A county agency may,
77.14alone or in combination with other county agencies, apply for caregiver support and
77.15respite care project funds. A public or nonprofit agency within a designated SAIL project
77.16area may apply for project funds if the agency has a letter of agreement with the county
77.17or counties in which services will be developed, stating the intention of the county or
77.18counties to coordinate their activities with the agency requesting a grant.
77.19(d) The commissioner shall select grantees based on the following criteria:
77.20(1) the ability of the proposal to demonstrate need in the area served, as evidenced
77.21by a community needs assessment or other demographic data;
77.22(2) the ability of the proposal to clearly describe how the project
77.23(3) assure the health and safety of the older adults;
77.24(4) identify at-risk caregivers;
77.25(5) provide information, education, and training for caregivers in the designated
77.26community; and
77.27(6) demonstrate the need in the proposed service area particularly where nursing
77.28facility closures have occurred or are occurring or areas with service needs identified
77.29by section 144A.351. Preference must be given for projects that reach underserved
77.30populations.
77.31(b) Projects must clearly describe:
77.32(1) how they will achieve the their purpose defined in paragraph (b);
77.33(3) the ability of the proposal to reach underserved populations;
77.34(4) the ability of the proposal to demonstrate community commitment to the project,
77.35as evidenced by letters of support and cooperation as well as formation of a community
77.36task force;
78.1(5) the ability of the proposal to clearly describe (2) the process for recruiting,
78.2training, and retraining volunteers; and
78.3(6) the inclusion in the proposal of the (3) a plan to promote the project in the
78.4designated community, including outreach to persons needing the services.
78.5(e) (c) Funds for all projects under this subdivision may be used to:
78.6(1) hire a coordinator to develop a coordinated network of volunteer and paid respite
78.7care services and assign workers to clients;
78.8(2) recruit and train volunteer providers;
78.9(3) train provide information, training, and education to caregivers;
78.10(4) ensure the development of support groups for caregivers;
78.11(5) (4) advertise the availability of the caregiver support and respite care project; and
78.12(6) (5) purchase equipment to maintain a system of assigning workers to clients.
78.13(f) (d) Project funds may not be used to supplant existing funding sources.

78.14    Sec. 31. Minnesota Statutes 2012, section 256B.0917, is amended by adding a
78.15subdivision to read:
78.16    Subd. 7a. Core home and community-based services. The commissioner shall
78.17select and contract with core home and community-based services providers for projects
78.18to provide services and supports to older adults both with and without family and other
78.19informal caregivers using a request for proposals process. Projects must:
78.20(1) have a credible, public, or private nonprofit sponsor providing ongoing financial
78.21support;
78.22(2) have a specific, clearly defined geographic service area;
78.23(3) use a practice framework designed to identify high-risk older adults and help them
78.24take action to better manage their chronic conditions and maintain their community living;
78.25(4) have a team approach to coordination and care, ensuring that the older adult
78.26participants, their families, and the formal and informal providers are all part of planning
78.27and providing services;
78.28(5) provide information, support services, homemaking services, counseling, and
78.29training for the older adults and family caregivers;
78.30(6) encourage service area or neighborhood residents and local organizations to
78.31collaborate in meeting the needs of older adults in their geographic service areas;
78.32(7) recruit, train, and direct the use of volunteers to provide informal services and
78.33other appropriate support to older adults and their caregivers; and
78.34(8) provide coordination and management of formal and informal services to older
78.35adults and their families using less expensive alternatives.

79.1    Sec. 32. Minnesota Statutes 2012, section 256B.0917, subdivision 13, is amended to
79.2read:
79.3    Subd. 13. Community service grants. The commissioner shall award contracts
79.4for grants to public and private nonprofit agencies to establish services that strengthen
79.5a community's ability to provide a system of home and community-based services
79.6for elderly persons. The commissioner shall use a request for proposal process. The
79.7commissioner shall give preference when awarding grants under this section to areas
79.8where nursing facility closures have occurred or are occurring or to areas with service
79.9needs identified under section 144A.351. The commissioner shall consider grants for:
79.10(1) caregiver support and respite care projects under subdivision 6;
79.11(2) the living-at-home/block nurse grant under subdivisions 7 to 10; and
79.12(3) services identified as needed for community transition.

79.13    Sec. 33. Minnesota Statutes 2012, section 256B.439, subdivision 1, is amended to read:
79.14    Subdivision 1. Development and implementation of quality profiles. (a) The
79.15commissioner of human services, in cooperation with the commissioner of health,
79.16shall develop and implement a quality profile system profiles for nursing facilities and,
79.17beginning not later than July 1, 2004 2014, other providers of long-term care services,
79.18except when the quality profile system would duplicate requirements under section
79.19256B.5011 , 256B.5012, or 256B.5013. The system quality profiles must be developed
79.20and implemented to the extent possible without the collection of significant amounts of
79.21new data. To the extent possible, the system using existing data sets maintained by the
79.22commissioners of health and human services to the extent possible. The profiles must
79.23incorporate or be coordinated with information on quality maintained by area agencies on
79.24aging, long-term care trade associations, the ombudsman offices, counties, tribes, health
79.25plans, and other entities and the long-term care database maintained under section 256.975,
79.26subdivision 7. The system profiles must be designed to provide information on quality to:
79.27(1) consumers and their families to facilitate informed choices of service providers;
79.28(2) providers to enable them to measure the results of their quality improvement
79.29efforts and compare quality achievements with other service providers; and
79.30(3) public and private purchasers of long-term care services to enable them to
79.31purchase high-quality care.
79.32(b) The system profiles must be developed in consultation with the long-term care
79.33task force, area agencies on aging, and representatives of consumers, providers, and labor
79.34unions. Within the limits of available appropriations, the commissioners may employ
79.35consultants to assist with this project.

80.1    Sec. 34. Minnesota Statutes 2012, section 256B.439, subdivision 2, is amended to read:
80.2    Subd. 2. Quality measurement tools. The commissioners shall identify and apply
80.3existing quality measurement tools to:
80.4(1) emphasize quality of care and its relationship to quality of life; and
80.5(2) address the needs of various users of long-term care services, including, but not
80.6limited to, short-stay residents, persons with behavioral problems, persons with dementia,
80.7and persons who are members of minority groups.
80.8    The tools must be identified and applied, to the extent possible, without requiring
80.9providers to supply information beyond current state and federal requirements.

80.10    Sec. 35. Minnesota Statutes 2012, section 256B.439, subdivision 3, is amended to read:
80.11    Subd. 3. Consumer surveys of nursing facilities residents. Following
80.12identification of the quality measurement tool, the commissioners shall conduct surveys
80.13of long-term care service consumers of nursing facilities to develop quality profiles
80.14of providers. To the extent possible, surveys must be conducted face-to-face by state
80.15employees or contractors. At the discretion of the commissioners, surveys may be
80.16conducted by telephone or by provider staff. Surveys must be conducted periodically to
80.17update quality profiles of individual service nursing facilities providers.

80.18    Sec. 36. Minnesota Statutes 2012, section 256B.439, is amended by adding a
80.19subdivision to read:
80.20    Subd. 3a. Home and community-based services report card in cooperation with
80.21the commissioner of health. The commissioner shall work with existing Department
80.22of Human Services advisory groups to develop recommendations for a home and
80.23community-based services report card. Health and human services staff that regulate
80.24home and community-based services as provided in chapter 245D and licensed home care
80.25as provided in chapter 144A shall be consulted. The advisory groups shall consider the
80.26requirements from the Minnesota consumer information guide under section 144G.06 as a
80.27base for development of the home and community-based services report card to compare
80.28the housing options available to consumers. Other items to be considered by the advisory
80.29groups in developing recommendations include:
80.30(1) defining the goals of the report card, including measuring outcomes, providing
80.31consumer information, and defining vehicle-for-pay performance;
80.32(2) developing separate measures for programs for the elderly population and for
80.33persons with disabilities;
80.34(3) the sources of information needed that are standardized and contain sufficient data;
81.1(4) the financial support needed for creating and publicizing the housing information
81.2guide, and ongoing funding for data collection and staffing to monitor, report, and analyze;
81.3(5) a recognition that home and community-based services settings exist with
81.4significant variations in size, settings, and services available;
81.5(6) ensuring that consumer choice and consumer information is retained and valued;
81.6and
81.7(7) the applicability of these measures to providers based on payor source, size, and
81.8population served.
81.9The advisory groups shall discuss whether there are additional funding, resources,
81.10and research needed. The commissioner shall report recommendations to the chairs and
81.11ranking minority members of the legislative committees and divisions with jurisdiction
81.12over health and human services issues by August 1, 2014. The report card shall be
81.13available on July 1, 2015.

81.14    Sec. 37. Minnesota Statutes 2012, section 256B.439, subdivision 4, is amended to read:
81.15    Subd. 4. Dissemination of quality profiles. By July 1, 2003 2014, the
81.16commissioners shall implement a system public awareness effort to disseminate the quality
81.17profiles developed from consumer surveys using the quality measurement tool. Profiles
81.18may be disseminated to through the Senior LinkAge Line and Disability Linkage Line and
81.19to consumers, providers, and purchasers of long-term care services through all feasible
81.20printed and electronic outlets. The commissioners may conduct a public awareness
81.21campaign to inform potential users regarding profile contents and potential uses.

81.22    Sec. 38. Minnesota Statutes 2012, section 256B.441, subdivision 13, is amended to read:
81.23    Subd. 13. External fixed costs. "External fixed costs" means costs related to the
81.24nursing home surcharge under section 256.9657, subdivision 1; licensure fees under
81.25section 144.122; until September 30, 2013, long-term care consultation fees under
81.26section 256B.0911, subdivision 6; family advisory council fee under section 144A.33;
81.27scholarships under section 256B.431, subdivision 36; planned closure rate adjustments
81.28under section 256B.437; or single bed room incentives under section 256B.431,
81.29subdivision 42
; property taxes and property insurance; and PERA.

81.30    Sec. 39. Minnesota Statutes 2012, section 256B.441, subdivision 53, is amended to read:
81.31    Subd. 53. Calculation of payment rate for external fixed costs. The commissioner
81.32shall calculate a payment rate for external fixed costs.
82.1    (a) For a facility licensed as a nursing home, the portion related to section 256.9657
82.2shall be equal to $8.86. For a facility licensed as both a nursing home and a boarding care
82.3home, the portion related to section 256.9657 shall be equal to $8.86 multiplied by the
82.4result of its number of nursing home beds divided by its total number of licensed beds.
82.5    (b) The portion related to the licensure fee under section 144.122, paragraph (d),
82.6shall be the amount of the fee divided by actual resident days.
82.7    (c) The portion related to scholarships shall be determined under section 256B.431,
82.8subdivision 36.
82.9    (d) Until September 30, 2013, the portion related to long-term care consultation shall
82.10be determined according to section 256B.0911, subdivision 6.
82.11    (e) The portion related to development and education of resident and family advisory
82.12councils under section 144A.33 shall be $5 divided by 365.
82.13    (f) The portion related to planned closure rate adjustments shall be as determined
82.14under section 256B.437, subdivision 6, and Minnesota Statutes 2010, section 256B.436.
82.15Planned closure rate adjustments that take effect before October 1, 2014, shall no longer
82.16be included in the payment rate for external fixed costs beginning October 1, 2016.
82.17Planned closure rate adjustments that take effect on or after October 1, 2014, shall no
82.18longer be included in the payment rate for external fixed costs beginning on October 1 of
82.19the first year not less than two years after their effective date.
82.20    (g) The portions related to property insurance, real estate taxes, special assessments,
82.21and payments made in lieu of real estate taxes directly identified or allocated to the nursing
82.22facility shall be the actual amounts divided by actual resident days.
82.23    (h) The portion related to the Public Employees Retirement Association shall be
82.24actual costs divided by resident days.
82.25    (i) The single bed room incentives shall be as determined under section 256B.431,
82.26subdivision 42. Single bed room incentives that take effect before October 1, 2014, shall
82.27no longer be included in the payment rate for external fixed costs beginning October 1,
82.282016. Single bed room incentives that take effect on or after October 1, 2014, shall no
82.29longer be included in the payment rate for external fixed costs beginning on October 1 of
82.30the first year not less than two years after their effective date.
82.31    (j) The payment rate for external fixed costs shall be the sum of the amounts in
82.32paragraphs (a) to (i).

82.33    Sec. 40. Minnesota Statutes 2012, section 256B.49, subdivision 12, is amended to read:
82.34    Subd. 12. Informed choice. Persons who are determined likely to require the level
82.35of care provided in a nursing facility as determined under section 256B.0911, subdivision
83.14e, or a hospital shall be informed of the home and community-based support alternatives
83.2to the provision of inpatient hospital services or nursing facility services. Each person
83.3must be given the choice of either institutional or home and community-based services
83.4using the provisions described in section 256B.77, subdivision 2, paragraph (p).

83.5    Sec. 41. Minnesota Statutes 2012, section 256B.49, subdivision 14, is amended to read:
83.6    Subd. 14. Assessment and reassessment. (a) Assessments and reassessments
83.7shall be conducted by certified assessors according to section 256B.0911, subdivision 2b.
83.8With the permission of the recipient or the recipient's designated legal representative,
83.9the recipient's current provider of services may submit a written report outlining their
83.10recommendations regarding the recipient's care needs prepared by a direct service
83.11employee with at least 20 hours of service to that client. The person conducting the
83.12assessment or reassessment must notify the provider of the date by which this information
83.13is to be submitted. This information shall be provided to the person conducting the
83.14assessment and the person or the person's legal representative and must be considered
83.15prior to the finalization of the assessment or reassessment.
83.16(b) There must be a determination that the client requires a hospital level of care or a
83.17nursing facility level of care as defined in section 256B.0911, subdivision 4a, paragraph
83.18(d) 4e, at initial and subsequent assessments to initiate and maintain participation in the
83.19waiver program.
83.20(c) Regardless of other assessments identified in section 144.0724, subdivision 4, as
83.21appropriate to determine nursing facility level of care for purposes of medical assistance
83.22payment for nursing facility services, only face-to-face assessments conducted according
83.23to section 256B.0911, subdivisions 3a, 3b, and 4d, that result in a hospital level of care
83.24determination or a nursing facility level of care determination must be accepted for
83.25purposes of initial and ongoing access to waiver services payment.
83.26(d) Recipients who are found eligible for home and community-based services under
83.27this section before their 65th birthday may remain eligible for these services after their
83.2865th birthday if they continue to meet all other eligibility factors.
83.29(e) The commissioner shall develop criteria to identify recipients whose level of
83.30functioning is reasonably expected to improve and reassess these recipients to establish
83.31a baseline assessment. Recipients who meet these criteria must have a comprehensive
83.32transitional service plan developed under subdivision 15, paragraphs (b) and (c), and be
83.33reassessed every six months until there has been no significant change in the recipient's
83.34functioning for at least 12 months. After there has been no significant change in the
83.35recipient's functioning for at least 12 months, reassessments of the recipient's strengths,
84.1informal support systems, and need for services shall be conducted at least every 12
84.2months and at other times when there has been a significant change in the recipient's
84.3functioning. Counties, case managers, and service providers are responsible for
84.4conducting these reassessments and shall complete the reassessments out of existing funds.

84.5    Sec. 42. [256B.85] COMMUNITY FIRST SERVICES AND SUPPORTS.
84.6    Subdivision 1. Basis and scope. (a) Upon federal approval, the commissioner
84.7shall establish a medical assistance state plan option for the provision of home and
84.8community-based personal assistance service and supports called "community first
84.9services and supports (CFSS)."
84.10(b) CFSS is a participant-controlled method of selecting and providing services
84.11and supports that allows the participant maximum control of the services and supports.
84.12Participants may choose the degree to which they direct and manage their supports by
84.13choosing to have a significant and meaningful role in the management of services and
84.14supports including by directly employing support workers with the necessary supports
84.15to perform that function.
84.16(c) CFSS is available statewide to eligible individuals to assist with accomplishing
84.17activities of daily living (ADLs), instrumental activities of daily living (IADLs), and
84.18health-related procedures and tasks through hands-on assistance to accomplish the task
84.19or constant supervision and cueing to accomplish the task; and to assist with acquiring,
84.20maintaining, and enhancing the skills necessary to accomplish ADLs, IADLs, and
84.21health-related procedures and tasks. CFSS allows payment for certain supports and goods
84.22such as environmental modifications and technology that are intended to replace or
84.23decrease the need for human assistance.
84.24(d) Upon federal approval, CFSS will replace the personal care assistance program
84.25under sections 256.476, 256B.0625, subdivisions 19a and 19c, and 256B.0659.
84.26    Subd. 2. Definitions. (a) For the purposes of this section, the terms defined in
84.27this subdivision have the meanings given.
84.28(b) "Activities of daily living" or "ADLs" means eating, toileting, grooming,
84.29dressing, bathing, mobility, positioning, and transferring.
84.30(c) "Agency-provider model" means a method of CFSS under which a qualified
84.31agency provides services and supports through the agency's own employees and policies.
84.32The agency must allow the participant to have a significant role in the selection and
84.33dismissal of support workers of their choice for the delivery of their specific services
84.34and supports.
85.1(d) "Behavior" means a description of a need for services and supports used to
85.2determine the home care rating and additional service units. The presence of Level I
85.3behavior is used to determine the home care rating. "Level I behavior" means physical
85.4aggression towards self or others or destruction of property that requires the immediate
85.5response of another person. If qualified for a home care rating as described in subdivision
85.68, additional service units can be added as described in subdivision 8, paragraph (f), for
85.7the following behaviors:
85.8(1) Level I behavior;
85.9(2) increased vulnerability due to cognitive deficits or socially inappropriate
85.10behavior; or
85.11(3) increased need for assistance for recipients who are verbally aggressive or
85.12resistive to care so that time needed to perform activities of daily living is increased.
85.13(e) "Complex health-related needs" means an intervention listed in clauses (1) to
85.14(8) that has been ordered by a physician, and is specified in a community support plan,
85.15including:
85.16(1) tube feedings requiring:
85.17(i) a gastrojejunostomy tube; or
85.18(ii) continuous tube feeding lasting longer than 12 hours per day;
85.19(2) wounds described as:
85.20(i) stage III or stage IV;
85.21(ii) multiple wounds;
85.22(iii) requiring sterile or clean dressing changes or a wound vac; or
85.23(iv) open lesions such as burns, fistulas, tube sites, or ostomy sites that require
85.24specialized care;
85.25(3) parenteral therapy described as:
85.26(i) IV therapy more than two times per week lasting longer than four hours for
85.27each treatment; or
85.28(ii) total parenteral nutrition (TPN) daily;
85.29(4) respiratory interventions, including:
85.30(i) oxygen required more than eight hours per day;
85.31(ii) respiratory vest more than one time per day;
85.32(iii) bronchial drainage treatments more than two times per day;
85.33(iv) sterile or clean suctioning more than six times per day;
85.34(v) dependence on another to apply respiratory ventilation augmentation devices
85.35such as BiPAP and CPAP; and
85.36(vi) ventilator dependence under section 256B.0652;
86.1(5) insertion and maintenance of catheter, including:
86.2(i) sterile catheter changes more than one time per month;
86.3(ii) clean intermittent catheterization, and including self-catheterization more than
86.4six times per day; or
86.5(iii) bladder irrigations;
86.6(6) bowel program more than two times per week requiring more than 30 minutes to
86.7perform each time;
86.8(7) neurological intervention, including:
86.9(i) seizures more than two times per week and requiring significant physical
86.10assistance to maintain safety; or
86.11(ii) swallowing disorders diagnosed by a physician and requiring specialized
86.12assistance from another on a daily basis; and
86.13(8) other congenital or acquired diseases creating a need for significantly increased
86.14direct hands-on assistance and interventions in six to eight activities of daily living.
86.15(f) "Community first services and supports" or "CFSS" means the assistance and
86.16supports program under this section needed for accomplishing activities of daily living,
86.17instrumental activities of daily living, and health-related tasks through hands-on assistance
86.18to complete the task or supervision and cueing to complete the task, or the purchase of
86.19goods as defined in subdivision 7, paragraph (a), clause (2), that replace the need for
86.20human assistance.
86.21(g) "Community first services and supports service delivery plan" or "service delivery
86.22plan" means a written summary of the services and supports, that is based on the community
86.23support plan identified in section 256B.0911 and coordinated services and support plan
86.24and budget identified in section 256B.0915, subdivision 6, if applicable, that is determined
86.25by the participant to meet the assessed needs, using a person-centered planning process.
86.26(h) "Critical activities of daily living" means transferring, mobility, eating, and
86.27toileting.
86.28(i) "Dependency" in activities of daily living means a person requires hands-on
86.29assistance or constant supervision and cueing to accomplish one or more of the activities
86.30of daily living every day or on the days during the week that the activity is performed;
86.31however, a child may not be found to be dependent in an activity of daily living if,
86.32because of the child's age, an adult would either perform the activity for the child or assist
86.33the child with the activity. Assistance needed is the assistance appropriate for a typical
86.34child of the same age.
86.35(j) "Extended CFSS" means CFSS services and supports under the agency–provider
86.36model included in a service plan through one of the home and community-based services
87.1waivers authorized under sections 256B.0915; 256B.092, subdivision 5; and 256B.49,
87.2which exceed the amount, duration, and frequency of the state plan CFSS services for
87.3participants.
87.4(k) "Financial management services contractor or vendor" means a qualified
87.5organization having a written contract with the department to provide services necessary to
87.6use the budget model under subdivision 13, that include but are not limited to: participant
87.7education and technical assistance; CFSS service delivery planning and budgeting; billing,
87.8making payments, and monitoring of spending; and assisting the participant in fulfilling
87.9employer-related requirements in accordance with Section 3504 of the IRS code and
87.10the IRS Revenue Procedure 70-6.
87.11(l) "Budget model" means a service delivery method of CFSS that uses an
87.12individualized CFSS service delivery plan and service budget and assistance from the
87.13financial management services contractor to facilitate participant employment of support
87.14workers and the acquisition of supports and goods.
87.15(m) "Health-related procedures and tasks" means procedures and tasks related to
87.16the specific needs of an individual that can be delegated or assigned by a state-licensed
87.17healthcare or behavioral health professional and performed by a support worker.
87.18(n) "Instrumental activities of daily living" means activities related to living
87.19independently in the community, including but not limited to: meal planning, preparation,
87.20and cooking; shopping for food, clothing, or other essential items; laundry; housecleaning;
87.21assistance with medications; managing money; communicating needs, preferences, and
87.22activities; arranging supports; and assistance with traveling around and participating
87.23in the community.
87.24(o) "Legal representative" means parent of a minor, a court-appointed guardian, or
87.25another representative with legal authority to make decisions about services and supports
87.26for the participant. Other representatives with legal authority to make decisions include
87.27but are not limited to a health care agent or an attorney-in-fact authorized through a health
87.28care directive or power of attorney.
87.29(p) "Medication assistance" means providing verbal or visual reminders to take
87.30regularly scheduled medication, and includes any of the following supports listed in clauses
87.31(1) to (3) and other types of assistance, except that a support worker may not determine
87.32medication dose or time for medication or inject medications into veins, muscles, or skin:
87.33(1) under the direction of the participant or the participant's representative, bringing
87.34medications to the participant including medications given through a nebulizer, opening a
87.35container of previously set-up medications, emptying the container into the participant's
88.1hand, opening and giving the medication in the original container to the participant, or
88.2bringing to the participant liquids or food to accompany the medication;
88.3(2) organizing medications as directed by the participant or the participant's
88.4representative; and
88.5(3) providing verbal or visual reminders to perform regularly scheduled medications.
88.6(q) "Participant's representative" means a parent, family member, advocate, or
88.7other adult authorized by the participant to serve as a representative in connection with
88.8the provision of CFSS. This authorization must be in writing or by another method
88.9that clearly indicates the participant's free choice. The participant's representative must
88.10have no financial interest in the provision of any services included in the participant's
88.11service delivery plan and must be capable of providing the support necessary to assist
88.12the participant in the use of CFSS. If through the assessment process described in
88.13subdivision 5 a participant is determined to be in need of a participant's representative, one
88.14must be selected. If the participant is unable to assist in the selection of a participant's
88.15representative, the legal representative shall appoint one. Two persons may be designated
88.16as a participant's representative for reasons such as divided households and court-ordered
88.17custodies. Duties of a participant's representatives may include:
88.18(1) being available while care is provided in a method agreed upon by the participant
88.19or the participant's legal representative and documented in the participant's CFSS service
88.20delivery plan;
88.21(2) monitoring CFSS services to ensure the participant's CFSS service delivery
88.22plan is being followed; and
88.23(3) reviewing and signing CFSS time sheets after services are provided to provide
88.24verification of the CFSS services.
88.25(r) "Person-centered planning process" means a process that is driven by the
88.26participant for discovering and planning services and supports that ensures the participant
88.27makes informed choices and decisions. The person-centered planning process must:
88.28(1) include people chosen by the participant;
88.29(2) provide necessary information and support to ensure that the participant directs
88.30the process to the maximum extent possible, and is enabled to make informed choices
88.31and decisions;
88.32(3) be timely and occur at time and locations of convenience to the participant;
88.33(4) reflect cultural considerations of the participant;
88.34(5) include strategies for solving conflict or disagreement within the process,
88.35including clear conflict-of-interest guidelines for all planning;
89.1(6) offer choices to the participant regarding the services and supports they receive
89.2and from whom;
89.3(7) include a method for the participant to request updates to the plan; and
89.4(8) record the alternative home and community-based settings that were considered
89.5by the participant.
89.6(s) "Shared services" means the provision of CFSS services by the same CFSS
89.7support worker to two or three participants who voluntarily enter into an agreement to
89.8receive services at the same time and in the same setting by the same provider.
89.9(t) "Support specialist" means a professional with the skills and ability to assist the
89.10participant using either the agency provider model under subdivision 11 or the flexible
89.11spending model under subdivision 13, in services including but not limited to assistance
89.12regarding:
89.13(1) the development, implementation, and evaluation of the CFSS service delivery
89.14plan under subdivision 6;
89.15(2) recruitment, training, or supervision, including supervision of health-related
89.16tasks or behavioral supports appropriately delegated by a health care professional, and
89.17evaluation of support workers; and
89.18(3) facilitating the use of informal and community supports, goods, or resources.
89.19(u) "Support worker" means an employee of the agency provider or of the participant
89.20who has direct contact with the participant and provides services as specified within the
89.21participant's service delivery plan.
89.22(v) "Wages and benefits" means the hourly wages and salaries, the employer's
89.23share of FICA taxes, Medicare taxes, state and federal unemployment taxes, workers'
89.24compensation, mileage reimbursement, health and dental insurance, life insurance,
89.25disability insurance, long-term care insurance, uniform allowance, contributions to
89.26employee retirement accounts, or other forms of employee compensation and benefits.
89.27    Subd. 3. Eligibility. (a) CFSS is available to a person who meets one of the
89.28following:
89.29(1) is a recipient of medical assistance as determined under section 256B.055,
89.30256B.056, or 256B.057, subdivisions 5 and 9;
89.31(2) is a recipient of the alternative care program under section 256B.0913;
89.32(3) is a waiver recipient as defined under section 256B.0915, 256B.092, 256B.093,
89.33or 256B.49; or
89.34(4) has medical services identified in a participant's individualized education
89.35program and is eligible for services as determined in section 256B.0625, subdivision 26.
90.1(b) In addition to meeting the eligibility criteria in paragraph (a), a person must also
90.2meet all of the following:
90.3(1) require assistance and be determined dependent in one activity of daily living or
90.4Level I behavior based on assessment under section 256B.0911;
90.5(2) is not a recipient under the family support grant under section 252.32;
90.6(3) lives in the person's own apartment or home including a family foster care setting
90.7licensed under chapter 245A, but not in corporate foster care under chapter 245A; or a
90.8noncertified boarding care or boarding and lodging establishments under chapter 157.
90.9    Subd. 4. Eligibility for other services. Selection of CFSS by a participant must not
90.10restrict access to other medically necessary care and services furnished under the state
90.11plan medical assistance benefit or other services available through alternative care.
90.12    Subd. 5. Assessment requirements. (a) The assessment of functional need must:
90.13(1) be conducted by a certified assessor according to the criteria established in
90.14section 256B.0911, subdivision 3a;
90.15(2) be conducted face-to-face, initially and at least annually thereafter, or when there
90.16is a significant change in the participant's condition or a change in the need for services
90.17and supports; and
90.18(3) be completed using the format established by the commissioner.
90.19(b) A participant who is residing in a facility may be assessed and choose CFSS for
90.20the purpose of using CFSS to return to the community as described in subdivisions 3
90.21and 7, paragraph (a), clause (5).
90.22(c) The results of the assessment and any recommendations and authorizations for
90.23CFSS must be determined and communicated in writing by the lead agency's certified
90.24assessor as defined in section 256B.0911 to the participant and the agency-provider or
90.25financial management services provider chosen by the participant within 40 calendar days
90.26and must include the participant's right to appeal under section 256.045, subdivision 3.
90.27(d) The lead agency assessor may request a temporary authorization for CFSS
90.28services. Authorization for a temporary level of CFSS services is limited to the time
90.29specified by the commissioner, but shall not exceed 45 days. The level of services
90.30authorized under this provision shall have no bearing on a future authorization.
90.31    Subd. 6. Community first services and support service delivery plan. (a) The
90.32CFSS service delivery plan must be developed, implemented, and evaluated through a
90.33person-centered planning process by the participant, or the participant's representative
90.34or legal representative who may be assisted by a support specialist. The CFSS service
90.35delivery plan must reflect the services and supports that are important to the participant
90.36and for the participant to meet the needs assessed by the certified assessor and identified
91.1in the community support plan under section 256B.0911 or the coordinated services and
91.2support plan identified in section 256B.0915, subdivision 6, if applicable. The CFSS
91.3service delivery plan must be reviewed by the participant and the agency-provider or
91.4financial management services contractor at least annually upon reassessment, or when
91.5there is a significant change in the participant's condition, or a change in the need for
91.6services and supports.
91.7(b) The commissioner shall establish the format and criteria for the CFSS service
91.8delivery plan.
91.9(c) The CFSS service delivery plan must be person-centered and:
91.10(1) specify the agency-provider or financial management services contractor selected
91.11by the participant;
91.12(2) reflect the setting in which the participant resides that is chosen by the participant;
91.13(3) reflect the participant's strengths and preferences;
91.14(4) include the means to address the clinical and support needs as identified through
91.15an assessment of functional needs;
91.16(5) include individually identified goals and desired outcomes;
91.17(6) reflect the services and supports, paid and unpaid, that will assist the participant
91.18to achieve identified goals, and the providers of those services and supports, including
91.19natural supports;
91.20(7) identify the amount and frequency of face-to-face supports and amount and
91.21frequency of remote supports and technology that will be used;
91.22(8) identify risk factors and measures in place to minimize them, including
91.23individualized backup plans;
91.24(9) be understandable to the participant and the individuals providing support;
91.25(10) identify the individual or entity responsible for monitoring the plan;
91.26(11) be finalized and agreed to in writing by the participant and signed by all
91.27individuals and providers responsible for its implementation;
91.28(12) be distributed to the participant and other people involved in the plan; and
91.29(13) prevent the provision of unnecessary or inappropriate care.
91.30(d) The total units of agency-provider services or the budget allocation amount for
91.31the budget model include both annual totals and a monthly average amount that cover
91.32the number of months of the service authorization. The amount used each month may
91.33vary, but additional funds must not be provided above the annual service authorization
91.34amount unless a change in condition is assessed and authorized by the certified assessor
91.35and documented in the community support plan, coordinated services and supports plan,
91.36and service delivery plan.
92.1    Subd. 7. Community first services and supports; covered services. Services
92.2and supports covered under CFSS include:
92.3(1) assistance to accomplish activities of daily living (ADLs), instrumental activities
92.4of daily living (IADLs), and health-related procedures and tasks through hands-on
92.5assistance to complete the task or supervision and cueing to complete the task;
92.6(2) assistance to acquire, maintain, or enhance the skills necessary for the participant
92.7to accomplish activities of daily living, instrumental activities of daily living, or
92.8health-related tasks;
92.9(3) expenditures for items, services, supports, environmental modifications, or
92.10goods, including assistive technology. These expenditures must:
92.11(i) relate to a need identified in a participant's CFSS service delivery plan;
92.12(ii) increase independence or substitute for human assistance to the extent that
92.13expenditures would otherwise be made for human assistance for the participant's assessed
92.14needs;
92.15(4) observation and redirection for behavior or symptoms where there is a need for
92.16assistance. A recipient qualifies as having a need for assistance due to behaviors if the
92.17recipient's behavior requires assistance at least four times per week and shows one or
92.18more of the following behaviors:
92.19(i) physical aggression towards self or others, or destruction of property that requires
92.20the immediate response of another person;
92.21(ii) increased vulnerability due to cognitive deficits or socially inappropriate
92.22behavior; or
92.23(iii) increased need for assistance for recipients who are verbally aggressive or
92.24resistive to care so that time needed to perform activities of daily living is increased;
92.25(5) back-up systems or mechanisms, such as the use of pagers or other electronic
92.26devices, to ensure continuity of the participant's services and supports;
92.27(6) transition costs, including:
92.28(i) deposits for rent and utilities;
92.29(ii) first month's rent and utilities;
92.30(iii) bedding;
92.31(iv) basic kitchen supplies;
92.32(v) other necessities, to the extent that these necessities are not otherwise covered
92.33under any other funding that the participant is eligible to receive; and
92.34(vi) other required necessities for an individual to make the transition from a nursing
92.35facility, institution for mental diseases, or intermediate care facility for persons with
93.1developmental disabilities to a community-based home setting where the participant
93.2resides; and
93.3(7) services by a support specialist defined under subdivision 2 that are chosen
93.4by the participant.
93.5    Subd. 8. Determination of CFSS service methodology. (a) All community first
93.6services and supports must be authorized by the commissioner or the commissioner's
93.7designee before services begin, except for the assessments established in section
93.8256B.0911. The authorization for CFSS must be completed as soon as possible following
93.9an assessment but no later than 40 calendar days from the date of the assessment.
93.10(b) The amount of CFSS authorized must be based on the recipient's home care
93.11rating described in subdivision 8, paragraphs (d) and (e), and any additional service units
93.12for which the person qualifies as described in subdivision 8, paragraph (f).
93.13(c) The home care rating shall be determined by the commissioner or the
93.14commissioner's designee based on information submitted to the commissioner identifying
93.15the following for a recipient:
93.16(1) the total number of dependencies of activities of daily living as defined in
93.17subdivision 2, paragraph (b);
93.18(2) the presence of complex health-related needs as defined in subdivision 2,
93.19paragraph (e); and
93.20(3) the presence of Level I behavior as defined in subdivision 2, paragraph (d),
93.21clause (1).
93.22(d) The methodology to determine the total service units for CFSS for each home
93.23care rating is based on the median paid units per day for each home care rating from
93.24fiscal year 2007 data for the PCA program.
93.25(e) Each home care rating is designated by the letters P through Z and EN and has
93.26the following base number of service units assigned:
93.27(i) P home care rating requires Level 1 behavior or one to three dependencies in
93.28ADLs and qualifies one for five service units;
93.29(ii) Q home care rating requires Level 1 behavior and one to three dependencies in
93.30ADLs and qualifies one for six service units;
93.31(iii) R home care rating requires complex health-related needs and one to three
93.32dependencies in ADLs and qualifies one for seven service units;
93.33(iv) S home care rating requires four to six dependencies in ADLs and qualifies
93.34one for ten service units;
93.35(v) T home care rating requires four to six dependencies in ADLs and Level 1
93.36behavior and qualifies one for 11 service units;
94.1(vi) U home care rating requires four to six dependencies in ADLs and a complex
94.2health need and qualifies one for 14 service units;
94.3(vii) V home care rating requires seven to eight dependencies in ADLs and qualifies
94.4one for 17 service units;
94.5(viii) W home care rating requires seven to eight dependencies in ADLs and Level 1
94.6behavior and qualifies one for 20 service units;
94.7(ix) Z home care rating requires seven to eight dependencies in ADLs and a complex
94.8health related need and qualifies one for 30 service units; and
94.9(x) EN home care rating includes ventilator dependency as defined in section
94.10256B.0651, subdivision 1, paragraph (g). Recipients who meet the definition of
94.11ventilator-dependent and the EN home care rating and utilize a combination of CFSS
94.12and other home care services are limited to a total of 96 service units per day for those
94.13services in combination. Additional units may be authorized when a recipient's assessment
94.14indicates a need for two staff to perform activities. Additional time is limited to 16 service
94.15units per day.
94.16(f) Additional service units are provided through the assessment and identification of
94.17the following:
94.18(1) 30 additional minutes per day for a dependency in each critical activity of daily
94.19living as defined in subdivision 2, paragraph (h);
94.20(2) 30 additional minutes per day for each complex health-related function as
94.21defined in subdivision 2, paragraph (e); and
94.22(3) 30 additional minutes per day for each behavior issue as defined in subdivision 2,
94.23paragraph (d).
94.24    Subd. 9. Noncovered services. (a) Services or supports that are not eligible for
94.25payment under this section include those that:
94.26(1) are not authorized by the certified assessor or included in the written service
94.27delivery plan;
94.28(2) are provided prior to the authorization of services and the approval of the written
94.29CFSS service delivery plan;
94.30(3) are duplicative of other paid services in the written service delivery plan;
94.31(4) supplant natural unpaid supports that appropriately meet a need in the service
94.32plan, are provided voluntarily to the participant and are selected by the participant in lieu
94.33of other services and supports;
94.34(5) are not effective means to meet the participant's needs; and
94.35(6) are available through other funding sources, including, but not limited to, funding
94.36through Title IV-E of the Social Security Act.
95.1(b) Additional services, goods, or supports that are not covered include:
95.2(1) those that are not for the direct benefit of the participant, except that services for
95.3caregivers such as training to improve the ability to provide CFSS are considered to directly
95.4benefit the participant if chosen by the participant and approved in the support plan;
95.5(2) any fees incurred by the participant, such as Minnesota health care programs fees
95.6and co-pays, legal fees, or costs related to advocate agencies;
95.7(3) insurance, except for insurance costs related to employee coverage;
95.8(4) room and board costs for the participant with the exception of allowable
95.9transition costs in subdivision 7, clause (6);
95.10(5) services, supports, or goods that are not related to the assessed needs;
95.11(6) special education and related services provided under the Individuals with
95.12Disabilities Education Act and vocational rehabilitation services provided under the
95.13Rehabilitation Act of 1973;
95.14(7) assistive technology devices and assistive technology services other than those
95.15for back-up systems or mechanisms to ensure continuity of service and supports listed in
95.16subdivision 7;
95.17(8) medical supplies and equipment;
95.18(9) environmental modifications, except as specified in subdivision 7;
95.19(10) expenses for travel, lodging, or meals related to training the participant, the
95.20participant's representative, legal representative, or paid or unpaid caregivers that exceed
95.21$500 in a 12-month period;
95.22(11) experimental treatments;
95.23(12) any service or good covered by other medical assistance state plan services,
95.24including prescription and over-the-counter medications, compounds, and solutions and
95.25related fees, including premiums and co-payments;
95.26(13) membership dues or costs, except when the service is necessary and appropriate
95.27to treat a physical condition or to improve or maintain the participant's physical condition.
95.28The condition must be identified in the participant's CFSS plan and monitored by a
95.29physician enrolled in a Minnesota health care program;
95.30(14) vacation expenses other than the cost of direct services;
95.31(15) vehicle maintenance or modifications not related to the disability, health
95.32condition, or physical need; and
95.33(16) tickets and related costs to attend sporting or other recreational or entertainment
95.34events.
96.1    Subd. 10. Provider qualifications and general requirements. (a)
96.2Agency-providers delivering services under the agency-provider model under subdivision
96.311 or financial management service (FMS) contractors under subdivision 13 shall:
96.4(1) enroll as a medical assistance Minnesota health care programs provider and meet
96.5all applicable provider standards;
96.6(2) comply with medical assistance provider enrollment requirements;
96.7(3) demonstrate compliance with law and policies of CFSS as determined by the
96.8commissioner;
96.9(4) comply with background study requirements under chapter 245C;
96.10(5) verify and maintain records of all services and expenditures by the participant,
96.11including hours worked by support workers and support specialists;
96.12(6) not engage in any agency-initiated direct contact or marketing in person, by
96.13telephone, or other electronic means to potential participants, guardians, family member,
96.14or participants' representatives;
96.15(7) pay support workers and support specialists based upon actual hours of services
96.16provided;
96.17(8) withhold and pay all applicable federal and state payroll taxes;
96.18(9) make arrangements and pay unemployment insurance, taxes, workers'
96.19compensation, liability insurance, and other benefits, if any;
96.20(10) enter into a written agreement with the participant, participant's representative,
96.21or legal representative that assigns roles and responsibilities to be performed before
96.22services, supports, or goods are provided using a format established by the commissioner;
96.23(11) report maltreatment as required under sections 626.556 and 626.557; and
96.24(12) provide the participant with a copy of the service-related rights under
96.25subdivision 19 at the start of services and supports.
96.26(b) The commissioner shall develop policies and procedures designed to ensure
96.27program integrity and fiscal accountability for goods and services provided in this section
96.28in consultation with the implementation council described in subdivision 21.
96.29    Subd. 11. Agency-provider model. (a) The agency-provider model is limited to
96.30the services provided by support workers and support specialists who are employed by
96.31an agency-provider that is licensed according to chapter 245A or meets other criteria
96.32established by the commissioner, including required training.
96.33(b) The agency-provider shall allow the participant to have a significant role in the
96.34selection and dismissal of the support workers for the delivery of the services and supports
96.35specified in the participant's service delivery plan.
97.1(c) A participant may use authorized units of CFSS services as needed within a
97.2service authorization that is not greater than 12 months. Using authorized units in a
97.3flexible manner in either the agency-provider model or the budget model does not increase
97.4the total amount of services and supports authorized for a participant or included in the
97.5participant's service delivery plan.
97.6(d) A participant may share CFSS services. Two or three CFSS participants may
97.7share services at the same time provided by the same support worker.
97.8(e) The agency-provider must use a minimum of 72.5 percent of the revenue
97.9generated by the medical assistance payment for CFSS for support worker wages and
97.10benefits. The agency-provider must document how this requirement is being met. The
97.11revenue generated by the support specialist and the reasonable costs associated with the
97.12support specialist must not be used in making this calculation.
97.13(f) The agency-provider model must be used by individuals who have been restricted
97.14by the Minnesota restricted recipient program under Minnesota Rules, parts 9505.2160
97.15to 9505.2245.
97.16    Subd. 12. Requirements for initial enrollment of CFSS provider agencies. (a)
97.17All CFSS provider agencies must provide, at the time of enrollment as a CFSS provider
97.18agency in a format determined by the commissioner, information and documentation that
97.19includes, but is not limited to, the following:
97.20(1) the CFSS provider agency's current contact information including address,
97.21telephone number, and e-mail address;
97.22(2) proof of surety bond coverage in the amount of $50,000 or ten percent of the
97.23provider's payments from Medicaid in the previous year, whichever is less;
97.24(3) proof of fidelity bond coverage in the amount of $20,000;
97.25(4) proof of workers' compensation insurance coverage;
97.26(5) proof of liability insurance;
97.27(6) a description of the CFSS provider agency's organization identifying the names
97.28or all owners, managing employees, staff, board of directors, and the affiliations of the
97.29directors, owners, or staff to other service providers;
97.30(7) a copy of the CFSS provider agency's written policies and procedures including:
97.31hiring of employees; training requirements; service delivery; and employee and consumer
97.32safety including process for notification and resolution of consumer grievances,
97.33identification and prevention of communicable diseases, and employee misconduct;
97.34(8) copies of all other forms the CFSS provider agency uses in the course of daily
97.35business including, but not limited to:
98.1(i) a copy of the CFSS provider agency's time sheet if the time sheet varies from
98.2the standard time sheet for CFSS services approved by the commissioner, and a letter
98.3requesting approval of the CFSS provider agency's nonstandard time sheet;
98.4(ii) the CFSS provider agency's template for the CFSS care plan; and
98.5(iii) the CFSS provider agency's template for the written agreement in subdivision
98.621 for recipients using the CFSS choice option, if applicable;
98.7(9) a list of all training and classes that the CFSS provider agency requires of its
98.8staff providing CFSS services;
98.9(10) documentation that the CFSS provider agency and staff have successfully
98.10completed all the training required by this section;
98.11(11) documentation of the agency's marketing practices;
98.12(12) disclosure of ownership, leasing, or management of all residential properties
98.13that is used or could be used for providing home care services;
98.14(13) documentation that the agency will use the following percentages of revenue
98.15generated from the medical assistance rate paid for CFSS services for employee personal
98.16care assistant wages and benefits: 72.5 percent of revenue from CFSS providers. The
98.17revenue generated by the support specialist and the reasonable costs associated with the
98.18support specialist shall not be used in making this calculation; and
98.19(14) documentation that the agency does not burden recipients' free exercise of their
98.20right to choose service providers by requiring personal care assistants to sign an agreement
98.21not to work with any particular CFSS recipient or for another CFSS provider agency after
98.22leaving the agency and that the agency is not taking action on any such agreements or
98.23requirements regardless of the date signed.
98.24(b) CFSS provider agencies shall provide to the commissioner the information
98.25specified in paragraph (a).
98.26(c) All CFSS provider agencies shall require all employees in management and
98.27supervisory positions and owners of the agency who are active in the day-to-day
98.28management and operations of the agency to complete mandatory training as determined
98.29by the commissioner. Employees in management and supervisory positions and owners
98.30who are active in the day-to-day operations of an agency who have completed the required
98.31training as an employee with a CFSS provider agency do not need to repeat the required
98.32training if they are hired by another agency, if they have completed the training within
98.33the past three years. CFSS provider agency billing staff shall complete training about
98.34CFSS program financial management. Any new owners or employees in management
98.35and supervisory positions involved in the day-to-day operations are required to complete
98.36mandatory training as a requisite of working for the agency. CFSS provider agencies
99.1certified for participation in Medicare as home health agencies are exempt from the
99.2training required in this subdivision.
99.3    Subd. 13. Budget model. (a) Under the budget model participants can exercise
99.4more responsibility and control over the services and supports described and budgeted
99.5within the CFSS service delivery plan. Under this model, participants may use their
99.6budget allocation to:
99.7(1) directly employ support workers;
99.8(2) obtain supports and goods as defined in subdivision 7; and
99.9(3) choose a range of support assistance services from the financial management
99.10services (FMS) contractor related to:
99.11(i) assistance in managing the budget to meet the service delivery plan needs,
99.12consistent with federal and state laws and regulations;
99.13(ii) the employment, training, supervision, and evaluation of workers by the
99.14participant;
99.15(iii) acquisition and payment for supports and goods; and
99.16(iv) evaluation of individual service outcomes as needed for the scope of the
99.17participant's degree of control and responsibility.
99.18(b) Participants who are unable to fulfill any of the functions listed in paragraph (a)
99.19may authorize a legal representative or participant's representative to do so on their behalf.
99.20(c) The FMS contractor shall not provide CFSS services and supports under the
99.21agency-provider service model. The FMS contractor shall provide service functions as
99.22determined by the commissioner that include but are not limited to:
99.23(1) information and consultation about CFSS;
99.24(2) assistance with the development of the service delivery plan and budget model
99.25as requested by the participant;
99.26(3) billing and making payments for budget model expenditures;
99.27(4) assisting participants in fulfilling employer-related requirements according to
99.28Internal Revenue Code Procedure 70-6, section 3504, Agency Employer Tax Liability,
99.29regulation 137036-08, which includes assistance with filing and paying payroll taxes, and
99.30obtaining worker compensation coverage;
99.31(5) data recording and reporting of participant spending; and
99.32(6) other duties established in the contract with the department.
99.33(d) A participant who requests to purchase goods and supports along with support
99.34worker services under the agency-provider model must use the budget model with
99.35a service delivery plan that specifies the amount of services to be authorized to the
99.36agency-provider and the expenditures to be paid by the FMS contractor.
100.1(e) The FMS contractor shall:
100.2(1) not limit or restrict the participant's choice of service or support providers or
100.3service delivery models consistent with any applicable state and federal requirements;
100.4(2) provide the participant and the targeted case manager, if applicable, with a
100.5monthly written summary of the spending for services and supports that were billed
100.6against the spending budget;
100.7(3) be knowledgeable of state and federal employment regulations under the Fair
100.8Labor Standards Act of 1938, and comply with the requirements under the Internal
100.9Revenue Service Revenue Code Procedure 70-6, Section 35-4, Agency Employer Tax
100.10Liability for vendor or fiscal employer agent, and any requirements necessary to process
100.11employer and employee deductions, provide appropriate and timely submission of
100.12employer tax liabilities, and maintain documentation to support medical assistance claims;
100.13(4) have current and adequate liability insurance and bonding and sufficient cash
100.14flow as determined by the commissioner and have on staff or under contract a certified
100.15public accountant or an individual with a baccalaureate degree in accounting;
100.16(5) assume fiscal accountability for state funds designated for the program; and
100.17(6) maintain documentation of receipts, invoices, and bills to track all services and
100.18supports expenditures for any goods purchased and maintain time records of support
100.19workers. The documentation and time records must be maintained for a minimum of
100.20five years from the claim date and be available for audit or review upon request by the
100.21commissioner. Claims submitted by the FMS contractor to the commissioner for payment
100.22must correspond with services, amounts, and time periods as authorized in the participant's
100.23spending budget and service plan.
100.24(f) The commissioner of human services shall:
100.25(1) establish rates and payment methodology for the FMS contractor;
100.26(2) identify a process to ensure quality and performance standards for the FMS
100.27contractor and ensure statewide access to FMS contractors; and
100.28(3) establish a uniform protocol for delivering and administering CFSS services
100.29to be used by eligible FMS contractors.
100.30(g) The commissioner of human services shall disenroll or exclude participants from
100.31the budget model and transfer them to the agency-provider model under the following
100.32circumstances that include but are not limited to:
100.33(1) when a participant has been restricted by the Minnesota restricted recipient
100.34program, the participant may be excluded for a specified time period under Minnesota
100.35Rules, parts 9505.2160 to 9505.2245;
101.1(2) when a participant exits the budget model during the participant's service plan
101.2year. Upon transfer, the participant shall not access the budget model for the remainder of
101.3that service plan year; or
101.4(3) when the department determines that the participant or participant's representative
101.5or legal representative cannot manage participant responsibilities under the budget model.
101.6The commissioner must develop policies for determining if a participant is unable to
101.7manage responsibilities under a budget model.
101.8(h) A participant may appeal under section 256.045, subdivision 3, in writing to the
101.9department to contest the department's decision under paragraph (c), clause (3), to remove
101.10or exclude the participant from the budget model.
101.11    Subd. 14. Participant's responsibilities under budget model. (a) A participant
101.12using the budget model must use an FMS contractor or vendor that is under contract with
101.13the department. Upon a determination of eligibility and completion of the assessment and
101.14community support plan, the participant shall choose a FMS contractor from a list of
101.15eligible vendors maintained by the department.
101.16(b) When the participant, participant's representative, or legal representative chooses
101.17to be the employer of the support worker, they are responsible for the hiring and supervision
101.18of the support worker, including, but not limited to, recruiting, interviewing, training, and
101.19discharging the support worker consistent with federal and state laws and regulations.
101.20(c) In addition to the employer responsibilities in paragraph (b), the participant,
101.21participant's representative, or legal representative is responsible for:
101.22(1) tracking the services provided and all expenditures for goods or other supports;
101.23(2) preparing and submitting time sheets, signed by both the participant and support
101.24worker, to the FMS contractor on a regular basis and in a timely manner according to
101.25the FMS contractor's procedures;
101.26(3) notifying the FMS contractor within ten days of any changes in circumstances
101.27affecting the CFSS service plan or in the participant's place of residence including, but
101.28not limited to, any hospitalization of the participant or change in the participant's address,
101.29telephone number, or employment;
101.30(4) notifying the FMS contractor of any changes in the employment status of each
101.31participant support worker; and
101.32(5) reporting any problems resulting from the quality of services rendered by the
101.33support worker to the FMS contractor. If the participant is unable to resolve any problems
101.34resulting from the quality of service rendered by the support worker with the assistance of
101.35the FMS contractor, the participant shall report the situation to the department.
102.1    Subd. 15. Documentation of support services provided. (a) Support services
102.2provided to a participant by a support worker employed by either an agency-provider
102.3or the participant acting as the employer must be documented daily by each support
102.4worker, on a time sheet form approved by the commissioner. All documentation may be
102.5Web-based, electronic, or paper documentation. The completed form must be submitted
102.6on a monthly basis to the provider or the participant and the FMS contractor selected by
102.7the participant to provide assistance with meeting the participant's employer obligations
102.8and kept in the recipient's health record.
102.9(b) The activity documentation must correspond to the written service delivery plan
102.10and be reviewed by the agency provider or the participant and the FMS contractor when
102.11the participant is acting as the employer of the support worker.
102.12(c) The time sheet must be on a form approved by the commissioner documenting
102.13time the support worker provides services in the home. The following criteria must be
102.14included in the time sheet:
102.15(1) full name of the support worker and individual provider number;
102.16(2) provider name and telephone numbers, if an agency-provider is responsible for
102.17delivery services under the written service plan;
102.18(3) full name of the participant;
102.19(4) consecutive dates, including month, day, and year, and arrival and departure
102.20times with a.m. or p.m. notations;
102.21(5) signatures of the participant or the participant's representative;
102.22(6) personal signature of the support worker;
102.23(7) any shared care provided, if applicable;
102.24(8) a statement that it is a federal crime to provide false information on CFSS
102.25billings for medical assistance payments; and
102.26(9) dates and location of recipient stays in a hospital, care facility, or incarceration.
102.27    Subd. 16. Support workers requirements. (a) Support workers shall:
102.28(1) enroll with the department as a support worker after a background study under
102.29chapter 245C has been completed and the support worker has received a notice from the
102.30commissioner that:
102.31(i) the support worker is not disqualified under section 245C.14; or
102.32(ii) is disqualified, but the support worker has received a set-aside of the
102.33disqualification under section 245C.22;
102.34(2) have the ability to effectively communicate with the participant or the
102.35participant's representative;
103.1(3) have the skills and ability to provide the services and supports according to the
103.2person's CFSS service delivery plan and respond appropriately to the participant's needs;
103.3(4) not be a participant of CFSS, unless the support services provided by the support
103.4worker differ from those provided to the support worker;
103.5(5) complete the basic standardized training as determined by the commissioner
103.6before completing enrollment. The training must be available in languages other than
103.7English and to those who need accommodations due to disabilities. Support worker
103.8training must include successful completion of the following training components: basic
103.9first aid, vulnerable adult, child maltreatment, OSHA universal precautions, basic roles
103.10and responsibilities of support workers including information about basic body mechanics,
103.11emergency preparedness, orientation to positive behavioral practices, orientation to
103.12responding to a mental health crisis, fraud issues, time cards and documentation, and an
103.13overview of person-centered planning and self-direction. Upon completion of the training
103.14components, the support worker must pass the certification test to provide assistance
103.15to participants;
103.16(6) complete training and orientation on the participant's individual needs; and
103.17(7) maintain the privacy and confidentiality of the participant, and not independently
103.18determine the medication dose or time for medications for the participant.
103.19(b) The commissioner may deny or terminate a support worker's provider enrollment
103.20and provider number if the support worker:
103.21(1) lacks the skills, knowledge, or ability to adequately or safely perform the
103.22required work;
103.23(2) fails to provide the authorized services required by the participant employer;
103.24(3) has been intoxicated by alcohol or drugs while providing authorized services to
103.25the participant or while in the participant's home;
103.26(4) has manufactured or distributed drugs while providing authorized services to the
103.27participant or while in the participant's home; or
103.28(5) has been excluded as a provider by the commissioner of human services, or the
103.29United States Department of Health and Human Services, Office of Inspector General,
103.30from participation in Medicaid, Medicare, or any other federal health care program.
103.31(c) A support worker may appeal in writing to the commissioner to contest the
103.32decision to terminate the support worker's provider enrollment and provider number.
103.33    Subd. 17. Support specialist requirements and payments. The commissioner
103.34shall develop qualifications, scope of functions, and payment rates and service limits for a
103.35support specialist that may provide additional or specialized assistance necessary to plan,
103.36implement, arrange, augment, or evaluate services and supports.
104.1    Subd. 18. Service unit and budget allocation requirements and limits. (a) For the
104.2agency-provider model, services will be authorized in units of service. The total service
104.3unit amount must be established based upon the assessed need for CFSS services, and must
104.4not exceed the maximum number of units available as determined under subdivision 8.
104.5(b) For the budget model, the budget allocation allowed for services and supports
104.6is established by multiplying the number of units authorized under subdivision 8 by the
104.7payment rate established by the commissioner.
104.8    Subd. 19. Support system. (a) The commissioner shall provide information,
104.9consultation, training, and assistance to ensure the participant is able to manage the
104.10services and supports and budgets, if applicable. This support shall include individual
104.11consultation on how to select and employ workers, manage responsibilities under CFSS,
104.12and evaluate personal outcomes.
104.13(b) The commissioner shall provide assistance with the development of risk
104.14management agreements.
104.15    Subd. 20. Service-related rights. (a) Participants must be provided with adequate
104.16information, counseling, training, and assistance, as needed, to ensure that the participant
104.17is able to choose and manage services, models, and budgets. This support shall include
104.18information regarding:
104.19(1) person-centered planning;
104.20(2) the range and scope of individual choices;
104.21(3) the process for changing plans, services and budgets;
104.22(4) the grievance process;
104.23(5) individual rights;
104.24(6) identifying and assessing appropriate services;
104.25(7) risks and responsibilities; and
104.26(8) risk management.
104.27(b) The commissioner must ensure that the participant has a copy of the most recent
104.28community support plan and service delivery plan.
104.29(c) A participant who appeals a reduction in previously authorized CFSS services
104.30may continue previously authorized services pending an appeal in accordance with section
104.31256.045.
104.32(d) If the units of service or budget allocation for CFSS are reduced, denied, or
104.33terminated, the commissioner must provide notice of the reasons for the reduction in the
104.34participant's notice of denial, termination, or reduction.
104.35(e) If all or part of a service delivery plan is denied approval, the commissioner must
104.36provide a notice that describes the basis of the denial.
105.1    Subd. 21. Development and Implementation Council. The commissioner
105.2shall establish a Development and Implementation Council of which the majority of
105.3members are individuals with disabilities, elderly individuals, and their representatives.
105.4The commissioner shall consult and collaborate with the council when developing and
105.5implementing this section for at least the first five years of operation. The commissioner,
105.6in consultation with the council, shall provide recommendations on how to improve the
105.7quality and integrity of CFSS, reduce the paper documentation required in subdivisions
105.810, 12, and 15, make use of electronic means of documentation and online reporting in
105.9order to reduce administrative costs and improve training to the legislative chairs of the
105.10health and human services policy and finance committees by February 1, 2014.
105.11    Subd. 22. Quality assurance and risk management system. (a) The commissioner
105.12shall establish quality assurance and risk management measures for use in developing and
105.13implementing CFSS, including those that (1) recognize the roles and responsibilities of
105.14those involved in obtaining CFSS, and (2) ensure the appropriateness of such plans and
105.15budgets based upon a recipient's resources and capabilities. Risk management measures
105.16must include background studies, and backup and emergency plans, including disaster
105.17planning.
105.18(b) The commissioner shall provide ongoing technical assistance and resource and
105.19educational materials for CFSS participants.
105.20(c) Performance assessment measures, such as a participant's satisfaction with the
105.21services and supports, and ongoing monitoring of health and well-being shall be identified
105.22in consultation with the council established in subdivision 21.
105.23(d) Data reporting requirements will be developed in consultation with the council
105.24established in subdivision 21.
105.25    Subd. 23. Commissioner's access. When the commissioner is investigating a
105.26possible overpayment of Medicaid funds, the commissioner must be given immediate
105.27access without prior notice to the agency provider or FMS contractor's office during
105.28regular business hours and to documentation and records related to services provided and
105.29submission of claims for services provided. Denying the commissioner access to records
105.30is cause for immediate suspension of payment and terminating the agency provider's
105.31enrollment according to section 256B.064 or terminating the FMS contract.
105.32    Subd. 24. CFSS agency-providers; background studies. CFSS agency-providers
105.33enrolled to provide personal care assistance services under the medical assistance program
105.34shall comply with the following:
105.35(1) owners who have a five percent interest or more and all managing employees
105.36are subject to a background study as provided in chapter 245C. This applies to currently
106.1enrolled CFSS agency-providers and those agencies seeking enrollment as a CFSS
106.2agency-provider. "Managing employee" has the same meaning as Code of Federal
106.3Regulations, title 42, section 455. An organization is barred from enrollment if:
106.4(i) the organization has not initiated background studies on owners managing
106.5employees; or
106.6(ii) the organization has initiated background studies on owners and managing
106.7employees, but the commissioner has sent the organization a notice that an owner or
106.8managing employee of the organization has been disqualified under section 245C.14, and
106.9the owner or managing employee has not received a set-aside of the disqualification
106.10under section 245C.22;
106.11(2) a background study must be initiated and completed for all support specialists; and
106.12(3) a background study must be initiated and completed for all support workers.
106.13EFFECTIVE DATE.This section is effective upon federal approval but no earlier
106.14than January 1, 2014. The service will begin 90 days after federal approval or January 1,
106.152014, whichever is later. The commissioner of human services shall notify the revisor of
106.16statutes when this occurs.

106.17    Sec. 43. Minnesota Statutes 2012, section 256I.05, is amended by adding a subdivision
106.18to read:
106.19    Subd. 1o. Supplementary service rate; exemptions. A county agency shall not
106.20negotiate a supplementary service rate under this section for any individual that has been
106.21determined to be eligible for Housing Stability Services as approved by the Centers
106.22for Medicare and Medicaid Services, and who resides in an establishment voluntarily
106.23registered under section 144D.025, as a supportive housing establishment or participates
106.24in the Minnesota supportive housing demonstration program under section 256I.04,
106.25subdivision 3, paragraph (a), clause (4).

106.26    Sec. 44. Minnesota Statutes 2012, section 626.557, subdivision 4, is amended to read:
106.27    Subd. 4. Reporting. (a) Except as provided in paragraph (b), a mandated reporter
106.28shall immediately make an oral report to the common entry point. The common entry
106.29point may accept electronic reports submitted through a Web-based reporting system
106.30established by the commissioner. Use of a telecommunications device for the deaf or other
106.31similar device shall be considered an oral report. The common entry point may not require
106.32written reports. To the extent possible, the report must be of sufficient content to identify
106.33the vulnerable adult, the caregiver, the nature and extent of the suspected maltreatment,
106.34any evidence of previous maltreatment, the name and address of the reporter, the time,
107.1date, and location of the incident, and any other information that the reporter believes
107.2might be helpful in investigating the suspected maltreatment. A mandated reporter may
107.3disclose not public data, as defined in section 13.02, and medical records under sections
107.4144.291 to 144.298, to the extent necessary to comply with this subdivision.
107.5(b) A boarding care home that is licensed under sections 144.50 to 144.58 and
107.6certified under Title 19 of the Social Security Act, a nursing home that is licensed under
107.7section 144A.02 and certified under Title 18 or Title 19 of the Social Security Act, or a
107.8hospital that is licensed under sections 144.50 to 144.58 and has swing beds certified under
107.9Code of Federal Regulations, title 42, section 482.66, may submit a report electronically
107.10to the common entry point instead of submitting an oral report. The report may be a
107.11duplicate of the initial report the facility submits electronically to the commissioner of
107.12health to comply with the reporting requirements under Code of Federal Regulations, title
107.1342, section 483.13. The commissioner of health may modify these reporting requirements
107.14to include items required under paragraph (a) that are not currently included in the
107.15electronic reporting form.
107.16EFFECTIVE DATE.This section is effective July 1, 2014.

107.17    Sec. 45. Minnesota Statutes 2012, section 626.557, subdivision 9, is amended to read:
107.18    Subd. 9. Common entry point designation. (a) Each county board shall designate
107.19a common entry point for reports of suspected maltreatment. Two or more county boards
107.20may jointly designate a single The commissioner of human services shall establish a
107.21 common entry point effective July 1, 2014. The common entry point is the unit responsible
107.22for receiving the report of suspected maltreatment under this section.
107.23(b) The common entry point must be available 24 hours per day to take calls from
107.24reporters of suspected maltreatment. The common entry point shall use a standard intake
107.25form that includes:
107.26(1) the time and date of the report;
107.27(2) the name, address, and telephone number of the person reporting;
107.28(3) the time, date, and location of the incident;
107.29(4) the names of the persons involved, including but not limited to, perpetrators,
107.30alleged victims, and witnesses;
107.31(5) whether there was a risk of imminent danger to the alleged victim;
107.32(6) a description of the suspected maltreatment;
107.33(7) the disability, if any, of the alleged victim;
107.34(8) the relationship of the alleged perpetrator to the alleged victim;
107.35(9) whether a facility was involved and, if so, which agency licenses the facility;
108.1(10) any action taken by the common entry point;
108.2(11) whether law enforcement has been notified;
108.3(12) whether the reporter wishes to receive notification of the initial and final
108.4reports; and
108.5(13) if the report is from a facility with an internal reporting procedure, the name,
108.6mailing address, and telephone number of the person who initiated the report internally.
108.7(c) The common entry point is not required to complete each item on the form prior
108.8to dispatching the report to the appropriate lead investigative agency.
108.9(d) The common entry point shall immediately report to a law enforcement agency
108.10any incident in which there is reason to believe a crime has been committed.
108.11(e) If a report is initially made to a law enforcement agency or a lead investigative
108.12agency, those agencies shall take the report on the appropriate common entry point intake
108.13forms and immediately forward a copy to the common entry point.
108.14(f) The common entry point staff must receive training on how to screen and
108.15dispatch reports efficiently and in accordance with this section.
108.16(g) The commissioner of human services shall maintain a centralized database
108.17for the collection of common entry point data, lead investigative agency data including
108.18maltreatment report disposition, and appeals data. The common entry point shall
108.19have access to the centralized database and must log the reports into the database and
108.20immediately identify and locate prior reports of abuse, neglect, or exploitation.
108.21(h) When appropriate, the common entry point staff must refer calls that do not
108.22allege the abuse, neglect, or exploitation of a vulnerable adult to other organizations
108.23that might resolve the reporter's concerns.
108.24(i) a common entry point must be operated in a manner that enables the
108.25commissioner of human services to:
108.26(1) track critical steps in the reporting, evaluation, referral, response, disposition,
108.27and investigative process to ensure compliance with all requirements for all reports;
108.28(2) maintain data to facilitate the production of aggregate statistical reports for
108.29monitoring patterns of abuse, neglect, or exploitation;
108.30(3) serve as a resource for the evaluation, management, and planning of preventative
108.31and remedial services for vulnerable adults who have been subject to abuse, neglect,
108.32or exploitation;
108.33(4) set standards, priorities, and policies to maximize the efficiency and effectiveness
108.34of the common entry point; and
108.35(5) track and manage consumer complaints related to the common entry point.
109.1(j) The commissioners of human services and health shall collaborate on the
109.2creation of a system for referring reports to the lead investigative agencies. This system
109.3shall enable the commissioner of human services to track critical steps in the reporting,
109.4evaluation, referral, response, disposition, investigation, notification, determination, and
109.5appeal processes.

109.6    Sec. 46. Minnesota Statutes 2012, section 626.557, subdivision 9e, is amended to read:
109.7    Subd. 9e. Education requirements. (a) The commissioners of health, human
109.8services, and public safety shall cooperate in the development of a joint program for
109.9education of lead investigative agency investigators in the appropriate techniques for
109.10investigation of complaints of maltreatment. This program must be developed by July
109.111, 1996. The program must include but need not be limited to the following areas: (1)
109.12information collection and preservation; (2) analysis of facts; (3) levels of evidence; (4)
109.13conclusions based on evidence; (5) interviewing skills, including specialized training to
109.14interview people with unique needs; (6) report writing; (7) coordination and referral
109.15to other necessary agencies such as law enforcement and judicial agencies; (8) human
109.16relations and cultural diversity; (9) the dynamics of adult abuse and neglect within family
109.17systems and the appropriate methods for interviewing relatives in the course of the
109.18assessment or investigation; (10) the protective social services that are available to protect
109.19alleged victims from further abuse, neglect, or financial exploitation; (11) the methods by
109.20which lead investigative agency investigators and law enforcement workers cooperate in
109.21conducting assessments and investigations in order to avoid duplication of efforts; and
109.22(12) data practices laws and procedures, including provisions for sharing data.
109.23(b) The commissioner of human services shall conduct an outreach campaign to
109.24promote the common entry point for reporting vulnerable adult maltreatment. This
109.25campaign shall use the Internet and other means of communication.
109.26(b) (c) The commissioners of health, human services, and public safety shall offer at
109.27least annual education to others on the requirements of this section, on how this section is
109.28implemented, and investigation techniques.
109.29(c) (d) The commissioner of human services, in coordination with the commissioner
109.30of public safety shall provide training for the common entry point staff as required in this
109.31subdivision and the program courses described in this subdivision, at least four times
109.32per year. At a minimum, the training shall be held twice annually in the seven-county
109.33metropolitan area and twice annually outside the seven-county metropolitan area. The
109.34commissioners shall give priority in the program areas cited in paragraph (a) to persons
109.35currently performing assessments and investigations pursuant to this section.
110.1(d) (e) The commissioner of public safety shall notify in writing law enforcement
110.2personnel of any new requirements under this section. The commissioner of public
110.3safety shall conduct regional training for law enforcement personnel regarding their
110.4responsibility under this section.
110.5(e) (f) Each lead investigative agency investigator must complete the education
110.6program specified by this subdivision within the first 12 months of work as a lead
110.7investigative agency investigator.
110.8A lead investigative agency investigator employed when these requirements take
110.9effect must complete the program within the first year after training is available or as soon
110.10as training is available.
110.11All lead investigative agency investigators having responsibility for investigation
110.12duties under this section must receive a minimum of eight hours of continuing education
110.13or in-service training each year specific to their duties under this section.

110.14    Sec. 47. FEDERAL APPROVAL.
110.15This article is contingent on federal approval.

110.16    Sec. 48. REPEALER.
110.17(a) Minnesota Statutes 2012, sections 245A.655; and 256B.0917, subdivisions 1, 2,
110.183, 4, 5, 7, 8, 9, 10, 11, 12, and 14, are repealed.
110.19(b) Minnesota Statutes 2012, section 256B.0911, subdivisions 4a, 4b, and 4c, are
110.20repealed effective October 1, 2013.

110.21ARTICLE 3
110.22SAFE AND HEALTHY DEVELOPMENT OF CHILDREN,
110.23YOUTH, AND FAMILIES

110.24    Section 1. Minnesota Statutes 2012, section 119B.05, subdivision 1, is amended to read:
110.25    Subdivision 1. Eligible participants. Families eligible for child care assistance
110.26under the MFIP child care program are:
110.27    (1) MFIP participants who are employed or in job search and meet the requirements
110.28of section 119B.10;
110.29    (2) persons who are members of transition year families under section 119B.011,
110.30subdivision 20
, and meet the requirements of section 119B.10;
110.31    (3) families who are participating in employment orientation or job search, or
110.32other employment or training activities that are included in an approved employability
110.33development plan under section 256J.95;
111.1    (4) MFIP families who are participating in work job search, job support,
111.2employment, or training activities as required in their employment plan, or in appeals,
111.3hearings, assessments, or orientations according to chapter 256J;
111.4    (5) MFIP families who are participating in social services activities under chapter
111.5256J or mental health treatment as required in their employment plan approved according
111.6to chapter 256J;
111.7    (6) families who are participating in services or activities that are included in an
111.8approved family stabilization plan under section 256J.575;
111.9    (7) MFIP child-only cases under section 256J.88, for up to 20 hours of child care
111.10per child per week under the following conditions: (i) child care will be authorized if the
111.11child's primary caregiver is receiving SSI for a disability related to depression or other
111.12serious mental illness; and (ii) child care will only be authorized for children five years
111.13of age or younger. The child's authorized care under this clause is not conditional based
111.14on the primary caregiver participating in an authorized activity under section 119B.07 or
111.15119B.11. Medical appointments, treatment, or therapy are considered authorized activities
111.16for participants in this category;
111.17    (8) families who are participating in programs as required in tribal contracts under
111.18section 119B.02, subdivision 2, or 256.01, subdivision 2; and
111.19    (8) (9) families who are participating in the transition year extension under section
111.20119B.011, subdivision 20a .

111.21    Sec. 2. Minnesota Statutes 2012, section 119B.09, subdivision 5, is amended to read:
111.22    Subd. 5. Provider choice. Parents may choose child care providers as defined under
111.23section 119B.011, subdivision 19, that best meet the needs of their family. Beginning
111.24July 1, 2018, parents or guardians must choose a rated provider under section 124D.142
111.25for their children not yet attending kindergarten, unless a waiver is granted by the
111.26commissioner of human services. Counties shall make resources available to parents in
111.27choosing quality child care services. Counties may require a parent to sign a release
111.28stating their knowledge and responsibilities in choosing a legal provider described under
111.29section 119B.011, subdivision 19. When a county knows that a particular provider is
111.30unsafe, or that the circumstances of the child care arrangement chosen by the parent are
111.31unsafe, the county may deny a child care subsidy. A county may not restrict access to a
111.32general category of provider allowed under section 119B.011, subdivision 19.

111.33    Sec. 3. Minnesota Statutes 2012, section 119B.125, subdivision 1, is amended to read:
112.1    Subdivision 1. Authorization. (a) Except as provided in subdivision 5, a county
112.2must authorize the provider chosen by an applicant or a participant before the county can
112.3authorize payment for care provided by that provider. The commissioner must establish
112.4the requirements necessary for authorization of providers.
112.5(b) In order to be authorized, a provider must:
112.6(1) beginning July 1, 2018, participate in the quality rating and improvement system
112.7under section 124D.142; and
112.8(2) beginning July 1, 2020, have at least a one- or two-star rating in the quality
112.9rating and improvement system.
112.10(c) In order to comply with federal regulations, the requirements in paragraph (b) do
112.11not apply to unlicensed or license-exempt providers. In addition, the commissioner has
112.12the authority to waive the requirements in paragraph (b), if: (1) the parents' authorized
112.13activities occur during times when care is not available from providers participating in
112.14the quality rating and improvement system, (2) a family lives in an area where care from
112.15providers participating in the quality rating and improvement system is not available, or
112.16(3) no providers participating in the quality rating and improvement system are willing
112.17or able to care for one or all of the children in the family.
112.18(d) A provider must be reauthorized every two years. A legal, nonlicensed family
112.19child care provider also must be reauthorized when another person over the age of 13 joins
112.20the household, a current household member turns 13, or there is reason to believe that a
112.21household member has a factor that prevents authorization. The provider is required to
112.22report all family changes that would require reauthorization. When a provider has been
112.23authorized for payment for providing care for families in more than one county, the county
112.24responsible for reauthorization of that provider is the county of the family with a current
112.25authorization for that provider and who has used the provider for the longest length of time.

112.26    Sec. 4. Minnesota Statutes 2012, section 119B.13, subdivision 1, is amended to read:
112.27    Subdivision 1. Subsidy restrictions. (a) Beginning October 31, 2011 July 1, 2014,
112.28the maximum rate paid for child care assistance in any county or multicounty region under
112.29the child care fund shall be the rate for like-care arrangements in the county effective July
112.301, 2006 2012, decreased increased by 2.5 two percent.
112.31    (b) Biennially, beginning in 2012, the commissioner shall survey rates charged
112.32by child care providers in Minnesota to determine the 75th percentile for like-care
112.33arrangements in counties. When the commissioner determines that, using the
112.34commissioner's established protocol, the number of providers responding to the survey is
112.35too small to determine the 75th percentile rate for like-care arrangements in a county or
113.1multicounty region, the commissioner may establish the 75th percentile maximum rate
113.2based on like-care arrangements in a county, region, or category that the commissioner
113.3deems to be similar.
113.4    (c) A rate which includes a special needs rate paid under subdivision 3 or under a
113.5school readiness service agreement paid under section 119B.231, may be in excess of the
113.6maximum rate allowed under this subdivision.
113.7    (d) The department shall monitor the effect of this paragraph on provider rates. The
113.8county shall pay the provider's full charges for every child in care up to the maximum
113.9established. The commissioner shall determine the maximum rate for each type of care
113.10on an hourly, full-day, and weekly basis, including special needs and disability care. The
113.11maximum payment to a provider for one day of care must not exceed the daily rate. The
113.12maximum payment to a provider for one week of care must not exceed the weekly rate.
113.13(e) Child care providers receiving reimbursement under this chapter must not be
113.14paid activity fees or an additional amount above the maximum rates for care provided
113.15during nonstandard hours for families receiving assistance.
113.16    (f) When the provider charge is greater than the maximum provider rate allowed,
113.17the parent is responsible for payment of the difference in the rates in addition to any
113.18family co-payment fee.
113.19    (g) All maximum provider rates changes shall be implemented on the Monday
113.20following the effective date of the maximum provider rate.

113.21    Sec. 5. Minnesota Statutes 2012, section 119B.13, subdivision 7, is amended to read:
113.22    Subd. 7. Absent days. (a) Licensed child care providers and license-exempt centers
113.23must not be reimbursed for more than ten 25 full-day absent days per child, excluding
113.24holidays, in a fiscal year, or for more than ten consecutive full-day absent days. Legal
113.25nonlicensed family child care providers must not be reimbursed for absent days. If a child
113.26attends for part of the time authorized to be in care in a day, but is absent for part of the
113.27time authorized to be in care in that same day, the absent time must be reimbursed but the
113.28time must not count toward the ten 25 absent day days limit. Child care providers must
113.29only be reimbursed for absent days if the provider has a written policy for child absences
113.30and charges all other families in care for similar absences.
113.31(b) Notwithstanding paragraph (a), children in families may exceed the ten 25 absent
113.32days limit if at least one parent: (1) is under the age of 21; (2) does not have a high school
113.33or general equivalency diploma; and (3) is a student in a school district or another similar
113.34program that provides or arranges for child care, parenting support, social services, career
113.35and employment supports, and academic support to achieve high school graduation, upon
114.1request of the program and approval of the county. If a child attends part of an authorized
114.2day, payment to the provider must be for the full amount of care authorized for that day.
114.3    (c) Child care providers must be reimbursed for up to ten federal or state holidays or
114.4designated holidays per year when the provider charges all families for these days and the
114.5holiday or designated holiday falls on a day when the child is authorized to be in attendance.
114.6Parents may substitute other cultural or religious holidays for the ten recognized state and
114.7federal holidays. Holidays do not count toward the ten 25 absent day days limit.
114.8    (d) A family or child care provider must not be assessed an overpayment for an
114.9absent day payment unless (1) there was an error in the amount of care authorized for the
114.10family, (2) all of the allowed full-day absent payments for the child have been paid, or (3)
114.11the family or provider did not timely report a change as required under law.
114.12    (e) The provider and family shall receive notification of the number of absent days
114.13used upon initial provider authorization for a family and ongoing notification of the
114.14number of absent days used as of the date of the notification.

114.15    Sec. 6. Minnesota Statutes 2012, section 245A.07, subdivision 2a, is amended to read:
114.16    Subd. 2a. Immediate suspension expedited hearing. (a) Within five working days
114.17of receipt of the license holder's timely appeal, the commissioner shall request assignment
114.18of an administrative law judge. The request must include a proposed date, time, and place
114.19of a hearing. A hearing must be conducted by an administrative law judge within 30
114.20calendar days of the request for assignment, unless an extension is requested by either
114.21party and granted by the administrative law judge for good cause. The commissioner shall
114.22issue a notice of hearing by certified mail or personal service at least ten working days
114.23before the hearing. The scope of the hearing shall be limited solely to the issue of whether
114.24the temporary immediate suspension should remain in effect pending the commissioner's
114.25final order under section 245A.08, regarding a licensing sanction issued under subdivision
114.263 following the immediate suspension. The burden of proof in expedited hearings under
114.27this subdivision shall be limited to the commissioner's demonstration that reasonable
114.28cause exists to believe that the license holder's actions or failure to comply with applicable
114.29law or rule poses, or if the actions of other individuals or conditions in the program
114.30poses an imminent risk of harm to the health, safety, or rights of persons served by the
114.31program. "Reasonable cause" means there exist specific articulable facts or circumstances
114.32which provide the commissioner with a reasonable suspicion that there is an imminent
114.33risk of harm to the health, safety, or rights of persons served by the program. When the
114.34commissioner has determined there is reasonable cause to order the temporary immediate
114.35suspension of a license based on a violation of safe sleep requirements, as defined in
115.1section 245A.1435, the commissioner is not required to demonstrate that an infant died or
115.2was injured as a result of the safe sleep violations.
115.3    (b) The administrative law judge shall issue findings of fact, conclusions, and a
115.4recommendation within ten working days from the date of hearing. The parties shall have
115.5ten calendar days to submit exceptions to the administrative law judge's report. The
115.6record shall close at the end of the ten-day period for submission of exceptions. The
115.7commissioner's final order shall be issued within ten working days from the close of the
115.8record. Within 90 calendar days after a final order affirming an immediate suspension, the
115.9commissioner shall make a determination regarding whether a final licensing sanction
115.10shall be issued under subdivision 3. The license holder shall continue to be prohibited
115.11from operation of the program during this 90-day period.
115.12    (c) When the final order under paragraph (b) affirms an immediate suspension, and a
115.13final licensing sanction is issued under subdivision 3 and the license holder appeals that
115.14sanction, the license holder continues to be prohibited from operation of the program
115.15pending a final commissioner's order under section 245A.08, subdivision 5, regarding the
115.16final licensing sanction.

115.17    Sec. 7. Minnesota Statutes 2012, section 245A.1435, is amended to read:
115.18245A.1435 REDUCTION OF RISK OF SUDDEN UNEXPECTED INFANT
115.19DEATH SYNDROME IN LICENSED PROGRAMS.
115.20    (a) When a license holder is placing an infant to sleep, the license holder must
115.21place the infant on the infant's back, unless the license holder has documentation from
115.22the infant's parent physician directing an alternative sleeping position for the infant. The
115.23parent physician directive must be on a form approved by the commissioner and must
115.24include a statement that the parent or legal guardian has read the information provided by
115.25the Minnesota Sudden Infant Death Center, related to the risk of SIDS and the importance
115.26of placing an infant or child on its back to sleep to reduce the risk of SIDS. remain on file
115.27at the licensed location. An infant who independently rolls onto its stomach after being
115.28placed to sleep on its back may be allowed to remain sleeping on its stomach if the infant
115.29is at least six months of age or the license holder has a signed statement from the parent
115.30indicating that the infant regularly rolls over at home.
115.31(b) The license holder must place the infant in a crib directly on a firm mattress with
115.32a fitted crib sheet that fits tightly on the mattress and overlaps the mattress so it cannot be
115.33dislodged by pulling on the corner of the sheet. The license holder must not place pillows,
115.34quilts, comforters, sheepskin, pillow-like stuffed toys, or other soft products in the crib
115.35with the infant The license holder must place the infant in a crib directly on a firm mattress
116.1with a fitted sheet that is appropriate to the mattress size, that fits tightly on the mattress,
116.2and overlaps the underside of the mattress so it cannot be dislodged by pulling on the corner
116.3of the sheet with reasonable effort. The license holder must not place anything in the crib
116.4with the infant except for the infant's pacifier. The requirements of this section apply to
116.5license holders serving infants up to and including 12 months younger than one year of age.
116.6Licensed child care providers must meet the crib requirements under section 245A.146.
116.7(c) If an infant falls asleep before being placed in a crib, the license holder must
116.8move the infant to a crib as soon as practicable, and must keep the infant within sight of
116.9the license holder until the infant is placed in a crib. When an infant falls asleep while
116.10being held, the license holder must consider the supervision needs of other children in
116.11care when determining how long to hold the infant before placing the infant in a crib to
116.12sleep. The sleeping infant must not be in a position where the airway may be blocked or
116.13with anything covering the infant's face.
116.14(d) Placing a swaddled infant down to sleep in a licensed setting is not recommended
116.15for an infant of any age and is prohibited for any infant who has begun to roll over
116.16independently. However, with the written consent of a parent or guardian according to this
116.17paragraph, a license holder may place the infant who has not yet begun to roll over on its
116.18own down to sleep in a one-piece sleeper equipped with an attached system that fastens
116.19securely only across the upper torso, with no constriction of the hips or legs, to create a
116.20swaddle. Prior to any use of swaddling for sleep by a provider licensed under this chapter,
116.21the license holder must obtain informed written consent for the use of swaddling from the
116.22parent or guardian of the infant on a form provided by the commissioner and prepared in
116.23partnership with the Minnesota Sudden Infant Death Center.

116.24    Sec. 8. Minnesota Statutes 2012, section 245A.144, is amended to read:
116.25245A.144 TRAINING ON RISK OF SUDDEN UNEXPECTED INFANT
116.26DEATH AND SHAKEN BABY SYNDROME ABUSIVE HEAD TRAUMA FOR
116.27CHILD FOSTER CARE PROVIDERS.
116.28    (a) Licensed child foster care providers that care for infants or children through five
116.29years of age must document that before staff persons and caregivers assist in the care
116.30of infants or children through five years of age, they are instructed on the standards in
116.31section 245A.1435 and receive training on reducing the risk of sudden unexpected infant
116.32death syndrome and shaken baby syndrome for abusive head trauma from shaking infants
116.33and young children. This section does not apply to emergency relative placement under
116.34section 245A.035. The training on reducing the risk of sudden unexpected infant death
116.35syndrome and shaken baby syndrome abusive head trauma may be provided as:
117.1    (1) orientation training to child foster care providers, who care for infants or children
117.2through five years of age, under Minnesota Rules, part 2960.3070, subpart 1; or
117.3    (2) in-service training to child foster care providers, who care for infants or children
117.4through five years of age, under Minnesota Rules, part 2960.3070, subpart 2.
117.5    (b) Training required under this section must be at least one hour in length and must
117.6be completed at least once every five years. At a minimum, the training must address
117.7the risk factors related to sudden unexpected infant death syndrome and shaken baby
117.8syndrome abusive head trauma, means of reducing the risk of sudden unexpected infant
117.9death syndrome and shaken baby syndrome abusive head trauma, and license holder
117.10communication with parents regarding reducing the risk of sudden unexpected infant
117.11death syndrome and shaken baby syndrome abusive head trauma.
117.12    (c) Training for child foster care providers must be approved by the county or
117.13private licensing agency that is responsible for monitoring the child foster care provider
117.14under section 245A.16. The approved training fulfills, in part, training required under
117.15Minnesota Rules, part 2960.3070.

117.16    Sec. 9. Minnesota Statutes 2012, section 245A.1444, is amended to read:
117.17245A.1444 TRAINING ON RISK OF SUDDEN UNEXPECTED INFANT
117.18DEATH SYNDROME AND SHAKEN BABY SYNDROME ABUSIVE HEAD
117.19TRAUMA BY OTHER PROGRAMS.
117.20    A licensed chemical dependency treatment program that serves clients with infants
117.21or children through five years of age, who sleep at the program and a licensed children's
117.22residential facility that serves infants or children through five years of age, must document
117.23that before program staff persons or volunteers assist in the care of infants or children
117.24through five years of age, they are instructed on the standards in section 245A.1435 and
117.25receive training on reducing the risk of sudden unexpected infant death syndrome and
117.26shaken baby syndrome abusive head trauma from shaking infants and young children. The
117.27training conducted under this section may be used to fulfill training requirements under
117.28Minnesota Rules, parts 2960.0100, subpart 3; and 9530.6490, subpart 4, item B.
117.29    This section does not apply to child care centers or family child care programs
117.30governed by sections 245A.40 and 245A.50.

117.31    Sec. 10. [245A.1446] FAMILY CHILD CARE DIAPERING AREA
117.32DISINFECTION.
117.33Notwithstanding Minnesota Rules, part 9502.0435, a family child care provider may
117.34disinfect the diaper changing surface with either a solution of at least two teaspoons
118.1of chlorine bleach to one quart of water or with a surface disinfectant that meets the
118.2following criteria:
118.3(1) the manufacturer's label or instructions state that the product is registered with
118.4the United States Environmental Protection Agency;
118.5(2) the manufacturer's label or instructions state that the disinfectant is effective
118.6against Staphylococcus aureus, Salmonella choleraesuis, and Pseudomonas aeruginosa;
118.7(3) the manufacturer's label or instructions state that the disinfectant is effective with
118.8a ten minute or less contact time;
118.9(4) the disinfectant is clearly labeled by the manufacturer with directions for mixing
118.10and use;
118.11(5) the disinfectant is used only in accordance with the manufacturer's directions; and
118.12(6) the product does not include triclosan or derivatives of triclosan.

118.13    Sec. 11. [245A.147] FAMILY CHILD CARE INFANT SLEEP SUPERVISION
118.14REQUIREMENTS.
118.15    Subdivision 1. In-person checks on infants. (a) License holders that serve infants
118.16are encouraged to monitor sleeping infants by conducting in-person checks on each infant
118.17in their care every 30 minutes.
118.18(b) Upon enrollment of an infant in a family child care program, the license holder is
118.19encouraged to conduct in-person checks on the sleeping infant every 15 minutes, during
118.20the first four months of care.
118.21(c) When an infant has an upper respiratory infection, the license holder is
118.22encouraged to conduct in-person checks on the sleeping infant every 15 minutes
118.23throughout the hours of sleep.
118.24    Subd. 2. Use of audio or visual monitoring devices. In addition to conducting
118.25the in-person checks encouraged under subdivision 1, license holders serving infants are
118.26encouraged to use and maintain an audio or visual monitoring device to monitor each
118.27sleeping infant in care during all hours of sleep.

118.28    Sec. 12. [245A.152] CHILD CARE LICENSE HOLDER INSURANCE.
118.29(a) A license holder must provide a written notice to all parents or guardians of all
118.30children to be accepted for care prior to admission stating whether the license holder has
118.31liability insurance. This notice may be incorporated into and provided on the admission
118.32form used by the license holder.
118.33(b) If the license holder has liability insurance:
119.1(1) the license holder shall inform parents in writing that a current certificate of
119.2coverage for insurance is available for inspection to all parents or guardians of children
119.3receiving services and to all parents seeking services from the family child care program;
119.4(2) the notice must provide the parent or guardian with the date of expiration or
119.5next renewal of the policy; and
119.6(3) upon the expiration date of the policy, the license holder must provide a new
119.7written notice indicating whether the insurance policy has lapsed or whether the license
119.8holder has renewed the policy.
119.9If the policy was renewed, the license holder must provide the new expiration date of the
119.10policy in writing to the parents or guardians.
119.11(c) If the license holder does not have liability insurance, the license holder must
119.12provide an annual notice on a form developed and made available by the commissioner,
119.13to the parents or guardians of children in care indicating that the license holder does not
119.14carry liability insurance.
119.15(d) The license holder must notify all parents and guardians in writing immediately
119.16of any change in insurance status.
119.17(e) The license holder must make available upon request the certificate of liability
119.18insurance to the parents of children in care, to the commissioner, and to county licensing
119.19agents.
119.20(f) The license holder must document, with the signature of the parent or guardian,
119.21that the parent or guardian received the notices required by this section.

119.22    Sec. 13. Minnesota Statutes 2012, section 245A.40, subdivision 5, is amended to read:
119.23    Subd. 5. Sudden unexpected infant death syndrome and shaken baby syndrome
119.24 abusive head trauma training. (a) License holders must document that before staff
119.25persons and volunteers care for infants, they are instructed on the standards in section
119.26245A.1435 and receive training on reducing the risk of sudden unexpected infant death
119.27syndrome. In addition, license holders must document that before staff persons care for
119.28infants or children under school age, they receive training on the risk of shaken baby
119.29syndrome abusive head trauma from shaking infants and young children. The training
119.30in this subdivision may be provided as orientation training under subdivision 1 and
119.31in-service training under subdivision 7.
119.32    (b) Sudden unexpected infant death syndrome reduction training required under
119.33this subdivision must be at least one-half hour in length and must be completed at least
119.34once every five years year. At a minimum, the training must address the risk factors
119.35related to sudden unexpected infant death syndrome, means of reducing the risk of sudden
120.1unexpected infant death syndrome in child care, and license holder communication with
120.2parents regarding reducing the risk of sudden unexpected infant death syndrome.
120.3    (c) Shaken baby syndrome Abusive head trauma training under this subdivision
120.4must be at least one-half hour in length and must be completed at least once every five
120.5years year. At a minimum, the training must address the risk factors related to shaken
120.6baby syndrome for shaking infants and young children, means to reduce the risk of shaken
120.7baby syndrome abusive head trauma in child care, and license holder communication with
120.8parents regarding reducing the risk of shaken baby syndrome abusive head trauma.
120.9(d) The commissioner shall make available for viewing a video presentation on the
120.10dangers associated with shaking infants and young children. The video presentation must
120.11be part of the orientation and annual in-service training of licensed child care center
120.12staff persons caring for children under school age. The commissioner shall provide to
120.13child care providers and interested individuals, at cost, copies of a video approved by the
120.14commissioner of health under section 144.574 on the dangers associated with shaking
120.15infants and young children.

120.16    Sec. 14. Minnesota Statutes 2012, section 245A.50, is amended to read:
120.17245A.50 FAMILY CHILD CARE TRAINING REQUIREMENTS.
120.18    Subdivision 1. Initial training. (a) License holders, caregivers, and substitutes must
120.19comply with the training requirements in this section.
120.20    (b) Helpers who assist with care on a regular basis must complete six hours of
120.21training within one year after the date of initial employment.
120.22    Subd. 2. Child growth and development and behavior guidance training. (a) For
120.23purposes of family and group family child care, the license holder and each adult caregiver
120.24who provides care in the licensed setting for more than 30 days in any 12-month period
120.25shall complete and document at least two four hours of child growth and development
120.26and behavior guidance training within the first year of prior to initial licensure, and before
120.27caring for children. For purposes of this subdivision, "child growth and development
120.28training" means training in understanding how children acquire language and develop
120.29physically, cognitively, emotionally, and socially. "Behavior guidance training" means
120.30training in the understanding of the functions of child behavior and strategies for managing
120.31challenging situations. Child growth and development and behavior guidance training
120.32must be repeated annually. Training curriculum shall be developed or approved by the
120.33commissioner of human services by January 1, 2014.
120.34    (b) Notwithstanding paragraph (a), individuals are exempt from this requirement if
120.35they:
121.1    (1) have taken a three-credit course on early childhood development within the
121.2past five years;
121.3    (2) have received a baccalaureate or master's degree in early childhood education or
121.4school-age child care within the past five years;
121.5    (3) are licensed in Minnesota as a prekindergarten teacher, an early childhood
121.6educator, a kindergarten to grade 6 teacher with a prekindergarten specialty, an early
121.7childhood special education teacher, or an elementary teacher with a kindergarten
121.8endorsement; or
121.9    (4) have received a baccalaureate degree with a Montessori certificate within the
121.10past five years.
121.11    Subd. 3. First aid. (a) When children are present in a family child care home
121.12governed by Minnesota Rules, parts 9502.0315 to 9502.0445, at least one staff person
121.13must be present in the home who has been trained in first aid. The first aid training must
121.14have been provided by an individual approved to provide first aid instruction. First aid
121.15training may be less than eight hours and persons qualified to provide first aid training
121.16include individuals approved as first aid instructors. First aid training must be repeated
121.17every two years.
121.18    (b) A family child care provider is exempt from the first aid training requirements
121.19under this subdivision related to any substitute caregiver who provides less than 30 hours
121.20of care during any 12-month period.
121.21    (c) Video training reviewed and approved by the county licensing agency satisfies
121.22the training requirement of this subdivision.
121.23    Subd. 4. Cardiopulmonary resuscitation. (a) When children are present in a family
121.24child care home governed by Minnesota Rules, parts 9502.0315 to 9502.0445, at least
121.25one staff person must be present in the home who has been trained in cardiopulmonary
121.26resuscitation (CPR) and in the treatment of obstructed airways that includes CPR
121.27techniques for infants and children. The CPR training must have been provided by an
121.28individual approved to provide CPR instruction, must be repeated at least once every three
121.29 two years, and must be documented in the staff person's records.
121.30    (b) A family child care provider is exempt from the CPR training requirement in
121.31this subdivision related to any substitute caregiver who provides less than 30 hours of
121.32care during any 12-month period.
121.33    (c) Video training reviewed and approved by the county licensing agency satisfies
121.34the training requirement of this subdivision. Persons providing CPR training must use
121.35CPR training that has been developed:
122.1    (1) by the American Heart Association or the American Red Cross and incorporates
122.2psychomotor skills to support the instruction; or
122.3    (2) using nationally recognized, evidence-based guidelines for CPR training and
122.4incorporates psychomotor skills to support the instruction.
122.5    Subd. 5. Sudden unexpected infant death syndrome and shaken baby syndrome
122.6 abusive head trauma training. (a) License holders must document that before staff
122.7persons, caregivers, and helpers assist in the care of infants, they are instructed on the
122.8standards in section 245A.1435 and receive training on reducing the risk of sudden
122.9unexpected infant death syndrome. In addition, license holders must document that before
122.10staff persons, caregivers, and helpers assist in the care of infants and children under
122.11school age, they receive training on reducing the risk of shaken baby syndrome abusive
122.12head trauma from shaking infants and young children. The training in this subdivision
122.13may be provided as initial training under subdivision 1 or ongoing annual training under
122.14subdivision 7.
122.15    (b) Sudden unexpected infant death syndrome reduction training required under this
122.16subdivision must be at least one-half hour in length and must be completed in person
122.17 at least once every five years two years. On the years when the license holder is not
122.18receiving the in-person training on sudden unexpected infant death reduction, the license
122.19holder must receive sudden unexpected infant death reduction training through a video
122.20of no more than one hour in length developed or approved by the commissioner. At a
122.21minimum, the training must address the risk factors related to sudden unexpected infant
122.22death syndrome, means of reducing the risk of sudden unexpected infant death syndrome
122.23 in child care, and license holder communication with parents regarding reducing the risk
122.24of sudden unexpected infant death syndrome.
122.25    (c) Shaken baby syndrome Abusive head trauma training required under this
122.26subdivision must be at least one-half hour in length and must be completed at least once
122.27every five years year. At a minimum, the training must address the risk factors related
122.28to shaken baby syndrome shaking infants and young children, means of reducing the
122.29risk of shaken baby syndrome abusive head trauma in child care, and license holder
122.30communication with parents regarding reducing the risk of shaken baby syndrome abusive
122.31head trauma.
122.32(d) Training for family and group family child care providers must be developed
122.33by the commissioner in conjunction with the Minnesota Sudden Infant Death Center
122.34and approved by the county licensing agency by the Minnesota Center for Professional
122.35Development.
123.1    (e) The commissioner shall make available for viewing by all licensed child care
123.2providers a video presentation on the dangers associated with shaking infants and young
123.3children. The video presentation shall be part of the initial and ongoing annual training of
123.4licensed child care providers, caregivers, and helpers caring for children under school age.
123.5The commissioner shall provide to child care providers and interested individuals, at cost,
123.6copies of a video approved by the commissioner of health under section 144.574 on the
123.7dangers associated with shaking infants and young children.
123.8    Subd. 6. Child passenger restraint systems; training requirement. (a) A license
123.9holder must comply with all seat belt and child passenger restraint system requirements
123.10under section 169.685.
123.11    (b) Family and group family child care programs licensed by the Department of
123.12Human Services that serve a child or children under nine years of age must document
123.13training that fulfills the requirements in this subdivision.
123.14    (1) Before a license holder, staff person, caregiver, or helper transports a child or
123.15children under age nine in a motor vehicle, the person placing the child or children in a
123.16passenger restraint must satisfactorily complete training on the proper use and installation
123.17of child restraint systems in motor vehicles. Training completed under this subdivision may
123.18be used to meet initial training under subdivision 1 or ongoing training under subdivision 7.
123.19    (2) Training required under this subdivision must be at least one hour in length,
123.20completed at initial training, and repeated at least once every five years. At a minimum,
123.21the training must address the proper use of child restraint systems based on the child's
123.22size, weight, and age, and the proper installation of a car seat or booster seat in the motor
123.23vehicle used by the license holder to transport the child or children.
123.24    (3) Training under this subdivision must be provided by individuals who are certified
123.25and approved by the Department of Public Safety, Office of Traffic Safety. License holders
123.26may obtain a list of certified and approved trainers through the Department of Public
123.27Safety Web site or by contacting the agency.
123.28    (c) Child care providers that only transport school-age children as defined in section
123.29245A.02, subdivision 19 , paragraph (f), in child care buses as defined in section 169.448,
123.30subdivision 1, paragraph (e), are exempt from this subdivision.
123.31    Subd. 7. Training requirements for family and group family child care. For
123.32purposes of family and group family child care, the license holder and each primary
123.33caregiver must complete eight 16 hours of ongoing training each year. For purposes
123.34of this subdivision, a primary caregiver is an adult caregiver who provides services in
123.35the licensed setting for more than 30 days in any 12-month period. Repeat of topical
123.36training requirements in subdivisions 2 to 8 shall count toward the annual 16-hour training
124.1requirement. Additional ongoing training subjects to meet the annual 16-hour training
124.2requirement must be selected from the following areas:
124.3    (1) "child growth and development training" has the meaning given in under
124.4 subdivision 2, paragraph (a);
124.5    (2) "learning environment and curriculum" includes, including training in
124.6establishing an environment and providing activities that provide learning experiences to
124.7meet each child's needs, capabilities, and interests;
124.8    (3) "assessment and planning for individual needs" includes, including training in
124.9observing and assessing what children know and can do in order to provide curriculum
124.10and instruction that addresses their developmental and learning needs, including children
124.11with special needs and bilingual children or children for whom English is not their
124.12primary language;
124.13    (4) "interactions with children" includes, including training in establishing
124.14supportive relationships with children, guiding them as individuals and as part of a group;
124.15    (5) "families and communities" includes, including training in working
124.16collaboratively with families and agencies or organizations to meet children's needs and to
124.17encourage the community's involvement;
124.18    (6) "health, safety, and nutrition" includes, including training in establishing and
124.19maintaining an environment that ensures children's health, safety, and nourishment,
124.20including child abuse, maltreatment, prevention, and reporting; home and fire safety; child
124.21injury prevention; communicable disease prevention and control; first aid; and CPR; and
124.22    (7) "program planning and evaluation" includes, including training in establishing,
124.23implementing, evaluating, and enhancing program operations.; and
124.24(8) behavior guidance, including training in the understanding of the functions of
124.25child behavior and strategies for managing behavior.
124.26    Subd. 8. Other required training requirements. (a) The training required of
124.27family and group family child care providers and staff must include training in the cultural
124.28dynamics of early childhood development and child care. The cultural dynamics and
124.29disabilities training and skills development of child care providers must be designed to
124.30achieve outcomes for providers of child care that include, but are not limited to:
124.31    (1) an understanding and support of the importance of culture and differences in
124.32ability in children's identity development;
124.33    (2) understanding the importance of awareness of cultural differences and
124.34similarities in working with children and their families;
124.35    (3) understanding and support of the needs of families and children with differences
124.36in ability;
125.1    (4) developing skills to help children develop unbiased attitudes about cultural
125.2differences and differences in ability;
125.3    (5) developing skills in culturally appropriate caregiving; and
125.4    (6) developing skills in appropriate caregiving for children of different abilities.
125.5    The commissioner shall approve the curriculum for cultural dynamics and disability
125.6training.
125.7    (b) The provider must meet the training requirement in section 245A.14, subdivision
125.811
, paragraph (a), clause (4), to be eligible to allow a child cared for at the family child
125.9care or group family child care home to use the swimming pool located at the home.
125.10    Subd. 9. Supervising for safety; training requirement. Effective July 1, 2014,
125.11all family child care license holders and each adult caregiver who provides care in the
125.12licensed family child care home for more than 30 days in any 12-month period shall
125.13complete and document at least six hours approved training on supervising for safety
125.14prior to initial licensure, and before caring for children. At least two hours of training
125.15on supervising for safety must be repeated annually. For purposes of this subdivision,
125.16"supervising for safety" includes supervision basics, supervision outdoors, equipment and
125.17materials, illness, injuries, and disaster preparedness. The commissioner shall develop
125.18the supervising for safety curriculum by January 1, 2014.
125.19    Subd. 10. Approved training. (a) County licensing staff must accept training
125.20approved by the Minnesota Center for Professional Development, including:
125.21(1) face-to-face or classroom training;
125.22(2) online training; and
125.23(3) relationship-based professional development, such as mentoring, coaching,
125.24and consulting.
125.25(b) New and increased training requirements under this section must not be imposed
125.26on providers until the commissioner establishes statewide accessibility to the required
125.27provider training.

125.28    Sec. 15. Minnesota Statutes 2012, section 252.27, subdivision 2a, is amended to read:
125.29    Subd. 2a. Contribution amount. (a) The natural or adoptive parents of a minor
125.30child, including a child determined eligible for medical assistance without consideration of
125.31parental income, must contribute to the cost of services used by making monthly payments
125.32on a sliding scale based on income, unless the child is married or has been married, parental
125.33rights have been terminated, or the child's adoption is subsidized according to section
125.34259.67 or through title IV-E of the Social Security Act. The parental contribution is a partial
125.35or full payment for medical services provided for diagnostic, therapeutic, curing, treating,
126.1mitigating, rehabilitation, maintenance, and personal care services as defined in United
126.2States Code, title 26, section 213, needed by the child with a chronic illness or disability.
126.3    (b) For households with adjusted gross income equal to or greater than 100 percent
126.4of federal poverty guidelines, the parental contribution shall be computed by applying the
126.5following schedule of rates to the adjusted gross income of the natural or adoptive parents:
126.6    (1) if the adjusted gross income is equal to or greater than 100 percent of federal
126.7poverty guidelines and less than 175 percent of federal poverty guidelines, the parental
126.8contribution is $4 per month;
126.9    (2) if the adjusted gross income is equal to or greater than 175 percent of federal
126.10poverty guidelines and less than or equal to 545 percent of federal poverty guidelines,
126.11the parental contribution shall be determined using a sliding fee scale established by the
126.12commissioner of human services which begins at one percent of adjusted gross income
126.13at 175 percent of federal poverty guidelines and increases to 7.5 percent of adjusted
126.14gross income for those with adjusted gross income up to 545 percent of federal poverty
126.15guidelines;
126.16    (3) if the adjusted gross income is greater than 545 percent of federal poverty
126.17guidelines and less than 675 percent of federal poverty guidelines, the parental
126.18contribution shall be 7.5 percent of adjusted gross income;
126.19    (4) if the adjusted gross income is equal to or greater than 675 percent of federal
126.20poverty guidelines and less than 975 percent of federal poverty guidelines, the parental
126.21contribution shall be determined using a sliding fee scale established by the commissioner
126.22of human services which begins at 7.5 percent of adjusted gross income at 675 percent of
126.23federal poverty guidelines and increases to ten percent of adjusted gross income for those
126.24with adjusted gross income up to 975 percent of federal poverty guidelines; and
126.25    (5) if the adjusted gross income is equal to or greater than 975 percent of federal
126.26poverty guidelines, the parental contribution shall be 12.5 percent of adjusted gross income.
126.27    If the child lives with the parent, the annual adjusted gross income is reduced by
126.28$2,400 prior to calculating the parental contribution. If the child resides in an institution
126.29specified in section 256B.35, the parent is responsible for the personal needs allowance
126.30specified under that section in addition to the parental contribution determined under this
126.31section. The parental contribution is reduced by any amount required to be paid directly to
126.32the child pursuant to a court order, but only if actually paid.
126.33    (c) The household size to be used in determining the amount of contribution under
126.34paragraph (b) includes natural and adoptive parents and their dependents, including the
126.35child receiving services. Adjustments in the contribution amount due to annual changes
127.1in the federal poverty guidelines shall be implemented on the first day of July following
127.2publication of the changes.
127.3    (d) For purposes of paragraph (b), "income" means the adjusted gross income of the
127.4natural or adoptive parents determined according to the previous year's federal tax form,
127.5except, effective retroactive to July 1, 2003, taxable capital gains to the extent the funds
127.6have been used to purchase a home shall not be counted as income.
127.7    (e) The contribution shall be explained in writing to the parents at the time eligibility
127.8for services is being determined. The contribution shall be made on a monthly basis
127.9effective with the first month in which the child receives services. Annually upon
127.10redetermination or at termination of eligibility, if the contribution exceeded the cost of
127.11services provided, the local agency or the state shall reimburse that excess amount to
127.12the parents, either by direct reimbursement if the parent is no longer required to pay a
127.13contribution, or by a reduction in or waiver of parental fees until the excess amount is
127.14exhausted. All reimbursements must include a notice that the amount reimbursed may be
127.15taxable income if the parent paid for the parent's fees through an employer's health care
127.16flexible spending account under the Internal Revenue Code, section 125, and that the
127.17parent is responsible for paying the taxes owed on the amount reimbursed.
127.18    (f) The monthly contribution amount must be reviewed at least every 12 months;
127.19when there is a change in household size; and when there is a loss of or gain in income
127.20from one month to another in excess of ten percent. The local agency shall mail a written
127.21notice 30 days in advance of the effective date of a change in the contribution amount.
127.22A decrease in the contribution amount is effective in the month that the parent verifies a
127.23reduction in income or change in household size.
127.24    (g) Parents of a minor child who do not live with each other shall each pay the
127.25contribution required under paragraph (a). An amount equal to the annual court-ordered
127.26child support payment actually paid on behalf of the child receiving services shall be
127.27deducted from the adjusted gross income of the parent making the payment prior to
127.28calculating the parental contribution under paragraph (b).
127.29    (h) The contribution under paragraph (b) shall be increased by an additional five
127.30percent if the local agency determines that insurance coverage is available but not
127.31obtained for the child. For purposes of this section, "available" means the insurance is a
127.32benefit of employment for a family member at an annual cost of no more than five percent
127.33of the family's annual income. For purposes of this section, "insurance" means health
127.34and accident insurance coverage, enrollment in a nonprofit health service plan, health
127.35maintenance organization, self-insured plan, or preferred provider organization.
128.1    Parents who have more than one child receiving services shall not be required
128.2to pay more than the amount for the child with the highest expenditures. There shall
128.3be no resource contribution from the parents. The parent shall not be required to pay
128.4a contribution in excess of the cost of the services provided to the child, not counting
128.5payments made to school districts for education-related services. Notice of an increase in
128.6fee payment must be given at least 30 days before the increased fee is due.
128.7    (i) The contribution under paragraph (b) shall be reduced by $300 per fiscal year if,
128.8in the 12 months prior to July 1:
128.9    (1) the parent applied for insurance for the child;
128.10    (2) the insurer denied insurance;
128.11    (3) the parents submitted a complaint or appeal, in writing to the insurer, submitted
128.12a complaint or appeal, in writing, to the commissioner of health or the commissioner of
128.13commerce, or litigated the complaint or appeal; and
128.14    (4) as a result of the dispute, the insurer reversed its decision and granted insurance.
128.15    For purposes of this section, "insurance" has the meaning given in paragraph (h).
128.16    A parent who has requested a reduction in the contribution amount under this
128.17paragraph shall submit proof in the form and manner prescribed by the commissioner or
128.18county agency, including, but not limited to, the insurer's denial of insurance, the written
128.19letter or complaint of the parents, court documents, and the written response of the insurer
128.20approving insurance. The determinations of the commissioner or county agency under this
128.21paragraph are not rules subject to chapter 14.
128.22(j) Notwithstanding paragraph (b), for the period from July 1, 2010, to June 30,
128.232015, the parental contribution shall be computed by applying the following contribution
128.24schedule to the adjusted gross income of the natural or adoptive parents:
128.25(1) if the adjusted gross income is equal to or greater than 100 percent of federal
128.26poverty guidelines and less than 175 percent of federal poverty guidelines, the parental
128.27contribution is $4 per month;
128.28(2) if the adjusted gross income is equal to or greater than 175 percent of federal
128.29poverty guidelines and less than or equal to 525 percent of federal poverty guidelines,
128.30the parental contribution shall be determined using a sliding fee scale established by the
128.31commissioner of human services which begins at one percent of adjusted gross income
128.32at 175 percent of federal poverty guidelines and increases to eight percent of adjusted
128.33gross income for those with adjusted gross income up to 525 percent of federal poverty
128.34guidelines;
129.1(3) if the adjusted gross income is greater than 525 percent of federal poverty
129.2guidelines and less than 675 percent of federal poverty guidelines, the parental
129.3contribution shall be 9.5 percent of adjusted gross income;
129.4(4) if the adjusted gross income is equal to or greater than 675 percent of federal
129.5poverty guidelines and less than 900 percent of federal poverty guidelines, the parental
129.6contribution shall be determined using a sliding fee scale established by the commissioner
129.7of human services which begins at 9.5 percent of adjusted gross income at 675 percent of
129.8federal poverty guidelines and increases to 12 percent of adjusted gross income for those
129.9with adjusted gross income up to 900 percent of federal poverty guidelines; and
129.10(5) if the adjusted gross income is equal to or greater than 900 percent of federal
129.11poverty guidelines, the parental contribution shall be 13.5 percent of adjusted gross
129.12income. If the child lives with the parent, the annual adjusted gross income is reduced by
129.13$2,400 prior to calculating the parental contribution. If the child resides in an institution
129.14specified in section 256B.35, the parent is responsible for the personal needs allowance
129.15specified under that section in addition to the parental contribution determined under this
129.16section. The parental contribution is reduced by any amount required to be paid directly to
129.17the child pursuant to a court order, but only if actually paid.

129.18    Sec. 16. Minnesota Statutes 2012, section 256.82, subdivision 3, is amended to read:
129.19    Subd. 3. Setting foster care standard rates. The commissioner shall annually
129.20establish minimum standard maintenance rates for foster care maintenance and difficulty
129.21of care payments for all children in foster care. Any increase in rates shall in no case
129.22exceed three percent per annum. The foster care rates in effect on January 1, 2013, shall
129.23remain in effect until December 13, 2015.

129.24    Sec. 17. Minnesota Statutes 2012, section 256J.08, subdivision 24, is amended to read:
129.25    Subd. 24. Disregard. "Disregard" means earned income that is not counted when
129.26determining initial eligibility in the initial income test in section 256J.21, subdivision 3,
129.27 or income that is not counted when determining ongoing eligibility and calculating the
129.28amount of the assistance payment for participants. The commissioner shall determine
129.29the amount of the disregard according to section 256J.24, subdivision 10 for ongoing
129.30eligibility shall be 50 percent of gross earned income.
129.31EFFECTIVE DATE.This section is effective October 1, 2013, or upon approval
129.32from the United States Department of Agriculture, whichever is later.

129.33    Sec. 18. Minnesota Statutes 2012, section 256J.21, subdivision 3, is amended to read:
130.1    Subd. 3. Initial income test. The county agency shall determine initial eligibility
130.2by considering all earned and unearned income that is not excluded under subdivision 2.
130.3To be eligible for MFIP, the assistance unit's countable income minus the disregards in
130.4paragraphs (a) and (b) must be below the transitional standard of assistance family wage
130.5level according to section 256J.24 for that size assistance unit.
130.6(a) The initial eligibility determination must disregard the following items:
130.7(1) the employment disregard is 18 percent of the gross earned income whether or
130.8not the member is working full time or part time;
130.9(2) dependent care costs must be deducted from gross earned income for the actual
130.10amount paid for dependent care up to a maximum of $200 per month for each child less
130.11than two years of age, and $175 per month for each child two years of age and older under
130.12this chapter and chapter 119B;
130.13(3) all payments made according to a court order for spousal support or the support
130.14of children not living in the assistance unit's household shall be disregarded from the
130.15income of the person with the legal obligation to pay support, provided that, if there has
130.16been a change in the financial circumstances of the person with the legal obligation to pay
130.17support since the support order was entered, the person with the legal obligation to pay
130.18support has petitioned for a modification of the support order; and
130.19(4) an allocation for the unmet need of an ineligible spouse or an ineligible child
130.20under the age of 21 for whom the caregiver is financially responsible and who lives with
130.21the caregiver according to section 256J.36.
130.22(b) Notwithstanding paragraph (a), when determining initial eligibility for applicant
130.23units when at least one member has received MFIP in this state within four months of
130.24the most recent application for MFIP, apply the disregard as defined in section 256J.08,
130.25subdivision 24
, for all unit members.
130.26After initial eligibility is established, the assistance payment calculation is based on
130.27the monthly income test.
130.28EFFECTIVE DATE.This section is effective October 1, 2013, or upon approval
130.29from the United States Department of Agriculture, whichever is later.

130.30    Sec. 19. Minnesota Statutes 2012, section 256J.24, subdivision 5, is amended to read:
130.31    Subd. 5. MFIP transitional standard. The MFIP transitional standard is based
130.32on the number of persons in the assistance unit eligible for both food and cash assistance
130.33unless the restrictions in subdivision 6 on the birth of a child apply. The amount of the
130.34transitional standard is published annually by the Department of Human Services.
131.1EFFECTIVE DATE.This section is effective July 1, 2014.

131.2    Sec. 20. Minnesota Statutes 2012, section 256J.24, subdivision 5a, is amended to read:
131.3    Subd. 5a. Food portion of Adjustments to the MFIP transitional standard. (a)
131.4Effective October 1, 2015, the commissioner shall adjust the MFIP transitional standard as
131.5needed to reflect a onetime increase in the cash portion of 16 percent.
131.6(b) When any adjustments are made in the Supplemental Nutrition Assistance
131.7Program, the commissioner shall adjust the food portion of the MFIP transitional standard
131.8as needed to reflect adjustments to the Supplemental Nutrition Assistance Program. The
131.9commissioner shall publish the transitional standard including a breakdown of the cash
131.10and food portions for an assistance unit of sizes one to ten in the State Register whenever
131.11an adjustment is made.

131.12    Sec. 21. Minnesota Statutes 2012, section 256J.24, subdivision 7, is amended to read:
131.13    Subd. 7. Family wage level. The family wage level is 110 percent of the transitional
131.14standard under subdivision 5 or 6, when applicable, and is the standard used when there is
131.15earned income in the assistance unit. As specified in section 256J.21. If there is earned
131.16income in the assistance unit, earned income is subtracted from the family wage level to
131.17determine the amount of the assistance payment, as specified in section 256J.21. The
131.18assistance payment may not exceed the transitional standard under subdivision 5 or 6,
131.19or the shared household standard under subdivision 9, whichever is applicable, for the
131.20assistance unit.
131.21EFFECTIVE DATE.This section is effective October 1, 2013, or upon approval
131.22from the United States Department of Agriculture, whichever is later.

131.23    Sec. 22. Minnesota Statutes 2012, section 256J.621, is amended to read:
131.24256J.621 WORK PARTICIPATION CASH BENEFITS.
131.25    Subdivision 1. Program characteristics. (a) Effective October 1, 2009, upon
131.26exiting the diversionary work program (DWP) or upon terminating the Minnesota family
131.27investment program with earnings, a participant who is employed may be eligible for work
131.28participation cash benefits of $25 per month to assist in meeting the family's basic needs
131.29as the participant continues to move toward self-sufficiency.
131.30    (b) To be eligible for work participation cash benefits, the participant shall not
131.31receive MFIP or diversionary work program assistance during the month and the
131.32participant or participants must meet the following work requirements:
132.1    (1) if the participant is a single caregiver and has a child under six years of age, the
132.2participant must be employed at least 87 hours per month;
132.3    (2) if the participant is a single caregiver and does not have a child under six years of
132.4age, the participant must be employed at least 130 hours per month; or
132.5    (3) if the household is a two-parent family, at least one of the parents must be
132.6employed 130 hours per month.
132.7    Whenever a participant exits the diversionary work program or is terminated from
132.8MFIP and meets the other criteria in this section, work participation cash benefits are
132.9available for up to 24 consecutive months.
132.10    (c) Expenditures on the program are maintenance of effort state funds under
132.11a separate state program for participants under paragraph (b), clauses (1) and (2).
132.12Expenditures for participants under paragraph (b), clause (3), are nonmaintenance of effort
132.13funds. Months in which a participant receives work participation cash benefits under this
132.14section do not count toward the participant's MFIP 60-month time limit.
132.15    Subd. 2. Program suspension. (a) Effective December 1, 2013, the work
132.16participation cash benefits program shall be suspended.
132.17(b) The commissioner of human services may reinstate the work participation cash
132.18benefits program if the United States Department of Human Services determines that the
132.19state of Minnesota did not meet the federal TANF work participation rate and sends a
132.20notice of penalty to reduce Minnesota's federal TANF block grant authorized under title I
132.21of Public Law 104-193, the Personal Responsibility and Work Opportunity Reconciliation
132.22Act of 1996, and under Public Law 109-171, the Deficit Reduction Act of 2005.
132.23(c) The commissioner shall notify the chairs and ranking minority members of the
132.24legislative committees with jurisdiction over human services policy and finance of the
132.25potential penalty and the commissioner's plans to reinstate the work participation cash
132.26benefit program within 30 days of the date the commissioner receives notification that
132.27the state failed to meet the federal work participation rate.

132.28    Sec. 23. Minnesota Statutes 2012, section 256J.626, subdivision 7, is amended to read:
132.29    Subd. 7. Performance base funds. (a) For the purpose of this section, the following
132.30terms have the meanings given.
132.31(1) "Caseload Reduction Credit" (CRC) means the measure of how much Minnesota
132.32TANF and separate state program caseload has fallen relative to federal fiscal year 2005
132.33based on caseload data from October 1 to September 30.
132.34(2) "TANF participation rate target" means a 50 percent participation rate reduced by
132.35the CRC for the previous year.
133.1(b) (a) For calendar year 2010 2016 and yearly thereafter, each county and tribe will
133.2 must be allocated 95 percent of their initial calendar year allocation. Allocations for
133.3counties and tribes will must be allocated additional funds adjusted based on performance
133.4as follows:
133.5    (1) a county or tribe that achieves the TANF participation rate target or a five
133.6percentage point improvement over the previous year's TANF participation rate under
133.7section 256J.751, subdivision 2, clause (7), as averaged across 12 consecutive months for
133.8the most recent year for which the measurements are available, will receive an additional
133.9allocation equal to 2.5 percent of its initial allocation;
133.10    (2) (1) a county or tribe that performs within or above its range of expected
133.11performance on the annualized three-year self-support index under section 256J.751,
133.12subdivision 2
, clause (6), will must receive an additional allocation equal to 2.5 five
133.13percent of its initial allocation; and
133.14    (3) a county or tribe that does not achieve the TANF participation rate target or
133.15a five percentage point improvement over the previous year's TANF participation rate
133.16under section 256J.751, subdivision 2, clause (7), as averaged across 12 consecutive
133.17months for the most recent year for which the measurements are available, will not
133.18receive an additional 2.5 percent of its initial allocation until after negotiating a multiyear
133.19improvement plan with the commissioner; or
133.20    (4) (2) a county or tribe that does not perform within or above performs below its
133.21range of expected performance on the annualized three-year self-support index under
133.22section 256J.751, subdivision 2, clause (6), will not receive an additional allocation equal
133.23to 2.5 percent of its initial allocation until after negotiating for a single year, may receive
133.24an additional allocation of up to five percent of its initial allocation. A county or tribe that
133.25continues to perform below its range of expected performance for two consecutive years
133.26must negotiate a multiyear improvement plan with the commissioner. If no improvement
133.27is shown by the end of the multiyear plan, the commissioner may decrease the county's or
133.28tribe's performance-based funds by up to five percent. The decrease must remain in effect
133.29until the county or tribe performs within or above its range of expected performance.
133.30    (c) (b) For calendar year 2009 2016 and yearly thereafter, performance-based funds
133.31for a federally approved tribal TANF program in which the state and tribe have in place a
133.32contract under section 256.01, addressing consolidated funding, will must be allocated
133.33as follows:
133.34    (1) a tribe that achieves the participation rate approved in its federal TANF plan
133.35using the average of 12 consecutive months for the most recent year for which the
134.1measurements are available, will receive an additional allocation equal to 2.5 percent of
134.2its initial allocation; and
134.3    (2) (1) a tribe that performs within or above its range of expected performance on the
134.4annualized three-year self-support index under section 256J.751, subdivision 2, clause (6),
134.5will must receive an additional allocation equal to 2.5 percent of its initial allocation; or
134.6    (3) a tribe that does not achieve the participation rate approved in its federal TANF
134.7plan using the average of 12 consecutive months for the most recent year for which the
134.8measurements are available, will not receive an additional allocation equal to 2.5 percent
134.9of its initial allocation until after negotiating a multiyear improvement plan with the
134.10commissioner; or
134.11    (4) (2) a tribe that does not perform within or above performs below its range of
134.12expected performance on the annualized three-year self-support index under section
134.13256J.751, subdivision 2 , clause (6), will not receive an additional allocation equal to 2.5
134.14percent until after negotiating for a single year may receive an additional allocation of up
134.15to five percent of its initial allocation. A county or tribe that continues to perform below
134.16its range of expected performance for two consecutive years must negotiate a multiyear
134.17improvement plan with the commissioner. If no improvement is shown by the end of the
134.18multiyear plan, the commissioner may decrease the tribe's performance-based funds by
134.19up to five percent. The decrease must remain in effect until the tribe performs within or
134.20above its range of expected performance.
134.21    (d) (c) Funds remaining unallocated after the performance-based allocations in
134.22paragraph paragraphs (a) and (b) are available to the commissioner for innovation projects
134.23under subdivision 5.
134.24     (1) (d) If available funds are insufficient to meet county and tribal allocations under
134.25paragraph paragraphs (a) and (b), the commissioner may make available for allocation
134.26funds that are unobligated and available from the innovation projects through the end of
134.27the current biennium shall proportionally prorate funds to counties and tribes that qualify
134.28for an additional allocation under paragraphs (a), clause (1), and (b), clause (1).
134.29    (2) If after the application of clause (1) funds remain insufficient to meet county and
134.30tribal allocations under paragraph (b), the commissioner must proportionally reduce the
134.31allocation of each county and tribe with respect to their maximum allocation available
134.32under paragraph (b).

134.33    Sec. 24. [256J.78] TANF DEMONSTRATION PROJECTS OR WAIVER FROM
134.34FEDERAL RULES AND REGULATIONS.
135.1    Subdivision 1. Duties of the commissioner. The commissioner of human services
135.2may pursue TANF demonstration projects or waivers of TANF requirements from the
135.3United States Department of Health and Human Services as needed to allow the state to
135.4build a more results-oriented Minnesota Family Investment Program to better meet the
135.5needs of Minnesota families.
135.6    Subd. 2. Purpose. The purpose of the TANF demonstration projects or waivers is to:
135.7(1) replace the federal TANF process measure and its complex administrative
135.8requirements with state-developed outcomes measures that track adult employment and
135.9exits from MFIP cash assistance;
135.10(2) simplify programmatic and administrative requirements; and
135.11(3) make other policy or programmatic changes that improve the performance of the
135.12program and the outcomes for participants.
135.13    Subd. 3. Report to legislature. The commissioner shall report to the members of
135.14the legislative committees having jurisdiction over human services issues by March 1,
135.152014, regarding the progress of this waiver or demonstration project.
135.16EFFECTIVE DATE.This section is effective the day following final enactment.

135.17    Sec. 25. Minnesota Statutes 2012, section 256K.45, is amended to read:
135.18256K.45 RUNAWAY AND HOMELESS YOUTH ACT.
135.19    Subdivision 1. Grant program established. The commissioner of human services
135.20shall establish a Homeless Youth Act fund and award grants to providers who are
135.21committed to serving homeless youth and youth at risk of homelessness, to provide
135.22street and community outreach and drop-in programs, emergency shelter programs,
135.23and integrated supportive housing and transitional living programs, consistent with the
135.24program descriptions in this act to reduce the incidence of homelessness among youth.
135.25    Subdivision 1. Subd. 1a. Definitions. (a) The definitions in this subdivision apply
135.26to this section.
135.27(b) "Commissioner" means the commissioner of human services.
135.28(c) "Homeless youth" means a person 21 years of age or younger who is
135.29unaccompanied by a parent or guardian and is without shelter where appropriate care and
135.30supervision are available, whose parent or legal guardian is unable or unwilling to provide
135.31shelter and care, or who lacks a fixed, regular, and adequate nighttime residence. The
135.32following are not fixed, regular, or adequate nighttime residences:
135.33(1) a supervised publicly or privately operated shelter designed to provide temporary
135.34living accommodations;
136.1(2) an institution or a publicly or privately operated shelter designed to provide
136.2temporary living accommodations;
136.3(3) transitional housing;
136.4(4) a temporary placement with a peer, friend, or family member that has not offered
136.5permanent residence, a residential lease, or temporary lodging for more than 30 days; or
136.6(5) a public or private place not designed for, nor ordinarily used as, a regular
136.7sleeping accommodation for human beings.
136.8Homeless youth does not include persons incarcerated or otherwise detained under
136.9federal or state law.
136.10(d) "Youth at risk of homelessness" means a person 21 years of age or younger
136.11whose status or circumstances indicate a significant danger of experiencing homelessness
136.12in the near future. Status or circumstances that indicate a significant danger may include:
136.13(1) youth exiting out-of-home placements; (2) youth who previously were homeless; (3)
136.14youth whose parents or primary caregivers are or were previously homeless; (4) youth
136.15who are exposed to abuse and neglect in their homes; (5) youth who experience conflict
136.16with parents due to chemical or alcohol dependency, mental health disabilities, or other
136.17disabilities; and (6) runaways.
136.18(e) "Runaway" means an unmarried child under the age of 18 years who is absent
136.19from the home of a parent or guardian or other lawful placement without the consent of
136.20the parent, guardian, or lawful custodian.
136.21    Subd. 2. Homeless and runaway youth report. The commissioner shall develop a
136.22 report for homeless youth, youth at risk of homelessness, and runaways. The report shall
136.23include coordination of services as defined under subdivisions 3 to 5 prepare a biennial
136.24report, beginning in February 2015, which provides meaningful information to the
136.25legislative committees having jurisdiction over the issue of homeless youth, that includes,
136.26but is not limited to: (1) a list of the areas of the state with the greatest need for services
136.27and housing for homeless youth, and the level and nature of the needs identified; (2) details
136.28about grants made; (3) the distribution of funds throughout the state based on population
136.29need; (4) follow-up information, if available, on the status of homeless youth and whether
136.30they have stable housing two years after services are provided; and (5) any other outcomes
136.31for populations served to determine the effectiveness of the programs and use of funding.
136.32    Subd. 3. Street and community outreach and drop-in program. Youth drop-in
136.33centers must provide walk-in access to crisis intervention and ongoing supportive services
136.34including one-to-one case management services on a self-referral basis. Street and
136.35community outreach programs must locate, contact, and provide information, referrals,
137.1and services to homeless youth, youth at risk of homelessness, and runaways. Information,
137.2referrals, and services provided may include, but are not limited to:
137.3(1) family reunification services;
137.4(2) conflict resolution or mediation counseling;
137.5(3) assistance in obtaining temporary emergency shelter;
137.6(4) assistance in obtaining food, clothing, medical care, or mental health counseling;
137.7(5) counseling regarding violence, prostitution, substance abuse, sexually transmitted
137.8diseases, and pregnancy;
137.9(6) referrals to other agencies that provide support services to homeless youth,
137.10youth at risk of homelessness, and runaways;
137.11(7) assistance with education, employment, and independent living skills;
137.12(8) aftercare services;
137.13(9) specialized services for highly vulnerable runaways and homeless youth,
137.14including teen parents, emotionally disturbed and mentally ill youth, and sexually
137.15exploited youth; and
137.16(10) homelessness prevention.
137.17    Subd. 4. Emergency shelter program. (a) Emergency shelter programs must
137.18provide homeless youth and runaways with referral and walk-in access to emergency,
137.19short-term residential care. The program shall provide homeless youth and runaways with
137.20safe, dignified shelter, including private shower facilities, beds, and at least one meal each
137.21day; and shall assist a runaway and homeless youth with reunification with the family or
137.22legal guardian when required or appropriate.
137.23(b) The services provided at emergency shelters may include, but are not limited to:
137.24(1) family reunification services;
137.25(2) individual, family, and group counseling;
137.26(3) assistance obtaining clothing;
137.27(4) access to medical and dental care and mental health counseling;
137.28(5) education and employment services;
137.29(6) recreational activities;
137.30(7) advocacy and referral services;
137.31(8) independent living skills training;
137.32(9) aftercare and follow-up services;
137.33(10) transportation; and
137.34(11) homelessness prevention.
137.35    Subd. 5. Supportive housing and transitional living programs. Transitional
137.36living programs must help homeless youth and youth at risk of homelessness to find and
138.1maintain safe, dignified housing. The program may also provide rental assistance and
138.2related supportive services, or refer youth to other organizations or agencies that provide
138.3such services. Services provided may include, but are not limited to:
138.4(1) educational assessment and referrals to educational programs;
138.5(2) career planning, employment, work skill training, and independent living skills
138.6training;
138.7(3) job placement;
138.8(4) budgeting and money management;
138.9(5) assistance in securing housing appropriate to needs and income;
138.10(6) counseling regarding violence, prostitution, substance abuse, sexually transmitted
138.11diseases, and pregnancy;
138.12(7) referral for medical services or chemical dependency treatment;
138.13(8) parenting skills;
138.14(9) self-sufficiency support services or life skill training;
138.15(10) aftercare and follow-up services; and
138.16(11) homelessness prevention.
138.17    Subd. 6. Funding. Any Funds appropriated for this section may be expended on
138.18programs described under subdivisions 3 to 5, technical assistance, and capacity building.
138.19Up to four percent of funds appropriated may be used for the purpose of monitoring and
138.20evaluating runaway and homeless youth programs receiving funding under this section.
138.21Funding shall be directed to meet the greatest need, with a significant share of the funding
138.22focused on homeless youth providers in greater Minnesota to meet the greatest need
138.23on a statewide basis.

138.24    Sec. 26. Minnesota Statutes 2012, section 256M.40, subdivision 1, is amended to read:
138.25    Subdivision 1. Formula. The commissioner shall allocate state funds appropriated
138.26under this chapter to each county board on a calendar year basis in an amount determined
138.27according to the formula in paragraphs (a) to (e).
138.28(a) For calendar years 2011 and 2012, the commissioner shall allocate available
138.29funds to each county in proportion to that county's share in calendar year 2010.
138.30(b) For calendar year 2013 and each calendar year thereafter, the commissioner shall
138.31allocate available funds to each county as follows:
138.32(1) 75 percent must be distributed on the basis of the county share in calendar year
138.332012;
138.34(2) five percent must be distributed on the basis of the number of persons residing in
138.35the county as determined by the most recent data of the state demographer;
139.1(3) ten percent must be distributed on the basis of the number of vulnerable children
139.2that are subjects of reports under chapter 260C and sections 626.556 and 626.5561, and in
139.3the county as determined by the most recent data of the commissioner; and
139.4(4) ten percent must be distributed on the basis of the number of vulnerable adults
139.5that are subjects of reports under section 626.557 in the county as determined by the most
139.6recent data of the commissioner.
139.7(c) For calendar year 2014, the commissioner shall allocate available funds to each
139.8county as follows:
139.9(1) 50 percent must be distributed on the basis of the county share in calendar year
139.102012;
139.11(2) Ten percent must be distributed on the basis of the number of persons residing in
139.12the county as determined by the most recent data of the state demographer;
139.13(3) 20 percent must be distributed on the basis of the number of vulnerable children
139.14that are subjects of reports under chapter 260C and sections 626.556 and 626.5561, in the
139.15county as determined by the most recent data of the commissioner; and
139.16(4) 20 percent must be distributed on the basis of the number of vulnerable adults
139.17that are subjects of reports under section 626.557 in the county as determined by the
139.18most recent data of the commissioner The commissioner is precluded from changing the
139.19formula under this subdivision or recommending a change to the legislature without
139.20public review and input.
139.21(d) For calendar year 2015, the commissioner shall allocate available funds to each
139.22county as follows:
139.23(1) 25 percent must be distributed on the basis of the county share in calendar year
139.242012;
139.25(2) 15 percent must be distributed on the basis of the number of persons residing in
139.26the county as determined by the most recent data of the state demographer;
139.27(3) 30 percent must be distributed on the basis of the number of vulnerable children
139.28that are subjects of reports under chapter 260C and sections 626.556 and 626.5561, in the
139.29county as determined by the most recent data of the commissioner; and
139.30(4) 30 percent must be distributed on the basis of the number of vulnerable adults
139.31that are subjects of reports under section 626.557 in the county as determined by the most
139.32recent data of the commissioner.
139.33(e) For calendar year 2016 and each calendar year thereafter, the commissioner shall
139.34allocate available funds to each county as follows:
139.35(1) 20 percent must be distributed on the basis of the number of persons residing in
139.36the county as determined by the most recent data of the state demographer;
140.1(2) 40 percent must be distributed on the basis of the number of vulnerable children
140.2that are subjects of reports under chapter 260C and sections 626.556 and 626.5561, in the
140.3county as determined by the most recent data of the commissioner; and
140.4(3) 40 percent must be distributed on the basis of the number of vulnerable adults
140.5that are subjects of reports under section 626.557 in the county as determined by the most
140.6recent data of the commissioner.

140.7    Sec. 27. Minnesota Statutes 2012, section 257.85, subdivision 11, is amended to read:
140.8    Subd. 11. Financial considerations. (a) Payment of relative custody assistance
140.9under a relative custody assistance agreement is subject to the availability of state funds
140.10and payments may be reduced or suspended on order of the commissioner if insufficient
140.11funds are available Beginning July 1, 2013, relative custody assistance shall be a forecasted
140.12program, and the commissioner, with the approval of the commissioner of management
140.13and budget, may transfer unencumbered appropriation balances within fiscal years of
140.14each biennium to other forecasted programs of the Department of Human Services. The
140.15commissioner shall inform the chairs and ranking minority members of the senate Health
140.16and Human Services Finance Division and the house of representatives Health and Human
140.17Services Finance Committee quarterly about transfers made under this provision.
140.18(b) Upon receipt from a local agency of a claim for reimbursement, the commissioner
140.19shall reimburse the local agency in an amount equal to 100 percent of the relative custody
140.20assistance payments provided to relative custodians. The local agency may not seek and
140.21the commissioner shall not provide reimbursement for the administrative costs associated
140.22with performing the duties described in subdivision 4.
140.23(c) For the purposes of determining eligibility or payment amounts under MFIP,
140.24relative custody assistance payments shall be excluded in determining the family's
140.25available income.

140.26    Sec. 28. Minnesota Statutes 2012, section 259A.05, subdivision 5, is amended to read:
140.27    Subd. 5. Transfer of funds. The commissioner of human services may transfer
140.28funds into the adoption assistance account when a deficit in the adoption assistance
140.29program occurs Beginning July 1, 2013, adoption assistance shall be a forecasted program
140.30and the commissioner, with the approval of the commissioner of management and budget,
140.31may transfer unencumbered appropriation balances within fiscal years of each biennium to
140.32other forecasted programs of the Department of Human Services. The commissioner shall
140.33inform the chairs and ranking minority members of the senate Health and Human Services
141.1Finance Division and the house of representatives Health and Human Services Finance
141.2Committee quarterly about transfers made under this provision.

141.3    Sec. 29. Minnesota Statutes 2012, section 259A.20, subdivision 4, is amended to read:
141.4    Subd. 4. Reimbursement for special nonmedical expenses. (a) Reimbursement
141.5for special nonmedical expenses is available to children, except those eligible for adoption
141.6assistance based on being an at-risk child.
141.7(b) Reimbursements under this paragraph shall be made only after the adoptive
141.8parent documents that the requested service was denied by the local social service agency,
141.9community agencies, the local school district, the local public health department, the
141.10parent's insurance provider, or the child's program. The denial must be for an eligible
141.11service or qualified item under the program requirements of the applicable agency or
141.12organization.
141.13(c) Reimbursements must be previously authorized, adhere to the requirements and
141.14procedures prescribed by the commissioner, and be limited to:
141.15(1) child care for a child age 12 and younger, or for a child age 13 or 14 who has a
141.16documented disability that requires special instruction for and services by the child care
141.17provider. Child care reimbursements may be made if all available adult caregivers are
141.18employed, unemployed due to a disability as defined in section 259A.01, subdivision 14,
141.19 or attending educational or vocational training programs. Documentation from a qualified
141.20expert that is dated within the last 12 months must be provided to verify the disability. If a
141.21parent is attending an educational or vocational training program, child care reimbursement
141.22is limited to no more than the time necessary to complete the credit requirements for an
141.23associate or baccalaureate degree as determined by the educational institution. Child
141.24care reimbursement is not limited for an adoptive parent completing basic or remedial
141.25education programs needed to prepare for postsecondary education or employment;
141.26(2) respite care provided for the relief of the child's parent up to 504 hours of respite
141.27care annually;
141.28(3) camping up to 14 days per state fiscal year for a child to attend a special needs
141.29camp. The camp must be accredited by the American Camp Association as a special needs
141.30camp in order to be eligible for camp reimbursement;
141.31(4) postadoption counseling to promote the child's integration into the adoptive
141.32family that is provided by the placing agency during the first year following the date of the
141.33adoption decree. Reimbursement is limited to 12 sessions of postadoption counseling;
141.34(5) family counseling that is required to meet the child's special needs.
141.35Reimbursement is limited to the prorated portion of the counseling fees allotted to the
142.1family when the adoptive parent's health insurance or Medicaid pays for the child's
142.2counseling but does not cover counseling for the rest of the family members;
142.3(6) home modifications to accommodate the child's special needs upon which
142.4eligibility for adoption assistance was approved. Reimbursement is limited to once every
142.5five years per child;
142.6(7) vehicle modifications to accommodate the child's special needs upon which
142.7eligibility for adoption assistance was approved. Reimbursement is limited to once every
142.8five years per family; and
142.9(8) burial expenses up to $1,000, if the special needs, upon which eligibility for
142.10adoption assistance was approved, resulted in the death of the child.
142.11(d) The adoptive parent shall submit statements for expenses incurred between July
142.121 and June 30 of a given fiscal year to the state adoption assistance unit within 60 days
142.13after the end of the fiscal year in order for reimbursement to occur.

142.14    Sec. 30. Minnesota Statutes 2012, section 260B.007, subdivision 6, is amended to read:
142.15    Subd. 6. Delinquent child. (a) Except as otherwise provided in paragraphs (b)
142.16and (c), "delinquent child" means a child:
142.17(1) who has violated any state or local law, except as provided in section 260B.225,
142.18subdivision 1
, and except for juvenile offenders as described in subdivisions 16 to 18;
142.19(2) who has violated a federal law or a law of another state and whose case has been
142.20referred to the juvenile court if the violation would be an act of delinquency if committed
142.21in this state or a crime or offense if committed by an adult;
142.22(3) who has escaped from confinement to a state juvenile correctional facility after
142.23being committed to the custody of the commissioner of corrections; or
142.24(4) who has escaped from confinement to a local juvenile correctional facility after
142.25being committed to the facility by the court.
142.26(b) The term delinquent child does not include a child alleged to have committed
142.27murder in the first degree after becoming 16 years of age, but the term delinquent child
142.28does include a child alleged to have committed attempted murder in the first degree.
142.29(c) The term delinquent child does not include a child under the age of 16 years
142.30 alleged to have engaged in conduct which would, if committed by an adult, violate any
142.31federal, state, or local law relating to being hired, offering to be hired, or agreeing to be
142.32hired by another individual to engage in sexual penetration or sexual conduct.
142.33EFFECTIVE DATE.This section is effective August 1, 2014, and applies to
142.34offenses committed on or after that date.

143.1    Sec. 31. Minnesota Statutes 2012, section 260B.007, subdivision 16, is amended to read:
143.2    Subd. 16. Juvenile petty offender; juvenile petty offense. (a) "Juvenile petty
143.3offense" includes a juvenile alcohol offense, a juvenile controlled substance offense,
143.4a violation of section 609.685, or a violation of a local ordinance, which by its terms
143.5prohibits conduct by a child under the age of 18 years which would be lawful conduct if
143.6committed by an adult.
143.7(b) Except as otherwise provided in paragraph (c), "juvenile petty offense" also
143.8includes an offense that would be a misdemeanor if committed by an adult.
143.9(c) "Juvenile petty offense" does not include any of the following:
143.10(1) a misdemeanor-level violation of section 518B.01, 588.20, 609.224, 609.2242,
143.11609.324 , subdivision 2 or 3, 609.5632, 609.576, 609.66, 609.746, 609.748, 609.79,
143.12or 617.23;
143.13(2) a major traffic offense or an adult court traffic offense, as described in section
143.14260B.225 ;
143.15(3) a misdemeanor-level offense committed by a child whom the juvenile court
143.16previously has found to have committed a misdemeanor, gross misdemeanor, or felony
143.17offense; or
143.18(4) a misdemeanor-level offense committed by a child whom the juvenile court
143.19has found to have committed a misdemeanor-level juvenile petty offense on two or
143.20more prior occasions, unless the county attorney designates the child on the petition
143.21as a juvenile petty offender notwithstanding this prior record. As used in this clause,
143.22"misdemeanor-level juvenile petty offense" includes a misdemeanor-level offense that
143.23would have been a juvenile petty offense if it had been committed on or after July 1, 1995.
143.24(d) A child who commits a juvenile petty offense is a "juvenile petty offender." The
143.25term juvenile petty offender does not include a child under the age of 16 years alleged
143.26to have violated any law relating to being hired, offering to be hired, or agreeing to be
143.27hired by another individual to engage in sexual penetration or sexual conduct which, if
143.28committed by an adult, would be a misdemeanor.
143.29EFFECTIVE DATE.This section is effective August 1, 2014, and applies to
143.30offenses committed on or after that date.

143.31    Sec. 32. Minnesota Statutes 2012, section 260C.007, subdivision 6, is amended to read:
143.32    Subd. 6. Child in need of protection or services. "Child in need of protection or
143.33services" means a child who is in need of protection or services because the child:
143.34    (1) is abandoned or without parent, guardian, or custodian;
144.1    (2)(i) has been a victim of physical or sexual abuse as defined in section 626.556,
144.2subdivision 2, (ii) resides with or has resided with a victim of child abuse as defined in
144.3subdivision 5 or domestic child abuse as defined in subdivision 13, (iii) resides with or
144.4would reside with a perpetrator of domestic child abuse as defined in subdivision 13 or
144.5child abuse as defined in subdivision 5 or 13, or (iv) is a victim of emotional maltreatment
144.6as defined in subdivision 15;
144.7    (3) is without necessary food, clothing, shelter, education, or other required care
144.8for the child's physical or mental health or morals because the child's parent, guardian,
144.9or custodian is unable or unwilling to provide that care;
144.10    (4) is without the special care made necessary by a physical, mental, or emotional
144.11condition because the child's parent, guardian, or custodian is unable or unwilling to
144.12provide that care;
144.13    (5) is medically neglected, which includes, but is not limited to, the withholding of
144.14medically indicated treatment from a disabled infant with a life-threatening condition. The
144.15term "withholding of medically indicated treatment" means the failure to respond to the
144.16infant's life-threatening conditions by providing treatment, including appropriate nutrition,
144.17hydration, and medication which, in the treating physician's or physicians' reasonable
144.18medical judgment, will be most likely to be effective in ameliorating or correcting all
144.19conditions, except that the term does not include the failure to provide treatment other
144.20than appropriate nutrition, hydration, or medication to an infant when, in the treating
144.21physician's or physicians' reasonable medical judgment:
144.22    (i) the infant is chronically and irreversibly comatose;
144.23    (ii) the provision of the treatment would merely prolong dying, not be effective in
144.24ameliorating or correcting all of the infant's life-threatening conditions, or otherwise be
144.25futile in terms of the survival of the infant; or
144.26    (iii) the provision of the treatment would be virtually futile in terms of the survival
144.27of the infant and the treatment itself under the circumstances would be inhumane;
144.28    (6) is one whose parent, guardian, or other custodian for good cause desires to be
144.29relieved of the child's care and custody, including a child who entered foster care under a
144.30voluntary placement agreement between the parent and the responsible social services
144.31agency under section 260C.227;
144.32    (7) has been placed for adoption or care in violation of law;
144.33    (8) is without proper parental care because of the emotional, mental, or physical
144.34disability, or state of immaturity of the child's parent, guardian, or other custodian;
145.1    (9) is one whose behavior, condition, or environment is such as to be injurious or
145.2dangerous to the child or others. An injurious or dangerous environment may include, but
145.3is not limited to, the exposure of a child to criminal activity in the child's home;
145.4    (10) is experiencing growth delays, which may be referred to as failure to thrive, that
145.5have been diagnosed by a physician and are due to parental neglect;
145.6    (11) has engaged in prostitution as defined in section 609.321, subdivision 9 is a
145.7sexually exploited youth;
145.8    (12) has committed a delinquent act or a juvenile petty offense before becoming
145.9ten years old;
145.10    (13) is a runaway;
145.11    (14) is a habitual truant;
145.12    (15) has been found incompetent to proceed or has been found not guilty by reason
145.13of mental illness or mental deficiency in connection with a delinquency proceeding, a
145.14certification under section 260B.125, an extended jurisdiction juvenile prosecution, or a
145.15proceeding involving a juvenile petty offense; or
145.16(16) has a parent whose parental rights to one or more other children were
145.17involuntarily terminated or whose custodial rights to another child have been involuntarily
145.18transferred to a relative and there is a case plan prepared by the responsible social services
145.19agency documenting a compelling reason why filing the termination of parental rights
145.20petition under section 260C.301, subdivision 3, is not in the best interests of the child; or.
145.21(17) is a sexually exploited youth.
145.22EFFECTIVE DATE.This section is effective August 1, 2014.

145.23    Sec. 33. Minnesota Statutes 2012, section 260C.007, subdivision 31, is amended to read:
145.24    Subd. 31. Sexually exploited youth. "Sexually exploited youth" means an
145.25individual who:
145.26(1) is alleged to have engaged in conduct which would, if committed by an adult,
145.27violate any federal, state, or local law relating to being hired, offering to be hired, or
145.28agreeing to be hired by another individual to engage in sexual penetration or sexual conduct;
145.29(2) is a victim of a crime described in section 609.342, 609.343, 609.344, 609.345,
145.30609.3451 , 609.3453, 609.352, 617.246, or 617.247;
145.31(3) is a victim of a crime described in United States Code, title 18, section 2260;
145.322421; 2422; 2423; 2425; 2425A; or 2256; or
145.33(4) is a sex trafficking victim as defined in section 609.321, subdivision 7b.
145.34EFFECTIVE DATE.This section is effective the day following final enactment.

146.1    Sec. 34. Minnesota Statutes 2012, section 518A.60, is amended to read:
146.2518A.60 COLLECTION; ARREARS ONLY.
146.3(a) Remedies available for the collection and enforcement of support in this chapter
146.4and chapters 256, 257, 518, and 518C also apply to cases in which the child or children
146.5for whom support is owed are emancipated and the obligor owes past support or has an
146.6accumulated arrearage as of the date of the youngest child's emancipation. Child support
146.7arrearages under this section include arrearages for child support, medical support, child
146.8care, pregnancy and birth expenses, and unreimbursed medical expenses as defined in
146.9section 518A.41, subdivision 1, paragraph (h).
146.10(b) This section applies retroactively to any support arrearage that accrued on or
146.11before June 3, 1997, and to all arrearages accruing after June 3, 1997.
146.12(c) Past support or pregnancy and confinement expenses ordered for which the
146.13obligor has specific court ordered terms for repayment may not be enforced using
146.14drivers' and occupational or professional license suspension, credit bureau reporting, and
146.15additional income withholding under section 518A.53, subdivision 10, paragraph (a),
146.16unless the obligor fails to comply with the terms of the court order for repayment.
146.17(d) If an arrearage exists at the time a support order would otherwise terminate
146.18and section 518A.53, subdivision 10, paragraph (c), does not apply to this section, the
146.19arrearage shall be repaid in an amount equal to the current support order until all arrears
146.20have been paid in full, absent a court order to the contrary.
146.21(e) If an arrearage exists according to a support order which fails to establish a
146.22monthly support obligation in a specific dollar amount, the public authority, if it provides
146.23child support services, or the obligee, may establish a payment agreement which shall
146.24equal what the obligor would pay for current support after application of section 518A.34,
146.25plus an additional 20 percent of the current support obligation, until all arrears have been
146.26paid in full. If the obligor fails to enter into or comply with a payment agreement, the
146.27public authority, if it provides child support services, or the obligee, may move the district
146.28court or child support magistrate, if section 484.702 applies, for an order establishing
146.29repayment terms.
146.30(f) If there is no longer a current support order because all of the children of the
146.31order are emancipated, the public authority may discontinue child support services and
146.32close its case under title IV-D of the Social Security Act if:
146.33(1) the arrearage is under $500; or
146.34(2) the arrearage is considered unenforceable by the public authority because there
146.35have been no collections for three years, and all administrative and legal remedies have
146.36been attempted or are determined by the public authority to be ineffective because the
147.1obligor is unable to pay, the obligor has no known income or assets, and there is no
147.2reasonable prospect that the obligor will be able to pay in the foreseeable future.
147.3    (g) At least 60 calendar days before the discontinuation of services under paragraph
147.4(f), the public authority must mail a written notice to the obligee and obligor at the
147.5obligee's and obligor's last known addresses that the public authority intends to close the
147.6child support enforcement case and explaining each party's rights. Seven calendar days
147.7after the first notice is mailed, the public authority must mail a second notice under this
147.8paragraph to the obligee.
147.9    (h) The case must be kept open if the obligee responds before case closure and
147.10provides information that could reasonably lead to collection of arrears. If the case is
147.11closed, the obligee may later request that the case be reopened by completing a new
147.12application for services, if there is a change in circumstances that could reasonably lead to
147.13the collection of arrears.

147.14    Sec. 35. Laws 1998, chapter 407, article 6, section 116, is amended to read:
147.15    Sec. 116. EBT TRANSACTION COSTS; APPROVAL FROM LEGISLATURE.
147.16    The commissioner of human services shall request and receive approval from the
147.17legislature before adjusting the payment to discontinue the state subsidy to retailers for
147.18electronic benefit transfer transaction costs Supplemental Nutrition Assistance Program
147.19transactions when the federal government discontinues the federal subsidy to the same.

147.20    Sec. 36. DIRECTION TO COMMISSIONERS; INCOME AND ASSET
147.21EXCLUSION.
147.22(a) The commissioner of human services shall not count conditional cash transfers
147.23made to families participating in a family independence demonstration as income or
147.24assets for purposes of determining or redetermining eligibility for child care assistance
147.25programs under Minnesota Statutes, chapter 119B; general assistance under Minnesota
147.26Statutes, chapter 256D; group residential housing under Minnesota Statutes, chapter 256I;
147.27the Minnesota family investment program, work benefit program, or diversionary work
147.28program under Minnesota Statutes, chapter 256J, during the duration of the demonstration.
147.29(b) The commissioner of human services shall not count conditional cash transfers
147.30made to families participating in a family independence demonstration as income or assets
147.31for purposes of determining or redetermining eligibility for medical assistance under
147.32Minnesota Statutes, chapter 256B, and MinnesotaCare under Minnesota Statutes, chapter
147.33256L, except that for enrollees subject to a modified adjusted gross income calculation to
147.34determine eligibility, the conditional cash transfer payments shall be counted as income if
148.1they are included on the enrollee's federal tax return as income, or if the payments can be
148.2taken into account in the month of receipt as a lump sum payment.
148.3(c) The commissioner of the Minnesota Housing Finance Agency shall not count
148.4conditional cash transfers made to families participating in a family independence
148.5demonstration as income or assets for purposes of determining or redetermining eligibility
148.6for housing assistance programs under Minnesota Statutes, section 462A.201, during
148.7the duration of the demonstration.
148.8(d) For the purposes of this section:
148.9(1) "conditional cash transfer" means a payment made to a participant in a family
148.10independence demonstration by a sponsoring organization to incent, support, or facilitate
148.11participation; and
148.12(2) "family independence demonstration" means an initiative sponsored or
148.13cosponsored by a governmental or nongovernmental organization, the goal of which is
148.14to facilitate individualized goal-setting and peer support for cohorts of no more than 12
148.15families each toward the development of financial and nonfinancial assets that enable the
148.16participating families to achieve financial independence.
148.17(e) The citizens league shall provide a report to the legislative committees having
148.18jurisdiction over human services issues by July 1, 2016, informing the legislature on the
148.19progress and outcomes of the demonstration under this section.

148.20    Sec. 37. UNIFORM BENEFITS FOR CHILDREN IN FOSTER CARE,
148.21PERMANENT RELATIVE CARE, AND ADOPTION ASSISTANCE.
148.22Using available resources, the commissioner of human services, in consultation with
148.23representatives of the judicial branch, county human services, and tribes participating in
148.24the American Indian child welfare initiative under Minnesota Statutes, section 256.01,
148.25subdivision 14b, together with other appropriate stakeholders, which might include
148.26communities of color; youth in foster care or those who have aged out of care; kinship
148.27caregivers, foster parents, adoptive parents, foster and adoptive agencies; guardians ad
148.28litem; and experts in permanency, adoption, child development, and the effects of trauma,
148.29and the use of medical assistance home and community-based waivers for persons with
148.30disabilities, shall analyze benefits and services available to children in family foster care
148.31under Minnesota Rules, parts 9560.0650 to 9560.0656, relative custody assistance under
148.32Minnesota Statutes, section 257.85, and adoption assistance under Minnesota Statutes,
148.33chapter 259A. The goal of the analysis is to establish a uniform set of benefits available
148.34to children in foster care, permanent relative care, and adoption so that the benefits
148.35can follow the child rather than being tied to the child's legal status. Included in the
149.1analysis is possible accessing of federal title IV-E through guardianship assistance. The
149.2commissioner shall report findings and conclusions to the chairs and ranking minority
149.3members of the legislative committees and divisions with jurisdiction over health and
149.4human services policy and finance by January 15, 2014, and include draft legislation
149.5establishing uniform benefits.

149.6    Sec. 38. WAIVER PROCESS RELATED TO CHILD CARE PROVIDER
149.7CHOICE.
149.8The commissioner of human services, within available appropriations, shall develop
149.9a simple waiver process related to Minnesota Statutes, section 119B.09, subdivision 5,
149.10that requires the parent or guardian to submit notice of a preferred alternative child care
149.11arrangement. The commissioner must monitor the waiver process and report on the usage
149.12of waivers to the legislature.

149.13    Sec. 39. REPEALER.
149.14(a) Minnesota Statutes 2012, section 256J.24, subdivision 6, is repealed effective
149.15July 1, 2014.
149.16(b) Minnesota Statutes 2012, section 609.093, is repealed effective the day following
149.17final enactment.

149.18ARTICLE 4
149.19STRENGTHENING CHEMICAL AND MENTAL HEALTH SERVICES

149.20    Section 1. Minnesota Statutes 2012, section 245.462, subdivision 20, is amended to read:
149.21    Subd. 20. Mental illness. (a) "Mental illness" means an organic disorder of the brain
149.22or a clinically significant disorder of thought, mood, perception, orientation, memory, or
149.23behavior that is detailed in a diagnostic codes list published by the commissioner, and that
149.24seriously limits a person's capacity to function in primary aspects of daily living such as
149.25personal relations, living arrangements, work, and recreation.
149.26    (b) An "adult with acute mental illness" means an adult who has a mental illness that
149.27is serious enough to require prompt intervention.
149.28    (c) For purposes of case management and community support services, a "person
149.29with serious and persistent mental illness" means an adult who has a mental illness and
149.30meets at least one of the following criteria:
149.31    (1) the adult has undergone two or more episodes of inpatient care for a mental
149.32illness within the preceding 24 months;
150.1    (2) the adult has experienced a continuous psychiatric hospitalization or residential
150.2treatment exceeding six months' duration within the preceding 12 months;
150.3    (3) the adult has been treated by a crisis team two or more times within the preceding
150.424 months;
150.5    (4) the adult:
150.6    (i) has a diagnosis of schizophrenia, bipolar disorder, major depression,
150.7schizoaffective disorder, or borderline personality disorder;
150.8    (ii) indicates a significant impairment in functioning; and
150.9    (iii) has a written opinion from a mental health professional, in the last three years,
150.10stating that the adult is reasonably likely to have future episodes requiring inpatient or
150.11residential treatment, of a frequency described in clause (1) or (2), unless ongoing case
150.12management or community support services are provided;
150.13    (5) the adult has, in the last three years, been committed by a court as a person who is
150.14mentally ill under chapter 253B, or the adult's commitment has been stayed or continued; or
150.15    (6) the adult (i) was eligible under clauses (1) to (5), but the specified time period
150.16has expired or the adult was eligible as a child under section 245.4871, subdivision 6; and
150.17(ii) has a written opinion from a mental health professional, in the last three years, stating
150.18that the adult is reasonably likely to have future episodes requiring inpatient or residential
150.19treatment, of a frequency described in clause (1) or (2), unless ongoing case management
150.20or community support services are provided; or
150.21    (7) the adult was eligible as a child under section 245.4871, subdivision 6, and is
150.22age 21 or younger.

150.23    Sec. 2. Minnesota Statutes 2012, section 245.4661, subdivision 5, is amended to read:
150.24    Subd. 5. Planning for pilot projects. (a) Each local plan for a pilot project, with
150.25the exception of the placement of a Minnesota specialty treatment facility as defined in
150.26paragraph (c), must be developed under the direction of the county board, or multiple
150.27county boards acting jointly, as the local mental health authority. The planning process
150.28for each pilot shall include, but not be limited to, mental health consumers, families,
150.29advocates, local mental health advisory councils, local and state providers, representatives
150.30of state and local public employee bargaining units, and the department of human services.
150.31As part of the planning process, the county board or boards shall designate a managing
150.32entity responsible for receipt of funds and management of the pilot project.
150.33(b) For Minnesota specialty treatment facilities, the commissioner shall issue a
150.34request for proposal for regions in which a need has been identified for services.
151.1(c) For purposes of this section, Minnesota specialty treatment facility is defined as
151.2an intensive rehabilitative mental health service under section 256B.0622, subdivision 2,
151.3paragraph (b).

151.4    Sec. 3. Minnesota Statutes 2012, section 245.4661, subdivision 6, is amended to read:
151.5    Subd. 6. Duties of commissioner. (a) For purposes of the pilot projects, the
151.6commissioner shall facilitate integration of funds or other resources as needed and
151.7requested by each project. These resources may include:
151.8(1) residential services funds administered under Minnesota Rules, parts 9535.2000
151.9to 9535.3000, in an amount to be determined by mutual agreement between the project's
151.10managing entity and the commissioner of human services after an examination of the
151.11county's historical utilization of facilities located both within and outside of the county
151.12and licensed under Minnesota Rules, parts 9520.0500 to 9520.0690;
151.13(2) community support services funds administered under Minnesota Rules, parts
151.149535.1700 to 9535.1760;
151.15(3) other mental health special project funds;
151.16(4) medical assistance, general assistance medical care, MinnesotaCare and group
151.17residential housing if requested by the project's managing entity, and if the commissioner
151.18determines this would be consistent with the state's overall health care reform efforts; and
151.19(5) regional treatment center resources consistent with section 246.0136, subdivision
151.201
.; and
151.21(6) funds transferred from section 246.18, subdivision 8, for grants to providers to
151.22participate in mental health specialty treatment services, awarded to providers through
151.23a request for proposal process.
151.24(b) The commissioner shall consider the following criteria in awarding start-up and
151.25implementation grants for the pilot projects:
151.26(1) the ability of the proposed projects to accomplish the objectives described in
151.27subdivision 2;
151.28(2) the size of the target population to be served; and
151.29(3) geographical distribution.
151.30(c) The commissioner shall review overall status of the projects initiatives at least
151.31every two years and recommend any legislative changes needed by January 15 of each
151.32odd-numbered year.
151.33(d) The commissioner may waive administrative rule requirements which are
151.34incompatible with the implementation of the pilot project.
152.1(e) The commissioner may exempt the participating counties from fiscal sanctions
152.2for noncompliance with requirements in laws and rules which are incompatible with the
152.3implementation of the pilot project.
152.4(f) The commissioner may award grants to an entity designated by a county board or
152.5group of county boards to pay for start-up and implementation costs of the pilot project.

152.6    Sec. 4. Minnesota Statutes 2012, section 245.4682, subdivision 2, is amended to read:
152.7    Subd. 2. General provisions. (a) In the design and implementation of reforms to
152.8the mental health system, the commissioner shall:
152.9    (1) consult with consumers, families, counties, tribes, advocates, providers, and
152.10other stakeholders;
152.11    (2) bring to the legislature, and the State Advisory Council on Mental Health, by
152.12January 15, 2008, recommendations for legislation to update the role of counties and to
152.13clarify the case management roles, functions, and decision-making authority of health
152.14plans and counties, and to clarify county retention of the responsibility for the delivery of
152.15social services as required under subdivision 3, paragraph (a);
152.16    (3) withhold implementation of any recommended changes in case management
152.17roles, functions, and decision-making authority until after the release of the report due
152.18January 15, 2008;
152.19    (4) ensure continuity of care for persons affected by these reforms including
152.20ensuring client choice of provider by requiring broad provider networks and developing
152.21mechanisms to facilitate a smooth transition of service responsibilities;
152.22    (5) provide accountability for the efficient and effective use of public and private
152.23resources in achieving positive outcomes for consumers;
152.24    (6) ensure client access to applicable protections and appeals; and
152.25    (7) make budget transfers necessary to implement the reallocation of services and
152.26client responsibilities between counties and health care programs that do not increase the
152.27state and county costs and efficiently allocate state funds.
152.28    (b) When making transfers under paragraph (a) necessary to implement movement
152.29of responsibility for clients and services between counties and health care programs,
152.30the commissioner, in consultation with counties, shall ensure that any transfer of state
152.31grants to health care programs, including the value of case management transfer grants
152.32under section 256B.0625, subdivision 20, does not exceed the value of the services being
152.33transferred for the latest 12-month period for which data is available. The commissioner
152.34may make quarterly adjustments based on the availability of additional data during the
152.35first four quarters after the transfers first occur. If case management transfer grants under
153.1section 256B.0625, subdivision 20, are repealed and the value, based on the last year prior
153.2to repeal, exceeds the value of the services being transferred, the difference becomes an
153.3ongoing part of each county's adult and children's mental health grants under sections
153.4245.4661 , 245.4889, and 256E.12.
153.5    (c) This appropriation is not authorized to be expended after December 31, 2010,
153.6unless approved by the legislature.

153.7    Sec. 5. Minnesota Statutes 2012, section 245.4875, subdivision 8, is amended to read:
153.8    Subd. 8. Transition services. The county board may continue to provide mental
153.9health services as defined in sections 245.487 to 245.4889 to persons over 18 years of
153.10age, but under 21 years of age, if the person was receiving case management or family
153.11community support services prior to age 18, and if one of the following conditions is met:
153.12(1) the person is receiving special education services through the local school
153.13district; or
153.14(2) it is in the best interest of the person to continue services defined in sections
153.15245.487 to 245.4889; or
153.16(3) the person is requesting services and the services are medically necessary.

153.17    Sec. 6. Minnesota Statutes 2012, section 245.4881, subdivision 1, is amended to read:
153.18    Subdivision 1. Availability of case management services. (a) The county board
153.19shall provide case management services for each child with severe emotional disturbance
153.20who is a resident of the county and the child's family who request or consent to the services.
153.21Case management services may be continued must be offered to be provided for a child with
153.22a serious emotional disturbance who is over the age of 18 consistent with section 245.4875,
153.23subdivision 8
, or the child's legal representative, provided the child's service needs can be
153.24met within the children's service system. Before discontinuing case management services
153.25under this subdivision for children between the ages of 17 and 21, a transition plan
153.26must be developed. The transition plan must be developed with the child and, with the
153.27consent of a child age 18 or over, the child's parent, guardian, or legal representative. The
153.28transition plan should include plans for health insurance, housing, education, employment,
153.29and treatment. Staffing ratios must be sufficient to serve the needs of the clients. The case
153.30manager must meet the requirements in section 245.4871, subdivision 4.
153.31(b) Except as permitted by law and the commissioner under demonstration projects,
153.32case management services provided to children with severe emotional disturbance eligible
153.33for medical assistance must be billed to the medical assistance program under sections
153.34256B.02, subdivision 8 , and 256B.0625.
154.1(c) Case management services are eligible for reimbursement under the medical
154.2assistance program. Costs of mentoring, supervision, and continuing education may be
154.3included in the reimbursement rate methodology used for case management services under
154.4the medical assistance program.

154.5    Sec. 7. Minnesota Statutes 2012, section 246.18, subdivision 8, is amended to read:
154.6    Subd. 8. State-operated services account. (a) The state-operated services account is
154.7established in the special revenue fund. Revenue generated by new state-operated services
154.8listed under this section established after July 1, 2010, that are not enterprise activities must
154.9be deposited into the state-operated services account, unless otherwise specified in law:
154.10(1) intensive residential treatment services;
154.11(2) foster care services; and
154.12(3) psychiatric extensive recovery treatment services.
154.13(b) Funds deposited in the state-operated services account are available to the
154.14commissioner of human services for the purposes of:
154.15(1) providing services needed to transition individuals from institutional settings
154.16within state-operated services to the community when those services have no other
154.17adequate funding source;
154.18(2) grants to providers participating in mental health specialty treatment services
154.19under section 245.4661; and
154.20(3) to fund the operation of the Intensive Residential Treatment Service program in
154.21Willmar.

154.22    Sec. 8. Minnesota Statutes 2012, section 246.18, is amended by adding a subdivision
154.23to read:
154.24    Subd. 9. Transfers. The commissioner may transfer state mental health grant funds
154.25to the account in subdivision 8 for noncovered allowable costs of a provider certified and
154.26licensed under section 256B.0622 and operating under section 246.014.

154.27    Sec. 9. Minnesota Statutes 2012, section 253B.10, subdivision 1, is amended to read:
154.28    Subdivision 1. Administrative requirements. (a) When a person is committed,
154.29the court shall issue a warrant or an order committing the patient to the custody of the
154.30head of the treatment facility. The warrant or order shall state that the patient meets the
154.31statutory criteria for civil commitment.
154.32(b) The commissioner shall prioritize patients being admitted from jail or a
154.33correctional institution who are:
155.1(1) ordered confined in a state hospital for an examination under Minnesota Rules of
155.2Criminal Procedure, rules 20.01, subdivision 4, paragraph (a), and 20.02, subdivision 2;
155.3(2) under civil commitment for competency treatment and continuing supervision
155.4under Minnesota Rules of Criminal Procedure, rule 20.01, subdivision 7;
155.5(3) found not guilty by reason of mental illness under Minnesota Rules of Criminal
155.6Procedure, rule 20.02, subdivision 8, and under civil commitment or are ordered to be
155.7detained in a state hospital or other facility pending completion of the civil commitment
155.8proceedings; or
155.9(4) committed under this chapter to the commissioner after dismissal of the patient's
155.10criminal charges.
155.11Patients described in this paragraph must be admitted to a service operated by the
155.12commissioner within 48 hours. The commitment must be ordered by the court as provided
155.13in section 253B.09, subdivision 1, paragraph (c).
155.14(c) Upon the arrival of a patient at the designated treatment facility, the head of the
155.15facility shall retain the duplicate of the warrant and endorse receipt upon the original
155.16warrant or acknowledge receipt of the order. The endorsed receipt or acknowledgment
155.17must be filed in the court of commitment. After arrival, the patient shall be under the
155.18control and custody of the head of the treatment facility.
155.19(d) Copies of the petition for commitment, the court's findings of fact and
155.20conclusions of law, the court order committing the patient, the report of the examiners,
155.21and the prepetition report shall be provided promptly to the treatment facility.

155.22    Sec. 10. Minnesota Statutes 2012, section 254B.13, is amended to read:
155.23254B.13 PILOT PROJECTS; CHEMICAL HEALTH CARE.
155.24    Subdivision 1. Authorization for navigator pilot projects. The commissioner may
155.25approve and implement navigator pilot projects developed under the planning process
155.26required under Laws 2009, chapter 79, article 7, section 26, to provide alternatives to and
155.27enhance coordination of the delivery of chemical health services required under section
155.28254B.03 .
155.29    Subd. 2. Program design and implementation. (a) The commissioner and
155.30counties participating in the navigator pilot projects shall continue to work in partnership
155.31to refine and implement the navigator pilot projects initiated under Laws 2009, chapter
155.3279, article 7, section 26.
155.33(b) The commissioner and counties participating in the navigator pilot projects shall
155.34complete the planning phase by June 30, 2010, and, if approved by the commissioner for
156.1implementation, enter into agreements governing the operation of the navigator pilot
156.2projects with implementation scheduled no earlier than July 1, 2010.
156.3    Subd. 2a. Eligibility for navigator pilot program. (a) To be considered for
156.4participation in a navigator pilot program, an individual must:
156.5(1) be a resident of a county with an approved navigator program;
156.6(2) be eligible for consolidated chemical dependency treatment fund services;
156.7(3) be a voluntary participant in the navigator program;
156.8(4) satisfy one of the following items:
156.9(i) have at least one severity rating of three or above in dimension four, five, or six in
156.10a comprehensive assessment under Minnesota Rules, part 9530.6422; or
156.11(ii) have at least one severity rating of two or above in dimension four, five, or six in
156.12a comprehensive assessment under Minnesota Rules, part 9530.6422, and be currently
156.13participating in a Rule 31 treatment program under Minnesota Rules, parts 9530.6405 to
156.149530.6505, or be within 60 days following discharge after participation in a Rule 31
156.15treatment program; and
156.16(5) have had at least two treatment episodes in the past two years, not limited
156.17to episodes reimbursed by the consolidated chemical dependency treatment funds. An
156.18admission to an emergency room, a detoxification program, or a hospital may be substituted
156.19for one treatment episode if it resulted from the individual's substance use disorder.
156.20(b) New eligibility criteria may be added as mutually agreed upon by the
156.21commissioner and participating navigator programs.
156.22    Subd. 3. Program evaluation. The commissioner shall evaluate navigator pilot
156.23projects under this section and report the results of the evaluation to the chairs and
156.24ranking minority members of the legislative committees with jurisdiction over chemical
156.25health issues by January 15, 2014. Evaluation of the navigator pilot projects must be
156.26based on outcome evaluation criteria negotiated with the navigator pilot projects prior
156.27to implementation.
156.28    Subd. 4. Notice of navigator pilot project discontinuation. Each county's
156.29participation in the navigator pilot project may be discontinued for any reason by the county
156.30or the commissioner of human services after 30 days' written notice to the other party.
156.31Any unspent funds held for the exiting county's pro rata share in the special revenue fund
156.32under the authority in subdivision 5, paragraph (d), shall be transferred to the consolidated
156.33chemical dependency treatment fund following discontinuation of the pilot project.
156.34    Subd. 5. Duties of commissioner. (a) Notwithstanding any other provisions in
156.35this chapter, the commissioner may authorize navigator pilot projects to use chemical
156.36dependency treatment funds to pay for nontreatment navigator pilot services:
157.1(1) in addition to those authorized under section 254B.03, subdivision 2, paragraph
157.2(a); and
157.3(2) by vendors in addition to those authorized under section 254B.05 when not
157.4providing chemical dependency treatment services.
157.5(b) For purposes of this section, "nontreatment navigator pilot services" include
157.6navigator services, peer support, family engagement and support, housing support, rent
157.7subsidies, supported employment, and independent living skills.
157.8(c) State expenditures for chemical dependency services and nontreatment navigator
157.9pilot services provided by or through the navigator pilot projects must not be greater than
157.10the chemical dependency treatment fund expected share of forecasted expenditures in the
157.11absence of the navigator pilot projects. The commissioner may restructure the schedule of
157.12payments between the state and participating counties under the local agency share and
157.13division of cost provisions under section 254B.03, subdivisions 3 and 4, as necessary to
157.14facilitate the operation of the navigator pilot projects.
157.15(d) To the extent that state fiscal year expenditures within a pilot project are less
157.16than the expected share of forecasted expenditures in the absence of the pilot projects,
157.17the commissioner shall deposit the unexpended funds in a separate account within the
157.18consolidated chemical dependency treatment fund, and make these funds available for
157.19expenditure by the pilot projects the following year. To the extent that treatment and
157.20nontreatment pilot services expenditures within the pilot project exceed the amount
157.21expected in the absence of the pilot projects, the pilot project county or counties are
157.22responsible for the portion of nontreatment pilot services expenditures in excess of the
157.23otherwise expected share of forecasted expenditures.
157.24(e) (d) The commissioner may waive administrative rule requirements that are
157.25incompatible with the implementation of the navigator pilot project, except that any
157.26chemical dependency treatment funded under this section must continue to be provided
157.27by a licensed treatment provider.
157.28(f) (e) The commissioner shall not approve or enter into any agreement related to
157.29navigator pilot projects authorized under this section that puts current or future federal
157.30funding at risk.
157.31(f) The commissioner shall provide participating navigator pilot projects with
157.32transactional data, reports, provider data, and other data generated by county activity to
157.33assess and measure outcomes. This information must be transmitted or made available in
157.34an acceptable form to participating navigator pilot projects at least once every six months
157.35or within a reasonable time following the commissioner's receipt of information from the
157.36counties needed to comply with this paragraph.
158.1    Subd. 6. Duties of county board. The county board, or other county entity that
158.2is approved to administer a navigator pilot project, shall:
158.3(1) administer the navigator pilot project in a manner consistent with the objectives
158.4described in subdivision 2 and the planning process in subdivision 5;
158.5(2) ensure that no one is denied chemical dependency treatment services for which
158.6they would otherwise be eligible under section 254A.03, subdivision 3; and
158.7(3) provide the commissioner with timely and pertinent information as negotiated in
158.8agreements governing operation of the navigator pilot projects.
158.9    Subd. 7. Managed care. An individual who is eligible for the navigator pilot
158.10program under subdivision 2a is excluded from mandatory enrollment in managed care
158.11until these services are included in the health plan's benefit set.
158.12    Subd. 8. Authorization for continuation of navigator pilots. The navigator pilot
158.13projects implemented pursuant to subdivision 1 are authorized to continue operation after
158.14July 1, 2013, under existing agreements governing operation of the pilot projects.
158.15EFFECTIVE DATE.The amendments to subdivisions 1 to 6 and 8 are effective
158.16August 1, 2013. Subdivision 7 is effective July 1, 2013.

158.17    Sec. 11. [254B.14] CONTINUUM OF CARE PILOT PROJECTS; CHEMICAL
158.18HEALTH CARE.
158.19    Subdivision 1. Authorization for continuum of care pilot projects. The
158.20commissioner shall establish chemical dependency continuum of care pilot projects to
158.21begin implementing the measures developed with stakeholder input and identified in the
158.22report completed pursuant to Laws 2012, chapter 247, article 5, section 8. The pilot
158.23projects are intended to improve the effectiveness and efficiency of the service continuum
158.24for chemically dependent individuals in Minnesota while reducing duplication of efforts
158.25and promoting scientifically supported practices.
158.26    Subd. 2. Program implementation. (a) The commissioner, in coordination with
158.27representatives of the Minnesota Association of County Social Service Administrators
158.28and the Minnesota Inter-County Association, shall develop a process for identifying and
158.29selecting interested counties and providers for participation in the continuum of care pilot
158.30projects. There will be three pilot projects; one representing the northern region, one for
158.31the metro region, and one for the southern region. The selection process of counties and
158.32providers must include consideration of population size, geographic distribution, cultural
158.33and racial demographics, and provider accessibility. The commissioner shall identify
158.34counties and providers that are selected for participation in the continuum of care pilot
158.35projects no later than September 30, 2013.
159.1(b) The commissioner and entities participating in the continuum of care pilot
159.2projects shall enter into agreements governing the operation of the continuum of care pilot
159.3projects. The agreements shall identify pilot project outcomes and include timelines for
159.4implementation and beginning operation of the pilot projects.
159.5(c) Entities that are currently participating in the navigator pilot project are
159.6eligible to participate in the continuum of care pilot project subsequent to or instead of
159.7participating in the navigator pilot project.
159.8(d) The commissioner may waive administrative rule requirements that are
159.9incompatible with implementation of the continuum of care pilot projects.
159.10(e) Notwithstanding section 254A.19, the commissioner may designate noncounty
159.11entities to complete chemical use assessments and placement authorizations required
159.12under section 254A.19 and Minnesota Rules, parts 9530.6600 to 9530.6655. Section
159.13254A.19, subdivision 3, is applicable to the continuum of care pilot projects at the
159.14discretion of the commissioner.
159.15    Subd. 3. Program design. (a) The operation of the pilot projects shall include:
159.16(1) new services that are responsive to the chronic nature of substance use disorder;
159.17(2) telehealth services, when appropriate to address barriers to services;
159.18(3) services that assure integration with the mental health delivery system when
159.19appropriate;
159.20(4) services that address the needs of diverse populations; and
159.21(5) an assessment and access process that permits clients to present directly to a
159.22service provider for a substance use disorder assessment and authorization of services.
159.23(b) Prior to implementation of the continuum of care pilot projects, a utilization
159.24review process must be developed and agreed to by the commissioner, participating
159.25counties, and providers. The utilization review process shall be described in the
159.26agreements governing operation of the continuum of care pilot projects.
159.27    Subd. 4. Notice of project discontinuation. Each entity's participation in the
159.28continuum of care pilot project may be discontinued for any reason by the county or the
159.29commissioner after 30 days' written notice to the entity.
159.30    Subd. 5. Duties of commissioner. (a) Notwithstanding any other provisions in this
159.31chapter, the commissioner may authorize chemical dependency treatment funds to pay for
159.32nontreatment services arranged by continuum of care pilot projects. Individuals who are
159.33currently accessing Rule 31 treatment services are eligible for concurrent participation in
159.34the continuum of care pilot projects.
160.1(b) County expenditures for continuum of care pilot project services shall not
160.2be greater than their expected share of forecasted expenditures in the absence of the
160.3continuum of care pilot projects.
160.4EFFECTIVE DATE.This section is effective August 1, 2013.

160.5    Sec. 12. [256B.0616] MENTAL HEALTH CERTIFIED FAMILY PEER
160.6SPECIALIST.
160.7    Subdivision 1. Scope. Medical assistance covers mental health certified family peer
160.8specialists services, as established in subdivision 2, subject to federal approval, if provided
160.9to recipients who have an emotional disturbance or severe emotional disturbance under
160.10chapter 245, and are provided by a certified family peer specialist who has completed the
160.11training under subdivision 5. A family peer specialist cannot provide services to the
160.12peer specialist's family.
160.13    Subd. 2. Establishment. The commissioner of human services shall establish a
160.14certified family peer specialists program model which:
160.15(1) provides nonclinical family peer support counseling, building on the strengths
160.16of families and helping them achieve desired outcomes;
160.17(2) collaborates with others providing care or support to the family;
160.18(3) provides nonadversarial advocacy;
160.19(4) promotes the individual family culture in the treatment milieu;
160.20(5) links parents to other parents in the community;
160.21(6) offers support and encouragement;
160.22(7) assists parents in developing coping mechanisms and problem-solving skills;
160.23(8) promotes resiliency, self-advocacy, development of natural supports, and
160.24maintenance of skills learned in other support services;
160.25(9) establishes and provides peer led parent support groups; and
160.26(10) increases the child's ability to function better within the child's home, school,
160.27and community by educating parents on community resources, assisting with problem
160.28solving, and educating parents on mental illnesses.
160.29    Subd. 3. Eligibility. Family peer support services may be located in inpatient
160.30hospitalization, partial hospitalization, residential treatment, treatment foster care, day
160.31treatment, children's therapeutic services and supports, or crisis services.
160.32    Subd. 4. Peer support specialist program providers. The commissioner shall
160.33develop a process to certify family peer support specialist programs, in accordance with
160.34the federal guidelines, in order for the program to bill for reimbursable services. Family
161.1peer support programs must operate within an existing mental health community provider
161.2or center.
161.3    Subd. 5. Certified family peer specialist training and certification. The
161.4commissioner shall develop a training and certification process for certified family peer
161.5specialists who must be at least 21 years of age and have a high school diploma or its
161.6equivalent. The candidates must have raised or are currently raising a child with a mental
161.7illness, have had experience navigating the children's mental health system, and must
161.8demonstrate leadership and advocacy skills and a strong dedication to family-driven and
161.9family-focused services. The training curriculum must teach participating family peer
161.10specialists specific skills relevant to providing peer support to other parents. In addition
161.11to initial training and certification, the commissioner shall develop ongoing continuing
161.12educational workshops on pertinent issues related to family peer support counseling.

161.13    Sec. 13. Minnesota Statutes 2012, section 256B.0623, subdivision 2, is amended to read:
161.14    Subd. 2. Definitions. For purposes of this section, the following terms have the
161.15meanings given them.
161.16(a) "Adult rehabilitative mental health services" means mental health services
161.17which are rehabilitative and enable the recipient to develop and enhance psychiatric
161.18stability, social competencies, personal and emotional adjustment, and independent living,
161.19parenting skills, and community skills, when these abilities are impaired by the symptoms
161.20of mental illness. Adult rehabilitative mental health services are also appropriate when
161.21provided to enable a recipient to retain stability and functioning, if the recipient would
161.22be at risk of significant functional decompensation or more restrictive service settings
161.23without these services.
161.24(1) Adult rehabilitative mental health services instruct, assist, and support the
161.25recipient in areas such as: interpersonal communication skills, community resource
161.26utilization and integration skills, crisis assistance, relapse prevention skills, health care
161.27directives, budgeting and shopping skills, healthy lifestyle skills and practices, cooking
161.28and nutrition skills, transportation skills, medication education and monitoring, mental
161.29illness symptom management skills, household management skills, employment-related
161.30skills, parenting skills, and transition to community living services.
161.31(2) These services shall be provided to the recipient on a one-to-one basis in the
161.32recipient's home or another community setting or in groups.
161.33(b) "Medication education services" means services provided individually or in
161.34groups which focus on educating the recipient about mental illness and symptoms; the role
161.35and effects of medications in treating symptoms of mental illness; and the side effects of
162.1medications. Medication education is coordinated with medication management services
162.2and does not duplicate it. Medication education services are provided by physicians,
162.3pharmacists, physician's assistants, or registered nurses.
162.4(c) "Transition to community living services" means services which maintain
162.5continuity of contact between the rehabilitation services provider and the recipient and
162.6which facilitate discharge from a hospital, residential treatment program under Minnesota
162.7Rules, chapter 9505, board and lodging facility, or nursing home. Transition to community
162.8living services are not intended to provide other areas of adult rehabilitative mental health
162.9services.

162.10    Sec. 14. Minnesota Statutes 2012, section 256B.0625, subdivision 48, is amended to
162.11read:
162.12    Subd. 48. Psychiatric consultation to primary care practitioners. Effective
162.13January 1, 2006, Medical assistance covers consultation provided by a psychiatrist,
162.14psychologist, or an advanced practice registered nurse certified in psychiatric mental
162.15health via telephone, e-mail, facsimile, or other means of communication to primary care
162.16practitioners, including pediatricians. The need for consultation and the receipt of the
162.17consultation must be documented in the patient record maintained by the primary care
162.18practitioner. If the patient consents, and subject to federal limitations and data privacy
162.19provisions, the consultation may be provided without the patient present.

162.20    Sec. 15. Minnesota Statutes 2012, section 256B.0625, subdivision 56, is amended to
162.21read:
162.22    Subd. 56. Medical service coordination. (a)(1) Medical assistance covers in-reach
162.23community-based service coordination that is performed through a hospital emergency
162.24department as an eligible procedure under a state healthcare program for a frequent user.
162.25A frequent user is defined as an individual who has frequented the hospital emergency
162.26department for services three or more times in the previous four consecutive months.
162.27In-reach community-based service coordination includes navigating services to address a
162.28client's mental health, chemical health, social, economic, and housing needs, or any other
162.29activity targeted at reducing the incidence of emergency room and other nonmedically
162.30necessary health care utilization.
162.31(2) Medical assistance covers in-reach community-based service coordination that
162.32is performed through a hospital emergency department or inpatient psychiatric unit
162.33for a child or young adult up to age 21 with a serious emotional disturbance who has
162.34frequented the hospital emergency room two or more times in the previous consecutive
163.1three months or been admitted to an inpatient psychiatric unit two or more times in the
163.2previous consecutive four months, or is being discharged to a shelter.
163.3    (b) Reimbursement must be made in 15-minute increments and allowed for up to 60
163.4days posthospital discharge based upon the specific identified emergency department visit
163.5or inpatient admitting event. In-reach community-based service coordination shall seek to
163.6connect frequent users with existing covered services available to them, including, but not
163.7limited to, targeted case management, waiver case management, or care coordination in a
163.8health care home. For children and young adults with a serious emotional disturbance,
163.9in-reach community-based service coordination includes navigating and arranging for
163.10community-based services prior to discharge to address a client's mental health, chemical
163.11health, social, educational, family support and housing needs, or any other activity targeted
163.12at reducing multiple incidents of emergency room use, inpatient readmissions, and other
163.13nonmedically necessary health care utilization. In-reach services shall seek to connect
163.14them with existing covered services, including targeted case management, waiver case
163.15management, care coordination in a health care home, children's therapeutic services and
163.16supports, crisis services, and respite care. Eligible in-reach service coordinators must hold
163.17a minimum of a bachelor's degree in social work, public health, corrections, or a related
163.18field. The commissioner shall submit any necessary application for waivers to the Centers
163.19for Medicare and Medicaid Services to implement this subdivision.
163.20    (c)(1) For the purposes of this subdivision, "in-reach community-based service
163.21coordination" means the practice of a community-based worker with training, knowledge,
163.22skills, and ability to access a continuum of services, including housing, transportation,
163.23chemical and mental health treatment, employment, education, and peer support services,
163.24by working with an organization's staff to transition an individual back into the individual's
163.25living environment. In-reach community-based service coordination includes working
163.26with the individual during their discharge and for up to a defined amount of time in the
163.27individual's living environment, reducing the individual's need for readmittance.
163.28    (2) Hospitals utilizing in-reach service coordinators shall report annually to the
163.29commissioner on the number of adults, children, and adolescents served; the postdischarge
163.30services which they accessed; and emergency department/psychiatric hospitalization
163.31readmissions. The commissioner shall ensure that services and payments provided under
163.32in-reach care coordination do not duplicate services or payments provided under section
163.33256B.0753, 256B.0755, or 256B.0625, subdivision 20.

163.34    Sec. 16. Minnesota Statutes 2012, section 256B.0625, is amended by adding a
163.35subdivision to read:
164.1    Subd. 61. Family psychoeducation services. Effective July 1, 2013, or upon
164.2federal approval, whichever is later, medical assistance covers family psychoeducation
164.3services provided to a child up to age 21 with a diagnosed mental health condition when
164.4identified in the child's individual treatment plan and provided by a licensed mental health
164.5professional, as defined in Minnesota Rules, part 9505.0371, subpart 5, item A, or a
164.6clinical trainee, as defined in Minnesota Rules, part 9505.0371, subpart 5, item C, who
164.7has determined it medically necessary to involve family members in the child's care. For
164.8the purposes of this subdivision, "family psychoeducation services" means information
164.9or demonstration provided to an individual or family as part of an individual, family,
164.10multifamily group, or peer group session to explain, educate, and support the child and
164.11family in understanding a child's symptoms of mental illness, the impact on the child's
164.12development, and needed components of treatment and skill development so that the
164.13individual, family, or group can help the child to prevent relapse, prevent the acquisition
164.14of comorbid disorders, and to achieve optimal mental health and long-term resilience.

164.15    Sec. 17. Minnesota Statutes 2012, section 256B.0625, is amended by adding a
164.16subdivision to read:
164.17    Subd. 62. Mental health clinical care consultation. Effective July 1, 2013, or upon
164.18federal approval, whichever is later, medical assistance covers clinical care consultation
164.19for a person up to age 21 who is diagnosed with a complex mental health condition or a
164.20mental health condition that co-occurs with other complex and chronic conditions, when
164.21described in the person's individual treatment plan and provided by a licensed mental
164.22health professional, as defined in Minnesota Rules, part 9505.0371, subpart 5, item A, or a
164.23clinical trainee, as defined in Minnesota Rules, part 9505.0371, subpart 5, item C. For the
164.24purposes of this subdivision, "clinical care consultation" means communication from a
164.25treating mental health professional to other providers or educators not under the clinical
164.26supervision of the treating mental health professional who are working with the same client
164.27to inform, inquire, and instruct regarding the client's symptoms; strategies for effective
164.28engagement, care, and intervention needs; treatment expectations across service settings;
164.29and to direct and coordinate clinical service components provided to the client and family.

164.30    Sec. 18. Minnesota Statutes 2012, section 256B.0943, subdivision 1, is amended to read:
164.31    Subdivision 1. Definitions. For purposes of this section, the following terms have
164.32the meanings given them.
164.33(a) "Children's therapeutic services and supports" means the flexible package of
164.34mental health services for children who require varying therapeutic and rehabilitative
165.1levels of intervention. The services are time-limited interventions that are delivered using
165.2various treatment modalities and combinations of services designed to reach treatment
165.3outcomes identified in the individual treatment plan.
165.4(b) "Clinical supervision" means the overall responsibility of the mental health
165.5professional for the control and direction of individualized treatment planning, service
165.6delivery, and treatment review for each client. A mental health professional who is an
165.7enrolled Minnesota health care program provider accepts full professional responsibility
165.8for a supervisee's actions and decisions, instructs the supervisee in the supervisee's work,
165.9and oversees or directs the supervisee's work.
165.10(c) "County board" means the county board of commissioners or board established
165.11under sections 402.01 to 402.10 or 471.59.
165.12(d) "Crisis assistance" has the meaning given in section 245.4871, subdivision 9a.
165.13(e) "Culturally competent provider" means a provider who understands and can
165.14utilize to a client's benefit the client's culture when providing services to the client. A
165.15provider may be culturally competent because the provider is of the same cultural or
165.16ethnic group as the client or the provider has developed the knowledge and skills through
165.17training and experience to provide services to culturally diverse clients.
165.18(f) "Day treatment program" for children means a site-based structured program
165.19consisting of group psychotherapy for more than three individuals and other intensive
165.20therapeutic services provided by a multidisciplinary team, under the clinical supervision
165.21of a mental health professional.
165.22(g) "Diagnostic assessment" has the meaning given in section 245.4871, subdivision
165.2311
.
165.24(h) "Direct service time" means the time that a mental health professional, mental
165.25health practitioner, or mental health behavioral aide spends face-to-face with a client
165.26and the client's family. Direct service time includes time in which the provider obtains
165.27a client's history or provides service components of children's therapeutic services and
165.28supports. Direct service time does not include time doing work before and after providing
165.29direct services, including scheduling, maintaining clinical records, consulting with others
165.30about the client's mental health status, preparing reports, receiving clinical supervision,
165.31and revising the client's individual treatment plan.
165.32(i) "Direction of mental health behavioral aide" means the activities of a mental
165.33health professional or mental health practitioner in guiding the mental health behavioral
165.34aide in providing services to a client. The direction of a mental health behavioral aide
165.35must be based on the client's individualized treatment plan and meet the requirements in
165.36subdivision 6, paragraph (b), clause (5).
166.1(j) "Emotional disturbance" has the meaning given in section 245.4871, subdivision
166.215
. For persons at least age 18 but under age 21, mental illness has the meaning given in
166.3section 245.462, subdivision 20, paragraph (a).
166.4(k) "Individual behavioral plan" means a plan of intervention, treatment, and
166.5services for a child written by a mental health professional or mental health practitioner,
166.6under the clinical supervision of a mental health professional, to guide the work of the
166.7mental health behavioral aide.
166.8(l) "Individual treatment plan" has the meaning given in section 245.4871,
166.9subdivision 21
.
166.10(m) "Mental health behavioral aide services" means medically necessary one-on-one
166.11activities performed by a trained paraprofessional to assist a child retain or generalize
166.12psychosocial skills as taught by a mental health professional or mental health practitioner
166.13and as described in the child's individual treatment plan and individual behavior plan.
166.14Activities involve working directly with the child or child's family as provided in
166.15subdivision 9, paragraph (b), clause (4).
166.16(n) "Mental health professional" means an individual as defined in section 245.4871,
166.17subdivision 27
, clauses (1) to (6), or tribal vendor as defined in section 256B.02,
166.18subdivision 7
, paragraph (b).
166.19    (o) "Mental health service plan development" includes:
166.20    (1) the development, review, and revision of a child's individual treatment plan,
166.21as provided in Minnesota Rules, part 9505.0371, subpart 7, including involvement of
166.22the client or client's parents, primary caregiver, or other person authorized to consent to
166.23mental health services for the client, and including arrangement of treatment and support
166.24activities specified in the individual treatment plan; and
166.25    (2) administering standardized outcome measurement instruments, determined
166.26and updated by the commissioner, as periodically needed to evaluate the effectiveness
166.27of treatment for children receiving clinical services and reporting outcome measures,
166.28as required by the commissioner.
166.29(o) (p) "Preschool program" means a day program licensed under Minnesota Rules,
166.30parts 9503.0005 to 9503.0175, and enrolled as a children's therapeutic services and
166.31supports provider to provide a structured treatment program to a child who is at least 33
166.32months old but who has not yet attended the first day of kindergarten.
166.33(p) (q) "Skills training" means individual, family, or group training, delivered
166.34by or under the direction of a mental health professional, designed to facilitate the
166.35acquisition of psychosocial skills that are medically necessary to rehabilitate the child
166.36to an age-appropriate developmental trajectory heretofore disrupted by a psychiatric
167.1illness or to self-monitor, compensate for, cope with, counteract, or replace skills deficits
167.2or maladaptive skills acquired over the course of a psychiatric illness. Skills training
167.3is subject to the following requirements:
167.4(1) a mental health professional or a mental health practitioner must provide skills
167.5training;
167.6(2) the child must always be present during skills training; however, a brief absence
167.7of the child for no more than ten percent of the session unit may be allowed to redirect or
167.8instruct family members;
167.9(3) skills training delivered to children or their families must be targeted to the
167.10specific deficits or maladaptations of the child's mental health disorder and must be
167.11prescribed in the child's individual treatment plan;
167.12(4) skills training delivered to the child's family must teach skills needed by parents
167.13to enhance the child's skill development and to help the child use in daily life the skills
167.14previously taught by a mental health professional or mental health practitioner and to
167.15develop or maintain a home environment that supports the child's progressive use skills;
167.16(5) group skills training may be provided to multiple recipients who, because of the
167.17nature of their emotional, behavioral, or social dysfunction, can derive mutual benefit from
167.18interaction in a group setting, which must be staffed as follows:
167.19(i) one mental health professional or one mental health practitioner under supervision
167.20of a licensed mental health professional must work with a group of four to eight clients; or
167.21(ii) two mental health professionals or two mental health practitioners under
167.22supervision of a licensed mental health professional, or one professional plus one
167.23practitioner must work with a group of nine to 12 clients.

167.24    Sec. 19. Minnesota Statutes 2012, section 256B.0943, subdivision 2, is amended to read:
167.25    Subd. 2. Covered service components of children's therapeutic services and
167.26supports. (a) Subject to federal approval, medical assistance covers medically necessary
167.27children's therapeutic services and supports as defined in this section that an eligible
167.28provider entity certified under subdivision 4 provides to a client eligible under subdivision
167.293.
167.30(b) The service components of children's therapeutic services and supports are:
167.31(1) individual, family, and group psychotherapy;
167.32(2) individual, family, or group skills training provided by a mental health
167.33professional or mental health practitioner;
167.34(3) crisis assistance;
167.35(4) mental health behavioral aide services; and
168.1(5) direction of a mental health behavioral aide.;
168.2(6) mental health service plan development;
168.3(7) clinical care consultation provided by a mental health professional under section
168.4256B.0625, subdivision 62;
168.5(8) family psychoeducation under section 256B.0625, subdivision 61; and
168.6(9) services provided by a family peer specialist under section 256B.0616.
168.7(c) Service components in paragraph (b) may be combined to constitute therapeutic
168.8programs, including day treatment programs and therapeutic preschool programs.

168.9    Sec. 20. Minnesota Statutes 2012, section 256B.0943, subdivision 7, is amended to read:
168.10    Subd. 7. Qualifications of individual and team providers. (a) An individual
168.11or team provider working within the scope of the provider's practice or qualifications
168.12may provide service components of children's therapeutic services and supports that are
168.13identified as medically necessary in a client's individual treatment plan.
168.14(b) An individual provider must be qualified as:
168.15(1) a mental health professional as defined in subdivision 1, paragraph (n); or
168.16(2) a mental health practitioner as defined in section 245.4871, subdivision 26. The
168.17mental health practitioner must work under the clinical supervision of a mental health
168.18professional; or
168.19(3) a mental health behavioral aide working under the clinical supervision of a
168.20mental health professional to implement the rehabilitative mental health services identified
168.21in the client's individual treatment plan and individual behavior plan.
168.22(A) A level I mental health behavioral aide must:
168.23(i) be at least 18 years old;
168.24(ii) have a high school diploma or general equivalency diploma (GED) or two years
168.25of experience as a primary caregiver to a child with severe emotional disturbance within
168.26the previous ten years; and
168.27(iii) meet preservice and continuing education requirements under subdivision 8.
168.28(B) A level II mental health behavioral aide must:
168.29(i) be at least 18 years old;
168.30(ii) have an associate or bachelor's degree or 4,000 hours of experience in delivering
168.31clinical services in the treatment of mental illness concerning children or adolescents or
168.32complete a certificate program established under subdivision 8a; and
168.33(iii) meet preservice and continuing education requirements in subdivision 8.
169.1(c) A preschool program multidisciplinary team must include at least one mental
169.2health professional and one or more of the following individuals under the clinical
169.3supervision of a mental health professional:
169.4(i) a mental health practitioner; or
169.5(ii) a program person, including a teacher, assistant teacher, or aide, who meets the
169.6qualifications and training standards of a level I mental health behavioral aide.
169.7(d) A day treatment multidisciplinary team must include at least one mental health
169.8professional and one mental health practitioner.

169.9    Sec. 21. Minnesota Statutes 2012, section 256B.0943, is amended by adding a
169.10subdivision to read:
169.11    Subd. 8a. Level II mental health behavioral aide. The commissioner of human
169.12services, in collaboration with the Board of Trustees of the Minnesota State Colleges and
169.13Universities, shall develop a certificate program of not fewer than 11 credits for level II
169.14mental health behavioral aides. The program shall include classroom and field-based
169.15learning. The program components must include, but not be limited to, mental illnesses
169.16in children, parent and family perspectives, skill training, documentation and reporting,
169.17communication skills, and cultural competence.

169.18    Sec. 22. Minnesota Statutes 2012, section 256B.0946, is amended to read:
169.19256B.0946 INTENSIVE TREATMENT IN FOSTER CARE.
169.20    Subdivision 1. Required covered service components. (a) Effective July 1, 2006,
169.21 upon enactment and subject to federal approval, medical assistance covers medically
169.22necessary intensive treatment services described under paragraph (b) that are provided
169.23by a provider entity eligible under subdivision 3 to a client eligible under subdivision 2
169.24who is placed in a treatment foster home licensed under Minnesota Rules, parts 2960.3000
169.25to 2960.3340.
169.26(b) Intensive treatment services to children with severe emotional disturbance mental
169.27illness residing in treatment foster care family settings must meet the relevant standards
169.28for mental health services under sections 245.487 to 245.4889. In addition, that comprise
169.29 specific required service components provided in clauses (1) to (5), are reimbursed by
169.30medical assistance must when they meet the following standards:
169.31(1) case management service component must meet the standards in Minnesota
169.32Rules, parts 9520.0900 to 9520.0926 and 9505.0322, excluding subparts 6 and 10;
170.1(1) psychotherapy provided by a mental health professional as defined in Minnesota
170.2Rules, part 9505.0371, subpart 5, item A, or a clinical trainee, as defined in Minnesota
170.3Rules, part 9505.0371, subpart 5, item C;
170.4(2) psychotherapy, crisis assistance, and skills training components must meet the
170.5 provided according to standards for children's therapeutic services and supports in section
170.6256B.0943 ; and
170.7(3) individual family, and group psychoeducation services under supervision of,
170.8defined in subdivision 1a, paragraph (q), provided by a mental health professional. or a
170.9clinical trainee;
170.10(4) clinical care consultation, as defined in subdivision 1a, and provided by a mental
170.11health professional or a clinical trainee; and
170.12(5) service delivery payment requirements as provided under subdivision 4.
170.13    Subd. 1a. Definitions. For the purposes of this section, the following terms have
170.14the meanings given them.
170.15(a) "Clinical care consultation" means communication from a treating clinician to
170.16other providers working with the same client to inform, inquire, and instruct regarding
170.17the client's symptoms, strategies for effective engagement, care and intervention needs,
170.18and treatment expectations across service settings, including but not limited to the client's
170.19school, social services, day care, probation, home, primary care, medication prescribers,
170.20disabilities services, and other mental health providers and to direct and coordinate clinical
170.21service components provided to the client and family.
170.22(b) "Clinical supervision" means the documented time a clinical supervisor and
170.23supervisee spend together to discuss the supervisee's work, to review individual client
170.24cases, and for the supervisee's professional development. It includes the documented
170.25oversight and supervision responsibility for planning, implementation, and evaluation of
170.26services for a client's mental health treatment.
170.27(c) "Clinical supervisor" means the mental health professional who is responsible
170.28for clinical supervision.
170.29(d) "Clinical trainee" has the meaning given in Minnesota Rules, part 9505.0371,
170.30subpart 5, item C;
170.31(e) "Crisis assistance" has the meaning given in section 245.4871, subdivision 9a,
170.32including the development of a plan that addresses prevention and intervention strategies
170.33to be used in a potential crisis, but does not include actual crisis intervention.
170.34(f) "Culturally appropriate" means providing mental health services in a manner that
170.35incorporates the child's cultural influences, as defined in Minnesota Rules, part 9505.0370,
171.1subpart 9, into interventions as a way to maximize resiliency factors and utilize cultural
171.2strengths and resources to promote overall wellness.
171.3(g) "Culture" means the distinct ways of living and understanding the world that
171.4are used by a group of people and are transmitted from one generation to another or
171.5adopted by an individual.
171.6(h) "Diagnostic assessment" has the meaning given in Minnesota Rules, part
171.79505.0370, subpart 11.
171.8(i) "Family" means a person who is identified by the client or the client's parent or
171.9guardian as being important to the client's mental health treatment. Family may include,
171.10but is not limited to, parents, foster parents, children, spouse, committed partners, former
171.11spouses, persons related by blood or adoption, persons who are a part of the client's
171.12permanency plan, or persons who are presently residing together as a family unit.
171.13(j) "Foster care" has the meaning given in section 260C.007, subdivision 18.
171.14(k) "Foster family setting" means the foster home in which the license holder resides.
171.15(l) "Individual treatment plan" has the meaning given in Minnesota Rules, part
171.169505.0370, subpart 15.
171.17(m) "Mental health practitioner" has the meaning given in Minnesota Rules, part
171.189505.0370, subpart 17.
171.19(n) "Mental health professional" has the meaning given in Minnesota Rules, part
171.209505.0370, subpart 18.
171.21(o) "Mental illness" has the meaning given in Minnesota Rules, part 9505.0370,
171.22subpart 20.
171.23(p) "Parent" has the meaning given in section 260C.007, subdivision 25.
171.24(q) "Psychoeducation services" means information or demonstration provided to
171.25an individual, family, or group to explain, educate, and support the individual, family, or
171.26group in understanding a child's symptoms of mental illness, the impact on the child's
171.27development, and needed components of treatment and skill development so that the
171.28individual, family, or group can help the child to prevent relapse, prevent the acquisition
171.29of comorbid disorders, and to achieve optimal mental health and long-term resilience.
171.30(r) "Psychotherapy" has the meaning given in Minnesota Rules, part 9505.0370,
171.31subpart 27.
171.32(s) "Team consultation and treatment planning" means the coordination of treatment
171.33plans and consultation among providers in a group concerning the treatment needs of the
171.34child, including disseminating the child's treatment service schedule to all members of the
171.35service team. Team members must include all mental health professionals working with
171.36the child, a parent, the child unless the team lead or parent deem it clinically inappropriate,
172.1and at least two of the following: an individualized education program case manager;
172.2probation agent; children's mental health case manager; child welfare worker, including
172.3adoption or guardianship worker; primary care provider; foster parent; and any other
172.4member of the child's service team.
172.5    Subd. 2. Determination of client eligibility. A client's eligibility to receive
172.6treatment foster care under this section shall be determined by An eligible recipient is an
172.7individual, from birth through age 20, who is currently placed in a foster home licensed
172.8under Minnesota Rules, parts 2960.3000 to 2960.3340, and has received a diagnostic
172.9assessment, and an evaluation of level of care needed, and development of an individual
172.10treatment plan, as defined in paragraphs (a) to (c) and (b).
172.11(a) The diagnostic assessment must:
172.12(1) meet criteria described in Minnesota Rules, part 9505.0372, subpart 1, and be
172.13conducted by a psychiatrist, licensed psychologist, or licensed independent clinical social
172.14worker that is mental health professional or a clinical trainee;
172.15(2) determine whether or not a child meets the criteria for mental illness, as defined
172.16in Minnesota Rules, part 9505.0370, subpart 20;
172.17(3) document that intensive treatment services are medically necessary within a
172.18foster family setting to ameliorate identified symptoms and functional impairments;
172.19(4) be performed within 180 days prior to before the start of service; and
172.20(2) include current diagnoses on all five axes of the client's current mental health
172.21status;
172.22(3) determine whether or not a child meets the criteria for severe emotional
172.23disturbance in section 245.4871, subdivision 6, or for serious and persistent mental illness
172.24in section 245.462, subdivision 20; and
172.25(4) be completed annually until age 18. For individuals between age 18 and 21,
172.26unless a client's mental health condition has changed markedly since the client's most
172.27recent diagnostic assessment, annual updating is necessary. For the purpose of this section,
172.28"updating" means a written summary, including current diagnoses on all five axes, by a
172.29mental health professional of the client's current mental status and service needs.
172.30(5) be completed as either a standard or extended diagnostic assessment annually to
172.31determine continued eligibility for the service.
172.32(b) The evaluation of level of care must be conducted by the placing county with
172.33an instrument, tribe, or case manager in conjunction with the diagnostic assessment as
172.34described by Minnesota Rules, part 9505.0372, subpart 1, item B, using a validated tool
172.35 approved by the commissioner of human services and not subject to the rulemaking
172.36process, consistent with section 245.4885, subdivision 1, paragraph (d), the result of which
173.1evaluation demonstrates that the child requires intensive intervention without 24-hour
173.2medical monitoring. The commissioner shall update the list of approved level of care
173.3instruments tools annually and publish on the department's Web site.
173.4(c) The individual treatment plan must be:
173.5(1) based on the information in the client's diagnostic assessment;
173.6(2) developed through a child-centered, family driven planning process that identifies
173.7service needs and individualized, planned, and culturally appropriate interventions that
173.8contain specific measurable treatment goals and objectives for the client and treatment
173.9strategies for the client's family and foster family;
173.10(3) reviewed at least once every 90 days and revised; and
173.11(4) signed by the client or, if appropriate, by the client's parent or other person
173.12authorized by statute to consent to mental health services for the client.
173.13    Subd. 3. Eligible mental health services providers. (a) Eligible providers for
173.14intensive children's mental health services in a foster family setting must be certified
173.15by the state and have a service provision contract with a county board or a reservation
173.16tribal council and must be able to demonstrate the ability to provide all of the services
173.17required in this section.
173.18(b) For purposes of this section, a provider agency must have an individual
173.19placement agreement for each recipient and must be a licensed child placing agency, under
173.20Minnesota Rules, parts 9543.0010 to 9543.0150, and either be:
173.21(1) a county county-operated entity certified by the state;
173.22(2) an Indian Health Services facility operated by a tribe or tribal organization under
173.23funding authorized by United States Code, title 25, sections 450f to 450n, or title 3 of the
173.24Indian Self-Determination Act, Public Law 93-638, section 638 (facilities or providers); or
173.25(3) a noncounty entity under contract with a county board.
173.26(c) Certified providers that do not meet the service delivery standards required in
173.27this section shall be subject to a decertification process.
173.28(d) For the purposes of this section, all services delivered to a client must be
173.29provided by a mental health professional or a clinical trainee.
173.30    Subd. 4. Eligible provider responsibilities Service delivery payment
173.31requirements. (a) To be an eligible provider for payment under this section, a provider
173.32must develop and practice written policies and procedures for treatment foster care services
173.33 intensive treatment in foster care, consistent with subdivision 1, paragraph (b), clauses (1),
173.34(2), and (3) and comply with the following requirements in paragraphs (b) to (n).
173.35(b) In delivering services under this section, a treatment foster care provider must
173.36ensure that staff caseload size reasonably enables the provider to play an active role in
174.1service planning, monitoring, delivering, and reviewing for discharge planning to meet
174.2the needs of the client, the client's foster family, and the birth family, as specified in each
174.3client's individual treatment plan.
174.4(b) A qualified clinical supervisor, as defined in and performing in compliance with
174.5Minnesota Rules, part 9505.0371, subpart 5, item D, must supervise the treatment and
174.6provision of services described in this section.
174.7(c) Each client receiving treatment services must receive an extended diagnostic
174.8assessment, as described in Minnesota Rules, part 9505.0372, subpart 1, item C, within
174.930 days of enrollment in this service unless the client has a previous extended diagnostic
174.10assessment that the client, parent, and mental health professional agree still accurately
174.11describes the client's current mental health functioning.
174.12(d) Each previous and current mental health, school, and physical health treatment
174.13provider must be contacted to request documentation of treatment and assessments that the
174.14eligible client has received and this information must be reviewed and incorporated into
174.15the diagnostic assessment and team consultation and treatment planning review process.
174.16(e) Each client receiving treatment must be assessed for a trauma history and
174.17the client's treatment plan must document how the results of the assessment will be
174.18incorporated into treatment.
174.19(f) Each client receiving treatment services must have an individual treatment plan
174.20that is reviewed, evaluated, and signed every 90 days using the team consultation and
174.21treatment planning process, as defined in subdivision 1a, paragraph (s).
174.22(g) Care consultation, as defined in subdivision 1a, paragraph (a), must be provided
174.23in accordance with the client's individual treatment plan.
174.24(h) Each client must have a crisis assistance plan within ten days of initiating
174.25services and must have access to clinical phone support 24 hours per day, seven days per
174.26week, during the course of treatment, and the crisis plan must demonstrate coordination
174.27with the local or regional mobile crisis intervention team.
174.28(i) Services must be delivered and documented at least three days per week, equaling
174.29at least six hours of treatment per week, unless reduced units of service are specified on
174.30the treatment plan as part of transition or on a discharge plan to another service or level of
174.31care. Documentation must comply with Minnesota Rules, parts 9505.2175 and 9505.2197.
174.32(j) Location of service delivery must be in the client's home, day care setting,
174.33school, or other community-based setting that is specified on the client's individualized
174.34treatment plan.
174.35(k) Treatment must be developmentally and culturally appropriate for the client.
175.1(l) Services must be delivered in continual collaboration and consultation with the
175.2client's medical providers and, in particular, with prescribers of psychotropic medications,
175.3including those prescribed on an off-label basis, and members of the service team must be
175.4aware of the medication regimen and potential side effects.
175.5(m) Parents, siblings, foster parents, and members of the child's permanency plan
175.6must be involved in treatment and service delivery unless otherwise noted in the treatment
175.7plan.
175.8(n) Transition planning for the child must be conducted starting with the first
175.9treatment plan and must be addressed throughout treatment to support the child's
175.10permanency plan and postdischarge mental health service needs.
175.11    Subd. 5. Service authorization. The commissioner will administer authorizations
175.12for services under this section in compliance with section 256B.0625, subdivision 25.
175.13    Subd. 6. Excluded services. (a) Services in clauses (1) to (4) (7) are not covered
175.14under this section and are not eligible for medical assistance payment as components of
175.15intensive treatment in foster care services, but may be billed separately:
175.16(1) treatment foster care services provided in violation of medical assistance policy
175.17in Minnesota Rules, part 9505.0220;
175.18(2) service components of children's therapeutic services and supports
175.19simultaneously provided by more than one treatment foster care provider;
175.20(3) home and community-based waiver services; and
175.21(4) treatment foster care services provided to a child without a level of care
175.22determination according to section 245.4885, subdivision 1.
175.23(1) inpatient psychiatric hospital treatment;
175.24(2) mental health targeted case management;
175.25(3) partial hospitalization;
175.26(4) medication management;
175.27(5) children's mental health day treatment services;
175.28(6) crisis response services under section 256B.0944; and
175.29(7) transportation.
175.30(b) Children receiving intensive treatment in foster care services are not eligible for
175.31medical assistance reimbursement for the following services while receiving intensive
175.32treatment in foster care:
175.33(1) mental health case management services under section 256B.0625, subdivision
175.3420
; and
175.35(2) (1) psychotherapy and skill skills training components of children's therapeutic
175.36services and supports under section 256B.0625, subdivision 35b.;
176.1(2) mental health behavioral aide services as defined in section 256B.0943,
176.2subdivision 1, paragraph (m);
176.3(3) home and community-based waiver services;
176.4(4) mental health residential treatment; and
176.5(5) room and board costs as defined in section 256I.03, subdivision 6.
176.6    Subd. 7. Medical assistance payment and rate setting. The commissioner shall
176.7establish a single daily per-client encounter rate for intensive treatment in foster care
176.8services. The rate must be constructed to cover only eligible services delivered to an
176.9eligible recipient by an eligible provider, as prescribed in subdivision 1, paragraph (b).

176.10    Sec. 23. Minnesota Statutes 2012, section 256B.761, is amended to read:
176.11256B.761 REIMBURSEMENT FOR MENTAL HEALTH SERVICES.
176.12(a) Effective for services rendered on or after July 1, 2001, payment for medication
176.13management provided to psychiatric patients, outpatient mental health services, day
176.14treatment services, home-based mental health services, and family community support
176.15services shall be paid at the lower of (1) submitted charges, or (2) 75.6 percent of the
176.1650th percentile of 1999 charges.
176.17(b) Effective July 1, 2001, the medical assistance rates for outpatient mental health
176.18services provided by an entity that operates: (1) a Medicare-certified comprehensive
176.19outpatient rehabilitation facility; and (2) a facility that was certified prior to January 1,
176.201993, with at least 33 percent of the clients receiving rehabilitation services in the most
176.21recent calendar year who are medical assistance recipients, will be increased by 38 percent,
176.22when those services are provided within the comprehensive outpatient rehabilitation
176.23facility and provided to residents of nursing facilities owned by the entity.
176.24(c) The commissioner shall establish three levels of payment for mental health
176.25diagnostic assessment, based on three levels of complexity. The aggregate payment under
176.26the tiered rates must not exceed the projected aggregate payments for mental health
176.27diagnostic assessment under the previous single rate. The new rate structure is effective
176.28January 1, 2011, or upon federal approval, whichever is later.
176.29(d) In addition to rate increases otherwise provided, the commissioner may
176.30restructure coverage policy and rates to improve access to adult rehabilitative mental
176.31health services under section 256B.0623 and related mental health support services under
176.32section 256B.021, subdivision 4, paragraph (f), clause (2). For state fiscal years 2015 and
176.332016, the projected state share of increased costs due to this paragraph is transferred
176.34from adult mental health grants under sections 245.4661 and 256E.12. The transfer for
176.35fiscal year 2016 is a permanent base adjustment for subsequent fiscal years. Payments
177.1made to managed care plans and county-based purchasing plans under sections 256B.69,
177.2256B.692, and 256L.12 shall reflect the rate changes described in this paragraph.

177.3    Sec. 24. Minnesota Statutes 2012, section 256I.05, subdivision 1e, is amended to read:
177.4    Subd. 1e. Supplementary rate for certain facilities. (a) Notwithstanding the
177.5provisions of subdivisions 1a and 1c, beginning July 1, 2005, a county agency shall
177.6negotiate a supplementary rate in addition to the rate specified in subdivision 1, not to
177.7exceed $700 per month, including any legislatively authorized inflationary adjustments,
177.8for a group residential housing provider that:
177.9(1) is located in Hennepin County and has had a group residential housing contract
177.10with the county since June 1996;
177.11(2) operates in three separate locations a 75-bed facility, a 50-bed facility, and a
177.1226-bed facility; and
177.13(3) serves a chemically dependent clientele, providing 24 hours per day supervision
177.14and limiting a resident's maximum length of stay to 13 months out of a consecutive
177.1524-month period.
177.16(b) Notwithstanding subdivisions 1a and 1c, a county agency shall negotiate a
177.17supplementary rate in addition to the rate specified in subdivision 1, not to exceed $700
177.18per month, including any legislatively authorized inflationary adjustments, of a group
177.19residential provider that:
177.20(1) is located in St. Louis County and has had a group residential housing contract
177.21with the county since 2006;
177.22(2) operates a 62-bed facility; and
177.23(3) serves a chemically dependent adult male clientele, providing 24 hours per
177.24day supervision and limiting a resident's maximum length of stay to 13 months out of
177.25a consecutive 24-month period.
177.26(c) Notwithstanding subdivisions 1a and 1c, beginning July 1, 2013, a county agency
177.27shall negotiate a supplementary rate in addition to the rate specified in subdivision 1, not
177.28to exceed $700 per month, including any legislatively authorized inflationary adjustments,
177.29for the group residential provider described under paragraphs (a) and (b), not to exceed
177.30an additional 115 beds.

177.31    Sec. 25. CHILD AND ADOLESCENT BEHAVIORAL HEALTH SERVICES.
177.32The commissioner of human services shall, in consultation with children's mental
177.33health community providers, hospitals providing care to children, children's mental health
177.34advocates, and other interested parties, develop recommendations and legislation, if
178.1necessary, for the state-operated child and adolescent behavioral health services facility
178.2to ensure that:
178.3(1) the facility and the services provided meet the needs of children with serious
178.4emotional disturbances, autism spectrum disorders, reactive attachment disorder, PTSD,
178.5serious emotional disturbance co-occurring with a developmental disability, borderline
178.6personality disorder, schizophrenia, fetal alcohol spectrum disorders, brain injuries,
178.7violent tendencies, and complex medical issues;
178.8(2) qualified personnel and staff can be recruited who have specific expertise and
178.9training to treat the children in the facility; and
178.10(3) the treatment provided at the facility is high-quality, effective treatment.

178.11    Sec. 26. PILOT PROVIDER INPUT SURVEY OF PEDIATRIC SERVICES AND
178.12CHILDREN'S MENTAL HEALTH SERVICES.
178.13(a) To assess the efficiency and other operational issues in the management of the
178.14health care delivery system, the commissioner of human services shall initiate a provider
178.15survey. The pilot survey shall consist of an electronic survey of providers of pediatric
178.16home health care services and children's mental health services to identify and measure
178.17issues that arise in dealing with the management of medical assistance. To the maximum
178.18degree possible, existing technology shall be used and interns sought to analyze the results.
178.19(b) The survey questions must focus on seven key business functions provided
178.20by medical assistance contractors: provider inquiries; provider outreach and education;
178.21claims processing; appeals; provider enrollment; medical review; and provider audit and
178.22reimbursement. The commissioner must consider the results of the survey in evaluating
178.23and renewing managed care and fee-for-service management contracts.
178.24(c) The commissioner shall report by January 15, 2014, the results of the survey to
178.25the chairs of the health and human services policy and finance committees and shall
178.26make recommendations on the value of implementing an annual survey with a rotating
178.27list of provider groups as a component of the continuous quality improvement system for
178.28medical assistance.

178.29    Sec. 27. MENTALLY ILL AND DANGEROUS COMMITMENTS
178.30STAKEHOLDERS GROUP.
178.31(a) The commissioner of human services, in consultation with the state court
178.32administrator, shall convene a stakeholder group to develop recommendations for the
178.33legislature that address issues raised in the February 2013 Office of the Legislative
178.34Auditor report on State-Operated Services for persons committed to the commissioner as
179.1mentally ill and dangerous under Minnesota Statutes, section 253B.18. Stakeholders must
179.2include representatives from the Department of Human Services, county human services,
179.3county attorneys, commitment defense attorneys, the ombudsman for mental health and
179.4developmental disabilities, the federal protection and advocacy system, and consumers
179.5and advocates for persons with mental illnesses.
179.6(b) The stakeholder group shall provide recommendations in the following areas:
179.7(1) the role of the special review board, including the scope of authority of the
179.8special review board and the authority of the commissioner to accept or reject special
179.9review board recommendations;
179.10(2) review of special review board decisions by the district court;
179.11(3) annual district court review of commitment, scope of court authority, and
179.12appropriate review criteria;
179.13(4) options, including annual court hearing and review, as alternatives to
179.14indeterminate commitment under Minnesota Statutes, section 253B.18; and
179.15(5) extension of the right to petition the court under Minnesota Statutes,
179.16section 253B.17, to those committed under Minnesota Statutes, section 253B.18.
179.17The commissioner of human services and the state court administrator shall provide
179.18relevant data for the group's consideration in developing these recommendations,
179.19including numbers of proceedings in each category and costs associated with court and
179.20administrative proceedings under Minnesota Statutes, section 253B.18.
179.21(c) By January 15, 2014, the commissioner of human services shall submit the
179.22recommendations of the stakeholder group to the chairs and ranking minority members
179.23of the committees of the legislature with jurisdiction over civil commitment and human
179.24services issues.

179.25ARTICLE 5
179.26DEPARTMENT OF HUMAN SERVICES PROGRAM INTEGRITY AND
179.27OFFICE OF INSPECTOR GENERAL

179.28    Section 1. Minnesota Statutes 2012, section 13.461, is amended by adding a
179.29subdivision to read:
179.30    Subd. 7b. Child care provider and recipient fraud investigations. Data related
179.31to child care fraud and recipient fraud investigations are governed by section 245E.01,
179.32subdivision 15.

179.33    Sec. 2. Minnesota Statutes 2012, section 243.166, subdivision 7, is amended to read:
180.1    Subd. 7. Use of data. (a) Except as otherwise provided in subdivision 7a or sections
180.2244.052 and 299C.093, the data provided under this section is private data on individuals
180.3under section 13.02, subdivision 12.
180.4(b) The data may be used only for by law enforcement and corrections agencies for
180.5 law enforcement and corrections purposes.
180.6(c) The commissioner of human services is authorized to have access to the data for:
180.7(1) state-operated services, as defined in section 246.014, are also authorized to
180.8have access to the data for the purposes described in section 246.13, subdivision 2,
180.9paragraph (b); and
180.10(2) purposes of completing background studies under chapter 245C.

180.11    Sec. 3. Minnesota Statutes 2012, section 245C.04, is amended by adding a subdivision
180.12to read:
180.13    Subd. 4a. Agency background studies. (a) The commissioner shall develop and
180.14implement an electronic process for the regular transfer of new criminal case information
180.15that is added to the Minnesota court information system. The commissioner's system
180.16must include for review only information that relates to individuals who have been the
180.17subject of a background study under this chapter that remain affiliated with the agency
180.18that initiated the background study. For purposes of this paragraph, an individual remains
180.19affiliated with an agency that initiated the background study until the agency informs the
180.20commissioner that the individual is no longer affiliated. When any individual no longer
180.21affiliated according to this paragraph returns to a position requiring a background study
180.22under this chapter, the agency with whom the individual is again affiliated shall initiate
180.23a new background study regardless of the length of time the individual was no longer
180.24affiliated with the agency.
180.25(b) The commissioner shall develop and implement an online system for agencies that
180.26initiate background studies under this chapter to access and maintain records of background
180.27studies initiated by that agency. The system must show all active background study subjects
180.28affiliated with that agency and the status of each individual's background study. Each
180.29agency that initiates background studies must use this system to notify the commissioner
180.30of discontinued affiliation for purposes of the processes required under paragraph (a).

180.31    Sec. 4. Minnesota Statutes 2012, section 245C.08, subdivision 1, is amended to read:
180.32    Subdivision 1. Background studies conducted by Department of Human
180.33Services. (a) For a background study conducted by the Department of Human Services,
180.34the commissioner shall review:
181.1    (1) information related to names of substantiated perpetrators of maltreatment of
181.2vulnerable adults that has been received by the commissioner as required under section
181.3626.557, subdivision 9c , paragraph (j);
181.4    (2) the commissioner's records relating to the maltreatment of minors in licensed
181.5programs, and from findings of maltreatment of minors as indicated through the social
181.6service information system;
181.7    (3) information from juvenile courts as required in subdivision 4 for individuals
181.8listed in section 245C.03, subdivision 1, paragraph (a), when there is reasonable cause;
181.9    (4) information from the Bureau of Criminal Apprehension, including information
181.10regarding a background study subject's registration in Minnesota as a predatory offender
181.11under section 243.166;
181.12    (5) except as provided in clause (6), information from the national crime information
181.13system when the commissioner has reasonable cause as defined under section 245C.05,
181.14subdivision 5; and
181.15    (6) for a background study related to a child foster care application for licensure or
181.16adoptions, the commissioner shall also review:
181.17    (i) information from the child abuse and neglect registry for any state in which the
181.18background study subject has resided for the past five years; and
181.19    (ii) information from national crime information databases, when the background
181.20study subject is 18 years of age or older.
181.21    (b) Notwithstanding expungement by a court, the commissioner may consider
181.22information obtained under paragraph (a), clauses (3) and (4), unless the commissioner
181.23received notice of the petition for expungement and the court order for expungement is
181.24directed specifically to the commissioner.
181.25    (c) The commissioner shall also review criminal case information received according
181.26to section 245C.04, subdivision 4a, from the Minnesota court information system that
181.27relates to individuals who have already been studied under this chapter and who remain
181.28affiliated with the agency that initiated the background study.

181.29    Sec. 5. Minnesota Statutes 2012, section 245C.32, subdivision 2, is amended to read:
181.30    Subd. 2. Use. (a) The commissioner may also use these systems and records to
181.31obtain and provide criminal history data from the Bureau of Criminal Apprehension,
181.32criminal history data held by the commissioner, and data about substantiated maltreatment
181.33under section 626.556 or 626.557, for other purposes, provided that:
181.34(1) the background study is specifically authorized in statute; or
182.1(2) the request is made with the informed consent of the subject of the study as
182.2provided in section 13.05, subdivision 4.
182.3(b) An individual making a request under paragraph (a), clause (2), must agree in
182.4writing not to disclose the data to any other individual without the consent of the subject
182.5of the data.
182.6(c) The commissioner may recover the cost of obtaining and providing background
182.7study data by charging the individual or entity requesting the study a fee of no more
182.8than $20 per study. The fees collected under this paragraph are appropriated to the
182.9commissioner for the purpose of conducting background studies.
182.10(d) The commissioner shall recover the cost of obtaining background study data
182.11required under section 524.5-118 through a fee of $50 per study for an individual who
182.12has not lived outside Minnesota for the past ten years, and a fee of $100 for an individual
182.13who has resided outside of Minnesota for any period during the ten years preceding the
182.14background study. The commissioner shall recover, from the individual, any additional
182.15fees charged by other states' licensing agencies that are associated with these data requests.
182.16Fees under subdivision 3 also apply when criminal history data from the National Criminal
182.17Records Repository is required.

182.18    Sec. 6. [245E.01] CHILD CARE PROVIDER AND RECIPIENT FRAUD
182.19INVESTIGATIONS WITHIN THE CHILD CARE ASSISTANCE PROGRAM.
182.20    Subdivision 1. Definitions. (a) For purposes of this section, the terms defined in this
182.21subdivision have the meanings given them.
182.22(b) "Applicant" has the meaning given in section 119B.011, subdivision 2.
182.23(c) "Child care assistance program" means any of the assistance programs under
182.24chapter 119B.
182.25(d) "Commissioner" means the commissioner of human services.
182.26(e) "Controlling individual" has the meaning given in section 245A.02, subdivision
182.275a.
182.28(f) "County" means a local county child care assistance program staff or
182.29subcontracted staff, or a county investigator acting on behalf of the commissioner.
182.30(g) "Department" means the Department of Human Services.
182.31(h) "Financial misconduct" or "misconduct" means an entity's or individual's acts or
182.32omissions that result in fraud and abuse or error against the Department of Human Services.
182.33(i) "Identify" means to furnish the full name, current or last known address, phone
182.34number, and e-mail address of the individual or business entity.
182.35(j) "License holder" has the meaning given in section 245A.02, subdivision 9.
183.1(k) "Mail" means the use of any mail service with proof of delivery and receipt.
183.2(l) "Provider" means either a provider as defined in section 119B.011, subdivision
183.319, or a legal unlicensed provider as defined in section 119B.011, subdivision 16.
183.4(m) "Recipient" means a family receiving assistance as defined under section
183.5119B.011, subdivision 13.
183.6(n) "Terminate" means revocation of participation in the child care assistance
183.7program.
183.8    Subd. 2. Investigating provider or recipient financial misconduct. The
183.9department shall investigate alleged or suspected financial misconduct by providers and
183.10errors related to payments issued by the child care assistance program under this chapter.
183.11Recipients, employees, and staff may be investigated when the evidence shows that their
183.12conduct is related to the financial misconduct of a provider, license holder, or controlling
183.13individual.
183.14    Subd. 3. Scope of investigations. (a) The department may contact any person,
183.15agency, organization, or other entity that is necessary to an investigation.
183.16(b) The department may examine or interview any individual, document, or piece of
183.17evidence that may lead to information that is relevant to child care assistance program
183.18benefits, payments, and child care provider authorizations. This includes, but is not
183.19limited to:
183.20(1) child care assistance program payments;
183.21(2) services provided by the program or related to child care assistance program
183.22recipients;
183.23(3) services provided to a provider;
183.24(4) provider financial records of any type;
183.25(5) daily attendance records of the children receiving services from the provider;
183.26(6) billings; and
183.27(7) verification of the credentials of a license holder, controlling individual,
183.28employee, staff person, contractor, subcontractor, and entities under contract with the
183.29provider to provide services or maintain service and the provider's financial records
183.30related to those services.
183.31    Subd. 4. Determination of investigation. After completing its investigation, the
183.32department shall issue one of the following determinations:
183.33(1) no violation of child care assistance requirements occurred;
183.34(2) there is insufficient evidence to show that a violation of child care assistance
183.35requirements occurred;
184.1(3) a preponderance of evidence shows a violation of child care assistance program
184.2law, rule, or policy; or
184.3(4) there exists a credible allegation of fraud.
184.4    Subd. 5. Actions or administrative sanctions. (a) In addition to section 256.98,
184.5after completing the determination under subdivision 4, the department may take one or
184.6more of the actions or sanctions specified in this subdivision.
184.7(b) The department may take the following actions:
184.8(1) refer the investigation to law enforcement or a county attorney for possible
184.9criminal prosecution;
184.10(2) refer relevant information to the department's licensing division, the child care
184.11assistance program, the Department of Education, the federal child and adult care food
184.12program, or appropriate child or adult protection agency;
184.13(3) enter into a settlement agreement with a provider, license holder, controlling
184.14individual, or recipient; or
184.15(4) refer the matter for review by a prosecutorial agency with appropriate jurisdiction
184.16for possible civil action under the Minnesota False Claims Act, chapter 15C.
184.17(c) The department may impose sanctions by:
184.18(1) pursuing administrative disqualification through hearings or waivers;
184.19(2) establishing and seeking monetary recovery or recoupment; or
184.20(3) issuing an order of corrective action that states the practices that are violations of
184.21child care assistance program policies, laws, or regulations, and that they must be corrected.
184.22    Subd. 6. Duty to provide access. (a) A provider, license holder, controlling
184.23individual, employee, staff person, or recipient has an affirmative duty to provide access
184.24upon request to information specified under subdivision 8 or the program facility.
184.25(b) Failure to provide access may result in denial or termination of authorizations for
184.26or payments to a recipient, provider, license holder, or controlling individual in the child
184.27care assistance program.
184.28(c) When a provider fails to provide access, a 15-day notice of denial or termination
184.29must be issued to the provider, which prohibits the provider from participating in the child
184.30care assistance program. Notice must be sent to recipients whose children are under the
184.31provider's care pursuant to Minnesota Rules, part 3400.0185.
184.32(d) If the provider continues to fail to provide access at the expiration of the 15-day
184.33notice period, child care assistance program payments to the provider must be denied
184.34beginning the 16th day following notice of the initial failure or refusal to provide access.
184.35The department may rescind the denial based upon good cause if the provider submits in
184.36writing a good cause basis for having failed or refused to provide access. The writing must
185.1be postmarked no later than the 15th day following the provider's notice of initial failure
185.2to provide access. Additionally, the provider, license holder, or controlling individual
185.3must immediately provide complete, ongoing access to the department. Repeated failures
185.4to provide access must, after the initial failure or for any subsequent failure, result in
185.5termination from participation in the child care assistance program.
185.6(e) The department, at its own expense, may photocopy or otherwise duplicate
185.7records referenced in subdivision 8. Photocopying must be done on the provider's
185.8premises on the day of the request or other mutually agreeable time, unless removal of
185.9records is specifically permitted by the provider. If requested, a provider, license holder,
185.10or controlling individual, or a designee, must assist the investigator in duplicating any
185.11record, including a hard copy or electronically stored data, on the day of the request.
185.12(f) A provider, license holder, controlling individual, employee, or staff person must
185.13grant the department access during the department's normal business hours, and any hours
185.14that the program is operated, to examine the provider's program or the records listed in
185.15subdivision 8. A provider shall make records available at the provider's place of business
185.16on the day for which access is requested, unless the provider and the department both agree
185.17otherwise. The department's normal business hours are 8:00 a.m. to 5:00 p.m., Monday
185.18through Friday, excluding state holidays as defined in section 645.44, subdivision 5.
185.19    Subd. 7. Honest and truthful statements. It shall be unlawful for a provider,
185.20license holder, controlling individual, or recipient to:
185.21(1) falsify, conceal, or cover up by any trick, scheme, or device a material fact;
185.22(2) make any materially false, fictitious, or fraudulent statement or representation; or
185.23(3) make or use any false writing or document knowing the same to contain any
185.24materially false, fictitious, or fraudulent statement or entry related to any child care
185.25assistance program services that the provider, license holder, or controlling individual
185.26supplies or in relation to any child care assistance payments received by a provider, license
185.27holder, or controlling individual or to any fraud investigator or law enforcement officer
185.28conducting a financial misconduct investigation.
185.29    Subd. 8. Record retention. (a) The following records must be maintained,
185.30controlled, and made immediately accessible to license holders, providers, and controlling
185.31individuals. The records must be organized and labeled to correspond to categories that
185.32make them easy to identify so that they can be made available immediately upon request
185.33to an investigator acting on behalf of the commissioner at the provider's place of business:
185.34(1) payroll ledgers, canceled checks, bank deposit slips, and any other accounting
185.35records;
186.1(2) daily attendance records required by and that comply with section 119B.125,
186.2subdivision 6;
186.3(3) billing transmittal forms requesting payments from the child care assistance
186.4program and billing adjustments related to child care assistance program payments;
186.5(4) records identifying all persons, corporations, partnerships, and entities with an
186.6ownership or controlling interest in the provider's child care business;
186.7(5) employee records identifying those persons currently employed by the provider's
186.8child care business or who have been employed by the business at any time within the
186.9previous five years. The records must include each employee's name, hourly and annual
186.10salary, qualifications, position description, job title, and dates of employment. In addition,
186.11employee records that must be made available include the employee's time sheets, current
186.12home address of the employee or last known address of any former employee, and
186.13documentation of background studies required under chapter 119B or 245C;
186.14(6) records related to transportation of children in care, including but not limited to:
186.15(i) the dates and times that transportation is provided to children for transportation to
186.16and from the provider's business location for any purpose. For transportation related to
186.17field trips or locations away from the provider's business location, the names and addresses
186.18of those field trips and locations must also be provided;
186.19(ii) the name, business address, phone number, and Web site address, if any, of the
186.20transportation service utilized; and
186.21(iii) all billing or transportation records related to the transportation.
186.22(b) A provider, license holder, or controlling individual must retain all records
186.23in paragraph (a) for at least six years after the date the record is created. Microfilm or
186.24electronically stored records satisfy the record keeping requirements of this subdivision.
186.25(c) A provider, license holder, or controlling individual who withdraws or is
186.26terminated from the child care assistance program must retain the records required under
186.27this subdivision and make them available to the department on demand.
186.28(d) If the ownership of a provider changes, the transferor, unless otherwise provided
186.29by law or by written agreement with the transferee, is responsible for maintaining,
186.30preserving, and upon request from the department, making available the records related to
186.31the provider that were generated before the date of the transfer. Any written agreement
186.32affecting this provision must be held in the possession of the transferor and transferee.
186.33The written agreement must be provided to the department or county immediately upon
186.34request, and the written agreement must be retained by the transferor and transferee for six
186.35years after the agreement is fully executed.
187.1(e) In the event of an appealed case, the provider must retain all records required in
187.2this subdivision for the duration of the appeal or six years, whichever is longer.
187.3(f) A provider's use of electronic record keeping or electronic signatures is governed
187.4by chapter 325L.
187.5    Subd. 9. Factors regarding imposition of administrative sanctions. (a) The
187.6department shall consider the following factors in determining the administrative sanctions
187.7to be imposed:
187.8(1) nature and extent of financial misconduct;
187.9(2) history of financial misconduct;
187.10(3) actions taken or recommended by other state agencies, other divisions of the
187.11department, and court and administrative decisions;
187.12(4) prior imposition of sanctions;
187.13(5) size and type of provider;
187.14(6) information obtained through an investigation from any source;
187.15(7) convictions or pending criminal charges; and
187.16(8) any other information relevant to the acts or omissions related to the financial
187.17misconduct.
187.18(b) Any single factor under paragraph (a) may be determinative of the department's
187.19decision of whether and what sanctions are imposed.
187.20    Subd. 10. Written notice of department sanction. (a) The department shall give
187.21notice in writing to a person of an administrative sanction that is to be imposed. The notice
187.22shall be sent by mail as defined in subdivision 1, paragraph (k).
187.23(b) The notice shall state:
187.24(1) the factual basis for the department's determination;
187.25(2) the sanction the department intends to take;
187.26(3) the dollar amount of the monetary recovery or recoupment, if any;
187.27(4) how the dollar amount was computed;
187.28(5) the right to dispute the department's determination and to provide evidence;
187.29(6) the right to appeal the department's proposed sanction; and
187.30(7) the option to meet informally with department staff, and to bring additional
187.31documentation or information, to resolve the issues.
187.32(c) In cases of determinations resulting in denial or termination of payments, in
187.33addition to the requirements of paragraph (b), the notice must state:
187.34(1) the length of the denial or termination;
187.35(2) the requirements and procedures for reinstatement; and
188.1(3) the provider's right to submit documents and written arguments against the
188.2denial or termination of payments for review by the department before the effective date
188.3of denial or termination.
188.4(d) The submission of documents and written argument for review by the department
188.5under paragraph (b), clause (5) or (7), or paragraph (c), clause (3), does not stay the
188.6deadline for filing an appeal.
188.7(e) Unless timely appealed, the effective date of the proposed sanction shall be 30
188.8days after the license holder's, provider's, controlling individual's, or recipient's receipt of
188.9the notice. If a timely appeal is made, the proposed sanction shall be delayed pending
188.10the final outcome of the appeal. Implementation of a proposed sanction following the
188.11resolution of a timely appeal may be postponed if, in the opinion of the department, the
188.12delay of sanction is necessary to protect the health or safety of children in care. The
188.13department may consider the economic hardship of a person in implementing the proposed
188.14sanction, but economic hardship shall not be a determinative factor in implementing the
188.15proposed sanction.
188.16(f) Requests for an informal meeting to attempt to resolve issues and requests
188.17for appeals must be sent or delivered to the department's Office of Inspector General,
188.18Financial Fraud and Abuse Division.
188.19    Subd. 11. Appeal of department sanction under this section. (a) If the department
188.20does not pursue a criminal action against a provider, license holder, controlling individual,
188.21or recipient for financial misconduct, but the department imposes an administrative
188.22sanction, any individual or entity against whom the sanction was imposed may appeal the
188.23department's administrative sanction under this section pursuant to section 119B.16 or
188.24256.045 with the additional requirements in clauses (1) to (4). An appeal must specify:
188.25(1) each disputed item, the reason for the dispute, and an estimate of the dollar
188.26amount involved for each disputed item, if appropriate;
188.27(2) the computation that is believed to be correct, if appropriate;
188.28(3) the authority in the statute or rule relied upon for each disputed item; and
188.29(4) the name, address, and phone number of the person at the provider's place of
188.30business with whom contact may be made regarding the appeal.
188.31(b) An appeal is considered timely only if postmarked or received by the
188.32department's Office of Inspector General, Financial Fraud and Abuse Division within 30
188.33days after receiving a notice of department sanction.
188.34(c) Before the appeal hearing, the department may deny or terminate authorizations
188.35or payment to the entity or individual if the department determines that the action is
188.36necessary to protect the public welfare or the interests of the child care assistance program.
189.1    Subd. 12. Consolidated hearings with licensing sanction. If a financial
189.2misconduct sanction has an appeal hearing right and it is timely appealed, and a licensing
189.3sanction exists for which there is an appeal hearing right and the sanction is timely
189.4appealed, and the overpayment recovery action and licensing sanction involve the same
189.5set of facts, the overpayment recovery action and licensing sanction must be consolidated
189.6in the contested case hearing related to the licensing sanction.
189.7    Subd. 13. Grounds for and methods of monetary recovery. (a) The department
189.8may obtain monetary recovery from a provider who has been improperly paid by the
189.9child care assistance program, regardless of whether the error was intentional or county
189.10error. The department does not need to establish a pattern as a precondition of monetary
189.11recovery of erroneous or false billing claims, duplicate billing claims, or billing claims
189.12based on false statements or financial misconduct.
189.13(b) The department shall obtain monetary recovery from providers by the following
189.14means:
189.15(1) permitting voluntary repayment of money, either in lump-sum payment or
189.16installment payments;
189.17(2) using any legal collection process;
189.18(3) deducting or withholding program payments; or
189.19(4) utilizing the means set forth in chapter 16D.
189.20    Subd. 14. Reporting of suspected fraudulent activity. (a) A person who, in
189.21good faith, makes a report of or testifies in any action or proceeding in which financial
189.22misconduct is alleged, and who is not involved in, has not participated in, or has not aided
189.23and abetted, conspired, or colluded in the financial misconduct, shall have immunity from
189.24any liability, civil or criminal, that results by reason of the person's report or testimony.
189.25For the purpose of any proceeding, the good faith of any person reporting or testifying
189.26under this provision shall be presumed.
189.27(b) If a person that is or has been involved in, participated in, aided and abetted,
189.28conspired, or colluded in the financial misconduct reports the financial misconduct,
189.29the department may consider that person's report and assistance in investigating the
189.30misconduct as a mitigating factor in the department's pursuit of civil, criminal, or
189.31administrative remedies.
189.32    Subd. 15. Data privacy. Data of any kind obtained or created in relation to a provider
189.33or recipient investigation under this section is defined, classified, and protected the same as
189.34all other data under section 13.46, and this data has the same classification as licensing data.
189.35    Subd. 16. Monetary recovery; random sample extrapolation. The department is
189.36authorized to calculate the amount of monetary recovery from a provider, license holder, or
190.1controlling individual based upon extrapolation from a statistical random sample of claims
190.2submitted by the provider, license holder, or controlling individual and paid by the child
190.3care assistance program. The department's random sample extrapolation shall constitute a
190.4rebuttable presumption of the accuracy of the calculation of monetary recovery. If the
190.5presumption is not rebutted by the provider, license holder, or controlling individual in the
190.6appeal process, the department shall use the extrapolation as the monetary recovery figure.
190.7The department may use sampling and extrapolation to calculate the amount of monetary
190.8recovery if the claims to be reviewed represent services to 50 or more children in care.
190.9    Subd. 17. Effect of department's monetary penalty determination. Unless
190.10a timely and proper appeal is received by the department's Office of Inspector General,
190.11Financial Fraud and Abuse Division, the department's administrative determination or
190.12sanction shall be considered a final department determination.
190.13    Subd. 18. Office of Inspector General recoveries. Overpayment recoveries
190.14resulting from child care provider fraud investigations initiated by the department's Office
190.15of Inspector General's fraud investigations staff are excluded from the county recovery
190.16provision in section 119B.11, subdivision 3.

190.17    Sec. 7. Minnesota Statutes 2012, section 256B.04, subdivision 21, is amended to read:
190.18    Subd. 21. Provider enrollment. (a) If the commissioner or the Centers for
190.19Medicare and Medicaid Services determines that a provider is designated "high-risk," the
190.20commissioner may withhold payment from providers within that category upon initial
190.21enrollment for a 90-day period. The withholding for each provider must begin on the date
190.22of the first submission of a claim.
190.23(b) An enrolled provider that is also licensed by the commissioner under chapter
190.24245A must designate an individual as the entity's compliance officer. The compliance
190.25officer must:
190.26(1) develop policies and procedures to assure adherence to medical assistance laws
190.27and regulations and to prevent inappropriate claims submissions;
190.28(2) train the employees of the provider entity, and any agents or subcontractors of
190.29the provider entity including billers, on the policies and procedures under clause (1);
190.30(3) respond to allegations of improper conduct related to the provision or billing of
190.31medical assistance services, and implement action to remediate any resulting problems;
190.32(4) use evaluation techniques to monitor compliance with medical assistance laws
190.33and regulations;
190.34(5) promptly report to the commissioner any identified violations of medical
190.35assistance laws or regulations; and
191.1    (6) within 60 days of discovery by the provider of a medical assistance
191.2reimbursement overpayment, report the overpayment to the commissioner and make
191.3arrangements with the commissioner for the commissioner's recovery of the overpayment.
191.4The commissioner may require, as a condition of enrollment in medical assistance, that a
191.5provider within a particular industry sector or category establish a compliance program that
191.6contains the core elements established by the Centers for Medicare and Medicaid Services.
191.7(c) The commissioner may revoke the enrollment of an ordering or rendering
191.8provider for a period of not more than one year, if the provider fails to maintain and, upon
191.9request from the commissioner, provide access to documentation relating to written orders
191.10or requests for payment for durable medical equipment, certifications for home health
191.11services, or referrals for other items or services written or ordered by such provider, when
191.12the commissioner has identified a pattern of a lack of documentation. A pattern means a
191.13failure to maintain documentation or provide access to documentation on more than one
191.14occasion. Nothing in this paragraph limits the authority of the commissioner to sanction a
191.15provider under the provisions of section 256B.064.
191.16(d) The commissioner shall terminate or deny the enrollment of any individual or
191.17entity if the individual or entity has been terminated from participation in Medicare or
191.18under the Medicaid program or Children's Health Insurance Program of any other state.
191.19(e) As a condition of enrollment in medical assistance, the commissioner shall
191.20require that a provider designated "moderate" or "high-risk" by the Centers for Medicare
191.21and Medicaid Services or the Minnesota Department of Human Services commissioner
191.22 permit the Centers for Medicare and Medicaid Services, its agents, or its designated
191.23contractors and the state agency, its agents, or its designated contractors to conduct
191.24unannounced on-site inspections of any provider location. The commissioner shall publish
191.25in the Minnesota Health Care Program Provider Manual a list of provider types designated
191.26"limited," "moderate," or "high-risk," based on the criteria and standards used to designate
191.27Medicare providers in Code of Federal Regulations, title 42, section 424.518. The list and
191.28criteria are not subject to the requirements of chapter 14. The commissioner's designations
191.29are not subject to administrative appeal.
191.30(f) As a condition of enrollment in medical assistance, the commissioner shall
191.31require that a high-risk provider, or a person with a direct or indirect ownership interest in
191.32the provider of five percent or higher, consent to criminal background checks, including
191.33fingerprinting, when required to do so under state law or by a determination by the
191.34commissioner or the Centers for Medicare and Medicaid Services that a provider is
191.35designated high-risk for fraud, waste, or abuse.
192.1(g) As a condition of enrollment, all durable medical equipment, prosthetics,
192.2orthotics, and supplies (DMEPOS) suppliers operating in Minnesota are required to name
192.3the Department of Human Services, in addition to the Centers for Medicare and Medicaid
192.4Services, as an obligee on all surety performance bonds required pursuant to section
192.54312(a) of the Balanced Budget Act of 1997, Public Law 105-33, amending Social
192.6Security Act, section 1834(a). The performance bond must also allow for recovery of
192.7costs and fees in pursuing a claim on the bond.
192.8(h) The Department of Human Services may require a provider to purchase a
192.9performance surety bond as a condition of initial enrollment, reenrollment, reinstatement,
192.10or continued enrollment if: (1) the provider fails to demonstrate financial viability; (2) the
192.11department determines there is significant evidence of or potential for fraud and abuse
192.12by the provider; or (3) the provider or category of providers is designated high-risk
192.13pursuant to paragraph (a) and Code of Federal Regulations, title 42, section 455.450, or
192.14the department otherwise finds it is in the best interest of the Medicaid program to do so.
192.15The performance bond must be in an amount of $100,000 or ten percent of the provider's
192.16payments from Medicaid during the immediately preceding 12 months, whichever is
192.17greater. The performance bond must name the Department of Human Services as an
192.18obligee and must allow for recovery of costs and fees in pursuing a claim on the bond.
192.19EFFECTIVE DATE.This section is effective the day following final enactment.

192.20    Sec. 8. Minnesota Statutes 2012, section 256B.04, is amended by adding a subdivision
192.21to read:
192.22    Subd. 22. Application fee. (a) The commissioner must collect and retain federally
192.23required nonrefundable application fees to pay for provider screening activities in
192.24accordance with Code of Federal Regulations, title 42, section 455, subpart E. The
192.25enrollment application must be made under the procedures specified by the commissioner,
192.26in the form specified by the commissioner, and accompanied by an application fee
192.27described in paragraph (b), or a request for a hardship exception as described in the
192.28specified procedures. Application fees must be deposited in the provider screening account
192.29in the special revenue fund. Amounts in the provider screening account are appropriated
192.30to the commissioner for costs associated with the provider screening activities required
192.31in Code of Federal Regulations, title 42, section 455, subpart E. The commissioner
192.32shall conduct screening activities as required by Code of Federal Regulations, title 42,
192.33section 455, subpart E, and as otherwise provided by law, to include database checks,
192.34unannounced pre- and postenrollment site visits, fingerprinting, and criminal background
193.1studies. The commissioner must revalidate all providers under this subdivision at least
193.2once every five years.
193.3(b) The application fee under this subdivision is $532 for the calendar year 2013.
193.4For calendar year 2014 and subsequent years, the fee:
193.5(1) is adjusted by the percentage change to the consumer price index for all urban
193.6consumers, United States city average, for the 12-month period ending with June of the
193.7previous year. The resulting fee must be announced in the Federal Register;
193.8(2) is effective from January 1 to December 31 of a calendar year;
193.9(3) is required on the submission of an initial application, an application to establish
193.10a new practice location, an application for reenrollment when the provider is not enrolled
193.11at the time of application of reenrollment, or at revalidation when required by federal
193.12regulation; and
193.13(4) must be in the amount in effect for the calendar year during which the application
193.14for enrollment, new practice location, or reenrollment is being submitted.
193.15(c) The application fee under this subdivision cannot be charged to:
193.16(1) providers who are enrolled in Medicare or who provide documentation of
193.17payment of the fee to, and enrollment with, another state;
193.18(2) providers who are enrolled but are required to submit new applications for
193.19purposes of reenrollment; or
193.20(3) a provider who enrolls as an individual.
193.21EFFECTIVE DATE.This section is effective the day following final enactment.

193.22    Sec. 9. Minnesota Statutes 2012, section 256B.064, subdivision 1a, is amended to read:
193.23    Subd. 1a. Grounds for sanctions against vendors. The commissioner may
193.24impose sanctions against a vendor of medical care for any of the following: (1) fraud,
193.25theft, or abuse in connection with the provision of medical care to recipients of public
193.26assistance; (2) a pattern of presentment of false or duplicate claims or claims for services
193.27not medically necessary; (3) a pattern of making false statements of material facts for
193.28the purpose of obtaining greater compensation than that to which the vendor is legally
193.29entitled; (4) suspension or termination as a Medicare vendor; (5) refusal to grant the state
193.30agency access during regular business hours to examine all records necessary to disclose
193.31the extent of services provided to program recipients and appropriateness of claims for
193.32payment; (6) failure to repay an overpayment or a fine finally established under this
193.33section; and (7) failure to correct errors in the maintenance of health service or financial
193.34records for which a fine was imposed or after issuance of a warning by the commissioner;
193.35and (8) any reason for which a vendor could be excluded from participation in the
194.1Medicare program under section 1128, 1128A, or 1866(b)(2) of the Social Security Act.
194.2The determination of services not medically necessary may be made by the commissioner
194.3in consultation with a peer advisory task force appointed by the commissioner on the
194.4recommendation of appropriate professional organizations. The task force expires as
194.5provided in section 15.059, subdivision 5.

194.6    Sec. 10. Minnesota Statutes 2012, section 256B.064, subdivision 1b, is amended to read:
194.7    Subd. 1b. Sanctions available. The commissioner may impose the following
194.8sanctions for the conduct described in subdivision 1a: suspension or withholding of
194.9payments to a vendor and suspending or terminating participation in the program, or
194.10imposition of a fine under subdivision 2, paragraph (f). When imposing sanctions under
194.11this section, the commissioner shall consider the nature, chronicity, or severity of the
194.12conduct and the effect of the conduct on the health and safety of persons served by the
194.13vendor. Regardless of imposition of sanctions, the commissioner may make a referral
194.14to the appropriate state licensing board.

194.15    Sec. 11. Minnesota Statutes 2012, section 256B.064, subdivision 2, is amended to read:
194.16    Subd. 2. Imposition of monetary recovery and sanctions. (a) The commissioner
194.17shall determine any monetary amounts to be recovered and sanctions to be imposed upon
194.18a vendor of medical care under this section. Except as provided in paragraphs (b) and
194.19(d), neither a monetary recovery nor a sanction will be imposed by the commissioner
194.20without prior notice and an opportunity for a hearing, according to chapter 14, on the
194.21commissioner's proposed action, provided that the commissioner may suspend or reduce
194.22payment to a vendor of medical care, except a nursing home or convalescent care facility,
194.23after notice and prior to the hearing if in the commissioner's opinion that action is
194.24necessary to protect the public welfare and the interests of the program.
194.25(b) Except when the commissioner finds good cause not to suspend payments under
194.26Code of Federal Regulations, title 42, section 455.23 (e) or (f), the commissioner shall
194.27withhold or reduce payments to a vendor of medical care without providing advance
194.28notice of such withholding or reduction if either of the following occurs:
194.29(1) the vendor is convicted of a crime involving the conduct described in subdivision
194.301a; or
194.31(2) the commissioner determines there is a credible allegation of fraud for which an
194.32investigation is pending under the program. A credible allegation of fraud is an allegation
194.33which has been verified by the state, from any source, including but not limited to:
194.34(i) fraud hotline complaints;
195.1(ii) claims data mining; and
195.2(iii) patterns identified through provider audits, civil false claims cases, and law
195.3enforcement investigations.
195.4Allegations are considered to be credible when they have an indicia of reliability
195.5and the state agency has reviewed all allegations, facts, and evidence carefully and acts
195.6judiciously on a case-by-case basis.
195.7(c) The commissioner must send notice of the withholding or reduction of payments
195.8under paragraph (b) within five days of taking such action unless requested in writing by a
195.9law enforcement agency to temporarily withhold the notice. The notice must:
195.10(1) state that payments are being withheld according to paragraph (b);
195.11(2) set forth the general allegations as to the nature of the withholding action, but
195.12need not disclose any specific information concerning an ongoing investigation;
195.13(3) except in the case of a conviction for conduct described in subdivision 1a, state
195.14that the withholding is for a temporary period and cite the circumstances under which
195.15withholding will be terminated;
195.16(4) identify the types of claims to which the withholding applies; and
195.17(5) inform the vendor of the right to submit written evidence for consideration by
195.18the commissioner.
195.19The withholding or reduction of payments will not continue after the commissioner
195.20determines there is insufficient evidence of fraud by the vendor, or after legal proceedings
195.21relating to the alleged fraud are completed, unless the commissioner has sent notice of
195.22intention to impose monetary recovery or sanctions under paragraph (a).
195.23(d) The commissioner shall suspend or terminate a vendor's participation in the
195.24program without providing advance notice and an opportunity for a hearing when the
195.25suspension or termination is required because of the vendor's exclusion from participation
195.26in Medicare. Within five days of taking such action, the commissioner must send notice of
195.27the suspension or termination. The notice must:
195.28(1) state that suspension or termination is the result of the vendor's exclusion from
195.29Medicare;
195.30(2) identify the effective date of the suspension or termination; and
195.31(3) inform the vendor of the need to be reinstated to Medicare before reapplying
195.32for participation in the program.
195.33(e) Upon receipt of a notice under paragraph (a) that a monetary recovery or
195.34sanction is to be imposed, a vendor may request a contested case, as defined in section
195.3514.02, subdivision 3 , by filing with the commissioner a written request of appeal. The
195.36appeal request must be received by the commissioner no later than 30 days after the date
196.1the notification of monetary recovery or sanction was mailed to the vendor. The appeal
196.2request must specify:
196.3(1) each disputed item, the reason for the dispute, and an estimate of the dollar
196.4amount involved for each disputed item;
196.5(2) the computation that the vendor believes is correct;
196.6(3) the authority in statute or rule upon which the vendor relies for each disputed item;
196.7(4) the name and address of the person or entity with whom contacts may be made
196.8regarding the appeal; and
196.9(5) other information required by the commissioner.
196.10(f) The commissioner may order a vendor to forfeit a fine for failure to fully document
196.11services according to standards in this chapter and Minnesota Rules, chapter 9505. The
196.12commissioner may assess fines if specific required components of documentation are
196.13missing. The fine for incomplete documentation shall equal 20 percent of the amount paid
196.14on the claims for reimbursement submitted by the vendor, or up to $5,000, whichever is less.
196.15(g) The vendor shall pay the fine assessed on or before the payment date specified. If
196.16the vendor fails to pay the fine, the commissioner may withhold or reduce payments and
196.17recover the amount of the fine. A timely appeal shall stay payment of the fine until the
196.18commissioner issues a final order.

196.19    Sec. 12. Minnesota Statutes 2012, section 256B.0659, subdivision 21, is amended to
196.20read:
196.21    Subd. 21. Requirements for initial enrollment of personal care assistance
196.22provider agencies. (a) All personal care assistance provider agencies must provide, at the
196.23time of enrollment as a personal care assistance provider agency in a format determined
196.24by the commissioner, information and documentation that includes, but is not limited to,
196.25the following:
196.26    (1) the personal care assistance provider agency's current contact information
196.27including address, telephone number, and e-mail address;
196.28    (2) proof of surety bond coverage in the amount of $50,000 $100,000 or ten percent
196.29of the provider's payments from Medicaid in the previous year, whichever is less more.
196.30The performance bond must be in a form approved by the commissioner, must be renewed
196.31annually, and must allow for recovery of costs and fees in pursuing a claim on the bond;
196.32    (3) proof of fidelity bond coverage in the amount of $20,000;
196.33    (4) proof of workers' compensation insurance coverage;
196.34    (5) proof of liability insurance;
197.1    (6) a description of the personal care assistance provider agency's organization
197.2identifying the names of all owners, managing employees, staff, board of directors, and
197.3the affiliations of the directors, owners, or staff to other service providers;
197.4    (7) a copy of the personal care assistance provider agency's written policies and
197.5procedures including: hiring of employees; training requirements; service delivery;
197.6and employee and consumer safety including process for notification and resolution
197.7of consumer grievances, identification and prevention of communicable diseases, and
197.8employee misconduct;
197.9    (8) copies of all other forms the personal care assistance provider agency uses in
197.10the course of daily business including, but not limited to:
197.11    (i) a copy of the personal care assistance provider agency's time sheet if the time
197.12sheet varies from the standard time sheet for personal care assistance services approved
197.13by the commissioner, and a letter requesting approval of the personal care assistance
197.14provider agency's nonstandard time sheet;
197.15    (ii) the personal care assistance provider agency's template for the personal care
197.16assistance care plan; and
197.17    (iii) the personal care assistance provider agency's template for the written
197.18agreement in subdivision 20 for recipients using the personal care assistance choice
197.19option, if applicable;
197.20    (9) a list of all training and classes that the personal care assistance provider agency
197.21requires of its staff providing personal care assistance services;
197.22    (10) documentation that the personal care assistance provider agency and staff have
197.23successfully completed all the training required by this section;
197.24    (11) documentation of the agency's marketing practices;
197.25    (12) disclosure of ownership, leasing, or management of all residential properties
197.26that is used or could be used for providing home care services;
197.27    (13) documentation that the agency will use the following percentages of revenue
197.28generated from the medical assistance rate paid for personal care assistance services
197.29for employee personal care assistant wages and benefits: 72.5 percent of revenue in the
197.30personal care assistance choice option and 72.5 percent of revenue from other personal
197.31care assistance providers. The revenue generated by the qualified professional and the
197.32reasonable costs associated with the qualified professional shall not be used in making
197.33this calculation; and
197.34    (14) effective May 15, 2010, documentation that the agency does not burden
197.35recipients' free exercise of their right to choose service providers by requiring personal
197.36care assistants to sign an agreement not to work with any particular personal care
198.1assistance recipient or for another personal care assistance provider agency after leaving
198.2the agency and that the agency is not taking action on any such agreements or requirements
198.3regardless of the date signed.
198.4    (b) Personal care assistance provider agencies shall provide the information specified
198.5in paragraph (a) to the commissioner at the time the personal care assistance provider
198.6agency enrolls as a vendor or upon request from the commissioner. The commissioner
198.7shall collect the information specified in paragraph (a) from all personal care assistance
198.8providers beginning July 1, 2009.
198.9    (c) All personal care assistance provider agencies shall require all employees in
198.10management and supervisory positions and owners of the agency who are active in the
198.11day-to-day management and operations of the agency to complete mandatory training
198.12as determined by the commissioner before enrollment of the agency as a provider.
198.13Employees in management and supervisory positions and owners who are active in
198.14the day-to-day operations of an agency who have completed the required training as
198.15an employee with a personal care assistance provider agency do not need to repeat
198.16the required training if they are hired by another agency, if they have completed the
198.17training within the past three years. By September 1, 2010, the required training must
198.18be available with meaningful access according to title VI of the Civil Rights Act and
198.19federal regulations adopted under that law or any guidance from the United States Health
198.20and Human Services Department. The required training must be available online or by
198.21electronic remote connection. The required training must provide for competency testing.
198.22Personal care assistance provider agency billing staff shall complete training about
198.23personal care assistance program financial management. This training is effective July 1,
198.242009. Any personal care assistance provider agency enrolled before that date shall, if it
198.25has not already, complete the provider training within 18 months of July 1, 2009. Any new
198.26owners or employees in management and supervisory positions involved in the day-to-day
198.27operations are required to complete mandatory training as a requisite of working for the
198.28agency. Personal care assistance provider agencies certified for participation in Medicare
198.29as home health agencies are exempt from the training required in this subdivision. When
198.30available, Medicare-certified home health agency owners, supervisors, or managers must
198.31successfully complete the competency test.
198.32EFFECTIVE DATE.This section is effective the day following final enactment.

198.33    Sec. 13. Minnesota Statutes 2012, section 299C.093, is amended to read:
198.34299C.093 DATABASE OF REGISTERED PREDATORY OFFENDERS.
199.1The superintendent of the Bureau of Criminal Apprehension shall maintain a
199.2computerized data system relating to individuals required to register as predatory offenders
199.3under section 243.166. To the degree feasible, the system must include the data required
199.4to be provided under section 243.166, subdivisions 4 and 4a, and indicate the time period
199.5that the person is required to register. The superintendent shall maintain this data in a
199.6manner that ensures that it is readily available to law enforcement agencies. This data is
199.7private data on individuals under section 13.02, subdivision 12, but may be used for law
199.8enforcement and corrections purposes. The commissioner of human services has access
199.9to the data for state-operated services, as defined in section 246.014, are also authorized
199.10to have access to the data for the purposes described in section 246.13, subdivision 2,
199.11paragraph (b), and for purposes of conducting background studies under chapter 245C.

199.12    Sec. 14. Minnesota Statutes 2012, section 524.5-118, subdivision 1, is amended to read:
199.13    Subdivision 1. When required; exception. (a) The court shall require a background
199.14study under this section:
199.15(1) before the appointment of a guardian or conservator, unless a background study
199.16has been done on the person under this section within the previous five two years; and
199.17(2) once every five two years after the appointment, if the person continues to serve
199.18as a guardian or conservator.
199.19(b) The background study must include:
199.20(1) criminal history data from the Bureau of Criminal Apprehension, other criminal
199.21history data held by the commissioner of human services, and data regarding whether the
199.22person has been a perpetrator of substantiated maltreatment of a vulnerable adult and a
199.23 or minor.;
199.24(c) The court shall request a search of the (2) criminal history data from the National
199.25Criminal Records Repository if the proposed guardian or conservator has not resided in
199.26Minnesota for the previous five ten years or if the Bureau of Criminal Apprehension
199.27information received from the commissioner of human services under subdivision 2,
199.28paragraph (b), indicates that the subject is a multistate offender or that the individual's
199.29multistate offender status is undetermined.; and
199.30(3) state licensing agency data if a search of the database or databases of the agencies
199.31listed in subdivision 2a shows that the proposed guardian or conservator has ever held a
199.32professional license directly related to the responsibilities of a professional fiduciary from
199.33an agency listed in subdivision 2a that was conditioned, suspended, revoked, or canceled.
199.34(d) (c) If the guardian or conservator is not an individual, the background study must
199.35be done on all individuals currently employed by the proposed guardian or conservator
200.1who will be responsible for exercising powers and duties under the guardianship or
200.2conservatorship.
200.3(e) (d) If the court determines that it would be in the best interests of the ward or
200.4protected person to appoint a guardian or conservator before the background study can
200.5be completed, the court may make the appointment pending the results of the study,
200.6however, the background study must then be completed as soon as reasonably possible
200.7after appointment, no later than 30 days after appointment.
200.8(f) (e) The fee for conducting a background study for appointment of a professional
200.9guardian or conservator must be paid by the guardian or conservator. In other cases,
200.10the fee must be paid as follows:
200.11(1) if the matter is proceeding in forma pauperis, the fee is an expense for purposes
200.12of section 524.5-502, paragraph (a);
200.13(2) if there is an estate of the ward or protected person, the fee must be paid from
200.14the estate; or
200.15(3) in the case of a guardianship or conservatorship of the person that is not
200.16proceeding in forma pauperis, the court may order that the fee be paid by the guardian or
200.17conservator or by the court.
200.18(g) (f) The requirements of this subdivision do not apply if the guardian or
200.19conservator is:
200.20(1) a state agency or county;
200.21(2) a parent or guardian of a proposed ward or protected person who has a
200.22developmental disability, if the parent or guardian has raised the proposed ward or
200.23protected person in the family home until the time the petition is filed, unless counsel
200.24appointed for the proposed ward or protected person under section 524.5-205, paragraph
200.25(d)
; 524.5-304, paragraph (b); 524.5-405, paragraph (a); or 524.5-406, paragraph (b),
200.26recommends a background study; or
200.27(3) a bank with trust powers, bank and trust company, or trust company, organized
200.28under the laws of any state or of the United States and which is regulated by the
200.29commissioner of commerce or a federal regulator.

200.30    Sec. 15. Minnesota Statutes 2012, section 524.5-118, is amended by adding a
200.31subdivision to read:
200.32    Subd. 2a. Procedure; state licensing agency data. (a) The court shall request the
200.33commissioner of human services to provide the court within 25 working days of receipt of
200.34the request with licensing agency data for licenses directly related to the responsibilities of
200.35a professional fiduciary from the following agencies in Minnesota:
201.1(1) Lawyers Responsibility Board;
201.2(2) State Board of Accountancy;
201.3(3) Board of Social Work;
201.4(4) Board of Psychology;
201.5(5) Board of Nursing;
201.6(6) Board of Medical Practice;
201.7(7) Department of Education;
201.8(8) Department of Commerce;
201.9(9) Board of Chiropractic Examiners;
201.10(10) Board of Dentistry;
201.11(11) Board of Marriage and Family Therapy;
201.12(12) Department of Human Services; and
201.13(13) Peace Officer Standards and Training (POST) Board.
201.14(b) The commissioner shall enter into agreements with these agencies to provide for
201.15electronic access to the relevant licensing data by the commissioner.
201.16(c) The commissioner shall provide to the court the electronically available data
201.17maintained in the agency's database, including whether the proposed guardian or
201.18conservator is or has been licensed by the agency, and if the licensing agency database
201.19indicates a disciplinary action or a sanction against the individual's license, including a
201.20condition, suspension, revocation, or cancellation.
201.21(d) If the proposed guardian or conservator has resided in a state other than
201.22Minnesota in the previous ten years, licensing agency data under this section shall also
201.23include the licensing agency data from any other state where the proposed guardian or
201.24conservator reported to have resided during the previous ten years. If the proposed
201.25guardian or conservator has or has had a professional license in another state that is
201.26directly related to the responsibilities of a professional fiduciary from one of the agencies
201.27listed under paragraph (a), state licensing agency data shall also include data from the
201.28relevant licensing agency of that state.
201.29(e) The commissioner is not required to repeat a search for Minnesota or out-of-state
201.30licensing data on an individual if the commissioner has provided this information to the
201.31court within the prior two years.
201.32(f) If an individual has continuously resided in Minnesota since a previous
201.33background study under this section was completed, the commissioner is not required to
201.34repeat a search for records in another state.

202.1    Sec. 16. Minnesota Statutes 2012, section 524.5-303, is amended to read:
202.2524.5-303 JUDICIAL APPOINTMENT OF GUARDIAN: PETITION.
202.3(a) An individual or a person interested in the individual's welfare may petition for
202.4a determination of incapacity, in whole or in part, and for the appointment of a limited
202.5or unlimited guardian for the individual.
202.6(b) The petition must set forth the petitioner's name, residence, current address if
202.7different, relationship to the respondent, and interest in the appointment and, to the extent
202.8known, state or contain the following with respect to the respondent and the relief requested:
202.9(1) the respondent's name, age, principal residence, current street address, and, if
202.10different, the address of the dwelling in which it is proposed that the respondent will
202.11reside if the appointment is made;
202.12(2) the name and address of the respondent's:
202.13(i) spouse, or if the respondent has none, an adult with whom the respondent has
202.14resided for more than six months before the filing of the petition; and
202.15(ii) adult children or, if the respondent has none, the respondent's parents and adult
202.16brothers and sisters, or if the respondent has none, at least one of the adults nearest in
202.17kinship to the respondent who can be found;
202.18(3) the name of the administrative head and address of the institution where the
202.19respondent is a patient, resident, or client of any hospital, nursing home, home care
202.20agency, or other institution;
202.21(4) the name and address of any legal representative for the respondent;
202.22(5) the name, address, and telephone number of any person nominated as guardian
202.23by the respondent in any manner permitted by law, including a health care agent nominated
202.24in a health care directive;
202.25(6) the name, address, and telephone number of any proposed guardian and the
202.26reason why the proposed guardian should be selected;
202.27(7) the name and address of any health care agent or proxy appointed pursuant to
202.28a health care directive as defined in section 145C.01, a living will under chapter 145B,
202.29or other similar document executed in another state and enforceable under the laws of
202.30this state;
202.31(8) the reason why guardianship is necessary, including a brief description of the
202.32nature and extent of the respondent's alleged incapacity;
202.33(9) if an unlimited guardianship is requested, the reason why limited guardianship
202.34is inappropriate and, if a limited guardianship is requested, the powers to be granted to
202.35the limited guardian; and
203.1(10) a general statement of the respondent's property with an estimate of its value,
203.2including any insurance or pension, and the source and amount of any other anticipated
203.3income or receipts.
203.4(c) The petition must also set forth the following information regarding the proposed
203.5guardian or any employee of the guardian responsible for exercising powers and duties
203.6under the guardianship:
203.7(1) whether the proposed guardian has ever been removed for cause from serving as
203.8a guardian or conservator and, if so, the case number and court location; and
203.9(2) if the proposed guardian is a professional guardian or conservator, a summary of
203.10the proposed guardian's educational background and relevant work and other experience.;
203.11(3) whether the proposed guardian has ever applied for or held, at any time, any
203.12professional license from an agency listed under section 524.5-118, subdivision 2a, and if
203.13so, the name of the licensing agency, and as applicable, the license number and status;
203.14whether the license is active or has been denied, conditioned, suspended, revoked, or
203.15canceled; and the basis for the denial, condition, suspension, revocation, or cancellation
203.16of the license;
203.17(4) whether the proposed guardian has ever been found civilly liable in an action
203.18that involved fraud, misrepresentation, material omission, misappropriation, theft, or
203.19conversion, and if so, the case number and court location;
203.20(5) whether the proposed guardian has ever filed for or received protection under the
203.21bankruptcy laws, and if so, the case number and court location;
203.22(6) whether the proposed guardian has any outstanding civil monetary judgments
203.23against the proposed guardian, and if so, the case number, court location, and outstanding
203.24amount owed;
203.25(7) whether an order for protection or harassment restraining order has ever been
203.26issued against the proposed guardian, and if so, the case number and court location; and
203.27(8) whether the proposed guardian has ever been convicted of a crime other than a
203.28petty misdemeanor or traffic offense, and if so, the case number and the crime of which
203.29the guardian was convicted.

203.30    Sec. 17. Minnesota Statutes 2012, section 524.5-316, is amended to read:
203.31524.5-316 REPORTS; MONITORING OF GUARDIANSHIP; COURT
203.32ORDERS.
203.33(a) A guardian shall report to the court in writing on the condition of the ward at least
203.34annually and whenever ordered by the court. A copy of the report must be provided to the
203.35ward and to interested persons of record with the court. A report must state or contain:
204.1(1) the current mental, physical, and social condition of the ward;
204.2(2) the living arrangements for all addresses of the ward during the reporting period;
204.3(3) any restrictions placed on the ward's right to communication and visitation with
204.4persons of the ward's choice and the factual bases for those restrictions;
204.5(4) the medical, educational, vocational, and other services provided to the ward and
204.6the guardian's opinion as to the adequacy of the ward's care;
204.7(5) a recommendation as to the need for continued guardianship and any
204.8recommended changes in the scope of the guardianship;
204.9(6) an address and telephone number where the guardian can be contacted; and
204.10(7) whether the guardian has ever been removed for cause from serving as a guardian
204.11or conservator and, if so, the case number and court location;
204.12(8) any changes occurring that would affect the accuracy of information contained
204.13in the most recent criminal background study of the guardian conducted under section
204.14524.5-118; and
204.15(9) (7) if applicable, the amount of reimbursement for services rendered to the ward
204.16that the guardian received during the previous year that were not reimbursed by county
204.17contract.
204.18(b) A guardian s