HF 1233

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

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 shall report to the court in writing within 30 days of the occurrence of
204.19any of the events listed in this paragraph. The guardian must report any of the occurrences
204.20in this paragraph and follow the same reporting requirements in this paragraph for
204.21any employee of the guardian responsible for exercising powers and duties under the
204.22guardianship. A copy of the report must be provided to the ward and to interested persons
204.23of record with the court. A guardian shall report when:
204.24(1) the guardian is removed for cause from serving as a guardian or conservator, and
204.25if so, the case number and court location;
204.26(2) the guardian has a professional license from an agency listed under section
204.27524.5-118, subdivision 2a, denied, conditioned, suspended, revoked, or canceled, and
204.28if so, the licensing agency and license number, and the basis for denial, condition,
204.29suspension, revocation, or cancellation of the license;
204.30(3) the guardian is found civilly liable in an action that involves fraud,
204.31misrepresentation, material omission, misappropriation, theft, or conversion, and if so, the
204.32case number and court location;
204.33(4) the guardian files for or receives protection under the bankruptcy laws, and
204.34if so, the case number and court location;
204.35(5) a civil monetary judgment is entered against the guardian, and if so, the case
204.36number, court location, and outstanding amount owed;
205.1(6) the guardian is convicted of a crime other than a petty misdemeanor or traffic
205.2offense, and if so, the case number and court location; or
205.3(7) an order for protection or harassment restraining order is issued against the
205.4guardian, and if so, the case number and court location.
205.5(b) (c) A ward or interested person of record with the court may submit to the court a
205.6written statement disputing statements or conclusions regarding the condition of the ward
205.7or addressing any disciplinary or legal action that are is contained in the report guardian's
205.8reports and may petition the court for an order that is in the best interests of the ward or
205.9for other appropriate relief.
205.10(c) (d) An interested person may notify the court in writing that the interested person
205.11does not wish to receive copies of reports required under this section.
205.12(d) (e) The court may appoint a visitor to review a report, interview the ward or
205.13guardian, and make any other investigation the court directs.
205.14(e) (f) The court shall establish a system for monitoring guardianships, including the
205.15filing and review of annual reports. If an annual report is not filed within 60 days of the
205.16required date, the court shall issue an order to show cause.
205.17(g) If a guardian fails to comply with this section, the court may decline to appoint that
205.18person as a guardian or conservator, or may remove a person as guardian or conservator.

205.19    Sec. 18. Minnesota Statutes 2012, section 524.5-403, is amended to read:
205.20524.5-403 ORIGINAL PETITION FOR APPOINTMENT OR PROTECTIVE
205.21ORDER.
205.22(a) The following may petition for the appointment of a conservator or for any
205.23other appropriate protective order:
205.24(1) the person to be protected;
205.25(2) an individual interested in the estate, affairs, or welfare of the person to be
205.26protected; or
205.27(3) a person who would be adversely affected by lack of effective management of
205.28the property and business affairs of the person to be protected.
205.29(b) The petition must set forth the petitioner's name, residence, current address
205.30if different, relationship to the respondent, and interest in the appointment or other
205.31protective order, and, to the extent known, state or contain the following with respect to
205.32the respondent and the relief requested:
205.33(1) the respondent's name, age, principal residence, current street address, and, if
205.34different, the address of the dwelling where it is proposed that the respondent will reside if
205.35the appointment is made;
206.1(2) if the petition alleges impairment in the respondent's ability to receive and
206.2evaluate information, a brief description of the nature and extent of the respondent's
206.3alleged impairment;
206.4(3) if the petition alleges that the respondent is missing, detained, or unable to
206.5return to the United States, a statement of the relevant circumstances, including the time
206.6and nature of the disappearance or detention and a description of any search or inquiry
206.7concerning the respondent's whereabouts;
206.8(4) the name and address of the respondent's:
206.9(i) spouse, or if the respondent has none, an adult with whom the respondent has
206.10resided for more than six months before the filing of the petition; and
206.11(ii) adult children or, if the respondent has none, the respondent's parents and adult
206.12brothers and sisters or, if the respondent has none, at least one of the adults nearest in
206.13kinship to the respondent who can be found;
206.14(5) the name of the administrative head and address of the institution where the
206.15respondent is a patient, resident, or client of any hospital, nursing home, home care
206.16agency, or other institution;
206.17(6) the name and address of any legal representative for the respondent;
206.18(7) the name and address of any health care agent or proxy appointed pursuant to
206.19a health care directive as defined in section 145C.01, a living will under chapter 145B,
206.20or other similar document executed in another state and enforceable under the laws of
206.21this state;
206.22(8) a general statement of the respondent's property with an estimate of its value,
206.23including any insurance or pension, and the source and amount of other anticipated
206.24income or receipts; and
206.25(9) the reason why a conservatorship or other protective order is in the best interest
206.26of the respondent.
206.27(c) If a conservatorship is requested, the petition must also set forth to the extent
206.28known:
206.29(1) the name, address, and telephone number of any proposed conservator and the
206.30reason why the proposed conservator should be selected;
206.31(2) the name, address, and telephone number of any person nominated as conservator
206.32by the respondent if the respondent has attained 14 years of age; and
206.33(3) the type of conservatorship requested and, if an unlimited conservatorship,
206.34the reason why limited conservatorship is inappropriate or, if a limited conservatorship,
206.35the property to be placed under the conservator's control and any limitation on the
206.36conservator's powers and duties.
207.1(d) The petition must also set forth the following information regarding the proposed
207.2conservator or any employee of the conservator responsible for exercising powers and
207.3duties under the conservatorship:
207.4(1) whether the proposed conservator has ever been removed for cause from serving
207.5as a guardian or conservator and, if so, the case number and court location; and
207.6(2) if the proposed conservator is a professional guardian or conservator, a summary
207.7of the proposed conservator's educational background and relevant work and other
207.8experience.;
207.9(3) whether the proposed conservator has ever applied for or held, at any time, any
207.10professional license from an agency listed under section 524.5-118, subdivision 2a, and if
207.11so, the name of the licensing agency, and as applicable, the license number and status;
207.12whether the license is active or has been denied, conditioned, suspended, revoked, or
207.13canceled; and the basis for the denial, condition, suspension, revocation, or cancellation
207.14of the license;
207.15(4) whether the proposed conservator has ever been found civilly liable in an action
207.16that involved fraud, misrepresentation, material omission, misappropriation, theft, or
207.17conversion, and if so, the case number and court location;
207.18(5) whether the proposed conservator has ever filed for or received protection under
207.19the bankruptcy laws, and if so, the case number and court location;
207.20(6) whether the proposed conservator has any outstanding civil monetary judgments
207.21against the proposed conservator, and if so, the case number, court location, and
207.22outstanding amount owed;
207.23(7) whether an order for protection or harassment restraining order has ever been
207.24issued against the proposed conservator, and if so, the case number and court location; and
207.25(8) whether the proposed conservator has ever been convicted of a crime other than
207.26a petty misdemeanor or traffic offense, and if so, the case number and the crime of which
207.27the conservator was convicted.

207.28    Sec. 19. Minnesota Statutes 2012, section 524.5-420, is amended to read:
207.29524.5-420 REPORTS; APPOINTMENT OF VISITOR; MONITORING;
207.30COURT ORDERS.
207.31(a) A conservator shall report to the court for administration of the estate annually
207.32unless the court otherwise directs, upon resignation or removal, upon termination of the
207.33conservatorship, and at other times as the court directs. An order, after notice and hearing,
207.34allowing an intermediate report of a conservator adjudicates liabilities concerning the
208.1matters adequately disclosed in the accounting. An order, after notice and hearing, allowing
208.2a final report adjudicates all previously unsettled liabilities relating to the conservatorship.
208.3(b) A report must state or contain a listing of the assets of the estate under the
208.4conservator's control and a listing of the receipts, disbursements, and distributions during
208.5the reporting period.
208.6(c) The report must also state:
208.7(1) an address and telephone number where the conservator can be contacted;.
208.8(2) whether the conservator has ever been removed for cause from serving as a
208.9guardian or conservator and, if so, the case number and court locations; and
208.10(3) any changes occurring that would affect the accuracy of information contained in
208.11the most recent criminal background study of the conservator conducted under section
208.12524.5-118.
208.13(d) A conservator shall report to the court in writing within 30 days of the occurrence
208.14of any of the events listed in this paragraph. The conservator must report any of the
208.15occurrences in this paragraph and follow the same reporting requirements in this paragraph
208.16for any employee of the conservator responsible for exercising powers and duties under
208.17the conservatorship. A copy of the report must be provided to the protected person and to
208.18interested persons of record with the court. A conservator shall report when:
208.19(1) the conservator is removed for cause from serving as a guardian or conservator,
208.20and if so, the case number and court location;
208.21(2) the conservator has a professional license from an agency listed under section
208.22524.5-118, subdivision 2a, denied, conditioned, suspended, revoked, or canceled, and
208.23if so, the licensing agency and license number, and the basis for denial, condition,
208.24suspension, revocation, or cancellation of the license;
208.25(3) the conservator is found civilly liable in an action that involves fraud,
208.26misrepresentation, material omission, misappropriation, theft, or conversion, and if so, the
208.27case number and court location;
208.28(4) the conservator files for or receives protection under the bankruptcy laws, and
208.29if so, the case number and court location;
208.30(5) a civil monetary judgment is entered against the conservator, and if so, the case
208.31number, court location, and outstanding amount owed;
208.32(6) the conservator is convicted of a crime other than a petty misdemeanor or traffic
208.33offense, and if so, the case number and court location; or
208.34(7) an order for protection or harassment restraining order is issued against the
208.35conservator, and if so, the case number and court location.
209.1(d) (e) A protected person or an interested person of record with the court may
209.2submit to the court a written statement disputing account statements regarding the
209.3administration of the estate or addressing any disciplinary or legal action that are is
209.4 contained in the report reports and may petition the court for any order that is in the best
209.5interests of the protected person and the estate or for other appropriate relief.
209.6(e) (f) An interested person may notify the court in writing that the interested person
209.7does not wish to receive copies of reports required under this section.
209.8(f) (g) The court may appoint a visitor to review a report or plan, interview the
209.9protected person or conservator, and make any other investigation the court directs. In
209.10connection with a report, the court may order a conservator to submit the assets of the
209.11estate to an appropriate examination to be made in a manner the court directs.
209.12(g) (h) The court shall establish a system for monitoring of conservatorships,
209.13including the filing and review of conservators' reports and plans. If an annual report is
209.14not filed within 60 days of the required date, the court shall issue an order to show cause.
209.15(i) If a conservator fails to comply with this section, the court may decline to appoint
209.16that person as a guardian or conservator, or may remove a person as guardian or conservator.

209.17    Sec. 20. INSTRUCTIONS TO THE COMMISSIONER.
209.18    In collaboration with labor organizations, the commissioner of human services shall
209.19develop clear and consistent standards for state-operated services programs to:
209.20    (1) address direct service staffing shortages;
209.21    (2) identify and help resolve workplace safety issues; and
209.22    (3) elevate the use and visibility of performance measures and objectives related to
209.23overtime use.

209.24ARTICLE 6

209.25HEALTH CARE

209.26    Section 1. Minnesota Statutes 2012, section 245.03, subdivision 1, is amended to read:
209.27    Subdivision 1. Establishment. There is created a Department of Human Services.
209.28A commissioner of human services shall be appointed by the governor under the
209.29provisions of section 15.06. The commissioner shall be selected on the basis of ability and
209.30experience in welfare and without regard to political affiliations. The commissioner shall
209.31 may appoint a up to two deputy commissioner commissioners.

209.32    Sec. 2. Minnesota Statutes 2012, section 256.9657, subdivision 3, is amended to read:
210.1    Subd. 3. Surcharge on HMOs and community integrated service networks. (a)
210.2Effective October 1, 1992, each health maintenance organization with a certificate of
210.3authority issued by the commissioner of health under chapter 62D and each community
210.4integrated service network licensed by the commissioner under chapter 62N shall pay to
210.5the commissioner of human services a surcharge equal to six-tenths of one percent of the
210.6total premium revenues of the health maintenance organization or community integrated
210.7service network as reported to the commissioner of health according to the schedule in
210.8subdivision 4.
210.9(b) Effective July 1, 2013, to June 30, 2015, the surcharge under paragraph (a) is
210.10increased to 1.48 percent.
210.11(c) For purposes of this subdivision, total premium revenue means:
210.12(1) premium revenue recognized on a prepaid basis from individuals and groups
210.13for provision of a specified range of health services over a defined period of time which
210.14is normally one month, excluding premiums paid to a health maintenance organization
210.15or community integrated service network from the Federal Employees Health Benefit
210.16Program;
210.17(2) premiums from Medicare wraparound subscribers for health benefits which
210.18supplement Medicare coverage;
210.19(3) Medicare revenue, as a result of an arrangement between a health maintenance
210.20organization or a community integrated service network and the Centers for Medicare
210.21and Medicaid Services of the federal Department of Health and Human Services, for
210.22services to a Medicare beneficiary, excluding Medicare revenue that states are prohibited
210.23from taxing under sections 1854, 1860D-12, and 1876 of title XVIII of the federal Social
210.24Security Act, codified as United States Code, title 42, sections 1395mm, 1395w-112, and
210.251395w-24, respectively, as they may be amended from time to time; and
210.26(4) medical assistance revenue, as a result of an arrangement between a health
210.27maintenance organization or community integrated service network and a Medicaid state
210.28agency, for services to a medical assistance beneficiary.
210.29If advance payments are made under clause (1) or (2) to the health maintenance
210.30organization or community integrated service network for more than one reporting period,
210.31the portion of the payment that has not yet been earned must be treated as a liability.
210.32(c) (d) When a health maintenance organization or community integrated service
210.33network merges or consolidates with or is acquired by another health maintenance
210.34organization or community integrated service network, the surviving corporation or the
210.35new corporation shall be responsible for the annual surcharge originally imposed on
210.36each of the entities or corporations subject to the merger, consolidation, or acquisition,
211.1regardless of whether one of the entities or corporations does not retain a certificate of
211.2authority under chapter 62D or a license under chapter 62N.
211.3(d) (e) Effective July 1 of each year, the surviving corporation's or the new
211.4corporation's surcharge shall be based on the revenues earned in the second previous
211.5calendar year by all of the entities or corporations subject to the merger, consolidation,
211.6or acquisition regardless of whether one of the entities or corporations does not retain a
211.7certificate of authority under chapter 62D or a license under chapter 62N until the total
211.8premium revenues of the surviving corporation include the total premium revenues of all
211.9the merged entities as reported to the commissioner of health.
211.10(e) (f) When a health maintenance organization or community integrated service
211.11network, which is subject to liability for the surcharge under this chapter, transfers,
211.12assigns, sells, leases, or disposes of all or substantially all of its property or assets, liability
211.13for the surcharge imposed by this chapter is imposed on the transferee, assignee, or buyer
211.14of the health maintenance organization or community integrated service network.
211.15(f) (g) In the event a health maintenance organization or community integrated
211.16service network converts its licensure to a different type of entity subject to liability
211.17for the surcharge under this chapter, but survives in the same or substantially similar
211.18form, the surviving entity remains liable for the surcharge regardless of whether one of
211.19the entities or corporations does not retain a certificate of authority under chapter 62D
211.20or a license under chapter 62N.
211.21(g) (h) The surcharge assessed to a health maintenance organization or community
211.22integrated service network ends when the entity ceases providing services for premiums
211.23and the cessation is not connected with a merger, consolidation, acquisition, or conversion.

211.24    Sec. 3. Minnesota Statutes 2012, section 256.969, subdivision 3a, is amended to read:
211.25    Subd. 3a. Payments. (a) Acute care hospital billings under the medical
211.26assistance program must not be submitted until the recipient is discharged. However,
211.27the commissioner shall establish monthly interim payments for inpatient hospitals that
211.28have individual patient lengths of stay over 30 days regardless of diagnostic category.
211.29Except as provided in section 256.9693, medical assistance reimbursement for treatment
211.30of mental illness shall be reimbursed based on diagnostic classifications. Individual
211.31hospital payments established under this section and sections 256.9685, 256.9686, and
211.32256.9695 , in addition to third-party and recipient liability, for discharges occurring during
211.33the rate year shall not exceed, in aggregate, the charges for the medical assistance covered
211.34inpatient services paid for the same period of time to the hospital. This payment limitation
211.35shall be calculated separately for medical assistance and general assistance medical
212.1care services. The limitation on general assistance medical care shall be effective for
212.2admissions occurring on or after July 1, 1991. Services that have rates established under
212.3subdivision 11 or 12, must be limited separately from other services. After consulting with
212.4the affected hospitals, the commissioner may consider related hospitals one entity and
212.5may merge the payment rates while maintaining separate provider numbers. The operating
212.6and property base rates per admission or per day shall be derived from the best Medicare
212.7and claims data available when rates are established. The commissioner shall determine
212.8the best Medicare and claims data, taking into consideration variables of recency of the
212.9data, audit disposition, settlement status, and the ability to set rates in a timely manner.
212.10The commissioner shall notify hospitals of payment rates by December 1 of the year
212.11preceding the rate year. The rate setting data must reflect the admissions data used to
212.12establish relative values. Base year changes from 1981 to the base year established for the
212.13rate year beginning January 1, 1991, and for subsequent rate years, shall not be limited
212.14to the limits ending June 30, 1987, on the maximum rate of increase under subdivision
212.151. The commissioner may adjust base year cost, relative value, and case mix index data
212.16to exclude the costs of services that have been discontinued by the October 1 of the year
212.17preceding the rate year or that are paid separately from inpatient services. Inpatient stays
212.18that encompass portions of two or more rate years shall have payments established based
212.19on payment rates in effect at the time of admission unless the date of admission preceded
212.20the rate year in effect by six months or more. In this case, operating payment rates for
212.21services rendered during the rate year in effect and established based on the date of
212.22admission shall be adjusted to the rate year in effect by the hospital cost index.
212.23    (b) For fee-for-service admissions occurring on or after July 1, 2002, the total
212.24payment, before third-party liability and spenddown, made to hospitals for inpatient
212.25services is reduced by .5 percent from the current statutory rates.
212.26    (c) In addition to the reduction in paragraph (b), the total payment for fee-for-service
212.27admissions occurring on or after July 1, 2003, made to hospitals for inpatient services
212.28before third-party liability and spenddown, is reduced five percent from the current
212.29statutory rates. Mental health services within diagnosis related groups 424 to 432, and
212.30facilities defined under subdivision 16 are excluded from this paragraph.
212.31    (d) In addition to the reduction in paragraphs (b) and (c), the total payment for
212.32fee-for-service admissions occurring on or after August 1, 2005, made to hospitals for
212.33inpatient services before third-party liability and spenddown, is reduced 6.0 percent
212.34from the current statutory rates. Mental health services within diagnosis related groups
212.35424 to 432 and facilities defined under subdivision 16 are excluded from this paragraph.
212.36Notwithstanding section 256.9686, subdivision 7, for purposes of this paragraph, medical
213.1assistance does not include general assistance medical care. Payments made to managed
213.2care plans shall be reduced for services provided on or after January 1, 2006, to reflect
213.3this reduction.
213.4    (e) In addition to the reductions in paragraphs (b), (c), and (d), the total payment for
213.5fee-for-service admissions occurring on or after July 1, 2008, through June 30, 2009, made
213.6to hospitals for inpatient services before third-party liability and spenddown, is reduced
213.73.46 percent from the current statutory rates. Mental health services with diagnosis related
213.8groups 424 to 432 and facilities defined under subdivision 16 are excluded from this
213.9paragraph. Payments made to managed care plans shall be reduced for services provided
213.10on or after January 1, 2009, through June 30, 2009, to reflect this reduction.
213.11    (f) In addition to the reductions in paragraphs (b), (c), and (d), the total payment for
213.12fee-for-service admissions occurring on or after July 1, 2009, through June 30, 2011, made
213.13to hospitals for inpatient services before third-party liability and spenddown, is reduced
213.141.9 percent from the current statutory rates. Mental health services with diagnosis related
213.15groups 424 to 432 and facilities defined under subdivision 16 are excluded from this
213.16paragraph. Payments made to managed care plans shall be reduced for services provided
213.17on or after July 1, 2009, through June 30, 2011, to reflect this reduction.
213.18    (g) In addition to the reductions in paragraphs (b), (c), and (d), the total payment
213.19for fee-for-service admissions occurring on or after July 1, 2011, made to hospitals for
213.20inpatient services before third-party liability and spenddown, is reduced 1.79 percent
213.21from the current statutory rates. Mental health services with diagnosis related groups
213.22424 to 432 and facilities defined under subdivision 16 are excluded from this paragraph.
213.23Payments made to managed care plans shall be reduced for services provided on or after
213.24July 1, 2011, to reflect this reduction.
213.25(h) In addition to the reductions in paragraphs (b), (c), (d), (f), and (g), the total
213.26payment for fee-for-service admissions occurring on or after July 1, 2009, made to
213.27hospitals for inpatient services before third-party liability and spenddown, is reduced
213.28one percent from the current statutory rates. Facilities defined under subdivision 16 are
213.29excluded from this paragraph. Payments made to managed care plans shall be reduced for
213.30services provided on or after October 1, 2009, to reflect this reduction.
213.31(i) In addition to the reductions in paragraphs (b), (c), (d), (g), and (h), the total
213.32payment for fee-for-service admissions occurring on or after July 1, 2011, made to
213.33hospitals for inpatient services before third-party liability and spenddown, is reduced
213.341.96 percent from the current statutory rates. Facilities defined under subdivision 16 are
213.35excluded from this paragraph. Payments made to managed care plans shall be reduced for
213.36services provided on or after January 1, 2011, to reflect this reduction.
214.1(j) For admissions occurring on or after January 1, 2015, the rate for inpatient
214.2hospital services must be increased 1.4 percent from the rate in effect on December 31,
214.32014. Payments made to managed care plans and county-based purchasing plans shall
214.4not be adjusted to reflect payments under this paragraph.

214.5    Sec. 4. Minnesota Statutes 2012, section 256.969, subdivision 29, is amended to read:
214.6    Subd. 29. Reimbursement for the fee increase for the early hearing detection
214.7and intervention program. (a) For admissions occurring on or after July 1, 2010,
214.8payment rates shall be adjusted to include the increase to the fee that is effective on July 1,
214.92010, for the early hearing detection and intervention program recipients under section
214.10144.125, subdivision 1 , that is paid by the hospital for public program recipients. This
214.11payment increase shall be in effect until the increase is fully recognized in the base year
214.12cost under subdivision 2b. This payment shall be included in payments to contracted
214.13managed care organizations.
214.14    (b) For admissions occurring on or after July 1, 2013, payment rates shall be adjusted
214.15to include the increase to the fee that is effective July 1, 2013, for the early hearing
214.16detection and intervention program under section 144.125, subdivision 1, paragraph (d),
214.17that is paid by the hospital for medical assistance and MinnesotaCare program enrollees.
214.18This payment increase shall be in effect until the increase is fully recognized in the
214.19base-year cost under subdivision 2b. This payment shall be included in payments to
214.20managed care plans and county-based purchasing plans.

214.21    Sec. 5. Minnesota Statutes 2012, section 256B.055, subdivision 14, is amended to read:
214.22    Subd. 14. Persons detained by law. (a) Medical assistance may be paid for an
214.23inmate of a correctional facility who is conditionally released as authorized under section
214.24241.26 , 244.065, or 631.425, if the individual does not require the security of a public
214.25detention facility and is housed in a halfway house or community correction center, or
214.26under house arrest and monitored by electronic surveillance in a residence approved
214.27by the commissioner of corrections, and if the individual meets the other eligibility
214.28requirements of this chapter.
214.29    (b) An individual who is enrolled in medical assistance, and who is charged with a
214.30crime and incarcerated for less than 12 months shall be suspended from eligibility at the
214.31time of incarceration until the individual is released. Upon release, medical assistance
214.32eligibility is reinstated without reapplication using a reinstatement process and form, if the
214.33individual is otherwise eligible.
215.1    (c) An individual, regardless of age, who is considered an inmate of a public
215.2institution as defined in Code of Federal Regulations, title 42, section 435.1010, and
215.3who meets the eligibility requirements in section 256B.056, is not eligible for medical
215.4assistance, except for covered services received while an inpatient in a medical institution
215.5as defined in Code of Federal Regulations, title 42, section 435.1010. Security issues,
215.6including costs, related to the inpatient treatment of an inmate are the responsibility of the
215.7entity with jurisdiction over the inmate.
215.8EFFECTIVE DATE.This section is effective January 1, 2014.

215.9    Sec. 6. Minnesota Statutes 2012, section 256B.06, subdivision 4, is amended to read:
215.10    Subd. 4. Citizenship requirements. (a) Eligibility for medical assistance is limited
215.11to citizens of the United States, qualified noncitizens as defined in this subdivision, and
215.12other persons residing lawfully in the United States. Citizens or nationals of the United
215.13States must cooperate in obtaining satisfactory documentary evidence of citizenship or
215.14nationality according to the requirements of the federal Deficit Reduction Act of 2005,
215.15Public Law 109-171.
215.16(b) "Qualified noncitizen" means a person who meets one of the following
215.17immigration criteria:
215.18(1) admitted for lawful permanent residence according to United States Code, title 8;
215.19(2) admitted to the United States as a refugee according to United States Code,
215.20title 8, section 1157;
215.21(3) granted asylum according to United States Code, title 8, section 1158;
215.22(4) granted withholding of deportation according to United States Code, title 8,
215.23section 1253(h);
215.24(5) paroled for a period of at least one year according to United States Code, title 8,
215.25section 1182(d)(5);
215.26(6) granted conditional entrant status according to United States Code, title 8,
215.27section 1153(a)(7);
215.28(7) determined to be a battered noncitizen by the United States Attorney General
215.29according to the Illegal Immigration Reform and Immigrant Responsibility Act of 1996,
215.30title V of the Omnibus Consolidated Appropriations Bill, Public Law 104-200;
215.31(8) is a child of a noncitizen determined to be a battered noncitizen by the United
215.32States Attorney General according to the Illegal Immigration Reform and Immigrant
215.33Responsibility Act of 1996, title V, of the Omnibus Consolidated Appropriations Bill,
215.34Public Law 104-200; or
216.1(9) determined to be a Cuban or Haitian entrant as defined in section 501(e) of Public
216.2Law 96-422, the Refugee Education Assistance Act of 1980.
216.3(c) All qualified noncitizens who were residing in the United States before August
216.422, 1996, who otherwise meet the eligibility requirements of this chapter, are eligible for
216.5medical assistance with federal financial participation.
216.6(d) Beginning December 1, 1996, qualified noncitizens who entered the United
216.7States on or after August 22, 1996, and who otherwise meet the eligibility requirements
216.8of this chapter are eligible for medical assistance with federal participation for five years
216.9if they meet one of the following criteria:
216.10(1) refugees admitted to the United States according to United States Code, title 8,
216.11section 1157;
216.12(2) persons granted asylum according to United States Code, title 8, section 1158;
216.13(3) persons granted withholding of deportation according to United States Code,
216.14title 8, section 1253(h);
216.15(4) veterans of the United States armed forces with an honorable discharge for
216.16a reason other than noncitizen status, their spouses and unmarried minor dependent
216.17children; or
216.18(5) persons on active duty in the United States armed forces, other than for training,
216.19their spouses and unmarried minor dependent children.
216.20 Beginning July 1, 2010, children and pregnant women who are noncitizens
216.21described in paragraph (b) or who are lawfully present in the United States as defined
216.22in Code of Federal Regulations, title 8, section 103.12, and who otherwise meet
216.23eligibility requirements of this chapter, are eligible for medical assistance with federal
216.24financial participation as provided by the federal Children's Health Insurance Program
216.25Reauthorization Act of 2009, Public Law 111-3.
216.26(e) Nonimmigrants who otherwise meet the eligibility requirements of this chapter
216.27are eligible for the benefits as provided in paragraphs (f) to (h). For purposes of this
216.28subdivision, a "nonimmigrant" is a person in one of the classes listed in United States
216.29Code, title 8, section 1101(a)(15).
216.30(f) Payment shall also be made for care and services that are furnished to noncitizens,
216.31regardless of immigration status, who otherwise meet the eligibility requirements of
216.32this chapter, if such care and services are necessary for the treatment of an emergency
216.33medical condition.
216.34(g) For purposes of this subdivision, the term "emergency medical condition" means
216.35a medical condition that meets the requirements of United States Code, title 42, section
216.361396b(v).
217.1(h)(1) Notwithstanding paragraph (g), services that are necessary for the treatment
217.2of an emergency medical condition are limited to the following:
217.3(i) services delivered in an emergency room or by an ambulance service licensed
217.4under chapter 144E that are directly related to the treatment of an emergency medical
217.5condition;
217.6(ii) services delivered in an inpatient hospital setting following admission from an
217.7emergency room or clinic for an acute emergency condition; and
217.8(iii) follow-up services that are directly related to the original service provided
217.9to treat the emergency medical condition and are covered by the global payment made
217.10to the provider.
217.11    (2) Services for the treatment of emergency medical conditions do not include:
217.12(i) services delivered in an emergency room or inpatient setting to treat a
217.13nonemergency condition;
217.14(ii) organ transplants, stem cell transplants, and related care;
217.15(iii) services for routine prenatal care;
217.16(iv) continuing care, including long-term care, nursing facility services, home health
217.17care, adult day care, day training, or supportive living services;
217.18(v) elective surgery;
217.19(vi) outpatient prescription drugs, unless the drugs are administered or dispensed as
217.20part of an emergency room visit;
217.21(vii) preventative health care and family planning services;
217.22(viii) dialysis;
217.23(ix) chemotherapy or therapeutic radiation services;
217.24(x) (viii) rehabilitation services;
217.25(xi) (ix) physical, occupational, or speech therapy;
217.26(xii) (x) transportation services;
217.27(xiii) (xi) case management;
217.28(xiv) (xii) prosthetics, orthotics, durable medical equipment, or medical supplies;
217.29(xv) (xiii) dental services;
217.30(xvi) (xiv) hospice care;
217.31(xvii) (xv) audiology services and hearing aids;
217.32(xviii) (xvi) podiatry services;
217.33(xix) (xvii) chiropractic services;
217.34(xx) (xviii) immunizations;
217.35(xxi) (xix) vision services and eyeglasses;
217.36(xxii) (xx) waiver services;
218.1(xxiii) (xxi) individualized education programs; or
218.2(xxiv) (xxii) chemical dependency treatment.
218.3(i) Beginning July 1, 2009, pregnant noncitizens who are undocumented,
218.4nonimmigrants, or lawfully present in the United States as defined in Code of Federal
218.5Regulations, title 8, section 103.12, are not covered by a group health plan or health
218.6insurance coverage according to Code of Federal Regulations, title 42, section 457.310,
218.7and who otherwise meet the eligibility requirements of this chapter, are eligible for
218.8medical assistance through the period of pregnancy, including labor and delivery, and 60
218.9days postpartum, to the extent federal funds are available under title XXI of the Social
218.10Security Act, and the state children's health insurance program.
218.11(j) Beginning October 1, 2003, persons who are receiving care and rehabilitation
218.12services from a nonprofit center established to serve victims of torture and are otherwise
218.13ineligible for medical assistance under this chapter are eligible for medical assistance
218.14without federal financial participation. These individuals are eligible only for the period
218.15during which they are receiving services from the center. Individuals eligible under this
218.16paragraph shall not be required to participate in prepaid medical assistance.
218.17(k) Notwithstanding paragraph (h), clause (2), the following services are covered as
218.18emergency medical conditions under paragraph (f) except where coverage is prohibited
218.19under federal law:
218.20(1) dialysis services provided in a hospital or freestanding dialysis facility; and
218.21(2) surgery and the administration of chemotherapy, radiation, and related services
218.22necessary to treat cancer if the recipient has a cancer diagnosis that is not in remission
218.23and requires surgery, chemotherapy, or radiation treatment.
218.24    (l) The commissioner or its third party medical review agent may authorize payment
218.25for follow-up care and alternative services, including, but not limited to, long-term care
218.26services that would not otherwise be paid for under this subdivision if the commissioner
218.27determines that the services, if provided, will directly prevent a medical emergency from
218.28immediately occurring.

218.29    Sec. 7. Minnesota Statutes 2012, section 256B.0625, subdivision 13e, is amended to
218.30read:
218.31    Subd. 13e. Payment rates. (a) The basis for determining the amount of payment
218.32shall be the lower of the actual acquisition costs of the drugs or the maximum allowable
218.33cost by the commissioner plus the fixed dispensing fee; or the usual and customary price
218.34charged to the public. The amount of payment basis must be reduced to reflect all discount
218.35amounts applied to the charge by any provider/insurer agreement or contract for submitted
219.1charges to medical assistance programs. The net submitted charge may not be greater
219.2than the patient liability for the service. The pharmacy dispensing fee shall be $3.65,
219.3except that the dispensing fee for intravenous solutions which must be compounded by the
219.4pharmacist shall be $8 per bag, $14 per bag for cancer chemotherapy products, and $30
219.5per bag for total parenteral nutritional products dispensed in one liter quantities, or $44 per
219.6bag for total parenteral nutritional products dispensed in quantities greater than one liter.
219.7Actual acquisition cost includes quantity and other special discounts except time and cash
219.8discounts. The actual acquisition cost of a drug shall be estimated by the commissioner at
219.9wholesale acquisition cost plus four percent for independently owned pharmacies located
219.10in a designated rural area within Minnesota, and at wholesale acquisition cost plus two
219.11percent for all other pharmacies. A pharmacy is "independently owned" if it is one of four
219.12or fewer pharmacies under the same ownership nationally. A "designated rural area" means
219.13an area defined as a small rural area or isolated rural area according to the four-category
219.14classification of the Rural Urban Commuting Area system developed for the United States
219.15Health Resources and Services Administration. Wholesale acquisition cost is defined as the
219.16manufacturer's list price for a drug or biological to wholesalers or direct purchasers in the
219.17United States, not including prompt pay or other discounts, rebates, or reductions in price,
219.18for the most recent month for which information is available, as reported in wholesale price
219.19guides or other publications of drug or biological pricing data. The maximum allowable
219.20cost of a multisource drug may be set by the commissioner and it shall be comparable to,
219.21but no higher than, the maximum amount paid by other third-party payors in this state who
219.22have maximum allowable cost programs. Establishment of the amount of payment for
219.23drugs shall not be subject to the requirements of the Administrative Procedure Act.
219.24    (b) An additional dispensing fee of $.30 may be added to the dispensing fee paid
219.25to pharmacists for legend drug prescriptions dispensed to residents of long-term care
219.26facilities when a unit dose blister card system, approved by the department, is used. Under
219.27this type of dispensing system, the pharmacist must dispense a 30-day supply of drug. The
219.28National Drug Code (NDC) from the drug container used to fill the blister card must be
219.29identified on the claim to the department. The unit dose blister card containing the drug
219.30must meet the packaging standards set forth in Minnesota Rules, part 6800.2700, that
219.31govern the return of unused drugs to the pharmacy for reuse. The pharmacy provider will
219.32be required to credit the department for the actual acquisition cost of all unused drugs that
219.33are eligible for reuse. The commissioner may permit the drug clozapine to be dispensed in
219.34a quantity that is less than a 30-day supply.
219.35    (c) Whenever a maximum allowable cost has been set for a multisource drug,
219.36payment shall be the lower of the usual and customary price charged to the public or the
220.1maximum allowable cost established by the commissioner unless prior authorization
220.2for the brand name product has been granted according to the criteria established by
220.3the Drug Formulary Committee as required by subdivision 13f, paragraph (a), and the
220.4prescriber has indicated "dispense as written" on the prescription in a manner consistent
220.5with section 151.21, subdivision 2.
220.6    (d) The basis for determining the amount of payment for drugs administered in an
220.7outpatient setting shall be the lower of the usual and customary cost submitted by the
220.8provider or, 106 percent of the average sales price as determined by the United States
220.9Department of Health and Human Services pursuant to title XVIII, section 1847a of the
220.10federal Social Security Act, the specialty pharmacy rate, or the maximum allowable cost
220.11set by the commissioner. If average sales price is unavailable, the amount of payment
220.12must be lower of the usual and customary cost submitted by the provider or, the wholesale
220.13acquisition cost, the specialty pharmacy rate, or the maximum allowable cost set by the
220.14commissioner. The payment for drugs administered in an outpatient setting shall be made
220.15to the administering facility or practitioner. A retail or specialty pharmacy dispensing a
220.16drug for administration in an outpatient setting is not eligible for direct reimbursement.
220.17    (e) The commissioner may negotiate lower reimbursement rates for specialty
220.18pharmacy products than the rates specified in paragraph (a). The commissioner may
220.19require individuals enrolled in the health care programs administered by the department
220.20to obtain specialty pharmacy products from providers with whom the commissioner has
220.21negotiated lower reimbursement rates. Specialty pharmacy products are defined as those
220.22used by a small number of recipients or recipients with complex and chronic diseases
220.23that require expensive and challenging drug regimens. Examples of these conditions
220.24include, but are not limited to: multiple sclerosis, HIV/AIDS, transplantation, hepatitis
220.25C, growth hormone deficiency, Crohn's Disease, rheumatoid arthritis, and certain forms
220.26of cancer. Specialty pharmaceutical products include injectable and infusion therapies,
220.27biotechnology drugs, antihemophilic factor products, high-cost therapies, and therapies
220.28that require complex care. The commissioner shall consult with the formulary committee
220.29to develop a list of specialty pharmacy products subject to this paragraph. In consulting
220.30with the formulary committee in developing this list, the commissioner shall take into
220.31consideration the population served by specialty pharmacy products, the current delivery
220.32system and standard of care in the state, and access to care issues. The commissioner shall
220.33have the discretion to adjust the reimbursement rate to prevent access to care issues.
220.34(f) Home infusion therapy services provided by home infusion therapy pharmacies
220.35must be paid at rates according to subdivision 8d.
220.36EFFECTIVE DATE.This section is effective January 1, 2014.

221.1    Sec. 8. Minnesota Statutes 2012, section 256B.0625, is amended by adding a
221.2subdivision to read:
221.3    Subd. 28b. Doula services. Medical assistance covers doula services provided by a
221.4certified doula as defined in section 148.995, subdivision 2, of the mother's choice. For
221.5purposes of this section, "doula services" means childbirth education and support services,
221.6including emotional and physical support provided during pregnancy, labor, birth, and
221.7postpartum.
221.8EFFECTIVE DATE.This section is effective July 1, 2014, or upon federal
221.9approval, whichever is later, and applies to services provided on or after the effective date.

221.10    Sec. 9. Minnesota Statutes 2012, section 256B.0625, subdivision 31, is amended to read:
221.11    Subd. 31. Medical supplies and equipment. (a) Medical assistance covers medical
221.12supplies and equipment. Separate payment outside of the facility's payment rate shall
221.13be made for wheelchairs and wheelchair accessories for recipients who are residents
221.14of intermediate care facilities for the developmentally disabled. Reimbursement for
221.15wheelchairs and wheelchair accessories for ICF/MR recipients shall be subject to the same
221.16conditions and limitations as coverage for recipients who do not reside in institutions. A
221.17wheelchair purchased outside of the facility's payment rate is the property of the recipient.
221.18The commissioner may set reimbursement rates for specified categories of medical
221.19supplies at levels below the Medicare payment rate.
221.20(b) Vendors of durable medical equipment, prosthetics, orthotics, or medical supplies
221.21must enroll as a Medicare provider.
221.22(c) When necessary to ensure access to durable medical equipment, prosthetics,
221.23orthotics, or medical supplies, the commissioner may exempt a vendor from the Medicare
221.24enrollment requirement if:
221.25(1) the vendor supplies only one type of durable medical equipment, prosthetic,
221.26orthotic, or medical supply;
221.27(2) the vendor serves ten or fewer medical assistance recipients per year;
221.28(3) the commissioner finds that other vendors are not available to provide same or
221.29similar durable medical equipment, prosthetics, orthotics, or medical supplies; and
221.30(4) the vendor complies with all screening requirements in this chapter and Code of
221.31Federal Regulations, title 42, part 455. The commissioner may also exempt a vendor from
221.32the Medicare enrollment requirement if the vendor is accredited by a Centers for Medicare
221.33and Medicaid Services approved national accreditation organization as complying with
221.34the Medicare program's supplier and quality standards and the vendor serves primarily
221.35pediatric patients.
222.1(d) Durable medical equipment means a device or equipment that:
222.2(1) can withstand repeated use;
222.3(2) is generally not useful in the absence of an illness, injury, or disability; and
222.4(3) is provided to correct or accommodate a physiological disorder or physical
222.5condition or is generally used primarily for a medical purpose.
222.6(e) Electronic tablets may be considered durable medical equipment if the electronic
222.7tablet will be used as an augmentative and alternative communication system as defined
222.8under subdivision 31a, paragraph (a). To be covered by medical assistance, the device
222.9must be locked in order to prevent use not related to communication.

222.10    Sec. 10. Minnesota Statutes 2012, section 256B.0625, is amended by adding a
222.11subdivision to read:
222.12    Subd. 31b. Preferred diabetic testing supply program. (a) The commissioner
222.13shall implement a point-of-sale preferred diabetic testing supply program by January 1,
222.142014. Medical assistance coverage for diabetic testing supplies shall conform to the
222.15limitations established under the program. The commissioner may enter into a contract
222.16with a vendor for the purpose of participating in a preferred diabetic testing supply list and
222.17supplemental rebate program. The commissioner shall ensure that any contract meets all
222.18federal requirements and maximizes federal financial participation. The commissioner
222.19shall maintain an accurate and up-to-date list on the department's Web site.
222.20(b) The commissioner may add to, delete from, and otherwise modify the preferred
222.21diabetic testing supply program drug list after consulting with the Drug Formulary
222.22Committee and appropriate medial specialists and providing public notice and the
222.23opportunity for public comment.
222.24(c) The commissioner shall adopt and administer the preferred diabetic testing
222.25supply program as part of the administration of the diabetic testing supply rebate program.
222.26Reimbursement for diabetic testing supplies not on the preferred diabetic testing supply
222.27list may be subject to prior authorization.
222.28(d) All claims for diabetic testing supplies in categories on the preferred diabetic
222.29testing supply list must be submitted by enrolled pharmacy providers using the most
222.30current National Council of Prescription Drug Providers electronic claims standard.
222.31(e) For purposes of this subdivision, "preferred diabetic testing supply list" means a
222.32list of diabetic testing supplies selected by the commissioner, for which prior authorization
222.33is not required.
222.34(f) The commissioner shall seek any federal waivers or approvals necessary to
222.35implement this subdivision.

223.1    Sec. 11. Minnesota Statutes 2012, section 256B.0625, subdivision 39, is amended to
223.2read:
223.3    Subd. 39. Childhood immunizations. Providers who administer pediatric vaccines
223.4within the scope of their licensure, and who are enrolled as a medical assistance provider,
223.5must enroll in the pediatric vaccine administration program established by section 13631
223.6of the Omnibus Budget Reconciliation Act of 1993. Medical assistance shall pay an
223.7$8.50 fee per dose for administration of the vaccine to children eligible for medical
223.8assistance. Medical assistance does not pay for vaccines that are available at no cost from
223.9the pediatric vaccine administration program.

223.10    Sec. 12. Minnesota Statutes 2012, section 256B.0625, subdivision 58, is amended to
223.11read:
223.12    Subd. 58. Early and periodic screening, diagnosis, and treatment services.
223.13Medical assistance covers early and periodic screening, diagnosis, and treatment services
223.14(EPSDT). The payment amount for a complete EPSDT screening shall not include charges
223.15for vaccines that are available at no cost to the provider and shall not exceed the rate
223.16established per Minnesota Rules, part 9505.0445, item M, effective October 1, 2010.

223.17    Sec. 13. Minnesota Statutes 2012, section 256B.0625, is amended by adding a
223.18subdivision to read:
223.19    Subd. 61. Payment for multiple services provided on the same day. The
223.20commissioner shall not prohibit payment, including supplemental payments, for mental
223.21health services or dental services provided to a patient by a clinic or health care
223.22professional solely because the mental health or dental services were provided on the same
223.23day as other covered health services furnished by the same provider.

223.24    Sec. 14. Minnesota Statutes 2012, section 256B.0631, subdivision 1, is amended to read:
223.25    Subdivision 1. Cost-sharing. (a) Except as provided in subdivision 2, the medical
223.26assistance benefit plan shall include the following cost-sharing for all recipients, effective
223.27for services provided on or after September 1, 2011:
223.28    (1) $3 per nonpreventive visit, except as provided in paragraph (b). For purposes
223.29of this subdivision, a visit means an episode of service which is required because of
223.30a recipient's symptoms, diagnosis, or established illness, and which is delivered in an
223.31ambulatory setting by a physician or physician ancillary, chiropractor, podiatrist, nurse
223.32midwife, advanced practice nurse, audiologist, optician, or optometrist;
224.1    (2) $3.50 for nonemergency visits to a hospital-based emergency room, except that
224.2this co-payment shall be increased to $20 upon federal approval;
224.3    (3) $3 per brand-name drug prescription and $1 per generic drug prescription,
224.4subject to a $12 per month maximum for prescription drug co-payments. No co-payments
224.5shall apply to antipsychotic drugs when used for the treatment of mental illness;
224.6(4) effective January 1, 2012, a family deductible equal to the maximum amount
224.7allowed under Code of Federal Regulations, title 42, part 447.54; and
224.8    (5) for individuals identified by the commissioner with income at or below 100
224.9percent of the federal poverty guidelines, total monthly cost-sharing must not exceed five
224.10percent of family income. For purposes of this paragraph, family income is the total
224.11earned and unearned income of the individual and the individual's spouse, if the spouse is
224.12enrolled in medical assistance and also subject to the five percent limit on cost-sharing.
224.13    (b) Recipients of medical assistance are responsible for all co-payments and
224.14deductibles in this subdivision.
224.15(c) Notwithstanding paragraph (b), the commissioner, through the contracting
224.16process under sections 256B.69 and 256B.692, may allow managed care plans and
224.17county-based purchasing plans to waive the family deductible under paragraph (a),
224.18clause (4). The value of the family deductible shall not be included in the capitation
224.19payment to managed care plans and county-based purchasing plans. Managed care plans
224.20and county-based purchasing plans shall certify annually to the commissioner the dollar
224.21value of the family deductible.
224.22(d) Notwithstanding paragraph (b), the commissioner may shall waive the collection
224.23of the family deductible described under paragraph (a), clause (4), from individuals and
224.24allow long-term care and waivered service providers to assume responsibility for payment.
224.25(e) Notwithstanding paragraph (b), the commissioner, through the contracting
224.26process under section 256B.0756 shall allow the pilot program in Hennepin County to
224.27waive co-payments. The value of the co-payments shall not be included as part of the
224.28payment system for the integrated health care delivery networks under the pilot program.

224.29    Sec. 15. Minnesota Statutes 2012, section 256B.0756, is amended to read:
224.30256B.0756 HENNEPIN AND RAMSEY COUNTIES PILOT PROGRAM.
224.31(a) The commissioner, upon federal approval of a new waiver request or amendment
224.32of an existing demonstration, may establish a pilot program in Hennepin County or Ramsey
224.33County, or both, to test alternative and innovative integrated health care delivery networks.
224.34(b) Individuals eligible for the pilot program shall be individuals who are eligible for
224.35medical assistance under section 256B.055, subdivision 15, and who reside in Hennepin
225.1County or Ramsey County. The commissioner may identify individuals to be enrolled
225.2in the Hennepin County pilot program by zip code or by whether the individuals would
225.3benefit from an integrated health care delivery network.
225.4(c) Individuals enrolled in the pilot program shall be enrolled in an integrated
225.5health care delivery network in their county of residence. The integrated health care
225.6delivery network in Hennepin County shall be a network, such as an accountable care
225.7organization or a community-based collaborative care network, created by or including
225.8Hennepin County Medical Center. The integrated health care delivery network in Ramsey
225.9County shall be a network, such as an accountable care organization or community-based
225.10collaborative care network, created by or including Regions Hospital.
225.11(d) The commissioner shall cap pilot program enrollment at 7,000 enrollees for
225.12Hennepin County and 3,500 enrollees for Ramsey County.
225.13(e) (d) In developing a payment system for the pilot programs, the commissioner
225.14shall establish a total cost of care for the recipients enrolled in the pilot programs that
225.15equals the cost of care that would otherwise be spent for these enrollees in the prepaid
225.16medical assistance program.
225.17(f) Counties may transfer funds necessary to support the nonfederal share of
225.18payments for integrated health care delivery networks in their county. Such transfers per
225.19county shall not exceed 15 percent of the expected expenses for county enrollees.
225.20(g) (e) The commissioner shall apply to the federal government for, or as appropriate,
225.21cooperate with counties, providers, or other entities that are applying for any applicable
225.22grant or demonstration under the Patient Protection and Affordable Health Care Act, Public
225.23Law 111-148, or the Health Care and Education Reconciliation Act of 2010, Public Law
225.24111-152, that would further the purposes of or assist in the creation of an integrated health
225.25care delivery network for the purposes of this subdivision, including, but not limited to, a
225.26global payment demonstration or the community-based collaborative care network grants.

225.27    Sec. 16. Minnesota Statutes 2012, section 256B.196, subdivision 2, is amended to read:
225.28    Subd. 2. Commissioner's duties. (a) For the purposes of this subdivision and
225.29subdivision 3, the commissioner shall determine the fee-for-service outpatient hospital
225.30services upper payment limit for nonstate government hospitals. The commissioner shall
225.31then determine the amount of a supplemental payment to Hennepin County Medical
225.32Center and Regions Hospital for these services that would increase medical assistance
225.33spending in this category to the aggregate upper payment limit for all nonstate government
225.34hospitals in Minnesota. In making this determination, the commissioner shall allot the
225.35available increases between Hennepin County Medical Center and Regions Hospital
226.1based on the ratio of medical assistance fee-for-service outpatient hospital payments to
226.2the two facilities. The commissioner shall adjust this allotment as necessary based on
226.3federal approvals, the amount of intergovernmental transfers received from Hennepin and
226.4Ramsey Counties, and other factors, in order to maximize the additional total payments.
226.5The commissioner shall inform Hennepin County and Ramsey County of the periodic
226.6intergovernmental transfers necessary to match federal Medicaid payments available
226.7under this subdivision in order to make supplementary medical assistance payments to
226.8Hennepin County Medical Center and Regions Hospital equal to an amount that when
226.9combined with existing medical assistance payments to nonstate governmental hospitals
226.10would increase total payments to hospitals in this category for outpatient services to
226.11the aggregate upper payment limit for all hospitals in this category in Minnesota. Upon
226.12receipt of these periodic transfers, the commissioner shall make supplementary payments
226.13to Hennepin County Medical Center and Regions Hospital.
226.14    (b) For the purposes of this subdivision and subdivision 3, the commissioner shall
226.15determine an upper payment limit for physicians and other billing professionals affiliated
226.16with Hennepin County Medical Center and with Regions Hospital. The upper payment
226.17limit shall be based on the average commercial rate or be determined using another method
226.18acceptable to the Centers for Medicare and Medicaid Services. The commissioner shall
226.19inform Hennepin County and Ramsey County of the periodic intergovernmental transfers
226.20necessary to match the federal Medicaid payments available under this subdivision in order
226.21to make supplementary payments to physicians and other billing professionals affiliated
226.22with Hennepin County Medical Center and to make supplementary payments to physicians
226.23and other billing professionals affiliated with Regions Hospital through HealthPartners
226.24Medical Group equal to the difference between the established medical assistance
226.25payment for physician and other billing professional services and the upper payment limit.
226.26Upon receipt of these periodic transfers, the commissioner shall make supplementary
226.27payments to physicians and other billing professionals affiliated with Hennepin County
226.28Medical Center and shall make supplementary payments to physicians and other billing
226.29professionals affiliated with Regions Hospital through HealthPartners Medical Group.
226.30    (c) Beginning January 1, 2010, Hennepin County and Ramsey County may make
226.31monthly voluntary intergovernmental transfers to the commissioner in amounts not to
226.32exceed $12,000,000 per year from Hennepin County and $6,000,000 per year from
226.33Ramsey County. The commissioner shall increase the medical assistance capitation
226.34payments to any licensed health plan under contract with the medical assistance program
226.35that agrees to make enhanced payments to Hennepin County Medical Center or Regions
226.36Hospital. The increase shall be in an amount equal to the annual value of the monthly
227.1transfers plus federal financial participation, with each health plan receiving its pro rata
227.2share of the increase based on the pro rata share of medical assistance admissions to
227.3Hennepin County Medical Center and Regions Hospital by those plans. Upon the request
227.4of the commissioner, health plans shall submit individual-level cost data for verification
227.5purposes. The commissioner may ratably reduce these payments on a pro rata basis in
227.6order to satisfy federal requirements for actuarial soundness. If payments are reduced,
227.7transfers shall be reduced accordingly. Any licensed health plan that receives increased
227.8medical assistance capitation payments under the intergovernmental transfer described in
227.9this paragraph shall increase its medical assistance payments to Hennepin County Medical
227.10Center and Regions Hospital by the same amount as the increased payments received in
227.11the capitation payment described in this paragraph.
227.12    (d) For the purposes of this subdivision and subdivision 3, the commissioner shall
227.13determine an upper payment limit for ambulance services affiliated with Hennepin County
227.14Medical Center. The upper payment limit shall be based on the average commercial
227.15rate or be determined using another method acceptable to the Centers for Medicare and
227.16Medicaid Services. The commissioner shall inform Hennepin County of the periodic
227.17intergovernmental transfers necessary to match the federal Medicaid payments available
227.18under this subdivision in order to make supplementary payments to Hennepin County
227.19Medical Center equal to the difference between the established medical assistance
227.20payment for ambulance services and the upper payment limit. Upon receipt of these
227.21periodic transfers, the commissioner shall make supplementary payments to Hennepin
227.22County Medical Center.
227.23    (e) The commissioner shall inform the transferring governmental entities on an
227.24ongoing basis of the need for any changes needed in the intergovernmental transfers in
227.25order to continue the payments under paragraphs (a) to (c) (d), at their maximum level,
227.26including increases in upper payment limits, changes in the federal Medicaid match, and
227.27other factors.
227.28    (e) (f) The payments in paragraphs (a) to (c) (d) shall be implemented independently
227.29of each other, subject to federal approval and to the receipt of transfers under subdivision 3.

227.30    Sec. 17. Minnesota Statutes 2012, section 256B.69, subdivision 5c, is amended to read:
227.31    Subd. 5c. Medical education and research fund. (a) The commissioner of human
227.32services shall transfer each year to the medical education and research fund established
227.33under section 62J.692, an amount specified in this subdivision. The commissioner shall
227.34calculate the following:
228.1(1) an amount equal to the reduction in the prepaid medical assistance payments as
228.2specified in this clause. Until January 1, 2002, the county medical assistance capitation
228.3base rate prior to plan specific adjustments and after the regional rate adjustments under
228.4subdivision 5b is reduced 6.3 percent for Hennepin County, two percent for the remaining
228.5metropolitan counties, and no reduction for nonmetropolitan Minnesota counties; and after
228.6January 1, 2002, the county medical assistance capitation base rate prior to plan specific
228.7adjustments is reduced 6.3 percent for Hennepin County, two percent for the remaining
228.8metropolitan counties, and 1.6 percent for nonmetropolitan Minnesota counties. Nursing
228.9facility and elderly waiver payments and demonstration project payments operating
228.10under subdivision 23 are excluded from this reduction. The amount calculated under
228.11this clause shall not be adjusted for periods already paid due to subsequent changes to
228.12the capitation payments;
228.13(2) beginning July 1, 2003, $4,314,000 from the capitation rates paid under this
228.14section;
228.15(3) beginning July 1, 2002, an additional $12,700,000 from the capitation rates
228.16paid under this section; and
228.17(4) beginning July 1, 2003, an additional $4,700,000 from the capitation rates paid
228.18under this section.
228.19(b) This subdivision shall be effective upon approval of a federal waiver which
228.20allows federal financial participation in the medical education and research fund. The
228.21amount specified under paragraph (a), clauses (1) to (4), shall not exceed the total amount
228.22transferred for fiscal year 2009. Any excess shall first reduce the amounts specified under
228.23paragraph (a), clauses (2) to (4). Any excess following this reduction shall proportionally
228.24reduce the amount specified under paragraph (a), clause (1).
228.25(c) Beginning September 1, 2011, of the amount in paragraph (a), the commissioner
228.26shall transfer $21,714,000 each fiscal year to the medical education and research fund.
228.27(d) Beginning September 1, 2011, of the amount in paragraph (a), following the
228.28transfer under paragraph (c), the commissioner shall transfer to the medical education
228.29research fund $23,936,000 in fiscal years 2012 and 2013 and $36,744,000 $43,148,000 in
228.30fiscal year 2014 and thereafter.

228.31    Sec. 18. Minnesota Statutes 2012, section 256B.69, subdivision 31, is amended to read:
228.32    Subd. 31. Payment reduction. (a) Beginning September 1, 2011, the commissioner
228.33shall reduce payments and limit future rate increases paid to managed care plans and
228.34county-based purchasing plans. The limits in paragraphs (a) to (f) shall be achieved
228.35on a statewide aggregate basis by program. The commissioner may use competitive
229.1bidding, payment reductions, or other reductions to achieve the reductions and limits
229.2in this subdivision.
229.3(b) Beginning September 1, 2011, the commissioner shall reduce payments to
229.4managed care plans and county-based purchasing plans as follows:
229.5(1) 2.0 percent for medical assistance elderly basic care. This shall not apply
229.6to Medicare cost-sharing, nursing facility, personal care assistance, and elderly waiver
229.7services;
229.8(2) 2.82 percent for medical assistance families and children;
229.9(3) 10.1 percent for medical assistance adults without children; and
229.10(4) 6.0 percent for MinnesotaCare families and children.
229.11(c) Beginning January 1, 2012, the commissioner shall limit rates paid to managed
229.12care plans and county-based purchasing plans for calendar year 2012 to a percentage of
229.13the rates in effect on August 31, 2011, as follows:
229.14(1) 98 percent for medical assistance elderly basic care. This shall not apply to
229.15Medicare cost-sharing, nursing facility, personal care assistance, and elderly waiver
229.16services;
229.17(2) 97.18 percent for medical assistance families and children;
229.18(3) 89.9 percent for medical assistance adults without children; and
229.19(4) 94 percent for MinnesotaCare families and children.
229.20(d) Beginning January 1, 2013, to December 31, 2013, the commissioner shall limit
229.21the maximum annual trend increases to rates paid to managed care plans and county-based
229.22purchasing plans as follows:
229.23(1) 7.5 percent for medical assistance elderly basic care. This shall not apply
229.24to Medicare cost-sharing, nursing facility, personal care assistance, and elderly waiver
229.25services;
229.26(2) 5.0 percent for medical assistance special needs basic care;
229.27(3) 2.0 percent for medical assistance families and children;
229.28(4) 3.0 percent for medical assistance adults without children;
229.29(5) 3.0 percent for MinnesotaCare families and children; and
229.30(6) 3.0 percent for MinnesotaCare adults without children.
229.31(e) The commissioner may limit trend increases to less than the maximum.
229.32Beginning July January 1, 2014, the commissioner shall limit the maximum annual trend
229.33increases to rates paid to managed care plans and county-based purchasing plans as
229.34follows for calendar years 2014 and, 2015, 2016, and 2017:
230.1(1) 7.5 6.0 percent for medical assistance elderly basic care. This shall not apply
230.2to Medicare cost-sharing, nursing facility, personal care assistance, and elderly waiver
230.3services;
230.4(2) 5.0 0.5 percent for medical assistance special needs basic care;
230.5(3) 2.0 0.5 percent for medical assistance families and children;
230.6(4) 3.0 0 percent for medical assistance adults without children;
230.7(5) 3.0 percent for MinnesotaCare families and children; and
230.8(6) 4.0 percent for MinnesotaCare adults without children.
230.9The commissioner may limit trend increases to less than the maximum.

230.10    Sec. 19. Minnesota Statutes 2012, section 256B.69, is amended by adding a
230.11subdivision to read:
230.12    Subd. 34. Risk corridors. (a) Effective for services rendered on or after January 1,
230.132014, the commissioner shall establish risk corridors that are actuarially sound for each
230.14managed care plan and each county-based purchasing plan providing services under this
230.15section and section 256B.692. The risk corridors shall be calculated annually based on the
230.16calendar year's net underwriting gain or loss. If the managed care plan or county-based
230.17purchasing plan achieved a net underwriting gain of greater than three percent of
230.18revenue, any excess must be repaid to the commissioner by July 31 of the year following
230.19calculation of the risk corridor year. If the managed care plan or county-based purchasing
230.20plan has incurred a net underwriting loss greater than three percent of total revenue, any
230.21excess must be repaid to the managed care plan or county-based purchasing plan by
230.22the commissioner by July 31 of the year following calculation of the risk corridor year.
230.23Determination of total revenues and net underwriting gain or loss must be based on the
230.24Minnesota supplement report #1 that is filed on April 1 of the year following calculation
230.25of the risk corridor and adjusted for the actual withhold calculation under subdivision 5a
230.26and section 256L.12, subdivision 9. The report must be filed with the commissioner of
230.27health and must be made available on the Department of Health's Web site.
230.28(b) This subdivision shall not apply to the special demonstration projects under
230.29subdivisions 23 and 28.

230.30    Sec. 20. Minnesota Statutes 2012, section 256B.76, subdivision 1, is amended to read:
230.31    Subdivision 1. Physician reimbursement. (a) Effective for services rendered on
230.32or after October 1, 1992, the commissioner shall make payments for physician services
230.33as follows:
231.1    (1) payment for level one Centers for Medicare and Medicaid Services' common
231.2procedural coding system codes titled "office and other outpatient services," "preventive
231.3medicine new and established patient," "delivery, antepartum, and postpartum care,"
231.4"critical care," cesarean delivery and pharmacologic management provided to psychiatric
231.5patients, and level three codes for enhanced services for prenatal high risk, shall be paid
231.6at the lower of (i) submitted charges, or (ii) 25 percent above the rate in effect on June
231.730, 1992. If the rate on any procedure code within these categories is different than the
231.8rate that would have been paid under the methodology in section 256B.74, subdivision 2,
231.9then the larger rate shall be paid;
231.10    (2) payments for all other services shall be paid at the lower of (i) submitted charges,
231.11or (ii) 15.4 percent above the rate in effect on June 30, 1992; and
231.12    (3) all physician rates shall be converted from the 50th percentile of 1982 to the 50th
231.13percentile of 1989, less the percent in aggregate necessary to equal the above increases
231.14except that payment rates for home health agency services shall be the rates in effect
231.15on September 30, 1992.
231.16    (b) Effective for services rendered on or after January 1, 2000, payment rates for
231.17physician and professional services shall be increased by three percent over the rates
231.18in effect on December 31, 1999, except for home health agency and family planning
231.19agency services. The increases in this paragraph shall be implemented January 1, 2000,
231.20for managed care.
231.21(c) Effective for services rendered on or after July 1, 2009, payment rates for
231.22physician and professional services shall be reduced by five percent, except that for the
231.23period July 1, 2009, through June 30, 2010, payment rates shall be reduced by 6.5 percent
231.24for the medical assistance and general assistance medical care programs, over the rates in
231.25effect on June 30, 2009. This reduction and the reductions in paragraph (d) do not apply
231.26to office or other outpatient visits, preventive medicine visits and family planning visits
231.27billed by physicians, advanced practice nurses, or physician assistants in a family planning
231.28agency or in one of the following primary care practices: general practice, general internal
231.29medicine, general pediatrics, general geriatrics, and family medicine. This reduction
231.30and the reductions in paragraph (d) do not apply to federally qualified health centers,
231.31rural health centers, and Indian health services. Effective October 1, 2009, payments
231.32made to managed care plans and county-based purchasing plans under sections 256B.69,
231.33256B.692 , and 256L.12 shall reflect the payment reduction described in this paragraph.
231.34(d) Effective for services rendered on or after July 1, 2010, payment rates for
231.35physician and professional services shall be reduced an additional seven percent over
231.36the five percent reduction in rates described in paragraph (c). This additional reduction
232.1does not apply to physical therapy services, occupational therapy services, and speech
232.2pathology and related services provided on or after July 1, 2010. This additional reduction
232.3does not apply to physician services billed by a psychiatrist or an advanced practice nurse
232.4with a specialty in mental health. Effective October 1, 2010, payments made to managed
232.5care plans and county-based purchasing plans under sections 256B.69, 256B.692, and
232.6256L.12 shall reflect the payment reduction described in this paragraph.
232.7(e) Effective for services rendered on or after September 1, 2011, through June 30,
232.82013, payment rates for physician and professional services shall be reduced three percent
232.9from the rates in effect on August 31, 2011. This reduction does not apply to physical
232.10therapy services, occupational therapy services, and speech pathology and related services.
232.11(f) Effective for services rendered on or after January 1, 2015, payment rates for
232.12physician and professional services, including physical therapy, occupational therapy,
232.13speech pathology, and mental health services shall be increased by five percent from
232.14the rates in effect on December 31, 2014. This increase does not apply to federally
232.15qualified health centers, rural health centers, and Indian health services. Payments made to
232.16managed care plans and county-based purchasing plans shall not be adjusted to reflect
232.17payments under this paragraph.

232.18    Sec. 21. Minnesota Statutes 2012, section 256B.76, subdivision 2, is amended to read:
232.19    Subd. 2. Dental reimbursement. (a) Effective for services rendered on or after
232.20October 1, 1992, the commissioner shall make payments for dental services as follows:
232.21    (1) dental services shall be paid at the lower of (i) submitted charges, or (ii) 25
232.22percent above the rate in effect on June 30, 1992; and
232.23    (2) dental rates shall be converted from the 50th percentile of 1982 to the 50th
232.24percentile of 1989, less the percent in aggregate necessary to equal the above increases.
232.25    (b) Beginning October 1, 1999, the payment for tooth sealants and fluoride treatments
232.26shall be the lower of (1) submitted charge, or (2) 80 percent of median 1997 charges.
232.27    (c) Effective for services rendered on or after January 1, 2000, payment rates for
232.28dental services shall be increased by three percent over the rates in effect on December
232.2931, 1999.
232.30    (d) Effective for services provided on or after January 1, 2002, payment for
232.31diagnostic examinations and dental x-rays provided to children under age 21 shall be the
232.32lower of (1) the submitted charge, or (2) 85 percent of median 1999 charges.
232.33    (e) The increases listed in paragraphs (b) and (c) shall be implemented January 1,
232.342000, for managed care.
233.1(f) Effective for dental services rendered on or after October 1, 2010, by a
233.2state-operated dental clinic, payment shall be paid on a reasonable cost basis that is based
233.3on the Medicare principles of reimbursement. This payment shall be effective for services
233.4rendered on or after January 1, 2011, to recipients enrolled in managed care plans or
233.5county-based purchasing plans.
233.6(g) Beginning in fiscal year 2011, if the payments to state-operated dental clinics
233.7in paragraph (f), including state and federal shares, are less than $1,850,000 per fiscal
233.8year, a supplemental state payment equal to the difference between the total payments
233.9in paragraph (f) and $1,850,000 shall be paid from the general fund to state-operated
233.10services for the operation of the dental clinics.
233.11(h) If the cost-based payment system for state-operated dental clinics described in
233.12paragraph (f) does not receive federal approval, then state-operated dental clinics shall be
233.13designated as critical access dental providers under subdivision 4, paragraph (b), and shall
233.14receive the critical access dental reimbursement rate as described under subdivision 4,
233.15paragraph (a).
233.16(i) Effective for services rendered on or after September 1, 2011, through June 30,
233.172013, payment rates for dental services shall be reduced by three percent. This reduction
233.18does not apply to state-operated dental clinics in paragraph (f).
233.19(j) Effective for services rendered on or after January 1, 2015, payment rates for
233.20dental services shall be increased by five percent from the rates in effect on December
233.2131, 2014. This increase does not apply to state-operated dental clinics in paragraph
233.22(f), federally qualified health centers, rural health centers, and Indian health services.
233.23Effective January 1, 2015, payments made to managed care plans and county-based
233.24purchasing plans under sections 256B.69, 256B.692, and chapter 256L shall reflect the
233.25payment increase described in this paragraph.

233.26    Sec. 22. Minnesota Statutes 2012, section 256B.76, subdivision 4, is amended to read:
233.27    Subd. 4. Critical access dental providers. (a) Effective for dental services rendered
233.28on or after January 1, 2002, the commissioner shall increase reimbursements to dentists
233.29and dental clinics deemed by the commissioner to be critical access dental providers.
233.30For dental services rendered on or after July 1, 2007, the commissioner shall increase
233.31reimbursement by 30 35 percent above the reimbursement rate that would otherwise be
233.32paid to the critical access dental provider. The commissioner shall pay the managed
233.33care plans and county-based purchasing plans in amounts sufficient to reflect increased
233.34reimbursements to critical access dental providers as approved by the commissioner.
234.1(b) The commissioner shall designate the following dentists and dental clinics as
234.2critical access dental providers:
234.3    (1) nonprofit community clinics that:
234.4(i) have nonprofit status in accordance with chapter 317A;
234.5(ii) have tax exempt status in accordance with the Internal Revenue Code, section
234.6501(c)(3);
234.7(iii) are established to provide oral health services to patients who are low income,
234.8uninsured, have special needs, and are underserved;
234.9(iv) have professional staff familiar with the cultural background of the clinic's
234.10patients;
234.11(v) charge for services on a sliding fee scale designed to provide assistance to
234.12low-income patients based on current poverty income guidelines and family size;
234.13(vi) do not restrict access or services because of a patient's financial limitations
234.14or public assistance status; and
234.15(vii) have free care available as needed;
234.16    (2) federally qualified health centers, rural health clinics, and public health clinics;
234.17    (3) city or county owned and operated hospital-based dental clinics;
234.18(4) a dental clinic or dental group owned and operated by a nonprofit corporation in
234.19accordance with chapter 317A with more than 10,000 patient encounters per year with
234.20patients who are uninsured or covered by medical assistance, general assistance medical
234.21care, or MinnesotaCare; and
234.22(5) a dental clinic owned and operated by the University of Minnesota or the
234.23Minnesota State Colleges and Universities system.; and
234.24(6) private practicing dentists if:
234.25(i) the dentist's office is located within a health professional shortage area as defined
234.26under Code of Federal Regulations, title 42, part 5, and United States Code, title 42,
234.27section 254E;
234.28(ii) more than 50 percent of the dentist's patient encounters per year are with patients
234.29who are uninsured or covered by medical assistance or MinnesotaCare;
234.30(iii) the dentist does not restrict access or services because of a patient's financial
234.31limitations or public assistance status; and
234.32(iv) the level of service provided by the dentist is critical to maintaining adequate
234.33levels of patient access within the service area in which the dentist operates.
234.34    (c) The commissioner may designate a dentist or dental clinic as a critical access
234.35dental provider if the dentist or dental clinic is willing to provide care to patients covered
235.1by medical assistance, general assistance medical care, or MinnesotaCare at a level which
235.2significantly increases access to dental care in the service area.
235.3(d) (c) A designated critical access clinic shall receive the reimbursement rate
235.4specified in paragraph (a) for dental services provided off site at a private dental office if
235.5the following requirements are met:
235.6(1) the designated critical access dental clinic is located within a health professional
235.7shortage area as defined under Code of Federal Regulations, title 42, part 5, and United
235.8States Code, title 42, section 254E, and is located outside the seven-county metropolitan
235.9area;
235.10(2) the designated critical access dental clinic is not able to provide the service
235.11and refers the patient to the off-site dentist;
235.12(3) the service, if provided at the critical access dental clinic, would be reimbursed
235.13at the critical access reimbursement rate;
235.14(4) the dentist and allied dental professionals providing the services off site are
235.15licensed and in good standing under chapter 150A;
235.16(5) the dentist providing the services is enrolled as a medical assistance provider;
235.17(6) the critical access dental clinic submits the claim for services provided off site
235.18and receives the payment for the services; and
235.19(7) the critical access dental clinic maintains dental records for each claim submitted
235.20under this paragraph, including the name of the dentist, the off-site location, and the
235.21license number of the dentist and allied dental professionals providing the services.

235.22    Sec. 23. Minnesota Statutes 2012, section 256B.76, is amended by adding a
235.23subdivision to read:
235.24    Subd. 7. Payment for certain primary care services and immunization
235.25administration. Payment for certain primary care services and immunization
235.26administration services rendered on or after January 1, 2013, through December 31, 2014,
235.27shall be made in accordance with section 1902(a)(13) of the Social Security Act.

235.28    Sec. 24. Minnesota Statutes 2012, section 256B.764, is amended to read:
235.29256B.764 REIMBURSEMENT FOR FAMILY PLANNING SERVICES.
235.30    (a) Effective for services rendered on or after July 1, 2007, payment rates for family
235.31planning services shall be increased by 25 percent over the rates in effect June 30, 2007,
235.32when these services are provided by a community clinic as defined in section 145.9268,
235.33subdivision 1.
236.1    (b) Effective for services rendered on or after July 1, 2014, payment rates for
236.2family planning services shall be increased by 20 percent over the rates in effect June
236.330, 2014, when these services are provided by a community clinic as defined in section
236.4145.9268, subdivision 1. The commissioner shall adjust capitation rates to managed care
236.5and county-based purchasing plans to reflect this increase, and shall require plans to pass
236.6on the full amount of the rate increase to eligible community clinics, in the form of higher
236.7payment rates for family planning services.

236.8    Sec. 25. Minnesota Statutes 2012, section 256B.766, is amended to read:
236.9256B.766 REIMBURSEMENT FOR BASIC CARE SERVICES.
236.10(a) Effective for services provided on or after July 1, 2009, total payments for basic
236.11care services, shall be reduced by three percent, except that for the period July 1, 2009,
236.12through June 30, 2011, total payments shall be reduced by 4.5 percent for the medical
236.13assistance and general assistance medical care programs, prior to third-party liability and
236.14spenddown calculation. Effective July 1, 2010, the commissioner shall classify physical
236.15therapy services, occupational therapy services, and speech-language pathology and
236.16related services as basic care services. The reduction in this paragraph shall apply to
236.17physical therapy services, occupational therapy services, and speech-language pathology
236.18and related services provided on or after July 1, 2010.
236.19(b) Payments made to managed care plans and county-based purchasing plans shall
236.20be reduced for services provided on or after October 1, 2009, to reflect the reduction
236.21effective July 1, 2009, and payments made to the plans shall be reduced effective October
236.221, 2010, to reflect the reduction effective July 1, 2010.
236.23(c) Effective for services provided on or after September 1, 2011, through June 30,
236.242013, total payments for outpatient hospital facility fees shall be reduced by five percent
236.25from the rates in effect on August 31, 2011.
236.26(d) Effective for services provided on or after September 1, 2011, through June
236.2730, 2013, total payments for ambulatory surgery centers facility fees, medical supplies
236.28and durable medical equipment not subject to a volume purchase contract, prosthetics
236.29and orthotics, renal dialysis services, laboratory services, public health nursing services,
236.30physical therapy services, occupational therapy services, speech therapy services,
236.31eyeglasses not subject to a volume purchase contract, hearing aids not subject to a volume
236.32purchase contract, and anesthesia services, and hospice services shall be reduced by three
236.33percent from the rates in effect on August 31, 2011.
236.34(e) Effective for services provided on or after January 1, 2015, payments for
236.35ambulatory surgery centers facility fees, medical supplies and durable medical equipment
237.1not subject to a volume purchase contract, prosthetics and orthotics, hospice services,
237.2renal dialysis services, laboratory services, public health nursing services, eyeglasses
237.3not subject to a volume purchase contract, and hearing aids not subject to a volume
237.4purchase contract shall be increased by three percent. Payments made to managed care
237.5plans and county-based purchasing plans shall not be adjusted to reflect payments under
237.6this paragraph.
237.7(e) (f) This section does not apply to physician and professional services, inpatient
237.8hospital services, family planning services, mental health services, dental services,
237.9prescription drugs, medical transportation, federally qualified health centers, rural health
237.10centers, Indian health services, and Medicare cost-sharing.

237.11    Sec. 26. Laws 2012, chapter 247, article 1, section 28, is amended to read:
237.12    Sec. 28. EMERGENCY MEDICAL ASSISTANCE STUDY.
237.13(a) The commissioner of human services shall convene a work group to develop a
237.14plan to provide coordinated and cost-effective health care and coverage for individuals
237.15who meet eligibility standards for emergency medical assistance and who are ineligible
237.16for other state public programs. The commissioner shall consult with work group shall
237.17consist of representatives of relevant stakeholders in the development of the plan,
237.18including but not limited to safety net hospitals, nonprofit health care coverage programs,
237.19nonprofit community clinics, and counties. The commissioner work group shall consider
237.20the following elements:
237.21(1) strategies to provide individuals with the most appropriate care in the appropriate
237.22setting, utilizing higher quality and lower cost providers;
237.23(2) payment mechanisms to encourage providers to manage the care of these
237.24populations, and to produce lower cost of care and better patient outcomes;
237.25(3) ensure coverage and payment options that address the unique needs of those
237.26needing episodic care, chronic care, and long-term care services;
237.27(4) strategies for coordinating health care and nonhealth care services, and
237.28integrating with existing coverage; and
237.29(5) other issues and strategies to ensure cost-effective and coordinated delivery
237.30of coverage and services.
237.31(b) The commissioner shall submit the plan of the work group to the chairs and
237.32ranking minority members of the legislative committees with jurisdiction over health and
237.33human services policy and financing by January 15 July 15, 2013.
237.34EFFECTIVE DATE.This section is effective the day following final enactment.

238.1    Sec. 27. Laws 2013, chapter 1, section 6, is amended to read:
238.2    Sec. 6. TRANSFER.
238.3(a) The commissioner of management and budget shall transfer from the health care
238.4access fund to the general fund up to $21,319,000 in fiscal year 2014; up to $42,314,000
238.5in fiscal year 2015; up to $56,147,000 in fiscal year 2016; and up to $64,683,000 in fiscal
238.6year 2017.
238.7(b) The commissioner of human services shall determine the difference between the
238.8actual cost to the medical assistance program of adding 19- and 20-year-olds and parents
238.9and relative caretaker populations with income between 100 and 138 percent of the federal
238.10poverty guidelines and the cost of adding those populations that was estimated during the
238.112013 legislative session based on the data from the February 2013 forecast.
238.12(c) For each fiscal year from 2014 to 2017, the commissioner of human services
238.13shall certify and report to the commissioner of management and budget the actual cost
238.14difference of adding 19- and 20-year-olds and parents and relative caretaker populations
238.15with income between 100 and 138 percent of the federal poverty guidelines, as determined
238.16under paragraph (b), by June 30 of each fiscal year. In each fiscal year, the commissioner
238.17of management and budget shall reduce the transfer under paragraph (a) by the amount
238.18of the costs certified under paragraph (b). If, for any fiscal year, the amount of the cost
238.19difference determined under paragraph (b) exceeds the amount of the transfer, the transfer
238.20for that year must be zero.

238.21    Sec. 28. 340B PROVIDER PRESCRIPTION DRUGS REIMBURSEMENT
238.22STUDY.
238.23(a) The commissioner of human services shall study and make recommendations on
238.24changes to standardize the medical assistance reimbursement rates for prescription drugs
238.25obtained through the federal 340B Program and dispensed to medical assistance enrollees.
238.26The study must examine the current medical assistance rate 340B providers are receiving
238.27through claims submissions and make recommendations on an overall reimbursement
238.28discount that will pay the same for drugs dispensed through the 340B Program as is paid
238.29for drugs dispensed by non340B providers, taking into consideration any federal rebate.
238.30(b) The commissioner shall consult with 340B providers that would be most
238.31affected by a change in the reimbursement formula, including but not limited to safety net
238.32hospitals, children's hospitals, community health centers, and family planning clinics.
238.33(c) The commissioner shall submit recommendations to the chairs and ranking
238.34minority members of the legislative committees and divisions with jurisdiction over health
238.35and human services policy and finance by January 15, 2014.

239.1    Sec. 29. DENTAL ACCESS AND REIMBURSEMENT REPORT.
239.2    Subdivision 1. Study. (a) The commissioner of human services shall study
239.3the current oral health and dental services delivery system for state public health
239.4care programs to improve access and ensure cost-effective delivery of services. The
239.5commissioner shall make recommendations on modifying the delivery of services and
239.6reimbursement methods, including modifications to the critical access dental provider
239.7payments under Minnesota Statutes, section 256B.76, subdivision 4.
239.8(b) The commissioner shall consult with dental providers enrolled in Minnesota
239.9health care programs, including providers who serve substantial numbers of low-income
239.10and uninsured patients and are currently receiving enhanced critical access dental provider
239.11payments.
239.12    Subd. 2. Service delivery and reimbursement methods. The recommendations
239.13must address:
239.14(1) targeting state funding and critical access dental payments to improve access
239.15to oral health services for individuals enrolled in Minnesota health care programs who
239.16are not receiving timely and appropriate dental services;
239.17(2) encouraging the use of cost-effective service delivery methods, workforce
239.18innovations, and the delivery of preventive services, including, but not limited to, dental
239.19sealants that will reduce dental disease and future costs of treatment;
239.20(3) improving access in all geographic areas of the state;
239.21(4) encouraging the use of tele-dentistry and mobile dental equipment to serve
239.22underserved patients and communities;
239.23(5) evaluating the use of a single administrator delivery model;
239.24(6) compensating providers for the added costs to providers of serving low-income
239.25and underserved patients and populations who experience the greatest oral health
239.26disparities in terms of incidence of oral health disease and access to and utilization of
239.27needed oral health services;
239.28(7) encouraging coordination of oral health care with other health care services;
239.29(8) preventing overtreatment, fraud, and abuse; and
239.30(9) reducing administrative costs for the state and for dental providers.
239.31    Subd. 3. Report. The commissioner shall submit a report on the recommendations to
239.32the chairs and ranking minority members of the of the legislative committees and divisions
239.33with jurisdiction over health and human services policy and finance by December 15, 2013.

239.34    Sec. 30. TAX FORM POSTING.
240.1Any nonprofit organization that receives state grant funds from the commissioner of
240.2human services or the commissioner of health shall annually post the organization's 990
240.3tax form on its Web site, if the organization has a Web site.

240.4ARTICLE 7

240.5CONTINUING CARE

240.6    Section 1. Minnesota Statutes 2012, section 144.0724, subdivision 6, is amended to read:
240.7    Subd. 6. Penalties for late or nonsubmission. (a) A facility that fails to complete
240.8or submit an assessment for a RUG-III or RUG-IV classification within seven days of the
240.9time requirements in subdivisions 4 and 5 is subject to a reduced rate for that resident.
240.10The reduced rate shall be the lowest rate for that facility. The reduced rate is effective on
240.11the day of admission for new admission assessments or on the day that the assessment
240.12was due for all other assessments and continues in effect until the first day of the month
240.13following the date of submission of the resident's assessment.
240.14    (b) If loss of revenue due to penalties incurred by a facility for any period of 92 days
240.15are equal to or greater than 1.0 percent of the total operating costs on the facility's most
240.16recent annual statistical and cost report, a facility may apply to the commissioner of
240.17human services for a reduction in the total penalty amount. The commissioner of human
240.18services, in consultation with the commissioner of health, may, at the sole discretion of
240.19the commissioner of human services, limit the penalty for residents covered by medical
240.20assistance to 15 days.

240.21    Sec. 2. Minnesota Statutes 2012, section 144A.071, subdivision 4b, is amended to read:
240.22    Subd. 4b. Licensed beds on layaway status. A licensed and certified nursing
240.23facility may lay away, upon prior written notice to the commissioner of health, licensed
240.24and certified beds. A nursing facility may not discharge a resident in order to lay away
240.25a bed. Notice to the commissioner shall be given 60 days prior to the effective date of
240.26the layaway. Beds on layaway shall have the same status as voluntarily delicensed and
240.27decertified beds and shall not be subject to license fees and license surcharge fees. In
240.28addition, beds on layaway may be removed from layaway at any time on or after one year
240.29 six months after the effective date of layaway in the facility of origin, with a 60-day notice
240.30to the commissioner. A nursing facility that removes beds from layaway may not place
240.31beds on layaway status for one year six months after the effective date of the removal from
240.32layaway. The commissioner may approve the immediate removal of beds from layaway if
240.33necessary to provide access to those nursing home beds to residents relocated from other
240.34nursing homes due to emergency situations or closure. In the event approval is granted,
241.1the one-year six-month restriction on placing beds on layaway after a removal of beds
241.2from layaway shall not apply. Beds may remain on layaway for up to ten years. The
241.3commissioner may approve placing and removing beds on layaway at any time during
241.4renovation or construction related to a moratorium project approved under this section
241.5or section 144A.073. Nursing facilities are not required to comply with any licensure or
241.6certification requirements for beds on layaway status.

241.7    Sec. 3. Minnesota Statutes 2012, section 245A.03, subdivision 7, is amended to read:
241.8    Subd. 7. Licensing moratorium. (a) The commissioner shall not issue an
241.9initial license for child foster care licensed under Minnesota Rules, parts 2960.3000 to
241.102960.3340, or adult foster care licensed under Minnesota Rules, parts 9555.5105 to
241.119555.6265, under this chapter for a physical location that will not be the primary residence
241.12of the license holder for the entire period of licensure. If a license is issued during this
241.13moratorium, and the license holder changes the license holder's primary residence away
241.14from the physical location of the foster care license, the commissioner shall revoke the
241.15license according to section 245A.07. Exceptions to the moratorium include:
241.16(1) foster care settings that are required to be registered under chapter 144D;
241.17(2) foster care licenses replacing foster care licenses in existence on May 15, 2009,
241.18and determined to be needed by the commissioner under paragraph (b);
241.19(3) new foster care licenses determined to be needed by the commissioner under
241.20paragraph (b) for the closure of a nursing facility, ICF/MR, or regional treatment center, or;
241.21 restructuring of state-operated services that limits the capacity of state-operated facilities;
241.22(4) new foster care licenses determined to be needed by the commissioner under
241.23paragraph (b) for persons requiring hospital level care; or
241.24(5) new foster care licenses determined to be needed by the commissioner for the
241.25transition of people from personal care assistance to the home and community-based
241.26services.
241.27(b) The commissioner shall determine the need for newly licensed foster care homes
241.28as defined under this subdivision. As part of the determination, the commissioner shall
241.29consider the availability of foster care capacity in the area in which the licensee seeks to
241.30operate, and the recommendation of the local county board. The determination by the
241.31commissioner must be final. A determination of need is not required for a change in
241.32ownership at the same address.
241.33(c) The commissioner shall study the effects of the license moratorium under this
241.34subdivision and shall report back to the legislature by January 15, 2011. This study shall
241.35include, but is not limited to the following:
242.1(1) the overall capacity and utilization of foster care beds where the physical location
242.2is not the primary residence of the license holder prior to and after implementation
242.3of the moratorium;
242.4(2) the overall capacity and utilization of foster care beds where the physical
242.5location is the primary residence of the license holder prior to and after implementation
242.6of the moratorium; and
242.7(3) the number of licensed and occupied ICF/MR beds prior to and after
242.8implementation of the moratorium.
242.9(d) (c) When a foster care recipient moves out of a foster home that is not the primary
242.10residence of the license holder according to section 256B.49, subdivision 15, paragraph
242.11(f), the county shall immediately inform the Department of Human Services Licensing
242.12Division. The department shall decrease the statewide licensed capacity for foster care
242.13settings where the physical location is not the primary residence of the license holder, if
242.14the voluntary changes described in paragraph (f) (e) are not sufficient to meet the savings
242.15required by reductions in licensed bed capacity under Laws 2011, First Special Session
242.16chapter 9, article 7, sections 1 and 40, paragraph (f), and maintain statewide long-term
242.17care residential services capacity within budgetary limits. Implementation of the statewide
242.18licensed capacity reduction shall begin on July 1, 2013. The commissioner shall delicense
242.19up to 128 beds by June 30, 2014, using the needs determination process. Under this
242.20paragraph, the commissioner has the authority to reduce unused licensed capacity of a
242.21current foster care program to accomplish the consolidation or closure of settings. Under
242.22this paragraph, the commissioner has the authority to manage statewide capacity, including
242.23adjusting the capacity available to each county and adjusting statewide available capacity,
242.24to meet the statewide needs identified through the process in paragraph (e). A decreased
242.25licensed capacity according to this paragraph is not subject to appeal under this chapter.
242.26(e) (d) Residential settings that would otherwise be subject to the decreased license
242.27capacity established in paragraph (d) (c) shall be exempt under the following circumstances:
242.28(1) until August 1, 2013, the license holder's beds occupied by residents whose
242.29primary diagnosis is mental illness and the license holder is:
242.30(i) a provider of assertive community treatment (ACT) or adult rehabilitative mental
242.31health services (ARMHS) as defined in section 256B.0623;
242.32(ii) a mental health center certified under Minnesota Rules, parts 9520.0750 to
242.339520.0870;
242.34(iii) a mental health clinic certified under Minnesota Rules, parts 9520.0750 to
242.359520.0870; or
243.1(iv) a provider of intensive residential treatment services (IRTS) licensed under
243.2Minnesota Rules, parts 9520.0500 to 9520.0670; or
243.3(2) the license holder's beds occupied by residents whose primary diagnosis is
243.4mental illness and the license holder is certified under the requirements in subdivision 6a.
243.5(f) (e) A resource need determination process, managed at the state level, using the
243.6available reports required by section 144A.351, and other data and information shall
243.7be used to determine where the reduced capacity required under paragraph (d) (c) will
243.8be implemented. The commissioner shall consult with the stakeholders described in
243.9section 144A.351, and employ a variety of methods to improve the state's capacity to
243.10meet long-term care service needs within budgetary limits, including seeking proposals
243.11from service providers or lead agencies to change service type, capacity, or location to
243.12improve services, increase the independence of residents, and better meet needs identified
243.13by the long-term care services reports and statewide data and information. By February
243.141 of each, 2013, and August 1, 2014, and each following year, the commissioner shall
243.15provide information and data on the overall capacity of licensed long-term care services,
243.16actions taken under this subdivision to manage statewide long-term care services and
243.17supports resources, and any recommendations for change to the legislative committees
243.18with jurisdiction over health and human services budget.
243.19    (g) (f) At the time of application and reapplication for licensure, the applicant and the
243.20license holder that are subject to the moratorium or an exclusion established in paragraph
243.21(a) are required to inform the commissioner whether the physical location where the foster
243.22care will be provided is or will be the primary residence of the license holder for the entire
243.23period of licensure. If the primary residence of the applicant or license holder changes, the
243.24applicant or license holder must notify the commissioner immediately. The commissioner
243.25shall print on the foster care license certificate whether or not the physical location is the
243.26primary residence of the license holder.
243.27    (h) (g) License holders of foster care homes identified under paragraph (g) (f) that
243.28are not the primary residence of the license holder and that also provide services in the
243.29foster care home that are covered by a federally approved home and community-based
243.30services waiver, as authorized under section 256B.0915, 256B.092, or 256B.49, must
243.31inform the human services licensing division that the license holder provides or intends to
243.32provide these waiver-funded services. These license holders must be considered registered
243.33under section 256B.092, subdivision 11, paragraph (c), and this registration status must
243.34be identified on their license certificates.

244.1    Sec. 4. Minnesota Statutes 2012, section 252.291, is amended by adding a subdivision
244.2to read:
244.3    Subd. 2b. Nicollet County facility project. The commissioner of health shall
244.4certify one additional bed in an intermediate care facility for persons with developmental
244.5disabilities in Nicollet County.

244.6    Sec. 5. Minnesota Statutes 2012, section 256B.0915, subdivision 3a, is amended to read:
244.7    Subd. 3a. Elderly waiver cost limits. (a) The monthly limit for the cost of
244.8waivered services to an individual elderly waiver client except for individuals described in
244.9paragraph paragraphs (b) and (d) shall be the weighted average monthly nursing facility
244.10rate of the case mix resident class to which the elderly waiver client would be assigned
244.11under Minnesota Rules, parts 9549.0050 to 9549.0059, less the recipient's maintenance
244.12needs allowance as described in subdivision 1d, paragraph (a), until the first day of the
244.13state fiscal year in which the resident assessment system as described in section 256B.438
244.14for nursing home rate determination is implemented. Effective on the first day of the state
244.15fiscal year in which the resident assessment system as described in section 256B.438 for
244.16nursing home rate determination is implemented and the first day of each subsequent state
244.17fiscal year, the monthly limit for the cost of waivered services to an individual elderly
244.18waiver client shall be the rate of the case mix resident class to which the waiver client
244.19would be assigned under Minnesota Rules, parts 9549.0050 to 9549.0059, in effect on
244.20the last day of the previous state fiscal year, adjusted by any legislatively adopted home
244.21and community-based services percentage rate adjustment.
244.22    (b) The monthly limit for the cost of waivered services to an individual elderly
244.23waiver client assigned to a case mix classification A under paragraph (a) with:
244.24(1) no dependencies in activities of daily living; or
244.25(2) up to two dependencies in bathing, dressing, grooming, walking, and eating
244.26when the dependency score in eating is three or greater as determined by an assessment
244.27performed under section 256B.0911 shall be $1,750 per month effective on July 1, 2011,
244.28for all new participants enrolled in the program on or after July 1, 2011. This monthly
244.29limit shall be applied to all other participants who meet this criteria at reassessment. This
244.30monthly limit shall be increased annually as described in paragraph (a).
244.31(c) If extended medical supplies and equipment or environmental modifications are
244.32or will be purchased for an elderly waiver client, the costs may be prorated for up to
244.3312 consecutive months beginning with the month of purchase. If the monthly cost of a
244.34recipient's waivered services exceeds the monthly limit established in paragraph (a) or
244.35(b), the annual cost of all waivered services shall be determined. In this event, the annual
245.1cost of all waivered services shall not exceed 12 times the monthly limit of waivered
245.2services as described in paragraph (a) or (b).
245.3(d) Effective July 1, 2013, the monthly cost limit of waiver services, including
245.4any necessary home care services described in section 256B.0651, subdivision 2, for
245.5individuals who meet the criteria as ventilator-dependent given in section 256B.0651,
245.6subdivision 1, paragraph (g), shall be the average of the monthly medical assistance
245.7amount established for home care services as described in section 256B.0652, subdivision
245.87, and the annual average contracted amount established by the commissioner for nursing
245.9facility services for ventilator-dependent individuals. This monthly limit shall be increased
245.10annually as described in paragraph (a).

245.11    Sec. 6. Minnesota Statutes 2012, section 256B.0915, is amended by adding a
245.12subdivision to read:
245.13    Subd. 3j. Individual community living support. Upon federal approval, there
245.14is established a new service called individual community living support (ICLS) that is
245.15available on the elderly waiver. ICLS providers may not be the landlord of recipients, nor
245.16have any interest in the recipient's housing. ICLS must be delivered in a single-family
245.17home or apartment where the service recipient or their family owns or rents, as
245.18demonstrated by a lease agreement, and maintains control over the individual unit. Case
245.19managers or care coordinators must develop individual ICLS plans in consultation with
245.20the client using a tool developed by the commissioner. The commissioner shall establish
245.21payment rates and mechanisms to align payments with the type and amount of service
245.22provided, assure statewide uniformity for payment rates, and assure cost-effectiveness.
245.23Licensing standards for ICLS shall be reviewed jointly by the Departments of Health and
245.24Human Services to avoid conflict with provider regulatory standards pursuant to section
245.25144A.43 and chapter 245D.

245.26    Sec. 7. Minnesota Statutes 2012, section 256B.0916, is amended by adding a
245.27subdivision to read:
245.28    Subd. 11. Excess spending. County and tribal agencies are responsible for spending
245.29in excess of the allocation made by the commissioner. In the event a county or tribal
245.30agency spends in excess of the allocation made by the commissioner for a given allocation
245.31period, they must submit a corrective action plan to the commissioner. The plan must state
245.32the actions the agency will take to correct their overspending for the year following the
245.33period when the overspending occurred. Failure to correct overspending shall result in
245.34recoupment of spending in excess of the allocation. Nothing in this subdivision shall be
246.1construed as reducing the county's responsibility to offer and make available feasible
246.2home and community-based options to eligible waiver recipients within the resources
246.3allocated to them for that purpose.

246.4    Sec. 8. Minnesota Statutes 2012, section 256B.092, subdivision 11, is amended to read:
246.5    Subd. 11. Residential support services. (a) Upon federal approval, there is
246.6established a new service called residential support that is available on the community
246.7alternative care, community alternatives for disabled individuals, developmental
246.8disabilities, and brain injury waivers. Existing waiver service descriptions must be
246.9modified to the extent necessary to ensure there is no duplication between other services.
246.10Residential support services must be provided by vendors licensed as a community
246.11residential setting as defined in section 245A.11, subdivision 8.
246.12    (b) Residential support services must meet the following criteria:
246.13    (1) providers of residential support services must own or control the residential site;
246.14    (2) the residential site must not be the primary residence of the license holder;
246.15    (3) the residential site must have a designated program supervisor responsible for
246.16program oversight, development, and implementation of policies and procedures;
246.17    (4) the provider of residential support services must provide supervision, training,
246.18and assistance as described in the person's coordinated service and support plan; and
246.19    (5) the provider of residential support services must meet the requirements of
246.20licensure and additional requirements of the person's coordinated service and support plan.
246.21    (c) Providers of residential support services that meet the definition in paragraph
246.22(a) must be registered using a process determined by the commissioner beginning July
246.231, 2009. Providers licensed to provide child foster care under Minnesota Rules, parts
246.242960.3000 to 2960.3340, or adult foster care licensed under Minnesota Rules, parts
246.259555.5105 to 9555.6265, and that meet the requirements in section 245A.03, subdivision
246.267 , paragraph (g) (f), are considered registered under this section.

246.27    Sec. 9. Minnesota Statutes 2012, section 256B.092, subdivision 12, is amended to read:
246.28    Subd. 12. Waivered services statewide priorities. (a) The commissioner shall
246.29establish statewide priorities for individuals on the waiting list for developmental
246.30disabilities (DD) waiver services, as of January 1, 2010. The statewide priorities must
246.31include, but are not limited to, individuals who continue to have a need for waiver services
246.32after they have maximized the use of state plan services and other funding resources,
246.33including natural supports, prior to accessing waiver services, and who meet at least one
246.34of the following criteria:
247.1(1) no longer require the intensity of services provided where they are currently
247.2living; or
247.3(2) make a request to move from an institutional setting.
247.4(b) After the priorities in paragraph (a) are met, priority must also be given to
247.5individuals who meet at least one of the following criteria:
247.6(1) have unstable living situations due to the age, incapacity, or sudden loss of
247.7the primary caregivers;
247.8(2) are moving from an institution due to bed closures;
247.9(3) experience a sudden closure of their current living arrangement;
247.10(4) require protection from confirmed abuse, neglect, or exploitation;
247.11(5) experience a sudden change in need that can no longer be met through state plan
247.12services or other funding resources alone; or
247.13(6) meet other priorities established by the department.
247.14(b) (c) When allocating resources to lead agencies, the commissioner must take into
247.15consideration the number of individuals waiting who meet statewide priorities and the
247.16lead agencies' current use of waiver funds and existing service options. The commissioner
247.17has the authority to transfer funds between counties, groups of counties, and tribes to
247.18accommodate statewide priorities and resource needs while accounting for a necessary
247.19base level reserve amount for each county, group of counties, and tribe.
247.20(c) The commissioner shall evaluate the impact of the use of statewide priorities and
247.21provide recommendations to the legislature on whether to continue the use of statewide
247.22priorities in the November 1, 2011, annual report required by the commissioner in sections
247.23256B.0916, subdivision 7, and 256B.49, subdivision 21.

247.24    Sec. 10. Minnesota Statutes 2012, section 256B.092, is amended by adding a
247.25subdivision to read:
247.26    Subd. 14. Reduce avoidable behavioral crisis emergency room admissions,
247.27psychiatric inpatient hospitalizations, and commitments to institutions. (a) Persons
247.28receiving home and community-based services authorized under this section who have
247.29had two or more admissions within a calendar year to an emergency room, psychiatric
247.30unit, or institution must receive consultation from a mental health professional as defined
247.31in section 245.462, subdivision 18, or a behavioral professional as defined in the home
247.32and community-based services state plan within 30 days of discharge. The mental health
247.33professional or behavioral professional must:
247.34(1) conduct a functional assessment of the crisis incident as defined in section
247.35245D.02, subdivision 11, which led to the hospitalization with the goal of developing
248.1proactive strategies as well as necessary reactive strategies to reduce the likelihood of
248.2future avoidable hospitalizations due to a behavioral crisis;
248.3(2) use the results of the functional assessment to amend the coordinated service and
248.4support plan set forth in section 245D.02, subdivision 4b, to address the potential need
248.5for additional staff training, increased staffing, access to crisis mobility services, mental
248.6health services, use of technology, and crisis stabilization services in section 256B.0624,
248.7subdivision 7; and
248.8(3) identify the need for additional consultation, testing, and mental health crisis
248.9intervention team services as defined in section 245D.02, subdivision 20, psychotropic
248.10medication use and monitoring under section 245D.051, and the frequency and duration
248.11of ongoing consultation.
248.12(b) For the purposes of this subdivision, "institution" includes, but is not limited to,
248.13the Anoka-Metro Regional Treatment Center and the Minnesota Security Hospital.

248.14    Sec. 11. Minnesota Statutes 2012, section 256B.095, is amended to read:
248.15256B.095 QUALITY ASSURANCE SYSTEM ESTABLISHED.
248.16    (a) Effective July 1, 1998, a quality assurance system for persons with developmental
248.17disabilities, which includes an alternative quality assurance licensing system for programs,
248.18is established in Dodge, Fillmore, Freeborn, Goodhue, Houston, Mower, Olmsted, Rice,
248.19Steele, Wabasha, and Winona Counties for the purpose of improving the quality of
248.20services provided to persons with developmental disabilities. A county, at its option, may
248.21choose to have all programs for persons with developmental disabilities located within
248.22the county licensed under chapter 245A using standards determined under the alternative
248.23quality assurance licensing system or may continue regulation of these programs under the
248.24licensing system operated by the commissioner. The project expires on June 30, 2014.
248.25    (b) Effective July 1, 2003, a county not listed in paragraph (a) may apply to
248.26participate in the quality assurance system established under paragraph (a). The
248.27commission established under section 256B.0951 may, at its option, allow additional
248.28counties to participate in the system.
248.29    (c) Effective July 1, 2003, any county or group of counties not listed in paragraph (a)
248.30may establish a quality assurance system under this section. A new system established
248.31under this section shall have the same rights and duties as the system established
248.32under paragraph (a). A new system shall be governed by a commission under section
248.33256B.0951 . The commissioner shall appoint the initial commission members based
248.34on recommendations from advocates, families, service providers, and counties in the
248.35geographic area included in the new system. Counties that choose to participate in a
249.1new system shall have the duties assigned under section 256B.0952. The new system
249.2shall establish a quality assurance process under section 256B.0953. The provisions of
249.3section 256B.0954 shall apply to a new system established under this paragraph. The
249.4commissioner shall delegate authority to a new system established under this paragraph
249.5according to section 256B.0955.
249.6    (d) Effective July 1, 2007, the quality assurance system may be expanded to include
249.7programs for persons with disabilities and older adults.
249.8(e) Effective July 1, 2013, a provider of service located in a county listed in
249.9paragraph (a) that is a non-opted-in county may opt in to the quality assurance system
249.10provided the county where services are provided indicates its agreement with a county
249.11with a delegation agreement with the Department of Human Services.
249.12EFFECTIVE DATE.This section is effective July 1, 2013.

249.13    Sec. 12. Minnesota Statutes 2012, section 256B.0951, subdivision 1, is amended to read:
249.14    Subdivision 1. Membership. The Quality Assurance Commission is established.
249.15The commission consists of at least 14 but not more than 21 members as follows: at
249.16least three but not more than five members representing advocacy organizations; at
249.17least three but not more than five members representing consumers, families, and their
249.18legal representatives; at least three but not more than five members representing service
249.19providers; at least three but not more than five members representing counties; and the
249.20commissioner of human services or the commissioner's designee. The first commission
249.21shall establish membership guidelines for the transition and recruitment of membership for
249.22the commission's ongoing existence. Members of the commission who do not receive a
249.23salary or wages from an employer for time spent on commission duties may receive a per
249.24diem payment when performing commission duties and functions. All members may be
249.25reimbursed for expenses related to commission activities. Notwithstanding the provisions
249.26of section 15.059, subdivision 5, the commission expires on June 30, 2014.

249.27    Sec. 13. Minnesota Statutes 2012, section 256B.0951, subdivision 4, is amended to read:
249.28    Subd. 4. Commission's authority to recommend variances of licensing
249.29standards. The commission may recommend to the commissioners of human services
249.30and health variances from the standards governing licensure of programs for persons with
249.31developmental disabilities in order to improve the quality of services by implementing
249.32an alternative developmental disabilities licensing system if the commission determines
249.33that the alternative licensing system does not adversely affect the health or safety of
250.1persons being served by the licensed program nor compromise the qualifications of staff
250.2to provide services.

250.3    Sec. 14. Minnesota Statutes 2012, section 256B.0952, subdivision 1, is amended to read:
250.4    Subdivision 1. Notification. Counties or providers shall give notice to the
250.5commission and commissioners of human services and health of intent to join the
250.6alternative quality assurance licensing system. A county or provider choosing to participate
250.7in the alternative quality assurance licensing system commits to participate for three years.

250.8    Sec. 15. Minnesota Statutes 2012, section 256B.0952, subdivision 5, is amended to read:
250.9    Subd. 5. Quality assurance teams. Quality assurance teams shall be comprised
250.10of county staff; providers; consumers, families, and their legal representatives; members
250.11of advocacy organizations; and other involved community members. Team members
250.12must satisfactorily complete the training program approved by the commission and must
250.13demonstrate performance-based competency. Team members are not considered to be
250.14county employees for purposes of workers' compensation, unemployment insurance, or
250.15state retirement laws solely on the basis of participation on a quality assurance team. The
250.16county may pay A per diem may be paid to team members for time spent on alternative
250.17quality assurance process matters. All team members may be reimbursed for expenses
250.18related to their participation in the alternative process.

250.19    Sec. 16. Minnesota Statutes 2012, section 256B.0955, is amended to read:
250.20256B.0955 DUTIES OF THE COMMISSIONER OF HUMAN SERVICES.
250.21(a) Effective July 1, 1998, the commissioner of human services shall delegate
250.22authority to perform licensing functions and activities, in accordance with section
250.23245A.16 , to counties participating in the alternative quality assurance licensing system.
250.24The commissioner shall not license or reimburse a facility, program, or service for persons
250.25with developmental disabilities in a county that participates in the alternative quality
250.26assurance licensing system if the commissioner has received from the appropriate county
250.27notification that the facility, program, or service has been reviewed by a quality assurance
250.28team and has failed to qualify for licensure.
250.29(b) The commissioner may conduct random licensing inspections based on outcomes
250.30adopted under section 256B.0951 at facilities, programs, and services governed by the
250.31alternative quality assurance licensing system. The role of such random inspections shall
250.32be to verify that the alternative quality assurance licensing system protects the safety
251.1and well-being of consumers and maintains the availability of high-quality services for
251.2persons with developmental disabilities.
251.3EFFECTIVE DATE.This section is effective July 1, 2013.

251.4    Sec. 17. Minnesota Statutes 2012, section 256B.097, subdivision 1, is amended to read:
251.5    Subdivision 1. Scope. (a) In order to improve the quality of services provided to
251.6Minnesotans with disabilities and to meet the requirements of the federally approved home
251.7and community-based waivers under section 1915c of the Social Security Act, a State
251.8Quality Assurance, Quality Improvement, and Licensing System for Minnesotans receiving
251.9disability services is enacted. This system is a partnership between the Department of
251.10Human Services and the State Quality Council established under subdivision 3.
251.11    (b) This system is a result of the recommendations from the Department of Human
251.12Services' licensing and alternative quality assurance study mandated under Laws 2005,
251.13First Special Session chapter 4, article 7, section 57, and presented to the legislature
251.14in February 2007.
251.15    (c) The disability services eligible under this section include:
251.16    (1) the home and community-based services waiver programs for persons with
251.17developmental disabilities under section 256B.092, subdivision 4, or section 256B.49,
251.18including brain injuries and services for those who qualify for nursing facility level of care
251.19or hospital facility level of care and any other services licensed under chapter 245D;
251.20    (2) home care services under section 256B.0651;
251.21    (3) family support grants under section 252.32;
251.22    (4) consumer support grants under section 256.476;
251.23    (5) semi-independent living services under section 252.275; and
251.24    (6) services provided through an intermediate care facility for the developmentally
251.25disabled.
251.26    (d) For purposes of this section, the following definitions apply:
251.27    (1) "commissioner" means the commissioner of human services;
251.28    (2) "council" means the State Quality Council under subdivision 3;
251.29    (3) "Quality Assurance Commission" means the commission under section
251.30256B.0951 ; and
251.31    (4) "system" means the State Quality Assurance, Quality Improvement and
251.32Licensing System under this section.

251.33    Sec. 18. Minnesota Statutes 2012, section 256B.097, subdivision 3, is amended to read:
252.1    Subd. 3. State Quality Council. (a) There is hereby created a State Quality
252.2Council which must define regional quality councils, and carry out a community-based,
252.3person-directed quality review component, and a comprehensive system for effective
252.4incident reporting, investigation, analysis, and follow-up.
252.5    (b) By August 1, 2011, the commissioner of human services shall appoint the
252.6members of the initial State Quality Council. Members shall include representatives
252.7from the following groups:
252.8    (1) disability service recipients and their family members;
252.9    (2) during the first two four years of the State Quality Council, there must be at least
252.10three members from the Region 10 stakeholders. As regional quality councils are formed
252.11under subdivision 4, each regional quality council shall appoint one member;
252.12    (3) disability service providers;
252.13    (4) disability advocacy groups; and
252.14    (5) county human services agencies and staff from the Department of Human
252.15Services and Ombudsman for Mental Health and Developmental Disabilities.
252.16    (c) Members of the council who do not receive a salary or wages from an employer
252.17for time spent on council duties may receive a per diem payment when performing council
252.18duties and functions.
252.19    (d) The State Quality Council shall:
252.20    (1) assist the Department of Human Services in fulfilling federally mandated
252.21obligations by monitoring disability service quality and quality assurance and
252.22improvement practices in Minnesota;
252.23    (2) establish state quality improvement priorities with methods for achieving results
252.24and provide an annual report to the legislative committees with jurisdiction over policy
252.25and funding of disability services on the outcomes, improvement priorities, and activities
252.26undertaken by the commission during the previous state fiscal year;
252.27(3) identify issues pertaining to financial and personal risk that impede Minnesotans
252.28with disabilities from optimizing choice of community-based services; and
252.29(4) recommend to the chairs and ranking minority members of the legislative
252.30committees with jurisdiction over human services and civil law by January 15, 2013
252.31 2014, statutory and rule changes related to the findings under clause (3) that promote
252.32individualized service and housing choices balanced with appropriate individualized
252.33protection.
252.34    (e) The State Quality Council, in partnership with the commissioner, shall:
252.35    (1) approve and direct implementation of the community-based, person-directed
252.36system established in this section;
253.1    (2) recommend an appropriate method of funding this system, and determine the
253.2feasibility of the use of Medicaid, licensing fees, as well as other possible funding options;
253.3    (3) approve measurable outcomes in the areas of health and safety, consumer
253.4evaluation, education and training, providers, and systems;
253.5    (4) establish variable licensure periods not to exceed three years based on outcomes
253.6achieved; and
253.7    (5) in cooperation with the Quality Assurance Commission, design a transition plan
253.8for licensed providers from Region 10 into the alternative licensing system by July 1, 2013.
253.9    (f) The State Quality Council shall notify the commissioner of human services that a
253.10facility, program, or service has been reviewed by quality assurance team members under
253.11subdivision 4, paragraph (b), clause (13), and qualifies for a license.
253.12    (g) The State Quality Council, in partnership with the commissioner, shall establish
253.13an ongoing review process for the system. The review shall take into account the
253.14comprehensive nature of the system which is designed to evaluate the broad spectrum of
253.15licensed and unlicensed entities that provide services to persons with disabilities. The
253.16review shall address efficiencies and effectiveness of the system.
253.17    (h) The State Quality Council may recommend to the commissioner certain
253.18variances from the standards governing licensure of programs for persons with disabilities
253.19in order to improve the quality of services so long as the recommended variances do
253.20not adversely affect the health or safety of persons being served or compromise the
253.21qualifications of staff to provide services.
253.22    (i) The safety standards, rights, or procedural protections referenced under
253.23subdivision 2, paragraph (c), shall not be varied. The State Quality Council may make
253.24recommendations to the commissioner or to the legislature in the report required under
253.25paragraph (c) regarding alternatives or modifications to the safety standards, rights, or
253.26procedural protections referenced under subdivision 2, paragraph (c).
253.27    (j) The State Quality Council may hire staff to perform the duties assigned in this
253.28subdivision.

253.29    Sec. 19. Minnesota Statutes 2012, section 256B.431, subdivision 44, is amended to read:
253.30    Subd. 44. Property rate increase increases for a facility in Bloomington effective
253.31November 1, 2010 certain nursing facilities. (a) Notwithstanding any other law to the
253.32contrary, money available for moratorium projects under section 144A.073, subdivision
253.3311 , shall be used, effective November 1, 2010, to fund an approved moratorium exception
253.34project for a nursing facility in Bloomington licensed for 137 beds as of November 1,
253.352010, up to a total property rate adjustment of $19.33.
254.1(b) Effective June 1, 2012, any nursing facility in McLeod County licensed for 110
254.2beds shall have its replacement-cost-new limit under subdivision 17e adjusted to allow
254.3$1,129,463 of a completed construction project to increase the property payment rate.
254.4Notwithstanding any other law to the contrary, money available under section 144A.073,
254.5subdivision 11, after the completion of the moratorium exception approval process in 2013
254.6under section 144A.073, subdivision 3, shall be used to reduce the fiscal impact to the
254.7medical assistance budget for the increase in the replacement-cost-new limit.
254.8(c) Effective July 1, 2012, any nursing facility in Dakota County licensed for
254.961 beds shall have their replacement-cost-new limit under subdivision 17e adjusted to
254.10allow $1,407,624 of a completed construction project to increase their property payment
254.11rate. Effective September 1, 2013, or later, their replacement-cost-new limit under
254.12subdivision 17e shall be adjusted to allow $1,244,599 of a completed construction project
254.13to increase the property payment rate. Notwithstanding any other law to the contrary,
254.14money available under section 144A.073, subdivision 11, after the completion of the
254.15moratorium exception approval process in 2013 under section 144A.073, subdivision 3,
254.16shall be used to reduce the fiscal impact to the medical assistance budget for the increase
254.17in the replacement-cost-new limit.
254.18EFFECTIVE DATE.Paragraph (b) is effective retroactively from June 1, 2012.
254.19Paragraph (c) is effective retroactively from July 1, 2012.

254.20    Sec. 20. Minnesota Statutes 2012, section 256B.434, subdivision 4, is amended to read:
254.21    Subd. 4. Alternate rates for nursing facilities. (a) For nursing facilities which
254.22have their payment rates determined under this section rather than section 256B.431, the
254.23commissioner shall establish a rate under this subdivision. The nursing facility must enter
254.24into a written contract with the commissioner.
254.25    (b) A nursing facility's case mix payment rate for the first rate year of a facility's
254.26contract under this section is the payment rate the facility would have received under
254.27section 256B.431.
254.28    (c) A nursing facility's case mix payment rates for the second and subsequent years
254.29of a facility's contract under this section are the previous rate year's contract payment
254.30rates plus an inflation adjustment and, for facilities reimbursed under this section or
254.31section 256B.431, an adjustment to include the cost of any increase in Health Department
254.32licensing fees for the facility taking effect on or after July 1, 2001. The index for the
254.33inflation adjustment must be based on the change in the Consumer Price Index-All Items
254.34(United States City average) (CPI-U) forecasted by the commissioner of management and
254.35budget's national economic consultant, as forecasted in the fourth quarter of the calendar
255.1year preceding the rate year. The inflation adjustment must be based on the 12-month
255.2period from the midpoint of the previous rate year to the midpoint of the rate year for
255.3which the rate is being determined. For the rate years beginning on July 1, 1999, July 1,
255.42000, July 1, 2001, July 1, 2002, July 1, 2003, July 1, 2004, July 1, 2005, July 1, 2006,
255.5July 1, 2007, July 1, 2008, October 1, 2009, and October 1, 2010, this paragraph shall
255.6apply only to the property-related payment rate. For the rate years beginning on October
255.71, 2011, and October 1, 2012, October 1, 2013, October 1, 2014, October 1, 2015, and
255.8October 1, 2016, the rate adjustment under this paragraph shall be suspended. Beginning
255.9in 2005, adjustment to the property payment rate under this section and section 256B.431
255.10shall be effective on October 1. In determining the amount of the property-related payment
255.11rate adjustment under this paragraph, the commissioner shall determine the proportion of
255.12the facility's rates that are property-related based on the facility's most recent cost report.
255.13    (d) The commissioner shall develop additional incentive-based payments of up to
255.14five percent above a facility's operating payment rate for achieving outcomes specified
255.15in a contract. The commissioner may solicit contract amendments and implement those
255.16which, on a competitive basis, best meet the state's policy objectives. The commissioner
255.17shall limit the amount of any incentive payment and the number of contract amendments
255.18under this paragraph to operate the incentive payments within funds appropriated for this
255.19purpose. The contract amendments may specify various levels of payment for various
255.20levels of performance. Incentive payments to facilities under this paragraph may be in the
255.21form of time-limited rate adjustments or onetime supplemental payments. In establishing
255.22the specified outcomes and related criteria, the commissioner shall consider the following
255.23state policy objectives:
255.24    (1) successful diversion or discharge of residents to the residents' prior home or other
255.25community-based alternatives;
255.26    (2) adoption of new technology to improve quality or efficiency;
255.27    (3) improved quality as measured in the Nursing Home Report Card;
255.28    (4) reduced acute care costs; and
255.29    (5) any additional outcomes proposed by a nursing facility that the commissioner
255.30finds desirable.
255.31    (e) Notwithstanding the threshold in section 256B.431, subdivision 16, facilities that
255.32take action to come into compliance with existing or pending requirements of the life
255.33safety code provisions or federal regulations governing sprinkler systems must receive
255.34reimbursement for the costs associated with compliance if all of the following conditions
255.35are met:
256.1    (1) the expenses associated with compliance occurred on or after January 1, 2005,
256.2and before December 31, 2008;
256.3    (2) the costs were not otherwise reimbursed under subdivision 4f or section
256.4144A.071 or 144A.073; and
256.5    (3) the total allowable costs reported under this paragraph are less than the minimum
256.6threshold established under section 256B.431, subdivision 15, paragraph (e), and
256.7subdivision 16.
256.8The commissioner shall use money appropriated for this purpose to provide to qualifying
256.9nursing facilities a rate adjustment beginning October 1, 2007, and ending September 30,
256.102008. Nursing facilities that have spent money or anticipate the need to spend money
256.11to satisfy the most recent life safety code requirements by (1) installing a sprinkler
256.12system or (2) replacing all or portions of an existing sprinkler system may submit to the
256.13commissioner by June 30, 2007, on a form provided by the commissioner the actual
256.14costs of a completed project or the estimated costs, based on a project bid, of a planned
256.15project. The commissioner shall calculate a rate adjustment equal to the allowable
256.16costs of the project divided by the resident days reported for the report year ending
256.17September 30, 2006. If the costs from all projects exceed the appropriation for this
256.18purpose, the commissioner shall allocate the money appropriated on a pro rata basis to the
256.19qualifying facilities by reducing the rate adjustment determined for each facility by an
256.20equal percentage. Facilities that used estimated costs when requesting the rate adjustment
256.21shall report to the commissioner by January 31, 2009, on the use of this money on a
256.22form provided by the commissioner. If the nursing facility fails to provide the report, the
256.23commissioner shall recoup the money paid to the facility for this purpose. If the facility
256.24reports expenditures allowable under this subdivision that are less than the amount received
256.25in the facility's annualized rate adjustment, the commissioner shall recoup the difference.

256.26    Sec. 21. Minnesota Statutes 2012, section 256B.437, subdivision 6, is amended to read:
256.27    Subd. 6. Planned closure rate adjustment. (a) The commissioner of human
256.28services shall calculate the amount of the planned closure rate adjustment available under
256.29subdivision 3, paragraph (b), for up to 5,140 beds according to clauses (1) to (4):
256.30(1) the amount available is the net reduction of nursing facility beds multiplied
256.31by $2,080;
256.32(2) the total number of beds in the nursing facility or facilities receiving the planned
256.33closure rate adjustment must be identified;
256.34(3) capacity days are determined by multiplying the number determined under
256.35clause (2) by 365; and
257.1(4) the planned closure rate adjustment is the amount available in clause (1), divided
257.2by capacity days determined under clause (3).
257.3(b) A planned closure rate adjustment under this section is effective on the first day
257.4of the month following completion of closure of the facility designated for closure in
257.5the application and becomes part of the nursing facility's total operating external fixed
257.6 payment rate.
257.7(c) Applicants may use the planned closure rate adjustment to allow for a property
257.8payment for a new nursing facility or an addition to an existing nursing facility or as
257.9an operating payment external fixed rate adjustment. Applications approved under this
257.10subdivision are exempt from other requirements for moratorium exceptions under section
257.11144A.073 , subdivisions 2 and 3.
257.12(d) Upon the request of a closing facility, the commissioner must allow the facility a
257.13closure rate adjustment as provided under section 144A.161, subdivision 10.
257.14(e) A facility that has received a planned closure rate adjustment may reassign it
257.15to another facility that is under the same ownership at any time within three years of its
257.16effective date. The amount of the adjustment shall be computed according to paragraph (a).
257.17(f) If the per bed dollar amount specified in paragraph (a), clause (1), is increased,
257.18the commissioner shall recalculate planned closure rate adjustments for facilities that
257.19delicense beds under this section on or after July 1, 2001, to reflect the increase in the per
257.20bed dollar amount. The recalculated planned closure rate adjustment shall be effective
257.21from the date the per bed dollar amount is increased.
257.22(g) For planned closures approved after June 30, 2009, the commissioner of human
257.23services shall calculate the amount of the planned closure rate adjustment available under
257.24subdivision 3, paragraph (b), according to paragraph (a), clauses (1) to (4).
257.25(h) Beginning Between July 16, 2011, and June 30, 2013, the commissioner shall no
257.26longer not accept applications for planned closure rate adjustments under subdivision 3.

257.27    Sec. 22. Minnesota Statutes 2012, section 256B.441, subdivision 55, is amended to read:
257.28    Subd. 55. Phase-in of rebased operating payment rates. (a) For the rate years
257.29beginning October 1, 2008, to October 1, 2015, the operating payment rate calculated
257.30under this section shall be phased in by blending the operating rate with the operating
257.31payment rate determined under section 256B.434. For purposes of this subdivision, the
257.32rate to be used that is determined under section 256B.434 shall not include the portion of
257.33the operating payment rate related to performance-based incentive payments under section
257.34256B.434, subdivision 4 , paragraph (d).:
258.1    (1) for the rate year beginning October 1, 2008, the operating payment rate for each
258.2facility shall be 13 percent of the operating payment rate from this section, and 87 percent
258.3of the operating payment rate from section 256B.434.;
258.4    (2) for the rate period from October 1, 2009, to September 30, 2013, no rate
258.5adjustments shall be implemented under this section, but shall be determined under
258.6section 256B.434.;
258.7    (3) for the rate year beginning October 1, 2013, the operating payment rate for each
258.8facility shall be 65 15.4 percent of the operating payment rate from this section, and 35
258.9 84.6 percent of the operating payment rate from section 256B.434.; and
258.10    (4) for the rate year beginning October 1, 2014 2015, the operating payment rate for
258.11each facility shall be 82 24.3 percent of the operating payment rate from this section, and
258.1218 75.7 percent of the operating payment rate from section 256B.434.
258.13     for the rate year beginning October 1, 2015, the operating payment rate for each
258.14facility shall be the operating payment rate determined under this section. The blending
258.15of operating payment rates under this section shall be performed separately for each
258.16RUG's class.
258.17    (b) For the rate year beginning October 1, 2008, the commissioner shall apply limits
258.18to the operating payment rate increases under paragraph (a) by creating a minimum
258.19percentage increase and a maximum percentage increase.:
258.20    (1) each nursing facility that receives a blended October 1, 2008, operating payment
258.21rate increase under paragraph (a) of less than one percent, when compared to its operating
258.22payment rate on September 30, 2008, computed using rates with RUG's weight of 1.00,
258.23shall receive a rate adjustment of one percent.;
258.24    (2) the commissioner shall determine a maximum percentage increase that will
258.25result in savings equal to the cost of allowing the minimum increase in clause (1). Nursing
258.26facilities with a blended October 1, 2008, operating payment rate increase under paragraph
258.27(a) greater than the maximum percentage increase determined by the commissioner, when
258.28compared to its operating payment rate on September 30, 2008, computed using rates with
258.29a RUG's weight of 1.00, shall receive the maximum percentage increase.;
258.30    (3) nursing facilities with a blended October 1, 2008, operating payment rate
258.31increase under paragraph (a) greater than one percent and less than the maximum
258.32percentage increase determined by the commissioner, when compared to its operating
258.33payment rate on September 30, 2008, computed using rates with a RUG's weight of 1.00,
258.34shall receive the blended October 1, 2008, operating payment rate increase determined
258.35under paragraph (a).; and
259.1    (4) the October 1, 2009, through October 1, 2015, operating payment rate for
259.2facilities receiving the maximum percentage increase determined in clause (2) shall be
259.3the amount determined under paragraph (a) less the difference between the amount
259.4determined under paragraph (a) for October 1, 2008, and the amount allowed under clause
259.5(2). This rate restriction does not apply to rate increases provided in any other section.
259.6    (c) A portion of the funds received under this subdivision that are in excess of
259.7operating payment rates that a facility would have received under section 256B.434, as
259.8determined in accordance with clauses (1) to (3), shall be subject to the requirements in
259.9section 256B.434, subdivision 19, paragraphs (b) to (h).:
259.10    (1) determine the amount of additional funding available to a facility, which shall be
259.11equal to total medical assistance resident days from the most recent reporting year times
259.12the difference between the blended rate determined in paragraph (a) for the rate year being
259.13computed and the blended rate for the prior year.;
259.14    (2) determine the portion of all operating costs, for the most recent reporting year,
259.15that are compensation related. If this value exceeds 75 percent, use 75 percent.;
259.16    (3) subtract the amount determined in clause (2) from 75 percent.; and
259.17    (4) the portion of the fund received under this subdivision that shall be subject to the
259.18requirements in section 256B.434, subdivision 19, paragraphs (b) to (h), shall equal the
259.19amount determined in clause (1) times the amount determined in clause (3).

259.20    Sec. 23. Minnesota Statutes 2012, section 256B.441, subdivision 56, is amended to read:
259.21    Subd. 56. Hold harmless. For the rate years beginning October 1, 2008, to October
259.221, 2016, no nursing facility shall receive an operating cost payment rate less than its
259.23operating cost payment rate under section 256B.434. For rate years beginning between
259.24October 1, 2009, and October 1, 2015, no nursing facility shall receive an operating
259.25payment rate less than its operating payment rate in effect on September 30, 2009. The
259.26comparison of operating payment rates under this section shall be made for a RUG's
259.27rate with a weight of 1.00.

259.28    Sec. 24. Minnesota Statutes 2012, section 256B.441, subdivision 62, is amended to read:
259.29    Subd. 62. Repeal of rebased operating payment rates. Notwithstanding
259.30subdivision 54 or 55, no further steps toward phase-in of rebased operating payment rates
259.31shall be taken, except for subdivision 55, paragraph (a), clauses (3) and (4).

259.32    Sec. 25. Minnesota Statutes 2012, section 256B.49, subdivision 11a, is amended to read:
260.1    Subd. 11a. Waivered services statewide priorities. (a) The commissioner shall
260.2establish statewide priorities for individuals on the waiting list for community alternative
260.3care, community alternatives for disabled individuals, and brain injury waiver services,
260.4as of January 1, 2010. The statewide priorities must include, but are not limited to,
260.5individuals who continue to have a need for waiver services after they have maximized the
260.6use of state plan services and other funding resources, including natural supports, prior to
260.7accessing waiver services, and who meet at least one of the following criteria:
260.8(1) no longer require the intensity of services provided where they are currently
260.9living; or
260.10(2) make a request to move from an institutional setting.
260.11(b) After the priorities in paragraph (a) are met, priority must also be given to
260.12individuals who meet at least one of the following criteria:
260.13(1) have unstable living situations due to the age, incapacity, or sudden loss of
260.14the primary caregivers;
260.15(2) are moving from an institution due to bed closures;
260.16(3) experience a sudden closure of their current living arrangement;
260.17(4) require protection from confirmed abuse, neglect, or exploitation;
260.18(5) experience a sudden change in need that can no longer be met through state plan
260.19services or other funding resources alone; or
260.20(6) meet other priorities established by the department.
260.21(b) (c) When allocating resources to lead agencies, the commissioner must take into
260.22consideration the number of individuals waiting who meet statewide priorities and the
260.23lead agencies' current use of waiver funds and existing service options. The commissioner
260.24has the authority to transfer funds between counties, groups of counties, and tribes to
260.25accommodate statewide priorities and resource needs while accounting for a necessary
260.26base level reserve amount for each county, group of counties, and tribe.
260.27(c) The commissioner shall evaluate the impact of the use of statewide priorities and
260.28provide recommendations to the legislature on whether to continue the use of statewide
260.29priorities in the November 1, 2011, annual report required by the commissioner in sections
260.30256B.0916, subdivision 7, and 256B.49, subdivision 21.

260.31    Sec. 26. Minnesota Statutes 2012, section 256B.49, subdivision 15, is amended to read:
260.32    Subd. 15. Coordinated service and support plan; comprehensive transitional
260.33service plan; maintenance service plan. (a) Each recipient of home and community-based
260.34waivered services shall be provided a copy of the written coordinated service and support
260.35plan which meets the requirements in section 256B.092, subdivision 1b.
261.1(b) In developing the comprehensive transitional service plan, the individual
261.2receiving services, the case manager, and the guardian, if applicable, will identify the
261.3transitional service plan fundamental service outcome and anticipated timeline to achieve
261.4this outcome. Within the first 20 days following a recipient's request for an assessment or
261.5reassessment, the transitional service planning team must be identified. A team leader must
261.6be identified who will be responsible for assigning responsibility and communicating with
261.7team members to ensure implementation of the transition plan and ongoing assessment and
261.8communication process. The team leader should be an individual, such as the case manager
261.9or guardian, who has the opportunity to follow the recipient to the next level of service.
261.10Within ten days following an assessment, a comprehensive transitional service plan
261.11must be developed incorporating elements of a comprehensive functional assessment and
261.12including short-term measurable outcomes and timelines for achievement of and reporting
261.13on these outcomes. Functional milestones must also be identified and reported according
261.14to the timelines agreed upon by the transitional service planning team. In addition, the
261.15comprehensive transitional service plan must identify additional supports that may assist
261.16in the achievement of the fundamental service outcome such as the development of greater
261.17natural community support, increased collaboration among agencies, and technological
261.18supports.
261.19The timelines for reporting on functional milestones will prompt a reassessment of
261.20services provided, the units of services, rates, and appropriate service providers. It is
261.21the responsibility of the transitional service planning team leader to review functional
261.22milestone reporting to determine if the milestones are consistent with observable skills
261.23and that milestone achievement prompts any needed changes to the comprehensive
261.24transitional service plan.
261.25For those whose fundamental transitional service outcome involves the need to
261.26procure housing, a plan for the recipient to seek the resources necessary to secure the least
261.27restrictive housing possible should be incorporated into the plan, including employment
261.28and public supports such as housing access and shelter needy funding.
261.29(c) Counties and other agencies responsible for funding community placement and
261.30ongoing community supportive services are responsible for the implementation of the
261.31comprehensive transitional service plans. Oversight responsibilities include both ensuring
261.32effective transitional service delivery and efficient utilization of funding resources.
261.33(d) Following one year of transitional services, the transitional services planning team
261.34will make a determination as to whether or not the individual receiving services requires
261.35the current level of continuous and consistent support in order to maintain the recipient's
261.36current level of functioning. Recipients who are determined to have not had a significant
262.1change in functioning for 12 months must move from a transitional to a maintenance
262.2service plan. Recipients on a maintenance service plan must be reassessed to determine if
262.3the recipient would benefit from a transitional service plan at least every 12 months and at
262.4other times when there has been a significant change in the recipient's functioning. This
262.5assessment should consider any changes to technological or natural community supports.
262.6(e) When a county is evaluating denials, reductions, or terminations of home and
262.7community-based services under section 256B.49 for an individual, the case manager
262.8shall offer to meet with the individual or the individual's guardian in order to discuss
262.9the prioritization of service needs within the coordinated service and support plan,
262.10comprehensive transitional service plan, or maintenance service plan. The reduction in
262.11the authorized services for an individual due to changes in funding for waivered services
262.12may not exceed the amount needed to ensure medically necessary services to meet the
262.13individual's health, safety, and welfare.
262.14(f) At the time of reassessment, local agency case managers shall assess each recipient
262.15of community alternatives for disabled individuals or brain injury waivered services
262.16currently residing in a licensed adult foster home that is not the primary residence of the
262.17license holder, or in which the license holder is not the primary caregiver, to determine if
262.18that recipient could appropriately be served in a community-living setting. If appropriate
262.19for the recipient, the case manager shall offer the recipient, through a person-centered
262.20planning process, the option to receive alternative housing and service options. In the
262.21event that the recipient chooses to transfer from the adult foster home, the vacated bed
262.22shall not be filled with another recipient of waiver services and group residential housing
262.23and the licensed capacity shall be reduced accordingly, unless the savings required by the
262.24licensed bed closure reductions under Laws 2011, First Special Session chapter 9, article 7,
262.25sections 1 and 40, paragraph (f), for foster care settings where the physical location is not
262.26the primary residence of the license holder are met through voluntary changes described
262.27in section 245A.03, subdivision 7, paragraph (f) (e), or as provided under paragraph (a),
262.28clauses (3) and (4). If the adult foster home becomes no longer viable due to these transfers,
262.29the county agency, with the assistance of the department, shall facilitate a consolidation of
262.30settings or closure. This reassessment process shall be completed by July 1, 2013.

262.31    Sec. 27. Minnesota Statutes 2012, section 256B.49, is amended by adding a
262.32subdivision to read:
262.33    Subd. 25. Reduce avoidable behavioral crisis emergency room admissions,
262.34psychiatric inpatient hospitalizations, and commitments to institutions. (a) Persons
262.35receiving home and community-based services authorized under this section who have
263.1two or more admissions within a calendar year to an emergency room, psychiatric unit,
263.2or institution must receive consultation from a mental health professional as defined in
263.3section 245.462, subdivision 18, or a behavioral professional as defined in the home and
263.4community-based services state plan within 30 days of discharge. The mental health
263.5professional or behavioral professional must:
263.6(1) conduct a functional assessment of the crisis incident as defined in section
263.7245D.02, subdivision 11, which led to the hospitalization with the goal of developing
263.8proactive strategies as well as necessary reactive strategies to reduce the likelihood of
263.9future avoidable hospitalizations due to a behavioral crisis;
263.10(2) use the results of the functional assessment to amend the coordinated service and
263.11support plan in section 245D.02, subdivision 4b, to address the potential need for additional
263.12staff training, increased staffing, access to crisis mobility services, mental health services,
263.13use of technology, and crisis stabilization services in section 256B.0624, subdivision 7; and
263.14(3) identify the need for additional consultation, testing, mental health crisis
263.15intervention team services as defined in section 245D.02, subdivision 20, psychotropic
263.16medication use and monitoring under section 245D.051, and the frequency and duration
263.17of ongoing consultation.
263.18(b) For the purposes of this subdivision, "institution" includes, but is not limited to,
263.19the Anoka-Metro Regional Treatment Center and the Minnesota Security Hospital.

263.20    Sec. 28. Minnesota Statutes 2012, section 256B.49, is amended by adding a
263.21subdivision to read:
263.22    Subd. 26. Excess allocations. County and tribal agencies will be responsible for
263.23authorizations in excess of the allocation made by the commissioner. In the event a county
263.24or tribal agency authorizes in excess of the allocation made by the commissioner for a
263.25given allocation period, the county or tribal agency must submit a corrective action plan to
263.26the commissioner. The plan must state the actions the agency will take to correct their
263.27overauthorization for the year following the period when the overspending occurred.
263.28Failure to correct overauthorizations shall result in recoupment of authorizations in excess
263.29of the allocation. Nothing in this subdivision shall be construed as reducing the county's
263.30responsibility to offer and make available feasible home and community-based options to
263.31eligible waiver recipients within the resources allocated to them for that purpose.

263.32    Sec. 29. Minnesota Statutes 2012, section 256B.492, is amended to read:
263.33256B.492 HOME AND COMMUNITY-BASED SETTINGS FOR PEOPLE
263.34WITH DISABILITIES.
264.1(a) Individuals receiving services under a home and community-based waiver under
264.2section 256B.092 or 256B.49 may receive services in the following settings:
264.3(1) an individual's own home or family home;
264.4(2) a licensed adult foster care setting of up to five people; and
264.5(3) community living settings as defined in section 256B.49, subdivision 23, where
264.6individuals with disabilities may reside in all of the units in a building of four or fewer
264.7units, and no more than the greater of four or 25 percent of the units in a multifamily
264.8building of more than four units, unless required by the Housing Opportunities for Persons
264.9with AIDS Program.
264.10(b) The settings in paragraph (a) must not:
264.11(1) be located in a building that is a publicly or privately operated facility that
264.12provides institutional treatment or custodial care;
264.13(2) be located in a building on the grounds of or adjacent to a public or private
264.14institution;
264.15(3) be a housing complex designed expressly around an individual's diagnosis or
264.16disability, unless required by the Housing Opportunities for Persons with AIDS Program;
264.17(4) be segregated based on a disability, either physically or because of setting
264.18characteristics, from the larger community; and
264.19(5) have the qualities of an institution which include, but are not limited to:
264.20regimented meal and sleep times, limitations on visitors, and lack of privacy. Restrictions
264.21agreed to and documented in the person's individual service plan shall not result in a
264.22residence having the qualities of an institution as long as the restrictions for the person are
264.23not imposed upon others in the same residence and are the least restrictive alternative,
264.24imposed for the shortest possible time to meet the person's needs.
264.25(c) The provisions of paragraphs (a) and (b) do not apply to any setting in which
264.26individuals receive services under a home and community-based waiver as of July 1,
264.272012, and the setting does not meet the criteria of this section.
264.28(d) Notwithstanding paragraph (c), a program in Hennepin County established as
264.29part of a Hennepin County demonstration project is qualified for the exception allowed
264.30under paragraph (c).
264.31(e) The commissioner shall submit an amendment to the waiver plan no later than
264.32December 31, 2012.

264.33    Sec. 30. Minnesota Statutes 2012, section 256B.493, subdivision 2, is amended to read:
264.34    Subd. 2. Planned closure process needs determination. The commissioner shall
264.35announce and implement a program for planned closure of adult foster care homes. Planned
265.1closure shall be the preferred method for achieving necessary budgetary savings required by
265.2the licensed bed closure budget reduction in section 245A.03, subdivision 7, paragraph (d)
265.3 (c). If additional closures are required to achieve the necessary savings, the commissioner
265.4shall use the process and priorities in section 245A.03, subdivision 7, paragraph (d) (c).

265.5    Sec. 31. Minnesota Statutes 2012, section 256B.501, is amended by adding a
265.6subdivision to read:
265.7    Subd. 14. Rate adjustment for ICF/DD in Cottonwood County. The
265.8commissioner of health shall decertify three beds in an intermediate care facility for
265.9persons with developmental disabilities with 21 certified beds located in Cottonwood
265.10County. The total payment rate shall be $282.62 per bed, per day.

265.11    Sec. 32. Minnesota Statutes 2012, section 256B.5012, is amended by adding a
265.12subdivision to read:
265.13    Subd. 15. ICF/DD rate increases effective January 1, 2015, and July 1, 2015. (a)
265.14Notwithstanding subdivision 12, for each facility reimbursed under this section, for the rate
265.15period beginning January 1, 2015, the commissioner shall increase operating payments
265.16equal to one percent of the operating payment rates in effect on December 31, 2014.
265.17For the rate period beginning July 1, 2015, the commissioner shall increase operating
265.18payments equal to one percent of the operating payment rates in effect on June 30, 2015.
265.19(b) For each facility, the commissioner shall apply the rate increase based on
265.20occupied beds, using the percentage specified in this subdivision multiplied by the total
265.21payment rate, including the variable rate, but excluding the property-related payment
265.22rate in effect on the preceding date. The total rate increase shall include the adjustment
265.23provided in section 256B.501, subdivision 12.

265.24    Sec. 33. Minnesota Statutes 2012, section 256D.44, subdivision 5, is amended to read:
265.25    Subd. 5. Special needs. In addition to the state standards of assistance established in
265.26subdivisions 1 to 4, payments are allowed for the following special needs of recipients of
265.27Minnesota supplemental aid who are not residents of a nursing home, a regional treatment
265.28center, or a group residential housing facility.
265.29    (a) The county agency shall pay a monthly allowance for medically prescribed
265.30diets if the cost of those additional dietary needs cannot be met through some other
265.31maintenance benefit. The need for special diets or dietary items must be prescribed by
265.32a licensed physician. Costs for special diets shall be determined as percentages of the
265.33allotment for a one-person household under the thrifty food plan as defined by the United
266.1States Department of Agriculture. The types of diets and the percentages of the thrifty
266.2food plan that are covered are as follows:
266.3    (1) high protein diet, at least 80 grams daily, 25 percent of thrifty food plan;
266.4    (2) controlled protein diet, 40 to 60 grams and requires special products, 100 percent
266.5of thrifty food plan;
266.6    (3) controlled protein diet, less than 40 grams and requires special products, 125
266.7percent of thrifty food plan;
266.8    (4) low cholesterol diet, 25 percent of thrifty food plan;
266.9    (5) high residue diet, 20 percent of thrifty food plan;
266.10    (6) pregnancy and lactation diet, 35 percent of thrifty food plan;
266.11    (7) gluten-free diet, 25 percent of thrifty food plan;
266.12    (8) lactose-free diet, 25 percent of thrifty food plan;
266.13    (9) antidumping diet, 15 percent of thrifty food plan;
266.14    (10) hypoglycemic diet, 15 percent of thrifty food plan; or
266.15    (11) ketogenic diet, 25 percent of thrifty food plan.
266.16    (b) Payment for nonrecurring special needs must be allowed for necessary home
266.17repairs or necessary repairs or replacement of household furniture and appliances using
266.18the payment standard of the AFDC program in effect on July 16, 1996, for these expenses,
266.19as long as other funding sources are not available.
266.20    (c) A fee for guardian or conservator service is allowed at a reasonable rate
266.21negotiated by the county or approved by the court. This rate shall not exceed five percent
266.22of the assistance unit's gross monthly income up to a maximum of $100 per month. If the
266.23guardian or conservator is a member of the county agency staff, no fee is allowed.
266.24    (d) The county agency shall continue to pay a monthly allowance of $68 for
266.25restaurant meals for a person who was receiving a restaurant meal allowance on June 1,
266.261990, and who eats two or more meals in a restaurant daily. The allowance must continue
266.27until the person has not received Minnesota supplemental aid for one full calendar month
266.28or until the person's living arrangement changes and the person no longer meets the criteria
266.29for the restaurant meal allowance, whichever occurs first.
266.30    (e) A fee of ten percent of the recipient's gross income or $25, whichever is less,
266.31is allowed for representative payee services provided by an agency that meets the
266.32requirements under SSI regulations to charge a fee for representative payee services. This
266.33special need is available to all recipients of Minnesota supplemental aid regardless of
266.34their living arrangement.
266.35    (f)(1) Notwithstanding the language in this subdivision, an amount equal to the
266.36maximum allotment authorized by the federal Food Stamp Program for a single individual
267.1which is in effect on the first day of July of each year will be added to the standards of
267.2assistance established in subdivisions 1 to 4 for adults under the age of 65 who qualify
267.3as shelter needy and are: (i) relocating from an institution, or an adult mental health
267.4residential treatment program under section 256B.0622; (ii) eligible for the self-directed
267.5supports option as defined under section 256B.0657, subdivision 2; or (iii) home and
267.6community-based waiver recipients living in their own home or rented or leased apartment
267.7which is not owned, operated, or controlled by a provider of service not related by blood
267.8or marriage, unless allowed under paragraph (g).
267.9    (2) Notwithstanding subdivision 3, paragraph (c), an individual eligible for the
267.10shelter needy benefit under this paragraph is considered a household of one. An eligible
267.11individual who receives this benefit prior to age 65 may continue to receive the benefit
267.12after the age of 65.
267.13    (3) "Shelter needy" means that the assistance unit incurs monthly shelter costs that
267.14exceed 40 percent of the assistance unit's gross income before the application of this
267.15special needs standard. "Gross income" for the purposes of this section is the applicant's or
267.16recipient's income as defined in section 256D.35, subdivision 10, or the standard specified
267.17in subdivision 3, paragraph (a) or (b), whichever is greater. A recipient of a federal or
267.18state housing subsidy, that limits shelter costs to a percentage of gross income, shall not be
267.19considered shelter needy for purposes of this paragraph.
267.20(g) Notwithstanding this subdivision, to access housing and services as provided
267.21in paragraph (f), the recipient may choose housing that may be owned, operated, or
267.22controlled by the recipient's service provider. In a multifamily building of more than four
267.23units, the maximum number of units that may be used by recipients of this program shall
267.24be the greater of four units or 25 percent of the units in the building, unless required by the
267.25Housing Opportunities for Persons with AIDS Program. In multifamily buildings of four
267.26or fewer units, all of the units may be used by recipients of this program. When housing is
267.27controlled by the service provider, the individual may choose the individual's own service
267.28provider as provided in section 256B.49, subdivision 23, clause (3). When the housing is
267.29controlled by the service provider, the service provider shall implement a plan with the
267.30recipient to transition the lease to the recipient's name. Within two years of signing the
267.31initial lease, the service provider shall transfer the lease entered into under this subdivision
267.32to the recipient. In the event the landlord denies this transfer, the commissioner may
267.33approve an exception within sufficient time to ensure the continued occupancy by the
267.34recipient. This paragraph expires June 30, 2016.

268.1    Sec. 34. Laws 2011, First Special Session chapter 9, article 7, section 39, subdivision
268.214, is amended to read:
268.3    Subd. 14. Assessment and reassessment. (a) Assessments of each recipient's
268.4strengths, informal support systems, and need for services shall be completed within 20
268.5working days of the recipient's request as provided in section 256B.0911. Reassessment
268.6of each recipient's strengths, support systems, and need for services shall be conducted
268.7at least every 12 months and at other times when there has been a significant change in
268.8the recipient's functioning.
268.9(b) There must be a determination that the client requires a hospital level of care or a
268.10nursing facility level of care as defined in section 256B.0911, subdivision 4a, paragraph
268.11(d), at initial and subsequent assessments to initiate and maintain participation in the
268.12waiver program.
268.13(c) Regardless of other assessments identified in section 144.0724, subdivision 4, as
268.14appropriate to determine nursing facility level of care for purposes of medical assistance
268.15payment for nursing facility services, only face-to-face assessments conducted according
268.16to section 256B.0911, subdivisions 3a, 3b, and 4d, that result in a hospital level of care
268.17determination or a nursing facility level of care determination must be accepted for
268.18purposes of initial and ongoing access to waiver services payment.
268.19(d) Persons with developmental disabilities who apply for services under the nursing
268.20facility level waiver programs shall be screened for the appropriate level of care according
268.21to section 256B.092.
268.22(e) Recipients who are found eligible for home and community-based services under
268.23this section before their 65th birthday may remain eligible for these services after their
268.2465th birthday if they continue to meet all other eligibility factors.
268.25(f) The commissioner shall develop criteria to identify recipients whose level of
268.26functioning is reasonably expected to improve and reassess these recipients to establish
268.27a baseline assessment. Recipients who meet these criteria must have a comprehensive
268.28transitional service plan developed under subdivision 15, paragraphs (b) and (c), and be
268.29reassessed every six months until there has been no significant change in the recipient's
268.30functioning for at least 12 months. After there has been no significant change in the
268.31recipient's functioning for at least 12 months, reassessments of the recipient's strengths,
268.32informal support systems, and need for services shall be conducted at least every 12
268.33months and at other times when there has been a significant change in the recipient's
268.34functioning. Counties, case managers, and service providers are responsible for
268.35conducting these reassessments and shall complete the reassessments out of existing funds.

269.1    Sec. 35. Laws 2012, chapter 247, article 6, section 4, is amended to read:

269.2 269.3

Sec. 4. BOARD OF NURSING HOME ADMINISTRATORS

$

-0-

$

10,000

269.4Administrative Services Unit. This
269.5appropriation is to provide a grant to the
269.6Minnesota Ambulance Association to
269.7coordinate and prepare an assessment of
269.8the extent and costs of uncompensated care
269.9as a direct result of emergency responses
269.10on interstate highways in Minnesota.
269.11The study will collect appropriate
269.12information from medical response units
269.13and ambulance services regulated under
269.14Minnesota Statutes, chapter 144E, and to
269.15the extent possible, firefighting agencies.
269.16In preparing the assessment, the Minnesota
269.17Ambulance Association shall consult with
269.18its membership, the Minnesota Fire Chiefs
269.19Association, the Office of the State Fire
269.20Marshal, and the Emergency Medical
269.21Services Regulatory Board. The findings
269.22of the assessment will be reported to the
269.23chairs and ranking minority members of the
269.24legislative committees with jurisdiction over
269.25health and public safety by January 1, 2013.
269.26 This is a onetime appropriation.

269.27    Sec. 36. DIRECTION TO COMMISSIONER.
269.28    The commissioner of human services shall request authority, in whatever form is
269.29necessary, from the federal Centers for Medicare and Medicaid Services to allow persons
269.30under age 65 participating in the home and community-based services waivers to continue
269.31to use the disregard of the nonassisted spouse's income and assets instead of the spousal
269.32impoverishment provisions under the federal Patient Protection and Affordable Care Act,
269.33Public Law 111-148, section 2404, as amended by the federal Health Care and Education
269.34Reconciliation Act of 2010, Public Law 111-152, and any amendments to, or regulations
269.35or guidance issued under, those acts.

270.1    Sec. 37. RECOMMENDATIONS ON RAISING THE ASSET LIMITS FOR
270.2SENIORS AND PERSONS WITH DISABILITIES.
270.3    The commissioner of human services shall consult with interested stakeholders to
270.4develop recommendations and a request for a federal 1115 demonstration waiver in order
270.5to increase the asset limit for individuals eligible for medical assistance due to disability
270.6or age who are not residing in a nursing facility, intermediate care facility for persons
270.7with developmental disabilities, or other institution whose costs for room and board are
270.8covered by medical assistance or state funds. The recommendations must be provided to
270.9the legislative committees and divisions with jurisdiction over health and human services
270.10policy and finance by February 1, 2014.

270.11    Sec. 38. NURSING HOME LEVEL OF CARE REPORT.
270.12    (a) The commissioner of human services shall report on the impact of the
270.13modification to the nursing facility level of care to be implemented January 1, 2014,
270.14including the following:
270.15    (1) the number of individuals who lose eligibility for home and community-based
270.16services waivers under Minnesota Statutes, sections 256B.0915 and 256B.49, and
270.17alternative care under Minnesota Statutes, section 256B.0913;
270.18    (2) the number of individuals who lose eligibility for medical assistance; and
270.19    (3) for individuals reported under clauses (1) and (2), and to the extent possible:
270.20    (i) their living situation before and after nursing facility level of care implementation;
270.21and
270.22    (ii) the programs or services they received before and after nursing facility level of
270.23care implementation, including, but not limited to, personal care assistant services and
270.24essential community supports.
270.25    (b) The commissioner of human services shall report to the chairs and ranking
270.26minority members of the legislative committees and divisions with jurisdiction over health
270.27and human services policy and finance with the information required under paragraph
270.28(a). A preliminary report shall be submitted on October 1, 2014, and a final report shall
270.29be submitted February 15, 2015.

270.30    Sec. 39. ASSISTIVE TECHNOLOGY EQUIPMENT FOR HOME AND
270.31COMMUNITY-BASED SERVICES WAIVERS FUNDING DEVELOPMENT.
270.32(a) For the purposes of this section, "assistive technology equipment" includes
270.33computer tablets, passive sensors, and other forms of technology allowing increased
270.34safety and independence, and used by those receiving services through a home and
271.1community-based services waiver under Minnesota Statutes, sections 256B.0915,
271.2256B.092, and 256B.49.
271.3(b) The commissioner of human services shall develop recommendations for
271.4assistive technology equipment funding to enable individuals receiving services identified
271.5in paragraph (a) to live in the least restrictive setting possible. In developing the funding,
271.6the commissioner shall examine funding for the following:
271.7(1) an assessment process to match the appropriate assistive technology equipment
271.8with the waiver recipient, including when the recipient's condition changes or progresses;
271.9(2) the use of monitoring services, if applicable, to the assistive technology
271.10equipment identified in clause (1);
271.11(3) the leasing of assistive technology equipment as a possible alternative to
271.12purchasing the equipment; and
271.13(4) ongoing support services, such as technological support.
271.14(c) The commissioner shall provide the chairs and ranking minority members of the
271.15legislative committees and divisions with jurisdiction over health and human services
271.16policy and finance a recommendation for implementing an assistive technology equipment
271.17program as developed in paragraph (b) by February 1, 2014.

271.18    Sec. 40. PROVIDER RATE AND GRANT INCREASES EFFECTIVE JANUARY
271.191, 2015, AND JULY 1, 2015.
271.20(a) The commissioner of human services shall increase reimbursement rates, grants,
271.21allocations, individual limits, and rate limits, as applicable, by one percent for the rate
271.22period beginning January 1, 2015, and by one percent for the rate period beginning July 1,
271.232015, for services rendered on or after those dates. County or tribal contracts for services
271.24specified in this section must be amended to pass through these rate increases within 60
271.25days of the effective date.
271.26(b) The rate changes described in this section must be provided to:
271.27(1) home and community-based waivered services for persons with developmental
271.28disabilities or related conditions, including consumer-directed community supports, under
271.29Minnesota Statutes, section 256B.501;
271.30(2) waivered services under community alternatives for disabled individuals,
271.31including consumer-directed community supports, under Minnesota Statutes, section
271.32256B.49;
271.33(3) community alternative care waivered services, including consumer-directed
271.34community supports, under Minnesota Statutes, section 256B.49;
272.1(4) brain injury waivered services, including consumer-directed community
272.2supports, under Minnesota Statutes, section 256B.49;
272.3(5) home and community-based waivered services for the elderly under Minnesota
272.4Statutes, section 256B.0915;
272.5(6) nursing services and home health services under Minnesota Statutes, section
272.6256B.0625, subdivision 6a;
272.7(7) personal care services and qualified professional supervision of personal care
272.8services under Minnesota Statutes, section 256B.0625, subdivisions 6a and 19a;
272.9(8) private duty nursing services under Minnesota Statutes, section 256B.0625,
272.10subdivision 7;
272.11(9) day training and habilitation services for adults with developmental disabilities
272.12or related conditions under Minnesota Statutes, sections 252.40 to 252.46, including the
272.13additional cost of rate adjustments on day training and habilitation services, provided as a
272.14social service, under Minnesota Statutes, section 256M.60;
272.15(10) alternative care services under Minnesota Statutes, section 256B.0913;
272.16(11) living skills training programs for persons with intractable epilepsy who need
272.17assistance in the transition to independent living under Laws 1988, chapter 689;
272.18(12) semi-independent living services (SILS) under Minnesota Statutes, section
272.19252.275, including SILS funding under county social services grants formerly funded
272.20under Minnesota Statutes, chapter 256I;
272.21(13) consumer support grants under Minnesota Statutes, section 256.476;
272.22(14) family support grants under Minnesota Statutes, section 252.32;
272.23(15) housing access grants under Minnesota Statutes, section 256B.0658;
272.24(16) self-advocacy grants under Laws 2009, chapter 101; and
272.25(17) technology grants under Laws 2009, chapter 79.
272.26(c) A managed care plan receiving state payments for the services in this section
272.27must include these increases in their payments to providers. To implement the rate increase
272.28in this section, capitation rates paid by the commissioner to managed care organizations
272.29under Minnesota Statutes, section 256B.69, shall reflect a one percent increase for the
272.30specified services for the period beginning January 1, 2015.
272.31(d) Counties shall increase the budget for each recipient of consumer-directed
272.32community supports by the amounts in paragraph (a) on the effective dates in paragraph (a).

272.33    Sec. 41. SAFETY NET FOR HOME AND COMMUNITY-BASED SERVICES
272.34WAIVERS.
273.1The commissioner of human services shall submit a request by December 31, 2013,
273.2to the federal government to amend the home and community-based services waivers for
273.3individuals with disabilities authorized under Minnesota Statutes, section 256B.49, to
273.4modify the financial management of the home and community-based services waivers
273.5to provide a state-administered safety net when costs for an individual increase above
273.6an identified threshold. The implementation of the safety net may result in a decreased
273.7allocation for individual counties, tribes, or collaboratives of counties or tribes, but must
273.8not result in a net decreased statewide allocation.

273.9    Sec. 42. SHARED LIVING MODEL.
273.10The commissioner of human services shall develop and promote a shared living model
273.11option for individuals receiving services through the home and community-based services
273.12waivers for individuals with disabilities, authorized under Minnesota Statutes, section
273.13256B.092 or 256B.49, as an option for individuals who require 24-hour assistance. The
273.14option must be a companion model with a limit of one or two individuals receiving support
273.15in the home, planned respite for the caregiver, and the availability of intensive training
273.16and support on the needs of the individual or individuals. Any necessary amendments to
273.17implement the model must be submitted to the federal government by December 31, 2013.

273.18    Sec. 43. MONEY FOLLOWS THE PERSON GRANT.
273.19The commissioner of human services shall submit to the federal government all
273.20necessary waiver amendments to implement the Money Follows the Person federal grant
273.21by December 31, 2013.

273.22    Sec. 44. REPEALER.
273.23Minnesota Statutes 2012, sections 256B.096, subdivisions 1, 2, 3, and 4; and
273.24256B.5012, subdivision 13; and Laws 2011, First Special Session chapter 9, article 7,
273.25section 54, as amended by Laws 2012, chapter 247, article 4, section 42, and Laws 2012,
273.26chapter 298, section 3, are repealed.

273.27ARTICLE 8

273.28WAIVER PROVIDER STANDARDS

273.29    Section 1. Minnesota Statutes 2012, section 13.461, is amended by adding a
273.30subdivision to read:
274.1    Subd. 7c. Human services license holders. Section 245D.095, subdivision 3,
274.2requires certain license holders to protect service recipient records in accordance with
274.3specified provisions of this chapter.

274.4    Sec. 2. Minnesota Statutes 2012, section 145C.01, subdivision 7, is amended to read:
274.5    Subd. 7. Health care facility. "Health care facility" means a hospital or other entity
274.6licensed under sections 144.50 to 144.58, a nursing home licensed to serve adults under
274.7section 144A.02, a home care provider licensed under sections 144A.43 to 144A.47,
274.8an adult foster care provider licensed under chapter 245A and Minnesota Rules, parts
274.99555.5105 to 9555.6265, a community residential setting licensed under chapter 245D, or
274.10a hospice provider licensed under sections 144A.75 to 144A.755.

274.11    Sec. 3. Minnesota Statutes 2012, section 243.166, subdivision 4b, is amended to read:
274.12    Subd. 4b. Health care facility; notice of status. (a) For the purposes of this
274.13subdivision, "health care facility" means a facility:
274.14(1) licensed by the commissioner of health as a hospital, boarding care home or
274.15supervised living facility under sections 144.50 to 144.58, or a nursing home under
274.16chapter 144A;
274.17(2) registered by the commissioner of health as a housing with services establishment
274.18as defined in section 144D.01; or
274.19(3) licensed by the commissioner of human services as a residential facility under
274.20chapter 245A to provide adult foster care, adult mental health treatment, chemical
274.21dependency treatment to adults, or residential services to persons with developmental
274.22 disabilities.
274.23(b) Prior to admission to a health care facility, a person required to register under
274.24this section shall disclose to:
274.25(1) the health care facility employee processing the admission the person's status
274.26as a registered predatory offender under this section; and
274.27(2) the person's corrections agent, or if the person does not have an assigned
274.28corrections agent, the law enforcement authority with whom the person is currently
274.29required to register, that inpatient admission will occur.
274.30(c) A law enforcement authority or corrections agent who receives notice under
274.31paragraph (b) or who knows that a person required to register under this section is
274.32planning to be admitted and receive, or has been admitted and is receiving health care
274.33at a health care facility shall notify the administrator of the facility and deliver a fact
274.34sheet to the administrator containing the following information: (1) name and physical
275.1description of the offender; (2) the offender's conviction history, including the dates of
275.2conviction; (3) the risk level classification assigned to the offender under section 244.052,
275.3if any; and (4) the profile of likely victims.
275.4(d) Except for a hospital licensed under sections 144.50 to 144.58, if a health care
275.5facility receives a fact sheet under paragraph (c) that includes a risk level classification for
275.6the offender, and if the facility admits the offender, the facility shall distribute the fact
275.7sheet to all residents at the facility. If the facility determines that distribution to a resident
275.8is not appropriate given the resident's medical, emotional, or mental status, the facility
275.9shall distribute the fact sheet to the patient's next of kin or emergency contact.

275.10    Sec. 4. [245.8251] POSITIVE SUPPORT STRATEGIES AND EMERGENCY
275.11MANUAL RESTRAINT; LICENSED FACILITIES AND PROGRAMS.
275.12    Subdivision 1. Rules. The commissioner of human services shall, within 24 months
275.13of enactment of this section, adopt rules governing the use of positive support strategies,
275.14safety interventions, and emergency use of manual restraint in facilities and services
275.15licensed under chapter 245D.
275.16    Subd. 2. Data collection. (a) The commissioner shall, with stakeholder input,
275.17develop data collection elements specific to incidents on the use of controlled procedures
275.18with persons receiving services from providers regulated under Minnesota Rules, parts
275.199525.2700 to 9525.2810, and incidents involving persons receiving services from
275.20providers identified to be licensed under chapter 245D effective January 1, 2014. Providers
275.21shall report the data in a format and at a frequency provided by the commissioner of
275.22human services.
275.23(b) Beginning July 1, 2013, providers regulated under Minnesota Rules, parts
275.249525.2700 to 9525.2810, shall submit data regarding the use of all controlled procedures
275.25in a format and at a frequency provided by the commissioner.

275.26    Sec. 5. Minnesota Statutes 2012, section 245A.02, subdivision 10, is amended to read:
275.27    Subd. 10. Nonresidential program. "Nonresidential program" means care,
275.28supervision, rehabilitation, training or habilitation of a person provided outside the
275.29person's own home and provided for fewer than 24 hours a day, including adult day
275.30care programs; and chemical dependency or chemical abuse programs that are located
275.31in a nursing home or hospital and receive public funds for providing chemical abuse or
275.32chemical dependency treatment services under chapter 254B. Nonresidential programs
275.33include home and community-based services and semi-independent living services for
276.1persons with developmental disabilities or persons age 65 and older that are provided in
276.2or outside of a person's own home under chapter 245D.

276.3    Sec. 6. Minnesota Statutes 2012, section 245A.02, subdivision 14, is amended to read:
276.4    Subd. 14. Residential program. "Residential program" means a program
276.5that provides 24-hour-a-day care, supervision, food, lodging, rehabilitation, training,
276.6education, habilitation, or treatment outside a person's own home, including a program
276.7in an intermediate care facility for four or more persons with developmental disabilities;
276.8and chemical dependency or chemical abuse programs that are located in a hospital
276.9or nursing home and receive public funds for providing chemical abuse or chemical
276.10dependency treatment services under chapter 254B. Residential programs include home
276.11and community-based services for persons with developmental disabilities or persons age
276.1265 and older that are provided in or outside of a person's own home under chapter 245D.

276.13    Sec. 7. Minnesota Statutes 2012, section 245A.03, subdivision 7, is amended to read:
276.14    Subd. 7. Licensing moratorium. (a) The commissioner shall not issue an initial
276.15license for child foster care licensed under Minnesota Rules, parts 2960.3000 to 2960.3340,
276.16or adult foster care licensed under Minnesota Rules, parts 9555.5105 to 9555.6265, under
276.17this chapter for a physical location that will not be the primary residence of the license
276.18holder for the entire period of licensure. If a license is issued during this moratorium, and
276.19the license holder changes the license holder's primary residence away from the physical
276.20location of the foster care license, the commissioner shall revoke the license according
276.21to section 245A.07. The commissioner shall not issue an initial license for a community
276.22residential setting licensed under chapter 245D. Exceptions to the moratorium include:
276.23(1) foster care settings that are required to be registered under chapter 144D;
276.24(2) foster care licenses replacing foster care licenses in existence on May 15, 2009, or
276.25community residential setting licenses replacing adult foster care licenses in existence on
276.26December 31, 2013, and determined to be needed by the commissioner under paragraph (b);
276.27(3) new foster care licenses or community residential setting licenses determined to
276.28be needed by the commissioner under paragraph (b) for the closure of a nursing facility,
276.29ICF/MR, or regional treatment center, or restructuring of state-operated services that
276.30limits the capacity of state-operated facilities;
276.31(4) new foster care licenses or community residential setting licenses determined
276.32to be needed by the commissioner under paragraph (b) for persons requiring hospital
276.33level care; or
277.1(5) new foster care licenses or community residential setting licenses determined to
277.2be needed by the commissioner for the transition of people from personal care assistance
277.3to the home and community-based services.
277.4(b) The commissioner shall determine the need for newly licensed foster care
277.5homes or community residential settings as defined under this subdivision. As part of the
277.6determination, the commissioner shall consider the availability of foster care capacity in
277.7the area in which the licensee seeks to operate, and the recommendation of the local
277.8county board. The determination by the commissioner must be final. A determination of
277.9need is not required for a change in ownership at the same address.
277.10(c) The commissioner shall study the effects of the license moratorium under this
277.11subdivision and shall report back to the legislature by January 15, 2011. This study shall
277.12include, but is not limited to the following:
277.13(1) the overall capacity and utilization of foster care beds where the physical location
277.14is not the primary residence of the license holder prior to and after implementation
277.15of the moratorium;
277.16(2) the overall capacity and utilization of foster care beds where the physical
277.17location is the primary residence of the license holder prior to and after implementation
277.18of the moratorium; and
277.19(3) the number of licensed and occupied ICF/MR beds prior to and after
277.20implementation of the moratorium.
277.21(d) When a foster care recipient resident served by the program moves out of a
277.22foster home that is not the primary residence of the license holder according to section
277.23256B.49, subdivision 15 , paragraph (f), or the community residential setting, the county
277.24shall immediately inform the Department of Human Services Licensing Division.
277.25The department shall decrease the statewide licensed capacity for foster care settings
277.26where the physical location is not the primary residence of the license holder, or for
277.27community residential settings, if the voluntary changes described in paragraph (f) are
277.28not sufficient to meet the savings required by reductions in licensed bed capacity under
277.29Laws 2011, First Special Session chapter 9, article 7, sections 1 and 40, paragraph (f),
277.30and maintain statewide long-term care residential services capacity within budgetary
277.31limits. Implementation of the statewide licensed capacity reduction shall begin on July
277.321, 2013. The commissioner shall delicense up to 128 beds by June 30, 2014, using the
277.33needs determination process. Under this paragraph, the commissioner has the authority
277.34to reduce unused licensed capacity of a current foster care program, or the community
277.35residential settings, to accomplish the consolidation or closure of settings. A decreased
277.36licensed capacity according to this paragraph is not subject to appeal under this chapter.
278.1(e) Residential settings that would otherwise be subject to the decreased license
278.2capacity established in paragraph (d) shall be exempt under the following circumstances:
278.3(1) until August 1, 2013, the license holder's beds occupied by residents whose
278.4primary diagnosis is mental illness and the license holder is:
278.5(i) a provider of assertive community treatment (ACT) or adult rehabilitative mental
278.6health services (ARMHS) as defined in section 256B.0623;
278.7(ii) a mental health center certified under Minnesota Rules, parts 9520.0750 to
278.89520.0870;
278.9(iii) a mental health clinic certified under Minnesota Rules, parts 9520.0750 to
278.109520.0870; or
278.11(iv) a provider of intensive residential treatment services (IRTS) licensed under
278.12Minnesota Rules, parts 9520.0500 to 9520.0670; or
278.13(2) the license holder is certified under the requirements in subdivision 6a or section
278.14245D.33.
278.15(f) A resource need determination process, managed at the state level, using the
278.16available reports required by section 144A.351, and other data and information shall
278.17be used to determine where the reduced capacity required under paragraph (d) will be
278.18implemented. The commissioner shall consult with the stakeholders described in section
278.19144A.351 , and employ a variety of methods to improve the state's capacity to meet
278.20long-term care service needs within budgetary limits, including seeking proposals from
278.21service providers or lead agencies to change service type, capacity, or location to improve
278.22services, increase the independence of residents, and better meet needs identified by the
278.23long-term care services reports and statewide data and information. By February 1 of each
278.24year, the commissioner shall provide information and data on the overall capacity of
278.25licensed long-term care services, actions taken under this subdivision to manage statewide
278.26long-term care services and supports resources, and any recommendations for change to
278.27the legislative committees with jurisdiction over health and human services budget.
278.28    (g) At the time of application and reapplication for licensure, the applicant and the
278.29license holder that are subject to the moratorium or an exclusion established in paragraph
278.30(a) are required to inform the commissioner whether the physical location where the foster
278.31care will be provided is or will be the primary residence of the license holder for the entire
278.32period of licensure. If the primary residence of the applicant or license holder changes, the
278.33applicant or license holder must notify the commissioner immediately. The commissioner
278.34shall print on the foster care license certificate whether or not the physical location is the
278.35primary residence of the license holder.
279.1    (h) License holders of foster care homes identified under paragraph (g) that are not
279.2the primary residence of the license holder and that also provide services in the foster care
279.3home that are covered by a federally approved home and community-based services
279.4waiver, as authorized under section 256B.0915, 256B.092, or 256B.49, must inform the
279.5human services licensing division that the license holder provides or intends to provide
279.6these waiver-funded services. These license holders must be considered registered under
279.7section 256B.092, subdivision 11, paragraph (c), and this registration status must be
279.8identified on their license certificates.

279.9    Sec. 8. Minnesota Statutes 2012, section 245A.03, subdivision 8, is amended to read:
279.10    Subd. 8. Excluded providers seeking licensure. Nothing in this section shall
279.11prohibit a program that is excluded from licensure under subdivision 2, paragraph
279.12(a), clause (28) (26), from seeking licensure. The commissioner shall ensure that any
279.13application received from such an excluded provider is processed in the same manner as
279.14all other applications for child care center licensure.

279.15    Sec. 9. Minnesota Statutes 2012, section 245A.042, subdivision 3, is amended to read:
279.16    Subd. 3. Implementation. (a) The commissioner shall implement the
279.17responsibilities of this chapter according to the timelines in paragraphs (b) and (c)
279.18only within the limits of available appropriations or other administrative cost recovery
279.19methodology.
279.20(b) The licensure of home and community-based services according to this section
279.21shall be implemented January 1, 2014. License applications shall be received and
279.22processed on a phased-in schedule as determined by the commissioner beginning July
279.231, 2013. Licenses will be issued thereafter upon the commissioner's determination that
279.24the application is complete according to section 245A.04.
279.25(c) Within the limits of available appropriations or other administrative cost recovery
279.26methodology, implementation of compliance monitoring must be phased in after January
279.271, 2014.
279.28(1) Applicants who do not currently hold a license issued under this chapter 245B
279.29 must receive an initial compliance monitoring visit after 12 months of the effective date of
279.30the initial license for the purpose of providing technical assistance on how to achieve and
279.31maintain compliance with the applicable law or rules governing the provision of home and
279.32community-based services under chapter 245D. If during the review the commissioner
279.33finds that the license holder has failed to achieve compliance with an applicable law or
279.34rule and this failure does not imminently endanger the health, safety, or rights of the
280.1persons served by the program, the commissioner may issue a licensing review report with
280.2recommendations for achieving and maintaining compliance.
280.3(2) Applicants who do currently hold a license issued under this chapter must receive
280.4a compliance monitoring visit after 24 months of the effective date of the initial license.
280.5(d) Nothing in this subdivision shall be construed to limit the commissioner's
280.6authority to suspend or revoke a license or issue a fine at any time under section 245A.07,
280.7or make issue correction orders and make a license conditional for failure to comply with
280.8applicable laws or rules under section 245A.06, based on the nature, chronicity, or severity
280.9of the violation of law or rule and the effect of the violation on the health, safety, or
280.10rights of persons served by the program.

280.11    Sec. 10. Minnesota Statutes 2012, section 245A.08, subdivision 2a, is amended to read:
280.12    Subd. 2a. Consolidated contested case hearings. (a) When a denial of a license
280.13under section 245A.05 or a licensing sanction under section 245A.07, subdivision 3, is
280.14based on a disqualification for which reconsideration was requested and which was not
280.15set aside under section 245C.22, the scope of the contested case hearing shall include the
280.16disqualification and the licensing sanction or denial of a license, unless otherwise specified
280.17in this subdivision. When the licensing sanction or denial of a license is based on a
280.18determination of maltreatment under section 626.556 or 626.557, or a disqualification for
280.19serious or recurring maltreatment which was not set aside, the scope of the contested case
280.20hearing shall include the maltreatment determination, disqualification, and the licensing
280.21sanction or denial of a license, unless otherwise specified in this subdivision. In such
280.22cases, a fair hearing under section 256.045 shall not be conducted as provided for in
280.23sections 245C.27, 626.556, subdivision 10i, and 626.557, subdivision 9d.
280.24    (b) Except for family child care and child foster care, reconsideration of a
280.25maltreatment determination under sections 626.556, subdivision 10i, and 626.557,
280.26subdivision 9d, and reconsideration of a disqualification under section 245C.22, shall
280.27not be conducted when:
280.28    (1) a denial of a license under section 245A.05, or a licensing sanction under section
280.29245A.07 , is based on a determination that the license holder is responsible for maltreatment
280.30or the disqualification of a license holder is based on serious or recurring maltreatment;
280.31    (2) the denial of a license or licensing sanction is issued at the same time as the
280.32maltreatment determination or disqualification; and
280.33    (3) the license holder appeals the maltreatment determination or disqualification,
280.34and denial of a license or licensing sanction. In these cases, a fair hearing shall not be
280.35conducted under sections 245C.27, 626.556, subdivision 10i, and 626.557, subdivision
281.19d. The scope of the contested case hearing must include the maltreatment determination,
281.2disqualification, and denial of a license or licensing sanction.
281.3    Notwithstanding clauses (1) to (3), if the license holder appeals the maltreatment
281.4determination or disqualification, but does not appeal the denial of a license or a licensing
281.5sanction, reconsideration of the maltreatment determination shall be conducted under
281.6sections 626.556, subdivision 10i, and 626.557, subdivision 9d, and reconsideration of the
281.7disqualification shall be conducted under section 245C.22. In such cases, a fair hearing
281.8shall also be conducted as provided under sections 245C.27, 626.556, subdivision 10i, and
281.9626.557, subdivision 9d .
281.10    (c) In consolidated contested case hearings regarding sanctions issued in family child
281.11care, child foster care, family adult day services, and adult foster care, and community
281.12residential settings, the county attorney shall defend the commissioner's orders in
281.13accordance with section 245A.16, subdivision 4.
281.14    (d) The commissioner's final order under subdivision 5 is the final agency action
281.15on the issue of maltreatment and disqualification, including for purposes of subsequent
281.16background studies under chapter 245C and is the only administrative appeal of the final
281.17agency determination, specifically, including a challenge to the accuracy and completeness
281.18of data under section 13.04.
281.19    (e) When consolidated hearings under this subdivision involve a licensing sanction
281.20based on a previous maltreatment determination for which the commissioner has issued
281.21a final order in an appeal of that determination under section 256.045, or the individual
281.22failed to exercise the right to appeal the previous maltreatment determination under
281.23section 626.556, subdivision 10i, or 626.557, subdivision 9d, the commissioner's order is
281.24conclusive on the issue of maltreatment. In such cases, the scope of the administrative
281.25law judge's review shall be limited to the disqualification and the licensing sanction or
281.26denial of a license. In the case of a denial of a license or a licensing sanction issued to
281.27a facility based on a maltreatment determination regarding an individual who is not the
281.28license holder or a household member, the scope of the administrative law judge's review
281.29includes the maltreatment determination.
281.30    (f) The hearings of all parties may be consolidated into a single contested case
281.31hearing upon consent of all parties and the administrative law judge, if:
281.32    (1) a maltreatment determination or disqualification, which was not set aside under
281.33section 245C.22, is the basis for a denial of a license under section 245A.05 or a licensing
281.34sanction under section 245A.07;
281.35    (2) the disqualified subject is an individual other than the license holder and upon
281.36whom a background study must be conducted under section 245C.03; and
282.1    (3) the individual has a hearing right under section 245C.27.
282.2    (g) When a denial of a license under section 245A.05 or a licensing sanction under
282.3section 245A.07 is based on a disqualification for which reconsideration was requested
282.4and was not set aside under section 245C.22, and the individual otherwise has no hearing
282.5right under section 245C.27, the scope of the administrative law judge's review shall
282.6include the denial or sanction and a determination whether the disqualification should
282.7be set aside, unless section 245C.24 prohibits the set-aside of the disqualification. In
282.8determining whether the disqualification should be set aside, the administrative law judge
282.9shall consider the factors under section 245C.22, subdivision 4, to determine whether the
282.10individual poses a risk of harm to any person receiving services from the license holder.
282.11    (h) Notwithstanding section 245C.30, subdivision 5, when a licensing sanction
282.12under section 245A.07 is based on the termination of a variance under section 245C.30,
282.13subdivision 4 , the scope of the administrative law judge's review shall include the sanction
282.14and a determination whether the disqualification should be set aside, unless section
282.15245C.24 prohibits the set-aside of the disqualification. In determining whether the
282.16disqualification should be set aside, the administrative law judge shall consider the factors
282.17under section 245C.22, subdivision 4, to determine whether the individual poses a risk of
282.18harm to any person receiving services from the license holder.

282.19    Sec. 11. Minnesota Statutes 2012, section 245A.10, is amended to read:
282.20245A.10 FEES.
282.21    Subdivision 1. Application or license fee required, programs exempt from fee.
282.22(a) Unless exempt under paragraph (b), the commissioner shall charge a fee for evaluation
282.23of applications and inspection of programs which are licensed under this chapter.
282.24(b) Except as provided under subdivision 2, no application or license fee shall be
282.25charged for child foster care, adult foster care, or family and group family child care, or
282.26a community residential setting.
282.27    Subd. 2. County fees for background studies and licensing inspections. (a) For
282.28purposes of family and group family child care licensing under this chapter, a county
282.29agency may charge a fee to an applicant or license holder to recover the actual cost of
282.30background studies, but in any case not to exceed $100 annually. A county agency may
282.31also charge a license fee to an applicant or license holder not to exceed $50 for a one-year
282.32license or $100 for a two-year license.
282.33    (b) A county agency may charge a fee to a legal nonlicensed child care provider or
282.34applicant for authorization to recover the actual cost of background studies completed
282.35under section 119B.125, but in any case not to exceed $100 annually.
283.1    (c) Counties may elect to reduce or waive the fees in paragraph (a) or (b):
283.2    (1) in cases of financial hardship;
283.3    (2) if the county has a shortage of providers in the county's area;
283.4    (3) for new providers; or
283.5    (4) for providers who have attained at least 16 hours of training before seeking
283.6initial licensure.
283.7    (d) Counties may allow providers to pay the applicant fees in paragraph (a) or (b) on
283.8an installment basis for up to one year. If the provider is receiving child care assistance
283.9payments from the state, the provider may have the fees under paragraph (a) or (b)
283.10deducted from the child care assistance payments for up to one year and the state shall
283.11reimburse the county for the county fees collected in this manner.
283.12    (e) For purposes of adult foster care and child foster care licensing, and licensing
283.13the physical plant of a community residential setting, under this chapter, a county agency
283.14may charge a fee to a corporate applicant or corporate license holder to recover the actual
283.15cost of licensing inspections, not to exceed $500 annually.
283.16    (f) Counties may elect to reduce or waive the fees in paragraph (e) under the
283.17following circumstances:
283.18(1) in cases of financial hardship;
283.19(2) if the county has a shortage of providers in the county's area; or
283.20(3) for new providers.
283.21    Subd. 3. Application fee for initial license or certification. (a) For fees required
283.22under subdivision 1, an applicant for an initial license or certification issued by the
283.23commissioner shall submit a $500 application fee with each new application required
283.24under this subdivision. An applicant for an initial day services facility license under
283.25chapter 245D shall submit a $250 application fee with each new application. The
283.26application fee shall not be prorated, is nonrefundable, and is in lieu of the annual license
283.27or certification fee that expires on December 31. The commissioner shall not process an
283.28application until the application fee is paid.
283.29(b) Except as provided in clauses (1) to (4) (3), an applicant shall apply for a license
283.30to provide services at a specific location.
283.31(1) For a license to provide residential-based habilitation services to persons with
283.32developmental disabilities under chapter 245B, an applicant shall submit an application
283.33for each county in which the services will be provided. Upon licensure, the license
283.34holder may provide services to persons in that county plus no more than three persons
283.35at any one time in each of up to ten additional counties. A license holder in one county
283.36may not provide services under the home and community-based waiver for persons with
284.1developmental disabilities to more than three people in a second county without holding
284.2a separate license for that second county. Applicants or licensees providing services
284.3under this clause to not more than three persons remain subject to the inspection fees
284.4established in section 245A.10, subdivision 2, for each location. The license issued by
284.5the commissioner must state the name of each additional county where services are being
284.6provided to persons with developmental disabilities. A license holder must notify the
284.7commissioner before making any changes that would alter the license information listed
284.8under section 245A.04, subdivision 7, paragraph (a), including any additional counties
284.9where persons with developmental disabilities are being served. For a license to provide
284.10home and community-based services to persons with disabilities or age 65 and older under
284.11chapter 245D, an applicant shall submit an application to provide services statewide.
284.12(2) For a license to provide supported employment, crisis respite, or
284.13semi-independent living services to persons with developmental disabilities under chapter
284.14245B, an applicant shall submit a single application to provide services statewide.
284.15(3) For a license to provide independent living assistance for youth under section
284.16245A.22 , an applicant shall submit a single application to provide services statewide.
284.17(4) (3) For a license for a private agency to provide foster care or adoption services
284.18under Minnesota Rules, parts 9545.0755 to 9545.0845, an applicant shall submit a single
284.19application to provide services statewide.
284.20(c) The initial application fee charged under this subdivision does not include the
284.21temporary license surcharge under section 16E.22.
284.22    Subd. 4. License or certification fee for certain programs. (a) Child care centers
284.23shall pay an annual nonrefundable license fee based on the following schedule:

284.24 284.25		Licensed Capacity	Child Care Center License Fee
284.26		1 to 24 persons	$200
284.27		25 to 49 persons	$300
284.28		50 to 74 persons	$400
284.29		75 to 99 persons	$500
284.30		100 to 124 persons	$600
284.31		125 to 149 persons	$700
284.32		150 to 174 persons	$800
284.33		175 to 199 persons	$900
284.34		200 to 224 persons	$1,000
284.35		225 or more persons	$1,100

284.36    (b) A day training and habilitation program serving persons with developmental
284.37disabilities or related conditions shall pay an annual nonrefundable license fee based on
284.38the following schedule:

285.1		Licensed Capacity	License Fee
285.2		1 to 24 persons	$800
285.3		25 to 49 persons	$1,000
285.4		50 to 74 persons	$1,200
285.5		75 to 99 persons	$1,400
285.6		100 to 124 persons	$1,600
285.7		125 to 149 persons	$1,800
285.8		150 or more persons	$2,000

285.9Except as provided in paragraph (c), when a day training and habilitation program
285.10serves more than 50 percent of the same persons in two or more locations in a community,
285.11the day training and habilitation program shall pay a license fee based on the licensed
285.12capacity of the largest facility and the other facility or facilities shall be charged a license
285.13fee based on a licensed capacity of a residential program serving one to 24 persons.
285.14    (c) When a day training and habilitation program serving persons with developmental
285.15disabilities or related conditions seeks a single license allowed under section 245B.07,
285.16subdivision 12, clause (2) or (3), the licensing fee must be based on the combined licensed
285.17capacity for each location.
285.18(d) A program licensed to provide supported employment services to persons
285.19with developmental disabilities under chapter 245B shall pay an annual nonrefundable
285.20license fee of $650.
285.21(e) A program licensed to provide crisis respite services to persons with
285.22developmental disabilities under chapter 245B shall pay an annual nonrefundable license
285.23fee of $700.
285.24(f) A program licensed to provide semi-independent living services to persons
285.25with developmental disabilities under chapter 245B shall pay an annual nonrefundable
285.26license fee of $700.
285.27(g) A program licensed to provide residential-based habilitation services under the
285.28home and community-based waiver for persons with developmental disabilities shall pay
285.29an annual license fee that includes a base rate of $690 plus $60 times the number of clients
285.30served on the first day of July of the current license year.
285.31(h) A residential program certified by the Department of Health as an intermediate
285.32care facility for persons with developmental disabilities (ICF/MR) and a noncertified
285.33residential program licensed to provide health or rehabilitative services for persons
285.34with developmental disabilities shall pay an annual nonrefundable license fee based on
285.35the following schedule:

285.36		Licensed Capacity	License Fee
285.37		1 to 24 persons	$535
286.1		25 to 49 persons	$735
286.2		50 or more persons	$935

286.3(b) A program licensed to provide one or more of the home and community-based
286.4services and supports identified under chapter 245D to persons with disabilities or age
286.565 and older, shall pay an annual nonrefundable license fee that includes a base rate of
286.6$563, plus $46 times the number of persons served on the last day of June of the current
286.7license year for programs serving ten or more persons. The fee is limited to a maximum of
286.8200 persons, regardless of the actual number of persons served. Programs serving nine
286.9or fewer persons pay only the base rate.
286.10(c) A facility licensed under chapter 245D to provide day services shall pay an
286.11annual nonrefundable license fee of $100.
286.12(i) (d) A chemical dependency treatment program licensed under Minnesota Rules,
286.13parts 9530.6405 to 9530.6505, to provide chemical dependency treatment shall pay an
286.14annual nonrefundable license fee based on the following schedule:

286.15		Licensed Capacity	License Fee
286.16		1 to 24 persons	$600
286.17		25 to 49 persons	$800
286.18		50 to 74 persons	$1,000
286.19		75 to 99 persons	$1,200
286.20		100 or more persons	$1,400

286.21(j) (e) A chemical dependency program licensed under Minnesota Rules, parts
286.229530.6510 to 9530.6590, to provide detoxification services shall pay an annual
286.23nonrefundable license fee based on the following schedule:

286.24		Licensed Capacity	License Fee
286.25		1 to 24 persons	$760
286.26		25 to 49 persons	$960
286.27		50 or more persons	$1,160

286.28(k) (f) Except for child foster care, a residential facility licensed under Minnesota
286.29Rules, chapter 2960, to serve children shall pay an annual nonrefundable license fee
286.30based on the following schedule:

286.31		Licensed Capacity	License Fee
286.32		1 to 24 persons	$1,000
286.33		25 to 49 persons	$1,100
286.34		50 to 74 persons	$1,200
286.35		75 to 99 persons	$1,300
286.36		100 or more persons	$1,400

287.1(l) (g) A residential facility licensed under Minnesota Rules, parts 9520.0500 to
287.29520.0670, to serve persons with mental illness shall pay an annual nonrefundable license
287.3fee based on the following schedule:

287.4		Licensed Capacity	License Fee
287.5		1 to 24 persons	$2,525
287.6		25 or more persons	$2,725

287.7(m) (h) A residential facility licensed under Minnesota Rules, parts 9570.2000 to
287.89570.3400, to serve persons with physical disabilities shall pay an annual nonrefundable
287.9license fee based on the following schedule:

287.10		Licensed Capacity	License Fee
287.11		1 to 24 persons	$450
287.12		25 to 49 persons	$650
287.13		50 to 74 persons	$850
287.14		75 to 99 persons	$1,050
287.15		100 or more persons	$1,250

287.16(n) (i) A program licensed to provide independent living assistance for youth under
287.17section 245A.22 shall pay an annual nonrefundable license fee of $1,500.
287.18(o) (j) A private agency licensed to provide foster care and adoption services under
287.19Minnesota Rules, parts 9545.0755 to 9545.0845, shall pay an annual nonrefundable
287.20license fee of $875.
287.21(p) (k) A program licensed as an adult day care center licensed under Minnesota
287.22Rules, parts 9555.9600 to 9555.9730, shall pay an annual nonrefundable license fee based
287.23on the following schedule:

287.24		Licensed Capacity	License Fee
287.25		1 to 24 persons	$500
287.26		25 to 49 persons	$700
287.27		50 to 74 persons	$900
287.28		75 to 99 persons	$1,100
287.29		100 or more persons	$1,300

287.30(q) (l) A program licensed to provide treatment services to persons with sexual
287.31psychopathic personalities or sexually dangerous persons under Minnesota Rules, parts
287.329515.3000 to 9515.3110, shall pay an annual nonrefundable license fee of $20,000.
287.33(r) (m) A mental health center or mental health clinic requesting certification for
287.34purposes of insurance and subscriber contract reimbursement under Minnesota Rules,
287.35parts 9520.0750 to 9520.0870, shall pay a certification fee of $1,550 per year. If the
287.36mental health center or mental health clinic provides services at a primary location with
288.1satellite facilities, the satellite facilities shall be certified with the primary location without
288.2an additional charge.
288.3    Subd. 6. License not issued until license or certification fee is paid. The
288.4commissioner shall not issue a license or certification until the license or certification fee
288.5is paid. The commissioner shall send a bill for the license or certification fee to the billing
288.6address identified by the license holder. If the license holder does not submit the license or
288.7certification fee payment by the due date, the commissioner shall send the license holder
288.8a past due notice. If the license holder fails to pay the license or certification fee by the
288.9due date on the past due notice, the commissioner shall send a final notice to the license
288.10holder informing the license holder that the program license will expire on December 31
288.11unless the license fee is paid before December 31. If a license expires, the program is no
288.12longer licensed and, unless exempt from licensure under section 245A.03, subdivision 2,
288.13must not operate after the expiration date. After a license expires, if the former license
288.14holder wishes to provide licensed services, the former license holder must submit a new
288.15license application and application fee under subdivision 3.
288.16    Subd. 7. Human services licensing fees to recover expenditures. Notwithstanding
288.17section 16A.1285, subdivision 2, related to activities for which the commissioner charges
288.18a fee, the commissioner must plan to fully recover direct expenditures for licensing
288.19activities under this chapter over a five-year period. The commissioner may have
288.20anticipated expenditures in excess of anticipated revenues in a biennium by using surplus
288.21revenues accumulated in previous bienniums.
288.22    Subd. 8. Deposit of license fees. A human services licensing account is created in
288.23the state government special revenue fund. Fees collected under subdivisions 3 and 4 must
288.24be deposited in the human services licensing account and are annually appropriated to the
288.25commissioner for licensing activities authorized under this chapter.
288.26EFFECTIVE DATE.This section is effective July 1, 2013.

288.27    Sec. 12. Minnesota Statutes 2012, section 245A.11, subdivision 2a, is amended to read:
288.28    Subd. 2a. Adult foster care and community residential setting license capacity.
288.29(a) The commissioner shall issue adult foster care and community residential setting
288.30 licenses with a maximum licensed capacity of four beds, including nonstaff roomers and
288.31boarders, except that the commissioner may issue a license with a capacity of five beds,
288.32including roomers and boarders, according to paragraphs (b) to (f).
288.33(b) An adult foster care The license holder may have a maximum license capacity
288.34of five if all persons in care are age 55 or over and do not have a serious and persistent
288.35mental illness or a developmental disability.
289.1(c) The commissioner may grant variances to paragraph (b) to allow a foster care
289.2provider facility with a licensed capacity of five persons to admit an individual under the
289.3age of 55 if the variance complies with section 245A.04, subdivision 9, and approval of
289.4the variance is recommended by the county in which the licensed foster care provider
289.5 facility is located.
289.6(d) The commissioner may grant variances to paragraph (b) to allow the use of a fifth
289.7bed for emergency crisis services for a person with serious and persistent mental illness
289.8or a developmental disability, regardless of age, if the variance complies with section
289.9245A.04, subdivision 9 , and approval of the variance is recommended by the county in
289.10which the licensed foster care provider facility is located.
289.11(e) The commissioner may grant a variance to paragraph (b) to allow for the use of a
289.12fifth bed for respite services, as defined in section 245A.02, for persons with disabilities,
289.13regardless of age, if the variance complies with sections 245A.03, subdivision 7, and
289.14245A.04, subdivision 9 , and approval of the variance is recommended by the county in
289.15which the licensed foster care provider facility is licensed located. Respite care may be
289.16provided under the following conditions:
289.17(1) staffing ratios cannot be reduced below the approved level for the individuals
289.18being served in the home on a permanent basis;
289.19(2) no more than two different individuals can be accepted for respite services in
289.20any calendar month and the total respite days may not exceed 120 days per program in
289.21any calendar year;
289.22(3) the person receiving respite services must have his or her own bedroom, which
289.23could be used for alternative purposes when not used as a respite bedroom, and cannot be
289.24the room of another person who lives in the foster care home facility; and
289.25(4) individuals living in the foster care home facility must be notified when the
289.26variance is approved. The provider must give 60 days' notice in writing to the residents
289.27and their legal representatives prior to accepting the first respite placement. Notice must
289.28be given to residents at least two days prior to service initiation, or as soon as the license
289.29holder is able if they receive notice of the need for respite less than two days prior to
289.30initiation, each time a respite client will be served, unless the requirement for this notice is
289.31waived by the resident or legal guardian.
289.32(f) The commissioner may issue an adult foster care or community residential setting
289.33 license with a capacity of five adults if the fifth bed does not increase the overall statewide
289.34capacity of licensed adult foster care or community residential setting beds in homes that
289.35are not the primary residence of the license holder, as identified in a plan submitted to the
290.1commissioner by the county, when the capacity is recommended by the county licensing
290.2agency of the county in which the facility is located and if the recommendation verifies that:
290.3(1) the facility meets the physical environment requirements in the adult foster
290.4care licensing rule;
290.5(2) the five-bed living arrangement is specified for each resident in the resident's:
290.6(i) individualized plan of care;
290.7(ii) individual service plan under section 256B.092, subdivision 1b, if required; or
290.8(iii) individual resident placement agreement under Minnesota Rules, part
290.99555.5105, subpart 19, if required;
290.10(3) the license holder obtains written and signed informed consent from each
290.11resident or resident's legal representative documenting the resident's informed choice
290.12to remain living in the home and that the resident's refusal to consent would not have
290.13resulted in service termination; and
290.14(4) the facility was licensed for adult foster care before March 1, 2011.
290.15(g) The commissioner shall not issue a new adult foster care license under paragraph
290.16(f) after June 30, 2016. The commissioner shall allow a facility with an adult foster care
290.17license issued under paragraph (f) before June 30, 2016, to continue with a capacity of five
290.18adults if the license holder continues to comply with the requirements in paragraph (f).

290.19    Sec. 13. Minnesota Statutes 2012, section 245A.11, subdivision 7, is amended to read:
290.20    Subd. 7. Adult foster care; variance for alternate overnight supervision. (a) The
290.21commissioner may grant a variance under section 245A.04, subdivision 9, to rule parts
290.22requiring a caregiver to be present in an adult foster care home during normal sleeping
290.23hours to allow for alternative methods of overnight supervision. The commissioner may
290.24grant the variance if the local county licensing agency recommends the variance and the
290.25county recommendation includes documentation verifying that:
290.26    (1) the county has approved the license holder's plan for alternative methods of
290.27providing overnight supervision and determined the plan protects the residents' health,
290.28safety, and rights;
290.29    (2) the license holder has obtained written and signed informed consent from
290.30each resident or each resident's legal representative documenting the resident's or legal
290.31representative's agreement with the alternative method of overnight supervision; and
290.32    (3) the alternative method of providing overnight supervision, which may include
290.33the use of technology, is specified for each resident in the resident's: (i) individualized
290.34plan of care; (ii) individual service plan under section 256B.092, subdivision 1b, if
291.1required; or (iii) individual resident placement agreement under Minnesota Rules, part
291.29555.5105, subpart 19, if required.
291.3    (b) To be eligible for a variance under paragraph (a), the adult foster care license
291.4holder must not have had a conditional license issued under section 245A.06, or any
291.5other licensing sanction issued under section 245A.07 during the prior 24 months based
291.6on failure to provide adequate supervision, health care services, or resident safety in
291.7the adult foster care home.
291.8    (c) A license holder requesting a variance under this subdivision to utilize
291.9technology as a component of a plan for alternative overnight supervision may request
291.10the commissioner's review in the absence of a county recommendation. Upon receipt of
291.11such a request from a license holder, the commissioner shall review the variance request
291.12with the county.
291.13(d) A variance granted by the commissioner according to this subdivision before
291.14January 1, 2014, to a license holder for an adult foster care home must transfer with the
291.15license when the license converts to a community residential setting license under chapter
291.16245D. The terms and conditions of the variance remain in effect as approved at the time
291.17the variance was granted.

291.18    Sec. 14. Minnesota Statutes 2012, section 245A.11, subdivision 7a, is amended to read:
291.19    Subd. 7a. Alternate overnight supervision technology; adult foster care license
291.20 and community residential setting licenses. (a) The commissioner may grant an
291.21applicant or license holder an adult foster care or community residential setting license
291.22for a residence that does not have a caregiver in the residence during normal sleeping
291.23hours as required under Minnesota Rules, part 9555.5105, subpart 37, item B, or section
291.24245D.02, subdivision 33b, but uses monitoring technology to alert the license holder
291.25when an incident occurs that may jeopardize the health, safety, or rights of a foster
291.26care recipient. The applicant or license holder must comply with all other requirements
291.27under Minnesota Rules, parts 9555.5105 to 9555.6265, or applicable requirements under
291.28chapter 245D, and the requirements under this subdivision. The license printed by the
291.29commissioner must state in bold and large font:
291.30    (1) that the facility is under electronic monitoring; and
291.31    (2) the telephone number of the county's common entry point for making reports of
291.32suspected maltreatment of vulnerable adults under section 626.557, subdivision 9.
291.33(b) Applications for a license under this section must be submitted directly to
291.34the Department of Human Services licensing division. The licensing division must
291.35immediately notify the host county and lead county contract agency and the host county
292.1licensing agency. The licensing division must collaborate with the county licensing
292.2agency in the review of the application and the licensing of the program.
292.3    (c) Before a license is issued by the commissioner, and for the duration of the
292.4license, the applicant or license holder must establish, maintain, and document the
292.5implementation of written policies and procedures addressing the requirements in
292.6paragraphs (d) through (f).
292.7    (d) The applicant or license holder must have policies and procedures that:
292.8    (1) establish characteristics of target populations that will be admitted into the home,
292.9and characteristics of populations that will not be accepted into the home;
292.10    (2) explain the discharge process when a foster care recipient resident served by the
292.11program requires overnight supervision or other services that cannot be provided by the
292.12license holder due to the limited hours that the license holder is on site;
292.13    (3) describe the types of events to which the program will respond with a physical
292.14presence when those events occur in the home during time when staff are not on site, and
292.15how the license holder's response plan meets the requirements in paragraph (e), clause
292.16(1) or (2);
292.17    (4) establish a process for documenting a review of the implementation and
292.18effectiveness of the response protocol for the response required under paragraph (e),
292.19clause (1) or (2). The documentation must include:
292.20    (i) a description of the triggering incident;
292.21    (ii) the date and time of the triggering incident;
292.22    (iii) the time of the response or responses under paragraph (e), clause (1) or (2);
292.23    (iv) whether the response met the resident's needs;
292.24    (v) whether the existing policies and response protocols were followed; and
292.25    (vi) whether the existing policies and protocols are adequate or need modification.
292.26    When no physical presence response is completed for a three-month period, the
292.27license holder's written policies and procedures must require a physical presence response
292.28drill to be conducted for which the effectiveness of the response protocol under paragraph
292.29(e), clause (1) or (2), will be reviewed and documented as required under this clause; and
292.30    (5) establish that emergency and nonemergency phone numbers are posted in a
292.31prominent location in a common area of the home where they can be easily observed by a
292.32person responding to an incident who is not otherwise affiliated with the home.
292.33    (e) The license holder must document and include in the license application which
292.34response alternative under clause (1) or (2) is in place for responding to situations that
292.35present a serious risk to the health, safety, or rights of people receiving foster care services
292.36in the home residents served by the program:
293.1    (1) response alternative (1) requires only the technology to provide an electronic
293.2notification or alert to the license holder that an event is underway that requires a response.
293.3Under this alternative, no more than ten minutes will pass before the license holder will be
293.4physically present on site to respond to the situation; or
293.5    (2) response alternative (2) requires the electronic notification and alert system under
293.6alternative (1), but more than ten minutes may pass before the license holder is present on
293.7site to respond to the situation. Under alternative (2), all of the following conditions are met:
293.8    (i) the license holder has a written description of the interactive technological
293.9applications that will assist the license holder in communicating with and assessing the
293.10needs related to the care, health, and safety of the foster care recipients. This interactive
293.11technology must permit the license holder to remotely assess the well being of the foster
293.12care recipient resident served by the program without requiring the initiation of the
293.13foster care recipient. Requiring the foster care recipient to initiate a telephone call does
293.14not meet this requirement;
293.15(ii) the license holder documents how the remote license holder is qualified and
293.16capable of meeting the needs of the foster care recipients and assessing foster care
293.17recipients' needs under item (i) during the absence of the license holder on site;
293.18(iii) the license holder maintains written procedures to dispatch emergency response
293.19personnel to the site in the event of an identified emergency; and
293.20    (iv) each foster care recipient's resident's individualized plan of care, individual
293.21service plan coordinated service and support plan under section sections 256B.0913,
293.22subdivision 8; 256B.0915, subdivision 6; 256B.092, subdivision 1b; and 256B.49,
293.23subdivision 15, if required, or individual resident placement agreement under Minnesota
293.24Rules, part 9555.5105, subpart 19, if required, identifies the maximum response time,
293.25which may be greater than ten minutes, for the license holder to be on site for that foster
293.26care recipient resident.
293.27    (f) Each foster care recipient's resident's placement agreement, individual service
293.28agreement, and plan must clearly state that the adult foster care or community residential
293.29setting license category is a program without the presence of a caregiver in the residence
293.30during normal sleeping hours; the protocols in place for responding to situations that
293.31present a serious risk to the health, safety, or rights of foster care recipients residents
293.32served by the program under paragraph (e), clause (1) or (2); and a signed informed
293.33consent from each foster care recipient resident served by the program or the person's
293.34legal representative documenting the person's or legal representative's agreement with
293.35placement in the program. If electronic monitoring technology is used in the home, the
293.36informed consent form must also explain the following:
294.1    (1) how any electronic monitoring is incorporated into the alternative supervision
294.2system;
294.3    (2) the backup system for any electronic monitoring in times of electrical outages or
294.4other equipment malfunctions;
294.5    (3) how the caregivers or direct support staff are trained on the use of the technology;
294.6    (4) the event types and license holder response times established under paragraph (e);
294.7    (5) how the license holder protects the foster care recipient's each resident's privacy
294.8related to electronic monitoring and related to any electronically recorded data generated
294.9by the monitoring system. A foster care recipient resident served by the program may
294.10not be removed from a program under this subdivision for failure to consent to electronic
294.11monitoring. The consent form must explain where and how the electronically recorded
294.12data is stored, with whom it will be shared, and how long it is retained; and
294.13    (6) the risks and benefits of the alternative overnight supervision system.
294.14    The written explanations under clauses (1) to (6) may be accomplished through
294.15cross-references to other policies and procedures as long as they are explained to the
294.16person giving consent, and the person giving consent is offered a copy.
294.17(g) Nothing in this section requires the applicant or license holder to develop or
294.18maintain separate or duplicative policies, procedures, documentation, consent forms, or
294.19individual plans that may be required for other licensing standards, if the requirements of
294.20this section are incorporated into those documents.
294.21(h) The commissioner may grant variances to the requirements of this section
294.22according to section 245A.04, subdivision 9.
294.23(i) For the purposes of paragraphs (d) through (h), "license holder" has the meaning
294.24under section 245A.2, subdivision 9, and additionally includes all staff, volunteers, and
294.25contractors affiliated with the license holder.
294.26(j) For the purposes of paragraph (e), the terms "assess" and "assessing" mean to
294.27remotely determine what action the license holder needs to take to protect the well-being
294.28of the foster care recipient.
294.29(k) The commissioner shall evaluate license applications using the requirements
294.30in paragraphs (d) to (f). The commissioner shall provide detailed application forms,
294.31including a checklist of criteria needed for approval.
294.32(l) To be eligible for a license under paragraph (a), the adult foster care or community
294.33residential setting license holder must not have had a conditional license issued under
294.34section 245A.06 or any licensing sanction under section 245A.07 during the prior 24
294.35months based on failure to provide adequate supervision, health care services, or resident
294.36safety in the adult foster care home or community residential setting.
295.1(m) The commissioner shall review an application for an alternative overnight
295.2supervision license within 60 days of receipt of the application. When the commissioner
295.3receives an application that is incomplete because the applicant failed to submit required
295.4documents or that is substantially deficient because the documents submitted do not meet
295.5licensing requirements, the commissioner shall provide the applicant written notice
295.6that the application is incomplete or substantially deficient. In the written notice to the
295.7applicant, the commissioner shall identify documents that are missing or deficient and
295.8give the applicant 45 days to resubmit a second application that is substantially complete.
295.9An applicant's failure to submit a substantially complete application after receiving
295.10notice from the commissioner is a basis for license denial under section 245A.05. The
295.11commissioner shall complete subsequent review within 30 days.
295.12(n) Once the application is considered complete under paragraph (m), the
295.13commissioner will approve or deny an application for an alternative overnight supervision
295.14license within 60 days.
295.15(o) For the purposes of this subdivision, "supervision" means:
295.16(1) oversight by a caregiver or direct support staff as specified in the individual
295.17resident's place agreement or coordinated service and support plan and awareness of the
295.18resident's needs and activities; and
295.19(2) the presence of a caregiver or direct support staff in a residence during normal
295.20sleeping hours, unless a determination has been made and documented in the individual's
295.21 coordinated service and support plan that the individual does not require the presence of a
295.22caregiver or direct support staff during normal sleeping hours.

295.23    Sec. 15. Minnesota Statutes 2012, section 245A.11, subdivision 7b, is amended to read:
295.24    Subd. 7b. Adult foster care data privacy and security. (a) An adult foster care
295.25 or community residential setting license holder who creates, collects, records, maintains,
295.26stores, or discloses any individually identifiable recipient data, whether in an electronic
295.27or any other format, must comply with the privacy and security provisions of applicable
295.28privacy laws and regulations, including:
295.29(1) the federal Health Insurance Portability and Accountability Act of 1996
295.30(HIPAA), Public Law 104-1; and the HIPAA Privacy Rule, Code of Federal Regulations,
295.31title 45, part 160, and subparts A and E of part 164; and
295.32(2) the Minnesota Government Data Practices Act as codified in chapter 13.
295.33(b) For purposes of licensure, the license holder shall be monitored for compliance
295.34with the following data privacy and security provisions:
296.1(1) the license holder must control access to data on foster care recipients residents
296.2served by the program according to the definitions of public and private data on individuals
296.3under section 13.02; classification of the data on individuals as private under section
296.413.46, subdivision 2 ; and control over the collection, storage, use, access, protection,
296.5and contracting related to data according to section 13.05, in which the license holder is
296.6assigned the duties of a government entity;
296.7(2) the license holder must provide each foster care recipient resident served by
296.8the program with a notice that meets the requirements under section 13.04, in which
296.9the license holder is assigned the duties of the government entity, and that meets the
296.10requirements of Code of Federal Regulations, title 45, part 164.52. The notice shall
296.11describe the purpose for collection of the data, and to whom and why it may be disclosed
296.12pursuant to law. The notice must inform the recipient individual that the license holder
296.13uses electronic monitoring and, if applicable, that recording technology is used;
296.14(3) the license holder must not install monitoring cameras in bathrooms;
296.15(4) electronic monitoring cameras must not be concealed from the foster care
296.16recipients residents served by the program; and
296.17(5) electronic video and audio recordings of foster care recipients residents served
296.18by the program shall be stored by the license holder for five days unless: (i) a foster care
296.19recipient resident served by the program or legal representative requests that the recording
296.20be held longer based on a specific report of alleged maltreatment; or (ii) the recording
296.21captures an incident or event of alleged maltreatment under section 626.556 or 626.557 or
296.22a crime under chapter 609. When requested by a recipient resident served by the program
296.23 or when a recording captures an incident or event of alleged maltreatment or a crime, the
296.24license holder must maintain the recording in a secured area for no longer than 30 days
296.25to give the investigating agency an opportunity to make a copy of the recording. The
296.26investigating agency will maintain the electronic video or audio recordings as required in
296.27section 626.557, subdivision 12b.
296.28(c) The commissioner shall develop, and make available to license holders and
296.29county licensing workers, a checklist of the data privacy provisions to be monitored
296.30for purposes of licensure.

296.31    Sec. 16. Minnesota Statutes 2012, section 245A.11, subdivision 8, is amended to read:
296.32    Subd. 8. Community residential setting license. (a) The commissioner shall
296.33establish provider standards for residential support services that integrate service standards
296.34and the residential setting under one license. The commissioner shall propose statutory
296.35language and an implementation plan for licensing requirements for residential support
297.1services to the legislature by January 15, 2012, as a component of the quality outcome
297.2standards recommendations required by Laws 2010, chapter 352, article 1, section 24.
297.3(b) Providers licensed under chapter 245B, and providing, contracting, or arranging
297.4for services in settings licensed as adult foster care under Minnesota Rules, parts 9555.5105
297.5to 9555.6265, or child foster care under Minnesota Rules, parts 2960.3000 to 2960.3340;
297.6and meeting the provisions of section 256B.092, subdivision 11, paragraph (b) section
297.7245D.02, subdivision 4a, must be required to obtain a community residential setting license.

297.8    Sec. 17. Minnesota Statutes 2012, section 245A.16, subdivision 1, is amended to read:
297.9    Subdivision 1. Delegation of authority to agencies. (a) County agencies and
297.10private agencies that have been designated or licensed by the commissioner to perform
297.11licensing functions and activities under section 245A.04 and background studies for family
297.12child care under chapter 245C; to recommend denial of applicants under section 245A.05;
297.13to issue correction orders, to issue variances, and recommend a conditional license under
297.14section 245A.06, or to recommend suspending or revoking a license or issuing a fine under
297.15section 245A.07, shall comply with rules and directives of the commissioner governing
297.16those functions and with this section. The following variances are excluded from the
297.17delegation of variance authority and may be issued only by the commissioner:
297.18    (1) dual licensure of family child care and child foster care, dual licensure of child
297.19and adult foster care, and adult foster care and family child care;
297.20    (2) adult foster care maximum capacity;
297.21    (3) adult foster care minimum age requirement;
297.22    (4) child foster care maximum age requirement;
297.23    (5) variances regarding disqualified individuals except that county agencies may
297.24issue variances under section 245C.30 regarding disqualified individuals when the county
297.25is responsible for conducting a consolidated reconsideration according to sections 245C.25
297.26and 245C.27, subdivision 2, clauses (a) and (b), of a county maltreatment determination
297.27and a disqualification based on serious or recurring maltreatment; and
297.28    (6) the required presence of a caregiver in the adult foster care residence during
297.29normal sleeping hours; and
297.30    (7) variances for community residential setting licenses under chapter 245D.
297.31Except as provided in section 245A.14, subdivision 4, paragraph (e), a county agency
297.32must not grant a license holder a variance to exceed the maximum allowable family child
297.33care license capacity of 14 children.
297.34    (b) County agencies must report information about disqualification reconsiderations
297.35under sections 245C.25 and 245C.27, subdivision 2, paragraphs (a) and (b), and variances
298.1granted under paragraph (a), clause (5), to the commissioner at least monthly in a format
298.2prescribed by the commissioner.
298.3    (c) For family day care programs, the commissioner may authorize licensing reviews
298.4every two years after a licensee has had at least one annual review.
298.5    (d) For family adult day services programs, the commissioner may authorize
298.6licensing reviews every two years after a licensee has had at least one annual review.
298.7    (e) A license issued under this section may be issued for up to two years.

298.8    Sec. 18. Minnesota Statutes 2012, section 245D.02, is amended to read:
298.9245D.02 DEFINITIONS.
298.10    Subdivision 1. Scope. The terms used in this chapter have the meanings given
298.11them in this section.
298.12    Subd. 2. Annual and annually. "Annual" and "annually" have the meaning given
298.13in section 245A.02, subdivision 2b.
298.14    Subd. 2a. Authorized representative. "Authorized representative" means a parent,
298.15family member, advocate, or other adult authorized by the person or the person's legal
298.16representative, to serve as a representative in connection with the provision of services
298.17licensed under this chapter. This authorization must be in writing or by another method
298.18that clearly indicates the person's free choice. The authorized representative must have no
298.19financial interest in the provision of any services included in the person's service delivery
298.20plan and must be capable of providing the support necessary to assist the person in the use
298.21of home and community-based services licensed under this chapter.
298.22    Subd. 3. Case manager. "Case manager" means the individual designated
298.23to provide waiver case management services, care coordination, or long-term care
298.24consultation, as specified in sections 256B.0913, 256B.0915, 256B.092, and 256B.49,
298.25or successor provisions.
298.26    Subd. 3a. Certification. "Certification" means the commissioner's written
298.27authorization for a license holder to provide specialized services based on certification
298.28standards in section 245D.33. The term certification and its derivatives have the same
298.29meaning and may be substituted for the term licensure and its derivatives in this chapter
298.30and chapter 245A.
298.31    Subd. 4. Commissioner. "Commissioner" means the commissioner of the
298.32Department of Human Services or the commissioner's designated representative.
298.33    Subd. 4a. Community residential setting. "Community residential setting" means
298.34a residential program as identified in section 245A.11, subdivision 8, where residential
298.35supports and services identified in section 245D.03, subdivision 1, paragraph (c), clause
299.1(3), items (i) and (ii), are provided and the license holder is the owner, lessor, or tenant
299.2of the facility licensed according to this chapter, and the license holder does not reside
299.3in the facility.
299.4    Subd. 4b. Coordinated service and support plan. "Coordinated service and support
299.5plan" has the meaning given in sections 256B.0913, subdivision 8; 256B.0915, subdivision
299.66; 256B.092, subdivision 1b; and 256B.49, subdivision 15, or successor provisions.
299.7    Subd. 4c. Coordinated service and support plan addendum. "Coordinated
299.8service and support plan addendum" means the documentation that this chapter requires
299.9of the license holder for each person receiving services.
299.10    Subd. 4d. Corporate foster care. "Corporate foster care" means a child foster
299.11residence setting licensed according to Minnesota Rules, parts 2960.0010 to 2960.3340,
299.12or an adult foster care home licensed according to Minnesota Rules, parts 9555.5105 to
299.139555.6265, where the license holder does not live in the home.
299.14    Subd. 4e. Cultural competence or culturally competent. "Cultural competence"
299.15or "culturally competent" means the ability and the will to respond to the unique needs of
299.16a person that arise from the person's culture and the ability to use the person's culture as a
299.17resource or tool to assist with the intervention and help meet the person's needs.
299.18    Subd. 4f. Day services facility. "Day services facility" means a facility licensed
299.19according to this chapter at which persons receive day services licensed under this chapter
299.20from the license holder's direct support staff for a cumulative total of more than 30 days
299.21within any 12-month period and the license holder is the owner, lessor, or tenant of the
299.22facility.
299.23    Subd. 5. Department. "Department" means the Department of Human Services.
299.24    Subd. 6. Direct contact. "Direct contact" has the meaning given in section 245C.02,
299.25subdivision 11 , and is used interchangeably with the term "direct support service."
299.26    Subd. 6a. Direct support staff or staff. "Direct support staff" or "staff" means
299.27employees of the license holder who have direct contact with persons served by the
299.28program and includes temporary staff or subcontractors, regardless of employer, providing
299.29program services for hire under the control of the license holder who have direct contact
299.30with persons served by the program.
299.31    Subd. 7. Drug. "Drug" has the meaning given in section 151.01, subdivision 5.
299.32    Subd. 8. Emergency. "Emergency" means any event that affects the ordinary
299.33daily operation of the program including, but not limited to, fires, severe weather, natural
299.34disasters, power failures, or other events that threaten the immediate health and safety of
299.35a person receiving services and that require calling 911, emergency evacuation, moving
300.1to an emergency shelter, or temporary closure or relocation of the program to another
300.2facility or service site for more than 24 hours.
300.3    Subd. 8a. Emergency use of manual restraint. "Emergency use of manual
300.4restraint" means using a manual restraint when a person poses an imminent risk of
300.5physical harm to self or others and is the least restrictive intervention that would achieve
300.6safety. Property damage, verbal aggression, or a person's refusal to receive or participate
300.7in treatment or programming on their own, do not constitute an emergency.
300.8    Subd. 8b. Expanded support team. "Expanded support team" means the members
300.9of the support team defined in subdivision 46, and a licensed health or mental health
300.10professional or other licensed, certified, or qualified professionals or consultants working
300.11with the person and included in the team at the request of the person or the person's legal
300.12representative.
300.13    Subd. 8c. Family foster care. "Family foster care" means a child foster family
300.14setting licensed according to Minnesota Rules, parts 2960.0010 to 2960.3340, or an adult
300.15foster care home licensed according to Minnesota Rules, parts 9555.5105 to 9555.6265,
300.16where the license holder lives in the home.
300.17    Subd. 9. Health services. "Health services" means any service or treatment
300.18consistent with the physical and mental health needs of the person, such as medication
300.19administration and monitoring, medical, dental, nutritional, health monitoring, wellness
300.20education, and exercise.
300.21    Subd. 10. Home and community-based services. "Home and community-based
300.22services" means the services subject to the provisions of this chapter identified in section
300.23245D.03, subdivision 1, and as defined in:
300.24(1) the federal federally approved waiver plans governed by United States Code,
300.25title 42, sections 1396 et seq., or the state's alternative care program according to section
300.26256B.0913, including the waivers for persons with disabilities under section 256B.49,
300.27subdivision 11, including the brain injury (BI) waiver, plan; the community alternative
300.28care (CAC) waiver, plan; the community alternatives for disabled individuals (CADI)
300.29waiver, plan; the developmental disability (DD) waiver, plan under section 256B.092,
300.30subdivision 5; the elderly waiver (EW), and plan under section 256B.0915, subdivision 1;
300.31or successor plans respective to each waiver; or
300.32(2) the alternative care (AC) program under section 256B.0913.
300.33    Subd. 11. Incident. "Incident" means an occurrence that affects the which involves
300.34a person and requires the program to make a response that is not a part of the program's
300.35 ordinary provision of services to a that person, and includes any of the following:
300.36(1) serious injury of a person as determined by section 245.91, subdivision 6;
301.1(2) a person's death;
301.2(3) any medical emergency, unexpected serious illness, or significant unexpected
301.3change in an illness or medical condition, or the mental health status of a person that
301.4requires calling the program to call 911 or a mental health crisis intervention team,
301.5physician treatment, or hospitalization;
301.6(4) any mental health crisis that requires the program to call 911 or a mental health
301.7crisis intervention team;
301.8(5) an act or situation involving a person that requires the program to call 911,
301.9law enforcement, or the fire department;
301.10(4) (6) a person's unauthorized or unexplained absence from a program;
301.11(5) (7) physical aggression conduct by a person receiving services against another
301.12person receiving services that causes physical pain, injury, or persistent emotional distress,
301.13including, but not limited to, hitting, slapping, kicking, scratching, pinching, biting,
301.14pushing, and spitting;:
301.15(i) is so severe, pervasive, or objectively offensive that it substantially interferes with
301.16a person's opportunities to participate in or receive service or support;
301.17(ii) places the person in actual and reasonable fear of harm;
301.18(iii) places the person in actual and reasonable fear of damage to property of the
301.19person; or
301.20(iv) substantially disrupts the orderly operation of the program;
301.21(6) (8) any sexual activity between persons receiving services involving force or
301.22coercion as defined under section 609.341, subdivisions 3 and 14; or
301.23(9) any emergency use of manual restraint as identified in section 245D.061; or
301.24(7) (10) a report of alleged or suspected child or vulnerable adult maltreatment
301.25under section 626.556 or 626.557.
301.26    Subd. 11a. Intermediate care facility for persons with developmental disabilities
301.27or ICF/DD. "Intermediate care facility for persons with developmental disabilities" or
301.28"ICF/DD" means a residential program licensed to serve four or more persons with
301.29developmental disabilities under section 252.28 and chapter 245A and licensed as a
301.30supervised living facility under chapter 144, which together are certified by the Department
301.31of Health as an intermediate care facility for persons with developmental disabilities.
301.32    Subd. 11b. Least restrictive alternative. "Least restrictive alternative" means
301.33the alternative method for providing supports and services that is the least intrusive and
301.34most normalized given the level of supervision and protection required for the person.
301.35This level of supervision and protection allows risk taking to the extent that there is no
301.36reasonable likelihood that serious harm will happen to the person or others.
302.1    Subd. 12. Legal representative. "Legal representative" means the parent of a
302.2person who is under 18 years of age, a court-appointed guardian, or other representative
302.3with legal authority to make decisions about services for a person. Other representatives
302.4with legal authority to make decisions include but are not limited to a health care agent or
302.5an attorney-in-fact authorized through a health care directive or power of attorney.
302.6    Subd. 13. License. "License" has the meaning given in section 245A.02,
302.7subdivision 8 .
302.8    Subd. 14. Licensed health professional. "Licensed health professional" means a
302.9person licensed in Minnesota to practice those professions described in section 214.01,
302.10subdivision 2 .
302.11    Subd. 15. License holder. "License holder" has the meaning given in section
302.12245A.02, subdivision 9 .
302.13    Subd. 16. Medication. "Medication" means a prescription drug or over-the-counter
302.14drug. For purposes of this chapter, "medication" includes dietary supplements.
302.15    Subd. 17. Medication administration. "Medication administration" means
302.16performing the following set of tasks to ensure a person takes both prescription and
302.17over-the-counter medications and treatments according to orders issued by appropriately
302.18licensed professionals, and includes the following:
302.19(1) checking the person's medication record;
302.20(2) preparing the medication for administration;
302.21(3) administering the medication to the person;
302.22(4) documenting the administration of the medication or the reason for not
302.23administering the medication; and
302.24(5) reporting to the prescriber or a nurse any concerns about the medication,
302.25including side effects, adverse reactions, effectiveness, or the person's refusal to take the
302.26medication or the person's self-administration of the medication.
302.27    Subd. 18. Medication assistance. "Medication assistance" means providing verbal
302.28or visual reminders to take regularly scheduled medication, which includes either of
302.29the following:
302.30(1) bringing to the person and opening a container of previously set up medications
302.31and emptying the container into the person's hand or opening and giving the medications
302.32in the original container to the person, or bringing to the person liquids or food to
302.33accompany the medication; or
302.34(2) providing verbal or visual reminders to perform regularly scheduled treatments
302.35and exercises.
303.1    Subd. 19. Medication management. "Medication management" means the
303.2provision of any of the following:
303.3(1) medication-related services to a person;
303.4(2) medication setup;
303.5(3) medication administration;
303.6(4) medication storage and security;
303.7(5) medication documentation and charting;
303.8(6) verification and monitoring of effectiveness of systems to ensure safe medication
303.9handling and administration;
303.10(7) coordination of medication refills;
303.11(8) handling changes to prescriptions and implementation of those changes;
303.12(9) communicating with the pharmacy; or
303.13(10) coordination and communication with prescriber.
303.14For the purposes of this chapter, medication management does not mean "medication
303.15therapy management services" as identified in section 256B.0625, subdivision 13h.
303.16    Subd. 20. Mental health crisis intervention team. "Mental health crisis
303.17intervention team" means a mental health crisis response providers provider as identified
303.18in section 256B.0624, subdivision 2, paragraph (d), for adults, and in section 256B.0944,
303.19subdivision 1 , paragraph (d), for children.
303.20    Subd. 20a. Most integrated setting. "Most integrated setting" means a setting that
303.21enables individuals with disabilities to interact with nondisabled persons to the fullest
303.22extent possible.
303.23    Subd. 21. Over-the-counter drug. "Over-the-counter drug" means a drug that
303.24is not required by federal law to bear the statement "Caution: Federal law prohibits
303.25dispensing without prescription."
303.26    Subd. 21a. Outcome. "Outcome" means the behavior, action, or status attained by
303.27the person that can be observed, measured, and determined reliable and valid.
303.28    Subd. 22. Person. "Person" has the meaning given in section 245A.02, subdivision
303.2911 .
303.30    Subd. 23. Person with a disability. "Person with a disability" means a person
303.31determined to have a disability by the commissioner's state medical review team as
303.32identified in section 256B.055, subdivision 7, the Social Security Administration, or
303.33the person is determined to have a developmental disability as defined in Minnesota
303.34Rules, part 9525.0016, subpart 2, item B, or a related condition as defined in section
303.35252.27, subdivision 1a .
304.1    Subd. 23a. Physician. "Physician" means a person who is licensed under chapter
304.2147.
304.3    Subd. 24. Prescriber. "Prescriber" means a licensed practitioner as defined in
304.4section 151.01, subdivision 23, person who is authorized under section 148.235; 151.01,
304.5subdivision 23; or 151.37 to prescribe drugs. For the purposes of this chapter, the term
304.6"prescriber" is used interchangeably with "physician."
304.7    Subd. 25. Prescription drug. "Prescription drug" has the meaning given in section
304.8151.01, subdivision 17 16 .
304.9    Subd. 26. Program. "Program" means either the nonresidential or residential
304.10program as defined in section 245A.02, subdivisions 10 and 14.
304.11    Subd. 27. Psychotropic medication. "Psychotropic medication" means any
304.12medication prescribed to treat the symptoms of mental illness that affect thought processes,
304.13mood, sleep, or behavior. The major classes of psychotropic medication are antipsychotic
304.14(neuroleptic), antidepressant, antianxiety, mood stabilizers, anticonvulsants, and
304.15stimulants and nonstimulants for the treatment of attention deficit/hyperactivity disorder.
304.16Other miscellaneous medications are considered to be a psychotropic medication when
304.17they are specifically prescribed to treat a mental illness or to control or alter behavior.
304.18    Subd. 28. Restraint. "Restraint" means physical or mechanical limiting of the free
304.19and normal movement of body or limbs.
304.20    Subd. 29. Seclusion. "Seclusion" means separating a person from others in a way
304.21that prevents social contact and prevents the person from leaving the situation if he or she
304.22chooses the placement of a person alone in a room from which exit is prohibited by a staff
304.23person or a mechanism such as a lock, a device, or an object positioned to hold the door
304.24closed or otherwise prevent the person from leaving the room.
304.25    Subd. 29a. Self-determination. "Self-determination" means the person makes
304.26decisions independently, plans for the person's own future, determines how money is spent
304.27for the person's supports, and takes responsibility for making these decisions. If a person
304.28has a legal representative, the legal representative's decision-making authority is limited to
304.29the scope of authority granted by the court or allowed in the document authorizing the
304.30legal representative to act.
304.31    Subd. 29b. Semi-independent living services. "Semi-independent living services"
304.32has the meaning given in section 252.275.
304.33    Subd. 30. Service. "Service" means care, training, supervision, counseling,
304.34consultation, or medication assistance assigned to the license holder in the coordinated
304.35service and support plan.
305.1    Subd. 31. Service plan. "Service plan" means the individual service plan or
305.2individual care plan identified in sections 256B.0913, 256B.0915, 256B.092, and 256B.49,
305.3or successor provisions, and includes any support plans or service needs identified as
305.4a result of long-term care consultation, or a support team meeting that includes the
305.5participation of the person, the person's legal representative, and case manager, or assigned
305.6to a license holder through an authorized service agreement.
305.7    Subd. 32. Service site. "Service site" means the location where the service is
305.8provided to the person, including, but not limited to, a facility licensed according to
305.9chapter 245A; a location where the license holder is the owner, lessor, or tenant; a person's
305.10own home; or a community-based location.
305.11    Subd. 33. Staff. "Staff" means an employee who will have direct contact with a
305.12person served by the facility, agency, or program.
305.13    Subd. 33a. Supervised living facility. "Supervised living facility" has the meaning
305.14given in Minnesota Rules, part 4665.0100, subpart 10.
305.15    Subd. 33b. Supervision. (a) "Supervision" means:
305.16(1) oversight by direct support staff as specified in the person's coordinated service
305.17and support plan or coordinated service and support plan addendum and awareness of
305.18the person's needs and activities;
305.19(2) responding to situations that present a serious risk to the health, safety, or rights
305.20of the person while services are being provided; and
305.21(3) the presence of direct support staff at a service site while services are being
305.22provided, unless a determination has been made and documented in the person's coordinated
305.23service and support plan or coordinated service and support plan addendum that the person
305.24does not require the presence of direct support staff while services are being provided.
305.25(b) For the purposes of this definition, "while services are being provided," means
305.26any period of time during which the license holder will seek reimbursement for services.
305.27    Subd. 34. Support team. "Support team" means the service planning team
305.28identified in section 256B.49, subdivision 15, or the interdisciplinary team identified in
305.29Minnesota Rules, part 9525.0004, subpart 14.
305.30    Subd. 34a. Time out. "Time out" means removing a person involuntarily from an
305.31ongoing activity to a room, either locked or unlocked, or otherwise separating a person
305.32from others in a way that prevents social contact and prevents the person from leaving
305.33the situation if the person chooses. For the purpose of chapter 245D, "time out" does
305.34not mean voluntary removal or self-removal for the purpose of calming, prevention of
305.35escalation, or de-escalation of behavior for a period of up to 15 minutes. "Time out"
305.36does not include a person voluntarily moving from an ongoing activity to an unlocked
306.1room or otherwise separating from a situation or social contact with others if the person
306.2chooses. For the purposes of this definition, "voluntarily" means without being forced,
306.3compelled, or coerced.
306.4    Subd. 35. Unit of government. "Unit of government" means every city, county,
306.5town, school district, other political subdivisions of the state, and any agency of the state
306.6or the United States, and includes any instrumentality of a unit of government.
306.7    Subd. 35a. Treatment. "Treatment" means the provision of care, other than
306.8medications, ordered or prescribed by a licensed health or mental health professional,
306.9provided to a person to cure, rehabilitate, or ease symptoms.
306.10    Subd. 36. Volunteer. "Volunteer" means an individual who, under the direction of the
306.11license holder, provides direct services without pay to a person served by the license holder.
306.12EFFECTIVE DATE.This section is effective January 1, 2014.

306.13    Sec. 19. Minnesota Statutes 2012, section 245D.03, is amended to read:
306.14245D.03 APPLICABILITY AND EFFECT.
306.15    Subdivision 1. Applicability. (a) The commissioner shall regulate the provision of
306.16home and community-based services to persons with disabilities and persons age 65 and
306.17older pursuant to this chapter. The licensing standards in this chapter govern the provision
306.18of the following basic support services: and intensive support services.
306.19(1) housing access coordination as defined under the current BI, CADI, and DD
306.20waiver plans or successor plans;
306.21(2) respite services as defined under the current CADI, BI, CAC, DD, and EW
306.22waiver plans or successor plans when the provider is an individual who is not an employee
306.23of a residential or nonresidential program licensed by the Department of Human Services
306.24or the Department of Health that is otherwise providing the respite service;
306.25(3) behavioral programming as defined under the current BI and CADI waiver
306.26plans or successor plans;
306.27(4) specialist services as defined under the current DD waiver plan or successor plans;
306.28(5) companion services as defined under the current BI, CADI, and EW waiver
306.29plans or successor plans, excluding companion services provided under the Corporation
306.30for National and Community Services Senior Companion Program established under the
306.31Domestic Volunteer Service Act of 1973, Public Law 98-288;
306.32(6) personal support as defined under the current DD waiver plan or successor plans;
306.33(7) 24-hour emergency assistance, on-call and personal emergency response as
306.34defined under the current CADI and DD waiver plans or successor plans;
307.1(8) night supervision services as defined under the current BI waiver plan or
307.2successor plans;
307.3(9) homemaker services as defined under the current CADI, BI, CAC, DD, and EW
307.4waiver plans or successor plans, excluding providers licensed by the Department of Health
307.5under chapter 144A and those providers providing cleaning services only;
307.6(10) independent living skills training as defined under the current BI and CADI
307.7waiver plans or successor plans;
307.8(11) prevocational services as defined under the current BI and CADI waiver plans
307.9or successor plans;
307.10(12) structured day services as defined under the current BI waiver plan or successor
307.11plans; or
307.12(13) supported employment as defined under the current BI and CADI waiver plans
307.13or successor plans.
307.14(b) Basic support services provide the level of assistance, supervision, and care that
307.15is necessary to ensure the health and safety of the person and do not include services that
307.16are specifically directed toward the training, treatment, habilitation, or rehabilitation of
307.17the person. Basic support services include:
307.18(1) in-home and out-of-home respite care services as defined in section 245A.02,
307.19subdivision 15, and under the brain injury, community alternative care, community
307.20alternatives for disabled individuals, developmental disability, and elderly waiver plans;
307.21(2) companion services as defined under the brain injury, community alternatives for
307.22disabled individuals, and elderly waiver plans, excluding companion services provided
307.23under the Corporation for National and Community Services Senior Companion Program
307.24established under the Domestic Volunteer Service Act of 1973, Public Law 98-288;
307.25(3) personal support as defined under the developmental disability waiver plan;
307.26(4) 24-hour emergency assistance, personal emergency response as defined under the
307.27community alternatives for disabled individuals and developmental disability waiver plans;
307.28(5) night supervision services as defined under the brain injury waiver plan; and
307.29(6) homemaker services as defined under the community alternatives for disabled
307.30individuals, brain injury, community alternative care, developmental disability, and elderly
307.31waiver plans, excluding providers licensed by the Department of Health under chapter
307.32144A and those providers providing cleaning services only.
307.33(c) Intensive support services provide assistance, supervision, and care that is
307.34necessary to ensure the health and safety of the person and services specifically directed
307.35toward the training, habilitation, or rehabilitation of the person. Intensive support services
307.36include:
308.1(1) intervention services, including:
308.2(i) behavioral support services as defined under the brain injury and community
308.3alternatives for disabled individuals waiver plans;
308.4(ii) in-home or out-of-home crisis respite services as defined under the developmental
308.5disability waiver plan; and
308.6(iii) specialist services as defined under the current developmental disability waiver
308.7plan;
308.8(2) in-home support services, including:
308.9(i) in-home family support and supported living services as defined under the
308.10developmental disability waiver plan;
308.11(ii) independent living services training as defined under the brain injury and
308.12community alternatives for disabled individuals waiver plans; and
308.13(iii) semi-independent living services;
308.14(3) residential supports and services, including:
308.15(i) supported living services as defined under the developmental disability waiver
308.16plan provided in a family or corporate child foster care residence, a family adult foster
308.17care residence, a community residential setting, or a supervised living facility;
308.18(ii) foster care services as defined in the brain injury, community alternative care,
308.19and community alternatives for disabled individuals waiver plans provided in a family or
308.20corporate child foster care residence, a family adult foster care residence, or a community
308.21residential setting; and
308.22(iii) residential services provided in a supervised living facility that is certified by
308.23the Department of Health as an ICF/DD;
308.24(4) day services, including:
308.25(i) structured day services as defined under the brain injury waiver plan;
308.26(ii) day training and habilitation services under sections 252.40 to 252.46, and as
308.27defined under the developmental disability waiver plan; and
308.28(iii) prevocational services as defined under the brain injury and community
308.29alternatives for disabled individuals waiver plans; and
308.30(5) supported employment as defined under the brain injury, developmental
308.31disability, and community alternatives for disabled individuals waiver plans.
308.32    Subd. 2. Relationship to other standards governing home and community-based
308.33services. (a) A license holder governed by this chapter is also subject to the licensure
308.34requirements under chapter 245A.
308.35(b) A license holder concurrently providing child foster care services licensed
308.36according to Minnesota Rules, chapter 2960, to the same person receiving a service licensed
309.1under this chapter is exempt from section 245D.04 as it applies to the person. A corporate
309.2or family child foster care site controlled by a license holder and providing services
309.3governed by this chapter is exempt from compliance with section 245D.04. This exemption
309.4applies to foster care homes where at least one resident is receiving residential supports
309.5and services licensed according to this chapter. This chapter does not apply to corporate or
309.6family child foster care homes that do not provide services licensed under this chapter.
309.7(c) A family adult foster care site controlled by a license holder and providing
309.8services governed by this chapter is exempt from compliance with Minnesota Rules, parts
309.99555.6185; 9555.6225, subpart 8; 9555.6235, item C; 9555.6245; 9555.6255, subpart
309.102; and 9555.6265. These exemptions apply to family adult foster care homes where at
309.11least one resident is receiving residential supports and services licensed according to this
309.12chapter. This chapter does not apply to family adult foster care homes that do not provide
309.13services licensed under this chapter.
309.14(d) A license holder providing services licensed according to this chapter in a
309.15supervised living facility is exempt from compliance with sections 245D.04; 245D.05,
309.16subdivision 2; and 245D.06, subdivision 2, clauses (1), (4), and (5).
309.17(e) A license holder providing residential services to persons in an ICF/DD is exempt
309.18from compliance with sections 245D.04; 245D.05, subdivision 1b; 245D.06, subdivision
309.192, clauses (4) and (5); 245D.071, subdivisions 4 and 5; 245D.081, subdivision 2; 245D.09,
309.20subdivision 7; 245D.095, subdivision 2; and 245D.11, subdivision 3.
309.21(c) (f) A license holder concurrently providing home care homemaker services
309.22registered licensed according to sections 144A.43 to 144A.49 to the same person receiving
309.23home management services licensed under this chapter and registered according to chapter
309.24144A is exempt from compliance with section 245D.04 as it applies to the person.
309.25(d) A license holder identified in subdivision 1, clauses (1), (5), and (9), is exempt
309.26from compliance with sections 245A.65, subdivision 2, paragraph (a), and 626.557,
309.27subdivision 14 , paragraph (b).
309.28(e) Notwithstanding section 245D.06, subdivision 5, a license holder providing
309.29structured day, prevocational, or supported employment services under this chapter
309.30and day training and habilitation or supported employment services licensed under
309.31chapter 245B within the same program is exempt from compliance with this chapter
309.32when the license holder notifies the commissioner in writing that the requirements under
309.33chapter 245B will be met for all persons receiving these services from the program. For
309.34the purposes of this paragraph, if the license holder has obtained approval from the
309.35commissioner for an alternative inspection status according to section 245B.031, that
309.36approval will apply to all persons receiving services in the program.
310.1(g) Nothing in this chapter prohibits a license holder from concurrently serving
310.2persons without disabilities or people who are or are not age 65 and older, provided this
310.3chapter's standards are met as well as other relevant standards.
310.4(h) The documentation required under sections 245D.07 and 245D.071 must meet
310.5the individual program plan requirements identified in section 256B.092 or successor
310.6provisions.
310.7    Subd. 3. Variance. If the conditions in section 245A.04, subdivision 9, are met,
310.8the commissioner may grant a variance to any of the requirements in this chapter, except
310.9sections 245D.04, and 245D.10, subdivision 4, paragraph (b) 245D.06, subdivision 4,
310.10paragraph (b), and 245D.061, subdivision 3, or provisions governing data practices and
310.11information rights of persons.
310.12    Subd. 4. License holders with multiple 245D licenses. (a) When a person changes
310.13service from one license to a different license held by the same license holder, the license
310.14holder is exempt from the requirements in section 245D.10, subdivision 4, paragraph (b).
310.15(b) When a staff person begins providing direct service under one or more licenses
310.16held by the same license holder, other than the license for which staff orientation was
310.17initially provided according to section 245D.09, subdivision 4, the license holder is
310.18exempt from those staff orientation requirements, except the staff person must review each
310.19person's service plan and medication administration procedures in accordance with section
310.20245D.09, subdivision 4, paragraph (c), if not previously reviewed by the staff person.
310.21    Subd. 5. Program certification. An applicant or a license holder may apply for
310.22program certification as identified in section 245D.33.
310.23EFFECTIVE DATE.This section is effective January 1, 2014.

310.24    Sec. 20. Minnesota Statutes 2012, section 245D.04, is amended to read:
310.25245D.04 SERVICE RECIPIENT RIGHTS.
310.26    Subdivision 1. License holder responsibility for individual rights of persons
310.27served by the program. The license holder must:
310.28(1) provide each person or each person's legal representative with a written notice
310.29that identifies the service recipient rights in subdivisions 2 and 3, and an explanation of
310.30those rights within five working days of service initiation and annually thereafter;
310.31(2) make reasonable accommodations to provide this information in other formats
310.32or languages as needed to facilitate understanding of the rights by the person and the
310.33person's legal representative, if any;
311.1(3) maintain documentation of the person's or the person's legal representative's
311.2receipt of a copy and an explanation of the rights; and
311.3(4) ensure the exercise and protection of the person's rights in the services provided
311.4by the license holder and as authorized in the coordinated service and support plan.
311.5    Subd. 2. Service-related rights. A person's service-related rights include the right to:
311.6(1) participate in the development and evaluation of the services provided to the
311.7person;
311.8(2) have services and supports identified in the coordinated service and support plan
311.9and the coordinated service and support plan addendum provided in a manner that respects
311.10and takes into consideration the person's preferences according to the requirements in
311.11sections 245D.07 and 245D.071;
311.12(3) refuse or terminate services and be informed of the consequences of refusing
311.13or terminating services;
311.14(4) know, in advance, limits to the services available from the license holder,
311.15including the license holder's knowledge, skill, and ability to meet the person's service and
311.16support needs based on the information required in section 245D.031, subdivision 2;
311.17(5) know conditions and terms governing the provision of services, including the
311.18license holder's admission criteria and policies and procedures related to temporary
311.19service suspension and service termination;
311.20(6) a coordinated transfer to ensure continuity of care when there will be a change
311.21in the provider;
311.22(7) know what the charges are for services, regardless of who will be paying for the
311.23services, and be notified of changes in those charges;
311.24(7) (8) know, in advance, whether services are covered by insurance, government
311.25funding, or other sources, and be told of any charges the person or other private party
311.26may have to pay; and
311.27(8) (9) receive services from an individual who is competent and trained, who has
311.28professional certification or licensure, as required, and who meets additional qualifications
311.29identified in the person's coordinated service and support plan. or coordinated service and
311.30support plan addendum.
311.31    Subd. 3. Protection-related rights. (a) A person's protection-related rights include
311.32the right to:
311.33(1) have personal, financial, service, health, and medical information kept private,
311.34and be advised of disclosure of this information by the license holder;
311.35(2) access records and recorded information about the person in accordance with
311.36applicable state and federal law, regulation, or rule;
312.1(3) be free from maltreatment;
312.2(4) be free from restraint, time out, or seclusion used for a purpose other than except
312.3for emergency use of manual restraint to protect the person from imminent danger to self
312.4or others according to the requirements in section 245D.06;
312.5(5) receive services in a clean and safe environment when the license holder is the
312.6owner, lessor, or tenant of the service site;
312.7(6) be treated with courtesy and respect and receive respectful treatment of the
312.8person's property;
312.9(7) reasonable observance of cultural and ethnic practice and religion;
312.10(8) be free from bias and harassment regarding race, gender, age, disability,
312.11spirituality, and sexual orientation;
312.12(9) be informed of and use the license holder's grievance policy and procedures,
312.13including knowing how to contact persons responsible for addressing problems and to
312.14appeal under section 256.045;
312.15(10) know the name, telephone number, and the Web site, e-mail, and street
312.16addresses of protection and advocacy services, including the appropriate state-appointed
312.17ombudsman, and a brief description of how to file a complaint with these offices;
312.18(11) assert these rights personally, or have them asserted by the person's family,
312.19authorized representative, or legal representative, without retaliation;
312.20(12) give or withhold written informed consent to participate in any research or
312.21experimental treatment;
312.22(13) associate with other persons of the person's choice;
312.23(14) personal privacy; and
312.24(15) engage in chosen activities.
312.25(b) For a person residing in a residential site licensed according to chapter 245A,
312.26or where the license holder is the owner, lessor, or tenant of the residential service site,
312.27protection-related rights also include the right to:
312.28(1) have daily, private access to and use of a non-coin-operated telephone for local
312.29calls and long-distance calls made collect or paid for by the person;
312.30(2) receive and send, without interference, uncensored, unopened mail or electronic
312.31correspondence or communication; and
312.32(3) have use of and free access to common areas in the residence; and
312.33(4) privacy for visits with the person's spouse, next of kin, legal counsel, religious
312.34advisor, or others, in accordance with section 363A.09 of the Human Rights Act, including
312.35privacy in the person's bedroom.
313.1(c) Restriction of a person's rights under subdivision 2, clause (10), or paragraph (a),
313.2clauses (13) to (15), or paragraph (b) is allowed only if determined necessary to ensure
313.3the health, safety, and well-being of the person. Any restriction of those rights must be
313.4documented in the person's coordinated service and support plan for the person and or
313.5coordinated service and support plan addendum. The restriction must be implemented
313.6in the least restrictive alternative manner necessary to protect the person and provide
313.7support to reduce or eliminate the need for the restriction in the most integrated setting
313.8and inclusive manner. The documentation must include the following information:
313.9(1) the justification for the restriction based on an assessment of the person's
313.10vulnerability related to exercising the right without restriction;
313.11(2) the objective measures set as conditions for ending the restriction;
313.12(3) a schedule for reviewing the need for the restriction based on the conditions for
313.13ending the restriction to occur, at a minimum, every three months for persons who do not
313.14have a legal representative and annually for persons who do have a legal representative
313.15 semiannually from the date of initial approval, at a minimum, or more frequently if
313.16requested by the person, the person's legal representative, if any, and case manager; and
313.17(4) signed and dated approval for the restriction from the person, or the person's
313.18legal representative, if any. A restriction may be implemented only when the required
313.19approval has been obtained. Approval may be withdrawn at any time. If approval is
313.20withdrawn, the right must be immediately and fully restored.
313.21EFFECTIVE DATE.This section is effective January 1, 2014.

313.22    Sec. 21. Minnesota Statutes 2012, section 245D.05, is amended to read:
313.23245D.05 HEALTH SERVICES.
313.24    Subdivision 1. Health needs. (a) The license holder is responsible for providing
313.25 meeting health services service needs assigned in the coordinated service and support plan
313.26and or the coordinated service and support plan addendum, consistent with the person's
313.27health needs. The license holder is responsible for promptly notifying the person or
313.28 the person's legal representative, if any, and the case manager of changes in a person's
313.29physical and mental health needs affecting assigned health services service needs assigned
313.30to the license holder in the coordinated service and support plan or the coordinated service
313.31and support plan addendum, when discovered by the license holder, unless the license
313.32holder has reason to know the change has already been reported. The license holder
313.33must document when the notice is provided.
314.1(b) When assigned in the service plan, If responsibility for meeting the person's
314.2health service needs has been assigned to the license holder in the coordinated service and
314.3support plan or the coordinated service and support plan addendum, the license holder is
314.4required to must maintain documentation on how the person's health needs will be met,
314.5including a description of the procedures the license holder will follow in order to:
314.6(1) provide medication administration, assistance or medication assistance, or
314.7medication management administration according to this chapter;
314.8(2) monitor health conditions according to written instructions from the person's
314.9physician or a licensed health professional;
314.10(3) assist with or coordinate medical, dental, and other health service appointments; or
314.11(4) use medical equipment, devices, or adaptive aides or technology safely and
314.12correctly according to written instructions from the person's physician or a licensed
314.13health professional.
314.14    Subd. 1a. Medication setup. For the purposes of this subdivision, "medication
314.15setup" means the arranging of medications according to instructions from the pharmacy,
314.16the prescriber, or a licensed nurse, for later administration when the license holder
314.17is assigned responsibility for medication assistance or medication administration in
314.18the coordinated service and support plan or the coordinated service and support plan
314.19addendum. A prescription label or the prescriber's written or electronically recorded order
314.20for the prescription is sufficient to constitute written instructions from the prescriber. The
314.21license holder must document in the person's medication administration record: dates
314.22of setup, name of medication, quantity of dose, times to be administered, and route of
314.23administration at time of setup; and, when the person will be away from home, to whom
314.24the medications were given.
314.25    Subd. 1b. Medication assistance. If responsibility for medication assistance
314.26is assigned to the license holder in the coordinated service and support plan or the
314.27coordinated service and support plan addendum, the license holder must ensure that
314.28the requirements of subdivision 2, paragraph (b), have been met when staff provides
314.29medication assistance to enable a person to self-administer medication or treatment when
314.30the person is capable of directing the person's own care, or when the person's legal
314.31representative is present and able to direct care for the person. For the purposes of this
314.32subdivision, "medication assistance" means any of the following:
314.33(1) bringing to the person and opening a container of previously set up medications,
314.34emptying the container into the person's hand, or opening and giving the medications in
314.35the original container to the person;
314.36(2) bringing to the person liquids or food to accompany the medication; or
315.1(3) providing reminders to take regularly scheduled medication or perform regularly
315.2scheduled treatments and exercises.
315.3    Subd. 2. Medication administration. (a) If responsibility for medication
315.4administration is assigned to the license holder in the coordinated service and support plan
315.5or the coordinated service and support plan addendum, the license holder must implement
315.6the following medication administration procedures to ensure a person takes medications
315.7and treatments as prescribed:
315.8(1) checking the person's medication record;
315.9(2) preparing the medication as necessary;
315.10(3) administering the medication or treatment to the person;
315.11(4) documenting the administration of the medication or treatment or the reason for
315.12not administering the medication or treatment; and
315.13(5) reporting to the prescriber or a nurse any concerns about the medication or
315.14treatment, including side effects, effectiveness, or a pattern of the person refusing to
315.15take the medication or treatment as prescribed. Adverse reactions must be immediately
315.16reported to the prescriber or a nurse.
315.17(b)(1) The license holder must ensure that the following criteria requirements in
315.18clauses (2) to (4) have been met before staff that is not a licensed health professional
315.19administers administering medication or treatment:.
315.20(1) (2) The license holder must obtain written authorization has been obtained from
315.21the person or the person's legal representative to administer medication or treatment
315.22orders; and must obtain reauthorization annually as needed. If the person or the person's
315.23legal representative refuses to authorize the license holder to administer medication, the
315.24medication must not be administered. The refusal to authorize medication administration
315.25must be reported to the prescriber as expediently as possible.
315.26(2) (3) The staff person has completed responsible for administering the medication
315.27or treatment must complete medication administration training according to section
315.28245D.09, subdivision 4 , paragraph 4a, paragraphs (a) and (c), clause (2); and, as applicable
315.29to the person, paragraph (d).
315.30(3) The medication or treatment will be administered under administration
315.31procedures established for the person in consultation with a licensed health professional.
315.32written instruction from the person's physician may constitute the medication
315.33administration procedures. A prescription label or the prescriber's order for the
315.34prescription is sufficient to constitute written instructions from the prescriber. A licensed
315.35health professional may delegate medication administration procedures.
316.1(4) For a license holder providing intensive support services, the medication or
316.2treatment must be administered according to the license holder's medication administration
316.3policy and procedures as required under section 245D.11, subdivision 2, clause (3).
316.4(b) (c) The license holder must ensure the following information is documented in
316.5the person's medication administration record:
316.6(1) the information on the current prescription label or the prescriber's current written
316.7or electronically recorded order or prescription that includes directions for the person's
316.8name, description of the medication or treatment to be provided, and the frequency and
316.9other information needed to safely and correctly administering administer the medication
316.10or treatment to ensure effectiveness;
316.11(2) information on any discomforts, risks, or other side effects that are reasonable to
316.12expect, and any contraindications to its use. This information must be readily available
316.13to all staff administering the medication;
316.14(3) the possible consequences if the medication or treatment is not taken or
316.15administered as directed;
316.16(4) instruction from the prescriber on when and to whom to report the following:
316.17(i) if the a dose of medication or treatment is not administered or treatment is not
316.18performed as prescribed, whether by error by the staff or the person or by refusal by
316.19the person; and
316.20(ii) the occurrence of possible adverse reactions to the medication or treatment;
316.21(5) notation of any occurrence of a dose of medication not being administered or
316.22treatment not performed as prescribed, whether by error by the staff or the person or by
316.23refusal by the person, or of adverse reactions, and when and to whom the report was
316.24made; and
316.25(6) notation of when a medication or treatment is started, administered, changed, or
316.26discontinued.
316.27(c) The license holder must ensure that the information maintained in the medication
316.28administration record is current and is regularly reviewed with the person or the person's
316.29legal representative and the staff administering the medication to identify medication
316.30administration issues or errors. At a minimum, the review must be conducted every three
316.31months or more often if requested by the person or the person's legal representative.
316.32Based on the review, the license holder must develop and implement a plan to correct
316.33medication administration issues or errors. If issues or concerns are identified related to
316.34the medication itself, the license holder must report those as required under subdivision 4.
316.35    Subd. 3. Medication assistance. The license holder must ensure that the
316.36requirements of subdivision 2, paragraph (a), have been met when staff provides assistance
317.1to enable a person to self-administer medication when the person is capable of directing
317.2the person's own care, or when the person's legal representative is present and able to
317.3direct care for the person.
317.4    Subd. 4. Reviewing and reporting medication and treatment issues. The
317.5following medication administration issues must be reported to the person or the person's
317.6legal representative and case manager as they occur or following timelines established
317.7in the person's service plan or as requested in writing by the person or the person's legal
317.8representative, or the case manager: (a) When assigned responsibility for medication
317.9administration, the license holder must ensure that the information maintained in
317.10the medication administration record is current and is regularly reviewed to identify
317.11medication administration errors. At a minimum, the review must be conducted every
317.12three months, or more frequently as directed in the coordinated service and support plan
317.13or coordinated service and support plan addendum or as requested by the person or the
317.14person's legal representative. Based on the review, the license holder must develop and
317.15implement a plan to correct patterns of medication administration errors when identified.
317.16(b) If assigned responsibility for medication assistance or medication administration,
317.17the license holder must report the following to the person's legal representative and case
317.18manager as they occur or as otherwise directed in the coordinated service and support plan
317.19or the coordinated service and support plan addendum:
317.20(1) any reports made to the person's physician or prescriber required under
317.21subdivision 2, paragraph (b) (c), clause (4);
317.22(2) a person's refusal or failure to take or receive medication or treatment as
317.23prescribed; or
317.24(3) concerns about a person's self-administration of medication or treatment.
317.25    Subd. 5. Injectable medications. Injectable medications may be administered
317.26according to a prescriber's order and written instructions when one of the following
317.27conditions has been met:
317.28(1) a registered nurse or licensed practical nurse will administer the subcutaneous or
317.29intramuscular injection;
317.30(2) a supervising registered nurse with a physician's order has delegated the
317.31administration of subcutaneous injectable medication to an unlicensed staff member
317.32and has provided the necessary training; or
317.33(3) there is an agreement signed by the license holder, the prescriber, and the
317.34person or the person's legal representative specifying what subcutaneous injections may
317.35be given, when, how, and that the prescriber must retain responsibility for the license
318.1holder's giving the injections. A copy of the agreement must be placed in the person's
318.2service recipient record.
318.3Only licensed health professionals are allowed to administer psychotropic
318.4medications by injection.
318.5EFFECTIVE DATE.This section is effective January 1, 2014.

318.6    Sec. 22. [245D.051] PSYCHOTROPIC MEDICATION USE AND
318.7MONITORING.
318.8    Subdivision 1. Conditions for psychotropic medication administration. (a)
318.9When a person is prescribed a psychotropic medication and the license holder is assigned
318.10responsibility for administration of the medication in the person's coordinated service
318.11and support plan or the coordinated service and support plan addendum, the license
318.12holder must ensure that the requirements in paragraphs (b) to (d) and section 245D.05,
318.13subdivision 2, are met.
318.14(b) Use of the medication must be included in the person's coordinated service and
318.15support plan or in the coordinated service and support plan addendum and based on a
318.16prescriber's current written or electronically recorded prescription.
318.17(c) The license holder must develop, implement, and maintain the following
318.18documentation in the person's coordinated service and support plan addendum according
318.19to the requirements in sections 245D.07 and 245D.071:
318.20(1) a description of the target symptoms that the psychotropic medication is to
318.21alleviate; and
318.22(2) documentation methods the license holder will use to monitor and measure
318.23changes in the target symptoms that are to be alleviated by the psychotropic medication if
318.24required by the prescriber. The license holder must collect and report on medication and
318.25symptom-related data as instructed by the prescriber. The license holder must provide
318.26the monitoring data to the expanded support team for review every three months, or as
318.27otherwise requested by the person or the person's legal representative.
318.28For the purposes of this section, "target symptom" refers to any perceptible
318.29diagnostic criteria for a person's diagnosed mental disorder as defined by the Diagnostic
318.30and Statistical Manual of Mental Disorders Fourth Edition Text Revision (DSM-IV-TR) or
318.31successive editions that has been identified for alleviation.
318.32(d) If a person is prescribed a psychotropic medication, monitoring the use of the
318.33psychotropic medication must be assigned to the license holder in the coordinated service
318.34and support plan or the coordinated service and support plan addendum. The assigned
318.35license holder must monitor the psychotropic medication as required by this section.
319.1    Subd. 2. Refusal to authorize psychotropic medication. If the person or the
319.2person's legal representative refuses to authorize the administration of a psychotropic
319.3medication as ordered by the prescriber, the license holder must follow the requirement
319.4in section 245D.05, subdivision 2, paragraph (b), clause (2). After reporting the refusal
319.5to the prescriber, the license holder must follow any directives or orders given by the
319.6prescriber. A court order must be obtained to override the refusal. Refusal to authorize
319.7administration of a specific psychotropic medication is not grounds for service termination
319.8and does not constitute an emergency. A decision to terminate services must be reached in
319.9compliance with section 245D.10, subdivision 3.
319.10EFFECTIVE DATE.This section is effective January 1, 2014.

319.11    Sec. 23. Minnesota Statutes 2012, section 245D.06, is amended to read:
319.12245D.06 PROTECTION STANDARDS.
319.13    Subdivision 1. Incident response and reporting. (a) The license holder must
319.14respond to all incidents under section 245D.02, subdivision 11, that occur while providing
319.15services to protect the health and safety of and minimize risk of harm to the person.
319.16(b) The license holder must maintain information about and report incidents to the
319.17person's legal representative or designated emergency contact and case manager within 24
319.18hours of an incident occurring while services are being provided, or within 24 hours of
319.19discovery or receipt of information that an incident occurred, unless the license holder
319.20has reason to know that the incident has already been reported, or as otherwise directed
319.21in a person's coordinated service and support plan or coordinated service and support
319.22plan addendum. An incident of suspected or alleged maltreatment must be reported as
319.23required under paragraph (d), and an incident of serious injury or death must be reported
319.24as required under paragraph (e).
319.25(c) When the incident involves more than one person, the license holder must not
319.26disclose personally identifiable information about any other person when making the report
319.27to each person and case manager unless the license holder has the consent of the person.
319.28(d) Within 24 hours of reporting maltreatment as required under section 626.556
319.29or 626.557, the license holder must inform the case manager of the report unless there is
319.30reason to believe that the case manager is involved in the suspected maltreatment. The
319.31license holder must disclose the nature of the activity or occurrence reported and the
319.32agency that received the report.
319.33(e) The license holder must report the death or serious injury of the person to the legal
319.34representative, if any, and case manager, as required in paragraph (b) and to the Department
320.1of Human Services Licensing Division, and the Office of Ombudsman for Mental Health
320.2and Developmental Disabilities as required under section 245.94, subdivision 2a, within
320.324 hours of the death, or receipt of information that the death occurred, unless the license
320.4holder has reason to know that the death has already been reported.
320.5(f) When a death or serious injury occurs in a facility certified as an intermediate
320.6care facility for persons with developmental disabilities, the death or serious injury must
320.7be reported to the Department of Health, Office of Health Facility Complaints, and the
320.8Office of Ombudsman for Mental Health and Developmental Disabilities, as required
320.9under sections 245.91 and 245.94, subdivision 2a, unless the license holder has reason to
320.10know that the death has already been reported.
320.11(f) (g) The license holder must conduct a an internal review of incident reports of
320.12deaths and serious injuries that occurred while services were being provided and that
320.13were not reported by the program as alleged or suspected maltreatment, for identification
320.14of incident patterns, and implementation of corrective action as necessary to reduce
320.15occurrences. The review must include an evaluation of whether related policies and
320.16procedures were followed, whether the policies and procedures were adequate, whether
320.17there is a need for additional staff training, whether the reported event is similar to past
320.18events with the persons or the services involved, and whether there is a need for corrective
320.19action by the license holder to protect the health and safety of persons receiving services.
320.20Based on the results of this review, the license holder must develop, document, and
320.21implement a corrective action plan designed to correct current lapses and prevent future
320.22lapses in performance by staff or the license holder, if any.
320.23(h) The license holder must verbally report the emergency use of manual restraint of
320.24a person as required in paragraph (b), within 24 hours of the occurrence. The license holder
320.25must ensure the written report and internal review of all incident reports of the emergency
320.26use of manual restraints are completed according to the requirements in section 245D.061.
320.27    Subd. 2. Environment and safety. The license holder must:
320.28(1) ensure the following when the license holder is the owner, lessor, or tenant
320.29of the an unlicensed service site:
320.30(i) the service site is a safe and hazard-free environment;
320.31(ii) doors are locked or toxic substances or dangerous items normally accessible are
320.32inaccessible to persons served by the program are stored in locked cabinets, drawers, or
320.33containers only to protect the safety of a person receiving services and not as a substitute
320.34for staff supervision or interactions with a person who is receiving services. If doors are
320.35locked or toxic substances or dangerous items normally accessible to persons served by the
320.36program are stored in locked cabinets, drawers, or containers are made inaccessible, the
321.1license holder must justify and document how this determination was made in consultation
321.2with the person or person's legal representative, and how access will otherwise be provided
321.3to the person and all other affected persons receiving services; and document an assessment
321.4of the physical plant, its environment, and its population identifying the risk factors which
321.5require toxic substances or dangerous items to be inaccessible and a statement of specific
321.6measures to be taken to minimize the safety risk to persons receiving services;
321.7(iii) doors are locked from the inside to prevent a person from exiting only when
321.8necessary to protect the safety of a person receiving services and not as a substitute for
321.9staff supervision or interactions with the person. If doors are locked from the inside, the
321.10license holder must document an assessment of the physical plant, the environment and
321.11the population served, identifying the risk factors which require the use of locked doors,
321.12and a statement of specific measures to be taken to minimize the safety risk to persons
321.13receiving services at the service site; and
321.14(iii) (iv) a staff person is available on site who is trained in basic first aid and, when
321.15required in a person's coordinated service and support plan or coordinated service and
321.16support plan addendum, cardiopulmonary resuscitation, "CPR," whenever persons are
321.17present and staff are required to be at the site to provide direct service. The CPR training
321.18must include in-person instruction, hands-on practice, and an observed skills assessment
321.19under the direct supervision of a CPR instructor;
321.20(2) maintain equipment, vehicles, supplies, and materials owned or leased by the
321.21license holder in good condition when used to provide services;
321.22(3) follow procedures to ensure safe transportation, handling, and transfers of the
321.23person and any equipment used by the person, when the license holder is responsible for
321.24transportation of a person or a person's equipment;
321.25(4) be prepared for emergencies and follow emergency response procedures to
321.26ensure the person's safety in an emergency; and
321.27(5) follow universal precautions and sanitary practices, including hand washing, for
321.28infection prevention and control, and to prevent communicable diseases.
321.29    Subd. 3. Compliance with fire and safety codes. When services are provided at a
321.30 service site licensed according to chapter 245A or where the license holder is the owner,
321.31lessor, or tenant of the service site, the license holder must document compliance with
321.32applicable building codes, fire and safety codes, health rules, and zoning ordinances, or
321.33document that an appropriate waiver has been granted.
321.34    Subd. 4. Funds and property. (a) Whenever the license holder assists a person
321.35with the safekeeping of funds or other property according to section 245A.04, subdivision
321.3613 , the license holder must have obtain written authorization to do so from the person or
322.1the person's legal representative and the case manager. Authorization must be obtained
322.2within five working days of service initiation and renewed annually thereafter. At the time
322.3initial authorization is obtained, the license holder must survey, document, and implement
322.4the preferences of the person or the person's legal representative and the case manager
322.5for frequency of receiving a statement that itemizes receipts and disbursements of funds
322.6or other property. The license holder must document changes to these preferences when
322.7they are requested.
322.8(b) A license holder or staff person may not accept powers-of-attorney from a
322.9person receiving services from the license holder for any purpose, and may not accept an
322.10appointment as guardian or conservator of a person receiving services from the license
322.11holder. This does not apply to license holders that are Minnesota counties or other
322.12units of government or to staff persons employed by license holders who were acting
322.13as power-of-attorney, guardian, or conservator attorney-in-fact for specific individuals
322.14prior to April 23, 2012 implementation of this chapter. The license holder must maintain
322.15documentation of the power-of-attorney, guardianship, or conservatorship in the service
322.16recipient record.
322.17(c) Upon the transfer or death of a person, any funds or other property of the person
322.18must be surrendered to the person or the person's legal representative, or given to the
322.19executor or administrator of the estate in exchange for an itemized receipt.
322.20    Subd. 5. Prohibitions. (a) The license holder is prohibited from using psychotropic
322.21medication chemical restraints, mechanical restraint practices, manual restraints, time out,
322.22or seclusion as a substitute for adequate staffing, for a behavioral or therapeutic program
322.23to reduce or eliminate behavior, as punishment, or for staff convenience, or for any reason
322.24other than as prescribed.
322.25(b) The license holder is prohibited from using restraints or seclusion under any
322.26circumstance, unless the commissioner has approved a variance request from the license
322.27holder that allows for the emergency use of restraints and seclusion according to terms
322.28and conditions approved in the variance. Applicants and license holders who have
322.29reason to believe they may be serving an individual who will need emergency use of
322.30restraints or seclusion may request a variance on the application or reapplication, and
322.31the commissioner shall automatically review the request for a variance as part of the
322.32application or reapplication process. License holders may also request the variance any
322.33time after issuance of a license. In the event a license holder uses restraint or seclusion for
322.34any reason without first obtaining a variance as required, the license holder must report
322.35the unauthorized use of restraint or seclusion to the commissioner within 24 hours of the
322.36occurrence and request the required variance.
323.1(b) For the purposes of this subdivision, "chemical restraint" means the
323.2administration of a drug or medication to control the person's behavior or restrict the
323.3person's freedom of movement and is not a standard treatment of dosage for the person's
323.4medical or psychological condition.
323.5(c) For the purposes of this subdivision, "mechanical restraint practice" means the
323.6use of any adaptive equipment or safety device to control the person's behavior or restrict
323.7the person's freedom of movement and not as ordered by a licensed health professional.
323.8Mechanical restraint practices include, but are not limited to, the use of bed rails or similar
323.9devices on a bed to prevent the person from getting out of bed, chairs that prevent a person
323.10from rising, or placing a person in a wheelchair so close to a wall that the wall prevents
323.11the person from rising. Wrist bands or devices on clothing that trigger electronic alarms to
323.12warn staff that a person is leaving a room or area do not, in and of themselves, restrict
323.13freedom of movement and should not be considered restraints.
323.14(d) A license holder must not use manual restraints, time out, or seclusion under any
323.15circumstance, except for emergency use of manual restraints according to the requirements
323.16in section 245D.061 or the use of controlled procedures with a person with a developmental
323.17disability as governed by Minnesota Rules, parts 9525.2700 to 9525.2810, or its successor
323.18provisions. License holders implementing nonemergency use of manual restraint, or any
323.19other programmatic use of mechanical restraint, time out, or seclusion with persons who
323.20do not have a developmental disability that is not subject to the requirements of Minnesota
323.21Rules, parts 9525.2700 to 9525.2810, must submit a variance request to the commissioner
323.22for continued use of the procedure within three months of implementation of this chapter.
323.23EFFECTIVE DATE.This section is effective January 1, 2014.

323.24    Sec. 24. [245D.061] EMERGENCY USE OF MANUAL RESTRAINTS.
323.25    Subdivision 1. Standards for emergency use of manual restraints. Except
323.26for the emergency use of controlled procedures with a person with a developmental
323.27disability as governed by Minnesota Rules, part 9525.2770, or its successor provisions,
323.28the license holder must ensure that emergency use of manual restraints complies with the
323.29requirements of this chapter and the license holder's policy and procedures as required
323.30under subdivision 10.
323.31    Subd. 2. Definitions. (a) The terms used in this section have the meaning given
323.32them in this subdivision.
323.33(b) "Manual restraint" means physical intervention intended to hold a person
323.34immobile or limit a person's voluntary movement by using body contact as the only source
323.35of physical restraint.
324.1(c) "Mechanical restraint" means the use of devices, materials, or equipment attached
324.2or adjacent to the person's body, or the use of practices which restrict freedom of movement
324.3or normal access to one's body or body parts, or limits a person's voluntary movement
324.4or holds a person immobile as an intervention precipitated by a person's behavior. The
324.5term does apply to mechanical restraint used to prevent injury with persons who engage in
324.6self-injurious behaviors, such as head-banging, gouging, or other actions resulting in tissue
324.7damage that have caused or could cause medical problems resulting from the self-injury.
324.8    Subd. 3. Conditions for emergency use of manual restraint. Emergency use of
324.9manual restraint must meet the following conditions:
324.10(1) immediate intervention must be needed to protect the person or others from
324.11imminent risk of physical harm; and
324.12(2) the type of manual restraint used must be the least restrictive intervention to
324.13eliminate the immediate risk of harm and effectively achieve safety. The manual restraint
324.14must end when the threat of harm ends.
324.15    Subd. 4. Permitted instructional techniques and therapeutic conduct. (a) Use of
324.16physical contact as therapeutic conduct or as an instructional technique as identified in
324.17paragraphs (b) and (c), is permitted and is not subject to the requirements of this section
324.18when such use is addressed in a person's coordinated service and support plan addendum
324.19and the required conditions have been met. For the purposes of this subdivision,
324.20"therapeutic conduct" has the meaning given in section 626.5572, subdivision 20.
324.21(b) Physical contact or instructional techniques must use the least restrictive
324.22alternative possible to meet the needs of the person and may be used:
324.23(1) to calm or comfort a person by holding that person with no resistance from
324.24that person;
324.25(2) to protect a person known to be at risk of injury due to frequent falls as a result of
324.26a medical condition; or
324.27(3) to position a person with physical disabilities in a manner specified in the
324.28person's coordinated service and support plan addendum.
324.29(c) Restraint may be used as therapeutic conduct:
324.30(1) to allow a licensed health care professional to safely conduct a medical
324.31examination or to provide medical treatment ordered by a licensed health care professional
324.32to a person necessary to promote healing or recovery from an acute, meaning short-term,
324.33medical condition;
324.34(2) to facilitate the person's completion of a task or response when the person does
324.35not resist or the person's resistance is minimal in intensity and duration;
325.1(3) to briefly block or redirect a person's limbs or body without holding the person
325.2or limiting the person's movement to interrupt the person's behavior that may result in
325.3injury to self or others; or
325.4(4) to assist in the safe evacuation of a person in the event of an emergency or to
325.5redirect a person who is at imminent risk of harm in a dangerous situation.
325.6(d) A plan for using restraint as therapeutic conduct must be developed according to
325.7the requirements in sections 245D.07 and 245D.071, and must include methods to reduce
325.8or eliminate the use of and need for restraint.
325.9    Subd. 5. Restrictions when implementing emergency use of manual restraint.
325.10(a) Emergency use of manual restraint procedures must not:
325.11(1) be implemented with a child in a manner that constitutes sexual abuse, neglect,
325.12physical abuse, or mental injury, as defined in section 626.556, subdivision 2;
325.13(2) be implemented with an adult in a manner that constitutes abuse or neglect as
325.14defined in section 626.5572, subdivisions 2 and 17;
325.15(3) be implemented in a manner that violates a person's rights and protections
325.16identified in section 245D.04;
325.17(4) restrict a person's normal access to a nutritious diet, drinking water, adequate
325.18ventilation, necessary medical care, ordinary hygiene facilities, normal sleeping
325.19conditions, or necessary clothing, or to any protection required by state licensing standards
325.20and federal regulations governing the program;
325.21(5) deny the person visitation or ordinary contact with legal counsel, a legal
325.22representative, or next of kin;
325.23(6) be used as a substitute for adequate staffing, for the convenience of staff, as
325.24punishment, or as a consequence if the person refuses to participate in the treatment
325.25or services provided by the program; or
325.26(7) use prone restraint. For the purposes of this section, "prone restraint" means use
325.27of manual restraint that places a person in a face-down position. This does not include
325.28brief physical holding of a person who, during an emergency use of manual restraint, rolls
325.29into a prone position, and the person is restored to a standing, sitting, or side-lying position
325.30as quickly as possible. Applying back or chest pressure while a person is in the prone or
325.31supine position or face-up is prohibited.
325.32    Subd. 6. Monitoring emergency use of manual restraint. The license holder shall
325.33monitor a person's health and safety during an emergency use of a manual restraint. Staff
325.34monitoring the procedure must not be the staff implementing the procedure when possible.
325.35The license holder shall complete a monitoring form, approved by the commissioner, for
325.36each incident involving the emergency use of a manual restraint.
326.1    Subd. 7. Reporting emergency use of manual restraint incident. (a) Within
326.2three calendar days after an emergency use of a manual restraint, the staff person who
326.3implemented the emergency use must report in writing to the designated coordinator the
326.4following information about the emergency use:
326.5(1) the staff and persons receiving services who were involved in the incident
326.6leading up to the emergency use of manual restraint;
326.7(2) a description of the physical and social environment, including who was present
326.8before and during the incident leading up to the emergency use of manual restraint;
326.9(3) a description of what less restrictive alternative measures were attempted to
326.10de-escalate the incident and maintain safety before the manual restraint was implemented
326.11that identifies when, how, and how long the alternative measures were attempted before
326.12manual restraint was implemented;
326.13(4) a description of the mental, physical, and emotional condition of the person who
326.14was restrained, and other persons involved in the incident leading up to, during, and
326.15following the manual restraint;
326.16(5) whether there was any injury to the person who was restrained or other persons
326.17involved in the incident, including staff, before or as a result of the use of manual
326.18restraint; and
326.19(6) whether there was an attempt to debrief with the staff, and, if not contraindicated,
326.20with the person who was restrained and other persons who were involved in or who
326.21witnessed the restraint, following the incident and the outcome of the debriefing. If the
326.22debriefing was not conducted at the time the incident report was made, the report should
326.23identify whether a debriefing is planned.
326.24(b) Each single incident of emergency use of manual restraint must be reported
326.25separately. For the purposes of this subdivision, an incident of emergency use of manual
326.26restraint is a single incident when the following conditions have been met:
326.27(1) after implementing the manual restraint, staff attempt to release the person at the
326.28moment staff believe the person's conduct no longer poses an imminent risk of physical
326.29harm to self or others and less restrictive strategies can be implemented to maintain safety;
326.30(2) upon the attempt to release the restraint, the person's behavior immediately
326.31re-escalates; and
326.32(3) staff must immediately reimplement the restraint in order to maintain safety.
326.33    Subd. 8. Internal review of emergency use of manual restraint. (a) Within five
326.34working days of the emergency use of manual restraint, the license holder must complete
326.35an internal review of each report of emergency use of manual restraint. The review must
326.36include an evaluation of whether:
327.1(1) the person's service and support strategies developed according to sections
327.2245D.07 and 245D.071 need to be revised;
327.3(2) related policies and procedures were followed;
327.4(3) the policies and procedures were adequate;
327.5(4) there is a need for additional staff training;
327.6(5) the reported event is similar to past events with the persons, staff, or the services
327.7involved; and
327.8(6) there is a need for corrective action by the license holder to protect the health
327.9and safety of persons.
327.10(b) Based on the results of the internal review, the license holder must develop,
327.11document, and implement a corrective action plan for the program designed to correct
327.12current lapses and prevent future lapses in performance by individuals or the license
327.13holder, if any. The corrective action plan, if any, must be implemented within 30 days of
327.14the internal review being completed.
327.15    Subd. 9. Expanded support team review. Within five working days after the
327.16completion of the internal review required in subdivision 8, the license holder must consult
327.17with the expanded support team following the emergency use of manual restraint to:
327.18(1) discuss the incident reported in subdivision 7, to define the antecedent or event
327.19that gave rise to the behavior resulting in the manual restraint and identify the perceived
327.20function the behavior served; and
327.21(2) determine whether the person's coordinated service and support plan addendum
327.22needs to be revised according to sections 245D.07 and 245D.071 to positively and
327.23effectively help the person maintain stability and to reduce or eliminate future occurrences
327.24requiring emergency use of manual restraint.
327.25    Subd. 10. Emergency use of manual restraints policy and procedures. The
327.26license holder must develop, document, and implement a policy and procedures that
327.27promote service recipient rights and protect health and safety during the emergency use of
327.28manual restraints. The policy and procedures must comply with the requirements of this
327.29section and must specify the following:
327.30(1) a description of the positive support strategies and techniques staff must use to
327.31attempt to de-escalate a person's behavior before it poses an imminent risk of physical
327.32harm to self or others;
327.33(2) a description of the types of manual restraints the license holder allows staff to
327.34use on an emergency basis, if any. If the license holder will not allow the emergency use
327.35of manual restraint, the policy and procedure must identify the alternative measures the
328.1license holder will require staff to use when a person's conduct poses an imminent risk of
328.2physical harm to self or others and less restrictive strategies would not achieve safety;
328.3(3) instructions for safe and correct implementation of the allowed manual restraint
328.4procedures;
328.5(4) the training that staff must complete and the timelines for completion, before they
328.6may implement an emergency use of manual restraint. In addition to the training on this
328.7policy and procedure and the orientation and annual training required in section 245D.09,
328.8subdivision 4, the training for emergency use of manual restraint must incorporate the
328.9following subjects:
328.10(i) alternatives to manual restraint procedures, including techniques to identify
328.11events and environmental factors that may escalate conduct that poses an imminent risk of
328.12physical harm to self or others;
328.13(ii) de-escalation methods, positive support strategies, and how to avoid power
328.14struggles;
328.15(iii) simulated experiences of administering and receiving manual restraint
328.16procedures allowed by the license holder on an emergency basis;
328.17(iv) how to properly identify thresholds for implementing and ceasing restrictive
328.18procedures;
328.19(v) how to recognize, monitor, and respond to the person's physical signs of distress,
328.20including positional asphyxia;
328.21(vi) the physiological and psychological impact on the person and the staff when
328.22restrictive procedures are used;
328.23(vii) the communicative intent of behaviors; and
328.24(viii) relationship building;
328.25(5) the procedures and forms to be used to monitor the emergency use of manual
328.26restraints, including what must be monitored and the frequency of monitoring per
328.27each incident of emergency use of manual restraint, and the person or position who is
328.28responsible for monitoring the use;
328.29(6) the instructions, forms, and timelines required for completing and submitting an
328.30incident report by the person or persons who implemented the manual restraint; and
328.31(7) the procedures and timelines for conducting the internal review and the expanded
328.32support team review, and the person or position responsible for completing the reviews and
328.33who is responsible for ensuring that corrective action is taken or the person's coordinated
328.34service and support plan addendum is revised, when determined necessary.
328.35EFFECTIVE DATE.This section is effective January 1, 2014.

329.1    Sec. 25. Minnesota Statutes 2012, section 245D.07, is amended to read:
329.2245D.07 SERVICE NEEDS PLANNING AND DELIVERY.
329.3    Subdivision 1. Provision of services. The license holder must provide services as
329.4specified assigned in the coordinated service and support plan and assigned to the license
329.5holder. The provision of services must comply with the requirements of this chapter and
329.6the federal waiver plans.
329.7    Subd. 1a. Person-centered planning and service delivery. (a) The license holder
329.8must provide services in response to the person's identified needs, interests, preferences,
329.9and desired outcomes as specified in the coordinated service and support plan, the
329.10coordinated service and support plan addendum, and in compliance with the requirements
329.11of this chapter. License holders providing intensive support services must also provide
329.12outcome-based services according to the requirements in section 245D.071.
329.13(b) Services must be provided in a manner that supports the person's preferences,
329.14daily needs, and activities and accomplishment of the person's personal goals and service
329.15outcomes, consistent with the principles of:
329.16(1) person-centered service planning and delivery that:
329.17(i) identifies and supports what is important to the person as well as what is
329.18important for the person, including preferences for when, how, and by whom direct
329.19support service is provided;
329.20(ii) uses that information to identify outcomes the person desires; and
329.21(iii) respects each person's history, dignity, and cultural background;
329.22(2) self-determination that supports and provides:
329.23(i) opportunities for the development and exercise of functional and age-appropriate
329.24skills, decision making and choice, personal advocacy, and communication; and
329.25(ii) the affirmation and protection of each person's civil and legal rights;
329.26(3) providing the most integrated setting and inclusive service delivery that supports,
329.27promotes, and allows:
329.28(i) inclusion and participation in the person's community as desired by the person
329.29in a manner that enables the person to interact with nondisabled persons to the fullest
329.30extent possible and supports the person in developing and maintaining a role as a valued
329.31community member;
329.32(ii) opportunities for self-sufficiency as well as developing and maintaining social
329.33relationships and natural supports; and
329.34(iii) a balance between risk and opportunity, meaning the least restrictive supports or
329.35interventions necessary are provided in the most integrated settings in the most inclusive
330.1manner possible to support the person to engage in activities of the person's own choosing
330.2that may otherwise present a risk to the person's health, safety, or rights.
330.3    Subd. 2. Service planning requirements for basic support services. (a) License
330.4holders providing basic support services must meet the requirements of this subdivision.
330.5(b) Within 15 days of service initiation the license holder must complete a
330.6preliminary coordinated service and support plan addendum based on the coordinated
330.7service and support plan.
330.8(c) Within 60 days of service initiation the license holder must review and revise as
330.9needed the preliminary coordinated service and support plan addendum to document the
330.10services that will be provided including how, when, and by whom services will be provided,
330.11and the person responsible for overseeing the delivery and coordination of services.
330.12(d) The license holder must participate in service planning and support team
330.13meetings related to for the person following stated timelines established in the person's
330.14 coordinated service and support plan or as requested by the support team, the person, or
330.15the person's legal representative, the support team or the expanded support team.
330.16    Subd. 3. Reports. The license holder must provide written reports regarding the
330.17person's progress or status as requested by the person, the person's legal representative, the
330.18case manager, or the team.
330.19EFFECTIVE DATE.This section is effective January 1, 2014.

330.20    Sec. 26. [245D.071] SERVICE PLANNING AND DELIVERY; INTENSIVE
330.21SUPPORT SERVICES.
330.22    Subdivision 1. Requirements for intensive support services. A license holder
330.23providing intensive support services identified in section 245D.03, subdivision 1,
330.24paragraph (c), must comply with the requirements in section 245D.07, subdivisions 1
330.25and 3, and this section.
330.26    Subd. 2. Abuse prevention. Prior to or upon initiating services, the license holder
330.27must develop, document, and implement an abuse prevention plan according to section
330.28245A.65, subdivision 2.
330.29    Subd. 3. Assessment and initial service planning. (a) Within 15 days of service
330.30initiation the license holder must complete a preliminary coordinated service and support
330.31plan addendum based on the coordinated service and support plan.
330.32(b) Within 45 days of service initiation the license holder must meet with the person,
330.33the person's legal representative, the case manager, and other members of the support team
330.34or expanded support team to assess and determine the following based on the person's
331.1coordinated service and support plan and the requirements in subdivision 4 and section
331.2245D.07, subdivision 1a:
331.3(1) the scope of the services to be provided to support the person's daily needs
331.4and activities;
331.5(2) the person's desired outcomes and the supports necessary to accomplish the
331.6person's desired outcomes;
331.7(3) the person's preferences for how services and supports are provided;
331.8(4) whether the current service setting is the most integrated setting available and
331.9appropriate for the person; and
331.10(5) how services must be coordinated across other providers licensed under this
331.11chapter serving the same person to ensure continuity of care for the person.
331.12(c) Within the scope of services, the license holder must, at a minimum, assess
331.13the following areas:
331.14(1) the person's ability to self-manage health and medical needs to maintain or
331.15improve physical, mental, and emotional well-being, including, when applicable, allergies,
331.16seizures, choking, special dietary needs, chronic medical conditions, self-administration
331.17of medication or treatment orders, preventative screening, and medical and dental
331.18appointments;
331.19(2) the person's ability to self-manage personal safety to avoid injury or accident in
331.20the service setting, including, when applicable, risk of falling, mobility, regulating water
331.21temperature, community survival skills, water safety skills, and sensory disabilities; and
331.22(3) the person's ability to self-manage symptoms or behavior that may otherwise
331.23result in an incident as defined in section 245D.02, subdivision 11, clauses (4) to
331.24(7), suspension or termination of services by the license holder, or other symptoms
331.25or behaviors that may jeopardize the health and safety of the person or others. The
331.26assessments must produce information about the person that is descriptive of the person's
331.27overall strengths, functional skills and abilities, and behaviors or symptoms.
331.28    Subd. 4. Service outcomes and supports. (a) Within ten working days of the
331.2945-day meeting, the license holder must develop and document the service outcomes and
331.30supports based on the assessments completed under subdivision 3 and the requirements
331.31in section 245D.07, subdivision 1a. The outcomes and supports must be included in the
331.32coordinated service and support plan addendum.
331.33(b) The license holder must document the supports and methods to be implemented
331.34to support the accomplishment of outcomes related to acquiring, retaining, or improving
331.35skills. The documentation must include:
332.1(1) the methods or actions that will be used to support the person and to accomplish
332.2the service outcomes, including information about:
332.3(i) any changes or modifications to the physical and social environments necessary
332.4when the service supports are provided;
332.5(ii) any equipment and materials required; and
332.6(iii) techniques that are consistent with the person's communication mode and
332.7learning style;
332.8(2) the measurable and observable criteria for identifying when the desired outcome
332.9has been achieved and how data will be collected;
332.10(3) the projected starting date for implementing the supports and methods and
332.11the date by which progress towards accomplishing the outcomes will be reviewed and
332.12evaluated; and
332.13(4) the names of the staff or position responsible for implementing the supports
332.14and methods.
332.15(c) Within 20 working days of the 45-day meeting, the license holder must obtain
332.16dated signatures from the person or the person's legal representative and case manager
332.17to document completion and approval of the assessment and coordinated service and
332.18support plan addendum.
332.19    Subd. 5. Progress reviews. (a) The license holder must give the person or the
332.20person's legal representative and case manager an opportunity to participate in the ongoing
332.21review and development of the methods used to support the person and accomplish
332.22outcomes identified in subdivisions 3 and 4. The license holder, in coordination with
332.23the person's support team or expanded support team, must meet with the person, the
332.24person's legal representative, and the case manager, and participate in progress review
332.25meetings following stated timelines established in the person's coordinated service and
332.26support plan or coordinated service and support plan addendum or within 30 days of a
332.27written request by the person, the person's legal representative, or the case manager,
332.28at a minimum of once per year.
332.29(b) The license holder must summarize the person's progress toward achieving the
332.30identified outcomes and make recommendations and identify the rationale for changing,
332.31continuing, or discontinuing implementation of supports and methods identified in
332.32subdivision 4 in a written report sent to the person or the person's legal representative
332.33and case manager five working days prior to the review meeting, unless the person, the
332.34person's legal representative, or the case manager request to receive the report at the
332.35time of the meeting.
333.1(c) Within ten working days of the progress review meeting, the license holder
333.2must obtain dated signatures from the person or the person's legal representative and
333.3the case manager to document approval of any changes to the coordinated service and
333.4support plan addendum.
333.5EFFECTIVE DATE.This section is effective January 1, 2014.

333.6    Sec. 27. [245D.081] PROGRAM COORDINATION, EVALUATION, AND
333.7OVERSIGHT.
333.8    Subdivision 1. Program coordination and evaluation. (a) The license holder
333.9is responsible for:
333.10(1) coordination of service delivery and evaluation for each person served by the
333.11program as identified in subdivision 2; and
333.12(2) program management and oversight that includes evaluation of the program
333.13quality and program improvement for services provided by the license holder as identified
333.14in subdivision 3.
333.15(b) The same person may perform the functions in paragraph (a) if the work and
333.16education qualifications are met in subdivisions 2 and 3.
333.17    Subd. 2. Coordination and evaluation of individual service delivery. (a) Delivery
333.18and evaluation of services provided by the license holder must be coordinated by a
333.19designated staff person. The designated coordinator must provide supervision, support,
333.20and evaluation of activities that include:
333.21(1) oversight of the license holder's responsibilities assigned in the person's
333.22coordinated service and support plan and the coordinated service and support plan
333.23addendum;
333.24(2) taking the action necessary to facilitate the accomplishment of the outcomes
333.25according to the requirements in section 245D.07;
333.26(3) instruction and assistance to direct support staff implementing the coordinated
333.27service and support plan and the service outcomes, including direct observation of service
333.28delivery sufficient to assess staff competency; and
333.29(4) evaluation of the effectiveness of service delivery, methodologies, and progress on
333.30the person's outcomes based on the measurable and observable criteria for identifying when
333.31the desired outcome has been achieved according to the requirements in section 245D.07.
333.32(b) The license holder must ensure that the designated coordinator is competent to
333.33perform the required duties identified in paragraph (a) through education and training in
333.34human services and disability-related fields, and work experience in providing direct care
333.35services and supports to persons with disabilities. The designated coordinator must have
334.1the skills and ability necessary to develop effective plans and to design and use data
334.2systems to measure effectiveness of services and supports. The license holder must verify
334.3and document competence according to the requirements in section 245D.09, subdivision
334.43. The designated coordinator must minimally have:
334.5(1) a baccalaureate degree in a field related to human services, and one year of
334.6full-time work experience providing direct care services to persons with disabilities or
334.7persons age 65 and older;
334.8(2) an associate degree in a field related to human services, and two years of
334.9full-time work experience providing direct care services to persons with disabilities or
334.10persons age 65 and older;
334.11(3) a diploma in a field related to human services from an accredited postsecondary
334.12institution and three years of full-time work experience providing direct care services to
334.13persons with disabilities or persons age 65 and older; or
334.14(4) a minimum of 50 hours of education and training related to human services
334.15and disabilities; and
334.16(5) four years of full-time work experience providing direct care services to persons
334.17with disabilities or persons age 65 and older under the supervision of a staff person who
334.18meets the qualifications identified in clauses (1) to (3).
334.19    Subd. 3. Program management and oversight. (a) The license holder must
334.20designate a managerial staff person or persons to provide program management and
334.21oversight of the services provided by the license holder. The designated manager is
334.22responsible for the following:
334.23(1) maintaining a current understanding of the licensing requirements sufficient to
334.24ensure compliance throughout the program as identified in section 245A.04, subdivision
334.251, paragraph (e), and when applicable, as identified in section 256B.04, subdivision 21,
334.26paragraph (b);
334.27(2) ensuring the duties of the designated coordinator are fulfilled according to the
334.28requirements in subdivision 2;
334.29(3) ensuring the program implements corrective action identified as necessary
334.30by the program following review of incident and emergency reports according to the
334.31requirements in section 245D.11, subdivision 2, clause (7). An internal review of
334.32incident reports of alleged or suspected maltreatment must be conducted according to the
334.33requirements in section 245A.65, subdivision 1, paragraph (b);
334.34(4) evaluation of satisfaction of persons served by the program, the person's legal
334.35representative, if any, and the case manager, with the service delivery and progress
335.1towards accomplishing outcomes identified in sections 245D.07 and 245D.071, and
335.2ensuring and protecting each person's rights as identified in section 245D.04;
335.3(5) ensuring staff competency requirements are met according to the requirements in
335.4section 245D.09, subdivision 3, and ensuring staff orientation and training is provided
335.5according to the requirements in section 245D.09, subdivisions 4, 4a, and 5;
335.6(6) ensuring corrective action is taken when ordered by the commissioner and that
335.7the terms and condition of the license and any variances are met; and
335.8(7) evaluating the information identified in clauses (1) to (6) to develop, document,
335.9and implement ongoing program improvements.
335.10(b) The designated manager must be competent to perform the duties as required and
335.11must minimally meet the education and training requirements identified in subdivision
335.122, paragraph (b), and have a minimum of three years of supervisory level experience in
335.13a program providing direct support services to persons with disabilities or persons age
335.1465 and older.
335.15EFFECTIVE DATE.This section is effective January 1, 2014.

335.16    Sec. 28. Minnesota Statutes 2012, section 245D.09, is amended to read:
335.17245D.09 STAFFING STANDARDS.
335.18    Subdivision 1. Staffing requirements. The license holder must provide the level of
335.19 direct service support staff sufficient supervision, assistance, and training necessary:
335.20(1) to ensure the health, safety, and protection of rights of each person; and
335.21(2) to be able to implement the responsibilities assigned to the license holder in each
335.22person's coordinated service and support plan or identified in the coordinated service and
335.23support plan addendum, according to the requirements of this chapter.
335.24    Subd. 2. Supervision of staff having direct contact. Except for a license holder
335.25who is the sole direct service support staff, the license holder must provide adequate
335.26supervision of staff providing direct service support to ensure the health, safety, and
335.27protection of rights of each person and implementation of the responsibilities assigned to
335.28the license holder in each person's service plan coordinated service and support plan or
335.29coordinated service and support plan addendum.
335.30    Subd. 3. Staff qualifications. (a) The license holder must ensure that staff is
335.31 providing direct support, or staff who have responsibilities related to supervising or
335.32managing the provision of direct support service, are competent as demonstrated through
335.33 skills and knowledge training, experience, and education to meet the person's needs
335.34and additional requirements as written in the coordinated service and support plan or
336.1coordinated service and support plan addendum, or when otherwise required by the case
336.2manager or the federal waiver plan. The license holder must verify and maintain evidence
336.3of staff competency, including documentation of:
336.4(1) education and experience qualifications relevant to the job responsibilities
336.5assigned to the staff and the needs of the general population of persons served by the
336.6program, including a valid degree and transcript, or a current license, registration, or
336.7certification, when a degree or licensure, registration, or certification is required by this
336.8chapter or in the coordinated service and support plan or coordinated service and support
336.9plan addendum;
336.10(2) completion of required demonstrated competency in the orientation and training
336.11 areas required under this chapter, including and when applicable, completion of continuing
336.12education required to maintain professional licensure, registration, or certification
336.13requirements. Competency in these areas is determined by the license holder through
336.14knowledge testing and observed skill assessment conducted by the trainer or instructor; and
336.15(3) except for a license holder who is the sole direct service support staff, periodic
336.16 performance evaluations completed by the license holder of the direct service support staff
336.17person's ability to perform the job functions based on direct observation.
336.18(b) Staff under 18 years of age may not perform overnight duties or administer
336.19medication.
336.20    Subd. 4. Orientation to program requirements. (a) Except for a license holder
336.21who does not supervise any direct service support staff, within 90 days of hiring direct
336.22service staff 60 days of hire, unless stated otherwise, the license holder must provide
336.23and ensure completion of 30 hours of orientation for direct support staff that combines
336.24supervised on-the-job training with review of and instruction on in the following areas:
336.25(1) the job description and how to complete specific job functions, including:
336.26(i) responding to and reporting incidents as required under section 245D.06,
336.27subdivision 1; and
336.28(ii) following safety practices established by the license holder and as required in
336.29section 245D.06, subdivision 2;
336.30(2) the license holder's current policies and procedures required under this chapter,
336.31including their location and access, and staff responsibilities related to implementation
336.32of those policies and procedures;
336.33(3) data privacy requirements according to sections 13.01 to 13.10 and 13.46, the
336.34federal Health Insurance Portability and Accountability Act of 1996 (HIPAA), and staff
336.35responsibilities related to complying with data privacy practices;
337.1(4) the service recipient rights under section 245D.04, and staff responsibilities
337.2related to ensuring the exercise and protection of those rights according to the requirements
337.3in section 245D.04;
337.4(5) sections 245A.65, 245A.66, 626.556, and 626.557, governing maltreatment
337.5reporting and service planning for children and vulnerable adults, and staff responsibilities
337.6related to protecting persons from maltreatment and reporting maltreatment. This
337.7orientation must be provided within 72 hours of first providing direct contact services and
337.8annually thereafter according to section 245A.65, subdivision 3;
337.9(6) what constitutes use of restraints, seclusion, and psychotropic medications,
337.10and staff responsibilities related to the prohibitions of their use the principles of
337.11person-centered service planning and delivery as identified in section 245D.07, subdivision
337.121a, and how they apply to direct support service provided by the staff person; and
337.13(7) other topics as determined necessary in the person's coordinated service and
337.14support plan by the case manager or other areas identified by the license holder.
337.15(b) License holders who provide direct service themselves must complete the
337.16orientation required in paragraph (a), clauses (3) to (7).
337.17    Subd. 4a. Orientation to individual service recipient needs. (c) (a) Before
337.18providing having unsupervised direct service to contact with a person served by the
337.19program, or for whom the staff person has not previously provided direct service support,
337.20or any time the plans or procedures identified in clauses (1) and (2) paragraphs (b) to
337.21(f) are revised, the staff person must review and receive instruction on the following
337.22as it relates requirements in paragraphs (b) to (f) as they relate to the staff person's job
337.23functions for that person:.
337.24(b) Training and competency evaluations must include the following:
337.25(1) appropriate and safe techniques in personal hygiene and grooming, including
337.26hair care, bathing, care of teeth, gums, oral prosthetic devices, and other activities of daily
337.27living (ADLs) as defined under section 256B.0659, subdivision 1;
337.28(2) an understanding of what constitutes a healthy diet according to data from the
337.29Centers for Disease Control and Prevention and the skills necessary to prepare that diet;
337.30(3) skills necessary to provide appropriate support in instrumental activities of daily
337.31living (IADLs) as defined under section 256B.0659, subdivision 1; and
337.32(4) demonstrated competence in providing first aid.
337.33(1) (c) The staff person must review and receive instruction on the person's
337.34 coordinated service and support plan or coordinated service and support plan addendum as
337.35it relates to the responsibilities assigned to the license holder, and when applicable, the
337.36person's individual abuse prevention plan according to section 245A.65, to achieve and
338.1demonstrate an understanding of the person as a unique individual, and how to implement
338.2those plans; and.
338.3(2) (d) The staff person must review and receive instruction on medication
338.4administration procedures established for the person when medication administration is
338.5 assigned to the license holder according to section 245D.05, subdivision 1, paragraph
338.6(b). Unlicensed staff may administer medications only after successful completion of a
338.7medication administration training, from a training curriculum developed by a registered
338.8nurse, clinical nurse specialist in psychiatric and mental health nursing, certified nurse
338.9practitioner, physician's assistant, or physician incorporating. The training curriculum
338.10must incorporate an observed skill assessment conducted by the trainer to ensure staff
338.11demonstrate the ability to safely and correctly follow medication procedures.
338.12Medication administration must be taught by a registered nurse, clinical nurse
338.13specialist, certified nurse practitioner, physician's assistant, or physician if, at the time of
338.14service initiation or any time thereafter, the person has or develops a health care condition
338.15that affects the service options available to the person because the condition requires:
338.16(i) (1) specialized or intensive medical or nursing supervision; and
338.17(ii) (2) nonmedical service providers to adapt their services to accommodate the
338.18health and safety needs of the person; and.
338.19(iii) necessary training in order to meet the health service needs of the person as
338.20determined by the person's physician.
338.21(e) The staff person must review and receive instruction on the safe and correct
338.22operation of medical equipment used by the person to sustain life, including but not
338.23limited to ventilators, feeding tubes, or endotracheal tubes. The training must be provided
338.24by a licensed health care professional or a manufacturer's representative and incorporate
338.25an observed skill assessment to ensure staff demonstrate the ability to safely and correctly
338.26operate the equipment according to the treatment orders and the manufacturer's instructions.
338.27(f) The staff person must review and receive instruction on what constitutes use of
338.28restraints, time out, and seclusion, including chemical restraint, and staff responsibilities
338.29related to the prohibitions of their use according to the requirements in section 245D.06,
338.30subdivision 5, why such procedures are not effective for reducing or eliminating symptoms
338.31or undesired behavior and why they are not safe, and the safe and correct use of manual
338.32restraint on an emergency basis according to the requirements in section 245D.061.
338.33(g) In the event of an emergency service initiation, the license holder must ensure
338.34the training required in this subdivision occurs within 72 hours of the direct support staff
338.35person first having unsupervised contact with the person receiving services. The license
339.1holder must document the reason for the unplanned or emergency service initiation and
339.2maintain the documentation in the person's service recipient record.
339.3(h) License holders who provide direct support services themselves must complete
339.4the orientation required in subdivision 4, clauses (3) to (7).
339.5    Subd. 5. Annual training. (a) A license holder must provide annual training
339.6to direct service support staff on the topics identified in subdivision 4, paragraph (a),
339.7 clauses (3) to (6) (7), and subdivision 4a. A license holder must provide a minimum of 24
339.8hours of annual training to direct service staff with fewer than five years of documented
339.9experience and 12 hours of annual training to direct service staff with five or more years
339.10of documented experience in topics described in subdivisions 4 and 4a, paragraphs (a)
339.11to (h). Training on relevant topics received from sources other than the license holder
339.12may count toward training requirements.
339.13(b) A license holder providing behavioral programming, specialist services, personal
339.14support, 24-hour emergency assistance, night supervision, independent living skills,
339.15structured day, prevocational, or supported employment services must provide a minimum
339.16of eight hours of annual training to direct service staff that addresses:
339.17(1) topics related to the general health, safety, and service needs of the population
339.18served by the license holder; and
339.19(2) other areas identified by the license holder or in the person's current service plan.
339.20Training on relevant topics received from sources other than the license holder
339.21may count toward training requirements.
339.22(c) When the license holder is the owner, lessor, or tenant of the service site and
339.23whenever a person receiving services is present at the site, the license holder must have
339.24a staff person available on site who is trained in basic first aid and, when required in a
339.25person's service plan, cardiopulmonary resuscitation.
339.26    Subd. 5a. Alternative sources of training. Orientation or training received by the
339.27staff person from sources other than the license holder in the same subjects as identified
339.28in subdivision 4 may count toward the orientation and annual training requirements if
339.29received in the 12-month period before the staff person's date of hire. The license holder
339.30must maintain documentation of the training received from other sources and of each staff
339.31person's competency in the required area according to the requirements in subdivision 3.
339.32    Subd. 6. Subcontractors and temporary staff. If the license holder uses a
339.33subcontractor or temporary staff to perform services licensed under this chapter on the
339.34license holder's behalf, the license holder must ensure that the subcontractor or temporary
339.35staff meets and maintains compliance with all requirements under this chapter that apply
339.36to the services to be provided, including training, orientation, and supervision necessary
340.1to fulfill their responsibilities. The license holder must ensure that a background study
340.2has been completed according to the requirements in sections 245C.03, subdivision 1,
340.3and 245C.04. Subcontractors and temporary staff hired by the license holder must meet
340.4the Minnesota licensing requirements applicable to the disciplines in which they are
340.5providing services. The license holder must maintain documentation that the applicable
340.6requirements have been met.
340.7    Subd. 7. Volunteers. The license holder must ensure that volunteers who provide
340.8direct support services to persons served by the program receive the training, orientation,
340.9and supervision necessary to fulfill their responsibilities. The license holder must ensure
340.10that a background study has been completed according to the requirements in sections
340.11245C.03, subdivision 1, and 245C.04. The license holder must maintain documentation
340.12that the applicable requirements have been met.
340.13    Subd. 8. Staff orientation and training plan. The license holder must develop
340.14a staff orientation and training plan documenting when and how compliance with
340.15subdivisions 4, 4a, and 5 will be met.
340.16EFFECTIVE DATE.This section is effective January 1, 2014.

340.17    Sec. 29. [245D.091] INTERVENTION SERVICES.
340.18    Subdivision 1. Licensure requirements. An individual meeting the staff
340.19qualification requirements of this section who is an employee of a program licensed
340.20according to this chapter and providing behavioral support services, specialist services,
340.21or crisis respite services is not required to hold a separate license under this chapter.
340.22An individual meeting the staff qualifications of this section who is not providing these
340.23services as an employee of a program licensed according to this chapter must obtain a
340.24license according to this chapter.
340.25    Subd. 2. Behavior professional qualifications. A behavior professional, as defined
340.26in the brain injury and community alternatives for disabled individuals waiver plans or
340.27successor plans, must have competencies in areas related to:
340.28(1) ethical considerations;
340.29(2) functional assessment;
340.30(3) functional analysis;
340.31(4) measurement of behavior and interpretation of data;
340.32(5) selecting intervention outcomes and strategies;
340.33(6) behavior reduction and elimination strategies that promote least restrictive
340.34approved alternatives;
340.35(7) data collection;
341.1(8) staff and caregiver training;
341.2(9) support plan monitoring;
341.3(10) co-occurring mental disorders or neuro-cognitive disorder;
341.4(11) demonstrated expertise with populations being served; and
341.5(12) must be a:
341.6(i) psychologist licensed under sections 148.88 to 148.98, who has stated to the
341.7Board of Psychology competencies in the above identified areas;
341.8(ii) clinical social worker licensed as an independent clinical social worker under
341.9chapter 148D, or a person with a master's degree in social work from an accredited college
341.10or university, with at least 4,000 hours of post-master's supervised experience in the
341.11delivery of clinical services in the areas identified in clauses (1) to (11);
341.12(iii) physician licensed under chapter 147 and certified by the American Board
341.13of Psychiatry and Neurology or eligible for board certification in psychiatry with
341.14competencies in the areas identified in clauses (1) to (11);
341.15(iv) licensed professional clinical counselor licensed under sections 148B.29 to
341.16148B.39 with at least 4,000 hours of post-master's supervised experience in the delivery
341.17of clinical services who has demonstrated competencies in the areas identified in clauses
341.18(1) to (11);
341.19(v) person with a master's degree from an accredited college or university in one
341.20of the behavioral sciences or related fields, with at least 4,000 hours of post-master's
341.21supervised experience in the delivery of clinical services with demonstrated competencies
341.22in the areas identified in clauses (1) to (11); or
341.23(vi) registered nurse who is licensed under sections 148.171 to 148.285, and who is
341.24certified as a clinical specialist or as a nurse practitioner in adult or family psychiatric and
341.25mental health nursing by a national nurse certification organization, or who has a master's
341.26degree in nursing or one of the behavioral sciences or related fields from an accredited
341.27college or university or its equivalent, with at least 4,000 hours of post-master's supervised
341.28experience in the delivery of clinical services.
341.29    Subd. 3. Behavior analyst qualifications. (a) A behavior analyst, as defined in
341.30the brain injury and community alternatives for disabled individuals waiver plans or
341.31successor plans, must:
341.32(1) have obtained a baccalaureate degree, master's degree, or PhD in a social services
341.33discipline; or
341.34(2) meet the qualifications of a mental health practitioner as defined in section
341.35245.462, subdivision 17.
341.36(b) In addition, a behavior analyst must:
342.1(1) have four years of supervised experience working with individuals who exhibit
342.2challenging behaviors as well as co-occurring mental disorders or neuro-cognitive disorder;
342.3(2) have received ten hours of instruction in functional assessment and functional
342.4analysis;
342.5(3) have received 20 hours of instruction in the understanding of the function of
342.6behavior;
342.7(4) have received ten hours of instruction on design of positive practices behavior
342.8support strategies;
342.9(5) have received 20 hours of instruction on the use of behavior reduction approved
342.10strategies used only in combination with behavior positive practices strategies;
342.11(6) be determined by a behavior professional to have the training and prerequisite
342.12skills required to provide positive practice strategies as well as behavior reduction
342.13approved and permitted intervention to the person who receives behavioral support; and
342.14(7) be under the direct supervision of a behavior professional.
342.15    Subd. 4. Behavior specialist qualifications. (a) A behavior specialist, as defined
342.16in the brain injury and community alternatives for disabled individuals waiver plans or
342.17successor plans, must meet the following qualifications:
342.18(1) have an associate's degree in a social services discipline; or
342.19(2) have two years of supervised experience working with individuals who exhibit
342.20challenging behaviors as well as co-occurring mental disorders or neuro-cognitive disorder.
342.21(b) In addition, a behavior specialist must:
342.22(1) have received a minimum of four hours of training in functional assessment;
342.23(2) have received 20 hours of instruction in the understanding of the function of
342.24behavior;
342.25(3) have received ten hours of instruction on design of positive practices behavioral
342.26support strategies;
342.27(4) be determined by a behavior professional to have the training and prerequisite
342.28skills required to provide positive practices strategies as well as behavior reduction
342.29approved intervention to the person who receives behavioral support; and
342.30(5) be under the direct supervision of a behavior professional.
342.31    Subd. 5. Specialist services qualifications. An individual providing specialist
342.32services, as defined in the developmental disabilities waiver plan or successor plan, must
342.33have:
342.34(1) the specific experience and skills required of the specialist to meet the needs of
342.35the person identified by the person's service planning team; and
343.1(2) the qualifications of the specialist identified in the person's coordinated service
343.2and support plan.
343.3EFFECTIVE DATE.This section is effective January 1, 2014.

343.4    Sec. 30. [245D.095] RECORD REQUIREMENTS.
343.5    Subdivision 1. Record-keeping systems. The license holder must ensure that the
343.6content and format of service recipient, personnel, and program records are uniform and
343.7legible according to the requirements of this chapter.
343.8    Subd. 2. Admission and discharge register. The license holder must keep a written
343.9or electronic register, listing in chronological order the dates and names of all persons
343.10served by the program who have been admitted, discharged, or transferred, including
343.11service terminations initiated by the license holder and deaths.
343.12    Subd. 3. Service recipient record. (a) The license holder must maintain a record of
343.13current services provided to each person on the premises where the services are provided
343.14or coordinated. When the services are provided in a licensed facility, the records must
343.15be maintained at the facility, otherwise the records must be maintained at the license
343.16holder's program office. The license holder must protect service recipient records against
343.17loss, tampering, or unauthorized disclosure according to the requirements in sections
343.1813.01 to 13.10 and 13.46.
343.19(b) The license holder must maintain the following information for each person:
343.20(1) an admission form signed by the person or the person's legal representative
343.21that includes:
343.22(i) identifying information, including the person's name, date of birth, address,
343.23and telephone number; and
343.24(ii) the name, address, and telephone number of the person's legal representative, if
343.25any, and a primary emergency contact, the case manager, and family members or others as
343.26identified by the person or case manager;
343.27(2) service information, including service initiation information, verification of the
343.28person's eligibility for services, documentation verifying that services have been provided
343.29as identified in the coordinated service and support plan or coordinated service and support
343.30plan addendum according to paragraph (a), and date of admission or readmission;
343.31(3) health information, including medical history, special dietary needs, and
343.32allergies, and when the license holder is assigned responsibility for meeting the person's
343.33health service needs according to section 245D.05:
344.1(i) current orders for medication, treatments, or medical equipment and a signed
344.2authorization from the person or the person's legal representative to administer or assist in
344.3administering the medication or treatments, if applicable;
344.4(ii) a signed statement authorizing the license holder to act in a medical emergency
344.5when the person's legal representative, if any, cannot be reached or is delayed in arriving;
344.6(iii) medication administration procedures;
344.7(iv) a medication administration record documenting the implementation of the
344.8medication administration procedures, and the medication administration record reviews,
344.9including any agreements for administration of injectable medications by the license
344.10holder according to the requirements in section 245D.05; and
344.11(v) a medical appointment schedule when the license holder is assigned
344.12responsibility for assisting with medical appointments;
344.13(4) the person's current coordinated service and support plan or that portion of the
344.14plan assigned to the license holder;
344.15(5) copies of the individual abuse prevention plan and assessments as required under
344.16section 245D.071, subdivisions 2 and 3;
344.17(6) a record of other service providers serving the person when the person's
344.18coordinated service and support plan or coordinated service and support plan addendum
344.19identifies the need for coordination between the service providers, that includes a contact
344.20person and telephone numbers, services being provided, and names of staff responsible for
344.21coordination;
344.22(7) documentation of orientation to service recipient rights according to section
344.23245D.04, subdivision 1, and maltreatment reporting policies and procedures according to
344.24section 245A.65, subdivision 1, paragraph (c);
344.25(8) copies of authorizations to handle a person's funds, according to section 245D.06,
344.26subdivision 4, paragraph (a);
344.27(9) documentation of complaints received and grievance resolution;
344.28(10) incident reports involving the person, required under section 245D.06,
344.29subdivision 1;
344.30(11) copies of written reports regarding the person's status when requested according
344.31to section 245D.07, subdivision 3, progress review reports as required under section
344.32245D.071, subdivision 5, progress or daily log notes that are recorded by the program,
344.33and reports received from other agencies involved in providing services or care to the
344.34person; and
344.35(12) discharge summary, including service termination notice and related
344.36documentation, when applicable.
345.1    Subd. 4. Access to service recipient records. The license holder must ensure that
345.2the following people have access to the information in subdivision 1 in accordance with
345.3applicable state and federal laws, regulations, or rules:
345.4(1) the person, the person's legal representative, and anyone properly authorized
345.5by the person;
345.6(2) the person's case manager;
345.7(3) staff providing services to the person unless the information is not relevant to
345.8carrying out the coordinated service and support plan or coordinated service and support
345.9plan addendum; and
345.10(4) the county child or adult foster care licensor, when services are also licensed as
345.11child or adult foster care.
345.12    Subd. 5. Personnel records. (a) The license holder must maintain a personnel
345.13record of each employee to document and verify staff qualifications, orientation, and
345.14training. The personnel record must include:
345.15(1) the employee's date of hire, completed application, an acknowledgement signed
345.16by the employee that job duties were reviewed with the employee and the employee
345.17understands those duties, and documentation that the employee meets the position
345.18requirements as determined by the license holder;
345.19 (2) documentation of staff qualifications, orientation, training, and performance
345.20evaluations as required under section 245D.09, subdivisions 3 to 5, including the date
345.21the training was completed, the number of hours per subject area, and the name of the
345.22trainer or instructor; and
345.23(3) a completed background study as required under chapter 245C.
345.24(b) For employees hired after January 1, 2014, the license holder must maintain
345.25documentation in the personnel record or elsewhere, sufficient to determine the date of the
345.26employee's first supervised direct contact with a person served by the program, and the
345.27date of first unsupervised direct contact with a person served by the program.
345.28EFFECTIVE DATE.This section is effective January 1, 2014.

345.29    Sec. 31. Minnesota Statutes 2012, section 245D.10, is amended to read:
345.30245D.10 POLICIES AND PROCEDURES.
345.31    Subdivision 1. Policy and procedure requirements. The A license holder
345.32 providing either basic or intensive supports and services must establish, enforce, and
345.33maintain policies and procedures as required in this chapter, chapter 245A, and other
346.1applicable state and federal laws and regulations governing the provision of home and
346.2community-based services licensed according to this chapter.
346.3    Subd. 2. Grievances. The license holder must establish policies and procedures
346.4that provide promote service recipient rights by providing a simple complaint process for
346.5persons served by the program and their authorized representatives to bring a grievance that:
346.6(1) provides staff assistance with the complaint process when requested, and the
346.7addresses and telephone numbers of outside agencies to assist the person;
346.8(2) allows the person to bring the complaint to the highest level of authority in the
346.9program if the grievance cannot be resolved by other staff members, and that provides
346.10the name, address, and telephone number of that person;
346.11(3) requires the license holder to promptly respond to all complaints affecting a
346.12person's health and safety. For all other complaints, the license holder must provide an
346.13initial response within 14 calendar days of receipt of the complaint. All complaints must
346.14be resolved within 30 calendar days of receipt or the license holder must document the
346.15reason for the delay and a plan for resolution;
346.16(4) requires a complaint review that includes an evaluation of whether:
346.17(i) related policies and procedures were followed and adequate;
346.18(ii) there is a need for additional staff training;
346.19(iii) the complaint is similar to past complaints with the persons, staff, or services
346.20involved; and
346.21(iv) there is a need for corrective action by the license holder to protect the health
346.22and safety of persons receiving services;
346.23(5) based on the review in clause (4), requires the license holder to develop,
346.24document, and implement a corrective action plan designed to correct current lapses and
346.25prevent future lapses in performance by staff or the license holder, if any;
346.26(6) provides a written summary of the complaint and a notice of the complaint
346.27resolution to the person and case manager that:
346.28(i) identifies the nature of the complaint and the date it was received;
346.29(ii) includes the results of the complaint review;
346.30(iii) identifies the complaint resolution, including any corrective action; and
346.31(7) requires that the complaint summary and resolution notice be maintained in the
346.32service recipient record.
346.33    Subd. 3. Service suspension and service termination. (a) The license holder must
346.34establish policies and procedures for temporary service suspension and service termination
346.35that promote continuity of care and service coordination with the person and the case
346.36manager and with other licensed caregivers, if any, who also provide support to the person.
347.1(b) The policy must include the following requirements:
347.2(1) the license holder must notify the person or the person's legal representative and
347.3case manager in writing of the intended termination or temporary service suspension, and
347.4the person's right to seek a temporary order staying the termination of service according to
347.5the procedures in section 256.045, subdivision 4a, or 6, paragraph (c);
347.6(2) notice of the proposed termination of services, including those situations
347.7that began with a temporary service suspension, must be given at least 60 days before
347.8the proposed termination is to become effective when a license holder is providing
347.9independent living skills training, structured day, prevocational or supported employment
347.10services to the person intensive supports and services identified in section 245D.03,
347.11subdivision 1, paragraph (c), and 30 days prior to termination for all other services
347.12licensed under this chapter;
347.13(3) the license holder must provide information requested by the person or case
347.14manager when services are temporarily suspended or upon notice of termination;
347.15(4) prior to giving notice of service termination or temporary service suspension,
347.16the license holder must document actions taken to minimize or eliminate the need for
347.17service suspension or termination;
347.18(5) during the temporary service suspension or service termination notice period,
347.19the license holder will work with the appropriate county agency to develop reasonable
347.20alternatives to protect the person and others;
347.21(6) the license holder must maintain information about the service suspension or
347.22termination, including the written termination notice, in the service recipient record; and
347.23(7) the license holder must restrict temporary service suspension to situations in
347.24which the person's behavior causes immediate and serious danger to the health and safety
347.25of the person or others conduct poses an imminent risk of physical harm to self or others
347.26and less restrictive or positive support strategies would not achieve safety.
347.27    Subd. 4. Availability of current written policies and procedures. (a) The license
347.28holder must review and update, as needed, the written policies and procedures required
347.29under this chapter.
347.30(b)(1) The license holder must inform the person and case manager of the policies
347.31and procedures affecting a person's rights under section 245D.04, and provide copies of
347.32those policies and procedures, within five working days of service initiation.
347.33(2) If a license holder only provides basic services and supports, this includes the:
347.34(i) grievance policy and procedure required under subdivision 2; and
347.35(ii) service suspension and termination policy and procedure required under
347.36subdivision 3.
348.1(3) For all other license holders this includes the:
348.2(i) policies and procedures in clause (2);
348.3(ii) emergency use of manual restraints policy and procedure required under
348.4subdivision 3a; and
348.5(iii) data privacy requirements under section 245D.11, subdivision 3.
348.6(c) The license holder must provide a written notice to all persons or their legal
348.7representatives and case managers at least 30 days before implementing any revised
348.8policies and procedures procedural revisions to policies affecting a person's service-related
348.9or protection-related rights under section 245D.04 and maltreatment reporting policies and
348.10procedures. The notice must explain the revision that was made and include a copy of the
348.11revised policy and procedure. The license holder must document the reason reasonable
348.12cause for not providing the notice at least 30 days before implementing the revisions.
348.13(d) Before implementing revisions to required policies and procedures, the license
348.14holder must inform all employees of the revisions and provide training on implementation
348.15of the revised policies and procedures.
348.16(e) The license holder must annually notify all persons, or their legal representatives,
348.17and case managers of any procedural revisions to policies required under this chapter,
348.18other than those in paragraph (c). Upon request, the license holder must provide the
348.19person, or the person's legal representative, and case manager with copies of the revised
348.20policies and procedures.
348.21EFFECTIVE DATE.This section is effective January 1, 2014.

348.22    Sec. 32. [245D.11] POLICIES AND PROCEDURES; INTENSIVE SUPPORT
348.23SERVICES.
348.24    Subdivision 1. Policy and procedure requirements. A license holder providing
348.25intensive support services as identified in section 245D.03, subdivision 1, paragraph (c),
348.26must establish, enforce, and maintain policies and procedures as required in this section.
348.27    Subd. 2. Health and safety. The license holder must establish policies and
348.28procedures that promote health and safety by ensuring:
348.29(1) use of universal precautions and sanitary practices in compliance with section
348.30245D.06, subdivision 2, clause (5);
348.31(2) if the license holder operates a residential program, health service coordination
348.32and care according to the requirements in section 245D.05, subdivision 1;
348.33(3) safe medication assistance and administration according to the requirements
348.34in sections 245D.05, subdivisions 1a, 2, and 5, and 245D.051, that are established in
348.35consultation with a registered nurse, nurse practitioner, physician's assistant, or medical
349.1doctor and require completion of medication administration training according to the
349.2requirements in section 245D.09, subdivision 4a, paragraph (c). Medication assistance
349.3and administration includes, but is not limited to:
349.4(i) providing medication-related services for a person;
349.5(ii) medication setup;
349.6(iii) medication administration;
349.7(iv) medication storage and security;
349.8(v) medication documentation and charting;
349.9(vi) verification and monitoring of effectiveness of systems to ensure safe medication
349.10handling and administration;
349.11(vii) coordination of medication refills;
349.12(viii) handling changes to prescriptions and implementation of those changes;
349.13(ix) communicating with the pharmacy; and
349.14(x) coordination and communication with prescriber;
349.15(4) safe transportation, when the license holder is responsible for transportation of
349.16persons, with provisions for handling emergency situations according to the requirements
349.17in section 245D.06, subdivision 2, clauses (2) to (4);
349.18(5) a plan for ensuring the safety of persons served by the program in emergencies as
349.19defined in section 245D.02, subdivision 8, and procedures for staff to report emergencies
349.20to the license holder. A license holder with a community residential setting or a day service
349.21facility license must ensure the policy and procedures comply with the requirements in
349.22section 245D.22, subdivision 4;
349.23(6) a plan for responding to all incidents as defined in section 245D.02, subdivision
349.2411; and reporting all incidents required to be reported according to section 245D.06,
349.25subdivision 1. The plan must:
349.26(i) provide the contact information of a source of emergency medical care and
349.27transportation; and
349.28(ii) require staff to first call 911 when the staff believes a medical emergency may be
349.29life threatening, or to call the mental health crisis intervention team when the person is
349.30experiencing a mental health crisis; and
349.31(7) a procedure for the review of incidents and emergencies to identify trends or
349.32patterns, and corrective action if needed. The license holder must establish and maintain
349.33a record-keeping system for the incident and emergency reports. Each incident and
349.34emergency report file must contain a written summary of the incident. The license holder
349.35must conduct a review of incident reports for identification of incident patterns, and
350.1implementation of corrective action as necessary to reduce occurrences. Each incident
350.2report must include:
350.3(i) the name of the person or persons involved in the incident. It is not necessary
350.4to identify all persons affected by or involved in an emergency unless the emergency
350.5resulted in an incident;
350.6(ii) the date, time, and location of the incident or emergency;
350.7(iii) a description of the incident or emergency;
350.8(iv) a description of the response to the incident or emergency and whether a person's
350.9coordinated service and support plan addendum or program policies and procedures were
350.10implemented as applicable;
350.11(v) the name of the staff person or persons who responded to the incident or
350.12emergency; and
350.13(vi) the determination of whether corrective action is necessary based on the results
350.14of the review.
350.15    Subd. 3. Data privacy. The license holder must establish policies and procedures that
350.16promote service recipient rights by ensuring data privacy according to the requirements in:
350.17(1) the Minnesota Government Data Practices Act, section 13.46, and all other
350.18applicable Minnesota laws and rules in handling all data related to the services provided;
350.19and
350.20(2) the Health Insurance Portability and Accountability Act of 1996 (HIPAA), to the
350.21extent that the license holder performs a function or activity involving the use of protected
350.22health information as defined under Code of Federal Regulations, title 45, section 164.501,
350.23including, but not limited to, providing health care services; health care claims processing
350.24or administration; data analysis, processing, or administration; utilization review; quality
350.25assurance; billing; benefit management; practice management; repricing; or as otherwise
350.26provided by Code of Federal Regulations, title 45, section 160.103. The license holder
350.27must comply with the Health Insurance Portability and Accountability Act of 1996 and
350.28its implementing regulations, Code of Federal Regulations, title 45, parts 160 to 164,
350.29and all applicable requirements.
350.30    Subd. 4. Admission criteria. The license holder must establish policies and
350.31procedures that promote continuity of care by ensuring that admission or service initiation
350.32criteria:
350.33(1) is consistent with the license holder's registration information identified in the
350.34requirements in section 245D.031, subdivision 2, and with the service-related rights
350.35identified in section 245D.04, subdivisions 2, clauses (4) to (7), and 3, clause (8);
351.1(2) identifies the criteria to be applied in determining whether the license holder
351.2can develop services to meet the needs specified in the person's coordinated service and
351.3support plan;
351.4(3) requires a license holder providing services in a health care facility to comply
351.5with the requirements in section 243.166, subdivision 4b, to provide notification to
351.6residents when a registered predatory offender is admitted into the program or to a
351.7potential admission when the facility was already serving a registered predatory offender.
351.8For purposes of this clause, "health care facility" means a facility licensed by the
351.9commissioner as a residential facility under chapter 245A to provide adult foster care or
351.10residential services to persons with disabilities; and
351.11(4) requires that when a person or the person's legal representative requests services
351.12from the license holder, a refusal to admit the person must be based on an evaluation of
351.13the person's assessed needs and the license holder's lack of capacity to meet the needs of
351.14the person. The license holder must not refuse to admit a person based solely on the
351.15type of residential services the person is receiving, or solely on the person's severity of
351.16disability, orthopedic or neurological handicaps, sight or hearing impairments, lack of
351.17communication skills, physical disabilities, toilet habits, behavioral disorders, or past
351.18failure to make progress. Documentation of the basis for refusal must be provided to the
351.19person or the person's legal representative and case manager upon request.
351.20EFFECTIVE DATE.This section is effective January 1, 2014.

351.21    Sec. 33. [245D.21] FACILITY LICENSURE REQUIREMENTS AND
351.22APPLICATION PROCESS.
351.23    Subdivision 1. Community residential settings and day service facilities. For
351.24purposes of this section, "facility" means both a community residential setting and day
351.25service facility and the physical plant.
351.26    Subd. 2. Inspections and code compliance. (a) Physical plants must comply with
351.27applicable state and local fire, health, building, and zoning codes.
351.28(b)(1) The facility must be inspected by a fire marshal or their delegate within
351.2912 months before initial licensure to verify that it meets the applicable occupancy
351.30requirements as defined in the State Fire Code and that the facility complies with the fire
351.31safety standards for that occupancy code contained in the State Fire Code.
351.32(2) The fire marshal inspection of a community residential setting must verify the
351.33residence is a dwelling unit within a residential occupancy as defined in section 9.117 of
351.34the State Fire Code. A home safety checklist, approved by the commissioner, must be
352.1completed for a community residential setting by the license holder and the commissioner
352.2before the satellite license is reissued.
352.3(3) The facility shall be inspected according to the facility capacity specified on the
352.4initial application form.
352.5(4) If the commissioner has reasonable cause to believe that a potentially hazardous
352.6condition may be present or the licensed capacity is increased, the commissioner shall
352.7request a subsequent inspection and written report by a fire marshal to verify the absence
352.8of hazard.
352.9(5) Any condition cited by a fire marshal, building official, or health authority as
352.10hazardous or creating an immediate danger of fire or threat to health and safety must be
352.11corrected before a license is issued by the department, and for community residential
352.12settings, before a license is reissued.
352.13(c) The facility must maintain in a permanent file the reports of health, fire, and
352.14other safety inspections.
352.15(d) The facility's plumbing, ventilation, heating, cooling, lighting, and other
352.16fixtures and equipment, including elevators or food service, if provided, must conform to
352.17applicable health, sanitation, and safety codes and regulations.
352.18EFFECTIVE DATE.This section is effective January 1, 2014.

352.19    Sec. 34. [245D.22] FACILITY SANITATION AND HEALTH.
352.20    Subdivision 1. General maintenance. The license holder must maintain the interior
352.21and exterior of buildings, structures, or enclosures used by the facility, including walls,
352.22floors, ceilings, registers, fixtures, equipment, and furnishings in good repair and in a
352.23sanitary and safe condition. The facility must be clean and free from accumulations of
352.24dirt, grease, garbage, peeling paint, mold, vermin, and insects. The license holder must
352.25correct building and equipment deterioration, safety hazards, and unsanitary conditions.
352.26    Subd. 2. Hazards and toxic substances. The license holder must ensure that
352.27service sites owned or leased by the license holder are free from hazards that would
352.28threaten the health or safety of a person receiving services by ensuring the requirements
352.29in paragraphs (a) to (g) are met.
352.30(a) Chemicals, detergents, and other hazardous or toxic substances must not be
352.31stored with food products or in any way that poses a hazard to persons receiving services.
352.32(b) The license holder must install handrails and nonslip surfaces on interior and
352.33exterior runways, stairways, and ramps according to the applicable building code.
353.1(c) If there are elevators in the facility, the license holder must have elevators
353.2inspected each year. The date of the inspection, any repairs needed, and the date the
353.3necessary repairs were made must be documented.
353.4(d) The license holder must keep stairways, ramps, and corridors free of obstructions.
353.5(e) Outside property must be free from debris and safety hazards. Exterior stairs and
353.6walkways must be kept free of ice and snow.
353.7(f) Heating, ventilation, air conditioning units, and other hot surfaces and moving
353.8parts of machinery must be shielded or enclosed.
353.9(g) Use of dangerous items or equipment by persons served by the program must be
353.10allowed in accordance with the person's coordinated service and support plan addendum
353.11or the program abuse prevention plan, if not addressed in the coordinated service and
353.12support plan addendum.
353.13    Subd. 3. Storage and disposal of medication. Schedule II controlled substances in
353.14the facility that are named in section 152.02, subdivision 3, must be stored in a locked
353.15storage area permitting access only by persons and staff authorized to administer the
353.16medication. This must be incorporated into the license holder's medication administration
353.17policy and procedures required under section 245D.11, subdivision 2, clause (3).
353.18Medications must be disposed of according to the Environmental Protection Agency
353.19recommendations.
353.20    Subd. 4. First aid must be available on site. (a) A staff person trained in first
353.21aid must be available on site and, when required in a person's coordinated service and
353.22support plan or coordinated service and support plan addendum, be able to provide
353.23cardiopulmonary resuscitation, whenever persons are present and staff are required to be
353.24at the site to provide direct service. The CPR training must include in-person instruction,
353.25hands-on practice, and an observed skills assessment under the direct supervision of a
353.26CPR instructor.
353.27(b) A facility must have first aid kits readily available for use by, and that meet
353.28the needs of, persons receiving services and staff. At a minimum, the first aid kit must
353.29be equipped with accessible first aid supplies including bandages, sterile compresses,
353.30scissors, an ice bag or cold pack, an oral or surface thermometer, mild liquid soap,
353.31adhesive tape, and first aid manual.
353.32    Subd. 5. Emergencies. (a) The license holder must have a written plan for
353.33responding to emergencies as defined in section 245D.02, subdivision 8, to ensure the
353.34safety of persons served in the facility. The plan must include:
353.35(1) procedures for emergency evacuation and emergency sheltering, including:
353.36(i) how to report a fire or other emergency;
354.1(ii) procedures to notify, relocate, and evacuate occupants, including use of adaptive
354.2procedures or equipment to assist with the safe evacuation of persons with physical or
354.3sensory disabilities; and
354.4(iii) instructions on closing off the fire area, using fire extinguishers, and activating
354.5and responding to alarm systems;
354.6(2) a floor plan that identifies:
354.7(i) the location of fire extinguishers;
354.8(ii) the location of audible or visual alarm systems, including but not limited to
354.9manual fire alarm boxes, smoke detectors, fire alarm enunciators and controls, and
354.10sprinkler systems;
354.11(iii) the location of exits, primary and secondary evacuation routes, and accessible
354.12egress routes, if any; and
354.13(iv) the location of emergency shelter within the facility;
354.14(3) a site plan that identifies:
354.15(i) designated assembly points outside the facility;
354.16(ii) the locations of fire hydrants; and
354.17(iii) the routes of fire department access;
354.18(4) the responsibilities each staff person must assume in case of emergency;
354.19(5) procedures for conducting quarterly drills each year and recording the date of
354.20each drill in the file of emergency plans;
354.21(6) procedures for relocation or service suspension when services are interrupted
354.22for more than 24 hours;
354.23(7) for a community residential setting with three or more dwelling units, a floor
354.24plan that identifies the location of enclosed exit stairs; and
354.25(8) an emergency escape plan for each resident.
354.26(b) The license holder must:
354.27(1) maintain a log of quarterly fire drills on file in the facility;
354.28(2) provide an emergency response plan that is readily available to staff and persons
354.29receiving services;
354.30(3) inform each person of a designated area within the facility where the person
354.31should go for emergency shelter during severe weather and the designated assembly points
354.32outside the facility; and
354.33(4) maintain emergency contact information for persons served at the facility that
354.34can be readily accessed in an emergency.
355.1    Subd. 6. Emergency equipment. The facility must have a flashlight and a portable
355.2radio or television set that do not require electricity and can be used if a power failure
355.3occurs.
355.4    Subd. 7. Telephone and posted numbers. A facility must have a non-coin operated
355.5telephone that is readily accessible. A list of emergency numbers must be posted in a
355.6prominent location. When an area has a 911 number or a mental health crisis intervention
355.7team number, both numbers must be posted and the emergency number listed must be
355.8911. In areas of the state without a 911 number, the numbers listed must be those of the
355.9local fire department, police department, emergency transportation, and poison control
355.10center. The names and telephone numbers of each person's representative, physician, and
355.11dentist must be readily available.
355.12EFFECTIVE DATE.This section is effective January 1, 2014.

355.13    Sec. 35. [245D.23] COMMUNITY RESIDENTIAL SETTINGS; SATELLITE
355.14LICENSURE REQUIREMENTS AND APPLICATION PROCESS.
355.15    Subdivision 1. Separate satellite license required for separate sites. (a) A license
355.16holder providing residential support services must obtain a separate satellite license for
355.17each community residential setting located at separate addresses when the community
355.18residential settings are to be operated by the same license holder. For purposes of this
355.19chapter, a community residential setting is a satellite of the home and community-based
355.20services license.
355.21(b) Community residential settings are permitted single-family use homes. After a
355.22license has been issued, the commissioner shall notify the local municipality where the
355.23residence is located of the approved license.
355.24    Subd. 2. Notification to local agency. The license holder must notify the local
355.25agency within 24 hours of the onset of changes in a residence resulting from construction,
355.26remodeling, or damages requiring repairs that require a building permit or may affect a
355.27licensing requirement in this chapter.
355.28    Subd. 3. Alternate overnight supervision. A license holder granted an alternate
355.29overnight supervision technology adult foster care license according to section 245A.11,
355.30subdivision 7a, that converts to a community residential setting satellite license according
355.31to this chapter, must retain that designation.
355.32EFFECTIVE DATE.This section is effective January 1, 2014.

356.1    Sec. 36. [245D.24] COMMUNITY RESIDENTIAL SETTINGS; PHYSICAL
356.2PLANT AND ENVIRONMENT.
356.3    Subdivision 1. Occupancy. The residence must meet the definition of a dwelling
356.4unit in a residential occupancy.
356.5    Subd. 2. Common area requirements. The living area must be provided with an
356.6adequate number of furnishings for the usual functions of daily living and social activities.
356.7The dining area must be furnished to accommodate meals shared by all persons living in
356.8the residence. These furnishings must be in good repair and functional to meet the daily
356.9needs of the persons living in the residence.
356.10    Subd. 3. Bedrooms. (a) People receiving services must mutually consent, in
356.11writing, to sharing a bedroom with one another. No more than two people receiving
356.12services may share one bedroom.
356.13(b) A single occupancy bedroom must have at least 80 square feet of floor space with
356.14a 7-1/2 foot ceiling. A double occupancy room must have at least 120 square feet of floor
356.15space with a 7-1/2 foot ceiling. Bedrooms must be separated from halls, corridors, and
356.16other habitable rooms by floor to ceiling walls containing no openings except doorways
356.17and must not serve as a corridor to another room used in daily living.
356.18(c) A person's personal possessions and items for the person's own use are the only
356.19items permitted to be stored in a person's bedroom.
356.20(d) Unless otherwise documented through assessment as a safety concern for the
356.21person, each person must be provided with the following furnishings:
356.22(1) a separate bed of proper size and height for the convenience and comfort of the
356.23person, with a clean mattress in good repair;
356.24(2) clean bedding appropriate for the season for each person;
356.25(3) an individual cabinet, or dresser, shelves, and a closet, for storage of personal
356.26possessions and clothing; and
356.27(4) a mirror for grooming.
356.28(e) When possible, a person must be allowed to have items of furniture that the
356.29person personally owns in the bedroom, unless doing so would interfere with safety
356.30precautions, violate a building or fire code, or interfere with another person's use of the
356.31bedroom. A person may choose not to have a cabinet, dresser, shelves, or a mirror in the
356.32bedroom, as otherwise required under paragraph (d), clause (3) or (4). A person may
356.33choose to use a mattress other than an innerspring mattress and may choose not to have
356.34the mattress on a mattress frame or support. If a person chooses not to have a piece of
356.35required furniture, the license holder must document this choice and is not required to
356.36provide the item. If a person chooses to use a mattress other than an innerspring mattress
357.1or chooses not to have a mattress frame or support, the license holder must document this
357.2choice and allow the alternative desired by the person.
357.3(f) A person must be allowed to bring personal possessions into the bedroom
357.4and other designated storage space, if such space is available, in the residence. The
357.5person must be allowed to accumulate possessions to the extent the residence is able to
357.6accommodate them, unless doing so is contraindicated for the person's physical or mental
357.7health, would interfere with safety precautions or another person's use of the bedroom, or
357.8would violate a building or fire code. The license holder must allow for locked storage
357.9of personal items. Any restriction on the possession or locked storage of personal items,
357.10including requiring a person to use a lock provided by the license holder, must comply
357.11with section 245D.04, subdivision 3, paragraph (c), and allow the person to be present if
357.12and when the license holder opens the lock.
357.13EFFECTIVE DATE.This section is effective January 1, 2014.

357.14    Sec. 37. [245D.25] COMMUNITY RESIDENTIAL SETTINGS; FOOD AND
357.15WATER.
357.16    Subdivision 1. Water. Potable water from privately owned wells must be tested
357.17annually by a Department of Health-certified laboratory for coliform bacteria and nitrate
357.18nitrogens to verify safety. The health authority may require retesting and corrective
357.19measures if results exceed state water standards in Minnesota Rules, chapter 4720, or in
357.20the event of flooding or an incident which may put the well at risk of contamination. To
357.21prevent scalding, the water temperature of faucets must not exceed 120 degrees Fahrenheit.
357.22    Subd. 2. Food. Food served must meet any special dietary needs of a person as
357.23prescribed by the person's physician or dietitian. Three nutritionally balanced meals a day
357.24must be served or made available to persons, and nutritious snacks must be available
357.25between meals.
357.26    Subd. 3. Food safety. Food must be obtained, handled, and properly stored to
357.27prevent contamination, spoilage, or a threat to the health of a person.
357.28EFFECTIVE DATE.This section is effective January 1, 2014.

357.29    Sec. 38. [245D.26] COMMUNITY RESIDENTIAL SETTINGS; SANITATION
357.30AND HEALTH.
357.31    Subdivision 1. Goods provided by the license holder. Individual clean bed linens
357.32appropriate for the season and the person's comfort, including towels and wash cloths,
357.33must be available for each person. Usual or customary goods for the operation of a
358.1residence which are communally used by all persons receiving services living in the
358.2residence must be provided by the license holder, including household items for meal
358.3preparation, cleaning supplies to maintain the cleanliness of the residence, window
358.4coverings on windows for privacy, toilet paper, and hand soap.
358.5    Subd. 2. Personal items. Personal health and hygiene items must be stored in a
358.6safe and sanitary manner.
358.7    Subd. 3. Pets and service animals. Pets and service animals housed within
358.8the residence must be immunized and maintained in good health as required by local
358.9ordinances and state law. The license holder must ensure that the person and the person's
358.10representative are notified before admission of the presence of pets in the residence.
358.11    Subd. 4. Smoking in the residence. License holders must comply with the
358.12requirements of the Minnesota Clean Indoor Air Act, sections 144.411 to 144.417, when
358.13smoking is permitted in the residence.
358.14    Subd. 5. Weapons. Weapons and ammunition must be stored separately in locked
358.15areas that are inaccessible to a person receiving services. For purposes of this subdivision,
358.16"weapons" means firearms and other instruments or devices designed for and capable of
358.17producing bodily harm.
358.18EFFECTIVE DATE.This section is effective January 1, 2014.

358.19    Sec. 39. [245D.27] DAY SERVICES FACILITIES; SATELLITE LICENSURE
358.20REQUIREMENTS AND APPLICATION PROCESS.
358.21Except for day service facilities on the same or adjoining lot, the license holder
358.22providing day services must apply for a separate license for each facility-based service
358.23site when the license holder is the owner, lessor, or tenant of the service site at which
358.24persons receive day services and the license holder's employees who provide day services
358.25are present for a cumulative total of more than 30 days within any 12-month period. For
358.26purposes of this chapter, a day services facility license is a satellite license of the day
358.27services program. A day services program may operate multiple licensed day service
358.28facilities in one or more counties in the state. For the purposes of this section, "adjoining
358.29lot" means day services facilities that are next door to or across the street from one another.
358.30EFFECTIVE DATE.This section is effective January 1, 2014.

358.31    Sec. 40. [245D.28] DAY SERVICES FACILITIES; PHYSICAL PLANT AND
358.32SPACE REQUIREMENTS.
359.1    Subdivision 1. Facility capacity and useable space requirements. (a) The facility
359.2capacity of each day service facility must be determined by the amount of primary space
359.3available, the scheduling of activities at other service sites, and the space requirements of
359.4all persons receiving services at the facility, not just the licensed services. The facility
359.5capacity must specify the maximum number of persons that may receive services on
359.6site at any one time.
359.7(b) When a facility is located in a multifunctional organization, the facility may
359.8share common space with the multifunctional organization if the required available
359.9primary space for use by persons receiving day services is maintained while the facility is
359.10operating. The license holder must comply at all times with all applicable fire and safety
359.11codes under section 245A.04, subdivision 2a, and adequate supervision requirements
359.12under section 245D.31 for all persons receiving day services.
359.13(c) A day services facility must have a minimum of 40 square feet of primary space
359.14available for each person receiving services who is present at the site at any one time.
359.15Primary space does not include:
359.16(1) common areas, such as hallways, stairways, closets, utility areas, bathrooms,
359.17and kitchens;
359.18(2) floor areas beneath stationary equipment; or
359.19(3) any space occupied by persons associated with the multifunctional organization
359.20while persons receiving day services are using common space.
359.21    Subd. 2. Individual personal articles. Each person must be provided space in a
359.22closet, cabinet, on a shelf, or a coat hook for storage of personal items for the person's own
359.23use while receiving services at the facility, unless doing so would interfere with safety
359.24precautions, another person's work space, or violate a building or fire code.
359.25EFFECTIVE DATE.This section is effective January 1, 2014.

359.26    Sec. 41. [245D.29] DAY SERVICES FACILITIES; HEALTH AND SAFETY
359.27REQUIREMENTS.
359.28    Subdivision 1. Refrigeration. If the license holder provides refrigeration at service
359.29sites owned or leased by the license holder for storing perishable foods and perishable
359.30portions of bag lunches, whether the foods are supplied by the license holder or the
359.31persons receiving services, the refrigeration must have a temperature of 40 degrees
359.32Fahrenheit or less.
359.33    Subd. 2. Drinking water. Drinking water must be available to all persons
359.34receiving services. If a person is unable to request or obtain drinking water, it must be
360.1provided according to that person's individual needs. Drinking water must be provided in
360.2single-service containers or from drinking fountains accessible to all persons.
360.3    Subd. 3. Individuals who become ill during the day. There must be an area in
360.4which a person receiving services can rest if:
360.5(1) the person becomes ill during the day;
360.6(2) the person does not live in a licensed residential site;
360.7(3) the person requires supervision; and
360.8(4) there is not a caretaker immediately available. Supervision must be provided
360.9until the caretaker arrives to bring the person home.
360.10    Subd. 4. Safety procedures. The license holder must establish general written
360.11safety procedures that include criteria for selecting, training, and supervising persons who
360.12work with hazardous machinery, tools, or substances. Safety procedures specific to each
360.13person's activities must be explained and be available in writing to all staff members
360.14and persons receiving services.
360.15EFFECTIVE DATE.This section is effective January 1, 2014.

360.16    Sec. 42. [245D.31] DAY SERVICES FACILITIES; STAFF RATIO AND
360.17FACILITY COVERAGE.
360.18    Subdivision 1. Scope. This section applies only to facility-based day services.
360.19    Subd. 2. Factors. (a) The number of direct support service staff members that a
360.20license holder must have on duty at the facility at a given time to meet the minimum
360.21staffing requirements established in this section varies according to:
360.22(1) the number of persons who are enrolled and receiving direct support services
360.23at that given time;
360.24(2) the staff ratio requirement established under subdivision 3 for each person who
360.25is present; and
360.26(3) whether the conditions described in subdivision 8 exist and warrant additional
360.27staffing beyond the number determined to be needed under subdivision 7.
360.28(b) The commissioner must consider the factors in paragraph (a) in determining a
360.29license holder's compliance with the staffing requirements and must further consider
360.30whether the staff ratio requirement established under subdivision 3 for each person
360.31receiving services accurately reflects the person's need for staff time.
360.32    Subd. 3. Staff ratio requirement for each person receiving services. The case
360.33manager, in consultation with the interdisciplinary team, must determine at least once each
360.34year which of the ratios in subdivisions 4, 5, and 6 is appropriate for each person receiving
360.35services on the basis of the characteristics described in subdivisions 4, 5, and 6. The ratio
361.1assigned each person and the documentation of how the ratio was arrived at must be kept
361.2in each person's individual service plan. Documentation must include an assessment of the
361.3person with respect to the characteristics in subdivisions 4, 5, and 6 recorded on a standard
361.4assessment form required by the commissioner.
361.5    Subd. 4. Person requiring staff ratio of one to four. A person must be assigned a
361.6staff ratio requirement of one to four if:
361.7(1) on a daily basis the person requires total care and monitoring or constant
361.8hand-over-hand physical guidance to successfully complete at least three of the following
361.9activities: toileting, communicating basic needs, eating, ambulating; or is not capable of
361.10taking appropriate action for self-preservation under emergency conditions; or
361.11(2) the person engages in conduct that poses an imminent risk of physical harm to
361.12self or others at a documented level of frequency, intensity, or duration requiring frequent
361.13daily ongoing intervention and monitoring as established in the person's coordinated
361.14service and support plan or coordinated service and support plan addendum.
361.15    Subd. 5. Person requiring staff ratio of one to eight. A person must be assigned a
361.16staff ratio requirement of one to eight if:
361.17(1) the person does not meet the requirements in subdivision 4; and
361.18(2) on a daily basis the person requires verbal prompts or spot checks and minimal
361.19or no physical assistance to successfully complete at least four of the following activities:
361.20toileting, communicating basic needs, eating, ambulating, or taking appropriate action for
361.21self-preservation under emergency conditions.
361.22    Subd. 6. Person requiring staff ratio of one to six. A person who does not have
361.23any of the characteristics described in subdivision 4 or 5 must be assigned a staff ratio
361.24requirement of one to six.
361.25    Subd. 7. Determining number of direct support service staff required. The
361.26minimum number of direct support service staff members required at any one time to
361.27meet the combined staff ratio requirements of the persons present at that time can be
361.28determined by the following steps:
361.29(1) assign to each person in attendance the three-digit decimal below that corresponds
361.30to the staff ratio requirement assigned to that person. A staff ratio requirement of one to
361.31four equals 0.250. A staff ratio requirement of one to eight equals 0.125. A staff ratio
361.32requirement of one to six equals 0.166. A staff ratio requirement of one to ten equals 0.100;
361.33(2) add all of the three-digit decimals (one three-digit decimal for every person in
361.34attendance) assigned in clause (1);
361.35(3) when the sum in clause (2) falls between two whole numbers, round off the sum
361.36to the larger of the two whole numbers; and
362.1(4) the larger of the two whole numbers in clause (3) equals the number of direct
362.2support service staff members needed to meet the staff ratio requirements of the persons
362.3in attendance.
362.4    Subd. 8. Staff to be included in calculating minimum staffing requirement.
362.5Only staff providing direct support must be counted as staff members in calculating
362.6the staff-to-participant ratio. A volunteer may be counted as a direct support staff in
362.7calculating the staff to participant ratio if the volunteer meets the same standards and
362.8requirements as paid staff. No person receiving services must be counted as or be
362.9substituted for a staff member in calculating the staff-to-participant ratio.
362.10    Subd. 9. Conditions requiring additional direct support staff. The license holder
362.11must increase the number of direct support staff members present at any one time beyond
362.12the number arrived at in subdivision 4 if necessary when any one or combination of the
362.13following circumstances can be documented by the commissioner as existing:
362.14(1) the health and safety needs of the persons receiving services cannot be met by
362.15the number of staff members available under the staffing pattern in effect even though the
362.16number has been accurately calculated under subdivision 7; or
362.17(2) the person's conduct frequently presents an imminent risk of physical harm to
362.18self or others.
362.19    Subd. 10. Supervision requirements. (a) At no time must one direct support
362.20staff member be assigned responsibility for supervision and training of more than ten
362.21persons receiving supervision and training, except as otherwise stated in each person's risk
362.22management plan.
362.23(b) In the temporary absence of the director or a supervisor, a direct support staff
362.24member must be designated to supervise the center.
362.25    Subd. 11. Multifunctional programs. A multifunctional program may count other
362.26employees of the organization besides direct support staff of the day service facility in
362.27calculating the staff-to-participant ratio if the employee is assigned to the day services
362.28facility for a specified amount of time, during which the employee is not assigned to
362.29another organization or program.
362.30EFFECTIVE DATE.This section is effective January 1, 2014.

362.31    Sec. 43. [245D.32] ALTERNATIVE LICENSING INSPECTIONS.
362.32    Subdivision 1. Eligibility for an alternative licensing inspection. (a) A license
362.33holder providing services licensed under this chapter, with a qualifying accreditation and
362.34meeting the eligibility criteria in paragraphs (b) and (c), may request approval for an
362.35alternative licensing inspection when all services provided under the license holder's
363.1license are accredited. A license holder with a qualifying accreditation and meeting
363.2the eligibility criteria in paragraphs (b) and (c) may request approval for an alternative
363.3licensing inspection for individual community residential settings or day services facilities
363.4licensed under this chapter.
363.5(b) In order to be eligible for an alternative licensing inspection, the program must
363.6have had at least one inspection by the commissioner following issuance of the initial
363.7license. For programs operating a day services facility, each facility must have had at least
363.8one on-site inspection by the commissioner following issuance of the initial license.
363.9(c) In order to be eligible for an alternative licensing inspection, the program must
363.10have been in substantial and consistent compliance at the time of the last licensing
363.11inspection and during the current licensing period. For purposes of this section,
363.12"substantial and consistent compliance" means:
363.13(1) the license holder's license was not made conditional, suspended, or revoked;
363.14(2) there have been no substantiated allegations of maltreatment against the license
363.15holder;
363.16(3) there were no program deficiencies identified that would jeopardize the health,
363.17safety, or rights of persons being served; and
363.18(4) the license holder maintained substantial compliance with the other requirements
363.19of chapters 245A and 245C and other applicable laws and rules.
363.20(d) For the purposes of this section, the license holder's license includes services
363.21licensed under this chapter that were previously licensed under chapter 245B until
363.22December 31, 2013.
363.23    Subd. 2. Qualifying accreditation. The commissioner must accept a three-year
363.24accreditation from the Commission on Accreditation of Rehabilitation Facilities (CARF)
363.25as a qualifying accreditation.
363.26    Subd. 3. Request for approval of an alternative inspection status. (a) A request
363.27for an alternative inspection must be made on the forms and in the manner prescribed
363.28by the commissioner. When submitting the request, the license holder must submit all
363.29documentation issued by the accrediting body verifying that the license holder has obtained
363.30and maintained the qualifying accreditation and has complied with recommendations
363.31or requirements from the accrediting body during the period of accreditation. Based
363.32on the request and the additional required materials, the commissioner may approve
363.33an alternative inspection status.
363.34(b) The commissioner must notify the license holder in writing that the request for
363.35an alternative inspection status has been approved. Approval must be granted until the
363.36end of the qualifying accreditation period.
364.1(c) The license holder must submit a written request for approval to be renewed
364.2one month before the end of the current approval period according to the requirements
364.3in paragraph (a). If the license holder does not submit a request to renew approval as
364.4required, the commissioner must conduct a licensing inspection.
364.5    Subd. 4. Programs approved for alternative licensing inspection; deemed
364.6compliance licensing requirements. (a) A license holder approved for alternative
364.7licensing inspection under this section is required to maintain compliance with all
364.8licensing standards according to this chapter.
364.9(b) A license holder approved for alternative licensing inspection under this section
364.10must be deemed to be in compliance with all the requirements of this chapter, and the
364.11commissioner must not perform routine licensing inspections.
364.12(c) Upon receipt of a complaint regarding the services of a license holder approved
364.13for alternative licensing inspection under this section, the commissioner must investigate
364.14the complaint and may take any action as provided under section 245A.06 or 245A.07.
364.15    Subd. 5. Investigations of alleged or suspected maltreatment. Nothing in this
364.16section changes the commissioner's responsibilities to investigate alleged or suspected
364.17maltreatment of a minor under section 626.556 or a vulnerable adult under section 626.557.
364.18    Subd. 6. Termination or denial of subsequent approval. Following approval of
364.19an alternative licensing inspection, the commissioner may terminate or deny subsequent
364.20approval of an alternative licensing inspection if the commissioner determines that:
364.21(1) the license holder has not maintained the qualifying accreditation;
364.22(2) the commissioner has substantiated maltreatment for which the license holder or
364.23facility is determined to be responsible during the qualifying accreditation period; or
364.24(3) during the qualifying accreditation period, the license holder has been issued
364.25an order for conditional license, fine, suspension, or license revocation that has not been
364.26reversed upon appeal.
364.27    Subd. 7. Appeals. The commissioner's decision that the conditions for approval for
364.28an alternative licensing inspection have not been met is final and not subject to appeal
364.29under the provisions of chapter 14.
364.30    Subd. 8. Commissioner's programs. Home and community-based services licensed
364.31under this chapter for which the commissioner is the license holder with a qualifying
364.32accreditation are excluded from being approved for an alternative licensing inspection.
364.33EFFECTIVE DATE.This section is effective January 1, 2014.

364.34    Sec. 44. [245D.33] ADULT MENTAL HEALTH CERTIFICATION STANDARDS.
365.1(a) The commissioner of human services shall issue a mental health certification
365.2for services licensed under this chapter when a license holder is determined to have met
365.3the requirements under paragraph (b). This certification is voluntary for license holders.
365.4The certification shall be printed on the license and identified on the commissioner's
365.5public Web site.
365.6(b) The requirements for certification are:
365.7(1) all staff have received at least seven hours of annual training covering all of
365.8the following topics:
365.9(i) mental health diagnoses;
365.10(ii) mental health crisis response and de-escalation techniques;
365.11(iii) recovery from mental illness;
365.12(iv) treatment options, including evidence-based practices;
365.13(v) medications and their side effects;
365.14(vi) co-occurring substance abuse and health conditions; and
365.15(vii) community resources;
365.16(2) a mental health professional, as defined in section 245.462, subdivision 18, or a
365.17mental health practitioner as defined in section 245.462, subdivision 17, is available
365.18for consultation and assistance;
365.19(3) there is a plan and protocol in place to address a mental health crisis; and
365.20(4) each person's individual service and support plan identifies who is providing
365.21clinical services and their contact information, and includes an individual crisis prevention
365.22and management plan developed with the person.
365.23(c) License holders seeking certification under this section must request this
365.24certification on forms and in the manner prescribed by the commissioner.
365.25(d) If the commissioner finds that the license holder has failed to comply with the
365.26certification requirements under paragraph (b), the commissioner may issue a correction
365.27order and an order of conditional license in accordance with section 245A.06 or may
365.28issue a sanction in accordance with section 245A.07, including and up to removal of
365.29the certification.
365.30(e) A denial of the certification or the removal of the certification based on a
365.31determination that the requirements under paragraph (b) have not been met is not subject to
365.32appeal. A license holder that has been denied a certification or that has had a certification
365.33removed may again request certification when the license holder is in compliance with the
365.34requirements of paragraph (b).
365.35EFFECTIVE DATE.This section is effective January 1, 2014.

366.1    Sec. 45. Minnesota Statutes 2012, section 256B.092, subdivision 11, is amended to read:
366.2    Subd. 11. Residential support services. (a) Upon federal approval, there is
366.3established a new service called residential support that is available on the community
366.4alternative care, community alternatives for disabled individuals, developmental
366.5disabilities, and brain injury waivers. Existing waiver service descriptions must be
366.6modified to the extent necessary to ensure there is no duplication between other services.
366.7Residential support services must be provided by vendors licensed as a community
366.8residential setting as defined in section 245A.11, subdivision 8, a foster care setting
366.9licensed under Minnesota Rules, parts 2960.3000 to 2960.3340, or an adult foster care
366.10setting licensed under Minnesota Rules, parts 9555.5105 to 9555.6265.
366.11    (b) Residential support services must meet the following criteria:
366.12    (1) providers of residential support services must own or control the residential site;
366.13    (2) the residential site must not be the primary residence of the license holder;
366.14    (3) (1) the residential site must have a designated program supervisor person
366.15 responsible for program management, oversight, development, and implementation of
366.16policies and procedures;
366.17    (4) (2) the provider of residential support services must provide supervision, training,
366.18and assistance as described in the person's coordinated service and support plan; and
366.19    (5) (3) the provider of residential support services must meet the requirements of
366.20licensure and additional requirements of the person's coordinated service and support plan.
366.21    (c) Providers of residential support services that meet the definition in paragraph (a)
366.22must be registered using a process determined by the commissioner beginning July 1, 2009
366.23 must be licensed according to chapter 245D. Providers licensed to provide child foster care
366.24under Minnesota Rules, parts 2960.3000 to 2960.3340, or adult foster care licensed under
366.25Minnesota Rules, parts 9555.5105 to 9555.6265, and that meet the requirements in section
366.26245A.03, subdivision 7 , paragraph (g), are considered registered under this section.

366.27    Sec. 46. Minnesota Statutes 2012, section 256B.4912, subdivision 1, is amended to read:
366.28    Subdivision 1. Provider qualifications. (a) For the home and community-based
366.29waivers providing services to seniors and individuals with disabilities under sections
366.30256B.0913, 256B.0915, 256B.092, and 256B.49, the commissioner shall establish:
366.31(1) agreements with enrolled waiver service providers to ensure providers meet
366.32Minnesota health care program requirements;
366.33(2) regular reviews of provider qualifications, and including requests of proof of
366.34documentation; and
366.35(3) processes to gather the necessary information to determine provider qualifications.
367.1    (b) Beginning July 1, 2012, staff that provide direct contact, as defined in section
367.2245C.02, subdivision 11 , for services specified in the federally approved waiver plans
367.3must meet the requirements of chapter 245C prior to providing waiver services and as
367.4part of ongoing enrollment. Upon federal approval, this requirement must also apply to
367.5consumer-directed community supports.
367.6    (c) Beginning January 1, 2014, service owners and managerial officials overseeing
367.7the management or policies of services that provide direct contact as specified in the
367.8federally approved waiver plans must meet the requirements of chapter 245C prior to
367.9reenrollment or, for new providers, prior to initial enrollment if they have not already done
367.10so as a part of service licensure requirements.

367.11    Sec. 47. Minnesota Statutes 2012, section 256B.4912, subdivision 7, is amended to read:
367.12    Subd. 7. Applicant and license holder training. An applicant or license holder
367.13for the home and community-based waivers providing services to seniors and individuals
367.14with disabilities under sections 256B.0913, 256B.0915, 256B.092, and 256B.49 that is
367.15not enrolled as a Minnesota health care program home and community-based services
367.16waiver provider at the time of application must ensure that at least one controlling
367.17individual completes a onetime training on the requirements for providing home and
367.18community-based services from a qualified source as determined by the commissioner,
367.19before a provider is enrolled or license is issued. Within six months of enrollment, a newly
367.20enrolled home and community-based waiver service provider must ensure that at least one
367.21controlling individual has completed training on waiver and related program billing.

367.22    Sec. 48. Minnesota Statutes 2012, section 256B.4912, is amended by adding a
367.23subdivision to read:
367.24    Subd. 8. Data on use of emergency use of manual restraint. Beginning July 1,
367.252013, facilities and services to be licensed under chapter 245D shall submit data regarding
367.26the use of emergency use of manual restraint as identified in section 245D.061 in a format
367.27and at a frequency identified by the commissioner.

367.28    Sec. 49. Minnesota Statutes 2012, section 256B.4912, is amended by adding a
367.29subdivision to read:
367.30    Subd. 9. Definitions. (a) For the purposes of this section, the following terms
367.31have the meanings given them.
368.1(b) "Controlling individual" means a public body, governmental agency, business
368.2entity, officer, owner, or managerial official whose responsibilities include the direction of
368.3the management or policies of a program.
368.4(c) "Managerial official" means an individual who has decision-making authority
368.5related to the operation of the program and responsibility for the ongoing management of
368.6or direction of the policies, services, or employees of the program.
368.7(d) "Owner" means an individual who has direct or indirect ownership interest in
368.8a corporation or partnership, or business association enrolling with the Department of
368.9Human Services as a provider of waiver services.

368.10    Sec. 50. Minnesota Statutes 2012, section 256B.4912, is amended by adding a
368.11subdivision to read:
368.12    Subd. 10. Enrollment requirements. All home and community-based waiver
368.13providers must provide, at the time of enrollment and within 30 days of a request, in a
368.14format determined by the commissioner, information and documentation that includes, but
368.15is not limited to, the following:
368.16(1) proof of surety bond coverage in the amount of $50,000 or ten percent of the
368.17provider's payments from Medicaid in the previous calendar year, whichever is greater;
368.18(2) proof of fidelity bond coverage in the amount of $20,000; and
368.19(3) proof of liability insurance.

368.20    Sec. 51. Minnesota Statutes 2012, section 626.557, subdivision 9a, is amended to read:
368.21    Subd. 9a. Evaluation and referral of reports made to common entry point unit.
368.22    The common entry point must screen the reports of alleged or suspected maltreatment for
368.23immediate risk and make all necessary referrals as follows:
368.24    (1) if the common entry point determines that there is an immediate need for
368.25adult protective services, the common entry point agency shall immediately notify the
368.26appropriate county agency;
368.27    (2) if the report contains suspected criminal activity against a vulnerable adult, the
368.28common entry point shall immediately notify the appropriate law enforcement agency;
368.29    (3) the common entry point shall refer all reports of alleged or suspected
368.30maltreatment to the appropriate lead investigative agency as soon as possible, but in any
368.31event no longer than two working days; and
368.32    (4) if the report involves services licensed by the Department of Human Services
368.33and subject to chapter 245D, the common entry point shall refer the report to the county as
369.1the lead agency according to clause (3), but shall also notify the Department of Human
369.2Services of the report; and
369.3    (5) (4) if the report contains information about a suspicious death, the common
369.4entry point shall immediately notify the appropriate law enforcement agencies, the local
369.5medical examiner, and the ombudsman for mental health and developmental disabilities
369.6established under section 245.92. Law enforcement agencies shall coordinate with the
369.7local medical examiner and the ombudsman as provided by law.

369.8    Sec. 52. Minnesota Statutes 2012, section 626.5572, subdivision 13, is amended to read:
369.9    Subd. 13. Lead investigative agency. "Lead investigative agency" is the primary
369.10administrative agency responsible for investigating reports made under section 626.557.
369.11(a) The Department of Health is the lead investigative agency for facilities or
369.12services licensed or required to be licensed as hospitals, home care providers, nursing
369.13homes, boarding care homes, hospice providers, residential facilities that are also federally
369.14certified as intermediate care facilities that serve people with developmental disabilities,
369.15or any other facility or service not listed in this subdivision that is licensed or required to
369.16be licensed by the Department of Health for the care of vulnerable adults. "Home care
369.17provider" has the meaning provided in section 144A.43, subdivision 4, and applies when
369.18care or services are delivered in the vulnerable adult's home, whether a private home or a
369.19housing with services establishment registered under chapter 144D, including those that
369.20offer assisted living services under chapter 144G.
369.21(b) Except as provided under paragraph (c), for services licensed according to
369.22chapter 245D, The Department of Human Services is the lead investigative agency for
369.23facilities or services licensed or required to be licensed as adult day care, adult foster care,
369.24programs for people with developmental disabilities, family adult day services, mental
369.25health programs, mental health clinics, chemical dependency programs, the Minnesota
369.26sex offender program, or any other facility or service not listed in this subdivision that is
369.27licensed or required to be licensed by the Department of Human Services.
369.28(c) The county social service agency or its designee is the lead investigative agency
369.29for all other reports, including, but not limited to, reports involving vulnerable adults
369.30receiving services from a personal care provider organization under section 256B.0659,
369.31or receiving home and community-based services licensed by the Department of Human
369.32Services and subject to chapter 245D.

369.33    Sec. 53. INTEGRATED LICENSING SYSTEM FOR HOME CARE AND HOME
369.34AND COMMUNITY-BASED SERVICES.
370.1(a) The Department of Health Compliance Monitoring Division and the Department
370.2of Human Services Licensing Division shall jointly develop an integrated licensing system
370.3for providers of both home care services subject to licensure under Minnesota Statutes,
370.4chapter 144A, and for home and community-based services subject to licensure under
370.5Minnesota Statutes, chapter 245D. The integrated licensing system shall:
370.6(1) require only one license of any provider of services under Minnesota Statutes,
370.7sections 144A.43 to 144A.482, and 245D.03, subdivision 1;
370.8(2) promote quality services that recognize a person's individual needs and protect
370.9the person's health, safety, rights, and well-being;
370.10(3) promote provider accountability through application requirements, compliance
370.11inspections, investigations, and enforcement actions;
370.12(4) reference other applicable requirements in existing state and federal laws,
370.13including the federal Affordable Care Act;
370.14(5) establish internal procedures to facilitate ongoing communications between the
370.15agencies and with providers and services recipients about the regulatory activities;
370.16(6) create a link between the agency Web sites so that providers and the public can
370.17access the same information regardless of which Web site is accessed initially; and
370.18(7) collect data on identified outcome measures as necessary for the agencies to
370.19report to the Centers for Medicare and Medicaid Services.
370.20(b) The joint recommendations for legislative changes to implement the integrated
370.21licensing system are due to the legislature by February 15, 2014.
370.22(c) Before implementation of the integrated licensing system, providers licensed as
370.23home care providers under Minnesota Statutes, chapter 144A, may also provide home
370.24and community-based services subject to licensure under Minnesota Statutes, chapter
370.25245D, without obtaining a home and community-based services license under Minnesota
370.26Statutes, chapter 245D. During this time, the conditions under clauses (1) to (3) shall
370.27apply to these providers:
370.28(1) the provider must comply with all requirements under Minnesota Statutes, chapter
370.29245D, for services otherwise subject to licensure under Minnesota Statutes, chapter 245D;
370.30(2) a violation of requirements under Minnesota Statutes, chapter 245D, may be
370.31enforced by the Department of Health under the enforcement authority set forth in
370.32Minnesota Statutes, section 144A.475; and
370.33(3) the Department of Health will provide information to the Department of Human
370.34Services about each provider licensed under this section, including the provider's license
370.35application, licensing documents, inspections, information about complaints received, and
370.36investigations conducted for possible violations of Minnesota Statutes, chapter 245D.

371.1    Sec. 54. REPEALER.
371.2(a) Minnesota Statutes 2012, sections 245B.01; 245B.02; 245B.03; 245B.031;
371.3245B.04; 245B.05, subdivisions 1, 2, 3, 5, 6, and 7; 245B.055; 245B.06; 245B.07; and
371.4245B.08, are repealed effective January 1, 2014.
371.5(b) Minnesota Statutes 2012, section 245D.08, is repealed.

371.6ARTICLE 9

371.7WAIVER PROVIDER STANDARDS TECHNICAL CHANGES

371.8    Section 1. Minnesota Statutes 2012, section 16C.10, subdivision 5, is amended to read:
371.9    Subd. 5. Specific purchases. The solicitation process described in this chapter is
371.10not required for acquisition of the following:
371.11(1) merchandise for resale purchased under policies determined by the commissioner;
371.12(2) farm and garden products which, as determined by the commissioner, may be
371.13purchased at the prevailing market price on the date of sale;
371.14(3) goods and services from the Minnesota correctional facilities;
371.15(4) goods and services from rehabilitation facilities and extended employment
371.16providers that are certified by the commissioner of employment and economic
371.17development, and day training and habilitation services licensed under sections 245B.01
371.18to 245B.08 chapter 245D;
371.19(5) goods and services for use by a community-based facility operated by the
371.20commissioner of human services;
371.21(6) goods purchased at auction or when submitting a sealed bid at auction provided
371.22that before authorizing such an action, the commissioner consult with the requesting
371.23agency to determine a fair and reasonable value for the goods considering factors
371.24including, but not limited to, costs associated with submitting a bid, travel, transportation,
371.25and storage. This fair and reasonable value must represent the limit of the state's bid;
371.26(7) utility services where no competition exists or where rates are fixed by law or
371.27ordinance; and
371.28(8) goods and services from Minnesota sex offender program facilities.
371.29EFFECTIVE DATE.This section is effective January 1, 2014.

371.30    Sec. 2. Minnesota Statutes 2012, section 16C.155, subdivision 1, is amended to read:
371.31    Subdivision 1. Service contracts. The commissioner of administration shall
371.32ensure that a portion of all contracts for janitorial services; document imaging;
371.33document shredding; and mailing, collating, and sorting services be awarded by the
372.1state to rehabilitation programs and extended employment providers that are certified
372.2by the commissioner of employment and economic development, and day training and
372.3habilitation services licensed under sections 245B.01 to 245B.08 chapter 245D. The
372.4amount of each contract awarded under this section may exceed the estimated fair market
372.5price as determined by the commissioner for the same goods and services by up to six
372.6percent. The aggregate value of the contracts awarded to eligible providers under this
372.7section in any given year must exceed 19 percent of the total value of all contracts for
372.8janitorial services; document imaging; document shredding; and mailing, collating, and
372.9sorting services entered into in the same year. For the 19 percent requirement to be
372.10applicable in any given year, the contract amounts proposed by eligible providers must be
372.11within six percent of the estimated fair market price for at least 19 percent of the contracts
372.12awarded for the corresponding service area.
372.13EFFECTIVE DATE.This section is effective January 1, 2014.

372.14    Sec. 3. Minnesota Statutes 2012, section 144D.01, subdivision 4, is amended to read:
372.15    Subd. 4. Housing with services establishment or establishment. (a) "Housing
372.16with services establishment" or "establishment" means:
372.17(1) an establishment providing sleeping accommodations to one or more adult
372.18residents, at least 80 percent of which are 55 years of age or older, and offering or
372.19providing, for a fee, one or more regularly scheduled health-related services or two or
372.20more regularly scheduled supportive services, whether offered or provided directly by the
372.21establishment or by another entity arranged for by the establishment; or
372.22(2) an establishment that registers under section 144D.025.
372.23(b) Housing with services establishment does not include:
372.24(1) a nursing home licensed under chapter 144A;
372.25(2) a hospital, certified boarding care home, or supervised living facility licensed
372.26under sections 144.50 to 144.56;
372.27(3) a board and lodging establishment licensed under chapter 157 and Minnesota
372.28Rules, parts 9520.0500 to 9520.0670, 9525.0215 to 9525.0355, 9525.0500 to 9525.0660,
372.29or 9530.4100 to 9530.4450, or under chapter 245B 245D;
372.30(4) a board and lodging establishment which serves as a shelter for battered women
372.31or other similar purpose;
372.32(5) a family adult foster care home licensed by the Department of Human Services;
372.33(6) private homes in which the residents are related by kinship, law, or affinity with
372.34the providers of services;
373.1(7) residential settings for persons with developmental disabilities in which the
373.2services are licensed under Minnesota Rules, parts 9525.2100 to 9525.2140, or applicable
373.3successor rules or laws;
373.4(8) a home-sharing arrangement such as when an elderly or disabled person or
373.5single-parent family makes lodging in a private residence available to another person
373.6in exchange for services or rent, or both;
373.7(9) a duly organized condominium, cooperative, common interest community, or
373.8owners' association of the foregoing where at least 80 percent of the units that comprise the
373.9condominium, cooperative, or common interest community are occupied by individuals
373.10who are the owners, members, or shareholders of the units; or
373.11(10) services for persons with developmental disabilities that are provided under
373.12a license according to Minnesota Rules, parts 9525.2000 to 9525.2140 in effect until
373.13January 1, 1998, or under chapter 245B 245D.
373.14EFFECTIVE DATE.This section is effective January 1, 2014.

373.15    Sec. 4. Minnesota Statutes 2012, section 174.30, subdivision 1, is amended to read:
373.16    Subdivision 1. Applicability. (a) The operating standards for special transportation
373.17service adopted under this section do not apply to special transportation provided by:
373.18(1) a common carrier operating on fixed routes and schedules;
373.19(2) a volunteer driver using a private automobile;
373.20(3) a school bus as defined in section 169.011, subdivision 71; or
373.21(4) an emergency ambulance regulated under chapter 144.
373.22(b) The operating standards adopted under this section only apply to providers
373.23of special transportation service who receive grants or other financial assistance from
373.24either the state or the federal government, or both, to provide or assist in providing that
373.25service; except that the operating standards adopted under this section do not apply
373.26to any nursing home licensed under section 144A.02, to any board and care facility
373.27licensed under section 144.50, or to any day training and habilitation services, day care,
373.28or group home facility licensed under sections 245A.01 to 245A.19 unless the facility or
373.29program provides transportation to nonresidents on a regular basis and the facility receives
373.30reimbursement, other than per diem payments, for that service under rules promulgated
373.31by the commissioner of human services.
373.32(c) Notwithstanding paragraph (b), the operating standards adopted under this
373.33section do not apply to any vendor of services licensed under chapter 245B 245D that
373.34provides transportation services to consumers or residents of other vendors licensed under
374.1chapter 245B 245D and transports 15 or fewer persons, including consumers or residents
374.2and the driver.
374.3EFFECTIVE DATE.This section is effective January 1, 2014.

374.4    Sec. 5. Minnesota Statutes 2012, section 245A.02, subdivision 1, is amended to read:
374.5    Subdivision 1. Scope. The terms used in this chapter and chapter 245B have the
374.6meanings given them in this section.
374.7EFFECTIVE DATE.This section is effective January 1, 2014.

374.8    Sec. 6. Minnesota Statutes 2012, section 245A.02, subdivision 9, is amended to read:
374.9    Subd. 9. License holder. "License holder" means an individual, corporation,
374.10partnership, voluntary association, or other organization that is legally responsible for the
374.11operation of the program, has been granted a license by the commissioner under this chapter
374.12or chapter 245B 245D and the rules of the commissioner, and is a controlling individual.
374.13EFFECTIVE DATE.This section is effective January 1, 2014.

374.14    Sec. 7. Minnesota Statutes 2012, section 245A.03, subdivision 9, is amended to read:
374.15    Subd. 9. Permitted services by an individual who is related. Notwithstanding
374.16subdivision 2, paragraph (a), clause (1), and subdivision 7, an individual who is related to a
374.17person receiving supported living services may provide licensed services to that person if:
374.18(1) the person who receives supported living services received these services in a
374.19residential site on July 1, 2005;
374.20(2) the services under clause (1) were provided in a corporate foster care setting for
374.21adults and were funded by the developmental disabilities home and community-based
374.22services waiver defined in section 256B.092;
374.23(3) the individual who is related obtains and maintains both a license under chapter
374.24245B 245D and an adult foster care license under Minnesota Rules, parts 9555.5105
374.25to 9555.6265; and
374.26(4) the individual who is related is not the guardian of the person receiving supported
374.27living services.
374.28EFFECTIVE DATE.This section is effective January 1, 2014.

374.29    Sec. 8. Minnesota Statutes 2012, section 245A.04, subdivision 13, is amended to read:
375.1    Subd. 13. Funds and property; other requirements. (a) A license holder must
375.2ensure that persons served by the program retain the use and availability of personal funds
375.3or property unless restrictions are justified in the person's individual plan. This subdivision
375.4does not apply to programs governed by the provisions in section 245B.07, subdivision 10.
375.5(b) The license holder must ensure separation of funds of persons served by the
375.6program from funds of the license holder, the program, or program staff.
375.7(c) Whenever the license holder assists a person served by the program with the
375.8safekeeping of funds or other property, the license holder must:
375.9(1) immediately document receipt and disbursement of the person's funds or other
375.10property at the time of receipt or disbursement, including the person's signature, or the
375.11signature of the conservator or payee; and
375.12(2) return to the person upon the person's request, funds and property in the license
375.13holder's possession subject to restrictions in the person's treatment plan, as soon as
375.14possible, but no later than three working days after the date of request.
375.15(d) License holders and program staff must not:
375.16(1) borrow money from a person served by the program;
375.17(2) purchase personal items from a person served by the program;
375.18(3) sell merchandise or personal services to a person served by the program;
375.19(4) require a person served by the program to purchase items for which the license
375.20holder is eligible for reimbursement; or
375.21(5) use funds of persons served by the program to purchase items for which the
375.22facility is already receiving public or private payments.
375.23EFFECTIVE DATE.This section is effective January 1, 2014.

375.24    Sec. 9. Minnesota Statutes 2012, section 245A.07, subdivision 3, is amended to read:
375.25    Subd. 3. License suspension, revocation, or fine. (a) The commissioner may
375.26suspend or revoke a license, or impose a fine if:
375.27(1) a license holder fails to comply fully with applicable laws or rules;
375.28(2) a license holder, a controlling individual, or an individual living in the household
375.29where the licensed services are provided or is otherwise subject to a background study has
375.30a disqualification which has not been set aside under section 245C.22;
375.31(3) a license holder knowingly withholds relevant information from or gives false
375.32or misleading information to the commissioner in connection with an application for
375.33a license, in connection with the background study status of an individual, during an
375.34investigation, or regarding compliance with applicable laws or rules; or
376.1(4) after July 1, 2012, and upon request by the commissioner, a license holder fails
376.2to submit the information required of an applicant under section 245A.04, subdivision 1,
376.3paragraph (f) or (g).
376.4A license holder who has had a license suspended, revoked, or has been ordered
376.5to pay a fine must be given notice of the action by certified mail or personal service. If
376.6mailed, the notice must be mailed to the address shown on the application or the last
376.7known address of the license holder. The notice must state the reasons the license was
376.8suspended, revoked, or a fine was ordered.
376.9    (b) If the license was suspended or revoked, the notice must inform the license
376.10holder of the right to a contested case hearing under chapter 14 and Minnesota Rules, parts
376.111400.8505 to 1400.8612. The license holder may appeal an order suspending or revoking
376.12a license. The appeal of an order suspending or revoking a license must be made in writing
376.13by certified mail or personal service. If mailed, the appeal must be postmarked and sent to
376.14the commissioner within ten calendar days after the license holder receives notice that the
376.15license has been suspended or revoked. If a request is made by personal service, it must be
376.16received by the commissioner within ten calendar days after the license holder received
376.17the order. Except as provided in subdivision 2a, paragraph (c), if a license holder submits
376.18a timely appeal of an order suspending or revoking a license, the license holder may
376.19continue to operate the program as provided in section 245A.04, subdivision 7, paragraphs
376.20(g) and (h), until the commissioner issues a final order on the suspension or revocation.
376.21    (c)(1) If the license holder was ordered to pay a fine, the notice must inform the
376.22license holder of the responsibility for payment of fines and the right to a contested case
376.23hearing under chapter 14 and Minnesota Rules, parts 1400.8505 to 1400.8612. The appeal
376.24of an order to pay a fine must be made in writing by certified mail or personal service. If
376.25mailed, the appeal must be postmarked and sent to the commissioner within ten calendar
376.26days after the license holder receives notice that the fine has been ordered. If a request is
376.27made by personal service, it must be received by the commissioner within ten calendar
376.28days after the license holder received the order.
376.29    (2) The license holder shall pay the fines assessed on or before the payment date
376.30specified. If the license holder fails to fully comply with the order, the commissioner
376.31may issue a second fine or suspend the license until the license holder complies. If the
376.32license holder receives state funds, the state, county, or municipal agencies or departments
376.33responsible for administering the funds shall withhold payments and recover any payments
376.34made while the license is suspended for failure to pay a fine. A timely appeal shall stay
376.35payment of the fine until the commissioner issues a final order.
377.1    (3) A license holder shall promptly notify the commissioner of human services,
377.2in writing, when a violation specified in the order to forfeit a fine is corrected. If upon
377.3reinspection the commissioner determines that a violation has not been corrected as
377.4indicated by the order to forfeit a fine, the commissioner may issue a second fine. The
377.5commissioner shall notify the license holder by certified mail or personal service that a
377.6second fine has been assessed. The license holder may appeal the second fine as provided
377.7under this subdivision.
377.8    (4) Fines shall be assessed as follows: the license holder shall forfeit $1,000 for
377.9each determination of maltreatment of a child under section 626.556 or the maltreatment
377.10of a vulnerable adult under section 626.557 for which the license holder is determined
377.11responsible for the maltreatment under section 626.556, subdivision 10e, paragraph (i),
377.12or 626.557, subdivision 9c, paragraph (c); the license holder shall forfeit $200 for each
377.13occurrence of a violation of law or rule governing matters of health, safety, or supervision,
377.14including but not limited to the provision of adequate staff-to-child or adult ratios, and
377.15failure to comply with background study requirements under chapter 245C; and the license
377.16holder shall forfeit $100 for each occurrence of a violation of law or rule other than
377.17those subject to a $1,000 or $200 fine above. For purposes of this section, "occurrence"
377.18means each violation identified in the commissioner's fine order. Fines assessed against a
377.19license holder that holds a license to provide the residential-based habilitation home and
377.20community-based services, as defined under identified in section 245B.02, subdivision
377.2120 245D.03, subdivision 1, and a community residential setting or day services facility
377.22license to provide foster care under chapter 245D where the services are provided, may be
377.23assessed against both licenses for the same occurrence, but the combined amount of the
377.24fines shall not exceed the amount specified in this clause for that occurrence.
377.25    (5) When a fine has been assessed, the license holder may not avoid payment by
377.26closing, selling, or otherwise transferring the licensed program to a third party. In such an
377.27event, the license holder will be personally liable for payment. In the case of a corporation,
377.28each controlling individual is personally and jointly liable for payment.
377.29(d) Except for background study violations involving the failure to comply with an
377.30order to immediately remove an individual or an order to provide continuous, direct
377.31supervision, the commissioner shall not issue a fine under paragraph (c) relating to a
377.32background study violation to a license holder who self-corrects a background study
377.33violation before the commissioner discovers the violation. A license holder who has
377.34previously exercised the provisions of this paragraph to avoid a fine for a background
377.35study violation may not avoid a fine for a subsequent background study violation unless at
378.1least 365 days have passed since the license holder self-corrected the earlier background
378.2study violation.
378.3EFFECTIVE DATE.This section is effective January 1, 2014.

378.4    Sec. 10. Minnesota Statutes 2012, section 256B.0625, subdivision 19c, is amended to
378.5read:
378.6    Subd. 19c. Personal care. Medical assistance covers personal care assistance
378.7services provided by an individual who is qualified to provide the services according to
378.8subdivision 19a and sections 256B.0651 to 256B.0656, provided in accordance with a
378.9plan, and supervised by a qualified professional.
378.10"Qualified professional" means a mental health professional as defined in section
378.11245.462, subdivision 18 , clauses (1) to (6), or 245.4871, subdivision 27, clauses (1) to (6);
378.12or a registered nurse as defined in sections 148.171 to 148.285, a licensed social worker
378.13as defined in sections 148E.010 and 148E.055, or a qualified developmental disabilities
378.14specialist under section 245B.07, subdivision 4 designated coordinator under section
378.15245D.081, subdivision 2. The qualified professional shall perform the duties required in
378.16section 256B.0659.
378.17EFFECTIVE DATE.This section is effective January 1, 2014.

378.18    Sec. 11. Minnesota Statutes 2012, section 256B.5011, subdivision 2, is amended to read:
378.19    Subd. 2. Contract provisions. (a) The service contract with each intermediate
378.20care facility must include provisions for:
378.21(1) modifying payments when significant changes occur in the needs of the
378.22consumers;
378.23(2) appropriate and necessary statistical information required by the commissioner;
378.24(3) annual aggregate facility financial information; and
378.25(4) additional requirements for intermediate care facilities not meeting the standards
378.26set forth in the service contract.
378.27(b) The commissioner of human services and the commissioner of health, in
378.28consultation with representatives from counties, advocacy organizations, and the provider
378.29community, shall review the consolidated standards under chapter 245B and the home and
378.30community-based services standards under chapter 245D and the supervised living facility
378.31rule under Minnesota Rules, chapter 4665, to determine what provisions in Minnesota
378.32Rules, chapter 4665, may be waived by the commissioner of health for intermediate care
378.33facilities in order to enable facilities to implement the performance measures in their
379.1contract and provide quality services to residents without a duplication of or increase in
379.2regulatory requirements.
379.3EFFECTIVE DATE.This section is effective January 1, 2014.

379.4    Sec. 12. Minnesota Statutes 2012, section 471.59, subdivision 1, is amended to read:
379.5    Subdivision 1. Agreement. Two or more governmental units, by agreement entered
379.6into through action of their governing bodies, may jointly or cooperatively exercise
379.7any power common to the contracting parties or any similar powers, including those
379.8which are the same except for the territorial limits within which they may be exercised.
379.9The agreement may provide for the exercise of such powers by one or more of the
379.10participating governmental units on behalf of the other participating units. The term
379.11"governmental unit" as used in this section includes every city, county, town, school
379.12district, independent nonprofit firefighting corporation, other political subdivision of
379.13this or another state, another state, federally recognized Indian tribe, the University
379.14of Minnesota, the Minnesota Historical Society, nonprofit hospitals licensed under
379.15sections 144.50 to 144.56, rehabilitation facilities and extended employment providers
379.16that are certified by the commissioner of employment and economic development, day
379.17training and habilitation services licensed under sections 245B.01 to 245B.08, day and
379.18supported employment services licensed under chapter 245D, and any agency of the state
379.19of Minnesota or the United States, and includes any instrumentality of a governmental
379.20unit. For the purpose of this section, an instrumentality of a governmental unit means an
379.21instrumentality having independent policy-making and appropriating authority.
379.22EFFECTIVE DATE.This section is effective January 1, 2014.

379.23    Sec. 13. Minnesota Statutes 2012, section 626.556, subdivision 2, is amended to read:
379.24    Subd. 2. Definitions. As used in this section, the following terms have the meanings
379.25given them unless the specific content indicates otherwise:
379.26    (a) "Family assessment" means a comprehensive assessment of child safety, risk
379.27of subsequent child maltreatment, and family strengths and needs that is applied to a
379.28child maltreatment report that does not allege substantial child endangerment. Family
379.29assessment does not include a determination as to whether child maltreatment occurred
379.30but does determine the need for services to address the safety of family members and the
379.31risk of subsequent maltreatment.
379.32    (b) "Investigation" means fact gathering related to the current safety of a child
379.33and the risk of subsequent maltreatment that determines whether child maltreatment
380.1occurred and whether child protective services are needed. An investigation must be used
380.2when reports involve substantial child endangerment, and for reports of maltreatment in
380.3facilities required to be licensed under chapter 245A or 245B; under sections 144.50 to
380.4144.58 and 241.021; in a school as defined in sections 120A.05, subdivisions 9, 11, and
380.513, and 124D.10; or in a nonlicensed personal care provider association as defined in
380.6sections 256B.04, subdivision 16, and 256B.0625, subdivision 19a.
380.7    (c) "Substantial child endangerment" means a person responsible for a child's care,
380.8and in the case of sexual abuse includes a person who has a significant relationship to the
380.9child as defined in section 609.341, or a person in a position of authority as defined in
380.10section 609.341, who by act or omission commits or attempts to commit an act against a
380.11child under their care that constitutes any of the following:
380.12    (1) egregious harm as defined in section 260C.007, subdivision 14;
380.13    (2) sexual abuse as defined in paragraph (d);
380.14    (3) abandonment under section 260C.301, subdivision 2;
380.15    (4) neglect as defined in paragraph (f), clause (2), that substantially endangers the
380.16child's physical or mental health, including a growth delay, which may be referred to as
380.17failure to thrive, that has been diagnosed by a physician and is due to parental neglect;
380.18    (5) murder in the first, second, or third degree under section 609.185, 609.19, or
380.19609.195 ;
380.20    (6) manslaughter in the first or second degree under section 609.20 or 609.205;
380.21    (7) assault in the first, second, or third degree under section 609.221, 609.222, or
380.22609.223 ;
380.23    (8) solicitation, inducement, and promotion of prostitution under section 609.322;
380.24    (9) criminal sexual conduct under sections 609.342 to 609.3451;
380.25    (10) solicitation of children to engage in sexual conduct under section 609.352;
380.26    (11) malicious punishment or neglect or endangerment of a child under section
380.27609.377 or 609.378;
380.28    (12) use of a minor in sexual performance under section 617.246; or
380.29    (13) parental behavior, status, or condition which mandates that the county attorney
380.30file a termination of parental rights petition under section 260C.301, subdivision 3,
380.31paragraph (a).
380.32    (d) "Sexual abuse" means the subjection of a child by a person responsible for the
380.33child's care, by a person who has a significant relationship to the child, as defined in
380.34section 609.341, or by a person in a position of authority, as defined in section 609.341,
380.35subdivision 10, to any act which constitutes a violation of section 609.342 (criminal sexual
380.36conduct in the first degree), 609.343 (criminal sexual conduct in the second degree),
381.1609.344 (criminal sexual conduct in the third degree), 609.345 (criminal sexual conduct
381.2in the fourth degree), or 609.3451 (criminal sexual conduct in the fifth degree). Sexual
381.3abuse also includes any act which involves a minor which constitutes a violation of
381.4prostitution offenses under sections 609.321 to 609.324 or 617.246. Sexual abuse includes
381.5threatened sexual abuse which includes the status of a parent or household member
381.6who has committed a violation which requires registration as an offender under section
381.7243.166, subdivision 1b, paragraph (a) or (b), or required registration under section
381.8243.166, subdivision 1b, paragraph (a) or (b).
381.9    (e) "Person responsible for the child's care" means (1) an individual functioning
381.10within the family unit and having responsibilities for the care of the child such as a
381.11parent, guardian, or other person having similar care responsibilities, or (2) an individual
381.12functioning outside the family unit and having responsibilities for the care of the child
381.13such as a teacher, school administrator, other school employees or agents, or other lawful
381.14custodian of a child having either full-time or short-term care responsibilities including,
381.15but not limited to, day care, babysitting whether paid or unpaid, counseling, teaching,
381.16and coaching.
381.17    (f) "Neglect" means the commission or omission of any of the acts specified under
381.18clauses (1) to (9), other than by accidental means:
381.19    (1) failure by a person responsible for a child's care to supply a child with necessary
381.20food, clothing, shelter, health, medical, or other care required for the child's physical or
381.21mental health when reasonably able to do so;
381.22    (2) failure to protect a child from conditions or actions that seriously endanger the
381.23child's physical or mental health when reasonably able to do so, including a growth delay,
381.24which may be referred to as a failure to thrive, that has been diagnosed by a physician and
381.25is due to parental neglect;
381.26    (3) failure to provide for necessary supervision or child care arrangements
381.27appropriate for a child after considering factors as the child's age, mental ability, physical
381.28condition, length of absence, or environment, when the child is unable to care for the
381.29child's own basic needs or safety, or the basic needs or safety of another child in their care;
381.30    (4) failure to ensure that the child is educated as defined in sections 120A.22 and
381.31260C.163, subdivision 11 , which does not include a parent's refusal to provide the parent's
381.32child with sympathomimetic medications, consistent with section 125A.091, subdivision 5;
381.33    (5) nothing in this section shall be construed to mean that a child is neglected solely
381.34because the child's parent, guardian, or other person responsible for the child's care in
381.35good faith selects and depends upon spiritual means or prayer for treatment or care of
381.36disease or remedial care of the child in lieu of medical care; except that a parent, guardian,
382.1or caretaker, or a person mandated to report pursuant to subdivision 3, has a duty to report
382.2if a lack of medical care may cause serious danger to the child's health. This section does
382.3not impose upon persons, not otherwise legally responsible for providing a child with
382.4necessary food, clothing, shelter, education, or medical care, a duty to provide that care;
382.5    (6) prenatal exposure to a controlled substance, as defined in section 253B.02,
382.6subdivision 2, used by the mother for a nonmedical purpose, as evidenced by withdrawal
382.7symptoms in the child at birth, results of a toxicology test performed on the mother at
382.8delivery or the child at birth, medical effects or developmental delays during the child's
382.9first year of life that medically indicate prenatal exposure to a controlled substance, or the
382.10presence of a fetal alcohol spectrum disorder;
382.11    (7) "medical neglect" as defined in section 260C.007, subdivision 6, clause (5);
382.12    (8) chronic and severe use of alcohol or a controlled substance by a parent or
382.13person responsible for the care of the child that adversely affects the child's basic needs
382.14and safety; or
382.15    (9) emotional harm from a pattern of behavior which contributes to impaired
382.16emotional functioning of the child which may be demonstrated by a substantial and
382.17observable effect in the child's behavior, emotional response, or cognition that is not
382.18within the normal range for the child's age and stage of development, with due regard to
382.19the child's culture.
382.20    (g) "Physical abuse" means any physical injury, mental injury, or threatened injury,
382.21inflicted by a person responsible for the child's care on a child other than by accidental
382.22means, or any physical or mental injury that cannot reasonably be explained by the child's
382.23history of injuries, or any aversive or deprivation procedures, or regulated interventions,
382.24that have not been authorized under section 121A.67 or 245.825.
382.25    Abuse does not include reasonable and moderate physical discipline of a child
382.26administered by a parent or legal guardian which does not result in an injury. Abuse does
382.27not include the use of reasonable force by a teacher, principal, or school employee as
382.28allowed by section 121A.582. Actions which are not reasonable and moderate include,
382.29but are not limited to, any of the following that are done in anger or without regard to the
382.30safety of the child:
382.31    (1) throwing, kicking, burning, biting, or cutting a child;
382.32    (2) striking a child with a closed fist;
382.33    (3) shaking a child under age three;
382.34    (4) striking or other actions which result in any nonaccidental injury to a child
382.35under 18 months of age;
382.36    (5) unreasonable interference with a child's breathing;
383.1    (6) threatening a child with a weapon, as defined in section 609.02, subdivision 6;
383.2    (7) striking a child under age one on the face or head;
383.3    (8) purposely giving a child poison, alcohol, or dangerous, harmful, or controlled
383.4substances which were not prescribed for the child by a practitioner, in order to control or
383.5punish the child; or other substances that substantially affect the child's behavior, motor
383.6coordination, or judgment or that results in sickness or internal injury, or subjects the
383.7child to medical procedures that would be unnecessary if the child were not exposed
383.8to the substances;
383.9    (9) unreasonable physical confinement or restraint not permitted under section
383.10609.379 , including but not limited to tying, caging, or chaining; or
383.11    (10) in a school facility or school zone, an act by a person responsible for the child's
383.12care that is a violation under section 121A.58.
383.13    (h) "Report" means any report received by the local welfare agency, police
383.14department, county sheriff, or agency responsible for assessing or investigating
383.15maltreatment pursuant to this section.
383.16    (i) "Facility" means:
383.17    (1) a licensed or unlicensed day care facility, residential facility, agency, hospital,
383.18sanitarium, or other facility or institution required to be licensed under sections 144.50 to
383.19144.58 , 241.021, or 245A.01 to 245A.16, or chapter 245B 245D;
383.20    (2) a school as defined in sections 120A.05, subdivisions 9, 11, and 13; and
383.21124D.10 ; or
383.22    (3) a nonlicensed personal care provider organization as defined in sections 256B.04,
383.23subdivision 16, and 256B.0625, subdivision 19a.
383.24    (j) "Operator" means an operator or agency as defined in section 245A.02.
383.25    (k) "Commissioner" means the commissioner of human services.
383.26    (l) "Practice of social services," for the purposes of subdivision 3, includes but is
383.27not limited to employee assistance counseling and the provision of guardian ad litem and
383.28parenting time expeditor services.
383.29    (m) "Mental injury" means an injury to the psychological capacity or emotional
383.30stability of a child as evidenced by an observable or substantial impairment in the child's
383.31ability to function within a normal range of performance and behavior with due regard to
383.32the child's culture.
383.33    (n) "Threatened injury" means a statement, overt act, condition, or status that
383.34represents a substantial risk of physical or sexual abuse or mental injury. Threatened
383.35injury includes, but is not limited to, exposing a child to a person responsible for the
383.36child's care, as defined in paragraph (e), clause (1), who has:
384.1    (1) subjected a child to, or failed to protect a child from, an overt act or condition
384.2that constitutes egregious harm, as defined in section 260C.007, subdivision 14, or a
384.3similar law of another jurisdiction;
384.4    (2) been found to be palpably unfit under section 260C.301, paragraph (b), clause
384.5(4), or a similar law of another jurisdiction;
384.6    (3) committed an act that has resulted in an involuntary termination of parental rights
384.7under section 260C.301, or a similar law of another jurisdiction; or
384.8    (4) committed an act that has resulted in the involuntary transfer of permanent
384.9legal and physical custody of a child to a relative under Minnesota Statutes 2010, section
384.10260C.201, subdivision 11 , paragraph (d), clause (1), section 260C.515, subdivision 4, or a
384.11similar law of another jurisdiction.
384.12A child is the subject of a report of threatened injury when the responsible social
384.13services agency receives birth match data under paragraph (o) from the Department of
384.14Human Services.
384.15(o) Upon receiving data under section 144.225, subdivision 2b, contained in a
384.16birth record or recognition of parentage identifying a child who is subject to threatened
384.17injury under paragraph (n), the Department of Human Services shall send the data to the
384.18responsible social services agency. The data is known as "birth match" data. Unless the
384.19responsible social services agency has already begun an investigation or assessment of the
384.20report due to the birth of the child or execution of the recognition of parentage and the
384.21parent's previous history with child protection, the agency shall accept the birth match
384.22data as a report under this section. The agency may use either a family assessment or
384.23investigation to determine whether the child is safe. All of the provisions of this section
384.24apply. If the child is determined to be safe, the agency shall consult with the county
384.25attorney to determine the appropriateness of filing a petition alleging the child is in need
384.26of protection or services under section 260C.007, subdivision 6, clause (16), in order to
384.27deliver needed services. If the child is determined not to be safe, the agency and the county
384.28attorney shall take appropriate action as required under section 260C.301, subdivision 3.
384.29    (p) Persons who conduct assessments or investigations under this section shall take
384.30into account accepted child-rearing practices of the culture in which a child participates
384.31and accepted teacher discipline practices, which are not injurious to the child's health,
384.32welfare, and safety.
384.33    (q) "Accidental" means a sudden, not reasonably foreseeable, and unexpected
384.34occurrence or event which:
384.35    (1) is not likely to occur and could not have been prevented by exercise of due
384.36care; and
385.1    (2) if occurring while a child is receiving services from a facility, happens when the
385.2facility and the employee or person providing services in the facility are in compliance
385.3with the laws and rules relevant to the occurrence or event.
385.4(r) "Nonmaltreatment mistake" means:
385.5(1) at the time of the incident, the individual was performing duties identified in the
385.6center's child care program plan required under Minnesota Rules, part 9503.0045;
385.7(2) the individual has not been determined responsible for a similar incident that
385.8resulted in a finding of maltreatment for at least seven years;
385.9(3) the individual has not been determined to have committed a similar
385.10nonmaltreatment mistake under this paragraph for at least four years;
385.11(4) any injury to a child resulting from the incident, if treated, is treated only with
385.12remedies that are available over the counter, whether ordered by a medical professional or
385.13not; and
385.14(5) except for the period when the incident occurred, the facility and the individual
385.15providing services were both in compliance with all licensing requirements relevant to the
385.16incident.
385.17This definition only applies to child care centers licensed under Minnesota
385.18Rules, chapter 9503. If clauses (1) to (5) apply, rather than making a determination of
385.19substantiated maltreatment by the individual, the commissioner of human services shall
385.20determine that a nonmaltreatment mistake was made by the individual.
385.21EFFECTIVE DATE.This section is effective January 1, 2014.

385.22    Sec. 14. Minnesota Statutes 2012, section 626.556, subdivision 3, is amended to read:
385.23    Subd. 3. Persons mandated to report. (a) A person who knows or has reason
385.24to believe a child is being neglected or physically or sexually abused, as defined in
385.25subdivision 2, or has been neglected or physically or sexually abused within the preceding
385.26three years, shall immediately report the information to the local welfare agency, agency
385.27responsible for assessing or investigating the report, police department, or the county
385.28sheriff if the person is:
385.29    (1) a professional or professional's delegate who is engaged in the practice of
385.30the healing arts, social services, hospital administration, psychological or psychiatric
385.31treatment, child care, education, correctional supervision, probation and correctional
385.32services, or law enforcement; or
385.33    (2) employed as a member of the clergy and received the information while
385.34engaged in ministerial duties, provided that a member of the clergy is not required by
386.1this subdivision to report information that is otherwise privileged under section 595.02,
386.2subdivision 1 , paragraph (c).
386.3    The police department or the county sheriff, upon receiving a report, shall
386.4immediately notify the local welfare agency or agency responsible for assessing or
386.5investigating the report, orally and in writing. The local welfare agency, or agency
386.6responsible for assessing or investigating the report, upon receiving a report, shall
386.7immediately notify the local police department or the county sheriff orally and in writing.
386.8The county sheriff and the head of every local welfare agency, agency responsible
386.9for assessing or investigating reports, and police department shall each designate a
386.10person within their agency, department, or office who is responsible for ensuring that
386.11the notification duties of this paragraph and paragraph (b) are carried out. Nothing in
386.12this subdivision shall be construed to require more than one report from any institution,
386.13facility, school, or agency.
386.14    (b) Any person may voluntarily report to the local welfare agency, agency responsible
386.15for assessing or investigating the report, police department, or the county sheriff if the
386.16person knows, has reason to believe, or suspects a child is being or has been neglected or
386.17subjected to physical or sexual abuse. The police department or the county sheriff, upon
386.18receiving a report, shall immediately notify the local welfare agency or agency responsible
386.19for assessing or investigating the report, orally and in writing. The local welfare agency or
386.20agency responsible for assessing or investigating the report, upon receiving a report, shall
386.21immediately notify the local police department or the county sheriff orally and in writing.
386.22    (c) A person mandated to report physical or sexual child abuse or neglect occurring
386.23within a licensed facility shall report the information to the agency responsible for
386.24licensing the facility under sections 144.50 to 144.58; 241.021; 245A.01 to 245A.16; or
386.25chapter 245B 245D; or a nonlicensed personal care provider organization as defined in
386.26sections 256B.04, subdivision 16; and 256B.0625, subdivision 19. A health or corrections
386.27agency receiving a report may request the local welfare agency to provide assistance
386.28pursuant to subdivisions 10, 10a, and 10b. A board or other entity whose licensees
386.29perform work within a school facility, upon receiving a complaint of alleged maltreatment,
386.30shall provide information about the circumstances of the alleged maltreatment to the
386.31commissioner of education. Section 13.03, subdivision 4, applies to data received by the
386.32commissioner of education from a licensing entity.
386.33    (d) Any person mandated to report shall receive a summary of the disposition of
386.34any report made by that reporter, including whether the case has been opened for child
386.35protection or other services, or if a referral has been made to a community organization,
386.36unless release would be detrimental to the best interests of the child. Any person who is
387.1not mandated to report shall, upon request to the local welfare agency, receive a concise
387.2summary of the disposition of any report made by that reporter, unless release would be
387.3detrimental to the best interests of the child.
387.4    (e) For purposes of this section, "immediately" means as soon as possible but in
387.5no event longer than 24 hours.
387.6EFFECTIVE DATE.This section is effective January 1, 2014.

387.7    Sec. 15. Minnesota Statutes 2012, section 626.556, subdivision 10d, is amended to read:
387.8    Subd. 10d. Notification of neglect or abuse in facility. (a) When a report is
387.9received that alleges neglect, physical abuse, sexual abuse, or maltreatment of a child while
387.10in the care of a licensed or unlicensed day care facility, residential facility, agency, hospital,
387.11sanitarium, or other facility or institution required to be licensed according to sections
387.12144.50 to 144.58; 241.021; or 245A.01 to 245A.16; or chapter 245B 245D, or a school as
387.13defined in sections 120A.05, subdivisions 9, 11, and 13; and 124D.10; or a nonlicensed
387.14personal care provider organization as defined in section 256B.04, subdivision 16, and
387.15256B.0625, subdivision 19a , the commissioner of the agency responsible for assessing
387.16or investigating the report or local welfare agency investigating the report shall provide
387.17the following information to the parent, guardian, or legal custodian of a child alleged to
387.18have been neglected, physically abused, sexually abused, or the victim of maltreatment
387.19of a child in the facility: the name of the facility; the fact that a report alleging neglect,
387.20physical abuse, sexual abuse, or maltreatment of a child in the facility has been received;
387.21the nature of the alleged neglect, physical abuse, sexual abuse, or maltreatment of a child
387.22in the facility; that the agency is conducting an assessment or investigation; any protective
387.23or corrective measures being taken pending the outcome of the investigation; and that a
387.24written memorandum will be provided when the investigation is completed.
387.25(b) The commissioner of the agency responsible for assessing or investigating the
387.26report or local welfare agency may also provide the information in paragraph (a) to the
387.27parent, guardian, or legal custodian of any other child in the facility if the investigative
387.28agency knows or has reason to believe the alleged neglect, physical abuse, sexual
387.29abuse, or maltreatment of a child in the facility has occurred. In determining whether
387.30to exercise this authority, the commissioner of the agency responsible for assessing
387.31or investigating the report or local welfare agency shall consider the seriousness of the
387.32alleged neglect, physical abuse, sexual abuse, or maltreatment of a child in the facility; the
387.33number of children allegedly neglected, physically abused, sexually abused, or victims of
387.34maltreatment of a child in the facility; the number of alleged perpetrators; and the length
387.35of the investigation. The facility shall be notified whenever this discretion is exercised.
388.1(c) When the commissioner of the agency responsible for assessing or investigating
388.2the report or local welfare agency has completed its investigation, every parent, guardian,
388.3or legal custodian previously notified of the investigation by the commissioner or
388.4local welfare agency shall be provided with the following information in a written
388.5memorandum: the name of the facility investigated; the nature of the alleged neglect,
388.6physical abuse, sexual abuse, or maltreatment of a child in the facility; the investigator's
388.7name; a summary of the investigation findings; a statement whether maltreatment was
388.8found; and the protective or corrective measures that are being or will be taken. The
388.9memorandum shall be written in a manner that protects the identity of the reporter and
388.10the child and shall not contain the name, or to the extent possible, reveal the identity of
388.11the alleged perpetrator or of those interviewed during the investigation. If maltreatment
388.12is determined to exist, the commissioner or local welfare agency shall also provide the
388.13written memorandum to the parent, guardian, or legal custodian of each child in the facility
388.14who had contact with the individual responsible for the maltreatment. When the facility is
388.15the responsible party for maltreatment, the commissioner or local welfare agency shall also
388.16provide the written memorandum to the parent, guardian, or legal custodian of each child
388.17who received services in the population of the facility where the maltreatment occurred.
388.18This notification must be provided to the parent, guardian, or legal custodian of each child
388.19receiving services from the time the maltreatment occurred until either the individual
388.20responsible for maltreatment is no longer in contact with a child or children in the facility
388.21or the conclusion of the investigation. In the case of maltreatment within a school facility,
388.22as defined in sections 120A.05, subdivisions 9, 11, and 13, and 124D.10, the commissioner
388.23of education need not provide notification to parents, guardians, or legal custodians of
388.24each child in the facility, but shall, within ten days after the investigation is completed,
388.25provide written notification to the parent, guardian, or legal custodian of any student
388.26alleged to have been maltreated. The commissioner of education may notify the parent,
388.27guardian, or legal custodian of any student involved as a witness to alleged maltreatment.
388.28EFFECTIVE DATE.This section is effective January 1, 2014.

388.29    Sec. 16. REPEALER.
388.30Minnesota Statutes 2012, section 256B.49, subdivision 16a, is repealed effective
388.31January 1, 2014.

389.1ARTICLE 10

389.2HEALTH-RELATED LICENSING BOARDS

389.3    Section 1. Minnesota Statutes 2012, section 13.411, subdivision 7, is amended to read:
389.4    Subd. 7. Examining and licensing boards. (a) Health licensing boards. Data
389.5held by health licensing boards are classified under sections 214.10, subdivision 8, and
389.6214.25, subdivision 1 .
389.7(b) Combined boards data. Data held by licensing boards participating in a health
389.8professional services program are classified under sections 214.34 and 214.35.
389.9(c) Criminal background checks. Criminal history record information obtained by
389.10a health-related licensing board is classified under section 214.075, subdivision 7.

389.11    Sec. 2. Minnesota Statutes 2012, section 148B.17, subdivision 2, is amended to read:
389.12    Subd. 2. Licensure and application fees. Nonrefundable licensure and application
389.13fees charged established by the board are as follows shall not exceed the following amounts:
389.14(1) application fee for national examination is $220 $110;
389.15(2) application fee for Licensed Marriage and Family Therapist (LMFT) state
389.16examination is $110;
389.17(3) initial LMFT license fee is prorated, but cannot exceed $125;
389.18(4) annual renewal fee for LMFT license is $125;
389.19(5) late fee for initial Licensed Associate Marriage and Family Therapist LAMFT
389.20 LMFT license renewal is $50;
389.21(6) application fee for LMFT licensure by reciprocity is $340 $220;
389.22(7) fee for initial Licensed Associate Marriage and Family Therapist (LAMFT)
389.23license is $75;
389.24(8) annual renewal fee for LAMFT license is $75;
389.25(9) late fee for LAMFT renewal is $50 $25;
389.26(10) fee for reinstatement of license is $150; and
389.27(11) fee for emeritus status is $125.

389.28    Sec. 3. Minnesota Statutes 2012, section 151.01, subdivision 27, is amended to read:
389.29    Subd. 27. Practice of pharmacy. "Practice of pharmacy" means:
389.30    (1) interpretation and evaluation of prescription drug orders;
389.31    (2) compounding, labeling, and dispensing drugs and devices (except labeling by
389.32a manufacturer or packager of nonprescription drugs or commercially packaged legend
389.33drugs and devices);
390.1    (3) participation in clinical interpretations and monitoring of drug therapy for
390.2assurance of safe and effective use of drugs;
390.3    (4) participation in drug and therapeutic device selection; drug administration for first
390.4dosage and medical emergencies; drug regimen reviews; and drug or drug-related research;
390.5    (5) participation in administration of influenza vaccines to all eligible individuals ten
390.6years of age and older and all other vaccines to patients 18 years of age and older under
390.7standing orders from a physician licensed under chapter 147 or by written protocol with a
390.8physician licensed under chapter 147 provided that:
390.9    (i) the standing orders or protocol include, at a minimum, the name, dosage, and
390.10route of each vaccine that may be given, the patient population to whom the vaccine may
390.11be given, contraindications and precautions to the vaccine, the procedure for handling an
390.12adverse reaction, the name and signature of the physician, the address of the physician, a
390.13phone number at which the physician can be contacted, and the date and time period for
390.14which the standing orders or protocol are valid;
390.15    (i) (ii) the pharmacist is trained in has successfully completed a program approved
390.16by the American Accreditation Council of Pharmaceutical for Pharmacy Education,
390.17specifically for the administration of immunizations, or graduated from a college of
390.18pharmacy in 2001 or thereafter; and a program approved according to rules adopted by
390.19the board;
390.20    (iii) the pharmacist completes continuing education concerning the administration of
390.21immunizations, as required by Minnesota Rules;
390.22    (iv) the pharmacist has a current cardiopulmonary resuscitation certificate;
390.23    (ii) (v) the pharmacist reports the administration of the immunization to the patient's
390.24primary physician or clinic or to the Minnesota Immunization Information Connection;
390.25    (vi) the pharmacist complies with guidelines for vaccines and immunizations
390.26established by the federal Advisory Committee on Immunization Practices (ACIP), except
390.27that a pharmacist does not need to comply with those guidelines if administering a vaccine
390.28pursuant to a valid, patient-specific order issued by a physician licensed under chapter 147
390.29when the order is consistent with United States Food and Drug Administration-approved
390.30labeling of the vaccine; and
390.31    (vii) the pharmacist complies with Centers for Disease Control and Prevention
390.32guidelines relating to immunization schedules, vaccine storage and handling, and vaccine
390.33administration and documentation;
390.34    (6) participation in the practice of managing drug therapy and modifying drug
390.35therapy, according to section 151.21, subdivision 1, according to a written protocol
390.36between the specific pharmacist and the individual dentist, optometrist, physician,
391.1podiatrist, or veterinarian who is responsible for the patient's care and authorized to
391.2independently prescribe drugs. Any significant changes in drug therapy must be reported
391.3by the pharmacist to the patient's medical record;
391.4    (7) participation in the storage of drugs and the maintenance of records;
391.5    (8) responsibility for participation in patient counseling on therapeutic values,
391.6content, hazards, and uses of drugs and devices; and
391.7    (9) offering or performing those acts, services, operations, or transactions necessary
391.8in the conduct, operation, management, and control of a pharmacy.

391.9    Sec. 4. Minnesota Statutes 2012, section 151.19, subdivision 1, is amended to read:
391.10    Subdivision 1. Pharmacy registration licensure requirements. The board shall
391.11require and provide for the annual registration of every pharmacy now or hereafter doing
391.12business within this state. Upon the payment of any applicable fee specified in section
391.13151.065, the board shall issue a registration certificate in such form as it may prescribe to
391.14such persons as may be qualified by law to conduct a pharmacy. Such certificate shall
391.15be displayed in a conspicuous place in the pharmacy for which it is issued and expire on
391.16the 30th day of June following the date of issue. It shall be unlawful for any person to
391.17conduct a pharmacy unless such certificate has been issued to the person by the board. (a)
391.18No person shall operate a pharmacy without first obtaining a license from the board and
391.19paying any applicable fee specified in section 151.065. The license shall be displayed in a
391.20conspicuous place in the pharmacy for which it is issued and expires on June 30 following
391.21the date of issue. It is unlawful for any person to operate a pharmacy unless the license
391.22has been issued to the person by the board.
391.23    (b) Application for a pharmacy license under this section shall be made in a manner
391.24specified by the board.
391.25    (c) No license shall be issued or renewed for a pharmacy located within the state
391.26unless the applicant agrees to operate the pharmacy in a manner prescribed by federal and
391.27state law and according to rules adopted by the board. No license shall be issued for a
391.28pharmacy located outside of the state unless the applicant agrees to operate the pharmacy
391.29in a manner prescribed by federal law and, when dispensing medications for residents of
391.30this state, the laws of this state, and Minnesota Rules.
391.31    (d) No license shall be issued or renewed for a pharmacy that is required to be
391.32licensed or registered by the state in which it is physically located unless the applicant
391.33supplies the board with proof of such licensure or registration.
392.1    (e) The board shall require a separate license for each pharmacy located within
392.2the state and for each pharmacy located outside of the state at which any portion of the
392.3dispensing process occurs for drugs dispensed to residents of this state.
392.4    (f) The board shall not issue an initial or renewed license for a pharmacy unless the
392.5pharmacy passes an inspection conducted by an authorized representative of the board. In
392.6the case of a pharmacy located outside of the state, the board may require the applicant to
392.7pay the cost of the inspection, in addition to the license fee in section 151.065, unless the
392.8applicant furnishes the board with a report, issued by the appropriate regulatory agency of
392.9the state in which the facility is located, of an inspection that has occurred within the 24
392.10months immediately preceding receipt of the license application by the board. The board
392.11may deny licensure unless the applicant submits documentation satisfactory to the board
392.12that any deficiencies noted in an inspection report have been corrected.
392.13    (g) The board shall not issue an initial or renewed license for a pharmacy located
392.14outside of the state unless the applicant discloses and certifies:
392.15    (1) the location, names, and titles of all principal corporate officers and all
392.16pharmacists who are involved in dispensing drugs to residents of this state;
392.17    (2) that it maintains its records of drugs dispensed to residents of this state so that the
392.18records are readily retrievable from the records of other drugs dispensed;
392.19    (3) that it agrees to cooperate with, and provide information to, the board concerning
392.20matters related to dispensing drugs to residents of this state;
392.21    (4) that, during its regular hours of operation, but no less than six days per week, for
392.22a minimum of 40 hours per week, a toll-free telephone service is provided to facilitate
392.23communication between patients in this state and a pharmacist at the pharmacy who has
392.24access to the patients' records; the toll-free number must be disclosed on the label affixed
392.25to each container of drugs dispensed to residents of this state; and
392.26    (5) that, upon request of a resident of a long-term care facility located in this
392.27state, the resident's authorized representative, or a contract pharmacy or licensed health
392.28care facility acting on behalf of the resident, the pharmacy will dispense medications
392.29prescribed for the resident in unit-dose packaging or, alternatively, comply with section
392.30151.415, subdivision 5.

392.31    Sec. 5. Minnesota Statutes 2012, section 151.19, subdivision 3, is amended to read:
392.32    Subd. 3. Sale of federally restricted medical gases. The board shall require and
392.33provide for the annual registration of every person or establishment not licensed as a
392.34pharmacy or a practitioner engaged in the retail sale or distribution of federally restricted
392.35medical gases. Upon the payment of any applicable fee specified in section 151.065, the
393.1board shall issue a registration certificate in such form as it may prescribe to those persons
393.2or places that may be qualified to sell or distribute federally restricted medical gases. The
393.3certificate shall be displayed in a conspicuous place in the business for which it is issued
393.4and expire on the date set by the board. It is unlawful for a person to sell or distribute
393.5federally restricted medical gases unless a certificate has been issued to that person by the
393.6board. (a) A person or establishment not licensed as a pharmacy or a practitioner shall not
393.7engage in the retail sale or distribution of federally restricted medical gases without first
393.8obtaining a registration from the board and paying the applicable fee specified in section
393.9151.065. The registration shall be displayed in a conspicuous place in the business for
393.10which it is issued and expires on the date set by the board. It is unlawful for a person to
393.11sell or distribute federally restricted medical gases unless a certificate has been issued to
393.12that person by the board.
393.13    (b) Application for a medical gas distributor registration under this section shall be
393.14made in a manner specified by the board.
393.15    (c) No registration shall be issued or renewed for a medical gas distributor located
393.16within the state unless the applicant agrees to operate in a manner prescribed by federal
393.17and state law and according to the rules adopted by the board. No license shall be issued
393.18for a medical gas distributor located outside of the state unless the applicant agrees to
393.19operate in a manner prescribed by federal law and, when distributing medical gases for
393.20residents of this state, the laws of this state and Minnesota Rules.
393.21    (d) No registration shall be issued or renewed for a medical gas distributor that is
393.22required to be licensed or registered by the state in which it is physically located unless the
393.23applicant supplies the board with proof of the licensure or registration. The board may, by
393.24rule, establish standards for the registration of a medical gas distributor that is not required
393.25to be licensed or registered by the state in which it is physically located.
393.26    (e) The board shall require a separate registration for each medical gas distributor
393.27located within the state and for each facility located outside of the state from which
393.28medical gases are distributed to residents of this state.
393.29    (f) The board shall not issue an initial or renewed registration for a medical gas
393.30distributor unless the medical gas distributor passes an inspection conducted by an
393.31authorized representative of the board. In the case of a medical gas distributor located
393.32outside of the state, the board may require the applicant to pay the cost of the inspection,
393.33in addition to the license fee in section 151.065, unless the applicant furnishes the board
393.34with a report, issued by the appropriate regulatory agency of the state in which the facility
393.35is located, of an inspection that has occurred within the 24 months immediately preceding
393.36receipt of the license application by the board. The board may deny licensure unless the
394.1applicant submits documentation satisfactory to the board that any deficiencies noted in
394.2an inspection report have been corrected.

394.3    Sec. 6. [151.252] LICENSING OF DRUG MANUFACTURERS; FEES;
394.4PROHIBITIONS.
394.5    Subdivision 1. Requirements. (a) No person shall act as a manufacturer without
394.6first obtaining a license from the board and paying any applicable fee specified in section
394.7151.065.
394.8    (b) Application for a manufacturer license under this section shall be made in a
394.9manner specified by the board.
394.10    (c) No license shall be issued or renewed for a manufacturer unless the applicant
394.11agrees to operate in a manner prescribed by federal and state law and according to
394.12Minnesota Rules.
394.13    (d) No license shall be issued or renewed for a manufacturer that is required to
394.14be registered pursuant to United State Code, title 21, section 360, unless the applicant
394.15supplies the board with proof of registration. The board may establish by rule the
394.16standards for licensure of manufacturers that are not required to be registered under United
394.17States Code, title 21, section 360.
394.18    (e) No license shall be issued or renewed for a manufacturer that is required to be
394.19licensed or registered by the state in which it is physically located unless the applicant
394.20supplies the board with proof of licensure or registration. The board may establish, by
394.21rule, standards for the licensure of a manufacturer that is not required to be licensed or
394.22registered by the state in which it is physically located.
394.23    (f) The board shall require a separate license for each facility located within the state
394.24at which manufacturing occurs and for each facility located outside of the state at which
394.25drugs that are shipped into the state are manufactured.
394.26    (g) The board shall not issue an initial or renewed license for a manufacturing
394.27facility unless the facility passes an inspection conducted by an authorized representative
394.28of the board. In the case of a manufacturing facility located outside of the state, the board
394.29may require the applicant to pay the cost of the inspection, in addition to the license fee
394.30in section 151.065, unless the applicant furnishes the board with a report, issued by the
394.31appropriate regulatory agency of the state in which the facility is located or by the United
394.32States Food and Drug Administration, of an inspection that has occurred within the 24
394.33months immediately preceding receipt of the license application by the board. The board
394.34may deny licensure unless the applicant submits documentation satisfactory to the board
394.35that any deficiencies noted in an inspection report have been corrected.
395.1    Subd. 2. Prohibition. It is unlawful for any person engaged in manufacturing to sell
395.2legend drugs to anyone located in this state except as provided in this chapter.

395.3    Sec. 7. Minnesota Statutes 2012, section 151.26, subdivision 1, is amended to read:
395.4    Subdivision 1. Generally. Nothing in this chapter shall subject a person duly
395.5licensed in this state to practice medicine, dentistry, or veterinary medicine, to inspection
395.6by the State Board of Pharmacy, nor prevent the person from administering drugs,
395.7medicines, chemicals, or poisons in the person's practice, nor prevent a duly licensed
395.8practitioner from furnishing to a patient properly packaged and labeled drugs, medicines,
395.9chemicals, or poisons as may be considered appropriate in the treatment of such patient;
395.10unless the person is engaged in the dispensing, sale, or distribution of drugs and the board
395.11provides reasonable notice of an inspection.
395.12    Except for the provisions of section 151.37, nothing in this chapter applies to or
395.13interferes with the dispensing, in its original package and at no charge to the patient, of
395.14a legend drug, other than a controlled substance, that was packaged by a manufacturer
395.15and provided to the dispenser for distribution dispensing as a professional sample, so
395.16long as the sample is prepared and distributed pursuant to Code of Federal Regulations,
395.17title 21, section 203, subpart D.
395.18    Nothing in this chapter shall prevent the sale of drugs, medicines, chemicals, or
395.19poisons at wholesale to licensed physicians, dentists and veterinarians for use in their
395.20practice, nor to hospitals for use therein.
395.21    Nothing in this chapter shall prevent the sale of drugs, chemicals, or poisons either
395.22at wholesale or retail for use for commercial purposes, or in the arts, nor interfere with the
395.23sale of insecticides, as defined in Minnesota Statutes 1974, section 24.069, and nothing in
395.24this chapter shall prevent the sale of common household preparations and other drugs,
395.25chemicals, and poisons sold exclusively for use for nonmedicinal purposes.
395.26    Nothing in this chapter shall apply to or interfere with the vending or retailing
395.27of any nonprescription medicine or drug not otherwise prohibited by statute which is
395.28prepackaged, fully prepared by the manufacturer or producer for use by the consumer, and
395.29labeled in accordance with the requirements of the state or federal Food and Drug Act; nor
395.30to the manufacture, wholesaling, vending, or retailing of flavoring extracts, toilet articles,
395.31cosmetics, perfumes, spices, and other commonly used household articles of a chemical
395.32nature, for use for nonmedicinal purposes. Nothing in this chapter shall prevent the sale of
395.33drugs or medicines by licensed pharmacists at a discount to persons over 65 years of age.

395.34    Sec. 8. Minnesota Statutes 2012, section 151.37, subdivision 4, is amended to read:
396.1    Subd. 4. Research. (a) Any qualified person may use legend drugs in the course
396.2of a bona fide research project, but cannot administer or dispense such drugs to human
396.3beings unless such drugs are prescribed, dispensed, and administered by a person lawfully
396.4authorized to do so.
396.5    (b) Drugs may be dispensed or distributed by a pharmacy licensed by the board for
396.6use by, or administration to, patients enrolled in a bona fide research study that is being
396.7conducted pursuant to either an investigational new drug application approved by the
396.8United States Food and Drug Administration or that has been approved by an institutional
396.9review board. For the purposes of this subdivision only:
396.10    (1) a prescription drug order is not required for a pharmacy to dispense a research
396.11drug, unless the study protocol requires the pharmacy to receive such an order;
396.12    (2) notwithstanding the prescription labeling requirements found in this chapter or
396.13the rules promulgated by the board, a research drug may be labeled as required by the
396.14study protocol; and
396.15    (3) dispensing and distribution of research drugs by pharmacies shall not be
396.16considered compounding, manufacturing, or wholesaling under this chapter.
396.17    (c) An entity that is under contract to a federal agency for the purpose of distributing
396.18drugs for bona fide research studies is exempt from the drug wholesaler licensing
396.19requirements of this chapter. Any other entity is exempt from the drug wholesaler
396.20licensing requirements of this chapter if the board finds that the entity is licensed or
396.21registered according to the laws of the state in which it is physically located and it is
396.22distributing drugs for use by, or administration to, patients enrolled in a bona fide research
396.23study that is being conducted pursuant to either an investigational new drug application
396.24approved by the United States Food and Drug Administration or that has been approved
396.25by an institutional review board.
396.26EFFECTIVE DATE.This section is effective the day following final enactment.

396.27    Sec. 9. Minnesota Statutes 2012, section 151.47, subdivision 1, is amended to read:
396.28    Subdivision 1. Requirements. (a) All wholesale drug distributors are subject to the
396.29requirements in paragraphs (a) to (f) of this subdivision.
396.30    (a) (b) No person or distribution outlet shall act as a wholesale drug distributor
396.31without first obtaining a license from the board and paying any applicable fee specified
396.32in section 151.065.
396.33    (c) Application for a wholesale drug distributor license under this section shall be
396.34made in a manner specified by the board.
397.1    (b) (d) No license shall be issued or renewed for a wholesale drug distributor to
397.2operate unless the applicant agrees to operate in a manner prescribed by federal and state
397.3law and according to the rules adopted by the board.
397.4    (c) The board may require a separate license for each facility directly or indirectly
397.5owned or operated by the same business entity within the state, or for a parent entity
397.6with divisions, subsidiaries, or affiliate companies within the state, when operations
397.7are conducted at more than one location and joint ownership and control exists among
397.8all the entities.
397.9    (e) No license may be issued or renewed for a drug wholesale distributor that is
397.10required to be licensed or registered by the state in which it is physically located unless
397.11the applicant supplies the board with proof of licensure or registration. The board may
397.12establish, by rule, standards for the licensure of a drug wholesale distributor that is not
397.13required to be licensed or registered by the state in which it is physically located.
397.14    (f) The board shall require a separate license for each drug wholesale distributor
397.15facility located within the state and for each drug wholesale distributor facility located
397.16outside of the state from which drugs are shipped into the state or to which drugs are
397.17reverse distributed.
397.18    (g) The board shall not issue an initial or renewed license for a drug wholesale
397.19distributor facility unless the facility passes an inspection conducted by an authorized
397.20representative of the board. In the case of a drug wholesale distributor facility located
397.21outside of the state, the board may require the applicant to pay the cost of the inspection,
397.22in addition to the license fee in section 151.065, unless the applicant furnishes the board
397.23with a report, issued by the appropriate regulatory agency of the state in which the facility
397.24is located, of an inspection that has occurred within the 24 months immediately preceding
397.25receipt of the license application by the board. The board may deny licensure unless the
397.26applicant submits documentation satisfactory to the board that any deficiencies noted in
397.27an inspection report have been corrected.
397.28    (d) (h) As a condition for receiving and retaining a wholesale drug distributor license
397.29issued under sections 151.42 to 151.51, an applicant shall satisfy the board that it has
397.30and will continuously maintain:
397.31    (1) adequate storage conditions and facilities;
397.32    (2) minimum liability and other insurance as may be required under any applicable
397.33federal or state law;
397.34    (3) a viable security system that includes an after hours central alarm, or comparable
397.35entry detection capability; restricted access to the premises; comprehensive employment
397.36applicant screening; and safeguards against all forms of employee theft;
398.1    (4) a system of records describing all wholesale drug distributor activities set forth
398.2in section 151.44 for at least the most recent two-year period, which shall be reasonably
398.3accessible as defined by board regulations in any inspection authorized by the board;
398.4    (5) principals and persons, including officers, directors, primary shareholders,
398.5and key management executives, who must at all times demonstrate and maintain their
398.6capability of conducting business in conformity with sound financial practices as well
398.7as state and federal law;
398.8    (6) complete, updated information, to be provided to the board as a condition for
398.9obtaining and retaining a license, about each wholesale drug distributor to be licensed,
398.10including all pertinent corporate licensee information, if applicable, or other ownership,
398.11principal, key personnel, and facilities information found to be necessary by the board;
398.12    (7) written policies and procedures that assure reasonable wholesale drug distributor
398.13preparation for, protection against, and handling of any facility security or operation
398.14problems, including, but not limited to, those caused by natural disaster or government
398.15emergency, inventory inaccuracies or product shipping and receiving, outdated product
398.16or other unauthorized product control, appropriate disposition of returned goods, and
398.17product recalls;
398.18    (8) sufficient inspection procedures for all incoming and outgoing product
398.19shipments; and
398.20    (9) operations in compliance with all federal requirements applicable to wholesale
398.21drug distribution.
398.22    (e) (i) An agent or employee of any licensed wholesale drug distributor need not
398.23seek licensure under this section.
398.24    (f) A wholesale drug distributor shall file with the board an annual report, in a
398.25form and on the date prescribed by the board, identifying all payments, honoraria,
398.26reimbursement or other compensation authorized under section 151.461, clauses (3) to
398.27(5), paid to practitioners in Minnesota during the preceding calendar year. The report
398.28shall identify the nature and value of any payments totaling $100 or more, to a particular
398.29practitioner during the year, and shall identify the practitioner. Reports filed under this
398.30provision are public data.

398.31    Sec. 10. Minnesota Statutes 2012, section 151.47, is amended by adding a subdivision
398.32to read:
398.33    Subd. 3. Prohibition. It is unlawful for any person engaged in wholesale drug
398.34distribution to sell drugs to a person located within the state or to receive drugs in reverse
398.35distribution from a person located within the state except as provided in this chapter.

399.1    Sec. 11. Minnesota Statutes 2012, section 151.49, is amended to read:
399.2151.49 LICENSE RENEWAL APPLICATION PROCEDURES.
399.3    Application blanks or notices for renewal of a license required by sections 151.42
399.4to 151.51 shall be mailed or otherwise provided to each licensee on or before the first
399.5day of the month prior to the month in which the license expires and, if application for
399.6renewal of the license with the required fee and supporting documents is not made before
399.7the expiration date, the existing license or renewal shall lapse and become null and void
399.8upon the date of expiration.

399.9    Sec. 12. Minnesota Statutes 2012, section 152.126, is amended to read:
399.10152.126 CONTROLLED SUBSTANCES PRESCRIPTION ELECTRONIC
399.11REPORTING SYSTEM PRESCRIPTION MONITORING PROGRAM.
399.12    Subdivision 1. Definitions. (a) For purposes of this section, the terms defined in
399.13this subdivision have the meanings given.
399.14    (a) (b) "Board" means the Minnesota State Board of Pharmacy established under
399.15chapter 151.
399.16    (b) (c) "Controlled substances" means those substances listed in section 152.02,
399.17subdivisions 3 to 5 6, and those substances defined by the board pursuant to section
399.18152.02, subdivisions 7 , 8, and 12. For the purpose of this section only, "controlled
399.19substances" includes tramadol and butalbital.
399.20    (c) (d) "Dispense" or "dispensing" has the meaning given in section 151.01,
399.21subdivision 30 . Dispensing does not include the direct administering of a controlled
399.22substance to a patient by a licensed health care professional.
399.23    (d) (e) "Dispenser" means a person authorized by law to dispense a controlled
399.24substance, pursuant to a valid prescription. For the purposes of this section, a dispenser does
399.25not include a licensed hospital pharmacy that distributes controlled substances for inpatient
399.26hospital care or a veterinarian who is dispensing prescriptions under section 156.18.
399.27    (e) (f) "Prescriber" means a licensed health care professional who is authorized to
399.28prescribe a controlled substance under section 152.12, subdivision 1.
399.29    (f) (g) "Prescription" has the meaning given in section 151.01, subdivision 16.
399.30    Subd. 1a. Treatment of intractable pain. This section is not intended to limit or
399.31interfere with the legitimate prescribing of controlled substances for pain. No prescriber
399.32shall be subject to disciplinary action by a health-related licensing board for prescribing a
399.33controlled substance according to the provisions of section 152.125.
400.1    Subd. 2. Prescription electronic reporting system. (a) The board shall establish
400.2by January 1, 2010, an electronic system for reporting the information required under
400.3subdivision 4 for all controlled substances dispensed within the state.
400.4    (b) The board may contract with a vendor for the purpose of obtaining technical
400.5assistance in the design, implementation, operation, and maintenance of the electronic
400.6reporting system.
400.7    Subd. 3. Prescription Electronic Reporting Monitoring Program Advisory
400.8Committee. (a) The board shall convene an advisory committee. The committee must
400.9include at least one representative of:
400.10    (1) the Department of Health;
400.11    (2) the Department of Human Services;
400.12    (3) each health-related licensing board that licenses prescribers;
400.13    (4) a professional medical association, which may include an association of pain
400.14management and chemical dependency specialists;
400.15    (5) a professional pharmacy association;
400.16    (6) a professional nursing association;
400.17    (7) a professional dental association;
400.18    (8) a consumer privacy or security advocate; and
400.19    (9) a consumer or patient rights organization; and
400.20    (10) an association of medical examiners and coroners.
400.21    (b) The advisory committee shall advise the board on the development and operation
400.22of the electronic reporting system prescription monitoring program, including, but not
400.23limited to:
400.24    (1) technical standards for electronic prescription drug reporting;
400.25    (2) proper analysis and interpretation of prescription monitoring data; and
400.26    (3) an evaluation process for the program.
400.27    Subd. 4. Reporting requirements; notice. (a) Each dispenser must submit the
400.28following data to the board or its designated vendor, subject to the notice required under
400.29paragraph (d):
400.30    (1) name of the prescriber;
400.31    (2) national provider identifier of the prescriber;
400.32    (3) name of the dispenser;
400.33    (4) national provider identifier of the dispenser;
400.34    (5) prescription number;
400.35    (6) name of the patient for whom the prescription was written;
400.36    (7) address of the patient for whom the prescription was written;
401.1    (8) date of birth of the patient for whom the prescription was written;
401.2    (9) date the prescription was written;
401.3    (10) date the prescription was filled;
401.4    (11) name and strength of the controlled substance;
401.5    (12) quantity of controlled substance prescribed;
401.6    (13) quantity of controlled substance dispensed; and
401.7    (14) number of days supply.
401.8    (b) The dispenser must submit the required information by a procedure and in a
401.9format established by the board. The board may allow dispensers to omit data listed in this
401.10subdivision or may require the submission of data not listed in this subdivision provided
401.11the omission or submission is necessary for the purpose of complying with the electronic
401.12reporting or data transmission standards of the American Society for Automation in
401.13Pharmacy, the National Council on Prescription Drug Programs, or other relevant national
401.14standard-setting body.
401.15    (c) A dispenser is not required to submit this data for those controlled substance
401.16prescriptions dispensed for:
401.17    (1) individuals residing in licensed skilled nursing or intermediate care facilities;
401.18    (2) individuals receiving assisted living services under chapter 144G or through a
401.19medical assistance home and community-based waiver;
401.20    (3) individuals receiving medication intravenously;
401.21    (4) individuals receiving hospice and other palliative or end-of-life care; and
401.22    (5) individuals receiving services from a home care provider regulated under
401.23chapter 144A. individuals residing in a health care facility as defined in section 151.58,
401.24subdivision 2, paragraph (b), when a drug is distributed through the use of an automated
401.25drug distribution system according to section 151.58; and
401.26    (2) individuals receiving a drug sample that was packaged by a manufacturer and
401.27provided to the dispenser for dispensing as a professional sample pursuant to Code of
401.28Federal Regulations, title 21, section 203, subpart D.
401.29    (d) A dispenser must not submit data under this subdivision unless provide a
401.30conspicuous notice of the reporting requirements of this section is given to the patient for
401.31whom the prescription was written.
401.32    Subd. 5. Use of data by board. (a) The board shall develop and maintain a database
401.33of the data reported under subdivision 4. The board shall maintain data that could identify
401.34an individual prescriber or dispenser in encrypted form. The database may be used by
401.35permissible users identified under subdivision 6 for the identification of:
402.1    (1) individuals receiving prescriptions for controlled substances from prescribers
402.2who subsequently obtain controlled substances from dispensers in quantities or with a
402.3frequency inconsistent with generally recognized standards of use for those controlled
402.4substances, including standards accepted by national and international pain management
402.5associations; and
402.6    (2) individuals presenting forged or otherwise false or altered prescriptions for
402.7controlled substances to dispensers.
402.8    (b) No permissible user identified under subdivision 6 may access the database
402.9for the sole purpose of identifying prescribers of controlled substances for unusual or
402.10excessive prescribing patterns without a valid search warrant or court order.
402.11    (c) No personnel of a state or federal occupational licensing board or agency may
402.12access the database for the purpose of obtaining information to be used to initiate or
402.13substantiate a disciplinary action against a prescriber.
402.14    (d) Data reported under subdivision 4 shall be retained by the board in the an active
402.15 database for a 12-month period, and shall be removed from the active database no later
402.16than 12 months from the last day of the month during which the data was received. The
402.17board may transfer the data into a database that may only be used by the authorized staff
402.18of the board for the purposes of administering, operating, and maintaining the prescription
402.19monitoring program and conducting trend analyses and other studies as necessary to
402.20evaluate the effectiveness of the program. No data that can be used to identify an
402.21individual may be transferred into this database.
402.22    Subd. 6. Access to reporting system data. (a) Except as indicated in this
402.23subdivision, the data submitted to the board under subdivision 4 is private data on
402.24individuals as defined in section 13.02, subdivision 12, and not subject to public disclosure.
402.25    (b) Except as specified in subdivision 5, the following persons shall be considered
402.26permissible users and may access the data submitted under subdivision 4 in the same or
402.27similar manner, and for the same or similar purposes, as those persons who are authorized
402.28to access similar private data on individuals under federal and state law:
402.29    (1) a prescriber or an agent or employee of the prescriber to whom the prescriber has
402.30delegated the task of accessing the data, to the extent the information relates specifically to
402.31a current patient, to whom the prescriber is prescribing or considering prescribing any
402.32controlled substance or to whom the prescriber is providing other medical treatment for
402.33which access to the data may be necessary and with the provision that the prescriber remains
402.34responsible for the use or misuse of data accessed by a delegated agent or employee;
402.35    (2) a dispenser or an agent or employee of the dispenser to whom the dispenser has
402.36delegated the task of accessing the data, to the extent the information relates specifically
403.1to a current patient to whom that dispenser is dispensing or considering dispensing any
403.2controlled substance or to whom the dispenser is providing other pharmaceutical care for
403.3which access to the data may be necessary and with the provision that the dispenser remains
403.4responsible for the use or misuse of data accessed by a delegated agent or employee;
403.5    (3) a licensed pharmacist who is providing pharmaceutical care for which access to
403.6the data may be necessary or when consulted by a prescriber who is requesting data in
403.7accordance with clause (1);
403.8    (3) (4) an individual who is the recipient of a controlled substance prescription for
403.9which data was submitted under subdivision 4, or a guardian of the individual, parent or
403.10guardian of a minor, or health care agent of the individual acting under a health care
403.11directive under chapter 145C;
403.12    (4) (5) personnel of the board specifically assigned to conduct a bona fide
403.13investigation of a specific licensee;
403.14    (5) (6) personnel of the board engaged in the collection of controlled substance
403.15prescription information as part of the assigned duties and responsibilities under this
403.16section;
403.17    (6) (7) authorized personnel of a vendor under contract with the board who are
403.18engaged in the design, implementation, operation, and maintenance of the electronic
403.19reporting system prescription monitoring program as part of the assigned duties and
403.20responsibilities of their employment, provided that access to data is limited to the
403.21minimum amount necessary to carry out such duties and responsibilities;
403.22    (7) (8) federal, state, and local law enforcement authorities acting pursuant to a
403.23valid search warrant; and
403.24    (8) (9) personnel of the medical assistance program Minnesota health care programs
403.25 assigned to use the data collected under this section to identify and manage recipients
403.26whose usage of controlled substances may warrant restriction to a single primary care
403.27physician provider, a single outpatient pharmacy, or and a single hospital; and
403.28    (10) a coroner or medical examiner, or an agent or employee of the coroner or
403.29medical examiner to whom the coroner or medical examiner has delegated the task of
403.30accessing the data, conducting an investigation pursuant to section 390.11, and with the
403.31provision that the coroner or medical examiner remains responsible for the use or misuse
403.32of data accessed by a delegated agent or employee.
403.33    For purposes of clause (3) (4), access by an individual includes persons in the
403.34definition of an individual under section 13.02.
403.35    (c) Any permissible user identified in paragraph (b), who directly accesses
403.36the data electronically, shall implement and maintain a comprehensive information
404.1security program that contains administrative, technical, and physical safeguards that
404.2are appropriate to the user's size and complexity, and the sensitivity of the personal
404.3information obtained. The permissible user shall identify reasonably foreseeable internal
404.4and external risks to the security, confidentiality, and integrity of personal information
404.5that could result in the unauthorized disclosure, misuse, or other compromise of the
404.6information and assess the sufficiency of any safeguards in place to control the risks.
404.7    (d) The board shall not release data submitted under this section unless it is provided
404.8with evidence, satisfactory to the board, that the person requesting the information is
404.9entitled to receive the data.
404.10    (e) The board shall not release the name of a prescriber without the written consent
404.11of the prescriber or a valid search warrant or court order. The board shall provide a
404.12mechanism for a prescriber to submit to the board a signed consent authorizing the release
404.13of the prescriber's name when data containing the prescriber's name is requested.
404.14    (f) The board shall maintain a log of all persons who access the data for a period of
404.15at least five years and shall ensure that any permissible user complies with paragraph (c)
404.16prior to attaining direct access to the data.
404.17    (g) (f) Section 13.05, subdivision 6, shall apply to any contract the board enters into
404.18pursuant to subdivision 2. A vendor shall not use data collected under this section for
404.19any purpose not specified in this section.
404.20    (g) The board may participate in an interstate prescription monitoring program data
404.21exchange system provided that permissible users in other states may have access to the data
404.22only as allowed under this section and that section 13.05, subdivision 6, shall apply to any
404.23contract or memorandum of understanding that the board enters into under this paragraph.
404.24    Subd. 7. Disciplinary action. (a) A dispenser who knowingly fails to submit data to
404.25the board as required under this section is subject to disciplinary action by the appropriate
404.26health-related licensing board.
404.27    (b) A prescriber or dispenser authorized to access the data who knowingly discloses
404.28the data in violation of state or federal laws relating to the privacy of health care data
404.29shall be subject to disciplinary action by the appropriate health-related licensing board,
404.30and appropriate civil penalties.
404.31    Subd. 8. Evaluation and reporting. (a) The board shall evaluate the prescription
404.32electronic reporting system to determine if the system is negatively impacting appropriate
404.33prescribing practices of controlled substances. The board may contract with a vendor to
404.34design and conduct the evaluation.
404.35    (b) The board shall submit the evaluation of the system to the legislature by July
404.3615, 2011.
405.1    Subd. 9. Immunity from liability; no requirement to obtain information. (a) A
405.2pharmacist, prescriber, or other dispenser making a report to the program in good faith
405.3under this section is immune from any civil, criminal, or administrative liability, which
405.4might otherwise be incurred or imposed as a result of the report, or on the basis that the
405.5pharmacist or prescriber did or did not seek or obtain or use information from the program.
405.6    (b) Nothing in this section shall require a pharmacist, prescriber, or other dispenser
405.7to obtain information about a patient from the program, and the pharmacist, prescriber,
405.8or other dispenser, if acting in good faith, is immune from any civil, criminal, or
405.9administrative liability that might otherwise be incurred or imposed for requesting,
405.10receiving, or using information from the program.
405.11    Subd. 10. Funding. (a) The board may seek grants and private funds from nonprofit
405.12charitable foundations, the federal government, and other sources to fund the enhancement
405.13and ongoing operations of the prescription electronic reporting system monitoring
405.14program established under this section. Any funds received shall be appropriated to the
405.15board for this purpose. The board may not expend funds to enhance the program in a way
405.16that conflicts with this section without seeking approval from the legislature.
405.17    (b) Notwithstanding any other section, the administrative services unit for the
405.18health-related licensing boards shall apportion between the Board of Medical Practice, the
405.19Board of Nursing, the Board of Dentistry, the Board of Podiatric Medicine, the Board of
405.20Optometry, the Board of Veterinary Medicine, and the Board of Pharmacy an amount to
405.21be paid through fees by each respective board. The amount apportioned to each board
405.22shall equal each board's share of the annual appropriation to the Board of Pharmacy
405.23from the state government special revenue fund for operating the prescription electronic
405.24reporting system monitoring program under this section. Each board's apportioned share
405.25shall be based on the number of prescribers or dispensers that each board identified in
405.26this paragraph licenses as a percentage of the total number of prescribers and dispensers
405.27licensed collectively by these boards. Each respective board may adjust the fees that the
405.28boards are required to collect to compensate for the amount apportioned to each board by
405.29the administrative services unit.

405.30    Sec. 13. [214.075] HEALTH-RELATED LICENSING BOARDS; CRIMINAL
405.31BACKGROUND CHECKS.
405.32    Subdivision 1. Applications. (a) By January 1, 2018, each health-related licensing
405.33board, as defined in section 214.01, subdivision 2, shall require applicants for initial
405.34licensure, licensure by endorsement, or reinstatement or other relicensure after a lapse
405.35in licensure, as defined by the individual health-related licensing boards, to submit to
406.1a criminal history records check of state data completed by the Bureau of Criminal
406.2Apprehension (BCA) and a national criminal history records check, including a search of
406.3the records of the Federal Bureau of Investigation (FBI).
406.4(b) An applicant must complete a criminal background check if more than one year
406.5has elapsed since the applicant last submitted a background check to the board.
406.6    Subd. 2. Investigations. If a health-related licensing board has reasonable cause
406.7to believe a licensee has been charged with or convicted of a crime in this or any other
406.8jurisdiction, the health-related licensing board may require the licensee to submit to a
406.9criminal history records check of state data completed by the BCA and a national criminal
406.10history records check, including a search of the records of the FBI.
406.11    Subd. 3. Consent form; fees; fingerprints. (a) In order to effectuate the federal
406.12and state level, fingerprint-based criminal background check, the applicant or licensee
406.13must submit a completed criminal history records check consent form and a full set of
406.14fingerprints to the respective health-related licensing board or a designee in the manner
406.15and form specified by the board.
406.16(b) The applicant or licensee is responsible for all fees associated with preparation of
406.17the fingerprints, the criminal records check consent form, and the criminal background
406.18check. The fees for the criminal records background check shall be set by the BCA and
406.19the FBI and are not refundable. The fees shall be submitted to the respective health-related
406.20licensing board by the applicant or licensee as prescribed by the respective board.
406.21    (c) All fees received by the health-related licensing boards under this subdivision
406.22shall be deposited in a dedicated account in the special revenue fund and are appropriated
406.23to the Board of Nursing Home Administrators for the administrative services unit to pay
406.24for the criminal background checks conducted by the Bureau of Criminal Apprehension
406.25and Federal Bureau of Investigation.
406.26    Subd. 4. Refusal to consent. (a) The health-related licensing boards shall not issue
406.27a license to any applicant who refuses to consent to a criminal background check or fails
406.28to submit fingerprints within 90 days after submission of an application for licensure. Any
406.29fees paid by the applicant to the board shall be forfeited if the applicant refuses to consent
406.30to the criminal background check or fails to submit the required fingerprints.
406.31(b) The failure of a licensee to submit to a criminal background check as provided in
406.32subdivision 3 is grounds for disciplinary action by the respective health licensing board.
406.33    Subd. 5. Submission of fingerprints to the Bureau of Criminal Apprehension.
406.34The health-related licensing board or designee shall submit applicant or licensee
406.35fingerprints to the BCA. The BCA shall perform a check for state criminal justice
406.36information and shall forward the applicant's or licensee's fingerprints to the FBI to
407.1perform a check for national criminal justice information regarding the applicant or
407.2licensee. The BCA shall report to the board the results of the state and national criminal
407.3justice information checks.
407.4    Subd. 6. Alternatives to fingerprint-based criminal background checks. The
407.5health-related licensing board may require an alternative method of criminal history
407.6checks for an applicant or licensee who has submitted at least three sets of fingerprints in
407.7accordance with this section that have been unreadable by the BCA or the FBI.
407.8    Subd. 7. Data practices. Criminal history record information obtained by the
407.9health-related licensing board under this section is private data on individuals under
407.10section 13.02, subdivision 12.
407.11    Subd. 8. Opportunity to challenge accuracy of report. Prior to taking disciplinary
407.12action against an applicant or a licensee based on a criminal conviction, the health-related
407.13licensing board shall provide the applicant or the licensee an opportunity to complete or
407.14challenge the accuracy of the criminal history information reported to the board. The
407.15applicant or licensee shall have 30 calendar days following notice from the board of
407.16the intent to deny licensure or to take disciplinary action to request an opportunity to
407.17correct or complete the record prior to the board taking disciplinary action based on the
407.18information reported to the board. The board shall provide the applicant up to 180 days to
407.19challenge the accuracy or completeness of the report with the agency responsible for the
407.20record. This subdivision does not affect the right of the subject of the data to contest the
407.21accuracy or completeness under section 13.04, subdivision 4.
407.22    Subd. 9. Instructions to the board; plans. The health-related licensing boards, in
407.23collaboration with the commissioner of human services and the BCA, shall establish a
407.24plan for completing criminal background checks of all licensees who were licensed before
407.25the effective date requirement under subdivision 1. The plan must seek to minimize
407.26duplication of requirements for background checks of licensed health professionals. The
407.27plan for background checks of current licensees shall be developed no later than January
407.281, 2017, and may be contingent upon the implementation of a system by the BCA or FBI
407.29in which any new crimes that an applicant or licensee commits after an initial background
407.30check are flagged in the BCA's or FBI's database and reported back to the board. The plan
407.31shall include recommendations for any necessary statutory changes.

407.32    Sec. 14. Minnesota Statutes 2012, section 214.12, is amended by adding a subdivision
407.33to read:
407.34    Subd. 4. Parental depression. The health-related licensing boards that regulate
407.35professions that serve caregivers at risk of depression, or their children, including
408.1behavioral health and therapy, chiropractic, marriage and family therapy, medical practice,
408.2nursing, psychology, and social work, shall provide educational materials to licensees on
408.3the subject of parental depression and its potential effects on children if unaddressed,
408.4including how to:
408.5(1) screen mothers for depression;
408.6(2) identify children who are affected by their mother's depression; and
408.7(3) provide treatment or referral information on needed services.

408.8    Sec. 15. Minnesota Statutes 2012, section 214.40, subdivision 1, is amended to read:
408.9    Subdivision 1. Definitions. (a) The definitions in this subdivision apply to this
408.10section.
408.11(b) "Administrative services unit" means the administrative services unit for the
408.12health-related licensing boards.
408.13(c) "Charitable organization" means a charitable organization within the meaning of
408.14section 501(c)(3) of the Internal Revenue Code that has as a purpose the sponsorship or
408.15support of programs designed to improve the quality, awareness, and availability of health
408.16care services and that serves as a funding mechanism for providing those services.
408.17(d) "Health care facility or organization" means a health care facility licensed under
408.18chapter 144 or 144A, or a charitable organization.
408.19(e) "Health care provider" means a physician licensed under chapter 147, physician
408.20assistant registered licensed and practicing under chapter 147A, nurse licensed and
408.21registered to practice under chapter 148, or dentist or, dental hygienist, or dental therapist
408.22 licensed under chapter 150A, or an advanced dental therapist licensed and certified under
408.23chapter 150A.
408.24(f) "Health care services" means health promotion, health monitoring, health
408.25education, diagnosis, treatment, minor surgical procedures, the administration of local
408.26anesthesia for the stitching of wounds, and primary dental services, including preventive,
408.27diagnostic, restorative, and emergency treatment. Health care services do not include the
408.28administration of general anesthesia or surgical procedures other than minor surgical
408.29procedures.
408.30(g) "Medical professional liability insurance" means medical malpractice insurance
408.31as defined in section 62F.03.
408.32EFFECTIVE DATE.This section is effective the day following final enactment.

408.33    Sec. 16. INCLUSION OF OTHER HEALTH-RELATED OCCUPATIONS TO
408.34CRIMINAL BACKGROUND CHECKS.
409.1(a) If the Department of Health is not reviewed by the Sunset Advisory Commission
409.2according to the schedule in Minnesota Statutes, section 3D.21, the commissioner
409.3of health, as the regulator for occupational therapy practitioners, speech-language
409.4pathologists, audiologists, and hearing instrument dispensers, shall require applicants
409.5for licensure or renewal to submit to a criminal history records check as required under
409.6Minnesota Statutes, section 214.075, for other health-related licensed occupations
409.7regulated by the health-related licensing boards.
409.8(b) Any statutory changes necessary to include the commissioner of health to
409.9Minnesota Statutes, section 214.075, shall be included in the plan required in Minnesota
409.10Statutes, section 214.075, subdivision 9.

409.11    Sec. 17. REPEALER.
409.12Minnesota Statutes 2012, sections 151.19, subdivision 2; 151.25; 151.45; 151.47,
409.13subdivision 2; and 151.48, are repealed.

409.14ARTICLE 11

409.15HOME CARE PROVIDERS

409.16    Section 1. Minnesota Statutes 2012, section 13.381, subdivision 2, is amended to read:
409.17    Subd. 2. Health occupations data. (a) Health-related licensees and registrants.
409.18The collection, analysis, reporting, and use of data on individuals licensed or registered by
409.19the commissioner of health or health-related licensing boards are governed by sections
409.20144.051, subdivision 2 subdivisions 2 to 6 , and 144.052.
409.21(b) Health services personnel. Data collected by the commissioner of health for the
409.22database on health services personnel are classified under section 144.1485.

409.23    Sec. 2. Minnesota Statutes 2012, section 13.381, subdivision 10, is amended to read:
409.24    Subd. 10. Home care and hospice provider. Data regarding a home care provider
409.25under sections 144A.43 to 144A.47 are governed by section 144A.45. Data regarding
409.26home care provider background studies are governed by section 144A.476, subdivision 1.
409.27Data regarding a hospice provider under sections 144A.75 to 144A.755 are governed by
409.28sections 144A.752 and 144A.754.

409.29    Sec. 3. Minnesota Statutes 2012, section 144.051, is amended by adding a subdivision
409.30to read:
409.31    Subd. 3. Data classification; private data. For providers regulated pursuant to
409.32sections 144A.43 to 144A.482, the following data collected, created, or maintained by
410.1the commissioner are classified as private data on individuals as defined in section 13.02,
410.2subdivision 12:
410.3(1) data submitted by or on behalf of applicants for licenses prior to issuance of
410.4the license;
410.5(2) the identity of complainants who have made reports concerning licensees or
410.6applicants unless the complainant consents to the disclosure;
410.7(3) the identity of individuals who provide information as part of surveys and
410.8investigations;
410.9(4) Social Security numbers; and
410.10(5) health record data.

410.11    Sec. 4. Minnesota Statutes 2012, section 144.051, is amended by adding a subdivision
410.12to read:
410.13    Subd. 4. Data classification; public data. For providers regulated pursuant to
410.14sections 144A.43 to 144A.482, the following data collected, created, or maintained by the
410.15commissioner are public:
410.16(1) all application data on licensees, license numbers, license status;
410.17(2) licensing information about licenses previously held under this chapter;
410.18(3) correction orders, including information about compliance with the order and
410.19whether the fine was paid;
410.20(4) final enforcement actions pursuant to chapter 14;
410.21(5) orders for hearing, findings of fact and conclusions of law; and
410.22(6) when the licensee and department agree to resolve the matter without a hearing,
410.23the agreement and specific reasons for the agreement are public data.

410.24    Sec. 5. Minnesota Statutes 2012, section 144.051, is amended by adding a subdivision
410.25to read:
410.26    Subd. 5. Data classification; confidential data. For providers regulated pursuant to
410.27sections 144A.43 to 144A.482, the following data collected, created, or maintained by
410.28the Department of Health are classified as confidential data on individuals as defined in
410.29section 13.02, subdivision 3: active investigative data relating to the investigation of
410.30potential violations of law by a licensee including data from the survey process before the
410.31correction order is issued by the department.

410.32    Sec. 6. Minnesota Statutes 2012, section 144.051, is amended by adding a subdivision
410.33to read:
411.1    Subd. 6. Release of private or confidential data. For providers regulated pursuant
411.2to sections 144A.43 to 144A.482, the department may release private or confidential data,
411.3except Social Security numbers, to the appropriate state, federal, or local agency and law
411.4enforcement office to facilitate investigative or enforcement efforts or further the public
411.5health protective process. Types of offices include Adult Protective Services, Office of the
411.6Ombudsmen for Long-Term Care and Office of the Ombudsmen for Mental Health and
411.7Developmental Disabilities, health licensing boards, the Department of Human Services,
411.8county or city attorney's offices, police, and local or county public health offices.

411.9    Sec. 7. Minnesota Statutes 2012, section 144A.43, is amended to read:
411.10144A.43 DEFINITIONS.
411.11    Subdivision 1. Applicability. The definitions in this section apply to sections
411.12144.699, subdivision 2 , and 144A.43 to 144A.47 144A.482.
411.13    Subd. 1a. Agent. "Agent" means the person upon whom all notices and orders shall
411.14be served and who is authorized to accept service of notices and orders on behalf of
411.15the home care provider.
411.16    Subd. 1b. Applicant. "Applicant" means an individual, organization, association,
411.17corporation, unit of government, or other entity that applies for a temporary license,
411.18license, or renewal of their home care provider license under section 144A.472.
411.19    Subd. 1c. Client. "Client" means a person to whom home care services are provided.
411.20    Subd. 1d. Client record. "Client record" means all records that document
411.21information about the home care services provided to the client by the home care provider.
411.22    Subd. 1e. Client representative. "Client representative" means a person who,
411.23because of the client's needs, makes decisions about the client's care on behalf of the
411.24client. A client representative may be a guardian, health care agent, family member, or
411.25other agent of the client. Nothing in this section expands or diminishes the rights of
411.26persons to act on behalf of clients under other law.
411.27    Subd. 2. Commissioner. "Commissioner" means the commissioner of health.
411.28    Subd. 2a. Controlled substance. "Controlled substance" has the meaning given
411.29in section 152.01, subdivision 4.
411.30    Subd. 2b. Department. "Department" means the Minnesota Department of Health.
411.31    Subd. 2c. Dietary supplement. "Dietary supplement" means a product taken by
411.32mouth that contains a "dietary ingredient" intended to supplement the diet. Dietary
411.33ingredients may include vitamins, minerals, herbs or other botanicals, amino acids, and
411.34substances such as enzymes, organ tissue, glandulars, or metabolites.
412.1    Subd. 2d. Dietitian. "Dietitian" is a person licensed under sections 148.621 to
412.2148.633.
412.3    Subd. 2e. Dietetics or nutrition practice. "Dietetics or nutrition practice" is
412.4performed by a licensed dietitian or licensed nutritionist and includes the activities of
412.5assessment, setting priorities and objectives, providing nutrition counseling, developing
412.6and implementing nutrition care services, and evaluating and maintaining appropriate
412.7standards of quality of nutrition care under sections 148.621 to 148.633.
412.8    Subd. 3. Home care service. "Home care service" means any of the following
412.9services when delivered in a place of residence to the home of a person whose illness,
412.10disability, or physical condition creates a need for the service:
412.11(1) nursing services, including the services of a home health aide;
412.12(2) personal care services not included under sections 148.171 to 148.285;
412.13(3) physical therapy;
412.14(4) speech therapy;
412.15(5) respiratory therapy;
412.16(6) occupational therapy;
412.17(7) nutritional services;
412.18(8) home management services when provided to a person who is unable to perform
412.19these activities due to illness, disability, or physical condition. Home management
412.20services include at least two of the following services: housekeeping, meal preparation,
412.21and shopping;
412.22(9) medical social services;
412.23(10) the provision of medical supplies and equipment when accompanied by the
412.24provision of a home care service; and
412.25(11) other similar medical services and health-related support services identified by
412.26the commissioner in rule.
412.27"Home care service" does not include the following activities conducted by the
412.28commissioner of health or a board of health as defined in section 145A.02, subdivision 2:
412.29communicable disease investigations or testing; administering or monitoring a prescribed
412.30therapy necessary to control or prevent a communicable disease; or the monitoring
412.31of an individual's compliance with a health directive as defined in section 144.4172,
412.32subdivision 6 .
412.33(1) assistive tasks as defined in section 144A.471, subdivision 6, provided by
412.34unlicensed personnel;
413.1(2) services provided by a registered nurse or licensed practical nurse, physical
413.2therapist, respiratory therapist, occupational therapist, speech-language pathologist,
413.3dietitian or nutritionist, or social worker;
413.4(3) medication and treatment management services; or
413.5(4) the provision of durable medical equipment services when provided with any of
413.6the home care services listed in clauses (1) to (3).
413.7    Subd. 3a. Hands-on-assistance. "Hands-on-assistance" means physical help by
413.8another person without which the client is not able to perform the activity.
413.9    Subd. 3b. Home. "Home" means the client's temporary or permanent place of
413.10residence.
413.11    Subd. 4. Home care provider. "Home care provider" means an individual,
413.12organization, association, corporation, unit of government, or other entity that is regularly
413.13engaged in the delivery of at least one home care service, directly or by contractual
413.14arrangement, of home care services in a client's home for a fee and who has a valid current
413.15temporary license or license issued under sections 144A.43 to 144A.482. At least one
413.16home care service must be provided directly, although additional home care services may
413.17be provided by contractual arrangements. "Home care provider" does not include:
413.18(1) any home care or nursing services conducted by and for the adherents of any
413.19recognized church or religious denomination for the purpose of providing care and
413.20services for those who depend upon spiritual means, through prayer alone, for healing;
413.21(2) an individual who only provides services to a relative;
413.22(3) an individual not connected with a home care provider who provides assistance
413.23with home management services or personal care needs if the assistance is provided
413.24primarily as a contribution and not as a business;
413.25(4) an individual not connected with a home care provider who shares housing with
413.26and provides primarily housekeeping or homemaking services to an elderly or disabled
413.27person in return for free or reduced-cost housing;
413.28(5) an individual or agency providing home-delivered meal services;
413.29(6) an agency providing senior companion services and other older American
413.30volunteer programs established under the Domestic Volunteer Service Act of 1973,
413.31Public Law 98-288;
413.32(7) an employee of a nursing home licensed under this chapter or an employee of a
413.33boarding care home licensed under sections 144.50 to 144.56 who responds to occasional
413.34emergency calls from individuals residing in a residential setting that is attached to or
413.35located on property contiguous to the nursing home or boarding care home;
414.1(8) a member of a professional corporation organized under chapter 319B that does
414.2not regularly offer or provide home care services as defined in subdivision 3;
414.3(9) the following organizations established to provide medical or surgical services
414.4that do not regularly offer or provide home care services as defined in subdivision 3:
414.5a business trust organized under sections 318.01 to 318.04, a nonprofit corporation
414.6organized under chapter 317A, a partnership organized under chapter 323, or any other
414.7entity determined by the commissioner;
414.8(10) an individual or agency that provides medical supplies or durable medical
414.9equipment, except when the provision of supplies or equipment is accompanied by a
414.10home care service;
414.11(11) an individual licensed under chapter 147; or
414.12(12) an individual who provides home care services to a person with a developmental
414.13disability who lives in a place of residence with a family, foster family, or primary caregiver.
414.14    Subd. 5. Medication reminder. "Medication reminder" means providing a verbal
414.15or visual reminder to a client to take medication. This includes bringing the medication
414.16to the client and providing liquids or nutrition to accompany medication that a client is
414.17self-administering.
414.18    Subd. 6. License. "License" means a basic or comprehensive home care license
414.19issued by the commissioner to a home care provider.
414.20    Subd. 7. Licensed health professional. "Licensed health professional" means a
414.21person, other than a registered nurse or licensed practical nurse, who provides home care
414.22services within the scope of practice of the person's health occupation license, registration,
414.23or certification as regulated and who is licensed by the appropriate Minnesota state board
414.24or agency.
414.25    Subd. 8. Licensee. "Licensee" means a home care provider that is licensed under
414.26this chapter.
414.27    Subd. 9. Managerial official. "Managerial official" means an administrator,
414.28director, officer, trustee, or employee of a home care provider, however designated, who
414.29has the authority to establish or control business policy.
414.30    Subd. 10. Medication. "Medication" means a prescription or over-the-counter drug.
414.31For purposes of this chapter only, medication includes dietary supplements.
414.32    Subd. 11. Medication administration. "Medication administration" means
414.33performing a set of tasks to ensure a client takes medications, and includes the following:
414.34(1) checking the client's medication record;
414.35(2) preparing the medication as necessary;
414.36(3) administering the medication to the client;
415.1(4) documenting the administration or reason for not administering the medication;
415.2and
415.3(5) reporting to a nurse any concerns about the medication, the client, or the client's
415.4refusal to take the medication.
415.5    Subd. 12. Medication management. "Medication management" means the
415.6provision of any of the following medication-related services to a client:
415.7(1) performing medication setup;
415.8(2) administering medication;
415.9(3) storing and securing medications;
415.10(4) documenting medication activities;
415.11(5) verifying and monitoring effectiveness of systems to ensure safe handling and
415.12administration;
415.13(6) coordinating refills;
415.14(7) handling and implementing changes to prescriptions;
415.15(8) communicating with the pharmacy about the client's medications; and
415.16(9) coordinating and communicating with the prescriber.
415.17    Subd. 13. Medication setup. "Medication setup" means arranging medications by a
415.18nurse, pharmacy, or authorized prescriber for later administration by the client or by
415.19comprehensive home care staff.
415.20    Subd. 14. Nurse. "Nurse" means a person who is licensed under sections 148.171 to
415.21148.285.
415.22    Subd. 15. Occupational therapist. "Occupational therapist" means a person who is
415.23licensed under sections 148.6401 to 148.6450.
415.24    Subd. 16. Over-the-counter drug. "Over-the-counter drug" means a drug that is
415.25not required by federal law to bear the symbol "Rx only."
415.26    Subd. 17. Owner. "Owner" means a proprietor, general partner, limited partner who
415.27has five percent or more of equity interest in a limited partnership, a person who owns or
415.28controls voting stock in a corporation in an amount equal to or greater than five percent of
415.29the shares issued and outstanding, or a corporation that owns equity interest in a licensee
415.30or applicant for a license.
415.31    Subd. 18. Pharmacist. "Pharmacist" has the meaning given in section 151.01,
415.32subdivision 3.
415.33    Subd. 19. Physical therapist. "Physical therapist" means a person who is licensed
415.34under sections 148.65 to 148.78.
415.35    Subd. 20. Physician. "Physician" means a person who is licensed under chapter 147.
416.1    Subd. 21. Prescriber. "Prescriber" means a person who is authorized by sections
416.2148.235; 151.01, subdivision 23; and 151.37, to prescribe prescription drugs.
416.3    Subd. 22. Prescription. "Prescription" has the meaning given in section 151.01,
416.4subdivision 16.
416.5    Subd. 23. Regularly scheduled. "Regularly scheduled" means ordered or planned
416.6to be completed at predetermined times or according to a predetermined routine.
416.7    Subd. 24. Reminder. "Reminder" means providing a verbal or visual reminder
416.8to a client.
416.9    Subd. 25. Respiratory therapist. "Respiratory therapist" means a person who
416.10is licensed under chapter 147C.
416.11    Subd. 26. Revenues. "Revenues" means all money received by a licensee derived
416.12from the provisions of home care services, including fees for services and appropriations
416.13of public money for home care services.
416.14    Subd. 27. Service plan. "Service plan" means the written plan between the client or
416.15client's representative and the temporary licensee or licensee about the services that will
416.16be provided to the client.
416.17    Subd. 28. Social worker. "Social worker" means a person who is licensed under
416.18chapter 148D or 148E.
416.19    Subd. 29. Speech language pathologist. "Speech language pathologist" has the
416.20meaning given in section 148.512.
416.21    Subd. 30. Standby assistance. "Standby assistance" means the presence of another
416.22person within arm's reach to minimize the risk of injury while performing daily activities
416.23through physical intervention or cuing.
416.24    Subd. 31. Substantial compliance. "Substantial compliance" means complying
416.25with the requirements in this chapter sufficiently to prevent unacceptable health or safety
416.26risks to the home care client.
416.27    Subd. 32. Survey. "Survey" means an inspection of a licensee or applicant for
416.28licensure for compliance with this chapter.
416.29    Subd. 33. Surveyor. "Surveyor" means a staff person of the department authorized
416.30to conduct surveys of home care providers and applicants.
416.31    Subd. 34. Temporary license. "Temporary license" means the initial basic or
416.32comprehensive home care license the department issues after approval of a complete
416.33written application and before the department completes the temporary license survey and
416.34determines that the temporary licensee is in substantial compliance.
417.1    Subd. 35. Treatment or therapy. "Treatment" or "therapy" means the provision
417.2of care, other than medications, ordered or prescribed by a licensed health professional
417.3provided to a client to cure, rehabilitate, or ease symptoms.
417.4    Subd. 36. Unit of government. "Unit of government" means every city, county,
417.5town, school district, other political subdivisions of the state, and any agency of the state
417.6or federal government, which includes any instrumentality of a unit of government.
417.7    Subd. 37. Unlicensed personnel. "Unlicensed personnel" are individuals not
417.8otherwise licensed or certified by a governmental health board or agency who provide
417.9home care services in the client's home.
417.10    Subd. 38. Verbal. "Verbal" means oral and not in writing.

417.11    Sec. 8. Minnesota Statutes 2012, section 144A.44, is amended to read:
417.12144A.44 HOME CARE BILL OF RIGHTS.
417.13    Subdivision 1. Statement of rights. A person who receives home care services
417.14has these rights:
417.15(1) the right to receive written information about rights in advance of before
417.16receiving care or during the initial evaluation visit before the initiation of treatment
417.17 services, including what to do if rights are violated;
417.18(2) the right to receive care and services according to a suitable and up-to-date plan,
417.19and subject to accepted health care, medical or nursing standards, to take an active part
417.20in creating and changing the plan developing, modifying, and evaluating care the plan
417.21 and services;
417.22(3) the right to be told in advance of before receiving care about the services that will
417.23be provided, the disciplines that will furnish care the type and disciplines of staff who will
417.24be providing the services, the frequency of visits proposed to be furnished, other choices
417.25that are available for addressing home care needs, and the consequences of these choices
417.26including the potential consequences of refusing these services;
417.27(4) the right to be told in advance of any change recommended changes by the
417.28provider in the service plan of care and to take an active part in any change decisions
417.29about changes to the service plan;
417.30(5) the right to refuse services or treatment;
417.31(6) the right to know, in advance before receiving services or during the initial
417.32visit, any limits to the services available from a home care provider, and the provider's
417.33grounds for a termination of services;
418.1(7) the right to know in advance of receiving care whether the services are covered
418.2by health insurance, medical assistance, or other health programs, the charges for services
418.3that will not be covered by Medicare, and the charges that the individual may have to pay;
418.4(8) (7) the right to know be told before services are initiated what the provider
418.5charges are for the services, no matter who will be paying the bill and if known, to what
418.6extent payment may be expected from health insurance, public programs or other sources,
418.7and what charges the client may be responsible for paying;
418.8(9) (8) the right to know that there may be other services available in the community,
418.9including other home care services and providers, and to know where to go for find
418.10 information about these services;
418.11(10) (9) the right to choose freely among available providers and to change providers
418.12after services have begun, within the limits of health insurance, long-term care insurance,
418.13medical assistance, or other health programs;
418.14(11) (10) the right to have personal, financial, and medical information kept private,
418.15and to be advised of the provider's policies and procedures regarding disclosure of such
418.16information;
418.17(12) (11) the right to be allowed access to the client's own records and written
418.18information from those records in accordance with sections 144.291 to 144.298;
418.19(13) (12) the right to be served by people who are properly trained and competent
418.20to perform their duties;
418.21(14) (13) the right to be treated with courtesy and respect, and to have the patient's
418.22 client's property treated with respect;
418.23(15) (14) the right to be free from physical and verbal abuse, neglect, financial
418.24exploitation, and all forms of maltreatment covered under the Vulnerable Adults Act and
418.25the Maltreatment of Minors Act;
418.26(16) (15) the right to reasonable, advance notice of changes in services or charges,
418.27including;
418.28(16) the right to know the provider's reason for termination of services;
418.29(17) the right to at least ten days' advance notice of the termination of a service by a
418.30provider, except in cases where:
418.31(i) the recipient of services client engages in conduct that significantly alters the
418.32conditions of employment as specified in the employment contract between terms of
418.33the service plan with the home care provider and the individual providing home care
418.34services, or creates;
418.35(ii) the client, person who lives with the client, or others create an abusive or unsafe
418.36work environment for the individual person providing home care services; or
419.1(ii) (iii) an emergency for the informal caregiver or a significant change in the
419.2recipient's client's condition has resulted in service needs that exceed the current service
419.3provider agreement plan and that cannot be safely met by the home care provider;
419.4(17) (18) the right to a coordinated transfer when there will be a change in the
419.5provider of services;
419.6(18) (19) the right to voice grievances regarding treatment or care that is complain
419.7about services that are provided, or fails to be, furnished, or regarding fail to be provided,
419.8and the lack of courtesy or respect to the patient client or the patient's client's property;
419.9(19) (20) the right to know how to contact an individual associated with the home
419.10care provider who is responsible for handling problems and to have the home care provider
419.11investigate and attempt to resolve the grievance or complaint;
419.12(20) (21) the right to know the name and address of the state or county agency to
419.13contact for additional information or assistance; and
419.14(21) (22) the right to assert these rights personally, or have them asserted by
419.15the patient's family or guardian when the patient has been judged incompetent, client's
419.16representative or by anyone on behalf of the client, without retaliation.
419.17    Subd. 2. Interpretation and enforcement of rights. These rights are established
419.18for the benefit of persons clients who receive home care services. "Home care services"
419.19means home care services as defined in section 144A.43, subdivision 3, and unlicensed
419.20personal care assistance services, including services covered by medical assistance under
419.21section 256B.0625, subdivision 19a. All home care providers, including those exempted
419.22under section 144A.471, must comply with this section. The commissioner shall enforce
419.23this section and the home care bill of rights requirement against home care providers
419.24exempt from licensure in the same manner as for licensees. A home care provider may
419.25not request or require a person client to surrender any of these rights as a condition of
419.26receiving services. A guardian or conservator or, when there is no guardian or conservator,
419.27a designated person, may seek to enforce these rights. This statement of rights does not
419.28replace or diminish other rights and liberties that may exist relative to persons clients
419.29 receiving home care services, persons providing home care services, or providers licensed
419.30under Laws 1987, chapter 378. A copy of these rights must be provided to an individual
419.31at the time home care services, including personal care assistance services, are initiated.
419.32The copy shall also contain the address and phone number of the Office of Health Facility
419.33Complaints and the Office of Ombudsman for Long-Term Care and a brief statement
419.34describing how to file a complaint with these offices. Information about how to contact
419.35the Office of Ombudsman for Long-Term Care shall be included in notices of change in
420.1client fees and in notices where home care providers initiate transfer or discontinuation of
420.2services sections 144A.43 to 144A.482.

420.3    Sec. 9. Minnesota Statutes 2012, section 144A.45, is amended to read:
420.4144A.45 REGULATION OF HOME CARE SERVICES.
420.5    Subdivision 1. Rules Regulations. The commissioner shall adopt rules for the
420.6regulation of regulate home care providers pursuant to sections 144A.43 to 144A.47
420.7 144A.482. The rules regulations shall include the following:
420.8    (1) provisions to assure, to the extent possible, the health, safety and well-being,
420.9and appropriate treatment of persons who receive home care services while respecting
420.10clients' autonomy and choice;
420.11    (2) requirements that home care providers furnish the commissioner with specified
420.12information necessary to implement sections 144A.43 to 144A.47 144A.482;
420.13    (3) standards of training of home care provider personnel, which may vary according
420.14to the nature of the services provided or the health status of the consumer;
420.15(4) standards for provision of home care services;
420.16    (4) (5) standards for medication management which may vary according to the
420.17nature of the services provided, the setting in which the services are provided, or the
420.18status of the consumer. Medication management includes the central storage, handling,
420.19distribution, and administration of medications;
420.20    (5) (6) standards for supervision of home care services requiring supervision by a
420.21registered nurse or other appropriate health care professional which must occur on site
420.22at least every 62 days, or more frequently if indicated by a clinical assessment, and in
420.23accordance with sections 148.171 to 148.285 and rules adopted thereunder, except that a
420.24person performing home care aide tasks for a class B licensee providing paraprofessional
420.25services does not require nursing supervision;
420.26    (6) (7) standards for client evaluation or assessment which may vary according to
420.27the nature of the services provided or the status of the consumer;
420.28    (7) (8) requirements for the involvement of a consumer's physician client's health
420.29care provider, the documentation of physicians' health care providers' orders, if required,
420.30and the consumer's treatment client's service plan, and;
420.31(9) the maintenance of accurate, current clinical client records;
420.32    (8) (10) the establishment of different classes basic and comprehensive levels of
420.33licenses for different types of providers and different standards and requirements for
420.34different kinds of home care based on services provided; and
421.1    (9) operating procedures required to implement (11) provisions to enforce these
421.2regulations and the home care bill of rights.
421.3    Subd. 1a. Home care aide tasks. Notwithstanding the provisions of Minnesota
421.4Rules, part 4668.0110, subpart 1, item E, home care aide tasks also include assisting
421.5toileting, transfers, and ambulation if the client is ambulatory and if the client has no
421.6serious acute illness or infectious disease.
421.7    Subd. 1b. Home health aide qualifications. Notwithstanding the provisions of
421.8Minnesota Rules, part 4668.0100, subpart 5, a person may perform home health aide tasks
421.9if the person maintains current registration as a nursing assistant on the Minnesota nursing
421.10assistant registry. Maintaining current registration on the Minnesota nursing assistant
421.11registry satisfies the documentation requirements of Minnesota Rules, part 4668.0110,
421.12subpart 3.
421.13    Subd. 2. Regulatory functions. (a) The commissioner shall:
421.14(1) evaluate, monitor, and license, survey, and monitor without advance notice, home
421.15care providers in accordance with sections 144A.45 to 144A.47 144A.43 to 144A.482;
421.16(2) inspect the office and records of a provider during regular business hours without
421.17advance notice to the home care provider;
421.18(2) survey every temporary licensee within one year of the temporary license issuance
421.19date subject to the temporary licensee providing home care services to a client or clients;
421.20(3) survey all licensed home care providers on an interval that will promote the
421.21health and safety of clients;
421.22(3) (4) with the consent of the consumer client, visit the home where services are
421.23being provided;
421.24(4) (5) issue correction orders and assess civil penalties in accordance with section
421.25144.653, subdivisions 5 to 8 , for violations of sections 144A.43 to 144A.47 or the rules
421.26adopted under those sections 144A.482;
421.27(5) (6) take action as authorized in section 144A.46, subdivision 3 144A.475; and
421.28(6) (7) take other action reasonably required to accomplish the purposes of sections
421.29144A.43 to 144A.47 144A.482.
421.30(b) In the exercise of the authority granted in sections 144A.43 to 144A.47, the
421.31commissioner shall comply with the applicable requirements of section 144.122, the
421.32Government Data Practices Act, and the Administrative Procedure Act.
421.33    Subd. 4. Medicaid reimbursement. Notwithstanding the provisions of section
421.34256B.37 or state plan requirements to the contrary, certification by the federal Medicare
421.35program must not be a requirement of Medicaid payment for services delivered under
421.36section 144A.4605.
422.1    Subd. 5. Home care providers; services for Alzheimer's disease or related
422.2disorder. (a) If a home care provider licensed under section 144A.46 or 144A.4605 markets
422.3or otherwise promotes services for persons with Alzheimer's disease or related disorders,
422.4the facility's direct care staff and their supervisors must be trained in dementia care.
422.5(b) Areas of required training include:
422.6(1) an explanation of Alzheimer's disease and related disorders;
422.7(2) assistance with activities of daily living;
422.8(3) problem solving with challenging behaviors; and
422.9(4) communication skills.
422.10(c) The licensee shall provide to consumers in written or electronic form a
422.11description of the training program, the categories of employees trained, the frequency
422.12of training, and the basic topics covered.

422.13    Sec. 10. [144A.471] HOME CARE PROVIDER AND HOME CARE SERVICES.
422.14    Subdivision 1. License required. A home care provider may not open, operate,
422.15manage, conduct, maintain, or advertise itself as a home care provider or provide home
422.16care services in Minnesota without a temporary or current home care provider license
422.17issued by the commissioner of health.
422.18    Subd. 2. Determination of direct home care service. "Direct home care service"
422.19means a home care service provided to a client by the home care provider or its employees,
422.20and not by contract. Factors that must be considered in determining whether an individual
422.21or a business entity provides at least one home care service directly include, but are not
422.22limited to, whether the individual or business entity:
422.23    (1) has the right to control, and does control, the types of services provided;
422.24(2) has the right to control, and does control, when and how the services are provided;
422.25    (3) establishes the charges;
422.26(4) collects fees from the clients or receives payment from third-party payers on
422.27the clients' behalf;
422.28(5) pays individuals providing services compensation on an hourly, weekly, or
422.29similar basis;
422.30(6) treats the individuals providing services as employees for the purposes of payroll
422.31taxes and workers' compensation insurance; and
422.32(7) holds itself out as a provider of home care services or acts in a manner that
422.33leads clients or potential clients to believe that it is a home care provider providing home
422.34care services.
422.35    None of the factors listed in this subdivision is solely determinative.
423.1    Subd. 3. Determination of regularly engaged. "Regularly engaged" means
423.2providing, or offering to provide, home care services as a regular part of a business. The
423.3following factors must be considered by the commissioner in determining whether an
423.4individual or a business entity is regularly engaged in providing home care services:
423.5    (1) whether the individual or business entity states or otherwise promotes that the
423.6individual or business entity provides home care services;
423.7    (2) whether persons receiving home care services constitute a substantial part of the
423.8individual's or the business entity's clientele; and
423.9(3) whether the home care services provided are other than occasional or incidental
423.10to the provision of services other than home care services.
423.11    None of the factors listed in this subdivision is solely determinative.
423.12    Subd. 4. Penalties for operating without license. A person involved in the
423.13management, operation, or control of a home care provider that operates without an
423.14appropriate license is guilty of a misdemeanor. This section does not apply to a person
423.15who has no legal authority to affect or change decisions related to the management,
423.16operation, or control of a home care provider.
423.17    Subd. 5. Basic and comprehensive levels of licensure. An applicant seeking
423.18to become a home care provider must apply for either a basic or comprehensive home
423.19care license.
423.20    Subd. 6. Basic home care license provider. Home care services that can be
423.21provided with a basic home care license are assistive tasks provided by licensed or
423.22unlicensed personnel that include:
423.23(1) assisting with dressing, self-feeding, oral hygiene, hair care, grooming, toileting,
423.24and bathing;
423.25(2) providing standby assistance;
423.26(3) providing verbal or visual reminders to the client to take regularly scheduled
423.27medication which includes bringing the client previously set-up medication, medication in
423.28original containers, or liquid or food to accompany the medication;
423.29(4) providing verbal or visual reminders to the client to perform regularly scheduled
423.30treatments and exercises;
423.31(5) preparing modified diets ordered by a licensed health professional; and
423.32(6) assisting with laundry, housekeeping, meal preparation, shopping, or other
423.33household chores and services if the provider is also providing at least one of the activities
423.34in clauses (1) to (5)
424.1    Subd. 7. Comprehensive home care license provider. Home care services that
424.2may be provided with a comprehensive home care license include any of the basic home
424.3care services listed in subdivision 6, and one or more of the following:
424.4(1) services of an advanced practice nurse, registered nurse, licensed practical
424.5nurse, physical therapist, respiratory therapist, occupational therapist, speech-language
424.6pathologist, dietitian or nutritionist, or social worker;
424.7(2) tasks delegated to unlicensed personnel by a registered nurse or assigned by a
424.8licensed health professional within the person's scope of practice;
424.9(3) medication management services;
424.10(4) hands-on assistance with transfers and mobility;
424.11(5) assisting clients with eating when the clients have complicating eating problems
424.12as identified in the client record or through an assessment such as difficulty swallowing,
424.13recurrent lung aspirations, or requiring the use of a tube or parenteral or intravenous
424.14instruments to be fed; or
424.15(6) providing other complex or specialty health care services.
424.16    Subd. 8. Exemptions from home care services licensure. (a) Except as otherwise
424.17provided in this chapter, home care services that are provided by the state, counties, or
424.18other units of government must be licensed under this chapter.
424.19(b) An exemption under this subdivision does not excuse the exempted individual or
424.20organization from complying with applicable provisions of the home care bill of rights
424.21in section 144A.44. The following individuals or organizations are exempt from the
424.22requirement to obtain a home care provider license:
424.23(1) an individual or organization that offers, provides, or arranges for personal care
424.24assistance services under the medical assistance program as authorized under sections
424.25256B.04, subdivision 16; 256B.0625, subdivision 19a; and 256B.0659;
424.26(2) a provider that is licensed by the commissioner of human services to provide
424.27semi-independent living services for persons with developmental disabilities under section
424.28252.275 and Minnesota Rules, parts 9525.0900 to 9525.1020;
424.29(3) a provider that is licensed by the commissioner of human services to provide
424.30home and community-based services for persons with developmental disabilities under
424.31section 256B.092 and Minnesota Rules, parts 9525.1800 to 9525.1930;
424.32(4) an individual or organization that provides only home management services, if
424.33the individual or organization is registered under section 144A.482; or
424.34(5) an individual who is licensed in this state as a nurse, dietitian, social worker,
424.35occupational therapist, physical therapist, or speech-language pathologist who provides
425.1health care services in the home independently and not through any contractual or
425.2employment relationship with a home care provider or other organization.
425.3    Subd. 9. Exclusions from home care licensure. The following are excluded from
425.4home care licensure and are not required to provide the home care bill of rights:
425.5(1) an individual or business entity providing only coordination of home care that
425.6includes one or more of the following:
425.7(i) determination of whether a client needs home care services, or assisting a client
425.8in determining what services are needed;
425.9(ii) referral of clients to a home care provider;
425.10(iii) administration of payments for home care services; or
425.11(iv) administration of a health care home established under section 256B.0751;
425.12(2) an individual who is not an employee of a licensed home care provider if the
425.13individual:
425.14(i) only provides services as an independent contractor to one or more licensed
425.15home care providers;
425.16(ii) provides no services under direct agreements or contracts with clients; and
425.17(iii) is contractually bound to perform services in compliance with the contracting
425.18home care provider's policies and service plans;
425.19(3) a business that provides staff to home care providers, such as a temporary
425.20employment agency, if the business:
425.21(i) only provides staff under contract to licensed or exempt providers;
425.22(ii) provides no services under direct agreements with clients; and
425.23(iii) is contractually bound to perform services under the contracting home care
425.24provider's direction and supervision;
425.25(4) any home care services conducted by and for the adherents of any recognized
425.26church or religious denomination for its members through spiritual means, or by prayer
425.27for healing;
425.28(5) an individual who only provides home care services to a relative;
425.29(6) an individual not connected with a home care provider that provides assistance
425.30with basic home care needs if the assistance is provided primarily as a contribution and
425.31not as a business;
425.32(7) an individual not connected with a home care provider that shares housing with
425.33and provides primarily housekeeping or homemaking services to an elderly or disabled
425.34person in return for free or reduced-cost housing;
425.35(8) an individual or provider providing home-delivered meal services;
426.1(9) an individual providing senior companion services and other Older American
426.2Volunteer Programs (OAVP) established under the Domestic Volunteer Service Act of
426.31973, United States Code, title 42, chapter 66;
426.4(10) an employee of a nursing home licensed under this chapter or an employee of a
426.5boarding care home licensed under sections 144.50 to 144.56 who responds to occasional
426.6emergency calls from individuals residing in a residential setting that is attached to or
426.7located on property contiguous to the nursing home or boarding care home;
426.8(11) a member of a professional corporation organized under chapter 319B that
426.9does not regularly offer or provide home care services as defined in section 144A.43,
426.10subdivision 3;
426.11(12) the following organizations established to provide medical or surgical services
426.12that do not regularly offer or provide home care services as defined in section 144A.43,
426.13subdivision 3: a business trust organized under sections 318.01 to 318.04, a nonprofit
426.14corporation organized under chapter 317A, a partnership organized under chapter 323, or
426.15any other entity determined by the commissioner;
426.16(13) an individual or agency that provides medical supplies or durable medical
426.17equipment, except when the provision of supplies or equipment is accompanied by a
426.18home care service;
426.19(14) a physician licensed under chapter 147;
426.20(15) an individual who provides home care services to a person with a developmental
426.21disability who lives in a place of residence with a family, foster family, or primary caregiver;
426.22(16) a business that only provides services that are primarily instructional and not
426.23medical services or health-related support services;
426.24(17) an individual who performs basic home care services for no more than 14 hours
426.25each calendar week to no more than one client;
426.26(18) an individual or business licensed as hospice as defined in sections 144A.75 to
426.27144A.755 who is not providing home care services independent of hospice service;
426.28(19) activities conducted by the commissioner of health or a board of health as
426.29defined in section 145A.02, subdivision 2, including communicable disease investigations
426.30or testing; or
426.31(20) administering or monitoring a prescribed therapy necessary to control or
426.32prevent a communicable disease, or the monitoring of an individual's compliance with a
426.33health directive as defined in section 144.4172, subdivision 6.

426.34    Sec. 11. [144A.472] HOME CARE PROVIDER LICENSE; APPLICATION
426.35AND RENEWAL.
427.1    Subdivision 1. License applications. Each application for a home care provider
427.2license must include information sufficient to show that the applicant meets the
427.3requirements of licensure, including:
427.4    (1) the applicant's name, e-mail address, physical address, and mailing address,
427.5including the name of the county in which the applicant resides and has a principal
427.6place of business;
427.7(2) the initial license fee in the amount specified in subdivision 7;
427.8(3) e-mail address, physical address, mailing address, and telephone number of the
427.9principal administrative office;
427.10(4) e-mail address, physical address, mailing address, and telephone number of
427.11each branch office, if any;
427.12(5) names, e-mail and mailing addresses, and telephone numbers of all owners
427.13and managerial officials;
427.14(6) documentation of compliance with the background study requirements of section
427.15144A.476 for all persons involved in the management, operation, or control of the home
427.16care provider;
427.17(7) documentation of a background study as required by section 144.057 for any
427.18individual seeking employment, paid or volunteer, with the home care provider;
427.19(8) evidence of workers' compensation coverage as required by sections 176.181
427.20and 176.182;
427.21(9) documentation of liability coverage, if the provider has it;
427.22(10) identification of the license level the provider is seeking;
427.23(11) documentation that identifies the managerial official who is in charge of
427.24day-to-day operations and attestation that the person has reviewed and understands the
427.25home care provider regulations;
427.26(12) documentation that the applicant has designated one or more owners,
427.27managerial officials, or employees as an agent or agents, which shall not affect the legal
427.28responsibility of any other owner or managerial official under this chapter;
427.29(13) the signature of the officer or managing agent on behalf of an entity, corporation,
427.30association, or unit of government;
427.31(14) verification that the applicant has the following policies and procedures in place
427.32so that if a license is issued, the applicant will implement the policies and procedures
427.33and keep them current:
427.34    (i) requirements in sections 626.556, reporting of maltreatment of minors, and
427.35626.557, reporting of maltreatment of vulnerable adults;
427.36(ii) conducting and handling background studies on employees;
428.1(iii) orientation, training, and competency evaluations of home care staff, and a
428.2process for evaluating staff performance;
428.3(iv) handling complaints from clients, family members, or client representatives
428.4regarding staff or services provided by staff;
428.5(v) conducting initial evaluation of clients' needs and the providers' ability to provide
428.6those services;
428.7(vi) conducting initial and ongoing client evaluations and assessments and how
428.8changes in a client's condition are identified, managed, and communicated to staff and
428.9other health care providers as appropriate;
428.10(vii) orientation to and implementation of the home care client bill of rights;
428.11(viii) infection control practices;
428.12(ix) reminders for medications, treatments, or exercises, if provided; and
428.13(x) conducting appropriate screenings, or documentation of prior screenings, to
428.14show that staff are free of tuberculosis, consistent with current United States Centers for
428.15Disease Control standards; and
428.16(15) other information required by the department.
428.17    Subd. 2. Comprehensive home care license applications. In addition to the
428.18information and fee required in subdivision 1, applicants applying for a comprehensive
428.19home care license must also provide verification that the applicant has the following
428.20policies and procedures in place so that if a license is issued, the applicant will implement
428.21the policies and procedures in this subdivision and keep them current:
428.22(1) conducting initial and ongoing assessments of the client's needs by a registered
428.23nurse or appropriate licensed health professional, including how changes in the client's
428.24conditions are identified, managed, and communicated to staff and other health care
428.25providers, as appropriate;
428.26(2) ensuring that nurses and licensed health professionals have current and valid
428.27licenses to practice;
428.28(3) medication and treatment management;
428.29(4) delegation of home care tasks by registered nurses or licensed health professionals;
428.30(5) supervision of registered nurses and licensed health professionals; and
428.31(6) supervision of unlicensed personnel performing delegated home care tasks.
428.32    Subd. 3. License renewal. (a) Except as provided in section 144A.475, a license
428.33may be renewed for a period of one year if the licensee satisfies the following:
428.34(1) submits an application for renewal in the format provided by the commissioner
428.35at least 30 days before expiration of the license;
428.36(2) submits the renewal fee in the amount specified in subdivision 7;
429.1(3) has provided home care services within the past 12 months;
429.2(4) complies with sections 144A.43 to 144A.4799;
429.3(5) provides information sufficient to show that the applicant meets the requirements
429.4of licensure, including items required under subdivision 1;
429.5(6) provides verification that all policies under subdivision 1 are current; and
429.6(7) provides any other information deemed necessary by the commissioner.
429.7(b) A renewal applicant who holds a comprehensive home care license must also
429.8provide verification that policies listed under subdivision 2 are current.
429.9    Subd. 4. Multiple units. Multiple units or branches of a licensee must be separately
429.10licensed if the commissioner determines that the units cannot adequately share supervision
429.11and administration of services from the main office.
429.12    Subd. 5. Transfers prohibited; changes in ownership. Any home care license
429.13issued by the commissioner may not be transferred to another party. Before acquiring
429.14ownership of a home care provider business, a prospective applicant must apply for a
429.15new temporary license. A change of ownership is a transfer of operational control to
429.16a different business entity, and includes:
429.17(1) transfer of the business to a different or new corporation;
429.18(2) in the case of a partnership, the dissolution or termination of the partnership under
429.19chapter 323A, with the business continuing by a successor partnership or other entity;
429.20(3) relinquishment of control of the provider to another party, including to a contract
429.21management firm that is not under the control of the owner of the business' assets;
429.22(4) transfer of the business by a sole proprietor to another party or entity; or
429.23(5) in the case of a privately held corporation, the change in ownership or control of
429.2450 percent or more of the outstanding voting stock.
429.25    Subd. 6. Notification of changes of information. The temporary licensee or
429.26licensee shall notify the commissioner in writing within ten working days after any
429.27change in the information required in subdivision 1, except the information required in
429.28subdivision 1, clause (5), is required at the time of license renewal.
429.29    Subd. 7. Fees; application, change of ownership, and renewal. (a) An applicant
429.30seeking a temporary home care licensure must submit the following application fee to the
429.31commissioner along with a completed application:
429.32(1) basic home care provider, $2,100; or
429.33(2) comprehensive home care provider, $4,200.
429.34(b) A home care provider who is filing a change of ownership as required under
429.35subdivision 5 must submit the following application fee to the commissioner, along with
429.36the documentation required for the change of ownership:
430.1(1) basic home care provider, $2,100; or
430.2(2) comprehensive home care provider, $4,200.
430.3(c) A home care provider who is seeking to renew the provider's license shall pay a
430.4fee to the commissioner based on revenues derived from the provision of home care
430.5services during the calendar year prior to the year in which the application is submitted,
430.6according to the following schedule:
430.7License Renewal Fee

430.8	Provider Annual Revenue		Fee
430.9	greater than $1,500,000		$6,625
430.10 430.11	greater than $1,275,000 and no more than $1,500,000		$5,797
430.12 430.13	greater than $1,100,000 and no more than $1,275,000		$4,969
430.14 430.15	greater than $950,000 and no more than $1,100,000		$4,141
430.16 430.17	greater than $850,000 and no more than $950,000		$3,727
430.18 430.19	greater than $750,000 and no more than $850,000		$3,313
430.20 430.21	greater than $650,000 and no more than $750,000		$2,898
430.22 430.23	greater than $550,000 and no more than $650,000		$2,485
430.24 430.25	greater than $450,000 and no more than $550,000		$2,070
430.26 430.27	greater than $350,000 and no more than $450,000		$1,656
430.28 430.29	greater than $250,000 and no more than $350,000		$1,242
430.30 430.31	greater than $100,000 and no more than $250,000		$828
430.32 430.33	greater than $50,000 and no more than $100,000		$500
430.34 430.35	greater than $25,000 and no more than $50,000		$400
430.36	no more than $25,000		$200

430.37(d) If requested, the home care provider shall provide the commissioner information
430.38to verify the provider's annual revenues or other information as needed, including copies
430.39of documents submitted to the Department of Revenue.
430.40(e) At each annual renewal, a home care provider may elect to pay the highest
430.41renewal fee for its license category, and not provide annual revenue information to the
430.42commissioner.
431.1(f) A temporary license or license applicant, or temporary licensee or licensee that
431.2knowingly provides the commissioner incorrect revenue amounts for the purpose of
431.3paying a lower license fee, shall be subject to a civil penalty in the amount of double the
431.4fee the provider should have paid.
431.5(g) Fees and penalties collected under this section shall be deposited in the state
431.6treasury and credited to the special state government revenue fund.

431.7    Sec. 12. [144A.473] ISSUANCE OF TEMPORARY LICENSE AND LICENSE
431.8RENEWAL.
431.9    Subdivision 1. Temporary license and renewal of license. (a) The department
431.10shall review each application to determine the applicant's knowledge of and compliance
431.11with Minnesota home care regulations. Before granting a temporary license or renewing a
431.12license, the commissioner may further evaluate the applicant or licensee by requesting
431.13additional information or documentation or by conducting an on-site survey of the
431.14applicant to determine compliance with sections 144A.43 to 144A.482.
431.15(b) Within 14 calendar days after receiving an application for a license,
431.16the commissioner shall acknowledge receipt of the application in writing. The
431.17acknowledgment must indicate whether the application appears to be complete or whether
431.18additional information is required before the application will be considered complete.
431.19(c) Within 90 days after receiving a complete application, the commissioner shall
431.20issue a temporary license, renew the license, or deny the license.
431.21(d) The commissioner shall issue a license that contains the home care provider's
431.22name, address, license level, expiration date of the license, and unique license number. All
431.23licenses are valid for one year from the date of issuance.
431.24    Subd. 2. Temporary license. (a) For new license applicants, the commissioner
431.25shall issue a temporary license for either the basic or comprehensive home care level. A
431.26temporary license is effective for one year from the date of issuance. Temporary licensees
431.27must comply with sections 144A.43 to 144A.482.
431.28(b) During the temporary license year, the commissioner shall survey the temporary
431.29licensee after the commissioner is notified or has evidence that the temporary licensee
431.30is providing home care services.
431.31(c) Within five days of beginning the provision of services, the temporary
431.32licensee must notify the commissioner that it is serving clients. The notification to the
431.33commissioner may be mailed or e-mailed to the commissioner at the address provided by
431.34the commissioner. If the temporary licensee does not provide home care services during
432.1the temporary license year, then the temporary license expires at the end of the year and
432.2the applicant must reapply for a temporary home care license.
432.3(d) A temporary licensee may request a change in the level of licensure prior to
432.4being surveyed and granted a license by notifying the commissioner in writing and
432.5providing additional documentation or materials required to update or complete the
432.6changed temporary license application. The applicant must pay the difference between the
432.7application fees when changing from the basic to the comprehensive level of licensure.
432.8No refund will be made if the provider chooses to change the license application to the
432.9basic level.
432.10(e) If the temporary licensee notifies the commissioner that the licensee has clients
432.11within 45 days prior to the temporary license expiration, the commissioner may extend the
432.12temporary license for up to 60 days in order to allow the commissioner to complete the
432.13on-site survey required under this section and follow-up survey visits.
432.14    Subd. 3. Temporary licensee survey. (a) If the temporary licensee is in substantial
432.15compliance with the survey, the commissioner shall issue either a basic or comprehensive
432.16home care license. If the temporary licensee is not in substantial compliance with the
432.17survey, the commissioner shall not issue a basic or comprehensive license and there will
432.18be no contested hearing right under chapter 14.
432.19(b) If the temporary licensee whose basic or comprehensive license has been denied
432.20disagrees with the conclusions of the commissioner, then the licensee may request a
432.21reconsideration by the commissioner or commissioner's designee. The reconsideration
432.22request process will be conducted internally by the commissioner or commissioner's
432.23designee, and chapter 14 does not apply.
432.24(c) The temporary licensee requesting reconsideration must make the request in
432.25writing and must list and describe the reasons why the licensee disagrees with the decision
432.26to deny the basic or comprehensive home care license.
432.27(d) A temporary licensee whose license is denied must comply with the requirements
432.28for notification and transfer of clients in section 144A.475, subdivision 5.

432.29    Sec. 13. [144A.474] SURVEYS AND INVESTIGATIONS.
432.30    Subdivision 1. Surveys. The commissioner shall conduct surveys of each home
432.31care provider. By June 30, 2016, the commissioner shall conduct a survey of home care
432.32providers on a frequency of at least once every three years. Survey frequency may be
432.33based on the license level, the provider's compliance history, number of clients served,
432.34or other factors as determined by the department deemed necessary to ensure the health,
432.35safety, and welfare of clients and compliance with the law.
433.1    Subd. 2. Types of home care surveys. (a) "Initial full survey" is the survey
433.2conducted of a new temporary licensee after the department is notified or has evidence that
433.3the licensee is providing home care services to determine if the provider is in compliance
433.4with home care requirements. Initial surveys must be completed within 14 months after
433.5the department's issuance of a temporary basic or comprehensive license.
433.6(b) "Core survey" means periodic inspection of home care providers to determine
433.7ongoing compliance with the home care requirements focusing on the essential health and
433.8safety requirements. Core surveys are available to licensed home care providers who have
433.9been licensed for three years, and been surveyed at least once in the past three years,
433.10with the latest survey having no widespread violation or violations beyond Level 1 as
433.11provided in subdivision 11. Providers must also have not had any substantiated licensing
433.12complaints, substantiated complaints against the agency under the Vulnerable Adults
433.13Act or Maltreatment of Minors Act, or an enforcement action as authorized in section
433.14144A.475 in the past three years. The core survey for basic license level providers will
433.15review compliance in the following areas:
433.16(1) reporting of maltreatment;
433.17(2) orientation to and implementation of home care client bill of rights;
433.18(3) statement of home care services;
433.19(4) initial evaluation of clients and initiation of services;
433.20(5) basic license level client review and monitoring;
433.21(6) service plan implementation and changes to the service plan;
433.22(7) client complaint and investigative process;
433.23(8) competency of unlicensed personnel; and
433.24(9) infection control.
433.25For comprehensive license level providers, the core survey will include everything
433.26in the basic license level core survey plus these areas:
433.27(1) assessment, monitoring, and reassessments of clients; and
433.28(2) medication, treatment, and therapy management.
433.29(c) "Full survey" means the periodic inspection of home care providers to determine
433.30ongoing compliance with the home care requirements that cover the core survey areas and
433.31all the legal requirements for home care providers. A full survey will be conducted for
433.32all temporary licensees, providers who do not meet the requirements needed for a core
433.33survey, and when a surveyor identifies unacceptable client health or safety risks during a
433.34core survey. A full survey will include all the tasks identified as part of the core survey
433.35and any additional review deemed necessary by the department, including additional
433.36observation, interviewing, or records review of additional clients and staff.
434.1(d) "Follow-up surveys" are conducted to determine if a home care provider has
434.2corrected deficient issues and systems identified during a core survey, full survey, or
434.3complaint investigation. Follow-up surveys may be conducted via phone, e-mail, fax,
434.4mail, or on-site reviews. Follow-up surveys, other than complaint surveys, shall be
434.5concluded with an exit conference and written information provided on the process for
434.6requesting a reconsideration of the survey results.
434.7(e) Upon receiving information alleging that a home care provider has violated or
434.8is currently violating a requirement of sections 144A.43 to 144A.482, the commissioner
434.9shall investigate the complaint according to sections 144A.51 to 144A.54.
434.10    Subd. 3. Survey process. The survey process for core surveys shall include the
434.11following as applicable to the particular licensee and setting surveyed:
434.12(1) presurvey review of pertinent documents and notification to the ombudsman
434.13for long-term care;
434.14(2) an entrance conference with available staff;
434.15(3) communication with managerial officials or the RN in charge, if available, and
434.16ongoing communication with key staff throughout the survey regarding information
434.17needed by the surveyor, clarifications regarding home care requirements, and applicable
434.18standards of practice;
434.19(4) presentation of written contact information to the provider about the survey staff
434.20conducting the survey, the supervisor, and the process for requesting a reconsideration of
434.21the survey results;
434.22(5) a brief tour of a sampling of the housing with services establishments in which
434.23the provider is providing home care services;
434.24(6) a sample selection of home care clients;
434.25(7) information gathering through client and staff observations, client and staff
434.26interviews, and reviews of records, policies, procedures, practices, and other agency
434.27information;
434.28(8) interviews of client's family members, if available, with client's consent when the
434.29client can legally give consent;
434.30(9) except for complaint surveys conducted by the Office of Health Facilities
434.31Complaints, an on-site exit conference with preliminary findings shared and discussed
434.32with the provider, documentation that an exit conference occurred, and written information
434.33on the process for requesting a reconsideration of the survey results; and
434.34(10) postsurvey analysis of findings and formulation of survey results, including
434.35correction orders when applicable.
435.1    Subd. 4. Scheduling surveys. Surveys and investigations shall be conducted
435.2without advance notice to home care providers. Surveyors may contact the home care
435.3provider on the day of a survey to arrange for someone to be available at the survey site.
435.4The contact does not constitute advance notice.
435.5    Subd. 5. Information provided by home care provider. The home care provider
435.6shall provide accurate and truthful information to the department during a survey,
435.7investigation, or other licensing activities.
435.8    Subd. 6. Providing client records. Upon request of a surveyor, home care providers
435.9shall provide a list of current and past clients or client representatives that includes
435.10addresses and telephone numbers and any other information requested about the services
435.11to clients within a reasonable period of time.
435.12    Subd. 7. Contacting and visiting clients. Surveyors may contact or visit a home
435.13care provider's clients to gather information without notice to the home care provider.
435.14Before visiting a client, a surveyor shall obtain the client's or client's representative's
435.15permission by telephone, mail, or in person. Surveyors shall inform all clients or client's
435.16representatives of their right to decline permission for a visit.
435.17    Subd. 8. Correction orders. (a) A correction order may be issued whenever the
435.18commissioner finds upon survey or during a complaint investigation that a home care
435.19provider, managerial official, or an employee of the provider is not in compliance with
435.20sections 144A.43 to 144A.482. The correction order shall cite the specific statute and
435.21document areas of noncompliance and the time allowed for correction.
435.22(b) The commissioner shall mail copies of any correction order to the last known
435.23address of the home care provider. A copy of each correction order and copies of any
435.24documentation supplied to the commissioner shall be kept on file by the home care
435.25provider, and public documents shall be made available for viewing by any person upon
435.26request. Copies may be kept electronically.
435.27(c) By the correction order date, the home care provider must document in the
435.28provider's records any action taken to comply with the correction order. The commissioner
435.29may request a copy of this documentation and the home care provider's action to respond
435.30to the correction order in future surveys, upon a complaint investigation, and as otherwise
435.31needed.
435.32    Subd. 9. Follow-up surveys. For providers that have Level III or Level IV
435.33violations or any violations determined to be widespread, the department shall conduct a
435.34follow-up survey within 90 calendar days of the survey. When conducting a follow-up
435.35survey, the surveyor will focus on whether the previous violations have been corrected and
435.36may also address any new violations that are observed while evaluating the corrections
436.1that have been made. If a new violation is identified on a follow-up survey, no fine will be
436.2imposed unless it is not corrected on the next follow-up survey.
436.3    Subd. 10. Performance incentive. A licensee is eligible for a performance
436.4incentive if there are no violations identified in a core or full survey. The performance
436.5incentive is a ten percent discount on the licensee's next home care renewal license fee.
436.6    Subd. 11. Fines. (a) Fines and enforcement actions under this subdivision may be
436.7assessed based on the level and scope of the violations described in paragraph (c) as follows:
436.8(1) Level I, no fines or enforcement;
436.9(2) Level II, fines ranging from $0 to $500, in addition to any of the enforcement
436.10mechanisms authorized in section 144A.475 for widespread violations;
436.11(3) Level III, fines ranging from $500 to $1,000, in addition to any of the
436.12enforcement mechanisms authorized in section 144A.475; and
436.13(4) Level IV, fines ranging from $1,000 to $5,000, in addition to any of the
436.14enforcement mechanisms authorized in section 144A.475.
436.15(b) Correction orders for violations will be categorized by both level and scope as
436.16follows, and fines will be assessed accordingly:
436.17(1) level of violation:
436.18(i) Level I, a violation that has no potential to cause more than a minimal impact on
436.19the client and does not affect health or safety;
436.20(ii) Level II, a violation that did not harm the client's health or safety, but had the
436.21potential to have harmed a client's health or safety, but not likely to cause serious injury,
436.22impairment, or death;
436.23(iii) Level III, a violation that harmed a client's health or safety, not including serious
436.24injury, impairment, or death, or a violation that has the potential to lead to serious injury,
436.25impairment, or death; and
436.26(iv) Level IV, a violation that results in serious injury, impairment or death.
436.27(2) scope of violation:
436.28(i) isolated, when one or a limited number of clients are affected, or one or a limited
436.29number of staff are involved, or the situation has occurred only occasionally;
436.30(ii) pattern, when more than a limited number of clients are affected, more than a
436.31limited number of staff are involved, or the situation has had repeated occurrences but
436.32is not found to be pervasive; or
436.33(iii) widespread; when problems are pervasive or represent a systemic failure that
436.34has affected or has the potential to affect a large portion or all of the clients.
436.35(c) If the commissioner finds that the applicant or a home care provider required
436.36to be licensed under sections 144A.43 to 144A.482 has not corrected violations by the
437.1date specified in the correction order or conditional license resulting from a survey or
437.2complaint investigation, the commissioner may impose a fine. A notice of noncompliance
437.3with a correction order must be mailed to the applicant's or provider's last known address.
437.4The noncompliance notice must list the violations not corrected.
437.5(d) The license holder must pay the fines assessed on or before the payment date
437.6specified. If the license holder fails to fully comply with the order, the commissioner
437.7may issue a second fine or suspend the license until the license holder complies by
437.8paying the fine. A timely appeal shall stay payment of the fine until the commissioner
437.9issues a final order.
437.10(e) A license holder shall promptly notify the commissioner in writing when a
437.11violation specified in the order is corrected. If upon reinspection, the commissioner
437.12determines that a violation has not been corrected as indicated by the order, the
437.13commissioner may issue a second fine. The commissioner shall notify the license holder by
437.14mail to the last known address in the licensing record that a second fine has been assessed.
437.15The license holder may appeal the second fine as provided under this subdivision.
437.16(f) A home care provider that has been assessed a fine under this subdivision has a
437.17right to a reconsideration or a hearing under this section and chapter 14.
437.18(g) When a fine has been assessed, the license holder may not avoid payment by
437.19closing, selling, or otherwise transferring the licensed program to a third party. In such an
437.20event, the license holder shall be liable for payment of the fine.
437.21(h) In addition to any fine imposed under this section, the commissioner may assess
437.22costs related to an investigation that results in a final order assessing a fine or other
437.23enforcement action authorized by this chapter.
437.24(i) Fines collected under this subdivision shall be deposited in the state government
437.25special revenue fund and credited to an account separate from the revenue collected under
437.26section 144A.472. Subject to an appropriation by the legislature, the revenue from the
437.27fines collected may be used by the commissioner for special projects to improve home care
437.28in Minnesota as recommended by the advisory council established in section 144A.4799.
437.29    Subd. 12. Reconsideration. (a) The commissioner shall make available to home
437.30care providers a correction order reconsideration process. This process may be used
437.31to challenge the correction order issued, including the level and scope described in
437.32subdivision 11, and any fine assessed. During the correction order reconsideration
437.33request, the issuance of the correction orders under reconsideration are not stayed, but
437.34the department will post information on the Web site with the correction order that the
437.35licensee has requested a reconsideration review and that the review is pending.
438.1(b) A licensed home care provider may request from the commissioner, in writing,
438.2a correction order reconsideration regarding any correction order issued to the provider.
438.3The correction order reconsideration shall not be reviewed by any surveyor, investigator,
438.4or supervisor that participated in the writing or reviewing of the correction order being
438.5disputed. The correction order reconsiderations may be conducted in person by telephone,
438.6by another electronic form, or in writing, as determined by the commissioner. The
438.7commissioner shall respond in writing to the request from a home care provider for
438.8a correction order reconsideration within 60 days of the date the provider requests a
438.9reconsideration. The commissioner's response shall identify the commissioner's decision
438.10regarding each citation challenged by the home care provider.
438.11(c) The findings of a correction order reconsideration process shall be one or more of
438.12the following:
438.13(1) supported in full: the correction order is supported in full, with no deletion of
438.14findings to the citation;
438.15(2) supported in substance: the correction order is supported, but one or more
438.16findings are deleted or modified without any change in the citation;
438.17 (3) correction order cited an incorrect home care licensing requirement: the correction
438.18order is amended by changing the correction order to the appropriate statutory reference;
438.19(4) correction order was issued under an incorrect citation: the correction order is
438.20amended to be issued under the more appropriate correction order citation;
438.21(5) the correction order is rescinded;
438.22(6) fine is amended: it is determined the fine assigned to the correction order was
438.23applied incorrectly; or
438.24(7) the level or scope of the citation is modified based on the reconsideration.
438.25(d) If the correction order findings are changed by the commissioner, the
438.26commissioner shall update the correction order on the Web site accordingly.
438.27    Subd. 13. Home care surveyor training. Before conducting a home care survey,
438.28each home care surveyor must receive training on the following topics:
438.29(1) Minnesota home care licensure requirements;
438.30(2) Minnesota home care client bill of rights;
438.31(3) Minnesota Vulnerable Adults Act and Reporting of Maltreatment of Minors;
438.32(4) principles of documentation;
438.33(5) survey protocol and processes;
438.34(6) Offices of the Ombudsman roles;
438.35(7) Office of Health Facility Complaints;
438.36(8) Minnesota landlord and tenant, and housing with services laws;
439.1(9) types of payors for home care services; and
439.2(10) Minnesota Nurse Practice Act for nurse surveyors.
439.3Materials used for this training will be posted on the Department of Health Web
439.4site. Requisite understanding of these topics will be reviewed as part of the quality
439.5improvement plan in section 30.

439.6    Sec. 14. [144A.475] ENFORCEMENT.
439.7    Subdivision 1. Conditions. (a) The commissioner may refuse to grant a temporary
439.8license or refuse to renew a license, may suspend or revoke a license, or may impose a
439.9conditional license if the home care provider or owner or managerial official of the home
439.10care provider:
439.11(1) is in violation of, or during the term of the license has violated, any of the
439.12requirements in sections 144A.471 to 144A.482;
439.13(2) permits, aids, or abets the commission of any illegal act in the provision of
439.14home care;
439.15(3) performs any act detrimental to the health, safety, and welfare of a client;
439.16(4) obtains the license by fraud or misrepresentation;
439.17(5) knowingly made or makes a false statement of a material fact in the application
439.18for a license or in any other record or report required by this chapter;
439.19(6) denies representatives of the department access to any part of the home care
439.20provider's books, records, files, or employees;
439.21(7) interferes with or impedes a representative of the department in contacting the
439.22home care provider's clients;
439.23(8) interferes with or impedes a representative of the department in the enforcement
439.24of this chapter or has failed to fully cooperate with an inspection, survey, or investigation
439.25by the department;
439.26(9) destroys or makes unavailable any records or other evidence relating to the home
439.27care provider's compliance with this chapter;
439.28(10) refuses to initiate a background study under section 144.057 or 245A.04;
439.29(11) fails to timely pay any fines assessed by the department;
439.30(12) violates any local, city, or township ordinance relating to home care services;
439.31(13) has repeated incidents of personnel performing services beyond their
439.32competency level; or
439.33(14) has operated beyond the scope of the home care provider's license level.
439.34    (b) A violation by a contractor providing the home care services of the home care
439.35provider is a violation by the home care provider.
440.1    Subd. 2. Terms to suspension or conditional license. A suspension or conditional
440.2license designation may include terms that must be completed or met before a suspension
440.3or conditional license designation is lifted. A conditional license designation may include
440.4restrictions or conditions that are imposed on the provider. Terms for a suspension or
440.5conditional license may include one or more of the following and the scope of each will be
440.6determined by the commissioner:
440.7(1) requiring a consultant to review, evaluate, and make recommended changes to
440.8the home care provider's practices and submit reports to the commissioner at the cost of
440.9the home care provider;
440.10(2) requiring supervision of the home care provider or staff practices at the cost
440.11of the home care provider by an unrelated person who has sufficient knowledge and
440.12qualifications to oversee the practices and who will submit reports to the commissioner;
440.13(3) requiring the home care provider or employees to obtain training at the cost of
440.14the home care provider;
440.15(4) requiring the home care provider to submit reports to the commissioner;
440.16(5) prohibiting the home care provider from taking any new clients for a period
440.17of time; or
440.18(6) any other action reasonably required to accomplish the purpose of this
440.19subdivision and section 144A.45, subdivision 2.
440.20    Subd. 3. Notice. Prior to any suspension, revocation, or refusal to renew a license,
440.21the home care provider shall be entitled to notice and a hearing as provided by sections
440.2214.57 to 14.69. In addition to any other remedy provided by law, the commissioner may,
440.23without a prior contested case hearing, temporarily suspend a license or prohibit delivery
440.24of services by a provider for not more than 90 days if the commissioner determines that
440.25the health or safety of a consumer is in imminent danger, provided:
440.26(1) advance notice is given to the home care provider;
440.27(2) after notice, the home care provider fails to correct the problem;
440.28(3) the commissioner has reason to believe that other administrative remedies are not
440.29likely to be effective; and
440.30(4) there is an opportunity for a contested case hearing within the 90 days.
440.31    Subd. 4. Time limits for appeals. To appeal the assessment of civil penalties
440.32under section 144A.45, subdivision 2, clause (5), and an action against a license under
440.33this section, a provider must request a hearing no later than 15 days after the provider
440.34receives notice of the action.
440.35    Subd. 5. Plan required. (a) The process of suspending or revoking a license
440.36must include a plan for transferring affected clients to other providers by the home care
441.1provider, which will be monitored by the commissioner. Within three business days of
441.2being notified of the final revocation or suspension action, the home care provider shall
441.3provide the commissioner, the lead agencies as defined in section 256B.0911, and the
441.4ombudsman for long-term care with the following information:
441.5(1) a list of all clients, including full names and all contact information on file;
441.6(2) a list of each client's representative or emergency contact person, including full
441.7names and all contact information on file;
441.8(3) the location or current residence of each client;
441.9(4) the payor sources for each client, including payor source identification numbers;
441.10and
441.11(5) for each client, a copy of the client's service plan, and a list of the types of
441.12services being provided.
441.13(b) The revocation or suspension notification requirement is satisfied by mailing the
441.14notice to the address in the license record. The home care provider shall cooperate with
441.15the commissioner and the lead agencies during the process of transferring care of clients to
441.16qualified providers. Within three business days of being notified of the final revocation or
441.17suspension action, the home care provider must notify and disclose to each of the home
441.18care provider's clients, or the client's representative or emergency contact persons, that
441.19the commissioner is taking action against the home care provider's license by providing a
441.20copy of the revocation or suspension notice issued by the commissioner.
441.21    Subd. 6. Owners and managerial officials; refusal to grant license. (a) The owner
441.22and managerial officials of a home care provider whose Minnesota license has not been
441.23renewed or that has been revoked because of noncompliance with applicable laws or rules
441.24shall not be eligible to apply for and shall not be granted a home care license, including
441.25other licenses under this chapter, or be given status as an enrolled personal care assistance
441.26provider agency or personal care assistant by the Department of Human Services under
441.27section 256B.0659 for five years following the effective date of the nonrenewal or
441.28revocation. If the owner and managerial officials already have enrollment status, their
441.29enrollment will be terminated by the Department of Human Services.
441.30(b) The commissioner shall not issue a license to a home care provider for five
441.31years following the effective date of license nonrenewal or revocation if the owner or
441.32managerial official, including any individual who was an owner or managerial official
441.33of another home care provider, had a Minnesota license that was not renewed or was
441.34revoked as described in paragraph (a).
441.35(c) Notwithstanding subdivision 1, the commissioner shall not renew, or shall
441.36suspend or revoke, the license of any home care provider that includes any individual
442.1as an owner or managerial official who was an owner or managerial official of a home
442.2care provider whose Minnesota license was not renewed or was revoked as described in
442.3paragraph (a) for five years following the effective date of the nonrenewal or revocation.
442.4(d) The commissioner shall notify the home care provider 30 days in advance of
442.5the date of nonrenewal, suspension, or revocation of the license. Within ten days after
442.6the receipt of the notification, the home care provider may request, in writing, that the
442.7commissioner stay the nonrenewal, revocation, or suspension of the license. The home
442.8care provider shall specify the reasons for requesting the stay; the steps that will be taken
442.9to attain or maintain compliance with the licensure laws and regulations; any limits on the
442.10authority or responsibility of the owners or managerial officials whose actions resulted in
442.11the notice of nonrenewal, revocation, or suspension; and any other information to establish
442.12that the continuing affiliation with these individuals will not jeopardize client health, safety,
442.13or well-being. The commissioner shall determine whether the stay will be granted within
442.1430 days of receiving the provider's request. The commissioner may propose additional
442.15restrictions or limitations on the provider's license and require that the granting of the stay
442.16be contingent upon compliance with those provisions. The commissioner shall take into
442.17consideration the following factors when determining whether the stay should be granted:
442.18(1) the threat that continued involvement of the owners and managerial officials with
442.19the home care provider poses to client health, safety, and well-being;
442.20(2) the compliance history of the home care provider; and
442.21(3) the appropriateness of any limits suggested by the home care provider.
442.22    If the commissioner grants the stay, the order shall include any restrictions or
442.23limitation on the provider's license. The failure of the provider to comply with any
442.24restrictions or limitations shall result in the immediate removal of the stay and the
442.25commissioner shall take immediate action to suspend, revoke, or not renew the license.
442.26    Subd. 7. Request for hearing. A request for a hearing must be in writing and must:
442.27(1) be mailed or delivered to the department or the commissioner's designee;
442.28(2) contain a brief and plain statement describing every matter or issue contested; and
442.29(3) contain a brief and plain statement of any new matter that the applicant or home
442.30care provider believes constitutes a defense or mitigating factor.
442.31    Subd. 8. Informal conference. At any time, the applicant or home care provider
442.32and the commissioner may hold an informal conference to exchange information, clarify
442.33issues, or resolve issues.
442.34    Subd. 9. Injunctive relief. In addition to any other remedy provided by law, the
442.35commissioner may bring an action in district court to enjoin a person who is involved in
442.36the management, operation, or control of a home care provider or an employee of the
443.1home care provider from illegally engaging in activities regulated by sections 144A.43 to
443.2144A.482. The commissioner may bring an action under this subdivision in the district
443.3court in Ramsey County or in the district in which a home care provider is providing
443.4services. The court may grant a temporary restraining order in the proceeding if continued
443.5activity by the person who is involved in the management, operation, or control of a home
443.6care provider, or by an employee of the home care provider, would create an imminent
443.7risk of harm to a recipient of home care services.
443.8    Subd. 10. Subpoena. In matters pending before the commissioner under sections
443.9144A.43 to 144A.482, the commissioner may issue subpoenas and compel the attendance
443.10of witnesses and the production of all necessary papers, books, records, documents, and
443.11other evidentiary material. If a person fails or refuses to comply with a subpoena or
443.12order of the commissioner to appear or testify regarding any matter about which the
443.13person may be lawfully questioned or to produce any papers, books, records, documents,
443.14or evidentiary materials in the matter to be heard, the commissioner may apply to the
443.15district court in any district, and the court shall order the person to comply with the
443.16commissioner's order or subpoena. The commissioner of health may administer oaths to
443.17witnesses or take their affirmation. Depositions may be taken in or outside the state in the
443.18manner provided by law for the taking of depositions in civil actions. A subpoena or other
443.19process or paper may be served on a named person anywhere in the state by an officer
443.20authorized to serve subpoenas in civil actions, with the same fees and mileage and in the
443.21same manner as prescribed by law for a process issued out of a district court. A person
443.22subpoenaed under this subdivision shall receive the same fees, mileage, and other costs
443.23that are paid in proceedings in district court.

443.24    Sec. 15. [144A.476] BACKGROUND STUDIES.
443.25    Subdivision 1. Prior criminal convictions; owner and managerial officials. (a)
443.26Before the commissioner issues a temporary license or renews a license, an owner or
443.27managerial official is required to complete a background study under section 144.057. No
443.28person may be involved in the management, operation, or control of a home care provider
443.29if the person has been disqualified under chapter 245C. If an individual is disqualified
443.30under section 144.057 or chapter 245C, the individual may request reconsideration of
443.31the disqualification. If the individual requests reconsideration and the commissioner
443.32sets aside or rescinds the disqualification, the individual is eligible to be involved in the
443.33management, operation, or control of the provider. If an individual has a disqualification
443.34under section 245C.15, subdivision 1, and the disqualification is affirmed, the individual's
444.1disqualification is barred from a set aside, and the individual must not be involved in the
444.2management, operation, or control of the provider.
444.3(b) For purposes of this section, owners of a home care provider subject to the
444.4background check requirement are those individuals whose ownership interest provides
444.5sufficient authority or control to affect or change decisions related to the operation of the
444.6home care provider. An owner includes a sole proprietor, a general partner, or any other
444.7individual whose individual ownership interest can affect the management and direction
444.8of the policies of the home care provider.
444.9(c) For the purposes of this section, managerial officials subject to the background
444.10check requirement are individuals who provide direct contact as defined in section
444.11245C.02, subdivision 11, or individuals who have the responsibility for the ongoing
444.12management or direction of the policies, services, or employees of the home care provider.
444.13Data collected under this subdivision shall be classified as private data on individuals as
444.14defined in section 13.02, subdivision 12.
444.15(d) The department shall not issue any license if the applicant, owner, or managerial
444.16official has been unsuccessful in having a background study disqualification set aside
444.17under section 144.057 and chapter 245C; if the owner or managerial official, as an owner
444.18or managerial official of another home care provider, was substantially responsible for
444.19the other home care provider's failure to substantially comply with sections 144A.43 to
444.20144A.482; or if an owner that has ceased doing business, either individually or as an
444.21owner of a home care provider, was issued a correction order for failing to assist clients in
444.22violation of this chapter.
444.23    Subd. 2. Employees, contractors, and volunteers. (a) Employees, contractors,
444.24and volunteers of a home care provider are subject to the background study required by
444.25section 144.057, and may be disqualified under chapter 245C. Nothing in this section shall
444.26be construed to prohibit a home care provider from requiring self-disclosure of criminal
444.27conviction information.
444.28(b) Termination of an employee in good faith reliance on information or records
444.29obtained under paragraph (a) or subdivision 1, regarding a confirmed conviction does not
444.30subject the home care provider to civil liability or liability for unemployment benefits.

444.31    Sec. 16. [144A.477] COMPLIANCE.
444.32    Subdivision 1. Medicare-certified providers; coordination of surveys. If feasible,
444.33the commissioner shall survey licensees to determine compliance with this chapter at the
444.34same time as surveys for certification for Medicare if Medicare certification is based on
444.35compliance with the federal conditions of participation and on survey and enforcement
445.1by the Department of Health as agent for the United States Department of Health and
445.2Human Services.
445.3    Subd. 2. Medicare-certified providers; equivalent requirements. For home care
445.4providers licensed to provide comprehensive home care services that are also certified for
445.5participation in Medicare as a home health agency under Code of Federal Regulations,
445.6title 42, part 484, the following state licensure regulations are considered equivalent to
445.7the federal requirements:
445.8(1) quality management, section 144A.479, subdivision 3;
445.9(2) personnel records, section 144A.479, subdivision 7;
445.10(3) acceptance of clients, section 144A.4791, subdivision 4;
445.11(4) referrals, section 144A.4791, subdivision 5;
445.12(5) client assessment, sections 144A.4791, subdivision 8, and 144A.4792,
445.13subdivisions 2 and 3;
445.14(6) individualized monitoring and reassessment, sections 144A.4791, subdivision
445.158, and 144A.4792, subdivisions 2 and 3;
445.16(7) individualized service plan, sections 144A.4791, subdivision 9, 144A.4792,
445.17subdivision 5, and 144A.4793, subdivision 3;
445.18(8) client complaint and investigation process, section 144A.4791, subdivision 11;
445.19(9) prescription orders, section 144A.4792, subdivisions 13 to 16;
445.20(10) client records, section 144A.4794, subdivisions 1 to 3;
445.21(11) qualifications for unlicensed personnel performing delegated tasks, section
445.22144A.4795;
445.23(12) training and competency staff, section 144A.4795;
445.24(13) training and competency for unlicensed personnel, section 144A.4795,
445.25subdivision 7;
445.26(14) delegation of home care services, section 144A.4795, subdivision 4;
445.27(15) availability of contact person, section 144A.4797, subdivision 1; and
445.28(16) supervision of staff, section 144A.4797, subdivisions 2 and 3.
445.29Violations of the requirements in clauses (1) to (16) may lead to enforcement actions
445.30under section 144A.474.

445.31    Sec. 17. [144A.478] INNOVATION VARIANCE.
445.32    Subdivision 1. Definition. For purposes of this section, "innovation variance"
445.33means a specified alternative to a requirement of this chapter. An innovation variance may
445.34be granted to allow a home care provider to offer home care services of a type or in a
445.35manner that is innovative, will not impair the services provided, will not adversely affect
446.1the health, safety, or welfare of the clients, and is likely to improve the services provided.
446.2The innovative variance cannot change any of the client's rights under section 144A.44.
446.3    Subd. 2. Conditions. The commissioner may impose conditions on the granting of
446.4an innovation variance that the commissioner considers necessary.
446.5    Subd. 3. Duration and renewal. The commissioner may limit the duration of any
446.6innovation variance and may renew a limited innovation variance.
446.7    Subd. 4. Applications; innovation variance. An application for innovation
446.8variance from the requirements of this chapter may be made at any time, must be made in
446.9writing to the commissioner, and must specify the following:
446.10(1) the statute or law from which the innovation variance is requested;
446.11(2) the time period for which the innovation variance is requested;
446.12(3) the specific alternative action that the licensee proposes;
446.13(4) the reasons for the request; and
446.14(5) justification that an innovation variance will not impair the services provided;
446.15will not adversely affect the health, safety, or welfare of clients; and is likely to improve
446.16the services provided.
446.17The commissioner may require additional information from the home care provider before
446.18acting on the request.
446.19    Subd. 5. Grants and denials. The commissioner shall grant or deny each request
446.20for an innovation variance in writing within 45 days of receipt of a complete request.
446.21Notice of a denial shall contain the reasons for the denial. The terms of a requested
446.22innovation variance may be modified upon agreement between the commissioner and
446.23the home care provider.
446.24    Subd. 6. Violation of innovation variances. A failure to comply with the terms of
446.25an innovation variance shall be deemed to be a violation of this chapter.
446.26    Subd. 7. Revocation or denial of renewal. The commissioner shall revoke or
446.27deny renewal of an innovation variance if:
446.28(1) it is determined that the innovation variance is adversely affecting the health,
446.29safety, or welfare of the licensee's clients;
446.30(2) the home care provider has failed to comply with the terms of the innovation
446.31variance;
446.32(3) the home care provider notifies the commissioner in writing that it wishes to
446.33relinquish the innovation variance and be subject to the statute previously varied; or
446.34(4) the revocation or denial is required by a change in law.

447.1    Sec. 18. [144A.479] HOME CARE PROVIDER RESPONSIBILITIES;
447.2BUSINESS OPERATION.
447.3    Subdivision 1. Display of license. The original current license must be displayed
447.4in the home care provider's principal business office and copies must be displayed in
447.5any branch office. The home care provider must provide a copy of the license to any
447.6person who requests it.
447.7    Subd. 2. Advertising. Home care providers shall not use false, fraudulent,
447.8or misleading advertising in the marketing of services. For purposes of this section,
447.9advertising includes any verbal, written, or electronic means of communicating to
447.10potential clients about the availability, nature, or terms of home care services.
447.11    Subd. 3. Quality management. The home care provider shall engage in quality
447.12management appropriate to the size of the home care provider and relevant to the type
447.13of services the home care provider provides. The quality management activity means
447.14evaluating the quality of care by periodically reviewing client services, complaints made,
447.15and other issues that have occurred and determining whether changes in services, staffing,
447.16or other procedures need to be made in order to ensure safe and competent services to
447.17clients. Documentation about quality management activity must be available for two
447.18years. Information about quality management must be available to the commissioner at
447.19the time of the survey, investigation, or renewal.
447.20    Subd. 4. Provider restrictions. (a) This subdivision does not apply to licensees
447.21that are Minnesota counties or other units of government.
447.22(b) A home care provider or staff cannot accept powers-of-attorney from clients for
447.23any purpose, and may not accept appointments as guardians or conservators of clients.
447.24(c) A home care provider cannot serve as a client's representative.
447.25    Subd. 5. Handling of client's finances and property. (a) A home care provider
447.26may assist clients with household budgeting, including paying bills and purchasing
447.27household goods, but may not otherwise manage a client's property. A home care provider
447.28must provide a client with receipts for all transactions and purchases paid with the client's
447.29funds. When receipts are not available, the transaction or purchase must be documented.
447.30A home care provider must maintain records of all such transactions.
447.31(b) A home care provider or staff may not borrow a client's funds or personal or
447.32real property, nor in any way convert a client's property to the home care provider's or
447.33staff's possession.
447.34(c) Nothing in this section precludes a home care provider or staff from accepting
447.35gifts of minimal value, or precludes the acceptance of donations or bequests made to a
448.1home care provider that are exempt from income tax under section 501(c) of the Internal
448.2Revenue Code of 1986.
448.3    Subd. 6. Reporting maltreatment of vulnerable adults and minors. (a) All
448.4home care providers must comply with requirements for the reporting of maltreatment
448.5of minors in section 626.556 and the requirements for the reporting of maltreatment
448.6of vulnerable adults in section 626.557. Home care providers must report suspected
448.7maltreatment of minors and vulnerable adults to the common entry point. Each home
448.8care provider must establish and implement a written procedure to ensure that all cases
448.9of suspected maltreatment are reported.
448.10(b) Each home care provider must develop and implement an individual abuse
448.11prevention plan for each vulnerable minor or adult for whom home care services are
448.12provided by a home care provider. The plan shall contain an individualized review or
448.13assessment of the person's susceptibility to abuse by another individual, including other
448.14vulnerable adults or minors; the person's risk of abusing other vulnerable adults or minors;
448.15and statements of the specific measures to be taken to minimize the risk of abuse to that
448.16person and other vulnerable adults or minors. For purposes of the abuse prevention plan,
448.17the term abuse includes self-abuse.
448.18    Subd. 7. Employee records. The home care provider must maintain current records
448.19of each paid employee, regularly scheduled volunteers providing home care services,
448.20and each individual contractor providing home care services. The records must include
448.21the following information:
448.22(1) evidence of current professional licensure, registration, or certification, if
448.23licensure, registration, or certification is required by this statute, or other rules;
448.24(2) records of orientation, required annual training and infection control training,
448.25and competency evaluations;
448.26(3) current job description, including qualifications, responsibilities, and
448.27identification of staff providing supervision;
448.28(4) documentation of annual performance reviews which identify areas of
448.29improvement needed and training needs;
448.30(5) for individuals providing home care services, verification that required health
448.31screenings under section 144A.4798 have taken place and the dates of those screenings; and
448.32(6) documentation of the background study as required under section 144.057.
448.33Each employee record must be retained for at least three years after a paid employee,
448.34home care volunteer, or contractor ceases to be employed by or under contract with the
448.35home care provider. If a home care provider ceases operation, employee records must be
448.36maintained for three years.

449.1    Sec. 19. [144A.4791] HOME CARE PROVIDER RESPONSIBILITIES WITH
449.2RESPECT TO CLIENTS.
449.3    Subdivision 1. Home care bill of rights; notification to client. (a) The home care
449.4provider shall make all reasonable efforts to provide the client or the client's representative
449.5a written notice of the rights under section 144A.44 before the initiation of services. The
449.6home care provider shall make all reasonable efforts to provide the notice in a language
449.7the client or client's representative understands. If a written version is not effective or
449.8available, the notice may be provided verbally.
449.9(b) In addition to the text of the home care bill of rights in section 144A.44,
449.10subdivision 1, the notice shall also contain the following statement describing how to file
449.11a complaint with these offices.
449.12"If you have a complaint about the provider or the person providing your
449.13home care services, you may call, write, or visit the Office of Health Facility
449.14Complaints, Minnesota Department of Health. You may also contact the Office of
449.15Ombudsman for Long-Term Care or the Office of Ombudsman for Mental Health
449.16and Developmental Disabilities."
449.17The statement should include the telephone number, Web site address, e-mail
449.18address, mailing address, and street address of the Office of Health Facility Complaints at
449.19the Minnesota Department of Health, the Office of the Ombudsman for Long-Term Care,
449.20and the Office of the Ombudsman for Mental Health and Developmental Disabilities. The
449.21statement should also include the home care provider's name, address, e-mail, telephone
449.22number, and name or title of the person at the provider to whom problems or complaints
449.23may be directed. It must also include a statement that the home care provider will not
449.24retaliate because of a complaint.
449.25(c) The home care provider shall obtain written acknowledgment of the client's
449.26receipt of the home care bill of rights or shall document why an acknowledgment cannot
449.27be obtained. The acknowledgment may be obtained from the client or the client's
449.28representative. Acknowledgment of receipt shall be retained in the client's record.
449.29    Subd. 2. Notice of services for dementia, Alzheimer's disease, or related
449.30disorders. The home care provider that provides services to clients with dementia shall
449.31provide in written or electronic form, to clients and families or other persons who request
449.32it, a description of the training program and related training it provides, including the
449.33categories of employees trained, the frequency of training, and the basic topics covered.
449.34This information satisfies the disclosure requirements in section 325F.72, subdivision
449.352, clause (4).
450.1    Subd. 3. Statement of home care services. Prior to the initiation of services,
450.2a home care provider must provide to the client or the client's representative a written
450.3statement which identifies if they have a basic or comprehensive home care license, the
450.4services they are authorized to provide, and which services they cannot provide under the
450.5scope of their license. The home care provider shall obtain written acknowledgment
450.6from the clients that they have provided the statement or must document why they could
450.7not obtain the acknowledgment.
450.8    Subd. 4. Acceptance of clients. No home care provider may accept a person as a
450.9client unless the home care provider has staff, sufficient in qualifications, competency,
450.10and numbers, to adequately provide the services agreed to in the service plan and that
450.11are within the provider's scope of practice.
450.12    Subd. 5. Referrals. If a home care provider reasonably believes that a client is in
450.13need of another medical or health service, including a licensed health professional, or
450.14social service provider, the home care provider shall:
450.15(1) determine the client's preferences with respect to obtaining the service; and
450.16(2) inform the client of resources available, if known, to assist the client in obtaining
450.17services.
450.18    Subd. 6. Initiation of services. When a provider initiates services and the
450.19individualized review or assessment required in subdivisions 7 and 8 has not been
450.20completed, the provider must complete a temporary plan and agreement with the client for
450.21services.
450.22    Subd. 7. Basic individualized client review and monitoring. (a) When services
450.23being provided are basic home care services, an individualized initial review of the client's
450.24needs and preferences must be conducted at the client's residence with the client or client's
450.25representative. This initial review must be completed within 30 days after the initiation of
450.26the home care services.
450.27(b) Client monitoring and review must be conducted as needed based on changes
450.28in the needs of the client and cannot exceed 90 days from the date of the last review.
450.29The monitoring and review may be conducted at the client's residence or through the
450.30utilization of telecommunication methods based on practice standards that meet the
450.31individual client's needs.
450.32    Subd. 8. Comprehensive assessment, monitoring, and reassessment. (a) When
450.33the services being provided are comprehensive home care services, an individualized
450.34initial assessment must be conducted in-person by a registered nurse. When the services
450.35are provided by other licensed health professionals, the assessment must be conducted by
451.1the appropriate health professional. This initial assessment must be completed within five
451.2days after initiation of home care services.
451.3(b) Client monitoring and reassessment must be conducted in the client's home no
451.4more than 14 days after initiation of services.
451.5(c) Ongoing client monitoring and reassessment must be conducted as needed based
451.6on changes in the needs of the client and cannot exceed 90 days from the last date of the
451.7assessment. The monitoring and reassessment may be conducted at the client's residence
451.8or through the utilization of telecommunication methods based on practice standards that
451.9meet the individual client's needs.
451.10    Subd. 9. Service plan, implementation, and revisions to service plan. (a) No later
451.11than 14 days after the initiation of services, a home care provider shall finalize a current
451.12written service plan.
451.13(b) The service plan and any revisions must include a signature or other
451.14authentication by the home care provider and by the client or the client's representative
451.15documenting agreement on the services to be provided. The service plan must be revised,
451.16if needed, based on client review or reassessment under subdivisions 7 and 8. The provider
451.17must provide information to the client about changes to the provider's fee for services and
451.18how to contact the Office of the Ombudsman for Long-Term Care.
451.19(c) The home care provider must implement and provide all services required by
451.20the current service plan.
451.21(d) The service plan and revised service plan must be entered into the client's record,
451.22including notice of a change in a client's fees when applicable.
451.23(e) Staff providing home care services must be informed of the current written
451.24service plan.
451.25(f) The service plan must include:
451.26(1) a description of the home care services to be provided, the fees for services, and
451.27the frequency of each service, according to the client's current review or assessment and
451.28client preferences;
451.29(2) the identification of the staff or categories of staff who will provide the services;
451.30(3) the schedule and methods of monitoring reviews or assessments of the client;
451.31(4) the frequency of sessions of supervision of staff and type of personnel who
451.32will supervise staff; and
451.33(5) a contingency plan that includes:
451.34(i) the action to be taken by the home care provider and by the client or client's
451.35representative if the scheduled service cannot be provided;
452.1(ii) information and method for a client or client's representative to contact the
452.2home care provider;
452.3(iii) names and contact information of persons the client wishes to have notified
452.4in an emergency or if there is a significant adverse change in the client's condition,
452.5including identification of and information as to who has authority to sign for the client in
452.6an emergency; and
452.7(iv) the circumstances in which emergency medical services are not to be summoned
452.8consistent with chapters 145B and 145C, and declarations made by the client under those
452.9chapters.
452.10    Subd. 10. Termination of service plan. (a) If a home care provider terminates a
452.11service plan with a client, and the client continues to need home care services, the home
452.12care provider shall provide the client and the client's representative, if any, with a written
452.13notice of termination which includes the following information:
452.14(1) the effective date of termination;
452.15(2) the reason for termination;
452.16(3) a list of known licensed home care providers in the client's immediate geographic
452.17area;
452.18(4) a statement that the home care provider will participate in a coordinated transfer
452.19of care of the client to another home care provider, health care provider, or caregiver, as
452.20required by the home care bill of rights, section 144A.44, subdivision 1, clause (17);
452.21(5) the name and contact information of a person employed by the home care
452.22provider with whom the client may discuss the notice of termination; and
452.23(6) if applicable, a statement that the notice of termination of home care services
452.24does not constitute notice of termination of the housing with services contract with a
452.25housing with services establishment.
452.26(b) When the home care provider voluntarily discontinues services to all clients, the
452.27home care provider must notify the commissioner, lead agencies, and the ombudsman for
452.28long-term care about its clients and comply with the requirements in this subdivision.
452.29    Subd. 11. Client complaint and investigative process. (a) The home care
452.30provider must have a written policy and system for receiving, investigating, reporting,
452.31and attempting to resolve complaints from its clients or clients' representatives. The
452.32policy should clearly identify the process by which clients may file a complaint or concern
452.33about home care services and an explicit statement that the home care provider will not
452.34discriminate or retaliate against a client for expressing concerns or complaints. A home
452.35care provider must have a process in place to conduct investigations of complaints made
452.36by the client or the client's representative about the services in the client's plan that are or
453.1are not being provided or other items covered in the client's home care bill of rights. This
453.2complaint system must provide reasonable accommodations for any special needs of the
453.3client or client's representative if requested.
453.4(b) The home care provider must document the complaint, name of the client,
453.5investigation, and resolution of each complaint filed. The home care provider must
453.6maintain a record of all activities regarding complaints received, including the date the
453.7complaint was received, and the home care provider's investigation and resolution of the
453.8complaint. This complaint record must be kept for each event for at least two years after
453.9the date of entry and must be available to the commissioner for review.
453.10(c) The required complaint system must provide for written notice to each client or
453.11client's representative that includes:
453.12(1) the client's right to complain to the home care provider about the services received;
453.13(2) the name or title of the person or persons with the home care provider to contact
453.14with complaints;
453.15(3) the method of submitting a complaint to the home care provider; and
453.16(4) a statement that the provider is prohibited against retaliation according to
453.17paragraph (d).
453.18(d) A home care provider must not take any action that negatively affects a client
453.19in retaliation for a complaint made or a concern expressed by the client or the client's
453.20representative.
453.21    Subd. 12. Disaster planning and emergency preparedness plan. The home care
453.22provider must have a written plan of action to facilitate the management of the client's care
453.23and services in response to a natural disaster, such as flood and storms, or other emergencies
453.24that may disrupt the home care provider's ability to provide care or services. The licensee
453.25must provide adequate orientation and training of staff on emergency preparedness.
453.26    Subd. 13. Request for discontinuation of life-sustaining treatment. (a) If a
453.27client, family member, or other caregiver of the client requests that an employee or other
453.28agent of the home care provider discontinue a life-sustaining treatment, the employee or
453.29agent receiving the request:
453.30(1) shall take no action to discontinue the treatment; and
453.31(2) shall promptly inform their supervisor or other agent of the home care provider
453.32of the client's request.
453.33(b) Upon being informed of a request for termination of treatment, the home care
453.34provider shall promptly:
453.35(1) inform the client that the request will be made known to the physician who
453.36ordered the client's treatment;
454.1(2) inform the physician of the client's request; and
454.2(3) work with the client and the client's physician to comply with the provisions of
454.3the Health Care Directive Act in chapter 145C.
454.4(c) This section does not require the home care provider to discontinue treatment,
454.5except as may be required by law or court order.
454.6(d) This section does not diminish the rights of clients to control their treatments,
454.7refuse services, or terminate their relationships with the home care provider.
454.8(e) This section shall be construed in a manner consistent with chapter 145B or
454.9145C, whichever applies, and declarations made by clients under those chapters.

454.10    Sec. 20. [144A.4792] MEDICATION MANAGEMENT.
454.11    Subdivision 1. Medication management services; comprehensive home care
454.12license. (a) This subdivision applies only to home care providers with a comprehensive
454.13home care license that provides medication management services to clients. Medication
454.14management services may not be provided by a home care provider that has a basic
454.15home care license.
454.16(b) A comprehensive home care provider who provides medication management
454.17services must develop, implement, and maintain current written medication management
454.18policies and procedures. The policies and procedures must be developed under the
454.19supervision and direction of a registered nurse, licensed health professional, or pharmacist
454.20consistent with current practice standards and guidelines.
454.21(c) The written policies and procedures must address requesting and receiving
454.22prescriptions for medications; preparing and giving medications; verifying that
454.23prescription drugs are administered as prescribed; documenting medication management
454.24activities; controlling and storing medications; monitoring and evaluating medication use;
454.25resolving medication errors; communicating with the prescriber, pharmacist, client, and
454.26client representative, if any; disposing of unused medications; and educating clients and
454.27client representatives about medications. When controlled substances are being managed,
454.28the policies and procedures must also identify how the provider will ensure security and
454.29accountability for the overall management, control, and disposition of those substances in
454.30compliance with state and federal regulations and with subdivision 22.
454.31    Subd. 2. Provision of medication management services. (a) For each client who
454.32requests medication management services, the comprehensive home care provider shall,
454.33prior to providing medication management services, have a registered nurse, licensed
454.34health professional, or authorized prescriber under section 151.37 conduct an assessment
454.35to determine what medication management services will be provided and how the services
455.1will be provided. This assessment must be conducted face-to-face with the client. The
455.2assessment must include an identification and review of all medications the client is known
455.3to be taking. The review and identification must include indications for medications, side
455.4effects, contraindications, allergic or adverse reactions, and actions to address these issues.
455.5(b) The assessment must identify interventions needed in management of
455.6medications to prevent diversion of medication by the client or others who may have
455.7access to the medications. Diversion of medications means the misuse, theft, or illegal
455.8or improper disposition of medications.
455.9    Subd. 3. Individualized medication monitoring and reassessment. The
455.10comprehensive home care provider must monitor and reassess the client's medication
455.11management services as needed under subdivision 14 when the client presents with
455.12symptoms or other issues that may be medication-related and, at a minimum, annually.
455.13    Subd. 4. Client refusal. The home care provider must document in the client's
455.14record any refusal for an assessment for medication management by the client. The
455.15provider must discuss with the client the possible consequences of the client's refusal and
455.16document the discussion in the client's record.
455.17    Subd. 5. Individualized medication management plan. (a) For each client
455.18receiving medication management services, the comprehensive home care provider must
455.19prepare and include in the service plan a written statement of the medication management
455.20services that will be provided to the client. The provider must develop and maintain a
455.21current individualized medication management record for each client based on the client's
455.22assessment that contains the following:
455.23(1) a statement describing the medication management services that will be provided;
455.24(2) a description of storage of medications based on the client's needs and
455.25preferences, risk of diversion, and consistent with the manufacturer's directions;
455.26(3) documentation of specific client instructions relating to the administration
455.27of medications;
455.28(4) identification of persons responsible for monitoring medication supplies and
455.29ensuring that medication refills are ordered on a timely basis;
455.30(5) identification of medication management tasks that may be delegated to
455.31unlicensed personnel;
455.32(6) procedures for staff notifying a registered nurse or appropriate licensed health
455.33professional when a problem arises with medication management services; and
455.34(7) any client-specific requirements relating to documenting medication
455.35administration, verification that all medications are administered as prescribed, and
455.36monitoring of medication use to prevent possible complications or adverse reactions.
456.1(b) The medication management record must be current and updated when there are
456.2any changes.
456.3    Subd. 6. Administration of medication. Medications may be administered by a
456.4nurse, physician, or other licensed health practitioner authorized to administer medications
456.5or by unlicensed personnel who have been delegated medication administration tasks by
456.6a registered nurse.
456.7    Subd. 7. Delegation of medication administration. When administration of
456.8medications is delegated to unlicensed personnel, the comprehensive home care provider
456.9must ensure that the registered nurse has:
456.10(1) instructed the unlicensed personnel in the proper methods to administer the
456.11medications, and the unlicensed personnel has demonstrated ability to competently follow
456.12the procedures;
456.13(2) specified, in writing, specific instructions for each client and documented those
456.14instructions in the client's records; and
456.15(3) communicated with the unlicensed personnel about the individual needs of
456.16the client.
456.17    Subd. 8. Documentation of administration of medications. Each medication
456.18administered by comprehensive home care provider staff must be documented in the
456.19client's record. The documentation must include the signature and title of the person
456.20who administered the medication. The documentation must include the medication
456.21name, dosage, date and time administered, and method and route of administration. The
456.22staff must document the reason why medication administration was not completed as
456.23prescribed and document any follow-up procedures that were provided to meet the client's
456.24needs when medication was not administered as prescribed and in compliance with the
456.25client's medication management plan.
456.26    Subd. 9. Documentation of medication set up. Documentation of dates of
456.27medication set up, name of medication, quantity of dose, times to be administered, route
456.28of administration, and name of person completing medication set up must be done at
456.29time of set up.
456.30    Subd. 10. Medications management for clients who will be away from home.
456.31(a) A home care provider that is providing medication management services to the client
456.32and controls the client's access to the medications must develop and implement policies
456.33and procedures for giving accurate and current medications to clients for planned or
456.34unplanned times away from home according to the client's individualized medication
456.35management plan.
456.36The policy and procedures must state that:
457.1(1) for planned time away, the medications must be obtained from the pharmacy or
457.2set up by the registered nurse according to appropriate state and federal laws and nursing
457.3standards of practice;
457.4(2) for unplanned time away, when the pharmacy is not able to provide the
457.5medications, a licensed nurse or unlicensed personnel shall give the client or the client's
457.6representative medications in amounts and dosages needed for the length of the anticipated
457.7absence, not to exceed 120 hours;
457.8(3) the client, or the client's representative, must be provided written information
457.9on medications, including any special instructions for administering or handling the
457.10medications, including controlled substances;
457.11(4) the medications must be placed in a medication container or containers
457.12appropriate to the provider's medication system and must be labeled with the client's name
457.13and the dates and times that the medications are scheduled; and
457.14(5) the client or client's representative must be provided in writing the home care
457.15provider's name and information on how to contact them.
457.16(b) For unplanned time away when the licensed nurse is not available, the registered
457.17nurse may delegate this task to unlicensed personnel if:
457.18(1) the registered nurse has trained and determined the unlicensed staff to be
457.19competent to follow the procedures for giving medications to clients;
457.20(2) the registered nurse has developed written procedures for the unlicensed
457.21personnel, including any special instructions or procedures regarding controlled substances
457.22that are prescribed for the client. The procedures must address:
457.23(i) the type of container or containers to be used for the medications appropriate to
457.24the provider's medication system;
457.25(ii) how the container or containers must be labeled;
457.26(iii) the written information about the medications to be given to the client or the
457.27client' s representative;
457.28(iv) how the unlicensed staff will document in the client's record that medications
457.29have been given to the client or the client's responsible person, including documenting the
457.30date the medications were given to the client or the client's responsible person and who
457.31received the medications, the person who gave the medications to the client, the number of
457.32medications that were given to the client, and other required information;
457.33(v) how the registered nurse will be notified that medications have been given to
457.34the client or the client's responsible person and whether the registered nurse needs to
457.35be contacted before the medications are given to the client or the client's responsible
457.36person; and
458.1(vi) a review by the registered nurse of the completion of this task to verify that this
458.2task was completed accurately by the unlicensed personnel.
458.3    Subd. 11. Prescribed and nonprescribed medication. The comprehensive home
458.4care provider must determine whether it will require a prescription for all medications it
458.5manages. The comprehensive home care provider must inform the client or the client's
458.6representative whether the comprehensive home care provider requires a prescription
458.7for all over-the-counter and dietary supplements before the comprehensive home care
458.8provider will agree to manage those medications.
458.9    Subd. 12. Medications; over-the-counter; dietary supplements not prescribed.
458.10A comprehensive home care provider providing medication management services for
458.11over-the-counter drugs or dietary supplements must retain those items in the original labeled
458.12container with directions for use prior to setting up for immediate or later administration.
458.13The provider must verify that the medications are up-to-date and stored as appropriate.
458.14    Subd. 13. Prescriptions. There must be a current written or electronically recorded
458.15prescription as defined in Minnesota Rules, part 6800.0100, subpart 11a, for all prescribed
458.16medications that the comprehensive home care provider is managing for the client.
458.17    Subd. 14. Renewal of prescriptions. Prescriptions must be renewed at least
458.18every 12 months or more frequently as indicated by the assessment in subdivision 2.
458.19Prescriptions for controlled substances must comply with chapter 152.
458.20    Subd. 15. Verbal prescription orders. Verbal prescription orders from an
458.21authorized prescriber must be received by a nurse or pharmacist. The order must be
458.22handled according to Minnesota Rules, part 6800.6200.
458.23    Subd. 16. Written or electronic prescription. When a written or electronic
458.24prescription is received, it must be communicated to the registered nurse in charge and
458.25recorded or placed in the client's record.
458.26    Subd. 17. Records confidential. A prescription or order received verbally, in
458.27writing, or electronically must be kept according to sections 144.291 to 144.298 and
458.28144A.44.
458.29    Subd. 18. Medications provided by client or family members. When the
458.30comprehensive home care provider is aware of any medications or dietary supplements
458.31that are being used by the client and are not included in the assessment for medication
458.32management services, the staff must advise the registered nurse and document that in
458.33the client's record.
458.34    Subd. 19. Storage of drugs. A comprehensive home care provider providing
458.35storage of medications outside of the client's private living space must store all prescription
459.1drugs in securely locked and substantially constructed compartments according to the
459.2manufacturer's directions and permit only authorized personnel to have access.
459.3    Subd. 20. Prescription drugs. A prescription drug, prior to being set up for
459.4immediate or later administration, must be kept in the original container in which it was
459.5dispensed by the pharmacy bearing the original prescription label with legible information
459.6including the expiration or beyond-use date of a time-dated drug.
459.7    Subd. 21. Prohibitions. No prescription drug supply for one client may be used or
459.8saved for use by anyone other than the client.
459.9    Subd. 22. Disposition of drugs. (a) Any current medications being managed by the
459.10comprehensive home care provider must be given to the client or the client's representative
459.11when the client's service plan ends or medication management services are no longer part
459.12of the service plan. Medications that have been stored in the client's private living space
459.13for a client that is deceased or that have been discontinued or that have expired may be
459.14given to the client or the client's representative for disposal.
459.15(b) The comprehensive home care provider will dispose of any medications
459.16remaining with the comprehensive home care provider that are discontinued or expired or
459.17upon the termination of the service contract or the client's death according to state and
459.18federal regulations for disposition of drugs and controlled substances.
459.19(c) Upon disposition, the comprehensive home care provider must document in the
459.20client's record the disposition of the medications including the medication's name, strength,
459.21prescription number as applicable, quantity, to whom the medications were given, date of
459.22disposition, and names of staff and other individuals involved in the disposition.
459.23    Subd. 23. Loss or spillage. (a) Comprehensive home care providers providing
459.24medication management must develop and implement procedures for loss or spillage of all
459.25controlled substances defined in Minnesota Rules, part 6800.4220. These procedures must
459.26require that when a spillage of a controlled substance occurs, a notation must be made
459.27in the client's record explaining the spillage and the actions taken. The notation must
459.28be signed by the person responsible for the spillage and include verification that any
459.29contaminated substance was disposed of according to state or federal regulations.
459.30(b) The procedures must require the comprehensive home care provider of
459.31medication management to investigate any known loss or unaccounted for prescription
459.32drugs and take appropriate action required under state or federal regulations and document
459.33the investigation in required records.

459.34    Sec. 21. [144A.4793] TREATMENT AND THERAPY MANAGEMENT
459.35SERVICES.
460.1    Subdivision 1. Providers with a comprehensive home care license. This section
460.2applies only to home care providers with a comprehensive home care license that provide
460.3treatment or therapy management services to clients. Treatment or therapy management
460.4services cannot be provided by a home care provider that has a basic home care license.
460.5    Subd. 2. Policies and procedures. (a) A comprehensive home care provider who
460.6provides treatment and therapy management services must develop, implement, and
460.7maintain up-to-date written treatment or therapy management policies and procedures.
460.8The policies and procedures must be developed under the supervision and direction of
460.9a registered nurse or appropriate licensed health professional consistent with current
460.10practice standards and guidelines.
460.11(b) The written policies and procedures must address requesting and receiving
460.12orders or prescriptions for treatments or therapies, providing the treatment or therapy,
460.13documenting of treatment or therapy activities, educating and communicating with clients
460.14about treatments or therapy they are receiving, monitoring and evaluating the treatment
460.15and therapy, and communicating with the prescriber.
460.16    Subd. 3. Individualized treatment or therapy management plan. For each
460.17client receiving management of ordered or prescribed treatments or therapy services, the
460.18comprehensive home care provider must prepare and include in the service plan a written
460.19statement of the treatment or therapy services that will be provided to the client. The
460.20provider must also develop and maintain a current individualized treatment and therapy
460.21management record for each client that contains at least the following:
460.22(1) a statement of the type of services that will be provided;
460.23(2) documentation of specific client instructions relating to the treatments or therapy
460.24administration;
460.25(3) identification of treatment or therapy tasks that will be delegated to unlicensed
460.26personnel;
460.27(4) procedures for notifying a registered nurse or appropriate licensed health
460.28professional when a problem arises with treatments or therapy services; and
460.29(5) any client-specific requirements relating to documentation of treatment and
460.30therapy received, verification that all treatments and therapy was administered as
460.31prescribed, and monitoring of treatment or therapy to prevent possible complications or
460.32adverse reactions. The treatment or therapy management record must be current and
460.33updated when there are any changes.
460.34    Subd. 4. Administration of treatments and therapy. Ordered or prescribed
460.35treatments or therapies must be administered by a nurse, physician, or other licensed health
460.36professional authorized to perform the treatment or therapy, or may be delegated or assigned
461.1to unlicensed personnel by the licensed health professional according to the appropriate
461.2practice standards for delegation or assignment. When administration of a treatment or
461.3therapy is delegated or assigned to unlicensed personnel, the home care provider must
461.4ensure that the registered nurse or authorized licensed health professional has:
461.5(1) instructed the unlicensed personnel in the proper methods with respect to each
461.6client and has demonstrated their ability to competently follow the procedures;
461.7(2) specified, in writing, specific instructions for each client and documented those
461.8instructions in the client's record; and
461.9(3) communicated with the unlicensed personnel about the individual needs of
461.10the client.
461.11    Subd. 5. Documentation of administration of treatments and therapies. Each
461.12treatment or therapy administered by a comprehensive home care provider must be
461.13documented in the client's record. The documentation must include the signature and title
461.14of the person who administered the treatment or therapy and must include the date and
461.15time of administration. When treatment or therapies are not administered as ordered or
461.16prescribed, the provider must document the reason why it was not administered and any
461.17follow-up procedures that were provided to meet the client's needs.
461.18    Subd. 6. Orders or prescriptions. There must be an up-to-date written or
461.19electronically recorded order or prescription for all treatments and therapies. The order
461.20must contain the name of the client, description of the treatment or therapy to be provided,
461.21and the frequency and other information needed to administer the treatment or therapy.

461.22    Sec. 22. [144A.4794] CLIENT RECORD REQUIREMENTS.
461.23    Subdivision 1. Client record. (a) The home care provider must maintain records
461.24for each client to whom it is providing services. Entries in the client records must be
461.25current, legible, permanently recorded, dated, and authenticated with the name and title
461.26of the person making the entry.
461.27(b) Client records, whether written or electronic, must be protected against loss,
461.28tampering, or unauthorized disclosure in compliance with chapter 13 and other applicable
461.29relevant federal and state laws. The home care provider shall establish and implement
461.30written procedures to control use, storage, and security of client's records and establish
461.31criteria for release of client information.
461.32(c) The home care provider may not disclose to any other person any personal,
461.33financial, medical, or other information about the client, except:
461.34(1) as may be required by law;
462.1(2) to employees or contractors of the home care provider, another home care
462.2provider, other health care practitioner or provider, or inpatient facility needing
462.3information in order to provide services to the client, but only such information that
462.4is necessary for the provision of services;
462.5(3) to persons authorized in writing by the client or the client's representative to
462.6receive the information, including third-party payers; and
462.7(4) to representatives of the commissioner authorized to survey or investigate home
462.8care providers under this chapter or federal laws.
462.9    Subd. 2. Access to records. The home care provider must ensure that the
462.10appropriate records are readily available to employees or contractors authorized to access
462.11the records. Client records must be maintained in a manner that allows for timely access,
462.12printing, or transmission of the records.
462.13    Subd. 3. Contents of client record. Contents of a client record include the
462.14following for each client:
462.15(1) identifying information, including the client's name, date of birth, address, and
462.16telephone number;
462.17(2) the name, address, and telephone number of an emergency contact, family
462.18members, client's representative, if any, or others as identified;
462.19(3) names, addresses, and telephone numbers of the client's health and medical
462.20service providers and other home care providers, if known;
462.21(4) health information, including medical history, allergies, and when the provider
462.22is managing medications, treatments or therapies that require documentation, and other
462.23relevant health records;
462.24(5) client's advance directives, if any;
462.25(6) the home care provider's current and previous assessments and service plans;
462.26(7) all records of communications pertinent to the client's home care services;
462.27(8) documentation of significant changes in the client's status and actions taken in
462.28response to the needs of the client including reporting to the appropriate supervisor or
462.29health care professional;
462.30(9) documentation of incidents involving the client and actions taken in response
462.31to the needs of the client including reporting to the appropriate supervisor or health
462.32care professional;
462.33(10) documentation that services have been provided as identified in the service plan;
462.34(11) documentation that the client has received and reviewed the home care bill
462.35of rights;
463.1(12) documentation that the client has been provided the statement of disclosure on
463.2limitations of services under section 144A.4791, subdivision 3;
463.3(13) documentation of complaints received and resolution;
463.4(14) discharge summary, including service termination notice and related
463.5documentation, when applicable; and
463.6(15) other documentation required under this chapter and relevant to the client's
463.7services or status.
463.8    Subd. 4. Transfer of client records. If a client transfers to another home care
463.9provider or other health care practitioner or provider, or is admitted to an inpatient facility,
463.10the home care provider, upon request of the client or the client's representative, shall take
463.11steps to ensure a coordinated transfer including sending a copy or summary of the client's
463.12record to the new home care provider, facility, or the client, as appropriate.
463.13    Subd. 5. Record retention. Following the client's discharge or termination of
463.14services, a home care provider must retain a client's record for at least five years, or as
463.15otherwise required by state or federal regulations. Arrangements must be made for secure
463.16storage and retrieval of client records if the home care provider ceases business.

463.17    Sec. 23. [144A.4795] HOME CARE PROVIDER RESPONSIBILITIES; STAFF.
463.18    Subdivision 1. Qualifications, training, and competency. All staff providing
463.19home care services must be trained and competent in the provision of home care services
463.20consistent with current practice standards appropriate to the client's needs.
463.21    Subd. 2. Licensed health professionals and nurses. (a) Licensed health
463.22professionals and nurses providing home care services as an employee of a licensed home
463.23care provider must possess current Minnesota license or registration to practice.
463.24(b) Licensed health professionals and registered nurses must be competent in
463.25assessing client needs, planning appropriate home care services to meet client needs,
463.26implementing services, and supervising staff if assigned.
463.27(c) Nothing in this section limits or expands the rights of nurses or licensed health
463.28professionals to provide services within the scope of their licenses or registrations, as
463.29provided by law.
463.30    Subd. 3. Unlicensed personnel. (a) Unlicensed personnel providing basic home
463.31care services must have:
463.32(1) successfully completed a training and competency evaluation appropriate to
463.33the services provided by the home care provider and the topics listed in subdivision 7,
463.34paragraph (b); or
464.1(2) demonstrated competency by satisfactorily completing a written or oral test on
464.2the tasks the unlicensed personnel will perform and in the topics listed in subdivision
464.37, paragraph (b); and successfully demonstrate competency of topics in subdivision 7,
464.4paragraph (b), clauses (5), (7), and (8), by a practical skills test.
464.5Unlicensed personnel providing home care services for a basic home care provider may
464.6not perform delegated nursing or therapy tasks.
464.7(b) Unlicensed personnel performing delegated nursing tasks for a comprehensive
464.8home care provider must have:
464.9(1) successfully completed training and demonstrated competency by successfully
464.10completing a written or oral test of the topics in subdivision 7, paragraphs (b) and (c), and
464.11a practical skills test on tasks listed in subdivision 7, paragraphs (b), clauses (5) and (7),
464.12and (c), clauses (3), (5), (6), and (7), and all the delegated tasks they will perform; or
464.13(2) satisfy the current requirements of Medicare for training or competency of home
464.14health aides or nursing assistants, as provided by Code of Federal Regulations, title 42,
464.15section 483 or section 484.36; or
464.16(3) before April 19, 1993, completed a training course for nursing assistants that was
464.17approved by the commissioner.
464.18(c) Unlicensed personnel performing therapy or treatment tasks delegated or
464.19assigned by a licensed health professional must meet the requirements for delegated
464.20tasks in subdivision 4 and any other training or competency requirements within the
464.21licensed health professional scope of practice relating to delegation or assignment of tasks
464.22to unlicensed personnel.
464.23    Subd. 4. Delegation of home care tasks. A registered nurse or licensed health
464.24professional may delegate tasks only to staff that are competent and possess the knowledge
464.25and skills consistent with the complexity of the tasks and according to the appropriate
464.26Minnesota Practice Act. The comprehensive home care provider must establish and
464.27implement a system to communicate up-to-date information to the registered nurse or
464.28licensed health professional regarding the current available staff and their competency so
464.29the registered nurse or licensed health professional has sufficient information to determine
464.30the appropriateness of delegating tasks to meet individual client needs and preferences.
464.31    Subd. 5. Individual contractors. When a home care provider contracts with an
464.32individual contractor excluded from licensure under section 144A.471 to provide home
464.33care services, the contractor must meet the same requirements required by this section for
464.34personnel employed by the home care provider.
464.35    Subd. 6. Temporary staff. When a home care provider contracts with a temporary
464.36staffing agency excluded from licensure under section 144A.471, those individuals must
465.1meet the same requirements required by this section for personnel employed by the home
465.2care provider and shall be treated as if they are staff of the home care provider.
465.3    Subd. 7. Requirements for instructors, training content, and competency
465.4evaluations for unlicensed personnel. (a) Instructors and competency evaluators must
465.5meet the following requirements:
465.6(1) training and competency evaluations of unlicensed personnel providing basic
465.7home care services must be conducted by individuals with work experience and training in
465.8providing home care services listed in section 144A.471, subdivisions 6 and 7; and
465.9(2) training and competency evaluations of unlicensed personnel providing
465.10comprehensive home care services must be conducted by a registered nurse, or another
465.11instructor may provide training in conjunction with the registered nurse. If the home care
465.12provider is providing services by licensed health professionals only, then that specific
465.13training and competency evaluation may be conducted by the licensed health professionals
465.14as appropriate.
465.15(b) Training and competency evaluations for all unlicensed personnel must include
465.16the following:
465.17(1) documentation requirements for all services provided;
465.18(2) reports of changes in the client's condition to the supervisor designated by the
465.19home care provider;
465.20(3) basic infection control, including blood-borne pathogens;
465.21(4) maintenance of a clean and safe environment;
465.22(5) appropriate and safe techniques in personal hygiene and grooming, including:
465.23(i) hair care and bathing;
465.24(ii) care of teeth, gums, and oral prosthetic devices;
465.25(iii) care and use of hearing aids; and
465.26(iv) dressing and assisting with toileting;
465.27(6) training on the prevention of falls for providers working with the elderly or
465.28individuals at risk of falls;
465.29(7) standby assistance techniques and how to perform them;
465.30(8) medication, exercise, and treatment reminders;
465.31(9) basic nutrition, meal preparation, food safety, and assistance with eating;
465.32(10) preparation of modified diets as ordered by a licensed health professional;
465.33(11) communication skills that include preserving the dignity of the client and
465.34showing respect for the client and the client's preferences, cultural background, and family;
465.35(12) awareness of confidentiality and privacy;
466.1(13) understanding appropriate boundaries between staff and clients and the client's
466.2family;
466.3(14) procedures to utilize in handling various emergency situations; and
466.4(15) awareness of commonly used health technology equipment and assistive devices.
466.5(c) In addition to paragraph (b), training and competency evaluation for unlicensed
466.6personnel providing comprehensive home care services must include:
466.7(1) observation, reporting, and documenting of client status;
466.8(2) basic knowledge of body functioning and changes in body functioning, injuries,
466.9or other observed changes that must be reported to appropriate personnel;
466.10(3) reading and recording temperature, pulse, and respirations of the client;
466.11(4) recognizing physical, emotional, cognitive, and developmental needs of the client;
466.12(5) safe transfer techniques and ambulation;
466.13(6) range of motioning and positioning; and
466.14(7) administering medications or treatments as required.
466.15(d) When the registered nurse or licensed health professional delegates tasks, they
466.16must ensure that prior to the delegation the unlicensed personnel is trained in the proper
466.17methods to perform the tasks or procedures for each client and are able to demonstrate
466.18the ability to competently follow the procedures and perform the tasks. If an unlicensed
466.19personnel has not regularly performed the delegated home care task for a period of 24
466.20consecutive months, the unlicensed personnel must demonstrate competency in the task
466.21to the registered nurse or appropriate licensed health professional. The registered nurse
466.22or licensed health professional must document instructions for the delegated tasks in
466.23the client's record.

466.24    Sec. 24. [144A.4796] ORIENTATION AND ANNUAL TRAINING
466.25REQUIREMENTS.
466.26    Subdivision 1. Orientation of staff and supervisors to home care. All staff
466.27providing and supervising direct home care services must complete an orientation to home
466.28care licensing requirements and regulations before providing home care services to clients.
466.29The orientation may be incorporated into the training required under subdivision 6. The
466.30orientation need only be completed once for each staff person and is not transferable
466.31to another home care provider.
466.32    Subd. 2. Content. The orientation must contain the following topics:
466.33    (1) an overview of sections 144A.43 to 144A.4798;
466.34(2) introduction and review of all the provider's policies and procedures related to
466.35the provision of home care services;
467.1(3) handling of emergencies and use of emergency services;
467.2(4) compliance with and reporting the maltreatment of minors or vulnerable adults
467.3under sections 626.556 and 626.557;
467.4(5) home care bill of rights, under section 144A.44;
467.5(6) handling of clients' complaints, reporting of complaints, and where to report
467.6complaints including information on the Office of Health Facility Complaints and the
467.7Common Entry Point;
467.8(7) consumer advocacy services of the Office of Ombudsman for Long-Term Care,
467.9Office of Ombudsman for Mental Health and Developmental Disabilities, Managed Care
467.10Ombudsman at the Department of Human Services, county managed care advocates,
467.11or other relevant advocacy services; and
467.12(8) review of the types of home care services the employee will be providing and
467.13the provider's scope of licensure.
467.14    Subd. 3. Verification and documentation of orientation. Each home care provider
467.15shall retain evidence in the employee record of each staff person having completed the
467.16orientation required by this section.
467.17    Subd. 4. Orientation to client. Staff providing home care services must be oriented
467.18specifically to each individual client and the services to be provided. This orientation may
467.19be provided in person, orally, in writing, or electronically.
467.20    Subd. 5. Training required relating to Alzheimer's disease and related disorders.
467.21For home care providers that provide services for persons with Alzheimer's or related
467.22disorders, all direct care staff and supervisors working with these clients must receive
467.23training that includes a current explanation of Alzheimer's disease and related disorders,
467.24effective approaches to use to problem solve when working with a client's challenging
467.25behaviors, and how to communicate with clients who have Alzheimer's or related disorders.
467.26    Subd. 6. Required annual training. All staff that perform direct home care
467.27services must complete at least eight hours of annual training for each 12 months of
467.28employment. The training may be obtained from the home care provider or another source
467.29and must include topics relevant to the provision of home care services. The annual
467.30training must include:
467.31(1) training on reporting of maltreatment of minors under section 626.556 and
467.32maltreatment of vulnerable adults under section 626.557, whichever is applicable to the
467.33services provided;
467.34(2) review of the home care bill of rights in section 144A.44;
467.35(3) review of infection control techniques used in the home and implementation of
467.36infection control standards including a review of hand washing techniques; the need for
468.1and use of protective gloves, gowns, and masks; appropriate disposal of contaminated
468.2materials and equipment, such as dressings, needles, syringes, and razor blades;
468.3disinfecting reusable equipment; disinfecting environmental surfaces; and reporting of
468.4communicable diseases; and
468.5(4) review of the provider's policies and procedures relating to the provision of home
468.6care services and how to implement those policies and procedures.
468.7    Subd. 7. Documentation. A home care provider must retain documentation in the
468.8employee records of the staff that have satisfied the orientation and training requirements
468.9of this section.

468.10    Sec. 25. [144A.4797] PROVISION OF SERVICES.
468.11    Subdivision 1. Availability of contact person to staff. (a) A home care provider
468.12with a basic home care license must have a person available to staff for consultation on
468.13items relating to the provision of services or about the client.
468.14(b) A home care provider with a comprehensive home care license must have a
468.15registered nurse available for consultation to staff performing delegated nursing tasks
468.16and must have an appropriate licensed health professional available if performing other
468.17delegated services such as therapies.
468.18(c) The appropriate contact person must be readily available either in person, by
468.19telephone, or by other means to the staff at times when the staff is providing services.
468.20    Subd. 2. Supervision of staff; basic home care services. (a) Staff who perform
468.21basic home care services must be supervised periodically where the services are being
468.22provided to verify that the work is being performed competently and to identify problems
468.23and solutions to address issues relating to the staff's ability to provide the services. The
468.24supervision of the unlicensed personnel must be done by staff of the home care provider
468.25having the authority, skills, and ability to provide the supervision of unlicensed personnel
468.26and who can implement changes as needed, and train staff.
468.27(b) Supervision includes direct observation of unlicensed personnel while they
468.28are providing the services and may also include indirect methods of gaining input such
468.29as gathering feedback from the client. Supervisory review of staff must be provided at a
468.30frequency based on the staff person's competency and performance.
468.31(c) For an individual who is licensed as a home care provider, this section does
468.32not apply.
468.33    Subd. 3. Supervision of staff performing delegated nursing or therapy home
468.34care tasks. (a) Staff who perform delegated nursing or therapy home care tasks must
468.35be supervised by an appropriately licensed health professional or a registered nurse
469.1periodically where the services are being provided to verify that the work is being
469.2performed competently and to identify problems and solutions related to the staff person's
469.3ability to perform the tasks. Supervision of staff performing medication or treatment
469.4administration shall be provided by a registered nurse or appropriately licensed health
469.5professional and must include observation of the staff administering the medication or
469.6treatment and the interaction with the client.
469.7(b) The direct supervision of staff performing delegated tasks must be provided
469.8within 30 days after the individual begins working for the home care provider and
469.9thereafter as needed based on performance. This requirement also applies to staff who
469.10have not performed delegated tasks for one year or longer.
469.11    Subd. 4. Documentation. A home care provider must retain documentation of
469.12supervision activities in the personnel records.
469.13    Subd. 5. Exemption. This section does not apply to an individual licensed under
469.14sections 144A.43 to 144A.4799.

469.15    Sec. 26. [144A.4798] EMPLOYEE HEALTH STATUS.
469.16    Subdivision 1. Tuberculosis (TB) prevention and control. A home care provider
469.17must establish and maintain a TB prevention and control program based on the most
469.18current guidelines issued by the Centers for Disease Control and Prevention (CDC).
469.19Components of a TB prevention and control program include screening all staff providing
469.20home care services, both paid and unpaid, at the time of hire for active TB disease and
469.21latent TB infection, and developing and implementing a written TB infection control plan.
469.22The commissioner shall make the most recent CDC standards available to home care
469.23providers on the department's Web site.
469.24    Subd. 2. Communicable diseases. A home care provider must follow
469.25current federal or state guidelines for prevention, control, and reporting of human
469.26immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus, or other
469.27communicable diseases as defined in Minnesota Rules, part 4605.7040.

469.28    Sec. 27. [144A.4799] DEPARTMENT OF HEALTH LICENSED HOME CARE
469.29PROVIDER ADVISORY COUNCIL.
469.30    Subdivision 1. Membership. The commissioner of health shall appoint eight
469.31persons to a home care provider advisory council consisting of the following:
469.32(1) three public members as defined in section 214.02 who shall be either persons
469.33who are currently receiving home care services or have family members receiving home
470.1care services, or persons who have family members who have received home care services
470.2within five years of the application date;
470.3(2) three Minnesota home care licensees representing basic and comprehensive
470.4levels of licensure who may be a managerial official, an administrator, a supervising
470.5registered nurse, or an unlicensed personnel performing home care tasks;
470.6(3) one member representing the Minnesota Board of Nursing; and
470.7(4) one member representing the ombudsman for long-term care.
470.8    Subd. 2. Organizations and meetings. The advisory council shall be organized
470.9and administered under section 15.059 with per diems and costs paid within the limits of
470.10available appropriations. Meetings will be held quarterly and hosted by the department.
470.11Subcommittees may be developed as necessary by the commissioner. Advisory council
470.12meetings are subject to the Open Meeting Law under chapter 13D.
470.13    Subd. 3. Duties. At the commissioner's request, the advisory council shall provide
470.14advice regarding regulations of Department of Health licensed home care providers in
470.15this chapter such as:
470.16(1) advice to the commissioner regarding community standards for home care
470.17practices;
470.18(2) advice to the commissioner on enforcement of licensing standards and whether
470.19certain disciplinary actions are appropriate;
470.20(3) advice to the commissioner about ways of distributing information to licensees
470.21and consumers of home care;
470.22(4) advice to the commissioner about training standards;
470.23(5) identify emerging issues and opportunities in the home care field, including the
470.24use of technology in home and telehealth capabilities; and
470.25(6) perform other duties as directed by the commissioner.

470.26    Sec. 28. [144A.481] HOME CARE LICENSING IMPLEMENTATION FOR
470.27NEW LICENSEES AND TRANSITION PERIOD FOR CURRENT LICENSEES.
470.28    Subdivision 1. Temporary home care licenses and changes of ownership. (a)
470.29Beginning January 1, 2014, all temporary license applicants must apply for either a
470.30temporary basic or comprehensive home care license.
470.31(b) Temporary home care licenses issued beginning January 1, 2014, will be
470.32issued according to the provisions in sections 144A.43 to 144A.4799 and fees in section
470.33144A.472 and will be required to comply with this chapter.
470.34(c) No temporary licenses will be accepted or issued between December 1, 2013,
470.35and December 31, 2013.
471.1(d) Beginning October 1, 2013, changes in ownership applications will require
471.2payment of the new fees listed in section 144A.472. Providers who are providing
471.3nursing, delegated nursing, or professional health care services, must submit the fee for
471.4comprehensive home care providers, and all other providers must submit the fee for basic
471.5home care providers as provided in section 144A.472. Change of ownership applicants will
471.6be issued a new home care license based on the licensure law in effect on June 30, 2013.
471.7    Subd. 2. Current home care licensees with licenses prior to July 1, 2013. (a)
471.8Beginning July 1, 2014, department licensed home care providers must apply for either
471.9the basic or comprehensive home care license on their regularly scheduled renewal date.
471.10(b) By June 30, 2015, all home care providers must either have a basic or
471.11comprehensive home care license or temporary license.
471.12    Subd. 3. Renewal and change of ownership application of home care licensure
471.13during transition period. Renewal and change of ownership applications of home care
471.14licenses issued beginning July 1, 2014, will be issued according to sections 144A.43
471.15to 144A.4799, and upon license renewal or issuance of a new license for a change of
471.16ownership, providers must comply with sections 144A.43 to 144A.4799. Prior to renewal,
471.17providers must comply with the home care licensure law in effect on June 30, 2013.
471.18The fees charged for licenses renewed between July 1, 2014, and June 30, 2016,
471.19shall be the lesser of 200 percent or $1,000, except where the 200 percent or $1,000
471.20increase exceeds the actual renewal fee charged, with a maximum renewal fee of $6,625.
471.21For fiscal year 2014 only the fees for providers with revenues greater than $25,000
471.22and no more than $100,000 will be $313 and for providers with revenues no more than
471.23$25,000 the fee will be $125.
471.24The license renewal fee schedule in section 144A.472 will be effective July 1, 2016.

471.25    Sec. 29. [144A.482] REGISTRATION OF HOME MANAGEMENT
471.26PROVIDERS.
471.27(a) For purposes of this section, a home management provider is an individual or
471.28organization that provides at least two of the following services: housekeeping, meal
471.29preparation, and shopping, to a person who is unable to perform these activities due to
471.30illness, disability, or physical condition.
471.31(b) A person or organization that provides only home management services may not
471.32operate in the state without a current certificate of registration issued by the commissioner
471.33of health. To obtain a certificate of registration, the person or organization must annually
471.34submit to the commissioner the name, mailing and physical address, e-mail address, and
471.35telephone number of the individual or organization and a signed statement declaring that
472.1the individual or organization is aware that the home care bill of rights applies to their
472.2clients and that the person or organization will comply with the home care bill of rights
472.3provisions contained in section 144A.44. An individual or organization applying for a
472.4certificate must also provide the name, business address, and telephone number of each of
472.5the individuals responsible for the management or direction of the organization.
472.6(c) The commissioner shall charge an annual registration fee of $20 for individuals
472.7and $50 for organizations. The registration fee shall be deposited in the state treasury and
472.8credited to the state government special revenue fund.
472.9(d) A home care provider that provides home management services and other home
472.10care services must be licensed, but licensure requirements other than the home care bill of
472.11rights do not apply to those employees or volunteers who provide only home management
472.12services to clients who do not receive any other home care services from the provider.
472.13A licensed home care provider need not be registered as a home management service
472.14provider, but must provide an orientation on the home care bill of rights to its employees
472.15or volunteers who provide home management services.
472.16(e) An individual who provides home management services under this section must,
472.17within 120 days after beginning to provide services, attend an orientation session approved
472.18by the commissioner that provides training on the home care bill of rights and an orientation
472.19on the aging process and the needs and concerns of elderly and disabled persons.
472.20(f) The commissioner may suspend or revoke a provider's certificate of registration
472.21or assess fines for violation of the home care bill of rights. Any fine assessed for a
472.22violation of the home care bill of rights by a provider registered under this section shall be
472.23in the amount established in the licensure rules for home care providers. As a condition
472.24of registration, a provider must cooperate fully with any investigation conducted by the
472.25commissioner, including providing specific information requested by the commissioner on
472.26clients served and the employees and volunteers who provide services. Fines collected
472.27under this paragraph shall be deposited in the state treasury and credited to the fund
472.28specified in the statute or rule in which the penalty was established.
472.29(g) The commissioner may use any of the powers granted in sections 144A.43 to
472.30144A.4799 to administer the registration system and enforce the home care bill of rights
472.31under this section.

472.32    Sec. 30. AGENCY QUALITY IMPROVEMENT PROGRAM.
472.33    Subdivision 1. Annual legislative report on home care licensing. The
472.34commissioner shall establish a quality improvement program for the home care survey
472.35and home care complaint investigation processes. The commissioner shall submit to the
473.1legislature an annual report, beginning October 1, 2015, and each October 1 thereafter.
473.2Each report will review the previous state fiscal year of home care licensing and regulatory
473.3activities. The report must include, but is not limited to, an analysis of:
473.4(1) the number of FTE's in the Compliance Monitoring Division, including the
473.5Office of Health Facilities Complaint units assigned to home care licensing, survey,
473.6investigation, and enforcement process;
473.7(2) numbers of and descriptive information about licenses issued, complaints
473.8received and investigated, including allegations made and correction orders issued,
473.9surveys completed and timelines, correction order reconsiderations, and results;
473.10(3) descriptions of emerging trends in home care provision and areas of concern
473.11identified by the department in its regulation of home care providers;
473.12(4) information and data regarding performance improvement projects underway
473.13and planned by the commissioner in the area of home care surveys; and
473.14(5) work of the Department of Health Home Care Advisory Council.
473.15    Subd. 2. Study of correction order appeal process. Starting July 1, 2015, the
473.16commissioner shall study whether to add a correction order appeal process conducted by
473.17an independent reviewer, such as an administrative law judge or other office, and submit a
473.18report to the legislature by February 1, 2016. The commissioner shall review home care
473.19regulatory systems in other states as part of that study. The commissioner shall consult
473.20with the home care providers and representatives.

473.21    Sec. 31. INTEGRATED LICENSING SYSTEM FOR HOME CARE AND HOME
473.22AND COMMUNITY-BASED SERVICES.
473.23(a) The Department of Health Compliance Monitoring Division and the Department
473.24of Human Services Licensing Division shall jointly develop an integrated licensing system
473.25for providers of both home care services subject to licensure under Minnesota Statutes,
473.26chapter 144A, and for home and community-based services subject to licensure under
473.27Minnesota Statutes, chapter 245D. The integrated licensing system shall:
473.28(1) require only one license of any provider of services under Minnesota Statutes,
473.29sections 144A.43 to 144A.482, and 245D.03, subdivision 1;
473.30(2) promote quality services that recognize a person's individual needs and protect
473.31the person's health, safety, rights, and well-being;
473.32(3) promote provider accountability through application requirements, compliance
473.33inspections, investigations, and enforcement actions;
473.34(4) reference other applicable requirements in existing state and federal laws,
473.35including the federal Affordable Care Act;
474.1(5) establish internal procedures to facilitate ongoing communications between the
474.2agencies, and with providers and services recipients about the regulatory activities;
474.3(6) create a link between the agency Web sites so that providers and the public can
474.4access the same information regardless of which Web site is accessed initially; and
474.5(7) collect data on identified outcome measures as necessary for the agencies to
474.6report to the Centers for Medicare and Medicaid Services.
474.7(b) The joint recommendations for legislative changes to implement the integrated
474.8licensing system are due to the legislature by February 15, 2014.
474.9(c) Before implementation of the integrated licensing system, providers licensed as
474.10home care providers under Minnesota Statutes, chapter 144A, may also provide home
474.11and community-based services subject to licensure under Minnesota Statutes, chapter
474.12245D, without obtaining a home and community-based services license under Minnesota
474.13Statutes, chapter 245D. During this time, the conditions under clauses (1) to (3) shall
474.14apply to these providers:
474.15(1) the provider must comply with all requirements under Minnesota Statutes, chapter
474.16245D, for services otherwise subject to licensure under Minnesota Statutes, chapter 245D;
474.17(2) a violation of requirements under Minnesota Statutes, chapter 245D, may be
474.18enforced by the Department of Health under the enforcement authority set forth in
474.19Minnesota Statutes, section 144A.475; and
474.20(3) the Department of Health will provide information to the Department of Human
474.21Services about each provider licensed under this section, including the provider's license
474.22application, licensing documents, inspections, information about complaints received, and
474.23investigations conducted for possible violations of Minnesota Statutes, chapter 245D.

474.24    Sec. 32. STUDY OF CORRECTION ORDER APPEAL PROCESS.
474.25Beginning July 1, 2015, the commissioner of health shall study whether to use
474.26a correction order appeal process conducted by an independent reviewer, such as
474.27an administrative law judge or other office. The commissioner shall review home
474.28care regulatory systems in other states and consult with the home care providers and
474.29representatives. By February 1, 2016, the commissioner shall submit a report to the chairs
474.30and ranking minority members of the committees of the legislature with jurisdiction over
474.31health and human services and judiciary issues with any recommendations regarding
474.32an independent appeal process.

474.33    Sec. 33. REPEALER.
474.34(a) Minnesota Statutes 2012, sections 144A.46; and 144A.461, are repealed.
475.1(b) Minnesota Rules, parts 4668.0002; 4668.0003; 4668.0005; 4668.0008;
475.24668.0012; 4668.0016; 4668.0017; 4668.0019; 4668.0030; 4668.0035; 4668.0040;
475.34668.0050; 4668.0060; 4668.0065; 4668.0070; 4668.0075; 4668.0080; 4668.0100;
475.44668.0110; 4668.0120; 4668.0130; 4668.0140; 4668.0150; 4668.0160; 4668.0170;
475.54668.0180; 4668.0190; 4668.0200; 4668.0218; 4668.0220; 4668.0230; 4668.0240;
475.64668.0800; 4668.0805; 4668.0810; 4668.0815; 4668.0820; 4668.0825; 4668.0830;
475.74668.0835; 4668.0840; 4668.0845; 4668.0855; 4668.0860; 4668.0865; 4668.0870;
475.84669.0001; 4669.0010; 4669.0020; 4669.0030; 4669.0040; and 4669.0050, are repealed.

475.9    Sec. 34. EFFECTIVE DATE.
475.10Sections 1 to 33 are effective the day following final enactment, unless a different
475.11effective date is specified.

475.12ARTICLE 12

475.13HEALTH DEPARTMENT

475.14    Section 1. Minnesota Statutes 2012, section 62J.692, subdivision 1, is amended to read:
475.15    Subdivision 1. Definitions. For purposes of this section, the following definitions
475.16apply:
475.17    (a) "Accredited clinical training" means the clinical training provided by a medical
475.18education program that is accredited through an organization recognized by the Department
475.19of Education, the Centers for Medicare and Medicaid Services, or another national body
475.20who reviews the accrediting organizations for multiple disciplines and whose standards
475.21for recognizing accrediting organizations are reviewed and approved by the commissioner
475.22of health in consultation with the Medical Education and Research Advisory Committee.
475.23    (b) "Commissioner" means the commissioner of health.
475.24    (c) "Clinical medical education program" means the accredited clinical training of
475.25physicians (medical students and residents), doctor of pharmacy practitioners, doctors
475.26of chiropractic, dentists, advanced practice nurses (clinical nurse specialists, certified
475.27registered nurse anesthetists, nurse practitioners, and certified nurse midwives), and
475.28 physician assistants, dental therapists and advanced dental therapists, psychologists,
475.29clinical social workers, community paramedics, and community health workers.
475.30    (d) "Sponsoring institution" means a hospital, school, or consortium located in
475.31Minnesota that sponsors and maintains primary organizational and financial responsibility
475.32for a clinical medical education program in Minnesota and which is accountable to the
475.33accrediting body.
476.1    (e) "Teaching institution" means a hospital, medical center, clinic, or other
476.2organization that conducts a clinical medical education program in Minnesota.
476.3    (f) "Trainee" means a student or resident involved in a clinical medical education
476.4program.
476.5    (g) "Eligible trainee FTE's" means the number of trainees, as measured by full-time
476.6equivalent counts, that are at training sites located in Minnesota with currently active
476.7medical assistance enrollment status and a National Provider Identification (NPI) number
476.8where training occurs in either an inpatient or ambulatory patient care setting and where
476.9the training is funded, in part, by patient care revenues. Training that occurs in nursing
476.10facility settings is not eligible for funding under this section.

476.11    Sec. 2. Minnesota Statutes 2012, section 62J.692, subdivision 3, is amended to read:
476.12    Subd. 3. Application process. (a) A clinical medical education program conducted
476.13in Minnesota by a teaching institution to train physicians, doctor of pharmacy practitioners,
476.14dentists, chiropractors, or physician assistants is, dental therapists and advanced dental
476.15therapists, psychologists, clinical social workers, community paramedics, or community
476.16health workers are eligible for funds under subdivision 4 if the program:
476.17(1) is funded, in part, by patient care revenues;
476.18(2) occurs in patient care settings that face increased financial pressure as a result
476.19of competition with nonteaching patient care entities; and
476.20(3) emphasizes primary care or specialties that are in undersupply in Minnesota.
476.21(b) A clinical medical education program for advanced practice nursing is eligible for
476.22funds under subdivision 4 if the program meets the eligibility requirements in paragraph
476.23(a), clauses (1) to (3), and is sponsored by the University of Minnesota Academic Health
476.24Center, the Mayo Foundation, or institutions that are part of the Minnesota State Colleges
476.25and Universities system or members of the Minnesota Private College Council.
476.26(c) Applications must be submitted to the commissioner by a sponsoring institution
476.27on behalf of an eligible clinical medical education program and must be received by
476.28October 31 of each year for distribution in the following year. An application for funds
476.29must contain the following information:
476.30(1) the official name and address of the sponsoring institution and the official
476.31name and site address of the clinical medical education programs on whose behalf the
476.32sponsoring institution is applying;
476.33(2) the name, title, and business address of those persons responsible for
476.34administering the funds;
477.1(3) for each clinical medical education program for which funds are being sought;
477.2the type and specialty orientation of trainees in the program; the name, site address, and
477.3medical assistance provider number and national provider identification number of each
477.4training site used in the program; the federal tax identification number of each training site
477.5used in the program, where available; the total number of trainees at each training site; and
477.6the total number of eligible trainee FTEs at each site; and
477.7(4) other supporting information the commissioner deems necessary to determine
477.8program eligibility based on the criteria in paragraphs (a) and (b) and to ensure the
477.9equitable distribution of funds.
477.10(d) An application must include the information specified in clauses (1) to (3) for
477.11each clinical medical education program on an annual basis for three consecutive years.
477.12After that time, an application must include the information specified in clauses (1) to (3)
477.13when requested, at the discretion of the commissioner:
477.14(1) audited clinical training costs per trainee for each clinical medical education
477.15program when available or estimates of clinical training costs based on audited financial
477.16data;
477.17(2) a description of current sources of funding for clinical medical education costs,
477.18including a description and dollar amount of all state and federal financial support,
477.19including Medicare direct and indirect payments; and
477.20(3) other revenue received for the purposes of clinical training.
477.21(e) An applicant that does not provide information requested by the commissioner
477.22shall not be eligible for funds for the current funding cycle.

477.23    Sec. 3. Minnesota Statutes 2012, section 62J.692, subdivision 4, is amended to read:
477.24    Subd. 4. Distribution of funds. (a) The commissioner shall annually distribute the
477.25available medical education funds to all qualifying applicants based on a distribution
477.26formula that reflects a summation of two factors:
477.27    (1) a public program volume factor, which is determined by the total volume of
477.28public program revenue received by each training site as a percentage of all public
477.29program revenue received by all training sites in the fund pool; and
477.30    (2) a supplemental public program volume factor, which is determined by providing
477.31a supplemental payment of 20 percent of each training site's grant to training sites whose
477.32public program revenue accounted for at least 0.98 percent of the total public program
477.33revenue received by all eligible training sites. Grants to training sites whose public
477.34program revenue accounted for less than 0.98 percent of the total public program revenue
478.1received by all eligible training sites shall be reduced by an amount equal to the total
478.2value of the supplemental payment.
478.3    Public program revenue for the distribution formula includes revenue from medical
478.4assistance, prepaid medical assistance, general assistance medical care, and prepaid
478.5general assistance medical care. Training sites that receive no public program revenue
478.6are ineligible for funds available under this subdivision. For purposes of determining
478.7training-site level grants to be distributed under paragraph (a), total statewide average
478.8costs per trainee for medical residents is based on audited clinical training costs per trainee
478.9in primary care clinical medical education programs for medical residents. Total statewide
478.10average costs per trainee for dental residents is based on audited clinical training costs
478.11per trainee in clinical medical education programs for dental students. Total statewide
478.12average costs per trainee for pharmacy residents is based on audited clinical training costs
478.13per trainee in clinical medical education programs for pharmacy students. Training sites
478.14whose training site level grant is less than $1,000 $5,000, based on the formula described
478.15in this paragraph, or that train fewer than 0.1 FTE eligible trainees, are ineligible for
478.16funds available under this subdivision. No training sites shall receive a grant per FTE
478.17trainee that is in excess of the 95th percentile grant per FTE across all eligible training
478.18sites; grants in excess of this amount will be redistributed to other eligible sites based on
478.19the formula described in this paragraph.
478.20    (b) Funds distributed shall not be used to displace current funding appropriations
478.21from federal or state sources.
478.22    (c) Funds shall be distributed to the sponsoring institutions indicating the amount
478.23to be distributed to each of the sponsor's clinical medical education programs based on
478.24the criteria in this subdivision and in accordance with the commissioner's approval letter.
478.25Each clinical medical education program must distribute funds allocated under paragraph
478.26(a) to the training sites as specified in the commissioner's approval letter. Sponsoring
478.27institutions, which are accredited through an organization recognized by the Department
478.28of Education or the Centers for Medicare and Medicaid Services, may contract directly
478.29with training sites to provide clinical training. To ensure the quality of clinical training,
478.30those accredited sponsoring institutions must:
478.31    (1) develop contracts specifying the terms, expectations, and outcomes of the clinical
478.32training conducted at sites; and
478.33    (2) take necessary action if the contract requirements are not met. Action may include
478.34the withholding of payments under this section or the removal of students from the site.
478.35    (d) Use of funds is limited to expenses related to clinical training program costs for
478.36eligible programs.
479.1    (e) Any funds not distributed in accordance with the commissioner's approval letter
479.2must be returned to the medical education and research fund within 30 days of receiving
479.3notice from the commissioner. The commissioner shall distribute returned funds to the
479.4appropriate training sites in accordance with the commissioner's approval letter.
479.5    (e) (f) A maximum of $150,000 of the funds dedicated to the commissioner
479.6under section 297F.10, subdivision 1, clause (2), may be used by the commissioner for
479.7administrative expenses associated with implementing this section.

479.8    Sec. 4. Minnesota Statutes 2012, section 62J.692, subdivision 5, is amended to read:
479.9    Subd. 5. Report. (a) Sponsoring institutions receiving funds under this section
479.10must sign and submit a medical education grant verification report (GVR) to verify that
479.11the correct grant amount was forwarded to each eligible training site. If the sponsoring
479.12institution fails to submit the GVR by the stated deadline, or to request and meet
479.13the deadline for an extension, the sponsoring institution is required to return the full
479.14amount of funds received to the commissioner within 30 days of receiving notice from
479.15the commissioner. The commissioner shall distribute returned funds to the appropriate
479.16training sites in accordance with the commissioner's approval letter.
479.17    (b) The reports must provide verification of the distribution of the funds and must
479.18include:
479.19    (1) the total number of eligible trainee FTEs in each clinical medical education
479.20program;
479.21    (2) the name of each funded program and, for each program, the dollar amount
479.22distributed to each training site and a training site expenditure report;
479.23    (3) documentation of any discrepancies between the initial grant distribution notice
479.24included in the commissioner's approval letter and the actual distribution;
479.25    (4) a statement by the sponsoring institution stating that the completed grant
479.26verification report is valid and accurate; and
479.27    (5) other information the commissioner, with advice from the advisory committee,
479.28 deems appropriate to evaluate the effectiveness of the use of funds for medical education.
479.29    (c) By February 15 of Each year, the commissioner, with advice from the
479.30advisory committee, shall provide an annual summary report to the legislature on the
479.31implementation of this section.

479.32    Sec. 5. Minnesota Statutes 2012, section 62J.692, subdivision 7a, is amended to read:
479.33    Subd. 7a. Clinical medical education innovations grants. (a) The commissioner
479.34shall award grants to teaching institutions and clinical training sites for projects that
480.1increase dental access for underserved populations and promote innovative clinical
480.2training of dental professionals.
480.3(b) $1,000,000 of the funds dedicated to the commissioner under section 297F.10,
480.4subdivision 1, clause (2), plus any federal financial participation on these funds, shall
480.5be distributed by the commissioner for primary care development grants pursuant to
480.6paragraph (c).
480.7(c) The commissioner shall award grants to teaching institutions and clinical training
480.8sites for projects that increase the supply and availability of primary care providers for
480.9public program enrollees, improve access for underserved and rural populations, and
480.10promote interdisciplinary and team training of primary care providers and related personnel.
480.11(d) In awarding the grants, the commissioner, in consultation with the commissioner
480.12of human services, shall consider the following:
480.13(1) potential to successfully increase access to an underserved population;
480.14(2) the long-term viability of the project to improve access beyond the period
480.15of initial funding;
480.16(3) evidence of collaboration between the applicant and local communities;
480.17(4) the efficiency in the use of the funding; and
480.18(5) the priority level of the project in relation to state clinical education, access,
480.19and workforce goals.
480.20(b) (e) The commissioner shall periodically evaluate the priorities in awarding the
480.21innovations grants in order to ensure that the priorities meet the changing workforce
480.22needs of the state.

480.23    Sec. 6. Minnesota Statutes 2012, section 62J.692, subdivision 9, is amended to read:
480.24    Subd. 9. Review of eligible providers. The commissioner and the Medical
480.25Education and Research Costs Advisory Committee may review provider groups included
480.26in the definition of a clinical medical education program to assure that the distribution
480.27of the funds continue to be consistent with the purpose of this section. The results of
480.28any such reviews must be reported to the chairs and ranking minority members of the
480.29legislative committees with jurisdiction over health care policy and finance.

480.30    Sec. 7. Minnesota Statutes 2012, section 62J.692, is amended by adding a subdivision
480.31to read:
480.32    Subd. 11. Distribution of funds. If federal approval is not received for the formula
480.33described in subdivision 4, paragraph (a), 100 percent of available medical education
481.1and research funds shall be distributed based on a distribution formula that reflects as
481.2summation of two factors:
481.3(1) a public program volume factor, that is determined by the total volume of public
481.4program revenue received by each training site as a percentage of all public program
481.5revenue received by all training sites in the fund pool; and
481.6(2) a supplemental public program volume factor, that is determined by providing a
481.7supplemental payment of 20 percent of each training site's grant to training sites whose
481.8public program revenue accounted for a least 0.98 percent of the total public program
481.9revenue received by all eligible training sites. Grants to training sites whose public
481.10program revenue accounted for less than 0.98 percent of the total public program revenue
481.11received by all eligible training sites shall be reduced by an amount equal to the total
481.12value of the supplemental payment.

481.13    Sec. 8. Minnesota Statutes 2012, section 62Q.19, subdivision 1, is amended to read:
481.14    Subdivision 1. Designation. (a) The commissioner shall designate essential
481.15community providers. The criteria for essential community provider designation shall be
481.16the following:
481.17(1) a demonstrated ability to integrate applicable supportive and stabilizing services
481.18with medical care for uninsured persons and high-risk and special needs populations,
481.19underserved, and other special needs populations; and
481.20(2) a commitment to serve low-income and underserved populations by meeting the
481.21following requirements:
481.22(i) has nonprofit status in accordance with chapter 317A;
481.23(ii) has tax-exempt status in accordance with the Internal Revenue Service Code,
481.24section 501(c)(3);
481.25(iii) charges for services on a sliding fee schedule based on current poverty income
481.26guidelines; and
481.27(iv) does not restrict access or services because of a client's financial limitation;
481.28(3) status as a local government unit as defined in section 62D.02, subdivision 11, a
481.29hospital district created or reorganized under sections 447.31 to 447.37, an Indian tribal
481.30government, an Indian health service unit, or a community health board as defined in
481.31chapter 145A;
481.32(4) a former state hospital that specializes in the treatment of cerebral palsy, spina
481.33bifida, epilepsy, closed head injuries, specialized orthopedic problems, and other disabling
481.34conditions;
482.1(5) a sole community hospital. For these rural hospitals, the essential community
482.2provider designation applies to all health services provided, including both inpatient and
482.3outpatient services. For purposes of this section, "sole community hospital" means a
482.4rural hospital that:
482.5(i) is eligible to be classified as a sole community hospital according to Code
482.6of Federal Regulations, title 42, section 412.92, or is located in a community with a
482.7population of less than 5,000 and located more than 25 miles from a like hospital currently
482.8providing acute short-term services;
482.9(ii) has experienced net operating income losses in two of the previous three
482.10most recent consecutive hospital fiscal years for which audited financial information is
482.11available; and
482.12(iii) consists of 40 or fewer licensed beds; or
482.13(6) a birth center licensed under section 144.615; or
482.14(7) a hospital or affiliated specialty clinic that:
482.15(i) serves patients who are predominately under the age of 21;
482.16(ii) provides intensive specialty pediatric services that are only routinely provided
482.17in less than five hospitals in the state; and
482.18(iii) serves children from at least half the counties in the state.
482.19(b) Prior to designation, the commissioner shall publish the names of all applicants
482.20in the State Register. The public shall have 30 days from the date of publication to submit
482.21written comments to the commissioner on the application. No designation shall be made
482.22by the commissioner until the 30-day period has expired.
482.23(c) The commissioner may designate an eligible provider as an essential community
482.24provider for all the services offered by that provider or for specific services designated by
482.25the commissioner.
482.26(d) For the purpose of this subdivision, supportive and stabilizing services include at
482.27a minimum, transportation, child care, cultural, and linguistic services where appropriate.

482.28    Sec. 9. Minnesota Statutes 2012, section 103I.005, is amended by adding a subdivision
482.29to read:
482.30    Subd. 1a. Bored geothermal heat exchanger. "Bored geothermal heat exchanger"
482.31means an earth-coupled heating or cooling device consisting of a sealed closed-loop
482.32piping system installed in a boring in the ground to transfer heat to or from the surrounding
482.33earth with no discharge.

483.1    Sec. 10. Minnesota Statutes 2012, section 103I.521, is amended to read:
483.2103I.521 FEES DEPOSITED WITH COMMISSIONER OF MANAGEMENT
483.3AND BUDGET.
483.4Unless otherwise specified, fees collected for licenses or registration by the
483.5commissioner under this chapter shall be deposited in the state treasury and credited to
483.6the state government special revenue fund.

483.7    Sec. 11. Minnesota Statutes 2012, section 144.123, subdivision 1, is amended to read:
483.8    Subdivision 1. Who must pay. Except for the limitation contained in this section,
483.9the commissioner of health shall charge a handling fee may enter into a contractual
483.10agreement to recover costs incurred for analysis for diagnostic purposes for each specimen
483.11submitted to the Department of Health for analysis for diagnostic purposes by any hospital,
483.12private laboratory, private clinic, or physician. No fee shall be charged to any entity which
483.13receives direct or indirect financial assistance from state or federal funds administered by
483.14the Department of Health, including any public health department, nonprofit community
483.15clinic, sexually transmitted disease clinic, or similar entity. No fee will be charged The
483.16commissioner shall not charge for any biological materials submitted to the Department
483.17of Health as a requirement of Minnesota Rules, part 4605.7040, or for those biological
483.18materials requested by the department to gather information for disease prevention or
483.19control purposes. The commissioner of health may establish other exceptions to the
483.20handling fee as may be necessary to protect the public's health. All fees collected pursuant
483.21to this section shall be deposited in the state treasury and credited to the state government
483.22special revenue fund. Funds generated in a contractual agreement made pursuant to this
483.23section shall be deposited in a special account and are appropriated to the commissioner
483.24for purposes of providing the services specified in the contracts. All such contractual
483.25agreements shall be processed in accordance with the provisions of chapter 16C.
483.26EFFECTIVE DATE.This section is effective July 1, 2014.

483.27    Sec. 12. Minnesota Statutes 2012, section 144.125, subdivision 1, is amended to read:
483.28    Subdivision 1. Duty to perform testing. (a) It is the duty of (1) the administrative
483.29officer or other person in charge of each institution caring for infants 28 days or less
483.30of age, (2) the person required in pursuance of the provisions of section 144.215, to
483.31register the birth of a child, or (3) the nurse midwife or midwife in attendance at the
483.32birth, to arrange to have administered to every infant or child in its care tests for heritable
484.1and congenital disorders according to subdivision 2 and rules prescribed by the state
484.2commissioner of health.
484.3    (b) Testing and the, recording and of test results, reporting of test results, and
484.4follow-up of infants with heritable congenital disorders, including hearing loss detected
484.5through the early hearing detection and intervention program in section 144.966, shall be
484.6performed at the times and in the manner prescribed by the commissioner of health. The
484.7commissioner shall charge a fee so that the total of fees collected will approximate the
484.8costs of conducting the tests and implementing and maintaining a system to follow-up
484.9infants with heritable or congenital disorders, including hearing loss detected through the
484.10early hearing detection and intervention program under section 144.966.
484.11    (c) The fee is $101 per specimen. Effective July 1, 2010, the fee shall be increased
484.12to $106 to support the newborn screening program, including tests administered under
484.13this section and section 144.966, shall be $135 per specimen. The increased fee amount
484.14shall be deposited in the general fund. Costs associated with capital expenditures and
484.15the development of new procedures may be prorated over a three-year period when
484.16calculating the amount of the fees. This fee amount shall be deposited in the state treasury
484.17and credited to the state government special revenue fund.
484.18(d) The fee to offset the cost of the support services provided under section 144.966,
484.19subdivision 3a, shall be $15 per specimen. This fee shall be deposited in the state treasury
484.20and credited to the general fund.

484.21    Sec. 13. [144.1251] NEWBORN SCREENING FOR CRITICAL CONGENITAL
484.22HEART DISEASE (CCHD).
484.23    Subdivision 1. Required testing and reporting. (a) Each licensed hospital or
484.24state-licensed birthing center or facility that provides maternity and newborn care services
484.25shall provide screening for congenital heart disease to all newborns prior to discharge
484.26using pulse oximetry screening. The screening must occur after the infant is 24 hours old,
484.27before discharge from the nursery. If discharge occurs before the infant is 24 hours old,
484.28the screening must occur as close as possible to the time of discharge.
484.29(b) For premature infants (less than 36 weeks of gestation) and infants admitted to a
484.30higher-level nursery (special care or intensive care), pulse oximetry must be performed
484.31when medically appropriate prior to discharge.
484.32(c) Results of the screening must be reported to the Department of Health.
484.33    Subd. 2. Implementation. The Department of Health shall:
484.34(1) communicate the screening protocol requirements;
485.1(2) make information and forms available to the hospitals, birthing centers, and other
485.2facilities that are required to provide the screening, health care providers who provide
485.3prenatal care and care to newborns, and expectant parents and parents of newborns. The
485.4information and forms must include screening protocol and reporting requirements and
485.5parental options;
485.6(3) provide training to ensure compliance with and appropriate implementation of
485.7the screening;
485.8(4) establish the mechanism for the required data collection and reporting of
485.9screening and follow-up diagnostic results to the Department of Health according to the
485.10Department of Health's recommendations;
485.11(5) coordinate the implementation of universal standardized screening;
485.12(6) act as a resource for providers as the screening program is implemented, and in
485.13consultation with the Advisory Committee on Heritable and Congenital Disorders, develop
485.14and implement policies for early medical and developmental intervention services and
485.15long-term follow-up services for children and their families identified with a CCHD; and
485.16(7) comply with sections 144.125 to 144.128.

485.17    Sec. 14. Minnesota Statutes 2012, section 144.212, is amended to read:
485.18144.212 DEFINITIONS.
485.19    Subdivision 1. Scope. As used in sections 144.211 to 144.227, the following terms
485.20have the meanings given.
485.21    Subd. 1a. Amendment. "Amendment" means completion or correction of made
485.22to certification items on a vital record. after a certification has been issued or more
485.23than one year after the event, whichever occurs first, that does not result in a sealed or
485.24replaced record.
485.25    Subd. 1b. Authorized representative. "Authorized representative" means an agent
485.26designated in a written and witnessed statement signed by the subject of the record or
485.27other qualified applicant.
485.28    Subd. 1c. Certification item. "Certification item" means all individual items
485.29appearing on a certificate of birth and the demographic and legal items on a certificate
485.30of death.
485.31    Subd. 2. Commissioner. "Commissioner" means the commissioner of health.
485.32    Subd. 2a. Correction. "Correction" means a change made to a noncertification
485.33item, including information collected for medical and statistical purposes. A correction
485.34also means a change to a certification item within one year of the event provided that no
485.35certification, whether paper or electronic, has been issued.
486.1    Subd. 2b. Court of competent jurisdiction. "Court of competent jurisdiction"
486.2means a court within the United States with jurisdiction over the individual and such other
486.3individuals that the court deems necessary.
486.4    Subd. 2a 2c. Delayed registration. "Delayed registration" means registration of a
486.5record of birth or death filed one or more years after the date of birth or death.
486.6    Subd. 2d. Disclosure. "Disclosure" means to make available or make known
486.7personally identifiable information contained in a vital record, by any means of
486.8communication.
486.9    Subd. 3. File. "File" means to present a vital record or report for registration to the
486.10Office of the State Registrar Vital Records and to have the vital record or report accepted
486.11for registration by the Office of the State Registrar Vital Records.
486.12    Subd. 4. Final disposition. "Final disposition" means the burial, interment,
486.13cremation, removal from the state, or other authorized disposition of a dead body or
486.14dead fetus.
486.15    Subd. 4a. Institution. "Institution" means a public or private establishment that:
486.16(1) provides inpatient or outpatient medical, surgical, or diagnostic care or treatment;
486.17or
486.18(2) provides nursing, custodial, or domiciliary care, or to which persons are
486.19committed by law.
486.20    Subd. 4b. Legal representative. "Legal representative" means a licensed attorney
486.21representing an individual.
486.22    Subd. 4c. Local issuance office. "Local issuance office" means a county
486.23governmental office authorized by the state registrar to issue certified birth and death
486.24records.
486.25    Subd. 4d. Record. "Record" means a report of a vital event that has been registered
486.26by the state registrar.
486.27    Subd. 5. Registration. "Registration" means the process by which vital records
486.28are completed, filed, and incorporated into the official records of the Office of the State
486.29Registrar.
486.30    Subd. 6. State registrar. "State registrar" means the commissioner of health or a
486.31designee.
486.32    Subd. 7. System of vital statistics. "System of vital statistics" includes the
486.33registration, collection, preservation, amendment, verification, maintenance of the security
486.34and integrity of, and certification of vital records, the collection of other reports required
486.35by sections 144.211 to 144.227, and related activities including the tabulation, analysis,
486.36publication, and dissemination of vital statistics.
487.1    Subd. 7a. Verification. "Verification" means a confirmation of the information on a
487.2vital record based on the facts contained in a certification.
487.3    Subd. 8. Vital record. "Vital record" means a record or report of birth, stillbirth,
487.4death, marriage, dissolution and annulment, and data related thereto. The birth record is
487.5not a medical record of the mother or the child.
487.6    Subd. 9. Vital statistics. "Vital statistics" means the data derived from records and
487.7reports of birth, death, fetal death, induced abortion, marriage, dissolution and annulment,
487.8and related reports.
487.9    Subd. 10. Local registrar. "Local registrar" means an individual designated under
487.10section 144.214, subdivision 1, to perform the duties of a local registrar.
487.11    Subd. 11. Consent to disclosure. "Consent to disclosure" means an affidavit filed
487.12with the state registrar which sets forth the following information:
487.13(1) the current name and address of the affiant;
487.14(2) any previous name by which the affiant was known;
487.15(3) the original and adopted names, if known, of the adopted child whose original
487.16birth record is to be disclosed;
487.17(4) the place and date of birth of the adopted child;
487.18(5) the biological relationship of the affiant to the adopted child; and
487.19(6) the affiant's consent to disclosure of information from the original birth record of
487.20the adopted child.

487.21    Sec. 15. Minnesota Statutes 2012, section 144.213, is amended to read:
487.22144.213 OFFICE OF THE STATE REGISTRAR VITAL RECORDS.
487.23    Subdivision 1. Creation; state registrar; Office of Vital Records. The
487.24commissioner shall establish an Office of the State Registrar Vital Records under the
487.25supervision of the state registrar. The commissioner shall furnish to local registrars the
487.26forms necessary for correct reporting of vital statistics, and shall instruct the local registrars
487.27in the collection and compilation of the data. The commissioner shall promulgate rules for
487.28the collection, filing, and registering of vital statistics information by the state and local
487.29registrars registrar, physicians, morticians, and others. Except as otherwise provided in
487.30sections 144.211 to 144.227, rules previously promulgated by the commissioner relating to
487.31the collection, filing and registering of vital statistics shall remain in effect until repealed,
487.32modified or superseded by a rule promulgated by the commissioner.
487.33    Subd. 2. General duties. (a) The state registrar shall coordinate the work of
487.34local registrars to maintain a statewide system of vital statistics. The state registrar is
487.35responsible for the administration and enforcement of sections 144.211 to 144.227, and
488.1shall supervise local registrars in the enforcement of sections 144.211 to 144.227 and the
488.2rules promulgated thereunder. Local issuance offices that fail to comply with the statutes
488.3or rules or to properly train employees may have their issuance privileges and access to
488.4the vital records system revoked.
488.5(b) To preserve vital records the state registrar is authorized to prepare typewritten,
488.6photographic, electronic or other reproductions of original records and files in the Office
488.7of Vital Records. The reproductions when certified by the state registrar shall be accepted
488.8as the original records.
488.9(c) The state registrar shall also:
488.10(1) establish, designate, and eliminate offices in the state to aid in the efficient
488.11issuance of vital records;
488.12(2) direct the activities of all persons engaged in activities pertaining to the operation
488.13of the system of vital statistics;
488.14(3) develop and conduct training programs to promote uniformity of policy and
488.15procedures throughout the state in matters pertaining to the system of vital statistics; and
488.16(4) prescribe, furnish, and distribute all forms required by sections 144.211 to
488.17144.227 and any rules adopted under these sections, and prescribe other means for the
488.18transmission of data, including electronic submission, that will accomplish the purpose of
488.19complete, accurate, and timely reporting and registration.
488.20    Subd. 3. Record keeping. To preserve vital records the state registrar is authorized
488.21to prepare typewritten, photographic, electronic or other reproductions of original records
488.22and files in the Office of the State Registrar. The reproductions when certified by the state
488.23or local registrar shall be accepted as the original records.

488.24    Sec. 16. [144.2131] SECURITY OF VITAL RECORDS SYSTEM.
488.25The state registrar shall:
488.26(1) authenticate all users of the system of vital statistics and document that all users
488.27require access based on their official duties;
488.28(2) authorize authenticated users of the system of vital statistics to access specific
488.29components of the vital statistics systems necessary for their official roles and duties;
488.30(3) establish separation of duties between staff roles that may be susceptible to fraud
488.31or misuse and routinely perform audits of staff work for the purposes of identifying fraud
488.32or misuse within the vital statistics system;
488.33(4) require that authenticated and authorized users of the system of vital
488.34statistics maintain a specified level of training related to security and provide written
488.35acknowledgment of security procedures and penalties;
489.1(5) validate data submitted for registration through site visits or with independent
489.2sources outside the registration system at a frequency specified by the state registrar to
489.3maximize the integrity of the data collected;
489.4(6) protect personally identifiable information and maintain systems pursuant to
489.5applicable state and federal laws;
489.6(7) accept a report of death if the decedent was born in Minnesota or if the decedent
489.7was a resident of Minnesota from the United States Department of Defense or the United
489.8States Department of State when the death of a United States citizen occurs outside the
489.9United States;
489.10(8) match death records registered in Minnesota and death records provided from
489.11other jurisdictions to live birth records in Minnesota;
489.12(9) match death records received from the United States Department of Defense
489.13or the United States Department of State for deaths of United States citizens occurring
489.14outside the United States to live birth records in Minnesota;
489.15(10) work with law enforcement to initiate and provide evidence for active fraud
489.16investigations;
489.17(11) provide secure workplace, storage, and technology environments that have
489.18limited role-based access;
489.19(12) maintain overt, covert, and forensic security measures for certifications,
489.20verifications, and automated systems that are part of the vital statistics system; and
489.21(13) comply with applicable state and federal laws and rules associated with
489.22information technology systems and related information security requirements.

489.23    Sec. 17. Minnesota Statutes 2012, section 144.215, subdivision 3, is amended to read:
489.24    Subd. 3. Father's name; child's name. In any case in which paternity of a child is
489.25determined by a court of competent jurisdiction, a declaration of parentage is executed
489.26under section 257.34, or a recognition of parentage is executed under section 257.75, the
489.27name of the father shall be entered on the birth record. If the order of the court declares
489.28the name of the child, it shall also be entered on the birth record. If the order of the court
489.29does not declare the name of the child, or there is no court order, then upon the request of
489.30both parents in writing, the surname of the child shall be defined by both parents.

489.31    Sec. 18. Minnesota Statutes 2012, section 144.215, subdivision 4, is amended to read:
489.32    Subd. 4. Social Security number registration. (a) Parents of a child born within
489.33this state shall give the parents' Social Security numbers to the Office of the State Registrar
490.1 Vital Records at the time of filing the birth record, but the numbers shall not appear on
490.2the certified record.
490.3(b) The Social Security numbers are classified as private data, as defined in section
490.413.02, subdivision 12, on individuals, but the Office of the State Registrar Vital Records
490.5 shall provide a Social Security number to the public authority responsible for child support
490.6services upon request by the public authority for use in the establishment of parentage and
490.7the enforcement of child support obligations.

490.8    Sec. 19. Minnesota Statutes 2012, section 144.216, subdivision 1, is amended to read:
490.9    Subdivision 1. Reporting a foundling. Whoever finds a live born infant of unknown
490.10parentage shall report within five days to the Office of the State Registrar Vital Records
490.11 such information as the commissioner may by rule require to identify the foundling.

490.12    Sec. 20. Minnesota Statutes 2012, section 144.217, subdivision 2, is amended to read:
490.13    Subd. 2. Court petition. If a delayed record of birth is rejected under subdivision
490.141, a person may petition the appropriate court in the county in which the birth allegedly
490.15occurred for an order establishing a record of the date and place of the birth and the
490.16parentage of the person whose birth is to be registered. The petition shall state:
490.17(1) that the person for whom a delayed record of birth is sought was born in this state;
490.18(2) that no record of birth can be found in the Office of the State Registrar Vital
490.19Records;
490.20(3) that diligent efforts by the petitioner have failed to obtain the evidence required
490.21in subdivision 1;
490.22(4) that the state registrar has refused to register a delayed record of birth; and
490.23(5) other information as may be required by the court.

490.24    Sec. 21. Minnesota Statutes 2012, section 144.218, subdivision 5, is amended to read:
490.25    Subd. 5. Replacement of vital records. Upon the order of a court of this state, upon
490.26the request of a court of another state, upon the filing of a declaration of parentage under
490.27section 257.34, or upon the filing of a recognition of parentage with a the state registrar, a
490.28replacement birth record must be registered consistent with the findings of the court, the
490.29declaration of parentage, or the recognition of parentage.

490.30    Sec. 22. [144.2181] AMENDMENT AND CORRECTION OF VITAL RECORDS.
491.1(a) A vital record registered under sections 144.212 to 144.227 may be amended
491.2or corrected only according to sections 144.212 to 144.227 and rules adopted by the
491.3commissioner of health to protect the integrity and accuracy of vital records.
491.4(b)(1) A vital record that is amended under this section shall indicate that it has been
491.5amended, except as otherwise provided in this section or by rule.
491.6(2) Electronic documentation shall be maintained by the state registrar that
491.7identifies the evidence upon which the amendment or correction was based, the date
491.8of the amendment or correction, and the identity of the authorized person making the
491.9amendment or correction.
491.10(c) Upon receipt of a certified copy of an order of a court of competent jurisdiction
491.11changing the name of a person whose birth is registered in Minnesota and upon request of
491.12such person if 18 years of age or older or having the status of emancipated minor, the state
491.13registrar shall amend the birth record to show the new name. If the person is a minor or
491.14an incapacitated person then a parent, guardian, or legal representative of the minor or
491.15incapacitated person may make the request.
491.16(d) When an applicant does not submit the minimum documentation required for
491.17amending a vital record or when the state registrar has cause to question the validity
491.18or completeness of the applicant's statements or the documentary evidence, and the
491.19deficiencies are not corrected, the state registrar shall not amend the vital record. The
491.20state registrar shall advise the applicant of the reason for this action and shall further
491.21advise the applicant of the right of appeal to a court with competent jurisdiction over
491.22the Department of Health.

491.23    Sec. 23. Minnesota Statutes 2012, section 144.225, subdivision 1, is amended to read:
491.24    Subdivision 1. Public information; access to vital records. Except as otherwise
491.25provided for in this section and section 144.2252, information contained in vital records
491.26shall be public information. Physical access to vital records shall be subject to the
491.27supervision and regulation of the state and local registrars registrar and their employees
491.28pursuant to rules promulgated by the commissioner in order to protect vital records from
491.29loss, mutilation or destruction and to prevent improper disclosure of vital records which
491.30are confidential or private data on individuals, as defined in section 13.02, subdivisions
491.313 and 12.

491.32    Sec. 24. Minnesota Statutes 2012, section 144.225, subdivision 4, is amended to read:
491.33    Subd. 4. Access to records for research purposes. The state registrar may permit
491.34persons performing medical research access to the information restricted in subdivision
492.12 or 2a if those persons agree in writing not to disclose private or confidential data on
492.2individuals.

492.3    Sec. 25. Minnesota Statutes 2012, section 144.225, subdivision 7, is amended to read:
492.4    Subd. 7. Certified birth or death record. (a) The state or local registrar or local
492.5issuance office shall issue a certified birth or death record or a statement of no vital record
492.6found to an individual upon the individual's proper completion of an attestation provided
492.7by the commissioner and payment of the required fee:
492.8    (1) to a person who has a tangible interest in the requested vital record. A person
492.9who has a tangible interest is:
492.10    (i) the subject of the vital record;
492.11    (ii) a child of the subject;
492.12    (iii) the spouse of the subject;
492.13    (iv) a parent of the subject;
492.14    (v) the grandparent or grandchild of the subject;
492.15    (vi) if the requested record is a death record, a sibling of the subject;
492.16    (vii) the party responsible for filing the vital record;
492.17    (viii) the legal custodian, guardian or conservator, or health care agent of the subject;
492.18    (ix) a personal representative, by sworn affidavit of the fact that the certified copy is
492.19required for administration of the estate;
492.20    (x) a successor of the subject, as defined in section 524.1-201, if the subject is
492.21deceased, by sworn affidavit of the fact that the certified copy is required for administration
492.22of the estate;
492.23    (xi) if the requested record is a death record, a trustee of a trust by sworn affidavit of
492.24the fact that the certified copy is needed for the proper administration of the trust;
492.25    (xii) a person or entity who demonstrates that a certified vital record is necessary for
492.26the determination or protection of a personal or property right, pursuant to rules adopted
492.27by the commissioner; or
492.28    (xiii) adoption agencies in order to complete confidential postadoption searches as
492.29required by section 259.83;
492.30    (2) to any local, state, or federal governmental agency upon request if the certified
492.31vital record is necessary for the governmental agency to perform its authorized duties.
492.32An authorized governmental agency includes the Department of Human Services, the
492.33Department of Revenue, and the United States Citizenship and Immigration Services;
492.34    (3) to an attorney upon evidence of the attorney's license;
493.1    (4) pursuant to a court order issued by a court of competent jurisdiction. For
493.2purposes of this section, a subpoena does not constitute a court order; or
493.3    (5) to a representative authorized by a person under clauses (1) to (4).
493.4    (b) The state or local registrar or local issuance office shall also issue a certified
493.5death record to an individual described in paragraph (a), clause (1), items (ii) to (viii), if,
493.6on behalf of the individual, a licensed mortician furnishes the registrar with a properly
493.7completed attestation in the form provided by the commissioner within 180 days of the
493.8time of death of the subject of the death record. This paragraph is not subject to the
493.9requirements specified in Minnesota Rules, part 4601.2600, subpart 5, item B.

493.10    Sec. 26. Minnesota Statutes 2012, section 144.225, subdivision 8, is amended to read:
493.11    Subd. 8. Standardized format for certified birth and death records. No later than
493.12July 1, 2000, The commissioner shall develop maintain a standardized format for certified
493.13birth records and death records issued by the state and local registrars registrar and local
493.14issuance offices. The format shall incorporate security features in accordance with this
493.15section. The standardized format must be implemented on a statewide basis by July 1, 2001.

493.16    Sec. 27. Minnesota Statutes 2012, section 144.226, is amended to read:
493.17144.226 FEES.
493.18    Subdivision 1. Which services are for fee. The fees for the following services shall
493.19be the following or an amount prescribed by rule of the commissioner:
493.20(a) The fee for the issuance of administrative review and processing of a request for
493.21 a certified vital record or a certification that the vital record cannot be found is $9. No
493.22fee shall be charged for a certified birth, stillbirth, or death record that is reissued within
493.23one year of the original issue, if an amendment is made to the vital record and if the
493.24previously issued vital record is surrendered. The fee is payable at the time of application
493.25and is nonrefundable.
493.26(b) The fee for processing a request for the replacement of a birth record for
493.27all events, except when filing a recognition of parentage pursuant to section 257.73,
493.28subdivision 1 , is $40. The fee is payable at the time of application and is nonrefundable.
493.29(c) The fee for administrative review and processing of a request for the filing of a
493.30delayed registration of birth, stillbirth, or death is $40. The fee is payable at the time of
493.31application and is nonrefundable. This fee includes one subsequent review of the request
493.32if the request is not acceptable upon the initial receipt.
493.33(d) The fee for administrative review and processing of a request for the amendment
493.34of any vital record when requested more than 45 days after the filing of the vital record is
494.1$40. No fee shall be charged for an amendment requested within 45 days after the filing
494.2of the vital record. The fee is payable at the time of application and is nonrefundable.
494.3This fee includes one subsequent review of the request if the request is not acceptable
494.4upon the initial receipt.
494.5(e) The fee for administrative review and processing of a request for the verification
494.6of information from vital records is $9 when the applicant furnishes the specific
494.7information to locate the vital record. When the applicant does not furnish specific
494.8information, the fee is $20 per hour for staff time expended. Specific information includes
494.9the correct date of the event and the correct name of the registrant subject of the record.
494.10Fees charged shall approximate the costs incurred in searching and copying the vital
494.11records. The fee is payable at the time of application and is nonrefundable.
494.12(f) The fee for administrative review and processing of a request for the issuance
494.13of a copy of any document on file pertaining to a vital record or statement that a related
494.14document cannot be found is $9. The fee is payable at the time of application and is
494.15nonrefundable.
494.16    Subd. 2. Fees to state government special revenue fund. Fees collected under
494.17this section by the state registrar shall be deposited in the state treasury and credited to
494.18the state government special revenue fund.
494.19    Subd. 3. Birth record surcharge. (a) In addition to any fee prescribed under
494.20subdivision 1, there shall be a nonrefundable surcharge of $3 for each certified birth or
494.21stillbirth record and for a certification that the vital record cannot be found. The local or
494.22 state registrar or local issuance office shall forward this amount to the commissioner of
494.23management and budget for deposit into the account for the children's trust fund for the
494.24prevention of child abuse established under section 256E.22. This surcharge shall not be
494.25charged under those circumstances in which no fee for a certified birth or stillbirth record
494.26is permitted under subdivision 1, paragraph (a). Upon certification by the commissioner of
494.27management and budget that the assets in that fund exceed $20,000,000, this surcharge
494.28shall be discontinued.
494.29(b) In addition to any fee prescribed under subdivision 1, there shall be a
494.30nonrefundable surcharge of $10 for each certified birth record. The local or state registrar
494.31or local issuance office shall forward this amount to the commissioner of management and
494.32budget for deposit in the general fund. This surcharge shall not be charged under those
494.33circumstances in which no fee for a certified birth record is permitted under subdivision 1,
494.34paragraph (a).
494.35    Subd. 4. Vital records surcharge. (a) In addition to any fee prescribed under
494.36subdivision 1, there is a nonrefundable surcharge of $2 $4 for each certified and
495.1noncertified birth, stillbirth, or death record, and for a certification that the record cannot
495.2be found. The local issuance office or state registrar shall forward this amount to the
495.3commissioner of management and budget to be deposited into the state government special
495.4revenue fund. This surcharge shall not be charged under those circumstances in which no
495.5fee for a birth, stillbirth, or death record is permitted under subdivision 1, paragraph (a).
495.6(b) Effective August 1, 2005, the surcharge in paragraph (a) is $4.
495.7    Subd. 5. Electronic verification. A fee for the electronic verification or electronic
495.8certification of a vital event, when the information being verified or certified is obtained
495.9from a certified birth or death record, shall be established through contractual or
495.10interagency agreements with interested local, state, or federal government agencies.
495.11    Subd. 6. Alternative payment methods. Notwithstanding subdivision 1, alternative
495.12payment methods may be approved and implemented by the state registrar or a local
495.13registrar issuance office.

495.14    Sec. 28. [144.492] DEFINITIONS.
495.15    Subdivision 1. Applicability. For the purposes of sections 144.492 to 144.494, the
495.16terms defined in this section have the meanings given them.
495.17    Subd. 2. Commissioner. "Commissioner" means the commissioner of health.
495.18    Subd. 3. Joint commission. "Joint commission" means the independent,
495.19not-for-profit organization that accredits and certifies health care organizations and
495.20programs in the United States.
495.21    Subd. 4. Stroke. "Stroke" means the sudden death of brain cells in a localized
495.22area due to inadequate blood flow.

495.23    Sec. 29. [144.493] CRITERIA.
495.24    Subdivision 1. Comprehensive stroke center. A hospital meets the criteria for a
495.25comprehensive stroke center if the hospital has been certified as a comprehensive stroke
495.26center by the joint commission or another nationally recognized accreditation entity.
495.27    Subd. 2. Primary stroke center. A hospital meets the criteria for a primary stroke
495.28center if the hospital has been certified as a primary stroke center by the joint commission
495.29or another nationally recognized accreditation entity.
495.30    Subd. 3. Acute stroke ready hospital. A hospital meets the criteria for an acute
495.31stroke ready hospital if the hospital has the following elements of an acute stroke ready
495.32hospital:
495.33(1) an acute stroke team available or on-call 24 hours a days, seven days a week;
496.1(2) written stroke protocols, including triage, stabilization of vital functions, initial
496.2diagnostic tests, and use of medications;
496.3(3) a written plan and letter of cooperation with emergency medical services regarding
496.4triage and communication that are consistent with regional patient care procedures;
496.5(4) emergency department personnel who are trained in diagnosing and treating
496.6acute stroke;
496.7(5) the capacity to complete basic laboratory tests, electrocardiograms, and chest
496.8x-rays 24 hours a day, seven days a week;
496.9(6) the capacity to perform and interpret brain injury imaging studies 24 hours a
496.10days, seven days a week;
496.11(7) written protocols that detail available emergent therapies and reflect current
496.12treatment guidelines, which include performance measures and are revised at least annually;
496.13(8) a neurosurgery coverage plan, call schedule, and a triage and transportation plan;
496.14(9) transfer protocols and agreements for stroke patients; and
496.15(10) a designated medical director with experience and expertise in acute stroke care.

496.16    Sec. 30. [144.494] DESIGNATING STROKE HOSPITALS.
496.17    Subdivision 1. Naming privileges. Unless it has been designated a stroke hospital
496.18by the commissioner, the joint commission, or another nationally recognized accreditation
496.19entity, no hospital shall use the term "stroke center" or "stroke hospital" in its name or its
496.20advertising or shall otherwise indicate it has stroke treatment capabilities.
496.21    Subd. 2. Designation. A hospital that voluntarily meets the criteria for a
496.22comprehensive stroke center, primary stroke center, or acute stroke ready hospital may
496.23apply to the commissioner for designation, and upon the commissioner's review and
496.24approval of the application, shall be designated as a comprehensive stroke center, a
496.25primary stroke center, or an acute stroke ready hospital for a three-year period. If a hospital
496.26loses its certification as a comprehensive stroke center or primary stroke center from
496.27the joint commission or other nationally recognized accreditation entity, its Minnesota
496.28designation will be immediately withdrawn. Prior to the expiration of the three-year
496.29designation, a hospital seeking to remain part of the voluntary acute stroke system may
496.30reapply to the commissioner for designation.

496.31    Sec. 31. [144.554] HEALTH FACILITIES CONSTRUCTION PLAN
496.32SUBMITTAL AND FEES.
496.33For hospitals, nursing homes, boarding care homes, residential hospices, supervised
496.34living facilities, freestanding outpatient surgical centers, and end-stage renal disease
497.1facilities, the commissioner shall collect a fee for the review and approval of architectural,
497.2mechanical, and electrical plans and specifications submitted before construction begins
497.3for each project relative to construction of new buildings, additions to existing buildings,
497.4or for remodeling or alterations of existing buildings. All fees collected in this section
497.5shall be deposited in the state treasury and credited to the state government special revenue
497.6fund. Fees must be paid at the time of submission of final plans for review and are not
497.7refundable. The fee is calculated as follows:

497.8	Construction project total estimated cost	Fee
497.9	$0 - $10,000	$30
497.10	$10,001 - $50,000	$150
497.11	$50,001 - $100,000	$300
497.12	$100,001 - $150,000	$450
497.13	$150,001 - $200,000	$600
497.14	$200,001 - $250,000	$750
497.15	$250,001 - $300,000	$900
497.16	$300,001 - $350,000	$1,050
497.17	$350,001 - $400,000	$1,200
497.18	$400,001 - $450,000	$1,350
497.19	$450,001 - $500,000	$1,500
497.20	$500,001 - $550,000	$1,650
497.21	$550,001 - $600,000	$1,800
497.22	$600,001 - $650,000	$1,950
497.23	$650,001 - $700,000	$2,100
497.24	$700,001 - $750,000	$2,250
497.25	$750,001 - $800,000	$2,400
497.26	$800,001 - $850,000	$2,550
497.27	$850,001 - $900,000	$2,700
497.28	$900,001 - $950,000	$2,850
497.29	$950,001 - $1,000,000	$3,000
497.30	$1,000,001 - $1,050,000	$3,150
497.31	$1,050,001 - $1,100,000	$3,300
497.32	$1,100,001 - $1,150,000	$3,450
497.33	$1,150,001 - $1,200,000	$3,600
497.34	$1,200,001 - $1,250,000	$3,750
497.35	$1,250,001 - $1,300,000	$3,900
497.36	$1,300,001 - $1,350,000	$4,050
497.37	$1,350,001 - $1,400,000	$4,200
497.38	$1,400,001 - $1,450,000	$4,350
497.39	$1,450,001 - $1,500,000	$4,500
497.40	$1,500,001 and over	$4,800

497.41    Sec. 32. Minnesota Statutes 2012, section 144.966, subdivision 2, is amended to read:
498.1    Subd. 2. Newborn Hearing Screening Advisory Committee. (a) The
498.2commissioner of health shall establish a Newborn Hearing Screening Advisory Committee
498.3to advise and assist the Department of Health and the Department of Education in:
498.4    (1) developing protocols and timelines for screening, rescreening, and diagnostic
498.5audiological assessment and early medical, audiological, and educational intervention
498.6services for children who are deaf or hard-of-hearing;
498.7    (2) designing protocols for tracking children from birth through age three that may
498.8have passed newborn screening but are at risk for delayed or late onset of permanent
498.9hearing loss;
498.10    (3) designing a technical assistance program to support facilities implementing the
498.11screening program and facilities conducting rescreening and diagnostic audiological
498.12assessment;
498.13    (4) designing implementation and evaluation of a system of follow-up and tracking;
498.14and
498.15    (5) evaluating program outcomes to increase effectiveness and efficiency and ensure
498.16culturally appropriate services for children with a confirmed hearing loss and their families.
498.17    (b) The commissioner of health shall appoint at least one member from each of the
498.18following groups with no less than two of the members being deaf or hard-of-hearing:
498.19    (1) a representative from a consumer organization representing culturally deaf
498.20persons;
498.21    (2) a parent with a child with hearing loss representing a parent organization;
498.22    (3) a consumer from an organization representing oral communication options;
498.23    (4) a consumer from an organization representing cued speech communication
498.24options;
498.25    (5) an audiologist who has experience in evaluation and intervention of infants
498.26and young children;
498.27    (6) a speech-language pathologist who has experience in evaluation and intervention
498.28of infants and young children;
498.29    (7) two primary care providers who have experience in the care of infants and young
498.30children, one of which shall be a pediatrician;
498.31    (8) a representative from the early hearing detection intervention teams;
498.32    (9) a representative from the Department of Education resource center for the deaf
498.33and hard-of-hearing or the representative's designee;
498.34    (10) a representative of the Commission of Deaf, DeafBlind and Hard-of-Hearing
498.35Minnesotans;
499.1    (11) a representative from the Department of Human Services Deaf and
499.2Hard-of-Hearing Services Division;
499.3    (12) one or more of the Part C coordinators from the Department of Education, the
499.4Department of Health, or the Department of Human Services or the department's designees;
499.5    (13) the Department of Health early hearing detection and intervention coordinators;
499.6    (14) two birth hospital representatives from one rural and one urban hospital;
499.7    (15) a pediatric geneticist;
499.8    (16) an otolaryngologist;
499.9    (17) a representative from the Newborn Screening Advisory Committee under
499.10this subdivision; and
499.11    (18) a representative of the Department of Education regional low-incidence
499.12facilitators.
499.13The commissioner must complete the appointments required under this subdivision by
499.14September 1, 2007.
499.15    (c) The Department of Health member shall chair the first meeting of the committee.
499.16At the first meeting, the committee shall elect a chair from its membership. The committee
499.17shall meet at the call of the chair, at least four times a year. The committee shall adopt
499.18written bylaws to govern its activities. The Department of Health shall provide technical
499.19and administrative support services as required by the committee. These services shall
499.20include technical support from individuals qualified to administer infant hearing screening,
499.21rescreening, and diagnostic audiological assessments.
499.22    Members of the committee shall receive no compensation for their service, but
499.23shall be reimbursed as provided in section 15.059 for expenses incurred as a result of
499.24their duties as members of the committee.
499.25    (d) This subdivision expires June 30, 2013 2019.

499.26    Sec. 33. Minnesota Statutes 2012, section 144.966, subdivision 3a, is amended to read:
499.27    Subd. 3a. Support services to families. (a) The commissioner shall contract with a
499.28nonprofit organization to provide support and assistance to families with children who are
499.29deaf or have a hearing loss. The family support provided must include:
499.30    (1) direct hearing loss specific parent-to-parent assistance and unbiased information
499.31on communication, educational, and medical options; and
499.32    (2) individualized deaf or hard-of-hearing mentors who provide education, including
499.33instruction in American Sign Language as an available option.
499.34The commissioner shall give preference to a nonprofit organization that has the ability to
499.35provide these services throughout the state.
500.1    (b) Family participation in the support and assistance services is voluntary.

500.2    Sec. 34. Minnesota Statutes 2012, section 144.98, subdivision 3, is amended to read:
500.3    Subd. 3. Annual fees. (a) An application for accreditation under subdivision 6 must
500.4be accompanied by the annual fees specified in this subdivision. The annual fees include:
500.5(1) base accreditation fee, $1,500 $600;
500.6(2) sample preparation techniques fee, $200 per technique;
500.7(3) an administrative fee for laboratories located outside this state, $3,750 $2,000; and
500.8(4) test category fees.
500.9(b) For the programs in subdivision 3a, the commissioner may accredit laboratories
500.10for fields of testing under the categories listed in clauses (1) to (10) upon completion of
500.11the application requirements provided by subdivision 6 and receipt of the fees for each
500.12category under each program that accreditation is requested. The categories offered and
500.13related fees include:
500.14(1) microbiology, $450 $200;
500.15(2) inorganics, $450 $200;
500.16(3) metals, $1,000 $500;
500.17(4) volatile organics, $1,300 $1,000;
500.18(5) other organics, $1,300 $1,000;
500.19(6) radiochemistry, $1,500 $750;
500.20(7) emerging contaminants, $1,500 $1,000;
500.21(8) agricultural contaminants, $1,250 $1,000;
500.22(9) toxicity (bioassay), $1,000 $500; and
500.23(10) physical characterization, $250.
500.24(c) The total annual fee includes the base fee, the sample preparation techniques
500.25fees, the test category fees per program, and, when applicable, an administrative fee for
500.26out-of-state laboratories.
500.27EFFECTIVE DATE.This section is effective the day following final enactment.

500.28    Sec. 35. Minnesota Statutes 2012, section 144.98, subdivision 5, is amended to read:
500.29    Subd. 5. State government special revenue fund. Fees collected by the
500.30commissioner under this section must be deposited in the state treasury and credited to
500.31the state government special revenue fund.
500.32EFFECTIVE DATE.This section is effective the day following final enactment.

501.1    Sec. 36. Minnesota Statutes 2012, section 144.98, is amended by adding a subdivision
501.2to read:
501.3    Subd. 10. Establishing a selection committee. (a) The commissioner shall
501.4establish a selection committee for the purpose of recommending approval of qualified
501.5laboratory assessors and assessment bodies. Committee members shall demonstrate
501.6competence in assessment practices. The committee shall initially consist of seven
501.7members appointed by the commissioner as follows:
501.8(1) one member from a municipal laboratory accredited by the commissioner;
501.9(2) one member from an industrial treatment laboratory accredited by the
501.10commissioner;
501.11(3) one member from a commercial laboratory located in this state and accredited by
501.12the commissioner;
501.13(4) one member from a commercial laboratory located outside the state and
501.14accredited by the commissioner;
501.15(5) one member from a nongovernmental client of environmental laboratories;
501.16(6) one member from a professional organization with a demonstrated interest in
501.17environmental laboratory data and accreditation; and
501.18(7) one employee of the laboratory accreditation program administered by the
501.19department.
501.20(b) Committee appointments begin on January 1 and end on December 31 of the
501.21same year.
501.22(c) The commissioner shall appoint persons to fill vacant committee positions,
501.23expand the total number of appointed positions, or change the designated positions upon
501.24the advice of the committee.
501.25(d) The commissioner shall rescind the appointment of a selection committee
501.26member for sufficient cause as the commissioner determines, such as:
501.27(1) neglect of duty;
501.28(2) failure to notify the commissioner of a real or perceived conflict of interest;
501.29(3) nonconformance with committee procedures;
501.30(4) failure to demonstrate competence in assessment practices; or
501.31(5) official misconduct.
501.32(e) Members of the selection committee shall be compensated according to the
501.33provisions in section 15.059, subdivision 3.

501.34    Sec. 37. Minnesota Statutes 2012, section 144.98, is amended by adding a subdivision
501.35to read:
502.1    Subd. 11. Activities of the selection committee. (a) The selection committee
502.2shall determine assessor and assessment body application requirements, the frequency
502.3of application submittal, and the application review schedule. The commissioner shall
502.4publish the application requirements and procedures on the accreditation program Web site.
502.5(b) In its selection process, the committee shall ensure its application requirements
502.6and review process:
502.7(1) meet the standards implemented in subdivision 2a;
502.8(2) ensure assessors have demonstrated competence in technical disciplines offered
502.9for accreditation by the commissioner; and
502.10(3) consider any history of repeated nonconformance or complaints regarding
502.11assessors or assessment bodies.
502.12(c) The selection committee shall consider an application received from qualified
502.13applicants and shall supply a list of recommended assessors and assessment bodies to
502.14the commissioner of health no later than 90 days after the commissioner notifies the
502.15committee of the need for review of applications.

502.16    Sec. 38. Minnesota Statutes 2012, section 144.98, is amended by adding a subdivision
502.17to read:
502.18    Subd. 12. Commissioner approval of assessors and scheduling of assessments.
502.19(a) The commissioner shall approve assessors who:
502.20(1) are employed by the commissioner for the purpose of accrediting laboratories
502.21and demonstrate competence in assessment practices for environmental laboratories; or
502.22(2) are employed by a state or federal agency with established agreements for
502.23mutual assistance or recognition with the commissioner and demonstrate competence in
502.24assessment practices for environmental laboratories.
502.25(b) The commissioner may approve other assessors or assessment bodies who are
502.26recommended by the selection committee according to subdivision 11, paragraph (c). The
502.27commissioner shall publish the list of assessors and assessment bodies approved from the
502.28recommendations.
502.29(c) The commissioner shall rescind approval for an assessor or assessment body for
502.30sufficient cause as the commissioner determines, such as:
502.31(1) failure to meet the minimum qualifications for performing assessments;
502.32(2) lack of availability;
502.33(3) nonconformance with the applicable laws, rules, standards, policies, and
502.34procedures;
503.1(4) misrepresentation of application information regarding qualifications and
503.2training; or
503.3(5) excessive cost to perform the assessment activities.

503.4    Sec. 39. Minnesota Statutes 2012, section 144.98, is amended by adding a subdivision
503.5to read:
503.6    Subd. 13. Laboratory requirements for assessor selection and scheduling
503.7assessments. (a) A laboratory accredited or seeking accreditation that requires an
503.8assessment by the commissioner must select an assessor, group of assessors, or an
503.9assessment body from the published list specified in subdivision 12, paragraph (b). An
503.10accredited laboratory must complete an assessment and make all corrective actions at least
503.11once every 24 months. Unless the commissioner grants interim accreditation, a laboratory
503.12seeking accreditation must complete an assessment and make all corrective actions
503.13prior to, but no earlier than, 18 months prior to the date the application is submitted to
503.14the commissioner.
503.15(b) A laboratory shall not select the same assessor more than twice in succession
503.16for assessments of the same facility unless the laboratory receives written approval
503.17from the commissioner for the selection. The laboratory must supply a written request
503.18to the commissioner for approval and must justify the reason for the request and provide
503.19the alternate options considered.
503.20(c) A laboratory must select assessors appropriate to the size and scope of the
503.21laboratory's application or existing accreditation.
503.22(d) A laboratory must enter into its own contract for direct payment of the assessors
503.23or assessment body. The contract must authorize the assessor, assessment body, or
503.24subcontractors to release all records to the commissioner regarding the assessment activity,
503.25when the assessment is performed in compliance with this statute.
503.26(e) A laboratory must agree to permit other assessors as selected by the commissioner
503.27to participate in the assessment activities.
503.28(f) If the laboratory determines no approved assessor is available to perform
503.29the assessment, the laboratory must notify the commissioner in writing and provide a
503.30justification for the determination. If the commissioner confirms no approved assessor
503.31is available, the commissioner may designate an alternate assessor from those approved
503.32in subdivision 12, paragraph (a), or the commissioner may delay the assessment until
503.33an assessor is available. If an approved alternate assessor performs the assessment, the
503.34commissioner may collect fees equivalent to the cost of performing the assessment
503.35activities.
504.1(g) Fees collected under this section are deposited in a special account and are
504.2annually appropriated to the commissioner for the purpose of performing assessment
504.3activities.
504.4EFFECTIVE DATE.This section is effective the day following final enactment.

504.5    Sec. 40. Minnesota Statutes 2012, section 144.99, subdivision 4, is amended to read:
504.6    Subd. 4. Administrative penalty orders. (a) The commissioner may issue an
504.7order requiring violations to be corrected and administratively assessing monetary
504.8penalties for violations of the statutes, rules, and other actions listed in subdivision 1. The
504.9procedures in section 144.991 must be followed when issuing administrative penalty
504.10orders. Except in the case of repeated or serious violations, the penalty assessed in the
504.11order must be forgiven if the person who is subject to the order demonstrates in writing
504.12to the commissioner before the 31st day after receiving the order that the person has
504.13corrected the violation or has developed a corrective plan acceptable to the commissioner.
504.14The maximum amount of an administrative penalty order is $10,000 for each violator for
504.15all violations by that violator identified in an inspection or review of compliance.
504.16(b) Notwithstanding paragraph (a), the commissioner may issue to a large public
504.17water supply, serving a population of more than 10,000 persons, an administrative penalty
504.18order imposing a penalty of at least $1,000 per day per violation, not to exceed $10,000
504.19for each violation of sections 144.381 to 144.385 and rules adopted thereunder.
504.20(c) Notwithstanding paragraph (a), the commissioner may issue to a certified lead
504.21firm or person performing regulated lead work, an administrative penalty order imposing a
504.22penalty of at least $5,000 per violation per day, not to exceed $10,000 for each violation of
504.23sections 144.9501 to 144.9512 and rules adopted thereunder. All revenue collected from
504.24monetary penalties in this section shall be deposited in the state treasury and credited to
504.25the state government special revenue fund.

504.26    Sec. 41. Minnesota Statutes 2012, section 145.906, is amended to read:
504.27145.906 POSTPARTUM DEPRESSION EDUCATION AND INFORMATION.
504.28(a) The commissioner of health shall work with health care facilities, licensed health
504.29and mental health care professionals, the women, infants, and children (WIC) program,
504.30mental health advocates, consumers, and families in the state to develop materials and
504.31information about postpartum depression, including treatment resources, and develop
504.32policies and procedures to comply with this section.
505.1(b) Physicians, traditional midwives, and other licensed health care professionals
505.2providing prenatal care to women must have available to women and their families
505.3information about postpartum depression.
505.4(c) Hospitals and other health care facilities in the state must provide departing new
505.5mothers and fathers and other family members, as appropriate, with written information
505.6about postpartum depression, including its symptoms, methods of coping with the illness,
505.7and treatment resources.
505.8(d) Information about postpartum depression, including its symptoms, potential
505.9impact on families, and treatment resources, must be available at WIC sites.
505.10(e) The commissioner of health, in collaboration with the commissioner of human
505.11services and to the extent authorized by the federal Centers for Disease Control and
505.12Prevention, shall review the materials and information related to postpartum depression to
505.13determine their effectiveness in transmitting the information in a way that reduces racial
505.14health disparities as reported in surveys of maternal attitudes and experiences before,
505.15during, and after pregnancy, including those conducted by the commissioner of health. The
505.16commissioner shall implement changes to reduce racial health disparities in the information
505.17reviewed, as needed, and ensure that women of color are receiving the information.

505.18    Sec. 42. [145.907] MATERNAL DEPRESSION; DEFINITION.
505.19"Maternal depression" means depression or other perinatal mood or anxiety disorder
505.20experienced by a woman during pregnancy or during the first year following the birth of
505.21her child.

505.22    Sec. 43. Minnesota Statutes 2012, section 145.986, is amended to read:
505.23145.986 STATEWIDE HEALTH IMPROVEMENT PROGRAM.
505.24    Subdivision 1. Grants to local communities Purpose. The purpose of the statewide
505.25health improvement program is to:
505.26(1) address the top three leading preventable causes of illness and death: tobacco use
505.27and exposure, poor diet, and lack of regular physical activity;
505.28(2) promote the development, availability, and use of evidence-based, community
505.29level, comprehensive strategies to create healthy communities; and
505.30(3) measure the impact of the evidence-based, community health improvement
505.31practices which over time work to contain health care costs and reduce chronic diseases.
505.32    Subd. 1a. Grants to local communities. (a) Beginning July 1, 2009, the
505.33commissioner of health shall award competitive grants to community health boards
505.34established pursuant to section 145A.09 and tribal governments to convene, coordinate,
506.1and implement evidence-based strategies targeted at reducing the percentage of
506.2Minnesotans who are obese or overweight and to reduce the use of tobacco.
506.3    (b) Grantee activities shall:
506.4    (1) be based on scientific evidence;
506.5    (2) be based on community input;
506.6    (3) address behavior change at the individual, community, and systems levels;
506.7    (4) occur in community, school, worksite, and health care settings; and
506.8    (5) be focused on policy, systems, and environmental changes that support healthy
506.9behaviors.; and
506.10(6) address the health disparities and inequities that exist in the grantee's community.
506.11    (c) To receive a grant under this section, community health boards and tribal
506.12governments must submit proposals to the commissioner. A local match of ten percent
506.13of the total funding allocation is required. This local match may include funds donated
506.14by community partners.
506.15    (d) In order to receive a grant, community health boards and tribal governments
506.16must submit a health improvement plan to the commissioner of health for approval. The
506.17commissioner may require the plan to identify a community leadership team, community
506.18partners, and a community action plan that includes an assessment of area strengths and
506.19needs, proposed action strategies, technical assistance needs, and a staffing plan.
506.20    (e) The grant recipient must implement the health improvement plan, evaluate the
506.21effectiveness of the interventions strategies, and modify or discontinue interventions
506.22 strategies found to be ineffective.
506.23    (f) By January 15, 2011, the commissioner of health shall recommend whether any
506.24funding should be distributed to community health boards and tribal governments based
506.25on health disparities demonstrated in the populations served.
506.26    (g) (f) Grant recipients shall report their activities and their progress toward the
506.27outcomes established under subdivision 2 to the commissioner in a format and at a time
506.28specified by the commissioner.
506.29    (h) (g) All grant recipients shall be held accountable for making progress toward
506.30the measurable outcomes established in subdivision 2. The commissioner shall require a
506.31corrective action plan and may reduce the funding level of grant recipients that do not
506.32make adequate progress toward the measurable outcomes.
506.33(h) Notwithstanding paragraph (a), the commissioner may award funding to
506.34convene, coordinate, and implement evidence-based strategies targeted at reducing other
506.35risk factors, aside from tobacco use and exposure, poor diet, and lack of regular physical
507.1activity, that are associated with chronic disease and may impact public health. The
507.2commissioner shall develop a criteria and procedures to allocate funding under this section.
507.3    Subd. 2. Outcomes. (a) The commissioner shall set measurable outcomes to meet
507.4the goals specified in subdivision 1, and annually review the progress of grant recipients
507.5in meeting the outcomes.
507.6    (b) The commissioner shall measure current public health status, using existing
507.7measures and data collection systems when available, to determine baseline data against
507.8which progress shall be monitored.
507.9    Subd. 3. Technical assistance and oversight. (a) The commissioner shall provide
507.10content expertise, technical expertise, and training to grant recipients and advice on
507.11evidence-based strategies, including those based on populations and types of communities
507.12served. The commissioner shall ensure that the statewide health improvement program
507.13meets the outcomes established under subdivision 2 by conducting a comprehensive
507.14statewide evaluation and assisting grant recipients to modify or discontinue interventions
507.15found to be ineffective.
507.16(b) For the purposes of carrying out the grant program under this section, including
507.17for administrative purposes, the commissioner shall award contracts to appropriate entities
507.18to assist in training and provide technical assistance to grantees.
507.19(c) Contracts awarded under paragraph (b) may be used to provide technical
507.20assistance and training in the areas of:
507.21(1) community engagement and capacity building;
507.22(2) tribal support;
507.23(3) community asset building and risk behavior reduction;
507.24(4) legal;
507.25(5) communications;
507.26(6) community, school, health care, work site, and other site-specific strategies; and
507.27(7) health equity.
507.28    Subd. 4. Evaluation. (a) Using the outcome measures established in subdivision 3,
507.29the commissioner shall conduct a biennial evaluation of the statewide health improvement
507.30program funded under this section. Grant recipients shall cooperate with the commissioner
507.31in the evaluation and provide the commissioner with the information necessary to conduct
507.32the evaluation.
507.33(b) Grant recipients will collect, monitor, and submit to the Department of Health
507.34baseline and annual data and provide information to improve the quality and impact of
507.35community health improvement strategies.
508.1(c) For the purposes of carrying out the grant program under this section, including
508.2for administrative purposes, the commissioner shall award contracts to appropriate entities
508.3to assist in designing and implementing evaluation systems.
508.4(d) Contracts awarded under paragraph (c) may be used to:
508.5(1) develop grantee monitoring and reporting systems to track grantee progress,
508.6including aggregated and disaggregated data;
508.7(2) manage, analyze, and report program evaluation data results; and
508.8(3) utilize innovative support tools to analyze and predict the impact of prevention
508.9strategies on health outcomes and state health care costs over time.
508.10    Subd. 5. Report. The commissioner shall submit a biennial report to the legislature
508.11on the statewide health improvement program funded under this section. These reports
508.12 The report must include information on each grant recipients recipient, including the
508.13activities that were conducted by the grantee using grant funds, evaluation data, and
508.14outcome measures, if available. the grantee's progress toward achieving the measurable
508.15outcomes established under subdivision 2, and the data provided to the commissioner by
508.16the grantee to measure these outcomes for grant activities. The commissioner shall provide
508.17information on grants in which a corrective action plan was required under subdivision
508.181a, the types of plan action, and the progress that has been made toward meeting the
508.19measurable outcomes. In addition, the commissioner shall provide recommendations
508.20on future areas of focus for health improvement. These reports are due by January 15
508.21of every other year, beginning in 2010. In the report due on January 15, 2010, the
508.22commissioner shall include recommendations on a sustainable funding source for the
508.23statewide health improvement program other than the health care access fund In the report
508.24due on January 15, 2014, the commissioner shall include a description of the contracts
508.25awarded under subdivision 4, paragraph (c), and the monitoring and evaluation systems
508.26that were designed and implemented under these contracts.
508.27    Subd. 6. Supplantation of existing funds. Community health boards and tribal
508.28governments must use funds received under this section to develop new programs, expand
508.29current programs that work to reduce the percentage of Minnesotans who are obese or
508.30overweight or who use tobacco, or replace discontinued state or federal funds previously
508.31used to reduce the percentage of Minnesotans who are obese or overweight or who use
508.32tobacco. Funds must not be used to supplant current state or local funding to community
508.33health boards or tribal governments used to reduce the percentage of Minnesotans who are
508.34obese or overweight or to reduce tobacco use.

508.35    Sec. 44. Minnesota Statutes 2012, section 145A.17, subdivision 1, is amended to read:
509.1    Subdivision 1. Establishment; goals. The commissioner shall establish a program
509.2to fund family home visiting programs designed to foster healthy beginnings, improve
509.3pregnancy outcomes, promote school readiness, prevent child abuse and neglect, reduce
509.4juvenile delinquency, promote positive parenting and resiliency in children, and promote
509.5family health and economic self-sufficiency for children and families. The commissioner
509.6shall promote partnerships, collaboration, and multidisciplinary visiting done by teams of
509.7professionals and paraprofessionals from the fields of public health nursing, social work,
509.8and early childhood education. A program funded under this section must serve families
509.9at or below 200 percent of the federal poverty guidelines, and other families determined
509.10to be at risk, including but not limited to being at risk for child abuse, child neglect, or
509.11juvenile delinquency. Programs must begin prenatally whenever possible and must be
509.12targeted to families with:
509.13    (1) adolescent parents;
509.14    (2) a history of alcohol or other drug abuse;
509.15    (3) a history of child abuse, domestic abuse, or other types of violence;
509.16    (4) a history of domestic abuse, rape, or other forms of victimization;
509.17    (5) reduced cognitive functioning;
509.18    (6) a lack of knowledge of child growth and development stages;
509.19    (7) low resiliency to adversities and environmental stresses;
509.20    (8) insufficient financial resources to meet family needs;
509.21    (9) a history of homelessness;
509.22    (10) a risk of long-term welfare dependence or family instability due to employment
509.23barriers; or
509.24(11) a serious mental health disorder, including maternal depression as defined in
509.25section 145.907; or
509.26    (11) (12) other risk factors as determined by the commissioner.

509.27    Sec. 45. Minnesota Statutes 2012, section 149A.02, subdivision 1a, is amended to read:
509.28    Subd. 1a. Alkaline hydrolysis. "Alkaline hydrolysis" means the reduction of a dead
509.29human body to essential elements through exposure to a combination of heat and alkaline
509.30hydrolysis and the repositioning or movement of the body during the process to facilitate
509.31reduction, a water-based dissolution process using alkaline chemicals, heat, agitation, and
509.32pressure to accelerate natural decomposition; the processing of the hydrolyzed remains
509.33after removal from the alkaline hydrolysis chamber, vessel; placement of the processed
509.34remains in a hydrolyzed remains container,; and release of the hydrolyzed remains to an
509.35appropriate party. Alkaline hydrolysis is a form of final disposition.

510.1    Sec. 46. Minnesota Statutes 2012, section 149A.02, is amended by adding a
510.2subdivision to read:
510.3    Subd. 1b. Alkaline hydrolysis container. "Alkaline hydrolysis container" means a
510.4hydrolyzable or biodegradable closed container or pouch resistant to leakage of bodily
510.5fluids that encases the body and into which a dead human body is placed prior to insertion
510.6into an alkaline hydrolysis vessel. Alkaline hydrolysis containers may be hydrolyzable or
510.7biodegradable alternative containers or caskets.

510.8    Sec. 47. Minnesota Statutes 2012, section 149A.02, is amended by adding a
510.9subdivision to read:
510.10    Subd. 1c. Alkaline hydrolysis facility. "Alkaline hydrolysis facility" means a
510.11building or structure containing one or more alkaline hydrolysis vessels for the alkaline
510.12hydrolysis of dead human bodies.

510.13    Sec. 48. Minnesota Statutes 2012, section 149A.02, is amended by adding a
510.14subdivision to read:
510.15    Subd. 1d. Alkaline hydrolysis vessel. "Alkaline hydrolysis vessel" means the
510.16container in which the alkaline hydrolysis of a dead human body is performed.

510.17    Sec. 49. Minnesota Statutes 2012, section 149A.02, subdivision 2, is amended to read:
510.18    Subd. 2. Alternative container. "Alternative container" means a nonmetal
510.19receptacle or enclosure, without ornamentation or a fixed interior lining, which is designed
510.20for the encasement of dead human bodies and is made of hydrolyzable or biodegradable
510.21materials, corrugated cardboard, fiberboard, pressed-wood, or other like materials.

510.22    Sec. 50. Minnesota Statutes 2012, section 149A.02, subdivision 3, is amended to read:
510.23    Subd. 3. Arrangements for disposition. "Arrangements for disposition" means
510.24any action normally taken by a funeral provider in anticipation of or preparation for the
510.25entombment, burial in a cemetery, alkaline hydrolysis, or cremation of a dead human body.

510.26    Sec. 51. Minnesota Statutes 2012, section 149A.02, subdivision 4, is amended to read:
510.27    Subd. 4. Cash advance item. "Cash advance item" means any item of service
510.28or merchandise described to a purchaser as a "cash advance," "accommodation," "cash
510.29disbursement," or similar term. A cash advance item is also any item obtained from a
510.30third party and paid for by the funeral provider on the purchaser's behalf. Cash advance
510.31items include, but are not limited to, cemetery, alkaline hydrolysis, or crematory services,
511.1pallbearers, public transportation, clergy honoraria, flowers, musicians or singers, obituary
511.2notices, gratuities, and death records.

511.3    Sec. 52. Minnesota Statutes 2012, section 149A.02, subdivision 5, is amended to read:
511.4    Subd. 5. Casket. "Casket" means a rigid container which is designed for the
511.5encasement of a dead human body and is usually constructed of hydrolyzable or
511.6biodegradable materials, wood, metal, fiberglass, plastic, or like material, and ornamented
511.7and lined with fabric.

511.8    Sec. 53. Minnesota Statutes 2012, section 149A.02, is amended by adding a
511.9subdivision to read:
511.10    Subd. 12a. Crypt. "Crypt" means a space in a mausoleum of sufficient size, used or
511.11intended to be used, to entomb human remains, cremated remains, or hydrolyzed remains.

511.12    Sec. 54. Minnesota Statutes 2012, section 149A.02, is amended by adding a
511.13subdivision to read:
511.14    Subd. 12b. Direct alkaline hydrolysis. "Direct alkaline hydrolysis" means a
511.15final disposition of a dead human body by alkaline hydrolysis, without formal viewing,
511.16visitation, or ceremony with the body present.

511.17    Sec. 55. Minnesota Statutes 2012, section 149A.02, subdivision 16, is amended to read:
511.18    Subd. 16. Final disposition. "Final disposition" means the acts leading to and the
511.19entombment, burial in a cemetery, alkaline hydrolysis, or cremation of a dead human body.

511.20    Sec. 56. Minnesota Statutes 2012, section 149A.02, subdivision 23, is amended to read:
511.21    Subd. 23. Funeral services. "Funeral services" means any services which may
511.22be used to: (1) care for and prepare dead human bodies for burial, alkaline hydrolysis,
511.23cremation, or other final disposition; and (2) arrange, supervise, or conduct the funeral
511.24ceremony or the final disposition of dead human bodies.

511.25    Sec. 57. Minnesota Statutes 2012, section 149A.02, is amended by adding a
511.26subdivision to read:
511.27    Subd. 24a. Holding facility. "Holding facility" means a secure enclosed room or
511.28confined area within a funeral establishment, crematory, or alkaline hydrolysis facility
511.29used for temporary storage of human remains awaiting final disposition.

512.1    Sec. 58. Minnesota Statutes 2012, section 149A.02, is amended by adding a
512.2subdivision to read:
512.3    Subd. 24b. Hydrolyzed remains. "Hydrolyzed remains" means the remains of a
512.4dead human body following the alkaline hydrolysis process. Hydrolyzed remains does not
512.5include pacemakers, prostheses, or similar foreign materials.

512.6    Sec. 59. Minnesota Statutes 2012, section 149A.02, is amended by adding a
512.7subdivision to read:
512.8    Subd. 24c. Hydrolyzed remains container. "Hydrolyzed remains container" means
512.9a receptacle in which hydrolyzed remains are placed. For purposes of this chapter, a
512.10hydrolyzed remains container is interchangeable with "urn" or similar keepsake storage
512.11jewelry.

512.12    Sec. 60. Minnesota Statutes 2012, section 149A.02, is amended by adding a
512.13subdivision to read:
512.14    Subd. 26a. Inurnment. "Inurnment" means placing hydrolyzed or cremated remains
512.15in a hydrolyzed or cremated remains container suitable for placement, burial, or shipment.

512.16    Sec. 61. Minnesota Statutes 2012, section 149A.02, subdivision 27, is amended to read:
512.17    Subd. 27. Licensee. "Licensee" means any person or entity that has been issued
512.18a license to practice mortuary science, to operate a funeral establishment, to operate an
512.19alkaline hydrolysis facility, or to operate a crematory by the Minnesota commissioner
512.20of health.

512.21    Sec. 62. Minnesota Statutes 2012, section 149A.02, is amended by adding a
512.22subdivision to read:
512.23    Subd. 30a. Niche. "Niche" means a space in a columbarium used, or intended to be
512.24used, for the placement of hydrolyzed or cremated remains.

512.25    Sec. 63. Minnesota Statutes 2012, section 149A.02, is amended by adding a
512.26subdivision to read:
512.27    Subd. 32a. Placement. "Placement" means the placing of a container holding
512.28hydrolyzed or cremated remains in a crypt, vault, or niche.

512.29    Sec. 64. Minnesota Statutes 2012, section 149A.02, subdivision 34, is amended to read:
513.1    Subd. 34. Preparation of the body. "Preparation of the body" means placement of
513.2the body into an appropriate cremation or alkaline hydrolysis container, embalming of
513.3the body or such items of care as washing, disinfecting, shaving, positioning of features,
513.4restorative procedures, application of cosmetics, dressing, and casketing.

513.5    Sec. 65. Minnesota Statutes 2012, section 149A.02, subdivision 35, is amended to read:
513.6    Subd. 35. Processing. "Processing" means the removal of foreign objects, drying or
513.7cooling, and the reduction of the hydrolyzed or cremated remains by mechanical means
513.8including, but not limited to, grinding, crushing, or pulverizing, to a granulated appearance
513.9appropriate for final disposition.

513.10    Sec. 66. Minnesota Statutes 2012, section 149A.02, subdivision 37, is amended to read:
513.11    Subd. 37. Public transportation. "Public transportation" means all manner of
513.12transportation via common carrier available to the general public including airlines, buses,
513.13railroads, and ships. For purposes of this chapter, a livery service providing transportation
513.14to private funeral establishments, alkaline hydrolysis facilities, or crematories is not public
513.15transportation.

513.16    Sec. 67. Minnesota Statutes 2012, section 149A.02, is amended by adding a
513.17subdivision to read:
513.18    Subd. 37c. Scattering. "Scattering" means the authorized dispersal of hydrolyzed
513.19or cremated remains in a defined area of a dedicated cemetery or in areas where no local
513.20prohibition exists provided that the hydrolyzed or cremated remains are not distinguishable
513.21to the public, are not in a container, and that the person who has control over disposition
513.22of the hydrolyzed or cremated remains has obtained written permission of the property
513.23owner or governing agency to scatter on the property.

513.24    Sec. 68. Minnesota Statutes 2012, section 149A.02, is amended by adding a
513.25subdivision to read:
513.26    Subd. 41. Vault. "Vault" means a space in a mausoleum of sufficient size, used or
513.27intended to be used, to entomb human remains, cremated remains, or hydrolyzed remains.
513.28Vault may also mean a sealed and lined casket enclosure.

513.29    Sec. 69. Minnesota Statutes 2012, section 149A.03, is amended to read:
513.30149A.03 DUTIES OF COMMISSIONER.
513.31    The commissioner shall:
514.1    (1) enforce all laws and adopt and enforce rules relating to the:
514.2    (i) removal, preparation, transportation, arrangements for disposition, and final
514.3disposition of dead human bodies;
514.4    (ii) licensure and professional conduct of funeral directors, morticians, interns,
514.5practicum students, and clinical students;
514.6    (iii) licensing and operation of a funeral establishment; and
514.7(iv) licensing and operation of an alkaline hydrolysis facility; and
514.8    (iv) (v) licensing and operation of a crematory;
514.9    (2) provide copies of the requirements for licensure and permits to all applicants;
514.10    (3) administer examinations and issue licenses and permits to qualified persons
514.11and other legal entities;
514.12    (4) maintain a record of the name and location of all current licensees and interns;
514.13    (5) perform periodic compliance reviews and premise inspections of licensees;
514.14    (6) accept and investigate complaints relating to conduct governed by this chapter;
514.15    (7) maintain a record of all current preneed arrangement trust accounts;
514.16    (8) maintain a schedule of application, examination, permit, and licensure fees,
514.17initial and renewal, sufficient to cover all necessary operating expenses;
514.18    (9) educate the public about the existence and content of the laws and rules for
514.19mortuary science licensing and the removal, preparation, transportation, arrangements
514.20for disposition, and final disposition of dead human bodies to enable consumers to file
514.21complaints against licensees and others who may have violated those laws or rules;
514.22    (10) evaluate the laws, rules, and procedures regulating the practice of mortuary
514.23science in order to refine the standards for licensing and to improve the regulatory and
514.24enforcement methods used; and
514.25    (11) initiate proceedings to address and remedy deficiencies and inconsistencies in
514.26the laws, rules, or procedures governing the practice of mortuary science and the removal,
514.27preparation, transportation, arrangements for disposition, and final disposition of dead
514.28human bodies.

514.29    Sec. 70. [149A.54] LICENSE TO OPERATE AN ALKALINE HYDROLYSIS
514.30FACILITY.
514.31    Subdivision 1. License requirement. Except as provided in section 149A.01,
514.32subdivision 3, a place or premise shall not be maintained, managed, or operated which
514.33is devoted to or used in the holding and alkaline hydrolysis of a dead human body
514.34without possessing a valid license to operate an alkaline hydrolysis facility issued by the
514.35commissioner of health.
515.1    Subd. 2. Requirements for an alkaline hydrolysis facility. (a) An alkaline
515.2hydrolysis facility licensed under this section must consist of:
515.3(1) a building or structure that complies with applicable local and state building
515.4codes, zoning laws and ordinances, wastewater management and environmental standards,
515.5containing one or more alkaline hydrolysis vessels for the alkaline hydrolysis of dead
515.6human bodies;
515.7(2) a method approved by the commissioner of health to dry the hydrolyzed remains
515.8and which is located within the licensed facility;
515.9(3) a means approved by the commissioner of health for refrigeration of dead human
515.10bodies awaiting alkaline hydrolysis;
515.11(4) an appropriate means of processing hydrolyzed remains to a granulated
515.12appearance appropriate for final disposition; and
515.13(5) an appropriate holding facility for dead human bodies awaiting alkaline
515.14hydrolysis.
515.15(b) An alkaline hydrolysis facility licensed under this section may also contain a
515.16display room for funeral goods.
515.17    Subd. 3. Application procedure; documentation; initial inspection. An
515.18application to license and operate an alkaline hydrolysis facility shall be submitted to the
515.19commissioner of health. A completed application includes:
515.20(1) a completed application form, as provided by the commissioner;
515.21(2) proof of business form and ownership;
515.22(3) proof of liability insurance coverage or other financial documentation, as
515.23determined by the commissioner, that demonstrates the applicant's ability to respond in
515.24damages for liability arising from the ownership, maintenance management, or operation
515.25of an alkaline hydrolysis facility; and
515.26(4) copies of wastewater and other environmental regulatory permits and
515.27environmental regulatory licenses necessary to conduct operations.
515.28Upon receipt of the application and appropriate fee, the commissioner shall review and
515.29verify all information. Upon completion of the verification process and resolution of any
515.30deficiencies in the application information, the commissioner shall conduct an initial
515.31inspection of the premises to be licensed. After the inspection and resolution of any
515.32deficiencies found and any reinspections as may be necessary, the commissioner shall
515.33make a determination, based on all the information available, to grant or deny licensure. If
515.34the commissioner's determination is to grant the license, the applicant shall be notified and
515.35the license shall issue and remain valid for a period prescribed on the license, but not to
515.36exceed one calendar year from the date of issuance of the license. If the commissioner's
516.1determination is to deny the license, the commissioner must notify the applicant in writing
516.2of the denial and provide the specific reason for denial.
516.3    Subd. 4. Nontransferability of license. A license to operate an alkaline hydrolysis
516.4facility is not assignable or transferable and shall not be valid for any entity other than the
516.5one named. Each license issued to operate an alkaline hydrolysis facility is valid only for the
516.6location identified on the license. A 50 percent or more change in ownership or location of
516.7the alkaline hydrolysis facility automatically terminates the license. Separate licenses shall
516.8be required of two or more persons or other legal entities operating from the same location.
516.9    Subd. 5. Display of license. Each license to operate an alkaline hydrolysis
516.10facility must be conspicuously displayed in the alkaline hydrolysis facility at all times.
516.11Conspicuous display means in a location where a member of the general public within the
516.12alkaline hydrolysis facility will be able to observe and read the license.
516.13    Subd. 6. Period of licensure. All licenses to operate an alkaline hydrolysis facility
516.14issued by the commissioner are valid for a period of one calendar year beginning on July 1
516.15and ending on June 30, regardless of the date of issuance.
516.16    Subd. 7. Reporting changes in license information. Any change of license
516.17information must be reported to the commissioner, on forms provided by the
516.18commissioner, no later than 30 calendar days after the change occurs. Failure to report
516.19changes is grounds for disciplinary action.
516.20    Subd. 8. Notification to the commissioner. If the licensee is operating under a
516.21wastewater or an environmental permit or license that is subsequently revoked, denied,
516.22or terminated, the licensee shall notify the commissioner.
516.23    Subd. 9. Application information. All information submitted to the commissioner
516.24for a license to operate an alkaline hydrolysis facility is classified as licensing data under
516.25section 13.41, subdivision 5.

516.26    Sec. 71. [149A.55] RENEWAL OF LICENSE TO OPERATE AN ALKALINE
516.27HYDROLYSIS FACILITY.
516.28    Subdivision 1. Renewal required. All licenses to operate an alkaline hydrolysis
516.29facility issued by the commissioner expire on June 30 following the date of issuance of the
516.30license and must be renewed to remain valid.
516.31    Subd. 2. Renewal procedure and documentation. Licensees who wish to renew
516.32their licenses must submit to the commissioner a completed renewal application no later
516.33than June 30 following the date the license was issued. A completed renewal application
516.34includes:
516.35(1) a completed renewal application form, as provided by the commissioner; and
517.1(2) proof of liability insurance coverage or other financial documentation, as
517.2determined by the commissioner, that demonstrates the applicant's ability to respond in
517.3damages for liability arising from the ownership, maintenance, management, or operation
517.4of an alkaline hydrolysis facility.
517.5Upon receipt of the completed renewal application, the commissioner shall review and
517.6verify the information. Upon completion of the verification process and resolution of
517.7any deficiencies in the renewal application information, the commissioner shall make a
517.8determination, based on all the information available, to reissue or refuse to reissue the
517.9license. If the commissioner's determination is to reissue the license, the applicant shall
517.10be notified and the license shall issue and remain valid for a period prescribed on the
517.11license, but not to exceed one calendar year from the date of issuance of the license. If
517.12the commissioner's determination is to refuse to reissue the license, section 149A.09,
517.13subdivision 2, applies.
517.14    Subd. 3. Penalty for late filing. Renewal applications received after the expiration
517.15date of a license will result in the assessment of a late filing penalty. The late filing penalty
517.16must be paid before the reissuance of the license and received by the commissioner no
517.17later than 31 calendar days after the expiration date of the license.
517.18    Subd. 4. Lapse of license. Licenses to operate alkaline hydrolysis facilities
517.19shall automatically lapse when a completed renewal application is not received by the
517.20commissioner within 31 calendar days after the expiration date of a license, or a late
517.21filing penalty assessed under subdivision 3 is not received by the commissioner within 31
517.22calendar days after the expiration of a license.
517.23    Subd. 5. Effect of lapse of license. Upon the lapse of a license, the person to whom
517.24the license was issued is no longer licensed to operate an alkaline hydrolysis facility in
517.25Minnesota. The commissioner shall issue a cease and desist order to prevent the lapsed
517.26license holder from operating an alkaline hydrolysis facility in Minnesota and may pursue
517.27any additional lawful remedies as justified by the case.
517.28    Subd. 6. Restoration of lapsed license. The commissioner may restore a lapsed
517.29license upon receipt and review of a completed renewal application, receipt of the late
517.30filing penalty, and reinspection of the premises, provided that the receipt is made within
517.31one calendar year from the expiration date of the lapsed license and the cease and desist
517.32order issued by the commissioner has not been violated. If a lapsed license is not restored
517.33within one calendar year from the expiration date of the lapsed license, the holder of the
517.34lapsed license cannot be relicensed until the requirements in section 149A.54 are met.
517.35    Subd. 7. Reporting changes in license information. Any change of license
517.36information must be reported to the commissioner, on forms provided by the
518.1commissioner, no later than 30 calendar days after the change occurs. Failure to report
518.2changes is grounds for disciplinary action.
518.3    Subd. 8. Application information. All information submitted to the commissioner
518.4by an applicant for renewal of licensure to operate an alkaline hydrolysis facility is
518.5classified as licensing data under section 13.41, subdivision 5.

518.6    Sec. 72. Minnesota Statutes 2012, section 149A.65, is amended by adding a
518.7subdivision to read:
518.8    Subd. 6. Alkaline hydrolysis facilities. The initial and renewal fee for an alkaline
518.9hydrolysis facility is $300. The late fee charge for a license renewal is $25.

518.10    Sec. 73. Minnesota Statutes 2012, section 149A.65, is amended by adding a
518.11subdivision to read:
518.12    Subd. 7. State government special revenue fund. Fees collected by the
518.13commissioner under this section must be deposited in the state treasury and credited to
518.14the state government special revenue fund.

518.15    Sec. 74. Minnesota Statutes 2012, section 149A.70, subdivision 1, is amended to read:
518.16    Subdivision 1. Use of titles. Only a person holding a valid license to practice
518.17mortuary science issued by the commissioner may use the title of mortician, funeral
518.18director, or any other title implying that the licensee is engaged in the business or practice
518.19of mortuary science. Only the holder of a valid license to operate an alkaline hydrolysis
518.20facility issued by the commissioner may use the title of alkaline hydrolysis facility, water
518.21cremation, water-reduction, biocremation, green-cremation, resomation, dissolution, or
518.22any other title, word, or term implying that the licensee operates an alkaline hydrolysis
518.23facility. Only the holder of a valid license to operate a funeral establishment issued by the
518.24commissioner may use the title of funeral home, funeral chapel, funeral service, or any
518.25other title, word, or term implying that the licensee is engaged in the business or practice
518.26of mortuary science. Only the holder of a valid license to operate a crematory issued by
518.27the commissioner may use the title of crematory, crematorium, green-cremation, or any
518.28other title, word, or term implying that the licensee operates a crematory or crematorium.

518.29    Sec. 75. Minnesota Statutes 2012, section 149A.70, subdivision 2, is amended to read:
518.30    Subd. 2. Business location. A funeral establishment, alkaline hydrolysis facility, or
518.31crematory shall not do business in a location that is not licensed as a funeral establishment,
519.1alkaline hydrolysis facility, or crematory and shall not advertise a service that is available
519.2from an unlicensed location.

519.3    Sec. 76. Minnesota Statutes 2012, section 149A.70, subdivision 3, is amended to read:
519.4    Subd. 3. Advertising. No licensee, clinical student, practicum student, or intern
519.5shall publish or disseminate false, misleading, or deceptive advertising. False, misleading,
519.6or deceptive advertising includes, but is not limited to:
519.7    (1) identifying, by using the names or pictures of, persons who are not licensed to
519.8practice mortuary science in a way that leads the public to believe that those persons will
519.9provide mortuary science services;
519.10    (2) using any name other than the names under which the funeral establishment,
519.11alkaline hydrolysis facility, or crematory is known to or licensed by the commissioner;
519.12    (3) using a surname not directly, actively, or presently associated with a licensed
519.13funeral establishment, alkaline hydrolysis facility, or crematory, unless the surname had
519.14been previously and continuously used by the licensed funeral establishment, alkaline
519.15hydrolysis facility, or crematory; and
519.16    (4) using a founding or establishing date or total years of service not directly or
519.17continuously related to a name under which the funeral establishment, alkaline hydrolysis
519.18facility, or crematory is currently or was previously licensed.
519.19    Any advertising or other printed material that contains the names or pictures of
519.20persons affiliated with a funeral establishment, alkaline hydrolysis facility, or crematory
519.21shall state the position held by the persons and shall identify each person who is licensed
519.22or unlicensed under this chapter.

519.23    Sec. 77. Minnesota Statutes 2012, section 149A.70, subdivision 5, is amended to read:
519.24    Subd. 5. Reimbursement prohibited. No licensee, clinical student, practicum
519.25student, or intern shall offer, solicit, or accept a commission, fee, bonus, rebate, or other
519.26reimbursement in consideration for recommending or causing a dead human body to
519.27be disposed of by a specific body donation program, funeral establishment, alkaline
519.28hydrolysis facility, crematory, mausoleum, or cemetery.

519.29    Sec. 78. Minnesota Statutes 2012, section 149A.71, subdivision 2, is amended to read:
519.30    Subd. 2. Preventive requirements. (a) To prevent unfair or deceptive acts or
519.31practices, the requirements of this subdivision must be met.
519.32    (b) Funeral providers must tell persons who ask by telephone about the funeral
519.33provider's offerings or prices any accurate information from the price lists described in
520.1paragraphs (c) to (e) and any other readily available information that reasonably answers
520.2the questions asked.
520.3    (c) Funeral providers must make available for viewing to people who inquire in
520.4person about the offerings or prices of funeral goods or burial site goods, separate printed
520.5or typewritten price lists using a ten-point font or larger. Each funeral provider must have a
520.6separate price list for each of the following types of goods that are sold or offered for sale:
520.7    (1) caskets;
520.8    (2) alternative containers;
520.9    (3) outer burial containers;
520.10(4) alkaline hydrolysis containers;
520.11    (4) (5) cremation containers;
520.12(6) hydrolyzed remains containers;
520.13    (5) (7) cremated remains containers;
520.14    (6) (8) markers; and
520.15    (7) (9) headstones.
520.16    (d) Each separate price list must contain the name of the funeral provider's place
520.17of business, address, and telephone number and a caption describing the list as a price
520.18list for one of the types of funeral goods or burial site goods described in paragraph (c),
520.19clauses (1) to (7) (9). The funeral provider must offer the list upon beginning discussion
520.20of, but in any event before showing, the specific funeral goods or burial site goods and
520.21must provide a photocopy of the price list, for retention, if so asked by the consumer. The
520.22list must contain, at least, the retail prices of all the specific funeral goods and burial site
520.23goods offered which do not require special ordering, enough information to identify each,
520.24and the effective date for the price list. However, funeral providers are not required to
520.25make a specific price list available if the funeral providers place the information required
520.26by this paragraph on the general price list described in paragraph (e).
520.27    (e) Funeral providers must give a printed price list, for retention, to persons who
520.28inquire in person about the funeral goods, funeral services, burial site goods, or burial site
520.29services or prices offered by the funeral provider. The funeral provider must give the list
520.30upon beginning discussion of either the prices of or the overall type of funeral service or
520.31disposition or specific funeral goods, funeral services, burial site goods, or burial site
520.32services offered by the provider. This requirement applies whether the discussion takes
520.33place in the funeral establishment or elsewhere. However, when the deceased is removed
520.34for transportation to the funeral establishment, an in-person request for authorization to
520.35embalm does not, by itself, trigger the requirement to offer the general price list. If the
520.36provider, in making an in-person request for authorization to embalm, discloses that
521.1embalming is not required by law except in certain special cases, the provider is not
521.2required to offer the general price list. Any other discussion during that time about prices
521.3or the selection of funeral goods, funeral services, burial site goods, or burial site services
521.4triggers the requirement to give the consumer a general price list. The general price list
521.5must contain the following information:
521.6    (1) the name, address, and telephone number of the funeral provider's place of
521.7business;
521.8    (2) a caption describing the list as a "general price list";
521.9    (3) the effective date for the price list;
521.10    (4) the retail prices, in any order, expressed either as a flat fee or as the prices per
521.11hour, mile, or other unit of computation, and other information described as follows:
521.12    (i) forwarding of remains to another funeral establishment, together with a list of
521.13the services provided for any quoted price;
521.14    (ii) receiving remains from another funeral establishment, together with a list of
521.15the services provided for any quoted price;
521.16    (iii) separate prices for each alkaline hydrolysis or cremation offered by the funeral
521.17provider, with the price including an alternative container or alkaline hydrolysis or
521.18cremation container, any alkaline hydrolysis or crematory charges, and a description of the
521.19services and container included in the price, where applicable, and the price of alkaline
521.20hydrolysis or cremation where the purchaser provides the container;
521.21    (iv) separate prices for each immediate burial offered by the funeral provider,
521.22including a casket or alternative container, and a description of the services and container
521.23included in that price, and the price of immediate burial where the purchaser provides the
521.24casket or alternative container;
521.25    (v) transfer of remains to the funeral establishment or other location;
521.26    (vi) embalming;
521.27    (vii) other preparation of the body;
521.28    (viii) use of facilities, equipment, or staff for viewing;
521.29    (ix) use of facilities, equipment, or staff for funeral ceremony;
521.30    (x) use of facilities, equipment, or staff for memorial service;
521.31    (xi) use of equipment or staff for graveside service;
521.32    (xii) hearse or funeral coach;
521.33    (xiii) limousine; and
521.34    (xiv) separate prices for all cemetery-specific goods and services, including all goods
521.35and services associated with interment and burial site goods and services and excluding
521.36markers and headstones;
522.1    (5) the price range for the caskets offered by the funeral provider, together with the
522.2statement "A complete price list will be provided at the funeral establishment or casket
522.3sale location." or the prices of individual caskets, as disclosed in the manner described
522.4in paragraphs (c) and (d);
522.5    (6) the price range for the alternative containers offered by the funeral provider,
522.6together with the statement "A complete price list will be provided at the funeral
522.7establishment or alternative container sale location." or the prices of individual alternative
522.8containers, as disclosed in the manner described in paragraphs (c) and (d);
522.9    (7) the price range for the outer burial containers offered by the funeral provider,
522.10together with the statement "A complete price list will be provided at the funeral
522.11establishment or outer burial container sale location." or the prices of individual outer
522.12burial containers, as disclosed in the manner described in paragraphs (c) and (d);
522.13(8) the price range for the alkaline hydrolysis container offered by the funeral
522.14provider, together with the statement: "A complete price list will be provided at the funeral
522.15establishment or alkaline hydrolysis container sale location.", or the prices of individual
522.16alkaline hydrolysis containers, as disclosed in the manner described in paragraphs (c)
522.17and (d);
522.18(9) the price range for the hydrolyzed remains container offered by the funeral
522.19provider, together with the statement: "A complete price list will be provided at the
522.20funeral establishment or hydrolyzed remains container sale location.", or the prices
522.21of individual hydrolyzed remains container, as disclosed in the manner described in
522.22paragraphs (c) and (d);
522.23    (8) (10) the price range for the cremation containers offered by the funeral provider,
522.24together with the statement "A complete price list will be provided at the funeral
522.25establishment or cremation container sale location." or the prices of individual cremation
522.26containers and cremated remains containers, as disclosed in the manner described in
522.27paragraphs (c) and (d);
522.28    (9) (11) the price range for the cremated remains containers offered by the funeral
522.29provider, together with the statement, "A complete price list will be provided at the funeral
522.30establishment or cremation cremated remains container sale location," or the prices of
522.31individual cremation containers as disclosed in the manner described in paragraphs (c)
522.32and (d);
522.33    (10) (12) the price for the basic services of funeral provider and staff, together with a
522.34list of the principal basic services provided for any quoted price and, if the charge cannot
522.35be declined by the purchaser, the statement "This fee for our basic services will be added
522.36to the total cost of the funeral arrangements you select. (This fee is already included in
523.1our charges for alkaline hydrolysis, direct cremations, immediate burials, and forwarding
523.2or receiving remains.)" If the charge cannot be declined by the purchaser, the quoted
523.3price shall include all charges for the recovery of unallocated funeral provider overhead,
523.4and funeral providers may include in the required disclosure the phrase "and overhead"
523.5after the word "services." This services fee is the only funeral provider fee for services,
523.6facilities, or unallocated overhead permitted by this subdivision to be nondeclinable,
523.7unless otherwise required by law;
523.8    (11) (13) the price range for the markers and headstones offered by the funeral
523.9provider, together with the statement "A complete price list will be provided at the funeral
523.10establishment or marker or headstone sale location." or the prices of individual markers
523.11and headstones, as disclosed in the manner described in paragraphs (c) and (d); and
523.12    (12) (14) any package priced funerals offered must be listed in addition to and
523.13following the information required in this paragraph (e) and must clearly state the funeral
523.14goods and services being offered, the price being charged for those goods and services,
523.15and the discounted savings.
523.16    (f) Funeral providers must give an itemized written statement, for retention, to each
523.17consumer who arranges an at-need funeral or other disposition of human remains at the
523.18conclusion of the discussion of the arrangements. The itemized written statement must be
523.19signed by the consumer selecting the goods and services as required in section 149A.80.
523.20If the statement is provided by a funeral establishment, the statement must be signed by
523.21the licensed funeral director or mortician planning the arrangements. If the statement is
523.22provided by any other funeral provider, the statement must be signed by an authorized
523.23agent of the funeral provider. The statement must list the funeral goods, funeral services,
523.24burial site goods, or burial site services selected by that consumer and the prices to be paid
523.25for each item, specifically itemized cash advance items (these prices must be given to the
523.26extent then known or reasonably ascertainable if the prices are not known or reasonably
523.27ascertainable, a good faith estimate shall be given and a written statement of the actual
523.28charges shall be provided before the final bill is paid), and the total cost of goods and
523.29services selected. At the conclusion of an at-need arrangement, the funeral provider is
523.30required to give the consumer a copy of the signed itemized written contract that must
523.31contain the information required in this paragraph.
523.32    (g) Upon receiving actual notice of the death of an individual with whom a funeral
523.33provider has entered a preneed funeral agreement, the funeral provider must provide
523.34a copy of all preneed funeral agreement documents to the person who controls final
523.35disposition of the human remains or to the designee of the person controlling disposition.
523.36The person controlling final disposition shall be provided with these documents at the time
524.1of the person's first in-person contact with the funeral provider, if the first contact occurs
524.2in person at a funeral establishment, alkaline hydrolysis facility, crematory, or other place
524.3of business of the funeral provider. If the contact occurs by other means or at another
524.4location, the documents must be provided within 24 hours of the first contact.

524.5    Sec. 79. Minnesota Statutes 2012, section 149A.71, subdivision 4, is amended to read:
524.6    Subd. 4. Casket, alternate container, alkaline hydrolysis containers, and
524.7cremation container sales; records; required disclosures. Any funeral provider who
524.8sells or offers to sell a casket, alternate container, alkaline hydrolysis container, hydrolyzed
524.9remains container, or cremation container, or cremated remains container to the public
524.10must maintain a record of each sale that includes the name of the purchaser, the purchaser's
524.11mailing address, the name of the decedent, the date of the decedent's death, and the place
524.12of death. These records shall be open to inspection by the regulatory agency. Any funeral
524.13provider selling a casket, alternate container, or cremation container to the public, and not
524.14having charge of the final disposition of the dead human body, shall provide a copy of the
524.15statutes and rules controlling the removal, preparation, transportation, arrangements for
524.16disposition, and final disposition of a dead human body. This subdivision does not apply to
524.17morticians, funeral directors, funeral establishments, crematories, or wholesale distributors
524.18of caskets, alternate containers, alkaline hydrolysis containers, or cremation containers.

524.19    Sec. 80. Minnesota Statutes 2012, section 149A.72, subdivision 3, is amended to read:
524.20    Subd. 3. Casket for alkaline hydrolysis or cremation provisions; deceptive acts
524.21or practices. In selling or offering to sell funeral goods or funeral services to the public, it
524.22is a deceptive act or practice for a funeral provider to represent that a casket is required for
524.23alkaline hydrolysis or cremations by state or local law or otherwise.

524.24    Sec. 81. Minnesota Statutes 2012, section 149A.72, is amended by adding a
524.25subdivision to read:
524.26    Subd. 3a. Casket for alkaline hydrolysis provision; preventive measures. To
524.27prevent deceptive acts or practices, funeral providers must place the following disclosure
524.28in immediate conjunction with the prices shown for alkaline hydrolysis: "Minnesota
524.29law does not require you to purchase a casket for alkaline hydrolysis. If you want to
524.30arrange for alkaline hydrolysis, you can use an alkaline hydrolysis container. An alkaline
524.31hydrolysis container is a hydrolyzable or biodegradable closed container or pouch resistant
524.32to leakage of bodily fluids that encases the body and into which a dead human body is
524.33placed prior to insertion into an alkaline hydrolysis vessel. The containers we provide
525.1are (specify containers provided)." This disclosure is required only if the funeral provider
525.2arranges alkaline hydrolysis.

525.3    Sec. 82. Minnesota Statutes 2012, section 149A.72, subdivision 9, is amended to read:
525.4    Subd. 9. Deceptive acts or practices. In selling or offering to sell funeral goods,
525.5funeral services, burial site goods, or burial site services to the public, it is a deceptive act
525.6or practice for a funeral provider to represent that federal, state, or local laws, or particular
525.7cemeteries, alkaline hydrolysis facilities, or crematories, require the purchase of any funeral
525.8goods, funeral services, burial site goods, or burial site services when that is not the case.

525.9    Sec. 83. Minnesota Statutes 2012, section 149A.73, subdivision 1, is amended to read:
525.10    Subdivision 1. Casket for alkaline hydrolysis or cremation provisions; deceptive
525.11acts or practices. In selling or offering to sell funeral goods, funeral services, burial site
525.12goods, or burial site services to the public, it is a deceptive act or practice for a funeral
525.13provider to require that a casket be purchased for alkaline hydrolysis or cremation.

525.14    Sec. 84. Minnesota Statutes 2012, section 149A.73, subdivision 2, is amended to read:
525.15    Subd. 2. Casket for alkaline hydrolysis or cremation; preventive requirements.
525.16To prevent unfair or deceptive acts or practices, if funeral providers arrange for alkaline
525.17hydrolysis or cremations, they must make a an alkaline hydrolysis container or cremation
525.18container available for alkaline hydrolysis or cremations.

525.19    Sec. 85. Minnesota Statutes 2012, section 149A.73, subdivision 4, is amended to read:
525.20    Subd. 4. Required purchases of funeral goods or services; preventive
525.21requirements. To prevent unfair or deceptive acts or practices, funeral providers must
525.22place the following disclosure in the general price list, immediately above the prices
525.23required by section 149A.71, subdivision 2, paragraph (e), clauses (4) to (10): "The goods
525.24and services shown below are those we can provide to our customers. You may choose
525.25only the items you desire. If legal or other requirements mean that you must buy any items
525.26you did not specifically ask for, we will explain the reason in writing on the statement we
525.27provide describing the funeral goods, funeral services, burial site goods, and burial site
525.28services you selected." However, if the charge for "services of funeral director and staff"
525.29cannot be declined by the purchaser, the statement shall include the sentence "However,
525.30any funeral arrangements you select will include a charge for our basic services." between
525.31the second and third sentences of the sentences specified in this subdivision. The statement
525.32may include the phrase "and overhead" after the word "services" if the fee includes a
526.1charge for the recovery of unallocated funeral overhead. If the funeral provider does
526.2not include this disclosure statement, then the following disclosure statement must be
526.3placed in the statement of funeral goods, funeral services, burial site goods, and burial site
526.4services selected, as described in section 149A.71, subdivision 2, paragraph (f): "Charges
526.5are only for those items that you selected or that are required. If we are required by law or
526.6by a cemetery, alkaline hydrolysis facility, or crematory to use any items, we will explain
526.7the reasons in writing below." A funeral provider is not in violation of this subdivision by
526.8failing to comply with a request for a combination of goods or services which would be
526.9impossible, impractical, or excessively burdensome to provide.

526.10    Sec. 86. Minnesota Statutes 2012, section 149A.74, is amended to read:
526.11149A.74 FUNERAL SERVICES PROVIDED WITHOUT PRIOR APPROVAL.
526.12    Subdivision 1. Services provided without prior approval; deceptive acts or
526.13practices. In selling or offering to sell funeral goods or funeral services to the public, it
526.14is a deceptive act or practice for any funeral provider to embalm a dead human body
526.15unless state or local law or regulation requires embalming in the particular circumstances
526.16regardless of any funeral choice which might be made, or prior approval for embalming
526.17has been obtained from an individual legally authorized to make such a decision. In
526.18seeking approval to embalm, the funeral provider must disclose that embalming is not
526.19required by law except in certain circumstances; that a fee will be charged if a funeral
526.20is selected which requires embalming, such as a funeral with viewing; and that no
526.21embalming fee will be charged if the family selects a service which does not require
526.22embalming, such as direct alkaline hydrolysis, direct cremation, or immediate burial.
526.23    Subd. 2. Services provided without prior approval; preventive requirement.
526.24To prevent unfair or deceptive acts or practices, funeral providers must include on
526.25the itemized statement of funeral goods or services, as described in section 149A.71,
526.26subdivision 2 , paragraph (f), the statement "If you selected a funeral that may require
526.27embalming, such as a funeral with viewing, you may have to pay for embalming. You do
526.28not have to pay for embalming you did not approve if you selected arrangements such
526.29as direct alkaline hydrolysis, direct cremation, or immediate burial. If we charged for
526.30embalming, we will explain why below."

526.31    Sec. 87. Minnesota Statutes 2012, section 149A.91, subdivision 9, is amended to read:
526.32    Subd. 9. Embalmed Bodies awaiting final disposition. All embalmed bodies
526.33awaiting final disposition shall be kept in an appropriate holding facility or preparation
526.34and embalming room. The holding facility must be secure from access by anyone except
527.1the authorized personnel of the funeral establishment, preserve the dignity and integrity of
527.2the body, and protect the health and safety of the personnel of the funeral establishment.

527.3    Sec. 88. Minnesota Statutes 2012, section 149A.93, subdivision 3, is amended to read:
527.4    Subd. 3. Disposition permit. A disposition permit is required before a body can
527.5be buried, entombed, alkaline hydrolyzed, or cremated. No disposition permit shall be
527.6issued until a fact of death record has been completed and filed with the local or state
527.7registrar of vital statistics.

527.8    Sec. 89. Minnesota Statutes 2012, section 149A.93, subdivision 6, is amended to read:
527.9    Subd. 6. Conveyances permitted for transportation. A dead human body may be
527.10transported by means of private vehicle or private aircraft, provided that the body must be
527.11encased in an appropriate container, that meets the following standards:
527.12    (1) promotes respect for and preserves the dignity of the dead human body;
527.13    (2) shields the body from being viewed from outside of the conveyance;
527.14    (3) has ample enclosed area to accommodate a cot, stretcher, rigid tray, casket,
527.15alternative container, alkaline hydrolysis container, or cremation container in a horizontal
527.16position;
527.17    (4) is designed to permit loading and unloading of the body without excessive tilting
527.18of the cot, stretcher, rigid tray, casket, alternative container, alkaline hydrolysis container,
527.19 or cremation container; and
527.20    (5) if used for the transportation of more than one dead human body at one time,
527.21the vehicle must be designed so that a body or container does not rest directly on top of
527.22another body or container and that each body or container is secured to prevent the body
527.23or container from excessive movement within the conveyance.
527.24    A vehicle that is a dignified conveyance and was specified for use by the deceased
527.25or by the family of the deceased may be used to transport the body to the place of final
527.26disposition.

527.27    Sec. 90. Minnesota Statutes 2012, section 149A.94, is amended to read:
527.28149A.94 FINAL DISPOSITION.
527.29    Subdivision 1. Generally. Every dead human body lying within the state, except
527.30unclaimed bodies delivered for dissection by the medical examiner, those delivered for
527.31anatomical study pursuant to section 149A.81, subdivision 2, or lawfully carried through
527.32the state for the purpose of disposition elsewhere; and the remains of any dead human
527.33body after dissection or anatomical study, shall be decently buried, or entombed in a
528.1public or private cemetery, alkaline hydrolyzed or cremated, within a reasonable time
528.2after death. Where final disposition of a body will not be accomplished within 72 hours
528.3following death or release of the body by a competent authority with jurisdiction over the
528.4body, the body must be properly embalmed, refrigerated, or packed with dry ice. A body
528.5may not be kept in refrigeration for a period exceeding six calendar days, or packed in dry
528.6ice for a period that exceeds four calendar days, from the time of death or release of the
528.7body from the coroner or medical examiner.
528.8    Subd. 3. Permit required. No dead human body shall be buried, entombed, or
528.9cremated without a disposition permit. The disposition permit must be filed with the person
528.10in charge of the place of final disposition. Where a dead human body will be transported out
528.11of this state for final disposition, the body must be accompanied by a certificate of removal.
528.12    Subd. 4. Alkaline hydrolysis or cremation. Inurnment of alkaline hydrolyzed or
528.13cremated remains and release to an appropriate party is considered final disposition and no
528.14further permits or authorizations are required for transportation, interment, entombment, or
528.15placement of the cremated remains, except as provided in section 149A.95, subdivision 16.

528.16    Sec. 91. [149A.941] ALKALINE HYDROLYSIS FACILITIES AND ALKALINE
528.17HYDROLYSIS.
528.18    Subdivision 1. License required. A dead human body may only be hydrolyzed in
528.19this state at an alkaline hydrolysis facility licensed by the commissioner of health.
528.20    Subd. 2. General requirements. Any building to be used as an alkaline hydrolysis
528.21facility must comply with all applicable local and state building codes, zoning laws and
528.22ordinances, wastewater management regulations, and environmental statutes, rules, and
528.23standards. An alkaline hydrolysis facility must have, on site, a purpose built human
528.24alkaline hydrolysis system approved by the commissioner of health, a system approved by
528.25the commissioner of health for drying the hydrolyzed remains, a motorized mechanical
528.26device approved by the commissioner of health for processing hydrolyzed remains and
528.27must have in the building a holding facility approved by the commissioner of health for
528.28the retention of dead human bodies awaiting alkaline hydrolysis. The holding facility
528.29must be secure from access by anyone except the authorized personnel of the alkaline
528.30hydrolysis facility, preserve the dignity of the remains, and protect the health and safety of
528.31the alkaline hydrolysis facility personnel.
528.32    Subd. 3. Lighting and ventilation. The room where the alkaline hydrolysis vessel
528.33is located and the room where the chemical storage takes place shall be properly lit and
528.34ventilated with an exhaust fan that provides at least 12 air changes per hour.
529.1    Subd. 4. Plumbing connections. All plumbing fixtures, water supply lines,
529.2plumbing vents, and waste drains shall be properly vented and connected pursuant to the
529.3Minnesota Plumbing Code. The alkaline hydrolysis facility shall be equipped with a
529.4functional sink with hot and cold running water.
529.5    Subd. 5. Flooring, walls, ceiling, doors, and windows. The room where the
529.6alkaline hydrolysis vessel is located and the room where the chemical storage takes place
529.7shall have nonporous flooring, so that a sanitary condition is provided. The walls and
529.8ceiling of the room where the alkaline hydrolysis vessel is located and the room where
529.9the chemical storage takes place shall run from floor to ceiling and be covered with tile,
529.10or by plaster or sheetrock painted with washable paint or other appropriate material so
529.11that a sanitary condition is provided. The doors, walls, ceiling, and windows shall be
529.12constructed to prevent odors from entering any other part of the building. All windows
529.13or other openings to the outside must be screened and all windows must be treated in a
529.14manner that prevents viewing into the room where the alkaline hydrolysis vessel is located
529.15and the room where the chemical storage takes place. A viewing window for authorized
529.16family members or their designees is not a violation of this subdivision.
529.17    Subd. 6. Equipment and supplies. The alkaline hydrolysis facility must have a
529.18functional emergency eye wash and quick drench shower.
529.19    Subd. 7. Access and privacy. (a) The room where the alkaline hydrolysis vessel is
529.20located and the room where the chemical storage takes place must be private and have no
529.21general passageway through it. The room shall, at all times, be secure from the entrance of
529.22unauthorized persons. Authorized persons are:
529.23(1) licensed morticians;
529.24(2) registered interns or students as described in section 149A.91, subdivision 6;
529.25(3) public officials or representatives in the discharge of their official duties;
529.26(4) trained alkaline hydrolysis facility operators; and
529.27(5) the persons with the right to control the dead human body as defined in section
529.28149A.80, subdivision 2, and their designees.
529.29    (b) Each door allowing ingress or egress shall carry a sign that indicates that the
529.30room is private and access is limited. All authorized persons who are present in or enter
529.31the room where the alkaline hydrolysis vessel is located while a body is being prepared for
529.32final disposition must be attired according to all applicable state and federal regulations
529.33regarding the control of infectious disease and occupational and workplace health and
529.34safety.
529.35    Subd. 8. Sanitary conditions and permitted use. The room where the alkaline
529.36hydrolysis vessel is located and the room where the chemical storage takes place and all
530.1fixtures, equipment, instruments, receptacles, clothing, and other appliances or supplies
530.2stored or used in the room must be maintained in a clean and sanitary condition at all times.
530.3    Subd. 9. Boiler use. When a boiler is required by the manufacturer of the alkaline
530.4hydrolysis vessel for its operation, all state and local regulations for that boiler must be
530.5followed.
530.6    Subd. 10. Occupational and workplace safety. All applicable provisions of state
530.7and federal regulations regarding exposure to workplace hazards and accidents shall be
530.8followed in order to protect the health and safety of all authorized persons at the alkaline
530.9hydrolysis facility.
530.10    Subd. 11. Licensed personnel. A licensed alkaline hydrolysis facility must employ
530.11a licensed mortician to carry out the process of alkaline hydrolysis of a dead human body.
530.12It is the duty of the licensed alkaline hydrolysis facility to provide proper procedures for
530.13all personnel, and the licensed alkaline hydrolysis facility shall be strictly accountable for
530.14compliance with this chapter and other applicable state and federal regulations regarding
530.15occupational and workplace health and safety.
530.16    Subd. 12. Authorization to hydrolyze required. No alkaline hydrolysis facility
530.17shall hydrolyze or cause to be hydrolyzed any dead human body or identifiable body part
530.18without receiving written authorization to do so from the person or persons who have the
530.19legal right to control disposition as described in section 149A.80 or the person's legal
530.20designee. The written authorization must include:
530.21(1) the name of the deceased and the date of death of the deceased;
530.22(2) a statement authorizing the alkaline hydrolysis facility to hydrolyze the body;
530.23(3) the name, address, telephone number, relationship to the deceased, and signature
530.24of the person or persons with legal right to control final disposition or a legal designee;
530.25(4) directions for the disposition of any nonhydrolyzed materials or items recovered
530.26from the alkaline hydrolysis vessel;
530.27(5) acknowledgment that the hydrolyzed remains will be dried and mechanically
530.28reduced to a granulated appearance and placed in an appropriate container and
530.29authorization to place any hydrolyzed remains that a selected urn or container will not
530.30accommodate into a temporary container;
530.31(6) acknowledgment that, even with the exercise of reasonable care, it is not possible
530.32to recover all particles of the hydrolyzed remains and that some particles may inadvertently
530.33become commingled with particles of other hydrolyzed remains that remain in the alkaline
530.34hydrolysis vessel or other mechanical devices used to process the hydrolyzed remains;
530.35(7) directions for the ultimate disposition of the hydrolyzed remains; and
531.1(8) a statement that includes, but is not limited to, the following information:
531.2"During the alkaline hydrolysis process, chemical dissolution using heat, water, and an
531.3alkaline solution is used to chemically break down the human tissue and the hydrolyzable
531.4alkaline hydrolysis container. After the process is complete, the liquid effluent solution
531.5contains the chemical by-products of the alkaline hydrolysis process except for the
531.6deceased's bone fragments. The solution is cooled and released according to local
531.7environmental regulations. A water rinse is applied to the hydrolyzed remains which are
531.8then dried and processed to facilitate inurnment or scattering."
531.9    Subd. 13. Limitation of liability. A licensed alkaline hydrolysis facility acting in
531.10good faith, with reasonable reliance upon an authorization to hydrolyze, pursuant to an
531.11authorization to hydrolyze and in an otherwise lawful manner, shall be held harmless from
531.12civil liability and criminal prosecution for any actions taken by the alkaline hydrolysis
531.13facility.
531.14    Subd. 14. Acceptance of delivery of body. (a) No dead human body shall be
531.15accepted for final disposition by alkaline hydrolysis unless:
531.16(1) encased in an appropriate alkaline hydrolysis container;
531.17(2) accompanied by a disposition permit issued pursuant to section 149A.93,
531.18subdivision 3, including a photocopy of the completed death record or a signed release
531.19authorizing alkaline hydrolysis of the body received from the coroner or medical
531.20examiner; and
531.21(3) accompanied by an alkaline hydrolysis authorization that complies with
531.22subdivision 12.
531.23    (b) An alkaline hydrolysis facility shall refuse to accept delivery of an alkaline
531.24hydrolysis container where there is:
531.25(1) evidence of leakage of fluids from the alkaline hydrolysis container;
531.26(2) a known dispute concerning hydrolysis of the body delivered;
531.27(3) a reasonable basis for questioning any of the representations made on the written
531.28authorization to hydrolyze; or
531.29(4) any other lawful reason.
531.30    Subd. 15. Bodies awaiting hydrolysis. A dead human body must be hydrolyzed
531.31within 24 hours of the alkaline hydrolysis facility accepting legal and physical custody of
531.32the body.
531.33    Subd. 16. Handling of alkaline hydrolysis containers for dead human bodies.
531.34All alkaline hydrolysis facility employees handling alkaline hydrolysis containers for
531.35dead human bodies shall use universal precautions and otherwise exercise all reasonable
532.1precautions to minimize the risk of transmitting any communicable disease from the body.
532.2No dead human body shall be removed from the container in which it is delivered.
532.3    Subd. 17. Identification of body. All licensed alkaline hydrolysis facilities shall
532.4develop, implement, and maintain an identification procedure whereby dead human
532.5bodes can be identified from the time the alkaline hydrolysis facility accepts delivery
532.6of the remains until the hydrolyzed remains are released to an authorized party. After
532.7hydrolyzation, an identifying disk, tab, or other permanent label shall be placed within the
532.8hydrolyzed remains container before the hydrolyzed remains are released from the alkaline
532.9hydrolysis facility. Each identification disk, tab, or label shall have a number that shall
532.10be recorded on all paperwork regarding the decedent. This procedure shall be designed
532.11to reasonably ensure that the proper body is hydrolyzed and that the hydrolyzed remains
532.12are returned to the appropriate party. Loss of all or part of the hydrolyzed remains or the
532.13inability to individually identify the hydrolyzed remains is a violation of this subdivision.
532.14    Subd. 18. Alkaline hydrolysis vessel for human remains. A licensed alkaline
532.15hydrolysis facility shall knowingly hydrolyze only dead human bodies or human remains
532.16in an alkaline hydrolysis vessel, along with the alkaline hydrolysis container used for
532.17infectious disease control.
532.18    Subd. 19. Alkaline hydrolysis procedures; privacy. The final disposition of
532.19dead human bodies by alkaline hydrolysis shall be done in privacy. Unless there is
532.20written authorization from the person with the legal right to control the disposition,
532.21only authorized alkaline hydrolysis facility personnel shall be permitted in the alkaline
532.22hydrolysis area while any dead human body is in the alkaline hydrolysis area awaiting
532.23alkaline hydrolysis, in the alkaline hydrolysis vessel, being removed from the alkaline
532.24hydrolysis vessel, or being processed and placed in a hydrolyzed remains container.
532.25    Subd. 20. Alkaline hydrolysis procedures; commingling of hydrolyzed remains
532.26prohibited. Except with the express written permission of the person with the legal right
532.27to control the disposition, no alkaline hydrolysis facility shall hydrolyze more than one
532.28dead human body at the same time and in the same alkaline hydrolysis vessel, or introduce
532.29a second dead human body into an alkaline hydrolysis vessel until reasonable efforts have
532.30been employed to remove all fragments of the preceding hydrolyzed remains, or hydrolyze
532.31a dead human body and other human remains at the same time and in the same alkaline
532.32hydrolysis vessel. This section does not apply where commingling of human remains
532.33during alkaline hydrolysis is otherwise provided by law. The fact that there is incidental
532.34and unavoidable residue in the alkaline hydrolysis vessel used in a prior hydrolyzation is
532.35not a violation of this subdivision.
533.1    Subd. 21. Alkaline hydrolysis procedures; removal from alkaline hydrolysis
533.2vessel. Upon completion of the alkaline hydrolysis process, reasonable efforts shall be
533.3made to remove from the alkaline hydrolysis vessel all of the recoverable hydrolyzed
533.4remains and nonhydrolyzed materials or items. Further, all reasonable efforts shall be
533.5made to separate and recover the nonhydrolyzed materials or items from the hydrolyzed
533.6human remains and dispose of these materials in a lawful manner, by the alkaline
533.7hydrolysis facility. The hydrolyzed human remains shall be placed in an appropriate
533.8container to be transported to the processing area.
533.9    Subd. 22. Drying device or mechanical processor procedures; commingling of
533.10hydrolyzed remains prohibited. Except with the express written permission of the
533.11person with the legal right to control the final disposition or otherwise provided by
533.12law, no alkaline hydrolysis facility shall dry or mechanically process the hydrolyzed
533.13human remains of more than one body at a time in the same drying device or mechanical
533.14processor, or introduce the hydrolyzed human remains of a second body into a drying
533.15device or mechanical processor until processing of any preceding hydrolyzed human
533.16remains has been terminated and reasonable efforts have been employed to remove all
533.17fragments of the preceding hydrolyzed remains. The fact that there is incidental and
533.18unavoidable residue in the drying device, the mechanical processor, or any container used
533.19in a prior alkaline hydrolysis process, is not a violation of this provision.
533.20    Subd. 23. Alkaline hydrolysis procedures; processing hydrolyzed remains. The
533.21hydrolyzed human remains shall be dried and then reduced by a motorized mechanical
533.22device to a granulated appearance appropriate for final disposition and placed in an
533.23alkaline hydrolysis remains container along with the appropriate identifying disk, tab,
533.24or permanent label. Processing must take place within the licensed alkaline hydrolysis
533.25facility. Dental gold, silver or amalgam, jewelry, or mementos, to the extent that they
533.26can be identified, may be removed prior to processing the hydrolyzed remains, only by
533.27staff licensed or registered by the commissioner of health; however, any dental gold and
533.28silver, jewelry, or mementos that are removed shall be returned to the hydrolyzed remains
533.29container unless otherwise directed by the person or persons having the right to control the
533.30final disposition. Every person who removes or possesses dental gold or silver, jewelry,
533.31or mementos from any hydrolyzed remains without specific written permission of the
533.32person or persons having the right to control those remains is guilty of a misdemeanor.
533.33The fact that residue and any unavoidable dental gold or dental silver, or other precious
533.34metals remain in the alkaline hydrolysis vessel or other equipment or any container used
533.35in a prior hydrolysis is not a violation of this section.
534.1    Subd. 24. Alkaline hydrolysis procedures; container of insufficient capacity.
534.2If a hydrolyzed remains container is of insufficient capacity to accommodate all
534.3hydrolyzed remains of a given dead human body, subject to directives provided in the
534.4written authorization to hydrolyze, the alkaline hydrolysis facility shall place the excess
534.5hydrolyzed remains in a secondary alkaline hydrolysis remains container and attach the
534.6second container, in a manner so as not to be easily detached through incidental contact, to
534.7the primary alkaline hydrolysis remains container. The secondary container shall contain a
534.8duplicate of the identification disk, tab, or permanent label that was placed in the primary
534.9container and all paperwork regarding the given body shall include a notation that the
534.10hydrolyzed remains were placed in two containers. Keepsake jewelry or similar miniature
534.11hydrolyzed remains containers are not subject to the requirements of this subdivision.
534.12    Subd. 25. Disposition procedures; commingling of hydrolyzed remains
534.13prohibited. No hydrolyzed remains shall be disposed of or scattered in a manner or in
534.14a location where the hydrolyzed remains are commingled with those of another person
534.15without the express written permission of the person with the legal right to control
534.16disposition or as otherwise provided by law. This subdivision does not apply to the
534.17scattering or burial of hydrolyzed remains at sea or in a body of water from individual
534.18containers, to the scattering or burial of hydrolyzed remains in a dedicated cemetery, to
534.19the disposal in a dedicated cemetery of accumulated residue removed from an alkaline
534.20hydrolysis vessel or other alkaline hydrolysis equipment, to the inurnment of members
534.21of the same family in a common container designed for the hydrolyzed remains of more
534.22than one body, or to the inurnment in a container or interment in a space that has been
534.23previously designated, at the time of sale or purchase, as being intended for the inurnment
534.24or interment of the hydrolyzed remains of more than one person.
534.25    Subd. 26. Alkaline hydrolysis procedures; disposition of accumulated residue.
534.26Every alkaline hydrolysis facility shall provide for the removal and disposition in a
534.27dedicated cemetery of any accumulated residue from any alkaline hydrolysis vessel,
534.28drying device, mechanical processor, container, or other equipment used in alkaline
534.29hydrolysis. Disposition of accumulated residue shall be according to the regulations of the
534.30dedicated cemetery and any applicable local ordinances.
534.31    Subd. 27. Alkaline hydrolysis procedures; release of hydrolyzed remains.
534.32Following completion of the hydrolyzation, the inurned hydrolyzed remains shall be
534.33released according to the instructions given on the written authorization to hydrolyze. If
534.34the hydrolyzed remains are to be shipped, they must be securely packaged and transported
534.35by a method which has an internal tracing system available and which provides for a
534.36receipt signed by the person accepting delivery. Where there is a dispute over release
535.1or disposition of the hydrolyzed remains, an alkaline hydrolysis facility may deposit
535.2the hydrolyzed remains with a court of competent jurisdiction pending resolution of the
535.3dispute or retain the hydrolyzed remains until the person with the legal right to control
535.4disposition presents satisfactory indication that the dispute is resolved.
535.5    Subd. 28. Unclaimed hydrolyzed remains. If, after 30 calendar days following
535.6the inurnment, the hydrolyzed remains are not claimed or disposed of according to the
535.7written authorization to hydrolyze, the alkaline hydrolysis facility or funeral establishment
535.8may give written notice, by certified mail, to the person with the legal right to control
535.9the final disposition or a legal designee, that the hydrolyzed remains are unclaimed and
535.10requesting further release directions. Should the hydrolyzed remains be unclaimed 120
535.11calendar days following the mailing of the written notification, the alkaline hydrolysis
535.12facility or funeral establishment may dispose of the hydrolyzed remains in any lawful
535.13manner deemed appropriate.
535.14    Subd. 29. Required records. Every alkaline hydrolysis facility shall create and
535.15maintain on its premises or other business location in Minnesota an accurate record of
535.16every hydrolyzation provided. The record shall include all of the following information
535.17for each hydrolyzation:
535.18(1) the name of the person or funeral establishment delivering the body for alkaline
535.19hydrolysis;
535.20(2) the name of the deceased and the identification number assigned to the body;
535.21(3) the date of acceptance of delivery;
535.22(4) the names of the alkaline hydrolysis vessel, drying device, and mechanical
535.23processor operator;
535.24(5) the time and date that the body was placed in and removed from the alkaline
535.25hydrolysis vessel;
535.26(6) the time and date that processing and inurnment of the hydrolyzed remains
535.27was completed;
535.28(7) the time, date, and manner of release of the hydrolyzed remains;
535.29(8) the name and address of the person who signed the authorization to hydrolyze;
535.30(9) all supporting documentation, including any transit or disposition permits, a
535.31photocopy of the death record, and the authorization to hydrolyze; and
535.32(10) the type of alkaline hydrolysis container.
535.33    Subd. 30. Retention of records. Records required under subdivision 29 shall be
535.34maintained for a period of three calendar years after the release of the hydrolyzed remains.
535.35Following this period and subject to any other laws requiring retention of records, the
535.36alkaline hydrolysis facility may then place the records in storage or reduce them to
536.1microfilm, microfiche, laser disc, or any other method that can produce an accurate
536.2reproduction of the original record, for retention for a period of ten calendar years from
536.3the date of release of the hydrolyzed remains. At the end of this period and subject to any
536.4other laws requiring retention of records, the alkaline hydrolysis facility may destroy
536.5the records by shredding, incineration, or any other manner that protects the privacy of
536.6the individuals identified.

536.7    Sec. 92. Minnesota Statutes 2012, section 149A.96, subdivision 9, is amended to read:
536.8    Subd. 9. Hydrolyzed and cremated remains. Subject to section 149A.95,
536.9subdivision 16 , inurnment of the hydrolyzed or cremated remains and release to an
536.10appropriate party is considered final disposition and no further permits or authorizations
536.11are required for disinterment, transportation, or placement of the hydrolyzed or cremated
536.12remains.

536.13    Sec. 93. Minnesota Statutes 2012, section 257.75, subdivision 7, is amended to read:
536.14    Subd. 7. Hospital and Department of Health; recognition form. Hospitals that
536.15provide obstetric services and the state registrar of vital statistics shall distribute the
536.16educational materials and recognition of parentage forms prepared by the commissioner of
536.17human services to new parents, shall assist parents in understanding the recognition of
536.18parentage form, including following the provisions for notice under subdivision 5, shall
536.19provide notary services for parents who complete the recognition of parentage form, and
536.20shall timely file the completed recognition of parentage form with the Office of the State
536.21Registrar of Vital Statistics Records unless otherwise instructed by the Office of the State
536.22Registrar of Vital Statistics Records. On and after January 1, 1994, hospitals may not
536.23distribute the declaration of parentage forms.

536.24    Sec. 94. Minnesota Statutes 2012, section 260C.635, subdivision 1, is amended to read:
536.25    Subdivision 1. Legal effect. (a) Upon adoption, the adopted child becomes the legal
536.26child of the adopting parent and the adopting parent becomes the legal parent of the child
536.27with all the rights and duties between them of a birth parent and child.
536.28(b) The child shall inherit from the adoptive parent and the adoptive parent's
536.29relatives the same as though the child were the birth child of the parent, and in case of the
536.30child's death intestate, the adoptive parent and the adoptive parent's relatives shall inherit
536.31the child's estate as if the child had been the adoptive parent's birth child.
536.32(c) After a decree of adoption is entered, the birth parents or previous legal parents
536.33of the child shall be relieved of all parental responsibilities for the child except child
537.1support that has accrued to the date of the order for guardianship to the commissioner
537.2which continues to be due and owing. The child's birth or previous legal parent shall not
537.3exercise or have any rights over the adopted child or the adopted child's property, person,
537.4privacy, or reputation.
537.5(d) The adopted child shall not owe the birth parents or the birth parent's relatives
537.6any legal duty nor shall the adopted child inherit from the birth parents or kindred unless
537.7otherwise provided for in a will of the birth parent or kindred.
537.8    (e) Upon adoption, the court shall complete a certificate of adoption form and mail
537.9the form to the Office of the State Registrar Vital Records at the Minnesota Department
537.10of Health. Upon receiving the certificate of adoption, the state registrar shall register a
537.11replacement vital record in the new name of the adopted child as required under section
537.12144.218 .

537.13    Sec. 95. Minnesota Statutes 2012, section 517.001, is amended to read:
537.14517.001 DEFINITION.
537.15As used in this chapter, "local registrar" has the meaning given in section 144.212,
537.16subdivision 10 means an individual designated by the county board of commissioners to
537.17register marriages.

537.18    Sec. 96. FUNERAL ESTABLISHMENTS; BRANCH LOCATIONS.
537.19    The commissioner of health shall review the statutory requirements for preparation
537.20and embalming rooms and develop legislation with input from stakeholders that provides
537.21appropriate health and safety protection for funeral home locations where deceased bodies
537.22are present, but are branch locations associated through a majority ownership of a licensed
537.23funeral establishment that meets the requirements of Minnesota Statutes, sections 149A.50
537.24and 149A.92, subdivisions 2 to 10. The review shall include consideration of distance
537.25between the main location and branch, and other health and safety issues.

537.26    Sec. 97. REVISOR'S INSTRUCTION.
537.27The revisor shall substitute the term "vertical heat exchangers" or "vertical
537.28heat exchanger" with "bored geothermal heat exchangers" or "bored geothermal heat
537.29exchanger" wherever it appears in Minnesota Statutes, sections 103I.005, subdivisions
537.302 and 12; 103I.101, subdivisions 2 and 5; 103I.105; 103I.205, subdivision 4; 103I.208,
537.31subdivision 2; 103I.501; 103I.531, subdivision 5; and 103I.641, subdivisions 1, 2, and 3.

537.32    Sec. 98. REPEALER.
538.1(a) Minnesota Statutes 2012, sections 62J.693; 103I.005, subdivision 20; 149A.025;
538.2149A.20, subdivision 8; 149A.30, subdivision 2; 149A.40, subdivision 8; 149A.45,
538.3subdivision 6; 149A.50, subdivision 6; 149A.51, subdivision 7; 149A.52, subdivision 5a;
538.4149A.53, subdivision 9; and 485.14, are repealed.
538.5(b) Minnesota Statutes 2012, section 144.123, subdivision 2, is repealed effective
538.6July 1, 2014.

538.7ARTICLE 13

538.8PAYMENT METHODOLOGIES FOR HOME AND
538.9COMMUNITY-BASED SERVICES

538.10    Section 1. Minnesota Statutes 2012, section 256B.4912, subdivision 2, is amended to
538.11read:
538.12    Subd. 2. Payment methodologies. (a) The commissioner shall establish, as defined
538.13under section 256B.4914, statewide payment methodologies that meet federal waiver
538.14requirements for home and community-based waiver services for individuals with
538.15disabilities. The payment methodologies must abide by the principles of transparency
538.16and equitability across the state. The methodologies must involve a uniform process of
538.17structuring rates for each service and must promote quality and participant choice.
538.18    (b) As of January 1, 2012, counties shall not implement changes to established
538.19processes for rate-setting methodologies for individuals using components of or data
538.20from research rates.

538.21    Sec. 2. Minnesota Statutes 2012, section 256B.4912, subdivision 3, is amended to read:
538.22    Subd. 3. Payment requirements. The payment methodologies established under
538.23this section shall accommodate:
538.24(1) supervision costs;
538.25(2) staffing patterns staff compensation;
538.26(3) staffing and supervisory patterns;
538.27(3) (4) program-related expenses;
538.28(4) (5) general and administrative expenses; and
538.29(5) (6) consideration of recipient intensity.

538.30    Sec. 3. Minnesota Statutes 2012, section 256B.4913, is amended by adding a
538.31subdivision to read:
538.32    Subd. 4a. Rate stabilization adjustment. (a) The commissioner of human services
538.33shall adjust individual reimbursement rates by no more than 1.0 percent per year effective
539.1January 1, 2016. Rates determined under section 256B.4914 must be adjusted so that
539.2the unit rate varies no more than 1.0 percent per year from the rate effective December
539.31 of the prior calendar year. This adjustment is made annually for three calendar years
539.4from the date of implementation.
539.5(b) Rate stabilization adjustment applies to services that are authorized in a
539.6recipient's service plan prior to January 1, 2016.
539.7(c) Exemptions shall be made only when there is a significant change in the
539.8recipient's assessed needs that results in a service authorization change. Exemption
539.9adjustments shall be limited to the difference in the authorized framework rate specific to
539.10change in assessed need. Exemptions shall be managed within lead agencies' budgets per
539.11existing allocation procedures.
539.12(d) This subdivision expires January 1, 2019.

539.13    Sec. 4. Minnesota Statutes 2012, section 256B.4913, subdivision 5, is amended to read:
539.14    Subd. 5. Stakeholder consultation. The commissioner shall continue consultation
539.15on regular intervals with the existing stakeholder group established as part of the
539.16rate-setting methodology process and others, to gather input, concerns, and data, and
539.17exchange ideas for the legislative proposals for to assist in the full implementation of
539.18 the new rate payment system and to make pertinent information available to the public
539.19through the department's Web site.

539.20    Sec. 5. Minnesota Statutes 2012, section 256B.4913, subdivision 6, is amended to read:
539.21    Subd. 6. Implementation. (a) The commissioner may shall implement changes
539.22no sooner than on January 1, 2014, to payment rates for individuals receiving home and
539.23community-based waivered services after the enactment of legislation that establishes
539.24specific payment methodology frameworks, processes for rate calculations, and specific
539.25values to populate the payment methodology frameworks disability waiver rates system.
539.26(b) On January 1, 2014, all new service authorizations must use the disability waiver
539.27rates system. Beginning January 1, 2014, all renewing individual service plans must use the
539.28disability waiver rates system as reassessment and reauthorization occurs. By December
539.2931, 2014, data for all recipients must be entered into the disability waiver rates system.

539.30    Sec. 6. [256B.4914] HOME AND COMMUNITY-BASED SERVICES WAIVERS;
539.31RATE SETTING.
540.1    Subdivision 1. Application. The payment methodologies in this section apply to
540.2home and community-based services waivers under sections 256B.092 and 256B.49. This
540.3section does not change existing waiver policies and procedures.
540.4    Subd. 2. Definitions. (a) For purposes of this section, the following terms have the
540.5meanings given them, unless the context clearly indicates otherwise.
540.6(b) "Commissioner" means the commissioner of human services.
540.7(c) "Component value" means underlying factors that are part of the cost of providing
540.8services that are built into the waiver rates methodology to calculate service rates.
540.9(d) "Customized living tool" means a methodology for setting service rates that
540.10delineates and documents the amount of each component service included in a recipient's
540.11customized living service plan.
540.12(e) "Disability waiver rates system" means a statewide system that establishes rates
540.13that are based on uniform processes and captures the individualized nature of waiver
540.14services and recipient needs.
540.15(f) "Lead agency" means a county, partnership of counties, or tribal agency charged
540.16with administering waivered services under sections 256B.092 and 256B.49.
540.17(g) "Median" means the amount that divides distribution into two equal groups,
540.18one-half above the median and one-half below the median.
540.19(h) "Payment or rate" means reimbursement to an eligible provider for services
540.20provided to a qualified individual based on an approved service authorization.
540.21(i) "Rates management system" means a Web-based software application that uses
540.22a framework and component values, as determined by the commissioner, to establish
540.23service rates.
540.24(j) "Recipient" means a person receiving home and community-based services
540.25funded under any of the disability waivers.
540.26    Subd. 3. Applicable services. Applicable services are those authorized under
540.27the state's home and community-based services waivers under sections 256B.092 and
540.28256B.49, including the following, as defined in the federally approved home and
540.29community-based services plan:
540.30(1) 24 hour customized living;
540.31(2) adult day care;
540.32(3) adult day care bath;
540.33(4) behavioral programming;
540.34(5) companion services;
540.35(6) customized living;
540.36(7) day training and habilitation;
541.1(8) housing access coordination;
541.2(9) independent living skills;
541.3(10) in-home family support;
541.4(11) night supervision;
541.5(12) personal support;
541.6(13) prevocational services;
541.7(14) residential care services;
541.8(15) residential support services;
541.9(16) respite services;
541.10(17) structured day services;
541.11(18) supported employment services;
541.12(19) supported living services;
541.13(20) transportation services; and
541.14(21) other services as approved by the federal government in the state home and
541.15community-based services plan.
541.16    Subd. 4. Data collection for rate determination. (a) Rates for all applicable home
541.17and community-based waivered services, including rate exceptions under subdivision 12,
541.18are set via the rates management system.
541.19(b) Only data and information in the rates management system may be used to
541.20calculate an individual's rate.
541.21(c) Service providers, with information from the community support plan, shall enter
541.22values and information needed to calculate an individual's rate into the rates management
541.23system. These values and information include:
541.24(1) shared staffing hours;
541.25(2) individual staffing hours;
541.26(3) staffing ratios;
541.27(4) information to document variable levels of service qualification for variable
541.28levels of reimbursement in each framework;
541.29(5) shared or individualized arrangements for unit-based services, including the
541.30staffing ratio; and
541.31(6) number of trips and miles for transportation services.
541.32(d) Updates to individual data shall include:
541.33(1) data for each individual that is updated annually when renewing service plans; and
541.34(2) requests by individuals or lead agencies to update a rate whenever there is a
541.35change in an individual's service needs, with accompanying documentation.
542.1(e) Lead agencies shall review and approve values to calculate the final payment rate
542.2for each individual. Lead agencies must notify the individual and the service provider
542.3of the final agreed-upon values and rate. If a value used was mistakenly or erroneously
542.4entered and used to calculate a rate, a provider may petition lead agencies to correct it.
542.5Lead agencies must respond to these requests.
542.6    Subd. 5. Base wage index and standard component values. (a) The base wage
542.7index is established to determine staffing costs associated with providing services to
542.8individuals receiving home and community-based services. For purposes of developing
542.9and calculating the proposed base wage, Minnesota-specific wages taken from job
542.10descriptions and standard occupational classification (SOC) codes from the Bureau of
542.11Labor Statistics as defined in the most recent edition of the Occupational Handbook shall
542.12be used. The base wage index shall be calculated as follows:
542.13(1) for residential direct-care basic staff, 50 percent of the median wage for personal
542.14and home health aide (SOC code 39-9021); 30 percent of the median wage for nursing
542.15aide (SOC code 31-1012); and 20 percent of the median wage for social and human
542.16services aide (SOC code 21-1093);
542.17(2) for residential direct-care intensive staff, 20 percent of the median wage for home
542.18health aide (SOC code 31-1011); 20 percent of the median wage for personal and home
542.19health aide (SOC code 39-9021); 20 percent of the median wage for nursing aide (SOC code
542.2021-1012); 20 percent of the median wage for psychiatric technician (SOC code 29-2053);
542.21and 20 percent of the median wage for social and human services aide (SOC code 21-1093);
542.22(3) for day services, 20 percent of the median wage for nursing aide (SOC code
542.2331-1012); 20 percent of the median wage for psychiatric technician (SOC code 29-2053);
542.24and 60 percent of the median wage for social and human services code (SOC code 21-1093);
542.25(4) for residential asleep-overnight staff, the wage will be $7.66 per hour, except in
542.26a family foster care setting, the wage is $2.80 per hour;
542.27(5) for behavior program analyst staff, 100 percent of the median wage for mental
542.28health counselors (SOC code 21-1014);
542.29(6) for behavior program professional staff, 100 percent of the median wage for
542.30clinical counseling and school psychologist (SOC code 19-3031);
542.31(7) for behavior program specialist staff, 100 percent of the median wage for
542.32psychiatric technicians (SOC code 29-2053);
542.33(8) for supportive living services staff, 20 percent of the median wage for nursing
542.34aide (SOC code 31-1012); 20 percent of the median wage for psychiatric technician (SOC
542.35code 29-2053); and 60 percent of the median wage for social and human services aide
542.36(SOC code 21-1093);
543.1(9) for housing access coordination staff, 50 percent of the median wage for
543.2community and social services specialist (SOC code 21-1099); and 50 percent of the
543.3median wage for social and human services aide (SOC code 21-1093);
543.4(10) for in-home family support staff, 20 percent of the median wage for nursing
543.5aide (SOC code 31-1012); 30 percent of community social service specialist (SOC code
543.621-1099); 40 percent of the median wage for social and human services aide (SOC code
543.721-1093); and ten percent of the median wage for psychiatric technician (SOC code
543.829-2053);
543.9(11) for independent living skills staff, 40 percent of the median wage for community
543.10social service specialist (SOC code 21-1099); 50 percent of the median wage for social
543.11and human services aide (SOC code 21-1093); and ten percent of the median wage for
543.12psychiatric technician (SOC code 29-2053);
543.13(12) for supported employment staff, 20 percent of the median wage for nursing aide
543.14(SOC code 31-1012); 20 percent of the median wage for psychiatric technician (SOC
543.15code 29-2053); and 60 percent of the median wage for social and human services aide
543.16(SOC code 21-1093);
543.17(13) for adult companion staff, 50 percent of the median wage for personal and home
543.18care aide (SOC code 39-9021); and 50 percent of the median wage for nursing aides,
543.19orderlies, and attendants (SOC code 31-1012);
543.20(14) for night supervision staff, 20 percent of the median wage for home health aide
543.21(SOC code 31-1011); 20 percent of the median wage for personal and home health aide
543.22(SOC code 39-9021); 20 percent of the median wage for nursing aide (SOC code 31-1012);
543.2320 percent of the median wage for psychiatric technician (SOC code 29-2053); and 20
543.24percent of the median wage for social and human services aide (SOC code 21-1093);
543.25(15) for respite staff, 50 percent of the median wage for personal and home care aide
543.26(SOC code 39-9021); and 50 percent of the median wage for nursing aides, orderlies, and
543.27attendants (SOC code 31-1012);
543.28(16) for personal support staff, 50 percent of the median wage for personal and home
543.29care aide (SOC code 39-9021); and 50 percent of the median wage for nursing aides,
543.30orderlies, and attendants (SOC code 31-1012); and
543.31(17) for supervisory staff, the basic wage is $17.43 per hour with exception of the
543.32supervisor of behavior analyst and behavior specialists, which shall be $30.75 per hour.
543.33(b) Component values for residential support services, excluding family foster
543.34care, are:
543.35(1) supervisory span of control ratio: 11 percent;
543.36(2) employee vacation, sick, and training allowance ratio: 8.71 percent;
544.1(3) employee-related cost ratio: 23.6 percent;
544.2(4) general administrative support ratio: 13.25 percent;
544.3(5) program-related expense ratio: 1.3 percent; and
544.4(6) absence and utilization factor ratio: 3.9 percent.
544.5(c) Component values for family foster care are:
544.6(1) supervisory span of control ratio: 11 percent;
544.7(2) employee vacation, sick, and training allowance ratio: 8.71 percent;
544.8(3) employee-related cost ratio: 23.6 percent;
544.9(4) general administrative support ratio: 3.3 percent; and
544.10(5) program-related expense ratio: 1.3 percent.
544.11(d) Component values for day services for all services are:
544.12(1) supervisory span of control ratio: 11 percent;
544.13(2) employee vacation, sick, and training allowance ratio: 8.71 percent;
544.14(3) employee-related cost ratio: 23.6 percent;
544.15(4) program plan support ratio: 5.6 percent;
544.16(5) client programming and support ratio: ten percent;
544.17(6) general administrative support ratio: 13.25 percent;
544.18(7) program-related expense ratio: 1.8 percent; and
544.19(8) absence and utilization factor ratio: 3.9 percent.
544.20(e) Component values for unit-based with program services are:
544.21(1) supervisory span of control ratio: 11 percent;
544.22(2) employee vacation, sick, and training allowance ratio: 8.71 percent;
544.23(3) employee-related cost ratio: 23.6 percent;
544.24(4) program plan supports ratio: 3.1 percent;
544.25(5) client programming and supports ratio: 8.6 percent;
544.26(6) general administrative support ratio: 13.25 percent;
544.27(7) program-related expense ratio: 6.1 percent; and
544.28(8) absence and utilization factor ratio: 3.9 percent.
544.29(f) Component values for unit-based services without programming except respite
544.30are:
544.31(1) supervisory span of control ratio: 11 percent;
544.32(2) employee vacation, sick, and training allowance ratio: 8.71 percent;
544.33(3) employee-related cost ratio: 23.6 percent;
544.34(4) program plan support ratio: 3.1 percent;
544.35(5) client programming and support ratio: 8.6 percent;
544.36(6) general administrative support ratio: 13.25 percent;
545.1(7) program-related expense ratio: 6.1 percent; and
545.2(8) absence and utilization factor ratio: 3.9 percent.
545.3(g) Component values for unit-based services without programming for respite are:
545.4(1) supervisory span of control ratio: 11 percent;
545.5(2) employee vacation, sick, and training allowance ratio: 8.71 percent;
545.6(3) employee-related cost ratio: 23.6 percent;
545.7(4) general administrative support ratio: 13.25 percent;
545.8(5) program-related expense ratio: 6.1 percent; and
545.9(6) absence and utilization factor ratio: 3.9 percent.
545.10(h) On July 1, 2017, the commissioner shall update the base wage index in paragraph
545.11(b) based on the wage data by standard occupational code (SOC) from the Bureau of
545.12Labor Statistics available on December 31, 2016. The commissioner shall publish these
545.13updated values and load them into the rate management system. This adjustment occurs
545.14every five years. For adjustments in 2021 and beyond, the commissioner shall use the data
545.15available on December 31 of the calendar year five years prior.
545.16(i) On July 1, 2017, the commissioner shall update the framework components in
545.17paragraph (c) for changes in the Consumer Price Index. The commissioner will adjust
545.18these values higher or lower by the percentage change in the Consumer Price Index-All
545.19Items, United States city average (CPI-U) from January 1, 2014, to January 1, 2017. The
545.20commissioner shall publish these updated values and load them into the rate management
545.21system. This adjustment occurs every five years. For adjustments in 2021 and beyond, the
545.22commissioner shall use the data available on January 1 of the calendar year four years
545.23prior and January 1 of the current calendar year.
545.24    Subd. 6. Payments for residential support services. (a) Payments for residential
545.25support services, as defined in sections 256B.092, subdivision 11, and 256B.49,
545.26subdivision 22, must be calculated as follows:
545.27(1) determine the number of units of service to meet a recipient's needs;
545.28(2) personnel hourly wage rate must be based on the 2009 Bureau of Labor Statistics
545.29national and Minnesota-specific rates or rates derived by the commissioner as provided
545.30in subdivision 5. This is defined as the direct-care rate;
545.31(3) for a recipient requiring customization for deaf and hard-of-hearing language
545.32accessibility under subdivision 12, add the customization rate provided in subdivision 12
545.33to the result of clause (2). This is defined as the customized direct-care rate;
545.34(4) multiply the number of residential services direct staff hours by the appropriate
545.35staff wage in subdivision 5, paragraph (a), or the customized direct-care rate;
546.1(5) multiply the number of direct staff hours by the product of the supervision span
546.2of control ratio in subdivision 5, paragraph (b), clause (1), and the appropriate supervision
546.3wage in subdivision 5, paragraph (a), clause (17);
546.4(6) combine the results of clauses (4) and (5), and multiply the result by one plus
546.5the employee vacation, sick, and training allowance ratio in subdivision 5, paragraph (b),
546.6clause (2). This is defined as the direct staffing cost;
546.7(7) for employee-related expenses, multiply the direct staffing cost by one plus the
546.8employee-related cost ratio in subdivision 5, paragraph (b), clause (3);
546.9(8) for client programming and supports, the commissioner shall add $2,179; and
546.10(9) for transportation, if provided, the commissioner shall add $1,680, or $3,000 if
546.11customized for adapted transport, per year.
546.12(b) The total rate shall be calculated using the following steps:
546.13(1) subtotal paragraph (a), clauses (7) to (9);
546.14(2) sum the standard general and administrative rate, the program-related expense
546.15ratio, and the absence and utilization ratio; and
546.16(3) divide the result of clause (1) by one minus the result of clause (2). This is
546.17the total payment amount.
546.18    Subd. 7. Payments for day programs. Payments for services with day programs
546.19including adult day care, day treatment and habilitation, prevocational services, and
546.20structured day services must be calculated as follows:
546.21(1) determine the number of units of service to meet a recipient's needs;
546.22(2) personnel hourly wage rates must be based on the 2009 Bureau of Labor Statistics
546.23Minnesota-specific rates or rates derived by the commissioner as provided in subdivision 5;
546.24(3) for a recipient requiring customization for deaf and hard-of-hearing language
546.25accessibility under subdivision 12, add the customization rate provided in subdivision 12
546.26to the result of clause (2). This is defined as the customized direct-care rate;
546.27(4) multiply the number of day program direct staff hours by the appropriate staff
546.28wage in subdivision 5, paragraph (a), or the customized direct-care rate;
546.29(5) multiply the number of day direct staff hours by the product of the supervision
546.30span of control ratio in subdivision 5, paragraph (d), clause (1), and the appropriate
546.31supervision wage in subdivision 5, paragraph (a), clause (17);
546.32(6) combine the results of clauses (4) and (5), and multiply the result by one plus
546.33the employee vacation, sick, and training allowance ratio in subdivision 5, paragraph (d),
546.34clause (2). This is defined as the direct staffing rate;
546.35(7) for program plan support, multiply the result of clause (6) by one plus the
546.36program plan support ratio in subdivision 5, paragraph (d), clause (4);
547.1(8) for employee-related expenses, multiply the result of clause (7) by one plus the
547.2employee-related cost ratio in subdivision 5, paragraph (d), clause (3);
547.3(9) for client programming and supports, multiply the result of clause (8) by one plus
547.4the client programming and support ratio in subdivision 5, paragraph (d), clause (5);
547.5(10) for program facility costs, add $8.30 per week with consideration of staffing
547.6ratios to meet individual needs;
547.7(11) for adult day bath services, add $7.01 per 15 minute unit;
547.8(12) this is the subtotal rate;
547.9(13) sum the standard general and administrative rate, the program-related expense
547.10ratio, and the absence and utilization factor ratio;
547.11(14) divide the result of clause (12) by one minus the result of clause (13). This is
547.12the total payment amount;
547.13(15) for transportation provided as part of day training and habilitation for an
547.14individual who does not require a lift, add:
547.15(i) $10.50 for a trip between zero and ten miles for a nonshared ride in a vehicle
547.16without a lift, $8.83 for a shared ride in a vehicle without a lift, and $9.25 for a shared
547.17ride in a vehicle with a lift;
547.18(ii) $15.75 for a trip between 11 and 20 miles for a nonshared ride in a vehicle
547.19without a lift, $10.58 for a shared ride in a vehicle without a lift, and $11.88 for a shared
547.20ride in a vehicle with a lift;
547.21(iii) $25.75 for a trip between 21 and 50 miles for a nonshared ride in a vehicle
547.22without a lift, $13.92 for a shared ride in a vehicle without a lift, and $16.88 for a shared
547.23ride in a vehicle with a lift; or
547.24(iv) $33.50 for a trip of 51 miles or more for a nonshared ride in a vehicle without a
547.25lift, $16.50 for a shared ride in a vehicle without a lift. and $20.75 for a shared ride in a
547.26vehicle with a lift;
547.27(16) for transportation provide as part of day training and habilitation for an
547.28individual who does require a lift, add:
547.29(i) $19.05 for a trip between zero and ten miles for a nonshared ride in a vehicle with
547.30a lift, and $15.05 for a shared ride in a vehicle with a lift;
547.31(ii) $32.16 for a trip between 11 and 20 miles for a nonshared ride in a vehicle with a
547.32lift, and $28.16 for a shared ride in a vehicle with a lift;
547.33(iii) $58.76 for a trip between 21 and 50 miles for a nonshared ride in a vehicle with
547.34a lift, and $58.76 for a shared ride in a vehicle with a lift; or
547.35(iv) $80.93 for a trip of 51 miles or more for a nonshared ride in a vehicle with a
547.36lift, and $80.93 for a shared ride in a vehicle with a lift.
548.1    Subd. 8. Payments for unit-based services with programming. Payments for
548.2unit-based with program services, including behavior programming, housing access
548.3coordination, in-home family support, independent living skills training, hourly supported
548.4living services, and supported employment provided to an individual outside of any day or
548.5residential service plan must be calculated as follows, unless the services are authorized
548.6separately under subdivision 6 or 7:
548.7(1) determine the number of units of service to meet a recipient's needs;
548.8(2) personnel hourly wage rate must be based on the 2009 Bureau of Labor Statistics
548.9Minnesota-specific rates or rates derived by the commissioner as provided in subdivision 5;
548.10(3) for a recipient requiring customization for deaf and hard-of-hearing language
548.11accessibility under subdivision 12, add the customization rate provided in subdivision 12
548.12to the result of clause (2). This is defined as the customized direct-care rate;
548.13(4) multiply the number of direct staff hours by the appropriate staff wage in
548.14subdivision 5, paragraph (a), or the customized direct care rate;
548.15(5) multiply the number of direct staff hours by the product of the supervision span
548.16of control ratio in subdivision 5, paragraph (e), clause (1), and the appropriate supervision
548.17wage in subdivision 5, paragraph (a), clause (17);
548.18(6) combine the results of clauses (4) and (5), and multiply the result by one plus
548.19the employee vacation, sick, and training allowance ratio in subdivision 5, paragraph (e),
548.20clause (2). This is defined as the direct staffing rate;
548.21(7) for program plan support, multiply the result of clause (6) by one plus the
548.22program plan supports ratio in subdivision 5, paragraph (e), clause (4);
548.23(8) for employee-related expenses, multiply the result of clause (7) by one plus the
548.24employee-related cost ratio in subdivision 5, paragraph (e), clause (3);
548.25(9) for client programming and supports, multiply the result of clause (8) by one plus
548.26the client programming and supports ratio in subdivision 5, paragraph (e), clause (5);
548.27(10) this is the subtotal rate;
548.28(11) sum the standard general and administrative rate, the program-related expense
548.29ratio, and the absence and utilization factor ratio; and
548.30(12) divide the result of clause (10) by one minus the result of clause (11). This is
548.31the total payment amount.
548.32    Subd. 9. Payments for unit-based services without programming. Payments
548.33for unit-based without program services, including night supervision, personal support,
548.34respite, and companion care provided to an individual outside of any day or residential
548.35service plan must be calculated as follows unless the services are authorized separately
548.36under subdivision 6 or 7:
549.1(1) for all services except respite, determine the number of units of service to meet
549.2a recipient's needs;
549.3(2) personnel hourly wage rates must be based on the 2009 Bureau of Labor Statistics
549.4Minnesota-specific rate or rates derived by the commissioner as provided in subdivision 5;
549.5(3) for a recipient requiring customization for deaf and hard-of-hearing language
549.6accessibility under subdivision 12, add the customization rate provided in subdivision 12
549.7to the result of clause (2). This is defined as the customized direct care rate;
549.8(4) multiply the number of direct staff hours by the appropriate staff wage in
549.9subdivision 5 or the customized direct care rate;
549.10(5) multiply the number of direct staff hours by the product of the supervision span
549.11of control ratio in subdivision 5, paragraph (f), clause (1), and the appropriate supervision
549.12wage in subdivision 5, paragraph (a), clause (17);
549.13(6) combine the results of clauses (4) and (5), and multiply the result by one plus
549.14the employee vacation, sick, and training allowance ratio in, subdivision 5, paragraph (f),
549.15clause (2). This is defined as the direct staffing rate;
549.16(7) for program plan support, multiply the result of clause (6) by one plus the
549.17program plan support ratio in subdivision 5, paragraph (f), clause (4);
549.18(8) for employee-related expenses, multiply the result of clause (7) by one plus the
549.19employee-related cost ratio in subdivision 5, paragraph (f), clause (3);
549.20(9) for client programming and supports, multiply the result of clause (8) by one plus
549.21the client programming and support ratio in subdivision 5, paragraph (f), clause (5);
549.22(10) this is the subtotal rate;
549.23(11) sum the standard general and administrative rate, the program-related expense
549.24ratio, and the absence and utilization factor ratio;
549.25(12) divide the result of clause (10) by one minus the result of clause (11). This is
549.26the total payment amount;
549.27(13) for respite services, determine the number of daily units of service to meet an
549.28individual's needs;
549.29(14) personnel hourly wage rates must be based on the 2009 Bureau of Labor Statistics
549.30Minnesota-specific rate or rates derived by the commissioner as provided in subdivision 5;
549.31(15) for a recipient requiring deaf and hard-of-hearing customization under
549.32subdivision 12, add the customization rate provided in subdivision 12 to the result of
549.33clause (14). This is defined as the customized direct care rate;
549.34(16) multiply the number of direct staff hours by the appropriate staff wage in
549.35subdivision 5, paragraph (a);
550.1(17) multiply the number of direct staff hours by the product of the supervisory span
550.2of control ratio in subdivision 5, paragraph (g), clause (1), and the appropriate supervision
550.3wage in subdivision 5, paragraph (a), clause (17);
550.4(18) combine the results of clauses (16) and (17), and multiply the result by one plus
550.5the employee vacation, sick, and training allowance ratio in subdivision 5, paragraph (g),
550.6clause (2). This is defined as the direct staffing rate;
550.7(19) for employee-related expenses, multiply the result of clause (18) by one plus
550.8the employee-related cost ratio in subdivision 5, paragraph (g), clause (3).
550.9(20) this is the subtotal rate;
550.10(21) sum the standard general and administrative rate, the program-related expense
550.11ratio, and the absence and utilization factor ratio; and
550.12(22) divide the result of clause (20) by one minus the result of clause (21). This is
550.13the total payment amount.
550.14    Subd. 10. Updating payment values and additional information. (a) The
550.15commissioner shall develop and implement uniform procedures to refine terms and update
550.16or adjust values used to calculate payment rates in this section. For calendar year 2014,
550.17the commissioner shall use the values, terms, and procedures provided in this section.
550.18(b) The commissioner shall work with stakeholders to assess efficacy of values
550.19and payment rates. The commissioner shall report back to the legislature with proposed
550.20changes for component values and recommendations for revisions on the schedule
550.21provided in paragraphs (c) and (d).
550.22(c) The commissioner shall work with stakeholders to continue refining a
550.23subset of component values, which are to be referred to as interim values, and report
550.24recommendations to the legislature by February 15, 2014. Interim component values are:
550.25transportation rates for day training and habilitation; transportation for adult day, structured
550.26day, and prevocational services; geographic difference factor; day program facility rate;
550.27services where monitoring technology replaces staff time; shared services for independent
550.28living skills training; and supported employment and billing for indirect services.
550.29(d) The commissioner shall report and make recommendations to the legislature on:
550.30February 15, 2015; February 15, 2017; February 15, 2019; and February 15, 2021. After
550.312021 reports shall be provided on a four-year cycle.
550.32(e) The commissioner shall provide a public notice via LISTSERV in October of
550.33each year beginning October 1, 2014. The notice shall contain information detailing
550.34legislatively approved changes in: calculation values, including derived wage rates
550.35and related employee and administrative factors; services utilization; county and tribal
550.36allocation changes; and information on adjustments to be made to calculation values
551.1and timing of those adjustments. Information in this notice shall be effective January
551.21 of the following year.
551.3    Subd. 11. Payment implementation. Upon implementation of the payment
551.4methodologies under this section, those payment rates supersede rates established in county
551.5contracts for recipients receiving waiver services under section 256B.092 or 256B.49.
551.6    Subd. 12. Customization of rates for individuals. (a) For persons determined to
551.7have higher needs based on being deaf or hard-of-hearing, the direct-care costs must be
551.8increased by an adjustment factor prior to calculating the rate under subdivisions 6, 7, 8,
551.9and 9. The customization rate with respect to deaf or hard-of-hearing persons shall be
551.10$2.50 per hour for waiver recipients who meet the respective criteria as determined by
551.11the commissioner.
551.12(b) For the purposes of this section, "deaf or hard-of-hearing" means:
551.13(1) the person has a developmental disability and an assessment score which
551.14indicates a hearing impairment that is severe or that the person has no useful hearing;
551.15(2) the person has a developmental disability and an expressive communications
551.16score that indicates the person uses single signs or gestures, uses an augmentative
551.17communication aid, or does not have functional communication, or the person's expressive
551.18communications is unknown; and
551.19(3) the person has a developmental disability and a communication score which
551.20indicates the person comprehends signs, gestures and modeling prompts or does not
551.21comprehend verbal, visual or gestural communication or that the person's receptive
551.22communication score is unknown; or
551.23(4) the person receives long-term care services and has an assessment score that
551.24indicates they hear only very loud sounds, have no useful hearing, or a determination
551.25cannot be made; and the person receives long-term care services and has an assessment
551.26that indicates the person communicates needs with sign language, symbol board, written
551.27messages, gestures or an interpreter; communicates with inappropriate content, makes
551.28garbled sounds or displays echolalia, or does not communicate needs.
551.29    Subd. 13. Transportation. The commissioner shall require that the purchase
551.30of transportation services be cost-effective and be limited to market rates where the
551.31transportation mode is generally available and accessible.
551.32    Subd. 14. Exceptions. (a) In a format prescribed by the commissioner, lead
551.33agencies must identify individuals with exceptional needs that cannot be met under the
551.34disability waiver rate system. The commissioner shall use that information to evaluate
551.35and, if necessary, approve an alternative payment rate for those individuals.
551.36(b) Lead agencies must submit exceptions requests to the state.
552.1(c) An application for a rate exception may be submitted for the following criteria:
552.2(1) an individual has service needs that cannot be met through additional units
552.3of service; or
552.4(2) an individual's rate determined under subdivisions 6, 7, 8, and 9 results in an
552.5individual being discharged.
552.6(d) Exception requests will include the following information:
552.7(1) the service needs required by each individual that are not accounted for in
552.8subdivisions 6, 7, 8, and 9;
552.9(2) the service rate requested and the difference from the rate determined in
552.10subdivisions 6, 7, 8, and 9;
552.11(3) a basis for the underlying costs used for the rate exception and any accompanying
552.12documentation;
552.13(4) the duration of the rate exception; and
552.14(5) any contingencies for approval.
552.15(e) Approved rate exceptions shall be managed within lead agency allocations under
552.16sections 256B.092 and 256B.49.
552.17(f) Individual disability waiver recipients may request that a lead agency submit an
552.18exceptions request. A lead agency that denies such a request shall notify the individual
552.19waiver recipient of its decision and the reasons for denying the request in writing no later
552.20than 30 days after the individual's request has been made.
552.21(g) The commissioner shall determine whether to approve or deny an exception
552.22request no more than 30 days after receiving the request. If the commissioner denies the
552.23request, the commissioner shall notify the lead agency and the individual disability waiver
552.24recipient in writing of the reasons for the denial.
552.25(h) The individual disability waiver recipient may appeal any denial of an exception
552.26request by either the lead agency or the commissioner, pursuant to sections 256.045 and
552.27256.0451. When the denial of an exception request results in the proposed demission of a
552.28waiver recipient from a residential or day habilitation program, the commissioner shall
552.29issue a temporary stay of demission, when requested by the disability waiver recipient,
552.30consistent with the provisions of section 256.045, subdivisions 4a and 6, paragraph (c).
552.31The temporary stay shall remain in effect until the lead agency can provide an informed
552.32choice of appropriate, alternative services to the disability waiver.
552.33(i) Providers may petition lead agencies to update values that were entered
552.34incorrectly or erroneously into the rate management system, based on past service level
552.35discussions and determination in subdivision 4, without applying for a rate exception.
553.1    Subd. 15. County or tribal allocations. (a) Upon implementation of the disability
553.2waiver rates management system on January 1, 2014, the commissioner shall establish
553.3a method of tracking and reporting the fiscal impact of the disability waiver rates
553.4management system on individual lead agencies.
553.5(b) Beginning January 1, 2014, and continuing through full implementation on
553.6December 31, 2017, the commissioner shall make annual adjustments to lead agencies'
553.7home and community-based waivered service budget allocations to adjust for rate
553.8differences and the resulting impact on county allocations upon implementation of the
553.9disability waiver rates system.
553.10    Subd. 16. Budget neutrality adjustment. The commissioner shall calculate the
553.11total spending for all home and community-based waiver services under the payments as
553.12defined in subdivisions 6, 7, 8, and 9 for all recipients as of July 1, 2013, and compare it to
553.13spending for services defined for subdivisions 6, 7, 8, and 9 under current law. If spending
553.14for services in one particular subdivision differs, there will be a percentage adjustment
553.15to increase or decrease individual rates for the services defined in each subdivision so
553.16aggregate spending matches projections under current law.
553.17    Subd. 17. Implementation. (a) On January 1, 2014, the commissioner shall fully
553.18implement the calculation of rates for waivered services under sections 256B.092 and
553.19256B.49 without additional legislative approval.
553.20(b) The commissioner shall phase in the application of rates determined in
553.21subdivisions 6 to 9 for two years.
553.22(c) The commissioner shall preserve rates in effect on December 31, 2013, for
553.23the two-year period.
553.24(d) The commissioner shall calculate and measure the difference in cost per
553.25individual using the historical rate and the rates under subdivisions 6 to 9 for all existing
553.26individuals. This measurement shall occur statewide, and for individuals in every county.
553.27The commissioner shall provide the results of this analysis by county for calendar year
553.282014 to the legislative committees and divisions with jurisdiction over health and human
553.29services finance by February 15, 2015.
553.30(e) The commissioner shall calculate the average rate per unit for each service by
553.31county. For individuals enrolled after January 1, 2014, individuals will receive the higher
553.32of the rate produced under subdivisions 6 to 9, or the by-county average rate.
553.33(f) On January 1, 2016, the rates determined in subdivisions 6 to 9 shall be applied.

553.34    Sec. 7. REPEALER.
553.35Minnesota Statutes 2012, section 256B.4913, subdivisions 1, 2, 3, and 4, is repealed.

554.1ARTICLE 14

554.2HEALTH AND HUMAN SERVICES APPROPRIATIONS

554.3

Section 1. HEALTH AND HUMAN SERVICES APPROPRIATIONS.

554.4The sums shown in the columns marked "Appropriations" are appropriated to the
554.5agencies and for the purposes specified in this article. The appropriations are from the
554.6general fund, or another named fund, and are available for the fiscal years indicated
554.7for each purpose. The figures "2014" and "2015" used in this article mean that the
554.8appropriations listed under them are available for the fiscal year ending June 30, 2014, or
554.9June 30, 2015, respectively. "The first year" is fiscal year 2014. "The second year" is fiscal
554.10year 2015. "The biennium" is fiscal years 2014 and 2015.

554.11				APPROPRIATIONS
554.12				Available for the Year
554.13				Ending June 30
554.14					2014		2015

554.15 554.16

Sec. 2. COMMISSIONER OF HUMAN SERVICES

554.17

Subdivision 1.Total Appropriation

$

6,411,182,000

$

6,392,303,000

554.18	Appropriations by Fund
554.19		2014	2015
554.20	General	5,807,515,000	5,831,770,000
554.21 554.22	State Government Special Revenue	3,815,000	4,915,000
554.23	Health Care Access	340,047,000	298,915,000
554.24	Federal TANF	257,915,000	254,813,000
554.25	Lottery Prize Fund	1,890,000	1,890,000

554.26Receipts for Systems Projects.
554.27Appropriations and federal receipts for
554.28information systems projects for MAXIS,
554.29PRISM, MMIS, and SSIS must be deposited
554.30in the state system account authorized
554.31in Minnesota Statutes, section 256.014.
554.32Money appropriated for computer projects
554.33approved by the commissioner of Minnesota
554.34information technology services, funded
554.35by the legislature, and approved by the
554.36commissioner of management and budget,
555.1may be transferred from one project to
555.2another and from development to operations
555.3as the commissioner of human services
555.4considers necessary. Any unexpended
555.5balance in the appropriation for these
555.6projects does not cancel but is available for
555.7ongoing development and operations.
555.8Nonfederal Share Transfers. The
555.9nonfederal share of activities for which
555.10federal administrative reimbursement is
555.11appropriated to the commissioner may be
555.12transferred to the special revenue fund.
555.13ARRA Supplemental Nutrition Assistance
555.14Benefit Increases. The funds provided for
555.15food support benefit increases under the
555.16Supplemental Nutrition Assistance Program
555.17provisions of the American Recovery and
555.18Reinvestment Act (ARRA) of 2009 must be
555.19used for benefit increases beginning July 1,
555.202009.
555.21Supplemental Nutrition Assistance
555.22Program Employment and Training.
555.23(1) Notwithstanding Minnesota Statutes,
555.24sections 256D.051, subdivisions 1a, 6b,
555.25and 6c, and 256J.626, federal Supplemental
555.26Nutrition Assistance employment and
555.27training funds received as reimbursement of
555.28MFIP consolidated fund grant expenditures
555.29for diversionary work program participants
555.30and child care assistance program
555.31expenditures must be deposited in the general
555.32fund. The amount of funds must be limited to
555.33$4,900,000 per year in fiscal years 2014 and
555.342015, and to $4,400,000 per year in fiscal
556.1years 2016 and 2017, contingent on approval
556.2by the federal Food and Nutrition Service.
556.3(2) Consistent with the receipt of the federal
556.4funds, the commissioner may adjust the
556.5level of working family credit expenditures
556.6claimed as TANF maintenance of effort.
556.7Notwithstanding any contrary provision in
556.8this article, this rider expires June 30, 2017.
556.9TANF Maintenance of Effort. (a) In order
556.10to meet the basic maintenance of effort
556.11(MOE) requirements of the TANF block grant
556.12specified under Code of Federal Regulations,
556.13title 45, section 263.1, the commissioner may
556.14only report nonfederal money expended for
556.15allowable activities listed in the following
556.16clauses as TANF/MOE expenditures:
556.17(1) MFIP cash, diversionary work program,
556.18and food assistance benefits under Minnesota
556.19Statutes, chapter 256J;
556.20(2) the child care assistance programs
556.21under Minnesota Statutes, sections 119B.03
556.22and 119B.05, and county child care
556.23administrative costs under Minnesota
556.24Statutes, section 119B.15;
556.25(3) state and county MFIP administrative
556.26costs under Minnesota Statutes, chapters
556.27256J and 256K;
556.28(4) state, county, and tribal MFIP
556.29employment services under Minnesota
556.30Statutes, chapters 256J and 256K;
556.31(5) expenditures made on behalf of legal
556.32noncitizen MFIP recipients who qualify for
556.33the MinnesotaCare program under Minnesota
556.34Statutes, chapter 256L;
557.1(6) qualifying working family credit
557.2expenditures under Minnesota Statutes,
557.3section 290.0671;
557.4(7) qualifying Minnesota education credit
557.5expenditures under Minnesota Statutes,
557.6section 290.0674; and
557.7(8) qualifying Head Start expenditures under
557.8Minnesota Statutes, section 119A.50.
557.9(b) The commissioner shall ensure that
557.10sufficient qualified nonfederal expenditures
557.11are made each year to meet the state's
557.12TANF/MOE requirements. For the activities
557.13listed in paragraph (a), clauses (2) to
557.14(8), the commissioner may only report
557.15expenditures that are excluded from the
557.16definition of assistance under Code of
557.17Federal Regulations, title 45, section 260.31.
557.18(c) For fiscal years beginning with state fiscal
557.19year 2003, the commissioner shall ensure
557.20that the maintenance of effort used by the
557.21commissioner of management and budget
557.22for the February and November forecasts
557.23required under Minnesota Statutes, section
557.2416A.103, contains expenditures under
557.25paragraph (a), clause (1), equal to at least 16
557.26percent of the total required under Code of
557.27Federal Regulations, title 45, section 263.1.
557.28(d) The requirement in Minnesota Statutes,
557.29section 256.011, subdivision 3, that federal
557.30grants or aids secured or obtained under that
557.31subdivision be used to reduce any direct
557.32appropriations provided by law, do not apply
557.33if the grants or aids are federal TANF funds.
557.34(e) For the federal fiscal years beginning on
557.35or after October 1, 2007, the commissioner
558.1may not claim an amount of TANF/MOE in
558.2excess of the 75 percent standard in Code
558.3of Federal Regulations, title 45, section
558.4263.1(a)(2), except:
558.5(1) to the extent necessary to meet the 80
558.6percent standard under Code of Federal
558.7Regulations, title 45, section 263.1(a)(1),
558.8if it is determined by the commissioner
558.9that the state will not meet the TANF work
558.10participation target rate for the current year;
558.11(2) to provide any additional amounts
558.12under Code of Federal Regulations, title 45,
558.13section 264.5, that relate to replacement of
558.14TANF funds due to the operation of TANF
558.15penalties; and
558.16(3) to provide any additional amounts that
558.17may contribute to avoiding or reducing
558.18TANF work participation penalties through
558.19the operation of the excess MOE provisions
558.20of Code of Federal Regulations, title 45,
558.21section 261.43(a)(2).
558.22For the purposes of clauses (1) to (3),
558.23the commissioner may supplement the
558.24MOE claim with working family credit
558.25expenditures or other qualified expenditures
558.26to the extent such expenditures are otherwise
558.27available after considering the expenditures
558.28allowed in this subdivision and subdivisions
558.292 and 3.
558.30(f) Notwithstanding any contrary provision
558.31in this article, paragraphs (a) to (e) expire
558.32June 30, 2017.
558.33Working Family Credit Expenditures
558.34as TANF/MOE. The commissioner may
558.35claim as TANF maintenance of effort up to
559.1$6,707,000 per year of working family credit
559.2expenditures in each fiscal year.

559.3 559.4

Subd. 2.Working Family Credit to be Claimed for TANF/MOE

559.5The commissioner may count the following
559.6amounts of working family credit
559.7expenditures as TANF/MOE:
559.8(1) fiscal year 2014, $45,196,000;
559.9(2) fiscal year 2015, $41,885,000;
559.10(3) fiscal year 2016, $8,869,000; and
559.11(4) fiscal year 2017, $11,181,000.

559.12 559.13

Subd. 3.TANF Transfer to Federal Child Care and Development Fund

559.14(a) The following TANF fund amounts
559.15are appropriated to the commissioner for
559.16purposes of MFIP/transition year child care
559.17assistance under Minnesota Statutes, section
559.18119B.05:
559.19(1) fiscal year 2014; $14,020,000; and
559.20(2) fiscal year 2015, $14,020,000.
559.21(b) The commissioner shall authorize the
559.22transfer of sufficient TANF funds to the
559.23federal child care and development fund to
559.24meet this appropriation and shall ensure that
559.25all transferred funds are expended according
559.26to federal child care and development fund
559.27regulations.

559.28

Subd. 4.Central Office

559.29The amounts that may be spent from this
559.30appropriation for each purpose are as follows:

559.31

(a) Operations

559.32	Appropriations by Fund
559.33	General	88,876,000	91,189,000
560.1 560.2	State Government Special Revenue	3,690,000	4,790,000
560.3	Health Care Access	13,177,000	13,004,000
560.4	Federal TANF	100,000	100,000

560.5DHS Receipt Center Accounting. The
560.6commissioner is authorized to transfer
560.7appropriations to, and account for DHS
560.8receipt center operations in, the special
560.9revenue fund.
560.10Administrative Recovery; Set-Aside. The
560.11commissioner may invoice local entities
560.12through the SWIFT accounting system as an
560.13alternative means to recover the actual cost
560.14of administering the following provisions:
560.15(1) Minnesota Statutes, section 125A.744,
560.16subdivision 3;
560.17(2) Minnesota Statutes, section 245.495,
560.18paragraph (b);
560.19(3) Minnesota Statutes, section 256B.0625,
560.20subdivision 20, paragraph (k);
560.21(4) Minnesota Statutes, section 256B.0924,
560.22subdivision 6, paragraph (g);
560.23(5) Minnesota Statutes, section 256B.0945,
560.24subdivision 4, paragraph (d); and
560.25(6) Minnesota Statutes, section 256F.10,
560.26subdivision 6, paragraph (b).
560.27Systems Modernization. The following
560.28amounts are appropriated for transfer to
560.29the state systems account authorized in
560.30Minnesota Statutes, section 256.014:
560.31(1) $1,825,000 in fiscal year 2014 and
560.32$2,502,000 in fiscal year 2015 is for the
560.33state share of Medicaid-allocated costs of
560.34the health insurance exchange information
561.1technology and operational structure. The
561.2funding base is $3,222,000 in fiscal year 2016
561.3and $3,037,000 in fiscal year 2017 but shall
561.4not be included in the base thereafter; and
561.5(2) $1,000,000 in fiscal year 2014 and
561.6$2,000,000 in fiscal year 2015 are for the
561.7modernization and streamlining of agency
561.8eligibility and child support systems. The
561.9funding base is $2,000,000 in fiscal year
561.102016 and $2,000,000 in fiscal year 2017 but
561.11shall not be included in the base thereafter.
561.12The unexpended balance of the $1,000,000
561.13appropriation in fiscal year 2014 and the
561.14$2,000,000 appropriation in fiscal year 2015
561.15must be transferred from the Department of
561.16Human Services state systems account to
561.17the Office of Enterprise Technology when
561.18the Office of Enterprise Technology has
561.19negotiated a federally approved internal
561.20service fund rates and billing process with
561.21sufficient internal accounting controls to
561.22properly maximize federal reimbursement
561.23to Minnesota for human services system
561.24modernization projects, but not later than
561.25June 30, 2015.
561.26If contingent funding is fully or partially
561.27disbursed under article 15, section 3, and
561.28transferred to the state systems account, the
561.29unexpended balance of that appropriation
561.30must be transferred to the Office of Enterprise
561.31Technology in accordance with this clause.
561.32Contingent funding must not exceed
561.33$15,463,000 for the biennium.
561.34Base Adjustment. The general fund base
561.35is increased by $646,000 in fiscal year 2016
562.1and $461,000 in fiscal year 2017. The health
562.2access fund base is decreased by $551,000 in
562.3fiscal years 2016 and 2017.

562.4

(b) Children and Families

562.5	Appropriations by Fund
562.6	General	7,569,000	7,519,000
562.7	Federal TANF	2,282,000	2,282,000

562.8Financial Institution Data Match and
562.9Payment of Fees. The commissioner is
562.10authorized to allocate up to $310,000 each
562.11year in fiscal years 2014 and 2015 from the
562.12PRISM special revenue account to make
562.13payments to financial institutions in exchange
562.14for performing data matches between account
562.15information held by financial institutions
562.16and the public authority's database of child
562.17support obligors as authorized by Minnesota
562.18Statutes, section 13B.06, subdivision 7.

562.19

(c) Health Care

562.20	Appropriations by Fund
562.21	General	13,643,000	13,227,000
562.22	Health Care Access	24,602,000	26,728,000

562.23Base Adjustment. The general fund base
562.24is decreased by $86,000 in fiscal year 2016
562.25and by $86,000 in fiscal year 2017. The
562.26health care access fund base is increased
562.27by $7,956,000 in fiscal year 2016 and by
562.28$6,354,000 in fiscal year 2017.

562.29

(d) Continuing Care

562.30	Appropriations by Fund
562.31	General	17,361,000	17,426,000
562.32 562.33	State Government Special Revenue	125,000	125,000

563.1Base Adjustment. The general fund base is
563.2decreased by $1,000 in fiscal year 2016 and
563.3by $1,000 in fiscal year 2017.

563.4

(e) Chemical and Mental Health

563.5	Appropriations by Fund
563.6	General	4,313,000	4,179,000
563.7	Lottery Prize Fund	157,000	157,000

563.8

Subd. 5.Forecasted Programs

563.9The amounts that may be spent from this
563.10appropriation for each purpose are as follows:

563.11

(a) MFIP/DWP

563.12	Appropriations by Fund
563.13	General	73,742,000	79,302,000
563.14	Federal TANF	80,342,000	76,851,000

563.15

(b) MFIP Child Care Assistance

62,030,000

64,731,000

563.16

(c) General Assistance

54,787,000

56,068,000

563.17General Assistance Standard. The
563.18commissioner shall set the monthly standard
563.19of assistance for general assistance units
563.20consisting of an adult recipient who is
563.21childless and unmarried or living apart
563.22from parents or a legal guardian at $203.
563.23The commissioner may reduce this amount
563.24according to Laws 1997, chapter 85, article
563.253, section 54.
563.26Emergency General Assistance. The
563.27amount appropriated for emergency general
563.28assistance funds is limited to no more
563.29than $6,729,812 in fiscal year 2014 and
563.30$6,729,812 in fiscal year 2015. Funds
563.31to counties shall be allocated by the
563.32commissioner using the allocation method in
563.33Minnesota Statutes, section 256D.06.

563.34

(d) MN Supplemental Assistance

38,646,000

39,821,000

564.1

(e) Group Residential Housing

140,447,000

149,984,000

564.2

(f) MinnesotaCare

299,290,000

257,020,000

564.3This appropriation is from the health care
564.4access fund.

564.5

(g) Medical Assistance

4,609,672,000

4,615,440,000

564.6Medical Eligibility for Inmates in Medical
564.7Institutions. The commissioner of human
564.8services shall execute an interagency
564.9agreement with the commissioner of
564.10corrections to recover the medical assistance
564.11cost attributable to medical assistance
564.12eligibility for inmates of public institutions
564.13admitted to hospitals on an inpatient basis.
564.14The amount that must be recovered from
564.15the Department of Corrections shall include
564.16all state medical assistance costs, including
564.17administrative costs, attributable to inmates
564.18under state and county jurisdiction admitted
564.19to hospitals on an inpatient basis.
564.20Support Services for Deaf and
564.21Hard-of-Hearing. $121,000 in fiscal
564.22year 2014 and $141,000 in fiscal year 2015;
564.23and $10,000 in fiscal year 2014 and $13,000
564.24in fiscal year 2015 are from the health care
564.25access fund for the hospital reimbursement
564.26increase in Minnesota Statutes, section
564.27256.969, subdivision 29, paragraph (b).

564.28

(h) Alternative Care

47,058,000

47,078,000

564.29Alternative Care Transfer. Any money
564.30allocated to the alternative care program that
564.31is not spent for the purposes indicated does
564.32not cancel but shall be transferred to the
564.33medical assistance account.

564.34

(i) CD Treatment Fund

81,440,000

74,875,000

565.1Balance Transfer. The commissioner must
565.2transfer $18,188,000 from the consolidated
565.3chemical dependency treatment fund to the
565.4general fund by September 30, 2013.

565.5

Subd. 6.Grant Programs

565.6The amounts that may be spent from this
565.7appropriation for each purpose are as follows:

565.8

(a) Support Services Grants

565.9	Appropriations by Fund
565.10	General	11,333,000	11,133,000
565.11	Federal TANF	94,611,000	94,611,000

565.12Paid Work Experience. $1,159,000 in fiscal
565.13year 2014, and $1,009,000 in fiscal year
565.142015 is from the general fund for paid work
565.15experience for long-term MFIP recipients.
565.16Paid work includes full and partial wage
565.17subsidies and other related services such as
565.18job development, marketing, preworksite
565.19training, job coaching, and postplacement
565.20services. Unexpended funds for fiscal year
565.212014 do not cancel but are available for this
565.22purpose in fiscal year 2015.
565.23Work Study Funding for MFIP
565.24Participants. $250,000 each year is from
565.25the general fund to pilot work study jobs for
565.26MFIP recipients in approved postsecondary
565.27education programs. This is a onetime
565.28appropriation. Unexpended funds for fiscal
565.29year 2014 do not cancel but are available for
565.30this purpose in fiscal year 2015.
565.31Base Adjustment. The general fund base is
565.32decreased by $2,418,000 in fiscal years 2016
565.33and 2017.

565.34 565.35

(b) Basic Sliding Fee Child Care Assistance Grants

39,039,000

40,391,000

566.1

(c) Child Care Development Grants

1,487,000

1,487,000

566.2

(d) Child Support Enforcement Grants

50,000

50,000

566.3Federal Child Support Demonstration
566.4Grants. Federal administrative
566.5reimbursement resulting from the federal
566.6child support grant expenditures authorized
566.7under United States Code, title 42, section
566.81315, is appropriated to the commissioner
566.9for this activity.

566.10

(e) Children's Services Grants

566.11	Appropriations by Fund
566.12	General	49,810,000	50,260,000
566.13	Federal TANF	140,000	140,000

566.14Adoption Assistance and Relative Custody
566.15Assistance. The commissioner may transfer
566.16unencumbered appropriation balances for
566.17adoption assistance and relative custody
566.18assistance between fiscal years and between
566.19programs.
566.20Title IV-E Adoption Assistance. Additional
566.21federal reimbursements to the state as a result
566.22of the Fostering Connections to Success
566.23and Increasing Adoptions Act's expanded
566.24eligibility for Title IV-E adoption assistance
566.25are appropriated for postadoption services,
566.26including a parent-to-parent support network.
566.27Privatized Adoption Grants. Federal
566.28reimbursement for privatized adoption grant
566.29and foster care recruitment grant expenditures
566.30is appropriated to the commissioner for
566.31adoption grants and foster care and adoption
566.32administrative purposes.
566.33Adoption Assistance Incentive Grants.
566.34 Federal funds available during fiscal years
567.12014 and 2015 for adoption incentive grants
567.2are appropriated for postadoption services,
567.3including a parent-to-parent support network.
567.4Base Adjustment. The general fund base is
567.5decreased by $466,000 in fiscal year 2016
567.6and by $822,000 in fiscal year 2017.

567.7

(f) Child and Community Service Grants

53,301,000

53,301,000

567.8

(g) Child and Economic Support Grants

20,972,000

20,973,000

567.9Minnesota Food Assistance Program.
567.10Unexpended funds for the Minnesota food
567.11assistance program for fiscal year 2014 do
567.12not cancel but are available for this purpose
567.13in fiscal year 2015.
567.14Family Assets for Independence. $250,000
567.15each year is for the Family Assets for
567.16Independence Minnesota program. This
567.17appropriation is available in either year of the
567.18biennium and may be transferred between
567.19fiscal years.
567.20Food Shelf Programs. $500,000 in fiscal
567.21year 2014 and $500,000 in fiscal year
567.222015 are for food shelf programs under
567.23Minnesota Statutes, section 256E.34. If the
567.24appropriation for either year is insufficient,
567.25the appropriation for the other year is
567.26available for it.
567.27Homeless Youth Act. $4,000,000 is for
567.28purposes of Minnesota Statutes, section
567.29256K.45.
567.30Safe Harbor Shelter and Housing.
567.31$2,000,000 in fiscal year 2014 and
567.32$2,000,000 in fiscal year 2015 is for a safe
567.33harbor shelter and housing fund for housing
568.1and supportive services for youth who are
568.2sexually exploited.

568.3

(h) Health Care Grants

568.4	Appropriations by Fund
568.5	General	190,000	190,000
568.6	Health Care Access	2,228,000	1,413,000

568.7Emergency Medical Assistance Referral
568.8and Assistance Grants. (a) The
568.9commissioner of human services shall
568.10award grants to nonprofit programs that
568.11provide immigration legal services based
568.12on indigency to provide legal services for
568.13immigration assistance to individuals with
568.14emergency medical conditions or complex
568.15and chronic health conditions who are not
568.16currently eligible for medical assistance
568.17or other public health care programs, but
568.18who may meet eligibility requirements with
568.19immigration assistance.
568.20(b) The grantees, in collaboration with
568.21hospitals and safety net providers, shall
568.22provide referral assistance to connect
568.23individuals identified in paragraph (a) with
568.24alternative resources and services to assist in
568.25meeting their health care needs. $100,000
568.26is appropriated in fiscal year 2014 and
568.27$100,000 in fiscal year 2015. This is a
568.28onetime appropriation.
568.29(c) The programs receiving grants under
568.30paragraph (a) must report to the commissioner
568.31of human services the number of individuals
568.32who were provided immigration assistance
568.33under the grants and who were eventually
568.34determined to be eligible for medical
568.35assistance or another public health care
569.1program due to this assistance. The
569.2commissioner shall report this information to
569.3the chairs and ranking minority members of
569.4the legislative committees with jurisdiction
569.5over human services policy and finance by
569.6January 1, 2015.
569.7Base Adjustment. The general fund is
569.8decreased by $100,000 in fiscal year 2016
569.9and $100,000 in fiscal year 2017. The health
569.10care access fund is decreased by $1,223,000
569.11in fiscal years 2016 and 2017.

569.12

(i) Aging and Adult Services Grants

22,043,000

22,910,000

569.13Base Adjustment. The general fund is
569.14increased by $5,000 in fiscal year 2016 and
569.15$5,000 in fiscal year 2017.

569.16

(j) Deaf and Hard-of-Hearing Grants

1,767,000

1,767,000

569.17

(k) Disabilities Grants

17,844,000

17,426,000

569.18Advocating Change Together. $310,000 in
569.19fiscal year 2014 is for a grant to Advocating
569.20Change Together (ACT) to maintain and
569.21promote services for persons with intellectual
569.22and developmental disabilities throughout
569.23the state. Of this appropriation:
569.24(1) $120,000 is for direct costs associated
569.25with the delivery and evaluation of
569.26peer-to-peer training programs administered
569.27throughout the state, focusing on education,
569.28employment, housing, transportation, and
569.29voting;
569.30(2) $100,000 is for delivery of statewide
569.31conferences focusing on leadership and
569.32skill development within the disability
569.33community; and
570.1(3) $90,000 is for administrative and general
570.2operating costs associated with managing
570.3or maintaining facilities, program delivery,
570.4staff, and technology. This is a onetime
570.5appropriation.
570.6Base Adjustment. The general fund base
570.7is increased by $448,000 in fiscal year 2016
570.8and by $470,000 in fiscal year 2017.

570.9

(l) Adult Mental Health Grants

570.10	Appropriations by Fund
570.11	General	70,777,000	69,108,000
570.12	Health Care Access	750,000	750,000
570.13	Lottery Prize	1,733,000	1,733,000

570.14Problem Gambling. $225,000 in fiscal year
570.152014 and $225,000 in fiscal year 2015 is
570.16appropriated from the lottery prize fund for a
570.17grant to the state affiliate recognized by the
570.18National Council on Problem Gambling. The
570.19affiliate must provide services to increase
570.20public awareness of problem gambling,
570.21education and training for individuals and
570.22organizations providing effective treatment
570.23services to problem gamblers and their
570.24families, and research relating to problem
570.25gambling.
570.26Funding Usage. Up to 75 percent of a fiscal
570.27year's appropriations for adult mental health
570.28grants may be used to fund allocations in that
570.29portion of the fiscal year ending December
570.3031.
570.31Base Adjustment. The general fund base is
570.32decreased by $4,197,000 in fiscal year 2016
570.33and by $4,197,000 in fiscal year 2017.

570.34

(m) Child Mental Health Grants

15,233,000

15,234,000

571.1Mental Health First Aid Training. $45,000
571.2for the biennium ending June 30, 2015, is
571.3to train teachers, social service personnel,
571.4law enforcement, and others who come into
571.5contact with children with mental illnesses,
571.6in children and adolescents mental health
571.7first aid training.
571.8Funding Usage. Up to 75 percent of a fiscal
571.9year's appropriation for child mental health
571.10grants may be used to fund allocations in that
571.11portion of the fiscal year ending December
571.1231.

571.13

(n) CD Treatment Support Grants

1,996,000

1,636,000

571.14SBIRT Training. $300,000 each year is
571.15for grants to train primary care clinicians to
571.16provide substance abuse brief intervention
571.17and referral to treatment (SBIRT). This is a
571.18onetime appropriation.
571.19Fetal Alcohol Syndrome Grant. (a)
571.20$360,000 is appropriated in fiscal year 2014
571.21to the commissioner of human services for
571.22a grant to the Minnesota Organization on
571.23Fetal Alcohol Syndrome (MOFAS). This is a
571.24onetime appropriation.
571.25(b) Grant money must be used to reduce the
571.26incidence of FASD and other prenatal drug
571.27related effects in children in Minnesota by
571.28identifying and serving pregnant women
571.29suspected of or known to use or abuse
571.30alcohol or other drugs. The grant recipient
571.31must provide intensive services to chemically
571.32dependent women in order to increase
571.33positive birth outcomes and report to the
571.34commissioner necessary data to prepare
571.35the required report to the legislature. The
572.1organization may retain two percent of the
572.2grant money for administrative costs.
572.3(c) A grant recipient must report to the
572.4commissioner of human services annually
572.5by January 15 on the services and programs
572.6funded by the appropriation. The report must
572.7include measurable outcomes, including
572.8the number of pregnant women served and
572.9toxic-free babies born in the previous year.
572.10Base Adjustment. The general fund base is
572.11decreased by $300,000 in fiscal year 2016
572.12and $300,000 in fiscal year 2017.

572.13

Subd. 7.State-Operated Services

572.14Transfer Authority Related to
572.15State-Operated Services. Money
572.16appropriated for state-operated services
572.17may be transferred between fiscal years
572.18of the biennium with the approval of the
572.19commissioner of management and budget.
572.20The amounts that may be spent from the
572.21appropriation for each purpose are as follows:

572.22

(a) SOS Mental Health

115,738,000

115,738,000

572.23Dedicated Receipts Available. Of the
572.24revenue received under Minnesota Statutes,
572.25section 246.18, subdivision 8, paragraph
572.26(a), $1,000,000 each year is available for
572.27the purposes of paragraph (b), clause (1),
572.28of that subdivision, $1,000,000 each year
572.29is available to transfer to the adult mental
572.30health budget activity for the purposes of
572.31paragraph (b), clause (2), of that subdivision,
572.32and up to $2,713,000 each year is available
572.33for the purposes of paragraph (b), clause (3),
572.34of that subdivision.

573.1

(b) SOS MN Security Hospital

69,582,000

69,582,000

573.2

Subd. 8.Sex Offender Program

76,769,000

79,745,000

573.3Transfer Authority Related to Minnesota
573.4Sex Offender Program. Money
573.5appropriated for the Minnesota sex offender
573.6program may be transferred between fiscal
573.7years of the biennium with the approval of the
573.8commissioner of management and budget.

573.9

Subd. 9.Technical Activities

80,440,000

80,829,000

573.10This appropriation is from the federal TANF
573.11fund.
573.12Base Adjustment. The federal TANF fund
573.13base is increased by $278,000 in fiscal year
573.142016 and increased by $651,000 in fiscal
573.15year 2017.

573.16

Subd. 10.Transfer.

573.17

Sec. 3. COMMISSIONER OF HEALTH

573.18

Subdivision 1.Total Appropriation

$

158,912,000

$

155,115,000

573.19	Appropriations by Fund
573.20		2014	2015
573.21	General	79,476,000	74,256,000
573.22 573.23	State Government Special Revenue	48,680,000	50,703,000
573.24	Health Care Access	18,743,000	18,143,000
573.25	Federal TANF	11,713,000	11,713,000
573.26	Special Revenue	300,000	300,000

573.27The amounts that may be spent for each
573.28purpose are specified in the following
573.29subdivisions.

573.30

Subd. 2.Health Improvement

573.31	Appropriations by Fund
573.32	General	52,864,000	47,644,000
573.33 573.34	State Government Special Revenue	1,033,000	1,033,000
574.1	Health Care Access	9,219,000	9,219,000
574.2	Federal TANF	11,713,000	11,713,000

574.3Statewide Health Improvement Program.
574.4$7,500,000 in fiscal year 2014 and
574.5$7,500,000 in fiscal year 2015 is from the
574.6health care access fund for the statewide
574.7health improvement program under
574.8Minnesota Statutes, section 145.986.
574.9Of the appropriation in fiscal year 2014,
574.10$10,000 is for the commissioner of
574.11management and budget to develop and
574.12implement a return on taxpayer investment
574.13(ROTI) methodology and practice related
574.14to the state health improvement program.
574.15In developing the methodology, the
574.16commissioner shall assess ROTI initiatives
574.17in other states, design implications for
574.18Minnesota, and identify one or more
574.19Minnesota institutions of higher education
574.20capable of providing rigorous and consistent
574.21nonpartisan institutional support for ROTI.
574.22The commissioner shall consult with
574.23representatives of other state agencies,
574.24counties, legislative staff, Minnesota
574.25institutions of higher education, and other
574.26stakeholders in developing the methodology.
574.27The commissioner shall report the results to
574.28the chairs and ranking minority members of
574.29the legislative committees and divisions with
574.30jurisdiction over health and human services,
574.31taxes, and finance by March 15, 2015.
574.32Statewide Cancer Surveillance System. Of
574.33the general fund appropriation, $350,000 in
574.34fiscal year 2014 and $350,000 in fiscal year
574.352015 is to develop and implement a new
575.1cancer reporting system under Minnesota
575.2Statutes, sections 144.671 to 144.69. Any
575.3information technology development or
575.4support costs necessary for the cancer
575.5surveillance system must be incorporated
575.6into the agency's service level agreement and
575.7paid to the Office of Enterprise Technology.
575.8Minnesota Poison Information Center.
575.9 $250,000 in fiscal year 2014 and $250,000
575.10in fiscal year 2015 from the general fund
575.11is for regional poison information centers
575.12according to Minnesota Statutes, section
575.13145.93.
575.14Text Message Suicide Prevention Program.
575.15 $1,500,000 for the biennium ending June 30,
575.162015, is for a grant to a nonprofit organization
575.17to establish and implement a statewide text
575.18message suicide prevention program. The
575.19program shall implement a suicide prevention
575.20counseling text line designed to use text
575.21messaging to connect with crisis counselors
575.22and to obtain emergency information and
575.23referrals to local resources in the local
575.24community. The program shall include
575.25training within schools and communities to
575.26encourage the use of the program.
575.27Support Services for Deaf and
575.28Hard-of-Hearing. (a) $365,000 in fiscal
575.29year 2014 and $349,000 in fiscal year 2015
575.30are for providing support services to families
575.31as required under Minnesota Statutes, section
575.32144.966, subdivision 3a.
575.33(b) $164,000 in fiscal year 2014 and $156,000
575.34in fiscal year 2015 are for home-based
575.35education in American Sign Language for
576.1families with children who are deaf or have
576.2hearing loss, as required under Minnesota
576.3Statutes, section 144.966, subdivision 3a.
576.4Reproductive Health Strategic Plan to
576.5Reduce Health Disparities for Somali
576.6Women. To the extent funds are available
576.7for fiscal years 2014 and 2015 for grants
576.8provided pursuant to Minnesota Statutes,
576.9section 145.928, the commissioner
576.10shall provide a grant to a Somali-based
576.11organization located in the metropolitan area
576.12to develop a reproductive health strategic
576.13plan to eliminate reproductive health
576.14disparities for Somali women. The plan shall
576.15develop initiatives to provide educational
576.16and information resources to health care
576.17providers, community organizations, and
576.18Somali women to ensure effective interaction
576.19with Somali culture and western medicine
576.20and the delivery of appropriate health care
576.21services, and the achievement of better health
576.22outcomes for Somali women. The plan must
576.23engage health care providers, the Somali
576.24community, and Somali health-centered
576.25organizations. The commissioner shall
576.26submit a report to the chairs and ranking
576.27minority members of the senate and house
576.28committees with jurisdiction over health
576.29policy on the strategic plan developed under
576.30this grant for eliminating reproductive health
576.31disparities for Somali women. The report
576.32must be submitted by February 15, 2014.
576.33TANF Appropriations. (1) $1,156,000 of
576.34the TANF funds is appropriated each year of
576.35the biennium to the commissioner for family
577.1planning grants under Minnesota Statutes,
577.2section 145.925.
577.3(2) $3,579,000 of the TANF funds is
577.4appropriated each year of the biennium to
577.5the commissioner for home visiting and
577.6nutritional services listed under Minnesota
577.7Statutes, section 145.882, subdivision 7,
577.8clauses (6) and (7). Funds must be distributed
577.9to community health boards according to
577.10Minnesota Statutes, section 145A.131,
577.11subdivision 1.
577.12(3) $2,000,000 of the TANF funds is
577.13appropriated each year of the biennium to
577.14the commissioner for decreasing racial and
577.15ethnic disparities in infant mortality rates
577.16under Minnesota Statutes, section 145.928,
577.17subdivision 7.
577.18(4) $4,978,000 of the TANF funds is
577.19appropriated each year of the biennium to the
577.20commissioner for the family home visiting
577.21grant program according to Minnesota
577.22Statutes, section 145A.17. $4,000,000 of the
577.23funding must be distributed to community
577.24health boards according to Minnesota
577.25Statutes, section 145A.131, subdivision 1.
577.26$978,000 of the funding must be distributed
577.27to tribal governments based on Minnesota
577.28Statutes, section 145A.14, subdivision 2a.
577.29(5) The commissioner may use up to 6.23
577.30percent of the funds appropriated each fiscal
577.31year to conduct the ongoing evaluations
577.32required under Minnesota Statutes, section
577.33145A.17, subdivision 7, and training and
577.34technical assistance as required under
578.1Minnesota Statutes, section 145A.17,
578.2subdivisions 4 and 5.
578.3TANF Carryforward. Any unexpended
578.4balance of the TANF appropriation in the
578.5first year of the biennium does not cancel but
578.6is available for the second year.

578.7

Subd. 3.Policy Quality and Compliance

578.8	Appropriations by Fund
578.9	General	9,391,000	9,391,000
578.10 578.11	State Government Special Revenue	14,434,000	16,454,000
578.12	Health Care Access	9,524,000	8,924,000

578.13Base Level Adjustment. The state
578.14government special revenue fund base shall
578.15be reduced by $2,000 in fiscal year 2017. The
578.16health care access base shall be increased by
578.17$600,000 in fiscal year 2016 and decreased
578.18by $600,000 in fiscal year 2017.

578.19

Subd. 4.Health Protection

578.20	Appropriations by Fund
578.21	General	9,449,000	9,449,000
578.22 578.23	State Government Special Revenue	33,213,000	33,216,000
578.24	Special Revenue	300,000	300,000

578.25Infectious Disease Laboratory. Of the
578.26general fund appropriation, $200,000 in
578.27fiscal year 2014 and $200,000 in fiscal year
578.282015 are to monitor infectious disease trends
578.29and investigate infectious disease outbreaks.
578.30Surveillance for Elevated Blood Lead
578.31Levels. Of the general fund appropriation,
578.32$100,000 in fiscal year 2014 and $100,000
578.33in fiscal year 2015 are for the blood lead
578.34surveillance system under Minnesota
578.35Statutes, section 144.9502.
579.1Base Level Adjustment. The state
579.2government special revenue base is increased
579.3by $6,000 in fiscal year 2016 and by $13,000
579.4in fiscal year 2017.

579.5

Subd. 5.Administrative Support Services

7,772,000

7,772,000

579.6Regional Support for Local Public Health
579.7Departments. $350,000 in fiscal year
579.82014 and $350,000 in fiscal year 2015 is
579.9for regional staff who provide specialized
579.10expertise to local public health departments.

579.11

Sec. 4. HEALTH-RELATED BOARDS

579.12

Subdivision 1.Total Appropriation

$

17,335,000

$

17,285,000

579.13This appropriation is from the state
579.14government special revenue fund.
579.15The amounts that may be spent for each
579.16purpose are specified in the following
579.17subdivisions.

579.18

Subd. 2.Board of Chiropractic Examiners

470,000

470,000

579.19

Subd. 3.Board of Dentistry

1,820,000

1,820,000

579.20Health Professional Services Program. Of
579.21this appropriation, $704,000 in fiscal year
579.222014 and $704,000 in fiscal year 2015 from
579.23the state government special revenue fund are
579.24for the health professional services program.

579.25 579.26

Subd. 4.Board of Dietetic and Nutrition Practice

111,000

111,000

579.27 579.28

Subd. 5.Board of Marriage and Family Therapy

168,000

168,000

579.29

Subd. 6.Board of Medical Practice

3,867,000

3,867,000

579.30

Subd. 7.Board of Nursing

3,637,000

3,637,000

579.31 579.32

Subd. 8.Board of Nursing Home Administrators

1,632,000

1,582,000

580.1Administrative Services Unit - Operating
580.2Costs. Of this appropriation, $676,000
580.3in fiscal year 2014 and $626,000 in
580.4fiscal year 2015 are for operating costs
580.5of the administrative services unit. The
580.6administrative services unit may receive
580.7and expend reimbursements for services
580.8performed by other agencies.
580.9Administrative Services Unit - Volunteer
580.10Health Care Provider Program. Of this
580.11appropriation, $150,000 in fiscal year 2014
580.12and $150,000 in fiscal year 2015 are to pay
580.13for medical professional liability coverage
580.14required under Minnesota Statutes, section
580.15214.40.
580.16Administrative Services Unit - Contested
580.17Cases and Other Legal Proceedings. Of
580.18this appropriation, $200,000 in fiscal year
580.192014 and $200,000 in fiscal year 2015 are
580.20for costs of contested case hearings and other
580.21unanticipated costs of legal proceedings
580.22involving health-related boards funded
580.23under this section. Upon certification of a
580.24health-related board to the administrative
580.25services unit that the costs will be incurred
580.26and that there is insufficient money available
580.27to pay for the costs out of money currently
580.28available to that board, the administrative
580.29services unit is authorized to transfer money
580.30from this appropriation to the board for
580.31payment of those costs with the approval
580.32of the commissioner of management and
580.33budget.

580.34

Subd. 9.Board of Optometry

107,000

107,000

580.35

Subd. 10.Board of Pharmacy

2,555,000

2,555,000

581.1Prescription Electronic Reporting. Of
581.2this appropriation, $356,000 in fiscal year
581.32014 and $356,000 in fiscal year 2015 from
581.4the state government special revenue fund
581.5are to the board to operate the prescription
581.6monitoring program in Minnesota Statutes,
581.7section 152.126.

581.8

Subd. 11.Board of Physical Therapy

346,000

346,000

581.9

Subd. 12.Board of Podiatry

76,000

76,000

581.10

Subd. 13.Board of Psychology

847,000

847,000

581.11

Subd. 14.Board of Social Work

1,054,000

1,054,000

581.12

Subd. 15.Board of Veterinary Medicine

230,000

230,000

581.13 581.14

Subd. 16.Board of Behavioral Health and Therapy

415,000

415,000

581.15 581.16

Sec. 5. EMERGENCY MEDICAL SERVICES REGULATORY BOARD

$

2,741,000

$

2,741,000

581.17Regional Grants. $585,000 in fiscal year
581.182014 and $585,000 in fiscal year 2015 are
581.19for regional emergency medical services
581.20programs, to be distributed equally to the
581.21eight emergency medical service regions.
581.22Cooper/Sams Volunteer Ambulance
581.23Program. $700,000 in fiscal year 2014 and
581.24$700,000 in fiscal year 2015 are for the
581.25Cooper/Sams volunteer ambulance program
581.26under Minnesota Statutes, section 144E.40.
581.27(a) Of this amount, $611,000 in fiscal year
581.282014 and $611,000 in fiscal year 2015
581.29are for the ambulance service personnel
581.30longevity award and incentive program under
581.31Minnesota Statutes, section 144E.40.
581.32(b) Of this amount, $89,000 in fiscal year
581.332014 and $89,000 in fiscal year 2015 are
582.1for the operations of the ambulance service
582.2personnel longevity award and incentive
582.3program under Minnesota Statutes, section
582.4144E.40.
582.5Ambulance Training Grant. $361,000 in
582.6fiscal year 2014 and $361,000 in fiscal year
582.72015 are for training grants.
582.8EMSRB Board Operations. $1,095,000 in
582.9fiscal year 2014 and $1,095,000 in fiscal year
582.102015 are for operations.

582.11

Sec. 6. COUNCIL ON DISABILITY

$

614,000

$

614,000

582.12 582.13 582.14

Sec. 7. OMBUDSMAN FOR MENTAL HEALTH AND DEVELOPMENTAL DISABILITIES

$

1,654,000

$

1,654,000

582.15

Sec. 8. OMBUDSPERSON FOR FAMILIES

$

333,000

$

334,000

582.16    Sec. 9. Minnesota Statutes 2012, section 256.01, subdivision 34, is amended to read:
582.17    Subd. 34. Federal administrative reimbursement dedicated. Federal
582.18administrative reimbursement resulting from the following activities is appropriated to the
582.19commissioner for the designated purposes:
582.20(1) reimbursement for the Minnesota senior health options project; and
582.21(2) reimbursement related to prior authorization and inpatient admission certification
582.22by a professional review organization. A portion of these funds must be used for activities
582.23to decrease unnecessary pharmaceutical costs in medical assistance.; and
582.24(3) reimbursement resulting from the federal child support grant expenditures
582.25authorized under United States Code, title 42, section 1315.

582.26    Sec. 10. Minnesota Statutes 2012, section 256.01, is amended by adding a subdivision
582.27to read:
582.28    Subd. 35. Federal reimbursement for privatized adoption grants. Federal
582.29reimbursement for privatized adoption grant and foster care recruitment grant expenditures
582.30is appropriated to the commissioner for adoption grants and foster care and adoption
582.31administrative purposes.

583.1    Sec. 11. Minnesota Statutes 2012, section 256.01, is amended by adding a subdivision
583.2to read:
583.3    Subd. 36. DHS receipt center accounting. The commissioner may transfer
583.4appropriations to, and account for DHS receipt center operations in, the special revenue
583.5fund.

583.6    Sec. 12. TRANSFERS AND ADJUSTMENTS.
583.7(a) The appropriation in subdivision 5, paragraph (g), includes up to $53,391,000
583.8in fiscal year 2014; $216,637,000 in fiscal year 2015; $261,660,000 in fiscal year 2016;
583.9and $279,984,000 in fiscal year 2017, for medical assistance eligibility and administration
583.10changes related to:
583.11(1) eligibility for children age two to 18 with income up to 275 percent of the federal
583.12poverty guidelines;
583.13(2) eligibility for pregnant women with income up to 275 percent of the federal
583.14poverty guidelines;
583.15(3) Affordable Care Act enrollment and renewal processes, including elimination
583.16of six-month renewals, ex parte eligibility reviews, preprinted renewal forms, changes
583.17in verification requirements, and other changes in the eligibility determination and
583.18enrollment and renewal process;
583.19(4) automatic eligibility for children who turn 18 in foster care until they reach age 26;
583.20(5) eligibility related to spousal impoverishment provisions for waiver recipients; and
583.21(6) presumptive eligibility determinations by hospitals.
583.22(b) The commissioner of the Department of Human Services shall determine the
583.23difference between the actual costs to the medical assistance program attributable to
583.24the program changes in paragraph (a), clauses (1) to (6), and the costs of paragraph (a),
583.25clauses (1) to (6), that were estimated during the 2013 legislative session based on data
583.26from the 2013 February forecast. The costs in this paragraph must be calculated between
583.27beginning January 1, 2014, and June 30, 2017.
583.28(c) For each fiscal year from 2014 to 2017, the commissioner of human services
583.29shall certify the actual cost differences to the medical assistance program determined
583.30under paragraph (b), and report the costs to the commissioner of management and budget
583.31by June 30 of each fiscal year. In each fiscal year, the commissioner of management
583.32and budget shall reduce the transfer from the health care access fund under section 3
583.33by the amounts determined in paragraph (b). If for any fiscal year the amount of the
583.34cost difference determined under paragraph (b) exceeds the amount of the transfer under
583.35section 14, the transfer for that year must be zero.
584.1(d) This section expires on January 1, 2018.

584.2    Sec. 13. HEALTH CARE ACCESS FUND TRANSFER TO GENERAL FUND
584.3FOR MINNESOTACARE POPULATIONS.
584.4(a) The commissioner of Minnesota management and budget shall transfer from the
584.5health care access fund to the general fund $53,391,000 in fiscal year 2014; $216,637,000
584.6in fiscal year 2015; $261,660,000 in fiscal year 2016; and $279,984,000 in fiscal year
584.72017, for medical assistance changes in section 12.
584.8(b) This section expires on January 1, 2018.

584.9    Sec. 14. HEALTH CARE ACCESS FUND TRANSFER TO GENERAL FUND.
584.10(a) The commissioner of Minnesota management and budget shall transfer from the
584.11health care access fund to the general fund $133,765,000 in fiscal year 2014; $23,893,000
584.12in fiscal year 2015; $48,371,000 in fiscal year 2016; and $32,325,000 in fiscal year 2017.
584.13For each fiscal year, the commissioner must reduce the amount of the transfer under this
584.14section according to section 12, paragraph (c).
584.15(b) This section expires on January 1, 2018.

584.16    Sec. 15. TRANSFERS.
584.17    Subdivision 1. Grants. The commissioner of human services, with the approval of
584.18the commissioner of management and budget, may transfer unencumbered appropriation
584.19balances for the biennium ending June 30, 2015, within fiscal years among the MFIP,
584.20general assistance, general assistance medical care under Minnesota Statutes 2009
584.21Supplement, section 256D.03, subdivision 3, medical assistance, MinnesotaCare, MFIP
584.22child care assistance under Minnesota Statutes, section 119B.05, Minnesota supplemental
584.23aid, group residential housing programs, the entitlement portion of the chemical
584.24dependency consolidated treatment fund, and between fiscal years of the biennium. The
584.25commissioner shall inform the chairs and ranking minority members of the senate Health
584.26and Human Services Finance Division and the house of representatives Health and Human
584.27Services Finance Committee quarterly about transfers made under this provision.
584.28    Subd. 2. Administration. Positions, salary money, and nonsalary administrative
584.29money may be transferred within the Departments of Human Services and Health as the
584.30commissioners consider necessary, with the advance approval of the commissioner of
584.31management and budget. The commissioner shall inform the chairs and ranking minority
584.32members of the senate Health and Human Services Finance Division and the house of
585.1representatives Health and Human Services Finance Committee quarterly about transfers
585.2made under this provision.

585.3    Sec. 16. INDIRECT COSTS NOT TO FUND PROGRAMS.
585.4The commissioners of health and human services shall not use indirect cost
585.5allocations to pay for the operational costs of any program for which they are responsible.

585.6    Sec. 17. EXPIRATION OF UNCODIFIED LANGUAGE.
585.7All uncodified language contained in this article expires on June 30, 2015, unless a
585.8different expiration date is explicit.

585.9    Sec. 18. EFFECTIVE DATE.
585.10This article is effective July 1, 2013, unless a different effective date is specified.

585.11ARTICLE 15

585.12REFORM 2020 CONTINGENT APPROPRIATIONS

585.13

Section 1. HEALTH AND HUMAN SERVICES APPROPRIATIONS.

585.14The sums shown in the columns marked "Appropriations" are appropriated to the
585.15agencies and for the purposes specified in this article. The appropriations are from the
585.16general fund, or another named fund, and are available for the fiscal years indicated
585.17for each purpose. The figures "2014" and "2015" used in this article mean that the
585.18appropriations listed under them are available for the fiscal year ending June 30, 2014, or
585.19June 30, 2015, respectively. "The first year" is fiscal year 2014. "The second year" is fiscal
585.20year 2015. "The biennium" is fiscal years 2014 and 2015.

585.21				APPROPRIATIONS
585.22				Available for the Year
585.23				Ending June 30
585.24					2014		2015

585.25 585.26

Sec. 2. COMMISSIONER OF HUMAN SERVICES

585.27

Subdivision 1.Total Appropriation

817,000

895,000

585.28

Subd. 2.Central Office

585.29The amounts that may be spent from this
585.30appropriation for each purpose are as follows:

585.31

(a) Operations

4,688,000

11,643,000

586.1Base Adjustment. The general fund base is
586.2decreased by $11,056,000 in fiscal year 2016
586.3and $11,056,000 in fiscal year 2017.

586.4

(b) Continuing Care

2,334,000

2,556,000

586.5Base Adjustment. The general fund base is
586.6decreased by $2,000 in fiscal year 2016 and
586.7by $27,000,000 in fiscal year 2017.

586.8

(c) Group Residential Housing

(1,166,000)

(8,602,000)

586.9

(d) Medical Assistance

(2,647,000)

(2,627,000)

586.10

(e) Alternative Care

(7,386,000)

(6,851,000)

586.11

(f) Child and Community Service Grants

3,000,000

3,000,000

586.12

(g) Aging and Adult Services Grants

1,430,000

1,237,000

586.13Gaps Analysis. In fiscal year 2014, and
586.14in each even-numbered year thereafter,
586.15$435,000 is appropriated to conduct an
586.16analysis of gaps in long-term care services
586.17under Minnesota Statutes, section 144A.351.
586.18This is a biennial appropriation. The base is
586.19increased by $435,000 in fiscal year 2016.
586.20Notwithstanding any contrary provisions in
586.21this article, this provision does not expire.
586.22Base Adjustment. The general fund base is
586.23increased by $597,000 in fiscal year 2016,
586.24and by $100,000 in fiscal year 2017.

586.25

(h) Disabilities Grants

(564,000)

(539,000)

586.26Base Adjustment. The general fund base is
586.27increased by $25,000 in fiscal year 2016 and
586.28by $25,000 in fiscal year 2017.

586.29    Sec. 3. FEDERAL APPROVAL.
586.30(a) The implementation of this article is contingent on federal approval.
586.31(b) Upon full or partial approval of the waiver application, the commissioner of
586.32human services shall submit to the commissioner of management and budget a plan for
587.1implementing the provisions in this article that received federal approval as well as any
587.2provisions that do not require federal approval. The plan must:
587.3(1) include fiscal estimates that, with federal administrative reimbursement, do
587.4not increase the general fund appropriations to the commissioner of human services in
587.5fiscal years 2014 and 2015; and
587.6(2) include a fiscal estimate for the systems modernization appropriation, which
587.7cannot exceed $15,463,000 for the biennium ending June 30, 2015.
587.8(c) Upon approval by the commissioner of management and budget, the
587.9commissioner of human services may implement the plan.
587.10(d) The commissioner of management and budget must notify the chairs and ranking
587.11minority members of the legislative committees with jurisdiction over health and human
587.12services finance when the plan is approved. The plan must be made publicly available.

587.13    Sec. 4. IMPLEMENTATION OF REFORM 2020 CONTINGENT PROVISIONS
587.14AND ADJUSTMENTS TO APPROPRIATIONS AND PLANNING ESTIMATES.
587.15Upon approval of the plan in section 3, the commissioner of management and
587.16budget shall make necessary adjustments to the appropriations in this article to reflect the
587.17effective date of federal approval. The adjustments must include the nondedicated revenue
587.18attributable to the provisions of this article and the related planning estimates for fiscal
587.19years 2016 and 2017 must reflect the revised fiscal estimates attributable to the provisions
587.20in this article. The revised appropriations for fiscal years 2014 and 2015 shall be included
587.21in the forecast and must not increase the appropriations to the commissioner of human
587.22services for fiscal years 2014 and 2015. If the adjustments to the planning estimates for
587.23fiscal years 2016 and 2017 result in increased general fund expenditure estimates for
587.24the commissioner of human services attributable to the provisions in this article, when
587.25compared to the planning estimates attributable to the provision in this article made in the
587.26February 2013 forecast, none of the provisions in this article shall be implemented.

587.27ARTICLE 16

587.28HUMAN SERVICES FORECAST ADJUSTMENTS

587.29 587.30

Section 1. COMMISSIONER OF HUMAN SERVICES

587.31

Subdivision 1.Total Appropriation

$

(161,031,000)

587.32	Appropriations by Fund
587.33		2013
587.34	General Fund	(158,668,000)
588.1	Health Care Access	(7,179,000)
588.2	TANF	4,816,000

588.3	Subd. 2.Forecasted Programs
588.4	(a) MFIP/DWP Grants

588.5	Appropriations by Fund
588.6	General Fund	(8,211,000)
588.7	TANF	4,399,000

588.8

(b) MFIP Child Care Assistance Grants

10,113,000

588.9

(c) General Assistance Grants

3,230,000

588.10

(d) Minnesota Supplemental Aid Grants

(1,008,000)

588.11

(e) Group Residential Housing Grants

(5,423,000)

588.12

(f) MinnesotaCare Grants

(7,179,000)

588.13This appropriation is from the health care
588.14access fund.

588.15

(g) Medical Assistance Grants

(159,733,000)

588.16

(h) Alternative Care Grants

-0-

588.17

(i) CD Entitlement Grants

2,364,000

588.18

Subd. 3.Technical Activities

417,000

588.19This appropriation is from the TANF fund.
588.20EFFECTIVE DATE.This section is effective the day following final enactment.