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HF 1233

4th Engrossment - 88th Legislature (2013 - 2014) Posted on 09/10/2013 03:06pm

KEY: stricken = removed, old language. underscored = added, new language.

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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, human services
1.4licensing, children and family services, program integrity, health-related
1.5licensing boards, chemical and mental health services, managed care
1.6organizations, waiver provider standards, home care, and the Department of
1.7Health; redesigning home and community-based services; establishing payment
1.8methodologies for home and community-based services; adjusting provider
1.9rates; setting and modifying fees; modifying autism coverage; modifying
1.10assistance programs; establishing Northstar care for children; making technical
1.11changes; requiring studies; requiring reports; appropriating money;amending
1.12Minnesota Statutes 2012, sections 13.381, subdivisions 2, 10; 13.461, by adding
1.13subdivisions; 16A.724, subdivisions 2, 3; 16C.10, subdivision 5; 16C.155,
1.14subdivision 1; 43A.23, by adding a subdivision; 62J.692, subdivisions 1, 3, 4,
1.155, 9, by adding a subdivision; 62Q.19, subdivision 1; 103I.005, by adding a
1.16subdivision; 103I.521; 119B.011, by adding a subdivision; 119B.02, by adding
1.17a subdivision; 119B.025, subdivision 1; 119B.03, subdivision 4; 119B.05,
1.18subdivision 1; 119B.13, subdivisions 1, 1a, 3a, 6, 7, by adding subdivisions;
1.19144.051, by adding subdivisions; 144.0724, subdivisions 4, 6; 144.123,
1.20subdivision 1; 144.125, subdivision 1; 144.212; 144.213; 144.215, subdivisions
1.213, 4; 144.216, subdivision 1; 144.217, subdivision 2; 144.218, subdivision 5;
1.22144.225, subdivisions 1, 4, 7, 8; 144.226; 144.966, subdivisions 2, 3a; 144.98,
1.23subdivisions 3, 5, by adding subdivisions; 144.99, subdivision 4; 144A.071,
1.24subdivision 4b; 144A.351; 144A.43; 144A.44; 144A.45; 144D.01, subdivision 4;
1.25145.906; 145.986; 145A.17, subdivision 1; 145C.01, subdivision 7; 148B.17,
1.26subdivision 2; 148E.065, subdivision 4a; 149A.02, subdivisions 1a, 2, 3, 4, 5,
1.2716, 23, 27, 34, 35, 37, by adding subdivisions; 149A.03; 149A.65, by adding
1.28subdivisions; 149A.70, subdivisions 1, 2, 3, 5; 149A.71, subdivisions 2, 4;
1.29149A.72, subdivisions 3, 9, by adding a subdivision; 149A.73, subdivisions 1,
1.302, 4; 149A.74; 149A.91, subdivision 9; 149A.93, subdivisions 3, 6; 149A.94;
1.31149A.96, subdivision 9; 151.19, subdivisions 1, 3; 151.37, subdivision 4; 151.47,
1.32subdivision 1, by adding a subdivision; 151.49; 174.30, subdivision 1; 214.12, by
1.33adding a 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; 245.4871, subdivision 26; 245.4875, subdivision 8; 245.4881,
1.36subdivision 1; 245.91, by adding a subdivision; 245.94, subdivisions 2, 2a;
1.37245A.02, subdivisions 1, 9, 10, 14; 245A.03, subdivisions 7, 8, 9; 245A.04,
1.38subdivision 13; 245A.042, subdivision 3; 245A.07, subdivisions 2a, 3; 245A.08,
1.39subdivision 2a; 245A.10; 245A.11, subdivisions 2a, 7, 7a, 7b, 8; 245A.1435;
2.1245A.144; 245A.1444; 245A.16, subdivision 1; 245A.40, subdivision 5;
2.2245A.50; 245C.04, by adding a subdivision; 245C.08, subdivision 1; 245D.02;
2.3245D.03; 245D.04; 245D.05; 245D.06; 245D.07; 245D.09; 245D.10; 246.18,
2.4subdivision 8, by adding a subdivision; 246.54; 252.27, subdivision 2a;
2.5252.291, by adding a subdivision; 252.41, subdivision 3; 252.42; 252.43;
2.6252.44; 252.45; 252.46, subdivision 1a; 253B.10, subdivision 1; 254B.04,
2.7subdivision 1; 254B.13; 256.01, subdivisions 2, 24, 34, by adding subdivisions;
2.8256.0112, by adding a subdivision; 256.015, subdivision 1; 256.82, subdivisions
2.92, 3; 256.9657, subdivisions 3, 3a, 4; 256.969, subdivision 29; 256.975,
2.10subdivision 7, by adding subdivisions; 256.9754, subdivision 5, by adding
2.11subdivisions; 256.98, subdivision 8; 256B.02, subdivision 17, as added, by
2.12adding subdivisions; 256B.021, by adding subdivisions; 256B.04, subdivisions
2.1318, 21, by adding a subdivision; 256B.055, subdivisions 3a, 6, 10, 14, 15, by
2.14adding a subdivision; 256B.056, subdivisions 1, 1c, 3, 4, as amended, 5c, 10, by
2.15adding a subdivision; 256B.057, subdivisions 1, 8, 10, by adding a subdivision;
2.16256B.06, subdivision 4; 256B.0623, subdivision 2; 256B.0625, subdivisions 9,
2.1713, 13e, 19c, 31, 39, 48, 56, 58, by adding subdivisions; 256B.0631, subdivision
2.181; 256B.064, subdivisions 1a, 1b, 2; 256B.0659, subdivision 21; 256B.0755,
2.19subdivision 3; 256B.0756; 256B.0911, subdivisions 1, 1a, 3a, 4d, 6, 7, by
2.20adding a subdivision; 256B.0913, subdivision 4; 256B.0915, subdivisions 3a,
2.215, by adding a subdivision; 256B.0916, by adding a subdivision; 256B.0917,
2.22subdivisions 6, 13, by adding subdivisions; 256B.092, subdivisions 1a, 7,
2.2311, 12, by adding subdivisions; 256B.0943, subdivisions 1, 2, 7, by adding a
2.24subdivision; 256B.0946; 256B.095; 256B.0951, subdivisions 1, 4; 256B.0952,
2.25subdivisions 1, 5; 256B.0955; 256B.097, subdivisions 1, 3; 256B.196,
2.26subdivision 2; 256B.431, subdivision 44; 256B.434, subdivision 4, by adding
2.27subdivisions; 256B.437, subdivision 6; 256B.439, subdivisions 1, 2, 3, 4, by
2.28adding subdivisions; 256B.441, subdivisions 13, 44, 53, by adding subdivisions;
2.29256B.49, subdivisions 11a, 12, 13, 14, 15, by adding subdivisions; 256B.4912,
2.30subdivisions 1, 2, 3, 7, by adding subdivisions; 256B.4913, subdivisions 5, 6, by
2.31adding a subdivision; 256B.492; 256B.493, subdivision 2; 256B.501, by adding
2.32a subdivision; 256B.5011, subdivision 2; 256B.5012, by adding subdivisions;
2.33256B.69, subdivisions 5c, 5i, 8, 9c, 31, by adding subdivisions; 256B.694;
2.34256B.76, subdivisions 1, 2, 4, by adding a subdivision; 256B.761; 256B.764;
2.35256B.766; 256B.767; 256D.44, subdivision 5; 256I.05, by adding a subdivision;
2.36256J.08, subdivision 24; 256J.21, subdivisions 2, 3; 256J.24, subdivisions 5, 7;
2.37256J.35; 256J.621; 256J.626, subdivision 7; 256K.45; 256L.01, subdivisions
2.383a, 5, by adding subdivisions; 256L.02, subdivision 2, by adding subdivisions;
2.39256L.03, subdivisions 1, 1a, 3, 5, 6, by adding a subdivision; 256L.04,
2.40subdivisions 1, 7, 8, 10, 12, by adding subdivisions; 256L.05, subdivisions
2.411, 2, 3, 3c; 256L.06, subdivision 3; 256L.07, subdivisions 1, 2, 3; 256L.09,
2.42subdivision 2; 256L.11, subdivisions 1, 3; 256L.12, subdivision 1; 256L.15,
2.43subdivisions 1, 2; 256M.40, subdivision 1; 257.0755, subdivision 1; 257.75,
2.44subdivision 7; 257.85, subdivisions 2, 5, 6; 259A.20, subdivision 4; 260B.007,
2.45subdivisions 6, 16; 260C.007, subdivisions 6, 31; 260C.446; 260C.635,
2.46subdivision 1; 299C.093; 402A.10; 402A.18; 471.59, subdivision 1; 517.001;
2.47518A.60; 626.556, subdivisions 2, 3, 10d; 626.557, subdivisions 4, 9, 9a, 9e;
2.48626.5572, subdivision 13; Laws 1998, chapter 407, article 6, section 116; Laws
2.492011, First Special Session chapter 9, article 1, section 3; article 2, section 27;
2.50article 10, section 3, subdivision 3, as amended; Laws 2012, chapter 247, article
2.516, section 4; Laws 2013, chapter 1, section 6; proposing coding for new law in
2.52Minnesota Statutes, chapters 62A; 144; 144A; 145; 149A; 151; 214; 245; 245A;
2.53245D; 254B; 256; 256B; 256J; 256L; 259A; 260C; 402A; proposing coding
2.54for new law as Minnesota Statutes, chapters 245E; 256N; repealing Minnesota
2.55Statutes 2012, sections 62J.693; 103I.005, subdivision 20; 144.123, subdivision
2.562; 144A.46; 144A.461; 149A.025; 149A.20, subdivision 8; 149A.30, subdivision
2.572; 149A.40, subdivision 8; 149A.45, subdivision 6; 149A.50, subdivision 6;
2.58149A.51, subdivision 7; 149A.52, subdivision 5a; 149A.53, subdivision 9;
3.1151.19, subdivision 2; 151.25; 151.45; 151.47, subdivision 2; 151.48; 245A.655;
3.2245B.01; 245B.02; 245B.03; 245B.031; 245B.04; 245B.05, subdivisions 1, 2,
3.33, 5, 6, 7; 245B.055; 245B.06; 245B.07; 245B.08; 245D.08; 252.40; 252.46,
3.4subdivisions 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 16, 17, 18, 19, 20, 21; 256.82,
3.5subdivision 4; 256B.055, subdivisions 3, 5, 10b; 256B.056, subdivision 5b;
3.6256B.057, subdivisions 1c, 2; 256B.0911, subdivisions 4a, 4b, 4c; 256B.0917,
3.7subdivisions 1, 2, 3, 4, 5, 7, 8, 9, 10, 11, 12, 14; 256B.096, subdivisions 1, 2, 3,
3.84; 256B.14, subdivision 3a; 256B.49, subdivision 16a; 256B.4913, subdivisions
3.91, 2, 3, 4; 256B.501, subdivision 8; 256B.5012, subdivision 13; 256J.24;
3.10256L.01, subdivision 4a; 256L.031; 256L.04, subdivisions 1b, 9, 10a; 256L.05,
3.11subdivision 3b; 256L.07, subdivisions 1, 5, 8, 9; 256L.11, subdivisions 5, 6;
3.12256L.17, subdivisions 1, 2, 3, 4, 5; 260C.441; 485.14; 609.093; Laws 2011, First
3.13Special Session chapter 9, article 7, section 54, as amended; Minnesota Rules,
3.14parts 4668.0002; 4668.0003; 4668.0005; 4668.0008; 4668.0012; 4668.0016;
3.154668.0017; 4668.0019; 4668.0030; 4668.0035; 4668.0040; 4668.0050;
3.164668.0060; 4668.0065; 4668.0070; 4668.0075; 4668.0080; 4668.0100;
3.174668.0110; 4668.0120; 4668.0130; 4668.0140; 4668.0150; 4668.0160;
3.184668.0170; 4668.0180; 4668.0190; 4668.0200; 4668.0218; 4668.0220;
3.194668.0230; 4668.0240; 4668.0800; 4668.0805; 4668.0810; 4668.0815;
3.204668.0820; 4668.0825; 4668.0830; 4668.0835; 4668.0840; 4668.0845;
3.214668.0855; 4668.0860; 4668.0865; 4668.0870; 4669.0001; 4669.0010;
3.224669.0020; 4669.0030; 4669.0040; 4669.0050; 9525.1860, subparts 3, items B,
3.23C, 4, item D; 9560.0650, subparts 1, 3, 6; 9560.0651; 9560.0655.
3.24BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

3.25ARTICLE 1
3.26AFFORDABLE CARE ACT IMPLEMENTATION; BETTER HEALTH
3.27CARE FOR MORE MINNESOTANS

3.28    Section 1. Minnesota Statutes 2012, section 16A.724, subdivision 3, is amended to read:
3.29    Subd. 3. MinnesotaCare federal receipts. Receipts received as a result of federal
3.30participation pertaining to administrative costs of the Minnesota health care reform waiver
3.31shall be deposited as nondedicated revenue in the health care access fund. Receipts
3.32received as a result of federal participation pertaining to grants shall be deposited in the
3.33federal fund and shall offset health care access funds for payments to providers. All federal
3.34funding received by Minnesota for implementation and administration of MinnesotaCare
3.35as a basic health program, as authorized in section 1331 of the Affordable Care Act,
3.36Public Law 111-148, as amended by Public Law 111-152, is dedicated to that program and
3.37shall be deposited into the health care access fund. Federal funding that is received for
3.38implementing and administering MinnesotaCare as a basic health program and deposited in
3.39the fund shall be used only for that program to purchase health care coverage for enrollees
3.40and reduce enrollee premiums and cost-sharing or provide additional enrollee benefits.
3.41EFFECTIVE DATE.This section is effective January 1, 2015.

3.42    Sec. 2. Minnesota Statutes 2012, section 254B.04, subdivision 1, is amended to read:
4.1    Subdivision 1. Eligibility. (a) Persons eligible for benefits under Code of Federal
4.2Regulations, title 25, part 20, persons eligible for medical assistance benefits under
4.3sections 256B.055, 256B.056, and 256B.057, subdivisions 1, 2, 5, and 6, or who meet
4.4the income standards of section 256B.056, subdivision 4, and persons eligible for general
4.5assistance medical care under section 256D.03, subdivision 3, are entitled to chemical
4.6dependency fund services. State money appropriated for this paragraph must be placed in
4.7a separate account established for this purpose.
4.8Persons with dependent children who are determined to be in need of chemical
4.9dependency treatment pursuant to an assessment under section 626.556, subdivision 10, or
4.10a case plan under section 260C.201, subdivision 6, or 260C.212, shall be assisted by the
4.11local agency to access needed treatment services. Treatment services must be appropriate
4.12for the individual or family, which may include long-term care treatment or treatment in a
4.13facility that allows the dependent children to stay in the treatment facility. The county
4.14shall pay for out-of-home placement costs, if applicable.
4.15(b) A person not entitled to services under paragraph (a), but with family income
4.16that is less than 215 percent of the federal poverty guidelines for the applicable family
4.17size, shall be eligible to receive chemical dependency fund services within the limit
4.18of funds appropriated for this group for the fiscal year. If notified by the state agency
4.19of limited funds, a county must give preferential treatment to persons with dependent
4.20children who are in need of chemical dependency treatment pursuant to an assessment
4.21under section 626.556, subdivision 10, or a case plan under section 260C.201, subdivision
4.226
, or 260C.212. A county may spend money from its own sources to serve persons under
4.23this paragraph. State money appropriated for this paragraph must be placed in a separate
4.24account established for this purpose.
4.25(c) Persons whose income is between 215 percent and 412 percent of the federal
4.26poverty guidelines for the applicable family size shall be eligible for chemical dependency
4.27services on a sliding fee basis, within the limit of funds appropriated for this group for the
4.28fiscal year. Persons eligible under this paragraph must contribute to the cost of services
4.29according to the sliding fee scale established under subdivision 3. A county may spend
4.30money from its own sources to provide services to persons under this paragraph. State
4.31money appropriated for this paragraph must be placed in a separate account established
4.32for this purpose.
4.33EFFECTIVE DATE.This section is effective January 1, 2014.

4.34    Sec. 3. Minnesota Statutes 2012, section 256.01, is amended by adding a subdivision
4.35to read:
5.1    Subd. 35. Federal approval. (a) The commissioner shall seek federal authority
5.2from the U.S. Department of Health and Human Services necessary to operate a health
5.3coverage program for Minnesotans with incomes up to 275 percent of the federal poverty
5.4guidelines (FPG). The proposal shall seek to secure all federal funding available from at
5.5least the following services:
5.6(1) all premium tax credits and cost sharing subsidies available under United States
5.7Code, title 26, section 36B, and United States Code, title 42, section 18071, for individuals
5.8with incomes above 133 percent and at or below 275 percent of the federal poverty
5.9guidelines who would otherwise be enrolled in the Minnesota Insurance Marketplace as
5.10defined in section 62V.02;
5.11(2) Medicaid funding; and
5.12(3) other funding sources identified by the commissioner that support coverage or
5.13care redesign in Minnesota.
5.14(b) Funding received shall be used to design and implement a health coverage
5.15program that creates a single streamlined program and meets the needs of Minnesotans with
5.16incomes up to 275 percent of the federal poverty guidelines. The program must incorporate:
5.17(1) payment reform characteristics included in the health care delivery system and
5.18accountable care organization payment models;
5.19(2) flexibility in benefit set design such that benefits can be targeted to meet enrollee
5.20needs in different income and health status situations and can provide a more seamless
5.21transition from public to private health care coverage;
5.22(3) flexibility in co-payment or premium structures to incent patients to seek
5.23high-quality, low-cost care settings; and
5.24(4) flexibility in premium structures to ease the transition from public to private
5.25health care coverage.
5.26(c) The commissioner shall develop and submit a proposal consistent with the above
5.27criteria and shall seek all federal authority necessary to implement the health coverage
5.28program. In developing the request, the commissioner shall consult with appropriate
5.29stakeholder groups and consumers.
5.30(d) The commissioner is authorized to seek any available waivers or federal
5.31approvals to accomplish the goals under paragraph (b) prior to 2017.
5.32(e) The commissioner shall report to the chairs and ranking minority members of
5.33the legislative committees with jurisdiction over health and human services policy and
5.34financing by January 15, 2015, on the progress of receiving a federal waiver and shall
5.35make recommendations on any legislative changes necessary to accomplish the project
5.36in this subdivision. Any implementation of the waiver that requires a state financial
6.1contribution to operate a health coverage program for Minnesotans with incomes between
6.2200 and 275 percent of the federal poverty guidelines, shall be contingent on legislative
6.3action approving the contribution.
6.4(f) The commissioner is authorized to accept and expend federal funds that support
6.5the purposes of this subdivision.

6.6    Sec. 4. Minnesota Statutes 2012, section 256.015, subdivision 1, is amended to read:
6.7    Subdivision 1. State agency has lien. When the state agency provides, pays for, or
6.8becomes liable for medical care or furnishes subsistence or other payments to a person,
6.9the agency shall have a lien for the cost of the care and payments on any and all causes of
6.10action or recovery rights under any policy, plan, or contract providing benefits for health
6.11care or injury which accrue to the person to whom the care or payments were furnished,
6.12or to the person's legal representatives, as a result of the occurrence that necessitated the
6.13medical care, subsistence, or other payments. For purposes of this section, "state agency"
6.14includes prepaid health plans under contract with the commissioner according to sections
6.15256B.69 , 256D.03, subdivision 4, paragraph (c), and 256L.12, 256L.01, subdivision 7,
6.16and 256L.03, subdivision 6; children's mental health collaboratives under section 245.493;
6.17demonstration projects for persons with disabilities under section 256B.77; nursing
6.18homes under the alternative payment demonstration project under section 256B.434; and
6.19county-based purchasing entities under section 256B.692.

6.20    Sec. 5. Minnesota Statutes 2012, section 256B.02, subdivision 17, as added by Laws
6.212013, chapter 1, section 1, is amended to read:
6.22    Subd. 17. Affordable Care Act or ACA. "Affordable Care Act" or "ACA" means
6.23Public Law 111-148, as amended by the federal Health Care and Education Reconciliation
6.24Act of 2010 (Public Law 111-152), and any amendments to, or regulations or guidance
6.25issued under, those acts means the federal Patient Protection and Affordable Care Act,
6.26Public Law 111-148, as amended, including the federal Health Care and Education
6.27Reconciliation Act of 2010, Public Law 111-152, and any amendments to, and any federal
6.28guidance or regulations issued under, these acts.
6.29EFFECTIVE DATE.This section is effective July 1, 2013.

6.30    Sec. 6. Minnesota Statutes 2012, section 256B.02, is amended by adding a subdivision
6.31to read:
7.1    Subd. 18. Caretaker relative. "Caretaker relative" means a relative, by blood,
7.2adoption, or marriage, of a child under age 19 with whom the child is living and who
7.3assumes primary responsibility for the child's care.
7.4EFFECTIVE DATE.This section is effective January 1, 2014.

7.5    Sec. 7. Minnesota Statutes 2012, section 256B.02, is amended by adding a subdivision
7.6to read:
7.7    Subd. 19. Insurance affordability program. "Insurance affordability program"
7.8means one of the following programs:
7.9(1) medical assistance under this chapter;
7.10(2) a program that provides advance payments of the premium tax credits established
7.11under section 36B of the Internal Revenue Code or cost-sharing reductions established
7.12under section 1402 of the Affordable Care Act;
7.13(3) MinnesotaCare as defined in chapter 256L; and
7.14(4) a Basic Health Plan as defined in section 1331 of the Affordable Care Act.
7.15EFFECTIVE DATE.This section is effective the day following final enactment.

7.16    Sec. 8. Minnesota Statutes 2012, section 256B.04, subdivision 18, is amended to read:
7.17    Subd. 18. Applications for medical assistance. (a) The state agency may take
7.18 shall accept applications for medical assistance and conduct eligibility determinations for
7.19MinnesotaCare enrollees by telephone, via mail, in-person, online via an Internet Web
7.20site, and through other commonly available electronic means.
7.21    (b) The commissioner of human services shall modify the Minnesota health care
7.22programs application form to add a question asking applicants whether they have ever
7.23served in the United States military.
7.24    (c) For each individual who submits an application or whose eligibility is subject to
7.25renewal or whose eligibility is being redetermined pursuant to a change in circumstances,
7.26if the agency determines the individual is not eligible for medical assistance, the agency
7.27shall determine potential eligibility for other insurance affordability programs.
7.28EFFECTIVE DATE.This section is effective January 1, 2014.

7.29    Sec. 9. Minnesota Statutes 2012, section 256B.055, subdivision 3a, is amended to read:
7.30    Subd. 3a. Families with children. Beginning July 1, 2002, Medical assistance may
7.31be paid for a person who is a child under the age of 18, or age 18 if a full-time student
7.32in a secondary school, or in the equivalent level of vocational or technical training, and
8.1reasonably expected to complete the program before reaching age 19; the parent or
8.2stepparent of a dependent child under the age of 19, including a pregnant woman; or a
8.3caretaker relative of a dependent child under the age of 19.
8.4EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
8.5approval, whichever is later. The commissioner of human services shall notify the revisor
8.6of statutes when federal approval is obtained.

8.7    Sec. 10. Minnesota Statutes 2012, section 256B.055, subdivision 6, is amended to read:
8.8    Subd. 6. Pregnant women; needy unborn child. Medical assistance may be paid
8.9for a pregnant woman who has written verification of a positive pregnancy test from a
8.10physician or licensed registered nurse, who meets the other eligibility criteria of this
8.11section and whose unborn child would be eligible as a needy child under subdivision 10 if
8.12born and living with the woman. In accordance with Code of Federal Regulations, title
8.1342, section 435.956, the commissioner must accept self-attestation of pregnancy unless
8.14the agency has information that is not reasonably compatible with such attestation. For
8.15purposes of this subdivision, a woman is considered pregnant for 60 days postpartum.
8.16EFFECTIVE DATE.This section is effective January 1, 2014.

8.17    Sec. 11. Minnesota Statutes 2012, section 256B.055, subdivision 10, is amended to read:
8.18    Subd. 10. Infants. Medical assistance may be paid for an infant less than one year
8.19of age, whose mother was eligible for and receiving medical assistance at the time of birth
8.20or who is less than two years of age and is in a family with countable income that is equal
8.21to or less than the income standard established under section 256B.057, subdivision 1.
8.22EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
8.23approval, whichever is later. The commissioner of human services shall notify the revisor
8.24of statutes when federal approval is obtained.

8.25    Sec. 12. Minnesota Statutes 2012, section 256B.055, subdivision 15, is amended to read:
8.26    Subd. 15. Adults without children. Medical assistance may be paid for a person
8.27who is:
8.28(1) at least age 21 and under age 65;
8.29(2) not pregnant;
8.30(3) not entitled to Medicare Part A or enrolled in Medicare Part B under Title XVIII
8.31of the Social Security Act;
9.1(4) not an adult in a family with children as defined in section 256L.01, subdivision
9.23a
; and not otherwise eligible under subdivision 7 as a person who meets the categorical
9.3eligibility requirements of the supplemental security income program;
9.4(5) not enrolled under subdivision 7 as a person who would meet the categorical
9.5eligibility requirements of the supplemental security income program except for excess
9.6income or assets; and
9.7(5) (6) not described in another subdivision of this section.
9.8EFFECTIVE DATE.This section is effective January 1, 2014.

9.9    Sec. 13. Minnesota Statutes 2012, section 256B.055, is amended by adding a
9.10subdivision to read:
9.11    Subd. 17. Adults who were in foster care at the age of 18. Medical assistance may
9.12be paid for a person under 26 years of age who was in foster care under the commissioner's
9.13responsibility on the date of attaining 18 years of age, and who was enrolled in medical
9.14assistance under the state plan or a waiver of the plan while in foster care, in accordance
9.15with section 2004 of the Affordable Care Act.
9.16EFFECTIVE DATE.This section is effective January 1, 2014.

9.17    Sec. 14. Minnesota Statutes 2012, section 256B.056, subdivision 1, is amended to read:
9.18    Subdivision 1. Residency. To be eligible for medical assistance, a person must
9.19reside in Minnesota, or, if absent from the state, be deemed to be a resident of Minnesota,
9.20 in accordance with the rules of the state agency Code of Federal Regulations, title 42,
9.21section 435.403.
9.22EFFECTIVE DATE.This section is effective January 1, 2014.

9.23    Sec. 15. Minnesota Statutes 2012, section 256B.056, subdivision 1c, is amended to read:
9.24    Subd. 1c. Families with children income methodology. (a)(1) [Expired, 1Sp2003
9.25c 14 art 12 s 17]
9.26(2) For applications processed within one calendar month prior to July 1, 2003,
9.27eligibility shall be determined by applying the income standards and methodologies in
9.28effect prior to July 1, 2003, for any months in the six-month budget period before July
9.291, 2003, and the income standards and methodologies in effect on July 1, 2003, for any
9.30months in the six-month budget period on or after that date. The income standards for
9.31each month shall be added together and compared to the applicant's total countable income
9.32for the six-month budget period to determine eligibility.
10.1(3) For children ages one through 18 whose eligibility is determined under section
10.2256B.057, subdivision 2, the following deductions shall be applied to income counted
10.3toward the child's eligibility as allowed under the state's AFDC plan in effect as of July
10.416, 1996: $90 work expense, dependent care, and child support paid under court order.
10.5This clause is effective October 1, 2003.
10.6(b) For families with children whose eligibility is determined using the standard
10.7specified in section 256B.056, subdivision 4, paragraph (c), 17 percent of countable
10.8earned income shall be disregarded for up to four months and the following deductions
10.9shall be applied to each individual's income counted toward eligibility as allowed under
10.10the state's AFDC plan in effect as of July 16, 1996: dependent care and child support paid
10.11under court order.
10.12(c) If the four-month disregard in paragraph (b) has been applied to the wage
10.13earner's income for four months, the disregard shall not be applied again until the wage
10.14earner's income has not been considered in determining medical assistance eligibility for
10.1512 consecutive months.
10.16(d) (b) The commissioner shall adjust the income standards under this section each
10.17July 1 by the annual update of the federal poverty guidelines following publication by the
10.18United States Department of Health and Human Services except that the income standards
10.19shall not go below those in effect on July 1, 2009.
10.20(e) (c) For children age 18 or under, annual gifts of $2,000 or less by a tax-exempt
10.21organization to or for the benefit of the child with a life-threatening illness must be
10.22disregarded from income.
10.23EFFECTIVE DATE.This section is effective January 1, 2014.

10.24    Sec. 16. Minnesota Statutes 2012, section 256B.056, subdivision 3, is amended to read:
10.25    Subd. 3. Asset limitations for certain individuals and families. (a) To be
10.26eligible for medical assistance, a person must not individually own more than $3,000 in
10.27assets, or if a member of a household with two family members, husband and wife, or
10.28parent and child, the household must not own more than $6,000 in assets, plus $200 for
10.29each additional legal dependent. In addition to these maximum amounts, an eligible
10.30individual or family may accrue interest on these amounts, but they must be reduced to the
10.31maximum at the time of an eligibility redetermination. The accumulation of the clothing
10.32and personal needs allowance according to section 256B.35 must also be reduced to the
10.33maximum at the time of the eligibility redetermination. The value of assets that are not
10.34considered in determining eligibility for medical assistance is the value of those assets
11.1excluded under the supplemental security income program for aged, blind, and disabled
11.2persons, with the following exceptions:
11.3(1) household goods and personal effects are not considered;
11.4(2) capital and operating assets of a trade or business that the local agency determines
11.5are necessary to the person's ability to earn an income are not considered;
11.6(3) motor vehicles are excluded to the same extent excluded by the supplemental
11.7security income program;
11.8(4) assets designated as burial expenses are excluded to the same extent excluded by
11.9the supplemental security income program. Burial expenses funded by annuity contracts
11.10or life insurance policies must irrevocably designate the individual's estate as contingent
11.11beneficiary to the extent proceeds are not used for payment of selected burial expenses;
11.12(5) for a person who no longer qualifies as an employed person with a disability due
11.13to loss of earnings, assets allowed while eligible for medical assistance under section
11.14256B.057, subdivision 9 , are not considered for 12 months, beginning with the first month
11.15of ineligibility as an employed person with a disability, to the extent that the person's total
11.16assets remain within the allowed limits of section 256B.057, subdivision 9, paragraph (d);
11.17    (6) when a person enrolled in medical assistance under section 256B.057, subdivision
11.189
, is age 65 or older and has been enrolled during each of the 24 consecutive months
11.19before the person's 65th birthday, the assets owned by the person and the person's spouse
11.20must be disregarded, up to the limits of section 256B.057, subdivision 9, paragraph (d),
11.21when determining eligibility for medical assistance under section 256B.055, subdivision
11.227
. The income of a spouse of a person enrolled in medical assistance under section
11.23256B.057, subdivision 9 , during each of the 24 consecutive months before the person's
11.2465th birthday must be disregarded when determining eligibility for medical assistance
11.25under section 256B.055, subdivision 7. Persons eligible under this clause are not subject to
11.26the provisions in section 256B.059. A person whose 65th birthday occurs in 2012 or 2013
11.27is required to have qualified for medical assistance under section 256B.057, subdivision 9,
11.28prior to age 65 for at least 20 months in the 24 months prior to reaching age 65; and
11.29(7) effective July 1, 2009, certain assets owned by American Indians are excluded as
11.30required by section 5006 of the American Recovery and Reinvestment Act of 2009, Public
11.31Law 111-5. For purposes of this clause, an American Indian is any person who meets the
11.32definition of Indian according to Code of Federal Regulations, title 42, section 447.50.
11.33(b) No asset limit shall apply to persons eligible under section 256B.055, subdivision
11.3415.
11.35EFFECTIVE DATE.This section is effective January 1, 2014.

12.1    Sec. 17. Minnesota Statutes 2012, section 256B.056, subdivision 4, as amended by
12.2Laws 2013, chapter 1, section 5, is amended to read:
12.3    Subd. 4. Income. (a) To be eligible for medical assistance, a person eligible under
12.4section 256B.055, subdivisions 7, 7a, and 12, may have income up to 100 percent of
12.5the federal poverty guidelines. Effective January 1, 2000, and each successive January,
12.6recipients of supplemental security income may have an income up to the supplemental
12.7security income standard in effect on that date.
12.8(b) To be eligible for medical assistance, families and children may have an income
12.9up to 133-1/3 percent of the AFDC income standard in effect under the July 16, 1996,
12.10AFDC state plan. Effective July 1, 2000, the base AFDC standard in effect on July 16,
12.111996, shall be increased by three percent.
12.12(c) (b) Effective January 1, 2014, to be eligible for medical assistance, under section
12.13256B.055, subdivision 3a , a parent or caretaker relative may have an income up to 133
12.14percent of the federal poverty guidelines for the household size.
12.15(d) (c) To be eligible for medical assistance under section 256B.055, subdivision
12.1615
, a person may have an income up to 133 percent of federal poverty guidelines for
12.17the household size.
12.18(e) (d) To be eligible for medical assistance under section 256B.055, subdivision
12.1916
, a child age 19 to 20 may have an income up to 133 percent of the federal poverty
12.20guidelines for the household size.
12.21(f) (e) To be eligible for medical assistance under section 256B.055, subdivision 3a,
12.22a child under age 19 may have income up to 275 percent of the federal poverty guidelines
12.23for the household size or an equivalent standard when converted using modified adjusted
12.24gross income methodology as required under the Affordable Care Act. Children who are
12.25enrolled in medical assistance as of December 31, 2013, and are determined ineligible
12.26for medical assistance because of the elimination of income disregards under modified
12.27adjusted gross income methodology as defined in subdivision 1a remain eligible for
12.28medical assistance under the Children's Health Insurance Program Reauthorization Act
12.29of 2009, Public Law 111-3, until the date of their next regularly scheduled eligibility
12.30redetermination as required in section 256B.056, subdivision 7a.
12.31(f) In computing income to determine eligibility of persons under paragraphs (a) to
12.32(e) who are not residents of long-term care facilities, the commissioner shall disregard
12.33increases in income as required by Public Laws 94-566, section 503; 99-272; and 99-509.
12.34For persons eligible under paragraph (a), veteran aid and attendance benefits and Veterans
12.35Administration unusual medical expense payments are considered income to the recipient.
12.36EFFECTIVE DATE.This section is effective January 1, 2014.

13.1    Sec. 18. Minnesota Statutes 2012, section 256B.056, subdivision 5c, is amended to read:
13.2    Subd. 5c. Excess income standard. (a) The excess income standard for families
13.3with children parents and caretaker relatives, pregnant women, infants, and children ages
13.4two through 20 is the standard specified in subdivision 4, paragraph (b).
13.5(b) The excess income standard for a person whose eligibility is based on blindness,
13.6disability, or age of 65 or more years is 70 percent of the federal poverty guidelines for the
13.7family size. Effective July 1, 2002, the excess income standard for this paragraph shall
13.8equal 75 percent of the federal poverty guidelines.
13.9EFFECTIVE DATE.This section is effective January 1, 2014.

13.10    Sec. 19. Minnesota Statutes 2012, section 256B.056, is amended by adding a
13.11subdivision to read:
13.12    Subd. 7a. Periodic renewal of eligibility. (a) The commissioner shall make an
13.13annual redetermination of eligibility based on information contained in the enrollee's case
13.14file and other information available to the agency, including but not limited to information
13.15accessed through an electronic database, without requiring the enrollee to submit any
13.16information when sufficient data is available for the agency to renew eligibility.
13.17(b) If the commissioner cannot renew eligibility in accordance with paragraph (a),
13.18the commissioner must provide the enrollee with a prepopulated renewal form containing
13.19eligibility information available to the agency and permit the enrollee to submit the form
13.20with any corrections or additional information to the agency and sign the renewal form via
13.21any of the modes of submission specified in section 256B.04, subdivision 18.
13.22(c) An enrollee who is terminated for failure to complete the renewal process may
13.23subsequently submit the renewal form and required information within four months after
13.24the date of termination and have coverage reinstated without a lapse, if otherwise eligible
13.25under this chapter.
13.26(d) Notwithstanding paragraph (a), individuals eligible under subdivision 5 shall be
13.27required to renew eligibility every six months.
13.28EFFECTIVE DATE.This section is effective January 1, 2014.

13.29    Sec. 20. Minnesota Statutes 2012, section 256B.056, subdivision 10, is amended to read:
13.30    Subd. 10. Eligibility verification. (a) The commissioner shall require women who
13.31are applying for the continuation of medical assistance coverage following the end of the
13.3260-day postpartum period to update their income and asset information and to submit
13.33any required income or asset verification.
14.1    (b) The commissioner shall determine the eligibility of private-sector health care
14.2coverage for infants less than one year of age eligible under section 256B.055, subdivision
14.310
, or 256B.057, subdivision 1, paragraph (d), and shall pay for private-sector coverage
14.4if this is determined to be cost-effective.
14.5    (c) The commissioner shall verify assets and income for all applicants, and for all
14.6recipients upon renewal.
14.7    (d) The commissioner shall utilize information obtained through the electronic
14.8service established by the secretary of the United States Department of Health and Human
14.9Services and other available electronic data sources in Code of Federal Regulations, title
14.1042, sections 435.940 to 435.956, to verify eligibility requirements. The commissioner
14.11shall establish standards to define when information obtained electronically is reasonably
14.12compatible with information provided by applicants and enrollees, including use of
14.13self-attestation, to accomplish real-time eligibility determinations and maintain program
14.14integrity.
14.15EFFECTIVE DATE.This section is effective January 1, 2014.

14.16    Sec. 21. Minnesota Statutes 2012, section 256B.057, subdivision 1, is amended to read:
14.17    Subdivision 1. Infants and pregnant women. (a)(1) An infant less than one year
14.18 two years of age or a pregnant woman who has written verification of a positive pregnancy
14.19test from a physician or licensed registered nurse is eligible for medical assistance if the
14.20individual's countable family household income is equal to or less than 275 percent of the
14.21federal poverty guideline for the same family household size or an equivalent standard
14.22when converted using modified adjusted gross income methodology as required under
14.23the Affordable Care Act. For purposes of this subdivision, "countable family income"
14.24means the amount of income considered available using the methodology of the AFDC
14.25program under the state's AFDC plan as of July 16, 1996, as required by the Personal
14.26Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA), Public
14.27Law 104-193, except for the earned income disregard and employment deductions.
14.28    (2) For applications processed within one calendar month prior to the effective date,
14.29eligibility shall be determined by applying the income standards and methodologies in
14.30effect prior to the effective date for any months in the six-month budget period before
14.31that date and the income standards and methodologies in effect on the effective date for
14.32any months in the six-month budget period on or after that date. The income standards
14.33for each month shall be added together and compared to the applicant's total countable
14.34income for the six-month budget period to determine eligibility.
14.35    (b)(1) [Expired, 1Sp2003 c 14 art 12 s 19]
15.1    (2) For applications processed within one calendar month prior to July 1, 2003,
15.2eligibility shall be determined by applying the income standards and methodologies in
15.3effect prior to July 1, 2003, for any months in the six-month budget period before July 1,
15.42003, and the income standards and methodologies in effect on the expiration date for any
15.5months in the six-month budget period on or after July 1, 2003. The income standards
15.6for each month shall be added together and compared to the applicant's total countable
15.7income for the six-month budget period to determine eligibility.
15.8    (3) An amount equal to the amount of earned income exceeding 275 percent of
15.9the federal poverty guideline, up to a maximum of the amount by which the combined
15.10total of 185 percent of the federal poverty guideline plus the earned income disregards
15.11and deductions allowed under the state's AFDC plan as of July 16, 1996, as required
15.12by the Personal Responsibility and Work Opportunity Act of 1996 (PRWORA), Public
15.13Law 104-193, exceeds 275 percent of the federal poverty guideline will be deducted for
15.14pregnant women and infants less than one year of age.
15.15    (c) Dependent care and child support paid under court order shall be deducted from
15.16the countable income of pregnant women.
15.17    (d) (b) An infant born to a woman who was eligible for and receiving medical
15.18assistance on the date of the child's birth shall continue to be eligible for medical assistance
15.19without redetermination until the child's first birthday.
15.20EFFECTIVE DATE.This section is effective January 1, 2014.

15.21    Sec. 22. Minnesota Statutes 2012, section 256B.057, subdivision 8, is amended to read:
15.22    Subd. 8. Children under age two. Medical assistance may be paid for a child under
15.23two years of age whose countable family income is above 275 percent of the federal poverty
15.24guidelines for the same size family but less than or equal to 280 percent of the federal
15.25poverty guidelines for the same size family or an equivalent standard when converted using
15.26modified adjusted gross income methodology as required under the Affordable Care Act.
15.27EFFECTIVE DATE.This section is effective January 1, 2014.

15.28    Sec. 23. Minnesota Statutes 2012, section 256B.057, subdivision 10, is amended to read:
15.29    Subd. 10. Certain persons needing treatment for breast or cervical cancer. (a)
15.30Medical assistance may be paid for a person who:
15.31(1) has been screened for breast or cervical cancer by the Minnesota breast and
15.32cervical cancer control program, and program funds have been used to pay for the person's
15.33screening;
16.1(2) according to the person's treating health professional, needs treatment, including
16.2diagnostic services necessary to determine the extent and proper course of treatment, for
16.3breast or cervical cancer, including precancerous conditions and early stage cancer;
16.4(3) meets the income eligibility guidelines for the Minnesota breast and cervical
16.5cancer control program;
16.6(4) is under age 65;
16.7(5) is not otherwise eligible for medical assistance under United States Code, title
16.842, section 1396a(a)(10)(A)(i); and
16.9(6) is not otherwise covered under creditable coverage, as defined under United
16.10States Code, title 42, section 1396a(aa).
16.11(b) Medical assistance provided for an eligible person under this subdivision shall
16.12be limited to services provided during the period that the person receives treatment for
16.13breast or cervical cancer.
16.14(c) A person meeting the criteria in paragraph (a) is eligible for medical assistance
16.15without meeting the eligibility criteria relating to income and assets in section 256B.056,
16.16subdivisions 1a to 5b 5a.
16.17EFFECTIVE DATE.This section is effective January 1, 2014.

16.18    Sec. 24. Minnesota Statutes 2012, section 256B.057, is amended by adding a
16.19subdivision to read:
16.20    Subd. 12. Presumptive eligibility determinations made by qualified hospitals.
16.21The commissioner shall establish a process to qualify hospitals that are participating
16.22providers under the medical assistance program to determine presumptive eligibility for
16.23medical assistance for applicants who may have a basis of eligibility using the modified
16.24adjusted gross income methodology as defined in section 256B.056, subdivision 1a,
16.25paragraph (b), clause (1).
16.26EFFECTIVE DATE.This section is effective January 1, 2014.

16.27    Sec. 25. 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.
17.1(b) "Qualified noncitizen" means a person who meets one of the following
17.2immigration criteria:
17.3(1) admitted for lawful permanent residence according to United States Code, title 8;
17.4(2) admitted to the United States as a refugee according to United States Code,
17.5title 8, section 1157;
17.6(3) granted asylum according to United States Code, title 8, section 1158;
17.7(4) granted withholding of deportation according to United States Code, title 8,
17.8section 1253(h);
17.9(5) paroled for a period of at least one year according to United States Code, title 8,
17.10section 1182(d)(5);
17.11(6) granted conditional entrant status according to United States Code, title 8,
17.12section 1153(a)(7);
17.13(7) determined to be a battered noncitizen by the United States Attorney General
17.14according to the Illegal Immigration Reform and Immigrant Responsibility Act of 1996,
17.15title V of the Omnibus Consolidated Appropriations Bill, Public Law 104-200;
17.16(8) is a child of a noncitizen determined to be a battered noncitizen by the United
17.17States Attorney General according to the Illegal Immigration Reform and Immigrant
17.18Responsibility Act of 1996, title V, of the Omnibus Consolidated Appropriations Bill,
17.19Public Law 104-200; or
17.20(9) determined to be a Cuban or Haitian entrant as defined in section 501(e) of Public
17.21Law 96-422, the Refugee Education Assistance Act of 1980.
17.22(c) All qualified noncitizens who were residing in the United States before August
17.2322, 1996, who otherwise meet the eligibility requirements of this chapter, are eligible for
17.24medical assistance with federal financial participation.
17.25(d) Beginning December 1, 1996, qualified noncitizens who entered the United
17.26States on or after August 22, 1996, and who otherwise meet the eligibility requirements
17.27of this chapter are eligible for medical assistance with federal participation for five years
17.28if they meet one of the following criteria:
17.29(1) refugees admitted to the United States according to United States Code, title 8,
17.30section 1157;
17.31(2) persons granted asylum according to United States Code, title 8, section 1158;
17.32(3) persons granted withholding of deportation according to United States Code,
17.33title 8, section 1253(h);
17.34(4) veterans of the United States armed forces with an honorable discharge for
17.35a reason other than noncitizen status, their spouses and unmarried minor dependent
17.36children; or
18.1(5) persons on active duty in the United States armed forces, other than for training,
18.2their spouses and unmarried minor dependent children.
18.3 Beginning July 1, 2010, children and pregnant women who are noncitizens
18.4described in paragraph (b) or who are lawfully present in the United States as defined
18.5in Code of Federal Regulations, title 8, section 103.12, and who otherwise meet
18.6eligibility requirements of this chapter, are eligible for medical assistance with federal
18.7financial participation as provided by the federal Children's Health Insurance Program
18.8Reauthorization Act of 2009, Public Law 111-3.
18.9(e) Nonimmigrants who otherwise meet the eligibility requirements of this chapter
18.10are eligible for the benefits as provided in paragraphs (f) to (h). For purposes of this
18.11subdivision, a "nonimmigrant" is a person in one of the classes listed in United States
18.12Code, title 8, section 1101(a)(15).
18.13(f) Payment shall also be made for care and services that are furnished to noncitizens,
18.14regardless of immigration status, who otherwise meet the eligibility requirements of
18.15this chapter, if such care and services are necessary for the treatment of an emergency
18.16medical condition.
18.17(g) For purposes of this subdivision, the term "emergency medical condition" means
18.18a medical condition that meets the requirements of United States Code, title 42, section
18.191396b(v).
18.20(h)(1) Notwithstanding paragraph (g), services that are necessary for the treatment
18.21of an emergency medical condition are limited to the following:
18.22(i) services delivered in an emergency room or by an ambulance service licensed
18.23under chapter 144E that are directly related to the treatment of an emergency medical
18.24condition;
18.25(ii) services delivered in an inpatient hospital setting following admission from an
18.26emergency room or clinic for an acute emergency condition; and
18.27(iii) follow-up services that are directly related to the original service provided
18.28to treat the emergency medical condition and are covered by the global payment made
18.29to the provider.
18.30    (2) Services for the treatment of emergency medical conditions do not include:
18.31(i) services delivered in an emergency room or inpatient setting to treat a
18.32nonemergency condition;
18.33(ii) organ transplants, stem cell transplants, and related care;
18.34(iii) services for routine prenatal care;
18.35(iv) continuing care, including long-term care, nursing facility services, home health
18.36care, adult day care, day training, or supportive living services;
19.1(v) elective surgery;
19.2(vi) outpatient prescription drugs, unless the drugs are administered or dispensed as
19.3part of an emergency room visit;
19.4(vii) preventative health care and family planning services;
19.5(viii) dialysis;
19.6(ix) chemotherapy or therapeutic radiation services;
19.7(x) rehabilitation services;
19.8(xi) physical, occupational, or speech therapy;
19.9(xii) transportation services;
19.10(xiii) case management;
19.11(xiv) prosthetics, orthotics, durable medical equipment, or medical supplies;
19.12(xv) dental services;
19.13(xvi) hospice care;
19.14(xvii) audiology services and hearing aids;
19.15(xviii) podiatry services;
19.16(xix) chiropractic services;
19.17(xx) immunizations;
19.18(xxi) vision services and eyeglasses;
19.19(xxii) waiver services;
19.20(xxiii) individualized education programs; or
19.21(xxiv) chemical dependency treatment.
19.22(i) Beginning July 1, 2009, Pregnant noncitizens who are undocumented,
19.23nonimmigrants, or lawfully present in the United States as defined in Code of Federal
19.24Regulations, title 8, section 103.12, ineligible for federally funded medical assistance
19.25because of immigration status, are not covered by a group health plan or health insurance
19.26coverage according to Code of Federal Regulations, title 42, section 457.310, and who
19.27 otherwise meet the eligibility requirements of this chapter, are eligible for medical
19.28assistance through the period of pregnancy, including labor and delivery, and 60 days
19.29postpartum, to the extent federal funds are available under title XXI of the Social Security
19.30Act, and the state children's health insurance program.
19.31(j) Beginning October 1, 2003, persons who are receiving care and rehabilitation
19.32services from a nonprofit center established to serve victims of torture and are otherwise
19.33ineligible for medical assistance under this chapter are eligible for medical assistance
19.34without federal financial participation. These individuals are eligible only for the period
19.35during which they are receiving services from the center. Individuals eligible under this
19.36paragraph shall not be required to participate in prepaid medical assistance.
20.1EFFECTIVE DATE.This section is effective January 1, 2014.

20.2    Sec. 26. Minnesota Statutes 2012, section 256B.0755, subdivision 3, is amended to read:
20.3    Subd. 3. Accountability. (a) Health care delivery systems must accept responsibility
20.4for the quality of care based on standards established under subdivision 1, paragraph (b),
20.5clause (10), and the cost of care or utilization of services provided to its enrollees under
20.6subdivision 1, paragraph (b), clause (1).
20.7(b) A health care delivery system may contract and coordinate with providers and
20.8clinics for the delivery of services and shall contract with community health clinics,
20.9federally qualified health centers, community mental health centers or programs, county
20.10agencies, and rural clinics to the extent practicable.
20.11(c) A health care delivery system must indicate how it will coordinate with other
20.12services affecting its patients' health, quality of care, and cost of care that are provided by
20.13other providers, county agencies, and other organizations in the local service area. The
20.14health care delivery system must indicate how it will engage other providers, counties, and
20.15organizations, including county-based purchasing plans, that provide services to patients
20.16of the health care delivery system on issues related to local population health, including
20.17applicable local needs, priorities, and public health goals. The health care delivery system
20.18must describe how local providers, counties, organizations, including county-based
20.19purchasing plans, and other relevant purchasers were consulted in developing the
20.20application to participate in the demonstration project.
20.21EFFECTIVE DATE.This section is effective July 1, 2013, and applies to health
20.22care delivery system contracts entered into on or after that date.

20.23    Sec. 27. Minnesota Statutes 2012, section 256B.694, is amended to read:
20.24256B.694 SOLE-SOURCE OR SINGLE-PLAN MANAGED CARE
20.25CONTRACT.
20.26    (a) MS 2010 [Expired, 2008 c 364 s 10]
20.27    (b) The commissioner shall consider, and may approve, contracting on a
20.28single-health plan basis with other county-based purchasing plans, or with other qualified
20.29health plans that have coordination arrangements with counties, to serve persons with a
20.30disability who voluntarily enroll enrolled in state public health care programs, in order
20.31to promote better coordination or integration of health care services, social services and
20.32other community-based services, provided that all requirements applicable to health plan
20.33purchasing, including those in section 256B.69, subdivision 23 sections 256B.69 and
21.1256B.692, are satisfied. Nothing in this paragraph supersedes or modifies the requirements
21.2in paragraph (a).

21.3    Sec. 28. Minnesota Statutes 2012, section 256L.01, is amended by adding a subdivision
21.4to read:
21.5    Subd. 1b. Affordable Care Act. "Affordable Care Act" means the federal Patient
21.6Protection and Affordable Care Act, Public Law 111-148, as amended, including the
21.7federal Health Care and Education Reconciliation Act of 2010, Public Law 111-152, and
21.8any amendments to, and any federal guidance or regulations issued under, these acts.

21.9    Sec. 29. Minnesota Statutes 2012, section 256L.01, subdivision 3a, is amended to read:
21.10    Subd. 3a. Family with children. (a) "Family with children" means:
21.11(1) parents and their children residing in the same household; or
21.12(2) grandparents, foster parents, relative caretakers as defined in the medical
21.13assistance program, or legal guardians; and their wards who are children residing in the
21.14same household. "Family" has the meaning given for family and family size as defined
21.15in Code of Federal Regulations, title 26, section 1.36B-1.
21.16(b) The term includes children who are temporarily absent from the household in
21.17settings such as schools, camps, or parenting time with noncustodial parents.
21.18EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
21.19approval, whichever is later. The commissioner of human services shall notify the revisor
21.20of statutes when federal approval is obtained.

21.21    Sec. 30. Minnesota Statutes 2012, section 256L.01, subdivision 5, is amended to read:
21.22    Subd. 5. Income. (a) "Income" has the meaning given for earned and unearned
21.23income for families and children in the medical assistance program, according to the
21.24state's aid to families with dependent children plan in effect as of July 16, 1996. The
21.25definition does not include medical assistance income methodologies and deeming
21.26requirements. The earned income of full-time and part-time students under age 19 is
21.27not counted as income. Public assistance payments and supplemental security income
21.28are not excluded income modified adjusted gross income, as defined in Code of Federal
21.29Regulations, title 26, section 1.36B-1.
21.30(b) For purposes of this subdivision, and unless otherwise specified in this section,
21.31the commissioner shall use reasonable methods to calculate gross earned and unearned
21.32income including, but not limited to, projecting income based on income received within
21.33the past 30 days, the last 90 days, or the last 12 months.
22.1EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
22.2approval, whichever is later. The commissioner of human services shall notify the revisor
22.3of statutes when federal approval is obtained.

22.4    Sec. 31. Minnesota Statutes 2012, section 256L.01, is amended by adding a subdivision
22.5to read:
22.6    Subd. 6. Minnesota Insurance Marketplace. "Minnesota Insurance Marketplace"
22.7means the Minnesota Insurance Marketplace as defined in section 62V.02.

22.8    Sec. 32. Minnesota Statutes 2012, section 256L.01, is amended by adding a subdivision
22.9to read:
22.10    Subd. 7. Participating entity. "Participating entity" means a health carrier as
22.11defined in section 62A.01, subdivision 2; a county-based purchasing plan established
22.12under section 256B.692; an accountable care organization or other entity operating a
22.13health care delivery systems demonstration project authorized under section 256B.0755;
22.14an entity operating a county integrated health care delivery network pilot project
22.15authorized under section 256B.0756; or a network of health care providers established to
22.16offer services under MinnesotaCare.
22.17EFFECTIVE DATE.This section is effective January 1, 2015.

22.18    Sec. 33. Minnesota Statutes 2012, section 256L.02, subdivision 2, is amended to read:
22.19    Subd. 2. Commissioner's duties. (a) The commissioner shall establish an office
22.20for the state administration of this plan. The plan shall be used to provide covered health
22.21services for eligible persons. Payment for these services shall be made to all eligible
22.22providers participating entities under contract with the commissioner. The commissioner
22.23shall adopt rules to administer the MinnesotaCare program. The commissioner shall
22.24establish marketing efforts to encourage potentially eligible persons to receive information
22.25about the program and about other medical care programs administered or supervised by
22.26the Department of Human Services.
22.27(b) A toll-free telephone number and Web site must be used to provide information
22.28about medical programs and to promote access to the covered services.
22.29EFFECTIVE DATE.Paragraph (a) is effective January 1, 2015. Paragraph (b) is
22.30effective January 1, 2014, or upon federal approval, whichever is later. The commissioner
22.31of human services shall notify the revisor of statutes when federal approval is obtained.

23.1    Sec. 34. Minnesota Statutes 2012, section 256L.02, is amended by adding a subdivision
23.2to read:
23.3    Subd. 6. Federal approval. (a) The commissioner of human services shall seek
23.4federal approval to implement the MinnesotaCare program under this chapter as a basic
23.5health program. In any agreement with the Centers for Medicare and Medicaid Services
23.6to operate MinnesotaCare as a basic health program, the commissioner shall seek to
23.7include procedures to ensure that federal funding is predictable, stable, and sufficient
23.8to sustain ongoing operation of MinnesotaCare. These procedures must address issues
23.9related to the timing of federal payments, payment reconciliation, enrollee risk adjustment,
23.10and minimization of state financial risk. The commissioner shall consult with the
23.11commissioner of management and budget, when developing the proposal for establishing
23.12MinnesotaCare as a basic health program to be submitted to the Centers for Medicare
23.13and Medicaid Services.
23.14(b) The commissioner of human services, in consultation with the commissioner of
23.15management and budget, shall work with the Centers for Medicare and Medicaid Services
23.16to establish a process for reconciliation and adjustment of federal payments that balances
23.17state and federal liability over time. The commissioner of human services shall request that
23.18the secretary of health and human services hold the state, and enrollees, harmless in the
23.19reconciliation process for the first three years, to allow the state to develop a statistically
23.20valid methodology for predicting enrollment trends and their net effect on federal payments.
23.21EFFECTIVE DATE.This section is effective the day following final enactment.

23.22    Sec. 35. Minnesota Statutes 2012, section 256L.02, is amended by adding a subdivision
23.23to read:
23.24    Subd. 7. Coordination with Minnesota Insurance Marketplace. MinnesotaCare
23.25shall be considered a public health care program for purposes of chapter 62V.
23.26EFFECTIVE DATE.This section is effective January 1, 2014.

23.27    Sec. 36. Minnesota Statutes 2012, section 256L.03, subdivision 1, is amended to read:
23.28    Subdivision 1. Covered health services. (a) "Covered health services" means the
23.29health services reimbursed under chapter 256B, with the exception of inpatient hospital
23.30services, special education services, private duty nursing services, adult dental care
23.31services other than services covered under section 256B.0625, subdivision 9, orthodontic
23.32services, nonemergency medical transportation services, personal care assistance and case
24.1management services, and nursing home or intermediate care facilities services, inpatient
24.2mental health services, and chemical dependency services.
24.3    (b) No public funds shall be used for coverage of abortion under MinnesotaCare
24.4except where the life of the female would be endangered or substantial and irreversible
24.5impairment of a major bodily function would result if the fetus were carried to term; or
24.6where the pregnancy is the result of rape or incest.
24.7    (c) Covered health services shall be expanded as provided in this section.
24.8EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
24.9approval, whichever is later. The commissioner of human services shall notify the revisor
24.10of statutes when federal approval is obtained.

24.11    Sec. 37. Minnesota Statutes 2012, section 256L.03, subdivision 1a, is amended to read:
24.12    Subd. 1a. Pregnant women and Children; MinnesotaCare health care reform
24.13waiver. Beginning January 1, 1999, Children and pregnant women are eligible for coverage
24.14of all services that are eligible for reimbursement under the medical assistance program
24.15according to chapter 256B, except that abortion services under MinnesotaCare shall be
24.16limited as provided under subdivision 1. Pregnant women and Children are exempt from
24.17the provisions of subdivision 5, regarding co-payments. Pregnant women and Children
24.18who are lawfully residing in the United States but who are not "qualified noncitizens" under
24.19title IV of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996,
24.20Public Law 104-193, Statutes at Large, volume 110, page 2105, are eligible for coverage
24.21of all services provided under the medical assistance program according to chapter 256B.
24.22EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
24.23approval, whichever is later. The commissioner of human services shall notify the revisor
24.24of statutes when federal approval is obtained.

24.25    Sec. 38. Minnesota Statutes 2012, section 256L.03, subdivision 3, is amended to read:
24.26    Subd. 3. Inpatient hospital services. (a) Covered health services shall include
24.27inpatient hospital services, including inpatient hospital mental health services and inpatient
24.28hospital and residential chemical dependency treatment, subject to those limitations
24.29necessary to coordinate the provision of these services with eligibility under the medical
24.30assistance spenddown. The inpatient hospital benefit for adult enrollees who qualify under
24.31section 256L.04, subdivision 7, or who qualify under section 256L.04, subdivisions 1 and
24.322
, with family gross income that exceeds 200 percent of the federal poverty guidelines or
25.1215 percent of the federal poverty guidelines on or after July 1, 2009, and who are not
25.2pregnant, is subject to an annual limit of $10,000.
25.3    (b) Admissions for inpatient hospital services paid for under section 256L.11,
25.4subdivision 3
, must be certified as medically necessary in accordance with Minnesota
25.5Rules, parts 9505.0500 to 9505.0540, except as provided in clauses (1) and (2):
25.6    (1) all admissions must be certified, except those authorized under rules established
25.7under section 254A.03, subdivision 3, or approved under Medicare; and
25.8    (2) payment under section 256L.11, subdivision 3, shall be reduced by five percent
25.9for admissions for which certification is requested more than 30 days after the day of
25.10admission. The hospital may not seek payment from the enrollee for the amount of the
25.11payment reduction under this clause.
25.12EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
25.13approval, whichever is later. The commissioner of human services shall notify the revisor
25.14of statutes when federal approval is obtained.

25.15    Sec. 39. Minnesota Statutes 2012, section 256L.03, is amended by adding a subdivision
25.16to read:
25.17    Subd. 4a. Loss ratio. Health coverage provided through the MinnesotaCare
25.18program must have a medical loss ratio of at least 85 percent, as defined using the loss
25.19ratio methodology described in section 1001 of the Affordable Care Act.
25.20EFFECTIVE DATE.This section is effective January 1, 2015.

25.21    Sec. 40. Minnesota Statutes 2012, section 256L.03, subdivision 5, is amended to read:
25.22    Subd. 5. Cost-sharing. (a) Except as otherwise provided in paragraphs (b) and (c)
25.23 this subdivision, the MinnesotaCare benefit plan shall include the following cost-sharing
25.24requirements for all enrollees:
25.25    (1) ten percent of the paid charges for inpatient hospital services for adult enrollees,
25.26subject to an annual inpatient out-of-pocket maximum of $1,000 per individual;
25.27    (2) (1) $3 per prescription for adult enrollees;
25.28    (3) (2) $25 for eyeglasses for adult enrollees;
25.29    (4) (3) $3 per nonpreventive visit. For purposes of this subdivision, a "visit" means
25.30an episode of service which is required because of a recipient's symptoms, diagnosis, or
25.31established illness, and which is delivered in an ambulatory setting by a physician or
25.32physician ancillary, chiropractor, podiatrist, nurse midwife, advanced practice nurse,
25.33audiologist, optician, or optometrist;
26.1    (5) (4) $6 for nonemergency visits to a hospital-based emergency room for services
26.2provided through December 31, 2010, and $3.50 effective January 1, 2011; and
26.3(6) (5) a family deductible equal to the maximum amount allowed under Code of
26.4Federal Regulations, title 42, part 447.54.
26.5    (b) Paragraph (a), clause (1), does not apply to parents and relative caretakers of
26.6children under the age of 21.
26.7    (c) (b) Paragraph (a) does not apply to pregnant women and children under the
26.8age of 21.
26.9    (d) (c) Paragraph (a), clause (4) (3), does not apply to mental health services.
26.10    (e) Adult enrollees with family gross income that exceeds 200 percent of the federal
26.11poverty guidelines or 215 percent of the federal poverty guidelines on or after July 1, 2009,
26.12and who are not pregnant shall be financially responsible for the coinsurance amount, if
26.13applicable, and amounts which exceed the $10,000 inpatient hospital benefit limit.
26.14    (f) When a MinnesotaCare enrollee becomes a member of a prepaid health plan,
26.15or changes from one prepaid health plan to another during a calendar year, any charges
26.16submitted towards the $10,000 annual inpatient benefit limit, and any out-of-pocket
26.17expenses incurred by the enrollee for inpatient services, that were submitted or incurred
26.18prior to enrollment, or prior to the change in health plans, shall be disregarded.
26.19(g) (d) MinnesotaCare reimbursements to fee-for-service providers and payments to
26.20managed care plans or county-based purchasing plans shall not be increased as a result of
26.21the reduction of the co-payments in paragraph (a), clause (5) (4), effective January 1, 2011.
26.22(h) (e) The commissioner, through the contracting process under section 256L.12,
26.23may allow managed care plans and county-based purchasing plans to waive the family
26.24deductible under paragraph (a), clause (6) (5). The value of the family deductible shall not
26.25be included in the capitation payment to managed care plans and county-based purchasing
26.26plans. Managed care plans and county-based purchasing plans shall certify annually to the
26.27commissioner the dollar value of the family deductible.
26.28EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
26.29approval, whichever is later. The commissioner of human services shall notify the revisor
26.30of statutes when federal approval is obtained.

26.31    Sec. 41. Minnesota Statutes 2012, section 256L.03, subdivision 6, is amended to read:
26.32    Subd. 6. Lien. When the state agency provides, pays for, or becomes liable for
26.33covered health services, the agency shall have a lien for the cost of the covered health
26.34services upon any and all causes of action accruing to the enrollee, or to the enrollee's
26.35legal representatives, as a result of the occurrence that necessitated the payment for the
27.1covered health services. All liens under this section shall be subject to the provisions
27.2of section 256.015. For purposes of this subdivision, "state agency" includes prepaid
27.3health plans participating entities, under contract with the commissioner according to
27.4sections 256B.69, 256D.03, subdivision 4, paragraph (c), and 256L.12; and county-based
27.5purchasing entities under section 256B.692 section 256L.121.
27.6EFFECTIVE DATE.This section is effective January 1, 2015.

27.7    Sec. 42. Minnesota Statutes 2012, section 256L.04, subdivision 1, is amended to read:
27.8    Subdivision 1. Families with children. (a) Families with children with family
27.9income above 133 percent of the federal poverty guidelines and equal to or less than 275
27.10 200 percent of the federal poverty guidelines for the applicable family size shall be eligible
27.11for MinnesotaCare according to this section. All other provisions of sections 256L.01 to
27.12256L.18 , including the insurance-related barriers to enrollment under section 256L.07,
27.13 shall apply unless otherwise specified. Children under age 19 with family income at or
27.14below 200 percent of the federal poverty guidelines and who are ineligible for medical
27.15assistance by sole reason of the application of federal household composition rules for
27.16medical assistance are eligible for MinnesotaCare.
27.17    (b) Parents who enroll in the MinnesotaCare program must also enroll their children,
27.18if the children are eligible. Children may be enrolled separately without enrollment by
27.19parents. However, if one parent in the household enrolls, both parents must enroll, unless
27.20other insurance is available. If one child from a family is enrolled, all children must
27.21be enrolled, unless other insurance is available. If one spouse in a household enrolls,
27.22the other spouse in the household must also enroll, unless other insurance is available.
27.23Families cannot choose to enroll only certain uninsured members.
27.24    (c) Beginning October 1, 2003, the dependent sibling definition no longer applies
27.25to the MinnesotaCare program. These persons are no longer counted in the parental
27.26household and may apply as a separate household.
27.27    (d) Parents are not eligible for MinnesotaCare if their gross income exceeds $57,500.
27.28(e) Children deemed eligible for MinnesotaCare under section 256L.07, subdivision
27.298
, are exempt from the eligibility requirements of this subdivision.
27.30EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
27.31approval, whichever is later. The commissioner of human services shall notify the revisor
27.32of statutes when federal approval is obtained.

28.1    Sec. 43. 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. 44. 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. 45. 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. 46. 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 and lawfully in the United States present noncitizens as defined in Code of Federal
29.20Regulations, title 8, section 103.12. Undocumented noncitizens and nonimmigrants
29.21 are ineligible for MinnesotaCare. For purposes of this subdivision, a nonimmigrant
29.22is an individual in one or more of the classes listed in United States Code, title 8,
29.23section 1101(a)(15), and an undocumented noncitizen is an individual who resides in the
29.24United States without the approval or acquiescence of the United States Citizenship and
29.25Immigration Services. Families with children who are citizens or nationals of the United
29.26States must cooperate in obtaining satisfactory documentary evidence of citizenship or
29.27nationality according to the requirements of the federal Deficit Reduction Act of 2005,
29.28Public Law 109-171.
29.29(b) Notwithstanding subdivisions 1 and 7, eligible persons include families and
29.30individuals who are lawfully present and ineligible for medical assistance by reason of
29.31immigration status and who have incomes equal to or less than 200 percent of federal
29.32poverty guidelines.
30.1EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
30.2approval, whichever is later. The commissioner of human services shall notify the revisor
30.3of statutes when federal approval is obtained.

30.4    Sec. 47. Minnesota Statutes 2012, section 256L.04, subdivision 12, is amended to read:
30.5    Subd. 12. Persons in detention. Beginning January 1, 1999, An applicant or
30.6enrollee residing in a correctional or detention facility is not eligible for MinnesotaCare,
30.7unless the applicant or enrollee is awaiting disposition of charges. An enrollee residing in
30.8a correctional or detention facility is not eligible at renewal of eligibility under section
30.9256L.05, subdivision 3a.
30.10EFFECTIVE DATE.This section is effective January 1, 2014.

30.11    Sec. 48. Minnesota Statutes 2012, section 256L.04, is amended by adding a subdivision
30.12to read:
30.13    Subd. 14. Coordination with medical assistance. (a) Individuals eligible for
30.14medical assistance under chapter 256B are not eligible for MinnesotaCare under this
30.15section.
30.16(b) The commissioner shall coordinate eligibility and coverage to ensure that
30.17individuals transitioning between medical assistance and MinnesotaCare have seamless
30.18eligibility and access to health care services.
30.19EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
30.20approval, whichever is later. The commissioner of human services shall notify the revisor
30.21of statutes when federal approval is obtained.

30.22    Sec. 49. Minnesota Statutes 2012, section 256L.05, subdivision 1, is amended to read:
30.23    Subdivision 1. Application assistance and information availability. (a) Applicants
30.24may submit applications online, in person, by mail, or by phone in accordance with the
30.25Affordable Care Act, and by any other means by which medical assistance applications
30.26may be submitted. Applicants may submit applications through the Minnesota Insurance
30.27Marketplace or through the MinnesotaCare program. Applications and application
30.28assistance must be made available at provider offices, local human services agencies,
30.29school districts, public and private elementary schools in which 25 percent or more of
30.30the students receive free or reduced price lunches, community health offices, Women,
30.31Infants and Children (WIC) program sites, Head Start program sites, public housing
30.32councils, crisis nurseries, child care centers, early childhood education and preschool
31.1program sites, legal aid offices, and libraries, and at any other locations at which medical
31.2assistance applications must be made available. These sites may accept applications and
31.3forward the forms to the commissioner or local county human services agencies that
31.4choose to participate as an enrollment site. Otherwise, applicants may apply directly to the
31.5commissioner or to participating local county human services agencies.
31.6(b) Application assistance must be available for applicants choosing to file an online
31.7application through the Minnesota Insurance Marketplace.
31.8EFFECTIVE DATE.This section is effective January 1, 2014.

31.9    Sec. 50. Minnesota Statutes 2012, section 256L.05, subdivision 2, is amended to read:
31.10    Subd. 2. Commissioner's duties. The commissioner or county agency shall use
31.11electronic verification through the Minnesota Insurance Marketplace as the primary
31.12method of income verification. If there is a discrepancy between reported income
31.13and electronically verified income, an individual may be required to submit additional
31.14verification to the extent permitted under the Affordable Care Act. In addition, the
31.15commissioner shall perform random audits to verify reported income and eligibility. The
31.16commissioner may execute data sharing arrangements with the Department of Revenue
31.17and any other governmental agency in order to perform income verification related to
31.18eligibility and premium payment under the MinnesotaCare program.
31.19EFFECTIVE DATE.This section is effective January 1, 2014.

31.20    Sec. 51. Minnesota Statutes 2012, section 256L.05, subdivision 3, is amended to read:
31.21    Subd. 3. Effective date of coverage. (a) The effective date of coverage is the
31.22first day of the month following the month in which eligibility is approved and the first
31.23premium payment has been received. As provided in section 256B.057, coverage for
31.24newborns is automatic from the date of birth and must be coordinated with other health
31.25coverage. The effective date of coverage for eligible newly adoptive children added to a
31.26family receiving covered health services is the month of placement. The effective date
31.27of coverage for other new members added to the family is the first day of the month
31.28following the month in which the change is reported. All eligibility criteria must be met
31.29by the family at the time the new family member is added. The income of the new family
31.30member is included with the family's modified adjusted gross income and the adjusted
31.31premium begins in the month the new family member is added.
31.32(b) The initial premium must be received by the last working day of the month for
31.33coverage to begin the first day of the following month.
32.1(c) Benefits are not available until the day following discharge if an enrollee is
32.2hospitalized on the first day of coverage.
32.3(d) (c) Notwithstanding any other law to the contrary, benefits under sections
32.4256L.01 to 256L.18 are secondary to a plan of insurance or benefit program under which
32.5an eligible person may have coverage and the commissioner shall use cost avoidance
32.6techniques to ensure coordination of any other health coverage for eligible persons. The
32.7commissioner shall identify eligible persons who may have coverage or benefits under
32.8other plans of insurance or who become eligible for medical assistance.
32.9(e) (d) The effective date of coverage for individuals or families who are exempt
32.10from paying premiums under section 256L.15, subdivision 1, paragraph (d), is the first
32.11day of the month following the month in which verification of American Indian status
32.12is received or eligibility is approved, whichever is later.
32.13(f) The effective date of coverage for children eligible under section 256L.07,
32.14subdivision 8, is the first day of the month following the date of termination from foster
32.15care or release from a juvenile residential correctional facility.
32.16EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
32.17approval, whichever is later. The commissioner of human services shall notify the revisor
32.18of statutes when federal approval is obtained.

32.19    Sec. 52. Minnesota Statutes 2012, section 256L.05, subdivision 3c, is amended to read:
32.20    Subd. 3c. Retroactive coverage. Notwithstanding subdivision 3, the effective
32.21date of coverage shall be the first day of the month following termination from medical
32.22assistance for families and individuals who are eligible for MinnesotaCare and who
32.23submitted a written request for retroactive MinnesotaCare coverage with a completed
32.24application within 30 days of the mailing of notification of termination from medical
32.25assistance. The applicant must provide all required verifications within 30 days of the
32.26written request for verification. For retroactive coverage, premiums must be paid in full
32.27for any retroactive month, current month, and next month within 30 days of the premium
32.28billing. General assistance medical care recipients may qualify for retroactive coverage
32.29under this subdivision at six-month renewal. This subdivision does not apply, and shall not
32.30be implemented by the commissioner, once eligibility determination for MinnesotaCare is
32.31conducted by the Minnesota Insurance Marketplace eligibility determination system.
32.32EFFECTIVE DATE.This section is effective January 1, 2014.

32.33    Sec. 53. Minnesota Statutes 2012, section 256L.06, subdivision 3, is amended to read:
33.1    Subd. 3. Commissioner's duties and payment. (a) Premiums are dedicated to the
33.2commissioner for MinnesotaCare.
33.3    (b) The commissioner shall develop and implement procedures to: (1) require
33.4enrollees to report changes in income; (2) adjust sliding scale premium payments, based
33.5upon both increases and decreases in enrollee income, at the time the change in income
33.6is reported; and (3) disenroll enrollees from MinnesotaCare for failure to pay required
33.7premiums. Failure to pay includes payment with a dishonored check, a returned automatic
33.8bank withdrawal, or a refused credit card or debit card payment. The commissioner may
33.9demand a guaranteed form of payment, including a cashier's check or a money order, as
33.10the only means to replace a dishonored, returned, or refused payment.
33.11    (c) Premiums are calculated on a calendar month basis and may be paid on a
33.12monthly, quarterly, or semiannual basis, with the first payment due upon notice from the
33.13commissioner of the premium amount required. The commissioner shall inform applicants
33.14and enrollees of these premium payment options. Premium payment is required before
33.15enrollment is complete and to maintain eligibility in MinnesotaCare. Premium payments
33.16received before noon are credited the same day. Premium payments received after noon
33.17are credited on the next working day.
33.18    (d) Nonpayment of the premium will result in disenrollment from the plan effective
33.19for the calendar month for which the premium was due. Persons disenrolled for
33.20nonpayment or who voluntarily terminate coverage from the program may not reenroll
33.21until four calendar months have elapsed. Persons disenrolled for nonpayment who pay
33.22all past due premiums as well as current premiums due, including premiums due for the
33.23period of disenrollment, within 20 days of disenrollment, shall be reenrolled retroactively
33.24to the first day of disenrollment. Persons disenrolled for nonpayment or who voluntarily
33.25terminate coverage from the program may not reenroll for four calendar months unless
33.26the person demonstrates good cause for nonpayment. Good cause does not exist if a
33.27person chooses to pay other family expenses instead of the premium. The commissioner
33.28shall define good cause in rule.
33.29EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
33.30approval, whichever is later. The commissioner of human services shall notify the revisor
33.31of statutes when federal approval is obtained.

33.32    Sec. 54. Minnesota Statutes 2012, section 256L.07, subdivision 1, is amended to read:
33.33    Subdivision 1. General requirements. (a) Children enrolled in the original
33.34children's health plan as of September 30, 1992, children who enrolled in the
33.35MinnesotaCare program after September 30, 1992, pursuant to Laws 1992, chapter 549,
34.1article 4, section 17, and children who have family gross incomes that are equal to or
34.2less than 200 percent of the federal poverty guidelines are eligible without meeting the
34.3requirements of subdivision 2 and the four-month requirement in subdivision 3, as long as
34.4they maintain continuous coverage in the MinnesotaCare program or medical assistance.
34.5    Parents Individuals enrolled in MinnesotaCare under section 256L.04, subdivision 1,
34.6and individuals enrolled in MinnesotaCare under section 256L.04, subdivision 7, whose
34.7income increases above 275 200 percent of the federal poverty guidelines, are no longer
34.8eligible for the program and shall be disenrolled by the commissioner. Beginning January
34.91, 2008, individuals enrolled in MinnesotaCare under section 256L.04, subdivision
34.107
, whose income increases above 200 percent of the federal poverty guidelines or 250
34.11percent of the federal poverty guidelines on or after July 1, 2009, are no longer eligible for
34.12the program and shall be disenrolled by the commissioner. For persons disenrolled under
34.13this subdivision, MinnesotaCare coverage terminates the last day of the calendar month
34.14following the month in which the commissioner determines that the income of a family or
34.15individual exceeds program income limits.
34.16    (b) Children may remain enrolled in MinnesotaCare if their gross family income as
34.17defined in section 256L.01, subdivision 4, is greater than 275 percent of federal poverty
34.18guidelines. The premium for children remaining eligible under this paragraph shall be the
34.19maximum premium determined under section 256L.15, subdivision 2, paragraph (b).
34.20    (c) Notwithstanding paragraph (a), parents are not eligible for MinnesotaCare if
34.21gross household income exceeds $57,500 for the 12-month period of eligibility.
34.22EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
34.23approval, whichever is later. The commissioner of human services shall notify the revisor
34.24of statutes when federal approval is obtained.

34.25    Sec. 55. Minnesota Statutes 2012, section 256L.07, subdivision 2, is amended to read:
34.26    Subd. 2. Must not have access to employer-subsidized minimum essential
34.27 coverage. (a) To be eligible, a family or individual must not have access to subsidized
34.28health coverage through an employer and must not have had access to employer-subsidized
34.29coverage through a current employer for 18 months prior to application or reapplication.
34.30A family or individual whose employer-subsidized coverage is lost due to an employer
34.31terminating health care coverage as an employee benefit during the previous 18 months is
34.32not eligible that is affordable and provides minimum value as defined in Code of Federal
34.33Regulations, title 26, section 1.36B-2.
34.34(b) This subdivision does not apply to a family or individual who was enrolled
34.35in MinnesotaCare within six months or less of reapplication and who no longer has
35.1employer-subsidized coverage due to the employer terminating health care coverage as an
35.2employee benefit. This subdivision does not apply to children with family gross incomes
35.3that are equal to or less than 200 percent of federal poverty guidelines.
35.4(c) For purposes of this requirement, subsidized health coverage means health
35.5coverage for which the employer pays at least 50 percent of the cost of coverage for
35.6the employee or dependent, or a higher percentage as specified by the commissioner.
35.7Children are eligible for employer-subsidized coverage through either parent, including
35.8the noncustodial parent. The commissioner must treat employer contributions to Internal
35.9Revenue Code Section 125 plans and any other employer benefits intended to pay
35.10health care costs as qualified employer subsidies toward the cost of health coverage for
35.11employees for purposes of this subdivision.
35.12EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
35.13approval, whichever is later. The commissioner of human services shall notify the revisor
35.14of statutes when federal approval is obtained.

35.15    Sec. 56. Minnesota Statutes 2012, section 256L.07, subdivision 3, is amended to read:
35.16    Subd. 3. Other health coverage. (a) Families and individuals enrolled in the
35.17MinnesotaCare program must have no To be eligible, a family or individual must not have
35.18minimum essential health coverage while enrolled, as defined by section 5000A of the
35.19Internal Revenue Code. Children with family gross incomes equal to or greater than 200
35.20percent of federal poverty guidelines, and adults, must have had no health coverage for
35.21at least four months prior to application and renewal. Children enrolled in the original
35.22children's health plan and children in families with income equal to or less than 200
35.23percent of the federal poverty guidelines, who have other health insurance, are eligible if
35.24the coverage:
35.25(1) lacks two or more of the following:
35.26(i) basic hospital insurance;
35.27(ii) medical-surgical insurance;
35.28(iii) prescription drug coverage;
35.29(iv) dental coverage; or
35.30(v) vision coverage;
35.31(2) requires a deductible of $100 or more per person per year; or
35.32(3) lacks coverage because the child has exceeded the maximum coverage for a
35.33particular diagnosis or the policy excludes a particular diagnosis.
36.1The commissioner may change this eligibility criterion for sliding scale premiums
36.2in order to remain within the limits of available appropriations. The requirement of no
36.3health coverage does not apply to newborns.
36.4(b) Coverage purchased as provided under section 256L.031, subdivision 2, medical
36.5assistance, and the Civilian Health and Medical Program of the Uniformed Service,
36.6CHAMPUS, or other coverage provided under United States Code, title 10, subtitle A,
36.7part II, chapter 55, are not considered insurance or health coverage for purposes of the
36.8four-month requirement described in this subdivision.
36.9(c) (b) For purposes of this subdivision, an applicant or enrollee who is entitled to
36.10Medicare Part A or enrolled in Medicare Part B coverage under title XVIII of the Social
36.11Security Act, United States Code, title 42, sections 1395c to 1395w-152, is considered
36.12to have minimum essential health coverage. An applicant or enrollee who is entitled to
36.13premium-free Medicare Part A may not refuse to apply for or enroll in Medicare coverage
36.14to establish eligibility for MinnesotaCare.
36.15(d) Applicants who were recipients of medical assistance within one month of
36.16application must meet the provisions of this subdivision and subdivision 2.
36.17(e) Cost-effective health insurance that was paid for by medical assistance is not
36.18considered health coverage for purposes of the four-month requirement under this
36.19section, except if the insurance continued after medical assistance no longer considered it
36.20cost-effective or after medical assistance closed.
36.21EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
36.22approval, whichever is later. The commissioner of human services shall notify the revisor
36.23of statutes when federal approval is obtained.

36.24    Sec. 57. Minnesota Statutes 2012, section 256L.09, subdivision 2, is amended to read:
36.25    Subd. 2. Residency requirement. To be eligible for health coverage under the
36.26MinnesotaCare program, pregnant women, individuals, and families with children must
36.27meet the residency requirements as provided by Code of Federal Regulations, title 42,
36.28section 435.403, except that the provisions of section 256B.056, subdivision 1, shall apply
36.29upon receipt of federal approval.
36.30EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
36.31approval, whichever is later. The commissioner of human services shall notify the revisor
36.32of statutes when federal approval is obtained.

36.33    Sec. 58. Minnesota Statutes 2012, section 256L.11, subdivision 1, is amended to read:
37.1    Subdivision 1. Medical assistance rate to be used. (a) Payment to providers
37.2under sections 256L.01 to 256L.11 this chapter shall be at the same rates and conditions
37.3established for medical assistance, except as provided in subdivisions 2 to 6 this section.
37.4(b) Effective for services provided on or after July 1, 2009, total payments for basic
37.5care services shall be reduced by three percent, in accordance with section 256B.766.
37.6Payments made to managed care and county-based purchasing plans shall be reduced for
37.7services provided on or after October 1, 2009, to reflect this reduction.
37.8(c) Effective for services provided on or after July 1, 2009, payment rates for
37.9physician and professional services shall be reduced as described under section 256B.76,
37.10subdivision 1, paragraph (c). Payments made to managed care and county-based
37.11purchasing plans shall be reduced for services provided on or after October 1, 2009,
37.12to reflect this reduction.
37.13EFFECTIVE DATE.This section is effective January 1, 2014.

37.14    Sec. 59. Minnesota Statutes 2012, section 256L.11, subdivision 3, is amended to read:
37.15    Subd. 3. Inpatient hospital services. Inpatient hospital services provided under
37.16section 256L.03, subdivision 3, shall be paid for as provided in subdivisions 4 to 6 at the
37.17medical assistance rate.
37.18EFFECTIVE DATE.This section is effective January 1, 2014.

37.19    Sec. 60. Minnesota Statutes 2012, section 256L.12, subdivision 1, is amended to read:
37.20    Subdivision 1. Selection of vendors. In order to contain costs, the commissioner of
37.21human services shall select vendors of medical care who can provide the most economical
37.22care consistent with high medical standards and shall, where possible, contract with
37.23organizations on a prepaid capitation basis to provide these services. The commissioner
37.24shall consider proposals by counties and vendors for managed care plans and managed
37.25care-like entities as defined by the final regulation implementing section 1331 of the
37.26Affordable Care Act regarding basic health plans, which may include: prepaid capitation
37.27programs, competitive bidding programs, or other vendor payment mechanisms designed
37.28to provide services in an economical manner or to control utilization, with safeguards to
37.29ensure that necessary services are provided.

37.30    Sec. 61. [256L.121] SERVICE DELIVERY.
37.31    Subdivision 1. Competitive process. The commissioner of human services shall
37.32establish a competitive process for entering into contracts with participating entities for
38.1the offering of standard health plans through MinnesotaCare. Coverage through standard
38.2health plans must be available to enrollees beginning January 1, 2015. Each standard
38.3health plan must cover the health services listed in and meet the requirements of section
38.4256L.03. The competitive process must meet the requirements of section 1331 of the
38.5Affordable Care Act and be designed to ensure enrollee access to high-quality health care
38.6coverage options. The commissioner, to the extent feasible, shall seek to ensure that
38.7enrollees have a choice of coverage from more than one participating entity within a
38.8geographic area. In counties that were part of a county-based purchasing plan on January
38.91, 2013, the commissioner shall use the medical assistance competitive procurement
38.10process under section 256B.69, subdivisions 1 to 32, under which selection of entities is
38.11based on criteria related to provider network access, coordination of health care with other
38.12local services, alignment with local public health goals, and other factors.
38.13    Subd. 2. Other requirements for participating entities. The commissioner shall
38.14require participating entities, as a condition of contract, to document to the commissioner:
38.15(1) the provision of culturally and linguistically appropriate services, including
38.16marketing materials, to MinnesotaCare enrollees; and
38.17(2) the inclusion in provider networks of providers designated as essential
38.18community providers under section 62Q.19.
38.19    Subd. 3. Coordination with state-administered health programs. The
38.20commissioner shall coordinate the administration of the MinnesotaCare program with
38.21medical assistance to maximize efficiency and improve the continuity of care. This
38.22includes, but is not limited to:
38.23(1) establishing geographic areas for MinnesotaCare that are consistent with the
38.24geographic areas of the medical assistance program, within which participating entities
38.25may offer health plans;
38.26(2) requiring, as a condition of participation in MinnesotaCare, participating entities
38.27to also participate in the medical assistance program;
38.28(3) complying with sections 256B.69, subdivision 3a; 256B.692, subdivision 1; and
38.29256B.694, when contracting with MinnesotaCare participating entities;
38.30(4) providing MinnesotaCare enrollees, to the extent possible, with the option to
38.31remain in the same health plan and provider network, if they later become eligible for
38.32medical assistance or coverage through the Minnesota health benefit exchange and if, in
38.33the case of becoming eligible for medical assistance, the enrollee's MinnesotaCare health
38.34plan is also a medical assistance health plan in the enrollee's county of residence; and
38.35(5) establishing requirements and criteria for selection that ensure that covered
38.36health care services will be coordinated with local public health services, social services,
39.1long-term care services, mental health services, and other local services affecting
39.2enrollees' health, access, and quality of care.
39.3EFFECTIVE DATE.This section is effective the day following final enactment.

39.4    Sec. 62. Minnesota Statutes 2012, section 256L.15, subdivision 1, is amended to read:
39.5    Subdivision 1. Premium determination. (a) Families with children and individuals
39.6shall pay a premium determined according to subdivision 2.
39.7    (b) Pregnant women and children under age two are exempt from the provisions
39.8of section 256L.06, subdivision 3, paragraph (b), clause (3), requiring disenrollment
39.9for failure to pay premiums. For pregnant women, this exemption continues until the
39.10first day of the month following the 60th day postpartum. Women who remain enrolled
39.11during pregnancy or the postpartum period, despite nonpayment of premiums, shall be
39.12disenrolled on the first of the month following the 60th day postpartum for the penalty
39.13period that otherwise applies under section 256L.06, unless they begin paying premiums.
39.14    (c) (b) Members of the military and their families who meet the eligibility criteria
39.15for MinnesotaCare upon eligibility approval made within 24 months following the end
39.16of the member's tour of active duty shall have their premiums paid by the commissioner.
39.17The effective date of coverage for an individual or family who meets the criteria of this
39.18paragraph shall be the first day of the month following the month in which eligibility is
39.19approved. This exemption applies for 12 months.
39.20(d) (c) Beginning July 1, 2009, American Indians enrolled in MinnesotaCare and
39.21their families shall have their premiums waived by the commissioner in accordance with
39.22section 5006 of the American Recovery and Reinvestment Act of 2009, Public Law 111-5.
39.23An individual must document status as an American Indian, as defined under Code of
39.24Federal Regulations, title 42, section 447.50, to qualify for the waiver of premiums.
39.25EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
39.26approval, whichever is later. The commissioner of human services shall notify the revisor
39.27of statutes when federal approval is obtained.

39.28    Sec. 63. Minnesota Statutes 2012, section 256L.15, subdivision 2, is amended to read:
39.29    Subd. 2. Sliding fee scale; monthly gross individual or family income. (a) The
39.30commissioner shall establish a sliding fee scale to determine the percentage of monthly
39.31gross individual or family income that households at different income levels must pay to
39.32obtain coverage through the MinnesotaCare program. The sliding fee scale must be based
39.33on the enrollee's monthly gross individual or family income. The sliding fee scale must
40.1contain separate tables based on enrollment of one, two, or three or more persons. Until
40.2June 30, 2009, the sliding fee scale begins with a premium of 1.5 percent of monthly gross
40.3individual or family income for individuals or families with incomes below the limits for
40.4the medical assistance program for families and children in effect on January 1, 1999, and
40.5proceeds through the following evenly spaced steps: 1.8, 2.3, 3.1, 3.8, 4.8, 5.9, 7.4, and
40.68.8 percent. These percentages are matched to evenly spaced income steps ranging from
40.7the medical assistance income limit for families and children in effect on January 1, 1999,
40.8to 275 percent of the federal poverty guidelines for the applicable family size, up to a
40.9family size of five. The sliding fee scale for a family of five must be used for families of
40.10more than five. The sliding fee scale and percentages are not subject to the provisions of
40.11chapter 14. If a family or individual reports increased income after enrollment, premiums
40.12shall be adjusted at the time the change in income is reported.
40.13    (b) Children in families whose gross income is above 275 percent of the federal
40.14poverty guidelines shall pay the maximum premium. The maximum premium is defined
40.15as a base charge for one, two, or three or more enrollees so that if all MinnesotaCare
40.16cases paid the maximum premium, the total revenue would equal the total cost of
40.17MinnesotaCare medical coverage and administration. In this calculation, administrative
40.18costs shall be assumed to equal ten percent of the total. The costs of medical coverage
40.19for pregnant women and children under age two and the enrollees in these groups shall
40.20be excluded from the total. The maximum premium for two enrollees shall be twice the
40.21maximum premium for one, and the maximum premium for three or more enrollees shall
40.22be three times the maximum premium for one.
40.23    (c) Beginning July 1, 2009 January 1, 2014, MinnesotaCare enrollees shall pay
40.24premiums according to the premium scale specified in paragraph (d) (c) with the exception
40.25that children 20 years of age and younger in families with income at or below 200 percent
40.26of the federal poverty guidelines shall pay no premiums. For purposes of paragraph (d),
40.27"minimum" means a monthly premium of $4.
40.28    (d) (c) The following premium scale is established for individuals and families
40.29with gross family incomes of 275 percent of the federal poverty guidelines or less each
40.30individual in the household who is 21 years of age or older and enrolled in MinnesotaCare:
40.31
Federal Poverty Guideline Range
Percent of Average Gross Monthly Income
40.32
0-45%
minimum
40.33
40.34
46-54%
$4 or 1.1% of family income, whichever is
greater
40.35
55-81%
1.6%
40.36
82-109%
2.2%
40.37
110-136%
2.9%
41.1
137-164%
3.6%
41.2
165-191%
4.6%
41.3
192-219%
5.6%
41.4
220-248%
6.5%
41.5
249-275%
7.2%
41.6
41.7
Federal Poverty Guideline
Greater than or Equal to
Less than
Individual Premium
Amount
41.8
0%
55%
$4
41.9
55%
80%
$6
41.10
80%
90%
$8
41.11
90%
100%
$10
41.12
100%
110%
$12
41.13
110%
120%
$15
41.14
120%
130%
$18
41.15
130%
140%
$21
41.16
140%
150%
$25
41.17
150%
160%
$29
41.18
160%
170%
$33
41.19
170%
180%
$38
41.20
180%
190%
$43
41.21
190%
$50
41.22EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
41.23approval, whichever is later. The commissioner of human services shall notify the revisor
41.24of statutes when federal approval is obtained.

41.25    Sec. 64. DETERMINATION OF FUNDING ADEQUACY FOR
41.26MINNESOTACARE.
41.27The commissioners of revenue and management and budget, in consultation with
41.28the commissioner of human services, shall conduct an assessment of health care taxes,
41.29including the gross premiums tax, the provider tax, and Medicaid surcharges, and their
41.30relationship to the long-term solvency of the health care access fund, as part of the state
41.31revenue and expenditure forecast in November 2013. The commissioners shall determine
41.32the amount of state funding that will be required after December 31, 2019, in addition
41.33to the federal payments made available under section 1331 of the Affordable Care Act,
41.34for the MinnesotaCare program. The commissioners shall evaluate the stability and
41.35likelihood of long-term federal funding for the MinnesotaCare program under section
41.361331. The commissioners shall report the results of this assessment to the chairs and
41.37ranking minority members of the legislative committees with jurisdiction over human
41.38services, finances, and taxes by January 15, 2014, along with recommendations for
42.1changes to state revenue for the health care access fund, if state funding continues to
42.2be required beyond December 31, 2019.

42.3    Sec. 65. STATE-BASED RISK ADJUSTMENT SYSTEM ASSESSMENT.
42.4(a) Notwithstanding Minnesota Rules, chapter 4653, the commissioner of health,
42.5as part of the commissioner's responsibilities under Minnesota Statutes, section 62U.04,
42.6subdivision 4, paragraph (b), shall collect from health carriers in the individual and
42.7small group health insurance market, beginning on January 1, 2014, for service dates
42.8beginning October 1, 2013, through December 31, 2014, all data required for conducting
42.9risk adjustment with standard risk adjusters such as the Adjusted Clinical Groups or the
42.10Hierarchical Condition Category System, including, but not limited to:
42.11(1) an indicator identifying the health plan product under which an enrollee is covered;
42.12(2) an indicator identifying whether an enrollee's policy is an individual or small
42.13group market policy;
42.14(3) an indicator identifying, if applicable, the metal level of an enrollee's health plan
42.15product, and whether the policy is a catastrophic policy; and
42.16(4) additional identified demographic data necessary to link individuals' data across
42.17health carriers and insurance affordability programs with 95 percent accuracy. The
42.18commissioner shall not collect more than the last four digits of an individual's Social
42.19Security number.
42.20(b) The commissioner of health shall assess the extent to which data collected under
42.21paragraph (a) and under Minnesota Statutes, section 62U.04, subdivision 4, paragraph (a),
42.22are sufficient for developing and operating a state alternative risk adjustment methodology
42.23consistent with applicable federal rules by evaluating:
42.24(1) if the data submitted are adequately complete, accurate, and timely;
42.25(2) if the data should be further enriched by nontraditional risk adjusters that help
42.26in better explaining variation in health care costs of a given population and account for
42.27risk selection across metal levels;
42.28(3) whether additional data or identifiers have the potential to strengthen a
42.29Minnesota-based risk adjustment approach; and
42.30(4) what, if any, changes to the technical infrastructure will be necessary to
42.31effectively perform state-based risk adjustment.
42.32(c) For purposes of paragraph (b), the commissioner of health shall have the
42.33authority to use identified data to validate and audit a statistically valid sample of data for
42.34each health carrier in the individual and small group health insurance market.
43.1(d) If the assessment conducted in paragraph (b) finds that the data collected
43.2under Minnesota Statutes, section 62U.04, subdivision 4, are sufficient for developing
43.3and operating a state alternative risk adjustment methodology consistent with applicable
43.4federal rules, the commissioners of health and human services, in consultation with the
43.5commissioner of commerce and the Board of MNsure, shall study whether Minnesota-based
43.6risk adjustment of the individual and small group health insurance market, using either the
43.7federal risk adjustment model or a state-based alternative, can be more cost-effective and
43.8perform better than risk adjustment conducted by federal agencies. The study shall assess
43.9the policies, infrastructure, and resources necessary to satisfy the requirements of Code of
43.10Federal Regulations, title 45, section 153, subpart D. The study shall also evaluate the
43.11extent to which Minnesota-based risk adjustment could meet requirements established in
43.12Code of Federal Regulations, title 45, section 153.330, including:
43.13(1) explaining the variation in health care costs of a given population;
43.14(2) linking risk factors to daily clinical practices and that which is clinically
43.15meaningful to providers;
43.16(3) encouraging favorable behavior among health care market participants and
43.17discouraging unfavorable behavior;
43.18(4) whether risk adjustment factors are relatively easy for stakeholders to understand
43.19and participate in;
43.20(5) providing stable risk scores over time and across health plan products;
43.21(6) minimizing administrative costs;
43.22(7) accounting for risk selection across metal levels;
43.23(8) aligning each of the elements of the methodology; and
43.24(9) can be conducted at per-member cost equal to or lower than the projected cost of
43.25the federal risk adjustment model.
43.26(e) In conducting the study described in paragraph (d), the commissioner of health
43.27shall contract with entities that do not have an economic interest in the outcome of
43.28Minnesota-based risk adjustment, but have demonstrated expertise in actuarial science
43.29or health economics and demonstrated experience with designing and implementing risk
43.30adjustment models. The commissioner of human services shall evaluate opportunities
43.31to maximize federal funding under section 1331 of the Affordable Care Act. The
43.32commissioner of human services shall make recommendations on risk adjustment
43.33strategies to maximize federal funding to the state of Minnesota.
43.34(f) The commissioner of health shall submit an interim report to the legislature by
43.35March 15, 2014, with preliminary findings from the assessment conducted in paragraph
43.36(b). The interim report shall include legislative recommendations for any necessary
44.1changes to Minnesota Statutes, section 62Q.03. The commissioners of health and human
44.2services shall submit a final report to the legislature by October 1, 2015. The final report
44.3must include findings from the overall assessment conducted under paragraph (e), and a
44.4recommendation on whether to conduct state-based risk adjustment.
44.5(g) The Board of MNsure shall apply for federal funding under section 1311 or
44.61321 of the Affordable Care Act, to fund the work under paragraphs (a), (b), (d), and (e).
44.7Federal funding awarded to MNsure for this purpose is approved and appropriated for
44.8this purpose. The commissioners of health and human services may only proceed with
44.9activities under paragraphs (a) to (e) if funding has been made available for this purpose.
44.10(h) For purposes of this section, the Board of MNsure means the board established
44.11under Minnesota Statutes, section 62V.03, and the Affordable Care Act has the meaning
44.12given in Minnesota Statutes, section 256B.02, subdivision 17.

44.13    Sec. 66. REQUEST FOR FEDERAL AUTHORITY.
44.14The commissioner of human services shall seek authority from the federal Centers
44.15for Medicare and Medicaid Services to allow persons under age 65, participating in
44.16a home and community-based services waiver under section 1915(c) of the Social
44.17Security Act, to continue to disregard spousal income and assets, in place of the spousal
44.18impoverishment provisions under the federal Patient Protection and Affordable Care Act,
44.19Public Law 111-148, section 2404, as amended by the federal Health Care and Education
44.20Reconciliation Act of 2010, Public Law 111-152, and any amendments to, or regulations
44.21and guidance issued under, those acts.

44.22    Sec. 67. REVISOR'S INSTRUCTION.
44.23The revisor of statutes shall: (1) remove cross-references to the sections repealed
44.24in this article wherever they appear in Minnesota Statutes and Minnesota Rules; (2)
44.25change the term "Minnesota Insurance Marketplace" to "MNsure" wherever it appears
44.26in this article and in Minnesota Statutes; and (3) make changes necessary to correct the
44.27punctuation, grammar, or structure of the remaining text and preserve its meaning.

44.28    Sec. 68. REPEALER.
44.29Minnesota Statutes 2012, sections 256L.01, subdivision 4a; 256L.031; 256L.04,
44.30subdivisions 1b, 9, and 10a; 256L.05, subdivision 3b; 256L.07, subdivisions 1, 5, 8, and 9;
44.31256L.11, subdivisions 5 and 6; and 256L.17, subdivisions 1, 2, 3, 4, and 5, are repealed
44.32effective January 1, 2014.
45.1(b) Minnesota Statutes 2012, sections 256B.055, subdivisions 3, 5, and 10b;
45.2256B.056, subdivision 5b; and 256B.057, subdivisions 1c and 2, are repealed effective
45.3January 1, 2014.

45.4ARTICLE 2
45.5CONTINGENT REFORM 2020; REDESIGNING HOME AND
45.6COMMUNITY-BASED SERVICES

45.7    Section 1. Minnesota Statutes 2012, section 144.0724, subdivision 4, is amended to read:
45.8    Subd. 4. Resident assessment schedule. (a) A facility must conduct and
45.9electronically submit to the commissioner of health case mix assessments that conform
45.10with the assessment schedule defined by Code of Federal Regulations, title 42, section
45.11483.20, and published by the United States Department of Health and Human Services,
45.12Centers for Medicare and Medicaid Services, in the Long Term Care Assessment
45.13Instrument User's Manual, version 3.0, and subsequent updates when issued by the
45.14Centers for Medicare and Medicaid Services. The commissioner of health may substitute
45.15successor manuals or question and answer documents published by the United States
45.16Department of Health and Human Services, Centers for Medicare and Medicaid Services,
45.17to replace or supplement the current version of the manual or document.
45.18(b) The assessments used to determine a case mix classification for reimbursement
45.19include the following:
45.20(1) a new admission assessment must be completed by day 14 following admission;
45.21(2) an annual assessment which must have an assessment reference date (ARD)
45.22within 366 days of the ARD of the last comprehensive assessment;
45.23(3) a significant change assessment must be completed within 14 days of the
45.24identification of a significant change; and
45.25(4) all quarterly assessments must have an assessment reference date (ARD) within
45.2692 days of the ARD of the previous assessment.
45.27(c) In addition to the assessments listed in paragraph (b), the assessments used to
45.28determine nursing facility level of care include the following:
45.29(1) preadmission screening completed under section 256B.0911, subdivision 4a, by a
45.30county, tribe, or managed care organization under contract with the Department of Human
45.31Services 256.975, subdivision 7a, by the Senior LinkAge Line or other organization under
45.32contract with the Minnesota Board on Aging; and
45.33(2) a nursing facility level of care determination as provided for under section
45.34256B.0911, subdivision 4e, as part of a face-to-face long-term care consultation assessment
46.1completed under section 256B.0911, subdivision 3a, 3b, or 4d, by a county, tribe, or
46.2managed care organization under contract with the Department of Human Services.

46.3    Sec. 2. Minnesota Statutes 2012, section 144A.351, is amended to read:
46.4144A.351 BALANCING LONG-TERM CARE SERVICES AND SUPPORTS:
46.5REPORT AND STUDY REQUIRED.
46.6    Subdivision 1. Report requirements. The commissioners of health and human
46.7services, with the cooperation of counties and in consultation with stakeholders, including
46.8persons who need or are using long-term care services and supports, lead agencies,
46.9regional entities, senior, disability, and mental health organization representatives, service
46.10providers, and community members shall prepare a report to the legislature by August 15,
46.112013, and biennially thereafter, regarding the status of the full range of long-term care
46.12services and supports for the elderly and children and adults with disabilities and mental
46.13illnesses in Minnesota. The report shall address:
46.14    (1) demographics and need for long-term care services and supports in Minnesota;
46.15    (2) summary of county and regional reports on long-term care gaps, surpluses,
46.16imbalances, and corrective action plans;
46.17    (3) status of long-term care services and related mental health services, housing
46.18options, and supports by county and region including:
46.19    (i) changes in availability of the range of long-term care services and housing options;
46.20    (ii) access problems, including access to the least restrictive and most integrated
46.21services and settings, regarding long-term care services; and
46.22    (iii) comparative measures of long-term care services availability, including serving
46.23people in their home areas near family, and changes over time; and
46.24    (4) recommendations regarding goals for the future of long-term care services and
46.25supports, policy and fiscal changes, and resource development and transition needs.
46.26    Subd. 2. Critical access study. The commissioner of human services shall conduct
46.27a onetime study to assess local capacity and availability of home and community-based
46.28services for older adults, people with disabilities, and people with mental illnesses. The
46.29study must assess critical access at the community level and identify potential strategies
46.30to build home and community-based service capacity in critical access areas. The report
46.31shall be submitted to the legislature no later than August 15, 2015.

46.32    Sec. 3. Minnesota Statutes 2012, section 148E.065, subdivision 4a, is amended to read:
46.33    Subd. 4a. City, county, and state social workers. (a) Beginning July 1, 2016, the
46.34licensure of city, county, and state agency social workers is voluntary, except an individual
47.1who is newly employed by a city or state agency after July 1, 2016, must be licensed
47.2if the individual who provides social work services, as those services are defined in
47.3section 148E.010, subdivision 11, paragraph (b), is presented to the public by any title
47.4incorporating the words "social work" or "social worker."
47.5(b) City, county, and state agencies employing social workers and staff who are
47.6designated to perform mandated duties under sections 256.975, subdivisions 7 to 7c and
47.7256.01, subdivision 24, are not required to employ licensed social workers.

47.8    Sec. 4. Minnesota Statutes 2012, section 256.01, subdivision 2, is amended to read:
47.9    Subd. 2. Specific powers. Subject to the provisions of section 241.021, subdivision
47.102
, the commissioner of human services shall carry out the specific duties in paragraphs (a)
47.11through (cc) (dd):
47.12    (a) Administer and supervise all forms of public assistance provided for by state law
47.13and other welfare activities or services as are vested in the commissioner. Administration
47.14and supervision of human services activities or services includes, but is not limited to,
47.15assuring timely and accurate distribution of benefits, completeness of service, and quality
47.16program management. In addition to administering and supervising human services
47.17activities vested by law in the department, the commissioner shall have the authority to:
47.18    (1) require county agency participation in training and technical assistance programs
47.19to promote compliance with statutes, rules, federal laws, regulations, and policies
47.20governing human services;
47.21    (2) monitor, on an ongoing basis, the performance of county agencies in the
47.22operation and administration of human services, enforce compliance with statutes, rules,
47.23federal laws, regulations, and policies governing welfare services and promote excellence
47.24of administration and program operation;
47.25    (3) develop a quality control program or other monitoring program to review county
47.26performance and accuracy of benefit determinations;
47.27    (4) require county agencies to make an adjustment to the public assistance benefits
47.28issued to any individual consistent with federal law and regulation and state law and rule
47.29and to issue or recover benefits as appropriate;
47.30    (5) delay or deny payment of all or part of the state and federal share of benefits and
47.31administrative reimbursement according to the procedures set forth in section 256.017;
47.32    (6) make contracts with and grants to public and private agencies and organizations,
47.33both profit and nonprofit, and individuals, using appropriated funds; and
47.34    (7) enter into contractual agreements with federally recognized Indian tribes with
47.35a reservation in Minnesota to the extent necessary for the tribe to operate a federally
48.1approved family assistance program or any other program under the supervision of the
48.2commissioner. The commissioner shall consult with the affected county or counties in
48.3the contractual agreement negotiations, if the county or counties wish to be included,
48.4in order to avoid the duplication of county and tribal assistance program services. The
48.5commissioner may establish necessary accounts for the purposes of receiving and
48.6disbursing funds as necessary for the operation of the programs.
48.7    (b) Inform county agencies, on a timely basis, of changes in statute, rule, federal law,
48.8regulation, and policy necessary to county agency administration of the programs.
48.9    (c) Administer and supervise all child welfare activities; promote the enforcement of
48.10laws protecting disabled, dependent, neglected and delinquent children, and children born
48.11to mothers who were not married to the children's fathers at the times of the conception
48.12nor at the births of the children; license and supervise child-caring and child-placing
48.13agencies and institutions; supervise the care of children in boarding and foster homes or
48.14in private institutions; and generally perform all functions relating to the field of child
48.15welfare now vested in the State Board of Control.
48.16    (d) Administer and supervise all noninstitutional service to disabled persons,
48.17including those who are visually impaired, hearing impaired, or physically impaired
48.18or otherwise disabled. The commissioner may provide and contract for the care and
48.19treatment of qualified indigent children in facilities other than those located and available
48.20at state hospitals when it is not feasible to provide the service in state hospitals.
48.21    (e) Assist and actively cooperate with other departments, agencies and institutions,
48.22local, state, and federal, by performing services in conformity with the purposes of Laws
48.231939, chapter 431.
48.24    (f) Act as the agent of and cooperate with the federal government in matters of
48.25mutual concern relative to and in conformity with the provisions of Laws 1939, chapter
48.26431, including the administration of any federal funds granted to the state to aid in the
48.27performance of any functions of the commissioner as specified in Laws 1939, chapter 431,
48.28and including the promulgation of rules making uniformly available medical care benefits
48.29to all recipients of public assistance, at such times as the federal government increases its
48.30participation in assistance expenditures for medical care to recipients of public assistance,
48.31the cost thereof to be borne in the same proportion as are grants of aid to said recipients.
48.32    (g) Establish and maintain any administrative units reasonably necessary for the
48.33performance of administrative functions common to all divisions of the department.
48.34    (h) Act as designated guardian of both the estate and the person of all the wards of
48.35the state of Minnesota, whether by operation of law or by an order of court, without any
48.36further act or proceeding whatever, except as to persons committed as developmentally
49.1disabled. For children under the guardianship of the commissioner or a tribe in Minnesota
49.2recognized by the Secretary of the Interior whose interests would be best served by
49.3adoptive placement, the commissioner may contract with a licensed child-placing agency
49.4or a Minnesota tribal social services agency to provide adoption services. A contract
49.5with a licensed child-placing agency must be designed to supplement existing county
49.6efforts and may not replace existing county programs or tribal social services, unless the
49.7replacement is agreed to by the county board and the appropriate exclusive bargaining
49.8representative, tribal governing body, or the commissioner has evidence that child
49.9placements of the county continue to be substantially below that of other counties. Funds
49.10encumbered and obligated under an agreement for a specific child shall remain available
49.11until the terms of the agreement are fulfilled or the agreement is terminated.
49.12    (i) Act as coordinating referral and informational center on requests for service for
49.13newly arrived immigrants coming to Minnesota.
49.14    (j) The specific enumeration of powers and duties as hereinabove set forth shall in no
49.15way be construed to be a limitation upon the general transfer of powers herein contained.
49.16    (k) Establish county, regional, or statewide schedules of maximum fees and charges
49.17which may be paid by county agencies for medical, dental, surgical, hospital, nursing and
49.18nursing home care and medicine and medical supplies under all programs of medical
49.19care provided by the state and for congregate living care under the income maintenance
49.20programs.
49.21    (l) Have the authority to conduct and administer experimental projects to test methods
49.22and procedures of administering assistance and services to recipients or potential recipients
49.23of public welfare. To carry out such experimental projects, it is further provided that the
49.24commissioner of human services is authorized to waive the enforcement of existing specific
49.25statutory program requirements, rules, and standards in one or more counties. The order
49.26establishing the waiver shall provide alternative methods and procedures of administration,
49.27shall not be in conflict with the basic purposes, coverage, or benefits provided by law, and
49.28in no event shall the duration of a project exceed four years. It is further provided that no
49.29order establishing an experimental project as authorized by the provisions of this section
49.30shall become effective until the following conditions have been met:
49.31    (1) the secretary of health and human services of the United States has agreed, for
49.32the same project, to waive state plan requirements relative to statewide uniformity; and
49.33    (2) a comprehensive plan, including estimated project costs, shall be approved by
49.34the Legislative Advisory Commission and filed with the commissioner of administration.
50.1    (m) According to federal requirements, establish procedures to be followed by
50.2local welfare boards in creating citizen advisory committees, including procedures for
50.3selection of committee members.
50.4    (n) Allocate federal fiscal disallowances or sanctions which are based on quality
50.5control error rates for the aid to families with dependent children program formerly
50.6codified in sections 256.72 to 256.87, medical assistance, or food stamp program in the
50.7following manner:
50.8    (1) one-half of the total amount of the disallowance shall be borne by the county
50.9boards responsible for administering the programs. For the medical assistance and the
50.10AFDC program formerly codified in sections 256.72 to 256.87, disallowances shall be
50.11shared by each county board in the same proportion as that county's expenditures for the
50.12sanctioned program are to the total of all counties' expenditures for the AFDC program
50.13formerly codified in sections 256.72 to 256.87, and medical assistance programs. For the
50.14food stamp program, sanctions shall be shared by each county board, with 50 percent of
50.15the sanction being distributed to each county in the same proportion as that county's
50.16administrative costs for food stamps are to the total of all food stamp administrative costs
50.17for all counties, and 50 percent of the sanctions being distributed to each county in the
50.18same proportion as that county's value of food stamp benefits issued are to the total of
50.19all benefits issued for all counties. Each county shall pay its share of the disallowance
50.20to the state of Minnesota. When a county fails to pay the amount due hereunder, the
50.21commissioner may deduct the amount from reimbursement otherwise due the county, or
50.22the attorney general, upon the request of the commissioner, may institute civil action
50.23to recover the amount due; and
50.24    (2) notwithstanding the provisions of clause (1), if the disallowance results from
50.25knowing noncompliance by one or more counties with a specific program instruction, and
50.26that knowing noncompliance is a matter of official county board record, the commissioner
50.27may require payment or recover from the county or counties, in the manner prescribed in
50.28clause (1), an amount equal to the portion of the total disallowance which resulted from the
50.29noncompliance, and may distribute the balance of the disallowance according to clause (1).
50.30    (o) Develop and implement special projects that maximize reimbursements and
50.31result in the recovery of money to the state. For the purpose of recovering state money,
50.32the commissioner may enter into contracts with third parties. Any recoveries that result
50.33from projects or contracts entered into under this paragraph shall be deposited in the
50.34state treasury and credited to a special account until the balance in the account reaches
50.35$1,000,000. When the balance in the account exceeds $1,000,000, the excess shall be
51.1transferred and credited to the general fund. All money in the account is appropriated to
51.2the commissioner for the purposes of this paragraph.
51.3    (p) Have the authority to make direct payments to facilities providing shelter
51.4to women and their children according to section 256D.05, subdivision 3. Upon
51.5the written request of a shelter facility that has been denied payments under section
51.6256D.05, subdivision 3 , the commissioner shall review all relevant evidence and make
51.7a determination within 30 days of the request for review regarding issuance of direct
51.8payments to the shelter facility. Failure to act within 30 days shall be considered a
51.9determination not to issue direct payments.
51.10    (q) Have the authority to establish and enforce the following county reporting
51.11requirements:
51.12    (1) the commissioner shall establish fiscal and statistical reporting requirements
51.13necessary to account for the expenditure of funds allocated to counties for human
51.14services programs. When establishing financial and statistical reporting requirements, the
51.15commissioner shall evaluate all reports, in consultation with the counties, to determine if
51.16the reports can be simplified or the number of reports can be reduced;
51.17    (2) the county board shall submit monthly or quarterly reports to the department
51.18as required by the commissioner. Monthly reports are due no later than 15 working days
51.19after the end of the month. Quarterly reports are due no later than 30 calendar days after
51.20the end of the quarter, unless the commissioner determines that the deadline must be
51.21shortened to 20 calendar days to avoid jeopardizing compliance with federal deadlines
51.22or risking a loss of federal funding. Only reports that are complete, legible, and in the
51.23required format shall be accepted by the commissioner;
51.24    (3) if the required reports are not received by the deadlines established in clause (2),
51.25the commissioner may delay payments and withhold funds from the county board until
51.26the next reporting period. When the report is needed to account for the use of federal
51.27funds and the late report results in a reduction in federal funding, the commissioner shall
51.28withhold from the county boards with late reports an amount equal to the reduction in
51.29federal funding until full federal funding is received;
51.30    (4) a county board that submits reports that are late, illegible, incomplete, or not
51.31in the required format for two out of three consecutive reporting periods is considered
51.32noncompliant. When a county board is found to be noncompliant, the commissioner
51.33shall notify the county board of the reason the county board is considered noncompliant
51.34and request that the county board develop a corrective action plan stating how the
51.35county board plans to correct the problem. The corrective action plan must be submitted
52.1to the commissioner within 45 days after the date the county board received notice
52.2of noncompliance;
52.3    (5) the final deadline for fiscal reports or amendments to fiscal reports is one year
52.4after the date the report was originally due. If the commissioner does not receive a report
52.5by the final deadline, the county board forfeits the funding associated with the report for
52.6that reporting period and the county board must repay any funds associated with the
52.7report received for that reporting period;
52.8    (6) the commissioner may not delay payments, withhold funds, or require repayment
52.9under clause (3) or (5) if the county demonstrates that the commissioner failed to
52.10provide appropriate forms, guidelines, and technical assistance to enable the county to
52.11comply with the requirements. If the county board disagrees with an action taken by the
52.12commissioner under clause (3) or (5), the county board may appeal the action according
52.13to sections 14.57 to 14.69; and
52.14    (7) counties subject to withholding of funds under clause (3) or forfeiture or
52.15repayment of funds under clause (5) shall not reduce or withhold benefits or services to
52.16clients to cover costs incurred due to actions taken by the commissioner under clause
52.17(3) or (5).
52.18    (r) Allocate federal fiscal disallowances or sanctions for audit exceptions when
52.19federal fiscal disallowances or sanctions are based on a statewide random sample in direct
52.20proportion to each county's claim for that period.
52.21    (s) Be responsible for ensuring the detection, prevention, investigation, and
52.22resolution of fraudulent activities or behavior by applicants, recipients, and other
52.23participants in the human services programs administered by the department.
52.24    (t) Require county agencies to identify overpayments, establish claims, and utilize
52.25all available and cost-beneficial methodologies to collect and recover these overpayments
52.26in the human services programs administered by the department.
52.27    (u) Have the authority to administer a drug rebate program for drugs purchased
52.28pursuant to the prescription drug program established under section 256.955 after the
52.29beneficiary's satisfaction of any deductible established in the program. The commissioner
52.30shall require a rebate agreement from all manufacturers of covered drugs as defined in
52.31section 256B.0625, subdivision 13. Rebate agreements for prescription drugs delivered on
52.32or after July 1, 2002, must include rebates for individuals covered under the prescription
52.33drug program who are under 65 years of age. For each drug, the amount of the rebate shall
52.34be equal to the rebate as defined for purposes of the federal rebate program in United
52.35States Code, title 42, section 1396r-8. The manufacturers must provide full payment
52.36within 30 days of receipt of the state invoice for the rebate within the terms and conditions
53.1used for the federal rebate program established pursuant to section 1927 of title XIX of
53.2the Social Security Act. The manufacturers must provide the commissioner with any
53.3information necessary to verify the rebate determined per drug. The rebate program shall
53.4utilize the terms and conditions used for the federal rebate program established pursuant to
53.5section 1927 of title XIX of the Social Security Act.
53.6    (v) Have the authority to administer the federal drug rebate program for drugs
53.7purchased under the medical assistance program as allowed by section 1927 of title XIX
53.8of the Social Security Act and according to the terms and conditions of section 1927.
53.9Rebates shall be collected for all drugs that have been dispensed or administered in an
53.10outpatient setting and that are from manufacturers who have signed a rebate agreement
53.11with the United States Department of Health and Human Services.
53.12    (w) Have the authority to administer a supplemental drug rebate program for drugs
53.13purchased under the medical assistance program. The commissioner may enter into
53.14supplemental rebate contracts with pharmaceutical manufacturers and may require prior
53.15authorization for drugs that are from manufacturers that have not signed a supplemental
53.16rebate contract. Prior authorization of drugs shall be subject to the provisions of section
53.17256B.0625, subdivision 13 .
53.18    (x) Operate the department's communication systems account established in Laws
53.191993, First Special Session chapter 1, article 1, section 2, subdivision 2, to manage shared
53.20communication costs necessary for the operation of the programs the commissioner
53.21supervises. A communications account may also be established for each regional
53.22treatment center which operates communications systems. Each account must be used
53.23to manage shared communication costs necessary for the operations of the programs the
53.24commissioner supervises. The commissioner may distribute the costs of operating and
53.25maintaining communication systems to participants in a manner that reflects actual usage.
53.26Costs may include acquisition, licensing, insurance, maintenance, repair, staff time and
53.27other costs as determined by the commissioner. Nonprofit organizations and state, county,
53.28and local government agencies involved in the operation of programs the commissioner
53.29supervises may participate in the use of the department's communications technology and
53.30share in the cost of operation. The commissioner may accept on behalf of the state any
53.31gift, bequest, devise or personal property of any kind, or money tendered to the state for
53.32any lawful purpose pertaining to the communication activities of the department. Any
53.33money received for this purpose must be deposited in the department's communication
53.34systems accounts. Money collected by the commissioner for the use of communication
53.35systems must be deposited in the state communication systems account and is appropriated
53.36to the commissioner for purposes of this section.
54.1    (y) Receive any federal matching money that is made available through the medical
54.2assistance program for the consumer satisfaction survey. Any federal money received for
54.3the survey is appropriated to the commissioner for this purpose. The commissioner may
54.4expend the federal money received for the consumer satisfaction survey in either year of
54.5the biennium.
54.6    (z) Designate community information and referral call centers and incorporate
54.7cost reimbursement claims from the designated community information and referral
54.8call centers into the federal cost reimbursement claiming processes of the department
54.9according to federal law, rule, and regulations. Existing information and referral centers
54.10provided by Greater Twin Cities United Way or existing call centers for which Greater
54.11Twin Cities United Way has legal authority to represent, shall be included in these
54.12designations upon review by the commissioner and assurance that these services are
54.13accredited and in compliance with national standards. Any reimbursement is appropriated
54.14to the commissioner and all designated information and referral centers shall receive
54.15payments according to normal department schedules established by the commissioner
54.16upon final approval of allocation methodologies from the United States Department of
54.17Health and Human Services Division of Cost Allocation or other appropriate authorities.
54.18    (aa) Develop recommended standards for foster care homes that address the
54.19components of specialized therapeutic services to be provided by foster care homes with
54.20those services.
54.21    (bb) Authorize the method of payment to or from the department as part of the
54.22human services programs administered by the department. This authorization includes the
54.23receipt or disbursement of funds held by the department in a fiduciary capacity as part of
54.24the human services programs administered by the department.
54.25    (cc) Have the authority to administer a drug rebate program for drugs purchased for
54.26persons eligible for general assistance medical care under section 256D.03, subdivision 3.
54.27For manufacturers that agree to participate in the general assistance medical care rebate
54.28program, the commissioner shall enter into a rebate agreement for covered drugs as
54.29defined in section 256B.0625, subdivisions 13 and 13d. For each drug, the amount of the
54.30rebate shall be equal to the rebate as defined for purposes of the federal rebate program in
54.31United States Code, title 42, section 1396r-8. The manufacturers must provide payment
54.32within the terms and conditions used for the federal rebate program established under
54.33section 1927 of title XIX of the Social Security Act. The rebate program shall utilize
54.34the terms and conditions used for the federal rebate program established under section
54.351927 of title XIX of the Social Security Act.
55.1    Effective January 1, 2006, drug coverage under general assistance medical care shall
55.2be limited to those prescription drugs that:
55.3    (1) are covered under the medical assistance program as described in section
55.4256B.0625, subdivisions 13 and 13d ; and
55.5    (2) are provided by manufacturers that have fully executed general assistance
55.6medical care rebate agreements with the commissioner and comply with such agreements.
55.7Prescription drug coverage under general assistance medical care shall conform to
55.8coverage under the medical assistance program according to section 256B.0625,
55.9subdivisions 13 to 13g
.
55.10    The rebate revenues collected under the drug rebate program are deposited in the
55.11general fund.
55.12(dd) Designate the agencies that operate the Senior LinkAge Line under section
55.13256.975, subdivision 7, and the Disability Linkage Line under subdivision 24 as the state
55.14of Minnesota Aging and the Disability Resource Centers under United States Code, title
55.1542, section 3001, the Older Americans Act Amendments of 2006, and incorporate cost
55.16reimbursement claims from the designated centers into the federal cost reimbursement
55.17claiming processes of the department according to federal law, rule, and regulations. Any
55.18reimbursement must be appropriated to the commissioner and treated consistent with
55.19section 256.011. All Aging and Disability Resource Center designated agencies shall
55.20receive payments of grant funding that supports the activity and generates the federal
55.21financial participation according to Board on Aging administrative granting mechanisms.

55.22    Sec. 5. Minnesota Statutes 2012, section 256.01, subdivision 24, is amended to read:
55.23    Subd. 24. Disability Linkage Line. The commissioner shall establish the Disability
55.24Linkage Line, to which shall serve people with disabilities as the designated Aging and
55.25Disability Resource Center under United States Code, title 42, section 3001, the Older
55.26Americans Act Amendments of 2006, in partnership with the Senior LinkAge Line and
55.27shall serve as Minnesota's neutral access point for statewide disability information and
55.28assistance and must be available during business hours through a statewide toll-free
55.29number and the Internet. The Disability Linkage Line shall:
55.30(1) deliver information and assistance based on national and state standards;
55.31    (2) provide information about state and federal eligibility requirements, benefits,
55.32and service options;
55.33(3) provide benefits and options counseling;
55.34    (4) make referrals to appropriate support entities;
56.1    (5) educate people on their options so they can make well-informed choices and link
56.2them to quality profiles;
56.3    (6) help support the timely resolution of service access and benefit issues;
56.4(7) inform people of their long-term community services and supports;
56.5(8) provide necessary resources and supports that can lead to employment and
56.6increased economic stability of people with disabilities; and
56.7(9) serve as the technical assistance and help center for the Web-based tool,
56.8Minnesota's Disability Benefits 101.org.

56.9    Sec. 6. Minnesota Statutes 2012, section 256.975, subdivision 7, is amended to read:
56.10    Subd. 7. Consumer information and assistance and long-term care options
56.11counseling; Senior LinkAge Line. (a) The Minnesota Board on Aging shall operate a
56.12statewide service to aid older Minnesotans and their families in making informed choices
56.13about long-term care options and health care benefits. Language services to persons
56.14with limited English language skills may be made available. The service, known as
56.15Senior LinkAge Line, shall serve older adults as the designated Aging and Disability
56.16Resource Center under United States Code, title 42, section 3001, the Older Americans
56.17Act Amendments of 2006 in partnership with the Disability LinkAge Line under section
56.18256.01, subdivision 24, and must be available during business hours through a statewide
56.19toll-free number and must also be available through the Internet. The Minnesota Board
56.20on Aging shall consult with, and when appropriate work through, the area agencies on
56.21aging counties, and other entities that serve aging and disabled populations of all ages,
56.22to provide and maintain the telephone infrastructure and related support for the Aging
56.23and Disability Resource Center partners which agree by memorandum to access the
56.24infrastructure, including the designated providers of the Senior LinkAge Line and the
56.25Disability Linkage Line.
56.26    (b) The service must provide long-term care options counseling by assisting older
56.27adults, caregivers, and providers in accessing information and options counseling about
56.28choices in long-term care services that are purchased through private providers or available
56.29through public options. The service must:
56.30    (1) develop and provide for regular updating of a comprehensive database that
56.31includes detailed listings in both consumer- and provider-oriented formats that can provide
56.32search results down to the neighborhood level;
56.33    (2) make the database accessible on the Internet and through other telecommunication
56.34and media-related tools;
57.1    (3) link callers to interactive long-term care screening tools and make these tools
57.2available through the Internet by integrating the tools with the database;
57.3    (4) develop community education materials with a focus on planning for long-term
57.4care and evaluating independent living, housing, and service options;
57.5    (5) conduct an outreach campaign to assist older adults and their caregivers in
57.6finding information on the Internet and through other means of communication;
57.7    (6) implement a messaging system for overflow callers and respond to these callers
57.8by the next business day;
57.9    (7) link callers with county human services and other providers to receive more
57.10in-depth assistance and consultation related to long-term care options;
57.11    (8) link callers with quality profiles for nursing facilities and other home and
57.12community-based services providers developed by the commissioner commissioners of
57.13health and human services;
57.14(9) develop an outreach plan to seniors and their caregivers with a particular focus
57.15on establishing a clear presence in places that seniors recognize and:
57.16(i) place a significant emphasis on improved outreach and service to seniors and
57.17their caregivers by establishing annual plans by neighborhood, city, and county, as
57.18necessary, to address the unique needs of geographic areas in the state where there are
57.19dense populations of seniors;
57.20(ii) establish an efficient workforce management approach and assign community
57.21living specialist staff and volunteers to geographic areas as well as aging and disability
57.22resource center sites so that seniors and their caregivers and professionals recognize the
57.23Senior LinkAge Line as the place to call for aging services and information;
57.24(iii) recognize the size and complexity of the metropolitan area service system by
57.25working with metropolitan counties to establish a clear partnership with them, including
57.26seeking county advice on the establishment of local aging and disabilities resource center
57.27sites; and
57.28(iv) maintain dashboards with metrics that demonstrate how the service is expanding
57.29and extending or enhancing its outreach efforts in dispersed or hard to reach locations in
57.30varied population centers;
57.31    (9) (10) incorporate information about the availability of housing options, as well
57.32as registered housing with services and consumer rights within the MinnesotaHelp.info
57.33network long-term care database to facilitate consumer comparison of services and costs
57.34among housing with services establishments and with other in-home services and to
57.35support financial self-sufficiency as long as possible. Housing with services establishments
57.36and their arranged home care providers shall provide information that will facilitate price
58.1comparisons, including delineation of charges for rent and for services available. The
58.2commissioners of health and human services shall align the data elements required by
58.3section 144G.06, the Uniform Consumer Information Guide, and this section to provide
58.4consumers standardized information and ease of comparison of long-term care options.
58.5The commissioner of human services shall provide the data to the Minnesota Board on
58.6Aging for inclusion in the MinnesotaHelp.info network long-term care database;
58.7(10) (11) provide long-term care options counseling. Long-term care options
58.8counselors shall:
58.9(i) for individuals not eligible for case management under a public program or public
58.10funding source, provide interactive decision support under which consumers, family
58.11members, or other helpers are supported in their deliberations to determine appropriate
58.12long-term care choices in the context of the consumer's needs, preferences, values, and
58.13individual circumstances, including implementing a community support plan;
58.14(ii) provide Web-based educational information and collateral written materials to
58.15familiarize consumers, family members, or other helpers with the long-term care basics,
58.16issues to be considered, and the range of options available in the community;
58.17(iii) provide long-term care futures planning, which means providing assistance to
58.18individuals who anticipate having long-term care needs to develop a plan for the more
58.19distant future; and
58.20(iv) provide expertise in benefits and financing options for long-term care, including
58.21Medicare, long-term care insurance, tax or employer-based incentives, reverse mortgages,
58.22private pay options, and ways to access low or no-cost services or benefits through
58.23volunteer-based or charitable programs;
58.24(11) (12) using risk management and support planning protocols, provide long-term
58.25care options counseling to current residents of nursing homes deemed appropriate for
58.26discharge by the commissioner and older adults who request service after consultation
58.27with the Senior LinkAge Line under clause (12). In order to meet this requirement, The
58.28Senior LinkAge Line shall also receive referrals from the residents or staff of nursing
58.29homes. The Senior LinkAge Line shall identify and contact residents deemed appropriate
58.30for discharge by developing targeting criteria in consultation with the commissioner who
58.31shall provide designated Senior LinkAge Line contact centers with a list of nursing
58.32home residents that meet the criteria as being appropriate for discharge planning via a
58.33secure Web portal. Senior LinkAge Line shall provide these residents, if they indicate a
58.34preference to receive long-term care options counseling, with initial assessment, review of
58.35risk factors, independent living support consultation, or and, if appropriate, a referral to:
58.36(i) long-term care consultation services under section 256B.0911;
59.1(ii) designated care coordinators of contracted entities under section 256B.035 for
59.2persons who are enrolled in a managed care plan; or
59.3(iii) the long-term care consultation team for those who are appropriate eligible
59.4 for relocation service coordination due to high-risk factors or psychological or physical
59.5disability; and
59.6(12) (13) develop referral protocols and processes that will assist certified health
59.7care homes and hospitals to identify at-risk older adults and determine when to refer these
59.8individuals to the Senior LinkAge Line for long-term care options counseling under this
59.9section. The commissioner is directed to work with the commissioner of health to develop
59.10protocols that would comply with the health care home designation criteria and protocols
59.11available at the time of hospital discharge. The commissioner shall keep a record of the
59.12number of people who choose long-term care options counseling as a result of this section.

59.13    Sec. 7. Minnesota Statutes 2012, section 256.975, is amended by adding a subdivision
59.14to read:
59.15    Subd. 7a. Preadmission screening activities related to nursing facility
59.16admissions. (a) All individuals seeking admission to Medicaid certified nursing facilities,
59.17including certified boarding care facilities, must be screened prior to admission regardless
59.18of income, assets, or funding sources for nursing facility care, except as described in
59.19subdivision 7b, paragraphs (a) and (b). The purpose of the screening is to determine the
59.20need for nursing facility level of care as described in section 256B.0911, subdivision
59.214e, and to complete activities required under federal law related to mental illness and
59.22developmental disability as outlined in paragraph (b).
59.23(b) A person who has a diagnosis or possible diagnosis of mental illness or
59.24developmental disability must receive a preadmission screening before admission
59.25regardless of the exemptions outlined in subdivision 7b, paragraphs (a) and (b), to identify
59.26the need for further evaluation and specialized services, unless the admission prior to
59.27screening is authorized by the local mental health authority or the local developmental
59.28disabilities case manager, or unless authorized by the county agency according to Public
59.29Law 101-508.
59.30(c) The following criteria apply to the preadmission screening:
59.31(1) requests for preadmission screenings must be submitted via an online form
59.32developed by the commissioner;
59.33(2) the Senior LinkAge Line must use forms and criteria developed by the
59.34commissioner to identify persons who require referral for further evaluation and
59.35determination of the need for specialized services; and
60.1(3) the evaluation and determination of the need for specialized services must be
60.2done by:
60.3(i) a qualified independent mental health professional, for persons with a primary or
60.4secondary diagnosis of a serious mental illness; or
60.5(ii) a qualified developmental disability professional, for persons with a primary or
60.6secondary diagnosis of developmental disability. For purposes of this requirement, a
60.7qualified developmental disability professional must meet the standards for a qualified
60.8developmental disability professional under Code of Federal Regulations, title 42, section
60.9483.430.
60.10(d) The local county mental health authority or the state developmental disability
60.11authority under Public Law Numbers 100-203 and 101-508 may prohibit admission to a
60.12nursing facility if the individual does not meet the nursing facility level of care criteria or
60.13needs specialized services as defined in Public Law Numbers 100-203 and 101-508. For
60.14purposes of this section, "specialized services" for a person with developmental disability
60.15means active treatment as that term is defined under Code of Federal Regulations, title
60.1642, section 483.440(a)(1).
60.17(e) In assessing a person's needs, the screener shall:
60.18(1) use an automated system designated by the commissioner;
60.19(2) consult with care transitions coordinators or physician; and
60.20(3) consider the assessment of the individual's physician.
60.21Other personnel may be included in the level of care determination as deemed
60.22necessary by the screener.
60.23EFFECTIVE DATE.This section is effective October 1, 2013.

60.24    Sec. 8. Minnesota Statutes 2012, section 256.975, is amended by adding a subdivision
60.25to read:
60.26    Subd. 7b. Exemptions and emergency admissions. (a) Exemptions from the federal
60.27screening requirements outlined in subdivision 7a, paragraphs (b) and (c), are limited to:
60.28(1) a person who, having entered an acute care facility from a certified nursing
60.29facility, is returning to a certified nursing facility; or
60.30(2) a person transferring from one certified nursing facility in Minnesota to another
60.31certified nursing facility in Minnesota.
60.32(b) Persons who are exempt from preadmission screening for purposes of level of
60.33care determination include:
60.34(1) persons described in paragraph (a);
61.1(2) an individual who has a contractual right to have nursing facility care paid for
61.2indefinitely by the Veterans' Administration;
61.3(3) an individual enrolled in a demonstration project under section 256B.69,
61.4subdivision 8, at the time of application to a nursing facility; and
61.5(4) an individual currently being served under the alternative care program or under
61.6a home and community-based services waiver authorized under section 1915(c) of the
61.7federal Social Security Act.
61.8(c) Persons admitted to a Medicaid-certified nursing facility from the community
61.9on an emergency basis as described in paragraph (d) or from an acute care facility on a
61.10nonworking day must be screened the first working day after admission.
61.11(d) Emergency admission to a nursing facility prior to screening is permitted when
61.12all of the following conditions are met:
61.13(1) a person is admitted from the community to a certified nursing or certified
61.14boarding care facility during Senior LinkAge Line nonworking hours;
61.15(2) a physician has determined that delaying admission until preadmission screening
61.16is completed would adversely affect the person's health and safety;
61.17(3) there is a recent precipitating event that precludes the client from living safely in
61.18the community, such as sustaining an injury, sudden onset of acute illness, or a caregiver's
61.19inability to continue to provide care;
61.20(4) the attending physician has authorized the emergency placement and has
61.21documented the reason that the emergency placement is recommended; and
61.22(5) the Senior LinkAge Line is contacted on the first working day following the
61.23emergency admission.
61.24Transfer of a patient from an acute care hospital to a nursing facility is not considered
61.25an emergency except for a person who has received hospital services in the following
61.26situations: hospital admission for observation, care in an emergency room without hospital
61.27admission, or following hospital 24-hour bed care and from whom admission is being
61.28sought on a nonworking day.
61.29(e) A nursing facility must provide written information to all persons admitted
61.30regarding the person's right to request and receive long-term care consultation services as
61.31defined in section 256B.0911, subdivision 1a. The information must be provided prior to
61.32the person's discharge from the facility and in a format specified by the commissioner.
61.33EFFECTIVE DATE.This section is effective October 1, 2013.

61.34    Sec. 9. Minnesota Statutes 2012, section 256.975, is amended by adding a subdivision
61.35to read:
62.1    Subd. 7c. Screening requirements. (a) A person may be screened for nursing
62.2facility admission by telephone or in a face-to-face screening interview. The Senior
62.3LinkAge Line shall identify each individual's needs using the following categories:
62.4(1) the person needs no face-to-face long-term care consultation assessment
62.5completed under section 256B.0911, subdivision 3a, 3b, or 4d, by a county, tribe, or
62.6managed care organization under contract with the Department of Human Services to
62.7determine the need for nursing facility level of care based on information obtained from
62.8other health care professionals;
62.9(2) the person needs an immediate face-to-face long-term care consultation
62.10assessment completed under section 256B.0911, subdivision 3a, 3b, or 4d, by a county,
62.11tribe, or managed care organization under contract with the Department of Human
62.12Services to determine the need for nursing facility level of care and complete activities
62.13required under subdivision 7a; or
62.14(3) the person may be exempt from screening requirements as outlined in subdivision
62.157b, but will need transitional assistance after admission or in-person follow-along after
62.16a return home.
62.17(b) Individuals under 65 years of age who are admitted to nursing facilities with
62.18only a telephone screening must receive a face-to-face assessment from the long-term
62.19care consultation team member of the county in which the facility is located or from the
62.20recipient's county case manager within 40 calendar days of admission as described in
62.21section 256B.0911, subdivision 4d, paragraph (c).
62.22(c) Persons admitted on a nonemergency basis to a Medicaid-certified nursing
62.23facility must be screened prior to admission.
62.24(d) Screenings provided by the Senior LinkAge Line must include processes
62.25to identify persons who may require transition assistance described in subdivision 7,
62.26paragraph (b), clause (12), and section 256B.0911, subdivision 3b.
62.27EFFECTIVE DATE.This section is effective October 1, 2013.

62.28    Sec. 10. Minnesota Statutes 2012, section 256.975, is amended by adding a subdivision
62.29to read:
62.30    Subd. 7d. Payment for preadmission screening. Funding for preadmission
62.31screening shall be provided to the Minnesota Board on Aging by the Department of
62.32Human Services to cover screener salaries and expenses to provide the services described
62.33in subdivisions 7a to 7c. The Minnesota Board on Aging shall employ, or contract with
62.34other agencies to employ, within the limits of available funding, sufficient personnel to
62.35provide preadmission screening and level of care determination services and shall seek to
63.1maximize federal funding for the service as provided under section 256.01, subdivision
63.22, paragraph (dd).
63.3EFFECTIVE DATE.This section is effective October 1, 2013.

63.4    Sec. 11. Minnesota Statutes 2012, section 256.9754, is amended by adding a
63.5subdivision to read:
63.6    Subd. 3a. Priority for other grants. The commissioner of health shall give priority
63.7to a grantee selected under subdivision 3 when awarding technology-related grants, if the
63.8grantee is using technology as part of the proposal unless that priority conflicts with
63.9existing state or federal guidance related to grant awards by the Department of Health.
63.10The commissioner of transportation shall give priority to a grantee under subdivision 3
63.11when distributing transportation-related funds to create transportation options for older
63.12adults unless that preference conflicts with existing state or federal guidance related to
63.13grant awards by the Department of Transportation.

63.14    Sec. 12. Minnesota Statutes 2012, section 256.9754, is amended by adding a
63.15subdivision to read:
63.16    Subd. 3b. State waivers. The commissioner of health may waive applicable state
63.17laws and rules on a time-limited basis if the commissioner of health determines that a
63.18participating grantee requires a waiver in order to achieve demonstration project goals.

63.19    Sec. 13. Minnesota Statutes 2012, section 256.9754, subdivision 5, is amended to read:
63.20    Subd. 5. Grant preference. The commissioner of human services shall give
63.21preference when awarding grants under this section to areas where nursing facility
63.22closures have occurred or are occurring or areas with service needs identified by section
63.23144A.351. The commissioner may award grants to the extent grant funds are available
63.24and to the extent applications are approved by the commissioner. Denial of approval of an
63.25application in one year does not preclude submission of an application in a subsequent
63.26year. The maximum grant amount is limited to $750,000.

63.27    Sec. 14. Minnesota Statutes 2012, section 256B.021, is amended by adding a
63.28subdivision to read:
63.29    Subd. 4a. Evaluation. The commissioner shall evaluate the projects contained in
63.30subdivision 4, paragraphs (f), clauses (2) and (12), and (h). The evaluation must include:
63.31(1) an impact assessment focusing on program outcomes, especially those
63.32experienced directly by the person receiving services;
64.1(2) study samples drawn from the population of interest for each project; and
64.2(3) a time series analysis to examine aggregate trends in average monthly
64.3utilization, expenditures, and other outcomes in the targeted populations before and after
64.4implementation of the initiatives.

64.5    Sec. 15. Minnesota Statutes 2012, section 256B.021, is amended by adding a
64.6subdivision to read:
64.7    Subd. 6. Work, empower, and encourage independence. As provided under
64.8subdivision 4, paragraph (e), upon federal approval, the commissioner shall establish a
64.9demonstration project to provide navigation, employment supports, and benefits planning
64.10services to a targeted group of federally funded Medicaid recipients to begin July 1, 2014.
64.11This demonstration shall promote economic stability, increase independence, and reduce
64.12applications for disability benefits while providing a positive impact on the health and
64.13future of participants.

64.14    Sec. 16. Minnesota Statutes 2012, section 256B.021, is amended by adding a
64.15subdivision to read:
64.16    Subd. 7. Housing stabilization. As provided under subdivision 4, paragraph (e),
64.17upon federal approval, the commissioner shall establish a demonstration project to provide
64.18service coordination, outreach, in-reach, tenancy support, and community living assistance
64.19to a targeted group of federally funded Medicaid recipients to begin January 1, 2014. This
64.20demonstration shall promote housing stability, reduce costly medical interventions, and
64.21increase opportunities for independent community living.

64.22    Sec. 17. Minnesota Statutes 2012, section 256B.0911, subdivision 1, is amended to read:
64.23    Subdivision 1. Purpose and goal. (a) The purpose of long-term care consultation
64.24services is to assist persons with long-term or chronic care needs in making care
64.25decisions and selecting support and service options that meet their needs and reflect
64.26their preferences. The availability of, and access to, information and other types of
64.27assistance, including assessment and support planning, is also intended to prevent or delay
64.28institutional placements and to provide access to transition assistance after admission.
64.29Further, the goal of these services is to contain costs associated with unnecessary
64.30institutional admissions. Long-term consultation services must be available to any person
64.31regardless of public program eligibility. The commissioner of human services shall seek
64.32to maximize use of available federal and state funds and establish the broadest program
64.33possible within the funding available.
65.1(b) These services must be coordinated with long-term care options counseling
65.2provided under subdivision 4d, section 256.975, subdivision subdivisions 7 to 7c, and
65.3section 256.01, subdivision 24. The lead agency providing long-term care consultation
65.4services shall encourage the use of volunteers from families, religious organizations, social
65.5clubs, and similar civic and service organizations to provide community-based services.

65.6    Sec. 18. Minnesota Statutes 2012, section 256B.0911, subdivision 1a, is amended to
65.7read:
65.8    Subd. 1a. Definitions. For purposes of this section, the following definitions apply:
65.9    (a) Until additional requirements apply under paragraph (b), "long-term care
65.10consultation services" means:
65.11    (1) intake for and access to assistance in identifying services needed to maintain an
65.12individual in the most inclusive environment;
65.13    (2) providing recommendations for and referrals to cost-effective community
65.14services that are available to the individual;
65.15    (3) development of an individual's person-centered community support plan;
65.16    (4) providing information regarding eligibility for Minnesota health care programs;
65.17    (5) face-to-face long-term care consultation assessments, which may be completed
65.18in a hospital, nursing facility, intermediate care facility for persons with developmental
65.19disabilities (ICF/DDs), regional treatment centers, or the person's current or planned
65.20residence;
65.21    (6) federally mandated preadmission screening activities described under
65.22subdivisions 4a and 4b;
65.23    (7) (6) determination of home and community-based waiver and other service
65.24eligibility as required under sections 256B.0913, 256B.0915, and 256B.49, including level
65.25of care determination for individuals who need an institutional level of care as determined
65.26under section 256B.0911, subdivision 4a, paragraph (d) 4e, based on assessment and
65.27community support plan development, appropriate referrals to obtain necessary diagnostic
65.28information, and including an eligibility determination for consumer-directed community
65.29supports;
65.30    (8) (7) providing recommendations for institutional placement when there are no
65.31cost-effective community services available;
65.32    (9) (8) providing access to assistance to transition people back to community settings
65.33after institutional admission; and
65.34(10) (9) providing information about competitive employment, with or without
65.35supports, for school-age youth and working-age adults and referrals to the Disability
66.1Linkage Line and Disability Benefits 101 to ensure that an informed choice about
66.2competitive employment can be made. For the purposes of this subdivision, "competitive
66.3employment" means work in the competitive labor market that is performed on a full-time
66.4or part-time basis in an integrated setting, and for which an individual is compensated at or
66.5above the minimum wage, but not less than the customary wage and level of benefits paid
66.6by the employer for the same or similar work performed by individuals without disabilities.
66.7(b) Upon statewide implementation of lead agency requirements in subdivisions 2b,
66.82c, and 3a, "long-term care consultation services" also means:
66.9(1) service eligibility determination for state plan home care services identified in:
66.10(i) section 256B.0625, subdivisions 7, 19a, and 19c;
66.11(ii) section 256B.0657; or
66.12(iii) consumer support grants under section 256.476;
66.13(2) notwithstanding provisions in Minnesota Rules, parts 9525.0004 to 9525.0024,
66.14determination of eligibility for case management services available under sections
66.15256B.0621, subdivision 2 , paragraph (4), and 256B.0924 and Minnesota Rules, part
66.169525.0016;
66.17(3) determination of institutional level of care, home and community-based service
66.18waiver, and other service eligibility as required under section 256B.092, determination
66.19of eligibility for family support grants under section 252.32, semi-independent living
66.20services under section 252.275, and day training and habilitation services under section
66.21256B.092 ; and
66.22(4) obtaining necessary diagnostic information to determine eligibility under clauses
66.23(2) and (3).
66.24    (c) "Long-term care options counseling" means the services provided by the linkage
66.25lines as mandated by sections 256.01, subdivision 24, and 256.975, subdivision 7, and
66.26also includes telephone assistance and follow up once a long-term care consultation
66.27assessment has been completed.
66.28    (d) "Minnesota health care programs" means the medical assistance program under
66.29chapter 256B and the alternative care program under section 256B.0913.
66.30    (e) "Lead agencies" means counties administering or tribes and health plans under
66.31contract with the commissioner to administer long-term care consultation assessment and
66.32support planning services.

66.33    Sec. 19. Minnesota Statutes 2012, section 256B.0911, subdivision 3a, is amended to
66.34read:
67.1    Subd. 3a. Assessment and support planning. (a) Persons requesting assessment,
67.2services planning, or other assistance intended to support community-based living,
67.3including persons who need assessment in order to determine waiver or alternative care
67.4program eligibility, must be visited by a long-term care consultation team within 20
67.5calendar days after the date on which an assessment was requested or recommended.
67.6Upon statewide implementation of subdivisions 2b, 2c, and 5, this requirement also
67.7applies to an assessment of a person requesting personal care assistance services and
67.8private duty nursing. The commissioner shall provide at least a 90-day notice to lead
67.9agencies prior to the effective date of this requirement. Face-to-face assessments must be
67.10conducted according to paragraphs (b) to (i).
67.11    (b) The lead agency may utilize a team of either the social worker or public health
67.12nurse, or both. Upon implementation of subdivisions 2b, 2c, and 5, lead agencies shall
67.13use certified assessors to conduct the assessment. The consultation team members must
67.14confer regarding the most appropriate care for each individual screened or assessed. For
67.15a person with complex health care needs, a public health or registered nurse from the
67.16team must be consulted.
67.17    (c) The assessment must be comprehensive and include a person-centered assessment
67.18of the health, psychological, functional, environmental, and social needs of referred
67.19individuals and provide information necessary to develop a community support plan that
67.20meets the consumers needs, using an assessment form provided by the commissioner.
67.21    (d) The assessment must be conducted in a face-to-face interview with the person
67.22being assessed and the person's legal representative, and other individuals as requested by
67.23the person, who can provide information on the needs, strengths, and preferences of the
67.24person necessary to develop a community support plan that ensures the person's health and
67.25safety, but who is not a provider of service or has any financial interest in the provision
67.26of services. For persons who are to be assessed for elderly waiver customized living
67.27services under section 256B.0915, with the permission of the person being assessed or
67.28the person's designated or legal representative, the client's current or proposed provider
67.29of services may submit a copy of the provider's nursing assessment or written report
67.30outlining its recommendations regarding the client's care needs. The person conducting
67.31the assessment will notify the provider of the date by which this information is to be
67.32submitted. This information shall be provided to the person conducting the assessment
67.33prior to the assessment.
67.34    (e) If the person chooses to use community-based services, the person or the person's
67.35legal representative must be provided with a written community support plan within 40
68.1calendar days of the assessment visit, regardless of whether the individual is eligible for
68.2Minnesota health care programs. The written community support plan must include:
68.3(1) a summary of assessed needs as defined in paragraphs (c) and (d);
68.4(2) the individual's options and choices to meet identified needs, including all
68.5available options for case management services and providers;
68.6(3) identification of health and safety risks and how those risks will be addressed,
68.7including personal risk management strategies;
68.8(4) referral information; and
68.9(5) informal caregiver supports, if applicable.
68.10For a person determined eligible for state plan home care under subdivision 1a,
68.11paragraph (b), clause (1), the person or person's representative must also receive a copy of
68.12the home care service plan developed by the certified assessor.
68.13(f) A person may request assistance in identifying community supports without
68.14participating in a complete assessment. Upon a request for assistance identifying
68.15community support, the person must be transferred or referred to long-term care options
68.16counseling services available under sections 256.975, subdivision 7, and 256.01,
68.17subdivision 24, for telephone assistance and follow up.
68.18    (g) The person has the right to make the final decision between institutional
68.19placement and community placement after the recommendations have been provided,
68.20except as provided in section 256.975, subdivision 4a, paragraph (c) 7a, paragraph (d).
68.21    (h) The lead agency must give the person receiving assessment or support planning,
68.22or the person's legal representative, materials, and forms supplied by the commissioner
68.23containing the following information:
68.24    (1) written recommendations for community-based services and consumer-directed
68.25options;
68.26(2) documentation that the most cost-effective alternatives available were offered to
68.27the individual. For purposes of this clause, "cost-effective" means community services and
68.28living arrangements that cost the same as or less than institutional care. For an individual
68.29found to meet eligibility criteria for home and community-based service programs under
68.30section 256B.0915 or 256B.49, "cost-effectiveness" has the meaning found in the federally
68.31approved waiver plan for each program;
68.32(3) the need for and purpose of preadmission screening conducted by long-term care
68.33options counselors according to section 256.975, subdivisions 7a to 7c, if the person selects
68.34nursing facility placement. If the individual selects nursing facility placement, the lead
68.35agency shall forward information needed to complete the level of care determinations and
69.1screening for developmental disability and mental illness collected during the assessment
69.2to the long-term care options counselor using forms provided by the commissioner;
69.3    (4) the role of long-term care consultation assessment and support planning in
69.4eligibility determination for waiver and alternative care programs, and state plan home
69.5care, case management, and other services as defined in subdivision 1a, paragraphs (a),
69.6clause (7), and (b);
69.7    (5) information about Minnesota health care programs;
69.8    (6) the person's freedom to accept or reject the recommendations of the team;
69.9    (7) the person's right to confidentiality under the Minnesota Government Data
69.10Practices Act, chapter 13;
69.11    (8) the certified assessor's decision regarding the person's need for institutional level
69.12of care as determined under criteria established in section 256B.0911, subdivision 4a,
69.13paragraph (d) 4e, and the certified assessor's decision regarding eligibility for all services
69.14and programs as defined in subdivision 1a, paragraphs (a), clause (7), and (b); and
69.15    (9) the person's right to appeal the certified assessor's decision regarding eligibility
69.16for all services and programs as defined in subdivision 1a, paragraphs (a), clause (7), and
69.17(b), and incorporating the decision regarding the need for institutional level of care or the
69.18lead agency's final decisions regarding public programs eligibility according to section
69.19256.045, subdivision 3 .
69.20    (i) Face-to-face assessment completed as part of eligibility determination for
69.21the alternative care, elderly waiver, community alternatives for disabled individuals,
69.22community alternative care, and brain injury waiver programs under sections 256B.0913,
69.23256B.0915 , and 256B.49 is valid to establish service eligibility for no more than 60
69.24calendar days after the date of assessment.
69.25(j) The effective eligibility start date for programs in paragraph (i) can never be
69.26prior to the date of assessment. If an assessment was completed more than 60 days
69.27before the effective waiver or alternative care program eligibility start date, assessment
69.28and support plan information must be updated in a face-to-face visit and documented in
69.29the department's Medicaid Management Information System (MMIS). Notwithstanding
69.30retroactive medical assistance coverage of state plan services, the effective date of
69.31eligibility for programs included in paragraph (i) cannot be prior to the date the most
69.32recent updated assessment is completed.

69.33    Sec. 20. Minnesota Statutes 2012, section 256B.0911, subdivision 4d, is amended to
69.34read:
70.1    Subd. 4d. Preadmission screening of individuals under 65 years of age. (a)
70.2It is the policy of the state of Minnesota to ensure that individuals with disabilities or
70.3chronic illness are served in the most integrated setting appropriate to their needs and have
70.4the necessary information to make informed choices about home and community-based
70.5service options.
70.6    (b) Individuals under 65 years of age who are admitted to a Medicaid-certified
70.7 nursing facility from a hospital must be screened prior to admission as outlined in
70.8subdivisions 4a through 4c according to the requirements outlined in section 256.975,
70.9subdivisions 7a to 7c. This shall be provided by the Senior LinkAge Line as required
70.10under section 256.975, subdivision 7.
70.11    (c) Individuals under 65 years of age who are admitted to nursing facilities with
70.12only a telephone screening must receive a face-to-face assessment from the long-term
70.13care consultation team member of the county in which the facility is located or from the
70.14recipient's county case manager within 40 calendar days of admission.
70.15    (d) Individuals under 65 years of age who are admitted to a nursing facility
70.16without preadmission screening according to the exemption described in subdivision 4b,
70.17paragraph (a), clause (3), and who remain in the facility longer than 30 days must receive
70.18a face-to-face assessment within 40 days of admission.
70.19    (e) (d) At the face-to-face assessment, the long-term care consultation team member
70.20or county case manager must perform the activities required under subdivision 3b.
70.21    (f) (e) For individuals under 21 years of age, a screening interview which
70.22recommends nursing facility admission must be face-to-face and approved by the
70.23commissioner before the individual is admitted to the nursing facility.
70.24    (g) (f) In the event that an individual under 65 years of age is admitted to a nursing
70.25facility on an emergency basis, the county Senior LinkAge Line must be notified of
70.26the admission on the next working day, and a face-to-face assessment as described in
70.27paragraph (c) must be conducted within 40 calendar days of admission.
70.28    (h) (g) At the face-to-face assessment, the long-term care consultation team member
70.29or the case manager must present information about home and community-based options,
70.30including consumer-directed options, so the individual can make informed choices. If the
70.31individual chooses home and community-based services, the long-term care consultation
70.32team member or case manager must complete a written relocation plan within 20 working
70.33days of the visit. The plan shall describe the services needed to move out of the facility
70.34and a time line for the move which is designed to ensure a smooth transition to the
70.35individual's home and community.
71.1    (i) (h) An individual under 65 years of age residing in a nursing facility shall receive
71.2a face-to-face assessment at least every 12 months to review the person's service choices
71.3and available alternatives unless the individual indicates, in writing, that annual visits are
71.4not desired. In this case, the individual must receive a face-to-face assessment at least
71.5once every 36 months for the same purposes.
71.6    (j) (i) Notwithstanding the provisions of subdivision 6, the commissioner may pay
71.7county agencies directly for face-to-face assessments for individuals under 65 years of age
71.8who are being considered for placement or residing in a nursing facility.
71.9(j) Funding for preadmission screening follow-up shall be provided to the Disability
71.10Linkage Line for the under 60 population by the Department of Human Services to
71.11cover options counseling salaries and expenses to provide the services described in
71.12subdivisions 7a to 7c. The Disability Linkage Line shall employ, or contract with other
71.13agencies to employ, within the limits of available funding, sufficient personnel to provide
71.14preadmission screening follow-up services and shall seek to maximize federal funding for
71.15the service as provided under section 256.01, subdivision 2, paragraph (dd).
71.16EFFECTIVE DATE.This section is effective October 1, 2013.

71.17    Sec. 21. Minnesota Statutes 2012, section 256B.0911, is amended by adding a
71.18subdivision to read:
71.19    Subd. 4e. Determination of institutional level of care. The determination of the
71.20need for nursing facility, hospital, and intermediate care facility levels of care must be
71.21made according to criteria developed by the commissioner, and in section 256B.092,
71.22using forms developed by the commissioner. Effective January 1, 2014, for individuals
71.23age 21 and older, the determination of need for nursing facility level of care shall be
71.24based on criteria in section 144.0724, subdivision 11. For individuals under age 21, the
71.25determination of the need for nursing facility level of care must be made according to
71.26criteria developed by the commissioner until criteria in section 144.0724, subdivision 11,
71.27becomes effective on or after October 1, 2019.

71.28    Sec. 22. Minnesota Statutes 2012, section 256B.0911, subdivision 6, is amended to read:
71.29    Subd. 6. Payment for long-term care consultation services. (a) Until September
71.3030, 2013, payment for long-term care consultation face-to-face assessment shall be made
71.31as described in this subdivision.
71.32    (b) The total payment for each county must be paid monthly by certified nursing
71.33facilities in the county. The monthly amount to be paid by each nursing facility for each
71.34fiscal year must be determined by dividing the county's annual allocation for long-term
72.1care consultation services by 12 to determine the monthly payment and allocating the
72.2monthly payment to each nursing facility based on the number of licensed beds in the
72.3nursing facility. Payments to counties in which there is no certified nursing facility must be
72.4made by increasing the payment rate of the two facilities located nearest to the county seat.
72.5    (b) (c) The commissioner shall include the total annual payment determined under
72.6paragraph (a) for each nursing facility reimbursed under section 256B.431, 256B.434,
72.7or 256B.441.
72.8    (c) (d) In the event of the layaway, delicensure and decertification, or removal
72.9from layaway of 25 percent or more of the beds in a facility, the commissioner may
72.10adjust the per diem payment amount in paragraph (b) (c) and may adjust the monthly
72.11payment amount in paragraph (a) (b). The effective date of an adjustment made under this
72.12paragraph shall be on or after the first day of the month following the effective date of the
72.13layaway, delicensure and decertification, or removal from layaway.
72.14    (d) (e) Payments for long-term care consultation services are available to the county
72.15or counties to cover staff salaries and expenses to provide the services described in
72.16subdivision 1a. The county shall employ, or contract with other agencies to employ,
72.17within the limits of available funding, sufficient personnel to provide long-term care
72.18consultation services while meeting the state's long-term care outcomes and objectives as
72.19defined in subdivision 1. The county shall be accountable for meeting local objectives
72.20as approved by the commissioner in the biennial home and community-based services
72.21quality assurance plan on a form provided by the commissioner.
72.22    (e) (f) Notwithstanding section 256B.0641, overpayments attributable to payment
72.23of the screening costs under the medical assistance program may not be recovered from
72.24a facility.
72.25    (f) (g) The commissioner of human services shall amend the Minnesota medical
72.26assistance plan to include reimbursement for the local consultation teams.
72.27    (g) (h) Until the alternative payment methodology in paragraph (h) (i) is implemented,
72.28the county may bill, as case management services, assessments, support planning, and
72.29follow-along provided to persons determined to be eligible for case management under
72.30Minnesota health care programs. No individual or family member shall be charged for an
72.31initial assessment or initial support plan development provided under subdivision 3a or 3b.
72.32(h) (i) The commissioner shall develop an alternative payment methodology,
72.33effective on October 1, 2013, for long-term care consultation services that includes
72.34the funding available under this subdivision, and for assessments authorized under
72.35sections 256B.092 and 256B.0659. In developing the new payment methodology, the
72.36commissioner shall consider the maximization of other funding sources, including federal
73.1administrative reimbursement through federal financial participation funding, for all
73.2long-term care consultation and preadmission screening activity. The alternative payment
73.3methodology shall include the use of the appropriate time studies and the state financing
73.4of nonfederal share as part of the state's medical assistance program.

73.5    Sec. 23. Minnesota Statutes 2012, section 256B.0911, subdivision 7, is amended to read:
73.6    Subd. 7. Reimbursement for certified nursing facilities. (a) Medical assistance
73.7reimbursement for nursing facilities shall be authorized for a medical assistance recipient
73.8only if a preadmission screening has been conducted prior to admission or the county has
73.9authorized an exemption. Medical assistance reimbursement for nursing facilities shall
73.10not be provided for any recipient who the local screener has determined does not meet the
73.11level of care criteria for nursing facility placement in section 144.0724, subdivision 11, or,
73.12if indicated, has not had a level II OBRA evaluation as required under the federal Omnibus
73.13Budget Reconciliation Act of 1987 completed unless an admission for a recipient with
73.14mental illness is approved by the local mental health authority or an admission for a
73.15recipient with developmental disability is approved by the state developmental disability
73.16authority.
73.17    (b) The nursing facility must not bill a person who is not a medical assistance
73.18recipient for resident days that preceded the date of completion of screening activities
73.19as required under section 256.975, subdivisions 4a, 4b, and 4c 7a to 7c. The nursing
73.20facility must include unreimbursed resident days in the nursing facility resident day totals
73.21reported to the commissioner.

73.22    Sec. 24. Minnesota Statutes 2012, section 256B.0913, subdivision 4, is amended to read:
73.23    Subd. 4. Eligibility for funding for services for nonmedical assistance recipients.
73.24    (a) Funding for services under the alternative care program is available to persons who
73.25meet the following criteria:
73.26    (1) the person has been determined by a community assessment under section
73.27256B.0911 to be a person who would require the level of care provided in a nursing
73.28facility, as determined under section 256B.0911, subdivision 4a, paragraph (d) 4e, but for
73.29the provision of services under the alternative care program;
73.30    (2) the person is age 65 or older;
73.31    (3) the person would be eligible for medical assistance within 135 days of admission
73.32to a nursing facility;
74.1    (4) the person is not ineligible for the payment of long-term care services by the
74.2medical assistance program due to an asset transfer penalty under section 256B.0595 or
74.3equity interest in the home exceeding $500,000 as stated in section 256B.056;
74.4    (5) the person needs long-term care services that are not funded through other
74.5state or federal funding, or other health insurance or other third-party insurance such as
74.6long-term care insurance;
74.7    (6) except for individuals described in clause (7), the monthly cost of the alternative
74.8care services funded by the program for this person does not exceed 75 percent of the
74.9monthly limit described under section 256B.0915, subdivision 3a. This monthly limit
74.10does not prohibit the alternative care client from payment for additional services, but in no
74.11case may the cost of additional services purchased under this section exceed the difference
74.12between the client's monthly service limit defined under section 256B.0915, subdivision
74.133
, and the alternative care program monthly service limit defined in this paragraph. If
74.14care-related supplies and equipment or environmental modifications and adaptations are or
74.15will be purchased for an alternative care services recipient, the costs may be prorated on a
74.16monthly basis for up to 12 consecutive months beginning with the month of purchase.
74.17If the monthly cost of a recipient's other alternative care services exceeds the monthly
74.18limit established in this paragraph, the annual cost of the alternative care services shall be
74.19determined. In this event, the annual cost of alternative care services shall not exceed 12
74.20times the monthly limit described in this paragraph;
74.21    (7) for individuals assigned a case mix classification A as described under section
74.22256B.0915, subdivision 3a , paragraph (a), with (i) no dependencies in activities of daily
74.23living, or (ii) up to two dependencies in bathing, dressing, grooming, walking, and eating
74.24when the dependency score in eating is three or greater as determined by an assessment
74.25performed under section 256B.0911, the monthly cost of alternative care services funded
74.26by the program cannot exceed $593 per month for all new participants enrolled in
74.27the program on or after July 1, 2011. This monthly limit shall be applied to all other
74.28participants who meet this criteria at reassessment. This monthly limit shall be increased
74.29annually as described in section 256B.0915, subdivision 3a, paragraph (a). This monthly
74.30limit does not prohibit the alternative care client from payment for additional services, but
74.31in no case may the cost of additional services purchased exceed the difference between the
74.32client's monthly service limit defined in this clause and the limit described in clause (6)
74.33for case mix classification A; and
74.34(8) the person is making timely payments of the assessed monthly fee.
74.35A person is ineligible if payment of the fee is over 60 days past due, unless the person
74.36agrees to:
75.1    (i) the appointment of a representative payee;
75.2    (ii) automatic payment from a financial account;
75.3    (iii) the establishment of greater family involvement in the financial management of
75.4payments; or
75.5    (iv) another method acceptable to the lead agency to ensure prompt fee payments.
75.6    The lead agency may extend the client's eligibility as necessary while making
75.7arrangements to facilitate payment of past-due amounts and future premium payments.
75.8Following disenrollment due to nonpayment of a monthly fee, eligibility shall not be
75.9reinstated for a period of 30 days.
75.10    (b) Alternative care funding under this subdivision is not available for a person who
75.11is a medical assistance recipient or who would be eligible for medical assistance without a
75.12spenddown or waiver obligation. A person whose initial application for medical assistance
75.13and the elderly waiver program is being processed may be served under the alternative care
75.14program for a period up to 60 days. If the individual is found to be eligible for medical
75.15assistance, medical assistance must be billed for services payable under the federally
75.16approved elderly waiver plan and delivered from the date the individual was found eligible
75.17for the federally approved elderly waiver plan. Notwithstanding this provision, alternative
75.18care funds may not be used to pay for any service the cost of which: (i) is payable by
75.19medical assistance; (ii) is used by a recipient to meet a waiver obligation; or (iii) is used to
75.20pay a medical assistance income spenddown for a person who is eligible to participate in the
75.21federally approved elderly waiver program under the special income standard provision.
75.22    (c) Alternative care funding is not available for a person who resides in a licensed
75.23nursing home, certified boarding care home, hospital, or intermediate care facility, except
75.24for case management services which are provided in support of the discharge planning
75.25process for a nursing home resident or certified boarding care home resident to assist with
75.26a relocation process to a community-based setting.
75.27    (d) Alternative care funding is not available for a person whose income is greater
75.28than the maintenance needs allowance under section 256B.0915, subdivision 1d, but equal
75.29to or less than 120 percent of the federal poverty guideline effective July 1 in the fiscal
75.30year for which alternative care eligibility is determined, who would be eligible for the
75.31elderly waiver with a waiver obligation.

75.32    Sec. 25. Minnesota Statutes 2012, section 256B.0915, subdivision 5, is amended to read:
75.33    Subd. 5. Assessments and reassessments for waiver clients. (a) Each client
75.34shall receive an initial assessment of strengths, informal supports, and need for services
75.35in accordance with section 256B.0911, subdivisions 3, 3a, and 3b. A reassessment of a
76.1client served under the elderly waiver must be conducted at least every 12 months and at
76.2other times when the case manager determines that there has been significant change in
76.3the client's functioning. This may include instances where the client is discharged from
76.4the hospital. There must be a determination that the client requires nursing facility level
76.5of care as defined in section 256B.0911, subdivision 4a, paragraph (d) 4e, at initial and
76.6subsequent assessments to initiate and maintain participation in the waiver program.
76.7(b) Regardless of other assessments identified in section 144.0724, subdivision
76.84, as appropriate to determine nursing facility level of care for purposes of medical
76.9assistance payment for nursing facility services, only face-to-face assessments conducted
76.10according to section 256B.0911, subdivisions 3a and 3b, that result in a nursing facility
76.11level of care determination will be accepted for purposes of initial and ongoing access to
76.12waiver service payment.

76.13    Sec. 26. Minnesota Statutes 2012, section 256B.0917, is amended by adding a
76.14subdivision to read:
76.15    Subd. 1a. Home and community-based services for older adults. (a) The purpose
76.16of projects selected by the commissioner of human services under this section is to
76.17make strategic changes in the long-term services and supports system for older adults
76.18including statewide capacity for local service development and technical assistance, and
76.19statewide availability of home and community-based services for older adult services,
76.20caregiver support and respite care services, and other supports in the state of Minnesota.
76.21These projects are intended to create incentives for new and expanded home and
76.22community-based services in Minnesota in order to:
76.23(1) reach older adults early in the progression of their need for long-term services
76.24and supports, providing them with low-cost, high-impact services that will prevent or
76.25delay the use of more costly services;
76.26(2) support older adults to live in the most integrated, least restrictive community
76.27setting;
76.28(3) support the informal caregivers of older adults;
76.29(4) develop and implement strategies to integrate long-term services and supports
76.30with health care services, in order to improve the quality of care and enhance the quality
76.31of life of older adults and their informal caregivers;
76.32(5) ensure cost-effective use of financial and human resources;
76.33(6) build community-based approaches and community commitment to delivering
76.34long-term services and supports for older adults in their own homes;
77.1(7) achieve a broad awareness and use of lower-cost in-home services as an
77.2alternative to nursing homes and other residential services;
77.3(8) strengthen and develop additional home and community-based services and
77.4alternatives to nursing homes and other residential services; and
77.5(9) strengthen programs that use volunteers.
77.6(b) The services provided by these projects are available to older adults who are
77.7eligible for medical assistance and the elderly waiver under section 256B.0915, the
77.8alternative care program under section 256B.0913, or essential community supports grant
77.9under subdivision 14, paragraph (b), and to persons who have their own funds to pay for
77.10services.

77.11    Sec. 27. Minnesota Statutes 2012, section 256B.0917, is amended by adding a
77.12subdivision to read:
77.13    Subd. 1b. Definitions. (a) For purposes of this section, the following terms have
77.14the meanings given.
77.15(b) "Community" means a town; township; city; or targeted neighborhood within a
77.16city; or a consortium of towns, townships, cities, or specific neighborhoods within a city.
77.17(c) "Core home and community-based services provider" means a Faith in Action,
77.18Living at Home Block Nurse, Congregational Nurse, or similar community-based
77.19program governed by a board, the majority of whose members reside within the program's
77.20service area, that organizes and uses volunteers and paid staff to deliver nonmedical
77.21services intended to assist older adults to identify and manage risks and to maintain their
77.22community living and integration in the community.
77.23(d) "Eldercare development partnership" means a team of representatives of county
77.24social service and public health agencies, the area agency on aging, local nursing home
77.25providers, local home care providers, and other appropriate home and community-based
77.26providers in the area agency's planning and service area.
77.27(e) "Long-term services and supports" means any service available under the
77.28elderly waiver program or alternative care grant programs, nursing facility services,
77.29transportation services, caregiver support and respite care services, and other home and
77.30community-based services identified as necessary either to maintain lifestyle choices for
77.31older adults or to support them to remain in their own home.
77.32(f) "Older adult" refers to an individual who is 65 years of age or older.

77.33    Sec. 28. Minnesota Statutes 2012, section 256B.0917, is amended by adding a
77.34subdivision to read:
78.1    Subd. 1c. Eldercare development partnerships. The commissioner of human
78.2services shall select and contract with eldercare development partnerships sufficient to
78.3provide statewide availability of service development and technical assistance using a
78.4request for proposals process. Eldercare development partnerships shall:
78.5(1) develop a local long-term services and supports strategy consistent with state
78.6goals and objectives;
78.7(2) identify and use existing local skills, knowledge, and relationships, and build
78.8on these assets;
78.9(3) coordinate planning for funds to provide services to older adults, including funds
78.10received under Title III of the Older Americans Act, Title XX of the Social Security Act,
78.11and the Local Public Health Act;
78.12(4) target service development and technical assistance where nursing facility
78.13closures have occurred or are occurring or in areas where service needs have been
78.14identified through activities under section 144A.351;
78.15(5) provide sufficient staff for development and technical support in its designated
78.16area; and
78.17(6) designate a single public or nonprofit member of the eldercare development
78.18partnerships to apply grant funding and manage the project.

78.19    Sec. 29. Minnesota Statutes 2012, section 256B.0917, subdivision 6, is amended to read:
78.20    Subd. 6. Caregiver support and respite care projects. (a) The commissioner
78.21shall establish up to 36 projects to expand the respite care network in the state and to
78.22support caregivers in their responsibilities for care. The purpose of each project shall
78.23be to availability of caregiver support and respite care services for family and other
78.24caregivers. The commissioner shall use a request for proposals to select nonprofit entities
78.25to administer the projects. Projects shall:
78.26(1) establish a local coordinated network of volunteer and paid respite workers;
78.27(2) coordinate assignment of respite workers care services to clients and care
78.28receivers and assure the health and safety of the client; and caregivers of older adults;
78.29(3) provide training for caregivers and ensure that support groups are available
78.30in the community.
78.31(b) The caregiver support and respite care funds shall be available to the four to six
78.32local long-term care strategy projects designated in subdivisions 1 to 5.
78.33(c) The commissioner shall publish a notice in the State Register to solicit proposals
78.34from public or private nonprofit agencies for the projects not included in the four to six
78.35local long-term care strategy projects defined in subdivision 2. A county agency may,
79.1alone or in combination with other county agencies, apply for caregiver support and
79.2respite care project funds. A public or nonprofit agency within a designated SAIL project
79.3area may apply for project funds if the agency has a letter of agreement with the county
79.4or counties in which services will be developed, stating the intention of the county or
79.5counties to coordinate their activities with the agency requesting a grant.
79.6(d) The commissioner shall select grantees based on the following criteria:
79.7(1) the ability of the proposal to demonstrate need in the area served, as evidenced
79.8by a community needs assessment or other demographic data;
79.9(2) the ability of the proposal to clearly describe how the project
79.10(3) assure the health and safety of the older adults;
79.11(4) identify at-risk caregivers;
79.12(5) provide information, education, and training for caregivers in the designated
79.13community; and
79.14(6) demonstrate the need in the proposed service area particularly where nursing
79.15facility closures have occurred or are occurring or areas with service needs identified
79.16by section 144A.351. Preference must be given for projects that reach underserved
79.17populations.
79.18(b) Projects must clearly describe:
79.19(1) how they will achieve the their purpose defined in paragraph (b);
79.20(3) the ability of the proposal to reach underserved populations;
79.21(4) the ability of the proposal to demonstrate community commitment to the project,
79.22as evidenced by letters of support and cooperation as well as formation of a community
79.23task force;
79.24(5) the ability of the proposal to clearly describe (2) the process for recruiting,
79.25training, and retraining volunteers; and
79.26(6) the inclusion in the proposal of the (3) a plan to promote the project in the
79.27designated community, including outreach to persons needing the services.
79.28(e) (c) Funds for all projects under this subdivision may be used to:
79.29(1) hire a coordinator to develop a coordinated network of volunteer and paid respite
79.30care services and assign workers to clients;
79.31(2) recruit and train volunteer providers;
79.32(3) train provide information, training, and education to caregivers;
79.33(4) ensure the development of support groups for caregivers;
79.34(5) (4) advertise the availability of the caregiver support and respite care project; and
79.35(6) (5) purchase equipment to maintain a system of assigning workers to clients.
79.36(f) (d) Project funds may not be used to supplant existing funding sources.

80.1    Sec. 30. Minnesota Statutes 2012, section 256B.0917, is amended by adding a
80.2subdivision to read:
80.3    Subd. 7a. Core home and community-based services. The commissioner shall
80.4select and contract with core home and community-based services providers for projects
80.5to provide services and supports to older adults both with and without family and other
80.6informal caregivers using a request for proposals process. Projects must:
80.7(1) have a credible, public, or private nonprofit sponsor providing ongoing financial
80.8support;
80.9(2) have a specific, clearly defined geographic service area;
80.10(3) use a practice framework designed to identify high-risk older adults and help them
80.11take action to better manage their chronic conditions and maintain their community living;
80.12(4) have a team approach to coordination and care, ensuring that the older adult
80.13participants, their families, and the formal and informal providers are all part of planning
80.14and providing services;
80.15(5) provide information, support services, homemaking services, counseling, and
80.16training for the older adults and family caregivers;
80.17(6) encourage service area or neighborhood residents and local organizations to
80.18collaborate in meeting the needs of older adults in their geographic service areas;
80.19(7) recruit, train, and direct the use of volunteers to provide informal services and
80.20other appropriate support to older adults and their caregivers; and
80.21(8) provide coordination and management of formal and informal services to older
80.22adults and their families using less expensive alternatives.

80.23    Sec. 31. Minnesota Statutes 2012, section 256B.0917, subdivision 13, is amended to
80.24read:
80.25    Subd. 13. Community service grants. The commissioner shall award contracts
80.26for grants to public and private nonprofit agencies to establish services that strengthen
80.27a community's ability to provide a system of home and community-based services
80.28for elderly persons. The commissioner shall use a request for proposal process. The
80.29commissioner shall give preference when awarding grants under this section to areas
80.30where nursing facility closures have occurred or are occurring or to areas with service
80.31needs identified under section 144A.351. The commissioner shall consider grants for:
80.32(1) caregiver support and respite care projects under subdivision 6;
80.33(2) the living-at-home/block nurse grant under subdivisions 7 to 10; and
80.34(3) services identified as needed for community transition.

81.1    Sec. 32. Minnesota Statutes 2012, section 256B.439, subdivision 3, is amended to read:
81.2    Subd. 3. Consumer surveys of nursing facilities residents. Following
81.3identification of the quality measurement tool, the commissioners shall conduct surveys
81.4of long-term care service consumers of nursing facilities to develop quality profiles
81.5of providers. To the extent possible, surveys must be conducted face-to-face by state
81.6employees or contractors. At the discretion of the commissioners, surveys may be
81.7conducted by telephone or by provider staff. Surveys must be conducted periodically to
81.8update quality profiles of individual service nursing facilities providers.

81.9    Sec. 33. Minnesota Statutes 2012, section 256B.439, is amended by adding a
81.10subdivision to read:
81.11    Subd. 3a. Home and community-based services report card in cooperation with
81.12the commissioner of health. The commissioner shall work with existing Department
81.13of Human Services advisory groups to develop recommendations for a home and
81.14community-based services report card. Health and human services staff that regulate
81.15home and community-based services as provided in chapter 245D and licensed home care
81.16as provided in chapter 144A shall be consulted. The advisory groups shall consider the
81.17requirements from the Minnesota consumer information guide under section 144G.06 as a
81.18base for development of the home and community-based services report card to compare
81.19the housing options available to consumers. Other items to be considered by the advisory
81.20groups in developing recommendations include:
81.21(1) defining the goals of the report card, including measuring outcomes, providing
81.22consumer information, and defining vehicle-for-pay performance;
81.23(2) developing separate measures for programs for the elderly population and for
81.24persons with disabilities;
81.25(3) the sources of information needed that are standardized and contain sufficient data;
81.26(4) the financial support needed for creating and publicizing the housing information
81.27guide, and ongoing funding for data collection and staffing to monitor, report, and analyze;
81.28(5) a recognition that home and community-based services settings exist with
81.29significant variations in size, settings, and services available;
81.30(6) ensuring that consumer choice and consumer information is retained and valued;
81.31(7) the applicability of these measures to providers based on payor source, size,
81.32and population served; and
81.33(8) dissemination of quality profiles.
81.34The advisory groups shall discuss whether there are additional funding, resources,
81.35and research needed. The commissioner shall report recommendations to the chairs and
82.1ranking minority members of the legislative committees and divisions with jurisdiction
82.2over health and human services issues by August 1, 2014. The report card shall be
82.3available on July 1, 2015.

82.4    Sec. 34. Minnesota Statutes 2012, section 256B.439, subdivision 4, is amended to read:
82.5    Subd. 4. Dissemination of quality profiles. By July 1, 2003 2014, the
82.6commissioners shall implement a system public awareness effort to disseminate the quality
82.7profiles developed from consumer surveys using the quality measurement tool. Profiles
82.8may be disseminated to through the Senior LinkAge Line and Disability Linkage Line and
82.9to consumers, providers, and purchasers of long-term care services through all feasible
82.10printed and electronic outlets. The commissioners may conduct a public awareness
82.11campaign to inform potential users regarding profile contents and potential uses.

82.12    Sec. 35. Minnesota Statutes 2012, section 256B.441, subdivision 13, is amended to read:
82.13    Subd. 13. External fixed costs. "External fixed costs" means costs related to the
82.14nursing home surcharge under section 256.9657, subdivision 1; licensure fees under
82.15section 144.122; until September 30, 2013, long-term care consultation fees under
82.16section 256B.0911, subdivision 6; family advisory council fee under section 144A.33;
82.17scholarships under section 256B.431, subdivision 36; planned closure rate adjustments
82.18under section 256B.437; or single bed room incentives under section 256B.431,
82.19subdivision 42
; property taxes and property insurance; and PERA.

82.20    Sec. 36. Minnesota Statutes 2012, section 256B.441, subdivision 53, is amended to read:
82.21    Subd. 53. Calculation of payment rate for external fixed costs. The commissioner
82.22shall calculate a payment rate for external fixed costs.
82.23    (a) For a facility licensed as a nursing home, the portion related to section 256.9657
82.24shall be equal to $8.86. For a facility licensed as both a nursing home and a boarding care
82.25home, the portion related to section 256.9657 shall be equal to $8.86 multiplied by the
82.26result of its number of nursing home beds divided by its total number of licensed beds.
82.27    (b) The portion related to the licensure fee under section 144.122, paragraph (d),
82.28shall be the amount of the fee divided by actual resident days.
82.29    (c) The portion related to scholarships shall be determined under section 256B.431,
82.30subdivision 36.
82.31    (d) Until September 30, 2013, the portion related to long-term care consultation shall
82.32be determined according to section 256B.0911, subdivision 6.
83.1    (e) The portion related to development and education of resident and family advisory
83.2councils under section 144A.33 shall be $5 divided by 365.
83.3    (f) The portion related to planned closure rate adjustments shall be as determined
83.4under section 256B.437, subdivision 6, and Minnesota Statutes 2010, section 256B.436.
83.5Planned closure rate adjustments that take effect before October 1, 2014, shall no longer
83.6be included in the payment rate for external fixed costs beginning October 1, 2016.
83.7Planned closure rate adjustments that take effect on or after October 1, 2014, shall no
83.8longer be included in the payment rate for external fixed costs beginning on October 1 of
83.9the first year not less than two years after their effective date.
83.10    (g) The portions related to property insurance, real estate taxes, special assessments,
83.11and payments made in lieu of real estate taxes directly identified or allocated to the nursing
83.12facility shall be the actual amounts divided by actual resident days.
83.13    (h) The portion related to the Public Employees Retirement Association shall be
83.14actual costs divided by resident days.
83.15    (i) The single bed room incentives shall be as determined under section 256B.431,
83.16subdivision 42. Single bed room incentives that take effect before October 1, 2014, shall
83.17no longer be included in the payment rate for external fixed costs beginning October 1,
83.182016. Single bed room incentives that take effect on or after October 1, 2014, shall no
83.19longer be included in the payment rate for external fixed costs beginning on October 1 of
83.20the first year not less than two years after their effective date.
83.21    (j) The payment rate for external fixed costs shall be the sum of the amounts in
83.22paragraphs (a) to (i).

83.23    Sec. 37. Minnesota Statutes 2012, section 256B.49, subdivision 12, is amended to read:
83.24    Subd. 12. Informed choice. Persons who are determined likely to require the level
83.25of care provided in a nursing facility as determined under section 256B.0911, subdivision
83.264e, or a hospital shall be informed of the home and community-based support alternatives
83.27to the provision of inpatient hospital services or nursing facility services. Each person
83.28must be given the choice of either institutional or home and community-based services
83.29using the provisions described in section 256B.77, subdivision 2, paragraph (p).

83.30    Sec. 38. Minnesota Statutes 2012, section 256B.49, subdivision 14, is amended to read:
83.31    Subd. 14. Assessment and reassessment. (a) Assessments and reassessments
83.32shall be conducted by certified assessors according to section 256B.0911, subdivision 2b.
83.33With the permission of the recipient or the recipient's designated legal representative,
83.34the recipient's current provider of services may submit a written report outlining their
84.1recommendations regarding the recipient's care needs prepared by a direct service
84.2employee with at least 20 hours of service to that client. The person conducting the
84.3assessment or reassessment must notify the provider of the date by which this information
84.4is to be submitted. This information shall be provided to the person conducting the
84.5assessment and the person or the person's legal representative and must be considered
84.6prior to the finalization of the assessment or reassessment.
84.7(b) There must be a determination that the client requires a hospital level of care or a
84.8nursing facility level of care as defined in section 256B.0911, subdivision 4a, paragraph
84.9(d) 4e, at initial and subsequent assessments to initiate and maintain participation in the
84.10waiver program.
84.11(c) Regardless of other assessments identified in section 144.0724, subdivision 4, as
84.12appropriate to determine nursing facility level of care for purposes of medical assistance
84.13payment for nursing facility services, only face-to-face assessments conducted according
84.14to section 256B.0911, subdivisions 3a, 3b, and 4d, that result in a hospital level of care
84.15determination or a nursing facility level of care determination must be accepted for
84.16purposes of initial and ongoing access to waiver services payment.
84.17(d) Recipients who are found eligible for home and community-based services under
84.18this section before their 65th birthday may remain eligible for these services after their
84.1965th birthday if they continue to meet all other eligibility factors.
84.20(e) The commissioner shall develop criteria to identify recipients whose level of
84.21functioning is reasonably expected to improve and reassess these recipients to establish
84.22a baseline assessment. Recipients who meet these criteria must have a comprehensive
84.23transitional service plan developed under subdivision 15, paragraphs (b) and (c), and be
84.24reassessed every six months until there has been no significant change in the recipient's
84.25functioning for at least 12 months. After there has been no significant change in the
84.26recipient's functioning for at least 12 months, reassessments of the recipient's strengths,
84.27informal support systems, and need for services shall be conducted at least every 12
84.28months and at other times when there has been a significant change in the recipient's
84.29functioning. Counties, case managers, and service providers are responsible for
84.30conducting these reassessments and shall complete the reassessments out of existing funds.

84.31    Sec. 39. Minnesota Statutes 2012, section 256B.69, subdivision 8, is amended to read:
84.32    Subd. 8. Preadmission screening waiver. Except as applicable to the project's
84.33operation, the provisions of section sections 256.975 and 256B.0911 are waived for the
84.34purposes of this section for recipients enrolled with demonstration providers or in the
84.35prepaid medical assistance program for seniors.

85.1    Sec. 40. Minnesota Statutes 2012, section 256I.05, is amended by adding a subdivision
85.2to read:
85.3    Subd. 1o. Supplementary service rate; exemptions. A county agency shall not
85.4negotiate a supplementary service rate under this section for any individual that has been
85.5determined to be eligible for Housing Stability Services as approved by the Centers
85.6for Medicare and Medicaid Services, and who resides in an establishment voluntarily
85.7registered under section 144D.025, as a supportive housing establishment or participates
85.8in the Minnesota supportive housing demonstration program under section 256I.04,
85.9subdivision 3, paragraph (a), clause (4).

85.10    Sec. 41. Minnesota Statutes 2012, section 626.557, subdivision 4, is amended to read:
85.11    Subd. 4. Reporting. (a) Except as provided in paragraph (b), a mandated reporter
85.12shall immediately make an oral report to the common entry point. The common entry
85.13point may accept electronic reports submitted through a Web-based reporting system
85.14established by the commissioner. Use of a telecommunications device for the deaf or other
85.15similar device shall be considered an oral report. The common entry point may not require
85.16written reports. To the extent possible, the report must be of sufficient content to identify
85.17the vulnerable adult, the caregiver, the nature and extent of the suspected maltreatment,
85.18any evidence of previous maltreatment, the name and address of the reporter, the time,
85.19date, and location of the incident, and any other information that the reporter believes
85.20might be helpful in investigating the suspected maltreatment. A mandated reporter may
85.21disclose not public data, as defined in section 13.02, and medical records under sections
85.22144.291 to 144.298, to the extent necessary to comply with this subdivision.
85.23(b) A boarding care home that is licensed under sections 144.50 to 144.58 and
85.24certified under Title 19 of the Social Security Act, a nursing home that is licensed under
85.25section 144A.02 and certified under Title 18 or Title 19 of the Social Security Act, or a
85.26hospital that is licensed under sections 144.50 to 144.58 and has swing beds certified under
85.27Code of Federal Regulations, title 42, section 482.66, may submit a report electronically
85.28to the common entry point instead of submitting an oral report. The report may be a
85.29duplicate of the initial report the facility submits electronically to the commissioner of
85.30health to comply with the reporting requirements under Code of Federal Regulations, title
85.3142, section 483.13. The commissioner of health may modify these reporting requirements
85.32to include items required under paragraph (a) that are not currently included in the
85.33electronic reporting form.
85.34EFFECTIVE DATE.This section is effective July 1, 2014.

86.1    Sec. 42. Minnesota Statutes 2012, section 626.557, subdivision 9, is amended to read:
86.2    Subd. 9. Common entry point designation. (a) Each county board shall designate
86.3a common entry point for reports of suspected maltreatment. Two or more county boards
86.4may jointly designate a single The commissioner of human services shall establish a
86.5 common entry point effective July 1, 2014. The common entry point is the unit responsible
86.6for receiving the report of suspected maltreatment under this section.
86.7(b) The common entry point must be available 24 hours per day to take calls from
86.8reporters of suspected maltreatment. The common entry point shall use a standard intake
86.9form that includes:
86.10(1) the time and date of the report;
86.11(2) the name, address, and telephone number of the person reporting;
86.12(3) the time, date, and location of the incident;
86.13(4) the names of the persons involved, including but not limited to, perpetrators,
86.14alleged victims, and witnesses;
86.15(5) whether there was a risk of imminent danger to the alleged victim;
86.16(6) a description of the suspected maltreatment;
86.17(7) the disability, if any, of the alleged victim;
86.18(8) the relationship of the alleged perpetrator to the alleged victim;
86.19(9) whether a facility was involved and, if so, which agency licenses the facility;
86.20(10) any action taken by the common entry point;
86.21(11) whether law enforcement has been notified;
86.22(12) whether the reporter wishes to receive notification of the initial and final
86.23reports; and
86.24(13) if the report is from a facility with an internal reporting procedure, the name,
86.25mailing address, and telephone number of the person who initiated the report internally.
86.26(c) The common entry point is not required to complete each item on the form prior
86.27to dispatching the report to the appropriate lead investigative agency.
86.28(d) The common entry point shall immediately report to a law enforcement agency
86.29any incident in which there is reason to believe a crime has been committed.
86.30(e) If a report is initially made to a law enforcement agency or a lead investigative
86.31agency, those agencies shall take the report on the appropriate common entry point intake
86.32forms and immediately forward a copy to the common entry point.
86.33(f) The common entry point staff must receive training on how to screen and
86.34dispatch reports efficiently and in accordance with this section.
86.35(g) The commissioner of human services shall maintain a centralized database
86.36for the collection of common entry point data, lead investigative agency data including
87.1maltreatment report disposition, and appeals data. The common entry point shall
87.2have access to the centralized database and must log the reports into the database and
87.3immediately identify and locate prior reports of abuse, neglect, or exploitation.
87.4(h) When appropriate, the common entry point staff must refer calls that do not
87.5allege the abuse, neglect, or exploitation of a vulnerable adult to other organizations
87.6that might resolve the reporter's concerns.
87.7(i) a common entry point must be operated in a manner that enables the
87.8commissioner of human services to:
87.9(1) track critical steps in the reporting, evaluation, referral, response, disposition,
87.10and investigative process to ensure compliance with all requirements for all reports;
87.11(2) maintain data to facilitate the production of aggregate statistical reports for
87.12monitoring patterns of abuse, neglect, or exploitation;
87.13(3) serve as a resource for the evaluation, management, and planning of preventative
87.14and remedial services for vulnerable adults who have been subject to abuse, neglect,
87.15or exploitation;
87.16(4) set standards, priorities, and policies to maximize the efficiency and effectiveness
87.17of the common entry point; and
87.18(5) track and manage consumer complaints related to the common entry point.
87.19(j) The commissioners of human services and health shall collaborate on the
87.20creation of a system for referring reports to the lead investigative agencies. This system
87.21shall enable the commissioner of human services to track critical steps in the reporting,
87.22evaluation, referral, response, disposition, investigation, notification, determination, and
87.23appeal processes.

87.24    Sec. 43. Minnesota Statutes 2012, section 626.557, subdivision 9e, is amended to read:
87.25    Subd. 9e. Education requirements. (a) The commissioners of health, human
87.26services, and public safety shall cooperate in the development of a joint program for
87.27education of lead investigative agency investigators in the appropriate techniques for
87.28investigation of complaints of maltreatment. This program must be developed by July
87.291, 1996. The program must include but need not be limited to the following areas: (1)
87.30information collection and preservation; (2) analysis of facts; (3) levels of evidence; (4)
87.31conclusions based on evidence; (5) interviewing skills, including specialized training to
87.32interview people with unique needs; (6) report writing; (7) coordination and referral
87.33to other necessary agencies such as law enforcement and judicial agencies; (8) human
87.34relations and cultural diversity; (9) the dynamics of adult abuse and neglect within family
87.35systems and the appropriate methods for interviewing relatives in the course of the
88.1assessment or investigation; (10) the protective social services that are available to protect
88.2alleged victims from further abuse, neglect, or financial exploitation; (11) the methods by
88.3which lead investigative agency investigators and law enforcement workers cooperate in
88.4conducting assessments and investigations in order to avoid duplication of efforts; and
88.5(12) data practices laws and procedures, including provisions for sharing data.
88.6(b) The commissioner of human services shall conduct an outreach campaign to
88.7promote the common entry point for reporting vulnerable adult maltreatment. This
88.8campaign shall use the Internet and other means of communication.
88.9(b) (c) The commissioners of health, human services, and public safety shall offer at
88.10least annual education to others on the requirements of this section, on how this section is
88.11implemented, and investigation techniques.
88.12(c) (d) The commissioner of human services, in coordination with the commissioner
88.13of public safety shall provide training for the common entry point staff as required in this
88.14subdivision and the program courses described in this subdivision, at least four times
88.15per year. At a minimum, the training shall be held twice annually in the seven-county
88.16metropolitan area and twice annually outside the seven-county metropolitan area. The
88.17commissioners shall give priority in the program areas cited in paragraph (a) to persons
88.18currently performing assessments and investigations pursuant to this section.
88.19(d) (e) The commissioner of public safety shall notify in writing law enforcement
88.20personnel of any new requirements under this section. The commissioner of public
88.21safety shall conduct regional training for law enforcement personnel regarding their
88.22responsibility under this section.
88.23(e) (f) Each lead investigative agency investigator must complete the education
88.24program specified by this subdivision within the first 12 months of work as a lead
88.25investigative agency investigator.
88.26A lead investigative agency investigator employed when these requirements take
88.27effect must complete the program within the first year after training is available or as soon
88.28as training is available.
88.29All lead investigative agency investigators having responsibility for investigation
88.30duties under this section must receive a minimum of eight hours of continuing education
88.31or in-service training each year specific to their duties under this section.

88.32    Sec. 44. FEDERAL APPROVAL.
88.33This article is contingent on federal approval.

88.34    Sec. 45. REPEALER.
89.1(a) Minnesota Statutes 2012, sections 245A.655; and 256B.0917, subdivisions 1, 2,
89.23, 4, 5, 7, 8, 9, 10, 11, and 12, are repealed.
89.3(b) Minnesota Statutes 2012, section 256B.0911, subdivisions 4a, 4b, and 4c, are
89.4repealed effective October 1, 2013.

89.5ARTICLE 3
89.6SAFE AND HEALTHY DEVELOPMENT OF CHILDREN,
89.7YOUTH, AND FAMILIES

89.8    Section 1. Minnesota Statutes 2012, section 119B.011, is amended by adding a
89.9subdivision to read:
89.10    Subd. 19b. Student parent. "Student parent" means a person who is:
89.11(1) under 21 years of age and has a child;
89.12(2) pursuing a high school or general equivalency diploma;
89.13(3) residing within a county that has a basic sliding fee waiting list under section
89.14119B.03, subdivision 4; and
89.15(4) not an MFIP participant.
89.16EFFECTIVE DATE.This section is effective November 11, 2013.

89.17    Sec. 2. Minnesota Statutes 2012, section 119B.02, is amended by adding a subdivision
89.18to read:
89.19    Subd. 7. Child care market rate survey. Biennially, the commissioner shall survey
89.20prices charged by child care providers in Minnesota to determine the 75th percentile for
89.21like-care arrangements in county price clusters.
89.22EFFECTIVE DATE.This section is effective February 3, 2014.

89.23    Sec. 3. Minnesota Statutes 2012, section 119B.025, subdivision 1, is amended to read:
89.24    Subdivision 1. Factors which must be verified. (a) The county shall verify the
89.25following at all initial child care applications using the universal application:
89.26(1) identity of adults;
89.27(2) presence of the minor child in the home, if questionable;
89.28(3) relationship of minor child to the parent, stepparent, legal guardian, eligible
89.29relative caretaker, or the spouses of any of the foregoing;
89.30(4) age;
89.31(5) immigration status, if related to eligibility;
89.32(6) Social Security number, if given;
90.1(7) income;
90.2(8) spousal support and child support payments made to persons outside the
90.3household;
90.4(9) residence; and
90.5(10) inconsistent information, if related to eligibility.
90.6(b) If a family did not use the universal application or child care addendum to apply
90.7for child care assistance, the family must complete the universal application or child care
90.8addendum at its next eligibility redetermination and the county must verify the factors
90.9listed in paragraph (a) as part of that redetermination. Once a family has completed a
90.10universal application or child care addendum, the county shall use the redetermination
90.11form described in paragraph (c) for that family's subsequent redeterminations. Eligibility
90.12must be redetermined at least every six months. A family is considered to have met the
90.13eligibility redetermination requirement if a complete redetermination form and all required
90.14verifications are received within 30 days after the date the form was due. Assistance shall
90.15be payable retroactively from the redetermination due date. For a family where at least
90.16one parent is under the age of 21, does not have a high school or general equivalency
90.17diploma, and is a student in a school district or another similar program that provides or
90.18arranges for child care, as well as parenting, social services, career and employment
90.19supports, and academic support to achieve high school graduation, the redetermination of
90.20eligibility shall be deferred beyond six months, but not to exceed 12 months, to the end of
90.21the student's school year. If a family reports a change in an eligibility factor before the
90.22family's next regularly scheduled redetermination, the county must recalculate eligibility
90.23without requiring verification of any eligibility factor that did not change.
90.24(c) The commissioner shall develop a redetermination form to redetermine eligibility
90.25and a change report form to report changes that minimize paperwork for the county and
90.26the participant.
90.27EFFECTIVE DATE.This section is effective August 4, 2014.

90.28    Sec. 4. Minnesota Statutes 2012, section 119B.03, subdivision 4, is amended to read:
90.29    Subd. 4. Funding priority. (a) First priority for child care assistance under the
90.30basic sliding fee program must be given to eligible non-MFIP families who do not have a
90.31high school or general equivalency diploma or who need remedial and basic skill courses
90.32in order to pursue employment or to pursue education leading to employment and who
90.33need child care assistance to participate in the education program. This includes student
90.34parents as defined under section 119B.011, subdivision 19b. Within this priority, the
90.35following subpriorities must be used:
91.1(1) child care needs of minor parents;
91.2(2) child care needs of parents under 21 years of age; and
91.3(3) child care needs of other parents within the priority group described in this
91.4paragraph.
91.5(b) Second priority must be given to parents who have completed their MFIP or
91.6DWP transition year, or parents who are no longer receiving or eligible for diversionary
91.7work program supports.
91.8(c) Third priority must be given to families who are eligible for portable basic sliding
91.9fee assistance through the portability pool under subdivision 9.
91.10(d) Fourth priority must be given to families in which at least one parent is a veteran
91.11as defined under section 197.447.
91.12(e) Families under paragraph (b) must be added to the basic sliding fee waiting list
91.13on the date they begin the transition year under section 119B.011, subdivision 20, and
91.14must be moved into the basic sliding fee program as soon as possible after they complete
91.15their transition year.
91.16EFFECTIVE DATE.This section is effective November 11, 2013.

91.17    Sec. 5. Minnesota Statutes 2012, section 119B.05, subdivision 1, is amended to read:
91.18    Subdivision 1. Eligible participants. Families eligible for child care assistance
91.19under the MFIP child care program are:
91.20    (1) MFIP participants who are employed or in job search and meet the requirements
91.21of section 119B.10;
91.22    (2) persons who are members of transition year families under section 119B.011,
91.23subdivision 20
, and meet the requirements of section 119B.10;
91.24    (3) families who are participating in employment orientation or job search, or
91.25other employment or training activities that are included in an approved employability
91.26development plan under section 256J.95;
91.27    (4) MFIP families who are participating in work job search, job support,
91.28employment, or training activities as required in their employment plan, or in appeals,
91.29hearings, assessments, or orientations according to chapter 256J;
91.30    (5) MFIP families who are participating in social services activities under chapter
91.31256J as required in their employment plan approved according to chapter 256J;
91.32    (6) families who are participating in services or activities that are included in an
91.33approved family stabilization plan under section 256J.575;
91.34    (7) families who are participating in programs as required in tribal contracts under
91.35section 119B.02, subdivision 2, or 256.01, subdivision 2; and
92.1    (8) families who are participating in the transition year extension under section
92.2119B.011, subdivision 20a; and
92.3(9) student parents as defined under section 119B.011, subdivision 19b.
92.4EFFECTIVE DATE.This section is effective November 11, 2013.

92.5    Sec. 6. Minnesota Statutes 2012, section 119B.13, subdivision 1, is amended to read:
92.6    Subdivision 1. Subsidy restrictions. (a) Beginning October 31, 2011 February 3,
92.72014, the maximum rate paid for child care assistance in any county or multicounty region
92.8 county price cluster under the child care fund shall be the rate for like-care arrangements in
92.9the county effective July 1, 2006, decreased by 2.5 percent greater of the 25th percentile of
92.10the 2011 child care provider rate survey or the maximum rate effective November 28, 2011.
92.11The commissioner may: (1) assign a county with no reported provider prices to a similar
92.12price cluster; and (2) consider county level access when determining final price clusters.
92.13    (b) Biennially, beginning in 2012, the commissioner shall survey rates charged
92.14by child care providers in Minnesota to determine the 75th percentile for like-care
92.15arrangements in counties. When the commissioner determines that, using the
92.16commissioner's established protocol, the number of providers responding to the survey is
92.17too small to determine the 75th percentile rate for like-care arrangements in a county or
92.18multicounty region, the commissioner may establish the 75th percentile maximum rate
92.19based on like-care arrangements in a county, region, or category that the commissioner
92.20deems to be similar.
92.21    (c) (b) A rate which includes a special needs rate paid under subdivision 3 or under a
92.22school readiness service agreement paid under section 119B.231, may be in excess of the
92.23maximum rate allowed under this subdivision.
92.24    (d) (c) The department shall monitor the effect of this paragraph on provider rates.
92.25The county shall pay the provider's full charges for every child in care up to the maximum
92.26established. The commissioner shall determine the maximum rate for each type of care
92.27on an hourly, full-day, and weekly basis, including special needs and disability care. The
92.28maximum payment to a provider for one day of care must not exceed the daily rate. The
92.29maximum payment to a provider for one week of care must not exceed the weekly rate.
92.30(e) (d) Child care providers receiving reimbursement under this chapter must not
92.31be paid activity fees or an additional amount above the maximum rates for care provided
92.32during nonstandard hours for families receiving assistance.
92.33    (f) (e) When the provider charge is greater than the maximum provider rate allowed,
92.34the parent is responsible for payment of the difference in the rates in addition to any
92.35family co-payment fee.
93.1    (g) (f) All maximum provider rates changes shall be implemented on the Monday
93.2following the effective date of the maximum provider rate.
93.3    (g) Notwithstanding Minnesota Rules, part 3400.0130, subpart 7, maximum
93.4registration fees in effect on January 1, 2013, shall remain in effect.

93.5    Sec. 7. Minnesota Statutes 2012, section 119B.13, subdivision 1a, is amended to read:
93.6    Subd. 1a. Legal nonlicensed family child care provider rates. (a) Legal
93.7nonlicensed family child care providers receiving reimbursement under this chapter must
93.8be paid on an hourly basis for care provided to families receiving assistance.
93.9(b) The maximum rate paid to legal nonlicensed family child care providers must be
93.1068 percent of the county maximum hourly rate for licensed family child care providers. In
93.11counties or county price clusters where the maximum hourly rate for licensed family child
93.12care providers is higher than the maximum weekly rate for those providers divided by 50,
93.13the maximum hourly rate that may be paid to legal nonlicensed family child care providers
93.14is the rate equal to the maximum weekly rate for licensed family child care providers
93.15divided by 50 and then multiplied by 0.68. The maximum payment to a provider for one
93.16day of care must not exceed the maximum hourly rate times ten. The maximum payment
93.17to a provider for one week of care must not exceed the maximum hourly rate times 50.
93.18(c) A rate which includes a special needs rate paid under subdivision 3 may be in
93.19excess of the maximum rate allowed under this subdivision.
93.20(d) Legal nonlicensed family child care providers receiving reimbursement under
93.21this chapter may not be paid registration fees for families receiving assistance.
93.22EFFECTIVE DATE.This section is effective February 3, 2014.

93.23    Sec. 8. Minnesota Statutes 2012, section 119B.13, subdivision 3a, is amended to read:
93.24    Subd. 3a. Provider rate differential for accreditation. A family child care
93.25provider or child care center shall be paid a 15 percent differential above the maximum
93.26rate established in subdivision 1, up to the actual provider rate, if the provider or center
93.27holds a current early childhood development credential or is accredited. For a family
93.28child care provider, early childhood development credential and accreditation includes
93.29an individual who has earned a child development associate degree, a child development
93.30associate credential, a diploma in child development from a Minnesota state technical
93.31college, or a bachelor's or post baccalaureate degree in early childhood education from
93.32an accredited college or university, or who is accredited by the National Association for
93.33Family Child Care or the Competency Based Training and Assessment Program. For a
93.34child care center, accreditation includes accreditation that meets the following criteria:
94.1the accrediting organization must demonstrate the use of standards that promote the
94.2physical, social, emotional, and cognitive development of children. The accreditation
94.3standards shall include, but are not limited to, positive interactions between adults and
94.4children, age-appropriate learning activities, a system of tracking children's learning,
94.5use of assessment to meet children's needs, specific qualifications for staff, a learning
94.6environment that supports developmentally appropriate experiences for children, health
94.7and safety requirements, and family engagement strategies. The commissioner of human
94.8services, in conjunction with the commissioners of education and health, will develop an
94.9application and approval process based on the criteria in this section and any additional
94.10criteria. The process developed by the commissioner of human services must address
94.11periodic reassessment of approved accreditations. The commissioner of human services
94.12must report the criteria developed, the application, approval, and reassessment processes,
94.13and any additional recommendations by February 15, 2013, to the chairs and ranking
94.14minority members of the legislative committees having jurisdiction over early childhood
94.15issues. Based on an application process developed by the commissioner in conjunction
94.16with the commissioners of education and health, the Department of Human Services must
94.17accept applications from accrediting organizations beginning on July 1, 2013, and on an
94.18annual basis thereafter. The provider rate differential shall be paid to centers holding an
94.19accreditation from an approved accrediting organization beginning on a billing cycle to be
94.20determined by the commissioner, no later than the last Monday in February of a calendar
94.21year. The commissioner shall annually publish a list of approved accrediting organizations.
94.22An approved accreditation must be reassessed by the commissioner every two years. If an
94.23approved accrediting organization is determined to no longer meet the approval criteria, the
94.24organization and centers being paid the differential under that accreditation must be given
94.25a 90-day notice by the commissioner and the differential payment must end after a 15-day
94.26notice to affected families and centers as directed in Minnesota Rules, part 3400.0185,
94.27subparts 3 and 4. The following accreditations shall be recognized for the provider rate
94.28differential until an approval process is implemented: the National Association for the
94.29Education of Young Children, the Council on Accreditation, the National Early Childhood
94.30Program Accreditation, the National School-Age Care Association, or the National Head
94.31Start Association Program of Excellence. For Montessori programs, accreditation includes
94.32the American Montessori Society, Association of Montessori International-USA, or the
94.33National Center for Montessori Education.

94.34    Sec. 9. Minnesota Statutes 2012, section 119B.13, is amended by adding a subdivision
94.35to read:
95.1    Subd. 3b. Provider rate differential for Parent Aware. A family child care
95.2provider or child care center shall be paid a 15 percent differential if they hold a three-star
95.3Parent Aware rating or a 20 percent differential if they hold a four-star Parent Aware
95.4rating. A 15 percent or 20 percent rate differential must be paid above the maximum rate
95.5established in subdivision 1, up to the actual provider rate.
95.6EFFECTIVE DATE.This section is effective March 3, 2014.

95.7    Sec. 10. Minnesota Statutes 2012, section 119B.13, is amended by adding a subdivision
95.8to read:
95.9    Subd. 3c. Weekly rate paid for children attending high-quality care. A licensed
95.10child care provider or license-exempt center may be paid up to the applicable weekly
95.11maximum rate, not to exceed the provider's actual charge, when the following conditions
95.12are met:
95.13(1) the child is age birth to five years, but not yet in kindergarten;
95.14(2) the child attends a child care provider that qualifies for the rate differential
95.15identified in subdivision 3a or 3b; and
95.16(3) the applicant's activities qualify for at least 30 hours of care per week under
95.17sections 119B.03, 119B.05, 119B.10, and Minnesota Rules, chapter 3400.
95.18EFFECTIVE DATE.This section is effective August 4, 2014.

95.19    Sec. 11. Minnesota Statutes 2012, section 119B.13, subdivision 6, is amended to read:
95.20    Subd. 6. Provider payments. (a) The provider shall bill for services provided
95.21within ten days of the end of the service period. If bills are submitted within ten days of
95.22the end of the service period, payments under the child care fund shall be made within 30
95.23days of receiving a bill from the provider. Counties or the state may establish policies that
95.24make payments on a more frequent basis.
95.25(b) If a provider has received an authorization of care and been issued a billing form
95.26for an eligible family, the bill must be submitted within 60 days of the last date of service on
95.27the bill. A bill submitted more than 60 days after the last date of service must be paid if the
95.28county determines that the provider has shown good cause why the bill was not submitted
95.29within 60 days. Good cause must be defined in the county's child care fund plan under
95.30section 119B.08, subdivision 3, and the definition of good cause must include county error.
95.31Any bill submitted more than a year after the last date of service on the bill must not be paid.
95.32(c) If a provider provided care for a time period without receiving an authorization
95.33of care and a billing form for an eligible family, payment of child care assistance may only
96.1be made retroactively for a maximum of six months from the date the provider is issued
96.2an authorization of care and billing form.
96.3(d) A county may refuse to issue a child care authorization to a licensed or legal
96.4nonlicensed provider, revoke an existing child care authorization to a licensed or legal
96.5nonlicensed provider, stop payment issued to a licensed or legal nonlicensed provider, or
96.6refuse to pay a bill submitted by a licensed or legal nonlicensed provider if:
96.7(1) the provider admits to intentionally giving the county materially false information
96.8on the provider's billing forms;
96.9(2) a county finds by a preponderance of the evidence that the provider intentionally
96.10gave the county materially false information on the provider's billing forms;
96.11(3) the provider is in violation of child care assistance program rules, until the
96.12agency determines those violations have been corrected;
96.13    (4) the provider is operating after receipt of an order of suspension or an order
96.14of revocation of the provider's license, or the provider has been issued an order citing
96.15violations of licensing standards that affect the health and safety of children in care due to
96.16the nature, chronicity, or severity of the licensing violations, until the licensing agency
96.17determines those violations have been corrected;
96.18(5) the provider submits false attendance reports or refuses to provide documentation
96.19of the child's attendance upon request; or
96.20(6) the provider gives false child care price information.
96.21The county may withhold the provider's authorization or payment for a period of
96.22time not to exceed three months beyond the time the condition has been corrected.
96.23(e) A county's payment policies must be included in the county's child care plan
96.24under section 119B.08, subdivision 3. If payments are made by the state, in addition to
96.25being in compliance with this subdivision, the payments must be made in compliance
96.26with section 16A.124.
96.27EFFECTIVE DATE.This section is effective February 3, 2014.

96.28    Sec. 12. Minnesota Statutes 2012, section 119B.13, subdivision 7, is amended to read:
96.29    Subd. 7. Absent days. (a) Licensed child care providers and license-exempt centers
96.30must not be reimbursed for more than ten 25 full-day absent days per child, excluding
96.31holidays, in a fiscal year, or for more than ten consecutive full-day absent days. Legal
96.32nonlicensed family child care providers must not be reimbursed for absent days. If a child
96.33attends for part of the time authorized to be in care in a day, but is absent for part of the
96.34time authorized to be in care in that same day, the absent time must be reimbursed but
96.35the time must not count toward the ten absent day days limit. Child care providers must
97.1only be reimbursed for absent days if the provider has a written policy for child absences
97.2and charges all other families in care for similar absences.
97.3(b) Notwithstanding paragraph (a), children with documented medical conditions
97.4that cause more frequent absences may exceed the 25 absent days limit, or ten consecutive
97.5full-day absent days limit. Absences due to a documented medical condition of a parent
97.6or sibling who lives in the same residence as the child receiving child care assistance
97.7do not count against the absent days limit in a fiscal year. Documentation of medical
97.8conditions must be on the forms and submitted according to the timelines established by
97.9the commissioner. A public health nurse or school nurse may verify the illness in lieu of
97.10a medical practitioner. If a provider sends a child home early due to a medical reason,
97.11including, but not limited to, fever or contagious illness, the child care center director or
97.12lead teacher may verify the illness in lieu of a medical practitioner.
97.13(b) (c) Notwithstanding paragraph (a), children in families may exceed the ten absent
97.14days limit if at least one parent: (1) is under the age of 21; (2) does not have a high school
97.15or general equivalency diploma; and (3) is a student in a school district or another similar
97.16program that provides or arranges for child care, parenting support, social services, career
97.17and employment supports, and academic support to achieve high school graduation, upon
97.18request of the program and approval of the county. If a child attends part of an authorized
97.19day, payment to the provider must be for the full amount of care authorized for that day.
97.20    (c) (d) Child care providers must be reimbursed for up to ten federal or state holidays
97.21or designated holidays per year when the provider charges all families for these days and the
97.22holiday or designated holiday falls on a day when the child is authorized to be in attendance.
97.23Parents may substitute other cultural or religious holidays for the ten recognized state and
97.24federal holidays. Holidays do not count toward the ten absent day days limit.
97.25    (d) (e) A family or child care provider must not be assessed an overpayment for an
97.26absent day payment unless (1) there was an error in the amount of care authorized for the
97.27family, (2) all of the allowed full-day absent payments for the child have been paid, or (3)
97.28the family or provider did not timely report a change as required under law.
97.29    (e) (f) The provider and family shall receive notification of the number of absent
97.30days used upon initial provider authorization for a family and ongoing notification of the
97.31number of absent days used as of the date of the notification.
97.32(g) For purposes of this subdivision, "absent days limit" means 25 full-day absent
97.33days per child, excluding holidays, in a fiscal year; and ten consecutive full-day absent days.
97.34EFFECTIVE DATE.This section is effective February 1, 2014.

97.35    Sec. 13. Minnesota Statutes 2012, section 245A.07, subdivision 2a, is amended to read:
98.1    Subd. 2a. Immediate suspension expedited hearing. (a) Within five working days
98.2of receipt of the license holder's timely appeal, the commissioner shall request assignment
98.3of an administrative law judge. The request must include a proposed date, time, and place
98.4of a hearing. A hearing must be conducted by an administrative law judge within 30
98.5calendar days of the request for assignment, unless an extension is requested by either
98.6party and granted by the administrative law judge for good cause. The commissioner shall
98.7issue a notice of hearing by certified mail or personal service at least ten working days
98.8before the hearing. The scope of the hearing shall be limited solely to the issue of whether
98.9the temporary immediate suspension should remain in effect pending the commissioner's
98.10final order under section 245A.08, regarding a licensing sanction issued under subdivision
98.113 following the immediate suspension. The burden of proof in expedited hearings under
98.12this subdivision shall be limited to the commissioner's demonstration that reasonable
98.13cause exists to believe that the license holder's actions or failure to comply with applicable
98.14law or rule poses, or if the actions of other individuals or conditions in the program
98.15poses an imminent risk of harm to the health, safety, or rights of persons served by the
98.16program. "Reasonable cause" means there exist specific articulable facts or circumstances
98.17which provide the commissioner with a reasonable suspicion that there is an imminent
98.18risk of harm to the health, safety, or rights of persons served by the program. When the
98.19commissioner has determined there is reasonable cause to order the temporary immediate
98.20suspension of a license based on a violation of safe sleep requirements, as defined in
98.21section 245A.1435, the commissioner is not required to demonstrate that an infant died or
98.22was injured as a result of the safe sleep violations.
98.23    (b) The administrative law judge shall issue findings of fact, conclusions, and a
98.24recommendation within ten working days from the date of hearing. The parties shall have
98.25ten calendar days to submit exceptions to the administrative law judge's report. The
98.26record shall close at the end of the ten-day period for submission of exceptions. The
98.27commissioner's final order shall be issued within ten working days from the close of the
98.28record. Within 90 calendar days after a final order affirming an immediate suspension, the
98.29commissioner shall make a determination regarding whether a final licensing sanction
98.30shall be issued under subdivision 3. The license holder shall continue to be prohibited
98.31from operation of the program during this 90-day period.
98.32    (c) When the final order under paragraph (b) affirms an immediate suspension, and a
98.33final licensing sanction is issued under subdivision 3 and the license holder appeals that
98.34sanction, the license holder continues to be prohibited from operation of the program
98.35pending a final commissioner's order under section 245A.08, subdivision 5, regarding the
98.36final licensing sanction.

99.1    Sec. 14. Minnesota Statutes 2012, section 245A.1435, is amended to read:
99.2245A.1435 REDUCTION OF RISK OF SUDDEN UNEXPECTED INFANT
99.3DEATH SYNDROME IN LICENSED PROGRAMS.
99.4    (a) When a license holder is placing an infant to sleep, the license holder must
99.5place the infant on the infant's back, unless the license holder has documentation from
99.6the infant's parent physician directing an alternative sleeping position for the infant. The
99.7parent physician directive must be on a form approved by the commissioner and must
99.8include a statement that the parent or legal guardian has read the information provided by
99.9the Minnesota Sudden Infant Death Center, related to the risk of SIDS and the importance
99.10of placing an infant or child on its back to sleep to reduce the risk of SIDS. remain on file
99.11at the licensed location. An infant who independently rolls onto its stomach after being
99.12placed to sleep on its back may be allowed to remain sleeping on its stomach if the infant
99.13is at least six months of age or the license holder has a signed statement from the parent
99.14indicating that the infant regularly rolls over at home.
99.15(b) The license holder must place the infant in a crib directly on a firm mattress with
99.16a fitted crib sheet that fits tightly on the mattress and overlaps the mattress so it cannot be
99.17dislodged by pulling on the corner of the sheet. The license holder must not place pillows,
99.18quilts, comforters, sheepskin, pillow-like stuffed toys, or other soft products in the crib
99.19with the infant The license holder must place the infant in a crib directly on a firm mattress
99.20with a fitted sheet that is appropriate to the mattress size, that fits tightly on the mattress,
99.21and overlaps the underside of the mattress so it cannot be dislodged by pulling on the
99.22corner of the sheet with reasonable effort. The license holder must not place anything in
99.23the crib with the infant except for the infant's pacifier, as defined in Code of Federal
99.24Regulations, title 16, part 1511. The requirements of this section apply to license holders
99.25serving infants up to and including 12 months younger than one year of age. Licensed
99.26child care providers must meet the crib requirements under section 245A.146.
99.27(c) If an infant falls asleep before being placed in a crib, the license holder must
99.28move the infant to a crib as soon as practicable, and must keep the infant within sight of
99.29the license holder until the infant is placed in a crib. When an infant falls asleep while
99.30being held, the license holder must consider the supervision needs of other children in
99.31care when determining how long to hold the infant before placing the infant in a crib to
99.32sleep. The sleeping infant must not be in a position where the airway may be blocked or
99.33with anything covering the infant's face.
99.34(d) Placing a swaddled infant down to sleep in a licensed setting is not recommended
99.35for an infant of any age and is prohibited for any infant who has begun to roll over
99.36independently. However, with the written consent of a parent or guardian according to this
100.1paragraph, a license holder may place the infant who has not yet begun to roll over on its
100.2own down to sleep in a one-piece sleeper equipped with an attached system that fastens
100.3securely only across the upper torso, with no constriction of the hips or legs, to create a
100.4swaddle. Prior to any use of swaddling for sleep by a provider licensed under this chapter,
100.5the license holder must obtain informed written consent for the use of swaddling from the
100.6parent or guardian of the infant on a form provided by the commissioner and prepared in
100.7partnership with the Minnesota Sudden Infant Death Center.

100.8    Sec. 15. Minnesota Statutes 2012, section 245A.144, is amended to read:
100.9245A.144 TRAINING ON RISK OF SUDDEN UNEXPECTED INFANT
100.10DEATH AND SHAKEN BABY SYNDROME ABUSIVE HEAD TRAUMA FOR
100.11CHILD FOSTER CARE PROVIDERS.
100.12    (a) Licensed child foster care providers that care for infants or children through five
100.13years of age must document that before staff persons and caregivers assist in the care
100.14of infants or children through five years of age, they are instructed on the standards in
100.15section 245A.1435 and receive training on reducing the risk of sudden unexpected infant
100.16death syndrome and shaken baby syndrome for abusive head trauma from shaking infants
100.17and young children. This section does not apply to emergency relative placement under
100.18section 245A.035. The training on reducing the risk of sudden unexpected infant death
100.19syndrome and shaken baby syndrome abusive head trauma may be provided as:
100.20    (1) orientation training to child foster care providers, who care for infants or children
100.21through five years of age, under Minnesota Rules, part 2960.3070, subpart 1; or
100.22    (2) in-service training to child foster care providers, who care for infants or children
100.23through five years of age, under Minnesota Rules, part 2960.3070, subpart 2.
100.24    (b) Training required under this section must be at least one hour in length and must
100.25be completed at least once every five years. At a minimum, the training must address
100.26the risk factors related to sudden unexpected infant death syndrome and shaken baby
100.27syndrome abusive head trauma, means of reducing the risk of sudden unexpected infant
100.28death syndrome and shaken baby syndrome abusive head trauma, and license holder
100.29communication with parents regarding reducing the risk of sudden unexpected infant
100.30death syndrome and shaken baby syndrome abusive head trauma.
100.31    (c) Training for child foster care providers must be approved by the county or
100.32private licensing agency that is responsible for monitoring the child foster care provider
100.33under section 245A.16. The approved training fulfills, in part, training required under
100.34Minnesota Rules, part 2960.3070.

101.1    Sec. 16. Minnesota Statutes 2012, section 245A.1444, is amended to read:
101.2245A.1444 TRAINING ON RISK OF SUDDEN UNEXPECTED INFANT
101.3DEATH SYNDROME AND SHAKEN BABY SYNDROME ABUSIVE HEAD
101.4TRAUMA BY OTHER PROGRAMS.
101.5    A licensed chemical dependency treatment program that serves clients with infants
101.6or children through five years of age, who sleep at the program and a licensed children's
101.7residential facility that serves infants or children through five years of age, must document
101.8that before program staff persons or volunteers assist in the care of infants or children
101.9through five years of age, they are instructed on the standards in section 245A.1435 and
101.10receive training on reducing the risk of sudden unexpected infant death syndrome and
101.11shaken baby syndrome abusive head trauma from shaking infants and young children. The
101.12training conducted under this section may be used to fulfill training requirements under
101.13Minnesota Rules, parts 2960.0100, subpart 3; and 9530.6490, subpart 4, item B.
101.14    This section does not apply to child care centers or family child care programs
101.15governed by sections 245A.40 and 245A.50.

101.16    Sec. 17. [245A.1446] FAMILY CHILD CARE DIAPERING AREA
101.17DISINFECTION.
101.18Notwithstanding Minnesota Rules, part 9502.0435, a family child care provider may
101.19disinfect the diaper changing surface with chlorine bleach in a manner consistent with label
101.20directions for disinfection or with a surface disinfectant that meets the following criteria:
101.21(1) the manufacturer's label or instructions state that the product is registered with
101.22the United States Environmental Protection Agency;
101.23(2) the manufacturer's label or instructions state that the disinfectant is effective
101.24against Staphylococcus aureus, Salmonella choleraesuis, and Pseudomonas aeruginosa;
101.25(3) the manufacturer's label or instructions state that the disinfectant is effective with
101.26a ten minute or less contact time;
101.27(4) the disinfectant is clearly labeled by the manufacturer with directions for mixing
101.28and use;
101.29(5) the disinfectant is used only in accordance with the manufacturer's directions; and
101.30(6) the product does not include triclosan or derivatives of triclosan.

101.31    Sec. 18. [245A.147] FAMILY CHILD CARE INFANT SLEEP SUPERVISION
101.32REQUIREMENTS.
102.1    Subdivision 1. In-person checks on infants. (a) License holders that serve infants
102.2are encouraged to monitor sleeping infants by conducting in-person checks on each infant
102.3in their care every 30 minutes.
102.4(b) Upon enrollment of an infant in a family child care program, the license holder is
102.5encouraged to conduct in-person checks on the sleeping infant every 15 minutes, during
102.6the first four months of care.
102.7(c) When an infant has an upper respiratory infection, the license holder is
102.8encouraged to conduct in-person checks on the sleeping infant every 15 minutes
102.9throughout the hours of sleep.
102.10    Subd. 2. Use of audio or visual monitoring devices. In addition to conducting
102.11the in-person checks encouraged under subdivision 1, license holders serving infants are
102.12encouraged to use and maintain an audio or visual monitoring device to monitor each
102.13sleeping infant in care during all hours of sleep.

102.14    Sec. 19. [245A.152] CHILD CARE LICENSE HOLDER INSURANCE.
102.15(a) A license holder must provide a written notice to all parents or guardians of all
102.16children to be accepted for care prior to admission stating whether the license holder has
102.17liability insurance. This notice may be incorporated into and provided on the admission
102.18form used by the license holder.
102.19(b) If the license holder has liability insurance:
102.20(1) the license holder shall inform parents in writing that a current certificate of
102.21coverage for insurance is available for inspection to all parents or guardians of children
102.22receiving services and to all parents seeking services from the family child care program;
102.23(2) the notice must provide the parent or guardian with the date of expiration or
102.24next renewal of the policy; and
102.25(3) upon the expiration date of the policy, the license holder must provide a new
102.26written notice indicating whether the insurance policy has lapsed or whether the license
102.27holder has renewed the policy.
102.28If the policy was renewed, the license holder must provide the new expiration date of the
102.29policy in writing to the parents or guardians.
102.30(c) If the license holder does not have liability insurance, the license holder must
102.31provide an annual notice, on a form developed and made available by the commissioner,
102.32to the parents or guardians of children in care indicating that the license holder does not
102.33carry liability insurance.
102.34(d) The license holder must notify all parents and guardians in writing immediately
102.35of any change in insurance status.
103.1(e) The license holder must make available upon request the certificate of liability
103.2insurance to the parents of children in care, to the commissioner, and to county licensing
103.3agents.
103.4(f) The license holder must document, with the signature of the parent or guardian,
103.5that the parent or guardian received the notices required by this section.

103.6    Sec. 20. Minnesota Statutes 2012, section 245A.40, subdivision 5, is amended to read:
103.7    Subd. 5. Sudden unexpected infant death syndrome and shaken baby syndrome
103.8 abusive head trauma training. (a) License holders must document that before staff
103.9persons and volunteers care for infants, they are instructed on the standards in section
103.10245A.1435 and receive training on reducing the risk of sudden unexpected infant death
103.11syndrome. In addition, license holders must document that before staff persons care for
103.12infants or children under school age, they receive training on the risk of shaken baby
103.13syndrome abusive head trauma from shaking infants and young children. The training
103.14in this subdivision may be provided as orientation training under subdivision 1 and
103.15in-service training under subdivision 7.
103.16    (b) Sudden unexpected infant death syndrome reduction training required under
103.17this subdivision must be at least one-half hour in length and must be completed at least
103.18once every five years year. At a minimum, the training must address the risk factors
103.19related to sudden unexpected infant death syndrome, means of reducing the risk of sudden
103.20unexpected infant death syndrome in child care, and license holder communication with
103.21parents regarding reducing the risk of sudden unexpected infant death syndrome.
103.22    (c) Shaken baby syndrome Abusive head trauma training under this subdivision
103.23must be at least one-half hour in length and must be completed at least once every five
103.24years year. At a minimum, the training must address the risk factors related to shaken
103.25baby syndrome for shaking infants and young children, means to reduce the risk of shaken
103.26baby syndrome abusive head trauma in child care, and license holder communication with
103.27parents regarding reducing the risk of shaken baby syndrome abusive head trauma.
103.28(d) The commissioner shall make available for viewing a video presentation on the
103.29dangers associated with shaking infants and young children. The video presentation must
103.30be part of the orientation and annual in-service training of licensed child care center
103.31staff persons caring for children under school age. The commissioner shall provide to
103.32child care providers and interested individuals, at cost, copies of a video approved by the
103.33commissioner of health under section 144.574 on the dangers associated with shaking
103.34infants and young children.

104.1    Sec. 21. Minnesota Statutes 2012, section 245A.50, is amended to read:
104.2245A.50 FAMILY CHILD CARE TRAINING REQUIREMENTS.
104.3    Subdivision 1. Initial training. (a) License holders, caregivers, and substitutes must
104.4comply with the training requirements in this section.
104.5    (b) Helpers who assist with care on a regular basis must complete six hours of
104.6training within one year after the date of initial employment.
104.7    Subd. 2. Child growth and development and behavior guidance training. (a) For
104.8purposes of family and group family child care, the license holder and each adult caregiver
104.9who provides care in the licensed setting for more than 30 days in any 12-month period
104.10shall complete and document at least two four hours of child growth and development
104.11and behavior guidance training within the first year of prior to initial licensure, and before
104.12caring for children. For purposes of this subdivision, "child growth and development
104.13training" means training in understanding how children acquire language and develop
104.14physically, cognitively, emotionally, and socially. "Behavior guidance training" means
104.15training in the understanding of the functions of child behavior and strategies for managing
104.16challenging situations. Child growth and development and behavior guidance training
104.17must be repeated annually. Training curriculum shall be developed or approved by the
104.18commissioner of human services by January 1, 2014.
104.19    (b) Notwithstanding paragraph (a), individuals are exempt from this requirement if
104.20they:
104.21    (1) have taken a three-credit course on early childhood development within the
104.22past five years;
104.23    (2) have received a baccalaureate or master's degree in early childhood education or
104.24school-age child care within the past five years;
104.25    (3) are licensed in Minnesota as a prekindergarten teacher, an early childhood
104.26educator, a kindergarten to grade 6 teacher with a prekindergarten specialty, an early
104.27childhood special education teacher, or an elementary teacher with a kindergarten
104.28endorsement; or
104.29    (4) have received a baccalaureate degree with a Montessori certificate within the
104.30past five years.
104.31    Subd. 3. First aid. (a) When children are present in a family child care home
104.32governed by Minnesota Rules, parts 9502.0315 to 9502.0445, at least one staff person
104.33must be present in the home who has been trained in first aid. The first aid training must
104.34have been provided by an individual approved to provide first aid instruction. First aid
104.35training may be less than eight hours and persons qualified to provide first aid training
105.1include individuals approved as first aid instructors. First aid training must be repeated
105.2every two years.
105.3    (b) A family child care provider is exempt from the first aid training requirements
105.4under this subdivision related to any substitute caregiver who provides less than 30 hours
105.5of care during any 12-month period.
105.6    (c) Video training reviewed and approved by the county licensing agency satisfies
105.7the training requirement of this subdivision.
105.8    Subd. 4. Cardiopulmonary resuscitation. (a) When children are present in a family
105.9child care home governed by Minnesota Rules, parts 9502.0315 to 9502.0445, at least
105.10one staff person must be present in the home who has been trained in cardiopulmonary
105.11resuscitation (CPR) and in the treatment of obstructed airways that includes CPR
105.12techniques for infants and children. The CPR training must have been provided by an
105.13individual approved to provide CPR instruction, must be repeated at least once every three
105.14 two years, and must be documented in the staff person's records.
105.15    (b) A family child care provider is exempt from the CPR training requirement in
105.16this subdivision related to any substitute caregiver who provides less than 30 hours of
105.17care during any 12-month period.
105.18    (c) Video training reviewed and approved by the county licensing agency satisfies
105.19the training requirement of this subdivision. Persons providing CPR training must use
105.20CPR training that has been developed:
105.21    (1) by the American Heart Association or the American Red Cross and incorporates
105.22psychomotor skills to support the instruction; or
105.23    (2) using nationally recognized, evidence-based guidelines for CPR training and
105.24incorporates psychomotor skills to support the instruction.
105.25    Subd. 5. Sudden unexpected infant death syndrome and shaken baby syndrome
105.26 abusive head trauma training. (a) License holders must document that before staff
105.27persons, caregivers, and helpers assist in the care of infants, they are instructed on the
105.28standards in section 245A.1435 and receive training on reducing the risk of sudden
105.29unexpected infant death syndrome. In addition, license holders must document that before
105.30staff persons, caregivers, and helpers assist in the care of infants and children under
105.31school age, they receive training on reducing the risk of shaken baby syndrome abusive
105.32head trauma from shaking infants and young children. The training in this subdivision
105.33may be provided as initial training under subdivision 1 or ongoing annual training under
105.34subdivision 7.
105.35    (b) Sudden unexpected infant death syndrome reduction training required under this
105.36subdivision must be at least one-half hour in length and must be completed in person
106.1 at least once every five years two years. On the years when the license holder is not
106.2receiving the in-person training on sudden unexpected infant death reduction, the license
106.3holder must receive sudden unexpected infant death reduction training through a video
106.4of no more than one hour in length developed or approved by the commissioner. At a
106.5minimum, the training must address the risk factors related to sudden unexpected infant
106.6death syndrome, means of reducing the risk of sudden unexpected infant death syndrome
106.7 in child care, and license holder communication with parents regarding reducing the risk
106.8of sudden unexpected infant death syndrome.
106.9    (c) Shaken baby syndrome Abusive head trauma training required under this
106.10subdivision must be at least one-half hour in length and must be completed at least once
106.11every five years year. At a minimum, the training must address the risk factors related
106.12to shaken baby syndrome shaking infants and young children, means of reducing the
106.13risk of shaken baby syndrome abusive head trauma in child care, and license holder
106.14communication with parents regarding reducing the risk of shaken baby syndrome abusive
106.15head trauma.
106.16(d) Training for family and group family child care providers must be developed
106.17by the commissioner in conjunction with the Minnesota Sudden Infant Death Center
106.18and approved by the county licensing agency by the Minnesota Center for Professional
106.19Development.
106.20    (e) The commissioner shall make available for viewing by all licensed child care
106.21providers a video presentation on the dangers associated with shaking infants and young
106.22children. The video presentation shall be part of the initial and ongoing annual training of
106.23licensed child care providers, caregivers, and helpers caring for children under school age.
106.24The commissioner shall provide to child care providers and interested individuals, at cost,
106.25copies of a video approved by the commissioner of health under section 144.574 on the
106.26dangers associated with shaking infants and young children.
106.27    Subd. 6. Child passenger restraint systems; training requirement. (a) A license
106.28holder must comply with all seat belt and child passenger restraint system requirements
106.29under section 169.685.
106.30    (b) Family and group family child care programs licensed by the Department of
106.31Human Services that serve a child or children under nine years of age must document
106.32training that fulfills the requirements in this subdivision.
106.33    (1) Before a license holder, staff person, caregiver, or helper transports a child or
106.34children under age nine in a motor vehicle, the person placing the child or children in a
106.35passenger restraint must satisfactorily complete training on the proper use and installation
107.1of child restraint systems in motor vehicles. Training completed under this subdivision may
107.2be used to meet initial training under subdivision 1 or ongoing training under subdivision 7.
107.3    (2) Training required under this subdivision must be at least one hour in length,
107.4completed at initial training, and repeated at least once every five years. At a minimum,
107.5the training must address the proper use of child restraint systems based on the child's
107.6size, weight, and age, and the proper installation of a car seat or booster seat in the motor
107.7vehicle used by the license holder to transport the child or children.
107.8    (3) Training under this subdivision must be provided by individuals who are certified
107.9and approved by the Department of Public Safety, Office of Traffic Safety. License holders
107.10may obtain a list of certified and approved trainers through the Department of Public
107.11Safety Web site or by contacting the agency.
107.12    (c) Child care providers that only transport school-age children as defined in section
107.13245A.02, subdivision 19 , paragraph (f), in child care buses as defined in section 169.448,
107.14subdivision 1, paragraph (e), are exempt from this subdivision.
107.15    Subd. 7. Training requirements for family and group family child care. For
107.16purposes of family and group family child care, the license holder and each primary
107.17caregiver must complete eight 16 hours of ongoing training each year. For purposes
107.18of this subdivision, a primary caregiver is an adult caregiver who provides services in
107.19the licensed setting for more than 30 days in any 12-month period. Repeat of topical
107.20training requirements in subdivisions 2 to 8 shall count toward the annual 16-hour training
107.21requirement. Additional ongoing training subjects to meet the annual 16-hour training
107.22requirement must be selected from the following areas:
107.23    (1) "child growth and development training" has the meaning given in under
107.24 subdivision 2, paragraph (a);
107.25    (2) "learning environment and curriculum" includes, including training in
107.26establishing an environment and providing activities that provide learning experiences to
107.27meet each child's needs, capabilities, and interests;
107.28    (3) "assessment and planning for individual needs" includes, including training in
107.29observing and assessing what children know and can do in order to provide curriculum
107.30and instruction that addresses their developmental and learning needs, including children
107.31with special needs and bilingual children or children for whom English is not their
107.32primary language;
107.33    (4) "interactions with children" includes, including training in establishing
107.34supportive relationships with children, guiding them as individuals and as part of a group;
108.1    (5) "families and communities" includes, including training in working
108.2collaboratively with families and agencies or organizations to meet children's needs and to
108.3encourage the community's involvement;
108.4    (6) "health, safety, and nutrition" includes, including training in establishing and
108.5maintaining an environment that ensures children's health, safety, and nourishment,
108.6including child abuse, maltreatment, prevention, and reporting; home and fire safety; child
108.7injury prevention; communicable disease prevention and control; first aid; and CPR; and
108.8    (7) "program planning and evaluation" includes, including training in establishing,
108.9implementing, evaluating, and enhancing program operations.; and
108.10(8) behavior guidance, including training in the understanding of the functions of
108.11child behavior and strategies for managing behavior.
108.12    Subd. 8. Other required training requirements. (a) The training required of
108.13family and group family child care providers and staff must include training in the cultural
108.14dynamics of early childhood development and child care. The cultural dynamics and
108.15disabilities training and skills development of child care providers must be designed to
108.16achieve outcomes for providers of child care that include, but are not limited to:
108.17    (1) an understanding and support of the importance of culture and differences in
108.18ability in children's identity development;
108.19    (2) understanding the importance of awareness of cultural differences and
108.20similarities in working with children and their families;
108.21    (3) understanding and support of the needs of families and children with differences
108.22in ability;
108.23    (4) developing skills to help children develop unbiased attitudes about cultural
108.24differences and differences in ability;
108.25    (5) developing skills in culturally appropriate caregiving; and
108.26    (6) developing skills in appropriate caregiving for children of different abilities.
108.27    The commissioner shall approve the curriculum for cultural dynamics and disability
108.28training.
108.29    (b) The provider must meet the training requirement in section 245A.14, subdivision
108.3011
, paragraph (a), clause (4), to be eligible to allow a child cared for at the family child
108.31care or group family child care home to use the swimming pool located at the home.
108.32    Subd. 9. Supervising for safety; training requirement. Effective July 1, 2014,
108.33all family child care license holders and each adult caregiver who provides care in the
108.34licensed family child care home for more than 30 days in any 12-month period shall
108.35complete and document at least six hours of approved training on supervising for safety
108.36prior to initial licensure, and before caring for children. At least two hours of training
109.1on supervising for safety must be repeated annually. For purposes of this subdivision,
109.2"supervising for safety" includes supervision basics, supervision outdoors, equipment and
109.3materials, illness, injuries, and disaster preparedness. The commissioner shall develop
109.4the supervising for safety curriculum by January 1, 2014.
109.5    Subd. 10. Approved training. County licensing staff must accept training approved
109.6by the Minnesota Center for Professional Development, including:
109.7(1) face-to-face or classroom training;
109.8(2) online training; and
109.9(3) relationship-based professional development, such as mentoring, coaching,
109.10and consulting.
109.11    Subd. 11. Provider training. New and increased training requirements under this
109.12section must not be imposed on providers until the commissioner establishes statewide
109.13accessibility to the required provider training.

109.14    Sec. 22. Minnesota Statutes 2012, section 252.27, subdivision 2a, is amended to read:
109.15    Subd. 2a. Contribution amount. (a) The natural or adoptive parents of a minor
109.16child, including a child determined eligible for medical assistance without consideration of
109.17parental income, must contribute to the cost of services used by making monthly payments
109.18on a sliding scale based on income, unless the child is married or has been married, parental
109.19rights have been terminated, or the child's adoption is subsidized according to section
109.20259.67 or through title IV-E of the Social Security Act. The parental contribution is a partial
109.21or full payment for medical services provided for diagnostic, therapeutic, curing, treating,
109.22mitigating, rehabilitation, maintenance, and personal care services as defined in United
109.23States Code, title 26, section 213, needed by the child with a chronic illness or disability.
109.24    (b) For households with adjusted gross income equal to or greater than 100 275
109.25 percent of federal poverty guidelines, the parental contribution shall be computed by
109.26applying the following schedule of rates to the adjusted gross income of the natural or
109.27adoptive parents:
109.28    (1) if the adjusted gross income is equal to or greater than 100 percent of federal
109.29poverty guidelines and less than 175 percent of federal poverty guidelines, the parental
109.30contribution is $4 per month;
109.31    (2) (1) if the adjusted gross income is equal to or greater than 175 275 percent
109.32of federal poverty guidelines and less than or equal to 545 percent of federal poverty
109.33guidelines, the parental contribution shall be determined using a sliding fee scale
109.34established by the commissioner of human services which begins at one 2.76 percent of
109.35adjusted gross income at 175 275 percent of federal poverty guidelines and increases to
110.17.5 percent of adjusted gross income for those with adjusted gross income up to 545
110.2percent of federal poverty guidelines;
110.3    (3) (2) if the adjusted gross income is greater than 545 percent of federal poverty
110.4guidelines and less than 675 percent of federal poverty guidelines, the parental
110.5contribution shall be 7.5 percent of adjusted gross income;
110.6    (4) (3) if the adjusted gross income is equal to or greater than 675 percent of federal
110.7poverty guidelines and less than 975 percent of federal poverty guidelines, the parental
110.8contribution shall be determined using a sliding fee scale established by the commissioner
110.9of human services which begins at 7.5 percent of adjusted gross income at 675 percent of
110.10federal poverty guidelines and increases to ten percent of adjusted gross income for those
110.11with adjusted gross income up to 975 percent of federal poverty guidelines; and
110.12    (5) (4) if the adjusted gross income is equal to or greater than 975 percent of federal
110.13poverty guidelines, the parental contribution shall be 12.5 percent of adjusted gross income.
110.14    If the child lives with the parent, the annual adjusted gross income is reduced by
110.15$2,400 prior to calculating the parental contribution. If the child resides in an institution
110.16specified in section 256B.35, the parent is responsible for the personal needs allowance
110.17specified under that section in addition to the parental contribution determined under this
110.18section. The parental contribution is reduced by any amount required to be paid directly to
110.19the child pursuant to a court order, but only if actually paid.
110.20    (c) The household size to be used in determining the amount of contribution under
110.21paragraph (b) includes natural and adoptive parents and their dependents, including the
110.22child receiving services. Adjustments in the contribution amount due to annual changes
110.23in the federal poverty guidelines shall be implemented on the first day of July following
110.24publication of the changes.
110.25    (d) For purposes of paragraph (b), "income" means the adjusted gross income of the
110.26natural or adoptive parents determined according to the previous year's federal tax form,
110.27except, effective retroactive to July 1, 2003, taxable capital gains to the extent the funds
110.28have been used to purchase a home shall not be counted as income.
110.29    (e) The contribution shall be explained in writing to the parents at the time eligibility
110.30for services is being determined. The contribution shall be made on a monthly basis
110.31effective with the first month in which the child receives services. Annually upon
110.32redetermination or at termination of eligibility, if the contribution exceeded the cost of
110.33services provided, the local agency or the state shall reimburse that excess amount to
110.34the parents, either by direct reimbursement if the parent is no longer required to pay a
110.35contribution, or by a reduction in or waiver of parental fees until the excess amount is
110.36exhausted. All reimbursements must include a notice that the amount reimbursed may be
111.1taxable income if the parent paid for the parent's fees through an employer's health care
111.2flexible spending account under the Internal Revenue Code, section 125, and that the
111.3parent is responsible for paying the taxes owed on the amount reimbursed.
111.4    (f) The monthly contribution amount must be reviewed at least every 12 months;
111.5when there is a change in household size; and when there is a loss of or gain in income
111.6from one month to another in excess of ten percent. The local agency shall mail a written
111.7notice 30 days in advance of the effective date of a change in the contribution amount.
111.8A decrease in the contribution amount is effective in the month that the parent verifies a
111.9reduction in income or change in household size.
111.10    (g) Parents of a minor child who do not live with each other shall each pay the
111.11contribution required under paragraph (a). An amount equal to the annual court-ordered
111.12child support payment actually paid on behalf of the child receiving services shall be
111.13deducted from the adjusted gross income of the parent making the payment prior to
111.14calculating the parental contribution under paragraph (b).
111.15    (h) The contribution under paragraph (b) shall be increased by an additional five
111.16percent if the local agency determines that insurance coverage is available but not
111.17obtained for the child. For purposes of this section, "available" means the insurance is a
111.18benefit of employment for a family member at an annual cost of no more than five percent
111.19of the family's annual income. For purposes of this section, "insurance" means health
111.20and accident insurance coverage, enrollment in a nonprofit health service plan, health
111.21maintenance organization, self-insured plan, or preferred provider organization.
111.22    Parents who have more than one child receiving services shall not be required
111.23to pay more than the amount for the child with the highest expenditures. There shall
111.24be no resource contribution from the parents. The parent shall not be required to pay
111.25a contribution in excess of the cost of the services provided to the child, not counting
111.26payments made to school districts for education-related services. Notice of an increase in
111.27fee payment must be given at least 30 days before the increased fee is due.
111.28    (i) The contribution under paragraph (b) shall be reduced by $300 per fiscal year if,
111.29in the 12 months prior to July 1:
111.30    (1) the parent applied for insurance for the child;
111.31    (2) the insurer denied insurance;
111.32    (3) the parents submitted a complaint or appeal, in writing to the insurer, submitted
111.33a complaint or appeal, in writing, to the commissioner of health or the commissioner of
111.34commerce, or litigated the complaint or appeal; and
111.35    (4) as a result of the dispute, the insurer reversed its decision and granted insurance.
111.36    For purposes of this section, "insurance" has the meaning given in paragraph (h).
112.1    A parent who has requested a reduction in the contribution amount under this
112.2paragraph shall submit proof in the form and manner prescribed by the commissioner or
112.3county agency, including, but not limited to, the insurer's denial of insurance, the written
112.4letter or complaint of the parents, court documents, and the written response of the insurer
112.5approving insurance. The determinations of the commissioner or county agency under this
112.6paragraph are not rules subject to chapter 14.
112.7(j) Notwithstanding paragraph (b), for the period from July 1, 2010, to June 30,
112.82015, the parental contribution shall be computed by applying the following contribution
112.9schedule to the adjusted gross income of the natural or adoptive parents:
112.10(1) if the adjusted gross income is equal to or greater than 100 percent of federal
112.11poverty guidelines and less than 175 percent of federal poverty guidelines, the parental
112.12contribution is $4 per month;
112.13(2) if the adjusted gross income is equal to or greater than 175 percent of federal
112.14poverty guidelines and less than or equal to 525 percent of federal poverty guidelines,
112.15the parental contribution shall be determined using a sliding fee scale established by the
112.16commissioner of human services which begins at one percent of adjusted gross income
112.17at 175 percent of federal poverty guidelines and increases to eight percent of adjusted
112.18gross income for those with adjusted gross income up to 525 percent of federal poverty
112.19guidelines;
112.20(3) if the adjusted gross income is greater than 525 percent of federal poverty
112.21guidelines and less than 675 percent of federal poverty guidelines, the parental
112.22contribution shall be 9.5 percent of adjusted gross income;
112.23(4) if the adjusted gross income is equal to or greater than 675 percent of federal
112.24poverty guidelines and less than 900 percent of federal poverty guidelines, the parental
112.25contribution shall be determined using a sliding fee scale established by the commissioner
112.26of human services which begins at 9.5 percent of adjusted gross income at 675 percent of
112.27federal poverty guidelines and increases to 12 percent of adjusted gross income for those
112.28with adjusted gross income up to 900 percent of federal poverty guidelines; and
112.29(5) if the adjusted gross income is equal to or greater than 900 percent of federal
112.30poverty guidelines, the parental contribution shall be 13.5 percent of adjusted gross
112.31income. If the child lives with the parent, the annual adjusted gross income is reduced by
112.32$2,400 prior to calculating the parental contribution. If the child resides in an institution
112.33specified in section 256B.35, the parent is responsible for the personal needs allowance
112.34specified under that section in addition to the parental contribution determined under this
112.35section. The parental contribution is reduced by any amount required to be paid directly to
112.36the child pursuant to a court order, but only if actually paid.
113.1EFFECTIVE DATE.Paragraph (b) is effective January 1, 2014. Paragraph (j)
113.2is effective July 1, 2013.

113.3    Sec. 23. Minnesota Statutes 2012, section 256.98, subdivision 8, is amended to read:
113.4    Subd. 8. Disqualification from program. (a) Any person found to be guilty of
113.5wrongfully obtaining assistance by a federal or state court or by an administrative hearing
113.6determination, or waiver thereof, through a disqualification consent agreement, or as part
113.7of any approved diversion plan under section 401.065, or any court-ordered stay which
113.8carries with it any probationary or other conditions, in the Minnesota family investment
113.9program and any affiliated program to include the diversionary work program and the
113.10work participation cash benefit program, the food stamp or food support program, the
113.11general assistance program, the group residential housing program, or the Minnesota
113.12supplemental aid program shall be disqualified from that program. In addition, any person
113.13disqualified from the Minnesota family investment program shall also be disqualified from
113.14the food stamp or food support program. The needs of that individual shall not be taken
113.15into consideration in determining the grant level for that assistance unit:
113.16(1) for one year after the first offense;
113.17(2) for two years after the second offense; and
113.18(3) permanently after the third or subsequent offense.
113.19The period of program disqualification shall begin on the date stipulated on the
113.20advance notice of disqualification without possibility of postponement for administrative
113.21stay or administrative hearing and shall continue through completion unless and until the
113.22findings upon which the sanctions were imposed are reversed by a court of competent
113.23jurisdiction. The period for which sanctions are imposed is not subject to review. The
113.24sanctions provided under this subdivision are in addition to, and not in substitution
113.25for, any other sanctions that may be provided for by law for the offense involved. A
113.26disqualification established through hearing or waiver shall result in the disqualification
113.27period beginning immediately unless the person has become otherwise ineligible for
113.28assistance. If the person is ineligible for assistance, the disqualification period begins
113.29when the person again meets the eligibility criteria of the program from which they were
113.30disqualified and makes application for that program.
113.31(b) A family receiving assistance through child care assistance programs under
113.32chapter 119B with a family member who is found to be guilty of wrongfully obtaining child
113.33care assistance by a federal court, state court, or an administrative hearing determination
113.34or waiver, through a disqualification consent agreement, as part of an approved diversion
113.35plan under section 401.065, or a court-ordered stay with probationary or other conditions,
114.1is disqualified from child care assistance programs. The disqualifications must be for
114.2periods of three months, six months, and one year and two years for the first, and
114.3 second, and third offenses, respectively. Subsequent violations must result in permanent
114.4disqualification. During the disqualification period, disqualification from any child care
114.5program must extend to all child care programs and must be immediately applied.
114.6(c) A provider caring for children receiving assistance through child care assistance
114.7programs under chapter 119B is disqualified from receiving payment for child care
114.8services from the child care assistance program under chapter 119B when the provider is
114.9found to have wrongfully obtained child care assistance by a federal court, state court,
114.10or an administrative hearing determination or waiver under section 256.046, through
114.11a disqualification consent agreement, as part of an approved diversion plan under
114.12section 401.065, or a court-ordered stay with probationary or other conditions. The
114.13disqualification must be for a period of one year for the first offense and two years for
114.14the second offense. Any subsequent violation must result in permanent disqualification.
114.15The disqualification period must be imposed immediately after a determination is made
114.16under this paragraph. During the disqualification period, the provider is disqualified from
114.17receiving payment from any child care program under chapter 119B.
114.18(d) Any person found to be guilty of wrongfully obtaining general assistance
114.19medical care, MinnesotaCare for adults without children, and upon federal approval, all
114.20categories of medical assistance and remaining categories of MinnesotaCare, except
114.21for children through age 18, by a federal or state court or by an administrative hearing
114.22determination, or waiver thereof, through a disqualification consent agreement, or as part
114.23of any approved diversion plan under section 401.065, or any court-ordered stay which
114.24carries with it any probationary or other conditions, is disqualified from that program. The
114.25period of disqualification is one year after the first offense, two years after the second
114.26offense, and permanently after the third or subsequent offense. The period of program
114.27disqualification shall begin on the date stipulated on the advance notice of disqualification
114.28without possibility of postponement for administrative stay or administrative hearing
114.29and shall continue through completion unless and until the findings upon which the
114.30sanctions were imposed are reversed by a court of competent jurisdiction. The period for
114.31which sanctions are imposed is not subject to review. The sanctions provided under this
114.32subdivision are in addition to, and not in substitution for, any other sanctions that may be
114.33provided for by law for the offense involved.
114.34EFFECTIVE DATE.This section is effective February 3, 2014.

114.35    Sec. 24. Minnesota Statutes 2012, section 256J.08, subdivision 24, is amended to read:
115.1    Subd. 24. Disregard. "Disregard" means earned income that is not counted when
115.2determining initial eligibility in the initial income test in section 256J.21, subdivision 3,
115.3 or income that is not counted when determining ongoing eligibility and calculating the
115.4amount of the assistance payment for participants. The commissioner shall determine
115.5the amount of the disregard according to section 256J.24, subdivision 10 for ongoing
115.6eligibility shall be 50 percent of gross earned income.
115.7EFFECTIVE DATE.This section is effective October 1, 2014, or upon approval
115.8from the United States Department of Agriculture, whichever is later.

115.9    Sec. 25. Minnesota Statutes 2012, section 256J.21, subdivision 2, is amended to read:
115.10    Subd. 2. Income exclusions. The following must be excluded in determining a
115.11family's available income:
115.12    (1) payments for basic care, difficulty of care, and clothing allowances received for
115.13providing family foster care to children or adults under Minnesota Rules, parts 9555.5050
115.14to 9555.6265, 9560.0521, and 9560.0650 to 9560.0655, and payments received and used
115.15for care and maintenance of a third-party beneficiary who is not a household member;
115.16    (2) reimbursements for employment training received through the Workforce
115.17Investment Act of 1998, United States Code, title 20, chapter 73, section 9201;
115.18    (3) reimbursement for out-of-pocket expenses incurred while performing volunteer
115.19services, jury duty, employment, or informal carpooling arrangements directly related to
115.20employment;
115.21    (4) all educational assistance, except the county agency must count graduate student
115.22teaching assistantships, fellowships, and other similar paid work as earned income and,
115.23after allowing deductions for any unmet and necessary educational expenses, shall
115.24count scholarships or grants awarded to graduate students that do not require teaching
115.25or research as unearned income;
115.26    (5) loans, regardless of purpose, from public or private lending institutions,
115.27governmental lending institutions, or governmental agencies;
115.28    (6) loans from private individuals, regardless of purpose, provided an applicant or
115.29participant documents that the lender expects repayment;
115.30    (7)(i) state income tax refunds; and
115.31    (ii) federal income tax refunds;
115.32    (8)(i) federal earned income credits;
115.33    (ii) Minnesota working family credits;
115.34    (iii) state homeowners and renters credits under chapter 290A; and
115.35    (iv) federal or state tax rebates;
116.1    (9) funds received for reimbursement, replacement, or rebate of personal or real
116.2property when these payments are made by public agencies, awarded by a court, solicited
116.3through public appeal, or made as a grant by a federal agency, state or local government,
116.4or disaster assistance organizations, subsequent to a presidential declaration of disaster;
116.5    (10) the portion of an insurance settlement that is used to pay medical, funeral, and
116.6burial expenses, or to repair or replace insured property;
116.7    (11) reimbursements for medical expenses that cannot be paid by medical assistance;
116.8    (12) payments by a vocational rehabilitation program administered by the state
116.9under chapter 268A, except those payments that are for current living expenses;
116.10    (13) in-kind income, including any payments directly made by a third party to a
116.11provider of goods and services;
116.12    (14) assistance payments to correct underpayments, but only for the month in which
116.13the payment is received;
116.14    (15) payments for short-term emergency needs under section 256J.626, subdivision 2;
116.15    (16) funeral and cemetery payments as provided by section 256.935;
116.16    (17) nonrecurring cash gifts of $30 or less, not exceeding $30 per participant in
116.17a calendar month;
116.18    (18) any form of energy assistance payment made through Public Law 97-35,
116.19Low-Income Home Energy Assistance Act of 1981, payments made directly to energy
116.20providers by other public and private agencies, and any form of credit or rebate payment
116.21issued by energy providers;
116.22    (19) Supplemental Security Income (SSI), including retroactive SSI payments and
116.23other income of an SSI recipient, except as described in section 256J.37, subdivision 3b;
116.24    (20) Minnesota supplemental aid, including retroactive payments;
116.25    (21) proceeds from the sale of real or personal property;
116.26    (22) state adoption assistance payments under section 259.67, and up to an equal
116.27amount of county adoption assistance payments;
116.28    (23) state-funded family subsidy program payments made under section 252.32 to
116.29help families care for children with developmental disabilities, consumer support grant
116.30funds under section 256.476, and resources and services for a disabled household member
116.31under one of the home and community-based waiver services programs under chapter 256B;
116.32    (24) interest payments and dividends from property that is not excluded from and
116.33that does not exceed the asset limit;
116.34    (25) rent rebates;
117.1    (26) income earned by a minor caregiver, minor child through age 6, or a minor
117.2child who is at least a half-time student in an approved elementary or secondary education
117.3program;
117.4    (27) income earned by a caregiver under age 20 who is at least a half-time student in
117.5an approved elementary or secondary education program;
117.6    (28) MFIP child care payments under section 119B.05;
117.7    (29) all other payments made through MFIP to support a caregiver's pursuit of
117.8greater economic stability;
117.9    (30) income a participant receives related to shared living expenses;
117.10    (31) reverse mortgages;
117.11    (32) benefits provided by the Child Nutrition Act of 1966, United States Code, title
117.1242, chapter 13A, sections 1771 to 1790;
117.13    (33) benefits provided by the women, infants, and children (WIC) nutrition program,
117.14United States Code, title 42, chapter 13A, section 1786;
117.15    (34) benefits from the National School Lunch Act, United States Code, title 42,
117.16chapter 13, sections 1751 to 1769e;
117.17    (35) relocation assistance for displaced persons under the Uniform Relocation
117.18Assistance and Real Property Acquisition Policies Act of 1970, United States Code, title
117.1942, chapter 61, subchapter II, section 4636, or the National Housing Act, United States
117.20Code, title 12, chapter 13, sections 1701 to 1750jj;
117.21    (36) benefits from the Trade Act of 1974, United States Code, title 19, chapter
117.2212, part 2, sections 2271 to 2322;
117.23    (37) war reparations payments to Japanese Americans and Aleuts under United
117.24States Code, title 50, sections 1989 to 1989d;
117.25    (38) payments to veterans or their dependents as a result of legal settlements
117.26regarding Agent Orange or other chemical exposure under Public Law 101-239, section
117.2710405, paragraph (a)(2)(E);
117.28    (39) income that is otherwise specifically excluded from MFIP consideration in
117.29federal law, state law, or federal regulation;
117.30    (40) security and utility deposit refunds;
117.31    (41) American Indian tribal land settlements excluded under Public Laws 98-123,
117.3298-124, and 99-377 to the Mississippi Band Chippewa Indians of White Earth, Leech
117.33Lake, and Mille Lacs reservations and payments to members of the White Earth Band,
117.34under United States Code, title 25, chapter 9, section 331, and chapter 16, section 1407;
118.1    (42) all income of the minor parent's parents and stepparents when determining the
118.2grant for the minor parent in households that include a minor parent living with parents or
118.3stepparents on MFIP with other children;
118.4    (43) income of the minor parent's parents and stepparents equal to 200 percent of the
118.5federal poverty guideline for a family size not including the minor parent and the minor
118.6parent's child in households that include a minor parent living with parents or stepparents
118.7not on MFIP when determining the grant for the minor parent. The remainder of income is
118.8deemed as specified in section 256J.37, subdivision 1b;
118.9    (44) payments made to children eligible for relative custody assistance under section
118.10257.85 ;
118.11    (45) vendor payments for goods and services made on behalf of a client unless the
118.12client has the option of receiving the payment in cash;
118.13    (46) the principal portion of a contract for deed payment; and
118.14    (47) cash payments to individuals enrolled for full-time service as a volunteer under
118.15AmeriCorps programs including AmeriCorps VISTA, AmeriCorps State, AmeriCorps
118.16National, and AmeriCorps NCCC; and
118.17    (48) housing assistance grants under section 256J.35, paragraph (a).

118.18    Sec. 26. Minnesota Statutes 2012, section 256J.21, subdivision 3, is amended to read:
118.19    Subd. 3. Initial income test. The county agency shall determine initial eligibility
118.20by considering all earned and unearned income that is not excluded under subdivision 2.
118.21To be eligible for MFIP, the assistance unit's countable income minus the disregards in
118.22paragraphs (a) and (b) must be below the transitional standard of assistance family wage
118.23level according to section 256J.24 for that size assistance unit.
118.24(a) The initial eligibility determination must disregard the following items:
118.25(1) the employment disregard is 18 percent of the gross earned income whether or
118.26not the member is working full time or part time;
118.27(2) dependent care costs must be deducted from gross earned income for the actual
118.28amount paid for dependent care up to a maximum of $200 per month for each child less
118.29than two years of age, and $175 per month for each child two years of age and older under
118.30this chapter and chapter 119B;
118.31(3) all payments made according to a court order for spousal support or the support
118.32of children not living in the assistance unit's household shall be disregarded from the
118.33income of the person with the legal obligation to pay support, provided that, if there has
118.34been a change in the financial circumstances of the person with the legal obligation to pay
119.1support since the support order was entered, the person with the legal obligation to pay
119.2support has petitioned for a modification of the support order; and
119.3(4) an allocation for the unmet need of an ineligible spouse or an ineligible child
119.4under the age of 21 for whom the caregiver is financially responsible and who lives with
119.5the caregiver according to section 256J.36.
119.6(b) Notwithstanding paragraph (a), when determining initial eligibility for applicant
119.7units when at least one member has received MFIP in this state within four months of
119.8the most recent application for MFIP, apply the disregard as defined in section 256J.08,
119.9subdivision 24
, for all unit members.
119.10After initial eligibility is established, the assistance payment calculation is based on
119.11the monthly income test.
119.12EFFECTIVE DATE.This section is effective October 1, 2014, or upon approval
119.13from the United States Department of Agriculture, whichever is later.

119.14    Sec. 27. Minnesota Statutes 2012, section 256J.24, subdivision 5, is amended to read:
119.15    Subd. 5. MFIP transitional standard. The MFIP transitional standard is based
119.16on the number of persons in the assistance unit eligible for both food and cash assistance
119.17unless the restrictions in subdivision 6 on the birth of a child apply. The amount of the
119.18transitional standard is published annually by the Department of Human Services.
119.19EFFECTIVE DATE.This section is effective January 1, 2015.

119.20    Sec. 28. Minnesota Statutes 2012, section 256J.24, subdivision 7, is amended to read:
119.21    Subd. 7. Family wage level. The family wage level is 110 percent of the transitional
119.22standard under subdivision 5 or 6, when applicable, and is the standard used when there is
119.23earned income in the assistance unit. As specified in section 256J.21. If there is earned
119.24income in the assistance unit, earned income is subtracted from the family wage level to
119.25determine the amount of the assistance payment, as specified in section 256J.21. The
119.26assistance payment may not exceed the transitional standard under subdivision 5 or 6,
119.27or the shared household standard under subdivision 9, whichever is applicable, for the
119.28assistance unit.
119.29EFFECTIVE DATE.This section is effective October 1, 2014, or upon approval
119.30from the United States Department of Agriculture, whichever is later.

120.1    Sec. 29. Minnesota Statutes 2012, section 256J.35, is amended to read:
120.2256J.35 AMOUNT OF ASSISTANCE PAYMENT.
120.3Except as provided in paragraphs (a) to (c) (d), the amount of an assistance payment
120.4is equal to the difference between the MFIP standard of need or the Minnesota family
120.5wage level in section 256J.24 and countable income.
120.6(a) Beginning July 1, 2015, MFIP assistance units are eligible for an MFIP housing
120.7assistance grant of $110 per month, unless:
120.8(1) the housing assistance unit is currently receiving public and assisted rental
120.9subsidies provided through the Department of Housing and Urban Development (HUD)
120.10and is subject to section 256J.37, subdivision 3a; or
120.11(2) the assistance unit is a child-only case under section 256J.88.
120.12(a) (b) When MFIP eligibility exists for the month of application, the amount of
120.13the assistance payment for the month of application must be prorated from the date of
120.14application or the date all other eligibility factors are met for that applicant, whichever is
120.15later. This provision applies when an applicant loses at least one day of MFIP eligibility.
120.16(b) (c) MFIP overpayments to an assistance unit must be recouped according to
120.17section 256J.38, subdivision 4.
120.18(c) (d) An initial assistance payment must not be made to an applicant who is not
120.19eligible on the date payment is made.

120.20    Sec. 30. Minnesota Statutes 2012, section 256J.621, is amended to read:
120.21256J.621 WORK PARTICIPATION CASH BENEFITS.
120.22    Subdivision 1. Program characteristics. (a) Effective October 1, 2009, upon
120.23exiting the diversionary work program (DWP) or upon terminating the Minnesota family
120.24investment program with earnings, a participant who is employed may be eligible for work
120.25participation cash benefits of $25 per month to assist in meeting the family's basic needs
120.26as the participant continues to move toward self-sufficiency.
120.27    (b) To be eligible for work participation cash benefits, the participant shall not
120.28receive MFIP or diversionary work program assistance during the month and the
120.29participant or participants must meet the following work requirements:
120.30    (1) if the participant is a single caregiver and has a child under six years of age, the
120.31participant must be employed at least 87 hours per month;
120.32    (2) if the participant is a single caregiver and does not have a child under six years of
120.33age, the participant must be employed at least 130 hours per month; or
120.34    (3) if the household is a two-parent family, at least one of the parents must be
120.35employed 130 hours per month.
121.1    Whenever a participant exits the diversionary work program or is terminated from
121.2MFIP and meets the other criteria in this section, work participation cash benefits are
121.3available for up to 24 consecutive months.
121.4    (c) Expenditures on the program are maintenance of effort state funds under
121.5a separate state program for participants under paragraph (b), clauses (1) and (2).
121.6Expenditures for participants under paragraph (b), clause (3), are nonmaintenance of effort
121.7funds. Months in which a participant receives work participation cash benefits under this
121.8section do not count toward the participant's MFIP 60-month time limit.
121.9    Subd. 2. Program suspension. (a) Effective December 1, 2014, the work
121.10participation cash benefits program shall be suspended.
121.11(b) The commissioner of human services may reinstate the work participation cash
121.12benefits program if the United States Department of Human Services determines that the
121.13state of Minnesota did not meet the federal TANF work participation rate and sends a
121.14notice of penalty to reduce Minnesota's federal TANF block grant authorized under title I
121.15of Public Law 104-193, the Personal Responsibility and Work Opportunity Reconciliation
121.16Act of 1996, and under Public Law 109-171, the Deficit Reduction Act of 2005.
121.17(c) The commissioner shall notify the chairs and ranking minority members of the
121.18legislative committees with jurisdiction over human services policy and finance of the
121.19potential penalty and the commissioner's plans to reinstate the work participation cash
121.20benefit program within 30 days of the date the commissioner receives notification that
121.21the state failed to meet the federal work participation rate.

121.22    Sec. 31. Minnesota Statutes 2012, section 256J.626, subdivision 7, is amended to read:
121.23    Subd. 7. Performance base funds. (a) For the purpose of this section, the following
121.24terms have the meanings given.
121.25(1) "Caseload Reduction Credit" (CRC) means the measure of how much Minnesota
121.26TANF and separate state program caseload has fallen relative to federal fiscal year 2005
121.27based on caseload data from October 1 to September 30.
121.28(2) "TANF participation rate target" means a 50 percent participation rate reduced by
121.29the CRC for the previous year.
121.30(b) (a) For calendar year 2010 2016 and yearly thereafter, each county and tribe will
121.31 must be allocated 95 100 percent of their initial calendar year allocation. Allocations for
121.32counties and tribes will must be allocated additional funds adjusted based on performance
121.33as follows:
121.34    (1) a county or tribe that achieves the TANF participation rate target or a five
121.35percentage point improvement over the previous year's TANF participation rate under
122.1section 256J.751, subdivision 2, clause (7), as averaged across 12 consecutive months for
122.2the most recent year for which the measurements are available, will receive an additional
122.3allocation equal to 2.5 percent of its initial allocation;
122.4    (2) (1) a county or tribe that performs within or above its range of expected
122.5performance on the annualized three-year self-support index under section 256J.751,
122.6subdivision 2
, clause (6), will must receive an additional allocation equal to 2.5 percent of
122.7its initial allocation; and
122.8    (3) a county or tribe that does not achieve the TANF participation rate target or
122.9a five percentage point improvement over the previous year's TANF participation rate
122.10under section 256J.751, subdivision 2, clause (7), as averaged across 12 consecutive
122.11months for the most recent year for which the measurements are available, will not
122.12receive an additional 2.5 percent of its initial allocation until after negotiating a multiyear
122.13improvement plan with the commissioner; or
122.14    (4) (2) a county or tribe that does not perform within or above performs below its
122.15range of expected performance on the annualized three-year self-support index under
122.16section 256J.751, subdivision 2, clause (6), will not receive an additional allocation equal
122.17to 2.5 percent of its initial allocation until after negotiating for two consecutive years must
122.18negotiate a multiyear improvement plan with the commissioner. If no improvement is
122.19shown by the end of the multiyear plan, the county's or tribe's allocation must be decreased
122.20by 2.5 percent. The decrease must remain in effect until the county or tribe performs
122.21within or above its range of expected performance.
122.22    (c) (b) For calendar year 2009 2016 and yearly thereafter, performance-based funds
122.23for a federally approved tribal TANF program in which the state and tribe have in place a
122.24contract under section 256.01, addressing consolidated funding, will must be allocated
122.25as follows:
122.26    (1) a tribe that achieves the participation rate approved in its federal TANF plan
122.27using the average of 12 consecutive months for the most recent year for which the
122.28measurements are available, will receive an additional allocation equal to 2.5 percent of
122.29its initial allocation; and
122.30    (2) (1) a tribe that performs within or above its range of expected performance on the
122.31annualized three-year self-support index under section 256J.751, subdivision 2, clause (6),
122.32will must receive an additional allocation equal to 2.5 percent of its initial allocation; or
122.33    (3) a tribe that does not achieve the participation rate approved in its federal TANF
122.34plan using the average of 12 consecutive months for the most recent year for which the
122.35measurements are available, will not receive an additional allocation equal to 2.5 percent
123.1of its initial allocation until after negotiating a multiyear improvement plan with the
123.2commissioner; or
123.3    (4) (2) a tribe that does not perform within or above performs below its range of
123.4expected performance on the annualized three-year self-support index under section
123.5256J.751, subdivision 2 , clause (6), will not receive an additional allocation equal to
123.62.5 percent until after negotiating for two consecutive years must negotiate a multiyear
123.7improvement plan with the commissioner. If no improvement is shown by the end of the
123.8multiyear plan, the tribe's allocation must be decreased by 2.5 percent. The decrease must
123.9remain in effect until the tribe performs within or above its range of expected performance.
123.10    (d) (c) Funds remaining unallocated after the performance-based allocations
123.11in paragraph (b) (a) are available to the commissioner for innovation projects under
123.12subdivision 5.
123.13     (1) (d) If available funds are insufficient to meet county and tribal allocations under
123.14paragraph paragraphs (a) and (b), the commissioner may make available for allocation
123.15funds that are unobligated and available from the innovation projects through the end of
123.16the current biennium shall proportionally prorate funds to counties and tribes that qualify
123.17for a bonus under paragraphs (a), clause (1), and (b), clause (2).
123.18    (2) If after the application of clause (1) funds remain insufficient to meet county and
123.19tribal allocations under paragraph (b), the commissioner must proportionally reduce the
123.20allocation of each county and tribe with respect to their maximum allocation available
123.21under paragraph (b).

123.22    Sec. 32. [256J.78] TANF DEMONSTRATION PROJECTS OR WAIVER FROM
123.23FEDERAL RULES AND REGULATIONS.
123.24    Subdivision 1. Duties of the commissioner. The commissioner of human services
123.25may pursue TANF demonstration projects or waivers of TANF requirements from the
123.26United States Department of Health and Human Services as needed to allow the state to
123.27build a more results-oriented Minnesota Family Investment Program to better meet the
123.28needs of Minnesota families.
123.29    Subd. 2. Purpose. The purpose of the TANF demonstration projects or waivers is to:
123.30(1) replace the federal TANF process measure and its complex administrative
123.31requirements with state-developed outcomes measures that track adult employment and
123.32exits from MFIP cash assistance;
123.33(2) simplify programmatic and administrative requirements; and
123.34(3) make other policy or programmatic changes that improve the performance of the
123.35program and the outcomes for participants.
124.1    Subd. 3. Report to legislature. The commissioner shall report to the members of
124.2the legislative committees having jurisdiction over human services issues by March 1,
124.32014, regarding the progress of this waiver or demonstration project.
124.4EFFECTIVE DATE.This section is effective the day following final enactment.

124.5    Sec. 33. Minnesota Statutes 2012, section 256K.45, is amended to read:
124.6256K.45 RUNAWAY AND HOMELESS YOUTH ACT.
124.7    Subdivision 1. Grant program established. The commissioner of human services
124.8shall establish a Homeless Youth Act fund and award grants to providers who are
124.9committed to serving homeless youth and youth at risk of homelessness, to provide
124.10street and community outreach and drop-in programs, emergency shelter programs,
124.11and integrated supportive housing and transitional living programs, consistent with the
124.12program descriptions in this act to reduce the incidence of homelessness among youth.
124.13    Subdivision 1. Subd. 1a. Definitions. (a) The definitions in this subdivision apply
124.14to this section.
124.15(b) "Commissioner" means the commissioner of human services.
124.16(c) "Homeless youth" means a person 21 years of age or younger who is
124.17unaccompanied by a parent or guardian and is without shelter where appropriate care and
124.18supervision are available, whose parent or legal guardian is unable or unwilling to provide
124.19shelter and care, or who lacks a fixed, regular, and adequate nighttime residence. The
124.20following are not fixed, regular, or adequate nighttime residences:
124.21(1) a supervised publicly or privately operated shelter designed to provide temporary
124.22living accommodations;
124.23(2) an institution or a publicly or privately operated shelter designed to provide
124.24temporary living accommodations;
124.25(3) transitional housing;
124.26(4) a temporary placement with a peer, friend, or family member that has not offered
124.27permanent residence, a residential lease, or temporary lodging for more than 30 days; or
124.28(5) a public or private place not designed for, nor ordinarily used as, a regular
124.29sleeping accommodation for human beings.
124.30Homeless youth does not include persons incarcerated or otherwise detained under
124.31federal or state law.
124.32(d) "Youth at risk of homelessness" means a person 21 years of age or younger
124.33whose status or circumstances indicate a significant danger of experiencing homelessness
124.34in the near future. Status or circumstances that indicate a significant danger may include:
125.1(1) youth exiting out-of-home placements; (2) youth who previously were homeless; (3)
125.2youth whose parents or primary caregivers are or were previously homeless; (4) youth
125.3who are exposed to abuse and neglect in their homes; (5) youth who experience conflict
125.4with parents due to chemical or alcohol dependency, mental health disabilities, or other
125.5disabilities; and (6) runaways.
125.6(e) "Runaway" means an unmarried child under the age of 18 years who is absent
125.7from the home of a parent or guardian or other lawful placement without the consent of
125.8the parent, guardian, or lawful custodian.
125.9    Subd. 2. Homeless and runaway youth report. The commissioner shall develop a
125.10 report for homeless youth, youth at risk of homelessness, and runaways. The report shall
125.11include coordination of services as defined under subdivisions 3 to 5 prepare a biennial
125.12report, beginning in February 2015, which provides meaningful information to the
125.13legislative committees having jurisdiction over the issue of homeless youth, that includes,
125.14but is not limited to: (1) a list of the areas of the state with the greatest need for services
125.15and housing for homeless youth, and the level and nature of the needs identified; (2) details
125.16about grants made; (3) the distribution of funds throughout the state based on population
125.17need; (4) follow-up information, if available, on the status of homeless youth and whether
125.18they have stable housing two years after services are provided; and (5) any other outcomes
125.19for populations served to determine the effectiveness of the programs and use of funding.
125.20    Subd. 3. Street and community outreach and drop-in program. Youth drop-in
125.21centers must provide walk-in access to crisis intervention and ongoing supportive services
125.22including one-to-one case management services on a self-referral basis. Street and
125.23community outreach programs must locate, contact, and provide information, referrals,
125.24and services to homeless youth, youth at risk of homelessness, and runaways. Information,
125.25referrals, and services provided may include, but are not limited to:
125.26(1) family reunification services;
125.27(2) conflict resolution or mediation counseling;
125.28(3) assistance in obtaining temporary emergency shelter;
125.29(4) assistance in obtaining food, clothing, medical care, or mental health counseling;
125.30(5) counseling regarding violence, prostitution sexual exploitation, substance abuse,
125.31sexually transmitted diseases, and pregnancy;
125.32(6) referrals to other agencies that provide support services to homeless youth,
125.33youth at risk of homelessness, and runaways;
125.34(7) assistance with education, employment, and independent living skills;
125.35(8) aftercare services;
126.1(9) specialized services for highly vulnerable runaways and homeless youth,
126.2including teen parents, emotionally disturbed and mentally ill youth, and sexually
126.3exploited youth; and
126.4(10) homelessness prevention.
126.5    Subd. 4. Emergency shelter program. (a) Emergency shelter programs must
126.6provide homeless youth and runaways with referral and walk-in access to emergency,
126.7short-term residential care. The program shall provide homeless youth and runaways with
126.8safe, dignified shelter, including private shower facilities, beds, and at least one meal each
126.9day; and shall assist a runaway and homeless youth with reunification with the family or
126.10legal guardian when required or appropriate.
126.11(b) The services provided at emergency shelters may include, but are not limited to:
126.12(1) family reunification services;
126.13(2) individual, family, and group counseling;
126.14(3) assistance obtaining clothing;
126.15(4) access to medical and dental care and mental health counseling;
126.16(5) education and employment services;
126.17(6) recreational activities;
126.18(7) advocacy and referral services;
126.19(8) independent living skills training;
126.20(9) aftercare and follow-up services;
126.21(10) transportation; and
126.22(11) homelessness prevention.
126.23    Subd. 5. Supportive housing and transitional living programs. Transitional
126.24living programs must help homeless youth and youth at risk of homelessness to find and
126.25maintain safe, dignified housing. The program may also provide rental assistance and
126.26related supportive services, or refer youth to other organizations or agencies that provide
126.27such services. Services provided may include, but are not limited to:
126.28(1) educational assessment and referrals to educational programs;
126.29(2) career planning, employment, work skill training, and independent living skills
126.30training;
126.31(3) job placement;
126.32(4) budgeting and money management;
126.33(5) assistance in securing housing appropriate to needs and income;
126.34(6) counseling regarding violence, prostitution sexual exploitation, substance abuse,
126.35sexually transmitted diseases, and pregnancy;
126.36(7) referral for medical services or chemical dependency treatment;
127.1(8) parenting skills;
127.2(9) self-sufficiency support services or life skill training;
127.3(10) aftercare and follow-up services; and
127.4(11) homelessness prevention.
127.5    Subd. 6. Funding. Any Funds appropriated for this section may be expended on
127.6programs described under subdivisions 3 to 5, technical assistance, and capacity building.
127.7Up to four percent of funds appropriated may be used for the purpose of monitoring and
127.8evaluating runaway and homeless youth programs receiving funding under this section.
127.9Funding shall be directed to meet the greatest need, with a significant share of the funding
127.10focused on homeless youth providers in greater Minnesota to meet the greatest need
127.11on a statewide basis.

127.12    Sec. 34. Minnesota Statutes 2012, section 256M.40, subdivision 1, is amended to read:
127.13    Subdivision 1. Formula. The commissioner shall allocate state funds appropriated
127.14under this chapter to each county board on a calendar year basis in an amount determined
127.15according to the formula in paragraphs (a) to (e).
127.16(a) For calendar years 2011 and 2012, the commissioner shall allocate available
127.17funds to each county in proportion to that county's share in calendar year 2010.
127.18(b) For calendar year 2013 and each calendar year thereafter, the commissioner shall
127.19allocate available funds to each county as follows:
127.20(1) 75 percent must be distributed on the basis of the county share in calendar year
127.212012;
127.22(2) five percent must be distributed on the basis of the number of persons residing in
127.23the county as determined by the most recent data of the state demographer;
127.24(3) ten percent must be distributed on the basis of the number of vulnerable children
127.25that are subjects of reports under chapter 260C and sections 626.556 and 626.5561, and in
127.26the county as determined by the most recent data of the commissioner; and
127.27(4) ten percent must be distributed on the basis of the number of vulnerable adults
127.28that are subjects of reports under section 626.557 in the county as determined by the most
127.29recent data of the commissioner.
127.30(c) For calendar year 2014, the commissioner shall allocate available funds to each
127.31county as follows:
127.32(1) 50 percent must be distributed on the basis of the county share in calendar year
127.332012;
127.34(2) Ten percent must be distributed on the basis of the number of persons residing in
127.35the county as determined by the most recent data of the state demographer;
128.1(3) 20 percent must be distributed on the basis of the number of vulnerable children
128.2that are subjects of reports under chapter 260C and sections 626.556 and 626.5561, in the
128.3county as determined by the most recent data of the commissioner; and
128.4(4) 20 percent must be distributed on the basis of the number of vulnerable adults
128.5that are subjects of reports under section 626.557 in the county as determined by the
128.6most recent data of the commissioner The commissioner is precluded from changing the
128.7formula under this subdivision or recommending a change to the legislature without
128.8public review and input.
128.9(d) For calendar year 2015, the commissioner shall allocate available funds to each
128.10county as follows:
128.11(1) 25 percent must be distributed on the basis of the county share in calendar year
128.122012;
128.13(2) 15 percent must be distributed on the basis of the number of persons residing in
128.14the county as determined by the most recent data of the state demographer;
128.15(3) 30 percent must be distributed on the basis of the number of vulnerable children
128.16that are subjects of reports under chapter 260C and sections 626.556 and 626.5561, in the
128.17county as determined by the most recent data of the commissioner; and
128.18(4) 30 percent must be distributed on the basis of the number of vulnerable adults
128.19that are subjects of reports under section 626.557 in the county as determined by the most
128.20recent data of the commissioner.
128.21(e) For calendar year 2016 and each calendar year thereafter, the commissioner shall
128.22allocate available funds to each county as follows:
128.23(1) 20 percent must be distributed on the basis of the number of persons residing in
128.24the county as determined by the most recent data of the state demographer;
128.25(2) 40 percent must be distributed on the basis of the number of vulnerable children
128.26that are subjects of reports under chapter 260C and sections 626.556 and 626.5561, in the
128.27county as determined by the most recent data of the commissioner; and
128.28(3) 40 percent must be distributed on the basis of the number of vulnerable adults
128.29that are subjects of reports under section 626.557 in the county as determined by the most
128.30recent data of the commissioner.

128.31    Sec. 35. Minnesota Statutes 2012, section 257.0755, subdivision 1, is amended to read:
128.32    Subdivision 1. Creation. One Each ombudsperson shall operate independently from
128.33but in collaboration with each of the following groups the community-specific board that
128.34appointed the ombudsperson under section 257.0768: the Indian Affairs Council, the
129.1Council on Affairs of Chicano/Latino people, the Council on Black Minnesotans, and
129.2the Council on Asian-Pacific Minnesotans.

129.3    Sec. 36. Minnesota Statutes 2012, section 259A.20, subdivision 4, is amended to read:
129.4    Subd. 4. Reimbursement for special nonmedical expenses. (a) Reimbursement
129.5for special nonmedical expenses is available to children, except those eligible for adoption
129.6assistance based on being an at-risk child.
129.7(b) Reimbursements under this paragraph shall be made only after the adoptive
129.8parent documents that the requested service was denied by the local social service agency,
129.9community agencies, the local school district, the local public health department, the
129.10parent's insurance provider, or the child's program. The denial must be for an eligible
129.11service or qualified item under the program requirements of the applicable agency or
129.12organization.
129.13(c) Reimbursements must be previously authorized, adhere to the requirements and
129.14procedures prescribed by the commissioner, and be limited to:
129.15(1) child care for a child age 12 and younger, or for a child age 13 or 14 who has a
129.16documented disability that requires special instruction for and services by the child care
129.17provider. Child care reimbursements may be made if all available adult caregivers are
129.18employed, unemployed due to a disability as defined in section 259A.01, subdivision 14,
129.19 or attending educational or vocational training programs. Documentation from a qualified
129.20expert that is dated within the last 12 months must be provided to verify the disability. If a
129.21parent is attending an educational or vocational training program, child care reimbursement
129.22is limited to no more than the time necessary to complete the credit requirements for an
129.23associate or baccalaureate degree as determined by the educational institution. Child
129.24care reimbursement is not limited for an adoptive parent completing basic or remedial
129.25education programs needed to prepare for postsecondary education or employment;
129.26(2) respite care provided for the relief of the child's parent up to 504 hours of respite
129.27care annually;
129.28(3) camping up to 14 days per state fiscal year for a child to attend a special needs
129.29camp. The camp must be accredited by the American Camp Association as a special needs
129.30camp in order to be eligible for camp reimbursement;
129.31(4) postadoption counseling to promote the child's integration into the adoptive
129.32family that is provided by the placing agency during the first year following the date of the
129.33adoption decree. Reimbursement is limited to 12 sessions of postadoption counseling;
129.34(5) family counseling that is required to meet the child's special needs.
129.35Reimbursement is limited to the prorated portion of the counseling fees allotted to the
130.1family when the adoptive parent's health insurance or Medicaid pays for the child's
130.2counseling but does not cover counseling for the rest of the family members;
130.3(6) home modifications to accommodate the child's special needs upon which
130.4eligibility for adoption assistance was approved. Reimbursement is limited to once every
130.5five years per child;
130.6(7) vehicle modifications to accommodate the child's special needs upon which
130.7eligibility for adoption assistance was approved. Reimbursement is limited to once every
130.8five years per family; and
130.9(8) burial expenses up to $1,000, if the special needs, upon which eligibility for
130.10adoption assistance was approved, resulted in the death of the child.
130.11(d) The adoptive parent shall submit statements for expenses incurred between July
130.121 and June 30 of a given fiscal year to the state adoption assistance unit within 60 days
130.13after the end of the fiscal year in order for reimbursement to occur.

130.14    Sec. 37. Minnesota Statutes 2012, section 260B.007, subdivision 6, is amended to read:
130.15    Subd. 6. Delinquent child. (a) Except as otherwise provided in paragraphs (b)
130.16and (c), "delinquent child" means a child:
130.17(1) who has violated any state or local law, except as provided in section 260B.225,
130.18subdivision 1
, and except for juvenile offenders as described in subdivisions 16 to 18;
130.19(2) who has violated a federal law or a law of another state and whose case has been
130.20referred to the juvenile court if the violation would be an act of delinquency if committed
130.21in this state or a crime or offense if committed by an adult;
130.22(3) who has escaped from confinement to a state juvenile correctional facility after
130.23being committed to the custody of the commissioner of corrections; or
130.24(4) who has escaped from confinement to a local juvenile correctional facility after
130.25being committed to the facility by the court.
130.26(b) The term delinquent child does not include a child alleged to have committed
130.27murder in the first degree after becoming 16 years of age, but the term delinquent child
130.28does include a child alleged to have committed attempted murder in the first degree.
130.29(c) The term delinquent child does not include a child under the age of 16 years
130.30 alleged to have engaged in conduct which would, if committed by an adult, violate any
130.31federal, state, or local law relating to being hired, offering to be hired, or agreeing to be
130.32hired by another individual to engage in sexual penetration or sexual conduct.
130.33EFFECTIVE DATE.This section is effective August 1, 2014, and applies to
130.34offenses committed on or after that date.

131.1    Sec. 38. Minnesota Statutes 2012, section 260B.007, subdivision 16, is amended to read:
131.2    Subd. 16. Juvenile petty offender; juvenile petty offense. (a) "Juvenile petty
131.3offense" includes a juvenile alcohol offense, a juvenile controlled substance offense,
131.4a violation of section 609.685, or a violation of a local ordinance, which by its terms
131.5prohibits conduct by a child under the age of 18 years which would be lawful conduct if
131.6committed by an adult.
131.7(b) Except as otherwise provided in paragraph (c), "juvenile petty offense" also
131.8includes an offense that would be a misdemeanor if committed by an adult.
131.9(c) "Juvenile petty offense" does not include any of the following:
131.10(1) a misdemeanor-level violation of section 518B.01, 588.20, 609.224, 609.2242,
131.11609.324 , subdivision 2 or 3, 609.5632, 609.576, 609.66, 609.746, 609.748, 609.79,
131.12or 617.23;
131.13(2) a major traffic offense or an adult court traffic offense, as described in section
131.14260B.225 ;
131.15(3) a misdemeanor-level offense committed by a child whom the juvenile court
131.16previously has found to have committed a misdemeanor, gross misdemeanor, or felony
131.17offense; or
131.18(4) a misdemeanor-level offense committed by a child whom the juvenile court
131.19has found to have committed a misdemeanor-level juvenile petty offense on two or
131.20more prior occasions, unless the county attorney designates the child on the petition
131.21as a juvenile petty offender notwithstanding this prior record. As used in this clause,
131.22"misdemeanor-level juvenile petty offense" includes a misdemeanor-level offense that
131.23would have been a juvenile petty offense if it had been committed on or after July 1, 1995.
131.24(d) A child who commits a juvenile petty offense is a "juvenile petty offender." The
131.25term juvenile petty offender does not include a child under the age of 16 years alleged
131.26to have violated any law relating to being hired, offering to be hired, or agreeing to be
131.27hired by another individual to engage in sexual penetration or sexual conduct which, if
131.28committed by an adult, would be a misdemeanor.
131.29EFFECTIVE DATE.This section is effective August 1, 2014, and applies to
131.30offenses committed on or after that date.

131.31    Sec. 39. Minnesota Statutes 2012, section 260C.007, subdivision 6, is amended to read:
131.32    Subd. 6. Child in need of protection or services. "Child in need of protection or
131.33services" means a child who is in need of protection or services because the child:
131.34    (1) is abandoned or without parent, guardian, or custodian;
132.1    (2)(i) has been a victim of physical or sexual abuse as defined in section 626.556,
132.2subdivision 2, (ii) resides with or has resided with a victim of child abuse as defined in
132.3subdivision 5 or domestic child abuse as defined in subdivision 13, (iii) resides with or
132.4would reside with a perpetrator of domestic child abuse as defined in subdivision 13 or
132.5child abuse as defined in subdivision 5 or 13, or (iv) is a victim of emotional maltreatment
132.6as defined in subdivision 15;
132.7    (3) is without necessary food, clothing, shelter, education, or other required care
132.8for the child's physical or mental health or morals because the child's parent, guardian,
132.9or custodian is unable or unwilling to provide that care;
132.10    (4) is without the special care made necessary by a physical, mental, or emotional
132.11condition because the child's parent, guardian, or custodian is unable or unwilling to
132.12provide that care;
132.13    (5) is medically neglected, which includes, but is not limited to, the withholding of
132.14medically indicated treatment from a disabled infant with a life-threatening condition. The
132.15term "withholding of medically indicated treatment" means the failure to respond to the
132.16infant's life-threatening conditions by providing treatment, including appropriate nutrition,
132.17hydration, and medication which, in the treating physician's or physicians' reasonable
132.18medical judgment, will be most likely to be effective in ameliorating or correcting all
132.19conditions, except that the term does not include the failure to provide treatment other
132.20than appropriate nutrition, hydration, or medication to an infant when, in the treating
132.21physician's or physicians' reasonable medical judgment:
132.22    (i) the infant is chronically and irreversibly comatose;
132.23    (ii) the provision of the treatment would merely prolong dying, not be effective in
132.24ameliorating or correcting all of the infant's life-threatening conditions, or otherwise be
132.25futile in terms of the survival of the infant; or
132.26    (iii) the provision of the treatment would be virtually futile in terms of the survival
132.27of the infant and the treatment itself under the circumstances would be inhumane;
132.28    (6) is one whose parent, guardian, or other custodian for good cause desires to be
132.29relieved of the child's care and custody, including a child who entered foster care under a
132.30voluntary placement agreement between the parent and the responsible social services
132.31agency under section 260C.227;
132.32    (7) has been placed for adoption or care in violation of law;
132.33    (8) is without proper parental care because of the emotional, mental, or physical
132.34disability, or state of immaturity of the child's parent, guardian, or other custodian;
133.1    (9) is one whose behavior, condition, or environment is such as to be injurious or
133.2dangerous to the child or others. An injurious or dangerous environment may include, but
133.3is not limited to, the exposure of a child to criminal activity in the child's home;
133.4    (10) is experiencing growth delays, which may be referred to as failure to thrive, that
133.5have been diagnosed by a physician and are due to parental neglect;
133.6    (11) has engaged in prostitution as defined in section 609.321, subdivision 9 is a
133.7sexually exploited youth;
133.8    (12) has committed a delinquent act or a juvenile petty offense before becoming
133.9ten years old;
133.10    (13) is a runaway;
133.11    (14) is a habitual truant;
133.12    (15) has been found incompetent to proceed or has been found not guilty by reason
133.13of mental illness or mental deficiency in connection with a delinquency proceeding, a
133.14certification under section 260B.125, an extended jurisdiction juvenile prosecution, or a
133.15proceeding involving a juvenile petty offense; or
133.16(16) has a parent whose parental rights to one or more other children were
133.17involuntarily terminated or whose custodial rights to another child have been involuntarily
133.18transferred to a relative and there is a case plan prepared by the responsible social services
133.19agency documenting a compelling reason why filing the termination of parental rights
133.20petition under section 260C.301, subdivision 3, is not in the best interests of the child; or.
133.21(17) is a sexually exploited youth.
133.22EFFECTIVE DATE.This section is effective August 1, 2014.

133.23    Sec. 40. Minnesota Statutes 2012, section 260C.007, subdivision 31, is amended to read:
133.24    Subd. 31. Sexually exploited youth. "Sexually exploited youth" means an
133.25individual who:
133.26(1) is alleged to have engaged in conduct which would, if committed by an adult,
133.27violate any federal, state, or local law relating to being hired, offering to be hired, or
133.28agreeing to be hired by another individual to engage in sexual penetration or sexual conduct;
133.29(2) is a victim of a crime described in section 609.342, 609.343, 609.344, 609.345,
133.30609.3451 , 609.3453, 609.352, 617.246, or 617.247;
133.31(3) is a victim of a crime described in United States Code, title 18, section 2260;
133.322421; 2422; 2423; 2425; 2425A; or 2256; or
133.33(4) is a sex trafficking victim as defined in section 609.321, subdivision 7b.
133.34EFFECTIVE DATE.This section is effective the day following final enactment.

134.1    Sec. 41. Minnesota Statutes 2012, section 518A.60, is amended to read:
134.2518A.60 COLLECTION; ARREARS ONLY.
134.3(a) Remedies available for the collection and enforcement of support in this chapter
134.4and chapters 256, 257, 518, and 518C also apply to cases in which the child or children
134.5for whom support is owed are emancipated and the obligor owes past support or has an
134.6accumulated arrearage as of the date of the youngest child's emancipation. Child support
134.7arrearages under this section include arrearages for child support, medical support, child
134.8care, pregnancy and birth expenses, and unreimbursed medical expenses as defined in
134.9section 518A.41, subdivision 1, paragraph (h).
134.10(b) This section applies retroactively to any support arrearage that accrued on or
134.11before June 3, 1997, and to all arrearages accruing after June 3, 1997.
134.12(c) Past support or pregnancy and confinement expenses ordered for which the
134.13obligor has specific court ordered terms for repayment may not be enforced using
134.14drivers' and occupational or professional license suspension, credit bureau reporting, and
134.15additional income withholding under section 518A.53, subdivision 10, paragraph (a),
134.16unless the obligor fails to comply with the terms of the court order for repayment.
134.17(d) If an arrearage exists at the time a support order would otherwise terminate
134.18and section 518A.53, subdivision 10, paragraph (c), does not apply to this section, the
134.19arrearage shall be repaid in an amount equal to the current support order until all arrears
134.20have been paid in full, absent a court order to the contrary.
134.21(e) If an arrearage exists according to a support order which fails to establish a
134.22monthly support obligation in a specific dollar amount, the public authority, if it provides
134.23child support services, or the obligee, may establish a payment agreement which shall
134.24equal what the obligor would pay for current support after application of section 518A.34,
134.25plus an additional 20 percent of the current support obligation, until all arrears have been
134.26paid in full. If the obligor fails to enter into or comply with a payment agreement, the
134.27public authority, if it provides child support services, or the obligee, may move the district
134.28court or child support magistrate, if section 484.702 applies, for an order establishing
134.29repayment terms.
134.30(f) If there is no longer a current support order because all of the children of the
134.31order are emancipated, the public authority may discontinue child support services and
134.32close its case under title IV-D of the Social Security Act if:
134.33(1) the arrearage is under $500; or
134.34(2) the arrearage is considered unenforceable by the public authority because there
134.35have been no collections for three years, and all administrative and legal remedies have
134.36been attempted or are determined by the public authority to be ineffective because the
135.1obligor is unable to pay, the obligor has no known income or assets, and there is no
135.2reasonable prospect that the obligor will be able to pay in the foreseeable future.
135.3    (g) At least 60 calendar days before the discontinuation of services under paragraph
135.4(f), the public authority must mail a written notice to the obligee and obligor at the
135.5obligee's and obligor's last known addresses that the public authority intends to close the
135.6child support enforcement case and explaining each party's rights. Seven calendar days
135.7after the first notice is mailed, the public authority must mail a second notice under this
135.8paragraph to the obligee.
135.9    (h) The case must be kept open if the obligee responds before case closure and
135.10provides information that could reasonably lead to collection of arrears. If the case is
135.11closed, the obligee may later request that the case be reopened by completing a new
135.12application for services, if there is a change in circumstances that could reasonably lead to
135.13the collection of arrears.

135.14    Sec. 42. Laws 1998, chapter 407, article 6, section 116, is amended to read:
135.15    Sec. 116. EBT TRANSACTION COSTS; APPROVAL FROM LEGISLATURE.
135.16    The commissioner of human services shall request and receive approval from the
135.17legislature before adjusting the payment to not subsidize retailers for electronic benefit
135.18transfer transaction costs Supplemental Nutrition Assistance Program transactions.
135.19EFFECTIVE DATE.This section is effective 30 days after the commissioner
135.20notifies retailers of the termination of their agreement with the state. The commissioner of
135.21human services must notify the revisor of statutes of that date.

135.22    Sec. 43. Laws 2011, First Special Session chapter 9, article 1, section 3, the effective
135.23date, is amended to read:
135.24EFFECTIVE DATE.This section is effective January 1, 2013 July 1, 2014.
135.25EFFECTIVE DATE.This section is effective retroactively from January 1, 2013.

135.26    Sec. 44. DIRECTION TO COMMISSIONERS; INCOME AND ASSET
135.27EXCLUSION.
135.28(a) The commissioner of human services shall not count conditional cash transfers
135.29made to families participating in a family independence demonstration as income or
135.30assets for purposes of determining or redetermining eligibility for child care assistance
135.31programs under Minnesota Statutes, chapter 119B; general assistance under Minnesota
135.32Statutes, chapter 256D; group residential housing under Minnesota Statutes, chapter 256I;
136.1the Minnesota family investment program, work benefit program, or diversionary work
136.2program under Minnesota Statutes, chapter 256J, during the duration of the demonstration.
136.3(b) The commissioner of human services shall not count conditional cash transfers
136.4made to families participating in a family independence demonstration as income or assets
136.5for purposes of determining or redetermining eligibility for medical assistance under
136.6Minnesota Statutes, chapter 256B, and MinnesotaCare under Minnesota Statutes, chapter
136.7256L, except that for enrollees subject to a modified adjusted gross income calculation to
136.8determine eligibility, the conditional cash transfer payments shall be counted as income if
136.9they are included on the enrollee's federal tax return as income, or if the payments can be
136.10taken into account in the month of receipt as a lump sum payment.
136.11(c) The commissioner of the Minnesota Housing Finance Agency shall not count
136.12conditional cash transfers made to families participating in a family independence
136.13demonstration as income or assets for purposes of determining or redetermining eligibility
136.14for housing assistance programs under Minnesota Statutes, section 462A.201, during
136.15the duration of the demonstration.
136.16(d) For the purposes of this section:
136.17(1) "conditional cash transfer" means a payment made to a participant in a family
136.18independence demonstration by a sponsoring organization to incent, support, or facilitate
136.19participation; and
136.20(2) "family independence demonstration" means an initiative sponsored or
136.21cosponsored by a governmental or nongovernmental organization, the goal of which is
136.22to facilitate individualized goal-setting and peer support for cohorts of no more than 12
136.23families each toward the development of financial and nonfinancial assets that enable the
136.24participating families to achieve financial independence.
136.25(e) The citizens league shall provide a report to the legislative committees having
136.26jurisdiction over human services issues by July 1, 2016, informing the legislature on the
136.27progress and outcomes of the demonstration under this section.

136.28    Sec. 45. REDUCTION OF YOUTH HOMELESSNESS.
136.29(a) The Minnesota Interagency Council on Homelessness established under the
136.30authority of Minnesota Statutes, section 462A.29, as it updates its statewide plan to
136.31prevent and end homelessness, shall make recommendations on strategies to reduce the
136.32number of youth experiencing homelessness and to prevent homelessness for youth who
136.33are at risk of becoming homeless.
136.34(b) Recommended strategies must take into consideration, to the extent feasible,
136.35issues that contribute to or reduce youth homelessness including, but not limited to, mental
137.1health, chemical dependency, trafficking of youth for sex or other purposes, exiting foster
137.2care, and involvement in gangs. The recommended strategies must include supportive
137.3services as outlined in Minnesota Statutes, section 256K.45, subdivision 5.
137.4(c) The council shall provide an update on the status of its work by December 1,
137.52014, to the legislative committees with jurisdiction over housing, homelessness, and
137.6matters pertaining to youth. If the council determines legislative action is required to
137.7implement recommended strategies, the council shall submit proposals to the legislature at
137.8the earliest possible opportunity.

137.9    Sec. 46. HOUSING ASSISTANCE GRANTS; FORECASTED PROGRAM.
137.10Beginning July 1, 2015, housing assistance grants under Minnesota Statutes, section
137.11256J.35, paragraph (a), must be a forecasted program and the commissioner, with the
137.12approval of the commissioner of management and budget, may transfer unencumbered
137.13appropriation balances within fiscal years of each biennium with other forecasted
137.14programs of the Department of Human Services. The commissioner shall inform the
137.15chairs and ranking minority members of the senate Health and Human Services Finance
137.16Division and the house of representatives Health and Human Services Finance committee
137.17quarterly about transfers made under this provision.

137.18    Sec. 47. PLAN FOR GROUP RESIDENTIAL HOUSING SPECIALTY RATE
137.19AND BANKED BEDS.
137.20The commissioner of human services, in consultation with and cooperation of the
137.21counties, shall review the statewide number and status of group residential housing beds
137.22with rates in excess of the MSA equivalent rate, including banked supplemental service
137.23rate beds. The commissioner shall study the type and amount of supplemental services
137.24delivered or planned for development, and develop a plan for rate setting criteria and
137.25an efficient use of these beds. The commissioner shall review the performance of all
137.26programs that receive supplemental service rates. The plan must require that all beds
137.27receiving supplemental service rates address critical service needs and must establish
137.28quality performance requirements for beds receiving supplemental service rates. The
137.29commissioner shall present the written plan no later than February 1, 2014, to the chairs
137.30and ranking minority members of the house of representatives and senate finance and
137.31policy committees and divisions with jurisdiction over the Department of Human Services.

137.32    Sec. 48. REPEALER.
137.33(a) Minnesota Statutes 2012, section 256J.24, is repealed January 1, 2015.
138.1(b) Minnesota Statutes 2012, section 609.093, is repealed effective the day following
138.2final enactment.

138.3ARTICLE 4
138.4STRENGTHENING CHEMICAL AND MENTAL HEALTH SERVICES

138.5    Section 1. Minnesota Statutes 2012, section 245.462, subdivision 20, is amended to read:
138.6    Subd. 20. Mental illness. (a) "Mental illness" means an organic disorder of the brain
138.7or a clinically significant disorder of thought, mood, perception, orientation, memory, or
138.8behavior that is detailed in a diagnostic codes list published by the commissioner, and that
138.9seriously limits a person's capacity to function in primary aspects of daily living such as
138.10personal relations, living arrangements, work, and recreation.
138.11    (b) An "adult with acute mental illness" means an adult who has a mental illness that
138.12is serious enough to require prompt intervention.
138.13    (c) For purposes of case management and community support services, a "person
138.14with serious and persistent mental illness" means an adult who has a mental illness and
138.15meets at least one of the following criteria:
138.16    (1) the adult has undergone two or more episodes of inpatient care for a mental
138.17illness within the preceding 24 months;
138.18    (2) the adult has experienced a continuous psychiatric hospitalization or residential
138.19treatment exceeding six months' duration within the preceding 12 months;
138.20    (3) the adult has been treated by a crisis team two or more times within the preceding
138.2124 months;
138.22    (4) the adult:
138.23    (i) has a diagnosis of schizophrenia, bipolar disorder, major depression,
138.24schizoaffective disorder, or borderline personality disorder;
138.25    (ii) indicates a significant impairment in functioning; and
138.26    (iii) has a written opinion from a mental health professional, in the last three years,
138.27stating that the adult is reasonably likely to have future episodes requiring inpatient or
138.28residential treatment, of a frequency described in clause (1) or (2), unless ongoing case
138.29management or community support services are provided;
138.30    (5) the adult has, in the last three years, been committed by a court as a person who is
138.31mentally ill under chapter 253B, or the adult's commitment has been stayed or continued; or
138.32    (6) the adult (i) was eligible under clauses (1) to (5), but the specified time period
138.33has expired or the adult was eligible as a child under section 245.4871, subdivision 6; and
138.34(ii) has a written opinion from a mental health professional, in the last three years, stating
138.35that the adult is reasonably likely to have future episodes requiring inpatient or residential
139.1treatment, of a frequency described in clause (1) or (2), unless ongoing case management
139.2or community support services are provided; or
139.3    (7) the adult was eligible as a child under section 245.4871, subdivision 6, and is
139.4age 21 or younger.

139.5    Sec. 2. Minnesota Statutes 2012, section 245.4661, subdivision 5, is amended to read:
139.6    Subd. 5. Planning for pilot projects. (a) Each local plan for a pilot project, with
139.7the exception of the placement of a Minnesota specialty treatment facility as defined in
139.8paragraph (c), must be developed under the direction of the county board, or multiple
139.9county boards acting jointly, as the local mental health authority. The planning process
139.10for each pilot shall include, but not be limited to, mental health consumers, families,
139.11advocates, local mental health advisory councils, local and state providers, representatives
139.12of state and local public employee bargaining units, and the department of human services.
139.13As part of the planning process, the county board or boards shall designate a managing
139.14entity responsible for receipt of funds and management of the pilot project.
139.15(b) For Minnesota specialty treatment facilities, the commissioner shall issue a
139.16request for proposal for regions in which a need has been identified for services.
139.17(c) For purposes of this section, "Minnesota specialty treatment facility" is defined
139.18as an intensive rehabilitative mental health service under section 256B.0622, subdivision
139.192, paragraph (b).

139.20    Sec. 3. Minnesota Statutes 2012, section 245.4661, subdivision 6, is amended to read:
139.21    Subd. 6. Duties of commissioner. (a) For purposes of the pilot projects, the
139.22commissioner shall facilitate integration of funds or other resources as needed and
139.23requested by each project. These resources may include:
139.24(1) residential services funds administered under Minnesota Rules, parts 9535.2000
139.25to 9535.3000, in an amount to be determined by mutual agreement between the project's
139.26managing entity and the commissioner of human services after an examination of the
139.27county's historical utilization of facilities located both within and outside of the county
139.28and licensed under Minnesota Rules, parts 9520.0500 to 9520.0690;
139.29(2) community support services funds administered under Minnesota Rules, parts
139.309535.1700 to 9535.1760;
139.31(3) other mental health special project funds;
139.32(4) medical assistance, general assistance medical care, MinnesotaCare and group
139.33residential housing if requested by the project's managing entity, and if the commissioner
139.34determines this would be consistent with the state's overall health care reform efforts; and
140.1(5) regional treatment center resources consistent with section 246.0136, subdivision
140.21
.; and
140.3(6) funds transferred from section 246.18, subdivision 8, for grants to providers to
140.4participate in mental health specialty treatment services, awarded to providers through
140.5a request for proposal process.
140.6(b) The commissioner shall consider the following criteria in awarding start-up and
140.7implementation grants for the pilot projects:
140.8(1) the ability of the proposed projects to accomplish the objectives described in
140.9subdivision 2;
140.10(2) the size of the target population to be served; and
140.11(3) geographical distribution.
140.12(c) The commissioner shall review overall status of the projects initiatives at least
140.13every two years and recommend any legislative changes needed by January 15 of each
140.14odd-numbered year.
140.15(d) The commissioner may waive administrative rule requirements which are
140.16incompatible with the implementation of the pilot project.
140.17(e) The commissioner may exempt the participating counties from fiscal sanctions
140.18for noncompliance with requirements in laws and rules which are incompatible with the
140.19implementation of the pilot project.
140.20(f) The commissioner may award grants to an entity designated by a county board or
140.21group of county boards to pay for start-up and implementation costs of the pilot project.

140.22    Sec. 4. Minnesota Statutes 2012, section 245.4682, subdivision 2, is amended to read:
140.23    Subd. 2. General provisions. (a) In the design and implementation of reforms to
140.24the mental health system, the commissioner shall:
140.25    (1) consult with consumers, families, counties, tribes, advocates, providers, and
140.26other stakeholders;
140.27    (2) bring to the legislature, and the State Advisory Council on Mental Health, by
140.28January 15, 2008, recommendations for legislation to update the role of counties and to
140.29clarify the case management roles, functions, and decision-making authority of health
140.30plans and counties, and to clarify county retention of the responsibility for the delivery of
140.31social services as required under subdivision 3, paragraph (a);
140.32    (3) withhold implementation of any recommended changes in case management
140.33roles, functions, and decision-making authority until after the release of the report due
140.34January 15, 2008;
141.1    (4) ensure continuity of care for persons affected by these reforms including
141.2ensuring client choice of provider by requiring broad provider networks and developing
141.3mechanisms to facilitate a smooth transition of service responsibilities;
141.4    (5) provide accountability for the efficient and effective use of public and private
141.5resources in achieving positive outcomes for consumers;
141.6    (6) ensure client access to applicable protections and appeals; and
141.7    (7) make budget transfers necessary to implement the reallocation of services and
141.8client responsibilities between counties and health care programs that do not increase the
141.9state and county costs and efficiently allocate state funds.
141.10    (b) When making transfers under paragraph (a) necessary to implement movement
141.11of responsibility for clients and services between counties and health care programs,
141.12the commissioner, in consultation with counties, shall ensure that any transfer of state
141.13grants to health care programs, including the value of case management transfer grants
141.14under section 256B.0625, subdivision 20, does not exceed the value of the services being
141.15transferred for the latest 12-month period for which data is available. The commissioner
141.16may make quarterly adjustments based on the availability of additional data during the
141.17first four quarters after the transfers first occur. If case management transfer grants under
141.18section 256B.0625, subdivision 20, are repealed and the value, based on the last year prior
141.19to repeal, exceeds the value of the services being transferred, the difference becomes an
141.20ongoing part of each county's adult and children's mental health grants under sections
141.21245.4661 , 245.4889, and 256E.12.
141.22    (c) This appropriation is not authorized to be expended after December 31, 2010,
141.23unless approved by the legislature.

141.24    Sec. 5. Minnesota Statutes 2012, section 245.4871, subdivision 26, is amended to read:
141.25    Subd. 26. Mental health practitioner. "Mental health practitioner" means a person
141.26providing services to children with emotional disturbances. A mental health practitioner
141.27must have training and experience in working with children. A mental health practitioner
141.28must be qualified in at least one of the following ways:
141.29(1) holds a bachelor's degree in one of the behavioral sciences or related fields from
141.30an accredited college or university and:
141.31(i) has at least 2,000 hours of supervised experience in the delivery of mental health
141.32services to children with emotional disturbances; or
141.33(ii) is fluent in the non-English language of the ethnic group to which at least 50
141.34percent of the practitioner's clients belong, completes 40 hours of training in the delivery
141.35of services to children with emotional disturbances, and receives clinical supervision from
142.1a mental health professional at least once a week until the requirement of 2,000 hours
142.2of supervised experience is met;
142.3(2) has at least 6,000 hours of supervised experience in the delivery of mental
142.4health services to children with emotional disturbances; hours worked as a mental health
142.5behavioral aide I or II under section 256B.0943, subdivision 7, may be included in the
142.66,000 hours of experience;
142.7(3) is a graduate student in one of the behavioral sciences or related fields and is
142.8formally assigned by an accredited college or university to an agency or facility for
142.9clinical training; or
142.10(4) holds a master's or other graduate degree in one of the behavioral sciences or
142.11related fields from an accredited college or university and has less than 4,000 hours
142.12post-master's experience in the treatment of emotional disturbance.

142.13    Sec. 6. Minnesota Statutes 2012, section 245.4875, subdivision 8, is amended to read:
142.14    Subd. 8. Transition services. The county board may continue to provide mental
142.15health services as defined in sections 245.487 to 245.4889 to persons over 18 years of
142.16age, but under 21 years of age, if the person was receiving case management or family
142.17community support services prior to age 18, and if one of the following conditions is met:
142.18(1) the person is receiving special education services through the local school
142.19district; or
142.20(2) it is in the best interest of the person to continue services defined in sections
142.21245.487 to 245.4889; or
142.22(3) the person is requesting services and the services are medically necessary.

142.23    Sec. 7. Minnesota Statutes 2012, section 245.4881, subdivision 1, is amended to read:
142.24    Subdivision 1. Availability of case management services. (a) The county board
142.25shall provide case management services for each child with severe emotional disturbance
142.26who is a resident of the county and the child's family who request or consent to the services.
142.27Case management services may be continued must be offered to be provided for a child with
142.28a serious emotional disturbance who is over the age of 18 consistent with section 245.4875,
142.29subdivision 8
, or the child's legal representative, provided the child's service needs can be
142.30met within the children's service system. Before discontinuing case management services
142.31under this subdivision for children between the ages of 17 and 21, a transition plan
142.32must be developed. The transition plan must be developed with the child and, with the
142.33consent of a child age 18 or over, the child's parent, guardian, or legal representative. The
142.34transition plan should include plans for health insurance, housing, education, employment,
143.1and treatment. Staffing ratios must be sufficient to serve the needs of the clients. The case
143.2manager must meet the requirements in section 245.4871, subdivision 4.
143.3(b) Except as permitted by law and the commissioner under demonstration projects,
143.4case management services provided to children with severe emotional disturbance eligible
143.5for medical assistance must be billed to the medical assistance program under sections
143.6256B.02, subdivision 8 , and 256B.0625.
143.7(c) Case management services are eligible for reimbursement under the medical
143.8assistance program. Costs of mentoring, supervision, and continuing education may be
143.9included in the reimbursement rate methodology used for case management services under
143.10the medical assistance program.

143.11    Sec. 8. Minnesota Statutes 2012, section 246.18, subdivision 8, is amended to read:
143.12    Subd. 8. State-operated services account. (a) The state-operated services account is
143.13established in the special revenue fund. Revenue generated by new state-operated services
143.14listed under this section established after July 1, 2010, that are not enterprise activities must
143.15be deposited into the state-operated services account, unless otherwise specified in law:
143.16(1) intensive residential treatment services;
143.17(2) foster care services; and
143.18(3) psychiatric extensive recovery treatment services.
143.19(b) Funds deposited in the state-operated services account are available to the
143.20commissioner of human services for the purposes of:
143.21(1) providing services needed to transition individuals from institutional settings
143.22within state-operated services to the community when those services have no other
143.23adequate funding source;
143.24(2) grants to providers participating in mental health specialty treatment services
143.25under section 245.4661; and
143.26(3) to fund the operation of the Intensive Residential Treatment Service program in
143.27Willmar.

143.28    Sec. 9. Minnesota Statutes 2012, section 246.18, is amended by adding a subdivision
143.29to read:
143.30    Subd. 9. Transfers. The commissioner may transfer state mental health grant funds
143.31to the account in subdivision 8 for noncovered allowable costs of a provider certified and
143.32licensed under section 256B.0622 and operating under section 246.014.

144.1    Sec. 10. Minnesota Statutes 2012, section 246.54, is amended to read:
144.2246.54 LIABILITY OF COUNTY; REIMBURSEMENT.
144.3    Subdivision 1. County portion for cost of care. (a) Except for chemical
144.4dependency services provided under sections 254B.01 to 254B.09, the client's county
144.5shall pay to the state of Minnesota a portion of the cost of care provided in a regional
144.6treatment center or a state nursing facility to a client legally settled in that county. A
144.7county's payment shall be made from the county's own sources of revenue and payments
144.8shall equal a percentage of the cost of care, as determined by the commissioner, for each
144.9day, or the portion thereof, that the client spends at a regional treatment center or a state
144.10nursing facility according to the following schedule:
144.11    (1) zero percent for the first 30 days;
144.12    (2) 20 percent for days 31 to 60; and
144.13    (3) 50 75 percent for any days over 60.
144.14    (b) The increase in the county portion for cost of care under paragraph (a), clause
144.15(3), shall be imposed when the treatment facility has determined that it is clinically
144.16appropriate for the client to be discharged.
144.17    (c) If payments received by the state under sections 246.50 to 246.53 exceed 80
144.18percent of the cost of care for days 31 to 60, or 50 25 percent for days over 60, the county
144.19shall be responsible for paying the state only the remaining amount. The county shall
144.20not be entitled to reimbursement from the client, the client's estate, or from the client's
144.21relatives, except as provided in section 246.53.
144.22    Subd. 2. Exceptions. (a) Subdivision 1 does not apply to services provided at the
144.23Minnesota Security Hospital or the Minnesota extended treatment options program. For
144.24services at these facilities the Minnesota Security Hospital, a county's payment shall be
144.25made from the county's own sources of revenue and payments shall be paid as follows:.
144.26Excluding the state-operated forensic transition service, payments to the state from the
144.27county shall equal ten percent of the cost of care, as determined by the commissioner, for
144.28each day, or the portion thereof, that the client spends at the facility. For the state-operated
144.29forensic transition service, payments to the state from the county shall equal 50 percent of
144.30the cost of care, as determined by the commissioner, for each day, or the portion thereof,
144.31that the client spends in the program. If payments received by the state under sections
144.32246.50 to 246.53 for services provided at the Minnesota Security Hospital, excluding the
144.33state-operated forensic transition service, exceed 90 percent of the cost of care, the county
144.34shall be responsible for paying the state only the remaining amount. If payments received
144.35by the state under sections 246.50 to 246.53 for the state-operated forensic transition service
144.36exceed 50 percent of the cost of care, the county shall be responsible for paying the state
145.1only the remaining amount. The county shall not be entitled to reimbursement from the
145.2client, the client's estate, or from the client's relatives, except as provided in section 246.53.
145.3    (b) Regardless of the facility to which the client is committed, subdivision 1 does
145.4not apply to the following individuals:
145.5    (1) clients who are committed as mentally ill and dangerous under section 253B.02,
145.6subdivision 17;
145.7    (2) (1) clients who are committed as sexual psychopathic personalities under section
145.8253B.02, subdivision 18b ; and
145.9    (3) (2) clients who are committed as sexually dangerous persons under section
145.10253B.02 , subdivision 18c.
145.11    For each of the individuals in clauses (1) to (3), the payment by the county to the state
145.12shall equal ten percent of the cost of care for each day as determined by the commissioner.

145.13    Sec. 11. Minnesota Statutes 2012, section 253B.10, subdivision 1, is amended to read:
145.14    Subdivision 1. Administrative requirements. (a) When a person is committed,
145.15the court shall issue a warrant or an order committing the patient to the custody of the
145.16head of the treatment facility. The warrant or order shall state that the patient meets the
145.17statutory criteria for civil commitment.
145.18(b) The commissioner shall prioritize patients being admitted from jail or a
145.19correctional institution who are:
145.20(1) ordered confined in a state hospital for an examination under Minnesota Rules of
145.21Criminal Procedure, rules 20.01, subdivision 4, paragraph (a), and 20.02, subdivision 2;
145.22(2) under civil commitment for competency treatment and continuing supervision
145.23under Minnesota Rules of Criminal Procedure, rule 20.01, subdivision 7;
145.24(3) found not guilty by reason of mental illness under Minnesota Rules of Criminal
145.25Procedure, rule 20.02, subdivision 8, and under civil commitment or are ordered to be
145.26detained in a state hospital or other facility pending completion of the civil commitment
145.27proceedings; or
145.28(4) committed under this chapter to the commissioner after dismissal of the patient's
145.29criminal charges.
145.30Patients described in this paragraph must be admitted to a service operated by the
145.31commissioner within 48 hours. The commitment must be ordered by the court as provided
145.32in section 253B.09, subdivision 1, paragraph (c).
145.33(c) Upon the arrival of a patient at the designated treatment facility, the head of the
145.34facility shall retain the duplicate of the warrant and endorse receipt upon the original
145.35warrant or acknowledge receipt of the order. The endorsed receipt or acknowledgment
146.1must be filed in the court of commitment. After arrival, the patient shall be under the
146.2control and custody of the head of the treatment facility.
146.3(d) Copies of the petition for commitment, the court's findings of fact and
146.4conclusions of law, the court order committing the patient, the report of the examiners,
146.5and the prepetition report shall be provided promptly to the treatment facility.

146.6    Sec. 12. Minnesota Statutes 2012, section 254B.13, is amended to read:
146.7254B.13 PILOT PROJECTS; CHEMICAL HEALTH CARE.
146.8    Subdivision 1. Authorization for navigator pilot projects. The commissioner may
146.9approve and implement navigator pilot projects developed under the planning process
146.10required under Laws 2009, chapter 79, article 7, section 26, to provide alternatives to and
146.11enhance coordination of the delivery of chemical health services required under section
146.12254B.03 .
146.13    Subd. 2. Program design and implementation. (a) The commissioner and
146.14counties participating in the navigator pilot projects shall continue to work in partnership
146.15to refine and implement the navigator pilot projects initiated under Laws 2009, chapter
146.1679, article 7, section 26.
146.17(b) The commissioner and counties participating in the navigator pilot projects shall
146.18complete the planning phase by June 30, 2010, and, if approved by the commissioner for
146.19implementation, enter into agreements governing the operation of the navigator pilot
146.20projects with implementation scheduled no earlier than July 1, 2010.
146.21    Subd. 2a. Eligibility for navigator pilot program. (a) To be considered for
146.22participation in a navigator pilot program, an individual must:
146.23(1) be a resident of a county with an approved navigator program;
146.24(2) be eligible for consolidated chemical dependency treatment fund services;
146.25(3) be a voluntary participant in the navigator program;
146.26(4) satisfy one of the following items:
146.27(i) have at least one severity rating of three or above in dimension four, five, or six in
146.28a comprehensive assessment under Minnesota Rules, part 9530.6422; or
146.29(ii) have at least one severity rating of two or above in dimension four, five, or six in
146.30a comprehensive assessment under Minnesota Rules, part 9530.6422, and be currently
146.31participating in a Rule 31 treatment program under Minnesota Rules, parts 9530.6405 to
146.329530.6505, or be within 60 days following discharge after participation in a Rule 31
146.33treatment program; and
146.34(5) have had at least two treatment episodes in the past two years, not limited
146.35to episodes reimbursed by the consolidated chemical dependency treatment funds. An
147.1admission to an emergency room, a detoxification program, or a hospital may be substituted
147.2for one treatment episode if it resulted from the individual's substance use disorder.
147.3(b) New eligibility criteria may be added as mutually agreed upon by the
147.4commissioner and participating navigator programs.
147.5    Subd. 3. Program evaluation. The commissioner shall evaluate navigator pilot
147.6projects under this section and report the results of the evaluation to the chairs and
147.7ranking minority members of the legislative committees with jurisdiction over chemical
147.8health issues by January 15, 2014. Evaluation of the navigator pilot projects must be
147.9based on outcome evaluation criteria negotiated with the navigator pilot projects prior
147.10to implementation.
147.11    Subd. 4. Notice of navigator pilot project discontinuation. Each county's
147.12participation in the navigator pilot project may be discontinued for any reason by the county
147.13or the commissioner of human services after 30 days' written notice to the other party.
147.14Any unspent funds held for the exiting county's pro rata share in the special revenue fund
147.15under the authority in subdivision 5, paragraph (d), shall be transferred to the consolidated
147.16chemical dependency treatment fund following discontinuation of the pilot project.
147.17    Subd. 5. Duties of commissioner. (a) Notwithstanding any other provisions in
147.18this chapter, the commissioner may authorize navigator pilot projects to use chemical
147.19dependency treatment funds to pay for nontreatment navigator pilot services:
147.20(1) in addition to those authorized under section 254B.03, subdivision 2, paragraph
147.21(a); and
147.22(2) by vendors in addition to those authorized under section 254B.05 when not
147.23providing chemical dependency treatment services.
147.24(b) For purposes of this section, "nontreatment navigator pilot services" include
147.25navigator services, peer support, family engagement and support, housing support, rent
147.26subsidies, supported employment, and independent living skills.
147.27(c) State expenditures for chemical dependency services and nontreatment navigator
147.28pilot services provided by or through the navigator pilot projects must not be greater than
147.29the chemical dependency treatment fund expected share of forecasted expenditures in the
147.30absence of the navigator pilot projects. The commissioner may restructure the schedule of
147.31payments between the state and participating counties under the local agency share and
147.32division of cost provisions under section 254B.03, subdivisions 3 and 4, as necessary to
147.33facilitate the operation of the navigator pilot projects.
147.34(d) To the extent that state fiscal year expenditures within a pilot project are less
147.35than the expected share of forecasted expenditures in the absence of the pilot projects,
147.36the commissioner shall deposit the unexpended funds in a separate account within the
148.1consolidated chemical dependency treatment fund, and make these funds available for
148.2expenditure by the pilot projects the following year. To the extent that treatment and
148.3nontreatment pilot services expenditures within the pilot project exceed the amount
148.4expected in the absence of the pilot projects, the pilot project county or counties are
148.5responsible for the portion of nontreatment pilot services expenditures in excess of the
148.6otherwise expected share of forecasted expenditures.
148.7(e) (d) The commissioner may waive administrative rule requirements that are
148.8incompatible with the implementation of the navigator pilot project, except that any
148.9chemical dependency treatment funded under this section must continue to be provided
148.10by a licensed treatment provider.
148.11(f) (e) The commissioner shall not approve or enter into any agreement related to
148.12navigator pilot projects authorized under this section that puts current or future federal
148.13funding at risk.
148.14(f) The commissioner shall provide participating navigator pilot projects with
148.15transactional data, reports, provider data, and other data generated by county activity to
148.16assess and measure outcomes. This information must be transmitted or made available in
148.17an acceptable form to participating navigator pilot projects at least once every six months
148.18or within a reasonable time following the commissioner's receipt of information from the
148.19counties needed to comply with this paragraph.
148.20    Subd. 6. Duties of county board. The county board, or other county entity that
148.21is approved to administer a navigator pilot project, shall:
148.22(1) administer the navigator pilot project in a manner consistent with the objectives
148.23described in subdivision 2 and the planning process in subdivision 5;
148.24(2) ensure that no one is denied chemical dependency treatment services for which
148.25they would otherwise be eligible under section 254A.03, subdivision 3; and
148.26(3) provide the commissioner with timely and pertinent information as negotiated in
148.27agreements governing operation of the navigator pilot projects.
148.28    Subd. 7. Managed care. An individual who is eligible for the navigator pilot
148.29program under subdivision 2a is excluded from mandatory enrollment in managed care
148.30until these services are included in the health plan's benefit set.
148.31    Subd. 8. Authorization for continuation of navigator pilots. The navigator pilot
148.32projects implemented pursuant to subdivision 1 are authorized to continue operation after
148.33July 1, 2013, under existing agreements governing operation of the pilot projects.
148.34EFFECTIVE DATE.The amendments to subdivisions 1 to 6 and 8 are effective
148.35August 1, 2013. Subdivision 7 is effective July 1, 2013.

149.1    Sec. 13. [254B.14] CONTINUUM OF CARE PILOT PROJECTS; CHEMICAL
149.2HEALTH CARE.
149.3    Subdivision 1. Authorization for continuum of care pilot projects. The
149.4commissioner shall establish chemical dependency continuum of care pilot projects to
149.5begin implementing the measures developed with stakeholder input and identified in the
149.6report completed pursuant to Laws 2012, chapter 247, article 5, section 8. The pilot
149.7projects are intended to improve the effectiveness and efficiency of the service continuum
149.8for chemically dependent individuals in Minnesota while reducing duplication of efforts
149.9and promoting scientifically supported practices.
149.10    Subd. 2. Program implementation. (a) The commissioner, in coordination with
149.11representatives of the Minnesota Association of County Social Service Administrators
149.12and the Minnesota Inter-County Association, shall develop a process for identifying and
149.13selecting interested counties and providers for participation in the continuum of care pilot
149.14projects. There shall be three pilot projects; one representing the northern region, one for
149.15the metro region, and one for the southern region. The selection process of counties and
149.16providers must include consideration of population size, geographic distribution, cultural
149.17and racial demographics, and provider accessibility. The commissioner shall identify
149.18counties and providers that are selected for participation in the continuum of care pilot
149.19projects no later than September 30, 2013.
149.20(b) The commissioner and entities participating in the continuum of care pilot
149.21projects shall enter into agreements governing the operation of the continuum of care pilot
149.22projects. The agreements shall identify pilot project outcomes and include timelines for
149.23implementation and beginning operation of the pilot projects.
149.24(c) Entities that are currently participating in the navigator pilot project are
149.25eligible to participate in the continuum of care pilot project subsequent to or instead of
149.26participating in the navigator pilot project.
149.27(d) The commissioner may waive administrative rule requirements that are
149.28incompatible with implementation of the continuum of care pilot projects.
149.29(e) Notwithstanding section 254A.19, the commissioner may designate noncounty
149.30entities to complete chemical use assessments and placement authorizations required
149.31under section 254A.19 and Minnesota Rules, parts 9530.6600 to 9530.6655. Section
149.32254A.19, subdivision 3, is applicable to the continuum of care pilot projects at the
149.33discretion of the commissioner.
149.34    Subd. 3. Program design. (a) The operation of the pilot projects shall include:
149.35(1) new services that are responsive to the chronic nature of substance use disorder;
149.36(2) telehealth services, when appropriate to address barriers to services;
150.1(3) services that assure integration with the mental health delivery system when
150.2appropriate;
150.3(4) services that address the needs of diverse populations; and
150.4(5) an assessment and access process that permits clients to present directly to a
150.5service provider for a substance use disorder assessment and authorization of services.
150.6(b) Prior to implementation of the continuum of care pilot projects, a utilization
150.7review process must be developed and agreed to by the commissioner, participating
150.8counties, and providers. The utilization review process shall be described in the
150.9agreements governing operation of the continuum of care pilot projects.
150.10    Subd. 4. Notice of project discontinuation. Each entity's participation in the
150.11continuum of care pilot project may be discontinued for any reason by the county or the
150.12commissioner after 30 days' written notice to the entity.
150.13    Subd. 5. Duties of commissioner. (a) Notwithstanding any other provisions in this
150.14chapter, the commissioner may authorize chemical dependency treatment funds to pay for
150.15nontreatment services arranged by continuum of care pilot projects. Individuals who are
150.16currently accessing Rule 31 treatment services are eligible for concurrent participation in
150.17the continuum of care pilot projects.
150.18(b) County expenditures for continuum of care pilot project services shall not
150.19be greater than their expected share of forecasted expenditures in the absence of the
150.20continuum of care pilot projects.
150.21    Subd. 6. Managed care. An individual who is eligible for the continuum of care
150.22pilot project is excluded from mandatory enrollment in managed care unless these services
150.23are included in the health plan's benefit set.
150.24EFFECTIVE DATE.This section is effective August 1, 2013.

150.25    Sec. 14. [256.478] HOME AND COMMUNITY-BASED SERVICES
150.26TRANSITIONS GRANTS.
150.27(a) The commissioner shall make available home and community-based services
150.28transition grants to serve individuals who do not meet eligibility criteria for the medical
150.29assistance program under section 256B.056 or 256B.057, but who otherwise meet the
150.30criteria under section 256B.092, subdivision 13, or 256B.49, subdivision 24.
150.31(b) For the purposes of this section, the commissioner has the authority to transfer
150.32funds between the medical assistance account and the home and community-based
150.33services transitions grants account.
150.34EFFECTIVE DATE.This section is effective July 1, 2013.

151.1    Sec. 15. [256B.0616] MENTAL HEALTH CERTIFIED FAMILY PEER
151.2SPECIALIST.
151.3    Subdivision 1. Scope. Medical assistance covers mental health certified family peer
151.4specialists services, as established in subdivision 2, subject to federal approval, if provided
151.5to recipients who have an emotional disturbance or severe emotional disturbance under
151.6chapter 245, and are provided by a certified family peer specialist who has completed the
151.7training under subdivision 5. A family peer specialist cannot provide services to the
151.8peer specialist's family.
151.9    Subd. 2. Establishment. The commissioner of human services shall establish a
151.10certified family peer specialists program model which:
151.11(1) provides nonclinical family peer support counseling, building on the strengths
151.12of families and helping them achieve desired outcomes;
151.13(2) collaborates with others providing care or support to the family;
151.14(3) provides nonadversarial advocacy;
151.15(4) promotes the individual family culture in the treatment milieu;
151.16(5) links parents to other parents in the community;
151.17(6) offers support and encouragement;
151.18(7) assists parents in developing coping mechanisms and problem-solving skills;
151.19(8) promotes resiliency, self-advocacy, development of natural supports, and
151.20maintenance of skills learned in other support services;
151.21(9) establishes and provides peer led parent support groups; and
151.22(10) increases the child's ability to function better within the child's home, school,
151.23and community by educating parents on community resources, assisting with problem
151.24solving, and educating parents on mental illnesses.
151.25    Subd. 3. Eligibility. Family peer support services may be located in inpatient
151.26hospitalization, partial hospitalization, residential treatment, treatment foster care, day
151.27treatment, children's therapeutic services and supports, or crisis services.
151.28    Subd. 4. Peer support specialist program providers. The commissioner shall
151.29develop a process to certify family peer support specialist programs, in accordance with
151.30the federal guidelines, in order for the program to bill for reimbursable services. Family
151.31peer support programs must operate within an existing mental health community provider
151.32or center.
151.33    Subd. 5. Certified family peer specialist training and certification. The
151.34commissioner shall develop a training and certification process for certified family peer
151.35specialists who must be at least 21 years of age and have a high school diploma or its
151.36equivalent. The candidates must have raised or are currently raising a child with a mental
152.1illness, have had experience navigating the children's mental health system, and must
152.2demonstrate leadership and advocacy skills and a strong dedication to family-driven and
152.3family-focused services. The training curriculum must teach participating family peer
152.4specialists specific skills relevant to providing peer support to other parents. In addition
152.5to initial training and certification, the commissioner shall develop ongoing continuing
152.6educational workshops on pertinent issues related to family peer support counseling.

152.7    Sec. 16. Minnesota Statutes 2012, section 256B.0623, subdivision 2, is amended to read:
152.8    Subd. 2. Definitions. For purposes of this section, the following terms have the
152.9meanings given them.
152.10(a) "Adult rehabilitative mental health services" means mental health services
152.11which are rehabilitative and enable the recipient to develop and enhance psychiatric
152.12stability, social competencies, personal and emotional adjustment, and independent living,
152.13parenting skills, and community skills, when these abilities are impaired by the symptoms
152.14of mental illness. Adult rehabilitative mental health services are also appropriate when
152.15provided to enable a recipient to retain stability and functioning, if the recipient would
152.16be at risk of significant functional decompensation or more restrictive service settings
152.17without these services.
152.18(1) Adult rehabilitative mental health services instruct, assist, and support the
152.19recipient in areas such as: interpersonal communication skills, community resource
152.20utilization and integration skills, crisis assistance, relapse prevention skills, health care
152.21directives, budgeting and shopping skills, healthy lifestyle skills and practices, cooking
152.22and nutrition skills, transportation skills, medication education and monitoring, mental
152.23illness symptom management skills, household management skills, employment-related
152.24skills, parenting skills, and transition to community living services.
152.25(2) These services shall be provided to the recipient on a one-to-one basis in the
152.26recipient's home or another community setting or in groups.
152.27(b) "Medication education services" means services provided individually or in
152.28groups which focus on educating the recipient about mental illness and symptoms; the role
152.29and effects of medications in treating symptoms of mental illness; and the side effects of
152.30medications. Medication education is coordinated with medication management services
152.31and does not duplicate it. Medication education services are provided by physicians,
152.32pharmacists, physician's assistants, or registered nurses.
152.33(c) "Transition to community living services" means services which maintain
152.34continuity of contact between the rehabilitation services provider and the recipient and
152.35which facilitate discharge from a hospital, residential treatment program under Minnesota
153.1Rules, chapter 9505, board and lodging facility, or nursing home. Transition to community
153.2living services are not intended to provide other areas of adult rehabilitative mental health
153.3services.

153.4    Sec. 17. Minnesota Statutes 2012, section 256B.0625, subdivision 48, is amended to
153.5read:
153.6    Subd. 48. Psychiatric consultation to primary care practitioners. Effective
153.7January 1, 2006, Medical assistance covers consultation provided by a psychiatrist, a
153.8psychologist, or an advanced practice registered nurse certified in psychiatric mental
153.9health via telephone, e-mail, facsimile, or other means of communication to primary care
153.10practitioners, including pediatricians. The need for consultation and the receipt of the
153.11consultation must be documented in the patient record maintained by the primary care
153.12practitioner. If the patient consents, and subject to federal limitations and data privacy
153.13provisions, the consultation may be provided without the patient present.

153.14    Sec. 18. Minnesota Statutes 2012, section 256B.0625, subdivision 56, is amended to
153.15read:
153.16    Subd. 56. Medical service coordination. (a)(1) Medical assistance covers in-reach
153.17community-based service coordination that is performed through a hospital emergency
153.18department as an eligible procedure under a state healthcare program for a frequent user.
153.19A frequent user is defined as an individual who has frequented the hospital emergency
153.20department for services three or more times in the previous four consecutive months.
153.21In-reach community-based service coordination includes navigating services to address a
153.22client's mental health, chemical health, social, economic, and housing needs, or any other
153.23activity targeted at reducing the incidence of emergency room and other nonmedically
153.24necessary health care utilization.
153.25(2) Medical assistance covers in-reach community-based service coordination that
153.26is performed through a hospital emergency department or inpatient psychiatric unit
153.27for a child or young adult up to age 21 with a serious emotional disturbance who has
153.28frequented the hospital emergency room two or more times in the previous consecutive
153.29three months or been admitted to an inpatient psychiatric unit two or more times in the
153.30previous consecutive four months, or is being discharged to a shelter.
153.31    (b) Reimbursement must be made in 15-minute increments and allowed for up to 60
153.32days posthospital discharge based upon the specific identified emergency department visit
153.33or inpatient admitting event. In-reach community-based service coordination shall seek to
153.34connect frequent users with existing covered services available to them, including, but not
154.1limited to, targeted case management, waiver case management, or care coordination in a
154.2health care home. For children and young adults with a serious emotional disturbance,
154.3in-reach community-based service coordination includes navigating and arranging for
154.4community-based services prior to discharge to address a client's mental health, chemical
154.5health, social, educational, family support and housing needs, or any other activity targeted
154.6at reducing multiple incidents of emergency room use, inpatient readmissions, and other
154.7nonmedically necessary health care utilization. In-reach services shall seek to connect
154.8them with existing covered services, including targeted case management, waiver case
154.9management, care coordination in a health care home, children's therapeutic services and
154.10supports, crisis services, and respite care. Eligible in-reach service coordinators must hold
154.11a minimum of a bachelor's degree in social work, public health, corrections, or a related
154.12field. The commissioner shall submit any necessary application for waivers to the Centers
154.13for Medicare and Medicaid Services to implement this subdivision.
154.14    (c)(1) For the purposes of this subdivision, "in-reach community-based service
154.15coordination" means the practice of a community-based worker with training, knowledge,
154.16skills, and ability to access a continuum of services, including housing, transportation,
154.17chemical and mental health treatment, employment, education, and peer support services,
154.18by working with an organization's staff to transition an individual back into the individual's
154.19living environment. In-reach community-based service coordination includes working
154.20with the individual during their discharge and for up to a defined amount of time in the
154.21individual's living environment, reducing the individual's need for readmittance.
154.22    (2) Hospitals utilizing in-reach service coordinators shall report annually to the
154.23commissioner on the number of adults, children, and adolescents served; the postdischarge
154.24services which they accessed; and emergency department/psychiatric hospitalization
154.25readmissions. The commissioner shall ensure that services and payments provided under
154.26in-reach care coordination do not duplicate services or payments provided under section
154.27256B.0753, 256B.0755, or 256B.0625, subdivision 20.

154.28    Sec. 19. Minnesota Statutes 2012, section 256B.0625, is amended by adding a
154.29subdivision to read:
154.30    Subd. 61. Family psychoeducation services. Effective July 1, 2013, or upon
154.31federal approval, whichever is later, medical assistance covers family psychoeducation
154.32services provided to a child up to age 21 with a diagnosed mental health condition when
154.33identified in the child's individual treatment plan and provided by a licensed mental health
154.34professional, as defined in Minnesota Rules, part 9505.0371, subpart 5, item A, or a
154.35clinical trainee, as defined in Minnesota Rules, part 9505.0371, subpart 5, item C, who
155.1has determined it medically necessary to involve family members in the child's care. For
155.2the purposes of this subdivision, "family psychoeducation services" means information
155.3or demonstration provided to an individual or family as part of an individual, family,
155.4multifamily group, or peer group session to explain, educate, and support the child and
155.5family in understanding a child's symptoms of mental illness, the impact on the child's
155.6development, and needed components of treatment and skill development so that the
155.7individual, family, or group can help the child to prevent relapse, prevent the acquisition
155.8of comorbid disorders, and achieve optimal mental health and long-term resilience.

155.9    Sec. 20. Minnesota Statutes 2012, section 256B.0625, is amended by adding a
155.10subdivision to read:
155.11    Subd. 62. Mental health clinical care consultation. Effective July 1, 2013, or upon
155.12federal approval, whichever is later, medical assistance covers clinical care consultation
155.13for a person up to age 21 who is diagnosed with a complex mental health condition or a
155.14mental health condition that co-occurs with other complex and chronic conditions, when
155.15described in the person's individual treatment plan and provided by a licensed mental health
155.16professional, as defined in Minnesota Rules, part 9505.0371, subpart 5, item A, or a clinical
155.17trainee, as defined in Minnesota Rules, part 9505.0371, subpart 5, item C. For the purposes
155.18of this subdivision, "clinical care consultation" means communication from a treating
155.19mental health professional to other providers or educators not under the clinical supervision
155.20of the treating mental health professional who are working with the same client to inform,
155.21inquire, and instruct regarding the client's symptoms; strategies for effective engagement,
155.22care, and intervention needs; and treatment expectations across service settings; and to
155.23direct and coordinate clinical service components provided to the client and family.

155.24    Sec. 21. Minnesota Statutes 2012, section 256B.092, is amended by adding a
155.25subdivision to read:
155.26    Subd. 13. Waiver allocations for transition populations. (a) The commissioner
155.27shall make available additional waiver allocations and additional necessary resources
155.28to assure timely discharges from the Anoka Metro Regional Treatment Center and the
155.29Minnesota Security Hospital in St. Peter for individuals who meet the following criteria:
155.30(1) are otherwise eligible for the developmental disabilities waiver under this section;
155.31(2) who would otherwise remain at the Anoka Metro Regional Treatment Center or
155.32the Minnesota Security Hospital;
155.33(3) whose discharge would be significantly delayed without the available waiver
155.34allocation; and
156.1(4) who have met treatment objectives and no longer meet hospital level of care.
156.2(b) Additional waiver allocations under this subdivision must meet cost-effectiveness
156.3requirements of the federal approved waiver plan.
156.4(c) Any corporate foster care home developed under this subdivision must be
156.5considered an exception under section 245A.03, subdivision 7, paragraph (a).
156.6EFFECTIVE DATE.This section is effective July 1, 2013.

156.7    Sec. 22. Minnesota Statutes 2012, section 256B.0943, subdivision 1, is amended to read:
156.8    Subdivision 1. Definitions. For purposes of this section, the following terms have
156.9the meanings given them.
156.10(a) "Children's therapeutic services and supports" means the flexible package of
156.11mental health services for children who require varying therapeutic and rehabilitative
156.12levels of intervention. The services are time-limited interventions that are delivered using
156.13various treatment modalities and combinations of services designed to reach treatment
156.14outcomes identified in the individual treatment plan.
156.15(b) "Clinical supervision" means the overall responsibility of the mental health
156.16professional for the control and direction of individualized treatment planning, service
156.17delivery, and treatment review for each client. A mental health professional who is an
156.18enrolled Minnesota health care program provider accepts full professional responsibility
156.19for a supervisee's actions and decisions, instructs the supervisee in the supervisee's work,
156.20and oversees or directs the supervisee's work.
156.21(c) "County board" means the county board of commissioners or board established
156.22under sections 402.01 to 402.10 or 471.59.
156.23(d) "Crisis assistance" has the meaning given in section 245.4871, subdivision 9a.
156.24(e) "Culturally competent provider" means a provider who understands and can
156.25utilize to a client's benefit the client's culture when providing services to the client. A
156.26provider may be culturally competent because the provider is of the same cultural or
156.27ethnic group as the client or the provider has developed the knowledge and skills through
156.28training and experience to provide services to culturally diverse clients.
156.29(f) "Day treatment program" for children means a site-based structured program
156.30consisting of group psychotherapy for more than three individuals and other intensive
156.31therapeutic services provided by a multidisciplinary team, under the clinical supervision
156.32of a mental health professional.
156.33(g) "Diagnostic assessment" has the meaning given in section 245.4871, subdivision
156.3411
.
157.1(h) "Direct service time" means the time that a mental health professional, mental
157.2health practitioner, or mental health behavioral aide spends face-to-face with a client
157.3and the client's family. Direct service time includes time in which the provider obtains
157.4a client's history or provides service components of children's therapeutic services and
157.5supports. Direct service time does not include time doing work before and after providing
157.6direct services, including scheduling, maintaining clinical records, consulting with others
157.7about the client's mental health status, preparing reports, receiving clinical supervision,
157.8and revising the client's individual treatment plan.
157.9(i) "Direction of mental health behavioral aide" means the activities of a mental
157.10health professional or mental health practitioner in guiding the mental health behavioral
157.11aide in providing services to a client. The direction of a mental health behavioral aide
157.12must be based on the client's individualized treatment plan and meet the requirements in
157.13subdivision 6, paragraph (b), clause (5).
157.14(j) "Emotional disturbance" has the meaning given in section 245.4871, subdivision
157.1515
. For persons at least age 18 but under age 21, mental illness has the meaning given in
157.16section 245.462, subdivision 20, paragraph (a).
157.17(k) "Individual behavioral plan" means a plan of intervention, treatment, and
157.18services for a child written by a mental health professional or mental health practitioner,
157.19under the clinical supervision of a mental health professional, to guide the work of the
157.20mental health behavioral aide.
157.21(l) "Individual treatment plan" has the meaning given in section 245.4871,
157.22subdivision 21
.
157.23(m) "Mental health behavioral aide services" means medically necessary one-on-one
157.24activities performed by a trained paraprofessional to assist a child retain or generalize
157.25psychosocial skills as taught by a mental health professional or mental health practitioner
157.26and as described in the child's individual treatment plan and individual behavior plan.
157.27Activities involve working directly with the child or child's family as provided in
157.28subdivision 9, paragraph (b), clause (4).
157.29(n) "Mental health professional" means an individual as defined in section 245.4871,
157.30subdivision 27
, clauses (1) to (6), or tribal vendor as defined in section 256B.02,
157.31subdivision 7
, paragraph (b).
157.32    (o) "Mental health service plan development" includes:
157.33    (1) the development, review, and revision of a child's individual treatment plan,
157.34as provided in Minnesota Rules, part 9505.0371, subpart 7, including involvement of
157.35the client or client's parents, primary caregiver, or other person authorized to consent to
158.1mental health services for the client, and including arrangement of treatment and support
158.2activities specified in the individual treatment plan; and
158.3    (2) administering standardized outcome measurement instruments, determined
158.4and updated by the commissioner, as periodically needed to evaluate the effectiveness
158.5of treatment for children receiving clinical services and reporting outcome measures,
158.6as required by the commissioner.
158.7(o) (p) "Preschool program" means a day program licensed under Minnesota Rules,
158.8parts 9503.0005 to 9503.0175, and enrolled as a children's therapeutic services and
158.9supports provider to provide a structured treatment program to a child who is at least 33
158.10months old but who has not yet attended the first day of kindergarten.
158.11(p) (q) "Skills training" means individual, family, or group training, delivered
158.12by or under the direction of a mental health professional, designed to facilitate the
158.13acquisition of psychosocial skills that are medically necessary to rehabilitate the child
158.14to an age-appropriate developmental trajectory heretofore disrupted by a psychiatric
158.15illness or to self-monitor, compensate for, cope with, counteract, or replace skills deficits
158.16or maladaptive skills acquired over the course of a psychiatric illness. Skills training
158.17is subject to the following requirements:
158.18(1) a mental health professional or a mental health practitioner must provide skills
158.19training;
158.20(2) the child must always be present during skills training; however, a brief absence
158.21of the child for no more than ten percent of the session unit may be allowed to redirect or
158.22instruct family members;
158.23(3) skills training delivered to children or their families must be targeted to the
158.24specific deficits or maladaptations of the child's mental health disorder and must be
158.25prescribed in the child's individual treatment plan;
158.26(4) skills training delivered to the child's family must teach skills needed by parents
158.27to enhance the child's skill development and to help the child use in daily life the skills
158.28previously taught by a mental health professional or mental health practitioner and to
158.29develop or maintain a home environment that supports the child's progressive use skills;
158.30(5) group skills training may be provided to multiple recipients who, because of the
158.31nature of their emotional, behavioral, or social dysfunction, can derive mutual benefit from
158.32interaction in a group setting, which must be staffed as follows:
158.33(i) one mental health professional or one mental health practitioner under supervision
158.34of a licensed mental health professional must work with a group of four to eight clients; or
159.1(ii) two mental health professionals or two mental health practitioners under
159.2supervision of a licensed mental health professional, or one professional plus one
159.3practitioner must work with a group of nine to 12 clients.

159.4    Sec. 23. Minnesota Statutes 2012, section 256B.0943, subdivision 2, is amended to read:
159.5    Subd. 2. Covered service components of children's therapeutic services and
159.6supports. (a) Subject to federal approval, medical assistance covers medically necessary
159.7children's therapeutic services and supports as defined in this section that an eligible
159.8provider entity certified under subdivision 4 provides to a client eligible under subdivision
159.93.
159.10(b) The service components of children's therapeutic services and supports are:
159.11(1) individual, family, and group psychotherapy;
159.12(2) individual, family, or group skills training provided by a mental health
159.13professional or mental health practitioner;
159.14(3) crisis assistance;
159.15(4) mental health behavioral aide services; and
159.16(5) direction of a mental health behavioral aide.;
159.17(6) mental health service plan development;
159.18(7) clinical care consultation under section 256B.0625, subdivision 62;
159.19(8) family psychoeducation under section 256B.0625, subdivision 61; and
159.20(9) services provided by a family peer specialist under section 256B.0616.
159.21(c) Service components in paragraph (b) may be combined to constitute therapeutic
159.22programs, including day treatment programs and therapeutic preschool programs.

159.23    Sec. 24. Minnesota Statutes 2012, section 256B.0943, subdivision 7, is amended to read:
159.24    Subd. 7. Qualifications of individual and team providers. (a) An individual
159.25or team provider working within the scope of the provider's practice or qualifications
159.26may provide service components of children's therapeutic services and supports that are
159.27identified as medically necessary in a client's individual treatment plan.
159.28(b) An individual provider must be qualified as:
159.29(1) a mental health professional as defined in subdivision 1, paragraph (n); or
159.30(2) a mental health practitioner as defined in section 245.4871, subdivision 26. The
159.31mental health practitioner must work under the clinical supervision of a mental health
159.32professional; or
160.1(3) a mental health behavioral aide working under the clinical supervision of a
160.2mental health professional to implement the rehabilitative mental health services identified
160.3in the client's individual treatment plan and individual behavior plan.
160.4(A) A level I mental health behavioral aide must:
160.5(i) be at least 18 years old;
160.6(ii) have a high school diploma or general equivalency diploma (GED) or two years
160.7of experience as a primary caregiver to a child with severe emotional disturbance within
160.8the previous ten years; and
160.9(iii) meet preservice and continuing education requirements under subdivision 8.
160.10(B) A level II mental health behavioral aide must:
160.11(i) be at least 18 years old;
160.12(ii) have an associate or bachelor's degree or 4,000 hours of experience in delivering
160.13clinical services in the treatment of mental illness concerning children or adolescents or
160.14complete a certificate program established under subdivision 8a; and
160.15(iii) meet preservice and continuing education requirements in subdivision 8.
160.16(c) A preschool program multidisciplinary team must include at least one mental
160.17health professional and one or more of the following individuals under the clinical
160.18supervision of a mental health professional:
160.19(i) a mental health practitioner; or
160.20(ii) a program person, including a teacher, assistant teacher, or aide, who meets the
160.21qualifications and training standards of a level I mental health behavioral aide.
160.22(d) A day treatment multidisciplinary team must include at least one mental health
160.23professional and one mental health practitioner.

160.24    Sec. 25. Minnesota Statutes 2012, section 256B.0943, is amended by adding a
160.25subdivision to read:
160.26    Subd. 8a. Level II mental health behavioral aide. The commissioner of human
160.27services, in collaboration with children's mental health providers and the Board of Trustees
160.28of the Minnesota State Colleges and Universities, shall develop a certificate program
160.29for level II mental health behavioral aides.

160.30    Sec. 26. Minnesota Statutes 2012, section 256B.0946, is amended to read:
160.31256B.0946 INTENSIVE TREATMENT IN FOSTER CARE.
160.32    Subdivision 1. Required covered service components. (a) Effective July 1, 2006,
160.33 upon enactment and subject to federal approval, medical assistance covers medically
160.34necessary intensive treatment services described under paragraph (b) that are provided
161.1by a provider entity eligible under subdivision 3 to a client eligible under subdivision 2
161.2who is placed in a treatment foster home licensed under Minnesota Rules, parts 2960.3000
161.3to 2960.3340.
161.4(b) Intensive treatment services to children with severe emotional disturbance mental
161.5illness residing in treatment foster care family settings must meet the relevant standards
161.6for mental health services under sections 245.487 to 245.4889. In addition, that comprise
161.7 specific required service components provided in clauses (1) to (5), are reimbursed by
161.8medical assistance must when they meet the following standards:
161.9(1) case management service component must meet the standards in Minnesota
161.10Rules, parts 9520.0900 to 9520.0926 and 9505.0322, excluding subparts 6 and 10;
161.11(1) psychotherapy provided by a mental health professional as defined in Minnesota
161.12Rules, part 9505.0371, subpart 5, item A, or a clinical trainee, as defined in Minnesota
161.13Rules, part 9505.0371, subpart 5, item C;
161.14(2) psychotherapy, crisis assistance, and skills training components must meet the
161.15 provided according to standards for children's therapeutic services and supports in section
161.16256B.0943 ; and
161.17(3) individual family, and group psychoeducation services under supervision of,
161.18defined in subdivision 1a, paragraph (q), provided by a mental health professional. or a
161.19clinical trainee;
161.20(4) clinical care consultation, as defined in subdivision 1a, and provided by a mental
161.21health professional or a clinical trainee; and
161.22(5) service delivery payment requirements as provided under subdivision 4.
161.23    Subd. 1a. Definitions. For the purposes of this section, the following terms have
161.24the meanings given them.
161.25(a) "Clinical care consultation" means communication from a treating clinician to
161.26other providers working with the same client to inform, inquire, and instruct regarding
161.27the client's symptoms, strategies for effective engagement, care and intervention needs,
161.28and treatment expectations across service settings, including but not limited to the client's
161.29school, social services, day care, probation, home, primary care, medication prescribers,
161.30disabilities services, and other mental health providers and to direct and coordinate clinical
161.31service components provided to the client and family.
161.32(b) "Clinical supervision" means the documented time a clinical supervisor and
161.33supervisee spend together to discuss the supervisee's work, to review individual client
161.34cases, and for the supervisee's professional development. It includes the documented
161.35oversight and supervision responsibility for planning, implementation, and evaluation of
161.36services for a client's mental health treatment.
162.1(c) "Clinical supervisor" means the mental health professional who is responsible
162.2for clinical supervision.
162.3(d) "Clinical trainee" has the meaning given in Minnesota Rules, part 9505.0371,
162.4subpart 5, item C;
162.5(e) "Crisis assistance" has the meaning given in section 245.4871, subdivision 9a,
162.6including the development of a plan that addresses prevention and intervention strategies
162.7to be used in a potential crisis, but does not include actual crisis intervention.
162.8(f) "Culturally appropriate" means providing mental health services in a manner that
162.9incorporates the child's cultural influences, as defined in Minnesota Rules, part 9505.0370,
162.10subpart 9, into interventions as a way to maximize resiliency factors and utilize cultural
162.11strengths and resources to promote overall wellness.
162.12(g) "Culture" means the distinct ways of living and understanding the world that
162.13are used by a group of people and are transmitted from one generation to another or
162.14adopted by an individual.
162.15(h) "Diagnostic assessment" has the meaning given in Minnesota Rules, part
162.169505.0370, subpart 11.
162.17(i) "Family" means a person who is identified by the client or the client's parent or
162.18guardian as being important to the client's mental health treatment. Family may include,
162.19but is not limited to, parents, foster parents, children, spouse, committed partners, former
162.20spouses, persons related by blood or adoption, persons who are a part of the client's
162.21permanency plan, or persons who are presently residing together as a family unit.
162.22(j) "Foster care" has the meaning given in section 260C.007, subdivision 18.
162.23(k) "Foster family setting" means the foster home in which the license holder resides.
162.24(l) "Individual treatment plan" has the meaning given in Minnesota Rules, part
162.259505.0370, subpart 15.
162.26(m) "Mental health practitioner" has the meaning given in Minnesota Rules, part
162.279505.0370, subpart 17.
162.28(n) "Mental health professional" has the meaning given in Minnesota Rules, part
162.299505.0370, subpart 18.
162.30(o) "Mental illness" has the meaning given in Minnesota Rules, part 9505.0370,
162.31subpart 20.
162.32(p) "Parent" has the meaning given in section 260C.007, subdivision 25.
162.33(q) "Psychoeducation services" means information or demonstration provided to
162.34an individual, family, or group to explain, educate, and support the individual, family, or
162.35group in understanding a child's symptoms of mental illness, the impact on the child's
162.36development, and needed components of treatment and skill development so that the
163.1individual, family, or group can help the child to prevent relapse, prevent the acquisition
163.2of comorbid disorders, and achieve optimal mental health and long-term resilience.
163.3(r) "Psychotherapy" has the meaning given in Minnesota Rules, part 9505.0370,
163.4subpart 27.
163.5(s) "Team consultation and treatment planning" means the coordination of treatment
163.6plans and consultation among providers in a group concerning the treatment needs of the
163.7child, including disseminating the child's treatment service schedule to all members of the
163.8service team. Team members must include all mental health professionals working with
163.9the child, a parent, the child unless the team lead or parent deem it clinically inappropriate,
163.10and at least two of the following: an individualized education program case manager;
163.11probation agent; children's mental health case manager; child welfare worker, including
163.12adoption or guardianship worker; primary care provider; foster parent; and any other
163.13member of the child's service team.
163.14    Subd. 2. Determination of client eligibility. A client's eligibility to receive
163.15treatment foster care under this section shall be determined by An eligible recipient is an
163.16individual, from birth through age 20, who is currently placed in a foster home licensed
163.17under Minnesota Rules, parts 2960.3000 to 2960.3340, and has received a diagnostic
163.18assessment, and an evaluation of level of care needed, and development of an individual
163.19treatment plan, as defined in paragraphs (a) to (c) and (b).
163.20(a) The diagnostic assessment must:
163.21(1) meet criteria described in Minnesota Rules, part 9505.0372, subpart 1, and be
163.22conducted by a psychiatrist, licensed psychologist, or licensed independent clinical social
163.23worker that is mental health professional or a clinical trainee;
163.24(2) determine whether or not a child meets the criteria for mental illness, as defined
163.25in Minnesota Rules, part 9505.0370, subpart 20;
163.26(3) document that intensive treatment services are medically necessary within a
163.27foster family setting to ameliorate identified symptoms and functional impairments;
163.28(4) be performed within 180 days prior to before the start of service; and
163.29(2) include current diagnoses on all five axes of the client's current mental health
163.30status;
163.31(3) determine whether or not a child meets the criteria for severe emotional
163.32disturbance in section 245.4871, subdivision 6, or for serious and persistent mental illness
163.33in section 245.462, subdivision 20; and
163.34(4) be completed annually until age 18. For individuals between age 18 and 21,
163.35unless a client's mental health condition has changed markedly since the client's most
163.36recent diagnostic assessment, annual updating is necessary. For the purpose of this section,
164.1"updating" means a written summary, including current diagnoses on all five axes, by a
164.2mental health professional of the client's current mental status and service needs.
164.3(5) be completed as either a standard or extended diagnostic assessment annually to
164.4determine continued eligibility for the service.
164.5(b) The evaluation of level of care must be conducted by the placing county with
164.6an instrument, tribe, or case manager in conjunction with the diagnostic assessment as
164.7described by Minnesota Rules, part 9505.0372, subpart 1, item B, using a validated tool
164.8 approved by the commissioner of human services and not subject to the rulemaking
164.9process, consistent with section 245.4885, subdivision 1, paragraph (d), the result of which
164.10evaluation demonstrates that the child requires intensive intervention without 24-hour
164.11medical monitoring. The commissioner shall update the list of approved level of care
164.12instruments tools annually and publish on the department's Web site.
164.13(c) The individual treatment plan must be:
164.14(1) based on the information in the client's diagnostic assessment;
164.15(2) developed through a child-centered, family driven planning process that identifies
164.16service needs and individualized, planned, and culturally appropriate interventions that
164.17contain specific measurable treatment goals and objectives for the client and treatment
164.18strategies for the client's family and foster family;
164.19(3) reviewed at least once every 90 days and revised; and
164.20(4) signed by the client or, if appropriate, by the client's parent or other person
164.21authorized by statute to consent to mental health services for the client.
164.22    Subd. 3. Eligible mental health services providers. (a) Eligible providers for
164.23intensive children's mental health services in a foster family setting must be certified
164.24by the state and have a service provision contract with a county board or a reservation
164.25tribal council and must be able to demonstrate the ability to provide all of the services
164.26required in this section.
164.27(b) For purposes of this section, a provider agency must have an individual
164.28placement agreement for each recipient and must be a licensed child placing agency, under
164.29Minnesota Rules, parts 9543.0010 to 9543.0150, and either be:
164.30(1) a county county-operated entity certified by the state;
164.31(2) an Indian Health Services facility operated by a tribe or tribal organization under
164.32funding authorized by United States Code, title 25, sections 450f to 450n, or title 3 of the
164.33Indian Self-Determination Act, Public Law 93-638, section 638 (facilities or providers); or
164.34(3) a noncounty entity under contract with a county board.
164.35(c) Certified providers that do not meet the service delivery standards required in
164.36this section shall be subject to a decertification process.
165.1(d) For the purposes of this section, all services delivered to a client must be
165.2provided by a mental health professional or a clinical trainee.
165.3    Subd. 4. Eligible provider responsibilities Service delivery payment
165.4requirements. (a) To be an eligible provider for payment under this section, a provider
165.5must develop and practice written policies and procedures for treatment foster care services
165.6 intensive treatment in foster care, consistent with subdivision 1, paragraph (b), clauses (1),
165.7(2), and (3) and comply with the following requirements in paragraphs (b) to (n).
165.8(b) In delivering services under this section, a treatment foster care provider must
165.9ensure that staff caseload size reasonably enables the provider to play an active role in
165.10service planning, monitoring, delivering, and reviewing for discharge planning to meet
165.11the needs of the client, the client's foster family, and the birth family, as specified in each
165.12client's individual treatment plan.
165.13(b) A qualified clinical supervisor, as defined in and performing in compliance with
165.14Minnesota Rules, part 9505.0371, subpart 5, item D, must supervise the treatment and
165.15provision of services described in this section.
165.16(c) Each client receiving treatment services must receive an extended diagnostic
165.17assessment, as described in Minnesota Rules, part 9505.0372, subpart 1, item C, within
165.1830 days of enrollment in this service unless the client has a previous extended diagnostic
165.19assessment that the client, parent, and mental health professional agree still accurately
165.20describes the client's current mental health functioning.
165.21(d) Each previous and current mental health, school, and physical health treatment
165.22provider must be contacted to request documentation of treatment and assessments that
165.23the eligible client has received. This information must be reviewed and incorporated into
165.24the diagnostic assessment and team consultation and treatment planning review process.
165.25(e) Each client receiving treatment must be assessed for a trauma history, and
165.26the client's treatment plan must document how the results of the assessment will be
165.27incorporated into treatment.
165.28(f) Each client receiving treatment services must have an individual treatment plan
165.29that is reviewed, evaluated, and signed every 90 days using the team consultation and
165.30treatment planning process, as defined in subdivision 1a, paragraph (s).
165.31(g) Care consultation, as defined in subdivision 1a, paragraph (a), must be provided
165.32in accordance with the client's individual treatment plan.
165.33(h) Each client must have a crisis assistance plan within ten days of initiating
165.34services and must have access to clinical phone support 24 hours per day, seven days per
165.35week, during the course of treatment. The crisis plan must demonstrate coordination with
165.36the local or regional mobile crisis intervention team.
166.1(i) Services must be delivered and documented at least three days per week, equaling
166.2at least six hours of treatment per week, unless reduced units of service are specified on
166.3the treatment plan as part of transition or on a discharge plan to another service or level of
166.4care. Documentation must comply with Minnesota Rules, parts 9505.2175 and 9505.2197.
166.5(j) Location of service delivery must be in the client's home, day care setting,
166.6school, or other community-based setting that is specified on the client's individualized
166.7treatment plan.
166.8(k) Treatment must be developmentally and culturally appropriate for the client.
166.9(l) Services must be delivered in continual collaboration and consultation with the
166.10client's medical providers and, in particular, with prescribers of psychotropic medications,
166.11including those prescribed on an off-label basis. Members of the service team must be
166.12aware of the medication regimen and potential side effects.
166.13(m) Parents, siblings, foster parents, and members of the child's permanency plan
166.14must be involved in treatment and service delivery unless otherwise noted in the treatment
166.15plan.
166.16(n) Transition planning for the child must be conducted starting with the first
166.17treatment plan and must be addressed throughout treatment to support the child's
166.18permanency plan and postdischarge mental health service needs.
166.19    Subd. 5. Service authorization. The commissioner will administer authorizations
166.20for services under this section in compliance with section 256B.0625, subdivision 25.
166.21    Subd. 6. Excluded services. (a) Services in clauses (1) to (4) (7) are not covered
166.22under this section and are not eligible for medical assistance payment as components of
166.23intensive treatment in foster care services, but may be billed separately:
166.24(1) treatment foster care services provided in violation of medical assistance policy
166.25in Minnesota Rules, part 9505.0220;
166.26(2) service components of children's therapeutic services and supports
166.27simultaneously provided by more than one treatment foster care provider;
166.28(3) home and community-based waiver services; and
166.29(4) treatment foster care services provided to a child without a level of care
166.30determination according to section 245.4885, subdivision 1.
166.31(1) inpatient psychiatric hospital treatment;
166.32(2) mental health targeted case management;
166.33(3) partial hospitalization;
166.34(4) medication management;
166.35(5) children's mental health day treatment services;
166.36(6) crisis response services under section 256B.0944; and
167.1(7) transportation.
167.2(b) Children receiving intensive treatment in foster care services are not eligible for
167.3medical assistance reimbursement for the following services while receiving intensive
167.4treatment in foster care:
167.5(1) mental health case management services under section 256B.0625, subdivision
167.620
; and
167.7(2) (1) psychotherapy and skill skills training components of children's therapeutic
167.8services and supports under section 256B.0625, subdivision 35b.;
167.9(2) mental health behavioral aide services as defined in section 256B.0943,
167.10subdivision 1, paragraph (m);
167.11(3) home and community-based waiver services;
167.12(4) mental health residential treatment; and
167.13(5) room and board costs as defined in section 256I.03, subdivision 6.
167.14    Subd. 7. Medical assistance payment and rate setting. The commissioner shall
167.15establish a single daily per-client encounter rate for intensive treatment in foster care
167.16services. The rate must be constructed to cover only eligible services delivered to an
167.17eligible recipient by an eligible provider, as prescribed in subdivision 1, paragraph (b).

167.18    Sec. 27. Minnesota Statutes 2012, section 256B.49, is amended by adding a
167.19subdivision to read:
167.20    Subd. 24. Waiver allocations for transition populations. (a) The commissioner
167.21shall make available additional waiver allocations and additional necessary resources
167.22to assure timely discharges from the Anoka Metro Regional Treatment Center and the
167.23Minnesota Security Hospital in St. Peter for individuals who meet the following criteria:
167.24(1) are otherwise eligible for the brain injury, community alternatives for disabled
167.25individuals, or community alternative care waivers under this section;
167.26(2) who would otherwise remain at the Anoka Metro Regional Treatment Center or
167.27the Minnesota Security Hospital;
167.28(3) whose discharge would be significantly delayed without the available waiver
167.29allocation; and
167.30(4) who have met treatment objectives and no longer meet hospital level of care.
167.31(b) Additional waiver allocations under this subdivision must meet cost-effectiveness
167.32requirements of the federal approved waiver plan.
167.33(c) Any corporate foster care home developed under this subdivision must be
167.34considered an exception under section 245A.03, subdivision 7, paragraph (a).
167.35EFFECTIVE DATE.This section is effective July 1, 2013.

168.1    Sec. 28. Minnesota Statutes 2012, section 256B.761, is amended to read:
168.2256B.761 REIMBURSEMENT FOR MENTAL HEALTH SERVICES.
168.3(a) Effective for services rendered on or after July 1, 2001, payment for medication
168.4management provided to psychiatric patients, outpatient mental health services, day
168.5treatment services, home-based mental health services, and family community support
168.6services shall be paid at the lower of (1) submitted charges, or (2) 75.6 percent of the
168.750th percentile of 1999 charges.
168.8(b) Effective July 1, 2001, the medical assistance rates for outpatient mental health
168.9services provided by an entity that operates: (1) a Medicare-certified comprehensive
168.10outpatient rehabilitation facility; and (2) a facility that was certified prior to January 1,
168.111993, with at least 33 percent of the clients receiving rehabilitation services in the most
168.12recent calendar year who are medical assistance recipients, will be increased by 38 percent,
168.13when those services are provided within the comprehensive outpatient rehabilitation
168.14facility and provided to residents of nursing facilities owned by the entity.
168.15(c) The commissioner shall establish three levels of payment for mental health
168.16diagnostic assessment, based on three levels of complexity. The aggregate payment under
168.17the tiered rates must not exceed the projected aggregate payments for mental health
168.18diagnostic assessment under the previous single rate. The new rate structure is effective
168.19January 1, 2011, or upon federal approval, whichever is later.
168.20(d) In addition to rate increases otherwise provided, the commissioner may
168.21restructure coverage policy and rates to improve access to adult rehabilitative mental
168.22health services under section 256B.0623 and related mental health support services under
168.23section 256B.021, subdivision 4, paragraph (f), clause (2). For state fiscal years 2015 and
168.242016, the projected state share of increased costs due to this paragraph is transferred
168.25from adult mental health grants under sections 245.4661 and 256E.12. The transfer for
168.26fiscal year 2016 is a permanent base adjustment for subsequent fiscal years. Payments
168.27made to managed care plans and county-based purchasing plans under sections 256B.69,
168.28256B.692, and 256L.12 shall reflect the rate changes described in this paragraph.

168.29    Sec. 29. CHILD AND ADOLESCENT BEHAVIORAL HEALTH SERVICES.
168.30The commissioner of human services shall, in consultation with children's mental
168.31health community providers, hospitals providing care to children, children's mental health
168.32advocates, and other interested parties, develop recommendations and legislation, if
168.33necessary, for the state-operated child and adolescent behavioral health services facility
168.34to ensure that:
169.1(1) the facility and the services provided meet the needs of children with serious
169.2emotional disturbances, autism spectrum disorders, reactive attachment disorder, PTSD,
169.3serious emotional disturbance co-occurring with a developmental disability, borderline
169.4personality disorder, schizophrenia, fetal alcohol spectrum disorders, brain injuries,
169.5violent tendencies, and complex medical issues;
169.6(2) qualified personnel and staff can be recruited who have specific expertise and
169.7training to treat the children in the facility; and
169.8(3) the treatment provided at the facility is high-quality, effective treatment.

169.9    Sec. 30. PILOT PROVIDER INPUT SURVEY OF PEDIATRIC SERVICES AND
169.10CHILDREN'S MENTAL HEALTH SERVICES.
169.11(a) To assess the efficiency and other operational issues in the management of the
169.12health care delivery system, the commissioner of human services shall initiate a provider
169.13survey. The pilot survey shall consist of an electronic survey of providers of pediatric
169.14home health care services and children's mental health services to identify and measure
169.15issues that arise in dealing with the management of medical assistance. To the maximum
169.16degree possible, existing technology shall be used and interns sought to analyze the results.
169.17(b) The survey questions must focus on seven key business functions provided
169.18by medical assistance contractors: provider inquiries; provider outreach and education;
169.19claims processing; appeals; provider enrollment; medical review; and provider audit and
169.20reimbursement. The commissioner must consider the results of the survey in evaluating
169.21and renewing managed care and fee-for-service management contracts.
169.22(c) The commissioner shall report by January 15, 2014, the results of the survey to
169.23the chairs of the health and human services policy and finance committees and shall
169.24make recommendations on the value of implementing an annual survey with a rotating
169.25list of provider groups as a component of the continuous quality improvement system for
169.26medical assistance.

169.27    Sec. 31. MENTALLY ILL AND DANGEROUS COMMITMENTS
169.28STAKEHOLDERS GROUP.
169.29(a) The commissioner of human services, in consultation with the state court
169.30administrator, shall convene a stakeholder group to develop recommendations for the
169.31legislature that address issues raised in the February 2013 Office of the Legislative
169.32Auditor report on State-Operated Services for persons committed to the commissioner as
169.33mentally ill and dangerous under Minnesota Statutes, section 253B.18. Stakeholders must
169.34include representatives from the Department of Human Services, county human services,
170.1county attorneys, commitment defense attorneys, the ombudsman for mental health and
170.2developmental disabilities, the federal protection and advocacy system, and consumers
170.3and advocates for persons with mental illnesses.
170.4(b) The stakeholder group shall provide recommendations in the following areas:
170.5(1) the role of the special review board, including the scope of authority of the
170.6special review board and the authority of the commissioner to accept or reject special
170.7review board recommendations;
170.8(2) review of special review board decisions by the district court;
170.9(3) annual district court review of commitment, scope of court authority, and
170.10appropriate review criteria;
170.11(4) options, including annual court hearing and review, as alternatives to
170.12indeterminate commitment under Minnesota Statutes, section 253B.18; and
170.13(5) extension of the right to petition the court under Minnesota Statutes,
170.14section 253B.17, to those committed under Minnesota Statutes, section 253B.18.
170.15The commissioner of human services and the state court administrator shall provide
170.16relevant data for the group's consideration in developing these recommendations,
170.17including numbers of proceedings in each category and costs associated with court and
170.18administrative proceedings under Minnesota Statutes, section 253B.18.
170.19(c) By January 15, 2014, the commissioner of human services shall submit the
170.20recommendations of the stakeholder group to the chairs and ranking minority members
170.21of the committees of the legislature with jurisdiction over civil commitment and human
170.22services issues.

170.23    Sec. 32. STATE ASSISTANCE TO COUNTIES; TRANSITIONS FOR HIGH
170.24NEEDS POPULATIONS.
170.25(a) Effective immediately, the commissioner of human services shall work with
170.26counties that request assistance to assure timely discharge from Anoka Metro Regional
170.27Treatment Center and the Minnesota Security Hospital for individuals who are ready
170.28for discharge but for whom the county may not have provider resources or appropriate
170.29placement available. Special consideration must be given to uninsured individuals who are
170.30not eligible for medical assistance and who may need continued treatment, and individuals
170.31with complex needs and other factors that hinder county efforts to place the individual in a
170.32safe, affordable setting.
170.33(b) The commissioner shall assure that, given Olmstead court directives and the
170.34role family and friends play in treatment progress, metropolitan area residents are asked
170.35whether they wished to be placed in an Intensive Residential Treatment Service program
171.1at Willmar or Cambridge or to be placed in a location more accessible to family, friends,
171.2and health providers.

171.3ARTICLE 5
171.4DEPARTMENT OF HUMAN SERVICES PROGRAM INTEGRITY

171.5    Section 1. Minnesota Statutes 2012, section 13.461, is amended by adding a
171.6subdivision to read:
171.7    Subd. 7b. Child care provider and recipient fraud investigations. Data related
171.8to child care fraud and recipient fraud investigations are governed by section 245E.01,
171.9subdivision 15.

171.10    Sec. 2. Minnesota Statutes 2012, section 243.166, subdivision 7, is amended to read:
171.11    Subd. 7. Use of data. (a) Except as otherwise provided in subdivision 7a or sections
171.12244.052 and 299C.093, the data provided under this section is private data on individuals
171.13under section 13.02, subdivision 12.
171.14(b) The data may be used only for by law enforcement and corrections agencies for
171.15 law enforcement and corrections purposes.
171.16(c) The commissioner of human services is authorized to have access to the data for:
171.17(1) state-operated services, as defined in section 246.014, are also authorized to
171.18have access to the data for the purposes described in section 246.13, subdivision 2,
171.19paragraph (b); and
171.20(2) purposes of completing background studies under chapter 245C.

171.21    Sec. 3. Minnesota Statutes 2012, section 245C.04, is amended by adding a subdivision
171.22to read:
171.23    Subd. 4a. Agency background studies. (a) The commissioner shall develop and
171.24implement an electronic process for the regular transfer of new criminal case information
171.25that is added to the Minnesota court information system. The commissioner's system
171.26must include for review only information that relates to individuals who have been the
171.27subject of a background study under this chapter that remain affiliated with the agency
171.28that initiated the background study. For purposes of this paragraph, an individual remains
171.29affiliated with an agency that initiated the background study until the agency informs the
171.30commissioner that the individual is no longer affiliated. When any individual no longer
171.31affiliated according to this paragraph returns to a position requiring a background study
171.32under this chapter, the agency with whom the individual is again affiliated shall initiate
172.1a new background study regardless of the length of time the individual was no longer
172.2affiliated with the agency.
172.3(b) The commissioner shall develop and implement an online system for agencies that
172.4initiate background studies under this chapter to access and maintain records of background
172.5studies initiated by that agency. The system must show all active background study subjects
172.6affiliated with that agency and the status of each individual's background study. Each
172.7agency that initiates background studies must use this system to notify the commissioner
172.8of discontinued affiliation for purposes of the processes required under paragraph (a).

172.9    Sec. 4. Minnesota Statutes 2012, section 245C.08, subdivision 1, is amended to read:
172.10    Subdivision 1. Background studies conducted by Department of Human
172.11Services. (a) For a background study conducted by the Department of Human Services,
172.12the commissioner shall review:
172.13    (1) information related to names of substantiated perpetrators of maltreatment of
172.14vulnerable adults that has been received by the commissioner as required under section
172.15626.557, subdivision 9c , paragraph (j);
172.16    (2) the commissioner's records relating to the maltreatment of minors in licensed
172.17programs, and from findings of maltreatment of minors as indicated through the social
172.18service information system;
172.19    (3) information from juvenile courts as required in subdivision 4 for individuals
172.20listed in section 245C.03, subdivision 1, paragraph (a), when there is reasonable cause;
172.21    (4) information from the Bureau of Criminal Apprehension, including information
172.22regarding a background study subject's registration in Minnesota as a predatory offender
172.23under section 243.166;
172.24    (5) except as provided in clause (6), information from the national crime information
172.25system when the commissioner has reasonable cause as defined under section 245C.05,
172.26subdivision 5; and
172.27    (6) for a background study related to a child foster care application for licensure or
172.28adoptions, the commissioner shall also review:
172.29    (i) information from the child abuse and neglect registry for any state in which the
172.30background study subject has resided for the past five years; and
172.31    (ii) information from national crime information databases, when the background
172.32study subject is 18 years of age or older.
172.33    (b) Notwithstanding expungement by a court, the commissioner may consider
172.34information obtained under paragraph (a), clauses (3) and (4), unless the commissioner
173.1received notice of the petition for expungement and the court order for expungement is
173.2directed specifically to the commissioner.
173.3    (c) The commissioner shall also review criminal case information received according
173.4to section 245C.04, subdivision 4a, from the Minnesota court information system that
173.5relates to individuals who have already been studied under this chapter and who remain
173.6affiliated with the agency that initiated the background study.

173.7    Sec. 5. [245E.01] CHILD CARE PROVIDER AND RECIPIENT FRAUD
173.8INVESTIGATIONS WITHIN THE CHILD CARE ASSISTANCE PROGRAM.
173.9    Subdivision 1. Definitions. (a) For purposes of this section, the terms defined in this
173.10subdivision have the meanings given them.
173.11(b) "Applicant" has the meaning given in section 119B.011, subdivision 2.
173.12(c) "Child care assistance program" means any of the assistance programs under
173.13chapter 119B.
173.14(d) "Commissioner" means the commissioner of human services.
173.15(e) "Controlling individual" has the meaning given in section 245A.02, subdivision
173.165a.
173.17(f) "County" means a local county child care assistance program staff or
173.18subcontracted staff, or a county investigator acting on behalf of the commissioner.
173.19(g) "Department" means the Department of Human Services.
173.20(h) "Financial misconduct" or "misconduct" means an entity's or individual's acts or
173.21omissions that result in fraud and abuse or error against the Department of Human Services.
173.22(i) "Identify" means to furnish the full name, current or last known address, phone
173.23number, and e-mail address of the individual or business entity.
173.24(j) "License holder" has the meaning given in section 245A.02, subdivision 9.
173.25(k) "Mail" means the use of any mail service with proof of delivery and receipt.
173.26(l) "Provider" means either a provider as defined in section 119B.011, subdivision
173.2719, or a legal unlicensed provider as defined in section 119B.011, subdivision 16.
173.28(m) "Recipient" means a family receiving assistance as defined under section
173.29119B.011, subdivision 13.
173.30(n) "Terminate" means revocation of participation in the child care assistance
173.31program.
173.32    Subd. 2. Investigating provider or recipient financial misconduct. The
173.33department shall investigate alleged or suspected financial misconduct by providers and
173.34errors related to payments issued by the child care assistance program under this chapter.
173.35Recipients, employees, and staff may be investigated when the evidence shows that their
174.1conduct is related to the financial misconduct of a provider, license holder, or controlling
174.2individual.
174.3    Subd. 3. Scope of investigations. (a) The department may contact any person,
174.4agency, organization, or other entity that is necessary to an investigation.
174.5(b) The department may examine or interview any individual, document, or piece of
174.6evidence that may lead to information that is relevant to child care assistance program
174.7benefits, payments, and child care provider authorizations. This includes, but is not
174.8limited to:
174.9(1) child care assistance program payments;
174.10(2) services provided by the program or related to child care assistance program
174.11recipients;
174.12(3) services provided to a provider;
174.13(4) provider financial records of any type;
174.14(5) daily attendance records of the children receiving services from the provider;
174.15(6) billings; and
174.16(7) verification of the credentials of a license holder, controlling individual,
174.17employee, staff person, contractor, subcontractor, and entities under contract with the
174.18provider to provide services or maintain service and the provider's financial records
174.19related to those services.
174.20    Subd. 4. Determination of investigation. After completing its investigation, the
174.21department shall issue one of the following determinations:
174.22(1) no violation of child care assistance requirements occurred;
174.23(2) there is insufficient evidence to show that a violation of child care assistance
174.24requirements occurred;
174.25(3) a preponderance of evidence shows a violation of child care assistance program
174.26law, rule, or policy; or
174.27(4) there exists a credible allegation of fraud.
174.28    Subd. 5. Actions or administrative sanctions. (a) After completing the
174.29determination under subdivision 4, the department may take one or more of the actions
174.30or sanctions specified in this subdivision.
174.31(b) The department may take the following actions:
174.32(1) refer the investigation to law enforcement or a county attorney for possible
174.33criminal prosecution;
174.34(2) refer relevant information to the department's licensing division, the child care
174.35assistance program, the Department of Education, the federal child and adult care food
174.36program, or appropriate child or adult protection agency;
175.1(3) enter into a settlement agreement with a provider, license holder, controlling
175.2individual, or recipient; or
175.3(4) refer the matter for review by a prosecutorial agency with appropriate jurisdiction
175.4for possible civil action under the Minnesota False Claims Act, chapter 15C.
175.5(c) In addition to section 256.98, the department may impose sanctions by:
175.6(1) pursuing administrative disqualification through hearings or waivers;
175.7(2) establishing and seeking monetary recovery or recoupment; or
175.8(3) issuing an order of corrective action that states the practices that are violations of
175.9child care assistance program policies, laws, or regulations, and that they must be corrected.
175.10    Subd. 6. Duty to provide access. (a) A provider, license holder, controlling
175.11individual, employee, staff person, or recipient has an affirmative duty to provide access
175.12upon request to information specified under subdivision 8 or the program facility.
175.13(b) Failure to provide access may result in denial or termination of authorizations for
175.14or payments to a recipient, provider, license holder, or controlling individual in the child
175.15care assistance program.
175.16(c) When a provider fails to provide access, a 15-day notice of denial or termination
175.17must be issued to the provider, which prohibits the provider from participating in the child
175.18care assistance program. Notice must be sent to recipients whose children are under the
175.19provider's care pursuant to Minnesota Rules, part 3400.0185.
175.20(d) If the provider continues to fail to provide access at the expiration of the 15-day
175.21notice period, child care assistance program payments to the provider must be denied
175.22beginning the 16th day following notice of the initial failure or refusal to provide access.
175.23The department may rescind the denial based upon good cause if the provider submits in
175.24writing a good cause basis for having failed or refused to provide access. The writing must
175.25be postmarked no later than the 15th day following the provider's notice of initial failure
175.26to provide access. Additionally, the provider, license holder, or controlling individual
175.27must immediately provide complete, ongoing access to the department. Repeated failures
175.28to provide access must, after the initial failure or for any subsequent failure, result in
175.29termination from participation in the child care assistance program.
175.30(e) The department, at its own expense, may photocopy or otherwise duplicate
175.31records referenced in subdivision 8. Photocopying must be done on the provider's
175.32premises on the day of the request or other mutually agreeable time, unless removal of
175.33records is specifically permitted by the provider. If requested, a provider, license holder,
175.34or controlling individual, or a designee, must assist the investigator in duplicating any
175.35record, including a hard copy or electronically stored data, on the day of the request.
176.1(f) A provider, license holder, controlling individual, employee, or staff person must
176.2grant the department access during the department's normal business hours, and any hours
176.3that the program is operated, to examine the provider's program or the records listed in
176.4subdivision 8. A provider shall make records available at the provider's place of business
176.5on the day for which access is requested, unless the provider and the department both agree
176.6otherwise. The department's normal business hours are 8:00 a.m. to 5:00 p.m., Monday
176.7through Friday, excluding state holidays as defined in section 645.44, subdivision 5.
176.8    Subd. 7. Honest and truthful statements. It shall be unlawful for a provider,
176.9license holder, controlling individual, or recipient to:
176.10(1) falsify, conceal, or cover up by any trick, scheme, or device a material fact;
176.11(2) make any materially false, fictitious, or fraudulent statement or representation; or
176.12(3) make or use any false writing or document knowing the same to contain any
176.13materially false, fictitious, or fraudulent statement or entry related to any child care
176.14assistance program services that the provider, license holder, or controlling individual
176.15supplies or in relation to any child care assistance payments received by a provider, license
176.16holder, or controlling individual or to any fraud investigator or law enforcement officer
176.17conducting a financial misconduct investigation.
176.18    Subd. 8. Record retention. (a) The following records must be maintained,
176.19controlled, and made immediately accessible to license holders, providers, and controlling
176.20individuals. The records must be organized and labeled to correspond to categories that
176.21make them easy to identify so that they can be made available immediately upon request
176.22to an investigator acting on behalf of the commissioner at the provider's place of business:
176.23(1) payroll ledgers, canceled checks, bank deposit slips, and any other accounting
176.24records;
176.25(2) daily attendance records required by and that comply with section 119B.125,
176.26subdivision 6;
176.27(3) billing transmittal forms requesting payments from the child care assistance
176.28program and billing adjustments related to child care assistance program payments;
176.29(4) records identifying all persons, corporations, partnerships, and entities with an
176.30ownership or controlling interest in the provider's child care business;
176.31(5) employee records identifying those persons currently employed by the provider's
176.32child care business or who have been employed by the business at any time within the
176.33previous five years. The records must include each employee's name, hourly and annual
176.34salary, qualifications, position description, job title, and dates of employment. In addition,
176.35employee records that must be made available include the employee's time sheets, current
177.1home address of the employee or last known address of any former employee, and
177.2documentation of background studies required under chapter 119B or 245C;
177.3(6) records related to transportation of children in care, including but not limited to:
177.4(i) the dates and times that transportation is provided to children for transportation to
177.5and from the provider's business location for any purpose. For transportation related to
177.6field trips or locations away from the provider's business location, the names and addresses
177.7of those field trips and locations must also be provided;
177.8(ii) the name, business address, phone number, and Web site address, if any, of the
177.9transportation service utilized; and
177.10(iii) all billing or transportation records related to the transportation.
177.11(b) A provider, license holder, or controlling individual must retain all records in
177.12paragraph (a) for at least six years after the last date of service. Microfilm or electronically
177.13stored records satisfy the record keeping requirements of this subdivision.
177.14(c) A provider, license holder, or controlling individual who withdraws or is
177.15terminated from the child care assistance program must retain the records required under
177.16this subdivision and make them available to the department on demand.
177.17(d) If the ownership of a provider changes, the transferor, unless otherwise provided
177.18by law or by written agreement with the transferee, is responsible for maintaining,
177.19preserving, and upon request from the department, making available the records related to
177.20the provider that were generated before the date of the transfer. Any written agreement
177.21affecting this provision must be held in the possession of the transferor and transferee.
177.22The written agreement must be provided to the department or county immediately upon
177.23request, and the written agreement must be retained by the transferor and transferee for six
177.24years after the agreement is fully executed.
177.25(e) In the event of an appealed case, the provider must retain all records required in
177.26this subdivision for the duration of the appeal or six years, whichever is longer.
177.27(f) A provider's use of electronic record keeping or electronic signatures is governed
177.28by chapter 325L.
177.29    Subd. 9. Factors regarding imposition of administrative sanctions. (a) The
177.30department shall consider the following factors in determining the administrative sanctions
177.31to be imposed:
177.32(1) nature and extent of financial misconduct;
177.33(2) history of financial misconduct;
177.34(3) actions taken or recommended by other state agencies, other divisions of the
177.35department, and court and administrative decisions;
177.36(4) prior imposition of sanctions;
178.1(5) size and type of provider;
178.2(6) information obtained through an investigation from any source;
178.3(7) convictions or pending criminal charges; and
178.4(8) any other information relevant to the acts or omissions related to the financial
178.5misconduct.
178.6(b) Any single factor under paragraph (a) may be determinative of the department's
178.7decision of whether and what sanctions are imposed.
178.8    Subd. 10. Written notice of department sanction. (a) The department shall give
178.9notice in writing to a person of an administrative sanction that is to be imposed. The notice
178.10shall be sent by mail as defined in subdivision 1, paragraph (k).
178.11(b) The notice shall state:
178.12(1) the factual basis for the department's determination;
178.13(2) the sanction the department intends to take;
178.14(3) the dollar amount of the monetary recovery or recoupment, if any;
178.15(4) how the dollar amount was computed;
178.16(5) the right to dispute the department's determination and to provide evidence;
178.17(6) the right to appeal the department's proposed sanction; and
178.18(7) the option to meet informally with department staff, and to bring additional
178.19documentation or information, to resolve the issues.
178.20(c) In cases of determinations resulting in denial or termination of payments, in
178.21addition to the requirements of paragraph (b), the notice must state:
178.22(1) the length of the denial or termination;
178.23(2) the requirements and procedures for reinstatement; and
178.24(3) the provider's right to submit documents and written arguments against the
178.25denial or termination of payments for review by the department before the effective date
178.26of denial or termination.
178.27(d) The submission of documents and written argument for review by the department
178.28under paragraph (b), clause (5) or (7), or paragraph (c), clause (3), does not stay the
178.29deadline for filing an appeal.
178.30(e) Unless timely appealed, the effective date of the proposed sanction shall be 30
178.31days after the license holder's, provider's, controlling individual's, or recipient's receipt of
178.32the notice. If a timely appeal is made, the proposed sanction shall be delayed pending
178.33the final outcome of the appeal. Implementation of a proposed sanction following the
178.34resolution of a timely appeal may be postponed if, in the opinion of the department, the
178.35delay of sanction is necessary to protect the health or safety of children in care. The
178.36department may consider the economic hardship of a person in implementing the proposed
179.1sanction, but economic hardship shall not be a determinative factor in implementing the
179.2proposed sanction.
179.3(f) Requests for an informal meeting to attempt to resolve issues and requests
179.4for appeals must be sent or delivered to the department's Office of Inspector General,
179.5Financial Fraud and Abuse Division.
179.6    Subd. 11. Appeal of department sanction under this section. (a) If the department
179.7does not pursue a criminal action against a provider, license holder, controlling individual,
179.8or recipient for financial misconduct, but the department imposes an administrative
179.9sanction under subdivision 5, paragraph (c), any individual or entity against whom the
179.10sanction was imposed may appeal the department's administrative sanction under this
179.11section pursuant to section 119B.16 or 256.045 with the additional requirements in clauses
179.12(1) to (4). An appeal must specify:
179.13(1) each disputed item, the reason for the dispute, and an estimate of the dollar
179.14amount involved for each disputed item, if appropriate;
179.15(2) the computation that is believed to be correct, if appropriate;
179.16(3) the authority in the statute or rule relied upon for each disputed item; and
179.17(4) the name, address, and phone number of the person at the provider's place of
179.18business with whom contact may be made regarding the appeal.
179.19(b) An appeal is considered timely only if postmarked or received by the department's
179.20Appeals Division within 30 days after receiving a notice of department sanction.
179.21(c) Before the appeal hearing, the department may deny or terminate authorizations
179.22or payment to the entity or individual if the department determines that the action is
179.23necessary to protect the public welfare or the interests of the child care assistance program.
179.24    Subd. 12. Consolidated hearings with licensing sanction. If a financial
179.25misconduct sanction has an appeal hearing right and it is timely appealed, and a licensing
179.26sanction exists for which there is an appeal hearing right and the sanction is timely
179.27appealed, and the overpayment recovery action and licensing sanction involve the same
179.28set of facts, the overpayment recovery action and licensing sanction must be consolidated
179.29in the contested case hearing related to the licensing sanction.
179.30    Subd. 13. Grounds for and methods of monetary recovery. (a) The department
179.31may obtain monetary recovery from a provider who has been improperly paid by the
179.32child care assistance program, regardless of whether the error was intentional or county
179.33error. The department does not need to establish a pattern as a precondition of monetary
179.34recovery of erroneous or false billing claims, duplicate billing claims, or billing claims
179.35based on false statements or financial misconduct.
180.1(b) The department shall obtain monetary recovery from providers by the following
180.2means:
180.3(1) permitting voluntary repayment of money, either in lump-sum payment or
180.4installment payments;
180.5(2) using any legal collection process;
180.6(3) deducting or withholding program payments; or
180.7(4) utilizing the means set forth in chapter 16D.
180.8    Subd. 14. Reporting of suspected fraudulent activity. (a) A person who, in
180.9good faith, makes a report of or testifies in any action or proceeding in which financial
180.10misconduct is alleged, and who is not involved in, has not participated in, or has not aided
180.11and abetted, conspired, or colluded in the financial misconduct, shall have immunity from
180.12any liability, civil or criminal, that results by reason of the person's report or testimony.
180.13For the purpose of any proceeding, the good faith of any person reporting or testifying
180.14under this provision shall be presumed.
180.15(b) If a person that is or has been involved in, participated in, aided and abetted,
180.16conspired, or colluded in the financial misconduct reports the financial misconduct,
180.17the department may consider that person's report and assistance in investigating the
180.18misconduct as a mitigating factor in the department's pursuit of civil, criminal, or
180.19administrative remedies.
180.20    Subd. 15. Data privacy. Data of any kind obtained or created in relation to a provider
180.21or recipient investigation under this section is defined, classified, and protected the same as
180.22all other data under section 13.46, and this data has the same classification as licensing data.
180.23    Subd. 16. Monetary recovery; random sample extrapolation. The department is
180.24authorized to calculate the amount of monetary recovery from a provider, license holder, or
180.25controlling individual based upon extrapolation from a statistical random sample of claims
180.26submitted by the provider, license holder, or controlling individual and paid by the child
180.27care assistance program. The department's random sample extrapolation shall constitute a
180.28rebuttable presumption of the accuracy of the calculation of monetary recovery. If the
180.29presumption is not rebutted by the provider, license holder, or controlling individual in the
180.30appeal process, the department shall use the extrapolation as the monetary recovery figure.
180.31The department may use sampling and extrapolation to calculate the amount of monetary
180.32recovery if the claims to be reviewed represent services to 50 or more children in care.
180.33    Subd. 17. Effect of department's monetary penalty determination. Unless a
180.34timely and proper appeal is received by the department, the department's administrative
180.35determination or sanction shall be considered a final department determination.
181.1    Subd. 18. Office of Inspector General recoveries. Overpayment recoveries
181.2resulting from child care provider fraud investigations initiated by the department's Office
181.3of Inspector General's fraud investigations staff are excluded from the county recovery
181.4provision in section 119B.11, subdivision 3.

181.5    Sec. 6. Minnesota Statutes 2012, section 256B.04, subdivision 21, is amended to read:
181.6    Subd. 21. Provider enrollment. (a) If the commissioner or the Centers for
181.7Medicare and Medicaid Services determines that a provider is designated "high-risk," the
181.8commissioner may withhold payment from providers within that category upon initial
181.9enrollment for a 90-day period. The withholding for each provider must begin on the date
181.10of the first submission of a claim.
181.11(b) An enrolled provider that is also licensed by the commissioner under chapter
181.12245A must designate an individual as the entity's compliance officer. The compliance
181.13officer must:
181.14(1) develop policies and procedures to assure adherence to medical assistance laws
181.15and regulations and to prevent inappropriate claims submissions;
181.16(2) train the employees of the provider entity, and any agents or subcontractors of
181.17the provider entity including billers, on the policies and procedures under clause (1);
181.18(3) respond to allegations of improper conduct related to the provision or billing of
181.19medical assistance services, and implement action to remediate any resulting problems;
181.20(4) use evaluation techniques to monitor compliance with medical assistance laws
181.21and regulations;
181.22(5) promptly report to the commissioner any identified violations of medical
181.23assistance laws or regulations; and
181.24    (6) within 60 days of discovery by the provider of a medical assistance
181.25reimbursement overpayment, report the overpayment to the commissioner and make
181.26arrangements with the commissioner for the commissioner's recovery of the overpayment.
181.27The commissioner may require, as a condition of enrollment in medical assistance, that a
181.28provider within a particular industry sector or category establish a compliance program that
181.29contains the core elements established by the Centers for Medicare and Medicaid Services.
181.30(c) The commissioner may revoke the enrollment of an ordering or rendering
181.31provider for a period of not more than one year, if the provider fails to maintain and, upon
181.32request from the commissioner, provide access to documentation relating to written orders
181.33or requests for payment for durable medical equipment, certifications for home health
181.34services, or referrals for other items or services written or ordered by such provider, when
181.35the commissioner has identified a pattern of a lack of documentation. A pattern means a
182.1failure to maintain documentation or provide access to documentation on more than one
182.2occasion. Nothing in this paragraph limits the authority of the commissioner to sanction a
182.3provider under the provisions of section 256B.064.
182.4(d) The commissioner shall terminate or deny the enrollment of any individual or
182.5entity if the individual or entity has been terminated from participation in Medicare or
182.6under the Medicaid program or Children's Health Insurance Program of any other state.
182.7(e) As a condition of enrollment in medical assistance, the commissioner shall
182.8require that a provider designated "moderate" or "high-risk" by the Centers for Medicare
182.9and Medicaid Services or the Minnesota Department of Human Services commissioner
182.10 permit the Centers for Medicare and Medicaid Services, its agents, or its designated
182.11contractors and the state agency, its agents, or its designated contractors to conduct
182.12unannounced on-site inspections of any provider location. The commissioner shall publish
182.13in the Minnesota Health Care Program Provider Manual a list of provider types designated
182.14"limited," "moderate," or "high-risk," based on the criteria and standards used to designate
182.15Medicare providers in Code of Federal Regulations, title 42, section 424.518. The list and
182.16criteria are not subject to the requirements of chapter 14. The commissioner's designations
182.17are not subject to administrative appeal.
182.18(f) As a condition of enrollment in medical assistance, the commissioner shall
182.19require that a high-risk provider, or a person with a direct or indirect ownership interest in
182.20the provider of five percent or higher, consent to criminal background checks, including
182.21fingerprinting, when required to do so under state law or by a determination by the
182.22commissioner or the Centers for Medicare and Medicaid Services that a provider is
182.23designated high-risk for fraud, waste, or abuse.
182.24(g)(1) Upon initial enrollment, reenrollment, and revalidation, all durable medical
182.25equipment, prosthetics, orthotics, and supplies (DMEPOS) suppliers operating in
182.26Minnesota and receiving Medicaid funds, must purchase a surety bond that is annually
182.27renewed and designates the Minnesota Department of Human Services as the obligee, and
182.28must be submitted in a form approved by the commissioner.
182.29(2) At the time of initial enrollment or reenrollment, the provider agency must
182.30purchase a performance bond of $50,000. If a revalidating provider's Medicaid revenue
182.31in the previous calendar year is up to and including $300,000, the provider agency must
182.32purchase a performance bond of $50,000. If a revalidating provider's Medicaid revenue
182.33in the previous calendar year is over $300,000, the provider agency must purchase a
182.34performance bond of $100,000. The performance bond must allow for recovery of costs
182.35and fees in pursuing a claim on the bond.
183.1(h) The Department of Human Services may require a provider to purchase a
183.2performance surety bond as a condition of initial enrollment, reenrollment, reinstatement,
183.3or continued enrollment if: (1) the provider fails to demonstrate financial viability, (2) the
183.4department determines there is significant evidence of or potential for fraud and abuse by
183.5the provider, or (3) the provider or category of providers is designated high-risk pursuant
183.6to paragraph (a) and as per Code of Federal Regulations, title 42, section 455.450. The
183.7performance bond must be in an amount of $100,000 or ten percent of the provider's
183.8payments from Medicaid during the immediately preceding 12 months, whichever is
183.9greater. The performance bond must name the Department of Human Services as an
183.10obligee and must allow for recovery of costs and fees in pursuing a claim on the bond.
183.11EFFECTIVE DATE.This section is effective the day following final enactment.

183.12    Sec. 7. Minnesota Statutes 2012, section 256B.04, is amended by adding a subdivision
183.13to read:
183.14    Subd. 22. Application fee. (a) The commissioner must collect and retain federally
183.15required nonrefundable application fees to pay for provider screening activities in
183.16accordance with Code of Federal Regulations, title 42, section 455, subpart E. The
183.17enrollment application must be made under the procedures specified by the commissioner,
183.18in the form specified by the commissioner, and accompanied by an application fee
183.19described in paragraph (b), or a request for a hardship exception as described in the
183.20specified procedures. Application fees must be deposited in the provider screening account
183.21in the special revenue fund. Amounts in the provider screening account are appropriated
183.22to the commissioner for costs associated with the provider screening activities required
183.23in Code of Federal Regulations, title 42, section 455, subpart E. The commissioner
183.24shall conduct screening activities as required by Code of Federal Regulations, title 42,
183.25section 455, subpart E, and as otherwise provided by law, to include database checks,
183.26unannounced pre- and postenrollment site visits, fingerprinting, and criminal background
183.27studies. The commissioner must revalidate all providers under this subdivision at least
183.28once every five years.
183.29(b) The application fee under this subdivision is $532 for the calendar year 2013.
183.30For calendar year 2014 and subsequent years, the fee:
183.31(1) is adjusted by the percentage change to the consumer price index for all urban
183.32consumers, United States city average, for the 12-month period ending with June of the
183.33previous year. The resulting fee must be announced in the Federal Register;
183.34(2) is effective from January 1 to December 31 of a calendar year;
184.1(3) is required on the submission of an initial application, an application to establish
184.2a new practice location, an application for re-enrollment when the provider is not enrolled
184.3at the time of application of re-enrollment, or at revalidation when required by federal
184.4regulation; and
184.5(4) must be in the amount in effect for the calendar year during which the application
184.6for enrollment, new practice location, or re-enrollment is being submitted.
184.7(c) The application fee under this subdivision cannot be charged to:
184.8(1) providers who are enrolled in Medicare or who provide documentation of
184.9payment of the fee to, and enrollment with, another state, unless the commissioner is
184.10required to rescreen the provider;
184.11(2) providers who are enrolled but are required to submit new applications for
184.12purposes of reenrollment;
184.13(3) a provider who enrolls as an individual; and
184.14(4) group practices and clinics that bill on behalf of individually enrolled providers
184.15within the practice who have reassigned their billing privileges to the group practice
184.16or clinic.
184.17EFFECTIVE DATE.This section is effective the day following final enactment.

184.18    Sec. 8. Minnesota Statutes 2012, section 256B.064, subdivision 1a, is amended to read:
184.19    Subd. 1a. Grounds for sanctions against vendors. The commissioner may
184.20impose sanctions against a vendor of medical care for any of the following: (1) fraud,
184.21theft, or abuse in connection with the provision of medical care to recipients of public
184.22assistance; (2) a pattern of presentment of false or duplicate claims or claims for services
184.23not medically necessary; (3) a pattern of making false statements of material facts for
184.24the purpose of obtaining greater compensation than that to which the vendor is legally
184.25entitled; (4) suspension or termination as a Medicare vendor; (5) refusal to grant the state
184.26agency access during regular business hours to examine all records necessary to disclose
184.27the extent of services provided to program recipients and appropriateness of claims for
184.28payment; (6) failure to repay an overpayment or a fine finally established under this
184.29section; and (7) failure to correct errors in the maintenance of health service or financial
184.30records for which a fine was imposed or after issuance of a warning by the commissioner;
184.31and (8) any reason for which a vendor could be excluded from participation in the
184.32Medicare program under section 1128, 1128A, or 1866(b)(2) of the Social Security Act.
184.33The determination of services not medically necessary may be made by the commissioner
184.34in consultation with a peer advisory task force appointed by the commissioner on the
185.1recommendation of appropriate professional organizations. The task force expires as
185.2provided in section 15.059, subdivision 5.

185.3    Sec. 9. Minnesota Statutes 2012, section 256B.064, subdivision 1b, is amended to read:
185.4    Subd. 1b. Sanctions available. The commissioner may impose the following
185.5sanctions for the conduct described in subdivision 1a: suspension or withholding of
185.6payments to a vendor and suspending or terminating participation in the program, or
185.7imposition of a fine under subdivision 2, paragraph (f). When imposing sanctions under
185.8this section, the commissioner shall consider the nature, chronicity, or severity of the
185.9conduct and the effect of the conduct on the health and safety of persons served by the
185.10vendor. Regardless of imposition of sanctions, the commissioner may make a referral
185.11to the appropriate state licensing board.

185.12    Sec. 10. Minnesota Statutes 2012, section 256B.064, subdivision 2, is amended to read:
185.13    Subd. 2. Imposition of monetary recovery and sanctions. (a) The commissioner
185.14shall determine any monetary amounts to be recovered and sanctions to be imposed upon
185.15a vendor of medical care under this section. Except as provided in paragraphs (b) and
185.16(d), neither a monetary recovery nor a sanction will be imposed by the commissioner
185.17without prior notice and an opportunity for a hearing, according to chapter 14, on the
185.18commissioner's proposed action, provided that the commissioner may suspend or reduce
185.19payment to a vendor of medical care, except a nursing home or convalescent care facility,
185.20after notice and prior to the hearing if in the commissioner's opinion that action is
185.21necessary to protect the public welfare and the interests of the program.
185.22(b) Except when the commissioner finds good cause not to suspend payments under
185.23Code of Federal Regulations, title 42, section 455.23 (e) or (f), the commissioner shall
185.24withhold or reduce payments to a vendor of medical care without providing advance
185.25notice of such withholding or reduction if either of the following occurs:
185.26(1) the vendor is convicted of a crime involving the conduct described in subdivision
185.271a; or
185.28(2) the commissioner determines there is a credible allegation of fraud for which an
185.29investigation is pending under the program. A credible allegation of fraud is an allegation
185.30which has been verified by the state, from any source, including but not limited to:
185.31(i) fraud hotline complaints;
185.32(ii) claims data mining; and
185.33(iii) patterns identified through provider audits, civil false claims cases, and law
185.34enforcement investigations.
186.1Allegations are considered to be credible when they have an indicia of reliability
186.2and the state agency has reviewed all allegations, facts, and evidence carefully and acts
186.3judiciously on a case-by-case basis.
186.4(c) The commissioner must send notice of the withholding or reduction of payments
186.5under paragraph (b) within five days of taking such action unless requested in writing by a
186.6law enforcement agency to temporarily withhold the notice. The notice must:
186.7(1) state that payments are being withheld according to paragraph (b);
186.8(2) set forth the general allegations as to the nature of the withholding action, but
186.9need not disclose any specific information concerning an ongoing investigation;
186.10(3) except in the case of a conviction for conduct described in subdivision 1a, state
186.11that the withholding is for a temporary period and cite the circumstances under which
186.12withholding will be terminated;
186.13(4) identify the types of claims to which the withholding applies; and
186.14(5) inform the vendor of the right to submit written evidence for consideration by
186.15the commissioner.
186.16The withholding or reduction of payments will not continue after the commissioner
186.17determines there is insufficient evidence of fraud by the vendor, or after legal proceedings
186.18relating to the alleged fraud are completed, unless the commissioner has sent notice of
186.19intention to impose monetary recovery or sanctions under paragraph (a).
186.20(d) The commissioner shall suspend or terminate a vendor's participation in the
186.21program without providing advance notice and an opportunity for a hearing when the
186.22suspension or termination is required because of the vendor's exclusion from participation
186.23in Medicare. Within five days of taking such action, the commissioner must send notice of
186.24the suspension or termination. The notice must:
186.25(1) state that suspension or termination is the result of the vendor's exclusion from
186.26Medicare;
186.27(2) identify the effective date of the suspension or termination; and
186.28(3) inform the vendor of the need to be reinstated to Medicare before reapplying
186.29for participation in the program.
186.30(e) Upon receipt of a notice under paragraph (a) that a monetary recovery or
186.31sanction is to be imposed, a vendor may request a contested case, as defined in section
186.3214.02, subdivision 3 , by filing with the commissioner a written request of appeal. The
186.33appeal request must be received by the commissioner no later than 30 days after the date
186.34the notification of monetary recovery or sanction was mailed to the vendor. The appeal
186.35request must specify:
187.1(1) each disputed item, the reason for the dispute, and an estimate of the dollar
187.2amount involved for each disputed item;
187.3(2) the computation that the vendor believes is correct;
187.4(3) the authority in statute or rule upon which the vendor relies for each disputed item;
187.5(4) the name and address of the person or entity with whom contacts may be made
187.6regarding the appeal; and
187.7(5) other information required by the commissioner.
187.8(f) The commissioner may order a vendor to forfeit a fine for failure to fully document
187.9services according to standards in this chapter and Minnesota Rules, chapter 9505. The
187.10commissioner may assess fines if specific required components of documentation are
187.11missing. The fine for incomplete documentation shall equal 20 percent of the amount paid
187.12on the claims for reimbursement submitted by the vendor, or up to $5,000, whichever is less.
187.13(g) The vendor shall pay the fine assessed on or before the payment date specified. If
187.14the vendor fails to pay the fine, the commissioner may withhold or reduce payments and
187.15recover the amount of the fine. A timely appeal shall stay payment of the fine until the
187.16commissioner issues a final order.

187.17    Sec. 11. Minnesota Statutes 2012, section 256B.0659, subdivision 21, is amended to
187.18read:
187.19    Subd. 21. Requirements for initial provider enrollment of personal care
187.20assistance provider agencies. (a) All personal care assistance provider agencies must
187.21provide, at the time of enrollment, reenrollment, and revalidation as a personal care
187.22assistance provider agency in a format determined by the commissioner, information and
187.23documentation that includes, but is not limited to, the following:
187.24    (1) the personal care assistance provider agency's current contact information
187.25including address, telephone number, and e-mail address;
187.26    (2) proof of surety bond coverage in the amount of $50,000 or ten percent of the
187.27provider's payments from Medicaid in the previous year, whichever is less;
187.28    (2) proof of surety bond coverage. Upon new enrollment, or if the provider's
187.29Medicaid revenue in the previous calendar year is up to and including $300,000,
187.30the provider agency must purchase a performance bond of $50,000. If the Medicaid
187.31revenue in the previous year is over $300,000, the provider agency must purchase a
187.32performance bond of $100,000. The performance bond must be in a form approved by the
187.33commissioner, must be renewed annually, and must allow for recovery of costs and fees
187.34in pursuing a claim on the bond;
187.35    (3) proof of fidelity bond coverage in the amount of $20,000;
188.1    (4) proof of workers' compensation insurance coverage;
188.2    (5) proof of liability insurance;
188.3    (6) a description of the personal care assistance provider agency's organization
188.4identifying the names of all owners, managing employees, staff, board of directors, and
188.5the affiliations of the directors, owners, or staff to other service providers;
188.6    (7) a copy of the personal care assistance provider agency's written policies and
188.7procedures including: hiring of employees; training requirements; service delivery;
188.8and employee and consumer safety including process for notification and resolution
188.9of consumer grievances, identification and prevention of communicable diseases, and
188.10employee misconduct;
188.11    (8) copies of all other forms the personal care assistance provider agency uses in
188.12the course of daily business including, but not limited to:
188.13    (i) a copy of the personal care assistance provider agency's time sheet if the time
188.14sheet varies from the standard time sheet for personal care assistance services approved
188.15by the commissioner, and a letter requesting approval of the personal care assistance
188.16provider agency's nonstandard time sheet;
188.17    (ii) the personal care assistance provider agency's template for the personal care
188.18assistance care plan; and
188.19    (iii) the personal care assistance provider agency's template for the written
188.20agreement in subdivision 20 for recipients using the personal care assistance choice
188.21option, if applicable;
188.22    (9) a list of all training and classes that the personal care assistance provider agency
188.23requires of its staff providing personal care assistance services;
188.24    (10) documentation that the personal care assistance provider agency and staff have
188.25successfully completed all the training required by this section;
188.26    (11) documentation of the agency's marketing practices;
188.27    (12) disclosure of ownership, leasing, or management of all residential properties
188.28that is used or could be used for providing home care services;
188.29    (13) documentation that the agency will use the following percentages of revenue
188.30generated from the medical assistance rate paid for personal care assistance services
188.31for employee personal care assistant wages and benefits: 72.5 percent of revenue in the
188.32personal care assistance choice option and 72.5 percent of revenue from other personal
188.33care assistance providers. The revenue generated by the qualified professional and the
188.34reasonable costs associated with the qualified professional shall not be used in making
188.35this calculation; and
189.1    (14) effective May 15, 2010, documentation that the agency does not burden
189.2recipients' free exercise of their right to choose service providers by requiring personal
189.3care assistants to sign an agreement not to work with any particular personal care
189.4assistance recipient or for another personal care assistance provider agency after leaving
189.5the agency and that the agency is not taking action on any such agreements or requirements
189.6regardless of the date signed.
189.7    (b) Personal care assistance provider agencies shall provide the information specified
189.8in paragraph (a) to the commissioner at the time the personal care assistance provider
189.9agency enrolls as a vendor or upon request from the commissioner. The commissioner
189.10shall collect the information specified in paragraph (a) from all personal care assistance
189.11providers beginning July 1, 2009.
189.12    (c) All personal care assistance provider agencies shall require all employees in
189.13management and supervisory positions and owners of the agency who are active in the
189.14day-to-day management and operations of the agency to complete mandatory training
189.15as determined by the commissioner before enrollment of the agency as a provider.
189.16Employees in management and supervisory positions and owners who are active in
189.17the day-to-day operations of an agency who have completed the required training as
189.18an employee with a personal care assistance provider agency do not need to repeat
189.19the required training if they are hired by another agency, if they have completed the
189.20training within the past three years. By September 1, 2010, the required training must
189.21be available with meaningful access according to title VI of the Civil Rights Act and
189.22federal regulations adopted under that law or any guidance from the United States Health
189.23and Human Services Department. The required training must be available online or by
189.24electronic remote connection. The required training must provide for competency testing.
189.25Personal care assistance provider agency billing staff shall complete training about
189.26personal care assistance program financial management. This training is effective July 1,
189.272009. Any personal care assistance provider agency enrolled before that date shall, if it
189.28has not already, complete the provider training within 18 months of July 1, 2009. Any new
189.29owners or employees in management and supervisory positions involved in the day-to-day
189.30operations are required to complete mandatory training as a requisite of working for the
189.31agency. Personal care assistance provider agencies certified for participation in Medicare
189.32as home health agencies are exempt from the training required in this subdivision. When
189.33available, Medicare-certified home health agency owners, supervisors, or managers must
189.34successfully complete the competency test.
189.35EFFECTIVE DATE.This section is effective the day following final enactment.

190.1    Sec. 12. Minnesota Statutes 2012, section 299C.093, is amended to read:
190.2299C.093 DATABASE OF REGISTERED PREDATORY OFFENDERS.
190.3The superintendent of the Bureau of Criminal Apprehension shall maintain a
190.4computerized data system relating to individuals required to register as predatory offenders
190.5under section 243.166. To the degree feasible, the system must include the data required
190.6to be provided under section 243.166, subdivisions 4 and 4a, and indicate the time period
190.7that the person is required to register. The superintendent shall maintain this data in a
190.8manner that ensures that it is readily available to law enforcement agencies. This data is
190.9private data on individuals under section 13.02, subdivision 12, but may be used for law
190.10enforcement and corrections purposes. The commissioner of human services has access
190.11to the data for state-operated services, as defined in section 246.014, are also authorized
190.12to have access to the data for the purposes described in section 246.13, subdivision 2,
190.13paragraph (b), and for purposes of conducting background studies under chapter 245C.

190.14    Sec. 13. Minnesota Statutes 2012, section 402A.10, is amended to read:
190.15402A.10 DEFINITIONS.
190.16    Subdivision 1. Terms defined. For the purposes of this chapter, the terms defined
190.17in this section have the meanings given.
190.18    Subd. 1a. Balanced set of program measures. A "balanced set of program
190.19measures" is a set of measures that, together, adequately quantify achievement toward a
190.20particular program's outcome. As directed by section 402A.16, the Human Services
190.21Performance Council must recommend to the commissioner when a particular program
190.22has a balanced set of program measures.
190.23    Subd. 2. Commissioner. "Commissioner" means the commissioner of human
190.24services.
190.25    Subd. 3. Council. "Council" means the State-County Results, Accountability, and
190.26Service Delivery Redesign Council established in section 402A.20.
190.27    Subd. 4. Essential human services or essential services. "Essential human
190.28services" or "essential services" means assistance and services to recipients or potential
190.29recipients of public welfare and other services delivered by counties or tribes that are
190.30mandated in federal and state law that are to be available in all counties of the state.
190.31    Subd. 4a. Essential human services program. An "essential human services
190.32program" for the purposes of remedies under section 402A.18 means the following
190.33programs:
190.34(1) child welfare, including protection, truancy, minor parent, guardianship, and
190.35adoption;
191.1(2) children's mental health;
191.2(3) children's disability services;
191.3(4) public assistance eligibility, including measures related to processing timelines
191.4across information services programs;
191.5(5) MFIP;
191.6(6) child support;
191.7(7) chemical dependency;
191.8(8) adult disability;
191.9(9) adult mental health;
191.10(10) adult services such as long-term care; and
191.11(11) adult protection.
191.12    Subd. 4b. Measure. A "measure" means a quantitative indicator of a performance
191.13outcome.
191.14    Subd. 4c. Performance improvement plan. A "performance improvement plan"
191.15means a plan developed by a county or service delivery authority that describes steps the
191.16county or service delivery authority must take to improve performance on a specific
191.17measure or set of measures. The performance improvement plan must be negotiated
191.18with and approved by the commissioner. The performance improvement plan must
191.19require a specific numerical improvement in the measure or measures on which the plan
191.20is based and may include specific programmatic best practices or specific performance
191.21management practices that the county must implement.
191.22    Subd. 4d. Performance management system for human services. A "performance
191.23management system for human services" means a process by which performance data for
191.24essential human services is collected from counties or service delivery authorities and used
191.25to inform a variety of stakeholders and to improve performance over time.
191.26    Subd. 5. Service delivery authority. "Service delivery authority" means a single
191.27county, or consortium of counties operating by execution of a joint powers agreement
191.28under section 471.59 or other contractual agreement, that has voluntarily chosen by
191.29resolution of the county board of commissioners to participate in the redesign under this
191.30chapter or has been assigned by the commissioner pursuant to section 402A.18. A service
191.31delivery authority includes an Indian tribe or group of tribes that have voluntarily chosen
191.32by resolution of tribal government to participate in redesign under this chapter.
191.33    Subd. 6. Steering committee. "Steering committee" means the Steering Committee
191.34on Performance and Outcome Reforms.

192.1    Sec. 14. [402A.12] ESTABLISHMENT OF A PERFORMANCE MANAGEMENT
192.2SYSTEM FOR HUMAN SERVICES.
192.3By January 1, 2014, the commissioner shall implement a performance management
192.4system for essential human services as described in sections 402A.15 to 402A.18 that
192.5includes initial performance measures and standards consistent with the recommendations
192.6of the Steering Committee on Performance and Outcome Reforms in the December 2012
192.7report to the legislature.

192.8    Sec. 15. [402A.16] HUMAN SERVICES PERFORMANCE COUNCIL.
192.9    Subdivision 1. Establishment. By October 1, 2013, the commissioner shall convene
192.10a Human Services Performance Council to advise the commissioner on the implementation
192.11and operation of the performance management system for human services.
192.12    Subd. 2. Duties. The Human Services Performance Council shall:
192.13(1) hold meetings at least quarterly that are in compliance with Minnesota's Open
192.14Meeting Law under chapter 13D;
192.15(2) annually review the annual performance data submitted by counties or service
192.16delivery authorities;
192.17(3) review and advise the commissioner on department procedures related to the
192.18implementation of the performance management system and system process requirements
192.19and on barriers to process improvement in human services delivery;
192.20(4) advise the commissioner on the training and technical assistance needs of county
192.21or service delivery authority and department personnel;
192.22(5) review instances in which a county or service delivery authority has not made
192.23adequate progress on a performance improvement plan and make recommendations to
192.24the commissioner under section 402A.18;
192.25(6) consider appeals from counties or service delivery authorities that are in the
192.26remedies process and make recommendations to the commissioner on resolving the issue;
192.27(7) convene working groups to update and develop outcomes, measures, and
192.28performance standards for the performance management system and, on an annual basis,
192.29present these recommendations to the commissioner, including recommendations on when
192.30a particular essential human service program has a balanced set of program measures
192.31in place;
192.32(8) make recommendations on human services administrative rules or statutes that
192.33could be repealed in order to improve service delivery;
192.34(9) provide information to stakeholders on the council's role and regularly collect
192.35stakeholder input on performance management system performance; and
193.1(10) submit an annual report to the legislature and the commissioner, which
193.2includes a comprehensive report on the performance of individual counties or service
193.3delivery authorities as it relates to system measures; a list of counties or service delivery
193.4authorities that have been required to create performance improvement plans and the areas
193.5identified for improvement as part of the remedies process; a summary of performance
193.6improvement training and technical assistance activities offered to the county personnel
193.7by the department; recommendations on administrative rules or state statutes that could be
193.8repealed in order to improve service delivery; recommendations for system improvements,
193.9including updates to system outcomes, measures, and standards; and a response from
193.10the commissioner.
193.11    Subd. 3. Membership. (a) Human Services Performance Council membership shall
193.12be equally balanced among the following five stakeholder groups: the Association of
193.13Minnesota Counties, the Minnesota Association of County Social Service Administrators,
193.14the Department of Human Services, tribes and communities of color, and service providers
193.15and advocates for persons receiving human services. The Association of Minnesota
193.16Counties and the Minnesota Association of County Social Service Administrators shall
193.17appoint their own respective representatives. The commissioner of human services shall
193.18appoint representatives of the Department of Human Services, tribes and communities of
193.19color, and social services providers and advocates. Minimum council membership shall
193.20be 15 members, with at least three representatives from each stakeholder group, and
193.21maximum council membership shall be 20 members, with four representatives from
193.22each stakeholder group.
193.23(b) Notwithstanding section 15.059, Human Services Performance Council members
193.24shall be appointed for a minimum of two years, but may serve longer terms at the
193.25discretion of their appointing authority.
193.26(c) Notwithstanding section 15.059, members of the council shall receive no
193.27compensation for their services.
193.28(d) A commissioner's representative and a county representative from either the
193.29Association of Minnesota Counties or the Minnesota Association of County Social Service
193.30Administrators shall serve as Human Services Performance Council cochairs.
193.31    Subd. 4. Commissioner duties. The commissioner shall:
193.32(1) implement and maintain the performance management system for human services;
193.33(2) establish and regularly update the system's outcomes, measures, and standards,
193.34including the minimum performance standard for each performance measure;
193.35(3) determine when a particular program has a balanced set of measures;
194.1(4) receive reports from counties or service delivery authorities at least annually on
194.2their performance against system measures, provide counties with data needed to assess
194.3performance and monitor progress, and provide timely feedback to counties or service
194.4delivery authorities on their performance;
194.5(5) implement and monitor the remedies process in section 402A.18;
194.6(6) report to the Human Services Performance Council on county or service delivery
194.7authority performance on a semiannual basis;
194.8(7) provide general training and technical assistance to counties or service delivery
194.9authorities on topics related to performance measurement and performance improvement;
194.10(8) provide targeted training and technical assistance to counties or service delivery
194.11authorities that supports their performance improvement plans; and
194.12(9) provide staff support for the Human Services Performance Council.
194.13    Subd. 5. County or service delivery authority duties. The counties or service
194.14delivery authorities shall:
194.15(1) report performance data to meet performance management system requirements;
194.16and
194.17(2) provide training to personnel on basic principles of performance measurement
194.18and improvement and participate in training provided by the department.

194.19    Sec. 16. Minnesota Statutes 2012, section 402A.18, is amended to read:
194.20402A.18 COMMISSIONER POWER TO REMEDY FAILURE TO MEET
194.21PERFORMANCE OUTCOMES.
194.22    Subdivision 1. Underperforming county; specific service. If the commissioner
194.23determines that a county or service delivery authority is deficient in achieving minimum
194.24performance outcomes standards for a specific essential service human services program,
194.25the commissioner may impose the following remedies and adjust state and federal
194.26program allocations accordingly:
194.27(1) voluntary incorporation of the administration and operation of the specific
194.28essential service human services program with an existing service delivery authority or
194.29another county. A service delivery authority or county incorporating an underperforming
194.30county shall not be financially liable for the costs associated with remedying performance
194.31outcome deficiencies;
194.32(2) mandatory incorporation of the administration and operation of the specific
194.33essential service human services program with an existing service delivery authority or
194.34another county. A service delivery authority or county incorporating an underperforming
195.1county shall not be financially liable for the costs associated with remedying performance
195.2outcome deficiencies; or
195.3(3) transfer of authority for program administration and operation of the specific
195.4essential service human services program to the commissioner.
195.5    Subd. 2. Underperforming county; more than one-half of services. If the
195.6commissioner determines that a county or service delivery authority is deficient in
195.7achieving minimum performance outcomes standards for more than one-half of the defined
195.8essential human services programs, the commissioner may impose the following remedies:
195.9(1) voluntary incorporation of the administration and operation of essential human
195.10services programs with an existing service delivery authority or another county. A
195.11service delivery authority or county incorporating an underperforming county shall
195.12not be financially liable for the costs associated with remedying performance outcome
195.13deficiencies;
195.14(2) mandatory incorporation of the administration and operation of essential human
195.15services programs with an existing service delivery authority or another county. A
195.16service delivery authority or county incorporating an underperforming county shall
195.17not be financially liable for the costs associated with remedying performance outcome
195.18deficiencies; or
195.19(3) transfer of authority for program administration and operation of essential human
195.20services programs to the commissioner.
195.21    Subd. 2a. Financial responsibility of underperforming county. A county subject
195.22to remedies under subdivision 1 or 2 shall provide to the entity assuming administration
195.23of the essential service or essential human services program or programs the amount of
195.24nonfederal and nonstate funding needed to remedy performance outcome deficiencies.
195.25    Subd. 3. Conditions prior to imposing remedies. Before the commissioner may
195.26impose the remedies authorized under this section, the following conditions must be met:
195.27(1) the county or service delivery authority determined by the commissioner
195.28to be deficient in achieving minimum performance outcomes has the opportunity, in
195.29coordination with the council, to develop a program outcome improvement plan. The
195.30program outcome improvement plan must be developed no later than six months from the
195.31date of the deficiency determination; and
195.32(2) the council has conducted an assessment of the program outcome improvement
195.33plan to determine if the county or service delivery authority has made satisfactory progress
195.34toward performance outcomes and has made a recommendation about remedies to the
195.35commissioner. The assessment and recommendation must be made to the commissioner
195.36within 12 months from the date of the deficiency determination. (a) The commissioner
196.1shall notify a county or service delivery authority that it must submit a performance
196.2improvement plan if:
196.3(1) the county or service delivery authority does not meet the minimum performance
196.4standard for a measure; or
196.5(2) the county or service delivery authority does not meet the minimum performance
196.6standard for one or more racial or ethnic subgroup for which there is a statistically valid
196.7population size for three or more measures, even if the county or service delivery authority
196.8met the standard for the overall population.
196.9The commissioner must approve the performance improvement plan. The county or
196.10service delivery authority may negotiate the terms of the performance improvement plan
196.11with the commissioner.
196.12(b) When the department determines that a county or service delivery authority does
196.13not meet the minimum performance standard for a given measure, the commissioner
196.14must advise the county or service delivery authority that fiscal penalties may result if the
196.15performance does not improve. The department must offer technical assistance to the
196.16county or service delivery authority. Within 30 days of the initial advisement from the
196.17department, the county or service delivery authority may claim and the department may
196.18approve an extenuating circumstance that relieves the county or service delivery authority
196.19of any further remedy. If a county or service delivery authority has a small number of
196.20participants in an essential human services program such that reliable measurement is
196.21not possible, the commissioner may approve extenuating circumstances or may average
196.22performance over three years.
196.23(c) If there are no extenuating circumstances, the county or service delivery authority
196.24must submit a performance improvement plan to the commissioner within 60 days of the
196.25initial advisement from the department. The term of the performance improvement plan
196.26must be two years, starting with the date the plan is approved by the commissioner. This
196.27plan must include a target level for improvement for each measure that did not meet
196.28the minimum performance standard. The commissioner must approve the performance
196.29improvement plan within 60 days of submittal.
196.30(d) The department must monitor the performance improvement plan for two
196.31years. After two years, if the county or service delivery authority meets the minimum
196.32performance standard, there is no further remedy. If the county or service delivery
196.33authority fails to meet the minimum performance standard, but meets the improvement
196.34target in the performance improvement plan, the county or service delivery authority shall
196.35modify the performance improvement plan for further improvement and the department
196.36shall continue to monitor the plan.
197.1(e) If, after two years of monitoring, the county or service delivery authority fails to
197.2meet both the minimum performance standard and the improvement target identified in
197.3the performance improvement plan, the next step of the remedies process shall be invoked
197.4by the commissioner. This phase of the remedies process may include:
197.5(1) fiscal penalties for the county or service delivery authority that do not exceed
197.6one percent of the county's human services expenditures and that are negotiated in the
197.7performance improvement plan, based on what is needed to improve outcomes. Counties
197.8or service delivery authorities must reinvest the amount of the fiscal penalty into the
197.9essential human services program that was underperforming. A county or service delivery
197.10authority shall not be required to pay more than three fiscal penalties in a year; and
197.11(2) the department's provision of technical assistance to the county or service
197.12delivery authority that is targeted to address the specific performance issues.
197.13The commissioner shall continue monitoring the performance improvement plan for a
197.14third year.
197.15(f) If, after the third year of monitoring, the county or service delivery authority
197.16meets the minimum performance standard, there is no further remedy. If the county or
197.17service delivery authority fails to meet the minimum performance standard, but meets the
197.18improvement target for the performance improvement plan, the county or service delivery
197.19authority shall modify the performance improvement plan for further improvement and
197.20the department shall continue to monitor the plan.
197.21(g) If, after the third year of monitoring, the county or service delivery authority fails
197.22to meet the minimum performance standard and the improvement target identified in the
197.23performance improvement plan, the Human Services Performance Council shall review
197.24the situation and recommend a course of action to the commissioner.
197.25(h) If the commissioner has determined that a program has a balanced set of program
197.26measures and a county or service delivery authority is subject to fiscal penalties for more
197.27than one-half of the measures for that program, the commissioner may apply further
197.28remedies as described in subdivisions 1 and 2.

197.29    Sec. 17. INSTRUCTIONS TO THE COMMISSIONER.
197.30    In collaboration with labor organizations, the commissioner of human services shall
197.31develop clear and consistent standards for state-operated services programs to:
197.32    (1) address direct service staffing shortages;
197.33    (2) identify and help resolve workplace safety issues; and
197.34    (3) elevate the use and visibility of performance measures and objectives related to
197.35overtime use.

198.1ARTICLE 6
198.2HEALTH CARE

198.3    Section 1. Minnesota Statutes 2012, section 245.03, subdivision 1, is amended to read:
198.4    Subdivision 1. Establishment. There is created a Department of Human Services.
198.5A commissioner of human services shall be appointed by the governor under the
198.6provisions of section 15.06. The commissioner shall be selected on the basis of ability and
198.7experience in welfare and without regard to political affiliations. The commissioner shall
198.8 may appoint a up to two deputy commissioner commissioners.

198.9    Sec. 2. Minnesota Statutes 2012, section 256.9657, subdivision 3, is amended to read:
198.10    Subd. 3. Surcharge on HMOs and community integrated service networks. (a)
198.11Effective October 1, 1992, each health maintenance organization with a certificate of
198.12authority issued by the commissioner of health under chapter 62D and each community
198.13integrated service network licensed by the commissioner under chapter 62N shall pay to
198.14the commissioner of human services a surcharge equal to six-tenths of one percent of the
198.15total premium revenues of the health maintenance organization or community integrated
198.16service network as reported to the commissioner of health according to the schedule in
198.17subdivision 4.
198.18(b) For purposes of this subdivision, total premium revenue means:
198.19(1) premium revenue recognized on a prepaid basis from individuals and groups
198.20for provision of a specified range of health services over a defined period of time which
198.21is normally one month, excluding premiums paid to a health maintenance organization
198.22or community integrated service network from the Federal Employees Health Benefit
198.23Program;
198.24(2) premiums from Medicare wraparound subscribers for health benefits which
198.25supplement Medicare coverage;
198.26(3) Medicare revenue, as a result of an arrangement between a health maintenance
198.27organization or a community integrated service network and the Centers for Medicare
198.28and Medicaid Services of the federal Department of Health and Human Services, for
198.29services to a Medicare beneficiary, excluding Medicare revenue that states are prohibited
198.30from taxing under sections 1854, 1860D-12, and 1876 of title XVIII of the federal Social
198.31Security Act, codified as United States Code, title 42, sections 1395mm, 1395w-112, and
198.321395w-24, respectively, as they may be amended from time to time; and
199.1(4) medical assistance revenue, as a result of an arrangement between a health
199.2maintenance organization or community integrated service network and a Medicaid state
199.3agency, for services to a medical assistance beneficiary.
199.4If advance payments are made under clause (1) or (2) to the health maintenance
199.5organization or community integrated service network for more than one reporting period,
199.6the portion of the payment that has not yet been earned must be treated as a liability.
199.7(c) When a health maintenance organization or community integrated service
199.8network merges or consolidates with or is acquired by another health maintenance
199.9organization or community integrated service network, the surviving corporation or the
199.10new corporation shall be responsible for the annual surcharge originally imposed on
199.11each of the entities or corporations subject to the merger, consolidation, or acquisition,
199.12regardless of whether one of the entities or corporations does not retain a certificate of
199.13authority under chapter 62D or a license under chapter 62N.
199.14(d) Effective July 1 June 15 of each year, the surviving corporation's or the new
199.15corporation's surcharge shall be based on the revenues earned in the second previous
199.16calendar year by all of the entities or corporations subject to the merger, consolidation,
199.17or acquisition regardless of whether one of the entities or corporations does not retain a
199.18certificate of authority under chapter 62D or a license under chapter 62N until the total
199.19premium revenues of the surviving corporation include the total premium revenues of all
199.20the merged entities as reported to the commissioner of health.
199.21(e) When a health maintenance organization or community integrated service
199.22network, which is subject to liability for the surcharge under this chapter, transfers,
199.23assigns, sells, leases, or disposes of all or substantially all of its property or assets, liability
199.24for the surcharge imposed by this chapter is imposed on the transferee, assignee, or buyer
199.25of the health maintenance organization or community integrated service network.
199.26(f) In the event a health maintenance organization or community integrated service
199.27network converts its licensure to a different type of entity subject to liability for the
199.28surcharge under this chapter, but survives in the same or substantially similar form, the
199.29surviving entity remains liable for the surcharge regardless of whether one of the entities
199.30or corporations does not retain a certificate of authority under chapter 62D or a license
199.31under chapter 62N.
199.32(g) The surcharge assessed to a health maintenance organization or community
199.33integrated service network ends when the entity ceases providing services for premiums
199.34and the cessation is not connected with a merger, consolidation, acquisition, or conversion.

199.35    Sec. 3. Minnesota Statutes 2012, section 256.9657, subdivision 4, is amended to read:
200.1    Subd. 4. Payments into the account. (a) Payments to the commissioner under
200.2subdivisions subdivision 1 to 3 must be paid in monthly installments due on the 15th of
200.3the month beginning October 15, 1992. The monthly payment must be equal to the annual
200.4surcharge divided by 12. Payments to the commissioner under subdivisions 2 and 3 for
200.5fiscal year 1993 must be based on calendar year 1990 revenues. Effective July 1 of each
200.6year, beginning in 1993, payments under subdivisions 2 and 3 must be based on revenues
200.7earned in the second previous calendar year.
200.8(b) Effective October 15, 2014, payment to the commissioner under subdivision 2
200.9must be paid in nine monthly installments due on the 15th of the month beginning October
200.1015, 2014, through June 15 of the following year. The monthly payment must be equal
200.11to the annual surcharge divided by nine.
200.12(b) (c) Effective October 1, 1995 2014, and each October 1 thereafter, the payments
200.13in subdivisions subdivision 2 and 3 must be based on revenues earned in the previous
200.14calendar year.
200.15(c) (d) If the commissioner of health does not provide by August 15 of any year data
200.16needed to update the base year for the hospital and or April 15 of any year data needed to
200.17update the base year for the health maintenance organization surcharges, the commissioner
200.18of human services may estimate base year revenue and use that estimate for the purposes
200.19of this section until actual data is provided by the commissioner of health.
200.20(d) (e) Payments to the commissioner under subdivision 3a must be paid in monthly
200.21installments due on the 15th of the month beginning July 15, 2003. The monthly payment
200.22must be equal to the annual surcharge divided by 12.
200.23(f) Payments due in July through September 2014 under subdivision 3 for revenue
200.24earned in calendar year 2012 shall be paid in a lump sum on June 15, 2014. On June
200.2515, 2014, each health maintenance organization and community-integrated service
200.26network shall pay all payments under subdivision 3 in a lump sum for revenue earned in
200.27calendar year 2013. Effective June 15, 2015, and each June 15 thereafter, the payments in
200.28subdivision 3 shall be based on revenues earned in the previous calendar year and paid
200.29in a lump sum on June 15 of each year.

200.30    Sec. 4. Minnesota Statutes 2012, section 256.969, subdivision 29, is amended to read:
200.31    Subd. 29. Reimbursement for the fee increase for the early hearing detection
200.32and intervention program. (a) For admissions occurring on or after July 1, 2010,
200.33payment rates shall be adjusted to include the increase to the fee that is effective on July 1,
200.342010, for the early hearing detection and intervention program recipients under section
200.35144.125, subdivision 1 , that is paid by the hospital for public program recipients. This
201.1payment increase shall be in effect until the increase is fully recognized in the base year
201.2cost under subdivision 2b. This payment shall be included in payments to contracted
201.3managed care organizations.
201.4    (b) For admissions occurring on or after July 1, 2013, payment rates shall be adjusted
201.5to include the increase to the fee that is effective July 1, 2013, for the early hearing
201.6detection and intervention program under section 144.125, subdivision 1, paragraph (d),
201.7that is paid by the hospital for medical assistance and MinnesotaCare program enrollees.
201.8This payment increase shall be in effect until the increase is fully recognized in the
201.9base-year cost under subdivision 2b. This payment shall be included in payments to
201.10managed care plans and county-based purchasing plans.

201.11    Sec. 5. Minnesota Statutes 2012, section 256B.04, is amended by adding a subdivision
201.12to read:
201.13    Subd. 22. Medical assistance costs for certain inmates. The commissioner shall
201.14execute an interagency agreement with the commissioner of corrections to recover the
201.15state cost attributable to medical assistance eligibility for inmates of public institutions
201.16admitted to a medical institution on an inpatient basis. The annual amount to be transferred
201.17from the Department of Corrections under the agreement must include all eligible state
201.18medical assistance costs, including administrative costs incurred by the Department of
201.19Human Services, attributable to inmates under state and county jurisdiction admitted to
201.20medical institutions on an inpatient basis that are related to the implementation of section
201.21256B.055, subdivision 14, paragraph (c).

201.22    Sec. 6. Minnesota Statutes 2012, section 256B.055, subdivision 14, is amended to read:
201.23    Subd. 14. Persons detained by law. (a) Medical assistance may be paid for an
201.24inmate of a correctional facility who is conditionally released as authorized under section
201.25241.26 , 244.065, or 631.425, if the individual does not require the security of a public
201.26detention facility and is housed in a halfway house or community correction center, or
201.27under house arrest and monitored by electronic surveillance in a residence approved
201.28by the commissioner of corrections, and if the individual meets the other eligibility
201.29requirements of this chapter.
201.30    (b) An individual who is enrolled in medical assistance, and who is charged with a
201.31crime and incarcerated for less than 12 months shall be suspended from eligibility at the
201.32time of incarceration until the individual is released. Upon release, medical assistance
201.33eligibility is reinstated without reapplication using a reinstatement process and form, if the
201.34individual is otherwise eligible.
202.1    (c) An individual, regardless of age, who is considered an inmate of a public
202.2institution as defined in Code of Federal Regulations, title 42, section 435.1010, and
202.3who meets the eligibility requirements in section 256B.056, is not eligible for medical
202.4assistance, except for covered services received while an inpatient in a medical institution
202.5as defined in Code of Federal Regulations, title 42, section 435.1010. Security issues,
202.6including costs, related to the inpatient treatment of an inmate are the responsibility of the
202.7entity with jurisdiction over the inmate.
202.8EFFECTIVE DATE.This section is effective January 1, 2014.

202.9    Sec. 7. Minnesota Statutes 2012, section 256B.06, subdivision 4, is amended to read:
202.10    Subd. 4. Citizenship requirements. (a) Eligibility for medical assistance is limited
202.11to citizens of the United States, qualified noncitizens as defined in this subdivision, and
202.12other persons residing lawfully in the United States. Citizens or nationals of the United
202.13States must cooperate in obtaining satisfactory documentary evidence of citizenship or
202.14nationality according to the requirements of the federal Deficit Reduction Act of 2005,
202.15Public Law 109-171.
202.16(b) "Qualified noncitizen" means a person who meets one of the following
202.17immigration criteria:
202.18(1) admitted for lawful permanent residence according to United States Code, title 8;
202.19(2) admitted to the United States as a refugee according to United States Code,
202.20title 8, section 1157;
202.21(3) granted asylum according to United States Code, title 8, section 1158;
202.22(4) granted withholding of deportation according to United States Code, title 8,
202.23section 1253(h);
202.24(5) paroled for a period of at least one year according to United States Code, title 8,
202.25section 1182(d)(5);
202.26(6) granted conditional entrant status according to United States Code, title 8,
202.27section 1153(a)(7);
202.28(7) determined to be a battered noncitizen by the United States Attorney General
202.29according to the Illegal Immigration Reform and Immigrant Responsibility Act of 1996,
202.30title V of the Omnibus Consolidated Appropriations Bill, Public Law 104-200;
202.31(8) is a child of a noncitizen determined to be a battered noncitizen by the United
202.32States Attorney General according to the Illegal Immigration Reform and Immigrant
202.33Responsibility Act of 1996, title V, of the Omnibus Consolidated Appropriations Bill,
202.34Public Law 104-200; or
203.1(9) determined to be a Cuban or Haitian entrant as defined in section 501(e) of Public
203.2Law 96-422, the Refugee Education Assistance Act of 1980.
203.3(c) All qualified noncitizens who were residing in the United States before August
203.422, 1996, who otherwise meet the eligibility requirements of this chapter, are eligible for
203.5medical assistance with federal financial participation.
203.6(d) Beginning December 1, 1996, qualified noncitizens who entered the United
203.7States on or after August 22, 1996, and who otherwise meet the eligibility requirements
203.8of this chapter are eligible for medical assistance with federal participation for five years
203.9if they meet one of the following criteria:
203.10(1) refugees admitted to the United States according to United States Code, title 8,
203.11section 1157;
203.12(2) persons granted asylum according to United States Code, title 8, section 1158;
203.13(3) persons granted withholding of deportation according to United States Code,
203.14title 8, section 1253(h);
203.15(4) veterans of the United States armed forces with an honorable discharge for
203.16a reason other than noncitizen status, their spouses and unmarried minor dependent
203.17children; or
203.18(5) persons on active duty in the United States armed forces, other than for training,
203.19their spouses and unmarried minor dependent children.
203.20 Beginning July 1, 2010, children and pregnant women who are noncitizens
203.21described in paragraph (b) or who are lawfully present in the United States as defined
203.22in Code of Federal Regulations, title 8, section 103.12, and who otherwise meet
203.23eligibility requirements of this chapter, are eligible for medical assistance with federal
203.24financial participation as provided by the federal Children's Health Insurance Program
203.25Reauthorization Act of 2009, Public Law 111-3.
203.26(e) Nonimmigrants who otherwise meet the eligibility requirements of this chapter
203.27are eligible for the benefits as provided in paragraphs (f) to (h). For purposes of this
203.28subdivision, a "nonimmigrant" is a person in one of the classes listed in United States
203.29Code, title 8, section 1101(a)(15).
203.30(f) Payment shall also be made for care and services that are furnished to noncitizens,
203.31regardless of immigration status, who otherwise meet the eligibility requirements of
203.32this chapter, if such care and services are necessary for the treatment of an emergency
203.33medical condition.
203.34(g) For purposes of this subdivision, the term "emergency medical condition" means
203.35a medical condition that meets the requirements of United States Code, title 42, section
203.361396b(v).
204.1(h)(1) Notwithstanding paragraph (g), services that are necessary for the treatment
204.2of an emergency medical condition are limited to the following:
204.3(i) services delivered in an emergency room or by an ambulance service licensed
204.4under chapter 144E that are directly related to the treatment of an emergency medical
204.5condition;
204.6(ii) services delivered in an inpatient hospital setting following admission from an
204.7emergency room or clinic for an acute emergency condition; and
204.8(iii) follow-up services that are directly related to the original service provided
204.9to treat the emergency medical condition and are covered by the global payment made
204.10to the provider.
204.11    (2) Services for the treatment of emergency medical conditions do not include:
204.12(i) services delivered in an emergency room or inpatient setting to treat a
204.13nonemergency condition;
204.14(ii) organ transplants, stem cell transplants, and related care;
204.15(iii) services for routine prenatal care;
204.16(iv) continuing care, including long-term care, nursing facility services, home health
204.17care, adult day care, day training, or supportive living services;
204.18(v) elective surgery;
204.19(vi) outpatient prescription drugs, unless the drugs are administered or dispensed as
204.20part of an emergency room visit;
204.21(vii) preventative health care and family planning services;
204.22(viii) dialysis;
204.23(ix) chemotherapy or therapeutic radiation services;
204.24(x) (viii) rehabilitation services;
204.25(xi) (ix) physical, occupational, or speech therapy;
204.26(xii) (x) transportation services;
204.27(xiii) (xi) case management;
204.28(xiv) (xii) prosthetics, orthotics, durable medical equipment, or medical supplies;
204.29(xv) (xiii) dental services;
204.30(xvi) (xiv) hospice care;
204.31(xvii) (xv) audiology services and hearing aids;
204.32(xviii) (xvi) podiatry services;
204.33(xix) (xvii) chiropractic services;
204.34(xx) (xviii) immunizations;
204.35(xxi) (xix) vision services and eyeglasses;
204.36(xxii) (xx) waiver services;
205.1(xxiii) (xxi) individualized education programs; or
205.2(xxiv) (xxii) chemical dependency treatment.
205.3(i) Beginning July 1, 2009, pregnant noncitizens who are undocumented,
205.4nonimmigrants, or lawfully present in the United States as defined in Code of Federal
205.5Regulations, title 8, section 103.12, are not covered by a group health plan or health
205.6insurance coverage according to Code of Federal Regulations, title 42, section 457.310,