Minnesota Legislature
HF 1510
as introduced - 92nd Legislature (2021 - 2022) Posted on 02/25/2021 03:16pm
Bill Text Versions
| Engrossments | ||
|---|---|---|
| Introduction | Posted on 02/25/2021 |
Current Version - as introduced
2.23 2.24
2.25 2.26 2.27 2.28 2.29 2.30 2.31
2.32 2.33 2.34 2.35 2.36 2.37 2.38 2.39 2.40 3.1 3.2 3.3 3.4 3.5 3.6 3.7 3.8 3.9 3.10 3.11 3.12 3.13 3.14 3.15 3.16 3.17 3.18 3.19 3.20 3.21 3.22 3.23 3.24 3.25 3.26 3.27 3.28 3.29 3.30 3.31 3.32 4.1 4.2 4.3 4.4 4.5 4.6 4.7 4.8 4.9 4.10 4.11 4.12 4.13 4.14 4.15 4.16 4.17 4.18 4.19 4.20 4.21 4.22 4.23 4.24 4.25 4.26 4.27 4.28 4.29 4.30 4.31 4.32 4.33 4.34 5.1 5.2 5.3 5.4 5.5 5.6 5.7 5.8 5.9 5.10 5.11 5.12 5.13 5.14 5.15 5.16 5.17 5.18 5.19 5.20 5.21 5.22 5.23 5.24 5.25 5.26 5.27 5.28 5.29 5.30 5.31 5.32 5.33 5.34 5.35 6.1 6.2 6.3 6.4
6.5 6.6 6.7 6.8 6.9 6.10 6.11 6.12 6.13 6.14 6.15 6.16 6.17 6.18 6.19 6.20 6.21 6.22 6.23 6.24 6.25 6.26 6.27 6.28 6.29 6.30 6.31 6.32 6.33 7.1 7.2 7.3 7.4 7.5 7.6 7.7 7.8 7.9 7.10 7.11 7.12 7.13 7.14 7.15 7.16 7.17 7.18 7.19
7.20 7.21 7.22 7.23 7.24 7.25 7.26 7.27 7.28 7.29 7.30 7.31 7.32 7.33 8.1 8.2 8.3 8.4 8.5 8.6 8.7 8.8 8.9 8.10 8.11 8.12 8.13 8.14 8.15 8.16 8.17 8.18 8.19 8.20 8.21 8.22 8.23 8.24 8.25 8.26 8.27 8.28 8.29 8.30 8.31 8.32 9.1 9.2 9.3 9.4 9.5 9.6 9.7 9.8 9.9 9.10 9.11 9.12 9.13 9.14 9.15 9.16 9.17 9.18 9.19 9.20 9.21 9.22 9.23 9.24 9.25 9.26 9.27 9.28 9.29 9.30 9.31 9.32 9.33 10.1 10.2 10.3 10.4 10.5 10.6 10.7 10.8 10.9 10.10 10.11 10.12 10.13 10.14 10.15 10.16 10.17 10.18 10.19 10.20 10.21 10.22 10.23 10.24 10.25 10.26 10.27 10.28 10.29 10.30 10.31 10.32 10.33 11.1 11.2 11.3 11.4 11.5 11.6
11.7
11.8 11.9 11.10 11.11 11.12 11.13 11.14 11.15 11.16 11.17 11.18 11.19 11.20 11.21 11.22 11.23 11.24 11.25 11.26 11.27 11.28 11.29 11.30 11.31 11.32 11.33 12.1 12.2 12.3 12.4 12.5 12.6 12.7 12.8 12.9 12.10 12.11 12.12 12.13 12.14 12.15 12.16 12.17 12.18 12.19 12.20 12.21
12.22
12.23 12.24 12.25 12.26 12.27 12.28 12.29 12.30 12.31 12.32 13.1 13.2 13.3 13.4 13.5 13.6 13.7
13.8 13.9 13.10 13.11 13.12 13.13 13.14 13.15 13.16 13.17 13.18 13.19 13.20 13.21 13.22 13.23 13.24 13.25 13.26 13.27 13.28
13.29 13.30 13.31 13.32 13.33 13.34 14.1 14.2 14.3 14.4
14.5 14.6 14.7 14.8 14.9 14.10 14.11 14.12 14.13 14.14 14.15 14.16 14.17
14.18 14.19 14.20 14.21 14.22 14.23 14.24 14.25
14.26 14.27 14.28 14.29
15.1 15.2 15.3 15.4
15.5 15.6 15.7 15.8 15.9
15.10 15.11 15.12 15.13 15.14 15.15 15.16 15.17 15.18 15.19 15.20 15.21 15.22 15.23 15.24 15.25 15.26 15.27 15.28 15.29 15.30 16.1 16.2
16.3 16.4 16.5 16.6 16.7 16.8 16.9 16.10 16.11 16.12 16.13 16.14 16.15
16.16 16.17 16.18 16.19 16.20 16.21 16.22 16.23 16.24 16.25 16.26 16.27 16.28 16.29 16.30 16.31 16.32
17.1 17.2 17.3 17.4 17.5 17.6 17.7 17.8 17.9 17.10 17.11 17.12 17.13 17.14 17.15 17.16 17.17 17.18 17.19 17.20 17.21 17.22 17.23 17.24 17.25 17.26 17.27 17.28 17.29 17.30 17.31 17.32 17.33 18.1 18.2 18.3 18.4 18.5 18.6
18.7 18.8 18.9 18.10 18.11 18.12 18.13 18.14 18.15 18.16 18.17 18.18 18.19 18.20 18.21
18.22 18.23 18.24 18.25 18.26 18.27 18.28 18.29 18.30 18.31 18.32 18.33 19.1 19.2
19.3 19.4 19.5 19.6 19.7 19.8 19.9
19.10 19.11 19.12 19.13 19.14 19.15 19.16 19.17 19.18 19.19 19.20 19.21 19.22 19.23 19.24 19.25 19.26 19.27 19.28 19.29
20.1 20.2 20.3 20.4 20.5 20.6 20.7 20.8 20.9
20.10 20.11 20.12 20.13 20.14 20.15 20.16
20.17 20.18 20.19 20.20 20.21 20.22 20.23 20.24 20.25 20.26 20.27 20.28 20.29 20.30 20.31 21.1 21.2 21.3 21.4 21.5 21.6 21.7 21.8 21.9 21.10 21.11 21.12 21.13 21.14 21.15 21.16 21.17 21.18 21.19 21.20 21.21 21.22 21.23 21.24 21.25 21.26 21.27 21.28 21.29 21.30 21.31 21.32 22.1 22.2 22.3 22.4 22.5 22.6 22.7 22.8 22.9 22.10 22.11 22.12
22.13 22.14 22.15 22.16 22.17 22.18 22.19 22.20 22.21 22.22 22.23 22.24
22.25 22.26 22.27 22.28 22.29 22.30 23.1 23.2 23.3
23.4
23.5 23.6 23.7 23.8 23.9 23.10 23.11 23.12 23.13 23.14 23.15 23.16 23.17 23.18 23.19 23.20 23.21 23.22 23.23 23.24 23.25 23.26 23.27
23.28 23.29 23.30 23.31 23.32 24.1 24.2 24.3 24.4 24.5 24.6 24.7 24.8 24.9 24.10 24.11 24.12 24.13 24.14 24.15 24.16 24.17 24.18 24.19 24.20 24.21 24.22 24.23 24.24 24.25 24.26 24.27 24.28 24.29 25.1 25.2 25.3 25.4 25.5 25.6 25.7 25.8 25.9 25.10 25.11 25.12 25.13 25.14 25.15 25.16 25.17 25.18 25.19 25.20 25.21 25.22 25.23 25.24 25.25 25.26 25.27 25.28 25.29 25.30 25.31 25.32 26.1 26.2 26.3 26.4 26.5
26.6 26.7 26.8 26.9 26.10 26.11 26.12 26.13 26.14 26.15 26.16 26.17 26.18 26.19 26.20 26.21 26.22 26.23 26.24 26.25 26.26
26.27 26.28 26.29 26.30 26.31 26.32 27.1 27.2 27.3 27.4 27.5 27.6 27.7 27.8 27.9 27.10 27.11 27.12 27.13 27.14 27.15 27.16 27.17 27.18 27.19 27.20 27.21 27.22 27.23 27.24 27.25 27.26 27.27 27.28 27.29 27.30 27.31 27.32 27.33 27.34 28.1 28.2 28.3 28.4 28.5 28.6 28.7 28.8 28.9 28.10 28.11 28.12 28.13 28.14 28.15 28.16 28.17 28.18 28.19 28.20 28.21 28.22 28.23 28.24 28.25 28.26 28.27 28.28 28.29 28.30 28.31 28.32 28.33 28.34 29.1 29.2 29.3 29.4 29.5 29.6 29.7 29.8 29.9 29.10 29.11 29.12 29.13 29.14 29.15 29.16 29.17 29.18 29.19 29.20 29.21 29.22 29.23 29.24 29.25 29.26 29.27 29.28 29.29 29.30 29.31 29.32 30.1 30.2 30.3 30.4 30.5 30.6 30.7 30.8 30.9 30.10
30.11 30.12 30.13 30.14 30.15 30.16 30.17 30.18 30.19 30.20 30.21 30.22 30.23 30.24 30.25 30.26 30.27 30.28 30.29 30.30 30.31 30.32 30.33 30.34 31.1 31.2 31.3 31.4 31.5 31.6 31.7 31.8 31.9 31.10 31.11 31.12 31.13 31.14 31.15 31.16 31.17 31.18 31.19 31.20 31.21 31.22 31.23 31.24 31.25 31.26 31.27 31.28 31.29 31.30 31.31 31.32 31.33 31.34 31.35 32.1 32.2 32.3 32.4 32.5 32.6 32.7 32.8 32.9 32.10 32.11 32.12 32.13 32.14 32.15 32.16 32.17 32.18 32.19 32.20 32.21 32.22 32.23 32.24 32.25 32.26 32.27 32.28 32.29 32.30 32.31 32.32 32.33 32.34 33.1 33.2 33.3 33.4 33.5 33.6 33.7 33.8 33.9 33.10 33.11 33.12 33.13 33.14 33.15
33.16 33.17 33.18 33.19 33.20 33.21 33.22 33.23 33.24 33.25 33.26 33.27 33.28 33.29 33.30 33.31 34.1 34.2 34.3 34.4 34.5 34.6 34.7 34.8 34.9 34.10 34.11 34.12 34.13 34.14 34.15 34.16
34.17 34.18 34.19 34.20 34.21 34.22 34.23 34.24 34.25 34.26 34.27 34.28 34.29 34.30 35.1 35.2 35.3 35.4 35.5 35.6 35.7 35.8 35.9 35.10 35.11 35.12 35.13 35.14 35.15 35.16 35.17 35.18 35.19 35.20 35.21 35.22 35.23 35.24 35.25 35.26 35.27 35.28 35.29 35.30 36.1 36.2 36.3 36.4 36.5 36.6 36.7 36.8 36.9 36.10 36.11 36.12 36.13 36.14 36.15 36.16 36.17 36.18 36.19 36.20 36.21 36.22 36.23 36.24 36.25 36.26 36.27 36.28 36.29 36.30 36.31 36.32 36.33 37.1 37.2 37.3 37.4 37.5 37.6 37.7 37.8 37.9 37.10 37.11 37.12 37.13 37.14 37.15 37.16 37.17 37.18 37.19 37.20 37.21 37.22 37.23 37.24 37.25 37.26 37.27 37.28 37.29 37.30 37.31
38.1 38.2 38.3 38.4 38.5 38.6 38.7 38.8 38.9 38.10 38.11 38.12 38.13 38.14 38.15 38.16 38.17 38.18 38.19 38.20 38.21 38.22 38.23 38.24 38.25 38.26 38.27 38.28 38.29 38.30 39.1 39.2 39.3 39.4 39.5 39.6 39.7 39.8 39.9 39.10 39.11 39.12 39.13 39.14 39.15 39.16 39.17 39.18 39.19 39.20 39.21 39.22 39.23 39.24 39.25 39.26 39.27
39.28 39.29 39.30 39.31 39.32
40.1 40.2 40.3 40.4 40.5 40.6 40.7 40.8 40.9 40.10 40.11 40.12 40.13 40.14 40.15 40.16 40.17 40.18 40.19 40.20 40.21 40.22 40.23 40.24 40.25 40.26 40.27 40.28 40.29 40.30 40.31 40.32 41.1 41.2 41.3 41.4 41.5 41.6 41.7 41.8 41.9 41.10 41.11 41.12 41.13 41.14 41.15 41.16 41.17 41.18 41.19 41.20 41.21 41.22 41.23 41.24 41.25 41.26 41.27 41.28 41.29 41.30 41.31 41.32 42.1 42.2 42.3 42.4 42.5 42.6
42.7 42.8 42.9 42.10 42.11
42.12 42.13
42.14 42.15 42.16 42.17 42.18 42.19 42.20 42.21 42.22 42.23 42.24 42.25 42.26 42.27 42.28 42.29 42.30 42.31 42.32 43.1 43.2 43.3 43.4 43.5 43.6 43.7 43.8 43.9 43.10 43.11 43.12 43.13 43.14 43.15 43.16 43.17 43.18 43.19 43.20 43.21 43.22 43.23 43.24 43.25 43.26 43.27 43.28 43.29 43.30 43.31 43.32 43.33 43.34 43.35 44.1 44.2 44.3 44.4 44.5 44.6 44.7 44.8 44.9 44.10 44.11 44.12
44.13
44.14 44.15 44.16 44.17 44.18 44.19 44.20 44.21 44.22 44.23 44.24 44.25 44.26
44.27
44.28 44.29 44.30 44.31 45.1 45.2 45.3 45.4 45.5 45.6 45.7 45.8 45.9 45.10 45.11 45.12 45.13 45.14 45.15 45.16 45.17 45.18 45.19 45.20 45.21 45.22 45.23 45.24 45.25 45.26 45.27 45.28 45.29 45.30 45.31 46.1 46.2 46.3 46.4 46.5 46.6 46.7 46.8 46.9 46.10 46.11 46.12 46.13 46.14 46.15 46.16 46.17 46.18 46.19 46.20 46.21 46.22
46.23
46.24 46.25 46.26 46.27 46.28 46.29 46.30 46.31 46.32 47.1 47.2 47.3 47.4 47.5 47.6 47.7 47.8 47.9 47.10 47.11 47.12 47.13 47.14 47.15 47.16 47.17 47.18 47.19 47.20 47.21 47.22 47.23 47.24 47.25 47.26 47.27 47.28 47.29 47.30 47.31 47.32 47.33 48.1 48.2 48.3 48.4 48.5 48.6 48.7 48.8
48.9
48.10 48.11 48.12 48.13 48.14 48.15
48.16
48.17 48.18 48.19 48.20 48.21 48.22 48.23 48.24 48.25 48.26 48.27
48.28
49.1 49.2 49.3 49.4 49.5 49.6 49.7 49.8
49.9
49.10 49.11 49.12 49.13 49.14 49.15 49.16 49.17 49.18 49.19 49.20 49.21 49.22 49.23 49.24 49.25 49.26 49.27 49.28 49.29 49.30 49.31 50.1 50.2 50.3
50.4
50.5 50.6 50.7 50.8 50.9 50.10 50.11 50.12 50.13 50.14 50.15 50.16 50.17 50.18 50.19 50.20 50.21 50.22 50.23 50.24 50.25 50.26 50.27 50.28 50.29 50.30 50.31 51.1 51.2 51.3 51.4 51.5 51.6 51.7 51.8 51.9 51.10 51.11 51.12 51.13 51.14 51.15 51.16 51.17 51.18 51.19 51.20 51.21 51.22 51.23 51.24
51.25
51.26 51.27 51.28 51.29 51.30 51.31 51.32 51.33 52.1 52.2 52.3 52.4 52.5 52.6 52.7 52.8 52.9 52.10 52.11 52.12 52.13 52.14 52.15 52.16 52.17 52.18 52.19 52.20 52.21 52.22 52.23 52.24 52.25 52.26 52.27 52.28 52.29 52.30 52.31 52.32 52.33 52.34 53.1 53.2 53.3 53.4 53.5 53.6 53.7 53.8 53.9 53.10 53.11 53.12 53.13 53.14 53.15 53.16 53.17 53.18 53.19 53.20 53.21 53.22 53.23 53.24
53.25
53.26 53.27 53.28 53.29 53.30 53.31
53.32
54.1 54.2 54.3 54.4 54.5
54.6
54.7 54.8 54.9 54.10 54.11
54.12
54.13 54.14 54.15 54.16 54.17
54.18
54.19 54.20 54.21 54.22 54.23 54.24 54.25 54.26 54.27
54.28
55.1 55.2 55.3 55.4 55.5
55.6
55.7 55.8 55.9 55.10 55.11
55.12
55.13 55.14 55.15 55.16 55.17 55.18 55.19 55.20 55.21 55.22
55.23
55.24 55.25 55.26 55.27 55.28 55.29 56.1 56.2 56.3 56.4 56.5 56.6 56.7 56.8 56.9 56.10 56.11 56.12 56.13 56.14 56.15 56.16 56.17 56.18 56.19 56.20 56.21 56.22 56.23 56.24 56.25 56.26 56.27 56.28 56.29 56.30 56.31 56.32 57.1 57.2 57.3 57.4 57.5 57.6 57.7 57.8 57.9 57.10 57.11 57.12 57.13 57.14 57.15 57.16 57.17 57.18 57.19 57.20 57.21 57.22 57.23 57.24 57.25 57.26 57.27 57.28 57.29 57.30 58.1 58.2 58.3 58.4 58.5 58.6 58.7 58.8 58.9 58.10 58.11 58.12 58.13 58.14 58.15 58.16 58.17 58.18 58.19 58.20 58.21 58.22 58.23 58.24 58.25 58.26 58.27 58.28 58.29 58.30 58.31 59.1 59.2 59.3 59.4 59.5 59.6 59.7 59.8 59.9 59.10 59.11 59.12 59.13 59.14 59.15 59.16 59.17 59.18 59.19 59.20 59.21 59.22 59.23 59.24 59.25 59.26 59.27 59.28 59.29 59.30 59.31 59.32 60.1 60.2 60.3 60.4 60.5 60.6 60.7 60.8 60.9 60.10 60.11 60.12 60.13 60.14 60.15 60.16 60.17 60.18 60.19 60.20 60.21 60.22 60.23 60.24 60.25 60.26 60.27 60.28 60.29 60.30 60.31 60.32 60.33 61.1 61.2 61.3 61.4 61.5 61.6 61.7 61.8 61.9 61.10 61.11 61.12 61.13 61.14 61.15 61.16 61.17 61.18 61.19 61.20 61.21 61.22 61.23 61.24 61.25 61.26 61.27 61.28 61.29 61.30 62.1 62.2 62.3 62.4 62.5 62.6 62.7 62.8 62.9 62.10 62.11 62.12 62.13 62.14 62.15 62.16 62.17 62.18 62.19 62.20 62.21 62.22 62.23 62.24 62.25 62.26 62.27 62.28 62.29 62.30 63.1 63.2 63.3 63.4 63.5 63.6 63.7 63.8 63.9 63.10 63.11 63.12 63.13 63.14 63.15 63.16 63.17 63.18 63.19 63.20 63.21 63.22 63.23 63.24 63.25 63.26 63.27 63.28 63.29 63.30 63.31 63.32 63.33 64.1 64.2 64.3 64.4 64.5 64.6 64.7 64.8 64.9 64.10 64.11 64.12 64.13 64.14 64.15 64.16 64.17 64.18 64.19 64.20 64.21 64.22 64.23 64.24 64.25 64.26 64.27 64.28 64.29 64.30 64.31 64.32 65.1 65.2 65.3 65.4 65.5 65.6 65.7 65.8 65.9 65.10 65.11 65.12 65.13 65.14 65.15
65.16
65.17 65.18 65.19 65.20 65.21 65.22 65.23 65.24 65.25 65.26
65.27 65.28 65.29 65.30 65.31 66.1 66.2 66.3 66.4
66.5 66.6 66.7 66.8
66.9 66.10 66.11 66.12 66.13 66.14 66.15 66.16 66.17 66.18 66.19 66.20 66.21 66.22 66.23 66.24 66.25 66.26 66.27 66.28 66.29 66.30 66.31 67.1 67.2 67.3 67.4 67.5 67.6 67.7 67.8 67.9 67.10 67.11 67.12 67.13 67.14 67.15 67.16 67.17 67.18 67.19 67.20 67.21 67.22 67.23 67.24 67.25 67.26 67.27 67.28
67.29 67.30 67.31 67.32 67.33 68.1 68.2 68.3 68.4 68.5 68.6 68.7
68.8 68.9 68.10 68.11 68.12 68.13 68.14 68.15 68.16 68.17 68.18 68.19 68.20 68.21 68.22 68.23 68.24
68.25 68.26 68.27 68.28 68.29 68.30 68.31 68.32 68.33 69.1 69.2 69.3 69.4
69.5 69.6 69.7 69.8 69.9 69.10 69.11 69.12
69.13 69.14 69.15 69.16 69.17 69.18 69.19 69.20 69.21 69.22 69.23 69.24 69.25 69.26 69.27 69.28 69.29 69.30 69.31 69.32 70.1 70.2 70.3 70.4 70.5 70.6 70.7 70.8 70.9 70.10 70.11 70.12 70.13 70.14 70.15 70.16 70.17 70.18 70.19 70.20 70.21 70.22 70.23 70.24 70.25 70.26 70.27 70.28 70.29 70.30
71.1 71.2 71.3 71.4 71.5 71.6 71.7 71.8 71.9 71.10 71.11 71.12 71.13 71.14 71.15 71.16 71.17 71.18 71.19 71.20 71.21 71.22 71.23 71.24 71.25 71.26 71.27 71.28 71.29 71.30 71.31 72.1 72.2 72.3 72.4 72.5 72.6 72.7 72.8 72.9 72.10 72.11 72.12 72.13 72.14 72.15 72.16 72.17 72.18 72.19 72.20 72.21 72.22 72.23 72.24 72.25 72.26 72.27 72.28 72.29 72.30 72.31 72.32 73.1 73.2 73.3 73.4 73.5 73.6 73.7 73.8 73.9
73.10 73.11 73.12 73.13 73.14 73.15 73.16 73.17 73.18 73.19 73.20 73.21 73.22 73.23 73.24 73.25 73.26 73.27 73.28 73.29 73.30
74.1 74.2 74.3 74.4 74.5 74.6 74.7 74.8 74.9 74.10 74.11 74.12 74.13 74.14 74.15
74.16 74.17 74.18 74.19 74.20 74.21 74.22 74.23 74.24 74.25 74.26 74.27 74.28 74.29 74.30 74.31 74.32 75.1 75.2 75.3 75.4
75.5 75.6 75.7 75.8 75.9 75.10 75.11 75.12 75.13 75.14 75.15 75.16 75.17 75.18 75.19 75.20 75.21
75.22 75.23 75.24 75.25 75.26 75.27 75.28 75.29 75.30 75.31 76.1 76.2 76.3 76.4
76.5 76.6 76.7 76.8 76.9 76.10
76.11 76.12 76.13 76.14 76.15 76.16 76.17 76.18 76.19 76.20 76.21 76.22 76.23 76.24 76.25 76.26 76.27 76.28 76.29 76.30 77.1 77.2 77.3 77.4 77.5 77.6 77.7 77.8 77.9 77.10 77.11 77.12 77.13 77.14 77.15 77.16 77.17 77.18
77.19 77.20 77.21 77.22 77.23 77.24 77.25 77.26 77.27 77.28 77.29 77.30 77.31 77.32 78.1 78.2 78.3 78.4 78.5 78.6 78.7 78.8 78.9 78.10 78.11 78.12 78.13 78.14 78.15 78.16 78.17 78.18 78.19 78.20 78.21 78.22 78.23 78.24 78.25 78.26 78.27 78.28 78.29 78.30 78.31 78.32 78.33
79.1 79.2 79.3 79.4 79.5 79.6 79.7 79.8 79.9 79.10 79.11 79.12 79.13 79.14 79.15 79.16 79.17 79.18
79.19 79.20 79.21 79.22 79.23 79.24 79.25 79.26 79.27 79.28 79.29 79.30 79.31 79.32 80.1 80.2 80.3 80.4
80.5 80.6 80.7 80.8 80.9 80.10 80.11 80.12 80.13 80.14 80.15 80.16 80.17 80.18 80.19 80.20
80.21 80.22 80.23 80.24
80.25 80.26 80.27 80.28
81.1 81.2 81.3 81.4 81.5 81.6
81.7 81.8 81.9 81.10 81.11 81.12 81.13 81.14 81.15 81.16 81.17 81.18
81.19 81.20 81.21 81.22
81.23 81.24 81.25 81.26 81.27 81.28 81.29 81.30 81.31 81.32 82.1 82.2
82.3 82.4 82.5 82.6 82.7 82.8 82.9 82.10 82.11 82.12 82.13 82.14 82.15 82.16 82.17 82.18 82.19
82.20 82.21 82.22 82.23 82.24 82.25 82.26 82.27 82.28 82.29 82.30 82.31
83.1 83.2 83.3 83.4 83.5 83.6 83.7
83.8 83.9 83.10 83.11 83.12 83.13 83.14 83.15 83.16 83.17 83.18 83.19 83.20
83.21 83.22 83.23 83.24 83.25 83.26 83.27 83.28 83.29 83.30 83.31 83.32
84.1 84.2 84.3 84.4 84.5 84.6 84.7 84.8 84.9 84.10 84.11 84.12 84.13 84.14 84.15 84.16
84.17 84.18 84.19 84.20 84.21 84.22 84.23 84.24 84.25 84.26 84.27 84.28 84.29
84.30
85.1 85.2 85.3 85.4 85.5 85.6 85.7 85.8 85.9 85.10 85.11 85.12 85.13 85.14 85.15 85.16 85.17 85.18 85.19 85.20 85.21 85.22 85.23 85.24 85.25 85.26 85.27 85.28 85.29 85.30 85.31 85.32 85.33 85.34 85.35 86.1 86.2 86.3 86.4 86.5 86.6 86.7 86.8 86.9 86.10 86.11 86.12 86.13 86.14 86.15 86.16 86.17 86.18 86.19 86.20 86.21 86.22 86.23 86.24 86.25 86.26 86.27 86.28 86.29 86.30 86.31 86.32 86.33 86.34 87.1 87.2 87.3 87.4 87.5 87.6 87.7 87.8 87.9
87.10
87.11 87.12 87.13 87.14 87.15 87.16 87.17 87.18 87.19 87.20 87.21 87.22 87.23 87.24 87.25 87.26 87.27 87.28 87.29 87.30 87.31 87.32 88.1 88.2 88.3 88.4 88.5 88.6 88.7 88.8 88.9 88.10 88.11 88.12 88.13 88.14 88.15 88.16 88.17 88.18 88.19 88.20 88.21 88.22 88.23 88.24 88.25 88.26 88.27 88.28 88.29 88.30 88.31 88.32 89.1 89.2 89.3 89.4 89.5 89.6 89.7 89.8 89.9 89.10 89.11 89.12 89.13 89.14 89.15 89.16 89.17 89.18 89.19 89.20 89.21 89.22 89.23 89.24 89.25 89.26 89.27 89.28 89.29 89.30 89.31 89.32 89.33 89.34 90.1 90.2 90.3 90.4 90.5 90.6 90.7 90.8 90.9 90.10 90.11 90.12 90.13 90.14 90.15 90.16 90.17 90.18 90.19 90.20 90.21 90.22 90.23 90.24 90.25 90.26 90.27 90.28 90.29 90.30 91.1 91.2 91.3 91.4 91.5 91.6 91.7 91.8 91.9 91.10 91.11 91.12 91.13 91.14 91.15 91.16 91.17 91.18 91.19 91.20 91.21 91.22 91.23 91.24 91.25 91.26 91.27 91.28 91.29 91.30 91.31 91.32 92.1 92.2 92.3 92.4 92.5 92.6 92.7 92.8 92.9 92.10 92.11 92.12 92.13 92.14 92.15 92.16 92.17 92.18
92.19 92.20 92.21 92.22 92.23 92.24 92.25 92.26 92.27 92.28 92.29 92.30 92.31 92.32 92.33 92.34 93.1 93.2 93.3 93.4 93.5 93.6 93.7 93.8 93.9 93.10 93.11 93.12 93.13
93.14
93.15 93.16 93.17 93.18 93.19 93.20 93.21 93.22 93.23 93.24 93.25 93.26 93.27 93.28 93.29 93.30 93.31 93.32 94.1 94.2 94.3 94.4 94.5 94.6 94.7 94.8 94.9 94.10 94.11 94.12 94.13 94.14 94.15 94.16 94.17 94.18 94.19 94.20 94.21 94.22 94.23 94.24 94.25 94.26 94.27 94.28 94.29 94.30 94.31 95.1 95.2 95.3 95.4 95.5
95.6 95.7 95.8 95.9 95.10 95.11 95.12 95.13 95.14 95.15 95.16 95.17 95.18 95.19 95.20 95.21 95.22 95.23 95.24 95.25 95.26 95.27 95.28 95.29 95.30 95.31
95.32
96.1 96.2 96.3 96.4 96.5 96.6 96.7 96.8 96.9 96.10 96.11 96.12 96.13 96.14 96.15 96.16 96.17 96.18 96.19 96.20 96.21 96.22
96.23 96.24 96.25 96.26 96.27 96.28
96.29 96.30 96.31 96.32 97.1 97.2 97.3 97.4 97.5 97.6 97.7 97.8 97.9 97.10 97.11 97.12 97.13 97.14 97.15 97.16 97.17 97.18 97.19 97.20 97.21 97.22 97.23 97.24 97.25 97.26 97.27 97.28 97.29 97.30 98.1 98.2 98.3 98.4 98.5 98.6 98.7 98.8 98.9 98.10 98.11 98.12 98.13 98.14 98.15 98.16 98.17 98.18 98.19 98.20 98.21 98.22 98.23 98.24 98.25 98.26 98.27 98.28 98.29 98.30 98.31 98.32 98.33 99.1 99.2 99.3 99.4 99.5 99.6 99.7 99.8 99.9 99.10 99.11 99.12 99.13 99.14 99.15 99.16 99.17 99.18 99.19 99.20 99.21 99.22 99.23 99.24 99.25 99.26 99.27 99.28 99.29 99.30 99.31 99.32 100.1 100.2 100.3 100.4 100.5 100.6 100.7 100.8 100.9
100.10
100.11 100.12 100.13 100.14 100.15 100.16 100.17 100.18 100.19 100.20 100.21 100.22 100.23 100.24 100.25 100.26 100.27 100.28 100.29 100.30 100.31 101.1 101.2 101.3 101.4 101.5 101.6 101.7 101.8 101.9 101.10 101.11 101.12 101.13 101.14 101.15 101.16 101.17 101.18
101.19 101.20 101.21 101.22 101.23 101.24 101.25 101.26 101.27 101.28 101.29 101.30 101.31 101.32 102.1 102.2 102.3 102.4 102.5 102.6 102.7 102.8 102.9 102.10 102.11 102.12 102.13 102.14 102.15 102.16 102.17 102.18 102.19 102.20 102.21 102.22 102.23 102.24 102.25
102.26 102.27 102.28 102.29 102.30 102.31 102.32 103.1 103.2 103.3 103.4 103.5 103.6 103.7 103.8 103.9 103.10 103.11 103.12 103.13 103.14 103.15 103.16 103.17 103.18 103.19 103.20 103.21 103.22 103.23 103.24 103.25 103.26 103.27 103.28 103.29 103.30 104.1 104.2 104.3 104.4 104.5 104.6 104.7 104.8 104.9 104.10 104.11 104.12 104.13 104.14 104.15 104.16 104.17 104.18 104.19 104.20 104.21 104.22 104.23 104.24 104.25 104.26 104.27
104.28 104.29 104.30 104.31 105.1 105.2 105.3 105.4 105.5 105.6 105.7 105.8 105.9 105.10 105.11 105.12 105.13 105.14 105.15 105.16 105.17 105.18 105.19 105.20 105.21 105.22 105.23 105.24 105.25 105.26 105.27 105.28 105.29 105.30 105.31 105.32 105.33 106.1 106.2 106.3 106.4 106.5 106.6 106.7 106.8 106.9 106.10 106.11 106.12
106.13 106.14 106.15 106.16 106.17 106.18 106.19 106.20 106.21 106.22 106.23 106.24 106.25 106.26 106.27 106.28 106.29 106.30 106.31 106.32 106.33 107.1 107.2 107.3 107.4
107.5 107.6 107.7 107.8 107.9 107.10 107.11 107.12 107.13 107.14 107.15 107.16 107.17 107.18 107.19 107.20 107.21 107.22 107.23 107.24 107.25 107.26 107.27
108.1 108.2 108.3 108.4 108.5 108.6 108.7 108.8 108.9 108.10 108.11 108.12 108.13 108.14 108.15 108.16 108.17 108.18 108.19 108.20 108.21 108.22 108.23 108.24 108.25 108.26 108.27 108.28 108.29 108.30 108.31 108.32 108.33 109.1 109.2 109.3 109.4 109.5 109.6 109.7 109.8 109.9 109.10 109.11 109.12 109.13 109.14 109.15 109.16 109.17 109.18 109.19 109.20 109.21 109.22 109.23 109.24 109.25 109.26 109.27 109.28 109.29 109.30 109.31 109.32 109.33 109.34
110.1
110.2 110.3 110.4 110.5 110.6 110.7 110.8 110.9 110.10 110.11 110.12 110.13 110.14 110.15 110.16 110.17 110.18 110.19 110.20 110.21 110.22 110.23 110.24 110.25 110.26 110.27 110.28 110.29 110.30 111.1 111.2 111.3 111.4 111.5 111.6 111.7 111.8 111.9 111.10 111.11 111.12 111.13 111.14 111.15 111.16 111.17 111.18 111.19 111.20 111.21 111.22 111.23 111.24 111.25 111.26 111.27 111.28 111.29 111.30 111.31 111.32
111.33
112.1 112.2 112.3 112.4 112.5 112.6 112.7 112.8 112.9 112.10 112.11 112.12 112.13 112.14 112.15 112.16 112.17 112.18 112.19 112.20 112.21 112.22 112.23 112.24 112.25 112.26 112.27 112.28 112.29 112.30 112.31 112.32 113.1 113.2 113.3 113.4 113.5 113.6 113.7 113.8 113.9 113.10 113.11 113.12 113.13 113.14 113.15 113.16 113.17
113.18
113.19 113.20 113.21 113.22 113.23 113.24 113.25 113.26 113.27 113.28 113.29 113.30 113.31 113.32 114.1 114.2 114.3 114.4 114.5 114.6 114.7 114.8 114.9 114.10 114.11 114.12 114.13 114.14 114.15 114.16 114.17 114.18 114.19 114.20 114.21 114.22 114.23 114.24 114.25 114.26 114.27 114.28 114.29 114.30 115.1 115.2 115.3 115.4 115.5 115.6 115.7 115.8 115.9 115.10 115.11 115.12 115.13 115.14 115.15 115.16 115.17 115.18 115.19 115.20 115.21 115.22 115.23 115.24 115.25 115.26 115.27 115.28 115.29 115.30 115.31 115.32 115.33 116.1 116.2
116.3
116.4 116.5 116.6 116.7 116.8 116.9 116.10 116.11 116.12 116.13 116.14 116.15 116.16 116.17 116.18 116.19 116.20 116.21 116.22 116.23 116.24 116.25 116.26 116.27 116.28 116.29
116.30
117.1 117.2 117.3 117.4 117.5 117.6 117.7 117.8 117.9 117.10 117.11 117.12 117.13 117.14 117.15 117.16
117.17
117.18 117.19 117.20 117.21 117.22 117.23 117.24 117.25 117.26 117.27 117.28 117.29 117.30 117.31 118.1 118.2 118.3 118.4 118.5 118.6 118.7 118.8 118.9 118.10 118.11 118.12 118.13 118.14 118.15 118.16 118.17 118.18 118.19 118.20 118.21 118.22 118.23 118.24 118.25 118.26 118.27 118.28 118.29 118.30 118.31 118.32 119.1 119.2 119.3 119.4 119.5 119.6 119.7 119.8 119.9 119.10 119.11 119.12 119.13 119.14 119.15 119.16 119.17 119.18 119.19 119.20 119.21 119.22 119.23 119.24 119.25 119.26 119.27 119.28 119.29 119.30 119.31 119.32 120.1 120.2
120.3
120.4 120.5 120.6 120.7 120.8 120.9 120.10 120.11 120.12
120.13
120.14 120.15 120.16 120.17 120.18 120.19 120.20 120.21 120.22 120.23 120.24 120.25 120.26 120.27 120.28 120.29 120.30 121.1 121.2 121.3 121.4 121.5 121.6 121.7 121.8 121.9 121.10 121.11 121.12 121.13 121.14 121.15 121.16 121.17 121.18 121.19 121.20 121.21 121.22 121.23 121.24 121.25 121.26 121.27 121.28 121.29 121.30 121.31 121.32 122.1 122.2 122.3 122.4 122.5 122.6 122.7 122.8 122.9 122.10 122.11 122.12 122.13 122.14 122.15 122.16 122.17 122.18 122.19 122.20 122.21 122.22 122.23 122.24 122.25 122.26 122.27 122.28 122.29
122.30
123.1 123.2 123.3 123.4 123.5 123.6 123.7 123.8 123.9 123.10 123.11 123.12 123.13 123.14 123.15 123.16 123.17 123.18 123.19 123.20 123.21 123.22 123.23 123.24 123.25 123.26 123.27 123.28 123.29 123.30 124.1 124.2 124.3 124.4 124.5 124.6 124.7 124.8 124.9 124.10 124.11 124.12 124.13 124.14 124.15 124.16 124.17 124.18 124.19 124.20 124.21 124.22 124.23 124.24 124.25 124.26 124.27 124.28 124.29 124.30 124.31 125.1 125.2 125.3 125.4 125.5 125.6 125.7 125.8 125.9 125.10 125.11 125.12 125.13 125.14 125.15 125.16 125.17 125.18 125.19 125.20 125.21 125.22 125.23 125.24 125.25 125.26 125.27 125.28 125.29 125.30 125.31
125.32
126.1 126.2 126.3 126.4 126.5 126.6 126.7 126.8 126.9 126.10 126.11 126.12 126.13 126.14 126.15 126.16 126.17 126.18 126.19 126.20 126.21 126.22 126.23 126.24 126.25 126.26 126.27
126.28
127.1 127.2 127.3 127.4 127.5 127.6 127.7 127.8 127.9 127.10 127.11 127.12 127.13 127.14 127.15 127.16 127.17 127.18
127.19
127.20 127.21 127.22 127.23 127.24 127.25 127.26 127.27
127.28
127.29 127.30 127.31 128.1 128.2 128.3 128.4 128.5 128.6 128.7 128.8 128.9 128.10 128.11 128.12 128.13 128.14 128.15 128.16 128.17 128.18 128.19 128.20 128.21 128.22 128.23 128.24 128.25 128.26 128.27 128.28 128.29 128.30 128.31 129.1 129.2 129.3 129.4 129.5 129.6 129.7 129.8 129.9 129.10 129.11 129.12 129.13 129.14 129.15 129.16 129.17 129.18 129.19 129.20 129.21 129.22 129.23 129.24 129.25 129.26 129.27 129.28 129.29 129.30 129.31 129.32 130.1 130.2 130.3 130.4 130.5 130.6 130.7 130.8 130.9 130.10 130.11 130.12 130.13 130.14 130.15 130.16 130.17 130.18 130.19 130.20 130.21 130.22 130.23
130.24
130.25 130.26 130.27 130.28 130.29 130.30 130.31 131.1 131.2 131.3 131.4 131.5 131.6 131.7 131.8 131.9 131.10 131.11 131.12 131.13 131.14 131.15 131.16 131.17 131.18 131.19 131.20 131.21 131.22 131.23 131.24 131.25 131.26 131.27 131.28 131.29
131.30
131.31 131.32 131.33
132.1 132.2
132.3 132.4 132.5 132.6 132.7 132.8 132.9 132.10 132.11 132.12 132.13 132.14 132.15 132.16 132.17 132.18 132.19 132.20 132.21 132.22 132.23 132.24 132.25 132.26 132.27 132.28 132.29 132.30 132.31 132.32 133.1 133.2 133.3 133.4 133.5 133.6 133.7 133.8 133.9 133.10 133.11 133.12 133.13 133.14 133.15 133.16 133.17 133.18 133.19 133.20 133.21 133.22 133.23 133.24 133.25 133.26 133.27 133.28 133.29 133.30 133.31 133.32 134.1 134.2 134.3 134.4 134.5 134.6 134.7 134.8 134.9 134.10 134.11 134.12 134.13 134.14 134.15 134.16 134.17
134.18 134.19 134.20 134.21 134.22 134.23 134.24 134.25 134.26 134.27 134.28 134.29 134.30 134.31 135.1 135.2 135.3 135.4 135.5 135.6 135.7 135.8 135.9 135.10 135.11 135.12 135.13 135.14 135.15 135.16 135.17 135.18 135.19
135.20 135.21 135.22 135.23 135.24 135.25 135.26 135.27 135.28 135.29 136.1 136.2 136.3 136.4 136.5 136.6 136.7
136.8
136.9 136.10 136.11 136.12 136.13 136.14 136.15 136.16 136.17 136.18 136.19 136.20 136.21 136.22 136.23 136.24 136.25
136.26 136.27 136.28 136.29 136.30 137.1 137.2 137.3 137.4 137.5 137.6
137.7 137.8 137.9 137.10
137.11 137.12 137.13 137.14 137.15 137.16 137.17 137.18 137.19 137.20 137.21 137.22 137.23 137.24 137.25 137.26 137.27 137.28
138.1 138.2 138.3 138.4 138.5 138.6 138.7 138.8 138.9 138.10 138.11 138.12 138.13 138.14 138.15 138.16 138.17 138.18 138.19 138.20 138.21 138.22 138.23 138.24
138.25 138.26 138.27 138.28 138.29
139.1 139.2 139.3 139.4
139.5 139.6 139.7 139.8 139.9 139.10 139.11
139.12 139.13 139.14 139.15 139.16 139.17 139.18 139.19 139.20 139.21 139.22 139.23
139.24 139.25 139.26 139.27 139.28 140.1 140.2 140.3 140.4 140.5 140.6 140.7 140.8 140.9 140.10
140.11 140.12 140.13 140.14 140.15
140.16 140.17 140.18 140.19 140.20 140.21 140.22 140.23 140.24 140.25 140.26 140.27
140.28 140.29 140.30 140.31 140.32
141.1 141.2 141.3 141.4 141.5 141.6 141.7 141.8
141.9 141.10 141.11 141.12 141.13 141.14 141.15
141.16 141.17 141.18 141.19 141.20 141.21 141.22 141.23 141.24 141.25 141.26 141.27 141.28 141.29 141.30 141.31 142.1 142.2 142.3 142.4
142.5 142.6 142.7 142.8 142.9 142.10 142.11 142.12 142.13 142.14
142.15 142.16 142.17 142.18 142.19
142.20 142.21 142.22 142.23 142.24 142.25 142.26 142.27 142.28 142.29
143.1 143.2 143.3 143.4 143.5 143.6 143.7 143.8
143.9 143.10 143.11 143.12
143.13 143.14 143.15 143.16 143.17 143.18
143.19 143.20 143.21 143.22
143.23 143.24 143.25 143.26 143.27 143.28
144.1 144.2 144.3 144.4
144.5 144.6 144.7 144.8 144.9
144.10 144.11 144.12 144.13 144.14 144.15 144.16 144.17 144.18 144.19 144.20 144.21 144.22 144.23 144.24 144.25 144.26
144.27 144.28 144.29 144.30 145.1 145.2
145.3 145.4 145.5 145.6 145.7 145.8 145.9 145.10 145.11 145.12
145.13 145.14 145.15 145.16 145.17 145.18 145.19
145.20 145.21 145.22 145.23 145.24 145.25 145.26 145.27 145.28
146.1 146.2 146.3 146.4 146.5 146.6 146.7 146.8 146.9
146.10 146.11 146.12 146.13 146.14 146.15 146.16 146.17 146.18 146.19 146.20 146.21 146.22 146.23
146.24 146.25 146.26 146.27 146.28 146.29 146.30 146.31 146.32
147.1 147.2 147.3 147.4 147.5 147.6 147.7 147.8 147.9 147.10 147.11 147.12 147.13 147.14 147.15 147.16 147.17 147.18
147.19 147.20 147.21 147.22 147.23 147.24 147.25
147.26 147.27 147.28 147.29 147.30 147.31 148.1 148.2 148.3 148.4 148.5 148.6 148.7
148.8 148.9 148.10 148.11
148.12 148.13 148.14 148.15 148.16
148.17 148.18 148.19 148.20 148.21
148.22 148.23 148.24 148.25 148.26 148.27
149.1 149.2 149.3 149.4 149.5 149.6 149.7 149.8 149.9 149.10 149.11 149.12 149.13 149.14 149.15 149.16 149.17 149.18 149.19 149.20 149.21 149.22 149.23 149.24 149.25 149.26
149.27 149.28 149.29 149.30 149.31 149.32 149.33 150.1 150.2
150.3 150.4 150.5 150.6
150.7 150.8 150.9 150.10 150.11 150.12 150.13 150.14 150.15 150.16 150.17 150.18 150.19 150.20 150.21 150.22 150.23 150.24 150.25 150.26 150.27 150.28 150.29 150.30 150.31 150.32 150.33 151.1 151.2 151.3 151.4 151.5 151.6 151.7 151.8 151.9
151.10 151.11 151.12 151.13 151.14 151.15 151.16 151.17 151.18
151.19 151.20 151.21 151.22 151.23 151.24 151.25 151.26 151.27 151.28
152.1 152.2 152.3 152.4 152.5
152.6 152.7 152.8 152.9 152.10 152.11
152.12 152.13 152.14 152.15 152.16 152.17 152.18 152.19 152.20 152.21 152.22 152.23 152.24
152.25 152.26 152.27 152.28 152.29
153.1 153.2 153.3 153.4 153.5 153.6 153.7 153.8 153.9 153.10 153.11 153.12 153.13 153.14 153.15 153.16 153.17 153.18 153.19 153.20 153.21 153.22 153.23 153.24 153.25 153.26 153.27
153.28 153.29 153.30 153.31 153.32 153.33 154.1 154.2 154.3 154.4 154.5 154.6 154.7 154.8 154.9 154.10 154.11 154.12 154.13 154.14 154.15 154.16 154.17 154.18 154.19 154.20 154.21 154.22 154.23 154.24 154.25 154.26 154.27 154.28 154.29 154.30 154.31 154.32 154.33 154.34 154.35 155.1 155.2
155.3 155.4 155.5 155.6 155.7 155.8 155.9 155.10 155.11 155.12 155.13
155.14 155.15 155.16 155.17 155.18 155.19 155.20 155.21 155.22 155.23 155.24 155.25 155.26 155.27 155.28 155.29
156.1 156.2 156.3 156.4 156.5 156.6 156.7 156.8 156.9 156.10 156.11 156.12 156.13 156.14 156.15 156.16 156.17 156.18 156.19 156.20 156.21 156.22 156.23 156.24 156.25 156.26 156.27 156.28 156.29 157.1 157.2 157.3 157.4 157.5
157.6 157.7 157.8 157.9 157.10 157.11 157.12 157.13 157.14 157.15 157.16 157.17 157.18 157.19 157.20 157.21 157.22
157.23 157.24 157.25 157.26 157.27 157.28 157.29 157.30 157.31 158.1 158.2
158.3 158.4 158.5 158.6 158.7 158.8 158.9 158.10 158.11 158.12 158.13 158.14 158.15 158.16 158.17 158.18 158.19 158.20 158.21 158.22 158.23 158.24 158.25 158.26 158.27 158.28 158.29 158.30 159.1 159.2 159.3 159.4 159.5 159.6 159.7 159.8 159.9 159.10 159.11 159.12 159.13 159.14 159.15 159.16 159.17 159.18 159.19 159.20 159.21 159.22 159.23 159.24 159.25 159.26 159.27 159.28 159.29 159.30 160.1 160.2 160.3 160.4 160.5 160.6 160.7 160.8 160.9 160.10 160.11 160.12 160.13 160.14 160.15 160.16 160.17 160.18 160.19 160.20 160.21 160.22 160.23 160.24 160.25 160.26 160.27 160.28 160.29 160.30 160.31 160.32 160.33 161.1 161.2 161.3 161.4 161.5 161.6 161.7 161.8 161.9 161.10 161.11
161.12 161.13 161.14 161.15 161.16 161.17 161.18 161.19 161.20 161.21
161.22 161.23 161.24 161.25 161.26 161.27 161.28 161.29 161.30 161.31 161.32
162.1 162.2 162.3 162.4 162.5 162.6 162.7 162.8 162.9 162.10 162.11 162.12 162.13
162.14 162.15 162.16 162.17 162.18 162.19 162.20 162.21 162.22 162.23 162.24 162.25 162.26 162.27 162.28 162.29 162.30 162.31 162.32 162.33 162.34 163.1 163.2
163.3 163.4 163.5 163.6 163.7 163.8
163.9 163.10 163.11 163.12 163.13 163.14 163.15 163.16 163.17 163.18 163.19 163.20 163.21 163.22 163.23 163.24 163.25 163.26 163.27 163.28 163.29 163.30 163.31
164.1 164.2 164.3 164.4 164.5 164.6 164.7 164.8 164.9 164.10 164.11 164.12 164.13 164.14 164.15 164.16 164.17 164.18 164.19 164.20 164.21 164.22 164.23 164.24 164.25 164.26 164.27 164.28 164.29 164.30 164.31 164.32 165.1 165.2
165.3 165.4 165.5 165.6 165.7 165.8 165.9 165.10 165.11 165.12
165.13 165.14 165.15 165.16 165.17 165.18 165.19 165.20
165.21 165.22 165.23 165.24 165.25 165.26 165.27 165.28 165.29
166.1 166.2 166.3 166.4 166.5 166.6 166.7 166.8 166.9 166.10 166.11 166.12 166.13 166.14 166.15 166.16 166.17 166.18 166.19 166.20 166.21 166.22 166.23 166.24 166.25 166.26 166.27 166.28 166.29 166.30 166.31 166.32 166.33 167.1 167.2 167.3 167.4 167.5 167.6 167.7 167.8 167.9 167.10 167.11 167.12 167.13 167.14 167.15 167.16 167.17 167.18 167.19 167.20 167.21 167.22 167.23 167.24 167.25 167.26 167.27 167.28 167.29 167.30 167.31 167.32
168.1 168.2 168.3 168.4 168.5 168.6 168.7 168.8 168.9 168.10 168.11 168.12 168.13
168.14 168.15 168.16 168.17 168.18 168.19
168.20 168.21 168.22 168.23 168.24 168.25 168.26 168.27 168.28 168.29 168.30 169.1 169.2 169.3 169.4 169.5 169.6
169.7 169.8 169.9 169.10 169.11 169.12 169.13 169.14 169.15 169.16 169.17 169.18 169.19 169.20 169.21 169.22 169.23 169.24 169.25 169.26 169.27 169.28 170.1 170.2 170.3 170.4 170.5 170.6
170.7 170.8 170.9 170.10 170.11 170.12 170.13 170.14 170.15 170.16 170.17 170.18
170.19 170.20 170.21 170.22 170.23 170.24
170.25 170.26 170.27 170.28 170.29 171.1 171.2 171.3 171.4 171.5 171.6 171.7 171.8 171.9 171.10 171.11 171.12
171.13 171.14 171.15 171.16 171.17 171.18 171.19 171.20 171.21 171.22 171.23 171.24 171.25 171.26 171.27 171.28 171.29 172.1 172.2 172.3 172.4 172.5 172.6 172.7 172.8 172.9 172.10 172.11 172.12 172.13 172.14 172.15 172.16 172.17 172.18 172.19 172.20 172.21 172.22 172.23 172.24 172.25 172.26 172.27 172.28 172.29 172.30 172.31 172.32 173.1 173.2 173.3 173.4 173.5 173.6 173.7 173.8 173.9 173.10 173.11 173.12 173.13 173.14 173.15
173.16 173.17 173.18 173.19 173.20 173.21 173.22 173.23 173.24 173.25 173.26 173.27 173.28 173.29 173.30 173.31
174.1 174.2 174.3 174.4 174.5 174.6 174.7 174.8 174.9 174.10 174.11 174.12 174.13 174.14 174.15 174.16 174.17 174.18 174.19 174.20 174.21 174.22 174.23 174.24 174.25 174.26 174.27 174.28 174.29 174.30 174.31 174.32 174.33 174.34 174.35 175.1 175.2 175.3 175.4 175.5 175.6 175.7 175.8 175.9 175.10 175.11 175.12 175.13 175.14 175.15 175.16 175.17 175.18 175.19 175.20 175.21 175.22 175.23 175.24 175.25 175.26 175.27 175.28 175.29 175.30 175.31 175.32 175.33 175.34 175.35 176.1 176.2 176.3 176.4 176.5 176.6 176.7 176.8 176.9 176.10 176.11 176.12 176.13 176.14 176.15 176.16 176.17 176.18 176.19 176.20 176.21 176.22 176.23 176.24 176.25 176.26 176.27 176.28 176.29 176.30 176.31 176.32 176.33 177.1 177.2 177.3 177.4 177.5 177.6 177.7 177.8 177.9 177.10 177.11 177.12 177.13 177.14 177.15 177.16 177.17 177.18 177.19 177.20 177.21 177.22 177.23 177.24 177.25 177.26 177.27 177.28 177.29 177.30 177.31 177.32 177.33 177.34 178.1 178.2 178.3 178.4
178.5 178.6 178.7 178.8 178.9 178.10 178.11 178.12 178.13 178.14 178.15 178.16 178.17 178.18 178.19 178.20 178.21 178.22 178.23 178.24 178.25 178.26
178.27 178.28 178.29 178.30 178.31 179.1 179.2 179.3 179.4 179.5 179.6 179.7 179.8 179.9 179.10 179.11 179.12 179.13 179.14 179.15 179.16 179.17 179.18 179.19 179.20 179.21 179.22 179.23 179.24 179.25 179.26 179.27 179.28 179.29 179.30 179.31 179.32 180.1 180.2 180.3 180.4 180.5 180.6 180.7 180.8 180.9 180.10 180.11 180.12 180.13 180.14 180.15 180.16 180.17 180.18 180.19 180.20 180.21 180.22 180.23 180.24 180.25 180.26 180.27 180.28 180.29 181.1 181.2 181.3 181.4 181.5 181.6 181.7 181.8 181.9 181.10 181.11 181.12 181.13 181.14 181.15 181.16 181.17 181.18 181.19 181.20 181.21 181.22 181.23 181.24 181.25 181.26 181.27 181.28 181.29 181.30 181.31 181.32 182.1 182.2 182.3 182.4 182.5 182.6 182.7 182.8 182.9 182.10 182.11 182.12 182.13 182.14 182.15 182.16 182.17 182.18 182.19 182.20 182.21 182.22 182.23 182.24 182.25 182.26 182.27 182.28 182.29 182.30 182.31 182.32 182.33 183.1 183.2 183.3 183.4 183.5 183.6 183.7 183.8 183.9 183.10 183.11 183.12 183.13 183.14 183.15 183.16 183.17 183.18 183.19 183.20 183.21 183.22 183.23 183.24 183.25 183.26 183.27 183.28 183.29 183.30 183.31 183.32 183.33 184.1 184.2 184.3 184.4 184.5 184.6 184.7 184.8 184.9 184.10 184.11 184.12 184.13 184.14 184.15
184.16 184.17 184.18 184.19 184.20 184.21 184.22 184.23 184.24 184.25 184.26 184.27 184.28 184.29 184.30 184.31 185.1 185.2 185.3 185.4
185.5 185.6 185.7 185.8
185.9 185.10 185.11 185.12 185.13 185.14 185.15 185.16 185.17 185.18 185.19 185.20 185.21 185.22 185.23 185.24 185.25 185.26 185.27 185.28 185.29 185.30 185.31 185.32 186.1 186.2
186.3 186.4 186.5 186.6 186.7 186.8 186.9 186.10 186.11 186.12 186.13 186.14 186.15 186.16 186.17 186.18 186.19 186.20 186.21 186.22 186.23 186.24 186.25 186.26 186.27 186.28 186.29 186.30 186.31 187.1 187.2 187.3 187.4 187.5 187.6 187.7 187.8 187.9 187.10 187.11 187.12 187.13 187.14 187.15 187.16 187.17 187.18 187.19 187.20 187.21 187.22 187.23 187.24 187.25 187.26 187.27 187.28 187.29
188.1 188.2 188.3 188.4 188.5 188.6 188.7 188.8 188.9 188.10 188.11 188.12 188.13 188.14 188.15 188.16 188.17 188.18 188.19 188.20 188.21 188.22 188.23 188.24 188.25 188.26 188.27 188.28 188.29 188.30 188.31 189.1 189.2 189.3
189.4 189.5 189.6 189.7 189.8 189.9 189.10 189.11 189.12 189.13 189.14 189.15 189.16 189.17 189.18 189.19 189.20 189.21 189.22 189.23 189.24 189.25 189.26 189.27 189.28 189.29 189.30 189.31 190.1 190.2 190.3 190.4 190.5 190.6 190.7 190.8 190.9 190.10 190.11 190.12 190.13 190.14 190.15 190.16 190.17 190.18 190.19 190.20 190.21 190.22 190.23 190.24 190.25 190.26 190.27 190.28 190.29 190.30 190.31
191.1 191.2 191.3 191.4 191.5 191.6 191.7 191.8 191.9 191.10 191.11 191.12 191.13 191.14 191.15 191.16 191.17 191.18 191.19 191.20 191.21 191.22 191.23 191.24 191.25 191.26 191.27 191.28 191.29 191.30 191.31 191.32 192.1 192.2
192.3 192.4 192.5 192.6 192.7 192.8 192.9 192.10 192.11 192.12 192.13 192.14 192.15 192.16 192.17 192.18 192.19 192.20 192.21 192.22 192.23 192.24 192.25 192.26 192.27 192.28 193.1 193.2 193.3 193.4 193.5 193.6 193.7 193.8 193.9 193.10 193.11 193.12 193.13 193.14 193.15 193.16 193.17 193.18 193.19 193.20 193.21 193.22 193.23 193.24 193.25 193.26 193.27 193.28 193.29 193.30 194.1 194.2 194.3 194.4 194.5 194.6 194.7 194.8 194.9 194.10 194.11 194.12 194.13 194.14 194.15 194.16 194.17 194.18 194.19 194.20 194.21 194.22 194.23 194.24 194.25 194.26 194.27 194.28
195.1 195.2 195.3 195.4 195.5 195.6 195.7 195.8 195.9 195.10 195.11 195.12 195.13 195.14 195.15 195.16 195.17 195.18 195.19 195.20 195.21 195.22 195.23 195.24 195.25 195.26 195.27 195.28 195.29 195.30 195.31 196.1 196.2 196.3 196.4 196.5 196.6 196.7 196.8 196.9 196.10 196.11 196.12 196.13
196.14 196.15 196.16 196.17 196.18 196.19 196.20 196.21 196.22 196.23 196.24 196.25 196.26 196.27 196.28 196.29 196.30 196.31 196.32 197.1 197.2 197.3 197.4 197.5 197.6 197.7 197.8 197.9 197.10 197.11 197.12 197.13 197.14
197.15 197.16 197.17 197.18 197.19 197.20 197.21 197.22 197.23 197.24 197.25 197.26 197.27 197.28 197.29 197.30 197.31 198.1 198.2 198.3 198.4 198.5 198.6 198.7 198.8 198.9 198.10 198.11 198.12 198.13 198.14 198.15
198.16 198.17 198.18 198.19 198.20 198.21 198.22 198.23 198.24 198.25 198.26 198.27 198.28 198.29 198.30 198.31 199.1 199.2 199.3 199.4 199.5 199.6 199.7 199.8 199.9 199.10 199.11 199.12 199.13 199.14 199.15 199.16 199.17 199.18 199.19 199.20 199.21 199.22 199.23 199.24 199.25 199.26 199.27 199.28 199.29 199.30 199.31 199.32 200.1 200.2 200.3 200.4 200.5 200.6 200.7 200.8 200.9 200.10 200.11 200.12 200.13 200.14 200.15 200.16 200.17 200.18 200.19 200.20 200.21 200.22 200.23 200.24 200.25 200.26
200.27 200.28 200.29 200.30 200.31 201.1 201.2 201.3 201.4 201.5 201.6 201.7 201.8 201.9 201.10 201.11 201.12 201.13 201.14 201.15
201.16 201.17 201.18 201.19 201.20 201.21 201.22 201.23 201.24 201.25 201.26 201.27 201.28 201.29 201.30 202.1 202.2 202.3 202.4 202.5 202.6 202.7 202.8 202.9 202.10 202.11 202.12 202.13 202.14 202.15
202.16 202.17 202.18 202.19 202.20 202.21 202.22 202.23 202.24 202.25 202.26 202.27 202.28 202.29 202.30 202.31 202.32 202.33 203.1 203.2 203.3 203.4 203.5 203.6 203.7 203.8 203.9 203.10 203.11 203.12 203.13 203.14 203.15 203.16 203.17 203.18 203.19 203.20 203.21 203.22 203.23 203.24 203.25 203.26 203.27 203.28 203.29 203.30 203.31 203.32 203.33 204.1 204.2 204.3 204.4 204.5 204.6 204.7 204.8 204.9 204.10 204.11
204.12 204.13 204.14 204.15 204.16 204.17 204.18 204.19 204.20 204.21 204.22 204.23 204.24 204.25 204.26 204.27 204.28 204.29 204.30 205.1 205.2 205.3 205.4 205.5 205.6 205.7 205.8 205.9 205.10 205.11 205.12 205.13 205.14 205.15 205.16 205.17 205.18 205.19 205.20 205.21 205.22 205.23 205.24 205.25 205.26 205.27 205.28 205.29 205.30 206.1 206.2 206.3 206.4 206.5 206.6 206.7 206.8 206.9 206.10 206.11 206.12 206.13 206.14 206.15 206.16 206.17 206.18 206.19 206.20 206.21
206.22 206.23 206.24 206.25 206.26 206.27 206.28 206.29 206.30 207.1 207.2 207.3 207.4 207.5 207.6 207.7 207.8 207.9 207.10 207.11 207.12 207.13 207.14 207.15 207.16 207.17 207.18 207.19 207.20 207.21 207.22 207.23 207.24 207.25 207.26 207.27 207.28
208.1 208.2 208.3 208.4 208.5 208.6 208.7 208.8 208.9 208.10 208.11 208.12 208.13 208.14 208.15 208.16 208.17 208.18 208.19 208.20 208.21 208.22 208.23 208.24 208.25 208.26 208.27 208.28 208.29 208.30 208.31 208.32 209.1 209.2
209.3 209.4 209.5 209.6 209.7 209.8 209.9 209.10 209.11 209.12 209.13 209.14 209.15 209.16 209.17 209.18 209.19 209.20 209.21 209.22 209.23 209.24 209.25 209.26 209.27 209.28 209.29 209.30 209.31 209.32 210.1 210.2 210.3 210.4 210.5 210.6 210.7 210.8 210.9 210.10 210.11
210.12 210.13 210.14 210.15 210.16 210.17 210.18 210.19 210.20 210.21 210.22 210.23 210.24 210.25 210.26 210.27 210.28 210.29 211.1 211.2 211.3 211.4 211.5 211.6 211.7
211.8 211.9 211.10 211.11 211.12 211.13 211.14 211.15 211.16 211.17 211.18 211.19 211.20 211.21 211.22 211.23 211.24 211.25 211.26 211.27 211.28 211.29 211.30 211.31
212.1 212.2 212.3 212.4 212.5 212.6 212.7 212.8 212.9 212.10 212.11 212.12 212.13 212.14 212.15 212.16 212.17 212.18 212.19 212.20 212.21 212.22 212.23 212.24 212.25 212.26 212.27 212.28 212.29 212.30 212.31 212.32 212.33 212.34 212.35 213.1 213.2 213.3 213.4
213.5 213.6 213.7 213.8 213.9 213.10 213.11 213.12 213.13
213.14 213.15 213.16 213.17
213.18
213.19 213.20
213.21 213.22 213.23 213.24
213.25 213.26 213.27 213.28 213.29
214.1 214.2 214.3 214.4 214.5
214.6 214.7 214.8 214.9
214.10 214.11 214.12 214.13 214.14 214.15 214.16 214.17 214.18 214.19 214.20 214.21 214.22 214.23
214.24 214.25 214.26 214.27 214.28 214.29 214.30 214.31 215.1 215.2 215.3 215.4 215.5 215.6 215.7 215.8 215.9 215.10 215.11 215.12 215.13 215.14 215.15 215.16 215.17 215.18 215.19 215.20 215.21 215.22 215.23 215.24 215.25 215.26 215.27 215.28 215.29 215.30 215.31 215.32 216.1 216.2 216.3 216.4 216.5 216.6 216.7 216.8 216.9 216.10 216.11 216.12 216.13 216.14 216.15 216.16
216.17 216.18 216.19 216.20 216.21 216.22 216.23 216.24 216.25 216.26 216.27 216.28 216.29 216.30 216.31 216.32 216.33 217.1 217.2 217.3 217.4 217.5
217.6 217.7 217.8 217.9 217.10 217.11 217.12 217.13 217.14
217.15 217.16 217.17 217.18 217.19 217.20 217.21 217.22 217.23 217.24 217.25 217.26 217.27 217.28 217.29 217.30 217.31 217.32 217.33
218.1 218.2 218.3 218.4 218.5 218.6 218.7 218.8 218.9 218.10 218.11 218.12 218.13 218.14 218.15 218.16 218.17 218.18 218.19
218.20 218.21 218.22 218.23 218.24 218.25 218.26 218.27 218.28 218.29 218.30 218.31 219.1 219.2 219.3 219.4 219.5 219.6 219.7 219.8 219.9 219.10 219.11 219.12 219.13 219.14 219.15 219.16 219.17 219.18 219.19 219.20 219.21 219.22 219.23 219.24 219.25
219.26 219.27 219.28 219.29 219.30 219.31 220.1 220.2 220.3 220.4 220.5 220.6 220.7 220.8 220.9 220.10 220.11 220.12 220.13 220.14 220.15 220.16 220.17 220.18 220.19 220.20 220.21 220.22 220.23 220.24 220.25 220.26 220.27
220.28 220.29 220.30 220.31 220.32 221.1 221.2 221.3 221.4 221.5 221.6 221.7 221.8 221.9
221.10 221.11 221.12 221.13 221.14 221.15 221.16 221.17 221.18 221.19 221.20 221.21 221.22 221.23 221.24 221.25 221.26 221.27 221.28 221.29 221.30 221.31 222.1 222.2 222.3 222.4 222.5 222.6 222.7 222.8 222.9 222.10 222.11 222.12 222.13 222.14 222.15 222.16 222.17 222.18 222.19 222.20 222.21 222.22
222.23 222.24 222.25 222.26 222.27
222.28 222.29 222.30 222.31 222.32
223.1 223.2
223.3 223.4 223.5 223.6 223.7 223.8 223.9 223.10 223.11 223.12 223.13 223.14 223.15 223.16 223.17 223.18 223.19 223.20 223.21 223.22 223.23 223.24 223.25 223.26 223.27 223.28 223.29 223.30 223.31 224.1 224.2 224.3 224.4 224.5 224.6 224.7 224.8 224.9 224.10
224.11 224.12 224.13 224.14 224.15 224.16 224.17 224.18 224.19 224.20 224.21
224.22 224.23 224.24 224.25 224.26 224.27 224.28 224.29 224.30 224.31 224.32 224.33 225.1 225.2 225.3 225.4 225.5 225.6 225.7 225.8 225.9 225.10 225.11 225.12 225.13 225.14 225.15 225.16 225.17 225.18 225.19 225.20 225.21 225.22 225.23 225.24 225.25 225.26 225.27 225.28 225.29 225.30 225.31 225.32 225.33 225.34 226.1 226.2 226.3 226.4 226.5 226.6 226.7 226.8 226.9 226.10 226.11 226.12 226.13 226.14 226.15 226.16 226.17 226.18 226.19 226.20 226.21 226.22 226.23 226.24 226.25 226.26 226.27 226.28 226.29 226.30 226.31 226.32 227.1 227.2 227.3 227.4 227.5 227.6 227.7 227.8 227.9 227.10 227.11 227.12 227.13 227.14 227.15 227.16 227.17 227.18 227.19 227.20 227.21 227.22 227.23 227.24 227.25 227.26 227.27 227.28 227.29 227.30 227.31 227.32 228.1
228.2 228.3 228.4 228.5 228.6 228.7 228.8 228.9 228.10 228.11 228.12 228.13 228.14 228.15 228.16 228.17 228.18 228.19 228.20 228.21 228.22 228.23 228.24 228.25 228.26 228.27 228.28 228.29 229.1 229.2 229.3 229.4 229.5 229.6 229.7 229.8 229.9 229.10 229.11 229.12 229.13 229.14 229.15 229.16 229.17 229.18 229.19 229.20 229.21 229.22 229.23 229.24 229.25 229.26 229.27 229.28 229.29 229.30 229.31 229.32 229.33 229.34 230.1 230.2 230.3 230.4 230.5
230.6 230.7 230.8 230.9 230.10 230.11 230.12 230.13 230.14 230.15 230.16 230.17 230.18
230.19
230.20 230.21 230.22 230.23 230.24 230.25 230.26 230.27 230.28 230.29 230.30 231.1 231.2 231.3 231.4 231.5 231.6 231.7 231.8 231.9 231.10 231.11 231.12 231.13 231.14 231.15 231.16 231.17 231.18 231.19 231.20 231.21 231.22
231.23
231.24 231.25 231.26 231.27 231.28 231.29 231.30 231.31 231.32 231.33 232.1 232.2 232.3
232.4
232.5 232.6 232.7 232.8 232.9 232.10 232.11 232.12 232.13 232.14 232.15 232.16 232.17 232.18 232.19 232.20 232.21 232.22 232.23 232.24 232.25 232.26 232.27 232.28 232.29 232.30 232.31 232.32 233.1 233.2 233.3 233.4 233.5 233.6 233.7 233.8 233.9 233.10 233.11 233.12 233.13 233.14 233.15 233.16 233.17 233.18 233.19 233.20 233.21 233.22 233.23 233.24 233.25 233.26 233.27 233.28 233.29 233.30 233.31 234.1 234.2 234.3 234.4 234.5 234.6 234.7 234.8 234.9 234.10 234.11 234.12
234.13
234.14 234.15 234.16 234.17 234.18 234.19 234.20 234.21 234.22 234.23 234.24 234.25 234.26 234.27 234.28 234.29 234.30 234.31 234.32 234.33 235.1 235.2 235.3 235.4 235.5 235.6 235.7 235.8 235.9 235.10 235.11 235.12 235.13 235.14 235.15 235.16 235.17 235.18 235.19 235.20 235.21 235.22 235.23 235.24 235.25 235.26 235.27 235.28 235.29 235.30 235.31
235.32
236.1 236.2 236.3 236.4 236.5 236.6 236.7 236.8 236.9 236.10 236.11 236.12 236.13 236.14 236.15 236.16 236.17 236.18 236.19 236.20 236.21 236.22 236.23 236.24 236.25 236.26 236.27 236.28 236.29 236.30 236.31 236.32 236.33 237.1 237.2 237.3 237.4 237.5 237.6 237.7 237.8 237.9 237.10 237.11 237.12 237.13 237.14 237.15 237.16 237.17 237.18 237.19 237.20 237.21
237.22
237.23 237.24 237.25 237.26 237.27 237.28 237.29 237.30 237.31 237.32 238.1 238.2 238.3 238.4 238.5 238.6 238.7 238.8 238.9 238.10 238.11 238.12 238.13 238.14 238.15 238.16 238.17 238.18 238.19 238.20 238.21 238.22 238.23 238.24 238.25 238.26 238.27 238.28 238.29 238.30
238.31
239.1 239.2 239.3 239.4 239.5 239.6 239.7 239.8 239.9 239.10 239.11 239.12 239.13 239.14 239.15 239.16 239.17 239.18 239.19 239.20 239.21 239.22 239.23 239.24 239.25 239.26 239.27 239.28 239.29 239.30 239.31 239.32 240.1 240.2 240.3 240.4 240.5 240.6 240.7 240.8 240.9 240.10 240.11 240.12 240.13 240.14 240.15 240.16 240.17 240.18 240.19 240.20 240.21 240.22 240.23 240.24 240.25 240.26 240.27 240.28 240.29 240.30 241.1 241.2 241.3 241.4 241.5 241.6
241.7
241.8 241.9 241.10 241.11 241.12 241.13 241.14 241.15 241.16 241.17 241.18 241.19 241.20 241.21 241.22 241.23 241.24 241.25 241.26 241.27 241.28 241.29 241.30 241.31 241.32 241.33 242.1 242.2 242.3 242.4 242.5 242.6 242.7 242.8
242.9
242.10 242.11 242.12 242.13 242.14 242.15 242.16 242.17
242.18
242.19 242.20 242.21 242.22 242.23 242.24 242.25 242.26 242.27 242.28 242.29 242.30 242.31 242.32 243.1 243.2 243.3 243.4 243.5 243.6 243.7 243.8 243.9 243.10
243.11
243.12 243.13 243.14 243.15 243.16 243.17 243.18 243.19 243.20 243.21 243.22
243.23
243.24 243.25 243.26 243.27 243.28 243.29 243.30 244.1 244.2 244.3
244.4
244.5 244.6 244.7 244.8 244.9 244.10 244.11 244.12 244.13 244.14
244.15
244.16 244.17 244.18 244.19 244.20 244.21 244.22 244.23 244.24 244.25 244.26
244.27
245.1 245.2 245.3 245.4 245.5 245.6
245.7
245.8 245.9 245.10 245.11 245.12 245.13 245.14 245.15 245.16 245.17 245.18 245.19 245.20 245.21 245.22 245.23 245.24 245.25 245.26 245.27 245.28 245.29 245.30 245.31 245.32 245.33 246.1 246.2 246.3 246.4 246.5 246.6 246.7 246.8 246.9 246.10 246.11 246.12 246.13 246.14 246.15 246.16 246.17 246.18 246.19 246.20 246.21 246.22 246.23 246.24 246.25 246.26 246.27 246.28 246.29 246.30
247.1
247.2 247.3 247.4 247.5 247.6 247.7 247.8
247.9
247.10 247.11 247.12 247.13 247.14 247.15 247.16 247.17 247.18 247.19 247.20 247.21 247.22 247.23 247.24 247.25 247.26 247.27 247.28 247.29 248.1 248.2 248.3 248.4 248.5 248.6 248.7 248.8 248.9 248.10 248.11 248.12 248.13 248.14 248.15 248.16 248.17 248.18 248.19 248.20 248.21 248.22 248.23 248.24 248.25 248.26 248.27 248.28 248.29 248.30 248.31 248.32 248.33 249.1 249.2 249.3 249.4 249.5 249.6 249.7 249.8 249.9 249.10 249.11 249.12 249.13 249.14 249.15 249.16 249.17 249.18 249.19 249.20 249.21 249.22 249.23 249.24 249.25 249.26 249.27 249.28 249.29 249.30 249.31 249.32 249.33 249.34 249.35 250.1 250.2 250.3 250.4 250.5 250.6 250.7 250.8 250.9 250.10 250.11 250.12 250.13 250.14 250.15 250.16 250.17 250.18 250.19 250.20 250.21 250.22 250.23 250.24 250.25 250.26 250.27 250.28 250.29 250.30 250.31 250.32 250.33 251.1 251.2 251.3 251.4 251.5 251.6 251.7 251.8 251.9 251.10 251.11
251.12
251.13 251.14 251.15 251.16 251.17 251.18 251.19 251.20 251.21 251.22 251.23 251.24 251.25 251.26 251.27 251.28 251.29 251.30 251.31 251.32 252.1 252.2 252.3 252.4 252.5 252.6 252.7 252.8 252.9 252.10 252.11 252.12 252.13 252.14 252.15 252.16 252.17 252.18 252.19 252.20 252.21 252.22 252.23 252.24 252.25 252.26 252.27 252.28 252.29 252.30 252.31 252.32 252.33 253.1 253.2 253.3 253.4 253.5 253.6 253.7 253.8 253.9 253.10 253.11 253.12 253.13 253.14 253.15 253.16 253.17 253.18 253.19 253.20 253.21 253.22 253.23 253.24 253.25 253.26 253.27 253.28 253.29 253.30 253.31 253.32 253.33 253.34 254.1 254.2 254.3 254.4 254.5 254.6 254.7 254.8 254.9 254.10 254.11 254.12 254.13 254.14 254.15 254.16 254.17 254.18 254.19 254.20 254.21 254.22 254.23 254.24 254.25 254.26 254.27 254.28 254.29 254.30 254.31 254.32 254.33 255.1 255.2
255.3
255.4 255.5 255.6 255.7 255.8 255.9 255.10 255.11 255.12 255.13 255.14 255.15 255.16 255.17 255.18 255.19 255.20 255.21 255.22 255.23 255.24 255.25 255.26 255.27 255.28
255.29
256.1 256.2 256.3 256.4 256.5 256.6 256.7 256.8 256.9 256.10 256.11 256.12 256.13 256.14 256.15 256.16 256.17 256.18 256.19 256.20 256.21 256.22 256.23
256.24
256.25 256.26 256.27 256.28 256.29 256.30 257.1 257.2 257.3 257.4 257.5 257.6 257.7 257.8 257.9 257.10 257.11 257.12 257.13
257.14
257.15 257.16 257.17 257.18 257.19 257.20 257.21 257.22 257.23 257.24 257.25 257.26 257.27 257.28 257.29 257.30 258.1 258.2 258.3 258.4 258.5 258.6 258.7 258.8 258.9 258.10 258.11 258.12 258.13 258.14 258.15 258.16 258.17 258.18 258.19 258.20 258.21 258.22 258.23 258.24 258.25 258.26 258.27 258.28 258.29 259.1 259.2 259.3 259.4 259.5 259.6 259.7 259.8 259.9 259.10 259.11 259.12 259.13 259.14 259.15 259.16 259.17 259.18 259.19 259.20 259.21 259.22 259.23 259.24 259.25 259.26 259.27 259.28 259.29 259.30 259.31 260.1 260.2 260.3 260.4 260.5 260.6 260.7 260.8 260.9 260.10 260.11 260.12 260.13 260.14 260.15 260.16 260.17 260.18 260.19 260.20 260.21 260.22 260.23 260.24 260.25 260.26 260.27 260.28 260.29 260.30 260.31 260.32 260.33 261.1 261.2 261.3 261.4 261.5 261.6 261.7 261.8 261.9 261.10 261.11 261.12 261.13 261.14 261.15 261.16
261.17 261.18 261.19 261.20 261.21 261.22 261.23 261.24 261.25 261.26 261.27 261.28 261.29 261.30 261.31 261.32 262.1 262.2 262.3 262.4 262.5 262.6 262.7 262.8 262.9 262.10 262.11 262.12 262.13 262.14 262.15 262.16 262.17 262.18 262.19 262.20 262.21 262.22 262.23 262.24 262.25 262.26 262.27 262.28 262.29 262.30 262.31
262.32 262.33 262.34 263.1 263.2 263.3 263.4 263.5 263.6 263.7 263.8 263.9 263.10 263.11 263.12 263.13 263.14 263.15 263.16 263.17 263.18 263.19 263.20 263.21 263.22 263.23 263.24 263.25 263.26 263.27 263.28 263.29 263.30 264.1 264.2 264.3 264.4 264.5 264.6 264.7 264.8 264.9 264.10 264.11 264.12 264.13 264.14 264.15 264.16 264.17 264.18 264.19 264.20 264.21 264.22 264.23 264.24 264.25 264.26 264.27 264.28 264.29 264.30 264.31 264.32 265.1 265.2 265.3 265.4 265.5 265.6 265.7 265.8 265.9 265.10 265.11 265.12 265.13 265.14 265.15 265.16 265.17 265.18 265.19 265.20 265.21 265.22 265.23 265.24 265.25 265.26 265.27 265.28 265.29 265.30 265.31 266.1 266.2 266.3 266.4 266.5 266.6
266.7 266.8 266.9 266.10 266.11 266.12
A bill for an act
relating to human services; modifying policy provisions governing continuing care
for older adults, children and family services, community supports, health care,
and human services licensing and background studies; making technical and
conforming changes; amending Minnesota Statutes 2020, sections 62C.01, by
adding a subdivision; 62D.01, by adding a subdivision; 62Q.02; 119B.11,
subdivision 2a; 119B.125, subdivision 1; 119B.13, subdivisions 6, 7; 144.216, by
adding subdivisions; 144.218, by adding a subdivision; 144.226, subdivision 1;
145.902; 245.4874, subdivision 1; 245.4885, subdivision 1; 245.697, subdivision
1; 245A.02, subdivisions 5a, 10b, by adding subdivisions; 245A.03, subdivision
7; 245A.04, subdivisions 1, 7; 245A.041, by adding subdivisions; 245A.11,
subdivision 7, by adding a subdivision; 245A.14, subdivision 4; 245A.1435;
245A.1443; 245A.146, subdivision 3; 245A.16, subdivision 1; 245A.18, subdivision
2; 245A.22, by adding a subdivision; 245A.52, subdivisions 1, 2, 3, 5, by adding
subdivisions; 245A.66, subdivision 2, by adding a subdivision; 245C.07; 245G.13,
subdivision 2; 245H.08, subdivisions 4, 5; 252.43; 252A.01, subdivision 1;
252A.02, subdivisions 2, 9, 11, 12, by adding subdivisions; 252A.03, subdivisions
3, 4; 252A.04, subdivisions 1, 2, 4; 252A.05; 252A.06, subdivisions 1, 2; 252A.07,
subdivisions 1, 2, 3; 252A.081, subdivisions 2, 3, 5; 252A.09, subdivisions 1, 2;
252A.101, subdivisions 2, 3, 5, 6, 7, 8; 252A.111, subdivisions 2, 4, 6; 252A.12;
252A.16; 252A.17; 252A.19, subdivisions 2, 4, 5, 7, 8; 252A.20; 252A.21,
subdivisions 2, 4; 254A.03, subdivision 3; 254A.171; 254A.19, subdivision 4;
254A.20; 254B.01, subdivisions 6, 8; 254B.02, subdivision 1; 254B.03, subdivisions
1, 2, 4; 254B.04, subdivision 1; 254B.05, subdivisions 1a, 1b, 4, 5; 254B.051;
254B.06, subdivisions 1, 3; 254B.12; 254B.13, subdivisions 1, 2a, 5, 6; 254B.14,
subdivisions 1, 5; 256.041; 256.042, subdivisions 2, 4; 256.741, by adding
subdivisions; 256.975, subdivision 7; 256B.051, subdivisions 1, 3, 5, 6, 7, by
adding a subdivision; 256B.0625, subdivisions 3c, 3d, 3e, 13c, 58; 256B.0638,
subdivisions 3, 5, 6; 256B.0659, subdivision 13; 256B.0911, subdivision 3c;
256B.0947, subdivision 6; 256B.4912, subdivision 13; 256B.69, subdivisions 5a,
9d; 256B.85, subdivisions 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 11b, 12, 12b, 13, 13a, 15,
17a, 18a, 20b, 23, 23a, by adding subdivisions; 256J.08, subdivision 21; 256J.09,
subdivision 3; 256J.45, subdivision 1; 256J.95, subdivision 5; 256N.02, subdivisions
16, 17; 256N.22, subdivision 1; 256N.23, subdivisions 2, 6; 256N.24, subdivisions
1, 8, 11, 12, 14; 256N.25, subdivision 1, by adding a subdivision; 256R.02,
subdivisions 4, 17, 18, 19, 29, 42a, 48a, by adding a subdivision; 256R.07,
subdivisions 1, 2, 3; 256R.08, subdivision 1; 256R.09, subdivisions 2, 5; 256R.13,
subdivision 4; 256R.16, subdivision 1; 256R.17, subdivision 3; 256R.26,
subdivision 1; 256R.37; 256R.39; 256S.20, subdivision 1; 259.22, subdivision 4;
259.241; 259.35, subdivision 1; 259.53, subdivision 4; 259.73; 259.75, subdivisions
5, 6, 9; 259.83, subdivision 1a; 259A.75, subdivisions 1, 2, 3, 4; 260C.007,
subdivisions 22a, 26c, 31; 260C.157, subdivision 3; 260C.212, subdivisions 1, 1a,
2, 13, by adding a subdivision; 260C.219, subdivision 5; 260C.452; 260C.503,
subdivision 2; 260C.515, subdivision 3; 260C.605, subdivision 1; 260C.607,
subdivision 6; 260C.609; 260C.615; 260C.704; 260C.706; 260C.708; 260C.71;
260C.712; 260C.714; 260D.01; 260D.05; 260D.06, subdivision 2; 260D.07;
260D.08; 260D.14; 260E.36, by adding a subdivision; 626.557, subdivisions 4, 9,
9b, 9c, 9d, 10b, 12b; 626.5572, subdivisions 2, 4, 17; Laws 2014, chapter 150,
article 4, section 6; proposing coding for new law in Minnesota Statutes, chapters
62A; 62J; 245A; 518A; repealing Minnesota Statutes 2020, sections 119B.04;
119B.125, subdivision 5; 245.981; 245A.03, subdivision 5; 245A.144; 245A.175;
246B.03, subdivision 2; 252.28, subdivisions 1, 5; 252A.02, subdivisions 8, 10;
252A.21, subdivision 3; 256.01, subdivision 31; 256.9657, subdivision 8; 256R.08,
subdivision 2; 256R.49; 256S.20, subdivision 2; 259A.70; Laws 2012, chapter
247, article 1, section 30; Minnesota Rules, parts 2960.3070; 2960.3210; 9502.0425,
subparts 5, 10; 9505.0275; 9505.1693; 9505.1696, subparts 1, 2, 3, 4, 5, 6, 7, 8,
9, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22; 9505.1699; 9505.1701; 9505.1703;
9505.1706; 9505.1712; 9505.1715; 9505.1718; 9505.1724; 9505.1727; 9505.1730;
9505.1733; 9505.1736; 9505.1739; 9505.1742; 9505.1745; 9505.1748; 9555.6255.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
ARTICLE 1
CONTINUING CARE FOR OLDER ADULTS
Section 1.
Minnesota Statutes 2020, section 245A.02, is amended by adding a subdivision
to read:
new text begin Subd. 6d. new text end
new text begin Family adult foster care home. new text end
new text begin
"Family adult foster care home" means an
adult foster care home:
new text end
new text begin
(1) that is licensed by the Department of Human Services;
new text end
new text begin
(2) that is the primary residence of the license holder; and
new text end
new text begin
(3) in which the license holder is the primary caregiver.
new text end
Sec. 2.
Minnesota Statutes 2020, section 245A.03, subdivision 7, is amended to read:
Subd. 7.
Licensing moratorium.
(a) The commissioner shall not issue an initial license
for child foster care licensed under Minnesota Rules, parts 2960.3000 to 2960.3340, or adult
foster care licensed under Minnesota Rules, parts 9555.5105 to 9555.6265, under this chapter
for a physical location that will not be the primary residence of the license holder for the
entire period of licensure. If a new text begin family adult foster care home new text end license is issued during this
moratorium, and the license holder changes the license holder's primary residence away
from the physical location of the foster care license, the commissioner shall revoke the
license according to section 245A.07. The commissioner shall not issue an initial license
for a community residential setting licensed under chapter 245D. When approving an
exception under this paragraph, the commissioner shall consider the resource need
determination process in paragraph (h), the availability of foster care licensed beds in the
geographic area in which the licensee seeks to operate, the results of a person's choices
during their annual assessment and service plan review, and the recommendation of the
local county board. The determination by the commissioner is final and not subject to appeal.
Exceptions to the moratorium include:
(1) foster care settings deleted text begin that are required to be registered under chapter deleted text end deleted text begin 144Ddeleted text end new text begin where at
least 80 percent of the residents are 55 years of age or oldernew text end ;
(2) foster care licenses replacing foster care licenses in existence on May 15, 2009, or
community residential setting licenses replacing adult foster care licenses in existence on
December 31, 2013, and determined to be needed by the commissioner under paragraph
(b);
(3) new foster care licenses or community residential setting licenses determined to be
needed by the commissioner under paragraph (b) for the closure of a nursing facility, ICF/DD,
or regional treatment center; restructuring of state-operated services that limits the capacity
of state-operated facilities; or allowing movement to the community for people who no
longer require the level of care provided in state-operated facilities as provided under section
256B.092, subdivision 13, or 256B.49, subdivision 24;
(4) new foster care licenses or community residential setting licenses determined to be
needed by the commissioner under paragraph (b) for persons requiring hospital level care;
or
(5) new foster care licenses or community residential setting licenses for people receiving
services under chapter 245D and residing in an unlicensed setting before May 1, 2017, and
for which a license is required. This exception does not apply to people living in their own
home. For purposes of this clause, there is a presumption that a foster care or community
residential setting license is required for services provided to three or more people in a
dwelling unit when the setting is controlled by the provider. A license holder subject to this
exception may rebut the presumption that a license is required by seeking a reconsideration
of the commissioner's determination. The commissioner's disposition of a request for
reconsideration is final and not subject to appeal under chapter 14. The exception is available
until June 30, 2018. This exception is available when:
(i) the person's case manager provided the person with information about the choice of
service, service provider, and location of service, including in the person's home, to help
the person make an informed choice; and
(ii) the person's services provided in the licensed foster care or community residential
setting are less than or equal to the cost of the person's services delivered in the unlicensed
setting as determined by the lead agency.
(b) The commissioner shall determine the need for newly licensed foster care homes or
community residential settings as defined under this subdivision. As part of the determination,
the commissioner shall consider the availability of foster care capacity in the area in which
the licensee seeks to operate, and the recommendation of the local county board. The
determination by the commissioner must be final. A determination of need is not required
for a change in ownership at the same address.
(c) When an adult resident served by the program moves out of a foster home that is not
the primary residence of the license holder according to section 256B.49, subdivision 15,
paragraph (f), or the adult community residential setting, the county shall immediately
inform the Department of Human Services Licensing Division. The department may decrease
the statewide licensed capacity for adult foster care settings.
(d) Residential settings that would otherwise be subject to the decreased license capacity
established in paragraph (c) shall be exempt if the license holder's beds are occupied by
residents whose primary diagnosis is mental illness and the license holder is certified under
the requirements in subdivision 6a or section 245D.33.
(e) A resource need determination process, managed at the state level, using the available
reports required by section 144A.351, and other data and information shall be used to
determine where the reduced capacity determined under section 256B.493 will be
implemented. The commissioner shall consult with the stakeholders described in section
144A.351, and employ a variety of methods to improve the state's capacity to meet the
informed decisions of those people who want to move out of corporate foster care or
community residential settings, long-term service needs within budgetary limits, including
seeking proposals from service providers or lead agencies to change service type, capacity,
or location to improve services, increase the independence of residents, and better meet
needs identified by the long-term services and supports reports and statewide data and
information.
(f) At the time of application and reapplication for licensure, the applicant and the license
holder that are subject to the moratorium or an exclusion established in paragraph (a) are
required to inform the commissioner whether the physical location where the foster care
will be provided is or will be the primary residence of the license holder for the entire period
of licensure. If the primary residence of the applicant or license holder changes, the applicant
or license holder must notify the commissioner immediately. The commissioner shall print
on the foster care license certificate whether or not the physical location is the primary
residence of the license holder.
(g) License holders of foster care homes identified under paragraph (f) that are not the
primary residence of the license holder and that also provide services in the foster care home
that are covered by a federally approved home and community-based services waiver, as
authorized under chapter 256S or section 256B.092 or 256B.49, must inform the human
services licensing division that the license holder provides or intends to provide these
waiver-funded services.
(h) The commissioner may adjust capacity to address needs identified in section
144A.351. Under this authority, the commissioner may approve new licensed settings or
delicense existing settings. Delicensing of settings will be accomplished through a process
identified in section 256B.493. Annually, by August 1, the commissioner shall provide
information and data on capacity of licensed long-term services and supports, actions taken
under the subdivision to manage statewide long-term services and supports resources, and
any recommendations for change to the legislative committees with jurisdiction over the
health and human services budget.
(i) The commissioner must notify a license holder when its corporate foster care or
community residential setting licensed beds are reduced under this section. The notice of
reduction of licensed beds must be in writing and delivered to the license holder by certified
mail or personal service. The notice must state why the licensed beds are reduced and must
inform the license holder of its right to request reconsideration by the commissioner. The
license holder's request for reconsideration must be in writing. If mailed, the request for
reconsideration must be postmarked and sent to the commissioner within 20 calendar days
after the license holder's receipt of the notice of reduction of licensed beds. If a request for
reconsideration is made by personal service, it must be received by the commissioner within
20 calendar days after the license holder's receipt of the notice of reduction of licensed beds.
(j) The commissioner shall not issue an initial license for children's residential treatment
services licensed under Minnesota Rules, parts 2960.0580 to 2960.0700, under this chapter
for a program that Centers for Medicare and Medicaid Services would consider an institution
for mental diseases. Facilities that serve only private pay clients are exempt from the
moratorium described in this paragraph. The commissioner has the authority to manage
existing statewide capacity for children's residential treatment services subject to the
moratorium under this paragraph and may issue an initial license for such facilities if the
initial license would not increase the statewide capacity for children's residential treatment
services subject to the moratorium under this paragraph.
Sec. 3.
Minnesota Statutes 2020, section 245C.07, is amended to read:
245C.07 STUDY SUBJECT AFFILIATED WITH MULTIPLE FACILITIES.
(a) Subject to the conditions in paragraph (d), when a license holder, applicant, or other
entity owns multiple programs or services that are licensed by the Department of Human
Services, Department of Health, or Department of Corrections, only one background study
is required for an individual who provides direct contact services in one or more of the
licensed programs or services if:
(1) the license holder designates one individual with one address and telephone number
as the person to receive sensitive background study information for the multiple licensed
programs or services that depend on the same background study; and
(2) the individual designated to receive the sensitive background study information is
capable of determining, upon request of the department, whether a background study subject
is providing direct contact services in one or more of the license holder's programs or services
and, if so, at which location or locations.
(b) When a license holder maintains background study compliance for multiple licensed
programs according to paragraph (a), and one or more of the licensed programs closes, the
license holder shall immediately notify the commissioner which staff must be transferred
to an active license so that the background studies can be electronically paired with the
license holder's active program.
(c) When a background study is being initiated by a licensed program or service or a
foster care provider that is also deleted text begin registereddeleted text end new text begin licensed as an assisted living facilitynew text end under chapter
deleted text begin 144Ddeleted text end new text begin 144Gnew text end , a study subject affiliated with multiple licensed programs or services may
attach to the background study form a cover letter indicating the additional names of the
programs or services, addresses, and background study identification numbers.
When the commissioner receives a notice, the commissioner shall notify each program
or service identified by the background study subject of the study results.
The background study notice the commissioner sends to the subsequent agencies shall
satisfy those programs' or services' responsibilities for initiating a background study on that
individual.
(d) If a background study was conducted on an individual related to child foster care
and the requirements under paragraph (a) are met, the background study is transferable
across all licensed programs. If a background study was conducted on an individual under
a license other than child foster care and the requirements under paragraph (a) are met, the
background study is transferable to all licensed programs except child foster care.
(e) The provisions of this section that allow a single background study in one or more
licensed programs or services do not apply to background studies submitted by adoption
agencies, supplemental nursing services agencies, personnel agencies, educational programs,
professional services agencies, and unlicensed personal care provider organizations.
(f) For an entity operating under NETStudy 2.0, the entity's active roster must be the
system used to document when a background study subject is affiliated with multiple entities.
For a background study to be transferable:
(1) the background study subject must be on and moving to a roster for which the person
designated to receive sensitive background study information is the same; and
(2) the same entity must own or legally control both the roster from which the transfer
is occurring and the roster to which the transfer is occurring. For an entity that holds or
controls multiple licenses, or unlicensed personal care provider organizations, there must
be a common highest level entity that has a legally identifiable structure that can be verified
through records available from the secretary of state.
Sec. 4.
Minnesota Statutes 2020, section 256.975, subdivision 7, is amended to read:
Subd. 7.
Consumer information and assistance and long-term care options
counseling; Senior LinkAge Line.
(a) The Minnesota Board on Aging shall operate a
statewide service to aid older Minnesotans and their families in making informed choices
about long-term care options and health care benefits. Language services to persons with
limited English language skills may be made available. The service, known as Senior
LinkAge Line, shall serve older adults as the designated Aging and Disability Resource
Center under United States Code, title 42, section 3001, the Older Americans Act
Amendments of 2006 in partnership with the Disability Hub under section 256.01,
subdivision 24, and must be available during business hours through a statewide toll-free
number and the Internet. The Minnesota Board on Aging shall consult with, and when
appropriate work through, the area agencies on aging counties, and other entities that serve
aging and disabled populations of all ages, to provide and maintain the telephone
infrastructure and related support for the Aging and Disability Resource Center partners
which agree by memorandum to access the infrastructure, including the designated providers
of the Senior LinkAge Line and the Disability Hub.
(b) The service must provide long-term care options counseling by assisting older adults,
caregivers, and providers in accessing information and options counseling about choices in
long-term care services that are purchased through private providers or available through
public options. The service must:
(1) develop and provide for regular updating of a comprehensive database that includes
detailed listings in both consumer- and provider-oriented formats that can provide search
results down to the neighborhood level;
(2) make the database accessible on the Internet and through other telecommunication
and media-related tools;
(3) link callers to interactive long-term care screening tools and make these tools available
through the Internet by integrating the tools with the database;
(4) develop community education materials with a focus on planning for long-term care
and evaluating independent living, housing, and service options;
(5) conduct an outreach campaign to assist older adults and their caregivers in finding
information on the Internet and through other means of communication;
(6) implement a messaging system for overflow callers and respond to these callers by
the next business day;
(7) link callers with county human services and other providers to receive more in-depth
assistance and consultation related to long-term care options;
(8) link callers with quality profiles for nursing facilities and other home and
community-based services providers developed by the commissioners of health and human
services;
(9) develop an outreach plan to seniors and their caregivers with a particular focus on
establishing a clear presence in places that seniors recognize and:
(i) place a significant emphasis on improved outreach and service to seniors and their
caregivers by establishing annual plans by neighborhood, city, and county, as necessary, to
address the unique needs of geographic areas in the state where there are dense populations
of seniors;
(ii) establish an efficient workforce management approach and assign community living
specialist staff and volunteers to geographic areas as well as aging and disability resource
center sites so that seniors and their caregivers and professionals recognize the Senior
LinkAge Line as the place to call for aging services and information;
(iii) recognize the size and complexity of the metropolitan area service system by working
with metropolitan counties to establish a clear partnership with them, including seeking
county advice on the establishment of local aging and disabilities resource center sites; and
(iv) maintain dashboards with metrics that demonstrate how the service is expanding
and extending or enhancing its outreach efforts in dispersed or hard to reach locations in
varied population centers;
(10) incorporate information about the availability of housing options, as well as
registered housing with services and consumer rights within the MinnesotaHelp.info network
long-term care database to facilitate consumer comparison of services and costs among
housing with services establishments and with other in-home services and to support financial
self-sufficiency as long as possible. Housing with services establishments and their arranged
home care providers shall provide information that will facilitate price comparisons, including
delineation of charges for rent and for services available. The commissioners of health and
human services shall align the data elements required deleted text begin by section 144G.06, the Uniform
Consumer Information Guidedeleted text end new text begin under the uniform checklist disclosure of services authorized
by section 144G.09, subdivision 3new text end , and this section to provide consumers standardized
information and ease of comparison of long-term care options. The commissioner of human
services shall provide the data to the Minnesota Board on Aging for inclusion in the
MinnesotaHelp.info network long-term care database;
(11) provide long-term care options counseling. Long-term care options counselors shall:
(i) for individuals not eligible for case management under a public program or public
funding source, provide interactive decision support under which consumers, family
members, or other helpers are supported in their deliberations to determine appropriate
long-term care choices in the context of the consumer's needs, preferences, values, and
individual circumstances, including implementing a community support plan;
(ii) provide web-based educational information and collateral written materials to
familiarize consumers, family members, or other helpers with the long-term care basics,
issues to be considered, and the range of options available in the community;
(iii) provide long-term care futures planning, which means providing assistance to
individuals who anticipate having long-term care needs to develop a plan for the more
distant future; and
(iv) provide expertise in benefits and financing options for long-term care, including
Medicare, long-term care insurance, tax or employer-based incentives, reverse mortgages,
private pay options, and ways to access low or no-cost services or benefits through
volunteer-based or charitable programs;
(12) using risk management and support planning protocols, provide long-term care
options counseling under clause (13) to current residents of nursing homes deemed
appropriate for discharge by the commissioner who meet a profile that demonstrates that
the consumer is either at risk of readmission to a nursing home or hospital, or would benefit
from long-term care options counseling to age in place. The Senior LinkAge Line shall
identify and contact residents or patients deemed appropriate by developing targeting criteria
and creating a profile in consultation with the commissioner. The commissioner shall provide
designated Senior LinkAge Line contact centers with a list of current or former nursing
home residents or people discharged from a hospital or for whom Medicare home care has
ended, that meet the criteria as being appropriate for long-term care options counseling
through a referral via a secure web portal. Senior LinkAge Line shall provide these residents,
if they indicate a preference to receive long-term care options counseling, with initial
assessment and, if appropriate, a referral to:
(i) long-term care consultation services under section 256B.0911;
(ii) designated care coordinators of contracted entities under section 256B.035 for persons
who are enrolled in a managed care plan; or
(iii) the long-term care consultation team for those who are eligible for relocation service
coordination due to high-risk factors or psychological or physical disability; and
(13) develop referral protocols and processes that will assist certified health care homes,
Medicare home care, and hospitals to identify at-risk older adults and determine when to
refer these individuals to the Senior LinkAge Line for long-term care options counseling
under this section. The commissioner is directed to work with the commissioner of health
to develop protocols that would comply with the health care home designation criteria and
protocols available at the time of hospital discharge or the end of Medicare home care. The
commissioner shall keep a record of the number of people who choose long-term care
options counseling as a result of this section.
(c) Nursing homes shall provide contact information to the Senior LinkAge Line for
residents identified in paragraph (b), clause (12), to provide long-term care options counseling
pursuant to paragraph (b), clause (11). The contact information for residents shall include
all information reasonably necessary to contact residents, including first and last names,
permanent and temporary addresses, telephone numbers, and e-mail addresses.
(d) The Senior LinkAge Line shall determine when it is appropriate to refer a consumer
who receives long-term care options counseling under paragraph (b), clause (12) or (13),
and who uses an unpaid caregiver to the self-directed caregiver service under subdivision
12.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective August 1, 2021.
new text end
Sec. 5.
Minnesota Statutes 2020, section 256B.0911, subdivision 3c, is amended to read:
Subd. 3c.
Consultation for housing with services.
(a) The purpose of long-term care
consultation for registered housing with services is to support persons with current or
anticipated long-term care needs in making informed choices among options that include
the most cost-effective and least restrictive settings. Prospective residents maintain the right
to choose housing with services or assisted living if that option is their preference.
(b) Registered housing with services establishments shall inform each prospective resident
or the prospective resident's designated or legal representative of the availability of long-term
care consultation and the need to receive and verify the consultation prior to signing a lease
or contract. Long-term care consultation for registered housing with services is provided
as determined by the commissioner of human services. The service is delivered under a
partnership between lead agencies as defined in subdivision 1a, paragraph (d), and the Area
Agencies on Aging, and is a point of entry to a combination of telephone-based long-term
care options counseling provided by Senior LinkAge Line and in-person long-term care
consultation provided by lead agencies. The point of entry service must be provided within
five working days of the request of the prospective resident as follows:
(1) the consultation shall be conducted with the prospective resident, deleted text begin or in the alternative,deleted text end
the new text begin prospective new text end resident's designated or legal representativenew text begin , or the prospective resident's
spouse or legal partnernew text end , if:
(i) the new text begin prospective new text end resident verbally requests; or
(ii) the registered housing with services provider has documentation of the new text begin authority of
the prospective resident's spouse or legal partner or new text end designated or legal deleted text begin representative's
authoritydeleted text end new text begin representativenew text end to enter into a lease or contract on behalf of the prospective resident
and accepts the documentation in good faith;
(2) the consultation shall be performed in a manner that provides objective and complete
information;
(3) the consultation must include a review of the prospective resident's reasons for
considering housing with services, the prospective resident's personal goals, a discussion
of the prospective resident's immediate and projected long-term care needs, and alternative
community services or housing with services settings that may meet the prospective resident's
needs;
(4) the prospective resident shall be informed of the availability of a face-to-face visit
at no charge to the prospective resident to assist the prospective resident in assessment and
planning to meet the prospective resident's long-term care needs; and
(5) verification of counseling shall be generated and provided to the prospective resident
by Senior LinkAge Line upon completion of the telephone-based counseling.
(c) Housing with services establishments registered under chapter 144D shall:
(1) inform each prospective resident or the prospective resident's new text begin spouse or legal partner
or new text end designated or legal representative of the availability of and contact information for
consultation services under this subdivision;
(2) receive a copy of the verification of counseling prior to executing a lease or service
contract with the prospective resident, and prior to executing a service contract with
individuals who have previously entered into lease-only arrangements; and
(3) retain a copy of the verification of counseling as part of the resident's file.
(d) Emergency admissions to registered housing with services establishments prior to
consultation under paragraph (b) are permitted according to policies established by the
commissioner.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective August 1, 2021.
new text end
Sec. 6.
Minnesota Statutes 2020, section 256R.02, subdivision 4, is amended to read:
Subd. 4.
Administrative costs.
"Administrative costs" means the identifiable costs for
administering the overall activities of the nursing home. These costs include salaries and
wages of the administrator, assistant administrator, business office employees, security
guards, new text begin purchasing and inventory employees, new text end and associated fringe benefits and payroll
taxes, fees, contracts, or purchases related to business office functions, licenses, permits
except as provided in the external fixed costs category, employee recognition, travel including
meals and lodging, all training except as specified in subdivision 17, voice and data
communication or transmission, office supplies, property and liability insurance and other
forms of insurance except insurance that is a fringe benefit under subdivision 22, personnel
recruitment, legal services, accounting services, management or business consultants, data
processing, information technology, website, central or home office costs, business meetings
and seminars, postage, fees for professional organizations, subscriptions, security services,
new text begin nonpromotional new text end advertising, board of directors fees, working capital interest expense, bad
debts, bad debt collection fees, and costs incurred for travel and deleted text begin housingdeleted text end new text begin lodgingnew text end for persons
employed by a new text begin Minnesota-registered new text end supplemental nursing services agency as defined in
section 144A.70, subdivision 6.
Sec. 7.
Minnesota Statutes 2020, section 256R.02, subdivision 17, is amended to read:
Subd. 17.
Direct care costs.
"Direct care costs" means costs for the wages of nursing
administration, direct care registered nurses, licensed practical nurses, certified nursing
assistants, trained medication aides, employees conducting training in resident care topics
and associated fringe benefits and payroll taxes; services from a new text begin Minnesota-registered
new text end supplemental nursing services agencynew text begin up to the maximum allowable charges under section
144A.74, excluding associated lodging and travel costsnew text end ; supplies that are stocked at nursing
stations or on the floor and distributed or used individually, including, but not limited to:
new text begin rubbing new text end alcoholnew text begin or alcohol swabsnew text end , applicators, cotton balls, incontinence pads, disposable
ice bags, dressings, bandages, water pitchers, tongue depressors, disposable gloves, enemas,
enema equipment, new text begin personal hygiene new text end soap, medication cups, diapers, deleted text begin plastic waste bags,deleted text end
sanitary products, new text begin disposable new text end thermometers, hypodermic needles and syringes, deleted text begin clinical
reagents or similar diagnostic agents,deleted text end drugs deleted text begin that are not paiddeleted text end new text begin not payablenew text end on a separate fee
schedule by the medical assistance program or any other payer, and deleted text begin technology relateddeleted text end new text begin
clinical software costs specificnew text end to the provision of nursing care to residents, such as electronic
charting systems; costs of materials used for resident care training, and training courses
outside of the facility attended by direct care staff on resident care topics; and costs for
nurse consultants, pharmacy consultants, and medical directors. Salaries and payroll taxes
for nurse consultants who work out of a central office must be allocated proportionately by
total resident days or by direct identification to the nursing facilities served by those
consultants.
Sec. 8.
Minnesota Statutes 2020, section 256R.02, subdivision 18, is amended to read:
Subd. 18.
Employer health insurance costs.
"Employer health insurance costs" means
premium expenses for group coveragedeleted text begin ;deleted text end new text begin andnew text end actual expenses incurred for self-insured plans,
including deleted text begin reinsurance;deleted text end new text begin actual claims paid, stop-loss premiums, plan fees,new text end and employer
contributions to employee health reimbursement and health savings accounts. new text begin Actual costs
of self-insurance plans must not include any allowance for future funding unless the plan
meets the Medicare requirements for reporting on a premium basis when the Medicare
regulations define the actual costs. new text end Premium and expense costs and contributions are
allowable for (1) all employees and (2) the spouse and dependents of those employees who
are employed on average at least 30 hours per week.
Sec. 9.
Minnesota Statutes 2020, section 256R.02, subdivision 19, is amended to read:
Subd. 19.
External fixed costs.
"External fixed costs" means costs related to the nursing
home surcharge under section 256.9657, subdivision 1; licensure fees under section 144.122;
family advisory council fee under section 144A.33; scholarships under section 256R.37;
planned closure rate adjustments under section 256R.40; consolidation rate adjustments
under section 144A.071, subdivisions 4c, paragraph (a), clauses (5) and (6), and 4d;
single-bed room incentives under section 256R.41; property taxes, special assessments, and
payments in lieu of taxes; employer health insurance costs; quality improvement incentive
payment rate adjustments under section 256R.39; performance-based incentive payments
under section 256R.38; special dietary needs under section 256R.51; deleted text begin rate adjustments for
compensation-related costs for minimum wage changes under section 256R.49 provided
on or after January 1, 2018;deleted text end Public Employees Retirement Association employer costs; and
border city rate adjustments under section 256R.481.
Sec. 10.
Minnesota Statutes 2020, section 256R.02, subdivision 29, is amended to read:
Subd. 29.
Maintenance and plant operations costs.
"Maintenance and plant operations
costs" means the costs for the salaries and wages of the maintenance supervisor, engineers,
heating-plant employees, and other maintenance employees and associated fringe benefits
and payroll taxes. It also includes identifiable costs for maintenance and operation of the
building and grounds, including, but not limited to, fuel, electricity, new text begin plastic waste bags,
new text end medical waste and garbage removal, water, sewer, supplies, tools, deleted text begin anddeleted text end repairsnew text begin , and minor
equipment not requiring capitalization under Medicare guidelinesnew text end .
Sec. 11.
Minnesota Statutes 2020, section 256R.02, is amended by adding a subdivision
to read:
new text begin Subd. 32a. new text end
new text begin Minor equipment. new text end
new text begin
"Minor equipment" means equipment that does not qualify
as either fixed equipment or depreciable movable equipment defined in section 256R.261.
new text end
Sec. 12.
Minnesota Statutes 2020, section 256R.02, subdivision 42a, is amended to read:
Subd. 42a.
Real estate taxes.
"Real estate taxes" means the real estate tax liability shown
on the annual property tax deleted text begin statementdeleted text end new text begin statementsnew text end of the nursing facility for the reporting
period. The term does not include personnel costs or fees for late payment.
Sec. 13.
Minnesota Statutes 2020, section 256R.02, subdivision 48a, is amended to read:
Subd. 48a.
Special assessments.
"Special assessments" means the actual special
assessments and related interest paid during the reporting periodnew text begin that are not voluntary costsnew text end .
The term does not include personnel costs deleted text begin ordeleted text end new text begin ,new text end fees for late paymentnew text begin , or special assessments
for projects that are reimbursed in the property ratenew text end .
Sec. 14.
Minnesota Statutes 2020, section 256R.07, subdivision 1, is amended to read:
Subdivision 1.
Criteria.
A nursing facility deleted text begin shalldeleted text end new text begin mustnew text end keep adequate documentation. In
order to be adequate, documentation must:
(1) be maintained in orderly, well-organized files;
(2) not include documentation of more than one nursing facility in one set of files unless
transactions may be traced by the commissioner to the nursing facility's annual cost report;
(3) include a paid invoice or copy of a paid invoice with date of purchase, vendor name
and address, purchaser name and delivery destination address, listing of items or services
purchased, cost of items purchased, account number to which the cost is posted, and a
breakdown of any allocation of costs between accounts or nursing facilities. If any of the
information is not available, the nursing facility deleted text begin shalldeleted text end new text begin mustnew text end document its good faith attempt
to obtain the information;
(4) include contracts, agreements, amortization schedules, mortgages, other debt
instruments, and all other documents necessary to explain the nursing facility's costs or
revenues; deleted text begin and
deleted text end
(5) new text begin include signed and dated position descriptions; and
new text end
new text begin (6) new text end be retained by the nursing facility to support the five most recent annual cost reports.
The commissioner may extend the period of retention if the field audit was postponed
because of inadequate record keeping or accounting practices as in section 256R.13,
subdivisions 2 and 4, the records are necessary to resolve a pending appeal, or the records
are required for the enforcement of sections 256R.04; 256R.05, subdivision 2; 256R.06,
subdivisions 2, 6, and 7; 256R.08, subdivisions 1 deleted text begin todeleted text end new text begin andnew text end 3; and 256R.09, subdivisions 3 and
4.
Sec. 15.
Minnesota Statutes 2020, section 256R.07, subdivision 2, is amended to read:
Subd. 2.
Documentation of compensation.
Compensation for personal services,
regardless of whether treated as identifiable costs or costs that are not identifiable, must be
documented on payroll records. Payrolls must be supported by time and attendance or
equivalent records for individual employees. Salaries and wages of employees which are
allocated to more than one cost category must be supported by time distribution records.
deleted text begin The method used must produce a proportional distribution of actual time spent, or an accurate
estimate of time spent performing assigned duties. The nursing facility that chooses to
estimate time spent must use a statistically valid method. The compensation must reflect
an amount proportionate to a full-time basis if the services are rendered on less than a
full-time basis.deleted text end new text begin Salary allocations are allowable using the Medicare-approved allocation
basis and methodology only if the salary costs cannot be directly determined, including
when employees provide shared services to noncovered operations.
new text end
Sec. 16.
Minnesota Statutes 2020, section 256R.07, subdivision 3, is amended to read:
Subd. 3.
Adequate documentation supporting nursing facility payrolls.
Payroll
records supporting compensation costs claimed by nursing facilities must be supported by
affirmative time and attendance records prepared by each individual at intervals of not more
than one month. The requirements of this subdivision are met when documentation is
provided under either clause (1) or (2) deleted text begin as followsdeleted text end :
(1) the affirmative time and attendance record must identify the individual's name; the
days worked during each pay period; the number of hours worked each day; and the number
of hours taken each day by the individual for vacation, sick, and other leave. The affirmative
time and attendance record must include a signed verification by the individual and the
individual's supervisor, if any, that the entries reported on the record are correct; or
(2) if the affirmative time and attendance records identifying the individual's name, the
days worked each pay period, the number of hours worked each day, and the number of
hours taken each day by the individual for vacation, sick, and other leave are deleted text begin placed on
microfilmdeleted text end new text begin stored electronicallynew text end , equipment must be made available for viewing and printing
deleted text begin them, or if the records are stored as automated data, summary data must be available for
viewing and printingdeleted text end new text begin the recordsnew text end .
Sec. 17.
Minnesota Statutes 2020, section 256R.08, subdivision 1, is amended to read:
Subdivision 1.
Reporting of financial statements.
(a) No later than February 1 of each
year, a nursing facility deleted text begin shalldeleted text end new text begin mustnew text end :
(1) provide the state agency with a copy of its audited financial statements or its working
trial balance;
(2) provide the state agency with a statement of ownership for the facility;
(3) provide the state agency with separate, audited financial statements or working trial
balances for every other facility owned in whole or in part by an individual or entity that
has an ownership interest in the facility;
(4) upon request, provide the state agency with separate, audited financial statements or
working trial balances for every organization with which the facility conducts business and
which is owned in whole or in part by an individual or entity which has an ownership interest
in the facility;
(5) provide the state agency with copies of leases, purchase agreements, and other
documents related to the lease or purchase of the nursing facility; and
(6) upon request, provide the state agency with copies of leases, purchase agreements,
and other documents related to the acquisition of equipment, goods, and services which are
claimed as allowable costs.
(b) Audited financial statements submitted under paragraph (a) must include a balance
sheet, income statement, statement of the rate or rates charged to private paying residents,
statement of retained earnings, statement of cash flows, notes to the financial statements,
audited applicable supplemental information, and the public accountant's report. Public
accountants must conduct audits in accordance with chapter 326A. The cost of an audit
deleted text begin shalldeleted text end new text begin mustnew text end not be an allowable cost unless the nursing facility submits its audited financial
statements in the manner otherwise specified in this subdivision. A nursing facility must
permit access by the state agency to the public accountant's audit work papers that support
the audited financial statements submitted under paragraph (a).
(c) Documents or information provided to the state agency pursuant to this subdivision
deleted text begin shalldeleted text end new text begin mustnew text end be publicnew text begin unless prohibited by the Health Insurance Portability and Accountability
Act or any other federal or state regulation. Data, notes, and preliminary drafts of reports
created, collected, and maintained by the audit offices of government entities, or persons
performing audits for government entities, and relating to an audit or investigation are
confidential data on individuals or protected nonpublic data until the final report has been
published or the audit or investigation is no longer being pursued actively, except that the
data must be disclosed as required to comply with section 6.67 or 609.456new text end .
(d) If the requirements of paragraphs (a) and (b) are not met, the reimbursement rate
may be reduced to 80 percent of the rate in effect on the first day of the fourth calendar
month after the close of the reporting period and the reduction deleted text begin shalldeleted text end new text begin mustnew text end continue until the
requirements are met.
Sec. 18.
Minnesota Statutes 2020, section 256R.09, subdivision 2, is amended to read:
Subd. 2.
Reporting of statistical and cost information.
All nursing facilities deleted text begin shalldeleted text end new text begin mustnew text end
provide information annually to the commissioner on a form and in a manner determined
by the commissioner. The commissioner may separately require facilities to submit in a
manner specified by the commissioner documentation of statistical and cost information
included in the report to ensure accuracy in establishing payment rates and to perform audit
and appeal review functions under this chapter. The commissioner may also require nursing
facilities to provide statistical and cost information for a subset of the items in the annual
report on a semiannual basis. Nursing facilities deleted text begin shalldeleted text end new text begin mustnew text end report only costs directly related
to the operation of the nursing facility. The facility deleted text begin shalldeleted text end new text begin mustnew text end not include costs which are
separately reimbursed new text begin or reimbursable new text end by residents, medical assistance, or other payors.
Allocations of costs from central, affiliated, or corporate office and related organization
transactions shall be reported according to sections 256R.07, subdivision 3, and 256R.12,
subdivisions 1 to 7. The commissioner shall not grant facilities extensions to the filing
deadline.
Sec. 19.
Minnesota Statutes 2020, section 256R.09, subdivision 5, is amended to read:
Subd. 5.
Method of accounting.
The accrual method of accounting in accordance with
generally accepted accounting principles is the only method acceptable for purposes of
satisfying the reporting requirements of this chapter. If a governmentally owned nursing
facility demonstrates that the accrual method of accounting is not applicable to its accounts
and that a cash or modified accrual method of accounting more accurately reports the nursing
facility's financial operations, the commissioner shall permit the governmentally owned
nursing facility to use a cash or modified accrual method of accounting.new text begin For reimbursement
purposes, the accrued expense must be paid by the providers within 90 days following the
end of the reporting period. An expense disallowed by the commissioner under this section
in any cost report period must not be claimed on a subsequent cost report. Specific
exemptions to the 90-day rule may be granted by the commissioner for documented
contractual arrangements such as receivership, property tax installment payments, and
pension contributions.
new text end
Sec. 20.
Minnesota Statutes 2020, section 256R.13, subdivision 4, is amended to read:
Subd. 4.
Extended record retention requirements.
The commissioner shall extend the
period for retention of records under section 256R.09, subdivision 3, for purposes of
performing field audits as necessary to enforce sections 256R.04; 256R.05, subdivision 2;
256R.06, subdivisions 2, 6, and 7; 256R.08, subdivisions 1 deleted text begin todeleted text end new text begin andnew text end 3; and 256R.09,
subdivisions 3 and 4, with written notice to the facility postmarked no later than 90 days
prior to the expiration of the record retention requirement.
Sec. 21.
Minnesota Statutes 2020, section 256R.16, subdivision 1, is amended to read:
Subdivision 1.
Calculation of a quality score.
(a) The commissioner shall determine
a quality score for each nursing facility using quality measures established in section
256B.439, according to methods determined by the commissioner in consultation with
stakeholders and experts, and using the most recently available data as provided in the
Minnesota Nursing Home Report Card. These methods deleted text begin shalldeleted text end new text begin mustnew text end be exempt from the
rulemaking requirements under chapter 14.
(b) For each quality measure, a score deleted text begin shalldeleted text end new text begin mustnew text end be determined with the number of points
assigned as determined by the commissioner using the methodology established according
to this subdivision. The determination of the quality measures to be used and the methods
of calculating scores may be revised annually by the commissioner.
(c) The quality score deleted text begin shalldeleted text end new text begin mustnew text end include up to 50 points related to the Minnesota quality
indicators score derived from the minimum data set, up to 40 points related to the resident
quality of life score derived from the consumer survey conducted under section 256B.439,
subdivision 3, and up to ten points related to the state inspection results score.
(d) The commissioner, in cooperation with the commissioner of health, may adjust the
formula in paragraph (c), or the methodology for computing the total quality score, deleted text begin effective
July 1 of any year,deleted text end with five months advance public notice. In changing the formula, the
commissioner shall consider quality measure priorities registered by report card users, advice
of stakeholders, and available research.
Sec. 22.
Minnesota Statutes 2020, section 256R.17, subdivision 3, is amended to read:
Subd. 3.
Resident assessment schedule.
(a) Nursing facilities deleted text begin shalldeleted text end new text begin mustnew text end conduct and
submit case mix classification assessments according to the schedule established by the
commissioner of health under section 144.0724, subdivisions 4 and 5.
(b) The case mix classifications established under section 144.0724, subdivision 3a,
deleted text begin shalldeleted text end new text begin mustnew text end be effective the day of admission for new admission assessments. The effective
date for significant change assessments deleted text begin shalldeleted text end new text begin mustnew text end be the assessment reference date. The
effective date for annual and quarterly assessments deleted text begin shalldeleted text end new text begin and significant corrections
assessments mustnew text end be the first day of the month following assessment reference date.
Sec. 23.
Minnesota Statutes 2020, section 256R.26, subdivision 1, is amended to read:
Subdivision 1.
Determination of limited undepreciated replacement cost.
A facility's
limited URC is the lesser of:
(1) the facility's new text begin recognized new text end URC from the appraisal; or
(2) the product of (i) the number of the facility's licensed beds three months prior to the
beginning of the rate year, (ii) the construction cost per square foot value, and (iii) 1,000
square feet.
Sec. 24.
Minnesota Statutes 2020, section 256R.37, is amended to read:
256R.37 SCHOLARSHIPS.
deleted text begin
(a) For the 27-month period beginning October 1, 2015, through December 31, 2017,
the commissioner shall allow a scholarship per diem of up to 25 cents for each nursing
facility with no scholarship per diem that is requesting a scholarship per diem to be added
to the external fixed payment rate to be used:
deleted text end
deleted text begin
(1) for employee scholarships that satisfy the following requirements:
deleted text end
deleted text begin
(i) scholarships are available to all employees who work an average of at least ten hours
per week at the facility except the administrator, and to reimburse student loan expenses
for newly hired registered nurses and licensed practical nurses, and training expenses for
nursing assistants as specified in section 144A.611, subdivisions 2 and 4, who are newly
hired; and
deleted text end
deleted text begin
(ii) the course of study is expected to lead to career advancement with the facility or in
long-term care, including medical care interpreter services and social work; and
deleted text end
deleted text begin
(2) to provide job-related training in English as a second language.
deleted text end
deleted text begin
(b) All facilities may annually request a rate adjustment under this section by submitting
information to the commissioner on a schedule and in a form supplied by the commissioner.
The commissioner shall allow a scholarship payment rate equal to the reported and allowable
costs divided by resident days.
deleted text end
deleted text begin
(c) In calculating the per diem under paragraph (b), the commissioner shall allow costs
related to tuition, direct educational expenses, and reasonable costs as defined by the
commissioner for child care costs and transportation expenses related to direct educational
expenses.
deleted text end
deleted text begin
(d) The rate increase under this section is an optional rate add-on that the facility must
request from the commissioner in a manner prescribed by the commissioner. The rate
increase must be used for scholarships as specified in this section.
deleted text end
deleted text begin
(e) For instances in which a rate adjustment will be 15 cents or greater, nursing facilities
that close beds during a rate year may request to have their scholarship adjustment under
paragraph (b) recalculated by the commissioner for the remainder of the rate year to reflect
the reduction in resident days compared to the cost report year.
deleted text end
new text begin
(a) The commissioner shall provide a scholarship per diem rate calculated using the
criteria in paragraphs (b) to (d). The per diem rate must be based on the allowable costs the
facility paid for employee scholarships for any employee, except the facility administrator,
who works an average of at least ten hours per week in the licensed nursing facility building
when the facility has incurred expenses for:
new text end
new text begin
(1) an employee's course of study that is expected to lead to career advancement with
the facility or in the field of long-term care;
new text end
new text begin
(2) an employee's job-related training in English as a second language;
new text end
new text begin
(3) the reimbursement of student loan expenses for newly hired registered nurses and
licensed practical nurses; and
new text end
new text begin
(4) the reimbursement of training, testing, and associated expenses for newly hired
nursing assistants as specified in section 144A.611, subdivisions 2 and 4. The reimbursement
of nursing assistant expenses under this clause is not subject to the ten-hour minimum work
requirement under this paragraph.
new text end
new text begin
(b) Allowable scholarship costs include: tuition; student loan reimbursement; other direct
educational expenses; and reasonable costs for child care and transportation expenses directly
related to education, as defined by the commissioner.
new text end
new text begin
(c) The commissioner shall provide a scholarship per diem rate equal to the allowable
scholarship costs divided by resident days. The commissioner shall compute the scholarship
per diem rate annually and include the scholarship per diem rate in the external fixed costs
payment rate.
new text end
new text begin
(d) When the resulting scholarship per diem rate is 15 cents or more, nursing facilities
that close beds during a rate year may request to have the scholarship rate recalculated. This
recalculation is effective from the date of the bed closure until the remainder of the rate
year and reflects the estimated reduction in resident days compared to the previous cost
report year.
new text end
new text begin
(e) Facilities electing to participate in this program must request this rate adjustment
annually by submitting information to the commissioner on a schedule and in a form supplied
by the commissioner.
new text end
Sec. 25.
Minnesota Statutes 2020, section 256R.39, is amended to read:
256R.39 QUALITY IMPROVEMENT INCENTIVE PROGRAM.
The commissioner shall develop a quality improvement incentive program in consultation
with stakeholders. The annual funding pool available for quality improvement incentive
payments deleted text begin shalldeleted text end new text begin mustnew text end be equal to 0.8 percent of all operating payments, not including any
rate components resulting from equitable cost-sharing for publicly owned nursing facility
program participation under section 256R.48, critical access nursing facility program
participation under section 256R.47, or performance-based incentive payment program
participation under section 256R.38. deleted text begin For the period from October 1, 2015, to December 31,
2016, rate adjustments provided under this section shall be effective for 15 months. Beginning
January 1, 2017,deleted text end new text begin Annew text end annual rate deleted text begin adjustmentsdeleted text end new text begin adjustmentnew text end provided under this section deleted text begin shalldeleted text end new text begin
mustnew text end be effective for one rate year.
Sec. 26.
Minnesota Statutes 2020, section 256S.20, subdivision 1, is amended to read:
Subdivision 1.
Customized living services provider requirements.
deleted text begin Only a provider
licensed by the Department of Health as a comprehensive home care provider may providedeleted text end new text begin
To delivernew text end customized living services or 24-hour customized living servicesdeleted text begin .deleted text end new text begin , a provider
must:
new text end
new text begin
(1) be licensed as an assisted living facility under chapter 144G; or
new text end
new text begin (2) be licensed as a comprehensive home care provider under chapter 144A and be
delivering services in a setting defined under section 144G.08, subdivision 7, clauses (11)
to (13). new text end A licensed home care provider is subject to section 256B.0651, subdivision 14.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective August 1, 2021.
new text end
Sec. 27.
Minnesota Statutes 2020, section 626.557, subdivision 4, is amended to read:
Subd. 4.
Reporting.
(a) Except as provided in paragraph (b), a mandated reporter shall
immediately make an oral report to the common entry point. deleted text begin The common entry point may
accept electronic reports submitted through a web-based reporting system established by
the commissioner. Use of a telecommunications device for the deaf or other similar device
shall be considered an oral report. The common entry point may not require written reports.deleted text end
To the extent possible, the report must be of sufficient content to identify the vulnerable
adult, the caregiver, the nature and extent of the suspected maltreatment, any evidence of
previous maltreatment, the name and address of the reporter, the time, date, and location of
the incident, and any other information that the reporter believes might be helpful in
investigating the suspected maltreatment. A mandated reporter may disclose not public data,
as defined in section 13.02, and medical records under sections 144.291 to 144.298, to the
extent necessary to comply with this subdivision.
(b) A boarding care home that is licensed under sections 144.50 to 144.58 and certified
under Title 19 of the Social Security Act, a nursing home that is licensed under section
144A.02 and certified under Title 18 or Title 19 of the Social Security Act, or a hospital
that is licensed under sections 144.50 to 144.58 and has swing beds certified under Code
of Federal Regulations, title 42, section 482.66, may submit a report electronically to the
common entry point instead of submitting an oral report. The report may be a duplicate of
the initial report the facility submits electronically to the commissioner of health to comply
with the reporting requirements under Code of Federal Regulations, title 42, section 483.12.
The commissioner of health may modify these reporting requirements to include items
required under paragraph (a) that are not currently included in the electronic reporting form.
Sec. 28.
Minnesota Statutes 2020, section 626.557, subdivision 9, is amended to read:
Subd. 9.
Common entry point designation.
(a) deleted text begin Each county board shall designate a
common entry point for reports of suspected maltreatment, for use until the commissioner
of human services establishes a common entry point. Two or more county boards may
jointly designate a single common entry point.deleted text end The commissioner of human services shall
establish a common entry point deleted text begin effective July 1, 2015deleted text end . The common entry point is the unit
responsible for receiving the report of suspected maltreatment under this section.
(b) The common entry point must be available 24 hours per day to take calls from
reporters of suspected maltreatment. The common entry point shall use a standard intake
form that includes:
(1) the time and date of the report;
(2)new text begin the name, relationship, and identifying and contact information for the person believed
to be a vulnerable adult and the individual or facility alleged responsible for maltreatment;
new text end
new text begin (3)new text end the name, deleted text begin address, and telephone number of the person reporting;deleted text end new text begin relationship, and
contact information for the:
new text end
new text begin
(i) reporter;
new text end
new text begin
(ii) initial reporter, witnesses, and persons who may have knowledge about the
maltreatment; and
new text end
new text begin
(iii) legal surrogate and persons who may provide support to the vulnerable adult;
new text end
new text begin
(4) the basis of vulnerability for the vulnerable adult;
new text end
deleted text begin (3)deleted text end new text begin (5)new text end the time, date, and location of the incident;
deleted text begin
(4) the names of the persons involved, including but not limited to, perpetrators, alleged
victims, and witnesses;
deleted text end
deleted text begin
(5) whether there was a risk of imminent danger to the alleged victim;
deleted text end
new text begin
(6) the immediate safety risk to the vulnerable adult;
new text end
deleted text begin (6)deleted text end new text begin (7)new text end a description of the suspected maltreatment;
deleted text begin
(7) the disability, if any, of the alleged victim;
deleted text end
deleted text begin
(8) the relationship of the alleged perpetrator to the alleged victim;
deleted text end
new text begin
(8) the impact of the suspected maltreatment on the vulnerable adult;
new text end
(9) whether a facility was involved and, if so, which agency licenses the facility;
deleted text begin
(10) any action taken by the common entry point;
deleted text end
deleted text begin
(11) whether law enforcement has been notified;
deleted text end
new text begin
(10) the actions taken to protect the vulnerable adult;
new text end
new text begin
(11) the required notifications and referrals made by the common entry point; and
new text end
(12) whether the reporter wishes to receive notification of the deleted text begin initial and final reports;
anddeleted text end new text begin disposition.
new text end
deleted text begin
(13) if the report is from a facility with an internal reporting procedure, the name, mailing
address, and telephone number of the person who initiated the report internally.
deleted text end
(c) The common entry point is not required to complete each item on the form prior to
dispatching the report to the appropriate lead investigative agency.
(d) The common entry point shall immediately report to a law enforcement agency any
incident in which there is reason to believe a crime has been committed.
(e) If a report is initially made to a law enforcement agency or a lead investigative agency,
those agencies shall take the report on the appropriate common entry point intake forms
and immediately forward a copy to the common entry point.
(f) The common entry point staff must receive training on how to screen and dispatch
reports efficiently and in accordance with this section.
(g) The commissioner of human services shall maintain a centralized database for the
collection of common entry point data, lead investigative agency data including maltreatment
report disposition, and appeals data. The common entry point shall have access to the
centralized database and must log the reports into the database deleted text begin and immediately identify
and locate prior reports of abuse, neglect, or exploitationdeleted text end .
(h) When appropriate, the common entry point staff must refer calls that do not allege
the abuse, neglect, or exploitation of a vulnerable adult to other organizations that might
resolve the reporter's concerns.
(i) A common entry point must be operated in a manner that enables the commissioner
of human services to:
(1) track critical steps in the reporting, evaluation, referral, response, disposition, and
investigative process to ensure compliance with all requirements for all reports;
(2) maintain data to facilitate the production of aggregate statistical reports for monitoring
patterns of abuse, neglect, or exploitation;
(3) serve as a resource for the evaluation, management, and planning of preventative
and remedial services for vulnerable adults who have been subject to abuse, neglect, or
exploitation;
(4) set standards, priorities, and policies to maximize the efficiency and effectiveness
of the common entry point; and
(5) track and manage consumer complaints related to the common entry point.
(j) The commissioners of human services and health shall collaborate on the creation of
a system for referring reports to the lead investigative agencies. This system shall enable
the commissioner of human services to track critical steps in the reporting, evaluation,
referral, response, disposition, investigation, notification, determination, and appeal processes.
Sec. 29.
Minnesota Statutes 2020, section 626.557, subdivision 9b, is amended to read:
Subd. 9b.
Response to reports.
Law enforcement is the primary agency to conduct
investigations of any incident in which there is reason to believe a crime has been committed.
Law enforcement shall initiate a response immediately. If the common entry point notified
a county agency for emergency adult protective services, law enforcement shall cooperate
with that county agency when both agencies are involved and shall exchange data to the
extent authorized in subdivision 12b, paragraph (g). County adult protection shall initiate
a response immediately. Each lead investigative agency shall complete the investigative
process for reports within its jurisdiction. A lead investigative agency, county, adult protective
agency, licensed facility, or law enforcement agency shall cooperate with other agencies in
the provision of protective services, coordinating its investigations, and assisting another
agency within the limits of its resources and expertise and shall exchange data to the extent
authorized in subdivision 12b, paragraph (g). The lead investigative agency shall obtain the
results of any investigation conducted by law enforcement officials. The lead investigative
agency has the right to enter facilities and inspect and copy records as part of investigations.
The lead investigative agency has access to not public data, as defined in section 13.02, and
medical records under sections 144.291 to 144.298, that are maintained by facilities to the
extent necessary to conduct its investigation. Each lead investigative agency shall develop
guidelines for prioritizing reports for investigation.new text begin When a county acts as a lead investigative
agency, the county shall make guidelines available to the public regarding which reports
the county prioritizes for investigation and adult protective services.
new text end
Sec. 30.
Minnesota Statutes 2020, section 626.557, subdivision 9c, is amended to read:
Subd. 9c.
Lead investigative agency; notifications, dispositions, determinations.
(a)
Upon request of the reporter, the lead investigative agency shall notify the reporter that it
has received the report, and provide information on the initial disposition of the report within
five business days of receipt of the report, provided that the notification will not endanger
the vulnerable adult or hamper the investigation.
new text begin
(b) In making the initial disposition of a report alleging maltreatment of a vulnerable
adult, the lead investigative agency may consider previous reports of suspected maltreatment
and may request and consider public information, records maintained by a lead investigative
agency or licensed providers, and information from any person who may have knowledge
regarding the alleged maltreatment and the basis for the adult's vulnerability.
new text end
new text begin
(c) Unless the lead investigative agency believes that: (1) the information would endanger
the well-being of the vulnerable adult; or (2) it would not be in the best interests of the
vulnerable adult, the lead investigative agency shall inform the vulnerable adult, or vulnerable
adult's guardian or health care agent when applicable to the surrogate's authority, of all
reports accepted by the agency for investigation, including the maltreatment allegation,
investigation guidelines, time frame, and evidence standards that the agency uses for
determinations. If the allegation is applicable to the guardian or health care agent, the lead
investigative agency must also inform the vulnerable adult's guardian or health care agent
of all reports accepted for investigation by the agency, including the maltreatment allegation,
investigation guidelines, time frame, and evidence standards that the agency uses for
determinations.
new text end
new text begin
(d) While investigating reports and providing adult protective services, the lead
investigative agency may coordinate with entities identified under subdivision 12b, paragraph
(g), and may coordinate with support persons to safeguard the welfare of the vulnerable
adult and prevent further maltreatment of the vulnerable adult.
new text end
deleted text begin (b)deleted text end new text begin (e)new text end Upon conclusion of every investigation it conducts, the lead investigative agency
shall make a final disposition as defined in section 626.5572, subdivision 8.
deleted text begin (c)deleted text end new text begin (f)new text end When determining whether the facility or individual is the responsible party for
substantiated maltreatment or whether both the facility and the individual are responsible
for substantiated maltreatment, the lead investigative agency shall consider at least the
following mitigating factors:
(1) whether the actions of the facility or the individual caregivers were in accordance
with, and followed the terms of, an erroneous physician order, prescription, resident care
plan, or directive. This is not a mitigating factor when the facility or caregiver is responsible
for the issuance of the erroneous order, prescription, plan, or directive or knows or should
have known of the errors and took no reasonable measures to correct the defect before
administering care;
(2) the comparative responsibility between the facility, other caregivers, and requirements
placed upon the employee, including but not limited to, the facility's compliance with related
regulatory standards and factors such as the adequacy of facility policies and procedures,
the adequacy of facility training, the adequacy of an individual's participation in the training,
the adequacy of caregiver supervision, the adequacy of facility staffing levels, and a
consideration of the scope of the individual employee's authority; and
(3) whether the facility or individual followed professional standards in exercising
professional judgment.
deleted text begin (d)deleted text end new text begin (g)new text end When substantiated maltreatment is determined to have been committed by an
individual who is also the facility license holder, both the individual and the facility must
be determined responsible for the maltreatment, and both the background study
disqualification standards under section 245C.15, subdivision 4, and the licensing actions
under section 245A.06 or 245A.07 apply.
deleted text begin (e)deleted text end new text begin (h)new text end The lead investigative agency shall complete its final disposition within 60
calendar days. If the lead investigative agency is unable to complete its final disposition
within 60 calendar days, the lead investigative agency shall notify the following persons
provided that the notification will not endanger the vulnerable adult or hamper the
investigation: (1) the vulnerable adult or the vulnerable adult's guardian or health care agent,
when known, if the lead investigative agency knows them to be aware of the investigation;
and (2) the facility, where applicable. The notice shall contain the reason for the delay and
the projected completion date. If the lead investigative agency is unable to complete its final
disposition by a subsequent projected completion date, the lead investigative agency shall
again notify the vulnerable adult or the vulnerable adult's guardian or health care agent,
when known if the lead investigative agency knows them to be aware of the investigation,
and the facility, where applicable, of the reason for the delay and the revised projected
completion date provided that the notification will not endanger the vulnerable adult or
hamper the investigation. The lead investigative agency must notify the health care agent
of the vulnerable adult only if the health care agent's authority to make health care decisions
for the vulnerable adult is currently effective under section 145C.06 and not suspended
under section 524.5-310 and the investigation relates to a duty assigned to the health care
agent by the principal. A lead investigative agency's inability to complete the final disposition
within 60 calendar days or by any projected completion date does not invalidate the final
disposition.
deleted text begin (f) Within ten calendar days of completing the final dispositiondeleted text end new text begin (i) When the lead
investigative agency is the Department of Health or the Department of Human Servicesnew text end ,
the lead investigative agency shall provide a copy of the public investigation memorandum
under subdivision 12b, paragraph (b), clause (1), deleted text begin when required to be completed under this
section,deleted text end new text begin within ten calendar days of completing the final dispositionnew text end to the following persons:
(1) the vulnerable adult, or the vulnerable adult's guardian or health care agent, if known,
unless the lead investigative agency knows that the notification would endanger the
well-being of the vulnerable adult;
(2) the reporter, if the reporter requested notification when making the report, provided
this notification would not endanger the well-being of the vulnerable adult;
(3) the deleted text begin alleged perpetratordeleted text end new text begin person or facility alleged responsible for maltreatmentnew text end , if
known;
(4) the facility; and
(5) the ombudsman for long-term care, or the ombudsman for mental health and
developmental disabilities, as appropriate.
new text begin
(j) When the lead investigative agency is a county agency, within ten calendar days of
completing the final disposition, the lead investigative agency shall provide notification of
the final disposition to the following persons:
new text end
new text begin
(1) the vulnerable adult, or the vulnerable adult's guardian or health care agent, if known,
when the allegation is applicable to the surrogate's authority, unless the agency knows that
the notification would endanger the well-being of the vulnerable adult;
new text end
new text begin
(2) the individual or facility determined responsible for maltreatment, if known; and
new text end
new text begin
(3) when the alleged incident involves a personal care assistant or provider agency, the
personal care provider organization under section 256B.0659.
new text end
deleted text begin (g)deleted text end new text begin (k)new text end If, as a result of a reconsideration, review, or hearing, the lead investigative
agency changes the final disposition, or if a final disposition is changed on appeal, the lead
investigative agency shall notify the parties specified in paragraph deleted text begin (f)deleted text end new text begin (i)new text end .
deleted text begin (h)deleted text end new text begin (l)new text end The lead investigative agency shall notify the vulnerable adult who is the subject
of the report or the vulnerable adult's guardian or health care agent, if known, and any person
or facility determined to have maltreated a vulnerable adult, of their appeal or review rights
under this section or section 256.021.
deleted text begin (i)deleted text end new text begin (m)new text end The lead investigative agency shall routinely provide investigation memoranda
for substantiated reports to the appropriate licensing boards. These reports must include the
names of substantiated perpetrators. The lead investigative agency may not provide
investigative memoranda for inconclusive or false reports to the appropriate licensing boards
unless the lead investigative agency's investigation gives reason to believe that there may
have been a violation of the applicable professional practice laws. If the investigation
memorandum is provided to a licensing board, the subject of the investigation memorandum
shall be notified and receive a summary of the investigative findings.
deleted text begin (j)deleted text end new text begin (n)new text end In order to avoid duplication, licensing boards shall consider the findings of the
lead investigative agency in their investigations if they choose to investigate. This does not
preclude licensing boards from considering other information.
deleted text begin (k)deleted text end new text begin (o)new text end The lead investigative agency must provide to the commissioner of human services
its final dispositions, including the names of all substantiated perpetrators. The commissioner
of human services shall establish records to retain the names of substantiated perpetrators.
Sec. 31.
Minnesota Statutes 2020, section 626.557, subdivision 9d, is amended to read:
Subd. 9d.
Administrative reconsideration; review panel.
(a) Except as provided under
paragraph (e), any individual or facility which a lead investigative agency determines has
maltreated a vulnerable adult, or the vulnerable adult or an interested person acting on behalf
of the vulnerable adult, regardless of the lead investigative agency's determination, who
contests the lead investigative agency's final disposition of an allegation of maltreatment,
may request the lead investigative agency to reconsider its final disposition. The request
for reconsideration must be submitted in writing to the lead investigative agency within 15
calendar days after receipt of notice of final disposition or, if the request is made by an
interested person who is not entitled to notice, within 15 days after receipt of the notice by
the vulnerable adult or the vulnerable adult's guardian or health care agent. If mailed, the
request for reconsideration must be postmarked and sent to the lead investigative agency
within 15 calendar days of the individual's or facility's receipt of the final disposition. If the
request for reconsideration is made by personal service, it must be received by the lead
investigative agency within 15 calendar days of the individual's or facility's receipt of the
final disposition. An individual who was determined to have maltreated a vulnerable adult
under this section and who was disqualified on the basis of serious or recurring maltreatment
under sections 245C.14 and 245C.15, may request reconsideration of the maltreatment
determination and the disqualification. The request for reconsideration of the maltreatment
determination and the disqualification must be submitted in writing within 30 calendar days
of the individual's receipt of the notice of disqualification under sections 245C.16 and
245C.17. If mailed, the request for reconsideration of the maltreatment determination and
the disqualification must be postmarked and sent to the lead investigative agency within 30
calendar days of the individual's receipt of the notice of disqualification. If the request for
reconsideration is made by personal service, it must be received by the lead investigative
agency within 30 calendar days after the individual's receipt of the notice of disqualification.
(b) Except as provided under paragraphs (e) and (f), if the lead investigative agency
denies the request or fails to act upon the request within 15 working days after receiving
the request for reconsideration, the person or facility entitled to a fair hearing under section
256.045, may submit to the commissioner of human services a written request for a hearing
under that statute. The vulnerable adult, or an interested person acting on behalf of the
vulnerable adult, may request a review by the Vulnerable Adult Maltreatment Review Panel
under section 256.021 if the lead investigative agency denies the request or fails to act upon
the request, or if the vulnerable adult or interested person contests a reconsidered disposition.new text begin
The Vulnerable Adult Maltreatment Review Panel shall not conduct a review if the interested
person making the request on behalf of the vulnerable adult is also the individual or facility
alleged responsible for the maltreatment of the vulnerable adult.new text end The lead investigative
agency shall notify persons who request reconsideration of their rights under this paragraph.
The request must be submitted in writing to the review panel and a copy sent to the lead
investigative agency within 30 calendar days of receipt of notice of a denial of a request for
reconsideration or of a reconsidered disposition. The request must specifically identify the
aspects of the lead investigative agency determination with which the person is dissatisfied.
(c) If, as a result of a reconsideration or review, the lead investigative agency changes
the final disposition, it shall notify the parties specified in subdivision 9c, paragraph deleted text begin (f)deleted text end new text begin (i)new text end .
(d) For purposes of this subdivision, "interested person acting on behalf of the vulnerable
adult" means a person designated in writing by the vulnerable adult to act on behalf of the
vulnerable adult, or a legal guardian or conservator or other legal representative, a proxy
or health care agent appointed under chapter 145B or 145C, or an individual who is related
to the vulnerable adult, as defined in section 245A.02, subdivision 13.
(e) If an individual was disqualified under sections 245C.14 and 245C.15, on the basis
of a determination of maltreatment, which was serious or recurring, and the individual has
requested reconsideration of the maltreatment determination under paragraph (a) and
reconsideration of the disqualification under sections 245C.21 to 245C.27, reconsideration
of the maltreatment determination and requested reconsideration of the disqualification
shall be consolidated into a single reconsideration. If reconsideration of the maltreatment
determination is denied and the individual remains disqualified following a reconsideration
decision, the individual may request a fair hearing under section 256.045. If an individual
requests a fair hearing on the maltreatment determination and the disqualification, the scope
of the fair hearing shall include both the maltreatment determination and the disqualification.
(f) If a maltreatment determination or a disqualification based on serious or recurring
maltreatment is the basis for a denial of a license under section 245A.05 or a licensing
sanction under section 245A.07, the license holder has the right to a contested case hearing
under chapter 14 and Minnesota Rules, parts 1400.8505 to 1400.8612. As provided for
under section 245A.08, the scope of the contested case hearing must include the maltreatment
determination, disqualification, and licensing sanction or denial of a license. In such cases,
a fair hearing must not be conducted under section 256.045. Except for family child care
and child foster care, reconsideration of a maltreatment determination under this subdivision,
and reconsideration of a disqualification under section 245C.22, must not be conducted
when:
(1) a denial of a license under section 245A.05, or a licensing sanction under section
245A.07, is based on a determination that the license holder is responsible for maltreatment
or the disqualification of a license holder based on serious or recurring maltreatment;
(2) the denial of a license or licensing sanction is issued at the same time as the
maltreatment determination or disqualification; and
(3) the license holder appeals the maltreatment determination or disqualification, and
denial of a license or licensing sanction.
Notwithstanding clauses (1) to (3), if the license holder appeals the maltreatment
determination or disqualification, but does not appeal the denial of a license or a licensing
sanction, reconsideration of the maltreatment determination shall be conducted under sections
260E.33 and 626.557, subdivision 9d, and reconsideration of the disqualification shall be
conducted under section 245C.22. In such cases, a fair hearing shall also be conducted as
provided under sections 245C.27, 260E.33, and 626.557, subdivision 9d.
If the disqualified subject is an individual other than the license holder and upon whom
a background study must be conducted under chapter 245C, the hearings of all parties may
be consolidated into a single contested case hearing upon consent of all parties and the
administrative law judge.
(g) Until August 1, 2002, an individual or facility that was determined by the
commissioner of human services or the commissioner of health to be responsible for neglect
under section 626.5572, subdivision 17, after October 1, 1995, and before August 1, 2001,
that believes that the finding of neglect does not meet an amended definition of neglect may
request a reconsideration of the determination of neglect. The commissioner of human
services or the commissioner of health shall mail a notice to the last known address of
individuals who are eligible to seek this reconsideration. The request for reconsideration
must state how the established findings no longer meet the elements of the definition of
neglect. The commissioner shall review the request for reconsideration and make a
determination within 15 calendar days. The commissioner's decision on this reconsideration
is the final agency action.
(1) For purposes of compliance with the data destruction schedule under subdivision
12b, paragraph (d), when a finding of substantiated maltreatment has been changed as a
result of a reconsideration under this paragraph, the date of the original finding of a
substantiated maltreatment must be used to calculate the destruction date.
(2) For purposes of any background studies under chapter 245C, when a determination
of substantiated maltreatment has been changed as a result of a reconsideration under this
paragraph, any prior disqualification of the individual under chapter 245C that was based
on this determination of maltreatment shall be rescinded, and for future background studies
under chapter 245C the commissioner must not use the previous determination of
substantiated maltreatment as a basis for disqualification or as a basis for referring the
individual's maltreatment history to a health-related licensing board under section 245C.31.
Sec. 32.
Minnesota Statutes 2020, section 626.557, subdivision 10b, is amended to read:
Subd. 10b.
Investigations; guidelines.
new text begin (a) new text end Each lead investigative agency shall develop
guidelines for prioritizing reports for investigation.
new text begin (b)new text end When investigating a report, the lead investigative agency shall conduct the following
activitiesdeleted text begin ,deleted text end as appropriate:
(1) interview of the deleted text begin alleged victimdeleted text end new text begin vulnerable adultnew text end ;
(2) interview of the reporter and others who may have relevant information;
(3) interview of the deleted text begin alleged perpetratordeleted text end new text begin individual or facility alleged responsible for
maltreatmentnew text end ;new text begin and
new text end
deleted text begin
(4) examination of the environment surrounding the alleged incident;
deleted text end
deleted text begin (5)deleted text end new text begin (4)new text end review ofnew text begin records andnew text end pertinent documentation of the alleged incidentdeleted text begin ; anddeleted text end new text begin .
new text end
deleted text begin
(6) consultation with professionals.
deleted text end
new text begin
(c) The lead investigative agency shall conduct the following activities as appropriate
to further the investigation, to prevent further maltreatment, or to safeguard the vulnerable
adult:
new text end
new text begin
(1) examining the environment surrounding the alleged incident;
new text end
new text begin
(2) consulting with professionals; and
new text end
new text begin
(3) communicating with state, federal, tribal, and other agencies including:
new text end
new text begin
(i) service providers;
new text end
new text begin
(ii) case managers;
new text end
new text begin
(iii) ombudsmen; and
new text end
new text begin
(iv) support persons for the vulnerable adult.
new text end
new text begin
(d) The lead investigative agency may decide not to conduct an interview of a vulnerable
adult, reporter, or witness under paragraph (b) if:
new text end
new text begin
(1) the vulnerable adult, reporter, or witness is deceased, declines to have an interview
with the agency, or is unable to be contacted despite the agency's diligent attempts;
new text end
new text begin
(2) an interview of the vulnerable adult or reporter was conducted by law enforcement
or a professional trained in forensic interview and an additional interview will not further
the investigation;
new text end
new text begin
(3) an interview of the witness will not further the investigation; or
new text end
new text begin
(4) the agency has a reason to believe that the interview will endanger the vulnerable
adult.
new text end
Sec. 33.
Minnesota Statutes 2020, section 626.557, subdivision 12b, is amended to read:
Subd. 12b.
Data management.
(a) In performing any of the duties of this section as a
lead investigative agency, the county social service agency shall maintain appropriate
records. Data collected by the county social service agency under this sectionnew text begin while providing
adult protective servicesnew text end are welfare data under section 13.46. new text begin Investigative data collected
under this section are confidential data on individuals or protected nonpublic data as defined
under section 13.02. new text end Notwithstanding section 13.46, subdivision 1, paragraph (a), data under
this paragraph that are inactive investigative data on an individual who is a vendor of services
are private data on individuals, as defined in section 13.02. The identity of the reporter may
only be disclosed as provided in paragraph (c).
Data maintained by the common entry point are confidential data on individuals or
protected nonpublic data as defined in section 13.02. Notwithstanding section 138.163, the
common entry point shall maintain data for three calendar years after date of receipt and
then destroy the data unless otherwise directed by federal requirements.
(b) The commissioners of health and human services shall prepare an investigation
memorandum for each report alleging maltreatment investigated under this section. County
social service agencies must maintain private data on individuals but are not required to
prepare an investigation memorandum. During an investigation by the commissioner of
health or the commissioner of human services, data collected under this section are
confidential data on individuals or protected nonpublic data as defined in section 13.02.
Upon completion of the investigation, the data are classified as provided in clauses (1) to
(3) and paragraph (c).
(1) The investigation memorandum must contain the following data, which are public:
(i) the name of the facility investigated;
(ii) a statement of the nature of the alleged maltreatment;
(iii) pertinent information obtained from medical or other records reviewed;
(iv) the identity of the investigator;
(v) a summary of the investigation's findings;
(vi) statement of whether the report was found to be substantiated, inconclusive, false,
or that no determination will be made;
(vii) a statement of any action taken by the facility;
(viii) a statement of any action taken by the lead investigative agency; and
(ix) when a lead investigative agency's determination has substantiated maltreatment, a
statement of whether an individual, individuals, or a facility were responsible for the
substantiated maltreatment, if known.
The investigation memorandum must be written in a manner which protects the identity
of the reporter and of the vulnerable adult and may not contain the names or, to the extent
possible, data on individuals or private data listed in clause (2).
(2) Data on individuals collected and maintained in the investigation memorandum are
private data, including:
(i) the name of the vulnerable adult;
(ii) the identity of the individual alleged to be the perpetrator;
(iii) the identity of the individual substantiated as the perpetrator; and
(iv) the identity of all individuals interviewed as part of the investigation.
(3) Other data on individuals maintained as part of an investigation under this section
are private data on individuals upon completion of the investigation.
(c) deleted text begin After the assessment or investigation is completed,deleted text end The name of the reporter must
be confidential. The subject of the report may compel disclosure of the name of the reporter
only with the consent of the reporter or upon a written finding by a court that the report was
false and there is evidence that the report was made in bad faith. This subdivision does not
alter disclosure responsibilities or obligations under the Rules of Criminal Procedure, except
that where the identity of the reporter is relevant to a criminal prosecution, the district court
shall do an in-camera review prior to determining whether to order disclosure of the identity
of the reporter.
(d) Notwithstanding section 138.163, data maintained under this section by the
commissioners of health and human services must be maintained under the following
schedule and then destroyed unless otherwise directed by federal requirements:
(1) data from reports determined to be false, maintained for three years after the finding
was made;
(2) data from reports determined to be inconclusive, maintained for four years after the
finding was made;
(3) data from reports determined to be substantiated, maintained for seven years after
the finding was made; and
(4) data from reports which were not investigated by a lead investigative agency and for
which there is no final disposition, maintained for three years from the date of the report.
(e) The commissioners of health and human services shall annually publish on their
websites the number and type of reports of alleged maltreatment involving licensed facilities
reported under this section, the number of those requiring investigation under this section,
and the resolution of those investigations. On a biennial basis, the commissioners of health
and human services shall jointly report the following information to the legislature and the
governor:
(1) the number and type of reports of alleged maltreatment involving licensed facilities
reported under this section, the number of those requiring investigations under this section,
the resolution of those investigations, and which of the two lead agencies was responsible;
(2) trends about types of substantiated maltreatment found in the reporting period;
(3) if there are upward trends for types of maltreatment substantiated, recommendations
for addressing and responding to them;
(4) efforts undertaken or recommended to improve the protection of vulnerable adults;
(5) whether and where backlogs of cases result in a failure to conform with statutory
time frames and recommendations for reducing backlogs if applicable;
(6) recommended changes to statutes affecting the protection of vulnerable adults; and
(7) any other information that is relevant to the report trends and findings.
(f) Each lead investigative agency must have a record retention policy.
(g) Lead investigative agencies,new text begin county agencies responsible for adult protective services,new text end
prosecuting authorities, and law enforcement agencies may exchange not public data, as
defined in section 13.02,new text begin with a tribal social services agency, facility, service provider,
vulnerable adult, primary support person for a vulnerable adult, state licensing board, federal
or state agency, the ombudsman for long-term care, or the ombudsman for mental health
and developmental disabilities,new text end if the agency or authority deleted text begin requestingdeleted text end new text begin providingnew text end the data
determines that the data are pertinent and necessary deleted text begin to the requesting agency in initiating,
furthering, or completingdeleted text end new text begin to prevent further maltreatment of a vulnerable adult, to safeguard
a vulnerable adult, or fornew text end an investigation under this section. Data collected under this section
must be made available to prosecuting authorities and law enforcement officials, local
county agencies, and licensing agencies investigating the alleged maltreatment under this
section. The lead investigative agency shall exchange not public data with the vulnerable
adult maltreatment review panel established in section 256.021 if the data are pertinent and
necessary for a review requested under that section. Notwithstanding section 138.17, upon
completion of the review, not public data received by the review panel must be destroyed.
(h) Each lead investigative agency shall keep records of the length of time it takes to
complete its investigations.
(i) A lead investigative agency may notify other affected parties and their authorized
representative if the lead investigative agency has reason to believe maltreatment has occurred
and determines the information will safeguard the well-being of the affected parties or dispel
widespread rumor or unrest in the affected facility.
(j) Under any notification provision of this section, where federal law specifically
prohibits the disclosure of patient identifying information, a lead investigative agency may
not provide any notice unless the vulnerable adult has consented to disclosure in a manner
which conforms to federal requirements.
Sec. 34.
Minnesota Statutes 2020, section 626.5572, subdivision 2, is amended to read:
Subd. 2.
Abuse.
"Abuse" means:
(a) An act against a vulnerable adult that constitutes a violation of, an attempt to violate,
or aiding and abetting a violation of:
(1) assault in the first through fifth degrees as defined in sections 609.221 to 609.224;
(2) the use of drugs to injure or facilitate crime as defined in section 609.235;
(3) the solicitation, inducement, and promotion of prostitution as defined in section
609.322; and
(4) criminal sexual conduct in the first through fifth degrees as defined in sections
609.342 to 609.3451.
A violation includes any action that meets the elements of the crime, regardless of
whether there is a criminal proceeding or conviction.
(b) Conduct which is not an accident or therapeutic conduct as defined in this section,
which produces or could reasonably be expected to produce physical pain or injury or
emotional distress including, but not limited to, the following:
(1) hitting, slapping, kicking, pinching, biting, or corporal punishment of a vulnerable
adult;
(2) use of repeated or malicious oral, written, or gestured language toward a vulnerable
adult or the treatment of a vulnerable adult which would be considered by a reasonable
person to be disparaging, derogatory, humiliating, harassing, or threatening;new text begin or
new text end
(3) use of any aversive or deprivation procedure, unreasonable confinement, or
involuntary seclusionnew text begin not authorized under chapter 245A or 245D or Minnesota Rules,
chapter 9544, or in violation of state or federal patient rightsnew text end , including the forced separation
of the vulnerable adult from other persons against the will of the vulnerable adult or the
legal representative of the vulnerable adultdeleted text begin ; anddeleted text end new text begin .
new text end
deleted text begin
(4) use of any aversive or deprivation procedures for persons with developmental
disabilities or related conditions not authorized under section 245.825.
deleted text end
(c) Any sexual contact or penetration as defined in section 609.341, between a facility
staff person or a person providing services in the facility and a resident, patient, or client
of that facility.
(d) The act of forcing, compelling, coercing, or enticing a vulnerable adult against the
vulnerable adult's will to perform services for the advantage of another.
(e) For purposes of this section, a vulnerable adult is not abused for the sole reason that
the vulnerable adult or a person with authority to make health care decisions for the
vulnerable adult under sections 144.651, 144A.44, chapter 145B, 145C or 252A, or section
253B.03 or 524.5-313, refuses consent or withdraws consent, consistent with that authority
and within the boundary of reasonable medical practice, to any therapeutic conduct, including
any care, service, or procedure to diagnose, maintain, or treat the physical or mental condition
of the vulnerable adult or, where permitted under law, to provide nutrition and hydration
parenterally or through intubation. This paragraph does not enlarge or diminish rights
otherwise held under law by:
(1) a vulnerable adult or a person acting on behalf of a vulnerable adult, including an
involved family member, to consent to or refuse consent for therapeutic conduct; or
(2) a caregiver to offer or provide or refuse to offer or provide therapeutic conduct.
(f) For purposes of this section, a vulnerable adult is not abused for the sole reason that
the vulnerable adult, a person with authority to make health care decisions for the vulnerable
adult, or a caregiver in good faith selects and depends upon spiritual means or prayer for
treatment or care of disease or remedial care of the vulnerable adult in lieu of medical care,
provided that this is consistent with the prior practice or belief of the vulnerable adult or
with the expressed intentions of the vulnerable adult.
(g) For purposes of this section, a vulnerable adult is not abused for the sole reason that
the vulnerable adult, who is not impaired in judgment or capacity by mental or emotional
dysfunction or undue influence, engages in consensual sexual contact with:
(1) a person, including a facility staff person, when a consensual sexual personal
relationship existed prior to the caregiving relationship; or
(2) a personal care attendant, regardless of whether the consensual sexual personal
relationship existed prior to the caregiving relationship.
Sec. 35.
Minnesota Statutes 2020, section 626.5572, subdivision 4, is amended to read:
Subd. 4.
Caregiver.
"Caregiver" means an individual or facility who has responsibility
for the care of a vulnerable adult deleted text begin as a result of a family relationship, or who has assumed
responsibility for all or a portion of the care of a vulnerable adultdeleted text end voluntarily, by contract,
or by agreement.
Sec. 36.
Minnesota Statutes 2020, section 626.5572, subdivision 17, is amended to read:
Subd. 17.
Neglect.
deleted text begin
"Neglect" means:
deleted text end
new text begin
Neglect means neglect by a caregiver or self-neglect.
new text end
(a)new text begin "Caregiver neglect" meansnew text end the failure or omission by a caregiver to supply a vulnerable
adult with care or services, including but not limited to, food, clothing, shelter, health care,
or supervision which is:
(1) reasonable and necessary to obtain or maintain the vulnerable adult's physical or
mental health or safety, considering the physical and mental capacity or dysfunction of the
vulnerable adult; and
(2) which is not the result of an accident or therapeutic conduct.
(b) deleted text begin The absence or likelihood of absence of care or services, including but not limited
to, food, clothing, shelter, health care, or supervision necessary to maintain the physical
and mental health of the vulnerable adultdeleted text end new text begin "Self-neglect" means neglect by a vulnerable adult
of the vulnerable adult's own food, clothing, shelter, health care, or other services that are
not the responsibility of a caregivernew text end which a reasonable person would deem essential to
obtain or maintain the vulnerable adult's health, safety, or comfort deleted text begin considering the physical
or mental capacity or dysfunction of the vulnerable adultdeleted text end .
(c) For purposes of this section, a vulnerable adult is not neglected for the sole reason
that:
(1) the vulnerable adult or a person with authority to make health care decisions for the
vulnerable adult under sections 144.651, 144A.44, chapter 145B, 145C, or 252A, or sections
253B.03 or 524.5-101 to 524.5-502, refuses consent or withdraws consent, consistent with
that authority and within the boundary of reasonable medical practice, to any therapeutic
conduct, including any care, service, or procedure to diagnose, maintain, or treat the physical
or mental condition of the vulnerable adult, or, where permitted under law, to provide
nutrition and hydration parenterally or through intubation; this paragraph does not enlarge
or diminish rights otherwise held under law by:
(i) a vulnerable adult or a person acting on behalf of a vulnerable adult, including an
involved family member, to consent to or refuse consent for therapeutic conduct; or
(ii) a caregiver to offer or provide or refuse to offer or provide therapeutic conduct; or
(2) the vulnerable adult, a person with authority to make health care decisions for the
vulnerable adult, or a caregiver in good faith selects and depends upon spiritual means or
prayer for treatment or care of disease or remedial care of the vulnerable adult in lieu of
medical care, provided that this is consistent with the prior practice or belief of the vulnerable
adult or with the expressed intentions of the vulnerable adult;
(3) the vulnerable adult, who is not impaired in judgment or capacity by mental or
emotional dysfunction or undue influence, engages in consensual sexual contact with:
(i) a person including a facility staff person when a consensual sexual personal
relationship existed prior to the caregiving relationship; or
(ii) a personal care attendant, regardless of whether the consensual sexual personal
relationship existed prior to the caregiving relationship; or
(4) an individual makes an error in the provision of therapeutic conduct to a vulnerable
adult which does not result in injury or harm which reasonably requires medical or mental
health care; or
(5) an individual makes an error in the provision of therapeutic conduct to a vulnerable
adult that results in injury or harm, which reasonably requires the care of a physician, and:
(i) the necessary care is provided in a timely fashion as dictated by the condition of the
vulnerable adult;
(ii) if after receiving care, the health status of the vulnerable adult can be reasonably
expected, as determined by the attending physician, to be restored to the vulnerable adult's
preexisting condition;
(iii) the error is not part of a pattern of errors by the individual;
(iv) if in a facility, the error is immediately reported as required under section 626.557,
and recorded internally in the facility;
(v) if in a facility, the facility identifies and takes corrective action and implements
measures designed to reduce the risk of further occurrence of this error and similar errors;
and
(vi) if in a facility, the actions required under items (iv) and (v) are sufficiently
documented for review and evaluation by the facility and any applicable licensing,
certification, and ombudsman agency.
(d) Nothing in this definition requires a caregiver, if regulated, to provide services in
excess of those required by the caregiver's license, certification, registration, or other
regulation.
(e) If the findings of an investigation by a lead investigative agency result in a
determination of substantiated maltreatment for the sole reason that the actions required of
a facility under paragraph (c), clause (5), item (iv), (v), or (vi), were not taken, then the
facility is subject to a correction order. An individual will not be found to have neglected
or maltreated the vulnerable adult based solely on the facility's not having taken the actions
required under paragraph (c), clause (5), item (iv), (v), or (vi). This must not alter the lead
investigative agency's determination of mitigating factors under section 626.557, subdivision
9c, paragraph deleted text begin (c)deleted text end new text begin (f)new text end .
Sec. 37. new text begin REPEALER.
new text end
new text begin
(a)
new text end
new text begin
Minnesota Statutes 2020, sections 245A.03, subdivision 5; and 256S.20, subdivision
2,
new text end
new text begin
are repealed.
new text end
new text begin
(b)
new text end
new text begin
Minnesota Statutes 2020, sections 256R.08, subdivision 2; and 256R.49,
new text end
new text begin
are repealed.
new text end
new text begin
(c)
new text end
new text begin
Minnesota Rules, part 9555.6255,
new text end
new text begin
is repealed.
new text end
ARTICLE 2
CHILDREN AND FAMILY SERVICES
Section 1.
Minnesota Statutes 2020, section 119B.11, subdivision 2a, is amended to read:
Subd. 2a.
Recovery of overpayments.
(a) An amount of child care assistance paid to a
recipient new text begin or provider new text end in excess of the payment due is recoverable by the county agency new text begin or
commissioner new text end under paragraphs (b) and (c), even when the overpayment was caused by
agency error or circumstances outside the responsibility and control of the family or provider.
(b) An overpayment must be recouped or recovered from the family if the overpayment
benefited the family by causing the family to pay less for child care expenses than the family
otherwise would have been required to pay under child care assistance program requirements.
If the family remains eligible for child care assistance, the overpayment must be recovered
through recoupment as identified in Minnesota Rules, part 3400.0187, except that the
overpayments must be calculated and collected on a service period basis. If the family no
longer remains eligible for child care assistance, the county new text begin or commissioner new text end may choose
to initiate efforts to recover overpayments from the family for deleted text begin overpaymentdeleted text end new text begin overpaymentsnew text end
less than $50new text begin that were not the result of fraud under section 256.98, theft under section
609.52, or a federal crime relating to theft of state funds or fraudulent receipt of benefits
for a program administered by the county or commissionernew text end . If the overpayment is greater
than or equal to $50, new text begin or it resulted from fraud under section 256.98, theft under section
609.52, or a federal crime relating to theft of state funds or fraudulent receipt of benefits
for a program administered by the county or commissioner, new text end the county new text begin or commissioner
new text end shall seek voluntary repayment of the overpayment from the family. If the county new text begin or
commissioner new text end is unable to recoup the overpayment through voluntary repayment, the county
new text begin or commissioner new text end shall initiate civil court proceedings to recover the overpayment unless
the county'snew text begin or commissioner'snew text end costs to recover the overpayment will exceed the amount of
the overpayment. A family with an outstanding debt under this subdivision is not eligible
for child care assistance until: (1) the debt is paid in full; deleted text begin ordeleted text end (2) satisfactory arrangements
are made with the county new text begin or commissioner new text end to retire the debt consistent with the requirements
of this chapter and Minnesota Rules, chapter 3400, and the family is in compliance with
the arrangementsnew text begin ; or (3) the commissioner determines that it is in the best interests of the
state to compromise debts owed to the state pursuant to section 16D.15new text end .
(c) The county new text begin or commissioner new text end must recover an overpayment from a provider if the
overpayment did not benefit the family by causing it to receive more child care assistance
or to pay less for child care expenses than the family otherwise would have been eligible
to receive or required to pay under child care assistance program requirements, and benefited
the provider by causing the provider to receive more child care assistance than otherwise
would have been paid on the family's behalf under child care assistance program
requirements. If the provider continues to care for children receiving child care assistance,
the overpayment must be recovered through deleted text begin reductions in child care assistance payments
for services as described in an agreement with the countydeleted text end new text begin recoupment as identified in
Minnesota Rules, part 3400.0187new text end . The provider may not charge families using that provider
more to cover the cost of recouping the overpayment. If the provider no longer cares for
children receiving child care assistance, the county new text begin or commissioner new text end may choose to initiate
efforts to recover overpayments of less than $50 new text begin that were not the result of fraud under
section 256.98, theft under section 609.52, or a federal crime relating to theft of state funds
or fraudulent billing for a program administered by the county or commissioner new text end from the
provider. If the overpayment is greater than or equal to $50, new text begin or it resulted from fraud under
section 256.98, theft under section 609.52, or a federal crime relating to theft of state funds
or fraudulent billing for a program administered by the county or commissioner, new text end the county
new text begin or commissioner new text end shall seek voluntary repayment of the overpayment from the provider. If
the county new text begin or commissioner new text end is unable to recoup the overpayment through voluntary
repayment, the county new text begin or commissioner new text end shall initiate civil court proceedings to recover the
overpayment unless the county'snew text begin or commissioner'snew text end costs to recover the overpayment will
exceed the amount of the overpayment. A provider with an outstanding debt under this
subdivision is not eligible to care for children receiving child care assistance until:
(1) the debt is paid in full; deleted text begin or
deleted text end
(2) satisfactory arrangements are made with the county new text begin or commissioner new text end to retire the
debt consistent with the requirements of this chapter and Minnesota Rules, chapter 3400,
and the provider is in compliance with the arrangementsdeleted text begin .deleted text end new text begin ; or
new text end
new text begin
(3) the commissioner determines that it is in the best interests of the state to compromise
debts owed to the state pursuant to section 16D.15.
new text end
(d) When both the family and the provider acted together to intentionally cause the
overpayment, both the family and the provider are jointly liable for the overpayment
regardless of who benefited from the overpayment. The county new text begin or commissioner new text end must
recover the overpayment as provided in paragraphs (b) and (c). When the family or the
provider is in compliance with a repayment agreement, the party in compliance is eligible
to receive child care assistance or to care for children receiving child care assistance despite
the other party's noncompliance with repayment arrangements.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective August 1, 2021.
new text end
Sec. 2.
Minnesota Statutes 2020, section 119B.125, subdivision 1, is amended to read:
Subdivision 1.
Authorization.
deleted text begin Except as provided in subdivision 5,deleted text end A county or the
commissioner must authorize the provider chosen by an applicant or a participant before
the county can authorize payment for care provided by that provider. The commissioner
must establish the requirements necessary for authorization of providers. A provider must
be reauthorized every two years. A legal, nonlicensed family child care provider also must
be reauthorized when another person over the age of 13 joins the household, a current
household member turns 13, or there is reason to believe that a household member has a
factor that prevents authorization. The provider is required to report all family changes that
would require reauthorization. When a provider has been authorized for payment for
providing care for families in more than one county, the county responsible for
reauthorization of that provider is the county of the family with a current authorization for
that provider and who has used the provider for the longest length of time.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective August 1, 2021.
new text end
Sec. 3.
Minnesota Statutes 2020, section 119B.13, subdivision 6, is amended to read:
Subd. 6.
Provider payments.
(a) A provider shall bill only for services documented
according to section 119B.125, subdivision 6. The provider shall bill for services provided
within ten days of the end of the service period. Payments under the child care fund shall
be made within 21 days of receiving a complete bill from the provider. Counties or the state
may establish policies that make payments on a more frequent basis.
(b) If a provider has received an authorization of care and been issued a billing form for
an eligible family, the bill must be submitted within 60 days of the last date of service on
the bill. A bill submitted more than 60 days after the last date of service must be paid if the
county determines that the provider has shown good cause why the bill was not submitted
within 60 days. Good cause must be defined in the county's child care fund plan under
section 119B.08, subdivision 3, and the definition of good cause must include county error.
Any bill submitted more than a year after the last date of service on the bill must not be
paid.
(c) If a provider provided care for a time period without receiving an authorization of
care and a billing form for an eligible family, payment of child care assistance may only be
made retroactively for a maximum of six months from the date the provider is issued an
authorization of care and billing form.
(d) A county or the commissioner may refuse to issue a child care authorization to a
new text begin certified, new text end licensednew text begin ,new text end or legal nonlicensed provider, revoke an existing child care authorization
to a new text begin certified, new text end licensednew text begin ,new text end or legal nonlicensed provider, stop payment issued to a new text begin certified,
new text end licensednew text begin ,new text end or legal nonlicensed provider, or refuse to pay a bill submitted by a new text begin certified,
new text end licensednew text begin ,new text end or legal nonlicensed provider if:
(1) the provider admits to intentionally giving the county materially false information
on the provider's billing forms;
(2) a county or the commissioner finds by a preponderance of the evidence that the
provider intentionally gave the county materially false information on the provider's billing
forms, or provided false attendance records to a county or the commissioner;
(3) the provider is in violation of child care assistance program rules, until the agency
determines those violations have been corrected;
(4) the provider is operating after:
(i) an order of suspension of the provider's license issued by the commissioner;
(ii) an order of revocation of the provider's licensenew text begin issued by the commissionernew text end ; or
(iii) deleted text begin a final order of conditional license issued by the commissioner for as long as the
conditional license is in effectdeleted text end new text begin an order of decertification issued to the providernew text end ;
(5) the provider submits false attendance reports or refuses to provide documentation
of the child's attendance upon request;
(6) the provider gives false child care price information; or
(7) the provider fails to report decreases in a child's attendance as required under section
119B.125, subdivision 9.
(e) For purposes of paragraph (d), clauses (3), (5), (6), and (7), the county or the
commissioner may withhold the provider's authorization or payment for a period of time
not to exceed three months beyond the time the condition has been corrected.
(f) A county's payment policies must be included in the county's child care plan under
section 119B.08, subdivision 3. If payments are made by the state, in addition to being in
compliance with this subdivision, the payments must be made in compliance with section
16A.124.
new text begin
(g) If the commissioner or responsible county agency suspends or refuses payment to a
provider under paragraph (d), clause (1) or (2), or chapter 245E and the provider has:
new text end
new text begin
(1) a disqualification for wrongfully obtaining assistance under section 256.98,
subdivision 8, paragraph (c);
new text end
new text begin
(2) an administrative disqualification under section 256.046, subdivision 3; or
new text end
new text begin
(3) a termination under section 245E.02, subdivision 4, paragraph (c), clause (4), or
245E.06;
new text end
new text begin
then the provider forfeits the payment to the commissioner or the responsible county agency,
regardless of the amount assessed in an overpayment, charged in a criminal complaint, or
ordered as criminal restitution.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective August 1, 2021.
new text end
Sec. 4.
Minnesota Statutes 2020, section 119B.13, subdivision 7, is amended to read:
Subd. 7.
Absent days.
(a) Licensed child care providers and license-exempt centers
must not be reimbursed for more than 25 full-day absent days per child, excluding holidays,
in a calendar year, or for more than ten consecutive full-day absent days. "Absent day"
means any day that the child is authorized and scheduled to be in care with a licensed
provider or license-exempt center, and the child is absent from the care for the entire day.
Legal nonlicensed family child care providers must not be reimbursed for absent days. If a
child attends for part of the time authorized to be in care in a day, but is absent for part of
the time authorized to be in care in that same day, the absent time must be reimbursed but
the time must not count toward the absent days limit. Child care providers must only be
reimbursed for absent days if the provider has a written policy for child absences and charges
all other families in care for similar absences.
(b) Notwithstanding paragraph (a), children with documented medical conditions that
cause more frequent absences may exceed the 25 absent days limit, or ten consecutive
full-day absent days limit. Absences due to a documented medical condition of a parent or
sibling who lives in the same residence as the child receiving child care assistance do not
count against the absent days limit in a calendar year. Documentation of medical conditions
must be on the forms and submitted according to the timelines established by the
commissioner. A public health nurse or school nurse may verify the illness in lieu of a
medical practitioner. If a provider sends a child home early due to a medical reason,
including, but not limited to, fever or contagious illness, the child care center director or
lead teacher may verify the illness in lieu of a medical practitioner.
(c) Notwithstanding paragraph (a), children in families may exceed the absent days limit
if at least one parent: (1) is under the age of 21; (2) does not have a high school diploma or
commissioner of education-selected high school equivalency certification; and (3) is a
student in a school district or another similar program that provides or arranges for child
care, parenting support, social services, career and employment supports, and academic
support to achieve high school graduation, upon request of the program and approval of the
county. If a child attends part of an authorized day, payment to the provider must be for the
full amount of care authorized for that day.
(d) Child care providers must be reimbursed for up to ten federal or state holidays or
designated holidays per year when the provider charges all families for these days and the
holiday or designated holiday falls on a day when the child is authorized to be in attendance.
Parents may substitute other cultural or religious holidays for the ten recognized state and
federal holidays. Holidays do not count toward the absent days limit.
(e) A family deleted text begin or child care providerdeleted text end must not be assessed an overpayment for an absent
day payment unless (1) there was an error in the amount of care authorized for the family,
new text begin or new text end (2) all of the allowed full-day absent payments for the child have been paiddeleted text begin , or (3) the
family or provider did not timely report a change as required under lawdeleted text end .
(f) The provider and family shall receive notification of the number of absent days used
upon initial provider authorization for a family and ongoing notification of the number of
absent days used as of the date of the notification.
(g) For purposes of this subdivision, "absent days limit" means 25 full-day absent days
per child, excluding holidays, in a calendar year; and ten consecutive full-day absent days.
(h) For purposes of this subdivision, "holidays limit" means ten full-day holidays per
child, excluding absent days, in a calendar year.
(i) If a day meets the criteria of an absent day or a holiday under this subdivision, the
provider must bill that day as an absent day or holiday. A provider's failure to properly bill
an absent day or a holiday results in an overpayment, regardless of whether the child reached,
or is exempt from, the absent days limit or holidays limit for the calendar year.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective August 1, 2021.
new text end
Sec. 5.
Minnesota Statutes 2020, section 144.216, is amended by adding a subdivision to
read:
new text begin Subd. 3. new text end
new text begin Reporting safe place newborn births. new text end
new text begin
A hospital that receives a safe place
newborn under section 145.902 shall report the birth of the newborn to the Office of Vital
Records within five days after receiving the newborn. The state registrar must register
information about the safe place newborn according to part 4601.0600, subpart 4, item C.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective August 1, 2021.
new text end
Sec. 6.
Minnesota Statutes 2020, section 144.216, is amended by adding a subdivision to
read:
new text begin Subd. 4. new text end
new text begin Status of safe place birth registrations. new text end
new text begin
(a) Information about the safe place
newborn registered under subdivision 3 shall constitute the record of birth for the child. The
birth record for the child is confidential data on individuals as defined in section 13.02,
subdivision 3. Information about the child's birth record or a child's birth certificate issued
from the child's birth record shall be disclosed only to the responsible social services agency
as defined in section 260C.007, subdivision 27a, or pursuant to court order.
new text end
new text begin
(b) Pursuant to section 144.218, subdivision 6, if the safe place newborn was born in a
hospital and it is known that the child's record of birth was registered, the Office of Vital
Records shall replace the original birth record registered under section 144.215.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective August 1, 2021.
new text end
Sec. 7.
Minnesota Statutes 2020, section 144.218, is amended by adding a subdivision to
read:
new text begin Subd. 6. new text end
new text begin Safe place newborns. new text end
new text begin
If a hospital receives a safe place newborn under section
145.902 and it is known that the child's record of birth was registered, the hospital shall
report the newborn to the Office of Vital Records and identify the child's birth record. The
state registrar shall issue a replacement birth record for the child that is free of information
that identifies a parent. The prior vital record is confidential data on individuals as defined
in section 13.02, subdivision 3, and shall not be disclosed except pursuant to court order.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective August 1, 2021.
new text end
Sec. 8.
Minnesota Statutes 2020, section 144.226, subdivision 1, is amended to read:
Subdivision 1.
Which services are for fee.
(a) The fees for the following services shall
be the following or an amount prescribed by rule of the commissioner:
(b) The fee for the administrative review and processing of a request for a certified vital
record or a certification that the vital record cannot be found is $9. The fee is payable at the
time of application and is nonrefundable.
(c) The fee for processing a request for the replacement of a birth record for all events,
except new text begin for safe place newborns pursuant to section 144.218, subdivision 6, and new text end when filing
a recognition of parentage pursuant to section 257.73, subdivision 1, is $40. The fee is
payable at the time of application and is nonrefundable.
(d) The fee for administrative review and processing of a request for the filing of a
delayed registration of birth, stillbirth, or death is $40. The fee is payable at the time of
application and is nonrefundable.
(e) The fee for administrative review and processing of a request for the amendment of
any vital record is $40. The fee is payable at the time of application and is nonrefundable.
(f) The fee for administrative review and processing of a request for the verification of
information from vital records is $9 when the applicant furnishes the specific information
to locate the vital record. When the applicant does not furnish specific information, the fee
is $20 per hour for staff time expended. Specific information includes the correct date of
the event and the correct name of the subject of the record. Fees charged shall approximate
the costs incurred in searching and copying the vital records. The fee is payable at the time
of application and is nonrefundable.
(g) The fee for administrative review and processing of a request for the issuance of a
copy of any document on file pertaining to a vital record or statement that a related document
cannot be found is $9. The fee is payable at the time of application and is nonrefundable.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective August 1, 2021.
new text end
Sec. 9.
Minnesota Statutes 2020, section 145.902, is amended to read:
145.902 GIVE LIFE A CHANCE; SAFE PLACE FOR NEWBORNS DUTIES;
IMMUNITY.
Subdivision 1.
General.
(a) For purposes of this section, a "safe place" means a hospital
licensed under sections 144.50 to 144.56,new text begin including the hospital where the newborn was
born,new text end a health care provider who provides urgent care medical services, or an ambulance
service licensed under chapter 144E dispatched in response to a 911 call from a mother or
a person with the mother's permission to relinquish a newborn infant.
(b) A safe place shall receive a newborn left with an employee on the premises of the
safe place during its hours of operation, provided that:
(1) the newborn was born within seven days of being left at the safe place, as determined
within a reasonable degree of medical certainty; and
(2) the newborn is left in an unharmed condition.
(c) The safe place must not inquire as to the identity of the mother or the person leaving
the newborn or call the police, provided the newborn is unharmed when presented to the
hospital. The safe place may ask the mother or the person leaving the newborn about the
medical history of the mother or newborn new text begin and if the newborn may have lineage to an Indian
tribe and, if known, the name of the tribe new text end but the mother or the person leaving the newborn
is not required to provide any information. The safe place may provide the mother or the
person leaving the newborn with information about how to contact relevant social service
agencies.
(d) A safe place that is a health care provider who provides urgent care medical services
shall dial 911, advise the dispatcher that the call is being made from a safe place for
newborns, and ask the dispatcher to send an ambulance or take other appropriate action to
transport the newborn to a hospital. An ambulance with whom a newborn is left shall
transport the newborn to a hospital for care. Hospitals must receive a newborn left with a
safe place and make the report as required in subdivision 2.
Subd. 2.
Reporting.
new text begin (a) new text end Within 24 hours of receiving a newborn under this section, the
hospital must inform the responsible social service agency that a newborn has been left at
the hospital, but must not do so in the presence of the mother or the person leaving the
newborn. The hospital must provide necessary care to the newborn pending assumption of
legal responsibility by the responsible social service agency pursuant to section 260C.139,
subdivision 5.
new text begin
(b) Within five days of receiving a newborn under this section, a hospital shall report
the newborn to the Office of Vital Records pursuant to section 144.216, subdivision 3. If a
hospital receives a safe place newborn under section 145.902 and it is known that the child's
record of birth was registered because the newborn was born at that hospital, the hospital
shall report the newborn to the Office of Vital Records and identify the child's birth record.
The state registrar shall issue a replacement birth record for the child pursuant to section
144.218, subdivision 6.
new text end
Subd. 3.
Immunity.
(a) A safe place with responsibility for performing duties under
this section, and any new text begin hospital, new text end employee, doctor, ambulance personnel, or other medical
professional working at the safe place, are immune from any criminal liability that otherwise
might result from their actions, if they are acting in good faith in receiving a newborn, and
are immune from any civil liability new text begin or administrative penalty new text end that otherwise might result
from merely receiving a newborn.
(b) A safe place performing duties under this section, or an employee, doctor, ambulance
personnel, or other medical professional working at the safe place who is a mandated reporter
under chapter 260E, is immune from any criminal or civil liability that otherwise might
result from the failure to make a report under that section if the person is acting in good
faith in complying with this section.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective August 1, 2021.
new text end
Sec. 10.
Minnesota Statutes 2020, section 245.4885, subdivision 1, is amended to read:
Subdivision 1.
Admission criteria.
(a) Prior to admission or placement, except in the
case of an emergency, all children referred for treatment of severe emotional disturbance
in a treatment foster care setting, residential treatment facility, or informally admitted to a
regional treatment center shall undergo an assessment to determine the appropriate level of
care if public funds are used to pay for the new text begin child's new text end services.
(b) The responsible social services agency shall determine the appropriate level of care
for a child when county-controlled funds are used to pay for the child's services or placement
in a qualified residential treatment facility under chapter 260C and licensed by the
commissioner under chapter 245A. In accordance with section 260C.157, a juvenile treatment
screening team shall conduct a screeningnew text begin of a childnew text end before the team may recommend whether
to place a child in a qualified residential treatment program as defined in section 260C.007,
subdivision 26d. When a social services agency does not have responsibility for a child's
placement and the child is enrolled in a prepaid health program under section 256B.69, the
enrolled child's contracted health plan must determine the appropriate level of carenew text begin for the
childnew text end . When Indian Health Services funds or funds of a tribally owned facility funded under
the Indian Self-Determination and Education Assistance Act, Public Law 93-638, are to be
usednew text begin for a childnew text end , the Indian Health Services or 638 tribal health facility must determine the
appropriate level of carenew text begin for the childnew text end . When more than one entity bears responsibility fornew text begin
a child'snew text end coverage, the entities shall coordinate level of care determination activitiesnew text begin for the
childnew text end to the extent possible.
(c) The responsible social services agency must make thenew text begin child'snew text end level of care
determination available to thenew text begin child'snew text end juvenile treatment screening team, as permitted under
chapter 13. The level of care determination shall inform the juvenile treatment screening
team process and the assessment in section 260C.704 when considering whether to place
the child in a qualified residential treatment program. When the responsible social services
agency is not involved in determining a child's placement, the child's level of care
determination shall determine whether the proposed treatment:
(1) is necessary;
(2) is appropriate to the child's individual treatment needs;
(3) cannot be effectively provided in the child's home; and
(4) provides a length of stay as short as possible consistent with the individual child's
deleted text begin needdeleted text end new text begin needsnew text end .
(d) When a level of care determination is conducted, the responsible social services
agency or other entity may not determine that a screeningnew text begin of a childnew text end under section 260C.157
or referral or admission to a treatment foster care setting or residential treatment facility is
not appropriate solely because services were not first provided to the child in a less restrictive
setting and the child failed to make progress toward or meet treatment goals in the less
restrictive setting. The level of care determination must be based on a diagnostic assessmentnew text begin
of a childnew text end that includes a functional assessment which evaluatesnew text begin the child'snew text end family, school,
and community living situations; and an assessment of the child's need for care out of the
home using a validated tool which assesses a child's functional status and assigns an
appropriate level of carenew text begin to the childnew text end . The validated tool must be approved by the
commissioner of human servicesnew text begin and may be the validated tool approved for the child's
assessment under section 260C.704 if the juvenile treatment screening team recommended
placement of the child in a qualified residential treatment programnew text end . If a diagnostic assessment
including a functional assessment has been completed by a mental health professional within
the past 180 days, a new diagnostic assessment need not be completed unless in the opinion
of the current treating mental health professional the child's mental health status has changed
markedly since the assessment was completed. The child's parent shall be notified if an
assessment will not be completed and of the reasons. A copy of the notice shall be placed
in the child's file. Recommendations developed as part of the level of care determination
process shall include specific community services needed by the child and, if appropriate,
the child's family, and shall indicate whether deleted text begin or notdeleted text end these services are available and accessible
to the child andnew text begin the child'snew text end family.
(e) During the level of care determination process, the child, child's family, or child's
legal representative, as appropriate, must be informed of the child's eligibility for case
management services and family community support services and that an individual family
community support plan is being developed by the case manager, if assigned.
(f) When the responsible social services agency has authority, the agency must engage
the child's parents in case planning under sections 260C.212 and 260C.708 unless a court
terminates the parent's rights or court orders restrict the parent from participating in case
planning, visitation, or parental responsibilities.
(g) The level of care determination, deleted text begin anddeleted text end placement decision, and recommendations for
mental health services must be documented in the child's record, as required in chapter
260C.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective September 30, 2021.
new text end
Sec. 11.
Minnesota Statutes 2020, section 245A.02, is amended by adding a subdivision
to read:
new text begin Subd. 3c. new text end
new text begin
At risk of becoming a victim of sex trafficking or commercial sexual
exploitation.
new text end
new text begin
For the purposes of section 245A.25, a youth who is "at risk of becoming a
victim of sex trafficking or commercial sexual exploitation" means a youth who meets the
criteria established by the commissioner of human services for this purpose.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 12.
Minnesota Statutes 2020, section 245A.02, is amended by adding a subdivision
to read:
new text begin Subd. 4a. new text end
new text begin Children's residential facility. new text end
new text begin
"Children's residential facility" is defined as
a residential program licensed under this chapter or chapter 241 according to the applicable
standards in Minnesota Rules, parts 2960.0010 to 2960.0710.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 13.
Minnesota Statutes 2020, section 245A.02, is amended by adding a subdivision
to read:
new text begin Subd. 6e. new text end
new text begin Foster family setting. new text end
new text begin
"Foster family setting" has the meaning given in
Minnesota Rules, chapter 2960.3010, subpart 23, and includes settings licensed by the
commissioner of human services or the commissioner of corrections.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 14.
Minnesota Statutes 2020, section 245A.02, is amended by adding a subdivision
to read:
new text begin Subd. 6f. new text end
new text begin Foster residence setting. new text end
new text begin
"Foster residence setting" has the meaning given in
Minnesota Rules, chapter 2960.3010, subpart 26, and includes settings licensed by the
commissioner of human services or the commissioner of corrections.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 15.
Minnesota Statutes 2020, section 245A.02, is amended by adding a subdivision
to read:
new text begin Subd. 18a. new text end
new text begin Trauma. new text end
new text begin
For the purposes of section 245A.25, "trauma" means an event,
series of events, or set of circumstances experienced by an individual as physically or
emotionally harmful or life-threatening and has lasting adverse effects on the individual's
functioning and mental, physical, social, emotional, or spiritual well-being. Trauma includes
the cumulative emotional or psychological harm of group traumatic experiences transmitted
across generations within a community that are often associated with racial and ethnic
population groups that have suffered major intergenerational losses.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 16.
Minnesota Statutes 2020, section 245A.02, is amended by adding a subdivision
to read:
new text begin Subd. 23. new text end
new text begin Victim of sex trafficking or commercial sexual exploitation. new text end
new text begin
For the purposes
of section 245A.25, "victim of sex trafficking or commercial sexual exploitation" means a
person who meets the definitions in section 260C.007, subdivision 31, clauses (4) and (5).
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 17.
Minnesota Statutes 2020, section 245A.02, is amended by adding a subdivision
to read:
new text begin Subd. 24. new text end
new text begin Youth. new text end
new text begin
For the purposes of section 245A.25, "youth" means a "child" as
defined in section 260C.007, subdivision 4, and includes individuals under 21 years of age
who are in foster care pursuant to section 260C.451.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 18.
Minnesota Statutes 2020, section 245A.041, is amended by adding a subdivision
to read:
new text begin Subd. 6. new text end
new text begin
First date of working in a children's residential facility or foster residence
setting; documentation requirements.
new text end
new text begin
Children's residential facility and foster residence
setting license holders must document the first date that a person who is a background study
subject begins working in the license holder's facility or setting. If the license holder does
not maintain documentation of each background study subject's first date of working in the
facility or setting in the license holder's personnel files, the license holder must provide
documentation to the commissioner that contains the first date that each background study
subject began working in the license holder's program upon the commissioner's request.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective August 1, 2021.
new text end
Sec. 19.
new text begin
[245A.25] RESIDENTIAL PROGRAM CERTIFICATIONS FOR
COMPLIANCE WITH THE FAMILY FIRST PREVENTION SERVICES ACT.
new text end
new text begin Subdivision 1. new text end
new text begin Certification scope and applicability. new text end
new text begin
(a) This section establishes the
requirements that a children's residential facility or child foster residence setting must meet
to be certified for the purposes of Title IV-E funding requirements as:
new text end
new text begin
(1) a qualified residential treatment program;
new text end
new text begin
(2) a residential setting specializing in providing care and supportive services for youth
who have been or are at risk of becoming victims of sex trafficking or commercial sexual
exploitation; or
new text end
new text begin
(3) a residential setting specializing in providing prenatal, postpartum, or parenting
support for youth.
new text end
new text begin
(b) This section does not apply to a foster family setting in which the license holder
resides in the foster home.
new text end
new text begin
(c) Children's residential facilities licensed as detention settings according to Minnesota
Rules, parts 2960.0230 to 2960.0290, or secure programs according to Minnesota Rules,
parts 2960.0300 to 2960.0420, may not be certified under this section.
new text end
new text begin
(d) For purposes of this section, "license holder" means an individual, organization, or
government entity that was issued a children's residential facility or foster residence setting
license by the commissioner of human services under this chapter or by the commissioner
of corrections under chapter 241.
new text end
new text begin
(e) Certifications issued under this section for foster residence settings may only be
issued by the commissioner of human services and are not delegated to county or private
licensing agencies under section 245A.16.
new text end
new text begin Subd. 2. new text end
new text begin Program certification types and requests for certification. new text end
new text begin
(a) The
commissioner of human services may issue certifications to license holders for the following
types of programs:
new text end
new text begin
(1) qualified residential treatment programs;
new text end
new text begin
(2) residential settings specializing in providing care and supportive services for youth
who have been or are at risk of becoming victims of sex trafficking or commercial sexual
exploitation; and
new text end
new text begin
(3) residential settings specializing in providing prenatal, postpartum, or parenting
support for youth.
new text end
new text begin
(b) An applicant or license holder must submit a request for certification under this
section on a form and in a manner prescribed by the commissioner of human services. The
decision of the commissioner of human services to grant or deny a certification request is
final and not subject to appeal under chapter 14.
new text end
new text begin Subd. 3. new text end
new text begin Trauma-informed care. new text end
new text begin
(a) Programs certified under subdivisions 4 or 5 must
provide services to a person according to a trauma-informed model of care that meets the
requirements of this subdivision, except that programs certified under subdivision 5 are not
required to meet the requirements of paragraph (e).
new text end
new text begin
(b) For the purposes of this section, "trauma-informed care" is defined as care that:
new text end
new text begin
(1) acknowledges the effects of trauma on a person receiving services and on the person's
family;
new text end
new text begin
(2) modifies services to respond to the effects of trauma on the person receiving services;
new text end
new text begin
(3) emphasizes skill and strength-building rather than symptom management; and
new text end
new text begin
(4) focuses on the physical and psychological safety of the person receiving services
and the person's family.
new text end
new text begin
(c) The license holder must have a process for identifying the signs and symptoms of
trauma in a youth and must address the youth's needs related to trauma. This process must
include:
new text end
new text begin
(1) screening for trauma by completing a trauma-specific screening tool with each youth
upon the youth's admission or obtaining the results of a trauma-specific screening tool that
was completed with the youth within 30 days prior to the youth's admission to the program;
and
new text end
new text begin
(2) ensuring that trauma-based interventions targeting specific trauma-related symptoms
are available to each youth when needed to assist the youth in obtaining services. For
qualified residential treatment programs, this must include the provision of services in
paragraph (e).
new text end
new text begin
(d) The license holder must develop and provide services to each youth according to the
principles of trauma-informed care including:
new text end
new text begin
(1) recognizing the impact of trauma on a youth when determining the youth's service
needs and providing services to the youth;
new text end
new text begin
(2) allowing each youth to participate in selecting which services to receive;
new text end
new text begin
(3) providing services to each youth that are person-centered and culturally responsive;
and
new text end
new text begin
(4) adjusting services for each youth to address additional needs of the youth.
new text end
new text begin
(e) In addition to the other requirements of this subdivision, qualified residential treatment
programs must use a trauma-based treatment model that includes:
new text end
new text begin
(1) assessing each youth to determine if the youth needs trauma-specific treatment
interventions;
new text end
new text begin
(2) identifying in each youth's treatment plan how the program will provide
trauma-specific treatment interventions to the youth;
new text end
new text begin
(3) providing trauma-specific treatment interventions to a youth that target the youth's
specific trauma-related symptoms; and
new text end
new text begin
(4) training all clinical staff of the program on trauma-specific treatment interventions.
new text end
new text begin
(f) At the license holder's program, the license holder must provide a physical, social,
and emotional environment that:
new text end
new text begin
(1) promotes the physical and psychological safety of each youth;
new text end
new text begin
(2) avoids aspects that may be retraumatizing;
new text end
new text begin
(3) responds to trauma experienced by each youth and the youth's other needs; and
new text end
new text begin
(4) includes designated spaces that are available to each youth for engaging in sensory
and self-soothing activities.
new text end
new text begin
(g) The license holder must base the program's policies and procedures on
trauma-informed principles. In the program's policies and procedures, the license holder
must:
new text end
new text begin
(1) describe how the program provides services according to a trauma-informed model
of care;
new text end
new text begin
(2) describe how the program's environment fulfills the requirements of paragraph (f);
new text end
new text begin
(3) prohibit the use of aversive consequences for a youth's violation of program rules
or any other reason;
new text end
new text begin
(4) describe the process for how the license holder incorporates trauma-informed
principles and practices into staff meetings; and
new text end
new text begin
(5) if the program is certified to use restrictive procedures under Minnesota Rules, part
2960.0710, how the program uses restrictive procedures only when necessary for a youth
in a manner that addresses the youth's history of trauma and avoids causing the youth
additional trauma.
new text end
new text begin
(h) Prior to allowing a staff person to have direct contact, as defined in section 245C.02,
subdivision 11, with a youth and annually thereafter, the license holder must train each staff
person about:
new text end
new text begin
(1) concepts of trauma-informed care and how to provide services to each youth according
to these concepts; and
new text end
new text begin
(2) impacts of each youth's culture, race, gender, and sexual orientation on the youth's
behavioral health and traumatic experiences.
new text end
new text begin Subd. 4. new text end
new text begin Qualified residential treatment programs; certification requirements. new text end
new text begin
(a)
To be certified as a qualified residential treatment program, a license holder must meet:
new text end
new text begin
(1) the definition of a qualified residential treatment program in section 260C.007,
subdivision 26d;
new text end
new text begin
(2) the requirements for providing trauma-informed care and using a trauma-based
treatment model in subdivision 3; and
new text end
new text begin
(3) the requirements of this subdivision.
new text end
new text begin
(b) For each youth placed at the license holder's program, the license holder must
collaborate with the responsible social services agency and other appropriate parties to
implement the youth's out-of-home placement plan and the youth's short-term and long-term
mental health and behavioral health goals in the assessment required by sections 260C.212,
subdivision 1; 260C.704; and 260C.708.
new text end
new text begin
(c) A qualified residential treatment program must use a trauma-based treatment model
that meets all of the requirements of subdivision 3 that is designed to address the needs,
including clinical needs, of youth with serious emotional or behavioral disorders or
disturbances. The license holder must develop, document, and review a treatment plan for
each youth according to the requirements of Minnesota Rules, parts 2960.0180, subpart 2,
item B; and 2960.0190, subpart 2.
new text end
new text begin
(d) The following types of staff must be on-site or face-to-face according to the program's
treatment model and must be available 24 hours a day and seven days a week to provide
care within the scope of their practice:
new text end
new text begin
(1) a registered nurse or licensed practical nurse licensed by the Minnesota Board of
Nursing to practice professional nursing or practical nursing as defined in section 148.171,
subdivisions 14 and 15; and
new text end
new text begin
(2) other licensed clinical staff to meet each youth's clinical needs.
new text end
new text begin
(e) A qualified residential treatment program must be accredited by one of the following
independent, not-for-profit organizations:
new text end
new text begin
(1) the Commission on Accreditation of Rehabilitation Facilities (CARF);
new text end
new text begin
(2) the Joint Commission;
new text end
new text begin
(3) the Council on Accreditation (COA); or
new text end
new text begin
(4) another independent, not-for-profit accrediting organization approved by the Secretary
of the United States Department of Health and Human Services.
new text end
new text begin
(f) The license holder must facilitate participation of a youth's family members in the
youth's treatment program, consistent with the youth's best interests and according to the
youth's out-of-home placement plan required by sections 260C.212, subdivision 1; and
260C.708.
new text end
new text begin
(g) The license holder must contact and facilitate outreach to each youth's family
members, including the youth's siblings, and must document outreach to the youth's family
members in the youth's file, including the contact method and each family member's contact
information. In the youth's file, the license holder must record and maintain the contact
information for all known biological family members and fictive kin of the youth.
new text end
new text begin
(h) The license holder must document in the youth's file how the program integrates
family members into the treatment process for the youth, including after the youth's discharge
from the program, and how the program maintains the youth's connections to the youth's
siblings.
new text end
new text begin
(i) The program must provide discharge planning and family-based aftercare support to
each youth for at least six months after the youth's discharge from the program. When
providing aftercare to a youth, the program must have monthly contact with the youth and
the youth's caregivers to promote the youth's engagement in aftercare services and to regularly
evaluate the family's needs. The program's monthly contact with the youth may be
face-to-face, by telephone, or virtual.
new text end
new text begin
(j) The license holder must maintain a service delivery plan that describes how the
program provides services according to the requirements in paragraphs (b) to (i).
new text end
new text begin Subd. 5. new text end
new text begin
Residential settings specializing in providing care and supportive services
for youth who have been or are at risk of becoming victims of sex trafficking or
commercial sexual exploitation; certification requirements.
new text end
new text begin
(a) To be certified as a
residential setting specializing in providing care and support services for youth who have
been or are at risk of becoming victims of sex trafficking or commercial sexual exploitation,
a license holder must meet the requirements of this subdivision.
new text end
new text begin
(b) Settings certified according to this subdivision are exempt from the requirements of
section 245A.04, subdivision 11, paragraph (b).
new text end
new text begin
(c) The program must use a trauma-informed model of care that meets all of the applicable
requirements of subdivision 3, and that is designed to address the needs, including emotional
and mental health needs, of youth who have been or are at risk of becoming victims of sex
trafficking or commercial sexual exploitation.
new text end
new text begin
(d) The program must provide high quality care and supportive services for youth who
have been or are at risk of becoming victims of sex trafficking or commercial sexual
exploitation and must:
new text end
new text begin
(1) offer a safe setting to each youth designed to prevent ongoing and future trafficking
of the youth;
new text end
new text begin
(2) provide equitable, culturally responsive, and individualized services to each youth;
new text end
new text begin
(3) assist each youth with accessing medical, mental health, legal, advocacy, and family
services based on the youth's individual needs;
new text end
new text begin
(4) provide each youth with relevant educational, life skills, and employment supports
based on the youth's individual needs;
new text end
new text begin
(5) offer a trafficking prevention education curriculum and provide support for each
youth at risk of future sex trafficking or commercial sexual exploitation; and
new text end
new text begin
(6) engage with the discharge planning process for each youth and the youth's family.
new text end
new text begin
(e) The license holder must maintain a service delivery plan that describes how the
program provides services according to the requirements in paragraphs (c) and (d).
new text end
new text begin
(f) The license holder must ensure that each staff person who has direct contact, as
defined in section 245C.02, subdivision 11, with a youth served by the license holder's
program completes a human trafficking training approved by the Department of Human
Services' Children and Family Services Administration before the staff person has direct
contact with a youth served by the program and annually thereafter. For programs certified
prior to January 1, 2022, the license holder must ensure that each staff person at the license
holder's program completes the initial training by January 1, 2022.
new text end
new text begin Subd. 6. new text end
new text begin
Residential settings specializing in providing prenatal, postpartum, or
parenting supports for youth; certification requirements.
new text end
new text begin
(a) To be certified as a
residential setting specializing in providing prenatal, postpartum, or parenting supports for
youth, a license holder must meet the requirements of this subdivision.
new text end
new text begin
(b) The license holder must collaborate with the responsible social services agency and
other appropriate parties to implement each youth's out-of-home placement plan required
by section 260C.212, subdivision 1.
new text end
new text begin
(c) The license holder must specialize in providing prenatal, postpartum, or parenting
supports for youth and must:
new text end
new text begin
(1) provide equitable, culturally responsive, and individualized services to each youth;
new text end
new text begin
(2) assist each youth with accessing postpartum services for at least six weeks postpartum,
including providing each youth with:
new text end
new text begin
(i) sexual and reproductive health services and education;
new text end
new text begin
(ii) a postpartum mental health assessment and follow-up services; and
new text end
new text begin
(3) discharge planning that includes the youth and the youth's family.
new text end
new text begin
(d) On or before the date of a youth's initial physical presence at the facility, the license
holder must provide education to the child's parent related to safe bathing and reducing the
risk of sudden unexpected infant death and abusive head trauma from shaking infants and
young children. The license holder must use the educational material developed by the
commissioner of human services to comply with this requirement. At a minimum, the
education must address:
new text end
new text begin
(1) instruction that: (i) a child or infant should never be left unattended around water;
(ii) a tub should be filled with only two to four inches of water for infants; and (iii) an infant
should never be put into a tub when the water is running; and
new text end
new text begin
(2) the risk factors related to sudden unexpected infant death and abusive head trauma
from shaking infants and young children and means of reducing the risks, including the
safety precautions identified in section 245A.1435 and the risks of co-sleeping.
new text end
new text begin
The license holder must document the parent's receipt of the education and keep the
documentation in the parent's file. The documentation must indicate whether the parent
agrees to comply with the safeguards described in this paragraph. If the parent refuses to
comply, program staff must provide additional education to the parent as described in the
parental supervision plan. The parental supervision plan must include the intervention,
frequency, and staff responsible for the duration of the parent's participation in the program
or until the parent agrees to comply with the safeguards described in this paragraph.
new text end
new text begin
(e) On or before the date of a youth's initial physical presence at the facility, the license
holder must document the parent's capacity to meet the health and safety needs of the child
while on the facility premises considering the following factors:
new text end
new text begin
(1) the parent's physical and mental health;
new text end
new text begin
(2) the parent being under the influence of drugs, alcohol, medications, or other chemicals;
new text end
new text begin
(3) the child's physical and mental health; and
new text end
new text begin
(4) any other information available to the license holder indicating that the parent may
not be able to adequately care for the child.
new text end
new text begin
(f) The license holder must have written procedures specifying the actions that staff shall
take if a parent is or becomes unable to adequately care for the parent's child.
new text end
new text begin
(g) If the parent refuses to comply with the safeguards described in paragraph (d) or is
unable to adequately care for the child, the license holder must develop a parental supervision
plan in conjunction with the parent. The plan must account for any factors in paragraph (e)
that contribute to the parent's inability to adequately care for the child. The plan must be
dated and signed by the staff person who completed the plan.
new text end
new text begin
(h) The license holder must have written procedures addressing whether the program
permits a parent to arrange for supervision of the parent's child by another youth in the
program. If permitted, the facility must have a procedure that requires staff approval of the
supervision arrangement before the supervision by the nonparental youth occurs. The
procedure for approval must include an assessment of the nonparental youth's capacity to
assume the supervisory responsibilities using the criteria in paragraph (e). The license holder
must document the license holder's approval of the supervisory arrangement and the
assessment of the nonparental youth's capacity to supervise the child and must keep this
documentation in the file of the parent whose child is being supervised by the nonparental
youth.
new text end
new text begin
(i) The license holder must maintain a service delivery plan that describes how the
program provides services according to the requirements in paragraphs (b) to (h).
new text end
new text begin Subd. 7. new text end
new text begin Monitoring and inspections. new text end
new text begin
(a) For a program licensed by the commissioner
of human services, the commissioner of human services may review a program's compliance
with certification requirements by conducting an inspection, a licensing review, or an
investigation of the program. The commissioner may issue a correction order to the license
holder for a program's noncompliance with the certification requirements of this section.
For a program licensed by the commissioner of human services, a license holder must make
a request for reconsideration of a correction order according to section 245A.06, subdivision
2.
new text end
new text begin
(b) For a program licensed by the commissioner of corrections, the commissioner of
human services may review the program's compliance with the requirements for a certification
issued under this section biennially and may issue a correction order identifying the program's
noncompliance with the requirements of this section. The correction order must state the
following:
new text end
new text begin
(1) the conditions that constitute a violation of a law or rule;
new text end
new text begin
(2) the specific law or rule violated; and
new text end
new text begin
(3) the time allowed for the program to correct each violation.
new text end
new text begin
(c) For a program licensed by the commissioner of corrections, if a license holder believes
that there are errors in the correction order of the commissioner of human services, the
license holder may ask the Department of Human Services to reconsider the parts of the
correction order that the license holder alleges are in error. To submit a request for
reconsideration, the license holder must send a written request for reconsideration by United
States mail to the commissioner of human services. The request for reconsideration must
be postmarked within 20 calendar days of the date that the correction order was received
by the license holder and must:
new text end
new text begin
(1) specify the parts of the correction order that are alleged to be in error;
new text end
new text begin
(2) explain why the parts of the correction order are in error; and
new text end
new text begin
(3) include documentation to support the allegation of error.
new text end
new text begin
A request for reconsideration does not stay any provisions or requirements of the correction
order. The commissioner of human services' disposition of a request for reconsideration is
final and not subject to appeal under chapter 14.
new text end
new text begin
(d) Nothing in this subdivision prohibits the commissioner of human services from
decertifying a license holder according to subdivision 8 prior to issuing a correction order.
new text end
new text begin Subd. 8. new text end
new text begin Decertification. new text end
new text begin
(a) The commissioner of human services may rescind a
certification issued under this section if a license holder fails to comply with the certification
requirements in this section.
new text end
new text begin
(b) The license holder may request reconsideration of a decertification by notifying the
commissioner of human services by certified mail or personal service. The license holder
must request reconsideration of a decertification in writing. If the license holder sends the
request for reconsideration of a decertification by certified mail, the license holder must
send the request by United States mail to the commissioner of human services and the
request must be postmarked within 20 calendar days after the license holder received the
notice of decertification. If the license holder requests reconsideration of a decertification
by personal service, the request for reconsideration must be received by the commissioner
of human services within 20 calendar days after the license holder received the notice of
decertification. When submitting a request for reconsideration of a decertification, the license
holder must submit a written argument or evidence in support of the request for
reconsideration.
new text end
new text begin
(c) The commissioner of human services' disposition of a request for reconsideration is
final and not subject to appeal under chapter 14.
new text end
new text begin Subd. 9. new text end
new text begin Variances. new text end
new text begin
The commissioner of human services may grant variances to the
requirements in this section that do not affect a youth's health or safety or compliance with
federal requirements for Title IV-E funding if the conditions in section 245A.04, subdivision
9, are met.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 20.
Minnesota Statutes 2020, section 256.741, is amended by adding a subdivision
to read:
new text begin Subd. 12a. new text end
new text begin Appeals of good cause determinations. new text end
new text begin
According to section 256.045, an
individual may appeal the determination or redetermination of good cause under this section.
To initiate an appeal of a good cause determination or redetermination, the individual must
make a request for a state agency hearing in writing within 30 calendar days after the date
that a notice of denial for good cause is mailed or otherwise transmitted to the individual.
Until a human services judge issues a decision under section 256.0451, subdivision 22, the
child support agency shall cease all child support enforcement efforts and shall not report
the individual's noncooperation to public assistance agencies.
new text end
Sec. 21.
Minnesota Statutes 2020, section 256.741, is amended by adding a subdivision
to read:
new text begin Subd. 12b. new text end
new text begin Reporting noncooperation. new text end
new text begin
The public authority may issue a notice of the
individual's noncooperation to each public assistance agency providing public assistance
to the individual if:
new text end
new text begin
(1) 30 calendar days have passed since the later of the initial county denial or the date
of the denial following the state agency hearing; or
new text end
new text begin
(2) the individual has not cooperated with the child support agency as required in
subdivision 5.
new text end
Sec. 22.
Minnesota Statutes 2020, section 256J.08, subdivision 21, is amended to read:
Subd. 21.
Date of application.
"Date of application" means the date on which the county
agency receives an applicant's deleted text begin signeddeleted text end applicationnew text begin as a signed application, an application
submitted by telephone, or an application submitted through Internet telepresencenew text end .
Sec. 23.
Minnesota Statutes 2020, section 256J.09, subdivision 3, is amended to read:
Subd. 3.
Submitting application form.
(a) A county agency must offer, in person or
by mail, the application forms prescribed by the commissioner as soon as a person makes
a written or oral inquiry. At that time, the county agency must:
(1) inform the person that assistance begins deleted text begin withdeleted text end new text begin onnew text end the datenew text begin thatnew text end the deleted text begin signeddeleted text end application
is received by the county agency new text begin as a signed application; an application submitted by
telephone; or an application submitted through Internet telepresence; new text end or new text begin on new text end the datenew text begin thatnew text end all
eligibility criteria are met, whichever is later;
new text begin
(2) inform a person that the person may submit the application by telephone or through
Internet telepresence;
new text end
new text begin
(3) inform a person that when the person submits the application by telephone or through
Internet telepresence, the county agency must receive a signed application within 30 days
of the date that the person submitted the application by telephone or through Internet
telepresence;
new text end
deleted text begin (2)deleted text end new text begin (4)new text end inform the person that any delay in submitting the application will reduce the
amount of assistance paid for the month of application;
deleted text begin (3)deleted text end new text begin (5)new text end inform a person that the person may submit the application before an interview;
deleted text begin (4)deleted text end new text begin (6)new text end explain the information that will be verified during the application process by
the county agency as provided in section 256J.32;
deleted text begin (5)deleted text end new text begin (7)new text end inform a person about the county agency's average application processing time
and explain how the application will be processed under subdivision 5;
deleted text begin (6)deleted text end new text begin (8)new text end explain how to contact the county agency if a person's application information
changes and how to withdraw the application;
deleted text begin (7)deleted text end new text begin (9)new text end inform a person that the next step in the application process is an interview and
what a person must do if the application is approved including, but not limited to, attending
orientation under section 256J.45 and complying with employment and training services
requirements in sections 256J.515 to 256J.57;
deleted text begin (8)deleted text end new text begin (10)new text end inform the person that deleted text begin thedeleted text end new text begin annew text end interview must be conductednew text begin . The interview may
be conductednew text end face-to-face in the county officenew text begin or at a location mutually agreed uponnew text end , through
Internet telepresence, or deleted text begin at a location mutually agreed upondeleted text end new text begin by telephonenew text end ;
deleted text begin
(9) inform a person who has received MFIP or DWP in the past 12 months of the option
to have a face-to-face, Internet telepresence, or telephone interview;
deleted text end
deleted text begin (10)deleted text end new text begin (11)new text end explain the child care and transportation services that are available under
paragraph (c) to enable caregivers to attend the interview, screening, and orientation; and
deleted text begin (11)deleted text end new text begin (12)new text end identify any language barriers and arrange for translation assistance during
appointments, including, but not limited to, screening under subdivision 3a, orientation
under section 256J.45, and assessment under section 256J.521.
(b) Upon receipt of a signed application, the county agency must stamp the date of receipt
on the face of the application. The county agency must process the application within the
time period required under subdivision 5. An applicant may withdraw the application at
any time by giving written or oral notice to the county agency. The county agency must
issue a written notice confirming the withdrawal. The notice must inform the applicant of
the county agency's understanding that the applicant has withdrawn the application and no
longer wants to pursue it. When, within ten days of the date of the agency's notice, an
applicant informs a county agency, in writing, that the applicant does not wish to withdraw
the application, the county agency must reinstate the application and finish processing the
application.
(c) Upon a participant's request, the county agency must arrange for transportation and
child care or reimburse the participant for transportation and child care expenses necessary
to enable participants to attend the screening under subdivision 3a and orientation under
section 256J.45.
Sec. 24.
Minnesota Statutes 2020, section 256J.45, subdivision 1, is amended to read:
Subdivision 1.
County agency to provide orientation.
A county agency must provide
deleted text begin a face-to-facedeleted text end new text begin annew text end orientation to each MFIP caregiver unless the caregiver is:
(1) a single parent, or one parent in a two-parent family, employed at least 35 hours per
week; or
(2) a second parent in a two-parent family who is employed for 20 or more hours per
week provided the first parent is employed at least 35 hours per week.
The county agency must inform caregivers who are not exempt under clause (1) or (2) that
failure to attend the orientation is considered an occurrence of noncompliance with program
requirements, and will result in the imposition of a sanction under section 256J.46. If the
client complies with the orientation requirement prior to the first day of the month in which
the grant reduction is proposed to occur, the orientation sanction shall be lifted.
Sec. 25.
Minnesota Statutes 2020, section 256J.95, subdivision 5, is amended to read:
Subd. 5.
Submitting application form.
The eligibility date for the diversionary work
program begins deleted text begin withdeleted text end new text begin onnew text end the date new text begin that new text end the deleted text begin signeddeleted text end combined application form (CAF) is received
by the county agency new text begin as a signed application; an application submitted by telephone; or an
application submitted through Internet telepresence; new text end or new text begin on new text end the date new text begin that new text end diversionary work
program eligibility criteria are met, whichever is later. new text begin The county agency must inform an
applicant that when the applicant submits the application by telephone or through Internet
telepresence, the county agency must receive a signed application within 30 days of the
date that the applicant submitted the application by telephone or through Internet telepresence.
new text end The county agency must inform the applicant that any delay in submitting the application
will reduce the benefits paid for the month of application. The county agency must inform
a person that an application may be submitted before the person has an interview
appointment. Upon receipt of a signed application, the county agency must stamp the date
of receipt on the face of the application. The applicant may withdraw the application at any
time prior to approval by giving written or oral notice to the county agency. The county
agency must follow the notice requirements in section 256J.09, subdivision 3, when issuing
a notice confirming the withdrawal.
Sec. 26.
Minnesota Statutes 2020, section 256N.02, subdivision 16, is amended to read:
Subd. 16.
Permanent legal and physical custody.
"Permanent legal and physical
custody" meansnew text begin : (1)new text end a new text begin full new text end transfer of permanent legal and physical custody new text begin of a child ordered
by a Minnesota juvenile court under section 260C.515, subdivision 4, new text end to a relative deleted text begin ordered
by a Minnesota juvenile court under section 260C.515, subdivision 4,deleted text end new text begin who is not the child's
parent as defined in section 260C.007, subdivision 25;new text end or new text begin (2) new text end for a child under jurisdiction
of a tribal court, a judicial determination under a similar provision in tribal code which
means that a relative will assume the duty and authority to provide care, control, and
protection of a child who is residing in foster care, and to make decisions regarding the
child's education, health care, and general welfare until adulthood.new text begin To establish eligibility
for Northstar kinship assistance, permanent legal and physical custody does not include
joint legal custody, joint physical custody, or joint legal and joint physical custody of a child
shared by the child's parent and relative custodian.
new text end
Sec. 27.
Minnesota Statutes 2020, section 256N.02, subdivision 17, is amended to read:
Subd. 17.
Reassessment.
"Reassessment" means an update of a previous assessment
through the process under section 256N.24 for a child who has been continuously eligible
for Northstar Care for Children, or when a child identified as an at-risk child (Level A)
under deleted text begin guardianship ordeleted text end adoption assistance has manifested the disability upon which eligibility
for the agreement was based according to section 256N.25, subdivision 3, paragraph (b).
A reassessment may be used to update an initial assessment, a special assessment, or a
previous reassessment.
Sec. 28.
Minnesota Statutes 2020, section 256N.22, subdivision 1, is amended to read:
Subdivision 1.
General eligibility requirements.
(a) To be eligible for Northstar kinship
assistance under this section, there must be a judicial determination under section 260C.515,
subdivision 4, that a transfer of permanent legal and physical custody to a relative new text begin who is
not the child's parent new text end is in the child's best interest. For a child under jurisdiction of a tribal
court, a judicial determination under a similar provision in tribal code indicating that a
relative will assume the duty and authority to provide care, control, and protection of a child
who is residing in foster care, and to make decisions regarding the child's education, health
care, and general welfare until adulthood, and that this is in the child's best interest is
considered equivalent. new text begin A child whose parent shares legal, physical, or legal and physical
custody of the child with a relative custodian is not eligible for Northstar kinship assistance.
new text end Additionally, a child must:
(1) have been removed from the child's home pursuant to a voluntary placement
agreement or court order;
(2)(i) have resided with the prospective relative custodian who has been a licensed child
foster parent for at least six consecutive months; or
(ii) have received from the commissioner an exemption from the requirement in item
(i) that the prospective relative custodian has been a licensed child foster parent for at least
six consecutive months, based on a determination that:
(A) an expedited move to permanency is in the child's best interest;
(B) expedited permanency cannot be completed without provision of Northstar kinship
assistance;
(C) the prospective relative custodian is uniquely qualified to meet the child's needs, as
defined in section 260C.212, subdivision 2, on a permanent basis;
(D) the child and prospective relative custodian meet the eligibility requirements of this
section; and
(E) efforts were made by the legally responsible agency to place the child with the
prospective relative custodian as a licensed child foster parent for six consecutive months
before permanency, or an explanation why these efforts were not in the child's best interests;
(3) meet the agency determinations regarding permanency requirements in subdivision
2;
(4) meet the applicable citizenship and immigration requirements in subdivision 3;
(5) have been consulted regarding the proposed transfer of permanent legal and physical
custody to a relative, if the child is at least 14 years of age or is expected to attain 14 years
of age prior to the transfer of permanent legal and physical custody; and
(6) have a written, binding agreement under section 256N.25 among the caregiver or
caregivers, the financially responsible agency, and the commissioner established prior to
transfer of permanent legal and physical custody.
(b) In addition to the requirements in paragraph (a), the child's prospective relative
custodian or custodians must meet the applicable background study requirements in
subdivision 4.
(c) To be eligible for title IV-E Northstar kinship assistance, a child must also meet any
additional criteria in section 473(d) of the Social Security Act. The sibling of a child who
meets the criteria for title IV-E Northstar kinship assistance in section 473(d) of the Social
Security Act is eligible for title IV-E Northstar kinship assistance if the child and sibling
are placed with the same prospective relative custodian or custodians, and the legally
responsible agency, relatives, and commissioner agree on the appropriateness of the
arrangement for the sibling. A child who meets all eligibility criteria except those specific
to title IV-E Northstar kinship assistance is entitled to Northstar kinship assistance paid
through funds other than title IV-E.
Sec. 29.
Minnesota Statutes 2020, section 256N.23, subdivision 2, is amended to read:
Subd. 2.
Special needs determination.
(a) A child is considered a child with special
needs under this section if the requirements in paragraphs (b) to (g) are met.
(b) There must be a determination that the child must not or should not be returned to
the home of the child's parents as evidenced by:
(1) a court-ordered termination of parental rights;
(2) a petition to terminate parental rights;
(3) consent of new text begin the child's new text end parent to adoption accepted by the court under chapter 260Cnew text begin
or, in the case of a child receiving Northstar kinship assistance payments under section
256N.22, consent of the child's parent to the child's adoption executed under chapter 259new text end ;
(4) in circumstances when tribal law permits the child to be adopted without a termination
of parental rights, a judicial determination by a tribal court indicating the valid reason why
the child cannot or should not return home;
(5) a voluntary relinquishment under section 259.25 deleted text begin or 259.47deleted text end or, if relinquishment
occurred in another state, the applicable laws in that state; or
(6) the death of the legal parent or parents if the child has two legal parents.
(c) There exists a specific factor or condition of which it is reasonable to conclude that
the child cannot be placed with adoptive parents without providing adoption assistance as
evidenced by:
(1) a determination by the Social Security Administration that the child meets all medical
or disability requirements of title XVI of the Social Security Act with respect to eligibility
for Supplemental Security Income benefits;
(2) a documented physical, mental, emotional, or behavioral disability not covered under
clause (1);
(3) a member of a sibling group being adopted at the same time by the same parent;
(4) an adoptive placement in the home of a parent who previously adopted a sibling for
whom they receive adoption assistance; or
(5) documentation that the child is an at-risk child.
(d) A reasonable but unsuccessful effort must have been made to place the child with
adoptive parents without providing adoption assistance as evidenced by:
(1) a documented search for an appropriate adoptive placement; or
(2) a determination by the commissioner that a search under clause (1) is not in the best
interests of the child.
(e) The requirement for a documented search for an appropriate adoptive placement
under paragraph (d), including the registration of the child with the state adoption exchange
and other recruitment methods under paragraph (f), must be waived if:
(1) the child is being adopted by a relative and it is determined by the child-placing
agency that adoption by the relative is in the best interests of the child;
(2) the child is being adopted by a foster parent with whom the child has developed
significant emotional ties while in the foster parent's care as a foster child and it is determined
by the child-placing agency that adoption by the foster parent is in the best interests of the
child; or
(3) the child is being adopted by a parent that previously adopted a sibling of the child,
and it is determined by the child-placing agency that adoption by this parent is in the best
interests of the child.
For an Indian child covered by the Indian Child Welfare Act, a waiver must not be
granted unless the child-placing agency has complied with the placement preferences required
by the Indian Child Welfare Act, United States Code, title 25, section 1915(a).
(f) To meet the requirement of a documented search for an appropriate adoptive placement
under paragraph (d), clause (1), the child-placing agency minimally must:
(1) conduct a relative search as required by section 260C.221 and give consideration to
placement with a relative, as required by section 260C.212, subdivision 2;
(2) comply with the placement preferences required by the Indian Child Welfare Act
when the Indian Child Welfare Act, United States Code, title 25, section 1915(a), applies;
(3) locate prospective adoptive families by registering the child on the state adoption
exchange, as required under section 259.75; and
(4) if registration with the state adoption exchange does not result in the identification
of an appropriate adoptive placement, the agency must employ additional recruitment
methods prescribed by the commissioner.
(g) Once the legally responsible agency has determined that placement with an identified
parent is in the child's best interests and made full written disclosure about the child's social
and medical history, the agency must ask the prospective adoptive parent if the prospective
adoptive parent is willing to adopt the child without receiving adoption assistance under
this section. If the identified parent is either unwilling or unable to adopt the child without
adoption assistance, the legally responsible agency must provide documentation as prescribed
by the commissioner to fulfill the requirement to make a reasonable effort to place the child
without adoption assistance. If the identified parent is willing to adopt the child without
adoption assistance, the parent must provide a written statement to this effect to the legally
responsible agency and the statement must be maintained in the permanent adoption record
of the legally responsible agency. For children under guardianship of the commissioner,
the legally responsible agency shall submit a copy of this statement to the commissioner to
be maintained in the permanent adoption record.
Sec. 30.
Minnesota Statutes 2020, section 256N.23, subdivision 6, is amended to read:
Subd. 6.
Exclusions.
The commissioner must not enter into an adoption assistance
agreement with the following individuals:
(1) a child's biological parent or stepparent;
(2) a child's relative under section 260C.007, subdivision 26b or 27, with whom the
child resided immediately prior to child welfare involvement unless:
(i) the child was in the custody of a Minnesota county or tribal agency pursuant to an
order under chapter 260C or equivalent provisions of tribal code and the agency had
placement and care responsibility for permanency planning for the child; and
(ii) the child is under guardianship of the commissioner of human services according to
the requirements of section 260C.325, subdivision 1 or 3, or is a ward of a Minnesota tribal
court after termination of parental rights, suspension of parental rights, or a finding by the
tribal court that the child cannot safely return to the care of the parent;
(3) an individual adopting a child who is the subject of a direct adoptive placement under
section 259.47 or the equivalent in tribal code;
(4) a child's legal custodian or guardian who is now adopting the childnew text begin , except for a
relative custodian as defined in section 256N.02, subdivision 19, who is currently receiving
Northstar kinship assistance benefits on behalf of the childnew text end ; or
(5) an individual who is adopting a child who is not a citizen or resident of the United
States and was either adopted in another country or brought to the United States for the
purposes of adoption.
Sec. 31.
Minnesota Statutes 2020, section 256N.24, subdivision 1, is amended to read:
Subdivision 1.
Assessment.
(a) Each child eligible under sections 256N.21, 256N.22,
and 256N.23, must be assessed to determine the benefits the child may receive under section
256N.26, in accordance with the assessment tool, process, and requirements specified in
subdivision 2.
(b) If an agency applies the emergency foster care rate for initial placement under section
256N.26, the agency may wait up to 30 days to complete the initial assessment.
(c) Unless otherwise specified in paragraph (d), a child must be assessed at the basic
level, level B, or one of ten supplemental difficulty of care levels, levels C to L.
(d) An assessment must not be completed for:
(1) a child eligible for Northstar deleted text begin kinship assistance under section 256N.22 ordeleted text end adoption
assistance under section 256N.23 who is determined to be an at-risk child. A child under
this clause must be assigned level A under section 256N.26, subdivision 1; and
(2) a child transitioning into Northstar Care for Children under section 256N.28,
subdivision 7, unless the commissioner determines an assessment is appropriate.
Sec. 32.
Minnesota Statutes 2020, section 256N.24, subdivision 8, is amended to read:
Subd. 8.
Completing the special assessment.
(a) The special assessment must be
completed in consultation with the child's caregiver. Face-to-face contact with the caregiver
is not required to complete the special assessment.
(b) If a new special assessment is required prior to the effective date of the Northstar
kinship assistance agreement, it must be completed by the financially responsible agency,
in consultation with the legally responsible agency if different. If the prospective relative
custodian is unable or unwilling to cooperate with the special assessment process, the child
shall be assigned the basic level, level B under section 256N.26, subdivision 3deleted text begin , unless the
child is known to be an at-risk child, in which case, the child shall be assigned level A under
section 256N.26, subdivision 1deleted text end .
(c) If a special assessment is required prior to the effective date of the adoption assistance
agreement, it must be completed by the financially responsible agency, in consultation with
the legally responsible agency if different. If there is no financially responsible agency, the
special assessment must be completed by the agency designated by the commissioner. If
the prospective adoptive parent is unable or unwilling to cooperate with the special
assessment process, the child must be assigned the basic level, level B under section 256N.26,
subdivision 3, unless the child is known to be an at-risk child, in which case, the child shall
be assigned level A under section 256N.26, subdivision 1.
(d) Notice to the prospective relative custodians or prospective adoptive parents must
be provided as specified in subdivision 13.
Sec. 33.
Minnesota Statutes 2020, section 256N.24, subdivision 11, is amended to read:
Subd. 11.
Completion of reassessment.
(a) The reassessment must be completed in
consultation with the child's caregiver. Face-to-face contact with the caregiver is not required
to complete the reassessment.
(b) For foster children eligible under section 256N.21, reassessments must be completed
by the financially responsible agency, in consultation with the legally responsible agency
if different.
(c) If reassessment is required after the effective date of the Northstar kinship assistance
agreement, the reassessment must be completed by the financially responsible agency.
(d) If a reassessment is required after the effective date of the adoption assistance
agreement, it must be completed by the financially responsible agency or, if there is no
financially responsible agency, the agency designated by the commissioner.
(e) If the child's caregiver is unable or unwilling to cooperate with the reassessment, the
child must be assessed at level B under section 256N.26, subdivision 3, unless the child has
deleted text begin andeleted text end new text begin a Northstarnew text end adoption assistance deleted text begin or Northstar kinship assistancedeleted text end agreement deleted text begin in placedeleted text end and
is known to be an at-risk child, in which case the child must be assessed at level A under
section 256N.26, subdivision 1.
Sec. 34.
Minnesota Statutes 2020, section 256N.24, subdivision 12, is amended to read:
Subd. 12.
Approval of initial assessments, special assessments, and reassessments.
(a)
Any agency completing initial assessments, special assessments, or reassessments must
designate one or more supervisors or other staff to examine and approve assessments
completed by others in the agency under subdivision 2. The person approving an assessment
must not be the case manager or staff member completing that assessment.
(b) In cases where a special assessment or reassessment for deleted text begin guardiandeleted text end new text begin Northstar kinshipnew text end
assistance and adoption assistance is required under subdivision 8 or 11, the commissioner
shall review and approve the assessment as part of the eligibility determination process
outlined in section 256N.22, subdivision 7, for Northstar kinship assistance, or section
256N.23, subdivision 7, for adoption assistance. The assessment determines the maximum
deleted text begin fordeleted text end new text begin ofnew text end the negotiated agreement amount under section 256N.25.
(c) The new rate is effective the calendar month that the assessment is approved, or the
effective date of the agreement, whichever is later.
Sec. 35.
Minnesota Statutes 2020, section 256N.24, subdivision 14, is amended to read:
Subd. 14.
Assessment tool determines rate of benefits.
The assessment tool established
by the commissioner in subdivision 2 determines the monthly benefit level for children in
foster care. The monthly payment for deleted text begin guardiandeleted text end new text begin Northstar kinshipnew text end assistance or adoption
assistance may be negotiated up to the monthly benefit level under foster care for those
children eligible for a payment under section 256N.26, subdivision 1.
Sec. 36.
Minnesota Statutes 2020, section 256N.25, subdivision 1, is amended to read:
Subdivision 1.
Agreement; Northstar kinship assistance; adoption assistance.
(a) In
order to receive Northstar kinship assistance or adoption assistance benefits on behalf of
an eligible child, a written, binding agreement between the caregiver or caregivers, the
financially responsible agency, or, if there is no financially responsible agency, the agency
designated by the commissioner, and the commissioner must be established prior to
finalization of the adoption or a transfer of permanent legal and physical custody. The
agreement must be negotiated with the caregiver or caregivers under subdivision 2 and
renegotiated under subdivision 3, if applicable.
(b) The agreement must be on a form approved by the commissioner and must specify
the following:
(1) duration of the agreement;
(2) the nature and amount of any payment, services, and assistance to be provided under
such agreement;
(3) the child's eligibility for Medicaid services;
(4) the terms of the payment, including any child care portion as specified in section
256N.24, subdivision 3;
(5) eligibility for reimbursement of nonrecurring expenses associated with adopting or
obtaining permanent legal and physical custody of the child, to the extent that the total cost
does not exceed $2,000 per childnew text begin pursuant to subdivision 1anew text end ;
(6) that the agreement must remain in effect regardless of the state of which the adoptive
parents or relative custodians are residents at any given time;
(7) provisions for modification of the terms of the agreement, including renegotiation
of the agreement;
(8) the effective date of the agreement; and
(9) the successor relative custodian or custodians for Northstar kinship assistance, when
applicable. The successor relative custodian or custodians may be added or changed by
mutual agreement under subdivision 3.
(c) The caregivers, the commissioner, and the financially responsible agency, or, if there
is no financially responsible agency, the agency designated by the commissioner, must sign
the agreement. A copy of the signed agreement must be given to each party. Once signed
by all parties, the commissioner shall maintain the official record of the agreement.
(d) The effective date of the Northstar kinship assistance agreement must be the date of
the court order that transfers permanent legal and physical custody to the relative. The
effective date of the adoption assistance agreement is the date of the finalized adoption
decree.
(e) Termination or disruption of the preadoptive placement or the foster care placement
prior to assignment of custody makes the agreement with that caregiver void.
Sec. 37.
Minnesota Statutes 2020, section 256N.25, is amended by adding a subdivision
to read:
new text begin Subd. 1a. new text end
new text begin Reimbursement of nonrecurring expenses. new text end
new text begin
(a) The commissioner of human
services must reimburse a relative custodian with a fully executed Northstar kinship assistance
benefit agreement for costs that the relative custodian incurs while seeking permanent legal
and physical custody of a child who is the subject of a Northstar kinship assistance benefit
agreement. The commissioner must reimburse a relative custodian for expenses that are
reasonable and necessary that the relative incurs during the transfer of permanent legal and
physical custody of a child to the relative custodian, subject to a maximum of $2,000. To
be eligible for reimbursement, the expenses must directly relate to the legal transfer of
permanent legal and physical custody of the child to the relative custodian, must not have
been incurred by the relative custodian in violation of state or federal law, and must not
have been reimbursed from other sources or funds. The relative custodian must submit
reimbursement requests to the commissioner within 21 months of the date of the child's
finalized transfer of permanent legal and physical custody, and the relative custodian must
follow all requirements and procedures that the commissioner prescribes.
new text end
new text begin
(b) The commissioner of human services must reimburse an adoptive parent for costs
that the adoptive parent incurs in an adoption of a child with special needs according to
section 256N.23, subdivision 2. The commissioner must reimburse an adoptive parent for
expenses that are reasonable and necessary for the adoption of the child to occur, subject
to a maximum of $2,000. To be eligible for reimbursement, the expenses must directly relate
to the legal adoption of the child, must not have been incurred by the adoptive parent in
violation of state or federal law, and must not have been reimbursed from other sources or
funds.
new text end
new text begin
(1) Children who have special needs but who are not citizens or residents of the United
States and were either adopted in another country or brought to this country for the purposes
of adoption are categorically ineligible for the reimbursement program in this section, except
when the child meets the eligibility criteria in this section after the dissolution of the child's
international adoption.
new text end
new text begin
(2) An adoptive parent, in consultation with the responsible child-placing agency, may
request reimbursement of nonrecurring adoption expenses by submitting a complete
application to the commissioner that follows the commissioner's requirements and procedures
on forms that the commissioner prescribes.
new text end
new text begin
(3) The commissioner must determine a child's eligibility for adoption expense
reimbursement under title IV-E of the Social Security Act, United States Code, title 42,
sections 670 to 679c. If the commissioner determines that a child is eligible, the commissioner
of human services must fully execute the agreement for nonrecurring adoption expense
reimbursement by signing the agreement. For a child to be eligible, the commissioner must
have fully executed the agreement for nonrecurring adoption expense reimbursement prior
to finalizing a child's adoption.
new text end
new text begin
(4) An adoptive parent who has a fully executed Northstar adoption assistance agreement
is not required to submit a separate application for reimbursement of nonrecurring adoption
expenses for the child who is the subject of the Northstar adoption assistance agreement.
new text end
new text begin
(5) If the commissioner has determined the child to be eligible, the adoptive parent must
submit reimbursement requests to the commissioner within 21 months of the date of the
child's adoption decree, and the adoptive parent must follow requirements and procedures
that the commissioner prescribes.
new text end
Sec. 38.
Minnesota Statutes 2020, section 259.22, subdivision 4, is amended to read:
Subd. 4.
Time for filing petition.
A petition shall be filed not later than 12 months after
a child is placed in a prospective adoptive home. If a petition is not filed by that time, the
agency that placed the child, or, in a direct adoptive placement, the agency that is supervising
the placement shall file with the district court in the county where the prospective adoptive
parent resides a motion for an order and a report recommending one of the following:
(1) that the time for filing a petition be extended because of the child's special needs as
defined under title IV-E of the Social Security Act, United States Code, title 42, section
673;
(2) that, based on a written plan for completing filing of the petition, including a specific
timeline, to which the prospective adoptive parents have agreed, the time for filing a petition
be extended long enough to complete the plan because such an extension is in the best
interests of the child and additional time is needed for the child to adjust to the adoptive
home; or
(3) that the child be removed from the prospective adoptive home.
The prospective adoptive parent must reimburse an agency for the cost of preparing and
filing the motion and report under this section, unless the costs are reimbursed by the
commissioner under section 259.73 or deleted text begin 259A.70deleted text end new text begin 256N.25, subdivision 1anew text end .
Sec. 39.
Minnesota Statutes 2020, section 259.241, is amended to read:
259.241 ADULT ADOPTION.
(a) Any adult person may be adopted, regardless of the adult person's residence. A
resident of Minnesota may petition the court of record having jurisdiction of adoption
proceedings to adopt an individual who has reached the age of 18 years or older.
(b) The consent of the person to be adopted shall be the only consent necessary, according
to section 259.24. The consent of an adult in the adult person's own adoption is invalid if
the adult is considered to be a vulnerable adult under section 626.5572, subdivision 21, or
if the person consenting to the adoption is determined not competent to give consent.
new text begin
(c) Notwithstanding paragraph (b), a person in extended foster care under section
260C.451 may consent to the person's own adoption as long as the court with jurisdiction
finds the person competent to give consent.
new text end
deleted text begin (c)deleted text end new text begin (d)new text end The decree of adoption establishes a parent-child relationship between the adopting
parent or parents and the person adopted, including the right to inherit, and also terminates
the parental rights deleted text begin and sibling relationshipdeleted text end between the adopted person and the adopted
person's birth parents deleted text begin and siblingsdeleted text end according to section 259.59.
deleted text begin (d)deleted text end new text begin (e)new text end If the adopted person requests a change of name, the adoption decree shall order
the name change.
Sec. 40.
Minnesota Statutes 2020, section 259.35, subdivision 1, is amended to read:
Subdivision 1.
Parental responsibilities.
Prior to commencing an investigation of the
suitability of proposed adoptive parents, a child-placing agency shall give the individuals
the following written notice in all capital letters at least one-eighth inch high:
"Minnesota Statutes, section 259.59, provides that upon legally adopting a child, adoptive
parents assume all the rights and responsibilities of birth parents. The responsibilities include
providing for the child's financial support and caring for health, emotional, and behavioral
problems. Except for subsidized adoptions under Minnesota Statutes, chapter deleted text begin 259Adeleted text end new text begin 256Nnew text end ,
or any other provisions of law that expressly apply to adoptive parents and children, adoptive
parents are not eligible for state or federal financial subsidies besides those that a birth
parent would be eligible to receive for a child. Adoptive parents may not terminate their
parental rights to a legally adopted child for a reason that would not apply to a birth parent
seeking to terminate rights to a child. An individual who takes guardianship of a child for
the purpose of adopting the child shall, upon taking guardianship from the child's country
of origin, assume all the rights and responsibilities of birth and adoptive parents as stated
in this paragraph."
Sec. 41.
Minnesota Statutes 2020, section 259.53, subdivision 4, is amended to read:
Subd. 4.
Preadoption residence.
No petition shall be grantednew text begin under this chapternew text end until
the child deleted text begin shall havedeleted text end new text begin hasnew text end livednew text begin fornew text end three months in the proposed new text begin adoptive new text end home, subject to a
right of visitation by the commissioner or an agency or their authorized representatives.
Sec. 42.
Minnesota Statutes 2020, section 259.73, is amended to read:
259.73 REIMBURSEMENT OF NONRECURRING ADOPTION EXPENSES.
An individual may apply for reimbursement for costs incurred in an adoption of a child
with special needs under section deleted text begin 259A.70deleted text end new text begin 256N.25, subdivision 1anew text end .
Sec. 43.
Minnesota Statutes 2020, section 259.75, subdivision 5, is amended to read:
Subd. 5.
Withdrawal of registration.
A child's registration shall be withdrawn when
the exchange service has been notified in writing by the local social service agency or the
licensed child-placing agency that the child has been placed in an adoptive home deleted text begin ordeleted text end new text begin ,new text end has
diednew text begin , or is no longer under the guardianship of the commissioner and is no longer seeking
an adoptive homenew text end .
Sec. 44.
Minnesota Statutes 2020, section 259.75, subdivision 6, is amended to read:
Subd. 6.
Periodic review of status.
new text begin (a) new text end The deleted text begin exchange servicedeleted text end new text begin commissionernew text end shall
deleted text begin semiannually checkdeleted text end new text begin reviewnew text end thenew text begin state adoption exchangenew text end status of deleted text begin listeddeleted text end children deleted text begin for whom
inquiries have been receiveddeleted text end new text begin identified under subdivision 2, including a child whose
registration was withdrawn pursuant to subdivision 5. The commissioner may determine
that a child who is unregistered, or whose registration has been deferred, must be registered
and require the authorized child-placing agency to register the child with the state adoption
exchange within ten working days of the commissioner's determinationnew text end .
new text begin (b)new text end Periodic deleted text begin checksdeleted text end new text begin reviewsnew text end shall be made by the deleted text begin servicedeleted text end new text begin commissionernew text end to determine the
progress toward adoption of deleted text begin those children and the status ofdeleted text end children registered deleted text begin but never
listeddeleted text end in the deleted text begin exchange book because of placement in an adoptive home prior to or at the
time of registrationdeleted text end new text begin state adoption exchangenew text end .
Sec. 45.
Minnesota Statutes 2020, section 259.75, subdivision 9, is amended to read:
Subd. 9.
Rules; staff.
The commissioner of human services shall make rules as necessary
to administer this section and shall employ necessary staff to carry out the purposes of this
section.new text begin The commissioner may contract for services to carry out the purposes of this section.
new text end
Sec. 46.
Minnesota Statutes 2020, section 259.83, subdivision 1a, is amended to read:
Subd. 1a.
Social and medical history.
(a) If a person aged 19 years and over who was
adopted on or after August 1, 1994, or the adoptive parent requests the detailed nonidentifying
social and medical history of the adopted person's birth family that was provided at the time
of the adoption, agencies must provide the information to the adopted person or adoptive
parent on thenew text begin applicablenew text end form required under deleted text begin sectiondeleted text end new text begin sectionsnew text end 259.43new text begin and 260C.212,
subdivision 15new text end .
(b) If an adopted person aged 19 years and over or the adoptive parent requests the
agency to contact the adopted person's birth parents to request current nonidentifying social
and medical history of the adopted person's birth family, agencies must use thenew text begin applicablenew text end
form required under deleted text begin sectiondeleted text end new text begin sectionsnew text end 259.43new text begin and 260C.212, subdivision 15,new text end when obtaining
the information for the adopted person or adoptive parent.
Sec. 47.
Minnesota Statutes 2020, section 259A.75, subdivision 1, is amended to read:
Subdivision 1.
General information.
(a) Subject to the procedures required by the
commissioner and the provisions of this section, a Minnesota countynew text begin or tribal agencynew text end shall
receive a reimbursement from the commissioner equal to 100 percent of the reasonable and
appropriate cost for contracted adoption placement services identified for a specific child
that are not reimbursed under other federal or state funding sources.
(b) The commissioner may spend up to $16,000 for each purchase of service contract.
Only one contract per child per adoptive placement is permitted. Funds encumbered and
obligated under the contract for the child remain available until the terms of the contract
are fulfilled or the contract is terminated.
(c) The commissioner shall set aside an amount not to exceed five percent of the total
amount of the fiscal year appropriation from the state for the adoption assistance program
to reimburse a Minnesota county or tribal social services placing agency for child-specific
adoption placement services. When adoption assistance payments for children's needs exceed
95 percent of the total amount of the fiscal year appropriation from the state for the adoption
assistance program, the amount of reimbursement available to placing agencies for adoption
services is reduced correspondingly.
Sec. 48.
Minnesota Statutes 2020, section 259A.75, subdivision 2, is amended to read:
Subd. 2.
Purchase of service contract child eligibility criteria.
deleted text begin (a)deleted text end A child who is the
subject of a purchase of service contract must:
(1) have the goal of adoption, which may include an adoption in accordance with tribal
law;
(2) be under the guardianship of the commissioner of human services or be a ward of
tribal court pursuant to section 260.755, subdivision 20; and
(3) meet all of the special needs criteria according to section deleted text begin 259A.10, subdivision 2deleted text end new text begin
256N.23, subdivision 2new text end .
deleted text begin
(b) A child under the guardianship of the commissioner must have an identified adoptive
parent and a fully executed adoption placement agreement according to section 260C.613,
subdivision 1, paragraph (a).
deleted text end
Sec. 49.
Minnesota Statutes 2020, section 259A.75, subdivision 3, is amended to read:
Subd. 3.
Agency eligibility criteria.
(a) A Minnesota countynew text begin or tribalnew text end social services
agency shall receive reimbursement for child-specific adoption placement services for an
eligible child that it purchases from a private adoption agency licensed in Minnesota or any
other state or tribal social services agency.
(b) Reimbursement for adoption services is available only for services provided prior
to the date of the adoption decree.
Sec. 50.
Minnesota Statutes 2020, section 259A.75, subdivision 4, is amended to read:
Subd. 4.
Application and eligibility determination.
(a) Anew text begin Minnesotanew text end countynew text begin or tribalnew text end
social services agency may request reimbursement of costs for adoption placement services
by submitting a complete purchase of service application, according to the requirements
and procedures and on forms prescribed by the commissioner.
(b) The commissioner shall determine eligibility for reimbursement of adoption placement
services. If determined eligible, the commissioner of human services shall sign the purchase
of service agreement, making this a fully executed contract. No reimbursement under this
section shall be made to an agency for services provided prior to the fully executed contract.
(c) Separate purchase of service agreements shall be made, and separate records
maintained, on each child. Only one agreement per child per adoptive placement is permitted.
For siblings who are placed together, services shall be planned and provided to best maximize
efficiency of the contracted hours.
Sec. 51.
Minnesota Statutes 2020, section 260C.007, subdivision 22a, is amended to read:
Subd. 22a.
Licensed residential family-based substance use disorder treatment
program.
"Licensed residential family-based substance use disorder treatment program"
means a residential treatment facility that provides the parent or guardian with parenting
skills training, parent education, or individual and family counseling, under an organizational
structure and treatment framework that involves understanding, recognizing, and responding
to the effects of all types of trauma according to recognized principles of a trauma-informed
approach and trauma-specific interventions to address the consequences of trauma and
facilitate healing. The residential program must be licensed by the Department of Human
Services under deleted text begin chapterdeleted text end new text begin chaptersnew text end 245A and deleted text begin sections 245G.01 to 245G.16, 245G.19, and
245G.21deleted text end new text begin 245G or tribally licensed or approvednew text end as a residential substance use disorder
treatment program specializing in the treatment of clients with children.
Sec. 52.
Minnesota Statutes 2020, section 260C.007, subdivision 26c, is amended to read:
Subd. 26c.
Qualified individual.
"Qualified individual" means a trained culturally
competent professional or licensed clinician, including a mental health professional under
section 245.4871, subdivision 27, who is not an employee of the responsible social services
agency and who is not connected to or affiliated with any placement setting in which a
responsible social services agency has placed children.
new text begin
When the Indian Child Welfare Act of 1978, United States Code, title 25, sections 1901
to 1963, applies to a child, the county must contact the child's tribe without delay to give
the tribe the option to designate a qualified individual who is a trained culturally competent
professional or licensed clinician, including a mental health professional under section
245.4871, subdivision 27, who is not employed by the responsible social services agency
and who is not connected to or affiliated with any placement setting in which a responsible
social services agency has placed children. Only a federal waiver that demonstrates
maintained objectivity may allow a responsible social services agency employee or tribal
employee affiliated with any placement setting in which the responsible social services
agency has placed children to be designated the qualified individual.
new text end
Sec. 53.
Minnesota Statutes 2020, section 260C.007, subdivision 31, is amended to read:
Subd. 31.
Sexually exploited youth.
"Sexually exploited youth" means an individual
who:
(1) is alleged to have engaged in conduct which would, if committed by an adult, violate
any federal, state, or local law relating to being hired, offering to be hired, or agreeing to
be hired by another individual to engage in sexual penetration or sexual conduct;
(2) is a victim of a crime described in section 609.342, 609.343, 609.344, 609.345,
609.3451, 609.3453, 609.352, 617.246, or 617.247;
(3) is a victim of a crime described in United States Code, title 18, section 2260; 2421;
2422; 2423; 2425; 2425A; or 2256; deleted text begin or
deleted text end
(4) is a sex trafficking victim as defined in section 609.321, subdivision 7bdeleted text begin .deleted text end new text begin ; or
new text end
new text begin
(5) is a victim of commercial sexual exploitation as defined in United States Code, title
22, section 7102(11)(A) and (12).
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective September 30, 2021.
new text end
Sec. 54.
Minnesota Statutes 2020, section 260C.157, subdivision 3, is amended to read:
Subd. 3.
Juvenile treatment screening team.
(a) The responsible social services agency
shall establish a juvenile treatment screening team to conduct screenings under this chapternew text begin ,
chapter 260D,new text end and section 245.487, subdivision 3, for a child to receive treatment for an
emotional disturbance, a developmental disability, or related condition in a residential
treatment facility licensed by the commissioner of human services under chapter 245A, or
licensed or approved by a tribe. A screening team is not required for a child to be in: (1) a
residential facility specializing in prenatal, postpartum, or parenting support; (2) a facility
specializing in high-quality residential care and supportive services to children and youth
who deleted text begin aredeleted text end new text begin have been or are at risk of becoming victims ofnew text end sex-trafficking deleted text begin victims or are at
risk of becoming sex-trafficking victimsdeleted text end new text begin or commercial sexual exploitationnew text end ; (3) supervised
settings for youthnew text begin who arenew text end 18 years deleted text begin olddeleted text end new text begin of agenew text end or oldernew text begin andnew text end living independently; or (4) a
licensed residential family-based treatment facility for substance abuse consistent with
section 260C.190. Screenings are also not required when a child must be placed in a facility
due to an emotional crisis or other mental health emergency.
(b) The responsible social services agency shall conduct screenings within 15 days of a
request for a screening, unless the screening is for the purpose of residential treatment and
the child is enrolled in a prepaid health program under section 256B.69, in which case the
agency shall conduct the screening within ten working days of a request. The responsible
social services agency shall convene the new text begin juvenile treatment screening new text end team, which may be
constituted under section 245.4885 or 256B.092 or Minnesota Rules, parts 9530.6600 to
9530.6655. The team shall consist of social workers; persons with expertise in the treatment
of juveniles who are emotionally disabled, chemically dependent, or have a developmental
disability; and the child's parent, guardian, or permanent legal custodian. The team may
include the child's relatives as defined in section 260C.007, subdivisions 26b and 27, the
child's foster care provider, and professionals who are a resource to the child's family such
as teachers, medical or mental health providers, and clergy, as appropriate, consistent with
the family and permanency team as defined in section 260C.007, subdivision 16a. Prior to
forming the team, the responsible social services agency must consult with the child if the
child is age 14 or older, the child's parents, and, if applicable, the child's tribe to ensure that
the team is family-centered and will act in the child's best interest. If the child, child's parents,
or legal guardians raise concerns about specific relatives or professionals, the team should
not include those individuals. This provision does not apply to paragraph (c).
(c) If the agency provides notice to tribes under section 260.761, and the child screened
is an Indian child, the responsible social services agency must make a rigorous and concerted
effort to include a designated representative of the Indian child's tribe on the juvenile
treatment screening team, unless the child's tribal authority declines to appoint a
representative. The Indian child's tribe may delegate its authority to represent the child to
any other federally recognized Indian tribe, as defined in section 260.755, subdivision 12.
The provisions of the Indian Child Welfare Act of 1978, United States Code, title 25, sections
1901 to 1963, and the Minnesota Indian Family Preservation Act, sections 260.751 to
260.835, apply to this section.
(d) If the court, prior to, or as part of, a final disposition or other court order, proposes
to place a child with an emotional disturbance or developmental disability or related condition
in residential treatment, the responsible social services agency must conduct a screening.
If the team recommends treating the child in a qualified residential treatment program, the
agency must follow the requirements of sections 260C.70 to 260C.714.
The court shall ascertain whether the child is an Indian child and shall notify the
responsible social services agency and, if the child is an Indian child, shall notify the Indian
child's tribe as paragraph (c) requires.
(e) When the responsible social services agency is responsible for placing and caring
for the child and the screening team recommends placing a child in a qualified residential
treatment program as defined in section 260C.007, subdivision 26d, the agency must: (1)
begin the assessment and processes required in section 260C.704 without delay; and (2)
conduct a relative search according to section 260C.221 to assemble the child's family and
permanency team under section 260C.706. Prior to notifying relatives regarding the family
and permanency team, the responsible social services agency must consult with the child
if the child is age 14 or older, the child's parents and, if applicable, the child's tribe to ensure
that the agency is providing notice to individuals who will act in the child's best interest.
The child and the child's parents may identify a culturally competent qualified individual
to complete the child's assessment. The agency shall make efforts to refer the assessment
to the identified qualified individual. The assessment may not be delayed for the purpose
of having the assessment completed by a specific qualified individual.
(f) When a screening team determines that a child does not need treatment in a qualified
residential treatment program, the screening team must:
(1) document the services and supports that will prevent the child's foster care placement
and will support the child remaining at home;
(2) document the services and supports that the agency will arrange to place the child
in a family foster home; or
(3) document the services and supports that the agency has provided in any other setting.
(g) When the Indian child's tribe or tribal health care services provider or Indian Health
Services provider proposes to place a child for the primary purpose of treatment for an
emotional disturbance, a developmental disability, or co-occurring emotional disturbance
and chemical dependency, the Indian child's tribe or the tribe delegated by the child's tribe
shall submit necessary documentation to the county juvenile treatment screening team,
which must invite the Indian child's tribe to designate a representative to the screening team.
(h) The responsible social services agency must conduct and document the screening in
a format approved by the commissioner of human services.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective September 30, 2021.
new text end
Sec. 55.
Minnesota Statutes 2020, section 260C.212, subdivision 1, is amended to read:
Subdivision 1.
Out-of-home placement; plan.
(a) An out-of-home placement plan shall
be prepared within 30 days after any child is placed in foster care by court order or a
voluntary placement agreement between the responsible social services agency and the
child's parent pursuant to section 260C.227 or chapter 260D.
(b) An out-of-home placement plan means a written document which is prepared by the
responsible social services agency jointly with the parent or parents or guardian of the child
and in consultation with the child's guardian ad litem, the child's tribe, if the child is an
Indian child, the child's foster parent or representative of the foster care facility, and, where
appropriate, the child. When a child is age 14 or older, the child may include two other
individuals on the team preparing the child's out-of-home placement plan. The child may
select one member of the case planning team to be designated as the child's advisor and to
advocate with respect to the application of the reasonable and prudent parenting standards.
The responsible social services agency may reject an individual selected by the child if the
agency has good cause to believe that the individual would not act in the best interest of the
child. For a child in voluntary foster care for treatment under chapter 260D, preparation of
the out-of-home placement plan shall additionally include the child's mental health treatment
provider. For a child 18 years of age or older, the responsible social services agency shall
involve the child and the child's parents as appropriate. As appropriate, the plan shall be:
(1) submitted to the court for approval under section 260C.178, subdivision 7;
(2) ordered by the court, either as presented or modified after hearing, under section
260C.178, subdivision 7, or 260C.201, subdivision 6; and
(3) signed by the parent or parents or guardian of the child, the child's guardian ad litem,
a representative of the child's tribe, the responsible social services agency, and, if possible,
the child.
(c) The out-of-home placement plan shall be explained to all persons involved in its
implementation, including the child who has signed the plan, and shall set forth:
(1) a description of the foster care home or facility selected, including how the
out-of-home placement plan is designed to achieve a safe placement for the child in the
least restrictive, most family-like, setting available which is in close proximity to the home
of the parent or parents or guardian of the child when the case plan goal is reunification,
and how the placement is consistent with the best interests and special needs of the child
according to the factors under subdivision 2, paragraph (b);
(2) the specific reasons for the placement of the child in foster care, and when
reunification is the plan, a description of the problems or conditions in the home of the
parent or parents which necessitated removal of the child from home and the changes the
parent or parents must make for the child to safely return home;
(3) a description of the services offered and provided to prevent removal of the child
from the home and to reunify the family including:
(i) the specific actions to be taken by the parent or parents of the child to eliminate or
correct the problems or conditions identified in clause (2), and the time period during which
the actions are to be taken; and
(ii) the reasonable efforts, or in the case of an Indian child, active efforts to be made to
achieve a safe and stable home for the child including social and other supportive services
to be provided or offered to the parent or parents or guardian of the child, the child, and the
residential facility during the period the child is in the residential facility;
(4) a description of any services or resources that were requested by the child or the
child's parent, guardian, foster parent, or custodian since the date of the child's placement
in the residential facility, and whether those services or resources were provided and if not,
the basis for the denial of the services or resources;
(5) the visitation plan for the parent or parents or guardian, other relatives as defined in
section 260C.007, subdivision 26b or 27, and siblings of the child if the siblings are not
placed together in foster care, and whether visitation is consistent with the best interest of
the child, during the period the child is in foster care;
(6) when a child cannot return to or be in the care of either parent, documentation of
steps to finalize adoption as the permanency plan for the child through reasonable efforts
to place the child for adoption. At a minimum, the documentation must include consideration
of whether adoption is in the best interests of the child, child-specific recruitment efforts
such as relative search and the use of state, regional, and national adoption exchanges to
facilitate orderly and timely placements in and outside of the state. A copy of this
documentation shall be provided to the court in the review required under section 260C.317,
subdivision 3, paragraph (b);
(7) when a child cannot return to or be in the care of either parent, documentation of
steps to finalize the transfer of permanent legal and physical custody to a relative as the
permanency plan for the child. This documentation must support the requirements of the
kinship placement agreement under section 256N.22 and must include the reasonable efforts
used to determine that it is not appropriate for the child to return home or be adopted, and
reasons why permanent placement with a relative through a Northstar kinship assistance
arrangement is in the child's best interest; how the child meets the eligibility requirements
for Northstar kinship assistance payments; agency efforts to discuss adoption with the child's
relative foster parent and reasons why the relative foster parent chose not to pursue adoption,
if applicable; and agency efforts to discuss with the child's parent or parents the permanent
transfer of permanent legal and physical custody or the reasons why these efforts were not
made;
(8) efforts to ensure the child's educational stability while in foster care for a child who
attained the minimum age for compulsory school attendance under state law and is enrolled
full time in elementary or secondary school, or instructed in elementary or secondary
education at home, or instructed in an independent study elementary or secondary program,
or incapable of attending school on a full-time basis due to a medical condition that is
documented and supported by regularly updated information in the child's case plan.
Educational stability efforts include:
(i) efforts to ensure that the child remains in the same school in which the child was
enrolled prior to placement or upon the child's move from one placement to another, including
efforts to work with the local education authorities to ensure the child's educational stability
and attendance; or
(ii) if it is not in the child's best interest to remain in the same school that the child was
enrolled in prior to placement or move from one placement to another, efforts to ensure
immediate and appropriate enrollment for the child in a new school;
(9) the educational records of the child including the most recent information available
regarding:
(i) the names and addresses of the child's educational providers;
(ii) the child's grade level performance;
(iii) the child's school record;
(iv) a statement about how the child's placement in foster care takes into account
proximity to the school in which the child is enrolled at the time of placement; and
(v) any other relevant educational information;
(10) the efforts by the responsible social services agency to ensure the oversight and
continuity of health care services for the foster child, including:
(i) the plan to schedule the child's initial health screens;
(ii) how the child's known medical problems and identified needs from the screens,
including any known communicable diseases, as defined in section 144.4172, subdivision
2, shall be monitored and treated while the child is in foster care;
(iii) how the child's medical information shall be updated and shared, including the
child's immunizations;
(iv) who is responsible to coordinate and respond to the child's health care needs,
including the role of the parent, the agency, and the foster parent;
(v) who is responsible for oversight of the child's prescription medications;
(vi) how physicians or other appropriate medical and nonmedical professionals shall be
consulted and involved in assessing the health and well-being of the child and determine
the appropriate medical treatment for the child; and
(vii) the responsibility to ensure that the child has access to medical care through either
medical insurance or medical assistance;
(11) the health records of the child including information available regarding:
(i) the names and addresses of the child's health care and dental care providers;
(ii) a record of the child's immunizations;
(iii) the child's known medical problems, including any known communicable diseases
as defined in section 144.4172, subdivision 2;
(iv) the child's medications; and
(v) any other relevant health care information such as the child's eligibility for medical
insurance or medical assistance;
(12) an independent living plan for a child 14 years of age or older, developed in
consultation with the child. The child may select one member of the case planning team to
be designated as the child's advisor and to advocate with respect to the application of the
reasonable and prudent parenting standards in subdivision 14. The plan should include, but
not be limited to, the following objectives:
(i) educational, vocational, or employment planning;
(ii) health care planning and medical coverage;
(iii) transportation including, where appropriate, assisting the child in obtaining a driver's
license;
(iv) money management, including the responsibility of the responsible social services
agency to ensure that the child annually receives, at no cost to the child, a consumer report
as defined under section 13C.001 and assistance in interpreting and resolving any inaccuracies
in the report;
(v) planning for housing;
(vi) social and recreational skills;
(vii) establishing and maintaining connections with the child's family and community;
and
(viii) regular opportunities to engage in age-appropriate or developmentally appropriate
activities typical for the child's age group, taking into consideration the capacities of the
individual child;
(13) for a child in voluntary foster care for treatment under chapter 260D, diagnostic
and assessment information, specific services relating to meeting the mental health care
needs of the child, and treatment outcomes;
(14) for a child 14 years of age or older, a signed acknowledgment that describes the
child's rights regarding education, health care, visitation, safety and protection from
exploitation, and court participation; receipt of the documents identified in section 260C.452;
and receipt of an annual credit report. The acknowledgment shall state that the rights were
explained in an age-appropriate manner to the child; and
(15) for a child placed in a qualified residential treatment program, the plan must include
the requirements in section 260C.708.
(d) The parent or parents or guardian and the child each shall have the right to legal
counsel in the preparation of the case plan and shall be informed of the right at the time of
placement of the child. The child shall also have the right to a guardian ad litem. If unable
to employ counsel from their own resources, the court shall appoint counsel upon the request
of the parent or parents or the child or the child's legal guardian. The parent or parents may
also receive assistance from any person or social services agency in preparation of the case
plan.
After the plan has been agreed upon by the parties involved or approved or ordered by
the court, the foster parents shall be fully informed of the provisions of the case plan and
shall be provided a copy of the plan.
Uponnew text begin the child'snew text end discharge from foster care, thenew text begin responsible social services agency must
provide the child'snew text end parent, adoptive parent, or permanent legal and physical custodian, deleted text begin as
appropriate,deleted text end and the child, if deleted text begin appropriate, must be provideddeleted text end new text begin the child is 14 years of age or
older,new text end with a current copy of the child's health and education record.new text begin If a child meets the
conditions in subdivision 15, paragraph (b), the agency must also provide the child with the
child's social and medical history. The responsible social services agency may give a copy
of the child's health and education record and social and medical history to a child who is
younger than 14 years of age, if it is appropriate and if subdivision 15, paragraph (b), applies.
new text end
Sec. 56.
Minnesota Statutes 2020, section 260C.212, subdivision 1a, is amended to read:
Subd. 1a.
Out-of-home placement plan update.
(a) Within 30 days of placing the child
in foster care, the agency must file thenew text begin child'snew text end initial out-of-home placement plan with the
court. After filing thenew text begin child'snew text end initial out-of-home placement plan, the agency shall update
and file thenew text begin child'snew text end out-of-home placement plan with the court as follows:
(1) when the agency moves a child to a different foster care setting, the agency shall
inform the court within 30 days of the new text begin child's new text end placement change or court-ordered trial home
visit. The agency must file the new text begin child's new text end updated out-of-home placement plan with the court
at the next required review hearing;
(2) when the agency places a child in a qualified residential treatment program as defined
in section 260C.007, subdivision 26d, or moves a child from one qualified residential
treatment program to a different qualified residential treatment program, the agency must
update thenew text begin child'snew text end out-of-home placement plan within 60 days. To meet the requirements
of section 260C.708, the agency must file thenew text begin child'snew text end out-of-home placement plan deleted text begin with the
court as part of the 60-day hearing anddeleted text end new text begin along with the agency's report seeking the court's
approval of the child's placement at a qualified residential treatment program under section
260C.71. After the court issues an order, the agencynew text end must update thenew text begin child's out-of-home
placementnew text end plan deleted text begin after the court hearingdeleted text end to document the court's approval or disapproval of
the child's placement in a qualified residential treatment program;
(3) when the agency places a child with the child's parent in a licensed residential
family-based substance use disorder treatment program under section 260C.190, the agency
must identify the treatment programnew text begin where the child will be placednew text end in the child's out-of-home
placement plan prior to the child's placement. The agency must file thenew text begin child'snew text end out-of-home
placement plan with the court at the next required review hearing; and
(4) under sections 260C.227 and 260C.521, the agency must update thenew text begin child'snew text end
out-of-home placement plan and file thenew text begin child's out-of-home placementnew text end plan with the court.
(b) When none of the items in paragraph (a) apply, the agency must update thenew text begin child'snew text end
out-of-home placement plan no later than 180 days after the child's initial placement and
every six months thereafter, consistent with section 260C.203, paragraph (a).
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective September 30, 2021.
new text end
Sec. 57.
Minnesota Statutes 2020, section 260C.212, subdivision 2, is amended to read:
Subd. 2.
Placement decisions based on best interests of the child.
(a) The policy of
the state of Minnesota is to ensure that the child's best interests are met by requiring an
individualized determination of the needs of the child and of how the selected placement
will serve the needs of the child being placed. The authorized child-placing agency shall
place a child, released by court order or by voluntary release by the parent or parents, in a
family foster home selected by considering placement with relatives and important friends
in the following order:
(1) with an individual who is related to the child by blood, marriage, or adoptionnew text begin ,
including the legal parent, guardian, or custodian of the child's siblingsnew text end ; or
(2) with an individual who is an important friend with whom the child has resided or
had significant contact.
For an Indian child, the agency shall follow the order of placement preferences in the Indian
Child Welfare Act of 1978, United States Code, title 25, section 1915.
(b) Among the factors the agency shall consider in determining the needs of the child
are the following:
(1) the child's current functioning and behaviors;
(2) the medical needs of the child;
(3) the educational needs of the child;
(4) the developmental needs of the child;
(5) the child's history and past experience;
(6) the child's religious and cultural needs;
(7) the child's connection with a community, school, and faith community;
(8) the child's interests and talents;
(9) the child's relationship to current caretakers, parents, siblings, and relatives;
(10) the reasonable preference of the child, if the court, or the child-placing agency in
the case of a voluntary placement, deems the child to be of sufficient age to express
preferences; and
(11) for an Indian child, the best interests of an Indian child as defined in section 260.755,
subdivision 2a.
(c) Placement of a child cannot be delayed or denied based on race, color, or national
origin of the foster parent or the child.
(d) Siblings should be placed together for foster care and adoption at the earliest possible
time unless it is documented that a joint placement would be contrary to the safety or
well-being of any of the siblings or unless it is not possible after reasonable efforts by the
responsible social services agency. In cases where siblings cannot be placed together, the
agency is required to provide frequent visitation or other ongoing interaction between
siblings unless the agency documents that the interaction would be contrary to the safety
or well-being of any of the siblings.
(e) Except for emergency placement as provided for in section 245A.035, the following
requirements must be satisfied before the approval of a foster or adoptive placement in a
related or unrelated home: (1) a completed background study under section 245C.08; and
(2) a completed review of the written home study required under section 260C.215,
subdivision 4, clause (5), or 260C.611, to assess the capacity of the prospective foster or
adoptive parent to ensure the placement will meet the needs of the individual child.
(f) The agency must determine whether colocation with a parent who is receiving services
in a licensed residential family-based substance use disorder treatment program is in the
child's best interests according to paragraph (b) and include that determination in the child's
case plan under subdivision 1. The agency may consider additional factors not identified
in paragraph (b). The agency's determination must be documented in the child's case plan
before the child is colocated with a parent.
(g) The agency must establish a juvenile treatment screening team under section 260C.157
to determine whether it is necessary and appropriate to recommend placing a child in a
qualified residential treatment program, as defined in section 260C.007, subdivision 26d.
Sec. 58.
Minnesota Statutes 2020, section 260C.212, subdivision 13, is amended to read:
Subd. 13.
Protecting missing and runaway children and youth at risk of sex
traffickingnew text begin or commercial sexual exploitationnew text end .
(a) The local social services agency shall
expeditiously locate any child missing from foster care.
(b) The local social services agency shall report immediately, but no later than 24 hours,
after receiving information on a missing or abducted child to the local law enforcement
agency for entry into the National Crime Information Center (NCIC) database of the Federal
Bureau of Investigation, and to the National Center for Missing and Exploited Children.
(c) The local social services agency shall not discharge a child from foster care or close
the social services case until diligent efforts have been exhausted to locate the child and the
court terminates the agency's jurisdiction.
(d) The local social services agency shall determine the primary factors that contributed
to the child's running away or otherwise being absent from care and, to the extent possible
and appropriate, respond to those factors in current and subsequent placements.
(e) The local social services agency shall determine what the child experienced while
absent from care, including screening the child to determine if the child is a possible sex
traffickingnew text begin or commercial sexual exploitationnew text end victim as defined in section deleted text begin 609.321,
subdivision 7bdeleted text end new text begin 260C.007, subdivision 31new text end .
(f) The local social services agency shall report immediately, but no later than 24 hours,
to the local law enforcement agency any reasonable cause to believe a child is, or is at risk
of being, a sex traffickingnew text begin or commercial sexual exploitationnew text end victim.
(g) The local social services agency shall determine appropriate services as described
in section 145.4717 with respect to any child for whom the local social services agency has
responsibility for placement, care, or supervision when the local social services agency has
reasonable cause to believenew text begin thatnew text end the child is, or is at risk of being, a sex traffickingnew text begin or
commercial sexual exploitationnew text end victim.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective September 30, 2021.
new text end
Sec. 59.
Minnesota Statutes 2020, section 260C.212, is amended by adding a subdivision
to read:
new text begin Subd. 15. new text end
new text begin Social and medical history. new text end
new text begin
(a) The responsible social services agency must
complete each child's social and medical history using forms developed by the commissioner.
The responsible social services agency must work with each child's birth family, foster
family, medical and treatment providers, and school to ensure that there is a detailed and
up-to-date social and medical history of the child on forms provided by the commissioner.
new text end
new text begin
(b) If the child continues to be in placement out of the home of the parent or guardian
from whom the child was removed, reasonable efforts by the responsible social services
agency to complete the child's social and medical history must begin no later than the child's
permanency progress review hearing required under section 260C.204 or six months after
the child's placement in foster care, whichever occurs earlier.
new text end
new text begin
(c) In a child's social and medical history, the responsible social services agency must
include background information and health history specific to the child, the child's birth
parents, and the child's other birth relatives. Applicable background and health information
about the child includes the child's current health condition, behavior, and demeanor;
placement history; education history; sibling information; and birth, medical, dental, and
immunization information. Redacted copies of pertinent records, assessments, and evaluations
must be attached to the child's social and medical history. Applicable background information
about the child's birth parents and other birth relatives includes general background
information; education and employment history; physical health and mental health history;
and reasons for the child's placement.
new text end
Sec. 60.
Minnesota Statutes 2020, section 260C.219, subdivision 5, is amended to read:
Subd. 5.
Children reaching age of majority; copies of records.
new text begin Regardless of new text end whethernew text begin
a child isnew text end under state guardianship deleted text begin or notdeleted text end , if a child leaves foster care by reason of having
attained the age of majority under state law, the child must be given at no cost a copy of
the child's social and medical history, as deleted text begin defineddeleted text end new text begin describednew text end in section deleted text begin 259.43,deleted text end new text begin 260C.212,
subdivision 15, including the child's healthnew text end and education report.
Sec. 61.
Minnesota Statutes 2020, section 260C.452, is amended to read:
260C.452 SUCCESSFUL TRANSITION TO ADULTHOOD.
Subdivision 1.
Scopenew text begin and purposenew text end .
new text begin
(a) For purposes of this section, "youth" means a
person who is at least 14 years of age and under 23 years of age.
new text end
new text begin (b) new text end This section pertains to a deleted text begin childdeleted text end new text begin youthnew text end whonew text begin :
new text end
new text begin (1)new text end isnew text begin in foster care and is 14 years of age or older, including a youth who isnew text end under the
guardianship of the commissioner of human servicesdeleted text begin , or whodeleted text end new text begin ;
new text end
new text begin (2)new text end has a permanency disposition of permanent custody to the agencydeleted text begin , or whodeleted text end new text begin ;
new text end
new text begin (3)new text end will leave foster care deleted text begin at 18 to 21 years of age.deleted text end new text begin when the youth is 18 years of age or
older and under 21 years of age;
new text end
new text begin
(4) has left foster care and was placed at a permanent adoptive placement when the youth
was 16 years of age or older;
new text end
new text begin
(5) is 16 years of age or older, has left foster care, and was placed with a relative to
whom permanent legal and physical custody of the youth has been transferred; or
new text end
new text begin
(6) was reunified with the youth's primary caretaker when the youth was 14 years of age
or older and under 18 years of age.
new text end
new text begin
(c) The purpose of this section is to provide support to each youth who is transitioning
to adulthood by providing services to the youth in the areas of:
new text end
new text begin
(1) education;
new text end
new text begin
(2) employment;
new text end
new text begin
(3) daily living skills such as financial literacy training and driving instruction; preventive
health activities including promoting abstinence from substance use and smoking; and
nutrition education and pregnancy prevention;
new text end
new text begin
(4) forming meaningful, permanent connections with caring adults;
new text end
new text begin
(5) engaging in age and developmentally appropriate activities under section 260C.212,
subdivision 14, and positive youth development;
new text end
new text begin
(6) financial, housing, counseling, and other services to assist a youth over 18 years of
age in achieving self-sufficiency and accepting personal responsibility for the transition
from adolescence to adulthood; and
new text end
new text begin
(7) making vouchers available for education and training.
new text end
new text begin
(d) The responsible social services agency may provide support and case management
services to a youth as defined in paragraph (a) until the youth reaches the age of 23 years.
According to section 260C.451, a youth's placement in a foster care setting will end when
the youth reaches the age of 21 years.
new text end
new text begin Subd. 1a. new text end
new text begin Case management services. new text end
new text begin
Case management services include the
responsibility for planning, coordinating, authorizing, monitoring, and evaluating services
for a youth and shall be provided to a youth by the responsible social services agency. Case
management services include the out-of-home placement plan under section 260C.212,
subdivision 1, when the youth is in out-of-home placement.
new text end
Subd. 2.
Independent living plan.
When the deleted text begin childdeleted text end new text begin youthnew text end is 14 years of age or oldernew text begin and
is receiving support from the responsible social services agency under this sectionnew text end , the
responsible social services agency, in consultation with the deleted text begin childdeleted text end new text begin youthnew text end , shall complete thenew text begin
youth'snew text end independent living plan according to section 260C.212, subdivision 1, paragraph
(c), clause (12)new text begin , regardless of the youth's current placement statusnew text end .
deleted text begin Subd. 3. deleted text end
deleted text begin Notification. deleted text end
deleted text begin
Six months before the child is expected to be discharged from
foster care, the responsible social services agency shall provide written notice to the child
regarding the right to continued access to services for certain children in foster care past 18
years of age and of the right to appeal a denial of social services under section 256.045.
deleted text end
Subd. 4.
Administrative or court review of placements.
(a) When the deleted text begin childdeleted text end new text begin youthnew text end is
14 years of age or older, the court, in consultation with the deleted text begin childdeleted text end new text begin youthnew text end , shall review thenew text begin
youth'snew text end independent living plan according to section 260C.203, paragraph (d).
(b) The responsible social services agency shall file a copy of the notification deleted text begin required
in subdivision 3deleted text end new text begin of foster care benefits for a youth who is 18 years of age or older according
to section 260C.451, subdivision 1,new text end with the court. If the responsible social services agency
does not file the notice by the time the deleted text begin childdeleted text end new text begin youthnew text end is 17-1/2 years of age, the court shall
require the responsible social services agency to file the notice.
(c) new text begin When a youth is 18 years of age or older, new text end the court shall ensure that the responsible
social services agency assists the deleted text begin childdeleted text end new text begin youthnew text end in obtaining the following documents before
the deleted text begin childdeleted text end new text begin youthnew text end leaves foster care: a Social Security card; an official or certified copy of the
deleted text begin child'sdeleted text end new text begin youth'snew text end birth certificate; a state identification card or driver's license, tribal enrollment
identification card, green card, or school visa; health insurance information; the deleted text begin child'sdeleted text end new text begin
youth'snew text end school, medical, and dental records; a contact list of the deleted text begin child'sdeleted text end new text begin youth'snew text end medical,
dental, and mental health providers; and contact information for the deleted text begin child'sdeleted text end new text begin youth'snew text end siblings,
if the siblings are in foster care.
(d) For a deleted text begin childdeleted text end new text begin youthnew text end who will be discharged from foster care at 18 years of age or older,
the responsible social services agency must develop a personalized transition plan as directed
by the deleted text begin childdeleted text end new text begin youthnew text end during the 90-day period immediately prior to the expected date of
discharge. The transition plan must be as detailed as the deleted text begin childdeleted text end new text begin youthnew text end elects and include
specific options, including but not limited to:
(1) affordable housing with necessary supports that does not include a homeless shelter;
(2) health insurance, including eligibility for medical assistance as defined in section
256B.055, subdivision 17;
(3) education, including application to the Education and Training Voucher Program;
(4) local opportunities for mentors and continuing support servicesdeleted text begin , including the Healthy
Transitions and Homeless Prevention program, if availabledeleted text end ;
(5) workforce supports and employment services;
(6) a copy of the deleted text begin child'sdeleted text end new text begin youth'snew text end consumer credit report as defined in section 13C.001
and assistance in interpreting and resolving any inaccuracies in the report, at no cost to the
deleted text begin childdeleted text end new text begin youthnew text end ;
(7) information on executing a health care directive under chapter 145C and on the
importance of designating another individual to make health care decisions on behalf of the
deleted text begin childdeleted text end new text begin youthnew text end if the deleted text begin childdeleted text end new text begin youthnew text end becomes unable to participate in decisions;
(8) appropriate contact information through 21 years of age if the deleted text begin childdeleted text end new text begin youthnew text end needs
information or help dealing with a crisis situation; and
(9) official documentation that the youth was previously in foster care.
Subd. 5.
Notice of termination of deleted text begin foster caredeleted text end new text begin social servicesnew text end .
(a) deleted text begin Whendeleted text end new text begin Beforenew text end a deleted text begin childdeleted text end new text begin
youth who is 18 years of age or oldernew text end leaves foster care deleted text begin at 18 years of age or olderdeleted text end , the
responsible social services agency shall give the deleted text begin childdeleted text end new text begin youthnew text end written notice that foster care
shall terminate 30 days from the datenew text begin thatnew text end the notice is sentnew text begin by the agency according to
section 260C.451, subdivision 8new text end .
deleted text begin
(b) The child or the child's guardian ad litem may file a motion asking the court to review
the responsible social services agency's determination within 15 days of receiving the notice.
The child shall not be discharged from foster care until the motion is heard. The responsible
social services agency shall work with the child to transition out of foster care.
deleted text end
deleted text begin
(c) The written notice of termination of benefits shall be on a form prescribed by the
commissioner and shall give notice of the right to have the responsible social services
agency's determination reviewed by the court under this section or sections 260C.203,
260C.317, and 260C.515, subdivision 5 or 6. A copy of the termination notice shall be sent
to the child and the child's attorney, if any, the foster care provider, the child's guardian ad
litem, and the court. The responsible social services agency is not responsible for paying
foster care benefits for any period of time after the child leaves foster care.
deleted text end
new text begin
(b) Before case management services will end for a youth who is at least 18 years of
age and under 23 years of age, the responsible social services agency shall give the youth:
(1) written notice that case management services for the youth shall terminate; and (2)
written notice that the youth has the right to appeal the termination of case management
services under section 256.045, subdivision 3, by responding in writing within ten days of
the date that the agency mailed the notice. The termination notice must include information
about services for which the youth is eligible and how to access the services.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2021.
new text end
Sec. 62.
Minnesota Statutes 2020, section 260C.503, subdivision 2, is amended to read:
Subd. 2.
Termination of parental rights.
(a) The responsible social services agency
must ask the county attorney to immediately file a termination of parental rights petition
when:
(1) the child has been subjected to egregious harm as defined in section 260C.007,
subdivision 14;
(2) the child is determined to be the sibling of a child who was subjected to egregious
harm;
(3) the child is an abandoned infant as defined in section 260C.301, subdivision 2,
paragraph (a), clause (2);
(4) the child's parent has lost parental rights to another child through an order involuntarily
terminating the parent's rights;
(5) the parent has committed sexual abuse as defined in section 260E.03, against the
child or another child of the parent;
(6) the parent has committed an offense that requires registration as a predatory offender
under section 243.166, subdivision 1b, paragraph (a) or (b); or
(7) another child of the parent is the subject of an order involuntarily transferring
permanent legal and physical custody of the child to a relative under this chapter or a similar
law of another jurisdiction;
The county attorney shall file a termination of parental rights petition unless the conditions
of paragraph (d) are met.
(b) When the termination of parental rights petition is filed under this subdivision, the
responsible social services agency shall identify, recruit, and approve an adoptive family
for the child. If a termination of parental rights petition has been filed by another party, the
responsible social services agency shall be joined as a party to the petition.
(c) If criminal charges have been filed against a parent arising out of the conduct alleged
to constitute egregious harm, the county attorney shall determine which matter should
proceed to trial first, consistent with the best interests of the child and subject to the
defendant's right to a speedy trial.
(d) The requirement of paragraph (a) does not apply if the responsible social services
agency and the county attorney determine and file with the court:
(1) a petition for transfer of permanent legal and physical custody to a relative under
sections 260C.505 and 260C.515, subdivision deleted text begin 3deleted text end new text begin 4new text end , including a determination that adoption
is not in the child's best interests and that transfer of permanent legal and physical custody
is in the child's best interests; or
(2) a petition under section 260C.141 alleging the child, and where appropriate, the
child's siblings, to be in need of protection or services accompanied by a case plan prepared
by the responsible social services agency documenting a compelling reason why filing a
termination of parental rights petition would not be in the best interests of the child.
Sec. 63.
Minnesota Statutes 2020, section 260C.515, subdivision 3, is amended to read:
Subd. 3.
Guardianship; commissioner.
The court may new text begin issue an new text end order new text begin that the child is
under the new text end guardianship deleted text begin todeleted text end new text begin ofnew text end the commissioner of human services under the following
procedures and conditions:
(1) there is an identified prospective adoptive parent agreed to by the responsible social
services agency deleted text begin havingdeleted text end new text begin that hasnew text end legal custody of the child pursuant to court order under this
chapter and that prospective adoptive parent has agreed to adopt the child;
(2) the court accepts the parent's voluntary consent to adopt in writing on a form
prescribed by the commissioner, executed before two competent witnesses and confirmed
by the consenting parent before the court or executed before the court. The consent shall
contain notice that consent given under this chapter:
(i) is irrevocable upon acceptance by the court unless fraud is established and an order
is issued permitting revocation as stated in clause (9) unless the matter is governed by the
Indian Child Welfare Act, United States Code, title 25, section 1913(c); and
(ii) will result in an order that the child is under the guardianship of the commissioner
of human services;
(3) a consent executed and acknowledged outside of this state, either in accordance with
the law of this state or in accordance with the law of the place where executed, is valid;
(4) the court must review the matter at least every 90 days under section 260C.317;
(5) a consent to adopt under this subdivision vests guardianship of the child with the
commissioner of human services and makes the child a ward of the commissioner of human
services under section 260C.325;
(6) the court must forward to the commissioner a copy of the consent to adopt, together
with a certified copy of the order transferring guardianship to the commissioner;
(7) if an adoption is not finalized by the identified prospective adoptive parent within
six months of the execution of the consent to adopt under this clause, the responsible social
services agency shall pursue adoptive placement in another home unless the court finds in
a hearing under section 260C.317 that the failure to finalize is not due to either an action
or a failure to act by the prospective adoptive parent;
(8) notwithstanding clause (7), the responsible social services agency must pursue
adoptive placement in another home as soon as the agency determines that finalization of
the adoption with the identified prospective adoptive parent is not possible, that the identified
prospective adoptive parent is not willing to adopt the child, or that the identified prospective
adoptive parent is not cooperative in completing the steps necessary to finalize the adoptionnew text begin .
The court may order a termination of parental rights under subdivision 2new text end ; and
(9) unless otherwise required by the Indian Child Welfare Act, United States Code, title
25, section 1913(c), a consent to adopt executed under this section shall be irrevocable upon
acceptance by the court except upon order permitting revocation issued by the same court
after written findings that consent was obtained by fraud.
Sec. 64.
Minnesota Statutes 2020, section 260C.605, subdivision 1, is amended to read:
Subdivision 1.
Requirements.
(a) Reasonable efforts to finalize the adoption of a child
under the guardianship of the commissioner shall be made by the responsible social services
agency responsible for permanency planning for the child.
(b) Reasonable efforts to make a placement in a home according to the placement
considerations under section 260C.212, subdivision 2, with a relative or foster parent who
will commit to being the permanent resource for the child in the event the child cannot be
reunified with a parent are required under section 260.012 and may be made concurrently
with reasonable, or if the child is an Indian child, active efforts to reunify the child with the
parent.
(c) Reasonable efforts under paragraph (b) must begin as soon as possible when the
child is in foster care under this chapter, but not later than the hearing required under section
260C.204.
(d) Reasonable efforts to finalize the adoption of the child include:
(1) using age-appropriate engagement strategies to plan for adoption with the child;
(2) identifying an appropriate prospective adoptive parent for the child by updating the
child's identified needs using the factors in section 260C.212, subdivision 2;
(3) making an adoptive placement that meets the child's needs by:
(i) completing or updating the relative search required under section 260C.221 and giving
notice of the need for an adoptive home for the child to:
(A) relatives who have kept the agency or the court apprised of their whereabouts and
who have indicated an interest in adopting the child; or
(B) relatives of the child who are located in an updated search;
(ii) an updated search is required whenever:
(A) there is no identified prospective adoptive placement for the child notwithstanding
a finding by the court that the agency made diligent efforts under section 260C.221, in a
hearing required under section 260C.202;
(B) the child is removed from the home of an adopting parent; or
(C) the court determines a relative search by the agency is in the best interests of the
child;
(iii) engaging the child's foster parent and the child's relatives identified as an adoptive
resource during the search conducted under section 260C.221, to commit to being the
prospective adoptive parent of the child; or
(iv) when there is no identified prospective adoptive parent:
(A) registering the child on the state adoption exchange as required in section 259.75
unless the agency documents to the court an exception to placing the child on the state
adoption exchange reported to the commissioner;
(B) reviewing all families with approved adoption home studies associated with the
responsible social services agency;
(C) presenting the child to adoption agencies and adoption personnel who may assist
with finding an adoptive home for the child;
(D) using newspapers and other media to promote the particular child;
(E) using a private agency under grant contract with the commissioner to provide adoption
services for intensive child-specific recruitment efforts; and
(F) making any other efforts or using any other resources reasonably calculated to identify
a prospective adoption parent for the child;
(4) updating and completing the social and medical history required under sections
deleted text begin 259.43deleted text end new text begin 260C.212, subdivision 15,new text end and 260C.609;
(5) making, and keeping updated, appropriate referrals required by section 260.851, the
Interstate Compact on the Placement of Children;
(6) giving notice regarding the responsibilities of an adoptive parent to any prospective
adoptive parent as required under section 259.35;
(7) offering the adopting parent the opportunity to apply for or decline adoption assistance
under chapter deleted text begin 259Adeleted text end new text begin 256Nnew text end ;
(8) certifying the child for adoption assistance, assessing the amount of adoption
assistance, and ascertaining the status of the commissioner's decision on the level of payment
if the adopting parent has applied for adoption assistance;
(9) placing the child with siblings. If the child is not placed with siblings, the agency
must document reasonable efforts to place the siblings together, as well as the reason for
separation. The agency may not cease reasonable efforts to place siblings together for final
adoption until the court finds further reasonable efforts would be futile or that placement
together for purposes of adoption is not in the best interests of one of the siblings; and
(10) working with the adopting parent to file a petition to adopt the child and with the
court administrator to obtain a timely hearing to finalize the adoption.
Sec. 65.
Minnesota Statutes 2020, section 260C.607, subdivision 6, is amended to read:
Subd. 6.
Motion and hearing to order adoptive placement.
(a) At any time after the
district court orders the child under the guardianship of the commissioner of human services,
but not later than 30 days after receiving notice required under section 260C.613, subdivision
1, paragraph (c), that the agency has made an adoptive placement, a relative or the child's
foster parent may file a motion for an order for adoptive placement of a child who is under
the guardianship of the commissioner if the relative or the child's foster parent:
(1) has an adoption home study under section 259.41 approving the relative or foster
parent for adoption and has been a resident of Minnesota for at least six months before filing
the motion; the court may waive the residency requirement for the moving party if there is
a reasonable basis to do so; or
(2) is not a resident of Minnesota, but has an approved adoption home study by an agency
licensed or approved to complete an adoption home study in the state of the individual's
residence and the study is filed with the motion for adoptive placement.
(b) The motion shall be filed with the court conducting reviews of the child's progress
toward adoption under this section. The motion and supporting documents must make a
prima facie showing that the agency has been unreasonable in failing to make the requested
adoptive placement. The motion must be served according to the requirements for motions
under the Minnesota Rules of Juvenile Protection Procedure and shall be made on all
individuals and entities listed in subdivision 2.
(c) If the motion and supporting documents do not make a prima facie showing for the
court to determine whether the agency has been unreasonable in failing to make the requested
adoptive placement, the court shall dismiss the motion. If the court determines a prima facie
basis is made, the court shall set the matter for evidentiary hearing.
(d) At the evidentiary hearing, the responsible social services agency shall proceed first
with evidence about the reason for not making the adoptive placement proposed by the
moving party. The moving party then has the burden of proving by a preponderance of the
evidence that the agency has been unreasonable in failing to make the adoptive placement.
(e) At the conclusion of the evidentiary hearing, if the court finds that the agency has
been unreasonable in failing to make the adoptive placement and that the relative or the
child's foster parent is the most suitable adoptive home to meet the child's needs using the
factors in section 260C.212, subdivision 2, paragraph (b), the court may order the responsible
social services agency to make an adoptive placement in the home of the relative or the
child's foster parent.
(f) If, in order to ensure that a timely adoption may occur, the court orders the responsible
social services agency to make an adoptive placement under this subdivision, the agency
shall:
(1) make reasonable efforts to obtain a fully executed adoption placement agreement;
(2) work with the moving party regarding eligibility for adoption assistance as required
under chapter deleted text begin 259Adeleted text end new text begin 256Nnew text end ; and
(3) if the moving party is not a resident of Minnesota, timely refer the matter for approval
of the adoptive placement through the Interstate Compact on the Placement of Children.
(g) Denial or granting of a motion for an order for adoptive placement after an evidentiary
hearing is an order which may be appealed by the responsible social services agency, the
moving party, the child, when age ten or over, the child's guardian ad litem, and any
individual who had a fully executed adoption placement agreement regarding the child at
the time the motion was filed if the court's order has the effect of terminating the adoption
placement agreement. An appeal shall be conducted according to the requirements of the
Rules of Juvenile Protection Procedure.
Sec. 66.
Minnesota Statutes 2020, section 260C.609, is amended to read:
260C.609 SOCIAL AND MEDICAL HISTORY.
deleted text begin
(a) The responsible social services agency shall work with the birth family of the child,
foster family, medical and treatment providers, and the child's school to ensure there is a
detailed, thorough, and currently up-to-date social and medical history of the child as required
under section 259.43 on the forms required by the commissioner.
deleted text end
deleted text begin
(b) When the child continues in foster care, the agency's reasonable efforts to complete
the history shall begin no later than the permanency progress review hearing required under
section 260C.204 or six months after the child's placement in foster care.
deleted text end
deleted text begin (c)deleted text end new text begin (a)new text end Thenew text begin responsible social servicesnew text end agency shall thoroughly discuss the child's history
with the deleted text begin adoptingdeleted text end new text begin prospective adoptivenew text end parent of the child and shall give anew text begin redactednew text end copy
of deleted text begin the report ofdeleted text end the child's social and medical historynew text begin as described in section 260C.212,
subdivision 15, including redacted attachments,new text end to the deleted text begin adoptingdeleted text end new text begin prospective adoptivenew text end parent.new text begin
If the prospective adoptive parent does not pursue adoption of the child, the prospective
adoptive parent must return the child's social and medical history and redacted attachments
to the agency. The responsible social services agency may givenew text end anew text begin redactednew text end copy of the child's
social and medical history deleted text begin may also be givendeleted text end to the childdeleted text begin , as appropriatedeleted text end new text begin according to section
260C.212, subdivision 1new text end .
deleted text begin (d)deleted text end new text begin (b)new text end The report shall not include information that identifies birth relatives. Redacted
copies of allnew text begin ofnew text end the child's relevant evaluations, assessments, and records must be attached
to the social and medical history.
new text begin
(c) The agency must submit the child's social and medical history to the Department of
Human Services at the time that the agency submits the child's adoption placement agreement.
Pursuant to section 260C.623, subdivision 4, the child's social and medical history must be
submitted to the court at the time the adoption petition is filed with the court.
new text end
Sec. 67.
Minnesota Statutes 2020, section 260C.615, is amended to read:
260C.615 DUTIES OF COMMISSIONER.
Subdivision 1.
Duties.
(a) For any child who is under the guardianship of the
commissioner, the commissioner has the exclusive rights to consent to:
(1) the medical care plan for the treatment of a child who is at imminent risk of death
or who has a chronic disease that, in a physician's judgment, will result in the child's death
in the near future including a physician's order not to resuscitate or intubate the child; and
(2) the child donating a part of the child's body to another person while the child is living;
the decision to donate a body part under this clause shall take into consideration the child's
wishes and the child's culture.
(b) In addition to the exclusive rights under paragraph (a), the commissioner has a duty
to:
(1) process any complete and accurate request for home study and placement through
the Interstate Compact on the Placement of Children under section 260.851;
(2) process any complete and accurate application for adoption assistance forwarded by
the responsible social services agency according to chapter deleted text begin 259Adeleted text end new text begin 256Nnew text end ;
(3) deleted text begin complete the execution ofdeleted text end new text begin review and processnew text end an adoption placement agreement
forwarded to the commissioner by the responsible social services agency and return it to
the agency in a timely fashion; and
(4) maintain records as required in chapter 259.
Subd. 2.
Duties not reserved.
All duties, obligations, and consents not specifically
reserved to the commissioner in this section are delegated to the responsible social services
agencynew text begin , subject to supervision by the commissioner under section 393.07new text end .
Sec. 68.
Minnesota Statutes 2020, section 260C.704, is amended to read:
260C.704 REQUIREMENTS FOR THE QUALIFIED INDIVIDUAL'S
ASSESSMENT OF THE CHILD FOR PLACEMENT IN A QUALIFIED
RESIDENTIAL TREATMENT PROGRAM.
(a) A qualified individual must complete an assessment of the child prior to or within
30 days of the child's placement in a qualified residential treatment program in a format
approved by the commissioner of human services, and must:
(1) assess the child's needs and strengths, using an age-appropriate, evidence-based,
validated, functional assessment approved by the commissioner of human services;
(2) determine whether the child's needs can be met by the child's family members or
through placement in a family foster home; or, if not, determine which residential setting
would provide the child with the most effective and appropriate level of care to the child
in the least restrictive environment;
(3) develop a list of short- and long-term mental and behavioral health goals for the
child; and
(4) work with the child's family and permanency team using culturally competent
practices.
(b) The child and the child's parents, when appropriate, may request that a specific
culturally competent qualified individual complete the child's assessment. The agency shall
make efforts to refer the child to the identified qualified individual to complete the
assessment. The assessment must not be delayed for a specific qualified individual to
complete the assessment.
(c) The qualified individual must provide the assessment, when complete, to the
responsible social services agencydeleted text begin , the child's parents or legal guardians, the guardian ad
litem, and the courtdeleted text end new text begin . If the assessment recommends placement of the child in a qualified
residential treatment facility, the agency must distribute the assessment along with the court
reportnew text end as required in section 260C.71new text begin , subdivision 2. If the assessment does not recommend
placement in a qualified residential treatment facility, the agency must provide a copy of
the assessment to the parents or legal guardians and the guardian ad litem and file the
assessment determination with the court at the next required hearing as required in section
260C.71, subdivision 5new text end . If court rules and chapter 13 permit disclosure of the results of the
child's assessment, the agency may share the results of the child's assessment with the child's
foster care provider, other members of the child's family, and the family and permanency
team. The agency must not share the child's private medical data with the family and
permanency team unless: (1) chapter 13 permits the agency to disclose the child's private
medical data to the family and permanency team; or (2) the child's parent has authorized
the agency to disclose the child's private medical data to the family and permanency team.
(d) For an Indian child, the assessment of the child must follow the order of placement
preferences in the Indian Child Welfare Act of 1978, United States Code, title 25, section
1915.
(e) In the assessment determination, the qualified individual must specify in writing:
(1) the reasons why the child's needs cannot be met by the child's family or in a family
foster home. A shortage of family foster homes is not an acceptable reason for determining
that a family foster home cannot meet a child's needs;
(2) why the recommended placement in a qualified residential treatment program will
provide the child with the most effective and appropriate level of care to meet the child's
needs in the least restrictive environment possible and how placing the child at the treatment
program is consistent with the short-term and long-term goals of the child's permanency
plan; and
(3) if the qualified individual's placement recommendation is not the placement setting
that the parent, family and permanency team, child, or tribe prefer, the qualified individual
must identify the reasons why the qualified individual does not recommend the parent's,
family and permanency team's, child's, or tribe's placement preferences. The out-of-home
placement plan under section 260C.708 must also include reasons why the qualified
individual did not recommend the preferences of the parents, family and permanency team,
child, or tribe.
(f) If the qualified individual determines that the child's family or a family foster home
or other less restrictive placement may meet the child's needs, the agency must move the
child out of the qualified residential treatment program and transition the child to a less
restrictive setting within 30 days of the determination.new text begin If the responsible social services
agency has placement authority of the child, the agency must make a plan for the child's
placement according to section 260C.212, subdivision 2. The agency must file the child's
assessment determination with the court at the next required hearing.
new text end
new text begin
(g) If the qualified individual recommends placing the child in a qualified residential
treatment program, the responsible social services agency shall make referrals to appropriate
qualified residential treatment programs and upon acceptance by an appropriate program,
place the child in an approved or certified qualified residential treatment program.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective September 30, 2021.
new text end
Sec. 69.
Minnesota Statutes 2020, section 260C.706, is amended to read:
260C.706 FAMILY AND PERMANENCY TEAM REQUIREMENTS.
(a) When the responsible social services agency's juvenile treatment screening team, as
defined in section 260C.157, recommends placing the child in a qualified residential treatment
program, the agency must assemble a family and permanency team within ten days.
(1) The team must include all appropriate biological family members, the child's parents,
legal guardians or custodians, foster care providers, and relatives as defined in section
260C.007, subdivisions deleted text begin 26cdeleted text end new text begin 26bnew text end and 27, and professionals, as appropriate, who are a resource
to the child's family, such as teachers, medical or mental health providers, or clergy.
(2) When a child is placed in foster care prior to the qualified residential treatment
program, the agency shall include relatives responding to the relative search notice as
required under section 260C.221 on this team, unless the juvenile court finds that contacting
a specific relative would endanger the parent, guardian, child, sibling, or any other family
member.
(3) When a qualified residential treatment program is the child's initial placement setting,
the responsible social services agency must engage with the child and the child's parents to
determine the appropriate family and permanency team members.
(4) When the permanency goal is to reunify the child with the child's parent or legal
guardian, the purpose of the relative search and focus of the family and permanency team
is to preserve family relationships and identify and develop supports for the child and parents.
(5) The responsible agency must make a good faith effort to identify and assemble all
appropriate individuals to be part of the child's family and permanency team and request
input from the parents regarding relative search efforts consistent with section 260C.221.
The out-of-home placement plan in section 260C.708 must include all contact information
for the team members, as well as contact information for family members or relatives who
are not a part of the family and permanency team.
(6) If the child is age 14 or older, the team must include members of the family and
permanency team that the child selects in accordance with section 260C.212, subdivision
1, paragraph (b).
(7) Consistent with section 260C.221, a responsible social services agency may disclose
relevant and appropriate private data about the child to relatives in order for the relatives
to participate in caring and planning for the child's placement.
(8) If the child is an Indian child under section 260.751, the responsible social services
agency must make active efforts to include the child's tribal representative on the family
and permanency team.
(b) The family and permanency team shall meet regarding the assessment required under
section 260C.704 to determine whether it is necessary and appropriate to place the child in
a qualified residential treatment program and to participate in case planning under section
260C.708.
(c) When reunification of the child with the child's parent or legal guardian is the
permanency plan, the family and permanency team shall support the parent-child relationship
by recognizing the parent's legal authority, consulting with the parent regarding ongoing
planning for the child, and assisting the parent with visiting and contacting the child.
(d) When the agency's permanency plan is to transfer the child's permanent legal and
physical custody to a relative or for the child's adoption, the team shall:
(1) coordinate with the proposed guardian to provide the child with educational services,
medical care, and dental care;
(2) coordinate with the proposed guardian, the agency, and the foster care facility to
meet the child's treatment needs after the child is placed in a permanent placement with the
proposed guardian;
(3) plan to meet the child's need for safety, stability, and connection with the child's
family and community after the child is placed in a permanent placement with the proposed
guardian; and
(4) in the case of an Indian child, communicate with the child's tribe to identify necessary
and appropriate services for the child, transition planning for the child, the child's treatment
needs, and how to maintain the child's connections to the child's community, family, and
tribe.
(e) The agency shall invite the family and permanency team to participate in case planning
and the agency shall give the team notice of court reviews under sections 260C.152 and
260C.221 until: (1) the child is reunited with the child's parents; or (2) the child's foster care
placement ends and the child is in a permanent placement.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective September 30, 2021.
new text end
Sec. 70.
Minnesota Statutes 2020, section 260C.708, is amended to read:
260C.708 OUT-OF-HOME PLACEMENT PLAN FOR QUALIFIED
RESIDENTIAL TREATMENT PROGRAM PLACEMENTS.
(a) When the responsible social services agency places a child in a qualified residential
treatment program as defined in section 260C.007, subdivision 26d, the out-of-home
placement plan must include:
(1) the case plan requirements in section deleted text begin 260.212, subdivision 1deleted text end new text begin 260C.212new text end ;
(2) the reasonable and good faith efforts of the responsible social services agency to
identify and include all of the individuals required to be on the child's family and permanency
team under section 260C.007;
(3) all contact information for members of the child's family and permanency team and
for other relatives who are not part of the family and permanency team;
(4) evidence that the agency scheduled meetings of the family and permanency team,
including meetings relating to the assessment required under section 260C.704, at a time
and place convenient for the family;
new text begin
(5) evidence that the family and permanency team is involved in the assessment required
under section 260C.704 to determine the appropriateness of the child's placement in a
qualified residential treatment program;
new text end
new text begin
(6) the family and permanency team's placement preferences for the child in the
assessment required under section 260C.704. When making a decision about the child's
placement preferences, the family and permanency team must recognize:
new text end
new text begin
(i) that the agency should place a child with the child's siblings unless a court finds that
placing a child with the child's siblings is contrary to the child's best interests; and
new text end
new text begin
(ii) that the agency should place an Indian child according to the requirements of the
Indian Child Welfare Act, the Minnesota Family Preservation Act under sections 260.751
to 260.835, and section 260C.193, subdivision 3, paragraph (g);
new text end
deleted text begin (5)deleted text end new text begin (7)new text end when reunification of the child with the child's parent or legal guardian is the
agency's goal, evidence demonstrating that the parent or legal guardian provided input about
the members of the family and permanency team under section 260C.706;
deleted text begin (6)deleted text end new text begin (8)new text end when the agency's permanency goal is to reunify the child with the child's parent
or legal guardian, the out-of-home placement plan must identify services and supports that
maintain the parent-child relationship and the parent's legal authority, decision-making, and
responsibility for ongoing planning for the child. In addition, the agency must assist the
parent with visiting and contacting the child;
deleted text begin (7)deleted text end new text begin (9)new text end when the agency's permanency goal is to transfer permanent legal and physical
custody of the child to a proposed guardian or to finalize the child's adoption, the case plan
must document the agency's steps to transfer permanent legal and physical custody of the
child or finalize adoption, as required in section 260C.212, subdivision 1, paragraph (c),
clauses (6) and (7); and
deleted text begin (8)deleted text end new text begin (10)new text end the qualified individual's recommendation regarding the child's placement in a
qualified residential treatment program and the court approval or disapproval of the placement
as required in section 260C.71.
(b) If the placement preferences of the family and permanency team, child, and tribe, if
applicable, are not consistent with the placement setting that the qualified individual
recommends, the case plan must include the reasons why the qualified individual did not
recommend following the preferences of the family and permanency team, child, and the
tribe.
(c) The agency must file the out-of-home placement plan with the court as part of the
60-day deleted text begin hearingdeleted text end new text begin court ordernew text end under section 260C.71.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective September 30, 2021.
new text end
Sec. 71.
Minnesota Statutes 2020, section 260C.71, is amended to read:
260C.71 COURT APPROVAL REQUIREMENTS.
new text begin Subdivision 1. new text end
new text begin Judicial review. new text end
new text begin
When the responsible social services agency has legal
authority to place a child at a qualified residential treatment facility under section 260C.007,
subdivision 21a, and the child's assessment under section 260C.704 recommends placing
the child in a qualified residential treatment facility, the agency shall place the child at a
qualified residential facility. Within 60 days of placing the child at a qualified residential
treatment facility, the agency must obtain a court order finding that the child's placement
is appropriate and meets the child's individualized needs.
new text end
new text begin Subd. 2. new text end
new text begin Qualified residential treatment program; agency report to court. new text end
new text begin
(a) The
responsible social services agency shall file a written report with the court within 35 days
of the date of the child's placement in a qualified residential treatment facility. The written
report shall contain or have attached:
new text end
new text begin
(1) the child's name, date of birth, race, gender, and current address;
new text end
new text begin
(2) the names, races, dates of birth, residence, and post office address of the child's
parents or legal custodian, or guardian;
new text end
new text begin
(3) the name and address of the qualified residential treatment program, including a
chief administrator of the facility;
new text end
new text begin
(4) a statement of the facts that necessitated the child's foster care placement;
new text end
new text begin
(5) the child's out-of-home placement plan under section 260C.212, subdivision 1,
including the requirements in section 260C.708;
new text end
new text begin
(6) if the child is placed in an out-of-state qualified residential treatment program, the
compelling reasons why the child's needs cannot be met by an in-state placement;
new text end
new text begin
(7) the qualified individual's assessment of the child under section 260C.704, paragraph
(c), in a format approved by the commissioner;
new text end
new text begin
(8) if, at the time required for the report under this subdivision, a child who is ten years
of age or older, a child's parent, the family and permanency team, or a tribe disagrees with
the recommended qualified residential treatment program placement, the agency shall
include information regarding the disagreement, and to the extent possible, the basis for the
disagreement in the report;
new text end
new text begin
(9) any other information that the responsible social services agency, child's parent, legal
custodian or guardian, child, or in the case of an Indian child, tribe would like the court to
consider; and
new text end
new text begin
(10) the agency shall file the written report with the court and serve on the parties a
request for a hearing or a court order without a hearing.
new text end
new text begin
(b) The agency must inform a child who is ten years of age or older and the child's parent
of the court review requirements of this section and the child and child's parent's right to
submit information to the court:
new text end
new text begin
(1) the agency must inform the child ten years of age or older and the child's parent of
the reporting date and the date by which the agency must receive information from the child
and child's parent so that the agency is able to submit the report required by this subdivision
to the court;
new text end
new text begin
(2) the agency must inform a child who is ten years of age or older and the child's parent
that the court will hold a hearing upon the request of the child or the child's parent; and
new text end
new text begin
(3) the agency must inform a child who is ten years of age or older and the child's parent
that they have the right to request a hearing and the right to present information to the court
for the court's review under this subdivision.
new text end
new text begin Subd. 3. new text end
new text begin Court hearing. new text end
new text begin
(a) The court shall hold a hearing when a party or a child who
is ten years of age or older requests a hearing.
new text end
new text begin
(b) In all other circumstances, the court has the discretion to hold a hearing or issue an
order without a hearing.
new text end
new text begin Subd. 4. new text end
new text begin Court findings and order. new text end
(a) Within 60 days from the beginning of each
placement in a qualified residential treatment programnew text begin when the qualified individual's
assessment of the child recommends placing the child in a qualified residential treatment
programnew text end , the court mustnew text begin consider the qualified individual's assessment of the child under
section 260C.704 and issue an order tonew text end :
deleted text begin
(1) consider the qualified individual's assessment of whether it is necessary and
appropriate to place the child in a qualified residential treatment program under section
260C.704;
deleted text end
deleted text begin (2)deleted text end new text begin (1)new text end determine whether a family foster home can meet the child's needs, whether it is
necessary and appropriate to place a child in a qualified residential treatment program that
is the least restrictive environment possible, and whether the child's placement is consistent
with the child's short and long term goals as specified in the permanency plan; and
deleted text begin (3)deleted text end new text begin (2)new text end approve or disapprove of the child's placement.
(b) deleted text begin In the out-of-home placement plan, the agency must document the court's approval
or disapproval of the placement, as specified in section 260C.708.deleted text end new text begin If the court disapproves
of the child's placement in a qualified residential treatment program, the responsible social
services agency shall: (1) remove the child from the qualified residential treatment program
within 30 days of the court's order; and (2) make a plan for the child's placement that is
consistent with the child's best interests under section 260C.212, subdivision 2.
new text end
new text begin Subd. 5. new text end
new text begin Court review and approval is not required. new text end
new text begin
When the responsible social
services agency has legal authority to place a child under section 260C.007, subdivision
21a, and the qualified individual's assessment of the child does not recommend placing the
child in a qualified residential treatment program, the court is not required to hold a hearing
and the court is not required to issue an order. Pursuant to section 260C.704, paragraph (f),
the responsible social services agency shall make a plan for the child's placement consistent
with the child's best interests under section 260C.212, subdivision 2. The agency must file
the agency's assessment determination for the child with the court at the next required
hearing.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective September 30, 2021.
new text end
Sec. 72.
Minnesota Statutes 2020, section 260C.712, is amended to read:
260C.712 ONGOING REVIEWS AND PERMANENCY HEARING
REQUIREMENTS.
As long as a child remains placed in a qualified residential treatment program, the
responsible social services agency shall submit evidence at each administrative review under
section 260C.203; each court review under sections 260C.202, 260C.203, deleted text begin anddeleted text end 260C.204new text begin ,
260D.06, 260D.07, and 260D.08new text end ; and each permanency hearing under section 260C.515,
260C.519, deleted text begin ordeleted text end 260C.521,new text begin or 260D.07new text end that:
(1) demonstrates that an ongoing assessment of the strengths and needs of the child
continues to support the determination that the child's needs cannot be met through placement
in a family foster home;
(2) demonstrates that the placement of the child in a qualified residential treatment
program provides the most effective and appropriate level of care for the child in the least
restrictive environment;
(3) demonstrates how the placement is consistent with the short-term and long-term
goals for the child, as specified in the child's permanency plan;
(4) documents how the child's specific treatment or service needs will be met in the
placement;
(5) documents the length of time that the agency expects the child to need treatment or
services; deleted text begin and
deleted text end
(6) documents the responsible social services agency's efforts to prepare the child to
return home or to be placed with a fit and willing relative, legal guardian, adoptive parent,
or foster familydeleted text begin .deleted text end new text begin ; and
new text end
new text begin
(7) if the child is placed in a qualified residential treatment program out-of-state, the
compelling reasons for placing the child out-of-state and the reasons that the child's needs
cannot be met by an in-state placement.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective September 30, 2021.
new text end
Sec. 73.
Minnesota Statutes 2020, section 260C.714, is amended to read:
260C.714 REVIEW OF EXTENDED QUALIFIED RESIDENTIAL TREATMENT
PROGRAM PLACEMENTS.
(a) When a responsible social services agency places a child in a qualified residential
treatment program for more than 12 consecutive months or 18 nonconsecutive months or,
in the case of a child who is under 13 years of age, for more than six consecutive or
nonconsecutive months, the agency must submit: (1) the signed approval by the county
social services director of the responsible social services agency; and (2) the evidence
supporting the child's placement at the most recent court review or permanency hearing
under section 260C.712deleted text begin , paragraph (b)deleted text end .
(b) The commissioner shall specify the procedures and requirements for the agency's
review and approval of a child's extended qualified residential treatment program placement.
The commissioner may consult with counties, tribes, child-placing agencies, mental health
providers, licensed facilities, the child, the child's parents, and the family and permanency
team members to develop case plan requirements and engage in periodic reviews of the
case plan.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective September 30, 2021.
new text end
Sec. 74.
Minnesota Statutes 2020, section 260D.01, is amended to read:
260D.01 CHILD IN VOLUNTARY FOSTER CARE FOR TREATMENT.
(a) Sections 260D.01 to 260D.10, may be cited as the "child in voluntary foster care for
treatment" provisions of the Juvenile Court Act.
(b) The juvenile court has original and exclusive jurisdiction over a child in voluntary
foster care for treatment upon the filing of a report or petition required under this chapter.
All obligations of thenew text begin responsible social servicesnew text end agency to a child and family in foster care
contained in chapter 260C not inconsistent with this chapter are also obligations of the
agency with regard to a child in foster care for treatment under this chapter.
(c) This chapter shall be construed consistently with the mission of the children's mental
health service system as set out in section 245.487, subdivision 3, and the duties of an agency
under sections 256B.092 and 260C.157 and Minnesota Rules, parts 9525.0004 to 9525.0016,
to meet the needs of a child with a developmental disability or related condition. This
chapter:
(1) establishes voluntary foster care through a voluntary foster care agreement as the
means for an agency and a parent to provide needed treatment when the child must be in
foster care to receive necessary treatment for an emotional disturbance or developmental
disability or related condition;
(2) establishes court review requirements for a child in voluntary foster care for treatment
due to emotional disturbance or developmental disability or a related condition;
(3) establishes the ongoing responsibility of the parent as legal custodian to visit the
child, to plan together with the agency for the child's treatment needs, to be available and
accessible to the agency to make treatment decisions, and to obtain necessary medical,
dental, and other care for the child; deleted text begin and
deleted text end
(4) applies to voluntary foster care when the child's parent and the agency agree that the
child's treatment needs require foster care either:
(i) due to a level of care determination by the agency's screening team informed by thenew text begin
child'snew text end diagnostic and functional assessment under section 245.4885; or
(ii) due to a determination regarding the level of services needed bynew text begin the child bynew text end the
responsible social deleted text begin services'deleted text end new text begin services agency'snew text end screening team under section 256B.092, and
Minnesota Rules, parts 9525.0004 to 9525.0016deleted text begin .deleted text end new text begin ; and
new text end
new text begin
(5) includes the requirements for a child's placement in sections 260C.70 to 260C.714,
when the juvenile treatment screening team recommends placing a child in a qualified
residential treatment program.
new text end
(d) This chapter does not apply when there is a current determination under chapter
260E that the child requires child protective services or when the child is in foster care for
any reason other than treatment for the child's emotional disturbance or developmental
disability or related condition. When there is a determination under chapter 260E that the
child requires child protective services based on an assessment that there are safety and risk
issues for the child that have not been mitigated through the parent's engagement in services
or otherwise, or when the child is in foster care for any reason other than the child's emotional
disturbance or developmental disability or related condition, the provisions of chapter 260C
apply.
(e) The paramount consideration in all proceedings concerning a child in voluntary foster
care for treatment is the safety, health, and the best interests of the child. The purpose of
this chapter is:
(1) to ensurenew text begin thatnew text end a child with a disability is provided the services necessary to treat or
ameliorate the symptoms of the child's disability;
(2) to preserve and strengthen the child's family ties whenever possible and in the child's
best interests, approving the child's placement away from the child's parents only when the
child's need for care or treatment requires deleted text begin itdeleted text end new text begin out-of-home placementnew text end and the child cannot
be maintained in the home of the parent; and
(3) to ensurenew text begin thatnew text end the child's parent retains legal custody of the child and associated
decision-making authority unless the child's parent willfully fails or is unable to make
decisions that meet the child's safety, health, and best interests. The court may not find that
the parent willfully fails or is unable to make decisions that meet the child's needs solely
because the parent disagrees with the agency's choice of foster care facility, unless the
agency files a petition under chapter 260C, and establishes by clear and convincing evidence
that the child is in need of protection or services.
(f) The legal parent-child relationship shall be supported under this chapter by maintaining
the parent's legal authority and responsibility for ongoing planning for the child and by the
agency's assisting the parent, deleted text begin wheredeleted text end new text begin whennew text end necessary, to exercise the parent's ongoing right
and obligation to visit or to have reasonable contact with the child. Ongoing planning means:
(1) actively participating in the planning and provision of educational services, medical,
and dental care for the child;
(2) actively planning and participating with the agency and the foster care facility for
the child's treatment needs; deleted text begin and
deleted text end
(3) planning to meet the child's need for safety, stability, and permanency, and the child's
need to stay connected to the child's family and communitydeleted text begin .deleted text end new text begin ; and
new text end
new text begin
(4) engaging with the responsible social services agency to ensure that the family and
permanency team under section 260C.706 consists of appropriate family members and if
applicable, expressing concerns about any individual on the team. The responsible social
services agency must make efforts to contact and engage with the child's parent when
assembling the family and permanency team and must address all of the child's parent's
concerns to the extent possible.
new text end
(g) The provisions of section 260.012 to ensure placement prevention, family
reunification, and all active and reasonable effort requirements of that section apply. This
chapter shall be construed consistently with the requirements of the Indian Child Welfare
Act of 1978, United States Code, title 25, section 1901, et al., and the provisions of the
Minnesota Indian Family Preservation Act, sections 260.751 to 260.835.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective September 30, 2021.
new text end
Sec. 75.
Minnesota Statutes 2020, section 260D.05, is amended to read:
260D.05 ADMINISTRATIVE REVIEW OF CHILD IN VOLUNTARY FOSTER
CARE FOR TREATMENT.
The administrative reviews required under section 260C.203 must be conducted for a
child in voluntary foster care for treatment, except that the initial administrative review
must take place prior to the submission of the report to the court required under section
260D.06, subdivision 2.new text begin When a child is placed in a qualified residential treatment program
as defined in section 260C.007, subdivision 26d, the responsible social services agency
must submit evidence to the court as specified in section 260C.712.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective September 30, 2021.
new text end
Sec. 76.
Minnesota Statutes 2020, section 260D.06, subdivision 2, is amended to read:
Subd. 2.
Agency report to court; court review.
The agency shall obtain judicial review
by reporting to the court according to the following procedures:
(a) A written report shall be forwarded to the court within 165 days of the date of the
voluntary placement agreement. The written report shall contain or have attached:
(1) a statement of facts that necessitate the child's foster care placement;
(2) the child's name, date of birth, race, gender, and current address;
(3) the names, race, date of birth, residence, and post office addresses of the child's
parents or legal custodian;
(4) a statement regarding the child's eligibility for membership or enrollment in an Indian
tribe and the agency's compliance with applicable provisions of sections 260.751 to 260.835;
(5) the names and addresses of the foster parents or chief administrator of the facility in
which the child is placed, if the child is not in a family foster home or group home;
(6) a copy of the out-of-home placement plan required under section 260C.212,
subdivision 1;
(7) a written summary of the proceedings of any administrative review required under
section 260C.203; deleted text begin and
deleted text end
(8) new text begin evidence as specified in section 260C.712 when a child is placed in a qualified
residential treatment program as defined in section 260C.007, subdivision 26d; and
new text end
new text begin (9) new text end any other information the agency, parent or legal custodian, the child or the foster
parent, or other residential facility wants the court to consider.
(b) In the case of a child in placement due to emotional disturbance, the written report
shall include as an attachment, the child's individual treatment plan developed by the child's
treatment professional, as provided in section 245.4871, subdivision 21, or the child's
standard written plan, as provided in section 125A.023, subdivision 3, paragraph (e).
(c) In the case of a child in placement due to developmental disability or a related
condition, the written report shall include as an attachment, the child's individual service
plan, as provided in section 256B.092, subdivision 1b; the child's individual program plan,
as provided in Minnesota Rules, part 9525.0004, subpart 11; the child's waiver care plan;
or the child's standard written plan, as provided in section 125A.023, subdivision 3, paragraph
(e).
(d) The agency must inform the child, age 12 or older, the child's parent, and the foster
parent or foster care facility of the reporting and court review requirements of this section
and of their right to submit information to the court:
(1) if the child or the child's parent or the foster care provider wants to send information
to the court, the agency shall advise those persons of the reporting date and the date by
which the agency must receive the information they want forwarded to the court so the
agency is timely able submit it with the agency's report required under this subdivision;
(2) the agency must also inform the child, age 12 or older, the child's parent, and the
foster care facility that they have the right to be heard in person by the court and how to
exercise that right;
(3) the agency must also inform the child, age 12 or older, the child's parent, and the
foster care provider that an in-court hearing will be held if requested by the child, the parent,
or the foster care provider; and
(4) if, at the time required for the report under this section, a child, age 12 or older,
disagrees about the foster care facility or services provided under the out-of-home placement
plan required under section 260C.212, subdivision 1, the agency shall include information
regarding the child's disagreement, and to the extent possible, the basis for the child's
disagreement in the report required under this section.
(e) After receiving the required report, the court has jurisdiction to make the following
determinations and must do so within ten days of receiving the forwarded report, whether
a hearing is requested:
(1) whether the voluntary foster care arrangement is in the child's best interests;
(2) whether the parent and agency are appropriately planning for the child; and
(3) in the case of a child age 12 or older, who disagrees with the foster care facility or
services provided under the out-of-home placement plan, whether it is appropriate to appoint
counsel and a guardian ad litem for the child using standards and procedures under section
260C.163.
(f) Unless requested by a parent, representative of the foster care facility, or the child,
no in-court hearing is required in order for the court to make findings and issue an order as
required in paragraph (e).
(g) If the court finds the voluntary foster care arrangement is in the child's best interests
and that the agency and parent are appropriately planning for the child, the court shall issue
an order containing explicit, individualized findings to support its determination. The
individualized findings shall be based on the agency's written report and other materials
submitted to the court. The court may make this determination notwithstanding the child's
disagreement, if any, reported under paragraph (d).
(h) The court shall send a copy of the order to the county attorney, the agency, parent,
child, age 12 or older, and the foster parent or foster care facility.
(i) The court shall also send the parent, the child, age 12 or older, the foster parent, or
representative of the foster care facility notice of the permanency review hearing required
under section 260D.07, paragraph (e).
(j) If the court finds continuing the voluntary foster care arrangement is not in the child's
best interests or that the agency or the parent are not appropriately planning for the child,
the court shall notify the agency, the parent, the foster parent or foster care facility, the child,
age 12 or older, and the county attorney of the court's determinations and the basis for the
court's determinations. In this case, the court shall set the matter for hearing and appoint a
guardian ad litem for the child under section 260C.163, subdivision 5.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective September 30, 2021.
new text end
Sec. 77.
Minnesota Statutes 2020, section 260D.07, is amended to read:
260D.07 REQUIRED PERMANENCY REVIEW HEARING.
(a) When the court has found that the voluntary arrangement is in the child's best interests
and that the agency and parent are appropriately planning for the child pursuant to the report
submitted under section 260D.06, and the child continues in voluntary foster care as defined
in section 260D.02, subdivision 10, for 13 months from the date of the voluntary foster care
agreement, or has been in placement for 15 of the last 22 months, the agency must:
(1) terminate the voluntary foster care agreement and return the child home; or
(2) determine whether there are compelling reasons to continue the voluntary foster care
arrangement and, if the agency determines there are compelling reasons, seek judicial
approval of its determination; or
(3) file a petition for the termination of parental rights.
(b) When the agency is asking for the court's approval of its determination that there are
compelling reasons to continue the child in the voluntary foster care arrangement, the agency
shall file a "Petition for Permanency Review Regarding a Child in Voluntary Foster Care
for Treatment" and ask the court to proceed under this section.
(c) The "Petition for Permanency Review Regarding a Child in Voluntary Foster Care
for Treatment" shall be drafted or approved by the county attorney and be under oath. The
petition shall include:
(1) the date of the voluntary placement agreement;
(2) whether the petition is due to the child's developmental disability or emotional
disturbance;
(3) the plan for the ongoing care of the child and the parent's participation in the plan;
(4) a description of the parent's visitation and contact with the child;
(5) the date of the court finding that the foster care placement was in the best interests
of the child, if required under section 260D.06, or the date the agency filed the motion under
section 260D.09, paragraph (b);
(6) the agency's reasonable efforts to finalize the permanent plan for the child, including
returning the child to the care of the child's family; deleted text begin and
deleted text end
(7) a citation to this chapter as the basis for the petitiondeleted text begin .deleted text end new text begin ; and
new text end
new text begin
(8) evidence as specified in section 260C.712 when a child is placed in a qualified
residential treatment program as defined in section 260C.007, subdivision 26d.
new text end
(d) An updated copy of the out-of-home placement plan required under section 260C.212,
subdivision 1, shall be filed with the petition.
(e) The court shall set the date for the permanency review hearing no later than 14 months
after the child has been in placement or within 30 days of the petition filing date when the
child has been in placement 15 of the last 22 months. The court shall serve the petition
together with a notice of hearing by United States mail on the parent, the child age 12 or
older, the child's guardian ad litem, if one has been appointed, the agency, the county
attorney, and counsel for any party.
(f) The court shall conduct the permanency review hearing on the petition no later than
14 months after the date of the voluntary placement agreement, within 30 days of the filing
of the petition when the child has been in placement 15 of the last 22 months, or within 15
days of a motion to terminate jurisdiction and to dismiss an order for foster care under
chapter 260C, as provided in section 260D.09, paragraph (b).
(g) At the permanency review hearing, the court shall:
(1) inquire of the parent if the parent has reviewed the "Petition for Permanency Review
Regarding a Child in Voluntary Foster Care for Treatment," whether the petition is accurate,
and whether the parent agrees to the continued voluntary foster care arrangement as being
in the child's best interests;
(2) inquire of the parent if the parent is satisfied with the agency's reasonable efforts to
finalize the permanent plan for the child, including whether there are services available and
accessible to the parent that might allow the child to safely be with the child's family;
(3) inquire of the parent if the parent consents to the court entering an order that:
(i) approves the responsible agency's reasonable efforts to finalize the permanent plan
for the child, which includes ongoing future planning for the safety, health, and best interests
of the child; and
(ii) approves the responsible agency's determination that there are compelling reasons
why the continued voluntary foster care arrangement is in the child's best interests; and
(4) inquire of the child's guardian ad litem and any other party whether the guardian or
the party agrees that:
(i) the court should approve the responsible agency's reasonable efforts to finalize the
permanent plan for the child, which includes ongoing and future planning for the safety,
health, and best interests of the child; and
(ii) the court should approve of the responsible agency's determination that there are
compelling reasons why the continued voluntary foster care arrangement is in the child's
best interests.
(h) At a permanency review hearing under this section, the court may take the following
actions based on the contents of the sworn petition and the consent of the parent:
(1) approve the agency's compelling reasons that the voluntary foster care arrangement
is in the best interests of the child; and
(2) find that the agency has made reasonable efforts to finalize the permanent plan for
the child.
(i) A child, age 12 or older, may object to the agency's request that the court approve its
compelling reasons for the continued voluntary arrangement and may be heard on the reasons
for the objection. Notwithstanding the child's objection, the court may approve the agency's
compelling reasons and the voluntary arrangement.
(j) If the court does not approve the voluntary arrangement after hearing from the child
or the child's guardian ad litem, the court shall dismiss the petition. In this case, either:
(1) the child must be returned to the care of the parent; or
(2) the agency must file a petition under section 260C.141, asking for appropriate relief
under sections 260C.301 or 260C.503 to 260C.521.
(k) When the court approves the agency's compelling reasons for the child to continue
in voluntary foster care for treatment, and finds that the agency has made reasonable efforts
to finalize a permanent plan for the child, the court shall approve the continued voluntary
foster care arrangement, and continue the matter under the court's jurisdiction for the purposes
of reviewing the child's placement every 12 months while the child is in foster care.
(l) A finding that the court approves the continued voluntary placement means the agency
has continued legal authority to place the child while a voluntary placement agreement
remains in effect. The parent or the agency may terminate a voluntary agreement as provided
in section 260D.10. Termination of a voluntary foster care placement of an Indian child is
governed by section 260.765, subdivision 4.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective September 30, 2021.
new text end
Sec. 78.
Minnesota Statutes 2020, section 260D.08, is amended to read:
260D.08 ANNUAL REVIEW.
(a) After the court conducts a permanency review hearing under section 260D.07, the
matter must be returned to the court for further review of the responsible social services
reasonable efforts to finalize the permanent plan for the child and the child's foster care
placement at least every 12 months while the child is in foster care. The court shall give
notice to the parent and child, age 12 or older, and the foster parents of the continued review
requirements under this section at the permanency review hearing.
(b) Every 12 months, the court shall determine whether the agency made reasonable
efforts to finalize the permanency plan for the child, which means the exercise of due
diligence by the agency to:
(1) ensure that the agreement for voluntary foster care is the most appropriate legal
arrangement to meet the child's safety, health, and best interests and to conduct a genuine
examination of whether there is another permanency disposition order under chapter 260C,
including returning the child home, that would better serve the child's need for a stable and
permanent home;
(2) engage and support the parent in continued involvement in planning and decision
making for the needs of the child;
(3) strengthen the child's ties to the parent, relatives, and community;
(4) implement the out-of-home placement plan required under section 260C.212,
subdivision 1, and ensure that the plan requires the provision of appropriate services to
address the physical health, mental health, and educational needs of the child; deleted text begin and
deleted text end
new text begin
(5) submit evidence to the court as specified in section 260C.712 when a child is placed
in a qualified residential treatment program setting as defined in section 260C.007,
subdivision 26d; and
new text end
deleted text begin (5)deleted text end new text begin (6)new text end ensure appropriate planning for the child's safe, permanent, and independent
living arrangement after the child's 18th birthday.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective September 30, 2021.
new text end
Sec. 79.
Minnesota Statutes 2020, section 260D.14, is amended to read:
260D.14 SUCCESSFUL TRANSITION TO ADULTHOOD FOR deleted text begin CHILDRENdeleted text end new text begin
YOUTHnew text end IN VOLUNTARY PLACEMENT.
Subdivision 1.
Case planning.
When deleted text begin the childdeleted text end new text begin a youthnew text end is 14 years of age or older, the
responsible social services agency shall ensurenew text begin thatnew text end a deleted text begin childdeleted text end new text begin youthnew text end in foster care under this
chapter is provided with the case plan requirements in section 260C.212, subdivisions 1
and 14.
Subd. 2.
Notification.
The responsible social services agency shall providenew text begin a youth withnew text end
written notice of deleted text begin the right to continued access to services for certain children in foster care
past 18 years of age under section 260C.452, subdivision 3deleted text end new text begin foster care benefits that a youth
who is 18 years of age or older may continue to receive according to section 260C.451,
subdivision 1new text end , and of the right to appeal a denial of social services under section 256.045.
The notice must be provided to the deleted text begin childdeleted text end new text begin youthnew text end six months before the deleted text begin child'sdeleted text end new text begin youth'snew text end 18th
birthday.
Subd. 3.
Administrative or court reviews.
When deleted text begin the childdeleted text end new text begin a youthnew text end is deleted text begin 17deleted text end new text begin 14new text end years of
age or older, the administrative review or court hearing must include a review of the
responsible social services agency's support for the deleted text begin child'sdeleted text end new text begin youth'snew text end successful transition to
adulthood as required in section 260C.452, subdivision 4.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2021.
new text end
Sec. 80.
Minnesota Statutes 2020, section 260E.36, is amended by adding a subdivision
to read:
new text begin Subd. 1b. new text end
new text begin Sex trafficking and sexual exploitation training requirement. new text end
new text begin
As required
by the Child Abuse Prevention and Treatment Act amendments through Public Law 114-22
and to implement Public Law 115-123, all child protection social workers and social services
staff who have responsibility for child protective duties under this chapter or chapter 260C
shall complete training implemented by the commissioner of human services regarding sex
trafficking and sexual exploitation of children and youth.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2021.
new text end
Sec. 81.
new text begin
[518A.80] MOTION TO TRANSFER TO TRIBAL COURT.
new text end
new text begin Subdivision 1. new text end
new text begin Definitions. new text end
new text begin
(a) For purposes of this section, the terms defined in this
subdivision have the meanings given.
new text end
new text begin
(b) "Case participant" means a person who is a party to the case.
new text end
new text begin
(c) "District court" means a district court of the state of Minnesota.
new text end
new text begin
(d) "Party" means a person or entity named or admitted as a party or seeking to be
admitted as a party in the district court action, including the county IV-D agency, regardless
of whether the person or entity is named in the caption.
new text end
new text begin
(e) "Tribal court" means a tribal court of a federally recognized Indian tribe located in
Minnesota that is receiving funding from the federal government to operate a child support
program under United States Code, title 42, chapter 7, subchapter IV, part D, sections 654
to 669b.
new text end
new text begin
(f) "Tribal IV-D agency" has the meaning given in Code of Federal Regulations, title
45, part 309.05.
new text end
new text begin
(g) "Title IV-D child support case" has the meaning given in section 518A.26, subdivision
10.
new text end
new text begin Subd. 2. new text end
new text begin Actions eligible for transfer. new text end
new text begin
Under this section, a postjudgment child support,
custody, or parenting time action is eligible for transfer to a tribal court. This section does
not apply to a child protection action or a dissolution action involving a child.
new text end
new text begin Subd. 3. new text end
new text begin Motion to transfer. new text end
new text begin
(a) A party's or tribal IV-D agency's motion to transfer a
child support, custody, or parenting time action to a tribal court shall include:
new text end
new text begin
(1) the address of each case participant;
new text end
new text begin
(2) the tribal affiliation of each case participant, if applicable;
new text end
new text begin
(3) the name, tribal affiliation if applicable, and date of birth of each living minor or
dependent child of a case participant who is subject to the action; and
new text end
new text begin
(4) the legal and factual basis for the court to find that the district court and a tribal court
have concurrent jurisdiction in the case.
new text end
new text begin
(b) A party or tribal IV-D agency bringing a motion to transfer a child support, custody,
or parenting time action to a tribal court must file the motion with the district court and
serve the required documents on each party and the tribal IV-D agency, regardless of whether
the tribal IV-D agency is a party to the action.
new text end
new text begin
(c) A party's or tribal IV-D agency's motion to transfer a child support, custody, or
parenting time action to a tribal court must be accompanied by an affidavit setting forth
facts in support of the motion.
new text end
new text begin
(d) When a party other than the tribal IV-D agency has filed a motion to transfer a child
support, custody, or parenting time action to a tribal court, an affidavit of the tribal IV-D
agency stating whether the tribal IV-D agency provides services to a party must be filed
and served on each party within 15 days from the date of service of the motion to transfer
the action.
new text end
new text begin Subd. 4. new text end
new text begin Order to transfer to tribal court. new text end
new text begin
(a) Unless a district court holds a hearing
under subdivision 6, upon motion of a party or a tribal IV-D agency, a district court must
transfer a postjudgment child support, custody, or parenting time action to a tribal court
when the district court finds that:
new text end
new text begin
(1) the district court and tribal court have concurrent jurisdiction of the action;
new text end
new text begin
(2) a case participant in the action is receiving services from the tribal IV-D agency; and
new text end
new text begin
(3) no party or tribal IV-D agency files and serves a timely objection to transferring the
action to a tribal court.
new text end
new text begin
(b) When the district court finds that each requirement of this subdivision is satisfied,
the district court is not required to hold a hearing on the motion to transfer the action to a
tribal court. The district court's order transferring the action to a tribal court must include
written findings that describe how each requirement of this subdivision is met.
new text end
new text begin Subd. 5. new text end
new text begin Objection to motion to transfer. new text end
new text begin
(a) To object to a motion to transfer a child
support, custody, or parenting time action to a tribal court, a party or tribal IV-D agency
must file with the court and serve on each party and the tribal IV-D agency a responsive
motion objecting to the motion to transfer within 30 days of the motion to transfer's date of
service.
new text end
new text begin
(b) If a party or tribal IV-D agency files with the district court and properly serves a
timely objection to the motion to transfer a child support, custody, or parenting time action
to a tribal court, the district court must hold a hearing on the motion.
new text end
new text begin Subd. 6. new text end
new text begin Hearing. new text end
new text begin
If a district court holds a hearing under this section, the district court
must evaluate and make written findings about all relevant factors, including:
new text end
new text begin
(1) whether an issue requires interpretation of tribal law, including the tribal constitution,
statutes, bylaws, ordinances, resolutions, treaties, or case law;
new text end
new text begin
(2) whether the action involves tribal traditional or cultural matters;
new text end
new text begin
(3) whether the tribe is a party to the action;
new text end
new text begin
(4) whether tribal sovereignty, jurisdiction, or territory is an issue in the action;
new text end
new text begin
(5) the tribal membership status of each case participant in the action;
new text end
new text begin
(6) where the claim arises that forms the basis of the action;
new text end
new text begin
(7) the location of the residence of each case participant in the action and each child
who is a subject of the action;
new text end
new text begin
(8) whether the parties have by contract chosen a forum or the law to be applied in the
event of a dispute;
new text end
new text begin
(9) the timing of any motion to transfer the action to a tribal court, each party's
expenditure of time and resources, the court's expenditure of time and resources, and the
district court's scheduling order;
new text end
new text begin
(10) which court will hear and decide the action more expeditiously;
new text end
new text begin
(11) the burden on each party if the court transfers the action to a tribal court, including
costs, access to and admissibility of evidence, and matters of procedure; and
new text end
new text begin
(12) any other factor that the court determines to be relevant.
new text end
new text begin Subd. 7. new text end
new text begin Future exercise of jurisdiction. new text end
new text begin
Nothing in this section shall be construed to
limit the district court's exercise of jurisdiction when the tribal court waives jurisdiction,
transfers the action back to district court, or otherwise declines to exercise jurisdiction over
the action.
new text end
new text begin Subd. 8. new text end
new text begin Transfer to Red Lake Nation Tribal Court. new text end
new text begin
When a party or tribal IV-D
agency brings a motion to transfer a child support, custody, or parenting time action to the
Red Lake Nation Tribal Court, the court must transfer the action to the Red Lake Nation
Tribal Court if the case participants and child resided within the boundaries of the Red Lake
Reservation for six months preceding the motion to transfer the action to the Red Lake
Nation Tribal Court.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 82.
Laws 2014, chapter 150, article 4, section 6, is amended to read:
Sec. 6. SUPPLEMENTAL deleted text begin COUNTY PROGRAMdeleted text end AID PAYMENTS.
(a) Before the money appropriated to county need aid is apportioned among the counties,
as provided in Minnesota Statutes, section 477A.0124, subdivision 3, for aids payable in
2015 through deleted text begin 2024deleted text end new text begin 2019new text end only, the total aid paid to Beltrami County shall be increased by
$3,000,000.new text begin For aids payable in 2020 through 2024, the total aid paid to Beltrami County
under Minnesota Statutes, section 477A.0126, shall be increased by $3,000,000.new text end The
increased aid shall be used for out-of-home placement costs.new text begin When the commissioner of
human services certifies to the commissioner of revenue that the Red Lake Nation has
assumed child welfare responsibilities under Minnesota Statutes, section 256.01, subdivision
14b, for Red Lake members on the reservation for any years remaining through aids payable
in 2024, the increased aid shall be paid annually to the Red Lake Nation as part of the
reimbursement amount received under Minnesota Statutes, section 477A.0126. If the
certification by the commissioner of human services to the commissioner of revenue is
received after June 1 of any aids payable year, the commissioner of revenue shall pay
Beltrami County the increased aid under this section, and the county treasurer of Beltrami
County must transfer the increased aid to the Red Lake Nation by January 31 of the following
aids payable year in the amount proportional to the calendar months that the Red Lake
Nation had assumed child welfare responsibilities under Minnesota Statutes, section 256.01,
subdivision 14b.
new text end
(b) Before the money appropriated to county need aid is apportioned among the counties,
as provided in Minnesota Statutes, section 477A.0124, subdivision 3, for aids payable in
2015 only, the total aid paid to Mahnomen County shall be increased by $1,500,000. Of
this amount, $750,000 shall be paid from Mahnomen County to the White Earth Band of
Ojibwe for transition costs associated with health and human services.
(c) new text begin For aids payable in 2015 through 2019, new text end the increased aid under this section shall be
paid in the same manner and at the same time as the regular aid payments under Minnesota
Statutes, section 477A.0124.new text begin For aids payable in 2020 through 2024, the increased aid under
this section shall be paid in the same manner and at the same time as the regular aid payments
under Minnesota Statutes, section 477A.0126.
new text end
(d) For aids payable in 2015 only, the total aid paid to counties under Minnesota Statutes,
section 477A.03, subdivision 2b, paragraph (a), is $105,295,000
(e) For aids payable in 2016 through deleted text begin 2024deleted text end new text begin 2019new text end only, the total aid paid to counties under
Minnesota Statutes, section 477A.03, subdivision 2b, paragraph (a), is $103,795,000.new text begin For
aids payable in 2020 through 2024, the total aid paid to counties and tribes under Minnesota
Statutes, section 477A.0126, subdivision 7, paragraph (a), is $8,000,000.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective for aids payable in 2020 through 2024.
new text end
Sec. 83. new text begin REPEALER.
new text end
new text begin
(a)
new text end
new text begin
Minnesota Statutes 2020, sections 119B.04; and 119B.125, subdivision 5,
new text end
new text begin
are repealed.
new text end
new text begin
(b)
new text end
new text begin
Minnesota Statutes 2020, section 259A.70,
new text end
new text begin
is repealed.
new text end
ARTICLE 3
COMMUNITY SUPPORTS
Section 1.
Minnesota Statutes 2020, section 245.4874, subdivision 1, is amended to read:
Subdivision 1.
Duties of county board.
(a) The county board must:
(1) develop a system of affordable and locally available children's mental health services
according to sections 245.487 to 245.4889;
(2) consider the assessment of unmet needs in the county as reported by the local
children's mental health advisory council under section 245.4875, subdivision 5, paragraph
(b), clause (3). The county shall provide, upon request of the local children's mental health
advisory council, readily available data to assist in the determination of unmet needs;
(3) assure that parents and providers in the county receive information about how to
gain access to services provided according to sections 245.487 to 245.4889;
(4) coordinate the delivery of children's mental health services with services provided
by social services, education, corrections, health, and vocational agencies to improve the
availability of mental health services to children and the cost-effectiveness of their delivery;
(5) assure that mental health services delivered according to sections 245.487 to 245.4889
are delivered expeditiously and are appropriate to the child's diagnostic assessment and
individual treatment plan;
(6) provide for case management services to each child with severe emotional disturbance
according to sections 245.486; 245.4871, subdivisions 3 and 4; and 245.4881, subdivisions
1, 3, and 5;
(7) provide for screening of each child under section 245.4885 upon admission to a
residential treatment facility, acute care hospital inpatient treatment, or informal admission
to a regional treatment center;
(8) prudently administer grants and purchase-of-service contracts that the county board
determines are necessary to fulfill its responsibilities under sections 245.487 to 245.4889;
(9) assure that mental health professionals, mental health practitioners, and case managers
employed by or under contract to the county to provide mental health services are qualified
under section 245.4871;
(10) assure that children's mental health services are coordinated with adult mental health
services specified in sections 245.461 to 245.486 so that a continuum of mental health
services is available to serve persons with mental illness, regardless of the person's age;
(11) assure that culturally competent mental health consultants are used as necessary to
assist the county board in assessing and providing appropriate treatment for children of
cultural or racial minority heritage; and
(12) consistent with section 245.486, arrange for or provide a children's mental health
screening for:
(i) a child receiving child protective services;
(ii) a child in out-of-home placement;
(iii) a child for whom parental rights have been terminated;
(iv) a child found to be delinquent; or
(v) a child found to have committed a juvenile petty offense for the third or subsequent
time.
A children's mental health screening is not required when a screening or diagnostic
assessment has been performed within the previous 180 days, or the child is currently under
the care of a mental health professional.
(b) When a child is receiving protective services or is in out-of-home placement, the
court or county agency must notify a parent or guardian whose parental rights have not been
terminated of the potential mental health screening and the option to prevent the screening
by notifying the court or county agency in writing.
(c) When a child is found to be delinquent or a child is found to have committed a
juvenile petty offense for the third or subsequent time, the court or county agency must
obtain written informed consent from the parent or legal guardian before a screening is
conducted unless the court, notwithstanding the parent's failure to consent, determines that
the screening is in the child's best interest.
(d) The screening shall be conducted with a screening instrument approved by the
commissioner of human services according to criteria that are updated and issued annually
to ensure that approved screening instruments are valid and useful for child welfare and
juvenile justice populations. Screenings shall be conducted by a mental health practitioner
as defined in section 245.4871, subdivision 26, or a probation officer or local social services
agency staff person who is trained in the use of the screening instrument. Training in the
use of the instrument shall include:
(1) training in the administration of the instrument;
(2) the interpretation of its validity given the child's current circumstances;
(3) the state and federal data practices laws and confidentiality standards;
(4) the parental consent requirement; and
(5) providing respect for families and cultural values.
If the screen indicates a need for assessment, the child's family, or if the family lacks
mental health insurance, the local social services agency, in consultation with the child's
family, shall have conducted a diagnostic assessment, including a functional assessment.
The administration of the screening shall safeguard the privacy of children receiving the
screening and their families and shall comply with the Minnesota Government Data Practices
Act, chapter 13, and the federal Health Insurance Portability and Accountability Act of
1996, Public Law 104-191. Screening results shall be considered private data deleted text begin and the
commissioner shall not collect individual screening resultsdeleted text end .new text begin The commissioner may collect
individual screening results for the purposes of program evaluation and improvement.
new text end
(e) When the county board refers clients to providers of children's therapeutic services
and supports under section 256B.0943, the county board must clearly identify the desired
services components not covered under section 256B.0943 and identify the reimbursement
source for those requested services, the method of payment, and the payment rate to the
provider.
Sec. 2.
Minnesota Statutes 2020, section 245.697, subdivision 1, is amended to read:
Subdivision 1.
Creation.
(a) A State Advisory Council on Mental Health is created. The
council must have members appointed by the governor in accordance with federal
requirements. In making the appointments, the governor shall consider appropriate
representation of communities of color. The council must be composed of:
(1) the assistant commissioner of mental health for the department of human services;
(2) a representative of the Department of Human Services responsible for the medical
assistance program;
new text begin
(3) a representative of the Department of Health;
new text end
deleted text begin (3)deleted text end new text begin (4)new text end one member of each of the following professions:
(i) psychiatry;
(ii) psychology;
(iii) social work;
(iv) nursing;
(v) marriage and family therapy; and
(vi) professional clinical counseling;
deleted text begin (4)deleted text end new text begin (5)new text end one representative from each of the following advocacy groups: Mental Health
Association of Minnesota, NAMI-MN, deleted text begin Mental Health Consumer/Survivor Network of
Minnesota, anddeleted text end Minnesota Disability Law Centernew text begin , American Indian Mental Health Advisory
Council, and a consumer-run mental health advocacy groupnew text end ;
deleted text begin (5)deleted text end new text begin (6)new text end providers of mental health services;
deleted text begin (6)deleted text end new text begin (7)new text end consumers of mental health services;
deleted text begin (7)deleted text end new text begin (8)new text end family members of persons with mental illnesses;
deleted text begin (8)deleted text end new text begin (9)new text end legislators;
deleted text begin (9)deleted text end new text begin (10)new text end social service agency directors;
deleted text begin (10)deleted text end new text begin (11)new text end county commissioners; and
deleted text begin (11)deleted text end new text begin (12)new text end other members reflecting a broad range of community interests, including
family physicians, or members as the United States Secretary of Health and Human Services
may prescribe by regulation or as may be selected by the governor.
(b) The council shall select a chair. Terms, compensation, and removal of members and
filling of vacancies are governed by section 15.059. Notwithstanding provisions of section
15.059, the council and its subcommittee on children's mental health do not expire. The
commissioner of human services shall provide staff support and supplies to the council.
Sec. 3.
Minnesota Statutes 2020, section 252.43, is amended to read:
252.43 COMMISSIONER'S DUTIES.
new text begin (a) new text end The commissioner shall supervise lead agencies' provision of day services to adults
with disabilities. The commissioner shall:
(1) determine the need for day deleted text begin servicesdeleted text end new text begin programsnew text end under deleted text begin sectiondeleted text end new text begin sectionsnew text end 256B.4914new text begin and
252.41 to 252.46new text end ;
(2) establish payment rates as provided under section 256B.4914;
(3) adopt rules for the administration and provision of day services under sections
245A.01 to 245A.16deleted text begin ,deleted text end new text begin ;new text end 252.28, subdivision 2deleted text begin ,deleted text end new text begin ;new text end or 252.41 to 252.46deleted text begin ,deleted text end new text begin ;new text end or Minnesota Rules,
parts 9525.1200 to 9525.1330;
(4) enter into interagency agreements necessary to ensure effective coordination and
provision of day services;
(5) monitor and evaluate the costs and effectiveness of day services; and
(6) provide information and technical help to lead agencies and vendors in their
administration and provision of day services.
new text begin
(b) A determination of need in paragraph (a), clause (1), shall not be required for a
change in day service provider name or ownership.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 4.
Minnesota Statutes 2020, section 252A.01, subdivision 1, is amended to read:
Subdivision 1.
Policy.
(a) It is the policy of the state of Minnesota to provide a
coordinated approach to the supervision, protection, and habilitation of its adult citizens
with a developmental disability. In furtherance of this policy, sections 252A.01 to 252A.21
are enacted to authorize the commissioner of human services to:
(1) supervise those adult citizens with a developmental disability who are unable to fully
provide for their own needs and for whom no qualified person is willing and able to seek
guardianship deleted text begin or conservatorshipdeleted text end under sections 524.5-101 to 524.5-502; and
(2) protect adults with a developmental disability from violation of their human and civil
rights by deleted text begin assuringdeleted text end new text begin ensuringnew text end that they receive the full range of needed social, financial,
residential, and habilitative services to which they are lawfully entitled.
(b) Public guardianship deleted text begin or conservatorshipdeleted text end is the most restrictive form of guardianship
deleted text begin or conservatorshipdeleted text end and should be imposed only when deleted text begin no other acceptable alternative is
availabledeleted text end new text begin less restrictive alternatives have been attempted and determined to be insufficient
to meet the person's needs. Less restrictive alternatives include but are not limited to
supported decision making, community or residential services, or appointment of a health
care agentnew text end .
Sec. 5.
Minnesota Statutes 2020, section 252A.02, subdivision 2, is amended to read:
Subd. 2.
Person with a developmental disability.
"Person with a developmental
disability" refers to any person age 18 or older whonew text begin :
new text end
new text begin (1)new text end has been diagnosed as having deleted text begin significantly subaverage intellectual functioning existing
concurrently with demonstrated deficits in adaptive behavior such as to require supervision
and protection for the person's welfare or the public welfare.deleted text end new text begin a developmental disability or
related condition;
new text end
new text begin
(2) is impaired to the extent of lacking sufficient understanding or capacity to make
personal decisions; and
new text end
new text begin
(3) is unable to meet personal needs for medical care, nutrition, clothing, shelter, or
safety, even with appropriate technological and supported decision-making assistance.
new text end
Sec. 6.
Minnesota Statutes 2020, section 252A.02, subdivision 9, is amended to read:
Subd. 9.
deleted text begin Warddeleted text end new text begin Person subject to public guardianshipnew text end .
deleted text begin "Ward"deleted text end new text begin "Person subject to
public guardianship"new text end means a person with a developmental disability for whom the court
has appointed a public guardian.
Sec. 7.
Minnesota Statutes 2020, section 252A.02, subdivision 11, is amended to read:
Subd. 11.
Interested person.
"Interested person" means an interested responsible adult,
deleted text begin including, but not limited to, a public official, guardian, spouse, parent, adult sibling, legal
counsel, adult child, or next of kin of a person alleged to have a developmental disability.deleted text end new text begin
including but not limited to:
new text end
new text begin
(1) the person subject to guardianship, protected person, or respondent;
new text end
new text begin
(2) a nominated guardian or conservator;
new text end
new text begin
(3) a legal representative;
new text end
new text begin
(4) the spouse; parent, including stepparent; adult children, including adult stepchildren
of a living spouse; and siblings. If no such persons are living or can be located, the next of
kin of the person subject to public guardianship or the respondent is an interested person;
new text end
new text begin
(5) a representative of a state ombudsman's office or a federal protection and advocacy
program that has notified the commissioner or lead agency that it has a matter regarding
the protected person subject to guardianship, person subject to conservatorship, or respondent;
and
new text end
new text begin
(6) a health care agent or proxy appointed pursuant to a health care directive as defined
in section 145C.01, subdivision 5a; a living will under chapter 145B; or other similar
documentation executed in another state and enforceable under the laws of this state.
new text end
Sec. 8.
Minnesota Statutes 2020, section 252A.02, subdivision 12, is amended to read:
Subd. 12.
Comprehensive evaluation.
new text begin (a) new text end "Comprehensive evaluation" deleted text begin shall consistdeleted text end new text begin
consistsnew text end of:
(1) a medical report on the health status and physical condition of the proposed deleted text begin ward,deleted text end new text begin
person subject to public guardianshipnew text end prepared under the direction of a licensed physician
or advanced practice registered nurse;
(2) a report on the deleted text begin proposed ward'sdeleted text end intellectual capacity and functional abilitiesdeleted text begin , specifyingdeleted text end new text begin
of the proposed person subject to public guardianship that specifiesnew text end the tests and other data
used in reaching its conclusionsdeleted text begin ,deleted text end new text begin and isnew text end prepared by a psychologist who is qualified in the
diagnosis of developmental disability; and
(3) a report from the case manager that includes:
(i) the most current assessment of individual service needs as described in rules of the
commissioner;
(ii) the most current individual service plan under section 256B.092, subdivision 1b;
and
(iii) a description of contacts with and responses of near relatives of the proposed deleted text begin warddeleted text end new text begin
person subject to public guardianshipnew text end notifying deleted text begin themdeleted text end new text begin the near relativesnew text end that a nomination
for public guardianship has been made and advising deleted text begin themdeleted text end new text begin the near relativesnew text end that they may
seek private guardianship.
new text begin (b) new text end Each report new text begin under paragraph (a), clause (3), new text end shall contain recommendations as to the
amount of assistance and supervision required by the proposed deleted text begin warddeleted text end new text begin person subject to public
guardianshipnew text end to function as independently as possible in society. To be considered part of
the comprehensive evaluation, new text begin the new text end reports must be completed no more than one year before
filing the petition under section 252A.05.
Sec. 9.
Minnesota Statutes 2020, section 252A.02, is amended by adding a subdivision to
read:
new text begin Subd. 16. new text end
new text begin Protected person. new text end
new text begin
"Protected person" means a person for whom a guardian
or conservator has been appointed or other protective order has been sought. A protected
person may be a minor.
new text end
Sec. 10.
Minnesota Statutes 2020, section 252A.02, is amended by adding a subdivision
to read:
new text begin Subd. 17. new text end
new text begin Respondent. new text end
new text begin
"Respondent" means an individual for whom the appointment
of a guardian or conservator or other protective order is sought.
new text end
Sec. 11.
Minnesota Statutes 2020, section 252A.02, is amended by adding a subdivision
to read:
new text begin Subd. 18. new text end
new text begin Supported decision making. new text end
new text begin
"Supported decision making" means assistance
to understand the nature and consequences of personal and financial decisions from one or
more persons of the individual's choosing to enable the individual to make the personal and
financial decisions and, when consistent with the individual's wishes, to communicate a
decision once made.
new text end
Sec. 12.
Minnesota Statutes 2020, section 252A.03, subdivision 3, is amended to read:
Subd. 3.
Standard for acceptance.
The commissioner shall accept the nomination ifnew text begin :new text end
deleted text begin the comprehensive evaluation concludes that:
deleted text end
deleted text begin
(1) the person alleged to have developmental disability is, in fact, developmentally
disabled;
deleted text end
new text begin
(1) the person's assessment confirms that they are a person with a developmental
disability under section 252A.02, subdivision 2;
new text end
(2) the person is in need of the supervision and protection of a deleted text begin conservator ordeleted text end guardian;
deleted text begin and
deleted text end
(3) no qualified person is willing to assume guardianship deleted text begin or conservatorshipdeleted text end under
sections 524.5-101 to 524.5-502deleted text begin .deleted text end new text begin ; and
new text end
new text begin
(4) the person subject to public guardianship was included in the process prior to the
submission of the nomination.
new text end
Sec. 13.
Minnesota Statutes 2020, section 252A.03, subdivision 4, is amended to read:
Subd. 4.
Alternatives.
new text begin (a) new text end Public guardianship deleted text begin or conservatorshipdeleted text end may be imposed only
whennew text begin :
new text end
new text begin
(1) the person subject to guardianship is impaired to the extent of lacking sufficient
understanding or capacity to make personal decisions;
new text end
new text begin
(2) the person subject to guardianship is unable to meet personal needs for medical care,
nutrition, clothing, shelter, or safety, even with appropriate technological and supported
decision-making assistance; and
new text end
new text begin (3)new text end no acceptable, less restrictive form of guardianship deleted text begin or conservatorshipdeleted text end is available.
new text begin (b)new text end The commissioner shall seek parents, near relatives, and other interested persons to
assume guardianship for persons with developmental disabilities who are currently under
public guardianship. If a person seeks to become a guardian deleted text begin or conservatordeleted text end , costs to the
person may be reimbursed under section 524.5-502. The commissioner must provide technical
assistance to parents, near relatives, and interested persons seeking to become guardians deleted text begin or
conservatorsdeleted text end .
Sec. 14.
Minnesota Statutes 2020, section 252A.04, subdivision 1, is amended to read:
Subdivision 1.
Local agency.
Upon receipt of a written nomination, the commissioner
shall promptly order the local agency of the county in which the proposed deleted text begin warddeleted text end new text begin person
subject to public guardianshipnew text end resides to coordinate or arrange for a comprehensive evaluation
of the proposed deleted text begin warddeleted text end new text begin person subject to public guardianshipnew text end .
Sec. 15.
Minnesota Statutes 2020, section 252A.04, subdivision 2, is amended to read:
Subd. 2.
Medication; treatment.
A proposed deleted text begin warddeleted text end new text begin person subject to public guardianshipnew text end
who, at the time the comprehensive evaluation is to be performed, has been under medical
care shall not be so under the influence or so suffer the effects of drugs, medication, or other
treatment as to be hampered in the testing or evaluation process. When in the opinion of
the licensed physician or advanced practice registered nurse attending the proposed deleted text begin warddeleted text end new text begin
person subject to public guardianshipnew text end , the discontinuance of medication or other treatment
is not in the deleted text begin proposed ward'sdeleted text end best interestnew text begin of the proposed person subject to public
guardianshipnew text end , the physician or advanced practice registered nurse shall record a list of all
drugs, medicationnew text begin ,new text end or other treatment deleted text begin whichdeleted text end new text begin thatnew text end the proposed deleted text begin warddeleted text end new text begin person subject to public
guardianshipnew text end received 48 hours immediately prior to any examination, testnew text begin ,new text end or interview
conducted in preparation for the comprehensive evaluation.
Sec. 16.
Minnesota Statutes 2020, section 252A.04, subdivision 4, is amended to read:
Subd. 4.
File.
The comprehensive evaluation shall be kept on file at the Department of
Human Services and shall be open to the inspection of the proposed deleted text begin warddeleted text end new text begin person subject to
public guardianshipnew text end and deleted text begin suchdeleted text end other persons deleted text begin as may be given permissiondeleted text end new text begin permittednew text end by the
commissioner.
Sec. 17.
Minnesota Statutes 2020, section 252A.05, is amended to read:
252A.05 COMMISSIONER'S PETITION FOR APPOINTMENT AS PUBLIC
GUARDIAN deleted text begin OR PUBLIC CONSERVATORdeleted text end .
In every case in which the commissioner agrees to accept a nomination, the local agency,
within 20 working days of receipt of the commissioner's acceptance, shall petition on behalf
of the commissioner in the county or court of the county of residence of the person with a
developmental disability for appointment to act as deleted text begin public conservator ordeleted text end public guardian of
the person with a developmental disability.
Sec. 18.
Minnesota Statutes 2020, section 252A.06, subdivision 1, is amended to read:
Subdivision 1.
Who may file.
deleted text begin The commissioner, the local agency, a person with a
developmental disability or any parent, spouse or relative of a person with a developmental
disability may filedeleted text end A verified petition alleging that the appointment of a deleted text begin public conservator
ordeleted text end public guardian is requirednew text begin may be filed by: the commissioner; the local agency; a person
with a developmental disability; or a parent, stepparent, spouse, or relative of a person with
a developmental disabilitynew text end .
Sec. 19.
Minnesota Statutes 2020, section 252A.06, subdivision 2, is amended to read:
Subd. 2.
Contents.
The petition shall set forth:
(1) the name and address of the petitionerdeleted text begin ,deleted text end and, in the case of a petition brought by a
person other than the commissioner, whether the petitioner is a parent, spouse, or relative
deleted text begin of the proposed warddeleted text end new text begin of the proposed person subject to guardianshipnew text end ;
(2) whether the commissioner has accepted a nomination to act as deleted text begin public conservator
ordeleted text end public guardian;
(3) the name, address, and date of birth of the proposed deleted text begin warddeleted text end new text begin person subject to public
guardianshipnew text end ;
(4) the names and addresses of the nearest relatives and spouse, if any, of the proposed
deleted text begin warddeleted text end new text begin person subject to public guardianshipnew text end ;
(5) the probable value and general character of the deleted text begin proposed ward'sdeleted text end real and personal
propertynew text begin of the proposed person subject to public guardianshipnew text end and the probable amount of
the deleted text begin proposed ward'sdeleted text end debtsnew text begin of the proposed person subject to public guardianshipnew text end ;new text begin and
new text end
(6) the facts supporting the establishment of public deleted text begin conservatorship ordeleted text end guardianship,
including that no family member or other qualified individual is willing to assume
guardianship deleted text begin or conservatorshipdeleted text end responsibilities under sections 524.5-101 to 524.5-502deleted text begin ;
anddeleted text end new text begin .
new text end
deleted text begin
(7) if conservatorship is requested, the powers the petitioner believes are necessary to
protect and supervise the proposed conservatee.
deleted text end
Sec. 20.
Minnesota Statutes 2020, section 252A.07, subdivision 1, is amended to read:
Subdivision 1.
With petition.
When a petition is brought by the commissioner or local
agency, a copy of the comprehensive evaluation shall be filed with the petition. If a petition
is brought by a person other than the commissioner or local agency and a comprehensive
evaluation has been prepared within a year of the filing of the petition, the local agency
shall deleted text begin forwarddeleted text end new text begin sendnew text end a copy of the comprehensive evaluation to the court upon notice of the
filing of the petition. If a comprehensive evaluation has not been prepared within a year of
the filing of the petition, the local agency, upon notice of the filing of the petition, shall
arrange for a comprehensive evaluation to be prepared and deleted text begin forwardeddeleted text end new text begin providednew text end to the court
within 90 days.
Sec. 21.
Minnesota Statutes 2020, section 252A.07, subdivision 2, is amended to read:
Subd. 2.
Copies.
A copy of the comprehensive evaluation shall be made available by
the court to the proposed deleted text begin warddeleted text end new text begin person subject to public guardianshipnew text end , the deleted text begin proposed ward'sdeleted text end
counselnew text begin of the proposed person subject to public guardianshipnew text end , the county attorney, the
attorney generalnew text begin ,new text end and the petitioner.
Sec. 22.
Minnesota Statutes 2020, section 252A.07, subdivision 3, is amended to read:
Subd. 3.
Evaluation required; exception.
new text begin (a) new text end No action for the appointment of a public
guardian may proceed to hearing unless a comprehensive evaluation has been first filed
with the courtdeleted text begin ; provided, however, that an action may proceed and a guardian appointeddeleted text end new text begin .
new text end
new text begin (b) Paragraph (a) does not applynew text end if the director of the local agency responsible for
conducting the comprehensive evaluation has filed an affidavit that the proposed deleted text begin warddeleted text end new text begin
person subject to public guardianshipnew text end refused to participate in the comprehensive evaluation
and the court finds on the basis of clear and convincing evidence that the proposed deleted text begin warddeleted text end new text begin
person subject to public guardianshipnew text end is developmentally disabled and in need of the
supervision and protection of a guardian.
Sec. 23.
Minnesota Statutes 2020, section 252A.081, subdivision 2, is amended to read:
Subd. 2.
Service of notice.
Service of notice on the deleted text begin warddeleted text end new text begin person subject to public
guardianshipnew text end or proposed deleted text begin warddeleted text end new text begin person subject to public guardianshipnew text end must be made by a
nonuniformed personnew text begin or nonuniformed visitornew text end . To the extent possible, the deleted text begin process server or
visitordeleted text end new text begin person or visitor serving the noticenew text end shall explain the document's meaning to the
proposed deleted text begin warddeleted text end new text begin person subject to public guardianshipnew text end . In addition to the persons required to
be served under sections 524.5-113, 524.5-205, and 524.5-304, the mailed notice of the
hearing must be served on the commissioner, the local agency, and the county attorney.
Sec. 24.
Minnesota Statutes 2020, section 252A.081, subdivision 3, is amended to read:
Subd. 3.
Attorney.
In place of the notice of attorney provisions in sections 524.5-205
and 524.5-304, the notice must state that the court will appoint an attorney for the proposed
deleted text begin warddeleted text end new text begin person subject to public guardianshipnew text end unless an attorney is provided by other persons.
Sec. 25.
Minnesota Statutes 2020, section 252A.081, subdivision 5, is amended to read:
Subd. 5.
Defective notice of service.
A defect in the service of notice or process, other
than personal service upon the proposed deleted text begin ward or conservateedeleted text end new text begin person subject to public
guardianshipnew text end or service upon the commissioner and local agency within the time allowed
and the form prescribed in this section and sections 524.5-113, 524.5-205, and 524.5-304,
does not invalidate any public guardianship deleted text begin or conservatorshipdeleted text end proceedings.
Sec. 26.
Minnesota Statutes 2020, section 252A.09, subdivision 1, is amended to read:
Subdivision 1.
Attorney appointment.
Upon the filing of the petition, the court shall
appoint an attorney for the proposed deleted text begin warddeleted text end new text begin person subject to public guardianshipnew text end , unless
such counsel is provided by others.
Sec. 27.
Minnesota Statutes 2020, section 252A.09, subdivision 2, is amended to read:
Subd. 2.
Representation.
Counsel shall visit with and, to the extent possible, consult
with the proposed deleted text begin warddeleted text end new text begin person subject to public guardianshipnew text end prior to the hearing and shall
be given adequate time to prepare deleted text begin therefordeleted text end new text begin for the hearingnew text end . Counsel shall be given the full
right of subpoena and shall be supplied with a copy of all documents filed with or issued
by the court.
Sec. 28.
Minnesota Statutes 2020, section 252A.101, subdivision 2, is amended to read:
Subd. 2.
Waiver of presence.
The proposed deleted text begin warddeleted text end new text begin person subject to public guardianshipnew text end
may waive the right to be present at the hearing only if the proposed deleted text begin warddeleted text end new text begin person subject
to public guardianshipnew text end has met with counsel and specifically waived the right to appear.
Sec. 29.
Minnesota Statutes 2020, section 252A.101, subdivision 3, is amended to read:
Subd. 3.
Medical care.
If, at the time of the hearing, the proposed deleted text begin warddeleted text end new text begin person subject
to public guardianshipnew text end has been under medical care, the deleted text begin warddeleted text end new text begin person subject to public
guardianshipnew text end has the same rights regarding limitation on the use of drugs, medication, or
other treatment before the hearing that are available under section 252A.04, subdivision 2.
Sec. 30.
Minnesota Statutes 2020, section 252A.101, subdivision 5, is amended to read:
Subd. 5.
Findings.
(a) In all cases the court shall make specific written findings of fact,
conclusions of law, and direct entry of an appropriate judgment or order. The court shall
order the appointment of the commissioner as guardian deleted text begin or conservatordeleted text end if it finds that:
(1) the proposed deleted text begin ward or conservateedeleted text end new text begin person subject to public guardianshipnew text end is a person
with a developmental disability as defined in section 252A.02, subdivision 2;
(2) the proposed deleted text begin ward or conservateedeleted text end new text begin person subject to public guardianshipnew text end is incapable
of exercising specific legal rights, which must be enumerated in deleted text begin itsdeleted text end new text begin the court'snew text end findings;
(3) the proposed deleted text begin ward or conservateedeleted text end new text begin person subject to public guardianshipnew text end is in need
of the supervision and protection of a new text begin public new text end guardian deleted text begin or conservatordeleted text end ; and
(4) no appropriate alternatives to public guardianship deleted text begin or public conservatorshipdeleted text end exist
that are less restrictive of the person's civil rights and liberties, such as appointing a new text begin private
new text end guardiannew text begin ,new text end deleted text begin or conservatordeleted text end new text begin supported decision maker, or health care agent; or arranging
residential or community servicesnew text end under sections 524.5-101 to 524.5-502.
(b) The court shall grant the specific powers that are necessary for the commissioner to
act as public guardian deleted text begin or conservatordeleted text end on behalf of the deleted text begin ward or conservateedeleted text end new text begin person subject
to public guardianshipnew text end .
Sec. 31.
Minnesota Statutes 2020, section 252A.101, subdivision 6, is amended to read:
Subd. 6.
Notice of order; appeal.
A copy of the order shall be served by mail upon the
deleted text begin ward or conservateedeleted text end new text begin person subject to public guardianshipnew text end and the deleted text begin ward'sdeleted text end counselnew text begin of the
person subject to public guardianshipnew text end . The order must be accompanied by a notice that
advises the deleted text begin ward or conservateedeleted text end new text begin person subject to public guardianshipnew text end of the right to appeal
the guardianship deleted text begin or conservatorshipdeleted text end appointment within 30 days.
Sec. 32.
Minnesota Statutes 2020, section 252A.101, subdivision 7, is amended to read:
Subd. 7.
Letters of guardianship.
new text begin (a) new text end Letters of guardianship deleted text begin or conservatorshipdeleted text end must
be issued by the court and contain:
(1) the name, address, and telephone number of the deleted text begin ward or conservateedeleted text end new text begin person subject
to public guardianshipnew text end ; and
(2) the powers to be exercised on behalf of the deleted text begin ward or conservateedeleted text end new text begin person subject to
public guardianshipnew text end .
new text begin (b) new text end The lettersnew text begin under paragraph (a)new text end must be served by mail upon the deleted text begin ward or conservateedeleted text end new text begin
person subject to public guardianshipnew text end , the deleted text begin ward'sdeleted text end counselnew text begin of the person subject to public
guardianshipnew text end , the commissioner, and the local agency.
Sec. 33.
Minnesota Statutes 2020, section 252A.101, subdivision 8, is amended to read:
Subd. 8.
Dismissal.
If upon the completion of the hearing and consideration of the record,
the court finds that the proposed deleted text begin warddeleted text end new text begin person subject to public guardianshipnew text end is not
developmentally disabled or is developmentally disabled but not in need of the supervision
and protection of a deleted text begin conservator ordeleted text end new text begin publicnew text end guardian, deleted text begin itdeleted text end new text begin the courtnew text end shall dismiss the application
and shall notify the proposed deleted text begin warddeleted text end new text begin person subject to public guardianshipnew text end , the deleted text begin ward'sdeleted text end counselnew text begin
of the person subject to public guardianshipnew text end , and the petitionernew text begin of the court's findingsnew text end .
Sec. 34.
Minnesota Statutes 2020, section 252A.111, subdivision 2, is amended to read:
Subd. 2.
Additional powers.
In addition to the powers contained in sections 524.5-207
and 524.5-313, the powers of a public guardian that the court may grant include:
(1) the power to permit or withhold permission for the deleted text begin warddeleted text end new text begin person subject to public
guardianshipnew text end to marry;
(2) the power to begin legal action or defend against legal action in the name of the deleted text begin warddeleted text end new text begin
person subject to public guardianshipnew text end ; and
(3) the power to consent to the adoption of the deleted text begin warddeleted text end new text begin person subject to public guardianshipnew text end
as provided in section 259.24.
Sec. 35.
Minnesota Statutes 2020, section 252A.111, subdivision 4, is amended to read:
Subd. 4.
Appointment of conservator.
If the deleted text begin warddeleted text end new text begin person subject to public guardianshipnew text end
has a personal estate beyond that which is necessary for the deleted text begin ward'sdeleted text end personal and immediate
needsnew text begin of the person subject to public guardianshipnew text end , the commissioner shall determine whether
a conservator should be appointed. The commissioner shall consult with the parents, spouse,
or nearest relative of the deleted text begin warddeleted text end new text begin person subject to public guardianshipnew text end . The commissioner
may petition the court for the appointment of a private conservator of the deleted text begin warddeleted text end new text begin person
subject to public guardianshipnew text end . The commissioner cannot act as conservator for public deleted text begin wardsdeleted text end new text begin
persons subject to public guardianshipnew text end or public protected persons.
Sec. 36.
Minnesota Statutes 2020, section 252A.111, subdivision 6, is amended to read:
Subd. 6.
Special duties.
In exercising powers and duties under this chapter, the
commissioner shall:
(1) maintain close contact with the deleted text begin warddeleted text end new text begin person subject to public guardianshipnew text end , visiting
at least twice a year;
(2) protect and exercise the legal rights of the deleted text begin warddeleted text end new text begin person subject to public guardianshipnew text end ;
(3) take actions and make decisions on behalf of the deleted text begin warddeleted text end new text begin person subject to public
guardianshipnew text end that encourage and allow the maximum level of independent functioning in a
manner least restrictive of the deleted text begin ward'sdeleted text end personal freedom new text begin of the person subject to public
guardianship new text end consistent with the need for supervision and protection; and
(4) permit and encourage maximum self-reliance on the part of the deleted text begin warddeleted text end new text begin person subject
to public guardianshipnew text end and permit and encourage input by the nearest relative of the deleted text begin warddeleted text end new text begin
person subject to public guardianshipnew text end in planning and decision making on behalf of the
deleted text begin warddeleted text end new text begin person subject to public guardianshipnew text end .
Sec. 37.
Minnesota Statutes 2020, section 252A.12, is amended to read:
252A.12 APPOINTMENT OF deleted text begin CONSERVATORdeleted text end new text begin PUBLIC GUARDIANnew text end NOT A
FINDING OF INCOMPETENCY.
An appointment of the commissioner as deleted text begin conservatordeleted text end new text begin public guardiannew text end shall not constitute
a judicial finding that the person with a developmental disability is legally incompetent
except for the restrictions deleted text begin whichdeleted text end new text begin thatnew text end the deleted text begin conservatorshipdeleted text end new text begin public guardianshipnew text end places on the
deleted text begin conservateedeleted text end new text begin person subject to public guardianshipnew text end . The appointment of a deleted text begin conservatordeleted text end new text begin public
guardiannew text end shall not deprive the deleted text begin conservateedeleted text end new text begin person subject to public guardianshipnew text end of the right
to vote.
Sec. 38.
Minnesota Statutes 2020, section 252A.16, is amended to read:
252A.16 ANNUAL REVIEW.
Subdivision 1.
Review required.
The commissioner shall require an annual review of
the physical, mental, and social adjustment and progress of every deleted text begin ward and conservateedeleted text end new text begin
person subject to public guardianshipnew text end . A copy of this review shall be kept on file at the
Department of Human Services and may be inspected by the deleted text begin ward or conservateedeleted text end new text begin person
subject to public guardianshipnew text end , the deleted text begin ward's or conservatee'sdeleted text end parents, spouse, or relatives new text begin of
the person subject to public guardianship, new text end and other persons who receive the permission of
the commissioner. The review shall contain information required under Minnesota Rules,
part 9525.3065, subpart 1.
Subd. 2.
Assessment of need for continued guardianship.
The commissioner shall
annually review the legal status of each deleted text begin warddeleted text end new text begin person subject to public guardianshipnew text end in light
of the progress indicated in the annual review. If the commissioner determines the deleted text begin warddeleted text end new text begin
person subject to public guardianshipnew text end is no longer in need of public guardianship deleted text begin or
conservatorshipdeleted text end or is capable of functioning under a less restrictive deleted text begin conservatorshipdeleted text end new text begin
guardianshipnew text end , the commissioner or local agency shall petition the court pursuant to section
252A.19 to restore the deleted text begin warddeleted text end new text begin person subject to public guardianshipnew text end to capacity or for a
modification of the court's previous order.
Sec. 39.
Minnesota Statutes 2020, section 252A.17, is amended to read:
252A.17 EFFECT OF SUCCESSION IN OFFICE.
The appointment by the court of the commissioner deleted text begin of human servicesdeleted text end as public
deleted text begin conservator ordeleted text end guardian shall be by the title of the commissioner's office. The authority of
the commissioner as public deleted text begin conservator ordeleted text end guardian shall cease upon the termination of the
commissioner's term of office and shall vest in a successor or successors in office without
further court proceedings.
Sec. 40.
Minnesota Statutes 2020, section 252A.19, subdivision 2, is amended to read:
Subd. 2.
Petition.
The commissioner, deleted text begin warddeleted text end new text begin person subject to public guardianshipnew text end , or
any interested person may petition the appointing court or the court to which venue has
been transferred deleted text begin for an order todeleted text end new text begin :
new text end
new text begin (1) for an order tonew text end remove the guardianship deleted text begin or todeleted text end new text begin ;
new text end
new text begin (2) for an order tonew text end limit or expand the powers of the guardianship deleted text begin or todeleted text end new text begin ;
new text end
new text begin (3) for an order tonew text end appoint a guardian deleted text begin or conservatordeleted text end under sections 524.5-101 to
524.5-502 deleted text begin or todeleted text end new text begin ;
new text end
new text begin (4) for an order tonew text end restore the deleted text begin warddeleted text end new text begin person subject to public guardianshipnew text end or protected
person to full legal capacity deleted text begin or todeleted text end new text begin ;
new text end
new text begin (5) tonew text end review de novo any decision made by the public guardian deleted text begin or public conservatordeleted text end
for or on behalf of a deleted text begin warddeleted text end new text begin person subject to public guardianshipnew text end or protected personnew text begin ;new text end or
new text begin (6) new text end for any other order as the court may deem just and equitable.
Sec. 41.
Minnesota Statutes 2020, section 252A.19, subdivision 4, is amended to read:
Subd. 4.
Comprehensive evaluation.
The commissioner shall, at the court's request,
arrange for the preparation of a comprehensive evaluation of the deleted text begin warddeleted text end new text begin person subject to
public guardianshipnew text end or protected person.
Sec. 42.
Minnesota Statutes 2020, section 252A.19, subdivision 5, is amended to read:
Subd. 5.
Court order.
Upon proof of the allegations of the petition the court shall enter
an order removing the guardianship or limiting or expanding the powers of the guardianship
or restoring the deleted text begin warddeleted text end new text begin person subject to public guardianshipnew text end or protected person to full legal
capacity or may enter such other order as the court may deem just and equitable.
Sec. 43.
Minnesota Statutes 2020, section 252A.19, subdivision 7, is amended to read:
Subd. 7.
Attorney general's role; commissioner's role.
The attorney general may
appear and represent the commissioner in such proceedings. The commissioner shall support
or oppose the petition if the commissioner deems such action necessary for the protection
and supervision of the deleted text begin warddeleted text end new text begin person subject to public guardianshipnew text end or protected person.
Sec. 44.
Minnesota Statutes 2020, section 252A.19, subdivision 8, is amended to read:
Subd. 8.
deleted text begin Court appointeddeleted text end new text begin Court-appointednew text end counsel.
In all such proceedings, the
protected person or deleted text begin warddeleted text end new text begin person subject to public guardianshipnew text end shall be afforded an
opportunity to be represented by counsel, and if neither the protected person or deleted text begin warddeleted text end new text begin person
subject to public guardianshipnew text end nor others provide counsel the court shall appoint counsel to
represent the protected person or deleted text begin warddeleted text end new text begin person subject to public guardianshipnew text end .
Sec. 45.
Minnesota Statutes 2020, section 252A.20, is amended to read:
252A.20 COSTS OF HEARINGS.
Subdivision 1.
Witness and attorney fees.
In each proceeding under sections 252A.01
to 252A.21, the court shall allow and order paid to each witness subpoenaed the fees and
mileage prescribed by law; to each physician, advanced practice registered nurse,
psychologist, or social worker who assists in the preparation of the comprehensive evaluation
and who is not deleted text begin in the employ ofdeleted text end new text begin employed bynew text end the local agency or the state Department of
Human Services, a reasonable sum for services and for travel; and to the deleted text begin ward'sdeleted text end counselnew text begin of
the person subject to public guardianshipnew text end , when appointed by the court, a reasonable sum
for travel and for each day or portion of a day actually employed in court or actually
consumed in preparing for the hearing. Upon order the county auditor shall issue a warrant
on the county treasurer for payment of the amount allowed.
Subd. 2.
Expenses.
When the settlement of the deleted text begin warddeleted text end new text begin person subject to public guardianshipnew text end
is found to be in another county, the court shall transmit to the county auditor a statement
of the expenses incurred pursuant to subdivision 1. The auditor shall transmit the statement
to the auditor of the county of the deleted text begin ward'sdeleted text end settlement new text begin of the person subject to public
guardianship new text end and this claim shall be paid as other claims against that county. If the auditor
to whom this claim is transmitted denies the claim, the auditor shall transmit it, together
with the objections thereto, to the commissioner, who shall determine the question of
settlement and certify findings to each auditor. If the claim is not paid within 30 days after
such certification, an action may be maintained thereon in the district court of the claimant
county.
Subd. 3.
Change of venue; cost of proceedings.
Whenever venue of a proceeding has
been transferred under sections 252A.01 to 252A.21, the costs of such proceedings shall be
reimbursed to the county of the deleted text begin ward'sdeleted text end settlement new text begin of the person subject to public guardianship
new text end by the state.
Sec. 46.
Minnesota Statutes 2020, section 252A.21, subdivision 2, is amended to read:
Subd. 2.
Rules.
The commissioner shall adopt rules to implement this chapter. The rules
must include standards for performance of guardianship deleted text begin or conservatorshipdeleted text end duties includingdeleted text begin ,deleted text end
but not limited to: twice a year visits with the deleted text begin warddeleted text end new text begin person subject to public guardianshipnew text end ;
a requirement that the duties of guardianship deleted text begin or conservatorshipdeleted text end and case management not
be performed by the same person; specific standards for action on "do not resuscitate" orders
as recommended by a physician, an advanced practice registered nurse, or a physician
assistant; sterilization requests; and the use of psychotropic medication and aversive
procedures.
Sec. 47.
Minnesota Statutes 2020, section 252A.21, subdivision 4, is amended to read:
Sec. 48.
Minnesota Statutes 2020, section 254A.03, subdivision 3, is amended to read:
Subd. 3.
Rules for substance use disorder care.
(a) The commissioner of human
services shall establish by rule criteria to be used in determining the appropriate level of
deleted text begin chemical dependencydeleted text end new text begin substance use disordernew text end care for each recipient of public assistance
seeking treatment for substance misuse or substance use disorder. deleted text begin Upon federal approval
of a comprehensive assessment as a Medicaid benefit, or on July 1, 2018, whichever is later,
anddeleted text end Notwithstanding the criteria in Minnesota Rules, parts 9530.6600 to 9530.6655, an
eligible vendor of comprehensive assessments under section 254B.05 may determine and
approve the appropriate level of substance use disorder treatment for a recipient of public
assistance. The process for determining an individual's financial eligibility for the
deleted text begin consolidated chemical dependency treatmentdeleted text end new text begin behavioral healthnew text end fund or determining an
individual's enrollment in or eligibility for a publicly subsidized health plan is not affected
by the individual's choice to access a comprehensive assessment for placement.
(b) The commissioner shall develop and implement a utilization review process for
publicly funded treatment placements to monitor and review the clinical appropriateness
and timeliness of all publicly funded placements in treatment.
(c) If a screen result is positive for deleted text begin alcohol ordeleted text end substance misuse, a brief screening for
deleted text begin alcohol ordeleted text end new text begin anew text end substance use disorder that is provided to a recipient of public assistance within
a primary care clinic, hospital, or other medical setting or school setting establishes medical
necessity and approval for an initial set of substance use disorder services identified in
section 254B.05, subdivision 5. The initial set of services approved for a recipient whose
screen result is positive may include any combination of up to four hours of individual or
group substance use disorder treatment, two hours of substance use disorder treatment
coordination, or two hours of substance use disorder peer support services provided by a
qualified individual according to chapter 245G. A recipient must obtain an assessment
pursuant to paragraph (a) to be approved for additional treatment services. Minnesota Rules,
parts 9530.6600 to 9530.6655, and a comprehensive assessment pursuant to section 245G.05
are not applicable to the initial set of services allowed under this subdivision. A positive
screen result establishes eligibility for the initial set of services allowed under this
subdivision.
(d) Notwithstanding Minnesota Rules, parts 9530.6600 to 9530.6655, an individual may
choose to obtain a comprehensive assessment as provided in section 245G.05. Individuals
obtaining a comprehensive assessment may access any enrolled provider that is licensed to
provide the level of service authorized pursuant to section 254A.19, subdivision 3, paragraph
(d). If the individual is enrolled in a prepaid health plan, the individual must comply with
any provider network requirements or limitations. This paragraph expires July 1, 2022.
Sec. 49.
Minnesota Statutes 2020, section 254A.171, is amended to read:
254A.171 INTERVENTION AND ADVOCACY PROGRAM.
Within the limit of money available, the commissioner shall fund voluntary outreach
programs targeted at women who deliver children affected by prenatal alcohol or drug use.
The programs shall help women obtain treatment, stay in recovery, and plan any future
pregnancies. An advocate shall be assigned to each woman in the program to provide
guidance and advice with respect to treatment programs, child safety and parenting, housing,
family planning, and any other personal issues that are barriers to remaining free of deleted text begin chemical
dependencydeleted text end new text begin a substance use disordernew text end .
Sec. 50.
Minnesota Statutes 2020, section 254A.19, subdivision 4, is amended to read:
Subd. 4.
Civil commitments.
A Rule 25 assessment, under Minnesota Rules, part
9530.6615, does not need to be completed for an individual being committed as a chemically
dependent person, as defined in section 253B.02, and for the duration of a civil commitment
under section deleted text begin 253B.065,deleted text end 253B.09deleted text begin ,deleted text end or 253B.095 in order for a county to access deleted text begin consolidated
chemical dependency treatmentdeleted text end new text begin behavioral healthnew text end funds under section 254B.04. The county
must determine if the individual meets the financial eligibility requirements for the
deleted text begin consolidated chemical dependency treatmentdeleted text end new text begin behavioral healthnew text end funds under section 254B.04.
Nothing in this subdivision prohibits placement in a treatment facility or treatment program
governed under this chapter or Minnesota Rules, parts 9530.6600 to 9530.6655.
Sec. 51.
Minnesota Statutes 2020, section 254A.20, is amended to read:
254A.20 DUTIES OF COMMISSIONER RELATED TO deleted text begin CHEMICAL HEALTHdeleted text end new text begin
SUBSTANCE USE DISORDERnew text end .
The commissioner shall develop a directory that identifies key characteristics of each
licensed deleted text begin chemical dependencydeleted text end new text begin substance use disordernew text end treatment program.
Sec. 52.
Minnesota Statutes 2020, section 254B.01, subdivision 6, is amended to read:
Subd. 6.
Local money.
"Local money" means county levies, federal social services
money, or other money that may be spent at county discretion to provide deleted text begin chemical
dependencydeleted text end new text begin substance use disordernew text end services eligible for payment according to deleted text begin Laws 1986,
chapter 394, sections 8 to 20deleted text end new text begin sections 254B.01 to 254B.09; 256B.02, subdivision 8; and
256B.70new text end .
Sec. 53.
Minnesota Statutes 2020, section 254B.01, subdivision 8, is amended to read:
Subd. 8.
Recovery community organization.
"Recovery community organization"
means an independent organization led and governed by representatives of local communities
of recovery. A recovery community organization mobilizes resources within and outside
of the recovery community to increase the prevalence and quality of long-term recovery
from deleted text begin alcohol and other drug addictiondeleted text end new text begin a substance use disordernew text end . Recovery community
organizations provide peer-based recovery support activities such as training of recovery
peers. Recovery community organizations provide mentorship and ongoing support to
individuals dealing with a substance use disorder and connect them with the resources that
can support each person's recovery. A recovery community organization also promotes a
recovery-focused orientation in community education and outreach programming, and
organize recovery-focused policy advocacy activities to foster healthy communities and
reduce the stigma of substance use disorder.
Sec. 54.
Minnesota Statutes 2020, section 254B.02, subdivision 1, is amended to read:
Subdivision 1.
deleted text begin Chemical dependencydeleted text end new text begin Substance use disordernew text end treatment
allocation.
The deleted text begin chemical dependencydeleted text end new text begin substance use disordernew text end treatment appropriation shall
be placed in a special revenue account. The money in the special revenue account must be
used according to the requirements in this chapter.
Sec. 55.
Minnesota Statutes 2020, section 254B.03, subdivision 1, is amended to read:
Subdivision 1.
Local agency duties.
(a) Every local agency shall provide deleted text begin chemical
dependencydeleted text end new text begin substance use disordernew text end services to persons residing within its jurisdiction who
meet criteria established by the commissioner for placement in a deleted text begin chemical dependencydeleted text end new text begin
substance use disordernew text end residential or nonresidential treatment service. deleted text begin Chemical dependencydeleted text end new text begin
Substance use disordernew text end money must be administered by the local agencies according to law
and rules adopted by the commissioner under sections 14.001 to 14.69.
(b) In order to contain costs, the commissioner of human services shall select eligible
vendors of deleted text begin chemical dependencydeleted text end new text begin substance use disordernew text end services who can provide economical
and appropriate treatment. Unless the local agency is a social services department directly
administered by a county or human services board, the local agency shall not be an eligible
vendor under section 254B.05. The commissioner may approve proposals from county
boards to provide services in an economical manner or to control utilization, with safeguards
to ensure that necessary services are provided. If a county implements a demonstration or
experimental medical services funding plan, the commissioner shall transfer the money as
appropriate.
(c) A culturally specific vendor that provides assessments under a variance under
Minnesota Rules, part 9530.6610, shall be allowed to provide assessment services to persons
not covered by the variance.
(d) Notwithstanding Minnesota Rules, parts 9530.6600 to 9530.6655, an individual may
choose to obtain a comprehensive assessment as provided in section 245G.05. Individuals
obtaining a comprehensive assessment may access any enrolled provider that is licensed to
provide the level of service authorized pursuant to section 254A.19, subdivision 3, paragraph
(d). If the individual is enrolled in a prepaid health plan, the individual must comply with
any provider network requirements or limitations.
(e) Beginning July 1, 2022, local agencies shall not make placement location
determinations.
Sec. 56.
Minnesota Statutes 2020, section 254B.03, subdivision 2, is amended to read:
Subd. 2.
Chemical dependency fund payment.
(a) Payment from the chemical
dependency fund is limited to payments for services other than detoxification licensed under
Minnesota Rules, parts 9530.6510 to 9530.6590, deleted text begin that, if located outside of federally
recognized tribal lands, would be required to be licensed by the commissioner as a chemical
dependency treatment or rehabilitation program under sections 245A.01 to 245A.16,deleted text end new text begin services
identified in section 254B.05,new text end and services other than detoxification provided in another
state that would be required to be licensed as a chemical dependency program if the program
were in the state. Out of state vendors must also provide the commissioner with assurances
that the program complies substantially with state licensing requirements and possesses all
licenses and certifications required by the host state to provide chemical dependency
treatment. Vendors receiving payments from the chemical dependency fund must not require
co-payment from a recipient of benefits for services provided under this subdivision. The
vendor is prohibited from using the client's public benefits to offset the cost of services paid
under this section. The vendor shall not require the client to use public benefits for room
or board costs. This includes but is not limited to cash assistance benefits under chapters
119B, 256D, and 256J, or SNAP benefits. Retention of SNAP benefits is a right of a client
receiving services through the consolidated chemical dependency treatment fund or through
state contracted managed care entities. Payment from the chemical dependency fund shall
be made for necessary room and board costs provided by vendors meeting the criteria under
section 254B.05, subdivision 1a, or in a community hospital licensed by the commissioner
of health according to sections 144.50 to 144.56 to a client who is:
(1) determined to meet the criteria for placement in a residential chemical dependency
treatment program according to rules adopted under section 254A.03, subdivision 3; and
(2) concurrently receiving a chemical dependency treatment service in a program licensed
by the commissioner and reimbursed by the chemical dependency fund.
(b) A county may, from its own resources, provide chemical dependency services for
which state payments are not made. A county may elect to use the same invoice procedures
and obtain the same state payment services as are used for chemical dependency services
for which state payments are made under this section if county payments are made to the
state in advance of state payments to vendors. When a county uses the state system for
payment, the commissioner shall make monthly billings to the county using the most recent
available information to determine the anticipated services for which payments will be made
in the coming month. Adjustment of any overestimate or underestimate based on actual
expenditures shall be made by the state agency by adjusting the estimate for any succeeding
month.
(c) The commissioner shall coordinate chemical dependency services and determine
whether there is a need for any proposed expansion of chemical dependency treatment
services. The commissioner shall deny vendor certification to any provider that has not
received prior approval from the commissioner for the creation of new programs or the
expansion of existing program capacity. The commissioner shall consider the provider's
capacity to obtain clients from outside the state based on plans, agreements, and previous
utilization history, when determining the need for new treatment services.
Sec. 57.
Minnesota Statutes 2020, section 254B.03, subdivision 4, is amended to read:
Subd. 4.
Division of costs.
(a) Except for services provided by a county under section
254B.09, subdivision 1, or services provided under section 256B.69, the county shall, out
of local money, pay the state for 22.95 percent of the cost of deleted text begin chemical dependencydeleted text end new text begin substance
use disordernew text end services, except for those services provided to persons enrolled in medical
assistance under chapter 256B and room and board services under section 254B.05,
subdivision 5, paragraph (b), clause (12). Counties may use the indigent hospitalization
levy for treatment and hospital payments made under this section.
(b) 22.95 percent of any state collections from private or third-party pay, less 15 percent
for the cost of payment and collections, must be distributed to the county that paid for a
portion of the treatment under this section.
Sec. 58.
Minnesota Statutes 2020, section 254B.04, subdivision 1, is amended to read:
Subdivision 1.
Eligibility.
(a) Persons eligible for benefits under Code of Federal
Regulations, title 25, part 20, who meet the income standards of section 256B.056,
subdivision 4, and are not enrolled in medical assistance, are entitled to deleted text begin chemical dependencydeleted text end new text begin
behavioral healthnew text end fund services. State money appropriated for this paragraph must be placed
in a separate account established for this purpose.
(b) Persons with dependent children who are determined to be in need of deleted text begin chemical
dependencydeleted text end new text begin substance use disordernew text end treatment pursuant to an assessment under section
260E.20, subdivision 1, or a case plan under section 260C.201, subdivision 6, or 260C.212,
shall be assisted by the local agency to access needed treatment services. Treatment services
must be appropriate for the individual or family, which may include long-term care treatment
or treatment in a facility that allows the dependent children to stay in the treatment facility.
The county shall pay for out-of-home placement costs, if applicable.
(c) Notwithstanding paragraph (a), persons enrolled in medical assistance are eligible
for room and board services under section 254B.05, subdivision 5, paragraph (b), clause
(12).
Sec. 59.
Minnesota Statutes 2020, section 254B.05, subdivision 1a, is amended to read:
Subd. 1a.
Room and board provider requirements.
(a) deleted text begin Effective January 1, 2000,deleted text end
Vendors of room and board are eligible for deleted text begin chemical dependencydeleted text end new text begin behavioral healthnew text end fund
payment if the vendor:
(1) has rules prohibiting residents bringing deleted text begin chemicalsdeleted text end new text begin substancesnew text end into the facility or using
deleted text begin chemicalsdeleted text end new text begin substancesnew text end while residing in the facility and provide consequences for infractions
of those rules;
(2) is determined to meet applicable health and safety requirements;
(3) is not a jail or prison;
(4) is not concurrently receiving funds under chapter 256I for the recipient;
(5) admits individuals who are 18 years of age or older;
(6) is registered as a board and lodging or lodging establishment according to section
157.17;
(7) has awake staff on site 24 hours per day;
(8) has staff who are at least 18 years of age and meet the requirements of section
245G.11, subdivision 1, paragraph (b);
(9) has emergency behavioral procedures that meet the requirements of section 245G.16;
(10) meets the requirements of section 245G.08, subdivision 5, if administering
medications to clients;
(11) meets the abuse prevention requirements of section 245A.65, including a policy on
fraternization and the mandatory reporting requirements of section 626.557;
(12) documents coordination with the treatment provider to ensure compliance with
section 254B.03, subdivision 2;
(13) protects client funds and ensures freedom from exploitation by meeting the
provisions of section 245A.04, subdivision 13;
(14) has a grievance procedure that meets the requirements of section 245G.15,
subdivision 2; and
(15) has sleeping and bathroom facilities for men and women separated by a door that
is locked, has an alarm, or is supervised by awake staff.
(b) Programs licensed according to Minnesota Rules, chapter 2960, are exempt from
paragraph (a), clauses (5) to (15).
(c) Licensed programs providing intensive residential treatment services or residential
crisis stabilization services pursuant to section 256B.0622 or 256B.0624 are eligible vendors
of room and board and are exempt from paragraph (a), clauses (6) to (15).
Sec. 60.
Minnesota Statutes 2020, section 254B.05, subdivision 1b, is amended to read:
Subd. 1b.
Additional vendor requirements.
Vendors must comply with the following
duties:
(1) maintain a provider agreement with the department;
(2) continually comply with the standards in the agreement;
(3) participate in the Drug Alcohol Normative Evaluation System;
(4) submit an annual financial statement which reports functional expenses of deleted text begin chemical
dependencydeleted text end new text begin substance use disordernew text end treatment costs in a form approved by the commissioner;
(5) report information about the vendor's current capacity in a manner prescribed by the
commissioner; and
(6) maintain adequate and appropriate insurance coverage necessary to provide deleted text begin chemical
dependencydeleted text end new text begin substance use disordernew text end treatment services, and at a minimum:
(i) employee dishonesty in the amount of $10,000 if the vendor has or had custody or
control of money or property belonging to clients; and
(ii) bodily injury and property damage in the amount of $2,000,000 for each occurrence,
except that a county or a county joint powers entity who is otherwise an eligible vendor
shall be subject to the limits on liability under section 466.04.
Sec. 61.
Minnesota Statutes 2020, section 254B.05, subdivision 4, is amended to read:
Subd. 4.
Regional treatment centers.
Regional treatment center deleted text begin chemical dependencydeleted text end new text begin
substance use disordernew text end treatment units are eligible vendors. The commissioner may expand
the capacity of deleted text begin chemical dependencydeleted text end new text begin substance use disordernew text end treatment units beyond the
capacity funded by direct legislative appropriation to serve individuals who are referred for
treatment by counties and whose treatment will be paid for by funding under this chapter
or other funding sources. Notwithstanding the provisions of sections 254B.03 to 254B.041,
payment for any person committed at county request to a regional treatment center under
chapter 253B for deleted text begin chemical dependencydeleted text end new text begin substance use disordernew text end treatment and determined to
be ineligible under the deleted text begin chemical dependency consolidated treatmentdeleted text end new text begin behavioral healthnew text end fund,
shall become the responsibility of the county.
Sec. 62.
Minnesota Statutes 2020, section 254B.05, subdivision 5, is amended to read:
Subd. 5.
Rate requirements.
(a) The commissioner shall establish rates for substance
use disorder services and service enhancements funded under this chapter.
(b) Eligible substance use disorder treatment services include:
(1) outpatient treatment services that are licensed according to sections 245G.01 to
245G.17, or applicable tribal license;
(2) comprehensive assessments provided according to sections 245.4863, paragraph (a),
and 245G.05;
(3) care coordination services provided according to section 245G.07, subdivision 1,
paragraph (a), clause (5);
(4) peer recovery support services provided according to section 245G.07, subdivision
2, clause (8);
(5) deleted text begin on July 1, 2019, or upon federal approval, whichever is later,deleted text end withdrawal management
services provided according to chapter 245F;
(6) medication-assisted therapy services that are licensed according to sections 245G.01
to 245G.17 and 245G.22, or applicable tribal license;
(7) medication-assisted therapy plus enhanced treatment services that meet the
requirements of clause (6) and provide nine hours of clinical services each week;
(8) high, medium, and low intensity residential treatment services that are licensed
according to sections 245G.01 to 245G.17 and 245G.21 or applicable tribal license which
provide, respectively, 30, 15, and five hours of clinical services each week;
(9) hospital-based treatment services that are licensed according to sections 245G.01 to
245G.17 or applicable tribal license and licensed as a hospital under sections 144.50 to
144.56;
(10) adolescent treatment programs that are licensed as outpatient treatment programs
according to sections 245G.01 to 245G.18 or as residential treatment programs according
to Minnesota Rules, parts 2960.0010 to 2960.0220, and 2960.0430 to 2960.0490, or
applicable tribal license;
(11) high-intensity residential treatment services that are licensed according to sections
245G.01 to 245G.17 and 245G.21 or applicable tribal license, which provide 30 hours of
clinical services each week provided by a state-operated vendor or to clients who have been
civilly committed to the commissioner, present the most complex and difficult care needs,
and are a potential threat to the community; and
(12) room and board facilities that meet the requirements of subdivision 1a.
(c) The commissioner shall establish higher rates for programs that meet the requirements
of paragraph (b) and one of the following additional requirements:
(1) programs that serve parents with their children if the program:
(i) provides on-site child care during the hours of treatment activity that:
(A) is licensed under chapter 245A as a child care center under Minnesota Rules, chapter
9503; or
(B) meets the licensure exclusion criteria of section 245A.03, subdivision 2, paragraph
(a), clause (6), and meets the requirements under section 245G.19, subdivision 4; or
(ii) arranges for off-site child care during hours of treatment activity at a facility that is
licensed under chapter 245A as:
(A) a child care center under Minnesota Rules, chapter 9503; or
(B) a family child care home under Minnesota Rules, chapter 9502;
(2) culturally specific programs as defined in section 254B.01, subdivision 4a, or
programs or subprograms serving special populations, if the program or subprogram meets
the following requirements:
(i) is designed to address the unique needs of individuals who share a common language,
racial, ethnic, or social background;
(ii) is governed with significant input from individuals of that specific background; and
(iii) employs individuals to provide individual or group therapy, at least 50 percent of
whom are of that specific background, except when the common social background of the
individuals served is a traumatic brain injury or cognitive disability and the program employs
treatment staff who have the necessary professional training, as approved by the
commissioner, to serve clients with the specific disabilities that the program is designed to
serve;
(3) programs that offer medical services delivered by appropriately credentialed health
care staff in an amount equal to two hours per client per week if the medical needs of the
client and the nature and provision of any medical services provided are documented in the
client file; and
(4) programs that offer services to individuals with co-occurring mental health and
deleted text begin chemical dependencydeleted text end new text begin substance use disordernew text end problems if:
(i) the program meets the co-occurring requirements in section 245G.20;
(ii) 25 percent of the counseling staff are licensed mental health professionals, as defined
in section 245.462, subdivision 18, clauses (1) to (6), or are students or licensing candidates
under the supervision of a licensed alcohol and drug counselor supervisor and licensed
mental health professional, except that no more than 50 percent of the mental health staff
may be students or licensing candidates with time documented to be directly related to
provisions of co-occurring services;
(iii) clients scoring positive on a standardized mental health screen receive a mental
health diagnostic assessment within ten days of admission;
(iv) the program has standards for multidisciplinary case review that include a monthly
review for each client that, at a minimum, includes a licensed mental health professional
and licensed alcohol and drug counselor, and their involvement in the review is documented;
(v) family education is offered that addresses mental health and substance abuse disorders
and the interaction between the two; and
(vi) co-occurring counseling staff shall receive eight hours of co-occurring disorder
training annually.
(d) In order to be eligible for a higher rate under paragraph (c), clause (1), a program
that provides arrangements for off-site child care must maintain current documentation at
the deleted text begin chemical dependencydeleted text end new text begin substance use disordernew text end facility of the child care provider's current
licensure to provide child care services. Programs that provide child care according to
paragraph (c), clause (1), must be deemed in compliance with the licensing requirements
in section 245G.19.
(e) Adolescent residential programs that meet the requirements of Minnesota Rules,
parts 2960.0430 to 2960.0490 and 2960.0580 to 2960.0690, are exempt from the requirements
in paragraph (c), clause (4), items (i) to (iv).
(f) Subject to federal approval, deleted text begin chemical dependencydeleted text end new text begin substance use disordernew text end services
that are otherwise covered as direct face-to-face services may be provided via two-way
interactive video. The use of two-way interactive video must be medically appropriate to
the condition and needs of the person being served. Reimbursement shall be at the same
rates and under the same conditions that would otherwise apply to direct face-to-face services.
The interactive video equipment and connection must comply with Medicare standards in
effect at the time the service is provided.
(g) For the purpose of reimbursement under this section, substance use disorder treatment
services provided in a group setting without a group participant maximum or maximum
client to staff ratio under chapter 245G shall not exceed a client to staff ratio of 48 to one.
At least one of the attending staff must meet the qualifications as established under this
chapter for the type of treatment service provided. A recovery peer may not be included as
part of the staff ratio.
Sec. 63.
Minnesota Statutes 2020, section 254B.051, is amended to read:
254B.051 SUBSTANCE USE DISORDER TREATMENT EFFECTIVENESS.
In addition to the substance use disorder treatment program performance outcome
measures that the commissioner of human services collects annually from treatment providers,
the commissioner shall request additional data from programs that receive appropriations
from the deleted text begin consolidated chemical dependency treatmentdeleted text end new text begin behavioral healthnew text end fund. This data
shall include new text begin the new text end number of client readmissions six months after release from inpatient
treatmentdeleted text begin ,deleted text end and the cost of treatment per person for each program receiving deleted text begin consolidated
chemical dependency treatmentdeleted text end new text begin behavioral healthnew text end funds. The commissioner may post this
data on the department website.
Sec. 64.
Minnesota Statutes 2020, section 254B.06, subdivision 1, is amended to read:
Subdivision 1.
State collections.
The commissioner is responsible for all collections
from persons determined to be partially responsible for the cost of care of an eligible person
receiving services under deleted text begin Laws 1986, chapter 394, sections 8 to 20deleted text end new text begin sections 254B.01 to
254B.09; 256B.02, subdivision 8; and 256B.70new text end . The commissioner may initiate, or request
the attorney general to initiate, necessary civil action to recover the unpaid cost of care. The
commissioner may collect all third-party payments for deleted text begin chemical dependencydeleted text end new text begin substance use
disordernew text end services provided under deleted text begin Laws 1986, chapter 394, sections 8 to 20deleted text end new text begin sections 254B.01
to 254B.09; 256B.02, subdivision 8; and 256B.70new text end , including private insurance and federal
Medicaid and Medicare financial participation. The remaining receipts must be deposited
in the deleted text begin chemical dependencydeleted text end new text begin behavioral healthnew text end fund.
Sec. 65.
Minnesota Statutes 2020, section 254B.06, subdivision 3, is amended to read:
Subd. 3.
Payment; denial.
The commissioner shall pay eligible vendors for placements
made by local agencies under section 254B.03, subdivision 1, and placements by tribal
designated agencies according to section 254B.09. The commissioner may reduce or deny
payment of the state share when services are not provided according to the placement criteria
established by the commissioner. The commissioner may pay for all or a portion of improper
county deleted text begin chemical dependencydeleted text end new text begin substance use disordernew text end placements and bill the county for the
entire payment made when the placement did not comply with criteria established by the
commissioner. The commissioner may make payments to vendors and charge the county
100 percent of the payments if documentation of a county approved placement is received
more than 30 working days, exclusive of weekends and holidays, after the date services
began. The commissioner shall not pay vendors until private insurance company claims
have been settled.
Sec. 66.
Minnesota Statutes 2020, section 254B.12, is amended to read:
254B.12 RATE METHODOLOGY.
Subdivision 1.
deleted text begin CCDTFdeleted text end new text begin Behavioral health fundnew text end rate methodology established.
The
commissioner shall establish a new rate methodology for the deleted text begin consolidated chemical
dependency treatmentdeleted text end new text begin behavioral healthnew text end fund. The new methodology must replace
county-negotiated rates with a uniform statewide methodology that must include a graduated
reimbursement scale based on the patients' level of acuity and complexity. At least biennially,
the commissioner shall review the financial information provided by vendors to determine
the need for rate adjustments.
Subd. 2.
Payment methodology for highly specialized vendors.
Notwithstanding
subdivision 1, deleted text begin the commissioner shall seek federal authority to developdeleted text end new text begin the followingnew text end separate
payment methodologies for substance use disorder treatment services provided under the
deleted text begin consolidated chemical dependency treatmentdeleted text end new text begin behavioral healthnew text end fundnew text begin existnew text end : (1) by a
state-operated vendor; or (2) for persons who have been civilly committed to the
commissioner, present the most complex and difficult care needs, and are a potential threat
to the community. deleted text begin A payment deleted text end deleted text begin methodology under this subdivision is effective for services
provided on or after October 1, 2015, or on or after the receipt of federal approval, whichever
is later.
deleted text end
Subd. 3.
deleted text begin Chemical dependencydeleted text end new text begin Substance use disordernew text end provider rate increase.
For
the deleted text begin chemical dependencydeleted text end new text begin substance use disordernew text end services listed in section 254B.05,
subdivision 5, and provided on or after July 1, 2017, payment rates shall be increased by
one percent over the rates in effect on January 1, 2017, for vendors who meet the
requirements of section 254B.05.
Sec. 67.
Minnesota Statutes 2020, section 254B.13, subdivision 1, is amended to read:
Subdivision 1.
Authorization for navigator pilot projects.
The commissioner may
approve and implement navigator pilot projects developed under the planning process
required under Laws 2009, chapter 79, article 7, section 26, to provide alternatives to and
enhance coordination of the delivery of deleted text begin chemical healthdeleted text end new text begin substance use disordernew text end services
required under section 254B.03.
Sec. 68.
Minnesota Statutes 2020, section 254B.13, subdivision 2a, is amended to read:
Subd. 2a.
Eligibility for navigator pilot program.
(a) To be considered for participation
in a navigator pilot program, an individual must:
(1) be a resident of a county with an approved navigator program;
(2) be eligible for deleted text begin consolidated chemical dependency treatmentdeleted text end new text begin behavioral healthnew text end fund
services;
(3) be a voluntary participant in the navigator program;
(4) satisfy one of the following items:
(i) have at least one severity rating of three or above in dimension four, five, or six in a
comprehensive assessment under section 245G.05, subdivision 2, paragraph (c), clauses (4)
to (6); or
(ii) have at least one severity rating of two or above in dimension four, five, or six in a
comprehensive assessment under section 245G.05, subdivision 2, paragraph (c), clauses (4)
to (6), and be currently participating in a Rule 31 treatment program under chapter 245G
or be within 60 days following discharge after participation in a Rule 31 treatment program;
and
(5) have had at least two treatment episodes in the past two years, not limited to episodes
reimbursed by the deleted text begin consolidated chemical dependency treatmentdeleted text end new text begin behavioral healthnew text end funds.
An admission to an emergency room, a detoxification program, or a hospital may be
substituted for one treatment episode if it resulted from the individual's substance use
disorder.
(b) New eligibility criteria may be added as mutually agreed upon by the commissioner
and participating navigator programs.
Sec. 69.
Minnesota Statutes 2020, section 254B.13, subdivision 5, is amended to read:
Subd. 5.
Duties of commissioner.
new text begin
(a) For purposes of this subdivision, "nontreatment
navigator pilot services" includes navigator services, peer support, family engagement and
support, housing support, rent subsidies, supported employment, and independent living
skills.
new text end
deleted text begin (a)deleted text end new text begin (b)new text end Notwithstanding any other provisions in this chapter, the commissioner may
authorize navigator pilot projects to use deleted text begin chemical dependency treatmentdeleted text end new text begin behavioral healthnew text end
funds to pay for nontreatment navigator pilot services:
(1) in addition to those authorized under section 254B.03, subdivision 2, paragraph (a);
and
(2) by vendors in addition to those authorized under section 254B.05 when not providing
deleted text begin chemical dependencydeleted text end new text begin substance use disordernew text end treatment services.
deleted text begin
(b) For purposes of this section, "nontreatment navigator pilot services" include navigator
services, peer support, family engagement and support, housing support, rent subsidies,
supported employment, and independent living skills.
deleted text end
(c) State expenditures for deleted text begin chemical dependencydeleted text end new text begin substance use disordernew text end services and
nontreatment navigator pilot services provided by or through the navigator pilot projects
must not be greater than the deleted text begin chemical dependencydeleted text end new text begin behavioral healthnew text end treatment fund expected
share of forecasted expenditures in the absence of the navigator pilot projects. The
commissioner may restructure the schedule of payments between the state and participating
counties under the local agency share and division of cost provisions under section 254B.03,
subdivisions 3 and 4, as necessary to facilitate the operation of the navigator pilot projects.
(d) The commissioner may waive administrative rule requirements that are incompatible
with the implementation of the navigator pilot project, except that any deleted text begin chemical dependencydeleted text end new text begin
substance use disordernew text end treatment funded under this section must continue to be provided by
a licensed treatment provider.
(e) The commissioner shall not approve or enter into any agreement related to navigator
pilot projects authorized under this section that puts current or future federal funding at risk.
(f) The commissioner shall provide participating navigator pilot projects with transactional
data, reports, provider data, and other data generated by county activity to assess and measure
outcomes. This information must be transmitted or made available in an acceptable form
to participating navigator pilot projects at least once every six months or within a reasonable
time following the commissioner's receipt of information from the counties needed to comply
with this paragraph.
Sec. 70.
Minnesota Statutes 2020, section 254B.13, subdivision 6, is amended to read:
Subd. 6.
Duties of county board.
The county board, or other county entity that is
approved to administer a navigator pilot project, shall:
(1) administer the navigator pilot project in a manner consistent with the objectives
described in subdivision 2 and the planning process in subdivision 5;
(2) ensure that no one is denied deleted text begin chemical dependencydeleted text end new text begin substance use disordernew text end treatment
services for which they would otherwise be eligible under section 254A.03, subdivision 3;
and
(3) provide the commissioner with timely and pertinent information as negotiated in
agreements governing operation of the navigator pilot projects.
Sec. 71.
Minnesota Statutes 2020, section 254B.14, subdivision 1, is amended to read:
Subdivision 1.
Authorization for continuum of care pilot projects.
The commissioner
shall establish deleted text begin chemical dependencydeleted text end new text begin substance use disordernew text end continuum of care pilot projects
to begin implementing the measures developed with stakeholder input and identified in the
report completed pursuant to Laws 2012, chapter 247, article 5, section 8. The pilot projects
are intended to improve the effectiveness and efficiency of the service continuum for
deleted text begin chemically dependentdeleted text end individuals new text begin with substance use disorders new text end in Minnesota while reducing
duplication of efforts and promoting scientifically supported practices.
Sec. 72.
Minnesota Statutes 2020, section 254B.14, subdivision 5, is amended to read:
Subd. 5.
Duties of commissioner.
(a) Notwithstanding any other provisions in this
chapter, the commissioner may authorize deleted text begin chemical dependency treatmentdeleted text end new text begin behavioral healthnew text end
funds to pay for nontreatment services arranged by continuum of care pilot projects.
Individuals who are currently accessing Rule 31 treatment services are eligible for concurrent
participation in the continuum of care pilot projects.
(b) County expenditures for continuum of care pilot project services shall not be greater
than their expected share of forecasted expenditures in the absence of the continuum of care
pilot projects.
Sec. 73.
Minnesota Statutes 2020, section 256.042, subdivision 2, is amended to read:
Subd. 2.
Membership.
(a) The council shall consist of the following 19 voting members,
appointed by the commissioner of human services except as otherwise specified, and three
nonvoting members:
(1) two members of the house of representatives, appointed in the following sequence:
the first from the majority party appointed by the speaker of the house and the second from
the minority party appointed by the minority leader. Of these two members, one member
must represent a district outside of the seven-county metropolitan area, and one member
must represent a district that includes the seven-county metropolitan area. The appointment
by the minority leader must ensure that this requirement for geographic diversity in
appointments is met;
(2) two members of the senate, appointed in the following sequence: the first from the
majority party appointed by the senate majority leader and the second from the minority
party appointed by the senate minority leader. Of these two members, one member must
represent a district outside of the seven-county metropolitan area and one member must
represent a district that includes the seven-county metropolitan area. The appointment by
the minority leader must ensure that this requirement for geographic diversity in appointments
is met;
(3) one member appointed by the Board of Pharmacy;
(4) one member who is a physician appointed by the Minnesota Medical Association;
(5) one member representing opioid treatment programs, sober living programs, or
substance use disorder programs licensed under chapter 245G;
(6) one member appointed by the Minnesota Society of Addiction Medicine who is an
addiction psychiatrist;
(7) one member representing professionals providing alternative pain management
therapies, including, but not limited to, acupuncture, chiropractic, or massage therapy;
(8) one member representing nonprofit organizations conducting initiatives to address
the opioid epidemic, with the commissioner's initial appointment being a member
representing the Steve Rummler Hope Network, and subsequent appointments representing
this or other organizations;
(9) one member appointed by the Minnesota Ambulance Association who is serving
with an ambulance service as an emergency medical technician, advanced emergency
medical technician, or paramedic;
(10) one member representing the Minnesota courts who is a judge or law enforcement
officer;
(11) one public member who is a Minnesota resident and who is in opioid addiction
recovery;
(12) two members representing Indian tribes, one representing the Ojibwe tribes and
one representing the Dakota tribes;
(13) one public member who is a Minnesota resident and who is suffering from chronic
pain, intractable pain, or a rare disease or condition;
(14) one mental health advocate representing persons with mental illness;
(15) one member appointed by the Minnesota Hospital Association;
(16) one member representing a local health department; and
(17) the commissioners of human services, health, and corrections, or their designees,
who shall be ex officio nonvoting members of the council.
(b) The commissioner of human services shall coordinate the commissioner's
appointments to provide geographic, racial, and gender diversity, and shall ensure that at
least one-half of council members appointed by the commissioner reside outside of the
seven-county metropolitan area. Of the members appointed by the commissioner, to the
extent practicable, at least one member must represent a community of color
disproportionately affected by the opioid epidemic.
(c) The council is governed by section 15.059, except that members of the council shall
serve three-year terms and shall receive no compensation other than reimbursement for
expenses. Notwithstanding section 15.059, subdivision 6, the council shall not expire.new text begin The
three-year term for members in paragraph (a), clauses (1), (3), (5), (7), (9), (11), (13), (15),
and (17), ends on September 30, 2022. The three-year term for members in paragraph (a),
clauses (2), (4), (6), (8), (10), (12), (14), and (16), ends on September 30, 2023.
new text end
(d) The chair shall convene the council at least quarterly, and may convene other meetings
as necessary. The chair shall convene meetings at different locations in the state to provide
geographic access, and shall ensure that at least one-half of the meetings are held at locations
outside of the seven-county metropolitan area.
(e) The commissioner of human services shall provide staff and administrative services
for the advisory council.
(f) The council is subject to chapter 13D.
Sec. 74.
Minnesota Statutes 2020, section 256.042, subdivision 4, is amended to read:
Subd. 4.
Grants.
(a) The commissioner of human services shall submit a report of the
grants proposed by the advisory council to be awarded deleted text begin for the upcoming fiscal yeardeleted text end to the
chairs and ranking minority members of the legislative committees with jurisdiction over
health and human services policy and finance, by deleted text begin Marchdeleted text end new text begin Decembernew text end 1 of each year, beginning
deleted text begin March 1, 2020deleted text end new text begin December 1, 2021, or as soon as the information becomes available thereafternew text end .
(b) The commissioner of human services shall award grants from the opiate epidemic
response fund under section 256.043. The grants shall be awarded to proposals selected by
the advisory council that address the priorities in subdivision 1, paragraph (a), clauses (1)
to (4), unless otherwise appropriated by the legislature. new text begin The council shall determine grant
awards and funding amounts. The commissioner of human services shall administer grants
from the opiate epidemic response fund in compliance with section 16B.97. new text end No more than
deleted text begin threedeleted text end new text begin tennew text end percent of the grant amount may be used by a grantee for administration.
Sec. 75.
Minnesota Statutes 2020, section 256B.051, subdivision 1, is amended to read:
Subdivision 1.
Purpose.
Housing deleted text begin supportdeleted text end new text begin stabilizationnew text end services are established to provide
housing deleted text begin supportdeleted text end new text begin stabilizationnew text end services to an individual with a disability that limits the
individual's ability to obtain or maintain stable housing. The services support an individual's
transition to housing in the community and increase long-term stability in housing, to avoid
future periods of being at risk of homelessness or institutionalization.
Sec. 76.
Minnesota Statutes 2020, section 256B.051, subdivision 3, is amended to read:
Subd. 3.
Eligibility.
An individual with a disability is eligible for housing deleted text begin supportdeleted text end new text begin
stabilizationnew text end services if the individual:
(1) is 18 years of age or older;
(2) is enrolled in medical assistance;
(3) has an assessment of functional need that determines a need for services due to
limitations caused by the individual's disability;
(4) resides in or plans to transition to a community-based setting as defined in Code of
Federal Regulations, title 42, section 441.301 (c); and
(5) has housing instability evidenced by:
(i) being homeless or at-risk of homelessness;
(ii) being in the process of transitioning from, or having transitioned in the past six
months from, an institution or licensed or registered setting;
(iii) being eligible for waiver services under chapter 256S or section 256B.092 or
256B.49; or
(iv) having been identified by a long-term care consultation under section 256B.0911
as at risk of institutionalization.
Sec. 77.
Minnesota Statutes 2020, section 256B.051, subdivision 5, is amended to read:
Subd. 5.
Housing deleted text begin supportdeleted text end new text begin stabilizationnew text end services.
(a) Housing deleted text begin supportdeleted text end new text begin stabilizationnew text end
services include housing transition services and housing and tenancy sustaining services.
(b) Housing transition services are defined as:
(1) tenant screening and housing assessment;
(2) assistance with the housing search and application process;
(3) identifying resources to cover onetime moving expenses;
(4) ensuring a new living arrangement is safe and ready for move-in;
(5) assisting in arranging for and supporting details of a move; and
(6) developing a housing support crisis plan.
(c) Housing and tenancy sustaining services include:
(1) prevention and early identification of behaviors that may jeopardize continued stable
housing;
(2) education and training on roles, rights, and responsibilities of the tenant and the
property manager;
(3) coaching to develop and maintain key relationships with property managers and
neighbors;
(4) advocacy and referral to community resources to prevent eviction when housing is
at risk;
(5) assistance with housing recertification process;
(6) coordination with the tenant to regularly review, update, and modify the housing
support and crisis plan; and
(7) continuing training on being a good tenant, lease compliance, and household
management.
(d) A housing deleted text begin supportdeleted text end new text begin stabilizationnew text end service may include person-centered planning for
people who are not eligible to receive person-centered planning through any other service,
if the person-centered planning is provided by a consultation service provider that is under
contract with the department and enrolled as a Minnesota health care program.
Sec. 78.
Minnesota Statutes 2020, section 256B.051, subdivision 6, is amended to read:
Subd. 6.
Provider qualifications and duties.
A provider eligible for reimbursement
under this section shall:
(1) enroll as a medical assistance Minnesota health care program provider and meet all
applicable provider standards and requirements;
(2) demonstrate compliance with federal and state laws and policies for housing deleted text begin supportdeleted text end new text begin
stabilizationnew text end services as determined by the commissioner;
(3) comply with background study requirements under chapter 245C and maintain
documentation of background study requests and results; deleted text begin and
deleted text end
(4) directly provide housing deleted text begin supportdeleted text end new text begin stabilizationnew text end services and not use a subcontractor
or reporting agentdeleted text begin .deleted text end new text begin ; and
new text end
new text begin
(5) complete annual vulnerable adult training.
new text end
Sec. 79.
Minnesota Statutes 2020, section 256B.051, subdivision 7, is amended to read:
Subd. 7.
Housing support supplemental service rates.
Supplemental service rates for
individuals in settings according to sections 144D.025, 256I.04, subdivision 3, paragraph
(a), clause (3), and 256I.05, subdivision 1g, shall be reduced by one-half over a two-year
period. This reduction only applies to supplemental service rates for individuals eligible for
housing deleted text begin supportdeleted text end new text begin stabilizationnew text end services under this section.
Sec. 80.
Minnesota Statutes 2020, section 256B.051, is amended by adding a subdivision
to read:
new text begin Subd. 8. new text end
new text begin Home and community-based service documentation requirements. new text end
new text begin
(a)
Documentation may be collected and maintained electronically or in paper form by providers
and must be produced upon request by the commissioner.
new text end
new text begin
(b) Documentation of a delivered service must be in English and must be legible according
to the standard of a reasonable person.
new text end
new text begin
(c) If the service is reimbursed at an hourly or specified minute-based rate, each
documentation of the provision of a service, unless otherwise specified, must include:
new text end
new text begin
(1) the date the documentation occurred;
new text end
new text begin
(2) the day, month, and year the service was provided;
new text end
new text begin
(3) the start and stop times with a.m. and p.m. designations, except for person-centered
planning services described under subdivision 5, paragraph (d);
new text end
new text begin
(4) the service name or description of the service provided; and
new text end
new text begin
(5) the name, signature, and title, if any, of the provider of service. If the service is
provided by multiple staff members, the provider may designate a staff member responsible
for verifying services and completing the documentation required by this paragraph.
new text end
Sec. 81.
Minnesota Statutes 2020, section 256B.0947, subdivision 6, is amended to read:
Subd. 6.
Service standards.
The standards in this subdivision apply to intensive
nonresidential rehabilitative mental health services.
(a) The treatment team must use team treatment, not an individual treatment model.
(b) Services must be available at times that meet client needs.
(c) Services must be age-appropriate and meet the specific needs of the client.
(d) The initial functional assessment must be completed within ten days of intake and
updated at least every six months or prior to discharge from the service, whichever comes
first.
(e) An individual treatment plan mustnew text begin be completed for each client and mustnew text end :
(1) be based on the information in the client's diagnostic assessment and baselines;
(2) identify goals and objectives of treatment, a treatment strategy, a schedule for
accomplishing treatment goals and objectives, and the individuals responsible for providing
treatment services and supports;
(3) be developed after completion of the client's diagnostic assessment by a mental health
professional or clinical trainee and before the provision of children's therapeutic services
and supports;
(4) be developed through a child-centered, family-driven, culturally appropriate planning
process, including allowing parents and guardians to observe or participate in individual
and family treatment services, assessments, and treatment planning;
(5) be reviewed at least once every six months and revised to document treatment progress
on each treatment objective and next goals or, if progress is not documented, to document
changes in treatment;
(6) be signed by the clinical supervisor and by the client or by the client's parent or other
person authorized by statute to consent to mental health services for the client. A client's
parent may approve the client's individual treatment plan by secure electronic signature or
by documented oral approval that is later verified by written signature;
(7) be completed in consultation with the client's current therapist and key providers and
provide for ongoing consultation with the client's current therapist to ensure therapeutic
continuity and to facilitate the client's return to the community. For clients under the age of
18, the treatment team must consult with parents and guardians in developing the treatment
plan;
(8) if a need for substance use disorder treatment is indicated by validated assessment:
(i) identify goals, objectives, and strategies of substance use disorder treatment; develop
a schedule for accomplishing treatment goals and objectives; and identify the individuals
responsible for providing treatment services and supports;
(ii) be reviewed at least once every 90 days and revised, if necessary;
(9) be signed by the clinical supervisor and by the client and, if the client is a minor, by
the client's parent or other person authorized by statute to consent to mental health treatment
and substance use disorder treatment for the client; and
(10) provide for the client's transition out of intensive nonresidential rehabilitative mental
health services by defining the team's actions to assist the client and subsequent providers
in the transition to less intensive or "stepped down" services.
(f) The treatment team shall actively and assertively engage the client's family members
and significant others by establishing communication and collaboration with the family and
significant others and educating the family and significant others about the client's mental
illness, symptom management, and the family's role in treatment, unless the team knows or
has reason to suspect that the client has suffered or faces a threat of suffering any physical
or mental injury, abuse, or neglect from a family member or significant other.
(g) For a client age 18 or older, the treatment team may disclose to a family member,
other relative, or a close personal friend of the client, or other person identified by the client,
the protected health information directly relevant to such person's involvement with the
client's care, as provided in Code of Federal Regulations, title 45, part 164.502(b). If the
client is present, the treatment team shall obtain the client's agreement, provide the client
with an opportunity to object, or reasonably infer from the circumstances, based on the
exercise of professional judgment, that the client does not object. If the client is not present
or is unable, by incapacity or emergency circumstances, to agree or object, the treatment
team may, in the exercise of professional judgment, determine whether the disclosure is in
the best interests of the client and, if so, disclose only the protected health information that
is directly relevant to the family member's, relative's, friend's, or client-identified person's
involvement with the client's health care. The client may orally agree or object to the
disclosure and may prohibit or restrict disclosure to specific individuals.
(h) The treatment team shall provide interventions to promote positive interpersonal
relationships.
Sec. 82.
Minnesota Statutes 2020, section 256B.4912, subdivision 13, is amended to read:
Subd. 13.
Waiver transportation documentation and billing requirements.
(a) A
waiver transportation service must be a waiver transportation service that: (1) is not covered
by medical transportation under the Medicaid state plan; and (2) is not included as a
component of another waiver service.
(b) In addition to the documentation requirements in subdivision 12, a waiver
transportation service provider must maintain:
(1) odometer and other records pursuant to section 256B.0625, subdivision 17b, paragraph
(b), clause (3), sufficient to distinguish an individual trip with a specific vehicle and driver
for a waiver transportation service that is billed directly by the mile. A common carrier as
defined by Minnesota Rules, part 9505.0315, subpart 1, item B, or a publicly operated transit
system provider are exempt from this clause; and
(2) documentation demonstrating that a vehicle and a driver meet the deleted text begin standards determined
by the Department of Human Services on vehicle and driver qualifications in section
256B.0625, subdivision 17, paragraph (c)deleted text end new text begin transportation waiver service provider standards
and qualifications according to the federally approved waiver plannew text end .
Sec. 83.
Minnesota Statutes 2020, section 256B.69, subdivision 5a, is amended to read:
Subd. 5a.
Managed care contracts.
(a) Managed care contracts under this section and
section 256L.12 shall be entered into or renewed on a calendar year basis. The commissioner
may issue separate contracts with requirements specific to services to medical assistance
recipients age 65 and older.
(b) A prepaid health plan providing covered health services for eligible persons pursuant
to chapters 256B and 256L is responsible for complying with the terms of its contract with
the commissioner. Requirements applicable to managed care programs under chapters 256B
and 256L established after the effective date of a contract with the commissioner take effect
when the contract is next issued or renewed.
(c) The commissioner shall withhold five percent of managed care plan payments under
this section and county-based purchasing plan payments under section 256B.692 for the
prepaid medical assistance program pending completion of performance targets. Each
performance target must be quantifiable, objective, measurable, and reasonably attainable,
except in the case of a performance target based on a federal or state law or rule. Criteria
for assessment of each performance target must be outlined in writing prior to the contract
effective date. Clinical or utilization performance targets and their related criteria must
consider evidence-based research and reasonable interventions when available or applicable
to the populations served, and must be developed with input from external clinical experts
and stakeholders, including managed care plans, county-based purchasing plans, and
providers. The managed care or county-based purchasing plan must demonstrate, to the
commissioner's satisfaction, that the data submitted regarding attainment of the performance
target is accurate. The commissioner shall periodically change the administrative measures
used as performance targets in order to improve plan performance across a broader range
of administrative services. The performance targets must include measurement of plan
efforts to contain spending on health care services and administrative activities. The
commissioner may adopt plan-specific performance targets that take into account factors
affecting only one plan, including characteristics of the plan's enrollee population. The
withheld funds must be returned no sooner than July of the following year if performance
targets in the contract are achieved. The commissioner may exclude special demonstration
projects under subdivision 23.
(d) The commissioner shall require that managed care plans use the assessment and
authorization processes, forms, timelines, standards, documentation, and data reporting
requirements, protocols, billing processes, and policies consistent with medical assistance
fee-for-service or the Department of Human Services contract requirements for all personal
care assistance services under section 256B.0659new text begin and community first services and supports
under section 256B.85new text end .
(e) Effective for services rendered on or after January 1, 2012, the commissioner shall
include as part of the performance targets described in paragraph (c) a reduction in the health
plan's emergency department utilization rate for medical assistance and MinnesotaCare
enrollees, as determined by the commissioner. For 2012, the reduction shall be based on
the health plan's utilization in 2009. To earn the return of the withhold each subsequent
year, the managed care plan or county-based purchasing plan must achieve a qualifying
reduction of no less than ten percent of the plan's emergency department utilization rate for
medical assistance and MinnesotaCare enrollees, excluding enrollees in programs described
in subdivisions 23 and 28, compared to the previous measurement year until the final
performance target is reached. When measuring performance, the commissioner must
consider the difference in health risk in a managed care or county-based purchasing plan's
membership in the baseline year compared to the measurement year, and work with the
managed care or county-based purchasing plan to account for differences that they agree
are significant.
The withheld funds must be returned no sooner than July 1 and no later than July 31 of
the following calendar year if the managed care plan or county-based purchasing plan
demonstrates to the satisfaction of the commissioner that a reduction in the utilization rate
was achieved. The commissioner shall structure the withhold so that the commissioner
returns a portion of the withheld funds in amounts commensurate with achieved reductions
in utilization less than the targeted amount.
The withhold described in this paragraph shall continue for each consecutive contract
period until the plan's emergency room utilization rate for state health care program enrollees
is reduced by 25 percent of the plan's emergency room utilization rate for medical assistance
and MinnesotaCare enrollees for calendar year 2009. Hospitals shall cooperate with the
health plans in meeting this performance target and shall accept payment withholds that
may be returned to the hospitals if the performance target is achieved.
(f) Effective for services rendered on or after January 1, 2012, the commissioner shall
include as part of the performance targets described in paragraph (c) a reduction in the plan's
hospitalization admission rate for medical assistance and MinnesotaCare enrollees, as
determined by the commissioner. To earn the return of the withhold each year, the managed
care plan or county-based purchasing plan must achieve a qualifying reduction of no less
than five percent of the plan's hospital admission rate for medical assistance and
MinnesotaCare enrollees, excluding enrollees in programs described in subdivisions 23 and
28, compared to the previous calendar year until the final performance target is reached.
When measuring performance, the commissioner must consider the difference in health risk
in a managed care or county-based purchasing plan's membership in the baseline year
compared to the measurement year, and work with the managed care or county-based
purchasing plan to account for differences that they agree are significant.
The withheld funds must be returned no sooner than July 1 and no later than July 31 of
the following calendar year if the managed care plan or county-based purchasing plan
demonstrates to the satisfaction of the commissioner that this reduction in the hospitalization
rate was achieved. The commissioner shall structure the withhold so that the commissioner
returns a portion of the withheld funds in amounts commensurate with achieved reductions
in utilization less than the targeted amount.
The withhold described in this paragraph shall continue until there is a 25 percent
reduction in the hospital admission rate compared to the hospital admission rates in calendar
year 2011, as determined by the commissioner. The hospital admissions in this performance
target do not include the admissions applicable to the subsequent hospital admission
performance target under paragraph (g). Hospitals shall cooperate with the plans in meeting
this performance target and shall accept payment withholds that may be returned to the
hospitals if the performance target is achieved.
(g) Effective for services rendered on or after January 1, 2012, the commissioner shall
include as part of the performance targets described in paragraph (c) a reduction in the plan's
hospitalization admission rates for subsequent hospitalizations within 30 days of a previous
hospitalization of a patient regardless of the reason, for medical assistance and MinnesotaCare
enrollees, as determined by the commissioner. To earn the return of the withhold each year,
the managed care plan or county-based purchasing plan must achieve a qualifying reduction
of the subsequent hospitalization rate for medical assistance and MinnesotaCare enrollees,
excluding enrollees in programs described in subdivisions 23 and 28, of no less than five
percent compared to the previous calendar year until the final performance target is reached.
The withheld funds must be returned no sooner than July 1 and no later than July 31 of
the following calendar year if the managed care plan or county-based purchasing plan
demonstrates to the satisfaction of the commissioner that a qualifying reduction in the
subsequent hospitalization rate was achieved. The commissioner shall structure the withhold
so that the commissioner returns a portion of the withheld funds in amounts commensurate
with achieved reductions in utilization less than the targeted amount.
The withhold described in this paragraph must continue for each consecutive contract
period until the plan's subsequent hospitalization rate for medical assistance and
MinnesotaCare enrollees, excluding enrollees in programs described in subdivisions 23 and
28, is reduced by 25 percent of the plan's subsequent hospitalization rate for calendar year
2011. Hospitals shall cooperate with the plans in meeting this performance target and shall
accept payment withholds that must be returned to the hospitals if the performance target
is achieved.
(h) Effective for services rendered on or after January 1, 2013, through December 31,
2013, the commissioner shall withhold 4.5 percent of managed care plan payments under
this section and county-based purchasing plan payments under section 256B.692 for the
prepaid medical assistance program. The withheld funds must be returned no sooner than
July 1 and no later than July 31 of the following year. The commissioner may exclude
special demonstration projects under subdivision 23.
(i) Effective for services rendered on or after January 1, 2014, the commissioner shall
withhold three percent of managed care plan payments under this section and county-based
purchasing plan payments under section 256B.692 for the prepaid medical assistance
program. The withheld funds must be returned no sooner than July 1 and no later than July
31 of the following year. The commissioner may exclude special demonstration projects
under subdivision 23.
(j) A managed care plan or a county-based purchasing plan under section 256B.692 may
include as admitted assets under section 62D.044 any amount withheld under this section
that is reasonably expected to be returned.
(k) Contracts between the commissioner and a prepaid health plan are exempt from the
set-aside and preference provisions of section 16C.16, subdivisions 6, paragraph (a), and
7.
(l) The return of the withhold under paragraphs (h) and (i) is not subject to the
requirements of paragraph (c).
(m) Managed care plans and county-based purchasing plans shall maintain current and
fully executed agreements for all subcontractors, including bargaining groups, for
administrative services that are expensed to the state's public health care programs.
Subcontractor agreements determined to be material, as defined by the commissioner after
taking into account state contracting and relevant statutory requirements, must be in the
form of a written instrument or electronic document containing the elements of offer,
acceptance, consideration, payment terms, scope, duration of the contract, and how the
subcontractor services relate to state public health care programs. Upon request, the
commissioner shall have access to all subcontractor documentation under this paragraph.
Nothing in this paragraph shall allow release of information that is nonpublic data pursuant
to section 13.02.
Sec. 84.
Minnesota Statutes 2020, section 256B.85, subdivision 1, is amended to read:
Subdivision 1.
Basis and scope.
(a) Upon federal approval, the commissioner shall
establish a state plan option for the provision of home and community-based personal
assistance service and supports called "community first services and supports (CFSS)."
(b) CFSS is a participant-controlled method of selecting and providing services and
supports that allows the participant maximum control of the services and supports.
Participants may choose the degree to which they direct and manage their supports by
choosing to have a significant and meaningful role in the management of services and
supports including by directly employing support workers with the necessary supports to
perform that function.
(c) CFSS is available statewide to eligible people to assist with accomplishing activities
of daily living (ADLs), instrumental activities of daily living (IADLs), and health-related
procedures and tasks through hands-on assistance to accomplish the task or constant
supervision and cueing to accomplish the task; and to assist with acquiring, maintaining,
and enhancing the skills necessary to accomplish ADLs, IADLs, and health-related
procedures and tasks. CFSS allows payment for new text begin the participant for new text end certain supports and
goods such as environmental modifications and technology that are intended to replace or
decrease the need for human assistance.
(d) Upon federal approval, CFSS will replace the personal care assistance program under
sections 256.476, 256B.0625, subdivisions 19a and 19c, and 256B.0659.
new text begin
(e) For the purposes of this section, notwithstanding the provisions of section 144A.43,
subdivision 3, supports purchased under CFSS are not considered home care services.
new text end
Sec. 85.
Minnesota Statutes 2020, section 256B.85, subdivision 2, is amended to read:
Subd. 2.
Definitions.
(a) For the purposes of this section, the terms defined in this
subdivision have the meanings given.
(b) "Activities of daily living" or "ADLs" means deleted text begin eating, toileting, grooming, dressing,
bathing, mobility, positioning, and transferring.deleted text end new text begin :
new text end
new text begin
(1) dressing, including assistance with choosing, applying, and changing clothing and
applying special appliances, wraps, or clothing;
new text end
new text begin
(2) grooming, including assistance with basic hair care, oral care, shaving, applying
cosmetics and deodorant, and care of eyeglasses and hearing aids. Grooming includes nail
care, except for recipients who are diabetic or have poor circulation;
new text end
new text begin
(3) bathing, including assistance with basic personal hygiene and skin care;
new text end
new text begin
(4) eating, including assistance with hand washing and applying orthotics required for
eating, transfers, or feeding;
new text end
new text begin
(5) transfers, including assistance with transferring the participant from one seating or
reclining area to another;
new text end
new text begin
(6) mobility, including assistance with ambulation and use of a wheelchair. Mobility
does not include providing transportation for a participant;
new text end
new text begin
(7) positioning, including assistance with positioning or turning a participant for necessary
care and comfort; and
new text end
new text begin
(8) toileting, including assistance with bowel or bladder elimination and care, transfers,
mobility, positioning, feminine hygiene, use of toileting equipment or supplies, cleansing
the perineal area, inspection of the skin, and adjusting clothing.
new text end
(c) "Agency-provider model" means a method of CFSS under which a qualified agency
provides services and supports through the agency's own employees and policies. The agency
must allow the participant to have a significant role in the selection and dismissal of support
workers of their choice for the delivery of their specific services and supports.
(d) "Behavior" means a description of a need for services and supports used to determine
the home care rating and additional service units. The presence of Level I behavior is used
to determine the home care rating.
(e) "Budget model" means a service delivery method of CFSS that allows the use of a
service budget and assistance from a financial management services (FMS) provider for a
participant to directly employ support workers and purchase supports and goods.
(f) "Complex health-related needs" means an intervention listed in clauses (1) to (8) that
has been ordered by a physician, new text begin advanced practice registered nurse, or physician's assistant
new text end and is specified in a community support plan, including:
(1) tube feedings requiring:
(i) a gastrojejunostomy tube; or
(ii) continuous tube feeding lasting longer than 12 hours per day;
(2) wounds described as:
(i) stage III or stage IV;
(ii) multiple wounds;
(iii) requiring sterile or clean dressing changes or a wound vac; or
(iv) open lesions such as burns, fistulas, tube sites, or ostomy sites that require specialized
care;
(3) parenteral therapy described as:
(i) IV therapy more than two times per week lasting longer than four hours for each
treatment; or
(ii) total parenteral nutrition (TPN) daily;
(4) respiratory interventions, including:
(i) oxygen required more than eight hours per day;
(ii) respiratory vest more than one time per day;
(iii) bronchial drainage treatments more than two times per day;
(iv) sterile or clean suctioning more than six times per day;
(v) dependence on another to apply respiratory ventilation augmentation devices such
as BiPAP and CPAP; and
(vi) ventilator dependence under section 256B.0651;
(5) insertion and maintenance of catheter, including:
(i) sterile catheter changes more than one time per month;
(ii) clean intermittent catheterization, and including self-catheterization more than six
times per day; or
(iii) bladder irrigations;
(6) bowel program more than two times per week requiring more than 30 minutes to
perform each time;
(7) neurological intervention, including:
(i) seizures more than two times per week and requiring significant physical assistance
to maintain safety; or
(ii) swallowing disorders diagnosed by a physiciannew text begin , advanced practice registered nurse,
or physician's assistantnew text end and requiring specialized assistance from another on a daily basis;
and
(8) other congenital or acquired diseases creating a need for significantly increased direct
hands-on assistance and interventions in six to eight activities of daily living.
(g) "Community first services and supports" or "CFSS" means the assistance and supports
program under this section needed for accomplishing activities of daily living, instrumental
activities of daily living, and health-related tasks through hands-on assistance to accomplish
the task or constant supervision and cueing to accomplish the task, or the purchase of goods
as defined in subdivision 7, clause (3), that replace the need for human assistance.
(h) "Community first services and supports service delivery plan" or "CFSS service
delivery plan" means a written document detailing the services and supports chosen by the
participant to meet assessed needs that are within the approved CFSS service authorization,
as determined in subdivision 8. Services and supports are based on the coordinated service
and support plan identified in deleted text begin sectiondeleted text end new text begin sections 256B.092, subdivision 1b, andnew text end 256S.10.
(i) "Consultation services" means a Minnesota health care program enrolled provider
organization that provides assistance to the participant in making informed choices about
CFSS services in general and self-directed tasks in particular, and in developing a
person-centered CFSS service delivery plan to achieve quality service outcomes.
(j) "Critical activities of daily living" means transferring, mobility, eating, and toileting.
(k) "Dependency" in activities of daily living means a person requires hands-on assistance
or constant supervision and cueing to accomplish one or more of the activities of daily living
every day or on the days during the week that the activity is performed; however, a child
deleted text begin maydeleted text end new text begin mustnew text end not be found to be dependent in an activity of daily living if, because of the child's
age, an adult would either perform the activity for the child or assist the child with the
activity and the assistance needed is the assistance appropriate for a typical child of the
same age.
(l) "Extended CFSS" means CFSS services and supports provided under CFSS that are
included in the CFSS service delivery plan through one of the home and community-based
services waivers and as approved and authorized under chapter 256S and sections 256B.092,
subdivision 5, and 256B.49, which exceed the amount, duration, and frequency of the state
plan CFSS services for participants.new text begin Extended CFSS excludes the purchase of goods.
new text end
(m) "Financial management services provider" or "FMS provider" means a qualified
organization required for participants using the budget model under subdivision 13 that is
an enrolled provider with the department to provide vendor fiscal/employer agent financial
management services (FMS).
(n) "Health-related procedures and tasks" means procedures and tasks related to the
specific assessed health needs of a participant that can be taught or assigned by a
state-licensed health care or mental health professional and performed by a support worker.
(o) "Instrumental activities of daily living" means activities related to living independently
in the community, including but not limited to: meal planning, preparation, and cooking;
shopping for food, clothing, or other essential items; laundry; housecleaning; assistance
with medications; managing finances; communicating needs and preferences during activities;
arranging supports; and assistance with traveling around and participating in the community.
(p) "Lead agency" has the meaning given in section 256B.0911, subdivision 1a, paragraph
(e).
(q) "Legal representative" means parent of a minor, a court-appointed guardian, or
another representative with legal authority to make decisions about services and supports
for the participant. Other representatives with legal authority to make decisions include but
are not limited to a health care agent or an attorney-in-fact authorized through a health care
directive or power of attorney.
(r) "Level I behavior" means physical aggression deleted text begin towardsdeleted text end new text begin towardnew text end self or others or
destruction of property that requires the immediate response of another person.
(s) "Medication assistance" means providing verbal or visual reminders to take regularly
scheduled medication, and includes any of the following supports listed in clauses (1) to
(3) and other types of assistance, except that a support worker deleted text begin maydeleted text end new text begin mustnew text end not determine
medication dose or time for medication or inject medications into veins, muscles, or skin:
(1) under the direction of the participant or the participant's representative, bringing
medications to the participant including medications given through a nebulizer, opening a
container of previously set-up medications, emptying the container into the participant's
hand, opening and giving the medication in the original container to the participant, or
bringing to the participant liquids or food to accompany the medication;
(2) organizing medications as directed by the participant or the participant's representative;
and
(3) providing verbal or visual reminders to perform regularly scheduled medications.
(t) "Participant" means a person who is eligible for CFSS.
(u) "Participant's representative" means a parent, family member, advocate, or other
adult authorized by the participant or participant's legal representative, if any, to serve as a
representative in connection with the provision of CFSS. deleted text begin This authorization must be in
writing or by another method that clearly indicates the participant's free choice and may be
withdrawn at any time. The participant's representative must have no financial interest in
the provision of any services included in the participant's CFSS service delivery plan and
must be capable of providing the support necessary to assist the participant in the use of
CFSS. If through the assessment process described in subdivision 5 a participant is
determined to be in need of a participant's representative, one must be selected.deleted text end If the
participant is unable to assist in the selection of a participant's representative, the legal
representative shall appoint one. deleted text begin Two persons may be designated as a participant's
representative for reasons such as divided households and court-ordered custodies. Duties
of a participant's representatives may include:
deleted text end
deleted text begin
(1) being available while services are provided in a method agreed upon by the participant
or the participant's legal representative and documented in the participant's CFSS service
delivery plan;
deleted text end
deleted text begin
(2) monitoring CFSS services to ensure the participant's CFSS service delivery plan is
being followed; and
deleted text end
deleted text begin
(3) reviewing and signing CFSS time sheets after services are provided to provide
verification of the CFSS services.
deleted text end
(v) "Person-centered planning process" means a process that is directed by the participant
to plan for CFSS services and supports.
(w) "Service budget" means the authorized dollar amount used for the budget model or
for the purchase of goods.
(x) "Shared services" means the provision of CFSS services by the same CFSS support
worker to two or three participants who voluntarily enter into deleted text begin andeleted text end new text begin a writtennew text end agreement to
receive services at the same time deleted text begin anddeleted text end new text begin ,new text end in the same setting deleted text begin bydeleted text end new text begin , and throughnew text end the same deleted text begin employerdeleted text end new text begin
agency-provider or FMS providernew text end .
(y) "Support worker" means a qualified and trained employee of the agency-provider
as required by subdivision 11b or of the participant employer under the budget model as
required by subdivision 14 who has direct contact with the participant and provides services
as specified within the participant's CFSS service delivery plan.
(z) "Unit" means the increment of service based on hours or minutes identified in the
service agreement.
(aa) "Vendor fiscal employer agent" means an agency that provides financial management
services.
(bb) "Wages and benefits" means the hourly wages and salaries, the employer's share
of FICA taxes, Medicare taxes, state and federal unemployment taxes, workers' compensation,
mileage reimbursement, health and dental insurance, life insurance, disability insurance,
long-term care insurance, uniform allowance, contributions to employee retirement accounts,
or other forms of employee compensation and benefits.
(cc) "Worker training and development" means services provided according to subdivision
18a for developing workers' skills as required by the participant's individual CFSS service
delivery plan that are arranged for or provided by the agency-provider or purchased by the
participant employer. These services include training, education, direct observation and
supervision, and evaluation and coaching of job skills and tasks, including supervision of
health-related tasks or behavioral supports.
Sec. 86.
Minnesota Statutes 2020, section 256B.85, subdivision 3, is amended to read:
Subd. 3.
Eligibility.
(a) CFSS is available to a person who deleted text begin meets one of the followingdeleted text end :
deleted text begin
(1) is an enrollee of medical assistance as determined under section 256B.055, 256B.056,
or 256B.057, subdivisions 5 and 9;
deleted text end
new text begin
(1) is determined eligible for medical assistance under this chapter, excluding those
under section 256B.057, subdivisions 3, 3a, 3b, and 4;
new text end
(2) is a participant in the alternative care program under section 256B.0913;
(3) is a waiver participant as defined under chapter 256S or section 256B.092, 256B.093,
or 256B.49; or
(4) has medical services identified in a person's individualized education program and
is eligible for services as determined in section 256B.0625, subdivision 26.
(b) In addition to meeting the eligibility criteria in paragraph (a), a person must also
meet all of the following:
(1) require assistance and be determined dependent in one activity of daily living or
Level I behavior based on assessment under section 256B.0911; and
(2) is not a participant under a family support grant under section 252.32.
(c) A pregnant woman eligible for medical assistance under section 256B.055, subdivision
6, is eligible for CFSS without federal financial participation if the woman: (1) is eligible
for CFSS under paragraphs (a) and (b); and (2) does not meet institutional level of care, as
determined under section 256B.0911.
Sec. 87.
Minnesota Statutes 2020, section 256B.85, subdivision 4, is amended to read:
Subd. 4.
Eligibility for other services.
Selection of CFSS by a participant must not
restrict access to other medically necessary care and services furnished under the state plan
benefit or other services available through new text begin the new text end alternative carenew text begin programnew text end .
Sec. 88.
Minnesota Statutes 2020, section 256B.85, subdivision 5, is amended to read:
Subd. 5.
Assessment requirements.
(a) The assessment of functional need must:
(1) be conducted by a certified assessor according to the criteria established in section
256B.0911, subdivision 3a;
(2) be conducted face-to-face, initially and at least annually thereafter, or when there is
a significant change in the participant's condition or a change in the need for services and
supports, or at the request of the participant when the participant experiences a change in
condition or needs a change in the services or supports; and
(3) be completed using the format established by the commissioner.
(b) The results of the assessment and any recommendations and authorizations for CFSS
must be determined and communicated in writing by the lead agency's deleted text begin certifieddeleted text end assessor as
defined in section 256B.0911 to the participant deleted text begin and the agency-provider or FMS provider
chosen by the participantdeleted text end new text begin or the participant's representative and chosen CFSS providersnew text end
within deleted text begin 40 calendardeleted text end new text begin ten business new text end days and must include the participant's right to appeal new text begin the
assessment new text end under section 256.045, subdivision 3.
(c) The lead agency assessor may authorize a temporary authorization for CFSS services
to be provided under the agency-provider model. new text begin The lead agency assessor may authorize
a temporary authorization for CFSS services to be provided under the agency-provider
model without using the assessment process described in this subdivision. new text end Authorization
for a temporary level of CFSS services under the agency-provider model is limited to the
time specified by the commissioner, but shall not exceed 45 days. The level of services
authorized under this paragraph shall have no bearing on a future authorization. deleted text begin Participants
approved for a temporary authorization shall access the consultation servicedeleted text end new text begin For CFSS
services needed beyond the 45-day temporary authorization, the lead agency must conduct
an assessment as described in this subdivision and participants must use consultation servicesnew text end
to complete their orientation and selection of a service model.
Sec. 89.
Minnesota Statutes 2020, section 256B.85, subdivision 6, is amended to read:
Subd. 6.
Community first services and supports service delivery plan.
(a) The CFSS
service delivery plan must be developed and evaluated through a person-centered planning
process by the participant, or the participant's representative or legal representative who
may be assisted by a consultation services provider. The CFSS service delivery plan must
reflect the services and supports that are important to the participant and for the participant
to meet the needs assessed by the certified assessor and identified in the coordinated service
and support plan identified in deleted text begin sectiondeleted text end new text begin sections 256B.092, subdivision 1b, andnew text end 256S.10. The
CFSS service delivery plan must be reviewed by the participant, the consultation services
provider, and the agency-provider or FMS provider prior to starting services and at least
annually upon reassessment, or when there is a significant change in the participant's
condition, or a change in the need for services and supports.
(b) The commissioner shall establish the format and criteria for the CFSS service delivery
plan.
(c) The CFSS service delivery plan must be person-centered and:
(1) specify the consultation services provider, agency-provider, or FMS provider selected
by the participant;
(2) reflect the setting in which the participant resides that is chosen by the participant;
(3) reflect the participant's strengths and preferences;
(4) include the methods and supports used to address the needs as identified through an
assessment of functional needs;
(5) include the participant's identified goals and desired outcomes;
(6) reflect the services and supports, paid and unpaid, that will assist the participant to
achieve identified goals, including the costs of the services and supports, and the providers
of those services and supports, including natural supports;
(7) identify the amount and frequency of face-to-face supports and amount and frequency
of remote supports and technology that will be used;
(8) identify risk factors and measures in place to minimize them, including individualized
backup plans;
(9) be understandable to the participant and the individuals providing support;
(10) identify the individual or entity responsible for monitoring the plan;
(11) be finalized and agreed to in writing by the participant and signed by deleted text begin alldeleted text end individuals
and providers responsible for its implementation;
(12) be distributed to the participant and other people involved in the plan;
(13) prevent the provision of unnecessary or inappropriate care;
(14) include a detailed budget for expenditures for budget model participants or
participants under the agency-provider model if purchasing goods; and
(15) include a plan for worker training and development provided according to
subdivision 18a detailing what service components will be used, when the service components
will be used, how they will be provided, and how these service components relate to the
participant's individual needs and CFSS support worker services.
(d) new text begin The CFSS service delivery plan must describe the units or dollar amount available
to the participant. new text end The total units of agency-provider services or the service budget amount
for the budget model include both annual totals and a monthly average amount that cover
the number of months of the service agreement. The amount used each month may vary,
but additional funds must not be provided above the annual service authorization amount,
determined according to subdivision 8, unless a change in condition is assessed and
authorized by the certified assessor and documented in the coordinated service and support
plan and CFSS service delivery plan.
(e) In assisting with the development or modification of the CFSS service delivery plan
during the authorization time period, the consultation services provider shall:
(1) consult with the FMS provider on the spending budget when applicable; and
(2) consult with the participant or participant's representative, agency-provider, and case
managerdeleted text begin /deleted text end new text begin or new text end care coordinator.
(f) The CFSS service delivery plan must be approved by the consultation services provider
for participants without a case manager or care coordinator who is responsible for authorizing
services. A case manager or care coordinator must approve the plan for a waiver or alternative
care program participant.
Sec. 90.
Minnesota Statutes 2020, section 256B.85, subdivision 7, is amended to read:
Subd. 7.
Community first services and supports; covered services.
Services and
supports covered under CFSS include:
(1) assistance to accomplish activities of daily living (ADLs), instrumental activities of
daily living (IADLs), and health-related procedures and tasks through hands-on assistance
to accomplish the task or constant supervision and cueing to accomplish the task;
(2) assistance to acquire, maintain, or enhance the skills necessary for the participant to
accomplish activities of daily living, instrumental activities of daily living, or health-related
tasks;
(3) expenditures for items, services, supports, environmental modifications, or goods,
including assistive technology. These expenditures must:
(i) relate to a need identified in a participant's CFSS service delivery plan; and
(ii) increase independence or substitute for human assistancenew text begin ,new text end to the extent that
expenditures would otherwise be made for human assistance for the participant's assessed
needs;
(4) observation and redirection for behavior or symptoms where there is a need for
assistance;
(5) back-up systems or mechanisms, such as the use of pagers or other electronic devices,
to ensure continuity of the participant's services and supports;
(6) services provided by a consultation services provider as defined under subdivision
17, that is under contract with the department and enrolled as a Minnesota health care
program provider;
(7) services provided by an FMS provider as defined under subdivision 13a, that is an
enrolled provider with the department;
(8) CFSS services provided by a support worker who is a parent, stepparent, or legal
guardian of a participant under age 18, or who is the participant's spouse. These support
workers shall notnew text begin :
new text end
new text begin (i)new text end provide any medical assistance home and community-based services in excess of 40
hours per seven-day period regardless of the number of parents providing services,
combination of parents and spouses providing services, or number of children who receive
medical assistance services; and
new text begin
(ii) have a wage that exceeds the current rate for a CFSS support worker including the
wage, benefits, and payroll taxes; and
new text end
(9) worker training and development services as described in subdivision 18a.
Sec. 91.
Minnesota Statutes 2020, section 256B.85, subdivision 8, is amended to read:
Subd. 8.
Determination of CFSS service authorization amount.
(a) All community
first services and supports must be authorized by the commissioner or the commissioner's
designee before services begin. The authorization for CFSS must be completed as soon as
possible following an assessment but no later than 40 calendar days from the date of the
assessment.
(b) The amount of CFSS authorized must be based on the participant's home care rating
described in paragraphs (d) and (e) and any additional service units for which the participant
qualifies as described in paragraph (f).
(c) The home care rating shall be determined by the commissioner or the commissioner's
designee based on information submitted to the commissioner identifying the following for
a participant:
(1) the total number of dependencies of activities of daily living;
(2) the presence of complex health-related needs; and
(3) the presence of Level I behavior.
(d) The methodology to determine the total service units for CFSS for each home care
rating is based on the median paid units per day for each home care rating from fiscal year
2007 data for the PCA program.
(e) Each home care rating is designated by the letters P through Z and EN and has the
following base number of service units assigned:
(1) P home care rating requires Level I behavior or one to three dependencies in ADLs
and qualifies the person for five service units;
(2) Q home care rating requires Level I behavior and one to three dependencies in ADLs
and qualifies the person for six service units;
(3) R home care rating requires a complex health-related need and one to three
dependencies in ADLs and qualifies the person for seven service units;
(4) S home care rating requires four to six dependencies in ADLs and qualifies the person
for ten service units;
(5) T home care rating requires four to six dependencies in ADLs and Level I behavior
and qualifies the person for 11 service units;
(6) U home care rating requires four to six dependencies in ADLs and a complex
health-related need and qualifies the person for 14 service units;
(7) V home care rating requires seven to eight dependencies in ADLs and qualifies the
person for 17 service units;
(8) W home care rating requires seven to eight dependencies in ADLs and Level I
behavior and qualifies the person for 20 service units;
(9) Z home care rating requires seven to eight dependencies in ADLs and a complex
health-related need and qualifies the person for 30 service units; and
(10) EN home care rating includes ventilator dependency as defined in section 256B.0651,
subdivision 1, paragraph (g). A person who meets the definition of ventilator-dependent
and the EN home care rating and utilize a combination of CFSS and home care nursing
services is limited to a total of 96 service units per day for those services in combination.
Additional units may be authorized when a person's assessment indicates a need for two
staff to perform activities. Additional time is limited to 16 service units per day.
(f) Additional service units are provided through the assessment and identification of
the following:
(1) 30 additional minutes per day for a dependency in each critical activity of daily
living;
(2) 30 additional minutes per day for each complex health-related need; and
(3) 30 additional minutes per day deleted text begin when thedeleted text end new text begin for eachnew text end behavior new text begin under this clause that
new text end requires assistance at least four times per week deleted text begin for one or more of the following behaviorsdeleted text end :
(i) level I behaviornew text begin that requires the immediate response of another personnew text end ;
(ii) increased vulnerability due to cognitive deficits or socially inappropriate behavior;
or
(iii) increased need for assistance for participants who are verbally aggressive or resistive
to care so that the time needed to perform activities of daily living is increased.
(g) The service budget for budget model participants shall be based on:
(1) assessed units as determined by the home care rating; and
(2) an adjustment needed for administrative expenses.
Sec. 92.
Minnesota Statutes 2020, section 256B.85, is amended by adding a subdivision
to read:
new text begin Subd. 8a. new text end
new text begin Authorization; exceptions. new text end
new text begin
All CFSS services must be authorized by the
commissioner or the commissioner's designee as described in subdivision 8 except when:
new text end
new text begin
(1) the lead agency temporarily authorizes services in the agency-provider model as
described in subdivision 5, paragraph (c);
new text end
new text begin
(2) CFSS services in the agency-provider model were required to treat an emergency
medical condition that if not immediately treated could cause a participant serious physical
or mental disability, continuation of severe pain, or death. The CFSS agency provider must
request retroactive authorization from the lead agency no later than five working days after
providing the initial emergency service. The CFSS agency provider must be able to
substantiate the emergency through documentation such as reports, notes, and admission
or discharge histories. A lead agency must follow the authorization process in subdivision
5 after the lead agency receives the request for authorization from the agency provider;
new text end
new text begin
(3) the lead agency authorizes a temporary increase to the amount of services authorized
in the agency or budget model to accommodate the participant's temporary higher need for
services. Authorization for a temporary level of CFSS services is limited to the time specified
by the commissioner, but shall not exceed 45 days. The level of services authorized under
this clause shall have no bearing on a future authorization;
new text end
new text begin
(4) a participant's medical assistance eligibility has lapsed, is then retroactively reinstated,
and an authorization for CFSS services is completed based on the date of a current
assessment, eligibility, and request for authorization;
new text end
new text begin
(5) a third-party payer for CFSS services has denied or adjusted a payment. Authorization
requests must be submitted by the provider within 20 working days of the notice of denial
or adjustment. A copy of the notice must be included with the request;
new text end
new text begin
(6) the commissioner has determined that a lead agency or state human services agency
has made an error; or
new text end
new text begin
(7) a participant enrolled in managed care experiences a temporary disenrollment from
a health plan, in which case the commissioner shall accept the current health plan
authorization for CFSS services for up to 60 days. The request must be received within the
first 30 days of the disenrollment. If the recipient's reenrollment in managed care is after
the 60 days and before 90 days, the provider shall request an additional 30-day extension
of the current health plan authorization, for a total limit of 90 days from the time of
disenrollment.
new text end
Sec. 93.
Minnesota Statutes 2020, section 256B.85, subdivision 9, is amended to read:
Subd. 9.
Noncovered services.
(a) Services or supports that are not eligible for payment
under this section include those that:
(1) are not authorized by the certified assessor or included in the CFSS service delivery
plan;
(2) are provided prior to the authorization of services and the approval of the CFSS
service delivery plan;
(3) are duplicative of other paid services in the CFSS service delivery plan;
(4) supplant natural unpaid supports that appropriately meet a need in the CFSS service
delivery plan, are provided voluntarily to the participant, and are selected by the participant
in lieu of other services and supports;
(5) are not effective means to meet the participant's needs; and
(6) are available through other funding sources, includingdeleted text begin ,deleted text end but not limited todeleted text begin ,deleted text end funding
through title IV-E of the Social Security Act.
(b) Additional services, goods, or supports that are not covered include:
(1) those that are not for the direct benefit of the participant, except that services for
caregivers such as training to improve the ability to provide CFSS are considered to directly
benefit the participant if chosen by the participant and approved in the support plan;
(2) any fees incurred by the participant, such as Minnesota health care programs fees
and co-pays, legal fees, or costs related to advocate agencies;
(3) insurance, except for insurance costs related to employee coverage;
(4) room and board costs for the participant;
(5) services, supports, or goods that are not related to the assessed needs;
(6) special education and related services provided under the Individuals with Disabilities
Education Act and vocational rehabilitation services provided under the Rehabilitation Act
of 1973;
(7) assistive technology devices and assistive technology services other than those for
back-up systems or mechanisms to ensure continuity of service and supports listed in
subdivision 7;
(8) medical supplies and equipment covered under medical assistance;
(9) environmental modifications, except as specified in subdivision 7;
(10) expenses for travel, lodging, or meals related to training the participant or the
participant's representative or legal representative;
(11) experimental treatments;
(12) any service or good covered by other state plan services, including prescription and
over-the-counter medications, compounds, and solutions and related fees, including premiums
and co-payments;
(13) membership dues or costs, except when the service is necessary and appropriate to
treat a health condition or to improve or maintain the new text begin adult new text end participant's health condition.
The condition must be identified in the participant's CFSS service delivery plan and
monitored by a Minnesota health care program enrolled physiciannew text begin , advanced practice
registered nurse, or physician's assistantnew text end ;
(14) vacation expenses other than the cost of direct services;
(15) vehicle maintenance or modifications not related to the disability, health condition,
or physical need;
(16) tickets and related costs to attend sporting or other recreational or entertainment
events;
(17) services provided and billed by a provider who is not an enrolled CFSS provider;
(18) CFSS provided by a participant's representative or paid legal guardian;
(19) services that are used solely as a child care or babysitting service;
(20) services that are the responsibility or in the daily rate of a residential or program
license holder under the terms of a service agreement and administrative rules;
(21) sterile procedures;
(22) giving of injections into veins, muscles, or skin;
(23) homemaker services that are not an integral part of the assessed CFSS service;
(24) home maintenance or chore services;
(25) home care services, including hospice services if elected by the participant, covered
by Medicare or any other insurance held by the participant;
(26) services to other members of the participant's household;
(27) services not specified as covered under medical assistance as CFSS;
(28) application of restraints or implementation of deprivation procedures;
(29) assessments by CFSS provider organizations or by independently enrolled registered
nurses;
(30) services provided in lieu of legally required staffing in a residential or child care
setting; deleted text begin and
deleted text end
(31) services provided by deleted text begin the residential or programdeleted text end new text begin a foster carenew text end license holder deleted text begin in a
residence for more than four participants.deleted text end new text begin except when the home of the person receiving
services is the licensed foster care provider's primary residence;
new text end
new text begin
(32) services that are the responsibility of the foster care provider under the terms of the
foster care placement agreement, assessment under sections 256N.24 and 260C.4411, and
administrative rules under sections 256N.24 and 260C.4411;
new text end
new text begin
(33) services in a setting that has a licensed capacity greater than six, unless all conditions
for a variance under section 245A.04, subdivision 9a, are satisfied for a sibling, as defined
in section 260C.007, subdivision 32;
new text end
new text begin
(34) services from a provider who owns or otherwise controls the living arrangement,
except when the provider of services is related by blood, marriage, or adoption or when the
provider is a licensed foster care provider who is not prohibited from providing services
under clauses (31) to (33);
new text end
new text begin
(35) instrumental activities of daily living for children younger than 18 years of age,
except when immediate attention is needed for health or hygiene reasons integral to an
assessed need for assistance with activities of daily living, health-related procedures, and
tasks or behaviors; or
new text end
new text begin
(36) services provided to a resident of a nursing facility, hospital, intermediate care
facility, or health care facility licensed by the commissioner of health.
new text end
Sec. 94.
Minnesota Statutes 2020, section 256B.85, subdivision 10, is amended to read:
Subd. 10.
Agency-provider and FMS provider qualifications and duties.
(a)
Agency-providers identified in subdivision 11 and FMS providers identified in subdivision
13a shall:
(1) enroll as a medical assistance Minnesota health care programs provider and meet all
applicable provider standards and requirementsnew text begin including completion of required provider
training as determined by the commissionernew text end ;
(2) demonstrate compliance with federal and state laws and policies for CFSS as
determined by the commissioner;
(3) comply with background study requirements under chapter 245C and maintain
documentation of background study requests and results;
(4) verify and maintain records of all services and expenditures by the participant,
including hours worked by support workers;
(5) not engage in any agency-initiated direct contact or marketing in person, by telephone,
or other electronic means to potential participants, guardians, family members, or participants'
representatives;
(6) directly provide services and not use a subcontractor or reporting agent;
(7) meet the financial requirements established by the commissioner for financial
solvency;
(8) have never had a lead agency contract or provider agreement discontinued due to
fraud, or have never had an owner, board member, or manager fail a state or FBI-based
criminal background check while enrolled or seeking enrollment as a Minnesota health care
programs provider; and
(9) have an office located in Minnesota.
(b) In conducting general duties, agency-providers and FMS providers shall:
(1) pay support workers based upon actual hours of services provided;
(2) pay for worker training and development services based upon actual hours of services
provided or the unit cost of the training session purchased;
(3) withhold and pay all applicable federal and state payroll taxes;
(4) make arrangements and pay unemployment insurance, taxes, workers' compensation,
liability insurance, and other benefits, if any;
(5) enter into a written agreement with the participant, participant's representative, or
legal representative that assigns roles and responsibilities to be performed before services,
supports, or goods are providednew text begin and that meets the requirements of subdivisions 20a, 20b,
and 20c for agency-providersnew text end ;
(6) report maltreatment as required under section 626.557 and chapter 260E;
(7) comply with the labor market reporting requirements described in section 256B.4912,
subdivision 1a;
(8) comply with any data requests from the department consistent with the Minnesota
Government Data Practices Act under chapter 13; deleted text begin and
deleted text end
(9) maintain documentation for the requirements under subdivision 16, paragraph (e),
clause (2), to qualify for an enhanced rate under this sectiondeleted text begin .deleted text end new text begin ; and
new text end
new text begin
(10) request reassessments 60 days before the end of the current authorization for CFSS
on forms provided by the commissioner.
new text end
Sec. 95.
Minnesota Statutes 2020, section 256B.85, subdivision 11, is amended to read:
Subd. 11.
Agency-provider model.
(a) The agency-provider model includes services
provided by support workers and staff providing worker training and development services
who are employed by an agency-provider that meets the criteria established by the
commissioner, including required training.
(b) The agency-provider shall allow the participant to have a significant role in the
selection and dismissal of the support workers for the delivery of the services and supports
specified in the participant's CFSS service delivery plan.new text begin The agency must make a reasonable
effort to fulfill the participant's request for the participant's preferred worker.
new text end
(c) A participant may use authorized units of CFSS services as needed within a service
agreement that is not greater than 12 months. Using authorized units in a flexible manner
in either the agency-provider model or the budget model does not increase the total amount
of services and supports authorized for a participant or included in the participant's CFSS
service delivery plan.
(d) A participant may share CFSS services. Two or three CFSS participants may share
services at the same time provided by the same support worker.
(e) The agency-provider must use a minimum of 72.5 percent of the revenue generated
by the medical assistance payment for CFSS for support worker wages and benefits, except
all of the revenue generated by a medical assistance rate increase due to a collective
bargaining agreement under section 179A.54 must be used for support worker wages and
benefits. The agency-provider must document how this requirement is being met. The
revenue generated by the worker training and development services and the reasonable costs
associated with the worker training and development services must not be used in making
this calculation.
(f) The agency-provider model must be used by deleted text begin individualsdeleted text end new text begin participantsnew text end who are restricted
by the Minnesota restricted recipient program under Minnesota Rules, parts 9505.2160 to
9505.2245.
(g) Participants purchasing goods under this model, along with support worker services,
must:
(1) specify the goods in the CFSS service delivery plan and detailed budget for
expenditures that must be approved by the consultation services provider, case manager, or
care coordinator; and
(2) use the FMS provider for the billing and payment of such goods.
Sec. 96.
Minnesota Statutes 2020, section 256B.85, subdivision 11b, is amended to read:
Subd. 11b.
Agency-provider model; support worker competency.
(a) The
agency-provider must ensure that support workers are competent to meet the participant's
assessed needs, goals, and additional requirements as written in the CFSS service delivery
plan. deleted text begin Within 30 days of any support worker beginning to provide services for a participant,deleted text end
The agency-provider must evaluate the competency of the worker through direct observation
of the support worker's performance of the job functions in a setting where the participant
is using CFSSdeleted text begin .deleted text end new text begin within 30 days of:
new text end
new text begin
(1) any support worker beginning to provide services for a participant; or
new text end
new text begin
(2) any support worker beginning to provide shared services.
new text end
(b) The agency-provider must verify and maintain evidence of support worker
competency, including documentation of the support worker's:
(1) education and experience relevant to the job responsibilities assigned to the support
worker and the needs of the participant;
(2) relevant training received from sources other than the agency-provider;
(3) orientation and instruction to implement services and supports to participant needs
and preferences as identified in the CFSS service delivery plan; deleted text begin and
deleted text end
new text begin
(4) orientation and instruction delivered by an individual competent to perform, teach,
or assign the health-related tasks for tracheostomy suctioning and services to participants
on ventilator support, including equipment operation and maintenance; and
new text end
deleted text begin (4)deleted text end new text begin (5)new text end periodic performance reviews completed by the agency-provider at least annually,
including any evaluations required under subdivision 11a, paragraph (a). If a support worker
is a minor, all evaluations of worker competency must be completed in person and in a
setting where the participant is using CFSS.
(c) The agency-provider must develop a worker training and development plan with the
participant to ensure support worker competency. The worker training and development
plan must be updated when:
(1) the support worker begins providing services;
new text begin
(2) the support worker begins providing shared services;
new text end
deleted text begin (2)deleted text end new text begin (3)new text end there is any change in condition or a modification to the CFSS service delivery
plan; or
deleted text begin (3)deleted text end new text begin (4)new text end a performance review indicates that additional training is needed.
Sec. 97.
Minnesota Statutes 2020, section 256B.85, subdivision 12, is amended to read:
Subd. 12.
Requirements for enrollment of CFSS agency-providers.
(a) All CFSS
agency-providers must provide, at the time of enrollment, reenrollment, and revalidation
as a CFSS agency-provider in a format determined by the commissioner, information and
documentation that includesdeleted text begin ,deleted text end but is not limited todeleted text begin ,deleted text end the following:
(1) the CFSS agency-provider's current contact information including address, telephone
number, and e-mail address;
(2) proof of surety bond coverage. Upon new enrollment, or if the agency-provider's
Medicaid revenue in the previous calendar year is less than or equal to $300,000, the
agency-provider must purchase a surety bond of $50,000. If the agency-provider's Medicaid
revenue in the previous calendar year is greater than $300,000, the agency-provider must
purchase a surety bond of $100,000. The surety bond must be in a form approved by the
commissioner, must be renewed annually, and must allow for recovery of costs and fees in
pursuing a claim on the bond;
(3) proof of fidelity bond coverage in the amount of $20,000new text begin per provider locationnew text end ;
(4) proof of workers' compensation insurance coverage;
(5) proof of liability insurance;
(6) a deleted text begin descriptiondeleted text end new text begin copynew text end of the CFSS agency-provider's deleted text begin organizationdeleted text end new text begin organizational chartnew text end
identifying the names new text begin and roles new text end of all owners, managing employees, staff, board of directors,
and deleted text begin thedeleted text end new text begin additional documentation reporting anynew text end affiliations of the directors and owners to
other service providers;
(7) deleted text begin a copy ofdeleted text end new text begin proof thatnew text end the CFSS deleted text begin agency-provider'sdeleted text end new text begin agency-provider hasnew text end written policies
and procedures including: hiring of employees; training requirements; service delivery; and
employee and consumer safety, including the process for notification and resolution of
participant grievances, incident response, identification and prevention of communicable
diseases, and employee misconduct;
(8) deleted text begin copies of all other formsdeleted text end new text begin proof thatnew text end the CFSS agency-provider deleted text begin uses in the course of
daily business including, but not limited todeleted text end new text begin has all of the following forms and documentsnew text end :
(i) a copy of the CFSS agency-provider's time sheet; and
(ii) a copy of the participant's individual CFSS service delivery plan;
(9) a list of all training and classes that the CFSS agency-provider requires of its staff
providing CFSS services;
(10) documentation that the CFSS agency-provider and staff have successfully completed
all the training required by this section;
(11) documentation of the agency-provider's marketing practices;
(12) disclosure of ownership, leasing, or management of all residential properties that
are used or could be used for providing home care services;
(13) documentation that the agency-provider will use at least the following percentages
of revenue generated from the medical assistance rate paid for CFSS services for CFSS
support worker wages and benefits: 72.5 percent of revenue from CFSS providers, except
100 percent of the revenue generated by a medical assistance rate increase due to a collective
bargaining agreement under section 179A.54 must be used for support worker wages and
benefits. The revenue generated by the worker training and development services and the
reasonable costs associated with the worker training and development services shall not be
used in making this calculation; and
(14) documentation that the agency-provider does not burden participants' free exercise
of their right to choose service providers by requiring CFSS support workers to sign an
agreement not to work with any particular CFSS participant or for another CFSS
agency-provider after leaving the agency and that the agency is not taking action on any
such agreements or requirements regardless of the date signed.
(b) CFSS agency-providers shall provide to the commissioner the information specified
in paragraph (a).
(c) All CFSS agency-providers shall require all employees in management and
supervisory positions and owners of the agency who are active in the day-to-day management
and operations of the agency to complete mandatory training as determined by the
commissioner. Employees in management and supervisory positions and owners who are
active in the day-to-day operations of an agency who have completed the required training
as an employee with a CFSS agency-provider do not need to repeat the required training if
they are hired by another agencydeleted text begin , ifdeleted text end new text begin andnew text end they have completed the training within the past
three years. CFSS agency-provider billing staff shall complete training about CFSS program
financial management. Any new owners or employees in management and supervisory
positions involved in the day-to-day operations are required to complete mandatory training
as a requisite of working for the agency.
deleted text begin
(d) The commissioner shall send annual review notifications to agency-providers 30
days prior to renewal. The notification must:
deleted text end
deleted text begin
(1) list the materials and information the agency-provider is required to submit;
deleted text end
deleted text begin
(2) provide instructions on submitting information to the commissioner; and
deleted text end
deleted text begin
(3) provide a due date by which the commissioner must receive the requested information.
deleted text end
deleted text begin
Agency-providers shall submit all required documentation for annual review within 30 days
of notification from the commissioner. If an agency-provider fails to submit all the required
documentation, the commissioner may take action under subdivision 23a.
deleted text end
new text begin
(d) Agency-providers shall submit all required documentation in this section within 30
days of notification from the commissioner. If an agency-provider fails to submit all the
required documentation, the commissioner may take action under subdivision 23a.
new text end
Sec. 98.
Minnesota Statutes 2020, section 256B.85, subdivision 12b, is amended to read:
Subd. 12b.
CFSS agency-provider requirements; notice regarding termination of
services.
(a) An agency-provider must provide written notice when it intends to terminate
services with a participant at least deleted text begin tendeleted text end new text begin 30new text end calendar days before the proposed service
termination is to become effective, except in cases where:
(1) the participant engages in conduct that significantly alters the terms of the CFSS
service delivery plan with the agency-provider;
(2) the participant or other persons at the setting where services are being provided
engage in conduct that creates an imminent risk of harm to the support worker or other
agency-provider staff; or
(3) an emergency or a significant change in the participant's condition occurs within a
24-hour period that results in the participant's service needs exceeding the participant's
identified needs in the current CFSS service delivery plan so that the agency-provider cannot
safely meet the participant's needs.
(b) When a participant initiates a request to terminate CFSS services with the
agency-provider, the agency-provider must give the participant a written deleted text begin acknowledgementdeleted text end new text begin
acknowledgmentnew text end of the participant's service termination request that includes the date the
request was received by the agency-provider and the requested date of termination.
(c) The agency-provider must participate in a coordinated transfer of the participant to
a new agency-provider to ensure continuity of care.
Sec. 99.
Minnesota Statutes 2020, section 256B.85, subdivision 13, is amended to read:
Subd. 13.
Budget model.
(a) Under the budget model participants exercise responsibility
and control over the services and supports described and budgeted within the CFSS service
delivery plan. Participants must use services specified in subdivision 13a provided by an
FMS provider. Under this model, participants may use their approved service budget
allocation to:
(1) directly employ support workers, and pay wages, federal and state payroll taxes, and
premiums for workers' compensation, liability, and health insurance coverage; and
(2) obtain supports and goods as defined in subdivision 7.
(b) Participants who are unable to fulfill any of the functions listed in paragraph (a) may
authorize a legal representative or participant's representative to do so on their behalf.
new text begin
(c) If two or more participants using the budget model live in the same household and
have the same worker, the participants must use the same FMS provider.
new text end
new text begin
(d) If the FMS provider advises that there is a joint employer in the budget model, all
participants associated with that joint employer must use the same FMS provider.
new text end
deleted text begin (c)deleted text end new text begin (e)new text end The commissioner shall disenroll or exclude participants from the budget model
and transfer them to the agency-provider model under, but not limited to, the following
circumstances:
(1) when a participant has been restricted by the Minnesota restricted recipient program,
in which case the participant may be excluded for a specified time period under Minnesota
Rules, parts 9505.2160 to 9505.2245;
(2) when a participant exits the budget model during the participant's service plan year.
Upon transfer, the participant shall not access the budget model for the remainder of that
service plan year; or
(3) when the department determines that the participant or participant's representative
or legal representative is unable to fulfill the responsibilities under the budget model, as
specified in subdivision 14.
deleted text begin (d)deleted text end new text begin (f)new text end A participant may appeal in writing to the department under section 256.045,
subdivision 3, to contest the department's decision under paragraph deleted text begin (c)deleted text end new text begin (e)new text end , clause (3), to
disenroll or exclude the participant from the budget model.
Sec. 100.
Minnesota Statutes 2020, section 256B.85, subdivision 13a, is amended to read:
Subd. 13a.
Financial management services.
(a) Services provided by an FMS provider
include but are not limited to: filing and payment of federal and state payroll taxes on behalf
of the participant; initiating and complying with background study requirements under
chapter 245C and maintaining documentation of background study requests and results;
billing for approved CFSS services with authorized funds; monitoring expenditures;
accounting for and disbursing CFSS funds; providing assistance in obtaining and filing for
liability, workers' compensation, and unemployment coverage; and providing participant
instruction and technical assistance to the participant in fulfilling employer-related
requirements in accordance with section 3504 of the Internal Revenue Code and related
regulations and interpretations, including Code of Federal Regulations, title 26, section
31.3504-1.
(b) Agency-provider services shall not be provided by the FMS provider.
(c) The FMS provider shall provide service functions as determined by the commissioner
for budget model participants that include but are not limited to:
(1) assistance with the development of the detailed budget for expenditures portion of
the CFSS service delivery plan as requested by the consultation services provider or
participant;
(2) data recording and reporting of participant spending;
(3) other duties established by the department, including with respect to providing
assistance to the participant, participant's representative, or legal representative in performing
employer responsibilities regarding support workers. The support worker shall not be
considered the employee of the FMS provider; and
(4) billing, payment, and accounting of approved expenditures for goods.
(d) The FMS provider shall obtain an assurance statement from the participant employer
agreeing to follow state and federal regulations and CFSS policies regarding employment
of support workers.
(e) The FMS provider shall:
(1) not limit or restrict the participant's choice of service or support providers or service
delivery models consistent with any applicable state and federal requirements;
(2) provide the participant, consultation services provider, and case manager or care
coordinator, if applicable, with a monthly written summary of the spending for services and
supports that were billed against the spending budget;
(3) be knowledgeable of state and federal employment regulations, including those under
the Fair Labor Standards Act of 1938, and comply with the requirements under section 3504
of the Internal Revenue Code and related regulations and interpretations, including Code
of Federal Regulations, title 26, section 31.3504-1, regarding agency employer tax liability
for vendor fiscal/employer agent, and any requirements necessary to process employer and
employee deductions, provide appropriate and timely submission of employer tax liabilities,
and maintain documentation to support medical assistance claims;
(4) have current and adequate liability insurance and bonding and sufficient cash flow
as determined by the commissioner and have on staff or under contract a certified public
accountant or an individual with a baccalaureate degree in accounting;
(5) assume fiscal accountability for state funds designated for the program and be held
liable for any overpayments or violations of applicable statutes or rules, including but not
limited to the Minnesota False Claims Act, chapter 15C; deleted text begin and
deleted text end
(6) maintain documentation of receipts, invoices, and bills to track all services and
supports expenditures for any goods purchased and maintain time records of support workers.
The documentation and time records must be maintained for a minimum of five years from
the claim date and be available for audit or review upon request by the commissioner. Claims
submitted by the FMS provider to the commissioner for payment must correspond with
services, amounts, and time periods as authorized in the participant's service budget and
service plan and must contain specific identifying information as determined by the
commissionerdeleted text begin .deleted text end new text begin ; and
new text end
new text begin
(7) provide written notice to the participant or the participant's representative at least 30
calendar days before a proposed service termination becomes effective.
new text end
(f) The commissioner deleted text begin of human servicesdeleted text end shall:
(1) establish rates and payment methodology for the FMS provider;
(2) identify a process to ensure quality and performance standards for the FMS provider
and ensure statewide access to FMS providers; and
(3) establish a uniform protocol for delivering and administering CFSS services to be
used by eligible FMS providers.
Sec. 101.
Minnesota Statutes 2020, section 256B.85, is amended by adding a subdivision
to read:
new text begin Subd. 14a. new text end
new text begin Participant's representative responsibilities. new text end
new text begin
(a) If a participant is unable
to direct the participant's own care, the participant must use a participant's representative
to receive CFSS services. A participant's representative is required if:
new text end
new text begin
(1) the person is under 18 years of age;
new text end
new text begin
(2) the person has a court-appointed guardian; or
new text end
new text begin
(3) an assessment according to section 256B.0659, subdivision 3a, determines that the
participant is in need of a participant's representative.
new text end
new text begin
(b) A participant's representative must:
new text end
new text begin
(1) be at least 18 years of age;
new text end
new text begin
(2) actively participate in planning and directing CFSS services;
new text end
new text begin
(3) have sufficient knowledge of the participant's circumstances to use CFSS services
consistent with the participant's health and safety needs identified in the participant's service
delivery plan;
new text end
new text begin
(4) not have a financial interest in the provision of any services included in the
participant's CFSS service delivery plan; and
new text end
new text begin
(5) be capable of providing the support necessary to assist the participant in the use of
CFSS services.
new text end
new text begin
(c) A participant's representative must not be the:
new text end
new text begin
(1) support worker;
new text end
new text begin
(2) worker training and development service provider;
new text end
new text begin
(3) agency-provider staff, unless related to the participant by blood, marriage, or adoption;
new text end
new text begin
(4) consultation service provider, unless related to the participant by blood, marriage,
or adoption;
new text end
new text begin
(5) FMS staff, unless related to the participant by blood, marriage, or adoption;
new text end
new text begin
(6) FMS owner or manager; or
new text end
new text begin
(7) lead agency staff acting as part of employment.
new text end
new text begin
(d) A licensed family foster parent who lives with the participant may be the participant's
representative if the family foster parent meets the other participant's representative
requirements.
new text end
new text begin
(e) There may be two persons designated as the participant's representative, including
instances of divided households and court-ordered custodies. Each person named as the
participant's representative must meet the program criteria and responsibilities.
new text end
new text begin
(f) The participant or the participant's legal representative shall appoint a participant's
representative. The participant's representative must be identified at the time of assessment
and listed on the participant's service agreement and CFSS service delivery plan.
new text end
new text begin
(g) A participant's representative must enter into a written agreement with an
agency-provider or FMS on a form determined by the commissioner and maintained in the
participant's file, to:
new text end
new text begin
(1) be available while care is provided using a method agreed upon by the participant
or the participant's legal representative and documented in the participant's service delivery
plan;
new text end
new text begin
(2) monitor CFSS services to ensure the participant's service delivery plan is followed;
new text end
new text begin
(3) review and sign support worker time sheets after services are provided to verify the
provision of services;
new text end
new text begin
(4) review and sign vendor paperwork to verify receipt of goods; and
new text end
new text begin
(5) in the budget model, review and sign documentation to verify worker training and
development expenditures.
new text end
new text begin
(h) A participant's representative may delegate responsibility to another adult who is not
the support worker during a temporary absence of at least 24 hours but not more than six
months. To delegate responsibility, the participant's representative must:
new text end
new text begin
(1) ensure that the delegate serving as the participant's representative satisfies the
requirements of the participant's representative;
new text end
new text begin
(2) ensure that the delegate performs the functions of the participant's representative;
new text end
new text begin
(3) communicate to the CFSS agency-provider or FMS provider about the need for a
delegate by updating the written agreement to include the name of the delegate and the
delegate's contact information; and
new text end
new text begin
(4) ensure that the delegate protects the participant's privacy according to federal and
state data privacy laws.
new text end
new text begin
(i) The designation of a participant's representative remains in place until:
new text end
new text begin
(1) the participant revokes the designation;
new text end
new text begin
(2) the participant's representative withdraws the designation or becomes unable to fulfill
the duties;
new text end
new text begin
(3) the legal authority to act as a participant's representative changes; or
new text end
new text begin
(4) the participant's representative is disqualified.
new text end
new text begin
(j) A lead agency may disqualify a participant's representative who engages in conduct
that creates an imminent risk of harm to the participant, the support workers, or other staff.
A participant's representative who fails to provide support required by the participant must
be referred to the common entry point.
new text end
Sec. 102.
Minnesota Statutes 2020, section 256B.85, subdivision 15, is amended to read:
Subd. 15.
Documentation of support services provided; time sheets.
(a) CFSS services
provided to a participant by a support worker employed by either an agency-provider or the
participant employer must be documented daily by each support worker, on a time sheet.
Time sheets may be created, submitted, and maintained electronically. Time sheets must
be submitted by the support worker new text begin at least once per month new text end to the:
(1) agency-provider when the participant is using the agency-provider model. The
agency-provider must maintain a record of the time sheet and provide a copy of the time
sheet to the participant; or
(2) participant and the participant's FMS provider when the participant is using the
budget model. The participant and the FMS provider must maintain a record of the time
sheet.
(b) The documentation on the time sheet must correspond to the participant's assessed
needs within the scope of CFSS covered services. The accuracy of the time sheets must be
verified by the:
(1) agency-provider when the participant is using the agency-provider model; or
(2) participant employer and the participant's FMS provider when the participant is using
the budget model.
(c) The time sheet must document the time the support worker provides services to the
participant. The following elements must be included in the time sheet:
(1) the support worker's full name and individual provider number;
(2) the agency-provider's name and telephone numbers, when responsible for the CFSS
service delivery plan;
(3) the participant's full name;
(4) the dates within the pay period established by the agency-provider or FMS provider,
including month, day, and year, and arrival and departure times with a.m. or p.m. notations
for days worked within the established pay period;
(5) the covered services provided to the participant on each date of service;
(6) deleted text begin adeleted text end new text begin thenew text end signature deleted text begin line fordeleted text end new text begin ofnew text end the participant or the participant's representative and a
statement that the participant's or participant's representative's signature is verification of
the time sheet's accuracy;
(7) the deleted text begin personaldeleted text end signature of the support worker;
(8) any shared care provided, if applicable;
(9) a statement that it is a federal crime to provide false information on CFSS billings
for medical assistance payments; and
(10) dates and location of participant stays in a hospital, care facility, or incarceration
occurring within the established pay period.
Sec. 103.
Minnesota Statutes 2020, section 256B.85, subdivision 17a, is amended to read:
Subd. 17a.
Consultation services provider qualifications and
requirements.
Consultation services providers must meet the following qualifications and
requirements:
(1) meet the requirements under subdivision 10, paragraph (a), excluding clauses (4)
and (5);
(2) are under contract with the department;
(3) are not the FMS provider, the lead agency, or the CFSS or home and community-based
services waiver vendor or agency-provider to the participant;
(4) meet the service standards as established by the commissioner;
new text begin
(5) have proof of surety bond coverage. Upon new enrollment, or if the consultation
service provider's Medicaid revenue in the previous calendar year is less than or equal to
$300,000, the consultation service provider must purchase a surety bond of $50,000. If the
agency-provider's Medicaid revenue in the previous calendar year is greater than $300,000,
the consultation service provider must purchase a surety bond of $100,000. The surety bond
must be in a form approved by the commissioner, must be renewed annually, and must
allow for recovery of costs and fees in pursuing a claim on the bond;
new text end
deleted text begin (5)deleted text end new text begin (6)new text end employ lead professional staff with a minimum of three years of experience in
providing services such as support planning, support broker, case management or care
coordination, or consultation services and consumer education to participants using a
self-directed program using FMS under medical assistance;
new text begin
(7) report maltreatment as required under chapter 260E and section 626.557;
new text end
deleted text begin (6)deleted text end new text begin (8)new text end comply with medical assistance provider requirements;
deleted text begin (7)deleted text end new text begin (9)new text end understand the CFSS program and its policies;
deleted text begin (8)deleted text end new text begin (10)new text end are knowledgeable about self-directed principles and the application of the
person-centered planning process;
deleted text begin (9)deleted text end new text begin (11)new text end have general knowledge of the FMS provider duties and the vendor
fiscal/employer agent model, including all applicable federal, state, and local laws and
regulations regarding tax, labor, employment, and liability and workers' compensation
coverage for household workers; and
deleted text begin (10)deleted text end new text begin (12)new text end have all employees, including lead professional staff, staff in management and
supervisory positions, and owners of the agency who are active in the day-to-day management
and operations of the agency, complete training as specified in the contract with the
department.
Sec. 104.
Minnesota Statutes 2020, section 256B.85, subdivision 18a, is amended to read:
Subd. 18a.
Worker training and development services.
(a) The commissioner shall
develop the scope of tasks and functions, service standards, and service limits for worker
training and development services.
(b) Worker training and development costs are in addition to the participant's assessed
service units or service budget. Services provided according to this subdivision must:
(1) help support workers obtain and expand the skills and knowledge necessary to ensure
competency in providing quality services as needed and defined in the participant's CFSS
service delivery plan and as required under subdivisions 11b and 14;
(2) be provided or arranged for by the agency-provider under subdivision 11, or purchased
by the participant employer under the budget model as identified in subdivision 13; deleted text begin and
deleted text end
new text begin
(3) be delivered by an individual competent to perform, teach, or assign the tasks,
including health-related tasks, identified in the plan through education, training, and work
experience relevant to the person's assessed needs; and
new text end
deleted text begin (3)deleted text end new text begin (4)new text end be described in the participant's CFSS service delivery plan and documented in
the participant's file.
(c) Services covered under worker training and development shall include:
(1) support worker training on the participant's individual assessed needs and condition,
provided individually or in a group setting by a skilled and knowledgeable trainer beyond
any training the participant or participant's representative provides;
(2) tuition for professional classes and workshops for the participant's support workers
that relate to the participant's assessed needs and condition;
(3) direct observation, monitoring, coaching, and documentation of support worker job
skills and tasks, beyond any training the participant or participant's representative provides,
including supervision of health-related tasks or behavioral supports that is conducted by an
appropriate professional based on the participant's assessed needs. These services must be
provided at the start of services or the start of a new support worker except as provided in
paragraph (d) and must be specified in the participant's CFSS service delivery plan; and
(4) the activities to evaluate CFSS services and ensure support worker competency
described in subdivisions 11a and 11b.
(d) The services in paragraph (c), clause (3), are not required to be provided for a new
support worker providing services for a participant due to staffing failures, unless the support
worker is expected to provide ongoing backup staffing coverage.
(e) Worker training and development services shall not include:
(1) general agency training, worker orientation, or training on CFSS self-directed models;
(2) payment for preparation or development time for the trainer or presenter;
(3) payment of the support worker's salary or compensation during the training;
(4) training or supervision provided by the participant, the participant's support worker,
or the participant's informal supports, including the participant's representative; or
(5) services in excess of deleted text begin 96 unitsdeleted text end new text begin the rate set by the commissionernew text end per annual service
agreement, unless approved by the department.
Sec. 105.
Minnesota Statutes 2020, section 256B.85, subdivision 20b, is amended to read:
Subd. 20b.
Service-related rights under an agency-provider.
A participant receiving
CFSS from an agency-provider has service-related rights to:
(1) participate in and approve the initial development and ongoing modification and
evaluation of CFSS services provided to the participant;
(2) refuse or terminate services and be informed of the consequences of refusing or
terminating services;
(3) before services are initiated, be told the limits to the services available from the
agency-provider, including the agency-provider's knowledge, skill, and ability to meet the
participant's needs identified in the CFSS service delivery plan;
(4) a coordinated transfer of services when there will be a change in the agency-provider;
(5) before services are initiated, be told what the agency-provider charges for the services;
(6) before services are initiated, be told to what extent payment may be expected from
health insurance, public programs, or other sources, if known; and what charges the
participant may be responsible for paying;
(7) receive services from an individual who is competent and trained, who has
professional certification or licensure, as required, and who meets additional qualifications
identified in the participant's CFSS service delivery plan;
(8) have the participant's preferences for support workers identified and documented,
and have those preferences met when possible; and
(9) before services are initiated, be told the choices that are available from the
agency-provider for meeting the participant's assessed needs identified in the CFSS service
delivery plan, including but not limited to which support worker staff will be providing
services deleted text begin anddeleted text end new text begin ,new text end the proposed frequency and schedule of visitsnew text begin , and any agreements for shared
servicesnew text end .
Sec. 106.
Minnesota Statutes 2020, section 256B.85, subdivision 23, is amended to read:
Subd. 23.
Commissioner's access.
(a) When the commissioner is investigating a possible
overpayment of Medicaid funds, the commissioner must be given immediate access without
prior notice to the agency-provider, consultation services provider, or FMS provider's office
during regular business hours and to documentation and records related to services provided
and submission of claims for services provided. deleted text begin Denying the commissioner access to records
is cause for immediate suspension of payment and terminatingdeleted text end new text begin Ifnew text end the deleted text begin agency-provider's
enrollment ordeleted text end new text begin agency-provider,new text end FMS deleted text begin provider's enrollmentdeleted text end new text begin provider, or consultation services
provider denies the commissioner access to records, the provider's payment may be
immediately suspended or the provider's enrollment may be terminatednew text end according to section
256B.064 deleted text begin or terminating the consultation services provider contractdeleted text end .
(b) The commissioner has the authority to request proof of compliance with laws, rules,
and policies from agency-providers, consultation services providers, FMS providers, and
participants.
(c) When relevant to an investigation conducted by the commissioner, the commissioner
must be given access to the business office, documents, and records of the agency-provider,
consultation services provider, or FMS provider, including records maintained in electronic
format; participants served by the program; and staff during regular business hours. The
commissioner must be given access without prior notice and as often as the commissioner
considers necessary if the commissioner is investigating an alleged violation of applicable
laws or rules. The commissioner may request and shall receive assistance from lead agencies
and other state, county, and municipal agencies and departments. The commissioner's access
includes being allowed to photocopy, photograph, and make audio and video recordings at
the commissioner's expense.
Sec. 107.
Minnesota Statutes 2020, section 256B.85, subdivision 23a, is amended to read:
Subd. 23a.
Sanctions; information for participants upon termination of services.
(a)
The commissioner may withhold payment from the provider or suspend or terminate the
provider enrollment number if the provider fails to comply fully with applicable laws or
rules. The provider has the right to appeal the decision of the commissioner under section
256B.064.
(b) Notwithstanding subdivision 13, paragraph (c), if a participant employer fails to
comply fully with applicable laws or rules, the commissioner may disenroll the participant
from the budget model. A participant may appeal in writing to the department under section
256.045, subdivision 3, to contest the department's decision to disenroll the participant from
the budget model.
(c) Agency-providers of CFSS services or FMS providers must provide each participant
with a copy of participant protections in subdivision 20c at least 30 days prior to terminating
services to a participant, if the termination results from sanctions under this subdivision or
section 256B.064, such as a payment withhold or a suspension or termination of the provider
enrollment number. If a CFSS agency-provider deleted text begin ordeleted text end new text begin ,new text end FMS providernew text begin , or consultation services
providernew text end determines it is unable to continue providing services to a participant because of
an action under this subdivision or section 256B.064, the agency-provider deleted text begin ordeleted text end new text begin , new text end FMS providernew text begin ,
or consultation services providernew text end must notify the participant, the participant's representative,
and the commissioner 30 days prior to terminating services to the participant, and must
assist the commissioner and lead agency in supporting the participant in transitioning to
another CFSS agency-provider deleted text begin ordeleted text end new text begin ,new text end FMS providernew text begin , or consultation services providernew text end of the
participant's choice.
(d) In the event the commissioner withholds payment from a CFSS agency-provider deleted text begin ordeleted text end new text begin ,new text end
FMS providernew text begin , or consultation services providernew text end , or suspends or terminates a provider
enrollment number of a CFSS agency-provider deleted text begin ordeleted text end new text begin ,new text end FMS providernew text begin , or consultation services
providernew text end under this subdivision or section 256B.064, the commissioner may inform the
Office of Ombudsman for Long-Term Care and the lead agencies for all participants with
active service agreements with the agency-provider deleted text begin ordeleted text end new text begin ,new text end FMS providernew text begin , or consultation
services providernew text end . At the commissioner's request, the lead agencies must contact participants
to ensure that the participants are continuing to receive needed care, and that the participants
have been given free choice of agency-provider deleted text begin ordeleted text end new text begin ,new text end FMS providernew text begin , or consultation services
providernew text end if they transfer to another CFSS agency-provider deleted text begin ordeleted text end new text begin ,new text end FMS providernew text begin , or consultation
services providernew text end . In addition, the commissioner or the commissioner's delegate may directly
notify participants who receive care from the agency-provider deleted text begin ordeleted text end new text begin ,new text end FMS providernew text begin , or
consultation services providernew text end that payments have been new text begin or will be new text end withheld or that the
provider's participation in medical assistance has been new text begin or will be new text end suspended or terminated,
if the commissioner determines that the notification is necessary to protect the welfare of
the participants.
Sec. 108. new text begin REVISOR INSTRUCTION.
new text end
new text begin
In Minnesota Statutes, sections 245A.191, paragraph (a); 245G.02, subdivision 3; 246.18,
subdivision 2; 246.23, subdivision 2; 246.64, subdivision 3; 254A.03, subdivision 3; 254A.19,
subdivision 4; 254B.03, subdivision 2; 254B.04, subdivision 1; 254B.05, subdivisions 1a
and 4; 254B.051; 254B.06, subdivision 1; 254B.12, subdivisions 1 and 2; 254B.13,
subdivisions 2a and 5; 254B.14, subdivision 5; 256L.03, subdivision 2; and 295.53,
subdivision 1, the revisor of statutes must change the term "consolidated chemical
dependency treatment fund" or similar terms to "behavioral health fund." The revisor may
make grammatical changes related to the term change.
new text end
Sec. 109. new text begin REPEALER.
new text end
new text begin
(a)
new text end
new text begin
Minnesota Statutes 2020, section 252.28, subdivisions 1 and 5,
new text end
new text begin
are repealed.
new text end
new text begin
(b)
new text end
new text begin
Minnesota Statutes 2020, sections 252A.02, subdivisions 8 and 10; and 252A.21,
subdivision 3,
new text end
new text begin
are repealed.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
Paragraph (a) is effective the day following final enactment.
new text end
ARTICLE 4
HEALTH CARE
Section 1.
new text begin
[62A.002] APPLICABILITY OF CHAPTER.
new text end
new text begin
Any benefit or coverage mandate included in this chapter does not apply to managed
care plans or county-based purchasing plans when the plan is providing coverage to state
public health care program enrollees under chapter 256B or 256L.
new text end
Sec. 2.
Minnesota Statutes 2020, section 62C.01, is amended by adding a subdivision to
read:
new text begin Subd. 4. new text end
new text begin Applicability. new text end
new text begin
Any benefit or coverage mandate included in this chapter does
not apply to managed care plans or county-based purchasing plans when the plan is providing
coverage to state public health care program enrollees under chapter 256B or 256L.
new text end
Sec. 3.
Minnesota Statutes 2020, section 62D.01, is amended by adding a subdivision to
read:
new text begin Subd. 3. new text end
new text begin Applicability. new text end
new text begin
Any benefit or coverage mandate included in this chapter does
not apply to managed care plans or county-based purchasing plans when the plan is providing
coverage to state public health care program enrollees under chapter 256B or 256L.
new text end
Sec. 4.
new text begin
[62J.011] APPLICABILITY OF CHAPTER.
new text end
new text begin
Any benefit or coverage mandate included in this chapter does not apply to managed
care plans or county-based purchasing plans when the plan is providing coverage to state
public health care program enrollees under chapter 256B or 256L.
new text end
Sec. 5.
Minnesota Statutes 2020, section 62Q.02, is amended to read:
62Q.02 APPLICABILITY OF CHAPTER.
(a) This chapter applies only to health plans, as defined in section 62Q.01, and not to
other types of insurance issued or renewed by health plan companies, unless otherwise
specified.
(b) This chapter applies to a health plan company only with respect to health plans, as
defined in section 62Q.01, issued or renewed by the health plan company, unless otherwise
specified.
(c) If a health plan company issues or renews health plans in other states, this chapter
applies only to health plans issued or renewed in this state for Minnesota residents, or to
cover a resident of the state, unless otherwise specified.
new text begin
(d) Any benefit or coverage mandate included in this chapter does not apply to managed
care plans or county-based purchasing plans when the plan is providing coverage to state
public health care program enrollees under chapter 256B or 256L.
new text end
Sec. 6.
Minnesota Statutes 2020, section 256B.0625, subdivision 3c, is amended to read:
Subd. 3c.
Health Services deleted text begin Policy Committeedeleted text end new text begin Advisory Councilnew text end .
(a) The commissioner,
after receiving recommendations from professional physician associations, professional
associations representing licensed nonphysician health care professionals, and consumer
groups, shall establish a deleted text begin 13-memberdeleted text end new text begin 14-membernew text end Health Services deleted text begin Policy Committeedeleted text end new text begin Advisory
Councilnew text end , which consists of deleted text begin 12deleted text end new text begin 13new text end voting members and one nonvoting member. The Health
Services deleted text begin Policy Committeedeleted text end new text begin Advisory Councilnew text end shall advise the commissioner regardingnew text begin (1)new text end
health services pertaining to the administration of health care benefits covered under deleted text begin the
medical assistance and MinnesotaCare programsdeleted text end new text begin Minnesota health care programs (MHCP);
and (2) evidence-based decision-making and health care benefit and coverage policies for
MHCP. The Health Services Advisory Council shall consider available evidence regarding
quality, safety, and cost-effectiveness when advising the commissionernew text end . The Health Services
deleted text begin Policy Committeedeleted text end new text begin Advisory Councilnew text end shall meet at least quarterly. The Health Services deleted text begin Policy
Committeedeleted text end new text begin Advisory Councilnew text end shall annually deleted text begin electdeleted text end new text begin selectnew text end a deleted text begin physiciandeleted text end chair from among its
membersdeleted text begin ,deleted text end who shall work directly with the commissioner's medical directordeleted text begin ,deleted text end to establish
the agenda for each meeting. The Health Services deleted text begin Policy Committee shall alsodeleted text end new text begin Advisory
Council maynew text end recommend criteria for verifying centers of excellence for specific aspects of
medical care where a specific set of combined services, a volume of patients necessary to
maintain a high level of competency, or a specific level of technical capacity is associated
with improved health outcomes.
(b) The commissioner shall establish a dental deleted text begin subcommitteedeleted text end new text begin subcouncilnew text end to operate under
the Health Services deleted text begin Policy Committeedeleted text end new text begin Advisory Councilnew text end . The dental deleted text begin subcommitteedeleted text end new text begin
subcouncilnew text end consists of general dentists, dental specialists, safety net providers, dental
hygienists, health plan company and county and public health representatives, health
researchers, consumers, and a designee of the commissioner of health. The dental
deleted text begin subcommitteedeleted text end new text begin subcouncilnew text end shall advise the commissioner regarding:
(1) the critical access dental program under section 256B.76, subdivision 4, including
but not limited to criteria for designating and terminating critical access dental providers;
(2) any changes to the critical access dental provider program necessary to comply with
program expenditure limits;
(3) dental coverage policy based on evidence, quality, continuity of care, and best
practices;
(4) the development of dental delivery models; and
(5) dental services to be added or eliminated from subdivision 9, paragraph (b).
deleted text begin
(c) The Health Services Policy Committee shall study approaches to making provider
reimbursement under the medical assistance and MinnesotaCare programs contingent on
patient participation in a patient-centered decision-making process, and shall evaluate the
impact of these approaches on health care quality, patient satisfaction, and health care costs.
The committee shall present findings and recommendations to the commissioner and the
legislative committees with jurisdiction over health care by January 15, 2010.
deleted text end
deleted text begin (d)deleted text end new text begin (c)new text end The Health Services deleted text begin Policy Committee shalldeleted text end new text begin Advisory Council maynew text end monitor and
track the practice patterns of deleted text begin physicians providing services to medical assistance and
MinnesotaCare enrolleesdeleted text end new text begin health care providers who serve MHCP recipientsnew text end under
fee-for-service, managed care, and county-based purchasing. The deleted text begin committeedeleted text end new text begin monitoring
and trackingnew text end shall focus on services or specialties for which there is a high variation in
utilization new text begin or quality new text end across deleted text begin physiciansdeleted text end new text begin providersnew text end , or which are associated with high medical
costs. The commissioner, based upon the findings of the deleted text begin committeedeleted text end new text begin Health Services Advisory
Councilnew text end , deleted text begin shall regularlydeleted text end new text begin maynew text end notify deleted text begin physiciansdeleted text end new text begin providersnew text end whose practice patterns indicate
new text begin below average quality or new text end higher than average utilization or costs. Managed care and
county-based purchasing plans shall provide the commissioner with utilization and cost
data necessary to implement this paragraph, and the commissioner shall make deleted text begin thisdeleted text end new text begin thesenew text end
data available to the deleted text begin committeedeleted text end new text begin Health Services Advisory Councilnew text end .
deleted text begin
(e) The Health Services Policy Committee shall review caesarean section rates for the
fee-for-service medical assistance population. The committee may develop best practices
policies related to the minimization of caesarean sections, including but not limited to
standards and guidelines for health care providers and health care facilities.
deleted text end
Sec. 7.
Minnesota Statutes 2020, section 256B.0625, subdivision 3d, is amended to read:
Subd. 3d.
Health Services deleted text begin Policy Committeedeleted text end new text begin Advisory Councilnew text end members.
(a) The
Health Services deleted text begin Policy Committeedeleted text end new text begin Advisory Councilnew text end consists of:
(1) deleted text begin sevendeleted text end new text begin sixnew text end voting members who are licensed physicians actively engaged in the practice
of medicine in Minnesota, deleted text begin one of whom must be actively engaged in the treatment of persons
with mental illness, anddeleted text end three of whom must represent health plans currently under contract
to serve deleted text begin medical assistancedeleted text end new text begin MHCPnew text end recipients;
(2) two voting members who are new text begin licensed new text end physician specialists actively practicing their
specialty in Minnesota;
(3) two voting members who are nonphysician health care professionals licensed or
registered in their profession and actively engaged in their practice of their profession in
Minnesota;
new text begin
(4) one voting member who is a health care or mental health professional licensed or
registered in the member's profession, actively engaged in the practice of the member's
profession in Minnesota, and actively engaged in the treatment of persons with mental
illness;
new text end
deleted text begin (4) one consumerdeleted text end new text begin (5) two consumersnew text end who shall serve as deleted text begin adeleted text end voting deleted text begin memberdeleted text end new text begin membersnew text end ; and
deleted text begin (5)deleted text end new text begin (6)new text end the commissioner's medical director who shall serve as a nonvoting member.
(b) Members of the Health Services deleted text begin Policy Committeedeleted text end new text begin Advisory Councilnew text end shall not be
employed by the deleted text begin Department of Human Servicesdeleted text end new text begin state of Minnesotanew text end , except for the medical
director.new text begin A quorum shall comprise a simple majority of the voting members. Vacant seats
shall not count toward a quorum.
new text end
Sec. 8.
Minnesota Statutes 2020, section 256B.0625, subdivision 3e, is amended to read:
Subd. 3e.
Health Services deleted text begin Policy Committeedeleted text end new text begin Advisory Councilnew text end terms and
compensation.
deleted text begin Committeedeleted text end Members shall serve staggered three-year terms, with one-third
of the voting members' terms expiring annually. Members may be reappointed by the
commissioner. The commissioner may require more frequent Health Services deleted text begin Policy
Committeedeleted text end new text begin Advisory Councilnew text end meetings as needed. An honorarium of $200 per meeting and
reimbursement for mileage and parking shall be paid to each deleted text begin committeedeleted text end new text begin councilnew text end member
in attendance except the medical director. The Health Services deleted text begin Policy Committeedeleted text end new text begin Advisory
Councilnew text end does not expire as provided in section 15.059, subdivision 6.
Sec. 9.
Minnesota Statutes 2020, section 256B.0625, subdivision 13c, is amended to read:
Subd. 13c.
Formulary Committee.
The commissioner, after receiving recommendations
from professional medical associations and professional pharmacy associations, and consumer
groups shall designate a Formulary Committee to carry out duties as described in subdivisions
13 to 13g. The Formulary Committee shall be comprised of four licensed physicians actively
engaged in the practice of medicine in Minnesotanew text begin ,new text end one of whom must be actively engaged
in the treatment of persons with mental illness; at least three licensed pharmacists actively
engaged in the practice of pharmacy in Minnesota; and one consumer representative; the
remainder to be made up of health care professionals who are licensed in their field and
have recognized knowledge in the clinically appropriate prescribing, dispensing, and
monitoring of covered outpatient drugs. Members of the Formulary Committee shall not
be employed by the Department of Human Services, but the committee shall be staffed by
an employee of the department who shall serve as an ex officio, nonvoting member of the
committee. The department's medical director shall also serve as an ex officio, nonvoting
member for the committee. Committee members shall serve three-year terms and may be
reappointed by the commissioner. The Formulary Committee shall meet at least twice per
year. The commissioner may require more frequent Formulary Committee meetings as
needed. An honorarium of $100 per meeting and reimbursement for mileage shall be paid
to each committee member in attendance. deleted text begin The Formulary Committee expires June 30, 2022.
deleted text end
Sec. 10.
Minnesota Statutes 2020, section 256B.0625, subdivision 58, is amended to read:
Subd. 58.
Early and periodic screening, diagnosis, and treatment services.
new text begin (a) new text end Medical
assistance covers early and periodic screening, diagnosis, and treatment services (EPSDT).
new text begin In administering the EPSDT program, the commissioner shall, at a minimum:
new text end
new text begin
(1) provide information to children and families, using the most effective mode identified,
regarding:
new text end
new text begin
(i) the benefits of preventative health care visits;
new text end
new text begin
(ii) the services available as part of the EPSDT program; and
new text end
new text begin
(iii) assistance finding a provider, transportation, or interpreter services;
new text end
new text begin
(2) maintain an up-to-date periodicity schedule published in the department policy
manual, taking into consideration the most up-to-date community standard of care; and
new text end
new text begin
(3) maintain up-to-date policies for providers on the delivery of EPSDT services that
are in the provider manual on the department website.
new text end
new text begin
(b) The commissioner may contract for the administration of the outreach services as
required within the EPSDT program.
new text end
new text begin (c) new text end The payment amount for a complete EPSDT screening shall not include charges for
health care services and products that are available at no cost to the provider and shall not
exceed the rate established per Minnesota Rules, part 9505.0445, item M, effective October
1, 2010.
Sec. 11.
Minnesota Statutes 2020, section 256B.0638, subdivision 3, is amended to read:
Subd. 3.
Opioid prescribing work group.
(a) The commissioner of human services, in
consultation with the commissioner of health, shall appoint the following voting members
to an opioid prescribing work group:
(1) two consumer members who have been impacted by an opioid abuse disorder or
opioid dependence disorder, either personally or with family members;
(2) one member who is a licensed physician actively practicing in Minnesota and
registered as a practitioner with the DEA;
(3) one member who is a licensed pharmacist actively practicing in Minnesota and
registered as a practitioner with the DEA;
(4) one member who is a licensed nurse practitioner actively practicing in Minnesota
and registered as a practitioner with the DEA;
(5) one member who is a licensed dentist actively practicing in Minnesota and registered
as a practitioner with the DEA;
(6) two members who are nonphysician licensed health care professionals actively
engaged in the practice of their profession in Minnesota, and their practice includes treating
pain;
(7) one member who is a mental health professional who is licensed or registered in a
mental health profession, who is actively engaged in the practice of that profession in
Minnesota, and whose practice includes treating patients with chemical dependency or
substance abuse;
(8) one member who is a medical examiner for a Minnesota county;
(9) one member of the Health Services Policy Committee established under section
256B.0625, subdivisions 3c to 3e;
(10) one member who is a medical director of a health plan company doing business in
Minnesota;
(11) one member who is a pharmacy director of a health plan company doing business
in Minnesota; deleted text begin and
deleted text end
(12) one member representing Minnesota law enforcementdeleted text begin .deleted text end new text begin ; and
new text end
new text begin
(13) two consumer members who are Minnesota residents and who have used or are
using opioids to manage chronic pain.
new text end
(b) In addition, the work group shall include the following nonvoting members:
(1) the medical director for the medical assistance program;
(2) a member representing the Department of Human Services pharmacy unit; and
(3) the medical director for the Department of Labor and Industry.
(c) An honorarium of $200 per meeting and reimbursement for mileage and parking
shall be paid to each voting member in attendance.
Sec. 12.
Minnesota Statutes 2020, section 256B.0638, subdivision 5, is amended to read:
Subd. 5.
Program implementation.
(a) The commissioner shall implement the programs
within the Minnesota health care program to improve the health of and quality of care
provided to Minnesota health care program enrollees. The commissioner shall annually
collect and report tonew text begin provider groups the sentinel measures of data showing individualnew text end opioid
deleted text begin prescribers data showing the sentinel measures of theirdeleted text end new text begin prescribers'new text end opioid prescribing
patterns compared to their anonymized peers.new text begin Provider groups shall distribute data to their
affiliated, contracted, or employed opioid prescribers.
new text end
(b) The commissioner shall notify an opioid prescriber and all provider groups with
which the opioid prescriber is employed or affiliated when the opioid prescriber's prescribing
pattern exceeds the opioid quality improvement standard thresholds. An opioid prescriber
and any provider group that receives a notice under this paragraph shall submit to the
commissioner a quality improvement plan for review and approval by the commissioner
with the goal of bringing the opioid prescriber's prescribing practices into alignment with
community standards. A quality improvement plan must include:
(1) components of the program described in subdivision 4, paragraph (a);
(2) internal practice-based measures to review the prescribing practice of the opioid
prescriber and, where appropriate, any other opioid prescribers employed by or affiliated
with any of the provider groups with which the opioid prescriber is employed or affiliated;
and
(3) appropriate use of the prescription monitoring program under section 152.126.
(c) If, after a year from the commissioner's notice under paragraph (b), the opioid
prescriber's prescribing practices do not improve so that they are consistent with community
standards, the commissioner shall take one or more of the following steps:
(1) monitor prescribing practices more frequently than annually;
(2) monitor more aspects of the opioid prescriber's prescribing practices than the sentinel
measures; or
(3) require the opioid prescriber to participate in additional quality improvement efforts,
including but not limited to mandatory use of the prescription monitoring program established
under section 152.126.
(d) The commissioner shall terminate from Minnesota health care programs all opioid
prescribers and provider groups whose prescribing practices fall within the applicable opioid
disenrollment standards.
Sec. 13.
Minnesota Statutes 2020, section 256B.0638, subdivision 6, is amended to read:
Subd. 6.
Data practices.
(a) Reports and data identifying an opioid prescriber are private
data on individuals as defined under section 13.02, subdivision 12, until an opioid prescriber
is subject to termination as a medical assistance provider under this section. Notwithstanding
this data classification, the commissioner shall share with all of the provider groups with
which an opioid prescriber is employednew text begin , contracted,new text end or affiliated, deleted text begin a report identifying an
opioid prescriber who is subject to quality improvement activitiesdeleted text end new text begin the datanew text end under subdivision
5, paragraphnew text begin (a),new text end (b)new text begin ,new text end or (c).
(b) Reports and data identifying a provider group are nonpublic data as defined under
section 13.02, subdivision 9, until the provider group is subject to termination as a medical
assistance provider under this section.
(c) Upon termination under this section, reports and data identifying an opioid prescriber
or provider group are public, except that any identifying information of Minnesota health
care program enrollees must be redacted by the commissioner.
Sec. 14.
Minnesota Statutes 2020, section 256B.0659, subdivision 13, is amended to read:
Subd. 13.
Qualified professional; qualifications.
(a) The qualified professional must
work for a personal care assistance provider agency, meet the definition of qualified
professional under section 256B.0625, subdivision 19c, deleted text begin and enroll with the department as
a qualified professional after clearingdeleted text end new text begin clearnew text end a background studynew text begin , and meet provider training
requirementsnew text end . Before a qualified professional provides services, the personal care assistance
provider agency must initiate a background study on the qualified professional under chapter
245C, and the personal care assistance provider agency must have received a notice from
the commissioner that the qualified professional:
(1) is not disqualified under section 245C.14; or
(2) is disqualified, but the qualified professional has received a set aside of the
disqualification under section 245C.22.
(b) The qualified professional shall perform the duties of training, supervision, and
evaluation of the personal care assistance staff and evaluation of the effectiveness of personal
care assistance services. The qualified professional shall:
(1) develop and monitor with the recipient a personal care assistance care plan based on
the service plan and individualized needs of the recipient;
(2) develop and monitor with the recipient a monthly plan for the use of personal care
assistance services;
(3) review documentation of personal care assistance services provided;
(4) provide training and ensure competency for the personal care assistant in the individual
needs of the recipient; and
(5) document all training, communication, evaluations, and needed actions to improve
performance of the personal care assistants.
(c) deleted text begin Effective July 1, 2011,deleted text end The qualified professional shall complete the provider training
with basic information about the personal care assistance program approved by the
commissioner. Newly hired qualified professionals must complete the training within six
months of the date hired by a personal care assistance provider agency. Qualified
professionals who have completed the required training as a worker from a personal care
assistance provider agency do not need to repeat the required training if they are hired by
another agency, if they have completed the training within the last three years. The required
training must be available with meaningful access according to title VI of the Civil Rights
Act and federal regulations adopted under that law or any guidance from the United States
Health and Human Services Department. The required training must be available online or
by electronic remote connection. The required training must provide for competency testing
to demonstrate an understanding of the content without attending in-person training. A
qualified professional is allowed to be employed and is not subject to the training requirement
until the training is offered online or through remote electronic connection. A qualified
professional employed by a personal care assistance provider agency certified for
participation in Medicare as a home health agency is exempt from the training required in
this subdivision. When available, the qualified professional working for a Medicare-certified
home health agency must successfully complete the competency test. The commissioner
shall ensure there is a mechanism in place to verify the identity of persons completing the
competency testing electronically.
Sec. 15. new text begin REVISOR INSTRUCTION.
new text end
new text begin
The revisor of statutes must change the term "Health Services Policy Committee" to
"Health Services Advisory Council" wherever the term appears in Minnesota Statutes and
may make any necessary changes to grammar or sentence structure to preserve the meaning
of the text.
new text end
Sec. 16. new text begin REPEALER.
new text end
new text begin
Minnesota Rules, parts 9505.0275; 9505.1693; 9505.1696, subparts 1, 2, 3, 4, 5, 6, 7,
8, 9, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, and 22; 9505.1699; 9505.1701; 9505.1703;
9505.1706; 9505.1712; 9505.1715; 9505.1718; 9505.1724; 9505.1727; 9505.1730;
9505.1733; 9505.1736; 9505.1739; 9505.1742; 9505.1745; and 9505.1748,
new text end
new text begin
are repealed.
new text end
ARTICLE 5
LICENSING AND BACKGROUND STUDIES
Section 1.
Minnesota Statutes 2020, section 245A.02, subdivision 5a, is amended to read:
Subd. 5a.
Controlling individual.
(a) "Controlling individual" means an owner of a
program or service provider licensed under this chapter and the following individuals, if
applicable:
(1) each officer of the organization, including the chief executive officer and chief
financial officer;
(2) the individual designated as the authorized agent under section 245A.04, subdivision
1, paragraph (b);
(3) the individual designated as the compliance officer under section 256B.04, subdivision
21, paragraph (g); deleted text begin and
deleted text end
(4) each managerial official whose responsibilities include the direction of the
management or policies of a programdeleted text begin .deleted text end new text begin ; and
new text end
new text begin
(5) the president and treasurer of the board of directors of a nonprofit corporation.
new text end
(b) Controlling individual does not include:
(1) a bank, savings bank, trust company, savings association, credit union, industrial
loan and thrift company, investment banking firm, or insurance company unless the entity
operates a program directly or through a subsidiary;
(2) an individual who is a state or federal official, or state or federal employee, or a
member or employee of the governing body of a political subdivision of the state or federal
government that operates one or more programs, unless the individual is also an officer,
owner, or managerial official of the program, receives remuneration from the program, or
owns any of the beneficial interests not excluded in this subdivision;
(3) an individual who owns less than five percent of the outstanding common shares of
a corporation:
(i) whose securities are exempt under section 80A.45, clause (6); or
(ii) whose transactions are exempt under section 80A.46, clause (2);
(4) an individual who is a member of an organization exempt from taxation under section
290.05, unless the individual is also an officer, owner, or managerial official of the program
or owns any of the beneficial interests not excluded in this subdivision. This clause does
not exclude from the definition of controlling individual an organization that is exempt from
taxation; or
(5) an employee stock ownership plan trust, or a participant or board member of an
employee stock ownership plan, unless the participant or board member is a controlling
individual according to paragraph (a).
(c) For purposes of this subdivision, "managerial official" means an individual who has
the decision-making authority related to the operation of the program, and the responsibility
for the ongoing management of or direction of the policies, services, or employees of the
program. A site director who has no ownership interest in the program is not considered to
be a managerial official for purposes of this definition.
Sec. 2.
Minnesota Statutes 2020, section 245A.02, subdivision 10b, is amended to read:
Subd. 10b.
Owner.
"Owner" means an individual or organization that has a direct or
indirect ownership interest of five percent or more in a program licensed under this chapter.
For purposes of this subdivision, "direct ownership interest" means the possession of equity
in capital, stock, or profits of an organization, and "indirect ownership interest" means a
direct ownership interest in an entity that has a direct or indirect ownership interest in a
licensed program. For purposes of this chapter, "owner of deleted text begin a nonprofit corporation" means
the president and treasurer of the board of directors or, for an entity owned bydeleted text end an employee
stock ownership plandeleted text begin ,deleted text end new text begin "new text end means the president and treasurer of the entity. A government entity
new text begin or nonprofit corporation new text end that is issued a license under this chapter shall be designated the
owner.
Sec. 3.
Minnesota Statutes 2020, section 245A.04, subdivision 1, is amended to read:
Subdivision 1.
Application for licensure.
(a) An individual, organization, or government
entity that is subject to licensure under section 245A.03 must apply for a license. The
application must be made on the forms and in the manner prescribed by the commissioner.
The commissioner shall provide the applicant with instruction in completing the application
and provide information about the rules and requirements of other state agencies that affect
the applicant. An applicant seeking licensure in Minnesota with headquarters outside of
Minnesota must have a program office located within 30 miles of the Minnesota border.
An applicant who intends to buy or otherwise acquire a program or services licensed under
this chapter that is owned by another license holder must apply for a license under this
chapter and comply with the application procedures in this section and section deleted text begin 245A.03deleted text end new text begin
245A.043new text end .
The commissioner shall act on the application within 90 working days after a complete
application and any required reports have been received from other state agencies or
departments, counties, municipalities, or other political subdivisions. The commissioner
shall not consider an application to be complete until the commissioner receives all of the
required information.
When the commissioner receives an application for initial licensure that is incomplete
because the applicant failed to submit required documents or that is substantially deficient
because the documents submitted do not meet licensing requirements, the commissioner
shall provide the applicant written notice that the application is incomplete or substantially
deficient. In the written notice to the applicant the commissioner shall identify documents
that are missing or deficient and give the applicant 45 days to resubmit a second application
that is substantially complete. An applicant's failure to submit a substantially complete
application after receiving notice from the commissioner is a basis for license denial under
section 245A.05.
(b) An application for licensure must identify all controlling individuals as defined in
section 245A.02, subdivision 5a, and must designate one individual to be the authorized
agent. The application must be signed by the authorized agent and must include the authorized
agent's first, middle, and last name; mailing address; and e-mail address. By submitting an
application for licensure, the authorized agent consents to electronic communication with
the commissioner throughout the application process. The authorized agent must be
authorized to accept service on behalf of all of the controlling individuals. A government
entity that holds multiple licenses under this chapter may designate one authorized agent
for all licenses issued under this chapter or may designate a different authorized agent for
each license. Service on the authorized agent is service on all of the controlling individuals.
It is not a defense to any action arising under this chapter that service was not made on each
controlling individual. The designation of a controlling individual as the authorized agent
under this paragraph does not affect the legal responsibility of any other controlling individual
under this chapter.
(c) An applicant or license holder must have a policy that prohibits license holders,
employees, subcontractors, and volunteers, when directly responsible for persons served
by the program, from abusing prescription medication or being in any manner under the
influence of a chemical that impairs the individual's ability to provide services or care. The
license holder must train employees, subcontractors, and volunteers about the program's
drug and alcohol policy.
(d) An applicant and license holder must have a program grievance procedure that permits
persons served by the program and their authorized representatives to bring a grievance to
the highest level of authority in the program.
(e) The commissioner may limit communication during the application process to the
authorized agent or the controlling individuals identified on the license application and for
whom a background study was initiated under chapter 245C. The commissioner may require
the applicant, except for child foster care, to demonstrate competence in the applicable
licensing requirements by successfully completing a written examination. The commissioner
may develop a prescribed written examination format.
(f) When an applicant is an individual, the applicant must provide:
(1) the applicant's taxpayer identification numbers including the Social Security number
or Minnesota tax identification number, and federal employer identification number if the
applicant has employees;
(2) at the request of the commissioner, a copy of the most recent filing with the secretary
of state that includes the complete business name, if any;
(3) if doing business under a different name, the doing business as (DBA) name, as
registered with the secretary of state;
(4) if applicable, the applicant's National Provider Identifier (NPI) number and Unique
Minnesota Provider Identifier (UMPI) number; and
(5) at the request of the commissioner, the notarized signature of the applicant or
authorized agent.
(g) When an applicant is an organization, the applicant must provide:
(1) the applicant's taxpayer identification numbers including the Minnesota tax
identification number and federal employer identification number;
(2) at the request of the commissioner, a copy of the most recent filing with the secretary
of state that includes the complete business name, and if doing business under a different
name, the doing business as (DBA) name, as registered with the secretary of state;
(3) the first, middle, and last name, and address for all individuals who will be controlling
individuals, including all officers, owners, and managerial officials as defined in section
245A.02, subdivision 5a, and the date that the background study was initiated by the applicant
for each controlling individual;
(4) if applicable, the applicant's NPI number and UMPI number;
(5) the documents that created the organization and that determine the organization's
internal governance and the relations among the persons that own the organization, have
an interest in the organization, or are members of the organization, in each case as provided
or authorized by the organization's governing statute, which may include a partnership
agreement, bylaws, articles of organization, organizational chart, and operating agreement,
or comparable documents as provided in the organization's governing statute; and
(6) the notarized signature of the applicant or authorized agent.
(h) When the applicant is a government entity, the applicant must provide:
(1) the name of the government agency, political subdivision, or other unit of government
seeking the license and the name of the program or services that will be licensed;
(2) the applicant's taxpayer identification numbers including the Minnesota tax
identification number and federal employer identification number;
(3) a letter signed by the manager, administrator, or other executive of the government
entity authorizing the submission of the license application; and
(4) if applicable, the applicant's NPI number and UMPI number.
(i) At the time of application for licensure or renewal of a license under this chapter, the
applicant or license holder must acknowledge on the form provided by the commissioner
if the applicant or license holder elects to receive any public funding reimbursement from
the commissioner for services provided under the license that:
(1) the applicant's or license holder's compliance with the provider enrollment agreement
or registration requirements for receipt of public funding may be monitored by the
commissioner as part of a licensing investigation or licensing inspection; and
(2) noncompliance with the provider enrollment agreement or registration requirements
for receipt of public funding that is identified through a licensing investigation or licensing
inspection, or noncompliance with a licensing requirement that is a basis of enrollment for
reimbursement for a service, may result in:
(i) a correction order or a conditional license under section 245A.06, or sanctions under
section 245A.07;
(ii) nonpayment of claims submitted by the license holder for public program
reimbursement;
(iii) recovery of payments made for the service;
(iv) disenrollment in the public payment program; or
(v) other administrative, civil, or criminal penalties as provided by law.
Sec. 4.
Minnesota Statutes 2020, section 245A.04, subdivision 7, is amended to read:
Subd. 7.
Grant of license; license extension.
(a) If the commissioner determines that
the program complies with all applicable rules and laws, the commissioner shall issue a
license consistent with this section or, if applicable, a temporary change of ownership license
under section 245A.043. At minimum, the license shall state:
(1) the name of the license holder;
(2) the address of the program;
(3) the effective date and expiration date of the license;
(4) the type of license;
(5) the maximum number and ages of persons that may receive services from the program;
and
(6) any special conditions of licensure.
(b) The commissioner may issue a license for a period not to exceed two years if:
(1) the commissioner is unable to conduct the deleted text begin evaluation ordeleted text end observation required by
subdivision 4, paragraph (a), clause deleted text begin (4)deleted text end new text begin (3)new text end , because the program is not yet operational;
(2) certain records and documents are not available because persons are not yet receiving
services from the program; and
(3) the applicant complies with applicable laws and rules in all other respects.
(c) A decision by the commissioner to issue a license does not guarantee that any person
or persons will be placed or cared for in the licensed program.
(d) Except as provided in paragraphs (f) and (g), the commissioner shall not issue or
reissue a license if the applicant, license holder, or controlling individual has:
(1) been disqualified and the disqualification was not set aside and no variance has been
granted;
(2) been denied a license under this chapter, within the past two years;
(3) had a license issued under this chapter revoked within the past five years;
(4) an outstanding debt related to a license fee, licensing fine, or settlement agreement
for which payment is delinquent; or
(5) failed to submit the information required of an applicant under subdivision 1,
paragraph (f) deleted text begin ordeleted text end new text begin ,new text end (g),new text begin or (h),new text end after being requested by the commissioner.
When a license issued under this chapter is revoked under clause (1) or (3), the license
holder and controlling individual may not hold any license under chapter 245A for five
years following the revocation, and other licenses held by the applicant, license holder, or
controlling individual shall also be revoked.
(e) The commissioner shall not issue or reissue a license under this chapter if an individual
living in the household where the services will be provided as specified under section
245C.03, subdivision 1, has been disqualified and the disqualification has not been set aside
and no variance has been granted.
(f) Pursuant to section 245A.07, subdivision 1, paragraph (b), when a license issued
under this chapter has been suspended or revoked and the suspension or revocation is under
appeal, the program may continue to operate pending a final order from the commissioner.
If the license under suspension or revocation will expire before a final order is issued, a
temporary provisional license may be issued provided any applicable license fee is paid
before the temporary provisional license is issued.
(g) Notwithstanding paragraph (f), when a revocation is based on the disqualification
of a controlling individual or license holder, and the controlling individual or license holder
is ordered under section 245C.17 to be immediately removed from direct contact with
persons receiving services or is ordered to be under continuous, direct supervision when
providing direct contact services, the program may continue to operate only if the program
complies with the order and submits documentation demonstrating compliance with the
order. If the disqualified individual fails to submit a timely request for reconsideration, or
if the disqualification is not set aside and no variance is granted, the order to immediately
remove the individual from direct contact or to be under continuous, direct supervision
remains in effect pending the outcome of a hearing and final order from the commissioner.
(h) For purposes of reimbursement for meals only, under the Child and Adult Care Food
Program, Code of Federal Regulations, title 7, subtitle B, chapter II, subchapter A, part 226,
relocation within the same county by a licensed family day care provider, shall be considered
an extension of the license for a period of no more than 30 calendar days or until the new
license is issued, whichever occurs first, provided the county agency has determined the
family day care provider meets licensure requirements at the new location.
(i) Unless otherwise specified by statute, all licenses issued under this chapter expire at
12:01 a.m. on the day after the expiration date stated on the license. A license holder must
apply for and be granted a new license to operate the program or the program must not be
operated after the expiration date.
(j) The commissioner shall not issue or reissue a license under this chapter if it has been
determined that a tribal licensing authority has established jurisdiction to license the program
or service.
Sec. 5.
Minnesota Statutes 2020, section 245A.041, is amended by adding a subdivision
to read:
new text begin Subd. 5. new text end
new text begin First date of direct contact; documentation requirements. new text end
new text begin
Except for family
child care, family foster care for children or adults, and family adult day services that the
license holder provides in the license holder's residence, license holders must document the
first date that a background study subject has direct contact, as defined in section 245C.02,
subdivision 11, with a person served by the license holder's program. Unless this chapter
otherwise requires, if the license holder does not maintain documentation in the license
holder's personnel files of the first date that a background study subject has direct contact
with a person served by the license holder's program, the license holder must provide
documentation to the commissioner that contains the first date that each background study
subject has direct contact with a person served by the license holder's program upon the
commissioner's request.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2022.
new text end
Sec. 6.
Minnesota Statutes 2020, section 245A.11, subdivision 7, is amended to read:
Subd. 7.
Adult foster care; variance for alternate overnight supervision.
(a) The
commissioner may grant a variance under section 245A.04, subdivision 9, to rule parts
requiring a caregiver to be present in an adult foster care home new text begin or a community residential
setting new text end during normal sleeping hours to allow for alternative methods of overnight
supervision. The commissioner may grant the variance if the local county licensing agency
recommends the variance and the county recommendation includes documentation verifying
that:
(1) the county has approved the license holder's plan for alternative methods of providing
overnight supervision and determined the plan protects the residents' health, safety, and
rights;
(2) the license holder has obtained written and signed informed consent from each
resident or each resident's legal representative documenting the resident's or legal
representative's agreement with the alternative method of overnight supervision; and
(3) the alternative method of providing overnight supervision, which may include the
use of technology, is specified for each resident in the resident's: (i) individualized plan of
care; (ii) individual service plan under section 256B.092, subdivision 1b, if required; or (iii)
individual resident placement agreement under Minnesota Rules, part 9555.5105, subpart
19, if required.
(b) To be eligible for a variance under paragraph (a), the adult foster carenew text begin or community
residential settingnew text end license holder must not have had a conditional license issued under section
245A.06, or any other licensing sanction issued under section 245A.07 during the prior 24
months based on failure to provide adequate supervision, health care services, or resident
safety in the adult foster care homenew text begin or community residential settingnew text end .
(c) A license holder requesting a variance under this subdivision to utilize technology
as a component of a plan for alternative overnight supervision may request the commissioner's
review in the absence of a county recommendation. Upon receipt of such a request from a
license holder, the commissioner shall review the variance request with the county.
deleted text begin
(d) A variance granted by the commissioner according to this subdivision before January
1, 2014, to a license holder for an adult foster care home must transfer with the license when
the license converts to a community residential setting license under chapter 245D. The
terms and conditions of the variance remain in effect as approved at the time the variance
was granted.
deleted text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 7.
Minnesota Statutes 2020, section 245A.11, is amended by adding a subdivision to
read:
new text begin Subd. 12. new text end
new text begin License holder qualifications for child foster care. new text end
new text begin
(a) Child foster care
license holders and household members must maintain the ability to care for a foster child.
License holders must immediately notify the licensing agency of:
new text end
new text begin
(1) any changes to the license holder or household member's physical or behavioral
health that may affect the license holder's ability to care for a foster child or pose a risk to
a foster child's health; or
new text end
new text begin
(2) the removal of a child for whom the license holder is responsible from the license
holder's home.
new text end
new text begin
(b) The licensing agency may request a license holder or household member to undergo
an evaluation by a specialist in such areas as health, mental health, or substance use disorders
to evaluate the license holder's ability to provide a safe environment for a foster child.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2022.
new text end
Sec. 8.
Minnesota Statutes 2020, section 245A.14, subdivision 4, is amended to read:
Subd. 4.
Special family day care homes.
Nonresidential child care programs serving
14 or fewer children that are conducted at a location other than the license holder's own
residence shall be licensed under this section and the rules governing family day care or
group family day care if:
(a) the license holder is the primary provider of care and the nonresidential child care
program is conducted in a dwelling that is located on a residential lot;
(b) the license holder is an employer who may or may not be the primary provider of
care, and the purpose for the child care program is to provide child care services to children
of the license holder's employees;
(c) the license holder is a church or religious organization;
(d) the license holder is a community collaborative child care provider. For purposes of
this subdivision, a community collaborative child care provider is a provider participating
in a cooperative agreement with a community action agency as defined in section 256E.31;
(e) the license holder is a not-for-profit agency that provides child care in a dwelling
located on a residential lot and the license holder maintains two or more contracts with
community employers or other community organizations to provide child care services.
The county licensing agency may grant a capacity variance to a license holder licensed
under this paragraph to exceed the licensed capacity of 14 children by no more than five
children during transition periods related to the work schedules of parents, if the license
holder meets the following requirements:
(1) the program does not exceed a capacity of 14 children more than a cumulative total
of four hours per day;
(2) the program meets a one to seven staff-to-child ratio during the variance period;
(3) all employees receive at least an extra four hours of training per year than required
in the rules governing family child care each year;
(4) the facility has square footage required per child under Minnesota Rules, part
9502.0425;
(5) the program is in compliance with local zoning regulations;
(6) the program is in compliance with the applicable fire code as follows:
(i) if the program serves more than five children older than 2-1/2 years of age, but no
more than five children 2-1/2 years of age or less, the applicable fire code is educational
occupancy, as provided in Group E Occupancy under the Minnesota State Fire Code deleted text begin 2015deleted text end new text begin
2020new text end , Section 202; or
(ii) if the program serves more than five children 2-1/2 years of age or less, the applicable
fire code is Group I-4 deleted text begin Occupanciesdeleted text end new text begin Occupancynew text end , as provided in the Minnesota State Fire
Code deleted text begin 2015deleted text end new text begin 2020new text end , Section 202, unless the rooms in which the childrennew text begin 2-1/2 years of age or
youngernew text end are cared for are located on a level of exit discharge and each of these child care
rooms has an exit door directly to the exterior, then the applicable fire code is Group E
deleted text begin occupanciesdeleted text end new text begin Occupancynew text end , as provided in the Minnesota State Fire Code deleted text begin 2015deleted text end new text begin 2020new text end , Section
202; and
(7) any age and capacity limitations required by the fire code inspection and square
footage determinations shall be printed on the license; or
(f) the license holder is the primary provider of care and has located the licensed child
care program in a commercial space, if the license holder meets the following requirements:
(1) the program is in compliance with local zoning regulations;
(2) the program is in compliance with the applicable fire code as follows:
(i) if the program serves more than five children older than 2-1/2 years of age, but no
more than five children 2-1/2 years of age or less, the applicable fire code is educational
occupancy, as provided in Group E Occupancy under the Minnesota State Fire Code deleted text begin 2015deleted text end new text begin
2020new text end , Section 202; or
(ii) if the program serves more than five children 2-1/2 years of age or less, the applicable
fire code is Group I-4 deleted text begin Occupanciesdeleted text end new text begin Occupancynew text end , as provided under the Minnesota State Fire
Code deleted text begin 2015deleted text end new text begin 2020new text end , Section 202new text begin , unless the rooms in which the children 2-1/2 years of age or
younger are cared for are located on a level of exit discharge and each of these child care
rooms has an exit door directly to the exterior, then the applicable fire code is Group E
Occupancy, as provided in the Minnesota State Fire Code 2020, Section 202new text end ;
(3) any age and capacity limitations required by the fire code inspection and square
footage determinations are printed on the license; and
(4) the license holder prominently displays the license issued by the commissioner which
contains the statement "This special family child care provider is not licensed as a child
care center."
(g) The commissioner may approve two or more licenses under paragraphs (a) to (f) to
be issued at the same location or under one contiguous roof, if each license holder is able
to demonstrate compliance with all applicable rules and laws. Each license holder must
operate the license holder's respective licensed program as a distinct program and within
the capacity, age, and ratio distributions of each license.
(h) The commissioner may grant variances to this section to allow a primary provider
of care, a not-for-profit organization, a church or religious organization, an employer, or a
community collaborative to be licensed to provide child care under paragraphs (e) and (f)
if the license holder meets the other requirements of the statute.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2022.
new text end
Sec. 9.
Minnesota Statutes 2020, section 245A.1435, is amended to read:
245A.1435 REDUCTION OF RISK OF SUDDEN UNEXPECTED INFANT DEATH
IN LICENSED PROGRAMS.
(a) When a license holder is placing an infant to sleep, the license holder must place the
infant on the infant's back, unless the license holder has documentation from the infant's
physician or advanced practice registered nurse directing an alternative sleeping position
for the infant. The physician or advanced practice registered nurse directive must be on a
form deleted text begin approveddeleted text end new text begin developednew text end by the commissioner and must remain on file at the licensed
location.
An infant who independently rolls onto its stomach after being placed to sleep on its
back may be allowed to remain sleeping on its stomach if the infant is at least six months
of age or the license holder has a signed statement from the parent indicating that the infant
regularly rolls over at home.
(b) The license holder must place the infant in a crib directly on a firm mattress with a
fitted sheet that is appropriate to the mattress size, that fits tightly on the mattress, and
overlaps the underside of the mattress so it cannot be dislodged by pulling on the corner of
the sheet with reasonable effort. The license holder must not place anything in the crib with
the infant except for the infant's pacifier, as defined in Code of Federal Regulations, title
16, part 1511. new text begin The pacifier must be free from any sort of attachment. new text end The requirements of
this section apply to license holders serving infants younger than one year of age. Licensed
child care providers must meet the crib requirements under section 245A.146. A correction
order shall not be issued under this paragraph unless there is evidence that a violation
occurred when an infant was present in the license holder's care.
(c) If an infant falls asleep before being placed in a crib, the license holder must move
the infant to a crib as soon as practicable, and must keep the infant within sight of the license
holder until the infant is placed in a crib. When an infant falls asleep while being held, the
license holder must consider the supervision needs of other children in care when determining
how long to hold the infant before placing the infant in a crib to sleep. The sleeping infant
must not be in a position where the airway may be blocked or with anything covering the
infant's face.
new text begin
(d) When a license holder places an infant under one year of age down to sleep, the
infant's clothing or sleepwear must not have weighted materials, a hood, or a bib.
new text end
new text begin
(e) A license holder may place an infant under one year of age down to sleep wearing
a helmet if the license holder has signed documentation by a physician, advanced practice
registered nurse, licensed occupational therapist, or a licensed physical therapist on a form
developed by the commissioner.
new text end
deleted text begin (d)deleted text end new text begin (f)new text end Placing a swaddled infant down to sleep in a licensed setting is not recommended
for an infant of any age and is prohibited for any infant who has begun to roll over
independently. However, with the written consent of a parent or guardian according to this
paragraph, a license holder may place the infant who has not yet begun to roll over on its
own down to sleep in a deleted text begin one-piece sleeper equipped with an attached system that fastens
securely only across the upper torso, with no constriction of the hips or legs, to create adeleted text end
swaddlenew text begin . A swaddle is defined as one-piece sleepwear that wraps over the infant's arms,
fastens securely only across the infant's upper torso, and does not constrict the infant's hips
or legs. If a swaddle is used by a license holder, the license holder must ensure that it meets
the requirements of paragraph (d) and is not so tight that it restricts the infant's ability to
breathe or so loose that the fabric could cover the infant's nose and mouthnew text end . Prior to any use
of swaddling for sleep by a provider licensed under this chapter, the license holder must
obtain informed written consent for the use of swaddling from the parent or guardian of the
infant on a form deleted text begin provideddeleted text end new text begin developednew text end by the commissioner deleted text begin and prepared in partnership with
the Minnesota Sudden Infant Death Centerdeleted text end .
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2022.
new text end
Sec. 10.
Minnesota Statutes 2020, section 245A.1443, is amended to read:
245A.1443 deleted text begin CHEMICAL DEPENDENCYdeleted text end new text begin SUBSTANCE USE DISORDER
TREATMENT LICENSEDnew text end PROGRAMS THAT SERVE PARENTS WITH THEIR
CHILDREN.
Subdivision 1.
Application.
This section applies to deleted text begin chemical dependencydeleted text end new text begin residential
substance use disordernew text end treatment facilities that are licensed under this chapter and deleted text begin Minnesota
Rules,deleted text end chapter deleted text begin 9530,deleted text end new text begin 245Gnew text end and that provide services in accordance with section 245G.19.
Subd. 2.
Requirements for providing education.
(a) On or before the date of a child's
initial physical presence at the facility, the license holder must provide education to the
child's parent related to safe bathing and reducing the risk of sudden unexpected infant death
and abusive head trauma from shaking infants and young children. new text begin The license holder must
use the educational material developed by the commissioner to comply with this requirement.
new text end At a minimum, the education must address:
(1) instruction that a child or infant should never be left unattended around water, a tub
should be filled with only two to four inches of water for infants, and an infant should never
be put into a tub when the water is running; and
(2) the risk factors related to sudden unexpected infant death and abusive head trauma
from shaking infants and young children, and means of reducing the risks, including the
safety precautions identified in section 245A.1435 and the deleted text begin dangersdeleted text end new text begin risksnew text end of co-sleeping.
(b) The license holder must document the parent's receipt of the education and keep the
documentation in the parent's file. The documentation must indicate whether the parent
agrees to comply with the safeguards. If the parent refuses to comply, program staff must
provide additional education to the parent deleted text begin at appropriate intervals, at least weeklydeleted text end new text begin as described
in the parental supervision plan. The parental supervision plan must include the intervention,
frequency, and staff responsiblenew text end for the duration of the parent's participation in the program
or until the parent agrees to comply with the safeguards.
Subd. 3.
Parental supervision of children.
(a) On or before the date of a child's initial
physical presence at the facility, the license holder must deleted text begin complete anddeleted text end document deleted text begin an
assessment ofdeleted text end the parent's capacity to meet the health and safety needs of the child while
on the facility premisesdeleted text begin , including identifying circumstances when the parent may be unable
to adequately care for their child due todeleted text end new text begin considering the following factorsnew text end :
(1) the parent's physical deleted text begin ordeleted text end new text begin andnew text end mental health;
(2) the parent being under the influence of drugs, alcohol, medications, or other chemicals;
deleted text begin
(3) the parent being unable to provide appropriate supervision for the child; or
deleted text end
new text begin
(3) the child's physical and mental health; and
new text end
(4) any other information available to the license holder that indicates the parent may
not be able to adequately care for the child.
(b) The license holder must have written procedures specifying the actions to be taken
by staff if a parent is or becomes unable to adequately care for the parent's child.
new text begin
(c) If the parent refuses to comply with the safeguards described in subdivision 2 or is
unable to adequately care for the child, the license holder must develop a parental supervision
plan in conjunction with the client. The plan must account for any factors in paragraph (a)
that contribute to the parent's inability to adequately care for the child. The plan must be
dated and signed by the staff person who completed the plan.
new text end
Subd. 4.
Alternative supervision arrangements.
The license holder must have written
procedures addressing whether the program permits a parent to arrange for supervision of
the parent's child by another client in the program. If permitted, the facility must have a
procedure that requires staff approval of the supervision arrangement before the supervision
by the nonparental client occurs. The procedure for approval must include an assessment
of the nonparental client's capacity to assume the supervisory responsibilities using the
criteria in subdivision 3. The license holder must document the license holder's approval of
the supervisory arrangement and the assessment of the nonparental client's capacity to
supervise the child, and must keep this documentation in the file of the parent of the child
being supervised.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2022.
new text end
Sec. 11.
Minnesota Statutes 2020, section 245A.146, subdivision 3, is amended to read:
Subd. 3.
License holder documentation of cribs.
(a) Annually, from the date printed
on the license, all license holders shall check all their cribs' brand names and model numbers
against the United States Consumer Product Safety Commission website listing of unsafe
cribs.
(b) The license holder shall maintain written documentation to be reviewed on site for
each crib showing that the review required in paragraph (a) has been completed, and which
of the following conditions applies:
(1) the crib was not identified as unsafe on the United States Consumer Product Safety
Commission website;
(2) the crib was identified as unsafe on the United States Consumer Product Safety
Commission website, but the license holder has taken the action directed by the United
States Consumer Product Safety Commission to make the crib safe; or
(3) the crib was identified as unsafe on the United States Consumer Product Safety
Commission website, and the license holder has removed the crib so that it is no longer
used by or accessible to children in care.
(c) Documentation of the review completed under this subdivision shall be maintained
by the license holder on site and made available to parents or guardians of children in care
and the commissioner.
(d) Notwithstanding Minnesota Rules, part 9502.0425, a family child care provider that
complies with this section may use a mesh-sided or fabric-sided play yard, pack and play,
or playpen or crib that has not been identified as unsafe on the United States Consumer
Product Safety Commission website for the care or sleeping of infants.
(e) On at least a monthly basis, the family child care license holder shall perform safety
inspections of every mesh-sided or fabric-sided play yard, pack and play, or playpen used
by or that is accessible to any child in care, and must document the following:
(1) there are no tears, holes, or loose or unraveling threads in mesh or fabric sides of
crib;
(2) the weave of the mesh on the crib is no larger than one-fourth of an inch;
(3) no mesh fabric is unsecure or unattached to top rail and floor plate of crib;
(4) no tears or holes to top rail of crib;
(5) the mattress floor board is not soft and does not exceed one inch thick;
(6) the mattress floor board has no rips or tears in covering;
(7) the mattress floor board in use is deleted text begin a waterproofdeleted text end new text begin annew text end original mattress or replacement
mattress provided by the manufacturer of the crib;
(8) there are no protruding or loose rivets, metal nuts, or bolts on the crib;
(9) there are no knobs or wing nuts on outside crib legs;
(10) there are no missing, loose, or exposed staples; and
(11) the latches on top and side rails used to collapse crib are secure, they lock properly,
and are not loose.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2022.
new text end
Sec. 12.
Minnesota Statutes 2020, section 245A.16, subdivision 1, is amended to read:
Subdivision 1.
Delegation of authority to agencies.
(a) County agencies and private
agencies that have been designated or licensed by the commissioner to perform licensing
functions and activities under section 245A.04 and background studies for family child care
under chapter 245C; to recommend denial of applicants under section 245A.05; to issue
correction orders, to issue variances, and recommend a conditional license under section
245A.06; or to recommend suspending or revoking a license or issuing a fine under section
245A.07, shall comply with rules and directives of the commissioner governing those
functions and with this section. The following variances are excluded from the delegation
of variance authority and may be issued only by the commissioner:
(1) dual licensure of family child care and child foster care, dual licensure of child new text begin foster
care new text end and adult foster carenew text begin or a community residential settingnew text end , and new text begin dual licensure of new text end adult
foster care and family child care;
(2) adult foster care maximum capacity;
(3) adult foster care minimum age requirement;
(4) child foster care maximum age requirement;
(5) variances regarding disqualified individuals except that, before the implementation
of NETStudy 2.0, county agencies may issue variances under section 245C.30 regarding
disqualified individuals when the county is responsible for conducting a consolidated
reconsideration according to sections 245C.25 and 245C.27, subdivision 2, clauses (a) and
(b), of a county maltreatment determination and a disqualification based on serious or
recurring maltreatment;
(6) the required presence of a caregiver in the adult foster care residence during normal
sleeping hours;
(7) variances to requirements relating to chemical use problems of a license holder or a
household member of a license holder; and
(8) variances to section 245A.53 for a time-limited period. If the commissioner grants
a variance under this clause, the license holder must provide notice of the variance to all
parents and guardians of the children in care.
Except as provided in section 245A.14, subdivision 4, paragraph (e), a county agency must
not grant a license holder a variance to exceed the maximum allowable family child care
license capacity of 14 children.
(b) A county agency that has been designated by the commissioner to issue family child
care variances must:
(1) publish the county agency's policies and criteria for issuing variances on the county's
public website and update the policies as necessary; and
(2) annually distribute the county agency's policies and criteria for issuing variances to
all family child care license holders in the county.
(c) Before the implementation of NETStudy 2.0, county agencies must report information
about disqualification reconsiderations under sections 245C.25 and 245C.27, subdivision
2, paragraphs (a) and (b), and variances granted under paragraph (a), clause (5), to the
commissioner at least monthly in a format prescribed by the commissioner.
(d) For family child care programs, the commissioner shall require a county agency to
conduct one unannounced licensing review at least annually.
(e) For family adult day services programs, the commissioner may authorize licensing
reviews every two years after a licensee has had at least one annual review.
(f) A license issued under this section may be issued for up to two years.
(g) During implementation of chapter 245D, the commissioner shall consider:
(1) the role of counties in quality assurance;
(2) the duties of county licensing staff; and
(3) the possible use of joint powers agreements, according to section 471.59, with counties
through which some licensing duties under chapter 245D may be delegated by the
commissioner to the counties.
Any consideration related to this paragraph must meet all of the requirements of the corrective
action plan ordered by the federal Centers for Medicare and Medicaid Services.
(h) Licensing authority specific to section 245D.06, subdivisions 5, 6, 7, and 8, or
successor provisions; and section 245D.061 or successor provisions, for family child foster
care programs providing out-of-home respite, as identified in section 245D.03, subdivision
1, paragraph (b), clause (1), is excluded from the delegation of authority to county and
private agencies.
(i) A county agency shall report to the commissioner, in a manner prescribed by the
commissioner, the following information for a licensed family child care program:
(1) the results of each licensing review completed, including the date of the review, and
any licensing correction order issued;
(2) any death, serious injury, or determination of substantiated maltreatment; and
(3) any fires that require the service of a fire department within 48 hours of the fire. The
information under this clause must also be reported to the state fire marshal within two
business days of receiving notice from a licensed family child care provider.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 13.
Minnesota Statutes 2020, section 245A.18, subdivision 2, is amended to read:
Subd. 2.
Child passenger restraint systems; training requirement.
(a) Programs
licensed by the Department of Human Services undernew text begin this chapter to follow standards innew text end
Minnesota Rules, chapter 2960deleted text begin , thatdeleted text end new text begin and this chapter tonew text end serve a child or children under eight
years of age must document training that fulfills the requirements in this subdivision.new text begin Section
245A.70, subdivision 4, and 245A.75, subdivision 4, describe training requirements for
family foster care and foster residence settings.
new text end
(b) Before a license holder, staff person, or caregiver transports a child or children under
age eight in a motor vehicle, the person transporting the child must satisfactorily complete
training on the proper use and installation of child restraint systems in motor vehicles.
deleted text begin Training completed under this section may be used to meet initial or ongoing training under
Minnesota Rules, part 2960.3070, subparts 1 and 2.
deleted text end
(c) Training required under this section must be completed at orientation or initial training
and repeated at least once every five years. At a minimum, the training must address the
proper use of child restraint systems based on the child's size, weight, and age, and the
proper installation of a car seat or booster seat in the motor vehicle used by the license
holder to transport the child or children.
(d) Training under paragraph (c) must be provided by individuals who are certified and
approved by the Department of Public Safety, Office of Traffic Safety. License holders may
obtain a list of certified and approved trainers through the Department of Public Safety
website or by contacting the agency.
deleted text begin
(e) Notwithstanding paragraph (a), for an emergency relative placement under section
245A.035, the commissioner may grant a variance to the training required by this subdivision
for a relative who completes a child seat safety check up. The child seat safety check up
trainer must be approved by the Department of Public Safety, Office of Traffic Safety, and
must provide one-on-one instruction on placing a child of a specific age in the exact child
passenger restraint in the motor vehicle in which the child will be transported. Once granted
a variance, and if all other licensing requirements are met, the relative applicant may receive
a license and may transport a relative foster child younger than eight years of age. A child
seat safety check up must be completed each time a child requires a different size car seat
according to car seat and vehicle manufacturer guidelines. A relative license holder must
complete training that meets the other requirements of this subdivision prior to placement
of another foster child younger than eight years of age in the home or prior to the renewal
of the child foster care license.
deleted text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2022.
new text end
Sec. 14.
Minnesota Statutes 2020, section 245A.22, is amended by adding a subdivision
to read:
new text begin Subd. 8. new text end
new text begin Maltreatment of minors training requirements. new text end
new text begin
The license holder must
train each mandatory reporter as described in section 260E.06, subdivision 1, on the
maltreatment of minors reporting requirements and definitions in chapter 260E before the
mandatory reporter has direct contact, as defined in section 245C.02, subdivision 11, with
a person served by the program and the license holder must train each mandatory reporter
annually thereafter.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2022.
new text end
Sec. 15.
Minnesota Statutes 2020, section 245A.52, subdivision 1, is amended to read:
Subdivision 1.
Means of escape.
(a)(1) At least one emergency escape route separate
from the main exit from the space must be available in each room used for sleeping by
anyone receiving licensed care, and (2) a basement used for child care. One means of escape
must be a stairway or door leading to the floor of exit discharge. The other must be a door
or window leading directly outside. A window used as an emergency escape route must be
openable without special knowledge.
(b) In homes with construction that began before deleted text begin May 2, 2016deleted text end new text begin March 31, 2020new text end , the
interior of the window leading directly outside must have a net clear opening area of not
less than 4.5 square feet or 648 square inches and have minimum clear opening dimensions
of 20 inches wide and 20 inches high.new text begin The net clear opening dimensions shall be the result
of normal operation of the opening.new text end The opening must be no higher than 48 inches from the
floor. The height to the window may be measured from a platform if a platform is located
below the window.
(c) In homes with construction that began on or after deleted text begin May 2, 2016deleted text end new text begin March 31, 2020new text end , the
interior of the window leading directly outside must have minimum clear opening dimensions
of 20 inches wide and 24 inches high. The net clear opening dimensions shall be the result
of normal operation of the opening. The opening must be no higher than 44 inches from the
floor. deleted text begin (d)deleted text end Additional requirements are dependent on the distance of the openings from the
ground outside the window: (1) windows or other openings with a sill height not more than
44 inches above or below the finished ground level adjacent to the opening (grade-floor
emergency escape and rescue openings) must have a minimum opening of five square feet;
and (2) non-grade-floor emergency escape and rescue openings must have a minimum
opening of 5.7 square feet.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2022.
new text end
Sec. 16.
Minnesota Statutes 2020, section 245A.52, subdivision 2, is amended to read:
Subd. 2.
Door to attached garage.
deleted text begin
Notwithstanding Minnesota Rules, part 9502.0425,
subpart 5, day care residences with an attached garage are not required to have a self-closing
door to the residence.
deleted text end
new text begin
If there is an opening between an attached garage and a day care
residence, there must be a door that is:
new text end
new text begin
(1) a solid wood bonded core door at least 1-3/8 inches thick;
new text end
deleted text begin The door to the residence may bedeleted text end new text begin (2)new text end a steel insulated door deleted text begin if the door isdeleted text end at least 1-3/8
inches thickdeleted text begin .deleted text end new text begin ; or
new text end
new text begin
(3) a door with a fire protection rating of 20 minutes or greater.
new text end
new text begin
The separation wall on the garage side between the residence and garage must consist of
1/2-inch-thick gypsum wallboard or its equivalent.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2022.
new text end
Sec. 17.
Minnesota Statutes 2020, section 245A.52, subdivision 3, is amended to read:
Subd. 3.
Heating and venting systems.
new text begin (a) new text end Notwithstanding Minnesota Rules, part
9502.0425, subpart 7,new text begin item C,new text end items that can be ignited and support combustion, including
but not limited to plastic, fabric, and wood products must not be located withinnew text begin :
new text end
new text begin (1)new text end 18 inches of deleted text begin adeleted text end new text begin anynew text end gas or fuel-oil deleted text begin heater or furnace.deleted text end new text begin fired heat-producing appliances;
or
new text end
new text begin
(2) 36 inches of any solid-fuel burning appliances.
new text end
new text begin (b)new text end If a license holder produces manufacturer instructions listing a smaller distance, then
the manufacturer instructions control the distance combustible items must be from gas,
fuel-oil, or solid-fuel burning deleted text begin heaters or furnacesdeleted text end new text begin appliancesnew text end .
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2022.
new text end
Sec. 18.
Minnesota Statutes 2020, section 245A.52, subdivision 5, is amended to read:
Subd. 5.
Carbon monoxide and smoke alarms.
(a) All homes must have an approved
and operational carbon monoxide alarm installed within ten feet of each room used for
sleeping children in care.
(b) Smoke alarms that have been listed by the Underwriter Laboratory must be properly
installed and maintained on all levels including basements, but not including crawl spaces
and uninhabitable attics, and in hallways outside rooms used for sleeping children in care.
(c) In homes with construction that began on or after deleted text begin May 2, 2016deleted text end new text begin March 31, 2003new text end ,
smoke alarms must be installed and maintained in each room used for sleeping children in
care.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2022.
new text end
Sec. 19.
Minnesota Statutes 2020, section 245A.52, is amended by adding a subdivision
to read:
new text begin Subd. 7. new text end
new text begin Stairways. new text end
new text begin
All stairways must meet the following conditions.
new text end
new text begin
(1) Stairways of four or more steps must have handrails on at least one side.
new text end
new text begin
(2) Any open area between the handrail and stair tread must be enclosed with a protective
guardrail as specified in the State Building Code. At open risers, openings located more
than 30 inches (762 mm), as measured vertically, to the floor or grade below shall not permit
the passage of a 4-inch-diameter (102 mm) sphere.
new text end
new text begin
(3) Gates or barriers must be used when children between the ages of six and 18 months
are in care.
new text end
new text begin
(4) Stairways must be well-lighted, in good repair, and free of clutter and obstructions.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2022.
new text end
Sec. 20.
Minnesota Statutes 2020, section 245A.52, is amended by adding a subdivision
to read:
new text begin Subd. 8. new text end
new text begin Fire code variances. new text end
new text begin
When a variance is requested of the standards contained
in subdivision 1, 2, 3, 4, or 5, an applicant or provider must submit written approval from
the state fire marshal of the variance requested and the alternative measures identified to
ensure the safety of children in care.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2022.
new text end
Sec. 21.
Minnesota Statutes 2020, section 245A.66, subdivision 2, is amended to read:
Subd. 2.
Child care centers; risk reduction plan.
(a) Child care centers licensed under
this chapter and Minnesota Rules, chapter 9503, must develop a risk reduction plan that
identifies the general risks to children served by the child care center. The license holder
must establish procedures to minimize identified risks, train staff on the procedures, and
deleted text begin annuallydeleted text end review the proceduresnew text begin once per calendar yearnew text end .
(b) The risk reduction plan must include an assessment of risk to children the center
serves or intends to serve and identify specific risks based on the outcome of the assessment.
The assessment of risk must be based on the following:
(1) an assessment of the risks presented by the physical plant where the licensed services
are provided, including an evaluation of the following factors: the condition and design of
the facility and its outdoor space, bathrooms, storage areas, and accessibility of medications
and cleaning products that are harmful to children when children are not supervised and the
existence of areas that are difficult to supervise; and
(2) an assessment of the risks presented by the environment for each facility and for
each site, including an evaluation of the following factors: the type of grounds and terrain
surrounding the building and the proximity to hazards, busy roads, and publicly accessed
businesses.
(c) The risk reduction plan must include a statement of measures that will be taken to
minimize the risk of harm presented to children for each risk identified in the assessment
required under paragraph (b) related to the physical plant and environment. At a minimum,
the stated measures must include the development and implementation of specific policies
and procedures or reference to existing policies and procedures that minimize the risks
identified.
(d) In addition to any program-specific risks identified in paragraph (b), the plan must
include development and implementation of specific policies and procedures or refer to
existing policies and procedures that minimize the risk of harm or injury to children,
including:
(1) closing children's fingers in doors, including cabinet doors;
(2) leaving children in the community without supervision;
(3) children leaving the facility without supervision;
(4) caregiver dislocation of children's elbows;
(5) burns from hot food or beverages, whether served to children or being consumed by
caregivers, and the devices used to warm food and beverages;
(6) injuries from equipment, such as scissors and glue guns;
(7) sunburn;
(8) feeding children foods to which they are allergic;
(9) children falling from changing tables; and
(10) children accessing dangerous items or chemicals or coming into contact with residue
from harmful cleaning products.
(e) The plan shall prohibit the accessibility of hazardous items to children.
(f) The plan must include specific policies and procedures to ensure adequate supervision
of children at all times as defined under section 245A.02, subdivision 18, with particular
emphasis on:
(1) times when children are transitioned from one area within the facility to another;
(2) nap-time supervision, including infant crib rooms as specified under section 245A.02,
subdivision 18, which requires that when an infant is placed in a crib to sleep, supervision
occurs when a staff person is within sight or hearing of the infant. When supervision of a
crib room is provided by sight or hearing, the center must have a plan to address the other
supervision components;
(3) child drop-off and pick-up times;
(4) supervision during outdoor play and on community activities, including but not
limited to field trips and neighborhood walks;
(5) supervision of children in hallways; and
(6) supervision of school-age children when using the restroom and visiting the child's
personal storage space.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 22.
Minnesota Statutes 2020, section 245A.66, is amended by adding a subdivision
to read:
new text begin Subd. 4. new text end
new text begin Annual training requirement. new text end
new text begin
In addition to the orientation training required
by the applicable licensing rules and statutes, children's residential facility, foster care for
children, and private child-placing agency license holders must provide a training annually
on the maltreatment of minors reporting requirements and definitions in chapter 260E to
each mandatory reporter, as described in section 260E.06, subdivision 1.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2022.
new text end
Sec. 23.
new text begin
[245A.70] FAMILY CHILD FOSTER CARE TRAINING REQUIREMENTS.
new text end
new text begin Subdivision 1. new text end
new text begin Applicability. new text end
new text begin
This section applies to programs licensed to provide foster
care for children in the license holder's residence. For the purposes of this section, "foster
parent" means the license holder or license holders.
new text end
new text begin Subd. 2. new text end
new text begin Orientation. new text end
new text begin
(a) Each foster parent applicant must complete a minimum of six
hours of orientation before the commissioner will license the applicant. An applicant's
orientation training hours do not count toward annual training hours. The commissioner
may grant a variance to the applicant regarding the number of orientation hours that this
subdivision requires.
new text end
new text begin
(b) The foster parent's orientation must include training about the following:
new text end
new text begin
(1) emergency procedures, including evacuation routes, emergency telephone numbers,
severe storm and tornado procedures, and the location of alarms and equipment;
new text end
new text begin
(2) all relevant laws and rules, including this chapter; chapters 260, 260C, and 260E;
Minnesota Rules, chapter 9560; and related legal issues and reporting requirements;
new text end
new text begin
(3) cultural diversity, gender sensitivity, culturally specific services, cultural competence,
and information about discrimination and racial bias to ensure that caregivers are culturally
competent to care for foster children according to section 260C.212, subdivision 11;
new text end
new text begin
(4) the foster parent's roles and responsibilities in developing and implementing the
child's case plan and involvement in court and administrative reviews of the child's placement;
new text end
new text begin
(5) the licensing agency's requirements;
new text end
new text begin
(6) one hour relating to reasonable and prudent parenting standards for the child's
participation in age-appropriate or developmentally appropriate extracurricular, social, or
cultural activities according to section 260C.212, subdivision 14;
new text end
new text begin
(7) two hours relating to children's mental health issues according to subdivision 3;
new text end
new text begin
(8) if subdivision 4 requires, the proper use and installation of child passenger restraint
systems in motor vehicles;
new text end
new text begin
(9) if subdivision 5 requires, at least one hour about reducing the risk of sudden
unexpected infant death and abusive head trauma from shaking infants and young children;
and
new text end
new text begin
(10) if subdivision 6 requires, operating medical equipment.
new text end
new text begin Subd. 3. new text end
new text begin Mental health training. new text end
new text begin
Prior to licensure, each foster parent must complete
two hours of training that addresses the causes, symptoms, and key warning signs of
children's mental health disorders; cultural considerations; and effective approaches to
manage a child's behaviors. Prior to caring for a foster child, each caregiver must complete
two hours of training that addresses the causes, symptoms, and key warning signs of
children's mental health disorders; cultural considerations; and effective approaches to
manage a child's behaviors. Each year, each foster parent and caregiver must complete at
least one hour of training about children's mental health issues and treatment. A short-term
substitute caregiver is exempt from this subdivision. The commissioner of human services
shall approve of a mental health training curriculum that satisfies the requirements of this
subdivision.
new text end
new text begin Subd. 4. new text end
new text begin Child passenger restraint systems. new text end
new text begin
(a) Each foster parent and caregiver must
satisfactorily complete training about the proper use and installation of child passenger
restraint systems in motor vehicles before transporting a child younger than eight years of
age in a motor vehicle.
new text end
new text begin
(b) An individual who is certified and approved by the Department of Public Safety,
Office of Traffic Safety must provide training about the proper use and installation of child
passenger restraint systems in motor vehicles to each foster parent and caregiver who
transports a child. At a minimum, the training must address the proper use of child passenger
restraint systems based on a child's size, weight, and age, and the proper installation of a
car seat or booster seat in the motor vehicle that will be transporting the child. A foster
parent or caregiver who transports a child must repeat the training in this subdivision at
least once every five years.
new text end
new text begin
(c) Notwithstanding paragraph (a), for an emergency relative placement under section
245A.035, the commissioner may grant a variance to the training required by this subdivision
to a child's relative who completes a child seat safety checkup. The Department of Public
Safety, Office of Traffic Safety must approve of the child seat safety checkup trainer and
must provide one-on-one instruction to the child's relative applicant about placing a child
of a specific age in the exact child passenger restraint in the motor vehicle that will be used
to transport the child. Once the commissioner grants a variance to the child's relative, the
child's relative may transport a relative foster child younger than eight years of age, and
once the child's relative meets all other licensing requirements, the commissioner may
license the child's relative applicant. The child's relative must complete a child seat safety
checkup each time that the child requires a different sized car seat according to car seat and
vehicle manufacturer guidelines. A relative license holder must complete training that meets
the other requirements of this subdivision prior to placement of another foster child younger
than eight years of age in the relative license holder's home or prior to the renewal of the
relative license holder's child foster care license.
new text end
new text begin Subd. 5. new text end
new text begin
Training about the risk of sudden unexpected infant death and abusive
head trauma.
new text end
new text begin
Each foster parent and caregiver who cares for an infant or a child five years
of age or younger must satisfactorily complete at least one hour of training about reducing
the risk of sudden unexpected infant death and abusive head trauma from shaking infants
and young children. The county or private licensing agency monitoring the foster care
provider under section 245A.16 must approve of the training about reducing the risk of
sudden unexpected infant death and abusive head trauma from shaking infants and young
children. At a minimum, the training must address the risk factors related to sudden
unexpected infant death and abusive head trauma, means of reducing the risk of sudden
unexpected infant death and abusive head trauma, and license holder communication with
parents regarding reducing the risk of sudden unexpected infant death and abusive head
trauma. Each foster parent must complete training about reducing the risk of sudden
unexpected infant death and abusive head trauma from shaking infants and young children
prior to licensure. Each caregiver must complete this training prior to caring for an infant
or a child five years of age or younger. This section does not apply to emergency relative
placement under section 245A.035. Each foster parent and caregiver must complete the
training in this subdivision at least once every five years.
new text end
new text begin Subd. 6. new text end
new text begin Training on use of medical equipment. new text end
new text begin
(a) If caring for a child who relies on
medical equipment to sustain the child's life or monitor the child's medical condition, each
foster parent and caregiver must satisfactorily complete training to operate the child's
equipment with a health care professional or an individual who provides training on the
child's equipment.
new text end
new text begin
(b) A foster parent or caregiver is exempt from this subdivision if:
new text end
new text begin
(1) the foster parent or caregiver is currently caring for an individual who is using the
same equipment in the foster home; or
new text end
new text begin
(2) the foster parent or caregiver has written documentation that the foster parent or
caregiver has cared for an individual who relied on the same equipment within the past six
months.
new text end
new text begin Subd. 7. new text end
new text begin Fetal alcohol spectrum disorders training. new text end
new text begin
Each foster parent and caregiver
must complete at least one hour of the annual training requirement about fetal alcohol
spectrum disorders. A provider who is also licensed to provide home and community-based
services under chapter 245D and the provider's staff are exempt from this subdivision. A
short-term substitute caregiver is exempt from this subdivision. The commissioner of human
services shall approve a fetal alcohol spectrum disorders training curriculum that satisfies
the requirements of this subdivision.
new text end
new text begin Subd. 8. new text end
new text begin Annual training requirement. new text end
new text begin
(a) Each foster parent must complete a minimum
of 12 hours of training per year. If a foster parent fails to complete the required annual
training and does not show good cause why the foster parent did not complete the training,
the foster parent is prohibited from accepting a new foster child placement until the foster
parent completes the training. The commissioner may grant a variance to the required number
of annual training hours.
new text end
new text begin
(b) Each year, each foster parent and caregiver must complete one hour of training about
children's mental health issues according to subdivision 3, and one hour of training about
fetal alcohol spectrum disorders, if required by subdivision 7.
new text end
new text begin
(c) Each year, each foster parent and caregiver must complete training about the reporting
requirements and definitions in chapter 260E, as section 245A.66 requires.
new text end
new text begin
(d) At least once every five years, each foster parent and caregiver must complete one
hour of training about reducing the risk of sudden unexpected infant death and abusive head
trauma, if required by subdivision 5.
new text end
new text begin
(e) At least once every five years, each foster parent and caregiver must complete training
regarding child passenger restraint systems, if required by subdivision 4.
new text end
new text begin
(f) The commissioner may provide each foster parent with a nonexclusive list of eligible
training topics that fulfill the remaining hours of required annual training.
new text end
new text begin Subd. 9. new text end
new text begin Documentation of training. new text end
new text begin
(a) The licensing agency must document the
trainings that this section requires on a form that the commissioner has developed.
new text end
new text begin
(b) For training required under subdivision 6, the agency must also retain a training and
skills form on file and update the form each year for each foster care provider who completes
training about caring for a child who relies on medical equipment to sustain the child's life
or monitor the child's medical condition. The agency placing the child must obtain a copy
of the training and skills form from the foster parent or from the agency supervising the
foster parent. The agency must retain the form and any updated information on file for the
placement's duration. The form must be available to the parent or guardian and the child's
social worker for the social worker to make an informed placement decision. The agency
must use the training and skills form that the commissioner has developed.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2022.
new text end
Sec. 24.
new text begin
[245A.75] FOSTER RESIDENCE SETTING STAFF TRAINING
REQUIREMENTS.
new text end
new text begin Subdivision 1. new text end
new text begin Applicability. new text end
new text begin
This section applies to foster residence settings, which is
defined as foster care that a license holder provides in a home in which the license holder
does not reside. "Foster residence setting" does not include any program licensed or certified
under Minnesota Rules, parts 2960.0010 to 2960.0710.
new text end
new text begin Subd. 2. new text end
new text begin Orientation. new text end
new text begin
The license holder must ensure that each staff person attends and
successfully completes at least six hours of orientation training before the staff person has
unsupervised contact with a foster child. Orientation training hours are not counted toward
the hours of annual training. Orientation must include training about the following:
new text end
new text begin
(1) emergency procedures, including evacuation routes, emergency telephone numbers,
severe storm and tornado procedures, and the location of facility alarms and equipment;
new text end
new text begin
(2) all relevant laws, rules, and legal issues, including reporting requirements for
maltreatment, abuse, and neglect specified in chapter 260E and section 626.557 and other
reporting requirements based on the children's ages;
new text end
new text begin
(3) cultural diversity, gender sensitivity, culturally specific services, and information
about discrimination and racial bias to ensure that caregivers are culturally sensitive and
culturally competent to care for foster children according to section 260C.212, subdivision
11;
new text end
new text begin
(4) general and special needs, including disability needs, of children and families served;
new text end
new text begin
(5) operational policies and procedures of the license holder;
new text end
new text begin
(6) data practices requirements and issues;
new text end
new text begin
(7) two hours of training about children's mental health disorders according to subdivision
3;
new text end
new text begin
(8) if required by subdivision 4, the proper use and installation of child passenger restraint
systems in motor vehicles;
new text end
new text begin
(9) if required by subdivision 5, at least one hour of training about reducing the risk of
sudden unexpected infant death and abusive head trauma from shaking infants and young
children; and
new text end
new text begin
(10) if required by subdivision 6, caring for a child who relies on medical equipment to
sustain the child's life or monitor the child's medical condition.
new text end
new text begin Subd. 3. new text end
new text begin Mental health training. new text end
new text begin
Prior to caring for a child, a staff person must complete
two hours of training that addresses the causes, symptoms, and key warning signs of mental
health disorders; cultural considerations; and effective approaches to manage a child's
behaviors. A foster residence staff person must complete at least one hour of the annual
training requirement regarding children's mental health issues and treatment. A short-term
substitute caregiver is exempt from this subdivision. The commissioner of human services
shall approve a mental health training curriculum that satisfies the requirements of this
subdivision.
new text end
new text begin Subd. 4. new text end
new text begin Child passenger restraint systems. new text end
new text begin
Prior to transporting a child younger than
eight years of age in a motor vehicle, a license holder, staff person, or caregiver must
satisfactorily complete training about the proper use and installation of child restraint systems
in motor vehicles. An individual who is certified and approved by the Department of Public
Safety, Office of Traffic Safety must provide training to a license holder, staff person, or
caregiver about the proper use and installation of child restraint systems in motor vehicles.
At a minimum, the training must address the proper use of child passenger restraint systems
based on a child's size, weight, and age and the proper installation of a car seat or booster
seat in the motor vehicle transporting the child. Each license holder, staff person, and
caregiver transporting a child younger than eight years of age in a motor vehicle must
complete the training in this subdivision at least once every five years.
new text end
new text begin Subd. 5. new text end
new text begin
Training about the risk of sudden unexpected infant death and abusive
head trauma.
new text end
new text begin
A license holder who cares for an infant or a child five years of age or younger
must document that each staff person has satisfactorily completed at least one hour of
training about reducing the risk of sudden unexpected infant death and abusive head trauma
from shaking infants and young children. The county or private licensing agency responsible
for monitoring the child foster care provider under section 245A.16 must approve of the
training about reducing the risk of sudden unexpected infant death and abusive head trauma
from shaking infants and young children. At a minimum, the training must address the risk
factors related to sudden unexpected infant death and abusive head trauma, means of reducing
the risk of sudden unexpected infant death and abusive head trauma, and license holder
communication with parents regarding reducing the risk of sudden unexpected infant death
and abusive head trauma from shaking infants and young children. Each staff person must
complete the training in this subdivision prior to caring for an infant or a child five years
of age or younger. Each staff person caring for an infant or a child five years of age or
younger must complete the training in this subdivision at least once every five years.
new text end
new text begin Subd. 6. new text end
new text begin Training on use of medical equipment. new text end
new text begin
(a) If caring for a child who relies on
medical equipment to sustain the child's life or monitor a child's medical condition, the
license holder or staff person must complete training to operate the child's equipment. A
health care professional or an individual who provides training on the equipment must train
the license holder or staff person about how to operate the child's equipment.
new text end
new text begin
(b) A license holder is exempt from this subdivision if:
new text end
new text begin
(1) the license holder is currently caring for an individual who is using the same
equipment in the foster home and each staff person has received training to use the
equipment; or
new text end
new text begin
(2) the license holder has written documentation that, within the past six months, the
license holder has cared for an individual who relied on the same equipment and each current
staff person has received training to use the same equipment.
new text end
new text begin Subd. 7. new text end
new text begin Fetal alcohol spectrum disorder training. new text end
new text begin
(a) Each staff person must complete
at least one hour of the annual training requirement about fetal alcohol spectrum disorders.
The commissioner of human services shall approve of a fetal alcohol spectrum disorder
training curriculum that satisfies the requirements of this subdivision.
new text end
new text begin
(b) A provider who is also licensed to provide home and community-based services
under chapter 245D and the provider's staff are exempt from this subdivision. A short-term
substitute caregiver is exempt from this subdivision.
new text end
new text begin Subd. 8. new text end
new text begin Prudent parenting standards training. new text end
new text begin
The license holder must have at least
one on-site staff person who is trained regarding the reasonable and prudent parenting
standards in section 260C.212, subdivision 14, and authorized to apply the reasonable and
prudent parenting standards to decisions involving the approval of a foster child's
participation in age-appropriate and developmentally appropriate extracurricular, social, or
cultural activities. The trained on-site staff person is not required to be available 24 hours
per day.
new text end
new text begin Subd. 9. new text end
new text begin Annual training plan and hours. new text end
new text begin
(a) A license holder must develop an annual
training plan for staff and volunteers. The license holder must modify training for staff and
volunteers each year to meet each staff person's current needs and provide sufficient training
to accomplish each staff person's duties. To determine the type and amount of training for
each staff person and volunteer, the license holder must consider the foster care program's
target population, the program's services, and expected outcomes from the services, as well
as the employee's job description, tasks, and the position's performance indicators.
new text end
new text begin
(b) A full-time staff person who has direct contact with children must complete at least
18 hours of in-service training per year, including nine hours of skill development training.
new text end
new text begin
(c) A part-time direct care staff person must complete sufficient training to competently
care for children. The amount of training must be at least one hour of training for each 60
hours that the part-time direct care staff person has worked, up to 18 hours of training per
part-time employee per year.
new text end
new text begin
(d) Other foster residence staff and volunteers must complete in-service training
requirements each year that is consistent with the foster residence staff and volunteers'
duties.
new text end
new text begin
(e) Section 245A.66 requires a license holder to ensure that all staff and volunteers have
training annually about the reporting requirements and definitions in chapter 260E.
new text end
new text begin Subd. 10. new text end
new text begin Documentation of training. new text end
new text begin
(a) For each staff person and volunteer, the
license holder must document the date, number of training hours, and the entity's name that
provided the training.
new text end
new text begin
(b) For training that subdivision 6 requires, the agency supervising the foster care provider
must retain a training and skills form on file and update the form each year for each staff
person who completes training about caring for a child who relies on medical equipment
to sustain the child's life or monitor a child's medical condition. The agency placing the
child must obtain a copy of the training and skills form from the foster care provider or the
agency supervising the foster care provider. The placing agency must retain the form and
any updated information on file for the placement's duration. The form must be available
to the child's parent or the child's primary caregiver and the child's social worker to make
an informed placement decision. The agency must use the training and skills form that the
commissioner has developed.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2022.
new text end
Sec. 25.
Minnesota Statutes 2020, section 245G.13, subdivision 2, is amended to read:
Subd. 2.
Staff development.
(a) A license holder must ensure that each staff member
has the training described in this subdivision.
(b) Each staff member must be trained every two years in:
(1) client confidentiality rules and regulations and client ethical boundaries; and
(2) emergency procedures and client rights as specified in sections 144.651, 148F.165,
and 253B.03.
(c) Annually each staff member with direct contact must be trained on mandatory
reporting as specified in sections 245A.65, 626.557, and 626.5572, and chapter 260E,
including specific training covering the license holder's policies for obtaining a release of
client information.
(d) Upon employment and annually thereafter, each staff member with direct contact
must receive training on HIV minimum standards according to section 245A.19.
(e) new text begin The license holder must ensure that each mandatory reporter, as described in section
260E.06, subdivision 1, is trained on the maltreatment of minors reporting requirements
and definitions in chapter 260E before the mandatory reporter has direct contact, as defined
in section 245C.02, subdivision 11, with a person served by the program.
new text end
new text begin (f) new text end A treatment director, supervisor, nurse, or counselor must have a minimum of 12
hours of training in co-occurring disorders that includes competencies related to philosophy,
trauma-informed care, screening, assessment, diagnosis and person-centered treatment
planning, documentation, programming, medication, collaboration, mental health
consultation, and discharge planning. A new staff member who has not obtained the training
must complete the training within six months of employment. A staff member may request,
and the license holder may grant, credit for relevant training obtained before employment,
which must be documented in the staff member's personnel file.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2022.
new text end
Sec. 26.
Minnesota Statutes 2020, section 245H.08, subdivision 4, is amended to read:
Subd. 4.
Maximum group size.
(a) For a child six weeks old through 16 months old,
the maximum group size shall be no more than eight children.
(b) For a child 16 months old through 33 months old, the maximum group size shall be
no more than 14 children.
(c) For a child 33 months old through prekindergarten, a maximum group size shall be
no more than 20 children.
(d) For a child in kindergarten through 13 years old, a maximum group size shall be no
more than 30 children.
(e) The maximum group size applies at all times except during group activity coordination
time not exceeding 15 minutes, during a meal, outdoor activity, field trip, nap and rest, and
special activity including a film, guest speaker, indoor large muscle activity, or holiday
program.
new text begin
(f) Notwithstanding paragraph (d), a certified center may continue to serve a child older
than 13 years old if one of the following conditions is true:
new text end
new text begin
(1) the child remains eligible for child care assistance under section 119B.09, subdivision
1, paragraph (e);
new text end
new text begin
(2) the certified center serves children in a middle school-only program, defined as
grades 6 through 8; or
new text end
new text begin
(3) the certified center serves only school-age children in a setting that has students
enrolled in no grade higher than 8th grade, and if a child older than 13 is in attendance, the
certified center groups the older children so that there is no more than a 48-month difference
in age between the youngest child and the oldest child in each group.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 27.
Minnesota Statutes 2020, section 245H.08, subdivision 5, is amended to read:
Subd. 5.
Ratios.
(a) The minimally acceptable staff-to-child ratios are:
| six weeks old through 16 months old |
1:4 |
| 16 months old through 33 months old |
1:7 |
| 33 months old through prekindergarten |
1:10 |
| kindergarten through 13 years old |
1:15 |
(b) Kindergarten includes a child of sufficient age to have attended the first day of
kindergarten or who is eligible to enter kindergarten within the next four months.
(c) For mixed groups, the ratio for the age group of the youngest child applies.
new text begin
(d) Notwithstanding paragraph (a), a certified center may continue to serve a child older
than 13 years old if one of the following conditions is true:
new text end
new text begin
(1) the child remains eligible for child care assistance under section 119B.09, subdivision
1, paragraph (e);
new text end
new text begin
(2) the certified center serves children in a middle school-only program, defined as
grades 6 through 8; or
new text end
new text begin
(3) the certified center serves only school-age children in a setting that has students
enrolled in no grade higher than 8th grade, and if a child older than 13 is in attendance, the
certified center groups the older children so that there is no more than a 48-month difference
in age between the youngest child and the oldest child in each group.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 28.
Minnesota Statutes 2020, section 256.041, is amended to read:
256.041 CULTURAL AND ETHNIC COMMUNITIES LEADERSHIP COUNCIL.
Subdivision 1.
Establishment; purpose.
new text begin (a) new text end There is hereby established the Cultural
and Ethnic Communities Leadership Council for the Department of Human Services. The
purpose of the council is to advise the commissioner of human services on deleted text begin reducingdeleted text end new text begin
implementing strategies to reduce inequities andnew text end disparities that new text begin particularly new text end affect racial
and ethnic groupsnew text begin in Minnesotanew text end .
new text begin
(b) This council is comprised of racially and ethnically diverse community leaders
including American Indians who are residents of Minnesota facing the compounded
challenges of systemic inequities. Members include people who are refugees, immigrants,
and LGBTQ+; people who have disabilities; and people who live in rural Minnesota.
new text end
Subd. 2.
Members.
(a) The council must consist of:
(1) the chairs and ranking minority members of the committees in the house of
representatives and the senate with jurisdiction over human services; and
(2) no fewer than 15 and no more than 25 members appointed by and serving at the
pleasure of the commissioner of human services, in consultation with county, tribal, cultural,
and ethnic communities; diverse program participants; and parent representatives from these
communitiesnew text begin , and cultural and ethnic communities leadership council membersnew text end .
(b) In making appointments under this section, the commissioner shall give priority
consideration to public members of the legislative councils of color established under deleted text begin chapter
3deleted text end new text begin section 15.0145new text end .
(c) Members must be appointed to allow for representation of the following groups:
(1) racial and ethnic minority groups;
(2) the American Indian community, which must be represented by two members;
(3) culturally and linguistically specific advocacy groups and service providers;
(4) human services program participants;
(5) public and private institutions;
(6) parents of human services program participants;
(7) members of the faith community;
(8) Department of Human Services employees; and
(9) any other group the commissioner deems appropriate to facilitate the goals and duties
of the council.
Subd. 3.
Guidelines.
The commissioner shall direct the development of guidelines
defining the membership of the council; setting out definitions; and developing duties of
the commissioner, the council, and council members regarding racial and ethnic disparities
reduction. The guidelines must be developed in consultation with:
(1) the chairs of relevant committees; and
(2) county, tribal, and cultural communities and program participants from these
communities.
Subd. 4.
Chair.
The commissioner shall new text begin accept recommendations from the council to
new text end appoint a chairnew text begin or chairsnew text end .
deleted text begin Subd. 5. deleted text end
deleted text begin Terms for first appointees. deleted text end
deleted text begin
The initial members appointed shall serve until
January 15, 2016.
deleted text end
Subd. 6.
Terms.
A term shall be for two years and appointees may be reappointed to
serve two additional terms. The commissioner shall make appointments to replace members
vacating their positions deleted text begin by January 15 of each yeardeleted text end new text begin in a timely manner, no more than three
months after the council reviews panel recommendationsnew text end .
Subd. 7.
Duties of commissioner.
(a) The commissioner of human services or the
commissioner's designee shall:
(1) maintain new text begin and actively engage with new text end the council established in this section;
(2) supervise and coordinate policies for persons from racial, ethnic, cultural, linguistic,
and tribal communities who experience disparities in access and outcomes;
(3) identify human services rules or statutes affecting persons from racial, ethnic, cultural,
linguistic, and tribal communities that may need to be revised;
(4) investigate and implement deleted text begin cost-effectivedeleted text end new text begin equitable and culturally responsivenew text end models
of service delivery deleted text begin such asdeleted text end new text begin includingnew text end careful deleted text begin adaptationdeleted text end new text begin adoptionnew text end of deleted text begin clinicallydeleted text end proven services
deleted text begin that constitute one strategy for increasingdeleted text end new text begin to increasenew text end the number of culturally relevant
services available to currently underserved populations; deleted text begin and
deleted text end
(5) based on recommendations of the council, review identified department policies that
maintain racial, ethnic, cultural, linguistic, and tribal disparities, and make adjustments to
ensure those disparities are not perpetuateddeleted text begin .deleted text end new text begin , and advise the department on progress and
accountability measures for addressing inequities;
new text end
new text begin
(6) in partnership with the council, renew and implement equity policy with action plans
and resources necessary to implement the action plans;
new text end
new text begin
(7) support interagency collaboration to advance equity;
new text end
new text begin
(8) address the council at least twice annually on the state of equity within the department;
and
new text end
new text begin
(9) support member participation in the council, including participation in educational
and community engagement events across Minnesota that address equity in human services.
new text end
(b) The commissioner of human services or the commissioner's designee shall consult
with the council and receive recommendations from the council when meeting the
requirements in this subdivision.
Subd. 8.
Duties of council.
The council shall:
(1) recommend to the commissioner for review deleted text begin identified policies in thedeleted text end Department of
Human Services new text begin policy, budgetary, and operational decisions and practices new text end that deleted text begin maintaindeleted text end new text begin
impactnew text end racial, ethnic, cultural, linguistic, and tribal disparities;
(2) new text begin with community input, advance legislative proposals to improve racial and health
equity outcomes;
new text end
new text begin (3) new text end identify issues regarding new text begin inequities and new text end disparities by engaging diverse populations
in human services programs;
deleted text begin (3)deleted text end new text begin (4)new text end engage in mutual learning essential for achieving human services parity and
optimal wellness for service recipients;
deleted text begin (4)deleted text end new text begin (5)new text end raise awareness about human services disparities to the legislature and media;
deleted text begin (5)deleted text end new text begin (6)new text end provide technical assistance and consultation support to counties, private nonprofit
agencies, and other service providers to build their capacity to provide equitable human
services for persons from racial, ethnic, cultural, linguistic, and tribal communities who
experience disparities in access and outcomes;
deleted text begin (6)deleted text end new text begin (7)new text end provide technical assistance to promote statewide development of culturally and
linguistically appropriate, accessible, and cost-effective human services and related policies;
deleted text begin (7) providedeleted text end new text begin (8) recommend and monitornew text end training and outreach to facilitate access to
culturally and linguistically appropriate, accessible, and cost-effective human services to
prevent disparities;
deleted text begin
(8) facilitate culturally appropriate and culturally sensitive admissions, continued services,
discharges, and utilization review for human services agencies and institutions;
deleted text end
(9) form work groups to help carry out the duties of the council that include, but are not
limited to, persons who provide and receive services and representatives of advocacy groups,
and provide the work groups with clear guidelines, standardized parameters, and tasks for
the work groups to accomplish;
(10) promote information sharing in the human services community and statewide; deleted text begin and
deleted text end
(11) by February 15 deleted text begin each yeardeleted text end new text begin in the second year of the bienniumnew text end , prepare and submit
to the chairs and ranking minority members of the committees in the house of representatives
and the senate with jurisdiction over human services a report that summarizes the activities
of the council, identifies the major problems and issues confronting racial and ethnic groups
in accessing human services, makes recommendations to address issues, and lists the specific
objectives that the council seeks to attain during the next bienniumnew text begin , and recommendations
to strengthen equity, diversity, and inclusion within the departmentnew text end . The report must deleted text begin also
include a list of programs, groups, and grants used to reduce disparities, and statistically
valid reports of outcomes on the reduction of the disparities.deleted text end new text begin identify racial and ethnic groups'
difficulty in accessing human services and make recommendations to address the issues.
The report must include any updated Department of Human Services equity policy,
implementation plans, equity initiatives, and the council's progress.
new text end
Subd. 9.
Duties of council members.
The members of the council shall:
(1) new text begin with no more than three absences per year, new text end attend and participate in scheduled
meetings and be prepared by reviewing meeting notes;
(2) maintain open communication channels with respective constituencies;
(3) identify and communicate issues and risks that could impact the timely completion
of tasks;
(4) collaborate on new text begin inequity and new text end disparity reduction efforts;
(5) communicate updates of the council's work progress and status on the Department
of Human Services website; deleted text begin and
deleted text end
(6) participate in any activities the council or chair deems appropriate and necessary to
facilitate the goals and duties of the councildeleted text begin .deleted text end new text begin ; and
new text end
new text begin
(7) participate in work groups to carry out council duties.
new text end
Subd. 10.
Expiration.
The council deleted text begin expires on June 30, 2022deleted text end new text begin shall expire when racial
and ethnic-based disparities no longer exist in the state of Minnesotanew text end .
Sec. 29.
Minnesota Statutes 2020, section 256B.69, subdivision 9d, is amended to read:
Subd. 9d.
Financial and quality assurance audits.
(a) The commissioner shall require,
in the request for bids and resulting contracts with managed care plans and county-based
purchasing plans under this section and section 256B.692, that each managed care plan and
county-based purchasing plan submit to and fully cooperate with the independent third-party
financial audits by the legislative auditor under subdivision 9e of the information required
under subdivision 9c, paragraph (b). Each contract with a managed care plan or county-based
purchasing plan under this section or section 256B.692 must provide the commissioner, the
legislative auditor, and vendors contracting with the legislative auditor, access to all data
required to complete audits under subdivision 9e.
(b) Each managed care plan and county-based purchasing plan providing services under
this section shall provide to the commissioner biweekly encounter data and claims data for
state public health care programs and shall participate in a quality assurance program that
verifies the timeliness, completeness, accuracy, and consistency of the data provided. The
commissioner shall develop written protocols for the quality assurance program and shall
make the protocols publicly available. The commissioner shall contract for an independent
third-party audit to evaluate the quality assurance protocols as to the capacity of the protocols
to ensure complete and accurate data and to evaluate the commissioner's implementation
of the protocols.
(c) Upon completion of the evaluation under paragraph (b), the commissioner shall
provide copies of the report to the legislative auditor and the chairs and ranking minority
members of the legislative committees with jurisdiction over health care policy and financing.
(d) Any actuary under contract with the commissioner to provide actuarial services must
meet the independence requirements under the professional code for fellows in the Society
of Actuaries and must not have provided actuarial services to a managed care plan or
county-based purchasing plan that is under contract with the commissioner pursuant to this
section and section 256B.692 during the period in which the actuarial services are being
provided. An actuary or actuarial firm meeting the requirements of this paragraph must
certify and attest to the rates paid to the managed care plans and county-based purchasing
plans under this section and section 256B.692, and the certification and attestation must be
auditable.
deleted text begin
(e) The commissioner, to the extent of available funding, shall conduct ad hoc audits of
state public health care program administrative and medical expenses reported by managed
care plans and county-based purchasing plans. This includes: financial and encounter data
reported to the commissioner under subdivision 9c, including payments to providers and
subcontractors; supporting documentation for expenditures; categorization of administrative
and medical expenses; and allocation methods used to attribute administrative expenses to
state public health care programs. These audits also must monitor compliance with data and
financial report certification requirements established by the commissioner for the purposes
of managed care capitation payment rate-setting. The managed care plans and county-based
purchasing plans shall fully cooperate with the audits in this subdivision. The commissioner
shall report to the chairs and ranking minority members of the legislative committees with
jurisdiction over health and human services policy and finance by February 1, 2016, and
each February 1 thereafter, the number of ad hoc audits conducted in the past calendar year
and the results of these audits.
deleted text end
deleted text begin (f)deleted text end new text begin (e)new text end Nothing in this subdivision shall allow the release of information that is nonpublic
data pursuant to section 13.02.
Sec. 30.
Minnesota Statutes 2020, section 626.557, subdivision 12b, is amended to read:
Subd. 12b.
Data management.
(a) In performing any of the duties of this section as a
lead investigative agency, the county social service agency shall maintain appropriate
records. Data collected by the county social service agency under this section are welfare
data under section 13.46. Notwithstanding section 13.46, subdivision 1, paragraph (a), data
under this paragraph that are inactive investigative data on an individual who is a vendor
of services are private data on individuals, as defined in section 13.02. The identity of the
reporter may only be disclosed as provided in paragraph (c).
Data maintained by the common entry point are confidential data on individuals or
protected nonpublic data as defined in section 13.02. Notwithstanding section 138.163, the
common entry point shall maintain data for three calendar years after date of receipt and
then destroy the data unless otherwise directed by federal requirements.
(b) The commissioners of health and human services shall prepare an investigation
memorandum for each report alleging maltreatment investigated under this section. County
social service agencies must maintain private data on individuals but are not required to
prepare an investigation memorandum. During an investigation by the commissioner of
health or the commissioner of human services, data collected under this section are
confidential data on individuals or protected nonpublic data as defined in section 13.02.
Upon completion of the investigation, the data are classified as provided in clauses (1) to
(3) and paragraph (c).
(1) The investigation memorandum must contain the following data, which are public:
(i) the name of the facility investigated;
(ii) a statement of the nature of the alleged maltreatment;
(iii) pertinent information obtained from medical or other records reviewed;
(iv) the identity of the investigator;
(v) a summary of the investigation's findings;
(vi) statement of whether the report was found to be substantiated, inconclusive, false,
or that no determination will be made;
(vii) a statement of any action taken by the facility;
(viii) a statement of any action taken by the lead investigative agency; and
(ix) when a lead investigative agency's determination has substantiated maltreatment, a
statement of whether an individual, individuals, or a facility were responsible for the
substantiated maltreatment, if known.
The investigation memorandum must be written in a manner which protects the identity
of the reporter and of the vulnerable adult and may not contain the names or, to the extent
possible, data on individuals or private data listed in clause (2).
(2) Data on individuals collected and maintained in the investigation memorandum are
private data, including:
(i) the name of the vulnerable adult;
(ii) the identity of the individual alleged to be the perpetrator;
(iii) the identity of the individual substantiated as the perpetrator; and
(iv) the identity of all individuals interviewed as part of the investigation.
(3) Other data on individuals maintained as part of an investigation under this section
are private data on individuals upon completion of the investigation.
(c) After the assessment or investigation is completed, the name of the reporter must be
confidential. The subject of the report may compel disclosure of the name of the reporter
only with the consent of the reporter or upon a written finding by a court that the report was
false and there is evidence that the report was made in bad faith. This subdivision does not
alter disclosure responsibilities or obligations under the Rules of Criminal Procedure, except
that where the identity of the reporter is relevant to a criminal prosecution, the district court
shall do an in-camera review prior to determining whether to order disclosure of the identity
of the reporter.
(d) Notwithstanding section 138.163, data maintained under this section by the
commissioners of health and human services must be maintained under the following
schedule and then destroyed unless otherwise directed by federal requirements:
(1) data from reports determined to be false, maintained for three years after the finding
was made;
(2) data from reports determined to be inconclusive, maintained for four years after the
finding was made;
(3) data from reports determined to be substantiated, maintained for seven years after
the finding was made; and
(4) data from reports which were not investigated by a lead investigative agency and for
which there is no final disposition, maintained for three years from the date of the report.
deleted text begin
(e) The commissioners of health and human services shall annually publish on their
websites the number and type of reports of alleged maltreatment involving licensed facilities
reported under this section, the number of those requiring investigation under this section,
and the resolution of those investigations. On a biennial basis, the commissioners of health
and human services shall jointly report the following information to the legislature and the
governor:
deleted text end
deleted text begin
(1) the number and type of reports of alleged maltreatment involving licensed facilities
reported under this section, the number of those requiring investigations under this section,
the resolution of those investigations, and which of the two lead agencies was responsible;
deleted text end
deleted text begin
(2) trends about types of substantiated maltreatment found in the reporting period;
deleted text end
deleted text begin
(3) if there are upward trends for types of maltreatment substantiated, recommendations
for addressing and responding to them;
deleted text end
deleted text begin
(4) efforts undertaken or recommended to improve the protection of vulnerable adults;
deleted text end
deleted text begin
(5) whether and where backlogs of cases result in a failure to conform with statutory
time frames and recommendations for reducing backlogs if applicable;
deleted text end
deleted text begin
(6) recommended changes to statutes affecting the protection of vulnerable adults; and
deleted text end
deleted text begin
(7) any other information that is relevant to the report trends and findings.
deleted text end
deleted text begin (f)deleted text end new text begin (e)new text end Each lead investigative agency must have a record retention policy.
deleted text begin (g)deleted text end new text begin (f)new text end Lead investigative agencies, prosecuting authorities, and law enforcement agencies
may exchange not public data, as defined in section 13.02, if the agency or authority
requesting the data determines that the data are pertinent and necessary to the requesting
agency in initiating, furthering, or completing an investigation under this section. Data
collected under this section must be made available to prosecuting authorities and law
enforcement officials, local county agencies, and licensing agencies investigating the alleged
maltreatment under this section. The lead investigative agency shall exchange not public
data with the vulnerable adult maltreatment review panel established in section 256.021 if
the data are pertinent and necessary for a review requested under that section.
Notwithstanding section 138.17, upon completion of the review, not public data received
by the review panel must be destroyed.
deleted text begin (h)deleted text end new text begin (g)new text end Each lead investigative agency shall keep records of the length of time it takes
to complete its investigations.
deleted text begin (i)deleted text end new text begin (h)new text end A lead investigative agency may notify other affected parties and their authorized
representative if the lead investigative agency has reason to believe maltreatment has occurred
and determines the information will safeguard the well-being of the affected parties or dispel
widespread rumor or unrest in the affected facility.
deleted text begin (j)deleted text end new text begin (i)new text end Under any notification provision of this section, where federal law specifically
prohibits the disclosure of patient identifying information, a lead investigative agency may
not provide any notice unless the vulnerable adult has consented to disclosure in a manner
which conforms to federal requirements.
Sec. 31. new text begin REPEALER.
new text end
new text begin
(a)
new text end
new text begin
Minnesota Statutes 2020, sections 245.981; 245A.144; 245A.175; 246B.03,
subdivision 2; 256.01, subdivision 31; and 256.9657, subdivision 8,
new text end
new text begin
are repealed.
new text end
new text begin
(b)
new text end
new text begin
Laws 2012, chapter 247, article 1, section 30,
new text end
new text begin
is repealed.
new text end
new text begin
(c)
new text end
new text begin
Minnesota Rules, parts 2960.3070; 2960.3210; and 9502.0425, subparts 5 and 10,
new text end
new text begin
are repealed.
new text end
APPENDIX
Repealed Minnesota Statutes: 21-02656
119B.04 FEDERAL CHILD CARE AND DEVELOPMENT FUND.
Subdivision 1.
Commissioner to administer program.
The commissioner is authorized and directed to receive, administer, and expend funds available under the child care and development fund under Public Law 104-193, Title VI.
Subd. 2.
Rulemaking authority.
The commissioner may adopt rules under chapter 14 to administer the child care and development fund.
119B.125 PROVIDER REQUIREMENTS.
Subd. 5.
Provisional payment.
After a county receives a completed application from a provider, the county may issue provisional authorization and payment to the provider during the time needed to determine whether to give final authorization to the provider.
245.981 COMPULSIVE GAMBLING ANNUAL REPORT.
(a) Each year by February 15, 2014, and thereafter, the commissioner of human services shall report to the chairs and ranking minority members of the legislative committees having jurisdiction over compulsive gambling on the percentage of gambling revenues that come from gamblers identified as problem gamblers, or a similarly defined term, as defined by the National Council on Problem Gambling. The report must disaggregate the revenue by the various types of gambling, including, but not limited to: lottery; electronic and paper pull-tabs; bingo; linked bingo; and pari-mutuel betting.
(b) By February 15, 2013, the commissioner shall provide a preliminary update for the report required under paragraph (a) to the chairs and ranking minority members of the legislative committees having jurisdiction over compulsive gambling and the estimated cost of the full report.
245A.03 WHO MUST BE LICENSED.
Subd. 5.
Excluded housing with services programs; right to seek licensure.
Nothing in this section shall prohibit a housing with services program that is excluded from licensure under subdivision 2, paragraph (a), clause (25), from seeking a license under this chapter. The commissioner shall ensure that any application received from such an excluded provider is processed in the same manner as all other applications for licensed adult foster care.
245A.144 TRAINING ON RISK OF SUDDEN UNEXPECTED INFANT DEATH AND ABUSIVE HEAD TRAUMA FOR CHILD FOSTER CARE PROVIDERS.
(a) Licensed child foster care providers that care for infants or children through five years of age must document that before staff persons and caregivers assist in the care of infants or children through five years of age, they are instructed on the standards in section 245A.1435 and receive training on reducing the risk of sudden unexpected infant death and abusive head trauma from shaking infants and young children. This section does not apply to emergency relative placement under section 245A.035. The training on reducing the risk of sudden unexpected infant death and abusive head trauma may be provided as:
(1) orientation training to child foster care providers, who care for infants or children through five years of age, under Minnesota Rules, part 2960.3070, subpart 1; or
(2) in-service training to child foster care providers, who care for infants or children through five years of age, under Minnesota Rules, part 2960.3070, subpart 2.
(b) Training required under this section must be at least one hour in length and must be completed at least once every five years. At a minimum, the training must address the risk factors related to sudden unexpected infant death and abusive head trauma, means of reducing the risk of sudden unexpected infant death and abusive head trauma, and license holder communication with parents regarding reducing the risk of sudden unexpected infant death and abusive head trauma.
(c) Training for child foster care providers must be approved by the county or private licensing agency that is responsible for monitoring the child foster care provider under section 245A.16. The approved training fulfills, in part, training required under Minnesota Rules, part 2960.3070.
245A.175 CHILD FOSTER CARE TRAINING REQUIREMENT; MENTAL HEALTH TRAINING; FETAL ALCOHOL SPECTRUM DISORDERS TRAINING.
Prior to a nonemergency placement of a child in a foster care home, the child foster care license holder and caregivers in foster family and treatment foster care settings, and all staff providing care in foster residence settings must complete two hours of training that addresses the causes, symptoms, and key warning signs of mental health disorders; cultural considerations; and effective approaches for dealing with a child's behaviors. At least one hour of the annual training requirement for the foster family license holder and caregivers, and foster residence staff must be on children's mental health issues and treatment. Except for providers and services under chapter 245D, the annual training must also include at least one hour of training on fetal alcohol spectrum disorders, which must be counted toward the 12 hours of required in-service training per year. Short-term substitute caregivers are exempt from these requirements. Training curriculum shall be approved by the commissioner of human services.
246B.03 LICENSURE, EVALUATION, AND GRIEVANCE RESOLUTION.
Subd. 2.
Minnesota Sex Offender Program evaluation.
(a) The commissioner shall contract with national sex offender experts to evaluate the sex offender treatment program. The consultant group shall consist of four national experts, including:
(1) three experts who are licensed psychologists, psychiatrists, clinical therapists, or other mental health treatment providers with established and recognized training and experience in the assessment and treatment of sexual offenders; and
(2) one nontreatment professional with relevant training and experience regarding the oversight or licensing of sex offender treatment programs or other relevant mental health treatment programs.
(b) These experts shall, in consultation with the executive clinical director of the sex offender treatment program:
(1) review and identify relevant information and evidence-based best practices and methodologies for effectively assessing, diagnosing, and treating civilly committed sex offenders;
(2) on at least an annual basis, complete a site visit and comprehensive program evaluation that may include a review of program policies and procedures to determine the program's level of compliance, address specific areas of concern brought to the panel's attention by the executive clinical director or executive director, offer recommendations, and complete a written report of its findings to the executive director and clinical director; and
(3) in addition to the annual site visit and review, provide advice, input, and assistance as requested by the executive clinical director or executive director.
(c) The commissioner or commissioner's designee shall enter into contracts as necessary to fulfill the responsibilities under this subdivision.
252.28 COMMISSIONER OF HUMAN SERVICES; DUTIES.
Subdivision 1.
Determinations; redeterminations.
In conjunction with the appropriate county boards, the commissioner of human services shall determine, and shall redetermine at least every four years, the need, anticipated growth or decline in need until the next anticipated redetermination, location, size, and program of public and private day training and habilitation services for persons with developmental disabilities. This subdivision does not apply to semi-independent living services and residential-based habilitation services provided to four or fewer persons at a single site funded as home and community-based services. A determination of need shall not be required for a change in ownership.
Subd. 5.
Appeals.
A county may appeal a determination of need, size, location, or program according to chapter 14. Notice of appeals must be provided to the commissioner within 30 days after the receipt of the commissioner's determination.
252A.02 DEFINITIONS.
Subd. 8.
Public conservator.
"Public conservator" means the commissioner of human services when exercising some, but not all the powers designated in section 252A.111.
Subd. 10.
Conservatee.
"Conservatee" means a person with a developmental disability for whom the court has appointed a public conservator.
252A.21 GENERAL PROVISIONS.
Subd. 3.
Terminology.
Whenever the term "guardian" is used in sections 252A.01 to 252A.21, it shall include "conservator," and the term "ward" shall include "conservatee" unless another intention clearly appears from the context.
256.01 COMMISSIONER OF HUMAN SERVICES; POWERS, DUTIES.
Subd. 31.
Consumer satisfaction; human services.
(a) The commissioner of human services shall submit a memorandum each year to the governor and the chairs of the house of representatives and senate standing committees with jurisdiction over the department's programs that provides the following information:
(1) the number of calls made to each of the department's help lines by consumers and citizens regarding the services provided by the department;
(2) the program area related to the call;
(3) the number of calls resolved at the department;
(4) the number of calls that were referred to a county agency for resolution;
(5) the number of calls that were referred elsewhere for resolution;
(6) the number of calls that remain open; and
(7) the number of calls that were without merit.
(b) The initial memorandum shall be submitted no later than February 15, 2012, with subsequent memoranda submitted no later than February 15 each following year.
(c) The commissioner shall publish the annual memorandum on the department's website each year no later than March 1.
256.9657 PROVIDER SURCHARGES.
Subd. 8.
Commissioner's duties.
The commissioner of human services shall report to the legislature quarterly on the first day of January, April, July, and October regarding the provider surcharge program. The report shall include information on total billings, total collections, and administrative expenditures. The report on January 1, 1993, shall include information on all surcharge billings, collections, federal matching payments received, efforts to collect unpaid amounts, and administrative costs pertaining to the surcharge program in effect from July 1, 1991, to September 30, 1992. The surcharge shall be adjusted by inflationary and caseload changes in future bienniums to maintain reimbursement of health care providers in accordance with the requirements of the state and federal laws governing the medical assistance program, including the requirements of the Medicaid moratorium amendments of 1991 found in Public Law No. 102-234. The commissioner shall request the Minnesota congressional delegation to support a change in federal law that would prohibit federal disallowances for any state that makes a good faith effort to comply with Public Law 102-234 by enacting conforming legislation prior to the issuance of federal implementing regulations.
256R.08 REPORTING OF FINANCIAL STATEMENTS.
Subd. 2.
Extensions.
The commissioner may grant up to a 15-day extension of the reporting deadline to a nursing facility for good cause. To receive such an extension, a nursing facility shall submit a written request by January 1. The commissioner shall notify the nursing facility of the decision by January 15. Between January 1 and February 1, the nursing facility may request a reporting extension for good cause by telephone and followed by a written request.
256R.49 RATE ADJUSTMENTS FOR COMPENSATION-RELATED COSTS FOR MINIMUM WAGE CHANGES.
Subdivision 1.
Rate adjustments for compensation-related costs.
(a) Rate increases provided under this section before October 1, 2016, expire effective January 1, 2018, and rate increases provided on or after October 1, 2016, expire effective January 1, 2019.
(b) Nursing facilities that receive approval of the applications in subdivision 2 must receive rate adjustments according to subdivision 4. The rate adjustments must be used to pay compensation costs for nursing facility employees paid less than $14 per hour.
Subd. 2.
Application process.
To receive a rate adjustment, nursing facilities must submit applications to the commissioner in a form and manner determined by the commissioner. The applications for the rate adjustments shall include specified data, and spending plans that describe how the funds from the rate adjustments will be allocated for compensation to employees paid less than $14 per hour. The applications must be submitted within three months of the effective date of any operating payment rate adjustment under this section. The commissioner may request any additional information needed to determine the rate adjustment within three weeks of receiving a complete application. The nursing facility must provide any additional information requested by the commissioner within six months of the effective date of any operating payment rate adjustment under this section. The commissioner may waive the deadlines in this section under extraordinary circumstances.
Subd. 3.
Additional application requirements for facilities with employees represented by an exclusive bargaining representative.
For nursing facilities in which employees are represented by an exclusive bargaining representative, the commissioner shall approve the applications submitted under subdivision 2 only upon receipt of a letter or letters of acceptance of the spending plans in regard to members of the bargaining unit, signed by the exclusive bargaining agent and dated after May 31, 2014. Upon receipt of the letter or letters of acceptance, the commissioner shall deem all requirements of this section as having been met in regard to the members of the bargaining unit.
Subd. 4.
Determination of the rate adjustments for compensation-related costs.
Based on the application in subdivision 2, the commissioner shall calculate the allowable annualized compensation costs by adding the totals of clauses (1), (2), and (3). The result must be divided by the standardized or resident days from the most recently available cost report to determine per day amounts, which must be included in the operating portion of the total payment rate and allocated to direct care or other operating as determined by the commissioner:
(1) the sum of the difference between $9.50 and any hourly wage rate less than $9.50 for October 1, 2016; and between the indexed value of the minimum wage, as defined in section 177.24, subdivision 1, paragraph (f), and any hourly wage less than that indexed value for rate years beginning on and after October 1, 2017; multiplied by the number of compensated hours at that wage rate;
(2) using wages and hours in effect during the first three months of calendar year 2014, beginning with the first pay period beginning on or after January 1, 2014; 22.2 percent of the sum of items (i) to (viii) for October 1, 2016;
(i) for all compensated hours from $8 to $8.49 per hour, the number of compensated hours is multiplied by $0.13;
(ii) for all compensated hours from $8.50 to $8.99 per hour, the number of compensated hours is multiplied by $0.25;
(iii) for all compensated hours from $9 to $9.49 per hour, the number of compensated hours is multiplied by $0.38;
(iv) for all compensated hours from $9.50 to $10.49 per hour, the number of compensated hours is multiplied by $0.50;
(v) for all compensated hours from $10.50 to $10.99 per hour, the number of compensated hours is multiplied by $0.40;
(vi) for all compensated hours from $11 to $11.49 per hour, the number of compensated hours is multiplied by $0.30;
(vii) for all compensated hours from $11.50 to $11.99 per hour, the number of compensated hours is multiplied by $0.20; and
(viii) for all compensated hours from $12 to $13 per hour, the number of compensated hours is multiplied by $0.10; and
(3) the sum of the employer's share of FICA taxes, Medicare taxes, state and federal unemployment taxes, workers' compensation, pensions, and contributions to employee retirement accounts attributable to the amounts in clauses (1) and (2).
256S.20 CUSTOMIZED LIVING SERVICES; POLICY.
Subd. 2.
Customized living services requirements.
Customized living services and 24-hour customized living services may only be provided in a building that is registered as a housing with services establishment under chapter 144D.
259A.70 REIMBURSEMENT OF NONRECURRING ADOPTION EXPENSES.
(a) The commissioner of human services shall provide reimbursement to an adoptive parent for costs incurred in an adoption of a child with special needs according to section 259A.10, subdivision 2. Reimbursement shall be made for expenses that are reasonable and necessary for the adoption to occur, subject to a maximum of $2,000. The expenses must directly relate to the legal adoption of the child, must not be incurred in violation of state or federal law, and must not have been reimbursed from other sources or funds.
(b) Children who have special needs but are not citizens or residents of the United States and were either adopted in another country or brought to this country for the purposes of adoption are categorically ineligible for this reimbursement program, except if the child meets the eligibility criteria after the dissolution of the international adoption.
(c) An adoptive parent, in consultation with the responsible child-placing agency, may request reimbursement of nonrecurring adoption expenses by submitting a complete application, according to the requirements and procedures and on forms prescribed by the commissioner.
(d) The commissioner shall determine the child's eligibility for adoption expense reimbursement under title IV-E of the Social Security Act, United States Code, title 42, sections 670 to 676. If determined eligible, the commissioner of human services shall sign the agreement for nonrecurring adoption expense reimbursement, making this a fully executed agreement. To be eligible, the agreement must be fully executed prior to the child's adoption finalization.
(e) An adoptive parent who has an adoption assistance agreement under section 259A.15, subdivision 2, is not required to make a separate application for reimbursement of nonrecurring adoption expenses for the child who is the subject of that agreement.
(f) If determined eligible, the adoptive parent shall submit reimbursement requests within 21 months of the date of the child's adoption decree, and according to requirements and procedures prescribed by the commissioner.
Repealed Minnesota Session Laws: 21-02656
Laws 2012, chapter 247, article 1, section 30
Sec. 30. new text begin COST-SHARING REQUIREMENTS STUDY.new text end
new text begin The commissioner of human services, in consultation with managed care plans, county-based purchasing plans, and other relevant stakeholders, shall develop recommendations to implement a revised cost-sharing structure for state public health care programs that ensures application of meaningful cost-sharing requirements within the limits of title 42, Code of Federal Regulations, section 447.54, for enrollees in these programs. The commissioner shall report to the chairs and ranking minority members of the legislative committees with jurisdiction over these issues by January 15, 2013, with draft legislation to implement these recommendations effective January 1, 2014. new text end
Repealed Minnesota Rule: 21-02656
2960.3070 FOSTER PARENT TRAINING.
Subpart 1.
Orientation.
A nonrelative foster parent must complete a minimum of six hours of orientation before admitting a foster child. Orientation is required for relative foster parents who will be licensed as a child's foster parents. Orientation for relatives must be completed within 30 days following the initial placement. The foster parent's orientation must include items A to E:
A.
emergency procedures, including evacuation routes, emergency telephone numbers, severe storm and tornado procedures, and location of alarms and equipment;
B.
relevant laws and rules, including, but not limited to, chapter 9560; Minnesota Statutes, chapters 245A, 260, and 260C; and Minnesota Statutes, section 626.556; and legal issues and reporting requirements;
C.
cultural diversity, gender sensitivity, culturally specific services, cultural competence, and information about discrimination and racial bias issues to ensure that caregivers will be culturally competent to care for foster children according to Minnesota Statutes, section 260C.212, subdivision 11;
D.
information about the role and responsibilities of the foster parent in the development and implementation of the case plan and in court and administrative reviews of the child's placement; and
Subp. 2.
In-service training.
Each foster parent must complete a minimum of 12 hours of training per year in one or more of the areas in this subpart or in other areas as agreed upon by the licensing agency and the foster parent. If the foster parent has not completed the required annual training at the time of relicensure and does not show good cause why the training was not completed, the foster parent may not accept new foster children until the training is completed. The nonexclusive list of topics in items A to Z provides examples of in-service training topics that could be useful to a foster parent:
E.
children's psychological, spiritual, cultural, sexual, emotional, intellectual, and social development;
N.
caring for children with disabilities and disability-related issues regarding developmental disabilities, emotional and behavioral disorders, and specific learning disabilities;
P.
physical and nonphysical behavior guidance, crisis de-escalation, and discipline techniques, including how to handle aggression for specific age groups and specific issues such as developmental disabilities, chemical dependency, emotional disturbances, learning disabilities, and past abuse;
2960.3210 STAFF TRAINING REQUIREMENTS.
Subpart 1.
Orientation.
The license holder must ensure that all staff attend and successfully complete at least six hours of orientation training before having unsupervised contact with foster children. The number of hours of orientation training are not counted as part of the hours of annual training. Orientation training must include at least the topics in items A to F:
A.
emergency procedures, including evacuation routes, emergency telephone numbers, severe storm and tornado procedures, and location of facility alarms and equipment;
B.
relevant statutes and administrative rules and legal issues, including reporting requirements for abuse and neglect specified in Minnesota Statutes, sections 626.556 and 626.557, and other reporting requirements based on the ages of the children;
C.
cultural diversity and gender sensitivity, culturally specific services, and information about discrimination and racial bias issues to ensure that caregivers have cultural sensitivity and will be culturally competent to care for children according to Minnesota Statutes, section 260C.212, subdivision 11;
Subp. 2.
Personnel training.
The license holder must provide training for staff that is modified annually to meet the current needs of individual staff persons. The license holder must develop an annual training plan for employees that addresses items A to C.
A.
Full-time and part-time direct care staff and volunteers must have sufficient training to accomplish their duties. To determine the type and amount of training an employee needs, the license holder must consider the foster care program's target population, services the program delivers, and outcomes expected from the services, as well as the employee's position description, tasks to be performed, and the performance indicators for the position. The license holder and staff who care for children who rely on medical equipment to sustain life or monitor a medical condition must meet the requirements of Minnesota Statutes, section 245A.155.
B.
Full-time staff who have direct contact with children must complete at least 18 hours of in-service training per year. One-half of the training must be skill development training. Other foster home staff and volunteers must complete in-service training requirements consistent with their duties.
C.
Part-time direct care staff must receive sufficient training to competently care for children. The amount of training must be provided at least at a ratio of one hour of training for each 60 hours worked, up to 18 hours of training per part-time employee per year.
Subp. 3.
Documentation of training.
The license holder must document the date and number of hours of orientation and in-service training completed by each staff person in each topic area and the name of the entity that provided the training.
9502.0425 PHYSICAL ENVIRONMENT.
Subp. 5.
Occupancy separations.
Day care residences with an attached garage must have a self-closing, tight fitting solid wood bonded core door at least 1-3/8 inch thick, or door with a fire protection rating of 20 minutes or greater and a separation wall consisting of 5/8 inch thick gypsum wallboard or its equivalent on the garage side between the residence and garage.
9505.0275 EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT.
Subpart 1.
Definition.
"Early and periodic screening, diagnosis, and treatment service" means a service provided to a recipient under age 21 to identify a potentially disabling condition and to provide diagnosis and treatment for a condition identified according to the requirements of the Code of Federal Regulations, title 42, section 441.55 and parts 9505.1693 to 9505.1748.
9505.1693 SCOPE AND PURPOSE.
Parts 9505.1693 to 9505.1748 govern the early and periodic screening, diagnosis, and treatment (EPSDT) program.
Parts 9505.1693 to 9505.1748 must be read in conjunction with section 1905(a)(4)(B) of the Social Security Act, as amended through December 31, 1981, and the Code of Federal Regulations, title 42, part 441, subpart B, as amended through October 1, 1987, and section 6403 of the Omnibus Budget Reconciliation Act of 1989. The purpose of the EPSDT program is to identify potentially disabling conditions in children eligible for medical assistance, to provide diagnosis and treatment for conditions identified, and to encourage parents and their children to use health care services when necessary.
9505.1696 DEFINITIONS.
Subpart 1.
Applicability.
As used in parts 9505.1693 to 9505.1748, the following terms have the meanings given them.
Subp. 2.
Child.
"Child" means a person who is eligible for early and periodic screening, diagnosis, and treatment under part 9505.1699.
Subp. 3.
Community health clinic.
"Community health clinic" means a clinic that provides services by or under the supervision of a physician and that:
B.
is exempt from federal income tax under Internal Revenue Code of 1986, section 501(c)(3), as amended through December 31, 1987;
D.
has written clinic policies describing the services provided by the clinic and concerning (1) the medical management of health problems, including problems that require referral to physicians, (2) emergency health services, and (3) the maintenance and review of health records by the physician.
Subp. 5.
Diagnosis.
"Diagnosis" means the identification and determination of the nature or cause of a disease or abnormality through the use of a health history; physical, developmental, and psychological examination; and laboratory tests.
Subp. 6.
Early and periodic screening clinic or EPS clinic.
"Early and periodic screening clinic" or "EPS clinic" means an individual or facility that is approved by the Minnesota Department of Health under parts 4615.0900 to 4615.2000.
Subp. 7.
Early and periodic screening, diagnosis, and treatment program or EPSDT program.
"Early and periodic screening, diagnosis, and treatment program" or "EPSDT program" means the program that provides screening, diagnosis, and treatment under parts 9505.1693 to 9505.1748; Code of Federal Regulations, title 42, section 441.55, as amended through October 1, 1986; and Minnesota Statutes, section 256B.02, subdivision 8, paragraph (12).
Subp. 8.
EPSDT clinic.
"EPSDT clinic" means a facility supervised by a physician that provides screening according to parts 9505.1693 to 9505.1748 or an EPS clinic.
Subp. 9.
EPSDT provider agreement.
"EPSDT provider agreement" means the agreement required by part 9505.1703, subpart 2.
Subp. 11.
Follow-up.
"Follow-up" means efforts by a local agency to ensure that a screening requested for a child is provided to that child and that diagnosis and treatment indicated as necessary by a screening are also provided to that child.
Subp. 12.
Head Start agency.
"Head Start agency" refers to the child development program administered by the United States Department of Health and Human Services, Office of Administration for Children, Youth and Families.
Subp. 13.
Local agency.
"Local agency" means the county welfare board, multicounty welfare board, or human service agency established in Minnesota Statutes, section 256B.02, subdivision 6, and Minnesota Statutes, chapter 393.
Subp. 14.
Medical assistance.
"Medical assistance" means the program authorized by title XIX of the Social Security Act and Minnesota Statutes, chapters 256 and 256B.
Subp. 15.
Outreach.
"Outreach" means efforts by the department or a local agency to inform eligible persons about early and periodic screening, diagnosis, and treatment or to encourage persons to use the EPSDT program.
Subp. 17.
Physician.
"Physician" means a person who is licensed to provide health services within the scope of the person's profession under Minnesota Statutes, chapter 147.
Subp. 18.
Prepaid health plan.
"Prepaid health plan" means a health insurer licensed and operating under Minnesota Statutes, chapters 60A, 62A, and 62C, and a health maintenance organization licensed and operating under Minnesota Statutes, chapter 62D to provide health services to recipients of medical assistance entitlements.
Subp. 19.
Public health nursing service.
"Public health nursing service" means the nursing program provided by a community health board under Minnesota Statutes, section 145A.04, subdivisions 1 and 1a.
Subp. 20.
Screening.
"Screening" means the use of quick, simple procedures to separate apparently well children from those who need further examination for possible physical, developmental, or psychological problems.
Subp. 21.
Skilled professional medical personnel and supporting staff.
"Skilled professional medical personnel" and "supporting staff" means persons as defined by Code of Federal Regulations, title 42, section 432.2, as amended through October 1, 1987.
Subp. 22.
Treatment.
"Treatment" means the prevention, correction, or amelioration of a disease or abnormality identified by screening or diagnosis.
9505.1699 ELIGIBILITY TO BE SCREENED.
A person under age 21 who is eligible for medical assistance is eligible for the EPSDT program.
9505.1701 CHOICE OF PROVIDER.
Subpart 1.
Choice of screening provider.
Except as provided by subpart 3, a child or parent of a child who requests screening may choose any screening provider who has signed an EPSDT provider agreement and a medical assistance provider agreement.
Subp. 2.
Choice of diagnosis and treatment provider.
Except as provided by subpart 3, a child or parent of a child may choose any diagnosis and treatment provider as provided by part 9505.0190.
Subp. 3.
Exception to subparts 1 and 2.
A child who is enrolled in a prepaid health plan must receive screening, diagnosis, and treatment from that plan.
9505.1703 ELIGIBILITY TO PROVIDE SCREENING.
Subpart 1.
Providers.
An EPSDT clinic or a community health clinic shall be approved for medical assistance reimbursement for EPSDT services if it complies with the requirements of parts 9505.1693 to 9505.1748. A Head Start agency shall be approved as provided by subpart 2.
Subp. 2.
EPSDT provider agreement.
To be eligible to provide screening and receive reimbursement under the EPSDT program, an individual or facility must sign an EPSDT provider agreement provided by the department and a medical assistance provider agreement under part 9505.0195 or be a prepaid health plan.
Subp. 3.
Terms of EPSDT provider agreement.
The EPSDT provider agreement required by subpart 2 must state that the provider must:
9505.1706 REIMBURSEMENT.
Subp. 2.
Eligibility for reimbursement; Head Start agency.
A Head Start agency may complete all the screening components under part 9505.1718, subparts 2 to 14 or those components that have not been completed by another provider within the six months before completion of the screening components by the Head Start agency. A Head Start agency that completes the previously incomplete screening components must document on the EPSDT screening form that the other screening components of part 9505.1718, subparts 2 to 14, have been completed by another provider.
The department shall reimburse a Head Start agency for those screening components of part 9505.1718, subparts 2 to 14, that the Head Start agency has provided. The amount of reimbursement must be the same as a Head Start agency's usual and customary cost for each screening component or the maximum fee determined under subpart 1, whichever is lower.
Subp. 3.
Prepaid health plan.
A prepaid health plan is not eligible for a separate payment for screening. The early and periodic screening, diagnosis, and treatment screening must be a service included within the prepaid capitation rate specified in its contract with the department.
9505.1712 TRAINING.
The department must train the staff of an EPSDT clinic that is supervised by a physician on how to comply with the procedures required by part 9505.1718 if the EPSDT clinic requests the training.
9505.1715 COMPLIANCE WITH SURVEILLANCE AND UTILIZATION REVIEW.
A screening provider must comply with the surveillance and utilization review requirements of parts 9505.2160 to 9505.2245.
9505.1718 SCREENING STANDARDS FOR AN EPSDT CLINIC.
Subpart 1.
Requirement.
An early and periodic screening, diagnosis, and treatment screening must meet the requirements of subparts 2 to 15 except as provided by part 9505.1706, subpart 2.
Subp. 2.
Health and developmental history.
A history of a child's health and development must be obtained from the child, parent of the child, or an adult who is familiar with the child's health history. The history must include information on sexual development, lead and tuberculosis exposure, nutrition intake, chemical abuse, and social, emotional, and mental health status.
Subp. 3.
Assessment of physical growth.
The child's height or length and the child's weight must be measured and the results plotted on a growth grid based on data from the National Center for Health Statistics (NCHS). The head circumference of a child up to 36 months of age or a child whose growth in head circumference appears to deviate from the expected circumference for that child must be measured and plotted on an NCHS-based growth grid.
Subp. 4.
Physical examination.
The following must be checked according to accepted medical procedures: pulse; respiration; blood pressure; head; eyes; ears; nose; mouth; pharynx; neck; chest; heart; lungs; abdomen; spine; genitals; extremities; joints; muscle tone; skin; and neurological condition.
Subp. 5.
Vision.
A child must be checked for a family history of maternal and neonatal infection and ocular abnormalities. A child must be observed for pupillary reflex; the presence of nystagmus; and muscle balance, which includes an examination for esotropia, exotropia, phorias, and extraocular movements. The external parts of a child's eyes must be examined including the lids, conjunctiva, cornea, iris, and pupils. A child or parent of the child must be asked whether he or she has concerns about the child's vision.
Subp. 6.
Vision of a child age three or older.
In addition to the requirements of subpart 5, the visual acuity of a child age three years or older must be checked by use of the Screening Test for Young Children and Retardates (STYCAR) or the Snellen Alphabet Chart.
Subp. 7.
Hearing.
A child must be checked for a family history of hearing disability or loss, delay of language acquisition or history of such delay, the ability to determine the direction of a sound, and a history of repeated otitis media during early life. A child or parent of the child must be asked whether he or she has any concerns regarding the child's hearing.
Subp. 8.
Hearing of a child age three or older.
In addition to the requirements of subpart 7, a child age three or older must receive a pure tone audiometric test or referral for the test if the examination under subpart 7 indicates the test is needed.
Subp. 9.
Development.
A child must be screened for the following according to the screening provider's standard procedures: fine and gross motor development, speech and language development, social development, cognitive development, and self-help skills. Standardized tests that are used in screening must be culturally sensitive and have norms for the age range tested, written procedures for administration and for scoring and interpretation that are statistically reliable and valid. The provider must use a combination of the child's health and developmental history and standardized test or clinical judgment to determine the child's developmental status or need for further assessment.
Subp. 10.
Sexual development.
A child must be evaluated to determine whether the child's sexual development is consistent with the child's chronological age. A female must receive a breast examination and pelvic examination when indicated. A male must receive a testicular examination when indicated. If it is in the best interest of a child, counseling on normal sexual development, information on birth control and sexually transmitted diseases, and prescriptions and tests must be offered to a child. If it is in the best interest of a child, a screening provider may refer the child to other resources for counseling or a pelvic examination.
Subp. 11.
Nutrition.
When the assessment of a child's physical growth performed according to subpart 3 indicates a nutritional risk condition, the child must be referred for further assessment, receive nutritional counseling, or be referred to a nutrition program such as the Special Supplemental Food Program for Women, Infants, and Children; food stamps or food support; Expanded Food and Nutrition Education Program; or Head Start.
Subp. 12.
Immunizations.
The immunization status of a child must be compared to the "Recommended Schedule for Active Immunization of Normal Infants and Children," current edition. Immunizations that the comparison shows are needed must be offered to the child and given to the child if the child or parent of the child accepts the offer. The "Recommended Schedule for Active Immunization of Normal Infants and Children," current edition, is developed and distributed by the Minnesota Department of Health, 717 Delaware Street Southeast, Minneapolis, Minnesota 55440. The "Recommended Schedule for Active Immunization of Normal Infants and Children," current edition, is incorporated by reference and is available at the State Law Library, Judicial Center, 25 Rev. Dr. Martin Luther King Jr. Blvd., Saint Paul, Minnesota 55155. It is subject to frequent change.
Subp. 13.
Laboratory tests.
Laboratory tests must be done according to items A to F.
A.
A Mantoux test must be administered yearly to a child whose health history indicates ongoing exposure to tuberculosis, unless the child has previously tested positive. A child who tests positive must be referred for diagnosis and treatment.
B.
A child aged one to five years must initially be screened for lead through the use of either an erythrocyte protoporphyrin (EP) test or a direct blood lead screening test until December 31, 1992. Beginning January 1, 1993, a child age one to five must initially be screened using a direct blood lead screening test. Either capillary or venous blood may be used as the specimen for the direct blood lead test. Blood tests must be performed at a minimum of once at 12 months of age and once at 24 months of age or whenever the history indicates that there are risk factors for lead poisoning. When the result of the EP or capillary blood test is greater than the maximum allowable level set by the Centers for Disease Control of the United States Public Health Service, the child must be referred for a venous blood lead test. A child with a venous blood lead level greater than the maximum allowable level set by the Centers for Disease Control must be referred for diagnosis and treatment.
C.
The urine of a child must be tested for the presence of glucose, ketones, protein, and other abnormalities. A female at or near the age of four and a female at or near the age of ten must be tested for bacteriuria.
D.
Either a microhematocrit determination or a hemoglobin concentration test for anemia must be done.
E.
A test for sickle cell or other hemoglobinopathy, or abnormal blood conditions must be offered to a child who is at risk of such abnormalities and who has not yet been tested. These tests must be provided if accepted or requested by the child or parent of the child. If the tests identify a hemoglobin abnormality or other abnormal blood condition, the child must be referred for genetic counseling.
F.
Other laboratory tests such as those for cervical cancer, sexually transmitted diseases, pregnancy, and parasites must be performed when indicated by a child's medical or family history.
Subp. 14.
Oral examination.
An oral examination of a child's mouth must be performed to detect deterioration of hard tissue, and inflammation or swelling of soft tissue. Counseling about the systemic use of fluoride must be given to a child when fluoride is not available through the community water supply or school programs.
Subp. 14a.
Health education and health counseling.
Health education and health counseling concerning the child's health must be offered to the child who is being screened and to the child's parent or representative. The health education and health counseling are for the purposes of assisting the child or the parent or representative of the child to understand the expected growth and development of the child and of informing the child or the parent or representative of the child about the benefits of healthy lifestyles and about practices to promote accident and disease prevention.
Subp. 15.
Schedule of age related screening standards.
An early and periodic screening, diagnosis, and treatment screening for a child at a specific age must include, at a minimum, the screening requirements of subparts 2 to 14 as provided by the following schedule:
Schedule of age related screening standards
A.
Infancy:
| Standards | Ages | |||||
| By 1 month | 2 months | 4 months | 6 months | 9 months | 12 months | |
| Health History | X | X | X | X | X | X |
| Assessment of Physical Growth: | ||||||
| Height | X | X | X | X | X | X |
| Weight | X | X | X | X | X | X |
| Head Circumference | X | X | X | X | X | X |
| Physical Examination | X | X | X | X | X | X |
| Vision | X | X | X | X | X | X |
| Hearing | X | X | X | X | X | X |
| Development | X | X | X | X | X | X |
| Health Education/Counseling | X | X | X | X | X | X |
| Sexual Development | X | X | X | X | X | X |
| Nutrition | X | X | X | X | X | X |
| Immunizations/Review | X | X | X | X | X | |
| Laboratory Tests: | ||||||
| Tuberculin | if history indicates | |||||
| Lead Absorption | if history indicates | X | ||||
| Urinalysis | ← | ← | ← | X | ← | ← |
| Hematocrit or Hemoglobin | ← | ← | ← | ← | X | X |
| Sickle Cell | at parent's or child's request | |||||
| Other Laboratory Tests | as indicated | |||||
| Oral Examination | X | X | X | X | X | X |
X = Procedure to be completed.
← = Procedure to be completed if not done at the previous visit, or on the first visit.
B.
Early Childhood:
| Standards | Ages | ||||
| 15 months | 18 months | 24 months | 3years | 4years | |
| Health History | X | X | X | X | X |
| Assessment of Physical Growth: | |||||
| Height | X | X | X | X | X |
| Weight | X | X | X | X | X |
| Head Circumference | X | X | X | X | X |
| Physical Examination | X | X | X | X | X |
| Vision | X | X | X | X | X |
| Hearing | X | X | X | X | X |
| Blood Pressure | X | X | |||
| Development | X | X | X | X | X |
| Health Education/Counseling | X | X | X | X | X |
| Sexual Development | X | X | X | X | X |
| Nutrition | X | X | X | X | X |
| Immunizations/Review | X | X | X | X | X |
| Laboratory Tests: | |||||
| Tuberculin | if history indicates | ||||
| Lead Absorption | if history indicates | X | if history indicates | ||
| Urinalysis | ← | ← | X | ← | ← |
| Bacteriuria (females) | X | ||||
| Hematocrit or Hemoglobin | ← | ← | ← | ← | ← |
| Sickle Cell | at parent's or child's request | ||||
| Other Laboratory Tests | as indicated | ||||
| Oral Examination | X | X | X | X | X |
X = Procedure to be completed.
← = Procedure to be completed if not done at the previous visit, or on the first visit.
C.
Late childhood:
| Standards | Ages | ||||
| 5 years | 6 years | 8 years | 10 years | 12 years | |
| Health History | X | X | X | X | X |
| Assessment of Physical Growth: | |||||
| Height | X | X | X | X | X |
| Weight | X | X | X | X | X |
| Physical Examination | X | X | X | X | X |
| Vision | X | X | X | X | X |
| Hearing | X | X | X | X | X |
| Blood Pressure | X | X | X | X | X |
| Development | X | X | X | X | X |
| Health Education/Counseling | X | X | X | X | X |
| Sexual Development | X | X | X | X | X |
| Nutrition | X | X | X | X | X |
| Immunizations/Review | X | X | X | X | X |
| Laboratory Tests: | |||||
| Tuberculin | if history indicates | ||||
| Lead Absorption | if history indicates | ||||
| Urinalysis | ← | ← | X | ← | ← |
| Bacteriuria (females) | ← | ← | X | ← | ← |
| Hemoglobin or Hematocrit | ← | ← | X | ← | |
| Sickle Cell | at parent's or child's request | ||||
| Other Laboratory Tests | as indicated | ||||
| Oral Examination | X | X | X | X | X |
X = Procedure to be completed.
← = Procedure to be completed if not done at the previous visit, or on the first visit.
D.
Adolescence:
| Standards | Ages | |||
| 14 years | 16 years | 18 years | 20 years | |
| Health History | X | X | X | X |
| Assessment of Physical Growth: | ||||
| Height | X | X | X | X |
| Weight | X | X | X | X |
| Physical Examination | X | X | X | X |
| Vision | X | X | X | X |
| Hearing | X | X | X | X |
| Blood Pressure | X | X | X | X |
| Development | X | X | X | X |
| Health Education/Counseling | X | X | X | X |
| Sexual Development | X | X | X | X |
| Nutrition | X | X | X | X |
| Immunizations/Review | X | X | X | X |
| Laboratory Tests: | ||||
| Tuberculin | if history indicates | |||
| Lead Absorption | if history indicates | |||
| Urinalysis | ← | X | ||
| Bacteriuria (females) | ← | ← | ||
| Hemoglobin or Hematocrit | ← | X | ||
| Sickle Cell | at parent's or child's request | |||
| Other Laboratory Tests | as indicated | |||
| Oral Examination | X | X | ||
X = Procedure to be completed.
← = Procedure to be completed if not done at the previous visit, or on the first visit.
Subp. 15a.
Additional screenings.
A child may have a partial or complete screening between the ages specified in the schedule under subpart 15 if the screening is medically necessary or a concern develops about the child's health or development.
9505.1724 PROVISION OF DIAGNOSIS AND TREATMENT.
Diagnosis and treatment identified as needed under part 9505.1718 shall be eligible for medical assistance payment subject to the provisions of parts 9505.0170 to 9505.0475.
9505.1727 INFORMING.
A local agency must inform each child or parent of a child about the EPSDT program no later than 60 days after the date the child is determined to be eligible for medical assistance. The information about the EPSDT program must be given orally and in writing, indicate the purpose and benefits of the EPSDT program, indicate that the EPSDT program is without cost to the child or parent of the child while the child is eligible for medical assistance, state the types of medical and dental services available under the EPSDT program, and state that the transportation and appointment scheduling assistance required under part 9505.1730 is available.
The department must send a written notice to a child or parent of a child who has been screened informing the child or parent that the child should be screened again. This notice must be sent at the following ages of the child: six months, nine months, one year, 18 months, two years, four years, and every three years after age four.
Each year, on the date the child was determined eligible for medical assistance entitlements, the department must send a written notice to a child or parent of a child who has never been screened informing the child or parent that the child is eligible to be screened.
9505.1730 ASSISTANCE WITH OBTAINING A SCREENING.
Within ten working days of receiving a request for screening from a child or parent of a child, a local agency must give or mail to the child or parent of the child:
9505.1733 ASSISTANCE WITH OBTAINING DIAGNOSIS AND TREATMENT.
An EPSDT clinic must notify a child or parent of a child who is referred for diagnosis and treatment that the local agency will provide names and addresses of diagnosis and treatment providers and will help with appointment scheduling and transportation to the diagnosis and treatment provider. The notice must be on a form provided by the department and must be given to the child or parent of the child on the day the child is screened.
If a child or parent of a child asks a local agency for assistance with obtaining diagnosis and treatment, the local agency must provide that assistance within ten working days of the date of the request.
9505.1736 SPECIAL NOTIFICATION REQUIREMENT.
A local agency must effectively inform an individual who is blind or deaf, or who cannot read or understand the English language, about the EPSDT program.
9505.1739 CHILDREN IN FOSTER CARE.
Subpart 1.
Dependent or neglected state wards.
The local agency must provide early and periodic screening, diagnosis, and treatment services for a child in foster care who is a dependent or neglected state ward under parts 9560.0410 to 9560.0470, and who is eligible for medical assistance unless the early and periodic screening, diagnosis, and treatment services are not in the best interest of the child.
Subp. 2.
Other children in foster care.
The local agency must discuss the EPSDT program with a parent of a child in foster care who is under the legal custody or protective supervision of the local agency or whose parent has entered into a voluntary placement agreement with the local agency. The local agency must help the parent decide whether to accept early and periodic screening, diagnosis, and treatment services for the child. If a parent cannot be consulted, the local agency must decide whether to accept early and periodic screening, diagnosis, and treatment services for the child and must document the reasons for the decision.
Subp. 3.
Assistance with appointment scheduling and transportation.
The local agency must help a child in foster care with appointment scheduling and transportation for screening, diagnosis, and treatment as provided by parts 9505.1730 to 9505.1733.
Subp. 4.
Notification.
The department must send a written notice to the local agency stating that a child in foster care who has been screened should be screened again. This notice must be sent at the following ages of the child: six months, nine months, one year, 18 months, two years, four years, and every three years thereafter.
Each year, by the anniversary of the date the child was determined eligible for medical assistance entitlements, the department must send a written notice to the local agency that a child in foster care who has never been screened is eligible to be screened.
If a written notice under this subpart pertains to a child who is a dependent or neglected state ward, the local agency must proceed according to subpart 1. The local agency must proceed according to subpart 2 if the written notice pertains to a child who is not a dependent or neglected state ward.
9505.1742 DOCUMENTATION.
The local agency must document compliance with parts 9505.1693 to 9505.1748 on forms provided by the department.
9505.1745 INTERAGENCY COORDINATION.
The local agency must coordinate the EPSDT program with other programs that provide health services to children as provided by Code of Federal Regulations, title 42, section 441.61(c), as amended through October 1, 1986. Examples of such agencies are a public health nursing service, a Head Start agency, and a school district.
9505.1748 CONTRACTS FOR ADMINISTRATIVE SERVICES.
Subpart 1.
Authority.
A local agency may contract with a county public health nursing service, a community health clinic, a Head Start agency, a community action agency, or a school district for early and periodic screening, diagnosis, and treatment administrative services. Early and periodic screening, diagnosis, and treatment administrative services include outreach; notification; appointment scheduling and transportation; follow-up; and documentation. For purposes of this subpart, "community action agency" means an entity defined in Minnesota Statutes, section 256E.31, subdivision 1, and "school district" means a school district as defined in Minnesota Statutes, section 120A.05, subdivisions 5, 10, and 14.
Subp. 2.
Federal financial participation.
The percent of federal financial participation for salaries, fringe benefits, and travel of skilled professional medical personnel and their supporting staff shall be paid as provided by Code of Federal Regulations, title 42, section 433.15(b)(5), as amended through October 1, 1986.
Subp. 3.
State reimbursement.
State reimbursement for contracts for EPSDT administrative services under this part shall be as provided by Minnesota Statutes, section 256B.19, subdivision 1, except for the provisions under subdivision 1 that pertain to a prepaid health plan.
Subp. 4.
Approval.
A contract for administrative services must be approved by the local agency and submitted to the department for approval by November 1 of the year before the beginning of the calendar year in which the contract will be effective. A contract must contain items A to L to be approved by the department for reimbursement:
D.
amount of the contract, budget breakdown, and a clause that stipulates that the department's procedures for certifying expenditures will be followed by the local agency;
F.
a clause that stipulates that the contract will be renegotiated if federal or state program regulations or federal financial reimbursement regulations change;
G.
a clause that stipulates that the contracting parties will provide program and fiscal records and maintain all nonpublic data required by the contract according to the Minnesota Government Data Practices Act and will cooperate with state and federal program reviews;
J.
signatures of the representatives of the contracting parties with the authority to obligate the parties by contract and dates of those signatures;
K.
a clause that stipulates that the services provided under contract must be performed by or under the supervision of skilled medical personnel; and
L.
a clause that stipulates that the contracting parties will comply with state and federal requirements for the receipt of medical assistance funds.
9555.6255 RESIDENT'S RIGHTS.
Subpart 1.
Information about rights.
The operator shall ensure that a resident and a resident's legal representative are given, at admission:
C.
the name, address, and telephone number of the local agency to which a resident or a resident's legal representative may submit an oral or written complaint.
Subp. 2.
Right to use telephone.
A resident has the right to daily, private access to and use of a non-coin operated telephone for local calls and long distance calls made collect or paid for by the resident.
Subp. 3.
Right to receive and send mail.
A resident has the right to receive and send uncensored, unopened mail.
Subp. 4.
Right to privacy.
A resident has the right to personal privacy and privacy for visits from others, and the respect of individuality and cultural identity. Privacy must be respected by operators, caregivers, household members, and volunteers by knocking on the door of a resident's bedroom and seeking consent before entering, except in an emergency, and during toileting, bathing, and other activities of personal hygiene, except as needed for resident safety or assistance as noted in the resident's individual record.
Subp. 5.
Right to use personal property.
A resident has the right to keep and use personal clothing and possessions as space permits, unless to do so would infringe on the health, safety, or rights of other residents or household members.
Subp. 6.
Right to associate.
A resident has the right to meet with or refuse to meet with visitors and participate in activities of commercial, religious, political, and community groups without interference if the activities do not infringe on the rights of other residents or household members.
Subp. 7.
Married residents.
Married residents have the right to privacy for visits by their spouses, and, if both spouses are residents of the adult foster home, they have the right to share a bedroom and bed.