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Capital IconMinnesota Legislature

HF 2185

1st Engrossment - 91st Legislature (2019 - 2020) Posted on 07/09/2019 01:26pm

KEY: stricken = removed, old language.
underscored = added, new language.
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A bill for an act
relating to human services; modifying policy provisions governing disability
services; amending Minnesota Statutes 2018, sections 245A.03, subdivision 7;
245D.03, subdivision 1; 245D.071, subdivisions 1, 3; 245D.091, subdivisions 2,
3, 4; 256B.0652, subdivision 10; 256B.0659, subdivision 3a; 256B.0911,
subdivisions 1a, 3a, 3f; 256B.0915, subdivision 6; 256B.092, subdivision 1b;
256B.49, subdivisions 13, 14; 256B.4914, subdivisions 3, 14; 256B.85, subdivisions
2, 4, 5, 6, 8, 9, 10, 11, 11b, 12, 12b, 13a, 18a, by adding a subdivision.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

Section 1.

Minnesota Statutes 2018, 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 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 that are required to be registered under chapter 144D;

(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;

deleted text begin (5) new foster care licenses or community residential setting licenses determined to be
needed by the commissioner for the transition of people from personal care assistance to
the home and community-based services;
deleted text end

deleted text begin (6)deleted text endnew text begin (5)new text end new foster care licenses or community residential setting licenses determined to
be needed by the commissioner for the transition of people from the residential care waiver
services to foster care services. This exception applies only when:

(i) the person's case manager provided the person with information about the choice of
service, service provider, and location of service to help the person make an informed choice;
and

(ii) the person's foster care services are less than or equal to the cost of the person's
services delivered in the residential care waiver service setting as determined by the lead
agency; or

deleted text begin (7)deleted text endnew text begin (6)new text end 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 section 256B.0915, 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.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day following final enactment.
new text end

Sec. 2.

Minnesota Statutes 2018, section 245D.03, subdivision 1, is amended to read:


Subdivision 1.

Applicability.

(a) The commissioner shall regulate the provision of home
and community-based services to persons with disabilities and persons age 65 and older
pursuant to this chapter. The licensing standards in this chapter govern the provision of
basic support services and intensive support services.

(b) Basic support services provide the level of assistance, supervision, and care that is
necessary to ensure the health and welfare of the person and do not include services that
are specifically directed toward the training, treatment, habilitation, or rehabilitation of the
person. Basic support services include:

(1) in-home and out-of-home respite care services as defined in section 245A.02,
subdivision 15, and under the brain injury, community alternative care, community access
for disability inclusion, developmental disability, and elderly waiver plans, excluding
out-of-home respite care provided to children in a family child foster care home licensed
under Minnesota Rules, parts 2960.3000 to 2960.3100, when the child foster care license
holder complies with the requirements under section 245D.06, subdivisions 5, 6, 7, and 8,
or successor provisions; and section 245D.061 or successor provisions, which must be
stipulated in the statement of intended use required under Minnesota Rules, part 2960.3000,
subpart 4;

(2) adult companion services as defined under the brain injury, community access for
disability inclusion,new text begin community alternative care,new text end and elderly waiver plans, excluding adult
companion services provided under the Corporation for National and Community Services
Senior Companion Program established under the Domestic Volunteer Service Act of 1973,
Public Law 98-288;

(3) personal support as defined under the developmental disability waiver plan;

(4) 24-hour emergency assistance, personal emergency response as defined under the
community access for disability inclusion and developmental disability waiver plans;

(5) night supervision services as defined under the brain injurynew text begin, community access for
disability inclusion, community alternative care, and developmental disability
new text end waiver deleted text beginplandeleted text endnew text begin
plans
new text end;

(6) homemaker services as defined under the community access for disability inclusion,
brain injury, community alternative care, developmental disability, and elderly waiver plans,
excluding providers licensed by the Department of Health under chapter 144A and those
providers providing cleaning services only; and

(7) individual community living support under section 256B.0915, subdivision 3j.

(c) Intensive support services provide assistance, supervision, and care that is necessary
to ensure the health and welfare of the person and services specifically directed toward the
training, habilitation, or rehabilitation of the person. Intensive support services include:

(1) intervention services, including:

(i) deleted text beginbehavioraldeleted text endnew text begin positivenew text end support services as defined under the brain injury deleted text beginanddeleted text endnew text begin,new text end community
access for disability inclusionnew text begin, community alternative care, and developmental disabilitynew text end
waiver plans;

(ii) in-home or out-of-home crisis respite services as defined under thenew text begin brain injury,
community access for disability inclusion, community alternative care, and
new text end developmental
disability waiver deleted text beginplandeleted text endnew text begin plansnew text end; and

(iii) specialist services as defined under the currentnew text begin brain injury, community access for
disability inclusion, community alternative care, and
new text end developmental disability waiver deleted text beginplandeleted text endnew text begin
plans
new text end;

(2) in-home support services, including:

(i) in-home family support and supported living services as defined under the
developmental disability waiver plan;

(ii) independent living services training as defined under the brain injury and community
access for disability inclusion waiver plans;

(iii) semi-independent living services; and

(iv) individualized home supports services as defined under the brain injury, community
alternative care, and community access for disability inclusion waiver plans;

(3) residential supports and services, including:

(i) supported living services as defined under the developmental disability waiver plan
provided in a family or corporate child foster care residence, a family adult foster care
residence, a community residential setting, or a supervised living facility;

(ii) foster care services as defined in the brain injury, community alternative care, and
community access for disability inclusion waiver plans provided in a family or corporate
child foster care residence, a family adult foster care residence, or a community residential
setting; and

(iii) residential services provided to more than four persons with developmental
disabilities in a supervised living facility, including ICFs/DD;

(4) day services, including:

(i) structured day services as defined under the brain injury waiver plan;

(ii) day training and habilitation services under sections 252.41 to 252.46, and as defined
under the developmental disability waiver plan; and

(iii) prevocational services as defined under the brain injury and community access for
disability inclusion waiver plans; and

(5) employment exploration services as defined under the brain injury, community
alternative care, community access for disability inclusion, and developmental disability
waiver plans;

(6) employment development services as defined under the brain injury, community
alternative care, community access for disability inclusion, and developmental disability
waiver plans; and

(7) employment support services as defined under the brain injury, community alternative
care, community access for disability inclusion, and developmental disability waiver plans.

Sec. 3.

Minnesota Statutes 2018, section 245D.071, subdivision 1, is amended to read:


Subdivision 1.

Requirements for intensive support services.

Except for services
identified in section 245D.03, subdivision 1, paragraph (c), clauses (1) and (2),new text begin item (ii),new text end a
license holder providing intensive support services identified in section 245D.03, subdivision
1
, paragraph (c), must comply with the requirements in this section and section 245D.07,
subdivisions 1new text begin, 1a,new text end
and 3. Services identified in section 245D.03, subdivision 1, paragraph
(c), clauses (1) and (2),new text begin item (ii),new text end must comply with the requirements in section 245D.07,
subdivision 2
.

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 2018, section 245D.071, subdivision 3, is amended to read:


Subd. 3.

Assessment and initial service planning.

(a) Within 15 days of service initiation
the license holder must complete a preliminary coordinated service and support plan
addendum based on the coordinated service and support plan.

(b) Within the scope of services, the license holder must, at a minimum, complete
assessments in the following areas before the 45-day planning meeting:

(1) the person's ability to self-manage health and medical needs to maintain or improve
physical, mental, and emotional well-being, including, when applicable, allergies, seizures,
choking, special dietary needs, chronic medical conditions, self-administration of medication
or treatment orders, preventative screening, and medical and dental appointments;

(2) the person's ability to self-manage personal safety to avoid injury or accident in the
service setting, including, when applicable, risk of falling, mobility, regulating water
temperature, community survival skills, water safety skills, and sensory disabilities; and

(3) the person's ability to self-manage symptoms or behavior that may otherwise result
in an incident as defined in section 245D.02, subdivision 11, clauses (4) to (7), suspension
or termination of services by the license holder, or other symptoms or behaviors that may
jeopardize the health and welfare of the person or others.

Assessments must produce information about the person that describes the person's overall
strengths, functional skills and abilities, and behaviors or symptoms. Assessments must be
based on the person's status within the last 12 months at the time of service initiation.
Assessments based on older information must be documented and justified. Assessments
must be conducted annually at a minimum or within 30 days of a written request from the
person or the person's legal representative or case manager. The results must be reviewed
by the support team or expanded support team as part of a service plan review.

(c) Within 45 days of service initiation, the license holder must meet with the person,
the person's legal representative, the case manager, and other members of the support team
or expanded support team to determine the following based on information obtained from
the assessments identified in paragraph (b), the person's identified needs in the coordinated
service and support plan, and the requirements in subdivision 4 and section 245D.07,
subdivision 1a
:

(1) the scope of the services to be provided to support the person's daily needs and
activities;

(2) the person's desired outcomes and the supports necessary to accomplish the person's
desired outcomes;

(3) the person's preferences for how services and supports are provided, including how
the provider will support the person to have control of the person's schedule;

(4) whether the current service setting is the most integrated setting available and
appropriate for the person; and

(5) how services must be coordinated across other providers licensed under this chapter
serving the person and members of the support team or expanded support team to ensure
continuity of care and coordination of services for the person.

(d) A discussion of how technology might be used to meet the person's desired outcomes
must be included in the 45-day planning meetingnew text begin and at least annually thereafternew text end. The
deleted text begin coordinated service and support plan ordeleted text end support plan addendum must include a summary
of this discussion. The summary must include a statement regarding any decision that is
made regarding the use of technology and a description of any further research that needs
to be completed before a decision regarding the use of technology can be made. Nothing
in this paragraph requires that the coordinated service and support plan include the use of
technology for the provision of services.

Sec. 5.

Minnesota Statutes 2018, section 245D.091, subdivision 2, is amended to read:


Subd. 2.

deleted text beginBehaviordeleted text endnew text begin Positive supportnew text end professional qualifications.

A deleted text beginbehaviordeleted text endnew text begin positive
support
new text end professional providing deleted text beginbehavioraldeleted text endnew text begin positivenew text end support services as identified in section
245D.03, subdivision 1, paragraph (c), clause (1), item (i), must have competencies in the
following areas as required under the brain injury deleted text beginanddeleted text endnew text begin,new text end community access for disability
inclusionnew text begin, community alternative care, and development disabilitynew text end waiver plans or successor
plans:

(1) ethical considerations;

(2) functional assessment;

(3) functional analysis;

(4) measurement of behavior and interpretation of data;

(5) selecting intervention outcomes and strategies;

(6) behavior reduction and elimination strategies that promote least restrictive approved
alternatives;

(7) data collection;

(8) staff and caregiver training;

(9) support plan monitoring;

(10) co-occurring mental disorders or neurocognitive disorder;

(11) demonstrated expertise with populations being served; and

(12) must be a:

(i) psychologist licensed under sections 148.88 to 148.98, who has stated to the Board
of Psychology competencies in the above identified areas;

(ii) clinical social worker licensed as an independent clinical social worker under chapter
148D, or a person with a master's degree in social work from an accredited college or
university, with at least 4,000 hours of post-master's supervised experience in the delivery
of clinical services in the areas identified in clauses (1) to (11);

(iii) physician licensed under chapter 147 and certified by the American Board of
Psychiatry and Neurology or eligible for board certification in psychiatry with competencies
in the areas identified in clauses (1) to (11);

(iv) licensed professional clinical counselor licensed under sections 148B.29 to 148B.39
with at least 4,000 hours of post-master's supervised experience in the delivery of clinical
services who has demonstrated competencies in the areas identified in clauses (1) to (11);

(v) person with a master's degree from an accredited college or university in one of the
behavioral sciences or related fields, with at least 4,000 hours of post-master's supervised
experience in the delivery of clinical services with demonstrated competencies in the areas
identified in clauses (1) to (11); deleted text beginor
deleted text end

new text begin (vi) person with a master's degree or PhD in one of the behavioral sciences or related
field with demonstrated expertise in positive support services, as determined by the person's
case manager based on the person's needs as outlined in the person's community support
plan; or
new text end

deleted text begin (vi)deleted text endnew text begin (vii)new text end registered nurse who is licensed under sections 148.171 to 148.285, and who
is certified as a clinical specialist or as a nurse practitioner in adult or family psychiatric
and mental health nursing by a national nurse certification organization, or who has a master's
degree in nursing or one of the behavioral sciences or related fields from an accredited
college or university or its equivalent, with at least 4,000 hours of post-master's supervised
experience in the delivery of clinical services.

Sec. 6.

Minnesota Statutes 2018, section 245D.091, subdivision 3, is amended to read:


Subd. 3.

deleted text beginBehaviordeleted text endnew text begin Positive supportnew text end analyst qualifications.

(a) A deleted text beginbehaviordeleted text endnew text begin positive
support
new text end analyst providing deleted text beginbehavioraldeleted text endnew text begin positivenew text end support services as identified in section
245D.03, subdivision 1, paragraph (c), clause (1), item (i), must have competencies in the
following areas as required under the brain injury deleted text beginanddeleted text endnew text begin,new text end community access for disability
inclusionnew text begin, community alternative care, and developmental disabilitynew text end waiver plans or successor
plans:

(1) have obtained a baccalaureate degree, master's degree, or PhD in a social services
discipline; deleted text beginor
deleted text end

(2) meet the qualifications of a mental health practitioner as defined in section 245.462,
subdivision 17
deleted text begin.deleted text endnew text begin; or
new text end

new text begin (3) certification as a board-certified behavior analyst or board-certified assistant behavior
analyst by the Behavior Analyst Certification Board.
new text end

(b) In addition, a deleted text beginbehaviordeleted text endnew text begin positive supportnew text end analyst must:

(1) have four years of supervised experience deleted text beginworking with individuals who exhibit
challenging behaviors as well as co-occurring mental disorders or neurocognitive disorder;
deleted text endnew text begin
conducting functional behavior assessments and designing, implementing, and evaluating
the effectiveness of positive practices behavior support strategies for people who exhibit
challenging behaviors as well as co-occurring mental disorders and neurocognitive disorder;
new text end

deleted text begin (2) have received ten hours of instruction in functional assessment and functional analysis;
deleted text end

deleted text begin (3) have received 20 hours of instruction in the understanding of the function of behavior;
deleted text end

deleted text begin (4) have received ten hours of instruction on design of positive practices behavior support
strategies;
deleted text end

deleted text begin (5) have received 20 hours of instruction on the use of behavior reduction approved
strategies used only in combination with behavior positive practices strategies;
deleted text end

new text begin (2) have training prior to hire or within 90 calendar days of hire that includes:
new text end

new text begin (i) ten hours of instruction in functional assessment and functional analysis;
new text end

new text begin (ii) 20 hours of instruction in the understanding of the function of behavior;
new text end

new text begin (iii) ten hours of instruction on design of positive practices behavior support strategies;
new text end

new text begin (iv) 20 hours of instruction preparing written intervention strategies, designing data
collection protocols, training other staff to implement positive practice behavior support
strategies, summarizing and reporting program evaluation data, analyzing program evaluation
data to identify design flaws in behavioral interventions or failures in implementation fidelity,
and recommending enhancements based on evaluation data; and
new text end

new text begin (v) eight hours of instruction on principles of person-centered thinking;
new text end

deleted text begin (6)deleted text endnew text begin (3)new text end be determined by a deleted text beginbehaviordeleted text endnew text begin positive supportnew text end professional to have the training
and prerequisite skills required to provide positive practice strategies as well as behavior
reduction approved and permitted intervention to the person who receives deleted text beginbehavioraldeleted text endnew text begin positivenew text end
support; and

deleted text begin (7)deleted text endnew text begin (4)new text end be under the direct supervision of a deleted text beginbehaviordeleted text endnew text begin positive supportnew text end professional.

new text begin (c) Meeting the qualifications for a positive support professional under subdivision 2
shall substitute for meeting the qualifications listed in paragraph (b).
new text end

Sec. 7.

Minnesota Statutes 2018, section 245D.091, subdivision 4, is amended to read:


Subd. 4.

deleted text beginBehaviordeleted text endnew text begin Positive supportnew text end specialist qualifications.

(a) A deleted text beginbehaviordeleted text endnew text begin positive
support
new text end specialist providing deleted text beginbehavioraldeleted text endnew text begin positivenew text end support services as identified in section
245D.03, subdivision 1, paragraph (c), clause (1), item (i), must have competencies in the
following areas as required under the brain injury deleted text beginanddeleted text endnew text begin,new text end community access for disability
inclusionnew text begin, community alternative care, and developmental disabilitynew text end waiver plans or successor
plans:

(1) have an associate's degree in a social services discipline; or

(2) have two years of supervised experience working with individuals who exhibit
challenging behaviors as well as co-occurring mental disorders or neurocognitive disorder.

(b) In addition, a behavior specialist must:

deleted text begin (1) have received a minimum of four hours of training in functional assessment;
deleted text end

deleted text begin (2) have received 20 hours of instruction in the understanding of the function of behavior;
deleted text end

deleted text begin (3) have received ten hours of instruction on design of positive practices behavioral
support strategies;
deleted text end

new text begin (1) have received training prior to hire or within 90 calendar days of hire that includes:
new text end

new text begin (i) a minimum of four hours of training in functional assessment;
new text end

new text begin (ii) 20 hours of instruction in the understanding of the function of behavior;
new text end

new text begin (iii) ten hours of instruction on design of positive practices behavior support strategies;
and
new text end

new text begin (iv) eight hours of instruction on person-centered thinking principles;
new text end

deleted text begin (4)deleted text endnew text begin (2)new text end be determined by a deleted text beginbehaviordeleted text endnew text begin positive supportnew text end professional to have the training
and prerequisite skills required to provide positive practices new text beginbehavior support new text endstrategies as
well as behavior reduction approved intervention to the person who receives deleted text beginbehavioraldeleted text endnew text begin
positive
new text end support; and

deleted text begin (5)deleted text endnew text begin (3)new text end be under the direct supervision of a deleted text beginbehaviordeleted text endnew text begin positive supportnew text end professional.

new text begin (c) Meeting the qualifications for a positive support professional under subdivision 2
shall substitute for meeting the qualifications listed in paragraphs (a) and (b).
new text end

Sec. 8.

Minnesota Statutes 2018, section 256B.0652, subdivision 10, is amended to read:


Subd. 10.

Authorization for foster care setting.

(a) Home care services provided in
an adult or child foster care setting must receive authorization by the commissioner according
to the limits established in subdivision 11.

(b) The commissioner may not authorize:

(1) home care services that are the responsibility of the foster care provider under the
terms of the foster care placement agreement, difficulty of care rate as of January 1, 2010,
and administrative rules;

(2) personal care assistance services when the foster care license holder is also the
personal care provider or personal care assistant, unless the foster home is the licensed
provider's primary residence as defined in section 256B.0625, subdivision 19a; or

(3) personal care assistant and home care nursing services when the licensed capacity
is greater than fournew text begin, unless all conditions for a variance under Minnesota Rules, part
2960.3030, subpart 3, are satisfied for a sibling, as defined in section 260C.007, subdivision
32
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. 9.

Minnesota Statutes 2018, section 256B.0659, subdivision 3a, is amended to read:


Subd. 3a.

Assessment; defined.

(a) "Assessment" means a review and evaluation of a
recipient's need for personal care assistance services conducted in person. Assessments for
personal care assistance services shall be conducted by the county public health nurse or a
certified public health nurse under contract with the county except when a long-term care
consultation assessment is being conducted for the purposes of determining a person's
eligibility for home and community-based waiver services including personal care assistance
services according to section 256B.0911.new text begin During the transition to MnCHOICES, a certified
assessor may complete the assessment required in this subdivision.
new text end An in-person assessment
must include: documentation of health status, determination of need, evaluation of service
effectiveness, identification of appropriate services, service plan development or modification,
coordination of services, referrals and follow-up to appropriate payers and community
resources, completion of required reports, recommendation of service authorization, and
consumer education. Once the need for personal care assistance services is determined under
this section, the county public health nurse or certified public health nurse under contract
with the county is responsible for communicating this recommendation to the commissioner
and the recipient. An in-person assessment must occur at least annually or when there is a
significant change in the recipient's condition or when there is a change in the need for
personal care assistance services. A service update may substitute for the annual face-to-face
assessment when there is not a significant change in recipient condition or a change in the
need for personal care assistance service. A service update may be completed by telephone,
used when there is no need for an increase in personal care assistance services, and used
for two consecutive assessments if followed by a face-to-face assessment. A service update
must be completed on a form approved by the commissioner. A service update or review
for temporary increase includes a review of initial baseline data, evaluation of service
effectiveness, redetermination of service need, modification of service plan and appropriate
referrals, update of initial forms, obtaining service authorization, and on going consumer
education. Assessments or reassessments must be completed on forms provided by the
commissioner within 30 days of a request for home care services by a recipient or responsible
party.

(b) This subdivision expires when notification is given by the commissioner as described
in section 256B.0911, subdivision 3a.

Sec. 10.

Minnesota Statutes 2018, section 256B.0911, subdivision 1a, is amended to read:


Subd. 1a.

Definitions.

For purposes of this section, the following definitions apply:

(a) Until additional requirements apply under paragraph (b), "long-term care consultation
services" means:

(1) intake for and access to assistance in identifying services needed to maintain an
individual in the most inclusive environment;

(2) providing recommendations for and referrals to cost-effective community services
that are available to the individual;

(3) development of an individual's person-centered community support plan;

(4) providing information regarding eligibility for Minnesota health care programs;

(5) face-to-face long-term care consultation assessments, which may be completed in a
hospital, nursing facility, intermediate care facility for persons with developmental disabilities
(ICF/DDs), regional treatment centers, or the person's current or planned residence;

(6) determination of home and community-based waiver and other service eligibility as
required under sections 256B.0913, 256B.0915, new text begin256B.092, new text endand 256B.49, including level
of care determination for individuals who need an institutional level of care as determined
under subdivision 4e, based on assessment and community support plan development,
appropriate referrals to obtain necessary diagnostic information, and including an eligibility
determination for consumer-directed community supports;

(7) providing recommendations for institutional placement when there are no
cost-effective community services available;

(8) providing access to assistance to transition people back to community settings after
institutional admission; and

(9) providing information about competitive employment, with or without supports, for
school-age youth and working-age adults and referrals to the Disability deleted text beginLinkage Linedeleted text endnew text begin Hubnew text end
and Disability Benefits 101 to ensure that an informed choice about competitive employment
can be made. For the purposes of this subdivision, "competitive employment" means work
in the competitive labor market that is performed on a full-time or part-time basis in an
integrated setting, and for which an individual is compensated at or above the minimum
wage, but not less than the customary wage and level of benefits paid by the employer for
the same or similar work performed by individuals without disabilities.

(b) Upon statewide implementation of lead agency requirements in subdivisions 2b, 2c,
and 3a, "long-term care consultation services" also means:

(1) service eligibility determination for state plan home care services identified in:

(i) section 256B.0625, subdivisions deleted text begin7,deleted text end 19adeleted text begin,deleted text end and 19c;

(ii) consumer support grants under section 256.476; or

(iii) section 256B.85;

(2) notwithstanding provisions in Minnesota Rules, parts 9525.0004 to 9525.0024,
deleted text begin determination of eligibility fordeleted text endnew text begin gaining access tonew text end case management services available under
sections 256B.0621, subdivision 2, paragraph (4), and 256B.0924 and Minnesota Rules,
part 9525.0016;new text begin and
new text end

deleted text begin (3) determination of institutional level of care, home and community-based service
waiver, and other service eligibility as required under section 256B.092, determination of
eligibility for family support grants under section 252.32, semi-independent living services
under section 252.275, and day training and habilitation services under section 256B.092;
and
deleted text end

deleted text begin (4)deleted text endnew text begin (3)new text end obtaining necessary diagnostic information to determine eligibility under deleted text beginclausesdeleted text endnew text begin
clause
new text end (2) deleted text beginand (3)deleted text end.

(c) "Long-term care options counseling" means the services provided by the linkage
lines as mandated by sections 256.01, subdivision 24, and 256.975, subdivision 7, and also
includes telephone assistance and follow up once a long-term care consultation assessment
has been completed.

(d) "Minnesota health care programs" means the medical assistance program under this
chapter and the alternative care program under section 256B.0913.

(e) "Lead agencies" means counties administering or tribes and health plans under
contract with the commissioner to administer long-term care consultation assessment and
support planning services.

(f) "Person-centered planning" is a process that includes the active participation of a
person in the planning of the person's services, including in making meaningful and informed
choices about the person's own goals, talents, and objectives, as well as making meaningful
and informed choices about the services the person receives. For the purposes of this section,
"informed choice" means a voluntary choice of services by a person from all available
service options based on accurate and complete information concerning all available service
options and concerning the person's own preferences, abilities, goals, and objectives. In
order for a person to make an informed choice, all available options must be developed and
presented to the person to empower the person to make decisions.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2019.
new text end

Sec. 11.

Minnesota Statutes 2018, section 256B.0911, subdivision 3a, is amended to read:


Subd. 3a.

Assessment and support planning.

(a) Persons requesting assessment, services
planning, or other assistance intended to support community-based living, including persons
who need assessment in order to determine waiver or alternative care program eligibility,
must be visited by a long-term care consultation team within 20 calendar days after the date
on whichnew text begin the person acceptsnew text end an assessment deleted text beginwas requested or recommendeddeleted text end. Upon statewide
implementation of subdivisions 2b, 2c, and 5, this requirement also applies to an assessment
of a person requesting personal care assistance services deleted text beginand home care nursingdeleted text end. The
commissioner shall provide at least a 90-day notice to lead agencies prior to the effective
date of this requirement. Face-to-face assessments must be conducted according to paragraphs
(b) to (i).

(b) Upon implementation of subdivisions 2b, 2c, and 5, lead agencies shall use certified
assessors to conduct the assessment. For a person with complex health care needs, a public
health or registered nurse from the team must be consulted.

(c) The MnCHOICES assessment provided by the commissioner to lead agencies must
be used to complete a comprehensive, person-centered assessment. The assessment must
include the health, psychological, functional, environmental, and social needs of the
deleted text begin individualdeleted text endnew text begin personnew text end necessary to develop a community support plan that meets the deleted text beginindividual'sdeleted text endnew text begin
person's
new text end needs and preferences.

(d) The deleted text beginassessment must be conducteddeleted text endnew text begin assessor must conduct the assessmentnew text end in a
face-to-face interview with the person being assessed deleted text beginand the person's legal representativedeleted text end.new text begin
The person's legal representative must provide input during the assessment interview and
may do so remotely.
new text end At the request of the person, other individuals may participate in the
assessment to provide information on the needs, strengths, and preferences of the person
necessary to develop a community support plan that ensures the person's health and safety.
Except for legal representatives or family members invited by the person, persons
participating in the assessment may not be a provider of service or have any financial interest
in the provision of services. For persons who are to be assessed for elderly waiver customized
living or adult day services under section 256B.0915, with the permission of the person
being assessed or the person's designated or legal representative, the client's current or
proposed provider of services may submit a copy of the provider's nursing assessment or
written report outlining its recommendations regarding the client's care needs. The person
conducting the assessment must notify the provider of the date by which this information
is to be submitted. This information shall be provided to the person conducting the assessment
prior to the assessment. For a person who is to be assessed for waiver services under section
256B.092 or 256B.49, with the permission of the person being assessed or the person's
designated legal representative, the person's current provider of services may submit a
written report outlining recommendations regarding the person's care needs prepared by a
direct service employee deleted text beginwith at least 20 hours of service to that clientdeleted text endnew text begin who is familiar with
the person
new text end. deleted text beginThe person conducting the assessment or reassessment must notify the provider
of the date by which this information is to be submitted.
deleted text end This information shall be provided
to the person conducting the assessment and the person or the person's legal representative,
and must be considered prior to the finalization of the assessment or reassessment.

(e) new text beginThe certified assessor and the individual responsible for developing the coordinated
service and support plan must ensure the person has timely access to needed resources and
must complete the community support plan and the coordinated service and support plan
no more than 60 calendar days from the assessment visit.
new text endThe person or the person's legal
representative must be provided with a written community support plan within deleted text begin40 calendar
days of the assessment visit
deleted text endnew text begin the timelines established by the commissionernew text end, regardless of
whether the deleted text beginindividualdeleted text endnew text begin personnew text end is eligible for Minnesota health care programs.new text begin The
commissioner shall monitor and evaluate lead agency performance in meeting timeline
requirements to ensure timely access for people seeking long-term services and supports.
new text end

(f) For a person being assessed for elderly waiver services under section 256B.0915, a
provider who submitted information under paragraph (d) shall receive the final written
community support plan when available and the Residential Services Workbook.

(g) The written community support plan must include:

(1) a summary of assessed needs as defined in paragraphs (c) and (d);

(2) the deleted text beginindividual'sdeleted text endnew text begin person'snew text end options and choices to meet identified needs, including all
available options for case management services and providers, including service provided
in a non-disability-specific setting;

(3) identification of health and safety risks and how those risks will be addressed,
including personal risk management strategies;

(4) referral information; and

(5) informal caregiver supports, if applicable.

For a person determined eligible for state plan home care under subdivision 1a, paragraph
(b), clause (1), the person or person's representative must also receive a copy of the home
care service plan developed by the certified assessor.

(h) A person may request assistance in identifying community supports without
participating in a complete assessment. Upon a request for assistance identifying community
support, the person must be transferred or referred to long-term care options counseling
services available under sections 256.975, subdivision 7, and 256.01, subdivision 24, for
telephone assistance and follow up.

(i) The person has the right to make the final decision between institutional placement
and community placement after the recommendations have been provided, except as provided
in section 256.975, subdivision 7a, paragraph (d).

(j) The lead agency must give the person receiving assessment or support planning, or
the person's legal representative, materials, and forms supplied by the commissioner
containing the following information:

(1) written recommendations for community-based services and consumer-directed
options;

(2) documentation that the most cost-effective alternatives available were offered to the
deleted text begin individualdeleted text endnew text begin personnew text end. For purposes of this clause, "cost-effective" means community services
and living arrangements that cost the same as or less than institutional care. For deleted text beginan individualdeleted text endnew text begin
a person
new text end found to meet eligibility criteria for home and community-based service programs
under section 256B.0915 or 256B.49, "cost-effectiveness" has the meaning found in the
federally approved waiver plan for each program;

(3) the need for and purpose of preadmission screening conducted by long-term care
options counselors according to section 256.975, subdivisions 7a to 7c, if the person selects
nursing facility placement. If the deleted text beginindividualdeleted text endnew text begin personnew text end selects nursing facility placement, the
lead agency shall forward information needed to complete the level of care determinations
and screening for developmental disability and mental illness collected during the assessment
to the long-term care options counselor using forms provided by the commissioner;

(4) the role of long-term care consultation assessment and support planning in eligibility
determination for waiver and alternative care programs, deleted text beginand state plan home care,deleted text end case
management, and other services as defined in subdivision 1a, paragraphs (a), clause (6),
and (b);

(5) information about Minnesota health care programs;

(6) the person's freedom to accept or reject the recommendations of the team;

(7) the person's right to confidentiality under the Minnesota Government Data Practices
Act, chapter 13;

(8) the certified assessor's decision regarding the person's need for institutional level of
care as determined under criteria established in subdivision 4e and the certified assessor's
decision regarding eligibility for all services and programs as defined in subdivision 1a,
paragraphs (a), clause (6), and (b); and

(9) the person's right to appeal the certified assessor's decision regarding eligibility for
all services and programs as defined in subdivision 1a, paragraphs (a), clauses (6), (7), and
(8), and (b), and incorporating the decision regarding the need for institutional level of care
or the lead agency's final decisions regarding public programs eligibility according to section
256.045, subdivision 3.

(k) Face-to-face assessment completed as part of eligibility determination for the
alternative care, elderly waiver, community access for disability inclusion, community
alternative care, deleted text beginanddeleted text end brain injurynew text begin, and developmental disabilitiesnew text end waiver programs under
sections 256B.0913, 256B.0915, new text begin256B.092, new text endand 256B.49 is valid to establish service
eligibility for no more than 60 calendar days after the date of assessment.

(l) The effective eligibility start date for programs in paragraph (k) can never be prior
to the date of assessment. If an assessment was completed more than 60 days before the
effective waiver or alternative care program eligibility start date, assessment and support
plan information must be updated and documented in the department's Medicaid Management
Information System (MMIS). Notwithstanding retroactive medical assistance coverage of
state plan services, the effective date of eligibility for programs included in paragraph (k)
cannot be prior to the date the most recent updated assessment is completed.

(m) If an eligibility update is completed within 90 days of the previous face-to-face
assessment and documented in the department's Medicaid Management Information System
(MMIS), the effective date of eligibility for programs included in paragraph (k) is the date
of the previous face-to-face assessment when all other eligibility requirements are met.

(n) At the time of reassessment, the certified assessor shall assess each person receiving
waiver services currently residing in a community residential setting, or licensed adult foster
care home that is not the primary residence of the license holder, or in which the license
holder is not the primary caregiver, to determine if that person would prefer to be served in
a community-living setting as defined in section 256B.49, subdivision 23. The certified
assessor shall offer the person, through a person-centered planning process, the option to
receive alternative housing and service options.

Sec. 12.

Minnesota Statutes 2018, section 256B.0911, subdivision 3f, is amended to read:


Subd. 3f.

Long-term care reassessments and community support plan
updates.

Reassessments must be tailored using the professional judgment of the assessor
to the person's known needs, strengths, preferences, and circumstances. Reassessments
provide information to support the person's informed choice and opportunities to express
choice regarding activities that contribute to quality of life, as well as information and
opportunity to identify goals related to desired employment, community activities, and
preferred living environment. Reassessments allow for a review of the current support plan's
effectiveness, monitoring of services, and the development of an updated person-centered
community support plan. Reassessments verify continued eligibility or offer alternatives as
warranted and provide an opportunity for quality assurance of service delivery. Face-to-face
assessments must be conducted annually or as required by federal and state laws and rules.new text begin
The certified assessor and the individual responsible for developing the coordinated service
and support plan must ensure the continuity of care for the person receiving services and
must complete the updated community support plan and the updated coordinated service
and support plan no more than 60 calendar days from the reassessment visit. The
commissioner shall monitor and evaluate lead agency performance in meeting timeline
requirements to ensure timely access for people seeking long-term services and supports.
new text end

Sec. 13.

Minnesota Statutes 2018, section 256B.0915, subdivision 6, is amended to read:


Subd. 6.

Implementation of coordinated service and support plan.

(a) Each elderly
waiver client shall be provided a copy of a written coordinated service and support plan
which:

(1) is developednew text begin withnew text end and signed by the recipient within deleted text beginten working days after the case
manager receives the assessment information and written community support plan as
described in section 256B.0911, subdivision 3a, from the certified assessor
deleted text endnew text begin the timelines
established by the commissioner and section 256B.0911, subdivision 3a, paragraph (e)
new text end;

(2) includes the person's need for service and identification of service needs that will be
or that are met by the person's relatives, friends, and others, as well as community services
used by the general public;

(3) reasonably ensures the health and welfare of the recipient;

(4) identifies the person's preferences for services as stated by the person or the person's
legal guardian or conservator;

(5) reflects the person's informed choice between institutional and community-based
services, as well as choice of services, supports, and providers, including available case
manager providers;

(6) identifies long-range and short-range goals for the person;

(7) identifies specific services and the amount, frequency, duration, and cost of the
services to be provided to the person based on assessed needs, preferences, and available
resources;

(8) includes information about the right to appeal decisions under section 256.045; and

(9) includes the authorized annual and estimated monthly amounts for the services.

(b) In developing the coordinated service and support plan, the case manager should
also include the use of volunteers, religious organizations, social clubs, and civic and service
organizations to support the individual in the community. The lead agency must be held
harmless for damages or injuries sustained through the use of volunteers and agencies under
this paragraph, including workers' compensation liability.

Sec. 14.

Minnesota Statutes 2018, section 256B.092, subdivision 1b, is amended to read:


Subd. 1b.

Coordinated service and support plan.

(a) Each recipient of home and
community-based waivered services shall be provided a copy of the written coordinated
service and support plan which:

(1) is developednew text begin withnew text end and signed by the recipient within deleted text beginten working days after the case
manager receives the assessment information and written community support plan as
described in section 256B.0911, subdivision 3a, from the certified assessor
deleted text endnew text begin the timelines
established by the commissioner and section 256B.0911, subdivision 3a, paragraph (e)
new text end;

(2) includes the person's need for service, including identification of service needs that
will be or that are met by the person's relatives, friends, and others, as well as community
services used by the general public;

(3) reasonably ensures the health and welfare of the recipient;

(4) identifies the person's preferences for services as stated by the person, the person's
legal guardian or conservator, or the parent if the person is a minor, including the person's
choices made on self-directed options and on services and supports to achieve employment
goals;

(5) provides for an informed choice, as defined in section 256B.77, subdivision 2,
paragraph (o), of service and support providers, and identifies all available options for case
management services and providers;

(6) identifies long-range and short-range goals for the person;

(7) identifies specific services and the amount and frequency of the services to be provided
to the person based on assessed needs, preferences, and available resources. The coordinated
service and support plan shall also specify other services the person needs that are not
available;

(8) identifies the need for an individual program plan to be developed by the provider
according to the respective state and federal licensing and certification standards, and
additional assessments to be completed or arranged by the provider after service initiation;

(9) identifies provider responsibilities to implement and make recommendations for
modification to the coordinated service and support plan;

(10) includes notice of the right to request a conciliation conference or a hearing under
section 256.045;

(11) is agreed upon and signed by the person, the person's legal guardian or conservator,
or the parent if the person is a minor, and the authorized county representative;

(12) is reviewed by a health professional if the person has overriding medical needs that
impact the delivery of services; and

(13) includes the authorized annual and monthly amounts for the services.

(b) In developing the coordinated service and support plan, the case manager is
encouraged to include the use of volunteers, religious organizations, social clubs, and civic
and service organizations to support the individual in the community. The lead agency must
be held harmless for damages or injuries sustained through the use of volunteers and agencies
under this paragraph, including workers' compensation liability.

(c) Approved, written, and signed changes to a consumer's services that meet the criteria
in this subdivision shall be an addendum to that consumer's individual service plan.

Sec. 15.

Minnesota Statutes 2018, section 256B.49, subdivision 13, is amended to read:


Subd. 13.

Case management.

(a) Each recipient of a home and community-based waiver
shall be provided case management services by qualified vendors as described in the federally
approved waiver application. The case management service activities provided must include:

(1) finalizing the written coordinated service and support plan within deleted text beginten working days
after the case manager receives the plan from the certified assessor
deleted text endnew text begin the timelines established
by the commissioner and section 256B.0911, subdivision 3a, paragraph (e)
new text end;

(2) informing the recipient or the recipient's legal guardian or conservator of service
options;

(3) assisting the recipient in the identification of potential service providers and available
options for case management service and providers, including services provided in a
non-disability-specific setting;

(4) assisting the recipient to access services and assisting with appeals under section
256.045; and

(5) coordinating, evaluating, and monitoring of the services identified in the service
plan.

(b) The case manager may delegate certain aspects of the case management service
activities to another individual provided there is oversight by the case manager. The case
manager may not delegate those aspects which require professional judgment including:

(1) finalizing the coordinated service and support plan;

(2) ongoing assessment and monitoring of the person's needs and adequacy of the
approved coordinated service and support plan; and

(3) adjustments to the coordinated service and support plan.

(c) Case management services must be provided by a public or private agency that is
enrolled as a medical assistance provider determined by the commissioner to meet all of
the requirements in the approved federal waiver plans. Case management services must not
be provided to a recipient by a private agency that has any financial interest in the provision
of any other services included in the recipient's coordinated service and support plan. For
purposes of this section, "private agency" means any agency that is not identified as a lead
agency under section 256B.0911, subdivision 1a, paragraph (e).

(d) For persons who need a positive support transition plan as required in chapter 245D,
the case manager shall participate in the development and ongoing evaluation of the plan
with the expanded support team. At least quarterly, the case manager, in consultation with
the expanded support team, shall evaluate the effectiveness of the plan based on progress
evaluation data submitted by the licensed provider to the case manager. The evaluation must
identify whether the plan has been developed and implemented in a manner to achieve the
following within the required timelines:

(1) phasing out the use of prohibited procedures;

(2) acquisition of skills needed to eliminate the prohibited procedures within the plan's
timeline; and

(3) accomplishment of identified outcomes.

If adequate progress is not being made, the case manager shall consult with the person's
expanded support team to identify needed modifications and whether additional professional
support is required to provide consultation.

Sec. 16.

Minnesota Statutes 2018, section 256B.49, subdivision 14, is amended to read:


Subd. 14.

Assessment and reassessment.

(a) Assessments and reassessments shall be
conducted by certified assessors according to section 256B.0911, subdivision 2b. The
certified assessor, with the permission of the recipient or the recipient's designated legal
representative, may invite other individuals to attend the assessment. With the permission
of the recipient or the recipient's designated legal representative, the recipient's current
provider of services may submit a written report outlining their recommendations regarding
the recipient's care needs prepared by a direct service employee deleted text beginwith at least 20 hours of
service to that client
deleted text endnew text begin who is familiar with the personnew text end. deleted text beginThe certified assessor must notify the
provider of the date by which this information is to be submitted.
deleted text end This information shall be
provided to the certified assessor and the person or the person's legal representative and
must be considered prior to the finalization of the assessment or reassessment.

(b) There must be a determination that the client requires a hospital level of care or a
nursing facility level of care as defined in section 256B.0911, subdivision 4e, at initial and
subsequent assessments to initiate and maintain participation in the waiver program.

(c) Regardless of other assessments identified in section 144.0724, subdivision 4, as
appropriate to determine nursing facility level of care for purposes of medical assistance
payment for nursing facility services, only face-to-face assessments conducted according
to section 256B.0911, subdivisions 3a, 3b, and 4d, that result in a hospital level of care
determination or a nursing facility level of care determination must be accepted for purposes
of initial and ongoing access to waiver services payment.

(d) Recipients who are found eligible for home and community-based services under
this section before their 65th birthday may remain eligible for these services after their 65th
birthday if they continue to meet all other eligibility factors.

Sec. 17.

Minnesota Statutes 2018, section 256B.4914, subdivision 3, is amended to read:


Subd. 3.

Applicable services.

Applicable services are those authorized under the state's
home and community-based services waivers under sections 256B.092 and 256B.49,
including the following, as defined in the federally approved home and community-based
services plan:

(1) 24-hour customized living;

(2) adult day care;

(3) adult day care bath;

(4) deleted text beginbehavioral programmingdeleted text endnew text begin positive support servicesnew text end;

(5) companion services;

(6) customized living;

(7) day training and habilitation;

new text begin (8) employment development services;
new text end

new text begin (9) employment exploration services;
new text end

new text begin (10) employment support services;
new text end

deleted text begin (8)deleted text endnew text begin (11)new text end housing access coordination;

deleted text begin (9)deleted text endnew text begin (12)new text end independent living skills;

new text begin (13) independent living skills specialist services;
new text end

new text begin (14) individualized home supports;
new text end

deleted text begin (10)deleted text endnew text begin (15)new text end in-home family support;

deleted text begin (11)deleted text endnew text begin (16)new text end night supervision;

deleted text begin (12)deleted text endnew text begin (17)new text end personal support;

deleted text begin (13)deleted text endnew text begin (18)new text end prevocational services;

deleted text begin (14)deleted text endnew text begin (19)new text end residential care services;

deleted text begin (15)deleted text endnew text begin (20)new text end residential support services;

deleted text begin (16)deleted text endnew text begin (21)new text end respite services;

deleted text begin (17)deleted text endnew text begin (22)new text end structured day services;

deleted text begin (18)deleted text endnew text begin (23)new text end supported employment services;

deleted text begin (19)deleted text endnew text begin (24)new text end supported living services;

deleted text begin (20)deleted text endnew text begin (25)new text end transportation services;new text begin and
new text end

deleted text begin (21) individualized home supports;
deleted text end

deleted text begin (22) independent living skills specialist services;
deleted text end

deleted text begin (23) employment exploration services;
deleted text end

deleted text begin (24) employment development services;
deleted text end

deleted text begin (25) employment support services; and
deleted text end

(26) other services as approved by the federal government in the state home and
community-based services plan.

Sec. 18.

Minnesota Statutes 2018, section 256B.4914, subdivision 14, is amended to read:


Subd. 14.

Exceptions.

(a) In a format prescribed by the commissioner, lead agencies
must identify individuals with exceptional needs that cannot be met under the disability
waiver rate system. The commissioner shall use that information to evaluate and, if necessary,
approve an alternative payment rate for those individuals. Whether granted, denied, or
modified, the commissioner shall respond to all exception requests in writing. The
commissioner shall include in the written response the basis for the action and provide
notification of the right to appeal under paragraph (h).

(b) Lead agencies must act on an exception request within 30 days deleted text beginanddeleted text endnew text begin from the date
that the lead agency receives all application materials described in paragraph (d). Lead
agencies must
new text end notify the initiator of the request of their recommendation in writing. A lead
agency shall submit all exception requests along with its recommendation to the
commissioner.

(c) An application for a rate exception may be submitted for the following criteria:

(1) an individual has service needs that cannot be met through additional units of service;

(2) an individual's rate determined under subdivisions 6, 7, 8, and 9 is so insufficient
that it has resulted in an individual receiving a notice of discharge from the individual's
provider; or

(3) an individual's service needs, including behavioral changes, require a level of service
which necessitates a change in provider or which requires the current provider to propose
service changes beyond those currently authorized.

(d) Exception requests must include the following information:

(1) the service needs required by each individual that are not accounted for in subdivisions
6, 7, 8, and 9;

(2) the service rate requested and the difference from the rate determined in subdivisions
6, 7, 8, and 9;

(3) a basis for the underlying costs used for the rate exception deleted text beginand any accompanyingdeleted text endnew text begin
based on real costs related to the individual's extraordinary needs borne by the provider,
including
new text end documentationnew text begin of these costsnew text end; and

(4) any contingencies for approval.

(e) Approved rate exceptions shall be managed within lead agency allocations under
sections 256B.092 and 256B.49.

(f) Individual disability waiver recipients, an interested party, or the license holder that
would receive the rate exception increase may request that a lead agency submit an exception
request. A lead agency that denies such a request shall notify the individual waiver recipient,
interested party, or license holder of its decision and the reasons for denying the request in
writing no later than 30 days after the request has been made and shall submit its denial to
the commissioner in accordance with paragraph (b). The reasons for the denial must be
based on the failure to meet the criteria in paragraph (c).

(g) The commissioner shall determine whether to approve or deny an exception request
no more than 30 days after receiving the request. If the commissioner denies the request,
the commissioner shall notify the lead agency and the individual disability waiver recipient,
the interested party, and the license holder in writing of the reasons for the denial.

(h) The individual disability waiver recipient may appeal any denial of an exception
request by either the lead agency or the commissioner, pursuant to sections 256.045 and
256.0451. When the denial of an exception request results in the proposed demission of a
waiver recipient from a residential or day habilitation program, the commissioner shall issue
a temporary stay of demission, when requested by the disability waiver recipient, consistent
with the provisions of section 256.045, subdivisions 4a and 6, paragraph (c). The temporary
stay shall remain in effect until the lead agency can provide an informed choice of
appropriate, alternative services to the disability waiver.

(i) Providers may petition lead agencies to update values that were entered incorrectly
or erroneously into the rate management system, based on past service level discussions
and determination in subdivision 4, without applying for a rate exception.

(j) The starting date for the rate exception will be the later of the date of the recipient's
change in support or the date of the request to the lead agency for an exception.

(k) The commissioner shall track all exception requests received and their dispositions.
The commissioner shall issue quarterly public exceptions statistical reports, including the
number of exception requests received and the numbers granted, denied, withdrawn, and
pending. The report shall include the average amount of time required to process exceptions.

(l) No later than January 15, 2016, the commissioner shall provide research findings on
the estimated fiscal impact, the primary cost drivers, and common population characteristics
of recipients with needs that cannot be met by the framework rates.

(m) No later than July 1, 2016, the commissioner shall develop and implement, in
consultation with stakeholders, a process to determine eligibility for rate exceptions for
individuals with rates determined under the methodology in section 256B.4913, subdivision
4a. Determination of eligibility for an exception will occur as annual service renewals are
completed.

(n) Approved rate exceptions will be implemented at such time that the individual's rate
is no longer banded and remain in effect in all cases until an individual's needs change as
defined in paragraph (c).

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2019.
new text end

Sec. 19.

Minnesota Statutes 2018, 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 begineating, toileting, grooming, dressing,
bathing, mobility, positioning, and transferring.
deleted text endnew text begin:
new text end

new text begin (1) dressing, including assistance with choosing, application, and changing of clothing
and application of 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. Nail care is included,
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 application of orthotics required
for eating, transfers, or feeding;
new text end

new text begin (5) transfers, including assistance with transferring the recipient 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 recipient;
new text end

new text begin (7) positioning, including assistance with positioning or turning a recipient 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, and is specified in a community services and 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 physician 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 beginsectiondeleted text endnew text begin sectionsnew text end 256B.0915, subdivision 6new text begin, and 256B.092,
subdivision 1b
new text end.

(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
may 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 sections 256B.0915; 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 towards 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 may 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 beginThis 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 beginTwo 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 an agreement to receive
services at the same time and in the same setting by the same employer.

(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. 20.

Minnesota Statutes 2018, 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 throughnew text begin thenew text end alternative carenew text begin programnew text end.

Sec. 21.

Minnesota Statutes 2018, 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 begincertifieddeleted text end assessor as
defined in section 256B.0911 to the participant deleted text beginand the agency-provider or FMS provider
chosen by the participant
deleted text endnew text begin or participant's representative and chosen CFSS providersnew text end within
deleted text begin 40 calendardeleted text endnew text begin ten businessnew text end days deleted text beginand must include the participant's right to appeal under section
256.045, subdivision 3
deleted text endnew text begin of the assessmentnew text end.

(c) The lead agency assessor may authorize a temporary authorization for CFSS services
to be provided under the agency-provider model. 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.

new text begin For CFSS services beyond the temporary authorization,new text end participants deleted text beginapproved for a temporary
authorization
deleted text end shall access the consultation service to complete their orientation and selection
of a service model.

Sec. 22.

Minnesota Statutes 2018, 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 beginsectiondeleted text endnew text begin sectionsnew text end 256B.0915, subdivision 6new text begin, and 256B.092,
subdivision 1b
new text end. 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 beginalldeleted 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 beginThe CFSS service delivery plan must describe the units or dollar amount available
to the participant.
new text endThe 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
manager/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. 23.

Minnesota Statutes 2018, 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) deleted text begin30 additional minutes per day when the behavior requires assistance at least four
times per week for one or more of the following behaviors
deleted text endnew text begin 30 additional minutes per day
for each behavior under this clause that requires assistance at least four times per week
new 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. 24.

Minnesota Statutes 2018, 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, including, but not limited to, 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 thenew text begin adultnew 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 physician;

(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 beginand
deleted text end

(31) services provided deleted text beginby the residential or program license holder in a residence for
more than four participants.
deleted text endnew text begin in licensed foster care, except when:
new text end

new text begin (i) the foster care home is the foster care license holder's primary residence; or
new text end

new text begin (ii) the licensed capacity is four or fewer, or all conditions for a variance under Minnesota
Rules, part 2960.3030, subpart 3, are met for a group of siblings, as defined in section
260C.007, subdivision 32;
new text end

new text begin (32) services from a provider who owns or otherwise controls for the living arrangement,
except when the provider of services is related by blood, marriage, or adoption or when the
provider meets the requirements under clause (31); and
new text end

new text begin (33) 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 the
personal care services and the assessor lists the need in the service plan.
new text end

Sec. 25.

Minnesota Statutes 2018, 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 commissioner
new 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 provided;

(6) report maltreatment as required under sections 626.556 and 626.557; deleted text beginand
deleted text end

(7) comply with any data requests from the department consistent with the Minnesota
Government Data Practices Act under chapter 13deleted text begin.deleted text endnew text begin; and
new text end

new text begin (8) request reassessments at least 60 days before the end of the current authorization for
CFSS on forms provided by the commissioner.
new text end

Sec. 26.

Minnesota Statutes 2018, 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. 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 individuals 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. 27.

Minnesota Statutes 2018, 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. Within 30 days of any support worker beginning to provide services for a participant,
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 CFSS.

(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 beginand
deleted text end

(4)new text begin 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

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;

(2) there is any change in condition or a modification to the CFSS service delivery plan;
or

(3) a performance review indicates that additional training is needed.

Sec. 28.

Minnesota Statutes 2018, 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 includes, but is not limited to, 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 begindescriptiondeleted text endnew text begin copynew text end of the CFSS agency-provider's deleted text beginorganizationdeleted text endnew text begin organizational chartnew text end
identifying the namesnew text begin and rolesnew text end of all owners, managing employees, staff, board of directors,
and deleted text beginthedeleted text endnew text begin additional documentation reporting anynew text end affiliations of the directors and owners to
other service providers;

(7) deleted text begina copy ofdeleted text endnew text begin proof thatnew text end the CFSS deleted text beginagency-provider'sdeleted text endnew 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 begincopies of all other formsdeleted text endnew text begin proof thatnew text end the CFSS agency-provider deleted text beginuses in the course of
daily business
deleted text endnew text begin has all of the following forms and documentsnew text end including, but not limited to:

(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. 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 agency, if 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

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.

Sec. 29.

Minnesota Statutes 2018, 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 begintendeleted text endnew 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 beginacknowledgementdeleted text endnew text begin
acknowledgment
new 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. 30.

Minnesota Statutes 2018, 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 beginand
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 endnew 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 of human services 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. 31.

Minnesota Statutes 2018, 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 and actively participate in planning and directing CFSS
services;
new text end

new text begin (2) 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 care
plan;
new text end

new text begin (3) 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 (4) 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
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 file must include written documentation that indicates the
participant's free choice. 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 shall enter into a written agreement with an
agency-provider or FMS, on a form determined by the commissioner, to:
new text end

new text begin (1) be available while care is provided in 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 the good; and
new text end

new text begin (5) review and sign documentation to verify worker training after receipt of the worker
training.
new text end

new text begin (h) A participant's representative may delegate the 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 as the participant's representative satisfies the requirement
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 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 that fails to provide support required by the participant must
be referred to the common entry point.
new text end

Sec. 32.

Minnesota Statutes 2018, 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 beginand
deleted text end

(3)new text begin be delivered by an individual competent to perform, teach, or assign the tasks
identified, including health-related tasks, in the plan through education, training, and work
experience relevant to the person's assessed needs; and
new 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 96 units per annual service agreement, unless approved by the
department.

Sec. 33. new text beginREVISOR INSTRUCTION; CORRECTING TERMINOLOGY.
new text end

new text begin (a) The revisor of statutes shall change the term "developmental disability waiver" or
similar terms to "developmental disabilities waiver" or similar terms wherever they appear
in Minnesota Statutes. The revisor shall also make technical and other necessary changes
to sentence structure to preserve the meaning of the text.
new text end

new text begin (b) In Minnesota Statutes, sections 256.01, subdivisions 2 and 24; 256.975, subdivision
7; 256B.0911, subdivisions 1a, 3b, and 4d; and 256B.439, subdivision 4, the revisor of
statutes shall substitute the term "Disability Linkage Line" or similar terms for "Disability
Hub" or similar terms. The revisor shall also make grammatical changes related to the
changes in terms.
new text end

Sec. 34. new text beginREVISOR INSTRUCTION; PCA TRANSITION TO CFSS.
new text end

new text begin The revisor of statutes, in consultation with the House Research Department, Office of
Senate Counsel, Research and Fiscal Analysis, and Department of Human Services, shall
prepare legislation for the 2020 legislative session to repeal laws governing the consumer
support grant program and personal care assistance program in Minnesota Statutes, chapters
256 and 256B, correct cross-references, remove obsolete language, and, as necessary, provide
for the transition from the personal care assistance program to community first services and
supports.
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