MN Legislature

Accessibility menu

Bills use visual text formatting such as stricken text to denote deleted language, and underlined text to denote new language. For users of the jaws screenreader it is recommended to configure jaws to use the proofreading scheme which will alter the pitch of the reading voice when reading stricken and underlined text. Instructions for configuring your jaws reader are provided by following this link.
If you can not or do not wish to configure your screen reader, deleted language will begin with the phrase "deleted text begin" and be followed by the phrase "deleted text end", new language will begin with the phrase "new text begin" and be followed by "new text end". Skip to text of HF 3138.

Menu

Revisor of Statutes Menu

HF 3138

3rd Engrossment - 90th Legislature (2017 - 2018) Posted on 05/02/2018 08:41am

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

Pdf

Rtf

Version List Authors and Status

A bill for an act
relating to state government finance; modifying provisions governing Department
of Health and public health, health care, chemical and mental health, opioids and
prescription drugs, community supports and continuing care, protections for older
adults and vulnerable adults, children and families, health licensing boards, and
MNsure; establishing the Vulnerable Adult Maltreatment Prevention and
Accountability Act; modifying requirements for data sharing and data
classifications; modifying a criminal penalty; establishing working groups;
establishing prescription drug repository program; entering into nurse licensure
compact; establishing a supplemental budget for transportation activities; modifying
various provisions governing transportation policy and finance; providing for
rulemaking; requiring reports; modifying fees; making forecast adjustments;
appropriating money; authorizing the sale and issuance of state bonds; amending
Minnesota Statutes 2016, sections 8.31, subdivision 1; 13.461, by adding a
subdivision; 13.6905, subdivision 3; 13.72, subdivision 10; 13.83, subdivision 2;
13.851, by adding a subdivision; 62A.30, by adding a subdivision; 62A.65,
subdivision 7; 62D.12, by adding a subdivision; 62Q.55, subdivision 5; 62V.05,
subdivisions 2, 5, 10; 103I.205, subdivision 9; 103I.301, subdivision 6; 119B.011,
by adding a subdivision; 119B.02, subdivision 7; 119B.03, subdivision 9; 144.057,
subdivision 1; 144.121, subdivision 1a, by adding a subdivision; 144.1501,
subdivisions 1, 3; 144.1506, subdivision 2; 144.608, subdivision 1; 144.6501,
subdivision 3, by adding a subdivision; 144.651, subdivisions 1, 2, 4, 14, 16, 20,
21; 144A.10, subdivision 1; 144A.26; 144A.43, subdivisions 11, 27, 30, by adding
a subdivision; 144A.44, subdivision 1; 144A.442; 144A.45, subdivisions 1, 2;
144A.472, subdivision 5; 144A.473; 144A.474, subdivisions 2, 8, 9; 144A.475,
subdivisions 1, 2, 5; 144A.476, subdivision 1; 144A.479, subdivision 7, by adding
a subdivision; 144A.4791, subdivisions 1, 3, 6, 7, 8, 9, 10, 13; 144A.4792,
subdivisions 1, 2, 5, 10; 144A.4793, subdivision 6; 144A.4797, subdivision 3;
144A.4798; 144A.4799, subdivision 1; 144A.484, subdivision 1; 144A.53,
subdivisions 1, 4, by adding subdivisions; 144D.01, subdivision 1; 144D.02;
144D.04, by adding a subdivision; 144E.16, by adding subdivisions; 144G.01,
subdivision 1; 145.56, subdivision 2; 145.928, subdivisions 1, 7; 146B.03, by
adding a subdivision; 147A.08; 148.512, subdivision 17a; 148.513, subdivisions
1, 2, by adding a subdivision; 148.515, subdivision 1; 148.516; 148.519, by adding
a subdivision; 148.5192, subdivision 1; 148.5193, by adding a subdivision;
148.5194, subdivision 8, by adding a subdivision; 148.5195, subdivision 3;
148.5196, subdivision 3; 148.59; 148.995, subdivision 2; 148E.180; 149A.40,
subdivision 11; 149A.95, subdivision 3; 150A.06, subdivision 1a, by adding
subdivisions; 150A.091, by adding subdivisions; 151.071, subdivision 2; 151.15,
by adding subdivisions; 151.19, subdivision 1; 151.214, subdivision 2; 151.46;
151.71, by adding a subdivision; 152.11, by adding a subdivision; 160.263,
subdivision 2; 160.295, subdivision 5; 161.115, subdivision 111; 161.14, by adding
subdivisions; 161.32, subdivision 2; 168.10, subdivision 1h; 168.101, subdivision
2a; 168.127, subdivision 6; 168.326; 168.33, by adding a subdivision; 168.345,
subdivision 2; 168A.02, subdivision 1; 168A.151, subdivision 1; 168A.29,
subdivision 1; 169.011, subdivisions 5, 9, 60; 169.06, subdivision 4a; 169.18,
subdivision 3; 169.222, subdivisions 1, 4; 169.26, subdivision 1; 169.28; 169.29;
169.345, subdivision 2; 169.442, by adding a subdivision; 169.448, subdivision
1; 169.4503, subdivisions 5, 13, by adding a subdivision; 169.475, subdivisions
2, 3; 169.55, subdivision 1; 169.57, subdivision 3; 169.64, subdivision 3, by adding
a subdivision; 169.81, by adding a subdivision; 169.8261, subdivision 2; 169.829,
by adding a subdivision; 169.87, subdivision 6; 169.974, subdivision 2; 174.66;
214.075, subdivisions 1, 4, 5, 6; 214.077; 214.10, subdivision 8; 214.12, by adding
a subdivision; 221.031, subdivision 2d, by adding a subdivision; 221.0314,
subdivision 9; 221.036, subdivisions 1, 3; 221.122, subdivision 1; 221.161,
subdivision 1, by adding a subdivision; 221.171, subdivision 1; 222.46; 222.50,
subdivisions 3, 4; 222.52; 222.57; 222.63, subdivision 8; 243.166, subdivision 4b;
245A.04, subdivision 7, by adding a subdivision; 245C.22, subdivision 4; 245D.071,
subdivision 5; 245D.091, subdivisions 2, 3, 4; 254B.02, subdivision 1; 256.01, by
adding a subdivision; 256.014, subdivision 2; 256.975, subdivision 7b; 256B.0575,
subdivision 1; 256B.0595, subdivision 3; 256B.0625, subdivisions 2, 18d, 30, by
adding subdivisions; 256B.0659, subdivisions 11, 21, 24, 28, by adding a
subdivision; 256B.4914, subdivision 4; 256B.5012, by adding a subdivision;
256B.69, subdivision 5a; 256K.45, subdivision 2; 256M.41, subdivision 3; 256R.53,
subdivision 2; 259.24, subdivision 2; 299A.705; 325F.71; 360.013, by adding a
subdivision; 360.017, subdivision 1; 360.021, subdivision 1; 360.024; 360.062;
360.063, subdivisions 1, 3; 360.064, subdivision 1; 360.065, subdivision 1; 360.066,
subdivision 1; 360.067, by adding a subdivision; 360.071, subdivision 2; 360.305,
subdivision 6; 394.22, by adding a subdivision; 394.23; 394.231; 394.25,
subdivision 3; 462.352, by adding a subdivision; 462.355, subdivision 1; 462.357,
subdivision 9, by adding a subdivision; 473.13, by adding subdivisions; 473.386,
subdivision 3, by adding a subdivision; 473.4051, subdivision 3; 473.606,
subdivision 5; 518A.32, subdivision 3; 518A.685; 574.26, subdivision 1a; 609.2231,
subdivision 8; 609.594, subdivision 2; 609.6055, subdivision 2; 626.557,
subdivisions 3, 4, 9, 9a, 9b, 9c, 9d, 10b, 12b, 14, 17; 626.5572, subdivision 6;
641.15, subdivision 3a; Minnesota Statutes 2017 Supplement, sections 3.972,
subdivision 4; 13.69, subdivision 1; 62D.02, subdivision 4; 62D.03, subdivision
1; 62D.05, subdivision 1; 62D.06, subdivision 1; 62D.19; 62E.02, subdivision 3;
103I.005, subdivisions 2, 8a, 17a; 103I.205, subdivisions 1, 4; 103I.208, subdivision
1; 103I.235, subdivision 3; 103I.601, subdivision 4; 119B.011, subdivision 20;
119B.025, subdivision 1; 119B.095, by adding a subdivision; 119B.13, subdivision
1; 144.1501, subdivision 2; 144A.10, subdivision 4; 144A.472, subdivision 7;
144A.474, subdivision 11; 144A.4796, subdivision 2; 144A.4799, subdivision 3;
144D.04, subdivision 2; 144H.01, subdivision 5; 144H.04, subdivision 1; 144H.06;
144H.08; 148.519, subdivision 1; 148.5193, subdivision 1; 148.5196, subdivision
1; 152.105, subdivision 2; 160.02, subdivision 1a; 169.442, subdivision 5; 169.64,
subdivision 8; 169.829, subdivision 4; 245A.03, subdivision 7; 245A.06,
subdivision 8; 245A.11, subdivision 2a; 245A.41, subdivision 3; 245A.50,
subdivision 7; 245A.51, subdivision 3; 245C.22, subdivision 5; 245D.03,
subdivision 1; 245G.03, subdivision 1; 245G.22, subdivision 2; 254A.03,
subdivision 3; 254B.03, subdivision 2; 256.045, subdivisions 3, 4; 256B.0625,
subdivisions 3b, 56a; 256B.0921; 256B.4914, subdivisions 2, 3, 5, 6, 7, 8, 9, 10,
10a; 260C.007, subdivision 6; 364.09; 473.4051, subdivision 2; Laws 2014, chapter
312, article 11, section 38, subdivisions 5, 6; article 27, section 76; Laws 2017,
First Special Session chapter 3, article 1, sections 2, subdivision 2; 4, subdivisions
1, 2; Laws 2017, First Special Session chapter 6, article 3, section 49; article 8,
sections 71; 72; 74; article 18, sections 3, subdivision 2; 16, subdivision 2;
proposing coding for new law in Minnesota Statutes, chapters 62Q; 137; 144;
144D; 144G; 148; 151; 161; 168; 174; 222; 245A; 256; 256B; 256K; 260C; 299A;
360; 604; repealing Minnesota Statutes 2016, sections 62A.65, subdivision 7a;
144A.45, subdivision 6; 144A.481; 151.55; 168.013, subdivision 21; 214.075,
subdivision 8; 221.161, subdivisions 2, 3, 4; 222.47; 222.50, subdivisions 1, 7;
222.51; 256.021; 256B.0705; 360.063, subdivision 4; 360.065, subdivision 2;
360.066, subdivisions 1a, 1b; Minnesota Statutes 2017 Supplement, sections
146B.02, subdivision 7a; 222.49; 222.50, subdivision 6.

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


ARTICLE 1

DEPARTMENT OF HEALTH AND PUBLIC HEALTH

Section 1.

Minnesota Statutes 2017 Supplement, section 62D.02, subdivision 4, is amended
to read:


Subd. 4.

Health maintenance organization.

"Health maintenance organization" means
a foreign or domestic nonprofit corporation organized under chapter 317A, or a local
governmental unit as defined in subdivision 11, controlled and operated as provided in
sections 62D.01 to 62D.30, which provides, either directly or through arrangements with
providers or other persons, comprehensive health maintenance services, or arranges for the
provision of these services, to enrollees on the basis of a fixed prepaid sum without regard
to the frequency or extent of services furnished to any particular enrollee.

EFFECTIVE DATE.

This section is effective contingent upon certification by the
legislative auditor under section 99, that the criteria in clause (2) of that section are satisfied,
but no earlier than January 1, 2019.

Sec. 2.

Minnesota Statutes 2017 Supplement, section 62D.03, subdivision 1, is amended
to read:


Subdivision 1.

Certificate of authority required.

Notwithstanding any law of this state
to the contrary, any foreign or domestic nonprofit corporation organized to do so or a local
governmental unit may apply to the commissioner of health for a certificate of authority to
establish and operate a health maintenance organization in compliance with sections 62D.01
to 62D.30. No person shall establish or operate a health maintenance organization in this
state, nor sell or offer to sell, or solicit offers to purchase or receive advance or periodic
consideration in conjunction with a health maintenance organization or health maintenance
contract unless the organization has a certificate of authority under sections 62D.01 to
62D.30.

EFFECTIVE DATE.

This section is effective contingent upon certification by the
legislative auditor under section 99, that the criteria in clause (2) of that section are satisfied,
but no earlier than January 1, 2019.

Sec. 3.

Minnesota Statutes 2017 Supplement, section 62D.05, subdivision 1, is amended
to read:


Subdivision 1.

Authority granted.

Any nonprofit corporation or local governmental
unit may, upon obtaining a certificate of authority as required in sections 62D.01 to 62D.30,
operate as a health maintenance organization.

EFFECTIVE DATE.

This section is effective contingent upon certification by the
legislative auditor under section 99, that the criteria in clause (2) of that section are satisfied,
but no earlier than January 1, 2019.

Sec. 4.

Minnesota Statutes 2017 Supplement, section 62D.06, subdivision 1, is amended
to read:


Subdivision 1.

Governing body composition; enrollee advisory body.

The governing
body of any health maintenance organization which is a nonprofit corporation may include
enrollees, providers, or other individuals; provided, however, that after a health maintenance
organization which is a nonprofit corporation has been authorized under sections 62D.01
to 62D.30 for one year, at least 40 percent of the governing body shall be composed of
enrollees and members elected by the enrollees and members from among the enrollees and
members. For purposes of this section, "member" means a consumer who receives health
care services through a self-insured contract that is administered by the health maintenance
organization or its related third-party administrator. The number of members elected to the
governing body shall not exceed the number of enrollees elected to the governing body. An
enrollee or member elected to the governing board may not be a person:

(1) whose occupation involves, or before retirement involved, the administration of
health activities or the provision of health services;

(2) who is or was employed by a health care facility as a licensed health professional;
or

(3) who has or had a direct substantial financial or managerial interest in the rendering
of a health service, other than the payment of a reasonable expense reimbursement or
compensation as a member of the board of a health maintenance organization.

After a health maintenance organization which is a local governmental unit has been
authorized under sections 62D.01 to 62D.30 for one year, an enrollee advisory body shall
be established. The enrollees who make up this advisory body shall be elected by the enrollees
from among the enrollees.

EFFECTIVE DATE.

This section is effective contingent upon certification by the
legislative auditor under section 99, that the criteria in clause (2) of that section are satisfied,
but no earlier than January 1, 2019.

Sec. 5.

Minnesota Statutes 2016, section 62D.12, is amended by adding a subdivision to
read:


Subd. 8a.

Net earnings.

All net earnings of the nonprofit health maintenance organization
shall be devoted to the nonprofit purposes of the health maintenance organization in providing
comprehensive health care. No health maintenance organization shall provide for the
payment, whether directly or indirectly, of any part of its net earnings, to any person as a
dividend or rebate; provided, however, that the health maintenance organizations may make
payments to providers or other persons based upon the efficient provision of services or as
incentives to provide quality care. The commissioner of health shall, pursuant to sections
62D.01 to 62D.30, revoke the certificate of authority of any health maintenance organization
in violation of this subdivision.

EFFECTIVE DATE.

This section is effective contingent upon certification by the
legislative auditor under section 99, that the criteria in clause (2) of that section are satisfied,
and shall become effective the day following that certification by the legislative auditor.

Sec. 6.

Minnesota Statutes 2017 Supplement, section 62D.19, is amended to read:


62D.19 UNREASONABLE EXPENSES.

No health maintenance organization shall incur or pay for any expense of any nature
which is unreasonably high in relation to the value of the service or goods provided. The
commissioner of health shall implement and enforce this section by rules adopted under
this section.

In an effort to achieve the stated purposes of sections 62D.01 to 62D.30 ; in order to
safeguard the underlying nonprofit status of health maintenance organizations;
and to ensure
that the payment of health maintenance organization money to major participating entities
results in a corresponding benefit to the health maintenance organization and its enrollees,
when determining whether an organization has incurred an unreasonable expense in relation
to a major participating entity, due consideration shall be given to, in addition to any other
appropriate factors, whether the officers and trustees of the health maintenance organization
have acted with good faith and in the best interests of the health maintenance organization
in entering into, and performing under, a contract under which the health maintenance
organization has incurred an expense. The commissioner has standing to sue, on behalf of
a health maintenance organization, officers or trustees of the health maintenance organization
who have breached their fiduciary duty in entering into and performing such contracts.

EFFECTIVE DATE.

This section is effective contingent upon certification by the
legislative auditor under section 99, that the criteria in clause (2) of that section are satisfied,
but no earlier than January 1, 2019.

Sec. 7.

Minnesota Statutes 2017 Supplement, section 62E.02, subdivision 3, is amended
to read:


Subd. 3.

Health maintenance organization.

"Health maintenance organization" means
a nonprofit corporation licensed and operated as provided in chapter 62D.

EFFECTIVE DATE.

This section is effective contingent upon certification by the
legislative auditor under section 99, that the criteria in clause (2) of that section are satisfied,
but no earlier than January 1, 2019.

Sec. 8.

Minnesota Statutes 2017 Supplement, section 103I.005, subdivision 2, is amended
to read:


Subd. 2.

Boring.

"Boring" means a hole or excavation that is not used to extract water
and includes exploratory borings, bored geothermal heat exchangers, temporary borings,
and elevator borings.

Sec. 9.

Minnesota Statutes 2017 Supplement, section 103I.005, subdivision 8a, is amended
to read:


Subd. 8a.

Environmental well.

"Environmental well" means an excavation 15 or more
feet in depth that is drilled, cored, bored, washed, driven, dug, jetted, or otherwise constructed
to:

(1) conduct physical, chemical, or biological testing of groundwater, and includes a
groundwater quality monitoring or sampling well;

(2) lower a groundwater level to control or remove contamination in groundwater, and
includes a remedial well and excludes horizontal trenches; or

(3) monitor or measure physical, chemical, radiological, or biological parameters of the
earth and earth fluids, or for vapor recovery or venting systems. An environmental well
includes an excavation used to:

(i) measure groundwater levels, including a piezometer;

(ii) determine groundwater flow direction or velocity;

(iii) measure earth properties such as hydraulic conductivity, bearing capacity, or
resistance;

(iv) obtain samples of geologic materials for testing or classification; or

(v) remove or remediate pollution or contamination from groundwater or soil through
the use of a vent, vapor recovery system, or sparge point.

An environmental well does not include an exploratory boring.

Sec. 10.

Minnesota Statutes 2017 Supplement, section 103I.005, subdivision 17a, is
amended to read:


Subd. 17a.

Temporary environmental well boring.

"Temporary environmental well"
means an environmental well as defined in section 103I.005, subdivision 8a, that is sealed
within 72 hours of the time construction on the well begins.
"Temporary boring" means an
excavation that is 15 feet or more in depth that is sealed within 72 hours of the start of
construction and is drilled, cored, washed, driven, dug, jetted, or otherwise constructed to:

(1) conduct physical, chemical, or biological testing of groundwater, including
groundwater quality monitoring;

(2) monitor or measure physical, chemical, radiological, or biological parameters of
earth materials or earth fluids, including hydraulic conductivity, bearing capacity, or
resistance;

(3) measure groundwater levels, including use of a piezometer;

(4) determine groundwater flow direction or velocity; or

(5) collect samples of geologic materials for testing or classification, or soil vapors for
testing or extraction.

Sec. 11.

Minnesota Statutes 2017 Supplement, section 103I.205, subdivision 1, is amended
to read:


Subdivision 1.

Notification required.

(a) Except as provided in paragraph (d), a person
may not construct a water-supply, dewatering, or environmental well until a notification of
the proposed well on a form prescribed by the commissioner is filed with the commissioner
with the filing fee in section 103I.208, and, when applicable, the person has met the
requirements of paragraph (e). If after filing the well notification an attempt to construct a
well is unsuccessful, a new notification is not required unless the information relating to
the successful well has substantially changed. A notification is not required prior to
construction of a temporary environmental well boring.

(b) The property owner, the property owner's agent, or the licensed contractor where a
well is to be located must file the well notification with the commissioner.

(c) The well notification under this subdivision preempts local permits and notifications,
and counties or home rule charter or statutory cities may not require a permit or notification
for wells unless the commissioner has delegated the permitting or notification authority
under section 103I.111.

(d) A person who is an individual that constructs a drive point water-supply well on
property owned or leased by the individual for farming or agricultural purposes or as the
individual's place of abode must notify the commissioner of the installation and location of
the well. The person must complete the notification form prescribed by the commissioner
and mail it to the commissioner by ten days after the well is completed. A fee may not be
charged for the notification. A person who sells drive point wells at retail must provide
buyers with notification forms and informational materials including requirements regarding
wells, their location, construction, and disclosure. The commissioner must provide the
notification forms and informational materials to the sellers.

(e) When the operation of a well will require an appropriation permit from the
commissioner of natural resources, a person may not begin construction of the well until
the person submits the following information to the commissioner of natural resources:

(1) the location of the well;

(2) the formation or aquifer that will serve as the water source;

(3) the maximum daily, seasonal, and annual pumpage rates and volumes that will be
requested in the appropriation permit; and

(4) other information requested by the commissioner of natural resources that is necessary
to conduct the preliminary assessment required under section 103G.287, subdivision 1,
paragraph (c).

The person may begin construction after receiving preliminary approval from the
commissioner of natural resources.

Sec. 12.

Minnesota Statutes 2017 Supplement, section 103I.205, subdivision 4, is amended
to read:


Subd. 4.

License required.

(a) Except as provided in paragraph (b), (c), (d), or (e),
section 103I.401, subdivision 2, or 103I.601, subdivision 2, a person may not drill, construct,
repair, or seal a well or boring unless the person has a well contractor's license in possession.

(b) A person may construct, repair, and seal an environmental well or temporary boring
if the person:

(1) is a professional engineer licensed under sections 326.02 to 326.15 in the branches
of civil or geological engineering;

(2) is a hydrologist or hydrogeologist certified by the American Institute of Hydrology;

(3) is a professional geoscientist licensed under sections 326.02 to 326.15;

(4) is a geologist certified by the American Institute of Professional Geologists; or

(5) meets the qualifications established by the commissioner in rule.

A person must be licensed by the commissioner as an environmental well contractor on
forms provided by the commissioner.

(c) A person may do the following work with a limited well/boring contractor's license
in possession. A separate license is required for each of the four activities:

(1) installing, repairing, and modifying well screens, pitless units and pitless adaptors,
well pumps and pumping equipment, and well casings from the pitless adaptor or pitless
unit to the upper termination of the well casing;

(2) sealing wells and borings;

(3) constructing, repairing, and sealing dewatering wells; or

(4) constructing, repairing, and sealing bored geothermal heat exchangers.

(d) A person may construct, repair, and seal an elevator boring with an elevator boring
contractor's license.

(e) Notwithstanding other provisions of this chapter requiring a license, a license is not
required for a person who complies with the other provisions of this chapter if the person
is:

(1) an individual who constructs a water-supply well on land that is owned or leased by
the individual and is used by the individual for farming or agricultural purposes or as the
individual's place of abode; or

(2) an individual who performs labor or services for a contractor licensed under the
provisions of this chapter in connection with the construction, sealing, or repair of a well
or boring at the direction and under the personal supervision of a contractor licensed under
the provisions of this chapter; or .

(3) a licensed plumber who is repairing submersible pumps or water pipes associated
with well water systems if: (i) the repair location is within an area where there is no licensed
well contractor within 50 miles, and (ii) the licensed plumber complies with all relevant
sections of the plumbing code.

Sec. 13.

Minnesota Statutes 2016, section 103I.205, subdivision 9, is amended to read:


Subd. 9.

Report of work.

Within 30 60 days after completion or sealing of a well or
boring, the person doing the work must submit a verified report to the commissioner
containing the information specified by rules adopted under this chapter.

Within 30 days after receiving the report, the commissioner shall send or otherwise
provide access to a copy of the report to the commissioner of natural resources, to the local
soil and water conservation district where the well is located, and to the director of the
Minnesota Geological Survey.

Sec. 14.

Minnesota Statutes 2017 Supplement, section 103I.208, subdivision 1, is amended
to read:


Subdivision 1.

Well notification fee.

The well notification fee to be paid by a property
owner is:

(1) for construction of a water supply well, $275, which includes the state core function
fee;

(2) for a well sealing, $75 for each well or boring, which includes the state core function
fee, except that a single fee of $75 is required for all temporary environmental wells borings
recorded on the sealing notification for a single property, having depths within a 25 foot
range, and
sealed within 72 hours of start of construction, except that temporary borings
less than 25 feet in depth are exempt from the notification and fee requirements in this
chapter
;

(3) for construction of a dewatering well, $275, which includes the state core function
fee, for each dewatering well except a dewatering project comprising five or more dewatering
wells shall be assessed a single fee of $1,375 for the dewatering wells recorded on the
notification; and

(4) for construction of an environmental well, $275, which includes the state core function
fee, except that a single fee of $275 is required for all environmental wells recorded on the
notification that are located on a single property, and except that no fee is required for
construction of a temporary environmental well boring.

Sec. 15.

Minnesota Statutes 2017 Supplement, section 103I.235, subdivision 3, is amended
to read:


Subd. 3.

Temporary environmental well boring and unsuccessful well exemption.

This section does not apply to temporary environmental wells borings or unsuccessful wells
that have been sealed by a licensed contractor in compliance with this chapter.

Sec. 16.

Minnesota Statutes 2016, section 103I.301, subdivision 6, is amended to read:


Subd. 6.

Notification required.

A person may not seal a well or boring until a notification
of the proposed sealing is filed as prescribed by the commissioner. Temporary borings less
than 25 feet in depth are exempt from the notification requirements in this chapter.

Sec. 17.

Minnesota Statutes 2017 Supplement, section 103I.601, subdivision 4, is amended
to read:


Subd. 4.

Notification and map of borings.

(a) By ten days before beginning exploratory
boring, an explorer must submit to the commissioner of health a notification of the proposed
boring on a form prescribed by the commissioner, map and a fee of $275 for each exploratory
boring
.

(b) By ten days before beginning exploratory boring, an explorer must submit to the
commissioners of health and natural resources a county road map on a single sheet of paper
that is eight and one-half by 11 inches in size and
having a scale of one-half inch equal to
one mile, as prepared by the Department of Transportation, or a 7.5 minute series topographic
map (1:24,000 scale), as prepared by the United States Geological Survey, showing the
location of each proposed exploratory boring to the nearest estimated 40 acre parcel.
Exploratory boring that is proposed on the map may not be commenced later than 180 days
after submission of the map, unless a new map is submitted.

Sec. 18.

[137.68] ADVISORY COUNCIL ON RARE DISEASES.

Subdivision 1.

Establishment.

The Board of Regents of the University of Minnesota is
requested to establish an advisory council on rare diseases to provide advice on research,
diagnosis, treatment, and education related to rare diseases. For purposes of this section,
"rare disease" has the meaning given in United States Code, title 21, section 360bb. The
council shall be called the Chloe Barnes Advisory Council on Rare Diseases.

Subd. 2.

Membership.

(a) The advisory council may consist of public members appointed
by the Board of Regents or a designee according to paragraph (b) and four members of the
legislature appointed according to paragraph (c).

(b) The Board of Regents or a designee is requested to appoint the following public
members:

(1) three physicians licensed and practicing in the state with experience researching,
diagnosing, or treating rare diseases;

(2) one registered nurse or advanced practice registered nurse licensed and practicing
in the state with experience treating rare diseases;

(3) at least two hospital administrators, or their designees, from hospitals in the state
that provide care to persons diagnosed with a rare disease. One administrator or designee
appointed under this clause must represent a hospital in which the scope of service focuses
on rare diseases of pediatric patients;

(4) three persons age 18 or older who either have a rare disease or are a caregiver of a
person with a rare disease;

(5) a representative of a rare disease patient organization that operates in the state;

(6) a social worker with experience providing services to persons diagnosed with a rare
disease;

(7) a pharmacist with experience with drugs used to treat rare diseases;

(8) a dentist licensed and practicing in the state with experience treating rare diseases;

(9) a representative of the biotechnology industry;

(10) a representative of health plan companies;

(11) a medical researcher with experience conducting research on rare diseases;

(12) a genetic counselor with experience providing services to persons diagnosed with
a rare disease or caregivers of those persons; and

(13) other public members, who may serve on an ad hoc basis.

(c) The advisory council shall include two members of the senate, one appointed by the
majority leader and one appointed by the minority leader; and two members of the house
of representatives, one appointed by the speaker of the house and one appointed by the
minority leader.

(d) The commissioner of health or a designee, a representative of Mayo Medical School,
and a representative of the University of Minnesota Medical School, shall serve as ex officio,
nonvoting members of the advisory council.

(e) Initial appointments to the advisory council shall be made no later than July 1, 2018.
Members appointed according to paragraph (b) shall serve for a term of three years, except
that the initial members appointed according to paragraph (b) shall have an initial term of
two, three, or four years determined by lot by the chairperson. Members appointed according
to paragraph (b) shall serve until their successors have been appointed.

Subd. 3.

Meetings.

The Board of Regents or a designee is requested to convene the first
meeting of the advisory council no later than September 1, 2018. The advisory council shall
meet at the call of the chairperson or at the request of a majority of advisory council members.

Subd. 4.

Duties.

The advisory council's duties may include, but are not limited to:

(1) in conjunction with the state's medical schools, the state's schools of public health,
and hospitals in the state that provide care to persons diagnosed with a rare disease,
developing resources or recommendations relating to quality of and access to treatment and
services in the state for persons with a rare disease, including but not limited to:

(i) a list of existing, publicly accessible resources on research, diagnosis, treatment, and
education relating to rare diseases;

(ii) identifying best practices for rare disease care implemented in other states, at the
national level, and at the international level, that will improve rare disease care in the state
and seeking opportunities to partner with similar organizations in other states and countries;

(iii) identifying problems faced by patients with a rare disease when changing health
plans, including recommendations on how to remove obstacles faced by these patients to
finding a new health plan and how to improve the ease and speed of finding a new health
plan that meets the needs of patients with a rare disease; and

(iv) identifying best practices to ensure health care providers are adequately informed
of the most effective strategies for recognizing and treating rare diseases; and

(2) advising, consulting, and cooperating with the Department of Health, the Advisory
Committee on Heritable and Congenital Disorders, and other agencies of state government
in developing information and programs for the public and the health care community
relating to diagnosis, treatment, and awareness of rare diseases.

Subd. 5.

Conflict of interest.

Advisory council members are subject to the Board of
Regents policy on conflicts of interest.

Subd. 6.

Annual report.

By January 1 of each year, beginning January 1, 2019, the
advisory council shall report to the chairs and ranking minority members of the legislative
committees with jurisdiction over higher education and health care policy on the advisory
council's activities under subdivision 4 and other issues on which the advisory council may
choose to report.

EFFECTIVE DATE.

This section is effective the day following final enactment.

Sec. 19.

Minnesota Statutes 2016, section 144.057, subdivision 1, is amended to read:


Subdivision 1.

Background studies required.

The commissioner of health shall contract
with the commissioner of human services to conduct background studies of:

(1) individuals providing services which have direct contact, as defined under section
245C.02, subdivision 11, with patients and residents in hospitals, boarding care homes,
outpatient surgical centers licensed under sections 144.50 to 144.58; nursing homes and
home care agencies licensed under chapter 144A; residential care homes licensed under
chapter 144B,
and board and lodging establishments that are registered to provide supportive
or health supervision services under section 157.17;

(2) individuals specified in section 245C.03, subdivision 1, who perform direct contact
services in a nursing home or a home care agency licensed under chapter 144A or a boarding
care home licensed under sections 144.50 to 144.58. If the individual under study resides
outside Minnesota, the study must include a check for substantiated findings of maltreatment
of adults and children in the individual's state of residence when the information is made
available by that state, and must include a check of the National Crime Information Center
database;

(3) beginning July 1, 1999, all other employees in nursing homes licensed under chapter
144A, and boarding care homes licensed under sections 144.50 to 144.58. A disqualification
of an individual in this section shall disqualify the individual from positions allowing direct
contact or access to patients or residents receiving services. "Access" means physical access
to a client or the client's personal property without continuous, direct supervision as defined
in section 245C.02, subdivision 8, when the employee's employment responsibilities do not
include providing direct contact services;

(4) individuals employed by a supplemental nursing services agency, as defined under
section 144A.70, who are providing services in health care facilities; and

(5) controlling persons of a supplemental nursing services agency, as defined under
section 144A.70 ; and

(6) individuals providing services who have direct contact, as defined under section
245C.02, subdivision 11, with medically complex or technologically dependent children at
a prescribed pediatric extended care center licensed under chapter 144H
.

If a facility or program is licensed by the Department of Human Services and subject to
the background study provisions of chapter 245C and is also licensed by the Department
of Health, the Department of Human Services is solely responsible for the background
studies of individuals in the jointly licensed programs.

Sec. 20.

[144.064] THE VIVIAN ACT.

Subdivision 1.

Short title.

This section shall be known and may be cited as the "Vivian
Act."

Subd. 2.

Definitions.

For purposes of this section, the following terms have the meanings
given them:

(1) "commissioner" means the commissioner of health;

(2) "health care practitioner" means a medical professional that provides prenatal or
postnatal care;

(3) "CMV" means the human herpesvirus cytomegalovirus, also called HCMV, human
herpesvirus 5, and HHV-5; and

(4) "congenital CMV" means the transmission of a CMV infection from a pregnant
mother to her fetus.

Subd. 3.

Commissioner duties.

(a) The commissioner shall make available to health
care practitioners and women who may become pregnant, expectant parents, and parents
of infants up-to-date and evidence-based information about congenital CMV that has been
reviewed by experts with knowledge of the disease. The information shall include the
following:

(1) the recommendation to consider testing for congenital CMV in babies who did not
pass their newborn hearing screen or in which a pregnancy history suggests increased risk
for congenital CMV infection;

(2) the incidence of CMV;

(3) the transmission of CMV to pregnant women and women who may become pregnant;

(4) birth defects caused by congenital CMV;

(5) available preventative measures to avoid the infection of women who are pregnant
or may become pregnant; and

(6) resources available for families of children born with congenital CMV.

(b) The commissioner shall follow existing department practice, inclusive of community
engagement, to ensure that the information in paragraph (a) is culturally and linguistically
appropriate for all recipients.

(c) The department shall establish an outreach program to:

(1) educate women who may become pregnant, expectant parents, and parents of infants
about CMV; and

(2) raise awareness for CMV among health care providers who provide care to expectant
mothers or infants.

Sec. 21.

Minnesota Statutes 2016, section 144.121, subdivision 1a, is amended to read:


Subd. 1a.

Fees for ionizing radiation-producing equipment.

(a) A facility with ionizing
radiation-producing equipment must pay an annual initial or annual renewal registration
fee consisting of a base facility fee of $100 and an additional fee for each radiation source,
as follows:

(1)
medical or veterinary equipment
$
100
(2)
dental x-ray equipment
$
40
(3)
x-ray equipment not used on
humans or animals
$
100
(4)
devices with sources of ionizing
radiation not used on humans or
animals
$
100
(5)
security screening system
$
100

(b) A facility with radiation therapy and accelerator equipment must pay an annual
registration fee of $500. A facility with an industrial accelerator must pay an annual
registration fee of $150.

(c) Electron microscopy equipment is exempt from the registration fee requirements of
this section.

(d) For purposes of this section, a security screening system means radiation-producing
equipment designed and used for security screening of humans who are in custody of a
correctional or detention facility, and is used by the facility to image and identify contraband
items concealed within or on all sides of a human body. For purposes of this section, a
correctional or detention facility is a facility licensed by the commissioner of corrections
under section 241.021, and operated by a state agency or political subdivision charged with
detection, enforcement, or incarceration in respect to state criminal and traffic laws.

Sec. 22.

Minnesota Statutes 2016, section 144.121, is amended by adding a subdivision
to read:


Subd. 9.

Exemption from examination requirements; operators of security screening
systems.

(a) An employee of a correctional or detention facility who operates a security
screening system and the facility in which the system is being operated are exempt from
the requirements of subdivisions 5 and 6.

(b) An employee of a correctional or detention facility who operates a security screening
system and the facility in which the system is being operated must meet the requirements
of a variance to Minnesota Rules, parts 4732.0305 and 4732.0565, issued under Minnesota
Rules, parts 4717.7000 to 4717.7050. This paragraph expires on December 31 of the year
that the permanent rules adopted by the commissioner governing security screening systems
are published in the State Register.

EFFECTIVE DATE.

This section is effective 30 days following final enactment.

Sec. 23.

[144.131] ADVISORY COUNCIL ON PANDAS AND PANS.

Subdivision 1.

Advisory council established.

The commissioner of health shall establish
an advisory council on pediatric autoimmune neuropsychiatric disorders associated with
streptococcal infections (PANDAS) and pediatric acute-onset neuropsychiatric syndrome
(PANS) to advise the commissioner regarding research, diagnosis, treatment, and education
relating to PANDAS and PANS.

Subd. 2.

Membership.

(a) The advisory council shall consist of 14 public members
appointed according to paragraph (b) and two members of the legislature appointed according
to paragraph (c).

(b) The commissioner shall appoint the following public members to the advisory council
in the manner provided in section 15.0597:

(1) an immunologist who is licensed by the Board of Medical Practice and who has
experience treating PANS with the use of intravenous immunoglobulin;

(2) a health care provider who is licensed and practicing in Minnesota and who has
experience treating persons with PANS and autism spectrum disorder;

(3) a representative of a nonprofit PANS advocacy organization;

(4) a family practice physician who is licensed by the Board of Medical Practice and
practicing in Minnesota and who has experience treating persons with PANS;

(5) a medical researcher with experience conducting research on PANDAS, PANS,
obsessive-compulsive disorder, and other neurological disorders;

(6) a health care provider who is licensed and practicing in Minnesota and who has
expertise in treating patients with eating disorders;

(7) a representative of a professional organization in Minnesota for school psychologists
or school social workers;

(8) a child psychiatrist who is licensed by the Board of Medical Practice and practicing
in Minnesota and who has experience treating persons with PANS;

(9) a pediatrician who is licensed by the Board of Medical Practice and practicing in
Minnesota and who has experience treating persons with PANS;

(10) a representative of an organization focused on autism spectrum disorder;

(11) a parent of a child who has been diagnosed with PANS and autism spectrum disorder;

(12) a social worker licensed by the Board of Social Work and practicing in Minnesota;

(13) a designee of the commissioner of education with expertise in special education;
and

(14) a representative of health plan companies that offer health plans in the individual
or group markets.

(c) Legislative members shall be appointed to the advisory council as follows:

(1) the Subcommittee on Committees of the Committee on Rules and Administration
in the senate shall appoint one member from the senate; and

(2) the speaker of the house shall appoint one member from the house of representatives.

(d) The commissioner of health or a designee shall serve as a nonvoting member of the
advisory council.

Subd. 3.

Terms.

Members of the advisory council shall serve for a term of three years
and may be reappointed. Members shall serve until their successors have been appointed.

Subd. 4.

Administration.

The commissioner of health or the commissioner's designee
shall provide meeting space and administrative services for the advisory council.

Subd. 5.

Compensation and expenses.

Public members of the advisory council shall
not receive compensation but may be reimbursed for allowed actual and necessary expenses
incurred in the performance of the member's duties for the advisory council, in the same
manner and amount as authorized by the commissioner's plan adopted under section 43A.18,
subdivision 2.

Subd. 6.

Chair; meetings.

(a) At the advisory council's first meeting, and every two
years thereafter, the members of the advisory council shall elect from among their
membership a chair and a vice-chair, whose duties shall be established by the advisory
council.

(b) The chair of the advisory council shall fix a time and place for regular meetings. The
advisory council shall meet at least four times each year at the call of the chair or at the
request of a majority of the advisory council's members.

Subd. 7.

Duties.

The advisory council shall:

(1) advise the commissioner regarding research, diagnosis, treatment, and education
relating to PANDAS and PANS;

(2) annually develop recommendations on the following issues related to PANDAS and
PANS:

(i) practice guidelines for diagnosis and treatment;

(ii) ways to increase clinical awareness and education of PANDAS and PANS among
pediatricians, other physicians, school-based health centers, and providers of mental health
services;

(iii) outreach to educators and parents to increase awareness of PANDAS and PANS;
and

(iv) development of a network of volunteer experts on the diagnosis and treatment of
PANDAS and PANS to assist in education and research; and

(3) by October 1, 2019, and each October 1 thereafter, complete an annual report with
the advisory council's recommendations on the issues listed in clause (2), and submit the
report to the chairs and ranking minority members of the legislative committees with
jurisdiction over health care and education. The commissioner shall also post a copy of each
annual report on the Department of Health Web site.

Subd. 8.

Expiration.

The advisory council expires October 1, 2024.

Sec. 24.

Minnesota Statutes 2016, section 144.1501, subdivision 1, is amended to read:


Subdivision 1.

Definitions.

(a) For purposes of this section, the following definitions
apply.

(b) "Advanced dental therapist" means an individual who is licensed as a dental therapist
under section 150A.06, and who is certified as an advanced dental therapist under section
150A.106.

(c) "Alcohol and drug counselor" means an individual who is licensed as an alcohol and
drug counselor under chapter 148F.

(c) (d) "Dental therapist" means an individual who is licensed as a dental therapist under
section 150A.06.

(d) (e) "Dentist" means an individual who is licensed to practice dentistry.

(e) (f) "Designated rural area" means a statutory and home rule charter city or township
that is outside the seven-county metropolitan area as defined in section 473.121, subdivision
2, excluding the cities of Duluth, Mankato, Moorhead, Rochester, and St. Cloud.

(f) (g) "Emergency circumstances" means those conditions that make it impossible for
the participant to fulfill the service commitment, including death, total and permanent
disability, or temporary disability lasting more than two years.

(g) (h) "Mental health professional" means an individual providing clinical services in
the treatment of mental illness who is qualified in at least one of the ways specified in section
245.462, subdivision 18.

(h) (i) "Medical resident" means an individual participating in a medical residency in
family practice, internal medicine, obstetrics and gynecology, pediatrics, or psychiatry.

(i) (j) "Midlevel practitioner" means a nurse practitioner, nurse-midwife, nurse anesthetist,
advanced clinical nurse specialist, or physician assistant.

(j) (k) "Nurse" means an individual who has completed training and received all licensing
or certification necessary to perform duties as a licensed practical nurse or registered nurse.

(k) (l) "Nurse-midwife" means a registered nurse who has graduated from a program of
study designed to prepare registered nurses for advanced practice as nurse-midwives.

(l) (m) "Nurse practitioner" means a registered nurse who has graduated from a program
of study designed to prepare registered nurses for advanced practice as nurse practitioners.

(m) (n) "Pharmacist" means an individual with a valid license issued under chapter 151.

(n) (o) "Physician" means an individual who is licensed to practice medicine in the areas
of family practice, internal medicine, obstetrics and gynecology, pediatrics, or psychiatry.

(o) (p) "Physician assistant" means a person licensed under chapter 147A.

(p) (q) "Public health nurse" means a registered nurse licensed in Minnesota who has
obtained a registration certificate as a public health nurse from the Board of Nursing in
accordance with Minnesota Rules, chapter 6316.

(q) (r) "Qualified educational loan" means a government, commercial, or foundation
loan for actual costs paid for tuition, reasonable education expenses, and reasonable living
expenses related to the graduate or undergraduate education of a health care professional.

(r) (s) "Underserved urban community" means a Minnesota urban area or population
included in the list of designated primary medical care health professional shortage areas
(HPSAs), medically underserved areas (MUAs), or medically underserved populations
(MUPs) maintained and updated by the United States Department of Health and Human
Services.

Sec. 25.

Minnesota Statutes 2017 Supplement, section 144.1501, subdivision 2, is amended
to read:


Subd. 2.

Creation of account.

(a) A health professional education loan forgiveness
program account is established. The commissioner of health shall use money from the
account to establish a loan forgiveness program:

(1) for medical residents and mental health professionals agreeing to practice in designated
rural areas or underserved urban communities or specializing in the area of pediatric
psychiatry;

(2) for midlevel practitioners agreeing to practice in designated rural areas or to teach
at least 12 credit hours, or 720 hours per year in the nursing field in a postsecondary program
at the undergraduate level or the equivalent at the graduate level;

(3) for nurses who agree to practice in a Minnesota nursing home; an intermediate care
facility for persons with developmental disability; a hospital if the hospital owns and operates
a Minnesota nursing home and a minimum of 50 percent of the hours worked by the nurse
is in the nursing home; a housing with services establishment as defined in section 144D.01,
subdivision 4
; or for a home care provider as defined in section 144A.43, subdivision 4; or
agree to teach at least 12 credit hours, or 720 hours per year in the nursing field in a
postsecondary program at the undergraduate level or the equivalent at the graduate level;

(4) for other health care technicians agreeing to teach at least 12 credit hours, or 720
hours per year in their designated field in a postsecondary program at the undergraduate
level or the equivalent at the graduate level. The commissioner, in consultation with the
Healthcare Education-Industry Partnership, shall determine the health care fields where the
need is the greatest, including, but not limited to, respiratory therapy, clinical laboratory
technology, radiologic technology, and surgical technology;

(5) for pharmacists, advanced dental therapists, dental therapists, and public health
nurses, and alcohol and drug counselors who agree to practice in designated rural areas;
and

(6) for dentists agreeing to deliver at least 25 percent of the dentist's yearly patient
encounters to state public program enrollees or patients receiving sliding fee schedule
discounts through a formal sliding fee schedule meeting the standards established by the
United States Department of Health and Human Services under Code of Federal Regulations,
title 42, section 51, chapter 303.

(b) Appropriations made to the account do not cancel and are available until expended,
except that at the end of each biennium, any remaining balance in the account that is not
committed by contract and not needed to fulfill existing commitments shall cancel to the
fund.

Sec. 26.

Minnesota Statutes 2016, section 144.1501, subdivision 3, is amended to read:


Subd. 3.

Eligibility.

(a) To be eligible to participate in the loan forgiveness program, an
individual must:

(1) be a medical or dental resident; a licensed pharmacist; or be enrolled in a training or
education program to become a dentist, dental therapist, advanced dental therapist, mental
health professional, pharmacist, public health nurse, midlevel practitioner, registered nurse,
or a licensed practical nurse, or alcohol and drug counselor. The commissioner may also
consider applications submitted by graduates in eligible professions who are licensed and
in practice; and

(2) submit an application to the commissioner of health.

(b) An applicant selected to participate must sign a contract to agree to serve a minimum
three-year full-time service obligation according to subdivision 2, which shall begin no later
than March 31 following completion of required training, with the exception of a nurse,
who must agree to serve a minimum two-year full-time service obligation according to
subdivision 2, which shall begin no later than March 31 following completion of required
training.

Sec. 27.

Minnesota Statutes 2016, section 144.1506, subdivision 2, is amended to read:


Subd. 2.

Expansion grant program.

(a) The commissioner of health shall award primary
care residency expansion grants to eligible primary care residency programs to plan and
implement new residency slots. A planning grant shall not exceed $75,000, and a training
grant shall not exceed $150,000 per new residency slot for the first year, $100,000 for the
second year, and $50,000 for the third year of the new residency slot. For eligible residency
programs longer than three years, training grants may be awarded for the duration of the
residency, not exceeding an average of $100,000 per residency slot per year.

(b) Funds may be spent to cover the costs of:

(1) planning related to establishing an accredited primary care residency program;

(2) obtaining accreditation by the Accreditation Council for Graduate Medical Education
or another national body that accredits residency programs;

(3) establishing new residency programs or new resident training slots;

(4) recruitment, training, and retention of new residents and faculty;

(5) travel and lodging for new residents;

(6) faculty, new resident, and preceptor salaries related to new residency slots;

(7) training site improvements, fees, equipment, and supplies required for new primary
care resident training slots; and

(8) supporting clinical education in which trainees are part of a primary care team model.

Sec. 28.

[144.397] STATEWIDE TOBACCO CESSATION SERVICES.

(a) The commissioner of health shall administer, or contract for the administration of,
statewide tobacco cessation services to assist Minnesotans who are seeking advice or services
to help them quit using tobacco products. The commissioner shall establish statewide public
awareness activities to inform the public of the availability of the services and encourage
the public to utilize the services because of the dangers and harm of tobacco use and
dependence.

(b) Services to be provided may include, but are not limited to:

(1) telephone-based coaching and counseling;

(2) referrals;

(3) written materials mailed upon request;

(4) Web-based texting or e-mail services; and

(5) free Food and Drug Administration-approved tobacco cessation medications.

(c) Services provided must be consistent with evidence-based best practices in tobacco
cessation services. Services provided must be coordinated with employer, health plan
company, and private sector tobacco prevention and cessation services that may be available
to individuals depending on their employment or health coverage.

Sec. 29.

Minnesota Statutes 2016, section 144.608, subdivision 1, is amended to read:


Subdivision 1.

Trauma Advisory Council established.

(a) A Trauma Advisory Council
is established to advise, consult with, and make recommendations to the commissioner on
the development, maintenance, and improvement of a statewide trauma system.

(b) The council shall consist of the following members:

(1) a trauma surgeon certified by the American Board of Surgery or the American
Osteopathic Board of Surgery who practices in a level I or II trauma hospital;

(2) a general surgeon certified by the American Board of Surgery or the American
Osteopathic Board of Surgery whose practice includes trauma and who practices in a
designated rural area as defined under section 144.1501, subdivision 1, paragraph (e) (f);

(3) a neurosurgeon certified by the American Board of Neurological Surgery who
practices in a level I or II trauma hospital;

(4) a trauma program nurse manager or coordinator practicing in a level I or II trauma
hospital;

(5) an emergency physician certified by the American Board of Emergency Medicine
or the American Osteopathic Board of Emergency Medicine whose practice includes
emergency room care in a level I, II, III, or IV trauma hospital;

(6) a trauma program manager or coordinator who practices in a level III or IV trauma
hospital;

(7) a physician certified by the American Board of Family Medicine or the American
Osteopathic Board of Family Practice whose practice includes emergency department care
in a level III or IV trauma hospital located in a designated rural area as defined under section
144.1501, subdivision 1, paragraph (e) (f);

(8) a nurse practitioner, as defined under section 144.1501, subdivision 1, paragraph (l)
(m)
, or a physician assistant, as defined under section 144.1501, subdivision 1, paragraph
(o) (p), whose practice includes emergency room care in a level IV trauma hospital located
in a designated rural area as defined under section 144.1501, subdivision 1, paragraph (e)
(f)
;

(9) a physician certified in pediatric emergency medicine by the American Board of
Pediatrics or certified in pediatric emergency medicine by the American Board of Emergency
Medicine or certified by the American Osteopathic Board of Pediatrics whose practice
primarily includes emergency department medical care in a level I, II, III, or IV trauma
hospital, or a surgeon certified in pediatric surgery by the American Board of Surgery whose
practice involves the care of pediatric trauma patients in a trauma hospital;

(10) an orthopedic surgeon certified by the American Board of Orthopaedic Surgery or
the American Osteopathic Board of Orthopedic Surgery whose practice includes trauma
and who practices in a level I, II, or III trauma hospital;

(11) the state emergency medical services medical director appointed by the Emergency
Medical Services Regulatory Board;

(12) a hospital administrator of a level III or IV trauma hospital located in a designated
rural area as defined under section 144.1501, subdivision 1, paragraph (e) (f);

(13) a rehabilitation specialist whose practice includes rehabilitation of patients with
major trauma injuries or traumatic brain injuries and spinal cord injuries as defined under
section 144.661;

(14) an attendant or ambulance director who is an EMT, EMT-I, or EMT-P within the
meaning of section 144E.001 and who actively practices with a licensed ambulance service
in a primary service area located in a designated rural area as defined under section 144.1501,
subdivision 1
, paragraph (e) (f); and

(15) the commissioner of public safety or the commissioner's designee.

Sec. 30.

Minnesota Statutes 2016, section 144A.43, subdivision 11, is amended to read:


Subd. 11.

Medication administration.

"Medication administration" means performing
a set of tasks to ensure a client takes medications, and includes that include the following:

(1) checking the client's medication record;

(2) preparing the medication as necessary;

(3) administering the medication to the client;

(4) documenting the administration or reason for not administering the medication; and

(5) reporting to a registered nurse or appropriate licensed health professional any concerns
about the medication, the client, or the client's refusal to take the medication.

Sec. 31.

Minnesota Statutes 2016, section 144A.43, is amended by adding a subdivision
to read:


Subd. 12a.

Medication reconciliation.

"Medication reconciliation" means the process
of identifying the most accurate list of all medications the client is taking, including the
name, dosage, frequency, and route by comparing the client record to an external list of
medications obtained from the client, hospital, prescriber, or other provider.

Sec. 32.

Minnesota Statutes 2016, section 144A.43, subdivision 27, is amended to read:


Subd. 27.

Service plan agreement.

"Service plan agreement" means the written plan
agreement
between the client or client's representative and the temporary licensee or licensee
about the services that will be provided to the client.

Sec. 33.

Minnesota Statutes 2016, section 144A.43, subdivision 30, is amended to read:


Subd. 30.

Standby assistance.

"Standby assistance" means the presence of another
person within arm's reach to minimize the risk of injury while performing daily activities
through physical intervention or cuing
to assist a client with an assistive task by providing
cues, oversight, and minimal physical assistance
.

Sec. 34.

Minnesota Statutes 2016, section 144A.472, subdivision 5, is amended to read:


Subd. 5.

Transfers prohibited; Changes in ownership.

Any (a) A home care license
issued by the commissioner may not be transferred to another party. Before acquiring
ownership of or a controlling interest in a home care provider business, a prospective
applicant owner must apply for a new temporary license. A change of ownership is a transfer
of operational control to a different business entity of the home care provider business and
includes:

(1) transfer of the business to a different or new corporation;

(2) in the case of a partnership, the dissolution or termination of the partnership under
chapter 323A, with the business continuing by a successor partnership or other entity;

(3) relinquishment of control of the provider to another party, including to a contract
management firm that is not under the control of the owner of the business' assets;

(4) transfer of the business by a sole proprietor to another party or entity; or

(5) in the case of a privately held corporation, the change in transfer of ownership or
control of 50 percent or more of the outstanding voting stock controlling interest of a home
care provider business not covered by clauses (1) to (4)
.

(b) An employee who was employed by the previous owner of the home care provider
business prior to the effective date of a change in ownership under paragraph (a), and who
will be employed by the new owner in the same or a similar capacity, shall be treated as if
no change in employer occurred, with respect to orientation, training, tuberculosis testing,
background studies, and competency testing and training on the policies identified in
subdivision 1, clause (14), and subdivision 2, if applicable.

(c) Notwithstanding paragraph (b), a new owner of a home care provider business must
ensure that employees of the provider receive and complete training and testing on any
provisions of policies that differ from those of the previous owner, within 90 days after the
date of the change in ownership.

Sec. 35.

Minnesota Statutes 2017 Supplement, section 144A.472, subdivision 7, is amended
to read:


Subd. 7.

Fees; application, change of ownership, and renewal.

(a) An initial applicant
seeking temporary home care licensure must submit the following application fee to the
commissioner along with a completed application:

(1) for a basic home care provider, $2,100; or

(2) for a comprehensive home care provider, $4,200.

(b) A home care provider who is filing a change of ownership as required under
subdivision 5 must submit the following application fee to the commissioner, along with
the documentation required for the change of ownership:

(1) for a basic home care provider, $2,100; or

(2) for a comprehensive home care provider, $4,200.

(c) For the period ending June 30, 2018, a home care provider who is seeking to renew
the provider's license shall pay a fee to the commissioner based on revenues derived from
the provision of home care services during the calendar year prior to the year in which the
application is submitted, according to the following schedule:

License Renewal Fee

Provider Annual Revenue
Fee
greater than $1,500,000
$6,625
greater than $1,275,000 and no more than
$1,500,000
$5,797
greater than $1,100,000 and no more than
$1,275,000
$4,969
greater than $950,000 and no more than
$1,100,000
$4,141
greater than $850,000 and no more than $950,000
$3,727
greater than $750,000 and no more than $850,000
$3,313
greater than $650,000 and no more than $750,000
$2,898
greater than $550,000 and no more than $650,000
$2,485
greater than $450,000 and no more than $550,000
$2,070
greater than $350,000 and no more than $450,000
$1,656
greater than $250,000 and no more than $350,000
$1,242
greater than $100,000 and no more than $250,000
$828
greater than $50,000 and no more than $100,000
$500
greater than $25,000 and no more than $50,000
$400
no more than $25,000
$200

(d) For the period between July 1, 2018, and June 30, 2020, a home care provider who
is seeking to renew the provider's license shall pay a fee to the commissioner in an amount
that is ten percent higher than the applicable fee in paragraph (c). A home care provider's
fee shall be based on revenues derived from the provision of home care services during the
calendar year prior to the year in which the application is submitted.

(e) Beginning July 1, 2020, a home care provider who is seeking to renew the provider's
license shall pay a fee to the commissioner based on revenues derived from the provision
of home care services during the calendar year prior to the year in which the application is
submitted, according to the following schedule:

License Renewal Fee

Provider Annual Revenue
Fee
greater than $1,500,000
$7,651
greater than $1,275,000 and no more than
$1,500,000
$6,695
greater than $1,100,000 and no more than
$1,275,000
$5,739
greater than $950,000 and no more than
$1,100,000
$4,783
greater than $850,000 and no more than $950,000
$4,304
greater than $750,000 and no more than $850,000
$3,826
greater than $650,000 and no more than $750,000
$3,347
greater than $550,000 and no more than $650,000
$2,870
greater than $450,000 and no more than $550,000
$2,391
greater than $350,000 and no more than $450,000
$1,913
greater than $250,000 and no more than $350,000
$1,434
greater than $100,000 and no more than $250,000
$957
greater than $50,000 and no more than $100,000
$577
greater than $25,000 and no more than $50,000
$462
no more than $25,000
$231

(f) If requested, the home care provider shall provide the commissioner information to
verify the provider's annual revenues or other information as needed, including copies of
documents submitted to the Department of Revenue.

(g) At each annual renewal, a home care provider may elect to pay the highest renewal
fee for its license category, and not provide annual revenue information to the commissioner.

(h) A temporary license or license applicant, or temporary licensee or licensee that
knowingly provides the commissioner incorrect revenue amounts for the purpose of paying
a lower license fee, shall be subject to a civil penalty in the amount of double the fee the
provider should have paid.

(i) The fee for failure to comply with the notification requirements of section 144A.473,
subdivision 2, paragraph (c), is $1,000.

(j) Fees and penalties collected under this section shall be deposited in the state treasury
and credited to the state government special revenue fund. All fees are nonrefundable. Fees
collected under paragraphs (c), (d), and (e) are nonrefundable even if received before July
1, 2017, for temporary licenses or licenses being issued effective July 1, 2017, or later.

Sec. 36.

Minnesota Statutes 2016, section 144A.473, is amended to read:


144A.473 ISSUANCE OF TEMPORARY LICENSE AND LICENSE RENEWAL.

Subdivision 1.

Temporary license and renewal of license.

(a) The department shall
review each application to determine the applicant's knowledge of and compliance with
Minnesota home care regulations. Before granting a temporary license or renewing a license,
the commissioner may further evaluate the applicant or licensee by requesting additional
information or documentation or by conducting an on-site survey of the applicant to
determine compliance with sections 144A.43 to 144A.482.

(b) Within 14 calendar days after receiving an application for a license, the commissioner
shall acknowledge receipt of the application in writing. The acknowledgment must indicate
whether the application appears to be complete or whether additional information is required
before the application will be considered complete.

(c) Within 90 days after receiving a complete application, the commissioner shall issue
a temporary license, renew the license, or deny the license.

(d) The commissioner shall issue a license that contains the home care provider's name,
address, license level, expiration date of the license, and unique license number. All licenses,
except for temporary licenses issued under subdivision 2,
are valid for up to one year from
the date of issuance.

Subd. 2.

Temporary license.

(a) For new license applicants, the commissioner shall
issue a temporary license for either the basic or comprehensive home care level. A temporary
license is effective for up to one year from the date of issuance, except that a temporary
license may be extended according to subdivision 3
. Temporary licensees must comply with
sections 144A.43 to 144A.482.

(b) During the temporary license year period, the commissioner shall survey the temporary
licensee within 90 calendar days after the commissioner is notified or has evidence that the
temporary licensee is providing home care services.

(c) Within five days of beginning the provision of services, the temporary licensee must
notify the commissioner that it is serving clients. The notification to the commissioner may
be mailed or e-mailed to the commissioner at the address provided by the commissioner. If
the temporary licensee does not provide home care services during the temporary license
year period, then the temporary license expires at the end of the year period and the applicant
must reapply for a temporary home care license.

(d) A temporary licensee may request a change in the level of licensure prior to being
surveyed and granted a license by notifying the commissioner in writing and providing
additional documentation or materials required to update or complete the changed temporary
license application. The applicant must pay the difference between the application fees
when changing from the basic level to the comprehensive level of licensure. No refund will
be made if the provider chooses to change the license application to the basic level.

(e) If the temporary licensee notifies the commissioner that the licensee has clients within
45 days prior to the temporary license expiration, the commissioner may extend the temporary
license for up to 60 days in order to allow the commissioner to complete the on-site survey
required under this section and follow-up survey visits.

Subd. 3.

Temporary licensee survey.

(a) If the temporary licensee is in substantial
compliance with the survey, the commissioner shall issue either a basic or comprehensive
home care license. If the temporary licensee is not in substantial compliance with the survey,
the commissioner shall either: (1) not issue a basic or comprehensive license and there will
be no contested hearing right under chapter 14
terminate the temporary license; or (2) extend
the temporary license for a period not to exceed 90 days and apply conditions, as permitted
under section 144A.475, subdivision 2, to the extension of a temporary license. If the
temporary licensee is not in substantial compliance with the survey within the time period
of the extension, or if the temporary licensee does not satisfy the license conditions, the
commissioner may deny the license
.

(b) If the temporary licensee whose basic or comprehensive license has been denied or
extended with conditions
disagrees with the conclusions of the commissioner, then the
temporary licensee may request a reconsideration by the commissioner or commissioner's
designee. The reconsideration request process must be conducted internally by the
commissioner or commissioner's designee, and chapter 14 does not apply.

(c) The temporary licensee requesting reconsideration must make the request in writing
and must list and describe the reasons why the temporary licensee disagrees with the decision
to deny the basic or comprehensive home care license or the decision to extend the temporary
license with conditions
.

(d) The reconsideration request and supporting documentation must be received by the
commissioner within 15 calendar days after the date the temporary licensee receives the
correction order.

(e) A temporary licensee whose license is denied, is permitted to continue operating as
a home care provider during the period of time when:

(1) a reconsideration request is in process;

(2) an extension of a temporary license is being negotiated;

(3) the placement of conditions on a temporary license is being negotiated; or

(4) a transfer of home care clients from the temporary licensee to a new home care
provider is in process.

(f) A temporary licensee whose license is denied must comply with the requirements
for notification and transfer of clients in section 144A.475, subdivision 5.

Sec. 37.

Minnesota Statutes 2016, section 144A.474, subdivision 2, is amended to read:


Subd. 2.

Types of home care surveys.

(a) "Initial full survey" means the survey of a
new temporary licensee conducted after the department is notified or has evidence that the
temporary licensee is providing home care services to determine if the provider is in
compliance with home care requirements. Initial full surveys must be completed within 14
months after the department's issuance of a temporary basic or comprehensive license.

(b) "Change in ownership survey" means a full survey of a new licensee due to a change
in ownership. Change in ownership surveys must be completed within six months after the
department's issuance of a new license due to a change in ownership.

(c) "Core survey" means periodic inspection of home care providers to determine ongoing
compliance with the home care requirements, focusing on the essential health and safety
requirements. Core surveys are available to licensed home care providers who have been
licensed for three years and surveyed at least once in the past three years with the latest
survey having no widespread violations beyond Level 1 as provided in subdivision 11.
Providers must also not have had any substantiated licensing complaints, substantiated
complaints against the agency under the Vulnerable Adults Act or Maltreatment of Minors
Act, or an enforcement action as authorized in section 144A.475 in the past three years.

(1) The core survey for basic home care providers must review compliance in the
following areas:

(i) reporting of maltreatment;

(ii) orientation to and implementation of the home care bill of rights;

(iii) statement of home care services;

(iv) initial evaluation of clients and initiation of services;

(v) client review and monitoring;

(vi) service plan agreement implementation and changes to the service plan agreement;

(vii) client complaint and investigative process;

(viii) competency of unlicensed personnel; and

(ix) infection control.

(2) For comprehensive home care providers, the core survey must include everything
in the basic core survey plus these areas:

(i) delegation to unlicensed personnel;

(ii) assessment, monitoring, and reassessment of clients; and

(iii) medication, treatment, and therapy management.

(c) (d) "Full survey" means the periodic inspection of home care providers to determine
ongoing compliance with the home care requirements that cover the core survey areas and
all the legal requirements for home care providers. A full survey is conducted for all
temporary licensees and , for licensees that receive licenses due to an approved change in
ownership,
for providers who do not meet the requirements needed for a core survey, and
when a surveyor identifies unacceptable client health or safety risks during a core survey.
A full survey must include all the tasks identified as part of the core survey and any additional
review deemed necessary by the department, including additional observation, interviewing,
or records review of additional clients and staff.

(d) (e) "Follow-up surveys" means surveys conducted to determine if a home care
provider has corrected deficient issues and systems identified during a core survey, full
survey, or complaint investigation. Follow-up surveys may be conducted via phone, e-mail,
fax, mail, or on-site reviews. Follow-up surveys, other than complaint surveys, shall be
concluded with an exit conference and written information provided on the process for
requesting a reconsideration of the survey results.

(e) (f) Upon receiving information alleging that a home care provider has violated or is
currently violating a requirement of sections 144A.43 to 144A.482, the commissioner shall
investigate the complaint according to sections 144A.51 to 144A.54.

Sec. 38.

Minnesota Statutes 2016, section 144A.475, subdivision 1, is amended to read:


Subdivision 1.

Conditions.

(a) The commissioner may refuse to grant a temporary
license, refuse to grant a license as a result of a change in ownership, refuse to renew a
license, suspend or revoke a license, or impose a conditional license if the home care provider
or owner or managerial official of the home care provider:

(1) is in violation of, or during the term of the license has violated, any of the requirements
in sections 144A.471 to 144A.482;

(2) permits, aids, or abets the commission of any illegal act in the provision of home
care;

(3) performs any act detrimental to the health, safety, and welfare of a client;

(4) obtains the license by fraud or misrepresentation;

(5) knowingly made or makes a false statement of a material fact in the application for
a license or in any other record or report required by this chapter;

(6) denies representatives of the department access to any part of the home care provider's
books, records, files, or employees;

(7) interferes with or impedes a representative of the department in contacting the home
care provider's clients;

(8) interferes with or impedes a representative of the department in the enforcement of
this chapter or has failed to fully cooperate with an inspection, survey, or investigation by
the department;

(9) destroys or makes unavailable any records or other evidence relating to the home
care provider's compliance with this chapter;

(10) refuses to initiate a background study under section 144.057 or 245A.04;

(11) fails to timely pay any fines assessed by the department;

(12) violates any local, city, or township ordinance relating to home care services;

(13) has repeated incidents of personnel performing services beyond their competency
level; or

(14) has operated beyond the scope of the home care provider's license level.

(b) A violation by a contractor providing the home care services of the home care provider
is a violation by the home care provider.

Sec. 39.

Minnesota Statutes 2016, section 144A.475, subdivision 2, is amended to read:


Subd. 2.

Terms to suspension or conditional license.

(a) A suspension or conditional
license designation may include terms that must be completed or met before a suspension
or conditional license designation is lifted. A conditional license designation may include
restrictions or conditions that are imposed on the provider. Terms for a suspension or
conditional license may include one or more of the following and the scope of each will be
determined by the commissioner:

(1) requiring a consultant to review, evaluate, and make recommended changes to the
home care provider's practices and submit reports to the commissioner at the cost of the
home care provider;

(2) requiring supervision of the home care provider or staff practices at the cost of the
home care provider by an unrelated person who has sufficient knowledge and qualifications
to oversee the practices and who will submit reports to the commissioner;

(3) requiring the home care provider or employees to obtain training at the cost of the
home care provider;

(4) requiring the home care provider to submit reports to the commissioner;

(5) prohibiting the home care provider from taking any new clients for a period of time;
or

(6) any other action reasonably required to accomplish the purpose of this subdivision
and section 144A.45, subdivision 2.

(b) A home care provider subject to this subdivision may continue operating during the
period of time home care clients are being transferred to other providers.

Sec. 40.

Minnesota Statutes 2016, section 144A.475, subdivision 5, is amended to read:


Subd. 5.

Plan required.

(a) The process of suspending or revoking a license must include
a plan for transferring affected clients to other providers by the home care provider, which
will be monitored by the commissioner. Within three business days of being notified of the
final revocation or suspension action, the home care provider shall provide the commissioner,
the lead agencies as defined in section 256B.0911, and the ombudsman for long-term care
with the following information:

(1) a list of all clients, including full names and all contact information on file;

(2) a list of each client's representative or emergency contact person, including full names
and all contact information on file;

(3) the location or current residence of each client;

(4) the payor sources for each client, including payor source identification numbers; and

(5) for each client, a copy of the client's service plan, and a list of the types of services
being provided.

(b) The revocation or suspension notification requirement is satisfied by mailing the
notice to the address in the license record. The home care provider shall cooperate with the
commissioner and the lead agencies during the process of transferring care of clients to
qualified providers. Within three business days of being notified of the final revocation or
suspension action, the home care provider must notify and disclose to each of the home
care provider's clients, or the client's representative or emergency contact persons, that the
commissioner is taking action against the home care provider's license by providing a copy
of the revocation or suspension notice issued by the commissioner.

(c) A home care provider subject to this subdivision may continue operating during the
period of time home care clients are being transferred to other providers.

Sec. 41.

Minnesota Statutes 2016, section 144A.476, subdivision 1, is amended to read:


Subdivision 1.

Prior criminal convictions; owner and managerial officials.

(a) Before
the commissioner issues a temporary license, issues a license as a result of an approved
change in ownership,
or renews a license, an owner or managerial official is required to
complete a background study under section 144.057. No person may be involved in the
management, operation, or control of a home care provider if the person has been disqualified
under chapter 245C. If an individual is disqualified under section 144.057 or chapter 245C,
the individual may request reconsideration of the disqualification. If the individual requests
reconsideration and the commissioner sets aside or rescinds the disqualification, the individual
is eligible to be involved in the management, operation, or control of the provider. If an
individual has a disqualification under section 245C.15, subdivision 1, and the disqualification
is affirmed, the individual's disqualification is barred from a set aside, and the individual
must not be involved in the management, operation, or control of the provider.

(b) For purposes of this section, owners of a home care provider subject to the background
check requirement are those individuals whose ownership interest provides sufficient
authority or control to affect or change decisions related to the operation of the home care
provider. An owner includes a sole proprietor, a general partner, or any other individual
whose individual ownership interest can affect the management and direction of the policies
of the home care provider.

(c) For the purposes of this section, managerial officials subject to the background check
requirement are individuals who provide direct contact as defined in section 245C.02,
subdivision 11
, or individuals who have the responsibility for the ongoing management or
direction of the policies, services, or employees of the home care provider. Data collected
under this subdivision shall be classified as private data on individuals under section 13.02,
subdivision 12
.

(d) The department shall not issue any license if the applicant or owner or managerial
official has been unsuccessful in having a background study disqualification set aside under
section 144.057 and chapter 245C; if the owner or managerial official, as an owner or
managerial official of another home care provider, was substantially responsible for the
other home care provider's failure to substantially comply with sections 144A.43 to
144A.482; or if an owner that has ceased doing business, either individually or as an owner
of a home care provider, was issued a correction order for failing to assist clients in violation
of this chapter.

Sec. 42.

Minnesota Statutes 2016, section 144A.479, subdivision 7, is amended to read:


Subd. 7.

Employee records.

The home care provider must maintain current records of
each paid employee, regularly scheduled volunteers providing home care services, and of
each individual contractor providing home care services. The records must include the
following information:

(1) evidence of current professional licensure, registration, or certification, if licensure,
registration, or certification is required by this statute or other rules;

(2) records of orientation, required annual training and infection control training, and
competency evaluations;

(3) current job description, including qualifications, responsibilities, and identification
of staff providing supervision;

(4) documentation of annual performance reviews which identify areas of improvement
needed and training needs;

(5) for individuals providing home care services, verification that required any health
screenings required by infection control programs established under section 144A.4798
have taken place and the dates of those screenings; and

(6) documentation of the background study as required under section 144.057.

Each employee record must be retained for at least three years after a paid employee, home
care volunteer, or contractor ceases to be employed by or under contract with the home care
provider. If a home care provider ceases operation, employee records must be maintained
for three years.

Sec. 43.

Minnesota Statutes 2016, section 144A.4791, subdivision 1, is amended to read:


Subdivision 1.

Home care bill of rights; notification to client.

(a) The home care
provider shall provide the client or the client's representative a written notice of the rights
under section 144A.44 before the initiation of date that services are first provided to that
client. The provider shall make all reasonable efforts to provide notice of the rights to the
client or the client's representative in a language the client or client's representative can
understand.

(b) In addition to the text of the home care bill of rights in section 144A.44, subdivision
1, the notice shall also contain the following statement describing how to file a complaint
with these offices.

"If you have a complaint about the provider or the person providing your home care
services, you may call, write, or visit the Office of Health Facility Complaints, Minnesota
Department of Health. You may also contact the Office of Ombudsman for Long-Term
Care or the Office of Ombudsman for Mental Health and Developmental Disabilities."

The statement should include the telephone number, Web site address, e-mail address,
mailing address, and street address of the Office of Health Facility Complaints at the
Minnesota Department of Health, the Office of the Ombudsman for Long-Term Care, and
the Office of the Ombudsman for Mental Health and Developmental Disabilities. The
statement should also include the home care provider's name, address, e-mail, telephone
number, and name or title of the person at the provider to whom problems or complaints
may be directed. It must also include a statement that the home care provider will not retaliate
because of a complaint.

(c) The home care provider shall obtain written acknowledgment of the client's receipt
of the home care bill of rights or shall document why an acknowledgment cannot be obtained.
The acknowledgment may be obtained from the client or the client's representative.
Acknowledgment of receipt shall be retained in the client's record.

Sec. 44.

Minnesota Statutes 2016, section 144A.4791, subdivision 3, is amended to read:


Subd. 3.

Statement of home care services.

Prior to the initiation of date that services
are first provided to the client
, a home care provider must provide to the client or the client's
representative a written statement which identifies if the provider has a basic or
comprehensive home care license, the services the provider is authorized to provide, and
which services the provider cannot provide under the scope of the provider's license. The
home care provider shall obtain written acknowledgment from the clients that the provider
has provided the statement or must document why the provider could not obtain the
acknowledgment.

Sec. 45.

Minnesota Statutes 2016, section 144A.4791, subdivision 6, is amended to read:


Subd. 6.

Initiation of services.

When a provider initiates provides home care services
and to a client before the individualized review or assessment by a licensed health
professional or registered nurse as
required in subdivisions 7 and 8 has not been is completed,
the provider licensed health professional or registered nurse must complete a temporary
plan and agreement with the client for services and orient staff assigned to deliver services
as identified in the
temporary plan.

Sec. 46.

Minnesota Statutes 2016, section 144A.4791, subdivision 7, is amended to read:


Subd. 7.

Basic individualized client review and monitoring.

(a) When services being
provided are basic home care services, an individualized initial review of the client's needs
and preferences must be conducted at the client's residence with the client or client's
representative. This initial review must be completed within 30 days after the initiation of
the
date that home care services are first provided.

(b) Client monitoring and review must be conducted as needed based on changes in the
needs of the client and cannot exceed 90 days from the date of the last review. The monitoring
and review may be conducted at the client's residence or through the utilization of
telecommunication methods based on practice standards that meet the individual client's
needs.

Sec. 47.

Minnesota Statutes 2016, section 144A.4791, subdivision 8, is amended to read:


Subd. 8.

Comprehensive assessment, monitoring, and reassessment.

(a) When the
services being provided are comprehensive home care services, an individualized initial
assessment must be conducted in person by a registered nurse. When the services are provided
by other licensed health professionals, the assessment must be conducted by the appropriate
health professional. This initial assessment must be completed within five days after initiation
of
the date that home care services are first provided.

(b) Client monitoring and reassessment must be conducted in the client's home no more
than 14 days after initiation of the date that home care services are first provided.

(c) Ongoing client monitoring and reassessment must be conducted as needed based on
changes in the needs of the client and cannot exceed 90 days from the last date of the
assessment. The monitoring and reassessment may be conducted at the client's residence
or through the utilization of telecommunication methods based on practice standards that
meet the individual client's needs.

Sec. 48.

Minnesota Statutes 2016, section 144A.4791, subdivision 9, is amended to read:


Subd. 9.

Service plan agreement, implementation, and revisions to service plan
agreement
.

(a) No later than 14 days after the initiation of date that home care services are
first provided
, a home care provider shall finalize a current written service plan agreement.

(b) The service plan agreement and any revisions must include a signature or other
authentication by the home care provider and by the client or the client's representative
documenting agreement on the services to be provided. The service plan agreement must
be revised, if needed, based on client review or reassessment under subdivisions 7 and 8.
The provider must provide information to the client about changes to the provider's fee for
services and how to contact the Office of the Ombudsman for Long-Term Care.

(c) The home care provider must implement and provide all services required by the
current service plan agreement.

(d) The service plan agreement and revised service plan agreement must be entered into
the client's record, including notice of a change in a client's fees when applicable.

(e) Staff providing home care services must be informed of the current written service
plan agreement.

(f) The service plan agreement must include:

(1) a description of the home care services to be provided, the fees for services, and the
frequency of each service, according to the client's current review or assessment and client
preferences;

(2) the identification of the staff or categories of staff who will provide the services;

(3) the schedule and methods of monitoring reviews or assessments of the client;

(4) the frequency of sessions of supervision of staff and type of personnel who will
supervise staff ; and the schedule and methods of monitoring staff providing home care
services; and

(5) a contingency plan that includes:

(i) the action to be taken by the home care provider and by the client or client's
representative if the scheduled service cannot be provided;

(ii) information and a method for a client or client's representative to contact the home
care provider;

(iii) names and contact information of persons the client wishes to have notified in an
emergency or if there is a significant adverse change in the client's condition, including
identification of and information as to who has authority to sign for the client in an
emergency
; and

(iv) the circumstances in which emergency medical services are not to be summoned
consistent with chapters 145B and 145C, and declarations made by the client under those
chapters.

Sec. 49.

Minnesota Statutes 2016, section 144A.4792, subdivision 1, is amended to read:


Subdivision 1.

Medication management services; comprehensive home care license.

(a) This subdivision applies only to home care providers with a comprehensive home care
license that provide medication management services to clients. Medication management
services may not be provided by a home care provider who has a basic home care license.

(b) A comprehensive home care provider who provides medication management services
must develop, implement, and maintain current written medication management policies
and procedures. The policies and procedures must be developed under the supervision and
direction of a registered nurse, licensed health professional, or pharmacist consistent with
current practice standards and guidelines.

(c) The written policies and procedures must address requesting and receiving
prescriptions for medications; preparing and giving medications; verifying that prescription
drugs are administered as prescribed; documenting medication management activities;
controlling and storing medications; monitoring and evaluating medication use; resolving
medication errors; communicating with the prescriber, pharmacist, and client and client
representative, if any; disposing of unused medications; and educating clients and client
representatives about medications. When controlled substances are being managed, stored,
and secured by the comprehensive home care provider,
the policies and procedures must
also identify how the provider will ensure security and accountability for the overall
management, control, and disposition of those substances in compliance with state and
federal regulations and with subdivision 22.

Sec. 50.

Minnesota Statutes 2016, section 144A.4792, subdivision 2, is amended to read:


Subd. 2.

Provision of medication management services.

(a) For each client who
requests medication management services, the comprehensive home care provider shall,
prior to providing medication management services, have a registered nurse, licensed health
professional, or authorized prescriber under section 151.37 conduct an assessment to
determine what medication management services will be provided and how the services
will be provided. This assessment must be conducted face-to-face with the client. The
assessment must include an identification and review of all medications the client is known
to be taking. The review and identification must include indications for medications, side
effects, contraindications, allergic or adverse reactions, and actions to address these issues.

(b) The assessment must:

(1) identify interventions needed in management of medications to prevent diversion of
medication by the client or others who may have access to the medications. ; and

(2) provide instructions to the client or client's representative on interventions to manage
the client's medications and prevent diversion of medications.

"Diversion of medications" means the misuse, theft, or illegal or improper disposition of
medications.

Sec. 51.

Minnesota Statutes 2016, section 144A.4792, subdivision 5, is amended to read:


Subd. 5.

Individualized medication management plan.

(a) For each client receiving
medication management services, the comprehensive home care provider must prepare and
include in the service plan agreement a written statement of the medication management
services that will be provided to the client. The provider must develop and maintain a current
individualized medication management record for each client based on the client's assessment
that must contain the following:

(1) a statement describing the medication management services that will be provided;

(2) a description of storage of medications based on the client's needs and preferences,
risk of diversion, and consistent with the manufacturer's directions;

(3) documentation of specific client instructions relating to the administration of
medications;

(4) identification of persons responsible for monitoring medication supplies and ensuring
that medication refills are ordered on a timely basis;

(5) identification of medication management tasks that may be delegated to unlicensed
personnel;

(6) procedures for staff notifying a registered nurse or appropriate licensed health
professional when a problem arises with medication management services; and

(7) any client-specific requirements relating to documenting medication administration,
verifications that all medications are administered as prescribed, and monitoring of
medication use to prevent possible complications or adverse reactions.

(b) The medication management record must be current and updated when there are any
changes.

(c) Medication reconciliation must be completed when a licensed nurse, licensed health
professional, or authorized prescriber is providing medication management.

Sec. 52.

Minnesota Statutes 2016, section 144A.4792, subdivision 10, is amended to read:


Subd. 10.

Medication management for clients who will be away from home.

(a) A
home care provider who is providing medication management services to the client and
controls the client's access to the medications must develop and implement policies and
procedures for giving accurate and current medications to clients for planned or unplanned
times away from home according to the client's individualized medication management
plan. The policy and procedures must state that:

(1) for planned time away, the medications must be obtained from the pharmacy or set
up by the registered a licensed nurse according to appropriate state and federal laws and
nursing standards of practice;

(2) for unplanned time away, when the pharmacy is not able to provide the medications,
a licensed nurse or unlicensed personnel shall give the client or client's representative
medications in amounts and dosages needed for the length of the anticipated absence, not
to exceed 120 hours seven calendar days;

(3) the client or client's representative must be provided written information on
medications, including any special instructions for administering or handling the medications,
including controlled substances;

(4) the medications must be placed in a medication container or containers appropriate
to the provider's medication system and must be labeled with the client's name and the dates
and times that the medications are scheduled; and

(5) the client or client's representative must be provided in writing the home care
provider's name and information on how to contact the home care provider.

(b) For unplanned time away when the licensed nurse is not available, the registered
nurse may delegate this task to unlicensed personnel if:

(1) the registered nurse has trained the unlicensed staff and determined the unlicensed
staff is competent to follow the procedures for giving medications to clients; and

(2) the registered nurse has developed written procedures for the unlicensed personnel,
including any special instructions or procedures regarding controlled substances that are
prescribed for the client. The procedures must address:

(i) the type of container or containers to be used for the medications appropriate to the
provider's medication system;

(ii) how the container or containers must be labeled;

(iii) the written information about the medications to be given to the client or client's
representative;

(iv) how the unlicensed staff must document in the client's record that medications have
been given to the client or the client's representative, including documenting the date the
medications were given to the client or the client's representative and who received the
medications, the person who gave the medications to the client, the number of medications
that were given to the client, and other required information;

(v) how the registered nurse shall be notified that medications have been given to the
client or client's representative and whether the registered nurse needs to be contacted before
the medications are given to the client or the client's representative; and

(vi) a review by the registered nurse of the completion of this task to verify that this task
was completed accurately by the unlicensed personnel. ; and

(vii) how the unlicensed staff must document in the client's record any unused medications
that are returned to the provider, including the name of each medication and the doses of
each returned medication.

Sec. 53.

Minnesota Statutes 2016, section 144A.4793, subdivision 6, is amended to read:


Subd. 6.

Treatment and therapy orders or prescriptions.

There must be an up-to-date
written or electronically recorded order or prescription from an authorized prescriber for
all treatments and therapies. The order must contain the name of the client, a description of
the treatment or therapy to be provided, and the frequency, duration, and other information
needed to administer the treatment or therapy. Treatment and therapy orders must be renewed
at least every 12 months.

Sec. 54.

Minnesota Statutes 2017 Supplement, section 144A.4796, subdivision 2, is
amended to read:


Subd. 2.

Content.

(a) The orientation must contain the following topics:

(1) an overview of sections 144A.43 to 144A.4798;

(2) introduction and review of all the provider's policies and procedures related to the
provision of home care services by the individual staff person;

(3) handling of emergencies and use of emergency services;

(4) compliance with and reporting of the maltreatment of minors or vulnerable adults
under sections 626.556 and 626.557;

(5) home care bill of rights under section 144A.44;

(6) handling of clients' complaints, reporting of complaints, and where to report
complaints including information on the Office of Health Facility Complaints and the
Common Entry Point;

(7) consumer advocacy services of the Office of Ombudsman for Long-Term Care,
Office of Ombudsman for Mental Health and Developmental Disabilities, Managed Care
Ombudsman at the Department of Human Services, county managed care advocates, or
other relevant advocacy services; and

(8) review of the types of home care services the employee will be providing and the
provider's scope of licensure.

(b) In addition to the topics listed in paragraph (a), orientation may also contain training
on providing services to clients with hearing loss. Any training on hearing loss provided
under this subdivision must be high quality and research-based, may include online training,
and must include training on one or more of the following topics:

(1) an explanation of age-related hearing loss and how it manifests itself, its prevalence,
and challenges it poses to communication;

(2) health impacts related to untreated age-related hearing loss, such as increased
incidence of dementia, falls, hospitalizations, isolation, and depression; or

(3) information about strategies and technology that may enhance communication and
involvement, including communication strategies, assistive listening devices, hearing aids,
visual and tactile alerting devices, communication access in real time, and closed captions.

Sec. 55.

Minnesota Statutes 2016, section 144A.4797, subdivision 3, is amended to read:


Subd. 3.

Supervision of staff providing delegated nursing or therapy home care
tasks.

(a) Staff who perform delegated nursing or therapy home care tasks must be supervised
by an appropriate licensed health professional or a registered nurse periodically where the
services are being provided to verify that the work is being performed competently and to
identify problems and solutions related to the staff person's ability to perform the tasks.
Supervision of staff performing medication or treatment administration shall be provided
by a registered nurse or appropriate licensed health professional and must include observation
of the staff administering the medication or treatment and the interaction with the client.

(b) The direct supervision of staff performing delegated tasks must be provided within
30 days after the date on which the individual begins working for the home care provider
and first performs delegated tasks for clients
and thereafter as needed based on performance.
This requirement also applies to staff who have not performed delegated tasks for one year
or longer.

Sec. 56.

Minnesota Statutes 2016, section 144A.4798, is amended to read:


144A.4798 EMPLOYEE HEALTH STATUS DISEASE PREVENTION AND
INFECTION CONTROL
.

Subdivision 1.

Tuberculosis (TB) prevention and infection control.

(a) A home care
provider must establish and maintain a TB prevention and comprehensive tuberculosis
infection
control program based on according to the most current tuberculosis infection
control
guidelines issued by the United States Centers for Disease Control and Prevention
(CDC), Division of Tuberculosis Elimination, as published in the CDC's Morbidity and
Mortality Weekly Report
. Components of a TB prevention and control program include
screening all staff providing home care services, both paid and unpaid, at the time of hire
for active TB disease and latent TB infection, and developing and implementing a written
TB infection control plan. The commissioner shall make the most recent CDC standards
available to home care providers on the department's Web site.
This program must include
a tuberculosis infection control plan that covers all paid and unpaid employees, contractors,
students, and volunteers. The commissioner shall provide technical assistance regarding
implementation of the guidelines.

(b) Written evidence of compliance with this subdivision must be maintained by the
home care provider.

Subd. 2.

Communicable diseases.

A home care provider must follow current federal
or state guidelines
state requirements for prevention, control, and reporting of human
immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus, or other
communicable diseases as defined in Minnesota Rules, part parts 4605.7040 , 4605.7044,
4605.7050, 4605.7075, 4605.7080, and 4605.7090
.

Subd. 3.

Infection control program.

A home care provider must establish and maintain
an effective infection control program that complies with accepted health care, medical,
and nursing standards for infection control.

Sec. 57.

Minnesota Statutes 2016, section 144A.4799, subdivision 1, is amended to read:


Subdivision 1.

Membership.

The commissioner of health shall appoint eight persons
to a home care and assisted living program advisory council consisting of the following:

(1) three public members as defined in section 214.02 who shall be either persons who
are currently receiving home care services or , persons who have received home care services
within five years of the application date,
persons who have family members receiving home
care services, or persons who have family members who have received home care services
within five years of the application date;

(2) three Minnesota home care licensees representing basic and comprehensive levels
of licensure who may be a managerial official, an administrator, a supervising registered
nurse, or an unlicensed personnel performing home care tasks;

(3) one member representing the Minnesota Board of Nursing; and

(4) one member representing the Office of Ombudsman for Long-Term Care.

Sec. 58.

Minnesota Statutes 2017 Supplement, section 144A.4799, subdivision 3, is
amended to read:


Subd. 3.

Duties.

(a) At the commissioner's request, the advisory council shall provide
advice regarding regulations of Department of Health licensed home care providers in this
chapter, including advice on the following:

(1) community standards for home care practices;

(2) enforcement of licensing standards and whether certain disciplinary actions are
appropriate;

(3) ways of distributing information to licensees and consumers of home care;

(4) training standards;

(5) identifying emerging issues and opportunities in the home care field, including and
assisted living;

(6) identifying the use of technology in home and telehealth capabilities;

(6) (7) allowable home care licensing modifications and exemptions, including a method
for an integrated license with an existing license for rural licensed nursing homes to provide
limited home care services in an adjacent independent living apartment building owned by
the licensed nursing home; and

(7) (8) recommendations for studies using the data in section 62U.04, subdivision 4,
including but not limited to studies concerning costs related to dementia and chronic disease
among an elderly population over 60 and additional long-term care costs, as described in
section 62U.10, subdivision 6.

(b) The advisory council shall perform other duties as directed by the commissioner.

(c) The advisory council shall annually review the balance of the account in the state
government special revenue fund described in section 144A.474, subdivision 11, paragraph
(i), and make annual recommendations by January 15 directly to the chairs and ranking
minority members of the legislative committees with jurisdiction over health and human
services regarding appropriations to the commissioner for the purposes in section 144A.474,
subdivision 11, paragraph (i).

Sec. 59.

Minnesota Statutes 2016, section 144A.484, subdivision 1, is amended to read:


Subdivision 1.

Integrated licensing established.

(a) From January 1, 2014, to June 30,
2015, the commissioner of health shall enforce the home and community-based services
standards under chapter 245D for those providers who also have a home care license pursuant
to this chapter as required under Laws 2013, chapter 108, article 8, section 60, and article
11, section 31. During this period, the commissioner shall provide technical assistance to
achieve and maintain compliance with applicable law or rules governing the provision of
home and community-based services, including complying with the service recipient rights
notice in subdivision 4, clause (4). If during the survey, the commissioner finds that the
licensee has failed to achieve compliance with an applicable law or rule under chapter 245D
and this failure does not imminently endanger the health, safety, or rights of the persons
served by the program, the commissioner may issue a licensing survey report with
recommendations for achieving and maintaining compliance.

(b) Beginning July 1, 2015, A home care provider applicant or license holder may apply
to the commissioner of health for a home and community-based services designation for
the provision of basic support services identified under section 245D.03, subdivision 1,
paragraph (b). The designation allows the license holder to provide basic support services
that would otherwise require licensure under chapter 245D, under the license holder's home
care license governed by sections 144A.43 to 144A.481 144A.4799.

Sec. 60.

Minnesota Statutes 2016, section 144E.16, is amended by adding a subdivision
to read:


Subd. 9.

Rules authorizing patient-assisted medication administration.

(a) The board
shall adopt rules authorizing EMTs, AEMTs, and paramedics certified under section 144E.28
to assist a patient, in emergency situations, with administering prescription medications that
are:

(1) carried by a patient;

(2) intended to treat adrenal insufficiency or another rare but previously diagnosed
condition that requires emergency treatment with a previously prescribed medication;

(3) intended to treat a specific life-threatening condition; and

(4) administered via routes of delivery that are within the skill set of the EMT, AEMT,
or paramedic.

(b) EMTs, AEMTs, and paramedics assisting a patient with medication administration
according to the rules adopted under this subdivision may do so only under the authority
of guidelines approved by the ambulance service medical director or under direct medical
control.

Sec. 61.

Minnesota Statutes 2016, section 144E.16, is amended by adding a subdivision
to read:


Subd. 10.

Rules establishing standards for communication with patients regarding
need for emergency medical services.

The board shall adopt rules to establish guidelines
for ambulance services to communicate with a patient in the service area of the ambulance
service, and with the patient's caregivers, concerning the patient's health condition, the
likelihood that the patient will need emergency medical services, and how to collaboratively
develop emergency medical services care plans to meet the patient's needs.

Sec. 62.

Minnesota Statutes 2017 Supplement, section 144H.01, subdivision 5, is amended
to read:


Subd. 5.

Medically complex or technologically dependent child.

"Medically complex
or technologically dependent child" means a child under 21 years of age who, because of
a medical condition, requires continuous therapeutic interventions or skilled nursing
supervision which must be prescribed by a licensed physician and administered by, or under
the direct supervision of, a licensed registered nurse.
:

(1) needs skilled assessment and intervention multiple times during a 24-hour period to
maintain health and prevent deterioration of health status;

(2) has both predictable health needs and the potential for changes in condition that
could lead to rapid deterioration or life-threatening episodes;

(3) requires a 24-hour plan of care, including a backup plan, to reasonably ensure health
and safety in the community; and

(4) is expected to require frequent or continuous care in a hospital without the provision
of services in the child's home or a community setting.

Sec. 63.

Minnesota Statutes 2017 Supplement, section 144H.04, subdivision 1, is amended
to read:


Subdivision 1.

Licenses.

(a) A person seeking licensure for a PPEC center must submit
a completed application for licensure to the commissioner, in a form and manner determined
by the commissioner. The applicant must also submit the application fee, in the amount
specified in section 144H.05, subdivision 1. Effective For the period January 1, 2019,
through December 31, 2020, the commissioner shall issue licenses for no more than two
PPEC centers according to the requirements in the phase-in of licensure of prescribed
pediatric extended care centers in section 92. Beginning
January 1, 2018 2021, the
commissioner shall issue a license for a PPEC center if the commissioner determines that
the applicant and center meet the requirements of this chapter and rules that apply to PPEC
centers. A license issued under this subdivision is valid for two years.

(b) The commissioner may limit issuance of PPEC center licenses to PPEC centers
located in areas of the state with a demonstrated home care worker shortage.

EFFECTIVE DATE.

This section is effective the day following final enactment.

Sec. 64.

Minnesota Statutes 2017 Supplement, section 144H.06, is amended to read:


144H.06 APPLICATION OF RULES FOR HOSPICE SERVICES AND
RESIDENTIAL HOSPICE FACILITIES.

Minnesota Rules, chapter 4664, shall apply to PPEC centers licensed under this chapter,
except that the following parts, subparts, and items, and subitems do not apply:

(1) Minnesota Rules, part 4664.0003, subparts 2, 6, 7, 11, 12, 13, 14, and 38;

(2) Minnesota Rules, part 4664.0008;

(3) Minnesota Rules, part 4664.0010, subparts 3; 4, items A, subitem (6), and item B;
and 8;

(4) Minnesota Rules, part 4664.0020, subpart 13;

(5) Minnesota Rules, part 4664.0370, subpart 1;

(6) Minnesota Rules, part 4664.0390, subpart 1, items A, C, and E;

(7) Minnesota Rules, part 4664.0420;

(8) Minnesota Rules, part 4664.0425, subparts 3, item A; 4; and 6;

(9) Minnesota Rules, part 4664.0430, subparts 3, 4, 5, 7, 8, 9, 10, 11, and 12;

(10) Minnesota Rules, part 4664.0490; and

(11) Minnesota Rules, part 4664.0520.

Sec. 65.

Minnesota Statutes 2017 Supplement, section 144H.08, is amended to read:


144H.08 ADMINISTRATION AND MANAGEMENT.

Subdivision 1.

Duties of owner Owners.

(a) The owner of a PPEC center shall:

(1) have full legal authority and responsibility for the operation of the center. A PPEC
center must be organized according to a written table of organization, describing the lines
of authority and communication to the child care level. The organizational structure must
be designed to ensure an integrated continuum of services for the children served. ; and

(b) The owner must (2) designate one person as a center administrator, who is responsible
and accountable for overall management of the center.

(b) In order to serve as an owner of a PPEC center, an individual must have at least two
years of experience in the past five years (1) operating a business that provides care to
medically complex or technologically dependent children, or (2) managing the care of
medically complex or technologically dependent children.

Subd. 2.

Duties of administrator Administrators.

(a) The center administrator is
responsible and accountable for overall management of the center. The administrator must:

(1) designate in writing a person to be responsible for the center when the administrator
is absent from the center for more than 24 hours;

(2) maintain the following written records, in a place and form and using a system that
allows for inspection of the records by the commissioner during normal business hours:

(i) a daily census record, which indicates the number of children currently receiving
services at the center;

(ii) a record of all accidents or unusual incidents involving any child or staff member
that caused, or had the potential to cause, injury or harm to a person at the center or to center
property;

(iii) copies of all current agreements with providers of supportive services or contracted
services;

(iv) copies of all current agreements with consultants employed by the center,
documentation of each consultant's visits, and written, dated reports; and

(v) a personnel record for each employee, which must include an application for
employment, references, employment history for the preceding five years, and copies of all
performance evaluations;

(3) develop and maintain a current job description for each employee;

(4) provide necessary qualified personnel and ancillary services to ensure the health,
safety, and proper care for each child; and

(5) develop and implement infection control policies that comply with rules adopted by
the commissioner regarding infection control.

(b) In order to serve as an administrator of a PPEC center, an individual must have at
least two years of experience in the past five years caring for or managing the care of
medically complex or technologically dependent children.

Sec. 66.

Minnesota Statutes 2016, section 145.56, subdivision 2, is amended to read:


Subd. 2.

Community-based programs.

To the extent funds are appropriated for the
purposes of this subdivision, the commissioner shall establish a grant program to fund:

(1) community-based programs to provide education, outreach, and advocacy services
to populations who may be at risk for suicide;

(2) community-based programs that educate community helpers and gatekeepers, such
as family members, spiritual leaders, coaches, and business owners, employers, and
coworkers on how to prevent suicide by encouraging help-seeking behaviors;

(3) community-based programs that educate populations at risk for suicide and community
helpers and gatekeepers that must include information on the symptoms of depression and
other psychiatric illnesses, the warning signs of suicide, skills for preventing suicides, and
making or seeking effective referrals to intervention and community resources;

(4) community-based programs to provide evidence-based suicide prevention and
intervention education to school staff, parents, and students in grades kindergarten through
12, and for students attending Minnesota colleges and universities;

(5) community-based programs to provide evidence-based suicide prevention and
intervention to public school nurses, teachers, administrators, coaches, school social workers,
peace officers, firefighters, emergency medical technicians, advanced emergency medical
technicians, paramedics, primary care providers, and others; and

(6) community-based, evidence-based postvention training to mental health professionals
and practitioners in order to provide technical assistance to communities after a suicide and
to prevent suicide clusters and contagion; and

(7) a nonprofit organization to provide crisis telephone counseling services across the
state to people in suicidal crisis or emotional distress, 24 hours a day, seven days a week,
365 days a year
.

Sec. 67.

Minnesota Statutes 2016, section 145.928, subdivision 1, is amended to read:


Subdivision 1.

Goal; establishment.

It is the goal of the state, by 2010, to decrease by
50 percent the disparities in infant mortality rates and adult and child immunization rates
for American Indians and populations of color, as compared with rates for whites. To do
so and to achieve other measurable outcomes, the commissioner of health shall establish a
program to close the gap in the health status of American Indians and populations of color
as compared with whites in the following priority areas: infant mortality, access to and
utilization of high-quality prenatal care,
breast and cervical cancer screening, HIV/AIDS
and sexually transmitted infections, adult and child immunizations, cardiovascular disease,
diabetes, and accidental injuries and violence.

Sec. 68.

Minnesota Statutes 2016, section 145.928, subdivision 7, is amended to read:


Subd. 7.

Community grant program; immunization rates, prenatal care access and
utilization,
and infant mortality rates.

(a) The commissioner shall award grants to eligible
applicants for local or regional projects and initiatives directed at reducing health disparities
in one or both more of the following priority areas:

(1) decreasing racial and ethnic disparities in infant mortality rates; or

(2) decreasing racial and ethnic disparities in access to and utilization of high-quality
prenatal care; or

(2) (3) increasing adult and child immunization rates in nonwhite racial and ethnic
populations.

(b) The commissioner may award up to 20 percent of the funds available as planning
grants. Planning grants must be used to address such areas as community assessment,
coordination activities, and development of community supported strategies.

(c) Eligible applicants may include, but are not limited to, faith-based organizations,
social service organizations, community nonprofit organizations, community health boards,
tribal governments, and community clinics. Applicants must submit proposals to the
commissioner. A proposal must specify the strategies to be implemented to address one or
both more of the priority areas listed in paragraph (a) and must be targeted to achieve the
outcomes established according to subdivision 3.

(d) The commissioner shall give priority to applicants who demonstrate that their
proposed project or initiative:

(1) is supported by the community the applicant will serve;

(2) is research-based or based on promising strategies;

(3) is designed to complement other related community activities;

(4) utilizes strategies that positively impact both two or more priority areas;

(5) reflects racially and ethnically appropriate approaches; and

(6) will be implemented through or with community-based organizations that reflect the
race or ethnicity of the population to be reached.

Sec. 69.

Minnesota Statutes 2016, section 146B.03, is amended by adding a subdivision
to read:


Subd. 7a.

Supervisors.

(a) A technician must have been licensed in Minnesota or in a
jurisdiction with which Minnesota has reciprocity for at least:

(1) two years as a tattoo technician in order to supervise a temporary tattoo technician;
or

(2) one year as a body piercing technician in order to supervise a temporary body piercing
technician.

(b) Any technician who agrees to supervise more than two temporary tattoo technicians
during the same time period, or more than four body piercing technicians during the same
time period, must provide to the commissioner a supervisory plan that describes how the
technician will provide supervision to each temporary technician in accordance with section
146B.01, subdivision 28.

(c) The commissioner may refuse to approve as a supervisor a technician who has been
disciplined in Minnesota or in another jurisdiction after considering the criteria in section
146B.02, subdivision 10, paragraph (b).

Sec. 70.

Minnesota Statutes 2016, section 147A.08, is amended to read:


147A.08 EXEMPTIONS.

(a) This chapter does not apply to, control, prevent, or restrict the practice, service, or
activities of persons listed in section 147.09, clauses (1) to (6) and (8) to (13), persons
regulated under section 214.01, subdivision 2, or persons defined in section 144.1501,
subdivision 1
, paragraphs (i), (k), and (j), (l), and (m).

(b) Nothing in this chapter shall be construed to require licensure of:

(1) a physician assistant student enrolled in a physician assistant educational program
accredited by the Accreditation Review Commission on Education for the Physician Assistant
or by its successor agency approved by the board;

(2) a physician assistant employed in the service of the federal government while
performing duties incident to that employment; or

(3) technicians, other assistants, or employees of physicians who perform delegated
tasks in the office of a physician but who do not identify themselves as a physician assistant.

Sec. 71.

Minnesota Statutes 2016, section 148.512, subdivision 17a, is amended to read:


Subd. 17a.

Speech-language pathology assistant.

"Speech-language pathology assistant"
means a person who provides speech-language pathology services under the supervision of
a licensed speech-language pathologist in accordance with section 148.5192
practices
speech-language pathology assisting, meets the requirements under section 148.5185 or
148.5186, and is licensed by the commissioner
.

EFFECTIVE DATE.

This section is effective January 1, 2019.

Sec. 72.

Minnesota Statutes 2016, section 148.513, subdivision 1, is amended to read:


Subdivision 1.

Unlicensed practice prohibited.

A person must not engage in the practice
of speech-language pathology or , audiology, or speech-language pathology assisting unless
the person is licensed as a speech-language pathologist or , an audiologist, or a
speech-language pathology assistant
under sections 148.511 to 148.5198 or is practicing as
a speech-language pathology assistant in accordance with section 148.5192. For purposes
of this subdivision, a speech-language pathology assistant's duties are limited to the duties
described in accordance with section 148.5192, subdivision 2
.

EFFECTIVE DATE.

This section is effective January 1, 2019.

Sec. 73.

Minnesota Statutes 2016, section 148.513, subdivision 2, is amended to read:


Subd. 2.

Protected titles and restrictions on use; speech-language pathologists and
audiologists
.

(a) Notwithstanding paragraph (b) Except as provided in subdivision 2b, the
use of the following terms or initials which represent the following terms, alone or in
combination with any word or words, by any person to form an occupational title is prohibited
unless that person is licensed as a speech-language pathologist or audiologist under sections
148.511 to 148.5198:

(1) speech-language;

(2) speech-language pathologist, S, SP, or SLP;

(3) speech pathologist;

(4) language pathologist;

(5) audiologist, A, or AUD;

(6) speech therapist;

(7) speech clinician;

(8) speech correctionist;

(9) language therapist;

(10) voice therapist;

(11) voice pathologist;

(12) logopedist;

(13) communicologist;

(14) aphasiologist;

(15) phoniatrist;

(16) audiometrist;

(17) audioprosthologist;

(18) hearing therapist;

(19) hearing clinician; or

(20) hearing aid audiologist.

Use of the term "Minnesota licensed" in conjunction with the titles protected under this
paragraph subdivision by any person is prohibited unless that person is licensed as a
speech-language pathologist or audiologist
under sections 148.511 to 148.5198.

(b) A speech-language pathology assistant practicing under section 148.5192 must not
represent, indicate, or imply to the public that the assistant is a licensed speech-language
pathologist and shall only utilize one of the following titles: "speech-language pathology
assistant," "SLP assistant," or "SLP asst."

EFFECTIVE DATE.

This section is effective January 1, 2019.

Sec. 74.

Minnesota Statutes 2016, section 148.513, is amended by adding a subdivision
to read:


Subd. 2b.

Protected titles and restrictions on use; speech-language pathology
assistants.

(a) Use of the following titles is prohibited, unless that person is licensed under
section 148.5185 or 148.5186: "speech-language pathology assistant," "SLP assistant," or
"SLP asst."

(b) A speech-language pathology assistant licensed under section 148.5185 or 148.5186
must not represent, indicate, or imply to the public that the assistant is a licensed
speech-language pathologist and shall only utilize one of the following titles:
"speech-language pathology assistant," "SLP assistant," or "SLP asst." A speech-language
pathology assistant licensed under section 148.5185 or 148.5186 may use the term "licensed"
or "Minnesota licensed" in connection with a title listed in this paragraph. Use of the term
"Minnesota licensed" in conjunction with any of the titles protected under paragraph (a) by
any person is prohibited unless that person is licensed under section 148.5185 or 148.5186.

EFFECTIVE DATE.

This section is effective January 1, 2019.

Sec. 75.

Minnesota Statutes 2016, section 148.515, subdivision 1, is amended to read:


Subdivision 1.

Applicability.

Except as provided in section 148.516 or 148.517, an
applicant for licensure as a speech-language pathologist or audiologist must meet the
requirements in this section.

EFFECTIVE DATE.

This section is effective January 1, 2019.

Sec. 76.

Minnesota Statutes 2016, section 148.516, is amended to read:


148.516 LICENSURE BY EQUIVALENCY.

An applicant who applies for licensure by equivalency as a speech-language pathologist
or audiologist
must show evidence of possessing a current certificate of clinical competence
issued by the American Speech-Language-Hearing Association or board certification by
the American Board of Audiology and must meet the requirements of section 148.514.

EFFECTIVE DATE.

This section is effective January 1, 2019.

Sec. 77.

[148.5185] RESTRICTED LICENSURE; SPEECH-LANGUAGE
PATHOLOGY ASSISTANTS.

Subdivision 1.

Qualifications for a restricted license.

To be eligible for restricted
licensure as a speech-language pathology assistant, an applicant must satisfy the requirements
in subdivision 2, 3, or 4.

Subd. 2.

Person practicing as a speech-language pathology assistant before January
1, 2019.

(a) A person who is practicing as a speech-language pathology assistant before
January 1, 2019, and who does not meet the qualifications for a license under section
148.5186 may apply for a restricted speech-language pathology assistant license from the
commissioner. An applicant under this paragraph must submit to the commissioner:

(1) proof of current employment as a speech-language pathology assistant; and

(2) a signed affidavit affirming supervision, from the licensed speech-language pathologist
currently supervising the applicant.

(b) In order to be licensed as a speech-language pathology assistant under section
148.5186, a licensee with a restricted license under this subdivision must obtain an associate
degree from a speech-language pathology assistant program that is accredited by the Higher
Learning Commission of the North Central Association of Colleges or its equivalent, as
approved by the commissioner, and that includes (1) coursework on an introduction to
communication disorders, phonetics, language development, articulation disorders, language
disorders, anatomy of speech/language hearing, stuttering, adult communication disorders,
and clinical documentations and materials management; and (2) at least 100 hours of
supervised field work experience in speech-language pathology assisting. Upon completion
of the requirements in this paragraph prior to January 1, 2025, a licensee with a restricted
license under this subdivision is eligible to apply for licensure under section 148.5186.

Subd. 3.

Person with a bachelor's degree in communication sciences or disorders
and practicing as a speech-language pathology assistant before January 1, 2019.

(a) A
person with a bachelor's degree in the discipline of communication sciences or disorders
and who is practicing as a speech-language pathology assistant before January 1, 2019, but
who does not meet the qualifications for a license under section 148.5186, may apply for a
restricted speech-language pathology assistant license from the commissioner. An applicant
under this paragraph must submit to the commissioner:

(1) a transcript from an educational institution documenting satisfactory completion of
a bachelor's degree in the discipline of communication sciences or disorders;

(2) proof of current employment as a speech-language pathology assistant; and

(3) a signed affidavit affirming supervision, from the licensed speech-language pathologist
currently supervising the applicant.

(b) In order to be licensed as a speech-language pathology assistant under section
148.5186, a licensee with a restricted license under this subdivision must complete (1)
coursework from a speech-language pathology assistant program in articulation disorders,
language disorders, adult communication disorders, and stuttering; and (2) at least 100 hours
of supervised field work experience in speech-language pathology assisting. Upon completion
of the requirements in this paragraph prior to January 1, 2025, a licensee with a restricted
license under this subdivision is eligible to apply for licensure under section 148.5186.

Subd. 4.

Person with an associate degree from a program that does not meet
requirements in section 148.5186.

(a) A person with an associate degree from a
speech-language pathology assistant program that does not meet the requirements in section
148.5186, subdivision 1, clause (1), may apply for a restricted speech-language pathology
assistant license from the commissioner. An applicant under this paragraph must submit to
the commissioner a transcript from an educational institution documenting satisfactory
completion of an associate degree from a speech-language pathology assistant program. If
the commissioner determines that the applicant's speech-language pathology assistant
program does not include coursework or supervised field work experience that is equivalent
to a program under section 148.5186, subdivision 1, clause (1), the commissioner may issue
a restricted license to the applicant.

(b) In order to be licensed as a speech-language pathology assistant under section
148.5186, a licensee with a restricted license under this subdivision must complete any
missing coursework or supervised field work experience, as determined by the commissioner,
in a speech-language pathology assisting program. Upon completion of the requirements
in this paragraph prior to January 1, 2025, a licensee with a restricted license under this
subdivision is eligible to apply for licensure under section 148.5186.

Subd. 5.

Additional requirements; restricted license.

(a) A restricted license issued
under subdivision 2, 3, or 4 may be renewed biennially until January 1, 2025.

(b) A licensee with a restricted license under subdivision 2 or 3 may only practice
speech-language pathology assisting for the employer with whom the licensee was employed
when the licensee applied for licensure.

Subd. 6.

Continuing education.

In order to renew a restricted license, a licensee must
comply with the continuing education requirements in section 148.5193, subdivision 1a.

Subd. 7.

Scope of practice.

Scope of practice for a speech-language pathology assistant
licensed under this section is governed by section 148.5192, subdivision 2.

EFFECTIVE DATE.

This section is effective January 1, 2019.

Sec. 78.

[148.5186] LICENSURE; SPEECH-LANGUAGE PATHOLOGY
ASSISTANTS.

Subdivision 1.

Requirements for licensure.

To be eligible for licensure as a
speech-language pathology assistant, an applicant must submit to the commissioner a
transcript from an educational institution documenting satisfactory completion of either:

(1) an associate degree from a speech-language pathology assistant program that is
accredited by the Higher Learning Commission of the North Central Association of Colleges
or its equivalent as approved by the commissioner, which includes at least 100 hours of
supervised field work experience in speech-language pathology assisting; or

(2) a bachelor's degree in the discipline of communication sciences or disorders and a
speech-language pathology assistant certificate program that includes (i) coursework in an
introduction to speech-language pathology assisting, stuttering, articulation disorders, and
language disorders; and (ii) at least 100 hours of supervised field work experience in
speech-language pathology assisting.

Subd. 2.

Licensure by equivalency.

An applicant who applies for licensure by
equivalency as a speech-language pathology assistant must provide evidence to the
commissioner of satisfying the requirements in subdivision 1.

Subd. 3.

Scope of practice.

Scope of practice for a speech-language pathology assistant
licensed under this section is governed by section 148.5192, subdivision 2.

EFFECTIVE DATE.

This section is effective January 1, 2019.

Sec. 79.

Minnesota Statutes 2017 Supplement, section 148.519, subdivision 1, is amended
to read:


Subdivision 1.

Applications for licensure; speech-language pathologists and
audiologists
.

(a) An applicant for licensure as a speech-language pathologist or audiologist
must:

(1) submit a completed application for licensure on forms provided by the commissioner.
The application must include the applicant's name, certification number under chapter 153A,
if applicable, business address and telephone number, or home address and telephone number
if the applicant practices speech-language pathology or audiology out of the home, and a
description of the applicant's education, training, and experience, including previous work
history for the five years immediately preceding the date of application. The commissioner
may ask the applicant to provide additional information necessary to clarify information
submitted in the application; and

(2) submit documentation of the certificate of clinical competence issued by the American
Speech-Language-Hearing Association, board certification by the American Board of
Audiology, or satisfy the following requirements:

(i) submit a transcript showing the completion of a master's or doctoral degree or its
equivalent meeting the requirements of section 148.515, subdivision 2;

(ii) submit documentation of the required hours of supervised clinical training;

(iii) submit documentation of the postgraduate clinical or doctoral clinical experience
meeting the requirements of section 148.515, subdivision 4; and

(iv) submit documentation of receiving a qualifying score on an examination meeting
the requirements of section 148.515, subdivision 6.

(b) In addition, an applicant must:

(1) sign a statement that the information in the application is true and correct to the best
of the applicant's knowledge and belief;

(2) submit with the application all fees required by section 148.5194;

(3) sign a waiver authorizing the commissioner to obtain access to the applicant's records
in this or any other state in which the applicant has engaged in the practice of speech-language
pathology or audiology; and

(4) consent to a fingerprint-based criminal history background check as required under
section 144.0572, pay all required fees, and cooperate with all requests for information. An
applicant must complete a new criminal history background check if more than one year
has elapsed since the applicant last applied for a license.

EFFECTIVE DATE.

This section is effective January 1, 2019.

Sec. 80.

Minnesota Statutes 2016, section 148.519, is amended by adding a subdivision
to read:


Subd. 1a.

Applications for licensure; speech-language pathology assistants.

An
applicant for licensure as a speech-language pathology assistant must submit to the
commissioner:

(1) a completed application on forms provided by the commissioner. The application
must include the applicant's name, business address and telephone number, home address
and telephone number, and a description of the applicant's education, training, and experience,
including previous work history for the five years immediately preceding the application
date. The commissioner may ask the applicant to provide additional information needed to
clarify information submitted in the application;

(2) documentation that the applicant satisfied one of the qualifications listed in section
148.5185 or 148.5186;

(3) a signed statement that the information in the application is true and correct to the
best of the applicant's knowledge and belief;

(4) all fees required under section 148.5194; and

(5) a signed waiver authorizing the commissioner to obtain access to the applicant's
records in this or any other state in which the applicant has worked as a speech-language
pathology assistant.

EFFECTIVE DATE.

This section is effective January 1, 2019.

Sec. 81.

Minnesota Statutes 2016, section 148.5192, subdivision 1, is amended to read:


Subdivision 1.

Delegation requirements.

A licensed speech-language pathologist may
delegate duties to a speech-language pathology assistant in accordance with this section.
Duties may only be delegated to an individual who has documented with a transcript from
an educational institution satisfactory completion of either:

(1) an associate degree from a speech-language pathology assistant program that is
accredited by the Higher Learning Commission of the North Central Association of Colleges
or its equivalent as approved by the commissioner; or

(2) a bachelor's degree in the discipline of communication sciences or disorders with
additional transcript credit in the area of instruction in assistant-level service delivery
practices and completion of at least 100 hours of supervised field work experience as a
speech-language pathology assistant student
is licensed under section 148.5185 or 148.5186.

EFFECTIVE DATE.

This section is effective January 1, 2019.

Sec. 82.

Minnesota Statutes 2017 Supplement, section 148.5193, subdivision 1, is amended
to read:


Subdivision 1.

Number of contact hours required.

(a) An applicant for licensure
renewal as a speech-language pathologist or audiologist must meet the requirements for
continuing education stipulated by the American Speech-Language-Hearing Association
or the American Board of Audiology, or satisfy the requirements described in paragraphs
(b) to (e).

(b) Within one month following expiration of a license, an applicant for licensure renewal
as either a speech-language pathologist or an audiologist must provide evidence to the
commissioner of a minimum of 30 contact hours of continuing education obtained within
the two years immediately preceding licensure expiration. A minimum of 20 contact hours
of continuing education must be directly related to the licensee's area of licensure. Ten
contact hours of continuing education may be in areas generally related to the licensee's
area of licensure. Licensees who are issued licenses for a period of less than two years shall
prorate the number of contact hours required for licensure renewal based on the number of
months licensed during the biennial licensure period. Licensees shall receive contact hours
for continuing education activities only for the biennial licensure period in which the
continuing education activity was performed.

(c) An applicant for licensure renewal as both a speech-language pathologist and an
audiologist must attest to and document completion of a minimum of 36 contact hours of
continuing education offered by a continuing education sponsor within the two years
immediately preceding licensure renewal. A minimum of 15 contact hours must be received
in the area of speech-language pathology and a minimum of 15 contact hours must be
received in the area of audiology. Six contact hours of continuing education may be in areas
generally related to the licensee's areas of licensure. Licensees who are issued licenses for
a period of less than two years shall prorate the number of contact hours required for licensure
renewal based on the number of months licensed during the biennial licensure period.
Licensees shall receive contact hours for continuing education activities only for the biennial
licensure period in which the continuing education activity was performed.

(d) If the licensee is licensed by the Professional Educator Licensing and Standards
Board:

(1) activities that are approved in the categories of Minnesota Rules, part 8710.7200,
subpart 3, items A and B, and that relate to speech-language pathology, shall be considered:

(i) offered by a sponsor of continuing education; and

(ii) directly related to speech-language pathology;

(2) activities that are approved in the categories of Minnesota Rules, part 8710.7200,
subpart 3, shall be considered:

(i) offered by a sponsor of continuing education; and

(ii) generally related to speech-language pathology; and

(3) one clock hour as defined in Minnesota Rules, part 8710.7200, subpart 1, is equivalent
to 1.0 contact hours of continuing education.

(e) Contact hours may not be accumulated in advance and transferred to a future
continuing education period.

EFFECTIVE DATE.

This section is effective January 1, 2019.

Sec. 83.

Minnesota Statutes 2016, section 148.5193, is amended by adding a subdivision
to read:


Subd. 1a.

Continuing education; speech-language pathology assistants.

An applicant
for licensure renewal as a speech-language pathology assistant must meet the requirements
for continuing education established by the commissioner.

EFFECTIVE DATE.

This section is effective January 1, 2019.

Sec. 84.

Minnesota Statutes 2016, section 148.5194, is amended by adding a subdivision
to read:


Subd. 3b.

Speech-language pathology assistant initial licensure and renewal fees.

The fee for initial speech-language pathology assistant licensure under section 148.5185 or
148.5186 is $130. The fee for licensure renewal is $120.

EFFECTIVE DATE.

This section is effective January 1, 2019.

Sec. 85.

Minnesota Statutes 2016, section 148.5194, subdivision 8, is amended to read:


Subd. 8.

Penalty fees.

(a) The penalty fee for practicing speech-language pathology or
audiology or using protected titles without a current license after the credential has expired
and before it is renewed is the amount of the license renewal fee for any part of the first
month, plus the license renewal fee for any part of any subsequent month up to 36 months.
The penalty fee for a speech-language pathology assistant who practices speech-language
pathology assisting or uses protected titles without a current license after a license has
expired and before it is renewed is the amount of the license renewal fee for any part of the
first month, plus the license renewal fee for any part of any subsequent month up to 36
months.

(b) The penalty fee for applicants who engage in the unauthorized practice of
speech-language pathology or audiology or using protected titles before being issued a
license is the amount of the license application fee for any part of the first month, plus the
license application fee for any part of any subsequent month up to 36 months. The penalty
fee for a speech-language pathology assistant who engages in the unauthorized practice of
speech-language pathology assisting or uses protected titles without being issued a license
is the amount of the license application fee for any part of the first month, plus the license
application fee for any part of any subsequent month up to 36 months.
This paragraph does
not apply to applicants not qualifying for a license who engage in the unauthorized practice
of speech language pathology or audiology.

(c) The penalty fee for practicing speech-language pathology or audiology and failing
to submit a continuing education report by the due date with the correct number or type of
hours in the correct time period is $100 plus $20 for each missing clock hour. The penalty
fee for a licensed speech-language pathology assistant who fails to submit a continuing
education report by the due date with the correct number or type of hours in the correct time
period is $100 plus $20 for each missing clock hour.
"Missing" means not obtained between
the effective and expiration dates of the certificate, the one-month period following the
certificate expiration date, or the 30 days following notice of a penalty fee for failing to
report all continuing education hours. The licensee must obtain the missing number of
continuing education hours by the next reporting due date.

(d) Civil penalties and discipline incurred by licensees prior to August 1, 2005, for
conduct described in paragraph (a), (b), or (c) shall be recorded as nondisciplinary penalty
fees. For conduct described in paragraph (a) or (b) occurring after August 1, 2005, and
exceeding six months, payment of a penalty fee does not preclude any disciplinary action
reasonably justified by the individual case.

EFFECTIVE DATE.

This section is effective January 1, 2019.

Sec. 86.

Minnesota Statutes 2016, section 148.5195, subdivision 3, is amended to read:


Subd. 3.

Grounds for disciplinary action by commissioner.

The commissioner may
take any of the disciplinary actions listed in subdivision 4 on proof that the individual has:

(1) intentionally submitted false or misleading information to the commissioner or the
advisory council;

(2) failed, within 30 days, to provide information in response to a written request by the
commissioner or advisory council;

(3) performed services of a speech-language pathologist or , audiologist, or
speech-language pathology assistant
in an incompetent or negligent manner;

(4) violated sections 148.511 to 148.5198;

(5) failed to perform services with reasonable judgment, skill, or safety due to the use
of alcohol or drugs, or other physical or mental impairment;

(6) violated any state or federal law, rule, or regulation, and the violation is a felony or
misdemeanor, an essential element of which is dishonesty, or which relates directly or
indirectly to the practice of speech-language pathology or , audiology, or speech-language
pathology assisting
. Conviction for violating any state or federal law which relates to
speech-language pathology or , audiology, or speech-language pathology assisting is
necessarily considered to constitute a violation, except as provided in chapter 364;

(7) aided or abetted another person in violating any provision of sections 148.511 to
148.5198;

(8) been or is being disciplined by another jurisdiction, if any of the grounds for the
discipline is the same or substantially equivalent to those under sections 148.511 to 148.5198;

(9) not cooperated with the commissioner or advisory council in an investigation
conducted according to subdivision 1;

(10) advertised in a manner that is false or misleading;

(11) engaged in conduct likely to deceive, defraud, or harm the public; or demonstrated
a willful or careless disregard for the health, welfare, or safety of a client;

(12) failed to disclose to the consumer any fee splitting or any promise to pay a portion
of a fee to any other professional other than a fee for services rendered by the other
professional to the client;

(13) engaged in abusive or fraudulent billing practices, including violations of federal
Medicare and Medicaid laws, Food and Drug Administration regulations, or state medical
assistance laws;

(14) obtained money, property, or services from a consumer through the use of undue
influence, high pressure sales tactics, harassment, duress, deception, or fraud;

(15) performed services for a client who had no possibility of benefiting from the services;

(16) failed to refer a client for medical evaluation or to other health care professionals
when appropriate or when a client indicated symptoms associated with diseases that could
be medically or surgically treated;

(17) had the certification required by chapter 153A denied, suspended, or revoked
according to chapter 153A;

(18) used the term doctor of audiology, doctor of speech-language pathology, AuD, or
SLPD without having obtained the degree from an institution accredited by the North Central
Association of Colleges and Secondary Schools, the Council on Academic Accreditation
in Audiology and Speech-Language Pathology, the United States Department of Education,
or an equivalent;

(19) failed to comply with the requirements of section 148.5192 regarding supervision
of speech-language pathology assistants; or

(20) if the individual is an audiologist or certified hearing instrument dispenser:

(i) prescribed or otherwise recommended to a consumer or potential consumer the use
of a hearing instrument, unless the prescription from a physician or recommendation from
an audiologist or certified dispenser is in writing, is based on an audiogram that is delivered
to the consumer or potential consumer when the prescription or recommendation is made,
and bears the following information in all capital letters of 12-point or larger boldface type:
"THIS PRESCRIPTION OR RECOMMENDATION MAY BE FILLED BY, AND
HEARING INSTRUMENTS MAY BE PURCHASED FROM, THE LICENSED
AUDIOLOGIST OR CERTIFIED DISPENSER OF YOUR CHOICE";

(ii) failed to give a copy of the audiogram, upon which the prescription or
recommendation is based, to the consumer when the consumer requests a copy;

(iii) failed to provide the consumer rights brochure required by section 148.5197,
subdivision 3
;

(iv) failed to comply with restrictions on sales of hearing instruments in sections
148.5197, subdivision 3, and 148.5198;

(v) failed to return a consumer's hearing instrument used as a trade-in or for a discount
in the price of a new hearing instrument when requested by the consumer upon cancellation
of the purchase agreement;

(vi) failed to follow Food and Drug Administration or Federal Trade Commission
regulations relating to dispensing hearing instruments;

(vii) failed to dispense a hearing instrument in a competent manner or without appropriate
training;

(viii) delegated hearing instrument dispensing authority to a person not authorized to
dispense a hearing instrument under this chapter or chapter 153A;

(ix) failed to comply with the requirements of an employer or supervisor of a hearing
instrument dispenser trainee;

(x) violated a state or federal court order or judgment, including a conciliation court
judgment, relating to the activities of the individual's hearing instrument dispensing; or

(xi) failed to include on the audiogram the practitioner's printed name, credential type,
credential number, signature, and date.

EFFECTIVE DATE.

This section is effective January 1, 2019.

Sec. 87.

Minnesota Statutes 2017 Supplement, section 148.5196, subdivision 1, is amended
to read:


Subdivision 1.

Membership.

The commissioner shall appoint 12 13 persons to a
Speech-Language Pathologist and Audiologist Advisory Council. The 12 13 persons must
include:

(1) three public members, as defined in section 214.02. Two of the public members shall
be either persons receiving services of a speech-language pathologist or audiologist, or
family members of or caregivers to such persons, and at least one of the public members
shall be either a hearing instrument user or an advocate of one;

(2) three speech-language pathologists licensed under sections 148.511 to 148.5198,
one of whom is currently and has been, for the five years immediately preceding the
appointment, engaged in the practice of speech-language pathology in Minnesota and each
of whom is employed in a different employment setting including, but not limited to, private
practice, hospitals, rehabilitation settings, educational settings, and government agencies;

(3) one speech-language pathologist licensed under sections 148.511 to 148.5198, who
is currently and has been, for the five years immediately preceding the appointment,
employed by a Minnesota public school district or a Minnesota public school district
consortium that is authorized by Minnesota Statutes and who is licensed in speech-language
pathology by the Professional Educator Licensing and Standards Board;

(4) three audiologists licensed under sections 148.511 to 148.5198, two of whom are
currently and have been, for the five years immediately preceding the appointment, engaged
in the practice of audiology and the dispensing of hearing instruments in Minnesota and
each of whom is employed in a different employment setting including, but not limited to,
private practice, hospitals, rehabilitation settings, educational settings, industry, and
government agencies;

(5) one nonaudiologist hearing instrument dispenser recommended by a professional
association representing hearing instrument dispensers; and

(6) one physician licensed under chapter 147 and certified by the American Board of
Otolaryngology, Head and Neck Surgery; and

(7) one speech-language pathology assistant licensed under section 148.5186.

EFFECTIVE DATE.

This section is effective January 1, 2019.

Sec. 88.

Minnesota Statutes 2016, section 148.5196, subdivision 3, is amended to read:


Subd. 3.

Duties.

The advisory council shall:

(1) advise the commissioner regarding speech-language pathologist and , audiologist,
and speech-language pathology assistant
licensure standards;

(2) advise the commissioner regarding the delegation of duties to and the training required
for speech-language pathology assistants;

(3) advise the commissioner on enforcement of sections 148.511 to 148.5198;

(4) provide for distribution of information regarding speech-language pathologist and ,
audiologist, and speech-language pathology assistant licensure standards;

(5) review applications and make recommendations to the commissioner on granting or
denying licensure or licensure renewal;

(6) review reports of investigations relating to individuals and make recommendations
to the commissioner as to whether licensure should be denied or disciplinary action taken
against the individual;

(7) advise the commissioner regarding approval of continuing education activities
provided by sponsors using the criteria in section 148.5193, subdivision 2; and

(8) perform other duties authorized for advisory councils under chapter 214, or as directed
by the commissioner.

EFFECTIVE DATE.

This section is effective January 1, 2019.

Sec. 89.

Minnesota Statutes 2016, section 148.995, subdivision 2, is amended to read:


Subd. 2.

Certified doula.

"Certified doula" means an individual who has received a
certification to perform doula services from the International Childbirth Education
Association, the Doulas of North America (DONA), the Association of Labor Assistants
and Childbirth Educators (ALACE), Birthworks, the Childbirth and Postpartum Professional
Association (CAPPA), Childbirth International, the International Center for Traditional
Childbearing, or Commonsense Childbirth, Inc., or Welcome Baby Care.

Sec. 90.

Minnesota Statutes 2016, section 149A.40, subdivision 11, is amended to read:


Subd. 11.

Continuing education.

The commissioner shall require 15 continuing education
hours for renewal of a license to practice mortuary science. Nine of the hours must be in
the following areas: body preparation, care, or handling, and cremation, 3 CE hours;
professional practices, 3 CE hours; and regulation and ethics, 3 CE hours. Continuing
education hours shall be reported to the commissioner every other year based on the licensee's
license number. Licensees whose license ends in an odd number must report CE hours at
renewal time every odd year. If a licensee's license ends in an even number, the licensee
must report the licensee's CE hours at renewal time every even year.

EFFECTIVE DATE.

This section is effective January 1, 2019, and applies to mortuary
science license renewals on or after that date.

Sec. 91.

Minnesota Statutes 2016, section 149A.95, subdivision 3, is amended to read:


Subd. 3.

Unlicensed personnel.

(a) A licensed crematory may employ unlicensed
personnel, provided that all applicable provisions of this chapter are followed. It is the duty
of the licensed crematory to provide proper training for to all unlicensed personnel and
ensure that unlicensed personnel performing cremations are in compliance with the
requirements in paragraph (b).
The licensed crematory shall be strictly accountable for
compliance with this chapter and other applicable state and federal regulations regarding
occupational and workplace health and safety.

(b) Unlicensed personnel performing cremations at a licensed crematory must:

(1) complete a certified crematory operator course that is approved by the commissioner
and that covers at least the following subjects:

(i) cremation and incinerator terminology;

(ii) combustion principles;

(iii) maintenance of and troubleshooting for cremation devices;

(iv) how to operate cremation devices;

(v) identification, the use of proper forms, and the record-keeping process for
documenting chain of custody of human remains;

(vi) guidelines for recycling, including but not limited to compliance, disclosure, recycling
procedures, and compensation;

(vii) legal and regulatory requirements regarding environmental issues, including specific
environmental regulations with which compliance is required; and

(viii) cremation ethics;

(2) obtain a crematory operator certification;

(3) publicly post the crematory operator certification at the licensed crematory where
the unlicensed personnel performs cremations; and

(4) maintain crematory operator certification through:

(i) recertification, if such recertification is required by the program through which the
unlicensed personnel is certified; or

(ii) if recertification is not required by the program, completion of at least seven hours
of continuing education credits in crematory operation every five years.

EFFECTIVE DATE.

This section is effective January 1, 2019, and applies to unlicensed
personnel performing cremations on or after that date.

Sec. 92. PHASE-IN OF LICENSURE OF PRESCRIBED PEDIATRIC EXTENDED
CARE CENTERS.

Subdivision 1.

2019-2020 licensure period.

The commissioner of health shall phase in
the licensure of prescribed pediatric extended care centers (PPEC centers) under Minnesota
Statutes, chapter 144H, by issuing licenses for no more than two PPEC centers for the
licensure period January 1, 2019, through December 31, 2020. Beginning January 1, 2021,
the commissioner shall license additional PPEC centers if the commissioner determines
that the applicant and the center meet the licensing requirements of Minnesota Statutes,
chapter 144H.

Subd. 2.

Quality measures; development and reporting.

The commissioner of health,
in consultation with prescribed pediatric extended care centers licensed for the 2019-2020
licensure period, shall develop quality measures for PPEC centers, procedures for PPEC
centers to report quality measures to the commissioner, and methods for the commissioner
to make the results of the quality measures available to the public.

Sec. 93. OLDER ADULT SOCIAL ISOLATION WORKING GROUP.

Subdivision 1.

Establishment; members.

The commissioner of health or the
commissioner's designee shall convene an older adult social isolation working group that
consists of no more than 35 members including, but not limited to:

(1) one person diagnosed with Alzheimer's or dementia;

(2) one caregiver of a person diagnosed with Alzheimer's or dementia;

(3) the executive director of Giving Voice;

(4) one representative from the Mayo Clinic Alzheimer's Disease Research Center;

(5) one representative from AARP Minnesota;

(6) one representative from Little Brothers-Friends of the Elderly, Minneapolis/St. Paul;

(7) one representative from the Alzheimer's Association Minnesota-North Dakota Chapter;

(8) one representative from the American Heart Association Minnesota Chapter;

(9) one representative from the Minnesota HomeCare Association;

(10) two representatives from long-term care trade associations;

(11) one representative from the Minnesota Rural Health Association;

(12) the commissioner of health or the commissioner's designee;

(13) one representative from the Minnesota Board on Aging;

(14) one representative from the Commission of Deaf, Deafblind and Hard of Hearing
Minnesotans;

(15) one representative from the Minnesota Nurses Association;

(16) one representative from the Minnesota Council of Churches;

(17) one representative from the Minnesota Leadership Council on Aging;

(18) one representative from the Minnesota Association of Senior Services;

(19) one representative from Metro Meals on Wheels;

(20) one rural Minnesota geriatrician or family physician;

(21) at least two representatives from the University of Minnesota;

(22) one representative from one of the Minnesota Area Agencies on Aging;

(23) at least two members representing Minnesota rural communities;

(24) additional members representing communities of color;

(25) one representative from the National Alliance on Mental Illness; and

(26) one representative from the Citizens League.

Subd. 2.

Duties; recommendations.

The older adult social isolation working group
must assess the current and future impact of social isolation on the lives of Minnesotans
over age 55. The working group shall consider and make recommendations to the governor
and chairs and members of the health and human services committees in the house of
representatives and senate on the following issues:

(1) the public health impact of social isolation in the older adult population of Minnesota;

(2) identify existing Minnesota resources, services, and capacity to respond to the issue
of social isolation in older adults;

(3) needed policies or community responses, including but not limited to expanding
current services or developing future services after identifying gaps in service for rural
geographical areas;

(4) needed policies or community responses, including but not limited to the expansion
of culturally appropriate current services or developing future services after identifying
gaps in service for persons of color; and

(5) impact of social isolation on older adults with disabilities and needed policies or
community responses.

Subd. 3.

Meetings.

The working group must hold at least four public meetings beginning
August 10, 2018. To the extent possible, technology must be utilized to reach the greatest
number of interested persons throughout the state. The working group must complete the
required meeting schedule by December 10, 2018.

Subd. 4.

Report.

The commissioner of health must submit a report and the working
group's recommendations to the governor and chairs and members of the health and human
services committees in the house of representatives and senate no later than January 14,
2019.

Subd. 5.

Sunset.

The working group sunsets upon delivery of the required report to the
governor and legislative committees.

Sec. 94. RULEMAKING; WELL AND BORING RECORDS.

(a) The commissioner of health shall amend Minnesota Rules, part 4725.1851, subpart
1, to require the licensee, registrant, or property owner or lessee to submit the record of well
or boring construction or sealing within 60 days after completion of the work, rather than
within 30 days after completion of the work.

(b) The commissioner may use the good cause exemption under Minnesota Statutes,
section 14.388, subdivision 1, clause (3), to adopt rules under this section, and Minnesota
Statutes, section 14.386, does not apply, except as provided under Minnesota Statutes,
section 14.388.

Sec. 95. RULEMAKING; SECURITY SCREENING SYSTEMS.

The commissioner of health may adopt permanent rules to implement Minnesota Statutes,
section 144.121, subdivision 9, by December 31, 2020. If the commissioner of health does
not adopt rules by December 31, 2020, rulemaking authority under this section is repealed.
Rulemaking authority under this section is not continuing authority to amend or repeal the
rule. Any additional action on rules once adopted must be pursuant to specific statutory
authority to take the additional action.

Sec. 96. ADVISORY COUNCIL ON PANDAS AND PANS; INITIAL
APPOINTMENTS AND FIRST MEETING.

The appointing authorities shall appoint the first members of the advisory council on
PANDAS and PANS under Minnesota Statutes, section 144.131, no later than October 1,
2018. The commissioner of health shall convene the first meeting by November 1, 2018,
and the commissioner or the commissioner's designee shall act as chair until the advisory
council elects a chair at its first meeting. Notwithstanding the length of terms specified in
Minnesota Statutes, section 144.131, subdivision 3, at the first meeting of the advisory
council, the chair elected by the members shall determine by lot one-third of the advisory
council members whose terms shall expire on September 30 of the calendar year following
the year of first appointment, one-third of the advisory council members whose terms shall
expire on September 30 of the second calendar year following the year of first appointment,
and the remaining advisory council members whose terms shall expire on September 30 of
the third calendar year following the year of first appointment.

Sec. 97. VARIANCE TO REQUIREMENT FOR SANITARY DUMPING STATION.

Notwithstanding any law or rule to the contrary, the commissioner of health shall provide
a variance to the requirement to provide a sanitary dumping station under Minnesota Rules,
part 4630.0900, for a resort in Hubbard County that is located on an island and is landlocked,
making it impractical to build a sanitary dumping station for use by recreational camping
vehicles and recreational camping on the resort property. There must be an alternative
dumping station available within a 15-mile radius of the resort or a vendor that is available
to pump any self-contained liquid waste system that is located on the resort property.

Sec. 98. TRANSITION; HEALTH MAINTENANCE ORGANIZATIONS.

(a) Beginning January 1, 2019, the commissioner of health shall only issue new
certificates of authority for health maintenance organizations that are nonprofit corporations
organized under Minnesota Statutes, chapter 317A, or local governmental units. A certificate
of authority for a health maintenance organization that: (1) is not a nonprofit corporation
organized under Minnesota Statutes, chapter 317A, or a local governmental unit; and (2) is
issued before January 1, 2019, shall expire 30 days after the last date on which health
maintenance contracts issued by that health maintenance organization expire.

(b) A health maintenance organization that is not a nonprofit corporation organized
under Minnesota Statutes, chapter 317A, or a local governmental unit shall not offer, sell,
issue, or renew health maintenance contracts after September 30, 2018.

EFFECTIVE DATE.

This section is effective contingent upon certification by the
legislative auditor under section 99, that the criteria in clause (2) of that section are satisfied,
but no earlier than July 1, 2018.

Sec. 99. ANALYSIS AND CERTIFICATION BY THE LEGISLATIVE AUDITOR.

The legislative auditor shall analyze how enactment of Minnesota Statutes, section
62D.12, subdivision 8a, and of the amendments in this article to Minnesota Statutes, sections
62D.02, subdivision 4; 62D.03, subdivision 1; 62D.05, subdivision 1; 62D.06, subdivision
1; 62D.19; and 62E.02, subdivision 3, would affect competition and the number of health
plan options available in the state in the individual, small group, and Medicare markets.
Upon completion of this analysis, the legislative auditor shall certify that either:

(1) these amendments would result in reduced competition or fewer health plan options
available in the state in the individual, small group, or Medicare market; or

(2) these amendments would not result in reduced competition or fewer health plan
options available in the state in the individual, small group, and Medicare markets.

EFFECTIVE DATE.

This section is effective the day following final enactment.

Sec. 100. REVISOR'S INSTRUCTIONS.

(a) The revisor of statutes shall change the terms "service plan or service agreement"
and "service agreement or service plan" to "service agreement" in the following sections of
Minnesota Statutes: sections 144A.442; 144D.045; 144G.03, subdivision 4, paragraph (c);
and 144G.04.

(b) The revisor of statutes shall change the term "service plan" to "service agreement"
and the term "service plans" to "service agreements" in the following sections of Minnesota
Statutes: sections 144A.44; 144A.45; 144A.475; 144A.4791; 144A.4792; 144A.4793;
144A.4794; 144D.04; and 144G.03, subdivision 4, paragraph (a).

Sec. 101. REPEALER.

(a) Minnesota Statutes 2016, sections 144A.45, subdivision 6; and 144A.481, are repealed.

(b) Minnesota Statutes 2017 Supplement, section 146B.02, subdivision 7a, is repealed.


ARTICLE 2

HEALTH CARE

Section 1.

Minnesota Statutes 2017 Supplement, section 13.69, subdivision 1, is amended
to read:


Subdivision 1.

Classifications.

(a) The following government data of the Department
of Public Safety are private data:

(1) medical data on driving instructors, licensed drivers, and applicants for parking
certificates and special license plates issued to physically disabled persons;

(2) other data on holders of a disability certificate under section 169.345, except that (i)
data that are not medical data may be released to law enforcement agencies, and (ii) data
necessary for enforcement of sections 169.345 and 169.346 may be released to parking
enforcement employees or parking enforcement agents of statutory or home rule charter
cities and towns;

(3) Social Security numbers in driver's license and motor vehicle registration records,
except that Social Security numbers must be provided to the Department of Revenue for
purposes of tax administration, the Department of Labor and Industry for purposes of
workers' compensation administration and enforcement, the judicial branch for purposes of
debt collection, and the Department of Natural Resources for purposes of license application
administration, and except that the last four digits of the Social Security number must be
provided to the Department of Human Services for purposes of recovery of Minnesota health
care program benefits paid
; and

(4) data on persons listed as standby or temporary custodians under section 171.07,
subdivision 11
, except that the data must be released to:

(i) law enforcement agencies for the purpose of verifying that an individual is a designated
caregiver; or

(ii) law enforcement agencies who state that the license holder is unable to communicate
at that time and that the information is necessary for notifying the designated caregiver of
the need to care for a child of the license holder.

The department may release the Social Security number only as provided in clause (3)
and must not sell or otherwise provide individual Social Security numbers or lists of Social
Security numbers for any other purpose.

(b) The following government data of the Department of Public Safety are confidential
data: data concerning an individual's driving ability when that data is received from a member
of the individual's family.

EFFECTIVE DATE.

This section is effective July 1, 2018.

Sec. 2.

Minnesota Statutes 2016, section 62A.30, is amended by adding a subdivision to
read:


Subd. 4.

Mammograms.

(a) For purposes of subdivision 2, coverage for a preventive
mammogram screening shall include digital breast tomosynthesis for enrollees at risk for
breast cancer, and shall be covered as a preventive item or service, as described under section
62Q.46.

(b) For purposes of this subdivision, "digital breast tomosynthesis" means a radiologic
procedure that involves the acquisition of projection images over the stationary breast to
produce cross-sectional digital three-dimensional images of the breast. "At risk for breast
cancer" means:

(1) having a family history with one or more first or second degree relatives with breast
cancer;

(2) testing positive for BRCA1 or BRCA2 mutations;

(3) having heterogeneously dense breasts or extremely dense breasts based on the Breast
Imaging Reporting and Data System established by the American College of Radiology; or

(4) having a previous diagnosis of breast cancer.

(c) This subdivision does not apply to coverage provided through a public health care
program under chapter 256B or 256L.

(d) Nothing in this subdivision limits the coverage of digital breast tomosynthesis in a
policy, plan, certificate, or contract referred to in subdivision 1 that is in effect prior to
January 1, 2019.

(e) Nothing in this subdivision prohibits a policy, plan, certificate, or contract referred
to in subdivision 1 from covering digital breast tomosynthesis for an enrollee who is not at
risk for breast cancer.

EFFECTIVE DATE.

This section is effective January 1, 2019, and applies to health
plans issued, sold, or renewed on or after that date.

Sec. 3.

Minnesota Statutes 2016, section 62A.65, subdivision 7, is amended to read:


Subd. 7.

Short-term coverage.

(a) For purposes of this section, "short-term coverage"
means an individual health plan that:

(1) is issued to provide coverage for a period of 185 days or less, except that the health
plan may permit coverage to continue until the end of a period of hospitalization for a
condition for which the covered person was hospitalized on the day that coverage would
otherwise have ended
than 12 months;

(2) is nonrenewable, provided that the health carrier may provide coverage for one or
more subsequent periods that satisfy clause (1), if the total of the periods of coverage do
not exceed a total of 365 days out of any 555-day period, plus any additional days covered
as a result of hospitalization on the day that a period of coverage would otherwise have
ended
may be renewed for only one additional period meeting the requirements of clause
(1)
; and

(3) does not cover any preexisting conditions for the first six months of coverage,
including ones that originated during a previous identical policy or contract with the same
health carrier where coverage was continuous between the previous and the current policy
or contract; and .

(4) is available with an immediate effective date without underwriting upon receipt of
a completed application indicating eligibility under the health carrier's eligibility
requirements, provided that coverage that includes optional benefits may be offered on a
basis that does not meet this requirement.

(b) Short-term coverage is not subject to subdivisions 2 and 5. Short-term coverage may
exclude as a preexisting condition any injury, illness, or condition for which the covered
person had medical treatment, symptoms, or any manifestations before the effective date
of the coverage, but dependent children born or placed for adoption during the policy period
must not be subject to this provision.

(c) Notwithstanding subdivision 3, and section 62A.021, a health carrier may combine
short-term coverage with its most commonly sold individual qualified plan, as defined in
section 62E.02, other than short-term coverage, for purposes of complying with the loss
ratio requirement.

(d) The 365-day coverage limitation provided in paragraph (a) applies to the total number
of days of short-term coverage that covers a person, regardless of the number of policies,
contracts, or health carriers that provide the coverage. A written application for short-term
coverage must ask the applicant whether the applicant has been covered by short-term
coverage by any health carrier within the 555 days immediately preceding the effective date
of the coverage being applied for. Short-term coverage issued in violation of the 365-day
limitation is valid until the end of its term and does not lose its status as short-term coverage,
in spite of the violation. A health carrier that knowingly issues short-term coverage in
violation of the 365-day limitation is subject to the administrative penalties otherwise
available to the commissioner of commerce or the commissioner of health, as appropriate.

Sec. 4.

Minnesota Statutes 2016, section 62Q.55, subdivision 5, is amended to read:


Subd. 5.

Coverage restrictions or limitations.

(a) If emergency services are provided
by a nonparticipating provider, with or without prior authorization, the health plan company
shall not impose coverage restrictions or limitations that are more restrictive than apply to
emergency services received from a participating provider. Cost-sharing requirements that
apply to emergency services received out-of-network must be the same as the cost-sharing
requirements that apply to services received in-network.

(b) If emergency services are provided by a nonparticipating provider:

(1) the nonparticipating provider shall not request payment from the enrollee in addition
to the applicable cost-sharing requirements authorized under paragraph (a); and

(2) the enrollee shall be held harmless and not liable for payment to the nonparticipating
provider that are in addition to the applicable cost-sharing requirements under paragraph
(a).

(c) A health plan company must attempt to negotiate the reimbursement, less any
applicable cost sharing requirements under paragraph (a), for the emergency services from
the nonparticipating provider. If a health plan company's and nonparticipating provider's
attempts to negotiate reimbursement for the emergency services do not result in a resolution,
the health plan company or provider may elect to refer the matter for binding arbitration.
The arbitrator must be chosen from the list created under section 62Q.556, subdivision 2,
paragraph (c). The arbitrator must consider the information described in section 62Q.556,
subdivision 2, paragraph (d), when reaching a decision. A nondisclosure agreement must
be executed by both parties prior to engaging an arbitrator in accordance with this
subdivision. The cost of arbitration must be shared equally between the parties.

EFFECTIVE DATE.

This section is effective January 1, 2019, and applies to emergency
services provided on or after that date.

Sec. 5.

[256.0113] ELIGIBILITY VERIFICATION.

Subdivision 1.

Verification required; vendor contract.

(a) The commissioner shall
ensure that medical assistance, MinnesotaCare, and Supplemental Nutrition Assistance
Program (SNAP) eligibility determinations through the MNsure information technology
system and through other agency eligibility determination systems include the computerized
verification of income, residency, identity, and when applicable, assets and compliance with
SNAP work requirements.

(b) The commissioner shall contract with a vendor to verify the eligibility of all persons
enrolled in medical assistance, MinnesotaCare, and SNAP during a specified audit period.
This contract shall be exempt from sections 16C.08, subdivision 2, clause (1); 16C.09,
paragraph (a), clause (1); 43A.047, paragraph (a), and any other law to the contrary.

(c) The contract must require the vendor to comply with enrollee data privacy
requirements and to use encryption to safeguard enrollee identity. The contract must also
provide penalties for vendor noncompliance.

(d) The contract must include a revenue sharing agreement, under which vendor
compensation is limited to a portion of any savings to the state resulting from the vendor's
implementation of eligibility verification initiatives under this section.

(e) The commissioner shall use existing resources to fund any agency administrative
and technology-related costs incurred as a result of implementing this section.

(f) All state savings resulting from implementation of the vendor contract under this
section, minus any payments to the vendor made under the terms of the revenue sharing
agreement, shall be deposited into the health care access fund.

Subd. 2.

Verification process; vendor duties.

(a) The verification process implemented
by the vendor must include but is not limited to data matches of the name, date of birth,
address, and Social Security number of each medical assistance, MinnesotaCare, and SNAP
enrollee against relevant information in federal and state data sources, including the federal
data hub established under the Affordable Care Act. In designing the verification process,
the vendor, to the extent feasible, shall incorporate procedures that are compatible and
coordinated with, and build upon or improve, existing procedures used by the MNsure
information technology system and other agency eligibility determination systems.

(b) The vendor, upon preliminary determination that an enrollee is eligible or ineligible,
shall notify the commissioner. Within 20 business days of notification, the commissioner
shall accept the preliminary determination or reject the preliminary determination with a
stated reason. The commissioner shall retain final authority over eligibility determinations.
The vendor shall keep a record of all preliminary determinations of ineligibility submitted
to the commissioner.

(c) The vendor shall recommend to the commissioner an eligibility verification process
that allows ongoing verification of enrollee eligibility under the MNsure information
technology system and other agency eligibility determination systems.

(d) The commissioner and the vendor, following the conclusion of the initial contract
period, shall jointly submit an eligibility verification audit report to the chairs and ranking
minority members of the legislative committees with jurisdiction over health and human
services policy and finance. The report shall include but is not limited to information in the
form of unidentified summary data on preliminary determinations of eligibility or ineligibility
communicated by the vendor, the actions taken on those preliminary determinations by the
commissioner, and the commissioner's reasons for rejecting preliminary determinations by
the vendor. The report must also include the recommendations for ongoing verification of
enrollee eligibility required under paragraph (c).

(e) An eligibility verification vendor contract shall be awarded for an initial one-year
period, beginning January 1, 2019. The commissioner shall renew the contract for up to
three additional one-year periods and require additional eligibility verification audits, if the
commissioner or the legislative auditor determines that the MNsure information technology
system and other agency eligibility determination systems cannot effectively verify the
eligibility of medical assistance, MinnesotaCare, and SNAP enrollees.

Sec. 6.

Minnesota Statutes 2016, section 256.014, subdivision 2, is amended to read:


Subd. 2.

State systems account created.

(a) A state systems account is created in the
state treasury. Money collected by the commissioner of human services for the programs
in subdivision 1 must be deposited in the account. Money in the state systems account and
federal matching money is appropriated to the commissioner of human services for purposes
of this section. Any unexpended balance in the appropriations for information systems
projects for MAXIS, PRISM, MMIS, ISDS, METS, or SSIS does not cancel and is available
for ongoing development and operations, subject to review by the Legislative Advisory
Commission under paragraphs (b) and (c).

(b) No unexpended balance under paragraph (a) may be expended by the commissioner
of human services until the commissioner of management and budget has submitted the
proposed expenditure to the members of the Legislative Advisory Commission for review
and recommendation. If the commission makes a positive recommendation or no
recommendation, or if the commission has not reviewed the request within 20 days after
the date the proposed expenditure was submitted, the commissioner of management and
budget may approve the proposed expenditure. If the commission recommends further
review of the proposed expenditure, the commissioner shall provide additional information
to the commission. If the commission makes a negative recommendation on the proposed
expenditure within ten days of receiving further information, the commissioner shall not
approve the proposed expenditure. If the commission makes a positive recommendation or
no recommendation within ten days of receiving further information, the commissioner may
approve the proposed expenditure.

(c) A recommendation of the commission must be made at a meeting of the commission
unless a written recommendation is signed by all members entitled to vote on the item as
specified in section 3.30, subdivision 2. A recommendation of the commission must be
made by a majority of the commission.

Sec. 7.

Minnesota Statutes 2017 Supplement, section 256B.0625, subdivision 3b, is
amended to read:


Subd. 3b.

Telemedicine services.

(a) Medical assistance covers medically necessary
services and consultations delivered by a licensed health care provider via telemedicine in
the same manner as if the service or consultation was delivered in person. Coverage is
limited to three telemedicine services per enrollee per calendar week, except as provided
in paragraph (f)
. Telemedicine services shall be paid at the full allowable rate.

(b) The commissioner shall establish criteria that a health care provider must attest to
in order to demonstrate the safety or efficacy of delivering a particular service via
telemedicine. The attestation may include that the health care provider:

(1) has identified the categories or types of services the health care provider will provide
via telemedicine;

(2) has written policies and procedures specific to telemedicine services that are regularly
reviewed and updated;

(3) has policies and procedures that adequately address patient safety before, during,
and after the telemedicine service is rendered;

(4) has established protocols addressing how and when to discontinue telemedicine
services; and

(5) has an established quality assurance process related to telemedicine services.

(c) As a condition of payment, a licensed health care provider must document each
occurrence of a health service provided by telemedicine to a medical assistance enrollee.
Health care service records for services provided by telemedicine must meet the requirements
set forth in Minnesota Rules, part 9505.2175, subparts 1 and 2, and must document:

(1) the type of service provided by telemedicine;

(2) the time the service began and the time the service ended, including an a.m. and p.m.
designation;

(3) the licensed health care provider's basis for determining that telemedicine is an
appropriate and effective means for delivering the service to the enrollee;

(4) the mode of transmission of the telemedicine service and records evidencing that a
particular mode of transmission was utilized;

(5) the location of the originating site and the distant site;

(6) if the claim for payment is based on a physician's telemedicine consultation with
another physician, the written opinion from the consulting physician providing the
telemedicine consultation; and

(7) compliance with the criteria attested to by the health care provider in accordance
with paragraph (b).

(d) For purposes of this subdivision, unless otherwise covered under this chapter,
"telemedicine" is defined as the delivery of health care services or consultations while the
patient is at an originating site and the licensed health care provider is at a distant site. A
communication between licensed health care providers, or a licensed health care provider
and a patient that consists solely of a telephone conversation, e-mail, or facsimile transmission
does not constitute telemedicine consultations or services. Telemedicine may be provided
by means of real-time two-way, interactive audio and visual communications, including the
application of secure video conferencing or store-and-forward technology to provide or
support health care delivery, which facilitate the assessment, diagnosis, consultation,
treatment, education, and care management of a patient's health care.

(e) For purposes of this section, "licensed health care provider" means a licensed health
care provider under section 62A.671, subdivision 6, a community paramedic as defined
under section 144E.001, subdivision 5f,
and a mental health practitioner defined under
section 245.462, subdivision 17, or 245.4871, subdivision 26, working under the general
supervision of a mental health professional; "health care provider" is defined under section
62A.671, subdivision 3; and "originating site" is defined under section 62A.671, subdivision
7
.

(f) The limit on coverage of three telemedicine services per enrollee per calendar week
does not apply if:

(1) the telemedicine services provided by the licensed health care provider are for the
treatment and control of tuberculosis; and

(2) the services are provided in a manner consistent with the recommendations and best
practices specified by the Centers for Disease Control and Prevention and the commissioner
of health.

Sec. 8.

Minnesota Statutes 2016, section 256B.0625, is amended by adding a subdivision
to read:


Subd. 17d.

Transportation services oversight.

The commissioner shall contract with
a vendor or dedicate staff for oversight of providers of nonemergency medical transportation
services pursuant to the commissioner's authority in section 256B.04 and Minnesota Rules,
parts 9505.2160 to 9505.2245.

EFFECTIVE DATE.

This section is effective July 1, 2018.

Sec. 9.

Minnesota Statutes 2016, section 256B.0625, is amended by adding a subdivision
to read:


Subd. 17e.

Transportation provider termination.

(a) A terminated nonemergency
medical transportation provider, including all named individuals on the current enrollment
disclosure form and known or discovered affiliates of the nonemergency medical
transportation provider, is not eligible to enroll as a nonemergency medical transportation
provider for five years following the termination.

(b) After the five-year period in paragraph (a), if a provider seeks to reenroll as a
nonemergency medical transportation provider, the nonemergency medical transportation
provider must be placed on a one-year probation period. During a provider's probation
period the commissioner shall complete unannounced site visits and request documentation
to review compliance with program requirements.

EFFECTIVE DATE.

This section is effective the day following final enactment.

Sec. 10.

Minnesota Statutes 2016, section 256B.0625, subdivision 18d, is amended to
read:


Subd. 18d.

Advisory committee members.

(a) The Nonemergency Medical
Transportation Advisory Committee consists of:

(1) four voting members who represent counties, utilizing the rural urban commuting
area classification system. As defined in subdivision 17, these members shall be designated
as follows:

(i) two counties within the 11-county metropolitan area;

(ii) one county representing the rural area of the state; and

(iii) one county representing the super rural area of the state.

The Association of Minnesota Counties shall appoint one county within the 11-county
metropolitan area and one county representing the super rural area of the state. The Minnesota
Inter-County Association shall appoint one county within the 11-county metropolitan area
and one county representing the rural area of the state;

(2) three voting members who represent medical assistance recipients, including persons
with physical and developmental disabilities, persons with mental illness, seniors, children,
and low-income individuals;

(3) four five voting members who represent providers that deliver nonemergency medical
transportation services to medical assistance enrollees, one of whom is a taxicab owner or
operator
;

(4) two voting members of the house of representatives, one from the majority party and
one from the minority party, appointed by the speaker of the house, and two voting members
from the senate, one from the majority party and one from the minority party, appointed by
the Subcommittee on Committees of the Committee on Rules and Administration;

(5) one voting member who represents demonstration providers as defined in section
256B.69, subdivision 2;

(6) one voting member who represents an organization that contracts with state or local
governments to coordinate transportation services for medical assistance enrollees;

(7) one voting member who represents the Minnesota State Council on Disability;

(8) the commissioner of transportation or the commissioner's designee, who shall serve
as a voting member;

(9) one voting member appointed by the Minnesota Ambulance Association; and

(10) one voting member appointed by the Minnesota Hospital Association.

(b) Members of the advisory committee shall not be employed by the Department of
Human Services. Members of the advisory committee shall receive no compensation.

Sec. 11.

Minnesota Statutes 2016, section 256B.0625, subdivision 30, is amended to read:


Subd. 30.

Other clinic services.

(a) Medical assistance covers rural health clinic services,
federally qualified health center services, nonprofit community health clinic services, and
public health clinic services. Rural health clinic services and federally qualified health center
services mean services defined in United States Code, title 42, section 1396d(a)(2)(B) and
(C). Payment for rural health clinic and federally qualified health center services shall be
made according to applicable federal law and regulation.

(b) A federally qualified health center that is beginning initial operation shall submit an
estimate of budgeted costs and visits for the initial reporting period in the form and detail
required by the commissioner. A federally qualified health center that is already in operation
shall submit an initial report using actual costs and visits for the initial reporting period.
Within 90 days of the end of its reporting period, a federally qualified health center shall
submit, in the form and detail required by the commissioner, a report of its operations,
including allowable costs actually incurred for the period and the actual number of visits
for services furnished during the period, and other information required by the commissioner.
Federally qualified health centers that file Medicare cost reports shall provide the
commissioner with a copy of the most recent Medicare cost report filed with the Medicare
program intermediary for the reporting year which support the costs claimed on their cost
report to the state.

(c) In order to continue cost-based payment under the medical assistance program
according to paragraphs (a) and (b), a federally qualified health center or rural health clinic
must apply for designation as an essential community provider within six months of final
adoption of rules by the Department of Health according to section 62Q.19, subdivision 7.
For those federally qualified health centers and rural health clinics that have applied for
essential community provider status within the six-month time prescribed, medical assistance
payments will continue to be made according to paragraphs (a) and (b) for the first three
years after application. For federally qualified health centers and rural health clinics that
either do not apply within the time specified above or who have had essential community
provider status for three years, medical assistance payments for health services provided
by these entities shall be according to the same rates and conditions applicable to the same
service provided by health care providers that are not federally qualified health centers or
rural health clinics.

(d) Effective July 1, 1999, the provisions of paragraph (c) requiring a federally qualified
health center or a rural health clinic to make application for an essential community provider
designation in order to have cost-based payments made according to paragraphs (a) and (b)
no longer apply.

(e) Effective January 1, 2000, payments made according to paragraphs (a) and (b) shall
be limited to the cost phase-out schedule of the Balanced Budget Act of 1997.

(f) Effective January 1, 2001, each federally qualified health center and rural health
clinic may elect to be paid either under the prospective payment system established in United
States Code, title 42, section 1396a(aa), or under an alternative payment methodology
consistent with the requirements of United States Code, title 42, section 1396a(aa), and
approved by the Centers for Medicare and Medicaid Services. The alternative payment
methodology shall be 100 percent of cost as determined according to Medicare cost
principles.

(g) For purposes of this section, "nonprofit community clinic" is a clinic that:

(1) has nonprofit status as specified in chapter 317A;

(2) has tax exempt status as provided in Internal Revenue Code, section 501(c)(3);

(3) is established to provide health services to low-income population groups, uninsured,
high-risk and special needs populations, underserved and other special needs populations;

(4) employs professional staff at least one-half of which are familiar with the cultural
background of their clients;

(5) charges for services on a sliding fee scale designed to provide assistance to
low-income clients based on current poverty income guidelines and family size; and

(6) does not restrict access or services because of a client's financial limitations or public
assistance status and provides no-cost care as needed.

(h) Effective for services provided on or after January 1, 2015, all claims for payment
of clinic services provided by federally qualified health centers and rural health clinics shall
be paid by the commissioner. the commissioner shall determine the most feasible method
for paying claims from the following options:

(1) federally qualified health centers and rural health clinics submit claims directly to
the commissioner for payment, and the commissioner provides claims information for
recipients enrolled in a managed care or county-based purchasing plan to the plan, on a
regular basis; or

(2) federally qualified health centers and rural health clinics submit claims for recipients
enrolled in a managed care or county-based purchasing plan to the plan, and those claims
are submitted by the plan to the commissioner for payment to the clinic.

(h) Federally qualified health centers and rural health clinics shall submit claims directly
to the commissioner for payment, and the commissioner shall provide claims information
for recipients enrolled in a managed care plan or county-based purchasing plan to the plan
on a regular basis as determined by the commissioner.

(i) For clinic services provided prior to January 1, 2015, the commissioner shall calculate
and pay monthly the proposed managed care supplemental payments to clinics, and clinics
shall conduct a timely review of the payment calculation data in order to finalize all
supplemental payments in accordance with federal law. Any issues arising from a clinic's
review must be reported to the commissioner by January 1, 2017. Upon final agreement
between the commissioner and a clinic on issues identified under this subdivision, and in
accordance with United States Code, title 42, section 1396a(bb), no supplemental payments
for managed care plan or county-based purchasing plan claims for services provided prior
to January 1, 2015, shall be made after June 30, 2017. If the commissioner and clinics are
unable to resolve issues under this subdivision, the parties shall submit the dispute to the
arbitration process under section 14.57.

(j) The commissioner shall seek a federal waiver, authorized under section 1115 of the
Social Security Act, to obtain federal financial participation at the 100 percent federal
matching percentage available to facilities of the Indian Health Service or tribal organization
in accordance with section 1905(b) of the Social Security Act for expenditures made to
organizations dually certified under Title V of the Indian Health Care Improvement Act,
Public Law 94-437, and as a federally qualified health center under paragraph (a) that
provides services to American Indian and Alaskan Native individuals eligible for services
under this subdivision.

EFFECTIVE DATE.

This section is effective January 1, 2019, and applies to services
provided on or after that date.

Sec. 12.

[256B.0759] DIRECT CONTRACTING PILOT PROGRAM.

Subdivision 1.

Establishment.

The commissioner shall establish a direct contracting
pilot program to test alternative and innovative methods of delivering care through
community-based collaborative care networks to medical assistance and MinnesotaCare
enrollees. The pilot program shall be designed to coordinate care delivery to enrollees who
demonstrate a combination of medical, economic, behavioral health, cultural, and geographic
risk factors, including persons determined to be at risk of substance abuse and opioid
addiction. The commissioner shall issue a request for proposals to select care networks to
deliver care through the pilot program for a three-year period beginning January 1, 2020.

Subd. 2.

Eligible individuals.

(a) The pilot program shall serve individuals who:

(1) are eligible for medical assistance under section 256B.055 or MinnesotaCare under
chapter 256L;

(2) reside in the service area of the care network;

(3) have a combination of multiple risk factors identified by the care network and
approved by the commissioner;

(4) have elected to participate in the pilot project as an alternative to receiving services
under fee-for-service or through a managed care or county-based purchasing plan or
integrated health partnership; and

(5) agree to participate in risk mitigation strategies as provided in subdivision 4, clause
(4), if the individual is determined to be at risk of opioid addiction or substance abuse.

(b) The commissioner may identify individuals who are potentially eligible to be enrolled
with a care network based on zip code or other geographic designation, utilization history,
or other factors indicating whether an individual resides in the service area of a care network.
The commissioner shall coordinate pilot program enrollment with the enrollment and
procurement process for managed care and county-based purchasing plans and integrated
health partnerships.

Subd. 3.

Selection of care networks.

Participation in the pilot program is limited to no
more than six care networks. The commissioner shall ensure that the care networks selected
serve different geographic areas of the state. The commissioner shall consider the following
criteria when selecting care networks to participate in the program:

(1) the ability of the care network to provide or arrange for the full range of health care
services required to be provided under section 256B.69, including but not limited to primary
care, inpatient hospital care, specialty care, behavioral health services, and chemical
dependency and substance abuse treatment services;

(2) at least 25,000 individuals reside in the service area of the care network;

(3) the care network serves a high percentage of patients who are enrolled in Minnesota
health care programs or are uninsured compared to the overall Minnesota population; and

(4) the care network can demonstrate the capacity to improve health outcomes and reduce
total cost of care for the population in its service area through better patient engagement,
coordination of care, and the provision of specialized services to address risk factors related
to opioid addiction and substance abuse, and address nonclinical risk factors and barriers
to access.

Subd. 4.

Requirements for participating care networks.

(a) A care network selected
to participate in the pilot program must:

(1) accept a capitation rate for enrollees equal to the capitation rate that would otherwise
apply to the enrollees under section 256B.69;

(2) comply with all requirements in section 256B.69 related to performance targets,
capitation rate withholds, and administrative expenses;

(3) maintain adequate reserves and demonstrate the ability to bear risk, based upon
criteria established by the commissioner under the request for proposals, or demonstrate to
the commissioner that this requirement has been met through a contract with a health plan
company, third-party administrator, stop-loss insurer, or other entity; and

(4) assess all enrollees for risk factors related to opioid addiction and substance abuse
and, based upon the professional judgment of the health care provider, require enrollees
determined to be at risk to enter into a patient provider agreement, submit to urine drug
screening, and participate in other risk mitigation strategies; and

(5) participate in quality of care and financial reporting initiatives, in the form and manner
specified by the commissioner.

(b) An existing integrated health partnership that meets the criteria in this section is
eligible to participate in the pilot program while continuing as an integrated health
partnership.

Subd. 5.

Requirements for the commissioner.

(a) The commissioner shall provide all
participating care networks with enrollee utilization and cost information similar to that
provided by the commissioner to integrated health partnerships.

(b) The commissioner, in consultation with the commissioner of health and care networks,
shall design and administer the pilot program in a manner that allows the testing of new
care coordination models and quality-of-care measures to determine the extent to which the
care delivered by the pilot program, relative to the care delivered under fee-for-service and
by managed care and county-based purchasing plans and integrated health partnerships:

(1) improves outcomes and reduces the total cost of care for the population served; and

(2) reduces administrative burdens and costs for health care providers and state agencies.

(c) The commissioner, based on the analysis under paragraph (b), shall evaluate the pilot
program and present recommendations as to whether the pilot program should be continued
or expanded to the chairs and ranking minority members of the legislative committees with
jurisdiction over health and human services policy and finance by February 15, 2022.

Sec. 13.

Minnesota Statutes 2016, section 256B.69, subdivision 5a, is amended to read:


Subd. 5a.

Managed care contracts.

(a) Managed care contracts under this section and
section 256L.12 shall be entered into or renewed on a calendar year basis. The commissioner
may issue separate contracts with requirements specific to services to medical assistance
recipients age 65 and older.

(b) A prepaid health plan providing covered health services for eligible persons pursuant
to chapters 256B and 256L is responsible for complying with the terms of its contract with
the commissioner. Requirements applicable to managed care programs under chapters 256B
and 256L established after the effective date of a contract with the commissioner take effect
when the contract is next issued or renewed.

(c) The commissioner shall withhold five percent of managed care plan payments under
this section and county-based purchasing plan payments under section 256B.692 for the
prepaid medical assistance program pending completion of performance targets. Each
performance target must be quantifiable, objective, measurable, and reasonably attainable,
except in the case of a performance target based on a federal or state law or rule. Criteria
for assessment of each performance target must be outlined in writing prior to the contract
effective date. Clinical or utilization performance targets and their related criteria must
consider evidence-based research and reasonable interventions when available or applicable
to the populations served, and must be developed with input from external clinical experts
and stakeholders, including managed care plans, county-based purchasing plans, and
providers. The managed care or county-based purchasing plan must demonstrate, to the
commissioner's satisfaction, that the data submitted regarding attainment of the performance
target is accurate. The commissioner shall periodically change the administrative measures
used as performance targets in order to improve plan performance across a broader range
of administrative services. The performance targets must include measurement of plan
efforts to contain spending on health care services and administrative activities. The
commissioner may adopt plan-specific performance targets that take into account factors
affecting only one plan, including characteristics of the plan's enrollee population. The
withheld funds must be returned no sooner than July of the following year if performance
targets in the contract are achieved. The commissioner may exclude special demonstration
projects under subdivision 23.

(d) The commissioner shall require that managed care plans use the assessment and
authorization processes, forms, timelines, standards, documentation, and data reporting
requirements, protocols, billing processes, and policies consistent with medical assistance
fee-for-service or the Department of Human Services contract requirements consistent with
medical assistance fee-for-service or the Department of Human Services contract
requirements for all personal care assistance services under section 256B.0659.

(e) Effective for services rendered on or after January 1, 2012, the commissioner shall
include as part of the performance targets described in paragraph (c) a reduction in the health
plan's emergency department utilization rate for medical assistance and MinnesotaCare
enrollees, as determined by the commissioner. For 2012, the reduction shall be based on
the health plan's utilization in 2009. To earn the return of the withhold each subsequent
year, the managed care plan or county-based purchasing plan must achieve a qualifying
reduction of no less than ten percent of the plan's emergency department utilization rate for
medical assistance and MinnesotaCare enrollees, excluding enrollees in programs described
in subdivisions 23 and 28, compared to the previous measurement year until the final
performance target is reached. When measuring performance, the commissioner must
consider the difference in health risk in a managed care or county-based purchasing plan's
membership in the baseline year compared to the measurement year, and work with the
managed care or county-based purchasing plan to account for differences that they agree
are significant.

The withheld funds must be returned no sooner than July 1 and no later than July 31 of
the following calendar year if the managed care plan or county-based purchasing plan
demonstrates to the satisfaction of the commissioner that a reduction in the utilization rate
was achieved. The commissioner shall structure the withhold so that the commissioner
returns a portion of the withheld funds in amounts commensurate with achieved reductions
in utilization less than the targeted amount.

The withhold described in this paragraph shall continue for each consecutive contract
period until the plan's emergency room utilization rate for state health care program enrollees
is reduced by 25 percent of the plan's emergency room utilization rate for medical assistance
and MinnesotaCare enrollees for calendar year 2009. Hospitals shall cooperate with the
health plans in meeting this performance target and shall accept payment withholds that
may be returned to the hospitals if the performance target is achieved.

(f) Effective for services rendered on or after January 1, 2012, the commissioner shall
include as part of the performance targets described in paragraph (c) a reduction in the plan's
hospitalization admission rate for medical assistance and MinnesotaCare enrollees, as
determined by the commissioner. To earn the return of the withhold each year, the managed
care plan or county-based purchasing plan must achieve a qualifying reduction of no less
than five percent of the plan's hospital admission rate for medical assistance and
MinnesotaCare enrollees, excluding enrollees in programs described in subdivisions 23 and
28, compared to the previous calendar year until the final performance target is reached.
When measuring performance, the commissioner must consider the difference in health risk
in a managed care or county-based purchasing plan's membership in the baseline year
compared to the measurement year, and work with the managed care or county-based
purchasing plan to account for differences that they agree are significant.

The withheld funds must be returned no sooner than July 1 and no later than July 31 of
the following calendar year if the managed care plan or county-based purchasing plan
demonstrates to the satisfaction of the commissioner that this reduction in the hospitalization
rate was achieved. The commissioner shall structure the withhold so that the commissioner
returns a portion of the withheld funds in amounts commensurate with achieved reductions
in utilization less than the targeted amount.

The withhold described in this paragraph shall continue until there is a 25 percent
reduction in the hospital admission rate compared to the hospital admission rates in calendar
year 2011, as determined by the commissioner. The hospital admissions in this performance
target do not include the admissions applicable to the subsequent hospital admission
performance target under paragraph (g). Hospitals shall cooperate with the plans in meeting
this performance target and shall accept payment withholds that may be returned to the
hospitals if the performance target is achieved.

(g) Effective for services rendered on or after January 1, 2012, the commissioner shall
include as part of the performance targets described in paragraph (c) a reduction in the plan's
hospitalization admission rates for subsequent hospitalizations within 30 days of a previous
hospitalization of a patient regardless of the reason, for medical assistance and MinnesotaCare
enrollees, as determined by the commissioner. To earn the return of the withhold each year,
the managed care plan or county-based purchasing plan must achieve a qualifying reduction
of the subsequent hospitalization rate for medical assistance and MinnesotaCare enrollees,
excluding enrollees in programs described in subdivisions 23 and 28, of no less than five
percent compared to the previous calendar year until the final performance target is reached.

The withheld funds must be returned no sooner than July 1 and no later than July 31 of
the following calendar year if the managed care plan or county-based purchasing plan
demonstrates to the satisfaction of the commissioner that a qualifying reduction in the
subsequent hospitalization rate was achieved. The commissioner shall structure the withhold
so that the commissioner returns a portion of the withheld funds in amounts commensurate
with achieved reductions in utilization less than the targeted amount.

The withhold described in this paragraph must continue for each consecutive contract
period until the plan's subsequent hospitalization rate for medical assistance and
MinnesotaCare enrollees, excluding enrollees in programs described in subdivisions 23 and
28, is reduced by 25 percent of the plan's subsequent hospitalization rate for calendar year
2011. Hospitals shall cooperate with the plans in meeting this performance target and shall
accept payment withholds that must be returned to the hospitals if the performance target
is achieved.

(h) Effective for services rendered on or after January 1, 2013, through December 31,
2013, the commissioner shall withhold 4.5 percent of managed care plan payments under
this section and county-based purchasing plan payments under section 256B.692 for the
prepaid medical assistance program. The withheld funds must be returned no sooner than
July 1 and no later than July 31 of the following year. The commissioner may exclude
special demonstration projects under subdivision 23.

(i) Effective for services rendered on or after January 1, 2014, the commissioner shall
withhold three percent of managed care plan payments under this section and county-based
purchasing plan payments under section 256B.692 for the prepaid medical assistance
program. The withheld funds must be returned no sooner than July 1 and no later than July
31 of the following year. The commissioner may exclude special demonstration projects
under subdivision 23.

(j) A managed care plan or a county-based purchasing plan under section 256B.692 may
include as admitted assets under section 62D.044 any amount withheld under this section
that is reasonably expected to be returned.

(k) Contracts between the commissioner and a prepaid health plan are exempt from the
set-aside and preference provisions of section 16C.16, subdivisions 6, paragraph (a), and
7.

(l) The return of the withhold under paragraphs (h) and (i) is not subject to the
requirements of paragraph (c).

(m) Managed care plans and county-based purchasing plans shall maintain current and
fully executed agreements for all subcontractors, including bargaining groups, for
administrative services that are expensed to the state's public health care programs.
Subcontractor agreements determined to be material, as defined by the commissioner after
taking into account state contracting and relevant statutory requirements, must be in the
form of a written instrument or electronic document containing the elements of offer,
acceptance, consideration, payment terms, scope, duration of the contract, and how the
subcontractor services relate to state public health care programs. Upon request, the
commissioner shall have access to all subcontractor documentation under this paragraph.
Nothing in this paragraph shall allow release of information that is nonpublic data pursuant
to section 13.02.

(n) Effective for services provided on or after January 1, 2019, through December 31,
2019, the commissioner shall withhold two percent of the capitation payment provided to
managed care plans under this section, and county-based purchasing plans under section
256B.692, for each medical assistance enrollee. The withheld funds must be returned no
sooner than July 1 and no later than July 31 of the following year, for capitation payments
for enrollees for whom the plan has submitted to the commissioner a verification of coverage
form completed and signed by the enrollee. The verification of coverage form must be
developed by the commissioner and made available to managed care and county-based
purchasing plans. The form must require the enrollee to provide the enrollee's name and
street address and the name of the managed care or county-based purchasing plan selected
by or assigned to the enrollee and must include a signature block that allows the enrollee
to attest that the information provided is accurate. A plan shall request that all enrollees
complete the verification of coverage form and shall submit all completed forms to the
commissioner by February 28, 2019. If a completed form for an enrollee is not received by
the commissioner by that date:

(1) the commissioner shall not return to the plan funds withheld for that enrollee;

(2) the commissioner shall cease making capitation payments to the plan for that enrollee,
effective with the April 2019 coverage month; and

(3) the commissioner shall disenroll the enrollee from medical assistance, subject to any
enrollee appeal.

(o) The commissioner may establish and administer a single preferred drug list for
medical assistance and MinnesotaCare enrollees receiving services through fee-for-service,
integrated health partnerships, managed care, or county-based purchasing, only if the
commissioner first studies this change and then obtains legislative approval in the form of
enacted legislation authorizing the change. In conducting the study, the commissioner shall
consult with interested and affected stakeholders including but not limited to managed care
organizations, county-based purchasers, integrated health partnerships, health care providers,
and enrollees. The commissioner shall report to the chairs and ranking minority members
of the legislative committees with jurisdiction over health and human services policy and
finance on the anticipated impact of the proposed change on: the state budget, access to
services, quality of both outcomes and enrollee experience, and administrative efficiency.
The report must also include an assessment of possible unintended consequences of the use
of a single preferred drug list.

Sec. 14. ENCOUNTER REPORTING OF 340B ELIGIBLE DRUGS.

(a) The commissioner of human services, in consultation with federally qualified health
centers, managed care organizations, and contract pharmacies, shall develop
recommendations for a process to identify and report at point of sale the 340B drugs that
are dispensed to enrollees of managed care organizations who are patients of a federally
qualified health center, and to exclude these claims from the Medicaid Drug Rebate Program
and ensure that duplicate discounts for drugs do not occur. In developing this process, the
commissioner shall assess the impact of allowing federally qualified health centers to utilize
the 340B Drug Pricing Program drug discounts if a federally qualified health center utilizes
a contract pharmacy for a patient enrolled in the prepaid medical assistance program.

(b) By March 1, 2019, the commissioner shall report the recommendations to the chairs
and ranking minority members of the house of representatives and senate committees with
jurisdiction over medical assistance.

Sec. 15. RECONCILIATION OF MINNESOTACARE PREMIUMS.

Subdivision 1.

Reconciliation required.

(a) The commissioner of human services shall
reconcile all MinnesotaCare premiums paid or due for health coverage provided during the
period January 1, 2014, through December 31, 2017, by July 1, 2018. Based on this
reconciliation, the commissioner shall notify each MinnesotaCare enrollee or former enrollee
of any amount owed as premiums, refund to the enrollee or former enrollee any premium
overpayment, and enter into a payment arrangement with the enrollee or former enrollee as
necessary.

(b) The commissioner of human services is prohibited from using agency staff and
resources to plan, develop, or promote any proposal that would offer a health insurance
product on the individual market that would offer consumers similar benefits and networks
as the standard MinnesotaCare program, until the commissioner of management and budget
has determined under subdivision 2 that the commissioner is in compliance with the
requirements of this section.

Subd. 2.

Determination of compliance; contingent transfer.

The commissioner of
management and budget shall determine whether the commissioner of human services has
complied with the requirements of subdivision 1. If the commissioner of management and
budget determines that the commissioner of human services is not in compliance with
subdivision 1, the commissioner of management and budget shall transfer $10,000 from
the central office operations account of the Department of Human Services to the premium
security plan account established under Minnesota Statutes, section 62E.25, for each business
day of noncompliance.

EFFECTIVE DATE.

This section is effective the day following final enactment.

Sec. 16. CONTRACT TO RECOVER THIRD-PARTY LIABILITY.

The commissioner shall contract with a vendor to implement a third-party liability
recovery program for medical assistance and MinnesotaCare. Under the terms of the contract,
the vendor shall be reimbursed using a percentage of the money recovered through the
third-party liability recovery program. All money recovered that remains after reimbursement
of the vendor is available for operation of the medical assistance and MinnesotaCare
programs. The use of this money must be authorized in law by the legislature.

EFFECTIVE DATE.

This section is effective July 1, 2018.

Sec. 17. STUDY AND REPORT ON DISPARITIES BETWEEN GEOGRAPHIC
RATING AREAS IN INDIVIDUAL AND SMALL GROUP MARKET HEALTH
INSURANCE RATES.

Subdivision 1.

Study and recommendations.

(a) As permitted by the availability of
resources, the legislative auditor is requested to study disparities between Minnesota's nine
geographic rating areas in individual and small group market health insurance rates and
recommend ways to reduce or eliminate rate disparities between the geographic rating areas
and provide for stability of the individual and small group health insurance markets in the
state. In the study, if conducted, the legislative auditor shall:

(1) identify the factors that cause higher individual and small group market health
insurance rates in certain geographic rating areas, and determine the extent to which each
identified factor contributes to the higher rates;

(2) identify the impact of referral centers on individual and small group market health
insurance rates in southeastern Minnesota, and identify ways to reduce the rate disparity
between southeastern Minnesota and the metropolitan area, taking into consideration the
patterns of referral center usage by patients in those regions;

(3) determine the extent to which individuals and small employers located in a geographic
rating area with higher health insurance rates than surrounding geographic rating areas have
obtained health insurance in a lower-cost geographic rating area, identify the strategies that
individuals and small employers use to obtain health insurance in a lower-cost geographic
rating area, and measure the effects of this practice on the rates of the individuals and small
employers remaining in the geographic rating area with higher health insurance rates; and

(4) develop proposals to redraw the boundaries of Minnesota's geographic rating areas,
and calculate the effect each proposal would have on rates in each of the proposed rating
areas. The legislative auditor shall examine at least three options for redrawing the boundaries
of Minnesota's geographic rating areas, at least one of which must reduce the number of
geographic rating areas. All options for redrawing Minnesota's geographic rating areas
considered by the legislative auditor must be designed:

(i) with the purposes of reducing or eliminating rate disparities between geographic
rating areas and providing for stability of the individual and small group health insurance
markets in the state;

(ii) with consideration of the composition of existing provider networks and referral
patterns in regions of the state; and

(iii) in compliance with the requirements for geographic rating areas in Code of Federal
Regulations, title 45, section 147.102(b), and other applicable federal law and guidance.

(b) The legislative auditor may secure de-identified data necessary to complete the study
and recommendations according to this subdivision directly from health carriers. For purposes
of this paragraph "de-identified" means a process to remove all identifiable information
regarding an individual or group from data. Data classified as nonpublic data or private data
on individuals, as defined in section 13.02, subdivisions 9 and 12, remains classified as
such.

(c) The legislative auditor may recommend one or more proposals for redrawing
Minnesota's geographic rating areas if the legislative auditor determines that the proposal
would reduce or eliminate individual and small group market health insurance rate disparities
between the geographic rating areas and provide for stability of the individual and small
group health insurance markets in the state.

Subd. 2.

Contract.

The legislative auditor may contract with another entity for technical
assistance in conducting the study and developing recommendations according to subdivision
1.

Subd. 3.

Report.

The legislative auditor is requested to complete the study and
recommendations by January 1, 2019, and to submit a report on the study and
recommendations by that date to the chairs and ranking minority members of the legislative
committees with jurisdiction over health care and health insurance.

Sec. 18. TESTIMONY ON USE OF DIGITAL BREAST TOMOSYNTHESIS BY
MEMBERS OF THE STATE EMPLOYEE GROUP INSURANCE PROGRAM.

The director of the state employee group insurance program must prepare and submit
written testimony to the house of representatives and senate committees with jurisdiction
over health and human services and state government finance regarding the impact of
Minnesota Statutes, section 62A.30, subdivision 4. The director must provide data on actual
utilization of the coverage under Minnesota Statutes, section 62A.30, subdivision 4 by
members of the state employee group insurance program from January 1, 2019, to June 30,
2019. The director may make recommendations for legislation addressing any issues relating
to the coverage required by Minnesota Statutes, section 62A.30, subdivision 4. The testimony
required under this section is due by December 31, 2019.

Sec. 19. MENTAL HEALTH AND SUBSTANCE USE DISORDER PARITY WORK
GROUP.

Subdivision 1.

Establishment; membership.

(a) A mental health and substance use
disorder parity work group is established and shall include the following members:

(1) two members representing health plan companies that offer health plans in the
individual market, appointed by the commissioner of commerce;

(2) two members representing health plan companies that offer health plans in the group
markets, appointed by the commissioner of commerce;

(3) the commissioner of health or a designee;

(4) the commissioner of commerce or a designee;

(5) the commissioner of management and budget or a designee;

(6) two members representing employers, appointed by the commissioner of commerce;

(7) two members who are providers representing the mental health and substance use
disorder community, appointed by the commissioner of commerce; and

(8) two members who are advocates representing the mental health and substance use
disorder community, appointed by the commissioner of commerce.

(b) Members of the work group must have expertise in standards for evidence-based
care, benefit design, or knowledge relating to the analysis of mental health and substance
use disorder parity under federal and state law, including nonquantitative treatment
limitations.

Subd. 2.

First appointments; first meeting; chair.

Appointing authorities shall appoint
members to the work group by July 1, 2018. The commissioner of commerce or a designee
shall convene the first meeting of the work group on or before August 1, 2018. The
commissioner of commerce or the commissioner's designee shall act as chair.

Subd. 3.

Duties.

The mental health and substance use disorder parity work group shall:

(1) develop recommendations on the most effective approach to determine and
demonstrate mental health and substance use disorder parity, in accordance with state and
federal law for individual and group health plans offered in Minnesota; and

(2) report recommendations to the legislature.

Subd. 4.

Report.

(a) By February 15, 2019, the work group shall submit a report with
recommendations to the chairs and ranking minority members of the legislative committees
with jurisdiction over health care policy and finance.

(b) The report must include the following:

(1) a summary of completed state enforcement actions relating to individual and group
health plans offered in Minnesota during the preceding 12-month period regarding
compliance with parity in mental health and substance use disorders benefits in accordance
with state and federal law and a summary of the results of completed state enforcement
actions. Data that is protected under state or federal law as nonpublic, private, or confidential
shall remain nonpublic, private, or confidential. This summary must include:

(i) the number of formal enforcement actions taken;

(ii) the benefit classifications examined in each enforcement action; and

(iii) the subject matter of each enforcement action, including quantitative and
nonquantitative treatment limitations;

(2) detailed information about any regulatory actions the commissioner of health or
commissioner of commerce has taken as a result of a completed state enforcement action
pertaining to health plan compliance with Minnesota Statutes, sections 62Q.47 and 62Q.53,
and United States Code, title 42, section 18031(j);

(3) a description of the work group's recommendations on educating the public about
alcoholism, mental health, or chemical dependency parity protections under state and federal
law; and

(4) recommendations on the most effective approach to determine and demonstrate
mental health and substance use disorder parity, in accordance with state and federal law
for individual and group health plans offered in Minnesota.

(c) In developing the report and recommendations, the work group may consult with
the Substance Abuse and Mental Health Services Agency and the National Association of
Insurance Commissioners for the latest developments on evaluation of mental health and
substance use disorder parity.

(d) The report must be written in plain language and must be made available to the public
by being posted on the Web sites of the Department of Health and Department of Commerce.
The work group may make the report publicly available in additional ways, at its discretion.

(e) The report must include any draft legislation necessary to implement the
recommendations of the work group.

Subd. 5.

Expiration.

The mental health and substance use disorder parity work group
expires February 16, 2019, or the day after submitting the report required in this section,
whichever is earlier.

Sec. 20. REPEALER.

Minnesota Statutes 2016, section 62A.65, subdivision 7a, is repealed.


ARTICLE 3

CHEMICAL AND MENTAL HEALTH

Section 1.

Minnesota Statutes 2016, section 13.851, is amended by adding a subdivision
to read:


Subd. 11.

Mental health screening.

The treatment of data collected by a sheriff or local
corrections agency related to individuals who may have a mental illness is governed by
section 641.15, subdivision 3a.

Sec. 2.

Minnesota Statutes 2016, section 245A.04, subdivision 7, is amended to read:


Subd. 7.

Grant of license; license extension.

(a) If the commissioner determines that
the program complies with all applicable rules and laws, the commissioner shall issue a
license consistent with this section or, if applicable, a temporary change of ownership license
under section 245A.043
. At minimum, the license shall state:

(1) the name of the license holder;

(2) the address of the program;

(3) the effective date and expiration date of the license;

(4) the type of license;

(5) the maximum number and ages of persons that may receive services from the program;
and

(6) any special conditions of licensure.

(b) The commissioner may issue an initial a license for a period not to exceed two years
if:

(1) the commissioner is unable to conduct the evaluation or observation required by
subdivision 4, paragraph (a), clauses (3) and (4), because the program is not yet operational;

(2) certain records and documents are not available because persons are not yet receiving
services from the program; and

(3) the applicant complies with applicable laws and rules in all other respects.

(c) A decision by the commissioner to issue a license does not guarantee that any person
or persons will be placed or cared for in the licensed program. A license shall not be
transferable to another individual, corporation, partnership, voluntary association, other
organization, or controlling individual or to another location.

(d) A license holder must notify the commissioner and obtain the commissioner's approval
before making any changes that would alter the license information listed under paragraph
(a).

(e) (d) Except as provided in paragraphs (g) (f) and (h) (g), the commissioner shall not
issue or reissue a license if the applicant, license holder, or controlling individual has:

(1) been disqualified and the disqualification was not set aside and no variance has been
granted;

(2) been denied a license within the past two years;

(3) had a license issued under this chapter revoked within the past five years;

(4) an outstanding debt related to a license fee, licensing fine, or settlement agreement
for which payment is delinquent; or

(5) failed to submit the information required of an applicant under subdivision 1,
paragraph (f) or (g), after being requested by the commissioner.

When a license issued under this chapter is revoked under clause (1) or (3), the license
holder and controlling individual may not hold any license under chapter 245A or 245D for
five years following the revocation, and other licenses held by the applicant, license holder,
or controlling individual shall also be revoked.

(f) (e) The commissioner shall not issue or reissue a license under this chapter if an
individual living in the household where the licensed services will be provided as specified
under section 245C.03, subdivision 1, has been disqualified and the disqualification has not
been set aside and no variance has been granted.

(g) (f) Pursuant to section 245A.07, subdivision 1, paragraph (b), when a license issued
under this chapter
has been suspended or revoked and the suspension or revocation is under
appeal, the program may continue to operate pending a final order from the commissioner.
If the license under suspension or revocation will expire before a final order is issued, a
temporary provisional license may be issued provided any applicable license fee is paid
before the temporary provisional license is issued.

(h) (g) Notwithstanding paragraph (g) (f), when a revocation is based on the
disqualification of a controlling individual or license holder, and the controlling individual
or license holder is ordered under section 245C.17 to be immediately removed from direct
contact with persons receiving services or is ordered to be under continuous, direct
supervision when providing direct contact services, the program may continue to operate
only if the program complies with the order and submits documentation demonstrating
compliance with the order. If the disqualified individual fails to submit a timely request for
reconsideration, or if the disqualification is not set aside and no variance is granted, the
order to immediately remove the individual from direct contact or to be under continuous,
direct supervision remains in effect pending the outcome of a hearing and final order from
the commissioner.

(i) (h) For purposes of reimbursement for meals only, under the Child and Adult Care
Food Program, Code of Federal Regulations, title 7, subtitle B, chapter II, subchapter A,
part 226, relocation within the same county by a licensed family day care provider, shall
be considered an extension of the license for a period of no more than 30 calendar days or
until the new license is issued, whichever occurs first, provided the county agency has
determined the family day care provider meets licensure requirements at the new location.

(j) (i) Unless otherwise specified by statute, all licenses issued under this chapter expire
at 12:01 a.m. on the day after the expiration date stated on the license. A license holder must
apply for and be granted a new license to operate the program or the program must not be
operated after the expiration date.

(k) (j) The commissioner shall not issue or reissue a license under this chapter if it has
been determined that a tribal licensing authority has established jurisdiction to license the
program or service.

Sec. 3.

Minnesota Statutes 2016, section 245A.04, is amended by adding a subdivision to
read:


Subd. 7a.

Notification required.

(a) A license holder must notify the commissioner and
obtain the commissioner's approval before making any change that would alter the license
information listed under subdivision 7, paragraph (a).

(b) At least 30 days before the effective date of a change, the license holder must notify
the commissioner in writing of any change:

(1) to the license holder's controlling individual as defined in section 245A.02, subdivision
5a;

(2) to license holder information on file with the secretary of state;

(3) in the location of the program or service licensed under this chapter; and

(4) in the federal or state tax identification number associated with the license holder.

(c) When a license holder notifies the commissioner of a change to the business structure
governing the licensed program or services but is not selling the business, the license holder
must provide amended articles of incorporation and other documentation of the change and
any other information requested by the commissioner.

EFFECTIVE DATE.

This section is effective August 1, 2018.

Sec. 4.

[245A.043] LICENSE APPLICATION AFTER CHANGE OF OWNERSHIP.

Subdivision 1.

Transfer prohibited.

A license issued under this chapter is only valid
for a premises and individual, organization, or government entity identified by the
commissioner on the license. A license is not transferable or assignable.

Subd. 2.

Change of ownership.

If the commissioner determines that there will be a
change of ownership, the commissioner shall require submission of a new license application.
A change of ownership occurs when:

(1) the license holder sells or transfers 100 percent of the property, stock, or assets;

(2) the license holder merges with another organization;

(3) the license holder consolidates with two or more organizations, resulting in the
creation of a new organization;

(4) there is a change in the federal tax identification number associated with the license
holder; or

(5) there is a turnover of each controlling individual associated with the license within
a 12-month period. A change to the license holder's controlling individuals, including a
change due to a transfer of stock, is not a change of ownership if at least one controlling
individual who was listed on the license for at least 12 consecutive months continues to be
a controlling individual after the reported change.

Subd. 3.

Change of ownership requirements.

(a) A license holder who intends to
change the ownership of the program or service under subdivision 2 to a party that intends
to assume operation without an interruption in service longer than 60 days after acquiring
the program or service must provide the commissioner with written notice of the proposed
sale or change, on a form provided by the commissioner, at least 60 days before the
anticipated date of the change in ownership. For purposes of this subdivision and subdivision
4, "party" means the party that intends to operate the service or program.

(b) The party must submit a license application under this chapter on a form and in the
manner prescribed by the commissioner at least 30 days before the change of ownership is
complete and must include documentation to support the upcoming change. The form and
manner of the application prescribed by the commissioner shall require only information
which is specifically required by statute or rule. The party must comply with background
study requirements under chapter 245C and shall pay the application fee required in section
245A.10. A party that intends to assume operation without an interruption in service longer
than 60 days after acquiring the program or service is exempt from the requirements of
Minnesota Rules, part 9530.6800.

(c) The commissioner may develop streamlined application procedures when the party
is an existing license holder under this chapter and is acquiring a program licensed under
this chapter or service in the same service class as one or more licensed programs or services
the party operates and those licenses are in substantial compliance according to the licensing
standards in this chapter and applicable rules. For purposes of this subdivision, "substantial
compliance" means within the past 12 months the commissioner did not: (i) issue a sanction
under section 245A.07 against a license held by the party or (ii) make a license held by the
party conditional according to section 245A.06.

(d) Except when a temporary change of ownership license is issued pursuant to
subdivision 4, the existing license holder is solely responsible for operating the program
according to applicable rules and statutes until a license under this chapter is issued to the
party.

(e) If a licensing inspection of the program or service was conducted within the previous
12 months and the existing license holder's license record demonstrates substantial
compliance with the applicable licensing requirements, the commissioner may waive the
party's inspection required by section 245A.04, subdivision 4. The party must submit to the
commissioner proof that the premises was inspected by a fire marshal or that the fire marshal
deemed that an inspection was not warranted and proof that the premises was inspected for
compliance with the building code or that no inspection was deemed warranted.

(f) If the party is seeking a license for a program or service that has an outstanding
correction order, the party must submit a letter with the license application identifying how
and within what length of time the party shall resolve the outstanding correction order and
come into full compliance with the licensing requirements.

(g) Any action taken under section 245A.06 or 245A.07 against the existing license
holder's license at the time the party is applying for a license, including when the existing
license holder is operating under a conditional license or is subject to a revocation, shall
remain in effect until the commissioner determines that the grounds for the action are
corrected or no longer exist.

(h) The commissioner shall evaluate the application of the party according to section
245A.04, subdivision 6. Pursuant to section 245A.04, subdivision 7, if the commissioner
determines that the party complies with applicable laws and rules, the commissioner may
issue a license or a temporary change of ownership license.

(i) The commissioner may deny an application as provided in section 245A.05. An
applicant whose application was denied by the commissioner may appeal the denial according
to section 245A.05.

(j) This subdivision does not apply to a licensed program or service located in a home
where the license holder resides.

Subd. 4.

Temporary change of ownership license.

(a) After receiving the party's
application and upon the written request of the existing license holder and the party, the
commissioner may issue a temporary change of ownership license to the party while the
commissioner evaluates the party's application. Until a decision is made to grant or deny a
license under this chapter, the existing license holder and the party shall both be responsible
for operating the program or service according to applicable laws and rules, and the sale or
transfer of the license holder's ownership interest in the licensed program or service does
not terminate the existing license.

(b) The commissioner may establish criteria to issue a temporary change of ownership
license, if a license holder's death, divorce, or other event affects the ownership of the
program, when an applicant seeks to assume operation of the program or service to ensure
continuity of the program or service while a license application is evaluated. This subdivision
applies to any program or service licensed under this chapter.

EFFECTIVE DATE.

This section is effective August 1, 2018.

Sec. 5.

Minnesota Statutes 2016, section 245C.22, subdivision 4, is amended to read:


Subd. 4.

Risk of harm; set aside.

(a) The commissioner may set aside the disqualification
if the commissioner finds that the individual has submitted sufficient information to
demonstrate that the individual does not pose a risk of harm to any person served by the
applicant, license holder, or other entities as provided in this chapter.

(b) In determining whether the individual has met the burden of proof by demonstrating
the individual does not pose a risk of harm, the commissioner shall consider:

(1) the nature, severity, and consequences of the event or events that led to the
disqualification;

(2) whether there is more than one disqualifying event;

(3) the age and vulnerability of the victim at the time of the event;

(4) the harm suffered by the victim;

(5) vulnerability of persons served by the program;

(6) the similarity between the victim and persons served by the program;

(7) the time elapsed without a repeat of the same or similar event;

(8) documentation of successful completion by the individual studied of training or
rehabilitation pertinent to the event; and

(9) any other information relevant to reconsideration.

(c) If the individual requested reconsideration on the basis that the information relied
upon to disqualify the individual was incorrect or inaccurate and the commissioner determines
that the information relied upon to disqualify the individual is correct, the commissioner
must also determine if the individual poses a risk of harm to persons receiving services in
accordance with paragraph (b).

(d) For an individual in the chemical dependency field, the commissioner must set aside
the disqualification if the following criteria are met:

(1) the individual submits sufficient documentation to demonstrate that the individual
is a nonviolent controlled substance offender under section 244.0513, subdivision 2, clauses
(1), (2), and (6);

(2) the individual is disqualified exclusively for one or more offenses listed under section
152.021, subdivision 2 or 2a; 152.022, subdivision 2; 152.023, subdivision 2; 152.024; or
152.025;

(3) the individual provided documentation of successful completion of treatment, at least
one year prior to the date of the request for reconsideration, at a program licensed under
chapter 245G;

(4) the individual provided documentation demonstrating abstinence from controlled
substances, as defined in section 152.01, subdivision 4, for the period one year prior to the
date of the request for reconsideration; and

(5) the individual is seeking employment in the chemical dependency field.

Sec. 6.

Minnesota Statutes 2017 Supplement, section 245C.22, subdivision 5, is amended
to read:


Subd. 5.

Scope of set-aside.

(a) If the commissioner sets aside a disqualification under
this section, the disqualified individual remains disqualified, but may hold a license and
have direct contact with or access to persons receiving services. Except as provided in
paragraph (b), the commissioner's set-aside of a disqualification is limited solely to the
licensed program, applicant, or agency specified in the set aside notice under section 245C.23.
For personal care provider organizations, the commissioner's set-aside may further be limited
to a specific individual who is receiving services. For new background studies required
under section 245C.04, subdivision 1, paragraph (h), if an individual's disqualification was
previously set aside for the license holder's program and the new background study results
in no new information that indicates the individual may pose a risk of harm to persons
receiving services from the license holder, the previous set-aside shall remain in effect.

(b) If the commissioner has previously set aside an individual's disqualification for one
or more programs or agencies, and the individual is the subject of a subsequent background
study for a different program or agency, the commissioner shall determine whether the
disqualification is set aside for the program or agency that initiated the subsequent
background study. A notice of a set-aside under paragraph (c) shall be issued within 15
working days if all of the following criteria are met:

(1) the subsequent background study was initiated in connection with a program licensed
or regulated under the same provisions of law and rule for at least one program for which
the individual's disqualification was previously set aside by the commissioner;

(2) the individual is not disqualified for an offense specified in section 245C.15,
subdivision 1 or 2;

(3) the individual is not disqualified for an offense specified in section 245C.15,
subdivision 2, unless the individual is employed in the chemical dependency field;

(4) the commissioner has received no new information to indicate that the individual
may pose a risk of harm to any person served by the program; and

(4) (5) the previous set-aside was not limited to a specific person receiving services.

(c) When a disqualification is set aside under paragraph (b), the notice of background
study results issued under section 245C.17, in addition to the requirements under section
245C.17, shall state that the disqualification is set aside for the program or agency that
initiated the subsequent background study. The notice must inform the individual that the
individual may request reconsideration of the disqualification under section 245C.21 on the
basis that the information used to disqualify the individual is incorrect.

Sec. 7.

Minnesota Statutes 2017 Supplement, section 245G.03, subdivision 1, is amended
to read:


Subdivision 1.

License requirements.

(a) An applicant for a license to provide substance
use disorder treatment must comply with the general requirements in chapters 245A and
245C, sections 626.556 and 626.557, and Minnesota Rules, chapter 9544.

(b) The assessment of need process under Minnesota Rules, parts 9530.6800 and
9530.6810, is not applicable to programs licensed under this chapter. However, the
commissioner may deny issuance of a license to an applicant if the commissioner determines
that the services currently available in the local area are sufficient to meet local need and
the addition of new services would be detrimental to individuals seeking these services.

(c) The commissioner may grant variances to the requirements in this chapter that do
not affect the client's health or safety if the conditions in section 245A.04, subdivision 9,
are met.

Sec. 8.

Minnesota Statutes 2017 Supplement, section 254A.03, subdivision 3, is amended
to read:


Subd. 3.

Rules for substance use disorder care.

(a) The commissioner of human
services shall establish by rule criteria to be used in determining the appropriate level of
chemical dependency care for each recipient of public assistance seeking treatment for
substance misuse or substance use disorder. Upon federal approval of a comprehensive
assessment as a Medicaid benefit, or on July 1, 2018, whichever is later, and notwithstanding
the criteria in Minnesota Rules, parts 9530.6600 to 9530.6655, an eligible vendor of
comprehensive assessments under section 254B.05 may determine and approve the
appropriate level of substance use disorder treatment for a recipient of public assistance.
The process for determining an individual's financial eligibility for the consolidated chemical
dependency treatment fund or determining an individual's enrollment in or eligibility for a
publicly subsidized health plan is not affected by the individual's choice to access a
comprehensive assessment for placement.

(b) The commissioner shall develop and implement a utilization review process for
publicly funded treatment placements to monitor and review the clinical appropriateness
and timeliness of all publicly funded placements in treatment.

(c) A structured assessment for alcohol or substance use disorder that is provided to a
recipient of public assistance by a primary care clinic, hospital, or other medical setting
establishes medical necessity and approval for an initial set of substance use disorder services
identified in section 254B.05, subdivision 5, when the screen result is positive for alcohol
or substance misuse. The initial set of services approved for a recipient whose screen result
is positive shall include four hours of individual or group substance use disorder treatment,
two hours of substance use disorder care coordination, and two hours of substance use
disorder peer support services. A recipient must obtain an assessment pursuant to paragraph
(a) to be approved for additional treatment services.

EFFECTIVE DATE.

This section is effective July 1, 2018, contingent on federal
approval. The commissioner of human services shall notify the revisor of statutes when
federal approval is obtained or denied.

Sec. 9.

Minnesota Statutes 2016, section 254B.02, subdivision 1, is amended to read:


Subdivision 1.

Chemical dependency treatment allocation.

The chemical dependency
treatment appropriation shall be placed in a special revenue account. The commissioner
shall annually transfer funds from the chemical dependency fund to pay for operation of
the drug and alcohol abuse normative evaluation system and to pay for all costs incurred
by adding two positions for licensing of chemical dependency treatment and rehabilitation
programs located in hospitals for which funds are not otherwise appropriated.
The remainder
of the
money in the special revenue account must be used according to the requirements in
this chapter.

Sec. 10.

Minnesota Statutes 2017 Supplement, section 254B.03, subdivision 2, is amended
to read:


Subd. 2.

Chemical dependency fund payment.

(a) Payment from the chemical
dependency fund is limited to payments for services other than detoxification licensed under
Minnesota Rules, parts 9530.6510 to 9530.6590, that, if located outside of federally
recognized tribal lands, would be required to be licensed by the commissioner as a chemical
dependency treatment or rehabilitation program under sections 245A.01 to 245A.16, and
services other than detoxification provided in another state that would be required to be
licensed as a chemical dependency program if the program were in the state. Out of state
vendors must also provide the commissioner with assurances that the program complies
substantially with state licensing requirements and possesses all licenses and certifications
required by the host state to provide chemical dependency treatment. Vendors receiving
payments from the chemical dependency fund must not require co-payment from a recipient
of benefits for services provided under this subdivision. The vendor is prohibited from using
the client's public benefits to offset the cost of services paid under this section. The vendor
shall not require the client to use public benefits for room or board costs. This includes but
is not limited to cash assistance benefits under chapters 119B, 256D, and 256J, or SNAP
benefits. Retention of SNAP benefits is a right of a client receiving services through the
consolidated chemical dependency treatment fund or through state contracted managed care
entities. Payment from the chemical dependency fund shall be made for necessary room
and board costs provided by vendors certified according to section 254B.05, or in a
community hospital licensed by the commissioner of health according to sections 144.50
to 144.56 to a client who is:

(1) determined to meet the criteria for placement in a residential chemical dependency
treatment program according to rules adopted under section 254A.03, subdivision 3; and

(2) concurrently receiving a chemical dependency treatment service in a program licensed
by the commissioner and reimbursed by the chemical dependency fund.

(b) A county may, from its own resources, provide chemical dependency services for
which state payments are not made. A county may elect to use the same invoice procedures
and obtain the same state payment services as are used for chemical dependency services
for which state payments are made under this section if county payments are made to the
state in advance of state payments to vendors. When a county uses the state system for
payment, the commissioner shall make monthly billings to the county using the most recent
available information to determine the anticipated services for which payments will be made
in the coming month. Adjustment of any overestimate or underestimate based on actual
expenditures shall be made by the state agency by adjusting the estimate for any succeeding
month.

(c) The commissioner shall coordinate chemical dependency services and determine
whether there is a need for any proposed expansion of chemical dependency treatment
services. The commissioner shall deny vendor certification to any provider that has not
received prior approval from the commissioner for the creation of new programs or the
expansion of existing program capacity. The commissioner shall consider the provider's
capacity to obtain clients from outside the state based on plans, agreements, and previous
utilization history, when determining the need for new treatment services
The commissioner
may deny vendor certification to a provider if the commissioner determines that the services
currently available in the local area are sufficient to meet local need and that the addition
of new services would be detrimental to individuals seeking these services
.

Sec. 11.

Minnesota Statutes 2017 Supplement, section 256.045, subdivision 3, is amended
to read:


Subd. 3.

State agency hearings.

(a) State agency hearings are available for the following:

(1) any person applying for, receiving or having received public assistance, medical
care, or a program of social services granted by the state agency or a county agency or the
federal Food Stamp Act whose application for assistance is denied, not acted upon with
reasonable promptness, or whose assistance is suspended, reduced, terminated, or claimed
to have been incorrectly paid;

(2) any patient or relative aggrieved by an order of the commissioner under section
252.27;

(3) a party aggrieved by a ruling of a prepaid health plan;

(4) except as provided under chapter 245C, any individual or facility determined by a
lead investigative agency to have maltreated a vulnerable adult under section 626.557 after
they have exercised their right to administrative reconsideration under section 626.557;

(5) any person whose claim for foster care payment according to a placement of the
child resulting from a child protection assessment under section 626.556 is denied or not
acted upon with reasonable promptness, regardless of funding source;

(6) any person to whom a right of appeal according to this section is given by other
provision of law;

(7) an applicant aggrieved by an adverse decision to an application for a hardship waiver
under section 256B.15;

(8) an applicant aggrieved by an adverse decision to an application or redetermination
for a Medicare Part D prescription drug subsidy under section 256B.04, subdivision 4a;

(9) except as provided under chapter 245A, an individual or facility determined to have
maltreated a minor under section 626.556, after the individual or facility has exercised the
right to administrative reconsideration under section 626.556;

(10) except as provided under chapter 245C, an individual disqualified under sections
245C.14 and 245C.15, following a reconsideration decision issued under section 245C.23,
on the basis of serious or recurring maltreatment; a preponderance of the evidence that the
individual has committed an act or acts that meet the definition of any of the crimes listed
in section 245C.15, subdivisions 1 to 4; or for failing to make reports required under section
626.556, subdivision 3, or 626.557, subdivision 3. Hearings regarding a maltreatment
determination under clause (4) or (9) and a disqualification under this clause in which the
basis for a disqualification is serious or recurring maltreatment, shall be consolidated into
a single fair hearing. In such cases, the scope of review by the human services judge shall
include both the maltreatment determination and the disqualification. The failure to exercise
the right to an administrative reconsideration shall not be a bar to a hearing under this section
if federal law provides an individual the right to a hearing to dispute a finding of
maltreatment;

(11) any person with an outstanding debt resulting from receipt of public assistance,
medical care, or the federal Food Stamp Act who is contesting a setoff claim by the
Department of Human Services or a county agency. The scope of the appeal is the validity
of the claimant agency's intention to request a setoff of a refund under chapter 270A against
the debt;

(12) a person issued a notice of service termination under section 245D.10, subdivision
3a, from residential supports and services as defined in section 245D.03, subdivision 1,
paragraph (c), clause (3), that is not otherwise subject to appeal under subdivision 4a;

(13) an individual disability waiver recipient based on a denial of a request for a rate
exception under section 256B.4914; or

(14) a person issued a notice of service termination under section 245A.11, subdivision
11, that is not otherwise subject to appeal under subdivision 4a. ; or

(15) a county disputes cost of care under section 246.54 based on administrative or other
delay of a client's discharge from a state-operated facility after notification to a county that
the client no longer meets medical criteria for the state-operated facility, when the county
has developed a viable discharge plan.

(b) The hearing for an individual or facility under paragraph (a), clause (4), (9), or (10),
is the only administrative appeal to the final agency determination specifically, including
a challenge to the accuracy and completeness of data under section 13.04. Hearings requested
under paragraph (a), clause (4), apply only to incidents of maltreatment that occur on or
after October 1, 1995. Hearings requested by nursing assistants in nursing homes alleged
to have maltreated a resident prior to October 1, 1995, shall be held as a contested case
proceeding under the provisions of chapter 14. Hearings requested under paragraph (a),
clause (9), apply only to incidents of maltreatment that occur on or after July 1, 1997. A
hearing for an individual or facility under paragraph (a), clauses (4), (9), and (10), is only
available when there is no district court action pending. If such action is filed in district
court while an administrative review is pending that arises out of some or all of the events
or circumstances on which the appeal is based, the administrative review must be suspended
until the judicial actions are completed. If the district court proceedings are completed,
dismissed, or overturned, the matter may be considered in an administrative hearing.

(c) For purposes of this section, bargaining unit grievance procedures are not an
administrative appeal.

(d) The scope of hearings involving claims to foster care payments under paragraph (a),
clause (5), shall be limited to the issue of whether the county is legally responsible for a
child's placement under court order or voluntary placement agreement and, if so, the correct
amount of foster care payment to be made on the child's behalf and shall not include review
of the propriety of the county's child protection determination or child placement decision.

(e) The scope of hearings under paragraph (a), clauses (12) and (14), shall be limited to
whether the proposed termination of services is authorized under section 245D.10,
subdivision 3a
, paragraph (b), or 245A.11, subdivision 11, and whether the requirements
of section 245D.10, subdivision 3a, paragraphs (c) to (e), or 245A.11, subdivision 2a,
paragraphs (d) to (f), were met. If the appeal includes a request for a temporary stay of
termination of services, the scope of the hearing shall also include whether the case
management provider has finalized arrangements for a residential facility, a program, or
services that will meet the assessed needs of the recipient by the effective date of the service
termination.

(f) A vendor of medical care as defined in section 256B.02, subdivision 7, or a vendor
under contract with a county agency to provide social services is not a party and may not
request a hearing under this section, except if assisting a recipient as provided in subdivision
4.

(g) An applicant or recipient is not entitled to receive social services beyond the services
prescribed under chapter 256M or other social services the person is eligible for under state
law.

(h) The commissioner may summarily affirm the county or state agency's proposed
action without a hearing when the sole issue is an automatic change due to a change in state
or federal law.

(i) Unless federal or Minnesota law specifies a different time frame in which to file an
appeal, an individual or organization specified in this section may contest the specified
action, decision, or final disposition before the state agency by submitting a written request
for a hearing to the state agency within 30 days after receiving written notice of the action,
decision, or final disposition, or within 90 days of such written notice if the applicant,
recipient, patient, or relative shows good cause, as defined in section 256.0451, subdivision
13, why the request was not submitted within the 30-day time limit. The individual filing
the appeal has the burden of proving good cause by a preponderance of the evidence.

Sec. 12.

Minnesota Statutes 2017 Supplement, section 256B.0625, subdivision 56a, is
amended to read:


Subd. 56a.

Post-arrest Officer-involved community-based service care coordination.

(a) Medical assistance covers post-arrest officer-involved community-based service care
coordination for an individual who:

(1) has been identified as having screened positive for benefiting from treatment for a
mental illness or substance use disorder using a screening tool approved by the commissioner;

(2) does not require the security of a public detention facility and is not considered an
inmate of a public institution as defined in Code of Federal Regulations, title 42, section
435.1010;

(3) meets the eligibility requirements in section 256B.056; and

(4) has agreed to participate in post-arrest officer-involved community-based service
care coordination through a diversion contract in lieu of incarceration.

(b) Post-arrest Officer-involved community-based service care coordination means
navigating services to address a client's mental health, chemical health, social, economic,
and housing needs, or any other activity targeted at reducing the incidence of jail utilization
and connecting individuals with existing covered services available to them, including, but
not limited to, targeted case management, waiver case management, or care coordination.

(c) Post-arrest Officer-involved community-based service care coordination must be
provided by an individual who is an employee of a county or is under contract with a county,
or is an employee of or under contract with an Indian health service facility or facility owned
and operated by a tribe or a tribal organization operating under Public Law 93-638 as a 638
facility
to provide post-arrest officer-involved community-based care coordination and is
qualified under one of the following criteria:

(1) a licensed mental health professional as defined in section 245.462, subdivision 18,
clauses (1) to (6);

(2) a mental health practitioner as defined in section 245.462, subdivision 17, working
under the clinical supervision of a mental health professional; or

(3) a certified peer specialist under section 256B.0615, working under the clinical
supervision of a mental health professional;

(4) an individual qualified as an alcohol and drug counselor under section 254G.11,
subdivision 5; or

(5) a recovery peer qualified under section 245G.11, subdivision 8, working under the
supervision of an individual qualified as an alcohol and drug counselor under section
245G.11, subdivision 5
.

(d) Reimbursement is allowed for up to 60 days following the initial determination of
eligibility.

(e) Providers of post-arrest officer-involved community-based service care coordination
shall annually report to the commissioner on the number of individuals served, and number
of the community-based services that were accessed by recipients. The commissioner shall
ensure that services and payments provided under post-arrest officer-involved
community-based service care coordination do not duplicate services or payments provided
under section 256B.0625, subdivision 20, 256B.0753, 256B.0755, or 256B.0757.

(f) Notwithstanding section 256B.19, subdivision 1, the nonfederal share of cost for
post-arrest community-based service coordination services shall be provided by the county
providing the services, from sources other than federal funds or funds used to match other
federal funds.

EFFECTIVE DATE.

Paragraphs (a) to (e) are effective retroactively from March 1,
2018.

Sec. 13.

Minnesota Statutes 2016, section 641.15, subdivision 3a, is amended to read:


Subd. 3a.

Intake procedure; approved mental health screening.

As part of its intake
procedure for new prisoners inmates, the sheriff or local corrections shall use a mental health
screening tool approved by the commissioner of corrections in consultation with the
commissioner of human services and local corrections staff to identify persons who may
have mental illness. Names of persons who have screened positive or may have a mental
illness may be shared with the local county social services agency. The jail may refer an
offender to county personnel of the welfare system, as defined in section 13.46, subdivision
1, paragraph (c), in order to arrange for services upon discharge and may share private data
as necessary to carry out the following:

(1) providing assistance in filling out an application for medical assistance or
MinnesotaCare;

(2) making a referral for case management as outlined under section 245.467, subdivision
4;

(3) providing assistance in obtaining a state photo identification;

(4) securing a timely appointment with a psychiatrist or other appropriate community
mental health provider;

(5) providing prescriptions for a 30-day supply of all necessary medications; or

(6) behavioral health service coordination.

Sec. 14.

Laws 2017, First Special Session chapter 6, article 8, section 71, the effective
date, is amended to read:


EFFECTIVE DATE.

This section is effective for services provided on July 1, 2017,
through April 30, 2019, and expires May 1, 2019 June 30, 2019, and expires July 1, 2019.

Sec. 15.

Laws 2017, First Special Session chapter 6, article 8, section 72, the effective
date, is amended to read:


EFFECTIVE DATE.

This section is effective for services provided on July 1, 2017,
through April 30, 2019, and expires May 1, 2019 June 30, 2019, and expires July 1, 2019.

Sec. 16.

Laws 2017, First Special Session chapter 6, article 8, section 74, is amended to
read:


Sec. 74. CHILDREN'S MENTAL HEALTH REPORT AND
RECOMMENDATIONS.

The commissioner of human services shall conduct a comprehensive analysis of
Minnesota's continuum of intensive mental health services and shall develop
recommendations for a sustainable and community-driven continuum of care for children
with serious mental health needs, including children currently being served in residential
treatment. The commissioner's analysis shall include, but not be limited to:

(1) data related to access, utilization, efficacy, and outcomes for Minnesota's current
system of residential mental health treatment for a child with a severe emotional disturbance;

(2) potential expansion of the state's psychiatric residential treatment facility (PRTF)
capacity, including increasing the number of PRTF beds and conversion of existing children's
mental health residential treatment programs into PRTFs;

(3) the capacity need for PRTF and other group settings within the state if adequate
community-based alternatives are accessible, equitable, and effective statewide;

(4) recommendations for expanding alternative community-based service models to
meet the needs of a child with a serious mental health disorder who would otherwise require
residential treatment and potential service models that could be utilized, including data
related to access, utilization, efficacy, and outcomes;

(5) models of care used in other states; and

(6) analysis and specific recommendations for the design and implementation of new
service models, including analysis to inform rate setting as necessary.

The analysis shall be supported and informed by extensive stakeholder engagement.
Stakeholders include individuals who receive services, family members of individuals who
receive services, providers, counties, health plans, advocates, and others. Stakeholder
engagement shall include interviews with key stakeholders, intentional outreach to individuals
who receive services and the individual's family members, and regional listening sessions.

The commissioner shall provide a report with specific recommendations and timelines
for implementation to the legislative committees with jurisdiction over children's mental
health policy and finance by November 15, 2018 January 15, 2019.


ARTICLE 4

OPIOIDS AND PRESCRIPTION DRUGS

Section 1.

Minnesota Statutes 2016, section 8.31, subdivision 1, is amended to read:


Subdivision 1.

Investigate offenses against provisions of certain designated sections;
assist in enforcement.

The attorney general shall investigate violations of the law of this
state respecting unfair, discriminatory, and other unlawful practices in business, commerce,
or trade, and specifically, but not exclusively, prohibition against price gouging for essential
off-patent or generic drugs (section 151.462),
the Nonprofit Corporation Act (sections
317A.001 to 317A.909), the Act Against Unfair Discrimination and Competition (sections
325D.01 to 325D.07), the Unlawful Trade Practices Act (sections 325D.09 to 325D.16),
the Antitrust Act (sections 325D.49 to 325D.66), section 325F.67 and other laws against
false or fraudulent advertising, the antidiscrimination acts contained in section 325D.67,
the act against monopolization of food products (section 325D.68), the act regulating
telephone advertising services (section 325E.39), the Prevention of Consumer Fraud Act
(sections 325F.68 to 325F.70), and chapter 53A regulating currency exchanges and assist
in the enforcement of those laws as in this section provided.

EFFECTIVE DATE.

This section is effective July 1, 2018.

Sec. 2.

[62Q.184] STEP THERAPY OVERRIDE.

Subdivision 1.

Definitions.

(a) For the purposes of this section, the terms in this
subdivision have the meanings given them.

(b) "Clinical practice guideline" means a systematically developed statement to assist
health care providers and enrollees in making decisions about appropriate health care services
for specific clinical circumstances and conditions developed independently of a health plan
company, pharmaceutical manufacturer, or any entity with a conflict of interest.

(c) "Clinical review criteria" means the written screening procedures, decision abstracts,
clinical protocols, and clinical practice guidelines used by a health plan company to determine
the medical necessity and appropriateness of health care services.

(d) "Health plan company" has the meaning given in section 62Q.01, subdivision 4, but
does not include a managed care organization or county-based purchasing plan participating
in a public program under chapters 256B or 256L, or an integrated health partnership under
section 256B.0755.

(e) "Step therapy protocol" means a protocol or program that establishes the specific
sequence in which prescription drugs for a specified medical condition, including
self-administered and physician-administered drugs, are medically appropriate for a particular
enrollee and are covered under a health plan.

(f) "Step therapy override" means that the step therapy protocol is overridden in favor
of coverage of the selected prescription drug of the prescribing health care provider because
at least one of the conditions of subdivision 3, paragraph (a), exists.

Subd. 2.

Establishment of a step therapy protocol.

A health plan company shall
consider available recognized evidence-based and peer-reviewed clinical practice guidelines
when establishing a step therapy protocol. Upon written request of an enrollee, a health plan
company shall provide any clinical review criteria applicable to a specific prescription drug
covered by the health plan.

Subd. 3.

Step therapy override process; transparency.

(a) When coverage of a
prescription drug for the treatment of a medical condition is restricted for use by a health
plan company through the use of a step therapy protocol, enrollees and prescribing health
care providers shall have access to a clear, readily accessible, and convenient process to
request a step therapy override. The process shall be made easily accessible on the health
plan company's Web site. A health plan company may use its existing medical exceptions
process to satisfy this requirement. A health plan company shall grant an override to the
step therapy protocol if at least one of the following conditions exist:

(1) the prescription drug required under the step therapy protocol is contraindicated
pursuant to the pharmaceutical manufacturer's prescribing information for the drug or, due
to a documented adverse event with a previous use or a documented medical condition,
including a comorbid condition, is likely to do any of the following:

(i) cause an adverse reaction to the enrollee;

(ii) decrease the ability of the enrollee to achieve or maintain reasonable functional
ability in performing daily activities; or

(iii) cause physical or mental harm to the enrollee;

(2) the enrollee has had a trial of the required prescription drug covered by their current
or previous health plan, or another prescription drug in the same pharmacologic class or
with the same mechanism of action, and was adherent during such trial for a period of time
sufficient to allow for a positive treatment outcome, and the prescription drug was
discontinued by the enrollee's health care provider due to lack of effectiveness, or an adverse
event. This clause does not prohibit a health plan company from requiring an enrollee to
try another drug in the same pharmacologic class or with the same mechanism of action if
that therapy sequence is supported by the evidence-based and peer-reviewed clinical practice
guideline, Food and Drug Administration label, or pharmaceutical manufacturer's prescribing
information; or

(3) the enrollee is currently receiving a positive therapeutic outcome on a prescription
drug for the medical condition under consideration if, while on their current health plan or
the immediately preceding health plan, the enrollee received coverage for the prescription
drug and the enrollee's prescribing health care provider gives documentation to the health
plan company that the change in prescription drug required by the step therapy protocol is
expected to be ineffective or cause harm to the enrollee based on the known characteristics
of the specific enrollee and the known characteristics of the required prescription drug.

(b) Upon granting a step therapy override, a health plan company shall authorize coverage
for the prescription drug if the prescription drug is a covered prescription drug under the
enrollee's health plan.

(c) The enrollee, or the prescribing health care provider if designated by the enrollee,
may appeal the denial of a step therapy override by a health plan company using the
complaint procedure under sections 62Q.68 to 62Q.73.

(d) In a denial of an override request and any subsequent appeal, a health plan company's
decision must specifically state why the step therapy override request did not meet the
condition under paragraph (a) cited by the prescribing health care provider in requesting
the step therapy override and information regarding the procedure to request external review
of the denial pursuant to section 62Q.73. A denial of a request for a step therapy override
that is upheld on appeal is a final adverse determination for purposes of section 62Q.73 and
is eligible for a request for external review by an enrollee pursuant to section 62Q.73.

(e) A health plan company shall respond to a step therapy override request or an appeal
within five days of receipt of a complete request. In cases where exigent circumstances
exist, a health plan company shall respond within 72 hours of receipt of a complete request.
If a health plan company does not send a response to the enrollee or prescribing health care
provider if designated by the enrollee within the time allotted, the override request or appeal
is granted and binding on the health plan company.

(f) Step therapy override requests must be accessible to and submitted by health care
providers, and accepted by group purchasers electronically through secure electronic
transmission, as described under section 62J.497, subdivision 5.

(g) Nothing in this section prohibits a health plan company from:

(1) requesting relevant documentation from an enrollee's medical record in support of
a step therapy override request; or

(2) requiring an enrollee to try a generic equivalent drug pursuant to section 151.21, or
a biosimilar, as defined under United States Code, title 42, section 262(i)(2), prior to
providing coverage for the equivalent branded prescription drug.

(h) This section shall not be construed to allow the use of a pharmaceutical sample for
the primary purpose of meeting the requirements for a step therapy override.

EFFECTIVE DATE.

This section is effective January 1, 2019, and applies to health
plans offered, issued, or sold on or after that date.

Sec. 3.

Minnesota Statutes 2016, section 151.071, subdivision 2, is amended to read:


Subd. 2.

Grounds for disciplinary action.

The following conduct is prohibited and is
grounds for disciplinary action:

(1) failure to demonstrate the qualifications or satisfy the requirements for a license or
registration contained in this chapter or the rules of the board. The burden of proof is on
the applicant to demonstrate such qualifications or satisfaction of such requirements;

(2) obtaining a license by fraud or by misleading the board in any way during the
application process or obtaining a license by cheating, or attempting to subvert the licensing
examination process. Conduct that subverts or attempts to subvert the licensing examination
process includes, but is not limited to: (i) conduct that violates the security of the examination
materials, such as removing examination materials from the examination room or having
unauthorized possession of any portion of a future, current, or previously administered
licensing examination; (ii) conduct that violates the standard of test administration, such as
communicating with another examinee during administration of the examination, copying
another examinee's answers, permitting another examinee to copy one's answers, or
possessing unauthorized materials; or (iii) impersonating an examinee or permitting an
impersonator to take the examination on one's own behalf;

(3) for a pharmacist, pharmacy technician, pharmacist intern, applicant for a pharmacist
or pharmacy license, or applicant for a pharmacy technician or pharmacist intern registration,
conviction of a felony reasonably related to the practice of pharmacy. Conviction as used
in this subdivision includes a conviction of an offense that if committed in this state would
be deemed a felony without regard to its designation elsewhere, or a criminal proceeding
where a finding or verdict of guilt is made or returned but the adjudication of guilt is either
withheld or not entered thereon. The board may delay the issuance of a new license or
registration if the applicant has been charged with a felony until the matter has been
adjudicated;

(4) for a facility, other than a pharmacy, licensed or registered by the board, if an owner
or applicant is convicted of a felony reasonably related to the operation of the facility. The
board may delay the issuance of a new license or registration if the owner or applicant has
been charged with a felony until the matter has been adjudicated;

(5) for a controlled substance researcher, conviction of a felony reasonably related to
controlled substances or to the practice of the researcher's profession. The board may delay
the issuance of a registration if the applicant has been charged with a felony until the matter
has been adjudicated;

(6) disciplinary action taken by another state or by one of this state's health licensing
agencies:

(i) revocation, suspension, restriction, limitation, or other disciplinary action against a
license or registration in another state or jurisdiction, failure to report to the board that
charges or allegations regarding the person's license or registration have been brought in
another state or jurisdiction, or having been refused a license or registration by any other
state or jurisdiction. The board may delay the issuance of a new license or registration if an
investigation or disciplinary action is pending in another state or jurisdiction until the
investigation or action has been dismissed or otherwise resolved; and

(ii) revocation, suspension, restriction, limitation, or other disciplinary action against a
license or registration issued by another of this state's health licensing agencies, failure to
report to the board that charges regarding the person's license or registration have been
brought by another of this state's health licensing agencies, or having been refused a license
or registration by another of this state's health licensing agencies. The board may delay the
issuance of a new license or registration if a disciplinary action is pending before another
of this state's health licensing agencies until the action has been dismissed or otherwise
resolved;

(7) for a pharmacist, pharmacy, pharmacy technician, or pharmacist intern, violation of
any order of the board, of any of the provisions of this chapter or any rules of the board or
violation of any federal, state, or local law or rule reasonably pertaining to the practice of
pharmacy;

(8) for a facility, other than a pharmacy, licensed by the board, violations of any order
of the board, of any of the provisions of this chapter or the rules of the board or violation
of any federal, state, or local law relating to the operation of the facility;

(9) engaging in any unethical conduct; conduct likely to deceive, defraud, or harm the
public, or demonstrating a willful or careless disregard for the health, welfare, or safety of
a patient; or pharmacy practice that is professionally incompetent, in that it may create
unnecessary danger to any patient's life, health, or safety, in any of which cases, proof of
actual injury need not be established;

(10) aiding or abetting an unlicensed person in the practice of pharmacy, except that it
is not a violation of this clause for a pharmacist to supervise a properly registered pharmacy
technician or pharmacist intern if that person is performing duties allowed by this chapter
or the rules of the board;

(11) for an individual licensed or registered by the board, adjudication as mentally ill
or developmentally disabled, or as a chemically dependent person, a person dangerous to
the public, a sexually dangerous person, or a person who has a sexual psychopathic
personality, by a court of competent jurisdiction, within or without this state. Such
adjudication shall automatically suspend a license for the duration thereof unless the board
orders otherwise;

(12) for a pharmacist or pharmacy intern, engaging in unprofessional conduct as specified
in the board's rules. In the case of a pharmacy technician, engaging in conduct specified in
board rules that would be unprofessional if it were engaged in by a pharmacist or pharmacist
intern or performing duties specifically reserved for pharmacists under this chapter or the
rules of the board;

(13) for a pharmacy, operation of the pharmacy without a pharmacist present and on
duty except as allowed by a variance approved by the board;

(14) for a pharmacist, the inability to practice pharmacy with reasonable skill and safety
to patients by reason of illness, drunkenness, use of drugs, narcotics, chemicals, or any other
type of material or as a result of any mental or physical condition, including deterioration
through the aging process or loss of motor skills. In the case of registered pharmacy
technicians, pharmacist interns, or controlled substance researchers, the inability to carry
out duties allowed under this chapter or the rules of the board with reasonable skill and
safety to patients by reason of illness, drunkenness, use of drugs, narcotics, chemicals, or
any other type of material or as a result of any mental or physical condition, including
deterioration through the aging process or loss of motor skills;

(15) for a pharmacist, pharmacy, pharmacist intern, pharmacy technician, medical gas
distributor, or controlled substance researcher, revealing a privileged communication from
or relating to a patient except when otherwise required or permitted by law;

(16) for a pharmacist or pharmacy, improper management of patient records, including
failure to maintain adequate patient records, to comply with a patient's request made pursuant
to sections 144.291 to 144.298, or to furnish a patient record or report required by law;

(17) fee splitting, including without limitation:

(i) paying, offering to pay, receiving, or agreeing to receive, a commission, rebate,
kickback, or other form of remuneration, directly or indirectly, for the referral of patients;
and

(ii) referring a patient to any health care provider as defined in sections 144.291 to
144.298 in which the licensee or registrant has a financial or economic interest as defined
in section 144.6521, subdivision 3, unless the licensee or registrant has disclosed the
licensee's or registrant's financial or economic interest in accordance with section 144.6521;

(18) engaging in abusive or fraudulent billing practices, including violations of the
federal Medicare and Medicaid laws or state medical assistance laws or rules;

(19) engaging in conduct with a patient that is sexual or may reasonably be interpreted
by the patient as sexual, or in any verbal behavior that is seductive or sexually demeaning
to a patient;

(20) failure to make reports as required by section 151.072 or to cooperate with an
investigation of the board as required by section 151.074;

(21) knowingly providing false or misleading information that is directly related to the
care of a patient unless done for an accepted therapeutic purpose such as the dispensing and
administration of a placebo;

(22) aiding suicide or aiding attempted suicide in violation of section 609.215 as
established by any of the following:

(i) a copy of the record of criminal conviction or plea of guilty for a felony in violation
of section 609.215, subdivision 1 or 2;

(ii) a copy of the record of a judgment of contempt of court for violating an injunction
issued under section 609.215, subdivision 4;

(iii) a copy of the record of a judgment assessing damages under section 609.215,
subdivision 5; or

(iv) a finding by the board that the person violated section 609.215, subdivision 1 or 2.
The board shall investigate any complaint of a violation of section 609.215, subdivision 1
or 2;

(23) for a pharmacist, practice of pharmacy under a lapsed or nonrenewed license. For
a pharmacist intern, pharmacy technician, or controlled substance researcher, performing
duties permitted to such individuals by this chapter or the rules of the board under a lapsed
or nonrenewed registration. For a facility required to be licensed under this chapter, operation
of the facility under a lapsed or nonrenewed license or registration; and

(24) for a pharmacist, pharmacist intern, or pharmacy technician, termination or discharge
from the health professionals services program for reasons other than the satisfactory
completion of the program; and

(25) for a manufacturer or wholesale drug distributor, a violation of section 151.462.

EFFECTIVE DATE.

This section is effective July 1, 2018.

Sec. 4.

Minnesota Statutes 2016, section 151.214, subdivision 2, is amended to read:


Subd. 2.

No prohibition on disclosure.

No contracting agreement between an
employer-sponsored health plan or health plan company, or its contracted pharmacy benefit
manager, and a resident or nonresident pharmacy registered licensed under this chapter,
may prohibit the :

(1) a pharmacy from disclosing to patients information a pharmacy is required or given
the option to provide under subdivision 1; or

(2) a pharmacist from informing a patient when the amount the patient is required to
pay under the patient's health plan for a particular drug is greater than the amount the patient
would be required to pay for the same drug if purchased out-of-pocket at the pharmacy's
usual and customary price
.

Sec. 5.

[151.462] PROHIBITION AGAINST PRICE GOUGING FOR ESSENTIAL
OFF-PATENT OR GENERIC DRUGS.

Subdivision 1.

Definitions.

(a) For purposes of this section, the following definitions
apply.

(b) "Essential off-patent or generic drug" means any prescription drug:

(1) for which all exclusive marketing rights, if any, granted under the federal Food,
Drug, and Cosmetic Act, United States Code, title 21, chapter 9; section 351 of the federal
Public Health Service Act, United States Code, title 42, section 262; and federal patent law
have expired;

(2) that has been designated by the board or commissioner of human services as an
essential medicine due to its efficacy in treating a life-threatening health condition or a
chronic health condition that substantially impairs an individual's ability to engage in
activities of daily living;

(3) that is actively manufactured and marketed for sale in the United States by three or
fewer manufacturers; and

(4) that is made available for sale in the state of Minnesota.

Essential off-patent or generic drug includes any drug-device combination product used for
the delivery of a drug for which all exclusive marketing rights, if any, granted under the
federal Food, Drug, and Cosmetic Act, section 351 of the federal Public Health Service
Act, and federal patent law have expired.

(c) "Health plan company" has the meaning provided in section 62Q.01, subdivision 4.

(d) "Price gouging" means an unconscionable increase in the price of a prescription
drug.

(e) "Unconscionable increase" means an increase in the price of a prescription drug that:

(1) is excessive and not justified by the cost of producing the drug or the cost of
appropriate expansion of access to the drug to promote public health; and

(2) results in consumers for whom the drug has been prescribed, the commissioner of
human services, and health plan companies having no meaningful choice about whether to
purchase the drug at an excessive price because of:

(i) the importance of the drug to the health of the consumer; and

(ii) insufficient competition in the market for the drug.

(f) "Wholesale acquisition cost" has the meaning given in United States Code, title 42,
section 1395w-3a.

Subd. 2.

Prohibition.

A manufacturer or wholesale drug distributor may not engage in
price gouging in the sale of an essential off-patent or generic drug. It is not a violation of
this subdivision for a wholesale drug distributor to increase the price of an essential off-patent
or generic drug if the price increase is directly attributable to additional costs for the drug
imposed on the wholesale drug distributor by the manufacturer of the drug.

Subd. 3.

Notification of attorney general.

(a) The board, the commissioner of human
services, or a health plan company may notify the attorney general of any increase in the
price of an essential off-patent or generic drug when:

(1) the price increase, by itself or in combination with other price increases:

(i) would result in an increase of 50 percent or more, compared to the preceding one-year
period, in the wholesale acquisition cost of the drug or other relevant measure of drug cost;
or

(ii) would result in an increase of 50 percent or more in the price paid by the medical
assistance or MinnesotaCare programs, or the health plan company, for the drug compared
to the preceding one-year period; and

(2)(i) a 30-day supply of the maximum recommended dosage of the drug for any
indication, according to the label for the drug approved under the federal Food, Drug, and
Cosmetic Act, would cost more than $80 at the drug's wholesale acquisition cost;

(ii) a full course of treatment with the drug, according to the label for the drug approved
under the federal Food, Drug, and Cosmetic Act, would cost more than $80 at the drug's
wholesale acquisition cost; or

(iii) if the drug is made available to consumers only in quantities that do not correspond
to a 30-day supply, a full course of treatment, or a single dose, it would cost more than $80
at the drug's wholesale acquisition cost to obtain a 30-day supply or a full course of treatment.

The commissioner of human services and the health plan company shall notify the board
of any notification to the attorney general provided under this paragraph.

(b) On request of the attorney general, the manufacturer of an essential off-patent or
generic drug identified in a notice under paragraph (a) shall, within 45 days after the request,
submit a statement to the attorney general:

(1) itemizing the components of the cost of producing the drug;

(2) identifying the circumstances and timing of any increase in materials or manufacturing
costs that caused any increase in the price of the drug within the one-year period preceding
the date of the price increase;

(3) identifying the circumstances and timing of any expenditures made by the
manufacturer to expand access to the drug and explaining any improvement in public health
associated with those expenditures; and

(4) providing any other information that the manufacturer believes to be relevant to a
determination of whether a violation of this section has occurred.

(c) The attorney general may require a manufacturer or a wholesale drug distributor to
produce any records or other documents that may be relevant to a determination of whether
a violation of this section has occurred. The attorney general or a person may use the powers
and procedures provided in this section or section 8.31.

(d) The attorney general may not bring an action for a remedy under paragraph (c) unless
the attorney general has provided the manufacturer or wholesale drug distributor an
opportunity to meet with the attorney general to offer a justification for the increase in the
price of the essential off-patent or generic drug.

(e) The attorney general shall make any information provided by a health plan company,
manufacturer, or wholesale drug distributor under paragraphs (a), (b), and (c) available to
the board upon request. Any information provided by a health plan company, manufacturer,
or wholesale drug distributor to the attorney general under paragraphs (a), (b), and (c) shall
be treated as nonpublic data under section 13.02, subdivision 9, unless the nonpublic
classification of the information is waived by the health plan company, manufacturer, or
wholesale drug distributor.

(f) In any action brought by the attorney general under paragraph (c), a person who is
alleged to have violated a requirement of this section may not assert as a defense that the
person did not deal directly with a consumer residing in the state.

Subd. 4.

Private right of action.

In addition to remedies otherwise provided by law,
any person injured by a violation of this section may bring a civil action and recover damages,
together with costs and disbursements, including costs of investigation and reasonable
attorney fees, and receive other equitable relief as determined by the court. The court may,
as appropriate, enter a consent judgment or decree without the finding of illegality. Any
civil action brought under this subdivision is for the benefit of the public.

Subd. 5.

Personal financial liability.

Notwithstanding section 3.736, the attorney general
shall be personally financially liable for all legal costs to the state resulting from any legal
proceeding that results in a state or federal court ruling that this section is not constitutional.

EFFECTIVE DATE.

This section is effective contingent upon certification by the
attorney general under section 12, that the criteria in clause (1) of that section are satisfied,
but no earlier than July 1, 2018.

Sec. 6.

[151.555] PRESCRIPTION DRUG REPOSITORY PROGRAM.

Subdivision 1.

Definitions.

(a) For the purposes of this section, the terms defined in this
subdivision have the meanings given.

(b) "Central repository" means a wholesale distributor that meets the requirements under
subdivision 3 and enters into a contract with the Board of Pharmacy in accordance with this
section.

(c) "Distribute" means to deliver, other than by administering or dispensing.

(d) "Donor" means:

(1) a health care facility as defined in this subdivision;

(2) a skilled nursing facility licensed under chapter 144A;

(3) an assisted living facility registered under chapter 144D where there is centralized
storage of drugs and 24-hour on-site licensed nursing coverage provided seven days a week;

(4) a pharmacy licensed under section 151.19, and located either in the state or outside
the state;

(5) a drug wholesaler licensed under section 151.47; or

(6) a drug manufacturer licensed under section 151.252.

(e) "Drug" means any prescription drug that has been approved for medical use in the
United States, is listed in the United States Pharmacopoeia or National Formulary, and
meets the criteria established under this section for donation. This definition includes cancer
drugs and antirejection drugs, but does not include controlled substances, as defined in
section 152.01, subdivision 4, or a prescription drug that can only be dispensed to a patient
registered with the drug's manufacturer in accordance with federal Food and Drug
Administration requirements.

(f) "Health care facility" means:

(1) a physician's office or health care clinic where licensed practitioners provide health
care to patients;

(2) a hospital licensed under section 144.50;

(3) a pharmacy licensed under section 151.19 and located in Minnesota; or

(4) a nonprofit community clinic, including a federally qualified health center; a rural
health clinic; public health clinic; or other community clinic that provides health care utilizing
a sliding fee scale to patients who are low-income, uninsured, or underinsured.

(g) "Local repository" means a health care facility that elects to accept donated drugs
and medical supplies and meets the requirements of subdivision 4.

(h) "Medical supplies" or "supplies" means any prescription and nonprescription medical
supply needed to administer a prescription drug.

(i) "Original, sealed, unopened, tamper-evident packaging" means packaging that is
sealed, unopened, and tamper-evident, including a manufacturer's original unit dose or
unit-of-use container, a repackager's original unit dose or unit-of-use container, or unit-dose
packaging prepared by a licensed pharmacy according to the standards of Minnesota Rules,
part 6800.3750.

(j) "Practitioner" has the meaning given in section 151.01, subdivision 23, except that
it does not include a veterinarian.

Subd. 2.

Establishment.

By January 1, 2019, the Board of Pharmacy shall establish a
drug repository program, through which donors may donate a drug or medical supply for
use by an individual who meets the eligibility criteria specified under subdivision 5. The
board shall contract with a central repository that meets the requirements of subdivision 3
to implement and administer the prescription drug repository program.

Subd. 3.

Central repository requirements.

(a) The board shall publish a request for
proposal for participants who meet the requirements of this subdivision and are interested
in acting as the central repository for the drug repository program. The board shall follow
all applicable state procurement procedures in the selection process.

(b) To be eligible to act as the central repository, the participant must be a wholesale
drug distributor located in Minnesota, licensed pursuant to section 151.47, and in compliance
with all applicable federal and state statutes, rules, and regulations.

(c) The central repository shall be subject to inspection by the board pursuant to section
151.06, subdivision 1.

Subd. 4.

Local repository requirements.

(a) To be eligible for participation in the drug
repository program, a health care facility must agree to comply with all applicable federal
and state laws, rules, and regulations pertaining to the drug repository program, drug storage,
and dispensing. The facility must also agree to maintain in good standing any required state
license or registration that may apply to the facility.

(b) A local repository may elect to participate in the program by submitting the following
information to the central repository on a form developed by the board and made available
on the board's Web site:

(1) the name, street address, and telephone number of the health care facility and any
state-issued license or registration number issued to the facility, including the issuing state
agency;

(2) the name and telephone number of a responsible pharmacist or practitioner who is
employed by or under contract with the health care facility; and

(3) a statement signed and dated by the responsible pharmacist or practitioner indicating
that the health care facility meets the eligibility requirements under this section and agrees
to comply with this section.

(c) Participation in the drug repository program is voluntary. A local repository may
withdraw from participation in the drug repository program at any time by providing written
notice to the central repository on a form developed by the board and made available on
the board's Web site. The central repository shall provide the board with a copy of the
withdrawal notice within ten business days from the date of receipt of the withdrawal notice.

Subd. 5.

Individual eligibility and application requirements.

(a) To be eligible for
the drug repository program, an individual must submit to a local repository an intake
application form that is signed by the individual and attests that the individual:

(1) is a resident of Minnesota;

(2) is uninsured, has no prescription drug coverage, or is underinsured;

(3) acknowledges that the drugs or medical supplies to be received through the program
may have been donated; and

(4) consents to a waiver of the child-resistant packaging requirements of the federal
Poison Prevention Packaging Act.

(b) Upon determining that an individual is eligible for the program, the local repository
shall furnish the individual with an identification card. The card shall be valid for one year
from the date of issuance and may be used at any local repository. A new identification card
may be issued upon expiration once the individual submits a new application form.

(c) The local repository shall send a copy of the intake application form to the central
repository by regular mail, facsimile, or secured e-mail within ten days from the date the
application is approved by the local repository.

(d) The board shall develop and make available on the board's Web site an application
form and the format for the identification card.

Subd. 6.

Standards and procedures for accepting donations of drugs and supplies.

(a) A donor may donate prescription drugs or medical supplies to the central repository or
a local repository if the drug or supply meets the requirements of this section as determined
by a pharmacist or practitioner who is employed by or under contract with the central
repository or a local repository.

(b) A prescription drug is eligible for donation under the drug repository program if the
following requirements are met:

(1) the donation is accompanied by a drug repository donor form described under
paragraph (d) that is signed by an individual who is authorized by the donor to attest to the
donor's knowledge in accordance with paragraph (d);

(2) the drug's expiration date is at least six months after the date the drug was donated.
If a donated drug bears an expiration date that is less than six months from the donation
date, the drug may be accepted and distributed if the drug is in high demand and can be
dispensed for use by a patient before the drug's expiration date;

(3) the drug is in its original, sealed, unopened, tamper-evident packaging that includes
the expiration date. Single-unit-dose drugs may be accepted if the single-unit-dose packaging
is unopened;

(4) the drug or the packaging does not have any physical signs of tampering, misbranding,
deterioration, compromised integrity, or adulteration;

(5) the drug does not require storage temperatures other than normal room temperature
as specified by the manufacturer or United States Pharmacopoeia, unless the drug is being
donated directly by its manufacturer, a wholesale drug distributor, or a pharmacy located
in Minnesota; and

(6) the prescription drug is not a controlled substance.

(c) A medical supply is eligible for donation under the drug repository program if the
following requirements are met:

(1) the supply has no physical signs of tampering, misbranding, or alteration and there
is no reason to believe it has been adulterated, tampered with, or misbranded;

(2) the supply is in its original, unopened, sealed packaging;

(3) the donation is accompanied by a drug repository donor form described under
paragraph (d) that is signed by an individual who is authorized by the donor to attest to the
donor's knowledge in accordance with paragraph (d); and

(4) if the supply bears an expiration date, the date is at least six months later than the
date the supply was donated. If the donated supply bears an expiration date that is less than
six months from the date the supply was donated, the supply may be accepted and distributed
if the supply is in high demand and can be dispensed for use by a patient before the supply's
expiration date.

(d) The board shall develop the drug repository donor form and make it available on the
board's Web site. The form must state that to the best of the donor's knowledge the donated
drug or supply has been properly stored and that the drug or supply has never been opened,
used, tampered with, adulterated, or misbranded.

(e) Donated drugs and supplies may be shipped or delivered to the premises of the central
repository or a local repository, and shall be inspected by a pharmacist or an authorized
practitioner who is employed by or under contract with the repository and who has been
designated by the repository to accept donations. A drop box must not be used to deliver
or accept donations.

(f) The central repository and local repository shall inventory all drugs and supplies
donated to the repository. For each drug, the inventory must include the drug's name, strength,
quantity, manufacturer, expiration date, and the date the drug was donated. For each medical
supply, the inventory must include a description of the supply, its manufacturer, the date
the supply was donated, and, if applicable, the supply's brand name and expiration date.

Subd. 7.

Standards and procedures for inspecting and storing donated prescription
drugs and supplies.

(a) A pharmacist or authorized practitioner who is employed by or
under contract with the central repository or a local repository shall inspect all donated
prescription drugs and supplies to determine, to the extent reasonably possible in the
professional judgment of the pharmacist or practitioner, that the drug or supply is not
adulterated or misbranded, has not been tampered with, is safe and suitable for dispensing,
and meets the requirements for donation. The pharmacist or practitioner who inspects the
drugs or supplies shall sign an inspection record stating that the requirements for donation
have been met. If a local repository receives drugs and supplies from the central repository,
the local repository does not need to reinspect the drugs and supplies.

(b) The central repository and local repositories shall store donated drugs and supplies
in a secure storage area under environmental conditions appropriate for the drug or supply
being stored. Donated drugs and supplies may not be stored with nondonated inventory. If
donated drugs or supplies are not inspected immediately upon receipt, a repository must
quarantine the donated drugs or supplies separately from all dispensing stock until the
donated drugs or supplies have been inspected and approved for dispensing under the
program.

(c) The central repository and local repositories shall dispose of all prescription drugs
and medical supplies that are not suitable for donation in compliance with applicable federal
and state statutes, regulations, and rules concerning hazardous waste.

(d) In the event that controlled substances or prescription drugs that can only be dispensed
to a patient registered with the drug's manufacturer are shipped or delivered to a central or
local repository for donation, the shipment delivery must be documented by the repository
and returned immediately to the donor or the donor's representative that provided the drugs.

(e) Each repository must develop drug and medical supply recall policies and procedures.
If a repository receives a recall notification, the repository shall destroy all of the drug or
medical supply in its inventory that is the subject of the recall and complete a record of
destruction form in accordance with paragraph (f). If a drug or medical supply that is the
subject of a Class I or Class II recall has been dispensed, the repository shall immediately
notify the recipient of the recalled drug or medical supply. A drug that potentially is subject
to a recall need not be destroyed if its packaging bears a lot number and that lot of the drug
is not subject to the recall. If no lot number is on the drug's packaging, it must be destroyed.

(f) A record of destruction of donated drugs and supplies that are not dispensed under
subdivision 8, are subject to a recall under paragraph (e), or are not suitable for donation
shall be maintained by the repository for at least five years. For each drug or supply
destroyed, the record shall include the following information:

(1) the date of destruction;

(2) the name, strength, and quantity of the drug destroyed; and

(3) the name of the person or firm that destroyed the drug.

Subd. 8.

Dispensing requirements.

(a) Donated drugs and supplies may be dispensed
if the drugs or supplies are prescribed by a practitioner for use by an eligible individual and
are dispensed by a pharmacist or practitioner. A repository shall dispense drugs and supplies
to eligible individuals in the following priority order: (1) individuals who are uninsured;
(2) individuals with no prescription drug coverage; and (3) individuals who are underinsured.
A repository shall dispense donated prescription drugs in compliance with applicable federal
and state laws and regulations for dispensing prescription drugs, including all requirements
relating to packaging, labeling, record keeping, drug utilization review, and patient
counseling.

(b) Before dispensing or administering a drug or supply, the pharmacist or practitioner
shall visually inspect the drug or supply for adulteration, misbranding, tampering, and date
of expiration. Drugs or supplies that have expired or appear upon visual inspection to be
adulterated, misbranded, or tampered with in any way must not be dispensed or administered.

(c) Before a drug or supply is dispensed or administered to an individual, the individual
must sign a drug repository recipient form acknowledging that the individual understands
the information stated on the form. The board shall develop the form and make it available
on the board's Web site. The form must include the following information:

(1) that the drug or supply being dispensed or administered has been donated and may
have been previously dispensed;

(2) that a visual inspection has been conducted by the pharmacist or practitioner to ensure
that the drug or supply has not expired, has not been adulterated or misbranded, and is in
its original, unopened packaging; and

(3) that the dispensing pharmacist, the dispensing or administering practitioner, the
central repository or local repository, the Board of Pharmacy, and any other participant of
the drug repository program cannot guarantee the safety of the drug or medical supply being
dispensed or administered and that the pharmacist or practitioner has determined that the
drug or supply is safe to dispense or administer based on the accuracy of the donor's form
submitted with the donated drug or medical supply and the visual inspection required to be
performed by the pharmacist or practitioner before dispensing or administering.

Subd. 9.

Handling fees.

(a) The central or local repository may charge the individual
receiving a drug or supply a handling fee of no more than 250 percent of the medical
assistance program dispensing fee for each drug or medical supply dispensed or administered
by that repository.

(b) A repository that dispenses or administers a drug or medical supply through the drug
repository program shall not receive reimbursement under the medical assistance program
or the MinnesotaCare program for that dispensed or administered drug or supply.

Subd. 10.

Distribution of donated drugs and supplies.

(a) The central repository and
local repositories may distribute drugs and supplies donated under the drug repository
program to other participating repositories for use pursuant to this program.

(b) A local repository that elects not to dispense donated drugs or supplies must transfer
all donated drugs and supplies to the central repository. A copy of the donor form that was
completed by the original donor under subdivision 6 must be provided to the central
repository at the time of transfer.

Subd. 11.

Forms and record-keeping requirements.

(a) The following forms developed
for the administration of this program shall be utilized by the participants of the program
and shall be available on the board's Web site:

(1) intake application form described under subdivision 5;

(2) local repository participation form described under subdivision 4;

(3) local repository withdrawal form described under subdivision 4;

(4) drug repository donor form described under subdivision 6;

(5) record of destruction form described under subdivision 7; and

(6) drug repository recipient form described under subdivision 8.

(b) All records, including drug inventory, inspection, and disposal of donated prescription
drugs and medical supplies must be maintained by a repository for a minimum of five years.
Records required as part of this program must be maintained pursuant to all applicable
practice acts.

(c) Data collected by the drug repository program from all local repositories shall be
submitted quarterly or upon request to the central repository. Data collected may consist of
the information, records, and forms required to be collected under this section.

(d) The central repository shall submit reports to the board as required by the contract
or upon request of the board.

Subd. 12.

Liability.

(a) The manufacturer of a drug or supply is not subject to criminal
or civil liability for injury, death, or loss to a person or to property for causes of action
described in clauses (1) and (2). A manufacturer is not liable for:

(1) the intentional or unintentional alteration of the drug or supply by a party not under
the control of the manufacturer; or

(2) the failure of a party not under the control of the manufacturer to transfer or
communicate product or consumer information or the expiration date of the donated drug
or supply.

(b) A health care facility participating in the program, a pharmacist dispensing a drug
or supply pursuant to the program, a practitioner dispensing or administering a drug or
supply pursuant to the program, or a donor of a drug or medical supply is immune from
civil liability for an act or omission that causes injury to or the death of an individual to
whom the drug or supply is dispensed and no disciplinary action by a health-related licensing
board shall be taken against a pharmacist or practitioner so long as the drug or supply is
donated, accepted, distributed, and dispensed according to the requirements of this section.
This immunity does not apply if the act or omission involves reckless, wanton, or intentional
misconduct, or malpractice unrelated to the quality of the drug or medical supply.

Sec. 7.

Minnesota Statutes 2016, section 151.71, is amended by adding a subdivision to
read:


Subd. 3.

Lowest cost to consumers.

(a) A health plan company or pharmacy benefits
manager shall not require an individual to make a payment at the point of sale for a covered
prescription medication in an amount greater than the allowable cost to consumers, as
defined in paragraph (b).

(b) For purposes of paragraph (a), "allowable cost to consumers" means the lowest of:
(1) the applicable co-payment for the prescription medication; or (2) the amount an individual
would pay for the prescription medication if the individual purchased the prescription
medication without using a health plan benefit.

Sec. 8.

Minnesota Statutes 2017 Supplement, section 152.105, subdivision 2, is amended
to read:


Subd. 2.

Sheriff to maintain collection receptacle.

The sheriff of each county shall
maintain or contract for the maintenance of at least one collection receptacle for the disposal
of noncontrolled substances, pharmaceutical controlled substances, and other legend drugs,
as permitted by federal law. For purposes of this section, "legend drug" has the meaning
given in section 151.01, subdivision 17. The collection receptacle must comply with federal
law. In maintaining and operating the collection receptacle, the sheriff shall follow all
applicable provisions of Code of Federal Regulations, title 21, parts 1300, 1301, 1304, 1305,
1307, and 1317, as amended through May 1, 2017. The sheriff of each county may meet
the requirements of this subdivision though the use of an alternative method for the disposal
of noncontrolled substances, pharmaceutical controlled substances, and other legend drugs
that has been approved by the Board of Pharmacy. This may include making available to
the public, without charge, at-home prescription drug deactivation and disposal products
that render drugs and medications inert and irretrievable.

Sec. 9.

Minnesota Statutes 2016, section 152.11, is amended by adding a subdivision to
read:


Subd. 5.

Limitations on the dispensing of opioid prescription drug orders.

(a) No
prescription drug order for an opioid drug listed in Schedule II may be dispensed by a
pharmacist or other dispenser more than 30 days after the date on which the prescription
drug order was issued.

(b) No prescription drug order for an opioid drug listed in Schedules III through V may
be initially dispensed by a pharmacist or other dispenser more than 30 days after the date
on which the prescription drug order was issued. No prescription drug order for an opioid
drug listed in Schedules III through V may be refilled by a pharmacist or other dispenser
more than 45 days after the previous date on which it was dispensed.

(c) For purposes of this section, "dispenser" has the meaning given in section 152.126,
subdivision 1.

Sec. 10. STUDENT HEALTH INITIATIVE TO LIMIT OPIOID HARM.

Subdivision 1.

Grant awards.

The commissioner of human services, in consultation
with the commissioner of education, the Board of Trustees of the Minnesota State Colleges
and Universities, the Board of Directors of the Minnesota Private College Council, and the
regents of the University of Minnesota, shall develop and administer a program to award
grants to secondary school students in grades 7 through 12 and undergraduate students
attending a Minnesota postsecondary educational institution, and their community partner
or partners, to conduct opioid awareness and opioid abuse prevention activities. If a grant
proposal includes more than one community partner, the proposal must designate a primary
community partner. Grant applications must be submitted by the primary community partner
and any grant award must be managed by the primary community partner on behalf of
secondary school and undergraduate student applicants and grantees. Grants shall be awarded
for a fiscal year and are onetime.

Subd. 2.

Grant criteria.

(a) Grant dollars may be used for opioid awareness campaigns
and events, education related to opioid addiction and abuse prevention, initiatives to limit
inappropriate opioid prescriptions, peer education programs targeted to students at high risk
of opioid addiction and abuse, and other related initiatives as approved by the commissioner.
Grant projects must include one or more of the following components as they relate to opioid
abuse and prevention and the role of the community partner: high-risk populations, law
enforcement, education, clinical services, or social services.

(b) The commissioner of human services shall seek to provide grant funding for at least
one proposal that addresses opioid abuse in the American Indian community.

Subd. 3.

Community partners.

For purposes of the grant program, community partners
may include but are not limited to public health agencies; local law enforcement; community
health centers; medical clinics; emergency medical service professionals; schools and
postsecondary educational institutions; opioid addiction, advocacy, and recovery
organizations; tribal governments; local chambers of commerce; and city councils and
county boards.

Subd. 4.

Report.

The commissioner of human services shall report to the chairs and
ranking minority members of the legislative committees with jurisdiction over health and
human services policy and finance, K-12 education policy and finance, and higher education
policy and finance by September 1, 2019, on the implementation of the grant program and
the grants awarded under this section.

Subd. 5.

Federal grants.

(a) The commissioner of human services shall apply for any
federal grant funding that aligns with the purposes of this section. The commissioner shall
submit to the legislature any changes to the program established under this section that are
necessary to comply with the terms of the federal grant.

(b) The commissioner shall notify the chairs and ranking minority members of the
legislative committees with jurisdiction over health and human services policy and finance,
K-12 education policy and finance, and higher education policy and finance of any grant
applications submitted and any federal actions taken related to the grant applications.

Sec. 11. OPIOID OVERDOSE REDUCTION PILOT PROGRAM.

Subdivision 1.

Establishment.

The commissioner of health shall provide grants to
ambulance services to fund activities by community paramedic teams to reduce opioid
overdoses in the state. Under this pilot program, ambulance services shall develop and
implement projects in which community paramedics connect with patients who are discharged
from a hospital or emergency department following an opioid overdose episode, develop
personalized care plans for those patients in consultation with the ambulance service medical
director, and provide follow-up services to those patients.

Subd. 2.

Priority areas; services.

(a) In a project developed under this section, an
ambulance service must target community paramedic team services to portions of the service
area with high levels of opioid use, high death rates from opioid overdoses, and urgent needs
for interventions.

(b) In a project developed under this section, a community paramedic team shall:

(1) provide services to patients released from a hospital following an opioid overdose
episode and place priority on serving patients who were administered the opiate antagonist
naloxone hydrochloride by emergency medical services personnel in response to a 911 call
during the opioid overdose episode;

(2) provide the following evaluations during an initial home visit: a home safety
assessment including whether there is a need to dispose of prescription drugs that are expired
or no longer needed; medication reconciliation; an HIV risk assessment; instruction on the
use of naloxone hydrochloride; and a basic needs assessment;

(3) provide patients with health assessments, medication management, chronic disease
monitoring and education, and assistance in following hospital discharge orders; and

(4) work with a multidisciplinary team to address the overall physical and mental health
needs of patients and health needs related to substance use disorder treatment.

Subd. 3.

Evaluation.

An ambulance service that receives a grant under this section must
evaluate the extent to which the project was successful in reducing the number of opioid
overdoses and opioid overdose deaths among patients who received services and in reducing
the inappropriate use of opioids by patients who received services. The commissioner of
health shall develop specific evaluation measures and reporting timelines for ambulance
services receiving grants. Ambulance services must submit the information required by the
commissioner to the commissioner and the chairs and ranking minority members of the
legislative committees with jurisdiction over health and human services by December 1,
2019.

Sec. 12. CERTIFICATION BY THE ATTORNEY GENERAL.

The attorney general shall analyze whether implementation of Minnesota Statutes, section
151.462, would be constitutional under the United States Constitution and the Minnesota
Constitution. Upon completion of this analysis, the attorney general shall certify that either:

(1) implementation of the section would be constitutional; or

(2) implementation of the section would not be constitutional.

EFFECTIVE DATE.

This section is effective the day following final enactment.

Sec. 13. REPEALER.

Minnesota Statutes 2016, section 151.55, is repealed.


ARTICLE 5

COMMUNITY SUPPORTS AND CONTINUING CARE

Section 1.

Minnesota Statutes 2017 Supplement, 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;

(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;

(6) 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

(7) 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 2019. 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. ; or

(8) a vacancy in a setting granted an exception under clause (7) may receive an exception
created by a person receiving services under chapter 245D and residing in the unlicensed
setting between January 1, 2017, and May 1, 2017, for which a vacancy occurs between
January 1, 2017, and the date of the exception request. This exception is available when the
lead agency provides documentation to the commissioner on the eligibility criteria being
met. This exception is available until June 30, 2019.

(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.

Sec. 2.

Minnesota Statutes 2017 Supplement, section 245A.11, subdivision 2a, is amended
to read:


Subd. 2a.

Adult foster care and community residential setting license capacity.

(a)
The commissioner shall issue adult foster care and community residential setting licenses
with a maximum licensed capacity of four beds, including nonstaff roomers and boarders,
except that the commissioner may issue a license with a capacity of five beds, including
roomers and boarders, according to paragraphs (b) to (g).

(b) The license holder may have a maximum license capacity of five if all persons in
care are age 55 or over and do not have a serious and persistent mental illness or a
developmental disability.

(c) The commissioner may grant variances to paragraph (b) to allow a facility with a
licensed capacity of up to five persons to admit an individual under the age of 55 if the
variance complies with section 245A.04, subdivision 9, and approval of the variance is
recommended by the county in which the licensed facility is located.

(d) The commissioner may grant variances to paragraph (a) to allow the use of an
additional bed, up to five, for emergency crisis services for a person with serious and
persistent mental illness or a developmental disability, regardless of age, if the variance
complies with section 245A.04, subdivision 9, and approval of the variance is recommended
by the county in which the licensed facility is located.

(e) The commissioner may grant a variance to paragraph (b) to allow for the use of an
additional bed, up to five, for respite services, as defined in section 245A.02, for persons
with disabilities, regardless of age, if the variance complies with sections 245A.03,
subdivision 7
, and 245A.04, subdivision 9, and approval of the variance is recommended
by the county in which the licensed facility is located. Respite care may be provided under
the following conditions:

(1) staffing ratios cannot be reduced below the approved level for the individuals being
served in the home on a permanent basis;

(2) no more than two different individuals can be accepted for respite services in any
calendar month and the total respite days may not exceed 120 days per program in any
calendar year;

(3) the person receiving respite services must have his or her own bedroom, which could
be used for alternative purposes when not used as a respite bedroom, and cannot be the
room of another person who lives in the facility; and

(4) individuals living in the facility must be notified when the variance is approved. The
provider must give 60 days' notice in writing to the residents and their legal representatives
prior to accepting the first respite placement. Notice must be given to residents at least two
days prior to service initiation, or as soon as the license holder is able if they receive notice
of the need for respite less than two days prior to initiation, each time a respite client will
be served, unless the requirement for this notice is waived by the resident or legal guardian.

(f) The commissioner may issue an adult foster care or community residential setting
license with a capacity of five adults if the fifth bed does not increase the overall statewide
capacity of licensed adult foster care or community residential setting beds in homes that
are not the primary residence of the license holder, as identified in a plan submitted to the
commissioner by the county, when the capacity is recommended by the county licensing
agency of the county in which the facility is located and if the recommendation verifies
that:

(1) the facility meets the physical environment requirements in the adult foster care
licensing rule;

(2) the five-bed living arrangement is specified for each resident in the resident's:

(i) individualized plan of care;

(ii) individual service plan under section 256B.092, subdivision 1b, if required; or

(iii) individual resident placement agreement under Minnesota Rules, part 9555.5105,
subpart 19, if required;

(3) the license holder obtains written and signed informed consent from each resident
or resident's legal representative documenting the resident's informed choice to remain
living in the home and that the resident's refusal to consent would not have resulted in
service termination; and

(4) the facility was licensed for adult foster care before March 1, 2011 June 30, 2016.

(g) The commissioner shall not issue a new adult foster care license under paragraph (f)
after June 30, 2019 2021. The commissioner shall allow a facility with an adult foster care
license issued under paragraph (f) before June 30, 2019 2021, to continue with a capacity
of five adults if the license holder continues to comply with the requirements in paragraph
(f).

Sec. 3.

Minnesota Statutes 2017 Supplement, 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 disabilities, 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, community alternative care, 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 disabilities waiver
plan;

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

(5) night supervision services as defined under the brain injury, community access for
disability inclusion, community alternative care, and developmental disabilities
waiver plan
plans
;

(6) homemaker services as defined under the community access for disability inclusion,
brain injury, community alternative care, developmental disability disabilities, 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) behavioral positive support services as defined under the brain injury and , community
access for disability inclusion, community alternative care, and developmental disabilities
waiver plans;

(ii) in-home or out-of-home crisis respite services as defined under the brain injury,
community access for disability inclusion, community alternative care, and
developmental
disability disabilities waiver plan plans; and

(iii) specialist services as defined under the current brain injury, community access for
disability inclusion, community alternative care, and
developmental disability disabilities
waiver plan plans;

(2) in-home support services, including:

(i) in-home family support and supported living services as defined under the
developmental disability disabilities 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 disabilities
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: