SF 74

2nd Engrossment - 91st Legislature (2019 - 2020) Posted on 02/14/2019 03:27pm

A bill for an act
relating to health and human services; modifying policy provisions relating to
home care, community supports and continuing care, children and families,
licensing, state-operated services, and chemical and mental health; modifying
home care licensing requirements; modifying the foster care licensing moratorium;
modifying home and community-based licensing standards; modifying the
MnCHOICES assessment process; modifying the housing supports program;
modifying licensing requirements for mental health providers; modifying
background check provisions for mental health providers; requiring reports;
amending Minnesota Statutes 2018, sections 13.851, by adding a subdivision;
144.057, subdivision 3; 144A.43, subdivisions 11, 27, 30, by adding a subdivision;
144A.472, subdivisions 5, 7; 144A.473; 144A.474, subdivision 2; 144A.475,
subdivisions 1, 2, 5; 144A.476, subdivision 1; 144A.479, subdivision 7; 144A.4791,
subdivisions 1, 3, 6, 7, 8, 9; 144A.4792, subdivisions 1, 2, 5, 10; 144A.4793,
subdivision 6; 144A.4796, subdivision 2; 144A.4797, subdivision 3; 144A.4798;
144A.4799, subdivisions 1, 3; 144A.484, subdivision 1; 243.166, subdivision 4b;
245A.03, subdivision 7; 245A.04, subdivision 7, by adding a subdivision; 245A.11,
subdivision 2a; 245C.02, by adding a subdivision; 245C.22, subdivisions 4, 5;
245D.03, subdivision 1; 245D.071, subdivision 5; 245D.091, subdivisions 2, 3,
4; 254B.03, subdivision 2; 256B.04, subdivision 21; 256B.0659, subdivision 3a;
256B.0911, subdivisions 1a, 3a, 3f, 5, by adding a subdivision; 256B.0915,
subdivision 6; 256B.092, subdivision 1b; 256B.0921; 256B.49, subdivisions 13,
14; 256B.4914, subdivision 3; 256I.03, subdivision 8; 256I.04, subdivision 2b, by
adding subdivisions; 641.15, subdivision 3a; proposing coding for new law in
Minnesota Statutes, chapter 245A; repealing Minnesota Statutes 2018, sections
144A.45, subdivision 6; 144A.481; 256I.05, subdivision 3; Minnesota Rules, parts
9530.6800; 9530.6810.

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

ARTICLE 1

HEALTH CARE

Section 1.

Minnesota Statutes 2018, section 256B.04, subdivision 21, is amended to read:

Subd. 21.

Provider enrollment.

(a) If the commissioner or the Centers for Medicare
and Medicaid Services determines that a provider is designated "high-risk," the commissioner
may withhold payment from providers within that category upon initial enrollment for a
90-day period. The withholding for each provider must begin on the date of the first
submission of a claim.

(b) An enrolled provider that is also licensed by the commissioner under chapter 245A,
or is licensed as a home care provider by the Department of Health under chapter 144A and
has a home and community-based services designation on the home care license under
section 144A.484, must designate an individual as the entity's compliance officer. The
compliance officer must:

(1) develop policies and procedures to assure adherence to medical assistance laws and
regulations and to prevent inappropriate claims submissions;

(2) train the employees of the provider entity, and any agents or subcontractors of the
provider entity including billers, on the policies and procedures under clause (1);

(3) respond to allegations of improper conduct related to the provision or billing of
medical assistance services, and implement action to remediate any resulting problems;

(4) use evaluation techniques to monitor compliance with medical assistance laws and
regulations;

(5) promptly report to the commissioner any identified violations of medical assistance
laws or regulations; and

(6) within 60 days of discovery by the provider of a medical assistance reimbursement
overpayment, report the overpayment to the commissioner and make arrangements with
the commissioner for the commissioner's recovery of the overpayment.

The commissioner may require, as a condition of enrollment in medical assistance, that a
provider within a particular industry sector or category establish a compliance program that
contains the core elements established by the Centers for Medicare and Medicaid Services.

(c) The commissioner may revoke the enrollment of an ordering or rendering provider
for a period of not more than one year, if the provider fails to maintain and, upon request
from the commissioner, provide access to documentation relating to written orders or requests
for payment for durable medical equipment, certifications for home health services, or
referrals for other items or services written or ordered by such provider, when the
commissioner has identified a pattern of a lack of documentation. A pattern means a failure
to maintain documentation or provide access to documentation on more than one occasion.
Nothing in this paragraph limits the authority of the commissioner to sanction a provider
under the provisions of section 256B.064.

(d) The commissioner shall terminate or deny the enrollment of any individual or entity
if the individual or entity has been terminated from participation in Medicare or under the
Medicaid program or Children's Health Insurance Program of any other state. new text begin The
commissioner may exempt a rehabilitation agency from termination or denial that would
otherwise be required under this paragraph, if the agency:
new text end

new text begin (1) is unable to retain Medicare certification and enrollment solely due to a lack of billing
to the Medicare program;
new text end

new text begin (2) meets all other applicable Medicare certification requirements based on an on-site
review completed by the commissioner of health; and
new text end

new text begin (3) serves primarily a pediatric population.
new text end

(e) As a condition of enrollment in medical assistance, the commissioner shall require
that a provider designated "moderate" or "high-risk" by the Centers for Medicare and
Medicaid Services or the commissioner permit the Centers for Medicare and Medicaid
Services, its agents, or its designated contractors and the state agency, its agents, or its
designated contractors to conduct unannounced on-site inspections of any provider location.
The commissioner shall publish in the Minnesota Health Care Program Provider Manual a
list of provider types designated "limited," "moderate," or "high-risk," based on the criteria
and standards used to designate Medicare providers in Code of Federal Regulations, title
42, section 424.518. The list and criteria are not subject to the requirements of chapter 14.
The commissioner's designations are not subject to administrative appeal.

(f) As a condition of enrollment in medical assistance, the commissioner shall require
that a high-risk provider, or a person with a direct or indirect ownership interest in the
provider of five percent or higher, consent to criminal background checks, including
fingerprinting, when required to do so under state law or by a determination by the
commissioner or the Centers for Medicare and Medicaid Services that a provider is designated
high-risk for fraud, waste, or abuse.

(g)(1) Upon initial enrollment, reenrollment, and notification of revalidation, all durable
medical equipment, prosthetics, orthotics, and supplies (DMEPOS) medical suppliers
meeting the durable medical equipment provider and supplier definition in clause (3),
operating in Minnesota and receiving Medicaid funds must purchase a surety bond that is
annually renewed and designates the Minnesota Department of Human Services as the
obligee, and must be submitted in a form approved by the commissioner. For purposes of
this clause, the following medical suppliers are not required to obtain a surety bond: a
federally qualified health center, a home health agency, the Indian Health Service, a
pharmacy, and a rural health clinic.

(2) At the time of initial enrollment or reenrollment, durable medical equipment providers
and suppliers defined in clause (3) must purchase a surety bond of $50,000. If a revalidating
provider's Medicaid revenue in the previous calendar year is up to and including $300,000,
the provider agency must purchase a surety bond of $50,000. If a revalidating provider's
Medicaid revenue in the previous calendar year is over $300,000, the provider agency must
purchase a surety bond of $100,000. The surety bond must allow for recovery of costs and
fees in pursuing a claim on the bond.

(3) "Durable medical equipment provider or supplier" means a medical supplier that can
purchase medical equipment or supplies for sale or rental to the general public and is able
to perform or arrange for necessary repairs to and maintenance of equipment offered for
sale or rental.

(h) The Department of Human Services may require a provider to purchase a surety
bond as a condition of initial enrollment, reenrollment, reinstatement, or continued enrollment
if: (1) the provider fails to demonstrate financial viability, (2) the department determines
there is significant evidence of or potential for fraud and abuse by the provider, or (3) the
provider or category of providers is designated high-risk pursuant to paragraph (a) and as
per Code of Federal Regulations, title 42, section 455.450. The surety bond must be in an
amount of $100,000 or ten percent of the provider's payments from Medicaid during the
immediately preceding 12 months, whichever is greater. The surety bond must name the
Department of Human Services as an obligee and must allow for recovery of costs and fees
in pursuing a claim on the bond. This paragraph does not apply if the provider currently
maintains a surety bond under the requirements in section 256B.0659 or 256B.85.

Sec. 2. new text begin PAIN MANAGEMENT.
new text end

new text begin (a) The Health Services Policy Committee established under Minnesota Statutes, section
256B.0625, subdivision 3c, shall evaluate and make recommendations on the integration
of nonpharmacologic pain management that are clinically viable and sustainable; reduce or
eliminate chronic pain conditions; improve functional status; and prevent addiction and
reduce dependence on opiates or other pain medications. The recommendations must be
based on best practices for the effective treatment of musculoskeletal pain provided by
health practitioners identified in paragraph (b), and covered under medical assistance. Each
health practitioner represented under paragraph (b) shall present the minimum best integrated
practice recommendations, policies, and scientific evidence for nonpharmacologic treatment
options for eliminating pain and improving functional status within their full professional
scope. Recommendations for integration of services may include guidance regarding
screening for co-occurring behavioral health diagnoses; protocols for communication between
all providers treating a unique individual, including protocols for follow-up; and universal
mechanisms to assess improvements in functional status.
new text end

new text begin (b) In evaluating and making recommendations, the Health Services Policy Committee
shall consult and collaborate with the following health practitioners: acupuncture practitioners
licensed under Minnesota Statutes, chapter 147B; chiropractors licensed under Minnesota
Statutes, sections 148.01 to 148.10; physical therapists licensed under Minnesota Statutes,
sections 148.68 to 148.78; medical and osteopathic physicians licensed under Minnesota
Statutes, chapter 147, and advanced practice registered nurses licensed under Minnesota
Statutes, sections 148.171 to 148.285, with experience in providing primary care
collaboratively within a multidisciplinary team of health care practitioners who employ
nonpharmacologic pain therapies; and psychologists licensed under Minnesota Statutes,
section 148.907.
new text end

new text begin (c) The commissioner shall submit a progress report to the chairs and ranking minority
members of the legislative committees with jurisdiction over health and human services
policy and finance by January 15, 2020, and shall report final recommendations by August
1, 2020. The final report may also contain recommendations for developing and implementing
a pilot program to assess the clinical viability, sustainability, and effectiveness of integrated
nonpharmacologic, multidisciplinary treatments for managing musculoskeletal pain and
improving functional status.
new text end

ARTICLE 2

HOME CARE LICENSING

Section 1.

Minnesota Statutes 2018, section 144A.43, subdivision 11, is amended to read:

Subd. 11.

Medication administration.

"Medication administration" means performing
a set of tasks deleted text begin to ensure a client takes medications, and includes deleted text end new text begin that include new text end 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 new text begin registered new text end nurse new text begin or appropriate licensed health professional new text end any concerns
about the medication, the client, or the client's refusal to take the medication.

Sec. 2.

Minnesota Statutes 2018, section 144A.43, is amended by adding a subdivision to
read:

new text begin Subd. 12a. new text end

new text begin Medication reconciliation. new text end

new text begin "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.
new text end

Sec. 3.

Minnesota Statutes 2018, section 144A.43, subdivision 27, is amended to read:

Subd. 27.

Service deleted text begin plan deleted text end new text begin agreement new text end .

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

Sec. 4.

Minnesota Statutes 2018, section 144A.43, subdivision 30, is amended to read:

Subd. 30.

Standby assistance.

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

Sec. 5.

Minnesota Statutes 2018, section 144A.472, subdivision 5, is amended to read:

Subd. 5.

deleted text begin Transfers prohibited; deleted text end Changes in ownership.

deleted text begin Any deleted text end new text begin (a) A new text end home care license
issued by the commissioner may not be transferred to another party. Before acquiring
ownership of new text begin or a controlling interest in new text end a home care provider business, a prospective
deleted text begin applicant deleted text end new text begin owner new text end must apply for a new deleted text begin temporary deleted text end license. A change of ownership is a transfer
of operational control deleted text begin to a different business entity deleted text end new text begin of the home care provider business new text end 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) deleted text begin in the case of a privately held corporation, the change in deleted text end new text begin transfer of new text end ownership or
control of 50 percent or more of the deleted text begin outstanding voting stock deleted text end new text begin controlling interest of a home
care provider business not covered by clauses (1) to (4) new text end .

new text begin (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
subdivisions 1, clause (14), and 2, if applicable.
new text end

new text begin (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.
new text end

Sec. 6.

Minnesota Statutes 2018, section 144A.472, subdivision 7, is amended to read:

Subd. 7.

Fees; application, change of ownership, deleted text begin and deleted text end renewal new text begin , and failure to
notify new text end .

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

new text begin (j) new text end 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. 7.

Minnesota Statutes 2018, 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 new text begin ,
except for temporary licenses issued under subdivision 2, new text end are valid for new text begin up to new text end 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 new text begin , except that a temporary
license may be extended according to subdivision 3 new text end . Temporary licensees must comply with
sections 144A.43 to 144A.482.

(b) During the temporary license deleted text begin year deleted text end new text begin period new text end , the commissioner shall survey the temporary
licensee new text begin within 90 calendar days new text end 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
deleted text begin year deleted text end new text begin period new text end , then the temporary license expires at the end of the deleted text begin year deleted text end new text begin period new text end and the applicant
must reapply for a temporary home care license. new text begin A temporary licensee who fails to comply
with the notification requirements of this paragraph is subject to the fee described in section
144A.472, subdivision 7, paragraph (i).
new text end

(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 new text begin either: (1) new text end not issue a deleted text begin basic or comprehensive deleted text end license and deleted text begin there will
be no contested hearing right under chapter 14 deleted text end new text begin 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 new text end .

(b) If the temporary licensee whose basic or comprehensive license has been denied new text begin or
extended with conditions new text end disagrees with the conclusions of the commissioner, then the
new text begin temporary new text end 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 new text begin temporary new text end licensee disagrees with the decision
to deny the basic or comprehensive home care license new text begin or the decision to extend the temporary
license with conditions new text end .

(d) new text begin 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.
new text end

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

new text begin (1) a reconsideration request is in process;
new text end

new text begin (2) an extension of a temporary license is being negotiated;
new text end

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

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

new text begin (f) new text end 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. 8.

Minnesota Statutes 2018, 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) new text begin "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.
new text end

new text begin (c) new text end "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 deleted text begin plan deleted text end new text begin agreement new text end implementation and changes to the service deleted text begin plan deleted text end new text begin agreement new text end ;

(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.

deleted text begin (c) deleted text end new text begin (d) new text end "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 deleted text begin and deleted text end new text begin , for licensees that receive licenses due to an approved change in
ownership, new text end 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.

deleted text begin (d) deleted text end new text begin (e) new text end "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.

deleted text begin (e) deleted text end new text begin (f) new text end 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. 9.

Minnesota Statutes 2018, section 144A.475, subdivision 1, is amended to read:

Subdivision 1.

Conditions.

(a) The commissioner may refuse to grant a temporary
license, new text begin refuse to grant a license as a result of a change in ownership, refuse to new text end 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. 10.

Minnesota Statutes 2018, section 144A.475, subdivision 2, is amended to read:

Subd. 2.

Terms to suspension or conditional license.

new text begin (a) new text end 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.

new text begin (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.
new text end

Sec. 11.

Minnesota Statutes 2018, 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.

new text begin (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.
new text end

Sec. 12.

Minnesota Statutes 2018, 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 new text begin , issues a license new text end new text begin as a result of an approved
change in ownership, new text end 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. 13.

Minnesota Statutes 2018, 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 deleted text begin required deleted text end new text begin any new text end health
screenings new text begin required by infection control programs established new text end 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. 14.

Minnesota Statutes 2018, 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 deleted text begin initiation of deleted text end new text begin date that new text end services new text begin are first provided new text end 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, website 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. 15.

Minnesota Statutes 2018, section 144A.4791, subdivision 3, is amended to read:

Subd. 3.

Statement of home care services.

Prior to the deleted text begin initiation of deleted text end new text begin date that new text end services new text begin
are first provided to the client new text end , 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. 16.

Minnesota Statutes 2018, section 144A.4791, subdivision 6, is amended to read:

Subd. 6.

Initiation of services.

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

Sec. 17.

Minnesota Statutes 2018, 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 deleted text begin initiation of
the deleted text end new text begin date that new text end home care services new text begin are first provided new text end .

(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. 18.

Minnesota Statutes 2018, 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 deleted text begin initiation
of deleted text end new text begin the date that new text end home care services new text begin are first provided new text end .

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

(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. 19.

Minnesota Statutes 2018, section 144A.4791, subdivision 9, is amended to read:

Subd. 9.

Service deleted text begin plan deleted text end new text begin agreement new text end , implementation, and revisions to service deleted text begin plan deleted text end new text begin
agreement new text end .

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

(b) The service deleted text begin plan deleted text end new text begin agreement new text end 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 deleted text begin plan deleted text end new text begin agreement new text end 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 deleted text begin plan deleted text end new text begin agreement new text end .

(d) The service deleted text begin plan deleted text end new text begin agreement new text end and revised service deleted text begin plan deleted text end new text begin agreement new text end 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
deleted text begin plan deleted text end new text begin agreement new text end .

(f) The service deleted text begin plan deleted text end new text begin agreement new text end 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) deleted text begin the frequency of sessions of supervision of staff and type of personnel who will
supervise staff deleted text end new text begin the schedule and methods of monitoring staff providing home care services new text end ;
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 deleted text begin , including
identification of and information as to who has authority to sign for the client in an
emergency deleted text end ; 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. 20.

Minnesota Statutes 2018, 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, new text begin stored,
and secured by the comprehensive home care provider, new text end 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. 21.

Minnesota Statutes 2018, 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 new text begin :
new text end

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

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

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

Sec. 22.

Minnesota Statutes 2018, 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 deleted text begin plan deleted text end new text begin agreement new text end 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.

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

Sec. 23.

Minnesota Statutes 2018, 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 deleted text begin the registered deleted text end new text begin a licensed new text end 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 deleted text begin 120 hours deleted text end new text begin seven calendar days new text end ;

(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; deleted text begin and
deleted text end

(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 deleted text begin . deleted text end new text begin ; and
new text end

new text begin (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.
new text end

Sec. 24.

Minnesota Statutes 2018, section 144A.4793, subdivision 6, is amended to read:

Subd. 6.

new text begin Treatment and therapy new text end orders deleted text begin or prescriptions deleted text end .

There must be an up-to-date
written or electronically recorded order deleted text begin or prescription deleted text end new text begin from an authorized prescriber new text end 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 new text begin , duration, new text end and other information
needed to administer the treatment or therapy. new text begin Treatment and therapy orders must be renewed
at least every 12 months.
new text end

Sec. 25.

Minnesota Statutes 2018, 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 new text begin by the individual staff person new text end ;

(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. 26.

Minnesota Statutes 2018, 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 new text begin date on which the new text end individual begins working for the home care provider new text begin
and first performs delegated tasks for clients new text end 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. 27.

Minnesota Statutes 2018, section 144A.4798, is amended to read:

144A.4798 deleted text begin EMPLOYEE HEALTH STATUS deleted text end new text begin DISEASE PREVENTION AND
INFECTION CONTROL new text end .

Subdivision 1.

Tuberculosis (TB) deleted text begin prevention and deleted text end new text begin infection new text end control.

new text begin (a) new text end A home care
provider must establish and maintain a deleted text begin TB prevention and deleted text end new text begin comprehensive tuberculosis
infection new text end control program deleted text begin based on deleted text end new text begin according to new text end the most current new text begin tuberculosis infection
control new text end guidelines issued by the new text begin United States new text end Centers for Disease Control and Prevention
(CDC) new text begin , Division of Tuberculosis Elimination, as published in the CDC's Morbidity and
Mortality Weekly Report new text end . deleted text begin 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 website. deleted text end new text begin 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.
new text end

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

Subd. 2.

Communicable diseases.

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

new text begin Subd. 3. new text end

new text begin Infection control program. new text end

new text begin 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.
new text end

Sec. 28.

Minnesota Statutes 2018, 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 deleted text begin either deleted text end persons who
are currently receiving home care services deleted text begin or deleted text end new text begin , persons who have received home care services
within five years of the application date, new text end new text begin persons who new text end 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 new text begin Office of new text end Ombudsman for Long-Term Care.

Sec. 29.

Minnesota Statutes 2018, 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 deleted text begin the deleted text end home care deleted text begin field, including deleted text end new text begin and
assisted living;
new text end

new text begin (6) identifying new text end the use of technology in home and telehealth capabilities;

deleted text begin (6) deleted text end new text begin (7) new text end 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

deleted text begin (7) deleted text end new text begin (8) new text end 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. 30.

Minnesota Statutes 2018, section 144A.484, subdivision 1, is amended to read:

Subdivision 1.

Integrated licensing established.

deleted text begin (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.
deleted text end

deleted text begin (b) Beginning July 1, 2015, deleted text end 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 deleted text begin 144A.481 deleted text end new text begin 144A.4799 new text end .

Sec. 31. new text begin REVISOR INSTRUCTIONS.
new text end

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

new text begin (b) The revisor of statutes shall change the term "service plan" to "service agreement"
and the term "service plans" to "service agreements" in 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).
new text end

Sec. 32. new text begin REPEALER.
new text end

new text begin Minnesota Statutes 2018, sections 144A.45, subdivision 6; and 144A.481, new text end new text begin are repealed.
new text end

ARTICLE 3

COMMUNITY SUPPORTS AND CONTINUING CARE

Section 1.

Minnesota Statutes 2018, section 245A.03, subdivision 7, is amended to read:

Subd. 7.

Licensing moratorium.

(a) The commissioner shall not issue an initial license
for child foster care licensed under Minnesota Rules, parts 2960.3000 to 2960.3340, or adult
foster care licensed under Minnesota Rules, parts 9555.5105 to 9555.6265, under this chapter
for a physical location that will not be the primary residence of the license holder for the
entire period of licensure. If a license is issued during this moratorium, and the license
holder changes the license holder's primary residence away from the physical location of
the foster care license, the commissioner shall revoke the license according to section
245A.07. The commissioner shall not issue an initial license for a community residential
setting licensed under chapter 245D. When approving an exception under this paragraph,
the commissioner shall consider the resource need determination process in paragraph (h),
the availability of foster care licensed beds in the geographic area in which the licensee
seeks to operate, the results of a person's choices during their annual assessment and service
plan review, and the recommendation of the local county board. The determination by the
commissioner is final and not subject to appeal. Exceptions to the moratorium include:

(1) foster care settings that are required to be registered under chapter 144D;

(2) foster care licenses replacing foster care licenses in existence on May 15, 2009, or
community residential setting licenses replacing adult foster care licenses in existence on
December 31, 2013, and determined to be needed by the commissioner under paragraph
(b);

(3) new foster care licenses or community residential setting licenses determined to be
needed by the commissioner under paragraph (b) for the closure of a nursing facility, ICF/DD,
or regional treatment center; restructuring of state-operated services that limits the capacity
of state-operated facilities; or allowing movement to the community for people who no
longer require the level of care provided in state-operated facilities as provided under section
256B.092, subdivision 13, or 256B.49, subdivision 24;

(4) new foster care licenses or community residential setting licenses determined to be
needed by the commissioner under paragraph (b) for persons requiring hospital level care;

(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; deleted text begin or
deleted text end

(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, deleted text begin 2018 deleted text end new text begin 2019 new text end . 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 deleted text begin . deleted text end new text begin ; or
new text end

new text begin (8) a vacancy in a setting granted an exception under clause (7), created between January
1, 2017, and the date of the exception request, by the departure of a person receiving services
under chapter 245D and residing in the unlicensed setting between January 1, 2017, and
May 1, 2017. 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.
new text end

(b) The commissioner shall determine the need for newly licensed foster care homes or
community residential settings as defined under this subdivision. As part of the determination,
the commissioner shall consider the availability of foster care capacity in the area in which
the licensee seeks to operate, and the recommendation of the local county board. The
determination by the commissioner must be final. A determination of need is not required
for a change in ownership at the same address.

(c) When an adult resident served by the program moves out of a foster home that is not
the primary residence of the license holder according to section 256B.49, subdivision 15,
paragraph (f), or the adult community residential setting, the county shall immediately
inform the Department of Human Services Licensing Division. The department may decrease
the statewide licensed capacity for adult foster care settings.

(d) Residential settings that would otherwise be subject to the decreased license capacity
established in paragraph (c) shall be exempt if the license holder's beds are occupied by
residents whose primary diagnosis is mental illness and the license holder is certified under
the requirements in subdivision 6a or section 245D.33.

(e) A resource need determination process, managed at the state level, using the available
reports required by section 144A.351, and other data and information shall be used to
determine where the reduced capacity determined under section 256B.493 will be
implemented. The commissioner shall consult with the stakeholders described in section
144A.351, and employ a variety of methods to improve the state's capacity to meet the
informed decisions of those people who want to move out of corporate foster care or
community residential settings, long-term service needs within budgetary limits, including
seeking proposals from service providers or lead agencies to change service type, capacity,
or location to improve services, increase the independence of residents, and better meet
needs identified by the long-term services and supports reports and statewide data and
information.

(f) At the time of application and reapplication for licensure, the applicant and the license
holder that are subject to the moratorium or an exclusion established in paragraph (a) are
required to inform the commissioner whether the physical location where the foster care
will be provided is or will be the primary residence of the license holder for the entire period
of licensure. If the primary residence of the applicant or license holder changes, the applicant
or license holder must notify the commissioner immediately. The commissioner shall print
on the foster care license certificate whether or not the physical location is the primary
residence of the license holder.

(g) License holders of foster care homes identified under paragraph (f) that are not the
primary residence of the license holder and that also provide services in the foster care home
that are covered by a federally approved home and community-based services waiver, as
authorized under section 256B.0915, 256B.092, or 256B.49, must inform the human services
licensing division that the license holder provides or intends to provide these waiver-funded
services.

(h) The commissioner may adjust capacity to address needs identified in section
144A.351. Under this authority, the commissioner may approve new licensed settings or
delicense existing settings. Delicensing of settings will be accomplished through a process
identified in section 256B.493. Annually, by August 1, the commissioner shall provide
information and data on capacity of licensed long-term services and supports, actions taken
under the subdivision to manage statewide long-term services and supports resources, and
any recommendations for change to the legislative committees with jurisdiction over the
health and human services budget.

(i) The commissioner must notify a license holder when its corporate foster care or
community residential setting licensed beds are reduced under this section. The notice of
reduction of licensed beds must be in writing and delivered to the license holder by certified
mail or personal service. The notice must state why the licensed beds are reduced and must
inform the license holder of its right to request reconsideration by the commissioner. The
license holder's request for reconsideration must be in writing. If mailed, the request for
reconsideration must be postmarked and sent to the commissioner within 20 calendar days
after the license holder's receipt of the notice of reduction of licensed beds. If a request for
reconsideration is made by personal service, it must be received by the commissioner within
20 calendar days after the license holder's receipt of the notice of reduction of licensed beds.

(j) The commissioner shall not issue an initial license for children's residential treatment
services licensed under Minnesota Rules, parts 2960.0580 to 2960.0700, under this chapter
for a program that Centers for Medicare and Medicaid Services would consider an institution
for mental diseases. Facilities that serve only private pay clients are exempt from the
moratorium described in this paragraph. The commissioner has the authority to manage
existing statewide capacity for children's residential treatment services subject to the
moratorium under this paragraph and may issue an initial license for such facilities if the
initial license would not increase the statewide capacity for children's residential treatment
services subject to the moratorium under this paragraph.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective retroactively from July 1, 2018, and
applies to exception requests made on or after that date.
new text end

Sec. 2.

Minnesota Statutes 2018, 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 deleted text begin March 1, 2011 deleted text end new text begin June 30, 2016 new text end .

(g) The commissioner shall not issue a new adult foster care license under paragraph (f)
after June 30, deleted text begin 2019 deleted text end new text begin 2021 new text end . The commissioner shall allow a facility with an adult foster care
license issued under paragraph (f) before June 30, deleted text begin 2019 deleted text end new text begin 2021 new text end , to continue with a capacity
of five adults if the license holder continues to comply with the requirements in paragraph
(f).

new text begin EFFECTIVE DATE. new text end

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

Sec. 3.

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

Subdivision 1.

Applicability.

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

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

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

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

(3) personal support as defined under the new text begin brain injury, community access for disability
inclusion, community alternative care, and new text end developmental deleted text begin disability deleted text end new text begin disabilities new text end waiver deleted text begin plan deleted text end
new text begin plans new text end ;

(4) 24-hour emergency assistance, personal emergency response as defined under the
new text begin brain injury, new text end community access for disability inclusion new text begin , community alternative care, new text end and
developmental deleted text begin disability deleted text end new text begin disabilities new text end waiver plans;

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

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

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

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

(1) intervention services, including:

(i) deleted text begin behavioral deleted text end new text begin positive new text end support services as defined under the brain injury deleted text begin and deleted text end new text begin , new text end community
access for disability inclusion new text begin , community alternative care, and developmental disabilities new text end
waiver plans;

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

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

(2) in-home support services, including:

(i) in-home family support and supported living services as defined under the new text begin brain
injury, community access for disability inclusion, community alternative care, and new text end
developmental deleted text begin disability deleted text end new text begin disabilities new text end waiver deleted text begin plan deleted text end new text begin plans new text end ;

new text begin (ii) supported living services as defined under the developmental disabilities waiver
plan;
new text end

deleted text begin (ii) deleted text end new text begin (iii) new text end independent living services training as defined under the brain injury and
community access for disability inclusion waiver plans;

deleted text begin (iii) deleted text end new text begin (iv) new text end semi-independent living services; and

deleted text begin (iv) deleted text end new text begin (v) new text end 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 deleted text begin disability deleted text end new text begin disabilities new text end
waiver plan provided in a family or corporate child foster care residence, a family adult
foster care residence, a community residential setting, or a supervised living facility;

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

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

(4) day services, including:

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

(ii) day training and habilitation services under sections 252.41 to 252.46, and as defined
under the developmental deleted text begin disability deleted text end new text begin disabilities new text end waiver plan; and

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

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

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

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

Sec. 4.

Minnesota Statutes 2018, section 245D.071, subdivision 5, is amended to read:

Subd. 5.

Service plan review and evaluation.

(a) The license holder must give the
person or the person's legal representative and case manager an opportunity to participate
in the ongoing review and development of the service plan and the methods used to support
the person and accomplish outcomes identified in subdivisions 3 and 4. new text begin At least once per
year, or within 30 days of a written request by the person, the person's legal representative,
or the case manager, new text end the license holder, in coordination with the person's support team or
expanded support team, must meet with the person, the person's legal representative, and
the case manager, and participate in service plan review meetings following stated timelines
established in the person's coordinated service and support plan or coordinated service and
support plan addendum deleted text begin or within 30 days of a written request by the person, the person's
legal representative, or the case manager, at a minimum of once per year deleted text end . The purpose of
the service plan review is to determine whether changes are needed to the service plan based
on the assessment information, the license holder's evaluation of progress towards
accomplishing outcomes, or other information provided by the support team or expanded
support team.

new text begin (b) At least once per year, the license holder, in coordination with the person's support
team or expanded support team, must meet with the person, the person's legal representative,
and the case manager to discuss how technology might be used to meet the person's desired
outcomes. The support plan addendum must include a summary of this discussion. The
summary must include a statement regarding any decision made related to the use of
technology and a description of any further research that must be completed before a decision
regarding the use of technology can be made. Nothing in this paragraph requires the
coordinated service and support plan to include the use of technology for the provision of
services.
new text end

deleted text begin (b) deleted text end new text begin (c) new text end The license holder must summarize the person's status and progress toward
achieving the identified outcomes and make recommendations and identify the rationale
for changing, continuing, or discontinuing implementation of supports and methods identified
in subdivision 4 in a report available at the time of the progress review meeting. The report
must be sent at least five working days prior to the progress review meeting if requested by
the team in the coordinated service and support plan or coordinated service and support
plan addendum.

deleted text begin (c) deleted text end new text begin (d) new text end The license holder must send the coordinated service and support plan addendum
to the person, the person's legal representative, and the case manager by mail within ten
working days of the progress review meeting. Within ten working days of the mailing of
the coordinated service and support plan addendum, the license holder must obtain dated
signatures from the person or the person's legal representative and the case manager to
document approval of any changes to the coordinated service and support plan addendum.

deleted text begin (d) deleted text end new text begin (e) new text end If, within ten working days of submitting changes to the coordinated service and
support plan and coordinated service and support plan addendum, the person or the person's
legal representative or case manager has not signed and returned to the license holder the
coordinated service and support plan or coordinated service and support plan addendum or
has not proposed written modifications to the license holder's submission, the submission
is deemed approved and the coordinated service and support plan addendum becomes
effective and remains in effect until the legal representative or case manager submits a
written request to revise the coordinated service and support plan addendum.

Sec. 5.

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

Subd. 2.

deleted text begin Behavior deleted text end new text begin Positive support new text end professional qualifications.

A deleted text begin behavior deleted text end new text begin positive
support new text end professional providing deleted text begin behavioral deleted text end new text begin positive new text end support services as identified in section
245D.03, subdivision 1, paragraph (c), clause (1), item (i), must have competencies in the
following areas as required under the brain injury deleted text begin and deleted text end new text begin , new text end community access for disability
inclusion new text begin , community alternative care, and developmental disabilities new text end waiver plans or
successor plans:

(1) ethical considerations;

(2) functional assessment;

(3) functional analysis;

(4) measurement of behavior and interpretation of data;

(5) selecting intervention outcomes and strategies;

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

(7) data collection;

(8) staff and caregiver training;

(9) support plan monitoring;

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

(11) demonstrated expertise with populations being served; and

(12) must be a:

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

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

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

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

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

(vi) new text begin person with a master's degree or PhD in one of the behavioral sciences or related
fields with demonstrated expertise in positive support services; or
new text end

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

Sec. 6.

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

Subd. 3.

deleted text begin Behavior deleted text end new text begin Positive support new text end analyst qualifications.

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

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

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

new text begin (3) be a board certified behavior analyst or board certified assistant behavior analyst by
the Behavior Analyst Certification Board, Incorporated.
new text end

(b) In addition, a deleted text begin behavior deleted text end new text begin positive support new text end analyst must:

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

(2) have received deleted text begin ten hours of instruction in functional assessment and functional analysis; deleted text end new text begin
training prior to hire or within 90 calendar days of hire that includes:
new text end

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

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

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

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

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

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

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

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

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

deleted text begin (7) deleted text end new text begin (4) new text end be under the direct supervision of a deleted text begin behavior deleted text end new text begin positive support new text end professional.

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

Sec. 7.

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

Subd. 4.

deleted text begin Behavior deleted text end new text begin Positive support new text end specialist qualifications.

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

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

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

(b) In addition, a behavior specialist must:

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

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

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

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

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

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

deleted text begin (5) deleted text end new text begin (3) new text end be under the direct supervision of a deleted text begin behavior deleted text end new text begin positive support new text end professional.

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

Sec. 8.

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

Subd. 3a.

Assessment; defined.

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

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

Sec. 9.

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

Subd. 1a.

Definitions.

For purposes of this section, the following definitions apply:

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

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

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

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

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

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

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

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

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

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

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

(1) service eligibility determination for state plan deleted text begin home care deleted text end services identified in:

(i) section 256B.0625, subdivisions deleted text begin 7 deleted text end deleted text begin , deleted text end 19a deleted text begin , deleted text end and 19c;

(ii) consumer support grants under section 256.476; or

(iii) section 256B.85;

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

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

(4) obtaining necessary diagnostic information to determine eligibility under clauses (2)
and (3).

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

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

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

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

Sec. 10.

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

Subd. 3a.

Assessment and support planning.

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

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

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

(d) The assessment must be conducted in a face-to-face new text begin conversational new text end interview with
the person being assessed deleted text begin and deleted text end new text begin . new text end The person's legal representative new text begin must provide input during
the assessment process and may do so remotely if requested new text end . At the request of the person,
other individuals may participate in the assessment to provide information on the needs,
strengths, and preferences of the person necessary to develop a community support plan
that ensures the person's health and safety. Except for legal representatives or family members
invited by the person, persons participating in the assessment may not be a provider of
service or have any financial interest in the provision of services. For persons who are to
be assessed for elderly waiver customized living or adult day services under section
256B.0915, with the permission of the person being assessed or the person's designated or
legal representative, the client's current or proposed provider of services may submit a copy
of the provider's nursing assessment or written report outlining its recommendations regarding
the client's care needs. The person conducting the assessment must notify the provider of
the date by which this information is to be submitted. This information shall be provided
to the person conducting the assessment prior to the assessment. For a person who is to be
assessed for waiver services under section 256B.092 or 256B.49, with the permission of
the person being assessed or the person's designated legal representative, the person's current
provider of services may submit a written report outlining recommendations regarding the
person's care needs prepared by a direct service employee new text begin who is familiar new text end with deleted text begin at least 20
hours of service deleted text end deleted text begin to that client. The person conducting the assessment or reassessment must
notify the provider deleted text end deleted text begin of the date by which this information is to be submitted. This information
shall be provided deleted text end deleted text begin to the person conducting the assessment and the person or the person's
legal representative, deleted text end deleted text begin and must be considered prior to the finalization of the assessment or
reassessment deleted text end new text begin the person. The provider must submit the report at least 60 days before the
end of the person's current service agreement. The certified assessor must consider the
content of the submitted report prior to finalizing the person's assessment or reassessment new text end .

(e) new text begin The certified assessor and the individual responsible for developing the coordinated
service and support plan must complete the community support plan and the coordinated
service and support plan no more than 60 calendar days from the assessment visit. new text end The
person or the person's legal representative must be provided with a written community
support plan within deleted text begin 40 calendar days of the assessment visit deleted text end new text begin the timelines established by
the commissioner new text end , regardless of whether the deleted text begin individual deleted text end new text begin person new text end is eligible for Minnesota
health care programs.

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

(g) The written community support plan must include:

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

(2) the individual's options and choices to meet identified needs, including all available
options for case management services and providers, including service provided in a
non-disability-specific setting;

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

(4) referral information; and

(5) informal caregiver supports, if applicable.

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

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

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

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

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

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

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

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

(5) information about Minnesota health care programs;

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

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

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

(9) the person's right to appeal the certified assessor's decision regarding eligibility for
all services and programs as defined in subdivision 1a, paragraphs (a), clauses (6), (7), and
(8), and (b), and incorporating the decision regarding the need for institutional level of care
or the lead agency's final decisions regarding public programs eligibility according to section
256.045, subdivision 3. new text begin The certified assessor must verbally communicate this appeal right
to the person and must visually point out where in the document the right to appeal is stated.
new text end

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

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

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

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

Sec. 11.

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

Subd. 3f.

Long-term care reassessments and community support plan updates.

new text begin (a)
Prior to a face-to-face reassessment, the certified assessor must review the person's most
recent assessment. new text end Reassessments must be tailored using the professional judgment of the
assessor to the person's known needs, strengths, preferences, and circumstances.
Reassessments provide information to support the person's informed choice and opportunities
to express choice regarding activities that contribute to quality of life, as well as information
and opportunity to identify goals related to desired employment, community activities, and
preferred living environment. Reassessments deleted text begin allow for deleted text end new text begin require new text end a review of new text begin the most recent
assessment, review of new text end the current new text begin coordinated service and new text end support plan's effectiveness,
monitoring of services, and the development of an updated person-centered community
support plan. Reassessments verify continued eligibility or offer alternatives as warranted
and provide an opportunity for quality assurance of service delivery. Face-to-face deleted text begin assessments deleted text end new text begin
reassessments new text end must be conducted annually or as required by federal and state laws and rules. new text begin
For reassessments, the certified assessor and the individual responsible for developing the
coordinated service and support plan must ensure the continuity of care for the person
receiving services and complete the updated community support plan and the updated
coordinated service and support plan no more than 60 days from the reassessment visit.
new text end

new text begin (b) The commissioner shall develop mechanisms for providers and case managers to
share information with the assessor to facilitate a reassessment and support planning process
tailored to the person's current needs and preferences.
new text end

Sec. 12.

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

new text begin Subd. 3g. new text end

new text begin Assessments for Rule 185 case management. new text end

new text begin Unless otherwise required by
federal law, the county agency is not required to conduct or arrange for an annual needs
reassessment by a certified assessor. The case manager who works on behalf of the person
to identify the person's needs and to minimize the impact of the disability on the person's
life must instead develop a person-centered service plan based on the person's assessed
needs and preferences. The person-centered service plan must be reviewed annually for
persons with developmental disabilities who are receiving only case management services
under Minnesota Rules, part 9525.0036, and who make an informed choice to decline an
assessment under this section.
new text end

Sec. 13.

Minnesota Statutes 2018, section 256B.0911, subdivision 5, is amended to read:

Subd. 5.

Administrative activity.

(a) The commissioner shall streamline the processes,
including timelines for when assessments need to be completed, required to provide the
services in this section and shall implement integrated solutions to automate the business
processes to the extent necessary for community support plan approval, reimbursement,
program planning, evaluation, and policy development.

(b) The commissioner of human services shall work with lead agencies responsible for
conducting long-term consultation services to modify the MnCHOICES application and
assessment policies to create efficiencies while ensuring federal compliance with medical
assistance and long-term services and supports eligibility criteria.

new text begin (c) The commissioner shall work with lead agencies responsible for conducting long-term
consultation services to develop a set of measurable benchmarks sufficient to demonstrate
quarterly improvement in the average time per assessment and other mutually agreed upon
measures of increasing efficiency. The commissioner shall collect data on these benchmarks
and provide to the lead agencies and the chairs and ranking minority members of the
legislative committees with jurisdiction over human services an annual trend analysis of
the data in order to demonstrate the commissioner's compliance with the requirements of
this subdivision.
new text end

Sec. 14.

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

Subd. 6.

Implementation of coordinated service and support plan.

(a) Each elderly
waiver client shall be provided a copy of a written coordinated service and support plan
deleted text begin which deleted text end new text begin that new text end :

(1) is developed new text begin with new text end and signed by the recipient within deleted text begin ten working days after the case
manager receives the assessment information and written community support plan as
described in section 256B.0911, subdivision 3a, from the certified assessor deleted text end new text begin the timelines
established by the commissioner. The timeline for completing the community support plan
under section 256B.0911, subdivision 3a, and the coordinated service and support plan must
not exceed 60 calendar days from the assessment visit new text end ;

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

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

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

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

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

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

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

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

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

Sec. 15.

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

Subd. 1b.

Coordinated service and support plan.

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

(1) is developed new text begin with new text end and signed by the recipient within deleted text begin ten working days after the case
manager receives the assessment information and written community support plan as
described in section 256B.0911, subdivision 3a, from the certified assessor deleted text end new text begin the timelines
established by the commissioner. The timeline for completing the community support plan
under section 256B.0911, subdivision 3a, and the coordinated service and support plan must
not exceed 60 calendar days from the assessment visit new text end ;

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Sec. 16.

Minnesota Statutes 2018, section 256B.0921, is amended to read:

256B.0921 HOME AND COMMUNITY-BASED SERVICES deleted text begin INCENTIVE deleted text end new text begin
INNOVATION new text end POOL.

The commissioner of human services shall develop an initiative to provide incentives
for innovation in: (1) achieving integrated competitive employment; (2) achieving integrated
competitive employment for youth under age 25 upon their graduation from school; (3)
living in the most integrated setting; and (4) other outcomes determined by the commissioner.
The commissioner shall seek requests for proposals and shall contract with one or more
entities to provide incentive payments for meeting identified outcomes.

Sec. 17.

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

Subd. 13.

Case management.

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

(1) finalizing the written coordinated service and support plan within deleted text begin ten working days
after the case manager receives the plan from the certified assessor deleted text end new text begin the timelines established
by the commissioner. The timeline for completing the community support plan under section
256B.0911, subdivision 3a, and the coordinated service and support plan must not exceed
60 calendar days from the assessment visit new text end ;

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

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

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

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

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

(1) finalizing the coordinated service and support plan;

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

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

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

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

(1) phasing out the use of prohibited procedures;

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

(3) accomplishment of identified outcomes.

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

Sec. 18.

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

Subd. 14.

Assessment and reassessment.

(a) Assessments and reassessments shall be
conducted by certified assessors according to section 256B.0911, subdivision 2b. The
certified assessor, with the permission of the recipient or the recipient's designated legal
representative, may invite other individuals to attend the assessment. With the permission
of the recipient or the recipient's designated legal representative, the recipient's current
provider of services may submit a written report outlining their recommendations regarding
the recipient's care needs prepared by a direct service employee deleted text begin with at least 20 hours of
service to that client. The certified assessor must notify the provider of the date by which
this information is to be submitted. This information shall be provided to the certified
assessor and the person or the person's legal representative and must be considered prior to
the finalization of the assessment or reassessment deleted text end new text begin who is familiar with the person. The
provider must submit the report at least 60 days before the end of the person's current service
agreement. The certified assessor must consider the content of the submitted report prior
to finalizing the person's assessment or reassessment new text end .

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

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

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

Sec. 19.

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

Subd. 3.

Applicable services.

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

(1) 24-hour customized living;

(2) adult day care;

(3) adult day care bath;

deleted text begin (4) behavioral programming;
deleted text end

deleted text begin (5) deleted text end new text begin (4) new text end companion services;

deleted text begin (6) deleted text end new text begin (5) new text end customized living;

deleted text begin (7) deleted text end new text begin (6) new text end day training and habilitation;

new text begin (7) employment development services;
new text end

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

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

deleted text begin (8) deleted text end new text begin (10) new text end housing access coordination;

deleted text begin (9) deleted text end new text begin (11) new text end independent living skills;

new text begin (12) independent living skills specialist services;
new text end

new text begin (13) individualized home supports;
new text end

deleted text begin (10) deleted text end new text begin (14) new text end in-home family support;

deleted text begin (11) deleted text end new text begin (15) new text end night supervision;

deleted text begin (12) deleted text end new text begin (16) new text end personal support;

new text begin (17) positive support service;
new text end

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Sec. 20.

Minnesota Statutes 2018, section 256I.03, subdivision 8, is amended to read:

Subd. 8.

Supplementary services.

"Supplementary services" means housing support
services provided to individuals in addition to room and board including, but not limited
to, oversight and up to 24-hour supervision, medication reminders, assistance with
transportation, arranging for meetings and appointments, and arranging for medical and
social services new text begin , and services identified in section 256I.03, subdivision 12 new text end .

Sec. 21.

Minnesota Statutes 2018, section 256I.04, subdivision 2b, is amended to read:

Subd. 2b.

Housing support agreements.

(a) Agreements between agencies and providers
of housing support must be in writing on a form developed and approved by the commissioner
and must specify the name and address under which the establishment subject to the
agreement does business and under which the establishment, or service provider, if different
from the group residential housing establishment, is licensed by the Department of Health
or the Department of Human Services; the specific license or registration from the
Department of Health or the Department of Human Services held by the provider and the
number of beds subject to that license; the address of the location or locations at which
group residential housing is provided under this agreement; the per diem and monthly rates
that are to be paid from housing support funds for each eligible resident at each location;
the number of beds at each location which are subject to the agreement; whether the license
holder is a not-for-profit corporation under section 501(c)(3) of the Internal Revenue Code;
and a statement that the agreement is subject to the provisions of sections 256I.01 to 256I.06
and subject to any changes to those sections.

(b) Providers are required to verify the following minimum requirements in the
agreement:

(1) current license or registration, including authorization if managing or monitoring
medications;

(2) all staff who have direct contact with recipients meet the staff qualifications;

(3) the provision of housing support;

(4) the provision of supplementary services, if applicable;

(5) reports of adverse events, including recipient death or serious injury; deleted text begin and
deleted text end

(6) submission of residency requirements that could result in recipient eviction deleted text begin . deleted text end new text begin ; and
new text end

new text begin (7) confirmation that the provider will not limit or restrict the number of hours an
applicant or recipient chooses to be employed, as specified in subdivision 5.
new text end

(c) Agreements may be terminated with or without cause by the commissioner, the
agency, or the provider with two calendar months prior notice. The commissioner may
immediately terminate an agreement under subdivision 2d.

Sec. 22.

Minnesota Statutes 2018, section 256I.04, is amended by adding a subdivision
to read:

new text begin Subd. 2h. new text end

new text begin Required supplementary services. new text end

new text begin Providers of supplementary services shall
ensure that recipients have, at a minimum, assistance with services as identified in the
recipient's professional statement of need under section 256I.03, subdivision 12. Providers
of supplementary services shall maintain case notes with the date and description of services
provided to individual recipients.
new text end

Sec. 23.

Minnesota Statutes 2018, section 256I.04, is amended by adding a subdivision
to read:

new text begin Subd. 5. new text end

new text begin Employment. new text end

new text begin A provider is prohibited from limiting or restricting the number
of hours an applicant or recipient is employed.
new text end

Sec. 24. new text begin DIRECTION TO COMMISSIONER; BI AND CADI WAIVER
CUSTOMIZED LIVING SERVICES PROVIDER LOCATED IN HENNEPIN
COUNTY.
new text end

new text begin (a) The commissioner of human services shall allow a housing with services establishment
located in Minneapolis that provides customized living and 24-hour customized living
services for clients enrolled in the brain injury (BI) or community access for disability
inclusion (CADI) waiver and had a capacity to serve 66 clients as of July 1, 2017, to transfer
service capacity of up to 66 clients to no more than three new housing with services
establishments located in Hennepin County.
new text end

new text begin (b) Notwithstanding Minnesota Statutes, section 256B.492, the commissioner shall
determine whether the new housing with services establishments described under paragraph
(a) meet the BI and CADI waiver customized living and 24-hour customized living size
limitation exception for clients receiving those services at the new housing with services
establishments described under paragraph (a).
new text end

Sec. 25. new text begin DIRECTION TO COMMISSIONER.
new text end

new text begin (a) The commissioner of human services must ensure that the MnCHOICES 2.0
assessment and support planning tool incorporates a qualitative approach with open-ended
questions and a conversational, culturally sensitive approach to interviewing that captures
the assessor's professional judgment based on the person's responses.
new text end

new text begin (b) If the commissioner of human services convenes a working group or consults with
stakeholders for the purposes of modifying the assessment and support planning process or
tool, the commissioner must include members of the disability community, including
representatives of organizations and individuals involved in assessment and support planning.
new text end

Sec. 26. new text begin REVISOR INSTRUCTION.
new text end

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

Sec. 27. new text begin REPEALER.
new text end

new text begin Minnesota Statutes 2018, section 256I.05, subdivision 3, new text end new text begin is repealed.
new text end

ARTICLE 4

MISCELLANEOUS

Section 1.

Minnesota Statutes 2018, section 13.851, is amended by adding a subdivision
to read:

new text begin Subd. 11. new text end

new text begin Mental health data sharing. new text end

new text begin Section 641.15, subdivision 3a, governs the
sharing of data on prisoners who may have a mental illness or need services with county
social service agencies or welfare system personnel.
new text end

Sec. 2.

Minnesota Statutes 2018, section 243.166, subdivision 4b, is amended to read:

Subd. 4b.

Health care facility; notice of status.

(a) For the purposes of this subdivision deleted text begin , deleted text end new text begin :
new text end

new text begin (1) new text end "health care facility" means a facility:

deleted text begin (1) deleted text end new text begin (i) new text end licensed by the commissioner of health as a hospital, boarding care home or
supervised living facility under sections 144.50 to 144.58, or a nursing home under chapter
144A;

deleted text begin (2) deleted text end new text begin (ii) new text end registered by the commissioner of health as a housing with services establishment
as defined in section 144D.01; or

deleted text begin (3) deleted text end new text begin (iii) new text end licensed by the commissioner of human services as a residential facility under
chapter 245A to provide adult foster care, adult mental health treatment, chemical dependency
treatment to adults, or residential services to persons with disabilities deleted text begin . deleted text end new text begin ; and
new text end

new text begin (2) "home care provider" has the meaning given in section 144A.43.
new text end

(b) Prior to admission to a health care facility new text begin or home care services from a home care
provider new text end , a person required to register under this section shall disclose to:

(1) the health care facility employee new text begin or the home care provider new text end processing the admission
the person's status as a registered predatory offender under this section; and

(2) the person's corrections agent, or if the person does not have an assigned corrections
agent, the law enforcement authority with whom the person is currently required to register,
that deleted text begin inpatient deleted text end admission will occur.

(c) A law enforcement authority or corrections agent who receives notice under paragraph
(b) or who knows that a person required to register under this section is planning to be
admitted and receive, or has been admitted and is receiving health care at a health care
facility new text begin or home care services from a home care provider, new text end shall notify the administrator of
the facility new text begin or the home care provider new text end and deliver a fact sheet to the administrator new text begin or provider
new text end containing the following information: (1) name and physical description of the offender;
(2) the offender's conviction history, including the dates of conviction; (3) the risk level
classification assigned to the offender under section 244.052, if any; and (4) the profile of
likely victims.

(d) Except for a hospital licensed under sections 144.50 to 144.58, if a health care facility
receives a fact sheet under paragraph (c) that includes a risk level classification for the
offender, and if the facility admits the offender, the facility shall distribute the fact sheet to
all residents at the facility. If the facility determines that distribution to a resident is not
appropriate given the resident's medical, emotional, or mental status, the facility shall
distribute the fact sheet to the patient's next of kin or emergency contact.

new text begin (e) If a home care provider receives a fact sheet under paragraph (c) that includes a risk
level classification for the offender, the provider shall distribute the fact sheet to any
individual who will provide direct services to the offender before the individual begins to
provide the service.
new text end

Sec. 3.

Minnesota Statutes 2018, section 641.15, subdivision 3a, is amended to read:

Subd. 3a.

Intake procedure; approved mental health screening new text begin ; data sharing new text end .

As
part of its intake procedure for new prisoners, the sheriff or local corrections shall use a
mental health screening tool approved by the commissioner of corrections new text begin , new text end in consultation
with the commissioner of human services and local corrections staff new text begin , new text end to identify persons
who may have new text begin a new text end mental illness. new text begin Notwithstanding section 13.85, the sheriff or local corrections
may share the names of persons who have screened positive for or may have a mental illness
with the local county social services agency. The sheriff or local corrections may refer a
person 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
on the individual as necessary to:
new text end

new text begin (1) provide assistance in filling out an application for medical assistance or
MinnesotaCare;
new text end

new text begin (2) make a referral for case management as provided under section 245.467, subdivision
4;
new text end

new text begin (3) provide assistance in obtaining a state photo identification;
new text end

new text begin (4) secure a timely appointment with a psychiatrist or other appropriate community
mental health provider;
new text end

new text begin (5) provide prescriptions for a 30-day supply of all necessary medications; or
new text end

new text begin (6) provide for behavioral health service coordination.
new text end

ARTICLE 5

CHILDREN AND FAMILIES

Section 1. new text begin REVISOR INSTRUCTION.
new text end

new text begin The revisor of statutes, in consultation with the Department of Human Services, House
Research Department, and Senate Counsel, Research and Fiscal Analysis shall change the
terms "food support" and "food stamps" to "Supplemental Nutrition Assistance Program"
or "SNAP" in Minnesota Statutes when appropriate. The revisor may make technical and
other necessary changes to sentence structure to preserve the meaning of the text.
new text end

ARTICLE 6

STATE-OPERATED SERVICES; CHEMICAL AND MENTAL HEALTH

Section 1.

Minnesota Statutes 2018, section 144.057, subdivision 3, is amended to read:

Subd. 3.

Reconsiderations.

The commissioner of health shall review and decide
reconsideration requests, including the granting of variances, in accordance with the
procedures and criteria contained in chapter 245C. new text begin The commissioner must set aside a
disqualification for an individual who requests reconsideration and who meets the criteria
described in section 245C.22, subdivision 4, paragraph (d). new text end The commissioner's decision
shall be provided to the individual and to the Department of Human Services. The
commissioner's decision to grant or deny a reconsideration of disqualification is the final
administrative agency action, except for the provisions under sections 245C.25, 245C.27,
and 245C.28, subdivision 3.

Sec. 2.

Minnesota Statutes 2018, 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 new text begin consistent with this section or, if applicable, a temporary change of ownership license
under section 245A.043 new text end . 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 deleted text begin an initial deleted text end new text begin a new text end 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. deleted text begin A license shall not be
transferable to another individual, corporation, partnership, voluntary association, other
organization, or controlling individual or to another location.
deleted text end

deleted text begin (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).
deleted text end

deleted text begin (e) deleted text end new text begin (d) new text end Except as provided in paragraphs deleted text begin (g) deleted text end new text begin (f) new text end and deleted text begin (h) deleted text end new text begin (g) new text end , 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 new text begin issued under this chapter new text end 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 new text begin issued under this chapter new text end 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.

deleted text begin (f) deleted text end new text begin (e) new text end The commissioner shall not issue or reissue a license new text begin under this chapter new text end if an
individual living in the household where the deleted text begin licensed deleted text end 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.

deleted text begin (g) deleted text end new text begin (f) new text end Pursuant to section 245A.07, subdivision 1, paragraph (b), when a license new text begin issued
under this chapter new text end 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.

deleted text begin (h) deleted text end new text begin (g) new text end Notwithstanding paragraph deleted text begin (g) deleted text end new text begin (f) new text end , 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.

deleted text begin (i) deleted text end new text begin (h) new text end 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.

deleted text begin (j) deleted text end new text begin (i) new text end Unless otherwise specified by statute, all licenses new text begin issued under this chapter new text end 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.

deleted text begin (k) deleted text end new text begin (j) new text end The commissioner shall not issue or reissue a license new text begin under this chapter new text end if it has
been determined that a tribal licensing authority has established jurisdiction to license the
program or service.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2020.
new text end

Sec. 3.

Minnesota Statutes 2018, section 245A.04, is amended by adding a subdivision to
read:

new text begin Subd. 7a. new text end

new text begin Notification required. new text end

new text begin (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).
new text end

new text begin (b) At least 30 days before the effective date of a change, the license holder must notify
the commissioner in writing of any change:
new text end

new text begin (1) to the license holder's controlling individual as defined in section 245A.02, subdivision
5a;
new text end

new text begin (2) to license holder information on file with the secretary of state;
new text end

new text begin (3) in the location of the program or service licensed under this chapter; and
new text end

new text begin (4) in the federal or state tax identification number associated with the license holder.
new text end

new text begin (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.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2020.
new text end

Sec. 4.

new text begin [245A.043] LICENSE APPLICATION AFTER CHANGE OF OWNERSHIP.
new text end

new text begin Subdivision 1. new text end

new text begin Transfer prohibited. new text end

new text begin 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.
new text end

new text begin Subd. 2. new text end

new text begin Change of ownership. new text end

new text begin 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:
new text end

new text begin (1) the license holder sells or transfers 100 percent of the property, stock, or assets;
new text end

new text begin (2) the license holder merges with another organization;
new text end

new text begin (3) the license holder consolidates with two or more organizations, resulting in the
creation of a new organization;
new text end

new text begin (4) there is a change in the federal tax identification number associated with the license
holder; or
new text end

new text begin (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.
new text end

new text begin Subd. 3. new text end

new text begin Change of ownership requirements. new text end

new text begin (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.
new text end

new text begin (b) The party must submit a license application under this chapter on the 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.
new text end

new text begin (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.
new text end

new text begin (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.
new text end

new text begin (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.
new text end

new text begin (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.
new text end

new text begin (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.
new text end

new text begin (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.
new text end

new text begin (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.
new text end

new text begin (j) This subdivision does not apply to a licensed program or service located in a home
where the license holder resides.
new text end

new text begin Subd. 4. new text end

new text begin Temporary change of ownership license. new text end

new text begin (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.
new text end

new text begin (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.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2020.
new text end

Sec. 5.

Minnesota Statutes 2018, section 245C.02, is amended by adding a subdivision to
read:

new text begin Subd. 20. new text end

new text begin Substance use disorder treatment field. new text end

new text begin "Substance use disorder treatment
field" means a program exclusively serving individuals 18 years of age and older and that
is required to be:
new text end

new text begin (1) licensed under chapter 245G; or
new text end

new text begin (2) registered under section 157.17 as a board and lodge facility that predominantly
serves individuals being treated for or recovering from a substance use disorder.
new text end

Sec. 6.

Minnesota Statutes 2018, 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).

new text begin (d) For an individual seeking employment in the substance use disorder field, the
commissioner shall set aside the disqualification if the following criteria are met:
new text end

new text begin (1) the individual is not disqualified for a crime of violence as listed under section
624.712, subdivision 5, excepting offenses listed under section 152.021, subdivision 2 or
2a; 152.022, subdivision 2; 152.023, subdivision 2; 152.024; or 152.025;
new text end

new text begin (2) the individual is not disqualified under section 245C.15, subdivision 1, permanent
disqualification;
new text end

new text begin (3) the individual is not disqualified under section 245C.15, subdivision 4, paragraph
(b);
new text end

new text begin (4) 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;
new text end

new text begin (5) the individual provided documentation demonstrating abstinence from controlled
substances, as defined in section 152.01, subdivision 4, for the period of one year prior to
the date of the request for reconsideration; and
new text end

new text begin (6) the individual is seeking employment in the substance use disorder field.
new text end

Sec. 7.

Minnesota Statutes 2018, 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 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) the previous set-aside was not limited to a specific person receiving services.

new text begin (c) Notwithstanding paragraph (b), clause (2), for an individual who is employed in the
substance use disorder field, if the commissioner has previously set aside an individual's
disqualification for one or more programs or agencies in the substance use disorder treatment
field, and the individual is the subject of a subsequent background study for a different
program or agency in the substance use disorder treatment field, the commissioner shall set
aside the disqualification for the program or agency in the substance use disorder treatment
field that initiated the subsequent background study when the criteria under paragraph (b),
clauses (1), (3), and (4) are met and the individual is not disqualified for an offense specified
in section 254C.15, subdivision 1. A notice of a set-aside under paragraph (d) shall be issued
within 15 working days.
new text end

deleted text begin (c) deleted text end new text begin (d) new text end 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. 8.

Minnesota Statutes 2018, 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. deleted text begin 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. deleted text end new text begin 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.
new text end

Sec. 9. new text begin REPEALER.
new text end

new text begin Minnesota Rules, parts 9530.6800; and 9530.6810, new text end new text begin are repealed.
new text end

APPENDIX

Repealed Minnesota Statutes: S0074-2

144A.45 REGULATION OF HOME CARE SERVICES.

Subd. 6.

Home care providers; tuberculosis prevention and control.

(a) A home care provider must establish and maintain a comprehensive tuberculosis infection control program 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 CDC's Morbidity and Mortality Weekly Report (MMWR). This program must include a tuberculosis infection control plan that covers all paid and unpaid employees, contractors, students, and volunteers. The Department of Health shall provide technical assistance regarding implementation of the guidelines.

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

144A.481 HOME CARE LICENSING IMPLEMENTATION FOR NEW LICENSEES AND TRANSITION PERIOD FOR CURRENT LICENSEES.

Subdivision 1.

Temporary home care licenses and changes of ownership.

(a) Beginning January 1, 2014, all temporary license applicants must apply for either a temporary basic or comprehensive home care license.

(b) Temporary home care licenses issued beginning January 1, 2014, shall be issued according to sections 144A.43 to 144A.4798, and the fees in section 144A.472. Temporary licensees must comply with the requirements of this chapter.

(c) No temporary license applications will be accepted nor temporary licenses issued between December 1, 2013, and December 31, 2013.

(d) Beginning October 1, 2013, changes in ownership applications will require payment of the new fees listed in section 144A.472. Providers who are providing nursing, delegated nursing, or professional health care services, must submit the fee for comprehensive home care providers, and all other providers must submit the fee for basic home care providers as provided in section 144A.472. Change of ownership applicants will be issued a new home care license based on the licensure law in effect on June 30, 2013.

Subd. 2.

Current home care licensees with licenses as of December 31, 2013.

(a) Beginning July 1, 2014, department licensed home care providers must apply for either the basic or comprehensive home care license on their regularly scheduled renewal date.

(b) By June 30, 2015, all home care providers must either have a basic or comprehensive home care license or temporary license.

Subd. 3.

Renewal application of home care licensure during transition period.

(a) Renewal and change of ownership applications of home care licenses issued beginning July 1, 2014, will be issued according to sections 144A.43 to 144A.4798 and, upon license renewal or issuance of a new license for a change of ownership, providers must comply with sections 144A.43 to 144A.4798. Prior to renewal, providers must comply with the home care licensure law in effect on June 30, 2013.

(b) The fees charged for licenses renewed between July 1, 2014, and June 30, 2016, shall be the lesser of 200 percent or $1,000, except where the 200 percent or $1,000 increase exceeds the actual renewal fee charged, with a maximum renewal fee of $6,625.

(c) For fiscal year 2014 only, the fees for providers with revenues greater than $25,000 and no more than $100,000 will be $313 and for providers with revenues no more than $25,000 the fee will be $125.

256I.05 MONTHLY RATES.

Subd. 3.

Limits on rates.

When a room and board rate is used to pay for an individual's room and board, the rate payable to the residence must not exceed the rate paid by an individual not receiving a room and board rate under this chapter.

Repealed Minnesota Rule: S0074-2

9530.6800 ASSESSMENT OF NEED FOR TREATMENT PROGRAMS.

Subpart 1.

Assessment of need required for licensure.

Before a license or a provisional license may be issued, the need for the chemical dependency treatment or rehabilitation program must be determined by the commissioner. Need for an additional or expanded chemical dependency treatment program must be determined, in part, based on the recommendation of the county board of commissioners of the county in which the program will be located and the documentation submitted by the applicant at the time of application.

If the county board fails to submit a statement to the commissioner within 60 days of the county board's receipt of the written request from an applicant, as required under part 9530.6810, the commissioner shall determine the need for the applicant's proposed chemical dependency treatment program based on the documentation submitted by the applicant at the time of application.

Subp. 2.

Documentation of need requirements.

An applicant for licensure under parts 9530.2500 to 9530.4000 and Minnesota Statutes, chapter 245G, must submit the documentation in items A and B to the commissioner with the application for licensure:

A.

The applicant must submit documentation that it has requested the county board of commissioners of the county in which the chemical dependency treatment program will be located to submit to the commissioner both a written statement that supports or does not support the need for the program and documentation of the rationale used by the county board to make its determination.

B.

The applicant must submit a plan for attracting an adequate number of clients to maintain its proposed program capacity, including:

(1)

a description of the geographic area to be served;

(2)

a description of the target population to be served;

(3)

documentation that the capacity or program designs of existing programs are not sufficient to meet the service needs of the chemically abusing or chemically dependent target population if that information is available to the applicant;

(4)

a list of referral sources, with an estimation as to the number of clients the referral source will refer to the applicant's program in the first year of operation; and

(5)

any other information available to the applicant that supports the need for new or expanded chemical dependency treatment capacity.

9530.6810 COUNTY BOARD RESPONSIBILITY TO REVIEW PROGRAM NEED.

When an applicant for licensure under parts 9530.2500 to 9530.4000 or Minnesota Statutes, chapter 245G, requests a written statement of support for a proposed chemical dependency treatment program from the county board of commissioners of the county in which the proposed program is to be located, the county board, or the county board's designated representative, shall submit a statement to the commissioner that either supports or does not support the need for the applicant's program. The county board's statement must be submitted in accordance with items A and B:

A.

the statement must be submitted within 60 days of the county board's receipt of a written request from the applicant for licensure; and

B.

the statement must include the rationale used by the county board to make its determination.