SF 1458

Conference Committee Report - 89th Legislature (2015 - 2016) Posted on 05/17/2015 10:38pm

1.1CONFERENCE COMMITTEE REPORT ON S.F. No. 1458

1.2A bill for an act

1.3relating to state government; establishing the health and human services budget;
1.4modifying provisions governing children and family services, chemical and
1.5mental health services, withdrawal management programs, direct care and
1.6treatment, health care, continuing care, Department of Health programs,
1.7health care delivery, health licensing boards, and MNsure; making changes
1.8to medical assistance, general assistance, MFIP, Northstar Care for Children,
1.9MinnesotaCare, child care assistance, and group residential housing programs;
1.10establishing uniform requirements for public assistance programs related
1.11to income calculation, reporting income, and correcting overpayments and
1.12underpayments; creating the Department of MNsure; modifying requirements
1.13for reporting maltreatment of minors; establishing the Minnesota ABLE plan
1.14and accounts; modifying child support provisions; establishing standards for
1.15withdrawal management programs; modifying requirements for background
1.16studies; making changes to provisions governing the health information
1.17exchange; authorizing rulemaking; requiring reports; making technical changes;
1.18modifying certain fees for Department of Health programs; modifying fees
1.19of certain health-related licensing boards; making human services forecast
1.20adjustments; appropriating money;amending Minnesota Statutes 2014, sections
1.2113.3806, subdivision 4; 13.46, subdivisions 2, 7; 13.461, by adding a subdivision;
1.2215.01; 15A.0815, subdivision 2; 16A.724, subdivision 2; 43A.241; 62A.02,
1.23subdivision 2; 62A.045; 62J.497, subdivisions 1, 3, 4, 5; 62J.498; 62J.4981;
1.2462J.4982, subdivisions 4, 5; 62J.692, subdivision 4; 62M.01, subdivision
1.252; 62M.02, subdivisions 12, 14, 15, 17, by adding subdivisions; 62M.05,
1.26subdivisions 3a, 3b, 4; 62M.06, subdivisions 2, 3; 62M.07; 62M.09, subdivision
1.273; 62M.10, subdivision 7; 62M.11; 62Q.02; 62U.02, subdivisions 1, 2, 3, 4;
1.2862U.04, subdivision 11; 62V.02, subdivisions 2, 11, by adding a subdivision;
1.2962V.03; 62V.05; 62V.06; 62V.07; 62V.08; 119B.011, subdivision 15; 119B.025,
1.30subdivision 1; 119B.035, subdivision 4; 119B.07; 119B.09, subdivision 4;
1.31119B.10, subdivision 1; 119B.11, subdivision 2a; 119B.125, by adding a
1.32subdivision; 144.057, subdivision 1; 144.1501, subdivisions 1, 2, 3, 4; 144.215,
1.33by adding a subdivision; 144.225, subdivision 4; 144.291, subdivision 2; 144.293,
1.34subdivisions 6, 8; 144.298, subdivisions 2, 3; 144.3831, subdivision 1; 144.9501,
1.35subdivisions 6d, 22b, 26b, by adding subdivisions; 144.9505; 144.9508;
1.36144A.70, subdivision 6, by adding a subdivision; 144A.71; 144A.72; 144A.73;
1.37144D.01, by adding a subdivision; 144E.001, by adding a subdivision; 144E.275,
1.38subdivision 1, by adding a subdivision; 144E.50; 144F.01, subdivision 5;
1.39145.928, by adding a subdivision; 145A.131, subdivision 1; 148.57, subdivisions
1.401, 2; 148.59; 148E.075; 148E.080, subdivisions 1, 2; 148E.180, subdivisions 2,
1.415; 149A.20, subdivisions 5, 6; 149A.40, subdivision 11; 149A.65; 149A.92,
1.42subdivision 1; 149A.97, subdivision 7; 150A.091, subdivisions 4, 5, 11, by adding
1.43subdivisions; 150A.31; 151.065, subdivisions 1, 2, 3, 4; 151.58, subdivisions 2,
2.15; 157.16; 169.686, subdivision 3; 174.29, subdivision 1; 174.30, subdivisions 3,
2.24, by adding subdivisions; 245.4661, subdivisions 5, 6, by adding subdivisions;
2.3245.467, subdivision 6; 245.469, by adding a subdivision; 245.4876, subdivision
2.47; 245.4889, subdivision 1, by adding a subdivision; 245C.03, by adding a
2.5subdivision; 245C.08, subdivision 1; 245C.10, by adding subdivisions; 245C.12;
2.6246.18, subdivision 8; 246.54, subdivision 1; 246B.01, subdivision 2b; 246B.10;
2.7253B.18, subdivisions 4c, 5; 254B.05, subdivision 5; 254B.12, subdivision 2;
2.8256.01, by adding subdivisions; 256.015, subdivision 7; 256.017, subdivision
2.91; 256.478; 256.741, subdivisions 1, 2; 256.962, subdivision 5, by adding a
2.10subdivision; 256.969, subdivisions 1, 2b, 3a, 3c, 9; 256.975, subdivision 8;
2.11256B.056, subdivision 5c; 256B.057, subdivision 9; 256B.059, subdivision
2.125; 256B.06, by adding a subdivision; 256B.0615, subdivision 3; 256B.0622,
2.13subdivisions 1, 2, 3, 4, 5, 7, 8, 9, 10, by adding a subdivision; 256B.0624,
2.14subdivision 7; 256B.0625, subdivisions 3b, 9, 13, 13e, 13h, 14, 17, 17a, 18a,
2.1518e, 31, 48, 57, 58, by adding subdivisions; 256B.0631; 256B.072; 256B.0757;
2.16256B.0916, subdivisions 2, 11, by adding a subdivision; 256B.441, by adding
2.17a subdivision; 256B.49, subdivision 26, by adding a subdivision; 256B.4913,
2.18subdivisions 4a, 5; 256B.4914, subdivisions 2, 8, 10, 14, 15; 256B.69,
2.19subdivisions 5a, 5i, 6, 9c, 9d, by adding a subdivision; 256B.75; 256B.76,
2.20subdivisions 2, 4, 7; 256B.767; 256D.01, subdivision 1a; 256D.02, subdivision
2.218, by adding subdivisions; 256D.06, subdivision 1; 256D.405, subdivision 3;
2.22256E.35, subdivision 2, by adding a subdivision; 256I.03, subdivisions 3,
2.237, by adding subdivisions; 256I.04; 256I.05, subdivisions 1c, 1g; 256I.06,
2.24subdivisions 2, 6, 7, 8; 256J.08, subdivisions 26, 86; 256J.24, subdivisions
2.255, 5a; 256J.30, subdivisions 1, 9; 256J.35; 256J.40; 256J.95, subdivision 19;
2.26256K.45, subdivisions 1a, 6; 256L.01, subdivisions 3a, 5; 256L.03, subdivision
2.275; 256L.04, subdivisions 1a, 1c, 7b; 256L.05, subdivisions 3, 3a, 4, by adding
2.28a subdivision; 256L.06, subdivision 3; 256L.11, by adding a subdivision;
2.29256L.121, subdivision 1; 256L.15, subdivision 2; 256N.22, subdivisions 9,
2.3010; 256N.24, subdivision 4; 256N.25, subdivision 1; 256N.27, subdivision 2;
2.31256P.001; 256P.01, subdivision 3, by adding subdivisions; 256P.02, by adding
2.32a subdivision; 256P.03, subdivision 1; 256P.04, subdivisions 1, 4; 256P.05,
2.33subdivision 1; 257.0755, subdivisions 1, 2; 257.0761, subdivision 1; 257.0766,
2.34subdivision 1; 257.0769, subdivision 1; 257.75, subdivisions 3, 5; 259A.75;
2.35260C.007, subdivisions 27, 32; 260C.203; 260C.212, subdivision 1, by adding
2.36subdivisions; 260C.221; 260C.331, subdivision 1; 260C.451, subdivisions 2, 6;
2.37260C.515, subdivision 5; 260C.521, subdivisions 1, 2; 260C.607, subdivision
2.384; 282.241, subdivision 1; 290.0671, subdivision 6; 297A.70, subdivision 7;
2.39514.73; 514.981, subdivision 2; 518A.26, subdivision 14; 518A.32, subdivision
2.402; 518A.39, subdivision 1, by adding a subdivision; 518A.41, subdivisions 1, 3,
2.414, 14, 15; 518A.43, by adding a subdivision; 518A.46, subdivision 3, by adding
2.42a subdivision; 518A.51; 518A.53, subdivisions 1, 4, 10; 518A.60; 518C.802;
2.43580.032, subdivision 1; 626.556, subdivisions 1, as amended, 2, 3, 6a, 7, as
2.44amended, 10, 10e, 10j, 10m, 11c, by adding subdivisions; Laws 2008, chapter
2.45363, article 18, section 3, subdivision 5; Laws 2013, chapter 108, article 14,
2.46section 12, as amended; Laws 2014, chapter 189, sections 5; 10; 11; 16; 17; 18;
2.4719; 23; 24; 27; 28; 29; 31; 43; 50; 51; 73; Laws 2014, chapter 312, article 24,
2.48section 45, subdivision 2; proposing coding for new law in Minnesota Statutes,
2.49chapters 15; 62A; 62M; 62Q; 62V; 144; 144D; 245; 246B; 256B; 256E; 256M;
2.50256P; 518A; proposing coding for new law as Minnesota Statutes, chapters 245F;
2.51256Q; repealing Minnesota Statutes 2014, sections 62V.04; 62V.09; 62V.11;
2.52144E.52; 148E.060, subdivision 12; 256.969, subdivisions 23, 30; 256B.69,
2.53subdivision 32; 256D.0513; 256D.06, subdivision 8; 256D.09, subdivision 6;
2.54256D.49; 256J.38; 256L.02, subdivision 3; 256L.05, subdivisions 1b, 1c, 3c, 5;
2.55256L.11, subdivision 7; 257.0768; 290.0671, subdivision 6a; Minnesota Rules,
2.56parts 3400.0170, subparts 5, 6, 12, 13; 8840.5900, subparts 12, 14.
2.57May 17, 2015
3.1The Honorable Sandra L. Pappas
3.2President of the Senate
3.3The Honorable Kurt L. Daudt
3.4Speaker of the House of Representatives
3.5We, the undersigned conferees for S.F. No. 1458 report that we have agreed upon
3.6the items in dispute and recommend as follows:
3.7That the House recede from its amendments and that S.F. No. 1458 be further
3.8amended as follows:
3.9Delete everything after the enacting clause and insert:

3.10"ARTICLE 1

3.11CHILDREN AND FAMILY SERVICES

3.12    Section 1. Minnesota Statutes 2014, section 119B.125, is amended by adding a
3.13subdivision to read:
3.14    Subd. 7. Failure to comply with attendance record requirements. (a) In
3.15establishing an overpayment claim for failure to provide attendance records in compliance
3.16with section 119B.125, subdivision 6, the county or commissioner is limited to the six
3.17years prior to the date the county or the commissioner requested the attendance records.
3.18(b) The commissioner may periodically audit child care providers to determine
3.19compliance with section 119B.125, subdivision 6.
3.20(c) When the commissioner or county establishes an overpayment claim against a
3.21current or former provider, the commissioner or county must provide notice of the claim to
3.22the provider. A notice of overpayment claim must specify the reason for the overpayment,
3.23the authority for making the overpayment claim, the time period in which the overpayment
3.24occurred, the amount of the overpayment, and the provider's right to appeal.
3.25(d) The commissioner or county shall seek to recoup or recover overpayments paid
3.26to a current or former provider.
3.27(e) When a provider has been disqualified or convicted of fraud under section
3.28256.98, theft under section 609.52, or a federal crime relating to theft of state funds
3.29or fraudulent billing for a program administered by the commissioner or a county,
3.30recoupment or recovery must be sought regardless of the amount of overpayment.

3.31    Sec. 2. Minnesota Statutes 2014, section 119B.13, subdivision 6, is amended to read:
3.32    Subd. 6. Provider payments. (a) The provider shall bill for services provided
3.33within ten days of the end of the service period. If bills are submitted within ten days of
3.34the end of the service period, payments under the child care fund shall be made within 30
4.1days of receiving a bill from the provider. Counties or the state may establish policies that
4.2make payments on a more frequent basis.
4.3(b) If a provider has received an authorization of care and been issued a billing form
4.4for an eligible family, the bill must be submitted within 60 days of the last date of service on
4.5the bill. A bill submitted more than 60 days after the last date of service must be paid if the
4.6county determines that the provider has shown good cause why the bill was not submitted
4.7within 60 days. Good cause must be defined in the county's child care fund plan under
4.8section 119B.08, subdivision 3, and the definition of good cause must include county error.
4.9Any bill submitted more than a year after the last date of service on the bill must not be paid.
4.10(c) If a provider provided care for a time period without receiving an authorization
4.11of care and a billing form for an eligible family, payment of child care assistance may only
4.12be made retroactively for a maximum of six months from the date the provider is issued
4.13an authorization of care and billing form.
4.14(d) A county or the commissioner may refuse to issue a child care authorization
4.15to a licensed or legal nonlicensed provider, revoke an existing child care authorization
4.16to a licensed or legal nonlicensed provider, stop payment issued to a licensed or legal
4.17nonlicensed provider, or refuse to pay a bill submitted by a licensed or legal nonlicensed
4.18provider if:
4.19(1) the provider admits to intentionally giving the county materially false information
4.20on the provider's billing forms;
4.21(2) a county or the commissioner finds by a preponderance of the evidence that the
4.22provider intentionally gave the county materially false information on the provider's
4.23billing forms, or provided false attendance records to a county or the commissioner;
4.24(3) the provider is in violation of child care assistance program rules, until the
4.25agency determines those violations have been corrected;
4.26    (4) the provider is operating after receipt of:
4.27    (i) an order of suspension or of the provider's license issued by the commissioner;
4.28    (ii) an order of revocation of the provider's license,; or
4.29    the provider has been issued an order citing violations of licensing standards that
4.30affect the health and safety of children in care due to the nature, chronicity, or severity
4.31of the licensing violations, until the licensing agency determines those violations have
4.32been corrected; (iii) a final order of conditional license issued by the commissioner for as
4.33long as the conditional license is in effect;
4.34(5) the provider submits false attendance reports or refuses to provide documentation
4.35of the child's attendance upon request; or
4.36(6) the provider gives false child care price information.
5.1(e) For purposes of paragraph (d), clauses (3), (5), and (6), the county or the
5.2commissioner may withhold the provider's authorization or payment for a period of time
5.3not to exceed three months beyond the time the condition has been corrected.
5.4(e) (f) A county's payment policies must be included in the county's child care plan
5.5under section 119B.08, subdivision 3. If payments are made by the state, in addition to
5.6being in compliance with this subdivision, the payments must be made in compliance
5.7with section 16A.124.

5.8    Sec. 3. Minnesota Statutes 2014, section 245C.03, is amended by adding a subdivision
5.9to read:
5.10    Subd. 10. Providers of group residential housing or supplementary services.
5.11The commissioner shall conduct background studies on any individual required under
5.12section 256I.04 to have a background study completed under this chapter.
5.13EFFECTIVE DATE.This section is effective July 1, 2016.

5.14    Sec. 4. Minnesota Statutes 2014, section 245C.03, is amended by adding a subdivision
5.15to read:
5.16    Subd. 11. Child protection workers or social services staff having responsibility
5.17for child protective duties. (a) The commissioner must complete background studies,
5.18according to paragraph (b) and 245C.04, subdivision 10, when initiated by a county social
5.19services agency or by a local welfare agency according to section 626.559, subdivision 1b.
5.20(b) For background studies completed by the commissioner under this subdivision,
5.21the commissioner shall not make a disqualification decision, but shall provide the
5.22background study information received to the county that initiated the study.

5.23    Sec. 5. Minnesota Statutes 2014, section 245C.04, is amended by adding a subdivision
5.24to read:
5.25    Subd. 10. Child protection workers or social services staff having responsibility
5.26for child protective duties. The commissioner shall conduct background studies of
5.27employees of county social services and local welfare agencies having responsibility
5.28for child protection duties when the background study is initiated according to section
5.29626.559, subdivision 1b.

5.30    Sec. 6. Minnesota Statutes 2014, section 245C.10, is amended by adding a subdivision
5.31to read:
6.1    Subd. 11. Providers of group residential housing or supplementary services.
6.2The commissioner shall recover the cost of background studies initiated by providers of
6.3group residential housing or supplementary services under section 256I.04 through a fee
6.4of no more than $20 per study. The fees collected under this subdivision are appropriated
6.5to the commissioner for the purpose of conducting background studies.
6.6EFFECTIVE DATE.This section is effective July 1, 2016.

6.7    Sec. 7. Minnesota Statutes 2014, section 245C.10, is amended by adding a subdivision
6.8to read:
6.9    Subd. 12. Child protection workers or social services staff having responsibility
6.10for child protective duties. The commissioner shall recover the cost of background studies
6.11initiated by county social services agencies and local welfare agencies for individuals
6.12who are required to have a background study under section 626.559, subdivision 1b,
6.13through a fee of no more than $20 per study. The fees collected under this subdivision are
6.14appropriated to the commissioner for the purpose of conducting background studies.

6.15    Sec. 8. Minnesota Statutes 2014, section 256.01, is amended by adding a subdivision
6.16to read:
6.17    Subd. 12a. Department of Human Services child fatality and near fatality
6.18review team. The commissioner shall establish a Department of Human Services child
6.19fatality and near fatality review team to review child fatalities and near fatalities due to
6.20child maltreatment and child fatalities and near fatalities that occur in licensed facilities
6.21and are not due to natural causes. The review team shall assess the entire child protection
6.22services process from the point of a mandated reporter reporting the alleged maltreatment
6.23through the ongoing case management process. Department staff shall lead and conduct
6.24on-site local reviews and utilize supervisors from local county and tribal child welfare
6.25agencies as peer reviewers. The review process must focus on critical elements of the case
6.26and on the involvement of the child and family with the county or tribal child welfare
6.27agency. The review team shall identify necessary program improvement planning to
6.28address any practice issues identified and training and technical assistance needs of
6.29the local agency. Summary reports of each review shall be provided to the state child
6.30mortality review panel when completed.

6.31    Sec. 9. Minnesota Statutes 2014, section 256.017, subdivision 1, is amended to read:
6.32    Subdivision 1. Authority and purpose. The commissioner shall administer a
6.33compliance system for the Minnesota family investment program, the food stamp or food
7.1support program, emergency assistance, general assistance, medical assistance, emergency
7.2general assistance, Minnesota supplemental assistance, group residential housing,
7.3preadmission screening, alternative care grants, the child care assistance program, and
7.4all other programs administered by the commissioner or on behalf of the commissioner
7.5under the powers and authorities named in section 256.01, subdivision 2. The purpose of
7.6the compliance system is to permit the commissioner to supervise the administration of
7.7public assistance programs and to enforce timely and accurate distribution of benefits,
7.8completeness of service and efficient and effective program management and operations,
7.9to increase uniformity and consistency in the administration and delivery of public
7.10assistance programs throughout the state, and to reduce the possibility of sanctions and
7.11fiscal disallowances for noncompliance with federal regulations and state statutes. The
7.12commissioner, or the commissioner's representative, may issue administrative subpoenas
7.13as needed in administering the compliance system.
7.14    The commissioner shall utilize training, technical assistance, and monitoring
7.15activities, as specified in section 256.01, subdivision 2, to encourage county agency
7.16compliance with written policies and procedures.

7.17    Sec. 10. Minnesota Statutes 2014, section 256.741, subdivision 1, is amended to read:
7.18    Subdivision 1. Definitions. (a) The term "direct support" as used in this chapter and
7.19chapters 257, 518, 518A, and 518C refers to an assigned support payment from an obligor
7.20which is paid directly to a recipient of public assistance.
7.21    (b) The term "public assistance" as used in this chapter and chapters 257, 518, 518A,
7.22and 518C, includes any form of assistance provided under the AFDC program formerly
7.23codified in sections 256.72 to 256.87, MFIP and MFIP-R formerly codified under chapter
7.24256, MFIP under chapter 256J, work first program formerly codified under chapter 256K;
7.25child care assistance provided through the child care fund under chapter 119B; any form
7.26of medical assistance under chapter 256B; MinnesotaCare under chapter 256L; and foster
7.27care as provided under title IV-E of the Social Security Act. MinnesotaCare and health
7.28plans subsidized by federal premium tax credits or federal cost-sharing reductions are not
7.29considered public assistance for purposes of a child support referral.
7.30    (c) The term "child support agency" as used in this section refers to the public
7.31authority responsible for child support enforcement.
7.32    (d) The term "public assistance agency" as used in this section refers to a public
7.33authority providing public assistance to an individual.
7.34    (e) The terms "child support" and "arrears" as used in this section have the meanings
7.35provided in section 518A.26.
8.1    (f) The term "maintenance" as used in this section has the meaning provided in
8.2section 518.003.

8.3    Sec. 11. Minnesota Statutes 2014, section 256.741, subdivision 2, is amended to read:
8.4    Subd. 2. Assignment of support and maintenance rights. (a) An individual
8.5receiving public assistance in the form of assistance under any of the following programs:
8.6the AFDC program formerly codified in sections 256.72 to 256.87, MFIP under chapter
8.7256J, MFIP-R and MFIP formerly codified under chapter 256, or work first program
8.8formerly codified under chapter 256K is considered to have assigned to the state at the
8.9time of application all rights to child support and maintenance from any other person the
8.10applicant or recipient may have in the individual's own behalf or in the behalf of any other
8.11family member for whom application for public assistance is made. An assistance unit is
8.12ineligible for the Minnesota family investment program unless the caregiver assigns all
8.13rights to child support and maintenance benefits according to this section.
8.14    (1) The assignment is effective as to any current child support and current
8.15maintenance.
8.16    (2) Any child support or maintenance arrears that accrue while an individual is
8.17receiving public assistance in the form of assistance under any of the programs listed in
8.18this paragraph are permanently assigned to the state.
8.19    (3) The assignment of current child support and current maintenance ends on the
8.20date the individual ceases to receive or is no longer eligible to receive public assistance
8.21under any of the programs listed in this paragraph.
8.22    (b) An individual receiving public assistance in the form of medical assistance,
8.23including MinnesotaCare, is considered to have assigned to the state at the time of
8.24application all rights to medical support from any other person the individual may have
8.25in the individual's own behalf or in the behalf of any other family member for whom
8.26medical assistance is provided.
8.27    (1) An assignment made after September 30, 1997, is effective as to any medical
8.28support accruing after the date of medical assistance or MinnesotaCare eligibility.
8.29    (2) Any medical support arrears that accrue while an individual is receiving public
8.30assistance in the form of medical assistance, including MinnesotaCare, are permanently
8.31assigned to the state.
8.32    (3) The assignment of current medical support ends on the date the individual ceases
8.33to receive or is no longer eligible to receive public assistance in the form of medical
8.34assistance or MinnesotaCare.
9.1    (c) An individual receiving public assistance in the form of child care assistance
9.2under the child care fund pursuant to chapter 119B is considered to have assigned to the
9.3state at the time of application all rights to child care support from any other person the
9.4individual may have in the individual's own behalf or in the behalf of any other family
9.5member for whom child care assistance is provided.
9.6    (1) The assignment is effective as to any current child care support.
9.7    (2) Any child care support arrears that accrue while an individual is receiving public
9.8assistance in the form of child care assistance under the child care fund in chapter 119B
9.9are permanently assigned to the state.
9.10    (3) The assignment of current child care support ends on the date the individual
9.11ceases to receive or is no longer eligible to receive public assistance in the form of child
9.12care assistance under the child care fund under chapter 119B.

9.13    Sec. 12. [256E.28] CHILD PROTECTION GRANTS TO ADDRESS CHILD
9.14WELFARE DISPARITIES.
9.15    Subdivision 1. Child welfare disparities grant program established. The
9.16commissioner may award grants to eligible entities for the development, implementation,
9.17and evaluation of activities to address racial disparities and disproportionality in the child
9.18welfare system by:
9.19    (1) identifying and addressing structural factors that contribute to inequities in
9.20outcomes;
9.21    (2) identifying and implementing strategies to reduce racial disparities in treatment
9.22and outcomes;
9.23    (3) using cultural values, beliefs, and practices of families, communities, and tribes
9.24for case planning, service design, and decision-making processes;
9.25    (4) using placement and reunification strategies to maintain and support relationships
9.26and connections between parents, siblings, children, kin, significant others, and tribes; and
9.27    (5) supporting families in the context of their communities and tribes to safely divert
9.28them from the child welfare system, whenever possible.
9.29    Subd. 2. State-community partnerships; plan. The commissioner, in partnership
9.30with the legislative task force on child protection; culturally based community
9.31organizations; the Indian Affairs Council under section 3.922; the Council on Affairs of
9.32Chicano/Latino People under section 3.9223; the Council on Black Minnesotans under
9.33section 3.9225; the Council on Asian-Pacific Minnesotans under section 3.9226; the
9.34American Indian Child Welfare Advisory Council under section 260.835; counties; and
10.1tribal governments, shall develop and implement a comprehensive, coordinated plan to
10.2award funds under this section for the priority areas identified in subdivision 1.
10.3    Subd. 3. Measurable outcomes. The commissioner, in consultation with the
10.4state-community partners listed in subdivision 2, shall establish measurable outcomes to
10.5determine the effectiveness of the grants and other activities funded under this section in
10.6reducing disparities identified in subdivision 1. The development of measurable outcomes
10.7must be completed before any funds are distributed under this section.
10.8    Subd. 4. Process. (a) The commissioner, in consultation with the state-community
10.9partners listed in subdivision 2, shall develop the criteria and procedures to allocate
10.10competitive grants under this section. In developing the criteria, the commissioner shall
10.11establish an administrative cost limit for grant recipients. A county awarded a grant shall
10.12not spend more than three percent of the grant on administrative costs. When a grant
10.13is awarded, the commissioner must provide a grant recipient with information on the
10.14outcomes established according to subdivision 3.
10.15    (b) A grant recipient must coordinate its activities with other entities receiving funds
10.16under this section that are in the grant recipient's service area.
10.17    (c) Grant funds must not be used to supplant any state or federal funds received
10.18for child welfare services.
10.19    Subd. 5. Grant program criteria. (a) The commissioner shall award competitive
10.20grants to eligible applicants for local or regional projects and initiatives directed at
10.21reducing disparities in the child welfare system.
10.22    (b) The commissioner may award up to 20 percent of the funds available as planning
10.23grants. Planning grants must be used to address such areas as community assessment,
10.24coordination activities, and development of community-supported strategies.
10.25    (c) Eligible applicants may include, but are not limited to, faith-based organizations,
10.26social service organizations, community nonprofit organizations, counties, and tribal
10.27governments. Applicants must submit proposals to the commissioner. A proposal must
10.28specify the strategies to be implemented to address one or more of the priority areas in
10.29subdivision 1 and must be targeted to achieve the outcomes established according to
10.30subdivision 3.
10.31    (d) The commissioner shall give priority to applicants who demonstrate that their
10.32proposed project or initiative:
10.33    (1) is supported by the community the applicant will serve;
10.34    (2) is evidence-based;
10.35    (3) is designed to complement other related community activities;
10.36    (4) utilizes strategies that positively impact priority areas;
11.1    (5) reflects culturally appropriate approaches; or
11.2    (6) will be implemented through or with community-based organizations that reflect
11.3the culture of the population to be reached.
11.4    Subd. 6. Evaluation. (a) Using the outcomes established according to subdivision
11.53, the commissioner shall conduct a biennial evaluation of the grant program funded under
11.6this section. Grant recipients shall cooperate with the commissioner in the evaluation and
11.7shall provide the commissioner with the information needed to conduct the evaluation.
11.8    (b) The commissioner shall consult with the legislative task force on child protection
11.9during the evaluation process and shall submit a biennial evaluation report to the task
11.10force and to the chairs and ranking minority members of the house of representatives and
11.11senate committees with jurisdiction over child protection funding.
11.12    Subd. 7. American Indian child welfare projects. Of the amount appropriated for
11.13purposes of this section, the commissioner shall award $75,000 to each tribe authorized to
11.14provide tribal delivery of child welfare services under section 256.01, subdivision 14b. To
11.15receive funds under this subdivision, a participating tribe is not required to apply to the
11.16commissioner for grant funds. Participating tribes are also eligible for competitive grant
11.17funds under this section.

11.18    Sec. 13. Minnesota Statutes 2014, section 256E.35, subdivision 2, is amended to read:
11.19    Subd. 2. Definitions. (a) The definitions in this subdivision apply to this section.
11.20    (b) "Eligible educational institution" means the following:
11.21    (1) an institution of higher education described in section 101 or 102 of the Higher
11.22Education Act of 1965; or
11.23    (2) an area vocational education school, as defined in subparagraph (C) or (D) of
11.24United States Code, title 20, chapter 44, section 2302 (3) (the Carl D. Perkins Vocational
11.25and Applied Technology Education Act), which is located within any state, as defined in
11.26United States Code, title 20, chapter 44, section 2302 (30). This clause is applicable only
11.27to the extent section 2302 is in effect on August 1, 2008.
11.28    (b) (c) "Family asset account" means a savings account opened by a household
11.29participating in the Minnesota family assets for independence initiative.
11.30    (c) (d) "Fiduciary organization" means:
11.31    (1) a community action agency that has obtained recognition under section 256E.31;
11.32    (2) a federal community development credit union serving the seven-county
11.33metropolitan area; or
11.34    (3) a women-oriented economic development agency serving the seven-county
11.35metropolitan area.
12.1(e) "Financial coach" means a person who:
12.2(1) has completed an intensive financial literacy training workshop that includes
12.3curriculum on budgeting to increase savings, debt reduction and asset building, building a
12.4good credit rating, and consumer protection;
12.5(2) participates in ongoing statewide family assets for independence in Minnesota
12.6(FAIM) network training meetings under FAIM program supervision; and
12.7(3) provides financial coaching to program participants under subdivision 4a.
12.8    (d) (f) "Financial institution" means a bank, bank and trust, savings bank, savings
12.9association, or credit union, the deposits of which are insured by the Federal Deposit
12.10Insurance Corporation or the National Credit Union Administration.
12.11    (g) "Household" means all individuals who share use of a dwelling unit as primary
12.12quarters for living and eating separate from other individuals.
12.13    (e) (h) "Permissible use" means:
12.14    (1) postsecondary educational expenses at an eligible educational institution as
12.15defined in paragraph (g) (b), including books, supplies, and equipment required for
12.16courses of instruction;
12.17    (2) acquisition costs of acquiring, constructing, or reconstructing a residence,
12.18including any usual or reasonable settlement, financing, or other closing costs;
12.19    (3) business capitalization expenses for expenditures on capital, plant, equipment,
12.20working capital, and inventory expenses of a legitimate business pursuant to a business
12.21plan approved by the fiduciary organization; and
12.22    (4) acquisition costs of a principal residence within the meaning of section 1034 of
12.23the Internal Revenue Code of 1986 which do not exceed 100 percent of the average area
12.24purchase price applicable to the residence determined according to section 143(e)(2) and
12.25(3) of the Internal Revenue Code of 1986.
12.26    (f) "Household" means all individuals who share use of a dwelling unit as primary
12.27quarters for living and eating separate from other individuals.
12.28    (g) "Eligible educational institution" means the following:
12.29    (1) an institution of higher education described in section 101 or 102 of the Higher
12.30Education Act of 1965; or
12.31    (2) an area vocational education school, as defined in subparagraph (C) or (D) of
12.32United States Code, title 20, chapter 44, section 2302 (3) (the Carl D. Perkins Vocational
12.33and Applied Technology Education Act), which is located within any state, as defined in
12.34United States Code, title 20, chapter 44, section 2302 (30). This clause is applicable only
12.35to the extent section 2302 is in effect on August 1, 2008.

13.1    Sec. 14. Minnesota Statutes 2014, section 256E.35, is amended by adding a subdivision
13.2to read:
13.3    Subd. 4a. Financial coaching. A financial coach shall provide the following
13.4to program participants:
13.5(1) financial education relating to budgeting, debt reduction, asset-specific training,
13.6and financial stability activities;
13.7(2) asset-specific training related to buying a home, acquiring postsecondary
13.8education, or starting or expanding a small business; and
13.9(3) financial stability education and training to improve and sustain financial security.

13.10    Sec. 15. Minnesota Statutes 2014, section 256I.03, subdivision 3, is amended to read:
13.11    Subd. 3. Group residential housing. "Group residential housing" means a group
13.12living situation that provides at a minimum room and board to unrelated persons who
13.13meet the eligibility requirements of section 256I.04. This definition includes foster care
13.14settings or community residential settings for a single adult. To receive payment for a
13.15group residence rate, the residence must meet the requirements under section 256I.04,
13.16subdivision subdivisions 2a to 2f.

13.17    Sec. 16. Minnesota Statutes 2014, section 256I.03, subdivision 7, is amended to read:
13.18    Subd. 7. Countable income. "Countable income" means all income received by
13.19an applicant or recipient less any applicable exclusions or disregards. For a recipient of
13.20any cash benefit from the SSI program, countable income means the SSI benefit limit in
13.21effect at the time the person is in a GRH a recipient of group residential housing, less the
13.22medical assistance personal needs allowance under section 256B.35. If the SSI limit
13.23has been or benefit is reduced for a person due to events occurring prior to the persons
13.24entering the GRH setting other than receipt of additional income, countable income means
13.25actual income less any applicable exclusions and disregards.

13.26    Sec. 17. Minnesota Statutes 2014, section 256I.03, is amended by adding a subdivision
13.27to read:
13.28    Subd. 9. Direct contact. "Direct contact" means providing face-to-face care,
13.29training, supervision, counseling, consultation, or medication assistance to recipients of
13.30group residential housing.

13.31    Sec. 18. Minnesota Statutes 2014, section 256I.03, is amended by adding a subdivision
13.32to read:
14.1    Subd. 10. Habitability inspection. "Habitability inspection" means an inspection to
14.2determine whether the housing occupied by an individual meets the habitability standards
14.3specified by the commissioner. The standards must be provided to the applicant in writing
14.4and posted on the Department of Human Services Web site.

14.5    Sec. 19. Minnesota Statutes 2014, section 256I.03, is amended by adding a subdivision
14.6to read:
14.7    Subd. 11. Long-term homelessness. "Long-term homelessness" means lacking a
14.8permanent place to live:
14.9(1) continuously for one year or more; or
14.10(2) at least four times in the past three years.

14.11    Sec. 20. Minnesota Statutes 2014, section 256I.03, is amended by adding a subdivision
14.12to read:
14.13    Subd. 12. Professional statement of need. "Professional statement of need" means
14.14a statement about an individual's illness, injury, or incapacity that is signed by a qualified
14.15professional. The statement must specify that the individual has an illness or incapacity
14.16which limits the individual's ability to work and provide self-support. The statement
14.17must also specify that the individual needs assistance to access or maintain housing, as
14.18evidenced by the need for two or more of the following services:
14.19(1) tenancy supports to assist an individual with finding the individual's own
14.20home, landlord negotiation, securing furniture and household supplies, understanding
14.21and maintaining tenant responsibilities, conflict negotiation, and budgeting and financial
14.22education;
14.23(2) supportive services to assist with basic living and social skills, household
14.24management, monitoring of overall well-being, and problem solving;
14.25(3) employment supports to assist with maintaining or increasing employment,
14.26increasing earnings, understanding and utilizing appropriate benefits and services,
14.27improving physical or mental health, moving toward self-sufficiency, and achieving
14.28personal goals; or
14.29(4) health supervision services to assist in the preparation and administration of
14.30medications other than injectables, the provision of therapeutic diets, taking vital signs, or
14.31providing assistance in dressing, grooming, bathing, or with walking devices.

14.32    Sec. 21. Minnesota Statutes 2014, section 256I.03, is amended by adding a subdivision
14.33to read:
15.1    Subd. 13. Prospective budgeting. "Prospective budgeting" means estimating the
15.2amount of monthly income a person will have in the payment month.

15.3    Sec. 22. Minnesota Statutes 2014, section 256I.03, is amended by adding a subdivision
15.4to read:
15.5    Subd. 14. Qualified professional. "Qualified professional" means an individual as
15.6defined in section 256J.08, subdivision 73a, or Minnesota Rules, part 9530.6450, subpart
15.73, 4, or 5; or an individual approved by the director of human services or a designee
15.8of the director.

15.9    Sec. 23. Minnesota Statutes 2014, section 256I.03, is amended by adding a subdivision
15.10to read:
15.11    Subd. 15. Supportive housing. "Supportive housing" means housing with support
15.12services according to the continuum of care coordinated assessment system established
15.13under Code of Federal Regulations, title 24, section 578.3.

15.14    Sec. 24. Minnesota Statutes 2014, section 256I.04, subdivision 1, is amended to read:
15.15    Subdivision 1. Individual eligibility requirements. An individual is eligible for
15.16and entitled to a group residential housing payment to be made on the individual's behalf
15.17if the agency has approved the individual's residence in a group residential housing setting
15.18and the individual meets the requirements in paragraph (a) or (b).
15.19(a) The individual is aged, blind, or is over 18 years of age and disabled as
15.20determined under the criteria used by the title II program of the Social Security Act, and
15.21meets the resource restrictions and standards of section 256P.02, and the individual's
15.22countable income after deducting the (1) exclusions and disregards of the SSI program,
15.23(2) the medical assistance personal needs allowance under section 256B.35, and (3) an
15.24amount equal to the income actually made available to a community spouse by an elderly
15.25waiver participant under the provisions of sections 256B.0575, paragraph (a), clause
15.26(4), and 256B.058, subdivision 2, is less than the monthly rate specified in the agency's
15.27agreement with the provider of group residential housing in which the individual resides.
15.28(b) The individual meets a category of eligibility under section 256D.05, subdivision
15.291 , paragraph (a), clauses (1), (3), (5) to (9), and (14), and paragraph (b), if applicable, and
15.30the individual's resources are less than the standards specified by section 256P.02, and
15.31the individual's countable income as determined under sections 256D.01 to 256D.21, less
15.32the medical assistance personal needs allowance under section 256B.35 is less than the
16.1monthly rate specified in the agency's agreement with the provider of group residential
16.2housing in which the individual resides.
16.3EFFECTIVE DATE.This section is effective September 1, 2015.

16.4    Sec. 25. Minnesota Statutes 2014, section 256I.04, subdivision 1a, is amended to read:
16.5    Subd. 1a. County approval. (a) A county agency may not approve a group
16.6residential housing payment for an individual in any setting with a rate in excess of the
16.7MSA equivalent rate for more than 30 days in a calendar year unless the county agency
16.8has developed or approved individual has a plan for the individual which specifies that:
16.9    (1) the individual has an illness or incapacity which prevents the person from living
16.10independently in the community; and
16.11    (2) the individual's illness or incapacity requires the services which are available in
16.12the group residence.
16.13    The plan must be signed or countersigned by any of the following employees of the
16.14county of financial responsibility: the director of human services or a designee of the
16.15director; a social worker; or a case aide professional statement of need under section
16.16256I.03, subdivision 12.
16.17    (b) If a county agency determines that an applicant is ineligible due to not meeting
16.18eligibility requirements under this section, a county agency may accept a signed personal
16.19statement from the applicant in lieu of documentation verifying ineligibility.
16.20(c) Effective July 1, 2016, to be eligible for supplementary service payments,
16.21providers must enroll in the provider enrollment system identified by the commissioner.

16.22    Sec. 26. Minnesota Statutes 2014, section 256I.04, subdivision 2a, is amended to read:
16.23    Subd. 2a. License required; staffing qualifications. A county (a) Except
16.24as provided in paragraph (b), an agency may not enter into an agreement with an
16.25establishment to provide group residential housing unless:
16.26(1) the establishment is licensed by the Department of Health as a hotel and
16.27restaurant; a board and lodging establishment; a residential care home; a boarding care
16.28home before March 1, 1985; or a supervised living facility, and the service provider
16.29for residents of the facility is licensed under chapter 245A. However, an establishment
16.30licensed by the Department of Health to provide lodging need not also be licensed to
16.31provide board if meals are being supplied to residents under a contract with a food vendor
16.32who is licensed by the Department of Health;
16.33(2) the residence is: (i) licensed by the commissioner of human services under
16.34Minnesota Rules, parts 9555.5050 to 9555.6265; (ii) certified by a county human services
17.1agency prior to July 1, 1992, using the standards under Minnesota Rules, parts 9555.5050
17.2to 9555.6265; (iii) a residence licensed by the commissioner under Minnesota Rules, parts
17.32960.0010 to 2960.0120, with a variance under section 245A.04, subdivision 9; or (iv)
17.4licensed under section 245D.02, subdivision 4a, as a community residential setting by
17.5the commissioner of human services; or
17.6(3) the establishment is registered under chapter 144D and provides three meals a
17.7day, or is an establishment voluntarily registered under section 144D.025 as a supportive
17.8housing establishment; or.
17.9(4) an establishment voluntarily registered under section 144D.025, other than
17.10a supportive housing establishment under clause (3), is not eligible to provide group
17.11residential housing.
17.12(b) The requirements under clauses (1) to (4) paragraph (a) do not apply to
17.13establishments exempt from state licensure because they are:
17.14(1) located on Indian reservations and subject to tribal health and safety
17.15requirements.; or
17.16    (2) a supportive housing establishment that has an approved habitability inspection
17.17and an individual lease agreement and that serves people who have experienced long-term
17.18homelessness and were referred through a coordinated assessment in section 256I.03,
17.19subdivision 15.
17.20    (c) Supportive housing establishments and emergency shelters must participate in
17.21the homeless management information system.
17.22    (d) Effective July 1, 2016, an agency shall not have an agreement with a provider
17.23of group residential housing or supplementary services unless all staff members who
17.24have direct contact with recipients:
17.25    (1) have skills and knowledge acquired through one or more of the following:
17.26    (i) a course of study in a health- or human services-related field leading to a bachelor
17.27of arts, bachelor of science, or associate's degree;
17.28    (ii) one year of experience with the target population served;
17.29    (iii) experience as a certified peer specialist according to section 256B.0615; or
17.30    (iv) meeting the requirements for unlicensed personnel under sections 144A.43
17.31to 144A.483;
17.32    (2) hold a current Minnesota driver's license appropriate to the vehicle driven
17.33if transporting recipients;
17.34    (3) complete training on vulnerable adults mandated reporting and child
17.35maltreatment mandated reporting, where applicable; and
18.1    (4) complete group residential housing orientation training offered by the
18.2commissioner.

18.3    Sec. 27. Minnesota Statutes 2014, section 256I.04, subdivision 2b, is amended to read:
18.4    Subd. 2b. Group residential housing agreements. (a) Agreements between county
18.5agencies and providers of group residential housing or supplementary services must be in
18.6writing on a form developed and approved by the commissioner and must specify the name
18.7and address under which the establishment subject to the agreement does business and
18.8under which the establishment, or service provider, if different from the group residential
18.9housing establishment, is licensed by the Department of Health or the Department of
18.10Human Services; the specific license or registration from the Department of Health or the
18.11Department of Human Services held by the provider and the number of beds subject to
18.12that license; the address of the location or locations at which group residential housing is
18.13provided under this agreement; the per diem and monthly rates that are to be paid from
18.14group residential housing or supplementary service funds for each eligible resident at each
18.15location; the number of beds at each location which are subject to the group residential
18.16housing agreement; whether the license holder is a not-for-profit corporation under section
18.17501(c)(3) of the Internal Revenue Code; and a statement that the agreement is subject to
18.18the provisions of sections 256I.01 to 256I.06 and subject to any changes to those sections.
18.19(b) Providers are required to verify the following minimum requirements in the
18.20agreement:
18.21(1) current license or registration, including authorization if managing or monitoring
18.22medications;
18.23(2) all staff who have direct contact with recipients meet the staff qualifications;
18.24(3) the provision of group residential housing;
18.25(4) the provision of supplementary services, if applicable;
18.26(5) reports of adverse events, including recipient death or serious injury; and
18.27(6) submission of residency requirements that could result in recipient eviction.
18.28Group residential housing (c) Agreements may be terminated with or without cause by
18.29either the county commissioner, the agency, or the provider with two calendar months prior
18.30notice. The commissioner may immediately terminate an agreement under subdivision 2d.

18.31    Sec. 28. Minnesota Statutes 2014, section 256I.04, subdivision 2c, is amended to read:
18.32    Subd. 2c. Crisis shelters Background study requirements. Secure crisis shelters
18.33for battered women and their children designated by the Minnesota Department of
18.34Corrections are not group residences under this chapter. (a) Effective July 1, 2016, a
19.1provider of group residential housing or supplementary services must initiate background
19.2studies in accordance with chapter 245C of the following individuals:
19.3(1) controlling individuals as defined in section 245A.02;
19.4(2) managerial officials as defined in section 245A.02; and
19.5(3) all employees and volunteers of the establishment who have direct contact
19.6with recipients, or who have unsupervised access to recipients, their personal property,
19.7or their private data.
19.8(b) The provider of group residential housing or supplementary services must
19.9maintain compliance with all requirements established for entities initiating background
19.10studies under chapter 245C.
19.11(c) Effective July 1, 2017, a provider of group residential housing or supplementary
19.12services must demonstrate that all individuals required to have a background study
19.13according to paragraph (a) have a notice stating either that:
19.14(1) the individual is not disqualified under section 245C.14; or
19.15(2) the individual is disqualified, but the individual has been issued a set-aside of
19.16the disqualification for that setting under section 245C.22.

19.17    Sec. 29. Minnesota Statutes 2014, section 256I.04, is amended by adding a subdivision
19.18to read:
19.19    Subd. 2d. Conditions of payment; commissioner's right to suspend or terminate
19.20agreement. (a) Group residential housing or supplementary services must be provided
19.21to the satisfaction of the commissioner, as determined at the sole discretion of the
19.22commissioner's authorized representative, and in accordance with all applicable federal,
19.23state, and local laws, ordinances, rules, and regulations, including business registration
19.24requirements of the Office of the Secretary of State. A provider shall not receive payment
19.25for services or housing found by the commissioner to be performed or provided in
19.26violation of federal, state, or local law, ordinance, rule, or regulation.
19.27(b) The commissioner has the right to suspend or terminate the agreement
19.28immediately when the commissioner determines the health or welfare of the housing or
19.29service recipients is endangered, or when the commissioner has reasonable cause to believe
19.30that the provider has breached a material term of the agreement under subdivision 2b.
19.31(c) Notwithstanding paragraph (b), if the commissioner learns of a curable material
19.32breach of the agreement by the provider, the commissioner shall provide the provider
19.33with a written notice of the breach and allow ten days to cure the breach. If the provider
19.34does not cure the breach within the time allowed, the provider shall be in default of the
19.35agreement and the commissioner may terminate the agreement immediately thereafter. If
20.1the provider has breached a material term of the agreement and cure is not possible, the
20.2commissioner may immediately terminate the agreement.

20.3    Sec. 30. Minnesota Statutes 2014, section 256I.04, is amended by adding a subdivision
20.4to read:
20.5    Subd. 2e. Providers holding health or human services licenses. (a) Except
20.6for facilities with only a board and lodging license, when group residential housing or
20.7supplementary service staff are also operating under a license issued by the Department of
20.8Health or the Department of Human Services, the minimum staff qualification requirements
20.9for the setting shall be the qualifications listed under the related licensing standards.
20.10(b) A background study completed for the licensed service must also satisfy the
20.11background study requirements under this section, if the provider has established the
20.12background study contact person according to chapter 245C and as directed by the
20.13Department of Human Services.

20.14    Sec. 31. Minnesota Statutes 2014, section 256I.04, is amended by adding a subdivision
20.15to read:
20.16    Subd. 2f. Required services. In licensed and registered settings under subdivision
20.172a, providers shall ensure that participants have at a minimum:
20.18(1) food preparation and service for three nutritional meals a day on site;
20.19(2) a bed, clothing storage, linen, bedding, laundering, and laundry supplies or
20.20service;
20.21(3) housekeeping, including cleaning and lavatory supplies or service; and
20.22(4) maintenance and operation of the building and grounds, including heat, water,
20.23garbage removal, electricity, telephone for the site, cooling, supplies, and parts and tools
20.24to repair and maintain equipment and facilities.

20.25    Sec. 32. Minnesota Statutes 2014, section 256I.04, is amended by adding a subdivision
20.26to read:
20.27    Subd. 2g. Crisis shelters. Secure crisis shelters for battered women and their
20.28children designated by the Minnesota Department of Corrections are not group residences
20.29under this chapter.

20.30    Sec. 33. Minnesota Statutes 2014, section 256I.04, subdivision 3, is amended to read:
21.1    Subd. 3. Moratorium on development of group residential housing beds. (a)
21.2County Agencies shall not enter into agreements for new group residential housing beds
21.3with total rates in excess of the MSA equivalent rate except:
21.4(1) for group residential housing establishments licensed under Minnesota Rules,
21.5parts 9525.0215 to 9525.0355, provided the facility is needed to meet the census reduction
21.6targets for persons with developmental disabilities at regional treatment centers;
21.7(2) up to 80 beds in a single, specialized facility located in Hennepin County that will
21.8provide housing for chronic inebriates who are repetitive users of detoxification centers
21.9and are refused placement in emergency shelters because of their state of intoxication,
21.10and planning for the specialized facility must have been initiated before July 1, 1991,
21.11in anticipation of receiving a grant from the Housing Finance Agency under section
21.12462A.05, subdivision 20a , paragraph (b);
21.13(3) notwithstanding the provisions of subdivision 2a, for up to 190 supportive
21.14housing units in Anoka, Dakota, Hennepin, or Ramsey County for homeless adults with a
21.15mental illness, a history of substance abuse, or human immunodeficiency virus or acquired
21.16immunodeficiency syndrome. For purposes of this section, "homeless adult" means a
21.17person who is living on the street or in a shelter or discharged from a regional treatment
21.18center, community hospital, or residential treatment program and has no appropriate
21.19housing available and lacks the resources and support necessary to access appropriate
21.20housing. At least 70 percent of the supportive housing units must serve homeless adults
21.21with mental illness, substance abuse problems, or human immunodeficiency virus or
21.22acquired immunodeficiency syndrome who are about to be or, within the previous six
21.23months, has been discharged from a regional treatment center, or a state-contracted
21.24psychiatric bed in a community hospital, or a residential mental health or chemical
21.25dependency treatment program. If a person meets the requirements of subdivision 1,
21.26paragraph (a), and receives a federal or state housing subsidy, the group residential housing
21.27rate for that person is limited to the supplementary rate under section 256I.05, subdivision
21.281a , and is determined by subtracting the amount of the person's countable income that
21.29exceeds the MSA equivalent rate from the group residential housing supplementary rate.
21.30A resident in a demonstration project site who no longer participates in the demonstration
21.31program shall retain eligibility for a group residential housing payment in an amount
21.32determined under section 256I.06, subdivision 8, using the MSA equivalent rate. Service
21.33funding under section 256I.05, subdivision 1a, will end June 30, 1997, if federal matching
21.34funds are available and the services can be provided through a managed care entity. If
21.35federal matching funds are not available, then service funding will continue under section
21.36256I.05, subdivision 1a ;
22.1(4) for an additional two beds, resulting in a total of 32 beds, for a facility located in
22.2Hennepin County providing services for recovering and chemically dependent men that
22.3has had a group residential housing contract with the county and has been licensed as a
22.4board and lodge facility with special services since 1980;
22.5(5) for a group residential housing provider located in the city of St. Cloud, or a county
22.6contiguous to the city of St. Cloud, that operates a 40-bed facility, that received financing
22.7through the Minnesota Housing Finance Agency Ending Long-Term Homelessness
22.8Initiative and serves chemically dependent clientele, providing 24-hour-a-day supervision;
22.9(6) for a new 65-bed facility in Crow Wing County that will serve chemically
22.10dependent persons, operated by a group residential housing provider that currently
22.11operates a 304-bed facility in Minneapolis, and a 44-bed facility in Duluth;
22.12(7) for a group residential housing provider that operates two ten-bed facilities, one
22.13located in Hennepin County and one located in Ramsey County, that provide community
22.14support and 24-hour-a-day supervision to serve the mental health needs of individuals
22.15who have chronically lived unsheltered; and
22.16(8) for a group residential facility in Hennepin County with a capacity of up to 48
22.17beds that has been licensed since 1978 as a board and lodging facility and that until August
22.181, 2007, operated as a licensed chemical dependency treatment program.
22.19    (b) A county An agency may enter into a group residential housing agreement for
22.20beds with rates in excess of the MSA equivalent rate in addition to those currently covered
22.21under a group residential housing agreement if the additional beds are only a replacement
22.22of beds with rates in excess of the MSA equivalent rate which have been made available
22.23due to closure of a setting, a change of licensure or certification which removes the beds
22.24from group residential housing payment, or as a result of the downsizing of a group
22.25residential housing setting. The transfer of available beds from one county agency to
22.26another can only occur by the agreement of both counties agencies.

22.27    Sec. 34. Minnesota Statutes 2014, section 256I.04, subdivision 4, is amended to read:
22.28    Subd. 4. Rental assistance. For participants in the Minnesota supportive housing
22.29demonstration program under subdivision 3, paragraph (a), clause (5), notwithstanding
22.30the provisions of section 256I.06, subdivision 8, the amount of the group residential
22.31housing payment for room and board must be calculated by subtracting 30 percent of the
22.32recipient's adjusted income as defined by the United States Department of Housing and
22.33Urban Development for the Section 8 program from the fair market rent established for the
22.34recipient's living unit by the federal Department of Housing and Urban Development. This
22.35payment shall be regarded as a state housing subsidy for the purposes of subdivision 3.
23.1Notwithstanding the provisions of section 256I.06, subdivision 6, the recipient's countable
23.2income will only be adjusted when a change of greater than $100 in a month occurs or
23.3upon annual redetermination of eligibility, whichever is sooner. The commissioner is
23.4directed to study the feasibility of developing a rental assistance program to serve persons
23.5traditionally served in group residential housing settings and report to the legislature by
23.6February 15, 1999.

23.7    Sec. 35. Minnesota Statutes 2014, section 256I.05, subdivision 1c, is amended to read:
23.8    Subd. 1c. Rate increases. A county An agency may not increase the rates
23.9negotiated for group residential housing above those in effect on June 30, 1993, except as
23.10provided in paragraphs (a) to (f).
23.11(a) A county An agency may increase the rates for group residential housing settings
23.12to the MSA equivalent rate for those settings whose current rate is below the MSA
23.13equivalent rate.
23.14(b) A county An agency may increase the rates for residents in adult foster care
23.15whose difficulty of care has increased. The total group residential housing rate for these
23.16residents must not exceed the maximum rate specified in subdivisions 1 and 1a. County
23.17Agencies must not include nor increase group residential housing difficulty of care rates
23.18for adults in foster care whose difficulty of care is eligible for funding by home and
23.19community-based waiver programs under title XIX of the Social Security Act.
23.20(c) The room and board rates will be increased each year when the MSA equivalent
23.21rate is adjusted for SSI cost-of-living increases by the amount of the annual SSI increase,
23.22less the amount of the increase in the medical assistance personal needs allowance under
23.23section 256B.35.
23.24(d) When a group residential housing rate is used to pay for an individual's room
23.25and board, or other costs necessary to provide room and board, the rate payable to
23.26the residence must continue for up to 18 calendar days per incident that the person is
23.27temporarily absent from the residence, not to exceed 60 days in a calendar year, if the
23.28absence or absences have received the prior approval of the county agency's social service
23.29staff. Prior approval is not required for emergency absences due to crisis, illness, or injury.
23.30(e) For facilities meeting substantial change criteria within the prior year. Substantial
23.31change criteria exists if the group residential housing establishment experiences a 25
23.32percent increase or decrease in the total number of its beds, if the net cost of capital
23.33additions or improvements is in excess of 15 percent of the current market value of the
23.34residence, or if the residence physically moves, or changes its licensure, and incurs a
23.35resulting increase in operation and property costs.
24.1(f) Until June 30, 1994, a county an agency may increase by up to five percent the
24.2total rate paid for recipients of assistance under sections 256D.01 to 256D.21 or 256D.33
24.3to 256D.54 who reside in residences that are licensed by the commissioner of health as
24.4a boarding care home, but are not certified for the purposes of the medical assistance
24.5program. However, an increase under this clause must not exceed an amount equivalent to
24.665 percent of the 1991 medical assistance reimbursement rate for nursing home resident
24.7class A, in the geographic grouping in which the facility is located, as established under
24.8Minnesota Rules, parts 9549.0050 to 9549.0058.

24.9    Sec. 36. Minnesota Statutes 2014, section 256I.05, subdivision 1g, is amended to read:
24.10    Subd. 1g. Supplementary service rate for certain facilities. On or after July 1,
24.112005, a county An agency may negotiate a supplementary service rate for recipients of
24.12assistance under section 256I.04, subdivision 1, paragraph (a) or (b), who relocate from a
24.13homeless shelter licensed and registered prior to December 31, 1996, by the Minnesota
24.14Department of Health under section 157.17, to have experienced long-term homelessness
24.15and who live in a supportive housing establishment developed and funded in whole or in
24.16part with funds provided specifically as part of the plan to end long-term homelessness
24.17required under Laws 2003, chapter 128, article 15, section 9, not to exceed $456.75 under
24.18section 256I.04, subdivision 2a, paragraph (b), clause (2).

24.19    Sec. 37. Minnesota Statutes 2014, section 256I.06, subdivision 2, is amended to read:
24.20    Subd. 2. Time of payment. A county agency may make payments to a group
24.21residence in advance for an individual whose stay in the group residence is expected
24.22to last beyond the calendar month for which the payment is made and who does not
24.23expect to receive countable earned income during the month for which the payment is
24.24made. Group residential housing payments made by a county agency on behalf of an
24.25individual who is not expected to remain in the group residence beyond the month for
24.26which payment is made must be made subsequent to the individual's departure from the
24.27group residence. Group residential housing payments made by a county agency on behalf
24.28of an individual with countable earned income must be made subsequent to receipt of a
24.29monthly household report form.
24.30EFFECTIVE DATE.This section is effective April 1, 2016.

24.31    Sec. 38. Minnesota Statutes 2014, section 256I.06, subdivision 6, is amended to read:
24.32    Subd. 6. Reports. Recipients must report changes in circumstances that affect
24.33eligibility or group residential housing payment amounts, other than changes in earned
25.1income, within ten days of the change. Recipients with countable earned income must
25.2complete a monthly household report form at least once every six months. If the report
25.3form is not received before the end of the month in which it is due, the county agency
25.4must terminate eligibility for group residential housing payments. The termination shall
25.5be effective on the first day of the month following the month in which the report was due.
25.6If a complete report is received within the month eligibility was terminated, the individual
25.7is considered to have continued an application for group residential housing payment
25.8effective the first day of the month the eligibility was terminated.
25.9EFFECTIVE DATE.This section is effective April 1, 2016.

25.10    Sec. 39. Minnesota Statutes 2014, section 256I.06, subdivision 7, is amended to read:
25.11    Subd. 7. Determination of rates. The agency in the county in which a group
25.12residence is located will shall determine the amount of group residential housing rate to
25.13be paid on behalf of an individual in the group residence regardless of the individual's
25.14county agency of financial responsibility.

25.15    Sec. 40. Minnesota Statutes 2014, section 256I.06, subdivision 8, is amended to read:
25.16    Subd. 8. Amount of group residential housing payment. (a) The amount of
25.17a group residential housing payment to be made on behalf of an eligible individual is
25.18determined by subtracting the individual's countable income under section 256I.04,
25.19subdivision 1 , for a whole calendar month from the group residential housing charge for
25.20that same month. The group residential housing charge is determined by multiplying the
25.21group residential housing rate times the period of time the individual was a resident or
25.22temporarily absent under section 256I.05, subdivision 1c, paragraph (d).
25.23(b) For an individual with earned income under paragraph (a), prospective budgeting
25.24must be used to determine the amount of the individual's payment for the following
25.25six-month period. An increase in income shall not affect an individual's eligibility or
25.26payment amount until the month following the reporting month. A decrease in income shall
25.27be effective the first day of the month after the month in which the decrease is reported.
25.28EFFECTIVE DATE.Paragraph (b) is effective April 1, 2016.

25.29    Sec. 41. Minnesota Statutes 2014, section 256J.21, subdivision 2, as amended by Laws
25.302015, chapter 21, article 1, section 60, is amended to read:
25.31    Subd. 2. Income exclusions. The following must be excluded in determining a
25.32family's available income:
26.1    (1) payments for basic care, difficulty of care, and clothing allowances received for
26.2providing family foster care to children or adults under Minnesota Rules, parts 9555.5050
26.3to 9555.6265, 9560.0521, and 9560.0650 to 9560.0655, payments for family foster care
26.4for children under section 260C.4411 or chapter 256N, and payments received and used
26.5for care and maintenance of a third-party beneficiary who is not a household member;
26.6    (2) reimbursements for employment training received through the Workforce
26.7Investment Act of 1998, United States Code, title 20, chapter 73, section 9201;
26.8    (3) reimbursement for out-of-pocket expenses incurred while performing volunteer
26.9services, jury duty, employment, or informal carpooling arrangements directly related to
26.10employment;
26.11    (4) all educational assistance, except the county agency must count graduate student
26.12teaching assistantships, fellowships, and other similar paid work as earned income and,
26.13after allowing deductions for any unmet and necessary educational expenses, shall
26.14count scholarships or grants awarded to graduate students that do not require teaching
26.15or research as unearned income;
26.16    (5) loans, regardless of purpose, from public or private lending institutions,
26.17governmental lending institutions, or governmental agencies;
26.18    (6) loans from private individuals, regardless of purpose, provided an applicant or
26.19participant documents that the lender expects repayment;
26.20    (7)(i) state income tax refunds; and
26.21    (ii) federal income tax refunds;
26.22    (8)(i) federal earned income credits;
26.23    (ii) Minnesota working family credits;
26.24    (iii) state homeowners and renters credits under chapter 290A; and
26.25    (iv) federal or state tax rebates;
26.26    (9) funds received for reimbursement, replacement, or rebate of personal or real
26.27property when these payments are made by public agencies, awarded by a court, solicited
26.28through public appeal, or made as a grant by a federal agency, state or local government,
26.29or disaster assistance organizations, subsequent to a presidential declaration of disaster;
26.30    (10) the portion of an insurance settlement that is used to pay medical, funeral, and
26.31burial expenses, or to repair or replace insured property;
26.32    (11) reimbursements for medical expenses that cannot be paid by medical assistance;
26.33    (12) payments by a vocational rehabilitation program administered by the state
26.34under chapter 268A, except those payments that are for current living expenses;
26.35    (13) in-kind income, including any payments directly made by a third party to a
26.36provider of goods and services;
27.1    (14) assistance payments to correct underpayments, but only for the month in which
27.2the payment is received;
27.3    (15) payments for short-term emergency needs under section 256J.626, subdivision 2;
27.4    (16) funeral and cemetery payments as provided by section 256.935;
27.5    (17) nonrecurring cash gifts of $30 or less, not exceeding $30 per participant in
27.6a calendar month;
27.7    (18) any form of energy assistance payment made through Public Law 97-35,
27.8Low-Income Home Energy Assistance Act of 1981, payments made directly to energy
27.9providers by other public and private agencies, and any form of credit or rebate payment
27.10issued by energy providers;
27.11    (19) Supplemental Security Income (SSI), including retroactive SSI payments and
27.12other income of an SSI recipient, except as described in section 256J.37, subdivision 3b;
27.13    (20) Minnesota supplemental aid, including retroactive payments;
27.14    (21) proceeds from the sale of real or personal property;
27.15    (22) adoption or kinship assistance payments under chapter 256N or 259A and
27.16Minnesota permanency demonstration title IV-E waiver payments;
27.17    (23) state-funded family subsidy program payments made under section 252.32 to
27.18help families care for children with developmental disabilities, consumer support grant
27.19funds under section 256.476, and resources and services for a disabled household member
27.20under one of the home and community-based waiver services programs under chapter 256B;
27.21    (24) interest payments and dividends from property that is not excluded from and
27.22that does not exceed the asset limit;
27.23    (25) rent rebates;
27.24    (26) income earned by a minor caregiver, minor child through age 6, or a minor
27.25child who is at least a half-time student in an approved elementary or secondary education
27.26program;
27.27    (27) income earned by a caregiver under age 20 who is at least a half-time student in
27.28an approved elementary or secondary education program;
27.29    (28) MFIP child care payments under section 119B.05;
27.30    (29) all other payments made through MFIP to support a caregiver's pursuit of
27.31greater economic stability;
27.32    (30) income a participant receives related to shared living expenses;
27.33    (31) reverse mortgages;
27.34    (32) benefits provided by the Child Nutrition Act of 1966, United States Code, title
27.3542, chapter 13A, sections 1771 to 1790;
28.1    (33) benefits provided by the women, infants, and children (WIC) nutrition program,
28.2United States Code, title 42, chapter 13A, section 1786;
28.3    (34) benefits from the National School Lunch Act, United States Code, title 42,
28.4chapter 13, sections 1751 to 1769e;
28.5    (35) relocation assistance for displaced persons under the Uniform Relocation
28.6Assistance and Real Property Acquisition Policies Act of 1970, United States Code, title
28.742, chapter 61, subchapter II, section 4636, or the National Housing Act, United States
28.8Code, title 12, chapter 13, sections 1701 to 1750jj;
28.9    (36) benefits from the Trade Act of 1974, United States Code, title 19, chapter
28.1012, part 2, sections 2271 to 2322;
28.11    (37) war reparations payments to Japanese Americans and Aleuts under United
28.12States Code, title 50, sections 1989 to 1989d;
28.13    (38) payments to veterans or their dependents as a result of legal settlements
28.14regarding Agent Orange or other chemical exposure under Public Law 101-239, section
28.1510405, paragraph (a)(2)(E);
28.16    (39) income that is otherwise specifically excluded from MFIP consideration in
28.17federal law, state law, or federal regulation;
28.18    (40) security and utility deposit refunds;
28.19    (41) American Indian tribal land settlements excluded under Public Laws 98-123,
28.2098-124, and 99-377 to the Mississippi Band Chippewa Indians of White Earth, Leech
28.21Lake, and Mille Lacs reservations and payments to members of the White Earth Band,
28.22under United States Code, title 25, chapter 9, section 331, and chapter 16, section 1407;
28.23    (42) all income of the minor parent's parents and stepparents when determining the
28.24grant for the minor parent in households that include a minor parent living with parents or
28.25stepparents on MFIP with other children;
28.26    (43) income of the minor parent's parents and stepparents equal to 200 percent of the
28.27federal poverty guideline for a family size not including the minor parent and the minor
28.28parent's child in households that include a minor parent living with parents or stepparents
28.29not on MFIP when determining the grant for the minor parent. The remainder of income is
28.30deemed as specified in section 256J.37, subdivision 1b;
28.31    (44) payments made to children eligible for relative custody assistance under section
28.32257.85 ;
28.33    (45) vendor payments for goods and services made on behalf of a client unless the
28.34client has the option of receiving the payment in cash;
28.35    (46) the principal portion of a contract for deed payment;
29.1    (47) cash payments to individuals enrolled for full-time service as a volunteer under
29.2AmeriCorps programs including AmeriCorps VISTA, AmeriCorps State, AmeriCorps
29.3National, and AmeriCorps NCCC; and
29.4    (48) housing assistance grants under section 256J.35, paragraph (a); and
29.5    (49) child support payments of up to $100 for an assistance unit with one child and
29.6up to $200 for an assistance unit with two or more children.

29.7    Sec. 42. Minnesota Statutes 2014, section 256J.24, subdivision 5a, is amended to read:
29.8    Subd. 5a. Food portion of MFIP transitional standard. The commissioner shall
29.9adjust the food portion of the MFIP transitional standard as needed to reflect adjustments
29.10to the Supplemental Nutrition Assistance Program and maintain compliance with federal
29.11waivers related to the Supplemental Nutrition Assistance Program under the United States
29.12Department of Agriculture. The commissioner shall publish the transitional standard
29.13including a breakdown of the cash and food portions for an assistance unit of sizes one to
29.14ten in the State Register whenever an adjustment is made.

29.15    Sec. 43. Minnesota Statutes 2014, section 256J.33, subdivision 4, is amended to read:
29.16    Subd. 4. Monthly income test. A county agency must apply the monthly income test
29.17retrospectively for each month of MFIP eligibility. An assistance unit is not eligible when
29.18the countable income equals or exceeds the MFIP standard of need or the family wage level
29.19for the assistance unit. The income applied against the monthly income test must include:
29.20(1) gross earned income from employment, prior to mandatory payroll deductions,
29.21voluntary payroll deductions, wage authorizations, and after the disregards in section
29.22256J.21, subdivision 4 , and the allocations in section 256J.36, unless the employment
29.23income is specifically excluded under section 256J.21, subdivision 2;
29.24(2) gross earned income from self-employment less deductions for self-employment
29.25expenses in section 256J.37, subdivision 5, but prior to any reductions for personal or
29.26business state and federal income taxes, personal FICA, personal health and life insurance,
29.27and after the disregards in section 256J.21, subdivision 4, and the allocations in section
29.28256J.36 ;
29.29(3) unearned income after deductions for allowable expenses in section 256J.37,
29.30subdivision 9 , and allocations in section 256J.36, unless the income has been specifically
29.31excluded in section 256J.21, subdivision 2;
29.32(4) gross earned income from employment as determined under clause (1) which
29.33is received by a member of an assistance unit who is a minor child or minor caregiver
29.34and less than a half-time student;
30.1(5) child support and received by an assistance unit, excluded under section 256J.21,
30.2subdivision 2, clause (49), or section 256P.06, subdivision 3, clause (2), item (xvi);
30.3(6) spousal support received by an assistance unit;
30.4(6) (7) the income of a parent when that parent is not included in the assistance unit;
30.5(7) (8) the income of an eligible relative and spouse who seek to be included in
30.6the assistance unit; and
30.7(8) (9) the unearned income of a minor child included in the assistance unit.

30.8    Sec. 44. Minnesota Statutes 2014, section 256K.45, subdivision 1a, is amended to read:
30.9    Subd. 1a. Definitions. (a) The definitions in this subdivision apply to this section.
30.10(b) "Commissioner" means the commissioner of human services.
30.11(c) "Homeless youth" means a person 21 24 years of age or younger who is
30.12unaccompanied by a parent or guardian and is without shelter where appropriate care and
30.13supervision are available, whose parent or legal guardian is unable or unwilling to provide
30.14shelter and care, or who lacks a fixed, regular, and adequate nighttime residence. The
30.15following are not fixed, regular, or adequate nighttime residences:
30.16(1) a supervised publicly or privately operated shelter designed to provide temporary
30.17living accommodations;
30.18(2) an institution or a publicly or privately operated shelter designed to provide
30.19temporary living accommodations;
30.20(3) transitional housing;
30.21(4) a temporary placement with a peer, friend, or family member that has not offered
30.22permanent residence, a residential lease, or temporary lodging for more than 30 days; or
30.23(5) a public or private place not designed for, nor ordinarily used as, a regular
30.24sleeping accommodation for human beings.
30.25Homeless youth does not include persons incarcerated or otherwise detained under
30.26federal or state law.
30.27(d) "Youth at risk of homelessness" means a person 21 24 years of age or younger
30.28whose status or circumstances indicate a significant danger of experiencing homelessness
30.29in the near future. Status or circumstances that indicate a significant danger may include:
30.30(1) youth exiting out-of-home placements; (2) youth who previously were homeless; (3)
30.31youth whose parents or primary caregivers are or were previously homeless; (4) youth
30.32who are exposed to abuse and neglect in their homes; (5) youth who experience conflict
30.33with parents due to chemical or alcohol dependency, mental health disabilities, or other
30.34disabilities; and (6) runaways.
31.1(e) "Runaway" means an unmarried child under the age of 18 years who is absent
31.2from the home of a parent or guardian or other lawful placement without the consent of
31.3the parent, guardian, or lawful custodian.

31.4    Sec. 45. Minnesota Statutes 2014, section 256K.45, subdivision 6, is amended to read:
31.5    Subd. 6. Funding. Funds appropriated for this section may be expended on
31.6programs described under subdivisions 3 to 5, technical assistance, and capacity building
31.7to meet the greatest need on a statewide basis. The commissioner will provide outreach,
31.8technical assistance, and program development support to increase capacity to new and
31.9existing service providers to better meet needs statewide, particularly in areas where
31.10services for homeless youth have not been established, especially in greater Minnesota.

31.11    Sec. 46. [256M.41] CHILD PROTECTION GRANT ALLOCATION.
31.12    Subdivision 1. Formula for county staffing funds. (a) The commissioner shall
31.13allocate state funds appropriated under this section to each county board on a calendar
31.14year basis in an amount determined according to the following formula:
31.15    (1) 50 percent must be distributed on the basis of the child population residing in the
31.16county as determined by the most recent data of the state demographer;
31.17    (2) 25 percent must be distributed on the basis of the number of screened-in
31.18reports of child maltreatment under sections 626.556 and 626.5561, and in the county as
31.19determined by the most recent data of the commissioner; and
31.20    (3) 25 percent must be distributed on the basis of the number of open child
31.21protection case management cases in the county as determined by the most recent data of
31.22the commissioner.
31.23    (b) Notwithstanding this subdivision, no county shall be awarded an allocation of
31.24less than $75,000.
31.25    Subd. 2. Prohibition on supplanting existing funds. Funds received under this
31.26section must be used to address staffing for child protection or expand child protection
31.27services. Funds must not be used to supplant current county expenditures for these
31.28purposes.
31.29    Subd. 3. Payments based on performance. (a) The commissioner shall make
31.30payments under this section to each county board on a calendar year basis in an amount
31.31determined under paragraph (b).
31.32    (b) Calendar year allocations under subdivision 1 shall be paid to counties in the
31.33following manner:
32.1    (1) 80 percent of the allocation as determined in subdivision 1 must be paid to
32.2counties on or before July 10 of each year;
32.3    (2) ten percent of the allocation shall be withheld until the commissioner determines
32.4if the county has met the performance outcome threshold of 90 percent based on
32.5face-to-face contact with alleged child victims. In order to receive the performance
32.6allocation, the county child protection workers must have a timely face-to-face contact
32.7with at least 90 percent of all alleged child victims of screened-in maltreatment reports.
32.8The standard requires that each initial face-to-face contact occur consistent with timelines
32.9defined in section 626.556, subdivision 10, paragraph (i). The commissioner shall make
32.10threshold determinations in January of each year and payments to counties meeting the
32.11performance outcome threshold shall occur in February of each year. Any withheld funds
32.12from this appropriation for counties that do not meet this requirement shall be reallocated
32.13by the commissioner to those counties meeting the requirement; and
32.14(3) ten percent of the allocation shall be withheld until the commissioner determines
32.15that the county has met the performance outcome threshold of 90 percent based on
32.16face-to-face visits by the case manager. In order to receive the performance allocation, the
32.17total number of visits made by caseworkers on a monthly basis to children in foster care
32.18and children receiving child protection services while residing in their home must be at
32.19least 90 percent of the total number of such visits that would occur if every child were
32.20visited once per month. The commissioner shall make such determinations in January
32.21of each year and payments to counties meeting the performance outcome threshold
32.22shall occur in February of each year. Any withheld funds from this appropriation for
32.23counties that do not meet this requirement shall be reallocated by the commissioner to
32.24those counties meeting the requirement. For 2015, the commissioner shall only apply
32.25the standard for monthly foster care visits.
32.26(c) The commissioner shall work with stakeholders and the Human Services
32.27Performance Council under section 402A.16 to develop recommendations for specific
32.28outcome measures that counties should meet in order to receive funds withheld under
32.29paragraph (b), and include in those recommendations a determination as to whether
32.30the performance measures under paragraph (b) should be modified or phased out. The
32.31commissioner shall report the recommendations to the legislative committees having
32.32jurisdiction over child protection issues by January 1, 2018.

32.33    Sec. 47. Minnesota Statutes 2014, section 256N.22, subdivision 9, is amended to read:
32.34    Subd. 9. Death or incapacity of relative custodian or dissolution modification
32.35of custody. The Northstar kinship assistance agreement ends upon death or dissolution
33.1incapacity of the relative custodian or modification of the order for permanent legal and
33.2physical custody of both relative custodians in the case of assignment of custody to two
33.3individuals, or the sole relative custodian in the case of assignment of custody to one
33.4individual in which legal or physical custody is removed from the relative custodian.
33.5In the case of a relative custodian's death or incapacity, Northstar kinship assistance
33.6eligibility may be continued according to subdivision 10.

33.7    Sec. 48. Minnesota Statutes 2014, section 256N.22, subdivision 10, is amended to read:
33.8    Subd. 10. Assigning a successor relative custodian for a child's Northstar
33.9kinship assistance to a court-appointed guardian or custodian. (a) Northstar kinship
33.10assistance may be continued with the written consent of the commissioner to In the event
33.11of the death or incapacity of the relative custodian, eligibility for Northstar kinship
33.12assistance and title IV-E assistance, if applicable, is not affected if the relative custodian
33.13is replaced by a successor named in the Northstar kinship assistance benefit agreement.
33.14Northstar kinship assistance shall be paid to a named successor who is not the child's legal
33.15parent, biological parent or stepparent, or other adult living in the home of the legal parent,
33.16biological parent, or stepparent.
33.17(b) In order to receive Northstar kinship assistance, a named successor must:
33.18(1) meet the background study requirements in subdivision 4;
33.19(2) renegotiate the agreement consistent with section 256N.25, subdivision 2,
33.20including cooperating with an assessment under section 256N.24;
33.21(3) be ordered by the court to be the child's legal relative custodian in a modification
33.22proceeding under section 260C.521, subdivision 2; and
33.23(4) satisfy the requirements in this paragraph within one year of the relative
33.24custodian's death or incapacity unless the commissioner certifies that the named successor
33.25made reasonable attempts to satisfy the requirements within one year and failure to satisfy
33.26the requirements was not the responsibility of the named successor.
33.27(c) Payment of Northstar kinship assistance to the successor guardian may be
33.28temporarily approved through the policies, procedures, requirements, and deadlines under
33.29section 256N.28, subdivision 2. Ongoing payment shall begin in the month when all the
33.30requirements in paragraph (b) are satisfied.
33.31(d) Continued payment of Northstar kinship assistance may occur in the event of the
33.32death or incapacity of the relative custodian when no successor has been named in the
33.33benefit agreement when the commissioner gives written consent to an individual who is a
33.34guardian or custodian appointed by a court for the child upon the death of both relative
33.35custodians in the case of assignment of custody to two individuals, or the sole relative
34.1custodian in the case of assignment of custody to one individual, unless the child is under
34.2the custody of a county, tribal, or child-placing agency.
34.3(b) (e) Temporary assignment of Northstar kinship assistance may be approved
34.4for a maximum of six consecutive months from the death or incapacity of the relative
34.5custodian or custodians as provided in paragraph (a) and must adhere to the policies and,
34.6procedures, requirements, and deadlines under section 256N.28, subdivision 2, that are
34.7prescribed by the commissioner. If a court has not appointed a permanent legal guardian
34.8or custodian within six months, the Northstar kinship assistance must terminate and must
34.9not be resumed.
34.10(c) (f) Upon assignment of assistance payments under this subdivision paragraphs
34.11(d) and (e), assistance must be provided from funds other than title IV-E.

34.12    Sec. 49. Minnesota Statutes 2014, section 256N.24, subdivision 4, is amended to read:
34.13    Subd. 4. Extraordinary levels. (a) The assessment tool established under
34.14subdivision 2 must provide a mechanism through which up to five levels can be added
34.15to the supplemental difficulty of care for a particular child under section 256N.26,
34.16subdivision 4. In establishing the assessment tool, the commissioner must design the tool
34.17so that the levels applicable to the portions of the assessment other than the extraordinary
34.18levels can accommodate the requirements of this subdivision.
34.19(b) These extraordinary levels are available when all of the following circumstances
34.20apply:
34.21(1) the child has extraordinary needs as determined by the assessment tool provided
34.22for under subdivision 2, and the child meets other requirements established by the
34.23commissioner, such as a minimum score on the assessment tool;
34.24(2) the child's extraordinary needs require extraordinary care and intense supervision
34.25that is provided by the child's caregiver as part of the parental duties as described in the
34.26supplemental difficulty of care rate, section 256N.02, subdivision 21. This extraordinary
34.27care provided by the caregiver is required so that the child can be safely cared for in the
34.28home and community, and prevents residential placement;
34.29(3) the child is physically living in a foster family setting, as defined in Minnesota
34.30Rules, part 2960.3010, subpart 23, in a foster residence setting, or physically living in the
34.31home with the adoptive parent or relative custodian; and
34.32(4) the child is receiving the services for which the child is eligible through medical
34.33assistance programs or other programs that provide necessary services for children with
34.34disabilities or other medical and behavioral conditions to live with the child's family, but
34.35the agency with caregiver's input has identified a specific support gap that cannot be met
35.1through home and community support waivers or other programs that are designed to
35.2provide support for children with special needs.
35.3(c) The agency completing an assessment, under subdivision 2, that suggests an
35.4extraordinary level must document as part of the assessment, the following:
35.5(1) the assessment tool that determined that the child's needs or disabilities require
35.6extraordinary care and intense supervision;
35.7(2) a summary of the extraordinary care and intense supervision that is provided by
35.8the caregiver as part of the parental duties as described in the supplemental difficulty of
35.9care rate, section 256N.02, subdivision 21;
35.10(3) confirmation that the child is currently physically residing in the foster family
35.11setting or in the home with the adoptive parent or relative custodian;
35.12(4) the efforts of the agency, caregiver, parents, and others to request support services
35.13in the home and community that would ease the degree of parental duties provided by the
35.14caregiver for the care and supervision of the child. This would include documentation of
35.15the services provided for the child's needs or disabilities, and the services that were denied
35.16or not available from the local social service agency, community agency, the local school
35.17district, local public health department, the parent, or child's medical insurance provider;
35.18(5) the specific support gap identified that places the child's safety and well-being at
35.19risk in the home or community and is necessary to prevent residential placement; and
35.20(6) the extraordinary care and intense supervision provided by the foster, adoptive,
35.21or guardianship caregivers to maintain the child safely in the child's home and prevent
35.22residential placement that cannot be supported by medical assistance or other programs
35.23that provide services, necessary care for children with disabilities, or other medical or
35.24behavioral conditions in the home or community.
35.25(d) An agency completing an assessment under subdivision 2 that suggests
35.26an extraordinary level is appropriate must forward the assessment and required
35.27documentation to the commissioner. If the commissioner approves, the extraordinary
35.28levels must be retroactive to the date the assessment was forwarded.

35.29    Sec. 50. Minnesota Statutes 2014, section 256N.25, subdivision 1, is amended to read:
35.30    Subdivision 1. Agreement; Northstar kinship assistance; adoption assistance. (a)
35.31In order to receive Northstar kinship assistance or adoption assistance benefits on behalf
35.32of an eligible child, a written, binding agreement between the caregiver or caregivers,
35.33the financially responsible agency, or, if there is no financially responsible agency, the
35.34agency designated by the commissioner, and the commissioner must be established prior
35.35to finalization of the adoption or a transfer of permanent legal and physical custody. The
36.1agreement must be negotiated with the caregiver or caregivers under subdivision 2 and
36.2renegotiated under subdivision 3, if applicable.
36.3(b) The agreement must be on a form approved by the commissioner and must
36.4specify the following:
36.5(1) duration of the agreement;
36.6(2) the nature and amount of any payment, services, and assistance to be provided
36.7under such agreement;
36.8(3) the child's eligibility for Medicaid services;
36.9(4) the terms of the payment, including any child care portion as specified in section
36.10256N.24, subdivision 3 ;
36.11(5) eligibility for reimbursement of nonrecurring expenses associated with adopting
36.12or obtaining permanent legal and physical custody of the child, to the extent that the
36.13total cost does not exceed $2,000 per child;
36.14(6) that the agreement must remain in effect regardless of the state of which the
36.15adoptive parents or relative custodians are residents at any given time;
36.16(7) provisions for modification of the terms of the agreement, including renegotiation
36.17of the agreement; and
36.18(8) the effective date of the agreement; and
36.19(9) the successor relative custodian or custodians for Northstar kinship assistance,
36.20when applicable. The successor relative custodian or custodians may be added or changed
36.21by mutual agreement under subdivision 3.
36.22(c) The caregivers, the commissioner, and the financially responsible agency, or, if
36.23there is no financially responsible agency, the agency designated by the commissioner, must
36.24sign the agreement. A copy of the signed agreement must be given to each party. Once
36.25signed by all parties, the commissioner shall maintain the official record of the agreement.
36.26(d) The effective date of the Northstar kinship assistance agreement must be the date
36.27of the court order that transfers permanent legal and physical custody to the relative. The
36.28effective date of the adoption assistance agreement is the date of the finalized adoption
36.29decree.
36.30(e) Termination or disruption of the preadoptive placement or the foster care
36.31placement prior to assignment of custody makes the agreement with that caregiver void.

36.32    Sec. 51. Minnesota Statutes 2014, section 256N.27, subdivision 2, is amended to read:
36.33    Subd. 2. State share. The commissioner shall pay the state share of the maintenance
36.34payments as determined under subdivision 4, and an identical share of the pre-Northstar
36.35Care foster care program under section 260C.4411, subdivision 1, the relative custody
37.1assistance program under section 257.85, and the pre-Northstar Care for Children adoption
37.2assistance program under chapter 259A. The commissioner may transfer funds into the
37.3account if a deficit occurs.

37.4    Sec. 52. Minnesota Statutes 2014, section 257.75, subdivision 3, is amended to read:
37.5    Subd. 3. Effect of recognition. (a) Subject to subdivision 2 and section 257.55,
37.6subdivision 1 , paragraph (g) or (h), the recognition has the force and effect of a judgment or
37.7order determining the existence of the parent and child relationship under section 257.66. If
37.8the conditions in section 257.55, subdivision 1, paragraph (g) or (h), exist, the recognition
37.9creates only a presumption of paternity for purposes of sections 257.51 to 257.74. Once a
37.10recognition has been properly executed and filed with the state registrar of vital statistics,
37.11if there are no competing presumptions of paternity, a judicial or administrative court may
37.12not allow further action to determine parentage regarding the signator of the recognition.
37.13An action to determine custody and parenting time may be commenced pursuant to
37.14chapter 518 without an adjudication of parentage. Until an a temporary or permanent
37.15order is entered granting custody to another, the mother has sole custody.
37.16(b) Following commencement of an action to determine custody or parenting time
37.17under chapter 518, the court may, pursuant to section 518.131, grant temporary parenting
37.18time rights and temporary custody to either parent.
37.19(c) The recognition is:
37.20(1) a basis for bringing an action for the following:
37.21(i) to award temporary custody or parenting time pursuant to section 518.131;
37.22(ii) to award permanent custody or parenting time to either parent,;
37.23(iii) establishing a child support obligation which may include up to the two years
37.24immediately preceding the commencement of the action,;
37.25(iv) ordering a contribution by a parent under section 256.87, or;
37.26(v) ordering a contribution to the reasonable expenses of the mother's pregnancy and
37.27confinement, as provided under section 257.66, subdivision 3,; or
37.28(vi) ordering reimbursement for the costs of blood or genetic testing, as provided
37.29under section 257.69, subdivision 2;
37.30(2) determinative for all other purposes related to the existence of the parent and
37.31child relationship; and
37.32(3) entitled to full faith and credit in other jurisdictions.
37.33EFFECTIVE DATE.This section is effective March 1, 2016.

37.34    Sec. 53. Minnesota Statutes 2014, section 257.75, subdivision 5, is amended to read:
38.1    Subd. 5. Recognition form. (a) The commissioner of human services shall prepare
38.2a form for the recognition of parentage under this section. In preparing the form, the
38.3commissioner shall consult with the individuals specified in subdivision 6. The recognition
38.4form must be drafted so that the force and effect of the recognition, the alternatives to
38.5executing a recognition, and the benefits and responsibilities of establishing paternity, and
38.6the limitations of the recognition of parentage for purposes of exercising and enforcing
38.7custody or parenting time are clear and understandable. The form must include a notice
38.8regarding the finality of a recognition and the revocation procedure under subdivision
38.92. The form must include a provision for each parent to verify that the parent has read
38.10or viewed the educational materials prepared by the commissioner of human services
38.11describing the recognition of paternity. The individual providing the form to the parents
38.12for execution shall provide oral notice of the rights, responsibilities, and alternatives to
38.13executing the recognition. Notice may be provided by audiotape, videotape, or similar
38.14means. Each parent must receive a copy of the recognition.
38.15(b) The form must include the following:
38.16(1) a notice regarding the finality of a recognition and the revocation procedure
38.17under subdivision 2;
38.18(2) a notice, in large print, that the recognition does not establish an enforceable right
38.19to legal custody, physical custody, or parenting time until such rights are awarded pursuant
38.20to a court action to establish custody and parenting time;
38.21(3) a notice stating that when a court awards custody and parenting time under
38.22chapter 518, there is no presumption for or against joint physical custody, except when
38.23domestic abuse, as defined in section 518B.01, subdivision 2, paragraph (a), has occurred
38.24between the parties;
38.25(4) a notice that the recognition of parentage is a basis for:
38.26(i) bringing a court action to award temporary or permanent custody or parenting time;
38.27(ii) establishing a child support obligation that may include the two years
38.28immediately preceding the commencement of the action;
38.29(iii) ordering a contribution by a parent under section 256.87;
38.30(iv) ordering a contribution to the reasonable expenses of the mother's pregnancy
38.31and confinement, as provided under section 257.66, subdivision 3; and
38.32(v) ordering reimbursement for the costs of blood or genetic testing, as provided
38.33under section 257.69, subdivision 2; and
38.34(5) a provision for each parent to verify that the parent has read or viewed the
38.35educational materials prepared by the commissioner of human services describing the
38.36recognition of paternity.
39.1(c) The individual providing the form to the parents for execution shall provide oral
39.2notice of the rights, responsibilities, and alternatives to executing the recognition. Notice
39.3may be provided in audio or video format, or by other similar means. Each parent must
39.4receive a copy of the recognition.
39.5EFFECTIVE DATE.This section is effective March 1, 2016.

39.6    Sec. 54. Minnesota Statutes 2014, section 259A.75, is amended to read:
39.7259A.75 REIMBURSEMENT OF CERTAIN AGENCY COSTS; PURCHASE
39.8OF SERVICE CONTRACTS AND TRIBAL CUSTOMARY ADOPTIONS.
39.9    Subdivision 1. General information. (a) Subject to the procedures required by
39.10the commissioner and the provisions of this section, a Minnesota county or tribal social
39.11services agency shall receive a reimbursement from the commissioner equal to 100 percent
39.12of the reasonable and appropriate cost for contracted adoption placement services identified
39.13for a specific child that are not reimbursed under other federal or state funding sources.
39.14(b) The commissioner may spend up to $16,000 for each purchase of service
39.15contract. Only one contract per child per adoptive placement is permitted. Funds
39.16encumbered and obligated under the contract for the child remain available until the terms
39.17of the contract are fulfilled or the contract is terminated.
39.18(c) The commissioner shall set aside an amount not to exceed five percent of the
39.19total amount of the fiscal year appropriation from the state for the adoption assistance
39.20program to reimburse a Minnesota county or tribal social services placing agencies agency
39.21for child-specific adoption placement services. When adoption assistance payments for
39.22children's needs exceed 95 percent of the total amount of the fiscal year appropriation from
39.23the state for the adoption assistance program, the amount of reimbursement available to
39.24placing agencies for adoption services is reduced correspondingly.
39.25    Subd. 2. Purchase of service contract child eligibility criteria. (a) A child who is
39.26the subject of a purchase of service contract must:
39.27(1) have the goal of adoption, which may include an adoption in accordance with
39.28tribal law;
39.29(2) be under the guardianship of the commissioner of human services or be a ward of
39.30tribal court pursuant to section 260.755, subdivision 20; and
39.31(3) meet all of the special needs criteria according to section 259A.10, subdivision 2.
39.32(b) A child under the guardianship of the commissioner must have an identified
39.33adoptive parent and a fully executed adoption placement agreement according to section
39.34260C.613, subdivision 1 , paragraph (a).
40.1    Subd. 3. Agency eligibility criteria. (a) A Minnesota county or tribal social
40.2services agency shall receive reimbursement for child-specific adoption placement
40.3services for an eligible child that it purchases from a private adoption agency licensed in
40.4Minnesota or any other state or tribal social services agency.
40.5(b) Reimbursement for adoption services is available only for services provided
40.6prior to the date of the adoption decree.
40.7    Subd. 4. Application and eligibility determination. (a) A county or tribal social
40.8services agency may request reimbursement of costs for adoption placement services by
40.9submitting a complete purchase of service application, according to the requirements and
40.10procedures and on forms prescribed by the commissioner.
40.11(b) The commissioner shall determine eligibility for reimbursement of adoption
40.12placement services. If determined eligible, the commissioner of human services shall
40.13sign the purchase of service agreement, making this a fully executed contract. No
40.14reimbursement under this section shall be made to an agency for services provided prior to
40.15the fully executed contract.
40.16(c) Separate purchase of service agreements shall be made, and separate records
40.17maintained, on each child. Only one agreement per child per adoptive placement is
40.18permitted. For siblings who are placed together, services shall be planned and provided to
40.19best maximize efficiency of the contracted hours.
40.20    Subd. 5. Reimbursement process. (a) The agency providing adoption services is
40.21responsible to track and record all service activity, including billable hours, on a form
40.22prescribed by the commissioner. The agency shall submit this form to the state for
40.23reimbursement after services have been completed.
40.24(b) The commissioner shall make the final determination whether or not the
40.25requested reimbursement costs are reasonable and appropriate and if the services have
40.26been completed according to the terms of the purchase of service agreement.
40.27    Subd. 6. Retention of purchase of service records. Agencies entering into
40.28purchase of service contracts shall keep a copy of the agreements, service records, and all
40.29applicable billing and invoicing according to the department's record retention schedule.
40.30Agency records shall be provided upon request by the commissioner.
40.31    Subd. 7. Tribal customary adoptions. (a) The commissioner shall enter into
40.32grant contracts with Minnesota tribal social services agencies to provide child-specific
40.33recruitment and adoption placement services for Indian children under the jurisdiction
40.34of tribal court.
40.35(b) Children served under these grant contracts must meet the child eligibility
40.36criteria in subdivision 2.

41.1    Sec. 55. Minnesota Statutes 2014, section 260C.007, subdivision 27, is amended to read:
41.2    Subd. 27. Relative. "Relative" means a person related to the child by blood,
41.3marriage, or adoption,; the legal parent, guardian, or custodian of the child's siblings; or an
41.4individual who is an important friend with whom the child has resided or had significant
41.5contact. For an Indian child, relative includes members of the extended family as defined
41.6by the law or custom of the Indian child's tribe or, in the absence of law or custom, nieces,
41.7nephews, or first or second cousins, as provided in the Indian Child Welfare Act of 1978,
41.8United States Code, title 25, section 1903.

41.9    Sec. 56. Minnesota Statutes 2014, section 260C.007, subdivision 32, is amended to read:
41.10    Subd. 32. Sibling. "Sibling" means one of two or more individuals who have one or
41.11both parents in common through blood, marriage, or adoption, including. This includes
41.12siblings as defined by the child's tribal code or custom. Sibling also includes an individual
41.13who would have been considered a sibling but for a termination of parental rights of one
41.14or both parents, suspension of parental rights under tribal code, or other disruption of
41.15parental rights such as the death of a parent.

41.16    Sec. 57. Minnesota Statutes 2014, section 260C.203, is amended to read:
41.17260C.203 ADMINISTRATIVE OR COURT REVIEW OF PLACEMENTS.
41.18    (a) Unless the court is conducting the reviews required under section 260C.202,
41.19there shall be an administrative review of the out-of-home placement plan of each child
41.20placed in foster care no later than 180 days after the initial placement of the child in foster
41.21care and at least every six months thereafter if the child is not returned to the home of the
41.22parent or parents within that time. The out-of-home placement plan must be monitored and
41.23updated at each administrative review. The administrative review shall be conducted by
41.24the responsible social services agency using a panel of appropriate persons at least one of
41.25whom is not responsible for the case management of, or the delivery of services to, either
41.26the child or the parents who are the subject of the review. The administrative review shall
41.27be open to participation by the parent or guardian of the child and the child, as appropriate.
41.28    (b) As an alternative to the administrative review required in paragraph (a), the court
41.29may, as part of any hearing required under the Minnesota Rules of Juvenile Protection
41.30Procedure, conduct a hearing to monitor and update the out-of-home placement plan
41.31pursuant to the procedure and standard in section 260C.201, subdivision 6, paragraph
41.32(d). The party requesting review of the out-of-home placement plan shall give parties to
41.33the proceeding notice of the request to review and update the out-of-home placement
41.34plan. A court review conducted pursuant to section 260C.141, subdivision 2; 260C.193;
42.1260C.201 , subdivision 1; 260C.202; 260C.204; 260C.317; or 260D.06 shall satisfy the
42.2requirement for the review so long as the other requirements of this section are met.
42.3    (c) As appropriate to the stage of the proceedings and relevant court orders, the
42.4responsible social services agency or the court shall review:
42.5    (1) the safety, permanency needs, and well-being of the child;
42.6    (2) the continuing necessity for and appropriateness of the placement;
42.7    (3) the extent of compliance with the out-of-home placement plan;
42.8    (4) the extent of progress that has been made toward alleviating or mitigating the
42.9causes necessitating placement in foster care;
42.10    (5) the projected date by which the child may be returned to and safely maintained in
42.11the home or placed permanently away from the care of the parent or parents or guardian; and
42.12    (6) the appropriateness of the services provided to the child.
42.13    (d) When a child is age 16 14 or older, in addition to any administrative review
42.14conducted by the agency, at the in-court review required under section 260C.317,
42.15subdivision 3, clause (3), or 260C.515, subdivision 5 or 6, the court shall review the
42.16independent living plan required under section 260C.212, subdivision 1, paragraph (c),
42.17clause (11) (12), and the provision of services to the child related to the well-being of
42.18the child as the child prepares to leave foster care. The review shall include the actual
42.19plans related to each item in the plan necessary to the child's future safety and well-being
42.20when the child is no longer in foster care.
42.21    (e) At the court review required under paragraph (d) for a child age 16 14 or older,
42.22the following procedures apply:
42.23(1) six months before the child is expected to be discharged from foster care, the
42.24responsible social services agency shall give the written notice required under section
42.25260C.451 , subdivision 1, regarding the right to continued access to services for certain
42.26children in foster care past age 18 and of the right to appeal a denial of social services
42.27under section 256.045. The agency shall file a copy of the notice, including the right to
42.28appeal a denial of social services, with the court. If the agency does not file the notice by
42.29the time the child is age 17-1/2, the court shall require the agency to give it;
42.30    (2) consistent with the requirements of the independent living plan, the court shall
42.31review progress toward or accomplishment of the following goals:
42.32    (i) the child has obtained a high school diploma or its equivalent;
42.33    (ii) the child has completed a driver's education course or has demonstrated the
42.34ability to use public transportation in the child's community;
42.35    (iii) the child is employed or enrolled in postsecondary education;
43.1    (iv) the child has applied for and obtained postsecondary education financial aid for
43.2which the child is eligible;
43.3    (v) the child has health care coverage and health care providers to meet the child's
43.4physical and mental health needs;
43.5    (vi) the child has applied for and obtained disability income assistance for which
43.6the child is eligible;
43.7    (vii) the child has obtained affordable housing with necessary supports, which does
43.8not include a homeless shelter;
43.9    (viii) the child has saved sufficient funds to pay for the first month's rent and a
43.10damage deposit;
43.11    (ix) the child has an alternative affordable housing plan, which does not include a
43.12homeless shelter, if the original housing plan is unworkable;
43.13    (x) the child, if male, has registered for the Selective Service; and
43.14    (xi) the child has a permanent connection to a caring adult; and
43.15    (3) the court shall ensure that the responsible agency in conjunction with the
43.16placement provider assists the child in obtaining the following documents prior to the
43.17child's leaving foster care: a Social Security card; the child's birth certificate; a state
43.18identification card or driver's license, tribal enrollment identification card, green card, or
43.19school visa; the child's school, medical, and dental records; a contact list of the child's
43.20medical, dental, and mental health providers; and contact information for the child's
43.21siblings, if the siblings are in foster care.
43.22    (f) For a child who will be discharged from foster care at age 18 or older, the
43.23responsible social services agency is required to develop a personalized transition plan as
43.24directed by the youth. The transition plan must be developed during the 90-day period
43.25immediately prior to the expected date of discharge. The transition plan must be as
43.26detailed as the child may elect and include specific options on housing, health insurance,
43.27education, local opportunities for mentors and continuing support services, and work force
43.28supports and employment services. The agency shall ensure that the youth receives, at
43.29no cost to the youth, a copy of the youth's consumer credit report as defined in section
43.3013C.001 and assistance in interpreting and resolving any inaccuracies in the report. The
43.31plan must include information on the importance of designating another individual to
43.32make health care treatment decisions on behalf of the child if the child becomes unable
43.33to participate in these decisions and the child does not have, or does not want, a relative
43.34who would otherwise be authorized to make these decisions. The plan must provide the
43.35child with the option to execute a health care directive as provided under chapter 145C.
44.1The agency shall also provide the youth with appropriate contact information if the youth
44.2needs more information or needs help dealing with a crisis situation through age 21.

44.3    Sec. 58. Minnesota Statutes 2014, section 260C.212, subdivision 1, is amended to read:
44.4    Subdivision 1. Out-of-home placement; plan. (a) An out-of-home placement plan
44.5shall be prepared within 30 days after any child is placed in foster care by court order or a
44.6voluntary placement agreement between the responsible social services agency and the
44.7child's parent pursuant to section 260C.227 or chapter 260D.
44.8    (b) An out-of-home placement plan means a written document which is prepared
44.9by the responsible social services agency jointly with the parent or parents or guardian
44.10of the child and in consultation with the child's guardian ad litem, the child's tribe, if the
44.11child is an Indian child, the child's foster parent or representative of the foster care facility,
44.12and, where appropriate, the child. When a child is age 14 or older, the child may include
44.13two other individuals on the team preparing the child's out-of-home placement plan. For
44.14a child in voluntary foster care for treatment under chapter 260D, preparation of the
44.15out-of-home placement plan shall additionally include the child's mental health treatment
44.16provider. As appropriate, the plan shall be:
44.17    (1) submitted to the court for approval under section 260C.178, subdivision 7;
44.18    (2) ordered by the court, either as presented or modified after hearing, under section
44.19260C.178 , subdivision 7, or 260C.201, subdivision 6; and
44.20    (3) signed by the parent or parents or guardian of the child, the child's guardian ad
44.21litem, a representative of the child's tribe, the responsible social services agency, and, if
44.22possible, the child.
44.23    (c) The out-of-home placement plan shall be explained to all persons involved in its
44.24implementation, including the child who has signed the plan, and shall set forth:
44.25    (1) a description of the foster care home or facility selected, including how the
44.26out-of-home placement plan is designed to achieve a safe placement for the child in the
44.27least restrictive, most family-like, setting available which is in close proximity to the home
44.28of the parent or parents or guardian of the child when the case plan goal is reunification,
44.29and how the placement is consistent with the best interests and special needs of the child
44.30according to the factors under subdivision 2, paragraph (b);
44.31    (2) the specific reasons for the placement of the child in foster care, and when
44.32reunification is the plan, a description of the problems or conditions in the home of the
44.33parent or parents which necessitated removal of the child from home and the changes the
44.34parent or parents must make in order for the child to safely return home;
45.1    (3) a description of the services offered and provided to prevent removal of the child
45.2from the home and to reunify the family including:
45.3    (i) the specific actions to be taken by the parent or parents of the child to eliminate
45.4or correct the problems or conditions identified in clause (2), and the time period during
45.5which the actions are to be taken; and
45.6    (ii) the reasonable efforts, or in the case of an Indian child, active efforts to be made
45.7to achieve a safe and stable home for the child including social and other supportive
45.8services to be provided or offered to the parent or parents or guardian of the child, the
45.9child, and the residential facility during the period the child is in the residential facility;
45.10    (4) a description of any services or resources that were requested by the child or the
45.11child's parent, guardian, foster parent, or custodian since the date of the child's placement
45.12in the residential facility, and whether those services or resources were provided and if
45.13not, the basis for the denial of the services or resources;
45.14    (5) the visitation plan for the parent or parents or guardian, other relatives as defined
45.15in section 260C.007, subdivision 27, and siblings of the child if the siblings are not placed
45.16together in foster care, and whether visitation is consistent with the best interest of the
45.17child, during the period the child is in foster care;
45.18    (6) when a child cannot return to or be in the care of either parent, documentation
45.19of steps to finalize adoption as the permanency plan for the child, including: (i) through
45.20reasonable efforts to place the child for adoption. At a minimum, the documentation must
45.21include consideration of whether adoption is in the best interests of the child, child-specific
45.22recruitment efforts such as relative search and the use of state, regional, and national
45.23adoption exchanges to facilitate orderly and timely placements in and outside of the state.
45.24A copy of this documentation shall be provided to the court in the review required under
45.25section 260C.317, subdivision 3, paragraph (b); and
45.26    (ii) documentation necessary to support the requirements of the kinship placement
45.27agreement under section 256N.22 when adoption is determined not to be in the child's
45.28best interests; (7) when a child cannot return to or be in the care of either parent,
45.29documentation of steps to finalize the transfer of permanent legal and physical custody
45.30to a relative as the permanency plan for the child. This documentation must support the
45.31requirements of the kinship placement agreement under section 256N.22 and must include
45.32the reasonable efforts used to determine that it is not appropriate for the child to return
45.33home or be adopted, and reasons why permanent placement with a relative through a
45.34Northstar kinship assistance arrangement is in the child's best interest; how the child meets
45.35the eligibility requirements for Northstar kinship assistance payments; agency efforts to
45.36discuss adoption with the child's relative foster parent and reasons why the relative foster
46.1parent chose not to pursue adoption, if applicable; and agency efforts to discuss with the
46.2child's parent or parents the permanent transfer of permanent legal and physical custody or
46.3the reasons why these efforts were not made;
46.4    (7) (8) efforts to ensure the child's educational stability while in foster care, including:
46.5(i) efforts to ensure that the child remains in the same school in which the child was
46.6enrolled prior to placement or upon the child's move from one placement to another,
46.7including efforts to work with the local education authorities to ensure the child's
46.8educational stability; or
46.9(ii) if it is not in the child's best interest to remain in the same school that the child
46.10was enrolled in prior to placement or move from one placement to another, efforts to
46.11ensure immediate and appropriate enrollment for the child in a new school;
46.12(8) (9) the educational records of the child including the most recent information
46.13available regarding:
46.14    (i) the names and addresses of the child's educational providers;
46.15    (ii) the child's grade level performance;
46.16    (iii) the child's school record;
46.17    (iv) a statement about how the child's placement in foster care takes into account
46.18proximity to the school in which the child is enrolled at the time of placement; and
46.19(v) any other relevant educational information;
46.20    (9) (10) the efforts by the local agency to ensure the oversight and continuity of
46.21health care services for the foster child, including:
46.22(i) the plan to schedule the child's initial health screens;
46.23(ii) how the child's known medical problems and identified needs from the screens,
46.24including any known communicable diseases, as defined in section 144.4172, subdivision
46.252, will be monitored and treated while the child is in foster care;
46.26(iii) how the child's medical information will be updated and shared, including
46.27the child's immunizations;
46.28(iv) who is responsible to coordinate and respond to the child's health care needs,
46.29including the role of the parent, the agency, and the foster parent;
46.30(v) who is responsible for oversight of the child's prescription medications;
46.31(vi) how physicians or other appropriate medical and nonmedical professionals
46.32will be consulted and involved in assessing the health and well-being of the child and
46.33determine the appropriate medical treatment for the child; and
46.34(vii) the responsibility to ensure that the child has access to medical care through
46.35either medical insurance or medical assistance;
46.36(10) (11) the health records of the child including information available regarding:
47.1(i) the names and addresses of the child's health care and dental care providers;
47.2(ii) a record of the child's immunizations;
47.3(iii) the child's known medical problems, including any known communicable
47.4diseases as defined in section 144.4172, subdivision 2;
47.5(iv) the child's medications; and
47.6(v) any other relevant health care information such as the child's eligibility for
47.7medical insurance or medical assistance;
47.8(11) (12) an independent living plan for a child age 16 14 or older. The plan should
47.9include, but not be limited to, the following objectives:
47.10    (i) educational, vocational, or employment planning;
47.11    (ii) health care planning and medical coverage;
47.12    (iii) transportation including, where appropriate, assisting the child in obtaining a
47.13driver's license;
47.14    (iv) money management, including the responsibility of the agency to ensure that
47.15the youth annually receives, at no cost to the youth, a consumer report as defined under
47.16section 13C.001 and assistance in interpreting and resolving any inaccuracies in the report;
47.17    (v) planning for housing;
47.18    (vi) social and recreational skills; and
47.19    (vii) establishing and maintaining connections with the child's family and
47.20community; and
47.21    (viii) regular opportunities to engage in age-appropriate or developmentally
47.22appropriate activities typical for the child's age group, taking into consideration the
47.23capacities of the individual child; and
47.24    (12) (13) for a child in voluntary foster care for treatment under chapter 260D,
47.25diagnostic and assessment information, specific services relating to meeting the mental
47.26health care needs of the child, and treatment outcomes.
47.27    (d) The parent or parents or guardian and the child each shall have the right to legal
47.28counsel in the preparation of the case plan and shall be informed of the right at the time
47.29of placement of the child. The child shall also have the right to a guardian ad litem.
47.30If unable to employ counsel from their own resources, the court shall appoint counsel
47.31upon the request of the parent or parents or the child or the child's legal guardian. The
47.32parent or parents may also receive assistance from any person or social services agency
47.33in preparation of the case plan.
47.34    After the plan has been agreed upon by the parties involved or approved or ordered
47.35by the court, the foster parents shall be fully informed of the provisions of the case plan
47.36and shall be provided a copy of the plan.
48.1    Upon discharge from foster care, the parent, adoptive parent, or permanent legal and
48.2physical custodian, as appropriate, and the child, if appropriate, must be provided with
48.3a current copy of the child's health and education record.

48.4    Sec. 59. Minnesota Statutes 2014, section 260C.212, is amended by adding a
48.5subdivision to read:
48.6    Subd. 13. Protecting missing and runaway children and youth at risk of sex
48.7trafficking. (a) The local social services agency shall expeditiously locate any child
48.8missing from foster care.
48.9(b) The local social services agency shall report immediately, but no later than
48.1024 hours, after receiving information on a missing or abducted child to the local law
48.11enforcement agency for entry into the National Crime Information Center (NCIC)
48.12database of the Federal Bureau of Investigation, and to the National Center for Missing
48.13and Exploited Children.
48.14(c) The local social services agency shall not discharge a child from foster care or
48.15close the social services case until diligent efforts have been exhausted to locate the child
48.16and the court terminates the agency's jurisdiction.
48.17(d) The local social services agency shall determine the primary factors that
48.18contributed to the child's running away or otherwise being absent from care and, to
48.19the extent possible and appropriate, respond to those factors in current and subsequent
48.20placements.
48.21(e) The local social services agency shall determine what the child experienced
48.22while absent from care, including screening the child to determine if the child is a possible
48.23sex trafficking victim as defined in section 609.321, subdivision 7b.
48.24(f) The local social services agency shall report immediately, but no later than 24
48.25hours, to the local law enforcement agency any reasonable cause to believe a child is, or is
48.26at risk of being, a sex trafficking victim.
48.27(g) The local social services agency shall determine appropriate services as described
48.28in section 145.4717 with respect to any child for whom the local social services agency has
48.29responsibility for placement, care, or supervision when the local social services agency
48.30has reasonable cause to believe the child is, or is at risk of being, a sex trafficking victim.

48.31    Sec. 60. Minnesota Statutes 2014, section 260C.212, is amended by adding a
48.32subdivision to read:
48.33    Subd. 14. Support age-appropriate and developmentally appropriate activities
48.34for foster children. Responsible social services agencies and child-placing agencies shall
49.1support a foster child's emotional and developmental growth by permitting the child
49.2to participate in activities or events that are generally accepted as suitable for children
49.3of the same chronological age or are developmentally appropriate for the child. Foster
49.4parents and residential facility staff are permitted to allow foster children to participate in
49.5extracurricular, social, or cultural activities that are typical for the child's age by applying
49.6reasonable and prudent parenting standards. Reasonable and prudent parenting standards
49.7are characterized by careful and sensible parenting decisions that maintain the child's
49.8health and safety, and are made in the child's best interest.

49.9    Sec. 61. Minnesota Statutes 2014, section 260C.221, is amended to read:
49.10260C.221 RELATIVE SEARCH.
49.11(a) The responsible social services agency shall exercise due diligence to identify
49.12and notify adult relatives prior to placement or within 30 days after the child's removal
49.13from the parent. The county agency shall consider placement with a relative under this
49.14section without delay and whenever the child must move from or be returned to foster
49.15care. The relative search required by this section shall be comprehensive in scope. After a
49.16finding that the agency has made reasonable efforts to conduct the relative search under
49.17this paragraph, the agency has the continuing responsibility to appropriately involve
49.18relatives, who have responded to the notice required under this paragraph, in planning
49.19for the child and to continue to consider relatives according to the requirements of
49.20section 260C.212, subdivision 2. At any time during the course of juvenile protection
49.21proceedings, the court may order the agency to reopen its search for relatives when it is in
49.22the child's best interest to do so.
49.23(b) The relative search required by this section shall include both maternal relatives
49.24and paternal adult relatives of the child; all adult grandparents; all legal parents, guardians
49.25or custodians; the child's siblings; and any other adult relatives suggested by the child's
49.26parents, subject to the exceptions due to family violence in paragraph (c). The search shall
49.27also include getting information from the child in an age-appropriate manner about who
49.28the child considers to be family members and important friends with whom the child has
49.29resided or had significant contact. The relative search required under this section must
49.30fulfill the agency's duties under the Indian Child Welfare Act regarding active efforts
49.31to prevent the breakup of the Indian family under United States Code, title 25, section
49.321912(d), and to meet placement preferences under United States Code, title 25, section
49.331915. The relatives must be notified:
50.1(1) of the need for a foster home for the child, the option to become a placement
50.2resource for the child, and the possibility of the need for a permanent placement for the
50.3child;
50.4(2) of their responsibility to keep the responsible social services agency and the court
50.5informed of their current address in order to receive notice in the event that a permanent
50.6placement is sought for the child and to receive notice of the permanency progress review
50.7hearing under section 260C.204. A relative who fails to provide a current address to the
50.8responsible social services agency and the court forfeits the right to receive notice of the
50.9possibility of permanent placement and of the permanency progress review hearing under
50.10section 260C.204. A decision by a relative not to be identified as a potential permanent
50.11placement resource or participate in planning for the child at the beginning of the case
50.12shall not affect whether the relative is considered for placement of the child with that
50.13relative later;
50.14(3) that the relative may participate in the care and planning for the child, including
50.15that the opportunity for such participation may be lost by failing to respond to the notice
50.16sent under this subdivision. "Participate in the care and planning" includes, but is not
50.17limited to, participation in case planning for the parent and child, identifying the strengths
50.18and needs of the parent and child, supervising visits, providing respite and vacation visits
50.19for the child, providing transportation to appointments, suggesting other relatives who
50.20might be able to help support the case plan, and to the extent possible, helping to maintain
50.21the child's familiar and regular activities and contact with friends and relatives;
50.22(4) of the family foster care licensing requirements, including how to complete an
50.23application and how to request a variance from licensing standards that do not present a
50.24safety or health risk to the child in the home under section 245A.04 and supports that are
50.25available for relatives and children who reside in a family foster home; and
50.26    (5) of the relatives' right to ask to be notified of any court proceedings regarding
50.27the child, to attend the hearings, and of a relative's right or opportunity to be heard by the
50.28court as required under section 260C.152, subdivision 5.
50.29(b) (c) A responsible social services agency may disclose private data, as defined
50.30in sections 13.02 and 626.556, to relatives of the child for the purpose of locating and
50.31assessing a suitable placement and may use any reasonable means of identifying and
50.32locating relatives including the Internet or other electronic means of conducting a search.
50.33The agency shall disclose data that is necessary to facilitate possible placement with
50.34relatives and to ensure that the relative is informed of the needs of the child so the
50.35relative can participate in planning for the child and be supportive of services to the child
50.36and family. If the child's parent refuses to give the responsible social services agency
51.1information sufficient to identify the maternal and paternal relatives of the child, the
51.2agency shall ask the juvenile court to order the parent to provide the necessary information.
51.3If a parent makes an explicit request that a specific relative not be contacted or considered
51.4for placement due to safety reasons including past family or domestic violence, the agency
51.5shall bring the parent's request to the attention of the court to determine whether the
51.6parent's request is consistent with the best interests of the child and the agency shall not
51.7contact the specific relative when the juvenile court finds that contacting the specific
51.8relative would endanger the parent, guardian, child, sibling, or any family member.
51.9(c) (d) At a regularly scheduled hearing not later than three months after the child's
51.10placement in foster care and as required in section 260C.202, the agency shall report to
51.11the court:
51.12(1) its efforts to identify maternal and paternal relatives of the child and to engage
51.13the relatives in providing support for the child and family, and document that the relatives
51.14have been provided the notice required under paragraph (a); and
51.15(2) its decision regarding placing the child with a relative as required under section
51.16260C.212, subdivision 2 , and to ask relatives to visit or maintain contact with the child in
51.17order to support family connections for the child, when placement with a relative is not
51.18possible or appropriate.
51.19(d) (e) Notwithstanding chapter 13, the agency shall disclose data about particular
51.20relatives identified, searched for, and contacted for the purposes of the court's review of
51.21the agency's due diligence.
51.22(e) (f) When the court is satisfied that the agency has exercised due diligence to
51.23identify relatives and provide the notice required in paragraph (a), the court may find that
51.24reasonable efforts have been made to conduct a relative search to identify and provide
51.25notice to adult relatives as required under section 260.012, paragraph (e), clause (3). If the
51.26court is not satisfied that the agency has exercised due diligence to identify relatives and
51.27provide the notice required in paragraph (a), the court may order the agency to continue its
51.28search and notice efforts and to report back to the court.
51.29(f) (g) When the placing agency determines that permanent placement proceedings
51.30are necessary because there is a likelihood that the child will not return to a parent's
51.31care, the agency must send the notice provided in paragraph (g) (h), may ask the court to
51.32modify the duty of the agency to send the notice required in paragraph (g) (h), or may
51.33ask the court to completely relieve the agency of the requirements of paragraph (g) (h).
51.34The relative notification requirements of paragraph (g) (h) do not apply when the child is
51.35placed with an appropriate relative or a foster home that has committed to adopting the
51.36child or taking permanent legal and physical custody of the child and the agency approves
52.1of that foster home for permanent placement of the child. The actions ordered by the
52.2court under this section must be consistent with the best interests, safety, permanency,
52.3and welfare of the child.
52.4(g) (h) Unless required under the Indian Child Welfare Act or relieved of this duty
52.5by the court under paragraph (e) (f), when the agency determines that it is necessary to
52.6prepare for permanent placement determination proceedings, or in anticipation of filing a
52.7termination of parental rights petition, the agency shall send notice to the relatives, any
52.8adult with whom the child is currently residing, any adult with whom the child has resided
52.9for one year or longer in the past, and any adults who have maintained a relationship or
52.10exercised visitation with the child as identified in the agency case plan. The notice must
52.11state that a permanent home is sought for the child and that the individuals receiving the
52.12notice may indicate to the agency their interest in providing a permanent home. The notice
52.13must state that within 30 days of receipt of the notice an individual receiving the notice must
52.14indicate to the agency the individual's interest in providing a permanent home for the child
52.15or that the individual may lose the opportunity to be considered for a permanent placement.

52.16    Sec. 62. Minnesota Statutes 2014, section 260C.331, subdivision 1, is amended to read:
52.17    Subdivision 1. Care, examination, or treatment. (a) Except where parental rights
52.18are terminated,
52.19    (1) whenever legal custody of a child is transferred by the court to a responsible
52.20social services agency,
52.21    (2) whenever legal custody is transferred to a person other than the responsible social
52.22services agency, but under the supervision of the responsible social services agency, or
52.23    (3) whenever a child is given physical or mental examinations or treatment under
52.24order of the court, and no provision is otherwise made by law for payment for the care,
52.25examination, or treatment of the child, these costs are a charge upon the welfare funds of
52.26the county in which proceedings are held upon certification of the judge of juvenile court.
52.27    (b) The court shall order, and the responsible social services agency shall require,
52.28the parents or custodian of a child, while the child is under the age of 18, to use the
52.29total income and resources attributable to the child for the period of care, examination,
52.30or treatment, except for clothing and personal needs allowance as provided in section
52.31256B.35 , to reimburse the county for the cost of care, examination, or treatment. Income
52.32and resources attributable to the child include, but are not limited to, Social Security
52.33benefits, Supplemental Security Income (SSI), veterans benefits, railroad retirement
52.34benefits and child support. When the child is over the age of 18, and continues to receive
52.35care, examination, or treatment, the court shall order, and the responsible social services
53.1agency shall require, reimbursement from the child for the cost of care, examination, or
53.2treatment from the income and resources attributable to the child less the clothing and
53.3personal needs allowance. Income does not include earnings from a child over the age of
53.418 who is working as part of a plan under section 260C.212, subdivision 1, paragraph (c),
53.5clause (11) (12), to transition from foster care, or the income and resources from sources
53.6other than Supplemental Security Income and child support that are needed to complete
53.7the requirements listed in section 260C.203.
53.8    (c) If the income and resources attributable to the child are not enough to reimburse
53.9the county for the full cost of the care, examination, or treatment, the court shall inquire
53.10into the ability of the parents to support the child and, after giving the parents a reasonable
53.11opportunity to be heard, the court shall order, and the responsible social services agency
53.12shall require, the parents to contribute to the cost of care, examination, or treatment of
53.13the child. When determining the amount to be contributed by the parents, the court shall
53.14use a fee schedule based upon ability to pay that is established by the responsible social
53.15services agency and approved by the commissioner of human services. The income of
53.16a stepparent who has not adopted a child shall be excluded in calculating the parental
53.17contribution under this section.
53.18    (d) The court shall order the amount of reimbursement attributable to the parents
53.19or custodian, or attributable to the child, or attributable to both sources, withheld under
53.20chapter 518A from the income of the parents or the custodian of the child. A parent or
53.21custodian who fails to pay without good reason may be proceeded against for contempt, or
53.22the court may inform the county attorney, who shall proceed to collect the unpaid sums,
53.23or both procedures may be used.
53.24    (e) If the court orders a physical or mental examination for a child, the examination
53.25is a medically necessary service for purposes of determining whether the service is
53.26covered by a health insurance policy, health maintenance contract, or other health
53.27coverage plan. Court-ordered treatment shall be subject to policy, contract, or plan
53.28requirements for medical necessity. Nothing in this paragraph changes or eliminates
53.29benefit limits, conditions of coverage, co-payments or deductibles, provider restrictions,
53.30or other requirements in the policy, contract, or plan that relate to coverage of other
53.31medically necessary services.
53.32(f) Notwithstanding paragraph (b), (c), or (d), a parent, custodian, or guardian of the
53.33child is not required to use income and resources attributable to the child to reimburse
53.34the county for costs of care and is not required to contribute to the cost of care of the
53.35child during any period of time when the child is returned to the home of that parent,
54.1custodian, or guardian pursuant to a trial home visit under section 260C.201, subdivision
54.21 , paragraph (a).

54.3    Sec. 63. Minnesota Statutes 2014, section 260C.451, subdivision 2, is amended to read:
54.4    Subd. 2. Independent living plan. Upon the request of any child in foster care
54.5immediately prior to the child's 18th birthday and who is in foster care at the time
54.6of the request, the responsible social services agency shall, in conjunction with the
54.7child and other appropriate parties, update the independent living plan required under
54.8section 260C.212, subdivision 1, paragraph (c), clause (11) (12), related to the child's
54.9employment, vocational, educational, social, or maturational needs. The agency shall
54.10provide continued services and foster care for the child including those services that are
54.11necessary to implement the independent living plan.

54.12    Sec. 64. Minnesota Statutes 2014, section 260C.451, subdivision 6, is amended to read:
54.13    Subd. 6. Reentering foster care and accessing services after age 18. (a)
54.14Upon request of an individual between the ages of 18 and 21 who had been under the
54.15guardianship of the commissioner and who has left foster care without being adopted, the
54.16responsible social services agency which had been the commissioner's agent for purposes
54.17of the guardianship shall develop with the individual a plan to increase the individual's
54.18ability to live safely and independently using the plan requirements of section 260C.212,
54.19subdivision 1 , paragraph (b) (c), clause (11) (12), and to assist the individual to meet
54.20one or more of the eligibility criteria in subdivision 4 if the individual wants to reenter
54.21foster care. The agency shall provide foster care as required to implement the plan. The
54.22agency shall enter into a voluntary placement agreement under section 260C.229 with the
54.23individual if the plan includes foster care.
54.24(b) Individuals who had not been under the guardianship of the commissioner of
54.25human services prior to age 18 and are between the ages of 18 and 21 may ask to reenter
54.26foster care after age 18 and, to the extent funds are available, the responsible social
54.27services agency that had responsibility for planning for the individual before discharge
54.28from foster care may provide foster care or other services to the individual for the purpose
54.29of increasing the individual's ability to live safely and independently and to meet the
54.30eligibility criteria in subdivision 3a, if the individual:
54.31(1) was in foster care for the six consecutive months prior to the person's 18th
54.32birthday and was not discharged home, adopted, or received into a relative's home under a
54.33transfer of permanent legal and physical custody under section 260C.515, subdivision 4; or
54.34(2) was discharged from foster care while on runaway status after age 15.
55.1(c) In conjunction with a qualifying and eligible individual under paragraph (b) and
55.2other appropriate persons, the responsible social services agency shall develop a specific
55.3plan related to that individual's vocational, educational, social, or maturational needs
55.4and, to the extent funds are available, provide foster care as required to implement the
55.5plan. The agency shall enter into a voluntary placement agreement with the individual
55.6if the plan includes foster care.
55.7(d) Youth who left foster care while under guardianship of the commissioner of
55.8human services retain eligibility for foster care for placement at any time between the
55.9ages of 18 and 21.

55.10    Sec. 65. Minnesota Statutes 2014, section 260C.515, subdivision 5, is amended to read:
55.11    Subd. 5. Permanent custody to agency. The court may order permanent custody to
55.12the responsible social services agency for continued placement of the child in foster care
55.13but only if it approves the responsible social services agency's compelling reasons that no
55.14other permanency disposition order is in the child's best interests and:
55.15(1) the child has reached age 12 16 and has been asked about the child's desired
55.16permanency outcome;
55.17(2) the child is a sibling of a child described in clause (1) and the siblings have a
55.18significant positive relationship and are ordered into the same foster home;
55.19(3) (2) the responsible social services agency has made reasonable efforts to locate
55.20and place the child with an adoptive family or a fit and willing relative who would either
55.21agree to adopt the child or to a transfer of permanent legal and physical custody of the
55.22child, but these efforts have not proven successful; and
55.23(4) (3) the parent will continue to have visitation or contact with the child and will
55.24remain involved in planning for the child.

55.25    Sec. 66. Minnesota Statutes 2014, section 260C.521, subdivision 1, is amended to read:
55.26    Subdivision 1. Child in permanent custody of responsible social services agency.
55.27(a) Court reviews of an order for permanent custody to the responsible social services
55.28agency for placement of the child in foster care must be conducted at least yearly at an
55.29in-court appearance hearing.
55.30(b) The purpose of the review hearing is to ensure:
55.31(1) the order for permanent custody to the responsible social services agency for
55.32placement of the child in foster care continues to be in the best interests of the child and
55.33that no other permanency disposition order is in the best interests of the child;
56.1(2) that the agency is assisting the child to build connections to the child's family
56.2and community; and
56.3(3) that the agency is appropriately planning with the child for development of
56.4independent living skills for the child and, as appropriate, for the orderly and successful
56.5transition to independent living that may occur if the child continues in foster care without
56.6another permanency disposition order.
56.7(c) The court must review the child's out-of-home placement plan and the reasonable
56.8efforts of the agency to finalize an alternative permanent plan for the child including the
56.9agency's efforts to:
56.10(1) ensure that permanent custody to the agency with placement of the child in
56.11foster care continues to be the most appropriate legal arrangement for meeting the child's
56.12need for permanency and stability or, if not, to identify and attempt to finalize another
56.13permanency disposition order under this chapter that would better serve the child's needs
56.14and best interests;
56.15(2) identify a specific foster home for the child, if one has not already been identified;
56.16(3) support continued placement of the child in the identified home, if one has been
56.17identified;
56.18(4) ensure appropriate services are provided to address the physical health, mental
56.19health, and educational needs of the child during the period of foster care and also ensure
56.20appropriate services or assistance to maintain relationships with appropriate family
56.21members and the child's community; and
56.22(5) plan for the child's independence upon the child's leaving foster care living as
56.23required under section 260C.212, subdivision 1.
56.24(d) The court may find that the agency has made reasonable efforts to finalize the
56.25permanent plan for the child when:
56.26(1) the agency has made reasonable efforts to identify a more legally permanent
56.27home for the child than is provided by an order for permanent custody to the agency
56.28for placement in foster care; and
56.29(2) the child has been asked about the child's desired permanency outcome; and
56.30(2) (3) the agency's engagement of the child in planning for independent living is
56.31reasonable and appropriate.

56.32    Sec. 67. Minnesota Statutes 2014, section 260C.521, subdivision 2, is amended to read:
56.33    Subd. 2. Modifying order for permanent legal and physical custody to a
56.34relative. (a) An order for a relative to have permanent legal and physical custody of a
56.35child may be modified using standards under sections 518.18 and 518.185.
57.1(b) When a child is receiving Northstar kinship assistance under chapter 256N, if
57.2a relative named as permanent legal and physical custodian in an order made under this
57.3chapter becomes incapacitated or dies, a successor custodian named in the Northstar
57.4Care for Children kinship assistance benefit agreement under section 256N.25 may file
57.5a request to modify the order for permanent legal and physical custody to name the
57.6successor custodian as the permanent legal and physical custodian of the child. The court
57.7may modify the order to name the successor custodian as the permanent legal and physical
57.8custodian upon reviewing the background study required under section 245C.33 if the
57.9court finds the modification is in the child's best interests.
57.10(c) The social services agency is a party to the proceeding and must receive notice.

57.11    Sec. 68. Minnesota Statutes 2014, section 260C.607, subdivision 4, is amended to read:
57.12    Subd. 4. Content of review. (a) The court shall review:
57.13(1) the agency's reasonable efforts under section 260C.605 to finalize an adoption
57.14for the child as appropriate to the stage of the case; and
57.15(2) the child's current out-of-home placement plan required under section 260C.212,
57.16subdivision 1, to ensure the child is receiving all services and supports required to meet
57.17the child's needs as they relate to the child's:
57.18(i) placement;
57.19(ii) visitation and contact with siblings;
57.20(iii) visitation and contact with relatives;
57.21(iv) medical, mental, and dental health; and
57.22(v) education.
57.23(b) When the child is age 16 14 and older, and as long as the child continues in foster
57.24care, the court shall also review the agency's planning for the child's independent living
57.25after leaving foster care including how the agency is meeting the requirements of section
57.26260C.212, subdivision 1 , paragraph (c), clause (11) (12). The court shall use the review
57.27requirements of section 260C.203 in any review conducted under this paragraph.

57.28    Sec. 69. Minnesota Statutes 2014, section 518A.26, subdivision 14, is amended to read:
57.29    Subd. 14. Obligor. "Obligor" means a person obligated to pay maintenance or
57.30support. A person who has primary physical custody of a child is presumed not to be
57.31an obligor for purposes of a child support order under section 518A.34, unless section
57.32518A.36, subdivision 3, applies or the court makes specific written findings to overcome
57.33this presumption. For purposes of ordering medical support under section 518A.41, a
58.1parent who has primary physical custody of a child may be an obligor subject to a payment
58.2agreement under section 518A.69.
58.3EFFECTIVE DATE.This section is effective March 1, 2016.

58.4    Sec. 70. Minnesota Statutes 2014, section 518A.32, subdivision 2, is amended to read:
58.5    Subd. 2. Methods. Determination of potential income must be made according
58.6to one of three methods, as appropriate:
58.7(1) the parent's probable earnings level based on employment potential, recent
58.8work history, and occupational qualifications in light of prevailing job opportunities and
58.9earnings levels in the community;
58.10(2) if a parent is receiving unemployment compensation or workers' compensation,
58.11that parent's income may be calculated using the actual amount of the unemployment
58.12compensation or workers' compensation benefit received; or
58.13(3) the amount of income a parent could earn working full time at 150 30 hours per
58.14week at 100 percent of the current federal or state minimum wage, whichever is higher.
58.15EFFECTIVE DATE.This section is effective March 1, 2016.

58.16    Sec. 71. Minnesota Statutes 2014, section 518A.39, subdivision 1, is amended to read:
58.17    Subdivision 1. Authority. After an order under this chapter or chapter 518 for
58.18maintenance or support money, temporary or permanent, or for the appointment of trustees
58.19to receive property awarded as maintenance or support money, the court may from time to
58.20time, on motion of either of the parties, a copy of which is served on the public authority
58.21responsible for child support enforcement if payments are made through it, or on motion
58.22of the public authority responsible for support enforcement, modify the order respecting
58.23the amount of maintenance or support money or medical support, and the payment of it,
58.24and also respecting the appropriation and payment of the principal and income of property
58.25held in trust, and may make an order respecting these matters which it might have made
58.26in the original proceeding, except as herein otherwise provided. A party or the public
58.27authority also may bring a motion for contempt of court if the obligor is in arrears in
58.28support or maintenance payments.
58.29EFFECTIVE DATE.This section is effective January 1, 2016.

58.30    Sec. 72. Minnesota Statutes 2014, section 518A.39, is amended by adding a
58.31subdivision to read:
59.1    Subd. 8. Medical support-only modification. (a) The medical support terms of
59.2a support order and determination of the child dependency tax credit may be modified
59.3without modification of the full order for support or maintenance, if the order has been
59.4established or modified in its entirety within three years from the date of the motion, and
59.5upon a showing of one or more of the following:
59.6(1) a change in the availability of appropriate health care coverage or a substantial
59.7increase or decrease in health care coverage costs;
59.8(2) a change in the eligibility for medical assistance under chapter 256B;
59.9(3) a party's failure to carry court-ordered coverage, or to provide other medical
59.10support as ordered;
59.11(4) the federal child dependency tax credit is not ordered for the same parent who is
59.12ordered to carry health care coverage; or
59.13(5) the federal child dependency tax credit is not addressed in the order and the
59.14noncustodial parent is ordered to carry health care coverage.
59.15(b) For a motion brought under this subdivision, a modification of the medical
59.16support terms of an order may be made retroactive only with respect to any period during
59.17which the petitioning party has pending a motion for modification, but only from the date
59.18of service of notice of the motion on the responding party and on the public authority if
59.19public assistance is being furnished or the county attorney is the attorney of record.
59.20(c) The court need not hold an evidentiary hearing on a motion brought under this
59.21subdivision for modification of medical support only.
59.22(d) Sections 518.14 and 518A.735 shall govern the award of attorney fees for
59.23motions brought under this subdivision.
59.24(e) The PICS originally stated in the order being modified shall be used to determine
59.25the modified medical support order under section 518A.41 for motions brought under
59.26this subdivision.
59.27EFFECTIVE DATE.This section is effective January 1, 2016.

59.28    Sec. 73. Minnesota Statutes 2014, section 518A.41, subdivision 1, is amended to read:
59.29    Subdivision 1. Definitions. The definitions in this subdivision apply to this chapter
59.30and chapter 518.
59.31    (a) "Health care coverage" means medical, dental, or other health care benefits that
59.32are provided by one or more health plans. Health care coverage does not include any
59.33form of public coverage.
59.34    (b) "Health carrier" means a carrier as defined in sections 62A.011, subdivision
59.352 , and 62L.02, subdivision 16.
60.1    (c) "Health plan" means a plan, other than any form of public coverage, that provides
60.2medical, dental, or other health care benefits and is:
60.3    (1) provided on an individual or group basis;
60.4    (2) provided by an employer or union;
60.5    (3) purchased in the private market; or
60.6    (4) available to a person eligible to carry insurance for the joint child, including a
60.7party's spouse or parent.
60.8Health plan includes, but is not limited to, a plan meeting the definition under section
60.962A.011, subdivision 3 , except that the exclusion of coverage designed solely to provide
60.10dental or vision care under section 62A.011, subdivision 3, clause (6), does not apply to
60.11the definition of health plan under this section; a group health plan governed under the
60.12federal Employee Retirement Income Security Act of 1974 (ERISA); a self-insured plan
60.13under sections 43A.23 to 43A.317 and 471.617; and a policy, contract, or certificate issued
60.14by a community-integrated service network licensed under chapter 62N.
60.15    (d) "Medical support" means providing health care coverage for a joint child by
60.16carrying health care coverage for the joint child or by contributing to the cost of health
60.17care coverage, public coverage, unreimbursed medical expenses, and uninsured medical
60.18expenses of the joint child.
60.19    (e) "National medical support notice" means an administrative notice issued by the
60.20public authority to enforce health insurance provisions of a support order in accordance
60.21with Code of Federal Regulations, title 45, section 303.32, in cases where the public
60.22authority provides support enforcement services.
60.23    (f) "Public coverage" means health care benefits provided by any form of medical
60.24assistance under chapter 256B or MinnesotaCare under chapter 256L. Public coverage
60.25does not include MinnesotaCare or health plans subsidized by federal premium tax credits
60.26or federal cost-sharing reductions.
60.27    (g) "Uninsured medical expenses" means a joint child's reasonable and necessary
60.28health-related expenses if the joint child is not covered by a health plan or public coverage
60.29when the expenses are incurred.
60.30    (h) "Unreimbursed medical expenses" means a joint child's reasonable and necessary
60.31health-related expenses if a joint child is covered by a health plan or public coverage and
60.32the plan or coverage does not pay for the total cost of the expenses when the expenses
60.33are incurred. Unreimbursed medical expenses do not include the cost of premiums.
60.34Unreimbursed medical expenses include, but are not limited to, deductibles, co-payments,
60.35and expenses for orthodontia, and prescription eyeglasses and contact lenses, but not
60.36over-the-counter medications if coverage is under a health plan.

61.1    Sec. 74. Minnesota Statutes 2014, section 518A.41, subdivision 3, is amended to read:
61.2    Subd. 3. Determining appropriate health care coverage. In determining whether
61.3a parent has appropriate health care coverage for the joint child, the court must consider
61.4the following factors:
61.5    (1) comprehensiveness of health care coverage providing medical benefits.
61.6Dependent health care coverage providing medical benefits is presumed comprehensive if
61.7it includes medical and hospital coverage and provides for preventive, emergency, acute,
61.8and chronic care; or if it meets the minimum essential coverage definition in United States
61.9Code, title 26, section 5000A(f). If both parents have health care coverage providing
61.10medical benefits that is presumed comprehensive under this paragraph, the court must
61.11determine which parent's coverage is more comprehensive by considering what other
61.12benefits are included in the coverage;
61.13    (2) accessibility. Dependent health care coverage is accessible if the covered joint
61.14child can obtain services from a health plan provider with reasonable effort by the parent
61.15with whom the joint child resides. Health care coverage is presumed accessible if:
61.16    (i) primary care is available within 30 minutes or 30 miles of the joint child's residence
61.17and specialty care is available within 60 minutes or 60 miles of the joint child's residence;
61.18    (ii) the health care coverage is available through an employer and the employee can
61.19be expected to remain employed for a reasonable amount of time; and
61.20    (iii) no preexisting conditions exist to unduly delay enrollment in health care
61.21coverage;
61.22    (3) the joint child's special medical needs, if any; and
61.23    (4) affordability. Dependent health care coverage is affordable if it is reasonable
61.24in cost. If both parents have health care coverage available for a joint child that is
61.25comparable with regard to comprehensiveness of medical benefits, accessibility, and the
61.26joint child's special needs, the least costly health care coverage is presumed to be the most
61.27appropriate health care coverage for the joint child.

61.28    Sec. 75. Minnesota Statutes 2014, section 518A.41, subdivision 4, is amended to read:
61.29    Subd. 4. Ordering health care coverage. (a) If a joint child is presently enrolled
61.30in health care coverage, the court must order that the parent who currently has the joint
61.31child enrolled continue that enrollment unless the parties agree otherwise or a party
61.32requests a change in coverage and the court determines that other health care coverage is
61.33more appropriate.
61.34    (b) If a joint child is not presently enrolled in health care coverage providing medical
61.35benefits, upon motion of a parent or the public authority, the court must determine whether
62.1one or both parents have appropriate health care coverage providing medical benefits
62.2for the joint child.
62.3    (c) If only one parent has appropriate health care coverage providing medical
62.4benefits available, the court must order that parent to carry the coverage for the joint child.
62.5    (d) If both parents have appropriate health care coverage providing medical benefits
62.6available, the court must order the parent with whom the joint child resides to carry the
62.7coverage for the joint child, unless:
62.8    (1) a party expresses a preference for health care coverage providing medical
62.9benefits available through the parent with whom the joint child does not reside;
62.10    (2) the parent with whom the joint child does not reside is already carrying
62.11dependent health care coverage providing medical benefits for other children and the cost
62.12of contributing to the premiums of the other parent's coverage would cause the parent with
62.13whom the joint child does not reside extreme hardship; or
62.14    (3) the parties agree as to which parent will carry health care coverage providing
62.15medical benefits and agree on the allocation of costs.
62.16    (e) If the exception in paragraph (d), clause (1) or (2), applies, the court must
62.17determine which parent has the most appropriate coverage providing medical benefits
62.18available and order that parent to carry coverage for the joint child.
62.19    (f) If neither parent has appropriate health care coverage available, the court must
62.20order the parents to:
62.21    (1) contribute toward the actual health care costs of the joint children based on
62.22a pro rata share; or
62.23    (2) if the joint child is receiving any form of public coverage, the parent with whom
62.24the joint child does not reside shall contribute a monthly amount toward the actual cost of
62.25public coverage. The amount of the noncustodial parent's contribution is determined by
62.26applying the noncustodial parent's PICS to the premium schedule for public coverage scale
62.27for MinnesotaCare under section 256L.15, subdivision 2, paragraph (d). If the noncustodial
62.28parent's PICS meets the eligibility requirements for public coverage MinnesotaCare, the
62.29contribution is the amount the noncustodial parent would pay for the child's premium. If
62.30the noncustodial parent's PICS exceeds the eligibility requirements for public coverage, the
62.31contribution is the amount of the premium for the highest eligible income on the appropriate
62.32premium schedule for public coverage scale for MinnesotaCare under section 256L.15,
62.33subdivision 2, paragraph (d). For purposes of determining the premium amount, the
62.34noncustodial parent's household size is equal to one parent plus the child or children who
62.35are the subject of the child support order. The custodial parent's obligation is determined
62.36under the requirements for public coverage as set forth in chapter 256B or 256L.; or
63.1(3) if the noncustodial parent's PICS meet the eligibility requirement for public
63.2coverage under chapter 256B or the noncustodial parent receives public assistance, the
63.3noncustodial parent must not be ordered to contribute toward the cost of public coverage.
63.4    (g) If neither parent has appropriate health care coverage available, the court may
63.5order the parent with whom the child resides to apply for public coverage for the child.
63.6    (h) The commissioner of human services must publish a table with the premium
63.7schedule for public coverage and update the chart for changes to the schedule by July
63.81 of each year.
63.9    (i) If a joint child is not presently enrolled in health care coverage providing dental
63.10benefits, upon motion of a parent or the public authority, the court must determine whether
63.11one or both parents have appropriate dental health care coverage for the joint child, and the
63.12court may order a parent with appropriate dental health care coverage available to carry
63.13the coverage for the joint child.
63.14    (j) If a joint child is not presently enrolled in available health care coverage
63.15providing benefits other than medical benefits or dental benefits, upon motion of a parent
63.16or the public authority, the court may determine whether that other health care coverage
63.17for the joint child is appropriate, and the court may order a parent with that appropriate
63.18health care coverage available to carry the coverage for the joint child.
63.19EFFECTIVE DATE.This section is effective August 1, 2015.

63.20    Sec. 76. Minnesota Statutes 2014, section 518A.41, subdivision 14, is amended to read:
63.21    Subd. 14. Child support enforcement services. The public authority must take
63.22necessary steps to establish and enforce, enforce, and modify an order for medical support
63.23if the joint child receives public assistance or a party completes an application for services
63.24from the public authority under section 518A.51.
63.25EFFECTIVE DATE.This section is effective January 1, 2016.

63.26    Sec. 77. Minnesota Statutes 2014, section 518A.41, subdivision 15, is amended to read:
63.27    Subd. 15. Enforcement. (a) Remedies available for collecting and enforcing child
63.28support apply to medical support.
63.29    (b) For the purpose of enforcement, the following are additional support:
63.30    (1) the costs of individual or group health or hospitalization coverage;
63.31    (2) dental coverage;
64.1    (3) medical costs ordered by the court to be paid by either party, including health
64.2care coverage premiums paid by the obligee because of the obligor's failure to obtain
64.3coverage as ordered; and
64.4    (4) liabilities established under this subdivision.
64.5    (c) A party who fails to carry court-ordered dependent health care coverage is liable
64.6for the joint child's uninsured medical expenses unless a court order provides otherwise.
64.7A party's failure to carry court-ordered coverage, or to provide other medical support as
64.8ordered, is a basis for modification of a medical support order under section 518A.39,
64.9subdivision 2 8, unless it meets the presumption in section 518A.39, subdivision 2.
64.10    (d) Payments by the health carrier or employer for services rendered to the dependents
64.11that are directed to a party not owed reimbursement must be endorsed over to and forwarded
64.12to the vendor or appropriate party or the public authority. A party retaining insurance
64.13reimbursement not owed to the party is liable for the amount of the reimbursement.
64.14EFFECTIVE DATE.This section is effective January 1, 2016.

64.15    Sec. 78. Minnesota Statutes 2014, section 518A.43, is amended by adding a
64.16subdivision to read:
64.17    Subd. 1a. Income disparity between parties. The court may deviate from the
64.18presumptive child support obligation under section 518A.34 and elect not to order a party
64.19who has between ten and 45 percent parenting time to pay basic support where such a
64.20significant disparity of income exists between the parties that an order directing payment
64.21of basic support would be detrimental to the parties' joint child.
64.22EFFECTIVE DATE.This section is effective March 1, 2016.

64.23    Sec. 79. Minnesota Statutes 2014, section 518A.46, subdivision 3, is amended to read:
64.24    Subd. 3. Contents of pleadings. (a) In cases involving establishment or
64.25modification of a child support order, the initiating party shall include the following
64.26information, if known, in the pleadings:
64.27(1) names, addresses, and dates of birth of the parties;
64.28(2) Social Security numbers of the parties and the minor children of the parties,
64.29which information shall be considered private information and shall be available only to
64.30the parties, the court, and the public authority;
64.31(3) other support obligations of the obligor;
64.32(4) names and addresses of the parties' employers;
64.33(5) gross income of the parties as calculated in section 518A.29;
65.1(6) amounts and sources of any other earnings and income of the parties;
65.2(7) health insurance coverage of parties;
65.3(8) types and amounts of public assistance received by the parties, including
65.4Minnesota family investment plan, child care assistance, medical assistance,
65.5MinnesotaCare, title IV-E foster care, or other form of assistance as defined in section
65.6256.741, subdivision 1 ; and
65.7(9) any other information relevant to the computation of the child support obligation
65.8under section 518A.34.
65.9(b) For all matters scheduled in the expedited process, whether or not initiated by
65.10the public authority, the nonattorney employee of the public authority shall file with the
65.11court and serve on the parties the following information:
65.12(1) information pertaining to the income of the parties available to the public
65.13authority from the Department of Employment and Economic Development;
65.14(2) a statement of the monthly amount of child support, medical support, child care,
65.15and arrears currently being charged the obligor on Minnesota IV-D cases;
65.16(3) a statement of the types and amount of any public assistance, as defined in
65.17section 256.741, subdivision 1, received by the parties; and
65.18(4) any other information relevant to the determination of support that is known to
65.19the public authority and that has not been otherwise provided by the parties.
65.20The information must be filed with the court or child support magistrate at least
65.21five days before any hearing involving child support, medical support, or child care
65.22reimbursement issues.

65.23    Sec. 80. Minnesota Statutes 2014, section 518A.46, is amended by adding a
65.24subdivision to read:
65.25    Subd. 3a. Contents of pleadings for medical support modifications. (a) In cases
65.26involving modification of only the medical support portion of a child support order
65.27under section 518A.39, subdivision 8, the initiating party shall include the following
65.28information, if known, in the pleadings:
65.29(1) names, addresses, and dates of birth of the parties;
65.30(2) Social Security numbers of the parties and the minor children of the parties,
65.31which shall be considered private information and shall be available only to the parties,
65.32the court, and the public authority;
65.33(3) names and addresses of the parties' employers;
65.34(4) gross income of the parties as stated in the order being modified;
65.35(5) health insurance coverage of the parties; and
66.1(6) any other information relevant to the determination of the medical support
66.2obligation under section 518A.41.
66.3(b) For all matters scheduled in the expedited process, whether or not initiated by
66.4the public authority, the nonattorney employee of the public authority shall file with the
66.5court and serve on the parties the following information:
66.6(1) a statement of the monthly amount of child support, medical support, child care,
66.7and arrears currently being charged the obligor on Minnesota IV-D cases;
66.8(2) a statement of the amount of medical assistance received by the parties; and
66.9(3) any other information relevant to the determination of medical support that is
66.10known to the public authority and that has not been otherwise provided by the parties.
66.11The information must be filed with the court or child support magistrate at least five
66.12days before the hearing on the motion to modify medical support.
66.13EFFECTIVE DATE.This section is effective January 1, 2016.

66.14    Sec. 81. Minnesota Statutes 2014, section 518A.51, is amended to read:
66.15518A.51 FEES FOR IV-D SERVICES.
66.16(a) When a recipient of IV-D services is no longer receiving assistance under the
66.17state's title IV-A, IV-E foster care, or medical assistance, or MinnesotaCare programs, the
66.18public authority responsible for child support enforcement must notify the recipient,
66.19within five working days of the notification of ineligibility, that IV-D services will be
66.20continued unless the public authority is notified to the contrary by the recipient. The
66.21notice must include the implications of continuing to receive IV-D services, including the
66.22available services and fees, cost recovery fees, and distribution policies relating to fees.
66.23(b) An application fee of $25 shall be paid by the person who applies for child
66.24support and maintenance collection services, except persons who are receiving public
66.25assistance as defined in section 256.741 and the diversionary work program under section
66.26256J.95, persons who transfer from public assistance to nonpublic assistance status, and
66.27minor parents and parents enrolled in a public secondary school, area learning center, or
66.28alternative learning program approved by the commissioner of education.
66.29(c) (b) In the case of an individual who has never received assistance under a state
66.30program funded under title IV-A of the Social Security Act and for whom the public
66.31authority has collected at least $500 of support, the public authority must impose an
66.32annual federal collections fee of $25 for each case in which services are furnished. This
66.33fee must be retained by the public authority from support collected on behalf of the
66.34individual, but not from the first $500 collected.
67.1(d) (c) When the public authority provides full IV-D services to an obligee who
67.2has applied for those services, upon written notice to the obligee, the public authority
67.3must charge a cost recovery fee of two percent of the amount collected. This fee must
67.4be deducted from the amount of the child support and maintenance collected and not
67.5assigned under section 256.741 before disbursement to the obligee. This fee does not
67.6apply to an obligee who:
67.7(1) is currently receiving assistance under the state's title IV-A, IV-E foster care, or
67.8medical assistance, or MinnesotaCare programs; or
67.9(2) has received assistance under the state's title IV-A or IV-E foster care programs,
67.10until the person has not received this assistance for 24 consecutive months.
67.11(e) (d) When the public authority provides full IV-D services to an obligor who has
67.12applied for such services, upon written notice to the obligor, the public authority must
67.13charge a cost recovery fee of two percent of the monthly court-ordered child support and
67.14maintenance obligation. The fee may be collected through income withholding, as well
67.15as by any other enforcement remedy available to the public authority responsible for
67.16child support enforcement.
67.17(f) (e) Fees assessed by state and federal tax agencies for collection of overdue
67.18support owed to or on behalf of a person not receiving public assistance must be imposed
67.19on the person for whom these services are provided. The public authority upon written
67.20notice to the obligee shall assess a fee of $25 to the person not receiving public assistance
67.21for each successful federal tax interception. The fee must be withheld prior to the release
67.22of the funds received from each interception and deposited in the general fund.
67.23(g) (f) Federal collections fees collected under paragraph (c) (b) and cost recovery
67.24fees collected under paragraphs (c) and (d) and (e) retained by the commissioner of human
67.25services shall be considered child support program income according to Code of Federal
67.26Regulations, title 45, section 304.50, and shall be deposited in the special revenue fund
67.27account established under paragraph (i) (h). The commissioner of human services must
67.28elect to recover costs based on either actual or standardized costs.
67.29(h) (g) The limitations of this section on the assessment of fees shall not apply to
67.30the extent inconsistent with the requirements of federal law for receiving funds for the
67.31programs under title IV-A and title IV-D of the Social Security Act, United States Code,
67.32title 42, sections 601 to 613 and United States Code, title 42, sections 651 to 662.
67.33(i) (h) The commissioner of human services is authorized to establish a special
67.34revenue fund account to receive the federal collections fees collected under paragraph (c)
67.35(b) and cost recovery fees collected under paragraphs (c) and (d) and (e).
68.1(j) (i) The nonfederal share of the cost recovery fee revenue must be retained by the
68.2commissioner and distributed as follows:
68.3(1) one-half of the revenue must be transferred to the child support system special
68.4revenue account to support the state's administration of the child support enforcement
68.5program and its federally mandated automated system;
68.6(2) an additional portion of the revenue must be transferred to the child support
68.7system special revenue account for expenditures necessary to administer the fees; and
68.8(3) the remaining portion of the revenue must be distributed to the counties to aid the
68.9counties in funding their child support enforcement programs.
68.10(k) (j) The nonfederal share of the federal collections fees must be distributed to the
68.11counties to aid them in funding their child support enforcement programs.
68.12(l) (k) The commissioner of human services shall distribute quarterly any of the
68.13funds dedicated to the counties under paragraphs (i) and (j) and (k) using the methodology
68.14specified in section 256.979, subdivision 11. The funds received by the counties must be
68.15reinvested in the child support enforcement program and the counties must not reduce the
68.16funding of their child support programs by the amount of the funding distributed.
68.17EFFECTIVE DATE.This section is effective July 1, 2016, except that the
68.18amendments striking MinnesotaCare are effective July 1, 2015.

68.19    Sec. 82. Minnesota Statutes 2014, section 518A.53, subdivision 1, is amended to read:
68.20    Subdivision 1. Definitions. (a) For the purpose of this section, the following terms
68.21have the meanings provided in this subdivision unless otherwise stated.
68.22(b) "Payor of funds" means any person or entity that provides funds to an obligor,
68.23including an employer as defined under chapter 24 of the Internal Revenue Code,
68.24section 3401(d), an independent contractor, payor of worker's compensation benefits or
68.25unemployment benefits, or a financial institution as defined in section 13B.06.
68.26(c) "Business day" means a day on which state offices are open for regular business.
68.27(d) "Arrears" means amounts owed under a support order that are past due has the
68.28meaning given in section 518A.26, subdivision 3.
68.29EFFECTIVE DATE.This section is effective July 1, 2016.

68.30    Sec. 83. Minnesota Statutes 2014, section 518A.53, subdivision 4, is amended to read:
68.31    Subd. 4. Collection services. (a) The commissioner of human services shall prepare
68.32and make available to the courts a notice of services that explains child support and
68.33maintenance collection services available through the public authority, including income
69.1withholding, and the fees for such services. Upon receiving a petition for dissolution of
69.2marriage or legal separation, the court administrator shall promptly send the notice of
69.3services to the petitioner and respondent at the addresses stated in the petition.
69.4(b) Either the obligee or obligor may at any time apply to the public authority for
69.5either full IV-D services or for income withholding only services.
69.6(c) For those persons applying for income withholding only services, a monthly
69.7service fee of $15 must be charged to the obligor. This fee is in addition to the amount of
69.8the support order and shall be withheld through income withholding. The public authority
69.9shall explain the service options in this section to the affected parties and encourage the
69.10application for full child support collection services.
69.11(d) If the obligee is not a current recipient of public assistance as defined in section
69.12256.741 , the person who applied for services may at any time choose to terminate either
69.13full IV-D services or income withholding only services regardless of whether income
69.14withholding is currently in place. The obligee or obligor may reapply for either full IV-D
69.15services or income withholding only services at any time. Unless the applicant is a
69.16recipient of public assistance as defined in section 256.741, a $25 application fee shall be
69.17charged at the time of each application.
69.18(e) When a person terminates IV-D services, if an arrearage for public assistance as
69.19defined in section 256.741 exists, the public authority may continue income withholding,
69.20as well as use any other enforcement remedy for the collection of child support, until all
69.21public assistance arrears are paid in full. Income withholding shall be in an amount equal
69.22to 20 percent of the support order in effect at the time the services terminated, unless the
69.23court has ordered a specific monthly payback amount to be applied toward the arrears. If a
69.24support order includes a specific monthly payback amount, income withholding shall be
69.25for the specific monthly payback amount ordered.
69.26EFFECTIVE DATE.This section is effective July 1, 2016.

69.27    Sec. 84. Minnesota Statutes 2014, section 518A.53, subdivision 10, is amended to read:
69.28    Subd. 10. Arrearage order. (a) This section does not prevent the court from
69.29ordering the payor of funds to withhold amounts to satisfy the obligor's previous arrearage
69.30in support order payments. This remedy shall not operate to exclude availability of other
69.31remedies to enforce judgments. The employer or payor of funds shall withhold from
69.32the obligor's income an additional amount equal to 20 percent of the monthly child
69.33support or maintenance obligation until the arrearage is paid, unless the court has ordered
69.34a specific monthly payback amount toward the arrears. If a support order includes a
69.35specific monthly payback amount, the employer or payor of funds shall withhold from
70.1the obligor's income an additional amount equal to the specific monthly payback amount
70.2ordered until all arrearages are paid.
70.3(b) Notwithstanding any law to the contrary, funds from income sources included
70.4in section 518A.26, subdivision 8, whether periodic or lump sum, are not exempt from
70.5attachment or execution upon a judgment for child support arrearage.
70.6(c) Absent an order to the contrary, if an arrearage exists at the time a support
70.7order would otherwise terminate, income withholding shall continue in effect or may be
70.8implemented in an amount equal to the support order plus an additional 20 percent of the
70.9monthly child support obligation, until all arrears have been paid in full.
70.10EFFECTIVE DATE.This section is effective July 1, 2016.

70.11    Sec. 85. Minnesota Statutes 2014, section 518A.60, is amended to read:
70.12518A.60 COLLECTION; ARREARS ONLY.
70.13(a) Remedies available for the collection and enforcement of support in this chapter
70.14and chapters 256, 257, 518, and 518C also apply to cases in which the child or children
70.15for whom support is owed are emancipated and the obligor owes past support or has an
70.16accumulated arrearage as of the date of the youngest child's emancipation. Child support
70.17arrearages under this section include arrearages for child support, medical support, child
70.18care, pregnancy and birth expenses, and unreimbursed medical expenses as defined in
70.19section 518A.41, subdivision 1, paragraph (h).
70.20(b) This section applies retroactively to any support arrearage that accrued on or
70.21before June 3, 1997, and to all arrearages accruing after June 3, 1997.
70.22(c) Past support or pregnancy and confinement expenses ordered for which the
70.23obligor has specific court ordered terms for repayment may not be enforced using drivers'
70.24and occupational or professional license suspension, and credit bureau reporting, and
70.25additional income withholding under section 518A.53, subdivision 10, paragraph (a),
70.26unless the obligor fails to comply with the terms of the court order for repayment.
70.27(d) If an arrearage exists at the time a support order would otherwise terminate
70.28and section 518A.53, subdivision 10, paragraph (c), does not apply to this section, the
70.29arrearage shall be repaid in an amount equal to the current support order until all arrears
70.30have been paid in full, absent a court order to the contrary.
70.31(e) If an arrearage exists according to a support order which fails to establish a
70.32monthly support obligation in a specific dollar amount, the public authority, if it provides
70.33child support services, or the obligee, may establish a payment agreement which shall
70.34equal what the obligor would pay for current support after application of section 518A.34,
71.1plus an additional 20 percent of the current support obligation, until all arrears have been
71.2paid in full. If the obligor fails to enter into or comply with a payment agreement, the
71.3public authority, if it provides child support services, or the obligee, may move the district
71.4court or child support magistrate, if section 484.702 applies, for an order establishing
71.5repayment terms.
71.6(f) If there is no longer a current support order because all of the children of the
71.7order are emancipated, the public authority may discontinue child support services and
71.8close its case under title IV-D of the Social Security Act if:
71.9(1) the arrearage is under $500; or
71.10(2) the arrearage is considered unenforceable by the public authority because there
71.11have been no collections for three years, and all administrative and legal remedies have
71.12been attempted or are determined by the public authority to be ineffective because the
71.13obligor is unable to pay, the obligor has no known income or assets, and there is no
71.14reasonable prospect that the obligor will be able to pay in the foreseeable future.
71.15    (g) At least 60 calendar days before the discontinuation of services under paragraph
71.16(f), the public authority must mail a written notice to the obligee and obligor at the
71.17obligee's and obligor's last known addresses that the public authority intends to close the
71.18child support enforcement case and explaining each party's rights. Seven calendar days
71.19after the first notice is mailed, the public authority must mail a second notice under this
71.20paragraph to the obligee.
71.21    (h) The case must be kept open if the obligee responds before case closure and
71.22provides information that could reasonably lead to collection of arrears. If the case is
71.23closed, the obligee may later request that the case be reopened by completing a new
71.24application for services, if there is a change in circumstances that could reasonably lead to
71.25the collection of arrears.
71.26EFFECTIVE DATE.This section is effective July 1, 2016.

71.27    Sec. 86. [518A.685] CONSUMER REPORTING AGENCY; REPORTING
71.28ARREARS.
71.29    (a) If a public authority determines that an obligor has not paid the current monthly
71.30support obligation plus any required arrearage payment for three months, the public
71.31authority must report this information to a consumer reporting agency.
71.32    (b) Before reporting that an obligor is in arrears for court-ordered child support,
71.33the public authority must:
71.34    (1) provide written notice to the obligor that the public authority intends to report the
71.35arrears to a consumer reporting agency; and
72.1    (2) mail the written notice to the obligor's last known mailing address at least 30
72.2days before the public authority reports the arrears to a consumer reporting agency.
72.3    (c) The obligor may, within 21 days of receipt of the notice, do the following to
72.4prevent the public authority from reporting the arrears to a consumer reporting agency:
72.5    (1) pay the arrears in full; or
72.6    (2) request an administrative review. An administrative review is limited to issues
72.7of mistaken identity, a pending legal action involving the arrears, or an incorrect arrears
72.8balance.
72.9    (d) If the public authority has reported that an obligor is in arrears for court-ordered
72.10child support and subsequently determines that the obligor has paid the court-ordered
72.11child support arrears in full, or is paying the current monthly support obligation plus any
72.12required arrearage payment, the public authority must report to the consumer reporting
72.13agency that the obligor is currently paying child support as ordered by the court.
72.14    (e) A public authority that reports arrearage information under this section must
72.15make monthly reports to a consumer reporting agency. The monthly report must be
72.16consistent with credit reporting industry standards for child support.
72.17    (f) For purposes of this section, "consumer reporting agency" has the meaning given
72.18in section 13C.001, subdivision 4, and United States Code, title 15, section 1681a(f).
72.19EFFECTIVE DATE.This section is effective July 1, 2016.

72.20    Sec. 87. Minnesota Statutes 2014, section 518C.802, is amended to read:
72.21518C.802 CONDITIONS OF RENDITION.
72.22(a) Before making demand that the governor of another state surrender an individual
72.23charged criminally in this state with having failed to provide for the support of an obligee,
72.24the governor of this state may require a prosecutor of this state to demonstrate that at least
72.2560 days previously the obligee had initiated proceedings for support pursuant to this
72.26chapter or that the proceeding would be of no avail.
72.27(b) If, under this chapter or a law substantially similar to this chapter, the Uniform
72.28Reciprocal Enforcement of Support Act, or the Revised Uniform Reciprocal Enforcement
72.29of Support Act, the governor of another state makes a demand that the governor of
72.30this state surrender an individual charged criminally in that state with having failed to
72.31provide for the support of a child or other individual to whom a duty of support is owed,
72.32the governor may require a prosecutor to investigate the demand and report whether
72.33a proceeding for support has been initiated or would be effective. If it appears that a
73.1proceeding would be effective but has not been initiated, the governor may delay honoring
73.2the demand for a reasonable time to permit the initiation of a proceeding.
73.3(c) If a proceeding for support has been initiated and the individual whose rendition is
73.4demanded prevails, the governor may decline to honor the demand. If the petitioner prevails
73.5and the individual whose rendition is demanded is subject to a support order, the governor
73.6may decline to honor the demand if the individual is complying with the support order.

73.7    Sec. 88. Minnesota Statutes 2014, section 626.556, subdivision 1, as amended by Laws
73.82015, chapter 4, section 1, is amended to read:
73.9    Subdivision 1. Public policy. (a) The legislature hereby declares that the public
73.10policy of this state is to protect children whose health or welfare may be jeopardized
73.11through physical abuse, neglect, or sexual abuse. While it is recognized that most parents
73.12want to keep their children safe, sometimes circumstances or conditions interfere with
73.13their ability to do so. When this occurs, the health and safety of the children shall must be
73.14of paramount concern. Intervention and prevention efforts shall must address immediate
73.15concerns for child safety and the ongoing risk of abuse or neglect and should engage the
73.16protective capacities of families. In furtherance of this public policy, it is the intent of the
73.17legislature under this section to:
73.18(1) protect children and promote child safety;
73.19(2) strengthen the family;
73.20(3) make the home, school, and community safe for children by promoting
73.21responsible child care in all settings; and
73.22(4) provide, when necessary, a safe temporary or permanent home environment for
73.23physically or sexually abused or neglected children.
73.24(b) In addition, it is the policy of this state to:
73.25(1) require the reporting of neglect or physical or sexual abuse of children in the
73.26home, school, and community settings;
73.27(2) provide for the voluntary reporting of abuse or neglect of children; to require
73.28a family assessment, when appropriate, as the preferred response to reports not alleging
73.29substantial child endangerment;
73.30(3) require an investigation when the report alleges sexual abuse or substantial
73.31child endangerment;
73.32(4) provide a family assessment, if appropriate, when the report does not allege
73.33sexual abuse or substantial child endangerment; and
73.34(4) (5) provide protective, family support, and family preservation services when
73.35needed in appropriate cases.

74.1    Sec. 89. Minnesota Statutes 2014, section 626.556, subdivision 2, is amended to read:
74.2    Subd. 2. Definitions. As used in this section, the following terms have the meanings
74.3given them unless the specific content indicates otherwise:
74.4    (a) "Family assessment" means a comprehensive assessment of child safety, risk of
74.5subsequent child maltreatment, and family strengths and needs that is applied to a child
74.6maltreatment report that does not allege sexual abuse or substantial child endangerment.
74.7Family assessment does not include a determination as to whether child maltreatment
74.8occurred but does determine the need for services to address the safety of family members
74.9and the risk of subsequent maltreatment.
74.10    (b) "Investigation" means fact gathering related to the current safety of a child
74.11and the risk of subsequent maltreatment that determines whether child maltreatment
74.12occurred and whether child protective services are needed. An investigation must be used
74.13when reports involve sexual abuse or substantial child endangerment, and for reports of
74.14maltreatment in facilities required to be licensed under chapter 245A or 245D; under
74.15sections 144.50 to 144.58 and 241.021; in a school as defined in sections 120A.05,
74.16subdivisions 9 , 11, and 13, and 124D.10; or in a nonlicensed personal care provider
74.17association as defined in section 256B.0625, subdivision 19a.
74.18    (c) "Substantial child endangerment" means a person responsible for a child's care,
74.19and in the case of sexual abuse includes a person who has a significant relationship to the
74.20child as defined in section 609.341, or a person in a position of authority as defined in
74.21section 609.341, who by act or omission, commits or attempts to commit an act against a
74.22child under their care that constitutes any of the following:
74.23    (1) egregious harm as defined in section 260C.007, subdivision 14;
74.24    (2) sexual abuse as defined in paragraph (d);
74.25    (3) abandonment under section 260C.301, subdivision 2;
74.26    (4) (3) neglect as defined in paragraph (f), clause (2), that substantially endangers
74.27the child's physical or mental health, including a growth delay, which may be referred to
74.28as failure to thrive, that has been diagnosed by a physician and is due to parental neglect;
74.29    (5) (4) murder in the first, second, or third degree under section 609.185, 609.19, or
74.30609.195 ;
74.31    (6) (5) manslaughter in the first or second degree under section 609.20 or 609.205;
74.32    (7) (6) assault in the first, second, or third degree under section 609.221, 609.222, or
74.33609.223 ;
74.34    (8) (7) solicitation, inducement, and promotion of prostitution under section 609.322;
74.35    (9) (8) criminal sexual conduct under sections 609.342 to 609.3451;
74.36    (10) (9) solicitation of children to engage in sexual conduct under section 609.352;
75.1    (11) (10) malicious punishment or neglect or endangerment of a child under section
75.2609.377 or 609.378;
75.3    (12) (11) use of a minor in sexual performance under section 617.246; or
75.4    (13) (12) parental behavior, status, or condition which mandates that the county
75.5attorney file a termination of parental rights petition under section 260C.503, subdivision 2.
75.6    (d) "Sexual abuse" means the subjection of a child by a person responsible for the
75.7child's care, by a person who has a significant relationship to the child, as defined in
75.8section 609.341, or by a person in a position of authority, as defined in section 609.341,
75.9subdivision 10, to any act which constitutes a violation of section 609.342 (criminal sexual
75.10conduct in the first degree), 609.343 (criminal sexual conduct in the second degree),
75.11609.344 (criminal sexual conduct in the third degree), 609.345 (criminal sexual conduct
75.12in the fourth degree), or 609.3451 (criminal sexual conduct in the fifth degree). Sexual
75.13abuse also includes any act which involves a minor which constitutes a violation of
75.14prostitution offenses under sections 609.321 to 609.324 or 617.246. Sexual abuse includes
75.15threatened sexual abuse which includes the status of a parent or household member
75.16who has committed a violation which requires registration as an offender under section
75.17243.166, subdivision 1b, paragraph (a) or (b), or required registration under section
75.18243.166, subdivision 1b, paragraph (a) or (b).
75.19    (e) "Person responsible for the child's care" means (1) an individual functioning
75.20within the family unit and having responsibilities for the care of the child such as a
75.21parent, guardian, or other person having similar care responsibilities, or (2) an individual
75.22functioning outside the family unit and having responsibilities for the care of the child
75.23such as a teacher, school administrator, other school employees or agents, or other lawful
75.24custodian of a child having either full-time or short-term care responsibilities including,
75.25but not limited to, day care, babysitting whether paid or unpaid, counseling, teaching,
75.26and coaching.
75.27    (f) "Neglect" means the commission or omission of any of the acts specified under
75.28clauses (1) to (9), other than by accidental means:
75.29    (1) failure by a person responsible for a child's care to supply a child with necessary
75.30food, clothing, shelter, health, medical, or other care required for the child's physical or
75.31mental health when reasonably able to do so;
75.32    (2) failure to protect a child from conditions or actions that seriously endanger the
75.33child's physical or mental health when reasonably able to do so, including a growth delay,
75.34which may be referred to as a failure to thrive, that has been diagnosed by a physician and
75.35is due to parental neglect;
76.1    (3) failure to provide for necessary supervision or child care arrangements
76.2appropriate for a child after considering factors as the child's age, mental ability, physical
76.3condition, length of absence, or environment, when the child is unable to care for the
76.4child's own basic needs or safety, or the basic needs or safety of another child in their care;
76.5    (4) failure to ensure that the child is educated as defined in sections 120A.22 and
76.6260C.163, subdivision 11 , which does not include a parent's refusal to provide the parent's
76.7child with sympathomimetic medications, consistent with section 125A.091, subdivision 5;
76.8    (5) nothing in this section shall be construed to mean that a child is neglected solely
76.9because the child's parent, guardian, or other person responsible for the child's care in
76.10good faith selects and depends upon spiritual means or prayer for treatment or care of
76.11disease or remedial care of the child in lieu of medical care; except that a parent, guardian,
76.12or caretaker, or a person mandated to report pursuant to subdivision 3, has a duty to report
76.13if a lack of medical care may cause serious danger to the child's health. This section does
76.14not impose upon persons, not otherwise legally responsible for providing a child with
76.15necessary food, clothing, shelter, education, or medical care, a duty to provide that care;
76.16    (6) prenatal exposure to a controlled substance, as defined in section 253B.02,
76.17subdivision 2, used by the mother for a nonmedical purpose, as evidenced by withdrawal
76.18symptoms in the child at birth, results of a toxicology test performed on the mother at
76.19delivery or the child at birth, medical effects or developmental delays during the child's
76.20first year of life that medically indicate prenatal exposure to a controlled substance, or the
76.21presence of a fetal alcohol spectrum disorder;
76.22    (7) "medical neglect" as defined in section 260C.007, subdivision 6, clause (5);
76.23    (8) chronic and severe use of alcohol or a controlled substance by a parent or
76.24person responsible for the care of the child that adversely affects the child's basic needs
76.25and safety; or
76.26    (9) emotional harm from a pattern of behavior which contributes to impaired
76.27emotional functioning of the child which may be demonstrated by a substantial and
76.28observable effect in the child's behavior, emotional response, or cognition that is not
76.29within the normal range for the child's age and stage of development, with due regard to
76.30the child's culture.
76.31    (g) "Physical abuse" means any physical injury, mental injury, or threatened injury,
76.32inflicted by a person responsible for the child's care on a child other than by accidental
76.33means, or any physical or mental injury that cannot reasonably be explained by the child's
76.34history of injuries, or any aversive or deprivation procedures, or regulated interventions,
76.35that have not been authorized under section 125A.0942 or 245.825.
77.1    Abuse does not include reasonable and moderate physical discipline of a child
77.2administered by a parent or legal guardian which does not result in an injury. Abuse does
77.3not include the use of reasonable force by a teacher, principal, or school employee as
77.4allowed by section 121A.582. Actions which are not reasonable and moderate include,
77.5but are not limited to, any of the following that are done in anger or without regard to the
77.6safety of the child:
77.7    (1) throwing, kicking, burning, biting, or cutting a child;
77.8    (2) striking a child with a closed fist;
77.9    (3) shaking a child under age three;
77.10    (4) striking or other actions which result in any nonaccidental injury to a child
77.11under 18 months of age;
77.12    (5) unreasonable interference with a child's breathing;
77.13    (6) threatening a child with a weapon, as defined in section 609.02, subdivision 6;
77.14    (7) striking a child under age one on the face or head;
77.15    (8) striking a child who is at least age one but under age four on the face or head,
77.16which results in an injury;
77.17    (8) (9) purposely giving a child poison, alcohol, or dangerous, harmful, or controlled
77.18substances which were not prescribed for the child by a practitioner, in order to control or
77.19punish the child; or other substances that substantially affect the child's behavior, motor
77.20coordination, or judgment or that results in sickness or internal injury, or subjects the
77.21child to medical procedures that would be unnecessary if the child were not exposed
77.22to the substances;
77.23    (9) (10) unreasonable physical confinement or restraint not permitted under section
77.24609.379 , including but not limited to tying, caging, or chaining; or
77.25    (10) (11) in a school facility or school zone, an act by a person responsible for the
77.26child's care that is a violation under section 121A.58.
77.27    (h) "Report" means any report communication received by the local welfare agency,
77.28police department, county sheriff, or agency responsible for assessing or investigating
77.29maltreatment child protection pursuant to this section that describes neglect or physical or
77.30sexual abuse of a child and contains sufficient content to identify the child and any person
77.31believed to be responsible for the neglect or abuse, if known.
77.32    (i) "Facility" means:
77.33    (1) a licensed or unlicensed day care facility, residential facility, agency, hospital,
77.34sanitarium, or other facility or institution required to be licensed under sections 144.50 to
77.35144.58 , 241.021, or 245A.01 to 245A.16, or chapter 245D;
78.1    (2) a school as defined in sections 120A.05, subdivisions 9, 11, and 13; and
78.2124D.10 ; or
78.3    (3) a nonlicensed personal care provider organization as defined in section
78.4256B.0625, subdivision 19a .
78.5    (j) "Operator" means an operator or agency as defined in section 245A.02.
78.6    (k) "Commissioner" means the commissioner of human services.
78.7    (l) "Practice of social services," for the purposes of subdivision 3, includes but is
78.8not limited to employee assistance counseling and the provision of guardian ad litem and
78.9parenting time expeditor services.
78.10    (m) "Mental injury" means an injury to the psychological capacity or emotional
78.11stability of a child as evidenced by an observable or substantial impairment in the child's
78.12ability to function within a normal range of performance and behavior with due regard to
78.13the child's culture.
78.14    (n) "Threatened injury" means a statement, overt act, condition, or status that
78.15represents a substantial risk of physical or sexual abuse or mental injury. Threatened
78.16injury includes, but is not limited to, exposing a child to a person responsible for the
78.17child's care, as defined in paragraph (e), clause (1), who has:
78.18    (1) subjected a child to, or failed to protect a child from, an overt act or condition
78.19that constitutes egregious harm, as defined in section 260C.007, subdivision 14, or a
78.20similar law of another jurisdiction;
78.21    (2) been found to be palpably unfit under section 260C.301, subdivision 1, paragraph
78.22(b), clause (4), or a similar law of another jurisdiction;
78.23    (3) committed an act that has resulted in an involuntary termination of parental rights
78.24under section 260C.301, or a similar law of another jurisdiction; or
78.25    (4) committed an act that has resulted in the involuntary transfer of permanent
78.26legal and physical custody of a child to a relative under Minnesota Statutes 2010, section
78.27260C.201, subdivision 11 , paragraph (d), clause (1), section 260C.515, subdivision 4, or a
78.28similar law of another jurisdiction.
78.29A child is the subject of a report of threatened injury when the responsible social
78.30services agency receives birth match data under paragraph (o) from the Department of
78.31Human Services.
78.32(o) Upon receiving data under section 144.225, subdivision 2b, contained in a
78.33birth record or recognition of parentage identifying a child who is subject to threatened
78.34injury under paragraph (n), the Department of Human Services shall send the data to the
78.35responsible social services agency. The data is known as "birth match" data. Unless the
78.36responsible social services agency has already begun an investigation or assessment of the
79.1report due to the birth of the child or execution of the recognition of parentage and the
79.2parent's previous history with child protection, the agency shall accept the birth match
79.3data as a report under this section. The agency may use either a family assessment or
79.4investigation to determine whether the child is safe. All of the provisions of this section
79.5apply. If the child is determined to be safe, the agency shall consult with the county
79.6attorney to determine the appropriateness of filing a petition alleging the child is in need
79.7of protection or services under section 260C.007, subdivision 6, clause (16), in order to
79.8deliver needed services. If the child is determined not to be safe, the agency and the county
79.9attorney shall take appropriate action as required under section 260C.503, subdivision 2.
79.10    (p) Persons who conduct assessments or investigations under this section shall take
79.11into account accepted child-rearing practices of the culture in which a child participates
79.12and accepted teacher discipline practices, which are not injurious to the child's health,
79.13welfare, and safety.
79.14    (q) "Accidental" means a sudden, not reasonably foreseeable, and unexpected
79.15occurrence or event which:
79.16    (1) is not likely to occur and could not have been prevented by exercise of due
79.17care; and
79.18    (2) if occurring while a child is receiving services from a facility, happens when the
79.19facility and the employee or person providing services in the facility are in compliance
79.20with the laws and rules relevant to the occurrence or event.
79.21(r) "Nonmaltreatment mistake" means:
79.22(1) at the time of the incident, the individual was performing duties identified in the
79.23center's child care program plan required under Minnesota Rules, part 9503.0045;
79.24(2) the individual has not been determined responsible for a similar incident that
79.25resulted in a finding of maltreatment for at least seven years;
79.26(3) the individual has not been determined to have committed a similar
79.27nonmaltreatment mistake under this paragraph for at least four years;
79.28(4) any injury to a child resulting from the incident, if treated, is treated only with
79.29remedies that are available over the counter, whether ordered by a medical professional or
79.30not; and
79.31(5) except for the period when the incident occurred, the facility and the individual
79.32providing services were both in compliance with all licensing requirements relevant to the
79.33incident.
79.34This definition only applies to child care centers licensed under Minnesota
79.35Rules, chapter 9503. If clauses (1) to (5) apply, rather than making a determination of
80.1substantiated maltreatment by the individual, the commissioner of human services shall
80.2determine that a nonmaltreatment mistake was made by the individual.

80.3    Sec. 90. Minnesota Statutes 2014, section 626.556, subdivision 3, is amended to read:
80.4    Subd. 3. Persons mandated to report; persons voluntarily reporting. (a) A
80.5person who knows or has reason to believe a child is being neglected or physically or
80.6sexually abused, as defined in subdivision 2, or has been neglected or physically or
80.7sexually abused within the preceding three years, shall immediately report the information
80.8to the local welfare agency, agency responsible for assessing or investigating the report,
80.9police department, or the county sheriff, tribal social services agency, or tribal police
80.10department if the person is:
80.11    (1) a professional or professional's delegate who is engaged in the practice of
80.12the healing arts, social services, hospital administration, psychological or psychiatric
80.13treatment, child care, education, correctional supervision, probation and correctional
80.14services, or law enforcement; or
80.15    (2) employed as a member of the clergy and received the information while
80.16engaged in ministerial duties, provided that a member of the clergy is not required by
80.17this subdivision to report information that is otherwise privileged under section 595.02,
80.18subdivision 1 , paragraph (c).
80.19    The police department or the county sheriff, upon receiving a report, shall
80.20immediately notify the local welfare agency or agency responsible for assessing or
80.21investigating the report, orally and in writing. The local welfare agency, or agency
80.22responsible for assessing or investigating the report, upon receiving a report, shall
80.23immediately notify the local police department or the county sheriff orally and in writing.
80.24The county sheriff and the head of every local welfare agency, agency responsible
80.25for assessing or investigating reports, and police department shall each designate a
80.26person within their agency, department, or office who is responsible for ensuring that
80.27the notification duties of this paragraph and paragraph (b) are carried out. Nothing in
80.28this subdivision shall be construed to require more than one report from any institution,
80.29facility, school, or agency.
80.30    (b) Any person may voluntarily report to the local welfare agency, agency
80.31responsible for assessing or investigating the report, police department, or the county
80.32sheriff, tribal social services agency, or tribal police department if the person knows,
80.33has reason to believe, or suspects a child is being or has been neglected or subjected to
80.34physical or sexual abuse. The police department or the county sheriff, upon receiving
80.35a report, shall immediately notify the local welfare agency or agency responsible for
81.1assessing or investigating the report, orally and in writing. The local welfare agency or
81.2agency responsible for assessing or investigating the report, upon receiving a report, shall
81.3immediately notify the local police department or the county sheriff orally and in writing.
81.4    (c) A person mandated to report physical or sexual child abuse or neglect occurring
81.5within a licensed facility shall report the information to the agency responsible for
81.6licensing the facility under sections 144.50 to 144.58; 241.021; 245A.01 to 245A.16; or
81.7chapter 245D; or a nonlicensed personal care provider organization as defined in section
81.8256B.0625, subdivision 19 . A health or corrections agency receiving a report may request
81.9the local welfare agency to provide assistance pursuant to subdivisions 10, 10a, and 10b. A
81.10board or other entity whose licensees perform work within a school facility, upon receiving
81.11a complaint of alleged maltreatment, shall provide information about the circumstances of
81.12the alleged maltreatment to the commissioner of education. Section 13.03, subdivision 4,
81.13applies to data received by the commissioner of education from a licensing entity.
81.14    (d) Any person mandated to report shall receive a summary of the disposition of
81.15any report made by that reporter, including whether the case has been opened for child
81.16protection or other services, or if a referral has been made to a community organization,
81.17unless release would be detrimental to the best interests of the child. Any person who is
81.18not mandated to report shall, upon request to the local welfare agency, receive a concise
81.19summary of the disposition of any report made by that reporter, unless release would be
81.20detrimental to the best interests of the child. Notification requirements under subdivision
81.2110 apply to all reports received under this section.
81.22    (e) For purposes of this section, "immediately" means as soon as possible but in
81.23no event longer than 24 hours.

81.24    Sec. 91. Minnesota Statutes 2014, section 626.556, subdivision 6a, is amended to read:
81.25    Subd. 6a. Failure to notify. If a local welfare agency receives a report under
81.26subdivision 3, paragraph (a) or (b), and fails to notify the local police department or county
81.27sheriff as required by subdivision 3, paragraph (a) or (b) 10, the person within the agency
81.28who is responsible for ensuring that notification is made shall be subject to disciplinary
81.29action in keeping with the agency's existing policy or collective bargaining agreement on
81.30discipline of employees. If a local police department or a county sheriff receives a report
81.31under subdivision 3, paragraph (a) or (b), and fails to notify the local welfare agency as
81.32required by subdivision 3, paragraph (a) or (b) 10, the person within the police department
81.33or county sheriff's office who is responsible for ensuring that notification is made shall be
81.34subject to disciplinary action in keeping with the agency's existing policy or collective
81.35bargaining agreement on discipline of employees.

82.1    Sec. 92. Minnesota Statutes 2014, section 626.556, subdivision 7, as amended by Laws
82.22015, chapter 4, section 2, is amended to read:
82.3    Subd. 7. Report; information provided to parent; reporter. (a) An oral report
82.4shall be made immediately by telephone or otherwise. An oral report made by a person
82.5required under subdivision 3 to report shall be followed within 72 hours, exclusive
82.6of weekends and holidays, by a report in writing to the appropriate police department,
82.7the county sheriff, the agency responsible for assessing or investigating the report, or
82.8the local welfare agency.
82.9    (b) The local welfare agency shall determine if the report is accepted for an
82.10assessment or investigation to be screened in or out as soon as possible but in no event
82.11longer than 24 hours after the report is received. When determining whether a report will
82.12be screened in or out, the agency receiving the report must consider, when relevant, all
82.13previous history, including reports that were screened out. The agency may communicate
82.14with treating professionals and individuals specified under subdivision 10, paragraph
82.15(i), clause (3), item (iii).
82.16    (b) (c) Any report shall be of sufficient content to identify the child, any person
82.17believed to be responsible for the abuse or neglect of the child if the person is known, the
82.18nature and extent of the abuse or neglect and the name and address of the reporter. The
82.19local welfare agency or agency responsible for assessing or investigating the report shall
82.20accept a report made under subdivision 3 notwithstanding refusal by a reporter to provide
82.21the reporter's name or address as long as the report is otherwise sufficient under this
82.22paragraph. Written reports received by a police department or the county sheriff shall be
82.23forwarded immediately to the local welfare agency or the agency responsible for assessing
82.24or investigating the report. The police department or the county sheriff may keep copies of
82.25reports received by them. Copies of written reports received by a local welfare department
82.26or the agency responsible for assessing or investigating the report shall be forwarded
82.27immediately to the local police department or the county sheriff.
82.28    (c) (d) When requested, the agency responsible for assessing or investigating a
82.29report shall inform the reporter within ten days after the report was made, either orally or
82.30in writing, whether the report was accepted or not. If the responsible agency determines
82.31the report does not constitute a report under this section, the agency shall advise the
82.32reporter the report was screened out. Any person mandated to report shall receive a
82.33summary of the disposition of any report made by that reporter, including whether the case
82.34has been opened for child protection or other services, or if a referral has been made to a
82.35community organization, unless release would be detrimental to the best interests of the
82.36child. Any person who is not mandated to report shall, upon request to the local welfare
83.1agency, receive a concise summary of the disposition of any report made by that reporter,
83.2unless release would be detrimental to the best interests of the child.
83.3    (e) Reports that are screened out must be maintained in accordance with subdivision
83.411c, paragraph (a).
83.5    (f) A local welfare agency or agency responsible for investigating or assessing a
83.6report may use a screened-out report for making an offer of social services to the subjects
83.7of the screened-out report. A local welfare agency or agency responsible for evaluating a
83.8report alleging maltreatment of a child shall consider prior reports, including screened-out
83.9reports, to determine whether an investigation or family assessment must be conducted.
83.10    (d) (g) Notwithstanding paragraph (a), the commissioner of education must inform
83.11the parent, guardian, or legal custodian of the child who is the subject of a report of
83.12alleged maltreatment in a school facility within ten days of receiving the report, either
83.13orally or in writing, whether the commissioner is assessing or investigating the report
83.14of alleged maltreatment.
83.15    (e) (h) Regardless of whether a report is made under this subdivision, as soon as
83.16practicable after a school receives information regarding an incident that may constitute
83.17maltreatment of a child in a school facility, the school shall inform the parent, legal
83.18guardian, or custodian of the child that an incident has occurred that may constitute
83.19maltreatment of the child, when the incident occurred, and the nature of the conduct
83.20that may constitute maltreatment.
83.21    (f) (i) A written copy of a report maintained by personnel of agencies, other than
83.22welfare or law enforcement agencies, which are subject to chapter 13 shall be confidential.
83.23An individual subject of the report may obtain access to the original report as provided
83.24by subdivision 11.

83.25    Sec. 93. Minnesota Statutes 2014, section 626.556, is amended by adding a subdivision
83.26to read:
83.27    Subd. 7a. Guidance for screening reports. (a) Child protection staff, supervisors,
83.28and others involved in child protection screening shall follow the guidance provided
83.29in the child maltreatment screening guidelines issued by the commissioner of human
83.30services and, when notified by the commissioner, shall immediately implement updated
83.31procedures and protocols.
83.32(b) Any modifications to the screening guidelines must be preapproved by the
83.33commissioner of human services and must not be less protective of children than is
83.34mandated by statute. The county agency must consult with the county attorney before
83.35proposing modifications to the commissioner. The guidelines may provide additional
84.1protections for children but must not limit reports that are screened in or provide
84.2additional limits on consideration of reports that were screened out in making screening
84.3determinations.

84.4    Sec. 94. Minnesota Statutes 2014, section 626.556, subdivision 10, is amended to read:
84.5    Subd. 10. Duties of local welfare agency and local law enforcement agency upon
84.6receipt of report; mandatory notification between police or sheriff and agency. (a)
84.7The police department or the county sheriff shall immediately notify the local welfare
84.8agency or agency responsible for child protection reports under this section orally and
84.9in writing when a report is received. The local welfare agency or agency responsible
84.10for child protection reports shall immediately notify the local police department or the
84.11county sheriff orally and in writing when a report is received. The county sheriff and the
84.12head of every local welfare agency, agency responsible for child protection reports, and
84.13police department shall each designate a person within their agency, department, or office
84.14who is responsible for ensuring that the notification duties of this paragraph are carried
84.15out. When the alleged maltreatment occurred on tribal land, the local welfare agency or
84.16agency responsible for child protection reports and the local police department or the
84.17county sheriff shall immediately notify the tribe's social services agency and tribal law
84.18enforcement orally and in writing when a report is received.
84.19    (b) Upon receipt of a report, the local welfare agency shall determine whether to
84.20conduct a family assessment or an investigation as appropriate to prevent or provide a
84.21remedy for child maltreatment. The local welfare agency:
84.22    (1) shall conduct an investigation on reports involving sexual abuse or substantial
84.23child endangerment;
84.24    (2) shall begin an immediate investigation if, at any time when it is using a family
84.25assessment response, it determines that there is reason to believe that sexual abuse or
84.26substantial child endangerment or a serious threat to the child's safety exists;
84.27    (3) may conduct a family assessment for reports that do not allege sexual abuse or
84.28substantial child endangerment. In determining that a family assessment is appropriate,
84.29the local welfare agency may consider issues of child safety, parental cooperation, and
84.30the need for an immediate response; and
84.31    (4) may conduct a family assessment on a report that was initially screened and
84.32assigned for an investigation. In determining that a complete investigation is not required,
84.33the local welfare agency must document the reason for terminating the investigation and
84.34notify the local law enforcement agency if the local law enforcement agency is conducting
84.35a joint investigation.
85.1    If the report alleges neglect, physical abuse, or sexual abuse by a parent, guardian,
85.2or individual functioning within the family unit as a person responsible for the child's
85.3care, or sexual abuse by a person with a significant relationship to the child when that
85.4person resides in the child's household or by a sibling, the local welfare agency shall
85.5immediately conduct a family assessment or investigation as identified in clauses (1)
85.6to (4). In conducting a family assessment or investigation, the local welfare agency
85.7shall gather information on the existence of substance abuse and domestic violence and
85.8offer services for purposes of preventing future child maltreatment, safeguarding and
85.9enhancing the welfare of the abused or neglected minor, and supporting and preserving
85.10family life whenever possible. If the report alleges a violation of a criminal statute
85.11involving sexual abuse, physical abuse, or neglect or endangerment, under section
85.12609.378 , the local law enforcement agency and local welfare agency shall coordinate the
85.13planning and execution of their respective investigation and assessment efforts to avoid a
85.14duplication of fact-finding efforts and multiple interviews. Each agency shall prepare a
85.15separate report of the results of its investigation or assessment. In cases of alleged child
85.16maltreatment resulting in death, the local agency may rely on the fact-finding efforts of a
85.17law enforcement investigation to make a determination of whether or not maltreatment
85.18occurred. When necessary the local welfare agency shall seek authority to remove the
85.19child from the custody of a parent, guardian, or adult with whom the child is living. In
85.20performing any of these duties, the local welfare agency shall maintain appropriate records.
85.21    If the family assessment or investigation indicates there is a potential for abuse of
85.22alcohol or other drugs by the parent, guardian, or person responsible for the child's care,
85.23the local welfare agency shall conduct a chemical use assessment pursuant to Minnesota
85.24Rules, part 9530.6615.
85.25    (b) (c) When a local agency receives a report or otherwise has information indicating
85.26that a child who is a client, as defined in section 245.91, has been the subject of physical
85.27abuse, sexual abuse, or neglect at an agency, facility, or program as defined in section
85.28245.91 , it shall, in addition to its other duties under this section, immediately inform the
85.29ombudsman established under sections 245.91 to 245.97. The commissioner of education
85.30shall inform the ombudsman established under sections 245.91 to 245.97 of reports
85.31regarding a child defined as a client in section 245.91 that maltreatment occurred at a
85.32school as defined in sections 120A.05, subdivisions 9, 11, and 13, and 124D.10.
85.33    (c) (d) Authority of the local welfare agency responsible for assessing or
85.34investigating the child abuse or neglect report, the agency responsible for assessing or
85.35investigating the report, and of the local law enforcement agency for investigating the
85.36alleged abuse or neglect includes, but is not limited to, authority to interview, without
86.1parental consent, the alleged victim and any other minors who currently reside with or
86.2who have resided with the alleged offender. The interview may take place at school or at
86.3any facility or other place where the alleged victim or other minors might be found or the
86.4child may be transported to, and the interview conducted at, a place appropriate for the
86.5interview of a child designated by the local welfare agency or law enforcement agency.
86.6The interview may take place outside the presence of the alleged offender or parent, legal
86.7custodian, guardian, or school official. For family assessments, it is the preferred practice
86.8to request a parent or guardian's permission to interview the child prior to conducting the
86.9child interview, unless doing so would compromise the safety assessment. Except as
86.10provided in this paragraph, the parent, legal custodian, or guardian shall be notified by
86.11the responsible local welfare or law enforcement agency no later than the conclusion of
86.12the investigation or assessment that this interview has occurred. Notwithstanding rule 32
86.13of the Minnesota Rules of Procedure for Juvenile Courts, the juvenile court may, after
86.14hearing on an ex parte motion by the local welfare agency, order that, where reasonable
86.15cause exists, the agency withhold notification of this interview from the parent, legal
86.16custodian, or guardian. If the interview took place or is to take place on school property,
86.17the order shall specify that school officials may not disclose to the parent, legal custodian,
86.18or guardian the contents of the notification of intent to interview the child on school
86.19property, as provided under this paragraph, and any other related information regarding
86.20the interview that may be a part of the child's school record. A copy of the order shall be
86.21sent by the local welfare or law enforcement agency to the appropriate school official.
86.22    (d) (e) When the local welfare, local law enforcement agency, or the agency
86.23responsible for assessing or investigating a report of maltreatment determines that an
86.24interview should take place on school property, written notification of intent to interview
86.25the child on school property must be received by school officials prior to the interview.
86.26The notification shall include the name of the child to be interviewed, the purpose of the
86.27interview, and a reference to the statutory authority to conduct an interview on school
86.28property. For interviews conducted by the local welfare agency, the notification shall
86.29be signed by the chair of the local social services agency or the chair's designee. The
86.30notification shall be private data on individuals subject to the provisions of this paragraph.
86.31School officials may not disclose to the parent, legal custodian, or guardian the contents
86.32of the notification or any other related information regarding the interview until notified
86.33in writing by the local welfare or law enforcement agency that the investigation or
86.34assessment has been concluded, unless a school employee or agent is alleged to have
86.35maltreated the child. Until that time, the local welfare or law enforcement agency or the
87.1agency responsible for assessing or investigating a report of maltreatment shall be solely
87.2responsible for any disclosures regarding the nature of the assessment or investigation.
87.3    Except where the alleged offender is believed to be a school official or employee,
87.4the time and place, and manner of the interview on school premises shall be within the
87.5discretion of school officials, but the local welfare or law enforcement agency shall have
87.6the exclusive authority to determine who may attend the interview. The conditions as to
87.7time, place, and manner of the interview set by the school officials shall be reasonable and
87.8the interview shall be conducted not more than 24 hours after the receipt of the notification
87.9unless another time is considered necessary by agreement between the school officials and
87.10the local welfare or law enforcement agency. Where the school fails to comply with the
87.11provisions of this paragraph, the juvenile court may order the school to comply. Every
87.12effort must be made to reduce the disruption of the educational program of the child, other
87.13students, or school staff when an interview is conducted on school premises.
87.14    (e) (f) Where the alleged offender or a person responsible for the care of the alleged
87.15victim or other minor prevents access to the victim or other minor by the local welfare
87.16agency, the juvenile court may order the parents, legal custodian, or guardian to produce
87.17the alleged victim or other minor for questioning by the local welfare agency or the local
87.18law enforcement agency outside the presence of the alleged offender or any person
87.19responsible for the child's care at reasonable places and times as specified by court order.
87.20    (f) (g) Before making an order under paragraph (e) (f), the court shall issue an order
87.21to show cause, either upon its own motion or upon a verified petition, specifying the basis
87.22for the requested interviews and fixing the time and place of the hearing. The order to
87.23show cause shall be served personally and shall be heard in the same manner as provided
87.24in other cases in the juvenile court. The court shall consider the need for appointment of a
87.25guardian ad litem to protect the best interests of the child. If appointed, the guardian ad
87.26litem shall be present at the hearing on the order to show cause.
87.27    (g) (h) The commissioner of human services, the ombudsman for mental health and
87.28developmental disabilities, the local welfare agencies responsible for investigating reports,
87.29the commissioner of education, and the local law enforcement agencies have the right to
87.30enter facilities as defined in subdivision 2 and to inspect and copy the facility's records,
87.31including medical records, as part of the investigation. Notwithstanding the provisions of
87.32chapter 13, they also have the right to inform the facility under investigation that they are
87.33conducting an investigation, to disclose to the facility the names of the individuals under
87.34investigation for abusing or neglecting a child, and to provide the facility with a copy of
87.35the report and the investigative findings.
88.1    (h) (i) The local welfare agency responsible for conducting a family assessment or
88.2investigation shall collect available and relevant information to determine child safety,
88.3risk of subsequent child maltreatment, and family strengths and needs and share not public
88.4information with an Indian's tribal social services agency without violating any law of the
88.5state that may otherwise impose duties of confidentiality on the local welfare agency in
88.6order to implement the tribal state agreement. The local welfare agency or the agency
88.7responsible for investigating the report shall collect available and relevant information
88.8to ascertain whether maltreatment occurred and whether protective services are needed.
88.9Information collected includes, when relevant, information with regard to the person
88.10reporting the alleged maltreatment, including the nature of the reporter's relationship to the
88.11child and to the alleged offender, and the basis of the reporter's knowledge for the report;
88.12the child allegedly being maltreated; the alleged offender; the child's caretaker; and other
88.13collateral sources having relevant information related to the alleged maltreatment. The
88.14local welfare agency or the agency responsible for investigating the report may make a
88.15determination of no maltreatment early in an investigation, and close the case and retain
88.16immunity, if the collected information shows no basis for a full investigation.
88.17    Information relevant to the assessment or investigation must be asked for, and
88.18may include:
88.19    (1) the child's sex and age,; prior reports of maltreatment, including any
88.20maltreatment reports that were screened out and not accepted for assessment or
88.21investigation; information relating to developmental functioning,; credibility of the child's
88.22statement,; and whether the information provided under this clause is consistent with other
88.23information collected during the course of the assessment or investigation;
88.24    (2) the alleged offender's age, a record check for prior reports of maltreatment, and
88.25criminal charges and convictions. The local welfare agency or the agency responsible for
88.26assessing or investigating the report must provide the alleged offender with an opportunity
88.27to make a statement. The alleged offender may submit supporting documentation relevant
88.28to the assessment or investigation;
88.29    (3) collateral source information regarding the alleged maltreatment and care of the
88.30child. Collateral information includes, when relevant: (i) a medical examination of the
88.31child; (ii) prior medical records relating to the alleged maltreatment or the care of the
88.32child maintained by any facility, clinic, or health care professional and an interview with
88.33the treating professionals; and (iii) interviews with the child's caretakers, including the
88.34child's parent, guardian, foster parent, child care provider, teachers, counselors, family
88.35members, relatives, and other persons who may have knowledge regarding the alleged
88.36maltreatment and the care of the child; and
89.1    (4) information on the existence of domestic abuse and violence in the home of
89.2the child, and substance abuse.
89.3    Nothing in this paragraph precludes the local welfare agency, the local law
89.4enforcement agency, or the agency responsible for assessing or investigating the report
89.5from collecting other relevant information necessary to conduct the assessment or
89.6investigation. Notwithstanding sections 13.384 or 144.291 to 144.298, the local welfare
89.7agency has access to medical data and records for purposes of clause (3). Notwithstanding
89.8the data's classification in the possession of any other agency, data acquired by the
89.9local welfare agency or the agency responsible for assessing or investigating the report
89.10during the course of the assessment or investigation are private data on individuals and
89.11must be maintained in accordance with subdivision 11. Data of the commissioner of
89.12education collected or maintained during and for the purpose of an investigation of
89.13alleged maltreatment in a school are governed by this section, notwithstanding the data's
89.14classification as educational, licensing, or personnel data under chapter 13.
89.15    In conducting an assessment or investigation involving a school facility as defined
89.16in subdivision 2, paragraph (i), the commissioner of education shall collect investigative
89.17reports and data that are relevant to a report of maltreatment and are from local law
89.18enforcement and the school facility.
89.19    (i) (j) Upon receipt of a report, the local welfare agency shall conduct a face-to-face
89.20contact with the child reported to be maltreated and with the child's primary caregiver
89.21sufficient to complete a safety assessment and ensure the immediate safety of the child.
89.22The face-to-face contact with the child and primary caregiver shall occur immediately
89.23if sexual abuse or substantial child endangerment is alleged and within five calendar
89.24days for all other reports. If the alleged offender was not already interviewed as the
89.25primary caregiver, the local welfare agency shall also conduct a face-to-face interview
89.26with the alleged offender in the early stages of the assessment or investigation. At the
89.27initial contact, the local child welfare agency or the agency responsible for assessing or
89.28investigating the report must inform the alleged offender of the complaints or allegations
89.29made against the individual in a manner consistent with laws protecting the rights of the
89.30person who made the report. The interview with the alleged offender may be postponed if
89.31it would jeopardize an active law enforcement investigation.
89.32    (j) (k) When conducting an investigation, the local welfare agency shall use a
89.33question and answer interviewing format with questioning as nondirective as possible to
89.34elicit spontaneous responses. For investigations only, the following interviewing methods
89.35and procedures must be used whenever possible when collecting information:
89.36    (1) audio recordings of all interviews with witnesses and collateral sources; and
90.1    (2) in cases of alleged sexual abuse, audio-video recordings of each interview with
90.2the alleged victim and child witnesses.
90.3    (k) (l) In conducting an assessment or investigation involving a school facility
90.4as defined in subdivision 2, paragraph (i), the commissioner of education shall collect
90.5available and relevant information and use the procedures in paragraphs (i), (j) and (k),
90.6and subdivision 3d, except that the requirement for face-to-face observation of the child
90.7and face-to-face interview of the alleged offender is to occur in the initial stages of the
90.8assessment or investigation provided that the commissioner may also base the assessment
90.9or investigation on investigative reports and data received from the school facility and
90.10local law enforcement, to the extent those investigations satisfy the requirements of
90.11paragraphs (i) and (j) and (k), and subdivision 3d.

90.12    Sec. 95. Minnesota Statutes 2014, section 626.556, subdivision 10e, is amended to read:
90.13    Subd. 10e. Determinations. (a) The local welfare agency shall conclude the family
90.14assessment or the investigation within 45 days of the receipt of a report. The conclusion of
90.15the assessment or investigation may be extended to permit the completion of a criminal
90.16investigation or the receipt of expert information requested within 45 days of the receipt
90.17of the report.
90.18    (b) After conducting a family assessment, the local welfare agency shall determine
90.19whether services are needed to address the safety of the child and other family members
90.20and the risk of subsequent maltreatment.
90.21    (c) After conducting an investigation, the local welfare agency shall make two
90.22determinations: first, whether maltreatment has occurred; and second, whether child
90.23protective services are needed. No determination of maltreatment shall be made when the
90.24alleged perpetrator is a child under the age of ten.
90.25    (d) If the commissioner of education conducts an assessment or investigation,
90.26the commissioner shall determine whether maltreatment occurred and what corrective
90.27or protective action was taken by the school facility. If a determination is made that
90.28maltreatment has occurred, the commissioner shall report to the employer, the school
90.29board, and any appropriate licensing entity the determination that maltreatment occurred
90.30and what corrective or protective action was taken by the school facility. In all other cases,
90.31the commissioner shall inform the school board or employer that a report was received,
90.32the subject of the report, the date of the initial report, the category of maltreatment alleged
90.33as defined in paragraph (f), the fact that maltreatment was not determined, and a summary
90.34of the specific reasons for the determination.
91.1    (e) When maltreatment is determined in an investigation involving a facility,
91.2the investigating agency shall also determine whether the facility or individual was
91.3responsible, or whether both the facility and the individual were responsible for the
91.4maltreatment using the mitigating factors in paragraph (i). Determinations under this
91.5subdivision must be made based on a preponderance of the evidence and are private data
91.6on individuals or nonpublic data as maintained by the commissioner of education.
91.7    (f) For the purposes of this subdivision, "maltreatment" means any of the following
91.8acts or omissions:
91.9    (1) physical abuse as defined in subdivision 2, paragraph (g);
91.10    (2) neglect as defined in subdivision 2, paragraph (f);
91.11    (3) sexual abuse as defined in subdivision 2, paragraph (d);
91.12    (4) mental injury as defined in subdivision 2, paragraph (m); or
91.13    (5) maltreatment of a child in a facility as defined in subdivision 2, paragraph (i).
91.14    (g) For the purposes of this subdivision, a determination that child protective
91.15services are needed means that the local welfare agency has documented conditions
91.16during the assessment or investigation sufficient to cause a child protection worker, as
91.17defined in section 626.559, subdivision 1, to conclude that a child is at significant risk of
91.18maltreatment if protective intervention is not provided and that the individuals responsible
91.19for the child's care have not taken or are not likely to take actions to protect the child
91.20from maltreatment or risk of maltreatment.
91.21    (h) This subdivision does not mean that maltreatment has occurred solely because
91.22the child's parent, guardian, or other person responsible for the child's care in good faith
91.23selects and depends upon spiritual means or prayer for treatment or care of disease
91.24or remedial care of the child, in lieu of medical care. However, if lack of medical care
91.25may result in serious danger to the child's health, the local welfare agency may ensure
91.26that necessary medical services are provided to the child.
91.27    (i) When determining whether the facility or individual is the responsible party, or
91.28whether both the facility and the individual are responsible for determined maltreatment in
91.29a facility, the investigating agency shall consider at least the following mitigating factors:
91.30    (1) whether the actions of the facility or the individual caregivers were according to,
91.31and followed the terms of, an erroneous physician order, prescription, individual care plan,
91.32or directive; however, this is not a mitigating factor when the facility or caregiver was
91.33responsible for the issuance of the erroneous order, prescription, individual care plan, or
91.34directive or knew or should have known of the errors and took no reasonable measures to
91.35correct the defect before administering care;
92.1    (2) comparative responsibility between the facility, other caregivers, and
92.2requirements placed upon an employee, including the facility's compliance with related
92.3regulatory standards and the adequacy of facility policies and procedures, facility training,
92.4an individual's participation in the training, the caregiver's supervision, and facility staffing
92.5levels and the scope of the individual employee's authority and discretion; and
92.6    (3) whether the facility or individual followed professional standards in exercising
92.7professional judgment.
92.8The evaluation of the facility's responsibility under clause (2) must not be based on the
92.9completeness of the risk assessment or risk reduction plan required under section 245A.66,
92.10but must be based on the facility's compliance with the regulatory standards for policies and
92.11procedures, training, and supervision as cited in Minnesota Statutes and Minnesota Rules.
92.12    (j) Notwithstanding paragraph (i), when maltreatment is determined to have been
92.13committed by an individual who is also the facility license holder, both the individual and
92.14the facility must be determined responsible for the maltreatment, and both the background
92.15study disqualification standards under section 245C.15, subdivision 4, and the licensing
92.16actions under sections 245A.06 or 245A.07 apply.
92.17(k) Individual counties may implement more detailed definitions or criteria that
92.18indicate which allegations to investigate, as long as a county's policies are consistent
92.19with the definitions in the statutes and rules and are approved by the county board. Each
92.20local welfare agency shall periodically inform mandated reporters under subdivision 3
92.21who work in the county of the definitions of maltreatment in the statutes and rules and any
92.22additional definitions or criteria that have been approved by the county board.

92.23    Sec. 96. Minnesota Statutes 2014, section 626.556, subdivision 10j, is amended to read:
92.24    Subd. 10j. Release of data to mandated reporters. (a) A local social services or
92.25child protection agency, or the agency responsible for assessing or investigating the report
92.26of maltreatment, may shall provide relevant private data on individuals obtained under
92.27this section to a mandated reporters reporter who made the report and who have has an
92.28ongoing responsibility for the health, education, or welfare of a child affected by the data,
92.29unless the agency determines that providing the data would not be in the best interests
92.30of the child. The agency may provide the data to other mandated reporters with ongoing
92.31responsibility for the health, education, or welfare of the child. Mandated reporters with
92.32ongoing responsibility for the health, education, or welfare of a child affected by the data
92.33include the child's teachers or other appropriate school personnel, foster parents, health
92.34care providers, respite care workers, therapists, social workers, child care providers,
92.35residential care staff, crisis nursery staff, probation officers, and court services personnel.
93.1Under this section, a mandated reporter need not have made the report to be considered a
93.2person with ongoing responsibility for the health, education, or welfare of a child affected
93.3by the data. Data provided under this section must be limited to data pertinent to the
93.4individual's responsibility for caring for the child.
93.5(b) A reporter who receives private data on individuals under this subdivision must
93.6treat the data according to that classification, regardless of whether the reporter is an
93.7employee of a government entity. The remedies and penalties under sections 13.08 and
93.813.09 apply if a reporter releases data in violation of this section or other law.

93.9    Sec. 97. Minnesota Statutes 2014, section 626.556, subdivision 10m, is amended to
93.10read:
93.11    Subd. 10m. Provision of child protective services; consultation with county
93.12attorney. (a) The local welfare agency shall create a written plan, in collaboration with
93.13the family whenever possible, within 30 days of the determination that child protective
93.14services are needed or upon joint agreement of the local welfare agency and the family
93.15that family support and preservation services are needed. Child protective services for a
93.16family are voluntary unless ordered by the court.
93.17(b) The local welfare agency shall consult with the county attorney to determine the
93.18appropriateness of filing a petition alleging the child is in need of protection or services
93.19under section 260C.007, subdivision 6, if:
93.20(1) the family does not accept or comply with a plan for child protective services;
93.21(2) voluntary child protective services may not provide sufficient protection for the
93.22child; or
93.23(3) the family is not cooperating with an investigation or assessment.

93.24    Sec. 98. Minnesota Statutes 2014, section 626.556, subdivision 11c, is amended to read:
93.25    Subd. 11c. Welfare, court services agency, and school records maintained.
93.26    Notwithstanding sections 138.163 and 138.17, records maintained or records derived
93.27from reports of abuse by local welfare agencies, agencies responsible for assessing or
93.28investigating the report, court services agencies, or schools under this section shall be
93.29destroyed as provided in paragraphs (a) to (d) by the responsible authority.
93.30    (a) For reports alleging child maltreatment that were not accepted for assessment
93.31or investigation, family assessment cases, and cases where an investigation results in no
93.32determination of maltreatment or the need for child protective services, the assessment or
93.33investigation records must be maintained for a period of four five years after the date the
93.34report was not accepted for assessment or investigation or of the final entry in the case
94.1record. Records of reports that were not accepted must contain sufficient information to
94.2identify the subjects of the report, the nature of the alleged maltreatment, and the reasons
94.3as to why the report was not accepted. Records under this paragraph may not be used for
94.4employment, background checks, or purposes other than to assist in future screening
94.5decisions and risk and safety assessments.
94.6    (b) All records relating to reports which, upon investigation, indicate either
94.7maltreatment or a need for child protective services shall be maintained for ten years after
94.8the date of the final entry in the case record.
94.9    (c) All records regarding a report of maltreatment, including any notification of intent
94.10to interview which was received by a school under subdivision 10, paragraph (d), shall be
94.11destroyed by the school when ordered to do so by the agency conducting the assessment or
94.12investigation. The agency shall order the destruction of the notification when other records
94.13relating to the report under investigation or assessment are destroyed under this subdivision.
94.14    (d) Private or confidential data released to a court services agency under subdivision
94.1510h must be destroyed by the court services agency when ordered to do so by the local
94.16welfare agency that released the data. The local welfare agency or agency responsible for
94.17assessing or investigating the report shall order destruction of the data when other records
94.18relating to the assessment or investigation are destroyed under this subdivision.
94.19(e) For reports alleging child maltreatment that were not accepted for assessment
94.20or investigation, counties shall maintain sufficient information to identify repeat reports
94.21alleging maltreatment of the same child or children for 365 days from the date the report
94.22was screened out. The commissioner of human services shall specify to the counties the
94.23minimum information needed to accomplish this purpose. Counties shall enter this data
94.24into the state social services information system.

94.25    Sec. 99. Minnesota Statutes 2014, section 626.556, is amended by adding a subdivision
94.26to read:
94.27    Subd. 16. Commissioner's duty to provide oversight; quality assurance reviews;
94.28annual summary of reviews. (a) The commissioner shall develop a plan to perform
94.29quality assurance reviews of local welfare agency screening practices and decisions.
94.30The commissioner shall provide oversight and guidance to counties to ensure consistent
94.31application of screening guidelines, thorough and appropriate screening decisions, and
94.32correct documentation and maintenance of reports. Quality assurance reviews must begin
94.33no later than September 30, 2015.
94.34(b) The commissioner shall produce an annual report of the summary results of the
94.35reviews. The report must only contain aggregate data and may not include any data that
95.1could be used to personally identify any subject whose data is included in the report. The
95.2report is public information and must be provided to the chairs and ranking minority
95.3members of the legislative committees having jurisdiction over child protection issues.

95.4    Sec. 100. Minnesota Statutes 2014, section 626.559, is amended by adding a
95.5subdivision to read:
95.6    Subd. 1b. Background studies. (a) County employees hired on or after July 1,
95.72015, who have responsibility for child protection duties or current county employees who
95.8are assigned new child protection duties on or after July 1, 2015, are required to undergo a
95.9background study. A county may complete these background studies by either:
95.10(1) use of the Department of Human Services NetStudy 2.0 system according to
95.11sections 245C.03 and 245C.10; or
95.12(2) an alternative process defined by the county.
95.13(b) County social services agencies and local welfare agencies must initiate
95.14background studies before an individual begins a position allowing direct contact with
95.15persons served by the agency.

95.16    Sec. 101. Laws 2014, chapter 189, section 5, is amended to read:
95.17    Sec. 5. Minnesota Statutes 2012, section 518C.201, is amended to read:
95.18518C.201 BASES FOR JURISDICTION OVER NONRESIDENT.
95.19(a) In a proceeding to establish, or enforce, or modify a support order or to determine
95.20parentage of a child, a tribunal of this state may exercise personal jurisdiction over a
95.21nonresident individual or the individual's guardian or conservator if:
95.22(1) the individual is personally served with a summons or comparable document
95.23within this state;
95.24(2) the individual submits to the jurisdiction of this state by consent, by entering a
95.25general appearance, or by filing a responsive document having the effect of waiving any
95.26contest to personal jurisdiction;
95.27(3) the individual resided with the child in this state;
95.28(4) the individual resided in this state and provided prenatal expenses or support
95.29for the child;
95.30(5) the child resides in this state as a result of the acts or directives of the individual;
95.31(6) the individual engaged in sexual intercourse in this state and the child may have
95.32been conceived by that act of intercourse;
95.33(7) the individual asserted parentage of a child under sections 257.51 to 257.75; or
96.1(8) there is any other basis consistent with the constitutions of this state and the
96.2United States for the exercise of personal jurisdiction.
96.3(b) The bases of personal jurisdiction in paragraph (a) or in any other law of this state
96.4may not be used to acquire personal jurisdiction for a tribunal of this state to modify a child
96.5support order of another state unless the requirements of section 518C.611 are met, or, in
96.6the case of a foreign support order, unless the requirements of section 518C.615 are met.

96.7    Sec. 102. Laws 2014, chapter 189, section 9, is amended to read:
96.8    Sec. 9. Minnesota Statutes 2012, section 518C.205, is amended to read:
96.9518C.205 CONTINUING, EXCLUSIVE JURISDICTION TO MODIFY
96.10CHILD SUPPORT ORDER.
96.11    (a) A tribunal of this state that has issued a support order consistent with the law
96.12of this state has and shall exercise continuing, exclusive jurisdiction to modify its child
96.13support order if the order is the controlling order and:
96.14    (1) at the time of the filing of a request for modification this state is the residence of the
96.15obligor, the individual obligee, or the child for whose benefit the support order is issued; or
96.16    (2) even if this state is not the residence of the obligor, the individual obligee, or the
96.17child for whose benefit the support order is issued, the parties consent in a record or in open
96.18court that the tribunal of this state may continue to exercise jurisdiction to modify its order.
96.19    (b) A tribunal of this state that has issued a child support order consistent with the
96.20law of this state may not exercise continuing, exclusive jurisdiction to modify the order if:
96.21    (1) all of the parties who are individuals file consent in a record with the tribunal of
96.22this state that a tribunal of another state that has jurisdiction over at least one of the parties
96.23who is an individual or that is located in the state of residence of the child may modify
96.24the order and assume continuing, exclusive jurisdiction; or
96.25    (2) its order is not the controlling order.
96.26    (c) If a tribunal of another state has issued a child support order pursuant to this
96.27chapter or a law substantially similar to this chapter the Uniform Interstate Family Support
96.28Act which modifies a child support order of a tribunal of this state, tribunals of this state
96.29shall recognize the continuing, exclusive jurisdiction of the tribunal of the other state.
96.30    (d) A tribunal of this state that lacks continuing, exclusive jurisdiction to modify a
96.31child support order may serve as an initiating tribunal to request a tribunal of another state
96.32to modify a support order issued in that state.
96.33    (e) A temporary support order issued ex parte or pending resolution of a jurisdictional
96.34conflict does not create continuing, exclusive jurisdiction in the issuing tribunal.

97.1    Sec. 103. Laws 2014, chapter 189, section 10, is amended to read:
97.2    Sec. 10. Minnesota Statutes 2012, section 518C.206, is amended to read:
97.3518C.206 ENFORCEMENT AND MODIFICATION OF SUPPORT ORDER
97.4BY TRIBUNAL HAVING CONTINUING JURISDICTION TO ENFORCE CHILD
97.5SUPPORT ORDER.
97.6(a) A tribunal of this state that has issued a child support order consistent with the
97.7law of this state may serve as an initiating tribunal to request a tribunal of another state
97.8to enforce:
97.9(1) the order if the order is the controlling order and has not been modified by
97.10a tribunal of another state that assumed jurisdiction pursuant to this chapter or a law
97.11substantially similar to this chapter the Uniform Interstate Family Support Act; or
97.12(2) a money judgment for arrears of support and interest on the order accrued before
97.13a determination that an order of a tribunal of another state is the controlling order.
97.14(b) A tribunal of this state having continuing, exclusive jurisdiction over a support
97.15order may act as a responding tribunal to enforce the order.

97.16    Sec. 104. Laws 2014, chapter 189, section 11, is amended to read:
97.17    Sec. 11. Minnesota Statutes 2012, section 518C.207, is amended to read:
97.18518C.207 RECOGNITION DETERMINATION OF CONTROLLING CHILD
97.19SUPPORT ORDER.
97.20(a) If a proceeding is brought under this chapter and only one tribunal has issued a
97.21child support order, the order of that tribunal is controlling controls and must be recognized.
97.22(b) If a proceeding is brought under this chapter, and two or more child support
97.23orders have been issued by tribunals of this state, another state, or a foreign country with
97.24regard to the same obligor and child, a tribunal of this state having personal jurisdiction
97.25over both the obligor and the individual obligee shall apply the following rules and by
97.26order shall determine which order controls and must be recognized:
97.27(1) If only one of the tribunals would have continuing, exclusive jurisdiction under
97.28this chapter, the order of that tribunal is controlling controls.
97.29(2) If more than one of the tribunals would have continuing, exclusive jurisdiction
97.30under this chapter:
97.31(i) an order issued by a tribunal in the current home state of the child controls; or
97.32(ii) if an order has not been issued in the current home state of the child, the order
97.33most recently issued controls.
97.34(3) If none of the tribunals would have continuing, exclusive jurisdiction under this
97.35chapter, the tribunal of this state shall issue a child support order, which controls.
98.1(c) If two or more child support orders have been issued for the same obligor and
98.2child, upon request of a party who is an individual or that is a support enforcement agency,
98.3a tribunal of this state having personal jurisdiction over both the obligor and the obligee
98.4who is an individual shall determine which order controls under paragraph (b). The
98.5request may be filed with a registration for enforcement or registration for modification
98.6pursuant to sections 518C.601 to 518C.616, or may be filed as a separate proceeding.
98.7(d) A request to determine which is the controlling order must be accompanied
98.8by a copy of every child support order in effect and the applicable record of payments.
98.9The requesting party shall give notice of the request to each party whose rights may
98.10be affected by the determination.
98.11(e) The tribunal that issued the controlling order under paragraph (a), (b), or (c) has
98.12continuing jurisdiction to the extent provided in section 518C.205, or 518C.206.
98.13(f) A tribunal of this state which determines by order which is the controlling order
98.14under paragraph (b), clause (1) or (2), or paragraph (c), or which issues a new controlling
98.15child support order under paragraph (b), clause (3), shall state in that order:
98.16(1) the basis upon which the tribunal made its determination;
98.17(2) the amount of prospective support, if any; and
98.18(3) the total amount of consolidated arrears and accrued interest, if any, under all of
98.19the orders after all payments made are credited as provided by section 518C.209.
98.20(g) Within 30 days after issuance of the order determining which is the controlling
98.21order, the party obtaining that order shall file a certified copy of it with each tribunal that
98.22issued or registered an earlier order of child support. A party or support enforcement
98.23agency obtaining the order that fails to file a certified copy is subject to appropriate
98.24sanctions by a tribunal in which the issue of failure to file arises. The failure to file does
98.25not affect the validity or enforceability of the controlling order.
98.26(h) An order that has been determined to be the controlling order, or a judgment for
98.27consolidated arrears of support and interest, if any, made pursuant to this section must be
98.28recognized in proceedings under this chapter.

98.29    Sec. 105. Laws 2014, chapter 189, section 16, is amended to read:
98.30    Sec. 16. Minnesota Statutes 2012, section 518C.301, is amended to read:
98.31518C.301 PROCEEDINGS UNDER THIS CHAPTER.
98.32(a) Except as otherwise provided in this chapter, sections 518C.301 to 518C.319
98.33apply to all proceedings under this chapter.
98.34(b) This chapter provides for the following proceedings:
99.1(1) establishment of an order for spousal support or child support pursuant to
99.2section 518C.401;
99.3(2) enforcement of a support order and income-withholding order of another state or
99.4a foreign country without registration pursuant to sections 518C.501 and 518C.502;
99.5(3) registration of an order for spousal support or child support of another state or a
99.6foreign country for enforcement pursuant to sections 518C.601 to 518C.612;
99.7(4) modification of an order for child support or spousal support issued by a tribunal
99.8of this state pursuant to sections 518C.203 to 518C.206;
99.9(5) registration of an order for child support of another state or a foreign country for
99.10modification pursuant to sections 518C.601 to 518C.612;
99.11(6) determination of parentage of a child pursuant to section 518C.701; and
99.12(7) assertion of jurisdiction over nonresidents pursuant to sections 518C.201 and
99.13518C.202.
99.14(c) (b) An individual petitioner or a support enforcement agency may commence
99.15a proceeding authorized under this chapter by filing a petition in an initiating tribunal
99.16for forwarding to a responding tribunal or by filing a petition or a comparable pleading
99.17directly in a tribunal of another state or a foreign country which has or can obtain personal
99.18jurisdiction over the respondent.

99.19    Sec. 106. Laws 2014, chapter 189, section 17, is amended to read:
99.20    Sec. 17. Minnesota Statutes 2012, section 518C.303, is amended to read:
99.21518C.303 APPLICATION OF LAW OF THIS STATE.
99.22Except as otherwise provided by this chapter, a responding tribunal of this state shall:
99.23(1) apply the procedural and substantive law, including the rules on choice of law,
99.24generally applicable to similar proceedings originating in this state and may exercise all
99.25powers and provide all remedies available in those proceedings; and
99.26(2) determine the duty of support and the amount payable in accordance with the
99.27law and support guidelines of this state.

99.28    Sec. 107. Laws 2014, chapter 189, section 18, is amended to read:
99.29    Sec. 18. Minnesota Statutes 2012, section 518C.304, is amended to read:
99.30518C.304 DUTIES OF INITIATING TRIBUNAL.
99.31(a) Upon the filing of a petition authorized by this chapter, an initiating tribunal of
99.32this state shall forward the petition and its accompanying documents:
99.33(1) to the responding tribunal or appropriate support enforcement agency in the
99.34responding state; or
100.1(2) if the identity of the responding tribunal is unknown, to the state information
100.2agency of the responding state with a request that they be forwarded to the appropriate
100.3tribunal and that receipt be acknowledged.
100.4(b) If requested by the responding tribunal, a tribunal of this state shall issue a
100.5certificate or other documents and make findings required by the law of the responding
100.6state. If the responding tribunal is in a foreign country, upon request the tribunal of this
100.7state shall specify the amount of support sought, convert that amount into the equivalent
100.8amount in the foreign currency under applicable official or market exchange rate as
100.9publicly reported, and provide other documents necessary to satisfy the requirements of
100.10the responding foreign tribunal.

100.11    Sec. 108. Laws 2014, chapter 189, section 19, is amended to read:
100.12    Sec. 19. Minnesota Statutes 2012, section 518C.305, is amended to read:
100.13518C.305 DUTIES AND POWERS OF RESPONDING TRIBUNAL.
100.14(a) When a responding tribunal of this state receives a petition or comparable
100.15pleading from an initiating tribunal or directly pursuant to section 518C.301, paragraph (c)
100.16(b) , it shall cause the petition or pleading to be filed and notify the petitioner where and
100.17when it was filed.
100.18(b) A responding tribunal of this state, to the extent otherwise authorized by not
100.19prohibited by other law, may do one or more of the following:
100.20(1) establish or enforce a support order, modify a child support order, determine the
100.21controlling child support order, or to determine parentage of a child;
100.22(2) order an obligor to comply with a support order, specifying the amount and
100.23the manner of compliance;
100.24(3) order income withholding;
100.25(4) determine the amount of any arrearages, and specify a method of payment;
100.26(5) enforce orders by civil or criminal contempt, or both;
100.27(6) set aside property for satisfaction of the support order;
100.28(7) place liens and order execution on the obligor's property;
100.29(8) order an obligor to keep the tribunal informed of the obligor's current residential
100.30address, electronic mail address, telephone number, employer, address of employment,
100.31and telephone number at the place of employment;
100.32(9) issue a bench warrant for an obligor who has failed after proper notice to appear
100.33at a hearing ordered by the tribunal and enter the bench warrant in any local and state
100.34computer systems for criminal warrants;
100.35(10) order the obligor to seek appropriate employment by specified methods;
101.1(11) award reasonable attorney's fees and other fees and costs; and
101.2(12) grant any other available remedy.
101.3(c) A responding tribunal of this state shall include in a support order issued under
101.4this chapter, or in the documents accompanying the order, the calculations on which
101.5the support order is based.
101.6(d) A responding tribunal of this state may not condition the payment of a support
101.7order issued under this chapter upon compliance by a party with provisions for visitation.
101.8(e) If a responding tribunal of this state issues an order under this chapter, the
101.9tribunal shall send a copy of the order to the petitioner and the respondent and to the
101.10initiating tribunal, if any.
101.11(f) If requested to enforce a support order, arrears, or judgment or modify a support
101.12order stated in a foreign currency, a responding tribunal of this state shall convert the
101.13amount stated in the foreign currency to the equivalent amount in dollars under the
101.14applicable official or market exchange rate as publicly reported.

101.15    Sec. 109. Laws 2014, chapter 189, section 23, is amended to read:
101.16    Sec. 23. Minnesota Statutes 2012, section 518C.310, is amended to read:
101.17518C.310 DUTIES OF STATE INFORMATION AGENCY.
101.18(a) The unit within the Department of Human Services that receives and disseminates
101.19incoming interstate actions under title IV-D of the Social Security Act is the State
101.20Information Agency under this chapter.
101.21(b) The State Information Agency shall:
101.22(1) compile and maintain a current list, including addresses, of the tribunals in this
101.23state which have jurisdiction under this chapter and any support enforcement agencies in
101.24this state and transmit a copy to the state information agency of every other state;
101.25(2) maintain a register of names and addresses of tribunals and support enforcement
101.26agencies received from other states;
101.27(3) forward to the appropriate tribunal in the place in this state in which the
101.28individual obligee or the obligor resides, or in which the obligor's property is believed
101.29to be located, all documents concerning a proceeding under this chapter received from
101.30another state or a foreign country; and
101.31(4) obtain information concerning the location of the obligor and the obligor's
101.32property within this state not exempt from execution, by such means as postal verification
101.33and federal or state locator services, examination of telephone directories, requests for the
101.34obligor's address from employers, and examination of governmental records, including, to
102.1the extent not prohibited by other law, those relating to real property, vital statistics, law
102.2enforcement, taxation, motor vehicles, driver's licenses, and Social Security.

102.3    Sec. 110. Laws 2014, chapter 189, section 24, is amended to read:
102.4    Sec. 24. Minnesota Statutes 2012, section 518C.311, is amended to read:
102.5518C.311 PLEADINGS AND ACCOMPANYING DOCUMENTS.
102.6(a) A petitioner seeking to establish or modify a support order, determine parentage
102.7of a child, or register and modify a support order of a tribunal of another state or a foreign
102.8country, in a proceeding under this chapter must file a petition. Unless otherwise ordered
102.9under section 518C.312, the petition or accompanying documents must provide, so far
102.10as known, the name, residential address, and Social Security numbers of the obligor and
102.11the obligee or parent and alleged parent, and the name, sex, residential address, Social
102.12Security number, and date of birth of each child for whom support is sought or whose
102.13parenthood parentage is to be determined. Unless filed at the time of registration, the
102.14petition must be accompanied by a certified copy of any support order in effect known
102.15to have been issued by another tribunal. The petition may include any other information
102.16that may assist in locating or identifying the respondent.
102.17(b) The petition must specify the relief sought. The petition and accompanying
102.18documents must conform substantially with the requirements imposed by the forms
102.19mandated by federal law for use in cases filed by a support enforcement agency.

102.20    Sec. 111. Laws 2014, chapter 189, section 27, is amended to read:
102.21    Sec. 27. Minnesota Statutes 2012, section 518C.314, is amended to read:
102.22518C.314 LIMITED IMMUNITY OF PETITIONER.
102.23(a) Participation by a petitioner in a proceeding under this chapter before a
102.24responding tribunal, whether in person, by private attorney, or through services provided
102.25by the support enforcement agency, does not confer personal jurisdiction over the
102.26petitioner in another proceeding.
102.27(b) A petitioner is not amenable to service of civil process while physically present
102.28in this state to participate in a proceeding under this chapter.
102.29(c) The immunity granted by this section does not extend to civil litigation based on
102.30acts unrelated to a proceeding under this chapter committed by a party while physically
102.31present in this state to participate in the proceeding.

102.32    Sec. 112. Laws 2014, chapter 189, section 28, is amended to read:
102.33    Sec. 28. Minnesota Statutes 2012, section 518C.316, is amended to read:
103.1518C.316 SPECIAL RULES OF EVIDENCE AND PROCEDURE.
103.2(a) The physical presence of the petitioner a nonresident party who is an individual
103.3in a responding tribunal of this state is not required for the establishment, enforcement,
103.4or modification of a support order or the rendition of a judgment determining parentage
103.5of a child.
103.6(b) A verified petition, An affidavit, a document substantially complying with
103.7federally mandated forms, and or a document incorporated by reference in any of them,
103.8not excluded under the hearsay rule if given in person, is admissible in evidence if given
103.9under oath penalty of perjury by a party or witness residing outside this state.
103.10(c) A copy of the record of child support payments certified as a true copy of the
103.11original by the custodian of the record may be forwarded to a responding tribunal. The copy
103.12is evidence of facts asserted in it, and is admissible to show whether payments were made.
103.13(d) Copies of bills for testing for parentage of a child, and for prenatal and postnatal
103.14health care of the mother and child, furnished to the adverse party at least ten days before
103.15trial, are admissible in evidence to prove the amount of the charges billed and that the
103.16charges were reasonable, necessary, and customary.
103.17(e) Documentary evidence transmitted from outside this state to a tribunal of this state
103.18by telephone, telecopier, or other electronic means that do not provide an original record
103.19may not be excluded from evidence on an objection based on the means of transmission.
103.20(f) In a proceeding under this chapter, a tribunal of this state shall permit a party
103.21or witness residing outside this state to be deposed or to testify under penalty of perjury
103.22by telephone, audiovisual means, or other electronic means at a designated tribunal or
103.23other location. A tribunal of this state shall cooperate with other tribunals in designating
103.24an appropriate location for the deposition or testimony.
103.25(g) If a party called to testify at a civil hearing refuses to answer on the ground that
103.26the testimony may be self-incriminating, the trier of fact may draw an adverse inference
103.27from the refusal.
103.28(h) A privilege against disclosure of communications between spouses does not
103.29apply in a proceeding under this chapter.
103.30(i) The defense of immunity based on the relationship of husband and wife or parent
103.31and child does not apply in a proceeding under this chapter.
103.32(j) A voluntary acknowledgment of paternity, certified as a true copy, is admissible
103.33to establish parentage of a child.

103.34    Sec. 113. Laws 2014, chapter 189, section 29, is amended to read:
103.35    Sec. 29. Minnesota Statutes 2012, section 518C.317, is amended to read:
104.1518C.317 COMMUNICATIONS BETWEEN TRIBUNALS.
104.2A tribunal of this state may communicate with a tribunal outside this state in
104.3writing, by e-mail, or a record, or by telephone, electronic mail, or other means, to obtain
104.4information concerning the laws of that state, the legal effect of a judgment, decree, or
104.5order of that tribunal, and the status of a proceeding. A tribunal of this state may furnish
104.6similar information by similar means to a tribunal outside this state.

104.7    Sec. 114. Laws 2014, chapter 189, section 31, is amended to read:
104.8    Sec. 31. Minnesota Statutes 2012, section 518C.319, is amended to read:
104.9518C.319 RECEIPT AND DISBURSEMENT OF PAYMENTS.
104.10(a) A support enforcement agency or tribunal of this state shall disburse promptly
104.11any amounts received pursuant to a support order, as directed by the order. The agency
104.12or tribunal shall furnish to a requesting party or tribunal of another state or a foreign
104.13country a certified statement by the custodian of the record of the amounts and dates
104.14of all payments received.
104.15(b) If neither the obligor, not nor the obligee who is an individual, nor the child
104.16resides in this state, upon request from the support enforcement agency of this state or
104.17another state, the support enforcement agency of this state or a tribunal of this state shall:
104.18(1) direct that the support payment be made to the support enforcement agency in
104.19the state in which the obligee is receiving services; and
104.20(2) issue and send to the obligor's employer a conforming income-withholding order
104.21or an administrative notice of change of payee, reflecting the redirected payments.
104.22(c) The support enforcement agency of this state receiving redirected payments from
104.23another state pursuant to a law similar to paragraph (b) shall furnish to a requesting party
104.24or tribunal of the other state a certified statement by the custodian of the record of the
104.25amount and dates of all payments received.

104.26    Sec. 115. Laws 2014, chapter 189, section 43, is amended to read:
104.27    Sec. 43. Minnesota Statutes 2012, section 518C.604, is amended to read:
104.28518C.604 CHOICE OF LAW.
104.29(a) Except as otherwise provided in paragraph (d), the law of the issuing state or
104.30foreign country governs:
104.31(1) the nature, extent, amount, and duration of current payments under a registered
104.32support order;
104.33(2) the computation and payment of arrearages and accrual of interest on the
104.34arrearages under the support order; and
105.1(3) the existence and satisfaction of other obligations under the support order.
105.2(b) In a proceeding for arrearages under a registered support order, the statute of
105.3limitation under the laws of this state or of the issuing state or foreign country, whichever
105.4is longer, applies.
105.5(c) A responding tribunal of this state shall apply the procedures and remedies of
105.6this state to enforce current support and collect arrears and interest due on a support order
105.7of another state or a foreign country registered in this state.
105.8(d) After a tribunal of this state or another state determines which is the controlling
105.9order and issues an order consolidating arrears, if any, a tribunal of this state shall
105.10prospectively apply the law of the state or foreign country issuing the controlling order,
105.11including its law on interest on arrears, on current and future support, and on consolidated
105.12arrears.

105.13    Sec. 116. Laws 2014, chapter 189, section 50, is amended to read:
105.14    Sec. 50. Minnesota Statutes 2012, section 518C.611, is amended to read:
105.15518C.611 MODIFICATION OF CHILD SUPPORT ORDER OF ANOTHER
105.16STATE.
105.17(a) If section 518C.613 does not apply, upon petition a tribunal of this state may
105.18modify a child support order issued in another state that is registered in this state if, after
105.19notice and hearing, it finds that:
105.20(1) the following requirements are met:
105.21(i) neither the child, nor the obligee who is an individual, nor the obligor resides
105.22in the issuing state;
105.23(ii) a petitioner who is a nonresident of this state seeks modification; and
105.24(iii) the respondent is subject to the personal jurisdiction of the tribunal of this state; or
105.25(2) this state is the residence of the child, or a party who is an individual is subject to
105.26the personal jurisdiction of the tribunal of this state and all of the parties who are individuals
105.27have filed written consents in a record in the issuing tribunal for a tribunal of this state to
105.28modify the support order and assume continuing, exclusive jurisdiction over the order.
105.29(b) Modification of a registered child support order is subject to the same
105.30requirements, procedures, and defenses that apply to the modification of an order issued
105.31by a tribunal of this state and the order may be enforced and satisfied in the same manner.
105.32(c) A tribunal of this state may not modify any aspect of a child support order that
105.33may not be modified under the law of the issuing state, including the duration of the
105.34obligation of support. If two or more tribunals have issued child support orders for the
106.1same obligor and child, the order that controls and must be recognized under section
106.2518C.207 establishes the aspects of the support order which are nonmodifiable.
106.3(d) In a proceeding to modify a child support order, the law of the state that is
106.4determined to have issued the initial controlling order governs the duration of the
106.5obligation of support. The obligor's fulfillment of the duty of support established by that
106.6order precludes imposition of a further obligation of support by a tribunal of this state.
106.7(e) On issuance of an order by a tribunal of this state modifying a child support order
106.8issued in another state, a tribunal of this state becomes the tribunal having continuing,
106.9exclusive jurisdiction.
106.10(f) Notwithstanding paragraphs (a) to (d) (e) and section 518C.201, paragraph (b),
106.11a tribunal of this state retains jurisdiction to modify an order issued by a tribunal of this
106.12state if:
106.13(1) one party resides in another state; and
106.14(2) the other party resides outside the United States.

106.15    Sec. 117. Laws 2014, chapter 189, section 51, is amended to read:
106.16    Sec. 51. Minnesota Statutes 2012, section 518C.612, is amended to read:
106.17518C.612 RECOGNITION OF ORDER MODIFIED IN ANOTHER STATE.
106.18If a child support order issued by a tribunal of this state is modified by a tribunal of
106.19another state which assumed jurisdiction according to this chapter or a law substantially
106.20similar to this chapter pursuant to the Uniform Interstate Family Support Act, a tribunal of
106.21this state:
106.22(1) may enforce its order that was modified only as to arrears and interest accruing
106.23before the modification;
106.24(2) may provide appropriate relief for violations of its order which occurred before
106.25the effective date of the modification; and
106.26(3) shall recognize the modifying order of the other state, upon registration, for the
106.27purpose of enforcement.

106.28    Sec. 118. Laws 2014, chapter 189, section 52, is amended to read:
106.29    Sec. 52. Minnesota Statutes 2012, section 518C.613, is amended to read:
106.30518C.613 JURISDICTION TO MODIFY SUPPORT ORDER OF ANOTHER
106.31STATE WHEN INDIVIDUAL PARTIES RESIDE IN THIS STATE.
106.32(a) If all of the parties who are individuals reside in this state and the child does not
106.33reside in the issuing state, a tribunal of this state has jurisdiction to enforce and to modify
106.34the issuing state's child support order in a proceeding to register that order.
107.1(b) A tribunal of this state exercising jurisdiction as provided in this section shall apply
107.2sections 518C.101 to 518C.209 518C.211 and 518C.601 to 518C.616 to the enforcement
107.3or modification proceeding. Sections 518C.301 to 518C.508 and 518C.701 to 518C.802
107.4do not apply and the tribunal shall apply the procedural and substantive law of this state.

107.5    Sec. 119. Laws 2014, chapter 189, section 73, is amended to read:
107.6    Sec. 73. EFFECTIVE DATE.
107.7This act becomes is effective on the date that the United States deposits the
107.8instrument of ratification for the Hague Convention on the International Recovery of Child
107.9Support and Other Forms of Family Maintenance with the Hague Conference on Private
107.10International Law July 1, 2015.
107.11EFFECTIVE DATE.This section is effective July 1, 2015.

107.12    Sec. 120. GROUP RESIDENTIAL HOUSING REPORT ON PROGRAM
107.13IMPROVEMENTS.
107.14(a) The commissioner shall, in coordination with stakeholders and advocates, build
107.15on the group residential housing (GRH) reforms made in the 2015 legislative session
107.16related to program integrity and uniformity, by restructuring the payment rates, exploring
107.17assessment tools, and proposing any other necessary modifications that will result in a
107.18more cost-effective program, and report to the members of the legislative committees
107.19having jurisdiction over GRH issues by December 15, 2016.
107.20(b) The working group, consisting of the commissioner, stakeholders, and advocates,
107.21shall examine the feasibility and fiscal implications of restructuring service rates by
107.22eliminating the supplemental service rates, and developing a plan to fund only those
107.23services, based on individual need, that are not covered by medical assistance, other
107.24insurance, or other programs. In addition, the working group shall analyze the payment
107.25structure, and explore different options, including tiered rates for services, and provide the
107.26plan and analysis under this paragraph in the report under paragraph (a).
107.27(c) To determine individual need, the working group shall explore assessment tools,
107.28and determine the appropriate assessment tool for the different populations served by the
107.29GRH program, which include homeless individuals, individuals with mental illness, and
107.30individuals who are chemically dependent. The working group shall coordinate efforts
107.31with agency staff who have expertise related to these populations, and use relevant
107.32information and data that is available, to determine the most appropriate and effective
107.33assessment tool or tools, and provide the analysis and an assessment recommendation in
107.34the report under paragraph (a).

108.1    Sec. 121. CHILD SUPPORT WORK GROUP.
108.2(a) A child support work group is established to review the parenting expense
108.3adjustment in Minnesota Statutes, section 518A.36, and to identify and recommend
108.4changes to the parenting expense adjustment.
108.5(b) Members of the work group shall include:
108.6(1) two members of the house of representatives, one appointed by the speaker of the
108.7house and one appointed by the minority leader;
108.8(2) two members of the senate, one appointed by the majority leader and one
108.9appointed by the minority leader;
108.10(3) the commissioner of human services or a designee;
108.11(4) one staff member from the Child Support Division of the Department of Human
108.12Services, appointed by the commissioner;
108.13(5) one representative of the Minnesota State Bar Association, Family Law section,
108.14appointed by the section;
108.15(6) one representative of the Minnesota County Attorney's Association, appointed
108.16by the association;
108.17(7) one representative of the Minnesota Legal Services Coalition, appointed by
108.18the coalition;
108.19(8) one representative of the Minnesota Family Support and Recovery Council,
108.20appointed by the council; and
108.21(9) two representatives from parent advocacy groups, one representing custodial
108.22parents and one representing noncustodial parents, appointed by the commissioner of
108.23human services.
108.24The commissioner, or the commissioner's designee, shall appoint the work group chair.
108.25(c) The work group shall be authorized to retain the services of an economist to help
108.26create an equitable parenting expense adjustment formula. The work group may hire an
108.27economist by use of a sole-source contract.
108.28(d) The work group shall issue a report to the chairs and ranking minority members
108.29of the legislative committees with jurisdiction over civil law, judiciary, and health and
108.30human services by January 15, 2016. The report must include recommendations for
108.31changes to the computation of child support and recommendations on the composition
108.32of a permanent child support task force.
108.33(e) Terms, compensation, and removal of members and the filling of vacancies are
108.34governed by Minnesota Statutes, section 15.059.
108.35(f) The work group expires January 16, 2016.

109.1    Sec. 122. INSTRUCTIONS TO THE COMMISSIONER; CHILD
109.2MALTREATMENT SCREENING GUIDELINES.
109.3(a) No later than October 1, 2015, the commissioner of human services shall update
109.4the child maltreatment screening guidelines to require agencies to consider prior reports that
109.5were not screened in when determining whether a new report will or will not be screened
109.6in. The updated guidelines must emphasize that intervention and prevention efforts are to
109.7focus on child safety and the ongoing risk of child abuse or neglect, and that the health and
109.8safety of children are of paramount concern. The commissioner shall work with a diverse
109.9group of community representatives who are experts on limiting cultural and ethnic bias
109.10when developing the updated guidelines. The guidelines must be developed with special
109.11sensitivity to reducing system bias with regard to screening and assessment tools.
109.12(b) No later than November 1, 2015, the commissioner shall publish and distribute
109.13the updated guidelines and ensure that all agency staff have received training on the
109.14updated guidelines.
109.15(c) Agency staff must implement the guidelines by January 1, 2016.

109.16    Sec. 123. COMMISSIONER'S DUTY TO PROVIDE TRAINING TO CHILD
109.17PROTECTION SUPERVISORS.
109.18    The commissioner shall establish requirements for competency-based initial
109.19training, support, and continuing education for child protection supervisors. This includes
109.20developing a set of competencies specific to child protection supervisor knowledge, skills,
109.21and attitudes based on the Minnesota Child Welfare Practice Model. Competency-based
109.22training of supervisors must advance continuous emphasis and improvement in skills that
109.23promote the use of the client's culture as a resource and the ability to integrate the client's
109.24traditions, customs, values, and faith into service delivery.

109.25    Sec. 124. CHILD PROTECTION UPDATED FORMULA.
109.26    The commissioner of human services shall evaluate the formulas in Minnesota
109.27Statutes, section 256M.41, and recommend an updated equitable distribution formula
109.28beginning in fiscal year 2018, for funding child protection staffing and expanded services
109.29to counties and tribes, taking into consideration any relief to counties and tribes for child
109.30welfare and foster care costs, additional tribes delivering social services, and any other
109.31relevant information that should be considered in developing a new distribution formula.
109.32The commissioner shall report to the legislative committees having jurisdiction over child
109.33protection issues by December 15, 2016.

110.1    Sec. 125. LEGISLATIVE TASK FORCE; CHILD PROTECTION.
110.2(a) A legislative task force is created to:
110.3(1) review the efforts being made to implement the recommendations of the
110.4Governor's Task Force on the Protection of Children, including a review of the roles and
110.5functions of the Office of Ombudsperson for Families;
110.6(2) expand the efforts into related areas of the child welfare system;
110.7(3) work with the commissioner of human services and community partners to
110.8establish and evaluate child protection grants to address disparities in child welfare
110.9pursuant to Minnesota Statutes, section 256E.28; and
110.10(4) identify additional areas within the child welfare system that need to be addressed
110.11by the legislature.
110.12(b) Members of the legislative task force shall include:
110.13(1) the four legislators who served as members of the Governor's Task Force on
110.14the Protection of Children;
110.15(2) two members from the house of representatives appointed by the speaker, one
110.16from the majority party and one from the minority party; and
110.17(3) two members from the senate appointed by the majority leader, one from the
110.18majority party and one from the minority party.
110.19The speaker and the majority leader shall each appoint a chair and vice-chair from the
110.20membership of the task force. The gavel shall rotate after each meeting, and the house of
110.21representatives shall assume the leadership of the task force first.
110.22(c) The task force may provide oversight and monitoring of:
110.23(1) the efforts by the Department of Human Services, counties, and tribes to
110.24implement laws related to child protection;
110.25(2) efforts by the Department of Human Services, counties, and tribes to implement
110.26the recommendations of the Governor's Task Force on the Protection of Children;
110.27(3) efforts by agencies, including but not limited to the Minnesota Department
110.28of Education, the Minnesota Housing Finance Agency, the Minnesota Department of
110.29Corrections, and the Minnesota Department of Public Safety, to work with the Department
110.30of Human Services to assure safety and well-being for children at risk of harm or children
110.31in the child welfare system; and
110.32(4) efforts by the Department of Human Services, other agencies, counties, and
110.33tribes to implement best practices to ensure every child is protected from maltreatment
110.34and neglect and to ensure every child has the opportunity for healthy development.
110.35(d) The task force, in cooperation with the commissioner of human services, shall
110.36issue a report to the legislature and governor February 1, 2016. The report must contain
111.1information on the progress toward implementation of changes to the child protection
111.2system, recommendations for additional legislative changes and procedures affecting child
111.3protection and child welfare, and funding needs to implement recommended changes.
111.4(e) The task force shall convene upon the effective date of this section and shall
111.5continue until the last day of the 2016 legislative session.
111.6EFFECTIVE DATE.This section is effective the day following final enactment.

111.7    Sec. 126. REVISOR'S INSTRUCTION.
111.8The revisor of statutes shall alphabetize the definitions in Minnesota Statutes, section
111.9626.556, subdivision 2, and correct related cross-references.

111.10ARTICLE 2

111.11CHEMICAL AND MENTAL HEALTH SERVICES

111.12    Section 1. Minnesota Statutes 2014, section 13.46, subdivision 2, is amended to read:
111.13    Subd. 2. General. (a) Data on individuals collected, maintained, used, or
111.14disseminated by the welfare system are private data on individuals, and shall not be
111.15disclosed except:
111.16    (1) according to section 13.05;
111.17    (2) according to court order;
111.18    (3) according to a statute specifically authorizing access to the private data;
111.19    (4) to an agent of the welfare system and an investigator acting on behalf of a county,
111.20the state, or the federal government, including a law enforcement person or attorney in the
111.21investigation or prosecution of a criminal, civil, or administrative proceeding relating to
111.22the administration of a program;
111.23    (5) to personnel of the welfare system who require the data to verify an individual's
111.24identity; determine eligibility, amount of assistance, and the need to provide services
111.25to an individual or family across programs; coordinate services for an individual or
111.26family; evaluate the effectiveness of programs; assess parental contribution amounts;
111.27and investigate suspected fraud;
111.28    (6) to administer federal funds or programs;
111.29    (7) between personnel of the welfare system working in the same program;
111.30    (8) to the Department of Revenue to assess parental contribution amounts for
111.31purposes of section 252.27, subdivision 2a, administer and evaluate tax refund or tax credit
111.32programs and to identify individuals who may benefit from these programs. The following
111.33information may be disclosed under this paragraph: an individual's and their dependent's
111.34names, dates of birth, Social Security numbers, income, addresses, and other data as
112.1required, upon request by the Department of Revenue. Disclosures by the commissioner
112.2of revenue to the commissioner of human services for the purposes described in this clause
112.3are governed by section 270B.14, subdivision 1. Tax refund or tax credit programs include,
112.4but are not limited to, the dependent care credit under section 290.067, the Minnesota
112.5working family credit under section 290.0671, the property tax refund and rental credit
112.6under section 290A.04, and the Minnesota education credit under section 290.0674;
112.7    (9) between the Department of Human Services, the Department of Employment
112.8and Economic Development, and when applicable, the Department of Education, for
112.9the following purposes:
112.10    (i) to monitor the eligibility of the data subject for unemployment benefits, for any
112.11employment or training program administered, supervised, or certified by that agency;
112.12    (ii) to administer any rehabilitation program or child care assistance program,
112.13whether alone or in conjunction with the welfare system;
112.14    (iii) to monitor and evaluate the Minnesota family investment program or the child
112.15care assistance program by exchanging data on recipients and former recipients of food
112.16support, cash assistance under chapter 256, 256D, 256J, or 256K, child care assistance
112.17under chapter 119B, or medical programs under chapter 256B, 256D, or 256L; and
112.18    (iv) to analyze public assistance employment services and program utilization,
112.19cost, effectiveness, and outcomes as implemented under the authority established in Title
112.20II, Sections 201-204 of the Ticket to Work and Work Incentives Improvement Act of
112.211999. Health records governed by sections 144.291 to 144.298 and "protected health
112.22information" as defined in Code of Federal Regulations, title 45, section 160.103, and
112.23governed by Code of Federal Regulations, title 45, parts 160-164, including health care
112.24claims utilization information, must not be exchanged under this clause;
112.25    (10) to appropriate parties in connection with an emergency if knowledge of
112.26the information is necessary to protect the health or safety of the individual or other
112.27individuals or persons;
112.28    (11) data maintained by residential programs as defined in section 245A.02 may
112.29be disclosed to the protection and advocacy system established in this state according
112.30to Part C of Public Law 98-527 to protect the legal and human rights of persons with
112.31developmental disabilities or other related conditions who live in residential facilities for
112.32these persons if the protection and advocacy system receives a complaint by or on behalf
112.33of that person and the person does not have a legal guardian or the state or a designee of
112.34the state is the legal guardian of the person;
112.35    (12) to the county medical examiner or the county coroner for identifying or locating
112.36relatives or friends of a deceased person;
113.1    (13) data on a child support obligor who makes payments to the public agency
113.2may be disclosed to the Minnesota Office of Higher Education to the extent necessary to
113.3determine eligibility under section 136A.121, subdivision 2, clause (5);
113.4    (14) participant Social Security numbers and names collected by the telephone
113.5assistance program may be disclosed to the Department of Revenue to conduct an
113.6electronic data match with the property tax refund database to determine eligibility under
113.7section 237.70, subdivision 4a;
113.8    (15) the current address of a Minnesota family investment program participant
113.9may be disclosed to law enforcement officers who provide the name of the participant
113.10and notify the agency that:
113.11    (i) the participant:
113.12    (A) is a fugitive felon fleeing to avoid prosecution, or custody or confinement after
113.13conviction, for a crime or attempt to commit a crime that is a felony under the laws of the
113.14jurisdiction from which the individual is fleeing; or
113.15    (B) is violating a condition of probation or parole imposed under state or federal law;
113.16    (ii) the location or apprehension of the felon is within the law enforcement officer's
113.17official duties; and
113.18    (iii) the request is made in writing and in the proper exercise of those duties;
113.19    (16) the current address of a recipient of general assistance or general assistance
113.20medical care may be disclosed to probation officers and corrections agents who are
113.21supervising the recipient and to law enforcement officers who are investigating the
113.22recipient in connection with a felony level offense;
113.23    (17) information obtained from food support applicant or recipient households may
113.24be disclosed to local, state, or federal law enforcement officials, upon their written request,
113.25for the purpose of investigating an alleged violation of the Food Stamp Act, according
113.26to Code of Federal Regulations, title 7, section 272.1(c);
113.27    (18) the address, Social Security number, and, if available, photograph of any
113.28member of a household receiving food support shall be made available, on request, to a
113.29local, state, or federal law enforcement officer if the officer furnishes the agency with the
113.30name of the member and notifies the agency that:
113.31    (i) the member:
113.32    (A) is fleeing to avoid prosecution, or custody or confinement after conviction, for a
113.33crime or attempt to commit a crime that is a felony in the jurisdiction the member is fleeing;
113.34    (B) is violating a condition of probation or parole imposed under state or federal
113.35law; or
114.1    (C) has information that is necessary for the officer to conduct an official duty related
114.2to conduct described in subitem (A) or (B);
114.3    (ii) locating or apprehending the member is within the officer's official duties; and
114.4    (iii) the request is made in writing and in the proper exercise of the officer's official
114.5duty;
114.6    (19) the current address of a recipient of Minnesota family investment program,
114.7general assistance, general assistance medical care, or food support may be disclosed to
114.8law enforcement officers who, in writing, provide the name of the recipient and notify the
114.9agency that the recipient is a person required to register under section 243.166, but is not
114.10residing at the address at which the recipient is registered under section 243.166;
114.11    (20) certain information regarding child support obligors who are in arrears may be
114.12made public according to section 518A.74;
114.13    (21) data on child support payments made by a child support obligor and data on
114.14the distribution of those payments excluding identifying information on obligees may be
114.15disclosed to all obligees to whom the obligor owes support, and data on the enforcement
114.16actions undertaken by the public authority, the status of those actions, and data on the
114.17income of the obligor or obligee may be disclosed to the other party;
114.18    (22) data in the work reporting system may be disclosed under section 256.998,
114.19subdivision 7 ;
114.20    (23) to the Department of Education for the purpose of matching Department of
114.21Education student data with public assistance data to determine students eligible for free
114.22and reduced-price meals, meal supplements, and free milk according to United States
114.23Code, title 42, sections 1758, 1761, 1766, 1766a, 1772, and 1773; to allocate federal and
114.24state funds that are distributed based on income of the student's family; and to verify
114.25receipt of energy assistance for the telephone assistance plan;
114.26    (24) the current address and telephone number of program recipients and emergency
114.27contacts may be released to the commissioner of health or a community health board as
114.28defined in section 145A.02, subdivision 5, when the commissioner or community health
114.29board has reason to believe that a program recipient is a disease case, carrier, suspect case,
114.30or at risk of illness, and the data are necessary to locate the person;
114.31    (25) to other state agencies, statewide systems, and political subdivisions of this
114.32state, including the attorney general, and agencies of other states, interstate information
114.33networks, federal agencies, and other entities as required by federal regulation or law for
114.34the administration of the child support enforcement program;
115.1    (26) to personnel of public assistance programs as defined in section 256.741, for
115.2access to the child support system database for the purpose of administration, including
115.3monitoring and evaluation of those public assistance programs;
115.4    (27) to monitor and evaluate the Minnesota family investment program by
115.5exchanging data between the Departments of Human Services and Education, on
115.6recipients and former recipients of food support, cash assistance under chapter 256, 256D,
115.7256J, or 256K, child care assistance under chapter 119B, or medical programs under
115.8chapter 256B, 256D, or 256L;
115.9    (28) to evaluate child support program performance and to identify and prevent
115.10fraud in the child support program by exchanging data between the Department of Human
115.11Services, Department of Revenue under section 270B.14, subdivision 1, paragraphs (a)
115.12and (b), without regard to the limitation of use in paragraph (c), Department of Health,
115.13Department of Employment and Economic Development, and other state agencies as is
115.14reasonably necessary to perform these functions;
115.15    (29) counties operating child care assistance programs under chapter 119B may
115.16disseminate data on program participants, applicants, and providers to the commissioner
115.17of education; or
115.18    (30) child support data on the child, the parents, and relatives of the child may be
115.19disclosed to agencies administering programs under titles IV-B and IV-E of the Social
115.20Security Act, as authorized by federal law.; or
115.21(31) to a health care provider governed by sections 144.291 to 144.298, to the extent
115.22necessary to coordinate services.
115.23    (b) Information on persons who have been treated for drug or alcohol abuse may
115.24only be disclosed according to the requirements of Code of Federal Regulations, title
115.2542, sections 2.1 to 2.67.
115.26    (c) Data provided to law enforcement agencies under paragraph (a), clause (15),
115.27(16), (17), or (18), or paragraph (b), are investigative data and are confidential or protected
115.28nonpublic while the investigation is active. The data are private after the investigation
115.29becomes inactive under section 13.82, subdivision 5, paragraph (a) or (b).
115.30    (d) Mental health data shall be treated as provided in subdivisions 7, 8, and 9, but are
115.31not subject to the access provisions of subdivision 10, paragraph (b).
115.32    For the purposes of this subdivision, a request will be deemed to be made in writing
115.33if made through a computer interface system.

115.34    Sec. 2. Minnesota Statutes 2014, section 13.46, subdivision 7, is amended to read:
116.1    Subd. 7. Mental health data. (a) Mental health data are private data on individuals
116.2and shall not be disclosed, except:
116.3(1) pursuant to section 13.05, as determined by the responsible authority for the
116.4community mental health center, mental health division, or provider;
116.5(2) pursuant to court order;
116.6(3) pursuant to a statute specifically authorizing access to or disclosure of mental
116.7health data or as otherwise provided by this subdivision; or
116.8(4) to personnel of the welfare system working in the same program or providing
116.9services to the same individual or family to the extent necessary to coordinate services,
116.10provided that a health record may be disclosed only as provided under section 144.293;
116.11(5) to a health care provider governed by sections 144.291 to 144.298, to the extent
116.12necessary to coordinate services; or
116.13(6) with the consent of the client or patient.
116.14(b) An agency of the welfare system may not require an individual to consent to the
116.15release of mental health data as a condition for receiving services or for reimbursing a
116.16community mental health center, mental health division of a county, or provider under
116.17contract to deliver mental health services.
116.18(c) Notwithstanding section 245.69, subdivision 2, paragraph (f), or any other law
116.19to the contrary, the responsible authority for a community mental health center, mental
116.20health division of a county, or a mental health provider must disclose mental health data to
116.21a law enforcement agency if the law enforcement agency provides the name of a client or
116.22patient and communicates that the:
116.23(1) client or patient is currently involved in an emergency interaction with the law
116.24enforcement agency; and
116.25(2) data is necessary to protect the health or safety of the client or patient or of
116.26another person.
116.27The scope of disclosure under this paragraph is limited to the minimum necessary for
116.28law enforcement to respond to the emergency. Disclosure under this paragraph may include,
116.29but is not limited to, the name and telephone number of the psychiatrist, psychologist,
116.30therapist, mental health professional, practitioner, or case manager of the client or patient.
116.31A law enforcement agency that obtains mental health data under this paragraph shall
116.32maintain a record of the requestor, the provider of the information, and the client or patient
116.33name. Mental health data obtained by a law enforcement agency under this paragraph
116.34are private data on individuals and must not be used by the law enforcement agency for
116.35any other purpose. A law enforcement agency that obtains mental health data under this
116.36paragraph shall inform the subject of the data that mental health data was obtained.
117.1(d) In the event of a request under paragraph (a), clause (4), a community mental
117.2health center, county mental health division, or provider must release mental health data to
117.3Criminal Mental Health Court personnel in advance of receiving a copy of a consent if the
117.4Criminal Mental Health Court personnel communicate that the:
117.5(1) client or patient is a defendant in a criminal case pending in the district court;
117.6(2) data being requested is limited to information that is necessary to assess whether
117.7the defendant is eligible for participation in the Criminal Mental Health Court; and
117.8(3) client or patient has consented to the release of the mental health data and a copy
117.9of the consent will be provided to the community mental health center, county mental
117.10health division, or provider within 72 hours of the release of the data.
117.11For purposes of this paragraph, "Criminal Mental Health Court" refers to a specialty
117.12criminal calendar of the Hennepin County District Court for defendants with mental illness
117.13and brain injury where a primary goal of the calendar is to assess the treatment needs of
117.14the defendants and to incorporate those treatment needs into voluntary case disposition
117.15plans. The data released pursuant to this paragraph may be used for the sole purpose of
117.16determining whether the person is eligible for participation in mental health court. This
117.17paragraph does not in any way limit or otherwise extend the rights of the court to obtain the
117.18release of mental health data pursuant to court order or any other means allowed by law.

117.19    Sec. 3. Minnesota Statutes 2014, section 62Q.55, subdivision 3, is amended to read:
117.20    Subd. 3. Emergency services. As used in this section, "emergency services" means,
117.21with respect to an emergency medical condition:
117.22(1) a medical screening examination, as required under section 1867 of the Social
117.23Security Act, that is within the capability of the emergency department of a hospital,
117.24including ancillary services routinely available to the emergency department to evaluate
117.25such emergency medical condition; and
117.26(2) within the capabilities of the staff and facilities available at the hospital, such
117.27further medical examination and treatment as are required under section 1867 of the Social
117.28Security Act to stabilize the patient; and
117.29(3) emergency services as defined in sections 245.462, subdivision 11, and 245.4871,
117.30subdivision 14.

117.31    Sec. 4. Minnesota Statutes 2014, section 144.293, subdivision 6, is amended to read:
117.32    Subd. 6. Consent does not expire. Notwithstanding subdivision 4, if a patient
117.33explicitly gives informed consent to the release of health records for the purposes and
118.1restrictions in clauses clause (1) and, (2), or (3), the consent does not expire after one
118.2year for:
118.3    (1) the release of health records to a provider who is being advised or consulted with
118.4in connection with the releasing provider's current treatment of the patient;
118.5    (2) the release of health records to an accident and health insurer, health service plan
118.6corporation, health maintenance organization, or third-party administrator for purposes of
118.7payment of claims, fraud investigation, or quality of care review and studies, provided that:
118.8    (i) the use or release of the records complies with sections 72A.49 to 72A.505;
118.9    (ii) further use or release of the records in individually identifiable form to a person
118.10other than the patient without the patient's consent is prohibited; and
118.11    (iii) the recipient establishes adequate safeguards to protect the records from
118.12unauthorized disclosure, including a procedure for removal or destruction of information
118.13that identifies the patient; or
118.14    (3) the release of health records to a program in the welfare system, as defined in
118.15section 13.46, to the extent necessary to coordinate services for the patient.

118.16    Sec. 5. Minnesota Statutes 2014, section 144.551, subdivision 1, is amended to read:
118.17    Subdivision 1. Restricted construction or modification. (a) The following
118.18construction or modification may not be commenced:
118.19(1) any erection, building, alteration, reconstruction, modernization, improvement,
118.20extension, lease, or other acquisition by or on behalf of a hospital that increases the bed
118.21capacity of a hospital, relocates hospital beds from one physical facility, complex, or site
118.22to another, or otherwise results in an increase or redistribution of hospital beds within
118.23the state; and
118.24(2) the establishment of a new hospital.
118.25(b) This section does not apply to:
118.26(1) construction or relocation within a county by a hospital, clinic, or other health
118.27care facility that is a national referral center engaged in substantial programs of patient
118.28care, medical research, and medical education meeting state and national needs that
118.29receives more than 40 percent of its patients from outside the state of Minnesota;
118.30(2) a project for construction or modification for which a health care facility held
118.31an approved certificate of need on May 1, 1984, regardless of the date of expiration of
118.32the certificate;
118.33(3) a project for which a certificate of need was denied before July 1, 1990, if a
118.34timely appeal results in an order reversing the denial;
119.1(4) a project exempted from certificate of need requirements by Laws 1981, chapter
119.2200, section 2;
119.3(5) a project involving consolidation of pediatric specialty hospital services within
119.4the Minneapolis-St. Paul metropolitan area that would not result in a net increase in the
119.5number of pediatric specialty hospital beds among the hospitals being consolidated;
119.6(6) a project involving the temporary relocation of pediatric-orthopedic hospital beds
119.7to an existing licensed hospital that will allow for the reconstruction of a new philanthropic,
119.8pediatric-orthopedic hospital on an existing site and that will not result in a net increase in
119.9the number of hospital beds. Upon completion of the reconstruction, the licenses of both
119.10hospitals must be reinstated at the capacity that existed on each site before the relocation;
119.11(7) the relocation or redistribution of hospital beds within a hospital building or
119.12identifiable complex of buildings provided the relocation or redistribution does not result
119.13in: (i) an increase in the overall bed capacity at that site; (ii) relocation of hospital beds
119.14from one physical site or complex to another; or (iii) redistribution of hospital beds within
119.15the state or a region of the state;
119.16(8) relocation or redistribution of hospital beds within a hospital corporate system
119.17that involves the transfer of beds from a closed facility site or complex to an existing site
119.18or complex provided that: (i) no more than 50 percent of the capacity of the closed facility
119.19is transferred; (ii) the capacity of the site or complex to which the beds are transferred
119.20does not increase by more than 50 percent; (iii) the beds are not transferred outside of a
119.21federal health systems agency boundary in place on July 1, 1983; and (iv) the relocation or
119.22redistribution does not involve the construction of a new hospital building;
119.23(9) a construction project involving up to 35 new beds in a psychiatric hospital in
119.24Rice County that primarily serves adolescents and that receives more than 70 percent of its
119.25patients from outside the state of Minnesota;
119.26(10) a project to replace a hospital or hospitals with a combined licensed capacity
119.27of 130 beds or less if: (i) the new hospital site is located within five miles of the current
119.28site; and (ii) the total licensed capacity of the replacement hospital, either at the time of
119.29construction of the initial building or as the result of future expansion, will not exceed 70
119.30licensed hospital beds, or the combined licensed capacity of the hospitals, whichever is less;
119.31(11) the relocation of licensed hospital beds from an existing state facility operated
119.32by the commissioner of human services to a new or existing facility, building, or complex
119.33operated by the commissioner of human services; from one regional treatment center
119.34site to another; or from one building or site to a new or existing building or site on the
119.35same campus;
120.1(12) the construction or relocation of hospital beds operated by a hospital having a
120.2statutory obligation to provide hospital and medical services for the indigent that does not
120.3result in a net increase in the number of hospital beds, notwithstanding section 144.552, 27
120.4beds, of which 12 serve mental health needs, may be transferred from Hennepin County
120.5Medical Center to Regions Hospital under this clause;
120.6(13) a construction project involving the addition of up to 31 new beds in an existing
120.7nonfederal hospital in Beltrami County;
120.8(14) a construction project involving the addition of up to eight new beds in an
120.9existing nonfederal hospital in Otter Tail County with 100 licensed acute care beds;
120.10(15) a construction project involving the addition of 20 new hospital beds
120.11used for rehabilitation services in an existing hospital in Carver County serving the
120.12southwest suburban metropolitan area. Beds constructed under this clause shall not be
120.13eligible for reimbursement under medical assistance, general assistance medical care,
120.14or MinnesotaCare;
120.15(16) a project for the construction or relocation of up to 20 hospital beds for the
120.16operation of up to two psychiatric facilities or units for children provided that the operation
120.17of the facilities or units have received the approval of the commissioner of human services;
120.18(17) a project involving the addition of 14 new hospital beds to be used for
120.19rehabilitation services in an existing hospital in Itasca County;
120.20(18) a project to add 20 licensed beds in existing space at a hospital in Hennepin
120.21County that closed 20 rehabilitation beds in 2002, provided that the beds are used only
120.22for rehabilitation in the hospital's current rehabilitation building. If the beds are used for
120.23another purpose or moved to another location, the hospital's licensed capacity is reduced
120.24by 20 beds;
120.25(19) a critical access hospital established under section 144.1483, clause (9), and
120.26section 1820 of the federal Social Security Act, United States Code, title 42, section
120.271395i-4, that delicensed beds since enactment of the Balanced Budget Act of 1997, Public
120.28Law 105-33, to the extent that the critical access hospital does not seek to exceed the
120.29maximum number of beds permitted such hospital under federal law;
120.30(20) notwithstanding section 144.552, a project for the construction of a new hospital
120.31in the city of Maple Grove with a licensed capacity of up to 300 beds provided that:
120.32(i) the project, including each hospital or health system that will own or control the
120.33entity that will hold the new hospital license, is approved by a resolution of the Maple
120.34Grove City Council as of March 1, 2006;
120.35(ii) the entity that will hold the new hospital license will be owned or controlled by
120.36one or more not-for-profit hospitals or health systems that have previously submitted a
121.1plan or plans for a project in Maple Grove as required under section 144.552, and the
121.2plan or plans have been found to be in the public interest by the commissioner of health
121.3as of April 1, 2005;
121.4(iii) the new hospital's initial inpatient services must include, but are not limited
121.5to, medical and surgical services, obstetrical and gynecological services, intensive
121.6care services, orthopedic services, pediatric services, noninvasive cardiac diagnostics,
121.7behavioral health services, and emergency room services;
121.8(iv) the new hospital:
121.9(A) will have the ability to provide and staff sufficient new beds to meet the growing
121.10needs of the Maple Grove service area and the surrounding communities currently being
121.11served by the hospital or health system that will own or control the entity that will hold
121.12the new hospital license;
121.13(B) will provide uncompensated care;
121.14(C) will provide mental health services, including inpatient beds;
121.15(D) will be a site for workforce development for a broad spectrum of
121.16health-care-related occupations and have a commitment to providing clinical training
121.17programs for physicians and other health care providers;
121.18(E) will demonstrate a commitment to quality care and patient safety;
121.19(F) will have an electronic medical records system, including physician order entry;
121.20(G) will provide a broad range of senior services;
121.21(H) will provide emergency medical services that will coordinate care with regional
121.22providers of trauma services and licensed emergency ambulance services in order to
121.23enhance the continuity of care for emergency medical patients; and
121.24(I) will be completed by December 31, 2009, unless delayed by circumstances
121.25beyond the control of the entity holding the new hospital license; and
121.26(v) as of 30 days following submission of a written plan, the commissioner of health
121.27has not determined that the hospitals or health systems that will own or control the entity
121.28that will hold the new hospital license are unable to meet the criteria of this clause;
121.29(21) a project approved under section 144.553;
121.30(22) a project for the construction of a hospital with up to 25 beds in Cass County
121.31within a 20-mile radius of the state Ah-Gwah-Ching facility, provided the hospital's
121.32license holder is approved by the Cass County Board;
121.33(23) a project for an acute care hospital in Fergus Falls that will increase the bed
121.34capacity from 108 to 110 beds by increasing the rehabilitation bed capacity from 14 to 16
121.35and closing a separately licensed 13-bed skilled nursing facility;
122.1(24) notwithstanding section 144.552, a project for the construction and expansion
122.2of a specialty psychiatric hospital in Hennepin County for up to 50 beds, exclusively for
122.3patients who are under 21 years of age on the date of admission. The commissioner
122.4conducted a public interest review of the mental health needs of Minnesota and the Twin
122.5Cities metropolitan area in 2008. No further public interest review shall be conducted for
122.6the construction or expansion project under this clause; or
122.7(25) a project for a 16-bed psychiatric hospital in the city of Thief River Falls, if
122.8the commissioner finds the project is in the public interest after the public interest review
122.9conducted under section 144.552 is complete; or
122.10(26)(i) a project for a 20-bed psychiatric hospital, within an existing facility in the
122.11city of Maple Grove, exclusively for patients who are under 21 years of age on the date of
122.12admission, if the commissioner finds the project is in the public interest after the public
122.13interest review conducted under section 144.552 is complete;
122.14(ii) this project shall serve patients in the continuing care benefit program under
122.15section 256.9693. The project may also serve patients not in the continuing care benefit
122.16program; and
122.17(iii) if the project ceases to participate in the continuing care benefit program, the
122.18commissioner must complete a subsequent public interest review under section 144.552.
122.19If the project is found not to be in the public interest, the license must be terminated six
122.20months from the date of that finding. If the commissioner of human services terminates the
122.21contract without cause or reduces per diem payment rates for patients under the continuing
122.22care benefit program below the rates in effect for services provided on December 31, 2015,
122.23the project may cease to participate in the continuing care benefit program and continue to
122.24operate without a subsequent public interest review.

122.25    Sec. 6. Minnesota Statutes 2014, section 145.56, subdivision 2, is amended to read:
122.26    Subd. 2. Community-based programs. To the extent funds are appropriated for the
122.27purposes of this subdivision, the commissioner shall establish a grant program to fund:
122.28(1) community-based programs to provide education, outreach, and advocacy
122.29services to populations who may be at risk for suicide;
122.30(2) community-based programs that educate community helpers and gatekeepers,
122.31such as family members, spiritual leaders, coaches, and business owners, employers, and
122.32coworkers on how to prevent suicide by encouraging help-seeking behaviors;
122.33(3) community-based programs that educate populations at risk for suicide and
122.34community helpers and gatekeepers that must include information on the symptoms
122.35of depression and other psychiatric illnesses, the warning signs of suicide, skills for
123.1preventing suicides, and making or seeking effective referrals to intervention and
123.2community resources; and
123.3(4) community-based programs to provide evidence-based suicide prevention and
123.4intervention education to school staff, parents, and students in grades kindergarten through
123.512, and for students attending Minnesota colleges and universities;
123.6(5) community-based programs to provide evidence-based suicide prevention and
123.7intervention to public school nurses, teachers, administrators, coaches, school social
123.8workers, peace officers, firefighters, emergency medical technicians, advanced emergency
123.9medical technicians, paramedics, primary care providers, and others; and
123.10(6) community-based, evidence-based postvention training to mental health
123.11professionals and practitioners in order to provide technical assistance to communities
123.12after a suicide and to prevent suicide clusters and contagion.

123.13    Sec. 7. Minnesota Statutes 2014, section 145.56, subdivision 4, is amended to read:
123.14    Subd. 4. Collection and reporting suicide data. (a) The commissioner shall
123.15coordinate with federal, regional, local, and other state agencies to collect, analyze, and
123.16annually issue a public report on Minnesota-specific data on suicide and suicidal behaviors.
123.17(b) The commissioner, in consultation with stakeholders, shall submit a detailed
123.18plan identifying proposed methods to improve the timeliness, usefulness, and quality of
123.19suicide-related data so that the data can help identify the scope of the suicide problem,
123.20identify high-risk groups, set priority prevention activities, and monitor the effects of
123.21suicide prevention programs. The report shall include how to improve external cause
123.22of injury coding, progress on implementing the Minnesota Violent Death Reporting
123.23System, how to obtain and release data in a timely manner, and how to support the use of
123.24psychological autopsies.
123.25(c) The written report must be provided to the chairs and ranking minority members
123.26of the house of representatives and senate finance and policy divisions and committees
123.27with jurisdiction over health and human services by February 1, 2016.

123.28    Sec. 8. Minnesota Statutes 2014, section 245.4661, subdivision 5, is amended to read:
123.29    Subd. 5. Planning for pilot projects. (a) Each local plan for a pilot project, with
123.30the exception of the placement of a Minnesota specialty treatment facility as defined in
123.31paragraph (c), must be developed under the direction of the county board, or multiple
123.32county boards acting jointly, as the local mental health authority. The planning process
123.33for each pilot shall include, but not be limited to, mental health consumers, families,
123.34advocates, local mental health advisory councils, local and state providers, representatives
124.1of state and local public employee bargaining units, and the department of human services.
124.2As part of the planning process, the county board or boards shall designate a managing
124.3entity responsible for receipt of funds and management of the pilot project.
124.4    (b) For Minnesota specialty treatment facilities, the commissioner shall issue a
124.5request for proposal for regions in which a need has been identified for services.
124.6    (c) For purposes of this section, "Minnesota specialty treatment facility" is defined
124.7as an intensive rehabilitative mental health residential treatment service under section
124.8256B.0622, subdivision 2, paragraph (b).

124.9    Sec. 9. Minnesota Statutes 2014, section 245.4661, subdivision 6, is amended to read:
124.10    Subd. 6. Duties of commissioner. (a) For purposes of the pilot projects, the
124.11commissioner shall facilitate integration of funds or other resources as needed and
124.12requested by each project. These resources may include:
124.13(1) community support services funds administered under Minnesota Rules, parts
124.149535.1700 to 9535.1760;
124.15(2) other mental health special project funds;
124.16(3) medical assistance, general assistance medical care, MinnesotaCare and group
124.17residential housing if requested by the project's managing entity, and if the commissioner
124.18determines this would be consistent with the state's overall health care reform efforts; and
124.19(4) regional treatment center resources consistent with section 246.0136, subdivision
124.201 ; and.
124.21(5) funds transferred from section 246.18, subdivision 8, for grants to providers to
124.22participate in mental health specialty treatment services, awarded to providers through
124.23a request for proposal process.
124.24(b) The commissioner shall consider the following criteria in awarding start-up and
124.25implementation grants for the pilot projects:
124.26(1) the ability of the proposed projects to accomplish the objectives described in
124.27subdivision 2;
124.28(2) the size of the target population to be served; and
124.29(3) geographical distribution.
124.30(c) The commissioner shall review overall status of the projects initiatives at least
124.31every two years and recommend any legislative changes needed by January 15 of each
124.32odd-numbered year.
124.33(d) The commissioner may waive administrative rule requirements which are
124.34incompatible with the implementation of the pilot project.
125.1(e) The commissioner may exempt the participating counties from fiscal sanctions
125.2for noncompliance with requirements in laws and rules which are incompatible with the
125.3implementation of the pilot project.
125.4(f) The commissioner may award grants to an entity designated by a county board or
125.5group of county boards to pay for start-up and implementation costs of the pilot project.

125.6    Sec. 10. Minnesota Statutes 2014, section 245.4661, is amended by adding a
125.7subdivision to read:
125.8    Subd. 9. Services and programs. (a) The following three distinct grant programs
125.9are funded under this section:
125.10(1) mental health crisis services;
125.11(2) housing with supports for adults with serious mental illness; and
125.12(3) projects for assistance in transitioning from homelessness (PATH program).
125.13(b) In addition, the following are eligible for grant funds:
125.14(1) community education and prevention;
125.15(2) client outreach;
125.16(3) early identification and intervention;
125.17(4) adult outpatient diagnostic assessment and psychological testing;
125.18(5) peer support services;
125.19(6) community support program services (CSP);
125.20(7) adult residential crisis stabilization;
125.21(8) supported employment;
125.22(9) assertive community treatment (ACT);
125.23(10) housing subsidies;
125.24(11) basic living, social skills, and community intervention;
125.25(12) emergency response services;
125.26(13) adult outpatient psychotherapy;
125.27(14) adult outpatient medication management;
125.28(15) adult mobile crisis services;
125.29(16) adult day treatment;
125.30(17) partial hospitalization;
125.31(18) adult residential treatment;
125.32(19) adult mental health targeted case management;
125.33(20) intensive community residential services (IRCS); and
125.34(21) transportation.

126.1    Sec. 11. Minnesota Statutes 2014, section 245.4661, is amended by adding a
126.2subdivision to read:
126.3    Subd. 10. Commissioner duty to report on use of grant funds biennially. By
126.4November 1, 2016, and biennially thereafter, the commissioner of human services shall
126.5provide sufficient information to the members of the legislative committees having
126.6jurisdiction over mental health funding and policy issues to evaluate the use of funds
126.7appropriated under this section of law. The commissioner shall provide, at a minimum,
126.8the following information:
126.9    (1) the amount of funding to mental health initiatives, what programs and services
126.10were funded in the previous two years, gaps in services that each initiative brought to
126.11the attention of the commissioner, and outcome data for the programs and services that
126.12were funded; and
126.13    (2) the amount of funding for other targeted services and the location of services.

126.14    Sec. 12. Minnesota Statutes 2014, section 245.467, subdivision 6, is amended to read:
126.15    Subd. 6. Restricted access to data. The county board shall establish procedures
126.16to ensure that the names and addresses of persons receiving mental health services are
126.17disclosed only to:
126.18(1) county employees who are specifically responsible for determining county of
126.19financial responsibility or making payments to providers; and
126.20(2) staff who provide treatment services or case management and their clinical
126.21supervisors.; and
126.22(3) personnel of the welfare system or health care providers who have access to the
126.23data under section 13.46, subdivision 7.
126.24Release of mental health data on individuals submitted under subdivisions 4 and 5,
126.25to persons other than those specified in this subdivision, or use of this data for purposes
126.26other than those stated in subdivisions 4 and 5, results in civil or criminal liability under
126.27the standards in section 13.08 or 13.09.

126.28    Sec. 13. Minnesota Statutes 2014, section 245.4876, subdivision 7, is amended to read:
126.29    Subd. 7. Restricted access to data. The county board shall establish procedures
126.30to ensure that the names and addresses of children receiving mental health services and
126.31their families are disclosed only to:
126.32(1) county employees who are specifically responsible for determining county of
126.33financial responsibility or making payments to providers; and
127.1(2) staff who provide treatment services or case management and their clinical
127.2supervisors.; and
127.3(3) personnel of the welfare system or health care providers who have access to the
127.4data under section 13.46, subdivision 7.
127.5Release of mental health data on individuals submitted under subdivisions 5 and 6,
127.6to persons other than those specified in this subdivision, or use of this data for purposes
127.7other than those stated in subdivisions 5 and 6, results in civil or criminal liability under
127.8section 13.08 or 13.09.

127.9    Sec. 14. Minnesota Statutes 2014, section 245.4889, subdivision 1, is amended to read:
127.10    Subdivision 1. Establishment and authority. (a) The commissioner is authorized
127.11to make grants from available appropriations to assist:
127.12    (1) counties;
127.13    (2) Indian tribes;
127.14    (3) children's collaboratives under section 124D.23 or 245.493; or
127.15    (4) mental health service providers
127.16for providing services to children with emotional disturbances as defined in section
127.17245.4871, subdivision 15, and their families. The commissioner may also authorize
127.18grants to young adults meeting the criteria for transition services in section 245.4875,
127.19subdivision 8, and their families.
127.20    (b) The following services are eligible for grants under this section:
127.21    (1) services to children with emotional disturbances as defined in section 245.4871,
127.22subdivision 15, and their families;
127.23    (2) transition services under section 245.4875, subdivision 8, for young adults under
127.24age 21 and their families;
127.25    (3) respite care services for children with severe emotional disturbances who are at
127.26risk of out-of-home placement;
127.27    (4) children's mental health crisis services;
127.28    (5) mental health services for people from cultural and ethnic minorities;
127.29    (6) children's mental health screening and follow-up diagnostic assessment and
127.30treatment;
127.31    (7) services to promote and develop the capacity of providers to use evidence-based
127.32practices in providing children's mental health services;
127.33    (8) school-linked mental health services;
127.34    (9) building evidence-based mental health intervention capacity for children birth to
127.35age five;
128.1    (10) suicide prevention and counseling services that use text messaging statewide;
128.2    (11) mental health first aid training;
128.3    (12) training for parents, collaborative partners, and mental health providers on the
128.4impact of adverse childhood experiences and trauma and development of an interactive
128.5Web site to share information and strategies to promote resilience and prevent trauma;
128.6    (13) transition age services to develop or expand mental health treatment and
128.7supports for adolescents and young adults 26 years of age or younger;
128.8    (14) early childhood mental health consultation;
128.9    (15) evidence-based interventions for youth at risk of developing or experiencing a
128.10first episode of psychosis, and a public awareness campaign on the signs and symptoms of
128.11psychosis; and
128.12    (16) psychiatric consultation for primary care practitioners.
128.13    (c) Services under paragraph (a) (b) must be designed to help each child to function
128.14and remain with the child's family in the community and delivered consistent with the
128.15child's treatment plan. Transition services to eligible young adults under paragraph (a) (b)
128.16must be designed to foster independent living in the community.

128.17    Sec. 15. Minnesota Statutes 2014, section 245.4889, is amended by adding a
128.18subdivision to read:
128.19    Subd. 3. Commissioner duty to report on use of grant funds biennially. By
128.20November 1, 2016, and biennially thereafter, the commissioner of human services shall
128.21provide sufficient information to the members of the legislative committees having
128.22jurisdiction over mental health funding and policy issues to evaluate the use of funds
128.23appropriated under this section. The commissioner shall provide, at a minimum, the
128.24following information:
128.25    (1) the amount of funding for children's mental health grants, what programs and
128.26services were funded in the previous two years, and outcome data for the programs and
128.27services that were funded; and
128.28    (2) the amount of funding for other targeted services and the location of services.

128.29    Sec. 16. [245.735] EXCELLENCE IN MENTAL HEALTH DEMONSTRATION
128.30PROJECT.
128.31    Subdivision 1. Excellence in Mental Health demonstration project. The
128.32commissioner shall develop and execute projects to reform the mental health system by
128.33participating in the Excellence in Mental Health demonstration project.
129.1    Subd. 2. Federal proposal. The commissioner shall develop and submit to the
129.2United States Department of Health and Human Services a proposal for the Excellence
129.3in Mental Health demonstration project. The proposal shall include any necessary state
129.4plan amendments, waivers, requests for new funding, realignment of existing funding, and
129.5other authority necessary to implement the projects specified in subdivision 3.
129.6    Subd. 3. Reform projects. (a) The commissioner shall establish standards for state
129.7certification of clinics as certified community behavioral health clinics, in accordance with
129.8the criteria published on or before September 1, 2015, by the United States Department
129.9of Health and Human Services. Certification standards established by the commissioner
129.10shall require that:
129.11(1) clinic staff have backgrounds in diverse disciplines, include licensed mental
129.12health professionals, and are culturally and linguistically trained to serve the needs of the
129.13clinic's patient population;
129.14(2) clinic services are available and accessible and that crisis management services
129.15are available 24 hours per day;
129.16(3) fees for clinic services are established using a sliding fee scale and services to
129.17patients are not denied or limited due to a patient's inability to pay for services;
129.18(4) clinics provide coordination of care across settings and providers to ensure
129.19seamless transitions for patients across the full spectrum of health services, including
129.20acute, chronic, and behavioral needs. Care coordination may be accomplished through
129.21partnerships or formal contracts with federally qualified health centers, inpatient
129.22psychiatric facilities, substance use and detoxification facilities, community-based mental
129.23health providers, and other community services, supports, and providers including
129.24schools, child welfare agencies, juvenile and criminal justice agencies, Indian Health
129.25Services clinics, tribally licensed health care and mental health facilities, urban Indian
129.26health clinics, Department of Veterans Affairs medical centers, outpatient clinics, drop-in
129.27centers, acute care hospitals, and hospital outpatient clinics;
129.28(5) services provided by clinics include crisis mental health services, emergency
129.29crisis intervention services, and stabilization services; screening, assessment, and diagnosis
129.30services, including risk assessments and level of care determinations; patient-centered
129.31treatment planning; outpatient mental health and substance use services; targeted case
129.32management; psychiatric rehabilitation services; peer support and counselor services and
129.33family support services; and intensive community-based mental health services, including
129.34mental health services for members of the armed forces and veterans; and
130.1(6) clinics comply with quality assurance reporting requirements and other reporting
130.2requirements, including any required reporting of encounter data, clinical outcomes data,
130.3and quality data.
130.4(b) The commissioner shall establish standards and methodologies for a prospective
130.5payment system for medical assistance payments for mental health services delivered by
130.6certified community behavioral health clinics, in accordance with guidance issued on or
130.7before September 1, 2015, by the Centers for Medicare and Medicaid Services. During the
130.8operation of the demonstration project, payments shall comply with federal requirements
130.9for a 90 percent enhanced federal medical assistance percentage.
130.10    Subd. 4. Public participation. In developing the projects under subdivision 3, the
130.11commissioner shall consult with mental health providers, advocacy organizations, licensed
130.12mental health professionals, and Minnesota public health care program enrollees who
130.13receive mental health services and their families.
130.14    Subd. 5. Information systems support. The commissioner and the state chief
130.15information officer shall provide information systems support to the projects as necessary
130.16to comply with federal requirements.

130.17    Sec. 17. Minnesota Statutes 2014, section 246.18, subdivision 8, is amended to read:
130.18    Subd. 8. State-operated services account. (a) The state-operated services account is
130.19established in the special revenue fund. Revenue generated by new state-operated services
130.20listed under this section established after July 1, 2010, that are not enterprise activities must
130.21be deposited into the state-operated services account, unless otherwise specified in law:
130.22(1) intensive residential treatment services;
130.23(2) foster care services; and
130.24(3) psychiatric extensive recovery treatment services.
130.25(b) Funds deposited in the state-operated services account are available appropriated
130.26to the commissioner of human services for the purposes of:
130.27(1) providing services needed to transition individuals from institutional settings
130.28within state-operated services to the community when those services have no other
130.29adequate funding source; and
130.30(2) grants to providers participating in mental health specialty treatment services
130.31under section 245.4661; and
130.32(3) to fund the operation of the intensive residential treatment service program in
130.33Willmar.

130.34    Sec. 18. Minnesota Statutes 2014, section 253B.18, subdivision 4c, is amended to read:
131.1    Subd. 4c. Special review board. (a) The commissioner shall establish one or more
131.2panels of a special review board. The board shall consist of three members experienced
131.3in the field of mental illness. One member of each special review board panel shall be a
131.4psychiatrist or a doctoral level psychologist with forensic experience and one member
131.5shall be an attorney. No member shall be affiliated with the Department of Human
131.6Services. The special review board shall meet at least every six months and at the call of
131.7the commissioner. It shall hear and consider all petitions for a reduction in custody or to
131.8appeal a revocation of provisional discharge. A "reduction in custody" means transfer
131.9from a secure treatment facility, discharge, and provisional discharge. Patients may be
131.10transferred by the commissioner between secure treatment facilities without a special
131.11review board hearing.
131.12    Members of the special review board shall receive compensation and reimbursement
131.13for expenses as established by the commissioner.
131.14    (b) The special review board must review each denied petition under subdivision
131.155 for barriers and obstacles preventing the patient from progressing in treatment. Based
131.16on the cases before the board in the previous year, the special review board shall provide
131.17to the commissioner an annual summation of the barriers to treatment progress, and
131.18recommendations to achieve the common goal of making progress in treatment.
131.19    (c) A petition filed by a person committed as mentally ill and dangerous to the
131.20public under this section must be heard as provided in subdivision 5 and, as applicable,
131.21subdivision 13. A petition filed by a person committed as a sexual psychopathic personality
131.22or as a sexually dangerous person under chapter 253D, or committed as both mentally ill
131.23and dangerous to the public under this section and as a sexual psychopathic personality or
131.24as a sexually dangerous person must be heard as provided in section 253D.27.
131.25EFFECTIVE DATE.This section is effective January 1, 2016.

131.26    Sec. 19. Minnesota Statutes 2014, section 253B.18, subdivision 5, is amended to read:
131.27    Subd. 5. Petition; notice of hearing; attendance; order. (a) A petition for
131.28a reduction in custody or revocation of provisional discharge shall be filed with the
131.29commissioner and may be filed by the patient or by the head of the treatment facility. A
131.30patient may not petition the special review board for six months following commitment
131.31under subdivision 3 or following the final disposition of any previous petition and
131.32subsequent appeal by the patient. The head of the treatment facility must schedule a
131.33hearing before the special review board for any patient who has not appeared before the
131.34special review board in the previous three years, and schedule a hearing at least every
131.35three years thereafter. The medical director may petition at any time.
132.1    (b) Fourteen days prior to the hearing, the committing court, the county attorney of
132.2the county of commitment, the designated agency, interested person, the petitioner, and
132.3the petitioner's counsel shall be given written notice by the commissioner of the time and
132.4place of the hearing before the special review board. Only those entitled to statutory notice
132.5of the hearing or those administratively required to attend may be present at the hearing.
132.6The patient may designate interested persons to receive notice by providing the names
132.7and addresses to the commissioner at least 21 days before the hearing. The board shall
132.8provide the commissioner with written findings of fact and recommendations within 21
132.9days of the hearing. The commissioner shall issue an order no later than 14 days after
132.10receiving the recommendation of the special review board. A copy of the order shall be
132.11mailed to every person entitled to statutory notice of the hearing within five days after it
132.12is signed. No order by the commissioner shall be effective sooner than 30 days after the
132.13order is signed, unless the county attorney, the patient, and the commissioner agree that
132.14it may become effective sooner.
132.15    (c) The special review board shall hold a hearing on each petition prior to making
132.16its recommendation to the commissioner. The special review board proceedings are not
132.17contested cases as defined in chapter 14. Any person or agency receiving notice that
132.18submits documentary evidence to the special review board prior to the hearing shall also
132.19provide copies to the patient, the patient's counsel, the county attorney of the county of
132.20commitment, the case manager, and the commissioner.
132.21    (d) Prior to the final decision by the commissioner, the special review board may be
132.22reconvened to consider events or circumstances that occurred subsequent to the hearing.
132.23    (e) In making their recommendations and order, the special review board and
132.24commissioner must consider any statements received from victims under subdivision 5a.
132.25EFFECTIVE DATE.This section is effective January 1, 2016, with hearings
132.26starting no later than February 1, 2016.

132.27    Sec. 20. Minnesota Statutes 2014, section 254B.05, subdivision 5, as amended by
132.28Laws 2015, chapter 21, article 1, section 52, is amended to read:
132.29    Subd. 5. Rate requirements. (a) The commissioner shall establish rates for
132.30chemical dependency services and service enhancements funded under this chapter.
132.31(b) Eligible chemical dependency treatment services include:
132.32(1) outpatient treatment services that are licensed according to Minnesota Rules,
132.33parts 9530.6405 to 9530.6480, or applicable tribal license;
132.34(2) medication-assisted therapy services that are licensed according to Minnesota
132.35Rules, parts 9530.6405 to 9530.6480 and 9530.6500, or applicable tribal license;
133.1(3) medication-assisted therapy plus enhanced treatment services that meet the
133.2requirements of clause (2) and provide nine hours of clinical services each week;
133.3(4) high, medium, and low intensity residential treatment services that are licensed
133.4according to Minnesota Rules, parts 9530.6405 to 9530.6480 and 9530.6505, or applicable
133.5tribal license which provide, respectively, 30, 15, and five hours of clinical services each
133.6week;
133.7(5) hospital-based treatment services that are licensed according to Minnesota Rules,
133.8parts 9530.6405 to 9530.6480, or applicable tribal license and licensed as a hospital under
133.9sections 144.50 to 144.56;
133.10(6) adolescent treatment programs that are licensed as outpatient treatment programs
133.11according to Minnesota Rules, parts 9530.6405 to 9530.6485, or as residential treatment
133.12programs according to Minnesota Rules, parts 2960.0010 to 2960.0220, and 2960.0430 to
133.132960.0490, or applicable tribal license; and
133.14(7) high-intensity residential treatment services that are licensed according to
133.15Minnesota Rules, parts 9530.6405 to 9530.6480 and 9530.6505, or applicable tribal
133.16license, which provide 30 hours of clinical services each week provided by a state-operated
133.17vendor or to clients who have been civilly committed to the commissioner, present the
133.18most complex and difficult care needs, and are a potential threat to the community; and
133.19(8) room and board facilities that meet the requirements of subdivision 1a.
133.20(c) The commissioner shall establish higher rates for programs that meet the
133.21requirements of paragraph (b) and the following additional requirements:
133.22(1) programs that serve parents with their children if the program:
133.23(i) provides on-site child care during hours of treatment activity that meets the
133.24requirements in Minnesota Rules, part 9530.6490, or section 245A.03, subdivision 2; or
133.25(ii) arranges for off-site child care during hours of treatment activity at a facility that
133.26is licensed under chapter 245A as:
133.27(A) a child care center under Minnesota Rules, chapter 9503; or
133.28(B) a family child care home under Minnesota Rules, chapter 9502;
133.29(2) culturally specific programs as defined in section 254B.01, subdivision 4a, if the
133.30program meets the requirements in Minnesota Rules, part 9530.6605, subpart 13;
133.31(3) programs that offer medical services delivered by appropriately credentialed
133.32health care staff in an amount equal to two hours per client per week if the medical
133.33needs of the client and the nature and provision of any medical services provided are
133.34documented in the client file; and
133.35(4) programs that offer services to individuals with co-occurring mental health and
133.36chemical dependency problems if:
134.1(i) the program meets the co-occurring requirements in Minnesota Rules, part
134.29530.6495;
134.3(ii) 25 percent of the counseling staff are licensed mental health professionals, as
134.4defined in section 245.462, subdivision 18, clauses (1) to (6), or are students or licensing
134.5candidates under the supervision of a licensed alcohol and drug counselor supervisor and
134.6licensed mental health professional, except that no more than 50 percent of the mental
134.7health staff may be students or licensing candidates with time documented to be directly
134.8related to provisions of co-occurring services;
134.9(iii) clients scoring positive on a standardized mental health screen receive a mental
134.10health diagnostic assessment within ten days of admission;
134.11(iv) the program has standards for multidisciplinary case review that include a
134.12monthly review for each client that, at a minimum, includes a licensed mental health
134.13professional and licensed alcohol and drug counselor, and their involvement in the review
134.14is documented;
134.15(v) family education is offered that addresses mental health and substance abuse
134.16disorders and the interaction between the two; and
134.17(vi) co-occurring counseling staff will receive eight hours of co-occurring disorder
134.18training annually.
134.19(d) In order to be eligible for a higher rate under paragraph (c), clause (1), a program
134.20that provides arrangements for off-site child care must maintain current documentation at
134.21the chemical dependency facility of the child care provider's current licensure to provide
134.22child care services. Programs that provide child care according to paragraph (c), clause
134.23(1), must be deemed in compliance with the licensing requirements in Minnesota Rules,
134.24part 9530.6490.
134.25(e) Adolescent residential programs that meet the requirements of Minnesota
134.26Rules, parts 2960.0430 to 2960.0490 and 2960.0580 to 2960.0690, are exempt from the
134.27requirements in paragraph (c), clause (4), items (i) to (iv).

134.28    Sec. 21. Minnesota Statutes 2014, section 254B.12, subdivision 2, is amended to read:
134.29    Subd. 2. Payment methodology for highly specialized vendors. (a)
134.30Notwithstanding subdivision 1, the commissioner shall seek federal authority to develop
134.31separate payment methodologies for chemical dependency treatment services provided
134.32under the consolidated chemical dependency treatment fund: (1) by a state-operated
134.33vendor; or (2) for persons who have been civilly committed to the commissioner, present
134.34the most complex and difficult care needs, and are a potential threat to the community. A
135.1payment methodology under this subdivision is effective for services provided on or after
135.2October 1, 2015, or on or after the receipt of federal approval, whichever is later.
135.3(b) Before implementing an approved payment methodology under paragraph
135.4(a), the commissioner must also receive any necessary legislative approval of required
135.5changes to state law or funding.

135.6    Sec. 22. Minnesota Statutes 2014, section 256B.0615, subdivision 3, is amended to read:
135.7    Subd. 3. Eligibility. Peer support services may be made available to consumers
135.8of (1) intensive rehabilitative mental health residential treatment services under section
135.9256B.0622 ; (2) adult rehabilitative mental health services under section 256B.0623; and
135.10(3) crisis stabilization and mental health mobile crisis intervention services under section
135.11256B.0624 .

135.12    Sec. 23. Minnesota Statutes 2014, section 256B.0622, subdivision 1, is amended to read:
135.13    Subdivision 1. Scope. Subject to federal approval, medical assistance covers
135.14medically necessary, intensive nonresidential assertive community treatment and intensive
135.15residential rehabilitative mental health treatment services as defined in subdivision 2, for
135.16recipients as defined in subdivision 3, when the services are provided by an entity meeting
135.17the standards in this section.

135.18    Sec. 24. Minnesota Statutes 2014, section 256B.0622, subdivision 2, is amended to read:
135.19    Subd. 2. Definitions. For purposes of this section, the following terms have the
135.20meanings given them.
135.21    (a) "Intensive nonresidential rehabilitative mental health services" means adult
135.22rehabilitative mental health services as defined in section 256B.0623, subdivision 2,
135.23paragraph (a), except that these services are provided by a multidisciplinary staff using
135.24a total team approach consistent with assertive community treatment, the Fairweather
135.25Lodge treatment model, as defined by the standards established by the National Coalition
135.26for Community Living, and other evidence-based practices, and directed to recipients with
135.27a serious mental illness who require intensive services. "Assertive community treatment"
135.28means intensive nonresidential rehabilitative mental health services provided according
135.29to the evidence-based practice of assertive community treatment. Core elements of this
135.30service include, but are not limited to:
135.31    (1) a multidisciplinary staff who utilize a total team approach and who serve as a
135.32fixed point of responsibility for all service delivery;
135.33    (2) providing services 24 hours per day and 7 days per week;
136.1    (3) providing the majority of services in a community setting;
136.2    (4) offering a low ratio of recipients to staff; and
136.3    (5) providing service that is not time-limited.
136.4    (b) "Intensive residential rehabilitative mental health treatment services" means
136.5short-term, time-limited services provided in a residential setting to recipients who are
136.6in need of more restrictive settings and are at risk of significant functional deterioration
136.7if they do not receive these services. Services are designed to develop and enhance
136.8psychiatric stability, personal and emotional adjustment, self-sufficiency, and skills to live
136.9in a more independent setting. Services must be directed toward a targeted discharge
136.10date with specified client outcomes and must be consistent with the Fairweather Lodge
136.11treatment model as defined in paragraph (a), and other evidence-based practices.
136.12    (c) "Evidence-based practices" are nationally recognized mental health services that
136.13are proven by substantial research to be effective in helping individuals with serious
136.14mental illness obtain specific treatment goals.
136.15    (d) "Overnight staff" means a member of the intensive residential rehabilitative
136.16mental health treatment team who is responsible during hours when recipients are
136.17typically asleep.
136.18    (e) "Treatment team" means all staff who provide services under this section to
136.19recipients. At a minimum, this includes the clinical supervisor, mental health professionals
136.20as defined in section 245.462, subdivision 18, clauses (1) to (6); mental health practitioners
136.21as defined in section 245.462, subdivision 17; mental health rehabilitation workers under
136.22section 256B.0623, subdivision 5, clause (3); and certified peer specialists under section
136.23256B.0615 .

136.24    Sec. 25. Minnesota Statutes 2014, section 256B.0622, subdivision 3, is amended to read:
136.25    Subd. 3. Eligibility. An eligible recipient is an individual who:
136.26(1) is age 18 or older;
136.27(2) is eligible for medical assistance;
136.28(3) is diagnosed with a mental illness;
136.29(4) because of a mental illness, has substantial disability and functional impairment
136.30in three or more of the areas listed in section 245.462, subdivision 11a, so that
136.31self-sufficiency is markedly reduced;
136.32(5) has one or more of the following: a history of two or more recurring or prolonged
136.33inpatient hospitalizations in the past year, significant independent living instability,
136.34homelessness, or very frequent use of mental health and related services yielding poor
136.35outcomes; and
137.1(6) in the written opinion of a licensed mental health professional, has the need for
137.2mental health services that cannot be met with other available community-based services,
137.3or is likely to experience a mental health crisis or require a more restrictive setting if
137.4intensive rehabilitative mental health services are not provided.

137.5    Sec. 26. Minnesota Statutes 2014, section 256B.0622, subdivision 4, is amended to read:
137.6    Subd. 4. Provider certification and contract requirements. (a) The intensive
137.7nonresidential rehabilitative mental health services assertive community treatment
137.8provider must:
137.9(1) have a contract with the host county to provide intensive adult rehabilitative
137.10mental health services; and
137.11(2) be certified by the commissioner as being in compliance with this section and
137.12section 256B.0623.
137.13(b) The intensive residential rehabilitative mental health treatment services provider
137.14must:
137.15(1) be licensed under Minnesota Rules, parts 9520.0500 to 9520.0670;
137.16(2) not exceed 16 beds per site;
137.17(3) comply with the additional standards in this section; and
137.18(4) have a contract with the host county to provide these services.
137.19(c) The commissioner shall develop procedures for counties and providers to submit
137.20contracts and other documentation as needed to allow the commissioner to determine
137.21whether the standards in this section are met.

137.22    Sec. 27. Minnesota Statutes 2014, section 256B.0622, subdivision 5, is amended to read:
137.23    Subd. 5. Standards applicable to both nonresidential assertive community
137.24treatment and residential providers. (a) Services must be provided by qualified staff as
137.25defined in section 256B.0623, subdivision 5, who are trained and supervised according to
137.26section 256B.0623, subdivision 6, except that mental health rehabilitation workers acting
137.27as overnight staff are not required to comply with section 256B.0623, subdivision 5,
137.28clause (3) (4), item (iv).
137.29(b) The clinical supervisor must be an active member of the treatment team. The
137.30treatment team must meet with the clinical supervisor at least weekly to discuss recipients'
137.31progress and make rapid adjustments to meet recipients' needs. The team meeting shall
137.32include recipient-specific case reviews and general treatment discussions among team
137.33members. Recipient-specific case reviews and planning must be documented in the
137.34individual recipient's treatment record.
138.1(c) Treatment staff must have prompt access in person or by telephone to a mental
138.2health practitioner or mental health professional. The provider must have the capacity to
138.3promptly and appropriately respond to emergent needs and make any necessary staffing
138.4adjustments to assure the health and safety of recipients.
138.5(d) The initial functional assessment must be completed within ten days of intake
138.6and updated at least every three months 30 days for intensive residential treatment services
138.7and every six months for assertive community treatment, or prior to discharge from the
138.8service, whichever comes first.
138.9(e) The initial individual treatment plan must be completed within ten days of intake
138.10and for assertive community treatment and within 24 hours of admission for intensive
138.11residential treatment services. Within ten days of admission, the initial treatment plan
138.12must be refined and further developed for intensive residential treatment services, except
138.13for providers certified according to Minnesota Rules, parts 9533.0010 to 9533.0180.
138.14The individual treatment plan must be reviewed with the recipient and updated at least
138.15monthly with the recipient for intensive residential treatment services and at least every
138.16six months for assertive community treatment.

138.17    Sec. 28. Minnesota Statutes 2014, section 256B.0622, subdivision 7, is amended to read:
138.18    Subd. 7. Additional standards for nonresidential services assertive community
138.19treatment. The standards in this subdivision apply to intensive nonresidential
138.20rehabilitative mental health assertive community treatment services.
138.21(1) The treatment team must use team treatment, not an individual treatment model.
138.22(2) The clinical supervisor must function as a practicing clinician at least on a
138.23part-time basis.
138.24(3) The staffing ratio must not exceed ten recipients to one full-time equivalent
138.25treatment team position.
138.26(4) Services must be available at times that meet client needs.
138.27(5) The treatment team must actively and assertively engage and reach out to the
138.28recipient's family members and significant others, after obtaining the recipient's permission.
138.29(6) The treatment team must establish ongoing communication and collaboration
138.30between the team, family, and significant others and educate the family and significant
138.31others about mental illness, symptom management, and the family's role in treatment.
138.32(7) The treatment team must provide interventions to promote positive interpersonal
138.33relationships.

138.34    Sec. 29. Minnesota Statutes 2014, section 256B.0622, subdivision 8, is amended to read:
139.1    Subd. 8. Medical assistance payment for intensive rehabilitative mental health
139.2services. (a) Payment for intensive residential and nonresidential treatment services
139.3and assertive community treatment in this section shall be based on one daily rate per
139.4provider inclusive of the following services received by an eligible recipient in a given
139.5calendar day: all rehabilitative services under this section, staff travel time to provide
139.6rehabilitative services under this section, and nonresidential crisis stabilization services
139.7under section 256B.0624.
139.8(b) Except as indicated in paragraph (c), payment will not be made to more than one
139.9entity for each recipient for services provided under this section on a given day. If services
139.10under this section are provided by a team that includes staff from more than one entity, the
139.11team must determine how to distribute the payment among the members.
139.12(c) The commissioner shall determine one rate for each provider that will bill
139.13medical assistance for residential services under this section and one rate for each
139.14nonresidential assertive community treatment provider. If a single entity provides both
139.15services, one rate is established for the entity's residential services and another rate for the
139.16entity's nonresidential services under this section. A provider is not eligible for payment
139.17under this section without authorization from the commissioner. The commissioner shall
139.18develop rates using the following criteria:
139.19(1) the cost for similar services in the local trade area;
139.20(2) (1) the provider's cost for services shall include direct services costs, other
139.21program costs, and other costs determined as follows:
139.22(i) the direct services costs must be determined using actual costs of salaries, benefits,
139.23payroll taxes, and training of direct service staff and service-related transportation;
139.24(ii) other program costs not included in item (i) must be determined as a specified
139.25percentage of the direct services costs as determined by item (i). The percentage used shall
139.26be determined by the commissioner based upon the average of percentages that represent
139.27the relationship of other program costs to direct services costs among the entities that
139.28provide similar services;
139.29(iii) in situations where a provider of intensive residential services can demonstrate
139.30actual program-related physical plant costs in excess of the group residential housing
139.31reimbursement, the commissioner may include these costs in the program rate, so long
139.32as the additional reimbursement does not subsidize the room and board expenses of the
139.33program physical plant costs calculated based on the percentage of space within the
139.34program that is entirely devoted to treatment and programming. This does not include
139.35administrative or residential space;
140.1(iv) intensive nonresidential services assertive community treatment physical plant
140.2costs must be reimbursed as part of the costs described in item (ii); and
140.3(v) subject to federal approval, up to an additional five percent of the total rate must
140.4may be added to the program rate as a quality incentive based upon the entity meeting
140.5performance criteria specified by the commissioner;
140.6(3) (2) actual cost is defined as costs which are allowable, allocable, and reasonable,
140.7and consistent with federal reimbursement requirements under Code of Federal
140.8Regulations, title 48, chapter 1, part 31, relating to for-profit entities, and Office of
140.9Management and Budget Circular Number A-122, relating to nonprofit entities;
140.10(4) (3) the number of service units;
140.11(5) (4) the degree to which recipients will receive services other than services under
140.12this section; and
140.13(6) (5) the costs of other services that will be separately reimbursed; and.
140.14(7) input from the local planning process authorized by the adult mental health
140.15initiative under section 245.4661, regarding recipients' service needs.
140.16(d) The rate for intensive rehabilitative mental health residential treatment services
140.17and assertive community treatment must exclude room and board, as defined in section
140.18256I.03, subdivision 6 , and services not covered under this section, such as partial
140.19hospitalization, home care, and inpatient services.
140.20(e) Physician services that are not separately billed may be included in the rate to the
140.21extent that a psychiatrist, or other health care professional providing physician services
140.22within their scope of practice, is a member of the treatment team. Physician services,
140.23whether billed separately or included in the rate, may be delivered by telemedicine. For
140.24purposes of this paragraph, "telemedicine" has the meaning given to "mental health
140.25telemedicine" in section 256B.0625, subdivision 46, when telemedicine is used to provide
140.26intensive residential treatment services.
140.27(e) (f) When services under this section are provided by an intensive nonresidential
140.28service assertive community treatment provider, case management functions must be an
140.29integral part of the team.
140.30(f) (g) The rate for a provider must not exceed the rate charged by that provider for
140.31the same service to other payors.
140.32(g) (h) The rates for existing programs must be established prospectively based upon
140.33the expenditures and utilization over a prior 12-month period using the criteria established
140.34in paragraph (c). The rates for new programs must be established based upon estimated
140.35expenditures and estimated utilization using the criteria established in paragraph (c).
141.1(h) (i) Entities who discontinue providing services must be subject to a settle-up
141.2process whereby actual costs and reimbursement for the previous 12 months are
141.3compared. In the event that the entity was paid more than the entity's actual costs plus
141.4any applicable performance-related funding due the provider, the excess payment must
141.5be reimbursed to the department. If a provider's revenue is less than actual allowed costs
141.6due to lower utilization than projected, the commissioner may reimburse the provider to
141.7recover its actual allowable costs. The resulting adjustments by the commissioner must
141.8be proportional to the percent of total units of service reimbursed by the commissioner
141.9and must reflect a difference of greater than five percent.
141.10(i) (j) A provider may request of the commissioner a review of any rate-setting
141.11decision made under this subdivision.

141.12    Sec. 30. Minnesota Statutes 2014, section 256B.0622, subdivision 9, is amended to read:
141.13    Subd. 9. Provider enrollment; rate setting for county-operated entities. Counties
141.14that employ their own staff to provide services under this section shall apply directly to
141.15the commissioner for enrollment and rate setting. In this case, a county contract is not
141.16required and the commissioner shall perform the program review and rate setting duties
141.17which would otherwise be required of counties under this section.

141.18    Sec. 31. Minnesota Statutes 2014, section 256B.0622, subdivision 10, is amended to
141.19read:
141.20    Subd. 10. Provider enrollment; rate setting for specialized program. A county
141.21contract is not required for a provider proposing to serve a subpopulation of eligible
141.22recipients may bypass the county approval procedures in this section and receive approval
141.23for provider enrollment and rate setting directly from the commissioner under the
141.24following circumstances:
141.25(1) the provider demonstrates that the subpopulation to be served requires a
141.26specialized program which is not available from county-approved entities; and
141.27(2) the subpopulation to be served is of such a low incidence that it is not feasible to
141.28develop a program serving a single county or regional group of counties.
141.29For providers meeting the criteria in clauses (1) and (2), the commissioner shall
141.30perform the program review and rate setting duties which would otherwise be required of
141.31counties under this section.

141.32    Sec. 32. Minnesota Statutes 2014, section 256B.0622, is amended by adding a
141.33subdivision to read:
142.1    Subd. 11. Sustainability grants. The commissioner may disburse grant funds
142.2directly to intensive residential treatment services providers and assertive community
142.3treatment providers to maintain access to these services.

142.4    Sec. 33. Minnesota Statutes 2014, section 256B.0624, subdivision 7, is amended to read:
142.5    Subd. 7. Crisis stabilization services. (a) Crisis stabilization services must be
142.6provided by qualified staff of a crisis stabilization services provider entity and must meet
142.7the following standards:
142.8(1) a crisis stabilization treatment plan must be developed which meets the criteria
142.9in subdivision 11;
142.10(2) staff must be qualified as defined in subdivision 8; and
142.11(3) services must be delivered according to the treatment plan and include
142.12face-to-face contact with the recipient by qualified staff for further assessment, help with
142.13referrals, updating of the crisis stabilization treatment plan, supportive counseling, skills
142.14training, and collaboration with other service providers in the community.
142.15(b) If crisis stabilization services are provided in a supervised, licensed residential
142.16setting, the recipient must be contacted face-to-face daily by a qualified mental health
142.17practitioner or mental health professional. The program must have 24-hour-a-day
142.18residential staffing which may include staff who do not meet the qualifications in
142.19subdivision 8. The residential staff must have 24-hour-a-day immediate direct or telephone
142.20access to a qualified mental health professional or practitioner.
142.21(c) If crisis stabilization services are provided in a supervised, licensed residential
142.22setting that serves no more than four adult residents, and no more than two are recipients
142.23of crisis stabilization services one or more individuals are present at the setting to receive
142.24residential crisis stabilization services, the residential staff must include, for at least eight
142.25hours per day, at least one individual who meets the qualifications in subdivision 8,
142.26paragraph (a), clause (1) or (2).
142.27(d) If crisis stabilization services are provided in a supervised, licensed residential
142.28setting that serves more than four adult residents, and one or more are recipients of crisis
142.29stabilization services, the residential staff must include, for 24 hours a day, at least one
142.30individual who meets the qualifications in subdivision 8. During the first 48 hours that a
142.31recipient is in the residential program, the residential program must have at least two staff
142.32working 24 hours a day. Staffing levels may be adjusted thereafter according to the needs
142.33of the recipient as specified in the crisis stabilization treatment plan.

143.1    Sec. 34. Minnesota Statutes 2014, section 256B.0625, is amended by adding a
143.2subdivision to read:
143.3    Subd. 45a. Psychiatric residential treatment facility services for persons under
143.421 years of age. (a) Medical assistance covers psychiatric residential treatment facility
143.5services for persons under 21 years of age. Individuals who reach age 21 at the time they
143.6are receiving services are eligible to continue receiving services until they no longer
143.7require services or until they reach age 22, whichever occurs first.
143.8(b) For purposes of this subdivision, "psychiatric residential treatment facility"
143.9means a facility other than a hospital that provides psychiatric services, as described in
143.10Code of Federal Regulations, title 42, sections 441.151 to 441.182, to individuals under
143.11age 21 in an inpatient setting.
143.12(c) The commissioner shall develop admissions and discharge procedures and
143.13establish rates consistent with guidelines from the federal Centers for Medicare and
143.14Medicaid Services.
143.15(d) The commissioner shall enroll up to 150 certified psychiatric residential
143.16treatment facility services beds at up to six sites. The commissioner shall select psychiatric
143.17residential treatment facility services providers through a request for proposals process.
143.18Providers of state-operated services may respond to the request for proposals.
143.19EFFECTIVE DATE.This section is effective July 1, 2017, or upon federal
143.20approval, whichever is later. The commissioner of human services shall notify the revisor
143.21of statutes when federal approval is obtained.

143.22    Sec. 35. Minnesota Statutes 2014, section 256B.0625, subdivision 48, is amended to
143.23read:
143.24    Subd. 48. Psychiatric consultation to primary care practitioners. Medical
143.25assistance covers consultation provided by a psychiatrist, a psychologist, or an advanced
143.26practice registered nurse certified in psychiatric mental health, a licensed independent
143.27clinical social worker, as defined in section 245.462, subdivision 18, clause (2), or a
143.28licensed marriage and family therapist, as defined in section 245.462, subdivision 18,
143.29clause (5), via telephone, e-mail, facsimile, or other means of communication to primary
143.30care practitioners, including pediatricians. The need for consultation and the receipt of the
143.31consultation must be documented in the patient record maintained by the primary care
143.32practitioner. If the patient consents, and subject to federal limitations and data privacy
143.33provisions, the consultation may be provided without the patient present.

144.1    Sec. 36. [256B.7631] CHEMICAL DEPENDENCY PROVIDER RATE
144.2INCREASE.
144.3For the chemical dependency services listed in section 254B.05, subdivision 5, and
144.4provided on or after July 1, 2015, payment rates shall be increased by two percent over
144.5the rates in effect on January 1, 2014, for vendors who meet the requirements of section
144.6254B.05.

144.7    Sec. 37. CLUBHOUSE PROGRAM SERVICES.
144.8The commissioner of human services, in consultation with stakeholders, shall
144.9develop service standards and a payment methodology for Clubhouse program services
144.10to be covered under medical assistance when provided by a Clubhouse International
144.11accredited provider or a provider meeting equivalent standards. The commissioner shall
144.12seek federal approval for the service standards and payment methodology. Upon federal
144.13approval, the commissioner must seek and obtain legislative approval of the services
144.14standards and funding methodology allowing medical assistance coverage of the service.

144.15    Sec. 38. EXCELLENCE IN MENTAL HEALTH DEMONSTRATION PROJECT.
144.16By January 15, 2016, the commissioner of human services shall report to the
144.17legislative committees in the house of representatives and senate with jurisdiction over
144.18human services issues on the progress of the Excellence in Mental Health demonstration
144.19project under Minnesota Statutes, section 245.735. The commissioner shall include in
144.20the report any recommendations for legislative changes needed to implement the reform
144.21projects specified in Minnesota Statutes, section 245.735, subdivision 3.

144.22    Sec. 39. RATE-SETTING METHODOLOGY FOR COMMUNITY-BASED
144.23MENTAL HEALTH SERVICES.
144.24The commissioner of human services shall conduct a comprehensive analysis
144.25of the current rate-setting methodology for all community-based mental health
144.26services for children and adults. The report shall include an assessment of alternative
144.27payment structures, consistent with the intent and direction of the federal Centers for
144.28Medicare and Medicaid Services, that could provide adequate reimbursement to sustain
144.29community-based mental health services regardless of geographic location. The report
144.30shall also include recommendations for establishing pay-for-performance measures for
144.31providers delivering services consistent with evidence-based practices. In developing the
144.32report, the commissioner shall consult with stakeholders and with outside experts in
144.33Medicaid financing. The commissioner shall provide a report on the analysis to the chairs
145.1of the legislative committees with jurisdiction over health and human services finance
145.2by January 1, 2017.

145.3    Sec. 40. REPORT ON HUMAN SERVICES DATA SHARING TO
145.4COORDINATE SERVICES AND CARE OF A PATIENT.
145.5The commissioner of human services, in coordination with Hennepin County, shall
145.6report to the legislative committees with jurisdiction over health care financing on the
145.7fiscal impact, including the estimated savings, resulting from the modifications to the Data
145.8Practices Act in the 2015 legislative session, permitting the sharing of public welfare data
145.9and allowing the exchange of health records between providers to the extent necessary to
145.10coordinate services and care for clients enrolled in public health care programs. Counties
145.11shall provide information on the fiscal impact, including the estimated savings, resulting
145.12from the modifications to the Data Practices Act in the 2015 legislative session, the
145.13number of clients receiving care coordination, and improved outcomes achieved due
145.14to data sharing, to the commissioner of human services to include in the report. The
145.15commissioner may establish the form in which the information must be provided. The
145.16report is due January 1, 2017.

145.17    Sec. 41. COMPREHENSIVE MENTAL HEALTH PROGRAM IN BELTRAMI
145.18COUNTY.
145.19(a) The commissioner of human services shall award a grant to Beltrami County
145.20to fund the planning and development of a comprehensive mental health program
145.21contingent upon Beltrami County providing to the commissioner of human services a
145.22formal commitment and plan to fund, operate, and sustain the program and services after
145.23the onetime state grant is expended. The county must provide evidence of the funding
145.24stream or mechanism, and a sufficient local funding commitment, that will ensure that
145.25the onetime state investment in the program will result in a sustainable program without
145.26future state grants. The funding stream may include state funding for programs and
145.27services for which the individuals served under this section may be eligible. The grant
145.28under this section cannot be used for any purpose that could be funded with state bond
145.29proceeds. This is a onetime appropriation.
145.30(b) The planning and development of the program by the county must include an
145.31integrated care model for the provision of mental health and substance use disorder
145.32treatment for the individuals served under paragraph (c), in collaboration with existing
145.33services. The model may include mobile crisis services, crisis residential services,
146.1outpatient services, and community-based services. The model must be patient-centered,
146.2culturally competent, and based on evidence-based practices.
146.3(c) The comprehensive mental health program will serve individuals who are:
146.4(1) under arrest or subject to arrest who are experiencing a mental health crisis;
146.5(2) under a transport hold under Minnesota Statutes, section 253B.05, subdivision
146.62; or
146.7(3) in immediate need of mental health crisis services.
146.8(d) The commissioner of human services may encourage the commissioners of
146.9the Minnesota Housing Finance Agency, corrections, and health to provide technical
146.10assistance and support in the planning and development of the mental health program
146.11under paragraph (a). The commissioners of the Minnesota Housing Finance Agency and
146.12human services may explore a plan to develop short-term and long-term housing for
146.13individuals served by the program, and the possibility of using existing appropriations
146.14available in the housing finance budget for low-income housing or homelessness.
146.15(e) The commissioner of human services, in consultation with Beltrami County,
146.16shall report to the senate and house of representatives committees having jurisdiction over
146.17mental health issues the status of the planning and development of the mental health
146.18program, and the plan to financially support the program and services after the state grant
146.19is expended, by November 1, 2017.

146.20    Sec. 42. MENTAL HEALTH CRISIS SERVICES.
146.21The commissioner of human services shall increase access to mental health crisis
146.22services for children and adults. In order to increase access, the commissioner must:
146.23(1) develop a central phone number where calls can be routed to the appropriate
146.24crisis services;
146.25(2) provide telephone consultation 24 hours a day to mobile crisis teams who are
146.26serving people with traumatic brain injury or intellectual disabilities who are experiencing
146.27a mental health crisis;
146.28(3) expand crisis services across the state, including rural areas of the state and
146.29examining access per population;
146.30(4) establish and implement state standards for crisis services; and
146.31(5) provide grants to adult mental health initiatives, counties, tribes, or community
146.32mental health providers to establish new mental health crisis residential service capacity.
146.33Priority will be given to regions that do not have a mental health crisis residential
146.34services program, do not have an inpatient psychiatric unit within the region, do not have
146.35an inpatient psychiatric unit within 90 miles, or have a demonstrated need based on the
147.1number of crisis residential or intensive residential treatment beds available to meet the
147.2needs of the residents in the region. At least 50 percent of the funds must be distributed to
147.3programs in rural Minnesota. Grant funds may be used for start-up costs, including but not
147.4limited to renovations, furnishings, and staff training. Grant applications shall provide
147.5details on how the intended service will address identified needs and shall demonstrate
147.6collaboration with crisis teams, other mental health providers, hospitals, and police.

147.7    Sec. 43. INSTRUCTIONS TO THE COMMISSIONER.
147.8The commissioner of human services shall, in consultation with stakeholders, develop
147.9recommendations on funding for children's mental health crisis residential services that will
147.10allow for timely access without requiring county authorization or child welfare placement.

147.11ARTICLE 3

147.12WITHDRAWAL MANAGEMENT PROGRAMS

147.13    Section 1. [245F.01] PURPOSE.
147.14It is hereby declared to be the public policy of this state that the public interest is best
147.15served by providing efficient and effective withdrawal management services to persons
147.16in need of appropriate detoxification, assessment, intervention, and referral services.
147.17The services shall vary to address the unique medical needs of each patient and shall be
147.18responsive to the language and cultural needs of each patient. Services shall not be denied
147.19on the basis of a patient's inability to pay.

147.20    Sec. 2. [245F.02] DEFINITIONS.
147.21    Subdivision 1. Scope. The terms used in this chapter have the meanings given
147.22them in this section.
147.23    Subd. 2. Administration of medications. "Administration of medications" means
147.24performing a task to provide medications to a patient, and includes the following tasks
147.25performed in the following order:
147.26(1) checking the patient's medication record;
147.27(2) preparing the medication for administration;
147.28(3) administering the medication to the patient;
147.29(4) documenting administration of the medication or the reason for not administering
147.30the medication as prescribed; and
147.31(5) reporting information to a licensed practitioner or a registered nurse regarding
147.32problems with the administration of the medication or the patient's refusal to take the
147.33medication.
148.1    Subd. 3. Alcohol and drug counselor. "Alcohol and drug counselor" means an
148.2individual qualified under Minnesota Rules, part 9530.6450, subpart 5.
148.3    Subd. 4. Applicant. "Applicant" means an individual, partnership, voluntary
148.4association, corporation, or other public or private organization that submits an application
148.5for licensure under this chapter.
148.6    Subd. 5. Care coordination. "Care coordination" means activities intended to bring
148.7together health services, patient needs, and streams of information to facilitate the aims
148.8of care. Care coordination includes an ongoing needs assessment, life skills advocacy,
148.9treatment follow-up, disease management, education, and other services as needed.
148.10    Subd. 6. Chemical. "Chemical" means alcohol, solvents, controlled substances as
148.11defined in section 152.01, subdivision 4, and other mood-altering substances.
148.12    Subd. 7. Clinically managed program. "Clinically managed program" means a
148.13residential setting with staff comprised of a medical director and a licensed practical nurse.
148.14A licensed practical nurse must be on site 24 hours a day, seven days a week. A qualified
148.15medical professional must be available by telephone or in person for consultation 24 hours
148.16a day. Patients admitted to this level of service receive medical observation, evaluation,
148.17and stabilization services during the detoxification process; access to medications
148.18administered by trained, licensed staff to manage withdrawal; and a comprehensive
148.19assessment pursuant to Minnesota Rules, part 9530.6422.
148.20    Subd. 8. Commissioner. "Commissioner" means the commissioner of human
148.21services or the commissioner's designated representative.
148.22    Subd. 9. Department. "Department" means the Department of Human Services.
148.23    Subd. 10. Direct patient contact. "Direct patient contact" has the meaning given
148.24for "direct contact" in section 245C.02, subdivision 11.
148.25    Subd. 11. Discharge plan. "Discharge plan" means a written plan that states with
148.26specificity the services the program has arranged for the patient to transition back into
148.27the community.
148.28    Subd. 12. Licensed practitioner. "Licensed practitioner" means a practitioner as
148.29defined in section 151.01, subdivision 23, who is authorized to prescribe.
148.30    Subd. 13. Medical director. "Medical director" means an individual licensed in
148.31Minnesota as a doctor of osteopathy or physician, or an individual licensed in Minnesota
148.32as an advanced practice registered nurse by the Board of Nursing and certified to practice
148.33as a clinical nurse specialist or nurse practitioner by a national nurse organization
148.34acceptable to the board. The medical director must be employed by or under contract with
148.35the license holder to direct and supervise health care for patients of a program licensed
148.36under this chapter.
149.1    Subd. 14. Medically monitored program. "Medically monitored program" means
149.2a residential setting with staff that includes a registered nurse and a medical director. A
149.3registered nurse must be on site 24 hours a day. A medical director must be on site seven
149.4days a week, and patients must have the ability to be seen by a medical director within 24
149.5hours. Patients admitted to this level of service receive medical observation, evaluation,
149.6and stabilization services during the detoxification process; medications administered by
149.7trained, licensed staff to manage withdrawal; and a comprehensive assessment pursuant to
149.8Minnesota Rules, part 9530.6422.
149.9    Subd. 15. Nurse. "Nurse" means a person licensed and currently registered to
149.10practice practical or professional nursing as defined in section 148.171, subdivisions
149.1114 and 15.
149.12    Subd. 16. Patient. "Patient" means an individual who presents or is presented for
149.13admission to a withdrawal management program that meets the criteria in section 245F.05.
149.14    Subd. 17. Peer recovery support services. "Peer recovery support services"
149.15means mentoring and education, advocacy, and nonclinical recovery support provided
149.16by a recovery peer.
149.17    Subd. 18. Program director. "Program director" means the individual who is
149.18designated by the license holder to be responsible for all operations of a withdrawal
149.19management program and who meets the qualifications specified in section 245F.15,
149.20subdivision 3.
149.21    Subd. 19. Protective procedure. "Protective procedure" means an action taken by a
149.22staff member of a withdrawal management program to protect a patient from imminent
149.23danger of harming self or others. Protective procedures include the following actions:
149.24(1) seclusion, which means the temporary placement of a patient, without the
149.25patient's consent, in an environment to prevent social contact; and
149.26(2) physical restraint, which means the restraint of a patient by use of physical holds
149.27intended to limit movement of the body.
149.28    Subd. 20. Qualified medical professional. "Qualified medical professional"
149.29means an individual licensed in Minnesota as a doctor of osteopathy or physician, or an
149.30individual licensed in Minnesota as an advanced practice registered nurse by the Board of
149.31Nursing and certified to practice as a clinical nurse specialist or nurse practitioner by a
149.32national nurse organization acceptable to the board.
149.33    Subd. 21. Recovery peer. "Recovery peer" means a person who has progressed in
149.34the person's own recovery from substance use disorder and is willing to serve as a peer
149.35to assist others in their recovery.
150.1    Subd. 22. Responsible staff person. "Responsible staff person" means the program
150.2director, the medical director, or a staff person with current licensure as a nurse in
150.3Minnesota. The responsible staff person must be on the premises and is authorized to
150.4make immediate decisions concerning patient care and safety.
150.5    Subd. 23. Substance. "Substance" means "chemical" as defined in subdivision 6.
150.6    Subd. 24. Substance use disorder. "Substance use disorder" means a pattern of
150.7substance use as defined in the current edition of the Diagnostic and Statistical Manual of
150.8Mental Disorders.
150.9    Subd. 25. Technician. "Technician" means a person who meets the qualifications in
150.10section 245F.15, subdivision 6.
150.11    Subd. 26. Withdrawal management program. "Withdrawal management
150.12program" means a licensed program that provides short-term medical services on
150.13a 24-hour basis for the purpose of stabilizing intoxicated patients, managing their
150.14withdrawal, and facilitating access to substance use disorder treatment as indicated by a
150.15comprehensive assessment.

150.16    Sec. 3. [245F.03] APPLICATION.
150.17(a) This chapter establishes minimum standards for withdrawal management
150.18programs licensed by the commissioner that serve one or more unrelated persons.
150.19(b) This chapter does not apply to a withdrawal management program licensed as a
150.20hospital under sections 144.50 to 144.581. A withdrawal management program located in
150.21a hospital licensed under sections 144.50 to 144.581 that chooses to be licensed under this
150.22chapter is deemed to be in compliance with section 245F.13.

150.23    Sec. 4. [245F.04] PROGRAM LICENSURE.
150.24    Subdivision 1. General application and license requirements. An applicant
150.25for licensure as a clinically managed withdrawal management program or medically
150.26monitored withdrawal management program must meet the following requirements,
150.27except where otherwise noted. All programs must comply with federal requirements and
150.28the general requirements in chapters 245A and 245C and sections 626.556, 626.557, and
150.29626.5572. A withdrawal management program must be located in a hospital licensed under
150.30sections 144.50 to 144.581, or must be a supervised living facility with a class B license
150.31from the Department of Health under Minnesota Rules, parts 4665.0100 to 4665.9900.
150.32    Subd. 2. Contents of application. Prior to the issuance of a license, an applicant
150.33must submit, on forms provided by the commissioner, documentation demonstrating
150.34the following:
151.1(1) compliance with this section;
151.2(2) compliance with applicable building, fire, and safety codes; health rules; zoning
151.3ordinances; and other applicable rules and regulations or documentation that a waiver
151.4has been granted. The granting of a waiver does not constitute modification of any
151.5requirement of this section;
151.6(3) completion of an assessment of need for a new or expanded program as required
151.7by Minnesota Rules, part 9530.6800; and
151.8(4) insurance coverage, including bonding, sufficient to cover all patient funds,
151.9property, and interests.
151.10    Subd. 3. Changes in license terms. (a) A license holder must notify the
151.11commissioner before one of the following occurs and the commissioner must determine
151.12the need for a new license:
151.13(1) a change in the Department of Health's licensure of the program;
151.14(2) a change in the medical services provided by the program that affects the
151.15program's capacity to provide services required by the program's license designation as a
151.16clinically managed program or medically monitored program;
151.17(3) a change in program capacity; or
151.18(4) a change in location.
151.19(b) A license holder must notify the commissioner and apply for a new license
151.20when a change in program ownership occurs.
151.21    Subd. 4. Variances. The commissioner may grant variances to the requirements of
151.22this chapter under section 245A.04, subdivision 9.

151.23    Sec. 5. [245F.05] ADMISSION AND DISCHARGE POLICIES.
151.24    Subdivision 1. Admission policy. A license holder must have a written admission
151.25policy containing specific admission criteria. The policy must describe the admission
151.26process and the point at which an individual who is eligible under subdivision 2 is
151.27admitted to the program. A license holder must not admit individuals who do not meet the
151.28admission criteria. The admission policy must be approved and signed by the medical
151.29director of the facility and must designate which staff members are authorized to admit
151.30and discharge patients. The admission policy must be posted in the area of the facility
151.31where patients are admitted and given to all interested individuals upon request.
151.32    Subd. 2. Admission criteria. For an individual to be admitted to a withdrawal
151.33management program, the program must make a determination that the program services
151.34are appropriate to the needs of the individual. A program may only admit individuals who
151.35meet the admission criteria and who, at the time of admission:
152.1(1) are impaired as the result of intoxication;
152.2(2) are experiencing physical, mental, or emotional problems due to intoxication or
152.3withdrawal from alcohol or other drugs;
152.4(3) are being held under apprehend and hold orders under section 253B.07,
152.5subdivision 2b;
152.6(4) have been committed under chapter 253B, and need temporary placement;
152.7(5) are held under emergency holds or peace and health officer holds under section
152.8253B.05, subdivision 1 or 2; or
152.9(6) need to stay temporarily in a protective environment because of a crisis related
152.10to substance use disorder. Individuals satisfying this clause may be admitted only at the
152.11request of the county of fiscal responsibility, as determined according to section 256G.02,
152.12subdivision 4. Individuals admitted according to this clause must not be restricted to
152.13the facility.
152.14    Subd. 3. Individuals denied admission by program. (a) A license holder must
152.15have a written policy and procedure for addressing the needs of individuals who are
152.16denied admission to the program. These individuals include:
152.17(1) individuals whose pregnancy, in combination with their presenting problem,
152.18requires services not provided by the program; and
152.19(2) individuals who are in imminent danger of harming self or others if their
152.20behavior is beyond the behavior management capabilities of the program and staff.
152.21(b) Programs must document denied admissions, including the date and time of
152.22the admission request, reason for the denial of admission, and where the individual was
152.23referred. If the individual did not receive a referral, the program must document why a
152.24referral was not made. This information must be documented on a form approved by the
152.25commissioner and made available to the commissioner upon request.
152.26    Subd. 4. License holder responsibilities; denying admission or terminating
152.27services. (a) If a license holder denies an individual admission to the program or
152.28terminates services to a patient and the denial or termination poses an immediate threat to
152.29the patient's or individual's health or requires immediate medical intervention, the license
152.30holder must refer the patient or individual to a medical facility capable of admitting the
152.31patient or individual.
152.32(b) A license holder must report to a law enforcement agency with proper jurisdiction
152.33all denials of admission and terminations of services that involve the commission of a crime
152.34against a staff member of the license holder or on the license holder's property, as provided
152.35in Code of Federal Regulations, title 42, section 2.12(c)(5), and title 45, parts 160 to 164.
153.1    Subd. 5. Discharge and transfer policies. A license holder must have a written
153.2policy and procedure, approved and signed by the medical director, that specifies
153.3conditions under which patients may be discharged or transferred. The policy must
153.4include the following:
153.5(1) guidelines for determining when a patient is medically stable and whether a
153.6patient is able to be discharged or transferred to a lower level of care;
153.7(2) guidelines for determining when a patient needs a transfer to a higher level of care.
153.8Clinically managed program guidelines must include guidelines for transfer to a medically
153.9monitored program, hospital, or other acute care facility. Medically monitored program
153.10guidelines must include guidelines for transfer to a hospital or other acute care facility;
153.11(3) procedures staff must follow when discharging a patient under each of the
153.12following circumstances:
153.13(i) the patient is involved in the commission of a crime against program staff or
153.14against a license holder's property. The procedures for a patient discharged under this
153.15item must specify how reports must be made to law enforcement agencies with proper
153.16jurisdiction as allowed under Code of Federal Regulations, title 42, section 2.12(c)(5), and
153.17title 45, parts 160 to 164;
153.18(ii) the patient is in imminent danger of harming self or others and is beyond the
153.19license holder's capacity to ensure safety;
153.20(iii) the patient was admitted under chapter 253B; or
153.21(iv) the patient is leaving against staff or medical advice; and
153.22(4) a requirement that staff must document where the patient was referred after
153.23discharge or transfer, and if a referral was not made, the reason the patient was not
153.24provided a referral.

153.25    Sec. 6. [245F.06] SCREENING AND COMPREHENSIVE ASSESSMENT.
153.26    Subdivision 1. Screening for substance use disorder. A nurse or an alcohol
153.27and drug counselor must screen each patient upon admission to determine whether a
153.28comprehensive assessment is indicated. The license holder must screen patients at
153.29each admission, except that if the patient has already been determined to suffer from a
153.30substance use disorder, subdivision 2 applies.
153.31    Subd. 2. Comprehensive assessment. (a) Prior to a medically stable discharge,
153.32but not later than 72 hours following admission, a license holder must provide a
153.33comprehensive assessment according to section 245.4863, paragraph (a), and Minnesota
153.34Rules, part 9530.6422, for each patient who has a positive screening for a substance use
153.35disorder. If a patient's medical condition prevents a comprehensive assessment from
154.1being completed within 72 hours, the license holder must document why the assessment
154.2was not completed. The comprehensive assessment must include documentation of the
154.3appropriateness of an involuntary referral through the civil commitment process.
154.4(b) If available to the program, a patient's previous comprehensive assessment may
154.5be used in the patient record. If a previously completed comprehensive assessment is used,
154.6its contents must be reviewed to ensure the assessment is accurate and current and complies
154.7with the requirements of this chapter. The review must be completed by a staff person
154.8qualified according to Minnesota Rules, part 9530.6450, subpart 5. The license holder must
154.9document that the review was completed and that the previously completed assessment is
154.10accurate and current, or the license holder must complete an updated or new assessment.

154.11    Sec. 7. [245F.07] STABILIZATION PLANNING.
154.12    Subdivision 1. Stabilization plan. Within 12 hours of admission, a license
154.13holder must develop an individualized stabilization plan for each patient accepted for
154.14stabilization services. The plan must be based on the patient's initial health assessment
154.15and continually updated based on new information gathered about the patient's condition
154.16from the comprehensive assessment, medical evaluation and consultation, and ongoing
154.17monitoring and observations of the patient. The patient must have an opportunity to have
154.18direct involvement in the development of the plan. The stabilization plan must:
154.19(1) identify medical needs and goals to be achieved while the patient is receiving
154.20services;
154.21(2) specify stabilization services to address the identified medical needs and goals,
154.22including amount and frequency of services;
154.23(3) specify the participation of others in the stabilization planning process and
154.24specific services where appropriate; and
154.25(4) document the patient's participation in developing the content of the stabilization
154.26plan and any updates.
154.27    Subd. 2. Progress notes. Progress notes must be entered in the patient's file at least
154.28daily and immediately following any significant event, including any change that impacts
154.29the medical, behavioral, or legal status of the patient. Progress notes must:
154.30(1) include documentation of the patient's involvement in the stabilization services,
154.31including the type and amount of each stabilization service;
154.32(2) include the monitoring and observations of the patient's medical needs;
154.33(3) include documentation of referrals made to other services or agencies;
154.34(4) specify the participation of others; and
154.35(5) be legible, signed, and dated by the staff person completing the documentation.
155.1    Subd. 3. Discharge plan. Before a patient leaves the facility, the license holder
155.2must conduct discharge planning for the patient, document discharge planning in the
155.3patient's record, and provide the patient with a copy of the discharge plan. The discharge
155.4plan must include:
155.5(1) referrals made to other services or agencies at the time of transition;
155.6(2) the patient's plan for follow-up, aftercare, or other poststabilization services;
155.7(3) documentation of the patient's participation in the development of the transition
155.8plan;
155.9(4) any service that will continue after discharge under the direction of the license
155.10holder; and
155.11(5) a stabilization summary and final evaluation of the patient's progress toward
155.12treatment objectives.

155.13    Sec. 8. [245F.08] STABILIZATION SERVICES.
155.14    Subdivision 1. General. The license holder must encourage patients to remain in
155.15care for an appropriate duration as determined by the patient's stabilization plan, and must
155.16encourage all patients to enter programs for ongoing recovery as clinically indicated. In
155.17addition, the license holder must offer services that are patient-centered, trauma-informed,
155.18and culturally appropriate. Culturally appropriate services must include translation services
155.19and dietary services that meet a patient's dietary needs. All services provided to the patient
155.20must be documented in the patient's medical record. The following services must be
155.21offered unless clinically inappropriate and the justifying clinical rationale is documented:
155.22(1) individual or group motivational counseling sessions;
155.23(2) individual advocacy and case management services;
155.24(3) medical services as required in section 245F.12;
155.25(4) care coordination provided according to subdivision 2;
155.26(5) peer recovery support services provided according to subdivision 3;
155.27(6) patient education provided according to subdivision 4; and
155.28(7) referrals to mutual aid, self-help, and support groups.
155.29    Subd. 2. Care coordination. Care coordination services must be initiated for each
155.30patient upon admission. The license holder must identify the staff person responsible for
155.31the provision of each service. Care coordination services must include:
155.32(1) coordination with significant others to assist in the stabilization planning process
155.33whenever possible;
155.34(2) coordination with and follow-up to appropriate medical services as identified by
155.35the nurse or licensed practitioner;
156.1(3) referral to substance use disorder services as indicated by the comprehensive
156.2assessment;
156.3(4) referral to mental health services as identified in the comprehensive assessment;
156.4(5) referrals to economic assistance, social services, and prenatal care in accordance
156.5with the patient's needs;
156.6(6) review and approval of the transition plan prior to discharge, except in an
156.7emergency, by a staff member able to provide direct patient contact;
156.8(7) documentation of the provision of care coordination services in the patient's
156.9file; and
156.10(8) addressing cultural and socioeconomic factors affecting the patient's access to
156.11services.
156.12    Subd. 3. Peer recovery support services. (a) Peers in recovery serve as mentors or
156.13recovery-support partners for individuals in recovery, and may provide encouragement,
156.14self-disclosure of recovery experiences, transportation to appointments, assistance with
156.15finding resources that will help locate housing, job search resources, and assistance finding
156.16and participating in support groups.
156.17(b) Peer recovery support services are provided by a recovery peer and must be
156.18supervised by the responsible staff person.
156.19    Subd. 4. Patient education. A license holder must provide education to each
156.20patient on the following:
156.21(1) substance use disorder, including the effects of alcohol and other drugs, specific
156.22information about the effects of substance use on unborn children, and the signs and
156.23symptoms of fetal alcohol spectrum disorders;
156.24(2) tuberculosis and reporting known cases of tuberculosis disease to health care
156.25authorities according to section 144.4804;
156.26(3) Hepatitis C treatment and prevention;
156.27(4) HIV as required in section 245A.19, paragraphs (b) and (c);
156.28(5) nicotine cessation options, if applicable;
156.29(6) opioid tolerance and overdose risks, if applicable; and
156.30(7) long-term withdrawal issues related to use of barbiturates and benzodiazepines,
156.31if applicable.
156.32    Subd. 5. Mutual aid, self-help, and support groups. The license holder must
156.33refer patients to mutual aid, self-help, and support groups when clinically indicated and
156.34to the extent available in the community.

156.35    Sec. 9. [245F.09] PROTECTIVE PROCEDURES.
157.1    Subdivision 1. Use of protective procedures. (a) Programs must incorporate
157.2person-centered planning and trauma-informed care into its protective procedure policies.
157.3Protective procedures may be used only in cases where a less restrictive alternative will
157.4not protect the patient or others from harm and when the patient is in imminent danger
157.5of harming self or others. When a program uses a protective procedure, the program
157.6must continuously observe the patient until the patient may safely be left for 15-minute
157.7intervals. Use of the procedure must end when the patient is no longer in imminent danger
157.8of harming self or others.
157.9(b) Protective procedures may not be used:
157.10(1) for disciplinary purposes;
157.11(2) to enforce program rules;
157.12(3) for the convenience of staff;
157.13(4) as a part of any patient's health monitoring plan; or
157.14(5) for any reason except in response to specific, current behaviors which create an
157.15imminent danger of harm to the patient or others.
157.16    Subd. 2. Protective procedures plan. A license holder must have a written policy
157.17and procedure that establishes the protective procedures that program staff must follow
157.18when a patient is in imminent danger of harming self or others. The policy must be
157.19appropriate to the type of facility and the level of staff training. The protective procedures
157.20policy must include:
157.21(1) an approval signed and dated by the program director and medical director prior
157.22to implementation. Any changes to the policy must also be approved, signed, and dated by
157.23the current program director and the medical director prior to implementation;
157.24(2) which protective procedures the license holder will use to prevent patients from
157.25imminent danger of harming self or others;
157.26(3) the emergency conditions under which the protective procedures are permitted
157.27to be used, if any;
157.28(4) the patient's health conditions that limit the specific procedures that may be used
157.29and alternative means of ensuring safety;
157.30(5) emergency resources the program staff must contact when a patient's behavior
157.31cannot be controlled by the procedures established in the policy;
157.32(6) the training that staff must have before using any protective procedure;
157.33(7) documentation of approved therapeutic holds;
157.34(8) the use of law enforcement personnel as described in subdivision 4;
158.1(9) standards governing emergency use of seclusion. Seclusion must be used only
158.2when less restrictive measures are ineffective or not feasible. The standards in items (i) to
158.3(vii) must be met when seclusion is used with a patient:
158.4(i) seclusion must be employed solely for the purpose of preventing a patient from
158.5imminent danger of harming self or others;
158.6(ii) seclusion rooms must be equipped in a manner that prevents patients from
158.7self-harm using projections, windows, electrical fixtures, or hard objects, and must allow
158.8the patient to be readily observed without being interrupted;
158.9(iii) seclusion must be authorized by the program director, a licensed physician, or
158.10a registered nurse. If one of these individuals is not present in the facility, the program
158.11director or a licensed physician or registered nurse must be contacted and authorization
158.12must be obtained within 30 minutes of initiating seclusion, according to written policies;
158.13(iv) patients must not be placed in seclusion for more than 12 hours at any one time;
158.14(v) once the condition of a patient in seclusion has been determined to be safe
158.15enough to end continuous observation, a patient in seclusion must be observed at a
158.16minimum of every 15 minutes for the duration of seclusion and must always be within
158.17hearing range of program staff;
158.18(vi) a process for program staff to use to remove a patient to other resources available
158.19to the facility if seclusion does not sufficiently assure patient safety; and
158.20(vii) a seclusion area may be used for other purposes, such as intensive observation, if
158.21the room meets normal standards of care for the purpose and if the room is not locked; and
158.22(10) physical holds may only be used when less restrictive measures are not feasible.
158.23The standards in items (i) to (iv) must be met when physical holds are used with a patient:
158.24(i) physical holds must be employed solely for preventing a patient from imminent
158.25danger of harming self or others;
158.26(ii) physical holds must be authorized by the program director, a licensed physician,
158.27or a registered nurse. If one of these individuals is not present in the facility, the program
158.28director or a licensed physician or a registered nurse must be contacted and authorization
158.29must be obtained within 30 minutes of initiating a physical hold, according to written
158.30policies;
158.31(iii) the patient's health concerns must be considered in deciding whether to use
158.32physical holds and which holds are appropriate for the patient; and
158.33(iv) only approved holds may be utilized. Prone holds are not allowed and must
158.34not be authorized.
158.35    Subd. 3. Records. Each use of a protective procedure must be documented in the
158.36patient record. The patient record must include:
159.1(1) a description of specific patient behavior precipitating a decision to use a
159.2protective procedure, including date, time, and program staff present;
159.3(2) the specific means used to limit the patient's behavior;
159.4(3) the time the protective procedure began, the time the protective procedure ended,
159.5and the time of each staff observation of the patient during the procedure;
159.6(4) the names of the program staff authorizing the use of the protective procedure,
159.7the time of the authorization, and the program staff directly involved in the protective
159.8procedure and the observation process;
159.9(5) a brief description of the purpose for using the protective procedure, including
159.10less restrictive interventions used prior to the decision to use the protective procedure
159.11and a description of the behavioral results obtained through the use of the procedure. If
159.12a less restrictive intervention was not used, the reasons for not using a less restrictive
159.13intervention must be documented;
159.14(6) documentation by the responsible staff person on duty of reassessment of the
159.15patient at least every 15 minutes to determine if seclusion or the physical hold can be
159.16terminated;
159.17(7) a description of the physical holds used in escorting a patient; and
159.18(8) any injury to the patient that occurred during the use of a protective procedure.
159.19    Subd. 4. Use of law enforcement. The program must maintain a central log
159.20documenting each incident involving use of law enforcement, including:
159.21(1) the date and time law enforcement arrived at and left the program;
159.22(2) the reason for the use of law enforcement;
159.23(3) if law enforcement used force or a protective procedure and which protective
159.24procedure was used; and
159.25(4) whether any injuries occurred.
159.26    Subd. 5. Administrative review. (a) The license holder must keep a record of all
159.27patient incidents and protective procedures used. An administrative review of each use
159.28of protective procedures must be completed within 72 hours by someone other than the
159.29person who used the protective procedure. The record of the administrative review of the
159.30use of protective procedures must state whether:
159.31(1) the required documentation was recorded for each use of a protective procedure;
159.32(2) the protective procedure was used according to the policy and procedures;
159.33(3) the staff who implemented the protective procedure was properly trained; and
159.34(4) the behavior met the standards for imminent danger of harming self or others.
160.1(b) The license holder must conduct and document a quarterly review of the use of
160.2protective procedures with the goal of reducing the use of protective procedures. The
160.3review must include:
160.4(1) any patterns or problems indicated by similarities in the time of day, day of the
160.5week, duration of the use of a protective procedure, individuals involved, or other factors
160.6associated with the use of protective procedures;
160.7(2) any injuries resulting from the use of protective procedures;
160.8(3) whether law enforcement was involved in the use of a protective procedure;
160.9(4) actions needed to correct deficiencies in the program's implementation of
160.10protective procedures;
160.11(5) an assessment of opportunities missed to avoid the use of protective procedures;
160.12and
160.13(6) proposed actions to be taken to minimize the use of protective procedures.

160.14    Sec. 10. [245F.10] PATIENT RIGHTS AND GRIEVANCE PROCEDURES.
160.15    Subdivision 1. Patient rights. Patients have the rights in sections 144.651,
160.16148F.165, and 253B.03, as applicable. The license holder must give each patient, upon
160.17admission, a written statement of patient rights. Program staff must review the statement
160.18with the patient.
160.19    Subd. 2. Grievance procedure. Upon admission, the license holder must explain
160.20the grievance procedure to the patient or patient's representative and give the patient a
160.21written copy of the procedure. The grievance procedure must be posted in a place visible
160.22to the patient and must be made available to current and former patients upon request. A
160.23license holder's written grievance procedure must include:
160.24(1) staff assistance in developing and processing the grievance;
160.25(2) an initial response to the patient who filed the grievance within 24 hours of the
160.26program's receipt of the grievance, and timelines for additional steps to be taken to resolve
160.27the grievance, including access to the person with the highest level of authority in the
160.28program if the grievance cannot be resolved by other staff members; and
160.29(3) the current addresses and telephone numbers of the Department of Human
160.30Services Licensing Division, Department of Health Office of Health Facilities Complaints,
160.31Board of Behavioral Health and Therapy, Board of Medical Practice, Board of Nursing,
160.32and Office of the Ombudsman for Mental Health and Developmental Disabilities.

160.33    Sec. 11. [245F.11] PATIENT PROPERTY MANAGEMENT.
161.1A license holder must meet the requirements for handling patient funds and property
161.2in section 245A.04, subdivision 13, except:
161.3(1) a license holder must establish policies regarding the use of personal property to
161.4assure that program activities and the rights of other patients are not infringed, and may
161.5take temporary custody of personal property if these policies are violated;
161.6(2) a license holder must retain the patient's property for a minimum of seven days
161.7after discharge if the patient does not reclaim the property after discharge; and
161.8(3) the license holder must return to the patient all of the patient's property held in
161.9trust at discharge, regardless of discharge status, except that:
161.10(i) drugs, drug paraphernalia, and drug containers that are subject to forfeiture under
161.11section 609.5316 must be given over to the custody of a local law enforcement agency or,
161.12if giving the property over to the custody of a local law enforcement agency would violate
161.13Code of Federal Regulations, title 42, sections 2.1 to 2.67, and title 45, parts 160 to 164,
161.14destroyed by a staff person designated by the program director; and
161.15(ii) weapons, explosives, and other property that may cause serious harm to self
161.16or others must be transferred to a local law enforcement agency. The patient must be
161.17notified of the transfer and the right to reclaim the property if the patient has a legal right
161.18to possess the item.

161.19    Sec. 12. [245F.12] MEDICAL SERVICES.
161.20    Subdivision 1. Services provided at all programs. Withdrawal management
161.21programs must have:
161.22(1) a standardized data collection tool for collecting health-related information about
161.23each patient. The data collection tool must be developed in collaboration with a registered
161.24nurse and approved and signed by the medical director; and
161.25(2) written procedures for a nurse to assess and monitor patient health within the
161.26nurse's scope of practice. The procedures must:
161.27(i) be approved by the medical director;
161.28(ii) include a follow-up screening conducted between four and 12 hours after service
161.29initiation to collect information relating to acute intoxication, other health complaints, and
161.30behavioral risk factors that the patient may not have communicated at service initiation;
161.31(iii) specify the physical signs and symptoms that, when present, require consultation
161.32with a registered nurse or a physician and that require transfer to an acute care facility or
161.33a higher level of care than that provided by the program;
161.34(iv) specify those staff members responsible for monitoring patient health and
161.35provide for hourly observation and for more frequent observation if the initial health
162.1assessment or follow-up screening indicates a need for intensive physical or behavioral
162.2health monitoring; and
162.3(v) specify the actions to be taken to address specific complicating conditions,
162.4including pregnancy or the presence of physical signs or symptoms of any other medical
162.5condition.
162.6    Subd. 2. Services provided at clinically managed programs. In addition to the
162.7services listed in subdivision 1, clinically managed programs must:
162.8(1) have a licensed practical nurse on site 24 hours a day and a medical director;
162.9(2) provide an initial health assessment conducted by a nurse upon admission;
162.10(3) provide daily on-site medical evaluation by a nurse;
162.11(4) have a registered nurse available by telephone or in person for consultation
162.1224 hours a day;
162.13(5) have a qualified medical professional available by telephone or in person for
162.14consultation 24 hours a day; and
162.15(6) have appropriately licensed staff available to administer medications according
162.16to prescriber-approved orders.
162.17    Subd. 3. Services provided at medically monitored programs. In addition to the
162.18services listed in subdivision 1, medically monitored programs must have a registered
162.19nurse on site 24 hours a day and a medical director. Medically monitored programs must
162.20provide intensive inpatient withdrawal management services which must include:
162.21(1) an initial health assessment conducted by a registered nurse upon admission;
162.22(2) the availability of a medical evaluation and consultation with a registered nurse
162.2324 hours a day;
162.24(3) the availability of a qualified medical professional by telephone or in person
162.25for consultation 24 hours a day;
162.26(4) the ability to be seen within 24 hours or sooner by a qualified medical
162.27professional if the initial health assessment indicates the need to be seen;
162.28(5) the availability of on-site monitoring of patient care seven days a week by a
162.29qualified medical professional; and
162.30(6) appropriately licensed staff available to administer medications according to
162.31prescriber-approved orders.

162.32    Sec. 13. [245F.13] MEDICATIONS.
162.33    Subdivision 1. Administration of medications. A license holder must employ or
162.34contract with a registered nurse to develop the policies and procedures for medication
162.35administration. A registered nurse must provide supervision as defined in section 148.171,
163.1subdivision 23, for the administration of medications. For clinically managed programs,
163.2the registered nurse supervision must include on-site supervision at least monthly or more
163.3often as warranted by the health needs of the patient. The medication administration
163.4policies and procedures must include:
163.5(1) a provision that patients may carry emergency medication such as nitroglycerin
163.6as instructed by their prescriber;
163.7(2) requirements for recording the patient's use of medication, including staff
163.8signatures with date and time;
163.9(3) guidelines regarding when to inform a licensed practitioner or a registered nurse
163.10of problems with medication administration, including failure to administer, patient
163.11refusal of a medication, adverse reactions, or errors; and
163.12(4) procedures for acceptance, documentation, and implementation of prescriptions,
163.13whether written, oral, telephonic, or electronic.
163.14    Subd. 2. Control of drugs. A license holder must have in place and implement
163.15written policies and procedures relating to control of drugs. The policies and procedures
163.16must be developed by a registered nurse and must contain the following provisions:
163.17(1) a requirement that all drugs must be stored in a locked compartment. Schedule II
163.18drugs, as defined in section 152.02, subdivision 3, must be stored in a separately locked
163.19compartment that is permanently affixed to the physical plant or a medication cart;
163.20(2) a system for accounting for all scheduled drugs each shift;
163.21(3) a procedure for recording a patient's use of medication, including staff signatures
163.22with time and date;
163.23(4) a procedure for destruction of discontinued, outdated, or deteriorated medications;
163.24(5) a statement that only authorized personnel are permitted to have access to the
163.25keys to the locked drug compartments; and
163.26(6) a statement that no legend drug supply for one patient may be given to another
163.27patient.

163.28    Sec. 14. [245F.14] STAFFING REQUIREMENTS AND DUTIES.
163.29    Subdivision 1. Program director. A license holder must employ or contract with a
163.30person, on a full-time basis, to serve as program director. The program director must be
163.31responsible for all aspects of the facility and the services delivered to the license holder's
163.32patients. An individual may serve as program director for more than one program owned
163.33by the same license holder.
163.34    Subd. 2. Responsible staff person. During all hours of operation, a license holder
163.35must designate a staff member as the responsible staff person to be present and awake
164.1in the facility and be responsible for the program. The responsible staff person must
164.2have decision-making authority over the day-to-day operation of the program as well
164.3as the authority to direct the activity of or terminate the shift of any staff member who
164.4has direct patient contact.
164.5    Subd. 3. Technician required. A license holder must have one technician awake
164.6and on duty at all times for every ten patients in the program. A license holder may assign
164.7technicians according to the need for care of the patients, except that the same technician
164.8must not be responsible for more than 15 patients at one time. For purposes of establishing
164.9this ratio, all staff whose qualifications meet or exceed those for technicians under section
164.10245F.15, subdivision 6, and who are performing the duties of a technician may be counted
164.11as technicians. The same individual may not be counted as both a technician and an
164.12alcohol and drug counselor.
164.13    Subd. 4. Registered nurse required. A license holder must employ or contract
164.14with a registered nurse, who must be available 24 hours a day by telephone or in person
164.15for consultation. The registered nurse is responsible for:
164.16(1) establishing and implementing procedures for the provision of nursing care and
164.17delegated medical care, including:
164.18(i) a health monitoring plan;
164.19(ii) a medication control plan;
164.20(iii) training and competency evaluations for staff performing delegated medical and
164.21nursing functions;
164.22(iv) handling serious illness, accident, or injury to patients;
164.23(v) an infection control program; and
164.24(vi) a first aid kit;
164.25(2) delegating nursing functions to other staff consistent with their education,
164.26competence, and legal authorization;
164.27(3) assigning, supervising, and evaluating the performance of nursing tasks; and
164.28(4) implementing condition-specific protocols in compliance with section 151.37,
164.29subdivision 2.
164.30    Subd. 5. Medical director required. A license holder must have a medical director
164.31available for medical supervision. The medical director is responsible for ensuring the
164.32accurate and safe provision of all health-related services and procedures. A license
164.33holder must obtain and document the medical director's annual approval of the following
164.34procedures before the procedures may be used:
164.35(1) admission, discharge, and transfer criteria and procedures;
164.36(2) a health services plan;
165.1(3) physical indicators for a referral to a physician, registered nurse, or hospital, and
165.2procedures for referral;
165.3(4) procedures to follow in case of accident, injury, or death of a patient;
165.4(5) formulation of condition-specific protocols regarding the medications that
165.5require a withdrawal regimen that will be administered to patients;
165.6(6) an infection control program;
165.7(7) protective procedures; and
165.8(8) a medication control plan.
165.9    Subd. 6. Alcohol and drug counselor. A withdrawal management program must
165.10provide one full-time equivalent alcohol and drug counselor for every 16 patients served
165.11by the program.
165.12    Subd. 7. Ensuring staff-to-patient ratio. The responsible staff person under
165.13subdivision 2 must ensure that the program does not exceed the staff-to-patient ratios in
165.14subdivisions 3 and 6 and must inform admitting staff of the current staffed capacity of
165.15the program for that shift. A license holder must have a written policy for documenting
165.16staff-to-patient ratios for each shift and actions to take when staffed capacity is reached.

165.17    Sec. 15. [245F.15] STAFF QUALIFICATIONS.
165.18    Subdivision 1. Qualifications for all staff who have direct patient contact. (a) All
165.19staff who have direct patient contact must be at least 18 years of age and must, at the time
165.20of hiring, document that they meet the requirements in paragraph (b), (c), or (d).
165.21(b) Program directors, supervisors, nurses, and alcohol and drug counselors must be
165.22free of substance use problems for at least two years immediately preceding their hiring
165.23and must sign a statement attesting to that fact.
165.24(c) Recovery peers must be free of substance use problems for at least one year
165.25immediately preceding their hiring and must sign a statement attesting to that fact.
165.26(d) Technicians and other support staff must be free of substance use problems
165.27for at least six months immediately preceding their hiring and must sign a statement
165.28attesting to that fact.
165.29    Subd. 2. Continuing employment; no substance use problems. License holders
165.30must require staff to be free from substance use problems as a condition of continuing
165.31employment. Staff are not required to sign statements attesting to their freedom from
165.32substance use problems after the initial statement required by subdivision 1. Staff with
165.33substance use problems must be immediately removed from any responsibilities that
165.34include direct patient contact.
165.35    Subd. 3. Program director qualifications. A program director must:
166.1(1) have at least one year of work experience in direct service to individuals
166.2with substance use disorders or one year of work experience in the management or
166.3administration of direct service to individuals with substance use disorders;
166.4(2) have a baccalaureate degree or three years of work experience in administration
166.5or personnel supervision in human services; and
166.6(3) know and understand the requirements of this chapter and chapters 245A and
166.7245C, and sections 253B.04, 253B.05, 626.556, 626.557, and 626.5572.
166.8    Subd. 4. Alcohol and drug counselor qualifications. An alcohol and drug
166.9counselor must meet the requirements in Minnesota Rules, part 9530.6450, subpart 5.
166.10    Subd. 5. Responsible staff person qualifications. Each responsible staff person
166.11must know and understand the requirements of this chapter and sections 245A.65,
166.12253B.04, 253B.05, 626.556, 626.557, and 626.5572. In a clinically managed program, the
166.13responsible staff person must be a licensed practical nurse employed by or under contract
166.14with the license holder. In a medically monitored program, the responsible staff person
166.15must be a registered nurse, program director, or physician.
166.16    Subd. 6. Technician qualifications. A technician employed by a program must
166.17demonstrate competency, prior to direct patient contact, in the following areas:
166.18(1) knowledge of the client bill of rights in section 148F.165, and staff responsibilities
166.19in sections 144.651 and 253B.03;
166.20(2) knowledge of and the ability to perform basic health screening procedures with
166.21intoxicated patients that consist of:
166.22(i) blood pressure, pulse, temperature, and respiration readings;
166.23(ii) interviewing to obtain relevant medical history and current health complaints; and
166.24(iii) visual observation of a patient's health status, including monitoring a patient's
166.25behavior as it relates to health status;
166.26(3) a current first aid certificate from the American Red Cross or an equivalent
166.27organization; a current cardiopulmonary resuscitation certificate from the American Red
166.28Cross, the American Heart Association, a community organization, or an equivalent
166.29organization; and knowledge of first aid for seizures, trauma, and loss of consciousness; and
166.30(4) knowledge of and ability to perform basic activities of daily living and personal
166.31hygiene.
166.32    Subd. 7. Recovery peer qualifications. Recovery peers must:
166.33(1) be at least 21 years of age and have a high school diploma or its equivalent;
166.34(2) have a minimum of one year in recovery from substance use disorder;
167.1(3) have completed a curriculum designated by the commissioner that teaches
167.2specific skills and training in the domains of ethics and boundaries, advocacy, mentoring
167.3and education, and recovery and wellness support; and
167.4(4) receive supervision in areas specific to the domains of their role by qualified
167.5supervisory staff.
167.6    Subd. 8. Personal relationships. A license holder must have a written policy
167.7addressing personal relationships between patients and staff who have direct patient
167.8contact. The policy must:
167.9(1) prohibit direct patient contact between a patient and a staff member if the staff
167.10member has had a personal relationship with the patient within two years prior to the
167.11patient's admission to the program;
167.12(2) prohibit access to a patient's clinical records by a staff member who has had a
167.13personal relationship with the patient within two years prior to the patient's admission,
167.14unless the patient consents in writing; and
167.15(3) prohibit a clinical relationship between a staff member and a patient if the staff
167.16member has had a personal relationship with the patient within two years prior to the
167.17patient's admission. If a personal relationship exists, the staff member must report the
167.18relationship to the staff member's supervisor and recuse the staff member from a clinical
167.19relationship with that patient.

167.20    Sec. 16. [245F.16] PERSONNEL POLICIES AND PROCEDURES.
167.21    Subdivision 1. Policy requirements. A license holder must have written personnel
167.22policies and must make them available to staff members at all times. The personnel
167.23policies must:
167.24(1) ensure that staff member's retention, promotion, job assignment, or pay are not
167.25affected by a good faith communication between the staff member and the Department
167.26of Human Services, Department of Health, Ombudsman for Mental Health and
167.27Developmental Disabilities, law enforcement, or local agencies that investigate complaints
167.28regarding patient rights, health, or safety;
167.29(2) include a job description for each position that specifies job responsibilities,
167.30degree of authority to execute job responsibilities, standards of job performance related to
167.31specified job responsibilities, and qualifications;
167.32(3) provide for written job performance evaluations for staff members of the license
167.33holder at least annually;
167.34(4) describe behavior that constitutes grounds for disciplinary action, suspension, or
167.35dismissal, including policies that address substance use problems and meet the requirements
168.1of section 245F.15, subdivisions 1 and 2. The policies and procedures must list behaviors
168.2or incidents that are considered substance use problems. The list must include:
168.3(i) receiving treatment for substance use disorder within the period specified for the
168.4position in the staff qualification requirements;
168.5(ii) substance use that has a negative impact on the staff member's job performance;
168.6(iii) substance use that affects the credibility of treatment services with patients,
168.7referral sources, or other members of the community; and
168.8(iv) symptoms of intoxication or withdrawal on the job;
168.9(5) include policies prohibiting personal involvement with patients and policies
168.10prohibiting patient maltreatment as specified under chapter 604 and sections 245A.65,
168.11626.556, 626.557, and 626.5572;
168.12(6) include a chart or description of organizational structure indicating the lines
168.13of authority and responsibilities;
168.14(7) include a written plan for new staff member orientation that, at a minimum,
168.15includes training related to the specific job functions for which the staff member was hired,
168.16program policies and procedures, patient needs, and the areas identified in subdivision 2,
168.17paragraphs (b) to (e); and
168.18(8) include a policy on the confidentiality of patient information.
168.19    Subd. 2. Staff development. (a) A license holder must ensure that each staff
168.20member receives orientation training before providing direct patient care and at least
168.2130 hours of continuing education every two years. A written record must be kept to
168.22demonstrate completion of training requirements.
168.23(b) Within 72 hours of beginning employment, all staff having direct patient contact
168.24must be provided orientation on the following:
168.25(1) specific license holder and staff responsibilities for patient confidentiality;
168.26(2) standards governing the use of protective procedures;
168.27(3) patient ethical boundaries and patient rights, including the rights of patients
168.28admitted under chapter 253B;
168.29(4) infection control procedures;
168.30(5) mandatory reporting under sections 245A.65, 626.556, and 626.557, including
168.31specific training covering the facility's policies concerning obtaining patient releases
168.32of information;
168.33(6) HIV minimum standards as required in section 245A.19;
168.34(7) motivational counseling techniques and identifying stages of change; and
168.35(8) eight hours of training on the program's protective procedures policy required in
168.36section 245F.09, including:
169.1(i) approved therapeutic holds;
169.2(ii) protective procedures used to prevent patients from imminent danger of harming
169.3self or others;
169.4(iii) the emergency conditions under which the protective procedures may be used, if
169.5any;
169.6(iv) documentation standards for using protective procedures;
169.7(v) how to monitor and respond to patient distress; and
169.8(vi) person-centered planning and trauma-informed care.
169.9(c) All staff having direct patient contact must be provided annual training on the
169.10following:
169.11(1) infection control procedures;
169.12(2) mandatory reporting under sections 245A.65, 626.556, and 626.557, including
169.13specific training covering the facility's policies concerning obtaining patient releases
169.14of information;
169.15(3) HIV minimum standards as required in section 245A.19; and
169.16(4) motivational counseling techniques and identifying stages of change.
169.17(d) All staff having direct patient contact must be provided training every two
169.18years on the following:
169.19(1) specific license holder and staff responsibilities for patient confidentiality;
169.20(2) standards governing use of protective procedures, including:
169.21(i) approved therapeutic holds;
169.22(ii) protective procedures used to prevent patients from imminent danger of harming
169.23self or others;
169.24(iii) the emergency conditions under which the protective procedures may be used, if
169.25any;
169.26(iv) documentation standards for using protective procedures;
169.27(v) how to monitor and respond to patient distress; and
169.28(vi) person-centered planning and trauma-informed care; and
169.29(3) patient ethical boundaries and patient rights, including the rights of patients
169.30admitted under chapter 253B.
169.31(e) Continuing education that is completed in areas outside of the required topics
169.32must provide information to the staff person that is useful to the performance of the
169.33individual staff person's duties.

169.34    Sec. 17. [245F.17] PERSONNEL FILES.
170.1A license holder must maintain a separate personnel file for each staff member. At a
170.2minimum, the file must contain:
170.3(1) a completed application for employment signed by the staff member that
170.4contains the staff member's qualifications for employment and documentation related to
170.5the applicant's background study data, as defined in chapter 245C;
170.6(2) documentation of the staff member's current professional license or registration,
170.7if relevant;
170.8(3) documentation of orientation and subsequent training;
170.9(4) documentation of a statement of freedom from substance use problems; and
170.10(5) an annual job performance evaluation.

170.11    Sec. 18. [245F.18] POLICY AND PROCEDURES MANUAL.
170.12A license holder must develop a written policy and procedures manual that is
170.13alphabetically indexed and has a table of contents, so that staff have immediate access
170.14to all policies and procedures, and that consumers of the services, and other authorized
170.15parties have access to all policies and procedures. The manual must contain the following
170.16materials:
170.17(1) a description of patient education services as required in section 245F.06;
170.18(2) personnel policies that comply with section 245F.16;
170.19(3) admission information and referral and discharge policies that comply with
170.20section 245F.05;
170.21(4) a health monitoring plan that complies with section 245F.12;
170.22(5) a protective procedures policy that complies with section 245F.09, if the program
170.23elects to use protective procedures;
170.24(6) policies and procedures for assuring appropriate patient-to-staff ratios that
170.25comply with section 245F.14;
170.26(7) policies and procedures for assessing and documenting the susceptibility for
170.27risk of abuse to the patient as the basis for the individual abuse prevention plan required
170.28by section 245A.65;
170.29(8) procedures for mandatory reporting as required by sections 245A.65, 626.556,
170.30and 626.557;
170.31(9) a medication control plan that complies with section 245F.13; and
170.32(10) policies and procedures regarding HIV that meet the minimum standards
170.33under section 245A.19.

170.34    Sec. 19. [245F.19] PATIENT RECORDS.
171.1    Subdivision 1. Patient records required. A license holder must maintain a file of
171.2current patient records on the program premises where the treatment is provided. Each
171.3entry in each patient record must be signed and dated by the staff member making the
171.4entry. Patient records must be protected against loss, tampering, or unauthorized disclosure
171.5in compliance with chapter 13 and section 254A.09; Code of Federal Regulations, title 42,
171.6sections 2.1 to 2.67; and title 45, parts 160 to 164.
171.7    Subd. 2. Records retention. A license holder must retain and store records as
171.8required by section 245A.041, subdivisions 3 and 4.
171.9    Subd. 3. Contents of records. Patient records must include the following:
171.10(1) documentation of the patient's presenting problem, any substance use screening,
171.11the most recent assessment, and any updates;
171.12(2) a stabilization plan and progress notes as required by section 245F.07,
171.13subdivisions 1 and 2;
171.14(3) a discharge summary as required by section 245F.07, subdivision 3;
171.15(4) an individual abuse prevention plan that complies with section 245A.65, and
171.16related rules;
171.17(5) documentation of referrals made; and
171.18(6) documentation of the monitoring and observations of the patient's medical needs.

171.19    Sec. 20. [245F.20] DATA COLLECTION REQUIRED.
171.20The license holder must participate in the drug and alcohol abuse normative
171.21evaluation system (DAANES) by submitting, in a format provided by the commissioner,
171.22information concerning each patient admitted to the program. Staff submitting data must
171.23be trained by the license holder with the DAANES Web manual.

171.24    Sec. 21. [245F.21] PAYMENT METHODOLOGY.
171.25The commissioner shall develop a payment methodology for services provided
171.26under this chapter or by an Indian Health Services facility or a facility owned and operated
171.27by a tribe or tribal organization operating under Public Law 93-638 as a 638 facility. The
171.28commissioner shall seek federal approval for the methodology. Upon federal approval, the
171.29commissioner must seek and obtain legislative approval of the funding methodology to
171.30support the service.

171.31ARTICLE 4

171.32DIRECT CARE AND TREATMENT

171.33    Section 1. Minnesota Statutes 2014, section 43A.241, is amended to read:
172.143A.241 INSURANCE CONTRIBUTIONS; FORMER CORRECTIONS
172.2EMPLOYEES.
172.3(a) This section applies to a person who:
172.4(1) was employed by the commissioner of the Department of Corrections at a state
172.5institution under control of the commissioner, and in that employment was a member
172.6of the general plan of the Minnesota State Retirement System; or by the Department
172.7of Human Services;
172.8(2) was covered by the correctional employee retirement plan under section 352.91
172.9or the general state employees retirement plan of the Minnesota State Retirement System
172.10as defined in section 352.021;
172.11(3) while employed under clause (1), was assaulted by:
172.12an inmate at a state institution under control of the commissioner of the Department
172.13of Corrections (i) a person under correctional supervision for a criminal offense; or
172.14(ii) a client or patient at the Minnesota sex offender program, or at a state-operated
172.15forensic services program as defined in section 352.91, subdivision 3j, under the control of
172.16the commissioner of the Department of Human Services; and
172.17(3) (4) as a direct result of the assault under clause (3), was determined to be
172.18totally and permanently physically disabled under laws governing the Minnesota State
172.19Retirement System.
172.20(b) For a person to whom this section applies, the commissioner of the Department
172.21of Corrections or the commissioner of the Department of Human Services must continue
172.22to make the employer contribution for hospital, medical, and dental benefits under the
172.23State Employee Group Insurance Program after the person terminates state service. If
172.24the person had dependent coverage at the time of terminating state service, employer
172.25contributions for dependent coverage also must continue under this section. The employer
172.26contributions must be in the amount of the employer contribution for active state
172.27employees at the time each payment is made. The employer contributions must continue
172.28until the person reaches age 65, provided the person makes the required employee
172.29contributions, in the amount required of an active state employee, at the time and in
172.30the manner specified by the commissioner.
172.31EFFECTIVE DATE.This section is effective the day following final enactment
172.32and applies to a person assaulted by an inmate, client, or patient on or after that date.

172.33    Sec. 2. Minnesota Statutes 2014, section 246.54, subdivision 1, is amended to read:
172.34    Subdivision 1. County portion for cost of care. (a) Except for chemical
172.35dependency services provided under sections 254B.01 to 254B.09, the client's county
173.1shall pay to the state of Minnesota a portion of the cost of care provided in a regional
173.2treatment center or a state nursing facility to a client legally settled in that county. A
173.3county's payment shall be made from the county's own sources of revenue and payments
173.4shall equal a percentage of the cost of care, as determined by the commissioner, for each
173.5day, or the portion thereof, that the client spends at a regional treatment center or a state
173.6nursing facility according to the following schedule:
173.7    (1) zero percent for the first 30 days;
173.8    (2) 20 percent for days 31 to 60 and over if the stay is determined to be clinically
173.9appropriate for the client; and
173.10    (3) 75 percent for any days over 60 100 percent for each day during the stay,
173.11including the day of admission, when the facility determines that it is clinically appropriate
173.12for the client to be discharged.
173.13    (b) The increase in the county portion for cost of care under paragraph (a), clause
173.14(3), shall be imposed when the treatment facility has determined that it is clinically
173.15appropriate for the client to be discharged.
173.16    (c) (b) If payments received by the state under sections 246.50 to 246.53 exceed
173.1780 percent of the cost of care for days over 31 to 60, or 25 percent for days over 60 for
173.18clients who meet the criteria in paragraph (a), clause (2), the county shall be responsible
173.19for paying the state only the remaining amount. The county shall not be entitled to
173.20reimbursement from the client, the client's estate, or from the client's relatives, except as
173.21provided in section 246.53.

173.22ARTICLE 5

173.23SIMPLIFICATION OF PUBLIC ASSISTANCE PROGRAMS

173.24    Section 1. Minnesota Statutes 2014, section 119B.011, subdivision 15, is amended to
173.25read:
173.26    Subd. 15. Income. "Income" means earned or unearned income received by all
173.27family members, including as defined under section 256P.01, subdivision 3, unearned
173.28income as defined under section 256P.01, subdivision 8, and public assistance cash benefits
173.29and, including the Minnesota family investment program, diversionary work program,
173.30work benefit, Minnesota supplemental aid, general assistance, refugee cash assistance,
173.31at-home infant child care subsidy payments, unless specifically excluded and child support
173.32and maintenance distributed to the family under section 256.741, subdivision 15. The
173.33following are excluded deducted from income: funds used to pay for health insurance
173.34premiums for family members, Supplemental Security Income, scholarships, work-study
173.35income, and grants that cover costs or reimbursement for tuition, fees, books, and
174.1educational supplies; student loans for tuition, fees, books, supplies, and living expenses;
174.2state and federal earned income tax credits; assistance specifically excluded as income by
174.3law; in-kind income such as food support, energy assistance, foster care assistance, medical
174.4assistance, child care assistance, and housing subsidies; earned income of full-time or
174.5part-time students up to the age of 19, who have not earned a high school diploma or GED
174.6high school equivalency diploma including earnings from summer employment; grant
174.7awards under the family subsidy program; nonrecurring lump-sum income only to the
174.8extent that it is earmarked and used for the purpose for which it is paid; and any income
174.9assigned to the public authority according to section 256.741 and child or spousal support
174.10paid to or on behalf of a person or persons who live outside of the household. Income
174.11sources not included in this subdivision and section 256P.06, subdivision 3, are not counted.

174.12    Sec. 2. Minnesota Statutes 2014, section 119B.025, subdivision 1, is amended to read:
174.13    Subdivision 1. Factors which must be verified. (a) The county shall verify the
174.14following at all initial child care applications using the universal application:
174.15(1) identity of adults;
174.16(2) presence of the minor child in the home, if questionable;
174.17(3) relationship of minor child to the parent, stepparent, legal guardian, eligible
174.18relative caretaker, or the spouses of any of the foregoing;
174.19(4) age;
174.20(5) immigration status, if related to eligibility;
174.21(6) Social Security number, if given;
174.22(7) income;
174.23(8) spousal support and child support payments made to persons outside the
174.24household;
174.25(9) residence; and
174.26(10) inconsistent information, if related to eligibility.
174.27(b) If a family did not use the universal application or child care addendum to apply
174.28for child care assistance, the family must complete the universal application or child care
174.29addendum at its next eligibility redetermination and the county must verify the factors
174.30listed in paragraph (a) as part of that redetermination. Once a family has completed a
174.31universal application or child care addendum, the county shall use the redetermination
174.32form described in paragraph (c) for that family's subsequent redeterminations. Eligibility
174.33must be redetermined at least every six months. A family is considered to have met the
174.34eligibility redetermination requirement if a complete redetermination form and all required
174.35verifications are received within 30 days after the date the form was due. Assistance shall
175.1be payable retroactively from the redetermination due date. For a family where at least
175.2one parent is under the age of 21, does not have a high school or general equivalency
175.3diploma, and is a student in a school district or another similar program that provides or
175.4arranges for child care, as well as parenting, social services, career and employment
175.5supports, and academic support to achieve high school graduation, the redetermination of
175.6eligibility shall be deferred beyond six months, but not to exceed 12 months, to the end of
175.7the student's school year. If a family reports a change in an eligibility factor before the
175.8family's next regularly scheduled redetermination, the county must recalculate eligibility
175.9without requiring verification of any eligibility factor that did not change. Changes must
175.10be reported as required by section 256P.07. A change in income occurs on the day the
175.11participant received the first payment reflecting the change in income.
175.12(c) The commissioner shall develop a redetermination form to redetermine eligibility
175.13and a change report form to report changes that minimize paperwork for the county and
175.14the participant.

175.15    Sec. 3. Minnesota Statutes 2014, section 119B.035, subdivision 4, is amended to read:
175.16    Subd. 4. Assistance. (a) A family is limited to a lifetime total of 12 months of
175.17assistance under subdivision 2. The maximum rate of assistance is equal to 68 percent
175.18of the rate established under section 119B.13 for care of infants in licensed family child
175.19care in the applicant's county of residence.
175.20(b) A participating family must report income and other family changes as specified in
175.21sections 256P.06 and 256P.07, and the county's plan under section 119B.08, subdivision 3.
175.22(c) Persons who are admitted to the at-home infant child care program retain their
175.23position in any basic sliding fee program. Persons leaving the at-home infant child care
175.24program reenter the basic sliding fee program at the position they would have occupied.
175.25(d) Assistance under this section does not establish an employer-employee
175.26relationship between any member of the assisted family and the county or state.

175.27    Sec. 4. Minnesota Statutes 2014, section 119B.09, subdivision 4, is amended to read:
175.28    Subd. 4. Eligibility; annual income; calculation. Annual income of the applicant
175.29family is the current monthly income of the family multiplied by 12 or the income for
175.30the 12-month period immediately preceding the date of application, or income calculated
175.31by the method which provides the most accurate assessment of income available to the
175.32family. Self-employment income must be calculated based on gross receipts less operating
175.33expenses. Income must be recalculated when the family's income changes, but no less
175.34often than every six months. For a family where at least one parent is under the age of
176.121, does not have a high school or general equivalency diploma, and is a student in a
176.2school district or another similar program that provides or arranges for child care, as well
176.3as parenting, social services, career and employment supports, and academic support to
176.4achieve high school graduation, income must be recalculated when the family's income
176.5changes, but otherwise shall be deferred beyond six months, but not to exceed 12 months,
176.6to the end of the student's school year. Included lump sums counted as income under
176.7section 256P.06, subdivision 3, must be annualized over 12 months. Income must be
176.8verified with documentary evidence. If the applicant does not have sufficient evidence of
176.9income, verification must be obtained from the source of the income.

176.10    Sec. 5. Minnesota Statutes 2014, section 256D.01, subdivision 1a, is amended to read:
176.11    Subd. 1a. Standards. (a) A principal objective in providing general assistance is
176.12to provide for single adults, childless couples, or children as defined in section 256D.02,
176.13subdivision 6 , ineligible for federal programs who are unable to provide for themselves.
176.14The minimum standard of assistance determines the total amount of the general assistance
176.15grant without separate standards for shelter, utilities, or other needs.
176.16(b) The commissioner shall set the standard of assistance for an assistance unit
176.17consisting of an adult recipient who is childless and unmarried or living apart from
176.18children and spouse and who does not live with a parent or parents or a legal custodian.
176.19When the other standards specified in this subdivision increase, this standard must also be
176.20increased by the same percentage.
176.21(c) For an assistance unit consisting of a single adult who lives with a parent or
176.22parents, the general assistance standard of assistance is the amount that the aid to families
176.23with dependent children standard of assistance, in effect on July 16, 1996, would increase
176.24if the recipient were added as an additional minor child to an assistance unit consisting
176.25of the recipient's parent and all of that parent's family members, except that the standard
176.26may not exceed the standard for a general assistance recipient living alone. Benefits
176.27received by a responsible relative of the assistance unit under the Supplemental Security
176.28Income program, a workers' compensation program, the Minnesota supplemental aid
176.29program, or any other program based on the responsible relative's disability, and any
176.30benefits received by a responsible relative of the assistance unit under the Social Security
176.31retirement program, may not be counted in the determination of eligibility or benefit
176.32level for the assistance unit. Except as provided below, the assistance unit is ineligible
176.33for general assistance if the available resources or the countable income of the assistance
176.34unit and the parent or parents with whom the assistance unit lives are such that a family
176.35consisting of the assistance unit's parent or parents, the parent or parents' other family
177.1members and the assistance unit as the only or additional minor child would be financially
177.2ineligible for general assistance. For the purposes of calculating the countable income
177.3of the assistance unit's parent or parents, the calculation methods, income deductions,
177.4exclusions, and disregards used when calculating the countable income for a single adult
177.5or childless couple must be used follow the provisions under section 256P.06.
177.6(d) For an assistance unit consisting of a childless couple, the standards of assistance
177.7are the same as the first and second adult standards of the aid to families with dependent
177.8children program in effect on July 16, 1996. If one member of the couple is not included
177.9in the general assistance grant, the standard of assistance for the other is the second adult
177.10standard of the aid to families with dependent children program as of July 16, 1996.

177.11    Sec. 6. Minnesota Statutes 2014, section 256D.02, is amended by adding a subdivision
177.12to read:
177.13    Subd. 1a. Assistance unit. "Assistance unit" means an individual who is, or an
177.14eligible married couple who live together who are, applying for or receiving benefits
177.15under this chapter.

177.16    Sec. 7. Minnesota Statutes 2014, section 256D.02, is amended by adding a subdivision
177.17to read:
177.18    Subd. 1b. Cash assistance benefit. "Cash assistance benefit" means any payment
177.19received as a disability benefit, including veterans or workers' compensation; old age,
177.20survivors, and disability insurance; railroad retirement benefits; unemployment benefits;
177.21and benefits under any federally aided categorical assistance program, Supplemental
177.22Security Income, or other assistance program.

177.23    Sec. 8. Minnesota Statutes 2014, section 256D.02, subdivision 8, is amended to read:
177.24    Subd. 8. Income. "Income" means any form of income, including remuneration
177.25for services performed as an employee and earned income from rental income and
177.26self-employment earnings as described under section 256P.05 earned income as defined
177.27under section 256P.01, subdivision 3, and unearned income as defined under section
177.28256P.01, subdivision 8.
177.29Income includes any payments received as an annuity, retirement, or disability
177.30benefit, including veteran's or workers' compensation; old age, survivors, and disability
177.31insurance; railroad retirement benefits; unemployment benefits; and benefits under any
177.32federally aided categorical assistance program, supplementary security income, or other
177.33assistance program; rents, dividends, interest and royalties; and support and maintenance
178.1payments. Such payments may not be considered as available to meet the needs of any
178.2person other than the person for whose benefit they are received, unless that person is
178.3a family member or a spouse and the income is not excluded under section 256D.01,
178.4subdivision 1a . Goods and services provided in lieu of cash payment shall be excluded
178.5from the definition of income, except that payments made for room, board, tuition or
178.6fees by a parent, on behalf of a child enrolled as a full-time student in a postsecondary
178.7institution, and payments made on behalf of an applicant or participant which the applicant
178.8or participant could legally demand to receive personally in cash, must be included as
178.9income. Benefits of an applicant or participant, such as those administered by the Social
178.10Security Administration, that are paid to a representative payee, and are spent on behalf of
178.11the applicant or participant, are considered available income of the applicant or participant.

178.12    Sec. 9. Minnesota Statutes 2014, section 256D.06, subdivision 1, is amended to read:
178.13    Subdivision 1. Eligibility; amount of assistance. General assistance shall be
178.14granted in an amount that when added to the nonexempt countable income as determined
178.15to be actually available to the assistance unit under section 256P.06, the total amount
178.16equals the applicable standard of assistance for general assistance. In determining
178.17eligibility for and the amount of assistance for an individual or married couple, the agency
178.18shall apply the earned income disregard as determined in section 256P.03.

178.19    Sec. 10. Minnesota Statutes 2014, section 256D.405, subdivision 3, is amended to read:
178.20    Subd. 3. Reports. Participants must report changes in circumstances according to
178.21section 256P.07 that affect eligibility or assistance payment amounts within ten days of the
178.22change. Participants who do not receive SSI because of excess income must complete a
178.23monthly report form if they have earned income, if they have income deemed to them
178.24from a financially responsible relative with whom the participant resides, or if they have
178.25income deemed to them by a sponsor. If the report form is not received before the end of
178.26the month in which it is due, the county agency must terminate assistance. The termination
178.27shall be effective on the first day of the month following the month in which the report
178.28was due. If a complete report is received within the month the assistance was terminated,
178.29the assistance unit is considered to have continued its application for assistance, effective
178.30the first day of the month the assistance was terminated.

178.31    Sec. 11. Minnesota Statutes 2014, section 256I.03, is amended by adding a subdivision
178.32to read:
179.1    Subd. 1b. Assistance unit. "Assistance unit" means an individual who is applying
179.2for or receiving benefits under this chapter.

179.3    Sec. 12. Minnesota Statutes 2014, section 256I.03, subdivision 7, is amended to read:
179.4    Subd. 7. Countable income. "Countable income" means all income received by an
179.5applicant or recipient as described under section 256P.06, less any applicable exclusions
179.6or disregards. For a recipient of any cash benefit from the SSI program, countable income
179.7means the SSI benefit limit in effect at the time the person is in a GRH, less the medical
179.8assistance personal needs allowance. If the SSI limit has been reduced for a person due to
179.9events occurring prior to the persons entering the GRH setting, countable income means
179.10actual income less any applicable exclusions and disregards.

179.11    Sec. 13. Minnesota Statutes 2014, section 256I.04, subdivision 1, is amended to read:
179.12    Subdivision 1. Individual eligibility requirements. An individual is eligible for
179.13and entitled to a group residential housing payment to be made on the individual's behalf
179.14if the agency has approved the individual's residence in a group residential housing setting
179.15and the individual meets the requirements in paragraph (a) or (b).
179.16(a) The individual is aged, blind, or is over 18 years of age and disabled as
179.17determined under the criteria used by the title II program of the Social Security Act, and
179.18meets the resource restrictions and standards of section 256P.02, and the individual's
179.19countable income after deducting the (1) exclusions and disregards of the SSI program,
179.20(2) the medical assistance personal needs allowance under section 256B.35, and (3) an
179.21amount equal to the income actually made available to a community spouse by an elderly
179.22waiver participant under the provisions of sections 256B.0575, paragraph (a), clause
179.23(4), and 256B.058, subdivision 2, is less than the monthly rate specified in the agency's
179.24agreement with the provider of group residential housing in which the individual resides.
179.25(b) The individual meets a category of eligibility under section 256D.05, subdivision
179.261 , paragraph (a), and the individual's resources are less than the standards specified by
179.27section 256P.02, and the individual's countable income as determined under sections
179.28256D.01 to 256D.21 section 256P.06, less the medical assistance personal needs allowance
179.29under section 256B.35 is less than the monthly rate specified in the agency's agreement
179.30with the provider of group residential housing in which the individual resides.

179.31    Sec. 14. Minnesota Statutes 2014, section 256I.06, subdivision 6, is amended to read:
179.32    Subd. 6. Reports. Recipients must report changes in circumstances according
179.33to section 256P.07 that affect eligibility or group residential housing payment amounts
180.1within ten days of the change. Recipients with countable earned income must complete
180.2a monthly household report form. If the report form is not received before the end of
180.3the month in which it is due, the county agency must terminate eligibility for group
180.4residential housing payments. The termination shall be effective on the first day of the
180.5month following the month in which the report was due. If a complete report is received
180.6within the month eligibility was terminated, the individual is considered to have continued
180.7an application for group residential housing payment effective the first day of the month
180.8the eligibility was terminated.

180.9    Sec. 15. Minnesota Statutes 2014, section 256J.08, subdivision 26, is amended to read:
180.10    Subd. 26. Earned income. "Earned income" means cash or in-kind income earned
180.11through the receipt of wages, salary, commissions, profit from employment activities, net
180.12profit from self-employment activities, payments made by an employer for regularly
180.13accrued vacation or sick leave, and any other profit from activity earned through effort or
180.14labor. The income must be in return for, or as a result of, legal activity has the meaning
180.15given in section 256P.01, subdivision 3.

180.16    Sec. 16. Minnesota Statutes 2014, section 256J.08, subdivision 86, is amended to read:
180.17    Subd. 86. Unearned income. "Unearned income" means income received by
180.18a person that does not meet the definition of earned income. Unearned income includes
180.19income from a contract for deed, interest, dividends, unemployment benefits, disability
180.20insurance payments, veterans benefits, pension payments, return on capital investment,
180.21insurance payments or settlements, severance payments, child support and maintenance
180.22payments, and payments for illness or disability whether the premium payments are
180.23made in whole or in part by an employer or participant has the meaning given in section
180.24256P.01, subdivision 8.

180.25    Sec. 17. Minnesota Statutes 2014, section 256J.30, subdivision 1, is amended to read:
180.26    Subdivision 1. Applicant reporting requirements. An applicant must provide
180.27information on an application form and supplemental forms about the applicant's
180.28circumstances which affect MFIP eligibility or the assistance payment. An applicant must
180.29report changes identified in subdivision 9 while the application is pending. When an
180.30applicant does not accurately report information on an application, both an overpayment
180.31and a referral for a fraud investigation may result. When an applicant does not provide
180.32information or documentation, the receipt of the assistance payment may be delayed or the
181.1application may be denied depending on the type of information required and its effect on
181.2eligibility according to section 256P.07.

181.3    Sec. 18. Minnesota Statutes 2014, section 256J.30, subdivision 9, is amended to read:
181.4    Subd. 9. Changes that must be reported. A caregiver must report the changes or
181.5anticipated changes specified in clauses (1) to (15) within ten days of the date they occur,
181.6at the time of the periodic recertification of eligibility under section 256P.04, subdivisions
181.78 and 9, or within eight calendar days of a reporting period as in subdivision 5, whichever
181.8occurs first. A caregiver must report other changes at the time of the periodic recertification
181.9of eligibility under section 256P.04, subdivisions 8 and 9, or at the end of a reporting period
181.10under subdivision 5, as applicable. A caregiver must make these reports in writing to the
181.11agency. When an agency could have reduced or terminated assistance for one or more
181.12payment months if a delay in reporting a change specified under clauses (1) to (14) had
181.13not occurred, the agency must determine whether a timely notice under section 256J.31,
181.14subdivision 4 , could have been issued on the day that the change occurred. When a timely
181.15notice could have been issued, each month's overpayment subsequent to that notice must be
181.16considered a client error overpayment under section 256J.38. Calculation of overpayments
181.17for late reporting under clause (15) is specified in section 256J.09, subdivision 9. Changes
181.18in circumstances which must be reported within ten days must also be reported on the
181.19MFIP household report form for the reporting period in which those changes occurred.
181.20Within ten days, a caregiver must report: changes as specified under section 256P.07.
181.21(1) a change in initial employment;
181.22(2) a change in initial receipt of unearned income;
181.23(3) a recurring change in unearned income;
181.24(4) a nonrecurring change of unearned income that exceeds $30;
181.25(5) the receipt of a lump sum;
181.26(6) an increase in assets that may cause the assistance unit to exceed asset limits;
181.27(7) a change in the physical or mental status of an incapacitated member of the
181.28assistance unit if the physical or mental status is the basis for reducing the hourly
181.29participation requirements under section 256J.55, subdivision 1, or the type of activities
181.30included in an employment plan under section 256J.521, subdivision 2;
181.31(8) a change in employment status;
181.32(9) the marriage or divorce of an assistance unit member;
181.33(10) the death of a parent, minor child, or financially responsible person;
181.34(11) a change in address or living quarters of the assistance unit;
181.35(12) the sale, purchase, or other transfer of property;
182.1(13) a change in school attendance of a caregiver under age 20 or an employed child;
182.2(14) filing a lawsuit, a workers' compensation claim, or a monetary claim against a
182.3third party; and
182.4(15) a change in household composition, including births, returns to and departures
182.5from the home of assistance unit members and financially responsible persons, or a change
182.6in the custody of a minor child.

182.7    Sec. 19. Minnesota Statutes 2014, section 256J.35, is amended to read:
182.8256J.35 AMOUNT OF ASSISTANCE PAYMENT.
182.9Except as provided in paragraphs (a) to (d), the amount of an assistance payment is
182.10equal to the difference between the MFIP standard of need or the Minnesota family wage
182.11level in section 256J.24 and countable income.
182.12(a) Beginning July 1, 2015, MFIP assistance units are eligible for an MFIP housing
182.13assistance grant of $110 per month, unless:
182.14(1) the housing assistance unit is currently receiving public and assisted rental
182.15subsidies provided through the Department of Housing and Urban Development (HUD)
182.16and is subject to section 256J.37, subdivision 3a; or
182.17(2) the assistance unit is a child-only case under section 256J.88.
182.18(b) When MFIP eligibility exists for the month of application, the amount of the
182.19assistance payment for the month of application must be prorated from the date of
182.20application or the date all other eligibility factors are met for that applicant, whichever is
182.21later. This provision applies when an applicant loses at least one day of MFIP eligibility.
182.22(c) MFIP overpayments to an assistance unit must be recouped according to section
182.23256J.38, subdivision 4 256P.08, subdivision 6.
182.24(d) An initial assistance payment must not be made to an applicant who is not
182.25eligible on the date payment is made.

182.26    Sec. 20. Minnesota Statutes 2014, section 256J.40, is amended to read:
182.27256J.40 FAIR HEARINGS.
182.28Caregivers receiving a notice of intent to sanction or a notice of adverse action that
182.29includes a sanction, reduction in benefits, suspension of benefits, denial of benefits, or
182.30termination of benefits may request a fair hearing. A request for a fair hearing must be
182.31submitted in writing to the county agency or to the commissioner and must be mailed
182.32within 30 days after a participant or former participant receives written notice of the
182.33agency's action or within 90 days when a participant or former participant shows good
182.34cause for not submitting the request within 30 days. A former participant who receives a
183.1notice of adverse action due to an overpayment may appeal the adverse action according
183.2to the requirements in this section. Issues that may be appealed are:
183.3(1) the amount of the assistance payment;
183.4(2) a suspension, reduction, denial, or termination of assistance;
183.5(3) the basis for an overpayment, the calculated amount of an overpayment, and
183.6the level of recoupment;
183.7(4) the eligibility for an assistance payment; and
183.8(5) the use of protective or vendor payments under section 256J.39, subdivision 2,
183.9clauses (1) to (3).
183.10Except for benefits issued under section 256J.95, a county agency must not reduce,
183.11suspend, or terminate payment when an aggrieved participant requests a fair hearing
183.12prior to the effective date of the adverse action or within ten days of the mailing of the
183.13notice of adverse action, whichever is later, unless the participant requests in writing not
183.14to receive continued assistance pending a hearing decision. An appeal request cannot
183.15extend benefits for the diversionary work program under section 256J.95 beyond the
183.16four-month time limit. Assistance issued pending a fair hearing is subject to recovery
183.17under section 256J.38 256P.08 when as a result of the fair hearing decision the participant
183.18is determined ineligible for assistance or the amount of the assistance received. A county
183.19agency may increase or reduce an assistance payment while an appeal is pending when the
183.20circumstances of the participant change and are not related to the issue on appeal. The
183.21commissioner's order is binding on a county agency. No additional notice is required to
183.22enforce the commissioner's order.
183.23A county agency shall reimburse appellants for reasonable and necessary expenses
183.24of attendance at the hearing, such as child care and transportation costs and for the
183.25transportation expenses of the appellant's witnesses and representatives to and from the
183.26hearing. Reasonable and necessary expenses do not include legal fees. Fair hearings
183.27must be conducted at a reasonable time and date by an impartial human services judge
183.28employed by the department. The hearing may be conducted by telephone or at a site that
183.29is readily accessible to persons with disabilities.
183.30The appellant may introduce new or additional evidence relevant to the issues on
183.31appeal. Recommendations of the human services judge and decisions of the commissioner
183.32must be based on evidence in the hearing record and are not limited to a review of the
183.33county agency action.

183.34    Sec. 21. Minnesota Statutes 2014, section 256J.95, subdivision 19, is amended to read:
184.1    Subd. 19. DWP overpayments and underpayments. DWP benefits are subject
184.2to overpayments and underpayments. Anytime an overpayment or an underpayment is
184.3determined for DWP, the correction shall be calculated using prospective budgeting.
184.4Corrections shall be determined based on the policy in section 256J.34, subdivision 1,
184.5paragraphs (a), (b), and (c). ATM errors must be recovered as specified in section 256J.38,
184.6subdivision 5 256P.08, subdivision 7. Cross program recoupment of overpayments cannot
184.7be assigned to or from DWP.

184.8    Sec. 22. Minnesota Statutes 2014, section 256P.001, is amended to read:
184.9256P.001 APPLICABILITY.
184.10General assistance and Minnesota supplemental aid under chapter 256D, child care
184.11assistance programs under chapter 119B, and programs governed by chapter 256I or 256J
184.12are subject to the requirements of this chapter, unless otherwise specified or exempted.

184.13    Sec. 23. Minnesota Statutes 2014, section 256P.01, is amended by adding a subdivision
184.14to read:
184.15    Subd. 2a. Assistance unit. "Assistance unit" is defined by program area under
184.16sections 119B.011, subdivision 13; 256D.02, subdivision 1a; 256D.35, subdivision 3a;
184.17256I.03, subdivision 1b; and 256J.08, subdivision 7.

184.18    Sec. 24. Minnesota Statutes 2014, section 256P.01, subdivision 3, is amended to read:
184.19    Subd. 3. Earned income. "Earned income" means cash or in-kind income earned
184.20through the receipt of wages, salary, commissions, bonuses, tips, gratuities, profit from
184.21employment activities, net profit from self-employment activities, payments made by
184.22an employer for regularly accrued vacation or sick leave, and any severance pay based
184.23on accrued leave time, payments from training programs at a rate at or greater than the
184.24state's minimum wage, royalties, honoraria, or other profit from activity earned through
184.25effort that results from the client's work, service, effort, or labor. The income must be in
184.26return for, or as a result of, legal activity.

184.27    Sec. 25. Minnesota Statutes 2014, section 256P.01, is amended by adding a subdivision
184.28to read:
184.29    Subd. 8. Unearned income. "Unearned income" has the meaning given in section
184.30256P.06, subdivision 3, clause (2).

185.1    Sec. 26. Minnesota Statutes 2014, section 256P.02, is amended by adding a subdivision
185.2to read:
185.3    Subd. 1a. Exemption. Participants who qualify for child care assistance programs
185.4under chapter 119B are exempt from this section.

185.5    Sec. 27. Minnesota Statutes 2014, section 256P.03, subdivision 1, is amended to read:
185.6    Subdivision 1. Exempted programs. Participants who qualify for child care
185.7assistance programs under chapter 119B, Minnesota supplemental aid under chapter
185.8256D, and for group residential housing under chapter 256I on the basis of eligibility for
185.9Supplemental Security Income are exempt from this section.

185.10    Sec. 28. Minnesota Statutes 2014, section 256P.04, subdivision 1, is amended to read:
185.11    Subdivision 1. Exemption. Participants who receive Minnesota supplemental aid
185.12and who maintain Supplemental Security Income eligibility under chapters 256D and 256I
185.13are exempt from the reporting requirements of this section, except that the policies and
185.14procedures for transfers of assets are those used by the medical assistance program under
185.15section 256B.0595. Participants who receive child care assistance under chapter 119B are
185.16exempt from the requirements of this section.

185.17    Sec. 29. Minnesota Statutes 2014, section 256P.04, subdivision 4, is amended to read:
185.18    Subd. 4. Factors to be verified. (a) The agency shall verify the following at
185.19application:
185.20(1) identity of adults;
185.21(2) age, if necessary to determine eligibility;
185.22(3) immigration status;
185.23(4) income;
185.24(5) spousal support and child support payments made to persons outside the
185.25household;
185.26(6) vehicles;
185.27(7) checking and savings accounts;
185.28(8) inconsistent information, if related to eligibility;
185.29(9) residence; and
185.30(10) Social Security number.; and
185.31(11) use of nonrecurring income under section 256P.06, subdivision 3, clause (2),
185.32item (ix), for the intended purpose for which it was given and received.
186.1(b) Applicants who are qualified noncitizens and victims of domestic violence as
186.2defined under section 256J.08, subdivision 73, clause (7), are not required to verify the
186.3information in paragraph (a), clause (10). When a Social Security number is not provided
186.4to the agency for verification, this requirement is satisfied when each member of the
186.5assistance unit cooperates with the procedures for verification of Social Security numbers,
186.6issuance of duplicate cards, and issuance of new numbers which have been established
186.7jointly between the Social Security Administration and the commissioner.

186.8    Sec. 30. Minnesota Statutes 2014, section 256P.05, subdivision 1, is amended to read:
186.9    Subdivision 1. Exempted programs. Participants who qualify for child care
186.10assistance programs under chapter 119B, Minnesota supplemental aid under chapter
186.11256D, and for group residential housing under chapter 256I on the basis of eligibility for
186.12Supplemental Security Income are exempt from this section.

186.13    Sec. 31. [256P.06] INCOME CALCULATIONS.
186.14    Subdivision 1. Reporting of income. To determine eligibility, the county agency
186.15must evaluate income received by members of the assistance unit, or by other persons
186.16whose income is considered available to the assistance unit, and only count income that
186.17is available to the assistance unit. Income is available if the individual has legal access
186.18to the income.
186.19    Subd. 2. Exempted individuals. The following members of an assistance unit
186.20under chapters 119B and 256J are exempt from having their earned income count towards
186.21the income of an assistance unit:
186.22(1) children under six years old;
186.23(2) caregivers under 20 years of age enrolled at least half-time in school; and
186.24(3) minors enrolled in school full time.
186.25    Subd. 3. Income inclusions. The following must be included in determining the
186.26income of an assistance unit:
186.27(1) earned income; and
186.28(2) unearned income, which includes:
186.29(i) interest and dividends from investments and savings;
186.30(ii) capital gains as defined by the Internal Revenue Service from any sale of real
186.31property;
186.32(iii) proceeds from rent and contract for deed payments in excess of the principal
186.33and interest portion owed on property;
186.34(iv) income from trusts, excluding special needs and supplemental needs trusts;
187.1(v) interest income from loans made by the participant or household;
187.2(vi) cash prizes and winnings;
187.3(vii) unemployment insurance income;
187.4(viii) retirement, survivors, and disability insurance payments;
187.5(ix) nonrecurring income over $60 per quarter unless earmarked and used for the
187.6purpose for which it is intended. Income and use of this income is subject to verification
187.7requirements under section 256P.04;
187.8(x) retirement benefits;
187.9(xi) cash assistance benefits, as defined by each program in chapters 119B, 256D,
187.10256I, and 256J;
187.11(xii) tribal per capita payments unless excluded by federal and state law;
187.12(xiii) income and payments from service and rehabilitation programs that meet
187.13or exceed the state's minimum wage rate;
187.14(xiv) income from members of the United States armed forces unless excluded from
187.15income taxes according to federal or state law;
187.16(xv) all child support payments for programs under chapters 119B, 256D, and 256I;
187.17(xvi) the amount of current child support received that exceeds $100 for assistance
187.18units with one child and $200 for assistance units with two or more children for programs
187.19under chapter 256J; and
187.20(xvii) spousal support.

187.21    Sec. 32. [256P.07] REPORTING OF INCOME AND CHANGES.
187.22    Subdivision 1. Exempted programs. Participants who qualify for Minnesota
187.23supplemental aid under chapter 256D and for group residential housing under chapter 256I
187.24on the basis of eligibility for Supplemental Security Income are exempt from this section.
187.25    Subd. 2. Reporting requirements. An applicant or participant must provide
187.26information on an application and any subsequent reporting forms about the assistance
187.27unit's circumstances that affect eligibility or benefits. An applicant or assistance unit must
187.28report changes identified in subdivision 3. When information is not accurately reported,
187.29both an overpayment and a referral for a fraud investigation may result. When information
187.30or documentation is not provided, the receipt of any benefit may be delayed or denied,
187.31depending on the type of information required and its effect on eligibility.
187.32    Subd. 3. Changes that must be reported. An assistance unit must report the
187.33changes or anticipated changes specified in clauses (1) to (12) within ten days of the date
187.34they occur, at the time of recertification of eligibility under section 256P.04, subdivisions
187.358 and 9, or within eight calendar days of a reporting period, whichever occurs first. An
188.1assistance unit must report other changes at the time of recertification of eligibility under
188.2section 256P.04, subdivisions 8 and 9, or at the end of a reporting period, as applicable.
188.3When an agency could have reduced or terminated assistance for one or more payment
188.4months if a delay in reporting a change specified under clauses (1) to (12) had not occurred,
188.5the agency must determine whether a timely notice could have been issued on the day
188.6that the change occurred. When a timely notice could have been issued, each month's
188.7overpayment subsequent to that notice must be considered a client error overpayment
188.8under section 119B.11, subdivision 2a, or 256P.08. Changes in circumstances that must
188.9be reported within ten days must also be reported for the reporting period in which those
188.10changes occurred. Within ten days, an assistance unit must report:
188.11(1) a change in earned income of $100 per month or greater;
188.12(2) a change in unearned income of $50 per month or greater;
188.13(3) a change in employment status and hours;
188.14(4) a change in address or residence;
188.15(5) a change in household composition with the exception of programs under
188.16chapter 256I;
188.17(6) a receipt of a lump-sum payment;
188.18(7) an increase in assets if over $9,000 with the exception of programs under chapter
188.19119B;
188.20(8) a change in citizenship or immigration status;
188.21(9) a change in family status with the exception of programs under chapter 256I;
188.22(10) a change in disability status of a unit member, with the exception of programs
188.23under chapter 119B;
188.24(11) a new rent subsidy or a change in rent subsidy; and
188.25(12) a sale, purchase, or transfer of real property.
188.26    Subd. 4. MFIP-specific reporting. In addition to subdivision 3, an assistance unit
188.27under chapter 256J, within ten days of the change, must report:
188.28(1) a pregnancy not resulting in birth when there are no other minor children; and
188.29(2) a change in school attendance of a parent under 20 years of age or of an
188.30employed child.
188.31    Subd. 5. DWP-specific reporting. In addition to subdivisions 3 and 4, an assistance
188.32unit participating in the diversionary work program under section 256J.95 must report
188.33on an application:
188.34(1) shelter expenses; and
188.35(2) utility expenses.
189.1    Subd. 6. Child care assistance programs-specific reporting. In addition to
189.2subdivision 3, an assistance unit under chapter 119B, within ten days of the change, must
189.3report:
189.4(1) a change in a parentally responsible individual's visitation schedule or custody
189.5arrangement for any child receiving child care assistance program benefits; and
189.6(2) a change in authorized activity status.
189.7    Subd. 7. Minnesota supplemental aid-specific reporting. In addition to
189.8subdivision 3, an assistance unit participating in the Minnesota supplemental aid program
189.9under section 256D.44, subdivision 5, paragraph (f), within ten days of the change, must
189.10report shelter expenses.

189.11    Sec. 33. [256P.08] CORRECTION OF OVERPAYMENTS AND
189.12UNDERPAYMENTS.
189.13    Subdivision 1. Exempted programs. Participants who qualify for child care
189.14assistance programs under chapter 119B or group residential housing under chapter 256I
189.15are exempt from this section.
189.16    Subd. 2. Scope of overpayment. (a) When a participant or former participant
189.17receives an overpayment due to client or ATM error, or due to assistance received while
189.18an appeal is pending and the participant or former participant is determined ineligible
189.19for assistance or for less assistance than was received, except as provided for interim
189.20assistance in section 256D.06, subdivision 5, the county agency must recoup or recover
189.21the overpayment using the following methods:
189.22(1) reconstruct each affected budget month and corresponding payment month;
189.23(2) use the policies and procedures that were in effect for the payment month; and
189.24(3) do not allow employment disregards in the calculation of the overpayment when
189.25the unit has not reported within two calendar months following the end of the month in
189.26which the income was received.
189.27(b) Establishment of an overpayment is limited to six years prior to the month of
189.28discovery due to client error or an intentional program violation determined under section
189.29256.046.
189.30(c) A participant or former participant is not responsible for overpayments due to
189.31agency error, unless the amount of the overpayment is large enough that a reasonable
189.32person would know it is an error.
189.33    Subd. 3. Notice of overpayment. When a county agency discovers that a participant
189.34or former participant has received an overpayment for one or more months, the county
189.35agency must notify the participant or former participant of the overpayment in writing.
190.1A notice of overpayment must specify the reason for the overpayment, the authority for
190.2citing the overpayment, the time period in which the overpayment occurred, the amount of
190.3the overpayment, and the participant's or former participant's right to appeal. No limit
190.4applies to the period in which the county agency is required to recoup or recover an
190.5overpayment according to subdivisions 4, 5, and 6.
190.6    Subd. 4. Recovering general assistance and Minnesota supplemental aid
190.7overpayments. (a) If an amount of assistance is paid to an assistance unit in excess of the
190.8payment due, it shall be recoverable by the agency. The agency shall give written notice to
190.9the participant of its intention to recover the overpayment.
190.10(b) If the individual is no longer receiving assistance, the agency may request
190.11voluntary repayment or pursue civil recovery.
190.12(c) If the individual is receiving assistance, except as provided for interim assistance
190.13in section 256D.06, subdivision 5, when an overpayment occurs the agency shall recover
190.14the overpayment by withholding an amount equal to:
190.15(1) three percent of the assistance unit's standard of need for all Minnesota
190.16supplemental aid assistance units, and nonfraud cases for general assistance; and
190.17(2) ten percent where fraud has occurred in general assistance cases; or
190.18(3) the amount of the monthly general assistance or Minnesota supplemental aid
190.19payment, whichever is less.
190.20(d) In cases when there is both an overpayment and underpayment, the county
190.21agency shall offset one against the other in correcting the payment.
190.22(e) Overpayments may also be voluntarily repaid, in part or in full, by the individual,
190.23in addition to the assistance reductions provided in this subdivision, to include further
190.24voluntary reductions in the grant level agreed to in writing by the individual, until the
190.25total amount of the overpayment is repaid.
190.26(f) The county agency shall make reasonable efforts to recover overpayments to
190.27individuals no longer on assistance. The agency need not attempt to recover overpayments
190.28of less than $35 paid to an individual no longer on assistance if the individual does not
190.29receive assistance again within three years, unless the individual has been convicted of
190.30violating section 256.98.
190.31(g) Establishment of an overpayment is limited to 12 months prior to the month of
190.32discovery due to agency error and six years prior to the month of discovery due to client
190.33error or an intentional program violation determined under section 256.046.
190.34(h) Residents of licensed residential facilities shall not have overpayments recovered
190.35from their personal needs allowance.
191.1(i) Overpayments by another maintenance benefit program shall not be recovered
191.2from the general assistance or Minnesota supplemental aid grant.
191.3    Subd. 5. Recovering MFIP overpayments. A county agency must initiate efforts
191.4to recover overpayments paid to a former participant or caregiver. Caregivers, both
191.5parental and nonparental, and minor caregivers of an assistance unit at the time an
191.6overpayment occurs, whether receiving assistance or not, are jointly and individually
191.7liable for repayment of the overpayment. The county agency must request repayment
191.8from the former participants and caregivers. When an agreement for repayment is
191.9not completed within six months of the date of discovery or when there is a default on
191.10an agreement for repayment after six months, the county agency must initiate recovery
191.11consistent with chapter 270A or section 541.05. When a person has been disqualified
191.12or convicted of fraud under section 256.98, recovery must be sought regardless of the
191.13amount of overpayment. When an overpayment is less than $35, and is not the result of a
191.14fraud conviction under section 256.98, the county agency must not seek recovery under
191.15this subdivision. The county agency must retain information about all overpayments
191.16regardless of the amount. When an adult, adult caregiver, or minor caregiver reapplies for
191.17assistance, the overpayment must be recouped under subdivision 6.
191.18    Subd. 6. Recouping overpayments from MFIP participants. A participant may
191.19voluntarily repay, in part or in full, an overpayment even if assistance is reduced under this
191.20subdivision, until the total amount of the overpayment is repaid. When an overpayment
191.21occurs due to fraud, the county agency must recover from the overpaid assistance unit,
191.22including child-only cases, ten percent of the applicable standard or the amount of the
191.23monthly assistance payment, whichever is less. When a nonfraud overpayment occurs,
191.24the county agency must recover from the overpaid assistance unit, including child-only
191.25cases, three percent of the MFIP standard of need or the amount of the monthly assistance
191.26payment, whichever is less.
191.27    Subd. 7. Recovering automatic teller machine errors. For recipients receiving
191.28benefits by electronic benefit transfer, if the overpayment is a result of an ATM dispensing
191.29funds in error to the recipient, the agency may recover the ATM error by immediately
191.30withdrawing funds from the recipient's electronic benefit transfer account, up to the
191.31amount of the error.
191.32    Subd. 8. Scope of underpayments. A county agency must issue a corrective
191.33payment for underpayments made to a participant or to a person who would be a
191.34participant if an agency or client error causing the underpayment had not occurred.
191.35Corrective payments are limited to 12 months prior to the month of discovery. The county
191.36agency must issue the corrective payment according to subdivision 10.
192.1    Subd. 9. Identifying the underpayment. An underpayment may be identified by
192.2a county agency, participant, former participant, or person who would be a participant
192.3except for agency or client error.
192.4    Subd. 10. Issuing corrective payments. A county agency must correct an
192.5underpayment within seven calendar days after the underpayment has been identified,
192.6by adding the corrective payment amount to the monthly assistance payment of the
192.7participant, issuing a separate payment to a participant or former participant, or reducing
192.8an existing overpayment balance. When an underpayment occurs in a payment month
192.9and is not identified until the next payment month or later, the county agency must first
192.10subtract the underpayment from any overpayment balance before issuing the corrective
192.11payment. The county agency must not apply an underpayment in a current payment month
192.12against an overpayment balance. When an underpayment in the current payment month
192.13is identified, the corrective payment must be issued within seven calendar days after the
192.14underpayment is identified. Corrective payments must be excluded when determining the
192.15applicant's or participant's income and resources for the month of payment. The county
192.16agency must correct underpayments using the following methods:
192.17(1) reconstruct each affected budget month and corresponding payment month; and
192.18(2) use the policies and procedures that were in effect for the payment month.
192.19    Subd. 11. Appeals. A participant may appeal an underpayment, an overpayment,
192.20and a reduction in an assistance payment made to recoup the overpayment under
192.21subdivisions 4 and 6. The participant's appeal of each issue must be timely under section
192.22256.045. When an appeal based on the notice issued under subdivision 3 is not timely, the
192.23fact or the amount of that overpayment must not be considered as a part of a later appeal,
192.24including an appeal of a reduction in an assistance payment to recoup that overpayment.

192.25    Sec. 34. REPEALER.
192.26(a) Minnesota Statutes 2014, sections 256D.0513; 256D.06, subdivision 8; 256D.09,
192.27subdivision 6; 256D.49; and 256J.38, are repealed.
192.28(b) Minnesota Rules, part 3400.0170, subparts 5, 6, 12, and 13, are repealed.

192.29    Sec. 35. EFFECTIVE DATE.
192.30This article is effective August 1, 2016.

193.1ARTICLE 6

193.2NURSING FACILITY PAYMENT REFORM AND WORKFORCE
193.3DEVELOPMENT

193.4    Section 1. [144.1503] HOME AND COMMUNITY-BASED SERVICES
193.5EMPLOYEE SCHOLARSHIP PROGRAM.
193.6    Subdivision 1. Creation. The home and community-based services employee
193.7scholarship grant program is established for the purpose of assisting qualified provider
193.8applicants to fund employee scholarships for education in nursing and other health care
193.9fields.
193.10    Subd. 2. Provision of grants. The commissioner shall make grants available
193.11to qualified providers of older adult services. Grants must be used by home and
193.12community-based service providers to recruit and train staff through the establishment of
193.13an employee scholarship fund.
193.14    Subd. 3. Eligibility. (a) Eligible providers must primarily provide services to
193.15individuals who are 65 years of age and older in home and community-based settings,
193.16including housing with services establishments as defined in section 144D.01, subdivision
193.174; adult day care as defined in section 245A.02, subdivision 2a; and home care services as
193.18defined in section 144A.43, subdivision 3.
193.19(b) Qualifying providers must establish a home and community-based services
193.20employee scholarship program, as specified in subdivision 4. Providers that receive
193.21funding under this section must use the funds to award scholarships to employees who
193.22work an average of at least 16 hours per week for the provider.
193.23    Subd. 4. Home and community-based services employee scholarship program.
193.24Each qualifying provider under this section must propose a home and community-based
193.25services employee scholarship program. Providers must establish criteria by which
193.26funds are to be distributed among employees. At a minimum, the scholarship program
193.27must cover employee costs related to a course of study that is expected to lead to career
193.28advancement with the provider or in the field of long-term care, including home care,
193.29care of persons with disabilities, or nursing.
193.30    Subd. 5. Participating providers. The commissioner shall publish a request for
193.31proposals in the State Register, specifying provider eligibility requirements, criteria for
193.32a qualifying employee scholarship program, provider selection criteria, documentation
193.33required for program participation, maximum award amount, and methods of evaluation.
193.34The commissioner must publish additional requests for proposals each year in which
193.35funding is available for this purpose.
194.1    Subd. 6. Application requirements. Eligible providers seeking a grant shall submit
194.2an application to the commissioner. Applications must contain a complete description of
194.3the employee scholarship program being proposed by the applicant, including the need for
194.4the organization to enhance the education of its workforce, the process for determining
194.5which employees will be eligible for scholarships, any other sources of funding for
194.6scholarships, the expected degrees or credentials eligible for scholarships, the amount of
194.7funding sought for the scholarship program, a proposed budget detailing how funds will
194.8be spent, and plans for retaining eligible employees after completion of their scholarship.
194.9    Subd. 7. Selection process. The commissioner shall determine a maximum
194.10award for grants and make grant selections based on the information provided in the
194.11grant application, including the demonstrated need for an applicant provider to enhance
194.12the education of its workforce, the proposed employee scholarship selection process,
194.13the applicant's proposed budget, and other criteria as determined by the commissioner.
194.14Notwithstanding any law or rule to the contrary, funds awarded to grantees in a grant
194.15agreement do not lapse until the grant agreement expires.
194.16    Subd. 8. Reporting requirements. Participating providers shall submit an invoice
194.17for reimbursement and a report to the commissioner on a schedule determined by the
194.18commissioner and on a form supplied by the commissioner. The report shall include
194.19the amount spent on scholarships; the number of employees who received scholarships;
194.20and, for each scholarship recipient, the name of the recipient, the current position of
194.21the recipient, the amount awarded, the educational institution attended, the nature of
194.22the educational program, and the expected or actual program completion date. During
194.23the grant period, the commissioner may require and collect from grant recipients other
194.24information necessary to evaluate the program.

194.25    Sec. 2. Minnesota Statutes 2014, section 144A.071, subdivision 4a, is amended to read:
194.26    Subd. 4a. Exceptions for replacement beds. It is in the best interest of the state
194.27to ensure that nursing homes and boarding care homes continue to meet the physical
194.28plant licensing and certification requirements by permitting certain construction projects.
194.29Facilities should be maintained in condition to satisfy the physical and emotional needs
194.30of residents while allowing the state to maintain control over nursing home expenditure
194.31growth.
194.32    The commissioner of health in coordination with the commissioner of human
194.33services, may approve the renovation, replacement, upgrading, or relocation of a nursing
194.34home or boarding care home, under the following conditions:
195.1    (a) to license or certify beds in a new facility constructed to replace a facility or to
195.2make repairs in an existing facility that was destroyed or damaged after June 30, 1987, by
195.3fire, lightning, or other hazard provided:
195.4    (i) destruction was not caused by the intentional act of or at the direction of a
195.5controlling person of the facility;
195.6    (ii) at the time the facility was destroyed or damaged the controlling persons of the
195.7facility maintained insurance coverage for the type of hazard that occurred in an amount
195.8that a reasonable person would conclude was adequate;
195.9    (iii) the net proceeds from an insurance settlement for the damages caused by the
195.10hazard are applied to the cost of the new facility or repairs;
195.11    (iv) the number of licensed and certified beds in the new facility does not exceed the
195.12number of licensed and certified beds in the destroyed facility; and
195.13    (v) the commissioner determines that the replacement beds are needed to prevent an
195.14inadequate supply of beds.
195.15Project construction costs incurred for repairs authorized under this clause shall not be
195.16considered in the dollar threshold amount defined in subdivision 2;
195.17    (b) to license or certify beds that are moved from one location to another within a
195.18nursing home facility, provided the total costs of remodeling performed in conjunction
195.19with the relocation of beds does not exceed $1,000,000;
195.20    (c) to license or certify beds in a project recommended for approval under section
195.21144A.073 ;
195.22    (d) to license or certify beds that are moved from an existing state nursing home to
195.23a different state facility, provided there is no net increase in the number of state nursing
195.24home beds;
195.25    (e) to certify and license as nursing home beds boarding care beds in a certified
195.26boarding care facility if the beds meet the standards for nursing home licensure, or in a
195.27facility that was granted an exception to the moratorium under section 144A.073, and if
195.28the cost of any remodeling of the facility does not exceed $1,000,000. If boarding care
195.29beds are licensed as nursing home beds, the number of boarding care beds in the facility
195.30must not increase beyond the number remaining at the time of the upgrade in licensure.
195.31The provisions contained in section 144A.073 regarding the upgrading of the facilities
195.32do not apply to facilities that satisfy these requirements;
195.33    (f) to license and certify up to 40 beds transferred from an existing facility owned and
195.34operated by the Amherst H. Wilder Foundation in the city of St. Paul to a new unit at the
195.35same location as the existing facility that will serve persons with Alzheimer's disease and
195.36other related disorders. The transfer of beds may occur gradually or in stages, provided
196.1the total number of beds transferred does not exceed 40. At the time of licensure and
196.2certification of a bed or beds in the new unit, the commissioner of health shall delicense
196.3and decertify the same number of beds in the existing facility. As a condition of receiving
196.4a license or certification under this clause, the facility must make a written commitment
196.5to the commissioner of human services that it will not seek to receive an increase in its
196.6property-related payment rate as a result of the transfers allowed under this paragraph;
196.7    (g) to license and certify nursing home beds to replace currently licensed and certified
196.8boarding care beds which may be located either in a remodeled or renovated boarding care
196.9or nursing home facility or in a remodeled, renovated, newly constructed, or replacement
196.10nursing home facility within the identifiable complex of health care facilities in which the
196.11currently licensed boarding care beds are presently located, provided that the number of
196.12boarding care beds in the facility or complex are decreased by the number to be licensed
196.13as nursing home beds and further provided that, if the total costs of new construction,
196.14replacement, remodeling, or renovation exceed ten percent of the appraised value of
196.15the facility or $200,000, whichever is less, the facility makes a written commitment to
196.16the commissioner of human services that it will not seek to receive an increase in its
196.17property-related payment rate by reason of the new construction, replacement, remodeling,
196.18or renovation. The provisions contained in section 144A.073 regarding the upgrading of
196.19facilities do not apply to facilities that satisfy these requirements;
196.20    (h) to license as a nursing home and certify as a nursing facility a facility that is
196.21licensed as a boarding care facility but not certified under the medical assistance program,
196.22but only if the commissioner of human services certifies to the commissioner of health that
196.23licensing the facility as a nursing home and certifying the facility as a nursing facility will
196.24result in a net annual savings to the state general fund of $200,000 or more;
196.25    (i) to certify, after September 30, 1992, and prior to July 1, 1993, existing nursing
196.26home beds in a facility that was licensed and in operation prior to January 1, 1992;
196.27    (j) to license and certify new nursing home beds to replace beds in a facility acquired
196.28by the Minneapolis Community Development Agency as part of redevelopment activities
196.29in a city of the first class, provided the new facility is located within three miles of the site
196.30of the old facility. Operating and property costs for the new facility must be determined
196.31and allowed under section 256B.431 or 256B.434;
196.32    (k) to license and certify up to 20 new nursing home beds in a community-operated
196.33hospital and attached convalescent and nursing care facility with 40 beds on April 21,
196.341991, that suspended operation of the hospital in April 1986. The commissioner of human
196.35services shall provide the facility with the same per diem property-related payment rate
196.36for each additional licensed and certified bed as it will receive for its existing 40 beds;
197.1    (l) to license or certify beds in renovation, replacement, or upgrading projects as
197.2defined in section 144A.073, subdivision 1, so long as the cumulative total costs of the
197.3facility's remodeling projects do not exceed $1,000,000;
197.4    (m) to license and certify beds that are moved from one location to another for the
197.5purposes of converting up to five four-bed wards to single or double occupancy rooms
197.6in a nursing home that, as of January 1, 1993, was county-owned and had a licensed
197.7capacity of 115 beds;
197.8    (n) to allow a facility that on April 16, 1993, was a 106-bed licensed and certified
197.9nursing facility located in Minneapolis to layaway all of its licensed and certified nursing
197.10home beds. These beds may be relicensed and recertified in a newly constructed teaching
197.11nursing home facility affiliated with a teaching hospital upon approval by the legislature.
197.12The proposal must be developed in consultation with the interagency committee on
197.13long-term care planning. The beds on layaway status shall have the same status as
197.14voluntarily delicensed and decertified beds, except that beds on layaway status remain
197.15subject to the surcharge in section 256.9657. This layaway provision expires July 1, 1998;
197.16    (o) to allow a project which will be completed in conjunction with an approved
197.17moratorium exception project for a nursing home in southern Cass County and which is
197.18directly related to that portion of the facility that must be repaired, renovated, or replaced,
197.19to correct an emergency plumbing problem for which a state correction order has been
197.20issued and which must be corrected by August 31, 1993;
197.21    (p) to allow a facility that on April 16, 1993, was a 368-bed licensed and certified
197.22nursing facility located in Minneapolis to layaway, upon 30 days prior written notice to
197.23the commissioner, up to 30 of the facility's licensed and certified beds by converting
197.24three-bed wards to single or double occupancy. Beds on layaway status shall have the
197.25same status as voluntarily delicensed and decertified beds except that beds on layaway
197.26status remain subject to the surcharge in section 256.9657, remain subject to the license
197.27application and renewal fees under section 144A.07 and shall be subject to a $100 per bed
197.28reactivation fee. In addition, at any time within three years of the effective date of the
197.29layaway, the beds on layaway status may be:
197.30    (1) relicensed and recertified upon relocation and reactivation of some or all of
197.31the beds to an existing licensed and certified facility or facilities located in Pine River,
197.32Brainerd, or International Falls; provided that the total project construction costs related to
197.33the relocation of beds from layaway status for any facility receiving relocated beds may
197.34not exceed the dollar threshold provided in subdivision 2 unless the construction project
197.35has been approved through the moratorium exception process under section 144A.073;
198.1    (2) relicensed and recertified, upon reactivation of some or all of the beds within the
198.2facility which placed the beds in layaway status, if the commissioner has determined a
198.3need for the reactivation of the beds on layaway status.
198.4    The property-related payment rate of a facility placing beds on layaway status
198.5must be adjusted by the incremental change in its rental per diem after recalculating the
198.6rental per diem as provided in section 256B.431, subdivision 3a, paragraph (c). The
198.7property-related payment rate for a facility relicensing and recertifying beds from layaway
198.8status must be adjusted by the incremental change in its rental per diem after recalculating
198.9its rental per diem using the number of beds after the relicensing to establish the facility's
198.10capacity day divisor, which shall be effective the first day of the month following the
198.11month in which the relicensing and recertification became effective. Any beds remaining
198.12on layaway status more than three years after the date the layaway status became effective
198.13must be removed from layaway status and immediately delicensed and decertified;
198.14    (q) to license and certify beds in a renovation and remodeling project to convert 12
198.15four-bed wards into 24 two-bed rooms, expand space, and add improvements in a nursing
198.16home that, as of January 1, 1994, met the following conditions: the nursing home was
198.17located in Ramsey County; had a licensed capacity of 154 beds; and had been ranked
198.18among the top 15 applicants by the 1993 moratorium exceptions advisory review panel.
198.19The total project construction cost estimate for this project must not exceed the cost
198.20estimate submitted in connection with the 1993 moratorium exception process;
198.21    (r) to license and certify up to 117 beds that are relocated from a licensed and certified
198.22138-bed nursing facility located in St. Paul to a hospital with 130 licensed hospital beds
198.23located in South St. Paul, provided that the nursing facility and hospital are owned by the
198.24same or a related organization and that prior to the date the relocation is completed the
198.25hospital ceases operation of its inpatient hospital services at that hospital. After relocation,
198.26the nursing facility's status shall be the same as it was prior to relocation. The nursing
198.27facility's property-related payment rate resulting from the project authorized in this
198.28paragraph shall become effective no earlier than April 1, 1996. For purposes of calculating
198.29the incremental change in the facility's rental per diem resulting from this project, the
198.30allowable appraised value of the nursing facility portion of the existing health care facility
198.31physical plant prior to the renovation and relocation may not exceed $2,490,000;
198.32    (s) to license and certify two beds in a facility to replace beds that were voluntarily
198.33delicensed and decertified on June 28, 1991;
198.34    (t) to allow 16 licensed and certified beds located on July 1, 1994, in a 142-bed
198.35nursing home and 21-bed boarding care home facility in Minneapolis, notwithstanding
198.36the licensure and certification after July 1, 1995, of the Minneapolis facility as a 147-bed
199.1nursing home facility after completion of a construction project approved in 1993 under
199.2section 144A.073, to be laid away upon 30 days' prior written notice to the commissioner.
199.3Beds on layaway status shall have the same status as voluntarily delicensed or decertified
199.4beds except that they shall remain subject to the surcharge in section 256.9657. The
199.516 beds on layaway status may be relicensed as nursing home beds and recertified at
199.6any time within five years of the effective date of the layaway upon relocation of some
199.7or all of the beds to a licensed and certified facility located in Watertown, provided that
199.8the total project construction costs related to the relocation of beds from layaway status
199.9for the Watertown facility may not exceed the dollar threshold provided in subdivision
199.102 unless the construction project has been approved through the moratorium exception
199.11process under section 144A.073.
199.12    The property-related payment rate of the facility placing beds on layaway status must
199.13be adjusted by the incremental change in its rental per diem after recalculating the rental per
199.14diem as provided in section 256B.431, subdivision 3a, paragraph (c). The property-related
199.15payment rate for the facility relicensing and recertifying beds from layaway status must be
199.16adjusted by the incremental change in its rental per diem after recalculating its rental per
199.17diem using the number of beds after the relicensing to establish the facility's capacity day
199.18divisor, which shall be effective the first day of the month following the month in which
199.19the relicensing and recertification became effective. Any beds remaining on layaway
199.20status more than five years after the date the layaway status became effective must be
199.21removed from layaway status and immediately delicensed and decertified;
199.22    (u) to license and certify beds that are moved within an existing area of a facility or
199.23to a newly constructed addition which is built for the purpose of eliminating three- and
199.24four-bed rooms and adding space for dining, lounge areas, bathing rooms, and ancillary
199.25service areas in a nursing home that, as of January 1, 1995, was located in Fridley and had
199.26a licensed capacity of 129 beds;
199.27    (v) to relocate 36 beds in Crow Wing County and four beds from Hennepin County
199.28to a 160-bed facility in Crow Wing County, provided all the affected beds are under
199.29common ownership;
199.30    (w) to license and certify a total replacement project of up to 49 beds located in
199.31Norman County that are relocated from a nursing home destroyed by flood and whose
199.32residents were relocated to other nursing homes. The operating cost payment rates for
199.33the new nursing facility shall be determined based on the interim and settle-up payment
199.34provisions of Minnesota Rules, part 9549.0057, and the reimbursement provisions of
199.35section 256B.431. Property-related reimbursement rates shall be determined under section
200.1256B.431 , taking into account any federal or state flood-related loans or grants provided
200.2to the facility;
200.3    (x) to license and certify a total to the licensee of a nursing home in Polk County
200.4that was destroyed by flood in 1997 replacement project projects with a total of up to 129
200.5beds, with at least 25 beds to be located in Polk County that are relocated from a nursing
200.6home destroyed by flood and whose residents were relocated to other nursing homes. and
200.7up to 104 beds distributed among up to three other counties. These beds may only be
200.8distributed to counties with fewer than the median number of age intensity adjusted beds
200.9per thousand, as most recently published by the commissioner of human services. If the
200.10licensee chooses to distribute beds outside of Polk County under this paragraph, prior to
200.11distributing the beds, the commissioner of health must approve the location in which the
200.12licensee plans to distribute the beds. The commissioner of health shall consult with the
200.13commissioner of human services prior to approving the location of the proposed beds.
200.14The licensee may combine these beds with beds relocated from other nursing facilities
200.15as provided in section 144A.073, subdivision 3c. The operating cost payment rates for
200.16the new nursing facility facilities shall be determined based on the interim and settle-up
200.17payment provisions of section 256B.431, 256B.434, or 256B.441 or Minnesota Rules, part
200.189549.0057, and the reimbursement provisions of section 256B.431, except that subdivision
200.1926, paragraphs (a) and (b), shall not apply until the second rate year after the settle-up cost
200.20report is filed. Property-related reimbursement rates shall be determined under section
200.21256B.431, taking into account any federal or state flood-related loans or grants provided to
200.22the facility; parts 9549.0010 to 9549.0080. Property-related reimbursement rates shall
200.23be determined under section 256B.431, 256B.434, or 256B.441. If the replacement beds
200.24permitted under this paragraph are combined with beds from other nursing facilities, the
200.25rates shall be calculated as the weighted average of rates determined as provided in this
200.26paragraph and section 256B.441, subdivision 60;
200.27    (y) to license and certify beds in a renovation and remodeling project to convert 13
200.28three-bed wards into 13 two-bed rooms and 13 single-bed rooms, expand space, and
200.29add improvements in a nursing home that, as of January 1, 1994, met the following
200.30conditions: the nursing home was located in Ramsey County, was not owned by a hospital
200.31corporation, had a licensed capacity of 64 beds, and had been ranked among the top 15
200.32applicants by the 1993 moratorium exceptions advisory review panel. The total project
200.33construction cost estimate for this project must not exceed the cost estimate submitted in
200.34connection with the 1993 moratorium exception process;
200.35    (z) to license and certify up to 150 nursing home beds to replace an existing 285
200.36bed nursing facility located in St. Paul. The replacement project shall include both the
201.1renovation of existing buildings and the construction of new facilities at the existing
201.2site. The reduction in the licensed capacity of the existing facility shall occur during the
201.3construction project as beds are taken out of service due to the construction process. Prior
201.4to the start of the construction process, the facility shall provide written information to the
201.5commissioner of health describing the process for bed reduction, plans for the relocation
201.6of residents, and the estimated construction schedule. The relocation of residents shall be
201.7in accordance with the provisions of law and rule;
201.8    (aa) to allow the commissioner of human services to license an additional 36 beds
201.9to provide residential services for the physically disabled under Minnesota Rules, parts
201.109570.2000 to 9570.3400, in a 198-bed nursing home located in Red Wing, provided that
201.11the total number of licensed and certified beds at the facility does not increase;
201.12    (bb) to license and certify a new facility in St. Louis County with 44 beds
201.13constructed to replace an existing facility in St. Louis County with 31 beds, which has
201.14resident rooms on two separate floors and an antiquated elevator that creates safety
201.15concerns for residents and prevents nonambulatory residents from residing on the second
201.16floor. The project shall include the elimination of three- and four-bed rooms;
201.17    (cc) to license and certify four beds in a 16-bed certified boarding care home in
201.18Minneapolis to replace beds that were voluntarily delicensed and decertified on or
201.19before March 31, 1992. The licensure and certification is conditional upon the facility
201.20periodically assessing and adjusting its resident mix and other factors which may
201.21contribute to a potential institution for mental disease declaration. The commissioner of
201.22human services shall retain the authority to audit the facility at any time and shall require
201.23the facility to comply with any requirements necessary to prevent an institution for mental
201.24disease declaration, including delicensure and decertification of beds, if necessary;
201.25    (dd) to license and certify 72 beds in an existing facility in Mille Lacs County with
201.2680 beds as part of a renovation project. The renovation must include construction of
201.27an addition to accommodate ten residents with beginning and midstage dementia in a
201.28self-contained living unit; creation of three resident households where dining, activities,
201.29and support spaces are located near resident living quarters; designation of four beds
201.30for rehabilitation in a self-contained area; designation of 30 private rooms; and other
201.31improvements;
201.32    (ee) to license and certify beds in a facility that has undergone replacement or
201.33remodeling as part of a planned closure under section 256B.437;
201.34    (ff) to license and certify a total replacement project of up to 124 beds located
201.35in Wilkin County that are in need of relocation from a nursing home significantly
201.36damaged by flood. The operating cost payment rates for the new nursing facility shall be
202.1determined based on the interim and settle-up payment provisions of Minnesota Rules,
202.2part 9549.0057, and the reimbursement provisions of section 256B.431. Property-related
202.3reimbursement rates shall be determined under section 256B.431, taking into account any
202.4federal or state flood-related loans or grants provided to the facility;
202.5    (gg) to allow the commissioner of human services to license an additional nine beds
202.6to provide residential services for the physically disabled under Minnesota Rules, parts
202.79570.2000 to 9570.3400, in a 240-bed nursing home located in Duluth, provided that the
202.8total number of licensed and certified beds at the facility does not increase;
202.9    (hh) to license and certify up to 120 new nursing facility beds to replace beds in a
202.10facility in Anoka County, which was licensed for 98 beds as of July 1, 2000, provided the
202.11new facility is located within four miles of the existing facility and is in Anoka County.
202.12Operating and property rates shall be determined and allowed under section 256B.431 and
202.13Minnesota Rules, parts 9549.0010 to 9549.0080, or section 256B.434 or 256B.441; or
202.14    (ii) to transfer up to 98 beds of a 129-licensed bed facility located in Anoka County
202.15that, as of March 25, 2001, is in the active process of closing, to a 122-licensed bed nonprofit
202.16nursing facility located in the city of Columbia Heights or its affiliate. The transfer is
202.17effective when the receiving facility notifies the commissioner in writing of the number of
202.18beds accepted. The commissioner shall place all transferred beds on layaway status held in
202.19the name of the receiving facility. The layaway adjustment provisions of section 256B.431,
202.20subdivision 30, do not apply to this layaway. The receiving facility may only remove the
202.21beds from layaway for recertification and relicensure at the receiving facility's current
202.22site, or at a newly constructed facility located in Anoka County. The receiving facility
202.23must receive statutory authorization before removing these beds from layaway status, or
202.24may remove these beds from layaway status if removal from layaway status is part of a
202.25moratorium exception project approved by the commissioner under section 144A.073.

202.26    Sec. 3. Minnesota Statutes 2014, section 256B.0913, subdivision 4, is amended to read:
202.27    Subd. 4. Eligibility for funding for services for nonmedical assistance recipients.
202.28    (a) Funding for services under the alternative care program is available to persons who
202.29meet the following criteria:
202.30    (1) the person has been determined by a community assessment under section
202.31256B.0911 to be a person who would require the level of care provided in a nursing
202.32facility, as determined under section 256B.0911, subdivision 4e, but for the provision of
202.33services under the alternative care program;
202.34    (2) the person is age 65 or older;
203.1    (3) the person would be eligible for medical assistance within 135 days of admission
203.2to a nursing facility;
203.3    (4) the person is not ineligible for the payment of long-term care services by the
203.4medical assistance program due to an asset transfer penalty under section 256B.0595 or
203.5equity interest in the home exceeding $500,000 as stated in section 256B.056;
203.6    (5) the person needs long-term care services that are not funded through other
203.7state or federal funding, or other health insurance or other third-party insurance such as
203.8long-term care insurance;
203.9    (6) except for individuals described in clause (7), the monthly cost of the alternative
203.10care services funded by the program for this person does not exceed 75 percent of the
203.11monthly limit described under section 256B.0915, subdivision 3a. This monthly limit
203.12does not prohibit the alternative care client from payment for additional services, but in no
203.13case may the cost of additional services purchased under this section exceed the difference
203.14between the client's monthly service limit defined under section 256B.0915, subdivision
203.153 , and the alternative care program monthly service limit defined in this paragraph. If
203.16care-related supplies and equipment or environmental modifications and adaptations are or
203.17will be purchased for an alternative care services recipient, the costs may be prorated on a
203.18monthly basis for up to 12 consecutive months beginning with the month of purchase.
203.19If the monthly cost of a recipient's other alternative care services exceeds the monthly
203.20limit established in this paragraph, the annual cost of the alternative care services shall be
203.21determined. In this event, the annual cost of alternative care services shall not exceed 12
203.22times the monthly limit described in this paragraph;
203.23    (7) for individuals assigned a case mix classification A as described under section
203.24256B.0915, subdivision 3a , paragraph (a), with (i) no dependencies in activities of daily
203.25living, or (ii) up to two dependencies in bathing, dressing, grooming, walking, and eating
203.26when the dependency score in eating is three or greater as determined by an assessment
203.27performed under section 256B.0911, the monthly cost of alternative care services funded
203.28by the program cannot exceed $593 per month for all new participants enrolled in
203.29the program on or after July 1, 2011. This monthly limit shall be applied to all other
203.30participants who meet this criteria at reassessment. This monthly limit shall be increased
203.31annually as described in section 256B.0915, subdivision 3a, paragraph paragraphs (a) and
203.32(e). This monthly limit does not prohibit the alternative care client from payment for
203.33additional services, but in no case may the cost of additional services purchased exceed the
203.34difference between the client's monthly service limit defined in this clause and the limit
203.35described in clause (6) for case mix classification A; and
203.36(8) the person is making timely payments of the assessed monthly fee.
204.1A person is ineligible if payment of the fee is over 60 days past due, unless the person
204.2agrees to:
204.3    (i) the appointment of a representative payee;
204.4    (ii) automatic payment from a financial account;
204.5    (iii) the establishment of greater family involvement in the financial management of
204.6payments; or
204.7    (iv) another method acceptable to the lead agency to ensure prompt fee payments.
204.8    The lead agency may extend the client's eligibility as necessary while making
204.9arrangements to facilitate payment of past-due amounts and future premium payments.
204.10Following disenrollment due to nonpayment of a monthly fee, eligibility shall not be
204.11reinstated for a period of 30 days.
204.12    (b) Alternative care funding under this subdivision is not available for a person who
204.13is a medical assistance recipient or who would be eligible for medical assistance without a
204.14spenddown or waiver obligation. A person whose initial application for medical assistance
204.15and the elderly waiver program is being processed may be served under the alternative care
204.16program for a period up to 60 days. If the individual is found to be eligible for medical
204.17assistance, medical assistance must be billed for services payable under the federally
204.18approved elderly waiver plan and delivered from the date the individual was found eligible
204.19for the federally approved elderly waiver plan. Notwithstanding this provision, alternative
204.20care funds may not be used to pay for any service the cost of which: (i) is payable by
204.21medical assistance; (ii) is used by a recipient to meet a waiver obligation; or (iii) is used to
204.22pay a medical assistance income spenddown for a person who is eligible to participate in the
204.23federally approved elderly waiver program under the special income standard provision.
204.24    (c) Alternative care funding is not available for a person who resides in a licensed
204.25nursing home, certified boarding care home, hospital, or intermediate care facility, except
204.26for case management services which are provided in support of the discharge planning
204.27process for a nursing home resident or certified boarding care home resident to assist with
204.28a relocation process to a community-based setting.
204.29    (d) Alternative care funding is not available for a person whose income is greater
204.30than the maintenance needs allowance under section 256B.0915, subdivision 1d, but equal
204.31to or less than 120 percent of the federal poverty guideline effective July 1 in the fiscal
204.32year for which alternative care eligibility is determined, who would be eligible for the
204.33elderly waiver with a waiver obligation.

204.34    Sec. 4. Minnesota Statutes 2014, section 256B.0915, subdivision 3a, is amended to read:
205.1    Subd. 3a. Elderly waiver cost limits. (a) The monthly limit for the cost of
205.2waivered services to an individual elderly waiver client except for individuals described
205.3in paragraphs (b) and (d) shall be the weighted average monthly nursing facility rate of
205.4the case mix resident class to which the elderly waiver client would be assigned under
205.5Minnesota Rules, parts 9549.0050 to 9549.0059, less the recipient's maintenance needs
205.6allowance as described in subdivision 1d, paragraph (a), until the first day of the state
205.7fiscal year in which the resident assessment system as described in section 256B.438 for
205.8nursing home rate determination is implemented. Effective on the first day of the state
205.9fiscal year in which the resident assessment system as described in section 256B.438 for
205.10nursing home rate determination is implemented and the first day of each subsequent state
205.11fiscal year, the monthly limit for the cost of waivered services to an individual elderly
205.12waiver client shall be the rate monthly limit of the case mix resident class to which the
205.13waiver client would be assigned under Minnesota Rules, parts 9549.0050 to 9549.0059, in
205.14effect on the last day of the previous state fiscal year, adjusted by any legislatively adopted
205.15home and community-based services percentage rate adjustment.
205.16    (b) The monthly limit for the cost of waivered services under paragraph (a) to an
205.17individual elderly waiver client assigned to a case mix classification A under paragraph
205.18(a) with:
205.19(1) no dependencies in activities of daily living; or
205.20(2) up to two dependencies in bathing, dressing, grooming, walking, and eating
205.21when the dependency score in eating is three or greater as determined by an assessment
205.22performed under section 256B.0911 shall be $1,750 per month effective on July 1, 2011,
205.23for all new participants enrolled in the program on or after July 1, 2011. This monthly
205.24limit shall be applied to all other participants who meet this criteria at reassessment. This
205.25monthly limit shall be increased annually as described in paragraph paragraphs (a) and (e).
205.26(c) If extended medical supplies and equipment or environmental modifications are
205.27or will be purchased for an elderly waiver client, the costs may be prorated for up to
205.2812 consecutive months beginning with the month of purchase. If the monthly cost of a
205.29recipient's waivered services exceeds the monthly limit established in paragraph (a) or,
205.30(b), (d), or (e), the annual cost of all waivered services shall be determined. In this event,
205.31the annual cost of all waivered services shall not exceed 12 times the monthly limit of
205.32waivered services as described in paragraph (a) or, (b), (d), or (e).
205.33(d) Effective July 1, 2013, the monthly cost limit of waiver services, including
205.34any necessary home care services described in section 256B.0651, subdivision 2, for
205.35individuals who meet the criteria as ventilator-dependent given in section 256B.0651,
205.36subdivision 1, paragraph (g), shall be the average of the monthly medical assistance
206.1amount established for home care services as described in section 256B.0652, subdivision
206.27 , and the annual average contracted amount established by the commissioner for nursing
206.3facility services for ventilator-dependent individuals. This monthly limit shall be increased
206.4annually as described in paragraph paragraphs (a) and (e).
206.5(e) Effective July 1, 2016, and each July 1 thereafter, the monthly cost limits for
206.6elderly waiver services in effect on the previous June 30 shall be increased by the
206.7difference between any legislatively adopted home and community-based provider rate
206.8increases effective on July 1 or since the previous July 1 and the average statewide
206.9percentage increase in nursing facility operating payment rates under sections 256B.431,
206.10256B.434, and 256B.441, effective the previous January 1. This paragraph shall only
206.11apply if the average statewide percentage increase in nursing facility operating payment
206.12rates is greater than any legislatively adopted home and community-based provider rate
206.13increases effective on July 1, or occurring since the previous July 1.
206.14EFFECTIVE DATE.This section is effective July 1, 2016.

206.15    Sec. 5. Minnesota Statutes 2014, section 256B.0915, subdivision 3e, is amended to read:
206.16    Subd. 3e. Customized living service rate. (a) Payment for customized living
206.17services shall be a monthly rate authorized by the lead agency within the parameters
206.18established by the commissioner. The payment agreement must delineate the amount of
206.19each component service included in the recipient's customized living service plan. The
206.20lead agency, with input from the provider of customized living services, shall ensure that
206.21there is a documented need within the parameters established by the commissioner for all
206.22component customized living services authorized.
206.23(b) The payment rate must be based on the amount of component services to be
206.24provided utilizing component rates established by the commissioner. Counties and tribes
206.25shall use tools issued by the commissioner to develop and document customized living
206.26service plans and rates.
206.27(c) Component service rates must not exceed payment rates for comparable elderly
206.28waiver or medical assistance services and must reflect economies of scale. Customized
206.29living services must not include rent or raw food costs.
206.30    (d) With the exception of individuals described in subdivision 3a, paragraph (b), the
206.31individualized monthly authorized payment for the customized living service plan shall not
206.32exceed 50 percent of the greater of either the statewide or any of the geographic groups'
206.33weighted average monthly nursing facility rate of the case mix resident class to which the
206.34elderly waiver eligible client would be assigned under Minnesota Rules, parts 9549.0050 to
206.359549.0059, less the maintenance needs allowance as described in subdivision 1d, paragraph
207.1(a), until the July 1 of the state fiscal year in which the resident assessment system as
207.2described in section 256B.438 for nursing home rate determination is implemented.
207.3Effective on July 1 of the state fiscal year in which the resident assessment system as
207.4described in section 256B.438 for nursing home rate determination is implemented and
207.5July 1 of each subsequent state fiscal year, the individualized monthly authorized payment
207.6for the services described in this clause shall not exceed the limit which was in effect on
207.7June 30 of the previous state fiscal year updated annually based on legislatively adopted
207.8changes to all service rate maximums for home and community-based service providers.
207.9(e) Effective July 1, 2011, the individualized monthly payment for the customized
207.10living service plan for individuals described in subdivision 3a, paragraph (b), must be the
207.11monthly authorized payment limit for customized living for individuals classified as case
207.12mix A, reduced by 25 percent. This rate limit must be applied to all new participants
207.13enrolled in the program on or after July 1, 2011, who meet the criteria described in
207.14subdivision 3a, paragraph (b). This monthly limit also applies to all other participants who
207.15meet the criteria described in subdivision 3a, paragraph (b), at reassessment.
207.16    (f) Customized living services are delivered by a provider licensed by the
207.17Department of Health as a class A or class F home care provider and provided in a
207.18building that is registered as a housing with services establishment under chapter 144D.
207.19Licensed home care providers are subject to section 256B.0651, subdivision 14.
207.20(g) A provider may not bill or otherwise charge an elderly waiver participant or their
207.21family for additional units of any allowable component service beyond those available
207.22under the service rate limits described in paragraph (d), nor for additional units of any
207.23allowable component service beyond those approved in the service plan by the lead agency.
207.24(h) Effective July 1, 2016, and each July 1 thereafter, individualized service rate
207.25limits for customized living services under this subdivision shall be increased by the
207.26difference between any legislatively adopted home and community-based provider rate
207.27increases effective on July 1 or since the previous July 1 and the average statewide
207.28percentage increase in nursing facility operating payment rates under sections 256B.431,
207.29256B.434, and 256B.441, effective the previous January 1. This paragraph shall only
207.30apply if the average statewide percentage increase in nursing facility operating payment
207.31rates is greater than any legislatively adopted home and community-based provider rate
207.32increases effective on July 1, or occurring since the previous July 1.
207.33EFFECTIVE DATE.This section is effective July 1, 2016.

207.34    Sec. 6. Minnesota Statutes 2014, section 256B.0915, subdivision 3h, is amended to read:
208.1    Subd. 3h. Service rate limits; 24-hour customized living services. (a) The
208.2payment rate for 24-hour customized living services is a monthly rate authorized by the
208.3lead agency within the parameters established by the commissioner of human services.
208.4The payment agreement must delineate the amount of each component service included
208.5in each recipient's customized living service plan. The lead agency, with input from
208.6the provider of customized living services, shall ensure that there is a documented need
208.7within the parameters established by the commissioner for all component customized
208.8living services authorized. The lead agency shall not authorize 24-hour customized living
208.9services unless there is a documented need for 24-hour supervision.
208.10(b) For purposes of this section, "24-hour supervision" means that the recipient
208.11requires assistance due to needs related to one or more of the following:
208.12    (1) intermittent assistance with toileting, positioning, or transferring;
208.13    (2) cognitive or behavioral issues;
208.14    (3) a medical condition that requires clinical monitoring; or
208.15    (4) for all new participants enrolled in the program on or after July 1, 2011, and
208.16all other participants at their first reassessment after July 1, 2011, dependency in at
208.17least three of the following activities of daily living as determined by assessment under
208.18section 256B.0911: bathing; dressing; grooming; walking; or eating when the dependency
208.19score in eating is three or greater; and needs medication management and at least 50
208.20hours of service per month. The lead agency shall ensure that the frequency and mode
208.21of supervision of the recipient and the qualifications of staff providing supervision are
208.22described and meet the needs of the recipient.
208.23(c) The payment rate for 24-hour customized living services must be based on the
208.24amount of component services to be provided utilizing component rates established by the
208.25commissioner. Counties and tribes will use tools issued by the commissioner to develop
208.26and document customized living plans and authorize rates.
208.27(d) Component service rates must not exceed payment rates for comparable elderly
208.28waiver or medical assistance services and must reflect economies of scale.
208.29(e) The individually authorized 24-hour customized living payments, in combination
208.30with the payment for other elderly waiver services, including case management, must not
208.31exceed the recipient's community budget cap specified in subdivision 3a. Customized
208.32living services must not include rent or raw food costs.
208.33(f) The individually authorized 24-hour customized living payment rates shall not
208.34exceed the 95 percentile of statewide monthly authorizations for 24-hour customized
208.35living services in effect and in the Medicaid management information systems on March
208.3631, 2009, for each case mix resident class under Minnesota Rules, parts 9549.0050
209.1to 9549.0059, to which elderly waiver service clients are assigned. When there are
209.2fewer than 50 authorizations in effect in the case mix resident class, the commissioner
209.3shall multiply the calculated service payment rate maximum for the A classification by
209.4the standard weight for that classification under Minnesota Rules, parts 9549.0050 to
209.59549.0059, to determine the applicable payment rate maximum. Service payment rate
209.6maximums shall be updated annually based on legislatively adopted changes to all service
209.7rates for home and community-based service providers.
209.8    (g) Notwithstanding the requirements of paragraphs (d) and (f), the commissioner
209.9may establish alternative payment rate systems for 24-hour customized living services in
209.10housing with services establishments which are freestanding buildings with a capacity of
209.1116 or fewer, by applying a single hourly rate for covered component services provided
209.12in either:
209.13    (1) licensed corporate adult foster homes; or
209.14    (2) specialized dementia care units which meet the requirements of section 144D.065
209.15and in which:
209.16    (i) each resident is offered the option of having their own apartment; or
209.17    (ii) the units are licensed as board and lodge establishments with maximum capacity
209.18of eight residents, and which meet the requirements of Minnesota Rules, part 9555.6205,
209.19subparts 1, 2, 3, and 4, item A.
209.20(h) Twenty-four-hour customized living services are delivered by a provider licensed
209.21by the Department of Health as a class A or class F home care provider and provided in a
209.22building that is registered as a housing with services establishment under chapter 144D.
209.23Licensed home care providers are subject to section 256B.0651, subdivision 14.
209.24(i) A provider may not bill or otherwise charge an elderly waiver participant or their
209.25family for additional units of any allowable component service beyond those available
209.26under the service rate limits described in paragraph (e), nor for additional units of any
209.27allowable component service beyond those approved in the service plan by the lead agency.
209.28(j) Effective July 1, 2016, and each July 1 thereafter, individualized service rate
209.29limits for 24-hour customized living services under this subdivision shall be increased by
209.30the difference between any legislatively adopted home and community-based provider
209.31rate increases effective on July 1 or since the previous July 1 and the average statewide
209.32percentage increase in nursing facility operating payment rates under sections 256B.431,
209.33256B.434, and 256B.441, effective the previous January 1. This paragraph shall only
209.34apply if the average statewide percentage increase in nursing facility operating payment
209.35rates is greater than any legislatively adopted home and community-based provider rate
209.36increases effective on July 1, or occurring since the previous July 1.
210.1EFFECTIVE DATE.This section is effective July 1, 2016.

210.2    Sec. 7. Minnesota Statutes 2014, section 256B.431, subdivision 2b, is amended to read:
210.3    Subd. 2b. Operating costs after July 1, 1985. (a) For rate years beginning on or
210.4after July 1, 1985, the commissioner shall establish procedures for determining per diem
210.5reimbursement for operating costs.
210.6(b) The commissioner shall contract with an econometric firm with recognized
210.7expertise in and access to national economic change indices that can be applied to the
210.8appropriate cost categories when determining the operating cost payment rate.
210.9(c) The commissioner shall analyze and evaluate each nursing facility's cost report
210.10of allowable operating costs incurred by the nursing facility during the reporting year
210.11immediately preceding the rate year for which the payment rate becomes effective.
210.12(d) The commissioner shall establish limits on actual allowable historical operating
210.13cost per diems based on cost reports of allowable operating costs for the reporting year
210.14that begins October 1, 1983, taking into consideration relevant factors including resident
210.15needs, geographic location, and size of the nursing facility. In developing the geographic
210.16groups for purposes of reimbursement under this section, the commissioner shall ensure
210.17that nursing facilities in any county contiguous to the Minneapolis-St. Paul seven-county
210.18metropolitan area are included in the same geographic group. The limits established by
210.19the commissioner shall not be less, in the aggregate, than the 60th percentile of total
210.20actual allowable historical operating cost per diems for each group of nursing facilities
210.21established under subdivision 1 based on cost reports of allowable operating costs in the
210.22previous reporting year. For rate years beginning on or after July 1, 1989, facilities located
210.23in geographic group I as described in Minnesota Rules, part 9549.0052, on January 1,
210.241989, may choose to have the commissioner apply either the care related limits or the
210.25other operating cost limits calculated for facilities located in geographic group II, or
210.26both, if either of the limits calculated for the group II facilities is higher. The efficiency
210.27incentive for geographic group I nursing facilities must be calculated based on geographic
210.28group I limits. The phase-in must be established utilizing the chosen limits. For purposes
210.29of these exceptions to the geographic grouping requirements, the definitions in Minnesota
210.30Rules, parts 9549.0050 to 9549.0059 (Emergency), and 9549.0010 to 9549.0080, apply.
210.31The limits established under this paragraph remain in effect until the commissioner
210.32establishes a new base period. Until the new base period is established, the commissioner
210.33shall adjust the limits annually using the appropriate economic change indices established
210.34in paragraph (e). In determining allowable historical operating cost per diems for purposes
210.35of setting limits and nursing facility payment rates, the commissioner shall divide the
211.1allowable historical operating costs by the actual number of resident days, except that
211.2where a nursing facility is occupied at less than 90 percent of licensed capacity days, the
211.3commissioner may establish procedures to adjust the computation of the per diem to
211.4an imputed occupancy level at or below 90 percent. The commissioner shall establish
211.5efficiency incentives as appropriate. The commissioner may establish efficiency incentives
211.6for different operating cost categories. The commissioner shall consider establishing
211.7efficiency incentives in care related cost categories. The commissioner may combine one
211.8or more operating cost categories and may use different methods for calculating payment
211.9rates for each operating cost category or combination of operating cost categories. For the
211.10rate year beginning on July 1, 1985, the commissioner shall:
211.11(1) allow nursing facilities that have an average length of stay of 180 days or less in
211.12their skilled nursing level of care, 125 percent of the care related limit and 105 percent
211.13of the other operating cost limit established by rule; and
211.14(2) exempt nursing facilities licensed on July 1, 1983, by the commissioner to
211.15provide residential services for the physically disabled under Minnesota Rules, parts
211.169570.2000 to 9570.3600, from the care related limits and allow 105 percent of the other
211.17operating cost limit established by rule.
211.18For the purpose of calculating the other operating cost efficiency incentive for
211.19nursing facilities referred to in clause (1) or (2), the commissioner shall use the other
211.20operating cost limit established by rule before application of the 105 percent.
211.21(e) The commissioner shall establish a composite index or indices by determining
211.22the appropriate economic change indicators to be applied to specific operating cost
211.23categories or combination of operating cost categories.
211.24(f) Each nursing facility shall receive an operating cost payment rate equal to the sum
211.25of the nursing facility's operating cost payment rates for each operating cost category. The
211.26operating cost payment rate for an operating cost category shall be the lesser of the nursing
211.27facility's historical operating cost in the category increased by the appropriate index
211.28established in paragraph (e) for the operating cost category plus an efficiency incentive
211.29established pursuant to paragraph (d) or the limit for the operating cost category increased
211.30by the same index. If a nursing facility's actual historic operating costs are greater than the
211.31prospective payment rate for that rate year, there shall be no retroactive cost settle up. In
211.32establishing payment rates for one or more operating cost categories, the commissioner may
211.33establish separate rates for different classes of residents based on their relative care needs.
211.34(g) The commissioner shall include the reported actual real estate tax liability or
211.35payments in lieu of real estate tax of each nursing facility as an operating cost of that
211.36nursing facility. Allowable costs under this subdivision for payments made by a nonprofit
212.1nursing facility that are in lieu of real estate taxes shall not exceed the amount which the
212.2nursing facility would have paid to a city or township and county for fire, police, sanitation
212.3services, and road maintenance costs had real estate taxes been levied on that property
212.4for those purposes. For rate years beginning on or after July 1, 1987, the reported actual
212.5real estate tax liability or payments in lieu of real estate tax of nursing facilities shall be
212.6adjusted to include an amount equal to one-half of the dollar change in real estate taxes
212.7from the prior year. The commissioner shall include a reported actual special assessment,
212.8and reported actual license fees required by the Minnesota Department of Health, for each
212.9nursing facility as an operating cost of that nursing facility. For rate years beginning
212.10on or after July 1, 1989, the commissioner shall include a nursing facility's reported
212.11Public Employee Retirement Act contribution for the reporting year as apportioned to the
212.12care-related operating cost categories and other operating cost categories multiplied by
212.13the appropriate composite index or indices established pursuant to paragraph (e) as costs
212.14under this paragraph. Total adjusted real estate tax liability, payments in lieu of real
212.15estate tax, actual special assessments paid, the indexed Public Employee Retirement Act
212.16contribution, and license fees paid as required by the Minnesota Department of Health,
212.17for each nursing facility (1) shall be divided by actual resident days in order to compute
212.18the operating cost payment rate for this operating cost category, (2) shall not be used to
212.19compute the care-related operating cost limits or other operating cost limits established
212.20by the commissioner, and (3) shall not be increased by the composite index or indices
212.21established pursuant to paragraph (e), unless otherwise indicated in this paragraph.
212.22(h) For rate years beginning on or after July 1, 1987, the commissioner shall adjust
212.23the rates of a nursing facility that meets the criteria for the special dietary needs of its
212.24residents and the requirements in section 31.651. The adjustment for raw food cost shall
212.25be the difference between the nursing facility's allowable historical raw food cost per
212.26diem and 115 percent of the median historical allowable raw food cost per diem of the
212.27corresponding geographic group.
212.28The rate adjustment shall be reduced by the applicable phase-in percentage as
212.29provided under subdivision 2h.

212.30    Sec. 8. Minnesota Statutes 2014, section 256B.431, subdivision 36, is amended to read:
212.31    Subd. 36. Employee scholarship costs and training in English as a second
212.32language. (a) For the period between July 1, 2001, and June 30, 2003, the commissioner
212.33shall provide to each nursing facility reimbursed under this section, section 256B.434,
212.34or any other section, a scholarship per diem of 25 cents to the total operating payment
212.35rate. For the 27-month period beginning October 1, 2015, through December 31, 2017,
213.1the commissioner shall allow a scholarship per diem of up to 25 cents for each nursing
213.2facility with no scholarship per diem that is requesting a scholarship per diem to be added
213.3to the external fixed payment rate to be used:
213.4(1) for employee scholarships that satisfy the following requirements:
213.5(i) scholarships are available to all employees who work an average of at least 20
213.6ten hours per week at the facility except the administrator, department supervisors, and
213.7registered nurses and to reimburse student loan expenses for newly hired and recently
213.8graduated registered nurses and licensed practical nurses, and training expenses for
213.9nursing assistants as defined in section 144A.611, subdivision 2, who are newly hired and
213.10have graduated within the last 12 months; and
213.11(ii) the course of study is expected to lead to career advancement with the facility or
213.12in long-term care, including medical care interpreter services and social work; and
213.13(2) to provide job-related training in English as a second language.
213.14(b) A facility receiving All facilities may annually request a rate adjustment under
213.15this subdivision may submit by submitting information to the commissioner on a schedule
213.16determined by the commissioner and on in a form supplied by the commissioner a
213.17calculation of the scholarship per diem, including: the amount received from this rate
213.18adjustment; the amount used for training in English as a second language; the number of
213.19persons receiving the training; the name of the person or entity providing the training;
213.20and for each scholarship recipient, the name of the recipient, the amount awarded, the
213.21educational institution attended, the nature of the educational program, the program
213.22completion date, and a determination of the per diem amount of these costs based on
213.23actual resident days. The commissioner shall allow a scholarship payment rate equal to
213.24the reported and allowable costs divided by resident days.
213.25(c) On July 1, 2003, the commissioner shall remove the 25 cent scholarship per diem
213.26from the total operating payment rate of each facility.
213.27(d) For rate years beginning after June 30, 2003, the commissioner shall provide to
213.28each facility the scholarship per diem determined in paragraph (b). In calculating the per
213.29diem under paragraph (b), the commissioner shall allow only costs related to tuition and,
213.30direct educational expenses, and reasonable costs as defined by the commissioner for child
213.31care costs and transportation expenses related to direct educational expenses.
213.32(d) The rate increase under this subdivision is an optional rate add-on that the facility
213.33must request from the commissioner in a manner prescribed by the commissioner. The
213.34rate increase must be used for scholarships as specified in this subdivision.
213.35(e) For instances in which a rate adjustment will be 15 cents or greater, nursing
213.36facilities that close beds during a rate year may request to have their scholarship
214.1adjustment under paragraph (b) recalculated by the commissioner for the remainder of the
214.2rate year to reflect the reduction in resident days compared to the cost report year.

214.3    Sec. 9. Minnesota Statutes 2014, section 256B.434, subdivision 4, is amended to read:
214.4    Subd. 4. Alternate rates for nursing facilities. (a) For nursing facilities which
214.5have their payment rates determined under this section rather than section 256B.431, the
214.6commissioner shall establish a rate under this subdivision. The nursing facility must enter
214.7into a written contract with the commissioner.
214.8    (b) A nursing facility's case mix payment rate for the first rate year of a facility's
214.9contract under this section is the payment rate the facility would have received under
214.10section 256B.431.
214.11    (c) A nursing facility's case mix payment rates for the second and subsequent years
214.12of a facility's contract under this section are the previous rate year's contract payment rates
214.13plus an inflation adjustment and, for facilities reimbursed under this section or section
214.14256B.431 , an adjustment to include the cost of any increase in Health Department licensing
214.15fees for the facility taking effect on or after July 1, 2001. The index for the inflation
214.16adjustment must be based on the change in the Consumer Price Index-All Items (United
214.17States City average) (CPI-U) forecasted by the commissioner of management and budget's
214.18national economic consultant, as forecasted in the fourth quarter of the calendar year
214.19preceding the rate year. The inflation adjustment must be based on the 12-month period
214.20from the midpoint of the previous rate year to the midpoint of the rate year for which the
214.21rate is being determined. For the rate years beginning on July 1, 1999, July 1, 2000, July
214.221, 2001, July 1, 2002, July 1, 2003, July 1, 2004, July 1, 2005, July 1, 2006, July 1, 2007,
214.23July 1, 2008, October 1, 2009, and October 1, 2010, this paragraph shall apply only to the
214.24property-related payment rate. For the rate years beginning on October 1, 2011, October 1,
214.252012, October 1, 2013, October 1, 2014, October 1, 2015, and October January 1, 2016, and
214.26January 1, 2017, the rate adjustment under this paragraph shall be suspended. Beginning
214.27in 2005, adjustment to the property payment rate under this section and section 256B.431
214.28shall be effective on October 1. In determining the amount of the property-related payment
214.29rate adjustment under this paragraph, the commissioner shall determine the proportion of
214.30the facility's rates that are property-related based on the facility's most recent cost report.
214.31    (d) The commissioner shall develop additional incentive-based payments of up to
214.32five percent above a facility's operating payment rate for achieving outcomes specified
214.33in a contract. The commissioner may solicit contract amendments and implement those
214.34which, on a competitive basis, best meet the state's policy objectives. The commissioner
214.35shall limit the amount of any incentive payment and the number of contract amendments
215.1under this paragraph to operate the incentive payments within funds appropriated for this
215.2purpose. The contract amendments may specify various levels of payment for various
215.3levels of performance. Incentive payments to facilities under this paragraph may be in the
215.4form of time-limited rate adjustments or onetime supplemental payments. In establishing
215.5the specified outcomes and related criteria, the commissioner shall consider the following
215.6state policy objectives:
215.7    (1) successful diversion or discharge of residents to the residents' prior home or other
215.8community-based alternatives;
215.9    (2) adoption of new technology to improve quality or efficiency;
215.10    (3) improved quality as measured in the Nursing Home Report Card;
215.11    (4) reduced acute care costs; and
215.12    (5) any additional outcomes proposed by a nursing facility that the commissioner
215.13finds desirable.
215.14    (e) Notwithstanding the threshold in section 256B.431, subdivision 16, facilities that
215.15take action to come into compliance with existing or pending requirements of the life
215.16safety code provisions or federal regulations governing sprinkler systems must receive
215.17reimbursement for the costs associated with compliance if all of the following conditions
215.18are met:
215.19    (1) the expenses associated with compliance occurred on or after January 1, 2005,
215.20and before December 31, 2008;
215.21    (2) the costs were not otherwise reimbursed under subdivision 4f or section
215.22144A.071 or 144A.073; and
215.23    (3) the total allowable costs reported under this paragraph are less than the minimum
215.24threshold established under section 256B.431, subdivision 15, paragraph (e), and
215.25subdivision 16.
215.26The commissioner shall use money appropriated for this purpose to provide to qualifying
215.27nursing facilities a rate adjustment beginning October 1, 2007, and ending September 30,
215.282008. Nursing facilities that have spent money or anticipate the need to spend money
215.29to satisfy the most recent life safety code requirements by (1) installing a sprinkler
215.30system or (2) replacing all or portions of an existing sprinkler system may submit to the
215.31commissioner by June 30, 2007, on a form provided by the commissioner the actual
215.32costs of a completed project or the estimated costs, based on a project bid, of a planned
215.33project. The commissioner shall calculate a rate adjustment equal to the allowable
215.34costs of the project divided by the resident days reported for the report year ending
215.35September 30, 2006. If the costs from all projects exceed the appropriation for this
215.36purpose, the commissioner shall allocate the money appropriated on a pro rata basis to the
216.1qualifying facilities by reducing the rate adjustment determined for each facility by an
216.2equal percentage. Facilities that used estimated costs when requesting the rate adjustment
216.3shall report to the commissioner by January 31, 2009, on the use of this money on a
216.4form provided by the commissioner. If the nursing facility fails to provide the report, the
216.5commissioner shall recoup the money paid to the facility for this purpose. If the facility
216.6reports expenditures allowable under this subdivision that are less than the amount received
216.7in the facility's annualized rate adjustment, the commissioner shall recoup the difference.

216.8    Sec. 10. Minnesota Statutes 2014, section 256B.434, is amended by adding a
216.9subdivision to read:
216.10    Subd. 4i. Construction project rate adjustments for certain nursing facilities.
216.11(a) This subdivision applies to nursing facilities with at least 120 active beds as of January
216.121, 2015, that have projects approved in 2015 under the nursing facility moratorium
216.13exception process in section 144A.073. When each facility's moratorium exception
216.14construction project is completed, the facility must receive the rate adjustment allowed
216.15under subdivision 4f. In addition to that rate adjustment, facilities with at least 120
216.16active beds, but not more than 149 active beds, as of January 1, 2015, must have their
216.17construction project rate adjustment increased by an additional $4; and facilities with at
216.18least 150 active beds, but not more than 160 active beds, as of January 1, 2015, must have
216.19their construction project rate adjustment increased by an additional $12.50.
216.20(b) Notwithstanding any other law to the contrary, money available under section
216.21144A.073, subdivision 11, after the completion of the moratorium exception approval
216.22process in 2015 under section 144A.073, subdivision 3, shall be used to reduce the fiscal
216.23impact to the medical assistance budget for the increases allowed in this subdivision.

216.24    Sec. 11. Minnesota Statutes 2014, section 256B.441, subdivision 1, is amended to read:
216.25    Subdivision 1. Rebasing Calculation of nursing facility operating payment
216.26rates. (a) The commissioner shall rebase nursing facility operating payment rates to align
216.27payments to facilities with the cost of providing care. The rebased calculate operating
216.28payment rates shall be calculated using the statistical and cost report filed by each nursing
216.29facility for the report period ending one year 15 months prior to the rate year.
216.30    (b) The new operating payment rates based on this section shall take effect beginning
216.31with the rate year beginning October 1, 2008, and shall be phased in over eight rate years
216.32through October 1, 2015. For each year of the phase-in, the operating payment rates shall
216.33be calculated using the statistical and cost report filed by each nursing facility for the
216.34report period ending one year prior to the rate year January 1, 2016.
217.1    (c) Operating payment rates shall be rebased on October 1, 2016, and every two
217.2years after that date.
217.3    (d) (c) Each cost reporting year shall begin on October 1 and end on the following
217.4September 30. Beginning in 2014, A statistical and cost report shall be filed by each
217.5nursing facility by February 1 in a form and manner specified by the commissioner.
217.6Notice of rates shall be distributed by August November 15 and the rates shall go into
217.7effect on October January 1 for one year.
217.8    (e) Effective October 1, 2014, property rates shall be rebased in accordance with
217.9section 256B.431 and Minnesota Rules, chapter 9549. The commissioner shall determine
217.10what the property payment rate for a nursing facility would be had the facility not had its
217.11property rate determined under section 256B.434. The commissioner shall allow nursing
217.12facilities to provide information affecting this rate determination that would have been
217.13filed annually under Minnesota Rules, chapter 9549, and nursing facilities shall report
217.14information necessary to determine allowable debt. The commissioner shall use this
217.15information to determine the property payment rate.

217.16    Sec. 12. Minnesota Statutes 2014, section 256B.441, subdivision 5, is amended to read:
217.17    Subd. 5. Administrative costs. "Administrative costs" means the direct costs for
217.18administering the overall activities of the nursing home. These costs include salaries and
217.19wages of the administrator, assistant administrator, business office employees, security
217.20guards, and associated fringe benefits and payroll taxes, fees, contracts, or purchases
217.21related to business office functions, licenses, and permits except as provided in the
217.22external fixed costs category, employee recognition, travel including meals and lodging,
217.23all training except as specified in subdivision 11, voice and data communication or
217.24transmission, office supplies, property and liability insurance and other forms of insurance
217.25not designated to other areas, personnel recruitment, legal services, accounting services,
217.26management or business consultants, data processing, information technology, Web
217.27site, central or home office costs, business meetings and seminars, postage, fees for
217.28professional organizations, subscriptions, security services, advertising, board of director's
217.29fees, working capital interest expense, and bad debts and bad debt collection fees.

217.30    Sec. 13. Minnesota Statutes 2014, section 256B.441, subdivision 6, is amended to read:
217.31    Subd. 6. Allowed costs. (a) "Allowed costs" means the amounts reported by the
217.32facility which are necessary for the operation of the facility and the care of residents
217.33and which are reviewed by the department for accuracy; reasonableness, in accordance
217.34with the requirements set forth in title XVIII of the federal Social Security Act and the
218.1interpretations in the provider reimbursement manual; and compliance with this section
218.2and generally accepted accounting principles. All references to costs in this section shall
218.3be assumed to refer to allowed costs.
218.4(b) For facilities where employees are represented by collective bargaining agents,
218.5costs related to the salaries and wages, payroll taxes, and employer's share of fringe benefit
218.6costs, except employer health insurance costs, for facility employees who are members of
218.7the bargaining unit are allowed costs only if:
218.8(1) these costs are incurred pursuant to a collective bargaining agreement. The
218.9commissioner shall allow until March 1 following the date on which the cost report was
218.10required to be submitted for a collective bargaining agent to notify the commissioner if
218.11a collective bargaining agreement, effective on the last day of the cost reporting year,
218.12was not in effect; or
218.13(2) the collective bargaining agent notifies the commissioner by October 1 following
218.14the date on which the cost report was required to be submitted that these costs are
218.15incurred pursuant to an agreement or understanding between the facility and the collective
218.16bargaining agent.
218.17(c) In any year when a portion of a facility's reported costs are not allowed costs
218.18under paragraph (b), when calculating the operating payment rate for the facility, the
218.19commissioner shall use the facility's allowed costs from the facility's second most recent
218.20cost report in place of the nonallowed costs. For the purpose of setting the price for other
218.21operating costs under subdivision 51, the price shall be reduced by the difference between
218.22the nonallowed costs and the allowed costs from the facility's second most recent cost
218.23report.

218.24    Sec. 14. Minnesota Statutes 2014, section 256B.441, is amended by adding a
218.25subdivision to read:
218.26    Subd. 11a. Employer health insurance costs. "Employer health insurance costs"
218.27means premium expenses for group coverage and reinsurance, actual expenses incurred
218.28for self-insured plans, and employer contributions to employee health reimbursement and
218.29health savings accounts. Premium and expense costs and contributions are allowable for
218.30employees who meet the definition of full-time employees and their spouse and dependents
218.31under the federal Affordable Care Act, Public Law 111-148, and part-time employees.

218.32    Sec. 15. Minnesota Statutes 2014, section 256B.441, subdivision 13, is amended to read:
218.33    Subd. 13. External fixed costs. "External fixed costs" means costs related to the
218.34nursing home surcharge under section 256.9657, subdivision 1; licensure fees under
219.1section 144.122; until September 30, 2013, long-term care consultation fees under
219.2section 256B.0911, subdivision 6; family advisory council fee under section 144A.33;
219.3scholarships under section 256B.431, subdivision 36; planned closure rate adjustments
219.4under section 256B.437; or single bed room incentives under section 256B.431,
219.5subdivision 42 ; property taxes and property insurance, assessments, and payments in
219.6lieu of taxes; employer health insurance costs; quality improvement incentive payment
219.7rate adjustments under subdivision 46c; performance-based incentive payments under
219.8subdivision 46d; special dietary needs under subdivision 51b; and PERA.

219.9    Sec. 16. Minnesota Statutes 2014, section 256B.441, subdivision 14, is amended to read:
219.10    Subd. 14. Facility average case mix index. "Facility average case mix index"
219.11or "CMI" means a numerical value score that describes the relative resource use for
219.12all residents within the groups under the resource utilization group (RUG-III) (RUG)
219.13classification system prescribed by the commissioner based on an assessment of each
219.14resident. The facility average CMI shall be computed as the standardized days divided by
219.15total days for all residents in the facility. The RUG's weights used in this section shall be
219.16as follows for each RUG's class: SE3 1.605; SE2 1.247; SE1 1.081; RAD 1.509; RAC
219.171.259; RAB 1.109; RAA 0.957; SSC 1.453; SSB 1.224; SSA 1.047; CC2 1.292; CC1
219.181.200; CB2 1.086; CB1 1.017; CA2 0.908; CA1 0.834; IB2 0.877; IB1 0.817; IA2 0.720;
219.19IA1 0.676; BB2 0.956; BB1 0.885; BA2 0.716; BA1 0.673; PE2 1.199; PE1 1.104; PD2
219.201.023; PD1 0.948; PC2 0.926; PC1 0.860; PB2 0.786; PB1 0.734; PA2 0.691; PA1 0.651;
219.21BC1 0.651; and DDF 1.000 shall be based on the system prescribed in section 256B.438.

219.22    Sec. 17. Minnesota Statutes 2014, section 256B.441, subdivision 17, is amended to read:
219.23    Subd. 17. Fringe benefit costs. "Fringe benefit costs" means the costs for group life,
219.24health, dental, workers' compensation, and other employee insurances and pension, except
219.25for the Public Employees Retirement Association and employer health insurance costs;
219.26profit sharing,; and retirement plans for which the employer pays all or a portion of the costs.

219.27    Sec. 18. Minnesota Statutes 2014, section 256B.441, subdivision 30, is amended to read:
219.28    Subd. 30. Peer groups Median total care-related cost per diem and other
219.29operating per diem determined. Facilities shall be classified into three groups by county.
219.30The groups shall consist of:
219.31    (1) group one: facilities in Anoka, Benton, Carlton, Carver, Chisago, Dakota,
219.32Dodge, Goodhue, Hennepin, Isanti, Mille Lacs, Morrison, Olmsted, Ramsey, Rice, Scott,
219.33Sherburne, St. Louis, Stearns, Steele, Wabasha, Washington, Winona, or Wright County;
220.1    (2) group two: facilities in Aitkin, Beltrami, Blue Earth, Brown, Cass, Clay,
220.2Cook, Crow Wing, Faribault, Fillmore, Freeborn, Houston, Hubbard, Itasca, Kanabec,
220.3Koochiching, Lake, Lake of the Woods, Le Sueur, Martin, McLeod, Meeker, Mower,
220.4Nicollet, Norman, Pine, Roseau, Sibley, Todd, Wadena, Waseca, Watonwan, or Wilkin
220.5County; and
220.6    (3) group three: facilities in all other counties (a) The commissioner shall determine
220.7the median total care-related per diem to be used in subdivision 50 and the median other
220.8operating per diem to be used in subdivision 51 using the cost reports from nursing
220.9facilities in Anoka, Carver, Dakota, Hennepin, Ramsey, Scott, and Washington Counties.
220.10(b) The median total care-related per diem shall be equal to the median direct care
220.11cost for a RUG's weight of 1.00 for facilities located in the counties listed in paragraph (a).
220.12(c) The median other operating per diem shall be equal to the median other
220.13operating per diem for facilities located in the counties listed in paragraph (a). The other
220.14operating per diem shall be the sum of each facility's administrative costs, dietary costs,
220.15housekeeping costs, laundry costs, and maintenance and plant operations costs divided
220.16by each facility's resident days.

220.17    Sec. 19. Minnesota Statutes 2014, section 256B.441, subdivision 31, is amended to read:
220.18    Subd. 31. Prior system operating cost payment rate. "Prior system operating cost
220.19payment rate" means the operating cost payment rate in effect on September 30, 2008
220.20December 31, 2015, under Minnesota Rules and Minnesota Statutes, not including planned
220.21closure rate adjustments under section 256B.437 or single bed room incentives under
220.22section 256B.431, subdivision 42 inclusive of health insurance plus property insurance
220.23costs from external fixed, but not including rate increases allowed under subdivision 55a.

220.24    Sec. 20. Minnesota Statutes 2014, section 256B.441, subdivision 33, is amended to read:
220.25    Subd. 33. Rate year. "Rate year" means the 12-month period beginning on October
220.26January 1 following the second most recent reporting year.

220.27    Sec. 21. Minnesota Statutes 2014, section 256B.441, subdivision 35, is amended to read:
220.28    Subd. 35. Reporting period. "Reporting period" means the one-year period
220.29beginning on October 1 and ending on the following September 30 during which incurred
220.30costs are accumulated and then reported on the statistical and cost report. If a facility is
220.31reporting for an interim or settle-up period, the reporting period beginning date may be a
220.32date other than October 1. An interim or settle-up report must cover at least five months,
220.33but no more than 17 months, and must always end on September 30.

221.1    Sec. 22. Minnesota Statutes 2014, section 256B.441, subdivision 40, is amended to read:
221.2    Subd. 40. Standardized days. "Standardized days" means the sum of resident days
221.3by case mix category multiplied by the RUG index for each category. When a facility has
221.4resident days at a penalty classification, these days shall be reported as resident days at the
221.5RUG class established immediately after the penalty period, if available, and otherwise, at
221.6the RUG class in effect before the penalty began.

221.7    Sec. 23. Minnesota Statutes 2014, section 256B.441, subdivision 44, is amended to read:
221.8    Subd. 44. Calculation of a quality score. (a) The commissioner shall determine
221.9a quality score for each nursing facility using quality measures established in section
221.10256B.439 , according to methods determined by the commissioner in consultation with
221.11stakeholders and experts, and using the most recently available data as provided in
221.12the Minnesota Nursing Home Report Card. These methods shall be exempt from the
221.13rulemaking requirements under chapter 14.
221.14(b) For each quality measure, a score shall be determined with a maximum the number
221.15of points available and number of points assigned as determined by the commissioner
221.16using the methodology established according to this subdivision. The scores determined
221.17for all quality measures shall be totaled. The determination of the quality measures to be
221.18used and the methods of calculating scores may be revised annually by the commissioner.
221.19(c) For the initial rate year under the new payment system, the quality measures
221.20shall include:
221.21(1) staff turnover;
221.22(2) staff retention;
221.23(3) use of pool staff;
221.24(4) quality indicators from the minimum data set; and
221.25(5) survey deficiencies.
221.26(d) Beginning July 1, 2013 January 1, 2016, the quality score shall be a value
221.27between zero and 100, using data as provided in the Minnesota nursing home report
221.28card, with include up to 50 percent derived from points related to the Minnesota quality
221.29indicators score, up to 40 percent derived from points related to the resident quality of life
221.30score, and up to ten percent derived from points related to the state inspection results score.
221.31(e) (d) The commissioner, in cooperation with the commissioner of health, may
221.32adjust the formula in paragraph (d) (c), or the methodology for computing the total quality
221.33score, effective July 1 of any year beginning in 2014 2017, with five months advance
221.34public notice. In changing the formula, the commissioner shall consider quality measure
221.35priorities registered by report card users, advice of stakeholders, and available research.

222.1    Sec. 24. Minnesota Statutes 2014, section 256B.441, subdivision 46c, is amended to
222.2read:
222.3    Subd. 46c. Quality improvement incentive system beginning October 1, 2015.
222.4The commissioner shall develop a quality improvement incentive program in consultation
222.5with stakeholders. The annual funding pool available for quality improvement incentive
222.6payments shall be equal to 0.8 percent of all operating payments, not including any rate
222.7components resulting from equitable cost-sharing for publicly owned nursing facility
222.8program participation under subdivision 55a, critical access nursing facility program
222.9participation under subdivision 63, or performance-based incentive payment program
222.10participation under section 256B.434, subdivision 4, paragraph (d). For the period from
222.11October 1, 2015, to December 31, 2016, rate adjustments provided under this subdivision
222.12shall be effective for 15 months. Beginning October 1, 2015 January 1, 2017, annual
222.13rate adjustments provided under this subdivision shall be effective for one year, starting
222.14October January 1 and ending the following September 30 December 31. The increase in
222.15this subdivision shall be included in the external fixed payment rate under subdivisions
222.1613 and 53.

222.17    Sec. 25. Minnesota Statutes 2014, section 256B.441, is amended by adding a
222.18subdivision to read:
222.19    Subd. 46d. Performance-based incentive payments. The commissioner shall
222.20develop additional incentive-based payments of up to five percent above a facility's
222.21operating payment rate for achieving outcomes specified in a contract. The commissioner
222.22may solicit proposals and select those which, on a competitive basis, best meet the state's
222.23policy objectives. The commissioner shall limit the amount of any incentive payment
222.24and the number of contract amendments under this subdivision to operate the incentive
222.25payments within funds appropriated for this purpose. The commissioner shall approve
222.26proposals through a memorandum of understanding which shall specify various levels of
222.27payment for various levels of performance. Incentive payments to facilities under this
222.28subdivision shall be in the form of time-limited rate adjustments which shall be included
222.29in the external fixed payment rate under subdivisions 13 and 53. In establishing the
222.30specified outcomes and related criteria, the commissioner shall consider the following
222.31state policy objectives:
222.32(1) successful diversion or discharge of residents to the residents' prior home or other
222.33community-based alternatives;
222.34(2) adoption of new technology to improve quality or efficiency;
222.35(3) improved quality as measured in the Minnesota Nursing Home Report Card;
223.1(4) reduced acute care costs; and
223.2(5) any additional outcomes proposed by a nursing facility that the commissioner
223.3finds desirable.

223.4    Sec. 26. Minnesota Statutes 2014, section 256B.441, subdivision 48, is amended to read:
223.5    Subd. 48. Calculation of operating care-related per diems. The direct care per
223.6diem for each facility shall be the facility's direct care costs divided by its standardized
223.7days. The other care-related per diem shall be the sum of the facility's activities costs,
223.8other direct care costs, raw food costs, therapy costs, and social services costs, divided by
223.9the facility's resident days. The other operating per diem shall be the sum of the facility's
223.10administrative costs, dietary costs, housekeeping costs, laundry costs, and maintenance
223.11and plant operations costs divided by the facility's resident days.

223.12    Sec. 27. Minnesota Statutes 2014, section 256B.441, subdivision 50, is amended to read:
223.13    Subd. 50. Determination of total care-related limit. (a) The limit on the median
223.14total care-related per diem shall be determined for each peer group and facility type group
223.15combination. A facility's total care-related per diems shall be limited to 120 percent of the
223.16median for the facility's peer and facility type group. The facility-specific direct care costs
223.17used in making this comparison and in the calculation of the median shall be based on a
223.18RUG's weight of 1.00. A facility that is above that limit shall have its total care-related per
223.19diem reduced to the limit. If a reduction of the total care-related per diem is necessary
223.20because of this limit, the reduction shall be made proportionally to both the direct care per
223.21diem and the other care-related per diem according to subdivision 30.
223.22    (b) Beginning with rates determined for October 1, 2016, the A facility's total
223.23care-related limit shall be a variable amount based on each facility's quality score, as
223.24determined under subdivision 44, in accordance with clauses (1) to (4) (3):
223.25    (1) for each facility, the commissioner shall determine the quality score, subtract 40,
223.26divide by 40, and convert to a percentage the quality score shall be multiplied by 0.5625;
223.27    (2) if the value determined in clause (1) is less than zero, the total care-related limit
223.28shall be 105 percent of the median for the facility's peer and facility type group add 89.375
223.29to the amount determined in clause (1), and divide the total by 100; and
223.30    (3) if the value determined in clause (1) is greater than 100 percent, the total
223.31care-related limit shall be 125 percent of the median for the facility's peer and facility type
223.32group; and multiply the amount determined in clause (2) by the median total care-related
223.33per diem determined in subdivision 30, paragraph (b).
224.1    (4) if the value determined in clause (1) is greater than zero and less than 100
224.2percent, the total care-related limit shall be 105 percent of the median for the facility's peer
224.3and facility type group plus one-fifth of the percentage determined in clause (1).
224.4(c) A RUG's weight of 1.00 shall be used in the calculation of the median total
224.5care-related per diem, and in comparisons of facility-specific direct care costs to the median.
224.6(d) A facility that is above its total care-related limit as determined according to
224.7paragraph (b) shall have its total care-related per diem reduced to its limit. If a reduction
224.8of the total care-related per diem is necessary due to this limit, the reduction shall be made
224.9proportionally to both the direct care per diem and the other care-related per diem.

224.10    Sec. 28. Minnesota Statutes 2014, section 256B.441, subdivision 51, is amended to read:
224.11    Subd. 51. Determination of other operating limit price. The limit on the A price
224.12for other operating per diem costs shall be determined for each peer group. A facility's
224.13other operating per diem shall be limited to The price shall be calculated as 105 percent
224.14of the median for its peer group other operating per diem described in subdivision 30,
224.15paragraph (c). A facility that is above that limit shall have its other operating per diem
224.16reduced to the limit.

224.17    Sec. 29. Minnesota Statutes 2014, section 256B.441, subdivision 51a, is amended to
224.18read:
224.19    Subd. 51a. Exception allowing contracting for specialized care facilities. (a)
224.20For rate years beginning on or after October January 1, 2016, the commissioner may
224.21negotiate increases to the care-related limit for nursing facilities that provide specialized
224.22care, at a cost to the general fund not to exceed $600,000 per year. The commissioner
224.23shall publish a request for proposals annually, and may negotiate increases to the limits
224.24that shall apply for either one or two years before the increase shall be subject to a new
224.25proposal and negotiation. the care-related limit may for specialized care facilities shall
224.26be increased by up to 50 percent.
224.27    (b) In selecting facilities with which to negotiate, the commissioner shall consider:
224.28"Specialized care facilities" are defined as a facility having a program licensed under
224.29chapter 245A and Minnesota Rules, chapter 9570, or a facility with 96 beds on January 1,
224.302015, located in Robbinsdale that specializes in the treatment of Huntington's Disease.
224.31    (1) the diagnoses or other circumstances of residents in the specialized program that
224.32require care that costs substantially more than the RUG's rates associated with those
224.33residents;
225.1    (2) the nature of the specialized program or programs offered to meet the needs
225.2of these individuals; and
225.3    (3) outcomes achieved by the specialized program.

225.4    Sec. 30. Minnesota Statutes 2014, section 256B.441, is amended by adding a
225.5subdivision to read:
225.6    Subd. 51b. Special dietary needs. The commissioner shall adjust the rates of
225.7a nursing facility that meets the criteria for the special dietary needs of its residents and
225.8the requirements in section 31.651 or 31.658. The adjustment for raw food cost shall be
225.9the difference between the nursing facility's most recently reported allowable raw food
225.10cost per diem and 115 percent of the median allowable raw food cost per diem. For rate
225.11years beginning on or after January 1, 2016, this amount shall be removed from allowable
225.12raw food per diem costs under operating costs and included in the external fixed per
225.13diem rate under subdivisions 13 and 53.

225.14    Sec. 31. Minnesota Statutes 2014, section 256B.441, subdivision 53, is amended to read:
225.15    Subd. 53. Calculation of payment rate for external fixed costs. The commissioner
225.16shall calculate a payment rate for external fixed costs.
225.17    (a) For a facility licensed as a nursing home, the portion related to section 256.9657
225.18shall be equal to $8.86. For a facility licensed as both a nursing home and a boarding care
225.19home, the portion related to section 256.9657 shall be equal to $8.86 multiplied by the
225.20result of its number of nursing home beds divided by its total number of licensed beds.
225.21    (b) The portion related to the licensure fee under section 144.122, paragraph (d),
225.22shall be the amount of the fee divided by actual resident days.
225.23    (c) The portion related to development and education of resident and family advisory
225.24councils under section 144A.33 shall be $5 divided by 365.
225.25    (d) The portion related to scholarships shall be determined under section 256B.431,
225.26subdivision 36.
225.27    (d) Until September 30, 2013, the portion related to long-term care consultation shall
225.28be determined according to section 256B.0911, subdivision 6.
225.29    (e) The portion related to development and education of resident and family advisory
225.30councils under section 144A.33 shall be $5 divided by 365.
225.31    (f) (e) The portion related to planned closure rate adjustments shall be as determined
225.32under section 256B.437, subdivision 6, and Minnesota Statutes 2010, section 256B.436.
225.33Planned closure rate adjustments that take effect before October 1, 2014, shall no longer
225.34be included in the payment rate for external fixed costs beginning October 1, 2016.
226.1Planned closure rate adjustments that take effect on or after October 1, 2014, shall no
226.2longer be included in the payment rate for external fixed costs beginning on October 1 of
226.3the first year not less than two years after their effective date.
226.4(f) The single bed room incentives shall be as determined under section 256B.431,
226.5subdivision 42.
226.6    (g) The portions related to property insurance, real estate taxes, special assessments,
226.7and payments made in lieu of real estate taxes directly identified or allocated to the nursing
226.8facility shall be the actual amounts divided by actual resident days.
226.9    (h) The portion related to employer health insurance costs shall be the allowable
226.10costs divided by resident days.
226.11    (i) The portion related to the Public Employees Retirement Association shall be
226.12actual costs divided by resident days.
226.13    (i) The single bed room incentives shall be as determined under section 256B.431,
226.14subdivision 42. Single bed room incentives that take effect before October 1, 2014, shall
226.15no longer be included in the payment rate for external fixed costs beginning October 1,
226.162016. Single bed room incentives that take effect on or after October 1, 2014, shall no
226.17longer be included in the payment rate for external fixed costs beginning on October 1 of
226.18the first year not less than two years after their effective date.
226.19(j) The portion related to quality improvement incentive payment rate adjustments
226.20shall be as determined under subdivision 46c.
226.21(k) The portion related to performance-based incentive payments shall be as
226.22determined under subdivision 46d.
226.23(l) The portion related to special dietary needs shall be the per diem amount
226.24determined under subdivision 51b.
226.25    (j) (m) The payment rate for external fixed costs shall be the sum of the amounts in
226.26paragraphs (a) to (i) (l).

226.27    Sec. 32. Minnesota Statutes 2014, section 256B.441, subdivision 54, is amended to read:
226.28    Subd. 54. Determination of total payment rates. In rate years when rates are
226.29rebased, The total care-related per diem, other operating price, and external fixed per
226.30diem for each facility shall be converted to payment rates. The total payment rate for
226.31a RUG's weight of 1.00 shall be the sum of the total care-related payment rate, other
226.32operating payment rate, efficiency incentive, external fixed cost rate, and the property rate
226.33determined under section 256B.434. To determine a total payment rate for each RUG's
226.34level, the total care-related payment rate shall be divided into the direct care payment rate
227.1and the other care-related payment rate, and the direct care payment rate multiplied by the
227.2RUG's weight for each RUG's level using the weights in subdivision 14.

227.3    Sec. 33. Minnesota Statutes 2014, section 256B.441, subdivision 55a, is amended to
227.4read:
227.5    Subd. 55a. Alternative to phase-in for publicly owned nursing facilities. (a) For
227.6operating payment rates implemented between October 1, 2011, and the day before the
227.7phase-in under subdivision 55 is complete operating payment rates are determined under
227.8this section, the commissioner shall allow nursing facilities whose physical plant is owned
227.9or whose license is held by a city, county, or hospital district to apply for a higher payment
227.10rate under this section if the local governmental entity agrees to pay a specified portion
227.11of the nonfederal share of medical assistance costs. Nursing facilities that apply shall be
227.12eligible to select an operating payment rate, with a weight of 1.00, up to the rate calculated
227.13in subdivision 54, without application of the phase-in under subdivision 55. The rates for
227.14the other RUGs shall be computed as provided under subdivision 54.
227.15(b) For operating payment rates implemented beginning the day when the phase-in
227.16under subdivision 55 is complete operating payment rates are determined under this
227.17section, the commissioner shall allow nursing facilities whose physical plant is owned or
227.18whose license is held by a city, county, or hospital district to apply for a higher payment
227.19rate under this section if the local governmental entity agrees to pay a specified portion of
227.20the nonfederal share of medical assistance costs. Nursing facilities that apply are eligible
227.21to select an operating payment rate with a weight of 1.00, up to an amount determined by
227.22the commissioner to be allowable under the Medicare upper payment limit test. The rates
227.23for the other RUGs shall be computed under subdivision 54. The rate increase allowed in
227.24this paragraph shall take effect only upon federal approval.
227.25(c) Rates determined under this subdivision shall take effect beginning October 1,
227.262011, based on cost reports for the reporting year ending September 30, 2010, and in
227.27future rate years, rates determined for nursing facilities participating under this subdivision
227.28shall take effect on October 1 of each year in accordance with the rate year in subdivision
227.2933, based on the most recent available cost report.
227.30(d) Eligible nursing facilities that wish to participate under this subdivision shall
227.31make an application to the commissioner by August 31, 2011, or by June September 30
227.32of any subsequent year.
227.33(e) For each participating nursing facility, the public entity that owns the physical
227.34plant or is the license holder of the nursing facility shall pay to the state the entire
227.35nonfederal share of medical assistance payments received as a result of the difference
228.1between the nursing facility's payment rate under paragraph (a) or (b), and the rates that
228.2the nursing facility would otherwise be paid without application of this subdivision under
228.3subdivision 54 or 55 as determined by the commissioner.
228.4(f) The commissioner may, at any time, reduce the payments under this subdivision
228.5based on the commissioner's determination that the payments shall cause nursing facility
228.6rates to exceed the state's Medicare upper payment limit or any other federal limitation. If
228.7the commissioner determines a reduction is necessary, the commissioner shall reduce all
228.8payment rates for participating nursing facilities by a percentage applied to the amount of
228.9increase they would otherwise receive under this subdivision and shall notify participating
228.10facilities of the reductions. If payments to a nursing facility are reduced, payments under
228.11section 256B.19, subdivision 1e, shall be reduced accordingly.

228.12    Sec. 34. Minnesota Statutes 2014, section 256B.441, subdivision 56, is amended to read:
228.13    Subd. 56. Hold harmless. (a) For the rate years beginning October 1, 2008, to
228.14October on or after January 1, 2016, no nursing facility shall receive an operating a cost
228.15payment rate, including the property insurance portion of operating costs plus the health
228.16insurance component of external fixed, less than its operating prior system cost payment
228.17rate under section 256B.434. For rate years beginning between October 1, 2009, and
228.18October 1, 2015, no nursing facility shall receive an operating payment rate less than its
228.19operating payment rate in effect on September 30, 2009, which included operating costs
228.20inclusive of health insurance costs plus the property insurance component of external
228.21fixed. The comparison of operating payment rates under this section shall be made for a
228.22RUG's rate with a weight of 1.00.
228.23(b) For rate years beginning on or after January 1, 2016, no facility shall be subject
228.24to a care-related payment rate limit reduction greater than five percent of the median
228.25determined in subdivision 30.

228.26    Sec. 35. Minnesota Statutes 2014, section 256B.441, subdivision 63, is amended to read:
228.27    Subd. 63. Critical access nursing facilities. (a) The commissioner, in consultation
228.28with the commissioner of health, may designate certain nursing facilities as critical access
228.29nursing facilities. The designation shall be granted on a competitive basis, within the
228.30limits of funds appropriated for this purpose.
228.31(b) The commissioner shall request proposals from nursing facilities every
228.32two years. Proposals must be submitted in the form and according to the timelines
228.33established by the commissioner. In selecting applicants to designate, the commissioner,
228.34in consultation with the commissioner of health, and with input from stakeholders, shall
229.1develop criteria designed to preserve access to nursing facility services in isolated areas,
229.2rebalance long-term care, and improve quality. Beginning in fiscal year 2015, to the
229.3extent practicable, the commissioner shall ensure an even distribution of designations
229.4across the state.
229.5(c) The commissioner shall allow the benefits in clauses (1) to (5) for nursing
229.6facilities designated as critical access nursing facilities:
229.7(1) partial rebasing, with the commissioner allowing a designated facility operating
229.8payment rates being the sum of up to 60 percent of the operating payment rate determined
229.9in accordance with subdivision 54 and at least 40 percent, with the sum of the two portions
229.10being equal to 100 percent, of the operating payment rate that would have been allowed
229.11had the facility not been designated. The commissioner may adjust these percentages by
229.12up to 20 percent and may approve a request for less than the amount allowed;
229.13(2) enhanced payments for leave days. Notwithstanding section 256B.431,
229.14subdivision 2r, upon designation as a critical access nursing facility, the commissioner
229.15shall limit payment for leave days to 60 percent of that nursing facility's total payment rate
229.16for the involved resident, and shall allow this payment only when the occupancy of the
229.17nursing facility, inclusive of bed hold days, is equal to or greater than 90 percent;
229.18(3) two designated critical access nursing facilities, with up to 100 beds in active
229.19service, may jointly apply to the commissioner of health for a waiver of Minnesota
229.20Rules, part 4658.0500, subpart 2, in order to jointly employ a director of nursing. The
229.21commissioner of health will consider each waiver request independently based on the
229.22criteria under Minnesota Rules, part 4658.0040;
229.23(4) the minimum threshold under section 256B.431, subdivision 15, paragraph (e),
229.24shall be 40 percent of the amount that would otherwise apply; and
229.25(5) notwithstanding subdivision 58, beginning October 1, 2014, the quality-based
229.26rate limits under subdivision 50 shall apply to designated critical access nursing facilities.
229.27(d) Designation of a critical access nursing facility shall be for a period of two
229.28years, after which the benefits allowed under paragraph (c) shall be removed. Designated
229.29facilities may apply for continued designation.
229.30(e) This subdivision is suspended and no state or federal funding shall be
229.31appropriated or allocated for the purposes of this subdivision from January 1, 2016, to
229.32December 31, 2017.

229.33    Sec. 36. Minnesota Statutes 2014, section 256B.441, is amended by adding a
229.34subdivision to read:
230.1    Subd. 65. Nursing facility in Golden Valley. Effective for the rate year beginning
230.2January 1, 2016, and all subsequent rate years, the operating payment rate for a facility
230.3located in the city of Golden Valley at 3915 Golden Valley Road with 44 licensed
230.4rehabilitation beds as of January 7, 2015, must be calculated without the application of
230.5subdivisions 50 and 51.

230.6    Sec. 37. Minnesota Statutes 2014, section 256B.441, is amended by adding a
230.7subdivision to read:
230.8    Subd. 66. Nursing facilities in border cities. Effective for the rate year beginning
230.9January 1, 2016, and annually thereafter, operating payment rates of a nonprofit nursing
230.10facility that exists on January 1, 2015, is located anywhere within the boundaries of the
230.11city of Breckenridge, and is reimbursed under this section, section 256B.431, or section
230.12256B.434, shall be adjusted to be equal to the median RUG's rates, including comparable
230.13rate components as determined by the commissioner, for the equivalent RUG's weight of
230.14the nonprofit nursing facility or facilities located in an adjacent city in another state and
230.15in cities contiguous to the adjacent city. The Minnesota facility's operating payment rate
230.16with a weight of 1.0 shall be computed by dividing the adjacent city's nursing facilities
230.17median operating payment rate with a weight of 1.02 by 1.02. If the adjustments under
230.18this subdivision result in a rate that exceeds the limits in subdivisions 50 and 51 in a given
230.19rate year, the facility's rate shall not be subject to those limits for that rate year. This
230.20subdivision shall apply only if it results in a higher operating payment rate than would
230.21otherwise be determined under this section, section 256B.431, or section 256B.434.

230.22    Sec. 38. Minnesota Statutes 2014, section 256B.441, is amended by adding a
230.23subdivision to read:
230.24    Subd. 67. Nursing facility; contract with insurance provider. Within the projected
230.25cost of nursing facility payment reform under this section, for a facility that did not provide
230.26employee health insurance coverage as of May 1, 2015, if the facility has a signed contract
230.27with a health insurance provider to begin providing employee health insurance coverage
230.28by January 1, 2016, the facility shall be paid for the employer health insurance costs
230.29portion of external fixed costs under subdivisions 13 and 53 beginning January 1, 2016.

230.30    Sec. 39. Minnesota Statutes 2014, section 256B.50, subdivision 1, is amended to read:
230.31    Subdivision 1. Scope. A provider may appeal from a determination of a payment
230.32rate established pursuant to this chapter or allowed costs under section 256B.441 and
230.33reimbursement rules of the commissioner if the appeal, if successful, would result in
231.1a change to the provider's payment rate or to the calculation of maximum charges to
231.2therapy vendors as provided by section 256B.433, subdivision 3. Appeals must be filed
231.3in accordance with procedures in this section. This section does not apply to a request
231.4from a resident or long-term care facility for reconsideration of the classification of a
231.5resident under section 144.0722.
231.6EFFECTIVE DATE.This section is effective July 1, 2015, and applies to appeals
231.7filed on or after that date.

231.8    Sec. 40. Minnesota Statutes 2014, section 256I.05, subdivision 2, is amended to read:
231.9    Subd. 2. Monthly rates; exemptions. This subdivision applies to a residence
231.10that on August 1, 1984, was licensed by the commissioner of health only as a boarding
231.11care home, certified by the commissioner of health as an intermediate care facility, and
231.12licensed by the commissioner of human services under Minnesota Rules, parts 9520.0500
231.13to 9520.0690. Notwithstanding the provisions of subdivision 1c, the rate paid to a
231.14facility reimbursed under this subdivision shall be determined under section 256B.431,
231.15or under section 256B.434, or 256B.441, if the facility is accepted by the commissioner
231.16for participation in the alternative payment demonstration project. The rate paid to this
231.17facility shall also include adjustments to the group residential housing rate according to
231.18subdivision 1, and any adjustments applicable to supplemental service rates statewide.

231.19    Sec. 41. DIRECTION TO COMMISSIONER; NURSING FACILITY PAYMENT
231.20REFORM REPORT.
231.21By January 1, 2017, the commissioner of human services shall evaluate and report to
231.22the house of representatives and senate committees and divisions with jurisdiction over
231.23nursing facility payment rates on:
231.24(1) the impact of using cost report data to set rates without accounting for cost
231.25report to rate year inflation;
231.26(2) the impact of the quality adjusted care limits;
231.27(3) the ability of nursing facilities to attract and retain employees, including how rate
231.28increases are being passed through to employees, under the new payment system;
231.29(4) the efficacy of the critical access nursing facility program under Minnesota
231.30Statutes, section 256B.441, subdivision 63, given the new nursing facility payment system;
231.31(5) creating a process for the commissioner to designate certain facilities as
231.32specialized care facilities for difficult-to-serve populations; and
231.33(6) limiting the hold harmless in Minnesota Statutes, section 256B.441, subdivision
231.3456.

232.1    Sec. 42. PROPERTY RATE SETTING.
232.2The commissioner shall conduct a study, in consultation with stakeholders and
232.3experts, of property rate setting, based on a rental value or other approach for Minnesota
232.4nursing facilities, and shall report the findings to the house of representatives and senate
232.5committees and divisions with jurisdiction over nursing facility payment rates by March 1,
232.62016, for a system implementation date of January 1, 2017. The commissioner shall:
232.7(1) contract with at least two firms to conduct appraisals of all nursing facilities in
232.8the medical assistance program. Each firm shall conduct appraisals of approximately
232.9equal portions of all nursing facilities assigned to them at random. The appraisals shall
232.10determine the value of the land, building, and equipment of each nursing facility, taking
232.11into account the quality of construction and current condition of the building;
232.12(2) use the information from the appraisals to complete the design of a rental value
232.13or other system and calculate a replacement value and an effective age for each nursing
232.14facility. Nursing facilities may request an appraisal by a second firm which shall be
232.15assigned randomly by the commissioner. The commissioner shall use the findings of
232.16the second appraisal. If the second firm increases the appraisal value by more than five
232.17percent, the state shall pay for the second appraisal. Otherwise, the nursing facility shall
232.18pay the cost of the appraisal. Results of appraisals are not otherwise subject to appeal
232.19under section 256B.50; and
232.20(3) include in the report required under this section the following items:
232.21(i) a description of the proposed rental value or other system;
232.22(ii) options for adjusting the system parameters that vary the cost of implementing
232.23the new property rate system and an analysis of individual nursing facilities under the
232.24current property payment rate and the rates under various approaches to calculating rates
232.25under the rental value or other system;
232.26(iii) recommended steps for transition to the rental value or other system;
232.27(iv) an analysis of the expected long-term incentives of the rental value or other
232.28system for nursing facilities to maintain and replace buildings, including how the current
232.29exceptions to the moratorium process under Minnesota Statutes, section 144A.073, may
232.30be adapted; and
232.31(v) bill language for implementation of the rental value or other system.

232.32    Sec. 43. REVISOR'S INSTRUCTION.
232.33The revisor of statutes, in consultation with the House Research Department, Office
232.34of Senate Counsel, Research, and Fiscal Analysis, Department of Human Services, and
232.35stakeholders, shall prepare legislation for the 2016 legislative session to recodify laws
233.1governing nursing home payments and rates in Minnesota Statutes, chapter 256B, and in
233.2Minnesota Rules, chapter 9549.
233.3EFFECTIVE DATE.This section is effective the day following final enactment.

233.4    Sec. 44. REPEALER.
233.5Minnesota Statutes 2014, sections 256B.434, subdivision 19b; and 256B.441,
233.6subdivisions 14a, 19, 50a, 52, 55, 58, and 62, are repealed.

233.7ARTICLE 7

233.8CONTINUING CARE

233.9    Section 1. Minnesota Statutes 2014, section 13.461, is amended by adding a
233.10subdivision to read:
233.11    Subd. 32. ABLE accounts and designated beneficiaries. Data on ABLE accounts
233.12and designated beneficiaries of ABLE accounts are classified under section 256Q.05,
233.13subdivision 7.

233.14    Sec. 2. Minnesota Statutes 2014, section 144.057, subdivision 1, is amended to read:
233.15    Subdivision 1. Background studies required. The commissioner of health shall
233.16contract with the commissioner of human services to conduct background studies of:
233.17(1) individuals providing services which have direct contact, as defined under
233.18section 245C.02, subdivision 11, with patients and residents in hospitals, boarding care
233.19homes, outpatient surgical centers licensed under sections 144.50 to 144.58; nursing
233.20homes and home care agencies licensed under chapter 144A; residential care homes
233.21licensed under chapter 144B, and board and lodging establishments that are registered to
233.22provide supportive or health supervision services under section 157.17;
233.23(2) individuals specified in section 245C.03, subdivision 1, who perform direct
233.24contact services in a nursing home or a home care agency licensed under chapter 144A
233.25or a boarding care home licensed under sections 144.50 to 144.58, and. If the individual
233.26under study resides outside Minnesota, the study must be at least as comprehensive as
233.27that of a Minnesota resident and include a search of information from the criminal justice
233.28data communications network in the state where the subject of the study resides include a
233.29check for substantiated findings of maltreatment of adults and children in the individual's
233.30state of residence when the information is made available by that state, and must include a
233.31check of the National Crime Information Center database;
233.32(3) beginning July 1, 1999, all other employees in nursing homes licensed under
233.33chapter 144A, and boarding care homes licensed under sections 144.50 to 144.58. A
234.1disqualification of an individual in this section shall disqualify the individual from
234.2positions allowing direct contact or access to patients or residents receiving services.
234.3"Access" means physical access to a client or the client's personal property without
234.4continuous, direct supervision as defined in section 245C.02, subdivision 8, when the
234.5employee's employment responsibilities do not include providing direct contact services;
234.6(4) individuals employed by a supplemental nursing services agency, as defined
234.7under section 144A.70, who are providing services in health care facilities; and
234.8(5) controlling persons of a supplemental nursing services agency, as defined under
234.9section 144A.70.
234.10If a facility or program is licensed by the Department of Human Services and
234.11subject to the background study provisions of chapter 245C and is also licensed by the
234.12Department of Health, the Department of Human Services is solely responsible for the
234.13background studies of individuals in the jointly licensed programs.

234.14    Sec. 3. Minnesota Statutes 2014, section 245A.06, is amended by adding a subdivision
234.15to read:
234.16    Subd. 1a. Correction orders and conditional licenses for programs licensed as
234.17home and community-based services. (a) For programs licensed under both this chapter
234.18and chapter 245D, if the license holder operates more than one service site under a single
234.19license governed by chapter 245D, the order issued under this section shall be specific to
234.20the service site or sites at which the violations of applicable law or rules occurred. The
234.21order shall not apply to other service sites governed by chapter 245D and operated by the
234.22same license holder unless the commissioner has included in the order the articulable basis
234.23for applying the order to another service site.
234.24(b) If the commissioner has issued more than one license to the license holder under
234.25this chapter, the conditions imposed under this section shall be specific to the license for
234.26the program at which the violations of applicable law or rules occurred and shall not apply
234.27to other licenses held by the same license holder if those programs are being operated in
234.28substantial compliance with applicable law and rules.

234.29    Sec. 4. [245A.081] SETTLEMENT AGREEMENT.
234.30(a) A license holder who has made a timely appeal pursuant to section 245A.06,
234.31subdivision 4, or 245A.07, subdivision 3, or the commissioner may initiate a discussion
234.32about a possible settlement agreement related to the licensing sanction. For the purposes
234.33of this section, the following conditions apply to a settlement agreement reached by the
234.34parties:
235.1(1) if the parties enter into a settlement agreement, the effect of the agreement shall
235.2be that the appeal is withdrawn and the agreement shall constitute the full agreement
235.3between the commissioner and the party who filed the appeal; and
235.4(2) the settlement agreement must identify the agreed upon actions the license holder
235.5has taken and will take in order to achieve and maintain compliance with the licensing
235.6requirements that the commissioner determined the license holder had violated.
235.7(b) Neither the license holder nor the commissioner is required to initiate a
235.8settlement discussion under this section.
235.9(c) If a settlement discussion is initiated by the license holder, the commissioner
235.10shall respond to the license holder within 14 calendar days of receipt of the license
235.11holder's submission.
235.12(d) If the commissioner agrees to engage in settlement discussions, the commissioner
235.13may decide at any time not to continue settlement discussions with a license holder.

235.14    Sec. 5. Minnesota Statutes 2014, section 245A.155, subdivision 1, is amended to read:
235.15    Subdivision 1. Licensed foster care and respite care. This section applies to
235.16foster care agencies and licensed foster care providers who place, supervise, or care for
235.17individuals who rely on medical monitoring equipment to sustain life or monitor a medical
235.18condition that could become life-threatening without proper use of the medical equipment
235.19in respite care or foster care.

235.20    Sec. 6. Minnesota Statutes 2014, section 245A.155, subdivision 2, is amended to read:
235.21    Subd. 2. Foster care agency requirements. In order for an agency to place an
235.22individual who relies on medical equipment to sustain life or monitor a medical condition
235.23that could become life-threatening without proper use of the medical equipment with a
235.24foster care provider, the agency must ensure that the foster care provider has received the
235.25training to operate such equipment as observed and confirmed by a qualified source,
235.26and that the provider:
235.27(1) is currently caring for an individual who is using the same equipment in the
235.28foster home; or
235.29(2) has written documentation that the foster care provider has cared for an
235.30individual who relied on such equipment within the past six months; or
235.31(3) has successfully completed training with the individual being placed with the
235.32provider.

235.33    Sec. 7. Minnesota Statutes 2014, section 245A.65, subdivision 2, is amended to read:
236.1    Subd. 2. Abuse prevention plans. All license holders shall establish and enforce
236.2ongoing written program abuse prevention plans and individual abuse prevention plans as
236.3required under section 626.557, subdivision 14.
236.4(a) The scope of the program abuse prevention plan is limited to the population,
236.5physical plant, and environment within the control of the license holder and the location
236.6where licensed services are provided. In addition to the requirements in section 626.557,
236.7subdivision 14 , the program abuse prevention plan shall meet the requirements in clauses
236.8(1) to (5).
236.9(1) The assessment of the population shall include an evaluation of the following
236.10factors: age, gender, mental functioning, physical and emotional health or behavior of the
236.11client; the need for specialized programs of care for clients; the need for training of staff to
236.12meet identified individual needs; and the knowledge a license holder may have regarding
236.13previous abuse that is relevant to minimizing risk of abuse for clients.
236.14(2) The assessment of the physical plant where the licensed services are provided
236.15shall include an evaluation of the following factors: the condition and design of the
236.16building as it relates to the safety of the clients; and the existence of areas in the building
236.17which are difficult to supervise.
236.18(3) The assessment of the environment for each facility and for each site when living
236.19arrangements are provided by the agency shall include an evaluation of the following
236.20factors: the location of the program in a particular neighborhood or community; the type
236.21of grounds and terrain surrounding the building; the type of internal programming; and
236.22the program's staffing patterns.
236.23(4) The license holder shall provide an orientation to the program abuse prevention
236.24plan for clients receiving services. If applicable, the client's legal representative must be
236.25notified of the orientation. The license holder shall provide this orientation for each new
236.26person within 24 hours of admission, or for persons who would benefit more from a later
236.27orientation, the orientation may take place within 72 hours.
236.28(5) The license holder's governing body or the governing body's delegated
236.29representative shall review the plan at least annually using the assessment factors in the
236.30plan and any substantiated maltreatment findings that occurred since the last review. The
236.31governing body or the governing body's delegated representative shall revise the plan,
236.32if necessary, to reflect the review results.
236.33(6) A copy of the program abuse prevention plan shall be posted in a prominent
236.34location in the program and be available upon request to mandated reporters, persons
236.35receiving services, and legal representatives.
237.1(b) In addition to the requirements in section 626.557, subdivision 14, the individual
237.2abuse prevention plan shall meet the requirements in clauses (1) and (2).
237.3(1) The plan shall include a statement of measures that will be taken to minimize the
237.4risk of abuse to the vulnerable adult when the individual assessment required in section
237.5626.557, subdivision 14 , paragraph (b), indicates the need for measures in addition to the
237.6specific measures identified in the program abuse prevention plan. The measures shall
237.7include the specific actions the program will take to minimize the risk of abuse within
237.8the scope of the licensed services, and will identify referrals made when the vulnerable
237.9adult is susceptible to abuse outside the scope or control of the licensed services. When
237.10the assessment indicates that the vulnerable adult does not need specific risk reduction
237.11measures in addition to those identified in the program abuse prevention plan, the
237.12individual abuse prevention plan shall document this determination.
237.13(2) An individual abuse prevention plan shall be developed for each new person as
237.14part of the initial individual program plan or service plan required under the applicable
237.15licensing rule. The review and evaluation of the individual abuse prevention plan shall
237.16be done as part of the review of the program plan or service plan. The person receiving
237.17services shall participate in the development of the individual abuse prevention plan to the
237.18full extent of the person's abilities. If applicable, the person's legal representative shall be
237.19given the opportunity to participate with or for the person in the development of the plan.
237.20The interdisciplinary team shall document the review of all abuse prevention plans at least
237.21annually, using the individual assessment and any reports of abuse relating to the person.
237.22The plan shall be revised to reflect the results of this review.

237.23    Sec. 8. Minnesota Statutes 2014, section 245C.08, subdivision 1, is amended to read:
237.24    Subdivision 1. Background studies conducted by Department of Human
237.25Services. (a) For a background study conducted by the Department of Human Services,
237.26the commissioner shall review:
237.27    (1) information related to names of substantiated perpetrators of maltreatment of
237.28vulnerable adults that has been received by the commissioner as required under section
237.29626.557, subdivision 9c , paragraph (j);
237.30    (2) the commissioner's records relating to the maltreatment of minors in licensed
237.31programs, and from findings of maltreatment of minors as indicated through the social
237.32service information system;
237.33    (3) information from juvenile courts as required in subdivision 4 for individuals
237.34listed in section 245C.03, subdivision 1, paragraph (a), when there is reasonable cause;
238.1    (4) information from the Bureau of Criminal Apprehension, including information
238.2regarding a background study subject's registration in Minnesota as a predatory offender
238.3under section 243.166;
238.4    (5) except as provided in clause (6), information from the national crime information
238.5system when the commissioner has reasonable cause as defined under section 245C.05,
238.6subdivision 5, or as required under section 144.057, subdivision 1, clause (2); and
238.7    (6) for a background study related to a child foster care application for licensure, a
238.8transfer of permanent legal and physical custody of a child under sections 260C.503 to
238.9260C.515 , or adoptions, the commissioner shall also review:
238.10    (i) information from the child abuse and neglect registry for any state in which the
238.11background study subject has resided for the past five years; and
238.12    (ii) information from national crime information databases, when the background
238.13study subject is 18 years of age or older.
238.14    (b) Notwithstanding expungement by a court, the commissioner may consider
238.15information obtained under paragraph (a), clauses (3) and (4), unless the commissioner
238.16received notice of the petition for expungement and the court order for expungement is
238.17directed specifically to the commissioner.
238.18    (c) The commissioner shall also review criminal case information received according
238.19to section 245C.04, subdivision 4a, from the Minnesota court information system that
238.20relates to individuals who have already been studied under this chapter and who remain
238.21affiliated with the agency that initiated the background study.
238.22    (d) When the commissioner has reasonable cause to believe that the identity of
238.23a background study subject is uncertain, the commissioner may require the subject to
238.24provide a set of classifiable fingerprints for purposes of completing a fingerprint-based
238.25record check with the Bureau of Criminal Apprehension. Fingerprints collected under this
238.26paragraph shall not be saved by the commissioner after they have been used to verify the
238.27identity of the background study subject against the particular criminal record in question.
238.28    (e) The commissioner may inform the entity that initiated a background study under
238.29NETStudy 2.0 of the status of processing of the subject's fingerprints.

238.30    Sec. 9. Minnesota Statutes 2014, section 245C.12, is amended to read:
238.31245C.12 BACKGROUND STUDY; TRIBAL ORGANIZATIONS.
238.32    (a) For the purposes of background studies completed by tribal organizations
238.33performing licensing activities otherwise required of the commissioner under this chapter,
238.34after obtaining consent from the background study subject, tribal licensing agencies shall
239.1have access to criminal history data in the same manner as county licensing agencies and
239.2private licensing agencies under this chapter.
239.3    (b) Tribal organizations may contract with the commissioner to obtain background
239.4study data on individuals under tribal jurisdiction related to adoptions according to
239.5section 245C.34. Tribal organizations may also contract with the commissioner to obtain
239.6background study data on individuals under tribal jurisdiction related to child foster care
239.7according to section 245C.34.
239.8    (c) For the purposes of background studies completed to comply with a tribal
239.9organization's licensing requirements for individuals affiliated with a tribally licensed
239.10nursing facility, the commissioner shall obtain criminal history data from the National
239.11Criminal Records Repository in accordance with section 245C.32.

239.12    Sec. 10. Minnesota Statutes 2014, section 245D.02, is amended by adding a
239.13subdivision to read:
239.14    Subd. 37. Working day. "Working day" means Monday, Tuesday, Wednesday,
239.15Thursday, or Friday, excluding any legal holiday.

239.16    Sec. 11. Minnesota Statutes 2014, section 245D.05, subdivision 1, is amended to read:
239.17    Subdivision 1. Health needs. (a) The license holder is responsible for meeting
239.18health service needs assigned in the coordinated service and support plan or the
239.19coordinated service and support plan addendum, consistent with the person's health needs.
239.20Unless directed otherwise in the coordinated service and support plan or the coordinated
239.21service and support plan addendum, the license holder is responsible for promptly
239.22notifying the person's legal representative, if any, and the case manager of changes in a
239.23person's physical and mental health needs affecting health service needs assigned to the
239.24license holder in the coordinated service and support plan or the coordinated service
239.25and support plan addendum, when discovered by the license holder, unless the license
239.26holder has reason to know the change has already been reported. The license holder
239.27must document when the notice is provided.
239.28(b) If responsibility for meeting the person's health service needs has been assigned
239.29to the license holder in the coordinated service and support plan or the coordinated service
239.30and support plan addendum, the license holder must maintain documentation on how the
239.31person's health needs will be met, including a description of the procedures the license
239.32holder will follow in order to:
240.1(1) provide medication setup, assistance, or administration according to this chapter.
240.2Unlicensed staff responsible for medication setup or medication administration under this
240.3section must complete training according to section 245D.09, subdivision 4a, paragraph (d);
240.4(2) monitor health conditions according to written instructions from a licensed
240.5health professional;
240.6(3) assist with or coordinate medical, dental, and other health service appointments; or
240.7(4) use medical equipment, devices, or adaptive aides or technology safely and
240.8correctly according to written instructions from a licensed health professional.

240.9    Sec. 12. Minnesota Statutes 2014, section 245D.05, subdivision 2, is amended to read:
240.10    Subd. 2. Medication administration. (a) For purposes of this subdivision,
240.11"medication administration" means:
240.12(1) checking the person's medication record;
240.13(2) preparing the medication as necessary;
240.14(3) administering the medication or treatment to the person;
240.15(4) documenting the administration of the medication or treatment or the reason for
240.16not administering the medication or treatment; and
240.17(5) reporting to the prescriber or a nurse any concerns about the medication or
240.18treatment, including side effects, effectiveness, or a pattern of the person refusing to
240.19take the medication or treatment as prescribed. Adverse reactions must be immediately
240.20reported to the prescriber or a nurse.
240.21(b)(1) If responsibility for medication administration is assigned to the license holder
240.22in the coordinated service and support plan or the coordinated service and support plan
240.23addendum, the license holder must implement medication administration procedures to
240.24ensure a person takes medications and treatments as prescribed. The license holder must
240.25ensure that the requirements in clauses (2) and (3) have been met before administering
240.26medication or treatment.
240.27(2) The license holder must obtain written authorization from the person or the
240.28person's legal representative to administer medication or treatment and must obtain
240.29reauthorization annually as needed. This authorization shall remain in effect unless it is
240.30withdrawn in writing and may be withdrawn at any time. If the person or the person's
240.31legal representative refuses to authorize the license holder to administer medication, the
240.32medication must not be administered. The refusal to authorize medication administration
240.33must be reported to the prescriber as expediently as possible.
241.1(3) For a license holder providing intensive support services, the medication or
241.2treatment must be administered according to the license holder's medication administration
241.3policy and procedures as required under section 245D.11, subdivision 2, clause (3).
241.4(c) The license holder must ensure the following information is documented in the
241.5person's medication administration record:
241.6(1) the information on the current prescription label or the prescriber's current
241.7written or electronically recorded order or prescription that includes the person's name,
241.8description of the medication or treatment to be provided, and the frequency and other
241.9information needed to safely and correctly administer the medication or treatment to
241.10ensure effectiveness;
241.11(2) information on any risks or other side effects that are reasonable to expect, and
241.12any contraindications to its use. This information must be readily available to all staff
241.13administering the medication;
241.14(3) the possible consequences if the medication or treatment is not taken or
241.15administered as directed;
241.16(4) instruction on when and to whom to report the following:
241.17(i) if a dose of medication is not administered or treatment is not performed as
241.18prescribed, whether by error by the staff or the person or by refusal by the person; and
241.19(ii) the occurrence of possible adverse reactions to the medication or treatment;
241.20(5) notation of any occurrence of a dose of medication not being administered or
241.21treatment not performed as prescribed, whether by error by the staff or the person or by
241.22refusal by the person, or of adverse reactions, and when and to whom the report was
241.23made; and
241.24(6) notation of when a medication or treatment is started, administered, changed, or
241.25discontinued.

241.26    Sec. 13. Minnesota Statutes 2014, section 245D.06, subdivision 1, is amended to read:
241.27    Subdivision 1. Incident response and reporting. (a) The license holder must
241.28respond to incidents under section 245D.02, subdivision 11, that occur while providing
241.29services to protect the health and safety of and minimize risk of harm to the person.
241.30(b) The license holder must maintain information about and report incidents to the
241.31person's legal representative or designated emergency contact and case manager within
241.3224 hours of an incident occurring while services are being provided, within 24 hours of
241.33discovery or receipt of information that an incident occurred, unless the license holder
241.34has reason to know that the incident has already been reported, or as otherwise directed
241.35in a person's coordinated service and support plan or coordinated service and support
242.1plan addendum. An incident of suspected or alleged maltreatment must be reported as
242.2required under paragraph (d), and an incident of serious injury or death must be reported
242.3as required under paragraph (e).
242.4(c) When the incident involves more than one person, the license holder must not
242.5disclose personally identifiable information about any other person when making the report
242.6to each person and case manager unless the license holder has the consent of the person.
242.7(d) Within 24 hours of reporting maltreatment as required under section 626.556
242.8or 626.557, the license holder must inform the case manager of the report unless there is
242.9reason to believe that the case manager is involved in the suspected maltreatment. The
242.10license holder must disclose the nature of the activity or occurrence reported and the
242.11agency that received the report.
242.12(e) The license holder must report the death or serious injury of the person as
242.13required in paragraph (b) and to the Department of Human Services Licensing Division,
242.14and the Office of Ombudsman for Mental Health and Developmental Disabilities as
242.15required under section 245.94, subdivision 2a, within 24 hours of the death or serious
242.16injury, or receipt of information that the death or serious injury occurred, unless the license
242.17holder has reason to know that the death or serious injury has already been reported.
242.18(f) When a death or serious injury occurs in a facility certified as an intermediate
242.19care facility for persons with developmental disabilities, the death or serious injury must
242.20be reported to the Department of Health, Office of Health Facility Complaints, and the
242.21Office of Ombudsman for Mental Health and Developmental Disabilities, as required
242.22under sections 245.91 and 245.94, subdivision 2a, unless the license holder has reason to
242.23know that the death or serious injury has already been reported.
242.24(g) The license holder must conduct an internal review of incident reports of deaths
242.25and serious injuries that occurred while services were being provided and that were not
242.26reported by the program as alleged or suspected maltreatment, for identification of incident
242.27patterns, and implementation of corrective action as necessary to reduce occurrences.
242.28The review must include an evaluation of whether related policies and procedures were
242.29followed, whether the policies and procedures were adequate, whether there is a need for
242.30additional staff training, whether the reported event is similar to past events with the
242.31persons or the services involved, and whether there is a need for corrective action by the
242.32license holder to protect the health and safety of persons receiving services. Based on
242.33the results of this review, the license holder must develop, document, and implement a
242.34corrective action plan designed to correct current lapses and prevent future lapses in
242.35performance by staff or the license holder, if any.
243.1(h) The license holder must verbally report the emergency use of manual restraint
243.2of a person as required in paragraph (b) within 24 hours of the occurrence. The license
243.3holder must ensure the written report and internal review of all incident reports of the
243.4emergency use of manual restraints are completed according to the requirements in section
243.5245D.061 or successor provisions.

243.6    Sec. 14. Minnesota Statutes 2014, section 245D.06, subdivision 2, is amended to read:
243.7    Subd. 2. Environment and safety. The license holder must:
243.8(1) ensure the following when the license holder is the owner, lessor, or tenant
243.9of the service site:
243.10(i) the service site is a safe and hazard-free environment;
243.11(ii) that toxic substances or dangerous items are inaccessible to persons served by
243.12the program only to protect the safety of a person receiving services when a known safety
243.13threat exists and not as a substitute for staff supervision or interactions with a person who
243.14is receiving services. If toxic substances or dangerous items are made inaccessible, the
243.15license holder must document an assessment of the physical plant, its environment, and its
243.16population identifying the risk factors which require toxic substances or dangerous items
243.17to be inaccessible and a statement of specific measures to be taken to minimize the safety
243.18risk to persons receiving services and to restore accessibility to all persons receiving
243.19services at the service site;
243.20(iii) doors are locked from the inside to prevent a person from exiting only when
243.21necessary to protect the safety of a person receiving services and not as a substitute for
243.22staff supervision or interactions with the person. If doors are locked from the inside, the
243.23license holder must document an assessment of the physical plant, the environment and
243.24the population served, identifying the risk factors which require the use of locked doors,
243.25and a statement of specific measures to be taken to minimize the safety risk to persons
243.26receiving services at the service site; and
243.27(iv) a staff person is available at the service site who is trained in basic first aid and,
243.28when required in a person's coordinated service and support plan or coordinated service
243.29and support plan addendum, cardiopulmonary resuscitation (CPR) whenever persons are
243.30present and staff are required to be at the site to provide direct support service. The CPR
243.31training must include in-person instruction, hands-on practice, and an observed skills
243.32assessment under the direct supervision of a CPR instructor;
243.33(2) maintain equipment, vehicles, supplies, and materials owned or leased by the
243.34license holder in good condition when used to provide services;
244.1(3) follow procedures to ensure safe transportation, handling, and transfers of the
244.2person and any equipment used by the person, when the license holder is responsible for
244.3transportation of a person or a person's equipment;
244.4(4) be prepared for emergencies and follow emergency response procedures to
244.5ensure the person's safety in an emergency; and
244.6(5) follow universal precautions and sanitary practices, including hand washing, for
244.7infection prevention and control, and to prevent communicable diseases.

244.8    Sec. 15. Minnesota Statutes 2014, section 245D.06, subdivision 7, is amended to read:
244.9    Subd. 7. Permitted actions and procedures. (a) Use of the instructional techniques
244.10and intervention procedures as identified in paragraphs (b) and (c) is permitted when used
244.11on an intermittent or continuous basis. When used on a continuous basis, it must be
244.12addressed in a person's coordinated service and support plan addendum as identified in
244.13sections 245D.07 and 245D.071. For purposes of this chapter, the requirements of this
244.14subdivision supersede the requirements identified in Minnesota Rules, part 9525.2720.
244.15(b) Physical contact or instructional techniques must use the least restrictive
244.16alternative possible to meet the needs of the person and may be used:
244.17(1) to calm or comfort a person by holding that person with no resistance from
244.18that person;
244.19(2) to protect a person known to be at risk of injury due to frequent falls as a result
244.20of a medical condition;
244.21(3) to facilitate the person's completion of a task or response when the person does
244.22not resist or the person's resistance is minimal in intensity and duration;
244.23(4) to block or redirect a person's limbs or body without holding the person or
244.24limiting the person's movement to interrupt the person's behavior that may result in injury
244.25to self or others with less than 60 seconds of physical contact by staff; or
244.26(5) to redirect a person's behavior when the behavior does not pose a serious threat
244.27to the person or others and the behavior is effectively redirected with less than 60 seconds
244.28of physical contact by staff.
244.29(c) Restraint may be used as an intervention procedure to:
244.30(1) allow a licensed health care professional to safely conduct a medical examination
244.31or to provide medical treatment ordered by a licensed health care professional to a person
244.32necessary to promote healing or recovery from an acute, meaning short-term, medical
244.33condition;
244.34(2) assist in the safe evacuation or redirection of a person in the event of an
244.35emergency and the person is at imminent risk of harm; or
245.1(3) position a person with physical disabilities in a manner specified in the person's
245.2coordinated service and support plan addendum.
245.3Any use of manual restraint as allowed in this paragraph must comply with the restrictions
245.4identified in subdivision 6, paragraph (b).
245.5(d) Use of adaptive aids or equipment, orthotic devices, or other medical equipment
245.6ordered by a licensed health professional to treat a diagnosed medical condition do not in
245.7and of themselves constitute the use of mechanical restraint.

245.8    Sec. 16. Minnesota Statutes 2014, section 245D.07, subdivision 2, is amended to read:
245.9    Subd. 2. Service planning requirements for basic support services. (a) License
245.10holders providing basic support services must meet the requirements of this subdivision.
245.11(b) Within 15 calendar days of service initiation the license holder must complete
245.12a preliminary coordinated service and support plan addendum based on the coordinated
245.13service and support plan.
245.14(c) Within 60 calendar days of service initiation the license holder must review
245.15and revise as needed the preliminary coordinated service and support plan addendum to
245.16document the services that will be provided including how, when, and by whom services
245.17will be provided, and the person responsible for overseeing the delivery and coordination
245.18of services.
245.19(d) The license holder must participate in service planning and support team
245.20meetings for the person following stated timelines established in the person's coordinated
245.21service and support plan or as requested by the person or the person's legal representative,
245.22the support team or the expanded support team.

245.23    Sec. 17. Minnesota Statutes 2014, section 245D.071, subdivision 5, is amended to read:
245.24    Subd. 5. Service plan review and evaluation. (a) The license holder must give the
245.25person or the person's legal representative and case manager an opportunity to participate
245.26in the ongoing review and development of the service plan and the methods used to support
245.27the person and accomplish outcomes identified in subdivisions 3 and 4. The license holder,
245.28in coordination with the person's support team or expanded support team, must meet
245.29with the person, the person's legal representative, and the case manager, and participate
245.30in service plan review meetings following stated timelines established in the person's
245.31coordinated service and support plan or coordinated service and support plan addendum or
245.32within 30 days of a written request by the person, the person's legal representative, or the
245.33case manager, at a minimum of once per year. The purpose of the service plan review
245.34is to determine whether changes are needed to the service plan based on the assessment
246.1information, the license holder's evaluation of progress towards accomplishing outcomes,
246.2or other information provided by the support team or expanded support team.
246.3(b) The license holder must summarize the person's status and progress toward
246.4achieving the identified outcomes and make recommendations and identify the rationale
246.5for changing, continuing, or discontinuing implementation of supports and methods
246.6identified in subdivision 4 in a written report sent to the person or the person's legal
246.7representative and case manager five working days prior to the review meeting, unless the
246.8person, the person's legal representative, or the case manager requests to receive the report
246.9available at the time of the progress review meeting. The report must be sent at least
246.10five working days prior to the progress review meeting if requested by the team in the
246.11coordinated service and support plan or coordinated service and support plan addendum.
246.12(c) The license holder must send the coordinated service and support plan addendum
246.13to the person, the person's legal representative, and the case manager by mail within ten
246.14working days of the progress review meeting. Within ten working days of the progress
246.15review meeting mailing of the coordinated service and support plan addendum, the license
246.16holder must obtain dated signatures from the person or the person's legal representative
246.17and the case manager to document approval of any changes to the coordinated service and
246.18support plan addendum.
246.19(d) If, within ten working days of submitting changes to the coordinated service
246.20and support plan and coordinated service and support plan addendum, the person or the
246.21person's legal representative or case manager has not signed and returned to the license
246.22holder the coordinated service and support plan or coordinated service and support plan
246.23addendum or has not proposed written modifications to the license holder's submission, the
246.24submission is deemed approved and the coordinated service and support plan addendum
246.25becomes effective and remains in effect until the legal representative or case manager
246.26submits a written request to revise the coordinated service and support plan addendum.

246.27    Sec. 18. Minnesota Statutes 2014, section 245D.09, subdivision 3, is amended to read:
246.28    Subd. 3. Staff qualifications. (a) The license holder must ensure that staff providing
246.29direct support, or staff who have responsibilities related to supervising or managing the
246.30provision of direct support service, are competent as demonstrated through skills and
246.31knowledge training, experience, and education relevant to the primary disability of the
246.32person and to meet the person's needs and additional requirements as written in the
246.33coordinated service and support plan or coordinated service and support plan addendum,
246.34or when otherwise required by the case manager or the federal waiver plan. The license
246.35holder must verify and maintain evidence of staff competency, including documentation of:
247.1(1) education and experience qualifications relevant to the job responsibilities
247.2assigned to the staff and to the primary disability of persons served by the program,
247.3including a valid degree and transcript, or a current license, registration, or certification,
247.4when a degree or licensure, registration, or certification is required by this chapter or in the
247.5coordinated service and support plan or coordinated service and support plan addendum;
247.6(2) demonstrated competency in the orientation and training areas required under
247.7this chapter, and when applicable, completion of continuing education required to
247.8maintain professional licensure, registration, or certification requirements. Competency in
247.9these areas is determined by the license holder through knowledge testing or observed
247.10skill assessment conducted by the trainer or instructor or by an individual who has been
247.11previously deemed competent by the trainer or instructor in the area being assessed; and
247.12(3) except for a license holder who is the sole direct support staff, periodic
247.13performance evaluations completed by the license holder of the direct support staff
247.14person's ability to perform the job functions based on direct observation.
247.15(b) Staff under 18 years of age may not perform overnight duties or administer
247.16medication.

247.17    Sec. 19. Minnesota Statutes 2014, section 245D.09, subdivision 5, is amended to read:
247.18    Subd. 5. Annual training. A license holder must provide annual training to direct
247.19support staff on the topics identified in subdivision 4, clauses (3) to (10). If the direct
247.20support staff has a first aid certification, annual training under subdivision 4, clause (9), is
247.21not required as long as the certification remains current. A license holder must provide a
247.22minimum of 24 hours of annual training to direct service staff providing intensive services
247.23and having fewer than five years of documented experience and 12 hours of annual
247.24training to direct service staff providing intensive services and having five or more years
247.25of documented experience in topics described in subdivisions 4 and 4a, paragraphs (a) to
247.26(f). Training on relevant topics received from sources other than the license holder may
247.27count toward training requirements. A license holder must provide a minimum of 12 hours
247.28of annual training to direct service staff providing basic services and having fewer than
247.29five years of documented experience and six hours of annual training to direct service staff
247.30providing basic services and having five or more years of documented experience.

247.31    Sec. 20. Minnesota Statutes 2014, section 245D.22, subdivision 4, is amended to read:
247.32    Subd. 4. First aid must be available on site. (a) A staff person trained in first
247.33aid must be available on site and, when required in a person's coordinated service and
247.34support plan or coordinated service and support plan addendum, be able to provide
248.1cardiopulmonary resuscitation, whenever persons are present and staff are required to be
248.2at the site to provide direct service. The CPR training must include in-person instruction,
248.3hands-on practice, and an observed skills assessment under the direct supervision of a
248.4CPR instructor.
248.5(b) A facility must have first aid kits readily available for use by, and that meet
248.6the needs of, persons receiving services and staff. At a minimum, the first aid kit must
248.7be equipped with accessible first aid supplies including bandages, sterile compresses,
248.8scissors, an ice bag or cold pack, an oral or surface thermometer, mild liquid soap,
248.9adhesive tape, and first aid manual.

248.10    Sec. 21. Minnesota Statutes 2014, section 245D.31, subdivision 3, is amended to read:
248.11    Subd. 3. Staff ratio requirement for each person receiving services. The case
248.12manager, in consultation with the interdisciplinary team, must determine at least once each
248.13year which of the ratios in subdivisions 4, 5, and 6 is appropriate for each person receiving
248.14services on the basis of the characteristics described in subdivisions 4, 5, and 6. The ratio
248.15assigned each person and the documentation of how the ratio was arrived at must be kept
248.16in each person's individual service plan. Documentation must include an assessment of the
248.17person with respect to the characteristics in subdivisions 4, 5, and 6 recorded on a standard
248.18assessment form required by the commissioner.

248.19    Sec. 22. Minnesota Statutes 2014, section 245D.31, subdivision 4, is amended to read:
248.20    Subd. 4. Person requiring staff ratio of one to four. A person must be assigned a
248.21staff ratio requirement of one to four if:
248.22(1) on a daily basis the person requires total care and monitoring or constant
248.23hand-over-hand physical guidance to successfully complete at least three of the following
248.24activities: toileting, communicating basic needs, eating, or ambulating; or is not capable
248.25of taking appropriate action for self-preservation under emergency conditions; or
248.26(2) the person engages in conduct that poses an imminent risk of physical harm to
248.27self or others at a documented level of frequency, intensity, or duration requiring frequent
248.28daily ongoing intervention and monitoring as established in the person's coordinated
248.29service and support plan or coordinated service and support plan addendum.

248.30    Sec. 23. Minnesota Statutes 2014, section 245D.31, subdivision 5, is amended to read:
248.31    Subd. 5. Person requiring staff ratio of one to eight. A person must be assigned a
248.32staff ratio requirement of one to eight if:
248.33(1) the person does not meet the requirements in subdivision 4; and
249.1(2) on a daily basis the person requires verbal prompts or spot checks and minimal
249.2or no physical assistance to successfully complete at least four three of the following
249.3activities: toileting, communicating basic needs, eating, or ambulating, or taking
249.4appropriate action for self-preservation under emergency conditions.

249.5    Sec. 24. Minnesota Statutes 2014, section 252.27, subdivision 2a, is amended to read:
249.6    Subd. 2a. Contribution amount. (a) The natural or adoptive parents of a minor
249.7child, including a child determined eligible for medical assistance without consideration of
249.8parental income, must contribute to the cost of services used by making monthly payments
249.9on a sliding scale based on income, unless the child is married or has been married, parental
249.10rights have been terminated, or the child's adoption is subsidized according to chapter
249.11259A or through title IV-E of the Social Security Act. The parental contribution is a partial
249.12or full payment for medical services provided for diagnostic, therapeutic, curing, treating,
249.13mitigating, rehabilitation, maintenance, and personal care services as defined in United
249.14States Code, title 26, section 213, needed by the child with a chronic illness or disability.
249.15    (b) For households with adjusted gross income equal to or greater than 275 percent
249.16of federal poverty guidelines, the parental contribution shall be computed by applying the
249.17following schedule of rates to the adjusted gross income of the natural or adoptive parents:
249.18    (1) if the adjusted gross income is equal to or greater than 275 percent of federal
249.19poverty guidelines and less than or equal to 545 percent of federal poverty guidelines,
249.20the parental contribution shall be determined using a sliding fee scale established by the
249.21commissioner of human services which begins at 2.48 2.23 percent of adjusted gross
249.22income at 275 percent of federal poverty guidelines and increases to 6.75 6.08 percent of
249.23adjusted gross income for those with adjusted gross income up to 545 percent of federal
249.24poverty guidelines;
249.25    (2) if the adjusted gross income is greater than 545 percent of federal poverty
249.26guidelines and less than 675 percent of federal poverty guidelines, the parental
249.27contribution shall be 6.75 6.08 percent of adjusted gross income;
249.28    (3) if the adjusted gross income is equal to or greater than 675 percent of federal
249.29poverty guidelines and less than 975 percent of federal poverty guidelines, the parental
249.30contribution shall be determined using a sliding fee scale established by the commissioner
249.31of human services which begins at 6.75 6.08 percent of adjusted gross income at 675 percent
249.32of federal poverty guidelines and increases to nine 8.1 percent of adjusted gross income
249.33for those with adjusted gross income up to 975 percent of federal poverty guidelines; and
250.1    (4) if the adjusted gross income is equal to or greater than 975 percent of federal
250.2poverty guidelines, the parental contribution shall be 11.25 10.13 percent of adjusted
250.3gross income.
250.4    If the child lives with the parent, the annual adjusted gross income is reduced by
250.5$2,400 prior to calculating the parental contribution. If the child resides in an institution
250.6specified in section 256B.35, the parent is responsible for the personal needs allowance
250.7specified under that section in addition to the parental contribution determined under this
250.8section. The parental contribution is reduced by any amount required to be paid directly to
250.9the child pursuant to a court order, but only if actually paid.
250.10    (c) The household size to be used in determining the amount of contribution under
250.11paragraph (b) includes natural and adoptive parents and their dependents, including the
250.12child receiving services. Adjustments in the contribution amount due to annual changes
250.13in the federal poverty guidelines shall be implemented on the first day of July following
250.14publication of the changes.
250.15    (d) For purposes of paragraph (b), "income" means the adjusted gross income of the
250.16natural or adoptive parents determined according to the previous year's federal tax form,
250.17except, effective retroactive to July 1, 2003, taxable capital gains to the extent the funds
250.18have been used to purchase a home shall not be counted as income.
250.19    (e) The contribution shall be explained in writing to the parents at the time eligibility
250.20for services is being determined. The contribution shall be made on a monthly basis
250.21effective with the first month in which the child receives services. Annually upon
250.22redetermination or at termination of eligibility, if the contribution exceeded the cost of
250.23services provided, the local agency or the state shall reimburse that excess amount to
250.24the parents, either by direct reimbursement if the parent is no longer required to pay a
250.25contribution, or by a reduction in or waiver of parental fees until the excess amount is
250.26exhausted. All reimbursements must include a notice that the amount reimbursed may be
250.27taxable income if the parent paid for the parent's fees through an employer's health care
250.28flexible spending account under the Internal Revenue Code, section 125, and that the
250.29parent is responsible for paying the taxes owed on the amount reimbursed.
250.30    (f) The monthly contribution amount must be reviewed at least every 12 months;
250.31when there is a change in household size; and when there is a loss of or gain in income
250.32from one month to another in excess of ten percent. The local agency shall mail a written
250.33notice 30 days in advance of the effective date of a change in the contribution amount.
250.34A decrease in the contribution amount is effective in the month that the parent verifies a
250.35reduction in income or change in household size.
251.1    (g) Parents of a minor child who do not live with each other shall each pay the
251.2contribution required under paragraph (a). An amount equal to the annual court-ordered
251.3child support payment actually paid on behalf of the child receiving services shall be
251.4deducted from the adjusted gross income of the parent making the payment prior to
251.5calculating the parental contribution under paragraph (b).
251.6    (h) The contribution under paragraph (b) shall be increased by an additional five
251.7percent if the local agency determines that insurance coverage is available but not
251.8obtained for the child. For purposes of this section, "available" means the insurance is a
251.9benefit of employment for a family member at an annual cost of no more than five percent
251.10of the family's annual income. For purposes of this section, "insurance" means health
251.11and accident insurance coverage, enrollment in a nonprofit health service plan, health
251.12maintenance organization, self-insured plan, or preferred provider organization.
251.13    Parents who have more than one child receiving services shall not be required
251.14to pay more than the amount for the child with the highest expenditures. There shall
251.15be no resource contribution from the parents. The parent shall not be required to pay
251.16a contribution in excess of the cost of the services provided to the child, not counting
251.17payments made to school districts for education-related services. Notice of an increase in
251.18fee payment must be given at least 30 days before the increased fee is due.
251.19    (i) The contribution under paragraph (b) shall be reduced by $300 per fiscal year if,
251.20in the 12 months prior to July 1:
251.21    (1) the parent applied for insurance for the child;
251.22    (2) the insurer denied insurance;
251.23    (3) the parents submitted a complaint or appeal, in writing to the insurer, submitted
251.24a complaint or appeal, in writing, to the commissioner of health or the commissioner of
251.25commerce, or litigated the complaint or appeal; and
251.26    (4) as a result of the dispute, the insurer reversed its decision and granted insurance.
251.27    For purposes of this section, "insurance" has the meaning given in paragraph (h).
251.28    A parent who has requested a reduction in the contribution amount under this
251.29paragraph shall submit proof in the form and manner prescribed by the commissioner or
251.30county agency, including, but not limited to, the insurer's denial of insurance, the written
251.31letter or complaint of the parents, court documents, and the written response of the insurer
251.32approving insurance. The determinations of the commissioner or county agency under this
251.33paragraph are not rules subject to chapter 14.

251.34    Sec. 25. Minnesota Statutes 2014, section 256.478, is amended to read:
252.1256.478 HOME AND COMMUNITY-BASED SERVICES TRANSITIONS
252.2GRANTS.
252.3(a) The commissioner shall make available home and community-based services
252.4transition grants to serve individuals who do not meet eligibility criteria for the medical
252.5assistance program under section 256B.056 or 256B.057, but who otherwise meet the
252.6criteria under section 256B.092, subdivision 13, or 256B.49, subdivision 24.
252.7(b) For the purposes of this section, the commissioner has the authority to transfer
252.8funds between the medical assistance account and the home and community-based
252.9services transitions grants account.

252.10    Sec. 26. Minnesota Statutes 2014, section 256.975, is amended by adding a subdivision
252.11to read:
252.12    Subd. 11. Regional and local dementia grants. (a) The Minnesota Board on
252.13Aging shall award competitive grants to eligible applicants for regional and local projects
252.14and initiatives targeted to a designated community, which may consist of a specific
252.15geographic area or population, to increase awareness of Alzheimer's disease and other
252.16dementias, increase the rate of cognitive testing in the population at risk for dementias,
252.17promote the benefits of early diagnosis of dementias, or connect caregivers of persons
252.18with dementia to education and resources.
252.19(b) The project areas for grants include:
252.20(1) local or community-based initiatives to promote the benefits of physician
252.21consultations for all individuals who suspect a memory or cognitive problem;
252.22(2) local or community-based initiatives to promote the benefits of early diagnosis of
252.23Alzheimer's disease and other dementias; and
252.24(3) local or community-based initiatives to provide informational materials and
252.25other resources to caregivers of persons with dementia.
252.26(c) Eligible applicants for local and regional grants may include, but are not limited
252.27to, community health boards, school districts, colleges and universities, community
252.28clinics, tribal communities, nonprofit organizations, and other health care organizations.
252.29(d) Applicants must:
252.30(1) describe the proposed initiative, including the targeted community and how the
252.31initiative meets the requirements of this subdivision; and
252.32(2) identify the proposed outcomes of the initiative and the evaluation process to be
252.33used to measure these outcomes.
252.34(e) In awarding the regional and local dementia grants, the Minnesota Board on
252.35Aging must give priority to applicants who demonstrate that the proposed project:
253.1(1) is supported by and appropriately targeted to the community the applicant serves;
253.2(2) is designed to coordinate with other community activities related to other health
253.3initiatives, particularly those initiatives targeted at the elderly;
253.4(3) is conducted by an applicant able to demonstrate expertise in the project areas;
253.5(4) utilizes and enhances existing activities and resources or involves innovative
253.6approaches to achieve success in the project areas; and
253.7(5) strengthens community relationships and partnerships in order to achieve the
253.8project areas.
253.9(f) The board shall divide the state into specific geographic regions and allocate a
253.10percentage of the money available for the local and regional dementia grants to projects or
253.11initiatives aimed at each geographic region.
253.12(g) The board shall award any available grants by January 1, 2016, and each July 1
253.13thereafter.
253.14(h) Each grant recipient shall report to the board on the progress of the initiative at
253.15least once during the grant period, and within two months of the end of the grant period
253.16shall submit a final report to the board that includes the outcome results.
253.17(i) The Minnesota Board on Aging shall:
253.18(1) develop the criteria and procedures to allocate the grants under this subdivision,
253.19evaluate all applicants on a competitive basis and award the grants, and select qualified
253.20providers to offer technical assistance to grant applicants and grantees. The selected
253.21provider shall provide applicants and grantees assistance with project design, evaluation
253.22methods, materials, and training; and
253.23(2) submit by January 15, 2017, and on each January 15 thereafter, a progress
253.24report on the dementia grants programs under this subdivision to the chairs and ranking
253.25minority members of the senate and house of representatives committees and divisions
253.26with jurisdiction over health finance and policy. The report shall include:
253.27(i) information on each grant recipient;
253.28(ii) a summary of all projects or initiatives undertaken with each grant;
253.29(iii) the measurable outcomes established by each grantee, an explanation of the
253.30evaluation process used to determine whether the outcomes were met, and the results of
253.31the evaluation; and
253.32(iv) an accounting of how the grant funds were spent.
253.33EFFECTIVE DATE.This section is effective July 1, 2015.

253.34    Sec. 27. Minnesota Statutes 2014, section 256B.056, subdivision 5c, is amended to read:
254.1    Subd. 5c. Excess income standard. (a) The excess income standard for parents
254.2and caretaker relatives, pregnant women, infants, and children ages two through 20 is the
254.3standard specified in subdivision 4, paragraph (b).
254.4(b) The excess income standard for a person whose eligibility is based on blindness,
254.5disability, or age of 65 or more years shall equal 75 80 percent of the federal poverty
254.6guidelines.
254.7EFFECTIVE DATE.This section is effective July 1, 2016.

254.8    Sec. 28. Minnesota Statutes 2014, section 256B.057, subdivision 9, is amended to read:
254.9    Subd. 9. Employed persons with disabilities. (a) Medical assistance may be paid
254.10for a person who is employed and who:
254.11(1) but for excess earnings or assets, meets the definition of disabled under the
254.12Supplemental Security Income program;
254.13(2) meets the asset limits in paragraph (d); and
254.14(3) pays a premium and other obligations under paragraph (e).
254.15    (b) For purposes of eligibility, there is a $65 earned income disregard. To be eligible
254.16for medical assistance under this subdivision, a person must have more than $65 of earned
254.17income. Earned income must have Medicare, Social Security, and applicable state and
254.18federal taxes withheld. The person must document earned income tax withholding. Any
254.19spousal income or assets shall be disregarded for purposes of eligibility and premium
254.20determinations.
254.21(c) After the month of enrollment, a person enrolled in medical assistance under
254.22this subdivision who:
254.23(1) is temporarily unable to work and without receipt of earned income due to a
254.24medical condition, as verified by a physician; or
254.25(2) loses employment for reasons not attributable to the enrollee, and is without
254.26receipt of earned income may retain eligibility for up to four consecutive months after the
254.27month of job loss. To receive a four-month extension, enrollees must verify the medical
254.28condition or provide notification of job loss. All other eligibility requirements must be met
254.29and the enrollee must pay all calculated premium costs for continued eligibility.
254.30(d) For purposes of determining eligibility under this subdivision, a person's assets
254.31must not exceed $20,000, excluding:
254.32(1) all assets excluded under section 256B.056;
254.33(2) retirement accounts, including individual accounts, 401(k) plans, 403(b) plans,
254.34Keogh plans, and pension plans;
254.35(3) medical expense accounts set up through the person's employer; and
255.1(4) spousal assets, including spouse's share of jointly held assets.
255.2(e) All enrollees must pay a premium to be eligible for medical assistance under this
255.3subdivision, except as provided under clause (5).
255.4(1) An enrollee must pay the greater of a $65 $35 premium or the premium calculated
255.5based on the person's gross earned and unearned income and the applicable family size
255.6using a sliding fee scale established by the commissioner, which begins at one percent of
255.7income at 100 percent of the federal poverty guidelines and increases to 7.5 percent of
255.8income for those with incomes at or above 300 percent of the federal poverty guidelines.
255.9(2) Annual adjustments in the premium schedule based upon changes in the federal
255.10poverty guidelines shall be effective for premiums due in July of each year.
255.11(3) All enrollees who receive unearned income must pay five one-half of one percent
255.12of unearned income in addition to the premium amount, except as provided under clause (5).
255.13(4) Increases in benefits under title II of the Social Security Act shall not be counted
255.14as income for purposes of this subdivision until July 1 of each year.
255.15(5) Effective July 1, 2009, American Indians are exempt from paying premiums as
255.16required by section 5006 of the American Recovery and Reinvestment Act of 2009, Public
255.17Law 111-5. For purposes of this clause, an American Indian is any person who meets the
255.18definition of Indian according to Code of Federal Regulations, title 42, section 447.50.
255.19(f) A person's eligibility and premium shall be determined by the local county
255.20agency. Premiums must be paid to the commissioner. All premiums are dedicated to
255.21the commissioner.
255.22(g) Any required premium shall be determined at application and redetermined at
255.23the enrollee's six-month income review or when a change in income or household size is
255.24reported. Enrollees must report any change in income or household size within ten days
255.25of when the change occurs. A decreased premium resulting from a reported change in
255.26income or household size shall be effective the first day of the next available billing month
255.27after the change is reported. Except for changes occurring from annual cost-of-living
255.28increases, a change resulting in an increased premium shall not affect the premium amount
255.29until the next six-month review.
255.30(h) Premium payment is due upon notification from the commissioner of the
255.31premium amount required. Premiums may be paid in installments at the discretion of
255.32the commissioner.
255.33(i) Nonpayment of the premium shall result in denial or termination of medical
255.34assistance unless the person demonstrates good cause for nonpayment. Good cause exists
255.35if the requirements specified in Minnesota Rules, part 9506.0040, subpart 7, items B to
255.36D, are met. Except when an installment agreement is accepted by the commissioner, all
256.1persons disenrolled for nonpayment of a premium must pay any past due premiums as well
256.2as current premiums due prior to being reenrolled. Nonpayment shall include payment with
256.3a returned, refused, or dishonored instrument. The commissioner may require a guaranteed
256.4form of payment as the only means to replace a returned, refused, or dishonored instrument.
256.5(j) For enrollees whose income does not exceed 200 percent of the federal poverty
256.6guidelines and who are also enrolled in Medicare, the commissioner shall reimburse
256.7the enrollee for Medicare part B premiums under section 256B.0625, subdivision 15,
256.8paragraph (a).
256.9EFFECTIVE DATE.This section is effective September 1, 2015.

256.10    Sec. 29. Minnesota Statutes 2014, section 256B.059, subdivision 5, is amended to read:
256.11    Subd. 5. Asset availability. (a) At the time of initial determination of eligibility for
256.12medical assistance benefits following the first continuous period of institutionalization on
256.13or after October 1, 1989, assets considered available to the institutionalized spouse shall
256.14be the total value of all assets in which either spouse has an ownership interest, reduced by
256.15the following amount for the community spouse:
256.16(1) prior to July 1, 1994, the greater of:
256.17(i) $14,148;
256.18(ii) the lesser of the spousal share or $70,740; or
256.19(iii) the amount required by court order to be paid to the community spouse;
256.20(2) for persons whose date of initial determination of eligibility for medical
256.21assistance following their first continuous period of institutionalization occurs on or after
256.22July 1, 1994, the greater of:
256.23(i) $20,000;
256.24(ii) the lesser of the spousal share or $70,740; or
256.25(iii) the amount required by court order to be paid to the community spouse.
256.26The value of assets transferred for the sole benefit of the community spouse under section
256.27256B.0595, subdivision 4 , in combination with other assets available to the community
256.28spouse under this section, cannot exceed the limit for the community spouse asset
256.29allowance determined under subdivision 3 or 4. Assets that exceed this allowance shall be
256.30considered available to the institutionalized spouse whether or not converted to income. If
256.31the community spouse asset allowance has been increased under subdivision 4, then the
256.32assets considered available to the institutionalized spouse under this subdivision shall be
256.33further reduced by the value of additional amounts allowed under subdivision 4.
256.34(b) An institutionalized spouse may be found eligible for medical assistance even
256.35though assets in excess of the allowable amount are found to be available under paragraph
257.1(a) if the assets are owned jointly or individually by the community spouse, and the
257.2institutionalized spouse cannot use those assets to pay for the cost of care without the
257.3consent of the community spouse, and if: (i) the institutionalized spouse assigns to the
257.4commissioner the right to support from the community spouse under section 256B.14,
257.5subdivision 3 ; (ii) the institutionalized spouse lacks the ability to execute an assignment
257.6due to a physical or mental impairment; or (iii) the denial of eligibility would cause an
257.7imminent threat to the institutionalized spouse's health and well-being.
257.8(c) After the month in which the institutionalized spouse is determined eligible for
257.9medical assistance, during the continuous period of institutionalization, no assets of the
257.10community spouse are considered available to the institutionalized spouse, unless the
257.11institutionalized spouse has been found eligible under paragraph (b).
257.12(d) Assets determined to be available to the institutionalized spouse under this
257.13section must be used for the health care or personal needs of the institutionalized spouse.
257.14(e) For purposes of this section, assets do not include assets excluded under the
257.15Supplemental Security Income program.

257.16    Sec. 30. Minnesota Statutes 2014, section 256B.0916, subdivision 2, is amended to read:
257.17    Subd. 2. Distribution of funds; partnerships. (a) Beginning with fiscal year 2000,
257.18the commissioner shall distribute all funding available for home and community-based
257.19waiver services for persons with developmental disabilities to individual counties or to
257.20groups of counties that form partnerships to jointly plan, administer, and authorize funding
257.21for eligible individuals. The commissioner shall encourage counties to form partnerships
257.22that have a sufficient number of recipients and funding to adequately manage the risk
257.23and maximize use of available resources.
257.24    (b) Counties must submit a request for funds and a plan for administering the
257.25program as required by the commissioner. The plan must identify the number of clients to
257.26be served, their ages, and their priority listing based on:
257.27    (1) requirements in Minnesota Rules, part 9525.1880; and
257.28    (2) statewide priorities identified in section 256B.092, subdivision 12.
257.29The plan must also identify changes made to improve services to eligible persons and to
257.30improve program management.
257.31    (c) In allocating resources to counties, priority must be given to groups of counties
257.32that form partnerships to jointly plan, administer, and authorize funding for eligible
257.33individuals and to counties determined by the commissioner to have sufficient waiver
257.34capacity to maximize resource use.
258.1    (d) Within 30 days after receiving the county request for funds and plans, the
258.2commissioner shall provide a written response to the plan that includes the level of
258.3resources available to serve additional persons.
258.4    (e) Counties are eligible to receive medical assistance administrative reimbursement
258.5for administrative costs under criteria established by the commissioner.
258.6(f) The commissioner shall manage waiver allocations in such a manner as to fully
258.7use available state and federal waiver appropriations.
258.8EFFECTIVE DATE.This section is effective the day following final enactment.

258.9    Sec. 31. Minnesota Statutes 2014, section 256B.0916, subdivision 11, is amended to
258.10read:
258.11    Subd. 11. Excess spending. County and tribal agencies are responsible for spending
258.12in excess of the allocation made by the commissioner. In the event a county or tribal agency
258.13spends in excess of the allocation made by the commissioner for a given allocation period,
258.14they must submit a corrective action plan to the commissioner for approval. The plan must
258.15state the actions the agency will take to correct their overspending for the year two years
258.16following the period when the overspending occurred. Failure to correct overspending
258.17shall result in recoupment of spending in excess of the allocation. The commissioner
258.18shall recoup spending in excess of the allocation only in cases where statewide spending
258.19exceeds the appropriation designated for the home and community-based services waivers.
258.20Nothing in this subdivision shall be construed as reducing the county's responsibility to
258.21offer and make available feasible home and community-based options to eligible waiver
258.22recipients within the resources allocated to them for that purpose.
258.23EFFECTIVE DATE.This section is effective the day following final enactment.

258.24    Sec. 32. Minnesota Statutes 2014, section 256B.0916, is amended by adding a
258.25subdivision to read:
258.26    Subd. 12. Use of waiver allocations. County and tribal agencies are responsible
258.27for spending the annual allocation made by the commissioner. In the event a county or
258.28tribal agency spends less than 97 percent of the allocation, while maintaining a list of
258.29persons waiting for waiver services, the county or tribal agency must submit a corrective
258.30action plan to the commissioner for approval. The commissioner may determine a plan
258.31is unnecessary given the size of the allocation and capacity for new enrollment. The
258.32plan must state the actions the agency will take to assure reasonable and timely access
258.33to home and community-based waiver services for persons waiting for services. If a
259.1county or tribe does not submit a plan when required or implement the changes required,
259.2the commissioner shall assure access to waiver services within the county's or tribe's
259.3available allocation and take other actions needed to assure that all waiver participants in
259.4that county or tribe are receiving appropriate waiver services to meet their needs.
259.5EFFECTIVE DATE.This section is effective the day following final enactment.

259.6    Sec. 33. Minnesota Statutes 2014, section 256B.49, subdivision 26, is amended to read:
259.7    Subd. 26. Excess allocations. (a) Effective through June 30, 2018, county and
259.8tribal agencies will be responsible for authorizations in excess of the annual allocation
259.9made by the commissioner. In the event a county or tribal agency authorizes in excess
259.10of the allocation made by the commissioner for a given allocation period, the county or
259.11tribal agency must submit a corrective action plan to the commissioner for approval.
259.12The plan must state the actions the agency will take to correct their overspending for
259.13the year two years following the period when the overspending occurred. Failure to
259.14correct overauthorizations shall result in recoupment of authorizations in excess of the
259.15allocation. The commissioner shall recoup funds spent in excess of the allocation only
259.16in cases where statewide spending exceeds the appropriation designated for the home
259.17and community-based services waivers. Nothing in this subdivision shall be construed
259.18as reducing the county's responsibility to offer and make available feasible home and
259.19community-based options to eligible waiver recipients within the resources allocated
259.20to them for that purpose.
259.21(b) Effective July 1, 2018, county and tribal agencies will be responsible for
259.22spending in excess of the annual allocation made by the commissioner. In the event a
259.23county or tribal agency spends in excess of the allocation made by the commissioner for a
259.24given allocation period, the county or tribal agency must submit a corrective action plan to
259.25the commissioner for approval. The plan must state the actions the agency will take to
259.26correct its overspending for the two years following the period when the overspending
259.27occurred. The commissioner shall recoup funds spent in excess of the allocation only in
259.28cases when statewide spending exceeds the appropriation designated for the home and
259.29community-based services waivers. Nothing in this subdivision shall be construed as
259.30reducing the county or tribe's responsibility to offer and make available feasible home and
259.31community-based options to eligible waiver recipients within the resources allocated to
259.32it for that purpose.

259.33    Sec. 34. Minnesota Statutes 2014, section 256B.49, is amended by adding a
259.34subdivision to read:
260.1    Subd. 27. Use of waiver allocations. (a) Effective until June 30, 2018, county
260.2and tribal agencies are responsible for authorizing the annual allocation made by the
260.3commissioner. In the event a county or tribal agency authorizes less than 97 percent of
260.4the allocation, while maintaining a list of persons waiting for waiver services, the county
260.5or tribal agency must submit a corrective action plan to the commissioner for approval.
260.6The commissioner may determine a plan is unnecessary given the size of the allocation
260.7and capacity for new enrollment. The plan must state the actions the agency will take
260.8to assure reasonable and timely access to home and community-based waiver services
260.9for persons waiting for services.
260.10(b) Effective July 1, 2018, county and tribal agencies are responsible for spending
260.11the annual allocation made by the commissioner. In the event a county or tribal agency
260.12spends less than 97 percent of the allocation, while maintaining a list of persons waiting
260.13for waiver services, the county or tribal agency must submit a corrective action plan to the
260.14commissioner for approval. The commissioner may determine a plan is unnecessary given
260.15the size of the allocation and capacity for new enrollment. The plan must state the actions
260.16the agency will take to assure reasonable and timely access to home and community-based
260.17waiver services for persons waiting for services.
260.18(c) If a county or tribe does not submit a plan when required or implement the
260.19changes required, the commissioner shall assure access to waiver services within the
260.20county or tribe's available allocation, and take other actions needed to assure that all
260.21waiver participants in that county or tribe are receiving appropriate waiver services
260.22to meet their needs.

260.23    Sec. 35. Minnesota Statutes 2014, section 256B.4913, subdivision 4a, is amended to
260.24read:
260.25    Subd. 4a. Rate stabilization adjustment. (a) For purposes of this subdivision,
260.26"implementation period" means the period beginning January 1, 2014, and ending on
260.27the last day of the month in which the rate management system is populated with the
260.28data necessary to calculate rates for substantially all individuals receiving home and
260.29community-based waiver services under sections 256B.092 and 256B.49. "Banding
260.30period" means the time period beginning on January 1, 2014, and ending upon the
260.31expiration of the 12-month period defined in paragraph (c), clause (5).
260.32(b) For purposes of this subdivision, the historical rate for all service recipients means
260.33the individual reimbursement rate for a recipient in effect on December 1, 2013, except that:
260.34(1) for a day service recipient who was not authorized to receive these waiver
260.35services prior to January 1, 2014; added a new service or services on or after January 1,
261.12014; or changed providers on or after January 1, 2014, the historical rate must be the
261.2authorized rate for the provider in the county of service, effective December 1, 2013; or
261.3(2) for a unit-based service with programming or a unit-based service without
261.4programming recipient who was not authorized to receive these waiver services prior to
261.5January 1, 2014; added a new service or services on or after January 1, 2014; or changed
261.6providers on or after January 1, 2014, the historical rate must be the weighted average
261.7authorized rate for each provider number in the county of service, effective December 1,
261.82013; or
261.9(3) for residential service recipients who change providers on or after January 1,
261.102014, the historical rate must be set by each lead agency within their county aggregate
261.11budget using their respective methodology for residential services effective December 1,
261.122013, for determining the provider rate for a similarly situated recipient being served by
261.13that provider.
261.14(c) The commissioner shall adjust individual reimbursement rates determined under
261.15this section so that the unit rate is no higher or lower than:
261.16(1) 0.5 percent from the historical rate for the implementation period;
261.17(2) 0.5 percent from the rate in effect in clause (1), for the 12-month period
261.18immediately following the time period of clause (1);
261.19(3) 1.0 0.5 percent from the rate in effect in clause (2), for the 12-month period
261.20immediately following the time period of clause (2);
261.21(4) 1.0 percent from the rate in effect in clause (3), for the 12-month period
261.22immediately following the time period of clause (3); and
261.23(5) 1.0 percent from the rate in effect in clause (4), for the 12-month period
261.24immediately following the time period of clause (4); and
261.25(6) no adjustment to the rate in effect in clause (5) for the 12-month period
261.26immediately following the time period of clause (5). During this banding rate period, the
261.27commissioner shall not enforce any rate decrease or increase that would otherwise result
261.28from the end of the banding period. The commissioner shall, upon enactment, seek federal
261.29approval for the addition of this banding period.
261.30(d) The commissioner shall review all changes to rates that were in effect on
261.31December 1, 2013, to verify that the rates in effect produce the equivalent level of spending
261.32and service unit utilization on an annual basis as those in effect on October 31, 2013.
261.33(e) By December 31, 2014, the commissioner shall complete the review in paragraph
261.34(d), adjust rates to provide equivalent annual spending, and make appropriate adjustments.
261.35(f) During the banding period, the Medicaid Management Information System
261.36(MMIS) service agreement rate must be adjusted to account for change in an individual's
262.1need. The commissioner shall adjust the Medicaid Management Information System
262.2(MMIS) service agreement rate by:
262.3(1) calculating a service rate under section 256B.4914, subdivision 6, 7, 8, or 9, for
262.4the individual with variables reflecting the level of service in effect on December 1, 2013;
262.5(2) calculating a service rate under section 256B.4914, subdivision 6, 7, 8, or
262.69, for the individual with variables reflecting the updated level of service at the time
262.7of application; and
262.8(3) adding to or subtracting from the Medicaid Management Information System
262.9(MMIS) service agreement rate, the difference between the values in clauses (1) and (2).
262.10(g) This subdivision must not apply to rates for recipients served by providers new
262.11to a given county after January 1, 2014. Providers of personal supports services who also
262.12acted as fiscal support entities must be treated as new providers as of January 1, 2014.

262.13    Sec. 36. Minnesota Statutes 2014, section 256B.4913, subdivision 5, is amended to read:
262.14    Subd. 5. Stakeholder consultation and county training. (a) The commissioner
262.15shall continue consultation on regular intervals with the existing stakeholder group
262.16established as part of the rate-setting methodology process and others, to gather input,
262.17concerns, and data, to assist in the full implementation of the new rate payment system and
262.18to make pertinent information available to the public through the department's Web site.
262.19(b) The commissioner shall offer training at least annually for county personnel
262.20responsible for administering the rate-setting framework in a manner consistent with this
262.21section and section 256B.4914.
262.22(c) The commissioner shall maintain an online instruction manual explaining the
262.23rate-setting framework. The manual shall be consistent with this section and section
262.24256B.4914, and shall be accessible to all stakeholders including recipients, representatives
262.25of recipients, county or tribal agencies, and license holders.
262.26(d) The commissioner shall not defer to the county or tribal agency on matters of
262.27technical application of the rate-setting framework, and a county or tribal agency shall not
262.28set rates in a manner that conflicts with this section or section 256B.4914.

262.29    Sec. 37. Minnesota Statutes 2014, section 256B.4914, subdivision 2, is amended to read:
262.30    Subd. 2. Definitions. (a) For purposes of this section, the following terms have the
262.31meanings given them, unless the context clearly indicates otherwise.
262.32(b) "Commissioner" means the commissioner of human services.
262.33(c) "Component value" means underlying factors that are part of the cost of providing
262.34services that are built into the waiver rates methodology to calculate service rates.
263.1(d) "Customized living tool" means a methodology for setting service rates that
263.2delineates and documents the amount of each component service included in a recipient's
263.3customized living service plan.
263.4(e) "Disability waiver rates system" means a statewide system that establishes rates
263.5that are based on uniform processes and captures the individualized nature of waiver
263.6services and recipient needs.
263.7(f) "Individual staffing" means the time spent as a one-to-one interaction specific to
263.8an individual recipient by staff brought in solely to provide direct support and assistance
263.9with activities of daily living, instrumental activities of daily living, and training to
263.10participants, and is based on the requirements in each individual's coordinated service and
263.11support plan under section 245D.02, subdivision 4b; any coordinated service and support
263.12plan addendum under section 245D.02, subdivision 4c; and an assessment tool; and.
263.13Provider observation of an individual's needs must also be considered.
263.14(g) "Lead agency" means a county, partnership of counties, or tribal agency charged
263.15with administering waivered services under sections 256B.092 and 256B.49.
263.16(h) "Median" means the amount that divides distribution into two equal groups,
263.17one-half above the median and one-half below the median.
263.18(i) "Payment or rate" means reimbursement to an eligible provider for services
263.19provided to a qualified individual based on an approved service authorization.
263.20(j) "Rates management system" means a Web-based software application that uses
263.21a framework and component values, as determined by the commissioner, to establish
263.22service rates.
263.23(k) "Recipient" means a person receiving home and community-based services
263.24funded under any of the disability waivers.
263.25(l) "Shared staffing" means time spent by employees, not defined under paragraph
263.26(f), providing or available to provide more than one individual with direct support and
263.27assistance with activities of daily living as defined under section 256B.0659, subdivision 1,
263.28paragraph (b); instrumental activities of daily living as defined under section 256B.0659,
263.29subdivision 1, paragraph (i); ancillary activities needed to support individual services; and
263.30training to participants, and is based on the requirements in each individual's coordinated
263.31service and support plan under section 245D.02, subdivision 4b; any coordinated service
263.32and support plan addendum under section 245D.02, subdivision 4c; an assessment tool; and
263.33provider observation of an individual's service need. Total shared staffing hours are divided
263.34proportionally by the number of individuals who receive the shared service provisions.
263.35(m) "Staffing ratio" means the number of recipients a service provider employee
263.36supports during a unit of service based on a uniform assessment tool, provider observation,
264.1case history, and the recipient's services of choice, and not based on the staffing ratios
264.2under section 245D.31.
264.3    (n) "Unit of service" means the following:
264.4    (1) for residential support services under subdivision 6, a unit of service is a day.
264.5Any portion of any calendar day, within allowable Medicaid rules, where an individual
264.6spends time in a residential setting is billable as a day;
264.7    (2) for day services under subdivision 7:
264.8    (i) for day training and habilitation services, a unit of service is either:
264.9    (A) a day unit of service is defined as six or more hours of time spent providing
264.10direct services and transportation; or
264.11    (B) a partial day unit of service is defined as fewer than six hours of time spent
264.12providing direct services and transportation; and
264.13    (C) for new day service recipients after January 1, 2014, 15 minute units of
264.14service must be used for fewer than six hours of time spent providing direct services
264.15and transportation;
264.16    (ii) for adult day and structured day services, a unit of service is a day or 15 minutes.
264.17A day unit of service is six or more hours of time spent providing direct services;
264.18    (iii) for prevocational services, a unit of service is a day or an hour. A day unit of
264.19service is six or more hours of time spent providing direct service;
264.20    (3) for unit-based services with programming under subdivision 8:
264.21    (i) for supported living services, a unit of service is a day or 15 minutes. When a
264.22day rate is authorized, any portion of a calendar day where an individual receives services
264.23is billable as a day; and
264.24    (ii) for all other services, a unit of service is 15 minutes; and
264.25    (4) for unit-based services without programming under subdivision 9:
264.26    (i) for respite services, a unit of service is a day or 15 minutes. When a day rate is
264.27authorized, any portion of a calendar day when an individual receives services is billable
264.28as a day; and
264.29    (ii) for all other services, a unit of service is 15 minutes.

264.30    Sec. 38. Minnesota Statutes 2014, section 256B.4914, subdivision 6, is amended to read:
264.31    Subd. 6. Payments for residential support services. (a) Payments for residential
264.32support services, as defined in sections 256B.092, subdivision 11, and 256B.49,
264.33subdivision 22, must be calculated as follows:
264.34(1) determine the number of shared staffing and individual direct staff hours to meet
264.35a recipient's needs provided on site or through monitoring technology;
265.1(2) personnel hourly wage rate must be based on the 2009 Bureau of Labor Statistics
265.2Minnesota-specific rates or rates derived by the commissioner as provided in subdivision
265.35. This is defined as the direct-care rate;
265.4(3) for a recipient requiring customization for deaf and hard-of-hearing language
265.5accessibility under subdivision 12, add the customization rate provided in subdivision 12
265.6to the result of clause (2). This is defined as the customized direct-care rate;
265.7(4) multiply the number of shared and individual direct staff hours provided on site
265.8or through monitoring technology and nursing hours by the appropriate staff wages in
265.9subdivision 5, paragraph (a), or the customized direct-care rate;
265.10(5) multiply the number of shared and individual direct staff hours provided on site
265.11or through monitoring technology and nursing hours by the product of the supervision
265.12span of control ratio in subdivision 5, paragraph (b), clause (1), and the appropriate
265.13supervision wage in subdivision 5, paragraph (a), clause (16);
265.14(6) combine the results of clauses (4) and (5), excluding any shared and individual
265.15direct staff hours provided through monitoring technology, and multiply the result by one
265.16plus the employee vacation, sick, and training allowance ratio in subdivision 5, paragraph
265.17(b), clause (2). This is defined as the direct staffing cost;
265.18(7) for employee-related expenses, multiply the direct staffing cost, excluding any
265.19shared and individual direct staff hours provided through monitoring technology, by one
265.20plus the employee-related cost ratio in subdivision 5, paragraph (b), clause (3);
265.21(8) for client programming and supports, the commissioner shall add $2,179; and
265.22(9) for transportation, if provided, the commissioner shall add $1,680, or $3,000 if
265.23customized for adapted transport, based on the resident with the highest assessed need.
265.24(b) The total rate must be calculated using the following steps:
265.25(1) subtotal paragraph (a), clauses (7) to (9), and the direct staffing cost of any
265.26shared and individual direct staff hours provided through monitoring technology that
265.27was excluded in clause (7);
265.28(2) sum the standard general and administrative rate, the program-related expense
265.29ratio, and the absence and utilization ratio;
265.30(3) divide the result of clause (1) by one minus the result of clause (2). This is
265.31the total payment amount; and
265.32(4) adjust the result of clause (3) by a factor to be determined by the commissioner
265.33to adjust for regional differences in the cost of providing services.
265.34(c) The payment methodology for customized living, 24-hour customized living, and
265.35residential care services must be the customized living tool. Revisions to the customized
266.1living tool must be made to reflect the services and activities unique to disability-related
266.2recipient needs.
266.3(d) The commissioner shall establish a Monitoring Technology Review Panel to
266.4annually review and approve the plans, safeguards, and rates that include residential
266.5direct care provided remotely through monitoring technology. Lead agencies shall submit
266.6individual service plans that include supervision using monitoring technology to the
266.7Monitoring Technology Review Panel for approval. Individual service plans that include
266.8supervision using monitoring technology as of December 31, 2013, shall be submitted to
266.9the Monitoring Technology Review Panel, but the plans are not subject to approval.
266.10(e) (d) For individuals enrolled prior to January 1, 2014, the days of service
266.11authorized must meet or exceed the days of service used to convert service agreements
266.12in effect on December 1, 2013, and must not result in a reduction in spending or service
266.13utilization due to conversion during the implementation period under section 256B.4913,
266.14subdivision 4a . If during the implementation period, an individual's historical rate,
266.15including adjustments required under section 256B.4913, subdivision 4a, paragraph (c),
266.16is equal to or greater than the rate determined in this subdivision, the number of days
266.17authorized for the individual is 365.
266.18(f) (e) The number of days authorized for all individuals enrolling after January 1,
266.192014, in residential services must include every day that services start and end.

266.20    Sec. 39. Minnesota Statutes 2014, section 256B.4914, subdivision 8, is amended to read:
266.21    Subd. 8. Payments for unit-based services with programming. Payments for
266.22unit-based with program services with programming, including behavior programming,
266.23housing access coordination, in-home family support, independent living skills training,
266.24hourly supported living services, and supported employment provided to an individual
266.25outside of any day or residential service plan must be calculated as follows, unless the
266.26services are authorized separately under subdivision 6 or 7:
266.27    (1) determine the number of units of service to meet a recipient's needs;
266.28    (2) personnel hourly wage rate must be based on the 2009 Bureau of Labor Statistics
266.29Minnesota-specific rates or rates derived by the commissioner as provided in subdivision 5;
266.30    (3) for a recipient requiring customization for deaf and hard-of-hearing language
266.31accessibility under subdivision 12, add the customization rate provided in subdivision 12
266.32to the result of clause (2). This is defined as the customized direct-care rate;
266.33    (4) multiply the number of direct staff hours by the appropriate staff wage in
266.34subdivision 5, paragraph (a), or the customized direct-care rate;
267.1    (5) multiply the number of direct staff hours by the product of the supervision span
267.2of control ratio in subdivision 5, paragraph (e), clause (1), and the appropriate supervision
267.3wage in subdivision 5, paragraph (a), clause (16);
267.4    (6) combine the results of clauses (4) and (5), and multiply the result by one plus
267.5the employee vacation, sick, and training allowance ratio in subdivision 5, paragraph (e),
267.6clause (2). This is defined as the direct staffing rate;
267.7    (7) for program plan support, multiply the result of clause (6) by one plus the
267.8program plan supports ratio in subdivision 5, paragraph (e), clause (4);
267.9    (8) for employee-related expenses, multiply the result of clause (7) by one plus the
267.10employee-related cost ratio in subdivision 5, paragraph (e), clause (3);
267.11    (9) for client programming and supports, multiply the result of clause (8) by one plus
267.12the client programming and supports ratio in subdivision 5, paragraph (e), clause (5);
267.13    (10) this is the subtotal rate;
267.14    (11) sum the standard general and administrative rate, the program-related expense
267.15ratio, and the absence and utilization factor ratio;
267.16    (12) divide the result of clause (10) by one minus the result of clause (11). This is
267.17the total payment amount;
267.18    (13) for supported employment provided in a shared manner, divide the total
267.19payment amount in clause (12) by the number of service recipients, not to exceed three.
267.20For independent living skills training provided in a shared manner, divide the total
267.21payment amount in clause (12) by the number of service recipients, not to exceed two; and
267.22    (14) adjust the result of clause (13) by a factor to be determined by the commissioner
267.23to adjust for regional differences in the cost of providing services.

267.24    Sec. 40. Minnesota Statutes 2014, section 256B.4914, subdivision 10, is amended to
267.25read:
267.26    Subd. 10. Updating payment values and additional information. (a) From
267.27January 1, 2014, through December 31, 2017, the commissioner shall develop and
267.28implement uniform procedures to refine terms and adjust values used to calculate payment
267.29rates in this section.
267.30(b) No later than July 1, 2014, the commissioner shall, within available resources,
267.31begin to conduct research and gather data and information from existing state systems or
267.32other outside sources on the following items:
267.33(1) differences in the underlying cost to provide services and care across the state; and
268.1(2) mileage, vehicle type, lift requirements, incidents of individual and shared rides,
268.2and units of transportation for all day services, which must be collected from providers
268.3using the rate management worksheet and entered into the rates management system; and
268.4(3) the distinct underlying costs for services provided by a license holder under
268.5sections 245D.05, 245D.06, 245D.07, 245D.071, 245D.081, and 245D.09, and for services
268.6provided by a license holder certified under section 245D.33.
268.7(c) Using a statistically valid set of rates management system data, the commissioner,
268.8in consultation with stakeholders, shall analyze for each service the average difference
268.9in the rate on December 31, 2013, and the framework rate at the individual, provider,
268.10lead agency, and state levels. The commissioner shall issue semiannual reports to the
268.11stakeholders on the difference in rates by service and by county during the banding period
268.12under section 256B.4913, subdivision 4a. The commissioner shall issue the first report
268.13by October 1, 2014.
268.14(d) No later than July 1, 2014, the commissioner, in consultation with stakeholders,
268.15shall begin the review and evaluation of the following values already in subdivisions 6 to
268.169, or issues that impact all services, including, but not limited to:
268.17(1) values for transportation rates for day services;
268.18(2) values for transportation rates in residential services;
268.19(3) values for services where monitoring technology replaces staff time;
268.20(4) values for indirect services;
268.21(5) values for nursing;
268.22(6) component values for independent living skills;
268.23(7) component values for family foster care that reflect licensing requirements;
268.24(8) adjustments to other components to replace the budget neutrality factor;
268.25(9) remote monitoring technology for nonresidential services;
268.26(10) values for basic and intensive services in residential services;
268.27(11) values for the facility use rate in day services, and the weightings used in the
268.28day service ratios and adjustments to those weightings;
268.29(12) values for workers' compensation as part of employee-related expenses;
268.30(13) values for unemployment insurance as part of employee-related expenses;
268.31(14) a component value to reflect costs for individuals with rates previously adjusted
268.32for the inclusion of group residential housing rate 3 costs, only for any individual enrolled
268.33as of December 31, 2013; and
268.34(15) any changes in state or federal law with an impact on the underlying cost of
268.35providing home and community-based services.
269.1(e) The commissioner shall report to the chairs and the ranking minority members of
269.2the legislative committees and divisions with jurisdiction over health and human services
269.3policy and finance with the information and data gathered under paragraphs (b) to (d)
269.4on the following dates:
269.5(1) January 15, 2015, with preliminary results and data;
269.6(2) January 15, 2016, with a status implementation update, and additional data
269.7and summary information;
269.8(3) January 15, 2017, with the full report; and
269.9(4) January 15, 2019, with another full report, and a full report once every four
269.10years thereafter.
269.11(f) Based on the commissioner's evaluation of the information and data collected in
269.12paragraphs (b) to (d), the commissioner shall make recommendations to the legislature by
269.13January 15, 2015, to address any issues identified during the first year of implementation.
269.14After January 15, 2015, the commissioner may make recommendations to the legislature
269.15to address potential issues.
269.16(g) The commissioner shall implement a regional adjustment factor to all rate
269.17calculations in subdivisions 6 to 9, effective no later than January 1, 2015. Prior to
269.18implementation, the commissioner shall consult with stakeholders on the methodology to
269.19calculate the adjustment.
269.20(h) The commissioner shall provide a public notice via LISTSERV in October of
269.21each year beginning October 1, 2014, containing information detailing legislatively
269.22approved changes in:
269.23(1) calculation values including derived wage rates and related employee and
269.24administrative factors;
269.25(2) service utilization;
269.26(3) county and tribal allocation changes; and
269.27(4) information on adjustments made to calculation values and the timing of those
269.28adjustments.
269.29The information in this notice must be effective January 1 of the following year.
269.30(i) No later than July 1, 2016, the commissioner shall develop and implement, in
269.31consultation with stakeholders, a methodology sufficient to determine the shared staffing
269.32levels necessary to meet, at a minimum, health and welfare needs of individuals who
269.33will be living together in shared residential settings, and the required shared staffing
269.34activities described in subdivision 2, paragraph (l). This determination methodology must
269.35ensure staffing levels are adaptable to meet the needs and desired outcomes for current and
269.36prospective residents in shared residential settings.
270.1(j) When the available shared staffing hours in a residential setting are insufficient to
270.2meet the needs of an individual who enrolled in residential services after January 1, 2014,
270.3or insufficient to meet the needs of an individual with a service agreement adjustment
270.4described in section 256B.4913, subdivision 4a, paragraph (f), then individual staffing
270.5hours shall be used.
270.6EFFECTIVE DATE.This section is effective the day following final enactment.

270.7    Sec. 41. Minnesota Statutes 2014, section 256B.4914, subdivision 14, is amended to
270.8read:
270.9    Subd. 14. Exceptions. (a) In a format prescribed by the commissioner, lead
270.10agencies must identify individuals with exceptional needs that cannot be met under the
270.11disability waiver rate system. The commissioner shall use that information to evaluate
270.12and, if necessary, approve an alternative payment rate for those individuals. Whether
270.13granted, denied, or modified, the commissioner shall respond to all exception requests in
270.14writing. The commissioner shall include in the written response the basis for the action
270.15and provide notification of the right to appeal under paragraph (h).
270.16(b) Lead agencies must act on an exception request within 30 days and notify the
270.17initiator of the request of their recommendation in writing. A lead agency shall submit all
270.18exception requests along with its recommendation to the state commissioner.
270.19(c) An application for a rate exception may be submitted for the following criteria:
270.20(1) an individual has service needs that cannot be met through additional units
270.21of service; or
270.22(2) an individual's rate determined under subdivisions 6, 7, 8, and 9 results is so
270.23insufficient that it has resulted in an individual being discharged receiving a notice of
270.24discharge from the individual's provider; or
270.25(3) an individual's service needs, including behavioral changes, require a level of
270.26service which necessitates a change in provider or which requires the current provider to
270.27propose service changes beyond those currently authorized.
270.28(d) Exception requests must include the following information:
270.29(1) the service needs required by each individual that are not accounted for in
270.30subdivisions 6, 7, 8, and 9;
270.31(2) the service rate requested and the difference from the rate determined in
270.32subdivisions 6, 7, 8, and 9;
270.33(3) a basis for the underlying costs used for the rate exception and any accompanying
270.34documentation; and
270.35(4) the duration of the rate exception; and
271.1(5) any contingencies for approval.
271.2(e) Approved rate exceptions shall be managed within lead agency allocations under
271.3sections 256B.092 and 256B.49.
271.4(f) Individual disability waiver recipients, an interested party, or the license holder
271.5that would receive the rate exception increase may request that a lead agency submit an
271.6exception request. A lead agency that denies such a request shall notify the individual
271.7waiver recipient, interested party, or license holder of its decision and the reasons for
271.8denying the request in writing no later than 30 days after the individual's request has been
271.9made and shall submit its denial to the commissioner in accordance with paragraph (b).
271.10The reasons for the denial must be based on the failure to meet the criteria in paragraph (c).
271.11(g) The commissioner shall determine whether to approve or deny an exception
271.12request no more than 30 days after receiving the request. If the commissioner denies the
271.13request, the commissioner shall notify the lead agency and the individual disability waiver
271.14recipient, the interested party, and the license holder in writing of the reasons for the denial.
271.15(h) The individual disability waiver recipient may appeal any denial of an exception
271.16request by either the lead agency or the commissioner, pursuant to sections 256.045 and
271.17256.0451 . When the denial of an exception request results in the proposed demission of a
271.18waiver recipient from a residential or day habilitation program, the commissioner shall
271.19issue a temporary stay of demission, when requested by the disability waiver recipient,
271.20consistent with the provisions of section 256.045, subdivisions 4a and 6, paragraph (c).
271.21The temporary stay shall remain in effect until the lead agency can provide an informed
271.22choice of appropriate, alternative services to the disability waiver.
271.23(i) Providers may petition lead agencies to update values that were entered
271.24incorrectly or erroneously into the rate management system, based on past service level
271.25discussions and determination in subdivision 4, without applying for a rate exception.
271.26(j) The starting date for the rate exception will be the later of the date of the
271.27recipient's change in support or the date of the request to the lead agency for an exception.
271.28(k) The commissioner shall track all exception requests received and their
271.29dispositions. The commissioner shall issue quarterly public exceptions statistical reports,
271.30including the number of exception requests received and the numbers granted, denied,
271.31withdrawn, and pending. The report shall include the average amount of time required to
271.32process exceptions.
271.33(l) No later than January 15, 2016, the commissioner shall provide research
271.34findings on the estimated fiscal impact, the primary cost drivers, and common population
271.35characteristics of recipients with needs that cannot be met by the framework rates.
272.1(m) No later than July 1, 2016, the commissioner shall develop and implement,
272.2in consultation with stakeholders, a process to determine eligibility for rate exceptions
272.3for individuals with rates determined under the methodology in section 256B.4913,
272.4subdivision 4a. Determination of eligibility for an exception will occur as annual service
272.5renewals are completed.
272.6(n) Approved rate exceptions will be implemented at such time that the individual's
272.7rate is no longer banded and remain in effect in all cases until an individual's needs change
272.8as defined in paragraph (c).

272.9    Sec. 42. Minnesota Statutes 2014, section 256B.4914, subdivision 15, is amended to
272.10read:
272.11    Subd. 15. County or tribal allocations. (a) Upon implementation of the disability
272.12waiver rates management system on January 1, 2014, the commissioner shall establish
272.13a method of tracking and reporting the fiscal impact of the disability waiver rates
272.14management system on individual lead agencies.
272.15(b) Beginning January 1, 2014, the commissioner shall make annual adjustments to
272.16lead agencies' home and community-based waivered service budget allocations to adjust
272.17for rate differences and the resulting impact on county allocations upon implementation of
272.18the disability waiver rates system.
272.19(c) During the first two years of implementation under section 256B.4913, Lead
272.20agencies exceeding their allocations shall be subject to the provisions under sections
272.21256B.092 256B.0916, subdivision 11, and 256B.49 shall only be held liable for spending
272.22in excess of their allocations after a reallocation of resources by the commissioner under
272.23paragraph (b). The commissioner shall reallocate resources under sections 256B.092,
272.24subdivision 12 , and 256B.49, subdivision 11a. The commissioner shall notify lead
272.25agencies of this process by July 1, 2014 256B.49, subdivision 26.

272.26    Sec. 43. Minnesota Statutes 2014, section 256B.492, is amended to read:
272.27256B.492 HOME AND COMMUNITY-BASED SETTINGS FOR PEOPLE
272.28WITH DISABILITIES.
272.29(a) Individuals receiving services under a home and community-based waiver under
272.30section 256B.092 or 256B.49 may receive services in the following settings:
272.31(1) an individual's own home or family home and community-based settings that
272.32comply with all requirements identified by the federal Centers for Medicare and Medicaid
272.33Services in the Code of Federal Regulations, title 42, section 441.301(c), and with the
273.1requirements of the federally approved transition plan and waiver plans for each home
273.2and community-based services waiver; and
273.3(2) a licensed adult foster care or child foster care setting of up to five people or
273.4community residential setting of up to five people; and settings required by the Housing
273.5Opportunities for Persons with AIDS Program.
273.6(3) community living settings as defined in section 256B.49, subdivision 23, where
273.7individuals with disabilities may reside in all of the units in a building of four or fewer units,
273.8and who receive services under a home and community-based waiver occupy no more
273.9than the greater of four or 25 percent of the units in a multifamily building of more than
273.10four units, unless required by the Housing Opportunities for Persons with AIDS Program.
273.11(b) The settings in paragraph (a) must not:
273.12(1) be located in a building that is a publicly or privately operated facility that
273.13provides institutional treatment or custodial care;
273.14(2) be located in a building on the grounds of or adjacent to a public or private
273.15institution;
273.16(3) be a housing complex designed expressly around an individual's diagnosis or
273.17disability, unless required by the Housing Opportunities for Persons with AIDS Program;
273.18(4) be segregated based on a disability, either physically or because of setting
273.19characteristics, from the larger community; and
273.20(5) have the qualities of an institution which include, but are not limited to:
273.21regimented meal and sleep times, limitations on visitors, and lack of privacy. Restrictions
273.22agreed to and documented in the person's individual service plan shall not result in a
273.23residence having the qualities of an institution as long as the restrictions for the person are
273.24not imposed upon others in the same residence and are the least restrictive alternative,
273.25imposed for the shortest possible time to meet the person's needs.
273.26(c) The provisions of paragraphs (a) and (b) do not apply to any setting in which
273.27individuals receive services under a home and community-based waiver as of July 1,
273.282012, and the setting does not meet the criteria of this section.
273.29(d) Notwithstanding paragraph (c), a program in Hennepin County established as
273.30part of a Hennepin County demonstration project is qualified for the exception allowed
273.31under paragraph (c).
273.32(e) Notwithstanding paragraphs (a) and (b), a program in Hennepin County, located
273.33in the city of Golden Valley, within the city of Golden Valley's Highway 55 West
273.34redevelopment area, that is not a provider-owned or controlled home and community-based
273.35setting, and is scheduled to open by July 1, 2016, is exempt from the restrictions in
274.1paragraphs (a) and (b). If the program fails to comply with the Centers for Medicare and
274.2Medicaid Services rules for home and community-based settings, the exemption is void.
274.3(f) The commissioner shall submit an amendment to the waiver plan no later than
274.4December 31, 2012.
274.5EFFECTIVE DATE.This section is effective July 1, 2016.

274.6    Sec. 44. [256Q.01] PLAN ESTABLISHED.
274.7    A savings plan known as the Minnesota ABLE plan is established. In establishing
274.8this plan, the legislature seeks to encourage and assist individuals and families in saving
274.9private funds for the purpose of supporting individuals with disabilities to maintain health,
274.10independence, and quality of life, and to provide secure funding for disability-related
274.11expenses on behalf of designated beneficiaries with disabilities that will supplement, but
274.12not supplant, benefits provided through private insurance, the Medicaid program under
274.13title XIX of the Social Security Act, the Supplemental Security Income program under
274.14title XVI of the Social Security Act, the beneficiary's employment, and other sources.

274.15    Sec. 45. [256Q.02] CITATION.
274.16    This chapter may be cited as the "Minnesota Achieving a Better Life Experience
274.17Act" or "Minnesota ABLE Act."

274.18    Sec. 46. [256Q.03] DEFINITIONS.
274.19    Subdivision 1. Scope. For the purposes of this chapter, the terms defined in this
274.20section have the meanings given them.
274.21    Subd. 2. ABLE account. "ABLE account" has the meaning given in section
274.22529A(e)(6) of the Internal Revenue Code.
274.23    Subd. 3. ABLE plan or plan. "ABLE plan" or "plan" means the qualified ABLE
274.24program, as defined in section 529A(b) of the Internal Revenue Code, provided for
274.25in this chapter.
274.26    Subd. 4. Account. "Account" means the formal record of transactions relating to an
274.27ABLE plan beneficiary.
274.28    Subd. 5. Account owner. "Account owner" means the designated beneficiary
274.29of the account.
274.30    Subd. 6. Annual contribution limit. "Annual contribution limit" has the meaning
274.31given in section 529A(b)(2) of the Internal Revenue Code.
275.1    Subd. 7. Application. "Application" means the form executed by a prospective
275.2account owner to enter into a participation agreement and open an account in the plan.
275.3The application incorporates by reference the participation agreement.
275.4    Subd. 8. Board. "Board" means the State Board of Investment.
275.5    Subd. 9. Commissioner. "Commissioner" means the commissioner of human
275.6services.
275.7    Subd. 10. Contribution. "Contribution" means a payment directly allocated to
275.8an account for the benefit of a beneficiary.
275.9    Subd. 11. Department. "Department" means the Department of Human Services.
275.10    Subd. 12. Designated beneficiary or beneficiary. "Designated beneficiary" or
275.11"beneficiary" has the meaning given in section 529A(e)(3) of the Internal Revenue Code
275.12and further defined through regulations issued under that section.
275.13    Subd. 13. Earnings. "Earnings" means the total account balance minus the
275.14investment in the account.
275.15    Subd. 14. Eligible individual. "Eligible individual" has the meaning given in
275.16section 529A(e)(1) of the Internal Revenue Code and further defined through regulations
275.17issued under that section.
275.18    Subd. 15. Executive director. "Executive director" means the executive director of
275.19the State Board of Investment.
275.20    Subd. 16. Internal Revenue Code. "Internal Revenue Code" means the Internal
275.21Revenue Code of 1986, as amended.
275.22    Subd. 17. Investment in the account. "Investment in the account" means the sum
275.23of all contributions made to an account by a particular date minus the aggregate amount
275.24of contributions included in distributions or rollover distributions, if any, made from the
275.25account as of that date.
275.26    Subd. 18. Member of the family. "Member of the family" has the meaning given in
275.27section 529A(e)(4) of the Internal Revenue Code.
275.28    Subd. 19. Participation agreement. "Participation agreement" means an agreement
275.29to participate in the Minnesota ABLE plan between an account owner and the state
275.30through its agencies, the commissioner, and the board.
275.31    Subd. 20. Person. "Person" means an individual, trust, estate, partnership,
275.32association, company, corporation, or the state.
275.33    Subd. 21. Plan administrator. "Plan administrator" means the person selected by
275.34the commissioner and the board to administer the daily operations of the ABLE plan and
275.35provide record keeping, investment management, and other services for the plan.
276.1    Subd. 22. Qualified disability expense. "Qualified disability expense" has the
276.2meaning given in section 529A(e)(5) of the Internal Revenue Code and further defined
276.3through regulations issued under that section.
276.4    Subd. 23. Qualified distribution. "Qualified distribution" means a withdrawal from
276.5an ABLE account to pay the qualified disability expenses of the beneficiary of the account.
276.6A qualified withdrawal may be made by the beneficiary, by an agent of the beneficiary
276.7who has the power of attorney, or by the beneficiary's legal guardian.
276.8    Subd. 24. Rollover distribution. "Rollover distribution" means a transfer of funds
276.9made:
276.10    (1) from one account in another state's qualified ABLE program to an account for
276.11the benefit of the same designated beneficiary or an eligible individual who is a family
276.12member of the former designated beneficiary; or
276.13    (2) from one account to another account for the benefit of an eligible individual who
276.14is a family member of the former designated beneficiary.
276.15    Subd. 25. Total account balance. "Total account balance" means the amount in an
276.16account on a particular date or the fair market value of an account on a particular date.

276.17    Sec. 47. [256Q.04] ABLE PLAN REQUIREMENTS.
276.18    Subdivision 1. State residency requirement. The designated beneficiary of an
276.19ABLE account must be a resident of Minnesota, or the resident of a state that has entered
276.20into a contract with Minnesota to provide its residents access to the Minnesota ABLE plan.
276.21    Subd. 2. Single account requirement. No more than one ABLE account shall be
276.22established per beneficiary, except as permitted under section 529A(c)(4) of the Internal
276.23Revenue Code.
276.24    Subd. 3. Accounts-type plan. The plan must be operated as an accounts-type
276.25plan. A separate account must be maintained for each designated beneficiary for whom
276.26contributions are made.
276.27    Subd. 4. Contribution and account requirements. Contributions to an ABLE
276.28account are subject to the requirements of section 529A(b)(2) of the Internal Revenue
276.29Code prohibiting noncash contributions and contributions in excess of the annual
276.30contribution limit. The total account balance may not exceed the maximum account
276.31balance limit imposed under section 136G.09, subdivision 8.
276.32    Subd. 5. Limited investment direction. Designated beneficiaries may not direct
276.33the investment of assets in their accounts more than twice in any calendar year.
276.34    Subd. 6. Security for loans. An interest in an account must not be used as security
276.35for a loan.

277.1    Sec. 48. [256Q.05] ABLE PLAN ADMINISTRATION.
277.2    Subdivision 1. Plan to comply with federal law. The commissioner shall ensure
277.3that the plan meets the requirements for an ABLE account under section 529A of the
277.4Internal Revenue Code, including any regulations released after the effective date of this
277.5section. The commissioner may request a private letter ruling or rulings from the Internal
277.6Revenue Service or Secretary of Health and Human Services and must take any necessary
277.7steps to ensure that the plan qualifies under relevant provisions of federal law.
277.8    Subd. 2. Plan rules and procedures. (a) The commissioner shall establish the
277.9rules, terms, and conditions for the plan, subject to the requirements of this chapter and
277.10section 529A of the Internal Revenue Code.
277.11    (b) The commissioner shall prescribe the application forms, procedures, and other
277.12requirements that apply to the plan.
277.13    Subd. 3. Consultation with other state agencies; annual fee. In designing and
277.14establishing the plan's requirements and in negotiating or entering into contracts with third
277.15parties under subdivision 4, the commissioner shall consult with the executive director of
277.16the board and the commissioner of the Office of Higher Education. The commissioner and
277.17the executive director shall establish an annual fee, equal to a percentage of the average
277.18daily net assets of the plan, to be imposed on account owners to recover the costs of
277.19administration, record keeping, and investment management as provided in subdivision 5.
277.20    Subd. 4. Administration. The commissioner shall administer the plan, including
277.21accepting and processing applications, verifying state residency, verifying eligibility,
277.22maintaining account records, making payments, and undertaking any other necessary
277.23tasks to administer the plan. Notwithstanding other requirements of this chapter, the
277.24commissioner shall adopt rules for purposes of implementing and administering the plan.
277.25The commissioner may contract with one or more third parties to carry out some or all of
277.26these administrative duties, including providing incentives. The commissioner and the
277.27board may jointly contract with third-party providers, if the commissioner and board
277.28determine that it is desirable to contract with the same entity or entities for administration
277.29and investment management.
277.30    Subd. 5. Authority to impose fees. The commissioner, or the commissioner's
277.31designee, may impose annual fees, as provided in subdivision 3, on account owners to
277.32recover the costs of administration. The commissioner must keep the fees as low as
277.33possible, consistent with efficient administration, so that the returns on savings invested in
277.34the plan are as high as possible.
277.35    Subd. 6. Federally mandated reporting. (a) As required under section 529A(d) of
277.36the Internal Revenue Code, the commissioner or the commissioner's designee shall submit
278.1a notice to the Secretary of the Treasury upon the establishment of each ABLE account.
278.2The notice must contain the name and state of residence of the designated beneficiary and
278.3other information as the secretary may require.
278.4    (b) As required under section 529A(d) of the Internal Revenue Code, the
278.5commissioner or the commissioner's designee shall submit electronically on a monthly
278.6basis to the Commissioner of Social Security, in a manner specified by the Commissioner
278.7of Social Security, statements on relevant distributions and account balances from all
278.8ABLE accounts.
278.9    Subd. 7. Data. (a) Data on ABLE accounts and designated beneficiaries of ABLE
278.10accounts are private data on individuals or nonpublic data as defined in section 13.02.
278.11    (b) The commissioner may share or disseminate data classified as private or
278.12nonpublic in this subdivision as follows:
278.13    (1) with other state or federal agencies, only to the extent necessary to verify
278.14identity of, determine the eligibility of, or process applications for an eligible individual
278.15participating in the Minnesota ABLE plan; and
278.16    (2) with a nongovernmental person, only to the extent necessary to carry out the
278.17functions of the Minnesota ABLE plan, provided the commissioner has entered into
278.18a data-sharing agreement with the person, as provided in section 13.05, subdivision 6,
278.19prior to sharing data under this clause or a contract with that person that complies with
278.20section 13.05, subdivision 11, as applicable.

278.21    Sec. 49. [256Q.06] PLAN ACCOUNTS.
278.22    Subdivision 1. Contributions to an account. Any person may make contributions
278.23to an ABLE account on behalf of a designated beneficiary. Contributions to an account
278.24made by persons other than the account owner become the property of the account owner.
278.25A person does not acquire an interest in an ABLE account by making contributions to
278.26an account. Contributions to an account must be made in cash, by check, or by other
278.27commercially acceptable means, as permitted by the Internal Revenue Service and
278.28approved by the plan administrator in cooperation with the commissioner and the board.
278.29    Subd. 2. Contribution and account limitations. Contributions to an ABLE
278.30account are subject to the requirements of section 529A(b) of the Internal Revenue Code.
278.31The total account balance of an ABLE account may not exceed the maximum account
278.32balance limit imposed under section 136G.09, subdivision 8. The plan administrator must
278.33reject any portion of a contribution to an account that exceeds the annual contribution limit
278.34or that would cause the total account balance to exceed the maximum account balance
278.35limit imposed under section 136G.09, subdivision 8.
279.1    Subd. 3. Authority of account owner. An account owner is the only person
279.2entitled to:
279.3    (1) request distributions;
279.4    (2) request rollover distributions; or
279.5    (3) change the beneficiary of an ABLE account to a member of the family of the
279.6current beneficiary, but only if the beneficiary to whom the ABLE account is transferred
279.7is an eligible individual.
279.8    Subd. 4. Effect of plan changes on participation agreement. Amendments to
279.9this chapter automatically amend the participation agreement. Any amendments to the
279.10operating procedures and policies of the plan automatically amend the participation
279.11agreement after adoption by the commissioner or the board.
279.12    Subd. 5. Special account to hold plan assets in trust. All assets of the plan,
279.13including contributions to accounts, are held in trust for the exclusive benefit of account
279.14owners. Assets must be held in a separate account in the state treasury to be known as
279.15the Minnesota ABLE plan account or in accounts with the third-party provider selected
279.16pursuant to section 256Q.05, subdivision 4. Plan assets are not subject to claims by creditors
279.17of the state, are not part of the general fund, and are not subject to appropriation by the
279.18state. Payments from the Minnesota ABLE plan account shall be made under this chapter.

279.19    Sec. 50. [256Q.07] INVESTMENT OF ABLE ACCOUNTS.
279.20    Subdivision 1. State Board of Investment to invest. The State Board of Investment
279.21shall invest the money deposited in accounts in the plan.
279.22    Subd. 2. Permitted investments. The board may invest the accounts in any
279.23permitted investment under section 11A.24, except that the accounts may be invested
279.24without limit in investment options from open-ended investment companies registered
279.25under the federal Investment Company Act of 1940, United States Code, title 15, sections
279.2680a-1 to 80a-64.
279.27    Subd. 3. Contracting authority. The board may contract with one or more third
279.28parties for investment management, record keeping, or other services in connection with
279.29investing the accounts. The board and commissioner may jointly contract with third-party
279.30providers, if the commissioner and board determine that it is desirable to contract with the
279.31same entity or entities for administration and investment management.

279.32    Sec. 51. [256Q.08] ACCOUNT DISTRIBUTIONS.
279.33    Subdivision 1. Qualified distribution methods. (a) Qualified distributions may
279.34be made:
280.1    (1) directly to participating providers of goods and services that are qualified
280.2disability expenses, if purchased for a beneficiary;
280.3    (2) in the form of a check payable to both the beneficiary and provider of goods or
280.4services that are qualified disability expenses; or
280.5    (3) directly to the beneficiary, if the beneficiary has already paid qualified disability
280.6expenses.
280.7    (b) Qualified distributions must be withdrawn proportionally from contributions and
280.8earnings in an account owner's account on the date of distribution as provided in section
280.9529A of the Internal Revenue Code.
280.10    Subd. 2. Distributions upon death of a beneficiary. Upon the death of a
280.11beneficiary, the amount remaining in the beneficiary's account must be distributed pursuant
280.12to section 529A(f) of the Internal Revenue Code.
280.13    Subd. 3. Nonqualified distribution. An account owner may request a nonqualified
280.14distribution from an account at any time. Nonqualified distributions are based on the total
280.15account balances in an account owner's account and must be withdrawn proportionally
280.16from contributions and earnings as provided in section 529A of the Internal Revenue
280.17Code. The earnings portion of a nonqualified distribution is subject to a federal additional
280.18tax pursuant to section 529A of the Internal Revenue Code. For purposes of this
280.19subdivision, "earnings portion" means the ratio of the earnings in the account to the total
280.20account balance, immediately prior to the distribution, multiplied by the distribution.

280.21    Sec. 52. INDIVIDUAL PROVIDERS OF DIRECT SUPPORT SERVICES.
280.22The labor agreement between the state of Minnesota and the Service Employees
280.23International Union Healthcare Minnesota, submitted to the Legislative Coordinating
280.24Commission on March 2, 2015, is ratified.
280.25EFFECTIVE DATE.This section is effective July 1, 2015.

280.26    Sec. 53. RATE INCREASE FOR DIRECT SUPPORT SERVICES PROVIDERS
280.27WORKFORCE NEGOTIATIONS.
280.28    (a) If the labor agreement between the state of Minnesota and the Service Employees
280.29International Union Healthcare Minnesota under Minnesota Statutes, section 179A.54, is
280.30approved pursuant to Minnesota Statutes, sections 3.855 and 179A.22, the commissioner
280.31of human services shall increase reimbursement rates, individual budgets, grants, or
280.32allocations by 1.53 percent for services provided on or after July 1, 2015, and by an
280.33additional 0.2 percent for services provided on or after July 1, 2016, to implement the
280.34minimum hourly wage and paid time off provisions of that agreement.
281.1    (b) The rate changes described in this section apply to direct support services
281.2provided through a covered program, as defined in Minnesota Statutes, section 256B.0711,
281.3subdivision 1.

281.4    Sec. 54. CONSUMER-DIRECTED COMMUNITY SUPPORTS BUDGET
281.5METHODOLOGY EXCEPTION.
281.6(a) No later than September 30, 2015, if necessary, the commissioner of human
281.7services shall submit an amendment to the Centers for Medicare and Medicaid Services
281.8for the home and community-based services waivers authorized under Minnesota Statutes,
281.9sections 256B.092 and 256B.49, to establish an exception to the consumer-directed
281.10community supports budget methodology to provide up to 20 percent more funds for:
281.11(1) consumer-directed community supports participants who have graduated
281.12from high school and have a coordinated service and support plan which identifies the
281.13need for more services under consumer-directed community supports, either prior to
281.14graduation or in order to increase the amount of time a person works or to improve their
281.15employment opportunities, than the amount they are eligible to receive under the current
281.16consumer-directed community supports budget methodology; and
281.17(2) home and community-based waiver participants who are currently using licensed
281.18services for employment supports or services during the day which cost more annually
281.19than the person would spend under a consumer-directed community supports plan for
281.20individualized employment supports or services during the day.
281.21(b) The exception under paragraph (a) is limited to those persons who can
281.22demonstrate either that they will have to leave consumer-directed community supports and
281.23use other waiver services because their need for day or employment supports cannot be
281.24met within the consumer-directed community supports budget limits or they will move
281.25to consumer-directed community supports and their services will cost less than services
281.26currently being used.
281.27EFFECTIVE DATE.The exception under this section is effective October 1, 2015,
281.28or upon federal approval, whichever is later. The commissioner of human services shall
281.29notify the revisor of statutes when this occurs.

281.30    Sec. 55. HOME AND COMMUNITY-BASED SERVICES INCENTIVE POOL.
281.31    The commissioner of human services shall develop an initiative to provide
281.32incentives for innovation in achieving integrated competitive employment, living in
281.33the most integrated setting, and other outcomes determined by the commissioner. The
281.34commissioner shall seek requests for proposals and shall contract with one or more entities
282.1to provide incentive payments for meeting identified outcomes. The initial requests for
282.2proposals must be issued by October 1, 2016.

282.3    Sec. 56. DIRECTION TO COMMISSIONER; REPORTS REQUIRED.
282.4The commissioner of human services shall develop and submit reports to the chairs
282.5and ranking minority members of the house of representatives and senate committees and
282.6divisions with jurisdiction over health and human services policy and finance on the
282.7implementation of Minnesota Statutes, sections 256B.0916, subdivisions 2, 11, and 12,
282.8and 256B.49, subdivisions 26 and 27. The commissioner shall submit two reports, one by
282.9February 15, 2018, and the second by February 15, 2019.

282.10    Sec. 57. INSTRUCTIONS TO THE COMMISSIONER.
282.11The commissioner shall determine the number of individuals who were determined
282.12to be ineligible to receive community first services and supports because they did not
282.13require constant supervision and cuing in order to accomplish activities of daily living.
282.14The commissioner shall issue a report with these findings to the chairs and ranking
282.15minority members of the house and senate committees with jurisdiction over human
282.16services programs.

282.17    Sec. 58. REPEALER.
282.18Laws 2012, chapter 247, article 4, section 47, as amended by Laws 2014, chapter
282.19312, article 27, section 72, is repealed upon the effective date of section 54.

282.20ARTICLE 8

282.21HEALTH DEPARTMENT AND PUBLIC HEALTH

282.22    Section 1. Minnesota Statutes 2014, section 16A.724, subdivision 2, is amended to read:
282.23    Subd. 2. Transfers. (a) Notwithstanding section 295.581, to the extent available
282.24resources in the health care access fund exceed expenditures in that fund, effective for
282.25the biennium beginning July 1, 2007, the commissioner of management and budget shall
282.26transfer the excess funds from the health care access fund to the general fund on June 30
282.27of each year, provided that the amount transferred in any fiscal biennium shall not exceed
282.28$96,000,000. The purpose of this transfer is to meet the rate increase required under Laws
282.292003, First Special Session chapter 14, article 13C, section 2, subdivision 6.
282.30    (b) For fiscal years 2006 to 2011, MinnesotaCare shall be a forecasted program, and,
282.31if necessary, the commissioner shall reduce these transfers from the health care access
282.32fund to the general fund to meet annual MinnesotaCare expenditures or, if necessary,
283.1transfer sufficient funds from the general fund to the health care access fund to meet
283.2annual MinnesotaCare expenditures.
283.3(c) Notwithstanding section 295.581, to the extent available resources in the health
283.4care access fund exceed expenditures in that fund after the transfer required in paragraph
283.5(a), effective for the biennium beginning July 1, 2013, the commissioner of management
283.6and budget shall transfer $1,000,000 each fiscal year from the health access fund to
283.7the medical education and research costs fund established under section 62J.692, for
283.8distribution under section 62J.692, subdivision 4, paragraph (c).

283.9    Sec. 2. Minnesota Statutes 2014, section 62J.498, is amended to read:
283.1062J.498 HEALTH INFORMATION EXCHANGE.
283.11    Subdivision 1. Definitions. The following definitions apply to sections 62J.498 to
283.1262J.4982 :
283.13(a) "Clinical data repository" means a real time database that consolidates data from
283.14a variety of clinical sources to present a unified view of a single patient and is used by a
283.15state-certified health information exchange service provider to enable health information
283.16exchange among health care providers that are not related health care entities as defined in
283.17section 144.291, subdivision 2, paragraph (j). This does not include clinical data that are
283.18submitted to the commissioner for public health purposes required or permitted by law,
283.19including any rules adopted by the commissioner.
283.20(a) (b) "Clinical transaction" means any meaningful use transaction or other health
283.21information exchange transaction that is not covered by section 62J.536.
283.22(b) (c) "Commissioner" means the commissioner of health.
283.23(c) "Direct health information exchange" means the electronic transmission of
283.24health-related information through a direct connection between the electronic health
283.25record systems of health care providers without the use of a health data intermediary.
283.26(d) "Health care provider" or "provider" means a health care provider or provider as
283.27defined in section 62J.03, subdivision 8.
283.28(e) "Health data intermediary" means an entity that provides the infrastructure
283.29technical capabilities or related products and services to connect computer systems or
283.30other electronic devices used by health care providers, laboratories, pharmacies, health
283.31plans, third-party administrators, or pharmacy benefit managers to facilitate the secure
283.32transmission of health information, including enable health information exchange among
283.33health care providers that are not related health care entities as defined in section 144.291,
283.34subdivision 2, paragraph (j). This includes but is not limited to: health information service
283.35providers (HISP), electronic health record vendors, and pharmaceutical electronic data
284.1intermediaries as defined in section 62J.495. This does not include health care providers
284.2engaged in direct health information exchange.
284.3(f) "Health information exchange" means the electronic transmission of health-related
284.4information between organizations according to nationally recognized standards.
284.5(g) "Health information exchange service provider" means a health data intermediary
284.6or health information organization that has been issued a certificate of authority by the
284.7commissioner under section 62J.4981.
284.8(h) "Health information organization" means an organization that oversees, governs,
284.9and facilitates the health information exchange of health-related information among
284.10organizations according to nationally recognized standards health care providers that are
284.11not related health care entities as defined in section 144.291, subdivision 2, paragraph (j),
284.12to improve coordination of patient care and the efficiency of health care delivery.
284.13(i) "HITECH Act" means the Health Information Technology for Economic and
284.14Clinical Health Act as defined in section 62J.495.
284.15(j) "Major participating entity" means:
284.16(1) a participating entity that receives compensation for services that is greater
284.17than 30 percent of the health information organization's gross annual revenues from the
284.18health information exchange service provider;
284.19(2) a participating entity providing administrative, financial, or management services
284.20to the health information organization, if the total payment for all services provided by the
284.21participating entity exceeds three percent of the gross revenue of the health information
284.22organization; and
284.23(3) a participating entity that nominates or appoints 30 percent or more of the board
284.24of directors or equivalent governing body of the health information organization.
284.25(k) "Master patient index" means an electronic database that holds unique identifiers
284.26of patients registered at a care facility and is used by a state-certified health information
284.27exchange service provider to enable health information exchange among health care
284.28providers that are not related health care entities as defined in section 144.291, subdivision
284.292, paragraph (j). This does not include data that are submitted to the commissioner for
284.30public health purposes required or permitted by law, including any rules adopted by the
284.31commissioner.
284.32(k) (l) "Meaningful use" means use of certified electronic health record technology
284.33that includes e-prescribing, and is connected in a manner that provides for the electronic
284.34exchange of health information and used for the submission of clinical quality measures
284.35to improve quality, safety, and efficiency and reduce health disparities; engage patients
284.36and families; improve care coordination and population and public health; and maintain
285.1privacy and security of patient health information as established by the Center for
285.2Medicare and Medicaid Services and the Minnesota Department of Human Services
285.3pursuant to sections 4101, 4102, and 4201 of the HITECH Act.
285.4(l) (m) "Meaningful use transaction" means an electronic transaction that a health
285.5care provider must exchange to receive Medicare or Medicaid incentives or avoid
285.6Medicare penalties pursuant to sections 4101, 4102, and 4201 of the HITECH Act.
285.7(m) (n) "Participating entity" means any of the following persons, health care
285.8providers, companies, or other organizations with which a health information organization
285.9or health data intermediary has contracts or other agreements for the provision of health
285.10information exchange service providers services:
285.11(1) a health care facility licensed under sections 144.50 to 144.56, a nursing home
285.12licensed under sections 144A.02 to 144A.10, and any other health care facility otherwise
285.13licensed under the laws of this state or registered with the commissioner;
285.14(2) a health care provider, and any other health care professional otherwise licensed
285.15under the laws of this state or registered with the commissioner;
285.16(3) a group, professional corporation, or other organization that provides the
285.17services of individuals or entities identified in clause (2), including but not limited to a
285.18medical clinic, a medical group, a home health care agency, an urgent care center, and
285.19an emergent care center;
285.20(4) a health plan as defined in section 62A.011, subdivision 3; and
285.21(5) a state agency as defined in section 13.02, subdivision 17.
285.22(n) (o) "Reciprocal agreement" means an arrangement in which two or more health
285.23information exchange service providers agree to share in-kind services and resources to
285.24allow for the pass-through of meaningful use clinical transactions.
285.25(o) (p) "State-certified health data intermediary" means a health data intermediary
285.26that: has been issued a certificate of authority to operate in Minnesota.
285.27(1) provides a subset of the meaningful use transaction capabilities necessary for
285.28hospitals and providers to achieve meaningful use of electronic health records;
285.29(2) is not exclusively engaged in the exchange of meaningful use transactions
285.30covered by section 62J.536; and
285.31(3) has been issued a certificate of authority to operate in Minnesota.
285.32(p) (q) "State-certified health information organization" means a nonprofit health
285.33information organization that provides transaction capabilities necessary to fully support
285.34clinical transactions required for meaningful use of electronic health records that has been
285.35issued a certificate of authority to operate in Minnesota.
286.1    Subd. 2. Health information exchange oversight. (a) The commissioner shall
286.2protect the public interest on matters pertaining to health information exchange. The
286.3commissioner shall:
286.4(1) review and act on applications from health data intermediaries and health
286.5information organizations for certificates of authority to operate in Minnesota;
286.6(2) provide ongoing monitoring to ensure compliance with criteria established under
286.7sections 62J.498 to 62J.4982;
286.8(3) respond to public complaints related to health information exchange services;
286.9(4) take enforcement actions as necessary, including the imposition of fines,
286.10suspension, or revocation of certificates of authority as outlined in section 62J.4982;
286.11(5) provide a biennial report on the status of health information exchange services
286.12that includes but is not limited to:
286.13(i) recommendations on actions necessary to ensure that health information exchange
286.14services are adequate to meet the needs of Minnesota citizens and providers statewide;
286.15(ii) recommendations on enforcement actions to ensure that health information
286.16exchange service providers act in the public interest without causing disruption in health
286.17information exchange services;
286.18(iii) recommendations on updates to criteria for obtaining certificates of authority
286.19under this section; and
286.20(iv) recommendations on standard operating procedures for health information
286.21exchange, including but not limited to the management of consumer preferences; and
286.22(6) other duties necessary to protect the public interest.
286.23(b) As part of the application review process for certification under paragraph (a),
286.24prior to issuing a certificate of authority, the commissioner shall:
286.25(1) hold public hearings that provide an adequate opportunity for participating
286.26entities and consumers to provide feedback and recommendations on the application under
286.27consideration. The commissioner shall make all portions of the application classified as
286.28public data available to the public for at least ten days in advance of the hearing while
286.29an application is under consideration. At the request of the commissioner, the applicant
286.30shall participate in the a public hearing by presenting an overview of their application and
286.31responding to questions from interested parties; and
286.32(2) make available all feedback and recommendations gathered at the hearing
286.33available to the public prior to issuing a certificate of authority; and
286.34(3) consult with hospitals, physicians, and other professionals eligible to receive
286.35meaningful use incentive payments or subject to penalties as established in the HITECH
287.1Act, and their respective statewide associations, providers prior to issuing a certificate of
287.2authority.
287.3(c) When the commissioner is actively considering a suspension or revocation of a
287.4certificate of authority as described in section 62J.4982, subdivision 3, all investigatory
287.5data that are collected, created, or maintained related to the suspension or revocation
287.6are classified as confidential data on individuals and as protected nonpublic data in the
287.7case of data not on individuals.
287.8(d) The commissioner may disclose data classified as protected nonpublic or
287.9confidential under paragraph (c) if disclosing the data will protect the health or safety of
287.10patients.
287.11(e) After the commissioner makes a final determination regarding a suspension or
287.12revocation of a certificate of authority, all minutes, orders for hearing, findings of fact,
287.13conclusions of law, and the specification of the final disciplinary action, are classified
287.14as public data.

287.15    Sec. 3. Minnesota Statutes 2014, section 62J.4981, is amended to read:
287.1662J.4981 CERTIFICATE OF AUTHORITY TO PROVIDE HEALTH
287.17INFORMATION EXCHANGE SERVICES.
287.18    Subdivision 1. Authority to require organizations to apply. The commissioner
287.19shall require an entity providing health information exchange services a health data
287.20intermediary or a health information organization to apply for a certificate of authority
287.21under this section. An applicant may continue to operate until the commissioner acts
287.22on the application. If the application is denied, the applicant is considered a health
287.23information organization exchange service provider whose certificate of authority has
287.24been revoked under section 62J.4982, subdivision 2, paragraph (d).
287.25    Subd. 2. Certificate of authority for health data intermediaries. (a) A health
287.26data intermediary that provides health information exchange services for the transmission
287.27of one or more clinical transactions necessary for hospitals, providers, or eligible
287.28professionals to achieve meaningful use must be registered with certified by the state and
287.29comply with requirements established in this section.
287.30(b) Notwithstanding any law to the contrary, any corporation organized to do so
287.31may apply to the commissioner for a certificate of authority to establish and operate as
287.32a health data intermediary in compliance with this section. No person shall establish or
287.33operate a health data intermediary in this state, nor sell or offer to sell, or solicit offers
287.34to purchase or receive advance or periodic consideration in conjunction with a health
288.1data intermediary contract unless the organization has a certificate of authority or has an
288.2application under active consideration under this section.
288.3(c) In issuing the certificate of authority, the commissioner shall determine whether
288.4the applicant for the certificate of authority has demonstrated that the applicant meets
288.5the following minimum criteria:
288.6(1) interoperate with at least one state-certified health information organization;
288.7(2) provide an option for Minnesota entities to connect to their services through at
288.8least one state-certified health information organization;
288.9(3) have a record locator service as defined in section 144.291, subdivision 2,
288.10paragraph (i), that is compliant with the requirements of section 144.293, subdivision 8,
288.11when conducting meaningful use transactions; and
288.12(4) (1) hold reciprocal agreements with at least one state-certified health information
288.13organization to enable access to record locator services to find patient data, and for the
288.14transmission and receipt of meaningful use clinical transactions consistent with the
288.15format and content required by national standards established by Centers for Medicare
288.16and Medicaid Services. Reciprocal agreements must meet the requirements established in
288.17subdivision 5.; and
288.18(2) participate in statewide shared health information exchange services as defined
288.19by the commissioner to support interoperability between state-certified health information
288.20organizations and state-certified health data intermediaries.
288.21    Subd. 3. Certificate of authority for health information organizations.
288.22(a) A health information organization that provides all electronic capabilities for the
288.23transmission of clinical transactions necessary for meaningful use of electronic health
288.24records must obtain a certificate of authority from the commissioner and demonstrate
288.25compliance with the criteria in paragraph (c).
288.26(b) Notwithstanding any law to the contrary, a nonprofit corporation organized to
288.27do so an organization may apply for a certificate of authority to establish and operate a
288.28health information organization under this section. No person shall establish or operate a
288.29health information organization in this state, nor sell or offer to sell, or solicit offers
288.30to purchase or receive advance or periodic consideration in conjunction with a health
288.31information organization or health information contract unless the organization has a
288.32certificate of authority under this section.
288.33(c) In issuing the certificate of authority, the commissioner shall determine whether
288.34the applicant for the certificate of authority has demonstrated that the applicant meets
288.35the following minimum criteria:
288.36(1) the entity is a legally established, nonprofit organization;
289.1(2) appropriate insurance, including liability insurance, for the operation of the
289.2health information organization is in place and sufficient to protect the interest of the
289.3public and participating entities;
289.4(3) strategic and operational plans clearly address governance, technical
289.5infrastructure, legal and policy issues, finance, and business operations in regard to how
289.6the organization will expand technical capacity of the health information organization
289.7to support providers in achieving meaningful use of electronic health records health
289.8information exchange goals over time;
289.9(4) the entity addresses the parameters to be used with participating entities and
289.10other health information organizations exchange service providers for meaningful use
289.11clinical transactions, compliance with Minnesota law, and interstate health information
289.12exchange in trust agreements;
289.13(5) the entity's board of directors or equivalent governing body is composed of
289.14members that broadly represent the health information organization's participating entities
289.15and consumers;
289.16(6) the entity maintains a professional staff responsible to the board of directors or
289.17equivalent governing body with the capacity to ensure accountability to the organization's
289.18mission;
289.19(7) the organization is compliant with criteria established under the Health
289.20Information Exchange Accreditation Program of the Electronic Healthcare Network
289.21Accreditation Commission (EHNAC) or equivalent criteria established national
289.22certification and accreditation programs designated by the commissioner;
289.23(8) the entity maintains a the capability to query for patient information based on
289.24national standards. The query capability may utilize a master patient index, clinical
289.25data repository, or record locator service as defined in section 144.291, subdivision 2,
289.26paragraph (i), that is. The entity must be compliant with the requirements of section
289.27144.293 , subdivision 8, when conducting meaningful use clinical transactions;
289.28(9) the organization demonstrates interoperability with all other state-certified health
289.29information organizations using nationally recognized standards;
289.30(10) the organization demonstrates compliance with all privacy and security
289.31requirements required by state and federal law; and
289.32(11) the organization uses financial policies and procedures consistent with generally
289.33accepted accounting principles and has an independent audit of the organization's
289.34financials on an annual basis.
289.35(d) Health information organizations that have obtained a certificate of authority must:
290.1(1) meet the requirements established for connecting to the Nationwide Health
290.2Information Network (NHIN) within the federally mandated timeline or within a time
290.3frame established by the commissioner and published in the State Register. If the state
290.4timeline for implementation varies from the federal timeline, the State Register notice
290.5shall include an explanation for the variation National eHealth Exchange;
290.6(2) annually submit strategic and operational plans for review by the commissioner
290.7that address:
290.8(i) increasing adoption rates to include a sufficient number of participating entities to
290.9achieve financial sustainability; and
290.10(ii) (i) progress in achieving objectives included in previously submitted strategic
290.11and operational plans across the following domains: business and technical operations,
290.12technical infrastructure, legal and policy issues, finance, and organizational governance;
290.13(3) develop and maintain a business plan that addresses:
290.14(i) (ii) plans for ensuring the necessary capacity to support meaningful use clinical
290.15transactions;
290.16(ii) (iii) approach for attaining financial sustainability, including public and private
290.17financing strategies, and rate structures;
290.18(iii) (iv) rates of adoption, utilization, and transaction volume, and mechanisms to
290.19support health information exchange; and
290.20(iv) (v) an explanation of methods employed to address the needs of community
290.21clinics, critical access hospitals, and free clinics in accessing health information exchange
290.22services;
290.23(4) annually submit a rate plan to the commissioner outlining fee structures for health
290.24information exchange services for approval by the commissioner. The commissioner
290.25shall approve the rate plan if it:
290.26(i) distributes costs equitably among users of health information services;
290.27(ii) provides predictable costs for participating entities;
290.28(iii) covers all costs associated with conducting the full range of meaningful use
290.29clinical transactions, including access to health information retrieved through other
290.30state-certified health information exchange service providers; and
290.31(iv) provides for a predictable revenue stream for the health information organization
290.32and generates sufficient resources to maintain operating costs and develop technical
290.33infrastructure necessary to serve the public interest;
290.34(5) (3) enter into reciprocal agreements with all other state-certified health
290.35information organizations and state-certified health data intermediaries to enable access
290.36to record locator services to find patient data, and for the transmission and receipt of
291.1meaningful use clinical transactions consistent with the format and content required by
291.2national standards established by Centers for Medicare and Medicaid Services. Reciprocal
291.3agreements must meet the requirements in subdivision 5; and
291.4(4) participate in statewide shared health information exchange services as defined
291.5by the commissioner to support interoperability between state-certified health information
291.6organizations and state-certified health data intermediaries; and
291.7(6) (5) comply with additional requirements for the certification or recertification of
291.8health information organizations that may be established by the commissioner.
291.9    Subd. 4. Application for certificate of authority for health information exchange
291.10service providers. (a) Each application for a certificate of authority shall be in a form
291.11prescribed by the commissioner and verified by an officer or authorized representative
291.12of the applicant. Each application shall include the following in addition to information
291.13described in the criteria in subdivisions 2 and 3:
291.14(1) for health information organizations only, a copy of the basic organizational
291.15document, if any, of the applicant and of each major participating entity, such as the
291.16articles of incorporation, or other applicable documents, and all amendments to it;
291.17(2) for health information organizations only, a list of the names, addresses, and
291.18official positions of the following:
291.19(i) all members of the board of directors or equivalent governing body, and the
291.20principal officers and, if applicable, shareholders of the applicant organization; and
291.21(ii) all members of the board of directors or equivalent governing body, and the
291.22principal officers of each major participating entity and, if applicable, each shareholder
291.23beneficially owning more than ten percent of any voting stock of the major participating
291.24entity;
291.25(3) for health information organizations only, the name and address of each
291.26participating entity and the agreed-upon duration of each contract or agreement if
291.27applicable;
291.28(4) a copy of each standard agreement or contract intended to bind the participating
291.29entities and the health information organization exchange service provider. Contractual
291.30provisions shall be consistent with the purposes of this section, in regard to the services to
291.31be performed under the standard agreement or contract, the manner in which payment for
291.32services is determined, the nature and extent of responsibilities to be retained by the health
291.33information organization, and contractual termination provisions;
291.34(5) a copy of each contract intended to bind major participating entities and the
291.35health information organization. Contract information filed with the commissioner under
291.36this section shall be nonpublic as defined in section 13.02, subdivision 9;
292.1(6) (5) a statement generally describing the health information organization exchange
292.2service provider, its health information exchange contracts, facilities, and personnel,
292.3including a statement describing the manner in which the applicant proposes to provide
292.4participants with comprehensive health information exchange services;
292.5(7) financial statements showing the applicant's assets, liabilities, and sources
292.6of financial support, including a copy of the applicant's most recent certified financial
292.7statement;
292.8(8) strategic and operational plans that specifically address how the organization
292.9will expand technical capacity of the health information organization to support providers
292.10in achieving meaningful use of electronic health records over time, a description of
292.11the proposed method of marketing the services, a schedule of proposed charges, and a
292.12financial plan that includes a three-year projection of the expenses and income and other
292.13sources of future capital;
292.14(9) (6) a statement reasonably describing the geographic area or areas to be served
292.15and the type or types of participants to be served;
292.16(10) (7) a description of the complaint procedures to be used as required under
292.17this section;
292.18(11) (8) a description of the mechanism by which participating entities will have an
292.19opportunity to participate in matters of policy and operation;
292.20(12) (9) a copy of any pertinent agreements between the health information
292.21organization and insurers, including liability insurers, demonstrating coverage is in place;
292.22(13) (10) a copy of the conflict of interest policy that applies to all members of the
292.23board of directors or equivalent governing body and the principal officers of the health
292.24information organization; and
292.25(14) (11) other information as the commissioner may reasonably require to be
292.26provided.
292.27(b) Within 30 45 days after the receipt of the application for a certificate of authority,
292.28the commissioner shall determine whether or not the application submitted meets the
292.29requirements for completion in paragraph (a), and notify the applicant of any further
292.30information required for the application to be processed.
292.31(c) Within 90 days after the receipt of a complete application for a certificate of
292.32authority, the commissioner shall issue a certificate of authority to the applicant if the
292.33commissioner determines that the applicant meets the minimum criteria requirements
292.34of subdivision 2 for health data intermediaries or subdivision 3 for health information
292.35organizations. If the commissioner determines that the applicant is not qualified, the
292.36commissioner shall notify the applicant and specify the reasons for disqualification.
293.1(d) Upon being granted a certificate of authority to operate as a state-certified health
293.2information organization or state-certified health data intermediary, the organization must
293.3operate in compliance with the provisions of this section. Noncompliance may result in
293.4the imposition of a fine or the suspension or revocation of the certificate of authority
293.5according to section 62J.4982.
293.6    Subd. 5. Reciprocal agreements between health information exchange entities.
293.7(a) Reciprocal agreements between two health information organizations or between a
293.8health information organization and a health data intermediary must include a fair and
293.9equitable model for charges between the entities that:
293.10(1) does not impede the secure transmission of clinical transactions necessary to
293.11achieve meaningful use;
293.12(2) does not charge a fee for the exchange of meaningful use transactions transmitted
293.13according to nationally recognized standards where no additional value-added service
293.14is rendered to the sending or receiving health information organization or health data
293.15intermediary either directly or on behalf of the client;
293.16(3) is consistent with fair market value and proportionately reflects the value-added
293.17services accessed as a result of the agreement; and
293.18(4) prevents health care stakeholders from being charged multiple times for the
293.19same service.
293.20(b) Reciprocal agreements must include comparable quality of service standards that
293.21ensure equitable levels of services.
293.22(c) Reciprocal agreements are subject to review and approval by the commissioner.
293.23(d) Nothing in this section precludes a state-certified health information organization
293.24or state-certified health data intermediary from entering into contractual agreements for
293.25the provision of value-added services beyond meaningful use transactions.
293.26(e) The commissioner of human services or health, when providing access to data or
293.27services through a certified health information organization, must offer the same data or
293.28services directly through any certified health information organization at the same pricing,
293.29if the health information organization pays for all connection costs to the state data or
293.30service. For all external connectivity to the respective agencies through existing or future
293.31information exchange implementations, the respective agency shall establish the required
293.32connectivity methods as well as protocol standards to be utilized.
293.33    Subd. 6. State participation in health information exchange. A state agency that
293.34connects to a health information exchange service provider for the purpose of exchanging
293.35meaningful use transactions must ensure that the contracted health information exchange
293.36service provider has reciprocal agreements in place as required by this section. The
294.1reciprocal agreements must provide equal access to information supplied by the agency as
294.2necessary for meaningful use by the participating entities of the other health information
294.3service providers.

294.4    Sec. 4. Minnesota Statutes 2014, section 62J.4982, subdivision 4, is amended to read:
294.5    Subd. 4. Coordination. (a) The commissioner shall, to the extent possible, seek
294.6the advice of the Minnesota e-Health Advisory Committee, in the review and update of
294.7criteria for the certification and recertification of health information exchange service
294.8providers when implementing sections 62J.498 to 62J.4982.
294.9(b) By January 1, 2011, the commissioner shall report to the governor and the chairs
294.10of the senate and house of representatives committees having jurisdiction over health
294.11information policy issues on the status of health information exchange in Minnesota, and
294.12provide recommendations on further action necessary to facilitate the secure electronic
294.13movement of health information among health providers that will enable Minnesota
294.14providers and hospitals to meet meaningful use exchange requirements.

294.15    Sec. 5. Minnesota Statutes 2014, section 62J.4982, subdivision 5, is amended to read:
294.16    Subd. 5. Fees and monetary penalties. (a) The commissioner shall assess fees
294.17on every health information exchange service provider subject to sections 62J.4981 and
294.1862J.4982 as follows:
294.19(1) filing an application for certificate of authority to operate as a health information
294.20organization, $10,500 $7,000;
294.21(2) filing an application for certificate of authority to operate as a health data
294.22intermediary, $7,000;
294.23(3) annual health information organization certificate fee, $14,000 $7,000; and
294.24(4) annual health data intermediary certificate fee, $7,000; and
294.25(5) fees for other filings, as specified by rule.
294.26(b) Fees collected under this section shall be deposited in the state treasury and
294.27credited to the state government special revenue fund.
294.28(b) (c) Administrative monetary penalties imposed under this subdivision shall
294.29be credited to an account in the special revenue fund and are appropriated to the
294.30commissioner for the purposes of sections 62J.498 to 62J.4982.

294.31    Sec. 6. Minnesota Statutes 2014, section 62J.692, subdivision 4, is amended to read:
294.32    Subd. 4. Distribution of funds. (a) The commissioner shall annually distribute the
294.33available medical education funds to all qualifying applicants based on a public program
295.1volume factor, which is determined by the total volume of public program revenue
295.2received by each training site as a percentage of all public program revenue received by
295.3all training sites in the fund pool.
295.4    Public program revenue for the distribution formula includes revenue from medical
295.5assistance, prepaid medical assistance, general assistance medical care, and prepaid
295.6general assistance medical care. Training sites that receive no public program revenue
295.7are ineligible for funds available under this subdivision. For purposes of determining
295.8training-site level grants to be distributed under this paragraph, total statewide average
295.9costs per trainee for medical residents is based on audited clinical training costs per trainee
295.10in primary care clinical medical education programs for medical residents. Total statewide
295.11average costs per trainee for dental residents is based on audited clinical training costs
295.12per trainee in clinical medical education programs for dental students. Total statewide
295.13average costs per trainee for pharmacy residents is based on audited clinical training
295.14costs per trainee in clinical medical education programs for pharmacy students. Training
295.15sites whose training site level grant is less than $5,000, based on the formula described
295.16in this paragraph, or that train fewer than 0.1 FTE eligible trainees, are ineligible for
295.17funds available under this subdivision. No training sites shall receive a grant per FTE
295.18trainee that is in excess of the 95th percentile grant per FTE across all eligible training
295.19sites; grants in excess of this amount will be redistributed to other eligible sites based on
295.20the formula described in this paragraph.
295.21(b) For funds distributed in fiscal years 2014 and 2015, the distribution formula shall
295.22include a supplemental public program volume factor, which is determined by providing
295.23a supplemental payment to training sites whose public program revenue accounted for
295.24at least 0.98 percent of the total public program revenue received by all eligible training
295.25sites. The supplemental public program volume factor shall be equal to ten percent of each
295.26training site's grant for funds distributed in fiscal year 2014 and for funds distributed in
295.27fiscal year 2015. Grants to training sites whose public program revenue accounted for less
295.28than 0.98 percent of the total public program revenue received by all eligible training sites
295.29shall be reduced by an amount equal to the total value of the supplemental payment. For
295.30fiscal year 2016 and beyond, the distribution of funds shall be based solely on the public
295.31program volume factor as described in paragraph (a).
295.32(c) Of available medical education funds, $1,000,000 shall be distributed each
295.33year for grants to family medicine residency programs located outside the seven-county
295.34metropolitan area, as defined in section 473.121, subdivision 4, focused on eduction and
295.35training of family medicine physicians to serve communities outside the metropolitan area.
295.36To be eligible for a grant under this paragraph, a family medicine residency program must
296.1demonstrate that over the most recent three calendar years, at least 25 percent of its residents
296.2practice in Minnesota communities outside the metropolitan area. Grant funds must be
296.3allocated proportionally based on the number of residents per eligible residency program.
296.4    (d) Funds distributed shall not be used to displace current funding appropriations
296.5from federal or state sources.
296.6    (e) (d) Funds shall be distributed to the sponsoring institutions indicating the amount
296.7to be distributed to each of the sponsor's clinical medical education programs based on the
296.8criteria in this subdivision and in accordance with the commissioner's approval letter. Each
296.9clinical medical education program must distribute funds allocated under paragraphs (a)
296.10and (b) to the training sites as specified in the commissioner's approval letter. Sponsoring
296.11institutions, which are accredited through an organization recognized by the Department
296.12of Education or the Centers for Medicare and Medicaid Services, may contract directly
296.13with training sites to provide clinical training. To ensure the quality of clinical training,
296.14those accredited sponsoring institutions must:
296.15    (1) develop contracts specifying the terms, expectations, and outcomes of the clinical
296.16training conducted at sites; and
296.17    (2) take necessary action if the contract requirements are not met. Action may include
296.18the withholding of payments under this section or the removal of students from the site.
296.19    (f) (e) Use of funds is limited to expenses related to clinical training program costs
296.20for eligible programs.
296.21    (g) (f) Any funds not distributed in accordance with the commissioner's approval
296.22letter must be returned to the medical education and research fund within 30 days of
296.23receiving notice from the commissioner. The commissioner shall distribute returned funds
296.24to the appropriate training sites in accordance with the commissioner's approval letter.
296.25    (h) (g) A maximum of $150,000 of the funds dedicated to the commissioner
296.26under section 297F.10, subdivision 1, clause (2), may be used by the commissioner for
296.27administrative expenses associated with implementing this section.

296.28    Sec. 7. Minnesota Statutes 2014, section 62Q.37, subdivision 2, is amended to read:
296.29    Subd. 2. Definitions. For purposes of this section, the following terms have the
296.30meanings given them.
296.31(a) "Commissioner" means the commissioner of health for purposes of regulating
296.32health maintenance organizations and community integrated service networks, the
296.33commissioner of commerce for purposes of regulating nonprofit health service plan
296.34corporations, or the commissioner of human services for the purpose of contracting with
297.1managed care organizations serving persons enrolled in programs under chapter 256B,
297.2256D, or 256L.
297.3(b) "Health plan company" means (i) a nonprofit health service plan corporation
297.4operating under chapter 62C; (ii) a health maintenance organization operating under
297.5chapter 62D; (iii) a community integrated service network operating under chapter 62N;
297.6or (iv) a managed care organization operating under chapter 256B, 256D, or 256L.
297.7(c) "Nationally recognized independent organization" means (i) an organization
297.8that sets specific national standards governing health care quality assurance processes,
297.9utilization review, provider credentialing, marketing, and other topics covered by
297.10this chapter and other chapters and audits and provides accreditation to those health
297.11plan companies that meet those standards. The American Accreditation Health Care
297.12Commission (URAC), the National Committee for Quality Assurance (NCQA), and
297.13the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), and the
297.14Accreditation Association for Ambulatory Health Care (AAAHC) are, at a minimum,
297.15defined as nationally recognized independent organizations; and (ii) the Centers for
297.16Medicare and Medicaid Services for purposes of reviews or audits conducted of health
297.17plan companies under Part C of Title XVIII of the Social Security Act or under section
297.181876 of the Social Security Act.
297.19(d) "Performance standard" means those standards relating to quality management
297.20and improvement, access and availability of service, utilization review, provider selection,
297.21provider credentialing, marketing, member rights and responsibilities, complaints, appeals,
297.22grievance systems, enrollee information and materials, enrollment and disenrollment,
297.23subcontractual relationships and delegation, confidentiality, continuity and coordination of
297.24care, assurance of adequate capacity and services, coverage and authorization of services,
297.25practice guidelines, health information systems, and financial solvency.

297.26    Sec. 8. Minnesota Statutes 2014, section 62U.04, subdivision 11, is amended to read:
297.27    Subd. 11. Restricted uses of the all-payer claims data. (a) Notwithstanding
297.28subdivision 4, paragraph (b), and subdivision 5, paragraph (b), the commissioner or the
297.29commissioner's designee shall only use the data submitted under subdivisions 4 and 5 for
297.30the following purposes:
297.31(1) to evaluate the performance of the health care home program as authorized under
297.32sections 256B.0751, subdivision 6, and 256B.0752, subdivision 2;
297.33(2) to study, in collaboration with the reducing avoidable readmissions effectively
297.34(RARE) campaign, hospital readmission trends and rates;
298.1(3) to analyze variations in health care costs, quality, utilization, and illness burden
298.2based on geographical areas or populations; and
298.3(4) to evaluate the state innovation model (SIM) testing grant received by the
298.4Departments of Health and Human Services, including the analysis of health care cost,
298.5quality, and utilization baseline and trend information for targeted populations and
298.6communities.; and
298.7(5) to compile one or more public use files of summary data or tables that must:
298.8(i) be available to the public for no or minimal cost by March 1, 2016, and available
298.9by Web-based electronic data download by June 30, 2019;
298.10(ii) not identify individual patients, payers, or providers;
298.11(iii) be updated by the commissioner, at least annually, with the most current data
298.12available;
298.13(iv) contain clear and conspicuous explanations of the characteristics of the data,
298.14such as the dates of the data contained in the files, the absence of costs of care for uninsured
298.15patients or nonresidents, and other disclaimers that provide appropriate context; and
298.16(v) not lead to the collection of additional data elements beyond what is authorized
298.17under this section as of June 30, 2015.
298.18(b) The commissioner may publish the results of the authorized uses identified
298.19in paragraph (a) so long as the data released publicly do not contain information or
298.20descriptions in which the identity of individual hospitals, clinics, or other providers may
298.21be discerned.
298.22(c) Nothing in this subdivision shall be construed to prohibit the commissioner from
298.23using the data collected under subdivision 4 to complete the state-based risk adjustment
298.24system assessment due to the legislature on October 1, 2015.
298.25(d) The commissioner or the commissioner's designee may use the data submitted
298.26under subdivisions 4 and 5 for the purpose described in paragraph (a), clause (3), until
298.27July 1, 2016.
298.28(e) The commissioner shall consult with the all-payer claims database work group
298.29established under subdivision 12 regarding the technical considerations necessary to create
298.30the public use files of summary data described in paragraph (a), clause (5).

298.31    Sec. 9. Minnesota Statutes 2014, section 62U.10, is amended by adding a subdivision
298.32to read:
298.33    Subd. 6. Projected spending baseline. Beginning February 15, 2016, and each
298.34February 15 thereafter, the commissioner of health shall report the projected impact on
298.35spending from specified health indicators related to various preventable illnesses and
299.1death. The impacts shall be reported over a ten-year time frame using a baseline forecast
299.2of private and public health care and long-term care spending for residents of this state,
299.3beginning with calendar year 2009 projected estimates of costs, and updated annually
299.4for each of the following health indicators:
299.5(1) costs related to rates of obesity, including obesity-related cancers, coronary
299.6heart disease, stroke, and arthritis;
299.7(2) costs related to the utilization of tobacco products;
299.8(3) costs related to hypertension;
299.9(4) costs related to diabetes or prediabetes; and
299.10(5) costs related to dementia and chronic disease among an elderly population over
299.1160, including additional long-term care costs.

299.12    Sec. 10. Minnesota Statutes 2014, section 62U.10, is amended by adding a subdivision
299.13to read:
299.14    Subd. 7. Outcomes reporting; savings determination. (a) Beginning November 1,
299.152016, and each November 1 thereafter, the commissioner of health shall determine the
299.16actual total private and public health care and long-term care spending for Minnesota
299.17residents related to each health indicator projected in subdivision 6 for the most recent
299.18calendar year available. The commissioner shall determine the difference between the
299.19projected and actual spending for each health indicator and for each year, and determine
299.20the savings attributable to changes in these health indicators. The assumptions and
299.21research methods used to calculate actual spending must be determined to be appropriate
299.22by an independent actuarial consultant. If the actual spending is less than the projected
299.23spending, the commissioner, in consultation with the commissioners of human services
299.24and management and budget, shall use the proportion of spending for state-administered
299.25health care programs to total private and public health care spending for each health
299.26indicator for the calendar year two years before the current calendar year to determine
299.27the percentage of the calculated aggregate savings amount accruing to state-administered
299.28health care programs.
299.29(b) The commissioner may use the data submitted under section 62U.04, subdivisions
299.304 and 5, to complete the activities required under this section, but may only report publicly
299.31on regional data aggregated to granularity of 25,000 lives or greater for this purpose.

299.32    Sec. 11. Minnesota Statutes 2014, section 62U.10, is amended by adding a subdivision
299.33to read:
300.1    Subd. 8. Transfers. When accumulated annual savings accruing to
300.2state-administered health care programs, as calculated under subdivision 7, meet or
300.3exceed $50,000,000 for all health indicators in aggregate statewide, the commissioner of
300.4health shall certify that event to the commissioner of management and budget, no later
300.5than December 15 of each year. In the next fiscal year following the certification, the
300.6commissioner of management and budget shall transfer $50,000,000 from the general
300.7fund to the health care access fund. This transfer shall repeat in each fiscal year following
300.8subsequent certifications of additional cumulative savings, up to $50,000,000 per year.
300.9The amount necessary to make the transfer is appropriated from the general fund to the
300.10commissioner of management and budget.

300.11    Sec. 12. Minnesota Statutes 2014, section 144.1501, subdivision 1, is amended to read:
300.12    Subdivision 1. Definitions. (a) For purposes of this section, the following definitions
300.13apply.
300.14(b) "Advanced dental therapist" means an individual who is licensed as a dental
300.15therapist under section 150A.06, and who is certified as an advanced dental therapist
300.16under section 150A.106.
300.17(c) "Dental therapist" means an individual who is licensed as a dental therapist
300.18under section 150A.06.
300.19(b) (d) "Dentist" means an individual who is licensed to practice dentistry.
300.20(c) (e) "Designated rural area" means a statutory and home rule charter city or
300.21township that is:
300.22(1) outside the seven-county metropolitan area as defined in section 473.121,
300.23subdivision 2; and, excluding the cities of Duluth, Mankato, Moorhead, Rochester, and
300.24St. Cloud.
300.25(2) has a population under 15,000.
300.26(d) (f) "Emergency circumstances" means those conditions that make it impossible
300.27for the participant to fulfill the service commitment, including death, total and permanent
300.28disability, or temporary disability lasting more than two years.
300.29(g) "Mental health professional" means an individual providing clinical services in
300.30the treatment of mental illness who is qualified in at least one of the ways specified in
300.31section 245.462, subdivision 18.
300.32(e) (h) "Medical resident" means an individual participating in a medical residency
300.33in family practice, internal medicine, obstetrics and gynecology, pediatrics, or psychiatry.
300.34(f) (i) "Midlevel practitioner" means a nurse practitioner, nurse-midwife, nurse
300.35anesthetist, advanced clinical nurse specialist, or physician assistant.
301.1(g) (j) "Nurse" means an individual who has completed training and received
301.2all licensing or certification necessary to perform duties as a licensed practical nurse
301.3or registered nurse.
301.4(h) (k) "Nurse-midwife" means a registered nurse who has graduated from a program
301.5of study designed to prepare registered nurses for advanced practice as nurse-midwives.
301.6(i) (l) "Nurse practitioner" means a registered nurse who has graduated from a
301.7program of study designed to prepare registered nurses for advanced practice as nurse
301.8practitioners.
301.9(j) (m) "Pharmacist" means an individual with a valid license issued under chapter
301.10151.
301.11(k) (n) "Physician" means an individual who is licensed to practice medicine in
301.12the areas of family practice, internal medicine, obstetrics and gynecology, pediatrics,
301.13or psychiatry.
301.14(l) (o) "Physician assistant" means a person licensed under chapter 147A.
301.15(p) "Public health nurse" means a registered nurse licensed in Minnesota who has
301.16obtained a registration certificate as a public health nurse from the Board of Nursing in
301.17accordance with Minnesota Rules, chapter 6316.
301.18(m) (q) "Qualified educational loan" means a government, commercial, or foundation
301.19loan for actual costs paid for tuition, reasonable education expenses, and reasonable living
301.20expenses related to the graduate or undergraduate education of a health care professional.
301.21(n) (r) "Underserved urban community" means a Minnesota urban area or population
301.22included in the list of designated primary medical care health professional shortage areas
301.23(HPSAs), medically underserved areas (MUAs), or medically underserved populations
301.24(MUPs) maintained and updated by the United States Department of Health and Human
301.25Services.

301.26    Sec. 13. Minnesota Statutes 2014, section 144.1501, subdivision 2, is amended to read:
301.27    Subd. 2. Creation of account. (a) A health professional education loan forgiveness
301.28program account is established. The commissioner of health shall use money from the
301.29account to establish a loan forgiveness program:
301.30    (1) for medical residents and mental health professionals agreeing to practice
301.31in designated rural areas or underserved urban communities or specializing in the area
301.32of pediatric psychiatry;
301.33    (2) for midlevel practitioners agreeing to practice in designated rural areas or to
301.34teach at least 12 credit hours, or 720 hours per year in the nursing field in a postsecondary
301.35program at the undergraduate level or the equivalent at the graduate level;
302.1    (3) for nurses who agree to practice in a Minnesota nursing home or; an intermediate
302.2care facility for persons with developmental disability; or a hospital if the hospital owns
302.3and operates a Minnesota nursing home and a minimum of 50 percent of the hours worked
302.4by the nurse is in the nursing home; or agree to teach at least 12 credit hours, or 720 hours
302.5per year in the nursing field in a postsecondary program at the undergraduate level or the
302.6equivalent at the graduate level;
302.7    (4) for other health care technicians agreeing to teach at least 12 credit hours, or 720
302.8hours per year in their designated field in a postsecondary program at the undergraduate
302.9level or the equivalent at the graduate level. The commissioner, in consultation with
302.10the Healthcare Education-Industry Partnership, shall determine the health care fields
302.11where the need is the greatest, including, but not limited to, respiratory therapy, clinical
302.12laboratory technology, radiologic technology, and surgical technology;
302.13    (5) for pharmacists, advanced dental therapists, dental therapists, and public health
302.14nurses who agree to practice in designated rural areas; and
302.15    (6) for dentists agreeing to deliver at least 25 percent of the dentist's yearly patient
302.16encounters to state public program enrollees or patients receiving sliding fee schedule
302.17discounts through a formal sliding fee schedule meeting the standards established by
302.18the United States Department of Health and Human Services under Code of Federal
302.19Regulations, title 42, section 51, chapter 303.
302.20    (b) Appropriations made to the account do not cancel and are available until
302.21expended, except that at the end of each biennium, any remaining balance in the account
302.22that is not committed by contract and not needed to fulfill existing commitments shall
302.23cancel to the fund.

302.24    Sec. 14. Minnesota Statutes 2014, section 144.1501, subdivision 3, is amended to read:
302.25    Subd. 3. Eligibility. (a) To be eligible to participate in the loan forgiveness program,
302.26an individual must:
302.27(1) be a medical or dental resident,; a licensed pharmacist; or be enrolled in a training
302.28or education program to become a dentist, dental therapist, advanced dental therapist,
302.29mental health professional, pharmacist, public health nurse, midlevel practitioner,
302.30registered nurse, or a licensed practical nurse training program . The commissioner may
302.31also consider applications submitted by graduates in eligible professions who are licensed
302.32and in practice; and
302.33(2) submit an application to the commissioner of health. If fewer applications are
302.34submitted by dental students or residents than there are dentist participant slots available,
303.1the commissioner may consider applications submitted by dental program graduates
303.2who are licensed dentists.
303.3(b) An applicant selected to participate must sign a contract to agree to serve a
303.4minimum three-year full-time service obligation according to subdivision 2, which
303.5shall begin no later than March 31 following completion of required training, with the
303.6exception of a nurse, who must agree to serve a minimum two-year full-time service
303.7obligation according to subdivision 2, which shall begin no later than March 31 following
303.8completion of required training.

303.9    Sec. 15. Minnesota Statutes 2014, section 144.1501, subdivision 4, is amended to read:
303.10    Subd. 4. Loan forgiveness. The commissioner of health may select applicants
303.11each year for participation in the loan forgiveness program, within the limits of available
303.12funding. In considering applications, the commissioner shall give preference to applicants
303.13who document diverse cultural competencies. The commissioner shall distribute available
303.14funds for loan forgiveness proportionally among the eligible professions according to the
303.15vacancy rate for each profession in the required geographic area, facility type, teaching
303.16area, patient group, or specialty type specified in subdivision 2. The commissioner shall
303.17allocate funds for physician loan forgiveness so that 75 percent of the funds available are
303.18used for rural physician loan forgiveness and 25 percent of the funds available are used
303.19for underserved urban communities and pediatric psychiatry loan forgiveness. If the
303.20commissioner does not receive enough qualified applicants each year to use the entire
303.21allocation of funds for any eligible profession, the remaining funds may be allocated
303.22proportionally among the other eligible professions according to the vacancy rate for
303.23each profession in the required geographic area, patient group, or facility type specified
303.24in subdivision 2. Applicants are responsible for securing their own qualified educational
303.25loans. The commissioner shall select participants based on their suitability for practice
303.26serving the required geographic area or facility type specified in subdivision 2, as indicated
303.27by experience or training. The commissioner shall give preference to applicants closest to
303.28completing their training. For each year that a participant meets the service obligation
303.29required under subdivision 3, up to a maximum of four years, the commissioner shall make
303.30annual disbursements directly to the participant equivalent to 15 percent of the average
303.31educational debt for indebted graduates in their profession in the year closest to the
303.32applicant's selection for which information is available, not to exceed the balance of the
303.33participant's qualifying educational loans. Before receiving loan repayment disbursements
303.34and as requested, the participant must complete and return to the commissioner a
303.35confirmation of practice form provided by the commissioner verifying that the participant
304.1is practicing as required under subdivisions 2 and 3. The participant must provide the
304.2commissioner with verification that the full amount of loan repayment disbursement
304.3received by the participant has been applied toward the designated loans. After each
304.4disbursement, verification must be received by the commissioner and approved before the
304.5next loan repayment disbursement is made. Participants who move their practice remain
304.6eligible for loan repayment as long as they practice as required under subdivision 2.

304.7    Sec. 16. [144.1506] PRIMARY CARE RESIDENCY EXPANSION GRANT
304.8PROGRAM.
304.9    Subdivision 1. Definitions. For purposes of this section, the following definitions
304.10apply:
304.11(1) "eligible primary care residency program" means a program that meets the
304.12following criteria:
304.13(i) is located in Minnesota;
304.14(ii) trains medical residents in the specialties of family medicine, general internal
304.15medicine, general pediatrics, psychiatry, geriatrics, or general surgery; and
304.16(iii) is accredited by the Accreditation Council for Graduate Medical Education or
304.17presents a credible plan to obtain accreditation;
304.18(2) "eligible project" means a project to establish a new eligible primary care
304.19residency program or create at least one new residency slot in an existing eligible primary
304.20care residency program; and
304.21(3) "new residency slot" means the creation of a new residency position and the
304.22execution of a contract with a new resident in a residency program.
304.23    Subd. 2. Expansion grant program. (a) The commissioner of health shall award
304.24primary care residency expansion grants to eligible primary care residency programs to
304.25plan and implement new residency slots. A planning grant shall not exceed $75,000, and a
304.26training grant shall not exceed $150,000 per new residency slot for the first year, $100,000
304.27for the second year, and $50,000 for the third year of the new residency slot.
304.28(b) Funds may be spent to cover the costs of:
304.29(1) planning related to establishing an accredited primary care residency program;
304.30(2) obtaining accreditation by the Accreditation Council for Graduate Medical
304.31Education or another national body that accredits residency programs;
304.32(3) establishing new residency programs or new resident training slots;
304.33(4) recruitment, training, and retention of new residents and faculty;
304.34(5) travel and lodging for new residents;
304.35(6) faculty, new resident, and preceptor salaries related to new residency slots;
305.1(7) training site improvements, fees, equipment, and supplies required for new
305.2primary care resident training slots; and
305.3(8) supporting clinical education in which trainees are part of a primary care team
305.4model.
305.5    Subd. 3. Applications for expansion grants. Eligible primary care residency
305.6programs seeking a grant shall apply to the commissioner. Applications must include the
305.7number of new primary care residency slots planned or under contract; attestation that
305.8funding will be used to support an increase in the number of available residency slots;
305.9a description of the training to be received by the new residents, including the location
305.10of training; a description of the project, including all costs associated with the project;
305.11all sources of funds for the project; detailed uses of all funds for the project; the results
305.12expected; and a plan to maintain the new residency slot after the grant period. The
305.13applicant must describe achievable objectives, a timetable, and roles and capabilities of
305.14responsible individuals in the organization.
305.15    Subd. 4. Consideration of expansion grant applications. The commissioner shall
305.16review each application to determine whether or not the residency program application
305.17is complete and whether the proposed new residency program and any new residency
305.18slots are eligible for a grant. The commissioner shall award grants to support up to six
305.19family medicine, general internal medicine, or general pediatrics residents; four psychiatry
305.20residents; two geriatrics residents; and two general surgery residents. If insufficient
305.21applications are received from any eligible specialty, funds may be redistributed to
305.22applications from other eligible specialties.
305.23    Subd. 5. Program oversight. During the grant period, the commissioner may
305.24require and collect from grantees any information necessary to evaluate the program.
305.25Appropriations made to the program do not cancel and are available until expended.

305.26    Sec. 17. [144.1911] INTERNATIONAL MEDICAL GRADUATES ASSISTANCE
305.27PROGRAM.
305.28    Subdivision 1. Establishment. The international medical graduates assistance
305.29program is established to address barriers to practice and facilitate pathways to assist
305.30immigrant international medical graduates to integrate into the Minnesota health
305.31care delivery system, with the goal of increasing access to primary care in rural and
305.32underserved areas of the state.
305.33    Subd. 2. Definitions. (a) For the purposes of this section, the following terms
305.34have the meanings given.
305.35(b) "Commissioner" means the commissioner of health.
306.1(c) "Immigrant international medical graduate" means an international medical
306.2graduate who was born outside the United States, now resides permanently in the United
306.3States, and who did not enter the United States on a J1 or similar nonimmigrant visa
306.4following acceptance into a United States medical residency or fellowship program.
306.5(d) "International medical graduate" means a physician who received a basic medical
306.6degree or qualification from a medical school located outside the United States and Canada.
306.7(e) "Minnesota immigrant international medical graduate" means an immigrant
306.8international medical graduate who has lived in Minnesota for at least two years.
306.9(f) "Rural community" means a statutory and home rule charter city or township that
306.10is outside the seven-county metropolitan area as defined in section 473.121, subdivision 2,
306.11excluding the cities of Duluth, Mankato, Moorhead, Rochester, and St. Cloud.
306.12(g) "Underserved community" means a Minnesota area or population included in
306.13the list of designated primary medical care health professional shortage areas, medically
306.14underserved areas, or medically underserved populations (MUPs) maintained and updated
306.15by the United States Department of Health and Human Services.
306.16    Subd. 3. Program administration. (a) In administering the international medical
306.17graduates assistance program, the commissioner shall:
306.18(1) provide overall coordination for the planning, development, and implementation
306.19of a comprehensive system for integrating qualified immigrant international medical
306.20graduates into the Minnesota health care delivery system, particularly those willing to
306.21serve in rural or underserved communities of the state;
306.22(2) develop and maintain, in partnership with community organizations working
306.23with international medical graduates, a voluntary roster of immigrant international medical
306.24graduates interested in entering the Minnesota health workforce to assist in planning
306.25and program administration, including making available summary reports that show the
306.26aggregate number and distribution, by geography and specialty, of immigrant international
306.27medical graduates in Minnesota;
306.28(3) work with graduate clinical medical training programs to address barriers
306.29faced by immigrant international medical graduates in securing residency positions in
306.30Minnesota, including the requirement that applicants for residency positions be recent
306.31graduates of medical school. The annual report required in subdivision 10 shall include
306.32any progress in addressing these barriers;
306.33(4) develop a system to assess and certify the clinical readiness of eligible immigrant
306.34international medical graduates to serve in a residency program. The system shall
306.35include assessment methods, an operating plan, and a budget. Initially, the commissioner
306.36may develop assessments for clinical readiness for practice of one or more primary
307.1care specialties, and shall add additional assessments as resources are available. The
307.2commissioner may contract with an independent entity or another state agency to conduct
307.3the assessments. In order to be assessed for clinical readiness for residency, an eligible
307.4international medical graduate must have obtained a certification from the Educational
307.5Commission of Foreign Medical Graduates. The commissioner shall issue a Minnesota
307.6certificate of clinical readiness for residency to those who pass the assessment;
307.7(5) explore and facilitate more streamlined pathways for immigrant international
307.8medical graduates to serve in nonphysician professions in the Minnesota workforce; and
307.9(6) study, in consultation with the Board of Medical Practice and other stakeholders,
307.10changes necessary in health professional licensure and regulation to ensure full utilization
307.11of immigrant international medical graduates in the Minnesota health care delivery
307.12system. The commissioner shall include recommendations in the annual report required
307.13under subdivision 10, due January 15, 2017.
307.14    Subd. 4. Career guidance and support services. (a) The commissioner shall
307.15award grants to eligible nonprofit organizations to provide career guidance and support
307.16services to immigrant international medical graduates seeking to enter the Minnesota
307.17health workforce. Eligible grant activities include the following:
307.18(1) educational and career navigation, including information on training and
307.19licensing requirements for physician and nonphysician health care professions, and
307.20guidance in determining which pathway is best suited for an individual international
307.21medical graduate based on the graduate's skills, experience, resources, and interests;
307.22(2) support in becoming proficient in medical English;
307.23(3) support in becoming proficient in the use of information technology, including
307.24computer skills and use of electronic health record technology;
307.25(4) support for increasing knowledge of and familiarity with the United States
307.26health care system;
307.27(5) support for other foundational skills identified by the commissioner;
307.28(6) support for immigrant international medical graduates in becoming certified
307.29by the Educational Commission on Foreign Medical Graduates, including help with
307.30preparation for required licensing examinations and financial assistance for fees; and
307.31(7) assistance to international medical graduates in registering with the program's
307.32Minnesota international medical graduate roster.
307.33(b) The commissioner shall award the initial grants under this subdivision by
307.34December 31, 2015.
308.1    Subd. 5. Clinical preparation. (a) The commissioner shall award grants to support
308.2clinical preparation for Minnesota international medical graduates needing additional
308.3clinical preparation or experience to qualify for residency. The grant program shall include:
308.4(1) proposed training curricula;
308.5(2) associated policies and procedures for clinical training sites, which must be part
308.6of existing clinical medical education programs in Minnesota; and
308.7(3) monthly stipends for international medical graduate participants. Priority shall
308.8be given to primary care sites in rural or underserved areas of the state, and international
308.9medical graduate participants must commit to serving at least five years in a rural or
308.10underserved community of the state.
308.11(b) The policies and procedures for the clinical preparation grants must be developed
308.12by December 31, 2015, including an implementation schedule that begins awarding grants
308.13to clinical preparation programs beginning in June of 2016.
308.14    Subd. 6. International medical graduate primary care residency grant program
308.15and revolving account. (a) The commissioner shall award grants to support primary
308.16care residency positions designated for Minnesota immigrant physicians who are willing
308.17to serve in rural or underserved areas of the state. No grant shall exceed $150,000 per
308.18residency position per year. Eligible primary care residency grant recipients include
308.19accredited family medicine, internal medicine, obstetrics and gynecology, psychiatry, and
308.20pediatric residency programs. Eligible primary care residency programs shall apply to the
308.21commissioner. Applications must include the number of anticipated residents to be funded
308.22using grant funds and a budget. Notwithstanding any law to the contrary, funds awarded
308.23to grantees in a grant agreement do not lapse until the grant agreement expires. Before any
308.24funds are distributed, a grant recipient shall provide the commissioner with the following:
308.25(1) a copy of the signed contract between the primary care residency program and
308.26the participating international medical graduate;
308.27(2) certification that the participating international medical graduate has lived in
308.28Minnesota for at least two years and is certified by the Educational Commission on
308.29Foreign Medical Graduates. Residency programs may also require that participating
308.30international medical graduates hold a Minnesota certificate of clinical readiness for
308.31residency, once the certificates become available; and
308.32(3) verification that the participating international medical graduate has executed a
308.33participant agreement pursuant to paragraph (b).
308.34(b) Upon acceptance by a participating residency program, international medical
308.35graduates shall enter into an agreement with the commissioner to provide primary
308.36care for at least five years in a rural or underserved area of Minnesota after graduating
309.1from the residency program and make payments to the revolving international medical
309.2graduate residency account for five years beginning in their second year of postresidency
309.3employment. Participants shall pay $15,000 or ten percent of their annual compensation
309.4each year, whichever is less.
309.5(c) A revolving international medical graduate residency account is established
309.6as an account in the special revenue fund in the state treasury. The commissioner of
309.7management and budget shall credit to the account appropriations, payments, and
309.8transfers to the account. Earnings, such as interest, dividends, and any other earnings
309.9arising from fund assets, must be credited to the account. Funds in the account are
309.10appropriated annually to the commissioner to award grants and administer the grant
309.11program established in paragraph (a). Notwithstanding any law to the contrary, any funds
309.12deposited in the account do not expire. The commissioner may accept contributions to the
309.13account from private sector entities subject to the following provisions:
309.14(1) the contributing entity may not specify the recipient or recipients of any grant
309.15issued under this subdivision;
309.16(2) the commissioner shall make public the identity of any private contributor to the
309.17account, as well as the amount of the contribution provided; and
309.18(3) a contributing entity may not specify that the recipient or recipients of any funds
309.19use specific products or services, nor may the contributing entity imply that a contribution
309.20is an endorsement of any specific product or service.
309.21    Subd. 7. Voluntary hospital programs. A hospital may establish residency
309.22programs for foreign-trained physicians to become candidates for licensure to practice
309.23medicine in the state of Minnesota. A hospital may partner with organizations, such as
309.24the New Americans Alliance for Development, to screen for and identify foreign-trained
309.25physicians eligible for a hospital's particular residency program.
309.26    Subd. 8. Board of Medical Practice. Nothing in this section alters the authority of
309.27the Board of Medical Practice to regulate the practice of medicine.
309.28    Subd. 9. Consultation with stakeholders. The commissioner shall administer the
309.29international medical graduates assistance program, including the grant programs described
309.30under subdivisions 4, 5, and 6, in consultation with representatives of the following sectors:
309.31(1) state agencies:
309.32(i) Board of Medical Practice;
309.33(ii) Office of Higher Education; and
309.34(iii) Department of Employment and Economic Development;
309.35(2) health care industry:
309.36(i) a health care employer in a rural or underserved area of Minnesota;
310.1(ii) a health plan company;
310.2(iii) the Minnesota Medical Association;
310.3(iv) licensed physicians experienced in working with international medical
310.4graduates; and
310.5(v) the Minnesota Academy of Physician Assistants;
310.6(3) community-based organizations:
310.7(i) organizations serving immigrant and refugee communities of Minnesota;
310.8(ii) organizations serving the international medical graduate community, such as the
310.9New Americans Alliance for Development and Women's Initiative for Self Empowerment;
310.10and
310.11(iii) the Minnesota Association of Community Health Centers;
310.12(4) higher education:
310.13(i) University of Minnesota;
310.14(ii) Mayo Clinic School of Health Professions;
310.15(iii) graduate medical education programs not located at the University of Minnesota
310.16or Mayo Clinic School of Health Professions; and
310.17(iv) Minnesota physician assistant education program; and
310.18(5) two international medical graduates.
310.19    Subd. 10. Report. The commissioner shall submit an annual report to the chairs and
310.20ranking minority members of the legislative committees with jurisdiction over health care
310.21and higher education on the progress of the integration of international medical graduates
310.22into the Minnesota health care delivery system. The report shall include recommendations
310.23on actions needed for continued progress integrating international medical graduates. The
310.24report shall be submitted by January 15 each year, beginning January 15, 2016.

310.25    Sec. 18. Minnesota Statutes 2014, section 144.291, subdivision 2, is amended to read:
310.26    Subd. 2. Definitions. For the purposes of sections 144.291 to 144.298, the following
310.27terms have the meanings given.
310.28    (a) "Group purchaser" has the meaning given in section 62J.03, subdivision 6.
310.29    (b) "Health information exchange" means a legal arrangement between health care
310.30providers and group purchasers to enable and oversee the business and legal issues
310.31involved in the electronic exchange of health records between the entities for the delivery
310.32of patient care.
310.33    (c) "Health record" means any information, whether oral or recorded in any form or
310.34medium, that relates to the past, present, or future physical or mental health or condition of
311.1a patient; the provision of health care to a patient; or the past, present, or future payment
311.2for the provision of health care to a patient.
311.3    (d) "Identifying information" means the patient's name, address, date of birth,
311.4gender, parent's or guardian's name regardless of the age of the patient, and other
311.5nonclinical data which can be used to uniquely identify a patient.
311.6    (e) "Individually identifiable form" means a form in which the patient is or can be
311.7identified as the subject of the health records.
311.8    (f) "Medical emergency" means medically necessary care which is immediately
311.9needed to preserve life, prevent serious impairment to bodily functions, organs, or parts,
311.10or prevent placing the physical or mental health of the patient in serious jeopardy.
311.11    (g) "Patient" means a natural person who has received health care services from a
311.12provider for treatment or examination of a medical, psychiatric, or mental condition, the
311.13surviving spouse and parents of a deceased patient, or a person the patient appoints in
311.14writing as a representative, including a health care agent acting according to chapter 145C,
311.15unless the authority of the agent has been limited by the principal in the principal's health
311.16care directive. Except for minors who have received health care services under sections
311.17144.341 to 144.347, in the case of a minor, patient includes a parent or guardian, or a
311.18person acting as a parent or guardian in the absence of a parent or guardian.
311.19(h) "Patient information service" means a service providing the following query
311.20options: a record locator service as defined in section 144.291, subdivision 2, paragraph
311.21(i), or a master patient index or clinical data repository as defined in section 62J.498,
311.22subdivision 1.
311.23    (h) (i) "Provider" means:
311.24    (1) any person who furnishes health care services and is regulated to furnish the
311.25services under chapter 147, 147A, 147B, 147C, 147D, 148, 148B, 148D, 148F, 150A,
311.26151, 153, or 153A;
311.27    (2) a home care provider licensed under section 144A.46 144A.471;
311.28    (3) a health care facility licensed under this chapter or chapter 144A; and
311.29    (4) a physician assistant registered under chapter 147A.
311.30    (i) (j) "Record locator service" means an electronic index of patient identifying
311.31information that directs providers in a health information exchange to the location of
311.32patient health records held by providers and group purchasers.
311.33    (j) (k) "Related health care entity" means an affiliate, as defined in section 144.6521,
311.34subdivision 3 , paragraph (b), of the provider releasing the health records.

311.35    Sec. 19. Minnesota Statutes 2014, section 144.293, subdivision 5, is amended to read:
312.1    Subd. 5. Exceptions to consent requirement. (a) This section does not prohibit the
312.2release of health records:
312.3    (1) for a medical emergency when the provider is unable to obtain the patient's
312.4consent due to the patient's condition or the nature of the medical emergency;
312.5    (2) to other providers within related health care entities when necessary for the
312.6current treatment of the patient; or
312.7    (3) to a health care facility licensed by this chapter, chapter 144A, or to the same
312.8types of health care facilities licensed by this chapter and chapter 144A that are licensed
312.9in another state when a patient:
312.10    (i) is returning to the health care facility and unable to provide consent; or
312.11    (ii) who resides in the health care facility, has services provided by an outside
312.12resource under Code of Federal Regulations, title 42, section 483.75(h), and is unable
312.13to provide consent.
312.14(b) A provider may release a deceased patient's health care records to another provider
312.15for the purposes of diagnosing or treating the deceased patient's surviving adult child.
312.16EFFECTIVE DATE.This section is effective the day following final enactment.

312.17    Sec. 20. Minnesota Statutes 2014, section 144.293, subdivision 8, is amended to read:
312.18    Subd. 8. Record locator or patient information service. (a) A provider or group
312.19purchaser may release patient identifying information and information about the location
312.20of the patient's health records to a record locator or patient information service without
312.21consent from the patient, unless the patient has elected to be excluded from the service
312.22under paragraph (d). The Department of Health may not access the record locator or
312.23patient information service or receive data from the record locator service. Only a
312.24provider may have access to patient identifying information in a record locator or patient
312.25information service. Except in the case of a medical emergency, a provider participating in
312.26a health information exchange using a record locator or patient information service does
312.27not have access to patient identifying information and information about the location of
312.28the patient's health records unless the patient specifically consents to the access. A consent
312.29does not expire but may be revoked by the patient at any time by providing written notice
312.30of the revocation to the provider.
312.31    (b) A health information exchange maintaining a record locator or patient
312.32information service must maintain an audit log of providers accessing information in a
312.33record locator the service that at least contains information on:
312.34    (1) the identity of the provider accessing the information;
312.35    (2) the identity of the patient whose information was accessed by the provider; and
313.1    (3) the date the information was accessed.
313.2    (c) No group purchaser may in any way require a provider to participate in a record
313.3locator or patient information service as a condition of payment or participation.
313.4    (d) A provider or an entity operating a record locator or patient information service
313.5must provide a mechanism under which patients may exclude their identifying information
313.6and information about the location of their health records from a record locator or patient
313.7information service. At a minimum, a consent form that permits a provider to access
313.8a record locator or patient information service must include a conspicuous check-box
313.9option that allows a patient to exclude all of the patient's information from the record
313.10locator service. A provider participating in a health information exchange with a record
313.11locator or patient information service who receives a patient's request to exclude all of the
313.12patient's information from the record locator service or to have a specific provider contact
313.13excluded from the record locator service is responsible for removing that information
313.14from the record locator service.

313.15    Sec. 21. Minnesota Statutes 2014, section 144.298, subdivision 2, is amended to read:
313.16    Subd. 2. Liability of provider or other person. A person who does any of the
313.17following is liable to the patient for compensatory damages caused by an unauthorized
313.18release or an intentional, unauthorized access, plus costs and reasonable attorney fees:
313.19    (1) negligently or intentionally requests or releases a health record in violation
313.20of sections 144.291 to 144.297;
313.21    (2) forges a signature on a consent form or materially alters the consent form of
313.22another person without the person's consent;
313.23    (3) obtains a consent form or the health records of another person under false
313.24pretenses; or
313.25(4) intentionally violates sections 144.291 to 144.297 by intentionally accessing a
313.26record locator or patient information service without authorization.

313.27    Sec. 22. Minnesota Statutes 2014, section 144.298, subdivision 3, is amended to read:
313.28    Subd. 3. Liability for record locator or patient information service. A patient
313.29is entitled to receive compensatory damages plus costs and reasonable attorney fees
313.30if a health information exchange maintaining a record locator or patient information
313.31service, or an entity maintaining a record locator or patient information service for a
313.32health information exchange, negligently or intentionally violates the provisions of section
313.33144.293, subdivision 8 .

314.1    Sec. 23. [144.3875] EARLY DENTAL PREVENTION INITIATIVE.
314.2(a) The commissioner of health, in collaboration with the commissioner of human
314.3services, shall implement a statewide initiative to increase awareness among communities
314.4of color and recent immigrants on the importance of early preventive dental intervention
314.5for infants and toddlers before and after primary teeth appear.
314.6(b) The commissioner shall develop educational materials and information for
314.7expectant and new parents within the targeted communities that include the importance
314.8of early dental care to prevent early cavities, including proper cleaning techniques and
314.9feeding habits, before and after primary teeth appear.
314.10(c) The commissioner shall develop a distribution plan to ensure that the materials
314.11are distributed to expectant and new parents within the targeted communities, including,
314.12but not limited to, making the materials available to health care providers, community
314.13clinics, WIC sites, and other relevant sites within the targeted communities.
314.14(d) In developing these materials and distribution plan, the commissioner shall work
314.15collaboratively with members of the targeted communities, dental providers, pediatricians,
314.16child care providers, and home visiting nurses.
314.17(e) The commissioner shall, with input from stakeholders listed in paragraph (d),
314.18develop and pilot incentives to encourage early dental care within one year of an infant's
314.19teeth erupting.

314.20    Sec. 24. [144.4961] MINNESOTA RADON LICENSING ACT.
314.21    Subdivision 1. Citation. This section may be cited as the "Minnesota Radon
314.22Licensing Act."
314.23    Subd. 2. Definitions. (a) As used in this section, the following terms have the
314.24meanings given them.
314.25(b) "Mitigation" means the act of repairing or altering a building or building design
314.26for the purpose in whole or in part of reducing the concentration of radon in the indoor
314.27atmosphere.
314.28(c) "Radon" means both the radioactive, gaseous element produced by the
314.29disintegration of radium, and the short-lived radionuclides that are decay products of radon.
314.30    Subd. 3. Rulemaking. The commissioner of health shall adopt rules for licensure
314.31and enforcement of applicable laws and rules relating to indoor radon in dwellings and
314.32other buildings, with the exception of newly constructed Minnesota homes according
314.33to section 326B.106, subdivision 6. The commissioner shall coordinate, oversee, and
314.34implement all state functions in matters concerning the presence, effects, measurement,
314.35and mitigation of risks of radon in dwellings and other buildings.
315.1    Subd. 4. System tag. All radon mitigation systems installed in Minnesota on or after
315.2October 1, 2017, must have a radon mitigation system tag provided by the commissioner.
315.3A radon mitigation professional must attach the tag to the radon mitigation system in
315.4a visible location.
315.5    Subd. 5. License required annually. A license is required annually for every
315.6person, firm, or corporation that sells a device or performs a service for compensation
315.7to detect the presence of radon in the indoor atmosphere, performs laboratory analysis,
315.8or performs a service to mitigate radon in the indoor atmosphere. This section does not
315.9apply to retail stores that only sell or distribute radon sampling but are not engaged in the
315.10manufacture of radon sampling devices.
315.11    Subd. 6. Exemptions. Radon systems installed in newly constructed Minnesota
315.12homes according to section 326B.106, subdivision 6, prior to the issuance of a certificate
315.13of occupancy are not required to follow the requirements of this section.
315.14    Subd. 7. License applications and other reports. The professionals, companies,
315.15and laboratories listed in subdivision 8 must submit applications for licenses, system
315.16tags, and any other reporting required under this section and Minnesota Rules on forms
315.17prescribed by the commissioner.
315.18    Subd. 8. Licensing fees. (a) All radon license applications submitted to the
315.19commissioner of health must be accompanied by the required fees. If the commissioner
315.20determines that insufficient fees were paid, the necessary additional fees must be paid
315.21before the commissioner approves the application. The commissioner shall charge the
315.22following fees for each radon license:
315.23(1) Each measurement professional license, $300 per year. "Measurement
315.24professional" means any person who performs a test to determine the presence and
315.25concentration of radon in a building they do not own or lease; provides professional or
315.26expert advice on radon testing, radon exposure, or health risks related to radon exposure;
315.27or makes representations of doing any of these activities.
315.28(2) Each mitigation professional license, $500 per year. "Mitigation professional"
315.29means an individual who performs radon mitigation in a building they do not own or
315.30lease; provides professional or expert advice on radon mitigation or radon entry routes;
315.31or provides on-site supervision of radon mitigation and mitigation technicians; or makes
315.32representations of doing any of these activities. This license also permits the licensee to
315.33perform the activities of a measurement professional described in clause (1).
315.34(3) Each mitigation company license, $500 per year. "Mitigation company" means
315.35any business or government entity that performs or authorizes employees to perform radon
315.36mitigation. This fee is waived if the company is a sole proprietorship.
316.1(4) Each radon analysis laboratory license, $500 per year. "Radon analysis
316.2laboratory" means a business entity or government entity that analyzes passive radon
316.3detection devices to determine the presence and concentration of radon in the devices.
316.4This fee is waived if the laboratory is a government entity and is only distributing test kits
316.5for the general public to use in Minnesota.
316.6(5) Each Minnesota Department of Health radon mitigation system tag, $75 per tag.
316.7"Minnesota Department of Health radon mitigation system tag" or "system tag" means a
316.8unique identifiable radon system label provided by the commissioner of health.
316.9(b) Fees collected under this section shall be deposited in the state treasury and
316.10credited to the state government special revenue fund.
316.11    Subd. 9. Enforcement. The commissioner shall enforce this section under the
316.12provisions of sections 144.989 to 144.993.
316.13EFFECTIVE DATE.This section is effective July 1, 2015, except subdivisions 4
316.14and 5, which are effective October 1, 2017.

316.15    Sec. 25. [144.566] VIOLENCE AGAINST HEALTH CARE WORKERS.
316.16    Subdivision 1. Definitions. (a) The following definitions apply to this section and
316.17have the meanings given.
316.18(b) "Act of violence" means an act by a patient or visitor against a health care
316.19worker that includes kicking, scratching, urinating, sexually harassing, or any act defined
316.20in sections 609.221 to 609.2241.
316.21(c) "Commissioner" means the commissioner of health.
316.22(d) "Health care worker" means any person, whether licensed or unlicensed,
316.23employed by, volunteering in, or under contract with a hospital, who has direct contact
316.24with a patient of the hospital for purposes of either medical care or emergency response to
316.25situations potentially involving violence.
316.26(e) "Hospital" means any facility licensed as a hospital under section 144.55.
316.27(f) "Incident response" means the actions taken by hospital administration and health
316.28care workers during and following an act of violence.
316.29(g) "Interfere" means to prevent, impede, discourage, or delay a health care worker's
316.30ability to report acts of violence, including by retaliating or threatening to retaliate against
316.31a health care worker.
316.32(h) "Preparedness" means the actions taken by hospital administration and health
316.33care workers to prevent a single act of violence or acts of violence generally.
317.1(i) "Retaliate" means to discharge, discipline, threaten, otherwise discriminate
317.2against, or penalize a health care worker regarding the health care worker's compensation,
317.3terms, conditions, location, or privileges of employment.
317.4    Subd. 2. Hospital duties. (a) All hospitals must design and implement preparedness
317.5and incident response action plans to acts of violence by January 15, 2016, and review the
317.6plan at least annually thereafter.
317.7(b) A hospital shall designate a committee of representatives of health care workers
317.8employed by the hospital, including nonmanagerial health care workers, nonclinical
317.9staff, administrators, patient safety experts, and other appropriate personnel to develop
317.10preparedness and incident response action plans to acts of violence. The hospital shall, in
317.11consultation with the designated committee, implement the plans under paragraph (a).
317.12Nothing in this paragraph shall require the establishment of a separate committee solely
317.13for the purpose required by this subdivision.
317.14(c) A hospital shall provide training to all health care workers employed or
317.15contracted with the hospital on safety during acts of violence. Each health care worker
317.16must receive safety training annually and upon hire. Training must, at a minimum, include:
317.17(1) safety guidelines for response to and de-escalation of an act of violence;
317.18(2) ways to identify potentially violent or abusive situations; and
317.19(3) the hospital's incident response reaction plan and violence prevention plan.
317.20(d) As part of its annual review required under paragraph (a), the hospital must
317.21review with the designated committee:
317.22(1) the effectiveness of its preparedness and incident response action plans;
317.23(2) the most recent gap analysis as provided by the commissioner; and
317.24(3) the number of acts of violence that occurred in the hospital during the previous
317.25year, including injuries sustained, if any, and the unit in which the incident occurred.
317.26(e) A hospital shall make its action plans and the information listed in paragraph
317.27(d) available to local law enforcement and, if any of its workers are represented by a
317.28collective bargaining unit, to the exclusive bargaining representatives of those collective
317.29bargaining units.
317.30(f) A hospital, including any individual, partner, association, or any person or group
317.31of persons acting directly or indirectly in the interest of the hospital, shall not interfere
317.32with or discourage a health care worker if the health care worker wishes to contact law
317.33enforcement or the commissioner regarding an act of violence.
317.34(g) The commissioner may impose an administrative fine of up to $250 for failure to
317.35comply with the requirements of subdivision 2.

318.1    Sec. 26. [144.586] REQUIREMENTS FOR CERTAIN NOTICES AND
318.2DISCHARGE PLANNING.
318.3    Subdivision 1. Observation stay notice. (a) Each hospital, as defined under
318.4section 144.50, subdivision 2, shall provide oral and written notice to each patient that
318.5the hospital places in observation status of such placement not later than 24 hours after
318.6such placement. The oral and written notices must include:
318.7(1) a statement that the patient is not admitted to the hospital but is under observation
318.8status;
318.9(2) a statement that observation status may affect the patient's Medicare coverage for:
318.10(i) hospital services, including medications and pharmaceutical supplies; or
318.11(ii) home or community-based care or care at a skilled nursing facility upon the
318.12patient's discharge; and
318.13(3) a recommendation that the patient contact the patient's health insurance provider
318.14or the Office of the Ombudsman for Long-Term Care or Office of the Ombudsman for
318.15State Managed Health Care Programs or the Beneficiary and Family Centered Care
318.16Quality Improvement Organization to better understand the implications of placement in
318.17observation status.
318.18(b) The hospital shall document the date in the patient's record that the notice
318.19required in paragraph (a) was provided to the patient, the patient's designated
318.20representative such as the patient's health care agent, legal guardian, conservator, or
318.21another person acting as the patient's representative.
318.22    Subd. 2. Postacute care discharge planning. Each hospital, including hospitals
318.23designated as critical access hospitals, must comply with the federal hospital requirements
318.24for discharge planning which include:
318.25(1) conducting a discharge planning evaluation that includes an evaluation of:
318.26(i) the likelihood of the patient needing posthospital services and of the availability
318.27of those services; and
318.28(ii) the patient's capacity for self-care or the possibility of the patient being cared for
318.29in the environment from which the patient entered the hospital;
318.30(2) timely completion of the discharge planning evaluation under clause (1) by
318.31hospital personnel so that appropriate arrangements for posthospital care are made before
318.32discharge, and to avoid unnecessary delays in discharge;
318.33(3) including the discharge planning evaluation under clause (1) in the patient's
318.34medical record for use in establishing an appropriate discharge plan. The hospital must
318.35discuss the results of the evaluation with the patient or individual acting on behalf of the
318.36patient. The hospital must reassess the patient's discharge plan if the hospital determines
319.1that there are factors that may affect continuing care needs or the appropriateness of
319.2the discharge plan; and
319.3(4) providing counseling, as needed, for the patient and family members or interested
319.4persons to prepare them for posthospital care. The hospital must provide a list of available
319.5Medicare-eligible home care agencies or skilled nursing facilities that serve the patient's
319.6geographic area, or other area requested by the patient if such care or placement is
319.7indicated and appropriate. Once the patient has designated their preferred providers, the
319.8hospital will assist the patient in securing care covered by their health plan or within the
319.9care network. The hospital must not specify or otherwise limit the qualified providers that
319.10are available to the patient. The hospital must document in the patient's record that the list
319.11was presented to the patient or to the individual acting on the patient's behalf.

319.12    Sec. 27. Minnesota Statutes 2014, section 144.9501, subdivision 6d, is amended to read:
319.13    Subd. 6d. Certified lead firm. "Certified lead firm" means a person that employs
319.14individuals to perform regulated lead work, with the exception of renovation, and that
319.15is certified by the commissioner under section 144.9505.

319.16    Sec. 28. Minnesota Statutes 2014, section 144.9501, is amended by adding a
319.17subdivision to read:
319.18    Subd. 6e. Certified renovation firm. "Certified renovation firm" means a person
319.19that employs individuals to perform renovation and is certified by the commissioner
319.20under section 144.9505.

319.21    Sec. 29. Minnesota Statutes 2014, section 144.9501, subdivision 22b, is amended to
319.22read:
319.23    Subd. 22b. Lead sampling technician. "Lead sampling technician" means an
319.24individual who performs clearance inspections for renovation sites and lead dust sampling
319.25for nonabatement sites, and who is registered with the commissioner under section
319.26144.9505.
319.27EFFECTIVE DATE.This section is effective July 1, 2016.

319.28    Sec. 30. Minnesota Statutes 2014, section 144.9501, subdivision 26b, is amended to
319.29read:
319.30    Subd. 26b. Renovation. "Renovation" means the modification of any pre-1978
319.31affected property that results in the disturbance of known or presumed lead-containing
319.32painted surfaces defined under section 144.9508, unless that activity is performed as an
320.1abatement lead hazard reduction. A renovation performed for the purpose of converting a
320.2building or part of a building into an affected property is a renovation under this subdivision.
320.3EFFECTIVE DATE.This section is effective July 1, 2016.

320.4    Sec. 31. Minnesota Statutes 2014, section 144.9501, is amended by adding a
320.5subdivision to read:
320.6    Subd. 26c. Lead renovator. "Lead renovator" means an individual who directs
320.7individuals who perform renovations. A lead renovator also performs renovation, surface
320.8coating testing, and cleaning verification.
320.9EFFECTIVE DATE.This section is effective July 1, 2016.

320.10    Sec. 32. Minnesota Statutes 2014, section 144.9505, is amended to read:
320.11144.9505 LICENSING CREDENTIALING OF LEAD FIRMS AND
320.12PROFESSIONALS.
320.13    Subdivision 1. Licensing and, certification; generally, and permitting. (a) All
320.14Fees received shall be paid collected under this section shall be deposited into the state
320.15treasury and credited to the lead abatement licensing and certification account and are
320.16appropriated to the commissioner to cover costs incurred under this section and section
320.17144.9508 state government special revenue fund.
320.18(b) Persons shall not advertise or otherwise present themselves as lead supervisors,
320.19lead workers, lead inspectors, lead risk assessors, lead sampling technicians, lead project
320.20designers, or renovation firms, or lead firms unless they have licenses or certificates issued
320.21by or are registered with the commissioner under this section.
320.22(c) The fees required in this section for inspectors, risk assessors, and certified lead
320.23firms are waived for state or local government employees performing services for or
320.24as an assessing agency.
320.25(d) An individual who is the owner of property on which regulated lead work is to be
320.26performed or an adult individual who is related to the property owner, as defined under
320.27section 245A.02, subdivision 13, is exempt from the requirements to obtain a license and
320.28pay a fee according to this section.
320.29(e) A person that employs individuals to perform regulated lead work outside of the
320.30person's property must obtain certification as a certified lead firm. An individual who
320.31performs regulated lead work lead hazard reduction, lead hazard screens, lead inspections,
320.32lead risk assessments, clearance inspections, lead project designer services, lead sampling
320.33technician services, swab team services, and activities performed to comply with lead
321.1orders must be employed by a certified lead firm, unless the individual is a sole proprietor
321.2and does not employ any other individual who performs regulated lead work individuals,
321.3the individual is employed by a person that does not perform regulated lead work outside
321.4of the person's property, or the individual is employed by an assessing agency.
321.5    Subd. 1a. Lead worker license. Before an individual performs regulated lead work
321.6as a worker, the individual shall first obtain a license from the commissioner. No license
321.7shall be issued unless the individual shows evidence of successfully completing a training
321.8course in lead hazard control. The commissioner shall specify the course of training and
321.9testing requirements and shall charge a $50 fee annually for the license. License fees are
321.10nonrefundable and must be submitted with each application. The license must be carried
321.11by the individual and be readily available for review by the commissioner and other public
321.12health officials charged with the health, safety, and welfare of the state's citizens.
321.13    Subd. 1b. Lead supervisor license. Before an individual performs regulated lead
321.14work as a supervisor, the individual shall first obtain a license from the commissioner. No
321.15license shall be issued unless the individual shows evidence of experience and successful
321.16completion of a training course in lead hazard control. The commissioner shall specify
321.17the course of training, experience, and testing requirements and shall charge a $50 fee
321.18annually for the license. License fees are nonrefundable and must be submitted with
321.19each application. The license must be carried by the individual and be readily available
321.20for review by the commissioner and other public health officials charged with the health,
321.21safety, and welfare of the state's citizens.
321.22    Subd. 1c. Lead inspector license. Before an individual performs lead inspection
321.23services, the individual shall first obtain a license from the commissioner. No license shall
321.24be issued unless the individual shows evidence of successfully completing a training
321.25course in lead inspection. The commissioner shall specify the course of training and
321.26testing requirements and shall charge a $50 fee annually for the license. License fees are
321.27nonrefundable and must be submitted with each application. The license must be carried
321.28by the individual and be readily available for review by the commissioner and other public
321.29health officials charged with the health, safety, and welfare of the state's citizens.
321.30    Subd. 1d. Lead risk assessor license. Before an individual performs lead risk
321.31assessor services, the individual shall first obtain a license from the commissioner. No
321.32license shall be issued unless the individual shows evidence of experience and successful
321.33completion of a training course in lead risk assessment. The commissioner shall specify
321.34the course of training, experience, and testing requirements and shall charge a $100 fee
321.35annually for the license. License fees are nonrefundable and must be submitted with
321.36each application. The license must be carried by the individual and be readily available
322.1for review by the commissioner and other public health officials charged with the health,
322.2safety, and welfare of the state's citizens.
322.3    Subd. 1e. Lead project designer license. Before an individual performs lead
322.4project designer services, the individual shall first obtain a license from the commissioner.
322.5No license shall be issued unless the individual shows evidence of experience and
322.6successful completion of a training course in lead project design. The commissioner shall
322.7specify the course of training, experience, and testing requirements and shall charge a
322.8$100 fee annually for the license. License fees are nonrefundable and must be submitted
322.9with each application. The license must be carried by the individual and be readily
322.10available for review by the commissioner and other public health officials charged with
322.11the health, safety, and welfare of the state's citizens.
322.12    Subd. 1f. Lead sampling technician. An individual performing lead sampling
322.13technician services shall first register with the commissioner. The commissioner shall not
322.14register an individual unless the individual shows evidence of successfully completing a
322.15training course in lead sampling. The commissioner shall specify the course of training
322.16and testing requirements. Proof of registration must be carried by the individual and be
322.17readily available for review by the commissioner and other public health officials charged
322.18with the health, safety, and welfare of the state's citizens.
322.19    Subd. 1g. Certified lead firm. A person who employs individuals to perform
322.20regulated lead work, with the exception of renovation, outside of the person's property
322.21must obtain certification as a lead firm. The certificate must be in writing, contain an
322.22expiration date, be signed by the commissioner, and give the name and address of the
322.23person to whom it is issued. A lead firm certificate is valid for one year. The certification
322.24fee is $100, is nonrefundable, and must be submitted with each application. The lead firm
322.25certificate or a copy of the certificate must be readily available at the worksite for review
322.26by the contracting entity, the commissioner, and other public health officials charged with
322.27the health, safety, and welfare of the state's citizens.
322.28    Subd. 1h. Certified renovation firm. A person who employs individuals to
322.29perform renovation activities outside of the person's property must obtain certification
322.30as a renovation firm. The certificate must be in writing, contain an expiration date, be
322.31signed by the commissioner, and give the name and address of the person to whom it is
322.32issued. A renovation firm certificate is valid for two years. The certification fee is $100,
322.33is nonrefundable, and must be submitted with each application. The renovation firm
322.34certificate or a copy of the certificate must be readily available at the worksite for review
322.35by the contracting entity, the commissioner, and other public health officials charged with
322.36the health, safety, and welfare of the state's citizens.
323.1    Subd. 1i. Lead training course. Before a person provides training to lead
323.2workers, lead supervisors, lead inspectors, lead risk assessors, lead project designers, lead
323.3sampling technicians, and lead renovators, the person shall first obtain a permit from the
323.4commissioner. The permit must be in writing, contain an expiration date, be signed by
323.5the commissioner, and give the name and address of the person to whom it is issued.
323.6A training course permit is valid for two years. Training course permit fees shall be
323.7nonrefundable and must be submitted with each application in the amount of $500 for an
323.8initial training course, $250 for renewal of a permit for an initial training course, $250 for
323.9a refresher training course, and $125 for renewal of a permit of a refresher training course.
323.10    Subd. 3. Licensed building contractor; information. The commissioner shall
323.11provide health and safety information on lead abatement and lead hazard reduction to all
323.12residential building contractors licensed under section 326B.805. The information must
323.13include the lead-safe practices and any other materials describing ways to protect the
323.14health and safety of both employees and residents.
323.15    Subd. 4. Notice of regulated lead work. (a) At least five working days before
323.16starting work at each regulated lead worksite, the person performing the regulated lead
323.17work shall give written notice to the commissioner and the appropriate board of health.
323.18(b) This provision does not apply to lead hazard screen, lead inspection, lead risk
323.19assessment, lead sampling technician, renovation, or lead project design activities.
323.20    Subd. 6. Duties of contracting entity. A contracting entity intending to have
323.21regulated lead work performed for its benefit shall include in the specifications and
323.22contracts for the work a requirement that the work be performed by contractors and
323.23subcontractors licensed by the commissioner under sections 144.9501 to 144.9512 and
323.24according to rules adopted by the commissioner related to regulated lead work. No
323.25contracting entity shall allow regulated lead work to be performed for its benefit unless the
323.26contracting entity has seen that the person has a valid license or certificate. A contracting
323.27entity's failure to comply with this subdivision does not relieve a person from any
323.28responsibility under sections 144.9501 to 144.9512.
323.29EFFECTIVE DATE.This section is effective July 1, 2016.

323.30    Sec. 33. Minnesota Statutes 2014, section 144.9508, is amended to read:
323.31144.9508 RULES.
323.32    Subdivision 1. Sampling and analysis. The commissioner shall adopt, by rule,
323.33methods for:
324.1(1) lead inspections, lead hazard screens, lead risk assessments, and clearance
324.2inspections;
324.3(2) environmental surveys of lead in paint, soil, dust, and drinking water to determine
324.4areas at high risk for toxic lead exposure;
324.5(3) soil sampling for soil used as replacement soil;
324.6(4) drinking water sampling, which shall be done in accordance with lab certification
324.7requirements and analytical techniques specified by Code of Federal Regulations, title
324.840, section 141.89; and
324.9(5) sampling to determine whether at least 25 percent of the soil samples collected
324.10from a census tract within a standard metropolitan statistical area contain lead in
324.11concentrations that exceed 100 parts per million.
324.12    Subd. 2. Regulated lead work standards and methods. (a) The commissioner shall
324.13adopt rules establishing regulated lead work standards and methods in accordance with the
324.14provisions of this section, for lead in paint, dust, drinking water, and soil in a manner that
324.15protects public health and the environment for all residences, including residences also
324.16used for a commercial purpose, child care facilities, playgrounds, and schools.
324.17(b) In the rules required by this section, the commissioner shall require lead hazard
324.18reduction of intact paint only if the commissioner finds that the intact paint is on a
324.19chewable or lead-dust producing surface that is a known source of actual lead exposure to
324.20a specific individual. The commissioner shall prohibit methods that disperse lead dust into
324.21the air that could accumulate to a level that would exceed the lead dust standard specified
324.22under this section. The commissioner shall work cooperatively with the commissioner
324.23of administration to determine which lead hazard reduction methods adopted under this
324.24section may be used for lead-safe practices including prohibited practices, preparation,
324.25disposal, and cleanup. The commissioner shall work cooperatively with the commissioner
324.26of the Pollution Control Agency to develop disposal procedures. In adopting rules under
324.27this section, the commissioner shall require the best available technology for regulated
324.28lead work methods, paint stabilization, and repainting.
324.29(c) The commissioner of health shall adopt regulated lead work standards and
324.30methods for lead in bare soil in a manner to protect public health and the environment.
324.31The commissioner shall adopt a maximum standard of 100 parts of lead per million in
324.32bare soil. The commissioner shall set a soil replacement standard not to exceed 25 parts
324.33of lead per million. Soil lead hazard reduction methods shall focus on erosion control
324.34and covering of bare soil.
324.35(d) The commissioner shall adopt regulated lead work standards and methods for lead
324.36in dust in a manner to protect the public health and environment. Dust standards shall use
325.1a weight of lead per area measure and include dust on the floor, on the window sills, and
325.2on window wells. Lead hazard reduction methods for dust shall focus on dust removal and
325.3other practices which minimize the formation of lead dust from paint, soil, or other sources.
325.4(e) The commissioner shall adopt lead hazard reduction standards and methods for
325.5lead in drinking water both at the tap and public water supply system or private well
325.6in a manner to protect the public health and the environment. The commissioner may
325.7adopt the rules for controlling lead in drinking water as contained in Code of Federal
325.8Regulations, title 40, part 141. Drinking water lead hazard reduction methods may include
325.9an educational approach of minimizing lead exposure from lead in drinking water.
325.10(f) The commissioner of the Pollution Control Agency shall adopt rules to ensure that
325.11removal of exterior lead-based coatings from residences and steel structures by abrasive
325.12blasting methods is conducted in a manner that protects health and the environment.
325.13(g) All regulated lead work standards shall provide reasonable margins of safety that
325.14are consistent with more than a summary review of scientific evidence and an emphasis on
325.15overprotection rather than underprotection when the scientific evidence is ambiguous.
325.16(h) No unit of local government shall have an ordinance or regulation governing
325.17regulated lead work standards or methods for lead in paint, dust, drinking water, or soil
325.18that require a different regulated lead work standard or method than the standards or
325.19methods established under this section.
325.20(i) Notwithstanding paragraph (h), the commissioner may approve the use by a unit
325.21of local government of an innovative lead hazard reduction method which is consistent
325.22in approach with methods established under this section.
325.23(j) The commissioner shall adopt rules for issuing lead orders required under section
325.24144.9504 , rules for notification of abatement or interim control activities requirements,
325.25and other rules necessary to implement sections 144.9501 to 144.9512.
325.26(k) The commissioner shall adopt rules consistent with section 402(c)(3) of the
325.27Toxic Substances Control Act to ensure that renovation in a pre-1978 affected property
325.28where a child or pregnant female resides is conducted in a manner that protects health
325.29and the environment. Notwithstanding sections 14.125 and 14.128, the authority to adopt
325.30these rules does not expire.
325.31(l) The commissioner shall adopt rules consistent with sections 406(a) and 406(b)
325.32of the Toxic Substances Control Act. Notwithstanding sections 14.125 and 14.128, the
325.33authority to adopt these rules does not expire.
325.34    Subd. 2a. Lead standards for exterior surfaces and street dust. The
325.35commissioner may, by rule, establish lead standards for exterior horizontal surfaces,
326.1concrete or other impervious surfaces, and street dust on residential property to protect the
326.2public health and the environment.
326.3    Subd. 3. Licensure and certification. The commissioner shall adopt rules to license
326.4lead supervisors, lead workers, lead project designers, lead inspectors, lead risk assessors,
326.5and lead sampling technicians. The commissioner shall also adopt rules requiring
326.6certification of firms that perform regulated lead work. The commissioner shall require
326.7periodic renewal of licenses and certificates and shall establish the renewal periods.
326.8    Subd. 4. Lead training course. The commissioner shall establish by rule
326.9requirements for training course providers and the renewal period for each lead-related
326.10training course required for certification or licensure. The commissioner shall establish
326.11criteria in rules for the content and presentation of training courses intended to qualify
326.12trainees for licensure under subdivision 3. The commissioner shall establish criteria in
326.13rules for the content and presentation of training courses for lead renovation and lead
326.14sampling technicians. Training course permit fees shall be nonrefundable and must be
326.15submitted with each application in the amount of $500 for an initial training course, $250
326.16for renewal of a permit for an initial training course, $250 for a refresher training course,
326.17and $125 for renewal of a permit of a refresher training course.
326.18    Subd. 5. Variances. In adopting the rules required under this section, the
326.19commissioner shall provide variance procedures for any provision in rules adopted under
326.20this section, except for the numerical standards for the concentrations of lead in paint,
326.21dust, bare soil, and drinking water. A variance shall be considered only according to the
326.22procedures and criteria in Minnesota Rules, parts 4717.7000 to 4717.7050.
326.23EFFECTIVE DATE.This section is effective the day following final enactment.

326.24    Sec. 34. [144.999] LIFE-SAVING ALLERGY MEDICATION.
326.25    Subdivision 1. Definitions. (a) For purposes of this section, the following terms
326.26have the meanings given.
326.27(b) "Administer" means the direct application of an epinephrine auto-injector to
326.28the body of an individual.
326.29(c) "Authorized entity" means entities that fall in the categories of recreation camps,
326.30colleges and universities, preschools and daycares, and any other category of entities or
326.31organizations that the commissioner authorizes to obtain and administer epinephrine
326.32auto-injectors without a prescription. This definition does not include a school covered
326.33under section 121A.2207.
326.34(d) "Commissioner" means the commissioner of health.
327.1(e) "Epinephrine auto-injector" means a single-use device used for the automatic
327.2injection of a premeasured dose of epinephrine into the human body.
327.3(f) "Provide" means to supply one or more epinephrine auto-injectors to an
327.4individual or the individual's parent, legal guardian, or caretaker.
327.5    Subd. 2. Commissioner duties. The commissioner may identify additional
327.6categories of entities or organizations to be authorized entities if the commissioner
327.7determines that individuals may come in contact with allergens capable of causing
327.8anaphylaxis. Beginning July 1, 2016, the commissioner may annually review the
327.9categories of authorized entities and may authorize additional categories of authorized
327.10entities as the commissioner deems appropriate. The commissioner may contract with a
327.11vendor to perform the review and identification of authorized entities.
327.12    Subd. 3. Obtaining and storing epinephrine auto-injectors. (a) Notwithstanding
327.13section 151.37, an authorized entity may obtain and possess epinephrine auto-injectors
327.14to be provided or administered to an individual if, in good faith, an owner, manager,
327.15employee, or agent of an authorized entity believes that the individual is experiencing
327.16anaphylaxis regardless of whether the individual has a prescription for an epinephrine
327.17auto-injector. The administration of an epinephrine auto-injector in accordance with
327.18this section is not the practice of medicine.
327.19(b) An authorized entity may obtain epinephrine auto-injectors from pharmacies
327.20licensed as wholesale drug distributors pursuant to section 151.47. Prior to obtaining an
327.21epinephrine auto-injector, an owner, manager, or authorized agent of the entity must
327.22present to the pharmacy a valid certificate of training obtained pursuant to subdivision 5.
327.23(c) An authorized entity shall store epinephrine auto-injectors in a location readily
327.24accessible in an emergency and in accordance with the epinephrine auto-injector's
327.25instructions for use and any additional requirements that may be established by the
327.26commissioner. An authorized entity shall designate employees or agents who have
327.27completed the training program required under subdivision 5 to be responsible for the
327.28storage, maintenance, and control of epinephrine auto-injectors obtained and possessed
327.29by the authorized entity.
327.30    Subd. 4. Use of epinephrine auto-injectors. (a) An owner, manager, employee, or
327.31agent of an authorized entity who has completed the training required under subdivision 5
327.32may:
327.33(1) provide an epinephrine auto-injector for immediate administration to an
327.34individual or the individual's parent, legal guardian, or caregiver if the owner, manager,
327.35employee, or agent believes, in good faith, the individual is experiencing anaphylaxis,
328.1regardless of whether the individual has a prescription for an epinephrine auto-injector or
328.2has previously been diagnosed with an allergy; or
328.3(2) administer an epinephrine auto-injector to an individual who the owner, manager,
328.4employee, or agent believes, in good faith, is experiencing anaphylaxis, regardless of
328.5whether the individual has a prescription for an epinephrine auto-injector or has previously
328.6been diagnosed with an allergy.
328.7(b) Nothing in this section shall be construed to require any authorized entity to
328.8maintain a stock of epinephrine auto-injectors.
328.9    Subd. 5. Training. (a) In order to use an epinephrine auto-injector as authorized
328.10under subdivision 4, an individual must complete, every two years, an anaphylaxis training
328.11program conducted by a nationally recognized organization experienced in training
328.12laypersons in emergency health treatment, a statewide organization with experience
328.13providing training on allergies and anaphylaxis under the supervision of board-certified
328.14allergy medical advisors, or an entity or individual approved by the commissioner to
328.15provide an anaphylaxis training program. The commissioner may approve specific entities
328.16or individuals to conduct the training program or may approve categories of entities or
328.17individuals to conduct the training program. Training may be conducted online or in
328.18person and, at a minimum, must cover:
328.19(1) how to recognize signs and symptoms of severe allergic reactions, including
328.20anaphylaxis;
328.21(2) standards and procedures for the storage and administration of an epinephrine
328.22auto-injector; and
328.23(3) emergency follow-up procedures.
328.24(b) The entity or individual conducting the training shall issue a certificate to each
328.25person who successfully completes the anaphylaxis training program. The commissioner
328.26may develop, approve, and disseminate a standard certificate of completion. The
328.27certificate of completion shall be valid for two years from the date issued.
328.28    Subd. 6. Good samaritan protections. Any act or omission taken pursuant to
328.29this section by an authorized entity that possesses and makes available epinephrine
328.30auto-injectors and its employees or agents, a pharmacy or manufacturer that dispenses
328.31epinephrine auto-injectors to an authorized entity, or an individual or entity that conducts
328.32the training described in subdivision 5 is considered "emergency care, advice, or
328.33assistance" under section 604A.01.

328.34    Sec. 35. Minnesota Statutes 2014, section 144A.70, subdivision 6, is amended to read:
329.1    Subd. 6. Supplemental nursing services agency. "Supplemental nursing services
329.2agency" means a person, firm, corporation, partnership, or association engaged for hire
329.3in the business of providing or procuring temporary employment in health care facilities
329.4for nurses, nursing assistants, nurse aides, and orderlies, and other licensed health
329.5professionals. Supplemental nursing services agency does not include an individual who
329.6only engages in providing the individual's services on a temporary basis to health care
329.7facilities. Supplemental nursing services agency does not include a professional home
329.8care agency licensed as a Class A provider under section 144A.46 and rules adopted
329.9thereunder 144A.471 that only provides staff to other home care providers.

329.10    Sec. 36. Minnesota Statutes 2014, section 144A.70, is amended by adding a
329.11subdivision to read:
329.12    Subd. 7. Oversight. The commissioner is responsible for the oversight of
329.13supplemental nursing services agencies through annual unannounced surveys, complaint
329.14investigations under sections 144A.51 to 144A.53, and other actions necessary to ensure
329.15compliance with sections 144A.70 to 144A.74.

329.16    Sec. 37. Minnesota Statutes 2014, section 144A.71, is amended to read:
329.17144A.71 SUPPLEMENTAL NURSING SERVICES AGENCY
329.18REGISTRATION.
329.19    Subdivision 1. Duty to register. A person who operates a supplemental nursing
329.20services agency shall register the agency annually with the commissioner. Each separate
329.21location of the business of a supplemental nursing services agency shall register the agency
329.22with the commissioner. Each separate location of the business of a supplemental nursing
329.23services agency shall have a separate registration. Fees collected under this section shall be
329.24deposited in the state treasury and credited to the state government special revenue fund.
329.25    Subd. 2. Application information and fee. The commissioner shall establish forms
329.26and procedures for processing each supplemental nursing services agency registration
329.27application. An application for a supplemental nursing services agency registration must
329.28include at least the following:
329.29(1) the names and addresses of the owner or owners of the supplemental nursing
329.30services agency;
329.31(2) if the owner is a corporation, copies of its articles of incorporation and current
329.32bylaws, together with the names and addresses of its officers and directors;
329.33(3) satisfactory proof of compliance with section 144A.72, subdivision 1, clauses
329.34(5) to (7);
330.1(4) any other relevant information that the commissioner determines is necessary
330.2to properly evaluate an application for registration; and
330.3(5) the annual registration fee for a supplemental nursing services agency, which
330.4is $891. a policy and procedure that describes how the supplemental nursing services
330.5agency's records will be immediately available at all times to the commissioner; and
330.6(6) a registration fee of $2,035.
330.7If a supplemental nursing services agency fails to provide the items in this
330.8subdivision to the department, the commissioner shall immediately suspend or refuse to
330.9issue the supplemental nursing services agency registration. The supplemental nursing
330.10services agency may appeal the commissioner's findings according to section 144A.475,
330.11subdivisions 3a and 7, except that the hearing must be conducted by an administrative law
330.12judge within 60 calendar days of the request for hearing assignment.
330.13    Subd. 3. Registration not transferable. A registration issued by the commissioner
330.14according to this section is effective for a period of one year from the date of its issuance
330.15unless the registration is revoked or suspended under section 144A.72, subdivision 2, or
330.16unless the supplemental nursing services agency is sold or ownership or management
330.17is transferred. When a supplemental nursing services agency is sold or ownership or
330.18management is transferred, the registration of the agency must be voided and the new
330.19owner or operator may apply for a new registration.

330.20    Sec. 38. Minnesota Statutes 2014, section 144A.72, is amended to read:
330.21144A.72 REGISTRATION REQUIREMENTS; PENALTIES.
330.22    Subdivision 1. Minimum criteria. (a) The commissioner shall require that, as a
330.23condition of registration:
330.24(1) the supplemental nursing services agency shall document that each temporary
330.25employee provided to health care facilities currently meets the minimum licensing, training,
330.26and continuing education standards for the position in which the employee will be working;
330.27(2) the supplemental nursing services agency shall comply with all pertinent
330.28requirements relating to the health and other qualifications of personnel employed in
330.29health care facilities;
330.30(3) the supplemental nursing services agency must not restrict in any manner the
330.31employment opportunities of its employees;
330.32(4) the supplemental nursing services agency shall carry medical malpractice
330.33insurance to insure against the loss, damage, or expense incident to a claim arising out
330.34of the death or injury of any person as the result of negligence or malpractice in the
331.1provision of health care services by the supplemental nursing services agency or by any
331.2employee of the agency;
331.3(5) the supplemental nursing services agency shall carry an employee dishonesty
331.4bond in the amount of $10,000;
331.5(6) the supplemental nursing services agency shall maintain insurance coverage
331.6for workers' compensation for all nurses, nursing assistants, nurse aides, and orderlies
331.7provided or procured by the agency;
331.8(7) the supplemental nursing services agency shall file with the commissioner of
331.9revenue: (i) the name and address of the bank, savings bank, or savings association
331.10in which the supplemental nursing services agency deposits all employee income tax
331.11withholdings; and (ii) the name and address of any nurse, nursing assistant, nurse aide, or
331.12orderly whose income is derived from placement by the agency, if the agency purports
331.13the income is not subject to withholding;
331.14(8) the supplemental nursing services agency must not, in any contract with any
331.15employee or health care facility, require the payment of liquidated damages, employment
331.16fees, or other compensation should the employee be hired as a permanent employee of a
331.17health care facility; and
331.18(9) the supplemental nursing services agency shall document that each temporary
331.19employee provided to health care facilities is an employee of the agency and is not
331.20an independent contractor.; and
331.21(10) the supplemental nursing services agency shall retain all records for five
331.22calendar years. All records of the supplemental nursing services agency must be
331.23immediately available to the department.
331.24(b) In order to retain registration, the supplemental nursing services agency must
331.25provide services to a health care facility during the year preceding the supplemental
331.26nursing services agency's registration renewal date.
331.27    Subd. 2. Penalties. A pattern of Failure to comply with this section shall subject
331.28the supplemental nursing services agency to revocation or nonrenewal of its registration.
331.29Violations of section 144A.74 are subject to a fine equal to 200 percent of the amount
331.30billed or received in excess of the maximum permitted under that section.
331.31    Subd. 3. Revocation. Notwithstanding subdivision 2, the registration of a
331.32supplemental nursing services agency that knowingly supplies to a health care facility a
331.33person with an illegally or fraudulently obtained or issued diploma, registration, license,
331.34certificate, or background study shall be revoked by the commissioner. The commissioner
331.35shall notify the supplemental nursing services agency 15 days in advance of the date
331.36of revocation.
332.1    Subd. 4. Hearing. (a) No supplemental nursing services agency's registration
332.2may be revoked without a hearing held as a contested case in accordance with chapter
332.314. The hearing must commence within 60 days after the proceedings are initiated
332.4section 144A.475, subdivisions 3a and 7, except the hearing must be conducted by an
332.5administrative law judge within 60 calendar days of the request for assignment.
332.6(b) If a controlling person has been notified by the commissioner of health that the
332.7supplemental nursing services agency will not receive an initial registration or that a
332.8renewal of the registration has been denied, the controlling person or a legal representative
332.9on behalf of the supplemental nursing services agency may request and receive a hearing
332.10on the denial. This The hearing shall be held as a contested case in accordance with
332.11chapter 14 a contested case in accordance with section 144A.475, subdivisions 3a and 7,
332.12except the hearing must be conducted by an administrative law judge within 60 calendar
332.13days of the request for assignment.
332.14    Subd. 5. Period of ineligibility. (a) The controlling person of a supplemental
332.15nursing services agency whose registration has not been renewed or has been revoked
332.16because of noncompliance with the provisions of sections 144A.70 to 144A.74 shall not
332.17be eligible to apply for nor will be granted a registration for five years following the
332.18effective date of the nonrenewal or revocation.
332.19(b) The commissioner shall not issue or renew a registration to a supplemental
332.20nursing services agency if a controlling person includes any individual or entity who was
332.21a controlling person of a supplemental nursing services agency whose registration was
332.22not renewed or was revoked as described in paragraph (a) for five years following the
332.23effective date of nonrenewal or revocation.

332.24    Sec. 39. Minnesota Statutes 2014, section 144A.73, is amended to read:
332.25144A.73 COMPLAINT SYSTEM.
332.26The commissioner shall establish a system for reporting complaints against a
332.27supplemental nursing services agency or its employees. Complaints may be made by
332.28any member of the public. Written complaints must be forwarded to the employer of
332.29each person against whom a complaint is made. The employer shall promptly report to
332.30the commissioner any corrective action taken Complaints against a supplemental nursing
332.31services agency shall be investigated by the Office of Health Facility Complaints under
332.32Minnesota Statutes, sections 144A.51 to 144A.53.

332.33    Sec. 40. Minnesota Statutes 2014, section 144A.75, subdivision 13, is amended to read:
333.1    Subd. 13. Residential hospice facility. (a) "Residential hospice facility" means
333.2a facility that resembles a single-family home located in a residential area that directly
333.3provides 24-hour residential and support services in a home-like setting for hospice patients
333.4as an integral part of the continuum of home care provided by a hospice and that houses:
333.5(1) no more than eight hospice patients; or
333.6(2) at least nine and no more than 12 hospice patients with the approval of the local
333.7governing authority, notwithstanding section 462.357, subdivision 8.
333.8(b) Residential hospice facility also means a facility that directly provides 24-hour
333.9residential and support services for hospice patients and that:
333.10(1) houses no more than 21 hospice patients;
333.11(2) meets hospice certification regulations adopted pursuant to title XVIII of the
333.12federal Social Security Act, United States Code, title 42, section 1395, et seq.; and
333.13(3) is located on St. Anthony Avenue in St. Paul, Minnesota, and was licensed as a
333.1440-bed non-Medicare certified nursing home as of January 1, 2015.
333.15EFFECTIVE DATE.This section is effective the day following final enactment.

333.16    Sec. 41. Minnesota Statutes 2014, section 144D.01, is amended by adding a
333.17subdivision to read:
333.18    Subd. 3a. Direct-care staff. "Direct-care staff" means staff and employees who
333.19provide home care services listed in section 144A.471, subdivisions 6 and 7.

333.20    Sec. 42. [144D.066] ENFORCEMENT OF DEMENTIA CARE TRAINING
333.21REQUIREMENTS.
333.22    Subdivision 1. Enforcement. (a) The commissioner shall enforce the dementia care
333.23training standards for staff working in housing with services settings and for housing
333.24managers according to clauses (1) to (3):
333.25    (1) for dementia care training requirements in section 144D.065, the commissioner
333.26shall review training records as part of the home care provider survey process for direct
333.27care staff and supervisors of direct care staff, in accordance with section 144A.474. The
333.28commissioner may also request and review training records at any time during the year;
333.29    (2) for dementia care training standards in section 144D.065, the commissioner
333.30shall review training records for maintenance, housekeeping, and food service staff and
333.31other staff not providing direct care working in housing with services settings as part of
333.32the housing with services registration application and renewal application process in
333.33accordance with section 144D.03. The commissioner may also request and review training
333.34records at any time during the year; and
334.1    (3) for housing managers, the commissioner shall review the statement verifying
334.2compliance with the required training described in section 144D.10, paragraph (d),
334.3through the housing with services registration application and renewal application process
334.4in accordance with section 144D.03. The commissioner may also request and review
334.5training records at any time during the year.
334.6    (b) The commissioner shall specify the required forms and what constitutes sufficient
334.7training records for the items listed in paragraph (a), clauses (1) to (3).
334.8    Subd. 2. Fines for noncompliance. (a) Beginning January 1, 2017, the
334.9commissioner may impose a $200 fine for every staff person required to obtain dementia
334.10care training who does not have training records to show compliance. For violations of
334.11subdivision 1, paragraph (a), clause (1), the fine will be imposed upon the home care
334.12provider, and may be appealed under the contested case procedure in section 144A.475,
334.13subdivisions 3a, 4, and 7. For violations of subdivision 1, paragraph (a), clauses (2) and
334.14(3), the fine will be imposed on the housing with services registrant and may be appealed
334.15under the contested case procedure in section 144A.475, subdivisions 3a, 4, and 7. Prior
334.16to imposing the fine, the commissioner must allow two weeks for staff to complete the
334.17required training. Fines collected under this section shall be deposited in the state treasury
334.18and credited to the state government special revenue fund.
334.19    (b) The housing with services registrant and home care provider must allow
334.20for the required training as part of employee and staff duties. Imposition of a fine
334.21by the commissioner does not negate the need for the required training. Continued
334.22noncompliance with the requirements of sections 144D.065 and 144D.10 may result in
334.23revocation or nonrenewal of the housing with services registration or home care license.
334.24The commissioner shall make public the list of all housing with services establishments
334.25that have complied with the training requirements.
334.26    Subd. 3. Technical assistance. From January 1, 2016, to December 31, 2016,
334.27the commissioner shall provide technical assistance instead of imposing fines for
334.28noncompliance with the training requirements. During the year of technical assistance,
334.29the commissioner shall review the training records to determine if the records meet the
334.30requirements and inform the home care provider. The commissioner shall also provide
334.31information about available training resources.

334.32    Sec. 43. Minnesota Statutes 2014, section 145.4131, subdivision 1, is amended to read:
334.33    Subdivision 1. Forms. (a) Within 90 days of July 1, 1998, the commissioner shall
334.34prepare a reporting form for use by physicians or facilities performing abortions. A copy
335.1of this section shall be attached to the form. A physician or facility performing an abortion
335.2shall obtain a form from the commissioner.
335.3(b) The form shall require the following information:
335.4(1) the number of abortions performed by the physician in the previous calendar
335.5year, reported by month;
335.6(2) the method used for each abortion;
335.7(3) the approximate gestational age expressed in one of the following increments:
335.8(i) less than nine weeks;
335.9(ii) nine to ten weeks;
335.10(iii) 11 to 12 weeks;
335.11(iv) 13 to 15 weeks;
335.12(v) 16 to 20 weeks;
335.13(vi) 21 to 24 weeks;
335.14(vii) 25 to 30 weeks;
335.15(viii) 31 to 36 weeks; or
335.16(ix) 37 weeks to term;
335.17(4) the age of the woman at the time the abortion was performed;
335.18(5) the specific reason for the abortion, including, but not limited to, the following:
335.19(i) the pregnancy was a result of rape;
335.20(ii) the pregnancy was a result of incest;
335.21(iii) economic reasons;
335.22(iv) the woman does not want children at this time;
335.23(v) the woman's emotional health is at stake;
335.24(vi) the woman's physical health is at stake;
335.25(vii) the woman will suffer substantial and irreversible impairment of a major bodily
335.26function if the pregnancy continues;
335.27(viii) the pregnancy resulted in fetal anomalies; or
335.28(ix) unknown or the woman refused to answer;
335.29(6) the number of prior induced abortions;
335.30(7) the number of prior spontaneous abortions;
335.31(8) whether the abortion was paid for by:
335.32(i) private coverage;
335.33(ii) public assistance health coverage; or
335.34(iii) self-pay;
335.35(9) whether coverage was under:
335.36(i) a fee-for-service plan;
336.1(ii) a capitated private plan; or
336.2(iii) other;
336.3(10) complications, if any, for each abortion and for the aftermath of each abortion.
336.4Space for a description of any complications shall be available on the form; and
336.5(11) the medical specialty of the physician performing the abortion;
336.6(12) whether the abortion resulted in a born alive infant, as defined in section
336.7145.423, subdivision 4, and:
336.8(i) any medical actions taken to preserve the life of the born alive infant;
336.9(ii) whether the born alive infant survived; and
336.10(iii) the status of the born alive infant, should the infant survive, if known.

336.11    Sec. 44. Minnesota Statutes 2014, section 145.423, is amended to read:
336.12145.423 ABORTION; LIVE BIRTHS.
336.13    Subdivision 1. Recognition; medical care. A live child born born alive infant as a
336.14result of an abortion shall be fully recognized as a human person, and accorded immediate
336.15protection under the law. All reasonable measures consistent with good medical practice,
336.16including the compilation of appropriate medical records, shall be taken by the responsible
336.17medical personnel to preserve the life and health of the child born alive infant.
336.18    Subd. 2. Physician required. When an abortion is performed after the twentieth
336.19week of pregnancy, a physician, other than the physician performing the abortion, shall
336.20be immediately accessible to take all reasonable measures consistent with good medical
336.21practice, including the compilation of appropriate medical records, to preserve the life and
336.22health of any live birth born alive infant that is the result of the abortion.
336.23    Subd. 3. Death. If a child born alive infant described in subdivision 1 dies after
336.24birth, the body shall be disposed of in accordance with the provisions of section 145.1621.
336.25    Subd. 4. Definition of born alive infant. (a) In determining the meaning of
336.26any Minnesota statute, or of any ruling, regulation, or interpretation of the various
336.27administrative bureaus and agencies of Minnesota, the words "person," "human being,"
336.28"child," and "individual" shall include every infant member of the species Homo sapiens
336.29who is born alive at any stage of development.
336.30(b) As used in this section, the term "born alive," with respect to a member of the
336.31species Homo sapiens, means the complete expulsion or extraction from his or her mother
336.32of that member, at any stage of development, who, after such expulsion or extraction,
336.33breathes or has a beating heart, pulsation of the umbilical cord, or definite movement of
336.34voluntary muscles, regardless of whether the umbilical cord has been cut, and regardless
337.1of whether the expulsion or extraction occurs as a result of a natural or induced labor,
337.2cesarean section, or induced abortion.
337.3(c) Nothing in this section shall be construed to affirm, deny, expand, or contract any
337.4legal status or legal right applicable to any member of the species Homo sapiens at any
337.5point prior to being born alive, as defined in this section.
337.6    Subd. 5. Civil and disciplinary actions. (a) Any person upon whom an abortion
337.7has been performed, or the parent or guardian of the mother if the mother is a minor,
337.8and the abortion results in the infant having been born alive, may maintain an action for
337.9death of or injury to the born alive infant against the person who performed the abortion
337.10if the death or injury was a result of simple negligence, gross negligence, wantonness,
337.11willfulness, intentional conduct, or another violation of the legal standard of care.
337.12(b) Any responsible medical personnel that does not take all reasonable measures
337.13consistent with good medical practice to preserve the life and health of the born alive
337.14infant, as required by subdivision 1, may be subject to the suspension or revocation of that
337.15person's professional license by the professional board with authority over that person.
337.16Any person who has performed an abortion and against whom judgment has been rendered
337.17pursuant to paragraph (a) shall be subject to an automatic suspension of the person's
337.18professional license for at least one year and said license shall be reinstated only after the
337.19person's professional board requires compliance with this section by all board licensees.
337.20(c) Nothing in this subdivision shall be construed to hold the mother of the born alive
337.21infant criminally or civilly liable for the actions of a physician, nurse, or other licensed
337.22health care provider in violation of this section to which the mother did not give her consent.
337.23    Subd. 6. Protection of privacy in court proceedings. In every civil action
337.24brought under this section, the court shall rule whether the anonymity of any female
337.25upon whom an abortion has been performed or attempted shall be preserved from public
337.26disclosure if she does not give her consent to such disclosure. The court, upon motion or
337.27sua sponte, shall make such a ruling and, upon determining that her anonymity should
337.28be preserved, shall issue orders to the parties, witnesses, and counsel and shall direct the
337.29sealing of the record and exclusion of individuals from courtrooms or hearing rooms to
337.30the extent necessary to safeguard her identity from public disclosure. Each order must be
337.31accompanied by specific written findings explaining why the anonymity of the female
337.32should be preserved from public disclosure, why the order is essential to that end, how the
337.33order is narrowly tailored to serve that interest, and why no reasonable, less restrictive
337.34alternative exists. This section may not be construed to conceal the identity of the plaintiff
337.35or of witnesses from the defendant.
338.1    Subd. 7. Status of born alive infant. Unless the abortion is performed to save the
338.2life of the woman or fetus, or, unless one or both of the parents of the born alive infant
338.3agree within 30 days of the birth to accept the parental rights and responsibilities for the
338.4child, the child shall be an abandoned ward of the state and the parents shall have no
338.5parental rights or obligations as if the parental rights had been terminated pursuant to
338.6section 260C.301. The child shall be provided for pursuant to chapter 256J.
338.7    Subd. 8. Severability. If any one or more provision, section, subdivision, sentence,
338.8clause, phrase, or word of this section or the application of it to any person or circumstance
338.9is found to be unconstitutional, it is declared to be severable and the balance of this section
338.10shall remain effective notwithstanding such unconstitutionality. The legislature intends
338.11that it would have passed this section, and each provision, section, subdivision, sentence,
338.12clause, phrase, or word, regardless of the fact that any one provision, section, subdivision,
338.13sentence, clause, phrase, or word is declared unconstitutional.
338.14    Subd. 9. Short title. This act may be cited as the "Born Alive Infants Protection Act."

338.15    Sec. 45. Minnesota Statutes 2014, section 145.928, subdivision 13, is amended to read:
338.16    Subd. 13. Report Reports. (a) The commissioner shall submit a biennial report
338.17to the legislature on the local community projects, tribal government, and community
338.18health board prevention activities funded under this section. These reports must include
338.19information on grant recipients, activities that were conducted using grant funds,
338.20evaluation data, and outcome measures, if available. These reports are due by January 15
338.21of every other year, beginning in the year 2003.
338.22(b) The commissioner shall submit an annual report to the chairs and ranking
338.23minority members of the house of representatives and senate committees with jurisdiction
338.24over public health on grants made under subdivision 7 to decrease racial and ethnic
338.25disparities in infant mortality rates. The report must provide specific information on the
338.26amount of each grant awarded to each agency or organization, the population served
338.27by each agency or organization, outcomes of the programs funded by each grant, and
338.28the amount of the appropriation retained by the commissioner for administrative and
338.29associated expenses. The commissioner shall issue a report each January 15 for the
338.30previous fiscal year beginning January 15, 2016.

338.31    Sec. 46. Minnesota Statutes 2014, section 145.928, is amended by adding a subdivision
338.32to read:
338.33    Subd. 15. Promising strategies. For all grants awarded under this section, the
338.34commissioner shall consider applicants that present evidence of a promising strategy to
339.1accomplish the applicant's objective. A promising strategy shall be given the same weight
339.2as a research or evidence-based strategy based on potential value and measurable outcomes.

339.3    Sec. 47. Minnesota Statutes 2014, section 145.986, subdivision 1a, is amended to read:
339.4    Subd. 1a. Grants to local communities. (a) Beginning July 1, 2009, the
339.5commissioner of health shall award competitive grants to community health boards and
339.6tribal governments to convene, coordinate, and implement evidence-based strategies
339.7targeted at reducing the percentage of Minnesotans who are obese or overweight and
339.8to reduce the use of tobacco. Grants shall be awarded to all community health boards
339.9and tribal governments whose proposals demonstrate the ability to implement programs
339.10designed to achieve the purposes in subdivision 1 and other requirements of this section.
339.11    (b) Grantee activities shall:
339.12    (1) be based on scientific evidence;
339.13    (2) be based on community input;
339.14    (3) address behavior change at the individual, community, and systems levels;
339.15    (4) occur in community, school, work site, and health care settings;
339.16    (5) be focused on policy, systems, and environmental changes that support healthy
339.17behaviors; and
339.18(6) address the health disparities and inequities that exist in the grantee's community.
339.19    (c) To receive a grant under this section, community health boards and tribal
339.20governments must submit proposals to the commissioner. A local match of ten percent
339.21of the total funding allocation is required. This local match may include funds donated
339.22by community partners.
339.23    (d) In order to receive a grant, community health boards and tribal governments
339.24must submit a health improvement plan to the commissioner of health for approval. The
339.25commissioner may require the plan to identify a community leadership team, community
339.26partners, and a community action plan that includes an assessment of area strengths and
339.27needs, proposed action strategies, technical assistance needs, and a staffing plan.
339.28    (e) The grant recipient must implement the health improvement plan, evaluate the
339.29effectiveness of the strategies, and modify or discontinue strategies found to be ineffective.
339.30    (f) Grant recipients shall report their activities and their progress toward the
339.31outcomes established under subdivision 2 to the commissioner in a format and at a time
339.32specified by the commissioner.
339.33    (g) All grant recipients shall be held accountable for making progress toward the
339.34measurable outcomes established in subdivision 2. The commissioner shall require a
340.1corrective action plan and may reduce the funding level of grant recipients that do not
340.2make adequate progress toward the measurable outcomes.
340.3(h) Beginning November 1, 2015, the commissioner shall offer grant recipients the
340.4option of using a grant awarded under this subdivision to implement health improvement
340.5strategies that improve the health status, delay the expression of dementia, or slow the
340.6progression of dementia, for a targeted population at risk for dementia and shall award
340.7at least two of the grants awarded on November 1, 2015, for these purposes. The grants
340.8must meet all other requirements of this section. The commissioner shall coordinate grant
340.9planning activities with the commissioner of human services, the Minnesota Board on
340.10Aging, and community-based organizations with a focus on dementia. Each grant must
340.11include selected outcomes and evaluation measures related to the incidence or progression
340.12of dementia among the targeted population using the procedure described in subdivision 2.

340.13    Sec. 48. Minnesota Statutes 2014, section 145.986, subdivision 2, is amended to read:
340.14    Subd. 2. Outcomes. (a) The commissioner shall set measurable outcomes to meet
340.15the goals specified in subdivision 1, and annually review the progress of grant recipients
340.16in meeting the outcomes.
340.17    (b) The commissioner shall measure current public health status, using existing
340.18measures and data collection systems when available, to determine baseline data against
340.19which progress shall be monitored.
340.20(c) For grants awarded on or after July 1, 2016, the commissioner, in coordination
340.21with each grant recipient under section 145.986, must identify:
340.22(1) each geographic area or population to be targeted;
340.23(2) the policy, systems, or environmental strategy to be used to address one or more
340.24of the health indicators listed in section 62U.10, subdivision 6; and
340.25(3) the selected outcomes and evaluation measures for the grant, related to one or
340.26more of the health indicators listed in section 62U.10, subdivision 6, within the geographic
340.27area or among the population targeted.

340.28    Sec. 49. Minnesota Statutes 2014, section 145.986, subdivision 4, is amended to read:
340.29    Subd. 4. Evaluation. (a) Using the outcome measures established in subdivision 3,
340.30the commissioner shall conduct a biennial evaluation of the statewide health improvement
340.31program funded under this section. Grant recipients shall cooperate with the commissioner
340.32in the evaluation and provide the commissioner with the information necessary to conduct
340.33the evaluation, including information on any impact on the health indicators listed in
340.34section 62U.10, subdivision 6, within the geographic area or among the population targeted.
341.1(b) Grant recipients will collect, monitor, and submit to the Department of Health
341.2baseline and annual data and provide information to improve the quality and impact of
341.3community health improvement strategies.
341.4(c) For the purposes of carrying out the grant program under this section, including
341.5for administrative purposes, the commissioner shall award contracts to appropriate entities
341.6to assist in designing and implementing evaluation systems.
341.7(d) Contracts awarded under paragraph (c) may be used to:
341.8(1) develop grantee monitoring and reporting systems to track grantee progress,
341.9including aggregated and disaggregated data;
341.10(2) manage, analyze, and report program evaluation data results; and
341.11(3) utilize innovative support tools to analyze and predict the impact of prevention
341.12strategies on health outcomes and state health care costs over time.

341.13    Sec. 50. Minnesota Statutes 2014, section 145A.131, subdivision 1, is amended to read:
341.14    Subdivision 1. Funding formula for community health boards. (a) Base funding
341.15for each community health board eligible for a local public health grant under section
341.16145A.03, subdivision 7 , shall be determined by each community health board's fiscal year
341.172003 allocations, prior to unallotment, for the following grant programs: community
341.18health services subsidy; state and federal maternal and child health special projects grants;
341.19family home visiting grants; TANF MN ENABL grants; TANF youth risk behavior grants;
341.20and available women, infants, and children grant funds in fiscal year 2003, prior to
341.21unallotment, distributed based on the proportion of WIC participants served in fiscal year
341.222003 within the CHS service area.
341.23(b) Base funding for a community health board eligible for a local public health
341.24grant under section 145A.03, subdivision 7, as determined in paragraph (a), shall be
341.25adjusted by the percentage difference between the base, as calculated in paragraph (a),
341.26and the funding available for the local public health grant.
341.27(c) Multicounty or multicity community health boards shall receive a local
341.28partnership base of up to $5,000 per year for each county or city in the case of a multicity
341.29community health board included in the community health board.
341.30(d) The State Community Health Advisory Committee may recommend a formula
341.31to the commissioner to use in distributing state and federal funds to community health
341.32boards organized and operating under sections 145A.03 to 145A.131 to achieve locally
341.33identified priorities under section 145A.04, subdivision 1a, for use in distributing funds to
341.34community health boards beginning January 1, 2006, and thereafter.
342.1(e) Notwithstanding any adjustment in paragraph (b), community health boards, all
342.2or a portion of which are located outside of the counties of Anoka, Chisago, Carver,
342.3Dakota, Hennepin, Isanti, Ramsey, Scott, Sherburne, Washington, and Wright, are eligible
342.4to receive an increase equal to ten percent of the grant award to the community health
342.5board under paragraph (a) starting July 1, 2015. The increase in calendar year 2015 shall
342.6be prorated for the last six months of the year. For calendar years beginning on or after
342.7January 1, 2016, the amount distributed under this paragraph shall be adjusted each year
342.8based on available funding and the number of eligible community health boards.

342.9    Sec. 51. Minnesota Statutes 2014, section 149A.20, subdivision 5, is amended to read:
342.10    Subd. 5. Examinations. After having met the educational requirements of
342.11subdivision 4, a person must attain a passing score on the National Board Examination
342.12administered by the Conference of Funeral Service Examining Boards of the United
342.13States, Inc. or any other examination that, in the determination of the commissioner,
342.14adequately and accurately assesses the knowledge and skills required to practice
342.15mortuary science. In addition, a person must attain a passing score on the state licensing
342.16examination administered by or on behalf of the commissioner. The state examination
342.17shall encompass the laws and rules of Minnesota that pertain to the practice of mortuary
342.18science. The commissioner shall make available copies of all pertinent laws and rules
342.19prior to administration of the state licensing examination. If a passing score is not attained
342.20on the state examination, the individual must wait two weeks before they can retake
342.21the examination.

342.22    Sec. 52. Minnesota Statutes 2014, section 149A.20, subdivision 6, is amended to read:
342.23    Subd. 6. Internship. (a) A person who attains a passing score on both examinations
342.24in subdivision 5 must complete a registered internship under the direct supervision of an
342.25individual currently licensed to practice mortuary science in Minnesota. Interns must file
342.26with the commissioner:
342.27    (1) the appropriate fee; and
342.28    (2) a registration form indicating the name and home address of the intern, the
342.29date the internship begins, and the name, license number, and business address of the
342.30supervising mortuary science licensee.
342.31    (b) Any changes in information provided in the registration must be immediately
342.32reported to the commissioner. The internship shall be a minimum of one calendar year
342.33and a maximum of three calendar years in duration; 2,080 hours to be completed within a
342.34three-year period, however, the commissioner may waive up to three months 520 hours of
343.1the internship time requirement upon satisfactory completion of a clinical or practicum
343.2in mortuary science administered through the program of mortuary science of the
343.3University of Minnesota or a substantially similar program approved by the commissioner.
343.4Registrations must be renewed on an annual basis if they exceed one calendar year. During
343.5the internship period, the intern must be under the direct supervision of a person holding a
343.6current license to practice mortuary science in Minnesota. An intern may be registered
343.7under only one licensee at any given time and may be directed and supervised only by
343.8the registered licensee. The registered licensee shall have only one intern registered at
343.9any given time. The commissioner shall issue to each registered intern a registration
343.10permit that must be displayed with the other establishment and practice licenses. While
343.11under the direct supervision of the licensee, the intern must actively participate in the
343.12embalming of at least 25 dead human bodies and in the arrangements for and direction of
343.13at least 25 funerals complete 25 case reports in each of the following areas: embalming,
343.14funeral arrangements, and services. Case reports, on forms provided by the commissioner,
343.15shall be completed by the intern, signed by the supervising licensee, and filed with the
343.16commissioner for at least 25 embalmings and funerals in which the intern participates prior
343.17to the completion of the internship. Information contained in these reports that identifies
343.18the subject or the family of the subject embalmed or the subject or the family of the subject
343.19of the funeral shall be classified as licensing data under section 13.41, subdivision 2.

343.20    Sec. 53. Minnesota Statutes 2014, section 149A.40, subdivision 11, is amended to read:
343.21    Subd. 11. Continuing education. The commissioner may shall require 15
343.22continuing education hours for renewal of a license to practice mortuary science. Nine
343.23of the hours must be in the following areas: body preparation, care, or handling, 3 CE
343.24hours; professional practices, 3 CE hours; regulation and ethics, 3 CE hours. Continuing
343.25education hours shall be reported to the commissioner every other year based on the
343.26licensee's license number. Licensees whose license ends in an odd number must report CE
343.27hours at renewal time every odd year. If a licensee's license ends in an even number, the
343.28licensee must report the licensee's CE hours at renewal time every even year.

343.29    Sec. 54. Minnesota Statutes 2014, section 149A.65, is amended to read:
343.30149A.65 FEES.
343.31    Subdivision 1. Generally. This section establishes the fees for registrations,
343.32examinations, initial and renewal licenses, and late fees authorized under the provisions
343.33of this chapter.
343.34    Subd. 2. Mortuary science fees. Fees for mortuary science are:
344.1    (1) $50 $75 for the initial and renewal registration of a mortuary science intern;
344.2    (2) $100 $125 for the mortuary science examination;
344.3    (3) $125 $200 for issuance of initial and renewal mortuary science licenses;
344.4    (4) $25 $100 late fee charge for a license renewal; and
344.5    (5) $200 $250 for issuing a mortuary science license by endorsement.
344.6    Subd. 3. Funeral directors. The license renewal fee for funeral directors is $125
344.7$200. The late fee charge for a license renewal is $25 $100.
344.8    Subd. 4. Funeral establishments. The initial and renewal fee for funeral
344.9establishments is $300 $425. The late fee charge for a license renewal is $25 $100.
344.10    Subd. 5. Crematories. The initial and renewal fee for a crematory is $300 $425.
344.11The late fee charge for a license renewal is $25 $100.
344.12    Subd. 6. Alkaline hydrolysis facilities. The initial and renewal fee for an alkaline
344.13hydrolysis facility is $300 $425. The late fee charge for a license renewal is $25 $100.
344.14    Subd. 7. State government special revenue fund. Fees collected by the
344.15commissioner under this section must be deposited in the state treasury and credited to
344.16the state government special revenue fund.

344.17    Sec. 55. Minnesota Statutes 2014, section 149A.92, subdivision 1, is amended to read:
344.18    Subdivision 1. Exemption Establishment update. All funeral establishments
344.19having a preparation and embalming room that has not been used for the preparation
344.20or embalming of a dead human body in the 12 calendar months prior to July 1, 1997,
344.21are exempt from the minimum requirements in subdivisions 2 to 6, except as provided
344.22in this section. (a) Notwithstanding subdivision 11, a funeral establishment with other
344.23establishment locations that uses one preparation and embalming room for all establishment
344.24locations has until July 1, 2017, to bring the other establishment locations that are not used
344.25for preparation or embalming into compliance with this section so long as the preparation
344.26and embalming room that is used complies with the minimum standards in this section.
344.27(b) At the time that ownership of a funeral establishment changes, the physical
344.28location of the establishment changes, or the building housing the funeral establishment or
344.29business space of the establishment is remodeled the existing preparation and embalming
344.30room must be brought into compliance with the minimum standards in this section and in
344.31accordance with subdivision 11.

344.32    Sec. 56. Minnesota Statutes 2014, section 149A.97, subdivision 7, is amended to read:
344.33    Subd. 7. Reports to commissioner. Every funeral provider lawfully doing business
344.34in Minnesota that accepts funds under subdivision 2 must make a complete annual report
345.1to the commissioner. The reports may be on forms provided by the commissioner or
345.2substantially similar forms containing, at least, identification and the state of each trust
345.3account, including all transactions involving principal and accrued interest, and must be
345.4filed by March 31 of the calendar year following the reporting year along with a filing fee
345.5of $25 for each report. Fees shall be paid to the commissioner of management and budget,
345.6state of Minnesota, for deposit in the state government special revenue fund in the state
345.7treasury. Reports must be signed by an authorized representative of the funeral provider
345.8and notarized under oath. All reports to the commissioner shall be reviewed for account
345.9inaccuracies or possible violations of this section. If the commissioner has a reasonable
345.10belief to suspect that there are account irregularities or possible violations of this section,
345.11the commissioner shall report that belief, in a timely manner, to the state auditor or other
345.12state agencies as determined by the commissioner. The commissioner may require a
345.13funeral provider reporting preneed trust accounts under this section to arrange for and
345.14pay an independent third-party auditing firm to complete an audit of the preneed trust
345.15accounts every other year. The funeral provider shall report the findings of the audit to the
345.16commissioner by March 31 of the calendar year following the reporting year. This report is
345.17in addition to the annual report. The commissioner shall also file an annual letter with the
345.18state auditor disclosing whether or not any irregularities or possible violations were detected
345.19in review of the annual trust fund reports filed by the funeral providers. This letter shall be
345.20filed with the state auditor by May 31 of the calendar year following the reporting year.

345.21    Sec. 57. Minnesota Statutes 2014, section 157.15, subdivision 8, is amended to read:
345.22    Subd. 8. Lodging establishment. "Lodging establishment" means: (1) a building,
345.23structure, enclosure, or any part thereof used as, maintained as, advertised as, or held out to
345.24be a place where sleeping accommodations are furnished to the public as regular roomers,
345.25for periods of one week or more, and having five or more beds to let to the public.; or (2) a
345.26building, structure, or enclosure or any part thereof located within ten miles distance from
345.27a hospital or medical center and maintained as, advertised as, or held out to be a place
345.28where sleeping accommodations are furnished exclusively to patients, their families, and
345.29caregivers while the patient is receiving or waiting to receive health care treatments or
345.30procedures for periods of one week or more, and where no supportive services, as defined
345.31under section 157.17, subdivision 1, paragraph (a), or health supervision services, as
345.32defined under section 157.17, subdivision 1, paragraph (b), or home care services, as
345.33defined under section 144A.471, subdivisions 6 and 7, are provided.
345.34EFFECTIVE DATE.This section is effective the day following final enactment.

346.1    Sec. 58. WORKING GROUP ON VIOLENCE AGAINST ASIAN WOMEN
346.2AND CHILDREN.
346.3    Subdivision 1. Establishment. The commissioner of health, in collaboration with
346.4the commissioners of human services and public safety, and the Council on Asian-Pacific
346.5Minnesotans, shall create a multidisciplinary working group to address violence against
346.6Asian women and children by July 1, 2015.
346.7    Subd. 2. The working group. The commissioner of health, in collaboration with
346.8the commissioners of human services and public safety, and the Council on Asian-Pacific
346.9Minnesotans, shall appoint 15 members representing the following groups to participate in
346.10the working group:
346.11(1) advocates;
346.12(2) survivors;
346.13(3) service providers;
346.14(4) community leaders;
346.15(5) city and county attorneys;
346.16(6) city officials;
346.17(7) law enforcement; and
346.18(8) health professionals.
346.19    At least eight of the members of the working group must be from the Asian-Pacific
346.20Islander community.
346.21    Subd. 3. Duties. (a) The working group must study the nature, scope, and prevalence
346.22of violence against Asian women and children in Minnesota, including domestic violence,
346.23trafficking, international abusive marriage, stalking, sexual assault, and other violence.
346.24(b) The working group may:
346.25(1) evaluate the adequacy and effectiveness of existing support programs;
346.26(2) conduct a needs assessment of culturally and linguistically appropriate programs
346.27and interventions;
346.28(3) identify barriers in delivering services to Asian women and children;
346.29(4) identify promising prevention and intervention strategies in addressing violence
346.30against Asian women and children; and
346.31(5) propose mechanisms to collect and monitor data on violence against Asian
346.32women and children.
346.33    Subd. 4. Chair. The commissioner of health shall designate one member to serve as
346.34chair of the working group.
347.1    Subd. 5. First meeting. The chair shall convene the first meeting by September
347.210, 2015.
347.3    Subd. 6. Compensation; expense reimbursement. Members of the working group
347.4shall be compensated and reimbursed for expenses under Minnesota Statutes, section
347.515.059, subdivision 3.
347.6    Subd. 7. Report. By January 1, 2017, the working group must submit its
347.7recommendations and any draft legislation necessary to implement those recommendations
347.8to the commissioners of health, human services, and public safety, and the Council on
347.9Asian-Pacific Minnesotans. The Council on Asian-Pacific Minnesotans shall submit a
347.10report of findings and recommendations to the chair and ranking minority members of the
347.11committees in the house of representatives and senate having jurisdiction over health and
347.12human services and public safety by February 15, 2017.
347.13    Subd. 8. Sunset. The working group on violence against Asian women and children
347.14sunsets the day after the Council on Asian-Pacific Minnesotans submits the report under
347.15subdivision 7.
347.16EFFECTIVE DATE.This section is effective the day following final enactment.

347.17    Sec. 59. HEALTH EQUITY GRANTS.
347.18For the competitive grants awarded under Laws 2014, chapter 312, article 30,
347.19section 3, subdivision 2, the commissioner of health shall consider applicants who present
347.20evidence of a promising strategy to accomplish the applicant's objective. A promising
347.21strategy shall be given the same weight as a research or evidence-based strategy based on
347.22potential value and measurable outcomes.
347.23EFFECTIVE DATE.This section is effective the day following final enactment.

347.24ARTICLE 9

347.25HEALTH CARE DELIVERY

347.26    Section 1. [62A.67] SHORT TITLE.
347.27Sections 62A.67 to 62A.672 may be cited as the "Minnesota Telemedicine Act."
347.28EFFECTIVE DATE.This section is effective January 1, 2016.

347.29    Sec. 2. [62A.671] DEFINITIONS.
348.1    Subdivision 1. Applicability. For purposes of sections 62A.67 to 62A.672, the
348.2terms defined in this section have the meanings given.
348.3    Subd. 2. Distant site. "Distant site" means a site at which a licensed health care
348.4provider is located while providing health care services or consultations by means of
348.5telemedicine.
348.6    Subd. 3. Health care provider. "Health care provider" has the meaning provided
348.7in section 62A.63, subdivision 2.
348.8    Subd. 4. Health carrier. "Health carrier" has the meaning provided in section
348.962A.011, subdivision 2.
348.10    Subd. 5. Health plan. "Health plan" means a health plan as defined in section
348.1162A.011, subdivision 3, and includes dental plans as defined in section 62Q.76, subdivision
348.123, but does not include dental plans that provide indemnity-based benefits, regardless of
348.13expenses incurred and are designed to pay benefits directly to the policyholder.
348.14    Subd. 6. Licensed health care provider. "Licensed health care provider" means a
348.15health care provider who is:
348.16(1) licensed under chapter 147, 147A, 148, 148B, 148E, 148F, 150A, or 153; a
348.17mental health professional as defined under section 245.462, subdivision 18, or 245.4871,
348.18subdivision 27; or vendor of medical care defined in section 256B.02, subdivision 7; and
348.19(2) authorized within their respective scope of practice to provide the particular
348.20service with no supervision or under general supervision.
348.21    Subd. 7. Originating site. "Originating site" means a site including, but not limited
348.22to, a health care facility at which a patient is located at the time health care services are
348.23provided to the patient by means of telemedicine.
348.24    Subd. 8. Store-and-forward technology. "Store-and-forward technology" means
348.25the transmission of a patient's medical information from an originating site to a health care
348.26provider at a distant site without the patient being present, or the delivery of telemedicine
348.27that does not occur in real time via synchronous transmissions.
348.28    Subd. 9. Telemedicine. "Telemedicine" means the delivery of health care services
348.29or consultations while the patient is at an originating site and the licensed health care
348.30provider is at a distant site. A communication between licensed health care providers
348.31that consists solely of a telephone conversation, e-mail, or facsimile transmission does
348.32not constitute telemedicine consultations or services. A communication between a
348.33licensed health care provider and a patient that consists solely of an e-mail or facsimile
348.34transmission does not constitute telemedicine consultations or services. Telemedicine may
348.35be provided by means of real-time two-way, interactive audio and visual communications,
348.36including the application of secure video conferencing or store-and-forward technology
349.1to provide or support health care delivery, which facilitate the assessment, diagnosis,
349.2consultation, treatment, education, and care management of a patient's health care.
349.3EFFECTIVE DATE.This section is effective January 1, 2016.

349.4    Sec. 3. [62A.672] COVERAGE OF TELEMEDICINE SERVICES.
349.5    Subdivision 1. Coverage of telemedicine. (a) A health plan sold, issued, or renewed
349.6by a health carrier for which coverage of benefits begins on or after January 1, 2017, shall
349.7include coverage for telemedicine benefits in the same manner as any other benefits covered
349.8under the policy, plan, or contract, and shall comply with the regulations of this section.
349.9(b) Nothing in this section shall be construed to:
349.10(1) require a health carrier to provide coverage for services that are not medically
349.11necessary;
349.12(2) prohibit a health carrier from establishing criteria that a health care provider
349.13must meet to demonstrate the safety or efficacy of delivering a particular service via
349.14telemedicine for which the health carrier does not already reimburse other health
349.15care providers for delivering via telemedicine, so long as the criteria are not unduly
349.16burdensome or unreasonable for the particular service; or
349.17(3) prevent a health carrier from requiring a health care provider to agree to certain
349.18documentation or billing practices designed to protect the health carrier or patients from
349.19fraudulent claims so long as the practices are not unduly burdensome or unreasonable
349.20for the particular service.
349.21    Subd. 2. Parity between telemedicine and in-person services. A health carrier
349.22shall not exclude a service for coverage solely because the service is provided via
349.23telemedicine and is not provided through in-person consultation or contact between a
349.24licensed health care provider and a patient.
349.25    Subd. 3. Reimbursement for telemedicine services. (a) A health carrier shall
349.26reimburse the distant site licensed health care provider for covered services delivered via
349.27telemedicine on the same basis and at the same rate as the health carrier would apply to
349.28those services if the services had been delivered in person by the distant site licensed
349.29health care provider.
349.30(b) It is not a violation of this subdivision for a health carrier to include a
349.31deductible, co-payment, or coinsurance requirement for a health care service provided via
349.32telemedicine, provided that the deductible, co-payment, or coinsurance is not in addition
349.33to, and does not exceed, the deductible, co-payment, or coinsurance applicable if the same
349.34services were provided through in-person contact.
350.1EFFECTIVE DATE.This section is effective January 1, 2016.

350.2    Sec. 4. Minnesota Statutes 2014, section 62U.02, subdivision 1, is amended to read:
350.3    Subdivision 1. Development. (a) The commissioner of health shall develop a
350.4standardized set of measures by which to assess the quality of health care services offered
350.5by health care providers, including health care providers certified as health care homes
350.6under section 256B.0751. Quality measures must be based on medical evidence and be
350.7developed through a process in which providers participate. The measures shall be used
350.8for the quality incentive payment system developed in subdivision 2 and must:
350.9    (1) include uniform definitions, measures, and forms for submission of data, to the
350.10greatest extent possible;
350.11    (2) seek to avoid increasing the administrative burden on health care providers;
350.12    (3) be initially based on existing quality indicators for physician and hospital
350.13services, which are measured and reported publicly by quality measurement organizations,
350.14including, but not limited to, Minnesota Community Measurement and specialty societies;
350.15    (4) place a priority on measures of health care outcomes, rather than process
350.16measures, wherever possible; and
350.17    (5) incorporate measures for primary care, including preventive services, coronary
350.18artery and heart disease, diabetes, asthma, depression, and other measures as determined
350.19by the commissioner.
350.20    (b) Effective July 1, 2016, the commissioner shall stratify quality measures by race,
350.21ethnicity, preferred language, and country of origin beginning with five measures, and
350.22stratifying additional measures to the extent resources are available. On or after January 1,
350.232018, the commissioner may require measures to be stratified by other sociodemographic
350.24factors that according to reliable data are correlated with health disparities and have an
350.25impact on performance on quality or cost indicators. New methods of stratifying data
350.26under this paragraph must be tested and evaluated through pilot projects prior to adding
350.27them to the statewide system. In determining whether to add additional sociodemographic
350.28factors and developing the methodology to be used, the commissioner shall consider the
350.29reporting burden on providers and determine whether there are alternative sources of data
350.30that could be used. The commissioner shall ensure that categories and data collection
350.31methods are developed in consultation with those communities impacted by health
350.32disparities using culturally appropriate community engagement principles and methods.
350.33The commissioner shall implement this paragraph in coordination with the contracting
350.34entity retained under section 62U.02, subdivision 4, in order to build upon the data
350.35stratification methodology that has been developed and tested by the entity. Nothing in
351.1this paragraph expands or changes the commissioner's authority to collect, analyze, or
351.2report health care data. Any data collected to implement this paragraph must be data that
351.3is available or is authorized to be collected under other laws. Nothing in this paragraph
351.4grants authority to the commissioner to collect or analyze patient-level or patient-specific
351.5data of the patient characteristics identified under this paragraph.
351.6    (b) (c) The measures shall be reviewed at least annually by the commissioner.

351.7    Sec. 5. Minnesota Statutes 2014, section 62U.02, subdivision 2, is amended to read:
351.8    Subd. 2. Quality incentive payments. (a) By July 1, 2009, the commissioner
351.9shall develop a system of quality incentive payments under which providers are eligible
351.10for quality-based payments that are in addition to existing payment levels, based upon
351.11a comparison of provider performance against specified targets, and improvement over
351.12time. The targets must be based upon and consistent with the quality measures established
351.13under subdivision 1.
351.14    (b) To the extent possible, the payment system must adjust for variations in patient
351.15population in order to reduce incentives to health care providers to avoid high-risk patients
351.16or populations, including those with risk factors related to race, ethnicity, language,
351.17country of origin, and sociodemographic factors.
351.18    (c) The requirements of section 62Q.101 do not apply under this incentive payment
351.19system.

351.20    Sec. 6. Minnesota Statutes 2014, section 62U.02, subdivision 3, is amended to read:
351.21    Subd. 3. Quality transparency. (a) The commissioner shall establish standards for
351.22measuring health outcomes, establish a system for risk adjusting quality measures, and
351.23issue annual public reports on provider quality beginning July 1, 2010.
351.24(b) Effective July 1, 2017, the risk adjustment system established under this
351.25subdivision shall adjust for patient characteristics identified under subdivision 1, paragraph
351.26(b), that are correlated with health disparities and have an impact on performance on cost
351.27and quality measures. The risk adjustment method may consist of reporting based on an
351.28actual-to-expected comparison that reflects the characteristics of the patient population
351.29served by the clinic or hospital. The commissioner shall implement this paragraph in
351.30coordination with any contracting entity retained under section 62U.02, subdivision 4.
351.31    (c) By January 1, 2010, physician clinics and hospitals shall submit standardized
351.32electronic information on the outcomes and processes associated with patient care to
351.33the commissioner or the commissioner's designee. In addition to measures of care
351.34processes and outcomes, the report may include other measures designated by the
352.1commissioner, including, but not limited to, care infrastructure and patient satisfaction.
352.2The commissioner shall ensure that any quality data reporting requirements established
352.3under this subdivision are not duplicative of publicly reported, communitywide quality
352.4reporting activities currently under way in Minnesota. Nothing in this subdivision is
352.5intended to replace or duplicate current privately supported activities related to quality
352.6measurement and reporting in Minnesota.

352.7    Sec. 7. Minnesota Statutes 2014, section 62U.02, subdivision 4, is amended to read:
352.8    Subd. 4. Contracting. The commissioner may contract with a private entity or
352.9consortium of private entities to complete the tasks in subdivisions 1 to 3. The private
352.10entity or consortium must be nonprofit and have governance that includes representatives
352.11from the following stakeholder groups: health care providers, including providers serving
352.12high concentrations of patients and communities impacted by health disparities;, health
352.13plan companies,; consumers, including consumers representing groups who experience
352.14health disparities;, employers or other health care purchasers,; and state government. No
352.15one stakeholder group shall have a majority of the votes on any issue or hold extraordinary
352.16powers not granted to any other governance stakeholder.

352.17    Sec. 8. Minnesota Statutes 2014, section 144E.001, is amended by adding a subdivision
352.18to read:
352.19    Subd. 5h. Community medical response emergency medical technician.
352.20"Community medical response emergency medical technician" or "CEMT" means
352.21a person who is certified as an emergency medical technician, who is a member of a
352.22registered medical response unit under section 144E.275, and who meets the requirements
352.23for additional certification as a CEMT as specified in section 144E.275, subdivision 7.

352.24    Sec. 9. Minnesota Statutes 2014, section 144E.275, subdivision 1, is amended to read:
352.25    Subdivision 1. Definition. For purposes of this section, the following definitions
352.26apply:
352.27(a) "Medical response unit" means an organized service recognized by a local
352.28political subdivision whose primary responsibility is to respond to medical emergencies to
352.29provide initial medical care before the arrival of a licensed ambulance service. Medical
352.30response units may also provide CEMT services as permitted under subdivision 7.
352.31(b) "Specialized medical response unit" means an organized service recognized by a
352.32board-approved authority other than a local political subdivision that responds to medical
352.33emergencies as needed or as required by local procedure or protocol.

353.1    Sec. 10. Minnesota Statutes 2014, section 144E.275, is amended by adding a
353.2subdivision to read:
353.3    Subd. 7. Community medical response emergency medical technician. (a) To be
353.4eligible for certification by the board as a CEMT, an individual shall:
353.5(1) be currently certified as an EMT or AEMT;
353.6(2) have two years of service as an EMT or AEMT;
353.7(3) be a member of a registered medical response unit as defined under this section;
353.8(4) successfully complete a CEMT training program from a college or university that
353.9has been approved by the board or accredited by a board-approved national accrediting
353.10organization. The training must include clinical experience under the supervision of the
353.11medical response unit medical director, an advanced practice registered nurse, a physician
353.12assistant, or a public health nurse operating under the direct authority of a local unit
353.13of government;
353.14(5) successfully complete a training program that includes training in providing
353.15culturally appropriate care; and
353.16(6) complete a board-approved application form.
353.17(b) A CEMT must practice in accordance with protocols and supervisory standards
353.18established by the medical response unit medical director in accordance with section
353.19144E.265.
353.20(c) A CEMT may provide services within the CEMT skill set as approved by the
353.21medical response unit medical director.
353.22(d) A CEMT may provide episodic individual patient education and prevention
353.23education but only as directed by a patient care plan developed by the patient's primary
353.24physician, an advanced practice registered nurse, or a physician assistant, in conjunction
353.25with the medical response unit medical director and relevant local health care providers.
353.26The patient care plan must ensure that the services provided by the CEMT are consistent
353.27with services offered by the patient's health care home, if one exists, that the patient
353.28receives the necessary services, and that there is no duplication of services to the patient.
353.29(e) A CEMT is subject to all certification, disciplinary, complaint, and other
353.30regulatory requirements that apply to EMTs under this chapter.
353.31(f) A CEMT may not provide services as defined in section 144A.471, subdivisions
353.326 and 7, except a CEMT may provide verbal or visual reminders to the patient to:
353.33(1) take a regularly scheduled medication, but not to provide or bring the patient
353.34medication; and
353.35(2) follow regularly scheduled treatment or exercise plans.

354.1    Sec. 11. Minnesota Statutes 2014, section 151.58, subdivision 2, is amended to read:
354.2    Subd. 2. Definitions. For purposes of this section only, the terms defined in this
354.3subdivision have the meanings given.
354.4(a) "Automated drug distribution system" or "system" means a mechanical system
354.5approved by the board that performs operations or activities, other than compounding or
354.6administration, related to the storage, packaging, or dispensing of drugs, and collects,
354.7controls, and maintains all required transaction information and records.
354.8(b) "Health care facility" means a nursing home licensed under section 144A.02;
354.9a housing with services establishment registered under section 144D.01, subdivision 4,
354.10in which a home provider licensed under chapter 144A is providing centralized storage
354.11of medications; a boarding care home licensed under sections 144.50 to 144.58 that is
354.12providing centralized storage of medications; or a Minnesota sex offender program facility
354.13operated by the Department of Human Services.
354.14(c) "Managing pharmacy" means a pharmacy licensed by the board that controls and
354.15is responsible for the operation of an automated drug distribution system.

354.16    Sec. 12. Minnesota Statutes 2014, section 151.58, subdivision 5, is amended to read:
354.17    Subd. 5. Operation of automated drug distribution systems. (a) The managing
354.18pharmacy and the pharmacist in charge are responsible for the operation of an automated
354.19drug distribution system.
354.20(b) Access to an automated drug distribution system must be limited to pharmacy
354.21and nonpharmacy personnel authorized to procure drugs from the system, except that field
354.22service technicians may access a system located in a health care facility for the purposes of
354.23servicing and maintaining it while being monitored either by the managing pharmacy, or a
354.24licensed nurse within the health care facility. In the case of an automated drug distribution
354.25system that is not physically located within a licensed pharmacy, access for the purpose
354.26of procuring drugs shall be limited to licensed nurses. Each person authorized to access
354.27the system must be assigned an individual specific access code. Alternatively, access to
354.28the system may be controlled through the use of biometric identification procedures. A
354.29policy specifying time access parameters, including time-outs, logoffs, and lockouts,
354.30must be in place.
354.31(c) For the purposes of this section only, the requirements of section 151.215 are met
354.32if the following clauses are met:
354.33(1) a pharmacist employed by and working at the managing pharmacy, or at a
354.34pharmacy that is acting as a central services pharmacy for the managing pharmacy,
354.35pursuant to Minnesota Rules, part 6800.4075, must review, interpret, and approve all
355.1prescription drug orders before any drug is distributed from the system to be administered
355.2to a patient. A pharmacy technician may perform data entry of prescription drug orders
355.3provided that a pharmacist certifies the accuracy of the data entry before the drug can
355.4be released from the automated drug distribution system. A pharmacist employed by
355.5and working at the managing pharmacy must certify the accuracy of the filling of any
355.6cassettes, canisters, or other containers that contain drugs that will be loaded into the
355.7automated drug distribution system, unless the filled cassettes, canisters, or containers
355.8have been provided by a repackager registered with the United States Food and Drug
355.9Administration and licensed by the board as a manufacturer; and
355.10(2) when the automated drug dispensing system is located and used within the
355.11managing pharmacy, a pharmacist must personally supervise and take responsibility for all
355.12packaging and labeling associated with the use of an automated drug distribution system.
355.13(d) Access to drugs when a pharmacist has not reviewed and approved the
355.14prescription drug order is permitted only when a formal and written decision to allow such
355.15access is issued by the pharmacy and the therapeutics committee or its equivalent. The
355.16committee must specify the patient care circumstances in which such access is allowed,
355.17the drugs that can be accessed, and the staff that are allowed to access the drugs.
355.18(e) In the case of an automated drug distribution system that does not utilize bar
355.19coding in the loading process, the loading of a system located in a health care facility may
355.20be performed by a pharmacy technician, so long as the activity is continuously supervised,
355.21through a two-way audiovisual system by a pharmacist on duty within the managing
355.22pharmacy. In the case of an automated drug distribution system that utilizes bar coding
355.23in the loading process, the loading of a system located in a health care facility may be
355.24performed by a pharmacy technician or a licensed nurse, provided that the managing
355.25pharmacy retains an electronic record of loading activities.
355.26(f) The automated drug distribution system must be under the supervision of a
355.27pharmacist. The pharmacist is not required to be physically present at the site of the
355.28automated drug distribution system if the system is continuously monitored electronically
355.29by the managing pharmacy. A pharmacist on duty within a pharmacy licensed by the
355.30board must be continuously available to address any problems detected by the monitoring
355.31or to answer questions from the staff of the health care facility. The licensed pharmacy
355.32may be the managing pharmacy or a pharmacy which is acting as a central services
355.33pharmacy, pursuant to Minnesota Rules, part 6800.4075, for the managing pharmacy.

355.34    Sec. 13. Minnesota Statutes 2014, section 256B.0625, subdivision 3b, is amended to
355.35read:
356.1    Subd. 3b. Telemedicine consultations services. (a) Medical assistance covers
356.2medically necessary services and consultations delivered by a licensed health care provider
356.3via telemedicine consultations. Telemedicine consultations must be made via two-way,
356.4interactive video or store-and-forward technology. Store-and-forward technology includes
356.5telemedicine consultations that do not occur in real time via synchronous transmissions,
356.6and that do not require a face-to-face encounter with the patient for all or any part of any
356.7such telemedicine consultation. The patient record must include a written opinion from the
356.8consulting physician providing the telemedicine consultation. A communication between
356.9two physicians that consists solely of a telephone conversation is not a telemedicine
356.10consultation in the same manner as if the service or consultation was delivered in person.
356.11Coverage is limited to three telemedicine consultations services per recipient enrollee per
356.12calendar week. Telemedicine consultations services shall be paid at the full allowable rate.
356.13(b) The commissioner shall establish criteria that a health care provider must attest
356.14to in order to demonstrate the safety or efficacy of delivering a particular service via
356.15telemedicine. The attestation may include that the health care provider:
356.16(1) has identified the categories or types of services the health care provider will
356.17provide via telemedicine;
356.18(2) has written policies and procedures specific to telemedicine services that are
356.19regularly reviewed and updated;
356.20(3) has policies and procedures that adequately address patient safety before, during,
356.21and after the telemedicine service is rendered;
356.22(4) has established protocols addressing how and when to discontinue telemedicine
356.23services; and
356.24(5) has an established quality assurance process related to telemedicine services.
356.25(c) As a condition of payment, a licensed health care provider must document
356.26each occurrence of a health service provided by telemedicine to a medical assistance
356.27enrollee. Health care service records for services provided by telemedicine must meet
356.28the requirements set forth in Minnesota Rules, part 9505.2175, subparts 1 and 2, and
356.29must document:
356.30(1) the type of service provided by telemedicine;
356.31(2) the time the service began and the time the service ended, including an a.m. and
356.32p.m. designation;
356.33(3) the licensed health care provider's basis for determining that telemedicine is an
356.34appropriate and effective means for delivering the service to the enrollee;
356.35(4) the mode of transmission of the telemedicine service and records evidencing that
356.36a particular mode of transmission was utilized;
357.1(5) the location of the originating site and the distant site;
357.2(6) if the claim for payment is based on a physician's telemedicine consultation
357.3with another physician, the written opinion from the consulting physician providing the
357.4telemedicine consultation; and
357.5(7) compliance with the criteria attested to by the health care provider in accordance
357.6with paragraph (b).
357.7(d) For purposes of this subdivision, unless otherwise covered under this chapter,
357.8"telemedicine" is defined as the delivery of health care services or consultations while
357.9the patient is at an originating site and the licensed health care provider is at a distant
357.10site. A communication between licensed health care providers, or a licensed health care
357.11provider and a patient that consists solely of a telephone conversation, e-mail, or facsimile
357.12transmission does not constitute telemedicine consultations or services. Telemedicine may
357.13be provided by means of real-time two-way, interactive audio and visual communications,
357.14including the application of secure video conferencing or store-and-forward technology
357.15to provide or support health care delivery, which facilitate the assessment, diagnosis,
357.16consultation, treatment, education, and care management of a patient's health care.
357.17(e) For purposes of this section, "licensed health care provider" is defined under
357.18section 62A.671, subdivision 6; "health care provider" is defined under section 62A.671,
357.19subdivision 3; and "originating site" is defined under section 62A.671, subdivision 7.
357.20EFFECTIVE DATE.This section is effective January 1, 2016.

357.21    Sec. 14. Minnesota Statutes 2014, section 256B.0625, subdivision 13, is amended to
357.22read:
357.23    Subd. 13. Drugs. (a) Medical assistance covers drugs, except for fertility drugs
357.24when specifically used to enhance fertility, if prescribed by a licensed practitioner and
357.25dispensed by a licensed pharmacist, by a physician enrolled in the medical assistance
357.26program as a dispensing physician, or by a physician, physician assistant, or a nurse
357.27practitioner employed by or under contract with a community health board as defined in
357.28section 145A.02, subdivision 5, for the purposes of communicable disease control.
357.29(b) The dispensed quantity of a prescription drug must not exceed a 34-day supply,
357.30unless authorized by the commissioner.
357.31(c) For the purpose of this subdivision and subdivision 13d, an "active
357.32pharmaceutical ingredient" is defined as a substance that is represented for use in a drug
357.33and when used in the manufacturing, processing, or packaging of a drug becomes an
357.34active ingredient of the drug product. An "excipient" is defined as an inert substance
357.35used as a diluent or vehicle for a drug. The commissioner shall establish a list of active
358.1pharmaceutical ingredients and excipients which are included in the medical assistance
358.2formulary. Medical assistance covers selected active pharmaceutical ingredients and
358.3excipients used in compounded prescriptions when the compounded combination is
358.4specifically approved by the commissioner or when a commercially available product:
358.5(1) is not a therapeutic option for the patient;
358.6(2) does not exist in the same combination of active ingredients in the same strengths
358.7as the compounded prescription; and
358.8(3) cannot be used in place of the active pharmaceutical ingredient in the
358.9compounded prescription.
358.10(d) Medical assistance covers the following over-the-counter drugs when prescribed
358.11by a licensed practitioner or by a licensed pharmacist who meets standards established by
358.12the commissioner, in consultation with the board of pharmacy: antacids, acetaminophen,
358.13family planning products, aspirin, insulin, products for the treatment of lice, vitamins for
358.14adults with documented vitamin deficiencies, vitamins for children under the age of seven
358.15and pregnant or nursing women, and any other over-the-counter drug identified by the
358.16commissioner, in consultation with the formulary committee, as necessary, appropriate,
358.17and cost-effective for the treatment of certain specified chronic diseases, conditions,
358.18or disorders, and this determination shall not be subject to the requirements of chapter
358.1914. A pharmacist may prescribe over-the-counter medications as provided under this
358.20paragraph for purposes of receiving reimbursement under Medicaid. When prescribing
358.21over-the-counter drugs under this paragraph, licensed pharmacists must consult with
358.22the recipient to determine necessity, provide drug counseling, review drug therapy
358.23for potential adverse interactions, and make referrals as needed to other health care
358.24professionals. Over-the-counter medications must be dispensed in a quantity that is the
358.25lower lowest of: (1) the number of dosage units contained in the manufacturer's original
358.26package; and (2) the number of dosage units required to complete the patient's course of
358.27therapy; or (3) if applicable, the number of dosage units dispensed from a system using
358.28retrospective billing, as provided under subdivision 13e, paragraph (b).
358.29(e) Effective January 1, 2006, medical assistance shall not cover drugs that
358.30are coverable under Medicare Part D as defined in the Medicare Prescription Drug,
358.31Improvement, and Modernization Act of 2003, Public Law 108-173, section 1860D-2(e),
358.32for individuals eligible for drug coverage as defined in the Medicare Prescription
358.33Drug, Improvement, and Modernization Act of 2003, Public Law 108-173, section
358.341860D-1(a)(3)(A). For these individuals, medical assistance may cover drugs from the
358.35drug classes listed in United States Code, title 42, section 1396r-8(d)(2), subject to this
359.1subdivision and subdivisions 13a to 13g, except that drugs listed in United States Code,
359.2title 42, section 1396r-8(d)(2)(E), shall not be covered.
359.3(f) Medical assistance covers drugs acquired through the federal 340B Drug Pricing
359.4Program and dispensed by 340B covered entities and ambulatory pharmacies under
359.5common ownership of the 340B covered entity. Medical assistance does not cover drugs
359.6acquired through the federal 340B Drug Pricing Program and dispensed by 340B contract
359.7pharmacies.
359.8EFFECTIVE DATE.This section is effective January 1, 2016, or upon federal
359.9approval, whichever is later.

359.10    Sec. 15. Minnesota Statutes 2014, section 256B.0625, subdivision 13e, is amended to
359.11read:
359.12    Subd. 13e. Payment rates. (a) The basis for determining the amount of payment
359.13shall be the lower of the actual acquisition costs of the drugs or the maximum allowable
359.14cost by the commissioner plus the fixed dispensing fee; or the usual and customary price
359.15charged to the public. The amount of payment basis must be reduced to reflect all discount
359.16amounts applied to the charge by any provider/insurer agreement or contract for submitted
359.17charges to medical assistance programs. The net submitted charge may not be greater
359.18than the patient liability for the service. The pharmacy dispensing fee shall be $3.65
359.19for legend prescription drugs, except that the dispensing fee for intravenous solutions
359.20which must be compounded by the pharmacist shall be $8 per bag, $14 per bag for cancer
359.21chemotherapy products, and $30 per bag for total parenteral nutritional products dispensed
359.22in one liter quantities, or $44 per bag for total parenteral nutritional products dispensed in
359.23quantities greater than one liter. The pharmacy dispensing fee for over the counter drugs
359.24shall be $3.65, except that the fee shall be $1.31 for retrospectively billing pharmacies
359.25when billing for quantities less than the number of units contained in the manufacturer's
359.26original package. Actual acquisition cost includes quantity and other special discounts
359.27except time and cash discounts. The actual acquisition cost of a drug shall be estimated
359.28by the commissioner at wholesale acquisition cost plus four percent for independently
359.29owned pharmacies located in a designated rural area within Minnesota, and at wholesale
359.30acquisition cost plus two percent for all other pharmacies. A pharmacy is "independently
359.31owned" if it is one of four or fewer pharmacies under the same ownership nationally. A
359.32"designated rural area" means an area defined as a small rural area or isolated rural area
359.33according to the four-category classification of the Rural Urban Commuting Area system
359.34developed for the United States Health Resources and Services Administration. Effective
359.35January 1, 2014, the actual acquisition cost of a drug acquired through the federal 340B
360.1Drug Pricing Program shall be estimated by the commissioner at wholesale acquisition
360.2cost minus 40 percent. Wholesale acquisition cost is defined as the manufacturer's list
360.3price for a drug or biological to wholesalers or direct purchasers in the United States, not
360.4including prompt pay or other discounts, rebates, or reductions in price, for the most
360.5recent month for which information is available, as reported in wholesale price guides or
360.6other publications of drug or biological pricing data. The maximum allowable cost of a
360.7multisource drug may be set by the commissioner and it shall be comparable to, but no
360.8higher than, the maximum amount paid by other third-party payors in this state who have
360.9maximum allowable cost programs. Establishment of the amount of payment for drugs
360.10shall not be subject to the requirements of the Administrative Procedure Act.
360.11    (b) Pharmacies dispensing prescriptions to residents of long-term care facilities
360.12using an automated drug distribution system meeting the requirements of section 151.58,
360.13or a packaging system meeting the packaging standards set forth in Minnesota Rules, part
360.146800.2700, that govern the return of unused drugs to the pharmacy for reuse, may employ
360.15retrospective billing for prescription drugs dispensed to long-term care facility residents.
360.16A retrospectively billing pharmacy must submit a claim only for the quantity of medication
360.17used by the enrolled recipient during the defined billing period. A retrospectively billing
360.18pharmacy must use a billing period not less than one calendar month or 30 days.
360.19    (c) An additional dispensing fee of $.30 may be added to the dispensing fee paid to
360.20pharmacists for legend drug prescriptions dispensed to residents of long-term care facilities
360.21when a unit dose blister card system, approved by the department, is used. Under this type
360.22of dispensing system, the pharmacist must dispense a 30-day supply of drug. The National
360.23Drug Code (NDC) from the drug container used to fill the blister card must be identified on
360.24the claim to the department. The unit dose blister card containing the drug must meet the
360.25packaging standards set forth in Minnesota Rules, part 6800.2700, that govern the return of
360.26unused drugs to the pharmacy for reuse. The A pharmacy provider will be using packaging
360.27that meets the standards set forth in Minnesota Rules, part 6800.2700, is required to credit
360.28the department for the actual acquisition cost of all unused drugs that are eligible for reuse,
360.29unless the pharmacy is using retrospective billing. The commissioner may permit the drug
360.30clozapine to be dispensed in a quantity that is less than a 30-day supply.
360.31    (c) (d) Whenever a maximum allowable cost has been set for a multisource drug,
360.32payment shall be the lower of the usual and customary price charged to the public or the
360.33maximum allowable cost established by the commissioner unless prior authorization
360.34for the brand name product has been granted according to the criteria established by
360.35the Drug Formulary Committee as required by subdivision 13f, paragraph (a), and the
361.1prescriber has indicated "dispense as written" on the prescription in a manner consistent
361.2with section 151.21, subdivision 2.
361.3    (d) (e) The basis for determining the amount of payment for drugs administered in
361.4an outpatient setting shall be the lower of the usual and customary cost submitted by
361.5the provider, 106 percent of the average sales price as determined by the United States
361.6Department of Health and Human Services pursuant to title XVIII, section 1847a of the
361.7federal Social Security Act, the specialty pharmacy rate, or the maximum allowable cost
361.8set by the commissioner. If average sales price is unavailable, the amount of payment
361.9must be lower of the usual and customary cost submitted by the provider, the wholesale
361.10acquisition cost, the specialty pharmacy rate, or the maximum allowable cost set by the
361.11commissioner. Effective January 1, 2014, the commissioner shall discount the payment
361.12rate for drugs obtained through the federal 340B Drug Pricing Program by 20 percent. The
361.13payment for drugs administered in an outpatient setting shall be made to the administering
361.14facility or practitioner. A retail or specialty pharmacy dispensing a drug for administration
361.15in an outpatient setting is not eligible for direct reimbursement.
361.16    (e) (f) The commissioner may negotiate lower reimbursement rates for specialty
361.17pharmacy products than the rates specified in paragraph (a). The commissioner may
361.18require individuals enrolled in the health care programs administered by the department
361.19to obtain specialty pharmacy products from providers with whom the commissioner has
361.20negotiated lower reimbursement rates. Specialty pharmacy products are defined as those
361.21used by a small number of recipients or recipients with complex and chronic diseases
361.22that require expensive and challenging drug regimens. Examples of these conditions
361.23include, but are not limited to: multiple sclerosis, HIV/AIDS, transplantation, hepatitis
361.24C, growth hormone deficiency, Crohn's Disease, rheumatoid arthritis, and certain forms
361.25of cancer. Specialty pharmaceutical products include injectable and infusion therapies,
361.26biotechnology drugs, antihemophilic factor products, high-cost therapies, and therapies
361.27that require complex care. The commissioner shall consult with the formulary committee
361.28to develop a list of specialty pharmacy products subject to this paragraph. In consulting
361.29with the formulary committee in developing this list, the commissioner shall take into
361.30consideration the population served by specialty pharmacy products, the current delivery
361.31system and standard of care in the state, and access to care issues. The commissioner shall
361.32have the discretion to adjust the reimbursement rate to prevent access to care issues.
361.33(f) (g) Home infusion therapy services provided by home infusion therapy
361.34pharmacies must be paid at rates according to subdivision 8d.
361.35EFFECTIVE DATE.This section is effective January 1, 2016, or upon federal
361.36approval, whichever is later.

362.1    Sec. 16. Minnesota Statutes 2014, section 256B.072, is amended to read:
362.2256B.072 PERFORMANCE REPORTING AND QUALITY IMPROVEMENT
362.3SYSTEM.
362.4(a) The commissioner of human services shall establish a performance reporting
362.5system for health care providers who provide health care services to public program
362.6recipients covered under chapters 256B, 256D, and 256L, reporting separately for
362.7managed care and fee-for-service recipients.
362.8(b) The measures used for the performance reporting system for medical groups
362.9shall include measures of care for asthma, diabetes, hypertension, and coronary artery
362.10disease and measures of preventive care services. The measures used for the performance
362.11reporting system for inpatient hospitals shall include measures of care for acute myocardial
362.12infarction, heart failure, and pneumonia, and measures of care and prevention of surgical
362.13infections. In the case of a medical group, the measures used shall be consistent with
362.14measures published by nonprofit Minnesota or national organizations that produce and
362.15disseminate health care quality measures or evidence-based health care guidelines. In
362.16the case of inpatient hospital measures, the commissioner shall appoint the Minnesota
362.17Hospital Association and Stratis Health to advise on the development of the performance
362.18measures to be used for hospital reporting. To enable a consistent measurement process
362.19across the community, the commissioner may use measures of care provided for patients in
362.20addition to those identified in paragraph (a). The commissioner shall ensure collaboration
362.21with other health care reporting organizations so that the measures described in this
362.22section are consistent with those reported by those organizations and used by other
362.23purchasers in Minnesota.
362.24(c) The commissioner may require providers to submit information in a required
362.25format to a health care reporting organization or to cooperate with the information collection
362.26procedures of that organization. The commissioner may collaborate with a reporting
362.27organization to collect information reported and to prevent duplication of reporting.
362.28(d) By October 1, 2007, and annually thereafter, the commissioner shall report
362.29through a public Web site the results by medical groups and hospitals, where possible,
362.30of the measures under this section, and shall compare the results by medical groups and
362.31hospitals for patients enrolled in public programs to patients enrolled in private health
362.32plans. To achieve this reporting, the commissioner may collaborate with a health care
362.33reporting organization that operates a Web site suitable for this purpose.
362.34(e) Performance measures must be stratified as provided under section 62U.02,
362.35subdivision 1, paragraph (b), and risk-adjusted as specified in section 62U.02, subdivision
362.363, paragraph (b).

363.1    Sec. 17. PROPOSAL FOR CHILD PROTECTION FOCUSED "COMMUNITY
363.2MEDICAL RESPONSE EMERGENCY MEDICAL TECHNICIAN" (CEMT)
363.3MODEL.
363.4The commissioner shall develop a proposal for a pilot project to create a
363.5community-based support system that coordinates services between child protection
363.6services and community emergency medical technicians. This pilot project model shall
363.7be developed with the input of stakeholders that represent both child protection services
363.8and community emergency medical technicians. The model must be designed so that the
363.9collaborative effort results in increased safety for children and increased support for
363.10families. The pilot project model must be reviewed by the Task Force on the Protection of
363.11Children, and the commissioner shall make recommendations for the pilot project to the
363.12members of the legislative committees with primary jurisdiction over CEMT and child
363.13protection issues no later than January 15, 2016.

363.14    Sec. 18. COMMUNITY MEDICAL RESPONSE EMERGENCY MEDICAL
363.15TECHNICIAN SERVICES COVERED UNDER THE MEDICAL ASSISTANCE
363.16PROGRAM.
363.17(a) The commissioner of human services, in consultation with representatives of
363.18emergency medical service providers, public health nurses, community health workers,
363.19the Minnesota State Fire Chiefs Association, the Minnesota Professional Firefighters
363.20Association, the Minnesota State Firefighters Department Association, Minnesota
363.21Academy of Family Physicians, Minnesota Licensed Practical Nurses Association,
363.22Minnesota Nurses Association, and local public health agencies, shall determine specified
363.23services and payment rates for these services to be performed by community medical
363.24response emergency medical technicians certified under Minnesota Statutes, section
363.25144E.275, subdivision 7, and covered by medical assistance under Minnesota Statutes,
363.26section 256B.0625. Services must be in the CEMT skill set and may include interventions
363.27intended to prevent avoidable ambulance transportation or hospital emergency department
363.28use.
363.29(b) In order to be eligible for payment, services provided by a community medical
363.30response emergency medical technician must be:
363.31(1) ordered by a medical response unit medical director;
363.32(2) part of a patient care plan that has been developed in coordination with the
363.33patient's primary physician, advanced practice registered nurse, and relevant local health
363.34care providers; and
364.1(3) billed by an eligible medical assistance enrolled provider that employs or
364.2contracts with the community medical response emergency medical technician.
364.3In determining the community medical response emergency medical technician services
364.4to include under medical assistance coverage, the commissioner of human services shall
364.5consider the potential of hospital admittance and emergency room utilization reductions as
364.6well as increased access to quality care in rural communities.
364.7(c) The commissioner of human services shall submit the list of services to be
364.8covered by medical assistance to the chairs and ranking minority members of the
364.9legislative committees with jurisdiction over health and human services policy and
364.10spending by February 15, 2016. These services shall not be covered by medical assistance
364.11until legislation providing coverage for the services is enacted in law.

364.12    Sec. 19. EVALUATION OF COMMUNITY MEDICAL RESPONSE
364.13EMERGENCY MEDICAL TECHNICIAN SERVICES.
364.14If legislation is enacted to cover community medical response emergency medical
364.15technician services with medical assistance, the commissioner of human services shall
364.16evaluate the effect of medical assistance and MinnesotaCare coverage for those services
364.17on the cost and quality of care under those programs and the coordination of those services
364.18with the health care home services. The commissioner shall present findings to the chairs
364.19and ranking minority members of the legislative committees with jurisdiction over health
364.20and human services policy and spending by December 1, 2017. The commissioner shall
364.21require medical assistance and MinnesotaCare enrolled providers that employ or contract
364.22with community medical response emergency medical technicians to provide to the
364.23commissioner, in the form and manner specified by the commissioner, the utilization, cost,
364.24and quality data necessary to conduct this evaluation.

364.25ARTICLE 10

364.26HEALTH LICENSING BOARDS

364.27    Section 1. Minnesota Statutes 2014, section 148.52, is amended to read:
364.28148.52 BOARD OF OPTOMETRY.
364.29The Board of Optometry shall consist of two public members as defined by section
364.30214.02 and five qualified Minnesota licensed optometrists appointed by the governor.
364.31Membership terms, compensation of members, removal of members, the filling of
364.32membership vacancies, and fiscal year and reporting requirements shall be as provided in
364.33sections 214.07 to 214.09.
365.1The provision of staff, administrative services and office space; the review and
365.2processing of complaints; the setting of board fees; and other provisions relating to board
365.3operations shall be as provided in chapter 214.

365.4    Sec. 2. Minnesota Statutes 2014, section 148.54, is amended to read:
365.5148.54 BOARD; SEAL.
365.6The Board of Optometry shall elect from among its members a president, vice
365.7president, and secretary and may adopt a seal.

365.8    Sec. 3. Minnesota Statutes 2014, section 148.57, subdivision 1, is amended to read:
365.9    Subdivision 1. Examination. (a) A person not authorized to practice optometry in
365.10the state and desiring to do so shall apply to the state Board of Optometry by filling out
365.11and swearing to an application for a license granted by the board and accompanied by a
365.12fee in an amount of $87 established by the board, not to exceed the amount specified in
365.13section 148.59. With the submission of the application form, the candidate shall prove
365.14that the candidate:
365.15(1) is of good moral character;
365.16(2) has obtained a clinical doctorate degree from a board-approved school or college
365.17of optometry, or is currently enrolled in the final year of study at such an institution; and
365.18(3) has passed all parts of an examination.
365.19(b) The examination shall include both a written portion and a clinical practical
365.20portion and shall thoroughly test the fitness of the candidate to practice in this state. In
365.21regard to the written and clinical practical examinations, the board may:
365.22(1) prepare, administer, and grade the examination itself;
365.23(2) recognize and approve in whole or in part an examination prepared, administered
365.24and graded by a national board of examiners in optometry; or
365.25(3) administer a recognized and approved examination prepared and graded by or
365.26under the direction of a national board of examiners in optometry.
365.27(c) The board shall issue a license to each applicant who satisfactorily passes the
365.28examinations and fulfills the other requirements stated in this section and section 148.575
365.29for board certification for the use of legend drugs. Applicants for initial licensure do not
365.30need to apply for or possess a certificate as referred to in sections 148.571 to 148.574. The
365.31fees mentioned in this section are for the use of the board and in no case shall be refunded.

365.32    Sec. 4. Minnesota Statutes 2014, section 148.57, subdivision 2, is amended to read:
366.1    Subd. 2. Endorsement. (a) An optometrist who holds a current license from
366.2another state, and who has practiced in that state not less than three years immediately
366.3preceding application, may apply for licensure in Minnesota by filling out and swearing
366.4to an application for license by endorsement furnished by the board. The completed
366.5application with all required documentation shall be filed at the board office along with a
366.6fee of $87 established by the board, not to exceed the amount specified in section 148.59.
366.7The application fee shall be for the use of the board and in no case shall be refunded.
366.8(b) To verify that the applicant possesses the knowledge and ability essential to the
366.9practice of optometry in this state, the applicant must provide evidence of:
366.10(1) having obtained a clinical doctorate degree from a board-approved school
366.11or college of optometry;
366.12(2) successful completion of both written and practical examinations for licensure in
366.13the applicant's original state of licensure that thoroughly tested the fitness of the applicant
366.14to practice;
366.15(3) successful completion of an examination of Minnesota state optometry laws;
366.16(4) compliance with the requirements for board certification in section 148.575;
366.17(5) compliance with all continuing education required for license renewal in every
366.18state in which the applicant currently holds an active license to practice; and
366.19(6) being in good standing with every state board from which a license has been
366.20issued.
366.21(c) Documentation from a national certification system or program, approved by
366.22the board, which supports any of the listed requirements, may be used as evidence. The
366.23applicant may then be issued a license if the requirements for licensure in the other state
366.24are deemed by the board to be equivalent to those of sections 148.52 to 148.62.

366.25    Sec. 5. Minnesota Statutes 2014, section 148.57, is amended by adding a subdivision
366.26to read:
366.27    Subd. 5. Change of address. A person regulated by the board shall maintain a
366.28current name and address with the board and shall notify the board in writing within 30
366.29days of any change in name or address. If a name change only is requested, the regulated
366.30person must request revised credentials and return the current credentials to the board.
366.31The board may require the regulated person to substantiate the name change by submitting
366.32official documentation from a court of law or agency authorized under law to receive and
366.33officially record a name change. If an address change only is requested, no request for
366.34revised credentials is required. If the regulated person's current credentials have been lost,
366.35stolen, or destroyed, the person shall provide a written explanation to the board.

367.1    Sec. 6. Minnesota Statutes 2014, section 148.574, is amended to read:
367.2148.574 PROHIBITIONS RELATING TO LEGEND DRUGS;
367.3AUTHORIZING SALES BY PHARMACISTS UNDER CERTAIN CONDITIONS.
367.4    An optometrist shall not purchase, possess, administer, prescribe or give any legend
367.5drug as defined in section 151.01 or 152.02 to any person except as is expressly authorized
367.6by sections 148.571 to 148.577. Nothing in chapter 151 shall prevent a pharmacist from
367.7selling topical ocular drugs to an optometrist authorized to use such drugs according to
367.8sections 148.571 to 148.577. Notwithstanding sections 151.37 and 152.12, an optometrist
367.9is prohibited from dispensing legend drugs at retail, unless the legend drug is within the
367.10scope designated in section 148.56, subdivision 1, and is administered to the eye through
367.11an ophthalmic good as defined in section 145.711, subdivision 4.

367.12    Sec. 7. Minnesota Statutes 2014, section 148.575, subdivision 2, is amended to read:
367.13    Subd. 2. Board certified Requirements defined. "Board certified" means that A
367.14licensed optometrist has been issued a certificate by the Board of Optometry certifying
367.15that the optometrist has complied shall comply with the following requirements for the use
367.16of legend drugs described in section 148.576:
367.17(1) successful completion of at least 60 hours of study in general and ocular
367.18pharmacology emphasizing drugs used for examination or treatment purposes, their
367.19systemic effects and management or referral of adverse reactions;
367.20(2) (1) successful completion of at least 100 hours of study in the examination,
367.21diagnosis, and treatment of conditions of the human eye with legend drugs;
367.22(3) (2) successful completion of two years of supervised clinical experience in
367.23differential diagnosis of eye disease or disorders as part of optometric training or one year
367.24of that experience and ten years of actual clinical experience as a licensed optometrist; and
367.25(4) (3) successful completion of a nationally standardized examination approved or
367.26administered by the board on the subject of treatment and management of ocular disease.

367.27    Sec. 8. Minnesota Statutes 2014, section 148.577, is amended to read:
367.28148.577 STANDARD OF CARE.
367.29A licensed optometrist who is board certified under section 148.575 is held to the
367.30same standard of care in the use of those legend drugs as physicians licensed by the state
367.31of Minnesota.

367.32    Sec. 9. Minnesota Statutes 2014, section 148.59, is amended to read:
368.1148.59 LICENSE RENEWAL; FEE LICENSE AND REGISTRATION FEES.
368.2A licensed optometrist shall pay to the state Board of Optometry a fee as set by the
368.3board in order to renew a license as provided by board rule. No fees shall be refunded.
368.4Fees may not exceed the following amounts but may be adjusted lower by board direction
368.5and are for the exclusive use of the board:
368.6(1) optometry licensure application, $160;
368.7(2) optometry annual licensure renewal, $135;
368.8(3) optometry late penalty fee, $75;
368.9(4) annual license renewal card, $10;
368.10(5) continuing education provider application, $45;
368.11(6) emeritus registration, $10;
368.12(7) endorsement/reciprocity application, $160;
368.13(8) replacement of initial license, $12; and
368.14(9) license verification, $50.

368.15    Sec. 10. Minnesota Statutes 2014, section 148.603, is amended to read:
368.16148.603 FORMS OF GROUNDS FOR DISCIPLINARY ACTIONS ACTION.
368.17When grounds exist under section 148.57, subdivision 3, or other statute or rule
368.18which the board is authorized to enforce, the board may take one or more of the following
368.19disciplinary actions, provided that disciplinary or corrective action may not be imposed
368.20by the board on any regulated person except after a contested case hearing conducted
368.21pursuant to chapter 14 or by consent of the parties:
368.22(1) deny an application for a credential;
368.23(2) revoke the regulated person's credential;
368.24(3) suspend the regulated person's credential;
368.25(4) impose limitations on the regulated person's credential;
368.26(5) impose conditions on the regulated person's credential;
368.27(6) censure or reprimand the regulated person;
368.28(7) impose a civil penalty not exceeding $10,000 for each separate violation, the
368.29amount of the civil penalty to be fixed so as to deprive the person of any economic
368.30advantage gained by reason of the violation or to discourage similar violations or to
368.31reimburse the board for the cost of the investigation and proceeding. For purposes of
368.32this section, the cost of the investigation and proceeding may include, but is not limited
368.33to, fees paid for services provided by the Office of Administrative Hearings, legal and
368.34investigative services provided by the Office of the Attorney General, court reporters,
369.1witnesses, reproduction of records, board members' per diem compensation, board staff
369.2time, and travel costs and expenses incurred by board staff and board members; or
369.3(8) when grounds exist under section 148.57, subdivision 3, or a board rule, enter
369.4into an agreement with the regulated person for corrective action which may include
369.5requiring the regulated person:
369.6(i) to complete an educational course or activity;
369.7(ii) to submit to the executive director or designated board member a written
369.8protocol or reports designed to prevent future violations of the same kind;
369.9(iii) to meet with a board member or board designee to discuss prevention of future
369.10violations of the same kind; or
369.11(iv) to perform other action justified by the facts.
369.12Listing the measures in clause (8) does not preclude the board from including
369.13them in an order for disciplinary action. The board may refuse to grant a license or
369.14may impose disciplinary action as described in section 148.607 against any optometrist
369.15for the following:
369.16(1) failure to demonstrate the qualifications or satisfy the requirements for a license
369.17contained in this chapter or in rules of the board. The burden of proof shall be on the
369.18applicant to demonstrate the qualifications or the satisfaction of the requirements;
369.19(2) obtaining a license by fraud or cheating, or attempting to subvert the licensing
369.20examination process. Conduct which subverts or attempts to subvert the licensing
369.21examination process includes, but is not limited to: (i) conduct which violates the
369.22security of the examination materials, such as removing examination materials from the
369.23examination room or having unauthorized possession of any portion of a future, current, or
369.24previously administered licensing examination; (ii) conduct which violates the standard of
369.25test administration, such as communicating with another examinee during administration
369.26of the examination, copying another examinee's answers, permitting another examinee
369.27to copy one's answers, or possessing unauthorized materials; or (iii) impersonating an
369.28examinee or permitting an impersonator to take the examination on one's own behalf;
369.29(3) conviction, during the previous five years, of a felony or gross misdemeanor,
369.30reasonably related to the practice of optometry. Conviction as used in this section shall
369.31include a conviction of an offense which if committed in this state would be deemed a
369.32felony or gross misdemeanor without regard to its designation elsewhere, or a criminal
369.33proceeding where a finding or verdict of guilt is made or returned but the adjudication of
369.34guilt is either withheld or not entered thereon;
369.35(4) revocation, suspension, restriction, limitation, or other disciplinary action against
369.36the person's optometry license in another state or jurisdiction, failure to report to the
370.1board that charges regarding the person's license have been brought in another state or
370.2jurisdiction, or having been refused a license by any other state or jurisdiction;
370.3(5) advertising which is false or misleading, which violates any rule of the board, or
370.4which claims without substantiation the positive cure of any disease;
370.5(6) violating a rule adopted by the board or an order of the board, a state or federal
370.6law, which relates to the practice of optometry, or a state or federal narcotics or controlled
370.7substance law;
370.8(7) engaging in any unethical conduct; conduct likely to deceive, defraud, or harm
370.9the public, or demonstrating a willful or careless disregard for the health, welfare, or
370.10safety of a patient; or practice of optometry which is professionally incompetent, in that
370.11it may create unnecessary danger to any patient's life, health, or safety, which in any of
370.12the cases, proof of actual injury need not be established;
370.13(8) failure to supervise an optometrist's assistant or failure to supervise an
370.14optometrist under any agreement with the board;
370.15(9) aiding or abetting an unlicensed person in the practice of optometry, except that
370.16it is not a violation of this section for an optometrist to employ, supervise, or delegate
370.17functions to a qualified person who may or may not be required to obtain a license or
370.18registration to provide health services if that person is practicing within the scope of that
370.19person's license or registration or delegated authority;
370.20(10) adjudication as mentally incompetent, mentally ill, or developmentally
370.21disabled, or as a chemically dependent person, a person dangerous to the public, a sexually
370.22dangerous person, or a person who has a sexual psychopathic personality by a court of
370.23competent jurisdiction, within or without this state. Such adjudication shall automatically
370.24suspend a license for the duration of the license unless the board orders otherwise;
370.25(11) engaging in unprofessional conduct which includes any departure from or the
370.26failure to conform to the minimal standards of acceptable and prevailing practice in which
370.27case actual injury to a patient need not be established;
370.28(12) inability to practice optometry with reasonable skill and safety to patients
370.29by reason of illness, use of alcohol, drugs, narcotics, chemicals, or any other type of
370.30material or as a result of any mental or physical condition, including deterioration through
370.31the aging process or loss of motor skills;
370.32(13) revealing a privileged communication from or relating to a patient except when
370.33otherwise required or permitted by law;
370.34(14) improper management of medical records, including failure to maintain
370.35adequate medical records, to comply with a patient's request made pursuant to sections
370.36144.291 to 144.298 or to furnish a medical record or report required by law;
371.1(15) fee splitting, including without limitation:
371.2(i) paying, offering to pay, receiving, or agreeing to receive a commission, rebate, or
371.3remuneration, directly or indirectly, primarily for the referral of patients or the prescription
371.4of drugs or devices; and
371.5(ii) dividing fees with another optometrist, other health care provider, or a
371.6professional corporation, unless the division is in proportion to the services provided
371.7and the responsibility assumed by each professional and the optometrist has disclosed
371.8the terms of the division;
371.9(16) engaging in abusive or fraudulent billing practices, including violations of the
371.10federal Medicare and Medicaid laws or state medical assistance laws;
371.11(17) becoming addicted or habituated to a drug or intoxicant;
371.12(18) prescribing a drug or device for other than accepted therapeutic or experimental
371.13or investigative purposes authorized by the state or a federal agency;
371.14(19) engaging in conduct with a patient which is sexual or may reasonably be
371.15interpreted by the patient as sexual, or in any verbal behavior which is seductive or
371.16sexually demeaning to a patient;
371.17(20) failure to make reports as required by section 148.604 or to cooperate with an
371.18investigation of the board as required by section 148.606;
371.19(21) knowingly providing false or misleading information that is directly related to
371.20the care of a patient; and
371.21(22) practice of a board-regulated profession under lapsed or nonrenewed credentials.

371.22    Sec. 11. [148.604] REPORTING OBLIGATIONS.
371.23    Subdivision 1. Permission to report. A person who has knowledge of any conduct
371.24constituting grounds for discipline under sections 148.52 to 148.62 may report the
371.25violation to the board.
371.26    Subd. 2. Institutions. Any hospital, clinic, prepaid medical plan, or other health
371.27care institution or organization located in this state shall report to the board any action
371.28taken by the institution or organization or any of its administrators or medical or other
371.29committees to revoke, suspend, restrict, or condition an optometrist's privilege to practice
371.30or treat patients in the institution, or as part of the organization, any denial of privileges,
371.31or any other disciplinary action. The institution or organization shall also report the
371.32resignation of any optometrist prior to the conclusion of any disciplinary proceeding, or
371.33prior to the commencement of formal charges but after the optometrist had knowledge
371.34that formal charges were contemplated or in preparation. Each report made under this
371.35subdivision must state the nature of the action taken, state in detail the reasons for
372.1the action, and identify the specific patient medical records upon which the action was
372.2based. No report shall be required of an optometrist voluntarily limiting the practice of
372.3the optometrist at a hospital provided that the optometrist notifies all hospitals where the
372.4optometrist has privileges of the voluntary limitation and the reasons for it.
372.5    Subd. 3. Licensed professionals. A licensed optometrist shall report to the board
372.6personal knowledge of any conduct by any optometrist which the person reasonably
372.7believes constitutes grounds for disciplinary action under sections 148.52 to 148.62,
372.8including any conduct indicating that the person may be incompetent, may have engaged
372.9in unprofessional conduct, or may be physically unable to safely engage in the practice
372.10of optometry.
372.11    Subd. 4. Self-reporting. An optometrist shall report to the board any personal
372.12action which would require that a report be filed with the board by any person, health care
372.13facility, business, or organization pursuant to subdivisions 2 and 3.
372.14    Subd. 5. Deadlines; forms; rulemaking. Reports required by subdivisions 2 to
372.154 must be submitted not later than 30 days after the occurrence of the reportable event
372.16or transaction. The board may provide forms for the submission of reports required by
372.17this section, may require that reports be submitted on the forms provided, and may adopt
372.18rules necessary to ensure prompt and accurate reporting.
372.19    Subd. 6. Subpoenas. The board may issue subpoenas for the production of any
372.20reports required by subdivisions 2 to 4 or any related documents.

372.21    Sec. 12. [148.605] IMMUNITY.
372.22    Subdivision 1. Reporting. Any person, health care facility, business, or organization
372.23is immune from civil liability or criminal prosecution for submitting a report to the
372.24board pursuant to section 148.604 or for otherwise reporting to the board violations or
372.25alleged violations of section 148.603, if they are acting in good faith and in the exercise
372.26of reasonable care.
372.27    Subd. 2. Investigation; indemnification. (a) Members of the board, persons
372.28employed by the board, and consultants retained by the board for the purpose of
372.29investigation of violations, the preparation of charges, and management of board orders on
372.30behalf of the board are immune from civil liability and criminal prosecution for any actions,
372.31transactions, or publications in the execution of, or relating to, their duties under sections
372.32148.52 to 148.62, if they are acting in good faith and in the exercise of reasonable care.
372.33(b) Members of the board and persons employed by the board or engaged in
372.34maintaining records and making reports regarding adverse health care events are immune
372.35from civil liability and criminal prosecution for any actions, transactions, or publications
373.1in the execution of, or relating to, their duties under sections 148.52 to 148.62, if they are
373.2acting in good faith and in the exercise of reasonable care.
373.3(c) For purposes of this section, a member of the board or a consultant described in
373.4paragraph (a) is considered a state employee under section 3.736, subdivision 9.

373.5    Sec. 13. [148.606] OPTOMETRIST COOPERATION.
373.6An optometrist who is the subject of an investigation by or on behalf of the board
373.7shall cooperate fully with the investigation. Cooperation includes responding fully and
373.8promptly to any question raised by or on behalf of the board relating to the subject of the
373.9investigation and providing copies of patient medical records, as reasonably requested
373.10by the board, to assist the board in its investigation. If the board does not have written
373.11consent from a patient permitting access to the patient's records, the optometrist shall
373.12delete any data in the record which identifies the patient before providing it to the board.
373.13The board shall maintain any records obtained pursuant to this section as investigative
373.14data pursuant to chapter 13.

373.15    Sec. 14. [148.607] DISCIPLINARY ACTIONS.
373.16When the board finds that a licensed optometrist under section 148.57 has violated a
373.17provision or provisions of sections 148.52 to 148.62, it may do one or more of the following:
373.18(1) revoke the license;
373.19(2) suspend the license;
373.20(3) impose limitations or conditions on the optometrist's practice of optometry,
373.21including the limitation of scope of practice to designated field specialties; the imposition
373.22of retraining or rehabilitation requirements; the requirement of practice under supervision;
373.23or the conditioning of continued practice on demonstration of knowledge or skills by
373.24appropriate examination or other review of skill and competence;
373.25(4) impose a civil penalty not exceeding $10,000 for each separate violation, the
373.26amount of the civil penalty to be fixed so as to deprive the optometrist of any economic
373.27advantage gained by reason of the violation charged or to reimburse the board for the cost
373.28of the investigation and proceeding; and
373.29(5) censure or reprimand the licensed optometrist.

373.30    Sec. 15. Minnesota Statutes 2014, section 148E.075, is amended to read:
373.31148E.075 INACTIVE LICENSES ALTERNATE LICENSES.
373.32    Subdivision 1. Inactive status Temporary leave license. (a) A licensee qualifies
373.33for inactive status under either of the circumstances described in paragraph (b) or (c).
374.1    (b) A licensee qualifies for inactive status when the licensee is granted temporary
374.2leave from active practice. A licensee qualifies for temporary leave from active practice if
374.3the licensee demonstrates to the satisfaction of the board that the licensee is not engaged
374.4in the practice of social work in any setting, including settings in which social workers are
374.5exempt from licensure according to section 148E.065. A licensee who is granted temporary
374.6leave from active practice may reactivate the license according to section 148E.080.
374.7    (b) A licensee may maintain a temporary leave license for no more than four
374.8consecutive years.
374.9    (c) A licensee qualifies for inactive status when a licensee is granted an emeritus
374.10license. A licensee qualifies for an emeritus license if the licensee demonstrates to the
374.11satisfaction of the board that:
374.12    (1) the licensee is retired from social work practice; and
374.13    (2) the licensee is not engaged in the practice of social work in any setting, including
374.14settings in which social workers are exempt from licensure according to section 148E.065.
374.15A licensee who possesses an emeritus license may reactivate the license according to
374.16section 148E.080.
374.17    (c) A licensee who is granted temporary leave from active practice may reactivate
374.18the license according to section 148E.080. If a licensee does not apply for reactivation
374.19within 60 days following the end of the consecutive four-year period, the license
374.20automatically expires. An individual with an expired license may apply for new licensure
374.21according to section 148E.055.
374.22    (d) Except as provided in paragraph (e), a licensee who holds a temporary leave
374.23license must not practice, attempt to practice, offer to practice, or advertise or hold out as
374.24authorized to practice social work.
374.25    (e) The board may grant a variance to the requirements of paragraph (d) if a licensee
374.26on temporary leave license provides emergency social work services. A variance is
374.27granted only if the board provides the variance in writing to the licensee. The board may
374.28impose conditions or restrictions on the variance.
374.29    (f) In making representations of professional status to the public, when holding a
374.30temporary leave license, a licensee must state that the license is not active and that the
374.31licensee cannot practice social work.
374.32    Subd. 1a. Emeritus inactive license. (a) A licensee qualifies for an emeritus inactive
374.33license if the licensee demonstrates to the satisfaction of the board that the licensee is:
374.34(1) retired from social work practice; and
374.35(2) not engaged in the practice of social work in any setting, including settings in
374.36which social workers are exempt from licensure according to section 148E.065.
375.1(b) A licensee with an emeritus inactive license may apply for reactivation according
375.2to section 148E.080 only during the four years following the granting of the emeritus
375.3inactive license. However, after four years following the granting of the emeritus inactive
375.4license, an individual may apply for new licensure according to section 148E.055.
375.5(c) Except as provided in paragraph (d), a licensee who holds an emeritus inactive
375.6license must not practice, attempt to practice, offer to practice, or advertise or hold out as
375.7authorized to practice social work.
375.8(d) The board may grant a variance to the requirements of paragraph (c) if a licensee
375.9on emeritus inactive license provides emergency social work services. A variance is
375.10granted only if the board provides the variance in writing to the licensee. The board may
375.11impose conditions or restrictions on the variance.
375.12(e) In making representations of professional status to the public, when holding
375.13an emeritus inactive license, a licensee must state that the license is not active and that
375.14the licensee cannot practice social work.
375.15    Subd. 1b. Emeritus active license. (a) A licensee qualifies for an emeritus active
375.16license if the applicant demonstrates to the satisfaction of the board that the licensee is:
375.17(1) retired from social work practice; and
375.18(2) in compliance with the supervised practice requirements, as applicable, under
375.19sections 148E.100 to 148E.125.
375.20(b) A licensee who is issued an emeritus active license is only authorized to engage in:
375.21(1) pro bono or unpaid social work practice as specified in section 148E.010,
375.22subdivisions 6 and 11; or
375.23(2) paid social work practice not to exceed 240 clock hours per calendar year, for the
375.24exclusive purpose to provide licensing supervision as specified in sections 148E.100 to
375.25148E.125; and
375.26(3) the authorized scope of practice specified in section 148E.050.
375.27(c) An emeritus active license must be renewed according to the requirements
375.28specified in section 148E.070, subdivisions 1, 2, 3, 4, and 5.
375.29(d) At the time of license renewal a licensee must provide evidence satisfactory to the
375.30board that the licensee has, during the renewal term, completed 20 clock hours of continuing
375.31education, including at least two clock hours in ethics, as specified in section 148E.130:
375.32(1) for licensed independent clinical social workers, at least 12 clock hours must be
375.33in the clinical content areas specified in section 148E.055, subdivision 5; and
375.34(2) for social workers providing supervision according to sections 148E.100 to
375.35148E.125, at least three clock hours must be in the practice of supervision.
376.1(e) Independent study hours must not consist of more than eight clock hours of
376.2continuing education per renewal term.
376.3(f) Failure to renew an active emeritus license on the expiration date will result in an
376.4expired license as specified in section 148E.070, subdivision 5.
376.5(g) The board may grant a variance to the requirements of paragraph (b) if a licensee
376.6holding an emeritus active license provides emergency social work services. A variance is
376.7granted only if the board provides the variance in writing to the licensee. The board may
376.8impose conditions or restrictions on the variance.
376.9(h) In making representations of professional status to the public, when holding an
376.10emeritus active license, a licensee must state that an emeritus active license authorizes only
376.11pro bono or unpaid social work practice, or paid social work practice not to exceed 240
376.12clock hours per calendar year, for the exclusive purpose to provide licensing supervision
376.13as specified in sections 148E.100 to 148E.125.
376.14(i) Notwithstanding the time limit and emeritus active license renewal requirements
376.15specified in this section, a licensee who possesses an emeritus active license may
376.16reactivate the license according to section 148E.080 or apply for new licensure according
376.17to section 148E.055.
376.18    Subd. 2. Application. A licensee may apply for inactive status temporary leave
376.19license, emeritus inactive license, or emeritus active license:
376.20    (1) at any time when currently licensed under section 148E.055, 148E.0555,
376.21148E.0556, or 148E.0557, or when licensed as specified in section 148E.075, by
376.22submitting an application for a temporary leave from active practice or for an emeritus
376.23license form required by the board; or
376.24    (2) as an alternative to applying for the renewal of a license by so recording on the
376.25application for license renewal form required by the board and submitting the completed,
376.26signed application to the board.
376.27    An application that is not completed or signed, or that is not accompanied by the
376.28correct fee, must be returned to the applicant, along with any fee submitted, and is void.
376.29For applications submitted electronically, a "signed application" means providing an
376.30attestation as specified by the board.
376.31    Subd. 3. Fee. (a) Regardless of when the application for inactive status temporary
376.32leave license or emeritus inactive license is submitted, the temporary leave license or
376.33emeritus inactive license fee specified in section 148E.180, whichever is applicable, must
376.34accompany the application. A licensee who is approved for inactive status temporary
376.35leave license or emeritus inactive license before the license expiration date is not entitled
376.36to receive a refund for any portion of the license or renewal fee.
377.1    (b) If an application for temporary leave or emeritus active license is received after
377.2the license expiration date, the licensee must pay a renewal late fee as specified in section
377.3148E.180 in addition to the temporary leave fee.
377.4    (c) Regardless of when the application for emeritus active license is submitted,
377.5the emeritus active license fee is one-half of the renewal fee for the applicable license
377.6specified in section 148E.180, subdivision 3, and must accompany the application. A
377.7licensee who is approved for emeritus active license before the license expiration date is
377.8not entitled to receive a refund for any portion of the license or renewal fee.
377.9    Subd. 4. Time limits for temporary leaves. A licensee may maintain an inactive
377.10license on temporary leave for no more than five consecutive years. If a licensee does
377.11not apply for reactivation within 60 days following the end of the consecutive five-year
377.12period, the license automatically expires.
377.13    Subd. 5. Time limits for emeritus license. A licensee with an emeritus license may
377.14not apply for reactivation according to section 148E.080 after five years following the
377.15granting of the emeritus license. However, after five years following the granting of the
377.16emeritus license, an individual may apply for new licensure according to section 148E.055.
377.17    Subd. 6. Prohibition on practice. (a) Except as provided in paragraph (b), a
377.18licensee whose license is inactive must not practice, attempt to practice, offer to practice,
377.19or advertise or hold out as authorized to practice social work.
377.20    (b) The board may grant a variance to the requirements of paragraph (a) if a licensee
377.21on inactive status provides emergency social work services. A variance is granted only
377.22if the board provides the variance in writing to the licensee. The board may impose
377.23conditions or restrictions on the variance.
377.24    Subd. 7. Representations of professional status. In making representations of
377.25professional status to the public, a licensee whose license is inactive must state that the
377.26license is inactive and that the licensee cannot practice social work.
377.27    Subd. 8. Disciplinary or other action. The board may resolve any pending
377.28complaints against a licensee before approving an application for inactive status an
377.29alternate license specified in this section. The board may take action according to sections
377.30148E.255 to 148E.270 against a licensee whose license is inactive who is issued an
377.31alternate license specified in this section based on conduct occurring before the license is
377.32inactive or conduct occurring while the license is inactive effective.

377.33    Sec. 16. Minnesota Statutes 2014, section 148E.080, subdivision 1, is amended to read:
377.34    Subdivision 1. Mailing notices to licensees on temporary leave. The board must
377.35mail a notice for reactivation to a licensee on temporary leave at least 45 days before the
378.1expiration date of the license according to section 148E.075, subdivision 4 1. Mailing
378.2the notice by United States mail to the licensee's last known mailing address constitutes
378.3valid mailing. Failure to receive the reactivation notice does not relieve a licensee of the
378.4obligation to comply with the provisions of this section to reactivate a license.

378.5    Sec. 17. Minnesota Statutes 2014, section 148E.080, subdivision 2, is amended to read:
378.6    Subd. 2. Reactivation from a temporary leave or emeritus status. To reactivate a
378.7license from a temporary leave or emeritus status, a licensee must do the following within
378.8the time period specified in section 148E.075, subdivisions 4 and 5 1, 1a, and 1b:
378.9    (1) complete an application form specified by the board;
378.10    (2) document compliance with the continuing education requirements specified in
378.11subdivision 4;
378.12    (3) submit a supervision plan, if required;
378.13    (4) pay the reactivation of an inactive licensee a license fee specified in section
378.14148E.180 ; and
378.15    (5) pay the wall certificate fee according to section 148E.095, subdivision 1,
378.16paragraph (b) or (c), if the licensee needs a duplicate license.

378.17    Sec. 18. Minnesota Statutes 2014, section 148E.180, subdivision 2, is amended to read:
378.18    Subd. 2. License fees. License fees are as follows:
378.19    (1) for a licensed social worker, $81;
378.20    (2) for a licensed graduate social worker, $144;
378.21    (3) for a licensed independent social worker, $216;
378.22    (4) for a licensed independent clinical social worker, $238.50;
378.23    (5) for an emeritus inactive license, $43.20; and
378.24    (6) for an emeritus active license, one-half of the renewal fee specified in subdivision
378.253; and
378.26    (7) for a temporary leave fee, the same as the renewal fee specified in subdivision 3.
378.27    If the licensee's initial license term is less or more than 24 months, the required
378.28license fees must be prorated proportionately.

378.29    Sec. 19. Minnesota Statutes 2014, section 148E.180, subdivision 5, is amended to read:
378.30    Subd. 5. Late fees. Late fees are as follows:
378.31    (1) renewal late fee, one-fourth of the renewal fee specified in subdivision 3; and
378.32    (2) supervision plan late fee, $40.; and
379.1    (3) license late fee, $100 plus the prorated share of the license fee specified in
379.2subdivision 2 for the number of months during which the individual practiced social
379.3work without a license.

379.4    Sec. 20. Minnesota Statutes 2014, section 150A.091, subdivision 4, is amended to read:
379.5    Subd. 4. Annual license fees. Each limited faculty or resident dentist shall submit
379.6with an annual license renewal application a fee established by the board not to exceed
379.7the following amounts:
379.8(1) limited faculty dentist, $168; and
379.9(2) resident dentist or dental provider, $59 $85.

379.10    Sec. 21. Minnesota Statutes 2014, section 150A.091, subdivision 5, is amended to read:
379.11    Subd. 5. Biennial license or permit fees. Each of the following applicants shall
379.12submit with a biennial license or permit renewal application a fee as established by the
379.13board, not to exceed the following amounts:
379.14(1) dentist or full faculty dentist, $336 $475;
379.15(2) dental therapist, $180 $300;
379.16(3) dental hygienist, $118 $200;
379.17(4) licensed dental assistant, $80 $150; and
379.18(5) dental assistant with a permit as described in Minnesota Rules, part 3100.8500,
379.19subpart 3, $24.

379.20    Sec. 22. Minnesota Statutes 2014, section 150A.091, subdivision 11, is amended to read:
379.21    Subd. 11. Certificate application fee for anesthesia/sedation. Each dentist
379.22shall submit with a general anesthesia or moderate sedation application or, a contracted
379.23sedation provider application, or biennial renewal, a fee as established by the board not to
379.24exceed the following amounts:
379.25(1) for both a general anesthesia and moderate sedation application, $250 $400;
379.26(2) for a general anesthesia application only, $250 $400;
379.27(3) for a moderate sedation application only, $250 $400; and
379.28(4) for a contracted sedation provider application, $250 $400.

379.29    Sec. 23. Minnesota Statutes 2014, section 150A.091, is amended by adding a
379.30subdivision to read:
380.1    Subd. 17. Advanced dental therapy examination fee. Any dental therapist eligible
380.2to sit for the advanced dental therapy certification examination must submit with the
380.3application a fee as established by the board, not to exceed $250.

380.4    Sec. 24. Minnesota Statutes 2014, section 150A.091, is amended by adding a
380.5subdivision to read:
380.6    Subd. 18. Corporation or professional firm late fee. Any corporation or
380.7professional firm whose annual fee is not postmarked or otherwise received by the board
380.8by the due date of December 31 shall, in addition to the fee, submit a late fee as established
380.9by the board, not to exceed $15.

380.10    Sec. 25. Minnesota Statutes 2014, section 150A.31, is amended to read:
380.11150A.31 FEES.
380.12(a) The initial biennial registration fee is $50.
380.13(b) The biennial renewal registration fee is $25 not to exceed $80.
380.14(c) The fees specified in this section are nonrefundable and shall be deposited in
380.15the state government special revenue fund.

380.16    Sec. 26. Minnesota Statutes 2014, section 151.01, subdivision 15a, is amended to read:
380.17    Subd. 15a. Pharmacy technician. "Pharmacy technician" means a person not
380.18licensed as a pharmacist or registered as a pharmacist intern, who assists the pharmacist
380.19in the preparation and dispensing of medications by performing computer entry of
380.20prescription data and other manipulative tasks. A pharmacy technician shall not perform
380.21tasks specifically reserved to a licensed pharmacist or requiring has been trained in
380.22pharmacy tasks that do not require the professional judgment of a licensed pharmacist. A
380.23pharmacy technician may not perform tasks specifically reserved to a licensed pharmacist.

380.24    Sec. 27. Minnesota Statutes 2014, section 151.01, subdivision 27, is amended to read:
380.25    Subd. 27. Practice of pharmacy. "Practice of pharmacy" means:
380.26    (1) interpretation and evaluation of prescription drug orders;
380.27    (2) compounding, labeling, and dispensing drugs and devices (except labeling by
380.28a manufacturer or packager of nonprescription drugs or commercially packaged legend
380.29drugs and devices);
380.30    (3) participation in clinical interpretations and monitoring of drug therapy for
380.31assurance of safe and effective use of drugs, including the performance of laboratory tests
380.32that are waived under the federal Clinical Laboratory Improvement Act of 1988, United
381.1States Code, title 42, section 263a et seq., provided that a pharmacist may interpret the
381.2results of laboratory tests but may modify drug therapy only pursuant to a protocol or
381.3collaborative practice agreement;
381.4    (4) participation in drug and therapeutic device selection; drug administration for first
381.5dosage and medical emergencies; drug regimen reviews; and drug or drug-related research;
381.6    (5) participation in administration of influenza vaccines to all eligible individuals ten
381.7six years of age and older and all other vaccines to patients 18 13 years of age and older
381.8by written protocol with a physician licensed under chapter 147, a physician assistant
381.9authorized to prescribe drugs under chapter 147A, or an advanced practice registered
381.10nurse authorized to prescribe drugs under section 148.235, provided that:
381.11(i) the protocol includes, at a minimum:
381.12(A) the name, dose, and route of each vaccine that may be given;
381.13(B) the patient population for whom the vaccine may be given;
381.14(C) contraindications and precautions to the vaccine;
381.15(D) the procedure for handling an adverse reaction;
381.16(E) the name, signature, and address of the physician, physician assistant, or
381.17advanced practice registered nurse;
381.18(F) a telephone number at which the physician, physician assistant, or advanced
381.19practice registered nurse can be contacted; and
381.20(G) the date and time period for which the protocol is valid;
381.21    (ii) the pharmacist has successfully completed a program approved by the
381.22Accreditation Council for Pharmacy Education specifically for the administration of
381.23immunizations or a program approved by the board;
381.24    (iii) the pharmacist utilizes the Minnesota Immunization Information Connection
381.25to assess the immunization status of individuals prior to the administration of vaccines,
381.26except when administering influenza vaccines to individuals age nine and older;
381.27    (iv) the pharmacist reports the administration of the immunization to the patient's
381.28primary physician or clinic or to the Minnesota Immunization Information Connection; and
381.29(iv) (v) the pharmacist complies with guidelines for vaccines and immunizations
381.30established by the federal Advisory Committee on Immunization Practices, except that a
381.31pharmacist does not need to comply with those portions of the guidelines that establish
381.32immunization schedules when administering a vaccine pursuant to a valid, patient-specific
381.33order issued by a physician licensed under chapter 147, a physician assistant authorized to
381.34prescribe drugs under chapter 147A, or an advanced practice nurse authorized to prescribe
381.35drugs under section 148.235, provided that the order is consistent with the United States
381.36Food and Drug Administration approved labeling of the vaccine;
382.1    (6) participation in the initiation, management, modification, and discontinuation
382.2of drug therapy according to a written protocol or collaborative practice agreement
382.3between: (i) one or more pharmacists and one or more dentists, optometrists, physicians,
382.4podiatrists, or veterinarians; or (ii) one or more pharmacists and one or more physician
382.5assistants authorized to prescribe, dispense, and administer under chapter 147A, or
382.6advanced practice nurses authorized to prescribe, dispense, and administer under section
382.7148.235 . Any changes in drug therapy made pursuant to a protocol or collaborative
382.8practice agreement must be documented by the pharmacist in the patient's medical record
382.9or reported by the pharmacist to a practitioner responsible for the patient's care;
382.10    (7) participation in the storage of drugs and the maintenance of records;
382.11    (8) patient counseling on therapeutic values, content, hazards, and uses of drugs
382.12and devices; and
382.13    (9) offering or performing those acts, services, operations, or transactions necessary
382.14in the conduct, operation, management, and control of a pharmacy.

382.15    Sec. 28. Minnesota Statutes 2014, section 151.02, is amended to read:
382.16151.02 STATE BOARD OF PHARMACY.
382.17The Minnesota State Board of Pharmacy shall consist of two three public members
382.18as defined by section 214.02 and five six pharmacists actively engaged in the practice of
382.19pharmacy in this state. Each of said pharmacists shall have had at least five consecutive
382.20years of practical experience as a pharmacist immediately preceding appointment.

382.21    Sec. 29. Minnesota Statutes 2014, section 151.065, subdivision 1, is amended to read:
382.22    Subdivision 1. Application fees. Application fees for licensure and registration
382.23are as follows:
382.24(1) pharmacist licensed by examination, $130 $145;
382.25(2) pharmacist licensed by reciprocity, $225 $240;
382.26(3) pharmacy intern, $30 $37.50;
382.27(4) pharmacy technician, $30 $37.50;
382.28(5) pharmacy, $190 $225;
382.29(6) drug wholesaler, legend drugs only, $200 $235;
382.30(7) drug wholesaler, legend and nonlegend drugs, $200 $235;
382.31(8) drug wholesaler, nonlegend drugs, veterinary legend drugs, or both, $175 $210;
382.32(9) drug wholesaler, medical gases, $150 $175;
382.33(10) drug wholesaler, also licensed as a pharmacy in Minnesota, $125 $150;
382.34(11) drug manufacturer, legend drugs only, $200 $235;
383.1(12) drug manufacturer, legend and nonlegend drugs, $200 $235;
383.2(13) drug manufacturer, nonlegend or veterinary legend drugs, $175 $210;
383.3(14) drug manufacturer, medical gases, $150 $185;
383.4(15) drug manufacturer, also licensed as a pharmacy in Minnesota, $125 $150;
383.5(16) medical gas distributor, $75 $110;
383.6(17) controlled substance researcher, $50 $75; and
383.7(18) pharmacy professional corporation, $100 $125.

383.8    Sec. 30. Minnesota Statutes 2014, section 151.065, subdivision 2, is amended to read:
383.9    Subd. 2. Original license fee. The pharmacist original licensure fee, $130 $145.

383.10    Sec. 31. Minnesota Statutes 2014, section 151.065, subdivision 3, is amended to read:
383.11    Subd. 3. Annual renewal fees. Annual licensure and registration renewal fees
383.12are as follows:
383.13(1) pharmacist, $130 $145;
383.14(2) pharmacy technician, $30 $37.50;
383.15(3) pharmacy, $190 $225;
383.16(4) drug wholesaler, legend drugs only, $200 $235;
383.17(5) drug wholesaler, legend and nonlegend drugs, $200 $235;
383.18(6) drug wholesaler, nonlegend drugs, veterinary legend drugs, or both, $175 $210;
383.19(7) drug wholesaler, medical gases, $150 $185;
383.20(8) drug wholesaler, also licensed as a pharmacy in Minnesota, $125 $150;
383.21(9) drug manufacturer, legend drugs only, $200 $235;
383.22(10) drug manufacturer, legend and nonlegend drugs, $200 $235;
383.23(11) drug manufacturer, nonlegend, veterinary legend drugs, or both, $175 $210;
383.24(12) drug manufacturer, medical gases, $150 $185;
383.25(13) drug manufacturer, also licensed as a pharmacy in Minnesota, $125 $150;
383.26(14) medical gas distributor, $75 $110;
383.27(15) controlled substance researcher, $50 $75; and
383.28(16) pharmacy professional corporation, $45 $75.

383.29    Sec. 32. Minnesota Statutes 2014, section 151.065, subdivision 4, is amended to read:
383.30    Subd. 4. Miscellaneous fees. Fees for issuance of affidavits and duplicate licenses
383.31and certificates are as follows:
383.32(1) intern affidavit, $15 $20;
383.33(2) duplicate small license, $15 $20; and
384.1(3) duplicate large certificate, $25 $30.

384.2    Sec. 33. Minnesota Statutes 2014, section 151.102, is amended to read:
384.3151.102 PHARMACY TECHNICIAN.
384.4    Subdivision 1. General. A pharmacy technician may assist a pharmacist in the
384.5practice of pharmacy by performing nonjudgmental tasks and that are not reserved to, and
384.6do not require the professional judgment of, a licensed pharmacist. A pharmacy technician
384.7works under the personal and direct supervision of the pharmacist. A pharmacist may
384.8supervise two up to three technicians, as long as the. A pharmacist assumes responsibility
384.9is responsible for all the functions work performed by the technicians who are under the
384.10supervision of the pharmacist. A pharmacy may exceed the ratio of pharmacy technicians
384.11to pharmacists permitted in this subdivision or in rule by a total of one technician at
384.12any given time in the pharmacy, provided at least one technician in the pharmacy
384.13holds a valid certification from the Pharmacy Technician Certification Board or from
384.14another national certification body for pharmacy technicians that requires passage of a
384.15nationally recognized, psychometrically valid certification examination for certification as
384.16determined by the Board of Pharmacy. The Board of Pharmacy may, by rule, set ratios of
384.17technicians to pharmacists greater than two three to one for the functions specified in rule.
384.18The delegation of any duties, tasks, or functions by a pharmacist to a pharmacy technician
384.19is subject to continuing review and becomes the professional and personal responsibility of
384.20the pharmacist who directed the pharmacy technician to perform the duty, task, or function.
384.21    Subd. 2. Waivers by board permitted. A pharmacist in charge in a pharmacy may
384.22petition the board for authorization to allow a pharmacist to supervise more than two three
384.23pharmacy technicians. The pharmacist's petition must include provisions addressing the
384.24maintenance of how patient care and safety will be maintained. A petition filed with the
384.25board under this subdivision shall be deemed approved 90 days after the board receives
384.26the petition, unless the board denies the petition within 90 days of receipt and notifies the
384.27petitioning pharmacist of the petition's denial and the board's reasons for denial.
384.28    Subd. 3. Registration fee. The board shall not register an individual as a pharmacy
384.29technician unless all applicable fees specified in section 151.065 have been paid.

384.30    Sec. 34. REPEALER.
384.31Minnesota Statutes 2014, sections 148.57, subdivisions 3 and 4; 148.571; 148.572;
384.32148.573, subdivision 1; 148.575, subdivisions 1, 3, 5, and 6; 148.576; 148E.060,
384.33subdivision 12; and 148E.075, subdivisions 4, 5, 6, and 7, are repealed.

385.1ARTICLE 11

385.2HEALTH CARE

385.3    Section 1. Minnesota Statutes 2014, section 62A.045, is amended to read:
385.462A.045 PAYMENTS ON BEHALF OF ENROLLEES IN GOVERNMENT
385.5HEALTH PROGRAMS.
385.6(a) As a condition of doing business in Minnesota or providing coverage to
385.7residents of Minnesota covered by this section, each health insurer shall comply with the
385.8requirements of the federal Deficit Reduction Act of 2005, Public Law 109-171, including
385.9any federal regulations adopted under that act, to the extent that it imposes a requirement
385.10that applies in this state and that is not also required by the laws of this state. This section
385.11does not require compliance with any provision of the federal act prior to the effective date
385.12provided for that provision in the federal act. The commissioner shall enforce this section.
385.13For the purpose of this section, "health insurer" includes self-insured plans, group
385.14health plans (as defined in section 607(1) of the Employee Retirement Income Security
385.15Act of 1974), service benefit plans, managed care organizations, pharmacy benefit
385.16managers, or other parties that are by contract legally responsible to pay a claim for a
385.17health-care item or service for an individual receiving benefits under paragraph (b).
385.18(b) No plan offered by a health insurer issued or renewed to provide coverage to
385.19a Minnesota resident shall contain any provision denying or reducing benefits because
385.20services are rendered to a person who is eligible for or receiving medical benefits pursuant
385.21to title XIX of the Social Security Act (Medicaid) in this or any other state; chapter 256;
385.22256B; or 256D or services pursuant to section 252.27; 256L.01 to 256L.10; 260B.331,
385.23subdivision 2 ; 260C.331, subdivision 2; or 393.07, subdivision 1 or 2. No health insurer
385.24providing benefits under plans covered by this section shall use eligibility for medical
385.25programs named in this section as an underwriting guideline or reason for nonacceptance
385.26of the risk.
385.27(c) If payment for covered expenses has been made under state medical programs for
385.28health care items or services provided to an individual, and a third party has a legal liability
385.29to make payments, the rights of payment and appeal of an adverse coverage decision for the
385.30individual, or in the case of a child their responsible relative or caretaker, will be subrogated
385.31to the state agency. The state agency may assert its rights under this section within three
385.32years of the date the service was rendered. For purposes of this section, "state agency"
385.33includes prepaid health plans under contract with the commissioner according to sections
385.34256B.69 , 256D.03, subdivision 4, paragraph (c), and 256L.12; children's mental health
385.35collaboratives under section 245.493; demonstration projects for persons with disabilities
386.1under section 256B.77; nursing homes under the alternative payment demonstration project
386.2under section 256B.434; and county-based purchasing entities under section 256B.692.
386.3(d) Notwithstanding any law to the contrary, when a person covered by a plan
386.4offered by a health insurer receives medical benefits according to any statute listed in this
386.5section, payment for covered services or notice of denial for services billed by the provider
386.6must be issued directly to the provider. If a person was receiving medical benefits through
386.7the Department of Human Services at the time a service was provided, the provider must
386.8indicate this benefit coverage on any claim forms submitted by the provider to the health
386.9insurer for those services. If the commissioner of human services notifies the health
386.10insurer that the commissioner has made payments to the provider, payment for benefits or
386.11notices of denials issued by the health insurer must be issued directly to the commissioner.
386.12Submission by the department to the health insurer of the claim on a Department of
386.13Human Services claim form is proper notice and shall be considered proof of payment of
386.14the claim to the provider and supersedes any contract requirements of the health insurer
386.15relating to the form of submission. Liability to the insured for coverage is satisfied to the
386.16extent that payments for those benefits are made by the health insurer to the provider or
386.17the commissioner as required by this section.
386.18(e) When a state agency has acquired the rights of an individual eligible for medical
386.19programs named in this section and has health benefits coverage through a health insurer,
386.20the health insurer shall not impose requirements that are different from requirements
386.21applicable to an agent or assignee of any other individual covered.
386.22(f) A health insurer must process a clean claim made by a state agency for covered
386.23expenses paid under state medical programs within 90 business days of the claim's
386.24submission. A health insurer must process all other claims made by a state agency for
386.25covered expenses paid under a state medical program within the timeline set forth in Code
386.26of Federal Regulations, title 42, section 447.45(d)(4).
386.27(g) A health insurer may request a refund of a claim paid in error to the Department
386.28of Human Services within two years of the date the payment was made to the department.
386.29A request for a refund shall not be honored by the department if the health insurer makes
386.30the request after the time period has lapsed.

386.31    Sec. 2. Minnesota Statutes 2014, section 150A.06, subdivision 1b, is amended to read:
386.32    Subd. 1b. Resident dentists. A person who is a graduate of a dental school and
386.33is an enrolled graduate student or student of an accredited advanced dental education
386.34program and who is not licensed to practice dentistry in the state shall obtain from the
386.35board a license to practice dentistry as a resident dentist. The license must be designated
387.1"resident dentist license" and authorizes the licensee to practice dentistry only under the
387.2supervision of a licensed dentist. A University of Minnesota School of Dentistry dental
387.3resident holding a resident dentist license is eligible for enrollment in medical assistance,
387.4as provided under section 256B.0625, subdivision 9b. A resident dentist license must be
387.5renewed annually pursuant to the board's rules. An applicant for a resident dentist license
387.6shall pay a nonrefundable fee set by the board for issuing and renewing the license. The
387.7requirements of sections 150A.01 to 150A.21 apply to resident dentists except as specified
387.8in rules adopted by the board. A resident dentist license does not qualify a person for
387.9licensure under subdivision 1.

387.10    Sec. 3. Minnesota Statutes 2014, section 174.29, subdivision 1, is amended to read:
387.11    Subdivision 1. Definition. For the purpose of sections 174.29 and 174.30 "special
387.12transportation service" means motor vehicle transportation provided on a regular basis
387.13by a public or private entity or person that is designed exclusively or primarily to serve
387.14individuals who are elderly or disabled and who are unable to use regular means of
387.15transportation but do not require ambulance service, as defined in section 144E.001,
387.16subdivision 3 . Special transportation service includes but is not limited to service provided
387.17by specially equipped buses, vans, taxis, and volunteers driving private automobiles.
387.18Special transportation service also means those nonemergency medical transportation
387.19services under section 256B.0625, subdivision 17, that are subject to the operating
387.20standards for special transportation service under sections 174.29 to 174.30 and Minnesota
387.21Rules, chapter 8840.
387.22EFFECTIVE DATE.This section is effective July 1, 2016.

387.23    Sec. 4. Minnesota Statutes 2014, section 174.30, subdivision 3, is amended to read:
387.24    Subd. 3. Other standards; wheelchair securement; protected transport. (a) A
387.25special transportation service that transports individuals occupying wheelchairs is subject
387.26to the provisions of sections 299A.11 to 299A.18 concerning wheelchair securement
387.27devices. The commissioners of transportation and public safety shall cooperate in the
387.28enforcement of this section and sections 299A.11 to 299A.18 so that a single inspection
387.29is sufficient to ascertain compliance with sections 299A.11 to 299A.18 and with the
387.30standards adopted under this section. Representatives of the Department of Transportation
387.31may inspect wheelchair securement devices in vehicles operated by special transportation
387.32service providers to determine compliance with sections 299A.11 to 299A.18 and to issue
387.33certificates under section 299A.14, subdivision 4.
388.1(b) In place of a certificate issued under section 299A.14, the commissioner may
388.2issue a decal under subdivision 4 for a vehicle equipped with a wheelchair securement
388.3device if the device complies with sections 299A.11 to 299A.18 and the decal displays the
388.4information in section 299A.14, subdivision 4.
388.5(c) For vehicles designated as protected transport under section 256B.0625,
388.6subdivision 17, paragraph (h), the commissioner of transportation, during the
388.7commissioner's inspection, shall check to ensure the safety provisions contained in that
388.8paragraph are in working order.
388.9EFFECTIVE DATE.This section is effective July 1, 2016.

388.10    Sec. 5. Minnesota Statutes 2014, section 174.30, subdivision 4, is amended to read:
388.11    Subd. 4. Vehicle and equipment inspection; rules; decal; complaint contact
388.12information; restrictions on name of service. (a) The commissioner shall inspect or
388.13provide for the inspection of vehicles at least annually. In addition to scheduled annual
388.14inspections and reinspections scheduled for the purpose of verifying that deficiencies have
388.15been corrected, unannounced inspections of any vehicle may be conducted.
388.16    (b) On determining that a vehicle or vehicle equipment is in a condition that is likely
388.17to cause an accident or breakdown, the commissioner shall require the vehicle to be taken
388.18out of service immediately. The commissioner shall require that vehicles and equipment
388.19not meeting standards be repaired and brought into conformance with the standards
388.20and shall require written evidence of compliance from the operator before allowing the
388.21operator to return the vehicle to service.
388.22    (c) The commissioner shall provide in the rules procedures for inspecting vehicles,
388.23removing unsafe vehicles from service, determining and requiring compliance, and
388.24reviewing driver qualifications.
388.25    (d) The commissioner shall design a distinctive decal to be issued to special
388.26transportation service providers with a current certificate of compliance under this section.
388.27A decal is valid for one year from the last day of the month in which it is issued. A person
388.28who is subject to the operating standards adopted under this section may not provide
388.29special transportation service in a vehicle that does not conspicuously display a decal
388.30issued by the commissioner.
388.31    (e) All special transportation service providers shall pay an annual fee of $45
388.32to obtain a decal. Providers of ambulance service, as defined in section 144E.001,
388.33subdivision 3, are exempt from the annual fee. Fees collected under this paragraph must
388.34be deposited in the trunk highway fund, and are appropriated to the commissioner to pay
388.35for costs related to administering the special transportation service program.
389.1    (f) Special transportation service providers shall prominently display in each vehicle
389.2all contact information for the submission of complaints regarding the transportation
389.3services provided to that individual. All vehicles providing service under section
389.4473.386 shall display contact information for the Metropolitan Council. All other special
389.5transportation service vehicles shall display contact information for the commissioner of
389.6transportation.
389.7(g) Nonemergency medical transportation providers must comply with Minnesota
389.8Rules, part 8840.5450, except that a provider may use the phrase "nonemergency medical
389.9transportation" in its name or in advertisements or information describing the service.
389.10EFFECTIVE DATE.This section is effective July 1, 2016.

389.11    Sec. 6. Minnesota Statutes 2014, section 174.30, is amended by adding a subdivision
389.12to read:
389.13    Subd. 4b. Variance from the standards. A nonemergency medical transportation
389.14provider who was not subject to the standards in this section prior to July 1, 2014, must
389.15apply for a variance from the commissioner if the provider cannot meet the standards
389.16by January 1, 2017. The commissioner may grant or deny the variance application.
389.17Variances, if granted, shall not exceed 60 days unless extended by the commissioner.
389.18EFFECTIVE DATE.This section is effective July 1, 2016.

389.19    Sec. 7. Minnesota Statutes 2014, section 174.30, is amended by adding a subdivision
389.20to read:
389.21    Subd. 10. Background studies. (a) Providers of special transportation service
389.22regulated under this section must initiate background studies in accordance with chapter
389.23245C on the following individuals:
389.24(1) each person with a direct or indirect ownership interest of five percent or higher
389.25in the transportation service provider;
389.26(2) each controlling individual as defined under section 245A.02;
389.27(3) managerial officials as defined in section 245A.02;
389.28(4) each driver employed by the transportation service provider;
389.29(5) each individual employed by the transportation service provider to assist a
389.30passenger during transport; and
389.31(6) all employees of the transportation service agency who provide administrative
389.32support, including those who:
390.1(i) may have face-to-face contact with or access to passengers, their personal
390.2property, or their private data;
390.3(ii) perform any scheduling or dispatching tasks; or
390.4(iii) perform any billing activities.
390.5(b) The transportation service provider must initiate the background studies required
390.6under paragraph (a) using the online NETStudy system operated by the commissioner
390.7of human services.
390.8(c) The transportation service provider shall not permit any individual to provide
390.9any service listed in paragraph (a) until the transportation service provider has received
390.10notification from the commissioner of human services indicating that the individual:
390.11(1) is not disqualified under chapter 245C; or
390.12(2) is disqualified, but has received a set-aside of that disqualification according to
390.13section 245C.23 related to that transportation service provider.
390.14    (d) When a local or contracted agency is authorizing a ride under section 256B.0625,
390.15subdivision 17, by a volunteer driver, and the agency authorizing the ride has reason
390.16to believe the volunteer driver has a history that would disqualify the individual or
390.17that may pose a risk to the health or safety of passengers, the agency may initiate a
390.18background study to be completed according to chapter 245C using the commissioner
390.19of human services' online NETStudy system, or through contacting the Department of
390.20Human Services background study division for assistance. The agency that initiates the
390.21background study under this paragraph shall be responsible for providing the volunteer
390.22driver with the privacy notice required under section 245C.05, subdivision 2c, and
390.23payment for the background study required under section 245C.10, subdivision 11, before
390.24the background study is completed.
390.25EFFECTIVE DATE.This section is effective January 1, 2016.

390.26    Sec. 8. Minnesota Statutes 2014, section 245C.03, is amended by adding a subdivision
390.27to read:
390.28    Subd. 11. Providers of special transportation service. The commissioner shall
390.29conduct background studies on any individual required under section 174.30 to have a
390.30background study completed under this chapter.
390.31EFFECTIVE DATE.This section is effective January 1, 2016.

390.32    Sec. 9. Minnesota Statutes 2014, section 245C.10, is amended by adding a subdivision
390.33to read:
391.1    Subd. 12. Providers of special transportation service. The commissioner shall
391.2recover the cost of background studies initiated by providers of special transportation
391.3service under section 174.30 through a fee of no more than $20 per study. The fees
391.4collected under this subdivision are appropriated to the commissioner for the purpose of
391.5conducting background studies.
391.6EFFECTIVE DATE.This section is effective January 1, 2016.

391.7    Sec. 10. Minnesota Statutes 2014, section 256.015, subdivision 7, is amended to read:
391.8    Subd. 7. Cooperation with information requests required. (a) Upon the request
391.9of the commissioner of human services:
391.10(1) any state agency or third-party payer shall cooperate by furnishing information to
391.11help establish a third-party liability, as required by the federal Deficit Reduction Act of
391.122005, Public Law 109-171;
391.13(2) any employer or third-party payer shall cooperate by furnishing a data file
391.14containing information about group health insurance plan or medical benefit plan coverage
391.15of its employees or insureds within 60 days of the request. The information in the data file
391.16must include at least the following: full name, date of birth, Social Security number if
391.17collected and stored in a system routinely used for producing data files by the employer
391.18or third-party payer, employer name, policy identification number, group identification
391.19number, and plan or coverage type.
391.20(b) For purposes of section 176.191, subdivision 4, the commissioner of labor and
391.21industry may allow the commissioner of human services and county agencies direct access
391.22and data matching on information relating to workers' compensation claims in order to
391.23determine whether the claimant has reported the fact of a pending claim and the amount
391.24paid to or on behalf of the claimant to the commissioner of human services.
391.25(c) For the purpose of compliance with section 169.09, subdivision 13, and
391.26federal requirements under Code of Federal Regulations, title 42, section 433.138
391.27(d)(4), the commissioner of public safety shall provide accident data as requested by
391.28the commissioner of human services. The disclosure shall not violate section 169.09,
391.29subdivision 13, paragraph (d).
391.30(d) The commissioner of human services and county agencies shall limit its use of
391.31information gained from agencies, third-party payers, and employers to purposes directly
391.32connected with the administration of its public assistance and child support programs. The
391.33provision of information by agencies, third-party payers, and employers to the department
391.34under this subdivision is not a violation of any right of confidentiality or data privacy.

392.1    Sec. 11. Minnesota Statutes 2014, section 256.969, subdivision 1, is amended to read:
392.2    Subdivision 1. Hospital cost index. (a) The hospital cost index shall be the change
392.3in the Consumer Price Index-All Items (United States city average) (CPI-U) forecasted
392.4by Data Resources, Inc. Centers for Medicare and Medicaid Services Inpatient Hospital
392.5Market Basket. The commissioner shall use the indices as forecasted in the third quarter
392.6of the calendar year prior to the rate year. The hospital cost index may be used to adjust
392.7the base year operating payment rate through the rate year on an annually compounded
392.8basis for the midpoint of the prior rate year to the midpoint of the current rate year.
392.9(b) For fiscal years beginning on or after July 1, 1993, the commissioner of human
392.10services shall not provide automatic annual inflation adjustments for hospital payment
392.11rates under medical assistance. The commissioner of management and budget shall
392.12include as a budget change request in each biennial detailed expenditure budget submitted
392.13to the legislature under section 16A.11 annual adjustments in hospital payment rates under
392.14medical assistance based upon the hospital cost index.

392.15    Sec. 12. Minnesota Statutes 2014, section 256.969, subdivision 2b, is amended to read:
392.16    Subd. 2b. Hospital payment rates. (a) For discharges occurring on or after
392.17November 1, 2014, hospital inpatient services for hospitals located in Minnesota shall be
392.18paid according to the following:
392.19(1) critical access hospitals as defined by Medicare shall be paid using a cost-based
392.20methodology;
392.21(2) long-term hospitals as defined by Medicare shall be paid on a per diem
392.22methodology under subdivision 25;
392.23(3) rehabilitation hospitals or units of hospitals that are recognized as rehabilitation
392.24distinct parts as defined by Medicare shall be paid according to the methodology under
392.25subdivision 12; and
392.26(4) all other hospitals shall be paid on a diagnosis-related group (DRG) methodology.
392.27    (b) For the period beginning January 1, 2011, through October 31, 2014, rates shall
392.28not be rebased, except that a Minnesota long-term hospital shall be rebased effective
392.29January 1, 2011, based on its most recent Medicare cost report ending on or before
392.30September 1, 2008, with the provisions under subdivisions 9 and 23, based on the rates
392.31in effect on December 31, 2010. For rate setting periods after November 1, 2014, in
392.32which the base years are updated, a Minnesota long-term hospital's base year shall remain
392.33within the same period as other hospitals.
392.34(c) Effective for discharges occurring on and after November 1, 2014, payment rates
392.35for hospital inpatient services provided by hospitals located in Minnesota or the local trade
393.1area, except for the hospitals paid under the methodologies described in paragraph (a),
393.2clauses (2) and (3), shall be rebased, incorporating cost and payment methodologies in a
393.3manner similar to Medicare. The base year for the rates effective November 1, 2014, shall
393.4be calendar year 2012. The rebasing under this paragraph shall be budget neutral, ensuring
393.5that the total aggregate payments under the rebased system are equal to the total aggregate
393.6payments that were made for the same number and types of services in the base year.
393.7Separate budget neutrality calculations shall be determined for payments made to critical
393.8access hospitals and payments made to hospitals paid under the DRG system. Only the rate
393.9increases or decreases under subdivision 3a or 3c that applied to the hospitals being rebased
393.10during the entire base period shall be incorporated into the budget neutrality calculation.
393.11(d) For discharges occurring on or after November 1, 2014, through June 30, 2016
393.12the next rebasing that occurs, the rebased rates under paragraph (c) that apply to hospitals
393.13under paragraph (a), clause (4), shall include adjustments to the projected rates that result
393.14in no greater than a five percent increase or decrease from the base year payments for any
393.15hospital. Any adjustments to the rates made by the commissioner under this paragraph and
393.16paragraph (e) shall maintain budget neutrality as described in paragraph (c).
393.17(e) For discharges occurring on or after November 1, 2014, through June 30, 2016,
393.18the next rebasing that occurs the commissioner may make additional adjustments to the
393.19rebased rates, and when evaluating whether additional adjustments should be made, the
393.20commissioner shall consider the impact of the rates on the following:
393.21(1) pediatric services;
393.22(2) behavioral health services;
393.23(3) trauma services as defined by the National Uniform Billing Committee;
393.24(4) transplant services;
393.25(5) obstetric services, newborn services, and behavioral health services provided
393.26by hospitals outside the seven-county metropolitan area;
393.27(6) outlier admissions;
393.28(7) low-volume providers; and
393.29(8) services provided by small rural hospitals that are not critical access hospitals.
393.30(f) Hospital payment rates established under paragraph (c) must incorporate the
393.31following:
393.32    (1) for hospitals paid under the DRG methodology, the base year payment rate per
393.33admission is standardized by the applicable Medicare wage index and adjusted by the
393.34hospital's disproportionate population adjustment;
393.35    (2) for critical access hospitals, interim per diem payment rates for discharges
393.36between November 1, 2014, and June 30, 2015, shall be based on the ratio of cost
394.1and charges reported on the base year Medicare cost report or reports and applied to
394.2medical assistance utilization data. Final settlement payments for a state fiscal year must
394.3be determined based on a review of the medical assistance cost report required under
394.4subdivision 4b for the applicable state fiscal year set to the same rate of payment that
394.5applied for discharges on October 31, 2014;
394.6    (3) the cost and charge data used to establish hospital payment rates must only
394.7reflect inpatient services covered by medical assistance; and
394.8    (4) in determining hospital payment rates for discharges occurring on or after the
394.9rate year beginning January 1, 2011, through December 31, 2012, the hospital payment
394.10rate per discharge shall be based on the cost-finding methods and allowable costs of the
394.11Medicare program in effect during the base year or years.
394.12(g) The commissioner shall validate the rates effective November 1, 2014, by
394.13applying the rates established under paragraph (c), and any adjustments made to the rates
394.14under paragraph (d) or (e), to hospital claims paid in calendar year 2013 to determine
394.15whether the total aggregate payments for the same number and types of services under the
394.16rebased rates are equal to the total aggregate payments made during calendar year 2013.
394.17(h) Effective for discharges occurring on or after July 1, 2017, and every two
394.18years thereafter, payment rates under this section shall be rebased to reflect only those
394.19changes in hospital costs between the existing base year and the next base year. The
394.20commissioner shall establish the base year for each rebasing period considering the most
394.21recent year for which filed Medicare cost reports are available. The estimated change in
394.22the average payment per hospital discharge resulting from a scheduled rebasing must be
394.23calculated and made available to the legislature by January 15 of each year in which
394.24rebasing is scheduled to occur, and must include by hospital the differential in payment
394.25rates compared to the individual hospital's costs.
394.26(i) Effective for discharges occurring on or after July 1, 2015, payment rates for
394.27critical access hospitals located in Minnesota or the local trade area shall be determined
394.28using a new cost-based methodology. The commissioner shall establish within the
394.29methodology tiers of payment designed to promote efficiency and cost-effectiveness.
394.30Payment rates for hospitals under this paragraph shall be set at a level that does not exceed
394.31the total cost for critical access hospitals as reflected in base year cost reports. Until the
394.32next rebasing that occurs, the new methodology shall result in no greater than a five
394.33percent decrease from the base year payments for any hospital, except a hospital that
394.34had payments that were greater than 100 percent of the hospital's costs in the base year
394.35shall have their rate set equal to 100 percent of costs in the base year. The rates paid for
394.36discharges on and after July 1, 2016, covered under this paragraph shall be increased by
395.1the inflation factor in subdivision 1, paragraph (a). The new cost-based rate shall be the
395.2final rate and shall not be settled to actual incurred costs. Hospitals shall be assigned a
395.3payment tier based on the following criteria:
395.4(1) hospitals that had payments at or below 80 percent of their costs in the base year
395.5shall have a rate set that equals 85 percent of their base year costs;
395.6(2) hospitals that had payments that were above 80 percent, up to and including
395.790 percent of their costs in the base year shall have a rate set that equals 95 percent of
395.8their base year costs; and
395.9(3) hospitals that had payments that were above 90 percent of their costs in the base
395.10year shall have a rate set that equals 100 percent of their base year costs.
395.11(j) The commissioner may refine the payment tiers and criteria for critical access
395.12hospitals to coincide with the next rebasing under paragraph (h). The factors used to
395.13develop the new methodology may include, but are not limited to:
395.14(1) the ratio between the hospital's costs for treating medical assistance patients and
395.15the hospital's charges to the medical assistance program;
395.16(2) the ratio between the hospital's costs for treating medical assistance patients and
395.17the hospital's payments received from the medical assistance program for the care of
395.18medical assistance patients;
395.19(3) the ratio between the hospital's charges to the medical assistance program and
395.20the hospital's payments received from the medical assistance program for the care of
395.21medical assistance patients;
395.22(4) the statewide average increases in the ratios identified in clauses (1), (2), and (3);
395.23(5) the proportion of that hospital's costs that are administrative and trends in
395.24administrative costs; and
395.25(6) geographic location.

395.26    Sec. 13. Minnesota Statutes 2014, section 256.969, subdivision 2d, is amended to read:
395.27    Subd. 2d. Interim payments. Notwithstanding subdivision 2b, paragraph (c), for
395.28discharges occurring on or after November 1, 2014, through June 30, 2015 March 1, 2016,
395.29the commissioner may implement an interim payment process to pay hospitals, including
395.30payments based on each hospital's average payments per claim for state fiscal years 2011
395.31and 2012. These interim payments may be used to pay hospitals if the rebasing under
395.32subdivision 2b, paragraph (c), is not implemented by November 1, 2014, or if electronic
395.33systems changes necessary to support the conversion to the International Classification of
395.34Diseases, 10th revision (ICD-10) coding system are not completed. Claims paid at interim
396.1payment rates shall be reprocessed and paid at the rates established under subdivision 2b,
396.2paragraphs (c) and (d), upon implementation of the rebased rates.

396.3    Sec. 14. Minnesota Statutes 2014, section 256.969, subdivision 3a, is amended to read:
396.4    Subd. 3a. Payments. (a) Acute care hospital billings under the medical assistance
396.5program must not be submitted until the recipient is discharged. However, the
396.6commissioner shall establish monthly interim payments for inpatient hospitals that have
396.7individual patient lengths of stay over 30 days regardless of diagnostic category. Except
396.8as provided in section 256.9693, medical assistance reimbursement for treatment of
396.9mental illness shall be reimbursed based on diagnostic classifications. Individual hospital
396.10payments established under this section and sections 256.9685, 256.9686, and 256.9695, in
396.11addition to third-party and recipient liability, for discharges occurring during the rate year
396.12shall not exceed, in aggregate, the charges for the medical assistance covered inpatient
396.13services paid for the same period of time to the hospital. Services that have rates established
396.14under subdivision 11 or 12, must be limited separately from other services. After
396.15consulting with the affected hospitals, the commissioner may consider related hospitals
396.16one entity and may merge the payment rates while maintaining separate provider numbers.
396.17The operating and property base rates per admission or per day shall be derived from the
396.18best Medicare and claims data available when rates are established. The commissioner
396.19shall determine the best Medicare and claims data, taking into consideration variables of
396.20recency of the data, audit disposition, settlement status, and the ability to set rates in a
396.21timely manner. The commissioner shall notify hospitals of payment rates 30 days prior to
396.22implementation. The rate setting data must reflect the admissions data used to establish
396.23relative values. The commissioner may adjust base year cost, relative value, and case mix
396.24index data to exclude the costs of services that have been discontinued by the October
396.251 of the year preceding the rate year or that are paid separately from inpatient services.
396.26Inpatient stays that encompass portions of two or more rate years shall have payments
396.27established based on payment rates in effect at the time of admission unless the date of
396.28admission preceded the rate year in effect by six months or more. In this case, operating
396.29payment rates for services rendered during the rate year in effect and established based on
396.30the date of admission shall be adjusted to the rate year in effect by the hospital cost index.
396.31    (b) For fee-for-service admissions occurring on or after July 1, 2002, the total
396.32payment, before third-party liability and spenddown, made to hospitals for inpatient
396.33services is reduced by .5 percent from the current statutory rates.
396.34    (c) In addition to the reduction in paragraph (b), the total payment for fee-for-service
396.35admissions occurring on or after July 1, 2003, made to hospitals for inpatient services before
397.1third-party liability and spenddown, is reduced five percent from the current statutory
397.2rates. Mental health services within diagnosis related groups 424 to 432 or corresponding
397.3APR-DRGs, and facilities defined under subdivision 16 are excluded from this paragraph.
397.4    (d) In addition to the reduction in paragraphs (b) and (c), the total payment for
397.5fee-for-service admissions occurring on or after August 1, 2005, made to hospitals for
397.6inpatient services before third-party liability and spenddown, is reduced 6.0 percent from
397.7the current statutory rates. Mental health services within diagnosis related groups 424
397.8to 432 or corresponding APR-DRGs, and facilities defined under subdivision 16 are
397.9excluded from this paragraph. Payments made to managed care plans shall be reduced for
397.10services provided on or after January 1, 2006, to reflect this reduction.
397.11    (e) In addition to the reductions in paragraphs (b), (c), and (d), the total payment for
397.12fee-for-service admissions occurring on or after July 1, 2008, through June 30, 2009, made
397.13to hospitals for inpatient services before third-party liability and spenddown, is reduced
397.143.46 percent from the current statutory rates. Mental health services with diagnosis
397.15related groups 424 to 432 or corresponding APR-DRGs, and facilities defined under
397.16subdivision 16 are excluded from this paragraph. Payments made to managed care plans
397.17shall be reduced for services provided on or after January 1, 2009, through June 30, 2009,
397.18to reflect this reduction.
397.19    (f) In addition to the reductions in paragraphs (b), (c), and (d), the total payment
397.20for fee-for-service admissions occurring on or after July 1, 2009, through June 30, 2011,
397.21made to hospitals for inpatient services before third-party liability and spenddown, is
397.22reduced 1.9 percent from the current statutory rates. Mental health services with diagnosis
397.23related groups 424 to 432 or corresponding APR-DRGs, and facilities defined under
397.24subdivision 16 are excluded from this paragraph. Payments made to managed care plans
397.25shall be reduced for services provided on or after July 1, 2009, through June 30, 2011,
397.26to reflect this reduction.
397.27    (g) In addition to the reductions in paragraphs (b), (c), and (d), the total payment
397.28for fee-for-service admissions occurring on or after July 1, 2011, made to hospitals for
397.29inpatient services before third-party liability and spenddown, is reduced 1.79 percent from
397.30the current statutory rates. Mental health services with diagnosis related groups 424 to 432
397.31or corresponding APR-DRGs, and facilities defined under subdivision 16 are excluded
397.32from this paragraph. Payments made to managed care plans shall be reduced for services
397.33provided on or after July 1, 2011, to reflect this reduction.
397.34(h) In addition to the reductions in paragraphs (b), (c), (d), (f), and (g), the total
397.35payment for fee-for-service admissions occurring on or after July 1, 2009, made to
397.36hospitals for inpatient services before third-party liability and spenddown, is reduced
398.1one percent from the current statutory rates. Facilities defined under subdivision 16 are
398.2excluded from this paragraph. Payments made to managed care plans shall be reduced for
398.3services provided on or after October 1, 2009, to reflect this reduction.
398.4(i) In addition to the reductions in paragraphs (b), (c), (d), (g), and (h), the total
398.5payment for fee-for-service admissions occurring on or after July 1, 2011, made to
398.6hospitals for inpatient services before third-party liability and spenddown, is reduced
398.71.96 percent from the current statutory rates. Facilities defined under subdivision 16 are
398.8excluded from this paragraph. Payments made to managed care plans shall be reduced for
398.9services provided on or after January 1, 2011, to reflect this reduction.
398.10(j) Effective for discharges on and after November 1, 2014, from hospitals paid
398.11under subdivision 2b, paragraph (a), clauses (1) and (4), the rate adjustments in this
398.12subdivision must be incorporated into the rebased rates established under subdivision 2b,
398.13paragraph (c), and must not be applied to each claim.
398.14(k) Effective for discharges on and after July 1, 2015, from hospitals paid under
398.15subdivision 2b, paragraph (a), clauses (2) and (3), the rate adjustments in this subdivision
398.16must be incorporated into the rates and must not be applied to each claim.

398.17    Sec. 15. Minnesota Statutes 2014, section 256.969, subdivision 3c, is amended to read:
398.18    Subd. 3c. Rateable reduction and readmissions reduction. (a) The total payment
398.19for fee for service admissions occurring on or after September 1, 2011, to October 31,
398.202014, made to hospitals for inpatient services before third-party liability and spenddown,
398.21is reduced ten percent from the current statutory rates. Facilities defined under subdivision
398.2216, long-term hospitals as determined under the Medicare program, children's hospitals
398.23whose inpatients are predominantly under 18 years of age, and payments under managed
398.24care are excluded from this paragraph.
398.25(b) Effective for admissions occurring during calendar year 2010 and each year
398.26after, the commissioner shall calculate a readmission rate for admissions to all hospitals
398.27occurring within 30 days of a previous discharge using data from the Reducing Avoidable
398.28Readmissions Effectively (RARE) campaign. The commissioner may adjust the
398.29readmission rate taking into account factors such as the medical relationship, complicating
398.30conditions, and sequencing of treatment between the initial admission and subsequent
398.31readmissions.
398.32(c) Effective for payments to all hospitals on or after July 1, 2013, through October
398.3331, 2014, the reduction in paragraph (a) is reduced one percentage point for every
398.34percentage point reduction in the overall readmissions rate between the two previous
398.35calendar years to a maximum of five percent.
399.1(d) The exclusion from the rate reduction in paragraph (a) shall apply to a hospital
399.2located in Hennepin County with a licensed capacity of 1,700 beds as of September 1,
399.32011, for admissions of children under 18 years of age occurring on or after September 1,
399.42011, through August 31, 2013, but shall not apply to payments for admissions occurring
399.5on or after September 1, 2013, through October 31, 2014.
399.6(e) Effective for discharges on or after November 1, 2014, from hospitals paid under
399.7subdivision 2b, paragraph (a), clauses (1) and (4), the rate adjustments in this subdivision
399.8must be incorporated into the rebased rates established under subdivision 2b, paragraph
399.9(c), and must not be applied to each claim.
399.10(f) Effective for discharges on and after July 1, 2015, from hospitals paid under
399.11subdivision 2b, paragraph (a), clauses (2) and (3), the rate adjustments in this subdivision
399.12must be incorporated into the rates and must not be applied to each claim.

399.13    Sec. 16. Minnesota Statutes 2014, section 256.969, subdivision 9, is amended to read:
399.14    Subd. 9. Disproportionate numbers of low-income patients served. (a) For
399.15admissions occurring on or after July 1, 1993, the medical assistance disproportionate
399.16population adjustment shall comply with federal law and shall be paid to a hospital,
399.17excluding regional treatment centers and facilities of the federal Indian Health Service,
399.18with a medical assistance inpatient utilization rate in excess of the arithmetic mean. The
399.19adjustment must be determined as follows:
399.20    (1) for a hospital with a medical assistance inpatient utilization rate above the
399.21arithmetic mean for all hospitals excluding regional treatment centers and facilities of the
399.22federal Indian Health Service but less than or equal to one standard deviation above the
399.23mean, the adjustment must be determined by multiplying the total of the operating and
399.24property payment rates by the difference between the hospital's actual medical assistance
399.25inpatient utilization rate and the arithmetic mean for all hospitals excluding regional
399.26treatment centers and facilities of the federal Indian Health Service; and
399.27    (2) for a hospital with a medical assistance inpatient utilization rate above one
399.28standard deviation above the mean, the adjustment must be determined by multiplying
399.29the adjustment that would be determined under clause (1) for that hospital by 1.1.
399.30The commissioner may establish a separate disproportionate population payment rate
399.31adjustment for critical access hospitals. The commissioner shall report annually on the
399.32number of hospitals likely to receive the adjustment authorized by this paragraph. The
399.33commissioner shall specifically report on the adjustments received by public hospitals and
399.34public hospital corporations located in cities of the first class.
400.1    (b) Certified public expenditures made by Hennepin County Medical Center shall
400.2be considered Medicaid disproportionate share hospital payments. Hennepin County
400.3and Hennepin County Medical Center shall report by June 15, 2007, on payments made
400.4beginning July 1, 2005, or another date specified by the commissioner, that may qualify
400.5for reimbursement under federal law. Based on these reports, the commissioner shall
400.6apply for federal matching funds.
400.7    (c) Upon federal approval of the related state plan amendment, paragraph (b) is
400.8effective retroactively from July 1, 2005, or the earliest effective date approved by the
400.9Centers for Medicare and Medicaid Services.
400.10    (d) Effective July 1, 2015, disproportionate share hospital (DSH) payments shall
400.11be paid in accordance with a new methodology using 2012 as the base year. Annual
400.12payments made under this paragraph shall equal the total amount of payments made for
400.132012. A licensed children's hospital shall receive only a single DSH factor for children's
400.14hospitals. Other DSH factors may be combined to arrive at a single factor for each hospital
400.15that is eligible for DSH payments. The new methodology shall make payments only to
400.16hospitals located in Minnesota and include the following factors:
400.17    (1) a licensed children's hospital with at least 1,000 fee-for-service discharges in
400.18the base year shall receive a factor of 0.868. A licensed children's hospital with less than
400.191,000 fee-for-service discharges in the base year shall receive a factor of 0.7880;
400.20    (2) a hospital that has in effect for the initial rate year a contract with the
400.21commissioner to provide extended psychiatric inpatient services under section 256.9693
400.22shall receive a factor of 0.0160;
400.23    (3) a hospital that has received payment from the fee-for-service program for at least
400.2420 transplant services in the base year shall receive a factor of 0.0435;
400.25    (4) a hospital that has a medical assistance utilization rate in the base year between
400.2620 percent up to one standard deviation above the statewide mean utilization rate shall
400.27receive a factor of 0.0468;
400.28    (5) a hospital that has a medical assistance utilization rate in the base year that is at
400.29least one standard deviation above the statewide mean utilization rate but is less than three
400.30standard deviations above the mean shall receive a factor of 0.2300; and
400.31(6) a hospital that has a medical assistance utilization rate in the base year that is
400.32at least three standard deviations above the statewide mean utilization rate shall receive
400.33a factor of 0.3711.
400.34    (e) Any payments or portion of payments made to a hospital under this subdivision
400.35that are subsequently returned to the commissioner because the payments are found to
400.36exceed the hospital-specific DSH limit for that hospital shall be redistributed, proportionate
401.1to the number of fee-for-service discharges, to other DSH-eligible nonchildren's hospitals
401.2that have a medical assistance utilization rate that is at least one standard deviation above
401.3the mean.

401.4    Sec. 17. [256B.0561] PERIODIC DATA MATCHING TO EVALUATE
401.5CONTINUED ELIGIBILITY.
401.6    Subdivision 1. Definition. For the purposes of this section, "periodic data
401.7matching" means obtaining updated electronic information about medical assistance and
401.8MinnesotaCare recipients on the MNsure information system from federal and state data
401.9sources accessible to the MNsure information system and using that data to evaluate
401.10continued eligibility between regularly scheduled renewals.
401.11    Subd. 2. Periodic data matching. (a) Beginning March 1, 2016, the commissioner
401.12shall conduct periodic data matching to identify recipients who, based on available
401.13electronic data, may not meet eligibility criteria for the public health care program in
401.14which the recipient is enrolled. The commissioner shall conduct data matching for
401.15medical assistance or MinnesotaCare recipients at least once during a recipient's 12-month
401.16period of eligibility.
401.17(b) If data matching indicates a recipient may no longer qualify for medical
401.18assistance or MinnesotaCare, the commissioner must notify the recipient and allow the
401.19recipient no more than 30 days to confirm the information obtained through the periodic
401.20data matching or provide a reasonable explanation for the discrepancy to the state or
401.21county agency directly responsible for the recipient's case. If a recipient does not respond
401.22within the advance notice period or does not respond with information that demonstrates
401.23eligibility or provides a reasonable explanation for the discrepancy within the 30-day time
401.24period, the commissioner shall terminate the recipient's eligibility in the manner provided
401.25for by the laws and regulations governing the health care program for which the recipient
401.26has been identified as being ineligible.
401.27(c) The commissioner shall not terminate eligibility for a recipient who is
401.28cooperating with the requirements of paragraph (b) and needs additional time to provide
401.29information in response to the notification.
401.30(d) Any termination of eligibility for benefits under this section may be appealed
401.31as provided for in sections 256.045 to 256.0451, and the laws governing the health care
401.32programs for which eligibility is terminated.
401.33    Subd. 3. Recipient communication requirements. The commissioner shall
401.34include in all communications with recipients affected by the periodic data matching the
401.35following contact information for: (1) the state or county agency directly responsible for
402.1the recipient's case; and (2) consumer assistance partners who may be able to assist the
402.2recipient in the periodic data matching process.
402.3    Subd. 4. Report. By September 1, 2017, and each September 1 thereafter, the
402.4commissioner shall submit a report to the chairs and ranking minority members of the
402.5house and senate committees with jurisdiction over human services finance that includes
402.6the number of cases affected by periodic data matching under this section, the number
402.7of recipients identified as possibly ineligible as a result of a periodic data match, and the
402.8number of recipients whose eligibility was terminated as a result of a periodic data match.
402.9The report must also specify, for recipients whose eligibility was terminated, how many
402.10cases were closed due to failure to cooperate.
402.11    Subd. 5. Federal compliance. The commissioner shall ensure that the
402.12implementation of this section complies with the Affordable Care Act, including the state's
402.13maintenance of effort requirements. The commissioner shall not terminate eligibility
402.14under this section if eligibility terminations would not conform with federal requirements,
402.15including requirements not yet codified in Minnesota Statutes.

402.16    Sec. 18. Minnesota Statutes 2014, section 256B.06, is amended by adding a
402.17subdivision to read:
402.18    Subd. 6. Legal referral and assistance grants. (a) The commissioner shall award
402.19grants to one or more nonprofit programs that provide legal services based on indigency to
402.20provide legal services to individuals with emergency medical conditions or chronic health
402.21conditions who are not currently eligible for medical assistance or other public health
402.22care programs based on their legal status, but who may meet eligibility requirements
402.23with legal assistance.
402.24(b) The grantees, in collaboration with hospitals and safety net providers, shall
402.25provide referral assistance to connect individuals identified in paragraph (a) with
402.26alternative resources and services to assist in meeting their health care needs.

402.27    Sec. 19. Minnesota Statutes 2014, section 256B.0625, is amended by adding a
402.28subdivision to read:
402.29    Subd. 9b. Dental services provided by faculty members and resident dentists
402.30at a dental school. (a) A dentist who is not enrolled as a medical assistance provider,
402.31is a faculty or adjunct member at the University of Minnesota or a resident dentist
402.32licensed under section 150A.06, subdivision 1b, and is providing dental services at a
402.33dental clinic owned or operated by the University of Minnesota, may be enrolled as a
402.34medical assistance provider if the provider completes and submits to the commissioner an
403.1agreement form developed by the commissioner. The agreement must specify that the
403.2faculty or adjunct member or resident dentist:
403.3(1) will not receive payment for the services provided to medical assistance or
403.4MinnesotaCare enrollees performed at the dental clinics owned or operated by the
403.5University of Minnesota;
403.6(2) will not be listed in the medical assistance or MinnesotaCare provider directory;
403.7and
403.8(3) is not required to serve medical assistance and MinnesotaCare enrollees when
403.9providing nonvolunteer services in a private practice.
403.10(b) A dentist or resident dentist enrolled under this subdivision as a fee-for-service
403.11provider shall not otherwise be enrolled in or receive payments from medical assistance or
403.12MinnesotaCare as a fee-for-service provider.

403.13    Sec. 20. Minnesota Statutes 2014, section 256B.0625, subdivision 13h, is amended to
403.14read:
403.15    Subd. 13h. Medication therapy management services. (a) Medical assistance and
403.16general assistance medical care cover covers medication therapy management services
403.17for a recipient taking three or more prescriptions to treat or prevent one or more chronic
403.18medical conditions; a recipient with a drug therapy problem that is identified by the
403.19commissioner or identified by a pharmacist and approved by the commissioner; or prior
403.20authorized by the commissioner that has resulted or is likely to result in significant
403.21nondrug program costs. The commissioner may cover medical therapy management
403.22services under MinnesotaCare if the commissioner determines this is cost-effective. For
403.23purposes of this subdivision, "medication therapy management" means the provision
403.24of the following pharmaceutical care services by a licensed pharmacist to optimize the
403.25therapeutic outcomes of the patient's medications:
403.26    (1) performing or obtaining necessary assessments of the patient's health status;
403.27    (2) formulating a medication treatment plan;
403.28    (3) monitoring and evaluating the patient's response to therapy, including safety
403.29and effectiveness;
403.30    (4) performing a comprehensive medication review to identify, resolve, and prevent
403.31medication-related problems, including adverse drug events;
403.32    (5) documenting the care delivered and communicating essential information to
403.33the patient's other primary care providers;
403.34    (6) providing verbal education and training designed to enhance patient
403.35understanding and appropriate use of the patient's medications;
404.1    (7) providing information, support services, and resources designed to enhance
404.2patient adherence with the patient's therapeutic regimens; and
404.3    (8) coordinating and integrating medication therapy management services within the
404.4broader health care management services being provided to the patient.
404.5Nothing in this subdivision shall be construed to expand or modify the scope of practice of
404.6the pharmacist as defined in section 151.01, subdivision 27.
404.7    (b) To be eligible for reimbursement for services under this subdivision, a pharmacist
404.8must meet the following requirements:
404.9    (1) have a valid license issued by the Board of Pharmacy of the state in which the
404.10medication therapy management service is being performed;
404.11    (2) have graduated from an accredited college of pharmacy on or after May 1996, or
404.12completed a structured and comprehensive education program approved by the Board of
404.13Pharmacy and the American Council of Pharmaceutical Education for the provision and
404.14documentation of pharmaceutical care management services that has both clinical and
404.15didactic elements;
404.16    (3) be practicing in an ambulatory care setting as part of a multidisciplinary team or
404.17have developed a structured patient care process that is offered in a private or semiprivate
404.18patient care area that is separate from the commercial business that also occurs in the
404.19setting, or in home settings, including long-term care settings, group homes, and facilities
404.20providing assisted living services, but excluding skilled nursing facilities; and
404.21    (4) make use of an electronic patient record system that meets state standards.
404.22    (c) For purposes of reimbursement for medication therapy management services,
404.23the commissioner may enroll individual pharmacists as medical assistance and general
404.24assistance medical care providers. The commissioner may also establish contact
404.25requirements between the pharmacist and recipient, including limiting the number of
404.26reimbursable consultations per recipient.
404.27(d) If there are no pharmacists who meet the requirements of paragraph (b) practicing
404.28within a reasonable geographic distance of the patient, a pharmacist who meets the
404.29requirements may provide the services via two-way interactive video. Reimbursement
404.30shall be at the same rates and under the same conditions that would otherwise apply to
404.31the services provided. To qualify for reimbursement under this paragraph, the pharmacist
404.32providing the services must meet the requirements of paragraph (b), and must be
404.33located within an ambulatory care setting approved by the commissioner that meets the
404.34requirements of paragraph (b), clause (3). The patient must also be located within an
404.35ambulatory care setting approved by the commissioner that meets the requirements of
405.1paragraph (b), clause (3). Services provided under this paragraph may not be transmitted
405.2into the patient's residence.
405.3(e) The commissioner shall establish a pilot project for an intensive medication
405.4therapy management program for patients identified by the commissioner with multiple
405.5chronic conditions and a high number of medications who are at high risk of preventable
405.6hospitalizations, emergency room use, medication complications, and suboptimal
405.7treatment outcomes due to medication-related problems. For purposes of the pilot
405.8project, medication therapy management services may be provided in a patient's home
405.9or community setting, in addition to other authorized settings. The commissioner may
405.10waive existing payment policies and establish special payment rates for the pilot project.
405.11The pilot project must be designed to produce a net savings to the state compared to the
405.12estimated costs that would otherwise be incurred for similar patients without the program.
405.13The pilot project must begin by January 1, 2010, and end June 30, 2012.
405.14(e) Medication therapy management services may be delivered into a patient's
405.15residence via secure interactive video if the medication therapy management services
405.16are performed electronically during a covered home care visit by an enrolled provider.
405.17Reimbursement shall be at the same rates and under the same conditions that would
405.18otherwise apply to the services provided. To qualify for reimbursement under this
405.19paragraph, the pharmacist providing the services must meet the requirements of paragraph
405.20(b) and must be located within an ambulatory care setting that meets the requirements of
405.21paragraph (b), clause (3).

405.22    Sec. 21. Minnesota Statutes 2014, section 256B.0625, subdivision 17, is amended to
405.23read:
405.24    Subd. 17. Transportation costs. (a) "Nonemergency medical transportation
405.25service" means motor vehicle transportation provided by a public or private person
405.26that serves Minnesota health care program beneficiaries who do not require emergency
405.27ambulance service, as defined in section 144E.001, subdivision 3, to obtain covered
405.28medical services. Nonemergency medical transportation service includes, but is not
405.29limited to, special transportation service, defined in section 174.29, subdivision 1.
405.30(b) Medical assistance covers medical transportation costs incurred solely for
405.31obtaining emergency medical care or transportation costs incurred by eligible persons in
405.32obtaining emergency or nonemergency medical care when paid directly to an ambulance
405.33company, common carrier, or other recognized providers of transportation services.
405.34Medical transportation must be provided by:
406.1(1) nonemergency medical transportation providers who meet the requirements
406.2of this subdivision;
406.3(2) ambulances, as defined in section 144E.001, subdivision 2;
406.4(3) taxicabs and;
406.5(4) public transit, as defined in section 174.22, subdivision 7; or
406.6(4) (5) not-for-hire vehicles, including volunteer drivers.
406.7(c) Medical assistance covers nonemergency medical transportation provided by
406.8nonemergency medical transportation providers enrolled in the Minnesota health care
406.9programs. All nonemergency medical transportation providers must comply with the
406.10operating standards for special transportation service as defined in sections 174.29 to
406.11174.30 and Minnesota Rules, chapter 8840, and in consultation with the Minnesota
406.12Department of Transportation. All nonemergency medical transportation providers shall
406.13bill for nonemergency medical transportation services in accordance with Minnesota
406.14health care programs criteria. Publicly operated transit systems, volunteers, and
406.15not-for-hire vehicles are exempt from the requirements outlined in this paragraph.
406.16(d) The administrative agency of nonemergency medical transportation must:
406.17(1) adhere to the policies defined by the commissioner in consultation with the
406.18Nonemergency Medical Transportation Advisory Committee;
406.19(2) pay nonemergency medical transportation providers for services provided to
406.20Minnesota health care programs beneficiaries to obtain covered medical services;
406.21(3) provide data monthly to the commissioner on appeals, complaints, no-shows,
406.22canceled trips, and number of trips by mode; and
406.23(4) by July 1, 2016, in accordance with subdivision 18e, utilize a Web-based single
406.24administrative structure assessment tool that meets the technical requirements established
406.25by the commissioner, reconciles trip information with claims being submitted by
406.26providers, and ensures prompt payment for nonemergency medical transportation services.
406.27    (e) Until the commissioner implements the single administrative structure and
406.28delivery system under subdivision 18e, clients shall obtain their level-of-service certificate
406.29from the commissioner or an entity approved by the commissioner that does not dispatch
406.30rides for clients using modes of transportation under paragraph (h), clauses (4), (5), (6),
406.31and (7).
406.32    (f) The commissioner may use an order by the recipient's attending physician or a
406.33medical or mental health professional to certify that the recipient requires nonemergency
406.34medical transportation services. Nonemergency medical transportation providers shall
406.35perform driver-assisted services for eligible individuals, when appropriate. Driver-assisted
406.36service includes passenger pickup at and return to the individual's residence or place of
407.1business, assistance with admittance of the individual to the medical facility, and assistance
407.2in passenger securement or in securing of wheelchairs or stretchers in the vehicle.
407.3Nonemergency medical transportation providers must have trip logs, which include pickup
407.4and drop-off times, signed by the medical provider or client attesting mileage traveled to
407.5obtain covered medical services, whichever is deemed most appropriate. Nonemergency
407.6medical transportation providers may not bill for separate base rates for the continuation
407.7of a trip beyond the original destination. Nonemergency medical transportation providers
407.8must take clients to the health care provider, using the most direct route, and must not
407.9exceed 30 miles for a trip to a primary care provider or 60 miles for a trip to a specialty
407.10care provider, unless the client receives authorization from the local agency. The minimum
407.11medical assistance reimbursement rates for special transportation services are:
407.12(1)(i) $17 for the base rate and $1.35 per mile for special transportation services to
407.13eligible persons who need a wheelchair-accessible van;
407.14(ii) $11.50 for the base rate and $1.30 per mile for special transportation services to
407.15eligible persons who do not need a wheelchair-accessible van; and
407.16(iii) $60 for the base rate and $2.40 per mile, and an attendant rate of $9 per trip,
407.17for special transportation services to eligible persons who need a stretcher-accessible
407.18vehicle; and
407.19(2) Nonemergency medical transportation providers must take clients to the health
407.20care provider using the most direct route, and must not exceed 30 miles for a trip to a
407.21primary care provider or 60 miles for a trip to a specialty care provider, unless the client
407.22receives authorization from the local agency.
407.23Nonemergency medical transportation providers may not bill for separate base rates
407.24for the continuation of a trip beyond the original destination. Nonemergency medical
407.25transportation providers must maintain trip logs, which include pickup and drop-off times,
407.26signed by the medical provider or client, whichever is deemed most appropriate, attesting
407.27to mileage traveled to obtain covered medical services. Clients requesting client mileage
407.28reimbursement must sign the trip log attesting mileage traveled to obtain covered medical
407.29services.
407.30(g) The covered modes of nonemergency medical transportation include
407.31transportation provided directly by clients or family members of clients with their own
407.32transportation, volunteers using their own vehicles, taxicabs, and public transit, or
407.33provided to a client who needs a stretcher-accessible vehicle, a lift/ramp equipped vehicle,
407.34or a vehicle that is not stretcher-accessible or lift/ramp equipped designed to transport ten
407.35or fewer persons. Upon implementation of a new rate structure, a new covered mode of
407.36nonemergency medical transportation shall include transportation provided to a client who
408.1needs a protected vehicle that is not an ambulance or police car and has safety locks, a
408.2video recorder, and a transparent thermoplastic partition between the passenger and the
408.3vehicle driver.
408.4(h) (g) The administrative agency shall use the level of service process established
408.5by the commissioner in consultation with the Nonemergency Medical Transportation
408.6Advisory Committee to determine the client's most appropriate mode of transportation.
408.7If public transit or a certified transportation provider is not available to provide the
408.8appropriate service mode for the client, the client may receive a onetime service upgrade.
408.9(h) The new covered modes of transportation, which may not be implemented
408.10without a new rate structure, are:
408.11(1) client reimbursement, which includes client mileage reimbursement provided to
408.12clients who have their own transportation, or to family or an acquaintance who provides
408.13transportation to the client;
408.14(2) volunteer transport, which includes transportation by volunteers using their
408.15own vehicle;
408.16(3) unassisted transport, which includes transportation provided to a client by a
408.17taxicab or public transit. If a taxicab or publicly operated public transit system is not
408.18available, the client can receive transportation from another nonemergency medical
408.19transportation provider;
408.20(4) assisted transport, which includes transport provided to clients who require
408.21assistance by a nonemergency medical transportation provider;
408.22(5) lift-equipped/ramp transport, which includes transport provided to a client who
408.23is dependent on a device and requires a nonemergency medical transportation provider
408.24with a vehicle containing a lift or ramp;
408.25(6) protected transport, which includes transport provided to a client who has
408.26received a prescreening that has deemed other forms of transportation inappropriate and
408.27who requires a provider: (i) with a protected vehicle that is not an ambulance or police car
408.28and has safety locks, a video recorder, and a transparent thermoplastic partition between
408.29the passenger and the vehicle driver; and (ii) who is certified as a protected transport
408.30provider; and
408.31(7) stretcher transport, which includes transport for a client in a prone or supine
408.32position and requires a nonemergency medical transportation provider with a vehicle that
408.33can transport a client in a prone or supine position.
408.34(i) In accordance with subdivision 18e, by July 1, 2016, The local agency shall be
408.35the single administrative agency and shall administer and reimburse for modes defined in
408.36paragraph (h) according to a new rate structure, once this is adopted paragraphs (l) and
409.1(m) when the commissioner has developed, made available, and funded the Web-based
409.2single administrative structure, assessment tool, and level of need assessment under
409.3subdivision 18e. The local agency's financial obligation is limited to funds provided by
409.4the state or federal government.
409.5(j) The commissioner shall:
409.6(1) in consultation with the Nonemergency Medical Transportation Advisory
409.7Committee, verify that the mode and use of nonemergency medical transportation is
409.8appropriate;
409.9(2) verify that the client is going to an approved medical appointment; and
409.10(3) investigate all complaints and appeals.
409.11(k) The administrative agency shall pay for the services provided in this subdivision
409.12and seek reimbursement from the commissioner, if appropriate. As vendors of medical
409.13care, local agencies are subject to the provisions in section 256B.041, the sanctions and
409.14monetary recovery actions in section 256B.064, and Minnesota Rules, parts 9505.2160
409.15to 9505.2245.
409.16(l) Payments for nonemergency medical transportation must be paid based on
409.17the client's assessed mode under paragraph (g), not the type of vehicle used to provide
409.18the service. The medical assistance reimbursement rates for nonemergency medical
409.19transportation services that are payable by or on behalf of the commissioner for
409.20nonemergency medical transportation services are:
409.21(1) $0.22 per mile for client reimbursement;
409.22(2) up to 100 percent of the Internal Revenue Service business deduction rate for
409.23volunteer transport;
409.24(3) equivalent to the standard fare for unassisted transport when provided by public
409.25transit, and $11 for the base rate and $1.30 per mile when provided by a nonemergency
409.26medical transportation provider;
409.27(4) $13 for the base rate and $1.30 per mile for assisted transport;
409.28(5) $18 for the base rate and $1.55 per mile for lift-equipped/ramp transport;
409.29(6) $75 for the base rate and $2.40 per mile for protected transport; and
409.30(7) $60 for the base rate and $2.40 per mile for stretcher transport, and $9 per trip
409.31for an additional attendant if deemed medically necessary.
409.32The base rates for special transportation services in areas defined under RUCA to be
409.33super rural shall be equal to the reimbursement rate established in paragraph (f), clause
409.34(1), plus 11.3 percent, and for special
409.35(m) The base rate for nonemergency medical transportation services in areas
409.36defined under RUCA to be super rural is equal to 111.3 percent of the respective base
410.1rate in paragraph (l), clauses (1) to (7). The mileage rate for nonemergency medical
410.2transportation services in areas defined under RUCA to be rural or super rural areas is:
410.3(1) for a trip equal to 17 miles or less, mileage reimbursement shall be equal to 125
410.4percent of the respective mileage rate in paragraph (f) (l), clause clauses (1) to (7); and
410.5(2) for a trip between 18 and 50 miles, mileage reimbursement shall be equal to
410.6112.5 percent of the respective mileage rate in paragraph (f) (l), clause clauses (1) to (7).
410.7(m) (n) For purposes of reimbursement rates for special nonemergency medical
410.8transportation services under paragraph (c) paragraphs (l) and (m), the zip code of the
410.9recipient's place of residence shall determine whether the urban, rural, or super rural
410.10reimbursement rate applies.
410.11(n) (o) For purposes of this subdivision, "rural urban commuting area" or "RUCA"
410.12means a census-tract based classification system under which a geographical area is
410.13determined to be urban, rural, or super rural.
410.14(o) Effective for services provided on or after September 1, 2011, nonemergency
410.15transportation rates, including special transportation, taxi, and other commercial carriers,
410.16are reduced 4.5 percent. Payments made to managed care plans and county-based
410.17purchasing plans must be reduced for services provided on or after January 1, 2012,
410.18to reflect this reduction.
410.19EFFECTIVE DATE.This section is effective July 1, 2016.

410.20    Sec. 22. Minnesota Statutes 2014, section 256B.0625, subdivision 17a, is amended to
410.21read:
410.22    Subd. 17a. Payment for ambulance services. (a) Medical assistance covers
410.23ambulance services. Providers shall bill ambulance services according to Medicare
410.24criteria. Nonemergency ambulance services shall not be paid as emergencies. Effective
410.25for services rendered on or after July 1, 2001, medical assistance payments for ambulance
410.26services shall be paid at the Medicare reimbursement rate or at the medical assistance
410.27payment rate in effect on July 1, 2000, whichever is greater.
410.28(b) Effective for services provided on or after September 1, 2011, ambulance
410.29services payment rates are reduced 4.5 percent. Payments made to managed care plans
410.30and county-based purchasing plans must be reduced for services provided on or after
410.31January 1, 2012, to reflect this reduction.
410.32EFFECTIVE DATE.This section is effective July 1, 2016.

411.1    Sec. 23. Minnesota Statutes 2014, section 256B.0625, subdivision 18a, is amended to
411.2read:
411.3    Subd. 18a. Access to medical services. (a) Medical assistance reimbursement for
411.4meals for persons traveling to receive medical care may not exceed $5.50 for breakfast,
411.5$6.50 for lunch, or $8 for dinner.
411.6    (b) Medical assistance reimbursement for lodging for persons traveling to receive
411.7medical care may not exceed $50 per day unless prior authorized by the local agency.
411.8    (c) Medical assistance direct mileage reimbursement to the eligible person or the
411.9eligible person's driver may not exceed 20 cents per mile.
411.10    (d) Regardless of the number of employees that an enrolled health care provider
411.11may have, medical assistance covers sign and oral language interpreter services when
411.12provided by an enrolled health care provider during the course of providing a direct,
411.13person-to-person covered health care service to an enrolled recipient with limited English
411.14proficiency or who has a hearing loss and uses interpreting services. Coverage for
411.15face-to-face oral language interpreter services shall be provided only if the oral language
411.16interpreter used by the enrolled health care provider is listed in the registry or roster
411.17established under section 144.058.
411.18EFFECTIVE DATE.This section is effective July 1, 2016.

411.19    Sec. 24. Minnesota Statutes 2014, section 256B.0625, subdivision 18e, is amended to
411.20read:
411.21    Subd. 18e. Single administrative structure and delivery system. The
411.22commissioner, in coordination with the commissioner of transportation, shall implement
411.23a single administrative structure and delivery system for nonemergency medical
411.24transportation, beginning the latter of the date the single administrative assessment tool
411.25required in this subdivision is available for use, as determined by the commissioner or by
411.26July 1, 2016.
411.27In coordination with the Department of Transportation, the commissioner shall
411.28develop and authorize a Web-based single administrative structure and assessment
411.29tool, which must operate 24 hours a day, seven days a week, to facilitate the enrollee
411.30assessment process for nonemergency medical transportation services. The Web-based
411.31tool shall facilitate the transportation eligibility determination process initiated by clients
411.32and client advocates; shall include an accessible automated intake and assessment
411.33process and real-time identification of level of service eligibility; and shall authorize an
411.34appropriate and auditable mode of transportation authorization. The tool shall provide a
411.35single framework for reconciling trip information with claiming and collecting complaints
412.1regarding inappropriate level of need determinations, inappropriate transportation modes
412.2utilized, and interference with accessing nonemergency medical transportation. The
412.3Web-based single administrative structure shall operate on a trial basis for one year from
412.4implementation and, if approved by the commissioner, shall be permanent thereafter.
412.5The commissioner shall seek input from the Nonemergency Medical Transportation
412.6Advisory Committee to ensure the software is effective and user-friendly and make
412.7recommendations regarding funding of the single administrative system.
412.8EFFECTIVE DATE.This section is effective July 1, 2015.

412.9    Sec. 25. Minnesota Statutes 2014, section 256B.0625, subdivision 28a, is amended to
412.10read:
412.11    Subd. 28a. Licensed physician assistant services. (a) Medical assistance covers
412.12services performed by a licensed physician assistant if the service is otherwise covered
412.13under this chapter as a physician service and if the service is within the scope of practice
412.14of a licensed physician assistant as defined in section 147A.09.
412.15(b) Licensed physician assistants, who are supervised by a physician certified by
412.16the American Board of Psychiatry and Neurology or eligible for board certification in
412.17psychiatry, may bill for medication management and evaluation and management services
412.18provided to medical assistance enrollees in inpatient hospital settings, and in outpatient
412.19settings after the licensed physician assistant completes 2,000 hours of clinical experience
412.20in the evaluation and treatment of mental health, consistent with their authorized scope of
412.21practice, as defined in section 147A.09, with the exception of performing psychotherapy
412.22or diagnostic assessments or providing clinical supervision.

412.23    Sec. 26. Minnesota Statutes 2014, section 256B.0625, subdivision 31, is amended to
412.24read:
412.25    Subd. 31. Medical supplies and equipment. (a) Medical assistance covers medical
412.26supplies and equipment. Separate payment outside of the facility's payment rate shall
412.27be made for wheelchairs and wheelchair accessories for recipients who are residents
412.28of intermediate care facilities for the developmentally disabled. Reimbursement for
412.29wheelchairs and wheelchair accessories for ICF/DD recipients shall be subject to the same
412.30conditions and limitations as coverage for recipients who do not reside in institutions. A
412.31wheelchair purchased outside of the facility's payment rate is the property of the recipient.
412.32The commissioner may set reimbursement rates for specified categories of medical
412.33supplies at levels below the Medicare payment rate.
413.1(b) Vendors of durable medical equipment, prosthetics, orthotics, or medical supplies
413.2must enroll as a Medicare provider.
413.3(c) When necessary to ensure access to durable medical equipment, prosthetics,
413.4orthotics, or medical supplies, the commissioner may exempt a vendor from the Medicare
413.5enrollment requirement if:
413.6(1) the vendor supplies only one type of durable medical equipment, prosthetic,
413.7orthotic, or medical supply;
413.8(2) the vendor serves ten or fewer medical assistance recipients per year;
413.9(3) the commissioner finds that other vendors are not available to provide same or
413.10similar durable medical equipment, prosthetics, orthotics, or medical supplies; and
413.11(4) the vendor complies with all screening requirements in this chapter and Code of
413.12Federal Regulations, title 42, part 455. The commissioner may also exempt a vendor from
413.13the Medicare enrollment requirement if the vendor is accredited by a Centers for Medicare
413.14and Medicaid Services approved national accreditation organization as complying with
413.15the Medicare program's supplier and quality standards and the vendor serves primarily
413.16pediatric patients.
413.17(d) Durable medical equipment means a device or equipment that:
413.18(1) can withstand repeated use;
413.19(2) is generally not useful in the absence of an illness, injury, or disability; and
413.20(3) is provided to correct or accommodate a physiological disorder or physical
413.21condition or is generally used primarily for a medical purpose.
413.22(e) Electronic tablets may be considered durable medical equipment if the electronic
413.23tablet will be used as an augmentative and alternative communication system as defined
413.24under subdivision 31a, paragraph (a). To be covered by medical assistance, the device
413.25must be locked in order to prevent use not related to communication.

413.26    Sec. 27. Minnesota Statutes 2014, section 256B.0625, subdivision 57, is amended to
413.27read:
413.28    Subd. 57. Payment for Part B Medicare crossover claims. (a) Effective for
413.29services provided on or after January 1, 2012, medical assistance payment for an enrollee's
413.30cost-sharing associated with Medicare Part B is limited to an amount up to the medical
413.31assistance total allowed, when the medical assistance rate exceeds the amount paid by
413.32Medicare.
413.33(b) Excluded from this limitation are payments for mental health services and
413.34payments for dialysis services provided to end-stage renal disease patients. The exclusion
414.1for mental health services does not apply to payments for physician services provided by
414.2psychiatrists and advanced practice nurses with a specialty in mental health.
414.3(c) Excluded from this limitation are payments to federally qualified health centers
414.4and rural health clinics.
414.5EFFECTIVE DATE.This section is effective January 1, 2016.

414.6    Sec. 28. Minnesota Statutes 2014, section 256B.0625, subdivision 58, is amended to
414.7read:
414.8    Subd. 58. Early and periodic screening, diagnosis, and treatment services.
414.9Medical assistance covers early and periodic screening, diagnosis, and treatment services
414.10(EPSDT). The payment amount for a complete EPSDT screening shall not include charges
414.11for vaccines health care services and products that are available at no cost to the provider
414.12and shall not exceed the rate established per Minnesota Rules, part 9505.0445, item M,
414.13effective October 1, 2010.

414.14    Sec. 29. Minnesota Statutes 2014, section 256B.0631, is amended to read:
414.15256B.0631 MEDICAL ASSISTANCE CO-PAYMENTS.
414.16    Subdivision 1. Cost-sharing. (a) Except as provided in subdivision 2, the medical
414.17assistance benefit plan shall include the following cost-sharing for all recipients, effective
414.18for services provided on or after September 1, 2011:
414.19    (1) $3 per nonpreventive visit, except as provided in paragraph (b). For purposes
414.20of this subdivision, a visit means an episode of service which is required because of
414.21a recipient's symptoms, diagnosis, or established illness, and which is delivered in an
414.22ambulatory setting by a physician or physician ancillary, chiropractor, podiatrist, nurse
414.23midwife, advanced practice nurse, audiologist, optician, or optometrist;
414.24    (2) $3.50 for nonemergency visits to a hospital-based emergency room, except that
414.25this co-payment shall be increased to $20 upon federal approval;
414.26    (3) $3 per brand-name drug prescription and $1 per generic drug prescription,
414.27subject to a $12 per month maximum for prescription drug co-payments. No co-payments
414.28shall apply to antipsychotic drugs when used for the treatment of mental illness;
414.29(4) effective January 1, 2012, a family deductible equal to the maximum amount
414.30allowed under Code of Federal Regulations, title 42, part 447.54 $2.75 per month per
414.31family and adjusted annually by the percentage increase in the medical care component
414.32of the CPI-U for the period of September to September of the preceding calendar year,
414.33rounded to the next higher five-cent increment; and
415.1    (5) for individuals identified by the commissioner with income at or below 100
415.2percent of the federal poverty guidelines, total monthly cost-sharing must not exceed five
415.3percent of family income. For purposes of this paragraph, family income is the total
415.4earned and unearned income of the individual and the individual's spouse, if the spouse is
415.5enrolled in medical assistance and also subject to the five percent limit on cost-sharing.
415.6This paragraph does not apply to premiums charged to individuals described under section
415.7256B.057, subdivision 9.
415.8    (b) Recipients of medical assistance are responsible for all co-payments and
415.9deductibles in this subdivision.
415.10(c) Notwithstanding paragraph (b), the commissioner, through the contracting
415.11process under sections 256B.69 and 256B.692, may allow managed care plans and
415.12county-based purchasing plans to waive the family deductible under paragraph (a),
415.13clause (4). The value of the family deductible shall not be included in the capitation
415.14payment to managed care plans and county-based purchasing plans. Managed care plans
415.15and county-based purchasing plans shall certify annually to the commissioner the dollar
415.16value of the family deductible.
415.17(d) Notwithstanding paragraph (b), the commissioner may waive the collection of
415.18the family deductible described under paragraph (a), clause (4), from individuals and
415.19allow long-term care and waivered service providers to assume responsibility for payment.
415.20(e) Notwithstanding paragraph (b), the commissioner, through the contracting
415.21process under section 256B.0756 shall allow the pilot program in Hennepin County to
415.22waive co-payments. The value of the co-payments shall not be included in the capitation
415.23payment amount to the integrated health care delivery networks under the pilot program.
415.24    Subd. 2. Exceptions. Co-payments and deductibles shall be subject to the following
415.25exceptions:
415.26(1) children under the age of 21;
415.27(2) pregnant women for services that relate to the pregnancy or any other medical
415.28condition that may complicate the pregnancy;
415.29(3) recipients expected to reside for at least 30 days in a hospital, nursing home, or
415.30intermediate care facility for the developmentally disabled;
415.31(4) recipients receiving hospice care;
415.32(5) 100 percent federally funded services provided by an Indian health service;
415.33(6) emergency services;
415.34(7) family planning services;
415.35(8) services that are paid by Medicare, resulting in the medical assistance program
415.36paying for the coinsurance and deductible;
416.1(9) co-payments that exceed one per day per provider for nonpreventive visits,
416.2eyeglasses, and nonemergency visits to a hospital-based emergency room; and
416.3(10) services, fee-for-service payments subject to volume purchase through
416.4competitive bidding.;
416.5(11) American Indians who meet the requirements in Code of Federal Regulations,
416.6title 42, sections 447.51 and 447.56;
416.7(12) persons needing treatment for breast or cervical cancer as described under
416.8section 256B.057, subdivision 10; and
416.9(13) services that currently have a rating of A or B from the United States Preventive
416.10Services Task Force (USPSTF), immunizations recommended by the Advisory Committee
416.11on Immunization Practices of the Centers for Disease Control and Prevention, and
416.12preventive services and screenings provided to women as described in Code of Federal
416.13Regulations, title 45, section 147.130.
416.14    Subd. 3. Collection. (a) The medical assistance reimbursement to the provider shall
416.15be reduced by the amount of the co-payment or deductible, except that reimbursements
416.16shall not be reduced:
416.17    (1) once a recipient has reached the $12 per month maximum for prescription drug
416.18co-payments; or
416.19    (2) for a recipient identified by the commissioner under 100 percent of the federal
416.20poverty guidelines who has met their monthly five percent cost-sharing limit.
416.21    (b) The provider collects the co-payment or deductible from the recipient. Providers
416.22may not deny services to recipients who are unable to pay the co-payment or deductible.
416.23    (c) Medical assistance reimbursement to fee-for-service providers and payments to
416.24managed care plans shall not be increased as a result of the removal of co-payments or
416.25deductibles effective on or after January 1, 2009.
416.26EFFECTIVE DATE.The amendment to subdivision 1, paragraph (a), clause (4), is
416.27effective retroactively from January 1, 2014.

416.28    Sec. 30. [256B.0638] OPIOID PRESCRIBING IMPROVEMENT PROGRAM.
416.29    Subdivision 1. Program established. The commissioner of human services, in
416.30conjunction with the commissioner of health, shall coordinate and implement an opioid
416.31prescribing improvement program to reduce opioid dependency and substance use by
416.32Minnesotans due to the prescribing of opioid analgesics by health care providers.
416.33    Subd. 2. Definitions. (a) For purposes of this section, the terms defined in this
416.34subdivision have the meanings given them.
416.35(b) "Commissioner" means the commissioner of human services.
417.1(c) "Commissioners" means the commissioner of human services and the
417.2commissioner of health.
417.3(d) "DEA" means the United States Drug Enforcement Administration.
417.4    (e) "Minnesota health care program" means a public health care program
417.5administered by the commissioner of human services under chapters 256B and 256L, and
417.6the Minnesota restricted recipient program.
417.7(f) "Opioid disenrollment standards" means parameters of opioid prescribing
417.8practices that fall outside community standard thresholds for prescribing to such a degree
417.9that a provider must be disenrolled as a medical assistance provider.
417.10(g) "Opioid prescriber" means a licensed health care provider who prescribes opioids
417.11to medical assistance and MinnesotaCare enrollees under the fee-for-service system or
417.12under a managed care or county-based purchasing plan.
417.13    (h) "Opioid quality improvement standard thresholds" means parameters of opioid
417.14prescribing practices that fall outside community standards for prescribing to such a
417.15degree that quality improvement is required.
417.16(i) "Program" means the statewide opioid prescribing improvement program
417.17established under this section.
417.18(j) "Provider group" means a clinic, hospital, or primary or specialty practice group
417.19that employs, contracts with, or is affiliated with an opioid prescriber. Provider group does
417.20not include a professional association supported by dues-paying members.
417.21(k) "Sentinel measures" means measures of opioid use that identify variations in
417.22prescribing practices during the prescribing intervals.
417.23    Subd. 3. Opioid prescribing work group. (a) The commissioner of human
417.24services, in consultation with the commissioner of health, shall appoint the following
417.25voting members to an opioid prescribing work group:
417.26(1) two consumer members who have been impacted by an opioid abuse disorder or
417.27opioid dependence disorder, either personally or with family members;
417.28(2) one member who is a licensed physician actively practicing in Minnesota and
417.29registered as a practitioner with the DEA;
417.30(3) one member who is a licensed pharmacist actively practicing in Minnesota and
417.31registered as a practitioner with the DEA;
417.32(4) one member who is a licensed nurse practitioner actively practicing in Minnesota
417.33and registered as a practitioner with the DEA;
417.34(5) one member who is a licensed dentist actively practicing in Minnesota and
417.35registered as a practitioner with the DEA;
418.1(6) two members who are nonphysician licensed health care professionals actively
418.2engaged in the practice of their profession in Minnesota, and their practice includes
418.3treating pain;
418.4(7) one member who is a mental health professional who is licensed or registered
418.5in a mental health profession, who is actively engaged in the practice of that profession
418.6in Minnesota, and whose practice includes treating patients with chemical dependency
418.7or substance abuse;
418.8(8) one member who is a medical examiner for a Minnesota county;
418.9(9) one member of the Health Services Policy Committee established under section
418.10256B.0625, subdivisions 3c to 3e;
418.11(10) one member who is a medical director of a health plan company doing business
418.12in Minnesota;
418.13(11) one member who is a pharmacy director of a health plan company doing
418.14business in Minnesota; and
418.15(12) one member representing Minnesota law enforcement.
418.16(b) In addition, the work group shall include the following nonvoting members:
418.17(1) the medical director for the medical assistance program;
418.18(2) a member representing the Department of Human Services pharmacy unit; and
418.19(3) the medical director for the Department of Labor and Industry.
418.20(c) An honorarium of $200 per meeting and reimbursement for mileage and parking
418.21shall be paid to each voting member in attendance.
418.22    Subd. 4. Program components. (a) The working group shall recommend to the
418.23commissioners the components of the statewide opioid prescribing improvement program,
418.24including, but not limited to, the following:
418.25(1) developing criteria for opioid prescribing protocols, including:
418.26(i) prescribing for the interval of up to four days immediately after an acute painful
418.27event;
418.28(ii) prescribing for the interval of up to 45 days after an acute painful event; and
418.29(iii) prescribing for chronic pain, which for purposes of this program means pain
418.30lasting longer than 45 days after an acute painful event;
418.31(2) developing sentinel measures;
418.32(3) developing educational resources for opioid prescribers about communicating
418.33with patients about pain management and the use of opioids to treat pain;
418.34(4) developing opioid quality improvement standard thresholds and opioid
418.35disenrollment standards for opioid prescribers and provider groups. In developing opioid
418.36disenrollment standards, the standards may be described in terms of the length of time in
419.1which prescribing practices fall outside community standards and the nature and amount
419.2of opioid prescribing that fall outside community standards; and
419.3(5) addressing other program issues as determined by the commissioners.
419.4(b) The opioid prescribing protocols shall not apply to opioids prescribed for patients
419.5who are experiencing pain caused by a malignant condition or who are receiving hospice
419.6care, or to opioids prescribed as medication-assisted therapy to treat opioid dependency.
419.7(c) All opioid prescribers who prescribe opioids to Minnesota health care program
419.8enrollees must participate in the program in accordance with subdivision 5. Any other
419.9prescriber who prescribes opioids may comply with the components of this program
419.10described in paragraph (a) on a voluntary basis.
419.11    Subd. 5. Program implementation. (a) The commissioner shall implement the
419.12programs within the Minnesota health care program to improve the health of and quality
419.13of care provided to Minnesota health care program enrollees. The commissioner shall
419.14annually collect and report to opioid prescribers data showing the sentinel measures of
419.15their opioid prescribing patterns compared to their anonymized peers.
419.16(b) The commissioner shall notify an opioid prescriber and all provider groups
419.17with which the opioid prescriber is employed or affiliated when the opioid prescriber's
419.18prescribing pattern exceeds the opioid quality improvement standard thresholds. An
419.19opioid prescriber and any provider group that receives a notice under this paragraph shall
419.20submit to the commissioner a quality improvement plan for review and approval by the
419.21commissioner with the goal of bringing the opioid prescriber's prescribing practices into
419.22alignment with community standards. A quality improvement plan must include:
419.23(1) components of the program described in subdivision 4, paragraph (a);
419.24(2) internal practice-based measures to review the prescribing practice of the
419.25opioid prescriber and, where appropriate, any other opioid prescribers employed by or
419.26affiliated with any of the provider groups with which the opioid prescriber is employed or
419.27affiliated; and
419.28(3) appropriate use of the prescription monitoring program under section 152.126.
419.29(c) If, after a year from the commissioner's notice under paragraph (b), the opioid
419.30prescriber's prescribing practices do not improve so that they are consistent with
419.31community standards, the commissioner shall take one or more of the following steps:
419.32(1) monitor prescribing practices more frequently than annually;
419.33(2) monitor more aspects of the opioid prescriber's prescribing practices than the
419.34sentinel measures; or
420.1(3) require the opioid prescriber to participate in additional quality improvement
420.2efforts, including but not limited to mandatory use of the prescription monitoring program
420.3established under section 152.126.
420.4(d) The commissioner shall terminate from Minnesota health care programs all
420.5opioid prescribers and provider groups whose prescribing practices fall within the
420.6applicable opioid disenrollment standards.
420.7    Subd. 6. Data practices. (a) Reports and data identifying an opioid prescriber
420.8are private data on individuals as defined under section 13.02, subdivision 12, until an
420.9opioid prescriber is subject to termination as a medical assistance provider under this
420.10section. Notwithstanding this data classification, the commissioner shall share with all of
420.11the provider groups with which an opioid prescriber is employed or affiliated, a report
420.12identifying an opioid prescriber who is subject to quality improvement activities under
420.13subdivision 5, paragraph (b) or (c).
420.14(b) Reports and data identifying a provider group are nonpublic data as defined
420.15under section 13.02, subdivision 9, until the provider group is subject to termination as a
420.16medical assistance provider under this section.
420.17(c) Upon termination under this section, reports and data identifying an opioid
420.18prescriber or provider group are public, except that any identifying information of
420.19Minnesota health care program enrollees must be redacted by the commissioner.
420.20    Subd. 7. Annual report to legislature. By September 15, 2016, and annually
420.21thereafter, the commissioner of human services shall report to the legislature on the
420.22implementation of the opioid prescribing improvement program in the Minnesota health
420.23care programs. The report must include data on the utilization of opioids within the
420.24Minnesota health care programs.

420.25    Sec. 31. Minnesota Statutes 2014, section 256B.0757, is amended to read:
420.26256B.0757 COORDINATED CARE THROUGH A HEALTH HOME.
420.27    Subdivision 1. Provision of coverage. (a) The commissioner shall provide
420.28medical assistance coverage of health home services for eligible individuals with chronic
420.29conditions who select a designated provider, a team of health care professionals, or a
420.30health team as the individual's health home.
420.31(b) The commissioner shall implement this section in compliance with the
420.32requirements of the state option to provide health homes for enrollees with chronic
420.33conditions, as provided under the Patient Protection and Affordable Care Act, Public
420.34Law 111-148, sections 2703 and 3502. Terms used in this section have the meaning
420.35provided in that act.
421.1(c) The commissioner shall establish health homes to serve populations with serious
421.2mental illness who meet the eligibility requirements described under subdivision 2, clause
421.3(4). The health home services provided by health homes shall focus on both the behavioral
421.4and the physical health of these populations.
421.5    Subd. 2. Eligible individual. An individual is eligible for health home services
421.6under this section if the individual is eligible for medical assistance under this chapter
421.7and has at least:
421.8(1) two chronic conditions;
421.9(2) one chronic condition and is at risk of having a second chronic condition; or
421.10(3) one serious and persistent mental health condition.; or
421.11(4) a condition that meets the definition in section 245.462, subdivision 20,
421.12paragraph (a), or 245.4871, subdivision 15, clause (2); and has a current diagnostic
421.13assessment as defined in Minnesota Rules, part 9505.0372, subpart 1, item B or C, as
421.14performed or reviewed by a mental health professional employed by or under contract
421.15with the behavioral health home. The commissioner shall establish criteria for determining
421.16continued eligibility.
421.17    Subd. 3. Health home services. (a) Health home services means comprehensive and
421.18timely high-quality services that are provided by a health home. These services include:
421.19(1) comprehensive care management;
421.20(2) care coordination and health promotion;
421.21(3) comprehensive transitional care, including appropriate follow-up, from inpatient
421.22to other settings;
421.23(4) patient and family support, including authorized representatives;
421.24(5) referral to community and social support services, if relevant; and
421.25(6) use of health information technology to link services, as feasible and appropriate.
421.26(b) The commissioner shall maximize the number and type of services included
421.27in this subdivision to the extent permissible under federal law, including physician,
421.28outpatient, mental health treatment, and rehabilitation services necessary for
421.29comprehensive transitional care following hospitalization.
421.30    Subd. 4. Health teams Designated provider. (a) Health home services
421.31are voluntary and an eligible individual may choose any designated provider. The
421.32commissioner shall establish health teams to support the patient-centered designated
421.33providers to serve as health home homes and provide the services described in subdivision
421.343 to individuals eligible under subdivision 2. The commissioner shall apply for grants or
421.35contracts as provided under section 3502 of the Patient Protection and Affordable Care Act
421.36to establish health teams homes and provide capitated payments to primary care designated
422.1providers. For purposes of this section, "health teams" "designated provider" means
422.2community-based, interdisciplinary, interprofessional teams of health care providers that
422.3support primary care practices. These providers may include medical specialists, nurses,
422.4advanced practice registered nurses, pharmacists, nutritionists, social workers, behavioral
422.5and mental health providers, doctors of chiropractic, licensed complementary and
422.6alternative medicine practitioners, and physician assistants. a provider, clinical practice or
422.7clinical group practice, rural clinic, community health center, community mental health
422.8center, or any other entity that is determined by the commissioner to be qualified to be a
422.9health home for eligible individuals. This determination must be based on documentation
422.10evidencing that the designated provider has the systems and infrastructure in place to
422.11provide health home services and satisfies the qualification standards established by the
422.12commissioner in consultation with stakeholders and approved by the Centers for Medicare
422.13and Medicaid Services.
422.14    (b) The commissioner shall develop and implement certification standards for
422.15designated providers under this subdivision.
422.16    Subd. 5. Payments. The commissioner shall make payments to each health home
422.17and each health team designated provider for the provision of health home services
422.18described in subdivision 3 to each eligible individual with chronic conditions under
422.19subdivision 2 that selects the health home as a provider.
422.20    Subd. 6. Coordination. The commissioner, to the extent feasible, shall ensure that
422.21the requirements and payment methods for health homes and health teams designated
422.22providers developed under this section are consistent with the requirements and payment
422.23methods for health care homes established under sections 256B.0751 and 256B.0753. The
422.24commissioner may modify requirements and payment methods under sections 256B.0751
422.25and 256B.0753 in order to be consistent with federal health home requirements and
422.26payment methods.
422.27    Subd. 8. Evaluation and continued development. (a) For continued certification
422.28under this section, health homes must meet process, outcome, and quality standards
422.29developed and specified by the commissioner. The commissioner shall collect data from
422.30health homes as necessary to monitor compliance with certification standards.
422.31(b) The commissioner may contract with a private entity to evaluate patient and
422.32family experiences, health care utilization, and costs.
422.33(c) The commissioner shall utilize findings from the implementation of behavioral
422.34health homes to determine populations to serve under subsequent health home models
422.35for individuals with chronic conditions.
423.1EFFECTIVE DATE.This section is effective July 1, 2016, or upon federal
423.2approval, whichever is later. The commissioner of human services shall notify the revisor
423.3of statutes when federal approval is obtained.

423.4    Sec. 32. [256B.0758] HEALTH CARE DELIVERY PILOT PROGRAM.
423.5(a) The commissioner may establish a health care delivery pilot program to test
423.6alternative and innovative integrated health care delivery networks, including accountable
423.7care organizations or a community-based collaborative care network created by or
423.8including North Memorial Health Care. If required, the commissioner shall seek federal
423.9approval of a new waiver request or amend an existing demonstration pilot project waiver.
423.10(b) Individuals eligible for the pilot program shall be individuals who are eligible for
423.11medical assistance under section 256B.055. The commissioner may identify individuals
423.12to be enrolled in the pilot program based on zip code or whether the individuals would
423.13benefit from an integrated health care delivery network.
423.14(c) In developing a payment system for the pilot programs, the commissioner shall
423.15establish a total cost of care for the individuals enrolled in the pilot program that equals
423.16the cost of care that would otherwise be spent for these enrollees in the prepaid medical
423.17assistance program.

423.18    Sec. 33. Minnesota Statutes 2014, section 256B.69, subdivision 5a, is amended to read:
423.19    Subd. 5a. Managed care contracts. (a) Managed care contracts under this section
423.20and section 256L.12 shall be entered into or renewed on a calendar year basis. The
423.21commissioner may issue separate contracts with requirements specific to services to
423.22medical assistance recipients age 65 and older.
423.23    (b) A prepaid health plan providing covered health services for eligible persons
423.24pursuant to chapters 256B and 256L is responsible for complying with the terms of its
423.25contract with the commissioner. Requirements applicable to managed care programs
423.26under chapters 256B and 256L established after the effective date of a contract with the
423.27commissioner take effect when the contract is next issued or renewed.
423.28    (c) The commissioner shall withhold five percent of managed care plan payments
423.29under this section and county-based purchasing plan payments under section 256B.692
423.30for the prepaid medical assistance program pending completion of performance targets.
423.31Each performance target must be quantifiable, objective, measurable, and reasonably
423.32attainable, except in the case of a performance target based on a federal or state law
423.33or rule. Criteria for assessment of each performance target must be outlined in writing
423.34prior to the contract effective date. Clinical or utilization performance targets and their
424.1related criteria must consider evidence-based research and reasonable interventions when
424.2available or applicable to the populations served, and must be developed with input from
424.3external clinical experts and stakeholders, including managed care plans, county-based
424.4purchasing plans, and providers. The managed care or county-based purchasing plan
424.5must demonstrate, to the commissioner's satisfaction, that the data submitted regarding
424.6attainment of the performance target is accurate. The commissioner shall periodically
424.7change the administrative measures used as performance targets in order to improve plan
424.8performance across a broader range of administrative services. The performance targets
424.9must include measurement of plan efforts to contain spending on health care services and
424.10administrative activities. The commissioner may adopt plan-specific performance targets
424.11that take into account factors affecting only one plan, including characteristics of the
424.12plan's enrollee population. The withheld funds must be returned no sooner than July of the
424.13following year if performance targets in the contract are achieved. The commissioner may
424.14exclude special demonstration projects under subdivision 23.
424.15(d) The commissioner shall require that managed care plans use the assessment and
424.16authorization processes, forms, timelines, standards, documentation, and data reporting
424.17requirements, protocols, billing processes, and policies consistent with medical assistance
424.18fee-for-service or the Department of Human Services contract requirements consistent
424.19with medical assistance fee-for-service or the Department of Human Services contract
424.20requirements for all personal care assistance services under section 256B.0659.
424.21(e) Effective for services rendered on or after January 1, 2012, the commissioner
424.22shall include as part of the performance targets described in paragraph (c) a reduction
424.23in the health plan's emergency department utilization rate for medical assistance and
424.24MinnesotaCare enrollees, as determined by the commissioner. For 2012, the reduction
424.25shall be based on the health plan's utilization in 2009. To earn the return of the withhold
424.26each subsequent year, the managed care plan or county-based purchasing plan must
424.27achieve a qualifying reduction of no less than ten percent of the plan's emergency
424.28department utilization rate for medical assistance and MinnesotaCare enrollees, excluding
424.29enrollees in programs described in subdivisions 23 and 28, compared to the previous
424.30measurement year until the final performance target is reached. When measuring
424.31performance, the commissioner must consider the difference in health risk in a managed
424.32care or county-based purchasing plan's membership in the baseline year compared to the
424.33measurement year, and work with the managed care or county-based purchasing plan to
424.34account for differences that they agree are significant.
424.35The withheld funds must be returned no sooner than July 1 and no later than July 31
424.36of the following calendar year if the managed care plan or county-based purchasing plan
425.1demonstrates to the satisfaction of the commissioner that a reduction in the utilization rate
425.2was achieved. The commissioner shall structure the withhold so that the commissioner
425.3returns a portion of the withheld funds in amounts commensurate with achieved reductions
425.4in utilization less than the targeted amount.
425.5The withhold described in this paragraph shall continue for each consecutive contract
425.6period until the plan's emergency room utilization rate for state health care program
425.7enrollees is reduced by 25 percent of the plan's emergency room utilization rate for medical
425.8assistance and MinnesotaCare enrollees for calendar year 2009. Hospitals shall cooperate
425.9with the health plans in meeting this performance target and shall accept payment
425.10withholds that may be returned to the hospitals if the performance target is achieved.
425.11(f) Effective for services rendered on or after January 1, 2012, the commissioner
425.12shall include as part of the performance targets described in paragraph (c) a reduction
425.13in the plan's hospitalization admission rate for medical assistance and MinnesotaCare
425.14enrollees, as determined by the commissioner. To earn the return of the withhold each
425.15year, the managed care plan or county-based purchasing plan must achieve a qualifying
425.16reduction of no less than five percent of the plan's hospital admission rate for medical
425.17assistance and MinnesotaCare enrollees, excluding enrollees in programs described in
425.18subdivisions 23 and 28, compared to the previous calendar year until the final performance
425.19target is reached. When measuring performance, the commissioner must consider the
425.20difference in health risk in a managed care or county-based purchasing plan's membership
425.21in the baseline year compared to the measurement year, and work with the managed care
425.22or county-based purchasing plan to account for differences that they agree are significant.
425.23The withheld funds must be returned no sooner than July 1 and no later than July
425.2431 of the following calendar year if the managed care plan or county-based purchasing
425.25plan demonstrates to the satisfaction of the commissioner that this reduction in the
425.26hospitalization rate was achieved. The commissioner shall structure the withhold so that
425.27the commissioner returns a portion of the withheld funds in amounts commensurate with
425.28achieved reductions in utilization less than the targeted amount.
425.29The withhold described in this paragraph shall continue until there is a 25 percent
425.30reduction in the hospital admission rate compared to the hospital admission rates in
425.31calendar year 2011, as determined by the commissioner. The hospital admissions in this
425.32performance target do not include the admissions applicable to the subsequent hospital
425.33admission performance target under paragraph (g). Hospitals shall cooperate with the
425.34plans in meeting this performance target and shall accept payment withholds that may be
425.35returned to the hospitals if the performance target is achieved.
426.1(g) Effective for services rendered on or after January 1, 2012, the commissioner
426.2shall include as part of the performance targets described in paragraph (c) a reduction in
426.3the plan's hospitalization admission rates for subsequent hospitalizations within 30 days of
426.4a previous hospitalization of a patient regardless of the reason, for medical assistance and
426.5MinnesotaCare enrollees, as determined by the commissioner. To earn the return of the
426.6withhold each year, the managed care plan or county-based purchasing plan must achieve
426.7a qualifying reduction of the subsequent hospitalization rate for medical assistance and
426.8MinnesotaCare enrollees, excluding enrollees in programs described in subdivisions 23
426.9and 28, of no less than five percent compared to the previous calendar year until the
426.10final performance target is reached.
426.11The withheld funds must be returned no sooner than July 1 and no later than July
426.1231 of the following calendar year if the managed care plan or county-based purchasing
426.13plan demonstrates to the satisfaction of the commissioner that a qualifying reduction in
426.14the subsequent hospitalization rate was achieved. The commissioner shall structure the
426.15withhold so that the commissioner returns a portion of the withheld funds in amounts
426.16commensurate with achieved reductions in utilization less than the targeted amount.
426.17The withhold described in this paragraph must continue for each consecutive
426.18contract period until the plan's subsequent hospitalization rate for medical assistance and
426.19MinnesotaCare enrollees, excluding enrollees in programs described in subdivisions 23
426.20and 28, is reduced by 25 percent of the plan's subsequent hospitalization rate for calendar
426.21year 2011. Hospitals shall cooperate with the plans in meeting this performance target and
426.22shall accept payment withholds that must be returned to the hospitals if the performance
426.23target is achieved.
426.24(h) Effective for services rendered on or after January 1, 2013, through December
426.2531, 2013, the commissioner shall withhold 4.5 percent of managed care plan payments
426.26under this section and county-based purchasing plan payments under section 256B.692
426.27for the prepaid medical assistance program. The withheld funds must be returned no
426.28sooner than July 1 and no later than July 31 of the following year. The commissioner may
426.29exclude special demonstration projects under subdivision 23.
426.30(i) Effective for services rendered on or after January 1, 2014, the commissioner
426.31shall withhold three percent of managed care plan payments under this section and
426.32county-based purchasing plan payments under section 256B.692 for the prepaid medical
426.33assistance program. The withheld funds must be returned no sooner than July 1 and
426.34no later than July 31 of the following year. The commissioner may exclude special
426.35demonstration projects under subdivision 23.
427.1(j) A managed care plan or a county-based purchasing plan under section 256B.692
427.2may include as admitted assets under section 62D.044 any amount withheld under this
427.3section that is reasonably expected to be returned.
427.4(k) Contracts between the commissioner and a prepaid health plan are exempt from
427.5the set-aside and preference provisions of section 16C.16, subdivisions 6, paragraph
427.6(a), and 7.
427.7(l) The return of the withhold under paragraphs (h) and (i) is not subject to the
427.8requirements of paragraph (c).
427.9(m) Managed care plans and county-based purchasing plans shall maintain current
427.10and fully executed agreements for all subcontractors, including bargaining groups, for
427.11administrative services that are expensed to the state's public health care programs.
427.12Subcontractor agreements determined to be material, as defined by the commissioner after
427.13taking into account state contracting and relevant statutory requirements, must be in the
427.14form of a written instrument or electronic document containing the elements of offer,
427.15acceptance, consideration, payment terms, scope, duration of the contract, and how the
427.16subcontractor services relate to state public health care programs. Upon request, the
427.17commissioner shall have access to all subcontractor documentation under this paragraph.
427.18Nothing in this paragraph shall allow release of information that is nonpublic data
427.19pursuant to section 13.02.

427.20    Sec. 34. Minnesota Statutes 2014, section 256B.69, subdivision 5i, is amended to read:
427.21    Subd. 5i. Administrative expenses. (a) Managed care plan and county-based
427.22purchasing plan Administrative costs for a prepaid health plan provided paid to managed
427.23care plans and county-based purchasing plans under this section or, section 256B.692,
427.24and section 256L.12 must not exceed by more than five 6.6 percent that prepaid health
427.25plan's or county-based purchasing plan's actual calculated administrative spending for the
427.26previous calendar year as a percentage of total revenue of total payments made to all
427.27managed care plans and county-based purchasing plans in aggregate across all state public
427.28health care programs, based on payments expected to be made at the beginning of each
427.29calendar year. The penalty for exceeding this limit must be the amount of administrative
427.30spending in excess of 105 percent of the actual calculated amount. The commissioner may
427.31waive this penalty if the excess administrative spending is the result of unexpected shifts
427.32in enrollment or member needs or new program requirements. The commissioner may
427.33reduce or eliminate administrative requirements to meet the administrative cost limit.
427.34For purposes of this paragraph, administrative costs do not include premium taxes paid
428.1under section 297I.05, subdivision 5, provider surcharges paid under section 256.9657,
428.2subdivision 3, and health insurance fees under section 9010 of the Affordable Care Act.
428.3    (b) The following expenses are not allowable administrative expenses for rate-setting
428.4purposes under this section:
428.5    (1) charitable contributions made by the managed care plan or the county-based
428.6purchasing plan;
428.7    (2) any portion of an individual's compensation in excess of $200,000 paid by the
428.8managed care plan or county-based purchasing plan compensation of individuals within
428.9the organization in excess of $200,000 such that the allocation of compensation for an
428.10individual across all state public health care programs in total cannot exceed $200,000;
428.11    (3) any penalties or fines assessed against the managed care plan or county-based
428.12purchasing plan; and
428.13    (4) any indirect marketing or advertising expenses of the managed care plan or
428.14county-based purchasing plan, including but not limited to costs to promote the managed
428.15care or county-based purchasing plan, costs of facilities used for special events, and costs
428.16of displays, demonstrations, donations, and promotional items such as memorabilia,
428.17models, gifts, and souvenirs. The commissioner may classify an item listed in this clause
428.18as an allowable administrative expense for rate-setting purposes, if the commissioner
428.19determines that the expense is incidental to an activity related to state pubic health care
428.20programs that is an allowable cost for purposes of rate setting;
428.21(5) any lobbying and political activities, events, or contributions;
428.22(6) administrative expenses related to the provision of services not covered under
428.23the state plan or waiver;
428.24(7) alcoholic beverages and related costs;
428.25(8) membership in any social, dining, or country club or organization; and
428.26    (9) entertainment, including amusement, diversion, and social activities, and any
428.27costs directly associated with these costs, including but not limited to tickets to shows or
428.28sporting events, meals, lodging, rentals, transportation, and gratuities.
428.29For the purposes of this subdivision, compensation includes salaries, bonuses and
428.30incentives, other reportable compensation on an IRS 990 form, retirement and other
428.31deferred compensation, and nontaxable benefits. Charitable contributions under clause
428.32(1) include payments for or to any organization or entity selected by the managed care
428.33plan or county-based purchasing plan that is operated for charitable, educational, political,
428.34religious, or scientific purposes, that are not related to medical and administrative services
428.35covered under state public health care programs.
429.1    (c) Payments to a quality improvement organization are an allowable administrative
429.2expense for rate-setting purposes under this section, to the extent they are allocated to a
429.3state public health care program and approved by the commissioner.
429.4    (d) Where reasonably possible, expenses for an administrative item shall be directly
429.5allocated so as to assign costs for an item to an individual state public health care program
429.6when the cost can be specifically identified with and benefits the individual state public
429.7health care program. For administrative services expensed to the state's public health care
429.8programs, managed care plans and county-based purchasing plans must clearly identify
429.9and separately record expense items listed under paragraph (b) in their accounting systems
429.10in a manner that allows for independent verification of unallowable expenses for purposes
429.11of determining payment rates for state public health care programs.
429.12(e) Notwithstanding paragraph (a), the commissioner shall reduce administrative
429.13expenses paid to managed care plans and county-based purchasing plans by .50 of a
429.14percentage point for contracts beginning January 1, 2016, and ending December 31,
429.152017. To meet the administrative reductions under this paragraph, the commissioner
429.16may reduce or eliminate administrative requirements, exclude additional unallowable
429.17administrative expenses identified under this section and resulting from the financial
429.18audits conducted under subdivision 9d, and utilize competitive bidding to gain efficiencies
429.19through economies of scale from increased enrollment. If the total reduction cannot be
429.20achieved through administrative reduction, the commissioner may limit total rate increases
429.21on payments to managed care plans and county-based purchasing plans.

429.22    Sec. 35. Minnesota Statutes 2014, section 256B.69, subdivision 9c, is amended to read:
429.23    Subd. 9c. Managed care financial reporting. (a) The commissioner shall collect
429.24detailed data regarding financials, provider payments, provider rate methodologies, and
429.25other data as determined by the commissioner. The commissioner, in consultation with the
429.26commissioners of health and commerce, and in consultation with managed care plans and
429.27county-based purchasing plans, shall set uniform criteria, definitions, and standards for the
429.28data to be submitted, and shall require managed care and county-based purchasing plans
429.29to comply with these criteria, definitions, and standards when submitting data under this
429.30section. In carrying out the responsibilities of this subdivision, the commissioner shall
429.31ensure that the data collection is implemented in an integrated and coordinated manner
429.32that avoids unnecessary duplication of effort. To the extent possible, the commissioner
429.33shall use existing data sources and streamline data collection in order to reduce public
429.34and private sector administrative costs. Nothing in this subdivision shall allow release of
429.35information that is nonpublic data pursuant to section 13.02.
430.1(b) Effective January 1, 2014, each managed care and county-based purchasing plan
430.2must quarterly provide to the commissioner the following information on state public
430.3programs, in the form and manner specified by the commissioner, according to guidelines
430.4developed by the commissioner in consultation with managed care plans and county-based
430.5purchasing plans under contract:
430.6(1) an income statement by program;
430.7(2) financial statement footnotes;
430.8(3) quarterly profitability by program and population group;
430.9(4) a medical liability summary by program and population group;
430.10(5) received but unpaid claims report by program;
430.11(6) services versus payment lags by program for hospital services, outpatient
430.12services, physician services, other medical services, and pharmaceutical benefits;
430.13(7) utilization reports that summarize utilization and unit cost information by
430.14program for hospitalization services, outpatient services, physician services, and other
430.15medical services;
430.16(8) pharmaceutical statistics by program and population group for measures of price
430.17and utilization of pharmaceutical services;
430.18(9) subcapitation expenses by population group;
430.19(10) third-party payments by program;
430.20(11) all new, active, and closed subrogation cases by program;
430.21(12) all new, active, and closed fraud and abuse cases by program;
430.22(13) medical loss ratios by program;
430.23(14) administrative expenses by category and subcategory by program that reconcile
430.24to other state and federal regulatory agencies, including Minnesota Supplement Report
430.25#1A;
430.26(15) revenues by program, including investment income;
430.27(16) nonadministrative service payments, provider payments, and reimbursement
430.28rates by provider type or service category, by program, paid by the managed care plan
430.29under this section or the county-based purchasing plan under section 256B.692 to
430.30providers and vendors for administrative services under contract with the plan, including
430.31but not limited to:
430.32(i) individual-level provider payment and reimbursement rate data;
430.33(ii) provider reimbursement rate methodologies by provider type, by program,
430.34including a description of alternative payment arrangements and payments outside the
430.35claims process;
430.36(iii) data on implementation of legislatively mandated provider rate changes; and
431.1(iv) individual-level provider payment and reimbursement rate data and plan-specific
431.2provider reimbursement rate methodologies by provider type, by program, including
431.3alternative payment arrangements and payments outside the claims process, provided to
431.4the commissioner under this subdivision are nonpublic data as defined in section 13.02;
431.5(17) data on the amount of reinsurance or transfer of risk by program; and
431.6(18) contribution to reserve, by program.
431.7(c) In the event a report is published or released based on data provided under
431.8this subdivision, the commissioner shall provide the report to managed care plans and
431.9county-based purchasing plans 15 days prior to the publication or release of the report.
431.10Managed care plans and county-based purchasing plans shall have 15 days to review the
431.11report and provide comment to the commissioner.
431.12The quarterly reports shall be submitted to the commissioner no later than 60 days after the
431.13end of the previous quarter, except the fourth-quarter report, which shall be submitted by
431.14April 1 of each year. The fourth-quarter report shall include audited financial statements,
431.15parent company audited financial statements, an income statement reconciliation report,
431.16and any other documentation necessary to reconcile the detailed reports to the audited
431.17financial statements.
431.18(d) Managed care plans and county-based purchasing plans shall certify to the
431.19commissioner for the purpose of financial reporting for state public health care programs
431.20under this subdivision that costs reported for state public health care programs include:
431.21(1) only services covered under the state plan and waivers, and related allowable
431.22administrative expenses; and
431.23(2) the dollar value of unallowable and nonstate plan services, including both
431.24medical and administrative expenditures, that have been excluded.

431.25    Sec. 36. Minnesota Statutes 2014, section 256B.69, subdivision 9d, is amended to read:
431.26    Subd. 9d. Financial audit and quality assurance audits. (a) The legislative
431.27auditor shall contract with an audit firm to conduct a biennial independent third-party
431.28financial audit of the information required to be provided by managed care plans and
431.29county-based purchasing plans under subdivision 9c, paragraph (b). The audit shall be
431.30conducted in accordance with generally accepted government auditing standards issued
431.31by the United States Government Accountability Office. The contract with the audit
431.32firm shall be designed and administered so as to render the independent third-party audit
431.33eligible for a federal subsidy, if available. The contract shall require the audit to include
431.34a determination of compliance with the federal Medicaid rate certification process. The
431.35contract shall require the audit to determine if the administrative expenses and investment
432.1income reported by the managed care plans and county-based purchasing plans are
432.2compliant with state and federal law.
432.3(b) For purposes of this subdivision, "independent third party" means an audit firm
432.4that is independent in accordance with government auditing standards issued by the United
432.5States Government Accountability Office and licensed in accordance with chapter 326A.
432.6An audit firm under contract to provide services in accordance with this subdivision must
432.7not have provided services to a managed care plan or county-based purchasing plan during
432.8the period for which the audit is being conducted.
432.9(c) (a) The commissioner shall require, in the request for bids and resulting contracts
432.10with managed care plans and county-based purchasing plans under this section and section
432.11256B.692 , that each managed care plan and county-based purchasing plan submit to and
432.12fully cooperate with the independent third-party financial audit audits by the legislative
432.13auditor under subdivision 9e of the information required under subdivision 9c, paragraph
432.14(b). Each contract with a managed care plan or county-based purchasing plan under this
432.15section or section 256B.692 must provide the commissioner and, the audit firm legislative
432.16auditor, and vendors contracting with the legislative auditor, access to all data required to
432.17complete the audit. For purposes of this subdivision, the contracting audit firm shall have
432.18the same investigative power as the legislative auditor under section 3.978, subdivision 2
432.19audits under subdivision 9e.
432.20(d) (b) Each managed care plan and county-based purchasing plan providing services
432.21under this section shall provide to the commissioner biweekly encounter data and claims
432.22data for state public health care programs and shall participate in a quality assurance
432.23program that verifies the timeliness, completeness, accuracy, and consistency of the data
432.24provided. The commissioner shall develop written protocols for the quality assurance
432.25program and shall make the protocols publicly available. The commissioner shall contract
432.26for an independent third-party audit to evaluate the quality assurance protocols as to
432.27the capacity of the protocols to ensure complete and accurate data and to evaluate the
432.28commissioner's implementation of the protocols. The audit firm under contract to provide
432.29this evaluation must meet the requirements in paragraph (b).
432.30(e) Upon completion of the audit under paragraph (a) and receipt by the legislative
432.31auditor, the legislative auditor shall provide copies of the audit report to the commissioner,
432.32the state auditor, the attorney general, and the chairs and ranking minority members of the
432.33health and human services finance committees of the legislature. (c) Upon completion
432.34of the evaluation under paragraph (d) (b), the commissioner shall provide copies of the
432.35report to the legislative auditor and the chairs and ranking minority members of the health
433.1finance committees of the legislature legislative committees with jurisdiction over health
433.2care policy and financing.
433.3(f) (d) Any actuary under contract with the commissioner to provide actuarial
433.4services must meet the independence requirements under the professional code for fellows
433.5in the Society of Actuaries and must not have provided actuarial services to a managed
433.6care plan or county-based purchasing plan that is under contract with the commissioner
433.7pursuant to this section and section 256B.692 during the period in which the actuarial
433.8services are being provided. An actuary or actuarial firm meeting the requirements
433.9of this paragraph must certify and attest to the rates paid to the managed care plans
433.10and county-based purchasing plans under this section and section 256B.692, and the
433.11certification and attestation must be auditable.
433.12(e) The commissioner, to the extent of available funding, shall conduct ad hoc audits
433.13of state public health care program administrative and medical expenses reported by
433.14managed care plans and county-based purchasing plans. This includes: financial and
433.15encounter data reported to the commissioner under subdivision 9c, including payments to
433.16providers and subcontractors; supporting documentation for expenditures; categorization
433.17of administrative and medical expenses; and allocation methods used to attribute
433.18administrative expenses to state public health care programs. These audits also must
433.19monitor compliance with data and financial report certification requirements established
433.20by the commissioner for the purposes of managed care capitation payment rate-setting.
433.21The managed care plans and county-based purchasing plans shall fully cooperate with
433.22the audits in this subdivision. The commissioner shall report to the chairs and ranking
433.23minority members of the legislative committees with jurisdiction over health and human
433.24services policy and finance by February 1, 2016, and each February 1 thereafter, the
433.25number of ad hoc audits conducted in the past calendar year and the results of these audits.
433.26(g) (f) Nothing in this subdivision shall allow the release of information that is
433.27nonpublic data pursuant to section 13.02.

433.28    Sec. 37. Minnesota Statutes 2014, section 256B.69, is amended by adding a
433.29subdivision to read:
433.30    Subd. 9e. Financial audits. (a) The legislative auditor shall conduct or contract with
433.31vendors to conduct independent third-party financial audits of the information required to
433.32be provided by managed care plans and county-based purchasing plans under subdivision
433.339c, paragraph (b). The audits by the vendors shall be conducted as vendor resources
433.34permit and in accordance with generally accepted government auditing standards issued
433.35by the United States Government Accountability Office. The contract with the vendors
434.1shall be designed and administered so as to render the independent third-party audits
434.2eligible for a federal subsidy, if available. The contract shall require the audits to include a
434.3determination of compliance with the federal Medicaid rate certification process.
434.4(b) For purposes of this subdivision, "independent third-party" means a vendor that
434.5is independent in accordance with government auditing standards issued by the United
434.6States Government Accountability Office.

434.7    Sec. 38. Minnesota Statutes 2014, section 256B.75, is amended to read:
434.8256B.75 HOSPITAL OUTPATIENT REIMBURSEMENT.
434.9    (a) For outpatient hospital facility fee payments for services rendered on or after
434.10October 1, 1992, the commissioner of human services shall pay the lower of (1) submitted
434.11charge, or (2) 32 percent above the rate in effect on June 30, 1992, except for those
434.12services for which there is a federal maximum allowable payment. Effective for services
434.13rendered on or after January 1, 2000, payment rates for nonsurgical outpatient hospital
434.14facility fees and emergency room facility fees shall be increased by eight percent over the
434.15rates in effect on December 31, 1999, except for those services for which there is a federal
434.16maximum allowable payment. Services for which there is a federal maximum allowable
434.17payment shall be paid at the lower of (1) submitted charge, or (2) the federal maximum
434.18allowable payment. Total aggregate payment for outpatient hospital facility fee services
434.19shall not exceed the Medicare upper limit. If it is determined that a provision of this
434.20section conflicts with existing or future requirements of the United States government with
434.21respect to federal financial participation in medical assistance, the federal requirements
434.22prevail. The commissioner may, in the aggregate, prospectively reduce payment rates to
434.23avoid reduced federal financial participation resulting from rates that are in excess of
434.24the Medicare upper limitations.
434.25    (b) Notwithstanding paragraph (a), payment for outpatient, emergency, and
434.26ambulatory surgery hospital facility fee services for critical access hospitals designated
434.27under section 144.1483, clause (9), shall be paid on a cost-based payment system that is
434.28based on the cost-finding methods and allowable costs of the Medicare program. Effective
434.29for services provided on or after July 1, 2015, rates established for critical access hospitals
434.30under this paragraph for the applicable payment year shall be the final payment and shall
434.31not be settled to actual costs.
434.32    (c) Effective for services provided on or after July 1, 2003, rates that are based
434.33on the Medicare outpatient prospective payment system shall be replaced by a budget
434.34neutral prospective payment system that is derived using medical assistance data. The
435.1commissioner shall provide a proposal to the 2003 legislature to define and implement
435.2this provision.
435.3    (d) For fee-for-service services provided on or after July 1, 2002, the total payment,
435.4before third-party liability and spenddown, made to hospitals for outpatient hospital
435.5facility services is reduced by .5 percent from the current statutory rate.
435.6    (e) In addition to the reduction in paragraph (d), the total payment for fee-for-service
435.7services provided on or after July 1, 2003, made to hospitals for outpatient hospital
435.8facility services before third-party liability and spenddown, is reduced five percent from
435.9the current statutory rates. Facilities defined under section 256.969, subdivision 16, are
435.10excluded from this paragraph.
435.11    (f) In addition to the reductions in paragraphs (d) and (e), the total payment for
435.12fee-for-service services provided on or after July 1, 2008, made to hospitals for outpatient
435.13hospital facility services before third-party liability and spenddown, is reduced three
435.14percent from the current statutory rates. Mental health services and facilities defined under
435.15section 256.969, subdivision 16, are excluded from this paragraph.

435.16    Sec. 39. Minnesota Statutes 2014, section 256B.76, subdivision 1, is amended to read:
435.17    Subdivision 1. Physician reimbursement. (a) Effective for services rendered on
435.18or after October 1, 1992, the commissioner shall make payments for physician services
435.19as follows:
435.20    (1) payment for level one Centers for Medicare and Medicaid Services' common
435.21procedural coding system codes titled "office and other outpatient services," "preventive
435.22medicine new and established patient," "delivery, antepartum, and postpartum care,"
435.23"critical care," cesarean delivery and pharmacologic management provided to psychiatric
435.24patients, and level three codes for enhanced services for prenatal high risk, shall be paid
435.25at the lower of (i) submitted charges, or (ii) 25 percent above the rate in effect on June
435.2630, 1992. If the rate on any procedure code within these categories is different than the
435.27rate that would have been paid under the methodology in section 256B.74, subdivision 2,
435.28then the larger rate shall be paid;
435.29    (2) payments for all other services shall be paid at the lower of (i) submitted charges,
435.30or (ii) 15.4 percent above the rate in effect on June 30, 1992; and
435.31    (3) all physician rates shall be converted from the 50th percentile of 1982 to the 50th
435.32percentile of 1989, less the percent in aggregate necessary to equal the above increases
435.33except that payment rates for home health agency services shall be the rates in effect
435.34on September 30, 1992.
436.1    (b) Effective for services rendered on or after January 1, 2000, payment rates for
436.2physician and professional services shall be increased by three percent over the rates
436.3in effect on December 31, 1999, except for home health agency and family planning
436.4agency services. The increases in this paragraph shall be implemented January 1, 2000,
436.5for managed care.
436.6(c) Effective for services rendered on or after July 1, 2009, payment rates for
436.7physician and professional services shall be reduced by five percent, except that for the
436.8period July 1, 2009, through June 30, 2010, payment rates shall be reduced by 6.5 percent
436.9for the medical assistance and general assistance medical care programs, over the rates in
436.10effect on June 30, 2009. This reduction and the reductions in paragraph (d) do not apply
436.11to office or other outpatient visits, preventive medicine visits and family planning visits
436.12billed by physicians, advanced practice nurses, or physician assistants in a family planning
436.13agency or in one of the following primary care practices: general practice, general internal
436.14medicine, general pediatrics, general geriatrics, and family medicine. This reduction
436.15and the reductions in paragraph (d) do not apply to federally qualified health centers,
436.16rural health centers, and Indian health services. Effective October 1, 2009, payments
436.17made to managed care plans and county-based purchasing plans under sections 256B.69,
436.18256B.692 , and 256L.12 shall reflect the payment reduction described in this paragraph.
436.19(d) Effective for services rendered on or after July 1, 2010, payment rates for
436.20physician and professional services shall be reduced an additional seven percent over
436.21the five percent reduction in rates described in paragraph (c). This additional reduction
436.22does not apply to physical therapy services, occupational therapy services, and speech
436.23pathology and related services provided on or after July 1, 2010. This additional reduction
436.24does not apply to physician services billed by a psychiatrist or an advanced practice nurse
436.25with a specialty in mental health. Effective October 1, 2010, payments made to managed
436.26care plans and county-based purchasing plans under sections 256B.69, 256B.692, and
436.27256L.12 shall reflect the payment reduction described in this paragraph.
436.28(e) Effective for services rendered on or after September 1, 2011, through June 30,
436.292013, payment rates for physician and professional services shall be reduced three percent
436.30from the rates in effect on August 31, 2011. This reduction does not apply to physical
436.31therapy services, occupational therapy services, and speech pathology and related services.
436.32(f) Effective for services rendered on or after September 1, 2014, payment rates for
436.33physician and professional services, including physical therapy, occupational therapy,
436.34speech pathology, and mental health services shall be increased by five percent from the
436.35rates in effect on August 31, 2014. In calculating this rate increase, the commissioner
436.36shall not include in the base rate for August 31, 2014, the rate increase provided under
437.1section 256B.76, subdivision 7. This increase does not apply to federally qualified health
437.2centers, rural health centers, and Indian health services. Payments made to managed
437.3care plans and county-based purchasing plans shall not be adjusted to reflect payments
437.4under this paragraph.
437.5(g) Effective for services rendered on or after July 1, 2015, payment rates for
437.6physical therapy, occupational therapy, and speech pathology and related services provided
437.7by a hospital meeting the criteria specified in section 62Q.19, subdivision 1, paragraph
437.8(a), clause (4), shall be increased by 90 percent from the rates in effect on June 30, 2015.
437.9Payments made to managed care plans and county-based purchasing plans shall not be
437.10adjusted to reflect payments under this paragraph.

437.11    Sec. 40. Minnesota Statutes 2014, section 256B.76, subdivision 2, is amended to read:
437.12    Subd. 2. Dental reimbursement. (a) Effective for services rendered on or after
437.13October 1, 1992, the commissioner shall make payments for dental services as follows:
437.14    (1) dental services shall be paid at the lower of (i) submitted charges, or (ii) 25
437.15percent above the rate in effect on June 30, 1992; and
437.16    (2) dental rates shall be converted from the 50th percentile of 1982 to the 50th
437.17percentile of 1989, less the percent in aggregate necessary to equal the above increases.
437.18    (b) Beginning October 1, 1999, the payment for tooth sealants and fluoride treatments
437.19shall be the lower of (1) submitted charge, or (2) 80 percent of median 1997 charges.
437.20    (c) Effective for services rendered on or after January 1, 2000, payment rates for
437.21dental services shall be increased by three percent over the rates in effect on December
437.2231, 1999.
437.23    (d) Effective for services provided on or after January 1, 2002, payment for
437.24diagnostic examinations and dental x-rays provided to children under age 21 shall be the
437.25lower of (1) the submitted charge, or (2) 85 percent of median 1999 charges.
437.26    (e) The increases listed in paragraphs (b) and (c) shall be implemented January 1,
437.272000, for managed care.
437.28(f) Effective for dental services rendered on or after October 1, 2010, by a
437.29state-operated dental clinic, payment shall be paid on a reasonable cost basis that is based
437.30on the Medicare principles of reimbursement. This payment shall be effective for services
437.31rendered on or after January 1, 2011, to recipients enrolled in managed care plans or
437.32county-based purchasing plans.
437.33(g) Beginning in fiscal year 2011, if the payments to state-operated dental clinics
437.34in paragraph (f), including state and federal shares, are less than $1,850,000 per fiscal
437.35year, a supplemental state payment equal to the difference between the total payments
438.1in paragraph (f) and $1,850,000 shall be paid from the general fund to state-operated
438.2services for the operation of the dental clinics.
438.3(h) If the cost-based payment system for state-operated dental clinics described in
438.4paragraph (f) does not receive federal approval, then state-operated dental clinics shall be
438.5designated as critical access dental providers under subdivision 4, paragraph (b), and shall
438.6receive the critical access dental reimbursement rate as described under subdivision 4,
438.7paragraph (a).
438.8(i) Effective for services rendered on or after September 1, 2011, through June 30,
438.92013, payment rates for dental services shall be reduced by three percent. This reduction
438.10does not apply to state-operated dental clinics in paragraph (f).
438.11(j) Effective for services rendered on or after January 1, 2014, payment rates for
438.12dental services shall be increased by five percent from the rates in effect on December
438.1331, 2013. This increase does not apply to state-operated dental clinics in paragraph (f),
438.14federally qualified health centers, rural health centers, and Indian health services. Effective
438.15January 1, 2014, payments made to managed care plans and county-based purchasing
438.16plans under sections 256B.69, 256B.692, and 256L.12 shall reflect the payment increase
438.17described in this paragraph.
438.18(k) Effective for services rendered on or after July 1, 2015, the commissioner shall
438.19increase payment rates for services furnished by dental providers located outside of the
438.20seven-county metropolitan area by the maximum percentage possible above the rates in
438.21effect on June 30, 2015, while remaining within the limits of funding appropriated for this
438.22purpose. This increase does not apply to state-operated dental clinics in paragraph (f),
438.23federally qualified health centers, rural health centers, and Indian health services. Effective
438.24January 1, 2016, payments to managed care plans and county-based purchasing plans
438.25under sections 256B.69 and 256B.692 shall reflect the payment increase described in this
438.26paragraph. The commissioner shall require managed care and county-based purchasing
438.27plans to pass on the full amount of the increase, in the form of higher payment rates to
438.28dental providers located outside of the seven-county metropolitan area.

438.29    Sec. 41. Minnesota Statutes 2014, section 256B.76, subdivision 4, as amended by
438.30Laws 2015, chapter 21, article 1, section 58, is amended to read:
438.31    Subd. 4. Critical access dental providers. (a) Effective for dental services
438.32rendered on or after January 1, 2002, the commissioner shall increase reimbursements
438.33to dentists and dental clinics deemed by the commissioner to be critical access dental
438.34providers. For dental services rendered on or after July 1, 2007, the commissioner shall
438.35increase reimbursement by 35 percent above the reimbursement rate that would otherwise
439.1be paid to the critical access dental provider. The commissioner shall pay the managed
439.2care plans and county-based purchasing plans in amounts sufficient to reflect increased
439.3reimbursements to critical access dental providers as approved by the commissioner.
439.4(b) The commissioner shall designate the following dentists and dental clinics as
439.5critical access dental providers:
439.6    (1) nonprofit community clinics that:
439.7(i) have nonprofit status in accordance with chapter 317A;
439.8(ii) have tax exempt status in accordance with the Internal Revenue Code, section
439.9501(c)(3);
439.10(iii) are established to provide oral health services to patients who are low income,
439.11uninsured, have special needs, and are underserved;
439.12(iv) have professional staff familiar with the cultural background of the clinic's
439.13patients;
439.14(v) charge for services on a sliding fee scale designed to provide assistance to
439.15low-income patients based on current poverty income guidelines and family size;
439.16(vi) do not restrict access or services because of a patient's financial limitations
439.17or public assistance status; and
439.18(vii) have free care available as needed;
439.19    (2) federally qualified health centers, rural health clinics, and public health clinics;
439.20    (3) city or county owned and operated hospital-based dental clinics;
439.21(4) a dental clinic or dental group owned and operated by a nonprofit corporation in
439.22accordance with chapter 317A with more than 10,000 patient encounters per year with
439.23patients who are uninsured or covered by medical assistance or MinnesotaCare;
439.24(5) a dental clinic owned and operated by the University of Minnesota or the
439.25Minnesota State Colleges and Universities system; and
439.26(6) private practicing dentists if:
439.27(i) the dentist's office is located within a health professional shortage area as defined
439.28under Code of Federal Regulations, title 42, part 5, and United States Code, title 42,
439.29section 254E;
439.30(ii) more than 50 percent of the dentist's patient encounters per year are with patients
439.31who are uninsured or covered by medical assistance or MinnesotaCare; and
439.32(iii) the dentist does not restrict access or services because of a patient's financial
439.33limitations or public assistance status; and
439.34(iv) (iii) the level of service provided by the dentist is critical to maintaining
439.35adequate levels of patient access within the service area in which the dentist operates.

440.1    Sec. 42. Minnesota Statutes 2014, section 256B.762, is amended to read:
440.2256B.762 REIMBURSEMENT FOR HEALTH CARE SERVICES.
440.3    (a) Effective for services provided on or after October 1, 2005, payment rates
440.4for the following services shall be increased by five percent over the rates in effect on
440.5September 30, 2005, when these services are provided as home health services under
440.6section 256B.0625, subdivision 6a:
440.7    (1) skilled nursing visit;
440.8    (2) physical therapy visit;
440.9    (3) occupational therapy visit;
440.10    (4) speech therapy visit; and
440.11    (5) home health aide visit.
440.12    (b) Effective for services provided on or after July 1, 2015, payment rates for
440.13managed care and fee-for-service visits for the following services shall be increased by
440.14ten percent over the rates in effect on June 30, 2015, when these services are provided as
440.15home health services under section 256B.0625, subdivision 6a:
440.16    (1) physical therapy;
440.17    (2) occupational therapy; and
440.18    (3) speech therapy.
440.19The commissioner shall adjust managed care and county-based purchasing plan capitation
440.20rates to reflect the payment rates under this paragraph.

440.21    Sec. 43. Minnesota Statutes 2014, section 256B.766, is amended to read:
440.22256B.766 REIMBURSEMENT FOR BASIC CARE SERVICES.
440.23(a) Effective for services provided on or after July 1, 2009, total payments for basic
440.24care services, shall be reduced by three percent, except that for the period July 1, 2009,
440.25through June 30, 2011, total payments shall be reduced by 4.5 percent for the medical
440.26assistance and general assistance medical care programs, prior to third-party liability and
440.27spenddown calculation. Effective July 1, 2010, the commissioner shall classify physical
440.28therapy services, occupational therapy services, and speech-language pathology and
440.29related services as basic care services. The reduction in this paragraph shall apply to
440.30physical therapy services, occupational therapy services, and speech-language pathology
440.31and related services provided on or after July 1, 2010.
440.32(b) Payments made to managed care plans and county-based purchasing plans shall
440.33be reduced for services provided on or after October 1, 2009, to reflect the reduction
440.34effective July 1, 2009, and payments made to the plans shall be reduced effective October
440.351, 2010, to reflect the reduction effective July 1, 2010.
441.1(c) Effective for services provided on or after September 1, 2011, through June 30,
441.22013, total payments for outpatient hospital facility fees shall be reduced by five percent
441.3from the rates in effect on August 31, 2011.
441.4(d) Effective for services provided on or after September 1, 2011, through June
441.530, 2013, total payments for ambulatory surgery centers facility fees, medical supplies
441.6and durable medical equipment not subject to a volume purchase contract, prosthetics
441.7and orthotics, renal dialysis services, laboratory services, public health nursing services,
441.8physical therapy services, occupational therapy services, speech therapy services,
441.9eyeglasses not subject to a volume purchase contract, hearing aids not subject to a volume
441.10purchase contract, and anesthesia services shall be reduced by three percent from the
441.11rates in effect on August 31, 2011.
441.12(e) Effective for services provided on or after September 1, 2014, payments
441.13for ambulatory surgery centers facility fees, hospice services, renal dialysis services,
441.14laboratory services, public health nursing services, eyeglasses not subject to a volume
441.15purchase contract, and hearing aids not subject to a volume purchase contract shall be
441.16increased by three percent and payments for outpatient hospital facility fees shall be
441.17increased by three percent. Payments made to managed care plans and county-based
441.18purchasing plans shall not be adjusted to reflect payments under this paragraph.
441.19(f) Payments for medical supplies and durable medical equipment not subject to a
441.20volume purchase contract, and prosthetics and orthotics, provided on or after July 1, 2014,
441.21through June 30, 2015, shall be decreased by .33 percent. Payments for medical supplies
441.22and durable medical equipment not subject to a volume purchase contract, and prosthetics
441.23and orthotics, provided on or after July 1, 2015, shall be increased by three percent from
441.24the rates in effect on June 30, 2014 as determined under paragraph (i).
441.25(g) Effective for services provided on or after July 1, 2015, payments for outpatient
441.26hospital facility fees, medical supplies and durable medical equipment not subject to a
441.27volume purchase contract, prosthetics and orthotics, and laboratory services to a hospital
441.28meeting the criteria specified in section 62Q.19, subdivision 1, paragraph (a), clause (4),
441.29shall be increased by 90 percent from the rates in effect on June 30, 2015. Payments made
441.30to managed care plans and county-based purchasing plans shall not be adjusted to reflect
441.31payments under this paragraph.
441.32(h) This section does not apply to physician and professional services, inpatient
441.33hospital services, family planning services, mental health services, dental services,
441.34prescription drugs, medical transportation, federally qualified health centers, rural health
441.35centers, Indian health services, and Medicare cost-sharing.
442.1(i) Effective July 1, 2015, the medical assistance payment rate for durable medical
442.2equipment, prosthetics, orthotics, or supplies shall be restored to the January 1, 2008,
442.3medical assistance fee schedule, updated to include subsequent rate increases in the
442.4Medicare and medical assistance fee schedules, and including individually priced
442.5items for the following categories: enteral nutrition and supplies, customized and other
442.6specialized tracheostomy tubes and supplies, electric patient lifts, and durable medical
442.7equipment repair and service. This paragraph does not apply to medical supplies and
442.8durable medical equipment subject to a volume purchase contract, products subject to the
442.9preferred diabetic testing supply program, and items provided to dually eligible recipients
442.10when Medicare is the primary payer for the item.

442.11    Sec. 44. Minnesota Statutes 2014, section 256B.767, is amended to read:
442.12256B.767 MEDICARE PAYMENT LIMIT.
442.13(a) Effective for services rendered on or after July 1, 2010, fee-for-service payment
442.14rates for physician and professional services under section 256B.76, subdivision 1, and
442.15basic care services subject to the rate reduction specified in section 256B.766, shall not
442.16exceed the Medicare payment rate for the applicable service, as adjusted for any changes
442.17in Medicare payment rates after July 1, 2010. The commissioner shall implement this
442.18section after any other rate adjustment that is effective July 1, 2010, and shall reduce rates
442.19under this section by first reducing or eliminating provider rate add-ons.
442.20(b) This section does not apply to services provided by advanced practice certified
442.21nurse midwives licensed under chapter 148 or traditional midwives licensed under chapter
442.22147D. Notwithstanding this exemption, medical assistance fee-for-service payment rates
442.23for advanced practice certified nurse midwives and licensed traditional midwives shall
442.24equal and shall not exceed the medical assistance payment rate to physicians for the
442.25applicable service.
442.26(c) This section does not apply to mental health services or physician services billed
442.27by a psychiatrist or an advanced practice registered nurse with a specialty in mental health.
442.28(d) Effective for durable medical equipment, prosthetics, orthotics, or supplies
442.29provided on or after July 1, 2013, through June 30, 2015, the payment rate for items
442.30that are subject to the rates established under Medicare's National Competitive Bidding
442.31Program shall be equal to the rate that applies to the same item when not subject to the
442.32rate established under Medicare's National Competitive Bidding Program. This paragraph
442.33does not apply to mail-order diabetic supplies and does not apply to items provided to
442.34dually eligible recipients when Medicare is the primary payer of the item.
443.1(d) Effective July 1, 2015, this section shall not apply to durable medical equipment,
443.2prosthetics, orthotics, or supplies.
443.3(e) This section does not apply to physical therapy, occupational therapy, speech
443.4pathology and related services, and basic care services provided by a hospital meeting the
443.5criteria specified in section 62Q.19, subdivision 1, paragraph (a), clause (4).

443.6    Sec. 45. [256B.79] INTEGRATED CARE FOR HIGH-RISK PREGNANT
443.7WOMEN.
443.8    Subdivision 1. Definitions. (a) For purposes of this section, the following terms
443.9have the meanings given them.
443.10(b) "Adverse outcomes" means maternal opiate addiction, other reportable prenatal
443.11substance abuse, low birth weight, or preterm birth.
443.12(c) "Qualified integrated perinatal care collaborative" or "collaborative" means
443.13a combination of (1) members of community-based organizations that represent
443.14communities within the identified targeted populations, and (2) local or tribally based
443.15service entities, including health care, public health, social services, mental health,
443.16chemical dependency treatment, and community-based providers, determined by the
443.17commissioner to meet the criteria for the provision of integrated care and enhanced
443.18services for enrollees within targeted populations.
443.19(d) "Targeted populations" means pregnant medical assistance enrollees residing
443.20in geographic areas identified by the commissioner as being at above-average risk for
443.21adverse outcomes.
443.22    Subd. 2. Pilot program established. The commissioner shall implement a pilot
443.23program to improve birth outcomes and strengthen early parental resilience for pregnant
443.24women who are medical assistance enrollees, are at significantly elevated risk for adverse
443.25outcomes of pregnancy, and are in targeted populations. The program must promote the
443.26provision of integrated care and enhanced services to these pregnant women, including
443.27postpartum coordination to ensure ongoing continuity of care, by qualified integrated
443.28perinatal care collaboratives.
443.29    Subd. 3. Grant awards. The commissioner shall award grants to qualifying
443.30applicants to support interdisciplinary, integrated perinatal care. Grants must be awarded
443.31beginning July 1, 2016. Grant funds must be distributed through a request for proposals
443.32process to a designated lead agency within an entity that has been determined to be a
443.33qualified integrated perinatal care collaborative or within an entity in the process of
443.34meeting the qualifications to become a qualified integrated perinatal care collaborative.
443.35Grant awards must be used to support interdisciplinary, team-based needs assessments,
444.1planning, and implementation of integrated care and enhanced services for targeted
444.2populations. In determining grant award amounts, the commissioner shall consider the
444.3identified health and social risks linked to adverse outcomes and attributed to enrollees
444.4within the identified targeted population.
444.5    Subd. 4. Eligibility for grants. To be eligible for a grant under this section, an
444.6entity must show that the entity meets or is in the process of meeting qualifications
444.7established by the commissioner to be a qualified integrated perinatal care collaborative.
444.8These qualifications must include evidence that the entity has or is in the process of
444.9developing policies, services, and partnerships to support interdisciplinary, integrated care.
444.10The policies, services, and partnerships must meet specific criteria and be approved by the
444.11commissioner. The commissioner shall establish a process to review the collaborative's
444.12capacity for interdisciplinary, integrated care, to be reviewed at the commissioner's
444.13discretion. In determining whether the entity meets the qualifications for a qualified
444.14integrated perinatal care collaborative, the commissioner shall verify and review whether
444.15the entity's policies, services, and partnerships:
444.16(1) optimize early identification of drug and alcohol dependency and abuse during
444.17pregnancy, effectively coordinate referrals and follow-up of identified patients to
444.18evidence-based or evidence-informed treatment, and integrate perinatal care services with
444.19behavioral health and substance abuse services;
444.20(2) enhance access to, and effective use of, needed health care or tribal health care
444.21services, public health or tribal public health services, social services, mental health
444.22services, chemical dependency services, or services provided by community-based
444.23providers by bridging cultural gaps within systems of care and by integrating
444.24community-based paraprofessionals such as doulas and community health workers as
444.25routinely available service components;
444.26(3) encourage patient education about prenatal care, birthing, and postpartum
444.27care, and document how patient education is provided. Patient education may include
444.28information on nutrition, reproductive life planning, breastfeeding, and parenting;
444.29(4) integrate child welfare case planning with substance abuse treatment planning
444.30and monitoring, as appropriate;
444.31(5) effectively systematize screening, collaborative care planning, referrals, and
444.32follow up for behavioral and social risks known to be associated with adverse outcomes
444.33and known to be prevalent within the targeted populations;
444.34(6) facilitate ongoing continuity of care to include postpartum coordination and
444.35referrals for interconception care, continued treatment for substance abuse, identification
444.36and referrals for maternal depression and other chronic mental health conditions,
445.1continued medication management for chronic diseases, and appropriate referrals to tribal
445.2or county-based social services agencies and tribal or county-based public health nursing
445.3services; and
445.4(7) implement ongoing quality improvement activities as determined by the
445.5commissioner, including collection and use of data from qualified providers on metrics
445.6of quality such as health outcomes and processes of care, and the use of other data that
445.7has been collected by the commissioner.
445.8    Subd. 5. Gaps in communication, support, and care. A collaborative receiving
445.9a grant under this section must develop means of identifying and reporting gaps in the
445.10collaborative's communication, administrative support, and direct care that must be
445.11remedied for the collaborative to effectively provide integrated care and enhanced services
445.12to targeted populations.
445.13    Subd. 6. Report. By January 31, 2019, the commissioner shall report to the chairs
445.14and ranking minority members of the legislative committees with jurisdiction over health
445.15and human services policy and finance on the status and progress of the pilot program.
445.16The report must:
445.17(1) describe the capacity of collaboratives receiving grants under this section;
445.18(2) contain aggregate information about enrollees served within targeted populations;
445.19(3) describe the utilization of enhanced prenatal services;
445.20(4) for enrollees identified with maternal substance use disorders, describe the
445.21utilization of substance use treatment and dispositions of any child protection cases;
445.22(5) contain data on outcomes within targeted populations and compare these
445.23outcomes to outcomes statewide, using standard categories of race and ethnicity; and
445.24(6) include recommendations for continuing the program or sustaining improvements
445.25through other means beyond June 30, 2019.
445.26    Subd. 7. Expiration. This section expires June 30, 2019.

445.27    Sec. 46. Minnesota Statutes 2014, section 256L.01, subdivision 3a, is amended to read:
445.28    Subd. 3a. Family. (a) Except as provided in paragraphs (c) and (d), "family" has
445.29the meaning given for family and family size as defined in Code of Federal Regulations,
445.30title 26, section 1.36B-1.
445.31(b) The term includes children who are temporarily absent from the household in
445.32settings such as schools, camps, or parenting time with noncustodial parents.
445.33(c) For an individual who does not expect to file a federal tax return and does not
445.34expect to be claimed as a dependent for the applicable tax year, "family" has the meaning
445.35given in Code of Federal Regulations, title 42, section 435.603(f)(3).
446.1(d) For a married couple, "family" has the meaning given in Code of Federal
446.2Regulations, title 42, section 435.603(f)(4).
446.3EFFECTIVE DATE.This section is effective the day following final enactment.

446.4    Sec. 47. Minnesota Statutes 2014, section 256L.01, subdivision 5, is amended to read:
446.5    Subd. 5. Income. "Income" has the meaning given for modified adjusted gross
446.6income, as defined in Code of Federal Regulations, title 26, section 1.36B-1., and means a
446.7household's projected annual income for the applicable tax year
446.8EFFECTIVE DATE.This section is effective the day following final enactment.

446.9    Sec. 48. Minnesota Statutes 2014, section 256L.03, subdivision 5, is amended to read:
446.10    Subd. 5. Cost-sharing. (a) Except as otherwise provided in this subdivision, the
446.11MinnesotaCare benefit plan shall include the following cost-sharing requirements for all
446.12enrollees:
446.13    (1) $3 per prescription for adult enrollees;
446.14    (2) $25 for eyeglasses for adult enrollees;
446.15    (3) $3 per nonpreventive visit. For purposes of this subdivision, a "visit" means an
446.16episode of service which is required because of a recipient's symptoms, diagnosis, or
446.17established illness, and which is delivered in an ambulatory setting by a physician or
446.18physician ancillary, chiropractor, podiatrist, nurse midwife, advanced practice nurse,
446.19audiologist, optician, or optometrist;
446.20    (4) $6 for nonemergency visits to a hospital-based emergency room for services
446.21provided through December 31, 2010, and $3.50 effective January 1, 2011; and
446.22(5) a family deductible equal to the maximum amount allowed under Code of
446.23Federal Regulations, title 42, part 447.54. $2.75 per month per family and adjusted
446.24annually by the percentage increase in the medical care component of the CPI-U for
446.25the period of September to September of the preceding calendar year, rounded to the
446.26next-higher five cent increment.
446.27    (b) Paragraph (a) does not apply to children under the age of 21 and to American
446.28Indians as defined in Code of Federal Regulations, title 42, section 447.51.
446.29    (c) Paragraph (a), clause (3), does not apply to mental health services.
446.30(d) MinnesotaCare reimbursements to fee-for-service providers and payments to
446.31managed care plans or county-based purchasing plans shall not be increased as a result of
446.32the reduction of the co-payments in paragraph (a), clause (4), effective January 1, 2011.
447.1(e) The commissioner, through the contracting process under section 256L.12,
447.2may allow managed care plans and county-based purchasing plans to waive the family
447.3deductible under paragraph (a), clause (5). The value of the family deductible shall not be
447.4included in the capitation payment to managed care plans and county-based purchasing
447.5plans. Managed care plans and county-based purchasing plans shall certify annually to the
447.6commissioner the dollar value of the family deductible.
447.7(f) The commissioner shall increase co-payments for covered services in a manner
447.8sufficient to reduce the actuarial value of the benefit to 94 percent. The cost-sharing
447.9changes described in this paragraph do not apply to eligible recipients or services exempt
447.10from cost-sharing under state law. The cost-sharing changes described in this paragraph
447.11shall not be implemented prior to January 1, 2016.
447.12(g) The cost-sharing changes authorized under paragraph (f) must satisfy the
447.13requirements for cost-sharing under the Basic Health Program as set forth in Code of
447.14Federal Regulations, title 42, sections 600.510 and 600.520.
447.15EFFECTIVE DATE.The amendment to paragraph (a), clause (5), is effective
447.16retroactively from January 1, 2014. The amendment to paragraph (b) is effective the
447.17day following final enactment.

447.18    Sec. 49. Minnesota Statutes 2014, section 256L.04, subdivision 1c, is amended to read:
447.19    Subd. 1c. General requirements. To be eligible for coverage under MinnesotaCare,
447.20a person must meet the eligibility requirements of this section. A person eligible for
447.21MinnesotaCare shall not be considered a qualified individual under section 1312 of the
447.22Affordable Care Act, and is not eligible for enrollment in a qualified health plan offered
447.23through MNsure under chapter 62V.
447.24EFFECTIVE DATE.This section is effective the day following final enactment.

447.25    Sec. 50. Minnesota Statutes 2014, section 256L.04, subdivision 7b, is amended to read:
447.26    Subd. 7b. Annual income limits adjustment. The commissioner shall adjust the
447.27income limits under this section each July 1 by the annual update of the federal poverty
447.28guidelines following publication by the United States Department of Health and Human
447.29Services except that the income standards shall not go below those in effect on July 1,
447.302009 annually on January 1 as provided in Code of Federal Regulations, title 26, section
447.311.36B-1(h).
447.32EFFECTIVE DATE.This section is effective the day following final enactment.

448.1    Sec. 51. Minnesota Statutes 2014, section 256L.05, is amended by adding a subdivision
448.2to read:
448.3    Subd. 2a. Eligibility and coverage. For purposes of this chapter, an individual
448.4is eligible for MinnesotaCare following a determination by the commissioner that the
448.5individual meets the eligibility criteria for the applicable period of eligibility. For an
448.6individual required to pay a premium, coverage is only available in each month of the
448.7applicable period of eligibility for which a premium is paid.
448.8EFFECTIVE DATE.This section is effective the day following final enactment.

448.9    Sec. 52. Minnesota Statutes 2014, section 256L.05, subdivision 3, is amended to read:
448.10    Subd. 3. Effective date of coverage. (a) The effective date of coverage is the first
448.11day of the month following the month in which eligibility is approved and the first premium
448.12payment has been received. The effective date of coverage for new members added to the
448.13family is the first day of the month following the month in which the change is reported. All
448.14eligibility criteria must be met by the family at the time the new family member is added.
448.15The income of the new family member is included with the family's modified adjusted gross
448.16income and the adjusted premium begins in the month the new family member is added.
448.17(b) The initial premium must be received by the last working day of the month for
448.18coverage to begin the first day of the following month.
448.19(c) Notwithstanding any other law to the contrary, benefits under sections 256L.01 to
448.20256L.18 are secondary to a plan of insurance or benefit program under which an eligible
448.21person may have coverage and the commissioner shall use cost avoidance techniques to
448.22ensure coordination of any other health coverage for eligible persons. The commissioner
448.23shall identify eligible persons who may have coverage or benefits under other plans of
448.24insurance or who become eligible for medical assistance.
448.25(d) The effective date of coverage for individuals or families who are exempt from
448.26paying premiums under section 256L.15, subdivision 1, paragraph (c), is the first day of
448.27the month following the month in which verification of American Indian status is received
448.28or eligibility is approved, whichever is later.

448.29    Sec. 53. Minnesota Statutes 2014, section 256L.05, subdivision 3a, is amended to read:
448.30    Subd. 3a. Renewal Redetermination of eligibility. (a) Beginning July 1, 2007, An
448.31enrollee's eligibility must be renewed every 12 months redetermined on an annual basis.
448.32The 12-month period begins in the month after the month the application is approved. The
448.33period of eligibility is the entire calendar year following the year in which eligibility is
448.34redetermined. Beginning in calendar year 2015, eligibility redeterminations shall occur
449.1during the open enrollment period for qualified health plans as specified in Code of
449.2Federal Regulations, title 45, section 155.410.
449.3    (b) Each new period of eligibility must take into account any changes in
449.4circumstances that impact eligibility and premium amount. An enrollee must provide all
449.5the information needed to redetermine eligibility by the first day of the month that ends
449.6the eligibility period. The premium for the new period of eligibility must be received
449.7Coverage begins as provided in section 256L.06 in order for eligibility to continue.
449.8(c) For children enrolled in MinnesotaCare, the first period of renewal begins the
449.9month the enrollee turns 21 years of age.
449.10EFFECTIVE DATE.This section is effective the day following final enactment.

449.11    Sec. 54. Minnesota Statutes 2014, section 256L.05, subdivision 4, is amended to read:
449.12    Subd. 4. Application processing. The commissioner of human services shall
449.13determine an applicant's eligibility for MinnesotaCare no more than 30 45 days from the
449.14date that the application is received by the Department of Human Services as set forth in
449.15Code of Federal Regulations, title 42, section 435.912. Beginning January 1, 2000, this
449.16requirement also applies to local county human services agencies that determine eligibility
449.17for MinnesotaCare.
449.18EFFECTIVE DATE.This section is effective the day following final enactment.

449.19    Sec. 55. Minnesota Statutes 2014, section 256L.06, subdivision 3, is amended to read:
449.20    Subd. 3. Commissioner's duties and payment. (a) Premiums are dedicated to the
449.21commissioner for MinnesotaCare.
449.22    (b) The commissioner shall develop and implement procedures to: (1) require
449.23enrollees to report changes in income; (2) adjust sliding scale premium payments, based
449.24upon both increases and decreases in enrollee income, at the time the change in income
449.25is reported; and (3) disenroll enrollees from MinnesotaCare for failure to pay required
449.26premiums. Failure to pay includes payment with a dishonored check, a returned automatic
449.27bank withdrawal, or a refused credit card or debit card payment. The commissioner may
449.28demand a guaranteed form of payment, including a cashier's check or a money order, as
449.29the only means to replace a dishonored, returned, or refused payment.
449.30    (c) Premiums are calculated on a calendar month basis and may be paid on a
449.31monthly, quarterly, or semiannual basis, with the first payment due upon notice from the
449.32commissioner of the premium amount required. The commissioner shall inform applicants
449.33and enrollees of these premium payment options. Premium payment is required before
450.1enrollment is complete and to maintain eligibility in MinnesotaCare. Premium payments
450.2received before noon are credited the same day. Premium payments received after noon
450.3are credited on the next working day.
450.4    (d) Nonpayment of the premium will result in disenrollment from the plan
450.5effective for the calendar month following the month for which the premium was due.
450.6Persons disenrolled for nonpayment who pay all past due premiums as well as current
450.7premiums due, including premiums due for the period of disenrollment, within 20 days of
450.8disenrollment, shall be reenrolled retroactively to the first day of disenrollment may not
450.9reenroll prior to the first day of the month following the payment of an amount equal to
450.10two months' premiums.
450.11EFFECTIVE DATE.This section is effective the day following final enactment.

450.12    Sec. 56. Minnesota Statutes 2014, section 256L.121, subdivision 1, is amended to read:
450.13    Subdivision 1. Competitive process. The commissioner of human services shall
450.14establish a competitive process for entering into contracts with participating entities for
450.15the offering of standard health plans through MinnesotaCare. Coverage through standard
450.16health plans must be available to enrollees beginning January 1, 2015. Each standard
450.17health plan must cover the health services listed in and meet the requirements of section
450.18256L.03 . The competitive process must meet the requirements of section 1331 of the
450.19Affordable Care Act and be designed to ensure enrollee access to high-quality health care
450.20coverage options. The commissioner, to the extent feasible, shall seek to ensure that
450.21enrollees have a choice of coverage from more than one participating entity within a
450.22geographic area. In counties that were part of a county-based purchasing plan on January
450.231, 2013, the commissioner shall use the medical assistance competitive procurement
450.24process under section 256B.69, subdivisions 1 to 32, under which selection of entities is
450.25based on criteria related to provider network access, coordination of health care with other
450.26local services, alignment with local public health goals, and other factors.

450.27    Sec. 57. Minnesota Statutes 2014, section 256L.15, subdivision 1, is amended to read:
450.28    Subdivision 1. Premium determination for MinnesotaCare. (a) Families with
450.29children and individuals shall pay a premium determined according to subdivision 2.
450.30    (b) Members of the military and their families who meet the eligibility criteria
450.31for MinnesotaCare upon eligibility approval made within 24 months following the end
450.32of the member's tour of active duty shall have their premiums paid by the commissioner.
450.33The effective date of coverage for an individual or family who meets the criteria of this
451.1paragraph shall be the first day of the month following the month in which eligibility is
451.2approved. This exemption applies for 12 months.
451.3(c) Beginning July 1, 2009, American Indians enrolled in MinnesotaCare and their
451.4families shall have their premiums waived by the commissioner in accordance with
451.5section 5006 of the American Recovery and Reinvestment Act of 2009, Public Law 111-5.
451.6An individual must document status as an American Indian, as defined under Code of
451.7Federal Regulations, title 42, section 447.50, to qualify for the waiver of premiums.
451.8(d) For premiums effective August 1, 2015, and after, the commissioner, after
451.9consulting with the chairs and ranking minority members of the legislative committees
451.10with jurisdiction over human services, shall increase premiums under subdivision 2
451.11for recipients based on June 2015 program enrollment. Premium increases shall be
451.12sufficient to increase projected revenue to the fund described in section 16A.724 by at
451.13least $27,800,000 for the biennium ending June 30, 2017. The commissioner shall publish
451.14the revised premium scale on the Department of Human Services Web site and in the State
451.15Register no later than June 15, 2015. The revised premium scale applies to all premiums
451.16on or after August 1, 2015, in place of the scale under subdivision 2.
451.17(e) By July 1, 2015, the commissioner shall provide the chairs and ranking minority
451.18members of the legislative committees with jurisdiction over human services the revised
451.19premium scale effective August 1, 2015, and statutory language to codify the revised
451.20premium schedule.
451.21(f) Premium changes authorized under paragraph (d) must only apply to enrollees not
451.22otherwise excluded from paying premiums under state or federal law. Premium changes
451.23authorized under paragraph (d) must satisfy the requirements for premiums for the Basic
451.24Health Program under title 42 of the Code of Federal Regulations, section 600.505.

451.25    Sec. 58. Minnesota Statutes 2014, section 256L.15, subdivision 2, is amended to read:
451.26    Subd. 2. Sliding fee scale; monthly individual or family income. (a) The
451.27commissioner shall establish a sliding fee scale to determine the percentage of monthly
451.28individual or family income that households at different income levels must pay to obtain
451.29coverage through the MinnesotaCare program. The sliding fee scale must be based on the
451.30enrollee's monthly individual or family income.
451.31    (b) Beginning January 1, 2014, MinnesotaCare enrollees shall pay premiums
451.32according to the premium scale specified in paragraph (c) with the exception that children
451.3320 years of age and younger in families with income at or below 200 percent of the federal
451.34poverty guidelines shall pay no premiums (d).
451.35(c) Paragraph (b) does not apply to:
452.1(1) children 20 years of age or younger; and
452.2(2) individuals with household incomes below 35 percent of the federal poverty
452.3guidelines.
452.4    (c) (d) The following premium scale is established for each individual in the
452.5household who is 21 years of age or older and enrolled in MinnesotaCare:

452.6 452.7	Federal Poverty Guideline Greater than or Equal to	Less than	Individual Premium Amount
452.8	0% 35%	55%	$4
452.9	55%	80%	$6
452.10	80%	90%	$8
452.11	90%	100%	$10
452.12	100%	110%	$12
452.13	110%	120%	$15 $14
452.14	120%	130%	$18 $15
452.15	130%	140%	$21 $16
452.16	140%	150%	$25
452.17	150%	160%	$29
452.18	160%	170%	$33
452.19	170%	180%	$38
452.20	180%	190%	$43
452.21	190%		$50

452.22EFFECTIVE DATE.This section is effective the day following final enactment.

452.23    Sec. 59. Laws 2008, chapter 363, article 18, section 3, subdivision 5, is amended to read:

452.24

Subd. 5.Basic Health Care Grants

452.25

(a) MinnesotaCare Grants

452.26

Health Care Access

-0-

(770,000)

452.27Incentive Program and Outreach Grants.
452.28Of the appropriation for the Minnesota health
452.29care outreach program in Laws 2007, chapter
452.30147, article 19, section 3, subdivision 7,
452.31paragraph (b):
452.32(1) $400,000 in fiscal year 2009 from the
452.33general fund and $200,000 in fiscal year 2009
452.34from the health care access fund are for the
452.35incentive program under Minnesota Statutes,
452.36section 256.962, subdivision 5. For the
453.1biennium beginning July 1, 2009, base level
453.2funding for this activity shall be $360,000
453.3from the general fund and $160,000 from the
453.4health care access fund; and
453.5(2) $100,000 in fiscal year 2009 from the
453.6general fund and $50,000 in fiscal year 2009
453.7from the health care access fund are for the
453.8outreach grants under Minnesota Statutes,
453.9section 256.962, subdivision 2. For the
453.10biennium beginning July 1, 2009, base level
453.11funding for this activity shall be $90,000
453.12from the general fund and $40,000 from the
453.13health care access fund.

453.14 453.15

(b) MA Basic Health Care Grants - Families and Children

-0-

(17,280,000)

453.16Third-Party Liability. (a) During
453.17fiscal year 2009, the commissioner shall
453.18employ a contractor paid on a percentage
453.19basis to improve third-party collections.
453.20Improvement initiatives may include, but not
453.21be limited to, efforts to improve postpayment
453.22collection from nonresponsive claims and
453.23efforts to uncover third-party payers the
453.24commissioner has been unable to identify.
453.25(b) In fiscal year 2009, the first $1,098,000
453.26of recoveries, after contract payments and
453.27federal repayments, is appropriated to
453.28the commissioner for technology-related
453.29expenses.
453.30Administrative Costs. (a) For contracts
453.31effective on or after January 1, 2009,
453.32the commissioner shall limit aggregate
453.33administrative costs paid to managed care
453.34plans under Minnesota Statutes, section
453.35256B.69, and to county-based purchasing
454.1plans under Minnesota Statutes, section
454.2256B.692, to an overall average of 6.6 percent
454.3of total contract payments under Minnesota
454.4Statutes, sections 256B.69 and 256B.692,
454.5for each calendar year. For purposes of
454.6this paragraph, administrative costs do not
454.7include premium taxes paid under Minnesota
454.8Statutes, section 297I.05, subdivision 5, and
454.9provider surcharges paid under Minnesota
454.10Statutes, section 256.9657, subdivision 3.
454.11(b) Notwithstanding any law to the contrary,
454.12the commissioner may reduce or eliminate
454.13administrative requirements to meet the
454.14administrative target under paragraph (a).
454.15(c) Notwithstanding any contrary provision
454.16of this article, this rider shall not expire.
454.17Hospital Payment Delay. Notwithstanding
454.18Laws 2005, First Special Session chapter 4,
454.19article 9, section 2, subdivision 6, payments
454.20from the Medicaid Management Information
454.21System that would otherwise have been made
454.22for inpatient hospital services for medical
454.23assistance enrollees are delayed as follows:
454.24(1) for fiscal year 2008, June payments must
454.25be included in the first payments in fiscal
454.26year 2009; and (2) for fiscal year 2009,
454.27June payments must be included in the first
454.28payment of fiscal year 2010. The provisions
454.29of Minnesota Statutes, section 16A.124,
454.30do not apply to these delayed payments.
454.31Notwithstanding any contrary provision in
454.32this article, this paragraph expires on June
454.3330, 2010.

454.34 454.35

(c) MA Basic Health Care Grants - Elderly and Disabled

(14,028,000)

(9,368,000)

455.1Minnesota Disability Health Options Rate
455.2Setting Methodology. The commissioner
455.3shall develop and implement a methodology
455.4for risk adjusting payments for community
455.5alternatives for disabled individuals (CADI)
455.6and traumatic brain injury (TBI) home
455.7and community-based waiver services
455.8delivered under the Minnesota disability
455.9health options program (MnDHO) effective
455.10January 1, 2009. The commissioner shall
455.11take into account the weighting system used
455.12to determine county waiver allocations in
455.13developing the new payment methodology.
455.14Growth in the number of enrollees receiving
455.15CADI or TBI waiver payments through
455.16MnDHO is limited to an increase of 200
455.17enrollees in each calendar year from January
455.182009 through December 2011. If those limits
455.19are reached, additional members may be
455.20enrolled in MnDHO for basic care services
455.21only as defined under Minnesota Statutes,
455.22section 256B.69, subdivision 28, and the
455.23commissioner may establish a waiting list for
455.24future access of MnDHO members to those
455.25waiver services.
455.26MA Basic Elderly and Disabled
455.27Adjustments. For the fiscal year ending June
455.2830, 2009, the commissioner may adjust the
455.29rates for each service affected by rate changes
455.30under this section in such a manner across
455.31the fiscal year to achieve the necessary cost
455.32savings and minimize disruption to service
455.33providers, notwithstanding the requirements
455.34of Laws 2007, chapter 147, article 7, section
455.3571.

455.36

(d) General Assistance Medical Care Grants

-0-

(6,971,000)

456.1

(e) Other Health Care Grants

-0-

(17,000)

456.2MinnesotaCare Outreach Grants Special
456.3Revenue Account. The balance in the
456.4MinnesotaCare outreach grants special
456.5revenue account on July 1, 2009, estimated
456.6to be $900,000, must be transferred to the
456.7general fund.
456.8Grants Reduction. Effective July 1, 2008,
456.9base level funding for nonforecast, general
456.10fund health care grants issued under this
456.11paragraph shall be reduced by 1.8 percent at
456.12the allotment level.

456.13    Sec. 60. Laws 2014, chapter 312, article 24, section 45, subdivision 2, is amended to
456.14read:
456.15    Subd. 2. Application for and terms of variance. A new provider may apply to the
456.16commissioner, on a form supplied by the commissioner for this purpose, for a variance
456.17from special transportation service operating standards. The commissioner may grant or
456.18deny the variance application. Variances expire on the earlier of February 1, 2016 2017, or
456.19the date that the commissioner of transportation begins certifying new providers under the
456.20terms of this act and successor legislation one year after the date the variance was issued.
456.21The commissioner must not grant variances under this subdivision after June 30, 2016.
456.22EFFECTIVE DATE.This section is effective July 1, 2016.

456.23    Sec. 61. STATEWIDE OPIOID PRESCRIBING IMPROVEMENT PROGRAM.
456.24The commissioner of human services, in collaboration with the commissioner of
456.25health, shall report to the legislature by December 1, 2015, on recommendations made
456.26by the opioid prescribing work group under Minnesota Statutes, section 256B.0638,
456.27subdivision 4, and steps taken by the commissioner of human services to implement the
456.28opioid prescribing improvement program under Minnesota Statutes, section 256B.0638,
456.29subdivision 5.

456.30    Sec. 62. TASK FORCE ON HEALTH CARE FINANCING.
457.1    Subdivision 1. Task force. (a) The governor shall convene a task force on health
457.2care financing to advise the governor and legislature on strategies that will increase access
457.3to and improve the quality of health care for Minnesotans. These strategies shall include
457.4options for sustainable health care financing, coverage, purchasing, and delivery for all
457.5insurance affordability programs, including MNsure, medical assistance, MinnesotaCare,
457.6and individuals eligible to purchase coverage with federal advanced premium tax credits
457.7and cost-sharing subsidies.
457.8    (b) The task force shall consist of:
457.9    (1) seven members appointed by the senate, four members appointed by the majority
457.10leader of the senate, one of whom must be a legislator; and three members appointed by
457.11the minority leader of the senate, one of whom must be a legislator;
457.12    (2) seven members of the house of representatives, four members appointed by the
457.13speaker of the house, one of whom must be a legislator; and three members appointed by
457.14the minority leader of the house of representatives, one of whom must be a legislator;
457.15    (3) 11 members appointed by the governor, including public and private health care
457.16experts and consumer representatives. The consumer representatives must include one
457.17member from a nonprofit organization with legal expertise representing low-income
457.18consumers, at least one member from a broad-based nonprofit consumer advocacy
457.19organization, and at least one member from an organization representing consumers of
457.20color; and
457.21(4) the commissioners of human services, commerce, and health, and the executive
457.22director of MNsure, or their designees.
457.23    (c) The commissioner of human services and a member of the task force voted
457.24by the task force shall serve as cochairs of the task force. The commissioner of human
457.25services shall convene the first meeting and the members shall vote on the cochair position
457.26at the first meeting.
457.27    Subd. 2. Duties. (a) The task force shall consider opportunities, including
457.28alternatives to MNsure, options under section 1332 of the Patient Protection and Affordable
457.29Care Act, and options under a section 1115 waiver of the Social Security Act, including:
457.30    (1) options for providing and financing seamless coverage for persons
457.31otherwise eligible for insurance affordability programs, including medical assistance,
457.32MinnesotaCare, and advanced premium tax credits used to purchase commercial
457.33insurance. This includes, but is not limited to: alignment of eligibility and enrollment
457.34requirements; smoothing consumer cost-sharing across programs; alignment and
457.35alternatives to benefit sets; alternatives to the individual mandate; the employer mandate
457.36and penalties; advanced premium tax credits; and qualified health plans;
458.1    (2) options for transforming health care purchasing and delivery, including, but not
458.2limited to: expansion of value-based direct contracting with providers and other entities
458.3to reward improved health outcomes and reduced costs, including selective contracting;
458.4contracting to provide services to public programs and commercial products; and payment
458.5models that support and reward coordination of care across the continuum of services
458.6and programs;
458.7    (3) options for alignment, consolidation, and governance of certain operational
458.8components, including, but not limited to: MNsure; program eligibility, enrollment, call
458.9centers, and contracting; and the shared eligibility IT platform; and
458.10(4) examining the impact of options on the health care workforce and delivery
458.11system, including, but not limited to, rural and safety net providers, clinics, and hospitals.
458.12    (b) In development of the options in paragraph (a), the task force options and
458.13recommendations shall include the following goals:
458.14    (1) seamless consumer experience across all programs;
458.15    (2) reducing barriers to accessibility and affordability of coverage;
458.16    (3) improving sustainable financing of health programs, including impact on the
458.17state budget;
458.18    (4) assessing the impact of options for innovation on their potential to reduce
458.19health disparities;
458.20    (5) expanding innovative health care purchasing and delivery systems strategies that
458.21reduce cost and improve health;
458.22    (6) promoting effectively and efficiently aligning program resources and operations;
458.23and
458.24    (7) increasing transparency and accountability of program operations.
458.25    Subd. 3. Staff. (a) The commissioner of human services shall provide staff and
458.26administrative services for the task force. The commissioner may accept outside resources
458.27to help support its efforts and shall leverage its existing vendor contracts to provide
458.28technical expertise to develop options under subdivision 2. The commissioner of human
458.29services shall receive expedited review and publication of competitive procurements for
458.30additional vendor support needed to support the task force.
458.31    (b) Technical assistance shall be provided by the Departments of Health, Commerce,
458.32Human Services, and Management and Budget.
458.33    Subd. 4. Report. The commissioner of human services shall submit
458.34recommendations by January 15, 2016, to the governor and the chairs and ranking
459.1minority members of the legislative committees with jurisdiction over health, human
459.2services, and commerce policy and finance.
459.3    Subd. 5. Expiration. The task force expires the day after submitting the report
459.4required under subdivision 4.

459.5    Sec. 63. HEALTH DISPARITIES PAYMENT ENHANCEMENT.
459.6(a) The commissioner of human services shall develop a methodology to pay a
459.7higher payment rate for health care providers and services that takes into consideration
459.8the higher cost, complexity, and resources needed to serve patients and populations
459.9who experience the greatest health disparities in order to achieve the same health and
459.10quality outcomes that are achieved for other patients and populations. In developing
459.11the methodology, the commissioner shall take into consideration all existing payment
459.12methods and rates, including add-on or enhanced rates paid to providers serving high
459.13concentrations of low-income patients or populations or providing access in underserved
459.14regions or populations. The new methodology must not result in a net decrease in total
459.15payment from all sources for those providers who qualify for additional add-on payments
459.16or enhanced payments, including, but not limited to, critical access dental, community
459.17clinic add-ons, federally qualified health centers payment rates, and disproportionate share
459.18payments. The commissioner shall develop the methodology in consultation with affected
459.19stakeholders, including communities impacted by health disparities, using culturally
459.20appropriate methods of community engagement. The proposed methodology must include
459.21recommendations for how the methodology could be incorporated into payment methods
459.22used in both fee-for-service and managed care plans.
459.23(b) The commissioner shall submit a report on the analysis and provide options
459.24for new payment methodologies that incorporate health disparities to the chairs and
459.25ranking minority members of the legislative committees with jurisdiction over health care
459.26policy and finance by February 1, 2016. The scope of the report and the development
459.27work described in paragraph (a) is limited to data currently available to the Department
459.28of Human Services; analyses of the data for reliability and completeness; analyses of
459.29how these data relate to health disparities, outcomes, and expenditures; and options for
459.30incorporating these data or measures into a payment methodology.

459.31    Sec. 64. CAPITATION PAYMENT DELAY.
459.32    The commissioner of human services shall delay $135,000,000 of the medical
459.33assistance capitation payment to managed care plans and county-based purchasing plans
459.34due in May 2017 and the payment due in April 2017 for special needs basic care until
460.1July 1, 2017. The payment shall be made no earlier than July 1, 2017, and no later than
460.2July 31, 2017.

460.3    Sec. 65. REPEALER.
460.4(a) Minnesota Statutes 2014, sections 256.01, subdivision 35; 256.969, subdivisions
460.523 and 30; and 256B.69, subdivision 32, are repealed effective July 1, 2015.
460.6(b) Minnesota Statutes 2014, sections 256L.02, subdivision 3; and 256L.05,
460.7subdivisions 1b, 1c, 3c, and 5, are repealed effective the day following final enactment.
460.8(c) Minnesota Rules, part 8840.5900, subparts 12 and 14, are repealed effective
460.9January 1, 2016.

460.10ARTICLE 12

460.11MNSURE

460.12    Section 1. Minnesota Statutes 2014, section 62A.02, subdivision 2, is amended to read:
460.13    Subd. 2. Approval. (a) The health plan form shall not be issued, nor shall any
460.14application, rider, endorsement, or rate be used in connection with it, until the expiration
460.15of 60 days after it has been filed unless the commissioner approves it before that time.
460.16(b) Notwithstanding paragraph (a), a rate filed with respect to a policy of accident and
460.17sickness insurance as defined in section 62A.01 by an insurer licensed under chapter 60A,
460.18may be used on or after the date of filing with the commissioner. Rates that are not approved
460.19or disapproved within the 60-day time period are deemed approved. This paragraph does
460.20not apply to Medicare-related coverage as defined in section 62A.3099, subdivision 17.
460.21(c) For coverage to begin on or after January 1, 2016, and each January 1 thereafter,
460.22health plans in the individual and small group markets that are not grandfathered plans to
460.23be offered outside MNsure and qualified health plans to be offered inside MNsure must
460.24receive rate approval from the commissioner no later than 30 days prior to the beginning
460.25of the annual open enrollment period for MNsure. Premium rates for all carriers in the
460.26applicable market for the next calendar year must be made available to the public by the
460.27commissioner only after all rates for the applicable market are final and approved. Final
460.28and approved rates must be publicly released at a uniform time for all individual and small
460.29group health plans that are not grandfathered plans to be offered outside MNsure and
460.30qualified health plans to be offered inside MNsure, and no later than 30 days prior to the
460.31beginning of the annual open enrollment period for MNsure.

460.32    Sec. 2. Minnesota Statutes 2014, section 62V.03, subdivision 2, is amended to read:
461.1    Subd. 2. Application of other law. (a) MNsure must be reviewed by the legislative
461.2auditor under section 3.971. The legislative auditor shall audit the books, accounts, and
461.3affairs of MNsure once each year or less frequently as the legislative auditor's funds and
461.4personnel permit. Upon the audit of the financial accounts and affairs of MNsure, MNsure
461.5is liable to the state for the total cost and expenses of the audit, including the salaries paid
461.6to the examiners while actually engaged in making the examination. The legislative
461.7auditor may bill MNsure either monthly or at the completion of the audit. All collections
461.8received for the audits must be deposited in the general fund and are appropriated to
461.9the legislative auditor. Pursuant to section 3.97, subdivision 3a, the Legislative Audit
461.10Commission is requested to direct the legislative auditor to report by March 1, 2014, to
461.11the legislature on any duplication of services that occurs within state government as a
461.12result of the creation of MNsure. The legislative auditor may make recommendations on
461.13consolidating or eliminating any services deemed duplicative. The board shall reimburse
461.14the legislative auditor for any costs incurred in the creation of this report.
461.15(b) Board members of MNsure are subject to sections 10A.07 and 10A.09. Board
461.16members and the personnel of MNsure are subject to section 10A.071.
461.17(c) All meetings of the board shall comply with the open meeting law in chapter
461.1813D, except that:.
461.19(1) meetings, or portions of meetings, regarding compensation negotiations with the
461.20director or managerial staff may be closed in the same manner and according to the same
461.21procedures identified in section 13D.03;
461.22(2) meetings regarding contract negotiation strategy may be closed in the same
461.23manner and according to the same procedures identified in section 13D.05, subdivision 3,
461.24paragraph (c); and
461.25(3) meetings, or portions of meetings, regarding not public data described in section
461.2662V.06, subdivision 3, and regarding trade secret information as defined in section 13.37,
461.27subdivision 1, paragraph (b), are closed to the public, but must otherwise comply with
461.28the procedures identified in chapter 13D.
461.29(d) MNsure and provisions specified under this chapter are exempt from:
461.30(1) chapter 14, including section 14.386, except as specified in section 62V.05; and
461.31(2) chapters 16B and 16C, with the exception of sections 16C.08, subdivision 2,
461.32paragraph (b), clauses (1) to (8); 16C.086; 16C.09, paragraph (a), clauses (1) and (3),
461.33paragraph (b), and paragraph (c); and section 16C.16. However, MNsure, in consultation
461.34with the commissioner of administration, shall implement policies and procedures to
461.35establish an open and competitive procurement process for MNsure that, to the extent
461.36practicable, conforms to the principles and procedures contained in chapters 16B and 16C.
462.1In addition, MNsure may enter into an agreement with the commissioner of administration
462.2for other services.
462.3(e) (d) The board and the Web site are exempt from chapter 60K. Any employee of
462.4MNsure who sells, solicits, or negotiates insurance to individuals or small employers must
462.5be licensed as an insurance producer under chapter 60K.
462.6(f) (e) Section 3.3005 applies to any federal funds received by MNsure.
462.7(g) MNsure is exempt from the following sections in chapter 16E: 16E.01,
462.8subdivision 3 , paragraph (b); 16E.03, subdivisions 3 and 4; 16E.04, subdivision 1,
462.9subdivision 2, paragraph (c), and subdivision 3, paragraph (b); 16E.0465; 16E.055;
462.1016E.145; 16E.15; 16E.16; 16E.17; 16E.18; and 16E.22.
462.11(h) (f) A MNsure decision that requires a vote of the board, other than a decision
462.12that applies only to hiring of employees or other internal management of MNsure, is an
462.13"administrative action" under section 10A.01, subdivision 2.

462.14    Sec. 3. Minnesota Statutes 2014, section 62V.05, subdivision 6, is amended to read:
462.15    Subd. 6. Appeals. (a) The board may conduct hearings, appoint hearing officers,
462.16and recommend final orders related to appeals of any MNsure determinations, except for
462.17those determinations identified in paragraph (d). An appeal by a health carrier regarding
462.18a specific certification or selection determination made by MNsure under subdivision 5
462.19must be conducted as a contested case proceeding under chapter 14, with the report or
462.20order of the administrative law judge constituting the final decision in the case, subject to
462.21judicial review under sections 14.63 to 14.69. For other appeals, the board shall establish
462.22hearing processes which provide for a reasonable opportunity to be heard and timely
462.23resolution of the appeal and which are consistent with the requirements of federal law and
462.24guidance. An appealing party may be represented by legal counsel at these hearings, but
462.25this is not a requirement.
462.26(b) MNsure may establish service-level agreements with state agencies to conduct
462.27hearings for appeals. Notwithstanding section 471.59, subdivision 1, a state agency is
462.28authorized to enter into service-level agreements for this purpose with MNsure.
462.29(c) For proceedings under this subdivision, MNsure may be represented by an
462.30attorney who is an employee of MNsure.
462.31(d) This subdivision does not apply to appeals of determinations where a state
462.32agency hearing is available under section 256.045.
462.33(e) An appellant aggrieved by an order of MNsure issued in an eligibility appeal, as
462.34defined in Minnesota Rules, part 7700.0101, may appeal the order to the district court of
462.35the appellant's county of residence by serving a written copy of a notice of appeal upon
463.1MNsure and any other adverse party of record within 30 days after the date MNsure
463.2issued the order, the amended order, or order affirming the original order, and by filing
463.3the original notice and proof of service with the court administrator of the district court.
463.4Service may be made personally or by mail; service by mail is complete upon mailing;
463.5no filing fee shall be required by the court administrator in appeals taken pursuant to this
463.6subdivision. MNsure shall furnish all parties to the proceedings with a copy of the decision
463.7and a transcript of any testimony, evidence, or other supporting papers from the hearing
463.8held before the appeals examiner within 45 days after service of the notice of appeal.
463.9(f) Any party aggrieved by the failure of an adverse party to obey an order issued
463.10by MNsure may compel performance according to the order in the manner prescribed in
463.11sections 586.01 to 586.12.
463.12(g) Any party may obtain a hearing at a special term of the district court by serving a
463.13written notice of the time and place of the hearing at least ten days prior to the date of
463.14the hearing. The court may consider the matter in or out of chambers, and shall take no
463.15new or additional evidence unless it determines that such evidence is necessary for a
463.16more equitable disposition of the appeal.
463.17(h) Any party aggrieved by the order of the district court may appeal the order as in
463.18other civil cases. No costs or disbursements shall be taxed against any party nor shall any
463.19filing fee or bond be required of any party.
463.20(i) If MNsure or district court orders eligibility for qualified health plan coverage
463.21through MNsure, or eligibility for federal advance payment of premium tax credits
463.22or cost-sharing reductions contingent upon full payment of respective premiums, the
463.23premiums must be paid or provided pending appeal to the district court, Court of Appeals,
463.24or Supreme Court. Provision of eligibility by MNsure pending appeal does not render
463.25moot MNsure's position in a court of law.

463.26    Sec. 4. Minnesota Statutes 2014, section 62V.05, subdivision 7, is amended to read:
463.27    Subd. 7. Agreements; consultation. (a) The board shall:
463.28(1) establish and maintain an agreement with the chief information officer of the
463.29Office of MN.IT Services for information technology services that ensures coordination
463.30with public health care programs. The board may establish and maintain agreements
463.31with the chief information officer of the Office of MN.IT Services for other information
463.32technology services, including an agreement that would permit MNsure to administer
463.33eligibility for additional health care and public assistance programs under the authority
463.34of the commissioner of human services;
464.1(2) (1) establish and maintain an agreement with the commissioner of human
464.2services for cost allocation and services regarding eligibility determinations and
464.3enrollment for public health care programs that use a modified adjusted gross income
464.4standard to determine program eligibility. The board may establish and maintain an
464.5agreement with the commissioner of human services for other services;
464.6(3) (2) establish and maintain an agreement with the commissioners of commerce and
464.7health for services regarding enforcement of MNsure certification requirements for health
464.8plans and dental plans offered through MNsure. The board may establish and maintain
464.9agreements with the commissioners of commerce and health for other services; and
464.10(4) (3) establish interagency agreements to transfer funds to other state agencies for
464.11their costs related to implementing and operating MNsure, excluding medical assistance
464.12allocatable costs.
464.13(b) The board shall consult with the commissioners of commerce and health
464.14regarding the operations of MNsure.
464.15(c) The board shall consult with Indian tribes and organizations regarding the
464.16operation of MNsure.
464.17(d) Beginning March 15, 2014 2016, and each March 15 thereafter, the board shall
464.18submit a report to the chairs and ranking minority members of the committees in the
464.19senate and house of representatives with primary jurisdiction over commerce, health, and
464.20human services on all the agreements entered into with the chief information officer of the
464.21Office of MN.IT Services, or the commissioners of human services, health, or commerce
464.22in accordance with this subdivision. The report shall include the agency in which the
464.23agreement is with; the time period of the agreement; the purpose of the agreement; and
464.24a summary of the terms of the agreement. A copy of the agreement must be submitted
464.25to the extent practicable.

464.26    Sec. 5. Minnesota Statutes 2014, section 62V.05, subdivision 8, is amended to read:
464.27    Subd. 8. Rulemaking. (a) If the board's policies, procedures, or other statements are
464.28rules, as defined in section 14.02, subdivision 4, the requirements in either paragraph (b)
464.29or (c) apply, as applicable.
464.30(b) Effective upon enactment until January 1, 2015:
464.31(1) the board shall publish notice of proposed rules in the State Register after
464.32complying with section 14.07, subdivision 2;
464.33(2) interested parties have 21 days to comment on the proposed rules. The board
464.34must consider comments it receives. After the board has considered all comments and
465.1has complied with section 14.07, subdivision 2, the board shall publish notice of the
465.2final rule in the State Register;
465.3(3) if the adopted rules are the same as the proposed rules, the notice shall state that
465.4the rules have been adopted as proposed and shall cite the prior publication. If the adopted
465.5rules differ from the proposed rules, the portions of the adopted rules that differ from the
465.6proposed rules shall be included in the notice of adoption, together with a citation to the
465.7prior State Register that contained the notice of the proposed rules; and
465.8(4) rules published in the State Register before January 1, 2014, take effect upon
465.9publication of the notice. Rules published in the State Register on and after January 1,
465.102014, take effect 30 days after publication of the notice.
465.11(c) Beginning January 1, 2015, The board may adopt rules to implement any
465.12provisions in this chapter using the expedited rulemaking process in section 14.389.
465.13(d) The notice of proposed rules required in paragraph (b) must provide information
465.14as to where the public may obtain a copy of the rules. The board shall post the proposed
465.15rules on the MNsure Web site at the same time the notice is published in the State Register.

465.16    Sec. 6. Minnesota Statutes 2014, section 62V.05, is amended by adding a subdivision
465.17to read:
465.18    Subd. 12. Prohibition on other product lines. MNsure is prohibited from
465.19certifying, selecting, or offering products and policies of coverage that do not meet the
465.20definition of health plan or dental plan as provided in section 62V.02.

465.21    Sec. 7. EXPANDED ACCESS TO THE SMALL BUSINESS HEALTH CARE
465.22TAX CREDIT.
465.23(a) The commissioner of human services, in consultation with the Board of Directors
465.24of MNsure and the MNsure Legislative Oversight Committee, shall develop a proposal
465.25to allow small employers the ability to receive the small business health care tax credit
465.26when the small employer pays the premiums on behalf of employees enrolled in either a
465.27qualified health plan offered through a small business health options program (SHOP)
465.28marketplace or a small group health plan offered outside of the SHOP marketplace within
465.29MNsure. To be eligible for the tax credit, the small employer must meet the requirements
465.30under the Affordable Care Act, except that employees may be enrolled in a small group
465.31health plan product offered outside of MNsure.
465.32(b) The commissioner shall seek all federal waivers and approvals necessary to
465.33implement the proposal in paragraph (a). The commissioner shall submit a draft proposal
465.34to the MNsure board and the MNsure Legislative Oversight Committee at least 30 days
466.1before submitting a final proposal to the federal government, and shall notify the board
466.2and Legislative Oversight Committee of any federal decision or action received regarding
466.3the proposal and submitted waiver.
466.4EFFECTIVE DATE.This section is effective the day following final enactment.

466.5    Sec. 8. EXPANDED ACCESS TO QUALIFIED HEALTH PLANS AND
466.6SUBSIDIES.
466.7The commissioner of commerce, in consultation with the Board of Directors of
466.8MNsure and the MNsure Legislative Oversight Committee, shall develop a proposal to
466.9allow individuals to purchase qualified health plans outside of MNsure directly from
466.10health plan companies and to allow eligible individuals to receive advanced premium tax
466.11credits and cost-sharing reductions when purchasing these health plans. The commissioner
466.12shall seek all federal waivers and approvals necessary to implement this proposal.
466.13The commissioner shall submit a draft proposal to the MNsure board and the MNsure
466.14Legislative Oversight Committee at least 30 days before submitting a final proposal to the
466.15federal government and shall notify the board and legislative oversight committee of any
466.16federal decision or action related to the proposal.

466.17    Sec. 9. REPEALER.
466.18Minnesota Statutes 2014, section 62V.11, subdivision 3, is repealed.

466.19ARTICLE 13

466.20HUMAN SERVICES FORECAST ADJUSTMENTS

466.21

Section 1. DEPARTMENT OF HUMAN SERVICES FORECAST ADJUSTMENT.

466.22The dollar amounts shown are added to or, if shown in parentheses, are subtracted
466.23from the appropriations in Laws 2013, chapter 108, article 14, as amended by Laws 2014,
466.24chapter 312, article 30, from the general fund, or any other fund named, to the Department
466.25of Human Services for the purposes specified in this article, to be available for the fiscal
466.26years indicated for each purpose. The figure "2015" used in this article means that the
466.27appropriations listed are available for the fiscal year ending June 30, 2015.

466.28				APPROPRIATIONS
466.29				Available for the Year
466.30				Ending June 30
466.31					2015

466.32 466.33

Sec. 2. COMMISSIONER OF HUMAN SERVICES

467.1

Subdivision 1.Total Appropriation

$

(255,104,000)

467.2	Appropriations by Fund
467.3		2015
467.4	General Fund	(125,910,000)
467.5	Health Care Access	(123,113,000)
467.6	TANF	(6,081,000)

467.7	Subd. 2.Forecasted Programs
467.8	(a) MFIP/DWP Grants

467.9	Appropriations by Fund
467.10	General Fund	(1,977,000)
467.11	TANF	(7,079,000)

467.12

(b) MFIP Child Care Assistance Grants

9,733,000

467.13

(c) General Assistance Grants

(1,423,000)

467.14

(d) Minnesota Supplemental Aid Grants

(1,121,000)

467.15

(e) Group Residential Housing Grants

(6,314,000)

467.16

(f) MinnesotaCare Grants

(75,675,000)

467.17This appropriation is from the health care
467.18access fund.

467.19

(g) Medical Assistance Grants

467.20	Appropriations by Fund
467.21	General Fund	(124,557,000)
467.22	Health Care Access	(47,438,000)

467.23

(h) Alternative Care Grants

0

467.24

(i) CD Entitlement Grants

(251,000)

467.25

Subd. 3.Technical Activities

998,000

467.26This appropriation is from the TANF fund.

467.27    Sec. 3. EFFECTIVE DATE.
467.28Sections 1 and 2 are effective the day following final enactment.

467.29ARTICLE 14

467.30HEALTH AND HUMAN SERVICES APPROPRIATIONS

467.31

Section 1. HEALTH AND HUMAN SERVICES APPROPRIATIONS.

468.1The sums shown in the columns marked "Appropriations" are appropriated to the
468.2agencies and for the purposes specified in this article. The appropriations are from the
468.3general fund, or another named fund, and are available for the fiscal years indicated
468.4for each purpose. The figures "2016" and "2017" used in this article mean that the
468.5appropriations listed under them are available for the fiscal year ending June 30, 2016, or
468.6June 30, 2017, respectively. "The first year" is fiscal year 2016. "The second year" is fiscal
468.7year 2017. "The biennium" is fiscal years 2016 and 2017.

468.8				APPROPRIATIONS
468.9				Available for the Year
468.10				Ending June 30
468.11					2016		2017

468.12 468.13

Sec. 2. COMMISSIONER OF HUMAN SERVICES

468.14

Subdivision 1.Total Appropriation

$

7,236,563,000

$

7,443,496,000

468.15	Appropriations by Fund
468.16		2016	2017
468.17	General	5,903,939,000	6,448,469,000
468.18 468.19	State Government Special Revenue	4,514,000	4,274,000
468.20	Health Care Access	1,059,147,000	725,326,000
468.21	Federal TANF	267,070,000	263,531,000
468.22	Lottery Prize	1,893,000	1,896,000

468.23Receipts for Systems Projects.
468.24Appropriations and federal receipts for
468.25information systems projects for MAXIS,
468.26PRISM, MMIS, ISDS, and SSIS must
468.27be deposited in the state systems account
468.28authorized in Minnesota Statutes, section
468.29256.014. Money appropriated for computer
468.30projects approved by the commissioner
468.31of the Office of MN.IT Services, funded
468.32by the legislature, and approved by the
468.33commissioner of management and budget
468.34may be transferred from one project to
468.35another and from development to operations
468.36as the commissioner of human services
468.37considers necessary. Any unexpended
469.1balance in the appropriation for these
469.2projects does not cancel but is available for
469.3ongoing development and operations.
469.4TANF Maintenance of Effort. (a) In order
469.5to meet the basic maintenance of effort
469.6(MOE) requirements of the TANF block grant
469.7specified under Code of Federal Regulations,
469.8title 45, section 263.1, the commissioner may
469.9only report nonfederal money expended for
469.10allowable activities listed in the following
469.11clauses as TANF/MOE expenditures:
469.12(1) MFIP cash, diversionary work program,
469.13and food assistance benefits under Minnesota
469.14Statutes, chapter 256J;
469.15(2) the child care assistance programs
469.16under Minnesota Statutes, sections 119B.03
469.17and 119B.05, and county child care
469.18administrative costs under Minnesota
469.19Statutes, section 119B.15;
469.20(3) state and county MFIP administrative
469.21costs under Minnesota Statutes, chapters
469.22256J and 256K;
469.23(4) state, county, and tribal MFIP
469.24employment services under Minnesota
469.25Statutes, chapters 256J and 256K;
469.26(5) expenditures made on behalf of legal
469.27noncitizen MFIP recipients who qualify for
469.28the MinnesotaCare program under Minnesota
469.29Statutes, chapter 256L;
469.30(6) qualifying working family credit
469.31expenditures under Minnesota Statutes,
469.32section 290.0671; and
470.1(7) qualifying Minnesota education credit
470.2expenditures under Minnesota Statutes,
470.3section 290.0674.
470.4(b) The commissioner shall ensure that
470.5sufficient qualified nonfederal expenditures
470.6are made each year to meet the state's
470.7TANF/MOE requirements. For the activities
470.8listed in paragraph (a), clauses (2) to
470.9(7), the commissioner may only report
470.10expenditures that are excluded from the
470.11definition of assistance under Code of
470.12Federal Regulations, title 45, section 260.31.
470.13(c) For fiscal years beginning with state fiscal
470.14year 2003, the commissioner shall ensure
470.15that the maintenance of effort used by the
470.16commissioner of management and budget
470.17for the February and November forecasts
470.18required under Minnesota Statutes, section
470.1916A.103, contains expenditures under
470.20paragraph (a), clause (1), equal to at least 16
470.21percent of the total required under Code of
470.22Federal Regulations, title 45, section 263.1.
470.23(d) The requirement in Minnesota Statutes,
470.24section 256.011, subdivision 3, that federal
470.25grants or aids secured or obtained under that
470.26subdivision be used to reduce any direct
470.27appropriations provided by law, does not
470.28apply if the grants or aids are federal TANF
470.29funds.
470.30(e) For the federal fiscal years beginning on
470.31or after October 1, 2007, the commissioner
470.32may not claim an amount of TANF/MOE in
470.33excess of the 75 percent standard in Code
470.34of Federal Regulations, title 45, section
470.35263.1(a)(2), except:
471.1(1) to the extent necessary to meet the 80
471.2percent standard under Code of Federal
471.3Regulations, title 45, section 263.1(a)(1),
471.4if it is determined by the commissioner
471.5that the state will not meet the TANF work
471.6participation target rate for the current year;
471.7(2) to provide any additional amounts
471.8under Code of Federal Regulations, title 45,
471.9section 264.5, that relate to replacement of
471.10TANF funds due to the operation of TANF
471.11penalties; and
471.12(3) to provide any additional amounts that
471.13may contribute to avoiding or reducing
471.14TANF work participation penalties through
471.15the operation of the excess MOE provisions
471.16of Code of Federal Regulations, title 45,
471.17section 261.43(a)(2).
471.18(f) For the purposes of paragraph (e), clauses
471.19(1) to (3), the commissioner may supplement
471.20the MOE claim with working family credit
471.21expenditures or other qualified expenditures
471.22to the extent such expenditures are otherwise
471.23available after considering the expenditures
471.24allowed in this subdivision and subdivision 2.
471.25(g) Notwithstanding any contrary provision
471.26in this article, paragraphs (a) to (f) expire
471.27June 30, 2019.
471.28Working Family Credit Expenditure
471.29as TANF/MOE. The commissioner may
471.30claim as TANF maintenance of effort up to
471.31$6,707,000 per year of working family credit
471.32expenditures in each fiscal year.

471.33 471.34

Subd. 2.Working Family Credit to be Claimed for TANF/MOE

472.1The commissioner may count the following
472.2additional amounts of working family credit
472.3expenditures as TANF maintenance of effort:
472.4(1) fiscal year 2016, $0;
472.5(2) fiscal year 2017, $1,283,000;
472.6(3) fiscal year 2018, $0; and
472.7(4) fiscal year 2019, $0.
472.8Notwithstanding any contrary provision in
472.9this article, this subdivision expires June 30,
472.102019.

472.11

Subd. 3.Central Office

472.12The amounts that may be spent from this
472.13appropriation for each purpose are as follows:

472.14

(a) Operations

472.15	Appropriations by Fund
472.16	General	115,577,000	113,733,000
472.17 472.18	State Government Special Revenue	4,389,000	4,149,000
472.19	Health Care Access	9,793,000	10,076,000
472.20	Federal TANF	100,000	100,000

472.21Administrative Recovery; Set-Aside. The
472.22commissioner may invoice local entities
472.23through the SWIFT accounting system as an
472.24alternative means to recover the actual cost
472.25of administering the following provisions:
472.26(1) Minnesota Statutes, section 125A.744,
472.27subdivision 3;
472.28(2) Minnesota Statutes, section 245.495,
472.29paragraph (b);
472.30(3) Minnesota Statutes, section 256B.0625,
472.31subdivision 20, paragraph (k);
472.32(4) Minnesota Statutes, section 256B.0924,
472.33subdivision 6, paragraph (g);
473.1(5) Minnesota Statutes, section 256B.0945,
473.2subdivision 4, paragraph (d); and
473.3(6) Minnesota Statutes, section 256F.10,
473.4subdivision 6, paragraph (b).
473.5IT Appropriations Generally. This
473.6appropriation includes funds for information
473.7technology projects, services, and support.
473.8Notwithstanding Minnesota Statutes,
473.9section 16E.0466, funding for information
473.10technology project costs shall be incorporated
473.11into the service level agreement and paid
473.12to the Office of MN.IT Services by the
473.13Department of Human Services under
473.14the rates and mechanism specified in that
473.15agreement.
473.16Periodic Data Matching for Medical
473.17Assistance and MinnesotaCare. $1,598,000
473.18in fiscal year 2016 and $2,017,000 in fiscal
473.19year 2017 from the general fund are for
473.20periodic data matching for medical assistance
473.21and MinnesotaCare recipients under
473.22Minnesota Statutes, section 256B.0561, and
473.23related administrative services.
473.24Base Level Adjustment. The general fund
473.25base is increased by $1,240,000 in fiscal
473.26year 2018 and by $1,291,000 in fiscal year
473.272019. The health care access fund base is
473.28decreased by $455,000 in fiscal year 2018
473.29and by $455,000 in fiscal year 2019.

473.30

(b) Children and Families

473.31	Appropriations by Fund
473.32	General	9,974,000	9,829,000
473.33	Federal TANF	2,582,000	2,582,000

474.1Financial Institution Data Match and
474.2Payment of Fees. The commissioner is
474.3authorized to allocate up to $310,000 each
474.4year in fiscal year 2016 and fiscal year
474.52017 from the PRISM special revenue
474.6account to make payments to financial
474.7institutions in exchange for performing
474.8data matches between account information
474.9held by financial institutions and the public
474.10authority's database of child support obligors
474.11as authorized by Minnesota Statutes, section
474.1213B.06, subdivision 7.
474.13Child Support Work Group. $12,000 in
474.14fiscal year 2016 is from the general fund for
474.15facilitation of the duties of the child support
474.16work group.
474.17Base Level Adjustment. The general fund
474.18base is increased by $31,000 in fiscal year
474.192018 and by $31,000 in fiscal year 2019.

474.20

(c) Health Care

474.21	Appropriations by Fund
474.22	General	16,667,000	16,309,000
474.23	Health Care Access	33,185,000	34,007,000

474.24Periodic Data Matching for Medical
474.25Assistance and MinnesotaCare. $116,000
474.26in fiscal year 2017 from the health care
474.27access fund is for periodic data matching
474.28for medical assistance and MinnesotaCare
474.29recipients under Minnesota Statutes, section
474.30256B.0561, and related administrative
474.31services.
474.32Task Force. Of the general fund
474.33appropriation, $770,000 in fiscal year 2016 is
474.34for administrative services and support to the
475.1Task Force on Health Care Financing. This
475.2is a onetime appropriation.
475.3Base Level Adjustment. The general fund
475.4base is decreased by $98,000 in fiscal year
475.52019. The health care access fund base is
475.6increased by $43,000 in fiscal year 2018 and
475.7by $150,000 in fiscal year 2019.

475.8

(d) Continuing Care

475.9	Appropriations by Fund
475.10	General	32,950,000	29,924,000
475.11 475.12	State Government Special Revenue	125,000	125,000

475.13Training of Direct Support Services
475.14Providers. $250,000 in fiscal year 2017 is
475.15for training of individual providers of direct
475.16support services as defined in Minnesota
475.17Statutes, section 256B.0711, subdivision
475.181. This appropriation is only available
475.19if the labor agreement between the state
475.20of Minnesota and the Service Employees
475.21International Union Healthcare Minnesota
475.22under Minnesota Statutes, section 179A.54,
475.23is approved under Minnesota Statutes,
475.24sections 3.855 and 179A.22.
475.25Deaf and Hard-of-Hearing Services
475.26Division. $650,000 in fiscal year 2016
475.27and $500,000 in fiscal year 2017 are
475.28from the general fund for the Deaf and
475.29Hard-of-Hearing Services Division under
475.30Minnesota Statutes, section 256C.233. This
475.31is a onetime appropriation. The funds must
475.32be used:
475.33(1) to provide linguistically and culturally
475.34appropriate mental health services;
476.1(2) to ensure that each regional advisory
476.2committee meets at least quarterly;
476.3(3) to increase the number of deafblind
476.4Minnesotans receiving services;
476.5(4) to conduct an analysis of how the regional
476.6offices and staff are operated, in consultation
476.7with the Commission of Deaf, DeafBlind,
476.8and Hard of Hearing Minnesotans;
476.9(5) during fiscal year 2016, to provide direct
476.10services to clients and purchase additional
476.11technology for the technology labs; and
476.12(6) to conduct an analysis of whether
476.13deafblind services are being provided in the
476.14best and most efficient way possible, with
476.15input from deafblind Minnesotans receiving
476.16services.
476.17Nursing Facilities. $890,000 in fiscal year
476.182016 is from the general fund for the nursing
476.19facility property rate setting appraisals and
476.20study. This is a onetime appropriation.
476.21Base Level Adjustment. The general fund
476.22base is decreased by $174,000 in fiscal year
476.232018 and by $234,000 in fiscal year 2019.

476.24

(e) Chemical and Mental Health

476.25	Appropriations by Fund
476.26	General	7,058,000	7,240,000
476.27	Lottery Prize	160,000	163,000

476.28Base Level Adjustment. The general fund
476.29base is decreased by $301,000 in fiscal year
476.302018 and is decreased by $354,000 in fiscal
476.31year 2019.

476.32

Subd. 4.Forecasted Programs

477.1The amounts that may be spent from this
477.2appropriation for each purpose are as follows:

477.3

(a) MFIP/DWP

477.4	Appropriations by Fund
477.5	General	93,620,000	98,452,000
477.6	Federal TANF	85,266,000	80,971,000

477.7

(b) MFIP Child Care Assistance

101,315,000

108,521,000

477.8

(c) General Assistance

55,117,000

57,847,000

477.9General Assistance Standard. The
477.10commissioner shall set the monthly standard
477.11of assistance for general assistance units
477.12consisting of an adult recipient who is
477.13childless and unmarried or living apart
477.14from parents or a legal guardian at $203.
477.15The commissioner may reduce this amount
477.16according to Laws 1997, chapter 85, article
477.173, section 54.
477.18Emergency General Assistance. The
477.19amount appropriated for emergency
477.20general assistance is limited to no more
477.21than $6,729,812 in fiscal year 2016 and
477.22$6,729,812 in fiscal year 2017. Funds
477.23to counties shall be allocated by the
477.24commissioner using the allocation method
477.25under Minnesota Statutes, section 256D.06.

477.26

(d) Minnesota Supplemental Aid

39,668,000

41,169,000

477.27

(e) Group Residential Housing

155,753,000

167,194,000

477.28

(f) Northstar Care for Children

41,096,000

46,337,000

477.29

(g) MinnesotaCare

361,114,000

387,081,000

477.30This appropriation is from the health care
477.31access fund.

477.32

(h) Medical Assistance

478.1	Appropriations by Fund
478.2	General	4,468,089,000	4,977,237,000
478.3	Health Care Access	650,139,000	288,224,000

478.4Behavioral Health Services. $1,000,000
478.5each fiscal year is for behavioral health
478.6services provided by hospitals identified
478.7under Minnesota Statutes, section 256.969,
478.8subdivision 2b, paragraph (a), clause (4).
478.9The increase in payments shall be made by
478.10increasing the adjustment under Minnesota
478.11Statutes, section 256.969, subdivision 2b,
478.12paragraph (e), clause (2).
478.13Base Adjustment. The health care access
478.14fund base for medical assistance is decreased
478.15by $30,917,000 in fiscal year 2018 and by
478.16$16,108,000 in fiscal year 2019.

478.17

(i) Alternative Care

43,997,000

43,590,000

478.18Alternative Care Transfer. Any money
478.19allocated to the alternative care program that
478.20is not spent for the purposes indicated does
478.21not cancel but must be transferred to the
478.22medical assistance account.

478.23

(j) Chemical Dependency Treatment Fund

83,868,000

86,962,000

478.24

Subd. 5.Grant Programs

478.25The amounts that may be spent from this
478.26appropriation for each purpose are as follows:

478.27

(a) Support Services Grants

478.28	Appropriations by Fund
478.29	General	13,133,000	8,715,000
478.30	Federal TANF	96,311,000	96,311,000

478.31 478.32

(b) Basic Sliding Fee Child Care Assistance Grants

48,439,000

51,559,000

479.1Basic Sliding Fee Waiting List Allocation.
479.2Notwithstanding Minnesota Statutes, section
479.3119B.03, $5,413,000 in fiscal year 2016 is to
479.4reduce the basic sliding fee program waiting
479.5list as follows:
479.6(1) The calendar year 2016 allocation shall
479.7be increased to serve families on the waiting
479.8list. To receive funds appropriated for this
479.9purpose, a county must have:
479.10(i) a waiting list in the most recent published
479.11waiting list month;
479.12(ii) an average of at least ten families on the
479.13most recent six months of published waiting
479.14list; and
479.15(iii) total expenditures in calendar year
479.162014 that met or exceeded 80 percent of the
479.17county's available final allocation.
479.18(2) Funds shall be distributed proportionately
479.19based on the average of the most recent six
479.20months of published waiting lists to counties
479.21that meet the criteria in clause (1).
479.22(3) Allocations in calendar years 2017
479.23and beyond shall be calculated using the
479.24allocation formula in Minnesota Statutes,
479.25section 119B.03.
479.26(4) The guaranteed floor for calendar year
479.272017 shall be based on the revised calendar
479.28year 2016 allocation.
479.29Base Level Adjustment. The general fund
479.30base is increased by $810,000 in fiscal year
479.312018 and increased by $821,000 in fiscal
479.32year 2019.

479.33

(c) Child Care Development Grants

1,737,000

1,737,000

480.1

(d) Child Support Enforcement Grants

50,000

50,000

480.2

(e) Children's Services Grants

480.3	Appropriations by Fund
480.4	General	39,015,000	38,665,000
480.5	Federal TANF	140,000	140,000

480.6Safe Place for Newborns. $350,000 from
480.7the general fund in fiscal year 2016 is to
480.8distribute information on the Safe Place
480.9for Newborns law in Minnesota to increase
480.10public awareness of the law. This is a
480.11onetime appropriation.
480.12Child Protection. $23,350,000 in fiscal year
480.132016 and $23,350,000 in fiscal year 2017
480.14are to address child protection staffing and
480.15services under Minnesota Statutes, section
480.16256M.41. $1,650,000 in fiscal year 2016 and
480.17$1,650,000 in fiscal year 2017 are for child
480.18protection grants to address child welfare
480.19disparities under Minnesota Statutes, section
480.20256E.28.
480.21Title IV-E Adoption Assistance. Additional
480.22federal reimbursement to the state as a result
480.23of the Fostering Connections to Success
480.24and Increasing Adoptions Act's expanded
480.25eligibility for title IV-E adoption assistance
480.26is appropriated to the commissioner
480.27for postadoption services, including a
480.28parent-to-parent support network.
480.29Adoption Assistance Incentive Grants.
480.30Federal funds available during fiscal years
480.312016 and 2017 for adoption incentive
480.32grants are appropriated to the commissioner
480.33for postadoption services, including a
480.34parent-to-parent support network.

481.1

(f) Children and Community Service Grants

56,301,000

56,301,000

481.2

(g) Children and Economic Support Grants

26,778,000

26,966,000

481.3Mobile Food Shelf Grants. (a) $1,000,000
481.4in fiscal year 2016 and $1,000,000 in
481.5fiscal year 2017 are for a grant to Hunger
481.6Solutions. This is a onetime appropriation
481.7and is available until June 30, 2017.
481.8(b) Hunger Solutions shall award grants of
481.9up to $75,000 on a competitive basis. Grant
481.10applications must include:
481.11(1) the location of the project;
481.12(2) a description of the mobile program,
481.13including size and scope;
481.14(3) evidence regarding the unserved or
481.15underserved nature of the community in
481.16which the project is to be located;
481.17(4) evidence of community support for the
481.18project;
481.19(5) the total cost of the project;
481.20(6) the amount of the grant request and how
481.21funds will be used;
481.22(7) sources of funding or in-kind
481.23contributions for the project that will
481.24supplement any grant award;
481.25(8) a commitment to mobile programs by the
481.26applicant and an ongoing commitment to
481.27maintain the mobile program; and
481.28(9) any additional information requested by
481.29Hunger Solutions.
481.30(c) Priority may be given to applicants who:
481.31(1) serve underserved areas;
482.1(2) create a new or expand an existing mobile
482.2program;
482.3(3) serve areas where a high amount of need
482.4is identified;
482.5(4) provide evidence of strong support for the
482.6project from citizens and other institutions in
482.7the community;
482.8(5) leverage funding for the project from
482.9other private and public sources; and
482.10(6) commit to maintaining the program on a
482.11multilayer basis.
482.12Homeless Youth Act. Of this appropriation,
482.13at least $500,000 must be awarded to
482.14providers in greater Minnesota, with at least
482.1525 percent of this amount for new applicant
482.16providers. The commissioner shall provide
482.17outreach and technical assistance to greater
482.18Minnesota providers and new providers to
482.19encourage responding to the request for
482.20proposals.
482.21Stearns County Veterans Housing.
482.22$85,000 in fiscal year 2016 and $85,000
482.23in fiscal year 2017 are for a grant to
482.24Stearns County to provide administrative
482.25funding in support of a service provider
482.26serving veterans in Stearns County. The
482.27administrative funding grant may be used to
482.28support group residential housing services,
482.29corrections-related services, veteran services,
482.30and other social services related to the service
482.31provider serving veterans in Stearns County.
482.32Safe Harbor. $800,000 in fiscal year 2016
482.33and $800,000 in fiscal year 2017 are from
482.34the general fund for emergency shelter and
483.1transitional and long-term housing beds for
483.2sexually exploited youth and youth at risk of
483.3sexual exploitation. Of this appropriation,
483.4$150,000 in fiscal year 2016 and $150,000 in
483.5fiscal year 2017 are from the general fund for
483.6statewide youth outreach workers connecting
483.7sexually exploited youth and youth at risk of
483.8sexual exploitation with shelter and services.
483.9Minnesota Food Assistance Program.
483.10Unexpended funds for the Minnesota food
483.11assistance program for fiscal year 2016 do
483.12not cancel but are available for this purpose
483.13in fiscal year 2017.
483.14Base Level Adjustment. The general fund
483.15base is decreased by $816,000 in fiscal year
483.162018 and is decreased by $606,000 in fiscal
483.17year 2019.

483.18

(h) Health Care Grants

483.19	Appropriations by Fund
483.20	General	536,000	2,482,000
483.21	Health Care Access	3,341,000	3,465,000

483.22Grants for Periodic Data Matching for
483.23Medical Assistance and MinnesotaCare.
483.24Of the general fund appropriation, $26,000
483.25in fiscal year 2016 and $1,276,000 in fiscal
483.26year 2017 are for grants to counties for
483.27costs related to periodic data matching
483.28for medical assistance and MinnesotaCare
483.29recipients under Minnesota Statutes,
483.30section 256B.0561. The commissioner
483.31must distribute these grants to counties in
483.32proportion to each county's number of cases
483.33in the prior year in the affected programs.
483.34Base Level Adjustment. The general fund
483.35base is increased by $1,637,000 in fiscal year
484.12018 and increased by $1,229,000 in fiscal
484.2year 2019.

484.3

(i) Other Long-Term Care Grants

1,551,000

3,069,000

484.4Transition Populations. $1,551,000 in fiscal
484.5year 2016 and $1,725,000 in fiscal year 2017
484.6are for home and community-based services
484.7transition grants to assist in providing home
484.8and community-based services and treatment
484.9for transition populations under Minnesota
484.10Statutes, section 256.478.
484.11Base Level Adjustment. The general fund
484.12base is increased by $156,000 in fiscal year
484.132018 and by $581,000 in fiscal year 2019.

484.14

(j) Aging and Adult Services Grants

28,463,000

28,162,000

484.15Dementia Grants. $750,000 in fiscal year
484.162016 and $750,000 in fiscal year 2017
484.17are for the Minnesota Board on Aging for
484.18regional and local dementia grants authorized
484.19in Minnesota Statutes, section 256.975,
484.20subdivision 11.

484.21

(k) Deaf and Hard-of-Hearing Grants

2,225,000

2,375,000

484.22Deaf, Deafblind, and Hard-of-Hearing
484.23Grants. $350,000 in fiscal year 2016 and
484.24$500,000 in fiscal year 2017 are for deaf
484.25and hard-of-hearing grants. The funds
484.26must be used to increase the number of
484.27deafblind Minnesotans receiving services
484.28under Minnesota Statutes, section 256C.261,
484.29and to provide linguistically and culturally
484.30appropriate mental health services to children
484.31who are deaf, deafblind, and hard-of-hearing.
484.32This is a onetime appropriation.
485.1Base Level Adjustment. The general fund
485.2base is decreased by $500,000 in fiscal year
485.32018 and by $500,000 in fiscal year 2019.

485.4

(l) Disabilities Grants

20,820,000

20,858,000

485.5State Quality Council. $573,000 in fiscal
485.6year 2016 and $600,000 in fiscal year
485.72017 are for the State Quality Council to
485.8provide technical assistance and monitoring
485.9of person-centered outcomes related to
485.10inclusive community living and employment.
485.11The funding must be used by the State
485.12Quality Council to assure a statewide plan
485.13for systems change in person-centered
485.14planning that will achieve desired outcomes
485.15including increased integrated employment
485.16and community living.

485.17

(m) Adult Mental Health Grants

485.18	Appropriations by Fund
485.19	General	69,992,000	71,244,000
485.20	Health Care Access	1,575,000	2,473,000
485.21	Lottery Prize	1,733,000	1,733,000

485.22Funding Usage. Up to 75 percent of a fiscal
485.23year's appropriation for adult mental health
485.24grants may be used to fund allocations in that
485.25portion of the fiscal year ending December
485.2631.
485.27Culturally Specific Mental Health
485.28Services. $100,000 in fiscal year 2016 is for
485.29grants to nonprofit organizations to provide
485.30resources and referrals for culturally specific
485.31mental health services to Southeast Asian
485.32veterans born before 1965 who do not qualify
485.33for services available to veterans formally
485.34discharged from the United States armed
485.35forces.
486.1Problem Gambling. $225,000 in fiscal year
486.22016 and $225,000 in fiscal year 2017 are
486.3from the lottery prize fund for a grant to the
486.4state affiliate recognized by the National
486.5Council on Problem Gambling. The affiliate
486.6must provide services to increase public
486.7awareness of problem gambling, education,
486.8and training for individuals and organizations
486.9providing effective treatment services to
486.10problem gamblers and their families, and
486.11research related to problem gambling.
486.12Sustainability Grants. $2,125,000 in fiscal
486.13year 2016 and $2,125,000 in fiscal year 2017
486.14are for sustainability grants under Minnesota
486.15Statutes, section 256B.0622, subdivision 11.
486.16Beltrami County Mental Health Services
486.17Grant. $1,000,000 in fiscal year 2016 and
486.18$1,000,000 in fiscal year 2017 are from the
486.19general fund for a grant to Beltrami County
486.20to fund the planning and development of
486.21a comprehensive mental health services
486.22program under article 2, section 41,
486.23Comprehensive Mental Health Program
486.24in Beltrami County. This is a onetime
486.25appropriation.
486.26Base Level Adjustment. The general fund
486.27base is increased by $723,000 in fiscal year
486.282018 and by $723,000 in fiscal year 2019.
486.29The health care access fund base is decreased
486.30by $1,723,000 in fiscal year 2018 and by
486.31$1,723,000 in fiscal year 2019.

486.32

(n) Child Mental Health Grants

23,386,000

24,313,000

486.33Services and Supports for First Episode
486.34Psychosis. $177,000 in fiscal year 2017 is
486.35for grants under Minnesota Statutes, section
487.1245.4889, to mental health providers to pilot
487.2evidence-based interventions for youth at risk
487.3of developing or experiencing a first episode
487.4of psychosis and for a public awareness
487.5campaign on the signs and symptoms of
487.6psychosis. The base for these grants is
487.7$236,000 in fiscal year 2018 and $301,000 in
487.8fiscal year 2019.
487.9Adverse Childhood Experiences. The base
487.10for grants under Minnesota Statutes, section
487.11245.4889, to children's mental health and
487.12family services collaboratives for adverse
487.13childhood experiences (ACEs) training
487.14grants and for an interactive Web site
487.15connection to support ACEs in Minnesota is
487.16$363,000 in fiscal year 2018 and $363,000 in
487.17fiscal year 2019.
487.18Funding Usage. Up to 75 percent of a fiscal
487.19year's appropriation for child mental health
487.20grants may be used to fund allocations in that
487.21portion of the fiscal year ending December
487.2231.
487.23Base Level Adjustment. The general fund
487.24base is increased by $422,000 in fiscal year
487.252018 and is increased by $487,000 in fiscal
487.26year 2019.

487.27 487.28

(o) Chemical Dependency Treatment Support Grants

1,561,000

1,561,000

487.29Chemical Dependency Prevention.
487.30$150,000 in fiscal year 2016 and $150,000
487.31in fiscal year 2017 are for grants to
487.32nonprofit organizations to provide chemical
487.33dependency prevention programs in
487.34secondary schools. When making grants, the
487.35commissioner must consider the expertise,
488.1prior experience, and outcomes achieved
488.2by applicants that have provided prevention
488.3programming in secondary education
488.4environments. An applicant for the grant
488.5funds must provide verification to the
488.6commissioner that the applicant has available
488.7and will contribute sufficient funds to match
488.8the grant given by the commissioner. This is
488.9a onetime appropriation.
488.10Fetal Alcohol Syndrome Grants. $250,000
488.11in fiscal year 2016 and $250,000 in fiscal year
488.122017 are for grants to be administered by the
488.13Minnesota Organization on Fetal Alcohol
488.14Syndrome to provide comprehensive,
488.15gender-specific services to pregnant and
488.16parenting women suspected of or known
488.17to use or abuse alcohol or other drugs.
488.18This appropriation is for grants to no fewer
488.19than three eligible recipients. Minnesota
488.20Organization on Fetal Alcohol Syndrome
488.21must report to the commissioner of human
488.22services annually by January 15 on the
488.23grants funded by this appropriation. The
488.24report must include measurable outcomes for
488.25the previous year, including the number of
488.26pregnant women served and the number of
488.27toxic-free babies born.
488.28Base Level Adjustment. The general fund
488.29base is decreased by $150,000 in fiscal year
488.302018 and by $150,000 in fiscal year 2019.

488.31

Subd. 6.DCT State-Operated Services

488.32Transfer Authority for State-Operated
488.33Services. Money appropriated for
488.34state-operated services may be transferred
488.35between fiscal years of the biennium
489.1with the approval of the commissioner of
489.2management and budget.
489.3The amounts that may be spent from the
489.4appropriation for each purpose are as follows:

489.5 489.6

(a) DCT State-Operated Services Mental Health

130,070,000

131,795,000

489.7Increased Capacity at AMRTC. $4,108,000
489.8in fiscal year 2016 and $4,108,000 in fiscal
489.9year 2017 are to increase the number
489.10of staffed beds at the Anoka Regional
489.11Treatment Center so that 15 additional beds
489.12are available for patients above the number
489.13of beds that are available on June 30, 2015.
489.14Transfer. Notwithstanding Minnesota
489.15Statutes, section 246.18, subdivision 8,
489.16the commissioner of human services shall
489.17transfer $2,000,000 in fiscal year 2017 from
489.18the account under Minnesota Statutes, section
489.19246.18, subdivision 8, in the special revenue
489.20fund to the general fund. This is a onetime
489.21transfer for repeal of never implemented
489.22grants for mental health specialty treatment
489.23services.
489.24Dedicated Receipts Available. Of the
489.25revenue received under Minnesota Statutes,
489.26section 246.18, subdivision 8, paragraph
489.27(a), up to $1,000,000 each year is available
489.28for the purposes of Minnesota Statutes,
489.29section 246.18, subdivision 8, paragraph (b),
489.30clause (1); and up to $2,713,000 each year
489.31is available for the purposes of Minnesota
489.32Statutes, section 246.18, subdivision 8,
489.33paragraph (b), clause (3).
489.34Transfers from State-Operated Services
489.35Account. (a) If the commissioner of
490.1human services notifies the commissioner
490.2of management and budget by July 31,
490.32015, that the fiscal year 2015 general
490.4fund expenditures exceed the general fund
490.5appropriation for state-operated services
490.6mental health to the Department of Human
490.7Services, notwithstanding Minnesota
490.8Statutes, section 246.18, subdivision 8,
490.9the commissioner of human services,
490.10with the approval of the commissioner of
490.11management and budget, shall transfer up
490.12to $1,000,000 in fiscal year 2015 from the
490.13account under Minnesota Statutes, section
490.14246.18, subdivision 8, in the special revenue
490.15fund to the general fund. The amount
490.16transferred under this paragraph must
490.17not exceed the amount of the fiscal year
490.182015 negative balance in the general fund
490.19appropriation for state-operated services
490.20mental health to the Department of Human
490.21Services. The amount transferred under
490.22this paragraph, up to $1,000,000 in fiscal
490.23year 2015, is appropriated from the general
490.24fund to the commissioner of human services
490.25for state-operated services mental health
490.26expenditures. This paragraph is effective the
490.27day following final enactment and expires
490.28on October 1, 2015. Any amount transferred
490.29under this paragraph that is not expended
490.30by September 30, 2015, shall cancel to
490.31the account from which the amount was
490.32transferred.
490.33(b) If the commissioner of human services
490.34notifies the commissioner of management
490.35and budget by July 31, 2015, that the
490.36balance in fiscal year 2015 in the Minnesota
491.1state-operated community services fund is a
491.2negative amount, notwithstanding Minnesota
491.3Statutes, section 246.18, subdivision 8, the
491.4commissioner of human services, with the
491.5approval of the commissioner of management
491.6and budget, shall transfer up to $3,200,000
491.7in fiscal year 2015 from the account
491.8under Minnesota Statutes, section 246.18,
491.9subdivision 8, in the special revenue fund
491.10to the Minnesota state-operated community
491.11services fund. The amount transferred under
491.12this paragraph must not exceed the amount
491.13of the fiscal year 2015 negative balance in
491.14the Minnesota state-operated community
491.15services fund. This paragraph is effective the
491.16day following final enactment and expires
491.17on October 1, 2015. Any amount transferred
491.18under this paragraph that is not expended
491.19by September 30, 2015, shall cancel to
491.20the account from which the amount was
491.21transferred.
491.22Appropriations Retroactive to Fiscal Year
491.232015. If the commissioner of human services
491.24notifies the commissioner of management and
491.25budget by July 31, 2015, that the fiscal year
491.262015 general fund expenditures exceed the
491.27general fund appropriation for state-operated
491.28services mental health to the Department of
491.29Human Services, up to $5,000,000 of this
491.30appropriation in fiscal year 2016 may be
491.31used in fiscal year 2015 for state-operated
491.32services mental health expenditures. The
491.33commissioner of human services must
491.34report to the commissioner of management
491.35and budget the purpose and amount of any
491.36expenditures under this paragraph, and the
492.1commissioner of management and budget
492.2must approve the total amount attributable to
492.3this paragraph. This paragraph is effective
492.4the day following final enactment and expires
492.5on October 1, 2015.

492.6 492.7

(b) DCT State-Operated Services Enterprise Services

9,626,000

6,113,000

492.8Community Addiction Recovery
492.9Enterprise. $9,626,000 in fiscal year 2016
492.10and $6,113,000 in fiscal year 2017 are for
492.11the C.A.R.E. program. The commissioner
492.12must transfer these amounts to the enterprise
492.13fund for the Community Addiction Recovery
492.14Enterprise. The base for this purpose
492.15is $5,991,000 in fiscal year 2018 and
492.16$5,991,000 in fiscal year 2019.
492.17Transfers from Consolidated Chemical
492.18Dependency Treatment Fund. (a) If the
492.19commissioner of human services notifies the
492.20commissioner of management and budget by
492.21July 31, 2015, that the balance in fiscal year
492.222015 in the community addiction recovery
492.23enterprise fund is a negative amount,
492.24notwithstanding Minnesota Statutes, section
492.25254B.06, subdivision 1, the commissioner
492.26of human services, with the approval of the
492.27commissioner of management and budget,
492.28shall transfer $2,000,000 in fiscal year 2015
492.29from the consolidated chemical dependency
492.30treatment fund account in the special revenue
492.31fund to the community addiction recovery
492.32enterprise fund. The amount transferred
492.33under this paragraph must not exceed the
492.34amount of the fiscal year 2015 negative
492.35balance in the community addiction recovery
492.36enterprise fund. This paragraph is effective
493.1the day following final enactment and expires
493.2on October 1, 2015. Any amount transferred
493.3under this paragraph that is not expended
493.4by September 30, 2015, shall cancel to
493.5the account from which the amount was
493.6transferred.
493.7(b) If the commissioner of human services
493.8notifies the commissioner of management
493.9and budget by July 31, 2015, that the
493.10fiscal year 2015 general fund expenditures
493.11exceed the general fund appropriation
493.12for state-operated services mental health
493.13to the Department of Human Services,
493.14notwithstanding Minnesota Statutes, section
493.15254B.06, subdivision 1, the commissioner
493.16of human services, with the approval of the
493.17commissioner of management and budget,
493.18shall transfer $1,500,000 in fiscal year 2015
493.19from the consolidated chemical dependency
493.20treatment fund account in the special revenue
493.21fund to the general fund. $1,500,000 in
493.22fiscal year 2015 is appropriated from the
493.23general fund to the commissioner of human
493.24services for state-operated services mental
493.25health expenditures. The amount transferred
493.26under this paragraph must not exceed the
493.27amount of the fiscal year 2015 negative
493.28balance in the general fund appropriation
493.29for state-operated services mental health to
493.30the Department of Human Services. This
493.31paragraph is effective the day following final
493.32enactment and expires on October 1, 2015.
493.33Any amount transferred under this paragraph
493.34that is not expended by September 30, 2015,
493.35shall cancel to the account from which the
493.36amount was transferred.
494.1Base Level Adjustment. The general fund
494.2base is decreased by $122,000 in fiscal year
494.32018 and by $122,000 in fiscal year 2019.

494.4 494.5

(c) DCT State-Operated Services Minnesota Security Hospital

81,821,000

83,233,000

494.6Base Level Adjustment. The general fund
494.7base is increased by $17,000 in fiscal year
494.82018 and by $34,000 in fiscal year 2019.

494.9 494.10

Subd. 7.DCT Minnesota Sex Offender Program

83,686,000

84,927,000

494.11Transfer Authority for Minnesota Sex
494.12Offender Program. Money appropriated
494.13for the Minnesota sex offender program
494.14may be transferred between fiscal years
494.15of the biennium with the approval of the
494.16commissioner of management and budget.
494.17Limited Carryforward Allowed.
494.18Notwithstanding any contrary provision
494.19in this article, of this appropriation, up to
494.20$875,000 in fiscal year 2016 and $2,625,000
494.21in fiscal year 2017 are available until June
494.2230, 2019.
494.23Minnesota Sex Offender Program. Any
494.24funds from the appropriation made by Laws
494.252014, chapter 312, article 30, section 2,
494.26subdivision 6, that are not used for payment
494.27of court-ordered costs in compliance with
494.28the United States District Court order of
494.29February 20, 2014, in the matter of Karsjens
494.30et al. v. Jesson et al., including any funds
494.31returned by the court that had been deposited
494.32with the court but not spent, may be used by
494.33the commissioner of human services to offset
494.34past and future litigation expenses in the
495.1same matter and to comply with any future
495.2orders of the United States District Court.

495.3

Subd. 8.Technical Activities

82,671,000

83,427,000

495.4This appropriation is from the federal TANF
495.5fund.
495.6Base Level Adjustment. The TANF fund
495.7appropriation is increased by $392,000 in
495.8fiscal year 2018 and by $80,000 in fiscal year
495.92019.

495.10

Sec. 3. COMMISSIONER OF HEALTH

495.11

Subdivision 1.Total Appropriation

$

188,912,000

$

188,939,000

495.12	Appropriations by Fund
495.13		2016	2017
495.14	General	89,369,000	91,357,000
495.15 495.16	State Government Special Revenue	53,843,000	52,448,000
495.17	Health Care Access	33,987,000	33,421,000
495.18	Federal TANF	11,713,000	11,713,000

495.19The amounts that may be spent for each
495.20purpose are specified in the following
495.21subdivisions.

495.22

Subd. 2.Health Improvement

495.23	Appropriations by Fund
495.24	General	68,653,000	68,984,000
495.25 495.26	State Government Special Revenue	6,264,000	6,182,000
495.27	Health Care Access	33,987,000	33,421,000
495.28	Federal TANF	11,713,000	11,713,000

495.29Violence Against Asian Women Working
495.30Group. $200,000 in fiscal year 2016 from
495.31the general fund is for the working group on
495.32violence against Asian women and children.
495.33MERC Program. $1,000,000 in fiscal year
495.342016 and $1,000,000 in fiscal year 2017 are
495.35from the general fund for the MERC program
496.1under Minnesota Statutes, section 62J.692,
496.2subdivision 4.
496.3Poison Information Center Grants.
496.4$750,000 in fiscal year 2016 and $750,000 in
496.5fiscal year 2017 are from the general fund
496.6for regional poison information center grants
496.7under Minnesota Statutes, section 145.93.
496.8Advanced Care Planning. $250,000 in
496.9fiscal year 2016 is from the general fund
496.10to award a grant to a statewide advance
496.11care planning resource organization that has
496.12expertise in convening and coordinating
496.13community-based strategies to encourage
496.14individuals, families, caregivers, and health
496.15care providers to begin conversations
496.16regarding end-of-life care choices that
496.17express an individual's health care values
496.18and preferences and are based on informed
496.19health care decisions. This is a onetime
496.20appropriation.
496.21Early Dental Prevention Initiatives.
496.22$172,000 in fiscal year 2016 and $140,000 in
496.23fiscal year 2017 are for the development and
496.24distribution of the early dental prevention
496.25initiative under Minnesota Statutes, section
496.26144.3875.
496.27International Medical Graduate
496.28Assistance Program. (a) $500,000 in fiscal
496.29year 2016 and $500,000 in fiscal year 2017
496.30are from the health care access fund for
496.31the grant programs and necessary contracts
496.32under Minnesota Statutes, section 144.1911,
496.33subdivisions 3, paragraph (a), clause (4), and
496.344 and 5. The commissioner may use up to
496.35$133,000 per year of the appropriation for
497.1international medical graduate assistance
497.2program administration duties in Minnesota
497.3Statutes, section 144.1911, subdivisions
497.43, 9, and 10, and for administering the
497.5grant programs under Minnesota Statutes,
497.6section 144.1911, subdivisions 4, 5,
497.7and 6. The commissioner shall develop
497.8recommendations for any additional funding
497.9required for initiatives needed to achieve the
497.10objectives of Minnesota Statutes, section
497.11144.1911. The commissioner shall report the
497.12funding recommendations to the legislature
497.13by January 15, 2016, in the report required
497.14under Minnesota Statutes, section 144.1911,
497.15subdivision 10. The base for this purpose is
497.16$1,000,000 in fiscal years 2018 and 2019.
497.17(b) $500,000 in fiscal year 2016 and
497.18$500,000 in fiscal year 2017 are from the
497.19health care access fund for transfer to the
497.20revolving international medical graduate
497.21residency account established in Minnesota
497.22Statutes, section 144.1911, subdivision 6.
497.23This is a onetime appropriation.
497.24Federally Qualified Health Centers.
497.25$1,000,000 in fiscal year 2016 and
497.26$1,000,000 in fiscal year 2017 are from the
497.27general fund to provide subsidies to federally
497.28qualified health centers under Minnesota
497.29Statutes, section 145.9269. This is a onetime
497.30appropriation.
497.31Organ Donation. $200,000 in fiscal year
497.322016 is from the general fund to establish
497.33a grant program to develop and create
497.34culturally appropriate outreach programs that
497.35provide education about the importance of
498.1organ donation. Grants shall be awarded to
498.2a federally designated organ procurement
498.3organization and hospital system that
498.4performs transplants. This is a onetime
498.5appropriation.
498.6Primary Care Residency. $1,500,000 in
498.7fiscal year 2016 and $1,500,000 in fiscal
498.8year 2017 are from the general fund for
498.9the purposes of the primary care residency
498.10expansion grant program under Minnesota
498.11Statutes, section 144.1506.
498.12Somali Women's Health Pilot Program.
498.13(a) The commissioner of health shall
498.14establish a pilot program between one or
498.15more federally qualified health centers, as
498.16defined under Minnesota Statutes, section
498.17145.9269, a nonprofit organization that
498.18helps Somali women, and the Minnesota
498.19Evaluation Studies Institute, to develop
498.20a promising strategy to address the
498.21preventative and primary health care needs
498.22of, and address health inequities experienced
498.23by, first generation Somali women. The
498.24pilot program must collaboratively develop
498.25a patient flow process for first generation
498.26Somali women by:
498.27(1) addressing and identifying clinical and
498.28cultural barriers to Somali women accessing
498.29preventative and primary care, including,
498.30but not limited to, cervical and breast cancer
498.31screenings;
498.32(2) developing a culturally appropriate health
498.33curriculum for Somali women based on
498.34the outcomes from the community-based
498.35participatory research report "Cultural
499.1Traditions and the Reproductive Health
499.2of Somali Refugees and Immigrants" to
499.3increase the health literacy of Somali women
499.4and develop culturally specific health care
499.5information; and
499.6(3) training the federally qualified health
499.7center's providers and staff to enhance
499.8provider and staff cultural competence
499.9regarding the cultural barriers, including
499.10female genital cutting.
499.11(b) The pilot program must develop a process
499.12that results in increased screening rates
499.13for cervical and breast cancer and can be
499.14replicated by other providers serving ethnic
499.15minorities. The pilot program must conduct
499.16an evaluation of the new patient flow process
499.17used by Somali women to access federally
499.18qualified health centers services.
499.19(c) The pilot program must report the
499.20outcomes to the commissioner by June 30,
499.212017.
499.22(d) $110,000 in fiscal year 2016 is for the
499.23Somali women's health pilot program. Of
499.24this appropriation, the commissioner may
499.25use up to $10,000 to administer the program.
499.26This appropriation is available until June 30,
499.272017. This is a onetime appropriation.
499.28Menthol Cigarette Usage in
499.29African-American Community
499.30Intervention Grants. Of the health care
499.31access fund appropriation for the statewide
499.32health improvement program, $200,000 in
499.33fiscal year 2016 is for at least one grant that
499.34must be awarded by the commissioner to
499.35implement strategies and interventions to
500.1reduce the disproportionately high usage of
500.2cigarettes by African-Americans, especially
500.3the use of menthol-flavored cigarettes, as
500.4well as the disproportionate harm tobacco
500.5causes in that community. The grantee shall
500.6engage members of the African-American
500.7community and community-based
500.8organizations. This grant shall be awarded
500.9as part of the statewide health improvement
500.10program grants awarded on November 1,
500.112015, and must meet the requirements of
500.12Minnesota Statutes, section 145.986.
500.13Targeted Home Visiting System. (a)
500.14$75,000 in fiscal year 2016 is for the
500.15commissioner of health, in consultation
500.16with the commissioners of human services
500.17and education, community health boards,
500.18tribal nations, and other home visiting
500.19stakeholders, to design baseline training
500.20for new home visitors to ensure statewide
500.21coordination across home visiting programs.
500.22(b) $575,000 in fiscal year 2016 and
500.23$2,000,000 fiscal year 2017 are to provide
500.24grants to community health boards and
500.25tribal nations for start-up grants for new
500.26nurse-family partnership programs and
500.27for grants to expand existing programs
500.28to serve first-time mothers, prenatally by
500.2928 weeks gestation until the child is two
500.30years of age, who are eligible for medical
500.31assistance under Minnesota Statutes, chapter
500.32256B, or the federal Special Supplemental
500.33Nutrition Program for Women, Infants, and
500.34Children. The commissioner shall award
500.35grants to community health boards or tribal
500.36nations in metropolitan and rural areas of
501.1the state. Priority for all grants shall be
501.2given to nurse-family partnership programs
501.3that provide services through a Minnesota
501.4health care program-enrolled provider that
501.5accepts medical assistance. Additionally,
501.6priority for grants to rural areas shall be
501.7given to community health boards and tribal
501.8nations that expand services within regional
501.9partnerships that provide the nurse-family
501.10partnership program. Funding available
501.11under this paragraph may only be used to
501.12supplement, not to replace, funds being used
501.13for nurse-family partnership home visiting
501.14services as of June 30, 2015.
501.15Opiate Antagonists. $270,000 in fiscal
501.16year 2016 and $20,000 in fiscal year 2017
501.17are from the general fund for grants to the
501.18eight regional emergency medical services
501.19programs to purchase opiate antagonists
501.20and educate and train emergency medical
501.21services persons, as defined in Minnesota
501.22Statutes, section 144.7401, subdivision
501.234, clauses (1) and (2), in the use of these
501.24antagonists in the event of an opioid or
501.25heroin overdose. For the purposes of
501.26this paragraph, "opiate antagonist" means
501.27naloxone hydrochloride or any similarly
501.28acting drug approved by the federal Food
501.29and Drug Administration for the treatment of
501.30drug overdose. Grants under this paragraph
501.31must be distributed to all eight regional
501.32emergency medical services programs. This
501.33is a onetime appropriation and is available
501.34until June 30, 2017. The commissioner may
501.35use up to $20,000 of the amount for opiate
501.36antagonists for administration.
502.1Local and Tribal Public Health Grants. (a)
502.2$894,000 in fiscal year 2016 and $894,000 in
502.3fiscal year 2017 are for an increase in local
502.4public health grants for community health
502.5boards under Minnesota Statutes, section
502.6145A.131, subdivision 1, paragraph (e).
502.7(b) $106,000 in fiscal year 2016 and $106,000
502.8in fiscal year 2017 are for an increase in
502.9special grants to tribal governments under
502.10Minnesota Statutes, section 145A.14,
502.11subdivision 2a.
502.12HCBS Employee Scholarships. $1,000,000
502.13in fiscal year 2016 and $1,000,000 in fiscal
502.14year 2017 are from the general fund for
502.15the home and community-based services
502.16employee scholarship program under
502.17Minnesota Statutes, section 144.1503. The
502.18commissioner may use up to $50,000 of the
502.19amount for the HCBS employee scholarships
502.20for administration.
502.21Family Planning Special Projects.
502.22$1,000,000 in fiscal year 2016 and
502.23$1,000,000 in fiscal year 2017 are from the
502.24general fund for family planning special
502.25project grants under Minnesota Statutes,
502.26section 145.925.
502.27Positive Alternatives. $1,000,000 in fiscal
502.28year 2016 and $1,000,000 in fiscal year
502.292017 are from the general fund for positive
502.30abortion alternatives under Minnesota
502.31Statutes, section 145.4235.
502.32Safe Harbor for Sexually Exploited Youth.
502.33$700,000 in fiscal year 2016 and $700,000 in
502.34fiscal year 2017 are from the general fund
502.35for the safe harbor program under Minnesota
503.1Statutes, sections 145.4716 to 145.4718.
503.2Funds shall be used for grants to increase
503.3the number of regional navigators; training
503.4for professionals who engage with exploited
503.5or at-risk youth; implementing statewide
503.6protocols and best practices for effectively
503.7identifying, interacting with, and referring
503.8sexually exploited youth to appropriate
503.9resources; and program operating costs.
503.10Health Care Grants for Uninsured
503.11Individuals. (a) $125,000 in fiscal year 2016
503.12and $125,000 in fiscal year 2017 are from
503.13the general fund for dental provider grants
503.14in Minnesota Statutes, section 145.929,
503.15subdivision 1 .
503.16(b) $437,500 in fiscal year 2016 and $437,500
503.17in fiscal year 2017 are from the general fund
503.18for community mental health program grants
503.19in Minnesota Statutes, section 145.929,
503.20subdivision 2 .
503.21(c) $1,500,000 in fiscal year 2016 and
503.22$1,500,000 in fiscal year 2017 are from the
503.23general fund for the emergency medical
503.24assistance outlier grant program in Minnesota
503.25Statutes, section 145.929, subdivision 3.
503.26(d) $437,500 of the general fund
503.27appropriation in fiscal years 2016 and 2017
503.28is for community health center grants under
503.29Minnesota Statutes, section 145.9269. A
503.30community health center that receives a grant
503.31from this appropriation is not eligible for a
503.32grant under paragraph (b).
503.33(e) The commissioner may use up to $25,000
503.34of the appropriations for health care grants
504.1for uninsured individuals in fiscal years 2016
504.2and 2017 for grant administration.
504.3TANF Appropriations. (a) $1,156,000 of
504.4the TANF funds is appropriated each year of
504.5the biennium to the commissioner for family
504.6planning grants under Minnesota Statutes,
504.7section 145.925.
504.8(b) $3,579,000 of the TANF funds is
504.9appropriated each year of the biennium to
504.10the commissioner for home visiting and
504.11nutritional services listed under Minnesota
504.12Statutes, section 145.882, subdivision 7,
504.13clauses (6) and (7). Funds must be distributed
504.14to community health boards according to
504.15Minnesota Statutes, section 145A.131,
504.16subdivision 1.
504.17(c) $2,000,000 of the TANF funds is
504.18appropriated each year of the biennium to
504.19the commissioner for decreasing racial and
504.20ethnic disparities in infant mortality rates
504.21under Minnesota Statutes, section 145.928,
504.22subdivision 7.
504.23(d) $4,978,000 of the TANF funds is
504.24appropriated each year of the biennium to the
504.25commissioner for the family home visiting
504.26grant program according to Minnesota
504.27Statutes, section 145A.17. $4,000,000 of the
504.28funding must be distributed to community
504.29health boards according to Minnesota
504.30Statutes, section 145A.131, subdivision 1.
504.31$978,000 of the funding must be distributed to
504.32tribal governments as provided in Minnesota
504.33Statutes, section 145A.14, subdivision 2a.
504.34(e) The commissioner may use up to 6.23
504.35percent of the funds appropriated each fiscal
505.1year to conduct the ongoing evaluations
505.2required under Minnesota Statutes, section
505.3145A.17, subdivision 7, and training and
505.4technical assistance as required under
505.5Minnesota Statutes, section 145A.17,
505.6subdivisions 4 and 5.
505.7TANF Carryforward. Any unexpended
505.8balance of the TANF appropriation in the
505.9first year of the biennium does not cancel but
505.10is available for the second year.
505.11Health Professional Loan Forgiveness.
505.12$2,631,000 in fiscal year 2016 and $2,631,000
505.13in fiscal year 2017 are from the general
505.14fund for the purposes of Minnesota Statutes,
505.15section 144.1501. Of this appropriation, the
505.16commissioner may use up to $131,000 each
505.17year to administer the program.
505.18Minnesota Stroke System. $350,000 in
505.19fiscal year 2016 and $350,000 in fiscal
505.20year 2017 are from the general fund for the
505.21Minnesota stroke system.
505.22Prevention of Violence in Health Care.
505.23$50,000 in fiscal year 2016 is to continue the
505.24prevention of violence in health care program
505.25and creating violence prevention resources
505.26for hospitals and other health care providers
505.27to use in training their staff on violence
505.28prevention. This is a onetime appropriation
505.29and is available until June 30, 2017.
505.30Health Care Savings Determinations. (a)
505.31The health care access fund base for the state
505.32health improvement program is decreased by
505.33$261,000 in fiscal year 2016 and decreased
505.34by $110,000 in fiscal year 2017.
506.1(b) $261,000 in fiscal year 2016 and $110,000
506.2in fiscal year 2017 are from the health care
506.3access fund for the forecasting, cost reporting,
506.4and analysis required by Minnesota Statutes,
506.5section 62U.10, subdivisions 6 and 7.
506.6Base Level Adjustments. The general fund
506.7base is decreased by $1,070,000 in fiscal
506.8year 2018 and by $1,020,000 in fiscal year
506.92019. The state government special revenue
506.10fund base is increased by $33,000 in fiscal
506.11year 2018. The health care access fund base
506.12is increased by $610,000 in fiscal year 2018
506.13and by $23,000 in fiscal year 2019.

506.14

Subd. 3.Health Protection

506.15	Appropriations by Fund
506.16	General	12,506,000	14,149,000
506.17 506.18	State Government Special Revenue	47,579,000	46,266,000

506.19Base Level Adjustments. The state
506.20government special revenue fund base is
506.21increased by $322,000 in fiscal year 2018
506.22and by $300,000 in fiscal year 2019.

506.23

Subd. 4.Administrative Support Services

8,210,000

8,224,000

506.24

Sec. 4. HEALTH-RELATED BOARDS

506.25

Subdivision 1.Total Appropriation

$

19,707,000

$

19,597,000

506.26This appropriation is from the state
506.27government special revenue fund. The
506.28amounts that may be spent for each purpose
506.29are specified in the following subdivisions.

506.30

Subd. 2.Board of Chiropractic Examiners

507,000

513,000

506.31

Subd. 3.Board of Dentistry

2,192,000

2,206,000

507.1This appropriation includes $864,000 in fiscal
507.2year 2016 and $878,000 in fiscal year 2017
507.3for the health professional services program.

507.4 507.5

Subd. 4.Board of Dietetics and Nutrition Practice

113,000

115,000

507.6 507.7

Subd. 5.Board of Marriage and Family Therapy

234,000

237,000

507.8

Subd. 6.Board of Medical Practice

3,933,000

3,962,000

507.9

Subd. 7.Board of Nursing

4,189,000

4,243,000

507.10 507.11

Subd. 8.Board of Nursing Home Administrators

2,365,000

2,062,000

507.12Administrative Services Unit - Operating
507.13Costs. Of this appropriation, $1,482,000
507.14in fiscal year 2016 and $1,497,000 in
507.15fiscal year 2017 are for operating costs
507.16of the administrative services unit. The
507.17administrative services unit may receive
507.18and expend reimbursements for services
507.19performed by other agencies.
507.20Administrative Services Unit - Volunteer
507.21Health Care Provider Program. Of this
507.22appropriation, $150,000 in fiscal year 2016
507.23and $150,000 in fiscal year 2017 are to pay
507.24for medical professional liability coverage
507.25required under Minnesota Statutes, section
507.26214.40.
507.27Administrative Services Unit - Retirement
507.28Costs. Of this appropriation, $320,000 in
507.29fiscal year 2016 is a onetime appropriation
507.30to the administrative services unit to pay for
507.31the retirement costs of health-related board
507.32employees. This funding may be transferred
507.33to the health board incurring the retirement
507.34costs. These funds are available either year
507.35of the biennium.
508.1Administrative Services Unit - Contested
508.2Cases and Other Legal Proceedings. Of
508.3this appropriation, $200,000 in fiscal year
508.42016 and $200,000 in fiscal year 2017 are
508.5for costs of contested case hearings and other
508.6unanticipated costs of legal proceedings
508.7involving health-related boards funded
508.8under this section. Upon certification by a
508.9health-related board to the administrative
508.10services unit that the costs will be incurred
508.11and that there is insufficient money available
508.12to pay for the costs out of money currently
508.13available to that board, the administrative
508.14services unit is authorized to transfer money
508.15from this appropriation to the board for
508.16payment of those costs with the approval
508.17of the commissioner of management and
508.18budget. The commissioner of management
508.19and budget must require any board that
508.20has an unexpended balance for an amount
508.21transferred under this paragraph to transfer
508.22the unexpended amount to the administrative
508.23services unit to be deposited in the state
508.24government special revenue fund.

508.25

Subd. 9.Board of Optometry

138,000

143,000

508.26

Subd. 10.Board of Pharmacy

2,847,000

2,888,000

508.27

Subd. 11.Board of Physical Therapy

354,000

359,000

508.28

Subd. 12.Board of Podiatry

78,000

79,000

508.29

Subd. 13.Board of Psychology

874,000

884,000

508.30

Subd. 14.Board of Social Work

1,141,000

1,155,000

508.31

Subd. 15.Board of Veterinary Medicine

262,000

265,000

508.32 508.33

Subd. 16.Board of Behavioral Health and Therapy

480,000

486,000

509.1 509.2

Sec. 5. EMERGENCY MEDICAL SERVICES REGULATORY BOARD

$

2,904,000

$

3,037,000

509.3Cooper/Sams Volunteer Ambulance
509.4Program. $700,000 in fiscal year 2016 and
509.5$700,000 in fiscal year 2017 are for the
509.6Cooper/Sams volunteer ambulance program
509.7under Minnesota Statutes, section 144E.40.
509.8(a) Of this amount, $611,000 in fiscal year
509.92016 and $611,000 in fiscal year 2017
509.10are for the ambulance service personnel
509.11longevity award and incentive program under
509.12Minnesota Statutes, section 144E.40.
509.13(b) Of this amount, $89,000 in fiscal year
509.142016 and $89,000 in fiscal year 2017 are
509.15for the operations of the ambulance service
509.16personnel longevity award and incentive
509.17program under Minnesota Statutes, section
509.18144E.40.
509.19Ambulance Training Grant. $361,000 in
509.20fiscal year 2016 and $361,000 in fiscal year
509.212017 are for training grants.
509.22EMSRB Board Operations. $1,226,000 in
509.23fiscal year 2016 and $1,360,000 in fiscal year
509.242017 are for board operations.
509.25Regional Grants. $585,000 in fiscal year
509.262016 and $585,000 in fiscal year 2017 are
509.27for regional emergency medical services
509.28programs, to be distributed equally to the
509.29eight emergency medical service regions.

509.30

Sec. 6. COUNCIL ON DISABILITY

$

622,000

$

629,000

509.31 509.32 509.33

Sec. 7. OMBUDSMAN FOR MENTAL HEALTH AND DEVELOPMENTAL DISABILITIES

$

1,917,000

$

2,032,000

510.1

Sec. 8. OMBUDSPERSONS FOR FAMILIES

$

392,000

$

453,000

510.2

Sec. 9. COMMISSIONER OF COMMERCE

$

210,000

$

213,000

510.3The commissioner of commerce shall
510.4develop a proposal to allow individuals
510.5to purchase qualified health plans outside
510.6of MNsure directly from health plan
510.7companies and to allow eligible individuals
510.8to receive advanced premium tax credits and
510.9cost-sharing reductions when purchasing
510.10qualified health plans outside of MNsure.

510.11    Sec. 10. APPROPRIATION.
510.12$455,000,000 is appropriated in fiscal year 2015 from the general fund to the
510.13commissioner of human services. The commissioner of human services must transfer
510.14$455,000,000 from the general fund to the health care access fund by June 30, 2015.
510.15EFFECTIVE DATE.This section is effective the day following final enactment.

510.16    Sec. 11. Minnesota Statutes 2014, section 256.01, is amended by adding a subdivision
510.17to read:
510.18    Subd. 40. Nonfederal share transfers. The nonfederal share of activities for
510.19which federal administrative reimbursement is appropriated to the commissioner may
510.20be transferred to the special revenue fund.

510.21    Sec. 12. TRANSFERS.
510.22    Subdivision 1. Grants. The commissioner of human services, with the approval of
510.23the commissioner of management and budget, may transfer unencumbered appropriation
510.24balances for the biennium ending June 30, 2017, within fiscal years among the MFIP,
510.25general assistance, general assistance medical care under Minnesota Statutes 2009
510.26Supplement, section 256D.03, subdivision 3, medical assistance, MinnesotaCare, MFIP
510.27child care assistance under Minnesota Statutes, section 119B.05, Minnesota supplemental
510.28aid, and group residential housing programs, the entitlement portion of Northstar Care
510.29for Children under Minnesota Statutes, chapter 256N, and the entitlement portion of
510.30the chemical dependency consolidated treatment fund, and between fiscal years of the
510.31biennium. The commissioner shall inform the chairs and ranking minority members of
511.1the senate Health and Human Services Finance Division and the house of representatives
511.2Health and Human Services Finance Committee quarterly about transfers made under
511.3this subdivision.
511.4    Subd. 2. Administration. Positions, salary money, and nonsalary administrative
511.5money may be transferred within the Departments of Health and Human Services as the
511.6commissioners consider necessary, with the advance approval of the commissioner of
511.7management and budget. The commissioner shall inform the chairs and ranking minority
511.8members of the senate Health and Human Services Finance Division and the house of
511.9representatives Health and Human Services Finance Committee quarterly about transfers
511.10made under this subdivision.

511.11    Sec. 13. INDIRECT COSTS NOT TO FUND PROGRAMS.
511.12The commissioners of health and human services shall not use indirect cost
511.13allocations to pay for the operational costs of any program for which they are responsible.

511.14    Sec. 14. EXPIRATION OF UNCODIFIED LANGUAGE.
511.15All uncodified language contained in this article expires on June 30, 2017, unless a
511.16different expiration date is explicit.

511.17    Sec. 15. EFFECTIVE DATE.
511.18This article is effective July 1, 2015, unless a different effective date is specified."
511.19Delete the title and insert:

511.20"A bill for an act

511.21relating to state government; establishing the health and human services budget;
511.22modifying provisions governing children and family services, chemical and
511.23mental health services, withdrawal management programs, direct care and
511.24treatment, health care, continuing care, Department of Health and public
511.25health programs, health care delivery, health licensing boards, and MNsure;
511.26making changes to medical assistance, MFIP, Northstar Care for Children,
511.27MinnesotaCare, child care assistance, and group residential housing programs;
511.28establishing uniform requirements for public assistance programs related
511.29to income calculation, reporting income, and correcting overpayments and
511.30underpayments; modifying requirements for reporting maltreatment of minors
511.31and juvenile safety and placement; establishing the Minnesota ABLE plan
511.32and accounts; modifying child support provisions; establishing standards for
511.33withdrawal management programs; modifying requirements for background
511.34studies; making changes to provisions governing the health information
511.35exchange; providing for protection of born alive infants; authorizing rulemaking;
511.36requiring reports and studies; making technical changes; modifying certain fees
511.37for Department of Health programs; modifying fees of certain health-related
511.38licensing boards; making human services forecast adjustments; appropriating
511.39money;amending Minnesota Statutes 2014, sections 13.46, subdivisions 2, 7;
511.4013.461, by adding a subdivision; 16A.724, subdivision 2; 43A.241; 62A.02,
511.41subdivision 2; 62A.045; 62J.498; 62J.4981; 62J.4982, subdivisions 4, 5;
512.162J.692, subdivision 4; 62Q.37, subdivision 2; 62Q.55, subdivision 3; 62U.02,
512.2subdivisions 1, 2, 3, 4; 62U.04, subdivision 11; 62U.10, by adding subdivisions;
512.362V.03, subdivision 2; 62V.05, subdivisions 6, 7, 8, by adding a subdivision;
512.4119B.011, subdivision 15; 119B.025, subdivision 1; 119B.035, subdivision
512.54; 119B.09, subdivision 4; 119B.125, by adding a subdivision; 119B.13,
512.6subdivision 6; 144.057, subdivision 1; 144.1501, subdivisions 1, 2, 3, 4; 144.291,
512.7subdivision 2; 144.293, subdivisions 5, 6, 8; 144.298, subdivisions 2, 3; 144.551,
512.8subdivision 1; 144.9501, subdivisions 6d, 22b, 26b, by adding subdivisions;
512.9144.9505; 144.9508; 144A.071, subdivision 4a; 144A.70, subdivision 6, by
512.10adding a subdivision; 144A.71; 144A.72; 144A.73; 144A.75, subdivision
512.1113; 144D.01, by adding a subdivision; 144E.001, by adding a subdivision;
512.12144E.275, subdivision 1, by adding a subdivision; 145.4131, subdivision 1;
512.13145.423; 145.56, subdivisions 2, 4; 145.928, subdivision 13, by adding a
512.14subdivision; 145.986, subdivisions 1a, 2, 4; 145A.131, subdivision 1; 148.52;
512.15148.54; 148.57, subdivisions 1, 2, by adding a subdivision; 148.574; 148.575,
512.16subdivision 2; 148.577; 148.59; 148.603; 148E.075; 148E.080, subdivisions 1, 2;
512.17148E.180, subdivisions 2, 5; 149A.20, subdivisions 5, 6; 149A.40, subdivision
512.1811; 149A.65; 149A.92, subdivision 1; 149A.97, subdivision 7; 150A.06,
512.19subdivision 1b; 150A.091, subdivisions 4, 5, 11, by adding subdivisions;
512.20150A.31; 151.01, subdivisions 15a, 27; 151.02; 151.065, subdivisions 1, 2, 3, 4;
512.21151.102; 151.58, subdivisions 2, 5; 157.15, subdivision 8; 174.29, subdivision
512.221; 174.30, subdivisions 3, 4, by adding subdivisions; 245.4661, subdivisions
512.235, 6, by adding subdivisions; 245.467, subdivision 6; 245.4876, subdivision
512.247; 245.4889, subdivision 1, by adding a subdivision; 245A.06, by adding a
512.25subdivision; 245A.155, subdivisions 1, 2; 245A.65, subdivision 2; 245C.03, by
512.26adding subdivisions; 245C.04, by adding a subdivision; 245C.08, subdivision 1;
512.27245C.10, by adding subdivisions; 245C.12; 245D.02, by adding a subdivision;
512.28245D.05, subdivisions 1, 2; 245D.06, subdivisions 1, 2, 7; 245D.07, subdivision
512.292; 245D.071, subdivision 5; 245D.09, subdivisions 3, 5; 245D.22, subdivision
512.304; 245D.31, subdivisions 3, 4, 5; 246.18, subdivision 8; 246.54, subdivision 1;
512.31252.27, subdivision 2a; 253B.18, subdivisions 4c, 5; 254B.05, subdivision 5, as
512.32amended; 254B.12, subdivision 2; 256.01, by adding subdivisions; 256.015,
512.33subdivision 7; 256.017, subdivision 1; 256.478; 256.741, subdivisions 1, 2;
512.34256.969, subdivisions 1, 2b, 2d, 3a, 3c, 9; 256.975, by adding a subdivision;
512.35256B.056, subdivision 5c; 256B.057, subdivision 9; 256B.059, subdivision
512.365; 256B.06, by adding a subdivision; 256B.0615, subdivision 3; 256B.0622,
512.37subdivisions 1, 2, 3, 4, 5, 7, 8, 9, 10, by adding a subdivision; 256B.0624,
512.38subdivision 7; 256B.0625, subdivisions 3b, 13, 13e, 13h, 17, 17a, 18a, 18e,
512.3928a, 31, 48, 57, 58, by adding subdivisions; 256B.0631; 256B.072; 256B.0757;
512.40256B.0913, subdivision 4; 256B.0915, subdivisions 3a, 3e, 3h; 256B.0916,
512.41subdivisions 2, 11, by adding a subdivision; 256B.431, subdivisions 2b, 36;
512.42256B.434, subdivision 4, by adding a subdivision; 256B.441, subdivisions 1,
512.435, 6, 13, 14, 17, 30, 31, 33, 35, 40, 44, 46c, 48, 50, 51, 51a, 53, 54, 55a, 56,
512.4463, by adding subdivisions; 256B.49, subdivision 26, by adding a subdivision;
512.45256B.4913, subdivisions 4a, 5; 256B.4914, subdivisions 2, 6, 8, 10, 14, 15;
512.46256B.492; 256B.50, subdivision 1; 256B.69, subdivisions 5a, 5i, 9c, 9d, by
512.47adding a subdivision; 256B.75; 256B.76, subdivisions 1, 2, 4, as amended;
512.48256B.762; 256B.766; 256B.767; 256D.01, subdivision 1a; 256D.02, subdivision
512.498, by adding subdivisions; 256D.06, subdivision 1; 256D.405, subdivision 3;
512.50256E.35, subdivision 2, by adding a subdivision; 256I.03, subdivisions 3,
512.517, by adding subdivisions; 256I.04, subdivisions 1, 1a, 2a, 2b, 2c, 3, 4, by
512.52adding subdivisions; 256I.05, subdivisions 1c, 1g, 2; 256I.06, subdivisions
512.532, 6, 7, 8; 256J.08, subdivisions 26, 86; 256J.21, subdivision 2, as amended;
512.54256J.24, subdivision 5a; 256J.30, subdivisions 1, 9; 256J.33, subdivision
512.554; 256J.35; 256J.40; 256J.95, subdivision 19; 256K.45, subdivisions 1a, 6;
512.56256L.01, subdivisions 3a, 5; 256L.03, subdivision 5; 256L.04, subdivisions
512.571c, 7b; 256L.05, subdivisions 3, 3a, 4, by adding a subdivision; 256L.06,
512.58subdivision 3; 256L.121, subdivision 1; 256L.15, subdivisions 1, 2; 256N.22,
513.1subdivisions 9, 10; 256N.24, subdivision 4; 256N.25, subdivision 1; 256N.27,
513.2subdivision 2; 256P.001; 256P.01, subdivision 3, by adding subdivisions;
513.3256P.02, by adding a subdivision; 256P.03, subdivision 1; 256P.04, subdivisions
513.41, 4; 256P.05, subdivision 1; 257.75, subdivisions 3, 5; 259A.75; 260C.007,
513.5subdivisions 27, 32; 260C.203; 260C.212, subdivision 1, by adding subdivisions;
513.6260C.221; 260C.331, subdivision 1; 260C.451, subdivisions 2, 6; 260C.515,
513.7subdivision 5; 260C.521, subdivisions 1, 2; 260C.607, subdivision 4; 518A.26,
513.8subdivision 14; 518A.32, subdivision 2; 518A.39, subdivision 1, by adding
513.9a subdivision; 518A.41, subdivisions 1, 3, 4, 14, 15; 518A.43, by adding
513.10a subdivision; 518A.46, subdivision 3, by adding a subdivision; 518A.51;
513.11518A.53, subdivisions 1, 4, 10; 518A.60; 518C.802; 626.556, subdivisions 1, as
513.12amended, 2, 3, 6a, 7, as amended, 10, 10e, 10j, 10m, 11c, by adding subdivisions;
513.13626.559, by adding a subdivision; Laws 2008, chapter 363, article 18, section 3,
513.14subdivision 5; Laws 2014, chapter 189, sections 5; 9; 10; 11; 16; 17; 18; 19; 23;
513.1524; 27; 28; 29; 31; 43; 50; 51; 52; 73; Laws 2014, chapter 312, article 24, section
513.1645, subdivision 2; proposing coding for new law in Minnesota Statutes, chapters
513.1762A; 144; 144D; 148; 245; 245A; 256B; 256E; 256M; 256P; 518A; proposing
513.18coding for new law as Minnesota Statutes, chapters 245F; 256Q; repealing
513.19Minnesota Statutes 2014, sections 62V.11, subdivision 3; 148.57, subdivisions 3,
513.204; 148.571; 148.572; 148.573, subdivision 1; 148.575, subdivisions 1, 3, 5, 6;
513.21148.576; 148E.060, subdivision 12; 148E.075, subdivisions 4, 5, 6, 7; 256.01,
513.22subdivision 35; 256.969, subdivisions 23, 30; 256B.434, subdivision 19b;
513.23256B.441, subdivisions 14a, 19, 50a, 52, 55, 58, 62; 256B.69, subdivision 32;
513.24256D.0513; 256D.06, subdivision 8; 256D.09, subdivision 6; 256D.49; 256J.38;
513.25256L.02, subdivision 3; 256L.05, subdivisions 1b, 1c, 3c, 5; Laws 2012, chapter
513.26247, article 4, section 47, as amended; Minnesota Rules, parts 3400.0170,
513.27subparts 5, 6, 12, 13; 8840.5900, subparts 12, 14."

514.1	We request the adoption of this report and repassage of the bill.
514.2	Senate Conferees:
514.3	.....		.....
514.4	Tony Lourey		Kathy Sheran
514.5	.....		.....
514.6	Jeff Hayden		Melisa Franzen
514.7	.....
514.8	Julie A. Rosen
514.9	House Conferees:
514.10	.....		.....
514.11	Matt Dean		Tara Mack
514.12	.....		.....
514.13	Joe Schomacker		Joe McDonald
514.14	.....
514.15	Nick Zerwas